Risk factors of acute pancreatitis]

A total of 689 operative cases of acute necrotic pancreatitis (ANP) were collected from 42 hospitals all over the country by the ANP Cooperative Study Group in the years of 1987 to 1989. General data, laboratory findings, pathology of the pancreas and the type of surgical treatment were analysed according to the outcome of the patient. The results showed that 37% of the cases were related to cholelithiasis, the highest incidence was in age above 60, and female patients were predominant and with higher mortality. Laboratory findings at admission, WBC greater than 20,000/mm3, Hb greater than 15 g%, blood sugar greater than 200 mg%, serum bilirubin greater than 5 mg%, BUN greater than 20 mg%, and serum calcium less than 7 mg% were related to the markedly elevated mortality rate. Operative findings noted in patients with bloody or cloudy peritoneal fluid, necrotic changes up to 75% of the pancreas, more than 2 areas of extrapancreatic involvements and resection of a large portion of the pancreas was found to be necessary were all related to a higher mortality. And emergency operations performed within 24 hours after the onset of the disease was also related with a highest mortality rate.     

Laparoscopic nephrectomy in a porcine model.

Laparoscopic nephrectomy was performed in 15 male pigs, the procedure was successful in 14. Extraction of the intact kidney through a 5-cm lower abdomen incision was done in 7 animals; complete destruction and evacuation of the kidney was accomplished by a round-knife suction device through a 1-cm port in another 7 pigs. Grossly, the specimen consisted of sausage-like tubular renal tissue and a small amount of tissue debris. Pathology revealed that the glomerular and tubular structures were well preserved, no interstitial hematoma could be found. Four ports were usually used, one 1-cm umbilical camera port, one 0.5-cm port for ureter traction, and two 1-cm working ports along the midclavicular line. All the pigs recovered uneventfully. The average operation time was 3 h 20 min. The application of endo-GIA (United States Surgical Corporation) for renal hilum reduced the operative time to 2 h 20 min. Complications included renal vein tear during endoclip application and cutting in the first case, mild subcutaneous emphysema in 2 cases. This first pig received exploratory laparotomy for the repair and ligation of the renal vein. No more major complications occurred with increasing experience. From this porcine experiment, we conclude that the combination of laparoscopy, a tissue destroyer and an endobag for the entrapment of kidney seem to be a promising technique for clinical nephrectomy.     

Neuromuscular block with vecuronium reduces the rapidly extracted auditory evoked potentials index during steady state anesthesia

PURPOSE: During clinical monitoring, vecuronium appeared to reduce the rapidly extracted auditory evoked potentials index (A-line ARX index or AAI) to some extent. A prospective and randomized study was designed to analyze this phenomenon. METHODS: Forty adult patients undergoing elective surgery were studied. After tracheal intubation, anesthesia was maintained with an end-tidal isoflurane concentration (F(ET)ISO) of 1.0% for 20 min, then a 10-mL dose of either vecuronium 0.05 mg*kg(-1), 0.1 mg*kg(-1), 0.2 mg*kg(-1) or saline was administered in a randomized, double-blind design. The AAI and bispectral index (BI(hx)) were monitored throughout the study and analyzed off-line. RESULTS: BI(hx) was unaltered after the administration of saline or vecuronium. The mean of the averaged (per patient) AAI values recorded from two minutes to ten minutes after the administration of saline or vecuronium 0.05 mg*kg(-1) did not differ significantly from the corresponding mean recorded from 15 min to 20 min after F(ET)ISO maintained 1.0% (P = 0.678, 0.169), however after the administration of vecuronium 0.1 mg*kg(-1) or 0.2 mg*kg(-1), AAI was reduced from 18.3, 18.0 to 14.8, 13.4 (P = 0.016, 0.017). CONCLUSIONS: Neuromuscular block with vecuronium reduces AAI in patients during steady state anesthesia without surgical stimuli, while BI(hx) is unaltered. The cut-off values of AAI for events should be determined according to the level of neuromuscular blockade when monitoring the depth of anesthesia/sedation.     

VEGF在肺癌组织中的表达及临床意义

目的：探讨血管内皮生长因子在肺癌中的表达情况与肺癌病理生物学行为之间的关系。方法：采用免疫组化SP法检测47例肺癌组织和10正常肺组织中VEGF的表达水平。结果：肺癌组织中VEGF的表达明显高于正常肺组织(P＜0．005)，P53、VEGF表达与肺癌的分化程度、淋巴结转移及P—TNM分期密切相关(P＜0．05)，与患者的性别、年龄、肿瘤大小及组织类型无关(P＞0．05)。结论：检测肺癌组织中VEGF的表达水平有助于了解肿瘤的生物学行为，并可作为判断其预后的有价值指标。     

头孢噻肟钠聚合物测定实验条件的改进

目的:对中国药典收载的头孢噻肟钠聚合物测定条件进行改进。 方法 :采用高效液相色谱法 ,以Sephadex G- 10色谱柱 4 2 cm× 1.3cm对 6批样品进行分析 ,分别进样 5 0μl和 2 0 0μl,按外标法计算聚合物的量。结果:头孢噻肟钠在 10～ 6 0 μg/m l范围内线性关系良好 (r=0 .9995 ) ,高中低浓度的加样回收率分别为 10 0 .2 %、10 0 .4 %、99.7% ;RSD分别为 1.7%、1.5 %、1.9% (n =3)。该方法与药典方法比较 ,差异无统计学意义 (P >0 .0 5 )。 结论:本方法简便、快速、可行 ,具有实用价值     

Influence of blood supply of the esophageal and gastric stumps on anastomotic healing after esophagogastrostomy in rabbits]

OBJECTIVE: To study how blood supply of the esophageal and gastric stumps influences the anastomotic healing after esophagogastrostomy in rabbits. METHODS: Twenty-seven New Zealand rabbits were randomly divided into 3 groups to receive esophagogastrostomy, followed by different procedures. Except for those in group I, all the rabbits were subjected to procedures of reducing the blood supply either of the esophageal or the gastric stump (group II and group III, respectively), followed by single-layer esophagogastric anastomoses using interrupted 5-0 polypropylene sutures. Ten days after operation, all the rats were killed and the anastomotic sites excised for measurement of the inner diameter, tensile strength, and hydroxyproline concentration. RESULTS: Healing of the esophagograstric anastomosis was obtained in all the rabbits but one with anastomotic leakage in group I and one with perforation of the gastric fundus in group III. The anastomotic inner diameters were similar in all the three groups, whereas the tensile strength and hydroxyproline concentration at the anastomoses decreased in group III in comparison with the other two groups (P<0.05) that had similar measurements (P>0.05). CONCLUSIONS: Extended length of the free esophageal stump does not significantly affect anastomotic healing as decrease of blood supply in the gastric stump.     

1.5T超导磁共振制冷系统的工作原理及日常维护

介绍GE 1.5T超导磁共振制冷系统的组成和工作原理,讨论日常维护的要点及其必要性。     

乳母血清泌乳素水平与泌乳量关系的观察

用放射免疫法测定产后40天和60天乳母血清泌乳素基础水平和吸吮后泌乳素最大反应性增值,发现其与乳母泌乳量、婴儿吸吮频率、吸吮时间之间均不存在正相关关系,推测引起泌乳素分泌除吸吮外,还存在其他机理。