犬瘟热的临诊鉴别与防治对策

犬瘟热是由犬瘟热病毒引起的犬的一种高度接触性传染病,在犬病中占有很大比重,是养犬业的灾难性疾病。其流行特点是在自然条件下可感染多种犬科野生食肉兽,如狼、貂、貉、獾等。断乳到6月龄的犬最易感;一年四季均可发生,春冬季多发;6月龄以内的幼仔犬特别易感,症状典型,死亡率也高.各地均有流行。

犬瘟热的临诊鉴别

犬瘟热是由犬瘟热病毒引起的犬的一种高度接触性传染病,一年四季均可发生,冬春多发。6月龄以内的幼仔犬特别易感,症状典型,死亡率较高。犬瘟热的典型临床症状按病程发展表现为:初期表现双相热,眼、鼻有分泌物,随即出现呼吸道症状,流鼻涕、打喷嚏、咳嗽,常为干咳,有时咳出白色粘稠液体,严重时鼻镜龟裂,呼出恶臭气体,流脓性鼻液,眼睑干燥,肺部听诊支气管音粗粝,可听到干性罗音、湿性罗音或捻发音。

Pneumatosis cystoides intestinalis:A single center experience

AIM： To share our experience of the management and outcomes of patients with pneumatosis cystoides in- testinalis （PCI）. METHODS： The charts of seven patients who under- went surgery for PCI between 2001 and 2009 were re- viewed retrospectively. Clinical features, diagnoses and surgical interventions of patients with PCI are discussed. RESULTS： Seven patients with PCI （3 males, 4 fe- males; mean age, 50 ~ 16.1 years; range, 29-74 years） were analyzed. In three of the patients, abdominal pain was the only complaint, whereas additional vomiting and/or constipation occurred in four. Leukocytosis was detected in four patients, whereas it was within normal limits in three. Subdiaphragmatic free air was observed radiologically in four patients but not in three. Six of the patients underwent an applied lapa- rotomy, whereas one underwent an applied explorative laparoscopy. PCI localized to the small intestine only was detected in four patients, whereas it was localized to the small intestine and the colon in three. Three patients underwent a partial small intestine resection and four did not after PCI was diagnosed. Five patients were diagnosed with secondary PCI and two with pri- mary PCI when the surgical findings and medical his- tory were assessed together. Gastric atony developed in one case only, as a complication during a postopera- tive follow-up of 5-14 d. CONCLUSION： Although rare, PCl should be consid- ered in the differential diagnosis of acute abdomen. Diagnostic laparoscopy and preoperative radiological tests, including computed tomography, play an impor- tant role in confirming the diagnosis.

Application of Real-time Ultrasound Elastography in Diagnosing Benign and Malignant Thyroid Solid Nodules

Objective Real-time ultrasound elastography(US-E) is a helpful tool in diagnosing thyroid nodules.This study aims to evaluate thyroid solid nodules,to establish the accuracy of US-E in providing information on the nature of these nodules,and to assess the clinical value of elasticity scores(ES) and strain ratio(SR) in differentiating thyroid solid nodules and to explore its distribution characteristics using pathological analysis as reference. Methods Traditional ultrasonography and US-E were performed on 131 thyroid solid nodules(99 benign ones and 32 malignant ones) in 120 patients(78 females and 41 males).Three radiologists evaluated the nodules based on a four-degree elasticity scoring system.The nodules were classified according to the ES as soft(ES 1-2) or hard(ES 3-4).The SR was calculated online. Results The sensitivity and specificity of the ES for thyroid cancer diagnosis were 78%and 80%,respectively.SR values > 2.9 used as a standard to distinguish benign from malignant nodules had a sensitivity of 87%and a specificity of 92%.The SR of the benign lesions was 1.64±1.37,which was significantly different from that of malignant lesions,which was 4.96±2.13(P<0.01). Conclusions Both the ES and SR were higher in malignant nodules than those in benign ones.Real-time US-E was a useful index in the differential diagnosis of thyroid solid nodules.It can provide quantitative information on thyroid nodule characterization and improve diagnostic confidence.

Misperceptions among patients with chronic hepatitis B in Singapore

AIM： To identify the misperceptions among CHB patients,as well as to determine the factors associated with betterknowledge.METHODS： A telephone interview was conducted on 292 adult CHB patients, who earlier responded to an advertisement for free screening. The questionnaire included items about socio-demographic factors and a24-item quiz on knowledge of general aspects,transmission, and management of HBV infection.RESULTS： The mean knowledge score on HBV was 10.4/14. Common misperceptions included availability of treatment for HBV infection and early liver cancer, as well as on transmission. Having completed tertiary education was the only independent factor associated with a high knowledge score, after controlling other demographic factors.CONCLUSION： More educational efforts should be focused on patients＇ misperceptions and target the less educated HBV carriers.

