保留贲门功能双腔空肠间位移置胃成形术研究

为解决胃癌根治术后达到Ａ级根治程度,有的必须切除３／４以上的胃,以常规手术式重建消化道,由于胃容量过于减少,术后多产生近期和远期的合并症,为了避免术后这一后遗症,因此,建立设计扩大至正常容量而符合正常生理功能的胃成形术式。其中方法为：将近侧空肠褥经横结后提至结肠上区,做成双脓肠襻形成单筒移置于残留贲门部的胃与十二指肠之间,既保留贲门功能又使其形成之代胃并接近正常容量和生理功能,提高了病人的术后生存     

50例胃印戒细胞癌的病理学观察

目的:探讨胃印戒细胞癌的病理形态特点,误诊和漏诊的防范.方法:对近年诊断的50例胃印戒细胞癌的相关病理资料进行回顾分析.结果:50例中有35例发生于胃窦、胃角,占70%,13例为弥漫浸润型,占26%.经典型印戒细胞和大印戒细胞多位于粘膜浅层,而小印戒细胞多位于深部.29例癌旁粘膜腺体有肠化及球样异型增生.结论:印戒细胞癌好发于胃窦及胃角,易形成弥漫浸润;分化程度不同的肿瘤细胞在分布区位上有一定的规律性;诊断中须与黄色瘤细胞、新生毛细血管内皮细胞、肌间神经节细胞、浆细胞等仔细鉴别;癌旁粘膜腺体上皮有球样异型增生,支持球样异型增生是印戒细胞癌的癌前病变.     

28例老年巨大甲状腺肿患者围手术期护理

 为探讨老年巨大甲状腺肿患者围手术期的护理对于防止并发症发生的意义,对中国人民解放军总医院经治的28例老年巨大甲状腺肿患者围手术期护理干预进行回顾性分析.观察本院的护理常规对于并发症发生率的影响,并与文献报道结果进行比较.结果表明,28例患者术后恢复顺利,无严重并发症发生,所有患者切口愈合良好,无一例患者出现术后出血、皮下血肿;无患者出现饮水呛咳;2例患者术后出现声音嘶哑,随访3~6个月后代偿性恢复;2例出现间断性口唇麻木感,经补钙治疗后恢复正常;1例发生肺部感染,经积极治疗后好转.上述结果均较各类文献中所提并发症发生率低,表明对于老年巨大甲状腺肿患者,采取恰当的手术方式,联合精心、合理、个性化的围手术期护理可以减少术后不适及并发症的发生.     

Vagal afferent innervation of the pylorus and the uper small intestine studied in the rat with the horseradish peroxidase technique

Summary The neuronal tracer horseradish peroxidase was injected into different segments of the gastrointestinal in the rat, in order to study the vagal afferent innervation. In the nodose ganglia the extent of labeling was greater in the experiments on the gastric antrum and pylorus than in the experiments on the first part of the small intestine. Vagal afferents are scarce in the upper doudenum and originate mainly from the left nodose ganglion.     

能量可控陡脉冲对荷瘤大鼠免疫功能的影响

采用细胞悬液注射法建立Wistar大鼠皮下瘤模型,研究能量可控陡脉冲(ECSP)对荷瘤大鼠免疫功能的影响.ECSP处理后利用MTT法检测各组大鼠脾淋巴细胞转化率及NK细胞活性,ELISA法检测大鼠腹腔巨噬细胞分泌TNF-α的表达.结果表明ECSP处理组肿瘤生长明显受到抑制;ECSP处理组淋巴细胞转化率、NK细胞活性及TNF-α的表达明显高于荷瘤对照组(P<0.05,P<0.05,P<0.05),且与正常对照组相似(P=0.953,P=0.130,P=0.080).ECSP可以抑制肿瘤生长,诱发机体抗癌免疫反应,改善和恢复荷瘤鼠淋巴细胞和巨噬细胞的免疫活性.     

全胃切除术后三种消化道重建方式预防反流性食管炎的效果比较

目的评估全胃切除术后三种消化道重建方式预防反流性食管炎的效果。方法统计分析2002-2007年行全胃切除无瘤生存1年以上的96例胃癌患者,分别采用袢式空肠代胃＋Braun吻合（Braun）、单纯Roux—en—Y吻合（RY）和Roux—eli—Y吻合＋P形代胃（RYP）三种方式重建消化道,对这些患者资料进行回顾性分析,以术后的消化道症状和营养状况作为评价依据。结果Braun组存在严重的食管反流,RY和RYP重建则有较强的抗反流作用,RYP组饮食限制少、进餐早期饱足感发生少;术后半年时无瘤生存患者的营养状况三组无差异,而1年以后体重恢复和血浆总蛋白水平RY和硝母两组优于Braun组。结论Braun吻合术后食管反流严重、营养状况较差;而RY及在此基础上的P形代胃术效果良好,是比较合适的重建术式,建议对预期术后生存期超过1年以上患者,采用P形代胃术。     

蟾蜍消化道肥大细胞的观察

采用3种不同的固定方法、2种甲苯胺蓝染色方法,对蟾蜍胃和小肠的肥大细胞(mast cells,MC)进行了研究.结果表明,蟾蜍胃和小肠中均有MC分布;MC呈长梭形、圆形、卵圆形、不规则形,主要存在于粘膜固有层或粘膜下层内,并且有围绕血管、腺泡分布的趋向;胃的固有层内MC少于粘膜下层,小肠固有层内MC多于粘膜下层;胃和小肠肌层中的MC都较少.3种固定方法中,用Carnoy液固定效果最好.在快速甲苯胺蓝染色法中,组织结构清晰可辨,MC易定位,呈紫红色;在常规甲苯胺蓝染色法中,MC不易定位,被染成蓝色.     

Cardiac activation and inhibition involved in molting behavior of a spiny lobster

To study the molting behavior of the spiny lobster, electrical activity of the heart, stomach and skeletal muscles was recorded using in-dwelling electrodes. For 1–2 h before molting the heart rate gradually increases. At the same time shorter trains of stomach burst discharges frequently occur. The heart rate then declines and burst discharges of skeletal muscles begin. The skeletal bursts are regularly spaced (10–15 s intervals). A peristalsis pattern of short and long bursts continues for 10–20 min and is terminated by a few bursts corresponding to abdominal flips. The short skeletal burst is followed by a drop in heart rate. Bioassay using the isolated heart suggests that at the final stage of molting the blood contains some substance(s) which inhibit heart beat.     

Genetic and histological aspects of stomach lesions induced by systemic injection of phenylbutazone in the rat

Summary Roman high-avoidance (RHA/Verh) rats, food-deprived (F-D) for 5 days, had higher stomach lesion scores than did F-D Roman low-avoidance (RLA/Verh) rats. F-D RLA/Verh rats which were injected i.p. with phenylbutazone (PBZ) 24 h before examination, however, had higher scores than did PBZ-treated, F-D RHA/-Verh rats. Histologically, extensive edema and cellular infiltration (including numerous erythrocytes) were seen below lesions, in the submucosa, denoting vascular damage. An attenuating influence of food on the ulcerogenic effects of PBZ, which were much more severe in F-D than in fed rats was also indicated.The authors thank K. Bättig and J. R. Martin for their assistance during the planning stages, B. Hauser, A. Waldvogel and P. Wild of the Veterinary Medical Faculty of Zurich University for preparing the histological sections and for the photography, and P. Elsinger for technical help.