先灌后切供体器官血管胚胎甲状腺及甲状旁腺移植（附六例…

为了缩短供体器官的热缺血时间，我们采用先全身冷灌注，后切取供体器官的方法，对６例甲状旁腺功能减退患者（其中２例还伴特发性甲状腺功能减退）行带血管的胚胎甲状腺－甲状旁腺移植，４例移植右侧，２例移植双侧。１例供胎还同时供胰腺移植给１例Ｉ型糖尿病患者。疗效１年内２例优，４例良；有５例随访８个月－４年，效果良好。胰腺移植后追踪观察２年，效果亦良好。作者认为先灌后切供体器官有以下优点。（１）尽量缩短热缺血时     

先灌后切供器官胚胎甲状旁腺移植二例报告

报道2例胚胎甲状旁腺移植术采用先低温灌注,然后切取脏器的方法,缩短了热缺血时间,临床效果满意。     

胚胎多脏器联合切取供胰及甲状腺—甲状旁腺(附1例报告)

介绍胚胎先灌后切多脏器联合切取供带血管胰及甲状腺—甲状旁腺移植的１例经验。作者认为此法可避免热缺血损害，并能同时提供多个脏器，优于常规的先切后灌法，从而为解决大龄胎尸供者缺乏的矛盾提供了一条新途经。     

胚胎多脏器联合切取供胰及甲状腺—甲状旁腺（附1例报告）

介绍胚胎先灌后切多脏器联合切取供带血管胰及甲状腺—甲状旁腺移植的1例经验。作者认为此法可避免热缺血损害．并能同时提供多个脏器，优于常规的先切后灌法，从而为解决大龄胎尸供者缺乏的矛盾提供了一条新建经。     

带血管甲状旁腺异体移植二例报告

例1 女,41岁。因双侧甲状腺腺瘤于1972年在某院行双侧甲状腺次全切除术,术后第3天出现全身麻木,手足搐搦,症状每天发作一次,每次持续10～20分钟,经静脉注射10％葡萄糖酸钙,肌内注射维生素D_3,口服二氢速变固醇(AT_(10))可控制发作。Chvostek征阳性,Tvousseau征阳性。血     

经60钴照射及裸鼠过渡的胚胎甲状旁腺同种移植四例

将６～８个月龄的新鲜死胎甲状旁腺用６Ｇｙ６０钴外照射，并在Ｂａｌｂ／ｃ裸鼠肾包膜下过渡１４天，然后切成０．５～１．０ｍｍ大小薄片移植给４例甲状旁腺功能低下症患者，受者仅术前１天和术后１～３天服用环孢素Ａ（剂量为２０～２５ｍｇ·ｋｇ－１／ｄ），以后不用任何免疫抑制剂。通过临床症状、体征、治疗的钙剂及ＶｉｔＤ制剂用量变化以及血钙、血甲状旁腺激素的追踪观察，以确定移植物的存活状况。结果表明，４例患者疗效均满意，其中３例疗效为优，１例疗效为良。对照我们过去的各种甲状旁腺移植方法，认为该方法是最理想的。     

甲状腺全切术中甲状旁腺自体移植的现状和思考

甲状旁腺功能减退是甲状腺术后最常见的并发症之一,不仅增加患者的住院时间、费用,而且导致患者术后生活质量下降.外科医生及患者希望尽可能避免永久性甲状旁腺功能减退的发生,因此甲状旁腺自体移植作为一种简单、易行的防治策略,在甲状腺手术中广泛应用.但是移植旁腺功能的有效性尚未明确,术中甲状旁腺是否移植?还存在争议.通过文献复习...     

