肝移植术后早期并发症

目的：探讨肝脏移植术后早期并发症的预防和治疗方法。方法：对该院进行的原位经典式肝脏移植手术后病人的并发症情况进行总结。结果：在5例肝脏移植病人中早期出现神经功能障碍、肝动脉狭窄和栓塞、胆瘘和胆道梗阻、慢性排斥反应。结论：肝移植术后早期并发症可引起严重后果，但恰当的治疗可以提高疗效。     

2007年北京大学第一医院研究生论文发表情况调查报告

Objective To investigate the quality of postgraduate education from the publication state.Method To analysis the publication states from different postgraduate students in 2007 in Peking University First Hospital. The papers from 69 students who acquired the qualification were analyzed.Ph.D.,M.D.and Master were selected.Results The number of publication were 3.17、1.93 and 1.58 in Ph D,M.D.and Master,respectively.The number of publication with science citation index were 1.50、0.18 and 0.08,respectively.The average impact factor(IF)were 4.72、0.57 and 0.15,respectively.The number of publication and IF were more in Ph. D.than that in other postgraduate students.Conclusions Postgraduate students with different academic degree received appropriated training.Ph.D.candidate acquired the ability of engage scientific research and writing thesis in high quality.     

肝移植术后感染细菌学和耐药性及相关因素分析

目的总结肝移植病人术后细菌感染的规律，为防治感染提供依据。方法回顾性分析23例肝移植术后感染病人细菌学及耐药性资料，比较研究围手术期因素和感染发生的相关性。结果(1)术后感染病人最多见的病原菌依次为：金黄色葡萄球菌、铜绿假单胞菌、阴沟肠杆菌、大肠埃希菌、肠球菌；(2)病原菌多数多重耐药；(3)感染相关因素有：有无肝硬化(P=0．000)、术前白蛋白(P=0．026)、术前有无感染(P=0．026)、手术时间(P=0．014)、术中输红细胞量(P=0．000)、ICU住院时间(P=0．000)、呼吸机使用时间(P=0．012)；(4)背驮式和经典式肝移植术后肠道菌菌血症发生率不同(P=0．029)。结论肝移植术后感染的病原菌大多是有强耐药性的院内感染细菌，抗菌药物的经验性使用可选择头孢哌酮／舒巴坦、头孢吡肟、碳青霉烯和糖肽类抗菌药。     

门静脉高压症血流动力学改变及冠状静脉脾静脉壁NOS2、VEGF表达与出血的关系

目的研究门静脉高压症病人门静脉系统血流动力学改变与食管胃底静脉曲张破裂出血的关系,及不同出血史病人门静脉系统血管壁NOS2、VEGF的表达.方法 43例门静脉高压症病人依照出血病史分为两组,A 组(无上消化道出血史或1次出血史)26例,B组(>1次出血史)17例行门静脉系统超声血流检查,术中测压,取冠状静脉脾静脉血管壁免疫组化NOS2、VEGF染色(S-P法).结果门静脉主干内径(PVD)(14.56±1.69)mm,最大血流速度(PVMAX)(19.47±5.35) cm/s,血流量(PVBF)(840.66±211.81)L/min,门静脉压(PVP)(33.2±7.07) cmH2O.A、B两组病人门静脉最大血流速度及门静脉压(PVP)无统计学意义.A组病人门静脉直径及门静脉血流量显著高于B组.43例中28例(65.1%)有冠状静脉逆流(离肝血流).脾静脉血流量(422.5±139.4)L/min,脾静脉平均血流量与门静脉平均血流量之比为0.503,B组病人脾静脉血流量低于A组.脾静脉NOS2阳性率A组为30.8%,B组为52.9%.冠状静脉VEGF阳性率A组为38.5%,B组为58.8%.门静脉系统血管内皮的NOS2和VEGF均有高表达.结论门静脉系统高血流动力学是引起出血的基本条件,初期高血流动力学是机体代偿机制;多次出血史病人门静脉脾静脉血流量明显下降;脾静脉主动充血在门静脉高压症的发生中起重要作用;血管结构改变是影响出血的重要抑或直接因素;门静脉系统血管内皮NOS2高表达在维持高血流动力学中起重要作用;门静脉系统血管内皮VEGF高表达与血管结构改变紧密关联,并因此影响出血情况.     

