活体肝移植供体胆管造影——磁共振胆管水成像和莫迪司增强胆管造影对比

目的对比磁共振胆管水成像（T2WI—MRC）和莫迪司对比增强磁共振胆管造影（CE—MRC）对肝移植供体的胆管显示的差别。方法32例肝移植供体,其中男性18例,女性14例,年龄21～63岁,平均年龄35岁。术前行MRC水成像和莫迪司增强后胆管造影检查．对两种检查方法显示肝内外胆管的优缺点进行比较。所有肝移植供体均行术中胆管造影检查。结果2种方法均可清楚显示3级肝内胆管．但T2WI—MRC显示肝内3级以上胆管明显优于CE—MRC（P〈0．05）。T2WI—MRC有5例（15．6％）供体肠道内液体影响胆管显示．CE—MRC则无一例供体肠道液体影响胆管显示。呼吸引起的运动伪影两种检查方法均不明显。胆管变异9例,两种检查方法均正确诊断。2例供体T2WI—MRC显示胆总管不连续,CE—MRC及术中胆管造影显示胆总管正常。结论T2WI—MRC和CE—MRC均可用来评估术前活体肝移植供体胆管解剖,两种检查方法各有优缺点．联合应用将明显提高其诊断准确性。     

胆总管探查在胆管结石中应用的临床分析

目的 探讨开腹胆总管探查的适应条件、必要性、并发症及胆总管探查的最新进展。方法 对两家医院在2014年1月~2017年6月行开腹胆囊切除胆总管探查术62例患者的临床资料进行回顾性分析,探讨术中胆总管探查的必要性。结果 62例均痊愈,术中证实胆总管扩张 54例,胆总管探查发现结石50例,术中胆道镜探查发现残余结石14例,术后有4例患者出现并发症,其中胆总管残余结石1例,胆道感染2例,胆汁性腹膜炎1例。结论 开腹进行胆总管探查仍具有不可替代的位置,对于胆管多发结石、胆总管明显扩张的患者,术中胆道镜探查是必要的。     

肝内胆管分叉部流体力学体外模拟测试的临床意义

临床发现肝内管结石和狭窄，多发于各级胆管的分叉部，其原因与该部胆管的解剖组织的结构和流体力学参数有关。因此研究肝内胆管分叉部的流体力学，对肝内胆管结石和狭窄成因的研究及其防治，均将具有重要意义。本文叙述了我们所进行的体外模拟肝内管分叉部流体力学参数的测试，和对该部位生物力学与特点的探讨。     

胆道造影检查在腹腔镜胆囊切除术中的应用

目的探讨腹腔镜胆囊切除术中经胆囊管胆道造影的临床价值。方法通过对58例Lc术中经IOC的病人临床资料进行回顾性分析。结果本组病例成功55例,占94．83％,失败3例,占5．17％。50例胆总管未发现结石,占90．91％,发现胆总管小结石（0．4cm）5例,占9．09％。其中4例经中转开腹行胆道探查,1例经腹腔镜胆总管切开胆纤镜网篮取石。胆囊管汇入右肝管1例。全组病例无胆道损伤、胆总管结石残留、胆漏、腹腔感染及IOC相关并发症。结论LC术中行IOC操作简单易行,成功率高,显影效果好,能及时发现胆道解剖变异;对基层医院减少胆道阴性探查、术中胆道损伤、术后胆总管结石残留等具有重要的临床应用价值。     

腹腔镜联合胆道镜胆总管探查取石术后胆管一期缝合与T管引流的疗效比较

目的 比较腹腔镜联合胆道镜胆总管探查取石术（LCBDE）后胆管一期缝合（PC）与T管引流（TD）的疗效。方法 回顾性分析2015年1月~2019年1月我院62例行LCBDE患者的临床资料,根据手术方式不同分为PC组30例,TD组32例,比较两组手术情况（术后通气时间、住院时间、手术时间、胆红素恢复时间）及并发症发生情况。结果 PC组术后通气时间、住院时间、手术时间优于TD组[（2.67±0.71）d vs（3.13±0.66）d]、[（5.93±0.74）d vs（9.34±0.86）d]、[（108.27±17.78）min vs（131.31±14.51）min],差异有统计学意义（P＜0.05）;两组胆红素恢复时间比较,差异无统计学意义（P＞0.05）。PC组并发症总发生率为3.33%,低于TD组的12.50%,差异有统计学意义（P＜0.05）。结论 LCBDE后胆管PC可有效缩短手术时间短、加快患者术后通气时间及恢复时间,不增加并发症发生率,其疗效优于TD。     

