多体位短间隔及加压追踪法全消化道钡餐检查的临床分析

目的:探讨多体位、短间隔及加压追踪法在全消化道钡餐透视检查的应用价值。方法:回顾性分析34例经手术病理确诊或内科治愈或钡餐明确诊断(憩室)的X线表现。年龄12岁81岁,男19例,女15例。采用多体位、短间隔加压追踪法的全消化道钡餐透视检查。结果:空肠近段神经鞘瘤并溃疡出血1例,先天性巨小肠1例,小肠粘连连带压迫空肠近段并不完全性肠梗阻1例,回盲部腺癌并不完全性肠梗阻1例,阑尾切除术后回肠末段肠粘连并不完性肠梗阻1例,美克尔憩室炎并周围溃疡伴不完全性肠梗阻1例,空回肠多发憩室4例,空肠炎9例,回肠炎5例,空回肠炎3例,肠激惹综合征3例。结论:多体位、短间隔加压追踪法全消化道钡餐透视检查,检出率较高,在小肠疾患的检查中有重要的临床意义。     

Permanent prostate brachytherapy for Japanese men: Results from initial 100 patients with prostate cancer

OBJECTIVE: To evaluate the initial results of brachytherapy for prostate cancer with permanent iodine-125 implant in Japan. METHODS: The results obtained with brachytherapy in the initial 100 Japanese patients treated at Nagano Municipal Hospital were reviewed. Patients with a prostate-specific antigen (PSA) level of less than 10 ng/mL and a Gleason's scores of 5, 6, 3 + 4 were classified as having a low risk of recurrence. Patients with a PSA level of 10-20 ng/mL and/or a Gleason's score of 4 + 3 were classified as having an intermediate risk for recurrence. Seventy-eight of the low-risk patients and 19 of the intermediate-risk patients were treated by seed implants alone, or seed implants combined with preceding external radiation, respectively. A total of 53 patients received neoadjuvant hormone therapy. The efficacy and morbidity of brachytherapy were investigated using the serum PSA, International Prostate Symptom Score, quality of life score and uroflowmetry data. RESULTS: The average V100 and D90 obtained by post-implant dosimetry was 94.3 and 113.7%, respectively. Serum PSA decreased gradually after treatment, although it had still not reached a nadir after 1 year. There was little difference of the PSA level between the patients with and without neoadjuvant hormone therapy even at 1 year after seed implantation. There were no PSA biochemical failure or clinical recurrence during the follow-up period. Voiding symptoms worsened until 3 months after treatment, and then gradually improved. Acute urinary retention occurred transiently in one patient (1%). Rectal bleeding and severe diarrhea did not occur. CONCLUSION: Brachytherapy is a feasible and effective option for the treatment of prostate cancer in Japanese men. Brachytherapy may have a different effect in Japanese patients with respect to voiding symptoms. Urinary retention was rare, but voiding symptoms were persistent in Japanese patients. Neoadjuvant hormone therapy deserves investigation to determine whether it can achieve better results, especially in patients with an intermediate risk.     

LOWER POSTPRANDIAL PLASMA GLUCOSE AND INSULIN AFTER ADDITION OF ACACIA CORIACEA FLOUR TO WHEAT BREAD

Many Australian Aboriginal bushfoods contain slowly digested carbohydrate which elicit low postprandial blood glucose and insulin responses compared to Western foods, such as wheat bread. This study has shown that incorporation of flour made from a slowly digested seed, Acacia coriacea , into wheat bread (18 g/82 g wheat flour) significantly reduces the initial rise in plasma glucose levels ( p < 0.05) and the area under the plasma glucose curve ( p < 0.005) in six healthy subjects. Insulin values were also lowered at 60 minutes ( p < 0.025) and 90 minutes ( p < 0.05). Our findings suggest that Acacia flour, when used to dilute wheat flour in the manufacture of breads, produces a very palatable food which could be useful in the diets of diabetic individuals.     

