内镜下逆行胰胆管造影术（ERCP）的护理体会

ERCP的基本原理是在十二指肠镜直视下,将造影管经十二指肠乳头开口插入胰管和胆管．注射造影剂后在X线下观察．而达到诊断胆胰疾病的目的。主要用于原因不明的梗阻性黄疸、良恶性胆管狭窄和畸形、肝胆胰腺肿瘤、     

家禽十二指肠瘻与空迴肠瘻的手术方法

为了从家禽小腸的十二指腸內获得胆汁、胰液和腸液;从空迴腸內获得腸液。如果采用同哺乳动物(狗)一样的慢性实驗手术方法,在禽体上分別进行胰导管外引术,胆囊与胆管外引术,是有很大困难的。因为家禽(鸡、鴨、鵝)胰腺导管与胆管有其形态学上的特征的限制。卽二条胰腺导管的开口部,胰腺导管与胆管的开口部均相距很近,仅有2—3毫米,故不易分別引出制备成瘘管而获得胰液和胆汁。     

川金丝猴肠,肝,胰的观察

对川金丝猴（Rhinioithecusrozxellane的肠、肝、胰作了观察。小肠全长284．0-296．0cm,其中十二指肠9．0－12．0cm,呈V形,余为空回肠。大肠长约120．0－130．0cm;无阑尾;升结肠短,仅7．0－8．0cm,横结肠19．0－20．0cm,降结肠及乙状结肠达80．0－90．0cm。肝分背、腹侧二部,腹侧部又分作上、下二部。胆总管开日于十二指肠上部。胰呈T形,胰头为十二指肠降、升部围绕,胰管由胰头发出,开口于十二指肠升部。对个体间的差别、盲结肠发达程度的相关因素、肝叶愈合与进化的关系作了讨论。     

主胰管在胰体尾切除术中的应用解剖学研究

目的:为行胰腺体尾部切除时寻找主胰管减少胰瘘提供解剖学资料。方法:解剖观测胰腺标本、胰腺动脉与胰管联合铸型标本各10例。结果:主胰管起于胰尾的中部,在胰颈、体、尾部与上缘之间的距离分别为(7.51±1.06)mm,(10.98±1.81)mm,(8.44±1.72)mm。胰腺各横断面上主胰管的后距,胰颈处为(2.15±0.61)mm,距胰颈1cm处的胰体部为(5.84±1.11)mm,2cm处为(6.12±0.93)mm,胰尾处为(7.44±0.86)mm。铸型标本中脾动脉有9例走行于胰腺上缘,与主胰管的距离在胰颈左侧2 cm处为(9.37±1.05)mm,胰体部中点处为(11.72±1.63)mm,胰尾处为(8.98±1.01)mm,脾动脉的位置变异1例。结论:在胰颈左侧2cm处按自下而上、由前往后的顺序分离并结扎主胰管可减少胰体尾切除术后胰瘘的发生。     

吗啡和纳洛酮对酸化十二指肠引起狗胰液分泌的影响

本工作用制备 Thomas 胰瘘和胃痿的5条狗进行慢性实验。实验时用0.1N 盐酸灌入十二指肠以刺激胰液分泌,并分別注射吗啡或/和纳洛酮,观察它们对胰液分泌和对胰液中碳酸氢盐和蛋白质浓度的影响。另外我们还观察了吗啡和纳洛酮对6条狗离体胰主导管紧张性的影响。结果表明:(1)吗啡抑制了胰液分泌量,对胰液中碳酸氢盐和蛋白质浓度无影响,由于分泌量减少故两者的排出量显著减少(P<0.05),(2)纳洛酮本身对胰液分泌量和碳酸氢盐及蛋白质浓度均无影响;(3)纳洛酮可以加强吗啡抑制胰液分泌的作用(P<0.01);(4)吗啡能增加狗的离体胰主导管肌条的紧张性,纳洛酮不能阻断或翻转吗啡的这一效应,相反能加强其效应。本工作表明,吗啡抑制酸化十二指肠所引起的胰碳酸氢盐和蛋白质排出量,其机制可能是吗啡刺激胰导管收缩,而纳洛酮则加强吗啡的这种抑制效应。     

胰瘘发生假说到捆绑式胰肠吻合的临床运用

为避免术后胰瘘的发生,在过去的100年间提出了多种胰肠吻合重建方式,但哪种方法最好一直备受争议.胰肠吻合后吻合针距间存在可能的间隙,这个问题或许成为胰肠吻合口瘘的爆发点,而且存在贯穿浆肌层缝合的胰腺表面外露的吻合针眼,如果缝针贯穿胰管小分支,胰液可能从针眼流出.这一假说构成了捆绑式胰肠吻合的基础.捆绑式胰肠吻合是一种安全、有效的预防术后胰瘘的吻合方式.     

