益母草防治初发期急性肾小管坏死的实验研究

ＳＤ成年雄性大鼠，禁止１６小时，肌注甘油引起急性肾小管坏死（ＡＴＮ），于其初发期给予不同药液，观察到益母草组３、２４及４８小时Ｂｃｒ升高值，２４及４８小时ＢＵＮ升高值均明显低于自来水组和单纯禁水组，而与校正对照异搏停组近似，肾组织损伤程度亦明显减轻。结果表明，益母草对初发期急性肾小管坏死（ＩＡＴＮ）有一定的防治作用。     

当归对急性肾小管坏死的防治作用及其机制

用甘油皮下注射复制兔急性肾小管坏死（ＡＴＮ）模型，观察当归（ＲＡＳ）对初发期ＡＴＮ的防治效果，并初步探讨其作机理，结果表明，注射甘油后２４ｈ，ＡＴＮ组动物出现典型急性肾衰性肾功能改变和肾小管坏死，ＡＴＮ＋ＲＡＳ组与ＡＴＮ组比较，动物死亡率，滤过钠排泄分数和尿总氨基酸含量下降，血清肌酐，尿素氮和丙二醛的上升幅度减弱，肾组织钙和丙二醛含量降低，而超氧化物岐化酶，谷胱甘肽过氧化物酶，ＡＴＰ酶活性升高，肾     

小儿急性坏死性肠炎中毒休克型18例分析

本文收集了小儿急性坏死性肠炎中毒休克型18例并加以临床分析，对发病机制及病因、诊断、鉴别诊断加以探讨，重点对本病伴体克患儿的抗休克及莨菪碱类饮用提出作者之见。     

参附液防治初发期急性肾小管坏死的实验研究

给Sprasue-Dawley雄性成年大鼠肌注甘油引起急性肾小管坏死,在初发期给不同实验组以不同处理。观察到:参附组的第48小时亚组动物存活率明显高于单纯禁水组(P<0.025),第3、12、24、48小时亚组SUN、Scr升高值与肾小管管型数,第24、48小时亚组肾小管坏死数,均明显低于单纯禁水组和生理盐水组(P<0.05-P<0.001),光镜电镜下肾脏病理形态改变亦明显轻于该二组。以上各指标,参附组却与纠正对照异搏停组相近。实验结果表明,参附液有防治初发期急性肾小管坏死的作用。     

1例急性坏死性肠炎患儿的护理体会

急性坏死性肠炎的主要病变时小肠急性坏死性炎症,发病急骤,病死率高,早期诊断和治疗甚为重要.本病多记于3～9岁儿童,亦可见于新生儿亦可见于新生儿期及婴儿期,全年均可发病,以夏秋季多见.病因尚未完全明确.2009年7月我科收治了1例急性坏死性肠炎的患儿.我们有针对性的实施个体化健康教育及护理,收到满意效果.现将本例患儿好护理体会汇报如下:     

肾小管损伤内皮素1,肿瘤坏死因子α的表达及其对离体肾间质成 …

目的 研究内皮素１、肿瘤坏死因子在肾这上皮细胞的表达、肾小管的损伤及它们对肾间质成纤维细胞的影响。方法 应用肾小管上皮细胞及肾间质成纤维细胞的体外培养;建立肾小管损伤动物模型;应用逆转录－聚合酶链反应、免疫组化ＳＰ法染色、放射免疫测定及双重免疫组织化学染色技术,并测定＾３Ｈ－ＴＤＲ掺入率。结果 肾小管上皮细胞既有ＥＴ－１ ｍＲＮＡ和ＴＮＦα ｍＲＮＡ的表达,还有ＥＴ－１及ＴＮＦ－α的蛋白合成及分泌     

急性出血坏死性胰腺炎术后并发症14例原因分析

我院自1987～1992年共收治出血坏死性胰腺炎29例。发生严重并发症14例,在发病72小时以内手术者10例,72小时以后手术者4例。均行胰腺被膜多口切开减张,松动胰床,腹腔灌洗。本文对急性出血坏死性胰腺炎的特点,手术时机、术式选择、手术适应症等,进行了详细地讨论。     

轮状病毒肠炎患儿血清肿瘤坏死因子-α的表达水平及意义

目的探讨轮状病毒肠炎患儿血清肿瘤坏死因子-α（TNF—α）含量的表达水平及其意义。方法采用酶联免疫吸附试验ELISA法检测98例消化内科住院腹泻患儿（其中轮状病毒肠炎患儿59例）及35例正常对照儿童血清中TNF—α的表达水平。结果轮状病毒肠炎患儿血清中TNF—α含量较明显高于正常患儿及实验组其它患儿，均有显著性差异（P〈0．001，P〈0．05=。结论轮状病毒肠炎患儿血清中TNF—α表达水平增高。细胞因子TNF—α在轮状病毒肠炎的诊断和治疗中具有重要意义。     

