261例外科治疗的癫痫患者的脑电图分析

１一般资料研究对象：２６１例癫痫患者，男性１６２例，女性９９例，年龄１５～４９岁，平均２５岁。病因：脑外伤性癫痫３７例，脑肿瘤４０例，脑炎后遗症２７例，先天畸形２０例，结节性硬化１例，原因不明１３６例。病程：１年半～３８年。首发时间：生后数日～４０...     

新疆喀什地区维吾尔族子宫颈癌的临床病理学观察

一、材料与方法自1980年至1993年，我科共收检宫颈癌标本485例，其中维族宫颈癌患者442例，早期35例，Ⅱa期87例，Ⅱb期134例，Ⅲa期117例，Ⅲb期44例，Ⅳ期25例，伴有胃转移1例，产后4个月以内16例，中期妊娠16例。汉族宫颈癌患者43例，早期6例，Ⅱa期8例，Ⅱb期13例，Ⅲa期9例，Ⅲb期5例，Ⅳ期2例。送检标本均经10％福马林液固定，常规石蜡切片，HE染色，少数病例经网织纤维、VG及免疫组化染色确诊。所有病例分维、汉两组并按年龄分组统计，行X2检验。二、结果1．维、汉两族宫颈癌患者检出率比较：维族病理检验标本8682例，诊断为恶性肿…     

流行性腮腺炎并发脑炎的脑电图分析

l病例资料一般资料：本文34例系lop年4月至lop年3月住院确诊为流行性腮腺炎并发脑炎患者，男26例，女百例；年龄4－9岁26例，10－14岁6例，28岁2例。临床表现：34例均有腮腺肿大，头痛、恶心、呕吐，呕吐为非喷射状，33例有发热，体温38－40℃，腮腺肿大单侧吕例，双侧26例，另有10例同时伴有颌下腺肿大。发病2－6天出现脑炎并发症。12例引出病理反射征，23例有颈抗，3例有昏迷抽搐及精神障碍，31例神志清楚，但精神萎靡不振。脑脊液检查：13例患儿在人院当天进行腰穿脑脊液常规检查，结果：白细胞（300－336）XI矿／L4例，（op－450）XId…     

氨茶碱负荷量治疗儿童哮喘的临床观察

我们于1996年8月至1997年4月用氨茶碱负荷量[1]治疗小儿哮喘50例，收到了明显疗效，现报道如下．1对象与方法1．1对象按照文献[2]儿童哮喘诊断标准，选择住院患儿共98例，其中病例组50例，男28例、女22例，年龄：6月至1岁14例，1岁至3岁1例，3岁至7岁21例．中度发作37例，重度发作13例，并发心衰4例，呼衰1例．对照组48例，男25例，女23例．年龄：6月至1岁10例，1岁至3岁14例3岁至7岁24例，中度发作37例，重度发作11例．l三方法防机分为两组，在综合治疗的基础上，治疗组用纪条红负荷量法：好扶幼负荷量一所需血药浓度又该药分布容积，若以…     

永久起搏器常见并发症的临床分析

目的探讨永久起搏器常见并发症发生原因、处理方法及预防措施。方法回顾分析新疆医科大学第一附属医院2005年1月～2008年4月安装永久起搏器患者456例临J末资料的并发症。其中男性275例，女性181例；年龄28～91岁．平均年龄60．23岁；病态窦房结综合征287例，Ⅲ°房室传导阻滞97例，高度房室传导阻滞28例，Ⅱ°房室传导阻滞19例．扩张型心肌病12例，其他疾病13例。起搏器类型：单腔起搏器，双腔起搏器，三腔起搏器，埋藏式自动复律除颤器（ICD）。结果并发症共27例，其中误穿刺入锁骨下动脉4例，气胸1例，冠状静脉窦口夹层1例，冠状静脉注入气泡1例，引流条断裂1例．电极接反2例，感知障碍2例，电池提前耗竭1例，起搏器综合征2例，起搏器介入的心动过速1例．电极脱位4例．囊袋血肿6例，囊袋感染1例。结论加深对起搏器常见并发症的了解，提高鉴别能力，重视术前预防，术中规范操作，加强术后随访及起搏器知识教育，早期发现积极处理各种并发症，可将并发症减少到最低限。     

