射频消融在脾脏疾病中的应用现状

射频消融（radiofrequency ablation,RFA）是一种良好的消融、凝血工具,较早应用于肝外科疾病手术,其作用已经从单纯消融肝脏肿瘤扩展到无血肝切除。然而RFA在脾脏疾病中应用相对局限,其临床价值似乎被低估。本文总结RFA在脾脏各种疾病中的应用,以期为临床拓展思路,为RFA在脾脏疾病的应用提供参考。     

健肌宁对实验性重症肌无力大鼠差异蛋白表达的调节作用

目的:观察中药复方健肌宁对实验性自身免疫性重症肌无力(experimental autoimmune myasthenia gravis,EAMG)大鼠脾脏差异蛋白表达的调控作用。方法:制备实验性EAMG大鼠模型,随机分为模型组、中药复方健肌宁组、强肌健力胶囊组和醋酸泼尼松龙组。采用双向电泳-串联质谱法分离和鉴定EAMG大鼠脾脏和正常组间的差异表达蛋白,并观察应用健肌宁、强肌健力胶囊和醋酸泼尼松龙连续干预4周后,各组差异蛋白表达水平的变化。结果:在已鉴定的12个疾病相关蛋白中,健肌宁对于同种异体移植炎性因子-1、过氧化氢酶Ⅰ和肌动蛋白相关蛋白2/3复合体亚单位5的蛋白表达水平有显著调控作用(P<0.01),这些蛋白多与免疫反应和细胞运动密切相关。结论:EAMG大鼠与正常大鼠间有差异蛋白表达,具有补益脾肾作用的中药复方健肌宁可以调节部分差异蛋白的表达水平。     

健脾益气方对脾气虚型更年期综合征糖脂影响的临床研究

 目的 观察健脾益气方改善脾气虚型更年期综合征(climactericsyndrome, CS)症状及调节内分泌代谢的临床疗效。方法 取脾气虚型的更年期综合征患者30例作为病例组,另取年龄匹配的无明显更年期综合征症状的更年期女性20例作为对照组。检测两组血清瘦素（leptin）、胰岛素(insulin, INS)、睾酮(testosterone,T)、胆固醇(total cholesterol, TC)、甘油三脂(triglycerides, TG)、低密度脂蛋白(low density lipoprotein, LDL)、高密度脂蛋白(high density lipoprotein, HDL)、空腹血糖(Blood glucose, BG)、餐后两小时血糖(2hBG)、胰岛素敏感指数(Insulin sensitivity index, ISI)、卵泡刺激素(follicle stimulating hormone, FSH)、黄体生成素(luteinizing hormone, LH)和雌二醇(estradiol, E2),测量两组腰围(waist circle, WC)、体重指数(Body mass index,BMI)和腰臀比(waist hip ratio, WHR),以及对病例组进行Kupperman评分、中医脾气虚证候评分,比较病例组与对照组检测指标的组间差异;病例组中24例作为中药组,采用健脾益气方治疗4周,比较治疗前后Kupperman评分、中医脾气虚证候评分及WC、BMI、WHR、Leptin、 INS、T、ISI、BG、2hBG、TC、TG、HDL、LDL、E2、LH、FSH。结果 病例组和对照组E2、T、FSH、LH水平无显著性差异(P >0.05);病例组和对照组WC、BMI、WHR及BG、 INS、 ISI、 Leptin比较病例组高于对照组,差异有统计学显著意义(P<0.05);病例组和对照组TC、TG、HDL、LDL比较虽无显著性差异(P>0.05),但病例组血脂水平均高于对照组;中药组治疗前后T、E2、FSH、LH无显著性差异(P >0.05);治疗后BG、血脂有下降趋势;血INS, Leptin下降而ISI增高有统计学差异(P<0.05);治疗后kupperman评分和脾气虚评分均显著下降有统计学差异（P<0.01）;结论 更年期综合征存在能量物质的代谢障碍;雌激素水平低下可能并不是引起脾气虚型更年期综合征症状以及糖脂代谢异常的唯一因素;INS、Leptin分泌异常可能是脾气虚型更年期综合征发病以及导致糖脂代谢异常的不可忽略的因素;健脾益气方能有效改善脾气虚型更年期综合征症状及调节INS、Leptin的异常。     

