电视胸腔镜在胸心外科临床应用76例报告

目的　总结分析 76例电视胸腔镜胸心外科手术。　方法　手术方法包括 :动脉导管钳闭 ;纵隔肿瘤 ,胸交感神经切除 ;肺、胸膜 ,纵隔淋巴结活检 ;肺大泡、自发性气胸治疗 ;外伤性血胸 ,自发性血胸 ,不明原因胸腔积液探查 ;胸膜固定术 ;心包开窗引流 ;包裹性脓肿清除。　结果　电视胸腔镜 PDA钳闭病例 ,彩色超声心动图复查均无残余分流 ,术后最长已随访 2年 ,未发现再通现象。纵隔肿瘤成功地在电视胸腔镜下摘除。原发性长 QT综合征左 T2 、T3交感神经节广泛切除后 ,术后即刻 QT间期即从 0 .6 0 s缩短为 0 .42 s,术后再未出现室性心动过速和昏厥现象。重症雷诺病患者行双侧胸交感神经节切除后 ,末梢循环得到显著改善 ;自发性气胸治疗多数术后仅留置闭式引流 2～ 4天 ;纵隔淋巴结活检为准确病理诊断提供了新手段。　结论　电视胸腔镜下动脉导管钳闭等手术安全可靠、创伤小 ,值得进一步应用和完善。     

淋巴瘤累及胃结肠韧带的CT表现

目的 探讨非霍奇金氏淋巴瘤（non-Hodgkin’s lymphoma,NHL）累及胃结肠韧带（gastrocolic ligament,GCL）的CT表现及其解剖学基础。方法 回顾性分析26例经病理确诊的累及GCL的NHL病例,着重观察GCL的CT表现。结果 GCL受累主要表现为GCL内淋巴结增大,增大淋巴结呈散在分布,未见淋巴结融合。增大淋巴结表现为均匀强化者25例,均匀强化合并环状强化者1例。有2例显示GCL增厚、局部呈饼状改变,伴有腹腔积液。结论 熟悉GCL影像解剖学特点有助于累及GCL的NHL的CT诊断。     

经鼻(面)罩机械通气治疗慢性阻塞性肺疾病呼吸衰竭

目的观察慢性阻塞性肺疾病（ＣＯＰＤ）呼吸衰竭患者经鼻（面）罩机械通气的效果。方法对２９例慢性阻塞性肺疾病呼吸衰竭患者行经鼻（面）罩机械通气。结果治疗后２小时、２４小时、４８小时、１周后,ｐＨ从７．２８±０．１上升至７．３４±０．０７、７．３５±０．０６、７．３８±０．０５、７．３７±０．０７（Ｐ＜０．０１）,ＰａＣＯ２从９４．６９±１８．４ｍｍＨｇ下降至８６．０５±２４．６ｍｍＨｇ（Ｐ＜０．０１）、７７．７６±１９．３ｍｍＨｇ（Ｐ＜０．０１）、６８．６０±１１．４ｍｍＨｇ（Ｐ＜０．００１）、６６．６９±２６．９ｍｍＨｇ（Ｐ＜０．００１）,ＰａＯ２从５２．７２±１３．１ｍｍＨｇ上升至６４．２５±２４．５ｍｍＨｇ（Ｐ＜０．０５）、６９．０１±１６．６ｍｍＨｇ（Ｐ＜０．００２）、７５．２７±３２．８ｍｍＨｇ（Ｐ＜０．００１）、９１．１６±４０．４ｍｍＨｇ（Ｐ＜０．００１）。临床症状明显改善,有效率７５．９％。结论经鼻（面）罩机械通气对轻、中度的患者有较好的疗效。     

动脉瘤性蛛网膜下腔出血后脑积水

目的：探讨动脉瘤性蛛网膜下腔出血（ＳＡＨ）后脑积水的类型、ＣＴ表现和治疗原则。方法：回顾分析１９８４年６月至１９９７年１２月经手术治疗的２１例动脉瘤性ＳＡＨ后脑积水情况,分别对动脉瘤发生部位、大小、ＳＡＨ次数、Ｈｕｎｔ－Ｈｅｓｓ分级和临床症状进行了统计和分析。结果：治疗后良好１４例,轻残２例,重残２例,死亡３例。结论：脑积水是动脉瘤性ＳＡＨ后的常见并发症之一,对预后有直接的影响。急性梗阻性脑积水以脑室外引流治疗最为有效,慢性交通性脑积水的治疗以脑室腹腔分流为宜     

