Liver regeneration in acute severe liver impairment: a clinicopathological correlation study.

BACKGROUND: Although normally quiescent, the adult mammalian liver possesses a great capacity to regenerate after different types of injury. Major players in the regeneration process are mature residual cells, including hepatocytes, cholangiocytes and stromal cells. However, if the regenerative capacity of mature cells is impaired, hepatic progenitor cells (HPCs) are activated and expand into the liver parenchyma. Upon transit amplification, the progenitor cells generate new hepatocytes and biliary cells to restore liver homeostasis. AIMS/METHODS: To study the relationship between different histopathological parameters as well as their correlations with clinical parameters and outcome, we examined liver specimens from 74 patients with acute or subacute severe liver impairment by immunohistochemistry for CK7/CK19 (evaluation of HPCs activation/differentiation), Mib1(Ki 67)/P21 (evaluation of proliferative activity/proliferation arrest of hepatocytes) and hematoxylin and eosin (evaluation of hepatocyte loss). RESULTS: Of the 74 patients, 32% survived without transplantation, 14% died without transplantation and 54% were transplanted. Our results show that a threshold of 50% loss of hepatocytes, associated with significant decrease in the proliferative activity of remaining mature hepatocytes, is needed for extensive hepatic progenitor cell activation. Such activation is a sign of disease severity and occurs early (within 1 week) in the disease course. However, development of intermediate hepatocytes, suggesting HPCs differentiation towards mature hepatocytes, takes at least 1 week's time. We found a positive correlation between histopathological parameters (percentage hepatocyte loss, number of proliferating hepatocytes and number of HPCs) and clinical parameters of liver impairment such as model for end stage liver diseases (MELD). Surviving patients compared with those who either died or were transplanted had significantly less hepatocyte loss, less HPCs activation and more mature hepatocyte proliferative activity. Hepatocyte proliferative activity and degree of hepatocyte loss were the most important independent histopathological parameters in predicting outcome. CONCLUSION: Liver biopsy can provide important additional information in a patient with severe acute liver impairment.     

Serial CT findings of Paragonimus infested dogs and the Micro-CT findings of the worm cysts.

OBJECTIVE: To investigate the serial CT findings of Paragonimus westermani infected dogs and the microscopic structures of the worm cysts using Micro-CT. MATERIALS AND METHODS: This study was approved by the committee on animal research at our institution. Fifteen dogs infected with P. westermani underwent serial contrast-enhanced CT scans at pre-infection, after 10 days of infection, and monthly thereafter until six months for determining the radiologic-pathologic correlation. Three dogs (one dog each time) were sacrificed at 1, 3 and 6 months, respectively. After fixation of the lungs, both multi-detector CT and Micro-CT were performed for examining the worm cysts. RESULTS: The initial findings were pleural effusion and/or subpleural ground-glass opacities or linear opacities at day 10. At day 30, subpleural and peribronchial nodules appeared with hydropneumothorax and abdominal or chest wall air bubbles. Cavitary change and bronchial dilatation began to be seen on CT scan at day 30 and this was mostly seen together with mediastinal lymphadenopathy at day 60. Thereafter, subpleural ground-glass opacities and nodules with or without cavitary changes were persistently observed until day 180. After cavitary change of the nodules, the migratory features of the subpleural or peribronchial nodules were seen on all the serial CT scans. Micro-CT showed that the cyst wall contained dilated interconnected tubular structures, which had communications with the cavity and the adjacent distal bronchus. CONCLUSION: The CT findings of paragonimiasis depend on the migratory stage of the worms. The worm cyst can have numerous interconnected tubular channels within its own wall and these channels have connections with the cavity and the adjacent distal bronchus.     

姜黄素对大鼠早期肝缺血再灌注损伤肺的保护作用

目的 探讨姜黄素对大鼠肝脏缺血再灌注早期损伤(再灌注1、3 h)肺的保护作用.方法 将大鼠随机分为假手术组(A组)、对照组(B组)和实验组(C组).通过检测再灌注早期肺组织病理学的改变及肺组织中SOD、CAT、MDA、MPO的含量来评价姜黄素对大鼠肝脏缺血再灌注损伤肺的保护作用.结果 姜黄素可减少大鼠肝缺血再灌注损伤肺间隔的水肿和肺泡中红细胞和白细胞的渗出.姜黄素提高了早期缺血再灌注后肺组织中SOD、CAT含量,降低了肺组织中MDA、MPO含量.结论 姜黄素通过抑制肺组织中的氧自由基的生成及中性粒细胞的浸润,从而在早期大鼠肝缺血再灌注损伤中起到了对肺的保护.     

孕妇血清AFP、uE3和β-hCG水平与严重胎儿缺陷的关系

①目的 探讨孕中期血清甲胎球蛋白（AFP），游离雌三醇（uF3)和β绒毛膜促性腺激素（β-HCG）水平与严重胎儿缺陷的关系。②方法 用ELISA方法对832例16-21周妊娠妇女血清AFP、UE3和β-hCG进行检测，以筛查阳性病人。③结果 14例胎儿被确诊为异常，其中唐氏综征2例，无脑儿3例，脊柱裂3例，唇腭裂1例，腹裂肠外翻1例，孕中期自然流产2例，死胎1例，葡萄胎1例，总检出率为1.68%，假阳性15例，占被检人数的1.80%。④结论 以上3种生化指标联合检测可作为产前诊断严重胎儿缺陷的有效方法。     

