不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

三金片治疗尿路重新感染疗效观察

目的三金片治疗尿路重新感染疗效观察。方法回顾性分析2005～2008年尿路重新感染门诊病例248例资料。结果治疗组三金片治疗8周后，半年内复发7例，1例复发三次，2例复发二次，4例复发一次，平均持续5d。对照组半年内复发52例，2例复发四次，18例复发三次，15例复发二次，17例复发一次，平均持续9d。结论服用三金片后治疗组复发率明显降低，而且复发次数明显降低，病程持续时间明显缩短，说明在有效抗菌素作用下合用三金片对重新感染防治效果很好。     

锁骨下静脉置管术前的宣教和处置

分析行锁骨下静脉置管术病人的特点，做好锁骨下静脉置管术前病人的宣教指导，增加病人对置管术的理解，减轻病人的担心和恐惧，积极配合手术操作。术后做好导管处置和注意并发症的发生。     

Neer法联合McLaughlin法治疗肩袖断裂伤

目的介绍肩袖断裂伤应用Neer法联合McLaughlin法治疗的手术方法和并对其临床疗效做初步报告。方法自1999年2月～2004年4月,我院对14例肩袖断裂伤患者,应用Neer法的前肩峰成形术,同时应用McLaughlin法将断裂后退的肩袖充分游离后,前进缝合在肱骨大结节以近的骨槽内。术后肩外展支架固定3～4周,以使肌腱-骨质愈合。结果所有患者随访2～38个月,平均13个月。所选病例术前肩外展均只有30°,9例术后恢复至180°,且疼痛消失,冈上冈下肌萎消失;4例术后恢复至100°～120°,疼痛消失;1例术后恢复至90°,冈上冈下肌萎消失。结论术前及术中根据肩袖断裂的程度,选择合适的病例,该方法既修补了断裂的肩袖,又消除了肩峰下撞击,方法操作简单,且安全有效。     

肝再生发生及其相关机制的研究进展

肝脏再生是指因手术、创伤、中毒、感染、坏死等致部分肝细胞功能丧失后,肝细胞重新修复的过程.对于肝再生的发生及其内在机制的认识和研究,大致可分为三个阶段:(1)最初认为可能存在一种特定的激素类物质决定肝再生的过程.     

胆汁CEA和CA72-4联合检测对胆管癌的诊断价值

胆管癌术前的定性诊断十分困难。检测胆汁肿瘤标志物是一条可研究的途径。本文探讨胆汁癌胚抗原(CEA)和糖类抗原72-4(CA_(72-4))联合检测对胆管癌的诊断价值。 1.材料和方法:研究对象来自本院自1999年1月至2002年4月收治的66位病人,胆管癌32例(男20例,女12例),胆管良性病变34例(男15例,女19例)。术前经ENBD或PTCD、术中直接穿刺胆管收集胆汁。经超速离心15 min后,取上清液5 ml,—20℃存放。     

分娩性臂丛神经损伤的诊治

分娩性臂丛神经损伤(又称产瘫),是指在分娩过程中胎儿的一侧或双侧臂丛神经因受到头肩分离暴力作用而发生的牵拉性损伤。几个世纪以来,产瘫被认为是上肢的一种先天性畸形。Smellie于1768年首先报道了1例分娩引起的双侧臂丛麻痹,Duchenne(1861)证实了产瘫的分娩性起源,Erb(1875)描述了产瘫所致最常见的臂丛上干损伤的典型表现,Seeligmueller(1877)和Klumpke(1885)则分别描述了全臂丛型及下干型产瘫。Kennedy(1903)曾建议对产瘫进行早期神经探查及外科     

社区卫生服务要走向市场

近年来在社区卫生服务发展中出现了一些误区,如:认为该服务领域是由政府办、政府管,体制与机制难以创新;过分强调承办者的“基层医疗机构”身份而保护了不合格的人员;过度承担政府布置的各种任务,影响了服务工作和自身建设;过分依赖公费医疗与基本医疗保险部门的认可,难以探索新的服务内容等。这些误区已经造成了社区卫生     

管碟法测定Nisin效价

对管碟法测定Nisin效价的条件进行了研究,考察了几个参数的影响,得出了Nisin测定的最佳条件:90mm培养皿中培养基加量为15mL,Na2HPO4·12H2O质量浓度1g/dL,菌悬液浓度109CFU/mL,琼脂质量浓度1g/dL,培养基pH值7.0,牛津杯中样品加液量100μL.在此条件下,Nisin效价在5～100IU/mL,其对数值与抑菌圈直径有较好的线性关系.