术中氩氦刀治疗晚期胰腺癌

目的 探讨术中氩靶向冷冻治疗系统（即氩氦刀）治疗晚期胰腺癌的安全性及疗效。方法 2001-2002年期间8例晚期胰腺癌使用了术中氩氦刀治疗。结果 8例晚期胰腺癌病人中，平均生存期为8．6个月，1例目前仍然存活。5例腹痛病人，3例完全缓解，2例部分缓解；1例腰背痛病人，疼痛部分缓解。结论 术中氩氦刀治疗尽管不能明显延长晚期胰腺癌病人的平均生存期，但能明显缓解病人的疼痛，提高病人的生活质量，仍不失为一种有效的晚期胰腺癌的姑息治疗方法。     

Direct injections of calcitriol into enlarged parathyroid glands in chronic dialysis patients with severe parathyroid hyperfunction

Summary: Severe secondary hyperparathyroidism in chronic dialysis patients has been recently treated by supraphysiological concentration of calcitriol achieved through pulse therapy. However, there are many patients resistant to this therapy, who usually have larger parathyroid gland(s). to overcome this resistance, calcitriol was injected directly into the enlarged glands under ultrasonographic guidance. We injected 70–90% of the calculated gland volume of calcitriol solution (1 μg/mL) into the glands of 7 patients three times per week for 2 weeks. the parathyroid hormone (PTH) levels decreased significantly after 2 weeks of direct injections of calcitriol. Following a further 4 weeks of calcitriol pulse therapy, PTH levels remained suppressed and serum alkaline phosphatase activity and the volume of parathyroid glands also decreased. During the long-term follow up, five patients remained well controlled with calcitriol pulse therapy, while two patients needed ethanol injections to control hyperparathyroidism. Although we could not completely rule out a toxic effect of the vehicle, direct injection of calcitriol into parathyroid glands may be another treatment option for chronic dialysis patients. Our data further support the important role of resistance of parathyroid cells to calcitriol in the pathogenesis of parathyroid hyper function in uraemic patients.     

Solid and papillary epithelial neoplasms of the pancreas: CT findings

Five female patients and one male patient with solid and papillary epithelial neoplasms of the pancreas were examined with computed tomography (CT). The mean age of the patients was 27 years (range, 13-46 years). All cases showed well-encapsulated, round or lobulated masses consisting of both cystic and solid areas. Cystic portions showed CT numbers that suggested hemorrhagic necrosis. There were no internal septations within the masses. In three tumors located in the head of the pancreas, dilatation of the biliary tree was absent or minimal, although the masses were large. Two tumors contained calcifications. One tumor demonstrated metastatic deposits in liver and lymph nodes. Metastatic masses appeared similar to the primary pancreatic mass. Solid and papillary neoplasm of the pancreas should be the primary diagnostic consideration when characteristic CT findings are detected in a young female patient.     

VEGF-C和VEGF-D蛋白表达在胰腺癌淋巴转移中的意义

目的探讨胰腺癌中VEGF-C、VEGF-D蛋白表达与淋巴结转移之间的相关关系,阐明癌周淋巴管增生在胰腺癌淋巴转移中的作用及意义。方法免疫组化检测30例胰腺癌组织中VEGF-C、VEGF-D的表达及其与临床病理、淋巴结转移的关系。结果胰腺癌VEGF-C、VEGF-D蛋白表达阳性率分别为73%(22/30)、57%(17/30),肿瘤周边部位显著高于肿瘤中心部位,其表达与肿瘤的部位、分化程度、组织学类型无关,与肿瘤的TNM分期有关,Ⅲ~Ⅳ期显著高于Ⅰ~Ⅱ期。在VEGF-C、VEGF-D蛋白阳性组,淋巴结转移均显著增多。结论VEGF-C和VEGF-D与诱导胰腺癌淋巴管生成,促进肿瘤细胞淋巴道转移有关。     

