腹腔镜肝切除技术的优化

目的通过动物实验优化腹腔镜肝切除中入肝血流阻断技术及肝实质离断技术。方法以10头猪为实验动物,以肝门阻断钳或可拆卸肝门阻断钳及鞘内解剖优化腹腔镜下入肝血流阻断技术;在没有任何入肝血流阻断的情况下,分别进行肝脏局部切除、左外侧叶及左内侧叶的序贯切除,肝实质离断采用超声刀、LigaSure、微波刀、双极电凝、外科夹及内镜切割闭合器完成,比较不同器械离断肝实质的效果和安全性。结果肝门阻断钳或可拆卸肝门阻断钳行入肝血流全部阻断或部分阻断后,缺血部分肝脏颜色变化明显;鞘内解剖左半肝入肝血流阻断后,左、右半肝间的缺血线明显;各种常用肝实质离断器械均有其适用范围,对其的优化使用可提高断肝效率,减少出血。结论通过动物实验优化的腹腔镜入肝血流阻断技术以及肝实质离断技术,可为腹腔镜解剖性广泛肝切除的临床应用提供依据。     

复方甘草甜素片治疗过敏性紫癜62例疗效观察

复方甘草甜素片的主要成分是从中药甘草中提取的甘草苷以及苷氨酸、盐酸半胱氨酸，其中以甘草酸苷具有很强的抗过敏作用，过敏性紫癜是侵犯皮肤及其他器管的毛细血管及细小动脉的一种过敏性血管炎。2005年4月-2006年6月，我们采用复方甘草甜索片（商品名：美能，日本诺发源制药株式社会生产）治疗过敏性紫癜62例，疗效较好，报告如下。     

肾主骨生髓与绝经后骨质疏松症病理基础关系

骨质疏松症(Osteoporosis,OP)是以骨量减少,骨组织显微结构退化,骨的脆性增加,极易于发生骨折的一种全身性骨骼疾病。其中绝经后骨质疏松症(Postmenopausal osteoporosis,PMOP)又称Ⅰ型骨质疏松症,是妇女退行性病变之一,多发生绝经后5～15年,即年龄在51～70岁。临床主要表现为腰背疼痛,活动不利;身高缩短,驼背;易发生骨折(常见脊椎压     

哮喘患儿血清白细胞介素-4、白细胞介素-17和干扰素-γ水平的检测

支气管哮喘（简称哮喘）是一种以气道阻塞、气道炎症和气道高反应性为特征的慢性呼吸道疾病,为儿童期最常见的慢性肺病,近年来其发病率有逐年增高趋势,世界范围内儿童哮喘流行病学调查结果显示,儿童哮喘患病率较10年前明显升高。全世界大约有2.35亿哮喘患儿,每年因哮喘而死亡的病人数高达万人,     

恶性脑胶质瘤放疗联合替莫唑胺化疗后假性进展1例

1 临床资料 患者男,60岁,吉林省长春市人,恶性脑胶质瘤术后、放化疗后3个月,因头部不适1周于2013年1月13日入院.该患缘于10个月前因右侧头部阵发性胀痛,伴有左下肢活动不灵就诊于我院神经外科,临床诊断为＂右侧颞叶胶质瘤＂,并于2012年3月12日行幕上开颅肿瘤切除术,术后病理回报：（右颞叶）星形细胞瘤Ⅲ-Ⅳ级.     

Use of hybrid chitosan membranes and human mesenchymal stem cells from the Wharton jelly of umbilical cord for promoting nerve regeneration in an axonotmesis rat model

Many studies have been dedicated to the development of scaffolds for improving post-traumatic nerve regeneration. The goal of this study was to assess the effect on nerve regeneration, associating a hybrid chitosan membrane with non-differentiated human mesenchymal stem cells isolated from Wharton’s jelly of umbilical cord, in peripheral nerve reconstruction after crush injury. Chromosome analysis on human mesenchymal stem cell line from Wharton’s jelly was carried out and no structural alterations were found in metaphase. Chitosan membranes were previously tested in vitro, to assess their ability in supporting human mesenchymal stem cell survival, expansion, and differentiation. For the in vivo testing, Sasco Sprague adult rats were divided in 4 groups of 6 or 7 animals each:Group 1, sciatic axonotmesis injury without any other intervention (Group 1-Crush); Group 2, the axonotmesis lesion of 3 mm was infiltrated with a suspension of 1 250-1 500 human mesenchymal stem cells (total volume of 50 μL) (Group 2-CrushCell); Group 3, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane covered with a monolayer of non-differentiated human mesenchymal stem cells (Group 3-CrushChitIIICell) and Group 4, axonotmesis lesion of 3 mm was enwrapped with a chitosan type III membrane (Group 4-CrushChitIII). Motor and sensory functional recovery was evaluated throughout a healing period of 12 weeks using sciatic functional index, static sciatic index, extensor postural thrust, and withdrawal reflex latency. Stereological analysis was carried out on regenerated nerve fibers. Results showed that infiltration of human mesenchymal stem cells, or the combination of chitosan membrane enwrapment and human mesenchymal stem cell enrichment after nerve crush injury provide a slight advantage to post-traumatic nerve regeneration. Results obtained with chitosan type III membrane alone confirmed that they significantly improve post-traumatic axonal regrowth and may represent a very promising clinical tool in peripheral nerve reconstructive surgery. Yet, umbilical cord human mesenchymal stem cells, that can be expanded in culture and induced toform several different types of cells, may prove, in future experiments, to be a new source of cells for cell therapy, including targets such as peripheral nerve and muscle.     

路艺主任医师糖尿病足治验

糖尿病足是糖尿病常见的并发症,其中医病因病机主要是湿热、痰浊循经脉下行于足部,久而引起局部组织损害。路艺主任医师将糖尿病足坏疽辨为湿热蕴结及热盛伤阴两种证型,采用药物外敷法及针灸治疗有明显效果。     

NCML教学方法在医学院校理论教学中的研究与探索

通过对LBL和PBL两种教学方法存在的问题进行分析,创造性地提出了一种新型的教学方法NCML,即基于网络课程—计算机—多媒体课件三者结合的一种教学方法,此方法主要从授课方法和目标、构建方式、特色与优势、工作基础与条件、预期效果等五个方面进行了系统的阐述。