第八届全国门静脉高压症学术会议暨腹部外科再手术专题研讨会征文通知

中华医学会外科学分会门静脉高压症学组、中华外科杂志编辑部及中华普通外科杂志编辑部将在2001年5月于青岛召开第八届全国门静脉高压症外科学术研讨会及腹部外科再次手术专题研讨会,会议将邀请著名专家就相关问题做演讲。参加会议的代表将获得中华医学会医学继续教育学分。会议征文包括以下内容:①门静脉高压症手术的术式选择和血流动力学的关系;②肝移植和门静脉高压症;③门静脉高压症非手术治疗和手术治疗的经验;④门静脉高压症的实验研究;⑤门静脉高压症外科治疗与肝功能评估;⑥腹部外科手术合并症与再手术治疗经验;⑦腹部外科疾病的分…     

造血干细胞与免疫活性细胞的沉降特性

应用Simonsen的脾指数测定方法以及体内生成脾结节和体外琼脂培养方法,分别研究了小鼠脾脏和外周血中造血干细胞和免疫活性细胞在自然沉降条件下的沉降特性。在小鼠脾脏细胞的沉降试验中,CFU-S的沉降速度为4.50毫米/小时,CFU-C的沉降速度为6.69毫米/小时,脾指数阳性细胞的沉降速度为3.57毫米/小时。在小鼠外周血白细胞的沉降试验中,CFU-S的沉降速度为4.96毫米/小时,脾指数阳性细胞的沉降速度为5.12毫米/小时。上述沉降试验表明,造血干细胞与免疫活性细胞有不同的沉降速度和分布特性,因此,有可能通过自然沉降,在一定程度上分开这两类细胞,其中,粒系定向造血干细胞(CFU-C)的沉降速度要高于多向性造血干细胞(CFU-S),因而,在沉降分离中CFU-C与免疫活性细胞可以得到较高程度的分离。从造血细胞中分离免疫活性细胞是当前造血干细胞移植中的重要研究课题。本文对于应用速度沉降装置分离免疫活性细胞、减轻造血细胞移植中的移植物抗宿主反应(GVHR)的前景作了讨论。     

邹城市预防艾滋病健康教育效果评价

目的评价预防艾滋病健康教育与行为干预效果。方法采用问卷方式对社区居民进行预防艾滋病信息的可及性及知信行的调查。结果社区居民艾滋病知晓率为97.41%,熟悉艾滋病传播途径的87.78%,62.78%的认为艾滋病病人或感染者和正常人享有一样的入学/就业权,38.70%的人愿意与感染艾滋病的同事继续共事,60.19%的人愿意与感染艾滋病的家人继续共同生活,最近3次性行为100%使用安全套者为26.48%,82.04%的人有医疗用血安全意识,64.81%的人有医疗器械安全意识。最想获取艾滋病预防措施、传播途径、病理知识、症状表现、治疗方法、检测途径及检测方法、疫情信息,新闻、电视公益广告、专题报道、反映艾滋病病人生活的电影或电视剧、科普材料、大型公益演出人们最喜欢。结论政府重视,多部门合作,组织机构健全,宣传教育广泛,干预措施到位,成效显著。     

唇腭裂合并的单侧牙槽突裂大鼠模型的建立和稳定性研究

目的建立唇腭裂合并的上颌骨缺损（牙槽突裂）大鼠模型,并研究其稳定性。方法以7周龄SD大鼠作为实验对象,于右侧上颌制备4mm×4mm×3mm的牙槽突裂,模拟建立唇腭裂合并的上颌骨缺损大鼠模型。根据术后骨缺损区的处理方式将模型大鼠分为对照组（骨缺损区不予特殊处理）和实验组（骨缺损区予以骨蜡填塞）,每组10只。两组大鼠分别于术毕即刻和术后4、8周时点分批处死后制备模型标本;利用显微CT（MicroCT）进行三维重建,观察和定量检测骨缺损区新骨形成情况,分析和比较两组模型的稳定性。结果 MicroCT三维图像重建显示,在术后8周时点,对照组有大量新骨充填于缺损区,缺损区明显缩小;而实验组仅断端边缘有少量新骨形成,缺损区无明显缩小。定量分析显示,对照组和实验组术后4周时点的新骨形成百分比分别为54.35%和16.53%,术后8周时点的新骨形成百分比分别为93.12%和29.30%,两组间比较差异均有统计学意义（P〈0.05）。结论成功建立模拟唇腭裂合并的上颌骨缺损（牙槽突裂）大鼠模型,利用骨蜡填塞骨缺损区能显著提高模型的稳定性。     

药学监护对终末期肾病血液透析伴高血压患者降压效果观察

目的:临床药师通过药学监护建立与血液透析患者的联系,与医师共同选择个体化降压治疗方案,降低患者的高血压,提高血液透析患者的生命质量。方法:选取我院符合纳入标准的血液透析伴高血压患者,随机分为药学监护组(20例)与非药学监护组(21例)。结果:治疗3个月后,药学监护组患者收缩压158mmHg下降至139mmHg,舒张压95mmHg下降至84mmHg,非药学监护组患者收缩压155mmHg下降至152mmHg,舒张压96mmHg下降至93mmHg,药学监护组与非药学监护组比较差异有统计学意义(P<0.05)。结论:通过药学监护,临床药师参与终末期肾病血液透析伴高血压患者个体化降压治疗,可促进医疗质量的提高。     