放射性125I粒子组织间植入或联合放化疗治疗复发直肠癌

目的探讨超声或CT引导下放射性125I粒子组织间植入治疗复发直肠癌的技术可行性、近期疗效和副反应.方法 15例直肠癌术后盆腔复发患者,女4例,男11例.硬膜外麻醉,2例经阴道超声引导,13例CT引导,行放射性125I粒子植入术.肿瘤匹配周边剂量为90～110 Gy,每颗粒子活度为0.50～0.70 mCi,植入33～70颗.术后24～48 h拍胸、盆腔X线片了解粒子是否发生移位.术后6例加三维适形放疗,4～6野/次,200～300 cGy/次,5次/周,总剂量为4 500～5 000 cGy,间隔4周.2例粒子治疗后加草酸铂、5-氟尿嘧啶和四氢叶酸化疗1个周期,随访3～15个月,根据CT扫描结果判断肿瘤大小. 结果术后平均7天疼痛缓解,其中12例完全缓解,2例部分缓解,1例无变化,有效率93%(14/15).9例肿瘤完全缓解,2例部分缓解,4例局部进展,局部控制率73%(11/15).2例术后6个月和12个月时死于肺转移.1例1颗粒子移位至盆壁,随访12个月无症状.无治疗相关并发症和副作用发生. 结论经超声或CT引导放射性125I粒子植入治疗复发直肠癌具有安全、微创、并发症发生率低和疗效肯定等优势,粒子治疗后应配合外放疗和全身化疗,有望进一步提高疗效.     

车前子对高脂血症大鼠脂质过氧化的影响

目的 :　探讨车前子对高脂血症大鼠脂质过氧化的影响。方法 :　采用大鼠血清及多脏器组织 ,观察车前子对高脂血症大鼠脂质过氧化的影响。结果 :　高脂对照组血清和心肌超氧化物歧化酶 ( SOD)活性显著降低 ,而脂质过氧化物 ( LPO)含量明显升高 ,血清和肝脏的过氧化氢酶( CAT)、谷胱苷肽过氧化物酶 ( GSH-Px)活性明显降低。补充车前子后显著升高血清及心肌组织SOD活性 2 2 %和 2 8% ,以及肝脏 GSH-Px活性 2 2 %。而使血清及心肌的 LPO含量分别下降 3 2 %和 1 7%。结论 :　 1 5 g/kg车前子可提高高脂血症大鼠体内抗氧化能力并免受自由基损伤     

大承气颗粒剂对胃肠动力影响的影像观察

目的 :探讨大承气颗粒剂对健康人群胃肠道动力的影响。 方法 :利用加入大承气颗粒剂钡餐造影技术 ,通过监视器、录像和摄片观察记录造影剂由胃排入十二指肠、十二指肠排入空肠、空肠排入空回肠、空回肠排入回肠、回肠排入回盲部的时间 ,结肠排出时间以及造影全过程总时间。受试者分三组各 3 0人。一组大承气颗粒剂组 (大承气组 ) ;二组为甘露醇组 ;三组为常规钡餐组。 结果 :大承气组除胃排入十二指肠、十二指肠排入空肠的时间与常规钡餐组比较无明显差别外 ,余各组小肠的排入时间、结肠排出时间以及造影全过程总时间与常规钡餐组比较P <0 0 5,与甘露醇组比较无明显差异。 结论 :大承气汤颗粒剂具有提高肠道张力、促进其推进作用     

手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌

目的探讨手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌的可行性和临床疗效. 方法2002年2月～2004年8月,我院行手助腹腔镜胆肠、胃肠内引流术联合125I粒子置入术治疗晚期胰腺癌12例(胰头癌10例,胰体癌2例). 结果 12例手术均获成功.手术时间104～181 min,(122±29) min.术中出血量45～152 ml,(60±18) ml.住院时间6～17 d,(8.5±1.3) d.术后病人黄疸逐渐减退,术后7～10 d肝功能恢复正常.腹痛消失3例,明显缓解7例.2例出现胃肠功能障碍,治疗后缓解.10例术后随访6个月复查CT肿瘤明显缩小(PR)4例,无变化(NC)4例,肿瘤进展(PD) 2例. 结论手助腹腔镜内引流术联合癌组织间125I粒子置入术是治疗晚期胰腺癌,使其缓解症状的有效方法,具有创伤小、恢复快、能改善病人生活质量.     

