Hematopoietic turnover index in reactive and neoplastic bone marrow lesions: quantification by apoptosis and PCNA labeling

 In order to determine the dynamics of hematopoietic cell turnover, proliferative activity and incidence of apoptosis (programmed cell death) were evaluated in bone marrow trephine biopsies. Selection of patients (20 in each group) included in addition to a control group, idiopathic thrombocytopenia (ITP), reactive thrombocytosis (TH), secondary polycythemia-smokers' polyglobuly (PG), primary (essential-hemorrhagic) thrombocythemia (PTH), polycythemia vera (PV), and finally acute myeloid leukemia (AML). Apoptosis was demonstrated by the in situ end-labeling technique (ISEL) and proliferative activity by applying the monoclonal antibody PC10 raised against proliferating cell nuclear antigen (PCNA). To assess dynamic features of hematopoiesis, an index was calculated consisting of the ratio between PCNA-positive nuclei and the apoptotic cell fraction. This factor was termed the hematopoietic turnover index (HTI). Morphometric analysis revealed that the HTI was significantly increased in AML and PV. According to cell culture studies both disorders are characterized by either a prevalent proliferation of the myeloid or erythroid cell mass. On the other hand, PG, PTH, and TH showed no relevant enhancement of this index in comparison to the control specimen. In vitro experiment results are in keeping with the finding that PG and PTH are not associated with a significant expansion of the erythroid lineage (CFU-E). Similar to ITP and TH, in PTH megakaryocyte proliferation (CFU-MEG) is the predominant feature of cell turnover. Differences between PTH and TH are in line with the reduced in vitro formation of CFU-MEG in the latter disorder. In conclusion, our in situ study on turnover rates of the bone marrow in various neoplastic and reactive lesions extends previous experimental data on hematopoietic cell kinetics. Received: 10 March 1997 / Accepted: 18 May 1997     

Primary lymphoma of the mandible with diffuse widening of the mandibular canal: report of a case

A case of primary non-Hodgkin's lymphoma (NHL) of the mandible with unusual radiographic presentation is reported. The panoramic radiography revealed diffuse widening of the right mandibular canal with ill-defined margins and absence of edge sclerosis. Computed tomography showed infiltration of the superior portion of the canal with involvement of the vestibular cortex of the bone and of the alveolar ridge. Correspondence to: M. Bertolotto     

原发性肝癌栓塞化疗后血清AFP浓度与疗效关系的探讨

目的 :分析 5 5例原发性肝癌经肝动脉插管栓塞化疗 (Transcatheterhepaticarterialchemo -embolization ,TAE)后血清AFP浓度与疗效的关系。方法 :通过动脉插管和血管造影 ,采用不同的化疗药物对肿瘤组织进行局部注入。用放射免疫法测定AFP浓度。结果 :TAE后血清AFP浓度降低与疗效有关 ,AFP≥ 4 0 0ng dl组有效率为 12 % ,AFP <10 0ng dl组有效率为 85 7%(P <0 0 1) ;TAE治疗后血清AFP浓度仍大于 4 0 0ng dl组癌肿转移率明显高于AFP <10 0ng dl组 ,而 2年生存率明显低于AFP <10 0ng dl组 (P <0 0 5和P <0 0 1)。结论 :TAE后血清AFP浓度的检测可反映肝癌介入治疗后疗效、预后及生存率     

急性心肌梗死再灌注期间的心电变化特征

目的　探讨急性心肌梗死 (AMI)再灌注期间的心电变化特征。方法　 46例经急诊冠状动脉造影明确为成功再灌注的AMI,其中 2 4例接受溶栓治疗和 2 2例接受直接经皮腔内冠状动脉成形 ,于发病的 6小时内以动态心电图技术持续2 4小时监测心电图变化 ,并与 1 5例无灌注者进行对比。结果　①再灌注发生后 ,相应导联ST段迅速下降 ,约 2小时达较低水平 ;同时 ,T波正向振幅进行性降低 ,距再灌注 0～ 2 2 (2 7± 4 5)小时呈现T波倒置并逐渐加深。②再灌注后的 1小时内 ,室性心律失常明显增加 ,6～ 8小时后显著减少。结论　AMI早期再灌注发生后呈现特征性心电变化 ,及时识别这些特征将有助于临床评估再灌注状态和危险度分层     

Tuberculosis in children: a 13-year follow up of 1714 patients in a Belgian home care centre

