Treatment of ulcerative colitis by traditional Chinese medicine and dynamic study of immune functions

The effect of the traditional Chinese medicinal herbs enema and enteric-coated capsules in the treatment of ulcerative colitis (UC) were compared in 260 cases. The immune complexes and the dynamic change of autoantibodies were monitored in 28 out of the 260 cases before and after treatment. The following results were observed. (1) There was no significant difference in the total effective rate between the enema group and the oral capsule group (93.3% and 87.5% respectively), but the recovery rates of purulent hemafecia, mucusfecia and erosion accompanying colitis, etc. in the former group were higher than those in the latter (P less than 0.01). (2) The circulating immune complexes were found 43 times above the normal range in 17 cases with positive rate 60.7%, and tended to decrease as the condition became better after treatment. Antinuclear antibodies were determined by the indirect fluorescent immune method and the indirect enzyme labelling method and the positive rates were 53.6% and 64.7% respectively, both being much higher than those in the controls (P less than 0.01).     

红细胞调控白细胞免疫功能新的自然实验研究体系

目的用血液免疫反应路线图实验体系评估红细胞在白细胞免疫活性中的作用。方法将0·3ml血浆加入0·2ml全血细胞悬液(全血细胞组)或0·2ml白细胞悬液(白细胞组)中,37℃温育1h,用免疫酶联法测定IL-8和IL-12水平,流式细胞仪测定白细胞膜CD4、CD8、CD35和CXCR4表达量。结果全血细胞组IL-8和IL-12水平(分别为5·96±4·26、9·84±2·23ρB·pg-1·ml-1)明显低于白细胞组(分别为15·09±9·86、13·59±3·69ρB·pg-1·ml-1,P<0·05),淋巴细胞CD4、CD35、CXCR4表达量(分别为37·79±12·00、154·66±70·00、34·40±20·45)明显高于白细胞组(分别为18·54±11·32、83·26±35·99、16·69±11·09,P<0.01),粒细胞CD35表达量(603·63±257·64)明显高于白细胞组(384·86±174·16,P<0.01)。成人全血细胞组淋巴细胞和粒细胞CD35和CXCR4表达量明显高于脐血全血细胞组(P<0·05或P<0·01)。结论红细胞是白细胞(包括T淋巴细胞、B淋巴细胞、NK细胞、树突状细胞、粒细胞等)免疫功能的调控者和指导者,脐血红细胞免疫调节功能明显下降;本研究为红细胞免疫调控活性测定提供了新的近似自然的方法。     

Laparoscopic Local Resection Based on Sentinel Node Evaluation for Early Gastric Cancer: A Preliminary Report

We previously reported that lymphatic mapping using isosulfan blue can be used to identify sentinel nodes (SNs). This study was undertaken to evaluate the feasibility of using the SN technique in treating early gastric cancer and to explore its usefulness for minimal invasive surgery. Twenty-three patients with early gastric cancer who underwent SN biopsy were retrospectively evaluated. Based on SN evaluation, individualized surgery was performed in five patients with T1N0M0 gastric cancer. When pathological examination of frozen sections revealed metastasis in SNs, we performed a standard D2 gastrectomy. Laparoscopic local resection was applied when the SN biopsy was negative. Our results showed that the success rate with SN biopsy in early gastric cancer was 100%, as were the accuracy, sensitivity, and specificity. All five patients with early gastric cancer had SNs negative for metastases both by frozen section and by postoperative pathology. Thus, all these patients underwent laparoscopic local resection without extended lymphadenectomy. We conclude that SN biopsy is a useful tool to individualize the operative procedure, and laparoscopic local resection can be safely performed using SN guidance in selected patients with early gastric cancer.     