重组人表皮生长因子对中毒性急性肾小管坏死恢复的促进作用

目的：探讨国产重组人表皮生长因子(recombinant human epidermal growth factor, rhEGF)对庆大霉素（gentamicin, GM）中毒性急性肾小管坏死的恢复是否具有促进作用并探讨其机制。方法：将成年Wistar大鼠随机分成3组。GM组,GM皮下注射2 d,400 mg/（kg·d）;EGF组,按上法注射GM,于最后1次注射GM后2 h开始rhEGF皮下注射3 d,90 μg/d;对照组,注射等量生理盐水代替GM。分别于首次注射GM后第2,5,8,11,15,22和29天处死各组大鼠并观察肾功能指标及肾脏组织形态学的改变,包括HE,PAS染色分级,并用免疫组织化学的方法检测肾脏组织中热休克蛋白27（heat shock protein 27,HSP27）的表达。结果：GM注射大鼠肾功能明显受损,但EGF组肾功能损伤程度较GM组轻,并提前恢复正常。组织学分级比较显示,第11和15天EGF组明显好于GM组。免疫组织化学结果显示,EGF组HSP27的表达强于GM组。结论：国产rhEGF具有促进GM中毒性急性肾小管坏死形态和功能恢复的作用,这可能与其促进小分子量热休克蛋白的表达有关。     

经肾动脉自体骨髓干细胞移植治疗急性肾小管坏死的实验研究

目的：采用经肾动脉灌注移植兔自体骨髓干细胞，观察自体骨髓干细胞移植对缺血再灌注（I/R）后急性肾小管坏死肾功能的作用及其机制。方法:28只日本大耳白兔采集骨髓，分离自体骨髓干细胞，5-溴-2-脱氧尿嘧啶核苷(5-bromo-2-deoxyuridine, BrdU)标记。全部实验兔建立肾脏I/R后随机分为移植组和对照组。移植组于肾血流恢复后经肾动脉灌注自体骨髓干细胞悬液，对照组同样方法注射等体积生理盐水。分别于I/R前和I/R后第1、3、5、7、14、21、28 d静脉采血，检测血清肌酐（SCr）和尿素氮（BUN），相同时点取肾组织行普通病理及BrdU免疫组化观察。结果:I/R后第1 d和第3 d 2组动物SCr、BUN均达到最高水平，以后逐渐下降；第7 d后移植组SCr及BUN水平逐渐低于对照组，到实验观察结束时的第28 d，对照组SCr和BUN分别为（135.6±32.5）μmol/L和（10.9±2.5）mmol/L，移植组SCr和BUN分别为（90.1±11.1）μmol/L和（8.0±1.5）mmol/L，2组间有显著差异（P<0.05）。普通病理观察，I/R后肾小管上皮细胞变性、坏死甚至脱落， BrdU免疫组化染色显示移植组于细胞移植后第5、7 d肾小管BrdU阳性染色并持续至实验结束，对照组阴性。结论:骨髓干细胞移植可以在一定程度上加速急性肾小管坏死后肾功能修复，自体骨髓干细胞移植是1种加速急性肾小管坏死后修复的安全而有效的方法。     

血栓性血小板减少性紫癜:一例尸检分析

死者女,48岁.因右下腹疼痛6 d,全身多处淤点、淤斑,多次发生晕厥、全身抽搐,意识不清1 d于2005年1月21日入当地医院,入院后行阑尾切除术.术后1 h出现阴道流血,较平时月经量多1倍以上.     

G-CSF-producing malignant pleural mesothelioma: an autopsy case report with literature review

This study reports a 54-year-old man who was a carpenter by occupation. He suffered from left chest and back pain and left pleural effusion. Peripheral blood showed granulocytosis and high serum titers of granulocyte-colony stimulating factor (G-CSF) and CYFRA. He died 20 months later. At autopsy, a pleural tumor located around the left lung and thickening of the pericardium, diaphragm, and esophagus by tumor infiltration was seen. The tumor proliferated in papillary and solid alveolar patterns by neoplastic cells. They were positive for calretinin, D2-40, CK5/6, HBME-1, G-CSF, CK19, and E-cadherin. He was diagnosed with G-CSF-producing epithelioid malignant pleural mesothelioma.     