慢性肺心病患者血小板功能的研究

目的研究慢性肺心病患者血小板功能的变化。方法将研究对象分为肺心病急性发作期组、肺心病缓解期组和正常对照组,采用放射免疫分析法、玻璃球旋转法、比浊法等分别测定各组血浆血栓素B2（TXB2）、6-酮前列腺素F1a（6－K－PGF1a）和血小板粘附率（PAdT）、血小板聚集率（PAgT）及血小板激活因子（PAF）水平。结果慢性肺心病急性发作期组TXB2、6－K－PGF1a、TXB2／6－K－PGF1a比值和PAdT、PAgT及PAF测定值分别为204．76±3589pg／ml、49.08±1438pg／ml、4.11±1.72和42±11％、21±8％和89.05±41.76ng／ml。在缓解期组,上述各项测定值分别为138．34±20.41pg／ml、66．25±17.12pg／ml、2．08±0.97和39±12％、46±14％和56．82±34.14ng／ml。而在正常对照组则分别为76.05±16．24pg／ml、88.65±21.87pg／ml、0．84±0．23和26±7％、35±12％和47．94±32．48ng／ml。结论慢性肺心病患者体内血小板被激活．血小板粘附、聚集等功能增强。     

ATP生物发光法与MTT法检测卵巢癌体外化疗敏感性的比较

目的比较ATh法与MTT（四唑蓝）法对卵巢癌细胞体外化疗敏感性的预测价值。方法分别以ATP法和MTF法检测5种化疗药物对卵巢癌3AO细胞株的抑制作用。结果（1）ATP法与MTT法相关性良好（r＝0．9031）。（2）ATP法更加灵敏、稳定。ATP法在80个细胞时即可测出发光强度的改变;而MTT法细胞数达300时才能测出OD值变化。试验所需细胞浓度,ATP法与MTT法分别为1×104－5×104个／ml和1×106-5×106个／ml,ATP法比MTT法低得多。结论ATP法作为检测卵巢癌细胞体外化疗敏感性的手段优于MTT法。     

超声引导经皮穿刺冷冻治疗肝癌的实验和临床研究

目的 探讨经皮穿刺冷冻治疗原发性肝癌的应用价值。方法 ①家猪１２只,腹腔镜下显露肝脏,ｒｏｃａｒ针穿刺腹壁,经一非金属鞘将冷冻头插入肝右叶冷冻;②１１例原发性肝癌,超 引导穿刺扩张皮肤直至肝内肿瘤表面,保留一非金属鞘,ＬＣＳ－２０００冷冻机５ｍｍ冻冷头经鞘管插至肿瘤中心冷冻。结果 ①实验动手术后无腹腔内出血,冷冻穿刺部位无严重冻伤;②１１例病人冷冻后恢复均顺利,其中５例肿瘤缩小≥５０％,１例肿瘤完     

Ulip/CRMP proteins are recognized by autoantibodies in paraneoplastic neurological syndromes

Anti-CV2 autoantibodies have recently been discovered in patients with paraneoplastic neurological diseases (PND). These disorders are associated with neuronal degeneration, mediated by autoimmune processes, in patients with systemic cancer. Anti-CV2 autoantibodies recognize a brain protein of 66 kDa developmentally regulated and specifically expressed by a subpopulation of oligodendrocytes in the adult brain. Here, we demonstrate that anti-CV2 sera recognize several post-translationally modified forms of Ulip4/CRMP3, a member of a protein family related to the axonal guidance and homologous to the Unc-33 gene product in Caenorhabditis elegans. The sequence of the human Ulip4/CRMP3 was determined and the gene localized to chromosome 10q25.2-q26, a region mutated in glioblastomas and containing tumour suppressor genes. The identification of the Ulip/CRMP proteins as recognized by anti-CV2 sera should provide new insights into the role of Ulip/CRMPs in oligodendrocytes and into pathophysiology of PND.     

Failure of stimulated skeletal muscle mainly contributed by passive force: an in vivo rabbit model

OBJECTIVE: To evaluate the role of active and passive muscle forces in the failure mechanism of stimulated muscle. DESIGN: An in vivo rabbit model. BACKGROUND: Eccentric contractions can result in a greater incidence of muscle injury. However, the relative role of the active and passive muscle force in the failure mechanism of the activated muscle is not well elucidated. METHODS: After anaesthesia, New Zealand white rabbits were fixed in a frame on a materials testing machine. The triceps surae muscle-tendon units were passively stretched to rupture with our without continuous nerve stimulation. The force and muscle length were simultaneously recorded. Active muscle force, passive muscle force, and ratio of the active to passive muscle were calculated and depicted against strain. RESULTS: The results showed that the mean maximal passive force of triceps surae muscle was 293.1 N at a strain of 38%. The mean peak active muscle force was 21.5 N at a strain of 21%. The ratio of active to passive muscle force reached its peak first, followed by the active muscle force, and then the passive muscle force. The ratio of active to passive muscle force at the peak total force was only 3.3%. CONCLUSIONS: The stimulated muscle can exert its maximal response at extreme physiological extension. Injury of the stimulated muscle is caused mainly by passive muscle force.     

心脏锐器伤并心包压塞的诊治探讨

目的 探讨心脏锐器伤并心包压塞的诊治。方法 对我院1982-2001年诊治的13例心脏锐器伤的临床资料进行回顾性分析。结果 12例手术治疗，其中11例治愈，1例因术后脑死亡而终止治疗，1例保守治愈。结论 单纯心包伤合并少量心包积血在监护下，可保守治疗;心脏锐器伤并心包压塞如伴有创伤性窒息，提示心包压塞程度严重。