豚鼠胃肠道粘膜下层内神经节丛与血管的伴行现象

对豚鼠胃肠道各段的研究发现,在胃体、胃底和幽门的粘膜下层内,血管仅由神经纤维束伴行。除小肠粘膜下层可见神经节丛与血管伴行外,在盲肠粘膜下层,亦可见神经节丛与小动、静脉伴行,尤以血管始段及第一分支段最明显。某些神经节丛还发出神经纤维束投射到血管壁上。在结肠和直肠均未见到神经节丛与血管的伴行现象。     

家兔实验性减压病时血浆中血拴素A_2及前列环素含量的变化

实验观察了“安全”减压和不适当减压条件下家兔减压病(DCS)的发病情况、Doppler超声以及血浆中TxB_2和6-keto-PGF_(1a)的变化;还观察了消炎痛对DCS的预防怍用。结果显示:减压愈不当,DCS发病愈重,Doppler超声气泡探测仪检测到的级别愈高。血浆TxB_2、6-keto-PGF_(1α)值在濒死动物中明显升高(P<0.01);存活动物中,TxB_2经历了下降、再恢复的过程(P<0.01),而6-keto-PGF_(1α)值未见明显变化。消炎痛在抑制血浆TxB_2升高的同时,有效地降低了DCS发病率。此结果表明:TxA_2、PGI_2参与了重型DCS的发病过程,消炎痛的顶防作用与抑制花生四烯酸代谢物的生成有关。     

Staging-laparoscopy

Summary. The so-called extended diagnostic laparoscopy (EDL) facilitates the comprehensive exploration of the abdominal cavity, thus improving the precision of the pretherapeutic tumor staging in gastrointestinal malignancies. EDL comprises visual inspection with a specific preparation of all relevant sites, laparoscopic sonography and retrieval of samples for biopsy and cytology. Additional relevant therapeutic information was obtained through EDL in 40.5 % of gastric cancer patients. EDL could be of similar importance for diagnosing esophageal, hepatobiliary and pancreatic malignancies.      

Open surgery of giant paraclinoid aneurysms improved by intraoperative angiography and endovascular retrograde suction decompression

Summary In three consecutive cases of giant left sided paraclinoid aneurysms we employed an endovascular retrograde suction decompression technique in combination with intra-operative angiography. A double-lumen balloon catheter was placed in the left internal carotid artery by the transfemoral route. After balloon inflation and placement of a temporary clip distal to the aneurysm blood was aspirated and the aneurysm collapsed. Thus further dissection of the aneurysm could easily be achieved and clips could be placed. Afterwards real-time digital subtraction angiography was performed. Intra-operative angiography led to clip repositioning in all cases either due to a clip induced stenosis of the parent vessel, or because of incomplete aneurysm obliteration. Afterwards successful clipping could be confirmed in all cases. Outcome was excellent in one case, good in the other. The third case, extremely complicated by an accompanying craniopharyngioma, showed a satisfactory outcome, but presented new neurological deficits.     

消化道恶性肿瘤确诊初期患者社会支持与生命质量的调查

目的 调查消化道恶性肿瘤确诊初期的患者半年中的社会支持和生命质量变化。方法 采用社会支持评定量表和CARES-SF对146名患者的社会支持和生命质量进行为期半年的追踪调查。结果 消化道恶性肿瘤确诊初期患者的生命质量为中等，其中婚姻关系维度、性关系维度得分半年后下降。患者所获得的社会支持最多的是情感支持，其次是实际支持，信息支持为第三位。情感支持大多来源于家庭成员，信息支持大多来源于医务人员。患者大多很少参与社交活动。在半年中情感支持、实际支持、信息支持的变化模式不一。诊断初期的患者不能有效地利用社会支持。结论 应对确诊初期患者加强咨询，以充分识别和利用社会资源。应持续评估患者的生命质量和社会支持，并制订干预方案，提高消化道恶性肿瘤确诊初期患者的社会支持程度，最终提高其生命质量。     

腰椎管狭窄症的手术减压与内固定选择(259例临床分析)

目的：探讨腰椎管狭窄症的手术减压指征、减压范围及内固定选择。方法：回顾性分析腰椎管狭窄症患者259例，平均年龄52．2岁，平均病程4年1个月。根据病情分别采用椎板间节段开窗潜行减压术139例，腰椎管内径扩大成形术63例，全椎板切除减压、椎间植骨融合内固定术57例。结果：221例获得平均4年2个月随访。三种手术方法优良率分别为91．53％、87．50％和85．45％；手术并发症发生率为13．69％、15．87％和20．11％。结论：对严重的腰椎管狭窄症若手术适应证和减压范围掌握恰当，不论采取何种手术方式的神经减压术，均可取得满意疗效。正确选择病例和熟练的外科技术是应用内固定器械的重要条件。     

前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全性截瘫

目的 探讨胸腰段爆裂性骨折伴不全瘫前路减压内固定优越性以及Z-plate系统的优点。方法 采用前路减压Z-plate内固定治疗胸腰段爆裂性骨折伴不全瘫25例。结果 全部病例均获随访，随访时间6～24个月，平均17个月。按Frankel分级评定有1～3级恢复，随访期间无后凸加重及内固定松动，植骨融合。结论 前路减压Z-plate内固定是治疗胸腰段爆裂性骨折的较好方法。     

Expression and significance of HIF-1α and ET-1 in gastrointestinal stromal tumors

Objective To explore the expression and the value of HIF-1α,and ET-1 in judging the prognosis of gastrointestinal stromal tumors (GISTs). Methods The expression of HIF-1α, and ET-1 protein was examined in 76 GISTs by immunohistochemistry S -P methods. Results There was a positive correlation between the expression of HIF-1 α and ET-1 ( P < 0.05 ). The positive expression rate of HIF-1 α and ET-1 was 73.68% (50/76) ,and 65.79% (50/76) respectively,which was related with histologicial grade, tumor diameter, infiltration and metastasis, nuclear division rating of GISTs ( P < 0.05 ), but had no relationship with patients' age, gender, initial position of the tumor ( P > 0.05 ). There was statistically sig-nificant difference in the expression of HIF-1 α and ET-1 in the following groups:among the three classes of very low-risk and low-risk, middle-risk, high-risk, bewteen the diameter < 2 cm and > 5 cm (P < 0.05). The more malignant degree and larger diameter, the more highly positive expression rate ( P < 0.05 ). The positive expression in the groups with infiltration and metastasis, and nuclear division ≥5/50 HP was sig-nificantly higher than the groups without infiltration and metastasis, and nuclear division < 5/50 HP (P < 0.05). Conclusion The expression of HIF-1α had a significant correlation with ET-1. HIF-1α,and ET-1 expression was closely related with the prognosis of GISTs,and can serve as important predictors for survival.