多学科协作诊疗直肠癌1例分析及体会

直肠癌术后并发症是外科临床医生经常面临的问题,多学科协作诊疗模式的出现,避免了既往单一学科诊疗的局限性。如何更好、更高效地集合不同学科的医生一起为患者拟定诊疗方案,是当下我们医护人员对于结直肠癌患者诊疗的关注点。现择取中国中医科学院西苑医院多学科协作诊疗的1例直肠癌病案,整理分析以供同道参考。     

巩膜外冷凝联合巩膜扣带术治疗视网膜脱离

目的 研究巩膜外冷凝联合巩膜扣带术治疗视网膜脱离的疗效。方法 在视网膜裂孔对应的巩膜外冷凝、放出视网膜下液、巩外加压。结果 随诊1mo以上,35眼中,32眼达到解剖复位,成功率为91．43％。结论 巩膜外冷凝联合巩膜扣带术治疗视网膜脱离,手术操作简单,手术反应轻,疗效满意,是一理想的手术方法。     

肢体负压对周围动脉闭塞性病变犬皮肤SP免疫反应阳性神经纤维影响

目的　观察肢体负压对周围动脉闭塞性病变犬皮肤中 SP免疫反应阳性神经纤维的影响 .方法　犬 17只 ,随机分治疗组 10只、非治疗组 5只和正常对照组 2只 ,治疗组和非治疗组均将动物制作左后肢缺血模型 ,治疗组在模型制作后 14d,开始行患肢负压治疗 10 d(15 min·次 - 1 ) ;非治疗组不做负压治疗 ;正常对照组不行缺血模型制作及负压治疗 . 3组均行左后肢趾皮肤免疫组化染色 ,检测 SP免疫反应阳性纤维 .结果　非治疗组皮肤中 SP免疫反应阳性神经纤维均较正常对照组明显增多 (P<0 .0 1) ,治疗组较非治疗组减少(P<0 .0 1) ,但仍较正常对照组增多 .结论　肢体负压疗法可促进皮肤感觉神经纤维中 SP的释放     

术中应用丝裂霉素C预防翼状胬肉术后复发的疗效观察

OBJECTIVE: To explore the feasibility of intraoperative application of mitomycin C (MMC) in pterygium and observe the ultrastructure change of pterygium with or without intraoperative application of MMC. METHODS: Sixty two eyes of 57 patients with primary pterygium were randomly divided into MMC group and control group, 29 patients (32 eyes) in MMC group underwent transposition with intraoperative application of MMC (0.4 mg.ml-1 for 1 minute), whereas 28 patients (30 eyes) in control group underwent transposition. The recurrence rate, complications and side effects were observed and compared between the two groups. The ultrastructure of pterygium with or without intraoperative application of MMC was studied with transmission electron microscopy. The mean follow-up was(7.6 +/- 3.4) months (1-13 minths). RESULT: Eleven eyes of the 30 eyes in control group (36.%) showed recurrence, whereas only 2 of 32 eyes (6.3%) in MMC group showed recurrence (P < 0.005). No severe complication and side effect appeared during the follow-up. Most of fibroblasts in pterygium that underwent intraoperative MMC occurred the change of rough endoplasmic reticulum (RER) dilatation. CONCLUSION: Intraoperative MMC appears to be an effective treatment in preventing recurrence of primary pterygium. The fibroblasts in pterygium have RER dilatation after application of MMC for 1 minute during the operation.     

椎基底动脉短暂缺血性眩晕患者脑血流量与脑干听力诱发电位的关系研究

为探讨椎基底动脉短暂缺血性眩晕 (VBTIV)患者的脑干听力诱发电位 (BAEP)与脑血流量 (CBF)和病理改变的关系 ,对 6 5例 VBTIV患者 (患者组 )作磁共振血管成像 (MRA)、经颅多普勒 (TCD)和 BAEP检查 ,对 2 6例对照组患者作 MRA和 TCD检查。结果 :MRA显示患者组 5 0例血管病理改变明显 ,1 5例改变不明显或无改变 ;对照组脑血流量为 1 1 2 .3～ 2 78.9ml/ min(2 s) ,较患者组 48.0～ 2 6 2 .0 m l/ min高 (P<0 .0 1 ) ,患者组 1 5例脑血流量下降 ,5 0例脑血流量正常 ;患者组 BAEP异常 47例 (72 .3% ) ,其中 ,1 5例脑血流量下降者 ,1 4例(93.3% ) BAEP异常 ,比 5 0例脑血流量正常者中的 33例 (6 6 % ) BAEP异常高 (P<0 .0 5 ) ;5 0例血管病理改变明显者 ,BAEP异常 40例 (80 % ) ,比 1 5例血管病理改变轻或无改变者中的 7例 (43.3% ) BAEP异常高 (P<0 .0 5 ) ,说明BAEP与 CBF和血管病理改变密切相关     

肺宝对小鼠免疫功能影响的实验研究

对小白鼠免疫功能影响进行了试验研究 ,试验结果表明 ,肺宝颗粒 1 3.4g/kg(相当生药 2 5 .8g/kg) ,能明显促进鸡红细胞免疫的小白鼠血清溶血素 (IgM)生成 ,具有增强特异性体液免疫功能的作用。 6 .7g/kg(相当生药 1 2 .9g/kg)能促进小白鼠网状内皮系统 (RES)吞噬功能 ,具有增强机体非特异性细胞免疫功能的作用。 1 3.4g/kg对卡介苗 (活菌 )所致小白鼠迟发超敏反应 (Ⅲ型变态反应 ) ,有非常显著的抑制作用 ,能明显提高机体特异性细胞免疫功能。     

Changes of type I collagen in the lungs of rats with hypoxic pulmonary hypertension]

The changes of type I collagen in the lung tissues of rats with hypoxic pulmonary hypertension (HPH) and its relationship to the mean pulmonary arterial pressure (mPAP) were investigated. The blood dynamic indexes of pulmonary circulation were measured by using Swan-Ganz. The distribution of type I collagen in pulmonary arteries, bronchi and plumonary interstitial was observed by using streptavidin peroxidase method (SP). The morphologic changes of small pulmonary arteries and the level of type I collagen were determined by image pattern analysis technique and gray scale scanning, respectively. The results showed, compared with the controls, mPAP of the hypoxic rats elevated (from 2.12 +/- 0.25 to 3.95 +/- 0.43 kPa, P < 0.01), their small pulmonary arteries, walls thickened (MT% from 16.35 +/- 2.64 to 35.83 +/- 3.55, MA% from 26.83 +/- 3.40 to 59.68 +/- 4.90, P < 0.01) and lumen narrowed. The distribution of type I collagen was mainly in the external layer of pulmonary arterial walls; the positive degrees of gray scale scanning increased and had a positive linear relationship to the mPAP and MT%. These findings suggest that the increase of type I collagen contents in pulmonary arteries is closely related to the development of HPH.     

关节灵片镇痛、抗炎作用的实验研究

为探讨关节灵片的镇痛、抗炎作用,用热板法和扭体法观察该药镇痛作用,结果关节灵片为不同剂量灌胃给药对小鼠热致痛和醋酸致痛均有明显抗痛作用,呈现一定的量效关系;关节灵片对二甲苯所致炎性水肿亦有显著的抑制作用。提示关节灵具有较好的镇痛抗炎作用。