会阴侧切口皮内连续缝合200例临床观察

我院采用合成线皮内缘连续缝合技术进行会阴口缝合,现报告如下.     

多层螺旋CT肝脏动态增强扫描中对比剂注射参数设置方法

肝脏血液供给来源于门静脉（机能性血管）和肝固有动脉（营养性血管），前者占肝脏总供血量的2／3～3／4，后者仅占1／4～1／3。由于循环途径不同，血液经左心室-肝固有动脉流入肝脏所需时间比经左心室-门静脉流入肝脏所需时间短，经静脉注射对比剂进行CT肝脏动态增强检查时，二种循环途径各自产生最大造影效果的出现时间有一定差别。螺旋CT扫描速度极快，能在动脉期和门静脉期分别完成全肝扫描。这种检查方法的诊断价值也已得到公认，特别是对肿瘤性病变，有效率达95％以上。     

食管异物的X线诊断

食管异物在临床上较为常见，其临床表现及X线表现均有一定特异性。笔者收集本院2006-2007年经食管镜证实病例20例，现报告如下。     

浅谈甲状腺病放射性核素诊治的卫生防护

甲状腺疾病（甲亢、毒性结节、甲状腺肿、功能自主性甲状腺瘤等）先普遍采用放射形核素131I（B射线）治疗，诊断采用吸131I率核素扫描（R射线）以及包括X射线等一些辅助检查。在诊断治疗过程中医生和患者如果防护措施不当，力量不足，会使医生和患者受到一定的射线辐射。     

闭合性肾损伤76例临床诊疗分析

目的:探讨闭合性肾损伤的诊断与治疗原则。方法:对1996年1月~2007年9月收治的76例闭合性肾损伤患者的临床资料进行回顾性分析。行B超、CT、静注尿路造影(IVU)检查者分别为65例(85.52%)、58例(76.31%)、18例(23.68%)。保守治疗64例(84.21%),手术治疗12例(15.79%),其中保肾手术7例。结果:治愈74例,死亡2例,其中1例合并骨盆骨折失血过多死亡,1例因合并颅脑损伤死亡。结论:B超和CT检查可迅速诊断并正确评估肾脏损伤程度。合理保肾是闭合性肾损伤的有效治疗方法。     

Viral replication modulated by synthetic peptide derived from hepatitis B virus X protein

AIM:A strategy for viral vaccine design is the use of conserved peptides to overcome the problem of sequence diversity. At present it is still unclear whether conserved peptide is safe as a candidate vaccine. We reported it here for the first time not only to highlight the biohazard issue and safety importance for viral peptide vaccine, but also to explore the effect of a fully conserved peptide on HBV replication within the carboxyl terminus of HBx.METHODS:We synthesized the fully conserved peptide (CP) with nine residues, FVLGGCRHK. HBV-producJng 2.2.15 cells were treated with or without 3.5μM CP for 36 hours.Quantitative detection of viral DNA was performed by realtime PCR. HBV antigens were determined by enzyme-linked immunoadsorbent assay (ELISA). Quantitative analyses of p53 and Bax proteins were based on immunofluorescence.Flow cytometry was performed to detect cell cycle and apoptosis.RESULTS: Both extracellular and intracellular copies of HBV DNA per ml were significantly increased after incubation with 3.5μM of CP.HBsAg and HBeAg in the cultured medium of CP-treatment cells were as abundant as untreated control ceils. CP influenced negatively the extracellular viral gene products, and 3.5μM CP could significantly inhibit intracellular HBsAg expression. In response to CP, intracellular HBeAg displayed an opposite pattern to that of HBsAg, and 3.5μM CP could efficiently increase the level of intracellular HBeAg.Flow cytometric analyses exhibited no significant changes on cell cycle, apoptosis, p53 and Bax proteins in 2.2,15 cells with or without CP.CONCLUSION: Together with the results generated from the synthetic peptide, we address that the conserved region,a domain of HBx, may be responsible for modulating HBV replication. As conserved peptides from infectious microbes are used as immunogens to elicit immune responses, their latent biological hazard for human beings should be evaluated.     

A preliminary study on the rheological properties of human ejaculate and changes during liquefaction

Aim: To study the changes in rheological properties, namely the parameters of the hysteresis loops and yield stress versus time for human semen after ejaculation. Methods: Ejaculates were obtained from volunteers and immediately put into the test cup of a Brookfield Programmable DV- 11 Rheometer, by which the hysteresis loops and yield stress were determined. Results: (1) Yield stress values dropped down from more than 3000 mPa to 60 mPa inabout 5 minutes after ejaculation; (2) The shape of the hysteresis loops of shear stress versus shear rate was changed from the counter-clockwise direction, that enclosed a large area, into the clockwise direction, that enclosed a very small area. Conclusion: Human ejaculate originally possesses semi-solid or visco-elastic body behavior and in 5 minutes after liquefaction, it becomes a thixotropic fluid or shearing thinning fluid with very low viscosity. (Asian J Androl 2004 Dec; 6: 299-304)     

Intrasellar tuberculoma: case report

Intrasellar tuberculoma is a rare disease that is often difficult to diagnose before surgery. We present a case of intrasellar tuberculoma treated at our department.     

Aortopulmonary window： a case diagnosed and surgery confirmed by ultrafast computed tomography

Aortopulmonary window (APW) is a rare congenital defect,found in 0.2% of patients with congenital heart disease,in which a communication exists between the ascending aorta and the pulmonary artery trunk with normal separation of the aortic and pulmonary valves.     

吉西他滨联合顺铂一线治疗晚期非小细胞肺癌79例临床报告

背景和目的 化疗是晚期非小细胞肺癌治疗的主要手段,本文拟总结吉西他滨联合顺铂治疗晚期非小细胞肺癌的近期疗效、毒性反应、疾病进展时间和总生存.方法 回顾性分析我院1999年10月～2005年11月接受吉西他滨联合顺铂治疗的初治晚期非小细胞肺癌患者.79例患者中男性51例,女性28例,中位年龄53岁(21～74岁);鳞癌17例(21.5%),腺癌53例(67.1%),大细胞癌3例(3.8%),腺鳞癌1例(1.3%),未分型者5例(6.3%);分期采用AJCC 1997年标准,ⅢB期29例(36.7%),Ⅳ期50例(63.3%);行为状态(ECOG)评分0～2分,ECOG 0分15例(19.0%),ECOG 1分55例(69.6%),ECOG 2分9例(11.4%),中位ECOG评分为1分.吉西他滨800～1250 mg/m2,第1、8天静脉滴注,顺铂75～80 mg/m2,第1天静脉滴注,或30 mg/m2连用3天,静脉滴注,每三周为一周期,每例患者完成2～4周期化疗.结果 79例患者均可评价疗效,近期有效率(完全缓解 部分缓解)为31.6%,总的临床获益率(完全缓解 部分缓解 稳定)为73.4%.中位随访2.33年(0.48～6.08年),中位疾病进展时间为5.06个月,1年生存率为64.9%,2年生存率为32%.主要的毒性反应为恶心呕吐等消化道反应和血液学毒性,Ⅲ～Ⅳ度白细胞减少和血小板减少的发生率分别为25.4%和31.6%,其余的毒性反应较轻,可耐受.结论 吉西他滨联合顺铂一线治疗晚期非小细胞肺癌安全、有效,是标准方案之一.在老年患者中,疗效良好,可以推荐.对中国患者吉西他滨1000 mg/m2是可以较好耐受的剂量.