125I粒子组织间种植对人胃癌裸鼠移植瘤的杀伤作用

目的 观察不同剂量^125I粒子对人胃癌裸鼠移植瘤的杀伤作用及组织损伤。方法 建立人胃癌BGC-823细胞裸鼠皮下移植瘤模型，随机分为对照组和实验组，将不同剂量（100、120、140Gy）地^125I粒子植于实验组。30、60d：比较移植瘤抑瘤率，病理组织学、局部皮肤反应、裸鼠体重及白细胞计数。结果30d，100、120、140Gy组抑瘤率分别为51．93％、79．18％、90．22％，病理组织学反应程度多为RCRG2（45．83％），各实验组组间除120Gy与140Gy（P〉O．05）组外，及分别与对照组比较，差异有统计学意义（P〈0．05）；局部皮肤反应各实验组与对照组比较，差异有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）。60d，各组抑瘤率分别为97．97％、100％、96．69％，病理组织学反应程度以RCRG1居多（62．5％），与对照组比较，差异均有统计学意义（P〈0．05），各实验组组间差异无统计学意义（P〉0．05）；局部皮肤反应随剂量增高而加重，各实验组组间及其分别与对照组比较，差异有统计学意义（P〈0．05）。结论 不同剂量的^125I粒子在不同时间对人胃癌裸鼠皮下移植瘤有显著杀伤作用，但120Gy和140Gy组随剂量累积，损伤明显增加。提示100Gy可能是治疗人胃癌裸鼠皮下移植瘤的有效剂量。     

Post-prandial cardiovascular responses in man after ingestion of carbohydrate,protein or fat

Changes in cardiac output and in superior mesenteric arterial flow were followed with Doppler ultrasound techniques in five young, healthy persons for 2 h after ingestion of medium-sized (4 MJ), fluid meals containing either carbohydrate, protein, fat or water only. Measurements were carried out before meals and at regular post-meal intervals, during which mean arterial blood pressure was also followed. All energy-containing meals caused marked and gradually developing post-prandial increases in cardiac output as well as in superior mesenteric arterial flow. The maximum flow levels were reached in the course of 30–60 min and maintained until the observations ended after 2 h. The intake of water caused no such flow increases. There were considerable interpersonal variations in the size and in the speed of development of the flow increases after the three types of energy-containing meals. The flow-increasing effects of the three meal types were not significantly different, even if the most marked increases (median values about 1 1 min^-1 for both cardiac output and superior mesenteric arterial flow) occurred after carbohydrate meals. The marked effects on circulation of the three food components were also revealed in the calculated, integrated amounts of ‘extra’ cardiac output and superior mesenteric arterial flow observed in the course of the 2 h following the meal. Values of more than 100 1 for such ‘extra’ flows were seen after carbohydrate meals. The marked ingestion-released increase in blood flow to the splanchnic organs is apparently partly met by an increase in cardiac output, and partly by some redistribution of flow, which benefits the digestive system.     

放射性~(125)I粒子组织间植入对家兔尿道损伤的实验研究

目的:研究不同剂量的放射性125I粒子对家兔尿道的放射性损伤。方法:麻醉下将放射性125I粒子植入雄性家兔尿道旁1.0cm处。125I粒子的放射性粒子活度分别为14.8MBq(A组)、29.6MBq(B组)和44.4MBq(C组),对照组(D组)仅尿道旁种植相当于粒子大小无放射性的无菌铅管1粒。植入后4周,摄尿道片,观察粒子位置等情况;原手术切口切开,取放射粒子周围2.0cm范围内的家兔尿道组织作肉眼、光学显微镜和电子显微镜观察,进行放射性损伤的评价。结果:术后4周,肉眼及光学显微镜观察,实验组与对照组粒子周围的尿道粘膜、粘膜下及肌层所见基本一致;C组少部分电镜视野中观察到尿道上皮胞质出现较多空泡变性、空化、嵴稀疏等超微结构的损伤。光镜下尿道入射性损伤评分,A、B、C、D组分别为(2.20±0.18)、(2.23±0.15)、(2.27±0.10)、(2.10±0.17)分,A、B、C组与D组相比,差异无显著性(P>0.05)。对线粒体作FlaMeng半定量分析,A、B、C、D各组评分分别为(1.23±0.13)、(1.34±0.25)、(1.41±0.30)、(1.12±0.13)分,A、B、C各组与D组(对照组)相比,差异无显著性(P>0.05)。结论:放射性125I粒子对尿道放射性损伤随粒子的放射性活度的增加而逐渐加重,呈明显的放射性活度效应关系;正常剂量的放射性粒子对尿道的损伤是很轻微的,是安全可行的。