食管后的

Mean epi-esophageal pressure after retractor opening was 76.3 mm Hg, and mean endo-esophageal pressure was 16.3 mm Hg.

结果：肌肉收缩后的平均食管表面压力为76.3mmHg，而平均食管内压力为16.3mmHg。

And There was no serious complication;②In the course ofinterventional therapy, Direct portal vein angiography demonstrated vena coronaria ventriculi(100%)andgastricveins(65.26%)andvenagastricaposterior38.43%, Angiography demonstrated venacoronariaventriculi communicate esophagus varicose veins, gastric veins and vena gastrica posterior communicategastric varicose veins. vena coronaria ventriculi had only a small percentage of double vein, about30.57%. The sites of vena coronaria ventriculi arising from the portal vein, splenic vein, portosplenic junction, were found in 52.06%、27.39%、20.55% respectively.③12 extrahepaticprotosystemic shunts were found in these patients. Include gastro-nephrosshuntof 3 cases, 7 caseswere splenetic- nephros shunt and 2 cases shown recanalization of umbilical vein .④The averageportal pressure before and after the procedure were 3.87±1.82kPa and 3.64±1.14kPa in 73patients, but to the time of rebleeding, it was 3.96±0.23kPa in the 11 cases.⑤There werethree kinds of variceal outcome: disappearance (54,low degree (19).⑥Spearman logisticanalyse and ANOVAtest shown liver function class, variceal degree of the splenic necrosis area,the blood direction in portal vein before operation and remain small collateral routes were thesignificant factors concerning outcome of varices.⑦The bleeding volume and portalhypertensive gastropathy are main risk factors of rebleeding.⑧The course of livercirrhosis is the risk factor of survival and extrahepatic portosystemic shunt , fine varices are thebeneficial factors to survival.⑨During all cases'followed-up data, the 1, 2, 3, 4, 5 yearcumulative survival rates and rebleeding rates were 17.81%, 28.77%, 38.36%, 43.84%, 47.95%and93.15%,91.78%,86.30%,83.56%,80.82%respectively. Conclusion The interventional disconnection treatment for liver cirrhosis and portalhypertension was designed suitability. It rapidlycontrol bleeding,butpressure of portal vein was notobvious high, perfusion was not low .it was compared with surgery therapeutic that interventionaldisconnection treatment was safe and had a significant clinical effect to hemorrhage and preventfrom rebleeding.

结果：①术后一过性发热62例(84.9%)，腹痛腹胀48例(65.8%)是介入断流术常见的并发症，未发生严重并发症；②门静脉造影显示胃冠状静脉、胃短静脉和胃后静脉的曲张分流的出现率是100%、65.26%和38.34%；显示食管静脉曲张主要由胃冠状静脉供血，胃静脉曲张主要由胃短静脉和胃后静脉供血；胃冠状静脉大多数为单支，少数为双支，其双支的出现率分别为30.57%；胃冠状静脉开口于门静脉主干的为52.06%，开口于脾静脉主干的为27.39%和开口于门脾静脉交汇处的为20.55%；③发现胃肾分流3例，脾肾分流7例、腹膜后门腔静脉分流2例，以及CTA检查发现脐静脉开放者2例；④73例患者介入断流术前和术后平均自由门静脉压力分别为3.87±1.82kpa和3.64±1.14kpa，前后比较存在显著性差异；11例再次介入手术患者的术前、术后和复发后的自由门静脉压力分别为4.02±0.24kpa、3.82±0.25kpa和3.93±0.23kpa ，前后比较发现首次术前与术后存在显著性差异，首次术前和复发出血术前门静脉压力比较无显著性差异；⑤介入术后复查曲张静脉转归基本消失54例，轻度19例；⑥Spearman相关分析和Logistic多因素回归分析，肝功能分级、静脉曲张程度、门脉血流方向和残存小侧支四个因素对曲张静脉转归有影响；Spearman相关分析和Logistic多因素回归分析门脉高压性胃病和出血量等因素对复发出血时间有影响；⑦COX回归分析，门体分流和曲张静脉转归两个因素对术后生存有影响；⑧术后随访6-70月，1、2、3、4、5年的累计复发出血率和累计生存率分别为17.81%、28.77%、38.36%、43.84%、47.95%和93.15%、91.78%、86.30%、83.56%、80.82%；结论：介入断流术治疗门脉高压食管胃底静脉曲张有独特的优点，可以快速直接控制曲张静脉出血而门静脉压力无显著增高，保证了肝脏灌注；与外科分流术相比适应证广、损伤轻、术后恢复快，不易遗漏曲张静脉；肝功能分级、曲张静脉程度、门脉血流方向和残存侧支血管对食管胃曲张静脉转归有影响；门脉高压性胃病对复发出血时间有影响；门体分流和曲张静脉转归对生存时间有影响。

EVL combines with sandostatin is an effective method for esophageal varicosis with cirrhosis after hepatitis B.

