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.     

青蒿琥酯皮肤擦剂在小鼠和兔体内的药代动力学研究

将青蒿琥酯溶于苯二甲酸二甲酯,加适量氨酮制成皮肤擦剂。给兔脱毛后,皮肤涂抹此擦剂25mg/kg后,血药浓度达峰时间平均为2 h,峰浓度平均为1.80μg/ml。药物在兔体内平均驻留时间为3.54 h,清除半衰期约为2.46 h。给小鼠脱毛皮肤涂抹擦剂6.7,31.3和71.4 mg/kg,血药浓度在给药后0.5～4 h达高峰,峰浓度分别为0.82,2.05和7.11μg/ml,体内药物平均驻留时间为3.39,2.79及3.54 h,清除半衰期为2.35,1.93及2.45 h。可见,给兔及小鼠皮肤擦剂后,青蒿琥酯吸收良好,血药浓度维持时间较长。     

颈椎病与中医辨证关系的探讨(附100例分析)

目的:探讨颈椎病与中医分型的辨证关系。方法:对100例该病的影像表现与中医分型进行系统分析。结果:主要临床表现颈部活动受限,颈、肩、背部疼痛,常伴头痛、头晕、视物模糊、耳鸣等症状。风寒型以软组织所致颈曲改变为主。肝肾亏虚型、痰湿交阻型以骨质增生、椎间隙及椎间孔狭窄为主。结论:X线、CT是本病首选检查方法,能与中医辨证有机结合,对中西医治疗有重要意义。     

无水酒精阻滞大鼠腹腔神经丛后脊髓、孤束核C-FOS和NOS-1的表达

目的:通过免疫组化的方法研究无水酒精阻滞大鼠腹腔神经丛后脊髓和延髓孤束核内CFOS和NOS1的表达。材料和方法:对70只Wistar大鼠实施手术,建立实验动物模型。分5组于术后不同时间取得脊髓和延髓样本,并用标准方法对其进行CFOS和NOS1免疫组化染色,观察脊髓和延髓孤束核CFOS和NOS1的表达。结果:无水酒精阻滞后脊髓后角、延髓孤束核神经元细胞内均有CFOS和NOS1表达。结论:无水酒精阻滞腹腔神经丛后,短时间内脊髓后角和延髓孤束核内CFOS和NOS1表达阳性,表明FOS和NOS1与内脏信息在脊髓水平的传导有关。CFOS和NOS1参与了内脏信息在孤束核内的传导。     

一种较好的RNA分离制备方法及其在人胚RNA提取中的应用

以钒基核苷酸复合物为核酸酶抑制剂,从人胚组织中制备总RNA,所得产品几乎不含DNA和蛋白质,经过分离Poly(A)~ mRNA,证明制品有合成cDNA的完整功能,方法比较简捷,适于大量制备以满足分离mRNA 之需,并讨论了此法的优缺点。     

AMACR(P504S)、P63、34βE12联合检测在前列腺癌早期诊断中的应用

目的:探讨AMACR(P504S)、P63、34βE12联合检测在前列腺癌(PCa)早期诊断中的临床应用价值。方法:应用即用型组合式单克隆抗体和双酶标记的免疫组化MaxvisionTM一步法检测42例PCa、12例高级别前列腺上皮内瘤变(HGPIN)和30例良性前列腺增生(BPH)穿刺活检标本中AMACR、P63、34βE12的表达情况。比较Glea-son评分各组中AMACR阳性表达情况。结果:AMACR、P63、34βE12抗原在PCa和BPH穿刺标本中的表达差异均有极显著性(P<0.01),PCa组织中AMACR阳性表达率为100%,无P63和34βE12表达;BPH组织中均无AM-ACR表达,P63和34βE12均高表达。HGPIN中AMACR的阳性表达率(91.67%)与BPH差异有极显著性(P<0.01),与PCa差异无显著性(P>0.05);P63和34βE12阳性表达率HGPIN(100%)与PCa差异有极显著性(P<0.01),而与BPH差异无显著性(P>0.05)。AMACR表达强弱与PCa的Gleason评分无关(P>0.05)。结论:AMACR是PCa高度敏感和特异的标志物,P63和34βE12联合标记基底细胞的特异性高,3者联合检测能增加前列腺穿刺活检标本诊断的准确性,在PCa早期诊断中具有重要的临床应用价值。     

Performance and comparison of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease formulae in estimating glomerular filtration rate in a Chinese Type 2 diabetic population.

