白细胞介素2葡聚糖微球并碘油栓塞治疗肝癌的动物实验

目的观察白细胞介素2(IL-2)葡聚糖微球并碘油经肝动脉栓塞后、实验兔肝种植瘤灶的坏死程度及其免疫功能的改变。方法20只肝脏载瘤兔,经肝动脉注入IL-2葡聚糖微球并碘油栓塞,栓塞前、后取血测IL-2和sIL-2R,栓塞后1周处死实验兔取瘤灶,进行光、电镜病理学检查,并以空白葡聚糖微球并碘油栓塞行对比观察。结果用药组术后IL-2血浓度明显升高,sIL-2R则明显下降,1周后瘤结节完全坏死,假包膜形成。对照组术后IL-2血浓度回升,sIL-2R下降,瘤结节中心性部分坏死,无假包膜形成。结论IL-2葡聚糖微球组与空白葡聚糖微球组各观察指标的对比分析表明,前者在肿瘤坏死程度、免疫功能促进方面明显优于后者。     

肝动脉化疗栓塞治疗富血供肝癌碘油灌注剂量的研究

目的:探讨肝动脉化疗栓塞治疗富血供肝癌的碘油灌注剂量.方法:120例富血供的肝癌患者,实验组用大剂量碘油,对照组用常规剂量碘油经肝动脉化疗栓塞肿瘤,一个月左右后,用CT扫描观察肿瘤区碘油沉积程度.结果:实验组碘油沉积良好率优于对照组.结论:大剂量碘油灌注化疗栓塞治疗富血供肝癌,碘油沉积更密集,栓塞更彻底,疗效更好.     

肝癌肝动脉碘油栓塞术后肝区平片的诊断价值

目的：探讨肝癌动脉碘油栓塞术后肝区平片诊断价值。材料与方法：40例原发性肝癌，男36例，女4例，平均年龄52岁，无经肝固有动脉行DSA及碘油乳剂栓塞，栓塞术后1周每月摄取肝区平片，分析肝区平片碘油聚集形式、碘油聚集大小、空缺现象与肿瘤大小、复发的关系。结果：肝癌动脉碘油栓塞术后肝区平片，检查简便、经济、能初步估价肝癌磺油栓塞术的疗效及有无复发。     

微导管栓塞技术在小肝癌中的应用

目的 研究微导管栓塞技术在小肝癌治疗中的临床价值。方法 ２６例单结节小肼癌（原发性２３例,转移性３例）接受了８３次微导管栓塞术治疗。其中,施行瘤内热碘油栓塞术８０次（２６例）,载瘤动脉保护性微弹簧栓塞术２次,瘤内动、静脉瘘无水酒精栓塞术１次。结果 ２６例均获得瘤体内完全性、充填性热碘油栓塞。２例施行了手术节除,病理检查显示：癌组织坏死１００％。全组平均随访３５个月（１４￣５５个月）,患者均存活,未     

微球联合碘油栓塞治疗肝癌的初步经验

目的 研究采用微球联合碘油作为栓塞剂治疗肝癌的安全性及疗效.方法 对肝癌患者行经动脉化疗栓塞(TACE)治疗时除使用化疗药物外,选用直径300～500μm的微球1～2ml及碘油10～20 ml作为栓塞剂.分别观察患者术前、术后肝功能、血清甲胎蛋白(AFP)水平、肿瘤的改变情况及栓塞相关并发症.结果 36例原发性肝癌患者入选本组研究.TACE术后患者黄疸指数、丙氨酸转氨酶和碱性磷酸酶均有不同程度升高,血清白蛋白、AFP水平明显降低;肿瘤不同程度坏死、缩小明显(P＜0.05).结论 在肝癌介入治疗中,使用微球联合碘油作为栓塞剂,疗效明显;但可造成一定程度的肝功能损害,应注意栓塞剂的用量及肝功能保护.     

肝节段动脉栓塞治疗原发性肝癌

目的：研究以无水乙醇碘油乳剂作栓塞剂，行肝节段动脉栓塞术治疗原发性肝癌。材料和方法：观察４例无水乙醇碘油乳剂选择性栓塞正常狗肝动脉前后的门脉血流动力学改变。采用同一栓塞剂，行肝节段动脉栓塞术治疗原发性肝癌患者３４例。依肿瘤的类型、血供特点分别采用３种不同的栓塞技术：同轴导管法、直接法或药物辅助法。结果：实验性肝动脉栓塞后，门脉造影表现出局部门脉分支的阻塞性改变。镜下见肝实质内栓塞剂沉积区域的门脉分支内有滴状的无水乙醇碘油乳剂。临床治疗３４例后均无严重并发症出现，随访３～１８个月，２４例非手术患者中有６例出现局部复发，目前尚存活２１例；１０例患者接受二期手术，术后病检４例肿瘤完全坏死，其余６例包括子灶、包膜浸润癌灶均可见明显坏死，均未发现弥漫性肝损害。结论：行肝节段动脉栓塞术，能使肿瘤所在部位达到动门脉双重栓塞，且并发症少，对于病灶局限的原发性肝癌是一种很好的治疗手段。     

