Objective:To investigate the clinical characteristics of colon complications in patients with necrotizing pancreatitis(NP).Methods:The clinical data of 403 patients with NP admitted to the Department of General Surgery,Xuanwu Hospital, Capital Medical University from January 2014 to December 2021 were retrospectively analyzed. There were 273 males and 130 females,aged (49.4±15.4) years(range: 18 to 90 years). Among them,there were 199 cases of biliary pancreatitis,110 cases of hyperlipidemic pancreatitis,and 94 cases of pancreatitis caused by other causes. A multidisciplinary diagnosis and treatment model was used to diagnose and treat patients. Depending on whether the patients had colon complications,they were divided into colon complications group and noncolon complications group. Patients with colon complications were treated with anti-infection therapy,parental nutritional support,keeping the drainage tube unobstructed,and terminal ileostomy. The clinical results of the two groups were compared and analyzed using a 1∶1 propensity score match(PSM) method. The t test, χ2 test, or rank-sum test was used to analyze data between groups,respectively. Results:The incidence of colon complications was 13.2%(53/403),including 15 cases of colon obstruction,23 cases of colon fistula,and 21 cases of colon hemorrhage. After PSM,the baseline and clinical characteristics at admission of the two groups of patients were comparable (all P>0.05). In terms of clinical outcome,compared to patients with NP without colon complications,the number of patients with colon complications who received minimally invasive intervention(88.7%(47/53) vs. 69.8%(37/53), χ2=5.736, P=0.030),the number of minimally invasive interventions ( M(IQR))(2(2) vs. 1(1), Z=4.638, P=0.034),the number of patients with multiple organ failure(45.3%(24/53) vs. 32.1%(17/53), χ2=4.826, P=0.041),and the number of extrapancreatic infections(79.2%(42/53) vs. 60.4%(32/53), χ2=4.476, P=0.034) increased significantly. The time required for enteral nutrition support(8(30)days vs. 2(10) days, Z=-3.048, P=0.002),parental nutritional support(32(37)days vs. 17(19)days, Z=-2.592, P=0.009),the length of stay in the ICU(24(51)days vs. 18(31)days, Z=-2.268, P=0.002),and the total length of stay (43(52)days vs. 30(40)days, Z=-2.589, P=0.013) were also significantly prolonged. However,mortality rates in the two groups were similar(37.7%(20/53) vs. 34.0%(18/53), χ2=0.164, P=0.840). Conclusions:Colonic complications in NP patients are not rare,which can lead to prolonged hospitalization and increased surgical intervention. Active surgical intervention can help improve the prognosis of these patients.

目的 分析甲胎蛋白升高型胃癌(alpha-fetoprotein-producing gastric cancer,AFPGC)患者的临床病理特征和预后影响因素.方法 回顾性分析2004年1月至2020年2月首都医科大学宣武医院收治的进行D2根治性手术治疗的531例胃癌患者的临床资料,选取所有AFPGC患者[甲胎蛋白(alpha fetoprotein,AFP)>30μg/L]为AFP升高胃癌组(22例),根据匹配原则另择同期首都医科大学宣武医院收治的22例AFP水平正常的胃癌患者为AFP正常胃癌组.比较分析两组患者的临床病理特征以及术后5年总生存率.分析影响AFPGC患者术后5年总生存率的独立危险因素.结果 本研究中,AFPGC的比例为4.14％(22/531).两组患者的肿瘤大小、肿瘤部位、肿瘤分化程度、肿瘤浸润深度、淋巴结转移、TNM分期比较差异均无显著性(P>0.05);AFP升高胃癌组患者的脉管浸润、同时性肝转移比例均显著高于AFP正常胃癌组(P<0.05).Kaplan-Meier生存曲线显示,AFP升高胃癌组患者的术后5年总生存率显著低于AFP正常胃癌组(P<0.05).单因素分析结果 显示,AFPGC患者的术后5年总生存率与术前血清AFP水平、肿瘤分化程度、淋巴结转移、脉管浸润、同时性肝转移和TNM分期显著相关(P<0.05).Cox多因素分析结果 显示,术前血清AFP水平升高是影响AFPGC患者术后5年总生存率的独立危险因素(P<0.05).结论 AFPGC患者易发生脉管浸润和同时性肝转移,预后往往较差,且术前血清AFP水平升高是AFPGC患者预后不良的独立危险因素.

