Experimental selective segmental ablation of rat liver by transportal ethanol injection

For use in the treatment of malignant hepatic tumors, we undertook selective segmental ablation of the liver by transportal ethanol injection, first studying its efficacy and safety in rats. We forced a 4: 1 mixture of ethanol and contrast medium from a syringe into hepatic tissues via a branch of the portal vein in 80 Wistar rats. The amount of ethanol injected was from 0.05 to 0.60 ml. Soon after the injection, the hepatic segment treated with ethanol was yellowish-white with a distinct outline. Two to three weeks after the injection, the segment was completely necrotic. The findings when a mixture of ethanol and India ink was injected suggested that the necrosis was a direct result of the ethanol. The portal branch into which the injection was made was completely obstructed immediately after the injection. The maximum ethanol concentration in the peripheral blood was 0.4 mg/ml. No histological changes were found in any other organ. Liver and kidney function was almost unaffected. This technique might be useful clinically for the treatment of malignant hepatic tumors. Correspondence to: T. Kaminou     

Klippel-Feil syndrome: patterns of bony fusion and wasp-waist sign

Cervical spine radiographs of 33 patients with Klippel-Feil syndrome were studied for patterns of bony fusion and presence of wasp-waist sign. Five patients were found to have the classic features of massive cervical fusion. Two patients with two adjacent levels of bony fusion showed a wasp-waist sign. Fusion at one level of the cervical spine accounted for 26 remaining cases. The wasp-waist sign was observed in 14 of the cases in which there was complete vertebral interbody fusion, making this finding a valuable radiologic sign. Partial anterior or posterior vertebral interbody fusion, or isolated fusion of the neural arch, however, may or may not be associated with the wasp-waist sign. Klippel-Feil syndrome, easy to recognize when presenting with classic features or when associated with the wasp-waist sign, may be confused with a variety of other entities.     

超选择性肾动脉碘油-无水乙醇乳化液栓塞术治疗肾肿瘤

目的探讨肾动脉内碘油-无水乙醇混合物栓塞治疗肾肿瘤的效果。方法收集20例肾脏恶性肿瘤和良性肿瘤,采用同轴微导管超选择性肾动脉插管,以容积比为2∶1的碘油-无水乙醇乳化液栓塞肾肿瘤供血血管各分支,术后4周复查肾动脉造影,酌情重复治疗,定期随访。结果18例经一次栓塞肿瘤坏死彻底,栓塞后4周,肿瘤供血中断。其中肾癌及肾转移癌体积减小在50%以上13例,占81.3%,碘油聚集良好;2例重复治疗1次,临床症状明显减轻。结论超选择性肾动脉碘油-无水乙醇乳化液栓塞术,可以在最大限度保护肾功能的前提下,在毛细血管水平栓塞肿瘤所有供血血管,达到永久性栓塞的效果,疗效肯定,值得推广。     

Uterine artery embolisation for uterine fibroids: Our experience at a tertiary care service hospital

Background

Uterine artery embolisation (UAE) has evolved as a minimally invasive and effective alternative, treatment modality for women with symptomatic fibroids. We discuss our initial experience of UAE in the management of symptomatic fibroids.

Methods

Twenty five symptomatic patients of uterine fibroids were treated with UAE by selectively cannulating and injecting poly vinyl alcohol particles into the uterine arteries. Post treatment follow up was done at 2 and 6 months respectively.

Results

Pre-treatment, the sizes of fibroids were between 3.9 and 10.9 cm (mean 7.4) on ultrasonography. Of the total 25 patients, 49 uterine arteries were embolised with a technical success rate of 98%. Menorrhagia persisted in 7 patients, dysmenorrhea in 4 patients and pressure symptoms in 2 patients respectively in follow up study of six months which corresponds to a reduction in symptoms by 68% for menorrhagia, 71% for dysmenorhoea and 75% for those with pressure symptoms respectively. At 2 months follow-up post embolisation, the mean diameter of the fibroid was 4.03 cm (range 2–5.2 cm) and at 6 months 3.2 cm (range 1.3–4.1 cm), corresponding to size reduction of 45.5% and 57%, respectively. Follow up with ultrasonography at 2 and 6 months period showed successful fibroid reduction in 24 patients with corresponding reduction in the symptomatology. One patient remained symptomatic with increase in fibroid size and had to undergo hysterectomy.

Conclusion

Uterine artery embolisation can be considered as an alternative to hysterectomy in appropriately selected symptomatic patients of uterine fibroids.     

利培酮治疗酒精所致精神障碍的疗效分析

目的 :探讨利培酮治疗酒精所致精神障碍的疗效.方法 :选取了80例酒精所致精神障碍患者,按随机数字表法分为两组,氯丙嗪组(39例)口服氯丙嗪片治疗,利培酮组(41例)口服利培酮片,通过观察两组治疗前后PANSS评分,HAMA,HAMD,Fugl-Meyer评分及随访期间不良反应发生情况,评价利培酮治疗酒精所致精神障碍的疗效.结果 :治疗前两组阳性症状、阴性症状、精神病理及PANSS总分对比,无统计学差异.治疗后,两组阳性症状、阴性症状、精神病理及PANSS总分均明显下降,且利培酮组患者阴性症状、精神病理及PANSS总分较低.治疗前两组HAMA和HAMD、Fugl-Meyer评分对比,无统计学差异,治疗后两组HAMA和HAMD评分均明显降低,且观察组分值更低.治疗后两组Fugl-Meyer评分均明显增加,且观察组分值更高,治疗期间,氯丙嗪组震颤、视物模糊的发生率明显高于利培酮组.结论 :利培酮对酒精所致精神障碍具有较好的疗效,能改善患者焦虑、抑郁情绪,提高患者运动和协调功能.用药后主要不良反应为锥体外系反应,严重不良反应为心动过速,故应服药期间应重点监测患者锥体外系反应和心功能.     

