先天性食管闭锁手术后吻合口狭窄的介入治疗

目的 报道13例先天性食管闭锁术后食管吻合口狭窄婴儿使用球囊扩张术治疗。方法 13例患儿均为食管闭锁术后吻合口狭窄,年龄为3～10个月,球囊扩张前均先行食管吞钡检查,显示狭窄段内径仅1～3mm。采用球囊导管分次扩张。所用球囊直径6～12mm。结果 每例经2～3次扩张,13例共进行球囊扩张30次,扩张后疗效明显,保持临床无症状期6～30个月,无食管穿孔并发症。结论 球囊扩张术简单、安全、有效,为婴儿先天性食管闭锁手术后吻合口狭窄的首选疗法。     

球囊扩张治疗小儿上胃肠道狭窄

目的:探讨球囊扩张成形术在小儿上胃肠道狭窄中的应用价值.方法:回顾性分析9例小儿上胃肠道狭窄球囊扩张治疗前后的胃肠造影表现.其中,先天性食管下段狭窄4例,贲门失弛缓症3例,强碱食管腐蚀伤后狭窄1例,十二指肠隔膜状狭窄术后吻合口狭窄1例.7例行两次球囊扩张,1例行三次球囊扩张,1例行一次球囊扩张.扩张前均行上消化道钡餐或碘油造影检查,明确病灶部位及狭窄程度后分别使用8 mm×40 mm～20 mm×40 mm球囊进行扩张;扩张后复查上消化道造影进行对照分析.结果:6例患儿扩张前狭窄段直径约0.3～0.5 cm,扩张后达1.4～2.0 cm;2例经球囊扩张后狭窄段直径达0.8～1.0 cm,梗阻症状明显改善,后转手术治疗;1例行一次扩张后自动出院,治疗效果不详.结论:球囊扩张成形术创伤小,操作简便,效果良好,是治疗小儿上胃肠道狭窄的首选方法.     

球囊扩张术治疗儿童食管良性狭窄的疗效北大核心CSCD

目的 探讨透视下球囊扩张术治疗不同原因的儿童食管良性狭窄的疗效及安全性。方法 回顾性分析2018年3月至2021年5月天津市儿童医院收治的17例食管良性狭窄患儿的临床资料。患儿中,食管闭锁术后吻合口狭窄组(Ⅰ组)8例,腐蚀性食管狭窄组(Ⅱ组)5例,食道裂孔疝加贲门成形术后贲门狭窄1例,贲门失迟缓症1例,先天性食管狭窄1例。患儿存在吞咽困难,经X线钡餐造影确诊食管狭窄后,在放射线引导下进行食管狭窄的球囊扩张治疗,术后随访6~18个月,观察疗效。结果 17例患儿共进行49次球囊扩张术,每例患儿平均扩张2.88次(1~9次),球囊直径为6~25 mm。Ⅰ组患儿扩张成功7例;Ⅱ组患儿成功扩张4例,其余患儿均扩张成功。术后随访6~18个月,长期有效13例,Ⅰ组长期有效6例,Ⅱ组长期有效4例,余患儿均长期有效。术中术后均无严重并发症出现。结论 透视下食管球囊扩张术治疗不同原因儿童食管良性狭窄安全有效。     

儿童食管化学性灼伤致疤痕狭窄的介入治疗

目的 探讨儿童食管化学性灼伤致疤痕狭窄的介入球囊扩张治疗的疗效。方法 8例化学性灼伤致食管疤痕患儿在出现临床症状如咽下困难，反流，及呕吐后1-3月内接受了球囊扩张治疗，全部患儿经随访6个月-2年。结果 8例患儿经球囊扩张治疗4-12次。其中7例临床症状明显改善，基本上能进普食，随访6个月-2年无狭窄症状；1例碱性物质灼伤共经12次扩张治疗效果不佳。行外科手术治疗。结论 球囊扩张术治疗儿童食管化学性灼伤致疤痕狭窄是一种安全可靠有效的治疗方法，但食管狭窄严重经多次球囊扩张术无效，需手术治疗。     

