胃镜诊断食管癌171例分析

为观察食管癌的检出率、发生部位、镜下及组织学类型，对纤维胃镜和病理证实的食管癌１７１例进行了分析。结果显示：男１３０例，女４１例，平均年龄５７．６９岁；总检出率３．６１％，随年龄增加检出率增高（Ｐ〈０．００１），男性高于女性（Ｐ〈０．０１），少数民族高于汉族（Ｐ〈０．０１）；发生部位中段〉下段〉上段；内镜下类型髓质型为主（５５．６２％）；组织学类型鳞癌８０．１２％，腺癌１９．３０％，分化型癌７４．     

尿道下裂的细菌学研究

目的 探索尿道下裂术后的再造尿道易于感染的原因、感染源及细菌种类；据此改进围手术期处理措施，以降低感染率。方法 应用细菌培养鉴定、基因分型鉴定等从分子水平证实细菌的来源及种类。结果 经尿道外口逆行进入和再造尿道材料携带是细菌主要来源。引起尿道下裂感染主要是革兰氏阳性球菌。最有效抗生素是去甲万古霉素。结论 尿道下裂术后感染是切口感染而不是泌尿系感染。再造尿道感染率高于皮肤(黏膜)的原因在于造成了比体表更适合细菌生长繁殖的微环境。     

大力推进重点专科建设实现医院跨越式发展

介绍了湖北省十堰市人民医院大力推进重点专科建设的经验,即确保重点专科建设科学规划、组织机构、保障措施、宣传工作四个到位;以人为本,构筑人才建设平台;突出医疗新业务、新技术,形成特色优势;科技兴院,医疗科教齐头并进,协调发展,完善硬件,环境与设备日新月异。     

Dermal wound healing is subject to redox control.

Previously we have reported in vitro evidence suggesting that that H2O2 may support wound healing by inducing VEGF expression in human keratinocytes (C. K. Sen et al., 2002, J. Biol. Chem.277, 33284-33290). Here, we test the significance of H2O2 in regulating wound healing in vivo. Using the Hunt-Schilling cylinder approach we present the first evidence that the wound site contains micromolar concentrations of H2O2. At the wound site, low concentrations of H2O2 supported the healing process, especially in p47(phox)- and MCP-1-deficient mice in which endogenous H2O2 generation is impaired. Higher doses of H2O2 adversely influenced healing. At low concentrations, H2O2 facilitated wound angiogenesis in vivo. H2O2 induced FAK phosphorylation both in wound-edge tissue in vivo and in human dermal microvascular endothelial cells. H2O2 induced site-specific (Tyr-925 and Tyr-861) phosphorylation of FAK. Other sites, including the Tyr-397 autophosphorylation site, were insensitive to H2O2. Adenoviral gene delivery of catalase impaired wound angiogenesis and closure. Catalase overexpression slowed tissue remodeling as evidenced by a more incomplete narrowing of the hyperproliferative epithelium region and incomplete eschar formation. Taken together, this work presents the first in vivo evidence indicating that strategies to influence the redox environment of the wound site may have a bearing on healing outcomes.     

运动及补充芦荟对糖尿病大鼠血清抗氧化酶活性的影响

目的 :研究运动及补充芦荟对糖尿病大鼠血清抗氧化酶活性的影响。方法 :以注射链脲佐菌素诱导成年雄性SD大鼠成糖尿病模型 ,观察运动、补充芦荟、运动结合补充芦荟对糖尿病大鼠血清SOD、GSH -Px、CAT、MDA及胰岛素、血糖的影响。结果 :各干预组血清SOD、GSH -Px、CAT活性及胰岛素水平均显著高于糖尿病安静组 (P <0 0 5 ) ,MDA含量及血糖浓度显著低于糖尿病安静组 (P <0 0 5 ) ,其中补充芦荟 +运动组较补充芦荟组和运动组也有显著性差异 (P <0 0 5 )。结果表明 :运动和补充芦荟均可提高糖尿病大鼠血清抗氧化酶活性 ,降低脂质过氧化程度 ,改善胰岛素和血糖水平 ,而以运动结合补充芦荟效果更显著。因此在糖尿病的治疗中 ,采用各种有效措施的综合疗法 ,易取得更为满意的疗效。     

经单侧鼻孔-蝶窦入路镜下切除垂体腺瘤(附12例分析)

目的 总结经单侧鼻孔-蝶窦入路镜下切除垂体腺瘤的体会。方法 对12例垂体腺瘤病人均采用经单侧鼻孔-蝶窦入路行肿瘤切除术。结果 10例全切除，1例大部切除，1例部分切除。4例病人术后出现短期尿崩，合并不同程度的水电解质紊乱，经口服双氢克脲噻、及时补液3～4d缓解。2例未完全切除肿瘤者术后行X-刀放射治疗。本组无一例出现脑脊液漏。12例获随访，平均10．2（6．18）月，均无肿瘤复发，视力减退者均有不同程度改善，尿崩症者均获痊愈。结论 肿瘤质地较硬，向鞍上扩展较大时应慎重选择经蝶窦入路；窥鼻镜准确地置于蝶窦前壁的最佳位置，是减少手术创伤的关键；明胶海绵加上EC耳脑胶修复鞍底可避免出现脑脊液漏；出现尿崩、水电解质失衡时应及时纠正。     

Non-communicating fluid filled tracheal cyst

Conclusion Tracheal cyst is a rare entity, commonly seen on right side, produce very little symptoms and is frequently an incidental finding on Post mortem. Present case demonstrates importance of keeping a tracheal pathology in mind while dealing with all paratracheal space occupying lesions. The serous fluid content of cyst was a usual finding in our case.     

Juvenile dermatomyositis with Sjögren’s syndrome

Juvenile dermatomyositis (JDM) is a rare disease, and Sjögren’s syndrome (SS) is unusual in adolescents. We report the first case of biopsy-proven JDM and SS with pulmonary involvement. A 15-year-old adolescent boy presented with recurrent parotid gland hypertrophy, severe muscle weakness, pronounced skin rash and widespread lymphadenopathy. JDM was diagnosed by clinical examination, elevated muscle enzymes, electromyography and muscle biopsy; SS was diagnosed by xerostomia, anti-Ro (SS-A) positivity and histopathological analysis of salivary gland tissue. This case illustrates a systematic approach which we feel is especially important in the younger patient with a more plastic immune system.

     

The transoral approach for the management of intradural lesions at the craniovertebral junction: review of 7 cases

The main difficulty in dealing with intradural lesions located ventrally in the region of the craniovertebral junction (CVJ) is related to their relative inaccessibility. Posterolateral approaches involve some manipulation of the brain stem and provide limited access because of the necessity of working between the cranial nerves. Even then, the view of the ventral midline and across is limited. The transoral approach, which has been widely used for the management of extradural lesions in this area, is also useful for the treatment of intradural lesions. It provides an unimpeded although somewhat restricted, view of the ventral aspect of the CVJ without the need for brain retraction. The cranial nerves and vertebral arteries are not interposed between the surgeon and the lesion. The risks of cerebrospinal fluid leakage and infection are greatly diminished by the use of fibrin adhesive and prolonged diversion of the cerebrospinal fluid. The use of this approach, together with its technical difficulties and results, in the management of seven purely intradural lesions located ventrally at the CVJ, is discussed.