创伤性膈疝21例临床分析

我院自１９８９年３月至１９９５年１０月手术治疗２１例创伤性膈疝，２１例疝愈。 发病机理与胸腹腔压力差、腹腔脏器冲击膈肌及胸腔负压有关。同时简要介绍了创伤性膈疝的诊断和治疗。     

The effect of MS-818, a pyrimidine compound,on the regeneration of peripheral nerve fibers of mice after a crush injury

One of the pyrimidine compounds, 2-piperadino-6-methyl-5-oxo-5,6-dihydro(7H)pyrrolo[3,4-d]pyrimidine (MS-818), has neurotropic effects in vitro. Therefore, we studied the effect of MS-818 on the regeneration of the peroneal nerve in C57BL/6J mice after a crush injury. Two test groups, which received a daily intraperitoneal injection of 5 mg/kg or 10 mg/kg MS-818, respectively, were compared with controls, which received daily intraperitoneal injections of physiological saline, over a 14-day period. The maximum foot-width ratio (crushed side/uncrushed side) was obtained on days 1, 8 and 14 after the crush injury, and the various morphometric parameters were evaluated at both 5 and 10 mm distal to the proximal portion of the crush site. The significant effects of MS-818 included a larger maximum foot width (P<0.04) and a greater number of unmyelinated axons per nerve at both levels (P<0.003) in both test groups than in controls. MS-818 had no significant effects on body weight, the increase of total transverse fascicular area after the crush injury, the total number of myelinated fibers with their size distributions, or the number of nuclei of Schwann cells and macrophages. Therefore, we conclude that MS-818 promotes axonal sprouting and elongation after a crush injury in mice.     

地塞米松促胎儿肺成熟的三种用药方式对母体糖代谢的影响

【目的】探讨地塞米松的用药方式对孕妇糖代谢的影响。【方法】对 1999年 9月至 2 0 0 1年 1月在本院住院的15 0名不同用药方式使用地塞米松促胎儿肺成熟的孕妇进行研究 ,在用药前及用药后 18～ 2 4h抽取肘前静脉血查空腹血糖、血浆C肽 ,糖负荷后 2h血糖、血浆C肽。【结果】使用地塞米松后 ,空腹血糖值、糖负荷后 2h血糖值、空腹C肽及糖负荷后 2hC肽值较用药前高 ;用药方式对母体空腹血糖值和空腹C肽值的影响差异无统计学意义 (P >0 0 5 ) ,对母体糖负荷后 2h血糖值和糖负荷后 2hC肽值的影响差异有统计学意义 (P <0 0 5 ) ;不同糖代谢状态的受试者使用地塞米松后 ,空腹C肽值、糖负荷后 2hC肽值的改变差异有统计学意义 (P <0 0 5 )。【结论】孕妇使用地塞米松促胎儿肺成熟对母体的糖代谢均有一定程度的影响 ,用药过程中和用药后需严密监测母体血糖和胎儿宫内状况     

Hypoxia effects on vascular endothelial growth factor derived epithelial cells of nasal polyps]

OBJECTIVE: To understand the role of nasal mucous epithelial cells to hypoxia in early stage of nasal polyps(NP) formation. METHODS: Epithelial cells of NP and inferior turbinate (IT) were cultured without serum under normal oxygen and hypoxia, and stimulus of inflammatory cytokines. Erythropoietin (EPO) was regarded as hypoxia mark, and expression of vascular endothelial growth factor(VEGF) mRNA and protein derived from epithelial cells were detected respectively by in situ hybridization and ELISA. RESULTS: 1. Under hypoxia, EPO mRNA was expressed intensely in epithelial cells from NP and IT, and there was no significant difference between both of them. This result suggested that EPO might be regarded as a hypoxic mark. 2. The ability of producing VEGF mRNA increased with cytokines stimulation, especially under hypoxia. Protein level of VEGF from epithelial cells of NP and IT increased with cytokines stimulation, especially in hypoxia and was time-dependent. CONCLUSION: Epithelial cells actively produce vast VEGF under hypoxia. The VEGF induced by hypoxia of the mucosa in middle meatus is of importance in the formation of nasal polyps(NP) in early stage, which may be the major cause of NP formation in middle meatus.     

