Lugol液染色对食管早期癌和癌前病变的诊断价值

目的 探讨Lugol液染色对食管早期癌和癌前病变的诊断价值。方法 对45例食管黏膜可疑病变经内镜以2％Lugol液喷洒染色，观察黏膜染色情况，并取活检送病理组织学检查。结果 45例食管病变染色后，39例呈浅染色或不染色，其中食管癌8例（食管早期癌5例，进展期癌3例），Barrett食管5例，轻至中度不典型增生1l例。本组Lugol液染色对食管早期癌和癌前病变的检出率达46．7％。结论 内镜下应用Lugol液染色结合活检有助于食管早期癌和癌前病变的诊断，且操作简便，具有重要的临床价值。     

和儿子过招

我现在能控制自己的生活，但是对于我的准翻版，我投入了许多心愿和期望的儿子，他的成长方向却完全让我不可理解和头痛。[编者按]     

乙肝歧视,大学校园该亮起的红灯

目的:通过调查在校大学生对乙肝的认知程度,使其了解乙肝的传播途径,并针对由乙肝认知误区所引起的大学生乙肝歧视进行讨论,得出相应解决措施,积极创建和谐校园。方法:采用问卷调查的方式对在校的非医学生和医学生进行调查。结果:调查发现,很多大学生都对乙肝有了正确的认知态度,理解了与乙肝患者的平等性。相对较多的大学生对乙肝患者或是乙肝病毒携带者没有明显的生活上的排斥,但是心里仍存在一定的恐惧和歧视。结论:乙肝歧视仍存在于当代大学生之间,要使整个社会对乙肝歧视有所消除,大学生首当其冲要作好消除乙肝歧视,发展和谐校园,让乙肝歧视在校园中亮起红灯。     

Influence of moderate hypothermia on cerebral oxygenation in pigs with intracranial hypertension

BACKGROUND: Moderate hypothermia is one of the effective therapeutic methods for head injury in recent years, there are many mechanisms of moderate hypothermia for brain protection, and its influence on cerebral oxygenation is also one of them. OBJECTIVE: To observe the influence of moderate hypothermia on cerebral oxygenation of animals with acute intracranial hypertension, and further investigate the protective mechanism of moderate hypothermia. DESIGN: A randomized controlled trial. SETTING: Department of Neurosurgery, Renji Hospital affiliated to the Medical College of Shanghai Jiao Tong University. MATERIALS: Twenty healthy little pigs, either male or female, weighing 4.5–5.5 kg, were used. Neurotrend-typed multiparameter monitoring system (Diametrics Company, British); CMA/100 micro-injection pump (Carnegie Company, Sweden). METHODS: The experiment was conducted in the Changzheng Hospital affiliated to the Second Military Medical University of Chinese PLA in November, 2001. The pigs were randomized into two groups: the normothermia group (control group, n =10) and moderate hypothermia group (n =10). ① Bilateral femoral arteries were separated, one was connected to pressometer for monitoring mean arterial pressure (MEP), and the other for analysis of blood gases [including peripheral blood pH value, arterial partial pressure of carbon dioxide (PaCO2), arterial partial pressure of carbon dioxide (PaCO2), HCO3–]. ② Rectal temperature was monitored with mercurial thermometer. ③ Intracranial pressure was monitored using Camino optic ICP probe placed in the subdural space. ④ Neurotrend multiparameter monitoring sensor was inserted into the white matter for about 4 cm to determine cerebral perfusion pressure (CPP, CPP=MAP(ICP), brain tissue partial oxygen pressure (PO2), partial pressure of carbon dioxide (PCO2), HCO3– and brain temperature. The rectal temperature of animals in the moderate hypothermia group was lowered to 34 ℃ using ice bags, and the body temperature was maintained at 33–35 ℃ for 2 hours. The changes of the parameters were observed continuously, and the pigs in the normothermia group were not treated with cooling. MAIN OUTCOME MEASURES: ① MAP, ICP, rectal temperature, CCP; Indexes of cerebral oxygenation detected with Neurotrend-typed multiparameter monitoring system; ② Results of blood gases analysis in the moderate hypothermia group. RESULTS: All the 20 pigs were involved in the analysis of results. ① MAP, ICP, rectal temperature, CCP and indexes of cerebral oxygenation: In the moderate hypothermia group, the ICP after cooling was obviously lower than that before cooling [(3.31±1.19), (5.33±0.95) kPa, P < 0.05], CCP was higher, brain tissue PCO2 [(12.03±1.73), (10.59±2.01) kPa, P < 0.05], and brain tissue pH value was higher [(7.03±1.63), (9.40±1.30) kPa, P < 0.05], whereas the brain temperature was decreased as compared with that before cooling [(34.9±0.3), (37.2±0.2) ℃, P < 0.05]. ② Results of blood gases analysis in the moderate hypothermia group: There were no significant differences in the parameters of peripheral arterial blood gases analysis before and after cooling in the moderate hypothermia group (P > 0.05) CONCLUSION: Moderate hypothermia will not impair the cerebral oxygenation, and it can reduce brain tissue CO2 and decrease brain tissue acidosis.     