益气活血法治疗缺血性脑卒中的临床研究

目的：观察益气活血法在治疗缺血性脑卒中的疗效，探讨益气活血法在对治疗缺血性脑卒中的意义。方法资料来自我院2013年4月~2014年4月治疗的缺血性脑卒中患者60例，随机分为对照组30例，治疗组30例，治疗组采用常规治疗和自拟益气活血方药治疗，对照组单纯常规治疗。结果治疗组30例，基本治愈6例，显著进步11例，进步12例，无变化1例，恶化0例，总有效率为95.3%；对照组30例，基本治愈3例，显著进步12例，进步11例，无变化3例，恶化1例总有效率81.2%。结论益气活血法在治疗缺血性脑卒中方面具有确切的疗效，可较好的应用于临床，值得推广。     

肾损伤处理的临床思维

目的：探讨肾损伤的诊断与治疗，以提高临床处理思维。方法：62例肾损伤患者行保守治疗10例，行手术治疗52例，其中肾切除7例，肾部分切除3例，肾修补术42例。结果：死亡1例（1．6％），为多处合并伤，出现顽固性休克。早期并发症6例，其中出现继发性出血4例，感染2例，其余55例均痊愈出院。结论：对肾损伤的程度、分类及有否合并伤的及早诊断，在治疗上有着重要意义。     

亚低温治疗心肺复苏病人的护理

1临床资料 23例患者中男15例，女8例，年龄17-78岁。入院时体温36℃-40℃；深昏迷16例，中昏迷5例，浅昏迷2例；双侧瞳孔散大12例，双侧瞳孔缩小6例，一侧瞳孔散大5例。GCS评分3～5分15例，6～8分8例。     

23例新生儿肾上腺出血的尸检分析

我院自1981年元月至1990年12月住院新生儿死亡336例，尸检204例，其中肾上腺出血23例。在死亡病例中发生率为6.8％，占尸检新生儿11．3％，现报告如下。临床资料一、一般情况男17例，女6例，男女之比为2．8：1。早产儿9例，足月儿12例，过期产儿2例。出生体重＜2500g9例，≥2500g14例。入院日龄≤24小时18例，－7天3例，-21天2例。有产时窒息史11例，宫内窘迫9例，脐带脱垂3例，脐绕颈4例，妊高征2例。二、临床特点生前均未作出诊断，尸检后结合临床资料和母亲围产期病史进行分析。本组资料原发病窒息合并MAS5例，其中4例有宫内窘迫史，3…     

对分离性癔症心理治疗的忽视

心理治疗是治疗津症的主要而有效的方法，但在临床实践中，对分高性疲症治疗的主要方法则是药物治疗，对分离性疲症的心理治疗有所忽视。现将我院93例分离性疲症的治疗情况分析如下。1资料与方法76年以来收住院的93例最症均符合分离住遗症的疹断。其中男46例，女47例，平均年龄34．75士966岁（Z士SD）；已婚79例，未婚8例，离丧再婚6例；文盲15例，小学41例，初中30例，高中5例，中专2例；健康者76例，心身疾病史者6例，其他病史者11例；精神疾病家族史阳性25例，阴性68例。平均病程：41．0士6．58（x士SD）。内向性格者59例，外向性格者3…     

Paraffin section immunohistochemistry. II. Hodgkin''s disease and large cell anaplastic (Ki1) lymphoma

A panel of antibodies that recognize antigens that survive fixation and conventional processing have been applied to 43 cases of Hodgkin's disease and five cases of large cell anaplastic lymphoma. Reed-Sternberg cells in all five cases of nodular lymphocyte predominance Hodgkin's disease were positive with leucocyte common (CD45) and B-cell antibodies, and negative with LeuM1 (CD15) and BerH2 (CD30) antibodies. In other types of Hodgkin's disease, Reed-Sternberg cells were positive with BerH2 in all cases, positive with LeuM1 in 63% of cases (with enzymic predigestion), positive with at least one B-cell antibody in 29% of cases and positive for CD45 in 8% of cases. In 19% of all cases, Reed-Sternberg cells were positive for epithelial membrane antigen and in 93% they were positive with TAL1B5 (anti-class II MHC). No case showed immunoreactivity with anti-T-cell antibodies. The patterns of immunoreactivity of large cell anaplastic lymphoma were similar, except that none was positive with B-cell antibodies and three were positive with T-cell antibodies. All five were positive with BerH2 (CD30) and TAL1B5. Comparison of the results with those seen in other cases of non-Hodgkin's lymphoma indicates that, with the currently available reagents, this immunohistological profile cannot be used as the sole diagnostic discriminant of these conditions; this must still be based upon careful morphological assessment.     

In-situ hybridization using biotinylated DNA probes to human papillomavirus in adenocarcinoma-in-situ and endocervical glandular dysplasia of the uterine cervix.

