The effects of intravesical and intradermal application of a new B.C.G. on the dog bladder

Summary Intravesical and intradermal application of B.C.G. (Bacillus Calmette Guérin) has proven to be effective in the prophylaxis of recurrence of superficial bladder carcinoma after transurethral resection and in the treatment of carcinoma in situ (C.I.S.) in man. Different strains of B.C.G. have been used for this purpose. In this article a new strain of B.C.G. (B.C.G.-R.I.V.M.) has been tested to assess its toxicity. The effects of intravesical and intradermal application of B.C.G.-R.I.V.M. were studied on normal and on coagulated canine urothelium. In this study no general side effects of B.C.G.-R.I.V.M. were seen. Only minor local changes occurred in the bladder wall. Small granulomas were found in the suburothelial tissue. No granulomas or signs of active inflammation were observed in the pelvic lymphnodes, spleen and liver. Because B.C.G.-R.I.V.M. seemed to be a safe agent in the dog we have started to use it for prophylaxis in superficial bladder cancer in man.Grant recipient of the Koningin Wilhelmina Fonds (Dutch Cancer Foundation)     

The "throbbing sign"--an indication of early venous congestion in replantation surgery.

Venous congestion in a replanted or transplanted digit can be detected, even before any obvious color changes, by the "throbbing" elicited by pinching the digit between the thumb and finger of the examiner until the skin blanches. Releasing the pressure slowly, a sensation of throbbing will be felt synchronous with the patient's pulse rate. The sign disappears when venous congestion is relieved or when swelling persists and increases enough to lessen the arterial inflow.     

中国近21年成人先天性胆管扩张症流行学特征及诊治经验

目的：探讨成人先天性胆管扩张症的流行病学特征和诊疗经验。方法：联合检索维普数据库和中国期刊网等多家中文数据库中1990年1月～2010年11月有关成人先天性胆管扩张症的文章，总结分析成人先天性魍管扩张症的流行病学特征和诊治经验。结果：中国近2{年共报道5146例成人先天性胆管扩张症，有准确年龄及平均年龄报道4298例，平均年龄34．84岁，男女比例约为1：2．55，43．44％分布在华东地区，68．38％有不同程度腹痛表现，25．22％有发热或高热症状，32，46％有不同程度黄疸，18．31％可触及腹部包块，具有典型三联征表现患者占15．98％。Todani分型I型8041％，II型4．27％，III型123％，IV型1155％，V型占2，54％。手术治疗为主要治疗手段，胆管囊肿切除加胆管空肠Roux—en—Y吻合术占71．63％；术后并发症以胆管炎症状为主，发生率为12．24％；术后随访率83．55％，治愈率8684％。结论：成人先天性胆管扩张症女性多发，其中以华东地区较多，Todani分型I型为主，囊肿切除加胆肠Roux—en—Y吻合术为主要治疗手段。     

动力髋螺钉治疗股骨粗隆间骨折54例分析

目的 总结动力髋螺钉(Dynamic Hip Screw,DHS)治疗股骨粗隆间骨折的经验。方法 54例股骨粗隆间骨折采用DHS内固定手术治疗(A1型27例,A2型20例,A3型7例)。结果 经4～36个月平均7个月随访疗效满意。结论 术中尽可能恢复股骨粗隆后内侧皮质的完整性;标准的粗螺钉固定位置及加强术后功能锻炼是取得良好疗效的关键。     

Local composite neurovascular island flap for skin cover in pulp loss of the thumb.

A local composite neurovascular island flap to provide stable skin cover with good soft tissue padding and sensibility for extensive pulp loss of the thumb was used in five patients. The island flap included the dorsoradial branches of the radial digital neurovascular bundle of the thumb.     

超声介导腹腔神经节去除治疗胰腺癌疼痛

目的:评价超声介导腹腔神经节去除在胰腺癌疼痛中的疗效。方法:采用B超定位,实时超声动态监测经皮穿刺,于腹腔动脉干根部旁侧注入无水乙醇15ml,对97例胰腺癌痛患者实施腹腔神经节去除术。比较治疗前后疼痛的视觉模拟评分(VAS)以及血清SP水平变化。结果:97例中1例穿刺失败, 成功率98.7％,无急性胰腺炎、胰瘘及出血等穿刺并发症;VAS及SP较术前明显降低(P<0.01,P<0．05),有效率87．5％,显效率76.1％,12例无效。结论:超声介导腹腔神经节去除术安全可靠,能显著减轻胰腺癌疼痛。     

Avulsion of the gall bladder in blunt abdominal trauma

T raumatic avulsion of the gall bladder, and its subsequent dislodgement into the pelvis has not previously been reported. The case described records severe damage to the biliary system without much damage to other viscera.     