透视下球囊扩张术治疗婴幼儿食管良性狭窄的临床疗效分析

目的：探讨透视下球囊扩张术治疗婴幼儿食管良性狭窄的临床疗效及安全性。 方法：回顾性分析我院2007年7月至2015年12月收治的53例食管良性狭窄患儿（其中食管腐蚀性狭窄组14例,食管闭锁术后吻合口狭窄组39例）的临床资料,所有患儿经X线钡餐造影确诊后,在影像引导下进行食管狭窄的球囊扩张治疗,比较两组术中的扩张效果。术后随访6~18个月,观察并比较两组疗效。 结果：53例患儿共进行187次球囊扩张术,平均每个患儿扩张3.5次（范围1~11次）,球囊直径范围为6~20 mm。食管腐蚀性狭窄组患儿均需经过两次及以上扩张,扩张成功14例（100%）。食管吻合口狭窄组患儿中,1次扩张成功11例（28.2%）,两次及以上扩张成功28例（71.8%）。两组的扩张次数差异无统计学意义（P>0.05）。术后行X线钡餐造影示食道狭窄段较前显著扩张,造影剂通过顺利,达到治愈标准,扩张成功率为100%。所有患儿术后随访6~18个月,总有效率（79.2%,42/53）,吻合口狭窄组患儿FBD治疗有效率（87.1%,34/39）高于腐蚀性狭窄组（57.1%,8/14）,差异有统计学意义（χ²=3.972,P<0.05）。 结论：透视下球囊扩张术治疗婴幼儿食管良性狭窄临床疗效显著,特别对于食管闭锁术后吻合口狭窄的患儿,安全性好,且易操作,临床应用和推广价值高。     

带囊导管扩张术治疗儿童良性食管狭窄

目的 评价儿童良性食管狭窄使用球囊扩张术治疗的疗效。方法 22例食管良性狭窄，其中，食管吻合术后吻合口狭窄9例，食管化学性灼伤后狭窄11例，Nisson术后食管下端狭窄1例，胃管代食管术后胃管段狭窄1例，用球囊扩张术治疗。结果 21例治愈，术后随访6－30个月保持临床无症状，治疗效果满意。结论 本方法安全简单、安全易行又实用，是食管良性狭窄首选的治疗方法。     

婴儿食管吻合口狭窄球囊扩张术

目的：本文报告４例婴儿食管吻合口狭窄使用球囊扩张术治疗。材料和方法：４例女婴均为食物闭锁术后２￣１５个月出现吻合口狭窄，狭窄内径３￣６ｍｍ。采用球囊导管分次扩张，球囊直径６￣１５ｍｍ。结果：４例共进行球囊扩张１２次，保持临床无症状期４￣６个月。无食管穿孔并发症。结论：球囊扩张术简单、安全、有效，为婴儿食物吻合口狭窄的首选治疗方法。     

食管上段狭窄球囊扩张及内支架治疗的临床疗效(附47例报告)

目的:探讨食管上段良、恶性狭窄行球囊扩张及内支架治疗的临床疗效。方法:对4 7例食管上段恶性狭窄4 4例,良性狭窄3例行食管球囊扩张及内支架置入,以食管钡餐造影及纤维内窥镜检查随访。结果:4 4例食管上段术后狭窄位于颈段食管2 1例,胸段食管2 3例行球囊扩张并行食管内支架,随访1～38个月,术后生存时间平均7～8个月。3例食管上段化学灼伤良性狭窄,狭窄均位于胸段,随访1～3年,患者进食无异常。结论:食管上段良、恶性狭窄行球囊扩张并内支架置入是治疗食管狭窄的有效方法     

食管-胃吻合口严重瘢痕性狭窄大球囊过度扩张治疗

目的探讨大球囊扩张成形治疗食管-胃吻合口严重瘢痕性狭窄的疗效和价值。方法透视下应用直径27～30mm的大球囊导管对36例食管-胃吻合口瘢痕性狭窄患者进行扩张治疗。结果26例(72．2％)一次性扩张治愈,8例(22．2％)扩张2次,2例(5．6％)扩张3次。术后随访6～40个月,吞咽困难缓解率100％,均无严重并发症和复发。结论利用大球囊扩张成形治疗食管一胃吻合口瘢痕性狭窄安全、有效,可取代内支架置入达到根治目的,值得大力推广。     

同轴双囊导管扩张术治疗贲门失弛缓症(附46例疗效分析)

球囊扩张术对上胃肠道吻合口狭窄、先天性食管狭窄以及食管灼伤后狭窄已有肯定的疗效,但对贲门失弛缓症的评价褒贬不一。我们四年来,用大球囊扩张治疗的方法,对46例患者实施了扩张,除7例扩张后不足一年,一例无效外,其余38例效果满意。资料与方法自1988年6月以来,经我们收治的贲门失弛缓症46例(男16例,女30例),年龄8～56岁(平均31岁),病史最短7个月,最长15年,(平均2年5个月),总计施行贲门扩张131次,所有病例均进行随访观察。根据病人吞咽困难的程度、呕吐次数及钡餐检查     

成批煤气爆燃烧伤的救治体会

报道治疗因煤气泄漏爆炸烧伤病员7例，经应用MEBT技术积极救治，其中6例于伤后17天痊愈出院，另一例特重伤员也于伤后30天康复出院。作者认为：应严格按照MEBT／MEBO要求进行规范治疗，正确处理生命体征、休克、感染、脏器功能和创面的辨证关系。同时，不能忽视外科营养在过程中的重要作用，它是创面修复的物质保证。     

Glutamine supplementation in vitro and in vivo,in exercise and in immunodepression

In situations of stress, such as clinical trauma, starvation or prolonged, strenuous exercise, the concentration of glutamine in the blood is decreased, often substantially. In endurance athletes this decrease occurs concomitantly with relatively transient immunodepression. Glutamine is used as a fuel by some cells of the immune system. Provision of glutamine or a glutamine precursor, such as branched chain amino acids, has been seen to have a beneficial effect on gut function, on morbidity and mortality, and on some aspects of immune cell function in clinical studies. It has also been seen to decrease the self-reported incidence of illness in endurance athletes. So far, there is no firm evidence as to precisely which aspect of the immune system is affected by glutamine feeding during the transient immunodepression that occurs after prolonged, strenuous exercise. However, there is increasing evidence that neutrophils may be implicated. Other aspects of glutamine and glutamine supplementation are also addressed.     

