人胚胎胃肠及胰腺D细胞发生的研究

用免疫细胞化学方法研究人胚胎各时期胃肠胰的Ｄ细胞发生及其形态与功能的关系。结果发现：Ｄ细胞最早出现于６周零５天胚的十二指肠，７周零３天胚的胰、胃、空肠，７周零６天胚的回肠，８周零４天胎的结肠及１０周零５天胎的阑尾；细胞密度在胚期低，胎期逐增，至胎晚期又依次在胰、胃窦、十二脂肠、胃体、空肠、回肠、升结肠及阑尾中降低，且肠绒毛顶端可见衰老的Ｄ细胞。     

人胎小肠内胰多肽免疫反应细胞的分布及形态学观察

目的探讨胰多肽免疫反应细胞(PP-IR细胞)在人胎小肠中的个体发生及分布。方法用免疫组织化学PAP法观察24例11～27周人胎小肠内PP-IR细胞的形态及定位。结果胎期小肠的PP-IR细胞主要见于十二指肠，偶见于空肠上皮，回肠中未见。11～13周时PP—IR细胞数量很少，单个分散在十二指肠绒毛上皮间。14周后，PP-IR细胞呈增多趋势，除分散在小肠腺和绒毛上皮外，在十二指肠腺上皮中也可见该细胞。17～27周时，PP-IR细胞数量未见明显增减。胎期小肠的PP-IR细胞形态多样。结论胰多肽在人胎小肠的内分泌细胞中已有表达。PP-IR细胞随着胎儿的发育而发生变化。     

人胎小肠内胰多肽免疫反应细胞的分布及形态学观察

目的 探讨胰多肽免疫反应细胞(PP—IR细胞)在人胎小肠中的个体发生及分布。方法 用免疫组织化学PAP法观察24例11-27周人胎小肠内PP—IR细胞的形态及定位。结果 胎期小肠的PP—IR细胞主要见于十二指肠，偶见于空肠上皮，回肠中未见。11-13周时PP～IR细胞数量很少，单个分散在十二指肠绒毛上皮间。14周后，PP—IR细胞呈增多趋势，除分散在小肠腺和绒毛上皮外，在十二指肠腺上皮中也可见该细胞。17～27周时，PP—IR细胞数量未见明显增减。胎期小肠的PP—IR细胞形态多样。结论 胰多肽在人胎小肠的内分泌细胞中已有表达。PP—IR细胞随着胎儿的发育而发生变化。     

消化性溃疡胃粘膜内分泌细胞的观察

收集消化性溃疡胃切除标本２７例，其中胃溃疡１７例，十二指肠溃疡１Ｏ例，应用免疫组织化学方法，第一抗体包括抗嗜铬粒蛋白Ａ，胃泌素，胃体抑素，胰高血糖素，五羟色胺，对胃窦阳性细胞进行观察。并对各类内分泌细胞进行计数。结果发现胃溃疡与十二指肠溃疡内分泌细胞变化不同。在胃溃疡中，萎缩及肠化生较为多见；Ｇ细胞与Ｄ细胞减少，Ｇ／Ｄ比值为７．３。胰高血糖素阳性细胞明显高于十二指肠溃疡。十二指肠溃疡Ｄ细胞明显减少，Ｇ／Ｄ比值为３４．５。上述结果表明胃溃疡的发病可能与肠型激素分泌及胃粘膜防护能力下降有关，十二指肠溃疡可能与Ｄ细胞减少，Ｇ细胞功能增强，导致胃酸分泌升高有关。     

十二指肠损伤9例治疗体会

为探讨十二指肠损伤最佳治疗方法，总结近３年来收治的９例治疗经验，并对诊断和手术时机及术式选择，术后处理进行分析。术前确诊１例，行单纯十二指肠修补５例，加胃造瘘，空肠造瘘各１例，十二指肠空肠侧侧吻合１例，胰十二指肠切除１例，９例中死亡１例，为术后１天死于ＤＩＣ，治愈８例，并发肾周围脓肿１例，十二指肠轻度狭窄１例。十二指肠损伤术前确诊困难，仔细的术中探查，正确选择手术时机，合适的手术方式，有效的胃肠减     

