Prospect of Endoscopic Mucosal Resection for Early Gastric Cancer: Our Devices in Insulated‐Tip Electrosurgical Knife Method

In Kobe University Hospital, a new method for endoscopic mucosal resection (EMR) using insulated‐tip electrosurgical knife (IT‐EMR) for early gastric cancer (EGC) was introduced from November 2001. To achieve an effective and safe IT‐EMR procedure, we use a high‐frequency surgical unit for cutting and coagulation (ERBOTOM ICC 200) with automatically controlled cutting mode (ENDOCUT). In this study, we show not only our results of IT‐EMR for EGC in comparison with those of the conventional strip biopsy method, but also the optimal conditions for the apparatus of a high‐frequency surgical unit to prevent complications such as bleeding and perforation.     

采血者针刺伤的调查及危险因素分析

针刺伤在采血工作中经常发生，其危害大，后果严重，一般情况下还没有引起人们足够的重视。我国是肝炎的高流行区，近年来艾滋病在我国的发病率呈倍增的趋势。血液污染的针刺伤是导致血站采血人员发生血源性传染病最主要的职业因素。作者从实际工作出发，收集相关资料，系统的阐述了针刺伤的发生因素及预防措施等，并结合相关理论提出了一系列的措施和建议。     

胎儿生长迟缓与新生儿胰岛素敏感性变化的相关性

目的探讨胎儿生长迟缓(FGR)与新生儿胰岛素敏感性变化的关系。 方法昆明医学院第一附属医院于2004年4~12月，对72例小于胎龄儿(SGA)和48例适于胎龄儿(AGA)空腹血糖(FPG)、空腹胰岛素(FINS)、C 肽、HDL C、LDL C、TG、非酯化脂肪酸(NEFA)等指标，计算葡萄糖/胰岛素比值(G/I)、胰岛素敏感性指数(ISI)、胰岛素抵抗指数(HOMA IR)、胰岛β细胞功能(HBCI)等，探讨FGR与新生儿胰岛素敏感性变化的关系。 结果(1)SGA组FPG、HDL C低于AGA组，而FINS、LDL C、TG、NEFA高于AGA组(P<001)；(2)SGA组G/I比值、ISI低于AGA组，HOMA IR高于AGA组(P<001)，而HBCI两组相比差异无显著性(P>005)。 结论FGR儿在生命早期存在胰岛素敏感性降低和不同程度的胰岛素抵抗(IR)，而胰岛β细胞功能无明显变化。     

百鹰汤治疗慢性乙型肝炎43例

目的：观察以“温阳益气、化湿清热”为法拟方的百鹰汤治疗慢性乙型肝炎的临床疗效。方法：43例慢性乙型肝炎采用百鹰汤治疗作为治疗组，另设30例随机对照组以五酯胶囊治疗。结果：治疗组患临床症状改善明显，其降酶疗效和HBeAg与HBV－DNA阴转率明显优于对照组（P＜0．05）。结论：百鹰汤能改善慢性乙型肝炎患临床症状，具有抗病毒及改善肝功能的作用。     

补阳还五汤对脑缺血再灌注损伤大鼠脑组织ET-1基因表达的影响

目的 :观察补阳还五汤对脑缺血再灌注损伤大鼠脑组织 ET- 1基因表达的影响 ,探讨其对脑缺血再灌注损伤的保护作用。方法 :采用线栓法制成大鼠 MCAO再灌注模型 ,并用地高辛精标记 ET- 1基因进行原位杂交。结果 :补阳还五汤治疗组缺血再灌注侧皮层及尾状核 ET- 1基因表达显著低于生理盐水对照组 (P<0 .0 5 ) ,两组大鼠缺血再灌注侧皮层和尾状核 ET- 1基因表达均显著高于健侧相应脑区 (P<0 .0 5 ,P<0 .0 1)。结论 :脑缺血再灌注可以诱导脑组织 ET- 1基因的异常表达 ,从而进一步加重脑损伤 ,补阳还五汤可在一定程度上下调脑缺血诱导的ET- 1基因的表达 ,可能是其防治缺血性脑血管病的主要作用机制之一。     

1 alpha(OH)D3 (ETALPHA) treatment and receptor studies in 16 patients with chronic and myeloproliferative disorders

10 patients with CLL and 2 with CML were treated with gradually increasing doses of 1 alpha(OH)D3, up to 4 micrograms daily during 6 wk. 3 patients with preleukemia and 1 with myelofibrosis were treated with 2 micrograms daily of 1 alpha(OH)D3 for a prolonged period up to 17 wk. The treatment with 1 alpha (OH)D3 did not result in changes of disease parameters in any of the patients under study. Receptor studies for 1,25(OH)2D3 were performed in 8 CLL patients and revealed only 1 patient with increased specific receptor binding capacity. The maximum tolerable dose of 1 alpha(OH)D3 varied individually, but was in the range of 2-4 micrograms daily.     

Bleeding complications precipitated by unrecognized Gingko biloba use after liver transplantation

Because of its neurocognitive enhancing effects, Gingko biloba has emerged as amongst the most commonly used herbal products. We report a liver transplant recipient with potentially life-threatening toxicity resulting from Gingko biloba use. Seven days after a second liver transplantation for recurrent hepatitisB virus infection, subphrenic hematoma was documented in a 59-year-old Korean patient. Failure to control bleeding with CT-guided drainage necessitated exploratory laparotomy for the evacuation of a large subphrenic hematoma. Three weeks later, an episode of vitreous hemorrhage was documented. Unbeknownst to his care providers, the patient had been consuming Gingko biloba throughout the postoperative period. No further bleeding episodes occurred after the cessation of Gingko biloba use. Unrecognized use of herbal products may be associated with serious side effects and adverse clinical sequelae in transplant recipients. Given their increasing popularity, the use of herbal products should be routinely sought as part of the history in transplant recipients.     

Biochemical activities of lysosomal acid hydrolases in leukemic cells

The biochemical activities of 8 lysosomal acid hydrolases in leukemic cells from 48 patients were examined. Characteristic alterations were found in α-mannosidase, β-galactosidase and N-acetyl-β-glucosaminidase activities of leukemic cells. The level of α-mannosidase activity was much higher in myelo(mono)genous leukemias (AML, AMoL, AMMoL, CML and CMMoL) than in lymphogenous ones (ALL, T-cell leukemia, hairy cell leukemia and CLL) without exception. The β-galactosidase activity also differed as a result of α-mannosidase, except in T-cell leukemia. In T-cell leukemia it was within the range of normal lymphocytes, but in the other lymphogenous leukemias it was significantly below normal. N-acetyl-β-glucosaminidase activity in myelo(mono)genous leukemic cells was above the range of normal granulocytes. The changes in these enzyme levels were consistent. The lymphocytic or myelocytic nature of three cases of acute undifferentiated leukemia could be determined by enzyme studies. In two cases it was lymphocytic and in one it was myelocytic. The enzymatic abnormalities were also found in morphologically mature neutrophils from patients with not only chronic types (CML, CMMoL) but also acute types (AMoL, AMMoL) of leukemias, and were similar to those of their respective leukemic cells. Analysis of lysosomal enzymes (at least three of those mentioned above), can elucidate one of the biochemical properties of leukemic cells and may be valuable in the differentiation of leukemias.