中西医结合治疗急性细菌性痢疾50例

采用中药清热燥湿解毒为主 ,辨证加减 ,并结合西药 (常规治疗 )治疗急性细菌性痢疾 50例 ,总有效率 10 0 % ,并同单纯西药治疗组 3 6例作疗效对照 ,结果表明治疗组与对照组有显著性差异 ,P <0 .0 5。提示中西医结合治疗对急性细菌性痢疾有较好的疗效。     

硬脊膜动静脉瘘栓塞后Foix-Alajouanine综合征2例分析

目的 总结硬脊膜动静脉瘘（SDAVF）患者栓塞后出现Foix-Alajouanine 综合征的治疗经验。方法 回顾分析2例SDAVF患者的血管造影、栓塞、手术治疗资料,以及随访治疗效果。结果 2例SDAVF患者经脊髓血管造影检查均明确诊断,均以NBCA胶成功栓塞;栓塞后即刻均无明显异常,但两患者分别于栓塞后3 h和5 h出现症状明显加重,表现类似于Foix-Alajouanine 综合征。造影复查发现瘘口复发,1例患者再次行NBCA胶栓塞,治疗后显著好转,随访半年,恢复正常;1例患者由于供血动脉纤细,微导管插入困难,予以急诊手术夹闭瘘口,术后患者症状较出院时有恢复,随访8个月,症状好转。结论 血管内栓塞是治疗SDAVF的重要方法,若瘘口没有完全栓塞,有一定复发率甚至有急性加重可能,及时造影复查可以明确原因,再次完全栓塞或手术治疗仍有较好效果。     

骨桥蛋白及其受体在黄韧带骨化症黄韧带细胞中的表达及其意义

BACKGROUND: The exact pathogenesis of ossification of ligamentum flavum has not been elucidated yet. And osteopontin may be an important factor involved in the ossification of ligamentum flavum. OBJECTIVE: To clarify the expression and significance of osteopontin and its receptors, CD44 and integrin-β3, in ligamentum flavum cells between normal controls and patients with ossification of ligamentum flavum.   METHODS: Ligamentum flavum tissues were obtained from normal adult controls and adult patients with ossification of ligamentum flavum (n=8 per group) who underwent thoracic/lumbar posterior decompression surgery. Ligmentum flavum cells were separated, cultured and identified in vitro, and osteopontin, CD44, integrin-β3 were stained using immunocytochemistry method and observed under inverted phase contrast microscope. And the mRNA expressions of osteopontin, CD44, integrin-β3 were measured by RT-PCR. RESULTS AND CONCLUSION: Immunocytochemistry results showed that the stronger positive staining for osteopontin, CD44, integrin-β3 was observed in the ossification of ligamentum flavum group than the control group (P < 0.01). The mRNA expressions of osteopontin, CD44 and integrin-β3 were also higher in the ossification of ligamentum flavum group than the control group (P < 0.05). These findings indicate that osteopontin and its receptors, CD44 and integrin-β3, in ligamentum flavum cells may play an important role in ossification of ligamentum flavum.      

偏瘤型麻风一例

患者，男，38岁。因全身散在无痒痛性红斑10年，双手畸形3年就诊。患者于10年前淋雨后出现面部肿胀，躯干及双下肢多处红色斑块，不痛不痒。患者就诊于当地县医院，诊断不明，治疗后（用药不详）病情有所好转。一周后皮损复发，当地县医院仍诊断不明治疗效果差。后患者到西安市某教学医院皮肤科就诊，先后按“荨麻疹”、“毛发红糠疹”给予曲安奈德、扑尔敏等药物治疗，红斑逐渐消退。但停药后皮损仍反复发作，曾在当地小诊所多次就诊，均诊断不明。3年前自觉手指无力，小指及无名指逐渐出现屈曲畸形。其母曾患麻风。2周前西安市疾病预防控制中心人员进行接触者检查时，怀疑其为麻风，遂转来我院就诊。     

肝硬化门静脉高压症肝动脉压力对门静脉压力的影响

选择自1998年3月至2006年6月我院手术的肝硬化门静脉高压症与非门静脉高压症患者各33例进行肝动脉压力对门静脉压力影响的对比研究,探讨肝硬化门静脉高压症肝动脉压力和门静脉压力之间的相互关系.     

胆汁回输在肝移植术后的应用及意义

自 2 0 0 1年 2月至 2 0 0 2年 6月我们对 4例肝移植患者实施了经鼻肠管胆汁回输 ,效果满意。现报告如下。临床资料一、一般资料4例均为男性 ,晚期肝硬化、肝功能失代偿 ,年龄 4 4～ 6 2岁 ,其中 1例合并肝癌。术前肝脏功能分级均为C级 ,血清总胆红素 382～ 6 2 1μmol/L ,凝血酶原时间 37～ 5 6s ,血浆白蛋白 16～ 2 5g/L ,腹水 4例 (4 0 0 0～ 16 0 0 0ml) ,胸水 3例 (单侧 2例、双侧 1例 ) ,肝昏迷 1例 ,肾功不全 1例。二、材料与方法采用荷兰Nutricia公司生产的复尔凯鼻肠管 ,带有金属导丝和多用途接口 ,可在X线下显影。麻醉前与胃管…     