人胎儿消化系统生长抑素的发生与分布

了解人胎儿消化系统生长抑素发生，发展及分布规律。应用放射免疫分析法系统测定了１５例胎儿消化系统各组织中的ＳＳ浓度。在人胚胎胃肠胰组织中均有不同浓度的ＳＳ存在，ＳＳ在消化系统出现的时间均早于１６周，２２周后呈典型成人型分布，ＳＳ含量以胰腺最高，依次为十二指肠，胃，食管，回肠，结肠，胆囊含量较低，与前者比较Ｐ〈０．０５。     

急性重症胰腺炎的胃肠道并发症

目的：观察急性重症胰腺炎出现胃肠道并发症的发生情况并提出防治对策。方法：分析我院自１９９６年１月至１９９８年２月收治的６５例急性胰腺炎患者。结果：发生严重肠麻痹、肠梗阻７例，６例经综合治疗后症状缓解；发生严重十二指肠扩张４例；发生肠坏死、肠瘘３例。全组共４例死亡。结论：急性胰腺炎引起的十二指肠淤滞、胃潴留可持续数周，胃十二指肠管或胃空肠管的应用有利于症状的缓解。营养支持对急性重症胰腺炎尤其重要，应多提倡鼻十二指肠输入或鼻空肠输入法。急性胰腺炎时肠瘘的发生率与胰腺炎的严重程度及剖腹引流次数有关。稳定全身情况、适当导泻、选择性肠道去污染（ＳＤＤ）、尽早肠道营养、引流术时避免肠管损伤等措施是预防急性胰腺炎患者发生肠瘘的要点。     

粪石致急性肠梗阻17例

１９８１～１９９７年，共手术治疗因胃肠道粪石而致肠梗阻患者１７例，现报道如下。１　临床资料　　本组１７例患者，年龄７～７３岁，平均４３－８岁。男性８例，女性９例。粪石部位：胃２例（１１－８％），其中１例为胃肠多发粪石，空肠７例（４１－２％），回肠７例（４１－２％），乙状、降结肠１例（５－９％）。原有腹部手术史者５例（２９－４％），其中２例为胆囊切除并胆总管十二指肠吻合术（１１－８％），１例ＢｉｌｌｒｏｔｈⅡ式胃大部切除术（５－９％），２例阑尾切除手术（１１－８％）。临床表现为腹痛、腹胀、呕吐、…     

胰肠吻合术后胰瘘的预防

目的:采用不同胰肠吻合方式并加以细节改进,探讨胰瘘发生的环节及预防体会。方法:39例行胰十二指肠切除术,采用Child(胰肠、胆肠、胃肠顺序吻合)术式36例,并均在胃肠吻合口以下的远近端空肠间加做Braun氏吻合;胰胃、胆肠、胃肠顺序吻合法3例。胰肠吻合方式:胰腺—空肠端端套入式吻合5例,胰管—空肠黏膜对黏膜吻合3例,胰—胃吻合3例,捆绑式胰肠吻合28例。胰管中置管32例,同时行胆总管引流18例。结果:术后5 d发生胰瘘1例(为胰—胃吻合者),发生率为2.5%。无死亡。结论:胰肠吻合方式的选择及熟练、精细的操作与胰瘘的发生有直接的关系,捆绑式胰肠吻合是值得临床推荐的方式;采用有效的内、外引流相结合,对减少胰瘘的发生具有重要的意义;做好围手术期的充分准备,重视围手术期的营养支持也是减少胰瘘发生的一个重要因素。     

保留幽门的胰十二指肠切除胰胃吻合术(附5例报告)

目的探讨胰十二指肠切除保留幽门后消化道重建原位胰胃吻合、肠肠吻合、胆肠吻合的临床疗效。方法对5例壶腹周围肿瘤行胰十二指肠切除保留幽门后,采用原位吻合方式,即胰胃吻合、十二指肠—空肠吻合、肝总管—空肠吻合方式重建消化道。胰胃吻合于胃后壁直接切口,黏膜与胰管、胃浆基层与胰断端直接吻合。结果术后随访1个月~15个月,5例病人中,近期并发胃排空延迟(呕吐)1例(1/5),腹腔感染1例(1/5),无明显胰、胆瘘发生,无上消化道出血病例。远期无胰功能不足及胃肠溃疡等并发症发生。结论保留幽门原位消化道重建、胰胃吻合创伤小,术后恢复快,更符合生理机制,胆胰瘘发生率低,是胰十二指肠切除后消化道重建的优良术式。     

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…     

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.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

Luo Lingjie's Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.