胆道铸型扫描电镜观察

用扫描电镜铸型法观察大鼠肝内胆道系统以及与肝组织间的空间结构关系。结果：当用中等剂量的铸型剂（８０μｌ）从总胆管逆向注入时，可见小叶间及小叶内胆管及Ｍａｌｌ＇ｓ间隙内有铸型剂充，胆小管中未见铸型剂；当用较大量（２００μｌ）注入时，除上述部位充盈外，还可见肝锹氏间、直血窦内有铸型剂。表明：铸型剂通过胆管上皮间隙，进入胆管周围淋巴而入Ｍａｌｌ＇ｓ间隙；当铸型剂增多时，可经Ｍａｌｌ＇ｓ间隙进入锹氏间隙和     

肝外胆道闭锁肝内胆管的三维构形变化——检测预后的一种 …

目的：通过肝内胆管三维结构重建，预测肝外胆道闭锁的预后。方法：对２例肝外胆道闭锁和１例对照的肝组织进行二维病理观察。系列组织切片在计算机辅助下，重建肝内胆管的三维构形。结果：二维病理学研究显示，胆道闭锁、肝内胆管增生，炎症和肝组织纤维化明显，胆道闭锁２例的肝内胆管三维构形是相似的，小叶间胆管弯曲扩张并形成微囊肿；增生的胆管主要来自赫令管，多数赫令管管腔开放并且互相连结形成网络状，少数赫令管形成膨大     

逆行胆道造影的体位改进方法

逆行胆道造影，是手术后放入T形管（或直接穿入胆管）并注入造影剂以显示胆管的检查。目的是使胆总管、左右肝管及分支充盈显示，以帮助了解胆管内有无炎症、结石、蛔虫及狭窄等。肝分泌的胆汁，经过一套管道系统排至十二指肠，在肝外的部分称胆道系统。胆道系统包括左右肝管、肝总管、胆总管、胆囊等。胆囊俗称苦胆，象一个鸭梨，位于肝下面的胆囊窝内，可分为底、体、颈三部。胆囊底为钝圆形，突出在肝前缘，与腹前壁相贴，它的表面投影在右锁骨中线与右肋弓相交处，此处为胆囊触诊区。胆囊颈移行为胆囊管并与肝总管汇合成胆总管，胆总管…     

肝外胆道闭锁肝内胆管的三维构形变化──检测预后的一种依据

目的：通过肝内胆管三维结构重建，预测肝外胆道闭锁的预后。方法：对２例肝外胆道闭锁和１例对照的肝组织进行二维病理观察。系列组织切片在计算机辅助下，重建肝内胆管的三维构形。结果：二维病理学研究显示，胆道闭锁、肝内胆管增生、炎症和肝组织纤维化明显。胆道闭锁２例的肝内胆管三维构形是相似的，小叶间胆管弯曲扩张并形成微囊肿；增生的胆管主要来自赫令管，多数赫令管管腔开放并且互相连结形成网络状，少数赫令管形成膨大盲端。结论：①肝外胆管闭锁的三维构形变化是检测预后的依据之一；②小叶间胆管的微囊肿和赫令管膨大盲端，指示肝外胆道闭锁不适合肝肠吻合术而需要肝移植治疗     

小儿先天性肝外胆道畸形活检肝组织的光镜和电镜观察

对２０例小儿先天性肝外胆道畸形的肝脏活俭组织进行了光镜和电镜观察，肝汇管区扩大，纤维细胞及胶原纤维增生。小胆管增多，腔内有大小及密度不同的胆汁块，肝细胞之间的毛细胆管扩张，腔内亦有大小及密皮不同的胆汁块，肝血多内皮细胞普遍极度肿胀甚至破裂。枯否氏细胞增生增大，胞质内有大量的溶酶体和胆汁块。部分肝细胳肿胀，其间有坏死灶，部分肝细胞呈浓缩状。多数肝组织中有多核巨肝细胞存在。肝细胞胞质中有胆汁淤积，膜性细胞器减少，其中滑面内质网消失或坏死。结果提示，小儿肝外胆道畸形有类似的肝脏病变，但胆道完全闭塞者病变重。     

