Atypical adult non-calcified pilomatricoma

We present a rare case of a non-calcified pilomatricoma in a 67-year-old man. This tumor was extremely large in size, and its location, in the lower extremity, was very unusual. The clinical, radiographic, and histopathological features are described in detail. The role of magnetic resonance imaging (MRI) in the diagnosis of this entity is discussed. Definite internal reticulations and septations were observed. A possible explanation for this observation is that the high signal intensity reticulations may represent edematous stroma surrounding basaloid cells. Received: 8 July 1999 Revision requested: 28 July 1999 Revision received: 10 September 1999 Accepted: 13 September 1999     

Alveolar soft part sarcoma: MR and angiographic findings

Objective. To present the MR and angiographic findings of alveolar soft part sarcoma (ASPS). Design and patients. MR examinations (12 tumors of 10 patients) of ASPS performed at multiple hospitals were retrospectively reviewed. The tumors were found in the thigh (n=4), lower leg (n=4), femur (n=2, local metastasis), scalp (n=1) and arm (n=1). The MR signal characteristics including signal intensity, homogeneity and signal void of lesions and bony invasion including direct invasion or local metastasis were evaluated. Angiographic findings (n=4) and post-embolotherapy follow-up MR imaging (n=2) findings were also assessed. Results. Local bony metastasis was found in two cases. Seven tumors showed heterogeneous high signal intensity on T1- and T2-weighted images with good enhancement. One tumor had a very high signal on T1-weighted images. Eight tumors (67%) showed numerous signal voids in or near the tumors. All four angiographic studies showed numerous enlarged vessels, arteriovenous shunts and delayed washout. Two cases mimicked arteriovenous malformations on angiographic studies but MR images demonstrated solid soft tissue components as well as tortuous vessels. Conclusions. High signal on T1-weighted image and numerous signal voids are highly suggestive of ASPS, although they are not universal as has been suggested and arteriovenous malformation should be included in the differential diagnosis. Local bony metastases in ASPS were seen in two cases and should be carefully investigated. Received: 12 April 2000 Revision requested: 27 June 2000, 8 August 2000 Revision received: 2 August 2000, 21 August 2000 Accepted: 22 August 2000     

纳洛酮治疗原发性脑干损伤

目的 :观察纳洛酮治疗原发性脑干损伤的疗效。方法 :83例原发性脑干损伤病人分为纳洛酮组 38例 ,在常规治疗基础上加用纳洛酮 0 .3mg·kg- 1加入氯化钠注射液 5 0 0mL中静脉滴注 ,qd× 3d ,3d后减为 4 .8mg·d- 1,qd× 7d ,10d为一个疗程 ;常规治疗组 4 5例 ,单用常规治疗。按格拉斯哥昏迷评分标准观察病人症状。结果 :常规治疗组和纳洛酮组的昏迷时间分别为 (30±s 4 )d和 (2 0±4 )d ,死亡分别为 16例和 6例 ,恢复良好分别为 12例和 2 3例 ,中残分别为 7例和 6例 ,重残分别为 10例和 3例、植物生存各 1例 ;2组昏迷时间及疗效比较 ,P <0 .0 1。结论 :纳洛酮在原发性脑干损伤的治疗中能降低死亡率 ,缩短昏迷时间 ,减少残存率。     

DNA adduct formation in precision-cut rat liver and lung slices exposed to benzo[a]pyrene.

Chemical-DNA adducts provide an integrated measure of exposure, absorption, bioactivation, detoxification, and DNA repair following exposure to a genotoxic agent. Benzo[a]pyrene (BaP), a prototypical polycyclic aromatic hydrocarbon (PAH), can be bioactivated by cytochrome P-450s (CYPs) and epoxide hydrolase to genotoxic metabolites which form covalent adducts with DNA. In this study, we utilized precision-cut rat liver and lung slices exposed to BaP to investigate tissue-specific differences in chemical absorption and formation of DNA adducts. To investigate the contribution of bioactivating CYPs (such as CYP1A1 and CYP1B1) on the formation of BaP-DNA adducts, animals were also pretreated in vivo with 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD, dioxin) prior to in vitro incubation of tissue slices with BaP. Furthermore, the tissue distribution of BaP and BaP-DNA adduct levels from in vivo studies were compared with those from the in vitro tissue slice experiments. The results indicate a time- and concentration-dependent increase in tissue-associated BaP following exposure of rat liver and lung tissue slices to BaP in vitro, with generally higher levels of BaP retained in lung tissue. Furthermore, rat liver and lung slices metabolized BaP to reactive intermediates that formed covalent adducts with DNA. Total BaP-DNA adducts increased with concentration and incubation time. Adduct levels (fmol adduct/microg DNA) in lung slices were greater than liver at all doses. Liver slices contained one major and two minor adducts, while lung slices contained two major and 3 minor adducts. The tissue-specific qualitative profile of these adducts in tissue slices was similar to that observed from in vivo studies, further validating the use of this model. Pretreatment of animals with TCDD prior to in vitro incubation with BaP potentiated the levels of DNA adduct formation. TCDD pretreatment altered the adduct distribution in lung but not in liver slices. Together, the results suggest that tissue-specific qualitative and quantitative differences in BaP-DNA adducts could contribute to the lung being a target tissue for BaP carcinogenesis. Furthermore, the results validate the use of precision-cut tissue slices incubated in dynamic organ culture as a useful model for the study of chemical-DNA adduct formation.     

