目的:分析经后腹腔镜肾上腺囊肿去顶减压术的疗效,安全性和临床价值。方法:我院2004年12月至2007年12月6例经后腹腔镜肾上腺囊肿去顶减压临床资料进行回顾分析。结果:经后腹腔镜5例肾上腺囊肿患者顺利切除去顶,其中左侧肾上腺囊肿3例,右侧肾上腺囊肿3例。1例转开放,为双侧肾上腺囊肿。平均手术时间(45.73±1.32)min,平均术中出血量(7.35±0.45)mL。平均住院天数(7.67±0.24)天,平均术后住院天数(5.0±0.11)天。结论:经后腹腔镜肾上腺囊肿去顶减压是一种安全,有效且可行的治疗方式,必要时应及时转开放。
Objective To investigate the relationship among rats′ stress ulcer and gastric acid, prostaglandin (PGs) and adrenocorticotropin (ACTH) and to probe the pathogenesis, prophylaxis and therapy. Methods Rats′ stress ulcer model was made by cold water soaking and was properly treated with drugs such as hyoscine, dexamethasone, ranitidine and losec. The amount and pH of gastric juice, change of gastric mucosa and PGs and ACTH of blood were determined. Results After rats were fasted for 24 hours a little gastric juice was aspirated. After cold water soaking of rats gastric juice was increased with the pH decreased, there was gastric mucosal bleeding, blood PGs was decreased and ACTH was increased. These suggest that on stress gastric mucosa bleeding is related with decreased gastric juice pH, decreased PGs and increase ACTH.Conclusion To control stress ulcer, pH of gastric juice and amount of PGs should be increased. Losec can increase gastric juice pH, so losec is the first choice to control stress ulcer.
Abstract： Objective To investigate the influence of vasoactive intestinal peptide （VIP) on the sling fibers and the clasp fibers of the lower esophageal sphincter （LES） and the difference， and explore whether VIP belongs to a nonadrenergic and noncholinergic （NANC） neurotransmitter. Methods Thirty LES specimens were obtained from 30 patients with high-position carcinoma of the middle thoracic esophagus who underwent esophagectomy from March to August 2010 in Fourth Affiliated Hospital of Hebei Medical University. There were 14 male patients and 16 female patients with their average age of 58.0±6.1 years. The clasp fibers and sling fibers were isolated and suspended in perfusion. Exogenous VIP was added to the two kinds of strips to draw a concentration-effect curve. Electric field stimulation （EFS） or exogenous VIP was applied to clasp fibers and sling fibers， and the influence of VIP （10-28） on LES was compared. Results ExogenousVIP in different concentration caused concentration-dependent relaxation of the sling fibers and clasp fibers of LES in vitro. There was statistical difference in relaxation between the sling fibers and clasp fibers under same VIP concentration （P＜0.05）， and the relaxation of sling fibers was more significant than that of clasp fibers. VIP （10-28） transiently inhibited the relaxationof the sling fibers and clasp fibers caused by exogenous VIP. VIP （10-28） also transiently inhibited the relaxation of the sling fibers and clasp fibers after the activation of EFS. Conclusion The relaxation of sling fibers and clasp fibers induced by EFS is related to VIP. VIP is a kind of NANC neurotransmitter in human LES.
【摘要】 目的 探讨超声显像对肾上腺肿瘤的定位、定性诊断与鉴别诊断价值。 方法 对 2003年1月-2009年1月125例疑为肾上腺肿瘤患者进行超声及CT检查，并经手术与病理证实。超声显像诊断后经手术与病理证实为嗜铬细胞瘤48例，肾上腺皮质腺瘤41例，皮质腺癌11例，肾上腺转移癌 9例，髓样脂肪瘤8例，结节样增生2例，肾上腺结核4例，胰尾部肿瘤1例，肝脏肿瘤1例，肾上极肿瘤1例。 结果 肾上腺肿瘤的病理类型不同，声像图表现亦各不相同。超声显像定位诊断符合率为96.0%（120/125），定性诊断符合率为91.2% （114/125）。 结论 超声显像对肾上腺肿瘤的定位与定性诊断价值较大，可作为临床诊断的首选检查方法。【Abstract】 Objective To assess the value of ultrasonography in the diagnosis and differential diagnosis of tumors of adrenal gland. Methods From January 2003 to January 2009, 125 patients who were suspected to suffering from adrenal tumors underwent ultrasonography and CT examination. The results were then confirmed by surgery and pathology. There were 48 cases of pheochromocytoma, 41 adenoma, 11 adenocarcinoma, 9 metastatic tumor, 8 adrenal medullary lipoma, 2 nubblar hyperplasia, 4 tuberculosis of adrenal gland, 1 tumor of cauda pancreatic, 1 tumor of liver and 1 tumor of upper pole of kidney. Results The ultrasonographic features varied with different pathological types. The accuracy diagnosis of localizition and qualitation were 96.0% (120/125) and 91.2% (114/125) respectively. Conclusion Ultrasonography is useful in diagnosing tumors of adrenal gland, which may be used as the first choice for the disease.
