小肠系膜海绵状淋巴瘤1例

患者男,8岁,无明显原因恶心半月,腹部发现包块6天。查体:T37.4℃,P82次/min,BP11/8kPa。心肺(-)。腹软,肝脾未触及,左下腹压痛,可触及7cm×8cm×7cm柔软包块,边界清,有轻压痛,无反跳痛,表面光滑。大便正常。B超检查:左下腹部探及一回声不均质之包块,呈     

胃肠结核误诊为胃癌1例报告

患者,女,57岁,已婚.住院号4099.因间断性左上腹隐痛伴消瘦5个月,加重伴腹胀反酸、恶心3d,于1992年5月11日入院.患者于1991年12月始出现左上腹隐痛,食欲不振,偶有反酸.1992年5月左上腹痛加重,腹胀、恶心、反酸、进食后明显.以“慢性胃炎、重度营养不良”收住院.既往无肝炎、结核病史.入院体检:体温35.8℃,脉博80次/min,呼吸22次/min,血压10.66/7.5 kPa.慢性病容,极消瘦呈恶液质状,神志清楚,皮肤巩膜无黄染,无出血点及瘀斑,全身未触及肿大淋巴结,心肺无异常,腹部平,腹壁较韧,肝脾肋下未触及,左上腹轻度压痛,无反跳痛,未触及包块.     

内镜黏膜下剥离术切除胃孤立性纤维性肿瘤一例并文献分析

患者女,49岁,因胃窦隆起型病变1年伴腹部隐痛1周入院.患者1年前无明显诱因下突发上腹部疼痛,于当地医院胃镜检查发现胃窦隆起型包块,病理示慢性浅表性胃炎、中度活动,当时末予特殊治疗.l周前患者无明显诱因下出现上腹部隐痛,遂来我院就诊.患者既往有高血压病史8年,血压控制可;曾有子宫肌瘤切除术史.入院查体:一般情况可,全身淋巴结末触及肿大,心肺无异常,腹平坦,全腹软,上腹部轻压痛,无反跳痛及肌紧张,未触及包块,肝脾肋下未触及,Murphy征阴性,肝肾区无叩击痛,移动性浊音阴性,肠鸣音3～5次/min.     

结肠憩室误诊阑尾炎一例

患者男,35岁,因右下腹疼痛不适半个月加重半天入院.患者半个月前无明显诱因出现右下腹疼痛不适,伴恶心,无呕吐、腹泻.体格检查：体温36.4℃,脉搏86次/min,呼吸20次/min.急性痛苦面容,心、肺未见异常.腹部平坦,未见肠型及蠕动波,肝脾未触及,未扪及包块,右下腹麦氏点有压痛、反跳痛,无肌紧张,无移动性浊音,肠鸣音3～4次/min.     

阑尾黏液性囊腺瘤1例报告

患者女,43岁,因右下腹包块1个月,于2010年5月3日来诊。患者于1个月前无意中发现右下腹一包块,约鸡蛋大。既往无腹痛、腹胀、腹泻、便秘、黑便、便血,无低热、盗汗、乏力。查体：腹部平软,于右下腹可触及一约6cm×5cm×3cm的包块,无压痛,活动度较大。     

邻近组织血管爬延致子宫肌瘤快速生长(附3例报告)

子宫肌瘤一般生长缓慢 ,如肌瘤在短期内快速生长 ,多发生了肉瘤样变 ,但我们曾收治 3例却非肉瘤样变所致 ,而是因邻近组织与子宫肌瘤粘连 ,前者血管爬延至子宫肌瘤内所致。现报告如下。1　临床资料例 1 :48岁。2年前于查体时发现浆膜下子宫肌瘤约 40天孕大 ,未治疗 ,肌瘤增长缓慢。入院前 4个月患者感腹胀 ,于耻骨上触及包块 ;1个月前腹胀加重 ,包块已占据整个下腹部。查体 :腹部膨隆 ,下腹部可触及 5个月孕大的包块 ,腹部移动性浊音阳性。妇科检查 :宫体约 2个月孕大 ;子宫左上方触及约 5个月孕大的包块 ,质硬、边界清、活动度欠佳、无压痛…     

以乳糜样腹水为主要临床表现的脂质细胞瘤一例

患者女,38岁,因腹胀半年入院.体检:全身浅表淋巴结无肿大,双肺呼吸音清,腹部稍饱满,全腹软,无压痛,肝脾肋下未触及,未触及腹部包块,移动性浊音阳性,双下肢无浮肿.     

