颅神经疾病的肿瘤性病因探讨

目的总结经治的面肌痉挛、三叉神经痛等一类颅神经疾病的肿瘤性病因，对其临床表现特点、发病机制和处理方法进行探讨和分析。方法以面肌痉挛、三又神经痛主诉就诊的患者术前MRI检查发现肿瘤性病因19例，占同期显微手术治疗1032例面肌痉挛、三叉神经痛中的1．8％。其中男7例，女12例。三叉神经痛16例，面肌痉挛3例。术前诊断胆脂瘤8例，脑膜瘤5例，听神经瘤6例。结果肿瘤获全切，病理诊断同术前一致。术后除一例胆脂瘤致三叉神经痛部分缓解外，余症状均消失，平均随访46个月，未见复发。结论颅神经疾病的肿瘤性病因并不少见，在本组三叉神经痛中高达6．3％（16／253）。其临床特点是发病年龄较轻，病程较短，症状较重，三叉神经痛倾向于不典型发作。临床医师应保持警惕，术前应常规MRI检查。一旦发现肿瘤应争取及时手术可获良好效果。     

Clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei infection

Objective To investigate the clinical characteristics and imaging manifestations of AIDS complicated with disseminated Penicillium marneffei （PM） infection. Methods A total of 12 patients with AIDS complicated with disseminated PM infection were collected and the symptoms, signs, laboratory examination results and image manifestations of these patients were analyzed retrospectively. Results （1） The diagnosis of PM infection in all the 12 cases were confirmed by peripheral blood culture. All the 12 cases （100%） had irregular fever （38-41℃） and enlarged lymph nodes, 8 cases （66%） had skin rashes; 8 cases （66%） had hepatomegaly; 9 cases （75%） had splenomegaly while 8 cases （66%） had anemia. （2） Imaging manifestation： Five cases manifested bilateral pulmonary disseminated miliary nodular shadows or lattice signs; 1 case showed enlarged hilar lymph node and 2 cases showed patchy shadow with pleuritis. One case presented sub-pleural curve line shadow at the posterior part of the right lower lung, and adhesion between the intestinal wall and intestinal mesentery in mass form in the abdomen by CT examination. Conclusion Patients suffering from AIDS （CD4 T lymphocytes 〈50/μ L） with impaired immunity might be susceptible to complication of disseminated PM infection, which presents mainly damage of multiple organs and symptoms such as fever; enlargement of liver, spleen and lymph nodes, as well as specific skin maculopapular rashes. Imaging manifestations in the lungs were revealed as miliary nodular shadows and lattice-like shadows. Intensified abdominal CT might reveal presence of several enlarged postperitoneal lymph nodes and intestinal adhesion in shape of ＂cakes＂.     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

超声引导下经皮经肝胆管穿刺置管引流在梗阻性黄疸病人中的应用

目的　评价超声引导下经皮经肝穿刺胆管置管引流 (UPTBD)对梗阻性黄疸病人的治疗价值。方法　对 1995年 1月至 2 0 0 2年 7月期间的 4 17例梗阻性黄疸病人进行 4 97次UPTBD治疗 ,并回顾总结他们的临床资料。结果　接受PTBD治疗共有 4 17例 (5 1例病人进行了两个胆管枝的PTBD) ,穿刺成功率达 93.2 % (4 36 / 4 6 8) ,32例首次穿刺失败的病人有 2 9例进行了第二次穿刺置管 ,全部成功。发生胆汁漏 /胆汁性腹膜炎 9例 ,胆道出血 8例 ,感染性休克 1例 ,无腹腔出血、后腹膜血肿、气胸等其他并发症。对 6 4例置管引流患者进行肝功能检测 ,与穿刺前相比 ,引流后 1周和 3周检测病人血清胆红素、转氨酶均显著下降。结论　UPTBD是一项姑息性治疗梗阻性黄疸的快捷、安全、有效的方法     

TUVP手术时间对血红蛋白及电解质的影响

目的 了解经尿道前列腺汽化电切手术时间对血红蛋白及血清电解质的影响。方法 对64例经尿道前列腺汽化电切术患按手术时间分组，观察手术前后血红蛋白及血清电解质的变化。结果 手术时间对血清电解质的降低有的影响，对血红蛋白降低的影响不显。结论 减少TUR综合征的关键是要操作熟练，缩短手术时间及手术中注意止血。     

