重症急性胆管炎急症手术中胆总管末端狭窄的处理(附37例分析)

目的探讨急诊手术中胆总管末端狭窄的手术方法.方法回顾性分析553例急诊胆总管切开探查术中并发胆总管末端狭窄37例的临床资料.结果37例中行胆总管十二指肠吻合术29例;例出‘s括约肌切开成形术3例;单纯T管引流5例.随访27例,随访率75.7%,疗效满意.结论胆总管十二指肠吻合术及Oddi‘s括约肌成形术是治疗胆总管末端良性狭窄的良好术式,但各有利弊,而胆总管十二指肠吻合术更适于急诊手术及基层医院开展.严格掌握其适应症及手术原则是减少术后并发症的关键.     

珠海市横琴岛嗜人按蚊生态习性研究

目的:研究珠海市横琴岛嗜人按蚊的生态习性。方法:蚊媒调查方法。结果:横琴岛嗜人按蚊主要孳生于水质清凉、遮阴良好的淡水沟溪及有丰富水体的香蕉地和甘蔗地等。属人、牛血兼吸品种，趋吸人血比例为76、34％，吸血后外逸比例为92、77％，夜间吸血活动高峰在午夜后至次日清晨，全年高峰季节在8～10月。结论:该地嗜人按蚊有人、牛血兼吸，趋吸人血比例较大陆品种低，偏野栖，夜间吸血活动持续时间长，全年活动高峰季节长的生态特点。     

中医药学研究方法的解构与特性分析

将中医药学研究方法从观念理论、核心方法和技术手段3个方面进行解构，并对其内在特性进行详细分析。明确提出中医药学研究方法的范式特性、观念理论的思辨性、核心方法的主观性以及整体刚性和局部柔性的特性，揭示了中医药研究方法的优势与不足，为中医药研究方法论的创新提供理论依据。     

Treatment of persistent and recurrent nasopharyngeal carcinoma by brachytherapy

The early results of brachytherapy for persistent and recurrent nasopharyngeal carcinoma in 30 patients is presented. Fifteen patients were treated by intracavitary caesium, 12 patients were treated by interstitial gold grain implant using the split-palate approach and three patients were treated by both intracavitary caesium and interstitial gold grain implant for the first and second relapse in the nasopharynx, respectively. The overall tumour control rate for intracavitary caesium was 5/18 (28%) with median follow-up of 25.2 months, and for interstitial gold grain implant it was 9/14 (64%) with median follow-up of 16.5 months. Interstitial gold grain implantation appears to be effective in the treatment of persistent and recurrent nasopharyngeal carcinoma.     

凝血酶受体结构与功能的研究现状

凝血酶（ｔｈｒｏｍｉｂｉｎ，Ⅱａ）是一种生成于损伤处血管内皮细胞多功能蛋白酶，它是参与凝血过程各个环节反应中的关键酶。在发挥止血作用的同时，还可能诱导炎症、增生及修复等反应。最近发现的凝血酶受体（ｔｈｒｏｍｂｉｎ ｒｅｃｅｐｔｏｒ，ＴＲ）分子可能为解释上述现象提供了一个理论框架。同时，ＴＲＮ端被Ⅱａ切下的４１个氨基酸片段是否具有特殊功效，值得研究探讨。     

Renal metastasis from choriocarcinoma: MRI appearance

Choriocarcinoma is the most malignant tumor of gestational trophoblastic neoplasia. It grows rapidly and metastasizes to the lung, liver, and, less frequently, to the brain. Renal involvement is rare. Magnetic resonance imaging (MRI) is a useful modality to image the affected tissues; it contributes to the evaluation and management of the disease. One case of renal choriocarcinoma with MRI evaluation is reported. Received: 24 February 1997/Accepted: 14 April 1997     

Inhibitory effect of islet amyloid polypeptide of glucose-induced proinsulin biosynthesis in rat insulinoma cells.

Islet amyloid polypeptide (IAPP) has been recently identified as the principal constituent of amyloid deposits in pancreatic islets of patients with type 2 (non-insulin-dependent) diabetes mellitus and causes insulin resistance in some target cells. In addition, glucose-induced insulin secretion is inhibited by IAPP. We studied the effect of IAPP on proinsulin biosynthesis in rat insulinoma (RINr) cells. Glucose at concentrations of 0, 15, 30, 60, 100, and 300 mg/dl stimulated proinsulin biosynthesis in a dose-responsive and and actino-mycin D-inhibitable manner after 6 h of incubation. At a glucose concentration of 300 mg/dl, IAPP decreased the mean responses of proinsulin biosynthesis to 61.2 and 29% at concentrations of 0.1 and 1 microM, respectively, compared with the IAPP-free control. In conclusion, IAPP inhibits glucose-induced proinsulin biosynthesis in RINr cells. IAPP might play an important role in the pathogenesis of type 2 diabetes mellitus.     

Percutaneous transluminal coronary angioplasty in a patient with paroxysmal nocturnal hemoglobinuria

Paroxysmal nocturnal hemoglobinuria (PNH) is an acquired chronic hemolytic anemia associated with an unusual susceptibility to hemolytic crisis, infection, and venous thrombosis which would be aggravated by a number of factors including surgery. We report a case of PNH undergoing percutaneous transluminal coronary angioplasty and discuss the corresponding perioperative management.     

Comparison between a new acceleration transducer and a conventional force transducer in the evaluation of twitch responses

An acceleration transducer elicits an output voltage proportional to the deformation of the piezo crystal, in accordance with the twitch responses of the applied fingers. The reliability of such a transducer was evaluated by comparing induced twitch responses with those from a force transducer applied on the contralateral arm of an individual during neuromuscular block with vecuronium. The results obtained from twitch responses with the acceleration transducer during neuromuscular block were almost identical to those obtained with the force transducer. Also, the twitch heights due to acceleration of the examined thumb correlated extremely well with the twitch height due to twitch tension with the force transducer. It is concluded that the acceleration transducer may be a useful and reliable device for monitoring neuromuscular block, although responses during tetanic stimulation such as tetanic fade cannot be determined by the transducer.