肾上腺区巨大髓外造血组织瘤样增生一例

患儿男,6岁.因右肾上腺区肿物1年于2007年12月入院.既往有遗传性球形红细胞增多症病史,脾功能亢进,曾多次输血治疗.体检:体温36.3℃,呼吸16次/min,脉搏88次/min,血压13/7 kPa(1 KPa=7.5 mm Hg).神志清,反应可,皮肤苍黄,浅表淋巴结未及肿大,心肺(-),肝右肋下6 cm,脾左肋下16 cm.     

肾上腺区巨大髓外造血组织瘤样增生一例

患儿男,6岁.因右肾上腺区肿物1年于2007年12月入院.既往有遗传性球形红细胞增多症病史,脾功能亢进,曾多次输血治疗.体检:体温36.3℃,呼吸16次/min,脉搏88次/min,血压13/7 kPa(1 KPa=7.5 mm Hg).神志清,反应可,皮肤苍黄,浅表淋巴结未及肿大,心肺(-),肝右肋下6 cm,脾左肋下16 cm.     

妊娠合并卵巢冠囊肿蒂扭转4周一例

病例:女性患者,22岁,主因初孕36~( 1),枕位,持续性右下腹痛1天于2001-12-10 16:40入院。入院查体:血压16/10kPa,心肺(—),肝脾肋下触及不满意,右下腹压痛,无反跳痛,肾区无叩击痛,浮肿(—)。产科情况:宫高33cm,腹围102cm。无宫缩,先露头,浅入,胎心136次/min。骨盘外测量正常。B超示羊水稍多。其它未见异常,入院后即请外     

足月分娩羊水栓塞一例报告

病例:患者,27岁,因孕39~( 1)w,阵发性下腹痛4h于3月29日8点入院。孕妇为经产妇,孕期顺利。因其他原因,未行产检。其于1997年4月足月顺产1女婴,体重3500g。入院查:体温36℃,脉搏88次/min,呼吸18次/min,血压115/85mmHg,心肺听诊正常。腹隆起,肝脾肋下触及不满意。产检:宫高39cm,腹围99cm,胎位LOA,头先露,半定,肛查:     

以反复感染发病的慢性肉芽肿1例

1 病历 女,11岁,因"发热、咳嗽20余天"入院.自5岁起反复发热,先后以"化脓性扁桃体炎、副鼻窦炎、大叶性肺炎"反复住院治疗,经抗感染治疗均痊愈出院.其同胞哥哥6岁死于"恶性组织细胞增生症".查体:T39.4℃,精神不振,发育正常.咽部充血 ,双肺呼吸音粗,可闻及固定湿性罗音.心率120次/min,律齐,无杂音.腹软,肝脏右肋下3cm,剑下2cm,质韧,无触痛.脾左肋下1.5cm.     

地中海贫血的脾脏形态学改变2例

例1,男性,16岁,因脾肿大贫血住院(入本院前,江西医学院第二附属医院诊断为"血吸虫病").患者鼻梁塌陷,呈"马鞍"形,额结节突出,发育营养较差.16岁男孩外观似10岁男童.脾下极达脐下4 cm,质中;肝肋下3.5 cm,质中;Hb 37 g/L.     

妊娠合并极高脂血症一例报告

病例:患者28岁,因停经39 6w,发现臀位2个月于2005 年3月1日入院.检查:T36.6℃,P 85次/min,R 20次/min,BP 110/70mmHg,心肺肝脾无异常.产科检查:宫高33cm,腹围92cm,胎心140/min,胎位LSA.入院化验检查:甘油三脂69mmol/l,胆固醇25.42mmol/l,总蛋白150g/l,球蛋白100g/l,凝血4项因为高脂血干扰,无法测出结果.患者4年前有甲状腺功能低下病史,已治愈,其母及其舅均有高脂血症.入院后经全院和上级医院专家会诊,诊断为:孕40w,G1P0,LSA,混合性家族性极高脂血症,经充分病历讨论和术前准备,于2005年3月5日在硬膜外麻下行新式剖宫产术,以LSA助娩1女婴,体重3450g,手术顺利,术后转监护室治疗2d,病情平稳转产科病房治疗6d好转出院.出院时复查TG 11mmol/l,CH 11.44mmol/l.     

