胰腺实性假乳头状瘤的 CT 表现与病理分析

目的：探讨胰腺实性假乳头状瘤（ SPTP）的CT特征及病理改变。方法：回顾性分析6例SPTP的临床资料,其中男1例、女5例,平均年龄24．5岁。所有患者均进行CT平扫及增强扫描。病灶位于胰头2例,胰体1例,胰尾3例;胰尾3例中,1例发生肝脾多发转移,1例发生肝脏多发转移。总结其CT表现及病理学表现特征。结果：CT平扫病灶大小约3 cm ×5 cm～11 cm ×10 cm,呈圆形、类圆形或分叶状囊实性肿块,均可见包膜;1例病灶周缘可见细条状及斑点状钙化,2例病灶内可见斑片状出血灶。增强扫描病灶实性部分呈渐进性持续强化,可见特征性表现“浮云”征。所有病例均未见胆管或胰管扩张。6例病变病理检查均显示肿瘤有完整或不完整的纤维包膜,瘤组织由实性区、假乳头区混合组成,瘤细胞形态较一致,部分区域有出血、坏死及退行性变。结论：SPTP好发于青年女性,其CT表现有一定特征性,多期增强扫描有助于诊断与鉴别诊断;肿瘤细胞以纤细的纤维血管为轴心形成特征性的分支状假乳头状结构是其组织病理学特征性改变。     

胰腺实性假乳头状瘤的CT表现与病理对照分析

为了分析胰腺实性假乳头状瘤(SPTP)的CT表现,并与病理结果对照,提高对该病的诊断率,回顾性分析23例经手术病理证实的SPTP患者的临床、CT及病理资料。23例患者中,女21例(91.3%),男2例(8.7%)。最常见症状为腹部不适伴钝痛12例(52.2%),其他包括体检发现胰腺包块9例(39.1%),恶心呕吐2例(8.7%)。1例女性患者共有2处病灶,24例肿瘤中,位于胰头6例(25.0%),胰颈3例(12.5%),胰体8例(33.3%),胰尾7例(29.2%);肿瘤最长径2.1~20.1cm,平均6.4cm;9例以实性成分为主(37.5%),10例囊、实性成分比例相仿(41.7%),5例以囊性成分为主(20.8%)。9例患者的病灶伴钙化(39.1%)。2例患者的病灶伴出血(8.7%)。1例患者伴肝内胆管扩张(4.3%)。1例患者出现肝转移(4.3%)。CT增强扫描24例肿瘤实性成分动脉期轻度强化,门脉期持续强化,其强化程度不及正常胰腺组织,囊性成分各期均未见强化。24例镜下见假乳头状结构以及出血、坏死或囊性变。总之,SPTP的CT表现具有一定的特征性,反映其病理特征,结合临床表现有助于做出正确的诊断及鉴别诊断。     

儿童胰腺实性假乳头状瘤多排螺旋CT表现

目的:探讨儿童胰腺实性假乳头状瘤（SPTP）的多排螺旋CT（MDCT）表现。 方法:回顾性分析经手术病理证实为SPTP的10例患儿临床及MDCT资料,分析总结其特征表现。 结果:10例患儿均为女性,SPTP均为单发病灶,位于胰腺头颈部3例,胰腺体尾部7例。肿瘤最大径为2.5~13.8 cm,平均值为5.94 cm。8例呈类圆形,2例呈分叶状。10例均边界清晰,8例有完整包膜。平扫1例肿瘤呈均匀低密度,增强无明显强化;其余9例呈囊实性,8例以实性为主,1例囊实性比例相当,其中1例可见包膜下弧形钙化,实性成分动脉期呈轻度强化,强化程度低于正常胰腺组织,门脉期呈渐进性不均匀强化,囊性成分无强化。1例肿瘤出现肝内胆管和主胰管轻度扩张,1例出现主胰管轻度扩张。所有肿瘤均未见肝脏及淋巴结转移。 结论:儿童SPTP好发于女性,其CT表现具有一定的特征性,对诊断和鉴别诊断具有一定意义。     

