胰原性区域性门脉高压症血流动力学的临床研究

目的：研究胰原性区域性门脉高压症静脉血流动力学改变。方法：利用彩色多普勒及直接测量法测量血流动力学及脾静脉压力。结果：门静脉、肠系膜上静脉的血管直径、平均流速在两组间无差异。实验组脾静脉直径扩张,流速降低且静脉压力明显升高（Ｐ＜０．０５）。结论：胰原疾病可导致区域性门脉高压,正确的治疗方法是行脾脏切除术。     

IL-1β and TNF-α produced by peripheral blood mononuclear cells before and during interferon therapy in patients with chronic hepatitis C

We investigated the spontaneous and phytohemagglutinin-stimulated production of interleukin-1 (IL-1) and tumor necrosis factor- (TNF-) by peripheral blood mononuclear cells in patients with chronic hepatitis C during treatment with interferon- (IFN-). Spontaneous productions of these were significantly higher in patients with chronic hepatitis C than in healthy subjects. For patients prescribed interferon, stimulated production of TNF- was significantly higher in complete responders than in partial responders, but the differences were small between the other cytokine levels and outcome of IFN treatment. Spontaneous production of these cytokines was higher in patients with genotype III with complete response than in genotype III patients with a partial response, but this was not the case in patients with genotype II. There was a negative correlation between these cytokines and histological activity index. Spontaneous production of cytokines was decreased only in complete responders after the administration of interferon. These data suggest that the elevated production of cytokines in patients with chronic hepatitis C may be due to host response to the virus, and monitoring cytokines along with alanine aminotransferase and hepatitis C virus RNA during treatment may provide more precise information of the effectiveness of therapy.     

A case of ductal carcinoma in situ (DCIS; non-comedo type) detected by ultrasonography: Demonstration of occult multiple foci

We report a case of ductal carcinoma in situ (DCIS) of the breast detected by ultrasonographic mass screening in a 51-year-old woman. In a mass screening program for breast cancer, physical examination with inspection and palpation, and ultrasonography (US) were performed. A hypoechoic mass with a slightly irregular margin was detected by US in the lateral upper quadrant of the right breast, at a distance 2 cm from the edge of the nipple. The mass was not detected by physical examinations or by mammography (MMG). The mass, which measured 0.8 x 0.5 cm and was examined by fine needle aspiration biopsy (FNAB) under US guidance, was cytologically diagnosed as class X. Modified radical mastectomy (Auchincloss method) was performed with the patient's consent. Pathological examination of the resected specimen revealed DCIS (noncomedo type) and occult multiple foci of malignancy which was considered tracking centripetally underneath the nipple. This case suggests that US and FNAB performed under US guidance are useful in the detection and diagnosis, respectively, of a breast mass. We should take multifocality into consideration, particularly with tendency tracking to the nipple, in the treatment of small breast cancers such as DCIS.     

Phyllodes tumor of the breast with a grossly malignant appearance: A case report

A huge phyllodes tumor of the breast that appeared grossly malignant in a 43-year-old woman is described. The patient suffered from a large breast tumor that suddenly increased in size over 5 months to occupy the entire breast. The tumor was hard, ulcerated and 20 cm in greatest diameter. Diagnostic imaging (US, CT and MRI) demonstrated a circumscribed mass with a large cystic cavity. She underwent total mastectomy under a diagnosis of malignant breast tumor. Grossly, the cut surface of the tumor showed a large cystic cavity surrounding a fleshy, hemorrhagic and necrotic mass with a lobulared or trabeculared appearance. Unexpectedly, benign phyllodes tumor (PT) without any stromal overgrowth was diagnosed histologically. She has been doing well since total mastectomy. In our case and in many other reported cases, PT does not show any distinctive correlation between pathologic findings and tumor behavior. Thus wide local excision is the preferred initial treatment for PT.     

