正交偏光镜下人体胆汁液晶光学性质的研究

本文报导了在正交偏光镜下，对人体胆汁液晶的光学性质的研究，结果表明，胆汁液晶是一种非均质体，在正交偏光镜下，呈现出特殊的干涉图样和四次消光现象，光性符号是单轴正性的，干涉色级是一级灰白，双折射率Δｎ＝０．０１１－０．０１７。     

伤寒史学研究成果简述

建国以来有关伤寒史学的研究成果表现在相关人物、相关著作、相关事件、学术关系及阶段特征五个方面。前期研究成果 ,尚不足以充分展示伤寒学历史地位和现实意义 ,更无充分依据昭示其未来之发展方向 ,因而有必要继续深入开展伤寒史学研究     

Bile-duct diameter at the porta hepatis and liver biopsies in Indian children with biliary atresia

Fibrous remnants from the porta hepatis and wedge biopsies of the liver were studied in 60 patients with biliary atresia. The patients were divided into three groups on the basis of bile duct diameter — I: no ducts; II: <50 m; III: >50 m. The liver damage was classified into three grades on the basis of ductular and parenchymal histopathologic changes and extent of inflammatory pathology. There was no correlation between severity of hepatic damage and duct diameter, although the levels of serum bilirubin and alkaline phosphatase varied in direct proportion to the degree of hepatic damage. There was an inverse relationship between age and duct diameter, but neither correlated with bile flow at surgery or in the postoperative period. The data suggest that Indian children with biliary atresia follow a different clinical course compared to those from Japan and Western countries. Correspondence to: V. Bhatnagar     

天津市1999-2021年0~14岁儿童伤害死亡谱及城乡差异分析

目的 分析天津市0~14岁儿童伤害死亡谱的特征、变化情况及城乡差异。方法 1999-2021年天津市儿童伤害死亡数据来源于天津市全人口全死因监测数据库,计算不同亚组人群和主要伤害原因的构成比、粗死亡率和标化死亡率并比较城乡差异。采用Cochran-Armitage趋势检验分析死亡原因构成比的时间变化趋势。采用Joinpoint回归分析变化趋势,计算平均年变化百分比（AAPC）。伤害死亡风险的季节差异用死亡率比值及其95%CI表示。结果 1999-2021年,伤害是天津市0~14岁儿童的第3位死因。农村儿童死于医疗卫生机构的比例为31.08%,低于城市的37.82%。儿童伤害的总体标化死亡率呈下降趋势（AAPC=-5.54%,P<0.001）。溺水和道路交通伤害的标化死亡率在城市和农村地区呈下降趋势（P<0.001）。意外中毒的标化死亡率仅在农村地区呈下降趋势（AAPC=-8.09%,P<0.001）,在城市地区无明显变化趋势（P>0.05）。自杀标化死亡率在城市地区无明显变化趋势（P>0.05）,在10~14岁农村儿童中呈上升趋势（AAPC=4.58%）。跌倒/坠落标化死亡率在城市和农村地区均无明显变化趋势（P>0.05）。伤害死亡的总体风险和溺水死亡风险在城乡均为夏季最高;道路交通伤害在城市为秋季最高,在农村为夏季最高;意外中毒死亡风险在城乡均为冬季最高。结论 近年来天津市儿童伤害死亡情况得到明显改善。城市和农村地区的儿童伤害死亡水平仍存在较大差异,在未来政策制定中,应充分考虑缩小城乡差距。     

胰高血糖素对胆道梗阻大鼠肝脏葡萄糖和酮体合成的作用

目的观察胰高血糖素对胆道梗阻大鼠肝脏葡萄糖和酮体合成作用的影响。方法大鼠胆道结扎４８小时后,用胶原酶灌流后分离肝细胞,加入胰高血糖素温育,用分光光度计按标准酶学方法检测葡萄糖、乙酰乙酸和三羟基丁酸。结果在基础或最大刺激条件下,加胰高血糖素结扎组、假手术组葡萄糖异生均明显大于未加胰高血糖素组（Ｐ＜０．０５）,加胰高血糖素对结扎组和假手术组的酮体异生无促进作用。结论胰高血糖素对胆道梗阻４８小时大鼠肝细胞的糖异生存在有意义的刺激作用,对酮体异生则无刺激作用     

