59例老年人肺结核临床特点分析

目的 探讨老年人肺结核病的临床特点,方法 回顾性分析了５９例６０岁以上老年肺结核的临床表现、肺Ｘ线特征、诊断及效果。结果 ①５９例患以肺结核诊断入院２１例（３５．６％）,其他疾病（非结核病）入院３８例（６４．４％）,其中１４例为复发性肺结核;②５４例（９１．５％）合并有不同脏器疾病;③４４例经抗结核治疗后治愈或好转,总有效率为７４．６％;④死亡７例（１３．４％）,其中因确诊晚未及治疗的３例,     

26例狼疮性肾炎并发急性肾功能衰竭的临床病理分析

为探讨狼疮性肾炎并发急性肾功能衰竭的危险因素,收集了符合狼疮性肾炎并发急性肾功能衰竭的病例２６例,与未发生急性肾功能衰竭的狼疮性肾炎３０例进行临床病理分析。结果：狼疮性肾炎并发急性肾功能衰竭常发生在具有临床活动指标及病理活动指标的患者,病理类型以Ⅳ型、Ⅴ型为主,其诱因有感染、不规则的激素治疗、劳累及日晒。结果表明：控制狼疮性肾炎的活动,避免诱发因素,是防止急性肾功能衰竭发生的重要环节。     

基于多尺度特征融合与反向注意力的COVID-19病灶分割

针对新型冠状病毒肺炎（COVID-19）分割问题中感染区域具有高变异性以及病灶与背景对比度低等问题,提出一种基于多尺度特征融合与反向注意力的COVID-19感染分割网络。首先,利用残差网络作为主干网络进行特征提取,并使用全局上下文聚合策略对不同层次特征进行融合得到粗略的分割结果;其次,在网络瓶颈处添加多尺度特征融合模块,利用空洞卷积与多核池化增强网络分割不同尺度病变的能力;最后,设计一种级联结构的反向注意力模块,利用互补区域的细节特征增强背景与目标的对比度。本文方法在COVID-19 CT分割测试集上的准确率、特异性、灵敏度分别达到0.714、0.700和0.958,误检和漏检区域明显减少,细小病灶的分割能力显著提升。     

慢性苯中毒患者34例骨髓象的临床观察

目的　通过对慢性苯中毒患者骨髓象分析,了解其临床类型特点。方法　按诊断标准对患者进行分组诊断,３４ 例患者均进行骨髓穿刺,选取材、涂片、染色好的骨髓片计数有核细胞２００ 个,进行分类并观察细胞形态。结果　除２ 例再生障碍性贫血（ 简称再障） 患者外,其他患者均表现骨髓增生活跃或明显活跃,但各组患者粒红比值均数低于正常值均数。骨髓增生异常综合征（ Ｍ Ｄ Ｓ） 患者骨髓中原粒和早幼粒细胞百分率高于正常,分别为５ ．０８ 和７ ．８５（ 正常参考值分别为０ ．６４ 和１ ．５９） ,粒细胞和红细胞有细胞形态异常和核畸形。结论　慢性苯中毒可以导致 Ｍ Ｄ Ｓ,慢性重度苯中毒患者 Ｍ Ｄ Ｓ 发病率高于再障,应考虑将骨髓象检查列为苯中毒诊断的必要项目。     

烹调油烟所致大鼠肺部病变及肺S9中SOD,MDA变化

利用动式吸入烹调油烟（浓度为（４３±４）ｍｇ／ｍ３）持续染毒６０天制备动物模型观察肺部病理形态改变,并通过分光光度法测试肺组织匀浆Ｓ９中的ＭＤＡ、ＳＯＤ,探讨其损伤机理。结果表明：ＣＯＦ染毒组肺组织病理形态改变以炎症改变为主,尚有肺泡上皮腺样化生、不典型腺样增生病变形成。阴性对照组有轻度间质性肺炎及轻度的上皮增生。Ｂ（ａ）Ｐ组肺组织炎症病变少,以鳞状上皮化生较多见。ＣＯＦ可使肺组织匀浆Ｓ９中ＭＤＡ含量增加,ＳＯＤ酶活性降低,与阴性对照组比较,差异有显著性,（Ｐ＜０．０５）。     

Classification of normal and pathological tremors using a multidimensional electromagnetic system

A new multidimensional movement analysis system was used to record limb tremor over six degrees-of-freedom, and signal processing techniques were explored to develop a suitable classification method to distinguish between different types of tremor. The specific aims were to investigate the ability of the system to screen for differences between normal subjects and a group of neurological patients, and then to differentiate between three diagnostic groups of patients.

Postural tremor at the hand was recorded in normal subjects (n=24) and patients with essential tremor (n=21), multiple sclerosis (n=17) and parkinsonism (n=19). Data were collected using a 3Space Fastrak^® (Polhemus, Inc.) over six degrees-of-freedom (three translational directions and three rotations). Spectral estimates produced measures of tremor frequency and amplitude. Mathematical models of the data, using autoregressive modelling and K-nearest neighbour classification, produced parameters used to classify, (1) the normal subjects and 24 patients (using the three rotational movements), and (2) the three patient groups (using all six movement directions). Results were given in terms of the probability of each subject belonging to the groups being classified.

