Management of hepatocellular carcinoma presenting as obstructive jaundice

Eleven (3%) of 340 patients with hepatocellular carcinoma (HCC) presented with obstructive jaundice. The tumor extensively infiltrated the major bile ducts in eight patients. Jaundice was relieved by endoscopic endoprosthesis in four patients, nasobiliary drainage in two patients, percutaneous transhepatic stenting in one patient, and surgical intubation in one patient. The survival interval of these eight patients (mean +/- SD) was 35 +/- 20 days. Three patients had tumor fragments in the common bile ducts. In two patients, major hepatic resection was done after initial tube decomposition of the biliary system. One patient remained tumor-free on follow-up at 24 months, and the other patient had recurrent tumor detected on follow-up at 17 months after surgery. The tumor was irresectable in the third patient. Multiple surgical and endoscopic procedures kept the bile duct patent for 17 months before the patient died of the disease. Not all patients who present with obstructive jaundice due to HCC are terminally ill. With proper management, good palliation and occasional cure are possible.     

雌激素,胎盘生乳素,钙,磷与妊高征的关系

目的：探讨雌激素，胎盘生乳素，钙在妊高征发病中的作用及其相互关系，方法：采用放射免疫法及离心分析钙试剂，测定了４２例妊高征患者血清雌二醇，胎盘生乳素，钙，磷及尿钙，磷的含量，３４例同期门诊正常孕妇作为对照组，结果：轻度妊高征患者血清雌二醇明显增加（Ｐ〈０．０５）。重度妊高征患者血清胎盘生乳素显著减少（Ｐ〈０．０５），轻，中，重度妊高征患者血钙，尿钙含量显著降低（Ｐ〈０．０５，Ｐ〈０．０１，Ｐ〈０．     

大型垂体瘤不同手术入路治疗的比较研究

本文回顾性比较106例大型垂体瘤的开颅和经蝶手术治疗的比较。开颅组58例,经蝶组48例。开颅组肿瘤次全切除9例,大部切除48例,部分切除1例;经蝶组全切除35例,大部切除12例,部分切除1例。开颅组术后视力好转率71%,无变化12例,恶化3例。手术后偏盲好转率67%;经蝶组手术后视力好转率77%,无变化者11例,无1例恶化。手术后偏盲好转率93%。开颅组20例有额叶挫伤,其中1例并发脑内血肿,死亡4例。作者认为垂体腺瘤不长向鞍旁、海绵窦、前颅窝底和脚间池和肿瘤不呈瓶颈样生长者,都应优先考虑经蝶窦入路手术。     

角膜损伤后神经再生的实验研究

应用神经组织化学技术观察了兔角膜NA能神经及AchE阳性神经在角膜损伤后的再生,证实术后1月,两种神经均有再生轴突进入植片;术后3月可见交界区和植床内神经密度明显增加;同时,对术后两种神经再生的功能意义进行了讨论。     

偏心圆剥离法在隆乳术中的应用

以往以乳头为圆心的同心圆剥离法常形成假体的移位，使假体的体表轮廓与前方的自然乳房分离，产生“双重乳房”现象。在研究了女性不同体位下不同的乳房形态及总结了以前的经验后，提出了偏心圆剥离的概念。偏心圆手术设计方法：以乳头为圆心，按其内侧、下侧为直径３／５的比例，以外侧、上侧为直径２／５的比例，形成一偏心圆的剥离范围。偏心圆的直径因考虑到假体的不同形态、大小及底面直径，以经中心假体纵截面的周长的１／２再放大２ｃｍ，作为剥离范围的直径。自１９９１年１０月以来已应用了１７６例，无一术后移位现象，也没有固较多地剥离胸大肌内、下侧止点纤维而影响上肢活动。自然乳房并不是静态的圆锥形或半球形，它具有伸缩的组织学特点，又有随体位变动而变化的特点。用偏心圆法剥离，可使置入的假体与前方的自然乳房融为一体，消除“双重乳房”现象，而成为“真实”的乳房。同时也应积极寻找一种与身体组织相容性好的，弹性、比重与女性乳腺较为一致的，假体容量相对恒定的生物性材料。这样隆乳术才可以更广泛地开展。     