Objective:To evaluate the treatment efficiency using transnasal ileus catheter in elderly patients with mechanical small intestinal obstruction.Method:Ninety geriatric patients with mechanical small intestinal obstruction admitted to Xuanwu Hospital of Capital Medical University from Jan 2018 to Dec 2019 were divided into intestinal obstruction catheter group with transnasal ileus catheter insertion ( n=40) and nasogastric tube group ( n=50). Results:The transnasal ileus catheter retained for (91.0±33.5) h significantly shorter than that in nasogastric tube group ((149.3±82.3) h, t=3.323, P=0.002). Compared to nasogastric tube group, the exhaust time, defecation time, feeding time, time to gas-liquid level disappearance and time to contrast agent appearance in the colon in intestinal obstruction catheter group were significantly shorter [(55.9±40.9) h vs. (127.6±59.1) h, t=5.149; (69.8±42.3) h vs. (134.9±48.4) h, t=5.371; (104.3±35.1) h vs. (178.3±79.8) h, t=4.297; (106.2±36.6) h vs. (175.8±79.1) h, t=4.050 and (101.4±37.3) h vs.(172.4±72.9) h, t=4.407, all P<0.05]. In addition, the length of hospital stay was shorter and in hospital expenses were lower [(8.1±3.8) d vs. (11.6±6.7) d, t=2.248; (8 236±5 451)￥ vs. (15 320±9 582)￥, t=3.293, all P<0.05]. Conclusion:The use of transnasal ileus catheter was safe and effective to relieve the symptoms of mechanical small intestinal obstruction, hence improving the success rate of conservative treatment.

目的 探讨肿瘤免疫营养指标预测胰腺癌可切除性的价值.方法 回顾性分析2015年1月至2018年12期间就诊于首都医科大学宣武医院、经病理学检查确诊的55例胰腺癌患者的临床资料,收集指标包括:中性粒细胞计数、淋巴细胞计数、单核细胞计数、血小板计数、血红蛋白、白蛋白、前白蛋白、胆固醇和血清肿瘤标志物(CEA和CA19-9),计算中性粒细胞计数/淋巴细胞计数比(NLR)、血小板计数/淋巴细胞计数比(PLR)、淋巴细胞计数/单核细胞计数比(LMR)、预后营养指数(PNI)、老年营养风险评分(GNIR)和控制营养状况评分(COUNT),采用受试者工作特征曲线(ROC曲线)评价各种指标对胰腺癌根治性切除的预测价值.结果 55例胰腺癌患者中,22例接受了根治性手术,33例未接受根治性手术.根治性手术组与非根治性手术组患者的性别、BMI、中性粒细胞计数、单核细胞计数、血小板计数、血红蛋白水平、白蛋白水平、前白蛋白水平、胆固醇水平和肿瘤部位比较差异均无统计学意义(P＞0.05),但2组患者的年龄、淋巴细胞计数、CEA和CA19-9水平比较差异均有统计学意义(P＜0.05).中性粒细胞计数、淋巴细胞计数、单核细胞计数、血小板计数、血红蛋白、白蛋白、前白蛋白、胆固醇、NLR、PLR、LMR、PNI和GNIR预测胰腺癌可切除性的曲线下面积(AUC)均无统计学意义(P＞0.05),而COUNT、CEA和CA19-9的AUC值均有统计学意义,具有一定的诊断效能.COUNT、CEA水平和CA19-9水平的AUC值分别为0.700、0.705和0.739,最佳临界点对应的灵敏度分别为59.09％、80.00％和100％,特异度分别为87.88％、66.67％和42.42％.COUNT的特异度比较高,而灵敏度差;血清肿瘤标志物CEA水平和CA19-9水平的灵敏度比较高,但特异度差.结论 COUNT可以作为预测胰腺癌可切除性的一项临床参考指标.COUNT、CEA及CA19-9的综合应用,可以帮助临床更好地判断胰腺癌的手术指征.

