胰十二指肠切除术的几点技术改进(附12例报告)

作者对胰十二指肠切除术做了四点技术改进：①经小肠系膜根部后方十二指肠水平段隧道提取空肠至横结肠上区，再做吻合；②经结肠后行十二指肠或胃与空肠端侧吻合术；③放置２５～３０ｃｍ长的胰管支撑内引流管；④经胃窦前壁通过幽门及吻合口放置空肠营养管。文内对上述改进的技术进行了详细的介绍，并阐述了每项技术的优点和意义。     

锌离子对大鼠海马突触体Ca^2＋—Mg^2＋ATP酶活性及蛋白合成的影响

行为实验己经证明，锌过多或缺锌均可影响脑功能。锌作为体内重要的微量元素，影响多种酶的活性及蛋白质和核酸的台成。本实验通过体外分离大鼠脑海马突触体，观察不同浓度锌离子对Ca2 －Mg2 ATP酶的活性和3H－Leu掺入突触蛋白合成的影响．结果表明：1．锌离子浓度在25μmol／L时增加该酶的活性（＜0．01），并促进3H－Leur掺入蛋白质的合成（＜0．05）。2．锌离子在50,100，200μmol／L的较高浓度时对Co2 －M2 ATP酶的活性有显著的抑制作用（分别为：P＜0.05．P＜0．01，P＜0.01），仅200μmol／L对3H—Leu掺入突触蛋白合成有抑制作用。本研究提示：适量的锌对突触体功能的维持是必要的，但剂量过高则起相反作用。     

PROTECTIVE EFFECTS OF PENTAGASTRIN AGAINST STRESS-INDUCED GASTRIC LESIONS IN RATS

The rats, pretreated with pentagastrin, 250 Vg/kg, daily for 7 days, were given restraint water immer sion stress for 3 hours and observed for lesion index of the gastric mucosa. The results showed that the lesion index of the pentagastrin group was sig- nificantly decreased as compared with that of the control group. Light and electron microscopically, the mucosal layer was thickened and both the chief cells and parietal cells were in an active state. This suggests that gastrin has protective effects against the stress-induced gastric lesions through its trophic action on the gastrointestinal tract.     

赖型钩端螺旋体重组DNApCX7的特异性鉴定和限制性内切酶谱分析

本实验将赖型钩端螺旋体（简称钩体）ＤＮＡ基因库的克隆ｐＣＸ７制备成￣（３２）Ｐ－重组ＤＮＡ探针，对８个不同血清群的１７株问号状钩体、双曲钩体ＰａｔｏｃⅠ株以及细螺旋体３０５５株ＤＮＡ进行打点杂交；同时用１５种ＤＮＡ片断进行限制性内切酶谱分析。结果表明，该重组ＤＮＡ具有问号状钩体种（Ｓｐｅｃｉｅｓ）特异性，但与不同问号状钩体之间的同源性程度有差别；限制性内切酶谱分析发现ｐＣＸ７重组ＤＮＡ片段长约１．７ｋｂ，具有１个Ｂｇ１Ⅱ识别位点和３个ＢｓｔＢ１识别位点。     

准分子激光冠状动脉成形术的初步临床应用经验

目的：介绍准分子激光冠状动脉成形术（ＥＬＣＡ）治疗冠状动脉狭窄的临床应用经验。材料和方法：１０例冠心病患者作冠状动脉造影确认有１４支冠状动脉狭窄（狭窄率７０％～７５％者５支，９０％～１００％者９支）。全部病例均作ＥＬＣＡ手术。ＥＬＣＡ采用脉冲间期为１８０－２２０ｍｓｅｃ，光导纤维直径为１．３～１．６ｍｍ，能量密度１４．５～２１．０ｍＪ，激光频率为２０Ｈｚ。ＥＬＣＡ术后辅以球囊扩张血管成形术（ＰＴＣＡ）。结果：９例１３支狭窄动脉中，９支狭窄率＞９０％者，作ＥＬＣＡ＋ＰＴＣＡ成功，其中７支动脉狭窄率减至１５％以下，２支减至４０％～４５％，１例因术中导丝头断裂，失败。成功的９支动脉术后冠状动脉造影示：内膜光滑４支，毛糙３支，夹层动脉瘤１支（２月后随访消失），术中出现血栓１支。术后６个月内造影随访，３例动脉再度狭窄。结论：准分子激光冠状动脉成形术可用于ＰＴＣＡ难以成功的有钙化硬斑、挟窄段较长（＞２．０ｃｍ）和闭塞的冠状动脉，安全有效。但它并不能避免术后再狭窄的发生。     

