影响直肠癌全直肠系膜切除术预后因素

目的：探讨影响直肠癌全直肠系膜切除术预后的主要因素.方法：选取2000年7月至2002年6月间的102例行直肠癌全直肠系膜切除术的病人作为研究对象,回顾性分析病人临床资料.结果：102例行直肠癌全直肠系膜切除术的病例,失访4例,失访率为3.9%,现存活96例,10例术后复发和转移,复发率为10.2%,91例术后性生活无显著障碍,99例泌尿功能基本正常.结果表明影响直肠癌全直肠系膜切除术预后存在因素.结论：直肠癌全直肠系膜切除术可以减少术后复发和转移,减少患者术后泌尿和性功能方面的并发症,可提高病人生活质量的保证.     

肝铸型标本肝静脉吻合的观测及临床意义

目的：观察肝静脉之间的吻合情况；方法：观察88个铸型标本中肝静脉侧支吻合的出现率，并对一例有丰富吻合支的肝脏用游标卡尺测量吻合中点处的直径；结果：88个肝铸型标本中有侧支吻合22例，显示率25％；1例丰富吻合标本，其中有17处吻合，最大直径为2．28mm，最小直径为0．62mm。副肝静脉与肝静脉吻合3处；结论：在肝静脉结扎或病理变化后，侧支循环开放、增多，受累肝段与未受累肝段间发生浅表和深部肝静脉侧支吻合，使得肝内血管解剖变得异常复杂而完全不同于正常解剖结构，为肝外科手术中处理肝静脉提供了解剖学依据。     

输精管精索部的应用解剖

目的：为输精管结扎术、吻合术的临床应用提供形态学基础。方法：选用３０具成人男性尸体对输精管精索部进行了解剖学观测。结果：输精管精索部位于精索后方，睾丸动脉位于中央，静脉位于最前方，生殖股神经生殖支位于输精管精索部外侧。输精管精索部长左侧７．６±２．９（５０～１１．３）ｃｍ；右侧７．３±３．２（５．２～１１．０）ｃｍ。其内径左、右侧均为０．６±０．１（０．４～０．８）ｍｍ。经统计学处理（Ｐ＞０．０５）左右侧均无显著性差异。结论：在输精管结扎术、吻合术手术时应注意保护输精管外侧的生殖股神经生殖支、输精管精索部管径小、壁厚、吻合成功率高。因管径小、术后不宜安放支架，以免术后引起管腔阻塞。     

临床1～3级肝管剖开术相关的解剖组织学研究

用31具成人正常肝标本人工镂空,赛璐璐灌注正常新鲜尸肝6具,观察和测量了1～3级肝管长度、周径和夹角以及与肝动脉、门静脉相互关系;正常尸肝15具和30例肝内胆管结石并狭窄的肝标本,光镜观察各级肝管壁组织结构和病理改变。讨论了胆管结石存在部位,高位肝管剖开取石和行胆肠吻合术的术式选择及注意事项。     

异种脱细胞真皮基质在开放性乳突病变切除术中的应用

目的探讨开放性乳突病变切除术后加速乳突术腔上皮化及缩小乳突术腔的有效办法。方法63例行开放性乳突病变切除术的患者按照复查治疗方法分为两组，异种脱细胞真皮组36例，应用异种脱细胞真皮基质覆盖术腔，碘仿纱条组27例，以碘仿纱条填塞术腔。术后随访两组患者，对比观察术腔愈合情况和上皮化时间。结果异种脱细胞真皮组术腔上皮化时间为2～4周，平均2．2周；碘仿纱条组术腔上皮化时间为9～35周，平均13．7周，异种脱细胞真皮组的上皮化时间短于碘仿纱条组（P〈0．01）。结论异种脱细胞真皮基质可促进上皮组织再生，减少术后感染及肉芽发生，加速乳突腔上皮化，提高开放性乳突病变切除术的疗效。     

The hepatic arterial blood flow response to portal vein occlusion in the dog

The acute effect of portal vein occlusion on hepatic arterial blood flow was studied in a group of nine anaesthetised dogs. The influence of hepatic artery denervation and total liver denervation on the hepatic arterial flow response was determined subsequently. Blood flows in the hepatic artery and portal vein were measured with electromagnetic flowmeters, and hepatic tissue perfusion with⁸⁵Krypton clearance. A side-to-side mesocaval shunt was constructed to provide a drainage channel for the mesenteric venous blood during the periods of portal vein occlusion.Occlusion of the portal vein produced an immediate and significant increase in hepatic arterial flow which was sustained at approximately 80% above control for the 6 min period of observation. Total liver blood flow and hepatic tissue perfusion were both significantly reduced by about 40%. Denervation either of the hepatic artery alone or the entire liver produced no change in the response, and it is concluded that there is no neurogenic component either initiating or modifying the early changes in hepatic arterial flow.     

Real-time PCR method for the quantitative analysis of human T-cell receptor gamma and beta gene rearrangements

Analyzing the status of T-cell receptor (TCR) gene rearrangements has been an essential part of deciphering the stages of thymocyte development, understanding the β vs. γδ lineage decision, and characterizing T-cell leukemias. Methods such as PCR and quantitative Southern blotting provide useful information, but also have significant shortcomings such as lack of quantitation in the case of PCR and technical challenges in the case of Southern blotting. Here we describe a real-time PCR method that overcomes many of these shortcomings. This new method shows comparable results for the fraction of unrearranged TCRγ and TCRβ genes in human thymocytes and peripheral blood T cells as Southern blotting, and has the advantages of being simple to perform, highly quantitative, and requiring nanogram quantities of DNA. We also describe a real-time PCR method to quantitate T-cell receptor excision circles formed during TCRβ rearrangements.     

肱骨髁上骨折合并肱动脉损伤的诊治

目的：为探讨肱骨髁上骨折合并不同类型肱动脉损伤的诊断与治疗。方法：采用交区克氏针固定骨折，应用机械扩张、血管探查、修补、吻合等措施修复肱动脉。结果：16例于术中探查肱动脉，有断裂伤、刺破伤及顽固性痉挛，均采用手术治疗，使前臂血运得到恢复，骨折得到固定。本组除1例因伤后24小时入院出现前臂缺血性肌挛维、1例因严重粉碎性骨折术后肘关节活动中度受限外，14例均恢复良好，结论：肱骨髁上骨折台井脏动脉损伤的后果严重，但通过及时诊断和有效手术治疗、预后良好。     

左肝管全程剖开胆肠吻合术的应用解剖学研究

左肝管全程剖开手术,必须熟悉左肝管与邻近血管的局部解剖关系.为此我们用 ABS 丙酮溶液灌注塑型了6具新鲜成人尸肝脏,解剖40例(成人30,儿童10)肝脏标本,测量了左肝管长度和管径,左肝管与肝总管夹角。全程剖开左肝管与右肝管,并观察左肝管与右肝管、左肝动脉、门静脉左干和肝圆韧带的关系,提出了右肝管全程剖开手术方法和注意事项。     

丁字形泪囊鼻腔吻合术(附8眼手术报告)

本文报告8眼丁字形泪囊鼻腔吻合术,其中6眼追踪观察廿年获得完全治愈;1眼观察6个月效果良好 1眼愈后不详。同时对主要手术步骤做了介绍,鼻粘膜瓣环钻法改用十字切开法更易于吻合。