继发性肝癌的外科治疗

目的探讨继发性肝癌的手术适应证和方法。方法对52例继发性肝癌的临床病例资料进行回顾性分析。结果分别采用了左半肝切除、右半肝切除、左外叶切除、右前叶切除、右后叶切除和肝楔形切除术。术后1、3、5年的生存率分别为28.3%、19.4%和11.9%。结论对适合手术的继发性肝癌,行肝切除术可以获得满意的效果。     

中等职业学校实行学分制初探

1学分制产生的背景　　学分制是随着课程选修制的产生、发展而建立起来的教学管理制度.它产生于18～19世纪的欧美国家,于20世纪20年代经我国的一些教育家从日本或欧美引进.     

重症胆管炎23例临床治疗分析

目的：探讨急性重症胆管炎患者的手术时机和死亡原因。方法：回顾性分析23例急性重症胆管炎患者的治疗及预后情况。结果：死亡2例（手术死亡及传统治疗死亡各1例）。早期大剂量短期应用糖皮质激素患者休克得到纠正率85％，明显高于未用糖皮质激素患者休克纠正率50％。结论：急性重症胆管炎患者应在出现休克和（或）精神症状之前手术，对已出现休克的患者，应先给予充分的保守治疗，待病情稳定后再手术。贻误手术时机，严重合并症如多器官功能衰竭及高龄是死亡的主要原因。     

听力对语言影响的表现与矫正

目的 通过对302例药物致聋聋儿的临床观察,研究听力对语言影响的表现,从中摸索积极的矫正补偿方法,使聋儿能听会说,早日回归主流社会。方法:根据听力损失以1/2增益法,选择不同型号的助听器,用具有频率特性的玩具进行适应性训练,采用视觉强化测听法和言语测听法,调整助听器增益,努力使各频率尽可能进入言语香蕉图。结果 100%聋儿表现听觉的敏感性和言语的清晰度低,且存在不同程度的“重振”;聋儿助听补偿效果越好,语言清晰度越高;聋儿只能在信噪比>10 dB SPL的情况下才能听懂语言;言语识别中存在有不同种类的掩蔽现象;双耳配戴助听器对言语接受阈能提高约15%左右。结论:双耳配戴助听器以及利用助听器的微调和耳模的声学作用来改变助听器的频响,选择电脑编程、全数字、带有“AGC”功能、带有指向性麦克风等不同功能的助听器,都是十分有效的矫正措施;选择信噪比≥10 dB SPL的学习环境;充分利用视觉、触觉功能补偿作用;努力学习好辅音;教师正确控制语音、语速、声调、掌握抑扬顿挫,防止声音向上、向后、向前掩蔽。     

“黄风湿”系列疗法——火针封闭治疗痛风石的疗效观察

痛风是一种由嘌呤代谢紊乱所致的疾病,日久不愈、反复发作则逐渐形成痛风石沉积。常规治疗对痛风石效果不明显。黄再军医院采用火针封闭疗法治疗痛风石36例,经临床观察治愈率为69.4%,显效率为25.0%,有效率为5.6%,总有效率达100%。     

糖尿病患者超声乳化白内障吸除手术的临床观察

目的:探讨糖尿病患者进行超声乳化白内障吸除联合人工晶状体植入手术的临床效果。方法:50例(61只眼)糖尿病患者(设为A组)和同期163例(174只眼)血糖正常患者(设为B组)接受超声乳化白内障吸除联合人工晶状体植入手术。糖尿病患者手术前通过饮食疗法、口服药物或肌注胰岛素治疗,使空腹血糖降到 10mmol/L以下。术后随访 1～28个月(平均 8.6个月),复查视力、裂隙灯及眼底检查。结果:术后矫正视力≥0.5者,A组为77.1%;B组为80.5%。两组经统计学处理差异无显著性(P>0.05)。两组术中出现后囊破裂及术后发生角膜水肿和前房渗出等并发症的差异无显著性(P>0.05 )。结论:糖尿病患者进行超声乳化白内障吸除手术前只要有效控制血糖,其手术效果与对照组患者相同。但术后血糖的控制仍然十分重要。眼科学报2003;19:98-100。