肝脏双功能对比剂Gd-BOPTA胆道成像临床初步研究

目的探讨肝脏双功能对比剂Gd-BOPTA应用于胆道成像的可行性及临床价值。方法应用GdBOPTA对15例患者（对照组10例,梗阻性黄疸组5例）进行胆道成像。比较胆系结构的显示（高信号对比剂充盈）率。测量计算肝脏和胆囊信号强度的变化值及其比值。结果对照组10例均能够显示胆总管、胆囊和肝总管,左右肝内胆管和胆囊管的显示率大于60%。梗阻性黄疸组1例于扩张胆总管内高信号胆汁对比下可见软组织信号充盈缺损。其余4例总胆红素大于131.4μmol/L,胆道未能显影。两组延迟扫描胆囊、肝脏信号强度变化及其比值差异有显著性（p=0.001,004,0.001）,对照组均高于梗阻性黄疸组。结论Gd-BOPTA在非梗阻性黄疸患者中可以得到较为满意的胆道二维及三维图像,为评价肝脏功能以及诊断或排除胆道病变提供了新的安全、无创检查手段。     

血吸虫病兔肝内血管壁的三色染色观察

以Ｍａｓｓｏｎ三色染色法，观察血吸虫病兔肝内门静脉、肝动脉、肝窦、中央静脉和小叶间静脉的改变。结果发现，管壁纤维结缔组织增多，中膜平滑肌增殖肥大，中央静脉移位。提示肝内的血管性病变在血吸虫病性门脉高压中具有重要作用。     

胆管残余结石的内镜治疗(附306例分析)

目的：探讨内镜治疗肝内外胆管残余结石的效果。方法：对1994年1月～2004年1月间306例胆道残余结石的治疗效果进行回顾性分析，采用十二指肠镜127例，胆道镜116例，经皮经肝胆道镜(PTCS)63例。结果：306例．1中有286例成功(93．46％)。十二指肠镜治疗127例成功125例；胆道镜经T管窦道治疗116例，成功109例；PTCS治疗肝内结石63例，成功52例。结论：内镜治疗肝内外胆道结石效果显著，可使绝大多数患者避免再次手术。     

PTCSL治疗胆总管结石的相关因素临床分析研究

目的 分析研究经皮肝胆道穿刺硬质胆道镜探查取石术（PTCSL）治疗胆总管结石梗阻的影响疗效的相关因素，以进一步提高手术疗效及安全性。方法 收集广州医科大学附属第一医院总院和海印分院于2013年1月至2019年3月约5000例行胆道结石手术病人的病案资料，从中筛出罹患胆总管结石并行经皮肝胆道穿刺胆道镜探察取石术（PTCSL）治疗的患者43例，其中男26人，女17人，年龄22～93岁；手术全部成功。每例取石 1～2 次。结果 经统计分析得出，穿刺胆管直径和穿刺胆管与胆总管夹角对PTCSL是否能一期手术取净结石有较大的影响，而进一步相关性分析可见穿刺胆管直径mm与ptcsl一期取净间有着负相关关系；穿刺胆管与胆总管夹角（冠状位）与ptcsl一期取净间有着正相关关系。结论 进行经皮肝胆道穿刺硬质胆道镜探查取石术时，穿刺胆管直径越大，一期取净效果越差，穿刺胆管与胆总管夹角越大对一期取净结石效果越好，     

小肠对颗粒性物质排除功能的初步观察

为确定颗粒性物质进入机体后的排除途径而进行了本实验，取成年Ｗｉｓｔａｒ大鼠经尾静脉注射印度墨水后，结扎胆管，观察到小肠全段对注入的碳粒具有清除作用，以十二指肠最为显著，镜可见小肠壁结缔组织内有大量碳粒存在。小肠绒毛顶端有上皮间通道形成，绒毛中轴内的碳粒由此而进入肠腔，而粘膜上皮小肠腺和十二指肠腺内均无碳粒，实验结果证明，小肠进入机体内的颗粒物具有排除作用，其排除作用主要借助小肠绒毛顶端的上皮细胞间     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.