胰腺癌组织中K—ras基因点突变的研究

应用Ｔａｑ酶直接测序技术对９例胰腺癌标本及１例恶性胰岛细胞瘤标本进行了Ｋ－ｒａｓ基因１２位点突变的检测。结果显示：９例胰腺癌中含Ｋ－ｒａｓ基因突变者５例。表现出２突变类型，即ＣＣＡ→ＣＧＡ型４例；ＣＣＡ→ＣＡＡ型１例。相应氨基酸改变分别为：甘氨酸→丙氨酸；甘氨酸→缬氨酸。分析了在突变率及突变内容上与国外学者不同的原因，探讨了检测Ｋ－ｒａｓ基因１２位点突变的意义。     

胰腺囊性肿瘤的诊断与治疗

目的：提高对胰腺囊性肿瘤诊断与治疗的认识。方法：对北京医科大学第一医院外科１９６６～１９９４年收治的２０例胰腺囊性肿瘤予以回顾性研究。结果：２０％的患者误诊为假性囊肿并内引流治疗；行根治切除胰腺恶性肿瘤者经１０个月至７ａ不等时间随访，无肿瘤复发。结论：胰腺囊性肿瘤性状常不典型，内覆上皮常剥脱或不连续，即使冰冻活检亦难以在各型肿瘤间进行鉴别。除有典型浆液性囊腺瘤表现者外，均应积极予肿瘤切除，以缓解症状及防治肿瘤恶变，对有孤立转移的囊腺癌亦应积极切除。     

2007年北京大学第一医院研究生论文发表情况调查报告

Objective To investigate the quality of postgraduate education from the publication state.Method To analysis the publication states from different postgraduate students in 2007 in Peking University First Hospital. The papers from 69 students who acquired the qualification were analyzed.Ph.D.,M.D.and Master were selected.Results The number of publication were 3.17、1.93 and 1.58 in Ph D,M.D.and Master,respectively.The number of publication with science citation index were 1.50、0.18 and 0.08,respectively.The average impact factor(IF)were 4.72、0.57 and 0.15,respectively.The number of publication and IF were more in Ph. D.than that in other postgraduate students.Conclusions Postgraduate students with different academic degree received appropriated training.Ph.D.candidate acquired the ability of engage scientific research and writing thesis in high quality.     

桥本氏病合并甲状腺恶性肿瘤(附10例报告)

本文报告86例桥本氏病,发现同时合并甲状腺恶性肿瘤10例。男1例,女9例,年龄31～69岁,平均46岁;其中乳头状癌5例,滤泡状癌1例,恶性淋巴瘤3例,肉瘤变1例。术后随访1～5年,存活8例,2例死于其它疾病。作者强调术前甲状腺同位素扫描,主张对桥本氏病合并发结节者应积极手术探查。     

2007年北京大学第一医院研究生论文发表情况调查报告

Objective To investigate the quality of postgraduate education from the publication state.Method To analysis the publication states from different postgraduate students in 2007 in Peking University First Hospital. The papers from 69 students who acquired the qualification were analyzed.Ph.D.,M.D.and Master were selected.Results The number of publication were 3.17、1.93 and 1.58 in Ph D,M.D.and Master,respectively.The number of publication with science citation index were 1.50、0.18 and 0.08,respectively.The average impact factor(IF)were 4.72、0.57 and 0.15,respectively.The number of publication and IF were more in Ph. D.than that in other postgraduate students.Conclusions Postgraduate students with different academic degree received appropriated training.Ph.D.candidate acquired the ability of engage scientific research and writing thesis in high quality.