胰头癌的早期诊断分析

目的 探讨胰头癌的早期诊断措施和各种影像学检查方法的合理应用。方法 对我院1998年1月～2002年12月间，42例胰头癌患者的临床资料和诊治过程进行回顾性统计分析。结果 所有病例均经剖腹手术和病理检查证实为胰头癌，92．8％的患者出现上腹饱胀不适的时间早于黄疸1～2月，胰头癌的ERCP、MRCP、CT等检查的影像学特征明显。对其中16例患者行胰十二指肠切除术，手术切除率为38．1％。结论 重视胰头癌早期非特异性症状，及时行B超检查。若B超发现阳性征象，应进一步综合、有序地运用各种影像学检查方法，力争达到早期诊断的目的。     

Effect of Shenmai Injection on L-type Calcium Current of Diaphragmatic Muscle in Rats

Diaphragmaticmuscleisanimportantrespiratorymuscle,anddiaphragmaticfatiguecanleadtomanydisorders .Onlyintherecent 2 0 yearshavethesys temicresearchesbeen performedtoinvestigatethefunctionofdiaphragmanditspathophysiology .Di aphragmaticfatiguecanbeinducedby…     

Development of phantom for radiographic image optimization of standard patient in the lateral view of chest and skull examination

We present the construction of a homogeneous phantom to be used in simulating the scattering and absorption of X-rays by a standard patient chest and skull when irradiated laterally. This phantom consisted of lucite and aluminium plates with their thickness determined by a tomographic exploratory method applied to the anthropomorphic phantom. Using this phantom, an optimized radiographic technique was established for chest and skull of standard sized patient in lateral view. Images generated with this optimized technique demonstrated improved image quality and reduced radiation doses.     

Gaseous homeostasis during low-flow anaesthesia

The object of this clinical study was to investigate the circle system gas homeostasis during low-flow anaesthesia using a technique designed to keep a constant inspired oxygen fraction of 0.30. Denitrogenation was adequately accomplished with mask preoxygenation, 10 l/min, for 1 min and an initial fresh gas flow of 5 l/min for 6 min after intubation. There was no need to wash out accumulated nitrogen at intervals, since the already low nitrogen concentration in the system tended to decrease after 1 h. The fresh gas flow of nitrous oxide to oxygen ratio and the inspiratory to end-expiratory oxygen concentration difference both reflected the uptake of nitrous oxide. The calculated rates of uptake of nitrous oxide, a subject of controversy, were in accordance with those found by Severinghaus and Barton & Nunn.     

体外与肝细胞共培养对结肠癌细胞移行和增殖的影响

目的探讨肝细胞对结肠癌细胞的移行、增殖能力的影响。方法在体外建立结肠癌细胞与肝细胞三维共培养模型，将结肠癌细胞系Colon-26细胞培养在共培养系统上层，肝细胞培养在下层。实验分为3组：（1）Colon-26细胞与小鼠的肝细胞共培养（肝细胞组）。（2）与成纤维细胞共培养（纤维细胞组）。（3）Colon-26细胞单独培养（对照组）。观察肝细胞对结肠癌细胞的移行、增殖的影响，以及共培养液内表皮细胞生长因子（EGF）、血管内皮生长因子（VEGF）浓度的变化。结果肝细胞组的Colon-26细胞移行能力分别比纤维细胞组和对照组增强（t1=6．296，P=0．000；t2=5．322，P=0．000），Colon-26细胞增殖能力在肝细胞组亦分别比另两组增强（t1=3．905，P=0．005；t2=3．719，P=0．006）。肝细胞组的共培养液中EGF浓度明显升高（z=3．077，P=0．002）。结论在体外能建立结肠癌细胞与肝细胞的三维共培养模型。体外肝细胞能通过分泌生长因子促进结肠癌细胞的移行和增殖。     

Spiral-shaped Metallic Implant in the Treatment of Achilles Tendon Ruptures: An Experimental Study on the Achilles Tendon of Sheep

There are 2 main factors contributing to the strength of tendon repair: the tensile strength of the material used in repair and the tendon-holding capacity of the suture configuration. In the current study, we aimed to find a technique with high repair strength by increasing both the tensile strength of the material and the tendon-holding capacity of the configuration. We developed metal implants (models 1 and 2) made from stainless-steel wire with 2 different spiral-shaped configurations. We measured tendon-holding capacities of these alternative implants biomechanically and compared them with frequently used suture techniques, the Bunnell and locking loop, which were achieved with 5 Ticron sutures. Sixty-four sheep Achilles' tendons were used in the study as 16 tendons in each group. Model 2 was more resistant to deformation under loading when compared with model 1. The results demonstrated that model 2 was superior to model 1 and both suture techniques. This study could be accepted as a step for reaching a strong tendon repair technique. It should be emphasized that the technique needs to be improved technically to make it convenient for clinical use.     

