军队医院纳入地方职工医疗保险定点后的影响及对策

总结了解放军第92医院与当地政府有关部门经过交涉,医院被纳入地方医疗保险定点医院,成为福建省首家纳入地方职工医疗保险定点的军队医院的主要做法,提出了医院纳入地方职工医疗保险定点后出现的一些新情况、新问题及应采取的对策。     

短肠综合征的营养康复治疗(附3例报告)

短肠综合征的治疗主要是营养支持和小肠移植 ,但两种疗法都有其限制和不足。本文报告对 3例短肠病人联合应用重组人生长激素、谷氨酰胺、纤维饮食行营养康复治疗 ,病人残存小肠的长度分别为 65cm、75cm、30 cm,治疗后病人残存肠管的吸收功能和营养状况均有明显改善。为短肠综合征病人提供了一个新的有希望的治疗选择     

The missing pedicle: a radiodiagnostic challenge

The absence of a vertebral pedicle, regardless of location, always merits careful consideration. There are a variety of disease states in addition to intrinsic mechanisms which may influence the development of the spine and hence potentiate pedicular absence. Each of these diseases or processes must be considered when confronted by a missing pedicle. This paper will identify and briefly discuss the most common conditions resulting in pedicular absence.     

Ultrastructural (SEM and TEM) observations on arterial lesions of the human aorto-iliac area obtained at surgery from donors

Ultrastructural observations on arterial lesions of the human aorto-iliac area obtained at surgery from donors after bilateral nephrectomy for kidney transplantation have revealed the presence of intimal fibro-muscular lesions, very similar to the "early lesions" of experimental animal models in the younger people of this group.     

Segmental biliary obstruction: false-negative diagnosis with direct cholangiography without US guidance

Segmental intrahepatic ductal obstruction with calculi can be a significant cause of acute cholangitis that may remain entirely undetected on a routine, "blind" direct cholangiogram. Ultrasonography (US) or computed tomography can demonstrate isolated intrahepatic ductal dilatation with or without calculi. US, in particular, can be used to direct the needle puncture for percutaneous transhepatic cholangiography (PTC) and thus enable the differential diagnosis and appropriate therapy to be determined. Four cases are reported in which US-guided PTC enabled confirmation of the diagnosis of acute cholangitis secondary to segmental biliary obstruction and intrahepatic calculi. In two the correct diagnosis could not be made with initial blind direct cholangiography, and in the other two, US and US-guided PTC were performed initially.     

Extraadrenal paragangliomas. An immunocytochemical and ultrastructural report

Although the majority of extraadrenal paragangliomas are nonfunctional, some of these tumors are associated with hormone production and clinical symptoms, notably hypertension. The authors have investigated 22 paragangliomas, five of which were diagnosed as clinically functional in a light microscopic immunocytochemical and electron microscopic study (nine cases). Histologically, all the paragangliomas exhibited similar features, with a "Zellballen" pattern of polygonal cells. All 22 cases were strongly immunoreactive to protein gene product 9.5 (PGP 9.5) antisera and moderately reactive to antineuron-specific enolase (NSE) sera. Ten cases (five functional) were focally immunoreactive to antichromogranin sera. Seven cases (four functional) were immunoreactive to neuropeptide Y and enkephalin antisera, and six (five functional) to tyrosine hydroxylase antisera. The clinically functional tumors expressed at least two of the antigens, enkephalin, neuropeptide Y, or tyrosine hydroxylase, whereas none of the 17 nonfunctional possessed more than one of these. Electron microscopic study revealed cells from all the nine cases studied to contain secretory granules. Granule sizes ranged from 100 to 280 nm and the morphologic examination of the secretory granules generally showed a dense core with a membrane-bound halo of variable size. Secretory granules were observed in the five functional cases and these were larger (220-280 nm) than those seen in the nonfunctional tumor cells (100-180 nm). Also, tumor cells from the functional cases contained numerous dilated mitochondrial profiles.