包膜超声造影剂喷射雾化制备方法研究

提出并研究了制备微米级包膜超声造影剂的一种新方法 :喷射雾化法。可胶化的聚合物海藻酸钠膜溶液经过气动雾化形成微小液滴 ,在含多价金属离子的溶液中胶化成包膜。应用海藻酸盐作为成膜材料 ,产生含CO2 的包膜微泡 ,平均直径约为 5 μm。还研究了海藻酸钠浓度、压缩气体的压强、液体的喷注流量等对微泡尺寸的影响。浓度较低的海藻酸钠溶液 ,较高的压缩气体压强和较低的溶液喷注流量对形成尺寸较小的微泡较有利。此外 ,喷嘴的形状、尺寸、喷嘴与接收皿之间的距离等也是影响雾化结果的因素。与超声空化法相比 ,喷射雾化法原理上能更直接和准确地控制微泡的尺寸分布等特性 ,并且适用于较高粘度的液体     

肝内胆管结石治疗模式的探讨

目的探讨多路微创技术治疗肝内胆管结石的疗效. 方法回顾性分析单纯手术(A组)与多路微创技术(B组)两种治疗模式治疗肝内胆管结石的疗效. 结果 B组病人在术后恢复、残余结石方面均优于A组. 结论多路微创技术治疗肝内胆管结石具有手术创伤小,取石率高,残余结石率低的优点,值得推广.     

肝内胆管结石治疗模式的探讨

目的 探讨多路微创技术治疗肝内胆管结石的疗效。方法 回顾性分析单纯手术（A组）与多路微创技术（B组）两种治疗模式治疗肝内胆管结石的疗效。结果 B组病人在术后恢复，残余结石方面均优于A组。结论 多路微创技术治疗肝内胆管结石具有手术创伤小，取石率高，残余结石率低的优点。值得推广。     

内镜逆行胰胆管造影取石术与开腹手术治疗胆总管结石的疗效比较

目的 探讨内镜逆行胰胆管造影(ERCP)取石术治疗胆总管结石的有效性和安全性.方法 选取2012年1月至2013年3月本院就诊的胆总管结石患者100例,按随机数字表分为治疗组(n=50)和对照组(n=50),分别采用ERCP取石术和开腹手术进行治疗.比较两组患者的手术情况、手术费用和住院费用.术后2周,记录患者的临床疗效和术后并发症情况.术前和术后2周采用胃肠疾病生活质量指数(GIQLI)量表对患者的生活质量进行评价.结果 治疗组患者的手术时间、术中出血量、术后通气时间、切口疼痛时间及住院天数均少于对照组(均P＜0.05).而两组患者的住院费用、结石未净的发生率、血清总胆红素(TBIL)、天门冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)水平差异均无统计学意义(均P＞0.05).治疗组患者术后高淀粉酶血症的发生率高于对照组(P＜0.05).治疗2周后随访显示,治疗组患者的自觉症状、心理情绪和生活质量总评分均显著高于对照组(均P＜0.05).结论 ERCP取石术治疗胆总管结石的有效性和安全性较高.     