病人,女性,63岁.因间断上腹部疼痛伴皮肤黄染8个月余,加重5个月余于2019年5月6日入院.腹部计算机断层扫描(CT)和磁共振胰胆管成像(MRCP)检查诊断为胆总管结石.实验室检查:血红蛋白127 g/L,红细胞压积为37.6％,白细胞4.26×109/L,丙氨酸氨基转氨酶(ALT) 175IU/L,γ-谷氨酰转肽酶(GGT)558 IU/L.于2019年5月9日行胆道支架植入术+内窥镜十二指肠乳头切开(EST)+内窥镜逆行胰胆管造影(ERCP)手术,手术使用0.035英寸直径,450 cm长度的斑马导丝.用取石网篮成功取出所有胆总管结石,并放置6cm×10 F胆道支架,术中失血量为10ml.ERCP术后返回病房.查血常规显示血红蛋白118 g/L,红细胞压积为35.0％,白细胞计数8.03×109/L,血流动力学稳定,给予外周输注抗生素预防感染、微量泵泵入胰酶抑制剂预防术后胰腺炎的发生.术后6小时,病人突发腹部剧痛伴大汗及血流动力学变化(血压53/32 mmHg,心率105次/分).

目的 探讨Seminar教学法在普通外科住院医师规范化培养中的应用价值.方法 将首都医科大学宣武医院普通外科接受住院医师规范化培训的35名学员(自2016年9月至2018年8月)采用Seminar教学法分为实验组即男生30人,女生5人,平均年龄(25.0±1.7)岁,均为大学本科学历,将2014年9月至2016年8月的前期住院医师采用传统教学法的35名住院医师(男生29人,女生6人,平均年龄(25.0±1.8)岁,均为大学本科学历)作为对照组采用传统教学法.采用客观结构化临床考试(OSCE)及学生满意度调查评价教学效果.结果 实验组OSCE考试中病史采集和查体、病例分析、基本操作技能及辅助检查结果判读得分均高于对照组(P<0.01),学员对教学方式的满意度评分中对Seminar教学模式满意,认为通过这种教学方式激发了学习兴趣,提高了自学能力,口头表达、总结、临床思维、专业知识理解等各方面综合能力.结论 Seminar教学法有助于提高普通外科住院医师规范化培训质量.

目的 探索成人甲状旁腺细胞培养方法的可行性.方法 采用胶原酶消化成人甲状旁腺组织,进行原代和传代细胞培养,隔日观察细胞的形态变化.取传代一代细胞,一部分通过电子显微镜观察细胞形态并检测培养液中甲状旁腺激素(parathyroid hormone,PTH)含量,另一部分采用聚合酶链反应(polymerase chain reaction,PCR)方法检测甲状旁腺细胞特异性标志物的RNA:钙敏感性受体(calcium-sensing receptor,CaSR)、PTH和神经胶质细胞缺失转录因子(glial cells missing-2,GCM-2).结果 电子显微镜下观察传代至第7d的细胞,发现细胞质丰富,含有丰富的线粒体、内质网和高尔基体,细胞质和细胞间可见分泌囊泡;细胞培养液上清中可检测出PTH;甲状旁腺细胞特异性标志物CaSR、PTH及GCM2呈阳性.结论 经胶原酶消化法消化成人甲状旁腺细胞并培养,所得甲状旁腺细胞具有良好的形态和分泌功能,并保持甲状旁腺细胞的特异表型,可作为永久性甲状旁腺功能低下时同种异体细胞移植的来源.