甲状旁腺癌的诊断和治疗（附30例报告）

目的 探讨甲状旁腺癌（parathyroid carcinoma,PC）的诊断与治疗。方法 回顾性分析上海交通大学医学院附属瑞金医院2000年1月至2013年12月30例PC病人的临床资料。结果 男性10例,女性20例,占同期收治原发性甲状旁腺功能亢进（primary hyperparathyroidism,PHPT）病人的8.2%。30例病人均经手术治疗,8例术后1～11年复发,不同的初次术式预后差距较大。结论 PC术前、术中诊断应结合临床表现、影像资料、实验室资料、术中探查等综合分析。诊断为PC的病人基本术式应为病变甲状旁腺切除+同侧甲状腺全切除。对于首次手术单纯切除病变旁腺或连带部分同侧甲状腺切除而后石蜡确诊PC的病人,应在初次术后2～3周内尽快行二次补充手术。     

同种异体甲状旁腺移植治疗甲状旁腺机能减退性心肌病三例报告

利用经培养的胎儿甲状旁腺（ＰＴＧ），对３例甲状旁腺机能减退性心肌病（ＨＯＰＴＣＰ）行ＰＴＧ移植治疗。供体为４～７个月水囊引产的死胎，在显微镜下将胎儿ＰＴＧ取出，４℃Ｈａｎｋ氏液漂洗，经培养５～８天后，在Ｂ型超声波引导下，一次性将６～１０个胎儿ＰＴＧ注入受者１侧肾包膜内。术后患者症状逐渐改善，随访１年半均未复发，该方法简便易行，符合生理需要。     

同种异体原位心脏移植六例

目的总结6例行原位心脏移植术患者的外科治疗经验。方法采用Shumway和Stanford方法行心脏移植,供心保护采用经主动脉根部灌注4℃心脏停搏液;术后免疫抑制治疗采用环孢素A、骁悉和强的松联合治疗,根据血环孢素A浓度及心内膜活检调整环孢素A用量。结果6例患者均康复,无手术及术后死亡,术后未发生超急性或急性排斥反应。结论受者-供者选择、供心保护、吻合技术、合理应用免疫抑制剂和围术期并发症的处理是手术成功的关键。     

胚胎肾上腺皮质组织移植治疗慢性支气管哮喘154例

采用胚胎肾上腺皮质组织移植治疗１５４例慢性支气管哮喘患者，移植后随访１年以上。结果临床治愈２１例，显效６８例，有效３７例，总有效率８１．８％。移植术后患者多感体力增加，上呼吸道感染减少，血清皮质醇较移植前上升；肺通气功能较移植前有明显改善；移植后血ＩｇＧ，ＩｇＥ，嗜酸粒细胞计数较移植前明显降低；血压，体重，血糖及血清电解质均无明显变化。     

Hepatic Vascular Disease After Kidney Transplantation: Report of Two Cases and Review of the Literature

Severe hepatic vascular disease developed in two patients 4and 8 years after kidney transplantation, while receiving combinedimmunosuppressive therapy with prednisone and azathioprine.Portal hypertension and marked liver failure were observed inboth cases. The diagnosis was established by histological examinationof liver biopsies showing typical veno-occiusive disease ofthe liver associated with peliosis in both cases. Azathioprine was discontinued. Two years later one patient wasasymptomatic and liver function tests were normal. The secondpatient died 3 years later from liver failure. Early recognitionof hepatic vascular disease arising in kidney transplant recipientswould be of utmost importance, as substitution of another immunosuppressiveagent for azathioprine could halt the process leading to portalhypertension.     

胎儿睾丸移植在男性性腺功能减退症治疗中的应用

目的 :探讨胎儿睾丸移植在男性性腺功能减退症治疗中的临床应用价值。　方法 :利用胎儿睾丸作供体 ,为 6例男性性腺功能减退症病人施行了胎儿睾丸移植术。　结果 :术后 5个月 ,6例病人的血清睾酮水平明显升高 ,性欲、性功能及第二性征明显改善 ,移植睾丸体积较术前增大。　结论 :胎儿睾丸移植治疗男性性腺功能减退症是有效的 ,且胎儿睾丸免疫原性低 ,具有较高的临床应用价值     