胆肠吻合术在治疗胆管结石中的应用价值

目的 探讨胆肠吻合术治疗胆管结石的效果、术式选择.方法 回顾分析188例肝内外胆管结石患者的临床资料,其中胆肠吻合组50例、T形管引流组138例,比较各术式的临床疗效.结果 胆肠吻合组与T形管引流组有效率分别为88.10%、70.48%, P< 0.05;两组结石复发率分别为12.12%、32.10%,P< 0.05;差异比较均有统计学意义.胆肠吻合组内各术式比较,Roux-en-y吻合、Warren吻合、胆总管十二指肠吻合有效率分别为90.00%、87.50%、75.00%;三组结石复发率分别为12.00%、0.00%、33.33%.结论 合理应用胆肠吻合术是治疗胆管结石有效措施之一,胆肠吻合术式以Roux-en-y吻合、Warren吻合疗效较佳.     

Hereditary colon cancer syndromes: an in vitro study

Assays of in vitro biological properties associated with cellular transformation revealed differences in cultured skin cells within the heritable colon cancer syndromes with and without polyposis coli. Such evidence suggested that an in vitro panel of biological assays could be used to recognize genotypes which increase the risk of colon cancer prior to clinical expression and supported the concept, long assumed on clinical differences, of genetic heterogeneity within the heritable colon cancer syndromes.     

Multicellular spheroids: a three-dimensional in vitro culture system to study tumour biology

The growth of tumour cells as three-dimensional multicellular spheroids in vitro has led to important insights in tumour biology, since properties of the in vivo -tumour such as proliferation or nutrient gradients, can be studied under controlled conditions. While this review starts with an update of recent data on spheroid monocultures, especially concerning tumour microenvironment and therapeutic modalities, the main emphasis is put on the spectrum of heterologous cultures which have evolved in previous years. This type of culture includes tumour cell interaction with endothelial, fibroblast or immunocompetent cells. The relation of the spheroid culture model to other types of three-dimensional culture and our critical evaluation and presentation of the technical aspects of growing and analysing spheroids are included in the text. These topics are chosed to help the experimental pathologist design experiments with tumour spheroids and to stimulate discussion.     

体外受精胚胎移植中选择性短时受精的临床研究

目的 研究受精失败高风险患者采用选择性短时受精联合补救单精于显微注射(ICSI)的胚胎质量与妊娠结局.方法 回顾性分析2010年9月至2011年 1月本中心助孕患者的临床资料.采用短时受精患者为A组(93例),其中受精率正常的患者为A-IVF(体外受精)组(58例),完全补救为A-ICSI组(21例),部分补救为A-half组(14例);过夜受精为B组(466例);非补救射精ICSI为C组(94例).对各组的受精率、临床妊娠率、多胎率、流产率、早产率及出生缺陷率进行比较.结果 A-IVF组和B组的受精率、2PN率和OPN率差异有统计学意义[74.4％(588/790)比80.8％ (4674/5782),45.7％(361/790)比64.1％ (3707/5782),14.1％(111/790)比,2.6％ (149/5782),均P＜0.05],但两组的临床妊娠率、多胎率、流产率、早产率及出生缺陷率差异无统计学意义(P＞0.05).A-ICSI组和C组的临床妊娠率、多胎率、流产率、早产率及出生缺陷率差异无统计学意义(P＞0.05);A-half组IVF部分的受精率为72.7％,低于B组80.8％ (P＜0.05).结论 选择性短时受精保障了大部分存在受精失败高风险患者的利益,可以采用.     

不同灌注介质对射频消融病灶大小影响体外研究

目的探讨在离体状态下，采用不同种类及浓度的离子溶液作为灌注介质对射频消融灶大小的影响。方法在新鲜猪肝内进行射频消融。按灌注介质不同，分为质量浓度25％乙酸溶液、质量浓度10％NaCl溶液、质量浓度5％NaCl溶液、质量浓度0．9％NaCl溶液、体积分数95％乙醇溶液及蒸馏水6组进行实验。每组实验重复8次。射频结束后将其剖开测量并比较消融灶的形态及体积。结果共得到48个消融灶。不同灌注介质所形成的消融灶体积按从大到小依次排列如下：质量浓度25％乙酸溶液组〉质量浓度10％NaCl溶液组〉质量浓度5％NaCl溶液组〉质量浓度0．9％NaCl溶液组〉蒸馏水组〉体积分数95％乙醇溶液组。结论采用高浓度的离子溶液作为灌注介质在体外条件下有助于形成较大的射频消融灶。     

