新安医家徐春甫的脾胃观在养生中的作用

中医养生是指运用中医学思维理论方法对人体进行调摄,达到保养身体,增强体质,调摄精神,预防疾病,延年益寿的目的。脾胃为后天之本,气血生化之源,脾胃功能旺盛是机体获得营养、维持生命活动的前提。新安医家徐春甫尤为重视养生,顺应自然、形神俱养、慎医慎食和情志养生为其养生理论核心,而保养脾胃是其养生观的重要环节之一。     

Tension pneumoperitoneum complicating cardiac resuscitation

A case of gastric rupture and tension pneumoperitoneum following cardiac resuscitation is presented. Respiratory embarrassment necessitated emergency decompression by needle puncture of the peritoneal cavity, followed by laparotomy and repair of the gastric tear. The post-operative course has been satisfactory. The eatiology of the gastric rupture is discussed and recommendations are made for the prevention and treatment of this unusual complication of combined mouth to mouth respiration and external cardiac massage.     

Wandering spleen with torsion: Appearance on CT and ultrasound

Wandering spleen is a rare entity which may present with symptoms suggestive of other, more common abdominal processes. Torsion of the long pedicle may occur causing abdominal pain. This article describes a case of wandering spleen diagnosed by computed tomography (CT). Liver spleen scintigraphy and sonography supported this diagnosis and suggested torsion. To our knowledge this is only the second case of this entity in which color flow and duplex Doppler findings have been reported.     

高强度聚焦超声致兔胃壁损伤的实验研究

目的 探讨模拟临床照射剂量条件下高强度聚焦超声(HIFU)对兔胃壁的破坏程度，以了解HIFU技术的安全性。方法 HIFU体外照射20只新西兰大白兔胃壁，观察照射过程中超声影像改变、局部损伤区的组织病理变化以及术后生存情况。结果 监控超声图像可较敏感的反映出HIFU照射组织损伤区的变化，术后病理观察可以证实兔胃壁发生急性坏死。结论 临床治疗剂量的HIFU照射足以使胃壁发生急性坏死，致胃穿孔发生导致死亡。     

内镜下局部注射HCPT、CF、5-FU和肾上腺素治疗晚期胃癌近期疗效的观察

目的 :在内镜下通过局部注射 10 -羟基喜树碱 (HCPT)、叶酸 (CF)、5 -氟尿嘧啶 (5 -FU)加肾上腺素治疗晚期胃癌与常规 5 -FU HCPT CF全身化疗治疗晚期胃癌作对比 ,观察其疗效。方法 :局部注射治疗组 :用“HCPT 2 0mg CF 30mg 5 -FU 5 0 0mg 0 .1%肾上腺素 0 .1ml”在肿瘤基底布及瘤体内多点注射 ,1次 / 3d ;常规化疗组 :用 5 -FU HCPT CF常规全身化疗。结果 :局部化疗组有效率 5 2 .2 % ,常规组为2 2 .3%。治疗组明显高于常规组 ,且治疗组的毒副反应也小于常规组。结论 :内镜下局部射HCPT ,CF ,5 -FU和肾上腺素治疗晚期胃癌 ,对缓解症状、提高病人的生存质量 ,是一种可行的方法。     

超声引导2 450 MHz水冷式微波电极高功率脾脏消融的实验研究

目的探讨2450MHz水冷式微波电极脾组织消融的高功率条件及安全性。方法4头小香猪建立淤血性脾肿大的动物模型;2450MHz水冷式微波电极行脾消融12个点,以功率不同分为70W、80W两组,每组6个点,时间均为600s;10个点开腹消融并同时测温,2个点经皮消融未测温。消融时观察脾局部的改变,消融后实测凝固区的长径、宽径,并计算体积。结果应用2450MHz水冷式微波电极70W、80W高功率条件下12个点的脾消融中,电极杆温均小于40℃。脾凝固区呈红褐色,表面干燥皱缩;出针后针道无活动性出血,包括经皮的2次消融。80W组的消融体积比70W组明显增大,两组温度场比较旁开15mm、20mm处差异显著,80W组温度明显增高。结论2450MHz水冷式微波电极高功率脾消融是安全的,功率的提高能够明显增大消融体积。     

