孤立性左肝胆管结石并肝管狭窄的外科治疗

目的总结近２０年来孤立性左肝胆管结石并发左肝胆管狭窄的临床治疗体会．方法原发性肝胆管结石１０１８例，年龄２７～７２岁，其中孤立性左肝胆管结石１３３例，手术治疗１１２例，对其临床资料进行回顾性分析，包括各肝管狭窄并发率，术前各项检查确诊率，手术治疗方式，再狭窄率．结果左肝管狭窄的发生率为５９８％，左外肝管和左内肝管分别为８４０％和８４８％，均以重度狭窄为主．狭窄切开整形后高位胆肠吻合术是处理左肝管狭窄的常用手术方式（５２２％），远期再狭窄率为１７１％；左半肝切除术施实率为１９４％，再狭窄率为００％；狭窄整形术和狭窄扩张术的施实率分别为９０％和１９４％，再狭窄率分别为５００％和９２３％．左外肝管狭窄通常采用肝段或肝叶切除术（７８７％），而左内肝管狭窄的处理则通常采用非左半肝切除术（８４８％）．左内肝管狭窄的术前／后影像学确诊率明显低于左肝管和左外肝管，平均确诊率依次２５９％，９３３％和８７９％．结论二级肝管狭窄是孤立性左肝管结石的常见并发症，肝叶或肝段切除术是其首选治疗原则．过多依赖非肝叶／段切除术和不适当的肝段切除术是遗留狭窄和远期疗效差的重要原因     

抗体工程与病理学

结合抗肝癌基因工程抗体的制备，概述了抗体工程的工作内容及其与病理学的关系，抗体工程的主要目的之一是制备人的或接近人的，而能在病人体内应用的抗体，一方面它可以来源于单克隆抗体的改造，首先克隆出鼠抗体可变区的轻链及重链成为小抗体或重组成单链抗体及人鼠嵌合抗体等基因工程抗体。另一方面，也可以用免疫过的小鼠脾细胞或者人的淋巴细胞建立鼠、人抗体库，然后抗原从抗体库中筛选出鼠或人的各种类型抗体。鉴于抗体对靶细胞一般只起导向作用，要携带效应分子才发挥杀伤肿瘤细胞的作用或其它作用。常用的“弹头”有毒素及细胞因子等。所以必须将这种基因与抗体基因融合在一起才能表达有作用的融合蛋白。抗体工程还包括抗体的增效或抗体的成熟，以及对照人抗体的结构进行置换，使抗体人源化等。     

用中子活化分析法测定江西荼叶中的微量元素

用中子活化分析法测定江西荼叶中的微量元素马永焕，陶秉莹，丘相国，谢明勇（南昌大学食品学院，南昌３３００２９）ＴｈｅＤｅｔｅｒｍｉｎａｔｉｏｎｏｆＴｒａｃｅＥｌｅｍｅｎｔｓｉｎＪｉａｎｇｘｉＴｅａｂｙＮｅｕｔｒｏｎＡｃｔｉｖａｔｉｏｎＡｎａｌｙｓｉｓＭ...     

胰高血糖素瘤综合征

我院近期收治２例胰高血糖素瘤，均具有典型胰高血糖素瘤综合征且合并肝转移，临床采用生长抑素，输注氨基酸、胰体尾切除及术后化疗等综合治疗。观察表明上述治疗对于皮疹的改善有一定效果，但低氨基酸血症及高胰血糖素水平的纠正不明显，且停药后常有反跳，结合文献，作者对胰高血糖素瘤的一般临床特点和诊治问题进行了介绍。     

腰椎管狭窄症50例临床分析

<正> 早在1936年 Towne 等首次对该病2例进行描术,1954Verbiest 提出椎管狭窄症。嗣后对此病陆续有报道.现将1982～1988年我科收治的50例手术病人进行总结.临床资料男38例,女19例,年龄26～65岁,全部进行手术治疗。发病至于术时间7个月～30年,平均6年1个月.     

Analysis of differentially expressed genes in fetal skin of scarless and scar-forming periods of gestational rats

Objective: To study the differences of gene expression between earlier gestational skin and later gestational skin of rats with the aids of single primer amplification (SPA) and high-density oligonucleotide DNA array to understand the molecular mechanism of scarless healing. Methods: Total RNAs were isolated from fetal rat skin of the scarless (E15) and scar-forming (E18) periods of gestation (term =21.5 days). The RNAs from earlier gestational skin (EGS) and later gestational skin (LGS) were both reversely transcribed to cDNAs, then labeled with the incorporation of fluorescent dCTP for preparing the hybridization probes by SPA method. The mixed probes were then hybridized to the oligonucleotide DNA arrays which contained 5 705 probes representing 5 705 rat genes. After highly stringent washing, these DNA arrays were scanned for fluorescent signals to display the differentially expressed genes between the 2 groups of skin. Results: Among 5 705 rat genes, there were 53 genes (0.93%) with differentially expressed levels between EGS and LGS groups, 27 genes, including fibroblast growth factor 2 ( FGF2 ) and follistatin were up-regulated (0.47%) and 26 genes were down-regulated (0.46%) in fetal skin during scarless period versus scar-forming period. Higher expressions of FGF2 and follistatin in EGS than those in LGS were also revealed by RT-PCR method. Conclusions: High-density oligonucleotide DNA array provided a powerful tool for investigating differential gene expression in earlier and later gestational fetal skins. This technology validates that the mechanism of fetal scarless healing is very complicate and the change of many gene expressions is associated with fetal scarless healing.