回盲部及升结肠游离致肠系膜静脉血栓一例

病人女，14岁。因突发下腹疼痛10h伴频繁血样便3h入院。呈持续性剧痛，阵发性加重，无放射痛及牵涉痛。查：痛苦病容，休克貌，腹平坦，脐下压痛，伴轻度肌卫，无反跳痛，移动性浊音阴性，肠鸣音减弱。予胃肠减压，抗休克、止血、抗炎、补液治疗，无好转，仍     

腰椎间突出症的手术治疗

目的：探讨腰椎间盘突出症术式选择、适应症。方法：总结126例腰椎间盘突出症手术治疗效果。结果术后出现腰困、疼不适23例均采用椎板切除术，并发足下垂、椎间隙感染各1例，占1．6％。结论：腰椎间盘突出症宜尽量采用开窗术式，是否进行侧隐窝扩大，不能单纯依靠CT片，更重要的是，要根据术中是否有神经压迫。术中压迫止血，应不留填塞物。     

数字减影左心室功能测定的应用

数字减影血管造影术(DSA)是近几年来应用于临床的诊断技术，通常临床目测电影造影上，左室室壁活动情况以估价左心室总体及局部功能，但主观估测误差较大。DSA图像有较高的空间、时间分析率，运用其内设诊断左心室功能可增加其诊断准确性、可重复性。     

外科治疗纵隔原发神经源性肿瘤的手术径路评价

目的　探讨外科治疗原发纵隔神经源性肿瘤的手术径路。方法　 1963年 3月至2 0 0 3年 9月外科治疗原发纵隔神经源性肿瘤 91例。所有病例均于术前行X线胸片检查 ,其中 65例行CT或磁共振检查。根据肿瘤的大小、部位及其是否向椎管内延伸选择不同的手术入路 ,其中胸后外侧切口 84例 ,半哈壳状切口 2例 ,高位胸后侧切口 4例 ,胸后外侧加脊柱旁切口 1例。所有病例均经病理证实并行 6个月～ 15年的术后随访。结果　本组手术切除率 97.8% ( 89/91) ,术后并发症发生率 4.4% ( 4 /91) ,无手术死亡病例。术后病理诊断良性肿瘤 79例 ( 86.8% ) ,恶性肿瘤12例 ( 13 .4% )。 1例神经纤维瘤 2年后复发经再次手术切除治愈 ;恶性肿瘤平均生存 3 8.1个月。结论　适当的手术径路是提高纵隔原发神经源性肿瘤切除率的关键。     

实验性糖尿病早期大鼠背根神经节一氧化氮合酶基因表达的变化

目的：观察糖尿病早期(2周)大鼠背根神经节(DRG)中一氧化氮合酶(nNOS、iNOS、eNOS)的表达变化以及胰岛素对其的影响。方法：按60mg／kg一次性腹腔注射链脲佐菌素(STZ)制备胰岛素依赖性糖尿病大鼠模型(16只)，造模成功后随机分成2组(模型组和治疗组)，治疗组于造模成功后第2天开始给予胰岛素治疗，正常对照组(8只)与模型组予皮下注射同样体积的生理盐水。2周后取各组大鼠背根神经节，Trizol法提取总RNA，应用RT—PCR法测定3种NOS mRNA的表达。结果：在糖尿病早期大鼠DRG中，iNOS表达明显上调，胰岛素能有效逆转此变化。而nNOS和eNOS的表达无明显变化。结论：在早期糖尿病DRG中iNOS基因表达异常，可能与糖尿病外周神经病变的发生发展有关。     

