胆道消融剂在选择性胆道消融栓塞中的选用

目的 观察不同胆道消融剂选择性胆道消融栓寒对肝脏结构和功能的影响。方法无水乙醇、醋酸、盐酸、氧氧化钠分别消融姐道，OB胶栓塞巴马小型猪左外叶胆管，观察术后肝功及病理变化。结果术后各组肝功能各项指标除白蛋白外．均出现一过性增高，术后两周内恢复正常。尤水乙醇肝功变化没有其他组显著。其它各组坏死范围较无水乙醇大。其中氢氧化钠出现急性肝坏死，醋酸坏死范围大于左外叶。光镜下左外叶汇管区纤维明显增生，肝细胞数目减少。假小叶形成。Masson染色提示胶原纤维显著增生。结论无水乙醇与OB胶联合使用．行选择性胆道消融栓塞能使消融栓塞胆道引流区域肝组织萎缩纤维化，肝内假小叶形成。而且对机体影响最小，是目前安全的胆道消融剂。     

多部位硬化性骨髓炎1例报告

硬化性骨髓炎（Garre＇s osteomylitis），属特发性骨皮质硬化和干性骨髓炎，此病少见且病因不明，国内外报道鲜见。国外报道多发源于下颌骨病炎，而多部位骨骼受累未见报道。我院骨科于2004年收治1例因腰骶疼痛8年余，经过抗风湿治疗症状无缓解的患者。住院后经过X线片、CT和同位素骨扫描检查发现患者的上、下颌骨、双侧锁骨、     

瓷表面处理方式对瓷修复体缺损美容修复影响的研究

目的：研究不同瓷表面粗化处理对Vita VMK95瓷粘结强度的影响。方法：瓷片按表面粗化方式分为6组，每组分别与树脂粘结，测剪切强度，统计分析所得数据。结果：喷砂后氢氟酸处理组粘结强度最高，喷砂后磷酸酸蚀组与不喷砂氢氟酸蚀组次之，单纯偶联剂处理组最低。结论：综合临床安全性考虑，喷砂后用磷酸处理是瓷修复体缺损后较好的瓷表面处理方法。     

正交设计法优选复方苦黄涂膜剂的基质组成

目的优选复方苦黄涂膜剂的基质组成。方法以聚乙烯醇-124、甘油和乙醇的用量为因素;以成膜时间和外观性状为指标,采用正交设计法,对复方苦黄涂膜剂的基质组成进行优化,确定基质中不同辅料的最佳配比。结果优选得到最佳处方为A3B3C2,即聚乙烯醇-1248g,甘油6ml,95％乙醇30ml。结论优选所得处方制得的涂膜剂成膜时间短、质量稳定,为临床使用提供了理论基础。     

介入血管栓塞联合内镜注射硬化治疗食管胃底静脉曲张

【摘要】目的：观察多种介入方法联合应用治疗食管胃底静脉曲张的临床效果。方法：25例食管胃底静脉曲张患者,分别行经皮肝穿冠状静脉栓塞（PTVE）和球囊阻断静脉逆行硬化闭塞胃静脉曲张（BRTO）,并发脾功能亢进者,同时行部分脾动脉栓塞（PSE）。术后对有残留食管静脉曲张的病例行内镜硬化剂注射治疗（EIS）。全部治疗完成后常规临床观察,并定期复查胃镜和CT增强扫描。结果：25例患者,7例行PTVE+PSE; 11例行BRTO,6例行BRTO+PSE,1例BRTO手术失败;术后11例患者接受内镜注射治疗一次,4例患者接受二次注射治疗。3例患者死亡,其中1例于术后2月死于再发出血。结论：多种介入方法联合应用,具有可靠的预防上消化道出血的效果。     

针刺结合拟胆碱能药物治疗膀胱逼尿肌收缩力低下症

目的：观察固定穴位针刺结合拟胆碱能药物治疗膀胱逼尿肌收缩力低下症的临床疗效。方法：对17例经尿流动力学检查诊断为膀胱逼尿肌收缩力低下症的患者,针刺百会、三阴交、关元、膀胱俞、肾俞、中极,同时口服拟胆碱能药溴吡斯的明,3例合并膀胱出口梗阻患者加用坦索洛辛。结果：治疗3疗程后,16例临床症状有不同程度缓解,其中4例恢复自行排尿;1例仍需膀胱造瘘引流。结论：固定穴位针刺结合拟胆碱能药物治疗膀胱逼尿肌收缩力低下症安全有效,疗效差异可能与原发疾病、病程长短和疗程有关。     

