急性左半结肠癌梗阻一期切除吻合治疗39例

目的：探讨左半结肠癌致急性肠梗阻的手术处理方法。方法：回顾分析1995－2001年间39例左半结肠癌致肠梗阻一期切除吻合术的外科临床效果。结果：全组39例病人均采用梗阻近端肠管减压灌洗，并留置盲肠造瘘管术后接负压吸引，术后均一期愈合，未出现吻合口漏。随访2例中，1例存活率58％，3年存活率16％，5年存活率8％。结论：严格掌握手术适应症和基本操作，在病情允许时，对左半结肠癌急性肠梗阻行一期切除吻合手术是可行的。     

原发性肝癌肝移植治疗现状与展望

肝移植已成为原发性肝癌治疗的一种重要选择。选择合适的肝癌病例作为移植对象是决定疗效及预后的关键,另外手术禁忌证及术后复发等问题也要慎重考虑。本文就肝癌肝移植治疗方面相关问题近年来的研究情况进行综述。     

山东省中小学生麻疹爆发原因的病例对照研究

为探讨山东省中小学生麻疹爆发的原因 ,采用 1∶2配比的病例对照方法对中小学生麻疹疫苗 (MV)效力进行了研究 ,同时对近年来中小学生MV接种率进行了估算。结果显示 :中小学生MV效力为 74 % ,95 %可信区间为4 7%～ 88% ;小学生MV效力明显高于中学生 ,分别为 82 %和 6 8% ;1999～ 2 0 0 1年学龄儿童的估算接种率分别为75 4 %、75 6 %和 5 5 7%。较低的MV效力和接种率是计划免疫工作薄弱地区中小学生麻疹爆发的主要原因。     

Benign giant cell tumor of bone with osteosarcomatous transformation (”dedifferentiated” primary malignant GCT): report of two cases

 It is not uncommon for sarcomatous transformation of giant cell tumor (GCT) of bone to occur after radiation, but rarely does malignant transformation occur spontaneously, with less than 15 cases reported up to 1995. Only four of these cases have been documented in detail. We report two additional cases of GCT of bone spontaneously transforming or ”dedifferentiating” into osteosarcoma without radiation therapy. The first case is absolutely unique and most interesting in that the dedifferentiation process occurred in one of multiple GCT lung metastases 6 years after successful eradication of a primary tibial tumor. The right lung was resected due to development of a large tumor, and at pathologic examination, demonstrated several small nodules of conventional GCT and a much larger, 14-cm mass composed of a mixture of GCT and high-grade osteosarcoma. The second case involved a physician, who had a large tumor in the sacrum with vague symptoms for 8 years. Open biopsy revealed conventional, benign GCT of bone with a secondary aneurysmal bone cyst. Complete curettage 2 weeks later revealed, in addition to areas of conventional, benign GCT a second component of very high grade osteosarcoma. Both patients died less than 1.5 years from diagnosis. This report of osteosarcomatous transformation of a conventional GCT of bone strengthens the theory that there is a mesenchymal cell line in GCT that may spontaneously tansform to sarcoma.     

Extramedullary plasmocytoma of the bronchial system

Summary. We present a case of primary plasmocytoma of the left upper bronchus. Occlusion led to atelectasis of the left upper lobe and subsequent poststenotic pneumonia. Therapy consisted of local excision of the bronchus and postoperative radiotherapy. This type of lung-conserving therapy in a case of primary plasmocytoma has not been described before.      

66例成人原发肾病综合征临床治疗与病理分析

本对６６例原发肾病综合征患进行病理类型与临床疗效分析。最常见病理类型为系膜增殖性肾炎，占４２．５％，其次为膜性肾病，占３２．５％，ＩｇＡ肾病占１５．０％。微小病变型及系膜增殖性肾炎对激素及免疫抑制剂治疗效果好，膜性肾病治疗效果差。不同病理类型患病理损害程度与疗效相关。伴肾小管间质病变治疗效果差（Ｐ〈０．０５）。ＮＳⅠ型疗效明显优于ＮＳⅡ型（Ｐ〈０．０５）。５０岁以下原发肾病综合征（ＰＮＳ）     

原发全身性癫痫遗传流行病学研究

本文报道１００例原发全身性癫痫家系的遗传流行病学研究结果。先证者一级亲属患病率为６．８６％，二级亲属为１．０３％；分别是对照组一级亲属的１３．８３倍和２．０８倍。原发全身性癫痫的遗传度为：一级亲属０．７５２１±０．０６７８，二级亲属０．３５９２±０．０７４６；加权平均０．５７４３±０．０５０２。说明遗传因素起重要作用。发病年龄影响因素分析表明：原发全身性癫痫有一定年龄依从性。ＥＥＧ家系分析显示，该型癫痫一级亲属癫痫样放电明显高于对照组一级亲属，提示癫痫样放电的遗传倾向。     

原发性心脏肿瘤外科治疗体会

目的 总结原发性心脏肿瘤的外科治疗经验.方法 回顾性分析87例原发性心脏肿瘤的临床特征及诊治结果 .1996年1月-2006年4月,共手术治疗原发性心脏肿瘤87例,占同期全部心脏手术的1.7%.其中男性31例,女性56例,年龄15～73(49.2±6.9)岁.良性肿瘤83例,占95.4%,其中心脏黏液瘤81例;恶性肿瘤4例,占4.6%.结果 围术期死亡2例,死亡率2.3%.其余病例顺利恢复.术后54例心脏良性肿瘤患者得到随访,随访时间2个月～10年,心功能Ⅰ～Ⅱ级(NYHA),无肿瘤复发病例.4例恶性肿瘤患者于术后1年内死亡.结论 原发性心脏肿瘤临床表现复杂多样,超声心动图对其诊断有特殊价值.一经诊断应首选手术摘除肿瘤.心脏良性肿瘤手术效果良好,恶性肿瘤预后差.     

在体或离体大鼠肝细胞经消炎痛处理后对半乳糖胺损伤的反应

我们曾观察到消炎痛预处理能使大鼠对半乳糖胺肝损伤产生明显的保护作用,本研究利用大鼠肝细胞原代培养的方法进一步观察了达一现象。结果提示,消炎痛整体处理可使肝细胞本身获得抗损伤的能力,而这种抗损伤能力的形成可能有赖于肝细胞外其它因素的参与。     

A BLIND RANDOMIZED CROSS -OVER TRIAL COMPARING BETAXOLOL WITH TIMOLOL IN OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION

Purpose: To compare the short-term efficacy and side effects of betaxolol and timoloi in treatment of primary open angle glaucoma or ocular hypertension. Methods: Fourteen patients with newly diagnosed early primary open angle glaucoma or ocular hypertension were included.Each patient received 0.5% timoloi and 0.5% betaxolol twice daily for four weeks in two phases. Between two courses of treatment there was four weeks wash out period. At the end of study the effect of these two drugs on intraocular pressure, mean arterial blood pressure,pulse rate,basic tear secretion and ocular symptoms were evaluated and statistically analyzed,using wilcoxon and chi-squar test.RESULTS:The study was performed on fourteen patients with baseline IOP of 26.7 ±1.5 mmHg.After four weeks treatmem,timoiol and betax-olol reduced IOP by 7.8±1.2mmHg or 29% and 6.1±1.3mmHg or 23%, respectively (P<0.001). The difference between two groups was significant(P<0.001). Mean arterial blood pressure was reduced with betaxolol and tim