恶性梗阻性黄疸的外科姑息治疗

不能切除肿瘤的恶性梗阻性黄疸的外科姑息治疗方法繁多，本文介绍自1989年以来，采取开腹经不同途径的带支撑导管胆肠内引流的方法治疗30例，减黄确切，尚对7例高位胆管癌在解除胆道梗阻的基础上行术后(192)Ir和(60)Co联合放疗，提高了病人生存质量及延长了生命。     

血清甘氨胆酸测定对肝硬化患者预后的评价

本文报告50例肝硬化患者SCG含量的临床意义.结果表明,SCG测定诊断肝硬化的阳性率为92％,明显高于SGPT(53％)及ADA(78.6％)的阳性率.Child-pugh肝功能分级中A、B、C级SCG值分别为10.14±6.03,23.55±11.27和54.66±24.47μmol/L(P<0.01).相关分析表明,SCG与血清白蛋白含量呈负相关(r=-0.5018.P<0.01),与胆红素含量呈正相关(r=0.6964,P<0.01).并发肝性脑病和原发性肝癌者及死亡病例,其SCG升高更为明显.我们认为肝硬化患者SCG值大于40μmol/L预示病情危重,预后不良.     

胎盘早期剥离13例分析

目的探讨胎盘早期剥离(胎盘早剥)的产前诊断和处理。方法对我院近10年发生的13例胎盘早剥作回顾性分析。结果妊高征及慢性高血压病占本组病因的46．2％。本组围产儿死亡率为23．08％，孕产妇死亡率为0。子宫卒中发生率46．15％，产后出血30．77％，DIC 7．70％。阴道出血、腹痛、胎心异常或消失、血性羊水为主要临床表现。产前诊断率为46．15％，B超检出率为60％。结论胎盘早剥的诊断需结合患者临床表现、发病诱因、B超检查结果全面考虑，确诊后应尽快终止妊娠。     

Treatment of Motor Neuron Disease with Qi-invigorating Herbs—— A Report of 31 Cases

The motor neuron disease (MND) refers to a group of progressive diseases with unknown reasons, which attacks the cells of the anterior horn of the spinal cord, the motor nuclei of the brain stem cranial nerves and the pyramidal cells of the cerebral motor cortex. It is characterized in clinic by atrophy of the muscles, myasthenia and even death due to paralysis of the respiratory muscle. Currently, there is still no any effective cure for this illness. 50-70% of the victims will die in 3 to 5 years, and the survival time for those with brain stem injuries is no more than two years.1 Since 1996, the authors have treated 31 cases of motor neuron disease with large dosage of qi-invigorating drugs in accordance with Prof. Liu Mocai's experience, and obtained certain therapeutic effects. A report follows.     

Effects of Electro-Acupuncture on Immune Function After Chemotherapy in 28 Cases

PURPOSE: To observe the effects of electroacupuncture therapy on T cells and activity of NK cell in the patient of Chemotherapy. METHOD: Electro-acupuncture therapy was simultaneously applied during chemotherapy, T cells and activity of NK cell of patients were determined before electroacupuncture treatment (before chemotherapy) and after 4-course electro-acupuncture treatments. RESULTS: Before chemotherapy, CD3 was low within the normal range, CD4 was much lower than the normal range, and CD8, CD4/CD8 and activity of NK cell were within the normal range. After one month of chemotherapy combined with electro-acupuncture, no decline of all the indices was found (P > 0.05). CONCLUSION: Electro-acupuncture can really increase the immune function of patients of chemotherapy.     

Microsurgical medialis pedis flaps for reconstruction of soft-tissue defects in the hand.

The medialis pedis flap (MPF) has been used for the reconstruction of soft-tissue defects in the hand since 1990. From January 1997 through January 2000, 19 patients (15 male, 4 female) with hand injuries underwent microsurgical MDF reconstruction at Chang Gung Memorial Hospital. There were finger injuries in 16 patients and palm defects in 3 patients. The mean patient age was 32.6 years (age range, 16-58 years). Flap size ranged from 4.5 x 2 cm to 7 x 6 cm (mean, 6 x 2.8 cm). Only one flap had partial loss. The donor site was closed primarily in 9 patients, and was closed using a split-thickness skin graft in 9 patients and a full-thickness skin graft in 1 patient. At a mean follow-up of 13 months, the protective sensation was 16 mm using the static two-point discrimination test and was 10 mm using the moving two-point discrimination test. Based on this retrospective study the authors conclude that (1) the MPF has the advantages of thin and glabrous skin, (2) the size of pedicle is compatible with the recipient vessel in the hand, (3) there is low donor site morbidity, and (4) achieving protective sensation is possible.     

巨噬细胞炎性蛋白4的突变和原核表达

目的 探索如何抑制嗜酸细胞的趋化作用，选择β-趋化因子巨噬细胞炎性蛋白4（MIP4）的突变性（Met-MIP4)作为趋化因子受体3的拮抗剂，将Met-MIP4基因在原核细胞中进行表达。方法 设计MIP4基因的PCR引物并进行氨基酸突变，将MIP4N末端的丙氨酸突变为蛋氨酸，以正常人肺酸突变，将MIP4N末端的丙氨酸突变为蛋氨酸。以正常人肺cDNA文库为模板，PCR方法获取Met-MIP4基因，克隆入载体pUC19，测序验证序列已得到突变，将正确的基因插入到GST融合表达载体pGEX-4T中，以IPTG诱导表达。结果 PCR产物为220bp左右的片段，连接入pUC19质粒后测序验证获得正确突变，构建的pGEX-4T融合表达载体在大肠杆菌中表达，经SDS-PAGE凝胶电泳显示有大小约34kU的新生融合蛋白表达。结论 成功突变并克隆了β-趋化因子MIP4基因，SDS-PAGE表明，与GST融合的Met-MIP4突变体已得到表达，为进一步研究其生物学活性奠定了基础。     

用Multiquadric方法实现医学图像的弹性配准

目的改进医学图像弹性配准的精确度和配准方法的稳定性，并简化配准操作。方法 利用Multiquadric插值方法的可平滑性质，将其与一种半自动标记点选择方法结合。建立一种新配准方法。结果 运用此方法进行医学图像的弹性配准，实现了标准图像与变形图像的快速，准确配准，结论 我们建立的配准方法是一种准确。简便和稳定的方法。