不同门奇断流术式对门静脉高压症犬食管下段血管再生的影响

Objective To explore the effect on blood vessel regeneration of distal esophagus in ca-nines of portal hypertension with liver cirrhosis after different procedures with paraesophagastrie devascular-ization. Methods Portal hypertension models were produced in canines by subcutaneous injection of 60% CC14 combined with food restriction. Forty eight model canines were randomly divided into 4 groups: group A, traditional paraesophagastrie devascularization;group B, selective paraesophagastric devascularization;group C, paraesophagastric devascularization plus distal esophageal transaction and reanastomosis with sta-pler;group D,control group. Every group had 12 canines which were randomly divided into A1 ,B1 ,C1 ,D1, A2,B2,C2 and D2 groups after the operation. Canines in groups A1 ,B1 ,C1 and D1 were executed at first month after the operation,and those in groups A2, B2, C2 and D2 were executed at the 6th month after the operation. The distal esophagus was segmented when the canines were executed. The upside and downside of the stoma in group C were distinguished and signed as Ca and Cb. Immunohistochemieal methods were used to detect VEGF,CD34 and FVⅧ-Rag,blood vessel-related factors,in lower esophagus. Results The expres-sion levels of VEGF and CD34 MVD,FⅧ-Rag MVD in groups A1 ,B1 and C1 were lower than those in group D1 one month after the operation (P <0.05). All the indices in group B1 were lower than those in groups A1 and Clb,but higher than those in group Cla (P <0.05). The indices in group Cla were lower than those in group C1b (P < 0.05 ). The indices in groups A2 and B2 were higher than those in groups A1 and B1, re-spectively at the 6th month after the operation (P <0.05). They were higer in outer membrane in group C1a than in group C2a (P <0.05). The indices in group C2b were higher than those in group Clb (P<0.05). Conclusion At the first month after operation, the expression of blood vessel-related factors was declined in three different procedures of paraesophagastric devascularization,which indicated that all three different pro-cedures could diminish the vessels in distal esophagus. The effect in group C was most obvious among all groups. At the 6th month after traditional paraesophagastrie devascularization and selective paraesophagastrie devascularization, the expression of blood vessel-related factors in distal esophagus was declined. But there were no significant changes in the expression of blood vessel-related factors in distal esophagus after parae-sophagastric devascularization plus distal esophageal transaction and reanastomosis with stapler. It indicated that the blood vessel regeneration in paraesophagastric devascularization pins distal esophageal transaction and reanastomosis with stapler was inferior to that in other procedures.     

胸腰段椎间盘突出症的诊断与治疗

胸腰段椎间盘突出症一般指位于T10～L2节段的椎间盘突出压迫脊髓腰膨大部位、脊髓圆椎或高位马尾神经所引发的一系列症状和体征。本病并不少见，由于部位的特殊，临床表现多样复杂，常被漏诊或误诊；在手术治疗上亦有一定的难度和风险；在治疗方法选择上没有形成较一致的认识；因而应当引起重视。     

肾素—血管紧张素系统的重大发现—ACE2与Ang（1～7）

肾素—血管紧张素系统(renin-angiotensin system，RAS)是最重要的心血管系统体液调节机制之一，最近发现了这一系统的许多新成员，包括ACE2、Ang-(1～7)、Ang-(1～9)等，这些物质的发现和对其生理意义的研究让我们对RAS有了许多新的认识。     

白蛋白在肠外营养支持中的地位

1 白蛋白的生理和生化[1,2] 白蛋白(albumin)是由585个氨基酸依靠17个二硫键链接而成的环状结构,其分子量为69 000D.白蛋白于肝细胞内合成,合成速度为每日120～270mg/kg,其合成速度与血管内胶体渗透压和血管外容积渗透压有关.     

C型利钠肽在低氧性肺动脉高压形成中的作用

在低氧性肺动脉高压形成过程中，肺小动脉收缩和平滑肌细胞增殖起着重要作用。其中因平滑肌细胞增殖引起的肺血管结构重建是不可逆发展的关键因素。目前国内外研究发现多种细胞因子参与了肺血管平滑肌细胞的增生和细胞表型转化的调控，Sudon等于1990年从猪脑中提取的第3个利钠肽家族成员-C型利钠肽(c-type natriuretic peptide，CNP)，