Competitive inhibition of the uptake of demethylphalloin by cholic acid in isolated hepatocytes

Summary Cholic acid inhibits the uptake of demethylphalloin (DMP), in a competitive manner. The bile acid increases the Michaelis constant but not V _max of the inward transport. The inhibition constant K _i for cholate was found to be 8 M. Cholate competes for the transport system but not for intracellular binding of phallotoxins. Various experimental data presented in this paper exclude an accumulation of phallotoxins in hepatocytes by intracellular binding only.Preincubation of hepatocytes with small concentrations of either (³H)-demethylphalloin or (¹⁴C)-cholate and subsequent treatment with high concentrations of the nonlabelled compounds reduces the intracellular concentration of both radioactive substrates. In accordance with earlier findings the above results suggest a common component needed for the transport of both phallotoxins and cholic acid.This work was supported by the Deutsche Forschungsgemeinschaft     

对肝外胆管梗阻时“软藤征”的再认识

本文回顾性分析了48例“软藤征”的病因,其中恶性疾病28例(占58.3％),良性疾病20例(占41.7％)。据本文资料,作者认为“软藤征”是肝管分叉部及肝外胆管急性完全(或接近完全)性梗阻时肝内胆管扩张的特征性X线表现,并非恶性梗阻特有,良性梗阻亦常见。作者指出,只要肝内胆管无或仅有轻度炎症,胆管具有良好的弹性和扩张性,不论良、恶性病变都可出现“软藤征”。那种认为当梗阻病变未显示时,仅根据“软藤征”即可作出恶性梗阻诊断的观点很值得商榷。作者认为,“软藤征”的定性及病因诊断主要应根据PTC或ERCP,或二者联合显示梗阻局部病变的形态学特征来确定。     

中西医结合对重症脑外伤昏迷病人促苏醒疗效观察

目的 :探讨醒脑开窍疗法对治疗重症颅脑损伤患者促苏醒作用以及对预后的影响。方法 :将 80例颅脑损伤患者 (GCS≤ 8)随机分成 2组 ,治疗组 4 0例 (在常规治疗基础上加用中药针刺疗法 ) ;对照组 4 0例。两组于伤后 1月按GCS预后评分评定预后 ,两组在促醒后 1月内意识好转率作一比较。结果 :治疗组预后恢复良好为 87 5 % ,显著高于对照组 6 2 5 % ,P <0 0 1;两组病死率差异无显著性意义 (P >0 0 5 )。治疗组 1月内清醒 32例 ,对照组 2 0例 ,P <0 0 1。结论 :中西医结合疗法在治疗重症脑外伤昏迷患者时 ,能加速促醒和提高生存质量。     

金属支架联合立体定向适形放疗治疗肝门部胆管癌

目的评价金属支架联合立体定向适形放疗肝门部胆管癌的疗效。方法31例肝门部胆管癌患者行金属支架置入联合立体定向适形放疗,并与23例行单纯支架治疗者进行对比研究。结果联合治疗组生存时间平均为11.1个月;对照组为5.1个月,差异有显著性意义(P<0.01)。结论胆道金属支架置入联合立体定向适形放疗是不能手术肝门部胆管癌的一种有效治疗方法。     

The local spread of lower bile duct cancer: evaluation by thin-section helical CT

This study illustrates the local spread of lower bile duct cancer with thin-section helical CT in correlation with the surgical and pathological findings. Pathologically, 16 patients had pancreatic invasion, 4 had small bowel mesentery invasion, 7 had extrapancreatic nerve plexus invasion, and 3 patients had vascular invasion. On thin-section helical CT, pancreatic invasion was correlated to the clarity or non-clarity of the bile duct mass-pancreas border and the presence of an intrapancreatic mass. Cases with small bowel mesentery and extrapancreatic nerve plexus invasion showed mass or stranding around the superior mesenteric artery and/or inferior pancreatoduodenal artery. Vascular invasion was seen as tumor contiguity to these vessels. Received: 28 September 1998; Revised: 30 December 1998; Accepted: 2 April 1999