利巴韦林注射液在细胞水平上抑制EV71病毒复制的初步研究

目的 通过体外实验,观察利巴韦林注射液对肠道病毒71型(EV71)病毒在横纹肌肉瘤传代细胞(RD-A细胞)复制的抑制作用和体外灭活作用.方法 使用在2008年4月安徽阜阳疫情中分离到的EV71病毒,通过三种体外细胞实验:药物在细胞中抑制EV71病毒复制的药效测定实验;药物对细胞的保护作用实验;药物体外对EV71病毒的灭活作用的药效测定实验.观察利巴韦林注射液对EV71病毒感染横纹肌肉瘤传代细胞(RD-A细胞)中所起的作用.结果 在利巴韦林注射液在细胞中抑制EV71病毒复制的药效测定实验中,1:640利巴韦林注射液稀释度组较病毒对照组延迟病变出现2 d,细胞生长未受到影响.在药物对细胞的保护作用实验中,1:8利巴韦林稀释度组较病毒对照组延迟病变出现4 d.在利巴韦林注射液药物体外对EV71病毒的灭活作用的药效测定研究中,1:40稀释度组较病毒对照组延迟病变出现2 d,而细胞生长未受到影响.结论 利巴韦林注射液在体外有抑制EV71病毒复制和部分灭活病毒的作用;并有一定的保护细胞抑制EV71病毒感染的作用.本研究对于临床上EV71感染的早期预防和治疗具有一定的指导意义.     

Mast cell activation markers for in vitro study

ABSTRACT

Mast cells (MCs) are well known for their role in allergic conditions. This cell can be activated by various types of secretagogues, ranging from a small chemical to a huge protein. Mast cell activation by secretagogues triggers the increase in intracellular calcium (iCa²⁺) concentration, granule trafficking, and exocytosis. Activated mast cells release their intra-granular pre-stored mediator or the newly synthesized mediator in the exocytosis process, in the form of degranulation or secretion. There are at least three types of exocytosis in mast cells, which are suggested to contribute to the release of different mediators, i.e.,, piecemeal, kiss-and-run, and compound exocytosis. The status of mast cells, i.e., activated or resting, is often determined by measuring the concentration of the released mediator such as histamine or β-hexosaminidase. This review summarizes several mast cell components that have been and are generally used as mast cell activation indicator, from the classical histamine and β-hexosaminidase measurement, to eicosanoid and granule trafficking observation. Basic principle of the component determination is also explained with their specified research application and purpose. The information will help to predict the experiment results with a certain study design.     

中药制剂对多重耐药细菌的体外抑菌试验

目的了解肺炎一号对MRSA(耐甲氧西林的金黄色葡萄球菌)、ES-BLs+(产超广谱β-内酰胺酶)的肺炎克雷伯菌抑菌效果。方法采用血清药理学方法,梯度稀释含药血清,进行体外抑菌试验。结果肺炎一号对MRSA、ESBLs+的肺炎克雷伯菌的抑菌效果与阴性对照组比较,差异有极显著性(P<0.01),抑菌效果明显。结论中药制剂在目前棘手的多重耐药的细菌MRSA、ESBLs+的肺炎克雷伯菌抑菌效果明显。     

Successful monozygotic twin delivery following in vitro maturation of oocytes retrieved from a woman with polycystic ovary syndrome: case report

