Sonographic diagnosis of early recurrence after inguinal herniorrhaphy: Potential pitfalls

Three patients who presented with scrotal swelling within a few days of inguinal herniorrhaphy are reported. Ultrasonography scans performed in these patients all demonstrated features suspicious of recurrence of hernia. One patient underwent surgical exploration, which revealed only a scrotal haematoma without evidence of recurrent hernia. The other two patients were managed conservatively because clinically the swellings were regarded to be more compatible with haematoma. Both patients had subsequent resolution of the scrotal swelling with no clinical evidence of recurrence of hernia on follow‐up. It is concluded that sonographic diagnosis of recurrence of hernia shortly after inguinal herniorrhaphy can occasionally be misleading.     

十二指肠间质瘤的临床特征及外科治疗

目的探讨十二指肠间质瘤的临床特征及外科治疗效果. 方法回顾性分析我科1990～2004年14例十二指肠间质瘤的临床资料. 结果病理类型:良性2例,潜在恶性4例,恶性8例.50.0%(7/14)发生在降部,其中恶性占57.1%(4/7).临床表现为右上腹肿物(6/14),右上腹隐痛不适(5/14)和乏力、体重下降(3/14),诊断手段为十二指肠低张造影(13/14)、B超(13/14)和CT(9/14).肿瘤距离十二指肠大乳头＜3 cm或位于降部、直径≥5 cm者宜行胰十二指肠切除术,肿瘤距离十二指肠大乳头＞3 cm及较小者宜行十二指肠节段性切除术. 结论十二指肠间质瘤恶性多见,临床表现无特异性,主要依靠十二指肠低张造影、B超、CT、EUS确诊,对无远处转移的肿瘤应积极争取根治性切除.     

锁定肱骨近端接骨板治疗肱骨近端骨折

目的探讨锁定肱骨近端接骨板治疗肱骨近端骨折的临床价值：方法采用切开复位AO锁定肱骨近端接骨板(LPHP)内固定治疗肱骨近端骨折12例。结果所有患随访3～13个月，平均7．5个月。临床疗效评估：优7例，良3例，进步2例，优良率为83．3％。结论LPHP具有固定可靠、减少软组织损伤、保护血运、利于关节囊和肩袖修复、有助于骨折愈合和肩关节功能恢复的特点，值得提倡。     

胃癌累及胰腺的外科治疗与预后(附120例报告)

目的探讨胃癌累及胰腺的外科治疗方法与预后的关系。方法回顾性分析我院1984年6月～2003年10月手术治疗累及胰腺的胃癌120例。结果本组120例中,根治切除组41例,姑息切除组23例,未切除组56例。根治组41例中经病理证实胰腺有癌细胞浸润者30例,占73.2%,淋巴结转移率为85.4%。其中No10、11淋巴结转移率为73.1%。术后102例得到随访,随访率为85%,1、3、5年的生存率分别为:根治切除组为73%、37%、17%,姑息切除组为22%、9%、4%,未切除组为9%、2%、0%。根治切除组1,3年生存率明显高于姑息性切除组和未切除组(P<0.05),5年生存率明显高于未切除组(P<0.01),但与姑息性切除组无显著性差异。姑息性切除组和未切除组1、3年生存率无显著性差异,但5年生存率明显高于未切除组(P<0.01)。结论胃癌累及胰腺的根治切除可提高1,3年生存率,选择合适的适应征是关键。姑息切除有助于改善生存质量,对改善预后意义不大。     

胃饲乙醇预处理诱导肝脏缺血耐受性的可行性探讨

目的探讨胃饲乙醇预处理对肝脏缺血再灌流损伤的影响,并初步评价其预处理的可行性。方法40%乙醇胃饲Wistar大鼠。分组:①大鼠36只,随机分6组:A组8g/kg、B组7g/kg、C组6g/kg、D组5g/kg、E组4g/kg、正常组0g/kg;以中毒症状及肝组织病理为指标,判定大鼠乙醇急性中毒剂量。②大鼠78只,随机分为4组:正常对照组(N)、单纯乙醇组(E)、单纯缺血组(ISCH)、胃饲乙醇预处理组(EPC);采用尾叶转流下的肝缺血模型,于再灌流3、6、12、24h留取标本。结果急性胃饲乙醇≤5g/kg预处理后,动物中毒症状轻,无死亡;乙醇预处理可以在一定程度上减轻肝脏90min的缺血再灌流损伤。结论适当剂量的乙醇胃饲预处理是一种安全的预处理措施,有望成为增强肝脏对缺血再灌流损伤耐受性的一种较好的预处理方式。     

