三明治构型大鼠原代肝细胞长期培养及功能测定

目的观察三明治构型大鼠原代肝细胞长期培养的形态学变化,并对其功能进行测定。方法采用改良原位两步法门静脉胶原酶灌注分离单肝细胞,台盼蓝拒染实验观察细胞活力,利用三明治培养构型培养成年大鼠原代肝细胞,倒置显微镜下连续观察肝细胞的形态学变化,定期收集培养细胞上清液,检测所培养肝细胞的分泌及生物转化功能,并与单层胶原培养肝细胞比较。结果平均每个鼠肝可获取(2～3)×108个肝细胞,存活率为(93±3)%;体外肝细胞培养第3天,细胞活力、清蛋白分泌功能恢复到最佳状态;三明治构型培养第7天,地西泮24h代谢量达到最高峰。三明治构型培养的肝细胞形成肝索样结构,并逐渐形成胆小管网络;在培养的21d内,清蛋白分泌、地西泮代谢始终维持较高的水平;肝细胞形态维持可达28d以上。结论三明治构型肝细胞培养体系更接近于肝细胞体内生长环境,肝细胞可在较长时间内保持良好的形态结构和功能。三明治构型不仅可以应用于肝细胞的基础研究,而且为肝细胞移植和生物人工肝治疗肝衰竭奠定了一定的基础。     

造影剂对重症急性胰腺炎胰腺微循环的影响

目的对重症急性胰腺炎(SAP)动物模型静脉注射临床上常用的造影剂后进行病理学分析,测量胰腺血流量,探讨造影剂对重症急性胰腺炎胰腺微循环的影响。方法选用健康W istar雄性大鼠,制备重症急性胰腺炎模型后,分为4组(每组6只):重症急性胰腺炎组、重症急性胰腺炎注射生理盐水对照组、重症急性胰腺炎注射76%泛影葡胺组、重症急性胰腺炎注射优维显300组。对胰腺组织的病理学评分并测量胰腺血流量,采用SPSS 10.0软件对数据进行统计学分析。结果重症急性胰腺炎注射造影剂组、注射生理盐水对照组与重症急性胰腺炎组比较差异无统计学意义;重症急性胰腺炎注射造影剂组,组间比较差异无统计学意义。结论造影剂对重症急性胰腺炎胰腺微循环没有产生负面作用,不会加重急性胰腺炎病情。     

聚丙烯网片修补巨大造口旁疝8例体会

造口旁疝是结肠造口术后最常见的并发症，发生率5%-50%。虽然造口旁疝有很多手术方法，但术后复发率较高，尤其巨大造口旁疝，仍然是疝外科的一个难点。目前，人工材料（聚丙烯或聚四氟乙烯网片）已被广泛应用于疝的修补，但造口旁疝的网片修补相对较少。现将我们1999年1月至2006年2月应用聚丙烯网片修补8例巨大造口旁疝的体会介绍如下。     

Fas基因在胰腺癌细胞凋亡中的研究

目的 探讨雌激素受体拮抗剂三苯氧胺诱导雌激素受体阳性胰腺癌细胞凋亡过程中与Fas基因间的关系。方法 流式细胞仪分离：Fas^( )和：Fas^(-)胰腺癌细胞，通过TAM诱导Fas^( )和Fas^(-)胰腺癌细胞株Bxpc-3凋亡，MTT法检测细胞活度，TUNEL法检测细胞凋亡，采用RT-PCR-ELISA法检测端粒酶活性，进行相关性分析。结果 TAM可以诱导出Fas^( )胰腺癌细胞凋亡，不能诱导出Fas^(-)胰腺癌细胞凋亡。结论 TAM诱导雌激素受体阳性胰腺癌细胞株Bxpc-3凋亡，必须有Fas^( )抗体的介导，不能单纯用表面膜受体拮抗剂的理论来解释TAM诱导雌激素受体阳性胰腺癌细胞株Bxpc-3凋亡。     

