书讯3

《伤科集成》一书由丁继华主编 ,余瀛鳌、施杞任副主编 ,人民卫生出版社出版。该书共分四个部分 ,其中“伤科专著载述”、“伤科古医案、医话”和“伤科有关专著”三个部分收集和引用了自春秋战国至明清各个历史时期的有关伤科的古医著近 30 0册 ,加上第四部分的有关现代文献、科研课题、伤科专业机构和人物的检索 ,共 440万字 ,分上下两册。在数千历史长河中 ,伤科专著甚少 ,多散在各医著中 ,但《集成》一书收集的伤科专著即近百册 ,其中近二十册为引自海外或私人献出的藏书 ,多为珍本和孤本 ,尚未列入《中医图书联合目录》中。同时 ,我们…     

���ܹ��Է��Դ���3������

我院 1997年 7月至 1999年 9月收治 3例胆总管自发性穿孔。报告如下。1　临床资料　　例 1 女性 ,6 3岁。右上腹痛 1周 ,突然加剧伴高热 1ｄ。3年前作过胆囊切除术。皮肤巩膜无黄染 ,Ｔ 38 8℃ ,Ｐ 92 /ｍｉｎ。全腹压痛、反跳痛、肌卫 ,以右上腹为主。白细胞计数 16× 10 9/Ｌ。Ｂ超提示胆总管多发性结石 ,胆总管腔外下方见 1 5ｃｍ× 1 5ｃｍ结石 1枚 ,近十二指肠处胆总管壁 2 / 3已坏疽、穿孔 ,仅剩部分后壁。胆总管远端一枚结石嵌顿 ,约 1 5ｃｍ× 1 8ｃｍ。胆总管直径 2 5ｃｍ。Ｏｄｄｉ括约肌纤维化 ,探查未能通过。术中利用近端较健…     

����������ֲ������ĩ�ڸ�����3������

肝肾联合移植术手术难度大，临床监护与并发症的防治要求高。我院自2000年来共为3例病人施行了肝肾联合移植术。现报告如下。     

��͸��ϸ��������ת����3���ٴ�����

??Research for 3 cases on the clinical characteristics of pancreatic metastasis tumor from renal clear cells ZHANG Lei, JI Yuan, LOU Wen-hui, et al. Pancreatic Tumor Group, Department of General Surgery, Zhongshan Hospital of Fu Dan University, Shanghai 200032, China Corresponding author: JIN Da-yong, E-mail: dyjin524@yahoo.com.cn Abstract Objective Analyze and research on the clinical feathers of pancreatic metastases of renal clear cell carcinoma. Methods Collect 3 cases which were diagnosed as pancreatic metastases of renal clear cell carcinoma by pathology from January 1st, 2003 to May 31st, 2009, retrospectively analyze the clinical manifestations, physical signs, B-ultrasound and CT findings, postoperative pathology as well as the survival time after operation of pancreatic metastases of renal clear cell carcinoma. Results (1) B-ultrasound shows masses with low density, and they are difficult to distinguish from pancreatic cancer.; According to CT arterial phase, pancreatic metastases of renal clear cell carcinoma can be showed as enhanced lesions which are difficult to distinguish from neuroendocrine tumors. (2) According to the general pathology after operation, they are showed as masses with clear boundary, sallow section, accompanied with grey and red necrotic region; Cells under microscopes show numerous with transparent color (cytoplasm), and cells align like a sheet. (3) One sample patient died 11 months after the operation, and others were alive with our research until May 2009 with survival time of 21 months and 2 months respectively, and they are still alive with our research. Conclusion The follows are the common clinical Feathers of pancreatic carcinoma metastasis in renal clear cells : B-ultrasound shows masses with low density; CT arterial phase shows masses as enhanced lesions; Preoperative diagnosis basically is on the ground of medical history and CT manifestation. It’s still difficult to confirm the survival time after radical excision, People can normally survive for a long time if there’s no further metastasis happened.     

关于方程X~3±3=2~n

本文解决了一类丢番图方程的求解问题,改进了Rabinowitz的研究结果。     

H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的影响

目的 通过比较不同细胞类型之间胰腺十二指肠同源盒1(Pdx-1)、配对盒基因4(Pax4)、MafA(mast cell function associated antigen)和Nkx6.1等胰岛组织特异性基因其转录起始区的H3K4m3和H3K9m3修饰的差异,探讨H3K4m3和H3K9m3修饰对胰岛组织特异性基因表达的作用.方法 采用染色质免疫共沉淀一实时定量聚合酶链反应(PCR)法检测小鼠胚胎干细胞(mES,1×10~7)、小鼠成纤维细胞株NIH3T3细胞(1×10~7)和小鼠β细胞株NIT-1细胞(1×10~7)三者中的胰岛组织特异性基因、Oct4基因和MLH1基因转录起始区H3K4m3和H3K9m3修饰的状况.同时采用实时定量逆转录(RT)-PCR检测上述3种细胞各基因mRNA表达水平.分析H3K4m3和H3K9m3修饰改变与基因表达之间的关系.结果 NIT-1细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K4m的修饰水平分别为:(4.84±0.05)%、(9.91±1.33)%、(10.64±0.87)%、(0.23±0.03)%,与mES细胞比较明显增高(P<0.05),基因表达;NIH3T3细胞中Pdx-1、Pax4、MafA、Nkx6.1等胰岛组织特异性基因转录起始区的H3K9m3的修饰水平分别为:(0.64±0.21)%、(7.04±1.29)%、(0.39±0.10)%、(2.35±0.81)%,与mES细胞比较明显增高(P<0.05),基因不表达.结论 H3K4m3与H3K9m3修饰能相互协调,共同调控胰岛组织特异性基因的表达.     

