Occlusion of the common iliac artery secondary of fungal endocarditis: Report of a case

Candida parapsilosis , and review the literature on this subject. (Received for publication on Dec. 24, 1998; accepted on Sept. 17, 1999)     

胸腰椎骨折三点加压固定中哈灵顿棒危险断面及其载荷影响的研究

本文采用二维光弹模型研究哈灵顿分离棒（ＨＤＲ）的应力分布。实验载荷包括作用于两端钩部的垂直力及作用于棒中点的水平力。实验发现棒棘齿区应力高于光滑区，ＨＤＲ光滑区—棘齿区交界处应力居棒同侧最高，是棒强度的危险断面，其应力值与载荷呈正直线相关．本文亦初步讨论了减少危险断面应力、避免ＨＤＲ疲劳断裂的途径。     

肾上腺肿瘤影像学诊断的评价(附385例报告)

目的　提高肾上腺肿瘤的影像学诊断水平。　方法　肾上腺肿瘤患者 385例。男 15 8例 ,女 2 2 7例。平均年龄 38.2岁。行B超CT检查 385例 ,行IVU检查 380例 ,行MRI检查 180例 ,行Doppler检查 6 3例 ,行数字减影血管造影 (DSA) 16例 ,行MRA检查 2 8例 ,行间位碘代苄胍(MIBG)检查 34例 ,行CT引导下肾上腺肿块活检术 3例。　结果　B超对醛固酮腺瘤 (APA)、库兴腺瘤、嗜铬细胞瘤 (Pheo)、髓样脂肪瘤定位诊断正确率分别为 92 .7%、88.3%、10 0 .0 %、10 0 .0 % ,定性诊断正确率分别为 83.2 %、86 .7%、83.4 %、10 0 .0 % ;CT的定位诊断正确率分别为 98.2 %、98.7%、10 0 .0 %、10 0 .0 % ,定性诊断准确率分别为 90 .5 %、92 .3%、83.4 %、10 0 .0 % ;MRI的定位诊断正确率分别为 90 .4 %、96 .5 %、10 0 .0 %、10 0 .0 % ;定性诊断正确率分别为 72 .8%、93.5 %、85 .8%、10 0 .0 %。　结论　全面完整的影像学资料对肾上腺肿瘤的定性诊断有一定参考价值 ;正确的影像学定位资料 ,能指导手术方案选择。     

误诊为胆囊良性疾病的胆囊癌二次根治术

目的探讨误诊为胆囊良性疾病的胆囊癌二次手术方式以及对预后的影响。方法对于1995年6月-2002年12月因误诊为胆囊良性疾病而切除胆囊,因术后病理证实为胆囊癌而二次行胆囊癌扩大根治术的41例患者进行回顾性分析。41例患者中,男12例,女29例,平均年龄51岁,均因胆囊炎(41例)或并发胆囊结石(32例)、胆囊息肉或腺瘤(9例)在第一次手术时行单纯胆囊切除。术后病理：胆囊腺癌32例,鳞癌6例,鳞腺癌3例;Nevin Ⅰ期6例,Ⅱ期16例,Ⅲ期17例,Ⅳ期2例,Ⅴ期0例。二次手术距一次手术间隔时间为6—30d。二次手术均行以改良的Glenn根治性胆囊癌切除术为标准的胆囊癌根治术式。结果二次手术时发现14例患者有淋巴结转移,14例患者有胆囊床转移,6例患者有胆管转移,2例患者有胰腺转移;Nevin Ⅳ期14例,Ⅴ期9例,无Ⅰ、Ⅱ、Ⅲ期者。二次手术后1年后存活率100％(41例),3年存活率53、8％(22例),5年存活率17．5％(7例)。结论扩大根治术是治疗误诊为胆囊良性疾病的胆囊癌的重要方法之一。     

