后腹腔镜手术切除肾上腺节细胞神经瘤疗效观察

目的 :探讨后腹腔镜微创手术治疗肾上腺节细胞神经瘤的适应证和可行性。方法 :采用后腹腔镜手术治疗肾上腺节细胞神经瘤患者 5例 ,其中左侧肾上腺节细胞神经瘤 2例 ,右侧 3例。结果 :5例后腹腔镜手术全部获得成功 ,4例肾上腺肿瘤为单发 ,1例为多发 (4个肿瘤 ) ;肿瘤最大直径 2 .5～ 8.0 (4 .2± 1.8)cm ;手术时间35～ 10 5 (5 9± 2 7)min ,估计出血量 10～ 30 (19± 7)ml,术后镇痛剂吗啡用量 0～ 2 0 (8± 8)mg ,2例未用镇痛剂 ;排气、恢复进食时间 1～ 3(1.4± 0 .5 )d ;术后住院时间 4～ 7(5 .4± 1.5 )d。无围手术期并发症发生。结论 :后腹腔镜手术切除肾上腺节细胞神经瘤是安全可行的 ,能充分体现腹腔镜手术创伤小、恢复快的优点。肾上腺节细胞神经瘤是腹腔镜手术很好的适应证。     

FⅧ-RAg VEGF在翼状胬肉中表达和微血管密度检测及其意义

目的 检测第Ⅷ因子相关抗原(FⅧ-RAg)和血管内皮生长因子(VEGF)在翼状胬肉中的表达及微血管密度(MVD),探讨其在翼状胬肉发生发展中的作用.方法 应用免疫组化Elivision法检测20例翼状胬肉、10例正常结膜中FⅧ-RAg和VEGF的表达,并检测MVD.结果 20例翼状胬肉和正常结膜中VEGF的阳性表达率分别为90%,20%.VEGF阳性表达两组间差异有统计学意义P＜0.01.FⅧ-RAg的阳性表达率分别为80%、30%,FⅧ-RAg阳性表达两组间差异有统计学意义,P＜0.05,翼状胬肉和正常结膜中微血管密度(MVD)分别为45.85±11.06、23.64±6.87,两组间差异有统计学意义,P＜0.001.结论 VEGF、FⅧ-RAg在翼状胬肉中的高表达,MVD升高,提示有新生血管化的发生,可能与翼状胬肉的发生、发展和术后复发有关.     

阀门植入术治疗儿童青光眼的进展

儿童青光眼作为一种严重的潜在性致盲眼病,因儿童患者的特殊性,治疗困难,效果不佳.近年来,随着阀门植入手术的日益开展,有关青光眼阀门应用于儿童青光眼治疗的相关报道日渐增多.与其他手术方式相比,阀门植入手术对婴幼儿难治性青光眼显示出较好的疗效和安全性,表现在结膜下瘢痕较小,滤过泡壁纤维化少、渗透性更好,从而能够长期有效地控制眼压.它能够很好避免因瘢痕形成所致的滤过失败,并且滤过泡渗漏和感染等严重并发症的发生率也明显降低.但目前还缺乏有关于此的大样本、长期疗效和安全性研究.     

2007中国医学信息应用和共享论坛暨浙江省医疗卫生医疗计算机用户协会学术年会举行

11月22日至25日,2007(第三届)中国医学信息应用和共享论坛暨浙江省医疗卫生医疗计算机用户协会学术年会在浙江杭州举行。     

推进继承创新,发挥特色优势,坚定不移地发展中医药事业——吴仪副总理在全国中医药工作会议上的讲话节选

2007年1月11日,中共中央政治局委员、国务院副总理吴仪在全国中医药工作会议上发表了重要讲话,该讲话从4个方面进行了论述,节选如下。     

体重指数、腰围、腰臀比与血压、血糖、血脂关系的探讨

目的 探讨体重指数(BMI)、腰围(WC)、腰臀比(WHR)与代谢性因素的关系.方法 对镇江市居民基线资料的1108例对象按BMI、WC、WHR分组.在正常体重、超重、肥胖;腰围正常、腰围过大;腰臀比正常、腰臀比过大各组中,比较收缩压(SBP)、舒张压(DBP)、血糖(FBG)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平.结果 不论男性女性组,超重肥胖、腰围过大组,血压、血糖、血脂水平与正常组比较均明显升高;腰臀比过大组与正常组比较,男性组TG、FBG明显升高;HDL-C明显降低;女性组TG、FBG、SBP明显升高,HDL-C明显降低.结论 BMI、WC、WHR指标与代谢性因素密切相关;BMI、WC在提示肥胖程度方面优于WHR指标.     

Angiopoietin1/Tie2 and VEGF/Flk1 induced by MSC treatment amplifies angiogenesis and vascular stabilization after stroke.

Bone marrow stromal cells (MSCs) increase vascular endothelial growth factor (VEGF) expression and promote angiogenesis after stroke. Angiopoietin-1 (Ang1) and its receptor Tie2 mediate vascular integrity and angiogenesis as does VEGF and its receptors. In this study, we tested whether MSC treatment of stroke increases Ang1/Tie2 expression, and whether Ang1/Tie2 with VEGF/ vascular endothelial growth factor receptor 2 (VEGFR2) (Flk1), in combination, induced by MSCs enhances angiogenesis and vascular integrity. Male Wistar rats were subjected to middle cerebral artery occlusion (MCAo) and treated with or without MSCs. Marrow stromal cell treatment significantly decreased blood-brain barrier (BBB) leakage and increased Ang1, Tie2, and occludin (a tight junction protein) expression in the ischemic border compared with MCAo control. To further test the mechanisms of MSC-induced angiogenesis and vascular stabilization, cocultures of MSCs with mouse brain endothelial cells (MBECs) or astrocytes were performed. Supernatant derived from MSCs cocultured with MBECs significantly increased MBEC expression of Ang1/Tie2 and Flk1 compared with MBEC alone. Marrow stromal cells cocultured with astrocytes also significantly increased astrocyte VEGF and Ang1/Tie2 expression compared with astrocyte culture alone. Conditioned media from MSCs alone, and media from cocultures of MSCs with astrocytes or MBECs, all significantly increased capillary tube-like formation of MBEC compared with control Dulbecco's modified Eagle's medium media. Inhibition of Flk1 and/or Ang1 significantly decreased MSC-induced MBEC tube formation. Knockdown of Tie2 expression in MBECs significantly inhibited MSC-induced tube formation. Our data indicate MSC treatment of stroke promotes angiogenesis and vascular stabilization, which is at least partially mediated by VEGF/Flk1 and Ang1/Tie2.     

Buccal mucosal graft for urethral reconstruction.

Urethral reconstruction with graft substances, such as skin and bladder mucosa, has been previously used when primary anastomosis cannot be achieved. However, stricture and meatal prolapse are associated with these grafts. We report the use of buccal mucosa for the reconstruction of urethral defects in 3 patients. One patient with failed operation for hypospadias received tube buccal mucosal graft for urethral replacement. Two patients with urethral necrosis and stricture received onlay buccal mucosal graft. All patients were disease-free during follow-up (range, 12 to 49 months; mean, 36 months). One patient had a pinhole fistula that was successfully managed with simple repair. This technique appears to be useful for urethral reconstruction when a local graft is not available, even in patients with complicated conditions.