创伤性脾脏损伤72例CT平扫分析

目的 旨在进一步提高脾脏损伤的CT诊断水平。方法 采用CT平扫对72例脾脏损伤患者进行中上腹部检查，层厚l0mm，层间距l0mm，部分病例作局部3—5mm薄层扫描。结果 脾脏表面损伤合并腹腔积血4例，脾脏裂伤合并腹腔积血l例，脾内血肿及延迟性脾损伤4例，脾脏挫裂伤(脾碎裂)合并腹腔积血50例，脾脏包膜下血肿合并腹腔积血l0例，脾脏损伤合并肝脏损伤及左膈疝各l例，误诊l例。结论 腹部CT平扫在诊断早期及延迟性脾脏损伤有其独特优势，而腹腔积血则在脾脏损伤诊断有重要的意义。     

Ruptured gastrointestinal stromal tumors: radiologic findings in six cases

Background Gastrointestinal stromal tumors (GISTs) are characterized by the expression of c-KIT (antigen CD 117) and are the most common mesenchymal tumors of the digestive tract. An important complication, although infrequently described in the literature, is the rupture of these tumors with accompanying hemoperitoneum. Methods We performed a retrospective evaluation of the clinical history and radiologic records of 23 patients with a diagnosis of GIST and anatomopathologic and immunohistochemical confirmation at our hospital between 1999 and 2004. Results In five cases there was rupture of the primary tumor (four gastric and one jejunal). In all five cases ultrasonographic and computed tomographic examinations showed a heterogenic tumor of laminated or whirled appearance, associated with echogenic or dense ascites. No relation was found between histologic criteria of malignancy and the rupture. Four patients underwent surgical intervention, three of them urgently. Two of five patients died. There was a sixth case with rupture of a hepatic metastasis, with accompanying hemoperitoneum and subcapsular hematoma. This patient died at 3 months, after recurrence of bleeding. Conclusions The finding of a heterogeneous tumor of laminated or whirled appearance associated with ascites with characteristics compatible with hemoperitoneum in an appropriate context must lead to a suspicion of the existence of a ruptured GIST.     

胃癌内镜超声分期与MMP-9基因表达的关系

目的 探讨内镜超声（EUS）对胃癌的术前分期及其与肿瘤转移相关基因表达的关系.方法 63例胃癌患者术前行胃镜和EUS检查并进行术前分期,同时运用ELISA法检测术前MMP-9血清水平,应用免疫组织化学技术和原位杂交技术检测胃癌组织中MMP-9蛋白的表达并与术后病理分期比较.结果 EUS对胃癌侵犯深度判断的总准确率为 80.95%,对淋巴结转移的总准确率为 73.02%.胃癌患者血清MMP-9水平与组织中MMP-9蛋白及MMP-9 mRNA表达呈一致性.MMP-9表达水平与胃癌组织浸润程度、EUS分期、淋巴结转移关系密切（P〈0.05）.联合EUS和MMP-9对胃癌侵犯深度判断的准确率明显提高,其总准确率为 95.22%.结论 ①EUS对胃癌的分期具有其分子生物学改变的基础.②胃癌患者术前血清MMP-9水平对EUS术前分期有参考价值,若显著增高者,术前EUS检查时,应注意癌肿是否已达或超过浆膜层.③EUS联合术前检测MMP-9血清水平,有利于提高对胃癌浸润转移判断的准确性.     

超声检查对胃癌的诊断价值

目的探讨超声对胃癌诊断的价值。方法选择21例超声诊断胃癌经胃镜、手术及病理证实的患者,先经腹扫查胃区及周围组织,然后饮造影剂,逐段扫查贲门、胃底、胃体、胃窦部必要时扫查邻近器官和周围淋巴结,观察胃壁是否平滑、胃壁厚度、层次是否清晰及蠕动情况。结果超声显像诊断超声显像诊断胃窦占位病变l0例,胃体占位病变6例,胃壁增厚原因待查3例,大部份胃内弥漫占位2例,后腹膜淋巴结肿大5例。结论超声检查可以作为胃癌辅助检查手段。