Objective To explore risk factors of hypocalcemia after thyroidectomy in general hospital. Method We collected clinical data of patients with thyroid diseases prospectively between January 2014 and September 2016. The clinical characteristics, laboratory markers, surgical details and postoperative pathologic results of normocalcemic and hypocalcemic patients were compared. Result Transient hypocalcemia were found in 35 (9%) out of 385 patients. Most patients with transient hypocalcemia or inadvertent parathyroidectomy (IPE) had no significant clinical manifestation. The percentage of hypocalmia caused by IPE was lower than disturbance of parathyroid or it's blood supply. The serum calcemia was lower in patients with malignant tumor, bilateral diseases, disturbance of bilateral capsule behind thyroid, longer operative time, central neck dissection or IPE. The odds ratio of "disturbance of bilateral capsule behind thyroid" and "IPE" were 16.1 and 4.16 respectively (P<0.05) according to multivariate logistic regression. Conclusion The major reason of hypocalcemia after thyroidectomy was disturbance of parathyroid or it's blood supply. IPE and disturbance of bilateral capsule behind thyroid were recognized as independent risk factors, and we recommend meticulous capsular dissection technique during surgery to keep parathyroid glands in situ.

Objective To discuss the necessity of D3 dissection in right colon cancer patients without lymph node metastasis in preoperative CT study. Method Retrospective analyses the clinical data of right colon cancer patients who received surgical therapy in our hospital between Jan 2006 and Dec 2014. The criterion of lymph node metastasis in CT study including short/long axis diameter ratio was greater than 0.8, clusters of different lymph nodes and irregular enhancement after introducing contrast. D3 dissection in right hemicolectomy was defined dissecting the lymph node at root of ileocolic artery, right colic artery (if present) and right branch or trunk of middle colic artery (extended right colectomy). Result Between Jan 2006 and Dec 2014, there were 1278 colon cancer patients received surgery in our department. Two hundred and seventy-five right colon cancer patients without lymph node metastasis in preoperative CT study were included in our study. D2 and D3 dissection were performed in 77 and 198 patients, respectively with apical lymph node metastasis rate 3.5%(7/198). Overall complication rate was 15.6%(43/275). Morbidity in D2 and D3 group was 13.0%(10/77) and 16.7%(33/198), respectively with no statistical difference. Elderly patients, emergency operation, open surgery and high T stage of tumor were the risk factors for postoperative complications in logistic regression analysis. Conclusion In right colon cancer patients without lymph node metastasis in preoperative study, despite D3 dissection did not increase the complication rate, the apical lymph node metastasis rate was extremely low. The impact of such surgery on prognosis needs further investigated.

目的 比较乳腺癌保留乳房和乳房全切手术患者的生活质量.方法 回顾性收集首都医科大学宣武医院普通外科2006年1月至2013年12月间,由同一组手术医师连续完成的保留乳房或乳房切除手术的乳腺癌患者资料,按照入组和排除标准筛选出符合入组条件患者232例,使用欧洲癌症治疗研究组织(EORTC)制定的测量癌症患者生活质量量表(QLQ)-C30和QLQ-BR23对其生活质量进行评价.于2014年2月至2015年4月调查期间,发放并回收生活质量调查问卷207份,分为保留乳房组(101例)和乳房全切组(106例).两组患者腋窝手术方式、化疗、放射治疗、内分泌治疗、文化程度等计数资料的比较采用x2检验,肿瘤分期差异采用Z检验,生活质量数据差异采用t检验比较.结果 问卷回收率为89％(207/232).对比两组患者一般资料,结果显示,保留乳房组和乳房全切组在肿瘤分期、腋窝淋巴结手术情况、化疗、内分泌治疗情况等差异均无统计学意义(Z=-1.925,x2=5.129、0.121、1.943,P均＞0.050),但保留乳房组的放射治疗比例明显高于乳房全切组[91.1％(92/101)比28.3％(30/106),x2=84.248,P＜0.001],且文化程度高者(高中及以上学历)占80.2％(81/101),显著高于乳房全切组的60.3％ (64/106)(x2=9.684,P=0.017).QLQ-C30结果显示,两组患者在总体生活质量、躯体功能、角色功能、情绪功能、认知功能、社会功能领域及疲乏、恶心与呕吐、疼痛、呼吸困难、睡眠障碍、食欲、便秘、腹泻、经济困难等子量表的评分差异均无统计学意义(t=0.456、2.297、2.106、-1.529、-0.400、0.689、-1.050、0.354、-1.219、-0.473、1.027、-0.118、0.623、0.179、-1.066,P均＞0.050).QLQ-BR23结果显示,保留乳房组患者的体象评分(83.2±19.6)显著高于全切组(66.2±20.1)(t=4.854,P＜0.001),在性功能、性欲、对未来的憧憬、系统治疗不良反应、乳房症状、上肢症状和对脱发的担忧方面评分组间差异均无统计学意义(t=-0.628、-0.874、-0.418、0.000、-0.193、-0.457、0.774,P均＞0.050).结论 保留乳房手术患者总体生活质量与乳房全切组没有差异,但保留乳房手术能很好的维护患者的体象,即患者体形满意度明显高于乳房切除组,所以保留乳房手术仍值得进一步推广.

