大网膜片覆盖肝断面减少肝切除术中和术后出血

为解决肝切除术中出血和术后继发性出血问题,中国医学科学院肿瘤医院腹部外科从1983年至1990年对115例肝癌切除术中,应用游离的大网膜片紧密贴附于肝断面。通过其纤维素生成、快速修复及良好的粘附能力,与肝断面迅速发生纤维素粘连、肉芽组织生成井机化,“封闭”肝断面,从而减少了术中出血,避免了术后继发性出血,大大减少了术后并发症发生,其中胸水7．8％,肺炎3．1％,膈下感染3．1％,切口感染1．4％,上消化道出血0．7％,胆瘘0．7％,均低于文献报道。无一手术死亡和住院死亡。与传统的肝断面处理的其他方法相比,使用游离的大…     

如意巴布剂中透皮促进剂的筛选研究

旨在筛选如意巴布剂中透皮促进剂的种类和用量。采有体外扩散池法，以如意巴布剂中小檗碱的经皮渗透量为指标，用ＨＰＬＣ法定量检测透过的小檗碱。结果表明，与不含促透剂样品比较，３％氮酮与１０％丙二醇合用可显著提高如意巴布剂中小檗碱的经皮渗透（Ｐ＜０．０１），７２ｈ中小檗碱的累积透过量增加了１６８．３％，经皮渗透速率提高了１．６３倍。说明３％氮酮与１０％丙二醇合用为如意巴布剂中最佳透皮促进剂，其中小檗碱的经皮渗透符合一级速率过程。     

小儿中小面积烧伤并消化道出血26例分析

目的 :探讨小儿烧伤消化道出血的临床特点及治疗。方法 :回顾分析 2 6例小儿烧伤后消化道出血的发病特点及治疗。结果 :治愈 2 0例 ,死亡 3例。结论 :早期及时有效的液体复苏是预防消化道出血的关键。H2 受体阻滞剂、止血药的正确应用及手术是抢救成功的重要方法。     

恶性肿瘤会遗传吗？

恶性肿瘤会遗传吗?越来越多的人关心这个问题。肿瘤病人担心会殃及子女,家属担心癌症的厄运迟早会降临自己。 已有的研究表明,癌变是一个多因子、多阶段、多途径的过程。一个正常细胞在内、外环境因素作用下,要经过多次的遗传物质的改变,才会变成增长不受控制的癌细胞。因此,从细胞水平上看,恶性肿瘤是一类遗传病。     

烫伤大鼠结肠动力基本功能单位细胞损害和内质网应激研究

Objective To observe expressions of glucose-regulated protein (GRF78) and caspase-12 in nervous system-interstitial cells of Cajal (ICC) in smooth muscle in colonic wall in rats with scald inju-ry, as well as their relevant ultrastructural changes, so as to probe the possible mechanisms of dynamic dam-age in murine colon after a scald injury. Methods Fifty healthy Sprague-Dawley rats were randomly di-vided into scald (n =40) and control (n = 10) groups. Rats in scald group were inflicted with 30% TBSA full-thickness scald, and received an intraperitoneally injection of Ringer lactate solution (50 mg/kg) for re-suscitation, while those in control group had similar treatment with the exception of scald. Rats in control group and scald group were sacrificed at 3, 6, 12, 24 post scald hour ( PSH, 10 rats at each time point) for collection of 4 cm of colonic tissue, 5 cm proximal to the cecum. A segment of colonic wall, 1 cm in length, was obtained from the middle of the harvested segment of colon, and it was fixed with 3% glutaraldebyde or 10% formaldehyde. The samples fixed with glutaraldehyde were used to observe uhrastructural alterations under transmission electron microscope, while that with formaldehyde were used to observe expressions of GRP78 and caspase-12 in colonic wall by immunohistochemical assay. Results The colonic smooth mus-cle cells of rats in control group showed regular arrangment, their organelles were abundant, nucleus central-ly located, euchromatin distributed evenly with more abundant mitochondrial cristae and less smooth endo-plasmic reticulum, neuronal organelles were abundant in intermuscular plexus, and ICC could be seen in the neighborhood of neurons. The colonic smooth muscle cells appeared in irregular and disordered manner in scald group, perinuclear space was widened, intercellular vacuoles were observed, mitochondria showed vac-uolation degeneration with dissolved and condensed cristae, rough endoplasmic reticula were dilated with par-tial dissolution, and perinuclear cytoplasm of ICC was obviously decreased. The expression of GRP78 was increased in scald group at 3, 6, 12 PSH (4.3±0.9, 6.0±0.7,4.8±1.1 score) as compared with that in control group ( 2.4±0.7 score, P<0.05 ). The expression of caspase-12 in scald group at 6, 12, 24 PSH was higher than that in control group (P<0.05). GRP78 was consistantly expressed in cytoplasm in con-trol group, while in scald group, it mainly appeared in mucosa, myenteric plexus, and stromal cells, but on-ly moderately or lightly expressed in smooth muscle cells. The expression of GRP78 was positive in scald group at 3, 6, 12 PSH, strongly positive at 6 PSH, and it was also expressed in cytoplasm in control group. The expression of caspase-12 in scald group was not obviously positive at 3 PSH, and weakly positive at 6, 24 PSH, but strongly positive at 12 PSH, while no expression was shown in control group. Conclusions Marked pathological changes are observed in enteric nervous system-interstitial cells of Cajal-smooth muscle in rats with severe scald injury. It may be related with cellular injuries induced by caspase-12 apoptotic path-ways through activated endoplasmic reticulum stress.     