β淀粉样肽25-35对原代培养的海马神经元电压门控钙通道电流的影响

目的 探讨β淀粉样肽25-35(Aβ25-35)对海马神经元电压门控的钙通道电流(VGCC)的作用.方法 应用全细胞膜片钳技术记录海马神经元上的VGCC,通过设定不同的钳制电压分别记录高电压激活的钙电流(HVA-ICa)和低电压激活的钙电流(LVA-ICa),并观察Aβ25-35对其的影响.结果 分别对原代培养的海马神经元急性胞外给予2μmol/L和10 μmol/L的凝聚态Aβ25-35,在最大激活电压下加药后ICa幅度分别是加药前的99.80%±0.02%及100.00%±1.58%,差异没有统计学意义.10 μmol/L凝聚态Aβ25-35预孵育24 h可增大ICa,对照组(未给Aβ25-35)为(24.49±4.35)pA/pF,Aβ25-35组(预孵育24 h)为(46.59±7.15)pA/pF,两组差异有统计学意义(P＜0.05);但Aβ25-35组的膜电容[(14.34±1.74)pF]与对照组[(14.44±0.97)pF]相比差异没有统计学意义.结论 急性给予凝聚态Aβ25-35对VGCC没有影响,24 h预孵育凝聚态Aβ25-35增大了VGCC,而膜电容没有改变,提示凝聚态Aβ25-35可通过对细胞膜上钙通道进行分子调控以增大VGCC.     

HPV检测和液基细胞学检查在宫颈病变筛查中的应用

目的 通过与病理组织学检查结果比较,评价高危型人乳头瘤病毒(HR-HPV)检测和液基细胞学检查在宫颈病变筛查中的应用价值.方法 对2004年12月～2006年12月在解放军总医院行HR-HPV和液基细胞学检查及电子阴道镜下宫颈活组织病理检查的690例患者的资料进行回顾性分析.结果 690例患者中液基细胞学与病理组织学检查的符合率为:低度鳞状上皮内病变(LSIL)22.34%(42/188),高度鳞状上皮内病变(HSIL)58.33%(56/96),宫颈癌100%(16/16).细胞学结果 示良性细胞改变75例;不典型鳞状细胞(ASC)、LSIL、HSIL和宫颈癌者分别为315、188、96、16例,其HR-HPV阳性率分别为53.96%(170/315)、77.12%(134/188)、80.21%(77/96)和100%(16/16).经阴道镜下多点活检病理组织学诊断为炎症、上皮内瘤变Ⅰ级和(或)湿疣(CIN Ⅰ/HPV)、CIN Ⅱ/CIN Ⅲ、宫颈浸润癌者分别为425、81、157和27例,其HR-HPV阳性率分别为43.29%(184/425)、74.93%(60/81)、91.72%(144/157)和92.5%(25/27).此外,413例HR-HPV阳性者中,病理学≥CIN Ⅰ/HPV者占55.45%(229/413);277例HR-HPV阴性者中,病理学为炎症者占87.01%(241/277),≥CIN Ⅰ/HPV者占12.99%(36/277),而36例≥CIN Ⅰ/HPV者中CIN Ⅱ/CIN Ⅲ和宫颈浸润癌仅占5.42%(15/277).315例ASC中,HR-HPV阳性者170例,病理学≥CIN Ⅰ/HPV占41.76%(71/170),其中CIN Ⅱ/CIN Ⅲ和宫颈浸润癌占69.01%(49/71);HR-HPV阴性145例,病理学≥CIN Ⅱ/CIN Ⅲ者仅占4.83%(7/145),炎症占90.34%(131/145).结论 HR-HPV和液基细胞学检查是筛查宫颈病变的有效方法 ,二者结合有利于宫颈病变的分流管理,提高宫颈癌及癌前病变的检出率.     

显微技术附睾管输精管吻合治疗梗阻性无精子症

目的　探讨附睾管梗阻性无精子症的有效治疗方法。方法　我科自2001年12月～2006年12月应用显微外科技术对9例附睾管梗阻性无精子症患者行附睾管输精管吻合术进行回顾性分析。结果　7例术后精液分析可见精子，其中5例精液分析结果正常，2例已生育。手术成功率77．8％。结论　应用显微外科技术行附睾管输精管吻合术是目前治疗附睾管梗阻性无精子症的有效方法。