聚乙烯醇-卟啉新型纳米颗粒的制备及其光热特性

目的 将一定比例的脱镁叶绿酸引入聚乙烯醇-硫辛酸聚合物中,分析其理化性质及光热特性.方法 采用“一步法”合成聚乙烯醇-硫辛酸-脱镁叶绿酸(PLP)聚合物,激光粒径测定仪测定PLP纳米颗粒(PLPN)的粒径、多分散系数和ζ电位,电镜下观察形态,分光光度法和热成像仪初步探索其体外荧光和光热特性;建立卵巢癌裸鼠模型,行初步的体内实验评价.结果 合成的PLP聚合物在水相中自组装形成规则的球状纳米颗粒,电镜下呈紧密的球状结构,平均粒径、多分散系数和ζ电位分别为(22.92±9.00)nm、0.117±0.056和(-25.43±0.77)mV;PLPN在磷酸盐缓冲液(PBS)中的荧光强度明显低于十二烷基硫酸钠(SDS)溶液(P＜0.05),而近红外光照后温度明显高于SDS溶液(P＜0.05);在荷瘤裸鼠模型中,PLPN可靶向聚集在肿瘤部位,近红外光激发后能明显提高肿瘤部位的温度,并能杀伤肿瘤细胞.结论 PLPN发射红色荧光,能靶向聚集在肿瘤部位并行活体显像,且在体内外均具有显著的光热转换特性,在体内能有效抑制肿瘤的生长.     

肝移植治疗终末期酒精性肝病

目的评价肝移植治疗终末期酒精性肝病(alcoholic liver disease,ALD)的可行性及疗效。方法回顾性地分析中山大学附属第三医院2003年12月至2007年4月进行的18例终末期ALD病人接受肝移植治疗后的生存情况及主要并发症发生率。结果18例ALD和229例非ALD良性终末期肝病病人肝移植术后1、2、3年存活率分别为88.9%、77.8%、77.8%和90.4%、84.0%和78.2%,两组间存活率的差异无统计学意义(P=0.778)。两组术后并发症的发生率分别为:肺部感染44.4%(8/18)和33.2%(76/229)(P=0.538),胆道并发症16.7%(3/18)和24.9%(57/229)(P=0.574),动脉并发症11.1%(2/18)和7.0%(16/229)(P=0.628),排斥反应11.1%(2/18)和6.6%(15/229)(P=0.357)。ALD组术后5.6%(1/18)恢复少量饮酒,没有病人重新出现酒精依赖。结论肝移植是治疗终末期酒精性肝病的有效手段,术后生存情况和非ALD良性终末期肝病接近。感染性并发症是ALD肝移植术后最主要的死亡原因,移植后应加强感染性并发症的监测和治疗。     

红蓝光治疗痤疮临床疗效观察

目的:探讨红蓝光照射治疗痤疮的临床疗效和安全性。方法:将113例轻、中度痤疮患者分为两组,实验组采用本院自制的克林霉素醇溶液联合红蓝光照射治疗,对照组仅外用本院自制的克林霉素醇溶液治疗。采用痤疮综合分级系统(GAGS)评价治疗前、后疗效。结果:实验组和对照组有效率分别为82.8%和43.6%,两组的治疗有效率存在显著性差异(P<0.01)。GAGS综合分值均较治疗前明显下降(P<0.01),但实验组下降更显著。结论:红蓝光治疗面部轻、中度痤疮安全有效。     

兔软骨细胞在可注射温敏型壳聚糖/聚乙烯醇凝胶中生长的研究

目的 探讨以壳聚糖(CS)和聚乙烯醇(PVA)制备的可注射温敏型凝胶作为兔软骨细胞生长支架的可行性.方法 将壳聚糖和聚乙烯醇溶液混合制成温敏型凝胶,取第三代软骨细胞接种于凝胶支架,于接种后24、48和72 h采用MTT测定细胞活性及毒力;于1、2及3周后采用扫描电镜及共聚焦激光扫描荧光显微镜观察软骨细胞在凝胶中的形态及生长状态.结果 MTT结果显示接种细胞数量随着接种细胞生长时间的推移而明显增加,各组之间差异有统计学意义(P＜0.05).扫描电镜及激光共聚焦荧光显微镜观察表明软骨细胞在CS/PVA凝胶支架中生长良好.软骨细胞在凝胶支架中保持了很高的增殖能力,材料对细胞无明显不良反应.结论 壳聚糖/聚乙烯醇混合凝胶可作为兔软骨细胞培养的生长支架,应用于软骨组织工程.     

低度酒蒸馏方程的推导

根据蒸馏酒理论采用微积分方法，以酒精质量分数与相对密度的对照表以及蒸馏时原酒液质量分数与蒸馏液质量分数对照表两组基础数据为依据，推导了原酒液酒度随蒸馏体积分数变化的关系方程式，进一步推导了以低度酒为原料进行蒸馏的蒸馏液酒度随蒸馏液体积变化的方程式，该方程可用于蒸馏过程酒度控制。