胎儿骨移植临床应用观察

本文报道了胎儿骨移植的临床应用研究，修复良性骨缺损13例临床随访结果，证明胎儿骨是良好的移植材料之一，对其优点及九疫原性等问题进行了讨论。     

纳米炭负显影及甲状旁腺自体移植在甲状腺乳头状癌手术中的应用

目的探讨纳米炭混悬注射液负显影联合甲状旁腺自体移植对甲状旁腺保护的临床意义。 方法回顾性分析2014年5月至2017年05月收治的134例甲状腺乳头状癌(TPC)患者临床资料,将67例注射纳米炭混悬注射液行甲状旁腺负显影及自体移植患者作为纳米炭组,67例常规手术患者作为对照组。应用SPSS17.0进行统计学处理,比较两组患者术后甲状旁腺误切率,手术后暂时性及永久性甲状旁腺功能减退的发生率,采用χ²检验,P<0.05差异有统计学意义。 结果纳米炭组甲状旁腺误切率10.44%(7/67)、暂时性甲状旁腺功能减退发生率10.44%(7/67)、永久性甲状旁腺功能减退发生率4.47%(3/67)明显低于对照组31.34%(21/67)、31.34%(21/67)、21.89%(14/67)差异有统计学意义(P<0.05)。 结论TPC根治术中通过纳米炭混悬注射液进行甲状旁腺负显影联合自体移植术,可有效减少甲状旁腺损伤,降低永久性甲状旁腺功能减退的发生率,提高手术安全性。     

Adenolipoma of the Thyroid Gland: Report of a Case

We report a case of adenolipoma of the thyroid gland, which is very unusual because thyroid adenoma rarely contains mature adipose tissue. A 55-year-old Japanese woman presented with a 1-month history of a neck mass. A blinded fine-needle aspiration biopsy showed benign follicular cells with no adipose cells, and we performed a left hemithyroidectomy. The specimen measured 7.0 × 4.4cm and weighed 59.9g. The cut surface of the tumor revealed a solid yellowish mass, and hematoxylin–eosin staining showed that the solid tumor was well separated from the adjacent thyroid tissue by a thin fibrous capsule. The tumor was found to be follicular adenoma composed of epithelial cells arranged in monotonous microfollicular patterns, intermingled with mature adipose tissue. No adipose tissue was found outside the tumor, and there were no signs of amyloid deposits in the tumor or adjacent thyroid tissue. The pathological diagnosis was adenolipoma of the thyroid gland. We discuss the pathogenesis of this entity and review the previously documented cases.     

Thyroid Tuberculosis Mimicking Carcinoma: Report of Two Cases

Among 527 patients with thyroid disease who underwent surgery at our hospital during a 20-year period, 2 (0.4%) had tuberculous thyroiditis mimicking carcinoma. The first patient was a 44-year-old man with a solitary thyroid nodule and the second was a 24-year old man with a thyroid abscess. The unexpected diagnosis was made postoperatively and was based on histological findings in both patients. No primary focus was found elsewhere in either patient, and both responded to antituberculous chemotherapy. Although the diagnosis is usually based on examination of resected specimens, recent reports indicate that find-needle aspiration cytology is a cost-effective technique of diagnosing thyroid tuberculosis. A review of 35 cases reported in the English literature is also discussed.     

实验性大鼠胚胎脊髓移植对损伤脊髓影响的观察

目的 建立了一个胚胎脊髓（ｆｅｔａｌ ｓｐｉｎａｌ ｃｏｒｄ）组织的低温保存方法笔一个损伤移植模式。方法 通过病理学、组织化学和免疫组织化学的研究,选用胎龄１４天的Ｗｉｓｔａｒ大鼠,分离胚胎脊髓,逐步降温,最后置于液氮中保存。１５天后取出,快速复温,并植入损伤大鼠脊椎内。全部动物于伤后８周处死。结果 经过低温保存的移植物能够在异体脊髓内存活并与宿主组织融合,其在损伤移植区的胶质细胞增生少于对照组。     

Fournier's Gangrene: Report of Six Cases

Fournier's gangrene (FG) is a fatal infectious disease with necrotic fasciitis of the external genitalia. This disease persists to this day in spite of recent advances in antibiotics. Although fewer than 100 cases have been reported in Japan, we have treated six cases in the last 4 years. The patients consisted of five men and one woman, with an average age of 47.5 years. All patients received surgical treatment including incisions, aggressive debridement, drainage, irrigation, and antibiotic therapy. Two patients, who suffered from underlying diseases of diabetic nephropathy and inclusion body myositis, died. These findings confirm the fact that FG requires a prompt diagnosis and immediate surgical treatment. Received: April 10, 2000 / Accepted: November 20, 2000