生长激素对大鼠重症胰腺炎肝肾功能的影响

重症胰腺炎多并发有多器官功能障碍综合征(MODS),死亡率较高。其中易并发损害的脏器有肺、肾、肝等,脏器功能障碍若不能及时有效治疗,会序贯发生多器官衰竭(MOF)。近年来研究表明生长激素可以有效降低肠道缺血再灌注损伤及胰腺炎肠源性细菌、内毒素移位,增强肠黏膜屏障功能[1～3],从而减少对脏器的损害。本实验对生长激素在胰腺炎中对肝肾功能的保护作用进行研究。1材料和方法1.1材料:200～250g Wistar大鼠,雄雌不限,购自吉林大学实验动物中心;牛磺胆酸钠购自Sigma公司;TNF-α、IL-6放免检测试剂盒购自解放军总医院科技开发中心放免所…     

门静脉高压症术后再出血问题

门静脉高压症合并食管、胃底曲张静脉破裂大出血来势凶猛,不论内、外科治疗效果均不满意。虽说经内镜栓塞及套扎为主的非手术疗法以及在终末期肝病所行的肝脏移植取得很大成功,但因在国内尚不能普遍开展,仍有较多病人在经非手术疗法无效时须采取急症手术止血。目前实行的各种手术无论分流或断流术后均有一定的再出血率。术后再出血的病人曾经历一次或数次手术,状态一般较差,第一次手术后所致的腹腔中粘连及解剖的改变,使其手术治疗成为对医生的严峻考验,这是目前关注的热点之一。我们认为在门静脉高压症再出血的处理时必须明确以下几个问题…     

股骨颈疝窝的影像特征

目的 分析股骨颈疝窝的影像表现.方法 回顾性分析9例股骨颈疝窝的X线平片、CT和MRI表现.9例均为男性,年龄21-73岁,均有髋部疼痛,疼痛史2个月至2年.结果 9例中6例股骨颈疝窝为双侧,3例为单侧(右),其中行X线平片检查2例,CT 6例,MRI 5例.疝窝大小为0.5 cm×0.6 cm～1.0 cm×1.5 cm.位于股骨颈前上区(7例)或前下区(2例).X线平片示股骨颈区囊状低密度区,围以硬化白边.CT示股骨颈皮质下低密度区,有硬化边缘,其中2例有骨皮质细微断裂.5例MR T1WI呈低信号,其中3例T2WI呈高信号,围以低信号带,2例呈低信号,脂肪抑制序列5例均呈高信号,矢状面示疝窝位于髂腰肌背侧.T2WI示髋关节少量渗液2例.结论 股骨颈疝窝具有特征性的CT、MRI表现,CT、MRI有利于明确股骨颈疝窝的诊断.     

地塞米松对重症胰腺炎急性肺损伤时水通道蛋白表达的影响

急性呼吸窘迫综合征(ARDS)是急性重症胰腺炎(SAP)常见而严重的并发症之一,死亡率超过50%。有95%的早期死亡病例中存在肺水肿和肺淤血的表现,防治肺损伤成为降低SAP早期死亡率的重要措施。既往研究中我们发现在SAP急性肺损伤时水通道蛋白1(Aquaporin 1,AQP-1)表达减少,本实验就SAP肺损伤时地塞米松对AQP-1的影响作进一步研究。     

家族性腺瘤样息肉病的治疗(附一家族病例分析)

临床资料家族性腺瘤样息肉病 (ＦＡＰ)是常染色体显性遗传性疾病[1] 。近年发现 4 0 %～ 90 %病人伴有上消化道息肉[2 ] 。该病治疗比较困难。通过对我科近年诊治的一家族情况随访 ,结合文献讨论、分析如下。采取回顾性分析法 ,对一ＦＡＰ家族 3人进行随访研究。父亲 5 3岁 ,2 5年前因粘液血便于我院诊断为全结肠多发息肉病伴部分结肠、直肠癌变 ,行全大肠切除术、回肠永久性造口术 ,术后恢复良好 ,每日大便 10余次 ,但不能自控 ,且伴有性功能障碍 ,现健在。其有两个孪生儿子 ,现年 2 7岁 ,均于13年前因粘液血便诊断为ＦＡＰ ,长子于 13年前…     

