彩色多普勒超声对高度近视眼后巩膜改变相关因素的评价

目的:探讨高度近视眼后巩膜形态改变与眼轴长度、近视程度及血流动力学变化之间的关系。方法:应用ATL超9型APOOGE-800型彩色多普勒超声诊断仪,探头频率5.0~10.0MHz。对26例正常眼,36例轻中度近视眼,51例高度近视眼后巩膜进行观察。并对26例正常眼,17例轻中度近视眼,26例高度近视眼的眼动脉(OA)、视网膜中央动脉(CRA)、睫状后动脉(PCA)进行检测。结果:轻中度近视组、高度近视组的眼轴长度与近视程度呈正相关性。两者之间的直线回归方程Y=-3510.3 1668.1X,R=0.9432,P<0.0001。后巩膜形态改变与正常对照组比较差异有显著性意义(P<0.001)。高度近视眼组、轻中度近视组与正常对照组比较,OA血流参数差异无显著性意义(P>0.05),而高度近视组的CRA、PCA的收缩期(PSV)、舒张期(EDV)、平均血流速度(AV)均减低,CRA的阻力指数(RI)升高(P<0.05)。轻中度组与对照组比较差异无显著性意义(P>0.05)。结论:视网膜血管、睫状血管系统血供不足与后巩膜形态变化的类型、眼轴长度、近视的程度及血流动力学改变密切相关,是引起高度近视眼病理性眼底改变发生和发展的重要因素。     

植入镍钛记忆合金支架治疗恶性胆道梗阻的临床分析

目的 评价植入镍钛记忆合金支架治疗恶性胆道梗阻的疗效。方法 对16例恶性胆道梗阻患者。采用经手术及介入方法植入镍钛记忆合金胆道支架。结果 术后1个月内死亡1例，15例黄疸完全解除。随访15例，12例术后平均生存13．1个月。结论 植入镍钛合金胆道支架可提高姑息切除的疗效；对不能切除病灶患者，支架植入可解除黄疸，改善生活质量。     

Should all the N3 lymph nodes group metastasis be regarded as distant metastasis (M1) in curatively resected gastric cancer?

Recently, metastasis to N3 lymph nodes group was regarded as distant metastasis by the new TNM staging system due to poor overall survival. However, the 5-year overall survival rate of patients with metastasis to N3 groups was 34.5% after curative surgery. Moreover, in patients with metastasis to lymph node subgroups of #12, #13, #14, the overall 5-year survival rate increased upto 47.2% after curative resection and adjuvant chemotherapy. This was similar to that of the patients with metastasis to N1 and N2 lymph nodes groups. But in these highly tumor burden states, no survival benefit was found with the addition of immunotherapy to chemotherapy as we achieved in stage II and III. Therefore, we suggest that, at least, metastasis to #12, #13, #14 lymph nodes subgroups should not be categorized as a distant metastasis. And in these situations, active curative radical surgery with extended lymphadenectomy and adjuvant chemotherapy are recommended.     

BIOEQUIVALENCE BETWEEN rhGH FOR RECONSTITUTION AND READY-TO-USE rhGH IN TWO LIQUID FORMULATIONS

Objective To evaluate the bioequivalence between recombinant human growth hormone （rhGH） for reconstitution, and two dosages of liquid formulation of rhGH [ （151U） 5mg or （301U） lOmg per 3ml ]. Methods The study drugs were tested in a randomized, single-blind and three-period crossover studies in 24 healthy male subjects. The three drugs were administered by subcutaneous injection at a dose of O. 21U/kg body weight. A continuous somatostatin infusion was given in order to suppress the secretion of endogenous GH. The ve- nous blood samples were drawn at different time points to test the serum concentration of GH. The pharmacokinetic parameters were analyzed by statistical methods. Results 90% confidence intervals （CI） of AUC0-24h among three products were all within 80% - 125% interval （ 103. 4% - 116. 5%, 105. 7% - 119. 6% and 91.9% - 103. 7%, respectively）, and the Cls of C,~ among three products were all within 70% - 143% interval （91.9% - 114. 0%, 103. 7% -127. 2% and 81.6% -97. 4%, respectively）. There was no statisitical difference of tmax among all the three products. Conclusion These data demonstrate that there is bioequivalence between rhGH for reconstitution and two liquid formulations of rhGH.     