Objective Using nerve growth factor ( NGF) and anti-NGF microspheres injected directly into the asthmatic rat adrenal gland, to explore the possible role of anti-NGF microsphere treatment in asthma.Methods 32 male SD rats were randomly divided into a normal control group, an asthma group, a NGF microspheres group, and an anti-NGF microspheres group. The behavior of rats, lung function testing, light microscopy of lung biopsy, electron microscopy of adrenal medulla cell ultrastructure changes, NGF and phenylethanolamine N-methyltransferase ( PNMT) expressions in the adrenal gland were assayed by immunohistochemistry method, and serum NGF, cortisol, corticosterone, epinephrine and norepinephrine concentrations were detected by ELISA. Results Behavior in the asthma rats showed varying degrees of sneezing, runny nose, wheezing, scratching the head and face, irritability holes, incontinence, increased aggression and other acts, while in the anti-NGF rats showed relatively slighter symptoms. The rats in the asthma, anti-NGF and NGF groups showed significant airway hyperresponsiveness, while RL value reduced and Cdyn value increased in the anti-NGF group compared with the asthma group. HE staining of lung tissue revealed obvious bronchoconstriction, inflammatory cell infiltration around small vessels and alveolar spaces and in interstitum, bronchial epithelial cells desquamation in the asthma group. In anti-NGF group, tracheal epithelium was relatively complete, inflammatory exudation, bronchoconstriction and inflammatory cell infiltration were milder compared to the asthma group. Electron microscopy showed vacuolated changes of adrenal medulla cells, uneven distribution of chromaffin granules in the asthma group and the NGFgroup, and the quantity and concentration of chromaffin granules were significantly lower than normal. There were villous clubbing processes on the adrenal medulla cell membrane in the NGF group. While the anti-NGF group had no significant vacuolar changes in chromaffin granules and the concentration was close to normal. Image analysis showed that mean gray values of PNMT and NGF in the anti-NGF group were significantly different fromthe asthma group. The ELISA results showed that: ( 1) The average concentrations of epinephrine in each group were as follows, ie. the control group gt; anti-NGF group gt; asthma group gt; NGF group. ( 2) The average concentrations of norepinephrine in each group were as follows, ie. the NGF group gt; asthma group gt; anti-NGF group gt; control group. ( 3) There was no significant difference among the groups in the average concentration of cortisol. ( 4) The average concentrations of norepinephrine in each group were as follows, ie. , the control group gt; anti-NGF group gt; asthma group gt; NGF group. Conclusions Local embedding of anti-NGF microspheres can alleviate inflammatory infiltration in lung tissue and improve lung function of rat model with asthma. The mechanismmay be the anti-NGF antagonists the NGF receptor and reverse adrenal medulla cell transdifferentiation process primined by NGF.
To quantitatively measure the α1-adrenergic receptors and select the suitable conditions of receptor-ligand binding assay. Radioligand binding analysis was used to measure the concentration of α1-adrenergic receptors, and the measuring conditions were selected, respectively. Under the selected conditions, the α1-adrenergic receptors in lier plasma membranes of 8 nonhepatopathy subjects were measured.Under such suitable conditions as ３H-prazosin concentration 0.1-2.0nmol/L, incubating temperature 37℃, reaction time 20 minutes and seperating free ligand from system with double layer of filter paper, the binding of 3H-prazosin to α1receptors from 8 nonhepatopathy subjects were saturable with a high affinity. The Bmax, Kd, RMC and Hill coefficient were 142.1±14.1 fmol per milligram of protein, 0.2382±0.0548 nM, 739.0±167.6 fmol per gram of liver and 0.90±0.03, respectively.The suitable conditions may be very important for measuring α1-adrenergic receptors in human liver plasma membranes, which should be considered in hepatopathy studies.
ObjectiveTo observe the effect of epinephrine in intraocular irrigation solution on retinal vascular caliber and macular thickness. MethodsA prospective control study. 32 eyes of 32 patients with macular hole who underwent vitrectomy were enrolled in this study. The patients including 14 males (14 eyes) and 27 females (18 eyes), with the average age of (64.0±4.5)years. Uncorrected visual acuity, corrected visual acuity, slit lamp biomicroscopy, indirect ophthalmoscopy, fundus color photography and optical coherence tomography were performed in all patients. Retinal vascular caliber located in 0.5-1.0 disc diameter from optic disk was measured from digital fundus photographs and summarized as central retinal artery (CRAE) and vein (CRVE) equivalents in all eyes at baseline and at the 1 month, 3 months follow-up visit. The macular thickness is the distance from retinal interface of inner plexiform layer to retinal pigment epithelium layer. The macula was divided into inner ring ( < 3 mm) and outer ring (3-6 mm) according to the distance from the fovea. The patients were divided into experiment group (include epinephrine in intraocular irrigation solution, 1:1000) and control group (without epinephrine in intraocular irrigation solution), 16 eyes in each group. The difference of CRAE and CRVE between two groups was not significant (P > 0.05). The difference of macular thickness between inner ring and outer ring was not significant (P > 0.05). The average follow-up was 3.5 months. CRAE, CRVE and macular thickness in inner ring and outer ring before and 1 month, 3 months after surgery were comparatively analyzed. ResultsThe differences of CRAE and CRVE before and 1, 3 months after surgery both in experiment group (tCRAE=0.322, 0.148; tCRVE=0.317, 0.005) and control group (tCRAE=0.226, 0.137; tCRVE=0.284, 0.151) were not significant (P > 0.05). The differences of CRAE (t=0.624, 0.424) and CRVE (t=0.015, 0.041) between experiment group and control group also were not significant (P > 0.05). The differences of macular thickness in inner ring and outer ring before and 1, 3 months after surgery both in experiment group (tinner=0.322, 0.148;touter=0.317, 0.005) and control group (tinner=0.226, 0.137;touter=0.284, 0.151) were not significant (P > 0.05). The differences of macular thickness in inner ring (t=1.568, 0.373) and outer ring (t=-1.697, 0.536) between experiment group and control group also were not significant (P > 0.05). ConclusionEpinephrine (1:1000) in intraocular irrigation solution has no effect on retinal vascular caliber and macular thickness in patients with macular hole.