肠系膜粘液细胞型腺癌误诊为晚期血吸虫病1例

患者,男,53岁,主诉腹部包块伴腹胀3年.近1月腹胀加重,自服利尿剂后稍有减轻,但腹部包块逐渐增大.就医拟诊为“结核性腹膜炎”,腹部包块待查,于1993年9月26日入院.既往无肺结核及肠道病史,粪便孵化发现血吸虫毛蚴,有2次吡喹酮治疗史.3年前在当地血防站诊断为晚期血吸虫病结肠肉芽肿型.体检:T36.5℃,慢性病容.皮肤巩膜无黄染,全身浅表淋巴结未扪及.心肺未见异常.腹部稍隆起,腹水征阳性,未见浅表静脉曲张,腹部可触及大小不等之包块.左上腹似小儿拳头大包块,质较硬,活动度差,无压痛.肠鸣音不亢进.实验室检查:     

经皮穿刺微创诊断腹部神经纤维瘤一例

患者,男,14岁,因"间断发热伴腹胀2年,发现腹部包块2个月"入院.患者2年前出现发热,体温约38℃左右,伴有腹胀,无腹痛腹泻,无恶心呕吐,无畏寒咳嗽.症状呈间断发作,当地医院以"感冒"治疗后好转.于2010年4月发现腹部隆起,可触及质硬包块,进行性肿大,伴有发热,体温高达41.5℃,食欲明显下降,给予抗感染治疗无效.同年6月当地医院行剖腹探查术,包块病理检查示:疑为腹膜后淋巴瘤.上级医院病理切片会诊报告显示:反应性增生.为进一步治疗入住我院.入院检查:一般情况尚可,体重1个月内下降约3.5kg.既往患过敏性紫癜、紫癜性肾炎,已治愈.否认肝炎、结核等传染病史,家族成员中无类似病史.T 36.7℃,P 104次/分,R 20次/分,Bp 126/93 nn Hg,全身浅表淋巴结未扪及肿大,胸骨无叩痛,心肺未见明显异常.     

腹腔巨大错构瘤一例

患者女 ,37岁 ,2年前自觉腹围渐粗。 2d前无明显诱因出现上腹部疼痛 ,呈持续性钝痛 ,向下腹部及腰背部放射 ,伴恶心呕吐 ,呕吐物为胃内容物 ,自觉腹胀 ,时有腹泻 ,食量较少 ,无胸闷气短及血尿。体检 :体温 36 .4℃ ,脉搏 78次 /min ,呼吸 2 0次 /min ,血压 110 /80mmHg (1mmHg =0 .133kPa) ,皮肤黏膜无苍白、黄染及发绀 ,浅表淋巴结无肿大 ,心肺检查未见异常 ,腹部饱满 ,无胃肠型及蠕动波 ,未见腹壁静脉曲张 ,无压痛 ,肝脾未触及 ,上腹及左侧腹部可触及包块 ,大小不等 ,界限不清 ,表面较光滑 ,质地中等 ,有时可有握雪感 ,活动度差 ,移动性…     