The incidence of monozygotic twinning (MZT) appears to be increasing within the field of assisted reproductive technology (ART), although the factors contributing to the phenomenon are still far from being identified. On the contrary, in vitro maturation (IVM) of oocytes is becoming more accepted and more and more babies have been born worldwide using this procedure. Assessing its safety and impact on monozygotic twinning (MZT), and following up the health of these babies, is essential. We report here a first case of successful monozygotic (MZ) twin delivery following IVM. The patient was a 28-year-old Japanese female, referred to the IVF clinic for primary infertility. Several previous cycles of ovarian stimulation had resulted in ovarian hyperstimulation syndrome (OHSS). The patient received norethisterone-mestranol to initiate the menstruation, and oocyte retrieval was performed 36 h after hCG. A total of 22 immature oocytes were obtained. Following incubation for 24 h in IVM medium, 50% of the oocytes were matured to the metaphase II (MII) stage. Nine oocytes were fertilized after ICSI with the husband's sperm. Three day 3 embryos were transferred into the uterus on the fourth day following oocyte retrieval. Three weeks after embryo transfer, a single gestational sac was visualized in the uterus. At 7 weeks of gestation, two fetal poles with cardiac activity were seen in the single gestational sac. Serial ultrasound examinations revealed a MZ, monochorionic diamniotic pregnancy. After intensive perinatal monitoring, two healthy male infants were delivered by Caesarean section at 35 weeks of gestation.     

In vitro hyperdiploidy in dermal fibroblasts: evidence for genetic predisposition in aerodigestive tract cancer

A numerical alteration in chromosome complement in human dermal fibroblast cultures, hyperdiploidy with a normal occurrence of tetraploidy (IVH) has been reported (Danes 1984) to be associated with some heritable single tumors including squamous carcinoma of the nasopharynx (Danes 1986). The incidence of IVH was compared in cultures derived from 65 patients with squamous carcinoma in different regions of the aerodigestive tract (ADT) and 32 clinically normal subjects without a family cancer history by 2 different assays, metaphase assay (MA) and flow cytometry (FCM). By MA, none of the 32 normals showed IVH. Of the 65 ADT patients studied, 35 had IVH and 30 did not. By FCM, there were significant differences in the FCM DNA index (p values less than 0.001) of IVH- (all normals and 30 ADT patients) and IVH+ ADT patients. The per cent of cells with a DI of 2 and greater than 1 could be used to distinguish all IVH- from the IVH+ subjects and were thus considered to be the parameters of choice in assaying IVH by FCM. None of the subjects studied showed increased in vitro tetraploidy (IVT) which has been associated with some heritable colon cancer syndromes. Irrespective of family cancer history, approximately half (35/65) of the ADT patients had IVH which has been shown to be associated with the in vivo expression of certain heritable tumors. The average age of squamous carcinoma diagnosis was earlier (mean 50 yrs) for the IVH+ group than for the IVH- ADT group (mean 72 yrs).     

Fine-needle aspiration cytology of ovarian cysts in in vitro fertilization patients: A study of 125 cases

Fine-needle aspiration (FNA) cytology of ovarian cysts, especially in in vitro fertifization (IVF) patients, has been only rarely reported. The aim of this study was to describe the spectrum of cytological findings seen in FNA specimens of 125 ovarian cysts obtained from 84 IVF patients at our institution from 1989–1993. The Papanicolaou-stained slides made following cytocentrifuge or membrane-filter preparation were reviewed blindly by two independent pathologists, and the consensus diagnoses were compiled and correlated with clinical and radiological findings as well as surgical pathology when available. Eight aspirates derived from 4 different patients contained neoplastic cells and, of these, one patient was later found to have a serous cystadenocarcinoma of low malignant potential, while another had a serous cystadenoma. The other 2 patients with neoplastic cells in their ovarian aspirates have persistent ovarian cysts that are being followed clinically for preservation of fertility. The breakdown of the cytological diagnoses of the other aspirates is as follows: 30 follicular cysts, 5 corpus luteum cysts, and 16 endometriotic cysts. The exact underlying nature of 66 cysts could not be determined as the aspirates consisted of foamy macrophages only. This study demonstrates that the nature of ovarian cysts in IVF patients can be determined in many cases by their cytological features, information that may help in defining an unsuspected cause for infertility (such as endometriosis), and in choosing the most appropriate therapy. This study also illustrates that FNA cytology of ovarian cysts can play a role in the detection of occult ovarian neoplasms in the IVF patient population. Diagn Cytopathol 1996;15:341–344. © 1996 Wiley-Liss, Inc.