地拉卓干预APS IgG诱导血液单核细胞组织因子活性的实验研究

 目的 探讨药物地拉卓(dilazep)对抗磷脂综合征(antiphospholipid syndrome,APS)患者血清IgG诱导单核细胞组织因子(tis-sue factor,TF)表达及其抑制机制。方法 将纯化的APS血清IgG以及地拉卓等药物与新鲜分离的外周血单核细胞培养一定时间,加入外源性因子Ⅶa和Ⅹ,通过因子Ⅹa的生成情况,判断单核细胞表面IF活性;利用TF primers,采用TaqMan PCR方法,观察单核细胞TF mRNA表达情况。结果　地拉卓呈量效递增性抑制APS IgG诱导单核细胞TF活性表达,但并非影响APS IgG诱导单核细胞TF mRNA表达。腺苷受体拮抗剂--茶碱(theophylline)可中和地拉卓的这一抑制效应。结论　地拉卓通过腺苷受体途径,在转录后水平干预APS IgG对单核细胞TF活性的诱导。提示某些阻止单核细胞TF活性的药物可望成为治疗APS的新突破。     

试管地黄形成过程中形态发生的研究

目的 :研究试管地黄形成的形态发生过程 ,比较试管地黄与自然条件下生长的地黄在形态解剖上的异同。方法 :取离体条件下和自然条件下不同阶段形成的地黄块根 ,染色后制成石蜡切片 ,于显微镜下观察。结果与结论 :试管地黄在形态解剖方面与自然条件下生长的地黄具有一致性 ,说明试管地黄在诱导过程中未发生结构上的变化。     

IL-10与可溶性鸡Ⅱ型胶原对实验性关节炎的联合治疗作用

目的 :考察重组人白细胞介素 10 (rhIL 10 )对可溶性鸡Ⅱ型胶原 (SCCⅡ )治疗大鼠佐剂性关节炎(AA)疗效的影响。方法 :通过测量足肿胀度、体重、胸腺与脾脏系数 ,观察不同部位淋巴细胞ConA增殖反应并检测腹腔巨噬细胞 (PMΦ)与滑膜组织细胞(SMCs)产生IL 1的水平。结果 :与SCCⅡ(0 .0 3mg·kg-1·d-1,ig)或IL 10 (1,2 μg·d-1,sc)单独治疗比较 ,二者联合治疗大鼠AA ,明显改善上述观察指标 ,同时使SCCⅡ的口服耐受诱导期缩短 ,增强了治疗效果。结论 :IL 10能提高SCCⅡ治疗大鼠AA的治疗效果。     

酸分泌抑制剂对颅脑损伤后应激性溃疡的预防作用

目的 :观察酸分泌抑制剂预防颅脑损伤后应激性溃疡的效果。方法 :将 112例颅脑损伤患者随机分成预防用药组(n =5 7)和对照组 (n =5 5 ) ;预防用药组根据使用药物不同再分成A组 (奥美拉唑 4 0mg·d-1)和B组 (西咪替丁 2 0～ 30mg·kg-1·d-1)。以呕血、胃液或粪隐血试验和空腹胃液的pH值等为观察指标。结果 :预防用药组应激性溃疡发生率 (17 5 4 % )和死亡率 (5 2 6 % ) ,与对照组 (4 5 .4 5 % ,18 18% )比较均有显著性降低 (P <0 0 1,P <0 0 5 ) ;A组应激性溃疡发生率 (6 90 % )与B组 (2 8 5 7% )比较明显减少 (P <0 0 5 ) ,但 2组死亡率比较无显著性差异 (P >0 0 5 )。结论 :颅脑损伤后尽早使用酸分泌抑制剂能显著降低应激性溃疡的发生率和死亡率 ;奥美拉唑预防作用明显优于西咪替丁     

神经外科术中急性脑膨出的原因分析及处理方法

目的：总结分析脑外科手术中急性脑膨出的发生原因和防治措施。方法：对术中出现急性脑膨出的74例病人进行回顾性分析，并对不同处理方法导致的结果进行比较。结果：本组应用综合措施处理术中急性脑膨出，术后3个月GOS评分，良好32例，中残21例，重残7例，植物生存4例，死亡7例。结论：尽早发现并去除致膨出因素，综合运用降颅压措施，尽量扩大颅腔容积，可以避免脑疝或膨出脑组织切除，明显改善患者预后。     

伤痛酊擦剂治疗急性闭合性软组织损伤150例

目的　观察伤痛酊擦剂治疗急性闭合性软组织损伤的临床疗效。方法　 2 0 0例急性闭合性软组织损伤患者随机分为 2组 ,治疗组 1 5 0例应用伤痛酊擦剂治疗 ,对照组 5 0例应用正红花油治疗。 2组均治疗 2周后观察疗效。结果　治疗组临床治愈率 49.3% ,总显效率 90 .0 % ,对照组分别为 2 8.0 %、5 2 .0 % ,2组比较均有非常显著性差异 (P <0 .0 1 )。结论　伤痛酊擦剂治疗急性闭合性软组织损伤疗效确切。