The ileoanal J pouch: radiographic evaluation

Endorectal ileoanal pull-through offers an attractive alternative to proctocolectomy and ileostomy for patients with ulcerative colitis, Gardner syndrome, and familial polyposis. To our knowledge, a careful radiographic analysis of the ileum, ileal pouch, and ileoanal anastomosis after ileoanal pull-through has not been reported. Thirty-two patients with ulcerative colitis, Gardner syndrome, and familial polyposis underwent colectomy, mucosal proctectomy, and endorectal ileoanal pull-through of a 15-cm ileal "J" pouch and loop ileostomy. Twenty-five (78%) of 32 of all the pouches radiographically demonstrated spiral folds extending from the middle of the pouch to the pectinate line. Other radiographic features included a mesenteric mass effect, pseudopolyps, and a central lucency that indicated intrapouch sutures. Radiographs provide useful information in the postoperative management of the ileal pull-through.     

Diagnosis and taxonomy of periodical psychosis

The concept and taxonomy of periodic psychosis still remains in controversy for the past 100 years. In China, it was first reported by Ji, and thereafter various rinds of terminology and views were given by different authors. In the presentation, clinical investigation and follow up were carried out in 62 cases. In many of these cases, the so-called "periodic psychosis" or "phasophrenia" was early clinical features of schizophrenia or manic-depression. In those cases with apparent symptoms and signs of diencephalic function, differential diagnosis should be carried out from organic brain syndrome. In a small number of cases, their clinical manifestations, conforming to previous diagnostic criteria, might be an uncommon syndrome. It was concluded by the authors that until now periodic could be considered only as a clinical syndrome rather than a disease entity.     

单纯性肥胖症瘦素水平的临床意义

目的 :探讨单纯性肥胖症血清瘦素 (Leptin)及其临床意义。方法 :用ELISA法检测 48例单纯性肥胖症 (体重指数≥ 2 5 )和 40例健康对照者的血清Leptin水平。结果 :肥胖症组血清瘦素水平明显高于健康对照组 (P <0 .0 0 1) ,女性几乎较男性高 2倍以上。瘦素与BMI及脂肪含量呈正相关 (相关系数r分别为男性r =0 .36 ,0 .33 ,P <0 .0 5 ;女性r =0 .90 ,0 .87,P <0 .0 5 )。结论 :单纯性肥胖症血清瘦素水平升高 ,提示瘦素抵抗存在 ,可能在肥胖的发生发展中起重要作用     

心肌梗塞大鼠心室胶原生化改建与心脏肾素—血管紧张素系统的关系

目的 研究心肌梗塞（MI）后心室胶原生化改建与心脏肾素-血管紧张素系统（RAS）的关系。方法 采用放射免疫等方法动态观测了大鼠MI后3、15及42天左、右心室胶原含量、总量和血管紧张素Ⅱ(AngⅡ）含量以及血浆AngⅡ含量的变化,结果 血浆AngⅡ含量仅在MI后3天有一过性升高;MI鼠左、右心室AngⅡ含量以及血浆AngⅡ含量的变化。结果 血浆AngⅡ含量仅在MI后3天有一过性升高;MI鼠左、右心室AngⅡ含量于3天时就明显升高,此后一直保持在3天时水平,MI后左、右心室胶原基质均发生了生化改建,除右心室胶原生化建建稍滞后于其AngⅡ的变化外,左、右心室的胶原生化改建与其心肌AngⅡ的变化形式基本一致。结论 MI后心脏RAS被明显激活;心肌AngⅡ在心肌胶原生化改建的过程中可能起着重要的作用。而且其作用不依赖于循环RAS。     