TIPS治疗对门静脉高压症患者食管、胃底组织内微血管生成的影响

目的:研究TIPS治疗对门静脉高压症患者食管、胃底组织内微血管生成的影响,探讨血管生成在门静脉高压症食管、胃底静脉曲张形成中的作用。方法:取门静脉高压症Sugiura术患者的食管贲门吻合圈标本78例。(1)PHT组:术前未行TIPS治疗。食管组织118例,胃组织25例;(2)TIPS组:术前曾行TIPS治疗,食管组织5例,胃组织12例。正常食管组织10例、胃组织8例作为对照组。应用免疫组化技术分别检测食管胃底组织内的微血管密度。结果:食管胃底组织微血管高密度区主要位于粘膜固有层,其次为粘膜下层。粘膜固有层微血管密度3组差别无统计学意义(P>0.05);粘膜下层微血管密度PHT组明显高于正常组(P<0．01)和TIPS组(p<0．05),TIPS组和正常组差别无统计学意义(P >0.05)。结论:食管胃底组织内的微血管密度与门静脉压力改变有关。门静脉高压时,食管胃底组织粘膜下层血管生成活跃,可能参与了食管胃底粘膜下静脉曲张的形成;经TIPS治疗后,粘膜下层血管生成减少。     

Endotoxin clearance after intralipid infusion

Healthy 6–8-wk-old New Zealand white rabbits were injected with chromium-chloride- or sodium-chromate-labeled E. coli endotoxin after rapid infusion (10 ml/kg in 1 hr) or slow and repeated infusions (40 ml/kg daily for 7 consecutive days) of 10% Intralipid. Endotoxin clearance rates and RES organ uptakes were determined and the results were compared with those of the controls treated with correspondingly equal volumes of 5% $\text{D}\text{W}$ instead of fat.In the acute experiment, the clearance rates were similar in all animals during the first 15 min following endotoxin injection. After this phase, however, experimental animals had faster endotoxin clearance and eventually higher organ uptakes than the controls. In the chronic experiment, there was no significant difference in endotoxin clearance rates or total and per-gram organ uptakes between experimental and corresponding control animals infused with 5% $\text{D}\text{W}$ instead of fat.Experimental animals, particularly those having received multiple infusions of fat emulsion, showed deposition of polarizable brown pigment inside and outside the reticuloendothelial cells in the liver, spleen, and bone marrow. None of the controls had these pigments in their organs.     

经皮透光负压旋切术治疗下肢深静脉血栓形成继发皮肤溃疡的临床研究

目的：探讨下肢深静脉血栓形成（DVTS）继发皮肤溃疡的微创治疗方法。方法：选择DVTS继发皮肤溃疡患者116例,其中经皮透光负压旋切术治疗72例72条下肢（A组）,非手术治疗44例44条下肢（B组）。于A组术后5、20、120和360 d（即B组入院后8、23d、出院后97、337 d）记录皮肤的感染率、坏死率、色素减退率、创面收缩率、溃疡愈合率及溃疡复发率等6项临床指标。结果：术后5 d A组皮肤感染率和皮肤坏死率低于B组（P〈0.05）;术后20 d A组创面收缩率与色素减退率较B组显著改善（P〈0.05）;术后120 d A组溃疡愈合率较B组显著升高（P〈0.05）;术后360 d溃疡复发率A组显著低于B组（P〈0.05）。结论：经皮透光负压旋切术治疗DVTS继发皮肤溃疡效果良好,具有微创性、可操作性、可控制性等特点,可作为外科治疗方法之一。     

Car seat belts and the eye

In a series of 22 successive victims of car accidents with eye injuries sufficiently severe to require their admission to an Eye Unit in Ayrshire, it was noted that not a single one had been wearing a seat belt, nor have any persons involved in similar accidents who were wearing seat belts, required to be admitted for any eye injury over a 3-year period.It is suggested that the wearing of seat belts could prevent injuries to the eyes, at least where the car frame remains intact.     

Survival after suction into jet engine intake

The case is reported of a man who survived suction into a jet engine intake, with relatively mild injuries. The manner of the accident was unusual.     

腔内激光联合点式潜行剥脱治疗下肢浅静脉曲张——五年随访报告

目的：应用腔内激光（EVLT）联合点式潜行剥脱治疗下肢浅静脉曲张,通过5年随访评价其远期疗效。方法：收治下肢浅静脉曲张患者56例,共88条患肢。行常规EVLT,并同期利用腹腔镜手术分离钳进行点式潜行曲张静脉团剥脱。结果：手术时间平均45 min,失血平均70 mL。5年随访发现静脉曲张复发6例（10.7%）,再次手术4例（7.1%）,3例术后大隐静脉根部未完全闭塞,另3例为交通支原因复发。结论：ELVT联合点式潜行剥脱治疗下肢静脉曲张相对简单、微创效果好、远期疗效较好,复发率尚可接受。