Observations on pathological and histochemical changes in piglet livers infected with Taenia saginata asiatica

To study the pathological and histochemical characteristics of lesions in piglet livers infected with Taenia saginata asiatica (T. saginata asiatica) throughout the different stages, piglets were fed with eggs of T. saginata asiatica and raised in isolation in an animal center to establish the T. saginata asiatica infection model with normal piglets as control. The pathological changes in the piglet livers were observed after the infection using liver sections stained with hematoxylin and eosin. Histochemical methods were used to check the changes in lipid, glycogen and protein content in the liver. The data collected by image analysis were analyzed statistically with Statistical Package for the Social Science. The results show that T. saginata asiatica-exposed piglets were indeed infected. Inflammatory reactions began on the fourth day and progressed rapidly. Kupffer cell hyperplasia, hepatic hydropic degeneration and ballooning degeneration were found in the 10th–20th days after infection. Hepatic central veins and hepatic sinusoids were dilated and congested. Spotty necrosis occurred in some local liver tissues. In the 40th–60th days, granulomatous reactions and mild hepatocirrhosis were the main lesions. In the 70th–80th days, hepatocirrhosis and bile duct proliferation were observed in the liver. In the different stages, lipid drops were increased while glycogen and protein levels were decreased to some degree. There was a significant difference in metabolism between the infected group and the control group (P < 0.01). It is concluded that pigs are the favorable intermediate host of T. saginata asiatica and its infection can result in serious pathological and histochemical lesions in host organs. Translated from Journal of Guiyang Medical College, 2006, 31(4): 296–300 [译自: 贵阳医学院学报]     

多囊卵巢综合征患者卵巢间质胰岛素样生长因子受体的表达

目的：探讨肥胖及非肥胖多囊卵巢综合征（ＰＣＯＳ）患者卵巢间质胰岛素样生长因子（ＩＧＦ－Ⅰ）受体基因的定量表达。方法：用逆转录基因扩增技术（ＲＴ－ＰＣＲ），检测３５例ＰＣＯＳ患者（肥胖组１５例，非肥胖组２０例）及２０例正常妇女（对照组）卵巢间质细胞ＩＧＦ－Ⅰ受体ｍＲＮＡ的表达量（灰度比值）。并对ＩＧＦ－Ⅰ受体基因ｍＲＮＡ逆转录的ｃＤＮＡ产物进行限制性内切酶酶切分析。结果：ＰＣＯＳ两组ＩＧＦ－Ⅰ受体基因的表达量显著高于对照组，ＰＣＯＳ两组灰度比值为１．１８４±０．２４０，对照组灰度比值为０．９９９±０．０８６（Ｐ＜０．００１）。非肥胖组（１．２３８±０．３８７）明显大于肥胖组（１．０５８±０．１０９，Ｐ＜０．１）。酶切分析证实，３组ＩＧＦ－Ⅰ受体基因扩增片段相同，ＰＣＯＳ两组未发现明显的碱基突变存在。结论：ＰＣＯＳ患者卵巢间质ＩＧＦ－Ⅰ受体基因呈过度表达。且ＰＣＯＳ非肥胖患者局部ＩＧＦ－Ｉ受体表达高于ＰＣＯＳ肥胖患者。     

钙拮抗药及烧伤血浆对大鼠PBMC内NF-κB活化和炎症介质产生的影响

目的 :探讨外周血单个核细胞 (PBMC)内上游信号分子及核因子 κB(NF κB)在烧伤后炎症级联反应中的作用。　方法 :体外检测在烧伤血浆作用下的PBMC内游离Ca2 及NF κB活化的变化 ,观察钙通道阻断药对NF κB活化及IL 6、NO表达水平的调控作用。　结果 :不同时相点的烧伤血浆可使体外PBMC内Ca2 明显增加 ,培养的PBMC核内NF κB的积聚明显增加 ,培养上清中NO和IL 6高表达。应用尼莫通 (Nimodipine)和丹曲林 (Dantrium)对NF κB的活化有调节作用 ,对IL 6和NO亦有下调作用。　结论 :烧伤血浆可使PBMC内信号分子浓度明显增高 ,NF κB过度活化 ,并易位进入细胞核内 ,NF κB介导的促炎性细胞因子和NO过度表达。两种钙通道阻断药有调控细胞内信号转导的作用 ,对烧伤后全身炎症反应综合征 (SIRS)可能有防治作用     

腹腔镜胆囊切除术前超声内镜检查胆总管必要性的探讨

目的 探讨腹腔镜胆囊切除（laparoscopic cholecystectomy,LC）术前超声内镜（endoscopic ultrasonography,EUS）检查胆总管的临床价值。方法 对25例术前经腹超声检查诊断胆囊结石,胆总管内径〉0.7 cm可疑胆总管梗阻的患者进行EUS检查,并与手术结果或内镜十二指肠乳头切开术（endoscopic sphincterotomy,EST）取石结果进行比较。结果 EUS对于胆总管病变诊断的敏感性、准确性和阴性预测值[100%（17/17）、92%（23/25）、100%（6/6）]均优于经腹超声[35%（6/17）、56%（14/25）、42%（8/19）]（P=0.000,0.008,0.020）。结论EUS对胆总管病变诊断优于经腹超声检查,可作为术前常规检查,特别是当胆总管内径〉1.0 cm时,EUS应作为术前必检项目。