Influence of blood supply of the esophageal and gastric stumps on anastomotic healing after esophagogastrostomy in rabbits]

OBJECTIVE: To study how blood supply of the esophageal and gastric stumps influences the anastomotic healing after esophagogastrostomy in rabbits. METHODS: Twenty-seven New Zealand rabbits were randomly divided into 3 groups to receive esophagogastrostomy, followed by different procedures. Except for those in group I, all the rabbits were subjected to procedures of reducing the blood supply either of the esophageal or the gastric stump (group II and group III, respectively), followed by single-layer esophagogastric anastomoses using interrupted 5-0 polypropylene sutures. Ten days after operation, all the rats were killed and the anastomotic sites excised for measurement of the inner diameter, tensile strength, and hydroxyproline concentration. RESULTS: Healing of the esophagograstric anastomosis was obtained in all the rabbits but one with anastomotic leakage in group I and one with perforation of the gastric fundus in group III. The anastomotic inner diameters were similar in all the three groups, whereas the tensile strength and hydroxyproline concentration at the anastomoses decreased in group III in comparison with the other two groups (P<0.05) that had similar measurements (P>0.05). CONCLUSIONS: Extended length of the free esophageal stump does not significantly affect anastomotic healing as decrease of blood supply in the gastric stump.     

用酶联免疫吸附术观察向附睾注射鱼肝油酸钠后抗精子抗体的变化

本研究用酶联免疫吸附术观察8只家兔在附睾注射鱼肝油酸钠后血清及精浆中的抗精子抗体。血清抗精子抗体阳性率为37.5～50.0%,最早检出率为术后2个月,6～7月达高峰。精浆抗精子抗体阳性率为25%,最早检出率为术后4个月,且此时己达高峰。与输精管结扎资料相比,发现血清抗精子抗体检出率偏低,而精浆相应抗体偏高,表明向附睾注射鱼肝油酸钠引起的免疫反应有别于结扎,以生殖道局部为主。     

动态监测胃黏膜内pH值对胆源性胰腺炎外科治疗的价值

目的探讨胃黏膜内pH值对胆源性胰腺炎病情预后评估及在决定手术冶疗中应用的价值。方法对确诊的146例胆源性胰腺炎患者经鼻插入胃黏膜二氧化碳张力计（TRIP-NGS导管）测定胃黏膜内pH值，每隔12小时测定一次，并进行APACHEⅡ评分，将2组数据与外科治疗进行相关分析。结果①pH值变化反映胆源性胰腺炎病情发展变化，与器官衰竭数呈负相关；②外科干预治疗与内科治疗比较差异有统计学意义（P〈0．05）；③pHI〉7．25与pH〈7．25患者开腹手术病死率和细菌培养阳性率比较差异有统计学意义（P〈0．05）。结论pH值对胆源性胰腺炎外科治疗有指导意义。外科处理原则是：①胆道无梗阻，以内科保守治疗为主；②伴胆道梗阻，先行经内镜十二指肠乳头括约肌切开术、经内镜鼻胆管引流术、B超导引引流、腹腔灌洗等，如胆道引流不畅或pH值持续下降，则开腹手术。     

老中青年急性心肌梗塞的临床特点及相关因素分析

急性心肌梗塞(acute myocardial infarction．AMI)是老年人常见的心血管疾病之一。但近年来，中青年AMI发病率有上升趋势，为了解各年龄段AMI的临床特点及其相关因素，现对某院近年来收住的AMI患者进行回顾性对比分析，现报告如下。     

亚硝酸钠与AFB1相互作用对遗传物质影响的实验研究

以正常人外周血淋巴细胞的ＳＣＥ率作为细胞遗传学指标，研究了Ｎａ＿２ＳｅＯ＿３与ＡＦＢ＿１相互作用对细胞遗传物质的影响。结果表明，一定浓度的Ｎａ＿２ＳｅＯ＿３（１０￣（－５）ｍｏｌ）对ＡＦＢ＿１所诱发的ＳＣＥ有明显的抑制作用，但当浓度达到１０￣（－２）ｍｏｌ时，细胞增殖受到抑制，到１０￣（－１）ｍｏｌ时细胞出现毒性现象。提示Ｎａ＿２ＳｅＯ＿３具有抑变和细胞毒性双相作用。所以在Ｎａ＿２ＳｅＯ＿３与ＡＦＢ＿１相互作用的ＳＣＥ实验中应避免Ｎａ＿２ＳｅＯ＿３的浓度过高而损伤培养的细胞。     

脑梗塞患者血清脂蛋白（a）测定及其临床意义

应用酶标法测定58例脑梗塞患者和56例健康对照者血清脂蛋白(a)[LP(a)]含量,并同时测定了其他脂代谢指标,对其中26例脑梗塞患者还测定了血浆纤维蛋白溶解(简称纤溶)指标。结果表明脑梗塞组存在显著的脂代谢和纤溶功能紊乱。LP(a)含量增高,与所测脂代谢、纤溶指标无显著相关,是脑梗塞发病独立的危险因素。