Splenic angiosarcoma metastasis to small bowel presented with gastrointestinal bleeding

Primary splenic angiosarcoma is a very rare,aggressive neoplasm with a high metastatic rate and dismal prognosis. This neoplasm usually presents with abdominal pain, splenomegaly, anemia, and thrombocytopenia. Splenic angiosarcoma with bleeding gastrointestinal metastases is extremely rare. The literature contains only two case reports. This study reported a 44-year-old male patient with splenic angiosarcoma with sustained repeated gastrointestinal bleeding due to small bowel metastases. Salvage surgery was performed by splenectomy and resection of the metastatic small bowel tumors. The post-operative course was uneventful; the patient survived with the disease and had no GI bleeding, 7 mo after surgery.

从“兰除陈气”探析肥胖辨治

肥胖是由遗传、饮食结构、生活方式与行为、心理、环境及社会等多因素引起能量过剩致体内脂肪异常或过多堆积的一种慢性、易反复、进行性的代谢性疾病。肥胖作为主要危险因素,增加了2型糖尿病、高血压、心血管疾病、卒中、部分恶性肿瘤等多种慢性疾病的发病风险。全球肥胖发病率逐年上升,随着人民生活水平不断提高,我国已有超过半数以上的成年人存在超重及肥胖,严重危害人民健康,增加社会与经济负担,成为亟待解决的重大公共卫生问题。肥胖,最早见于《黄帝内经》,有“肥贵人,则高梁之疾也”之描述,并提出“肥者令人内热,甘者令人中满,故其气上溢,转为消渴。治之以兰,除陈气也”。膏粱酒食之积不化而成陈气,故肥胖为“陈气”之疾。肥胖是因嗜食膏粱酒酪,辛辣浓味,生冷寒凉,甜腻食物,或饱食安逸少动、久坐熬夜,或喜、怒、忧、思、恐等五志过及,或因先天禀赋异常,致脾胃受纳运化失常,小肠化物泌别吸收失调,陈气内生,堆积于脏腑与肌肤,而见形体肥满。食饮入口,离不开胃之受纳腐熟、小肠之受盛泌别清浊、脾之转输,其病位在脾、胃、小肠。兰者,兰泽香草也,狭义即佩兰、泽兰,芳香之品,能畅气机,除陈腐,涤垢腻;广义凡气味香辛,可醒脾升清,和胃降浊,助小肠化物泌别如常,逐退盈余者,皆谓之“兰”。因此,肥胖当治以“兰除陈气”,旨在运用辛香之品调整脾、胃、小肠之功能,逐退食湿痰浊郁热等盈余,以复中焦升降平衡,肥者不肥也。