Psoas abscess: Difficulties encountered

From 1961 to 1989, 67 patients underwent various surgical procedures for psoas abscess. Retrospective analysis was undertaken in an effort to determine optimal surgical therapy. Forty patients were cured with one operation. Twenty-one patients required two operations, four patients required three operations, and two patients required more than three operations. The reason for failure of treatment was failure to resect the diseased bowel or to drain the psoas abscess adequately. A technique to recognize and treat the abscess definitively will be illustrated. The most common etiologies were Crohn's disease in 49 patients, postoperative sepsis in eight patients, and complications of renal disease in four patients. The length of hospital stay ranged from 5 to 392 days (mean, 26 days). There were two deaths. Failure to recognize and treat psoas abscess results in considerable morbidity.Poster presentation at the meeting of The American Society of Colon and Rectal Surgeons, St. Louis, Missouri, April 29 to May 4, 1990.     

Use of a somatostatin analogue, octreotide acetate, in the management of acute gastrointestinal graft-versus-host disease

PURPOSE: Because the secretory diarrhea of acute graft-versus-host disease (GvHD) of the gut induces serious metabolic and nutritional disturbances, this study was initiated to assess the use of a somatostatin analogue, octreotide acetate, as adjunctive therapy for severe GvHD of the gut with massive diarrhea. PATIENTS AND METHODS: In a pilot study, six patients with biopsy-confirmed acute gut GvHD after allogeneic bone marrow transplantation received octreotide 50 to 250 micrograms three times a day subcutaneously. RESULTS: Three of the six treated patients had a prompt and dramatic reduction in stool volume within 1 to 3 days of initiation of octreotide therapy. CONCLUSIONS: Somatostatin and its analogues have been used successfully in diarrheal states by antagonism of neuropeptide overproduction, although other potential therapeutic mechanisms include inhibition of fluid secretion, enhanced salt absorption, and inhibition of gut motility. Somatostatin and its analogues may be promising adjunctive agents in the treatment of gastrointestinal GvHD, although assessment in a controlled trial will be required to confirm their therapeutic efficacy.     

The use of 6-flavor Rehmannia decoction with additives in the prevention of ototoxic deafness induced by gentamicin in guinea pigs]

The purpose of this study is to discuss the effects of the Chinese medicine six-flavor Rehmannia Decoction with additives on preventing deafness induced by gentamicin (GM) in guinea pig by means of testing the thresholds of Preyer's reflex (PR) cochlear microphonic potential (CM), action potential of the auditory nerve (N1) and scanning electron microscope of inner ear (SEM). The results showed that the medicine is effective in reducing the ototoxic effect of GM on inner ear.     

大蒜对焦炉工生物膜损伤和细胞免疫保护作用初探

采用大蒜对焦炉工在不脱离生产情况下，进行为期半年的实验服用，观察其对生物膜损伤和细胞免疫功能的保护作用。结果表明：服用大蒜制剂后焦炉工的唾液酸（ＳＡ）和脂质过氧化（ＬＰＯ）比服用前降低（Ｐ＜０．０１），谷胱甘肽过氧化物酶（ＧＳＨ－Ｐｘ）有所增高，但Ｐ＞０．０５，在细胞免疫方面，表现为酸性α－醋酸萘酯酶（ＡＮＡＥ）和活性Ｅ－花环％（Ｅａ）的增高（Ｐ＜０．０１）。对照组的细胞免疫功能及生物膜损伤情况均无改善，提示：大蒜对焦炉工的生物膜和细胞免疫均有一定的保护作用。     

Factors affecting patency of internal thoracic artery graft: clinical and angiographic study in 1434 symptomatic patients operated between 1982 and 2002.

OBJECTIVE: The purpose is to define factors influencing long-term patency of the internal thoracic artery (ITA) to optimize the operative strategy. METHODS: 1482 left internal thoracic artery (LITA) and 636 right internal thoracic artery (RITA) symptom-directed angiograms were studied in 1434 patients. Data were prospectively collected from patients who had primary coronary artery bypass surgery during the period 1982-2002. The mean age of patients was 59 years; 85% were male. The mean period from operation to re-angiogram was 80 months. LITA was grafted to left anterior descending coronary artery (LAD) in 82% of cases, RITA to right coronary artery (RCA) in 40% and circumflex artery in 35% of cases. Graft failure was defined as > or =80% stenosis. RESULTS: 96.3% of LITA and 88.1% of RITA grafts were patent. No patient variables were significantly associated with graft patency (age, gender, diabetes, hypertension, LVEF, NYHA, AMI). Target coronary artery was associated with patency of both LITA and RITA grafts with maximum patency when grafted to LAD (P = 0.02) RITA had the worst patency to RCA, patency for the left system was identical to LITA. Proximal anastomosis to aorta (free RITA) had significantly better patency when compared with in situ RITA to RCA system (P = 0.005) while similar patency when grafted to left system. ITA diameter and target artery diameter were not associated with graft patency. Recent operations had better RITA patency (P = 0.03). The interval from operation to angiogram was not associated with ITA patency (96% patency for LITA and 88% patency for RITA, remained stable when studied at <1, 1-4, 5-9, 10-14 and >15 years). CONCLUSIONS: Even in a patient cohort that had adverse symptoms, excellent LITA and RITA patency was achieved which almost remained constant through all time intervals studied.     