≤3cm乳头状肾细胞癌与肾透明细胞癌的CT鉴别诊断

目的分析直径≤3cm的乳头状肾细胞癌(PRCC)与直径≤3cm肾透明细胞癌(CCRCC)的CT表现,旨在提高二者的CT鉴别诊断水平。方法分析经手术病理证实的11例乳头状肾细胞癌(papillary renal cell carcinoma,PRCC)患者(直径≤3cm)及44例CCRCC患者(直径≤3cm)的CT扫描图像,包括CT征象、病灶密度值及增强程度值,对相应资料进行统计学分析。结果PRCC瘤内坏死或囊变少见(0/11),平扫边界清楚多见(11/11),增强后多表现为均匀强化(6/11);CCRCC瘤内坏死或囊变较PRCC多见(17/44),平扫边界不清较PRCC多见(20/44),增强后多表现为明显的不均匀强化(35/44)。PRCC两期增强密度值及病灶增强程度值均低于CCRCC。结论瘤内坏死或囊变、平扫边界、增强均匀性、病灶增强密度值及增强程度值有助于直径≤3cm PRCC与CCRCC的CT鉴别诊断。     

胰腺尾部内副脾1例

患者,男,51岁.体检发现胰尾部肿物5天入院.B超示胰尾部肿物3.7 cm×2.7 cm x2.5 cm,境界清楚,回声与胰腺相似,未见异常血流.CT示胰尾部肿块,增强后肿块周围密度较中央密度略低.临床以"胰尾占位病变性质待查-非功能性胰岛细胞瘤?胰腺实性假乳头状肿瘤?"行剖腹检查,行胰腺体尾部及脾切除术.     

腹膜后成熟性囊性畸胎瘤合并类癌1例

患者女性,57岁,因左上腹部饱胀不适半年入院.20年前曾因胰腺尾部囊肿,行胰尾部假性囊肿空肠内引流术.本次入院腹部MRI示胰腺尾部囊性瘤;腹部增强CT示左侧中上腹腔实性巨大占位性病变.术中见肿块位于腹膜后,胰尾、脾脏、肾脏之间,大小为26 cm×16 cm×8 cm,囊实性,并与空肠吻合.胃肠道、肺及卵巢等器官均未见异常.     

胰腺囊性肿瘤92例临床病理分析

目的探讨胰腺囊性肿瘤的临床病理特征及免疫组织化学特点,以期提高对胰腺囊性肿瘤的认识。方法复习复旦大学附属中山医院1999—2005年间手术切除的92例胰腺囊性肿瘤的临床病理资料和影像资料,根据2002年WHO胰腺肿瘤分类标准将其分类。并采用免疫组织化学EnVision法,借助-组抗体进行鉴别诊断。结果在92例囊性肿瘤中,发病年龄16～80岁,男33例,女59例。其中,浆液性肿瘤18例,黏液性肿瘤14例,导管内乳头状黏液性肿瘤36例,实性假乳头状肿瘤18例,导管腺癌囊性变4例,胰腺内分泌肿瘤囊性变2例。免疫组织化学检测无特异性标记物可以完全区分各类型,常有交叉和重叠。浆液性囊腺瘤表达MUC-1,黏液性囊性肿瘤表达MUC-5AC为主,实性假乳头状肿瘤表达d-抗胰蛋白酶、d-抗胰糜蛋白酶、波形蛋白及孕激素受体,导管内乳头状黏液性腺瘤表达MUC-2,囊性恶性肿瘤主要表达MUC-1。结论胰腺各类囊性肿瘤在临床症状、影像学表现、组织形态及免疫表型上均有一定特征,但均无特异性,需结合起来综合判断,才能做出正确诊断,以指导临床治疗和预后判断。     

肾上腺转移瘤的CT诊断

通过回顾性分析32例肾上腺转移瘤的CT检查资料,结合文献进行讨论,来探讨肾上腺转移瘤的CT表现特征.研究结果表明:肾上腺转移瘤多见于单侧,肿块直径变化范围大,形态可呈类圆形、椭圆形和不规则形.平扫呈实性、囊性或囊实性密度,增强后实性肿块与囊壁强化.瘤侧肾上腺正常结构消失或肢体可见粗大.最终得出结论:CT对绝大多数肾上腺转移瘤均可做出正确诊断,主要需与无功能性肾上腺肿瘤鉴别.     

