原发性中枢神经系统淋巴瘤35例临床分析

目的 探讨原发性中枢神经系统淋巴瘤的临床特点、诊断及治疗方法。方法 回顾性分析35例原发性中枢神经系统淋巴瘤的临床资料、病理特征及术前诊断方法。结果 本组男19例，女16例，男女比例为1．2：1。年龄26～72岁，平均年龄52岁。所有患者人免疫缺陷病毒(HIV)检查均为阴性。临床症状主要表现为颅内压增高、肢体无力、瘫痪和神经精神症状。57％的患者病史短于4周，发病急，病情进展快。肿瘤多位于额部、颚顶部和基底节区，本组共35例52个肿瘤，其中16例为多发性肿瘤(45．7％)。结论 原发性中枢神经系统淋巴瘤是一组异质性肿瘤，侵袭性大。病史短，发病急，病情进展快，常发生于幕上大脑半球，易多发，术前诊断困难．预后差．     

Pathology of the lung in the fetus and neonate, with particular reference to problems of growth and maturation

The major forms of lung pathology in the perinatal period are reviewed with emphasis on disturbances of growth and maturation. Lung hypoplasia results from impairment in the physiological control of lung growth during the fetal period. It is more common than organogenetic defects which are discussed only briefly. Hyaline membrane disease is now seldom seen in a pure form due to improvements in perinatal care. However, its complications and sequelae such as interstitial emphysema, pneumothorax and bronchopulmonary dysplasia are encountered more frequently. In addition, a wide variety of pathological processes may localize to, or be expressed in, the lung of the newborn, notably asphyxial changes, persistent pulmonary hypertension, haemorrhage and infection.     

妊高征合并胎儿宫内发育迟缓者胎盘病理改变与血管细胞粘附分子-1表达水平的关系

目的探讨妊高征(PIH)合并胎儿宫内发育迟缓(IUGR)时胎盘病理改变与胎盘组织中血管细胞粘附分子-1(VCAM-1)表达水平变化的关系。方法选取本院2001年1~9月分娩的妊高征合并IUGR患者(实验组)胎盘30例、单纯IUGR(IUGR组)28例、单纯PIH(PIH组)25例、正常妊娠(正常妊娠组)30例,常规HE染色及PAS染色,观察胎盘形态学变化。利用免疫组化方法对胎盘组织切片染色,观察子宫蜕膜层中螺旋动脉、绒毛组织滋养细胞及绒毛中毛细血管的VCAM-1表达。结果实验组中22例(73.33%)胎盘有明显病理改变,有病理改变的胎盘蜕膜组织内血管内皮细胞及胎盘绒毛毛细血管内皮VCAM-1的表达显著高于无病理改变者(P<0.001);而绒毛上皮组织滋养层细胞VCAM-1的表达则显著低于无病理改变者(P=0.019)。结论妊高征合并IUGR时胎盘发生了明显的病理改变,这种病理改变与胎盘中VCAM-1的异常表达密切相关。     

RETROPERITONEAL SCHWANNOMA: A CASE SERIES AND REVIEW

Schwannomas account for only a small percentage of retroperitoneal tumours. Presentation is typically varied and non-specific and pre-operative diagnosis is difficult. Herein are described five cases of retroperitoneal schwannoma. Presentation was varied, ranging from abdominal pain, abdominal mass, obstructed labour or an incidental finding. All patients had either an abdominal computed tomography scan and/or ultrasound performed. Pre-operative biopsy either by fine needle aspiration (in one patient) or core biopsy in two patients was unhelpful. In four patients with smaller tumours, complete excision was possible with no apparent long-term morbidity and no clinical evidence of recurrent tumour with follow up from 3.5 months to 11 years. For the largest tumour, complete surgical excision was not attempted as it would have entailed significant morbidity.     

大剂量地塞米松及SOD在实验性脑损伤中的治疗作用

大剂量地塞米松和ＳＯＤ是外伤性脑继发性损害药物治疗的新方案。本实验在豚鼠局灶性脑损伤模型上试用该两种药物，通过脑含水量、灶周伊文斯兰渗出、血ＣＫ、Ｃａ和ＬＤＨ含室及光镜和电镜病理检查等指标。     

梗阻性黄疸引起肾脏病理学及超微病理学改变的实验与临床研究

作者对梗阻性黄疸（梗黄）大鼠及６例临床梗黄病人的肾脏组织进行了光镜和电镜观察。目的是描述肾脏损害的病理和超微病理改变，并试图从病理改变来探讨肾脏损害的可能病因及肾脏功能的改变。观察发现主要病变为肾小球萎缩，鲍曼氏囊间隙扩大，肾小球毛细血管基膜明显增厚，其三层结构消失，内有大量胆色素颗粒沉积，血管内皮窗孔明显减少，足突融合；近曲小管上皮细胞变性、坏死，胞质内有大量胆色素颗粒沉积，小管腔内可见脱落的坏死细胞、胆泥、胆栓及蛋白管型，微绒毛紊乱、稀疏、脱落，线粒体高度水肿，内质网扩张，脂滴、溶酶体明显增多。据此，我们认为：（１）梗黄可引起明显肾脏损害，其病变同时累及肾小球和肾小管，但以近曲小管病变为重；（２）胆汁成分于肾脏内的沉积在梗黄引起肾脏损害的发病中起一定作用；（３）梗黄可导致肾脏功能改变。     

Histopathology of the teeth in segmental odontomaxillary dysplasia: new findings

Histological examination of the deciduous teeth in two cases of segmental odontomaxillary dysplasia (SOMD) showed fibrous enlargement of the pulps, an irregular pulp/dentine interface displaying many pseudoinclusions and pulp stones. There were tubular defects in the coronal dentine from pulp horn to cusp tip, an irregular tubular structure to the circumpulpal dentine of the apical half, a focally deficient odontoblast layer and widespread external resorption. Together with the clinical features of unilateral maxillary enlargement, upper alveolar expansion in the distal segment, increased spacing and delayed eruption of the deciduous molars and absence of premolar teeth, these histological appearances allow distinction of this condition from fibrous dysplasia (FD), segmental hemifacial hypertrophy (SHH) and regional odontodysplasia (ROD).     

阿昔洛韦对单纯疱疹病毒脑炎小鼠脑细胞的保护作用

目的 了解单纯疱疹病毒脑炎(HSE)脑细胞结构的改变及药物的影响。方法 采用光学显微镜及透射电子显微镜观察HSE小鼠脑细胞结构的变化，并给予阿昔洛韦(ACV)及地塞米松(DEX)治疗，观察治疗后脑细胞结构的变化。结果 HSE小鼠脑神经细胞明显肿胀，核仁固缩，核内结构破坏，线粒体及高尔基体可见空泡样变性，核仁内可见病毒颗粒。用药物干预的小鼠脑神经细胞改变较轻微，未找到病毒颗粒；与单用ACV干预的小鼠相比，用ACV DEX干预的小鼠脑神经细胞及毛细血管周围水肿明显减轻。结论 HSE早期给予ACV DEX治疗，对HSE脑细胞结构有明显保护作用。     

宫颈上皮内瘤变108例临床分析

目的通过总结108例宫颈上皮内瘤变（CIN）的临床与预后，探讨分析CIN的诊断与治疗。方法归纳总结共108例各级CIN的临床特点及治疗方法，术前肉眼多点活检及阴道镜下活检与术后病理诊断的符合率，分析其预后。结果所有病人均有性生活史。除45／108（417％）无症状外，63／108（58．3％）有分泌物增多，或同房出血或阴道不规则流血。术前阴道镜下活检与术后病理诊断的符合率高于肉眼多．最活检符合率，但统计学差异无显著性，（P〉0．05）。根据病人要求、CIN级别及病变部位、范围采取不同的手术方式，其中14例随访超过5a，全部病人无1例复发，3、5a存活率均为100％。结论临床上对有性生活史的生育年龄妇女要警惕CIN，肉眼多点活检或阴道镜下活检可作为确诊手段，对不同的病人，依据病灶的性质，采用不同的手术方式，可避免复发，获100％的治愈率。