Association of multiple liver cell adenomas with spontaneous intrahepatic portohepatic shunt

The association of multiple liver cell adenomas containing foci of focal nodular hyperplasia with a spontaneous intrahepatic portohepatic venous shunt is reported in a 13-year-old male patient. At least eight nodules less than 10 cm in diameter were recognized and proved by means of surgical resection or surgical biopsies. These lesions were heterogeneous and hypodense on precontrast computed tomographic (CT) scans, and were slightly enhanced after injection of contrast medium. At magnetic resonance (MR) imaging, the signal intensity of these nodules varied. It was either hyperintense or hypointense on T1-weighted SE images. Sonography and angiography demonstrated a portohepatic venous shunt and hepatic arterialization was observed. These findings emphasize the hypothesis that hepatic arterialization may cause the development of liver cell adenomas. Moreover, it is suggested that liver cell adenoma and focal nodular hyperplasia have a common pathogenesis.     

双标记原位杂交法检测间期细胞BCR/ABL融合基因

目的 :应用双标记原位杂交方法检测 BCR/ ABL融合基因。方法 :BCR基因探针用地高辛标记 ,碱性磷酸酶显色 ;ABL基因用3 H- d ATP标记 ,核子乳胶放射自显影。结果 :检测 9例初治的慢性粒细胞白血病 ( CML)病人均为阳性 ,阳性细胞比例为 93% ;检测 CML来源的 K5 62细胞株阳性细胞占 98.8% ;正常人假阳性率为 0 .75 %。结论 :该方法简便、快速 ,适用于 CML微小残留病的检测     

三氧化二砷诱导慢性髓系白血病细胞G2/M周期停滞及其机理

目的 研究三氧化二砷对慢性髓系白血病细胞的体外作用特点及其机理。方法 将三氧化二砷与慢性髓性白血病细胞系K562作用后，测定细胞的生长曲线及活性，流式细胞测量术检测细胞凋亡和细胞周期分布的改变；同时，采用RT-PCR方法检测药物作用前后细胞周期相关基因表达的变化。结果 ①三氧化二砷明显抑制K562细胞的生长，其作用呈时间和浓度依赖性；②三氧化二砷诱导K562细胞凋亡的作用较弱，但可明显诱导K562细胞在G2／M期停滞，此效应也呈时间和浓度依赖性；③三氧化二砷作用后，细胞周期抑制基因p57表达明显上调，而细胞周期促进基因cyclinB的表达受到抑制。结论 三氧化二砷能有效抑制慢性髓系白血病细胞的生长，其机理主要为诱导细胞G2／M期周期停滞；该效应与细胞周期相关基因的表达变化有关。     

Wortmannin抑制PI3-K途径对K562及NB4细胞增殖的影响

目的 :为探讨Wortmannin抑制磷酰肌醇 - 3激酶 (PI- 3K)途径对K5 62 ,NB4细胞增殖的影响 ,探寻慢性髓细胞性白血病 (CML)的治疗新途径 .方法 :用磷酰肌醇 - 3激酶 (PI - 3K)特异抑制剂Wort mannin抑制PI - 3K活性 ,观察慢性髓细胞性白血病细胞系K5 62细胞和急性早幼粒细胞性白血病细胞系NB4细胞在 2 4,48,72h增殖能力的变化 .t检验统计分析 .结果 :K5 62和NB4细胞在 2 4,48,72h的增殖抑制率分别为 3 4 67% ,5 7 46% ,65 85 %和 2 6 2 9% ,5 5 1% ,2 10 % .集落形成实验以GM -CSF为主要生长刺激物的培养体系在 3 7℃ ,5 %CO2 孵箱培养 14d后细胞系的集落数和集落形成率分别为K5 62 :80 75±10 2 4和 16 15 % ,K5 62 +WT :3 8 0 0± 12 75和 7 60 % ,NB4:2 9 5 0± 5 97和 5 90 % ,NB4+WT :3 0 5 0± 5 74和 6 10 % .集落形成抑制率为 :5 2 94%和 3 3 9% .结论 :Wortmannin可显著抑制K5 62细胞的增殖和集落形成 ,而对NB4细胞无明显影响 (P均 <0 0 5 ) .Wortmannin可以通过抑制PI - 3K通路抑制K5 62细胞的增殖 ,而对NB4细胞增殖无明显影响     

Diffuse peripheral odontogenic fibroma: report of 3 cases

Since peripheral odontogenic fibroma (POF) is characteristically described as a solitary lesion and no diffuse POF had been reported in the literature, our cases should be considered as extremely unusual. Three diffuse cases of POF are described of which one case was seen in association with ocular and skin lesions. The question arises whether POF should be considered as a true odontogenic tumor rather than a diffuse hamartomatous lesion caused by uncontrolled induction of the gingiva. It is also possible that such lesions could be part of a yet undescribed syndrome.     

