肝细胞癌合并门静脉、肝静脉或下腔静脉癌栓的处理

目的探讨肝细胞癌(HCC)合并门静脉(PV)、肝静脉或下腔静脉(IVC)癌栓的处理。方法总结1993年1月~2002年1月采用肝切除和癌栓取出术治疗HCC合并PV、肝静脉或IVC癌栓68例,其中PV癌栓63例,肝左静脉癌栓1例,肝中静脉癌栓合并PV左支癌栓1例,肝右静脉、IVC合并PV右支癌栓1例,IVC癌栓2例。结果6例患者术后3个月内死于肝肾功能衰竭,其中2例患者在术后30d内死亡,术后30d病死率为2.9%,其余62例患者术后恢复良好。结论肝切除和癌栓取出术治疗HCC合并PV、肝静脉或IVC癌栓是安全的。     

Effects of taste stimulation on the behavior of serum amino acid concentrations and amylase and trypsin activities in fasting rats

The effect of taste stimulation on serum free-amino acid concentrations and amylase and trypsin activities in fasting rats was studied. Following an acclimation period of 5 d, male Sprague-Dawley rats were fasted for 4 d and sacrificed after taste stimulation with a palatable sodium saccharin or unpalatable quinine sulfate flavored diet. Blood was collected from the portal vein and inferior vena cava at 0, 5, 10, 20 and 30 min after taste stimulation. Intestinal contents were also collected at the same time intervals as the blood collections. Total amino acid concentrations in the saccharin stimulated group increased significantly at 5 and 20 min following taste stimulation in comparison with the control of 0 time in the portal vein, and a significant difference between the saccharin and quinine stimulated groups was also observed at 5 min. No difference was found in the inferior vena cava. A high level of alanine and low level of glutamine were depicted in the portal vein as compared to that of the inferior vena cava. The elevation of alanine that is gluconeogenic amino acid was remarkable in the saccharin group at 20 min in the portal vein. Moreover, amylase and trypsin activities in the saccharin group reached peak values promptly and kept constant throughout the experiment as compared to the quinine group. The results suggest that taste stimulation originates changes in the cephalic phase amino acid concentrations in the portal vein and that taste information, overcoming a hunger, plays an important role in amino acid metabolism and digestive enzyme activities. Therefore, eating with gusto is significant for the maintenance of body functions even under starvation conditions.     

基于磁压榨技术的介入下肝外门腔分流器械的研制

介绍了一种门腔分流器械．包括子、母两个钕铁硼永磁体和介入操作器械。它基于磁压榨技术原理．通过介入途径分别将子、母磁体置入门静脉和下腔静脉．子母磁体自动对位相吸后压榨门静脉壁和下腔静脉壁。两周后．在二次介入操作下将子母磁体取出,门腔分流道即建立。主要用于门脉高压症微创分流手术。优点是介入下操作,门腔分流道建立后体内不存留任何异物．分流道可保持长期通畅．而且分流道口径不会扩张,可降低肝性脑病发生率。     

经口补充谷氨酰胺对烧伤大鼠小肠功能的影响

大鼠２０％ＢＳＡⅢ°烧伤后１４天，门静脉、后腔静脉和腹主动脉血浆谷氨酰胺（Ｌ一Ｇｌｕｔａｍｉｎｅ，Ｇｌｎ）含量均明显降低，小肠粘膜的蛋白质、ＤＮＡ、ＡＴＰ含量及乳糖酶活性均明显低于正常。烧伤后在饲料中补充２％或５％Ｇｌｎ，大鼠血浆Ｇｌｎ水平，小肠粘膜的蛋白质、ＤＮＡ、ＡＴＰ含量，以及乳糖酶活性均明显高于烧伤对照和补充甘氨酸（Ｇｌｙ）组，其中ＡＴＰ含量和乳糖酶活性接近正常组。补充５％Ｇｌｎ的大鼠血浆Ｇｌｎ水平高于２％Ｇｌｎ组，其他指标则并不优于补充２％Ｇｌｎ的动物。上述结果表明，烧伤后经口补充Ｇｌｎ，有助于支持肠道的物质和能量代谢，防治或减轻肠道功能的损伤。     

Echinococcus multilocularis infection in India: first case report proved at autopsy

The occurrence of Echinococcus multilocularis is reported in India for the first time. The patient was a young man, various clinical diagnoses were made and he finally died after an attempted membranotomy for suspected membranous obstruction in the inferior vena cava. Autopsy revealed classical E. multilocularis infection of the liver with direct spread of the inferior vena cava, the right atrium and through the diaphragm into the base of the left lung. It also had caused an outflow tract obstruction to the hepatic venous flow by direct physical pressure distorting the proximal intrahepatic portion of the inferior vena cava. In addition the patient had multi-valvular lesions of rheumatic origin and a terminal infective endocarditis due to staphyloccal infection.     