Objective To explore the short-term outcomes and safety of laparoscopic complete mesocolic excision(CME) in patients with colon cancer. Method The clinical pathological factors of 96 patients with colon cancer who were in general surgery Xuanwu Hospital from February 2012 to March 2016 were analyzed retrospectivly. These patients were divided into laparoscopic CME surgery groups (n=52) and laparoscopic traditional surgery groups (n=44). The number of lymph node dissection, operation time, blood loss, postoperative feeding time and postoperative complications were compared between the two groups. Result More number of lymph nodes were removed in the CME group than that in the control group(18.38±2.73 vs 16.48±1.72, P<0.01). In patients with right colon cancer, CME group was associated with higher lymph node counts (19.18±2.73 vs 16.96±1.68, P<0.01). In patients with stage Ⅲ cancer,CME group was associated with great harvest of lymph node (19.50±2.96 vs 17.09±1.35, P<0.01). There were no differences in operation time, intraoperative blood loss, time to eating and postoperative hospital stay(P>0.05). There were some acceptable postoperative complications in each groups,such as pulmonary infection, deep venous thrombosis and incomplete intestinal obstruction, but showed no statistical significances (P>0.05). Conclusion Laparoscopic CME procedure is so safe that will not affect postoperative recovery. It also does not increase the risk of postoperative complications.More important, patients can achieve better oncologic clearance effects than the control group.

Objective To validate the accuracy of the determinant-based classification (DBC) for the severity of acute pancreatitis (AP).Methods Retrospective analysis the clinical data of 243 patients with acute pancreatitis who admitted to our hospital between January 2012 and December 2013.Length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality was assessed,respectively in subgroup of mild,moderate,severe and critical acute pancreatitis according to DBC.Results Pancreatic or peripancreatic necrosis was present in 65 of the patients (26.7％).Transient and persistent organ failures were present in 26 patients (10.7％) and 9 patients (3.7％),respectively.On the basis of the DBC,178 (73.3％),35 (14.4％),21 (8.6％),and 9 (3.7％) patients were determined to have mild,moderate,severe,or critical AP,respectively.The different categories of severity for DBC system were associated with statistically significant and clinically relevant differences in length of total parenteral nutrition,length of ICU and hospital stay,operation rate and mortality.Conclusions The DBC accurately classify the severity of AP in subgroups of patients.

