纤维胆道镜临床应用160例

0　引言　纤维胆道镜 (下称胆道镜 )在肝内外胆道疾病中的应用 ,其诊治价值已得到充分肯定 .我院 1996 - 0 1/ 1999- 12 ,术中、术后使用胆道镜诊治胆道肿瘤及结石 16 0例 ,取得了较满意的效果 .1　对象和方法1.1　对象　术中应用胆道镜行胆道探查共 38(男 2 3,女 15 )例 ,其中胆总管结石 2 9例 ,肝内胆管多发结石 5例 ,胆管肿瘤4例 .术后经 T管瘘道取石或活检 12 2 (男 78,女 44 )例 ,年龄18～ 77岁 ,其中肝外胆管残余结石 114例 ,多发性肝内胆管残余结石 5例 ,胆总管下端肿瘤活检 2例 ,置管造影 1例 .1.2　方法　日本 Olympus CHP2 OQ…     

Factors associated with the use of breast and cervical cancer screening services among Chinese women in Hong Kong

We conducted a cross-sectional survey using a self-administered questionnaire among attendees of a well women clinic in Hong Kong during June and July 1998. The study aimed to examine the factors associated with the past and future use of screening services among Chinese women in Hong Kong and their perception of service providers. Of the 430 respondents (64% response rate), 87% were aged 31-50 y, 85% married, 93% attained education to upper secondary school level, and 96% were non-smokers. Nearly all respondents (99%) reported having sexual experience and most of them (87%) had such experience with only one partner; 59% reported having a pap-smear test, 28% a mammogram and 44% a breast self-examination. Women who were health conscious (ate a lower fat diet and performed regular exercise) were more likely to have used the screening service (mammogram and pap-smear test) and performed breast self-examination. Staff manner, privacy and cost were the most common contributing factors for respondent's desire for future use of the screening service. Respondents showed a preference for doctors (70%) over nurses (30%), and females (80%) over males (20%) as their service providers. The findings suggest the need to disseminate appropriate information on screening services among the public to dispel misconceptions about the preference for doctors over nurses and females over males. Improving clinician- and other staff-patient communication would be important for breast and cervical screening programs in Hong Kong.     

Cellular phenotypes of normal and leukemic hemopoietic cells determined by analysis with selected antibody combinations

Individual leukemic cells and the corresponding rare normal cell types in nonleukemic bone marrow were analyzed with various combinations of antisera (labeled with different fluorochromes: TRITC and FITC). Double staining for membrane Ia-like molecules (TRITC) and nuclear terminal transferase (FITC) was a very useful combination that distinguished common non-T, non-B ALL (Ia+,TdT+) and thymic ALL (Ia-,TdT+) from the rare cases of B ALL (Ia+,TdT-) and from AML (frequently Ia+, TdT-; in some cases Ia-, TdT-). Additional antisera (such as anti-ALL, anti- HuTLA, anti-immunoglobulin reagents, etc.) confirmed the diagnosis and further characterized the leukemic blasts. Ia+,TdT+ cells could be observed in low numbers in normal and nonleukemic regenerating marrow and were probably normal precursor cells; this reagent combinations was, therefore, not useful for monitoring residual non-T, non-B ALL blasts in treated patients. Other marker combinations detecting pre-B ALL blasts (double staining for cytoplasmic IgM and nuclear TdT) and Thy-ALL blasts (HuTLA+,TdT+) were, however, virtually leukemia specific in the bone marrow and could be used to effectively monitor residual leukemic cells throughout the disease. These combined single-cell assays are not only economical and informative but are also important for assessing the heterogeneity of leukemia and for standardizing new mouse or rat monoclonal antibodies for diagnosis.     

Hepatocellular carcinoma with extrahepatic collateral arterial supply

Haepatocellular carcinoma (HCC) is the most common primary liver malignancy, representing the fifth most common cancer in the world. Without treatment, the median survival of HCC patients has been reported to be 8 weeks from symptomatic presentation. Transarterial chemoembolisation is widely used to manage unresectable HCCs. However, when a tumour is large or locates near the liver capsule, it may receive supplies from vessels other than hepatic arteries. In this paper, we discuss the anatomy of possible extrahepatic collateral arterial supplies of HCCs.     

Influence of breastfeeding and complementary food on growth between 5 and 10 months

The aim of this study was to examine the nature of the association between breastfeeding, complementary feeding and growth in a random sample of infants from Denmark, where the prevalence of breastfeeding is high. A semiquantitative food frequency questionnaire and a questionnaire on breastfeeding duration and on weight and length measurements taken at the infant welfare visit at 5 and 10 months were sent to 590 families with 10-month-old infants. A total of 339 infants with complete growth data were included in the analyses. When controlling for mid-parental height and birth weight infants breastfed for ≥ 7 months gained 198 g less in weight ( p < 0:01) and 7 mm less in length ( p < 0:01) during the period from 5 to 10 months than infants breastfed for < 7 months. Controlling for these effects, the 10% of the sample with the highest protein intake (i.e. ≥16 energy percentage) gained 262g more than those with a lower protein intake ( p = 0:03). Infants breastfed for ≥ 7 months received significantly less cow's milk ( p < 0:01), and fewer meat-containing dishes ( p < 0:05) and sweets or cakes ( p < 0:01), which may partly explain the effect of breastfeeding. The long-term consequences of this moderate difference in growth velocity are unknown and the findings should not be used to advocate against breastfeeding during late infancy.