重型颅脑伤后胃血流改变的彩超多普勒实验研究

本文对猫颅脑伤模型进行了伤后早期不同时间胃网膜动脉多普勒测定，并对比研究了伤后早期胃血流及其声像图特征。结果显示，实验动物颅脑撞击伤后，收缩期血流峰值速度（ＰＦＶ），舒张末期血流速度（ＥＤＶ）和平均血流速度（ＭＦＶ）３小时测值最大，到６小时又回落接近伤前水平。此外，动脉搏动指数（ＰＩ）和阻力指数（ＲＩ）则随着伤后时间的延长逐渐增大，将上述参数行组间和组内对照，差异显著（ｐ＜０．０５，ｐ＜０．０１）     

CyclinL2在化疗药物杀伤胃癌细胞的增敏作用

目的：探讨cyclinL2基因在化疗药物顺铂（DI）P）、氟尿嘧啶（5-Fu）和多西紫杉醇（Doc）诱导下的胃癌细胞凋亡中的作用。方法选用胃腺癌BCG-823细胞，MTT法检测DDP、5-Fu和Doe不同药物浓度对胃癌细胞生长的抑制作用，以及CyclinL2转染、反义cyclinL2转染后对该细胞生长的抑制作用的影响，同时利用流式细胞术定量检测细胞凋亡。结果不同浓度的化疗药物对该胃癌细胞生长均有明显的抑制作用，并有浓度的依赖性。细胞凋亡率和cydinL2基因表达率成正相关。结论CydinL2基因在化疗药物诱导胃癌细胞凋亡中起重要作用。     

心理干预对胃癌患者心理健康状况的影响

目的探讨心理干预对胃癌患者心理状况的影响。方法对32例胃癌患者进行心理状况调查。根据每个患者的测评结果实施有针对性的心理与行为方式干预措施，比较干预前后患者心理健康状况。结果心理干预前后。除偏执症状外，患者的强迫、人际关系敏感、抑郁、敌对、惊恐、精神病性等维度评分均存在统计学差异（均P〈0．05）。结论心理干预对胃癌患者负性心理状况有明显改善作用。     

MANAGEMENT OF VARICEAL HEMORRHAGE: CURRENT CONCEPTS

Introduction

The treatment of portal hypertension is complex and the the best strategy depends on the underlying disease (cirrhosis vs. schistosomiasis), patient''s clinical condition and time on it is performed (during an acute episode of variceal bleeding or electively, as pre-primary, primary or secondary prophylaxis). With the advent of new pharmacological options and technical development of endoscopy and interventional radiology treatment of portal hypertension has changed in recent decades.

Aim

To review the strategies employed in elective and emergency treatment of variceal bleeding in cirrhotic and schistosomotic patients.

Methods

Survey of publications in PubMed, Embase, Lilacs, SciELO and Cochrane databases through June 2013, using the headings: portal hypertension, esophageal and gastric varices, variceal bleeding, liver cirrhosis, schistosomiasis mansoni, surgical treatment, pharmacological treatment, secondary prophylaxis, primary prophylaxis, pre-primary prophylaxis.

Conclusion

Pre-primary prophylaxis doesn''t have specific treatment strategies; the best recommendation is treatment of the underlying disease. Primary prophylaxis should be performed in cirrhotic patients with beta-blockers or endoscopic variceal ligation. There is controversy regarding the effectiveness of primary prophylaxis in patients with schistosomiasis; when indicated, it is done with beta-blockers or endoscopic therapy in high-risk varices. Treatment of acute variceal bleeding is systematized in the literature, combination of vasoconstrictor drugs and endoscopic therapy, provided significant decline in mortality over the last decades. TIPS and surgical treatment are options as rescue therapy. Secondary prophylaxis plays a fundamental role in the reduction of recurrent bleeding, the best option in cirrhotic patients is the combination of pharmacological therapy with beta-blockers and endoscopic band ligation. TIPS or surgical treatment, are options for controlling rebleeding on failure of secondary prophylaxis. Despite the increasing evidence of the effectiveness of pharmacological and endoscopic treatment in schistosomotic patients, surgical therapy still plays an important role in secondary prophylaxis.     

Anaesthesia for obesity surgery

The aim of this article is to give a brief but comprehensive overview of the current management of the patient undergoing bariatric (weight loss) surgery. This article will discuss the different types of obesity surgery commonly performed, and the practical aspects of how to manage these patients both perioperatively and postoperatively. The principles described can be utilised in the management of obese patients attending for other types of surgery.