【Objective】To investigate the factors that might affect the quality of breast cancer surgery.【Methods】The patients who received breast cancer surgery by the same team in a thyroid and breast unit from a university hospital in 2011 were retrospectively analyzed. All of the relevant data were input to the website of NQMBCTM and compared with the database input by other centers and the percentile of this center was obtained.【Results】The average time between core needle biopsy and initial breast cancer surgery was 5.0 days and this result lies in the95 th percentile of all centers; the needle biopsy rate is 85.7% and is in the 49 th percentile; the percent of sentinel node biopsy is 83.3% which is in the 42 nd percentile; the percent of overall breast conservation surgery is 80.0%which is in the 76 th percentile; the re-excision rate of post breast conservation surgery is 0 and the rate of post lumpectomy radiation is 94.3%, which result in the 100 th percentile and 50 th percentile respectively. 【Conclusions】NQMBC is a good tool to evaluate the quality of breast cancer surgery. Some aspects of quality of our patientsu0027 breast cancer surgery are comparable to that of American centers. In order to improve the quality of breast cancer surgery, the rates of needle biopsy and sentinel node biopsy should be increased.

保留乳房手术已成为早期乳腺癌的标准治疗方法。保留乳房手术加放射治疗可获得与乳房全切同样的局部复发率及生存率[1-2]。但是，若肿瘤扩大切除组织超过乳腺体积的20%[3]，或肿瘤位于内下象限等美容敏感区域，常常出现难以接受的乳房畸形，比如局部凹陷、乳头偏斜等，严重影响保留乳房手术的效果。近年来，为减少局部复发及术后乳房畸形，乳房整形技术在保留乳房手术中得到应用，使切除组织增加的同时并能较好的维持乳房形态，但由于切除量明显大于传统的保留乳房手术，有时会使双侧乳房明显不对称，常需要健侧乳房行对称性手术加以纠正。2009年10月至2014年7月，首都医科大学宣武医院普通外科由同一医师应用肿瘤整形技术完成了91例乳腺癌保留乳房手术，其中10例(2011年6月至2014年7月)即刻进行了健侧乳房的对称性整形手术。现将这10例患者的手术方法及术后效果总结与分析如下。

Objective To explore the short-term outcomes and safety of laparoscopic complete mesocolic excision ( CME) in elderly patients with colon cancer. Method The clinical pathological factors of 54 patients with colon cancer who were over 70 years old in department of general surgery of Xuan Wu Hospital from January 2012 to Feb-ruary 2015 were analyzed retrospectivly. These patients were divided into laparoscopic CME surgery groups (n=23) and laparoscopic traditional surgery groups (n=31). Short-term outcomes, safety and complications were compared between the patients of two groups. Result More number of lymph nodes were removed in the CME group than that in the control group(18. 21±2. 70 vs 15. 76±1. 35,P<0. 01). In patients with stageⅢcancer,CME group was associated with gratifying harvest of lymph node (19. 79±2. 33 vs 16. 12±1. 41,P<0. 01). In patients with right co-lon cancer,CME group was associated with higher lymph node counts(22. 92±2. 76 vs 19. 45±2. 24,P<0. 01). There were no differences in operation time,intraoperative blood loss, time to eating and postoperative hospital stay (P>0. 05). There were some acceptable postoperative complications in each groups,but showed no statistical signifi-cance(P>0. 05). Conclusion Elderly patients undergoing laparoscopic are safe and this surgical proceduredoes not affect postoperative recovery. It also does not increase the risk of postoperative complications. More important,laparo-scopic CME surgery can achieve better oncologic clearance effects than the control group.

住院医师规范化培训是医学教育的重要阶段，也是培养高水平临床医师的必经途径。经过30余年的努力，我国开始建立国家住院医师规范化培训制度，为住院医师规范化培训提供了法律保障，对住院医师培训建立健全、稳定的经费投入机制。只有保证受训者的工资、福利待遇、培训考核及管理的经费，才能做到以质量为中心，不断建设、持续发展。笔者根据所在医院的情况，从住院医师待遇、培训和考核花费、基本设施投入三个方面进行统计，分析每位住院医师每年所需的费用，为管理部门的决策提供参考。

