腹腔镜下切口疝补片修补术后膀胱瘘一例报道

病例:男,73岁,因发现原膀胱造瘘口处可复性肿块3年而入院.7年前因前列腺癌于外院行双侧睾丸切除加膀胱造瘘术.3年前无明显诱因下出现造瘘口外侧无痛性肿物,站立时出现,平卧后可自行回纳,肿块渐增大,无明显腹痛、腹胀等不适症状.半年前入院行前列腺电切术加造瘘口回纳术.     

Volumetric measurements of the brachial and carotid arteries in dialysis grafts: is there evidence of a subclavian-carotid artery steal syndrome?

Dialysis grafts may lead to major hyperperfusion in the graft arm and to hypertrophic, hypervolemic cardiomyopathy. No data have been published concerning the impact of dialysis grafts on the cerebral perfusion in relation to a potential carotid steal syndrome, possibly causing neurologic or neuropsychologic symptoms. In 30 patients (32 to 74 years old) with dialysis grafts we studied the following hemodynamic parameters in the brachial and common carotid arteries bilaterally: Flow velocities (spectral Doppler sonography), diameter (B-mode) and volume flow (color M-mode) with a color duplex system (Philips P700). Volume flow in the brachial arteries of the graft arm averaged 1032 ml/min (range, 158 to 2854 ml/min) as compared to 42 ml/min (range, 15 to 108 ml/min) in the nongraft arm. Almost identical volume flow data could be seen in both common carotid arteries (418 versus 421 ml/min) with no evidence of reduced flow in the carotid arteries in patients with high flow in the graft arm. A tendency toward higher volume flow in both carotid arteries in patients with high volume flow in the graft arm was noted. We found no evidence of shunt-induced cerebral hypoperfusion. Cerebral autoregulation appears to be patent even with high brachial artery shunt volume.     

缺血性脑血管病与颈动脉粥样硬化及其危险因素的关系

目的探讨缺血性脑血管病(ICVD)与颈动脉粥样硬化及其危险因素的关系。方法对186例ICVD患者与194例非脑血管病患者和正常体检者(对照组)行颈部血管超声检查和血液生化检查;比较两组间的颈动脉硬化程度及脑卒中危险因素的差异。结果ICVD组年龄[(69±7)岁]和患有高血压(66.1%)、糖尿病(53.4%)、代谢综合征患者(44.6%)的比率非常明显高于对照组[(61±5)岁、48.8%、15.2%、12.9%](均P<0.001)。ICVD组颈动脉粥样硬化分级计分≥2分(斑块发生率)、≥3分(血管狭窄发生率)分别为69.3%、20.4%,明显高于对照组的33.5%和5.1%(均P<0.05)。结论颈动脉粥样硬化是ICVD的危险因素之一;各种危险因素的聚集对ICVD的发生起重要作用。     

当前PCO行业和市场问题的浅析

广州鼠害与卫生虫害防治协会(以下简称协会)成立于2001年5月18日,截止2003年11月31日止,现有团体会员238个(其中厂家9个),个人会员93个,在团体会员中,领有灭鼠杀虫服务资质证有220个(其中街镇124个占56%,社会PCO公司96个占44%),从事灭鼠杀虫的从业人员近1 600人.2002、2003年已进行"病媒生物防治工"职业培训,并领取中华人民共和国职业资格证书共1 354人,除去外地区22人,实际本市1 332人,占从业人员的83.3%,以后每年都进行初级、中级的培训.协会作为行业协会"应定位在自律性行业管理组织上,应以服务为宗旨,同时做好自律、协调、监督工作"."改革逼使我们尽快培育和发展行业协会,使行业协会的作用真正得到发挥,并承担起政府转移出去的一些职能".协会成立二年来,为政府、社会、会员的服务中在市爱卫办的指导和会员单位的大力支持下,摸着石头过河,取得了一点成绩,但我市协会在实际工作中,碰到一些急待探讨的问题,部分问题通过协会的自治管理是可以解决的,有些问题不是协会本身能解决的.     