不同类型高危儿早期干预的临床研究

目的 探索早期干预对窒息、高胆、早产三类高危儿智力发育改善的效果，寻找更合适的早期干预措施。方法 将三类高危儿分为干预组及对照组，同时随机选取正常对照组进行随访。干预组采用鲍秀兰教授“0～3岁”早期干预方案训练，各组均在6个月、1岁时分别采用婴幼儿智能发育量表(CDCC)进行智力发育测评，结果用MDI、PDI表示。结果 (1)6个月龄时MDI各干预组与对照组间有显著性差异，窒息组、早产组与正常组间亦有显著性差异；高胆组与正常组间无差异；PDI窒息组中干预组与对照组之间有显著差异(P＜0．01)，高胆组、早产组均无差异(P＞0．05)。(2)1岁时MDI和PDI结果一致，干预组与对照组间比较窒息组、高胆组有显著差异，早产组无差异；窒息组、高胆组干预组与正常组比较无差异，对照组和早产组与正常组比较均有显著差异(P＜0．01)。(3)所有干预组测评分值均高于对照组，6个月与1岁之间比较有显著差异，各观察组间比较有显著性差异(P＜0．01)。结论 三类高危儿早期干预效果差异较大，干预组均较对照组分值高，早期干预有改善智力发育的作用；三类高危儿中，窒息组、高胆组效果最好，均达到或超过正常水平。所有未干预组均不及正常水平；早期干预对足月高危儿效果显著，对早产儿欠佳，远期效果尚需进一步随访观察。     

胰腺黏液非囊性癌9例临床分析

目的探讨胰腺黏液非囊性癌的组织学特点、生物学特征、治疗方法及预后。方法回顾性分析复旦大学附属中山医院普外科2000~2005年间收治的9例胰腺黏液非囊性癌病人的临床特点、影像学改变、病理学特征、治疗经过及随访资料。9例胰腺黏液非囊性癌病人,男7例,女2例,年龄平均(63·1±8·7)岁。肿瘤位于胰头8例,胰体尾1例。行胰十二指肠切除术8例,其中4例合并扩大淋巴结清扫术,1例行胰体尾切除。结果术后病理报告:瘤体平均4·3cm×4·3cm×4·4cm。镜下见8例胰头肿瘤均侵犯十二指肠,侵犯肠系膜上静脉4例。肿瘤侵犯神经3例,淋巴结转移2例。镜下肿瘤表现明确的间质黏液湖及其上漂浮较少的恶性上皮细胞。随访8例,死亡5例。术后存活5~23个月,平均存活11个月,均死于肿瘤复发和肝转移。结论胰腺黏液非囊性癌应是胰腺恶性肿瘤的一个独立的类型,其生物学特征有待进一步研究。     

清宫止血颗粒防治药流后阴道出血的临床观察附:178例病例报告

目的：探寻防治药流后阴道不规则出血的有效、低毒新药，为进一步推广此法扫清障碍。方法：将符合诊断和入选标准的药流后阴道不规则出血、并自愿参予本课题临床试验的178例受试者分为3组，即：清宫止血颗粒治疗组(66例)、益母草对照组(59例)和空白对照组(53例)，在严密观察和保证安全的前提下进行试验。前2组在接受药流后分别服用清宫止血颗粒、益母草冲剂治疗，空白对照组则不服用任何药物，观察其自然恢复过程。结果：清宫颗粒组受试者其出血时间短于其余2组(P＜0．0l或P＜0．05)；其出血量少于其余2组(P＜0．0l或P＜0．05)；其完全流产率高于其余2组(P＜0．0l或P＜0．05)；其月经恢复时间短于其余2组(P＜0．0l或P＜0．05)。结论：清宫止血颗粒对药流后不规则阴道出血有良好的防治作用，其疗效优于益母草冲剂。