胆管结石乳头局部组织中血管活性肠肽和一氧化氮合酶表达的改变及意义

目的 探讨胆管结石患者乳头局部组织中血管活性肠肽(VIP)和一氧化氮合酶(NOS)表达的改变及意义。方法 选择68例进行逆行胰胆管造影和/或乳头括约肌切开术的胆管结石患者,采用内镜下活检乳头局部组织。常规石蜡包埋,连续切片,免疫组化SABC法检测VIP及NOS。对照组为门诊胃镜检查胃粘膜大致正常者。结果 结石组乳头粘膜内 VlP和NOS阳性产物与对照组相比较显著降低(P相似文献   

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。     

愈肝片对实验性大鼠急慢性肝损伤的保护作用

目的：探讨愈肝片对大鼠D-氨基半乳糖急性肝损伤和四氯化碳慢性肝损伤的保护作用。方法：分组造模给药后测定大鼠血清中AST、ALT、TP、ALB和出凝血时间的变化，取肝组织做病理学检测。结果：愈肝片能降低D-氨基半乳糖急性肝损伤大鼠血清AST、升高白蛋白ALB，改善出凝血时间，可明显减轻肝组织变性、坏死程度；并能降低四氯化碳慢性肝损伤大鼠血清AST、ALT，升高ALB、TP。结论：愈肝片对D氨基半乳糖和四氯化碳所致的急慢性肝损伤有保护作用。     

常温下肝脏缺血/再灌注损伤及其机制的实验研究

目的　研究常温下肝脏缺血 /再灌注损伤及其机制。方法　 2 4只兔随机均分为缺血组和对照组。组织气体分析仪持续测定兔肝组织氧压 (HepatictissueoxygeonpressurePtiO2 ) ;光镜及电镜观察肝脏组织病理改变 ;全自动生化仪测定血清丙氨酸氨基转氨酶 (ALT)。结果　缺血组兔肝脏在缺血后肝PtiO2 值开始下降、30min降至 2 0 1± 2 8,再灌注后的肝PtiO2 值开始恢复 ,再灌注 6 0min肝PtiO2 未恢复正常 (P <0 0 5 )。肝细胞出现变性、坏死 ,血清ALT值显著升高 ,在肝脏再灌注 6 0min时最为严重。结论　常温下用Pringle氏法阻断入肝血流可导致肝脏缺血/再灌注后肝细胞功能障碍和病理损害。其作用机制与缺血期肝细胞缺氧、再灌注期肝脏微循环障碍和肝细胞线粒体的损伤有关。     

A Survey on Injury Incidence in School Children in Shantou City, China

INTRODUCTION Injury is emerging as the most important preventable cause of death and disability in children beyond the first few months of life[1,2]. In China, injury has become a leading cause of death in children over one year[2]. In addition, injuries …     

电针预处理对兔脊髓缺血再灌注损伤细胞内Ca~(2 )变化的影响

目的 :探讨重复电针预处理诱导缺血耐受对脊髓缺血再灌注损伤保护作用的机制。方法 :76只雄性新西兰大白兔随机分成 4组 :对照组 (C组 ) ,戊巴比妥钠组 (SP组 ) ,假手术组 (S组 ) ,电针预处理组 (EA组 )。最后一次预处理后 2 4h ,阻闭肾下腹主动脉 ,制作兔脊髓缺血模型 ;S组动物手术操作同C组 ,但不阻闭腹主动脉。分别于阻闭后不同时相点测定细胞内Ca2 含量 ,并分别对动物后肢运动功能评分。结果 :EA组脊髓组织细胞内Ca2 含量显著低于C组和SP组各时相值 (P <0 0 1) ,神经功能评分EA组明显高于C组 (P <0 0 1) ,C组和SP组细胞内Ca2 和神经功能评分无显著性差异 (P >0 0 5 )。结论 :电针预处理具有降低脊髓组织细胞内Ca2 含量 ,防止Ca2 超载 ,稳定细胞内环境的能力 ,对腹主动脉阻断所致的脊髓缺血再灌注损伤具有良好的保护作用。     