直肠低位切除后排便功能的观察

由于对直肠癌生物特性的研究,近年来对于距肛门5～10cm的肿瘤越来越多地采用各种原路排便的手术方式。我院1979～1990年采用保留肛门的直肠癌低位切除术89例和直肠多发息肉一例,就其排便情况进行随诊,总结如下。临床资料 1.年龄:最小28岁,最大82岁,平     

腹腔压力与重症急性胰腺炎严重程度的关系

Objective Previous investigations suggest that severe acute pancreatitis (SAP) is one of the main causes of intra-ahdominal pressure (lAP) increase. The aims of this study were, to evaluate the increased IAP in patients with SAP and the correlation between LAP and severity or prognosis. Method Data of 75 SAP patients admitted to Xuan-Wu Hospital of Capital Medical University intensive care unit with SAP from January 2000 to Jan-uary 2008 were collected. All the patients had at least one organ dysfunction, and they were diagnozed with en-hanced CT, lAP were monitored in the 56 patients. The 56 patients were divided into three groups according to IAP, group A (7- 15 mmHg), group B (16-25 mmHg) and group C (26-31 mmHg). Maximal APECHE Ⅱscore, maximal Ranson score, maximal C-response protein (CRP), maximal arterial lactate, maximal creatinine, organ dysfunction, length of stay and mortality were compared. Results The 56 patients (24 male and 32 female)with average age of (52±14.1) years (ranging 21 - 72 years) and average body mass index (BMI) of 28±12.5(ranging 21 - 35) were monitored with IAP. The etiologic causes of SAP were biliary in 27 patients, alcohol in 14cases, hyperlipidemia in 11 cases and idiopathic in 4 cases. The rate of intra-abdominal hypertension was 89% (50/56), and 32% (18/56) patients complicated with abdominal compartment syndrome. There were 22, 26 and 8 patients in the A, B and C groups respectively. With the increasing of IAP, the maximal APACHE Ⅱ, maximal Ranson score, maximal CRP, maximal creatinine, organ dysfunction and mortality were also increased significant-ly. The mortality of the three groups was 13.6% (3/22), 23.1% (6/26) and 62.5% (5/8) respectively (χ2 =7.56, p = 0.023), and the total mortality of the 56 patients was 25%. The hospital stay of the three groups had no significant differenee(F = 2.23,P = 0.117). Conclusions IAP may be one of the markers used to evaluate the severity of SAP, and the monitoring of IAP is useful to assess the prognosis in patients with SAP.     

梗阻性黄疸肝功能受损机制——胆盐诱发肝细胞凋亡

梗阻性黄疸呆导致肝功能受损，其机理尚不清楚，细胞凋亡规律的失常与许多肝胆系统疾病有关，本实验观察胆盐是否诱发肝细胞的凋亡。方法经胶原酶灌注取肝细胞后３５ｍｍ，６孔培养板短期培养，培养基为Ｆ１２／ＤＭＥＭ各半，胰岛素０．５μ／ｍｌ，胶原铺底，分别加入２５、５０、１００、２００、３００μｍｏｌ的甘氨鹅脱胆酸后培养３、６、９、１２、１８、２０、２４小时，行流式细胞术检测，抽提ＤＮＡ电泳，涂片后生物素－ｄ     

重症急性胰腺炎当前诊治应注意的问题

临床上为了便于估计预后及指导治疗，常将AP分为轻型AP和重症AP(severe acute pancreatitis，SAP)。轻型占80％，仅引起极轻微的脏器功能紊乱，临床恢复顺利。重症可出现休克、ARDS、肾功能不全等多器官和系统功能不全，甚至死亡，需积极的监护治疗。     

腹部手术后血氧分压变化及治疗的观察

腹部手术后,由于手术创伤、麻醉、输血等原因,可引起术后氧输送及血氧分压的降低,以至影响病人的康复。针对这个问题,我院普外科自1991年4月至8月,对41例连续