可视化仿真手术在胰腺和脾脏手术中的应用研究

目的 研究基于64排螺旋CT胰腺和脾脏扫描数据的三维重建和可视化仿真手术.方法 采集胰腺和脾脏CT的扫描数据,通过自适应区域生长法对CT序列图像进行程序分割和提取,再采用自行开发的医学图像处理软件对分割后的图像数据进行三维重建,然后利用FreeForm Modeling System和PHANTOM软件进行胰腺和脾脏的可视化仿真手术.结果 利用自适应区域生长法对胰腺和脾脏CT图像进行程序分割速度快、效果好.用自行设计的图像处理软件进行三维重建,图像结构清晰,可真实再现胰腺和脾脏的解剖结构.通过Freeform Modeling System和PHANTOM可以进行和实际手术过程一样的可视化仿真手术.结论 基于螺旋CT数据的三维重建和可视化仿真手术,对胰腺和脾脏等腹部脏器的个体化手术方案制定、风险评估、临床教学训练等方面都有很大的应用价值.     

“白血”之古籍探微

"白血"一词首次出现在《素问·至真要大论》。通过检索古籍,分析归纳历代医家对"白血"一词的有关论述,归纳针对其本质的探讨,有"肺血""肾精""脾痰"三种观点。对《内经》原文条分缕析,认为"白血"实乃燥气所胜、金实乘木,所吐之"肺血肺阴",并总结历代医家关于"白血"之治法,以丰富对"白血"的认识。     

Composite hemangioendothelioma of the spleen with multiple metastases: CT findings and review of the literature

Composite hemangioendothelioma (CHE) is a rare vascular neoplasm of intermediate malignant potential. Only 52 cases have been reported in the English literature, and one case previously reported occurred in the spleen. The purpose of our study was to report a 65-year-old man diagnosed as CHE primary arising from the spleen with multiple metastases.Clinical and imaging features, laboratory tests, and pathological results about CHE were described in detail in this study.The patient presented with multiple lesions in bilateral lungs and spleen that had been incidentally detected by computed tomography (CT). Except for thrombocytopenia, other laboratory tests were not significant. The CT scan of the abdomen revealed multiple round-like and irregularly mixed density masses with unclear borders in enlarged spleen. And contrast enhancement showed mild heterogeneous enhancement. CT scan also showed widespread liver, ribs, lungs, and vertebral bodies metastases. This diagnosis was confirmed by histopathological examination. The patient underwent splenectomy and still survives with tumors after six months followed-up.Due to the lack of specificity of clinical features and laboratory tests, it is necessary to combine imaging features and pathological findings to make a correct diagnosis.     

郭霞珍教授活血化瘀法治疗青春期崩漏经验

郭霞珍教授认为肝脾肾三脏的功能失调与青春期崩漏的发生关系密切,如肝郁血热、脾虚失摄、肾精不足等。无论何种原因导致的崩漏,血出日久,或过用固涩药物止血,最终均可发展为血瘀。故临床治疗应以活血化瘀以澄其源,同时针对"瘀"形成的不同原因,佐以疏肝清热、健脾益气或补肾填精,方能取得预期疗效。     

Preparation,characterization and storage of human ferritin for use as a standard for the assay of serum ferritin

Summary. This paper describes studies on the source, preparation, characterization and storage of human ferritin for use as a standard for the immunoassay of serum ferritin. Ferritin was prepared from the liver or spleen by methods including either ultracentrifugation or cadmium sulphate crystallization. Preparations were characterized by polyacrylamide gel electrophoresis in dissociating and non-dissociating buffers, iso-electric focusing, analysis of amino acid composition and measurement of protein content. The protein content of solutions of liver or spleen ferritin may be determined by the method of Lowry with bovine serum albumin as standard. Lyophilization under carefully controlled conditions in buffer containing high concentrations of albumin provides a stable preparation of ferritin. Accelerated degradation and collaborative immunological studies of two lyophilized preparations of ferritin, one from liver and one from spleen, indicate that either is an acceptable reference material.