多发性大动脉炎主动脉破裂尸检及文献复习

目的探讨多发性大动脉炎的临床、病理学特点及鉴别诊断。方法对1例多发性大动脉炎的尸体解剖病例进行病理学检查并复习文献。结果多发性大动脉炎是主要累及主动脉及其主要分支的全血管性非特异性炎症,以动脉管壁增厚、狭窄为主要特征,急性期无特征性症状,可致节段性内膜剥离,形成致命性夹层动脉瘤。结论多发性大动脉炎急性期无特征性症状,容易误诊,对无明显原因胸痛青年患者应提高警惕。     

Ataxia telangiectasia with vascular abnormalities in the brain parenchyma: report of an autopsy case and literature review

A 25-year-old man was admitted to the Department of Neurology, Gunma University Hospital, in June 1997. He had an intellectual disability and had suffered from repeated infection since childhood. Cerebellar ataxia had developed at 19 years of age and he had been clinically diagnosed with ataxia telangiectasia (AT) comprising cerebellar ataxia and oculocutaneous telangiectasia at 24 years of age. He died from pneumonia and renal failure at 26 years of age. Neuropathological examination revealed Purkinje cell loss and atrophy of the dentate nuclei in the cerebellum, anterior horn-cell atrophy and demyelination of the gracile fasciculi in the spinal cord, and the existence of nucleocytomegalic cells in the anterior pituitary gland. These neuropathological findings correlated with previously reported cases of AT. In addition, spongy degeneration was found, predominantly around the blood vessels in the cerebral cortex. Diffuse spongy degeneration and multiple foci of coagulative necrosis with calcification were noted in the white matter. Abnormal vasculature was noted in both degenerative and necrotic areas in the cerebral cortex and in the white matter. The vessels at the center of the areas of spongy degeneration in the cerebral cortex had irregularly arranged and enlarged smooth-muscle-cell nuclei and a distorted, narrow lumen. The vessels present in the white matter were hyalinized. To our knowledge, these vascular abnormalities in the brain parenchyma have not been reported previously.     

Thymoma with extensive necrosis: a case report and review of literature

Thymoma exhibiting extensive necrosis is extremely rare and remains a diagnostic challenge for both radiologists and pathologists. We describe such a thymoma in an 18-year-old African-American female. Core needle biopsy contained only necrotic tumor tissue. A well-encapsulated 13-cm anterior mediastinal thymoma with extensive necrosis and areas of hemorrhage was resected. Microscopically, the thymus was almost completely replaced by tumor composed of plump epithelial cells with vesicular nuclei and prominent nucleoli in a background of lymphocytes and extensive necrosis. The clinical, immunohistochemical and diagnostic pitfalls of this tumor in core needle biopsies is discussed.     

血管内大B细胞淋巴瘤尸体解剖临床病理分析

目的 探讨血管内大B细胞淋巴瘤(IVLBCL)的临床病理特征及病理诊断.方法 对2例IVLBCL的尸体解剖检查(简称尸检)病例进行了临床病理、免疫表型(SP法染色)及抗原受体基因(TCRγ、IgH)重排检测.结果 (1)一般情况:2例尸检分别于2005年和1979年进行,均为男性患者,年龄为70岁和50岁.2人均以神经系统功能障碍(双下肢麻木或无力)为首发表现,起病急,病程短(分别为30 d和20 d),病情进展迅速,并在短期内出现多器官功能衰竭而死亡,生存期分别为85 d和44 d.(2)尸检主要发现:除例1患者有多发性皮肤和左心外膜下结节(直径0.5～2.5 cm)外,全身均未见明显占位性病变,但双肺、肾脏、脑、脾脏等脏器有不同程度地均匀肿大和重量增加.例1患者还有多浆膜腔积液.组织学观察见多脏器、组织(脑、垂体、脊髓和脊神经根、心、肺、肾、肝、脾、消化管、淋巴结、胰、肾上腺、甲状腺、睾丸等)的小血管内见数量不等的异形淋巴样细胞存在,且各处之肿瘤细胞形态相似.瘤细胞中等偏大,呈圆形或卵圆形,细胞质丰富,核质比高.细胞核为圆形或卵圆形,核膜较厚,核染色质呈斑块状散在分布,可见1～3个嗜碱性的小核仁.(3)免疫表型及抗原受体基因重排检测:肿瘤细胞均表达B淋巴细胞分化抗原CD20和CD79a;部分瘤细胞表达bcl-2蛋白和CD5抗原;2例之肿瘤细胞均不表达T细胞及髓系分化抗原等[CD3、髓过氧化物酶(MPO)、bcl-6、CD30、CD10和PCK等];Ki-67阳性率均为80%.PCR检测均检出免疫球蛋白重链基因(IgH)克隆性重排,而TCRγ基因呈胚系构型.结论 2例IVLBCL均以神经系统功能障碍为首发表现,有相似的病理形态学特征,免疫表型及基因型,预后差.     

Primary renal diffuse large B-cell lymphoma with central nervous system involvement: a rare case report and literature review

Primary renal lymphoma is a rare entity. Of these, diffuse large B-cell lymphoma is the most common pathological type and, R-CHOP regimen was the preferred chemotherapy for it. Here we present an adult case of primary renal diffuse large B-cell lymphoma.