In-situ hybridization using biotinylated probes to human papillomavirus (HPV) DNA was performed on formalin fixed paraffin embedded tissue in 30 patients with histologically confirmed adenocarcinoma-in-situ (AIS). Thirteen of the 30 cases contained areas of endocervical glandular dysplasia (EGD) admixed with AIS. Twenty one patients showed positive staining of the AIS nuclei for HPV DNA. Ten cases (33%) were positive for HPV 16 DNA and 11 cases (37%) were positive for HPV 18 DNA. No case showed synchronous expression of HPV 16 and 18 DNA. All cases of AIS were negative for HPV 6b and 11 DNA. Four cases of EGD were positive for HPV 18 DNA and 2 cases were positive for HPV 16 DNA. Four of 6 cases of intestinal dysplasia/AIS were positive for HPV 18 DNA. Associated squamous abnormalities (HPV +/- CIN +/- SCC) were noted in 15 cases. Of these, 7 showed positive staining for HPV DNA in the squamous lesion. Moreover, 5 of these were positive in both the AIS and squamous lesion. In-situ hybridization using biotinylated DNA probes is a sensitive and safe technique readily adaptable to routine histopathology.     

Loss of E-cadherin and cytoplasmic-nuclear expression of beta-catenin are the most useful immunoprofiles in the diagnosis of solid-pseudopapillary neoplasm of the pancreas

Solid-pseudopapillary neoplasm of the pancreas occurs preferentially in young women and has a favorable prognosis. Differentiation of solid-pseudopapillary neoplasm from pancreatic endocrine neoplasm or adenocarcinoma can be difficult in the small biopsy specimen because they share common morphological features and immunoprofiles. Alterations of adenomatous polyposis coli (APC)/beta-catenin pathway have been identified as a genetic event contributing to the development of solid-pseudopapillary neoplasm. In the present study, to establish the diagnostic utility of beta-catenin and E-cadherin as markers for solid-pseudopapillary neoplasm, we performed immunohistochemical staining in 4 core biopsy specimens diagnosed as solid-pseudopapillary neoplasm and in tissue microarray blocks that contained histologically confirmed samples of 302 cases of adenocarcinoma, 56 cases of pancreatic endocrine neoplasm, and 50 cases of solid-pseudopapillary neoplasm. We compared the immunohistochemical results for beta-catenin and E-cadherin with those for known markers. Of the solid-pseudopapillary neoplasm cases, 51 (94.4%) were positive for nuclear beta-catenin, 45 (83.3%) were positive for CD10, 30 (55.5%) were positive for CD56, 15 (27.8%) were positive for synaptophysin, 3 (5.6%) were positive for cytokeratin (CK), and none was positive for E-cadherin and chromogranin. Of the adenocarcinoma cases, all were positive for CK, 300 (99.3%) were positive for E-cadherin, 30 (9.9%) were positive for CD10, 2 (0.7%) were positive for synaptophysin, 1 (0.3%) was positive for CD56, and none was positive for chromogranin and nuclear expression of beta-catenin. Of the pancreatic endocrine neoplasm cases, 54 (96.4%) were positive for synaptophysin and E-cadherin, 50 (89.3%) were positive for chromogranin, 26 (46.4%) were positive for CK, 15 (26.8%) were positive for CD56, 6 (10.7%) were positive for CD10, and none was positive for nuclear expression of beta-catenin. In conclusion, nuclear expression of beta-catenin and loss of E-cadherin can be used in the definite diagnosis of solid-pseudopapillary neoplasm on small biopsy specimens. CD10 immunopositivity should be carefully interpreted in the diagnosis of solid-pseudopapillary neoplasm because pancreatic adenocarcinoma or pancreatic endocrine neoplasm can also stain for CD10.     

Unique expression of MUC3, MUC5AC and cytokeratins in salivary gland carcinomas

The differential diagnosis of salivary gland carcinoma is often difficult because of the confusing histopathological features of the different types of salivary gland carcinomas. The expression of MUC3, MUC5AC, MUC6, cytokeratin (CK)7 and CK20 was studied in 20 mucoepidermoid carcinomas (MEC), 20 adenoid cystic carcinomas (AdCC), and 11 acinic cell carcinomas (ACC). All the cases (51/51, 100%) were positive for CK7, but they were not positive for CK20. All the cases (100%) of the MEC were positive for MUC5AC, while all MEC (100%) were negative for MUC3. Only two cases (10%) were positive for MUC6. All cases (100%) of AdCC were negative for MUC3, MUC5AC and MUC6. Eight cases (73%) of ACC were positive for MUC3, but all the cases (100%) were negative for MUC5AC and MUC6. It is concluded that the positive expression of MUC5AC is very unique to MEC, and that the positive expression of MUC3 is very unique to ACC. These findings will be very useful for the differential diagnosis of the salivary gland carcinomas.     

