Evaluation of ERCP in the diagnosis of hepatocellular carcinoma invading bile ducts

Endoscopic retrograde cholangiopancreatography (ERCP) was performed preoperatively on 29 patients suffering from hepatocellular carcinoma (HCC) invading bile ducts. The outstanding features were: 1. Most of the filling defects were situated within the common, right or left hepatic duct associated with proximal bile duct dilatations (17 cases);2. Tumor encasement resulted in localised or diffused irregular strictures and dilatations (9 cases); 3. Displacement and stretching of the intrahepatic ducts by pressure of tumor mass (3 cases). These features are different from that in cholangiocarcinoma.ERCP should be considered as an important diagnostic procedure for HCC. It is especially useful for cases with obscure intrahepatic duct dialatation and/or an increase of AFP, and will help early diagnosis of HCC.     

绞股蓝浸出液的抑瘤作用

定期给荷瘤小鼠注射或灌服一定剂量浓度的绞股蓝浸出液后,小鼠体质增强,胸腺的萎缩速度减慢,每克体重的胸腺和脾脏重均显著高于对照组.胸腺与脾脏每克重细胞数增多.每克体重的瘤重明显降低,瘤细胞数减少,取荷瘤小鼠胸腺淋巴细胞与瘤细胞离体混合培养后,被致敏的淋巴细胞的“粘瘤”和“钻瘤”作用加强,癌细胞发生轻度皱缩,淋巴细胞钻入的癌细胞发生裂解,碎片逐渐增多,而淋巴细胞的形态和数量无变化.实验结果表明:纹股蓝浸出液具有增强荷瘤小鼠免疫力和抑制;肿瘤生长的作用。     

甲状腺癌骨转移的诊疗措施的个例报道及其文献回顾

研究目的：探究甲状腺癌骨转移的规范诊疗措施,为提高甲状腺癌骨转移的生存期提供指导。创新要点：本例病人通过普外科、骨科联合手术,内分泌激素替代治疗,I^131治疗等多学科联合治疗,取得较好的疗效,对探究甲状腺癌骨转移的规范化诊疗措施有重要的指导意义。研究方法：本文分析本科室一例甲状腺癌骨转移病人,同时搜集了1996年至2013年中文文献报道的甲状腺癌骨转移患者11例,通过统计其病理类型、手术方式、转移部位、随访资料等,讨论其规范化治疗方式。重要结论：彻底的术前检查对发现甲状腺癌骨转移至关重要。甲状腺癌骨转移需要多学科协同治疗,手术治疗仍为首选,联合手术的激素替代治疗、I^131治疗、二膦酸盐治疗是较好的选择。放疗的作用仍需大样本数据的评估。     

Hydrogen Breath Tests in Gastrointestinal Diseases

Hydrogen breath tests are widely used to explore pathophysiology of functional gastrointestinal (GI) disorders. Small intestinal bacterial overgrowth (SIBO) and carbohydrate malabsorption are disorders detected by these tests that have been proposed to be of great importance for symptoms of GI diseases. Glucose hydrogen breath test is more acceptable for diagnosis of SIBO whereas lactose and fructose hydrogen breath tests are used for detection of lactose and fructose maldigestion respectively. Lactulose hydrogen breath test is also used widely to measure the orocecal transit time for GI motility. These methods are noninvasive and inexpensive. Many patients with functional gut disorders are unaware of the relationship between diet and GI symptoms they present. In particular, patients with chronic symptoms may regard their condition as normal and may not be aware that their symptoms can be effectively managed following a proper diagnosis. Patients with symptoms of abdominal pain, bloating, flatulence and altered bowel movements (diarrhea and constipation), or with a medical diagnosis of irritable bowel syndrome or celiac disease, may have undiagnosed carbohydrate malabsorption or SIBO. Hydrogen breath tests are specific and sensitive diagnostic tests that can be used to either confirm or eliminate the possibility of carbohydrate malabsorption or SIBO in such patients. Breath tests, though valuable tools, are underutilized in evaluating dyspepsia and functional bloating and diarrhea as well as suspected malabsorption. However, because of their simplicity, reproducibility and safety of procedure they are now being substituted to more uncomfortable and expensive techniques that were traditionally used in gastroenterology.     

原发性肝细胞肝癌合并胆栓临床诊断与治疗进展

原发性肝细胞癌伴胆管癌栓(hepatocellular carcinoma with bile duct tumor thrombi,HCCBDT)是胆道系统最常见的继发性肿瘤,其主要以肝细胞癌向胆道系统转移所致梗阻性黄疸为特点,肝细胞肝癌合并胆管癌栓的发病率不到原发性肝细胞癌患者的10%[1],尸检发现其发生率为1.2%~9.0%[2]。虽然原发性肝细胞癌合并胆管癌栓发病率低,但由于我国人口基数较大,致使患者绝对数量也较大,发病人数每年超过10000人。以往通常认为肝癌出现黄疸症状已属肝癌晚期的表现,导致人们对肝细胞肝癌合并胆管癌栓多采取保守治疗或消极态度,缺乏根治的方法,致使很大一部分原发性肝细胞癌合并胆管癌栓病人丧失治疗机会,预后较差。近年来,随着外科领域的不断进步,发现原发性肝癌合并胆管癌栓其实并非肝癌的晚期表现。     

早期饲喂对肉鸡生长性能和肠道消化酶的影响

为研究早期饲喂对肉鸡生长性能和肠道消化酶的影响,选择360只刚出壳的AA肉用雏鸡,采用单因子试验设计,随机分成4个处理组,每组4个重复,每个重复20只,试验1组出壳后12 h饲喂,试验Ⅱ组出壳24 h后饲喂,试验Ⅲ组出壳36 h后饲喂,对照组出壳48 h后饲喂.饲喂相同日粮,试验期为6周.于21日龄和42日龄分别测定肉鸡进行生产性能和酶活性.结果表明：早期饲喂显著提高了肉鸡的日增重,降低了料重比,试验Ⅰ组和试验Ⅱ组与对照组相比,日增重分别提高了4.19%和3.70%,料重比分别降低5.61%和5.10%,差异显著（P〈0.05）;试验Ⅰ组、试验Ⅱ组和试验Ⅲ组肠道消化酶水平高于对照组.早期饲喂提高了肉鸡肠道消化酶水平,以出壳后12 h饲喂最好.     

磁处理党参药液对消化功能影响的药效研究

研究磁处理党参药液对消化功能影响的药效作用.用炭末法比较生理盐水、磁处理党参药液与非磁处理党参药液对小鼠肠推进运动的影响;用麦特(Mett)氏法比较正常对照组、非磁处理党参药液组与磁处理党参药液组的胃蛋白酶活性.与生理盐水组比较,磁处理药液组小鼠肠的炭末推进率显著增加(P0.01);与非磁处理药液组比较,磁处理药液组小鼠肠的炭末推进率显著减小(P0.01).与正常对照组比较,磁处理药液组的胃蛋白酶活性显著增强(P0.01);与非磁处理药液组比较,磁处理药液组的胃蛋白酶活性亦显著增强(P0.01及P0.05).党参磁处理药液对小鼠肠的推进及胃蛋白酶活性有明显作用.