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  hepatitis b
This study evaluates the survival outcomes of patients who underwent living-donor liver transplantation (LDLT) using right lobe liver grafts for fulminant liver failure due to hepatitis B infection.
      
Expression and Characterization of Hepatitis B Surface Antigen in Transgenic Potato Plants
      
Transgenic potato plants expressing the gene of hepatitis B surface antigen (HBsAg) under the control of the double promoter of 35S RNA of cauliflower mosaic virus (CaMV 35SS) and the promoter of patatin gene of potato tubers have been obtained.
      
The molecular weight of HBsAg peptide was approximately 24 kD, which is in agreement with the size of the major protein of the envelope of hepatitis B virus.
      
Therefore, as well as in recombinant HBsAg-yeast cells, assembling of HBsAg monomers into immunogenic aggregates takes place in HBsAg-transgenic potato, which can be used as a source of recombinant vaccine against hepatitis B virus.
      
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A total of 658 breast biopsy and mastectomy specimens were revi-ewed(benign,647;carcinoma in situ,11 cases).Among the 658breast specimens,68(10.30%)atypical lobules(AL)were identifedand studied histopathologically.In addition to H & E staining,someslides were stained for AB/PAS,by Phosphotungstic acid Hemato-xylin and Gomori Silver.The results show that atypical lobules ty-pe A(ALA,54 cases)was more frequnent that atypical Iobulestype B(ALB.14 cases)Females of 31~45-year age group havethe highest incidence of...

A total of 658 breast biopsy and mastectomy specimens were revi-ewed(benign,647;carcinoma in situ,11 cases).Among the 658breast specimens,68(10.30%)atypical lobules(AL)were identifedand studied histopathologically.In addition to H & E staining,someslides were stained for AB/PAS,by Phosphotungstic acid Hemato-xylin and Gomori Silver.The results show that atypical lobules ty-pe A(ALA,54 cases)was more frequnent that atypical Iobulestype B(ALB.14 cases)Females of 31~45-year age group havethe highest incidence of ALA and ALB There was only quantitativedifference in AB/PAS staining between AL grades IV and carcinomain situ(CIS),and of no qualitive significance.It is considered thatthe histologic criteria of distinction between AL grades IV and CISwere the degree of cell atypia and the presence or absene of cent-ral necrosis.Besides ALA and ALB of variable degrees found in thevicinity of 11 cases of CIS,2 cases of ALB were also found inDCIS.It suggests that AL is closely related to malignant change &ALA and ALB may progress to DCIS & LCIS respectively.In thispaper,the typing,grading and histogenesis of AL are discussedwith review of literatures

从乳腺活检和手术切除标本切片658例(良性病变647例和原位癌11例)中,检出68例(10.3%)乳腺异型小叶(AL)进行病理组织学探讨。部分切片尚采用AB/PAS、磷钨酸苏木素和镀银染色,结果显示甲型异型小叶(ALA,54例)比乙型异型小叶(ALB,14例)常见。31~45岁中年妇女组检出率最高。AB/PAS染色在AL和原位癌(CIS)之间只有量的差异,并无定性意义。区别ALⅣ级与CIS的主要组织学依据是细胞异型性程度以及有否坏死。除11例CIS癌旁检出不同级别的ALA和ALB外,并在导管原位癌(DCIS)旁发现ALB2例。从而提示AL与癌变关系密切,ALA和ALB可分别发展为DCIS和小叶原位癌(LCIS)。本文着重讨论了AL的分型、分级与组织发生。

The authors retrospectively analyzed 86 cases of TIPSS focused on the puncture technique,.the effectiveness and various influential factors. 68 patients were male,and 18,female with mean age of 48 years(range,22-74 years).71 patients had history of hepatitis B. 69 cases had recurrent bleeding from gastro-eseophageal varices,58 of them received more than once endoscopic sclerotherapy. 6 patients were treated on an emergency basis because of massive active bleeding. All patients had obvious gastroeseophageal varices....

The authors retrospectively analyzed 86 cases of TIPSS focused on the puncture technique,.the effectiveness and various influential factors. 68 patients were male,and 18,female with mean age of 48 years(range,22-74 years).71 patients had history of hepatitis B. 69 cases had recurrent bleeding from gastro-eseophageal varices,58 of them received more than once endoscopic sclerotherapy. 6 patients were treated on an emergency basis because of massive active bleeding. All patients had obvious gastroeseophageal varices. TIPSS was technically successful in 78 of 86 pa- tients,no death was associated with the procedure. Portal vein pressure was reduced from 40.5± 3. 0cmH_2O(1cmH_2O=0.098kPa) before to 24.0±3.5cmH_2O after shunting,Doppler US revealed that the maximum blood flow velocity in the main portal vein increased from 12.0±4.5cm/s to 48.5 ±14,5/s. The mean follow-up time in the successful cases was 8 months(range,2-16 months).Shunt occlusion was found in 2 patients 1 month after TIPSS.3 patients died unrelated to the proce- dures at 2 months. 7 cases were lost to follow up and the remaining 66 patients had regular follow up records,6 patients had recurrence of gastrointestinal bleeding within six months,the cause was 8hunt occlusion in 2 cases and shunt stenosis in another 2 whchwere reintervented successfully. Variceal bleeding was confirmed in 1 case by endoscopy,another bleeding was unrelated to varices. Varices recurred but without recurrent bleeding in 3 patients 4~7months after shunting. Angiogra- phy revealed>70%stenosis in 2 cases, which were successful treated.Shunt patency was determined by color Doppler US in the remaining patients.The overall primary patency was 87.9%;Angioplasty and stent placement in the stenotic shunt resulted in a secondary patency of 93.9%. The results sug- gested that TIPSS is a relatively safe and effective means of lowering portal pressure and controlling variceal bleeding. The immediate and short-term results were mainly affected by improper stent placement and some unfavourable configuration of the stent.The shunt stenosis and occlusion oc-curred most frequently at the hepatic vein insertion site due to intimal hyperplasia which played an important role in middle and long term therapeutic effect.