Modulation by dietary vitamin E of I-compounds (putative indigenous DNA modifications) in rat liver and kidney

I(indigenous)-compounds are age-related, carcinogen adduct-like, putative indigenous DNA modifications detectable by 32P-postlabeling assay in untreated animals. To investigate the origins of these DNA derivatives, we examined the effects of dietary vitamin E, a natural antioxidant, on I-compounds of rat liver and kidney DNA. Weanling female Sprague-Dawley rats were fed Draper's diets containing 0, 100, 1000, or 10,000 mg/kg alpha-tocopheryl acetate for 6 mo. The DNA from four individual rats of each group was analyzed by a nuclease P1-enhanced version of the 32P-postlabeling assay for DNA adducts. The amount of vitamin E in the liver was measured by high performance liquid chromatography. Rats fed vitamin E-deficient diet (0 mg/kg) showed identical profiles and similar levels of I-compounds as those fed the 100 mg/kg diet. Most I-spots were significantly intensified and one tissue-specific extra spot was found in both liver and kidney DNA of rats fed the 1000 or 10,000 mg/kg vitamin E diet. However, one of the five major I-spots detected in the kidney was weaker in the 1000 and 10,000 mg/kg groups than in the 0 and 100 mg/kg groups. These results show that formation of most I-compounds was not affected by vitamin E-deficient diet, and that long-term feeding of diet containing high levels of vitamin E may cause metabolic alterations leading to an increased formation of DNA-reactive (potentially mutagenic or carcinogenic) electrophiles.     

In vivo determination of body fat by measuring total body carbon

Total body carbon (TBC) is measured in vivo by neutron inelastic scattering. The fast neutrons needed for the irradiation are produced by a miniature deuterium-tritium (D-T) neutron generator. Body fat and protein are the main contributors to TBC. Bone ash and carbohydrates contribute less than 3%. Fat is calculated from TBC after the subtraction of the carbon contributions from protein, bone, and glycogen. The technique was applied to 14 normal volunteers (8 females, 6 males) aged 24-94 y who underwent neutron inelastic scattering and neutron activation measurements for body carbon, nitrogen, and calcium. The initial results agree with other techniques. Unlike models that evaluate body fat by subtracting lean body mass from body weight, the TBC technique is not sensitive to assumptions on the composition of lean body; therefore, it is appropriate for studies of adults of any age and health condition.     

Morphometric diagnosis of bladder tumor

This paper reports the morphometric analysis results of 100 cases of bladder tumor cells with a Q-900 computer-assisted image analysis system. According to the nuclear area, axis ratio and area ratio of tumor nuclei, bladder transitional cell tumors were divided into 4 grades. This system is called the morphometric grading system (M grading). The results show that the higher the M grading, the lower the survival rate and the higher the recurrence rate. As the M grade increases the tumors could be accompanied by muscular invasion. When recurring, the tumor has a poor prognosis if M grading increases. We conclude that the morphometric grading system is able to yield a quantitative pathologic diagnosis and can predict the biological behavior of bladder tumors. Recently, new techniques for diagnosing and predicting the biological behavior of bladder tumors have been developed. One such technique is morphometric analysis of bladder transitional cell carcinoma with computer-assisted image instruments [1]. Because this morphometric method is easily applicable to pathological section routinely stained with HE and the results are reproducible and more objective, the studies about morphometric analysis of bladder tumor have increased in recent times. This paper reports the preliminary morphometric analysis results of bladder tumor cells examined by a Q-900 image analysis instrument for 100 cases.