心理护理对老年股骨粗隆间骨折术后的影响

目的探讨围手术期心理护理对老年股骨粗隆间骨折手术后的影响。方法选择在我院手术治疗的老年股骨粗隆间骨折患者62例,随机分为观察组和对照组,每组31例。观察组在实施骨科常规护理措施的基础上,配合有针对性的心理护理措施．对照组则仅实施骨科常规护理措施。比较两组患者手术后的疼痛视觉模拟评分情况及对患者护理的满意程度。结果观察组手术后的疼痛程度明显低于对照组,护理满意度则明显高于对照组,两组差异均有统计学意义（P〈0．05）。结论心理护理能明显减轻老年股骨粗隆间骨折患者手术后的疼痛程度,促进患者的身心康复,改善护患关系,提高护理满意度。     

结直肠癌术后患者异时性进展期腺瘤风险筛查模型的构建及验证

目的 筛选结直肠癌术后患者发生异时性进展期腺瘤的危险因素,构建个体化风险筛查模型并验证模型的筛查效果。方法 将2007年4月至2017年10月行结直肠癌根治术的734例患者分为建模组和验证组,术后3年结肠镜随访。建模组采用单因素及多因素Logistic回归分析,建立风险筛查模型。利用验证组验证模型的筛查效果。结果 734例患者包括建模组485例,验证组249例。平均年龄为(64.6±11.5)岁,男性440例,女性294例。总的异时性进展期腺瘤发生率为11.9%(建模组12.0%,验证组11.6%)。多因素Logistic回归分析显示,男性、糖尿病病史、右半结肠癌、中低分化腺癌、腺癌合并腺瘤,腺癌合并进展期腺瘤为异时性进展期腺瘤的独立预测因素。根据Logistic多因素分析结果,建立筛查结直肠癌术后出现异时性进展期腺瘤的模型,并建立风险筛查列线图。受试者工作特征(receiver operating characteristic, ROC)曲线分析结果显示,该模型的受试者工作特征曲线下面积(area under the curve, AUC)=0.957(95%CI:0.935～0.9...     

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??Updates and interpretations of PODF definition and grading system (2016 edition) by ISGPS SHI Si, XIANG Jin-feng, XU Jin, et al. Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center; Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China
Corresponding author: YU Xian-jun, E-mail: yuxianjun@
fudanpci.org
Abstract The definition and grading system of postoperative pancreatic fistula (PODF) developed by the International Study Group of Pancreatic Fistula (ISGPF) in 2005 has been widely accepted. However, the use of the process found that the version of the definition and classification system, there are still some problems and shortcomings. Based on this, the International Pancreatic Surgery Research Group (ISGPS) updated the relevant content, published 2016 version ,which is more concise and has clinical value than 2005 version. In 2005 version , PODF was emphasized as a complication that closely associated with the clinical management. A former grade A has been renamed as Biochemical Leak (BL) which is no longer considered as a fistula in 2016 version. Besides, grades B and C are defined more strictly. In particular, grade B requires a change in the postoperative management. Drains either left in place >3 weeks or repositioned through endoscopic or percutaneous is definitely considered as grade B. On the other hand, grade C refers to POPF that needs reoperation or leads to single/multiple organ failure and/or mortality.     

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??Analysis on the relationship between methods of reconstruction after gastrectomy and digestive tract obstruction LIU Tong??QI Feng??ZHAO Zhong-zhi. Department of Gastraintestinal Surgery, Tianjin Medical University General Hospital??Tianjin General Surgery Institute??Tianjin 300052??China
Corresponding author??LIU Tong??E-mail??liutonga@126.com
Abstract The progress of surgical techniques and surgical instruments has brought a variety of innovation for gastric surgery. The causes of postoperative digestive tract obstruction also become diversified??involving primary disease??choice of procedure??anastomosis method and other factors. Anastomotic stenosis or obstruction after gastrectomy mainly occurs in stomach-duodenum??stomach-jejunum??esophagus-jejunum, esophagus-residual stomach and other anastomosis??closely related to the selection of anastomosis, procedures and instruments??scar or tumor relapse. The afferent loop and efferent loop obstruction are still one of the important complications. It is more afferent loop obstruction in clinic. The Roux limb of Roux-en-Y anastomosis may also have some unique obstructions, such as intussusception??internal hernia??Roux stasis syndrome. In addition??gastric paralysis or adhesive intestinal obstruction may also occur. Therefore??with the changes in disease spectrum and the development of gastrointestinal surgery??the causes and characteristics of digestive tract obstruction after gastrectomy have undergone great changes. Surgeons need to carry forward the artisan spirit??strive for excellence??and constantly sum up clinical experience.