目的 探讨胃泌素瘤的诊断和治疗经验。方法 回顾绵阳市中心医院确诊的2例胃泌素瘤患者的临床资料，并结合相关文献分析。结果 2例均表现为难治性消化性溃疡，CT检查发现胰腺包块，生化与病理检测确诊为胃泌素瘤。结论 对多发性、异位、顽固性消化性溃疡应警惕本病的存在，以免延误诊治.
Objective To improve the knowledge of lung injury induced by rituximab. Methods Clinical data of 5 lymphoma patients with lung injury caused by rituximab chemotherapy were analyzed. Results Five patients received chemotherapy including rituximab, and had fever, cough and dyspnea after 3 to 5 chemotherapy cycles. Chest CT showed bilateral diffuse interstitial infiltrates. All 5 cases experienced hypoxemia or respiratory failure. Clinical symptoms were improved 3 to 5 days after the treatment of glucocorticoids, and pulmonary lesions were significantly alleviated 1 to 2 weeks after the treatment. According to the literature, the incidence rate of lung injury caused by rituximab was 0. 03% to 4. 9%, which has increased recently. Conclusions With the comprehensive application of rituximab, lung injury caused by this drug is not rare. The good prognosis depends on early diagnosis and treatment by further recognition of the side effect of rituximab.
【 Abstract 】 Objective To investigate the precautionary effect of fibrin glue on postoperative bleeding and bile leakage when used in partial hepatic resection. Methods House-hold rabbit partial hepatectomy model was prepared and 40 rabbits were divided into sham operation （ SO) group (n=10), control group (n=10) and protocol group (n=20) randomly. The SO rabbits received laparotomy only, while both the control and protocol group received partial hepatectomy. Fibrin glue was used in the protocol group following electric coagulation therapy while the control group received electric coagulation therapy only. The animals’ diet, weight and adverse effects were observed then, and the celiac drainage volume, levels of hemoglobin (Hg), WBC and TBil in celiac outflow and ALT, AST, LDH and TBil in rabbit serum were checked on schedule after operation. Results The average blood loss volume and operation time in the protocol group were (16.0±2.7) ml and (23.7±2.9) min respectively, which were lower than those in the control group 〔 (20.8 ± 3.5) ml and (27.3 ± 2.9) min (P ＜ 0.01) 〕 . The celiac drainage volume, levels of Hg, WBC and TBil in celiac outflow decreased gradually on postoperative days in protocol groups (P ＜ 0.05). The levels of Hg in celiac outflow of the protocol group on the 1st, 2nd and 7th postoperative day were lower than those of the control group (P ＜ 0.05), and the result of TBil was the same on the 1st, 2nd, 3rd, 5th and 7th postoperative day (P ＜ 0.05). The serum ALT, AST, LDH and TBil levels in the control and protocol groups were higher than those in the SO group significantly (P ＜ 0.01), while the serum ALT, AST (except on the 3rd postoperative day) and LDH levels in the protocol group were lower than those in the control group (P ＜ 0.05) in significance.All animals had good appetite, normal weight gain and no adverse reaction and death occurred. Conclusion Application of fibrin glue may effectively prevent and cure the postoperative bleeding and bile leakage in partial hepatectomy without any adverse reaction.
Objective To observe the protective effect on rat lung by using N-acetyl-L-cysteine(NAC) a inhibiter of nuclear factor-kappa B (NF-κB) in the period of reperfusion. Methods Twenty-four rats were randomly divided into a control group and a trail group.The harvested lung blocks of 12 rats were flushed with and stored in the low-potassium-dextran (LPD) solution at 4℃ for 16 hours. The isolated rat lung reperfusion models were established and the donor lungs were perfused for 1 hour. NAC was used in the trail group but normal saline was used in control group. Partical pressure of oxygen in artery (PaO2), peak airway pressure (PawP) were measured at every 15 min intervals during reperfusion. After reperfusion, the lung tissue wet-to-dry(W/D)ratio, and myeloperoxidase(MPO) activity were obtained. The protein and mRNA expressions of intercellular adhesion molecule-1(ICAM-1), NF-κB were also observed by using immunohistochemistry and semi-quantitative RT-PCR at the end of reperfusion. Results The level of decreased PaO2 and increased PawP in trail group were lower than those in control group at every interval time the sample obtained after reperfusion in 60 min. (Plt;0.01 or lt;0.05). After reperfusion the W/D,MPO, the protein and mRNA expressions of ICAM-1, NF-κB were decreased evidently in trail group than those in control group(Plt;0.01 or lt;0.05). Conclusion Using NAC in the period of reperfusion, can effectively inhibit the expression of NF-κB and ICAM-1,further improve lung respiratory functions.
ObjectiveTo evaluate long-term therapeutic effect of esophagogastric devascularization without splenectomy in treatment of portal hypertension with esophagogastric varices hemorrhage. MethodsThe patients who took esophagogastric devascularization without splenectomy from 2008 to 2013 were followed-up in clinic or through phone. The remission of esophagogastric varices, rebleeding, survival and long-term postoperative complications were observed. ResultsA total of 32 patients were taken esophagogastric devascularization without splenectomy in Peking University People's Hospital from 2008 to 2013. One patient died during the perioperative period. Twenty-three patients were followed-up for 10-81 months with an average 45.5 months, of whom 7 patients had rebleeding, 5 patients died, 3 patients had new onset portal vein thrombosis, 2 patients had esophageal anastomotic strictures. ConclusionEsophagogastric devascularization without splenectomy is an effective method in treatment of portal hypertension with esophagogastric varices hemorrhage in selected patients.