全去带乙状结肠原位可控膀胱术25例随访报告

目的：探讨全去带乙状结肠原位可控膀胱术的临床效果。方法：对25例施行该术式术后患者的可控性、尿动力、血清电解质、肾功能、生活质量等进行随访观察。结果：25例随访2－15个月，平均11．3个月。白天完全自控排尿25例（100％）；夜间完全自控排尿24例（96．0％），1例偶有遗尿；贮尿囊容量220－370ml，平均320ml；贮尿囊内压力1．86－3．92kPa，平均2.44kPa。IVU及贮尿囊造影示单侧贮尿囊输尿管反流2例（8．0％），无肾积水；膀胱镜检查2例（8．0％）贮尿囊内出现细沙样结石，1例（4．0％）贮尿囊后尿道吻合口狭窄，经尿道直视内切开术治愈。15例（60．0％）男性患者保留性功能，肾功能正常，1例（4．0％）出现一过性高氯血症。结论：全去带乙状结肠原位可控膀胱术手术成功率高，疗效可靠，患者生活质量高，是一种较理想的尿路分流术，值得推广。     

儿童颈椎间盘钙化症的影像诊断

目的 探讨儿童颈椎间盘钙化症的影像表现及诊断价值，并提高对本病的认识。方法 回顾分析16例儿童颈椎钙化性椎间盘病的影像表现。结果 16例患均行颈椎平片检查，5例行CT扫描并作了三维重建，8例行MRI检查。16例平片均显示了椎间盘钙化灶，均为单发，CT平扫加三维重建显示4例钙化呈卵圆形，1例钙化为不规则形。MRI检查不仅显示了椎间盘内改变还清晰显示了病变相邻椎体边缘信号改变，在T1、T2加权像上呈低信号。结论 平片检查可以显示椎间盘钙化；CT平扫加三维重建能清晰显示了钙化灶的大小、形态；MRI检查在显示受累椎体及周围组织的改变方面明显优于CT和平片。     

量化健康教育在CCU住院病人健康教育中的应用

医院健康教育是护理人员通过各种教育形式使病人或家属获得预防疾病、促进康复、保持健康知识的护理活动[1]。它有多种教育形式,本文就量化健康教育与随机健康教育效果进行比较。1对象与方法1.1对象2002年1月—2004年1月,知道自己所患病情,能清楚表达自己意愿的200例CCU住院病人为对象。按随机数字表将200例病人分为实验组和对照组。实验组男68例,女40例,年龄(58.7±6.9)岁;初中及以下35例,高中及以上73例;高血压36例,急性心肌梗死13例,不稳定性心绞痛17例,恶性心律失常27例(行起搏器植入术7例),急性左心衰竭15例。对照组男60例,女32例,年…     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.     

Lipid extract from completely sporoderm‐broken germinating Ganoderma sinensis spores elicits potent antitumor immune responses in human macrophages

Ganoderma sinensis has been used widely in Oriental countries for the prevention and treatment of various diseases including cancer. Previous studies have shown that the lipid extract from Ganoderma exhibits direct cytotoxicity against tumor cells. Here, it is reported that the lipid extract from germinating G. sinensis spores, at lower concentrations that have no direct tumoricidal activity, induce potent antitumor immune responses in human monocytes/macrophages. Upon stimulation with the lipid extract, monocytes/macrophages exhibited markedly increased production of proinflammatory cytokines and surface expression of costimulatory molecules. Conditioned medium from stimulated cells effectively suppressed the growth of tumor cells. Apparently, the lipid extract triggered macrophage activation via a mechanism different from that associated with LPS. Moreover, it was observed that the lipid extract could partially re‐establish the antitumor activity of the immunosuppressive tumor‐associated macrophages. These results indicated that in addition to its direct tumoricidal activity, the lipid extract from G. sinensis spores could exert antitumor activity by stimulating the activation of human monocytes/macrophages. Copyright © 2008 John Wiley & Sons, Ltd.     

Kindergarten children's representation and understanding of written number symbols

Two samples of kindergarten children's representation and understanding of written number symbols were examined in two time points in one academic year. About 85% of Chinese five year olds (mean = 5 years 10 months) were able to use conventional number symbols to represent the quantity of 30 or larger. At the end of the kindergarten year, 94% of Chinese six year olds (mean = 6 years 4 months) were able to use conventional number symbols to represent the quantity of 100 or larger. Some Chinese six year olds had problems in representing written addition and subtraction tasks. Children's ability to represent written number symbols, ability to represent written addition and subtraction formula and their performance on written addition and subtraction were closely related. The performance of children in a university-affiliated childcare center was better than that of the center serving working-class families in Time 1, but the performance reversed at the end of the kindergarten year.