胆石病的非手术治疗

胆石病是胆道系统主要疾病，在急腹症中仅次于阑尾炎，居第二位。国内胆石病发率为8%～10%，美国每年都有10万新胆石病患者。自从100多年前langenburch施行第一例胆囊切除以来，手术治疗已成为常规的胆石病治疗方法。但手术有一定并发症及死亡率，病人往往不愿意接受手术治疗。     

大肠癌合并胆石病的治疗

大肠癌与环境因素的关系较为密切[1],而高热量、高脂肪、高胆固醇饮食又是胆石病形成的主要原因之一[2]。随着我国人民生活水平的提高,大肠癌和胆石病的发病率都有明显的上升,大肠癌合并胆石病的病例也随之增加。而且,有认为胆石病与大肠癌的发生存在一定的关系。因此对合并胆石病的大肠癌患者进行根治性手术时,是否需处理病变的胆囊,本文就这一问题进行讨论。材料与方法本文收集了仁济医院自1993年1月～1998年6月间收治的大肠癌病例287例,因胆石病已行胆囊切除10例,277例中经B超及手术探查证实伴胆石病有57例,占20.58％其中男性2…     

胆石病的实验室结果分析与预防

胆石病是一种常见的疾病 ,随着人们生活的改善和平均年龄增高 ,本病有逐年增多的趋势。胆石可以发生在肝内胆管、肝外胆管或胆囊内。也可同时存在于胆囊与胆管内 ,或同时存在于肝内胆管与肝外胆管内。在 2 0世纪 90年代的抽样调查结果表明 ,我国胆石病的发病率已达到 10 % ,其中 80 %为胆囊结石。为了有效的控制胆石病的发生 ,特对我院 39例胆石病患者的实验室结果分析报道如下。1　资料与方法1.1　病例选择　 39例患者均系我院住院及门诊经 B超确诊的胆石病患者 ,均有不同程度临床症状占 35例。女性 2 8例 ,男性 11例 ,年龄最小 2 2岁 ,最…     

胆石病的成因及发病机制研究进展

胆石病是一种常见疾病,据报道西方国家成年人胆石病的发病率达15%～20%,我国的发病率为7%～10%,而70%～80%的胆囊结石为胆固醇结石[1]。很多的胆石病患者没有明显的症状,但40岁以上的胆囊结石患者中有40%的人因明显的症状和严重的并发症而被迫行腹[2]     

广西胆石病临床调查结果报告

胆石病是我国的常见病、多发病之一。中国幅员辽阔,各地的发病情况不尽相同。广西地处祖国南疆,为胆石病的多发区。为了摸清我区胆石病的发病情况,区胆石病协作组根据全国胆石病研究协作组的协议规定,组织全区回顾性胆石病临床调查,现将结果报告如下。     

基层医院胆道再手术21例体会

胆石病的再手术率一般在10～25％，由于病情复杂，处理比较困难。我院白1985～1992年．困胆石病行胆道手术289例．其中21例为再次手术，现将21例的处理体会报告如下。     

胆石病危险因素的条件Logistic回归分析

目的　探讨胆石病的危险因素 ,为胆石病的预防提供依据。方法　按性别、年龄对 10 4例胆石病病例进行1∶1配对的病例对照研究 ,用条件Logistic回归作单因素、多因素分析。结果　胆囊炎 (OR =30 .938)、油腻饮食(OR =19.6 0 9)、家族史 (OR =16 .6 76 )、甘油三脂 (OR =5 .92 4)、体质指数 (OR =2 .835 )、饮酒 (OR =1.86 8)、多孕次 (OR =1.818)、素食 (OR =0 .2 97)等因素与胆石病的发生有统计学意义 (P <0 .0 5 )。结论　胆囊炎、油腻饮食、家族史、高血脂、肥胖、饮酒、多孕次是胆石病的主要危险因素 ,而素食可能有保护作用。     

腹腔镜胆总管切开取石与内镜联合腹腔镜治疗胆囊合并胆总管结石的对比分析

胆石病是目前临床常见病,1994年我国第2次胆石病调查报告显示:胆石病患者中有10%为胆囊合并胆总管结石。随着十二指肠镜及腹腔镜的临床应用,胆囊合并胆总管结石的治疗取得了进一步的发展。我院应用腹腔镜下胆囊切除-胆总管探查术与腹腔镜下胆囊切除术联合内镜下Oddi括约肌切开术两种术式治疗胆囊合并胆总管结石,取得了较满意的疗效,现报道如下。1资料与方法     

女性胆石病与肥胖、血脂关系的研究

目的探讨女性胆石病与肥胖、血脂的关系.方法对68例女性胆石病患者和81例非胆石症女性进行对照分析.结果胆石病组体重指数显著高于对照组,胆石病组肥胖及腹型肥胖的比例显著高于对照组.胆石病组总胆固醇、高密度脂蛋白胆固醇显著高于对照组.结论肥胖,尤其是腹型肥胖是女性胆石病发生的独立危险因素,同时提示高密度脂蛋白胆固醇对结石形成的作用尚待研究.     