后腹腔镜进路应用解剖学研究

目的　探讨后腹腔镜手术的应用解剖学基础。　方法　选择国人成人尸体 2 0具 ,男性12具 ,女性 8具。对其侧腹壁神经、血管和后腹膜间隙结构与后腹腔镜进路之间的距离进行测量。结果　髂嵴距腰下三角顶点的距离 :男性 :左侧 (4 0 2± 1 2 6)cm ,右侧 (3 83± 0 90 )cm ;女性 :左侧(3 90± 0 3 7)cm ,右侧 (3 87± 0 3 7)cm。髂腹下神经距髂嵴的距离 :男性 :左侧 (0 82± 0 13 )cm ,右侧(0 84± 0 0 8)cm ;女性 :左侧 (0 94± 0 0 6)cm ,右侧 (0 93± 0 10 )cm。肋下神经距肋缘下的距离 ,在腋后线和腋中线 :男性 :左侧分别为 (0 79± 0 2 6)cm、(1 65± 1 12 )cm ,右侧分别为 (0 78± 0 3 0 )cm、(1 5 9± 1 0 7)cm ;女性 :左侧分别为 (0 61± 0 14)cm、(1 3 7± 0 89)cm ,右侧分别为 (0 64± 0 13 )cm、(1 3 2± 0 95 )cm。肾下极水平输尿管距腰大肌外缘的距离 :男性 :左侧 (2 2 4± 0 67)cm ,右侧 (2 19±0 73 )cm ;女性 :左侧 (2 0 0± 0 2 3 )cm ,右侧 (1 91± 0 13 )cm。输尿管髂血管交界处距腰大肌外缘的距离 :男性 :左侧 (3 91± 0 5 9)cm ,右侧 (3 76± 0 5 3 )cm ;女性 :左侧 (3 43± 0 3 1)cm ,右侧 (3 85±0 43 )cm。　结论　临床上选择髂嵴上 2cm腰下     

中药"消癃通闭"对大鼠前列腺上皮细胞凋亡的影响

目的：研究中药“消癃通闭”对前列腺上皮细胞凋亡的影响。方法：将大鼠分为消癃通闭组，保列治组，去势组、空白组，采用免疫组化原位末端标记染色法，因实验后第7d,14d,21d时，检测各组大前列腺上皮细胞的凋亡百分率。结果：消癃通闭组及保列治组在实验第7d时，凋亡百分率达到高峰，分别为9．27％、5．65％，第14d时稍减少，第21d锂有所恢复，去势组在第7d时凋亡即出现，到第14d时凋亡百分率达到高峰，与其它组相比差异显著。结论：中药消癃通闭可在较短时间促进大鼠前列腺上皮细胞凋亡，为该药治疗前列腺增生提供了理论依据。     

Quantitative evaluation of the growth of established cell lines on the surface of collagen,collagen composite and reconstituted basement membrane

Summary As a step in the development of a system for assessing growth of human urothelium and transitional cell carcinoma, the growth of two established cell lines on collagen-based membranes has been evaluated. HT1080 (metastatic human fibrosarcoma) and WI38 VA13 (virus-transformed human fibroblasts) were grown on substrates of collagen, collagen/hyaluronic acid or chondroitin sulphate and reconstituted basement membrane (Matrigel). Cell growth was quantified using a new fluorimetric assay utilizing carboxyfluorescein diacetate. There were differences in morphology between cells grown on collagen and those grown on polystyrene. There were, however, no differences in growth of the WI38 VA13 cells on collagen compared with polystyrene, but growth of the HT1080 cells was increased on membranes of collagen/2:5% hyaluronic acid and collagen/5% chondroitin sulphate, and decreased on Matrigel. Adequate growth on collagen substrates is dependent on cell line. The fluorimetric assay used was suitable for quantifying cell growth on such substrates.     

