CO中毒致迟发性脑病大鼠脑内CD4+T淋巴细胞浸润及神经胶质酸性蛋白的表达

目的观察CO中毒致迟发性脑病（DNS）大鼠脑内CD4^＋T淋巴细胞浸润以及神经胶质酸性蛋白（GFAP）的表达情况，探讨CO中毒致DNS的病理过程。方法25只SD雄性大鼠随机分为对照组、染毒后3、7、10、20d组，每组5只。采用HE和免疫组织化学染色方法，观察染毒后各时间点大鼠脑内病理形态学变化，及CD4^＋T淋巴细胞浸润和GFAP的表达情况。结果HE染色结果显示：各染毒组在大脑皮层及海马均出现神经细胞不同程度的变性、坏死，染毒后7d组最重。免疫组织化学染色结果显示：对照组无CD4^＋T淋巴细胞浸润，有少量GFAP表达；各染毒组不同脑区CD4^＋T淋巴细胞、GFAP均有不同程度的浸润和表达。CD4^＋T淋巴细胞染毒后3d开始浸润，7d达峰值，两者在数量上差异有统计学意义（P〈0．01）。各组染毒后GFAP均有大量表达，随染毒时间延长表达数量呈上升趋势。结论CD4^＋T淋巴细胞可能参与了CO中毒致DNS的免疫病理过程，GFAP阳性细胞对CO中毒引发的DNS可能具有保护作用。     

自发性食管破裂的护理

目的 总结自发性食管破裂患者的护理措施，提高护理水平。方法 在保守及手术治疗的同时，严密观察病情变化，做好心理护理，加强呼吸道、消化道及各种管道的护理。结果 7例患者治愈出院。结论 精心的专业化护理在治疗自发性食管破裂中起重要作用。     

CO2激光治疗宫颈糜烂2412例疗效观察

目的 探讨CO2激光治疗宫颈糜烂的疗效。方法 采用CO2激光输出功率20-40w，波长10．6μm，针对轻、中、重不同糜烂程度采用不同光束强度，光斑直径约0．3-0．5的连续波治疗宫颈糜烂2412例。结果 术后三个月复查，总有效率100％。结论 CO2激光治疗术简单、安全、疗效满意，适用于治疗I-Ⅲ0宫颈糜烂。     

Sentinel Bleeding After Pancreaticoduodenectomy: A Disregarded Sign

Introduction Delayed massive hemorrhage induced by pancreatic fistula after pancreaticoduodenectomy is a rare but life-threatening complication. The purpose of this study was to analyze the clinical course of patients with late hemorrhage, with or without sentinel bleeding, to better define treatment options in the future. Material and Methods From April 1998 to December 2006, 189 pancreaticoduodenectomies were performed. Eleven patients, including two patients referred from other hospitals, were treated with delayed massive hemorrhage occurring 5 days or more after pancreaticoduodenectomy. Sentinel bleeding was defined as minor blood loss via surgical drains or the gastrointestinal tract with an asymptomatic interval until development of hemorrhagic shock. The clinical data of patients with bleeding episodes were analyzed retrospectively. Results Eight of the 11 patients had sentinel bleeding, and seven of them had it at least 6 h before acute deterioration. Seven out of 11 patients died, five out of eight with sentinel bleeding. No differences could be detected between patients with or without sentinel bleeding before delayed massive hemorrhage. The only difference found was that non-surviving patients were significantly older than surviving patients. Delayed massive hemorrhage is a common cause of death after pancreaticoduodenostomy complicated by pancreatic fistula formation. The observation of sentinel bleeding should lead to emergency angiography and dependent from the result to emergency relaparotomy to increase the likelihood of survival.     

食管癌贲门癌术后胸胃排空障碍的临床分析

目的探讨食管癌贲门癌术后胸胃排空障碍的诱因、诊断和治疗。方法回顾性分析1990年1月-2003年12月我院施行1369例食管癌贲门癌切除术的病人临床资料。结果本组病例发生胸胃排空障碍17例,发生率1.24%,其中机械性胸胃排空障碍5例,功能性胸胃排空障碍12例,均发生于术后3～12d,再次手术治疗5例;治愈16例,死亡1例。结论上消化道造影、胃镜是鉴别机械性胃排空障碍和功能性胃排空障碍的重要方法,对食管癌术后机械性胃排空障碍应采取手术治疗,而功能性胃排空障碍采取保守治疗多能好转。     

外伤性脾破裂非手术治疗29例体会

目的 总结外伤性脾破裂的非手术治疗经验。方法 对我院1993-2002年以禁食、卧床、止血、抗生素等非手术治疗29例外伤性脾破裂的临床资料进行分析。结果 29例均非手术治愈出院，住院时间8～22d，平均15d；获随访25例，随访3～6个月，无1例出现并发症。结论 只要严格掌握适应证和密切动态观察病情变化，随时做好中转手术的准备，非手术治疗外伤性脾破裂是安全可行的，是一种重要保脾手段，对非手术治疗期间血液动力学不稳定或发生延迟性出血者应及时手术。     

Post-operative esophageal leak treated with removable silicone-covered polyester stent

Self-expanding removable covered stents are increasingly being used for the treatment of benign esophageal diseases such as leaks or perforations and stenosis. They are easy to place and remove and good outcomes have been reported. We report a case of a postoperative esophageal leak successfully managed with a removable silicone-covered polyester stent.     

CD44v6和组织蛋白酶D表达与食管癌预后的关系

目的　研究CD4 4v6和组织蛋白酶D(cathepsinD ,CD)表达与食管癌生物学行为的关系。方法　应用免疫组化法 ,检测 6 5例食管鳞状细胞癌组织中CD4 4v6和CD表达水平。结果　在食管癌中CD4 4v6和CD表达阳性率分别为 5 8.5 %和 6 4 .6 %。CD4 4v6和CD表达均与肿瘤分级、浸润、淋巴结转移和预后相关。结论　CD4 4v6和CD异常表达与食管癌的病理生物学行为密切相关 ,可作为是预测食管癌转移潜能和评估食管癌预后的客观指标     

雷公藤挥发油对小鼠免疫功能的影响

观察雷公藤挥发油对小鼠免疫功能的影响,发现给药1周后,其可减少脾脏有核细胞数,减少 PFC 和 RFC 数目,抑制脾细胞对 ConA 诱导 T 细胞增殖的反应性,减轻DTH。这说明雷公藤挥发油对小鼠体液免疫和细胞免疫均有明显的抑制作用。