抑癌基因P16在膀胱移行细胞癌中的表达及临床意义

目的　探讨抑癌基因P16蛋白在膀胱移行细胞癌中的表达。方法　采用S -P放射免疫法检测 3 2例膀胱移行细胞癌、10例正常膀胱粘膜中P16蛋白的表达。结果　 3 2例膀胱移行细胞癌中 ,P16蛋白表达总阳性率为 40 .63 % ;在膀胱移行细胞癌Ⅰ、Ⅱ、Ⅲ级中分别为 63 .64 %、3 3 .3 3 %、2 5 .0 0 %。P16蛋白表达的阳性率随病理分级增高而降低 ,Ⅰ级与Ⅱ级、Ⅲ级比较差异无显著性 (P >0 .0 5 )。结论　P16蛋白检测有助于对膀胱移行细胞癌的诊断 ;P16蛋白的缺失与膀胱移行细胞癌的发生、发展和预后有关。     

思维的非演绎方法在歌唱中的运用

从非演绎方法入手,从分析与综合、归纳与概括、类比与联想三个方面联系歌唱的思维过程,论述非演绎思维方法在歌唱过程中的运用。思维的非演绎方法贯穿于歌唱的全过程,它们之间存在着紧密的联系。掌握思维的非演绎方法对于歌唱水平的提高有积极的促进作用。     

Emergency endovascular repair of iliac artery rupture caused by post-stenting angioplasty with an endograft

I liac artery rupture is a rare complication of post-stenting angioplasty and can lead to massive life-threatening haemorrhage. Conventional surgery can not repair the damaged vessel easily and may cause substantial blood loss and high operative morbidity and mortality. We report our experience with a self-expanding covered endoprosthesis for endovascular repair of the rupture of an iliac artery caused by stenting angioplasty.     

输尿管镜气压弹道碎石治疗输尿管结石（附32例报告）

目的 总结输尿管镜气压弹道碎石治疗输尿管结石的临床效果。方法 回顾分析32例应用输尿管镜气压弹道碎石治疗输尿管结石患者资料。男10例，女22例；平均年龄29岁。结石位于输尿管下段24例，中段6例。上段2例。其中行原位体外冲击波碎石（ESWL）治疗后结石未能排出者8例。结果 碎石成功率90．6％（29／32）。2例因输尿管异常置镜失败，转开放性手术；1例输尿管穿孔后留置双J管，择期行ESWL治疗成功。B超显示肾积水较术前减轻或消失，KUB、IVP未发现输尿管狭窄。结论 输尿管镜气压弹道碎石治疗输尿管结石创伤小、成功率高、并发症少。     

下颌第一磨牙三维有限元模型的建立

目的：建立下颌第一磨牙三维有限元模型。方法：通过螺旋CT扫描的方法，利用Mimics、Geomagic Studio 7等图像处理软件，HyperMesh网格自动划分软件，通过特定的MSC．MARC有限元软件建立下颌第一磨牙三维有限元模型。结果：准确的建立了牙本质、牙釉质、髓腔、牙槽骨、牙周膜等组织形态的三维有限元模型。结论：本实验建模方法可行性强，方便快捷，具有良好的生物力学与几何力学相似性。为临床口腔医师提供了一种简捷而精确的有限元建模方法。     

噻吗洛尔与普萘洛尔治疗高血压病与心绞痛的疗效比较

劳累性心绞痛38例采用噻吗洛尔2.5-5mg, tid,共4wk;另12例采用普萘洛尔10-20mg, tid,共4wk。结果:前者显效率为79％,显著高于后者42％(P<0.05)。高血压病(Ⅰ,Ⅱ期)37例采用噻吗洛尔治疗,方法同上;另13例采用普萘洛尔20-40mg, tid,疗程亦4wk。结果:2组均有显著降压疗效(P<0.01),噻吗洛尔治疗后1h即获显效,普萘洛尔须24h才获显效。噻吗洛尔7％(5/75)、普萘洛尔4％(1/25)治疗后发生窦性心动过缓,前者被迫停药,后者未停药。