Plummer-Vinson综合征并发下咽癌1例报告及文献复习

目的:观察Plummer-Vinson综合征(PVS)患者中颈段食管蹼样狭窄的临床表现,分析其与下咽癌发病的关系,提高临床医生对该疾病的认识。方法:对临床上极为少见的1例PVS并发下咽癌患者的诊治过程进行总结,并结合相关文献分析其临床特点。结果:1例以“吞咽困难”为主诉的PVS患者,经电子喉镜检查和病理活检后诊断为下咽癌。经胃镜检查,患者下咽后壁及侧壁向下延伸至食管蹼上方的黏膜在窄带成像(NBI)中可见大量上皮内乳头样毛细血管襻(IPCL)。于IPCL密集处的下咽黏膜行病理活检,结果为中-重度不典型增生。入院后给予针对下咽癌的诱导化疗2个疗程后,患者症状消失,肿瘤体积明显缩小。结论:下咽癌的发生与PVS的黏膜改变有关。NBI技术有助于早期诊断PVS患者下咽及食管黏膜变性。

Plummer—Vinson综合征一例报告

Plummer-Vinson综合征又称缺铁性吞咽困难,系缺铁性贫血并发症之一,在临床工作中诊治1例,报告如下:患者女,50岁。1980年始头昏、乏力、月经不调,诊为贫血。经治疗效不满意,并有恶化。

Plummer-Vinson Syndrome: A Rare Entity in Sub-Saharan Africa

Plummer-Vinson syndrome (PVS) is a rare condition characterized by classical triad;high dysphagia, iron-deficiency anemia and oesophageal ring formation. We report a case of PVS in a 62-year-old patient admitted to the department of gastroenterology and internal medicine for high dysphagia. The clinical examination showed anemic syndrome, general impairment and polyarthritis. Biological examinations concluded to iron deficiency anemia. The endoscopy had observed a circular ring immediately above Killian’s mouth ruptured during the examination. The patient was treated with iron and proton pump inhibitors. The oesophageal symptomatology regressed completely from the second day of treatment.

^(131)I注射治疗Plummer’s病患者的临床研究

目的:研究探讨131I注射治疗Plummer’s病患者的临床应用价值。方法:36例Plummer’s病患者采 用131I直接注射到自主功能性甲状腺结节(AFTN)的中心部位,治疗前、后疾病组和32例对照组均检测T3、T4、 TSH(采用ACCESS微粒子化学发光免疫分析法)含量;测定AFTN及外周血液Hb及各类细胞(采用COULTER 三分类法)治疗前、后的变化。结果:应用131I注射治疗Plummer’s病患者疗效显著(P<0.001),对外周血液 Hb及各类细胞均无明显影响(P>0.05),1年左右AFTN消失,随访三年甲亢未见复发,没有发现甲减、甲癌及 血液方面等病例。结论:应用131I注射治疗Plummer’s病患者具有临床应用价值,小剂量核素可达到治疗效果, 毒副反应小,是一项行之有效的新治疗方法。

^(131)碘局部注射法治疗Plummer病的初步研究

对采用131碘局部注射和131碘口服治疗Plummer病的两种方法及其疗效、用药剂量等方面进行了对比性研究。结果显示：两种方法虽都有确切的疗效，但局部注射法在用药剂量以及患者受辐射量等方面要小于口服法。同时该法具有简便易行、治疗前后无需服用甲状腺等优点。实践证明131碘局部注射法治疗Plummer病是一种有效的新方法。

Plummer-Vinson syndrome associated with solidpseudopapillary tumor of the pancreas

Plummer-Vinson syndrome （PVS）, also known as Paterson-Kelly syndrome or sideropenic dysphagia1 is characterized by dysphagia, iron deficiency anemia and esophageal webs. This syndrome is known to be associated with an increased risk of hypopharyngeal and/or cervical esophageal cancer. Three to 15 percent of the patients with PVS, mostly women between 15 and 50 years of age, have been reported to develop esophageal or pharyngeal cancer. There is a decreasing trend in the overall incidence of hypopharyngeal cancer in women, probably due to the diminished prevalence of PVS. There are few reports of gastric cancer in association with PVS.2