A case of Non-Hodgkin's lymphoma in a patient with Crohn's disease]

Although adenocarcinoma is a well known complication of chronic inflammatory bowel disease, primary gastrointestinal lymphoma occurring in Crohn's disease is rare. A 40-year-old man with 10 year-history of Crohn's disease had multiple longitudinal ulcerative lesions on descending colon in follow-up colonoscopic examination. Microscopic examination of proximal descending colon revealed peripheral T cell lymphoma and other site of the descending colon was consistent with Crohn's disease. The patient reached complete remission of malignant lymphoma after three cycles of combined chemotherapy. He has been well for 10 months with sulfasalazine maintenance therapy but was admitted to the hospital due to spontaneous bowel perforation of ascending colon. Right hemicolectomy was done, but the patient died of post-surgical recurrent mesenteric abscess and sepsis. To the best of our knowledge, this is the first case of Non-Hodgkin's lymphoma complicating Crohn's disease in Korea which was confirmed by immunohistochemical studies.     

肿胀法外超声吸脂术的组织学研究

目的 观察外超声能量作用于活体组织后的组织学变化，以探索其作用机制。方法 对3只家猪腹部两侧进行外超声与非超声比较，作用不同时间后在光镜和电镜下观察其皮肤组织全层的变化。结果 在外超声作用18min内，随着作用时间的延长，猪的皮下脂肪组织和生物大分子结构的破坏程度不断加重，脂肪组织中产生的空泡不断增大而皮肤组织及血管无明显变化。结论 外超声吸脂术可通过稳定的空泡效应选择性地使脂肪细胞结构发生不可逆的坏死性改变，这一改变与作用时间成正比。     

Prognostic role of alveolar-arterial oxygen pressure difference in acute pulmonary embolism.

BACKGROUND: This study investigated the utility of the alveolar - arterial oxygen pressure difference (AaDO (2)) in predicting the short-term prognosis of acute pulmonary embolism (PE). METHODS AND RESULTS: This study retrospectively enrolled 114 consecutive patients with acute PE, diagnosed by either spiral computed tomography or high probability ventilation - perfusion lung scans. During the first 24 h of admission, all patients had initial artery blood gas collected under room air. Patient exclusion criteria were chronic lung disease, septic emboli, and moderate and low probability lung scans. Patients were assigned to 2 groups based on either 30-day death or a 30-day composite event. Receiver operating characteristic analyses was used to determine the AaDO(2) cut-off value for predicting primary and composite endpoints. Statistical analysis demonstrated significant differences in AaDO(2) between the 30-day composite endpoint group and the 30-day composite event-free survival group (p=0.012). The AaDO(2) had a strong trend between the 30-day death group and the survival group (p=0.062). The best cut-off value for AaDO(2) was 53 mmHg and using this, the positive predictive value for 30-day death was 25% and the negative predictive value was 92%. For the 30-day composite endpoint, the positive predictive value for AaDO(2) was 35%, and the negative predictive value was 84%. In this study, thrombocytopenia was also an indicator of poor prognosis for patients with acute PE. CONCLUSION: The AaDO(2) measurement is a highly useful and simple measurement for predicting short-term prognosis in patients with acute PE. It has high negative predictive value and moderate positive predictive value for 30-day death and 30-day composite event. Aggressive thrombolytic treatment strategies should be considered for patients with an initial poor prognostic parameter (ie, AaDO(2) >or=53 mmHg).     

当归多糖组分促进淋巴细胞增殖及对IL-2和IFN-γ的诱生作用

目的:观察当归多糖及其3个组分对淋巴细胞增殖和细胞因子IL-2、IFN-γ的影响.方法:机械分散法制备小鼠单个脾细胞悬液;MTT法检测细胞增殖;酶联免疫法测定培养上清液中IL-2和IFN-γ的浓度.结果:当归多糖及其3个组分在30～100 μg/ml剂量范围内,能显著促进脾细胞的增殖;其中组分AP-3能够显著促进巨噬细胞、混合淋巴细胞的增殖反应,剂量依赖性地增加细胞上清液中IL-2和IFN-γ的浓度.结论:当归多糖能够活化巨噬细胞和T细胞,还可以通过细胞因子IL-2、IFN￣γ发挥免疫调节作用.     

肺螨病的病理观察

本文报道螨类接种豚鼠气管引起的肺部病变,并对5种常见螨类的致病性进行比较。发现螨类接种后6天豚鼠肺部已形成典型的结节性病灶。结节圆锥形淡黄色,直径1～5mm之间。镜下表现为细支气管炎和细支气管周围炎,肺实质内有明显的异物肉芽肿形成,炎症在螨类接种豚鼠20天时,肺部嗜酸粒细胞浸润不明显,但30或40天时则出现明显的嗜酸细胞浸润,细支气管周围小动脉受到损害,部分小动脉内可见到螨体残骸。5种常见螨炎接种于5组豚鼠可引起大致相同的病变。从而证明豚鼠可作为动物模型以供肺螨病的研究,同时也证明5种常见贮藏螨具有相同的致病性。