Factors affecting the neonatal response to artificial surfactant

Objective : To define the individual neonatal response to the artificial surfactant, Exosurf, and factors that may influence the response.
Methodology : Eighty-two consecutive, preterm neonates with respiratory distress syndrome, who received Exosurf at <12h of age were studied. Their response was categorized from the graphical change in the oxygenation index with postnatal age, for 12h after each of two doses of surfactant and assessed independently by two observers. Clinical factors were analysed for their effect on the four pre-defined categories of response, namely: none; mild; good; relapsed; and good: sustained.
Results : Within the first 12h, 11% of the neonates showed no response, 5% a mild response and 84% a good response, but 34% relapsed. By 24h, 6% still showed no response (all died), 11% showed a mild response and 83% a good response, of whom half relapsed. At 24h, no response was significantly associated with low gestational age and asphyxia mild response with less severe lung disease. According to the response there was a gradation in the risk of death during the first week.
Conclusions : The response to Exosurf can be individually and reproducibly categorized and demonstrated that 83% of neonates had a good response but half relapsed. No response was associated with extreme prematurity and asphyxia     

Adult-onset rod disease with abundant intranuclear rods

Summary The third case of adult-onset rod disease (nemaline myopathy) with abundant myofibrillar as well as intranuclear rods is described. The 61-year-old woman suffered from progressive weakness of proximal extremities and of the neck, mimicking polymyositis. Muscle biopsy revealed a striking myopathic pattern, with intranuclear rods occurring in 31% of the fibres. On light and electron microscopy and by immunohistochemical study, the rods differed from myofibrillar rods. The absence of -actinin in intranuclear rods suggests an enhanced readiness of actin filaments to bind to diverse proteins, instead of overproduction of -actinin as the pathogenetic basis of the rod formation.     

大鼠肠系膜淋巴结高内皮微静脉与淋巴迷路之间的网状纤维支架的研究

目的 研究大鼠肠系膜淋巴结内高内皮微静脉与淋巴迷路之间淋巴细胞归巢的通路.方法 用镀银染色光镜观察法和冻裂割断扫描电镜观察法观察健康、成熟Wistar大鼠肠系膜淋巴结的基质网状结构.结果 位于高内皮微静脉和淋巴迷路周围有网状纤维支架,在二者相临近部位有密集交织的网状纤维网.结论 淋巴结内高内皮微静脉和淋巴迷路之间密集交织的网状纤维网,为细胞的居留和迁移提供结构支持和适宜的微环境,可能是淋巴细胞归巢的重要通路.     

树突状细胞在胆囊癌组织内浸润的研究

目的通过对胆囊癌组织中树突状细胞浸润情况的研究,阐述树突状细胞与肿瘤免疫之间的关系。方法采用免疫组化SP法。结果树突状细胞在胆囊癌组织的浸润程度与年龄、性别和病理组织学类型无关,与病理分化程度呈负相关关系(P<005)。结论树突状细胞在胆囊癌组织的浸润程度与病理分化程度、Nevin分期、肝浸润及淋巴结转移存在密切的关系。树突状细胞的定量检测可作为估计胆囊癌预后的标志。     

蛋白酶激活受体2激动剂对肥大细胞释放组胺的影响

目的 研究PAR-2激动剂(tc-LIGRLO-NH2与SLIGKV-NH2)和胰蛋白酶对结肠肥大细胞释放组胺的影响。方法 结肠组织经酶消化后,细胞成份用全HBSS重新悬浮。激发过程在LP4试管中、37℃条件下完成。组胺水平用以玻璃纤维为基础的荧光方法测定。结果PAR-2激动剂tc-LIGRLO-NH2和SLIGKV-NH2均可诱导人结肠肥大细胞剂量依赖性组胺释放。浓度为100μmol／mL时,tc-LIGRLO-NH2和SLIGKV-NH2可分别引起比基础分泌量多出2．5倍和2倍的组胺释放,而反PAR-2激动剂tc-OLRGIL-NH2和VKGILS-NH2在实验浓度高至300μmol／mL时仍对组胺释放无影响。胰蛋白酶在1．0～100μg/mL间可引起剂量相关性组胺释放,胰蛋白酶抑制剂可抑制之。PAR-2激动剂tc-LIGRLO-NH2的作用从加样后1min开始,3min后完成。细胞经过百日咳毒素和代谢抑制剂预先处理后,几乎失去了对tc-LIGRLO-NH2、SLIGKV-NH2和胰蛋白酶刺激的反应性。结论 PAR-2激动剂和胰蛋白酶是高效的组胺释放刺激剂,其在人结肠炎症性疾病中起一定的作用。