壶腹周围癌合并糖尿病胰头十二指肠切除术后糖代谢功能的变化

我院于2000年1至2003年6月收治的行胰头十二指肠切除术患者共104例，有15例术前血糖增高（占14.4％）。现将胰头十二指肠切除术前后对血糖代谢的观察报告如下。     

NF-κB激活及MCP-1和MMP-9表达在兔颈总动脉瘤中的作用

目的 探讨核转录因子(NF-κB)的激活及单核细胞趋化蛋白-1(MCP-1)和基质金属蛋白酶-9(MMP-9)的表达及在脑动脉瘤(CA)形成中的作用.方法 新西兰兔24只,雌雄各半,随机分成4组:A组(对照组)、B组(1周组)、C组(2周组)、D组(3周组),每组6只.用弹性蛋白酶(EA)滴注法建立兔右颈总动脉瘤模型,并用CTA和HE染色观察模型动脉瘤的形态及病理变化,同时用免疫组化分析NF-κB、MCP-1和MMP-9蛋白表达,RT-PCR检测其mRNA的表达.结果 (1)1周后实验兔行CTA检查,18只实验兔均发现作用血管段形成明显的梭形或囊性动脉瘤,其中可见血栓形成,并且血管有闭塞现象,正常对照组6只兔未发现动脉瘤样病变.HE染色检查,实验组动脉瘤瘤壁变薄,弹性纤维断裂,最终消失,平滑肌细胞减少萎缩,降解明显,对照组也有少量炎性细胞浸润,但未观察到弹力纤维降解和平滑肌退行性变.(2)对照组免疫组化显示未见NF-κB及MCP-1表达,MMP-9极少量表达,RT-PCR结果显示均见少量表达;实验组NF-κB及MCP-1均于1周时表达达高峰,3周时表达明显降低,MMP-9表达呈逐渐增强趋势.结论 NF-κB的活化可能是脑动脉瘤发生与发展的始动因素之一,MCP-1及MMP-9表达增高在脑动脉瘤发生发展过程中起着重要作用.

Abstract：

Objective To study the effects of nuclear factor Kappa B( NF - κB) , MCP - 1 and MMP -9 at the early phase of cerebral aneurysm(CA). Methods 24 healthy New Zealand rabbits, half female and half male, were randomly divided into 4 groups: group A (control group), group B( 1 week), group C(2 weeks), group D (3 weeks), 6 rabbits per - group. The morphologic change of the right common carotid artery and formation of the aneurysm were detected by CT angiography and HE dyeing. Aneurysm samples were collected, and immunohistochemistry and real - time rolymerase chain reaction ( Real - time PCR)used to detect the expression of the proteinum and mRNA of NF - κB, MCP - 1 and MMP - 9. Results (1) After a week, using CT angiography to detect all the 18 experimental rabbits, all of them have found visible fusiform or cystiform aneurysms where the elastase was dropped, and also found that some vessels were obstructed. Aneurysms have not found in all the control group rabbits. The pathological examination of the experimental aneurysms showed that the wall of aneurysm becoming thinner, the internal elastic layers were disrupted or disappeared and the reduced medial vascular smooth muscle cell becoming atrophy or degradation obviously. Inflammatory cell infiltrate were also observed in the control group, but the internal elastic layers degradation and vascular smooth muscle degeneration were not found. (2) The result of immunohistochemistry and Real - time PCR indicate that NF - kB and MCP - 1 reached the peak at 1 week, and decreased at 3 weeks. MMP -9 was increased gradually. The expression of NF - kB and MCP -1 were not found in control group. Conclusion NF - κB activation may be one of the initiating agents in the development of the cerebral aneurysm. MCP - 1 and MMP - 9 significantly increased in CA that play an important role in the pathogenesis of cerebral aneurysm (CA).     

肝外胆管癌206例诊断分析

目的探讨肝外胆管癌的诊断程序，提高其诊疗水平。方法对1995年6月至2004年10月206例经手术证实的肝外胆管癌进行回顾性分析。结果（1）肝外胆管癌初诊时多以黄疸为首发症状，其他常见症状依次有上腹部隐痛（49．5％）、乏力（30．6％）、消瘦（27．2％）、厌食（13．1％）。（2）实验室检查碱性磷酸酶（AKP），γ-谷氨酰转移酶（γ—GT），糖类抗原（CA19-9）阳性率分别为100％（206／206）、93．7％（193／206）和68．4％（140／206）。（3）影像学检查中联合B超＋CT、血管造影（CTA）＋磁共振胰胆管成像（MRCP）＋逆行性胰胆管造影（ERCP）或经皮肝穿刺胆管造影（PTC）对肝外胆管癌的确诊率为100％，2例早期胆管癌均是通过ERCP确诊的。结论建立规范的肝外胆管癌诊断程序，是改善肝外胆管癌愈后的关键。