尿蛋白-1与糖尿病肾病关系的研究

目的为了探讨尿蛋白-1(UP-)与糖尿病肾病的关系。方法用酶联免疫法测定了90例非胰岛素依赖型糖尿病(NIDDM)患者的UP-1,同时测定尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG)、β2-微球蛋白(β2-mG)。结果糖尿病患者UP-1均较正常对照组增高,UP-1与尿A1b、尿NAG和β2-mG呈正相关。结论在糖尿病早期阶段,肾小管会受到损害,UP-1可作为诊断早期糖尿病肾病的敏感指标。     

三吡萘啶对伯氏疟原虫ANKA株超微结构的影响

受染伯氏疟原虫ＡＮＫＡ株小鼠ｉｇ三吡萘啶游离碱１１ｍｇ／ｋｇ给药后１ｈ可见少数滋养体复合物层次增多且断裂，皱缩，并出现间隙，食物泡融合增大，２ｈ后进一步加剧，且疟原虫髓样物也增多，线粒体肿胀，４ｈ后出现变化的原虫更明显增多，８ｈ后绝大多数滋养体结构多已瓦解，仅留上膜残体及大小不等的空泡，总之，其超微结构的变化与咯萘啶作用甚为相似。     

肝动脉化疗,栓塞与肝静脉暂时闭塞治疗肝癌

本文报道在10例肝癌患者中运用肝静脉暂时闭塞和肝动脉内灌注化疗、栓塞的方法治疗取得较好疗效。7例甲胎蛋白阳性患者5例下降大于50%,2例转阴。4例肿瘤缩小>50%。2例合并肝动-静脉瘘者成功实行碘油栓塞,1例经治疗后肝动-静脉瘘消失。对肝功能的影响与普通介入治疗相同。消化道反应相对较轻。并可提高肿瘤局部药物浓度,延长药物作用时间。配合肝段动脉或靶血管的插管可进一步提高疗效,减少并发症。     

Synergistic renal protection by combining alkaline-diuresis with lipid peroxidation inhibitors in rhabdomyolysis: possible interaction between oxidant and non-oxidant mechanisms

BACKGROUND AND PURPOSE.: Heme-proteins, besides causing renal tubular obstruction, maycontribute to rhabdomyolysis-induced renal injury through aheme-iron-mediated lipid peroxidation process. In the presentstudy, we compared the combined therapy of a lipid peroxidationinhibitor, 21-aminosteroid (21-AS) and fluid-alkaline-mannitol(FAM) diuresis with either of them alone to determine the efficacyof the combination therapy and to delineate the roles of lipidperoxidation and cast formation. METHODS AND RESULTS.: Employing Raman spectroscopy, we confirmed in vitro the abilityof 21-AS to inhibit iron-induced fatty acid peroxidation. 21-ASwas then administered to rats developing renal failure fromglycerol-induced rhabdomyolysis. Although 21-AS inhibited rhabdomyolysis-inducedplasma and renal lipid peroxidation, renal protection was incomplete.Administration of FAM to inhibit cast formation afforded a betterrenal protection. However, when these therapies were combinedto inhibit both lipid peroxidation and cast formation, therewas a synergistic renal functional protection. This was accompaniedby a maximum inhibition of renal and plasma lipid peroxidation,as well as, renal tubular necrosis and cast formation. Comparedto combination therapy, FAM therapy alone, despite identicalvolume, was accompanied by a higher tubular necrosis and castformation. CONCLUSIONS.: That combining a lipid peroxidation inhibitor with fluid-alkalinediuresis in rhabdomyolysis further lowers renal lipid peroxidation,tubular necrosis and cast formation and synergistically limitsrenal dysfunction (i) supports a role for lipid peroxidationin the pathophysiology of rhabdomyolysis ARF, (ii) underscoresthe role of intratubular heme retention, a cause for tubularobstruction as well a source for prodigious amount of iron,likely involved in the lipid peroxidation, and (iii) raisesthe possibility of interactions between non-oxidant and oxidantmechanisms.     

中国农村地区5岁以下儿童肺炎死亡社会危险因素研究

目的 调查农村5岁以下儿童肺炎死亡相关的社会危险因素.方法1995年11月—1997年2月在湖北恩施和建始两个贫困地区对5岁以下儿童肺炎死亡的危险因素进行病例—对照研究,死亡病例组226例,肺炎对照组 452例.结果 引起儿童肺炎死亡的社会-经济危险因素有:家庭的人均年收入少于 450元、母亲没有立即带孩子看病的理由是没钱看病或交通不便、家中曾有过一个孩子死亡、家长和村医生的文化程度低、父亲的职业是农民、居室内有火炉、母亲对疾病的认识不够、医生的专业培训不足等.结论 除生物相关因素外,社会危险因素同样是农村5岁以下儿童肺炎死亡的重要因素.它们中某些因素是可以借助对父母的健康教育和急性呼吸道感染病例标准管理而得到控制.