Agenesis of the right lobe of the liver: Report of a case

(Received for publication on Feb. 28, 1997; accepted on July 8, 1997)     

胰腺实性假乳头状瘤17例影像学分析

目的 探讨胰腺实性假乳头状瘤（SPTP）影像学特点。方法 收集2005年1月至2011年4月于我院经手术及病理证实的SPTP 17例,回顾性分析其影像学特征、手术方式及预后情况。结果 肿物位于胰头、胰颈部7例,胰体尾部10例,直径1.5～9.0 cm,平均4.8 cm。超声显示肿物多为低回声光团,内呈混杂回声,有明显包膜。CT平扫多为囊实混杂密度,动脉期实性部分呈现轻中度强化,静脉期及平衡期实性部分及壁结构强化逐渐增强,囊性部分无强化。MRI扫描T1WI、T2WI上呈高、低混杂信号,实性部分在T1WI呈稍低信号,T2WI呈等或稍高信号;囊性部分T1WI呈低信号,T2WI呈高信号。其中伴钙化5例,界限不清3例,胰胆管扩张2例。术前准确诊断15例,误诊为胰腺癌1例,误诊为胰腺假性囊肿1例。均行手术治疗,其中行肿物切除10例,行胰头十二指肠切除术2例,行胰体尾切除3例,行胰尾联合脾切除2例。10例得到随访9～36个月,均未复发及转移。结论 影像学对SPTP的诊断及恶性程度的评估均有一定意义,结合临床特点,多可达到准确的术前诊断及并指导治疗。     

Evaluation of the efficiency of Boston brace on scoliotic curve control: A review of literature

Context: Bracing is one of the most important treatment approaches that have been utilized in patients with scoliosis. Boston brace used to manage a scoliotic curve especially in lumbar and thoracolumbar areas.Objective: The aim of this review was to evaluate the efficiency of Boston brace to control the progression of the curve based on the available literature.Methods: A search was carried out using the following databases including Scopus, ISI Web of knowledge, PubMed, Ebsco, and Embasco. The key words used for the search were Boston brace, Boston orthosis which were used in combination with scoliosis. Articles identified were screened based on titles and abstracts. The quality of the studies was evaluated using Black and Down tool. Data were summarized based on PICO style.Results: Based on the aforementioned key words, 18 papers were selected, in which 7 studies focused on efficiency of Boston brace, 3 papers focused on quality of life, 5 papers on finite element analysis and 3 papers on comparison of efficiency of Boston with other available braces. The quality of the selected studies varied between 14 and 21.Conclusion: The results of most of the studies support the efficiency of this brace to control the progression of scoliotic curve, especially for the curve between T6 and L2. The efficiency of this brace may be due to its rigid structure and also location and direction of the straps.     

The effect of anesthetics on control of respiration

Ventilatory control in humans depends on complex mechanisms which aim to maintain a cellular CO2-, O2- and H(+)-homeostasis under physiological conditions. This regulation is based on chemical control which predominantly acts via peripheral chemoreceptors in the carotid bodies and central chemoreceptors in the ventral medulla of the brainstem on the one hand, and behavioural control on the other, by which it is possible to adapt respiration to conditions of daily living. The influence of anaesthesia and related conditions may depress respiration and have a sustained effect on ventilatory control. Perioperative respiratory depression remains a serious clinical problem in perioperative medicine. This review will give an overview of ventilatory control and discuss the most relevant responses, describe the effects of pain, anaesthetics and opioids on ventilatory control and their interaction. The current body of knowledge is put into perspective to identify patients at risk for perioperative respiratory depression.     

Development of primary leiomyosarcoma of the sternum postirradiation: Report of a case

(Received for publication on July 22, 1997; accepted on Mar. 10, 1998)     

桡骨远端关节内骨折手术与非手术治疗的Meta分析

目的 通过Meta分析比较桡骨远端关节内骨折手术与非手术治疗的疗效.方法 通过检索1988年1月至2008年6月关于桡骨远端骨折于术与非手术治疗对照研究的文献(共5篇),采用循证医学Meta分析对患者腕关节功能,骨折复位后X线位置、患者满意度及并发症进行综合分析.结果 Meta分析发现:与非手术治疗相比,手术治疗能明显改善腕关节功能(OR=0.23,95%CI 0.11-0.48,P<0.05)、可以良好复位(OR=0.20,95%CI 0.10-0.39,P<0.05)、减少并发症的发生(OR=0.29,95%CI0.17-0.49,P<0.05),但患者满意度方面低于非于术治疗(OR=0.32,95%CI 0.14-0.75,P=0.009).结论桡骨远端关节内骨折应采用手术治疗,同时应该关注患者的要求及期望值.     