负载型丝光沸石催化剂的催化性能研究

运用二元碱氮置换吸附红外光谱法、分子筛孔径分布测定技术、XPS技术,考察了丝光沸石表面酸性与孔结构的相互关系、钯在丝光沸石上分布情况和价态及其与沸石的相互作用。结果表明,随着丝光沸石脱铝程度的增加,表面出现大量不规整晶格,存在较多的次级孔道。强质子酸中心主要分布在它的“外表面”。钯在其表面富集,并与“外表面”上的质子酸中心协同作用,促进了轻质烷烃异构化反应。     

前列腺癌组织中细胞外基质的免疫组织化学研究

为探讨前列腺癌（ＰＣａ）细胞的转移机制，应用免疫组织化学ＡＢＣ法在良性前列腺增生（ＢＰＨ）及ＰＣａ组织中对基膜连接蛋白（ＬＮ），胶原Ⅳ型蛋白（ＣＯＬⅣ），纤维连接蛋白（ＦＮ）等细胞外基质（ＥＣＭ）蛋白的表达进行检测，结果ＢＰＨ组织中基底膜部位ＬＮ，ＣＯＬⅣ及ＦＮ的染色呈连续线状分布，ＰＣａ组组织基底膜部位ＬＮ，ＣＯＬⅣ及ＦＮ的阳性染色呈碎片状或断线状分布。ＣＯＬⅣ在ＢＰＨ与ＰＣａ组织中的强阳性率无显著性差异（Ｐ＞０．０５）。结果提示ＥＣＭ在ＰＣａ组织中基底膜部位的明显缺失（非连续线状分布）可能是肿瘤转移的重要因素。     

血管内氧合器的研制

为了探索呼吸辅助的新方法，我们采用国产聚丙烯中空纤维，自行设计、制造模具，研制出一种血管内氧合器。该氧合器是一个小的、细长的可经单侧股静脉或颈静脉切开，置入腔静脉内的装置。氧合器有效长度４０ｃｍ，膜交换面积０．０９ｍ＾２。经负压调节通过血管内氧合器的氧流量，以防止纤维破裂造成的血管内气栓的危险。一根双腔导气管使气体经同一静脉切开部位循环，气体经内芯管流经血管内氧合器尖端，然后经中空纤维束流出。目前     

Active oxygen radicals produced by leukocytes of malignant lymphoma.

The electron spin resonance (ESR) spectra of active oxygen radicals produced during the respiratory burst of PMA-stimulated leukocytes and oxygen consumption are studied by ESR spin trapping and spin probe oxymetry for 31 times in 17 cases of malignant lymphoma. The results showed that the spectra produced from PMA-stimulated patients' leukocytes were predominantly spin adducts of DMPO-hydroxyl radicals (DMPO-OH). The decrease in oxygen consumption during respiratory burst suggested that respiratory burst function was inhibited. Kinetic observations of patient condition showed that respiratory burst and oxygen consumption were improved and even approached normal, when the patient was in remission or the condition was ameliorated. This paper is the first of its type and helps clarify the mechanism of malignant proliferation and metastasis.

     

Effects of Phentolamine on Hemorrheology and Hemodynamics in Dogs with Acute Liver Damage

ＥｆｆｅｃｔｓｏｆＰｈｅｎｔｏｌａｍｉｎｅｏｎＨｅｍｏｒｒｈｅｏｌｏｇｙａｎｄＨｅｍｏｄｙｎａｍｉｃｓｉｎＤｏｇｓｗｉｔｈＡｃｕｔｅＬｉｖｅｒＤａｍａｇｅＤＡＮＺｉｌｉ（但自力）；ＺＨＡＮＧＷｅｎｙｉｎｇ（张文英）；ＬＩＳｈａｏｂａｉ（李绍白）（Ｉｎ...