报告86例经颈静脉肝内门腔静脉内支架分流术(TIPSS)的临床应用结果,主要探讨与建立分流道有关的技术问题和影响疗效的因素。86例中男68例,女18例,年龄22~74岁(平均48岁),71例有明确的乙型肝炎病史,69例有一次以上呕血或黑便史,58例曾接受一次以上经内镜注射硬化剂治疗,6例因大出血不止行急诊TIPSS。全部病例有中度以上食管胃底静脉曲张。结果:78例成功,8例失败,无死亡并发症。建立分流后门脉压从术前的40.5±3.0cmH_2O=(1cmH_2O=0.098kPa)降至24.0±3.5cmH_2O,Doppler超声显示门脉主干血流速度从术前12.0+±.5cm/s增至48.5±14.5cm/s。术后随访观察2~16个月(平均8个月),分流道早闭2例,3例术后2个月死于其他原因,7例失去联系,其余66例有定期随访记录,其中36例随访在6个月以上。术后半年内复发出血6例,经造影证实为分流道狭窄2例(经再通成功)、阻塞2例,1例内镜检查仍见重度静脉曲张,未行进一步检查,1例为非静脉曲张性出血;静脉曲张消失或减轻后再次出现3例,发生于术后4~7个月,超声波检查均提示分流道狭窄,2例造影证...

报告86例经颈静脉肝内门腔静脉内支架分流术(TIPSS)的临床应用结果,主要探讨与建立分流道有关的技术问题和影响疗效的因素。86例中男68例,女18例,年龄22~74岁(平均48岁),71例有明确的乙型肝炎病史,69例有一次以上呕血或黑便史,58例曾接受一次以上经内镜注射硬化剂治疗,6例因大出血不止行急诊TIPSS。全部病例有中度以上食管胃底静脉曲张。结果:78例成功,8例失败,无死亡并发症。建立分流后门脉压从术前的40.5±3.0cmH_2O=(1cmH_2O=0.098kPa)降至24.0±3.5cmH_2O,Doppler超声显示门脉主干血流速度从术前12.0+±.5cm/s增至48.5±14.5cm/s。术后随访观察2~16个月(平均8个月),分流道早闭2例,3例术后2个月死于其他原因,7例失去联系,其余66例有定期随访记录,其中36例随访在6个月以上。术后半年内复发出血6例,经造影证实为分流道狭窄2例(经再通成功)、阻塞2例,1例内镜检查仍见重度静脉曲张,未行进一步检查,1例为非静脉曲张性出血;静脉曲张消失或减轻后再次出现3例,发生于术后4~7个月,超声波检查均提示分流道狭窄,2例造影证实分流道狭?

patients (PTS) underwent coronary artery bypass grafting (CABG) and left ventricular aneurysm resection(VAR), 43 males and 8 fomales. Age ranged from 39 to 68 years. Most of PTS had high risk factors, unstable angina (34) ,previous myocardial infarction (24) , multi-vessel diseases (25) , left main trunk lesion ( 5 ) and associated hypertension (10) .LVEF ranged from 0.14 to 0.79 (Lessthan 0.30 in 6 cases) .The operations were performed under CPB with cardiac arrest. The total number or vessel grafts wore 101....

patients (PTS) underwent coronary artery bypass grafting (CABG) and left ventricular aneurysm resection(VAR), 43 males and 8 fomales. Age ranged from 39 to 68 years. Most of PTS had high risk factors, unstable angina (34) ,previous myocardial infarction (24) , multi-vessel diseases (25) , left main trunk lesion ( 5 ) and associated hypertension (10) .LVEF ranged from 0.14 to 0.79 (Lessthan 0.30 in 6 cases) .The operations were performed under CPB with cardiac arrest. The total number or vessel grafts wore 101. 10 PTS had VAR.C AB G with VAR plus VSD repair or septal aneurysmectomy for 1 case respectively. In addition, valve replacements, endarterectomy and laser transmyocardial revascularization were simultaneously performed m 4 cases respectively, OTCA in 2 cases and TVP in 1 case.7 PTS died, the cauces of death were related to the preoperative risk factors and poor LV function. Following-up 6 to 108 months, 31 PTS wore free of angina,4 had mild angina and 7 had effort angina.There was two late death. because of severe serum hepatitis and cardiac arrhythmia respectively.The patient selection for operation, corconary artery endarterectomy, ventricular aneurysm resection and valve replacement with C A B G are discussed.

本文报道冠状动脉旁路移植术和室壁瘤切除术51例。全组中34例为不稳定心绞痛,25例多支病变,5例左主干狭窄,24例陈旧性心肌梗死,10例合并高血压,左室射血分数0.14~0.79,小于0.3者6例。均在常规体外循环和心脏停搏下手术,共架血管桥101支。全组10例同期作了室壁瘤切除术,后者还同时修补室间隔穿孔和间隔瘤各1例。附加手术有心脏瓣膜替换术,冠状动脉内膜切除术和激光心肌再血管化各4例,术中冠脉腔内成形术2例及三尖瓣成形术1例。手术死亡7例,均与术前高危因素及左室功能差有关。随访6~108个月,31例心绞痛消失,4例偶有轻度心绞痛,7例仍有劳力性心绞痛;晚期死亡2例,分别死于重症乙型肝炎和心律失常。重点讨论了手术病例选择,冠状动脉内膜切除术,室壁瘤切除修复术以及架桥与换瓣同期手术问题。

 
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