应用输尿管镜放置双J管早期治疗输尿管阴道瘘

Objective To evaluate the clinical effect of placing double J stent using a ureteroscope in early managing ureterovaginal fistula.Methods Twenty-eight patients cases with ureterovaginal fistula from 2002 to 2008 were treated early with placing double J stent using a ureteroscope and the clinical data were reviewed.Results Twenty-two of 28 cases were treated and double J stent was placed in them by a uretero-scope and 75% (21/28)of cases were cured.Four of 21 cases were treated twice by a ureteroscope and were cured finally.7 cases with failure ureterovaginal treatment underwent ureterocystostomy and were cured.The follow-up from 6 months to 33 months (average 10.1±6.4 months)showed that all of the 28 cases had been cured and had no urinary fistula.Conclusion Placing double J stent using a ureteroscope is the first choice of operative procedure for the early treatment of ureterovaginal fistula.     

重组人角质细胞生长因子-2基因的克隆和表达

目的：克隆人KGF-2基因，并在大肠杆菌中进行表达。方法：通过PCR扩增，从人胎肝cDNA文库中获得编码人KGF-2的cDNA，并将其分别克隆入pBV220，pLEX和pGEX4T-1质粒中，研究其在不同表达质粒和大肠杆菌中的表达情况。结果：克隆得到的KGF-2cDNA经测序证明与文献报道的序列一致。将其克隆于pBV220质粒中，在E．coli JM109中表达量相对最高，约占茵体总蛋白的4％；克隆于pLEX质粒中，在E．coli G1724中的表达量约占全茵总蛋白的5％；克隆于pGEX4T-1中，在E．coli JM109中的表达量可占到全茵总蛋白的20％。结论：采用GST融合蛋白表达质粒pGEX4T-1对KGF-2进行表达，较pBV220和pLEX具有明显优势，能实现对KGF-2的高效表达，为进一步的功能研究奠定了基础。     

低压状态下猪鼾症模型的建立及其CT研究

目的探讨低压环境对动物上气道软组织形态学的影响。方法将试验猪置于一个低压环境饲养6个月建立猪的鼾症模型,当出现类似鼾症临床症状和鼾症相似的咽腔压力波形时,再进行CT扫描影像学检查。并与正常状态饲养的对照组进行对比。结果模型猪咽后壁及软腭明显增厚,分别为(0.94±0.16)cm和(1.06±0.23)cm;对照组分别为(0.60±0.11)cm和(0.59±0.13)cm。模型猪的气管截面积在在前、中、后部分别为(1.49±0.12)cm2、(1.37±0.32)cm2和(1.00±0.21)cm2,其中以悬雍垂水平(后部)最为狭窄;对照组前、中、后部分别为(1.30±0.14)cm2、(1.57±0.32)cm2和(2.48±0.42)cm2。结论低压状态是鼾症的重要的致病因素之一,低压状态可建立鼾症的动物模型。     

内乳动脉插管介入治疗胸部病变

目的 探讨内乳动脉在胸部疾病中的血管造影表现及其在介人治疗中的价值。方法 应用seldinger法，对3l例病灶为内乳动脉供血或参与主要供血的胸部疾病患者进行了内乳动脉造影及介人治疗。结果3l例患者中，20例肺癌患者进行单纯内乳动脉或与其他供血动脉共同灌注化疗，部分行明胶海绵颗粒栓塞治疗，疗效满意。4例中、晚期乳癌灌注化疗后肿块明显缩小。1例低度侵袭性胸腺瘤灌注化疗后明显缩小转放疗。6例大咯血经内乳动脉和其他出血动脉灌注止血药物及明胶海绵栓塞后完全止血。结论 内乳动脉在一些胸部疾病中为主要供血动脉，经该动脉进行介入治疗有重要价值。     

斑点免疫金渗滤法的改进

目的 :改进斑点免疫金渗滤法的渗滤装置 ,降低成本 ,使之更适用于现场操作。方法 :用自制的圆形渗滤片替代塑料渗滤盒 ,并比较二者的效果。结果 :自制的渗滤片体积更小 ,成本更低 ,为一次性使用材料 ;检测抗体的效果与塑料渗滤盒法一致。结论 :自制的渗滤片优于常用的塑料渗滤盒