国产下腔静脉滤器保护下Trellis振动溶栓仪治疗下肢深静脉血栓形成的临床观察

目的：评价国产下腔静脉滤器保护下Trellis振动溶栓仪治疗下肢深静脉血栓形成的作用。方法：全组10例下肢深静脉血栓形成患者,首先放置国产下腔静脉滤器,然后切开股静脉,行Fogarty取栓管取栓,然后进行静脉造影,置入Trellis振动溶栓仪振动溶栓后Fogarty取栓管取栓,再次行静脉造影,比较前后溶栓效果。结果：在国产下腔静脉滤器保护下10例患者均未发生肺栓塞。首次Fogarty取栓管取栓后。7例虽然取出部分血栓,且导管可进入下腔静脉,但静脉造影可见静脉腔内仍有大量附壁血栓,管腔重度狭窄。插入振动溶栓导管进行静脉内振动溶栓后,通过振动溶栓导管吸栓孔可吸出少量已溶解的软血栓。撤出振动溶栓导管再次利用Fogarty取栓管取栓时则可取出大量已部分机化的附壁血栓。再次静脉造影可见静脉腔明显增宽,静脉壁较前明显光滑。2例Fogarty取栓管直接取栓无效,改为先行Trellis振动溶栓仪振动溶栓,有效的溶解了附壁血栓,再行Fogarty取栓管取栓成功。1例无法置入Trellis振动溶栓仪,溶栓失败,有效率90%。结论：国产腔静脉滤器可以有效地预防肺动脉栓塞,Trellis振动溶栓仪可以有效的溶解深静脉血栓,并具有微创、安全等优点。     

Dietary diacylglycerol-rich oil stimulation of glucose intolerance in genetically obese rats

The effects of dietary 1,3-diacylglycerol-rich oil (DG oil) on glucose and lipid metabolism were investigated in comparison with triacylglycerol (TG) oil in female genetically obese Wistar fatty rats. The obese rats and their lean littermates (8 wk old) were fed a synthetic diet containing 10%, (w/w) DG or TG oil for 5 wk. The body weights, abdominal fat weights, and the plasma and liver TG concentrations were not significantly different due to dietary fat type in the obese and lean rats. The plasma glucose concentrations were significantly elevated by dietary DG oil as compared to TG oil in the portal vein and inferior vena cava of obese and lean rats. The plasma free fatty acid concentrations were markedly elevated by dietary DG oil as compared to TG oil in the portal vein and inferior vena cava of both genotype rats, particularly in the obese rats. In the glucose tolerance test, the obese rats fed DG oil showed glucose intolerance, possibly due to the markedly elevated plasma free fatty acids. Thus, the effects of dietary DG oil on lipid-lowering effects and anti-obesity were not observed in either genotype in the present study. Moreover, it is remarkable that glucose intolerance was induced by dietary DG oil in the genetically obese rats. dietary     

下腔静脉永久性滤器置入术患者围手术期护理

目的:探讨下腔静脉滤器置入术患者围手术期护理要点。方法:对18例因下肢深静脉血栓行下腔静脉永久滤器置入术的患者实施精心护理。结果:18例患者术后均未发生致命性肺栓塞,未发生严重并发症。1例患者出现术肢深静脉血栓形成。结论:应用下肢静脉滤器置入术预防肺栓塞较为简单、安全和有效,术前、术中及术后的心理指导和正确护理有助于提高手术疗效,避免出现并发症。     

Direct azygos vein and superior vena cava cannulation for parenteral nutrition

As a result of superior vena cava thrombosis and ligation of the inferior vena cava, central venous access was limited in a patient with large, recurrent, intestinal fistulas. Transthoracic catheterization of the azygos vein provided a successful route for parenteral nutrition for 9 wk on one occasion, and transthoracic catheterization of the superior vena cava allowed parenteral nutrition for over 9 months on another.     

Digestion and absorption of sugars and sugar substitutes in rat small intestine

The bioavailability of newly developed sugar substitutes was observed by measuring the transmural potential difference (delta PD) evoked by Na+-dependent active transport of glucose, which is supposed to be produced by the hydrolysis of sugar substitutes. delta PD was measured using everted intestinal sac prepared from jejunum of adult rats and compared with the digestibility of sugar substitutes in the mucosal homogenate of everted sac. delta PDs evoked by glucose, maltose or maltosylfructose had almost the same levels, however, the delta PD evoked by sucrose was a little lower. delta PDs evoked by maltitol or palatinose were low, and delta PDs evoked by fructo-oligosaccharides were negligible. The hydrolyzing activities of these sugars and sugar substitutes by the mucosal homogenate were correlated with the delta PDs. A significant positive correlation was observed between delta PDmax of various sugars and sugar substitutes and the Vmax of their corresponding hydrolyzing activities. Also, a significant positive correlation was observed between Kt and Km values of these sugars. These results suggest that the absorption of sugar substitutes is dependent on digestibility by membrane digestive enzymes.     

