博来霉素A5病灶内注射治疗血管瘤样病变

目的探讨博来霉素A5病灶内注射治疗血管瘤样病变的方法和疗效.方法自1997年7月至2004年9月用博来霉素A5局部用药治疗血管瘤样病变患者28例,其中体表病变21例,口腔和咽喉部位病变7例,每3周1次.结果儿童17例真性毛细血管瘤注射2～3次后病灶完全消失,1例海绵状血管瘤注射3次后缩小70%;7例成人口腔和咽喉部位病变注射3次后病灶都完全消失,3例成人体表海绵状血管瘤注射3次后病灶都缩小60%～70%.结论博来霉素A5病灶内注射是治疗血管瘤样病变安全、有效的方法.     

少见的椎体缘变异—爱神弓形椎

本文随机抽出500例腰椎片发现弓形椎变异45例,41个腰椎标本发现4个。对这种椎体下终板的对称性双凹形变异,所引起的X 线异常投影进行了观察、分级和鉴别.特别指出临床的重要性是避免与病理性椎体终板缺损相混淆。笔者结合国外首位报告文献,对发生率和发生机制进行了探讨。     

小剂量胰岛素静点治疗持续高血糖状态观察

对104例血糖＞20．0mmol/L的2型糖尿病，随机分为2组。53例采用小剂量胰岛素静点，至血糖降至10—15．0mmol/L后改用其它方法。另5l例采用药物控制。结果：小剂量胰岛素静点组，在减轻脱水，改善症状方面效果较好，血糖下降时间缩短(P＜0．01)。但两组在控制血糖达标方面无明显差异；结论：在持续高血糖状态时，用小剂量胰岛素静点组优于药物治疗组。     

43例食管异物再次手术的体会

我科从1998年1月~2005年1月收治43例食管异物取出术失败的病人,并对其行食管异物进行再次取出术,取得了较好的临床效果,现报道如下。1资料和方法1.1临床资料43例病人中,男31例,女12例;年龄17~72岁,平均44.6岁。38例曾行1次食管异物取出术,4例行2次食管异物取出术,1例行3次食管异物取出术。术前X片显示食管入口处异物30例,食管胸段处异物13例。已并发食管穿孔14例(32.6%)。发病时间1~5 d。异物种类包括动物骨22例、鱼刺6例,假牙10例,金属异物5例。所有病人就诊时均有吞咽困难和吞咽疼痛,其中呼吸困难4例,40例局部有压痛,6例有畏寒发热,17例…     

落差造就一种气势

前些年去贵州看黄果树瀑布,只见滔滔的河水从数十米高的危崖跌落,凌空翻飞,倾入莫测的深潭之中,掀起轩然大波,发出震天巨响,在阳光的照射下,雾化出色彩缤纷的霓虹。这恢宏的气势,动魄的风景,使我久久地为大瀑布落差创造出来的壮美,赞叹不已。     

后腹膜神经节细胞瘤的CT和MR诊断(附1例报告与文献复习)

目的分析后腹膜神经节细胞瘤的CT和MR表现。方法回顾性分析1例经手术证实的后腹膜神经节细胞瘤患者的肿瘤的CT和MR表现,并作文献复习。结果肿块边界清楚,CT平扫表现为均一的低密度,并且其中可以看见小点状钙化。增强扫描延迟期可见进行性不均一的强化。MRT2WI上呈不均一的高信号,T1WI上表现为低信号。增强MR扫描呈轻度强化。结论在后腹膜肿瘤的鉴别诊断中神经节细胞瘤是一种较少见的肿瘤,它常常表现为边界清的肿块,并且具有包绕周围大血管生长的倾向。CT平扫为低密度,增强扫描在CT和MR上均表现为延迟期进行性的增强。     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

不同给药途径的腺苷预处理对大鼠缺血再灌注心肌的保护

Objective To evaluate the effect on myocardial protection of adenosine preconditioning in different route of administration through right jugular vein and left ventricle.Methods 48 SD rats were randomly divided into ischemia reperfusion group(blank control),ischemic preconditioning group(IP,positive control),adenosine venous infusion group,adenosine in ventricular group,normal saline(NS)venous infusion group(negative control I)and NS in ventricular group(negative control Ⅱ).The ischemia reperfusion rats model were established in vivo,and then changes of heart function,serum cardiac troponin T (cTnT),superoxide dismutase(SOD),malondialdehyde(MDA)and expression of nuclear factor KB(NF-kB) were observed.Results SOD in IP[(208.63±23.88)U/ml],adenosine venous infusion group [(178.27±11.56) U/ml]and adenosine in ventricular group[(191.31±28.14)U/ml]were significantly higher than that in the ischemia reperfusion group[(145.05±23.18)U/ml](P<0.05),cTnT,MDA and expression of NF-kB were lower than that in the ischemia reperfusion group (P<0.05).Heart function was significantly better than that in the ischemia reperfusion group(P<0.05);SOD in adenosine in ventricular group was significantly higher than that in adenosine venous infusion group(P<0.05).cTnT,MDA and expression of NF-kB were lower than that in adenosine venous infusion group (P<0.05).Conclusion Adenosine preconditioning may mimic protective effect of ischemic preconditioning. The effect on myocardial protection of adenosine in ventricular group was better than that of adenosine venous infusion group.     

手术治疗咽旁颞下区肿瘤11例报告

咽旁颞下区肿瘤常需手术摘除。由于该区解剖较复杂 ,手术时不易暴露 ,因此正确选择手术入路 ,暴露及保护重要神经、大血管是手术成功的关键。现将作者手术治疗的 11例 ,报告如下。1　临床资料1.1　一般资料 :本文 11例中男性 10例 ,女性 1例 ,年龄 14～ 58岁。恶性肿瘤 3例 (耵聍腺 1例 ,恶性神经鞘瘤 1例 ,腮腺混合瘤恶变 1例 ) ,良性肿瘤 8例 (腮腺混合瘤 2例 ,神经源性肿瘤 4例 ,造釉细胞瘤 1例 ,间叶瘤 1例 )。 6例术前进行了 CT或颈动脉造影检查 ,1例术前进行了 MRI检查 ,肿瘤均未侵入颅内 ,颈内动脉穿过肿瘤 1例 ,被推压于肿瘤后外…