临床医学专科教材第三版《生理学》刍议

由钟国隆教授主编的临床医学专科第三版《生理学》出版已近三年了。笔者幸获此书,即刻捧读,又经过年余的教学应用,感到该书在当前临床医学专科教材中,不失为一部具有实用性的教材。但纵横全书,除了读到该书的衔华佩实之处外。

Endoclips vs large or small-volume epinephrine in peptic ulcer recurrent bleeding

AIM:To compare the recurrent bleeding after endoscopic injection of different epinephrine volumes with hemoclips in patients with bleeding peptic ulcer.METHODS:Between January 2005 and December 2009,150 patients with gastric or duodenal bleeding ulcer with major stigmata of hemorrhage and nonbleeding visible vessel in an ulcer bed(Forrest Ⅱa) were included in the study.Patients were randomized to receive a small-volume epinephrine group(15 to 25 mL injection group;Group 1,n = 50),a large-volume epinephrine group(30 to 40 mL injection group;Group 2,n = 50) and a hemoclip group(Group 3,n = 50).The rate of recurrent bleeding,as the primary outcome,was compared between the groups of patients included in the study.Secondary outcomes compared between the groups were primary hemostasis rate,permanent hemostasis,need for emergency surgery,30 d mortality,bleeding-related deaths,length of hospital stay and transfusion requirements.RESULTS:Initial hemostasis was obtained in all patients.The rate of early recurrent bleeding was 30%(15/50) in the small-volume epinephrine group(Group 1) and 16%(8/50) in the large-volume epinephrine group(Group 2)(P = 0.09).The rate of recurrent bleeding was 4%(2/50) in the hemoclip group(Group 3);the difference was statistically significant with regard to patients treated with either small-volume or large-volume epinephrine solution(P = 0.0005 and P = 0.045,respectively).Duration of hospital stay was significantly shorter among patients treated with hemoclips than among patients treated with epinephrine whereas there were no differences in transfusion requirement or even 30 d mortality between the groups.CONCLUSION:Endoclip is superior to both small and large volume injection of epinephrine in the prevention of recurrent bleeding in patients with peptic ulcer.

Effect of radiotherapy on angiogenesis of human pancreatic cancer transplanted tumor in nude mice

Objective: The aim of this study was to observe the effect of radiation on micro-vessel density (MVD) and vascular endothelial growth factor (VEGF) expression in an transplanted tumor of human pancreatic cancer in nude mice and to explore the role of radiotherapy on pancreatic cancer angiogenesis. Methods: After vaccinated pancreatic cancer PANC-1 cells, 20 nude mice were randomly divided into radiation group and control group. Radiation group received the radiation (dose of 20 Gy) and were killed 5 days later. The MVD and VEGF expression were determined by immunohistochemistry and then compared with the control group. Results: The number of MVD in the radiation group was significantly lower than that of the control group (8.30 ± 4.55 vs. 13.60 ± 4.28, P < 0.01). The optical density (OD) of VEGF in the radiation group was higher (2.11 ± 0.54 vs. 1.32 ± 0.61, P < 0.05) compared with the control group. Conclusion: The radiotherapy can reduce the number of vessels and increase the VEGF expression of human pancreatic cancer transplanted tumor in nude mice.

Oscillatory blood flow through a capillary in presence of thermal radiation

This paper deals with the theoretical investigation of a fundamental problem of magne- tohydrodynamic （MHD） flow of blood in a capillary in the presence of thermal radiation and chemical reaction. The unsteadiness in the flow and temperature fields is caused by the time-dependence of the stretching velocity and the surface temperature. The fluid is considered to be non-Newtonian, whose flow is governed by the equation of a third-order fluid. The problem is first reduced to solving a system of coupled nonlinear differential equations involving several parameters. Considering blood as an electrically conducting fluid and using the present analysis, an attempt is made to compute some parameters of the blood flow by developing a suitable numerical method and by devising an appropri- ate finite difference scheme. The computational results are presented in graphical form, and thereby some theoretical predictions are made with respect to the hemodynamical flow of the blood in a hyperthermal state under the action of a magnetic field. Com- putational results for the variation in velocity, temperature, concentration, skin-friction coefi^icient, Nusselt number and Sherwood number are presented in graphical/tabular form. Since the study takes care of thermal radiation in blood flow, the results reported here are likely to have an important bearing on the therapeutic procedure of hyperthermia, particularly in understanding blood flow and heat transfer in capillaries.