情景游戏对患儿心理行为及其家属情绪状态的影响

目的探讨情景游戏对住院患儿心理行为、患儿家属焦虑与抑郁程度及住院满意度的影响。方法将101例住院患儿按入院时间分为对照组（50例）和观察组（51例）。对照组给予儿内科常规护理;观察组在此基础上融入情景游戏,分别在入院首日、有创操作前及首次检查前,由研究者将患儿及其家属带至情景游戏室,让患儿在模拟情景与游戏中熟悉并理解相关检查与操作,所有过程鼓励患儿家属参与。采用Achenbach儿童行为量表（CBCL）评价两组患儿的行为问题,采用焦虑自评量表（SAS）、抑郁自评量表（SDS）及自行设计的满意度调查表测评患儿家属的焦虑、抑郁程度及对护理工作的满意度。结果两组患儿入院时与出院前CBCL评分比较,差异有显著性意义（均P〈0.01）。观察组出院前CBCL评分低于对照组,但差异无显著性意义（P〉0.05）;其家属出院前SAS、SDS评分及对护理工作的满意度与对照组家属比较,差异有显著性意义（P〈0.05,P〈0.01）。结论情景游戏可减缓患儿住院期间的行为退化;可有效降低患儿家属的焦虑、抑郁程度,提高家属满意度。     

The Effects of a Broad-Spectrum Matrix Metalloproteinase Inhibitor on Characteristics of Wound Healing

This study investigates the effects of a broad-spectrum matrix metalloproteinase inhibitor (MMP-i) on the rate of closure, hydroxyproline deposition, and macrophage infiltration in healing wounds. Full-thickness excisional wounds were created on the dorsal surface of hairless mice. Two experimental groups were used to measure rates of wound closure: (a) MMP-i administration (0.03, 0.3, 3.0, and 30 &#119 g/mL) on days 0-1 postwounding (inflammatory phase) and (b) MMP-i administration (0.03, 0.3, 3.0, and 30 &#119 g/mL) on days 6-8 postwounding (proliferative phase). Additionally, hydroxyproline deposition and percent macrophage infiltration were measured in skin wound margins on days 2, 8, and 16 postwounding. MMP-i administration at concentrations of 0.03, 0.3, and 3.0 &#119 g/mL on days 0-1 postwounding significantly ( p < .05) increased the rate of wound closure. No significant effect on the rate of wound closure was observed with MMP-i administration on days 6-8 postwounding. Hydroxyproline deposition was significantly ( p < .05) increased on day 8 postwounding, and the percent macrophage infiltration was significantly ( p < .05) decreased on day 2 postwounding by MMP-i administration on days 0-1 postwounding. These experiments demonstrate that MMP-i administration during the inflammatory phase significantly affects several characteristics of wound healing. We postulate that these effects may be attributed to decreased degradation of ECM components, increased concentrations of endogenous growth factors, and a shortened inflammatory phase.     

Effects of urinary incontinence on quality of life

The effects of urinary incontinence on quality of life were retrospectively studied by analyzing questionnaires obtained from 85 patients who were operated on for stress incontinence by means of a modified Stamey procedure. Ninety percent of the patients expressed satisfaction with the surgery at a mean follow-up of 18 months. Prior to surgery urine loss during sexual intercourse had been prevalent in 46% of our patients. Urinary incontinence had more devastating effects on the non-sexual aspects of everyday life, rather than on sexual activities. Although surgery was marginally beneficial in restoring the latter, the former was greatly improved postoperatively.     

