患儿,男,3岁.因"体检发现心脏杂音1年"于2005年6月15日收入院.患儿1年前因"上呼吸道感染"就诊于当地医院,病程中无活动后心慌、气短,无咳嗽、咳痰等症状,易患"上呼吸道感染".入院查体:体温37.2℃,脉搏112次/min,呼吸22次/min,血压110/60 mm Hg(1 mm Hg=0.133kPa).

AIM: To investigate the effect of silymarin on homocysteine-induced cell viability and apoptosis in human umbilical vein endothelial cells (HUVECs). METHODS: Cell viability was analyzed by using MTT and LDH assay. Apoptotic cells were detected by using DNA fragmentation and flow cytometric analysis. The level of intracellular reactive oxygen species (ROS) and the potential of mitochondrial membrane were determined by flow cytometric assay. The activity of caspase-3, -6 and -9 were measured with microplate spectrofluorometer. Protein levels were examined by Western blotting. RESULTS: Treatment of cultured HUVECs with HCY for 48 h induced a significant decrease in cell viability, and the percentage of apoptosis increased to 76.8%. The level of intracellular ROS and activity of caspase-3, -6 and -9 enhanced, and the red/green ratios of mitochondrial membrane decreased. However, simultaneous treatment with silymarin exhibited cytoprotective effects, reduced formation of the DNA ladder, prevented the levels of Bax and Bcl-2 proteins and the accumulation of ROS as well as caspase-3, -6 and -9 activation, reconverted the potential of mitochondrial membrane, and the percentage of apoptosis/necrosis was significantly decreased to 12.7% in a dose-dependent manner. CONCLUSION: These results demonstrate that silymarin has the protective capacity to antagonize HCY-induced apoptosis in HUVECs. The antiapoptotic action of silymarin may be partially dependent on an anti-oxidative stress effects, inhibition of caspases activity, and maintenance of mitochondria function.

为了有效地预防或减少食管胃吻合口常见的并发症,我科自1986年10月,采用食管胃深套叠吻合法[1],治疗食管、贲门癌79例,效果满意,现报告如下.

创伤性浮动胸壁是常见严重的胸外伤,多年来在其病理生理及治疗上存在争议.自1986年以来我科收治18例创伤性浮动胸壁,疗效满意.现报告如下. 1 资料与方法 1.1 临床资料:本组18例浮动胸壁中男15例,女3例.年龄22～56岁.致伤原因:车祸15例,其他原因3例,发生于左胸13例,右胸5例.全组病人伤后均有胸痛,浮动胸壁,呼吸困难,其中发绀3例,血痰6例,皮下气肿9例,不同程度休克5例,伤侧呼吸音均减弱,可闻及中小水泡音及痰鸣音,X线检查示肋骨骨折3～10根,甚至多例发生双段以上骨折,伤侧肺野内均呈大小不等片絮状阴影.双肺改变者4例,合并血气胸10例,锁骨骨折3例.

目的:探讨42例原发性纵隔肿瘤的诊断和治疗.方法:42例患者经X线及CT检查确诊为本病,然后行手术治疗.结果:42例纵隔肿瘤均经手术治疗,除1例胸腺瘤合并重症肌无力患者死亡外,余均获满意疗效.结论:术前明确诊断,选择适合的手术切口及合理操作是治疗本病的关键.

为防止食管、贲门癌根治术后反流性食管炎的发生,改善患者术后的生存质量,我科在采用胃腔内食管胃吻合法的基础上[1],对此术式进行了改良.即在吻合部行胃腔内胃管成形共行食管癌、贲门癌切除术21例,术后观察满意.

1988年1月至2000年12月,我们共手术治疗胸腺瘤33例,其中术前确诊胸腺瘤28例,术前未明确诊断,术后病理证实为胸腺瘤者5例,现报告如下.

我院自1980年1月至2000年12月共收治膈肌损伤30例,本文就其诊断和治疗的体会报告如下. 1 资料与方法 1.1 一般资料:本组男性28例,女性2例,年龄9～54岁,急诊入院28例,余2例由外地分别于伤后4个月、3 a 5个月转入.30例中开放性损伤24例(80%),其中锐器伤19例,辗挫伤1例,枪伤2例,爆炸伤2例,闭合性损伤6例(20%),其中交通事故伤4例,坠落伤1例,挤压伤1例.

目的研究胸外伤患者可溶性白细胞介素-2受体(sIL-2R)和肿瘤坏死因子-α(TNF-α)在创伤感染发生机制中的作用.方法根据胸外伤创伤严重程度评分(AIS-ISS)分为:≥16分组36例,＜16分组30例,根据是否合并感染分为:创伤组46例,创伤感染组20例.于入院后第1、3、7、14天抽取血样,运用双抗体夹心ELISA法测定:sIL-2R和TNF-α含量.结果①重症胸外伤组伤后第1天sIL-2R及TNF-α水平皆高于胸外伤组和正常对照组;②创伤感染组sIL-2R水平持续升高,3～7 d最为显著,伤后14 d仍未降至正常水平,而创伤组无此改变.③创伤组和创伤感染组均见TNF-α短暂升高.结论重症胸外伤后,sIL-2R在细胞免疫功能紊乱及创伤感染的发生机制中起重要作用,而TNF-α在创伤后早期病理过程中起重要作用.

为了有效地预防或减少食管胃吻合口常见的并发症,我科自1985年10月起,采用食管胃深套叠吻合法治疗食管、贲门癌59例,效果满意,现报告如下.