支架置入治疗小鼠原位结直肠癌模型所致结肠狭窄的实验研究

目的:探索小鼠原位结直肠癌(colorectal cancer, CRC)模型中结肠支架置入的方法与价值。方法:6～8周龄BALB/c雌性裸鼠20只,接受内窥镜引导下小鼠结肠黏膜下人结肠癌HCT-116细胞注射。结肠肿瘤形成后,选取肿瘤大小达到4级的15只小鼠作为实验模型,进行支架放置,观察支架置入后小鼠结肠肿瘤及肠腔变化。结果:利用小动物内窥镜行结肠黏膜注射肿瘤细胞建立小鼠结肠癌模型的技术成功率为100%,结肠腔内肿瘤形成率为95%。肿瘤大小达到4级需要12～16天(中位时间14天)。所有小鼠的支架置入技术成功率为100%。支架置入后结肠肠腔内肿瘤受压肠腔通畅,肿瘤呈现为1级,一周后肿瘤快速增殖沿支架网眼向肠腔内生长,导致肠腔再次狭窄。结论:通过小鼠原位CRC模型的支架置入可以完美地模拟人类CRC梗阻支架置入后再狭窄的过程,为研究肿瘤支架置入后肠腔再狭窄的机制奠定了基础。     

超声对原位劈离式肝移植术前供肝评估价值初探

目的初步探讨超声对原位劈离式肝移植(ISSLT)术前供肝评估的价值。 方法回顾性分析5例脑死亡器官捐献供者接受供肝在体劈离术前的超声检查资料。5例供者术前均行常规二维超声、彩色多普勒超声和剪切波弹性成像检查,酌情行超声造影。 结果常规二维超声显示肝实质回声细小2例,略粗略强2例,增粗增强1例。5例供者肝内动脉、门静脉主干及其属支、肝中静脉及其属支彩色多普勒超声均显示良好。5例供者右肝前叶剪切波成像弹性值为2.67～4.35 kPa。2例供者行超声造影,1例未见异常,1例肝动脉解剖变异。术中所见肝脏血管情况与超声评估相符。病理结果示5例供肝肝小叶结构大致正常,均未见脂肪变性。 结论超声可以作为ISSLT术前供肝评估的首选影像学方法,了解供肝大小、质地、脂肪变性、血管变异等情况,剪切波弹性成像及超声造影从硬度、微循环灌注检测两方面进一步评估供肝质量,作为常规超声的有效补充。     

国医大师何任治疗神志病经验拾零

何任教授系浙江中医药大学主任医师,获首届"国医大师"荣誉称号。何任老师年届九秩,精神颇佳,老当益壮。笔者跟随何任老师临证抄方,并阅读何师的有关医案,发现何师治疗神志病的经验非常丰富,重视经方的运用,强调化痰祛瘀治法,用药平常,获效甚好。     

鼻骨骨折整复术98例术后护理

外鼻创伤占鼻部创伤的50%,其中以裂伤和鼻骨骨折多见,除造成换气功能障碍外,常合并面部外伤。2008年3月～2009年10月,我们为98例鼻骨骨折患者行整复术,术后给予精心护理,效果满意。现报告如下。1临床资料     

读《金匮要略校注》后

<正>《金匮要略校注》(以下称《校注》)一书,乃浙江何任先生主编,殷品之、杨百茀、刘渡舟、欧阳锜等专家审定,人民卫生出版社1990年8月出版,为卫生部、国家中医药管理局文献研究课题之一,理应给人读书以启迪,然读后使人感到颇有可商之处,为了中医药学术之发展,特根据"百家争鸣"精神,顺序摘出疑点如下,以与何任先生商     

中医的思维模式，由模糊走向清晰

<正>中医是道术并重的国学,低碳环保的国医。它所以能够做到这一点,与它所依赖的传统文化有关。传统文化的精华,是古人看待世界的方法论、世界观。有了大视野,才能有大智慧。中医认识人体,采用的比较早、比较多的方法是"取象比类"。1以象统数,取象比类相同的研究对象,可以使用不同的研究方法,有的方法可能比较     

Functional roles and clinical values of insulin-like growth factor-binding protein-5 in different types of cancers

Insulin-like growth factor-bindin g proteins (IGFBPs) are critical regulators of the mitogenic activity of insulin-like growth factors (IGFs). IGFBP5, one of these IGFBPs, has special structural features, including a nuclear transport domain, heparin-binding motif, and IGF/extracellular matrix/acid-labile subunit-binding sites. Furthermore, IGFBP5 has several functional effects on carcinogenesis and even normal cell processes, such as cell growth, death, motility, and tissue remodeling. These biological effects are sometimes related with IGF (IGF-dependent effects) and sometimes not (IGF-independent effects). The functional role of IGFBP5 is most likely determined in a cell-type and tissue-type specific manner but also depends on cell context, especially in terms of the diversity of interacting proteins and the potential for nuclear localization. Clinical findings show that IGFBP5 has the potential to be a useful clinical biomarker for predicting response to therapy and clinical outcome of cancer patients. In this review, we summarize the functional diversity and clinical importance of IGFBP5 in different types of cancers.     

Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis scores for diagnosis of acute appendicitis

AIM:To assess the reliability and practical applicability of the widely used Alvarado,Eskelinen,Ohhmann and Raja Isteri Pengiran Anak Saleha Appendicitis(RIPASA)scoring systems in patients with suspected acute appendicitis.METHODS:Patients admitted to our tertiary center due to suspected acute appendicitis constituted the study group.Patients were divided into two groups.appendicitis group(Group A)consisted of patients who underwent appendectomy and were histopathologically diagnosed with acute appendicitis,and non-appendicitis group(Group N-A)consisted of patients who underwent negative appendectomy and were diagnosed with pathologies other than appendicitis and patients that were followed non-operatively.The operative findings for the patients,the additional analyses from follow up of the patients and the results of those analyses were recorded using the follow-up forms.RESULTS:One hundred and thirteen patients with suspected acute appendicitis were included in the study.Of the 113 patients(62 males,51 females),the mean age was 30.2±10.1(range 18-67)years.Of the 113patients,94 patients underwent surgery,while the rest were followed non-operatively.Of the 94 patients,77patients were histopathologically diagnosed with acute appendicitis.Our study showed a sensitivity level of81%for the Alvarado system when a cut-off value of 6.5was used,a sensitivity level of 83.1%for the Ohmann system when a cut-off value of 13.75 was used,a sensitivity level of 80.5%for the Eskelinen system when a cut-off value of 63.72 was used,and a sensitivity level of 83.1%for the RIPASA system when a cut-off value of 10.25 was used.CONCLUSION:The Ohmann and RIPASA scoring systems had the highest specificity for the diagnosis of acute appendicitis.     

响应面法优化白刺花总黄酮提取工艺研究

目的:优选白刺花中总黄酮的最佳提取工艺。方法:采用响应面分析法优化,以总黄酮提取率为评价指标,在考察单因素试验的基础上,选取乙醇浓度、加液量、提取温度和提取时间为自变量,利用Design-Expert软件分析优化出白刺花中总黄酮的最佳提取工艺条件。结果:优化所得白刺花中总黄酮的最佳提取工艺条件为:乙醇浓度为72%,加液量为21倍,提取温度为71℃,提取时间为133 min。结论:响应面优化所得到的最佳提取工艺准确、稳定,是提取白刺花中总黄酮的可行方法。