The effect of acute poisoning with potassium nitrate and sodium nitrite on the processes of intestinal absorption of D-xylose in rats

The intestinal transport of D-xylose was studied during the acute poisoning of male Wistar rats with orally administered potassium nitrate and sodium nitrite. At the peak of xylose absorption, the metabolic parameters of Na⁺/K⁺-ATPase, alkaline phosphatase, oxygen uptake, and lactic acid level were determined in the small intestine mucosa. Nitrite in a dose of 80 mg NaNO₂/kg b.w. increased the permeability of gastric mucosa for D-xylose and raised the uptake of oxygen by the small intestine mucosa. No changes were observed in the activity of Na⁺+/K⁺-ATPase and alkaline phosphatase. A dose of 10 mg NaNO₂/kg b.w. was not followed by increased absorption of this sugar. It was also demonstrated that potassium nitrate had no effect on the process of intestinal absorption of D-xylose and failed to change the determined metabolic parameters of the small intestine mucosa.     

Two cannula method for parenteral infusion and serial blood sampling in the freely moving rat

Materials and techniques are described for positioning and exteriorizing two chronic venous cannulas in the rat. A cannula for fluid infusion is placed in the inferior vena cava via the femoral vein and exteriorized on the tail, whereas a cannula for blood withdrawal is placed in the superior vena cava and exteriorized in the scapular region. Grooming behavior and range of motion are not impeded since the cannula used for chronic infusion is shielded by a light-weight tail cover instead of a torso harness. Application of this method can minimize numbers of rats used in total parenteral nutrition (TPN) studies as demonstrated by our feasibility study in which serum parameters of liver function were serially monitored in toxin-treated rats infused with nutrient mixtures.     

Agenesis of inferior vena cava combined with multiple genetic predisposition in the case of deep venous thrombosis in a young male

Deep venous thrombosis in the young age may be a complication of the rare congenital abnormality of the vena cava inferior. Genetic factors predisposing to thrombophilia in coincidence with vena cava malformation put the patients at much higher risk to develop thrombosis. The authors report a case of a 25-year old male who suffered from a massive deep venous thrombosis derived from the vena poplitea involving the vena iliaca communis. The molecular genetic examination of the patient revealed his combined genetic predisposition to venous thrombosis (Heterozygosity for Factor V. Leiden, Heterozygosity for prothrombin G20210A). Authors conclude that it is essential to perform all the relevant molecular genetic examinations to identify the presence of thrombophilic vulnerabilty and radiological imaging procedures in all cases of young patients with deep venous thrombosis if the suspicion of vascular malformation arises. The review of the literature revealed that the vena cava malformation in association with genetic factor predisposing to thrombophilia is an infrequent condition. In the authors knowledge this is the first report presenting a multiple combined genetic predisposition of risk factors in deep venous thrombosis.     

Relationship between zinc and prostaglandin metabolisms in plasma and small intestine of rats

The effect of zinc nutriture on levels of prostaglandin (PG) E2, F2 alpha and 6-keto-PGF1 alpha in the plasma and small intestine of rats, and that of PGE2 and PGF2 alpha on unidirectional uptake of 65Zn by everted gut sac of rats was determined. When zinc was given intraperitoneally, plasma PGE2 and intestinal PGF2 alpha levels increased, while the intestinal PGE2 and the plasma PGF2 alpha and 6-keto-PGF1 alpha levels decreased in accordance with the amount of zinc given. Oral administration of excess zinc increased intestinal PGE2, PGF2 alpha and 6-keto-PGF1 alpha levels and the plasma 6-keto-PGF1 alpha levels. The intestinal levels of PGE2 increased significantly only in rats on zinc excess diet, and of PGF2 alpha only in rats on a zinc deficient diet. The plasma PGE2 levels in rats on both zinc deficient and zinc excess diets increased but PGF2 alpha levels in zinc deficient rats were greatly reduced compared to controls. Unidirectional zinc uptake by everted gut sac of the rat is also enhanced by PG metabolites. These results are consistent with the view that PGs participate in regulating the zinc transport mechanism in small intestine.     