��������Ư��Ѫ˨3������

动脉栓塞的病因非常复杂 ,Ｄａｒｌｉｎｇ等[1 ] 196 7年报道约6 %～ 13%的动脉栓塞原因不明。胸主动脉漂浮血栓 (ｆｌｏａｔ ｉｎｇｔｈｒｏｍｂｕｓ ,ＦＴ)所致周围动脉栓塞在 1988年已有报道[2 ] ,这一病变非常罕见 ,但其ＦＴ和粥样斑块碎片作为动脉栓塞的潜在来源 ,可导致脏器和肢体动脉栓塞 ,产生缺血症状 ,最严重的是冠状动脉和脑动脉栓塞 ,可危及生命。随影像学技术的发展 ,特别是临床上经食道超声心动图 (ＴＥＥ)的应用和推广 ,进一步加强了升主动脉、主动脉弓和降主动脉这些罕见部位血栓及斑块的检出 ,大大增加了该病的检出率 ,而…     

3D��ӡ��������Ԥ�������Ƹ�����������������

??3D printing guiding stent graft fenestration in endovascular aneurysm repair for complex aortic arch diseases LIU Chang-jian??LIU Zhao. Department of Vascular Surgery??Nanjing Drum Tower Hospital??the Affiliated Hospital of Nanjing University Medical School??Nanjing 210008??China
Corresponding author?? LIU Chang-jian??E-mail??dr_cjliu@
hotmail.com
Abstract The aortic arch diseases which involve important branches have high mortality and complications. It is one of the most difficult clinical challenges. The 3D printing aortic arch model can intuitively help surgeons to understand and determine the 3D relationships between aortic arch lesions and branches. Thus??it could provide guidance for TEVAR surgeries and making surgical plans. Moreover??the stent-graft can be deployed inside the 3D model and the branch opening localizations can be confirmed before operation. The authors introduced a new method of treatment for aortic arch diseases with triple pre-fenestrated stent-graft under 3D printing guidance.The procedure mainly includes????1?? data collection and 3D printing model production before the operation????2??accomplish the fenestration and reduction of the diameter of the stent graft by physicians on table during the operation????3?? deploy the aortic stent graft and branched stent grafts. The novel method has plenty of advantages????1?? the commercial thoracic aortic stent graft can be used for physician-modified stent-graft ??PMSG????which is cheap??and 3D printing model preparation can be completed within 6 hours.It takes a short time and even maybe used for emergency patients????2??the procedure is relatively simple and has short learning curve. Therefore??experienced vascular surgeons can be competent to implement it quickly after short-term training;??3??the 3D printing model can greatly improve the accuracy of pre-fenestration for aortic arch lesions with complex anatomical structures????4??the procedure is convenient and safe??with minimal trauma and quick recovery. There is no need for blood transfusion??extracorporeal circulation or hypothermia circulation????5??Because of reduction of stent graft and fenestrations??the blood supply of brain is sufficient during operation. The complicated procedure of extracorporeal bypass during triple in-situ fenestration can be avoided. As a result??it reduces the cerebral complications significantly. No death and type I inner leakage occurr during early postoperative follow-up??but the medium and long-term results remain to be further observed.     

����������ֲ3������

目的 探讨胰肾联合移植治疗糖尿病伴糖尿病肾病的疗效。方法 总结了近期施行的３例胰肾移植手术的方法、疗铲及并发症的防治。结果 ３例病人移植后分别于术后２０小时、第９天、１５小时停用外源性胰岛素,于术后第２天及第４天肾功能恢复正常。术后仅出现排斥反应和血尿并发症。均痊愈出院,定期随访。结论 胰肾联合移植是治疗糖尿病伴糖尿肾的最有效方法。供胰肾原位灌注、快速整块切取、以预防为主、加强围手术期管理是减少各     

Are 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors renoprotective?

Statins reduce serum cholesterol and cardiovascular morbidity and mortality. The mechanisms for these beneficial effects are reviewed. Altered inflammatory responses and improved endothelial function mediated by statins are thought to be partly responsible for the reduction of morbidity and mortality as a result of cardiovascular events. In analogy, whether statins confer similar benefits on the kidney has not been established. This review critically considers the available data whereby dyslipidemia mediates renal dysfunction by modulating the inflammatory response to diverse cytokines. Also reviewed is the emerging database indicating that statins may modulate renal function by altering the response of the kidney to dyslipidemia.