From May 1970 to September 1983, 1714 children with different forms of primary tuberculosis were referred to the paediatric home care centre (Enfants soignés au Foyer, E.S.F.) of the Brussels University Hospital St.-Pierre. They were subdivided in five groups: asymptomatic (33%), symptomatic (28%), dubious tuberculous infections (35%), high-risk contacts (3%) and unestablished diagnosis (1%). They were aged from 10 days to 19 years, and 82% of them were migrants of low socio-economic level. Fifty percent of the symptomatic infections, mainly pulmonary, appeared in children under 3 years of age. An adult source of contamination was identified in 33% of the case (48% of the symptomatic children). Diagnosis was based on tuberculin screening with a 2IU intradermal test. Gastric aspirates yieldedMycobacterium tuberculosis in 15% of our patients, 11% of them showing resistance to one or more tuberculostatic drugs. Treatment was given to 1359 patients with excellent results. Therapy was shortened during the last 2 years of the study from 12 to 6 months for the asymptomatic patients and from 12 to 9 months for the symptomatic infections. Few complications were observed. Tuberculosis remains a serious cause of morbidity particularly in migrant children. Correct diagnosis and treatment of the disease is very important.     

Surface topography of enamel and dentine from primary teeth following infrared Nd-YAG laser irradiation: An in vitro study

Data on the effects of laser radiation on primary teeth are scarce. This study investigates the effects of exposing sound enamel, photo-initiated sound enamel, sound dentine and carious dentine of extracted primary teeth to a pulsed neodymium-yttrium aluminium garnet laser (Nd-YAG, wavelength 1.06 μm, pulse length 15μs). Each type of tissue was exposed to three fiuences. Qualitative and quantitative assessments of the irradiated areas revealed that the most marked changes were produced in carious dentine, followed in ranking order by sound dentine, photo-initiated enamel and sound enamel. Evidence of thermal damage to the hard tissues peripheral to the fibre-optic tip, and considerable inter-sample variation were found. The experimental evidence obtained in this in vitro study does not support the clinical use of pulsed laser at 1.06 μm wavelength for cutting primary enamel and dentine.     

创伤骨科中责任制护理初探

本文复习了有关责任制护理的理论，从创伤骨科的角度，介绍了这一护理技术在创伤骨科中具体应用方法。通过对创伤骨科病人心理及临床特点的分析，提出了针对创伤病人的护理问题，订出护理计划，在阐述了责任制护理具体实施的优点时，对现存的问题也进行了分析，提出了改进措施。     

原发性色素性结节状肾上腺皮质病(附4例报告)

目的：探讨原发性色素性结节状肾上腺皮质病(PPNAD)的临床表现和诊断治疗方法。方法：总结4例PPNAD的临床资料，4例均有库欣综合征的临床表现，内分泌检查结果提示为功能自主性肾上腺皮质肿瘤，但影像学检查并未发现肾上腺肿瘤。结果：4例患者均行单侧肾上腺全切除术，手术标本均表现为肾上腺大小正常或轻度增大，外表和切面上见黑色或深褐色小结节，结节间皮质萎缩，光镜下见组成结节的细胞体积大，脑质嗜伊红染色、颗粒状，部分细胞脑质中的颗粒状色素颗粒具脂褐质染色特征。结论：PPNAD在青少年中是一种引起库欣综合征的罕见病因，双侧肾上腺切除术是治愈本病的方法。     

原发性肝癌的分期、根治切除标准及预后指标

论述了原发性肝癌的分期方案，根治切除标准及预后指标。三者的研究进展及相互间的关系。肝癌临床分期尚没有统一的实用方案，TNM分期随着不断修订，得到了一定的认可和推广。我国1999年修订的方案大致与TNM分期相对应，目前也没有通用的肝癌切除根治标准，临床上通常分为根治性切除与姑息性切除两类，比较笼统，在细胞病理学的基础上可分为病理根治性，临床根治性和姑息性切除三类，多因素分析表明，影响肝癌总体预后的因素主要是肿瘤分期，病理类型，治疗措施。肿瘤生物学特性以及并发症，而影响手术后复发和转移的因素主要是手术切除程度和病理特征，临床分期是选择治疗方案的基础。预后分析则是验证肝癌的分期和根治切除标准是否合理的手段；肝癌的准确分期，根治切除的判断及预后水平的提高均有赖于分子生物学技术的进步。     

温经化瘀合剂临床疗效观察与研究

目的:验证"温经化瘀舍剂"对妇女寒凝血瘀型痛经的治疗效果;方法:将符合中医诊断标准寒凝血瘀型痛经患者,随机分为2组,分别给予"温经化瘀合剂"和"痛经宁冲剂"进行治疗;结果:治疗组总有效率达95%,对照组总有效率80.5%,治疗组优于对照组,治疗组痊愈率48.3%,对照组痊愈率14.6%,治疗组明显优于对照组.实验动物无明显急性毒性反应,能减轻二甲苯引起的小鼠耳肿胀度,减少缩宫素所致大鼠扭体反应次数,和前列腺素E1所致小鼠扭体反应次数,对大鼠离体子宫有双向调节作用,证明"温经化瘀舍剂"具有镇痛、抗炎作用.