肾上腺神经节瘤的CT表现

目的探讨肾上腺神经节瘤的CT表现特点及其诊断价值。方法回顾性分析16例患者的临床病理及影像学资料。7例患者行CT平扫,9例行CT平扫加增强;15例经手术病理证实,1例经穿刺活检证实为肾上腺神经节瘤。结果16例患者CT扫描可见2例肿物为囊实性,14例为实性;5例肿物内伴有钙化;平扫CT值介于20～40 HU左右;9例增强扫描后,5例轻度延迟强化,4例强化不明显。结论肾上腺节细胞神经瘤CT扫描具有特征性,CT扫描对正确诊断肾上腺神经节瘤具有重要价值。     

卵巢纤维瘤和纤维卵泡膜细胞瘤的CT扫描分析

目的：探讨CT扫描技术在卵巢纤维瘤和纤维卵泡膜细胞瘤临床诊断中的应用价值。方法观察卵巢纤维瘤和纤维卵泡膜细胞瘤患者的CT平扫影像学特征,并与CT扫描强化征象特征进行对比分析,通过分析卵巢纤维瘤和纤维卵泡膜细胞瘤患者的CT影像学特点,探讨CT扫描技术在上述两种肿瘤临床诊疗中的价值。结果我院收治的27例患者中卵巢纤维瘤21例,纤维卵泡膜细胞瘤6例,18例患者病灶位于左侧,9例患者病灶位于右侧;卵巢纤维瘤CT影像学图像显示为实性,浅分《可见于瘤体较大者,而纤维卵泡膜细胞瘤CT影像学图像表现为囊实性,实性与囊性之间分界明显,囊壁延续于实性区,肿瘤整体上边缘清晰;CT平扫影像图显示肿瘤密度无变化,相比正常子宫肌未见明显降低,27例患者增强后23例影像学图像无强化,仅4例轻度强化,低于正常子宫肌密度。结论卵巢纤维瘤和纤维卵泡膜细胞瘤的CT影像图具有一定特征性,尤其是强化征象显示肿瘤密度低于正常子宫肌,对提高诊断准确率有一定临床价值。     

Level of functioning of siblings and parents of probands of varying degrees of retardation

A further analysis of already published data supports the position that retardates of low ability level less frequently have retarded siblings, retarded parents, and parents low in occupational level than do retardates higher in ability level. The analysis supports the position that there are two types of retarded individuals, persons retarded as a result of gene or chromosomal anomalies, brain injury, etc., who more frequently occur in the lower-level retardate group, and persons whose retardation represents polygenic segregation, who more frequently occur in the higher-level group.     

局部注射辛伐他汀对骨质疏松大鼠股骨髁骨小梁的改建效应

背景：局部注射具有成骨作用的辛伐他汀,可显著增加骨质疏松大鼠股骨颈及股骨髁部的骨密度及力学强度,分析局部注射辛伐他汀对股骨髁骨小梁的影响。 目的：进一步研究骨质疏松大鼠股骨内局部注射辛伐他汀对股骨髁骨小梁的影响。为将辛伐他汀应用于临床骨质疏松局部治疗提供实验基础。 方法：18只雌性SD大鼠双侧卵巢切除后3个月,制备大鼠骨质疏松模型。实验大鼠随机数字表法均分为3组,分别在实验大鼠的右侧股骨髓腔内单次注射辛伐他汀溶液5 mg、10 mg,对照组单纯注射空白载体。分别在注射后1个月处死大鼠并取材。Micro-CT扫描并定量分析骨组织形态变化。 结果与结论：给药后1个月,Micro-CT扫描结果显示,辛伐他汀治疗组的骨微结构参数如骨皮质厚度、骨小梁密度及连接率明显优于对照组。说明疏松骨骼单次注射小剂量辛伐他汀可显著促进股骨髁部骨小梁改建,改善骨骼微结构,可为强化局部、防治骨质疏松骨折的新选择进一步提供实验基础。     

石斛属民族药用植物的分类及生药学研究

中药石斛早在《神农本草经》中就被列为上品,其应用历史悠久,具有养阴生津、补肾益气、润喉护嗓、活血明目、抗癌防老等功效。本文对国内外石斛属民族药用植物的分类及生药学研究进行了综述。     

