Conservative management of recurrent enterogenous cysts of the cervical spine: A case report

Enterogenous cysts are rare benign congenital tumours of the central nervous system. The aim of management is complete resection to minimise the chance of recurrence. To date, management of recurrence has favoured further surgical resection. We describe the case of a recurrent enterogenous cyst of the cervical spine, initially treated with decompression via laminectomy and fenestration. Magnetic Resonance Imaging (MRI) follow up has demonstrated spontaneous recurrence and deflation of the cyst on multiple occasions. We propose that conservative management of recurrent enterogenous cysts may be a valid management option following fenestration or partial resection of the cyst, and that recurrence may not always warrant further surgical intervention.     

脊髓神经管原肠性囊肿的显微手术治疗及分析

目的探讨脊髓神经管原肠性囊肿的临床、组织病理及形态学特点,分析手术切除方式对预后的影响。方法回顾性分析自1998年1月至2010年12月8例脊髓神经管原肠性囊肿病例的临床资料。其中4例首发症状为局部脊髓节段疼痛伴肢体乏力、感觉减退、肌肉萎缩,3例以神经根性疼痛症状发病,1例表现为Brown-Sequard综合征。8例患者的影像学表现均为髓外硬膜下型,均给予脊髓后路手术切除。结果全部手术的8例患者中,5例全切,2例部分切除行囊腔旷置,1例部分切除行囊腔蛛网膜下腔分流术。术后8例患者症状均有不同程度缓解,影像学、电话及门诊随访6例(4例完全切除、1例部分切除行旷置术、1例部分切除行囊腔-蛛网膜下腔分流术)(25.0±9.0)月(12～38)月,症状均无再次加重。结论神经管原肠性囊肿可通过后正中入路手术全切或部分切除获得治愈,应尽早手术治疗。     

椎管内肠源性囊肿的CT和MRI影像

椎管内肠源性囊肿是由胚胎发育时期的神经肠管残余和异位组织演变而来,临床比较少见,多无典型临床表现,其发现与诊断多依靠影像学检查,如CT、MRI等.本文介绍4例经CT、MRI诊断并经手术和病理证实的椎管内肠源性囊肿.     

成批重度烧伤患者相关感染的个体化治疗

成批重度烧伤患者的成功救治是考验科室对突发事件应急能力的重要标准之一。成批烧创复合伤患者救治的过程中,烧伤脓毒症、肺部感染、局部创面感染以及肠源性感染等一系列感染问题严重地威胁着患者的生命。除了对重度烧伤患者的常规治疗以外,本文着重介绍了针对患者不同感染情况进行的个体化治疗方案,并且取得良好效果。成批重度烧伤患者的治疗,需要针对具体情况进行调整,才能最大程度地提高救治成功率。     

肠源性高草酸尿大鼠模型的建立

目的：建立肠源性高草酸尿的大鼠模型。方法随机选取30只雌性SD大鼠置于大鼠代谢笼中适应性喂养7 d之后收集24 h尿,记录尿量,采用离子色谱仪测定其草酸浓度,计算正常大鼠在该条件下24 h尿草酸排泄量。菠菜汁灌胃处理大鼠,再测定灌胃后24 h尿草酸排泄量。对比灌胃菠菜汁前后,大鼠24 h尿草酸排泄量的差别;分组对照实验,随机选取20只雌性SD大鼠,随机分成A组和B组,B组灌胃菠菜汁,A组灌胃等量纯净水,其他条件相同,比较两组24 h尿草酸排泄量。结果反复测定,正常大鼠灌胃菠菜汁前24 h尿草酸排泄量为（0.53±0.18） mg,灌胃菠菜汁后第1天为（1.93±0.36） mg,第3天为（1.85±0.38） mg,第7天为（2.03±0.39） mg;A组（0.44±0.12） mg,B组（1.68±0.38） mg。结论大鼠在灌胃菠菜汁之后其尿液24 h草酸排泄量明显增加,大概增加3~4倍,说明每天对大鼠进行定量定浓度的菠菜汁灌胃,可以使其保持长期的高草酸尿状态,该方法建立的肠源性高草酸尿大鼠模型简便可行,可广泛用于其他方面的研究。     

Enterogenous cyst as a rare cause of hemifacial spasm

Hemifacial spasm (HFS) is most frequently caused by vascular compression of the facial nerve at the root exit zone of the brain stem, but there are other rare causes. An enterogenous cyst (EC) is a rare congenital lesion which occurs rarely in the cerebellopontine angle. The authors report a patient with HFS from an EC and review unusual causes of HFS.     