新疆石河子地区奶牛隐性乳房炎的调查与分析

采用LMT法对新疆石河子地区三个规模化奶牛场泌乳牛群进行了隐性乳房炎检测,共检测994头泌乳牛3976个乳区.结果表明:奶牛隐性乳房炎阳性率为81.9%,乳区阳性率为49.1%.数据分析表明,不同年龄、胎次以及有无卧床奶牛的隐性乳房炎阳性率差异显著(P<0.05),后乳区的隐性乳房炎感染率显著高于前乳区感染率(P<0.05),隐性乳房炎乳区发生数也明显影响当日产奶量(P<0.05).     

Sex differences in neuromuscular fatigability in response to load carriage in the field in British Army recruits

Objectives

Women are resistant to neuromuscular fatigue compared to men in response to a range of exercise tasks. The sex differences in the neuromuscular responses to load carriage have yet to be investigated.

Decrease in eccentric hamstring strength in runners in the Tirol Speed Marathon

Background

The local muscular endurance of knee flexors, during eccentric work in particular, is important in preventing or delaying kinematic changes associated with fatigue during treadmill running. This result, however, may not be transferable to overground running.

Objective

To test the hypothesis that overground running is associated with eccentric hamstring fatigue.

Methods

Thirteen runners (12 male and one female) performed an isokinetic muscle test three to four days before and 18 hours after a marathon. Both legs were tested. The testing protocol consisted of concentric and eccentric quadriceps and hamstring contractions.

Results

There were no significant differences between peak torque before and after the race, except that eccentric peak hamstring torque (both thighs) was reduced.

Conclusion

Overground running (running a marathon) is associated with eccentric hamstring fatigue. Eccentric hamstring fatigue may be a potential risk factor for knee and soft tissue injuries during running. Eccentric hamstring training should therefore be introduced as an integral part of the training programme of runners.     

肺心病慢性呼吸性酸中毒合并代谢性酸碱失衡判断方法探讨(附80例次血气分析)

目的：对42例肺心病慢性呼吸性酸中毒患者的80例次血气测定结果。方法：用不同的酸碱图（卡）及代偿公式进行酸碱类型的初步差别分析。结果：结合临床表现、各种影响因素与治疗反应等作出综合判定。结论：比较二种判定的差异，并提出较为实用、可靠的判断建议，以助于复合型呼吸性酸碱失衡的临床诊断与处理。     

Oxalosis in primary hyperoxaluria in infancy

Primary hyperoxaluria (PH1) is a rare inborn autosomal recessive metabolic disorder due to the deficiency of hepatic alanine-glyoxylate-aminotransferase. This deficiency results in excessive synthesis and urinary excretion of oxalate, inducing renal stone formation and deposition of calcium oxalate in the kidney, bone, myocardium, and vessels (systemic oxalosis, SO) in the most severely affected individuals. We report renal and skeletal changes in a 3-month-old girl with PH1 and SO. Intense cortico-medullary hyperechogenicity and increased homogeneous radiopacity of normal-sized kidneys suggested the diagnosis of SO. Skeletal survey showed osteopenia and characteristic symmetrical metaphyseal transverse bands in long bones, progressively becoming more dense and migrating towards the diaphysis. Multiple pathological and slowly healing fractures of the limbs occurred at the dense band level. A radiopaque rim was then observed in flat bones, epiphyseal nuclei, and vertebral bodies. Inflammatory granulomatous reaction, induced by the presence of oxalate crystals in the marrow spaces, coexisted with progressively evident radiological signs of secondary hyperparathyroidism, with partially overlapping features. The patient was treated by peritoneal dialysis and hemodialysis until combined liver–kidney transplantation. There are no previous reports of infants treated with hemodialysis for more than 2 years.     

Interventional radiology in oncology in private practice

Interventional oncology in private practice requires expert training and can be performed in a stand-alone facility for type 1 procedures in a hospital setting for type 2 and 3 procedures where subspecialized radiologists, state-of-the-art equipment, and postprocedure hospital monitoring are available. A multidisciplinary effort with oncologists, internal medicine physicians and anesthesiologists is necessary. The practice of interventional oncology requires around the clock availability, meticulous and established protocols and procedures and a financial investment. On the other hand, it is professionally gratifying because of constant technical advances and the impact on patients.