胆胰肠结合部术中损伤的合理治疗方式

胆胰肠结合部损伤是指胆道探查术中因各种原因所致的胆总管下段和(或)胰腺、十二指肠的损伤.可造成胆汁、胰液、十二指肠液的漏出且互相混合,激活形成腐蚀性极强的消化液,引起腹膜后的严重感染,甚至危及患者生命,临床处理非常棘手.     

Symmetry主动脉吻合器对大隐静脉移植物的损伤

目的　观察使用Symmetry主动脉吻合器时对大隐静脉移植物内皮有无损伤。 方法　对 10例使用Symmetry主动脉吻合器行冠状动脉旁路移植术患者进行自身对照研究。在主动脉吻合器使用前和使用后 ,切取自体大隐静脉片断 ,进行Ⅷ因子免疫组化染色 ,对照血管内皮损伤情况。结果　血管内皮细胞均匀着色 ,为深褐色颗粒 ,损伤处褐色颗粒排列中断。吻合器组内皮损伤处平均为 2 .5 5处 ,对照组为 2 .0处。结论　Symmetry主动脉吻合器对静脉内皮细胞无明显的机械损伤     

Adrafinil-induced orofacial dyskinesia.

We describe the first case of orofacial abnormal movements induced by adrafinil, a vigilance promoting agent of the same pharmacological class as modafinil. The dyskinesias did not spontaneously recover despite adrafinil withdrawal for a 4-month period. They were secondly dramatically improved by tetrabenazine, a presynaptic dopaminergic depleting drug which was introduced after the 4-month adrafinil-free period.     

支气管肺隔离症1例报道

男性,28岁,体检发现右下肺肿块1月余,无明显自觉症状.以往有肺结核病史.胸部X线平片(图1)显示右肺下叶后基底段一6 cm×4 cm×5 cm的团块影,边缘清晰,双肺上叶可见陈旧性结核灶.CT增强扫描(图2)显示右下肺肿块,中央CT值约40HU,增强后无强化,肿块内侧可见一粗大的血管断面伴随,血管与肿块关系密切.CT血管造影(CTA)MIP重建显示一较大的血管自膈下发出一直径约1cm的供血动脉,并可见引流的肺静脉影(图3).     

湿润烧伤膏治疗外伤性末节指(趾)骨外露体会

目的：探讨MEBO治疗骨外露的临床疗效。方法：对2005年10月至2006年2月处置外伤性指（趾）骨外露3例采用MEBO治疗。结果：3例创面全部愈合,时间均为3周。结论：MEBO治疗外伤性末节指（趾）骨外露简便,实用,疗效可靠,不影响美观。     

Upper Gastrointestinal Irritation and Arrhythmia

Abstract: The influence of endoscopic examination on the occurrence of arrhythmia was investigated electrocardiographically in 30 patients with cardiovascular disease who underwent transesophageal echocardiography (TEE) (group A) and 38 patients with digestive tract disease who underwent upper gastrointestinal endoscopy (UGIE) (group B). The mode and frequency of arrhythmia during the examination were compared between the two groups. (1) Arrhythmia was more frequently observed in group A (22 of 30, 73.3%) than in group B (9 of 38, 23.7%) patients (p<0.001). The common arrhythmias in both groups were supraventricular premature beat and ventricular premature beat. Serious arrhythmias, such as 2nd degree atrioventricular block and ventricular fibrillation were detected only in group A patients. (2) The region of the esophagus where the tip of the probe or scope was located was classified into three segments: upper (0–15 cm), middle (15–35 cm) and lower (35 cm<). Arrhythmias tended to be frequent when the tip of the probe or scope was located in the middle segment of the esophagus. These data indicate that arrhythmias observed during TEE or UGIE are related to the underlying heart disease. Furthermore, the middle segment of the esophagus appears to be particularly susceptible to the provocation of arrhythmia.     

脆性X综合征的遗传学诊断与产前诊断

脆性X综合征( fragile X syndrome,FraX )是一种常见的遗传性智力低下综合征,其发病率仅次于Down综合征,呈X连锁遗传,占X连锁智力低下的40%[1].1992年,Erster SH等报道其发病率男性为1/1250,女性约为1/2000;1997年,De Vries BB等报道其发病率男性为1/4000,女性为1/6000[2-3].发病率下降的原因可能是随着诊断技术的提高,减少误诊的结果.     

抗人喉癌/抗VEGF双功能抗体制备及应用研究

目的：研制抗人喉癌／抗血管内皮因子（VEGF）双功能克隆抗体，用于喉癌抗血管生成治疗。方法：采用二次杂交瘤技术制备抗人喉癌／抗VEGF双功能抗体。经酶联免疫吸附试验法和SP法检测喉癌及癌前病患者血清及癌组织中VEGF的含量表达。结果：获得6株分泌抗人喉癌／抗VEGF双功能抗体的杂交瘤，经免疫组化证实与喉癌细胞特异性结合率为93％，而与血管内皮细胞结合率为89％。血清中VEGF含量表达，喉癌组与癌前病组及正常对照组相比差异均显著。IgG亚型鉴定为IgG2aBSAb抗体效价为1：25 600倍（ELISA法）。结论：二次杂交瘤法制备的双功能抗体具有均匀性、可控性、效价高、稳定性好，可用于喉癌抗血管生成治疗，动态检测可作为判断喉癌预后的客观指标。     

Deletion spanning the 5′ ends of both the COL4A5 and COL4A6 genes in a patient with Alport's syndrome and leiomyomatosis

Alport's syndrome is characterized clinically by a nonimmune glomerulopathy, often accompanied by sensorineural hearing loss and lens abnormalities, frequently due to mutations in the COL4A5 gene. The association of AS with diffuse leiomyomatosis, a benign proliferation of smooth muscle that occurs most often in the esophagus, trachea, and female genitalia, has been reported. Recently, a deletion involving both the COL4A5 and COL4A6 genes has been reported in four unrelated families. We report an additional case with Alport's syndrome associated with leiomyomatosis carrying a deletion of both COL4A5 and COL4A6 genes. A detailed characterization of the genomic region involved in the deletion event has been performed. Our results demonstrate that the deletion removed exon l of COL4A5 and exons l and 2 of COL4A6. © 1994 Wiley-Liss, Inc.