Immunohistological and molecular genetic findings in GIST of the stomach

The authors described immunohistological and molecular genetic findings in series of 21 tumours with spindle and epithelioid cells histology of the stomach. In 18 cases the tumours were KIT (CD117) positive and the diagnosis of gastrointestinal stromal tumour (GIST) was confirmed. Three cases were KIT (CD117) negative. According to additional immunohistological markers (desmin and smooth muscle actin positivity) two of them were categorized as leiomyomas. The immunohistological profile of the third case showed that the tumour could be classified as a transitional form between leiomyoma and GIST. All but one KIT (CD117) positive tumours were also CD34 positive. In other three KIT (CD117) positive cases up to 10% of CD34 positive cells were found. Desmin was negative in KIT (CD117) positive cases. S100 protein was positive in three KIT (CD117) positive cases ranging from single cells to 10% of cells. Nine tumours were NSE positive. In our study the connection between proliferation factors (Ki67 and PCNA) and the mitotic index was not established. Risk factors were identified based on the size of the tumours and the mitotic index. Very low and low risk of aggressive behaviour included 12 cases, intermediate risk category 5 cases, high risk category 4 cases. For molecular genetic examination, DNA was extracted from formalin-fixed, paraffin-embedded tissues. Exon 11 was analyzed by SSCP (single-strand conformational polymorphism analysis) with following sequencing. Deletion was found in 7 cases, point mutation in one case, silent point mutation in one case and in two cases the examination could not be detected. In 10 cases (47%) a "wild type" was found. We suggest that other exons, e.g. 9, 13, 17, (which were not examined) and genes than KIT gene could also trigger tyrosine-kinase activity.     

血液病患儿血小板抗体筛查及交叉配型输注效果分析

目的:分析血液病患儿血小板抗体筛查及交叉配型输注效果。方法:回顾性分析2016-01—2018-05在我院接受多次血小板输注治疗的血液病患儿78例,依据血小板抗体检测结果分为阳性组(n=28)和阴性组(n=50),阴性组直接输注ABO同型血小板,阳性组进行交叉配型,根据配型结果分为未配型组(n=13)和配型组(n=15),未配型组输注ABO同型血小板,配型组输注相同的血小板。所有患儿于输注血小板1h、24h后检测血小板计数,计算血小板增值指数(CCI),分析患者血小板抗体筛查结果、交叉配型及其血小板输注无效(PTR)和非溶血性输血反应(NHTR)情况。结果:阳性组患儿中HLA-I抗体阳性23例(82.14%),HLA-I+HPA抗体阳性4例(14.29%),HPA抗体阳性1例(3.57%)。其中配型组中有HLA-I抗体阳性者12例(80.00%),HLA-I+HPA抗体阳性2例(13.33%),HPA抗体阳性1例(6.67%);而未配型组中有HLA-I抗体阳性者11例(84.61%),HLA-I+HPA抗体阳性2例(15.39%)。阳性组患儿血小板输注后1h、24h的CCI值均低于阴性组(P<0.05),且阳性组PTR、NHTR发生率均明显高于阴性组患儿(P<0.05)。配型组血小板输注后1h、24h的CCI均高于同时点的未配型组,PTR和NHTR发生率均低于未配型组(P<0.05)。配型组血小板输注有效率也明显高于未配型组(P<0.01)。结论:多次血小板输注的血液病患儿,依据血小板交叉配型试验结果选择交叉配型相合的血小板进行输注,可提高血小板的输注效果。     

用PCR技术产前诊断人巨细胞病毒感染

用ＥＬＩＳＡ法筛选早孕妇女血人巨细胞病毒ＩｇＭ（ＨＣＭＶ－ＩｇＭ），在孕１２￣２０周用聚合酶链式反应（ＰＣＲ）技术检测其羊水中ＨＣＭＶ－ＤＮＡ，对胎儿巨细胞病毒感染作出产前诊断。在３８４例孕妇中，筛选出血ＨＣＭＶ－ＩｇＭ阳性２６例为实验组，其羊水ＨＣＭＶ－ＤＮＡ检出率为３４．６２％；从２５８例ＨＣＭＶ－ＩｇＭ阴性中选出２０例为对照组，其羊水ＨＣＭＶ－ＤＮＡ检出率为１０．０％，两组比较有显著性差异（     

