人膈肌内神经分支分布

目的：探讨人膈的神经支配和肌内神经分支分布特点。方法：改良Sihler’s肌内神经分支染色法。结果：(1)一侧膈神经入肌后一般分为3—4支(3支型4例,4支型2例),1支(前支)向前内侧走行,支配胸部,1～2支(前外侧支)向外侧走行,支配肋部,最后1支(后支)最粗大,向后下走行,分为后外侧支和后脚支,分别支配膈中心腱外侧叶后外侧的肋部和腰部,各级神经的分支在肌束中部密集排列成神经丛。(2)6例标本均未发现左侧或右侧膈神经越过中线至对侧。(3)2例带肋间肌的标本肉眼未见有肋间神经分支进入膈。结论：(1)左、右膈神经分布于膈,未见左右侧膈神经重叠支配和优势支配。(2)膈神经的终末分支在肌束中部密集排列形成似“肾形”的神经丛带。     

检测先心病患儿EEG和BAEP的意义

目的　评价先心病儿心脏手术前后脑电图 (EEG)、脑干听觉诱发电位 (BAEP)的变化。方法　对 30例先心病儿童术前EEG、BAEP的变化和 2 0例接受不停跳体外循环心内直视手术患儿手术前后EEG、BAEP的动态变化进行对比观察 ,并设 30名健康儿童为对照。结果　 ( 1)术前 :①EEG :发绀组 (CCHD)异常率为 80 % ( 8/ 10 ) ,非发绀组 (NCCHD)异常率为 30 % ( 6 / 2 0 ) ,有显著性差异(P <0 .0 5 )。②BAEP :CCHD组异常率为 10 0 % ( 10 / 10 ) ,NCCHD异常率为 6 5 % ( 13/ 2 0 ) ,有显著性差异 (P <0 .0 5 ) ,Ⅴ波潜伏期 (PL)、Ⅲ～Ⅴ、Ⅰ～Ⅴ波峰间潜伏期 (IPL)先心病患儿与对照组比较 ,CCHD组显著延长 (P <0 .0 5 )。③EEG与BAEP :EEG异常者BAEP均异常 ( 10 0 % ) ,EEG正常者BAEP有 5 6 .3 %异常。 ( 2 )手术前后比较 ,EEG和BAEP异常率有显著性差异 (P <0 .0 5 )。结论　①先心病患儿伴有脑功能异常 ,CCHD较NCCHD为重。②EEG与BAEP均可反映脑功能异常改变但非同步。③术后短期内EEG、BAEP无好转 ,提示脑功能恢复可能需要较长时间。     

普萘洛尔(心得安)对灰鼠噪声性聋的影响

目的 研究噪声和β受体阻滞剂普萘洛尔（心得安）对灰鼠耳蜗复合动作电位和耳蜗血流的影响。方法 使用１／２倍频程窄带、噪声其中心频率１５００ＨＺ,强度１１５ｄＢＳＰＬ,持续刺激９０分钟。观察不同浓度普洛尔对灰鼠耳蜗复合动作电位和耳蜗充的影响结果     

Primary liver tumors in China

Until now, no large series studies on the clinicopathological features of primary liver tumors (PLTs) in mainland China have been reported. The authors retrospectively investigated 3,160 cases of PLTs surgically resected at Shanghai Oriental Hospital of Hepatobiliary Surgery between January 1982 and January 1996. Most of them are true neoplasms, others are tumor-like lesions. The 3,160 cases of PLTs could be divided into 3 groups of 25 types arising from three germinal layers, of which tumor-like lesions (Group 1) were of 4 types involving 112 cases (3.5%), benign PLTs (Group 2) were of 10 types involving 499 cases (15.8%) and malignant PLTs (Group 3) were of 11 types involving 2,549 cases (80.7%). The most common type of lesion in each group was solitary necrotic nodule, cavernous hemangioma and hepatocellular carcinoma (HCC), accounting for 73.2%, 74.3% and 96.6% of their respective groups. The patients ranged in age from 5 months to 79 years (mean, 45.7 years), but the age distribution and sex ratio varied reciprocally from group to group and from lesion to lesion. For example, the mean age of the patients in Group 1 was 39.1 years of age, whereas in Group 2 and Group 3, it was 45.9 years and 49.6 years, respectively. The sex ratio of men to women was 2.6:1 in Group 1, 1:1.1 in Group 2 and 7.7:1 in Group 3. The rates of serum HBsAg positivity and concomitant liver cirrhosis in the patients with HCC were 74.4% and 72%, respectively, and the concomitant rate of cirrhosis in small HCC (<3 cm in diameter) was as high as 83.3% (P<0.05), demonstrating a close relationship of HCC with HBV infection and liver cirrhosis. HCC amounts to 78.4% of the total 3,160 PLTs in this series, indicating that HCC is the most common malignant tumor of the liver in China.     