The diagnosis and differential diagnosis of granulocytic sarcoma

Objective： To discuss the diagnosis and differential diagnosis of granulocytic sarcoma （GS）. Methods： Six cases were reported in this paper. They were assessed by pathologists. Immunohistochemistry （IHC） stain and routine hematoxylin and eosin （H＆E） stain were applied. Results： All patients involved in different anatomic sites respectively including skin, lymph node, soft tissue, breast, cervix and penis. All cases were previously error diagnoses. Three of them were initially diagnosed as non-Hodgkin lymphoma （NHL）. One case of cervical lymph node lesion was first considered as metastasized carcinoma by clinician. One biopsied skin sample was initially reported as Karposi＇s sarcoma. And one breast case was suspicious of the Iobular carcinoma with the frozen samples without antecedent clinical history information. GS was accompanied with acute myeloid leukemia （AML） in one case and with acute lymphocytic leukemia （ALL） in one case. Histopathologically, blastic, immature and differentiated variants were found in four, one and one, respectively. Immunohistochemistry （IHC） showed that myeloperoxidase （MPO） and lysozyme were both found to be positive in all cases, CD43 was found in 5 of 6 cases. Three of six cases were CD68, CD15 and LCA positive. CD34 and CDl17 were positive in 1/5 and 1/6 cases, respectively. However, CD20 and CD3 were negative in all cases. Conclusion： GS was uncommon and it may be misdiagnosed easily in routine practice. Each area had its own character, but they had the common features too. It can be correctly diagnosed by combination of H＆E stain, IHC stain, peripheral blood and bone marrow. MPO and Lysozyme were necessary for the nature of granulocytes. In addition, CD43, CD68 and CD15 were very helpful.

The use of RAPD analysis to identify 4 main medicinal plants in Vitex

Objective： To identify the plants in Vitex including Vitex negundo L. , V. negundo var. cannabifolia （Sieb. et Zuee. ） Hand. -Mazz. , V. trifolia L. and V. trifolia L. var. simplicifolia Cham.. Methods： Both intra- and inter-species relationships among these plants were analyzed by RAPD marker. Twenty-one samples collected from different locations in China were tested using 25 RAPD arbitrary 10- mer primers which were screened from 32 primers. Cluster analysis was conducted by Ward＇s minimumvariance method of SAS software. Results： A total of 224 bands were produced and 128 bands showed polymorphism among 21 samples. The level of polymorphism within species was 51.7%. The dendrogram constructed based on RAPD analysis showed that 21 samples can be placed in 2 groups at the level of SPRS value of 0. 3636. The first group included V. trifolia var. simplicifolia and V. trifolia. The other consisted of V. negundo and V. negundo var. cannabifolia.. At the level of SPRS value of 0. 1, 21 samples can be obviously divided into 3 groups. V. trifolia and V. trifolia var. simplicifolia were clustered into one group, V. negundo and V. negundo var. cannabifolia were separately clustered to 2 groups. Conclusion： RAPD analysis is in good agreement with the traditional plant taxonomic classification, and fundamentally identical with their origins and morphologie characteristics, which indicates that the genetic relationship among samples is related to their center of origin. These medicinal species in Vitex have their specific bands which are available to identify. These specific bands can be used as species-specific molecular markers of Fruetus Vitieis for the application of germplasm identification and classification.

Eosinophilic colitis

Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination. Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

CASTLEMAN＇S DISEASE IN THE RETROPERITONEAL AREA：REPORT OF 5 CASES AND REVIEW OF THE LITERATURE

Objective To investigate the diagnostic and treatment methods of Castleman's disease(CD).Methods Five CD cases were treated in our department,we presented its clinical characteristics and had a comprehensive review of different reports from other centers.Results We presented five patients who had retroperitoneal mass and postoperative pathological results confirmed all of them had hyaline vascular(HV)type CD.We also discussed CD by reviewing different literatures on its diagnosis,treatment and outcome.Conclusion CD is an atypical lymphoproliferative disorder and a heterogeneous entity that can be either localized or systematic.The etiology and pathogenesis of this entity is still unclear.The imaging findings though are not specific,still can help make differential diagnosis.The hyaline vascular type frequently appears as a benign isolated mediastinal or rarely retroperitoneal mass,which does not recur after curative surgical excision.