胆石病的治疗现状与展望

本文通过利用文献检索、数据库收集整理胆石病的治疗方法及相关文献资料,分析总结了近年来胆石病的若干治疗方法及其相应的临床疗效,将相关结果汇总,为胆石病的临床防治以及相关研究提供一定的借鉴和理论参考,以期促进胆石病防治研究的发展和扩大临床应用,从而达到提高胆石病临床防治效果的目的。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

Development on Adjustable Calibration Marker for Shock Wave Focus

Shock wave lithotripsy （SWL） is a treatment of choice for upper urinary stones. However, this procedure is inappropriate for obese patients because the focus is often unable to reach the target owing to the limited focal distance in shock wave source. Although treating such patients in a blast path may increase the application length of shock wave source, it＇s difficult to find this path on the lithotripter monitor. For this reason, we invented an adjustable calibration marker in order to set an effective focus in the shock wave hath.     

Study on the TCM Pathogenesis of Angiopathic Complications of Type II Diabetes

Excess production of reactive oxygen species(ROS)of mitochondrion mediated by hyperglycemia is the common pathogenesis of angiopathic complications of diabetes.TCM holds that the damp from the dysfunction of spleen.kidney and liver is the causative factor of complications of diabetes.This is similar to the mechanism of Ros resulting in angiopathic complications of diabetes.When the angiopathic complications of type II diabetes mellitus(T2DM)are difierentiated as caused by turbid damp in TCM can be explained as ROS.Since the obstruction of pathogenic damp in channels and collaterals is said to be the main pathogenesis,the treating principle should be dissolving the damp to remove the obstruction.     

Leptin, Ghrelin and TNF-α before and after Hypo-caloric Traditional Chinese Diet and Auricular Acupuncture

INTRODUCTION Obesity is a complex emergent problem, which can be possibly solved not only by the diet but also by the life style and promotion of a constant physical exercise. 1, 2 No doubt careful attentions must be given to the nutritional condition of obese people, the dietary habits, the somatic build (i.e. distribution of fat mass) and the organic functions linked to formation of the fat mass. All the parameters should be constantly monitored before, during and after a diet treatment. 3, 4, 5     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

Relationship between Dysglycemia and Carotid Atherosclerosis in Tibetan Population

People with dysglycemia are at high risk for atherosclerotic diseases. This study aims at investigating the atherosclerotic vascular damage in dysglycemia and its metabolic origin in Tibetan population.     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

CLINICAL SIGNIFICANCE OF SERUM CYTOKINES IL-1β,sIL-2R,IL-6,TNF-α,AND IFN-v IN ACUTE CORONARY SYNDROME

Objectives To explore serum cytokines levels (including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v) and their significance in patients with acute coronary syndrome (ACS) and the subsequent follow-ups, with attempt to estimate the role of various serum inflammatory markers in the diagnosis and assessment of ACS.Methods The study population include 40 patients with acute myocardial infarction (AMI), 40 patients with unstable angina pectoris (UAP), and 40 controls. Among the 80 patients, 60 patients attended a follow up 4 months later. Serum inflammatory markers including IL-1 β, sIL-2R, IL-6, TNF-α, and IFN-v were measured by enzyme linked immunosorbent assay.Results Serum IL- 1 β, sIL-2R, IL-6, TNF-α were significantly higher in AMI group or UAP group compared to the control group and became significantly lower 4 months later in the follow-up patients. Serum levels of IFN-v shows no significant difference between AMI group or UAP group and controls, also showing no significant change when measured in follow up patients. There was no correlation between serum creatine kinase-MB isoenzyme levels and serum inflammatory markers either in UAP or AMI group. Furthermore, when divided into two subgroups using Wagner's QRS scoring system in the AMI group, there is no difference of each serum inflammatory marker between ≤ 6 scores group and ＞ 6 scores group.Conclusion Serum levels of certain inflammatory markers may have some diagnostic value for ACS, and can be a useful marker reflecting disease stability.     

Possible Spread of adenovirus type 3 from poultry to humans ：indirect evidence from an outbreak in China

Objective:To explore the epidemiology and etiology for an outbreak of acute respiratory tract infection that occurred in one county of Jiangsu Province, China 2004. Methods: Only cases meeting the case definition were included in the study. We reviewed the medical records of the cases who were admitted to the local hospitals, interviewed cases by a standard questionnaire, and then described the epidemiotogic features and analyzed risk factors by means of a case-control study. We collected pharyngeal swab specimens and sent them to different laboratories for isolation and culture. The laboratory used different detection methods such as DIP, PCR, electron microscope examination and microneutralization assay, to identify and then type the positive specimens. Results:A total of 871 cases were reported during the period from April 18 to July 4,2004. The distribution of onset times presented two peaks, one in late May and another in middle June. The epidemic occurred mainly in the elementary and junior high schools in ten townships of one county, and the mean age of the cases was 12 years (range 7 months to 18 years). The course of the disease was acute, and was characterized by fever accompanied with sore throat and tonsillitis. The WBC count of cases was normal or elevated. The mean duration of illness was 5 days (range 2 to 12 days). No fatalities from illness were reported. A case-control study indicated that the possible risk factors were close contact with a case and/or poultry before onset and sharing of towels among members of the family. The typical CPE was observed through inoculating pharyngeal swab specimens into the HEP-2 cell cultures in different laboratories. An infection of adenovirus type 3 was verified by detecting positive specimens in different methods. Conclusion:This investigation demonstrated that the acute respiratory infection in cases was caused by adenovirus type 3. Cases occurred in over 70 schools in ten townships in 2004, and the route of transmission was possibly close contact with cases or droplet transmission.