Tremor frequency and amplitude showed large overlap between the groups. The screening classification produced high probabilities of correctly classifying normal subjects (>70%) and patients (>70%). The diagnostic classification produced clear differences between the patient groups (60% for essential tremor, 80% for multiple sclerosis and 60% for parkinsonism).

The ability of this assessment technique to distinguish between postural tremor in normal subjects and neurological patients suggests that it could be developed as a screening tool. Classification of tremors between the patients groups, with a high degree of sensitivity, indicates the potential for further development of the system as a diagnostic aid.     

一起病毒性心肌炎爆发流行的调查分析

目的：阐明病因和流行因素,为本病的防治提供依据。方法：对疫区环境和人群进行现场流行病学调查,同时采集患者和高危人群的血和粪便等标本用细胞和乳小白鼠进行病原分离和血清中和抗体检测,用原代猴肾细胞进行病毒鉴定。结果：本次流行发病９１人,病死１３人,罹患率为１４８５％;病死率为１４６１％。临床和病理诊断为病毒性心肌炎,流行病学调查结果也符合病毒性心肌炎的流行特点。从患者体内分离到６株柯萨奇Ｂ４病毒,患者和高危人群血清中柯萨奇Ｂ４病毒抗体有升高。结论：本次心肌炎爆发流行是由柯萨奇Ｂ４病毒污染水源引起。     

Generalized amyloidosis from β2-microglobulin,with caecal perforation after long-term haemodialysis

Summary A 73-year-old man with chronic renal failure of undetermined aetiology had received haemodialysis for 12 years when he died of acute purulent peritonitis due to caecal perforation. Amyloid deposits detected in a cystic bone lesion in the left hip had caused a pathological fracture 17 days before death. At autopsy, extensive amyloid deposits were found in the osteoarticular system, in the cartilaginous surface and the capsular tissue of joints, ligaments, vertebral discs and bone. In addition, vascular amyloid deposits were diagnosed in the heart, kidneys, testes, lungs, skin and in the gastrointestinal tract. A special feature of this case were interstitial amyloid deposits forming a fine-meshed structure in the myocardium and plate-like deposits in the gastrointestinal tract. Immunohistochemically, all these deposits reacted strongly with antibody to human ₂-microglobulin but showed no reaction with antibodies to AA, Alambda, A-kappa and AF. The present case demonstrates that extra-osteoarticular manifestations of AB-amyloidosis can cause serious complications.     

粘膜相关淋巴组织淋巴瘤临床病理研究

目的：探讨粘膜相关淋巴组织(MALT)淋巴瘤临床病理特征。方法：对我院确诊和会诊的粘膜相关淋巴瘤18例，进行临床病理分析。按原发部位分为胃肠(GI)和非胃肠(NON-GI)两组，男性11例，女性7例，男女之比为1．6：1，平均年龄52岁(31岁-63岁)。结果：Gl组9例，临床表现无特异性，以腹部疼痛最常见，占本组78％(7／9)，其次是腹部包块，占33％(3／9)，内镜下表现多样；NON-GI组9例，以局部无痛性包块为主。手术后标本行免疫组化染色，结果均为B细胞恶性淋巴瘤。结论：粘膜相关淋巴组织(MALT)淋巴瘤是非霍奇金淋巴瘤的一种亚型，具有起病隐匿，病程长，进展慢及患病率低，好发于中老年男性，治疗和预后良好等特征。     

68例骨肿瘤致病理性骨折的治疗

目的:研究不同的外科治疗方法对骨肿瘤病理性骨折患者预后的影响.方法:自1995年6月～2002年10月共收治68例病理性骨折.引起病理性骨折的肿瘤中,转移癌27例(转移至四肢17例,脊柱8例,锁骨2例).原发恶性肿瘤20例(骨肉瘤13例,尤文氏肉瘤3例,软骨肉瘤2例,恶性纤维组织细胞瘤2例).良性肿瘤21例(骨巨细胞瘤12例,骨囊肿4例,内生软骨瘤及动脉瘤样骨囊肿各2例,纤维异样增殖症1例).通过回顾性分析研究,对其临床表现、诊断、治疗进行初步临床分析.结果:随访6个月～7.2年,转移癌中7例行局部广泛切除,假体置换,未见局部复发,功能良好.8例行病灶刮除,髓内针内固定,其中4例死亡,3例局部复发.13例骨肉瘤患者,9例对化疗敏感,行保肢手术,术后未见局部复发,预后良好,4例对化疗不敏感,行截肢术,术后均有肺转移.12例骨巨细胞瘤,7例行肿瘤广泛切除,假体置换,术后随访未见局部复发.5例行病灶刮除,骨水泥填充,其中3例复发.结论:对于转移癌、骨巨细胞瘤和一些良性肿瘤所致的病理性骨折,肿瘤的彻底切除和假体置换对于控制局部复发是有效的,并可获得良好的功能.对化疗敏感的骨肉瘤患者,即使骨折,经过化疗和适当处理后,也可行肿瘤的彻底切除和假体置换,也可获得良好的局部控制和降低肺转移发生率.