大黄-丹参药对对慢性肾衰竭模型大鼠肠源性尿毒素含量和肠道屏障功能的影响

目的:研究大黄-丹参药对对慢性肾衰竭(CRF)模型大鼠肠源性尿毒素含量和肠道屏障功能的影响。方法:将55只雄性Wistar大鼠随机分为假手术组(10只)和造模组(45只),假手术组大鼠分离肾组织但不切除,造模组大鼠采用5/6肾切除法复制CRF模型。造模成功后(剔除死亡和不成模大鼠5只),将模型大鼠分为模型组(水)、尿毒清颗粒组(2.5 g/kg)和大黄-丹参药对高、低剂量组(6、3 g/kg,以生药量计),每组10只。假手术组和模型组大鼠灌胃等体积水,各给药组灌胃相应药物,每天1次,连续12周。末次给药后,采用全自动生化分析仪检测各组大鼠血清中肌酐(Scr)、尿素氮(BUN)含量和24 h尿液中尿肌酐(Ucr)含量,并计算肌酐清除率(Ccr);采用超高效液相色谱-电喷雾串联三重四极杆质谱法同时测定大鼠血清中尿毒素[氧化三甲胺(TMAO)、硫酸吲哚酚(IS)、硫酸对甲酚(PCS)]的含量;采用实时荧光定量聚合酶链式反应(RT-PCR)法、免疫荧光法分别检测大鼠回肠组织中闭合蛋白(Occludin)、紧密连接蛋白1(ZO-1)的m RNA和蛋白表达水平;采用苏木素-伊红染色法、Masson染色法观察大鼠肾组织的病理学变化;采用透射电镜法观察大鼠结肠组织的超微结构变化。结果:与假手术组比较,模型组大鼠血清中Scr、BUN、TMAO、PCS、IS含量均显著升高(P<0.01),尿液中Ucr含量和Ccr及回肠组织中Occludin、ZO-1的mRNA及蛋白表达水平均显著降低(P<0.01);肾组织中肾小球硬化、肾小管扩张,肾间质可见炎性细胞浸润和纤维化;结肠上皮屏障结构重度损伤。与模型组比较,各给药组大鼠血清中Scr、BUN、TMAO、PCS、IS含量均显著降低(P<0.05或P<0.01);尿液中Ucr含量和回肠组织中Occludin、ZO-1的mRNA及蛋白表达水平均显著升高(大黄-丹参药对低剂量组的ZO-1 mRNA除外,P<0.05或P<0.01);肾间质炎性细胞浸润、纤维化程度和结肠上皮屏障结构损伤程度均减轻。结论:大黄-丹参药对能有效保护CRF模型大鼠残存的肾功能,其作用机制可能与降低大鼠血清中肠源性尿毒素含量,上调回肠组织中Occludin、ZO-1的mRNA及蛋白表达水平从而改善肠道屏障功能有关。     

罕见部位肠源性囊肿2例并文献复习

目的 探讨罕见部位肠源性囊肿的发病机理及磁共振表现,提高其诊断准确性.方法 回顾性分析2例经手术和病理证实的罕见部位肠源性囊肿患者的临床资料,结合相关文献分析其磁共振特点.结果 2例罕见部位肠源性囊肿,1例位于尾骨后方软组织内,与椎体后部相连,不与椎管相通;另1例位于后纵隔,与椎体前部相连,局部向椎管内延续.MR平扫,病灶T1WI低信号,T2WI呈稍高/高信号;MR增强,囊壁呈环形强化、实性部分强化.结论 本文所报道的2例肠源性囊肿发病部位特殊,且有特征性MR表现,这对以后诊断该病具有一定提示意义.     

An epithelial cyst of the spinal cord. An electron microscopic study

Summary The fine structure of an intradural and extramedullary cyst compressing the spinal cord was examined. The cyst was lined by a single epithelial layer of both ciliated and non-ciliated cells. The non-ciliated cells differ from the former by the presence of secretory granules and a surface coating as well as other characteristics. The epithelial layer was bordered by a basement membrane and prominent interdigitation was found along the lateral borders. The origin of these cells is unknown but the similarity between them and the epithelium of the respiratory tract is noted.This study was aided by the Sandy Schneider Memorial Fund and the USPHS General Research Support Grant No. RR. 5499.     

Neurenteric cyst of the posterior fossa. Case report and review of the literature

Intracranial neurenteric cysts are rare entities. The term is currently used to describe epithelial cysts that are lined with a presumed endodermal-derived epithelium and are mostly located in the posterior fossa.Preoperative diagnosis is often difficult because of their clinical presentation, which may resemble a subarachnoid hemorrhage, and the radiological aspect, which can mimic vascular pathologies.We describe a posterior fossa neurenteric cyst in a 27-year-old woman, who presented with sudden headache as the only symptom and who was addressed to our hospital for subarachnoid hemorrhage. Diagnostic angiography was negative and MRI revealed a prepontine cystic lesion. The patient underwent a posterolateral approach on the right side, with subtotal resection of the lesion.We discuss the embryologic, diagnostic and therapeutic aspects of these cysts and review the literature.