原发性十二指肠肿瘤43例诊治分析

目的　探讨原发性十二指肠肿瘤 (PTD)的诊断和治疗。方法　回顾性分析我院 1995 2 0 0 3年间 4 3例PTD的临床资料。结果　十二指肠镜确诊率为 85 .7% ,B超检查的阳性率为 5 5 .6 % ,CT检查阳性率为 80 % ,肿瘤位于十二指肠降段 (乳头部或其对侧 ) 35例 ,占 81.4 % ,2例平滑肌瘤切除术后存活 5年以上 ,1例乳头部腺瘤行肿瘤局部切除术后半年出现黄疸 ,病因不详。 4例间质瘤均健在且生存 16 2 1个月 ,36例原发性十二指肠恶性肿瘤中胰头十二指肠切除 18例 ,节段切除 1例 ,手术切除率为 5 1.2 %。结论　B超、CT、纤维十二指肠镜检查是诊断PTD的主要手段。手术切除是最基本有效的治疗方法。对于良性肿瘤可行局部肿瘤切除、十二指肠节段切除或经内镜切除。对于恶性肿瘤 ,胰十二指肠切除术是首选术式。     

鼓室穿刺治疗腭裂渗出性中耳炎的临床评价

目的　探讨腭裂修复同期 ,鼓室穿刺对腭裂伴分泌性中耳炎患者中耳功能及听力损失的影响。方法　将 80例 ( 14 6耳 )患有分泌性中耳炎的腭裂患者 ,随机分为实验组 ( 78耳 ) :常规腭裂修复术 ,术毕作鼓室穿刺。对照组 ( 68耳 ) :单纯腭裂修复术。术后 6个月两组均进行鼓室图、脑干听觉诱发电位检查 ,并进行比较。结果　实验组术后无论与术前比较 ,还是与对照组术后比较 ,鼓室图、V波反应阈值及轻、中度听力损失 ,均有显著进步 (P <0 0 1) ;术后半年内实验组听力恢复早 ,而且治愈率高 ( 96 2 % ,75 /78) ,明显优于对照组 ( 3 8 2 % ,2 6/68)。结论　腭裂修复同期鼓室穿刺 ,不仅有助于改善伴有分泌性中耳炎腭裂患者的中耳功能 ,提高听力 ;而且可避免或减少粘连性中耳炎的发生     

国产氟康唑对小鼠隐球菌病的疗效

以５×１０３ｃｆｕ／鼠的新型隐球菌给小鼠脑室感染（ｉｃ）１ｈ后，分别口服氟康唑（Ｆｌｕ）５和１０ｍｇ／（ｋｇ·ｄ）或酮康唑（Ｋｅｔ）５０和１００ｍｇ／（ｋｇ·ｄ），ｂｉｄ×９ｄ。对ｉｃ小鼠连续观察４０天的存活率和平均存活时间，Ｆｕｌ分别为５０％～７０％和８～１５天，Ｋｅｔ是３０％～４０％和５～９天。由小鼠侧尾静脉注射１０６ｃｆｕ／鼠新型隐球菌３天后产生的全身感染，分别给小鼠口服Ｆｌｕ２．５～１０ｍｇ／（ｋｇ·ｄ）或Ｋｅｔ２５～１００ｍｇ／（ｋｇ·ｄ），ｂｉｄ×９ｄ。感染２４、２８和３２天的ＰＤ５０Ｆｌｕ是２．７、３．５和６．７ｍｇ／ｋｇ，Ｋｅｔ为２８．４、７０．４和８３ｍｇ／ｋｇ；Ｆｌｕ和Ｋｅｔ的平均存活时间分别是２３～３４天和２０～３１天。在上述两种实验模型中分离脑和肺做细菌培养，Ｆｌｕ均与对照和５０ｍｇ／（ｋｇ·ｄ）的Ｋｅｔ比较，对ｉｃ１０天及静脉注射感染１３天的小鼠，口服５和１０ｍｇ／（ｋｇ·ｄ）或２．５～１０ｍｇ／（ｋｇ·ｄ）Ｆｌｕ均显著抑制新型隐球菌生长。     

Estimation of body composition in Chinese and British men by ultrasonographic assessment of segmental adipose tissue volume.

It has been shown that ultrasonographic measurements can be used to predict body composition in adults. The purpose of this study was to assess the relationship between ultrasonograph and caliper (SKF) measurements of subcutaneous adipose tissue thickness in athletic Caucasian (English, E) and Asian (Chinese, C) men against estimates of body composition determined from hydrodensitometry (HYD). The usefulness of a proposed ultrasonographic method of estimating lean and fat proportions in the upper and lower limbs was also evaluated as a potential method of predicting body composition. Ultrasonography (US) was used to measure adipose and skin thickness at the following sites: biceps, triceps, subscapular, suprailiac, abdominal, pectoral, thigh and calf. Caliper measurements were also made at the above sites. Subcutaneous fat thickness and segmental radius were measured directly from the display screen of the ultrasonic scanner (Aloka 500 SD). By applying the geometry of a cone, the proximal and distal radii of the upper arm and upper leg were used to calculate the proportionate volumes of adipose tissue. The best correlations for US and SKF were obtained at the quadriceps, subscapular and pectoral sites for E (r = 0.96, 0.93 and 0.90, respectively) and at the quadriceps, calf and abdominal sites for C (r = 0.90, 0.81 and 0.75, respectively). The best ultrasonographic predictor of the percentage fat in both groups was the percentage adipose tissue volume in the upper leg (r = 0.83 and 0.79 for C and E, respectively). Stepwise multiple regression analysis indicated that the prediction of percentage fat was improved by the addition of the ultrasonographic abdomen measurement in both groups: Chinese sample: %fat = %fat(leg) (0.491) + US abdomen (0.337) + 0.95 ( R = 0.89, s.e.e. = 1.9%); English sample: %fat = %fat(leg) (0.435) + US abdomen (0.230) - 0.765 ( R = 0.80, s.e.e. = 3.6%). It is concluded that ultrasonographic measurements of subcutaneous adipose tissue and volumetric assessment of percentage adipose tissue in the thigh are useful estimates of body composition in athletic English and Chinese males.     