1018例甲状腺癌临床病理分析

Objective To explore the incidence and pathologic feature of patients with thyroid carcinoma treated at the First Hospital of Jilin University. Methods From January 2000 to July 2010,clinicopathologic data of 1018 patients with thyroid carcinoma treated in the First Hospital of Jilin University were retrospectively analyzed. Results The cases of thyroid carcinoma between 2008 and 2010 were more than 73% higher than that in the preceding 8 years. Cancer cases from January 2009 to July 2010 were more1018 cases reviewed, 976 cases were clearly classified pathologically. Papillary thyroid carcinoma, follicular thyroid carcinoma, medullary thyroid carcinoma and anaplastic thyroid carcinoma were present in 897 (91.91%), 43(4. 41% ), 22(2. 25% ) and 6(0. 61% ) cases respectively. Of the 1018 cases reviewed,804 cases were recorded with or without lymphnode metastasis. The rate of lymphnode metastasis of male and female patient were 39. 24% and 28. 64% respectively and the difference was significant( χ2 = 6. 71 ,P ＜0. 05). The rate of lymphnode metastasis of age ＜45 years and age ≥45 years were 37.65% and 23. 26%respectively and the difference was significant ( χ2 = 19. 54, P ＜ 0. 05 ). Conclusions In the past ten and a half years, the number of the thyroid carcinoma patients treated in the First Hospital of Jilin University increased year by year. The increase of papillary thyroid carcinoma was the most obvious. Thyroid carcinoma was more common among females. The peak incidence age of males and females was 30 -59. The rate of lymphnode metastasis of males was larger than that of females. The rate of lymphnode metastasis of age ＜45years was larger than that of age≥45 years.     

甲状腺癌破裂引起颈部血肿一例

患者,女,41岁,因发现右侧颈部肿物2个月,颈部突然肿胀3d,伴吞咽困难2d入院.既往有高血压病史10年,未系统诊治.查体:血压220/140mmHg,双侧颈部肿胀,以左侧著,轻压痛,无波动感,质地硬韧.颈部超声:颈部组织弥漫性增厚、回声紊乱,以左侧为著(图1).甲状腺及气管明显向右位移;甲状腺右叶增大,其内见四个低回声肿物,较大的位于近上部前侧被膜下,大小约14 mm×14 mm,边界不清,内部回声不均,内见细点状钙化回声.纤维喉镜检查:会厌及双侧劈裂弥漫性充血肿胀、看不见声门及梨状窝(图2).     

颈部异位胸腺瘤1例报道并文献复习

背景与目的:颈部异位胸腺瘤(ECT)临床上容易与甲状腺和甲状旁腺肿物相混淆。本文探讨颈部异位胸腺瘤的临床及病理特征、诊治要点。方法:回顾性分析1例颈部ECT患者的临床资料,结合国内外文献,总结颈部异位胸腺瘤临床及病理特征、诊断要点。结果:患者,中年女性,术前彩超及CT均提示甲状腺左叶下极部位肿物,~(99m)Tc-MIBI SPECT/CT可见相应位置反射性增高区,临床初步考虑甲状腺腺瘤或甲状旁腺功能亢进,行左侧颈深部肿物切除术,术后病理回报AB型胸腺瘤。结论:ECT是颈部肿物的罕见病因之一,诊断上较难与甲状腺及甲状旁腺肿物相鉴别,对于甲状腺下极或后方肿物,PTH正常且~(99m)Tc-MIBI SPECT阳性的患者,应警惕ECT。