经典乳癌根治手术的改良

目的：为了在乳癌根治术中达到既根治又美容的目的，我们对21例乳癌根治手术进行了改良。方法：改纵行切口为斜行的Orr切口；游离皮瓣时，采用自制的二齿皮肤牵拉钳拉平皮肤，以双刃刀作拉锯式切割均匀游离皮瓣；游离带蒂背阔肌肌瓣，将肌瓣翻转，填充于腋窝，末端与胸大肌锁骨端缝合固定，并覆盖于腋静脉、臂丛神经表面；创面内喷洒ZT胶或生物蛋白胶，减少渗血和术后渗出。结果：21例患者中术后发生皮瓣坏死的1例，无1例发生腋窝积液，1例发生切口旁皮下少量积液，平均住院12d。结论：彻底根治，预防术后局部复发，又减少了腋窝积液，皮瓣坏死等并发症，缩短了住院时间，又保持了外形的美观。     

胰腺组织修复中转化生长因子β作用的研究

急性胰腺炎发病机理不十分清楚,治疗也较困难.过去对胰腺炎的损害因素研究较多,Chiari于1886年提出"胰酶自身消化"学说,Opie提出"胆管阻塞"说[1],近年随着新概念新技术的不断引入,微循环障碍、缺血-再灌注损伤、内毒素、氧自由基、一氧化氮、炎症前细胞因子(TNF-α,IL-1,IL-6)等对胰腺组织的损害得到了深入研究,并且针对其不同的发病机制,在治疗方面进行了探索,取得一定效果.     

无创法监测犬肝硬化门静脉高压成模的应用

在犬肝硬化门静脉高压模型制备过程中,人们习惯采用的测定门静脉压的方法多是有创的,本实验通过一些方法的联合应用,无创性的测定门静脉压力及动态地监测肝纤维化向肝硬化发展的进程,取代了有创的反复开腹切取肝组织病理检查及门静脉压测定,降低了模型建立后动物的死亡率,现将结果报道如下。一、材料和方法1.实验动物:健康杂种犬16条,体重16～2 0kg ,制模前各项指标均作自身对照。2 .肝硬化门静脉高压模型的制备[1] :犬腹腔内注射5 0 %四氯化碳(CCl4 )溶液,每次0 2 2ml/kg ,每周注射2次,饲喂含10 %猪油的米饭并控制每日饲量,以10 %乙醇水…     

二氢青蒿素对胰腺癌生长的抑制作用

Objective To investigate the anti-tumor activity of dihydroartemisinin in pancreatic cancer in vitro and in vivo. Methods For cultured cells,cell growth was determined by the MTT assay and apoptosis was evaluated by flow cytometry analysis stained with Annexin V-FITG/PI. The protein expression in BxPC-3 cells was analyzed by Western blot assay. BxPC-3 cells were injected subcutaneously into nude mice to establish pancreatic xenograft tumors and the tumor volume was monitored after exposure to dihydroartemisinin. Ki-67 staining and TUNEL assay were used to assess tumor cell proliferation and apoptosis in tumor tissue. Results After treatment by dihydroartemisinin in vitro, the proliferative inhibition rates of pancreatic cancer cells BxPC-3 and AsPC-1 reached up to (76.2 ± 3.5) % and (79.5 ± 2.9) %, and the apoptosis rates were up to (55.5 ± 3.2)% and (40.0 ± 3.5)%, the differences were significantly (P ＜ 0.01) compared with control [(2.0 ± 1.3) % and (0.9 ± 0.4) %]. Dihydroartemisinin inhibited the growth of pancreatic xenograft tumors in nude mice. The proliferation index and apoptusis index were (49.1 ± 3.9)% and (50.2 ± 4.4)% respectively in dihydroarternisinin 50 mg/kg treatment group, compared to those of (72.1 ± 3.3) % and (9.4 ± 2.9) % in control, the differences were significantly (P ＜0.01). Western blot assay indicated that dihydroartemisinin up-regulates expression of proliferation-associated protein p21WAF1 and down-regulates expression of PCNA, increases expression of apoptosis-associated protein Bax and decreases expression of Bcl-2 and activates caspase-9 in BxPC-3 cells. Conclusions Dihydroartemisinin exerts anti-tumor activity in pancreatic cancer both in vitro and in vivo by proliferation inhibition and apoptusis induction. Dihydroartemisinin can be used as a potential anti-tumor drug in pancreatic cancer.     