结论套扎联合善宁是治疗肝炎后肝硬化食管静脉曲张的较为理想的方法。

There were portal collateral vessels around the main portal vein in 8 patients and among them, there was 1 patient with the varix of gallbladder wall, 2 with gastroepiploic varix, 1 with varix on the bile duct wall, 1 with open of the retroperitoneal-paravertebral vein and the splenorenal vein, and 1 with open of the retroperitoneal-paravertebral vein.

结果 在门脉闭塞后，引起相应血管的纡曲扩张及侧支血管的形成，其中有门脉周围形成门－门侧支循环，胆囊壁静脉的曲张，胃网膜静脉的增粗纡曲，胆管壁静脉的纡曲扩张，腹膜后椎体旁侧支血管的开放，脾－肾静脉短路的开放，胃底食管静脉的曲张。

CD8~+ cell is the main T lymphocyte subset in spleen, and B lymphocyte mainly is IgG~+ cell, moreover the amount of these B lymphocytes could exceed CD3~+ T lymphocyte subset after 7 days. CD8~+ cell is the main T lymphocyte subset in tonsil of appendix, and B lymphocyte is IgM~+ cell, and the amount could exceed CD3~+ T lymphocytes after 35 days. After 21 days, B lymphocytes in esophago tonsil are the main IgA~+ cells and the amount exceeds CD3~+ lymphocytes. The amount of CD4~+ lymphocytes is more than CD8+ lymphocytes.4. CD3~+、CD4~+ and CD8~+ T lymphocytes in spleen mainly distribute in periarterial lymphoid sheath. However IgM~+、IgG~+ and IgA~+ cells mainly distribute in ellipsoid periarterial lymphoid sheath and germinal center. T lymphocytes in appendix tonsil mainly distribute in middle and inferior part of mucous and the B lymphocytes mainly in middle and mucous between 4~7 days. Whereafter T, B lymphocytes equably distribute in mucous. CD4~+ cells arrange tightly and mainly occupy the central part in aggregates of T lymphocytes in esophago tonsil and CD8~+ lymphocytes mainly distribute in periphery. Meanwhile B lymphocytes encircle the periphery of aggregates of T lymphocytes. The aggregates of B lymphocytes is mainly the germinal center with lots of IgM~+、IgG~+ and IgA~+ cells. Meanwihle T lymphocytes encircle the periphery of aggregates of B lymphocytes.5. There is an intimate relationship between the development of tissue structure of peripheral immune organs and lymphcytopoiesis. The maturation of tissue structure is stimulated by the immigration of lymphocytes and the mature tissue structure provides place where lymphocytes grow mature and functionate.

脾脏在21日龄时达到稳定，食管扁桃体和盲肠扁桃体均在35日龄时达到稳定；脾脏中T淋巴细胞亚群以CD8~+细胞为主，B淋巴细胞则以IgG~+细胞为主，并在7日龄后数量超过CD3~+T淋巴细胞；盲肠扁桃体中T淋巴细胞亚群以CD8~+细胞为主，B淋巴细胞以IgM~+细胞为主，并在35日龄后数量超过CD3~+T淋巴细胞；21日龄后，食管扁桃体中B淋巴细胞以IgA~+细胞为主，数量超过CD3~+细胞，CD4~+细胞的数量多于CD8~+细胞。4、在T、B淋巴细胞组织定位方面，脾脏中CD3~+、CD4~+和CD8~+T淋巴细胞主要分布在动脉周围淋巴鞘中，而IgM~+、IgG~+和IgA~+细胞主要分布在椭球周围淋巴鞘和生发中心中；4～7日龄时，盲肠扁桃体中T淋巴细胞主要分布在粘膜固有层的中下部区域，而B淋巴细胞则主要分布在中上部区域，随后各日龄T、B淋巴细胞均匀地分布在粘膜固有层中；在食管扁桃体的T淋巴细胞聚集物中，CD4~+细胞紧密排列，主要占据中央部位，CD8~+细胞主要散布在外周，同时B淋巴细胞又环绕在整个T淋巴细胞聚集物的外周；B淋巴细胞聚集物主要为生发中心，其中存在大量IgM~+、IgG~+和IgA~+细胞，同时T淋巴细胞又环绕在整个B淋巴细胞聚集物的外周。5、外周免疫器官的组织结构发育和淋巴细胞发生之间存在密切的关系，淋巴细胞迁入淋巴器官刺激组织结构的发育成熟，同时成熟的组织结构又为淋巴细胞发育成熟并行使功能活动提供场所。