胰岛的血液引流与胰腺外分泌的机能和临床意义

目的　研究胰岛的血液引流与胰腺外分泌的机能联系与临床意义。方法　运用微血管树脂 /墨汁灌注扫描电镜 /光镜观察法、保留动态及组织信息在静态样本的微循环观察法、FITC标记红细胞 (FITC- RBC)荧光活体显微镜观察法以及计算机图像处理微血管三维重建法 ,对 11例男性尸体、40只猴、2 4只狗、62只鼠、2 4只兔的胰岛血液引流通道与胰腺外分泌腺泡的关系进行了系统研究。结果　不同动物的内分泌胰岛血液主要经胰岛的三种类型输出血管引流至不同的外分泌腺泡区域 ,灵长类的部分胰岛血液还引流至邻近的小胰岛 ,研究者根据胰岛引流系统的特征对其进行了分类及命名 :1连续型引流系统 ,所有胰岛具有这类引流 (输出 )管道 ,其管径细 ,行程短、引流至胰岛周围的腺泡毛细血管区域。 2聚合型引流系统 ,为部分胰岛所有 ,其管径粗、行程长 ,引流至远离胰岛的腺泡毛细血管区域。 3跨越型引流系统 ,为部分胰岛所有 ,其输出管道越过小叶间隔引流至另一胰腺小叶的腺泡毛细血管区域 ,而这一小叶往往没有胰岛存在。 4胰岛 -胰岛型引流系统 ,灵长类部分胰岛的血液通过胰岛 -胰岛型引流通道回流至邻近的小胰岛。结论　胰岛具有完善联系外分泌腺泡的引流系统 ,提示含有高浓度胰岛内分泌激素的胰岛血液可能对外分泌腺泡的机能     

云南个旧和宣威地区肺癌p53突变检测研究

目的　云南个旧及宣威地区是云南省肺癌的两大点状高发区 ,个旧以矿工为高发人群 ,宣威以农民为高发 ,该两地区肺癌发生的病因已初步阐明 ,本研究旨在深入探讨其发病的分子生物学基础。方法　对 2 6例个旧矿工肺癌患者 ,15例宣威农民肺癌患者 ,应用聚合酶链反应 -单链构象多态性法研究 p5 3第 5至第 8外显子突变 ,并对有突变的个体进行测序。结果　发现云锡矿工肺癌患者中有 13例、宣威农民肺癌患者中有 4例发生 p5 3突变 ,应用 DNA测序 ,发现云锡矿工肺癌中有 1例于第 135位密码子发生突变 ,由 GCC→ GTC,导致氨基酸改变 ,由丙氨酸→缬氨酸 (Ala→ Val) ,宣威农民肺癌患者中有 1例于 2 47位密码子突变 ,由 AAC→ TTC,导致氨基酸发生改变 ,由天冬酰氨→苯丙氨酸 (Asn→ Phe)。结论　 p5 3突变在云锡矿工肺癌和宣威农民肺癌中较常发生 ,并发现两例新的突变位点。 p5 3突变与病人的年龄、性别、坑龄及组织学分类无明显联系     

计算机技术在病案管理中的应用和展望

实现医院信息网络资料共享,减少重复劳动和提高工作效率,已成为医院现阶段乃至今后一个阶段的主要课题。     

A comprehensive reconstruction strategy for moderate to severe faciocervical scar contractures

The focus of treatment of faciocervical scar contractures includes cervical reconstruction and elimination of hypertrophic scars. Unfortunately, most previous studies have neglected the esthetic appearance of scars. In this study, we tried to combine surgical therapy and ultrapulse fractional CO₂ laser (UFCL) to eliminate facial scars while restoring neck reconstruction and to establish the optimal conventional management for faciocervical contracture. Thirty-eight individuals were enrolled and divided into two groups. After received cervical release surgeries, comprehensive UFCL therapy group received treatment of UFCL at 3-month intervals, silicone sheets, and pressure garments, while another group only received treatment of silicone sheeting and compression. Twelve months after the termination of therapy, faciocervical scars of both two groups were assessed by two uninvolved physicians according to the Vancouver Scar Scale (VSS), and patients’ satisfaction survey was also recorded by the study participants using a patient four-point satisfaction scale. Thirty-six patients completed the treatment and follow-up. The results show that the VSS scores of both two groups decreased after 12 months, but comprehensive UFCL therapy group dropped more significantly than the conventional treatment group at follow-up session, which was statistically significant (P?<?0.001), and the patient satisfaction was higher than that of the conventional treatment group. This comprehensive treatment combined of surgery, UFCL, silicone sheets, and pressure garments works as an effective and esthetic reconstruction for moderate to severe postburn faciocervical scar contractures.

     

Safety and efficacy of magnetic resonance imaging-guided focused ultrasound neurosurgery for Parkinson’s disease: a systematic review

Neurosurgical Review - Magnetic resonance imaging-guided focused ultrasound (MRgFUS) neurosurgery is a new option for medication-resistant Parkinson’s disease (PD), but its safety and...