肝脏汇管区炎症伴小胆管增生

1.病例简介:患儿女,2岁。因精神稍差,腹部不适,B超提示肝内弥漫性病变于2004年1—3月3次入院。患儿有阵发性发热,体温波动于37.5~38.8℃。体检:腹部膨隆,肝肋下6cm可及,质中偏硬,脾肋下2cm,无皮疹,双侧腹股沟可触及黄豆大小的淋巴结数枚。辅助检查:血常规示嗜酸性粒细胞计数增高达(1036~7560)×106/L;肝功能基本正常,但白蛋白逐渐下降,白球蛋白比例达0.87,谷胺酰转肽酶(γ-GT)及血清磷酸酶(AKP)逐渐增高,甲胎蛋白(AFP)及癌胚抗原(CEA)均阴性;腹部B超:肝肋下6cm,肝内多发性低回声团块,脾肋下2.5cm,后腹膜、肝门、腹腔淋巴结肿大。由于…     

妊娠合并骨髓异常综合征1例

病例:患者张芳芳,31岁,孕2产2.于孕8月自感头晕,乏力,皮肤粘膜苍白,曾在基层医院诊断为营养不良性贫血,给于硫酸亚铁等抗贫血治疗1月,于入院前1w自感头晕,乏力加重,食欲逐渐减少,上腹部不适,继之出现全身浮肿,在基层医院诊治无效,于2001年2月17日入院.患者既往无高血压,肝炎,无消化道出血和月经过多病史.查体:T36.6℃,P88次/min,R20次/min,BP 17/11kPa.神志清,巩膜及周身皮肤无黄染,颜面部浮肿,中度贫血貌,心肺检查未见异常,肝脾不大,腹壁凹隐性水肿,无静脉曲张,肝、脾触及不满,双下肢凹陷性水肿,水肿程度 、部位Ⅳ、生理反射正常,病理反射未引出,腹围90cm,官高28cm,胎心率140次/min,先露头、无产兆.     

先天性复杂性心脏病一例报道

病例:患儿女,2天,因“唇周发绀10h”入院,患儿为G3P2,38 4w,因胎儿窘迫(产前有胎心音的减低)剖宫娩出,生后阿氏评分9分,产重3650g,入院前10h(即患儿生后1天)家属发现患儿哭闹后即出现唇周发绀伴气促,无呼吸困难。其母31岁母孕期否认疾病史,父体健,有一姐5岁体健。入院查体:T36P78次/min R70次/min足月成熟儿貌,反应可哭声响,烦燥,面色欠红润,气促无三凹征,前囟平软.胸廓较饱满,双肺音清,未闻及干湿罗音,胸骨右缘闻及心音最强,心率78次/min,律不齐,但未闻及杂音.上腹部较膨龙隆,肝脏剑下4cm肋下2cm质稍硬略钝,脾未及,肠鸣音4次/分,脊柱四肢…     

Molecular characterization of a strain of group a streptococcus isolated from a patient with a psoas abscess

We report the first case of a primary group A streptococcus (GAS) psoas abscess in a 31-year-old woman. The psoas abscess was preceded by an episode of acute pharyngitis. The M-protein gene (emm) and streptolysin S structural gene (sagA) were present in the isolate, with no significant amino acid differences from previously described sequences of M1 GAS isolates. Multilocus sequence typing (MLST) showed that the isolate belonged to MLST sequence type (MLST-ST) 28, the predominant MLST-ST associated with invasive disease caused by M1 isolates.     

Once in a lifetime: a case of a pineal tumour

This paper describes the case of a 14-year-old boy who presented to his general practitioner with a history of headaches and visual problems. Investigations subsequently revealed that he had a pineal tumour. The management of the patient is described and this rare condition discussed.     

Multicentric reticulohistiocytosis: a report of a case and a review of the pathology

A case of multicentric reticulohistiocytosis (MR) in a 24-yr-old woman is presented. MR is a rare disorder characterized by progressive polyarthropathy and a papulo-nodular skin rash. The diagnosis was established by histological examination of biopsies of erythematous nodules on the fingers which showed circumscribed collections of large mononuclear cells and multinucleate giant cells in the reticular dermis. These were embedded in a fine network of mature fibrous tissue with a scanty lymphocytic infiltrate. Histochemical, immunopathological and ultrastructural investigations confirmed that the large mononuclear cells had the properties of macrophages. The histopathological features of MR are reviewed in the light of current knowledge of macrophage physiology, and evidence for lymphocyte-histiocyte interactions in the pathogenesis of this bizarre granulomatous disorder is presented.     

Investigating a single facet of a multilocus model

We consider looking at a single locus of a multilocus model, such as that for IDDM, in particular the use of the sib-pair method concentrating attention on the influence of HLA.