肿瘤休眠研究进展

肿瘤休眠是一个临床概念,已有近50年的研究历史,经历了对肿瘤休眠的现象描述、肿瘤休眠动物模型的建立、肿瘤休眠机制研究、实验性肿瘤休眠诱导与肿瘤休眠疗法等阶段.休眠肿瘤细胞的长期存在是恶性肿瘤难以彻底根治的主要原因,也是导致肿瘤复发和远处转移的根源.彻底阐明肿瘤休眠机制,将有助于实现对肿瘤复发与转移的有效控制.     

环状胎盘一例

患者２８岁。因足月妊娠４０周，于１９９６年１２月１１日入本院产科。孕２产１。即往人工流产１次。此次妊娠经过顺利。孕期无阴道流血，门诊于妊娠２８周、３７周、４０周分别行Ｂ超检查，示胎盘附着于子宫侧壁、子宫前壁、子宫前侧壁。妊娠４０周＋３自然临产，顺娩一...     

蠲痹汤联合肩关节内注射玻璃酸钠治疗肩周炎46例疗效观察

目的:观察蠲痹汤联合肩关节内注射玻璃酸钠治疗肩周炎的临床疗效。方法:将87例肩周炎患者随机分为2组。治疗组46例,采用蠲痹汤(处方:羌活、姜黄、防风、桂枝、当归、赤芍、黄芪、党参、杜仲、海风藤、伸筋草、续断、徐长卿、乳香、没药、附子、生姜、大枣、甘草)联合肩关节内注射玻璃钠治疗;对照组41例,采用消炎镇痛药物戴芬胶囊或西乐葆胶囊治疗。结果:治疗后治疗组肩关节前曲、外展、后伸功能均明显改善,并可明显减轻关节疼痛,日常生活活动(ADL)能力也明显提高,与治疗前比较,差异均有非常显著性意义(P<0.01)。治疗组与对照组治疗后比较,差异亦均有显著性意义(P<0.05)。结论:蠲痹汤联合肩关节内注射玻璃酸钠治疗肩周炎,可明显减轻关节疼痛,对肩关节功能恢复具有良好的治疗效果。     

三七和三七剪口中糖类物质分析

三七(Panax notoginseng(Burk)F.H.Chen)为五加科植物,干燥根入药.别名山膝、金不换、田三七等.三七是我国的传统珍贵药材,具有止血、散瘀,消肿、止痛的功效[1].对三七的研究主要集中在皂苷类成分上[2],而对三七和三七剪口中糖类物质成分的含量分析则鲜见报道,本文采用3,5-二硝基水杨酸测定三七和三七剪口中糖类物质的含量[3].     

高效液相色谱法测定康复胶囊中大黄酚的含量

目的：建立康复胶囊中大黄酚的含量测定方法。方法：采用高效液相色谱法，Zorbax SB 18硅胶柱(4.6 mm×250.0 mm，5 μm)，流动相：甲醇∶水∶磷酸(900∶100∶0.1)，流速：1.0 mL·min 1，检测波长：290 nm。结果：线性范围0.32～3.20 μg(r＝0.999 9)，平均回收率101.33%，RSD＝2.31%。结论：该法简便，快速，准确。     

抗肝纤颗粒的质量标准

目的制定抗肝纤颗粒的质量标准。方法采用薄层色谱(TLC)法对方中的黄芪、虎杖进行鉴别试验,用高效液相色谱(HPLC)法对丹参酮ⅡA的含量进行测定,流动相:甲醇-水(20:1)、检测波长270nm。结果薄层鉴别显示供试品的色谱与对照品色谱在相应的位置上,显相同颜色的斑点,阴性对照显示无干扰;HPLC法测定结果显示丹参酮ⅡA在0.038～0.38ug范围内线性关系良好,γ=0.9998(n=5),平均回收率为99.45%结论本方法专属性强,操作简便、准确,可用于抗肝纤颗粒的质量控制。     

早期肾盂癌的诊断和诊断方法的比较

目的探讨早期肾盂癌的诊断和最有效的诊断方法。方法在诊断肾盂癌时采用B超、静注尿路造影(IVU)、逆行性肾盂造影、CT、泌尿系磁共振水成像(MRU)、输尿管肾盂镜检查等多种方法,比较各种方法对早期肾盂癌诊断的准确率。结果IVU和逆行性肾盂造影、CT、输尿管肾盂镜、MRU、B超对早期肾盂癌的诊断阳性率分别是89%、94%、80%、50%、40%和22%。结论IVU和逆行性肾盂造影是诊断早期肾盂癌最基本和最必要的有效检查方法,是其他方法不能代替的。因输尿管肾盂镜检查为有创性检查,故可作为疑难病例最后的确诊性检查方法,不宜做首选的检查方法。B超可作为普查之用。     

Amplatzer封堵器治疗先天性心脏病497例

先天性心脏病(先心病)是小儿最常见的心脏病,在存活的婴儿中发生率约占0.8%,估计我国每年有15万先心病病儿出生[1].自上世纪60年代开始,应用经皮穿刺介入治疗先心病已部分取代了外科手术而作为首选治疗方法.2004年3月～2005年9月应用国产Amplatzer封堵器经皮介入治疗497例先心病患者,取得了较好的近期临床效果,报告如下.     

A retrospective study of fluid therapy for 100 patients of liver transplantation

Objective: To review the evolution of fluid therapy (IOFT) during liver transplantation (LTX) based on clinical experience in our institute over 7 years. Methods: All patient records (n = 130) of LTX from 1996 to 2003 were examined. After excluding patients with co-morbidities 100 cases were found suitable for IOFT analysis. All patients had undergone LTX and follow-up under the same surgical team. Based on IOFT records we tried to identify distinct patterns of practice evolving over 7 years. Intraoperalive hemodynamics (IOHD) and long-term outcome records were examined. Results: Retrospectively, 3 types of IOFT were found. Group A (n= 18, period 1996-1997) received high amounts of crystalloids; group B (n= 24, period 1998-2000) received high amounts of plasma and albumin; and group C (n = 58, period 2001-2003) received lower amounts of albumin and plasma and recommended amounts of 6% hy-droxyethyl starch 200/0. 5 (HES) and high amounts of vasoprcssors. Intraoperatively, group A exhibited the highest levels of central venous and pulmonary artery pressures in the neo-hepatic stage (P<0. 05). Postoperatively, the patients in group C had the shortest time to extubation; the values for group A,B,C were (15.8±11), (17. 3±10. 2) and (7. 98±3. 2) h respectively( P<0. 05). At the end of one-year follow-up, the patients in group C had the lowest mortality (group A, B, C were 27. 78%, 29. 17% and 6. 25% respectively; P<0. 05). Conclusion: In our institute over the years the use of crystalloids, albumin and plasma during IOFT of LTX is gradually replaced to a large extent by HES. The improvements in IOHD and long term outcomes are likely to be related to improved surgical experience of our team. Nevertheless, the shift in IOFT practices might be associated with an beneficial effect on IOHD or long term outcome. Treatment with proper amount of liquid and vasoactive drugs may be a better method of fluid therapy.     

腹腔镜肝门空肠吻合手术治疗胆道闭锁的探讨

目前治疗先天性胆道闭锁标准术式是肝门肠吻合术，这是腹部外科最复杂的手术之一，对患儿打击大。为减少对患儿的损伤，有些学者开始研究探讨经腹腔镜行此手术的可行性。但是例数极少，经验不多。