Management of paroxysmal ectopic atrial tachycardia with long sinus pauses in a teenager

Sinus pauses in the setting of supraventricular tachycardia is rare in children. We describe an asymptomatic teen with irregular heart rate detected during an incidental exam who was found to have short runs of a slow ectopic atrial tachycardia on electrocardiogram and prolonged sinus pauses on routine ambulatory ECG. Successful catheter ablation of the ectopic atrial tachycardia led to resolution of the sinus pauses.     

SHIV感染恒河猴十二指肠黏膜活检组织病理学观察

目的使用消化内窥镜对SHIV感染恒河猴十二指肠黏膜进行观察。方法SHIV感染恒河猴,消化内镜检查并进行活检取材,对活检标本进行固定,石蜡包埋,常规HE染色镜检。结果内镜大体观察胃黏膜和十二指肠黏膜基本上完整平滑,1例胃黏膜有弥漫性白斑,3例有小面积的出血;光镜下十二指肠黏膜完整未见脱落,固有层中有散在分布的慢性炎细胞,活检取材最深可达黏膜下层,未见其他特异性病理改变。结论不同毒株,不同感染时间的SHIV感染恒河猴和对照恒河猴的十二指肠黏膜活检组织HE染色组织结构清晰,呈慢性炎症改变,病理形态上没有明显的差异。     

A human case of Echinostoma hortense (Trematoda: Echinostomatidae) infection diagnosed by gastroduodenal endoscopy in Korea

A human Echinostoma hortense infection was diagnosed by gastroduodenoscopy. An 81-year-old Korean male, living in Yeongcheon-shi, Gyeongsangbuk-do and with epigastric discomfort of several days duration, was subjected to upper gastrointestinal endoscopy. He was in the habit of eating fresh water fish. Two live worms were found in the duodenal bulb area and were removed using an endoscopic forceps. Based on their morphological characteristics, the worms were identified as E. hortense. The patient was treated with praziquantel 10 mg/kg as a single dose. The source of the infection in this case remains unclear, but the fresh water fish consumed, including the loach, may have been the source. This is the second case of E. hortense infection diagnosed by endoscopy in Korea.     

Perspectives,potentials and trends of ex vivo and in vivo optical molecular pathology

It is pivotal for medical applications, such as noninvasive histopathologic characterization of tissue, to realize label‐free and molecule‐specific representation of morphologic and biochemical composition in real‐time with subcellular spatial resolution. This unmet clinical need requires new approaches for rapid and reliable real‐time assessment of pathologies to complement established diagnostic tools. Photonic imaging combined with digitalization offers the potential to provide the clinician the requested information both under in vivo and ex vivo conditions. This report summarizes photonic approaches and their use in combination with image processing, machine learning and augmented virtual reality that might solve current challenges in modern medicine. Details are given for pathology, intraoperative diagnosis in head and neck cancer and endoscopic diagnosis in gastroenterology.      

三种输尿管镜治疗输尿管上段结石的疗效比较

目的:比较半硬性输尿管镜、输尿管软镜、孙氏末段可弯输尿管镜治疗输尿管上段结石的临床疗效,为临床上治疗方式的选择提供参考。方法:回顾性分析2015年8月到2017年12月间于上海市第十人民医院泌尿外科因输尿管上段结石行输尿管镜下钬激光治疗的515例患者的临床资料。按照所用输尿管镜类型分为3组:硬镜组(给予半硬性输尿管镜治疗)297例,软镜组172例(给予输尿管软镜治疗),孙氏镜组(给予孙氏末段可弯输尿管镜治疗)46例。比较三组的手术时间、一期清石率、术后住院时间及术中、术后并发症。结果:硬镜组、软镜组、孙氏镜组清石率分别为81.5%、94.2%、95.7%,其中软镜组、孙氏镜组清石率显著高于硬镜组(P0.05)。硬镜组、软镜组、孙氏镜组术中并发症发生率分别为18.9%、5.8%、4.3%,其中硬镜组术中并发症发生率显著高于软镜组和孙氏镜组(P0.05),三组术后并发症发生率整体比较差异无统计学意义(P0.05)。硬镜组、软镜组、孙氏镜组平均手术时间分别为(28.6±6.2)min、(49.4±12.4)min、(26.1±6.5)min,软镜组平均手术时间显著高于硬镜组及孙氏镜组,差异有统计学意义(均P0.05)。硬镜组、软镜组、孙氏镜组平均住院时间分别为(5.4±3.2)d、(6.7±5.7)d、(5.0±2.5)d,软镜组住院时间显著高于硬镜组和孙氏镜组,差异有统计学意义(均P0.05)。结论:软镜清石效果和手术安全性较硬镜更有优势,但手术耗时长,患者术后住院时间长。孙氏镜有望成为治疗输尿管上段结石的更佳选择。     

