角蛋白人工腱膜预防全椎板切除术后硬脊膜黏连

[目的]探讨角蛋白（keratinsubstance，KS）人工腱膜材料用于预防全椎板切除术后硬脊膜黏连的效果。[方法]Wistar大白鼠60只，随机分3组，每组20只，咬除T。：全椎板，造成2rnrnX8rnlffl大小的椎板缺损，加入不同处理因素，A组：空白对照组；B组：人工腱膜组；C组：白体腱膜组。术后2、4、8，12周处死动物，各时间点大体观察采用Rydell瘢痕黏连程度评级标准评分。完整取出T。：节段，包括椎旁肌。经HE染色后，镜下组织学观察采用改良Nussbaum标准行评分。同时切取2，4、8、12周人工腱膜组硬膜外瘢痕组织进行透射电镜观察。所测数据行Kruskal—Wallis秩和检验，取a〈0．05作为统计显著差异的标准。[结果]KS人工腱膜材料无毒性和排异反应：A组的Rydell评分，改良Nussbaum评分高于B、C组（P〈0．05），B组C组比较无差别（P〉0．05）。B、C组与对照组比较，均能够明显减少椎板切除术后的硬膜外瘢痕形成。[结论]硬膜外瘢痕黏连主要来自硬膜后方的血肿和成纤维细胞（fibroblast，FB）的增殖。KS人工腱膜具有良好的组织相容性，无局部及全身的不良反应，具有良好物理屏障作用。将l（S人工腱膜放置在椎板缺损处，能够有效的防止纤维组织侵入椎管，预防硬膜外瘢痕黏连。在动物实验中，KS人工腱膜能够安全有效的预防椎板切除术后硬膜外瘢痕黏连。     

桂附地黄丸对肺纤维化模型肺组织IL-10表达的影响

目的：探讨桂附地黄丸防治肺纤维化的作用及机理。方法：用平阳霉素诱导肺纤维化模型大鼠后，用药组每天灌胃桂附地黄丸，第28d后处死各组大鼠，观察、比较各组大鼠肺部病理组织学改变及肺组织中白细胞介素10（IL-10）的表达。结果：桂附地黄丸组、强的松对照组肺纤维化程度显著低于模型对照组（P〈0．05），而肺组织IL-10的表达显著高于模型对照组；且桂附地黄丸组IL-10的表达显著高于强的松对照组。结论：桂附地黄丸能明显减轻平阳霉素所致的大鼠肺纤维化程度，并能显著增强IL-10的表达。     

从彭勃治"暗瘀"说探索肝纤维化的中医论治

系统阐述了彭勃治"暗瘀"说的基本内涵,并以此学说为基础进一步提出了"肝纤维化期相当于暗瘀期"的新观点。并解决了肝纤维化的中医病名、病因病机、辨证论治等诸多难题,从而使肝纤维化的中医论治有了自身的系统的中医基础理论的支持和准确的切入点,并有望取得突破。     

实验性肝纤维化胶原变化的研究

目的：研究肝纤维化过程中胶原成分的变化规律。方法：制作四氯化碳肝纤维化模型，测定肝组织羟脯氨酸含量，用ＶＧ、ＲＦ染色显示Ⅰ、Ⅱ型胶原并进行计算机图像分析，放免法测定肝匀浆及血清Ⅲ型前胶原水平，应用上述指标反映肝纤维化过程中胶原的变化规律。结果：随实验时间延长，肝内胶原含量逐渐增加。肝纤维化早、中期以Ⅲ型胶原增生为主，肝纤维化后期及肝硬化期以Ⅰ期胶原为增生为主。血清ＰＣⅢ与肝内胶原变化基本同步。结论     

Histometric analysis of the distal pancreas in pancreatic head cancer

To clarify the histological status of the pancreas tail after pancreatoduodenectomy (PD), fibrosis, islets of Langerhans, and A, B, and D cells were examined histometrically in surgical cases of pancreatic cancer. The same investigations were also performed during an autopsy examination of the pancreas tail of survivors of surgery who had received either PD or total pancreatectomy with segmental autotransplantation (SAT). In the surgical cases, fibrosis and the islet percentage compared with nonpancreatic cancer cases were significantly higher while the B cell ratio was significantly lower. In addition, in pancreatic cancer patients, the fibrosis and islet ratio in the group with a blocked pancreatic duct were higher while the B cell ratio was lower than in the group with an open pancreatic duct. A direct relationship between the islet ratio and the degree of fibrosis, and an inverse relationship between the B cell ratio and the degree of fibrosis, were thus found. From the autopsy cases, the fibrosis progressed and the islet ratio increased following PD, but after SAT only the islet ratio increased compared to the time of surgery. The progression of fibrosis after PD thus suggests the presence of some problems in both the surgical method and postoperative management.     