医学影像学联合检查在甲状腺“热”结节鉴别诊断中的应用

目的:建立在甲状腺"热"结节鉴别诊断中区别自主性结节与先天性—叶甲状腺的简便方法。材料与方法:12例甲状腺扫描呈热结节而结节外未见放射性分布者,用 B 超探查结节外是否存在被抑制的甲状腺组织,作出是 Plmmer病自主性结节还是代偿性肿大的先天性—叶甲状腺的诊断。结果:9例 B 超探测到结节外存在甲状腺组织,3例未见结节外有甲状腺组织,结合扫描结果分别诊断为 Plummer 病自主性结节和先天性—叶甲状腺。结论:甲状腺放射性核素显像加 B 超检查是 Plummer 病自主性结节与先天性—叶甲状腺鉴别诊断中可以取代 TSH 兴奋显像的简便诊断程序。

^（131）Ⅰ对41例功能自主性甲状腺腺瘤并甲亢的疗效观察

^（１３１）Ⅰ对４１例功能自主性甲状腺腺瘤并甲亢的疗效观察...

基于PLC的自动调平系统

目的 设计自动调平控制系统,满足所需精度.方法 以德国西门子(Siemens)公司生产的SIMATICS7-300可编程逻辑控制器为主控器件,设计一种自动调平系统,给出系统的硬件构成,设计系统的控制软件.结果 经实验验证,达到了预期的控制指标.结论 所述的控制方案可广泛应用于各种调平系统中.

Endoscopic management for congenital esophageal stenosis: A systematic review

Congenital esophageal stenosis(CES) is an extremely rare malformation, and standard treatment have not been completely established. By years of clinical research, evidence has been accumulated. We conducted systematic review to assess outcomes of the treatment for CES, especially the role of endoscopic modalities. A total of 144 literatures were screened and reviewed. CES was categorized in fibromuscularthickening, tracheobronchial remnants(TBR) and membranous web, and the frequency was 54%, 30% and 16%, respectively. Therapeutic option includes surgery and dilatation, and surgery tends to be reserved for ineffective dilatation. An essential point is that dilatation for TBR type of CES has low success rate and high rate of perforation. TBR can be distinguished by using endoscopic ultrasonography(EUS). Overall success rate of dilatation for CES with or without case selection by using EUS was 90% and 29%, respectively. Overall rate of perforation with or without case selection was 7% and 24%, respectively. By case selection using EUS, high success rate with low rate of perforation could be achieved. In conclusion, endoscopic dilatation has been established as a primary therapy for CES except TBR type. Repetitive dilatation with gradual step-up might be one of safe ways to minimize the risk of perforation.

19世纪末20世纪初美国普瑞特图书馆学校的儿童图书馆员教育

19世纪末,美国普瑞特图书馆学校尝试在一年制图书馆常规技能教育的基础上拓展专业的儿童图书馆员培训,开启了美国儿童图书馆员教育的先河,为第二代儿童图书馆员提供了专门训练,并与20世纪上半叶最具影响力的匹兹堡卡内基儿童图书馆员培训学校有着天然的联系。由其创办者和主要实践者的儿童工作和儿童馆员教育理念出发,探讨普瑞特图书馆学校面向儿童馆员的培训方式、课程设置及其特点,发现其具有教学与实践相结合的培训方式,注重实践工作,并与幼儿园合作开展教育,这些在当时都具有一定的先进性。

玛丽·莱特·普卢默图书馆学思想述略

美国图书馆学家普卢默的思想主要体现在:把图书馆学课程体系划分为管理、技术、书目、评论等几种类型,重视图书馆学原理和理论,反对把所有的教育都集中于技术方面;主张图书馆每年对馆藏图书进行清查,清查的办法是核对图书清单和书架书目;提出馆员应当向孩子们示范索引及所有参考书的使用,使它们成为孩子们终身学习的伴侣;认为馆员有责任让有阅读能力的孩子远离无价值的小说、耸人听闻的消息和不道德的作品;指出合适的图书、宽敞的空间、足够的帮助和贴心的管理是理想的儿童图书馆的必要条件。

Experimental and theoretical study on field emission properties of zinc oxide nanoparticles decorated carbon nanotubes

Field emission properties of zinc oxide （ZnO） nanoparticles （NPs） decorated carbon nanotubes （CNTs） are investigated experimentally and theoretically. CNTs are in situ decorated with ZnO NPs during the growth process by chemical vapor deposition using a carbon source from the iron phthalocyanine pyrolysis. The experimental field emission test shows that the ZnO NP decoration significantly improves the emission current from 50 μA to 275 μA at 550 V and the reduced threshold voltage from 450 V to 350 V. The field emission mechanism of ZnO NPs on CNTs is theoretically studied by the density functional theory （DFT） combined with the Penn-Plummer method. The ZnO NPs reconstruct the ZnO-CNT structure and pull down the surface barrier of the entire emitter system to 0.49 eV so as to reduce the threshold electric field. The simulation results suggest that the presence of ZnO NPs would increase the LDOS near the Fermi level and increase the emission current. The calculation results are consistent with the experiment results.