颊部全厚梯形四边矩形皮瓣转移Ⅰ期修复全下唇缺损

下唇兼具功能和美容双重作用,当完全缺损时,不仅毁容,且同时由于口不能闭合也严重影响进食、语言等上唇功能。因此唇缺损的修复不仅要重建唇的功能,也要尽可能恢复良好的外型。但Ⅰ期修复全下唇缺损,在取材和修复方法上均较困难,常用双颊部组织瓣推进法,双侧带神经血管的扇形皮瓣,颈部筋膜瓣加上唇粘膜瓣等方法修复。我们自1991年9月至1993年1月采用设计颊部全厚梯形四边矩形皮瓣转移法1期修复4例全下唇缺损,效果满意。皮瓣设计和手术操作一、皮瓣取自颊部,以上唇红唇缘近口角处为皮瓣蒂部,按图1设计皮瓣。于口角处定 D 点并向下做一垂     

33例腹腔原发恶性淋巴瘤的针吸细胞学诊断与临床分析

我室自1987～1991年期间细胞学诊断为腹腔恶性淋巴瘤33例(其中10例得到组织学证实)均为 HE 染色。均原发于腹腔,占同期腹腔肿块(363例)的9.1%,占同期恶性淋巴瘤(99例)的35.1%。在本组33例中,男21例,女12例。男女之比约为1.75:1。年龄分布5～15岁8例,15～30岁7例,31～     

耻骨上经膀胱根治性前列腺切除术及扩大性切除术

前列腺癌是威胁男性老年人生命和健康的疾病。治疗方法有内分泌激素治疗、睾丸切除或放疗。作为姑息治疗手段，其远期疗效不理想。少数早期病例能采取前列腺根治性切除。此法在国内外文献中都只介绍经会阴、经耻其后，或经尿道等途径。由于视野狭小，手术操作困难，手术质量不易保证。中国医学科学院肿瘤医院许秉责教授自1980年创造了耻骨上经膀脱根治性前列腺切除术。手术自耻骨上首先切开膀眈，达膀眈后壁的后面，自上而下分离出输精管远段，切断、结扎上、下断瑞，游离精囊后，沿前列腺包膜向下游离至前列腺尖部，离断尿道后将前列腺全部…     

煎煮时间对大黄蒽醌类成分的影响研究

目的以大黄组分代谢物含量为指标,探讨大黄在临床使用中合理的煎煮时间。方法采用醋酸镁染色紫外分光光度法测定大黄蒽醌类组分的含量。结景大黄总蒽醌在30min达到最高,游离蒽醌在60min达到最高,结合型蒽醌在15—30min达到最大值。结论临床使用中,大黄用于清热泻火,煎煮60min可使游离蒽醌含量最高;用于泻下,煎煮30min即可,不可久煎。