非增强螺旋CT与B超在泌尿系结石诊断中的价值比较

目的:探讨非增强螺旋CT(NCHCT)对泌尿系结石的诊断价值.方法:对50例急性腰腹部绞痛而怀疑泌尿系结石患者行NCHCT检查,并同时行泌尿系B超检查作对照,对检查结果进行临床随访,随访3天～3个月(平均0.5个月).结果:38例患者被证实为泌尿系结石(3例保守治疗后自行排出结石,28例经体外冲击波碎石后排出结石证实,7例手术取出结石),NCHCT诊断泌尿系结石38例;B超诊断泌尿系结石28例,1例假阳性.NCHCT与B超诊断泌尿系结石的敏感度分别为100%、73.7%,特异度分别为100%、91.7%,阳性预测值分别为100%、96.6%,阴性预测值分别为100%、52.4%,约登指数(正确指数)分别为1.0、0.65,NCHCT与B超相比较(u=3.23,P＜0.01),差异具有显著性意义.结论:NCHCT诊断泌尿系结石比B超具有更高的敏感度和特异度,可作为临床怀疑泌尿系结石、尤其是急性肾绞痛患者的常规检查方法.     

子宫切除术对生存质量的影响

目的：研究子宫切除术对生存质量的影响。方法：对108例因良性疾病而行腹式子宫切除术者进行前瞻性队列研究，术前及术后3，6，12个月进行调查问卷，观察症状、泌尿及胃肠功能、性功能、心理状况、社会生活状态的变化。结果：子宫切除术后3个月症状、压抑、焦虑程度减轻，社会生活状态显著提高，泌尿及胃肠功能、性功能无改变，这些改善持续至术后12个月。结论：子宫切除术可有效缓解妇科良性疾病所产生的症状，症状的缓解有利于改善生存质量。大多数因妇科良性疾病而行腹式子宫切除术的妇女，在术后1年，生存质量提高。     

经导管同期封堵治疗膜周部室间隔缺损合并房间隔缺损

目的　探讨经导管介入同期治疗膜周部室间隔缺损 (VSD)合并房间隔缺损 (ASD)的可行性、方法及疗效。方法　 4例患者 ,年龄为 12～ 2 6岁。术前超声检查提示VSD合并ASD。VSD均为膜周部缺损 ,缺损直径 3～ 6mm ,缺损上缘距主动脉瓣 2～ 6mm。ASD均为继发孔型 ,缺损直径 5～ 8mm。4例患者均于术中先行左心室造影 ,确定VSD适合封堵后 ,先行VSD封堵 ,最后行ASD封堵。结果　 4例患者均经导管一次封堵治疗成功。左心室造影显示VSD呈囊袋型 3例 ,囊袋直径分别为 4、5和 10mm ,封堵器的直径分别为 4、8和 12mm。 1例缺损为管状 ,直径 3.5mm ,用 4mm的封堵器治疗成功。4例患者ASD伸展径为 6～ 10mm ,封堵器直径为 6～ 12mm。所有患者术中及术后无并发症。结论　经导管介入同期封堵治疗膜周部VSD合并ASD具有技术上的可行性、安全性和良好的治疗效果     

结肠CT扫描技术初探

目的 :通过分析比较结肠扫描不同充填剂与不同体位的方法 ,探讨出最佳充填剂与最佳体位以提高结肠 CT扫描质量。方法 :分别对 4 0例结肠 CT扫描病人采用不同的充填剂 ,与不同的体位 ,评价不同的充填剂与不同体位的优缺点。结果 :水作为充填剂组病灶显示情况明显优于泛影萄胺组且伪影少 ,选择不同体位组图像质量也明显优于常规体位组。结论 :结肠 CT扫描时应首选水作为充填剂 ,根据病变不同选择不同的体位 ,有利于图像质量的提高     

Prevalence of occupational allergy due to live fish bait

BACKGROUND: Larvae of insects and worms, used as live fish bait (LFB), are a common source of allergy in anglers and occupationally exposed workers, but the prevalence and predictors have not yet been investigated. OBJECTIVE: This study assessed the prevalence and associated factors of occupational allergy in workers exposed to LFB. METHODS: We assessed the prevalence of sensitization to LFB and work-related symptoms (WRS) in 76 workers occupationally exposed to it. All workers completed a case history questionnaire and underwent skin prick tests (SPT) for common aeroallergens and bluebottle (Calliphora vomitoria), bee moth (Galleria mellonella), mealworm (Tenebrio molitor), and gusano rojo (Cilecomadia moorei). Specific IgE were tested in 64 subjects. Two-thirds of the workers had a high level of LFB exposure. RESULTS: Sensitization to LFB was found in 24 workers (31.6%). Seven subjects (9.2%) reported WRS (asthma in 3, rhinoconjunctivitis in 5, and contact urticaria in 1), and 5 were positive for SPT and serum IgE to one or more LFB extracts. One was also exposed to LFB while fishing. Sensitization to LFB extracts and WRS were strongly associated (Odds Ratio = 6.6, P < 0.05). The 7 subjects with WRS had been exposed longer than asymptomatic subjects with positive skin tests to LFB (P < 0.05). No differences in sex, age, smoking habit, duration or level of exposure, and atopy were detected in symptomatic or in sensitized subjects, compared with normal workers. CONCLUSION: Sensitization to LFB and WRS are relatively frequent in occupationally exposed workers. No associated factors of occupational allergy to LFB could be detected.     

某部性病基本知识调查分析

目的　探讨部队性病防治情况。方法　设计 10个与性病有关的问题 ,对随机抽样某师 4个营官兵现场无记名调查。结果　有关性病的基本知识已被大部分官兵所认知 ,但也有一部分官兵对性病缺乏了解 ,甚至误解。结论　在官兵中加强性病基本知识的宣传 ,强调性病的危害对部队防治性病很有必要。