Benign Stenosis of Oesophagus: About 101 Cases in the Digestive Endoscopy Department of the General Idrissa Pouye Hospital (Dakar, Senegal)

Introduction: Benign oesophageal strictures are defined as narrowing of the oesophageal lumen not related to neoplastic pathology. They are frequently encountered during endoscopic practice and are often responsible for a reduction in the quality of life of patients due to the appearance of dysphagia. In sub-Saharan Africa, little data are available on these benign esophageal strictures. The objective of our study was to determine the sociodemographic, diagnostic and therapeutic aspects of benign oesophageal strictures in a digestive endoscopy centre in Senegal. Patients and Methods: This was a retrospective, descriptive study analysing reports of upper GI endoscopies performed between January 2015 and December 2017 in a hospital in Senegal. Reports that concluded to have non-neoplastic oesophageal stenosis were collated. Sociodemographic data, indications for and results of endoscopy, and therapeutic modalities were collected. These data were analysed using the Sphinx version 5 software. Results: We collected 101 cases of benign oesophageal stenosis, representing a prevalence of 2.1% in the endoscopy centre. The mean age of the patients was 34 years (range 2 and 83 years) with a median of 37.9 years. There was a female predominance with a sex ratio of 0.38 (73 females). Dysphagia, the main symptom, was present in 87 patients (86.1% of cases) with a Dysphagia score greater than or equal to 2 in 51 patients (50.5%). The average duration of this dysphagia, excluding caustic stenosis, was 4 years (extremes 1 and 15 years). Endoscopy revealed simple stenosis in 76 cases (75.2% of cases). A membranous ring of the cervical oesophagus, suggestive of the Plummer-Vinson syndrome ring, was found in 60 patients (59.4% of cases) and was the primary cause;other aetiologies were dominated by caustic stenosis (19 cases), Schatzki rings (8 cases) and peptic stenosis (4 cases). Endoscopic dilatation was performed in 90 patients (89.1% of cases) with Savary Gilliard bougies (87 cases) and hydrostatic balloons (3 cases). The average number of dilatation sessions was 1.69. In 10 patients (11.1%), refractory stenosis was observed. This stenosis could be resolved after further dilatation in 8 cases before the 8th session. In 2 patients, dilatation failed. Conclusion: Benign oesophageal strictures in our digestive endoscopy centre in Senegal mainly affect young adults, with a predominance of women. Diagnosis is often late. Cervical oesophageal rings in the context of Plummer-Vinson syndrome are the main cause. Oesophageal dilatation with bougies is of great therapeutic value.

甲状腺功能亢进症的手术疗效观察

甲状腺功能亢进症（以下简称甲亢）是指因甲状腺素分泌过度而引起的高代谢状态。主要分为三类：（1）弥漫性毒性甲状腺肿,又称Graves病,最为常见;（2）结节性毒性甲状腺肿,又称Plummer病;（3）毒性甲状腺瘤或高功能腺瘤。此外甲状腺瘤、亚急性或慢性甲状腺炎及某些类型的垂体肿瘤和卵巢肿瘤亦可伴发甲亢。对甲亢的围手术期治疗、如何有效防治并发症、手术中注意事项、不同类型的甲亢病人采取选择性精细化的手术方案等取得了较好治疗效果,现报道如下。

中西医结合治疗自主性高功能甲状腺结节36例

自主性高功能甲状腺结节，又称结节性甲亢、Plummer病，是一种在多结节性甲状腺肿基础上发生的甲亢，通常发生于原有多年多结节性甲状腺肿的病人。一般在40岁以上出现甲亢症状，较毒性弥漫性甲状腺肿的发病年龄为大，女性发病率较男性高。临床多采用手术治疗，对于无手术指征、药物治疗无效或不能耐受药物治疗的Plummer病患者。