肝细胞性肝癌:MRI与病理对照研究

为了解肝癌MRI表现的病理基础,作者对63例组织学证实的肝癌病例进行了MRI与病理对照研究。男48例,女15例,共72处病灶;MRI检查与组织学检查间隔在4周内。26个肿瘤直径<2cm,16个2～3 cm,30个≥3 cm。61例伴有肝硬化或慢性肝炎,全部病例在行MRI检查和组织学证实之前未行肝动脉栓塞及化疗。所用MR为1.5T,用SET_1、T_2加权象。病理主要观察纤维包膜和镶嵌征象(肉眼所见肿瘤的不均匀性或/和肿瘤内存在的纤维分隔)。根据瘤细胞的分化程度分为Ⅰ～Ⅳ级;根据组织学所见分为索状型、假腺管型、实体型和硬化型。另外还观察了肿瘤内有无脂肪变性、坏死、出血、铁质沉积以及肝窦状隙扩大。影象分析包括观察肿瘤包膜(肿瘤周围环状结构)及镶嵌征象(肿瘤信号     

膈下动脉碘油化疗药物栓塞治疗肝癌

目的　评价膈下动脉碘油化疗药物栓塞对肝癌治疗的疗效及膈下动脉供血的肿瘤的部位。方法　 2 5例肝癌 ,巨块型 12例、结节型 8例、多发结节型 5例。均采用Seldingers法行肝动脉和膈下动脉碘油化疗药物及明胶海绵颗粒栓塞。结果　膈下动脉发自于腹腔干起始处者 16例 ,占 6 4 % ,直接发自主动脉腹腔干周围者 8例 ,占 32 %。其中供应右叶 (Ⅶ ,Ⅷ段 ) 2 3例 ;肿瘤位于左叶 (Ⅳ段 )膈下者2例。膈下动脉碘油化疗药物栓塞后累积 1、2年生存率分别是 84 %和 6 8%。未出现严重并发症。结论　经膈下动脉碘油化疗药物栓塞治疗肝癌是一种安全有效的方法。当肿瘤位于膈下 ,邻近膈肌 ,肝韧带或肝裸区 ,特别是肝动脉造影时肿瘤染色有缺损或无肿瘤染色 ,但肿瘤在CT上有增强或血AFP升高时 ,应考虑到肿瘤由膈下动脉供血。     

对比微球与传统碘油栓塞治疗原发性肝癌疗效

原发性肝癌是世界上最常见的恶性肿瘤之一,经导管动脉化疗栓塞术（TACE）已经成为公认的肝癌非手术治疗的首选方法。碘油是目前临床治疗肝癌最常用的栓塞剂,微球是一种新型的末梢栓塞剂,近年来,有学者认为微球栓塞延长肝癌患者的生存率,而且毒性较小,其临床疗效优于应用碘油的传统TACE;然而,另一些学者则认为传统碘油栓塞更具优势。本文就这两种栓塞剂研究进展及其疗效对比加以综述。     

暂时阻断肝静脉行动脉化疗栓塞治疗栓塞治疗大鼠移植性肝肿瘤

目的　观察暂时阻断肝静脉行肝动脉化疗栓塞术 (TACE -THVO)的疗效 ,对比阿霉素碘油 ,无水乙醇碘油化疗栓塞剂对移植瘤的作用。方法　建立 75只肝内移植性肝癌大鼠模型 ,随机将其分为 5组 ,设立对照 ,暂时阻断肝静脉后 ,用 2种不同的化疗药物碘油栓塞剂行肝动脉化疗栓塞术。 1周后 ,处死实验大鼠 ,观察大体标本与光镜下苏木素 -伊红染色病理切片的移植瘤缩小和坏死状况 ;苏丹Ⅲ染色切片光镜及扫描电镜观察药物碘油栓塞剂沉积部位与瘤细胞超微结构改变。结果　经肝动脉化疗栓塞治疗各组瘤灶体积均缩小。TACE -THVO试验组的肿瘤生长率小于未阻断肝静脉行肝动脉化疗栓塞的对照组 ;试验组肿瘤坏死范围和门静脉碘油沉积例数高于对照组 ;应用阿霉素碘油栓塞剂行肝动脉化疗栓塞术组的肿瘤坏死范围小于用无水乙醇碘油栓塞剂组 ;试验组中肿瘤细胞粗面内质网出现空泡变性 ,瘤细胞核内出现脂滴样物质 ,细胞核崩解。结论　用无水乙醇碘油做化疗栓塞剂经肝动脉栓塞移植性肝癌 ,其肿瘤的坏死范围高于用阿霉素碘油栓塞剂 ,TACE -THVO有可能成为治疗肝癌的一种有效方法。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.