软骨粘液样纤维瘤骨骼的X线改变(附6例报告)

本文报到软骨粘液样纤维瘤6例,据国内统计本病发病率占良性骨肿瘤的2.13％。叙述了本病的临床表现和病理改变。其好发部位为下肢长骨、次为短骨、扁骨少见。以发生于长骨偏心性生长者、其X线表现最为典型,并多见。中心性生长者易发生病理性骨折。骨“皮质”下和骨膜下生长者,有时很不典型。此外,讨论了本病与其他骨肿瘤的X线鉴别诊断。软骨粘液样纤维瘤在1948年始被Jaffe氏等命名,随后国外作者不断报导,据曹氏等统计在国外本病的发病率为原发性骨肿瘤的1.4—3.0％。国内从1964年开始有报导,有何、李、陈三氏共报导15例。至1979年李氏又报导16例。根据1981年刘氏病理统计、软骨粘液样纤维瘤占良性肿瘤的2.13％。由于本病的病理与X线表现较复杂,故在诊断上易发生误诊。为了提高对本病的认识,我们又复习了文献,并对本组病例进行分析,在这个基础上重点讨论了X线鉴别诊断,以及对软骨粘液样纤维瘤发生病理性骨折问题等提出了我们的看法。     

骨的软骨粘液样纤维瘤(附7例报告)

本文报告7例骨的软骨粘液样纤维瘤。患部有轻度疼痛和可触及的肿块。X线表现病变位于长管状骨的干骺端,偏心性地破坏其上的皮质,呈膨胀性生长。肿瘤外形被一层薄的骨膜新生的骨壳所局限。其内髓腔与正常骨质之间有清晰的硬化带。按照其特征须与骨囊肿和软骨肉瘤等鉴别。肿瘤为良性,切除或彻底刮除加植骨即可治愈。     

肋骨软骨黏液样纤维瘤误诊1例报告

患者,男,40岁,因近日洗澡时发现在胸部有突起物,前来医院就诊,临床拟诊为肋骨囊肿而入院。查体:双肺呼吸音清,无干湿性口罗音;心脏听诊无异常;左侧第7肋骨于腑前线处可触及6cm×3cm肿物,质硬有压痛。X线片示:左侧第7肋骨沿其长轴见15cm长的骨质破坏区,前至软骨,后达肋颈部,最宽处2·5cm,突出1·5cm,其内未见骨嵴及分隔,也无钙化及硬化边缘,而呈磨砂玻璃样,骨皮质变薄,无骨膜增生。X线意见:骨纤维异常增殖症。手术切开皮肤见肋骨明显增粗变脆,切除病肋送病理,病理诊断为:肋骨软骨黏液样纤维瘤。讨论软骨黏液样纤维瘤为少见良性骨肿瘤,起源于…     

软骨粘液样纤维瘤的X线诊断

目的为研究软骨粘液样纤维瘤的特征性X线表现.方法回顾了10例经手术和病理证实的软骨粘液样纤维瘤.结果发现软骨粘液样纤维瘤有以下重要X线特征,按照其出现频率依次是①病变位于长短状骨的干骺端或不规则骨的近关节处(10/10)②病灶呈现地图状骨质破坏,边缘有分叶和硬化圈(以髓腔面和近关节面为主),病灶内部有粗分隔(9/10);③发病年龄为20～30岁.结论软骨粘液样纤维瘤有特征性X线表现,X线往往能确立诊断,而缺少特征的病变X线难以诊断.     

骨的软骨粘液样纤维瘤

骨的软骨粘液样纤维瘤(Chondromyxoid fibroma of bone)为少见的良性骨肿瘤,1948年首先由Jaffe和Lichtenstein氏提出并报告8例。骨的软骨粘液样纤维瘤来源于形成软骨的结缔组     

短管状骨软骨黏液样纤维瘤的X线诊断

骨的软骨黏液样纤维瘤 ,为一少见的良性骨肿瘤 ,1948年由Ｊａｆｆｅ等首先报道并命名。本病多见于长管状骨 ,发生于短管状骨者更为少见 ,国内尚未见有短管状骨软骨黏液样纤维瘤的报道。我们得见 10例 ,报告如下。1　临床资料1 1　一般资料本组 10例病人 ,男 7例 ,女 3例 ;年龄 14～ 5 6岁 ,2 0～30岁者 7例。发病部位 :5例位于指骨 ,3例位于掌骨 ,2例位于跖骨。临床表现 :全组病人均有轻度疼痛及局部肿胀 ,邻近关节或病变范围较大时 ,可影响关节活动 ,局部皮肤温度增高或轻微红肿。有典型外伤史者 4例。病程最短 5ｄ ,最长 11年。1 2　Ｘ线…     

蝶鞍部软骨粘液样纤维瘤一例

蝶鞍部软骨粘液样纤维瘤一例孙抒，李日镛，朴东明，安天雄延边医学院病理学教研室延边医学院附属医院病理科关键词纤维瘤，软骨，蝶鞍中图法分类号Ｒ７３９．４１软骨粘液样纤维瘤起源于形成软骨的结缔组织骨肿瘤，此瘤少见，约占骨肿瘤的１％。发病部位以下肢为多见，发...     

软骨粘液样纤维瘤的病理及X线诊断

目的:探讨软骨粘液样纤维瘤的病理及x线诊断.方法:报告经手术病理证实的4例并结合文献分析,其中男3例,女1例,年龄15～49岁,平均24岁;病史最长者9年,最短者2年4个月,其中1例有外伤史.摄x线平片正位、侧位和/或斜位.结果:2例x线表现为膨胀性粗厚的蜂窝状,有“囊套囊“及软组织肿块征象,其中1例伴小点状钙化;1例病变近髓腔侧呈扇形增生硬化,其内见粗大骨嵴,骨皮质变薄似波浪状;另1例呈边缘清楚的“吹气球“样改变,均未见骨膜反应.结论:临床、x线、病理三者综合分析是诊断软骨粘液样纤维瘤的最佳方法.     

C_2椎弓软骨粘液样纤维瘤一例

软骨粘液样纤维瘤是较少见的良性骨肿瘤,发病率占骨肿瘤的1%,多发生于下肢管状骨干骺端,躯干骨极少见,颈椎椎弓更为罕见.我院收治1例,报告如下. 患者男性,57岁,农民.因颈后部疼痛伴活动受限1月余于1988年11月26日入院.检查:一般情     

指骨软骨粘液样纤维瘤一例报告

<正> 软骨粘液样纤维瘤比较少见,发生于短管状骨者尤为少见。现将收治的一例指骨软骨粘液样纤维瘤及随访结果报告如下: 患者男,34岁,工人。因轻微外伤后右手环指近节反复肿痛2年入院。X线片示:近节指骨基底部呈溶骨性改变,轻度膨胀,并似见多囊状改变,另有数处骨皮质断裂,未见明显钙化。入院诊断:内生软骨瘤伴病理性骨折。术中见局部骨膜轻度水肿,增厚,部分骨皮质变薄、易碎,骨髓腔内充满白色胶冻状物,予以完全刮除后植入术前准备的六个月死胎儿松质骨,并将刮除物送病检。病检结果:因刮除物较细碎,大体标本难以确切描述。镜下见瘤组织大小、形态不一的     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.