[卡其].肯拜尔鸭和北京鸭胰脏和胰管的比较解剖

本研究共观察[卡其]·肯拜尔鸭(Khaki Campbell)45只,北京鸭[Pekin duck(Anas domestica L.)]41只,比较了两种鸭胰叶和胰管的形态结构。结果如下:[卡其]·肯拜尔鸭和北京鸭的胰脏都分为背侧胰叶,腹侧胰叶和脾胰叶。除有背侧胰管和腹侧胰管外,还观察到自背侧胰叶尾端发出另一胰管入十二指肠,并命名为第一胰管。[卡其]·肯拜尔鸭和北京鸭的背侧和腹侧胰管入肠类型均可分为三种:背、腹侧胰管以左、右向排列;背侧胰管在前,腹侧胰管在后;腹侧胰管在前,背侧胰管在后。此外,[卡其]·肯拜尔鸭出现多条胰管入肠的例数多于北京鸭。     

应用奥曲肽预防胰十二指肠切除术后胰漏作用的研究

目的：预防性使用奥曲肽是否能减少胰十二指肠切除术后胰漏发生率存在着争议。本研究旨在研究奥曲肽在不同胰腺情况下预防胰十二指肠切除术后胰漏发生的作用。方法：本研究将＂软胰腺＂、＂细胰管＂作为术后胰漏发生的高危险因素,将184例胰十二指肠切除术病例分为4组：低危险/非奥曲肽组、低危险/奥曲肽组、高危险/非奥曲肽组、高危险/奥曲肽组。观察术后胰漏等术后并发症情况。结果：共发生术后胰漏35例（19%）,其中高危险组胰漏发生率是低危险组2倍以上（27%versus 10%,P〈0.01）。在胰漏发生低危险胰腺情况下,奥曲肽组与非奥曲肽组术后胰漏发生无显著差别;在胰漏发生高危险胰腺情况下,奥曲肽能显著降低术后胰漏发生率。结论：在胰十二指肠切除术围手术期应根据胰腺的具体情况选择性使用奥曲肽既能有效预防术后胰漏的发生,又能避免不必要的浪费。     

应用奥曲肽预防胰十二指肠切除术后胰漏作用的研究

目的:预防性使用奥曲肽是否能减少胰十二指肠切除术后胰漏发生率存在着争议。本研究旨在研究奥曲肽在不同胰腺情况下预防胰十二指肠切除术后胰漏发生的作用。方法:本研究将"软胰腺"、"细胰管"作为术后胰漏发生的高危险因素,将184例胰十二指肠切除术病例分为4组:低危险/非奥曲肽组、低危险/奥曲肽组、高危险/非奥曲肽组、高危险/奥曲肽组。观察术后胰漏等术后并发症情况。结果:共发生术后胰漏35例(19%),其中高危险组胰漏发生率是低危险组2倍以上(27%versus 10%,P<0.01)。在胰漏发生低危险胰腺情况下,奥曲肽组与非奥曲肽组术后胰漏发生无显著差别;在胰漏发生高危险胰腺情况下,奥曲肽能显著降低术后胰漏发生率。结论:在胰十二指肠切除术围手术期应根据胰腺的具体情况选择性使用奥曲肽既能有效预防术后胰漏的发生,又能避免不必要的浪费。     

白鲟肝脏和胰脏的组织学与形态学研究

白鲟肝脏较大,可分为左右两大叶及小的中叶,胆囊位于右叶的凹缺内。肝板多由双层细胞构成,肝小叶不明显。肝内毛细胆小管由4个肝实质细胞围成。胰脏有3支,被厚的浆膜。胰岛明显。胰管与胆管汇合后共同开口于小肠最前部背面。对肝、胰实质细胞的显微或亚显微结构进行了描述。     

Investigation of the mechanism of temperature sensitivity of the electroreceptors of ampullae of lorenzini

In experiments on Black Sea skates (Raja clavata), the potential of the receptor epithelium of the ampullae of Lorenzini and spike activity of single nerve fibers connected to them were investigated during electrical and temperature stimulation. Usually the potential within the canal was between 0 and –2 mV, and the input resistance of the ampulla 250–400 k. Heating of the region of the receptor epithelium was accompanied by a negative wave of potential, an increase in input resistance, and inhibition of spike activity. With worsening of the animal's condition the transepithelial potential became positive (up to +10 mV) but the input resistance of the ampulla during stimulation with a positive current was nonlinear in some cases: a regenerative spike of positive polarity appeared in the channel. During heating, the spike response was sometimes reversed in sign. It is suggested that fluctuations of the transepithelial potential and spike responses to temperature stimulation reflect changes in the potential difference on the basal membrane of the receptor cells, which is described by a relationship of the Nernst's or Goldman's equation type.I. P. Pavlov Institute of Physiology, Academy of Sciences of the USSR, Leningrad. I. M. Sechenov, Institute of Evolutionary Physiology and Biochemistry, Academy of Sciences of the USSR, Leningrad. Pacific Institute of Oceanology, Far Eastern Scientific Center, Academy of Sciences of the USSR, Vladivostok. Translated from Neirofiziologiya, Vol. 12, No. 1, pp. 67–74, January–February, 1980.     

Principles of organization and evolution of systems of regulation of functions

Evolution of living organisms is closely connected with evolution of structure of the system of regulations and its mechanisms. The functional ground of regulations is chemical signalization. As early as in unicellular organisms there is a set of signal mechanisms providing their life activity and orientation in space and time. Subsequent evolution of ways of chemical signalization followed the way of development of delivery pathways of chemical signal and development of mechanisms of its regulation. The mechanism of chemical regulation of the signal interaction is discussed by the example of the specialized system of transduction of signal from neuron to neuron, of effect of hormone on the epithelial cell and modulation of this effect. These mechanisms are considered as the most important ways of the fine and precise adaptation of chemical signalization underlying functioning of physiological systems and organs of the living organism