216例恶性阻塞性黄疸患者手术疗效的因素分析

目的 探讨影响恶性阻塞性黄疸临床治疗的预后因素。方法 对１９９０年１月～１９９７年１２月２１６例恶性阻塞性黄疸手术患者的１７种临床指标进行分析。结果 １７３例（８０．１％）手术后１个月存活,发生并发症８１例,发生率３７．５％。台术者胆管炎、胆瘘、出血、肾功能衰竭等并发症均高于姑息术者,差异均有显著性（Ｐ〈０．０１）;１月生存率和术后并发症发生率与ＡＳＡ分级、黄疸持续的时间等有明显关系（Ｐ〈０．０１     

Subjective and functional results after total gastrectomy: prospective study for longterm comparison of reconstruction procedures

Background: Many reconstruction procedures have been developed in efforts to resolve patients' complaints after total gastrectomy. However, there have been few reports of longterm comparisons between reconstruction procedures, especially with regard to the prevention of duodenal food passage. This study was undertaken to compare the longterm subjective and functional results among Roux-en-Y esophagojejunostomy (R-Y), R-Y with pouch (P-Y), and jejunal interposition with pouch (P-I) after total gastrectomy. Methods: Consecutive patients requiring curative total gastrectomy were enrolled in this prospective study by the envelope method. Results: Hospital stay was longer following a P-I than an R-Y or a P-Y. Over 50% of R-Y patients complained of heartburn, and 20% of R-Y patients showed dumping syndrome throughout the postoperative period, with this rate being significantly different from rates in the other two groups. P-Y patients complained of early satiety in the late postoperative period, while P-I patients complained of early satiety in the early postoperative period. The nutritional index in P-I patients was higher than those in patients with the other two procedures. Gastrointestinal and hepatobiliary dual scintigraphy (GHDS) showed that the rate of bile reflux with an R-Y was relatively high after surgery. Food reflux with a P-Y was increased (9.4% to 11.1%), but with a P-I food reflux was decreased at 3 years after surgery (13.3% to 9.9%). Patients with a P-Y had a faster recovery of body, weight in the early postoperative period; however, at 5 years after operation, body weight recovery with a P-I was greatest. Conclusion: Reconstruction should be performed with pouch formation after total gastrectomy with curative intent. Received: March 7, 2002 / Accepted: September 26, 2002 Acknowledgments This study was partly supported by the University of Tsukuba Research Project. Offprint requests to: S. Adachi     

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。     

高血压患者血尿酸水平变化与肾损害的关系

目的探讨高血压患者血尿酸(UA)浓度变化与肾脏损害的关系。方法随机选择126例高血压住院患者,分为高血压未发生肾损害组(n=58)、高血压早期肾损害组(n=41)、高血压临床肾损害组(n=27),以67例血压正常者作为对照,检测血清UA、肌酐(Cr)、尿素(Urea)和尿微量白蛋白(m-Alb)、尿N-乙酰-β-D-氨基葡萄糖苷酶(NAG),进行比较分析。结果126例高血压患者的UA为(334.7±96.0)μmol/L,67例对照组UA为(226.4±54.6)μmol/L熏两组有显著性差异(t=8.526,P<0.001)。高血压组高UA血症发生率为24.60%,对照组高UA血症发生率为2.98%,两组有显著性差异(χ2=14.42,P<0.01)。高血压早期肾损害组血UA水平为(325.5±87.4)μmol/L,与高血压未发生肾损害组的穴323.4±85.9)μmol/L无显著性差异(t=0.119,P>0.05),高血压临床肾损害组UA(372.8±117.8)μmol/L明显高于高血压未发生肾损害组(t=2.165,P<0.05)。血UA与m-Alb、Urea呈正相关(r=0.209、0.593,P<0.05、P<0.01)。结论高血压患者血UA与肾脏损害存在着一定的关联,高血压并发明显肾损害是引起血UA增高的一个原因。