A nocturnal nasogastric feeding programme in cystic fibrosis adults

Fourteen adult patients (mean age 22.5 years, range 18–35) with cystic fibrosis undertook nocturnal nasogastric feeding for a mean period of 14.7 (range 6–18) months consuming an average of 1042 ml of a high energy feed on five nights of each week. Following this protocol all patients gained weight (mean weight gain 5.4 kg, range 2–17). For the group as a whole, lung function remained stable during the period of feeding; however a significant correlation between improvement in lung function and weight gain was demonstrated. Hyperglycaemia during feeding in this adult population was common (9/14, 64%) but was easily controlled with insulin therapy.     

益肺抗纤方对博莱霉素诱导大鼠肺纤维化的防治作用

目的 :观察益肺抗纤方抗肺纤维化的作用。方法 :实验用雄性Wistar大鼠分为 4组 ,对照组、模型组、益肺抗纤方组、地塞米松组 ;对照组气管内注入生理盐水 ,其余 3组气管内注入博莱霉素制作大鼠肺纤维化模型。造模后 ,益肺抗纤方组给益肺抗纤方 10ml/kg灌胃 ,地塞米松组给地塞米松 1.5mg/kg腹腔注射 ,模型组和对照组均给生理盐水灌胃 ,均给药 1次 /d。观察各组大鼠肺部病理变化 ,测定各组第 7d、2 8d肺组织超氧化物歧化酶(SOD)、脂质过氧化物 (LPO)和羟脯氨酸 (HP)的含量。结果 :气管内注入博莱霉素第 2 8d时 ,模型组多呈 3级肺纤维化和 1级肺泡炎改变 ;益肺抗纤方组多呈 1级纤维化改变 ,肺泡炎不明显 ;地塞米松组多呈 1级纤维化和 1～ 3级肺泡炎改变 ;对照组呈正常肺结构。第 2 8d时 ,模型组和地塞米松组肺组织SOD活性均较对照组明显下降 (P <0 .0 1和P <0 .0 5 ) ,地塞米松组较模型组SOD活性下降更明显 (P <0 .0 5 ) ;益肺抗纤方组与对照组之间SOD活性无明显差别。对照组、模型组、益肺抗纤方组肺组织LPO含量明显低于地塞米松组 (P <0 .0 1) ;益肺抗纤方组与对照组和模型组之间无明显差别。结论 :益肺抗纤方可通过提高SOD活性 ,降低脂质过氧化 ,减轻氧自由基损伤 ,抑制胶原沉积 ,保护肺组织     

各种肝病的肝纤维化标志改变的探讨

目的 :探讨各种肝病患者血清肝纤维化标志的改变 ,甘草酸二胺注射液对肝脏炎症、纤维化指标的作用。方法 :用放免法检测透明质酸 (HA)、层粘蛋白 (LN)、Ⅲ型前胶原多肽 (PCⅢ )。结果 :急性肝炎的三种肝纤指标均升高 (P <0 0 5 )。急黄肝高于急无黄肝 (P <0 0 5 )。慢性肝炎 1 1 2例 ,三项肝纤指标显著高于正常对照 (P <0 0 5 )。慢肝重度显著高于慢肝轻度 (P<0 0 0 1 )。肝硬化的三项肝纤指标又显著高于慢肝 (P <0 0 0 1 ) ,其它肝病的肝纤指标也升高。 2 5例慢肝用甘草酸二胺注射液治疗 2月 ,ALT、AST、GGT显著降低 (P <0 0 1 )。三项肝纤指标中HA降低较显著 (P =0 0 5 ) ,LN和PCⅢ虽有降低 ,但差异不明显 (P =0 4 5 9,P =0 1 92 )。结论 :各种肝病的三项肝纤维化指标均升高 ,以慢肝重度 ,肝硬化升高明显。甘草酸二胺注射液治疗有抗炎及改善肝纤维化的作用