力学信号对成骨细胞凋亡的影响

目的综述力学信号对成骨细胞凋亡的影响。方法检索查阅近年来各种力学负荷对成骨细胞影响的基础研究与综述等相关文献,并对其进行综合分析与总结。结果成骨细胞的凋亡与众多骨疾病的发生发展相关,其中具有代表性的疾病包括骨质疏松与各种原因导致的骨质流失等,对成骨细胞凋亡的研究可能为这些疾病的治疗与康复提供新的思路。目前相关研究已经证实,力学信号对成骨细胞的凋亡过程有着重要的调控作用,这可能为临床治疗成骨细胞相关骨疾病提供新的思路。综合现有文献,当前研究使用的力学负荷以流体剪切应力、牵张应力与静水压力3种应力为主,主要研究方向包括各种应力对成骨细胞凋亡的抑制作用或促进作用,应力加载的时间及强度对成骨细胞凋亡的影响及力学信号对成骨细胞凋亡影响的亚细胞水平机制等。结论通过对相关文献的综合分析,可以认为3种力学信号对成骨细胞的影响存在相似性,且根据对研究数据的分析,3种力学信号对于成骨细胞凋亡的作用均存在与时间和强度相关的多效性,即抗凋亡-促凋亡转化现象。现有研究中,使用流体剪切应力和牵张应力提供力学信号的研究较为完善,使用静水压力进行的研究数量较少且尚不够完善,有待于未来研究的补充。     

胰腺癌VEGF-C表达的器官差异性与淋巴结转移度及肿瘤细胞凋亡的关系

目的探讨VEGF-C在胰腺癌原发灶和转移淋巴结中表达的差异及与淋巴结转移度(LNR)和胰腺癌细胞凋亡的关系。方法对因胰头癌而行区域性胰腺切除术(RP),且行全数淋巴结检测有淋巴结转移(LNM)的15例病例标本,采用免疫组织化学和TUNEL法染色,检测并分析胰腺癌原发灶和转移淋巴结中肿瘤细胞VEGF-C的表达与LNR及肿瘤细胞凋亡的关系。结果原发灶和LNM灶肿瘤细胞中,LNM灶VEGF-C表达水平明显高于原发灶(P<0.05);两者的VEGF-C表达均与LNR显著相关(P<0.05,P<0.01),LNM灶的表达水平与LNR的相关系数明显高于原发灶(P<0.05);原发灶VEGF-C的表达与肿瘤细胞凋亡率无显著相关(P>0.05),而LNM灶VEGF-C的表达与凋亡率显著负相关(P<0.01)。结论胰腺癌VEGF-C在原发灶和LNM灶中的表达差异具有统计学意义,而LNM灶表达水平与LNR的关系更为密切,且与LNM灶中胰腺癌细胞的凋亡相关。     

胃肉瘤的诊断与治疗

目的 探讨胃肉瘤的临床特点及治疗方法。方法 回顾性分析５８例胃肉瘤（其中平滑肌肉瘤４４例,恶性淋巴瘤１１例,神经纤维瘤２例,脂肪肉瘤１例）患者的临床资料。结果 胃大部切除２３例,胃大部切除加淋巴清扫１６例,全胃切除７例,联合切除８例,未切除４例,手术无并发症及死亡。结果 胃肉瘤以根治性胃切除为主,伴胃财脏器浸润或转移,则联合切除术,胃肉瘤手术切除率主,预后好。     

Urease-induced precipitation of phosphate salts in vitro on indwelling catheters made of different materials

Summary The urease-induced precipitation of phosphate salts on indwelling catheters was studied in an experimental in vitro model. The precipitation was strongly pH-related and was much higher in synthetic urine than in human urine. In the latter, it was significantly lower on silicone catheters than on latex catheters, including those with a hydrophilic coating. The precipitation on silicone catheters that had been in situ was not increased as compared with that on unused catheters, in contrast to latex catheters with a hydrophilic coating, among which the precipitation on used catheters was higher.