Experimental study on the antitumor effect of mouse B7-1 gene

ＴｗｏｓｉｇｎａｌｔｈｅｏｒｙｆｏｒＴｃｅｌａｃｔｉｖａｔｉｏｎｐｒｏｖｉｄｅｄａｎｅｗａｐｐｒｏａｃｈｆｏｒｔｕｍｏｒｇｅｎｅｔｈｅｒａｐｙ［１－２］．Ｅｘｐｒｅｓｓｉｏｎｏｆｃｏｓｔｉｍｕｌａｔｏｒｙｍｏｌｅｃｕｌｅｇｅｎｅｉｎｔｒａｎｓｆｅｃｔ...     

192例腰椎间盘突出症患者的诊断及手术治疗分析

目的：总结分析１９２例腰椎间盘突出症及侧隐窝狭窄伴黄韧带肥厚患者的诊断和手术治疗。方法：经临床检查明确定位、定性诊断,影像学检查证实,采用小切口半椎板或全椎板切除减压、突出椎间盘髓核切除手术治疗。结果：手术证实腰椎间盘突出症１８９例,侧隐窝狭窄伴黄韧带肥厚３例,术后随访６月－５年,优良率７９％。结论：临床检查是腰椎间盘突出症诊断的基础,影像学检查对进一步明确定位诊断和鉴别诊断是必要的。手术指征的严格把握是手术成功的关键。     

愈溃膏治疗臁疮的临床评价

目的探讨治疗臁疮的有效方药;方法应用白行研制的愈溃膏,采用外敷的方法,治疗臁疮80例,同期常规治疗45例作为对照;结果应用愈溃膏治疗80例患均取得较好效果,明显优于对照组;结论愈溃膏对于臁疮有较好疗效。     

彩色多普勒超声对甲状腺癌的诊断价值

目的 客观评价彩色多普勒超声(CDUS)对甲状腺癌(TC)的术前诊断价值。方法80例TC术前均经CDUS观察,术后病理证实。结果68例TC与术前CDUS诊断符合,符合率85％。误诊12例,误诊率15%,声像图特征：(1)病灶周围低回声晕环。CDFI和CDE显示晕环内无血流信号。(2)癌肿内部“实性结构为主,囊变率30％。(3)癌肿内大多数出现纡曲扩张的变形血管。(4)癌肿内钙化率65％。(5)单发于右侧叶或峡部癌肿多见。(6)CDFI和CDE显示癌肿内高速血流出现率7,6％,最高峰值0．70～1,61m／s。结论CDUS显像结合CDFI和CDE技术应用,对TC术前正确诊断具有很高价值。     

小儿缩窄性心包炎的临床和病理观察

对３０例小儿缩窄性心包炎进行了临床和病量分析。结果显示：临床症状及体征无显性差异。由金典色葡萄球菌引起的急性心包炎中在较短时间内形成缩窄。病理改变既有炎症反应,肉芽组织增生,又有纤维组织增生。     

沙利度胺治疗多发性骨髓瘤的临床疗效

目的 :探讨沙利度胺治疗多发性骨髓瘤 (MM)的临床有效性。方法 :初治、难治或复发MM患者 10例 ,沙利度胺起始剂量 5 0～ 2 0 0mg·d-1,每 2wk增加 5 0～ 2 0 0mg·d-1,直到患者能够耐受或有效 ;同时联合应用化疗。根据M蛋白评定疗效为完全缓解 (CR)、很好的部分缓解 (VGPR)、部分缓解 (PR)、微小反应 (MR)和无反应 (NR)。同时对贫血、骨髓浆细胞比例和其他如口腔溃疡等进行评价。结果 :CR 3例 ,VGPR 3例 ,PR 4例。平均随访时间 5 0 5wk ,总生存率 90 %,无病生存率 30 %。无不能耐受的不良反应。结论 :沙利度胺可作为初发或难治MM的治疗。