Objective To analyze the results of the residents' clinical competency competition,and discuss the influ-ence factors of the cultivation of the residents' clinical ability. MethOd We made statistic analysis of the general condition and the performance of the competition of the 250 residents. Result The score of the auxiliary examination interpretation,dealing with patients and the awareness of health law and regulations were low ( 67. 59 ± 13. 87, 69. 21±16. 28,64. 45±5. 36). The ability of modifying the students' records,writing pathology application,critically ill noticing and writing discharge instructions were bad(30. 31±16. 84,70. 26±7. 51,75. 15±14. 68,63. 49± 18. 27). COnclusiOn The clinical competency competition of residents is helpful to test the residents' clinical abili-ty. System,social factors,the graduation examination,the teachers' teaching consciousness and the enthusiasm and initiative of the residents influence the cultivation of clinical ability of the residents.

To investigate the compliance of endocrine therapy in hormone receptors positive breast cancer patients and analyze the potential factors which would affect the compliance. Method Clinical data were retrospec-tively collected and analyzed from the hormone receptors positive breast cancer patients treated by a same group of surgical oncologists in a teaching hospital from January 2006 to December 2012. The endocrine therapy compliance was studied by a self-made questionnaire. Result 10 patients were lost to follow up and 6 were died,220 patients fol-lowed up. 197 (89. 5%) patients were defined as compliance. Statistical analysis showed that the following factors were associated with poor compliance, which including: younger than 40 years old; unable to take care herself in daily life;financial difficulties;disease deterioration;unknown to the treatment background;failed to follow up reg-ularly;taking medication more than 2 years; intolerance to the side effects. Conclusion The compliance of endo-crine therapy of our study patients is relatively higher. This appears to owe to more detailed explanations by physi-cians, more local patients in this study and more patients followed by surgical oncologists.

Objective To investigate the way to culture human parathyroid cells and to investigate its secretory function. Methods After digested by collagenase, parathyroid cells were isolated to get the original generation cells, then the cells were cultured and passaged, and morphological changes of original generation cells and passage cells were observed on every day. The parathyroid hormone(PTH) level secreted by the original generation cells and passage cells were measured on the 1st, 5th, 10 th, 15 th, and 20 th day(original generation cells only) respectively. Results The cellular morphology was complete after digestion. On the 2nd day, most of the parathyroid cells had adhered and spreaded, on the 3rd day, all cells had spread. There was no very obvious changes on these cells after cultured for 4-15 days. From 16 to 20 days, some parathyroid cells went senescence. On the 1st day, all of the passage cells, which were fusiform and little bigger than those of the original generation cells, had adhered and spreaded. From 2 to 15 days, there was no very obvious changes. The concentration of PTH in original generation cells begin to decreased significantly on the 10 th day(P0.01). The concentration of PTH in passage cells were all lower than those of original generation cells at the same corresponding time, but there were no significant difference on the PTH level on 5th day and 1st day, 10 th day and 5th day, 15 th day and 10 th day in passage cells(P0.05). Conclusions Parathyroid cells which were cultured within 10 days possess well morphologic structure and have the strongest secretory function. Although the passage cells still possess secretory function, it is greatly inferior to original generation cells. At last, we consider that original generation cells cultured within 10 days can be regarded as the source of allogeneic cell transplantation.

目的 探讨急性肠系膜血管闭塞(AMVO)的早期诊断及治疗.方法 回顾性分析51例AMVO的临床特点.结果 肠系膜上动脉栓塞(SMAE) 33例,肠系膜上动脉血栓形成(SMAT)7例,肠系膜上静脉血栓形成(SMVT) 11例.入院即诊断为SMAE的仅有16例;手术27例,非手术治疗6例;死亡20例,治愈13例.入院即诊断为SMAT的仅有4例;手术4例,介入治疗1例,非手术治疗2例;死亡4例,存活3例.入院即诊断为SMVT的有8例;手术3例,介入治疗2例,非手术治疗6例;死亡3例,存活8例.结论 早期诊断、积极行介入治疗与剖腹探查为主的外科治疗是提高AMVO疗效的关键.