不同的胃癌淋巴结分期对患者预后的影响

目的探讨胃癌淋巴结分期与患者预后的关系。方法应用新旧两种胃癌淋巴结分期系统,对1104例接受标准R2根治术胃癌患者的预后进行统计分析。结果(1)旧式N分期的N1和N2期患者的中位生存期分别为35.5和26.6个月。新式N分期将旧式N分期的423例N1期和282例N2期患者分成3个组(N1、N2和N3),3组间的中位生存期差异有显著性意义(P<0.05)。相反,旧式分期对患者的中位生存期无明显影响。(2)ⅢA期的5年生存率从旧式24.8%上升至32.7%,ⅢB期的5年生存率从17.3%下降到9.1%。结论两种分期系统都是很好的评价患者预后的指标,但新分期有更好的判断预后效果。     

二氢青蒿素对胰腺癌生长的抑制作用

Objective To investigate the anti-tumor activity of dihydroartemisinin in pancreatic cancer in vitro and in vivo. Methods For cultured cells,cell growth was determined by the MTT assay and apoptosis was evaluated by flow cytometry analysis stained with Annexin V-FITG/PI. The protein expression in BxPC-3 cells was analyzed by Western blot assay. BxPC-3 cells were injected subcutaneously into nude mice to establish pancreatic xenograft tumors and the tumor volume was monitored after exposure to dihydroartemisinin. Ki-67 staining and TUNEL assay were used to assess tumor cell proliferation and apoptosis in tumor tissue. Results After treatment by dihydroartemisinin in vitro, the proliferative inhibition rates of pancreatic cancer cells BxPC-3 and AsPC-1 reached up to (76.2 ± 3.5) % and (79.5 ± 2.9) %, and the apoptosis rates were up to (55.5 ± 3.2)% and (40.0 ± 3.5)%, the differences were significantly (P ＜ 0.01) compared with control [(2.0 ± 1.3) % and (0.9 ± 0.4) %]. Dihydroartemisinin inhibited the growth of pancreatic xenograft tumors in nude mice. The proliferation index and apoptusis index were (49.1 ± 3.9)% and (50.2 ± 4.4)% respectively in dihydroarternisinin 50 mg/kg treatment group, compared to those of (72.1 ± 3.3) % and (9.4 ± 2.9) % in control, the differences were significantly (P ＜0.01). Western blot assay indicated that dihydroartemisinin up-regulates expression of proliferation-associated protein p21WAF1 and down-regulates expression of PCNA, increases expression of apoptosis-associated protein Bax and decreases expression of Bcl-2 and activates caspase-9 in BxPC-3 cells. Conclusions Dihydroartemisinin exerts anti-tumor activity in pancreatic cancer both in vitro and in vivo by proliferation inhibition and apoptusis induction. Dihydroartemisinin can be used as a potential anti-tumor drug in pancreatic cancer.     

结肠巨大黄色瘤一例

患者女，59岁，无明显诱因出现右下腹部疼痛3d于2005年6月4日急诊入院。疼痛呈持续性，逐渐加重，伴发热，有里急后重感，但无黏液脓血便，检查：体温38.2℃，心率74次/分，血压135/85mmHg（18/11.3kPa）,腹部稍膨隆，未见肠型及蠕动波，右侧腹部压痛明显，以右下腹部为主，并伴有明显的肌紧张和反跳痛，肠鸣间稍弱，直肠指检未及肿块。     

肝硬化门静脉高压症脾切除术后血小板数量变化分析

目的:探讨肝硬化门脉高压症脾切除术后血小板数量变化的临床意义。方法:统计分析153例肝硬化伴脾大脾亢患者脾切除术前后(肝硬化组)血小板(PLT)计数和肝功能,观察血小板变化趋势,比较脾切除术前后血小板变化和肝功能变化的关系,同时与脾外伤组对比。结果:肝硬化组术后多数血小板升高,部分不升高,甚至降低,并与肝功能相关。肝硬化组较外伤组手术前后血小板变化不明显。结论:肝硬化血小板减少数民的原因除与脾肿大等有关外,还可能与肝脏功能变化有关。     

肝圆韧带及其在腹部手术中的应用

1 肝圆韧带概述 1.1 肝圆韧带的形态学 肝圆韧带为藏于镰状韧带游离缘内的脐静脉闭锁而成的条索状韧带,下连脐环。上连脐静脉导管(闭锁后称静脉导管索),连门静脉左支,约有70％左右的人未闭合,可给予再通。临订上常于此作逆行性肝一门静脉造影或经此路插管注药治疗肝肿瘤等或门-体分流手术的途径。 脐旁静脉(paraumbilical veins)起始于脐周围的脉网,向后向上。经肝圆韧带表面或实质,终止于肝门静脉主干(73.80％)或肝门静脉左支(26.20％)是肝门静脉和腹前壁静脉间的重要吻合支 脐周静脉网形成肝门静脉系与上,下腔静脉系之间的吻合: