左半结直肠癌临床与病理学特点及诊治分析

目的　探讨左半结直肠癌 (LCRC)临床病理特点及诊治对策。方法　采用直接结肠镜检查加病理活检的方法确诊LCRC 85例 ,其中 37例经手术治疗。结果　本组 50岁以上占 60 %。农民占 73 %。首发症状至确诊 <3个月占 56 .5 % ,<1年占 89.4%。便血、腹痛腹胀、排便习惯改变、肛门异常是LCRC常见症状 ,便血为主要表现占 83 .5 % ,始发便血 56例 ,占 56/ 71 (76 .87% )。本组临床误诊率 63 .5 %。活检符合率 88.57%。病理形态以隆起 (肿块型 85 .88% )管状腺癌 (98.36 % )为主。 37例手术DUKES分期DaDb1 7例为可切除可治愈癌 ,占 45 .95 %。病程 <3个月DaDb 47.4% ,DcDd 52 .6 %。手术率乙状结肠以上癌 2 0 / 2 6(76 .92 % ) ,肛直肠癌 1 7/59(2 8.81 % )。结论　 >50岁属LCRC高发人群 ,为重点结肠镜检查对象。便血是LCRC始发主要表现和重要的结肠镜检查指征 ,应提高对便血的认识 ,放宽镜检范围。LCRC一经诊 ,应及早手术 ,这是切除或治愈LCRC的重要手段。     

减压后脑肿大早期磁共振弥散加权像和病理的实验研究

目的：探讨减压后脑肿大早期病理基础。方法：利用磁共振弥散加权成像（DWI）对脑水肿检测的敏感性和特异性，于减压后2h、4和6h三个时点，对18只猫作减压后脑肿大动脉DWI检查，每相应时点处死6只猫形成一组，制取脑标本作Evan‘s Blue染色、光镜和电镜检查。结果：减压后2hDWI即显示脑肿大部位为低强度信号区，其范围在减压后4和6h明显扩大，中线向对侧移位加剧；1只猫减压后6h肿大部位原低强度信号区转变为高强度信号区。减压后2h即见脑肿大部位Evan‘s Blue染色，减压后4和6h染色范围明显扩大。减压后2h光镜和电镜检查发现全脑微小血管内淤血，但以脑肿大部位为重并伴有微小血管周围间隙明显扩大；减压后6h肿大脑组织内变性坏死脑细胞增多。结论：减压后脑肿大早期（＜2h)由充血性脑肿胀和血管源性脑水肿共同构成，6h则可能有细胞毒性脑水肿发生。     

支气管哮喘患者早期病理形态学改变

目的：应用电镜对支气管哮喘患者以气管粘膜进行观察，了解支气管病理形态学改变。方法：对持续咳嗽３￣１２个月的１２例哮喘患者，１周内未使用类固醇、妥痉平湍及抗组织胺类药物，行支气管镜常规检查，每例患者取２￣３块病理组织行电镜检查。结果：电镜下观察早期哮喘患者已具备了哮喘病理形态学改变，并且还发现线粒体变性、粗面内质网（ＲＥＲ）扩张及髓磷体的出现和轻度钙过载。意义：即使是早期哮喘患者的病理形态学改变也与     

Massive residual dental cyst: Case report

A case report is presented of a massive residual dental cyst that involved over half an edentulous mandible. Presentation, diagnosis and management of the massive cyst is discussed.     

视网膜母细胞瘤术后随访

复查69例视网膜母细胞瘤,56眼进入青光眼期。病理检查:未分化型占80%,对肿瘤细胞已浸润至视网膜、玻璃体及视神经断端者,术后深部X线或钴~(60)照射,很有价值,可提高存活率。本病易误诊为眼内炎、青光眼等。     

Amyloid in surgical pathology

Amyloid is defined as a proteinaceous tissue deposit that shows a typical green birefringence in polarized light after staining with Congo red, the presence of non-branching linear fibrils of indefinite length with a mean diameter of 10 nm, and a distinct X-ray diffraction pattern consistent with Pauling's model of a cross -fibril. Amyloid may deposit locally or may present as a systemic disease. The origin of amyloid is diverse: 25 different fibril proteins have been described so far. The precursor proteins differ from each other in their primary structures and functions. The only common denominator is the propensity to form anti-parallel cross -fibrils under certain circumstances. Early diagnosis of amyloid is still a major challenge in surgical pathology. Histological proof can be obtained using Congo-red staining and polarization microscopy. However, small deposits may be difficult to discern, and sensitivity can be improved using fluorescence microscopy. Classification of amyloid is mandatory, since amyloid is treatable and different treatment regimens are applied to different amyloid diseases. This review focuses on the epidemiology, clinical features, pathology and diagnosis of amyloid in surgical pathology.     

慢性乙肝肝组织病理、肝内Ⅳ型胶原免疫组化与血清肝纤维化指标联合检测对肝纤维化诊断的相关研究

目的探讨慢性乙型肝炎（CHB）肝组织病理学、肝内Ⅳ型胶原（CIV）免疫组化与血清肝纤维化指标联合检测对肝纤维化诊断的相关性。方法对104例CHB患者进行了肝组织病理学，肝内CIV免疫组化检测及病理图像定量分析和血清肝纤维化指标（CIV、PC Ⅲ及HA）的同步检测。结果慢性乙肝肝内CIV及血清CIV、PC Ⅲ和HA检测值均随肝病理损害及肝纤维化程度的加重而升高，经相关分析，其r值分别为0．995、0．985、0．980，P均〈0．01。结论①肝内CIV与血清CIV、PCⅢ、HA检测可作为肝纤维化诊断的重要指标：②CHB患者肝窦内CIV的检出，为血清CIV的检测提供了病理学的证据；③CHB患者肝纤维化的程度，随肝损害程度的加重而逐渐增强。     

血清谷氨酰转肽酶含量测定在慢性乙型肝炎中的临床意义

目的探讨血清谷氨酰转肽酶（GGT）含量变化在慢性乙型肝炎（CHB）不同程度肝脏病理损害中的变化规律及临床意义。方法测定70例CHB患者血清ALT、AST、GGT水平，同时行肝活体组织检查，对肝脏进行炎症分级和纤维分期。分析ALT、AST、GGT与CHB之间的关系。结果（1）ALT、AST、GGT随炎症程度和纤维化程度的上升而上升，但到G4和s4后则下降。GGT随ALT、AST的升高而升高，ALT、AST和GGT的相关系数分别为：0．322、0．328（P〈0．05）。在保肝治疗后，ALT较快降至正常且GGT保持在一个较低水平的为轻度CHB，而随着ALT下降，GGT仍持续在一个较高水平的为中度及重度CHB，其中重度CHB的GGT水平有所波动。结论血清GGT比ALT、AST更准确的反映肝脏的炎症程度，GGT的活动度给临床判断慢乙肝的炎症提供了重要的判断依据。     

Cystic Medullary Thyroid Carcinoma: Report of a Case with Morphological and Clinical Correlations

Cystic lesions of the thyroid are common findings. Although many thyroid cysts are of benign, some cases of hemorrhagic degenerative changes occur in neoplastic nodules, mostly follicular neoplasms and papillary carcinomas. The occurrence of hemorrhagic changes in medullary carcinomas has never been documented with aspirative cytological and histological pictures to the best of our knowledge. A case of medullary thyroid carcinoma with a large central hemorrhagic cyst is described, and the literature regarding the pathogenesis of this regression and the occurrence of cystic neoplasms in the thyroid is reviewed.