Three layer functional model and energy exchange concept of aging process

Relying on a certain degree of abstraction, we can propose that no particular distinction exists between animate or living matter and inanimate matter. While focusing attention on some specifics, the dividing line between the two can be drawn. The most apparent distinction is in the level of structural and functional organization with the dissimilar streams of ‘energy flow’ between the observed entity and the surrounding environment. In essence, living matter is created from inanimate matter which is organized to contain internal intense energy processes and maintain lower intensity energy exchange processes with the environment. Taking internal and external energy processes into account, we contend in this paper that living matter can be referred to as matter of dissipative structure, with this structure assumed to be a common quality of all living creatures and living matter in general. Interruption of internal energy conversion processes and terminating the controlled energy exchange with the environment leads to degeneration of dissipative structure and reduction of the same to inanimate matter, (gas, liquid and/or solid inanimate substances), and ultimately what can be called ‘death.’ This concept of what we call dissipative nature can be extended from living organisms to social groups of animals, to mankind. An analogy based on the organization of matter provides a basis for a functional model of living entities. The models relies on the parallels among the three central structures of any cell (nucleus, cytoplasm and outer membrane) and the human body (central organs, body fluids along with the connective tissues, and external skin integument). This three-part structural organization may be observed almost universally in nature. It can be observed from the atomic structure to the planetary and intergalactic organizations. This similarity is corroborated by the membrane theory applied to living organisms. According to the energy nature of living matter and the proposed functional model, the decreased integrity of a human body's external envelope membrane is a first cause of the structural degradation and aging of the entire organism. The aging process than progresses externally to internally, as in single cell organisms, suggesting that much of the efforts towards the restoration and maintenance of the mechanisms responsible for structural development should be focused accordingly, on the membrane, i.e., the skin. Numerous reports indicate that all parts of the human body, like: bones, blood with blood vessels, muscles, skin, and so on, have some ability for restoration. Therefore, actual revival of not only aging tissue of the human body's membrane, but the entire human body enclosed within, with all internal organs, might be expected. We assess several aging theories within the context of our model and provide suggestions on how to activate the body's own anti-aging mechanisms and increase longevity. This paper presents some analogies and some distinctions that exist between the living dissipative structure matter and inanimate matter, discusses the aging process and proposes certain aging reversal solutions.     

Unusual responses of nocturnal pineal melatonin synthesis and secretion to swimming: Attempts to define mechanisms

Abstract: The effect of swimming at night on rat pineal melatonin synthesis was compared with that of light exposure at night. Rats were forced to swim at 0030 hr (lights out at 2000 hr) and sacrificed by decapitation 15 and 30 min later, immediately after swimming. Other groups of animals were exposed to white light (650μW/cm²) for 15 and 30 min at same time. Swimming caused a rapid and highly significant drop in the melatonin content in the pineal gland; however, the activity of N-acetyltransferase (NAT), the supposed rate limiting enzyme in the melatonin production, was not changed. Despite the drop in pineal melatonin levels, serum concentrations of the indole remained elevated in the rats that swam. In contrast, melatonin levels in the pineal and serum of light exposed rats fell precipitously, accompanied by a significant suppression of NAT activity. Since we anticipated that the strenuous exercise associated with swimming may induce release of artrial natriuretic peptide (ANP) from the heart, which in turn could cause the release of pineal melatonin, in a second study we injected physiological saline intravenously to stretch the cardiac muscle and release ANP. Three milliliters of normal saline was injected during the day into the jugular vein of anesthetized rats that were pretreated with isoproterenol to stimulate pineal melatonin production. Animals were killed 15 min after the saline injection, and pineal NAT activity and pineal melatonin levels were measured. The saline injections caused no alteration in the elevated levels of either NAT or melatonin. These data suggest that the disparity in pineal NAT activity (which was high) and pineal melatonin (which was low), in animals swum at night, may not be caused by ANP which is released during strenuous exercise such as swimming.     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Melatonin and photoperiodic time measurement: Seasonal breeding in the sheep

Abstract: Well-established circadian physiology supports the view that photoperiodic time measurement utilizes the coincidence between the presence of light and a photosensitive phase of a 'biological clock' to alter reproductive status—the so-called external coincidence model of seasonal breeding. In this review, we examine the mechanism whereby photoperiod interacts with presumed suprachiasmatic nuclei activity to allow endogenous melatonin to normally synchronize reproductive activity to the optimal time of year. The Romney Marsh sheep is particularly explored as an experimental model. It is suggested that the on/off activity of seasonal reproduction may be a robust mechanism able to be predictably manipulated by the judicious use of the light/dark cycle and exogenous melatonin, but firmly based on circadian principles.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.