Integrating human factors into the medical curriculum

Background  The study of human factors is a scientific discipline that deals with the interactions between human beings and the elements of a system. This is important because shortcomings in these areas, if unchecked, can result in adverse outcomes. Research into human factors in industries where safety is paramount has provided the basis of countermeasures against human error. Adverse outcomes in medicine resulting from human error exact a high cost in both patient suffering and financial outlay.
CRM training  One of the approaches used to minimise the effect of human error is to train people in a set of knowledge, skills and attitudes that underpin the domain-specific competencies for that profession. These are referred to as non-technical skills (NTS). In aviation, such an approach has been shown to be both translatable from the training environment to the workplace and effective in reducing adverse outcomes.
Discussion  Medicine has incorporated this style of training, usually centred around simulator-based courses, but as yet in a piecemeal, episodic fashion which relies on participants volunteering to attend courses. Unlike other industries there is no systematic approach to linking the content of this teaching with the more conventional range of topics. As a consequence it is difficult to assess the impact of human factors training in medicine. This is partly because very little work has been done to date in identifying the key non-technical skills required in medicine, and the overall experience of workplace based assessment is limited. Lessons from other high reliability organisations may help to address the main challenges of developing the content, integrating it into the curriculum, reinforcing the concepts in the workplace through staff development and establishing its role in summative assessment.     

免疫性血小板减少性紫癜辨证分型与血小板表面相关抗体及T淋巴细胞亚群的关系

为探讨免疫性血小板减少性紫癜（ITP）中医辨证分型与免疫机理的关系,将ITP患者中医辨证分型结合血小板相关抗体（PAIg）及T淋巴细胞亚群进行分析。发现作为本病主要抗体的PAIgG脾肾阴亏型明显高于脾虚失统型（P<0.01）;OKT₈⁺值亦显著高于脾虚失统型（P<0.05）,OKT₄⁺/OKT₈⁺比值则明显低于脾虚失统型（P<0.05）。提示脾肾阴亏型的免疫损伤程度较脾虚失统型严重。     

应用单克隆抗体(MoAb)对白血病免疫分型的临床研究

报告了应用单克隆抗体对25例淋巴细胞白血病、5例慢性粒细胞白血病及15例急性非淋巴细胞白血病进行免疫分型并与AB分型作比较,结果提示免疫分型可以弥补FAB分型的不足,它有助于白血病临床诊断、鉴别诊断、指导治疗和判断预后。     

Asymptomatic renal abscess: Evaluation with gadolinium DTPA-enhanced MRI

Incidental detection of renal mass in a transplant patient is a diagnostic challenge. These patients are at risk for the development of neoplasms and, more commonly, infection with atypical organisms. Symptomatology may be lacking in either, and both conditions may present with similar symptoms. Magnetic resonance imaging (MRI) evaluation with gadolinium DTPA is helpful in the evaluation of asymptomatic renal mass, with enhancement effectively excluding simple and hemorrhagic cysts. Because the MRI appearances of renal cell neoplasm and renal abscess overlap, both must be considered in the differential diagnosis.     

叶内型肺隔离症致咯血的栓塞治疗

目的探讨叶内型肺隔离症患者咯血的栓塞治疗效果。方法结合文献复习，回顾性分析6例叶内型肺隔离症患者血管造影表现，并对畸形动脉行栓塞治疗。结果6例叶内型肺隔离症患者血管造影显示畸形动脉7支，表现为粗大、迂曲的体循环血管影；在毛细血管期可见隔离肺叶染色及引流静脉早显；静脉期显示引流静脉（肺静脉）。6例患者均进行畸形血管栓塞治疗，临床止血总有效率100％，随访1a均未复发。结论畸形血管栓塞术对叶内型肺隔离症致咯血的治疗，安全有效。