实时超声引导在60例早产儿脐静脉置管术中的应用研究

目的 探讨实时超声引导在早产儿脐静脉置管术的应用价值。方法 通过对需进行脐静脉置管的60例早产儿进行实时超声引导脐静脉置管,置管前应用高频探头测量引导路径各段的长度,估算导管插入长度,置管术中根据超声测值预判导管顶端置于脐静脉肝内段时开始进行实时超声引导,缓慢引导导管顶端通过门静脉左支囊部、静脉导管到达下腔静脉内,而未进入右心房内,回抽血顺利,固定导管后,超声扫查再次确认导管顶端置于下腔静脉内,引导结束。结果 60例研究对象中脐静脉置管一次性置管成功率达93.3%(56/60);术前超声测量引导路径预判导管插入深度(7.70±0.72)cm,实际置管深度(7.59±1.20) cm,差异无统计学意义(P=0.574)。结论 实时超声引导下脐静脉置管的一次性置管成功率高,具有很好的导航作用,且可明确置管失败的原因;术前应用超声检查可观察置管路径各段的情况,且术前超声测量引导路径预判导管插入深度可给实际置管提供参考。     

雏鸡离体空肠对纳米氧化铜吸收速率的研究

目的:采用翻转肠囊法研究雏鸡离体空肠对硫酸铜、氧化铜和纳米氧化铜的吸收速率。方法:选取50日龄白莱航公雏鸡9只,随机分为3组,扑杀后取空肠制成3段翻转肠囊,翻转肠囊长4~5 cm,进行体外培养。1~3组培养基质中分别以硫酸铜、氧化铜和纳米氧化铜的形式添加铜16 mg/L。结果:在培养时间为0.5、1和1.5 h,空肠对纳米氧化铜的吸收速率显著高于硫酸铜和氧化铜(P<0.05),纳米氧化铜组空肠肠壁铜沉积极显著高于硫酸铜和氧化铜组(P<0.01)。结论:试验表明,雏鸡离体空肠对纳米氧化铜的吸收速率显著高于硫酸铜和氧化铜。     

Deep venous thrombosis as a complication of congenital absence of vena cava inferior]

A 19-year-old man was admitted with fever, haematuria, general malaise, pain on the left side of the pelvis and a full feeling in the left lower abdominal quadrant of the abdomen. His history mentioned a varices operation. During admission he developed an acute abdomen and deep vein thrombosis in both legs. CT of the abdomen showed a pathologic mass and absence of the vena cava inferior. Laparotomy revealed extensive thrombosis in widened veins. Clinical improvement occurred following adequate thrombolysis. Congenital absence of the vena cava inferior results from aberrant development during organogenesis. Patients are typically asymptomatic, but may present with venous insufficiency at a young age and deep vein thrombosis. Absence of the vena cava inferior can be accompanied by other congenital abnormalities such as dextrocardia and congenital heart diseases. Diagnosis is made using CT or MRI. Treatment consists of lifelong anticoagulant therapy and, if necessary, surgery.     

Stimulation of lead absorption by vitamin D administration.

Two methods for the determination of lead absorption have been developed using the rat as the test animal. One is an everted intestinal sac method in which the time course of 210Pb transport across intestinal wall can be followed in vitro; and the other, 210Pb absorption from the intestine following gastric intubation can be followed in vivo. By using these techniques it can be clearly demonstrated that vitamin D markedly enhances lead absorption. Both techniques provide evidence that the distal small intestine is the major site of lead absorption and the site of greatest vitamin D stimulation. Lead acetate is apparently absorbed to the extent of 45% as it passes through the small intestine at a concentration of 0.01 mM.     

A case of essential mesocaval shunt

Essential mesocaval shunt is very rare entity. A case of chronic cholecystitis with mesocaval shunt from the branch of superior mesenteric vein was reported. This rare hepatofugal pathway was clearly demonstrated by percutaneous transhepatic portography. Selective middle colic venography showed that the branch of this vein was directly connected to the inferior vena cava. After ligation and resection of the shunt, the level of patient's blood ammonia was decreased and the pressure of portal vein was increased. This rare case indicate that the possibility of early diagnosis and interventional radiology for +hepatic encephalopathy.     

下肢静脉步进式数字减影血管造影的优势

目的探讨下肢静脉步进DSA（数字减影血管造影）较常规分段DSA的优势。方法将98例需行下肢静脉造影的患肢随机分成两组,研究组49例行步进式DSA,对照组49例行常规分段DSA,并对两组造影影像质量、对比剂的平均用量、平均辐射剂量和平均检查时间进行评价。结果研究组对比剂使用总量较对照组下降33．33％,并且研究组髂静脉和下腔静脉显示清楚率较对照组分别提高了22．44％和67．34％,研究组均术出现因对比剂滞留而出现伪影;研究组平均辐射剂培较对照组下降54．91％,平均检查时间较对照组下降了65．45％。结论下肢静脉步进DSA较常规分段DSA在对比剂用最,检查时间,辐射剂量和髂静脉和下腔静脉的显示方面存在优势。