何杰金病的免疫组织化学研究

收集有完整临床和病理资料的何杰金病３０例，用ＬＣＡＬ，Ｌ２６，ＵＣＨＬ１，Ｍａｃ３８７，ＥＭＡ，ＢｅｒＨ２和Ｖｉｍｅｎｔｉｎ作免疫组化染色，结果显示何杰金细胞，Ｒｅｅｄ－Ｓｔｅｒｎｂｅｒｇｃｅｌｌ（Ｒ－ＳＣ）的表达如下：６例ＵＣＨＬ１，染色阳性，１７例ＢｅｒＨ２染色阳性，其阳性率与组织学分型我相关性，同时显示ＢｅｒＨ２对ＨＣ和Ｒ－ＳＣ的检出是很价值的；淋巴细胞主型中２例ＬＣＡ阳性，５例Ｌ２６阳性；     

The utility of CD20 and CD43 in subclassification of low-grade B-cell lymphoma on paraffin sections.

To identify phenotypic differences among the low-grade lympho-proliferative disorders in paraffin-embedded tissue, we studied 49 cases. All 22 follicular small cleaved cell lymphomas (FSC) were CD43 negative and CD20 positive. In contrast, of 20 small lymphocytic lymphomas (SL), 90% were CD20 positive, 85% were CD43 positive, and 75% were positive for both. Of three lymphomas of intermediate differentiation (IDL), two were CD20 positive and two were CD43 positive. All four monocytoid B-cell lymphomas were positive for CD20 and 50% (two cases) were positive for CD43. Some 86% of 14 chronic lymphocytic leukemias (CLL) (on cytospins) were positive for CD43; all nine of the CLL studied for CD20 were positive and 89% (8/9) expressed both antibodies CD5 expression (on frozen sections or cytospin preparations) was compared to CD43 in 21 cases of SL and CLL. Some 77% were positive for both CD5 and CD20. All seven of the CD5-positive SL also expressed CD43. The antibody MT2 was also examined with the following results: FSC, 16/20 (80%) positive; SL, 18/19 (94%) positive; MBC, 3/3 positive; and ILL, 2/3 positive. All 56 cases tested were CD45RO (UCHL1) negative. We conclude that CD43 is expressed on most cases of low-grade lymphoproliferative disorders with the exception of FSC. Its pattern of expression seems similar to CD5; however, unlike CD5, CD43 can be studied in formalin-fixed tissue. MT2 is not helpful in distinguishing among these lesions.     

No direct role for Epstein-Barr virus in American hepatocellular carcinoma

Epstein-Barr virus (EBV) was recently linked to hepatocellular carcinogenesis in Japanese patients. It is not clear whether EBV infection is also associated with hepatocellular carcinoma (HCC) occurring in American patients. We studied 41 cases of HCC from the Los Angeles area for evidence of EBV infection by in situ hybridization, immunohistochemistry, and polymerase chain reaction methods. Of 41 cases, 16 were seropositive for hepatitis B virus surface antigen (39%), 9 of 29 tested were seropositive for hepatitis C virus antibody (31%); in total, 22 cases were seropositive for hepatitis B virus and/or hepatitis C virus (53%). Of 41 cases, 1 was positive for EBV-encoded small nonpolyadenylated RNA (EBER)-1 (2%) by in situ hybridization. By immunohistochemistry, two cases were positive for EBV nuclear antigen (EBNA)-1 (5%), one was positive for the transactivating immediate early BZLF1 (ZEBRA) (2%), and none was positive for latent membrane protein-1. None of the 41 cases was positive for latent membrane protein-1 and EBV nuclear antigen (EBNA)-4 DNAs by polymerase chain reaction assay. All four positive cases showed rare EBER-1-, ZEBRA-, or EBNA-1- positive cells (<0.1%); in none of these cases was there expression of any other EBV viral genes. In the one case each that was positive for EBER-1 and ZEBRA, both of which occurred in patients of non-Asian ethnicity, the staining was limited to infiltrating small lymphocytes, and tumor cells were negative. In the two cases that were positive for EBNA-1, both of which occurred in patients of Asian ethnicity, the staining was limited to tumor cells, and infiltrating small lymphocytes were negative. Our study indicates that rare cases of American HCC may contain EBV-infected cells, but it is unlikely that EBV plays a major role in the carcinogenesis of HCC.