Treatment options for spontaneous and postoperative sclerosing mesenteritis

Sclerosing mesenteritis is a rare pathology with only a few described cases in the literature. The etiology is unclear; however, several potential triggers, including abdominal surgery and abdominal trauma, have been discussed. The pathology includes a benign acute or chronic inflammatory process affecting the adipose tissue of the mesenterium. Despite it being a rare disease, sclerosing mesenteritis is an important differential diagnosis in patients after abdominal surgery or patients presenting spontaneously with signs of acute inflammation and abdominal pain. We present here three cases with sclerosing mesenteritis. In two cases, sclerosing mesenteritis occurred postoperatively after abdominal surgery. One patient was treated because of abdominal pain and specific radiological signs revealing spontaneous manifestation of sclerosing mesenteritis. So far there are no distinct treatment algorithms, so the patients were treated differently, including steroids, antibiotics and watchful waiting. In addition, we reviewed the current literature on treatment options for this rare disease.     

64层螺旋CT使用低剂量对比剂在CTA中对脑动脉瘤的诊断价值

目的 研究64层螺旋CT使用低剂量对比剂联合生理盐水在CTA中对脑动脉瘤的应用价值.方法 对临床疑有脑动脉瘤51例患者分为三组:甲组90ml对比剂不用生理盐水冲洗;乙组、丙组分别使用70ml、50ml对比剂之后用相同流速生理盐水40ml冲洗.对比剂流速为5.0ml/s.当颈内静脉显影的一刹那开始扫描.利用工作站软件进行图像处理,评估三组血管图像质量及动脉瘤显示情况.结果 三组病例动脉瘤的灵敏度、特异性在统计学上没有明显差异,甲组动静脉均显示很好,CT值较高.丙组动脉显示良好,静脉少,污染轻,血管CT值略低.乙组居于二者之间.结论 使用低剂量对比剂50ml+40ml生理盐水以5.0ml/s流率注射,不仅可以得到理想的图像,还是一种安全、快速、经济的检查方法.     

Rheumatoid arthritis of the craniocervical region: assessment and characterization of inflammatory soft tissue proliferations with unenhanced and contrast-enhanced CT

The aim of this study was to depict and characterize inflammatory soft tissue proliferations caused by rheumatoid arthritis (RA) in the craniocervical region by unenhanced and contrast-enhanced CT. Computed tomography of the craniocervical region was performed in 35 patients in the axial plane before and after the i. v. administration of contrast material. According to the densities and contrast enhancement of the inflammatory soft tissue proliferations, four groups were classified. Ancillary findings, such as a compression of the dural sac or spinal cord, erosions of the bony structures, and atlantoaxial subluxation, were also evaluated. Inflammatory soft tissue proliferations were depicted in 28 of 35 patients and could be differentiated by unenhanced and contrast-enhanced CT according to the above defined criteria: effusion in 6 patients (17 %); hypervascular pannus in 8 (23 %); hypovascular pannus in 5 (14 %); and fibrous tissue in 9 patients (26 %). A compression of the dural sac was seen in 11 (31 %) patients; 3 of these had neurological symptoms. Erosions of the odontoid process were found in 20 (57 %) patients; 16 (80 %) of these also showed erosions of the atlas. Atlantoaxial subluxation was seen in 11 (31 %) patients. Inflammatory soft tissue proliferations in the craniocervical region caused by RA can be reliably demonstrated and classified by unenhanced and contrast-enhanced CT, which can differentiate between joint effusion and various forms of pannus and depict ancillary findings. Computed tomography is an alternative method for patients unable to undergo an MRI examination. Received: 4 October 1999; Revised: 7 March 2000; Accepted: 14 March 2000     

Sclerosing encapsulating peritonitis in a child secondary to peritoneal dialysis

Sclerosing encapsulating peritonitis, or “abdominal cocoon,” is a rare but serious complication of continuous ambulatory peritoneal dialysis. It is characterized by the diffuse appearance of marked sclerotic thickening of the peritoneal membrane resulting in intestinal obstruction.A 14-year-old adolescent boy with a history of end-stage renal failure on continuous ambulatory peritoneal dialysis presented with symptoms of acute intestinal obstruction. A computed tomography scan of the abdomen revealed distended small bowel loops clustered and displaced to the right upper quadrant. The overlying peritoneum was markedly thickened and calcified. Laparotomy confirmed the diagnosis of sclerosing encapsulating peritonitis and the patient was treated with excision of the fibrocollagenous membrane. Postoperatively, he had prolonged ileus requiring parenteral nutritional support and peritoneal dialysis was restarted on postoperative day 10.A high degree of cognizance is needed to facilitate diagnosis and treatment of this uncommon and potentially life-threatening condition.