AIMS: Our aim was to assess performances of the Cockcroft-Gault and simplified Modification of Diet in Renal Disease (MDRD) formulae in estimating glomerular filtration rate (GFR) in Chinese diabetic populations and their association with vascular risks. METHODS: A total of 1009 patients with Type 2 diabetes were categorized into low estimated GFR groups (GFR < 60 ml/min/1.73 m(2)) and control groups by the two equations. The performances of these formulae were assessed at different stages of kidney function. Carotid artery intima-media thickness (IMT) and the prevalence of diabetic retinopathy or albuminuria were compared among the groups. The ability of these formulae to identify established vascular risk markers using sensitivity, specificity, positive and negative predictive values were also compared. RESULTS: The prevalence of low estimated GFR was 32.7% with the Cockcroft-Gault formula and 5.2% with the MDRD formula, respectively. In low estimated GFR subjects by the MDRD formula, IMT was significantly thicker than those by the Cockcroft-Gault formula (1.2 mm vs. 1.0 mm; P < 0.05), with a higher prevalence of albuminuria (78.4 vs. 52.8%, P < 0.05) and diabetic retinopathy (46.5 vs. 30.5%; P < 0.05). The Cockcroft-Gault formula gave a specificity of 71.7% and a sensitivity of 37.0%, and the MDRD formula gave a specificity of 96.6% and a sensitivity of 7.9% in estimating low GFR relevant for established vascular risks. CONCLUSIONS: These formulae performed differently in Chinese diabetic populations. The simplified MDRD formula is minimally superior to the Cockcroft-Gault formula for its high specificity and positive predictive values in estimating low GFR relevant for vascular risks.     

血管内栓塞结合显微手术治疗颅内动脉瘤临床研究

目的应用显微手术夹闭、血管内栓塞和栓塞后手术夹闭3种治疗方法，探讨治疗颅内破裂动脉瘤的安全有效方案。方法显微手术瘤颈夹闭30个动脉瘤，栓塞34个动脉瘤，栓塞后夹闭15个动脉瘤。结果夹闭组30个完全夹闭，无复发，死亡率6％（2／30）。栓塞组完全闭塞率70．6％（24／34），复发率17．6％（6／34），死亡率11．8％（4／34）。栓塞后手术组15个完全夹闭，无复发，死亡率6．7％（1／15）。治疗结束用GOS评价，1个月后3组良好率分别为80．0％、79．4％和80．0％；半年后良好率分别为90．0％、88．2％和86．7％。结论显微手术瘤颈夹闭术仍然是治疗破裂动脉瘤的有效方法，具有1次治疗彻底和复发率低的优势，并可作为栓塞失败的补救手段。     

乳腺非典型增生病与血管生成关系的实验研究

目的：建立乳腺非典型增生病动物模型，探讨非典型增生与血管生成的关系。方法：采用灌服二甲基苯蒽＋颈部枷具方法复制大鼠肝郁血瘀型乳腺非典型增生动物模型，并给予中药乳复汤治疗。常规染色观察大鼠乳腺组织病理组织形态．免疫组化方法检测MVD、VEGF和bFGF的表达。结果：病证模型组乳腺非典型增生率90％．较单纯造模组高．P=0．0415；中药乳复汤治疗组非典型增生率较病证模型组低．P=0．0459；随着一般增生到非典型增生程度加重，MVD计数增多，VEGF、bFGF的表达升高，P〈0．05。结论：病证结合造模更适合中医动物实验要求，中药乳复汤具有抑制血管生成作用。     

某儿童医院10年临床报告细菌性痢疾的流行病学特征

目的探讨细菌性痢疾(以下简称菌痢)近10年流行特点。方法对10年来收集的全院各科上报的菌痢进行回顾性分析。结果1993-2002年报告菌痢10861例,占传染病报告总数的62.92%,传染科门诊量占全院门诊百分比的年变化为8.54%～4.33%;菌痢发病占传染科门诊的年比率变化为1.05%～3.45%;<1岁、1～3岁、4～6岁、7～9岁、≥10岁5个年龄组,各组之间菌痢检出率差异有统计学意义,1～3岁组检出率最高;细菌性痢疾每年4月检出率开始上升,8月达最高,11月检出率恢复到上升前水平;不同性别的儿童检出率差异有统计学意义,男童明显高于女童。结论细菌性痢疾检出年龄特点为婴幼儿最高,随年龄增长,发病逐渐减少;发病高峰季节向春秋季扩展。