Dynamic evaluation of 18F-FDG uptake by microPET and whole-body autoradiography in a fibrosarcoma-bearing mouse model.

BACKGROUND AND PURPOSE: Fluorine-18-2-deoxy-D-glucose (18F-FDG) has been used in the clinic as a diagnostic radiotracer for monitoring many kinds of tumors, but its value for monitoring fibrosarcoma is not well established. METHODS: In this study, the uptake of 18F-FDG in a fibrosarcoma-bearing mouse model was evaluated using the high resolution positron emission tomography (PET) system microPET. Tumor cells were implanted in 3 FVB/N mice, and static microPET scanning was performed on day 1, 7, 12 and 15 after implantation. A dynamic microPET image was scanned on day 12 to determine the 18F-FDG uptake in 3 other tumor-bearing mice. Time-activity curves were plotted by drawing regions of interest in the tumor, liver, kidneys and muscles. The mice were sacrificed after dynamic microPET imaging and whole-body autoradiography (WBAR) was performed. For biodistribution study, 9 tumor-bearing mice, 3 per experimental group, were studied at 3 time points and the results were compared with the static microPET images. RESULTS: MicroPET images suggested that 18F-FDG could be used to monitor the growth of tumors 7 days after implantation. Dynamic scans of 18F-FDG uptake reached a plateau in the tumor after 20 minutes on day 12 after implantation. Both microPET and WBAR revealed evidence of tumor necrosis. The results of biodistribution and WBAR agreed with those from microPET images. CONCLUSION: MicroPET was useful for monitoring the growth of fibrosarcoma and determination of the maximal uptake time point of 18F-FDG in tumors in this tumor-bearing mouse model.     

肝靶向半乳糖基干扰素的合成及其生物学性质研究

本文采用２－亚氨基－２－甲氧乙基－１－β－硫代－Ｄ－半乳吡喃糖甙与基因工程干扰素（ＩＦＮａ１）相偶联，得到半乳糖基基因工程干扰素ａ１偶物（Ｇａｌ－ＬＦＮａ１）。并分别进行小鼠体内分布实验和家兔显像实验，其趋肝性实验结果表明，肝脏对Ｇａｌ－ＩＦＮａ１和ＩＦＮａ１的最大摄取值分别为２９．１％和１０．０％，并采用细胞致病变效应（ＣＰＥ）抑制微量法测定了偶联物的效价，偶联物Ｇａｌ－ＩＦＮａ１与对照品（ＩＦ     

自拟人参二苓解毒汤联合盐酸恩丹西酮注射液治疗顺铂引起恶心呕吐临床观察

[目的]探讨顺铂引起恶心呕吐的有效治疗途径。[方法]对肺癌患者64例,随机分2组。自拟人参二苓解毒汤联合盐酸恩丹西酮注射液(以下简称商品名欧贝)(B组)和单独使用欧贝(A组)对顺铂为主的静脉化疗后镇吐疗效。[结果]B组(78·13%,93·75%)较A组(59·38%,75·00%)在近期镇吐治疗(指化疗后24-48h出现恶心呕吐)有明显差异(P<0·05),并在副作用方面,如便秘,乏力症状和血三系下降有明显差异(P<0·05)。[结论]辅以自拟人参二苓解毒汤确有增效解毒功能。     

舒张功能障碍对冠心病的诊断价值

目的应用超声多普勒方法评价冠心病患者的左室整体舒张功能及舒张功能障碍的发生率，探讨舒张功能障碍在冠心病无创诊断中的价值。方法对入选病人行常规检查，同时进行二尖瓣血流频谱、肺静脉血流频谱及二尖瓣环组织多普勒检查，对比临床标准与舒张功能障碍标准对冠心病的诊断率。结果舒张功能障碍标准对冠心病的检出率显著高于临床标准。结论舒张功能检查可作为冠心病诊断的初筛检查。     

ENDOSCOPIC MUCOSAL RESECTION AND SUBMUCOSAL DISSECTION METHOD FOR LARGE COLORECTAL TUMORS

The goal of endoscopic mucosal resection (EMR) is to allow the endoscopist to obtain tissue or resect lesions not previously amenable to standard biopsy or excisional techniques and to remove malignant lesions without open surgery. In this article, we describe the results of conventional EMR and EMR using an insulation‐tipped (IT) electrosurgical knife (submucosal dissection method) for large colorectal mucosal neoplasms and discuss the problems and future prospects of these procedures. At present, conventional EMR is much more feasible than EMR using IT‐knife from the perspectives of time, money, complication, and organ preservation. However, larger lesions tend to be resected in a piecemeal fashion; and it is difficult to confirm whether EMR has been complete. For accurate histopathological assessment of the resected specimen en bloc EMR is desirable although further experience is needed to establish its safety and efficacy. Further improvements of in EMR with special knife techniques are required to simply and safely remove large colorectal neoplasms.