功能性消化不良的突出症状与临床特征及病理生理学机制的关系

背景与目的：功能性消化不良（FD）被认为是一类由不同病理生理原因导致的多种机能紊乱而促发的症状。Rome Ⅱ委员会建议将具有同种病理生理学及临床特征的FD患划分为感觉明显疼痛组和感觉不适组两个亚组。该研究旨在分析显疼痛或感觉不适与病理生理学机制间的关系，评价是否考虑到个体的显性症状将会产生更好的结果。方法：持续性FD患（n=720；489例女性；年龄41．3±0．6岁）填写消化不良调查问卷并确定出最令人烦恼的症状。分析此显症状在人口统计学、临床、病理生理学特点上的相互联系（研究592例患幽门螺杆菌感染、胃排空情况，对332例患行胃敏感性、顺应性试验）。结果：根据Rome Ⅱ标准，22％疼痛明显，78％不适感明显。疼痛明显的患超敏性的发生率较高（44％ vs 25％），且在这些病例中观察到的胃排空迟缓较少出现（16％ vs 26％），但是有较多的重叠。详细分析表明可能有8种消化不良症状其中之一较为突出。     

不经胸食管钝性剥离拔脱术的临床应用

应用不经胸食管钝性剥离拔脱术治疗26例咽下癌与高位食管癌,效果良好,术后5例发生开发症,其中颈部吻合口痿3例,暂时性咳呛1例,腹部切口局限裂开1例。手术死亡率7.6%(2/26)。介绍了手术方法,对不经胸施术、胃体缝缩、颈部食管胃Gambee氏吻合法应用进行了讨论。     

痧病的诊治体会

痧病在中医院校的教科书上并无专门的论述,而在春夏之季的农村则尤为常见。痧病有其临床表现特征,在治疗上也有许多简、便、验、廉且易行的方法。笔者在农村从事医疗工作多年,深感有必要对此加以研究或整理,使人们有一正确的认识。兹就痧病的诊疗谈谈个人的一点体会。1典型病例案1:刘某,男,24岁,学生,1997年7月25日初诊。因身重、肢体酸痛、胸闷1周而求诊。1周前因劳动时淋“毛毛雨”,感觉乏力,身重,全身肌肉酸痛,胸闷,饮食不振,纳谷乏味,微恶风寒,头胀痛,头重,颈项不适,大小便正常。前医诊为“风寒湿型感冒”,应用西药速效伤风胶囊及中药荆…     

Stimulation of tumor growthin vitro andin vivo by suramin on the VX2 model

Suramin is an antitrypanosomal compound with confirmed efficacy against several human malignancies. It is generally assumed that its mechanism of action includes the interaction with different growth factors, unlike most of the anticancer drugs. Its anticancer activity has not been testedin vivo against squamous cell carcinoma. The purpose of this study was to assess the efficacy and toxicity of suraminin vivo andin vitro on the VX2 tumor model at therapeutic monitored plasma concentrations. We determined the pharmacokinetics of suramin in rabbits, and modelized its administration in order to obtain plasma concentrations between 150 and 300 μg/ml throughout the treatment course of 3 weeks. Under these conditions, antitumor effects of suramin were evaluatedin vivo by comparing liver tumor involvement in suramin-treated and control rabbits. Liver involvement was quantified by image analysis andin vitro effects were also determined at the same concentrations.In vivo, suramin promoted liver tumor growth significantly (p<0.05), compared to untreated controls.In vitro, suramin significantly stimulated tumor cell growth at concentrations above 200 μg/ml (p<0.01). Suramin may have stimulatory effects on tumor growth in squamous cell carcinoma at relevant plasma drug concentrations. Caution should be taken in further trials in patients with squamous cell carcinomas.     

茶碱和双丁酰-cAMP对巨噬细胞水解酶影响的细胞化学观察

本文通过细胞体外培养,细胞化学定量分析等方法,观察了茶碱和双丁酰-cAMP对C_(57)BL/6J小鼠腹腔巨噬细胞酸性磷酸酶、α-醋酸萘酚酯酶的作用和影响.卡介苗活化的巨噬细胞与固有巨噬细胞相比,其酸性磷酸酶、α-醋酸萘酚酯酶活性明显升高.卡介苗活化的巨噬细胞在茶碱或双丁酰-cAMP作用下。酸性磷酸酶、α-醋酸萘酚酯酶活性明显受到抑制.茶碱或双丁酰-cAMP对固有巨噬细胞的酸性磷酸酶、α-醋酸萘酚酯酶无抑制作用.     

围手术期肠外营养支持在胃癌根治术的应用

1986～1988年的胃癌扩大根治术221例及根治性全胃切除术19例非肠外营养(N-TPN)支持为对照组,与1991～1993年的198例及61例施行TPN治疗为实验组进行对比。N-TPN组术后并发症总发生率为7.2％,TPN组则为2.0％;全胃切除术并发症发生率分别为31.6％和4.9％(P<0.01)。吻合口瘘发生率N-TPN组分别为2.7％和10.5％,而TPN组则均为0.0％(P<0.01)。膈下脓肿发生率N-TPN组为31.6％和15.8％,而TPN组则为1.5％和3.3％(P<0.05)。但本研究是回顾性的,所以要有待进行前瞻性的、对照的、随机的大范围研究。     

384例女青年乳房形态学调查

对384例未婚女青年的双侧乳房进行了调查研究,提供了有关乳房、乳头、乳晕的形态、大小和位置等各项重要的测量数据,可供乳房成形术时参考。     

Surgical Management of PICA Aneurysm and Incidental Facial Nerve Schwannoma: Case Report.

We report a patient with a posterior inferior cerebellar artery (PICA) aneurysm and an incidental facial nerve schwannoma at the cerebellopontine angle (CPA). A 46-year-old woman presented with the sudden onset of a severe headache, nausea, and vomiting. She had no other abnormal neurological symptoms and signs. Computed tomography (CT) showed hemorrhage in the fourth ventricle. Cerebral angiography demonstrated an aneurysm arising from the tonsillomedullary segment of the left PICA. A facial nerve schwannoma was incidentally found as the aneurysm was being clipped. The aneurysm was clipped via a left transcondylar approach. Subsequently, the schwannoma (2 x 3 x 2 mm) was resected from the facial nerve fascicles, and the facial nerve was preserved. Postoperatively, the patient developed mild to moderate dysfunction of the facial nerve (House-Brackmann grade III [H-B III]) but her hearing was intact. Both a facial nerve schwannoma involving the CPA and an aneurysm involving the PICA can be managed through the transcondylar approach. An asymptomatic facial nerve schwannoma can be resected safely with minimal facial nerve dysfunction.     

腹腔镜胆囊切除术后钛夹在腹腔内异位的观察

目的　观察腹腔镜胆囊切除术 (LaparoscopicCholecystectomy ,L .C)后钛夹在腹腔内异位。方法　前瞻性对2 0 0 2年 1～ 5月间 6 0例L .C病人进行追踪观察临床表现 ,采用B超、腹部X线检查等方法 ,观察钛夹位置的变化与肝外胆管的关系。结果　 6 0例L .C后病人中 5例钛夹发生位置改变。结论　①钛夹在体内 ,对胆道无压迫、无胆漏 ;②观察钛夹异位 ,以采用B超为最简单、经济的方法。