膝关节骨性关节炎的关节镜治疗体会

目的我科自2001～2005年4月对59例67膝的骨性关节炎（0A），进行关节镜检查及镜下清理术。方法镜检：膝关节骨性关节炎伴不同程度滑膜炎，滑膜皱壁粘连纤维片，关节软骨不同程度破坏。镜下清除增生滑膜，松解粘连，去除剥脱软骨、修复关节面。结果随访2月～4年，平均1.5年，术后综合评估2月～1年，优良率94％；1～2年，优良率79.2％；2年以上优良率54.8％。结论关节镜对膝关节骨性关节炎诊断能提供了比较全面的资料，并对骨性关节炎早期有良好疗效，具有创伤小、恢复快、并发症少和重复治疗等优点。     

Anatomical study of distribution of valves of the cutaneous veins of adult''s limbs

Since the cutaneous veins of the four limbs have been used as autogenous grafts in the treatment of cardiovascular disorders, knowledge of distribution of the valves is increasingly required depending upon the use. In the gross anatomical study of distribution of valves of the trunci venae, there has been argument about locational relationships between the venous roots and the valves in the vicinity of the roots and the inter-valvular distance. However, there have been only few reports discussing detailed information about valves of the cutaneous veins of the four limbs. The authors observed patterns of distribution of the cutaneous venous valves of the four limbs of cadavers prepared for practice in anatomy. The following parts were excised from each cadaver: the cephalic, basilic, and the great saphenous veins, which originate from the acral venous network and flow into the proximal deep veins, and the venous roots communicating with these veins. An incision was made on each excised vein in the direction of the long axis under observation with a stereoscopic microscope, and the inter-valvular distance and the distance between the valve and the orifice of venous root in the vicinity of the valve were measured. The inter-valvular distance varied with type of the truncus venae, and it varied according to area even in the same truncus venae.     

Pathways of the realization of immunomodulating effects of neurotransmitters

Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 115, N ^o 4, pp. 401–404, April, 1993     

Characterization of sterols of three digenetic trematodes of buffalo

Sterols of three digenetic trematodes were isolated and characterized by infrared and 1H nuclear magnetic resonance spectroscopies, and gas-liquid chromatography and gas chromatography-mass spectrometry. Sterols identified were cholesterol, cholestanol, 24-methylcholesterol, 24-methylcholestanol, 24-ethyl-22-dehydrocholesterol, 24-ethyl-22-dehydrocholestanol, 24-ethylcholesterol and 24-ethylcholestanol.     

Mechanisms of generation of slow components of bioelectric activity in diagnostics of functional state of the gastrointestinal tract

New electrophysiologic devices were used for the diagnostics of the state of excitable structures in the gastrointestinal tract and correction of their motor functions. Bioelectrical and biomechanical activities form the basis of functioning of internal organs. The mechanisms of generation of slow bioelectrical activity that are important for clinical and physiological studies are described. One of these mechanisms is a capacitance parametric transducer converting the energy of contractions into specific electric signals reflecting muscle functions. Another mechanism results from slow oscillations of resting potentials of interrelated excitable cells in large neuromuscular structures of internal organs. The elaborated procedure is efficient for preventing early postoperative paresis of the gastrointestinal tract. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 10, pp. 448–452, October, 1999     

胃小弯侧血管弓的MDCT解剖

目的：研究正常胃小弯侧血管弓及其属支血管的多排螺旋CT表现。方法：回顾性分析51例正常成人的上腹部CT资料,观察胃小弯侧血管弓及其属支血管的显示情况、血管弓形态及其与胃壁的关系。结果：51例均显示胃小弯侧血管弓,血管弓贲门部属支、胃体部属支和幽门部属支分别显示46例、15例和10例;血管弓与胃壁紧邻41例。结论：MDCT检查可良好显示正常胃小弯侧血管弓及其属支血管。     

Assessment of the efficacy of treatment of hemangiomas

Assessment of the aftereffects of cryoexposure and ultrahigh-frequency cryoexposure on hemangioma tissue of various types, cavernous and squamous, showed a higher cryogenic effect in hemangiomatous tissue preexposed to ultrahigh-frequency waves. A quantitative criterion is proposed for assessing the efficacy of the studied methods of exposure. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 119, N ^o 6, pp. 669–672, June, 1995