Synthesis of hexaprofen [2-(4-cyclohexylphenyl) propionic acid]

A novel preparative method for hexaprofen, which is a potent antiinflammatory agent, is described. Friedel-Crafts reaction of cyclohexylbenzene with ethyl α-chloro-α-(methylthio) acetate1 and α-chloro-α-(methylthio) acetonitrile2 afforded ethyl 2-(methylthio)-2-(4-cyclohexylphenyl) acetate7 and 2-methylthio-2-(4-cyclohexylphenyl) acetonitrile8, respectively. Compounds7 and8 were converted into the corresponding ethyl 2-methylthio-2-(4-cyclohexylphenyl) propionate9 and 2-methylthio-2-(4-cyclohexylphenyl) propionitrile10 by methylation with sodium hydride and methyl iodide. Hexaprofen13 was prepared by hydrolysis of ethyl 2-(4-cyclohexylphenyl) propionate11 and of 2-(4-cyclohexylphenyl) propionitrile12 followed by desulfurization of compounds9 and10.     

Radiation therapy in patients with unresectable hepatocellular carcinoma

From April 1978 through December 1989, a total of 17 patients with unresectable hepatocellular carcinoma (HCC) were treated with radiation therapy alone or radiation therapy in conjunction with percutaneous ethanol injection (PEI), transarterial infusion chemotherapy (TAI), or transarterial embolization (TAE) at the National Medical Center Hospital. The median survival of all patients was 13.8 months. The survival values determined at 1, 2, and 3 years were 58.8%, 26.1%, and 9.8%, respectively. Only the pretreatment liver function affected the survival value. Between patients who did not have liver cirrhosis (LC) as well as those who had LC of Child's class A and patients who had LC of Child's class B or C, the differences observed in the 1-year survival value and the median duration of survival were statistically significant (P<0.05). the=" serum=" cholinesterase=" (che)=" level=" seemed=" to=" be=" a=" good=" indicator=" of=" liver=" function=" during=" the=" radiation=" therapy.=" a=" field=" size=" of=" 150=">² and a total dose of 5000 cGy (TDF 82) seemed to be well tolerated by patients who did not have LC and those who had LC of Child's class A. The field size determined whether patients with poor liver function such as LC of Child's class B or C would develop severe hepatic deterioration after undergoing radiation therapy.Presented at The Second International Symposium on Treatment of Liver Cancer. Taipei, 3–4 February 1991     

高效液相色谱法同时测定复方对乙酰氨基酚维生素C泡腾片中2组分含量

目的 :建立同时测定复方对乙酰氨基酚维生素C泡腾片中对乙酰氨基酚和维生素C含量的高效液相色谱法。方法 :色谱柱 :YWG -C18柱 (10 μm,2 5 0mm× 4 .6mm) ;流动相 :甲醇 乙腈 0 .0 5mol·L-1磷酸二氢铵 磷酸缓冲液 (5 0∶11∶2 5 0 ) ;流速 :1.0mL·min-1;检测波长 :2 5 4nm。结果 :对乙酰氨基酚线性范围为 8～ 16 0mg·L-1;维生素C线性范围为 5～ 10 0mg·L-1。对乙酰氨基酚回收率为 10 0 .4 % (RSD =2 .4 0 % ) ,维生素C回收率为 10 1.2 % (RSD =1.90 % )。结论 :应用本法同时测定对乙酰氨基酚和维生素C含量 ,具有简便、快速、准确、可靠的特点     

抗生素后效应

抗生素后效应是近年来在抗生素化疗领域中受到重视的一种新理论。本文将各种抗生素的抗生素后效应加以综述。     

生孢梭菌孢子作为生物指示剂用于残存概率灭菌工艺验证的可行性

测定并分析生孢梭菌孢子在不同介质及不同温度下的耐热参数，评价生孢梭菌孢子的耐热特性及其作为生物指示剂在残存概率湿热灭菌工艺验证中的应用。     

手术方式对老年性胃癌根治术预后的影响

目的　重点讨论手术方式对老年性胃癌根治术预后的关系。 方法　 回顾分析 1995年 1月～2 0 0 0年 1月共收治的 83例 6 5岁以上老年性胃癌根治术随访 3年 ,分析手术方式和心肺合并症的关系及其对死亡的影响。 结果　 三年后U区癌心肺合并症死亡 2 6例 (2 6 / 83,31 1% ) ,M区癌心肺合并症死亡 2例 (2 / 83,2 4 % ) ,L区癌心肺合并症死亡 8例 (8/ 83,9 6 % ) ,M区和L区共计 10例 (10 / 83,12 % )。两组 (U区与M +L区 )死亡率相比有显著差异 ,P <0 0 1。 结论　U区开胸手术易引起心肺合并症 ,是老年性胃癌根治术后死亡率增高的主要原因。