鼻内镜术与鼻息肉摘除术对鼻窦炎合并鼻息肉患者的鼻腔通气功能、嗅觉功能和生活质量的影响

目的:探讨鼻内镜术与鼻息肉摘除术对鼻窦炎合并鼻息肉患者的鼻腔通气功能、嗅觉功能和生活质量的影响。方法:选取2016年1月-2017年8月期间我院收治的94例鼻窦炎合并鼻息肉患者。根据数表法将患者随机分为对照组(n=47)与研究组(n=47),其中对照组患者行传统鼻息肉摘除术,研究组则行鼻内镜术。观察两组患者临床疗效、临床指标及并发症发生情况,比较两组患者术前、术后6个月鼻腔通气功能、嗅觉功能和生活质量评分。结果:研究组临床总有效率为91.49%(43/47),高于对照组的65.96%(31/47)(P0.05)。研究组患者手术时间、术后住院时间、术中出血量均低于对照组(P0.05)。两组患者术后6个月鼻腔通气功能、嗅觉功能评分均较术前降低,且研究组低于对照组(P0.05)。两组患者术后6个月躯体功能(PF)、躯体角色(RP)、躯体疼痛(BP)、总体健康(GH)、情感角色(RE)以及心理健康(MH)均较术前升高,且研究组高于对照组(P0.05)。研究组头晕、头痛、流脓涕、鼻塞、复发等并发症发生率均低于对照组(P0.05)。结论:鼻窦炎合并鼻息肉患者采用鼻内镜术治疗,疗效确切,可显著改善患者临床指标、生活质量,对患者鼻腔通气功能、嗅觉功能均有促进作用,且术后并发症少,值得临床推广。     

脂肪因子瘦素和内脂素与心房颤动关系的研究

摘要 目的：心房颤动（Atrial fibrillation,AF）是最常见的心律失常之一,其发生机制目前尚未完全阐明。多项研究表明脂肪因子（Adipokines）中的瘦素（leptin）、内脂素（Visfatin）与心血管疾病的关系密切,本研究拟探讨瘦素、内脂素与心房颤动的关系。方法：本研究通过收集检测AF组、窦性心律组外周血及心外膜脂肪组织,检测瘦素、内脂素分泌水平来探讨瘦素、内脂素与AF发生的相关性。结果：房颤组血清内脂素的平均浓度为15.95±10.44 ng/mL,窦性心律组为20.28±12.90 ng/mL（P=0.169）;房颤组血清瘦素的平均浓度为1.48 ng/mL,窦律组为2.56 ng/mL（P=0.0027）,窦性心律组血清瘦素水平明显高于心房颤动组;心外膜脂肪组织中,瘦素在房颤组中的表达量显著低于窦性心律组（P=0.032）,内脂素在两组中的表达无显著统计学差异（P=0.06）。结论：临床患者外周血血清及心外膜脂肪组织中高水平的瘦素可能降低房颤的发生率,然而,内脂素与房颤可能不具有相关性。     

Identification and characterization of a hyperglycemic hormone from freshwater giant prawn, Macrobrachium rosenbergii

Crustacean hyperglycemic hormone (CHH), a physiologically important neurohormone stored in the sinus gland of eyestalks, primarily regulates carbohydrate metabolism and also plays significant roles in reproduction, molting and other physiological processes. In the freshwater giant prawn, Macrobrachium rosenbergii, an injection of X-organ sinus gland (XOSG) extract evoked a hyperglycemic response, peaked in 1 h. The hyperglycemic effect of the eyestalk extract was maximal at the dose of 0.5 eyestalk equivalent. CHH fractionated by RP-HPLC, in M. rosenbergii was identified by its hyperglycemic activity and partial amino acid sequence, and the molecular weight of 8534 was determined by matrix-assisted laser desorption ionization mass spectrometry--time of flight analysis (MALDI-TOF). The amino acid sequence of the first 25 residues of CHH showed 72% homology with the first 25 residues of CHH A and CHH B of the American lobster Homarus americanus.     

锯缘青蟹窦腺显微和超微结构研究

借助光学和电子显微镜观察据缘青蟹（Ｓｃｙｌｌａ ｓｅｒｒａｔａ）窦腺的形态结构。窦腺位于眼柄视神经节内髓背侧近外髓处。窦腺呈羹状;腺体壁山神经分泌细胞的末梢和神经胶质细胞组成。神经末梢内充满了电子致密的神经分泌颗粒。根据颗粒的大小、形态及电子致密度等特征,可以区分出４种类型的神经末梢。一些末梢中的多形性颗粒可能是由Ⅱ型末梢中的颗粒转变而成的。一些现象表明,神经分泌物质可以通过胞吐作用或一种类似“顶浆分泌”的方式释放,从而说明神经激素的释放可能是多途径的．