血清前白蛋白测定在肝胆外科疾病中的临床意义

目的探讨肝胆外科病人术前检测血清前白蛋白，白蛋白，总胆汁酸及凝血酶原时间的临床意义。方法将被检者175人分为7组，其中健康对照组25例（A组）；肝内胆管结石25例（B组）；肝硬化门脉高压症25例（C组）；原发性肝癌25例（D组）；肝门部胆管癌25例（E组）；肝脏损伤25例（F组）；急性化脓性胆管炎25例（G组）。所有被检对象均在清晨空腹静脉采血，用ELISA法分别测定PA，ALB TBA及PT。结果在本实验中从B组-G组结果显示，患者血清中前白蛋白逐渐降低（均值（mg／L）A组232．6；B组206．7；C组102．2；D组95．5；E组82．6；F组70．1；G组40．2）。各组与对照组比较，C、D及E组明显下降（P〈0．05），F及G组下降更明显（P〈0．01），肝内外胆管结石无明显下降（P〉0．05）。TBA在C组至G组明显下降（P〈0．05），B组无明显下降（P〉0．05）。而白蛋白、PT在C、D和E组与对照组比较有显著性差异（p〈0．05）。结论血清中前白蛋白含量的改变能敏感、特异、快速反应肝胆外科患者肝脏功能的变化。     

Identification of Phenolic Antioxidants in Elastomers for Pharmaceutical and Medical Use

Phenolic antioxidants were identified by thin-layer chromatography (TLC) in 102 samples of pharmaceutical and medical rubber articles. Despite the large number of antioxidants proposed for elastomers, only eight compounds were found in the articles analyzed. The choice of antioxidants apparently does not depend on the sterilizing processes or on the use or brand of articles.     

Ketamine as analgesic for total intravenous anaesthesia with propofol

A prospective study of 18 patients who underwent noncardiac surgery was performed to study the use of ketamine as an analgesic during total intravenous anaesthesia with propofol. A comparison was made with the combination propofol/fentanyl. The propofol/ketamine combination resulted in haemodynamically stable anaesthesia without the need for additional analgesics. Postoperative behaviour was normal in all patients and none of the patients reported dreaming during or after the operation. Propofol seems to be effective in eliminating side effects of a subanaesthetic dose of ketamine in humans. We recommend the propofol/ketamine combination for total intravenous anaesthesia for surgery when stable haemodynamics are required.     

Iodine 131 uptake in a pleuropericardial cyst: case report of a false-positive radioiodine total body scan result in a patient with a thyroid cancer

An uptake of iodine 131 was casually discovered in the precordial region of a patient with a thyroid cancer and corresponded to a pleuropericardial cyst. Offprint requests to: M. Schlumberger     

全胃切除功能性空肠代胃术68例临床分析

目的：分析全胃切除术后功能性空肠代胃作消化道重建手术方式的疗效。方法：回顾性分析2003年1月～2007年12月施行全胃切除功能性空肠代胃术68例患者的临床资料。结果：部分病例出现轻度反流性食管炎、消化不良或肠功能障碍,均可缓解。所有患者术后体重、血红蛋白、清蛋白、总蛋白量均增加。结论：全胃切除功能性空肠代胃术是一种安全可靠、效果满意的手术方式。     

保留自主神经全直肠系膜切除与直肠癌根治术后局部复发关系

目的：比较保肛与非保肛术应用全直肠系膜切除（TME）加保留自主神经术（ANP）的局部复发率（LRR）差异及影响因素。方法：172例直肠癌分两组（Dixon组123例与Miles组50例），按Heald及Havenga法行TME及ANP。结果：①Dixon组与Miles组的总局部复发率分别为4．8％（6／123）与18．0（9／50），P＜0．05；Dixon组内从A期到D期的LRR分别为0％（0／25），2．9％（／34）、7．7％（4／25）及8．3％（1／7），其百分率趋势检验有显著差异，P＜0．05。②1997年以前Miles组的LRR为36．8％（7／19），显著高于1997年以后Miles组的6．5％（2／31），P＜0．05；前者与Dixon组的LRR4．8％比有极显著差异，P＜0．001，后者与Dixon组比无显著差异，P＞0．05。结论：TME加ANP是降低两类直肠癌根治术后LRR重要因素。     

Spontaneous late dislocation of the high flexion tibial insert after Genesis II total knee arthroplasty. A case report

We present the first case of late spontaneous dislocation of a high flexion polyethylene insert after Genesis II total knee arthroplasty. Dislocation of the fixed insert occurred at 14 months post surgery while walking down a steep aircraft staircase. The total knee arthroplasty had been uneventful till that moment. The clinical presentation, possible causes and management are discussed. A surgical error, failure to remove a posterior femoral osteophyte, seems the most probable cause for the late insert dislocation in our case.     

病毒性肝炎患者血清总胆汁酸测定及临床意义

目的 探讨血清总胆汁酸（TBA）测定在病毒性肝炎诊断中的价值。方法 用酶比色法对213例病毒性肝炎患及30例正常对照进行测定，并对结果进行统计处理。结果 正常对照组TBA为11.11±3.64umol/L。病毒性肝炎组急性期（或活动期）的TBA与正常对照组相比差异均有显（P＜0.01）各组中急性期（或活动）与恢复期相比差异亦具有显性（P＜0.01），在恢复期组中，慢性肝炎中度及肝硬变组与急性黄疸期比较差异具有显性（P＜0.05）。结论 血清TBA的含量与肝病的病变相关，对肝炎的诊断，预后判断及辅助鉴别诊断具有一定的价值。     

Low Mediterranean Diet scores are associated with reduced kidney function and health related quality of life but not other markers of cardiovascular risk in adults with diabetes and chronic kidney disease

Background and aimsHow Mediterranean-style diets impact cardiovascular and health outcomes in patients with diabetes and chronic kidney disease (CKD) is not well known. Our aim was to investigate the association between diet quality, using Mediterranean Diet Scores (MDS) and health outcomes.Methods and resultsThis is a post-hoc analysis of an RCT and longitudinal study investigating patients with diabetes and CKD. MDS was calculated annually. Scores were analyzed for correlation with lipids, HbA_1c, serum potassium, health-related quality of life (HRQOL) and depression. 178 diet records from 50 patients who attended two or more visits were included. Mean MDS was moderate (4.1 ± 1.6) and stable over time. Stage 1–2 vs 3–5 CKD had lower raw MDS (3.8 ± 1.5 vs 4.6 ± 1.5, p < 0.001). Having hyperkalemia was associated with a lower raw MDS scores (3.6 ± 1.6 vs 4.2 ± 1.5, p = 0.03) but not energy adjusted MDS. MDS was not associated with HbA_1c or lipids. High vs low MDS was associated with improved HRQOL (mental health 84.4 ± 14.3 vs 80.3 ± 17.1, p < 0.05; general health 62.6 ± 21.0 vs 56.3 ± 19.8, p < 0.001) and fewer depressive symptoms (9.1 ± 7.4 vs 11.7 ± 10.6, p = 0.01).ConclusionsLow MDS was associated with reduced kidney function and health related quality of life, but not other markers of cardiovascular risk. Further studies are needed to understand the nature and direction of the association between diet quality and disease outcomes in this population.