Resujts:① The distribution of lesions are mostly symmetrical, extensive, predominant in the middle and lower lung fields, and posterior areas in peripheral;② There are so many HRCT findings of lung, ILD is predominant: intralobular interstitial thickening 46 cases (100%), ground-glass opacity 41 cases (89.13%), peribronchovascular or centrilobular interstitial thickening 40 cases (86.96%), interlobular septal thickening 38 cases (82.61%), irregular linear opacity 37 cases (80.43%), small nodular opacity 34 cases (73.91%), subpleural line 27 cases (58.70%), bmnchiectasis or bronchiolectasis 19 cases (41.30%), patch opacity 18 cases (39.13%), expiratory mosaic sign 15 cases (32.61%), interface sign 14 cases (30.43%), honeycombing 12 cases (26.09%), emphysema or bulla 3 cases, cystic airspace suspected 1 case, and atelectasis suspected 1 case;③ Mediastinum and pleura: multiple small lymphonodi in mediastinum 41 cases (89.13%), pleural thickening or rough 38 cases (82.61%), esophagoectasis 11 cases (23.91%), unilateral little pleural fluid 1 case, and mediastinal emphysema 1 case.

结果：①皮肌炎肺部病变分布呈对称、广泛、偏中下、偏外后的特点；②肺部HRCT表现多样，以肺间质性改变为主：小叶内间质增厚46例(100%)，磨玻璃影41例(89.13%)，支气管血管束增宽或小叶核心增大40例(86.96%)，小叶间隔增厚38例(82.61%)，不规则纤维索条影37例(80.43%)，结节影34例(73.91%)，胸膜下线27例(58.70%)，支气管或细支气管扩张19例(41.30%)，斑片影18例(39.13%)，呼气相马赛克征15例(32.61%)，界面征14例(30.43%)，蜂窝影12例(26.09%)，肺气肿或肺大泡3例，单纯囊状气腔1例，肺不张l例；③纵隔及胸膜：纵隔小淋巴结影41例(89.13%)，胸膜增厚或毛糙38例(82.61%)，食管扩张11例(23.91%)，单侧少量性胸腔积液1例，纵隔气肿1例。

ObjectiveTo explore the therapeutic effect of sandostatin for rebleeding of esophageal varicosis treated by endoscopic varical band ligation. Methods 82 patients with cirrhosis after hepatitis B complicated with esophageal variceal bleeding were divided into EVL group and EVL group + sandostatin group. The therapeutic effects of the two methods were compared for esophageal varicosis.

目的探讨善宁对食管静脉曲张套扎术后再出血的防治作用方法82例乙型病毒性肝炎后肝硬化并食管静脉曲张随机分套扎组和套扎+善宁组，比较两治疗方法对食管静脉曲张的治疗效果。

Enhanced wind-up after secondary oesophageal hyperalgesia suggests that isceral pain hypersensitiity induced by central sensitisation results from increased central neuronal excitability.

继发性食管痛觉增敏后的易化效应增强，这表明了内脏痛觉高敏感是由中枢致敏诱发，而中枢致敏由中枢神经的兴奋性决定。

Material and methods: 1 In this study, 35 cases surgically resected esophageal carcinoma and 6 cases normal esophageal mucosa.

1采用手术后的食管癌组织标本，其中癌组织35例、正常食管黏膜组织6例作对照。

This study was conducted to examiune the fibrotic effect of Ni-Ti and 317L al loys in esophagus.The extract fluid from Ni-Ti,317L alloys was made according t o the ASTM standards of U.S.A. The Fb of esophageal scar was cultured primarily ,then incubated with alloy abstract fluid. The proliferating activity of Fb was measured by MTT at 4, 24, 48, 72 hours in the course of culturing. The esophagu s embedding test of Ni-Ti,317L alloys was made according to ASTM standards of U .S.A.The tissue around the alloys was taken at weeks 2 and 12,and the pathologi c changes were analysed.

为探讨新型支架材料Ni-Ti、317L合金在食管局部的致纤维化作用，按美国ASTM标准制备NiTi、317L合金的金属浸提液；&组织块培养法&原代培养食管壁疤痕的成纤维细胞，传代后以金属浸提液进行培养，分组后分别培养4、24、48、72 h，MTT法检测不同培养时间后Fb增殖功能的变化；按美国ASTM标准进行NiTi、317L合金试件的食管壁内包埋实验，即将金属试件经表面处理后直接置入食管壁粘膜层与肌层之间，术后2、12周取出包埋组织，分析试件周围组织的病理变化，并进行胶原纤维染色，观察纤维形成状况。

Fancy gold-plated dangling earrings with facetted White Opal crystals.

花式镀金悬垂耳环与facetted白欧泊水晶。

This essay chooses the study aim from biology teachers in middle school in Shi Jiazhuang which tells us that most of the middle school biology teachers in Shi Jiazhuang have the"burnout", lower successfulness, individualize.

本文选取石家庄市初中生物教师作为研究对象，运用问卷调查的方法对石家庄市初中生物教师职业倦怠的现状进行调查，调查结果发现，石家庄市初中生物教师这一群体普遍存在职业倦怠，情感枯竭程度偏高，成就感偏低，去个性化程度最为严重。