284例朝鲜族儿童肿瘤临床病理特点分析

目的探讨朝鲜族儿童肿瘤的发病特点和规律,为少数民族儿童肿瘤的有效防治提供科学依据。方法对284例朝鲜族儿童肿瘤的病理资料进行统计分析。结果肿瘤的检出率随年龄增长逐渐增加,各年龄段之间差异有统计学意义（P〈0．05）,好发年龄为7～14岁;良恶性之比9．52：1;某些肿瘤存在性别特点;良性肿瘤的分布具有较明显的年龄特点,以脉管性肿瘤（26．85％）、骨软骨肿瘤（23．23％）和表皮囊肿（11．68％）多见;恶性肿瘤以恶性淋巴瘤、软组织肉瘤和神经母细胞瘤（均占14．82％）较多见;在学龄期所占比例最大。结论朝鲜族儿童肿瘤的某些临床病理指标具有较明显的种族和群体特征。应当根据本地区小儿肿瘤的发病规律和特点,制定相应的防治措施。     

原发性小肠肿瘤诊治体会(附52例分析)

原发性小肠肿瘤极为少见，约占消化道肿瘤1～5％[1]，加上临床表现不具有特异性，且缺乏较理想有效的检查方法，常易漏诊误诊。本院自1976年1月至1995年3月共收治52例原发性小肠肿瘤，现将诊治情况报告如下。1．临床资料1．1性别与年龄：男37例，女15例。最小年龄7岁，最大年龄80岁，平均年龄54．5岁，以50岁以上发病较多，共31例（59．6％）。1．2病理类型与发病部位；本组良性肿瘤7例（13．5％），恶性肿瘤45例（86．5％），良恶性之比为1:6.4。恶性肿瘤以腺癌多见。（表1）1．3临床表现：本组病例以腹痛多见，其次为消瘦、纳美、乏力及贫…     

山东地区383例儿童恶性实体肿瘤临床病理学分析

目的：研究探讨山东地区儿童恶性实体肿瘤的分布特点。方法：对10年383例儿童恶性实体肿瘤进行回顾临床病理分析。结果：儿童恶性实体肿瘤多见于中枢神经系统、淋巴系统、肾脏和视网膜；多见于10岁以前；上皮来源的恶性肿瘤较少见；山东地区儿童鼻咽癌相对较多。结论：发病较多的儿童恶性实体肿瘤的排序，国内外报道基本相同，山东地区儿童鼻咽癌多多与山东地区鼻咽癌患者的总数相关。     

儿童恶性实体瘤116例临床病理分析

[目的 ]对比研究延边朝鲜族自治州朝鲜族、汉族两个民族儿童恶性实体瘤的发病特点 .[方法 ]选择 116例儿童恶性实体瘤 ,对比不同病理类型肿瘤在朝鲜族、汉族两个民族的不同年龄、性别中的分布特点 .[结果 ]116例中朝鲜族 5 5例 ,汉族 6 1例 ;男性 5 7例 ,女性 5 9例 ;病理类型中最多的是淋巴肉瘤和肾母细胞瘤 .癌与肉瘤的分类中 ,肉瘤 (78.5 % )明显多于癌 (17.2 % ) .[结论 ]116例中朝鲜族、汉族两个民族之间在发病年龄及性别、病理类型分布等方面未见明显差异 ;116例的肿瘤发病原因与先天性因素相关的肿瘤占多数 (如母细胞瘤、胚胎性肿瘤等 )     

37例黏膜相关淋巴组织型淋巴瘤的病理、临床资料分析

目的：为开展黏膜相关淋巴组织型（MALT）淋巴瘤的标准化诊断和规范化治疗提供病理及临床依据。方法：对我院2000年1月至2002年6月诊断的37例MALT型淋巴瘤的病理、临床分期、恶性程度、预后因素及治疗进行回顾性分析。结果：442例非霍奇金淋巴瘤（NHL）中MALT型39例占8.82%（可追踪病例37例），发病中位年龄52岁，50岁以上患者占63．6％。MALT型NHL的发病部位以胃肠最多见，共28例，占71．8％；其次为甲状腺、腮腺、眼眶、肺。MALT型NHL中低度恶性占70．3％，低度恶性伴转化（中度恶性）占27％。临床分期I期占53．6％，Ⅱ期28.6%,Ⅲ期14．3％，Ⅳ期3．6％。37例可追踪MALT型NHL的病理标本中35例表达CD20抗原，2例不确定，其中4例疑难病例通过PCR检测IgH克隆性重排协助诊断。13例胃MALT型淋巴瘤行幽门螺杆菌（HP）检测，阳性率为46．15％。胃MALT型淋巴瘤患者均接受抗HP三联治疗，仅1例接受单纯抗生素治疗。28例胃肠MALT型淋巴瘤患者除5例外，均曾接受手术治疗；多数患者接受系统化疗，部分加局部放疗，尚无接受单纯胃放射治疗者。结论：MALT型淋巴瘤多发生于老年患者，以低度恶性为主，肿瘤发展进程缓慢；不同的发病部位、分类、分期及分子遗传学改变均为重要的预后风险因素，可用于协助选择合适的治疗方案。     

48例偶发肾癌临床分析

目的：探讨偶发肾癌临床特点．方法：对在我院行肾癌根治术的141例肾癌患者资料进行回顾性分析。结果：偶发肾癌和非偶发肾癌在发病年龄、性别、患侧、细胞类型上差异无显著性．而在肿瘤体积大小、病理分期、术后远期生存率、恶性程度等方面差异有显著性意义。结论：B超和CT是发现偶发肾癌的主要方法。偶发肾癌具有体积小、病理分期低、生长局限，恶性程度低、术后远期生存率高等特点，根治性肾切除术仍是偶发肾癌最佳治疗方法。     

消化道平滑肌肿瘤(附79例报告)

平滑肌肿瘤是消化道中较常见的肿瘤．发病率仅低于癌居第二位。在消化道不同部位其发病率不同，良恶性比率不同，临床诊断亦不同。临床确诊较难，绝大多数为术后病理诊断。现将我院外科1975年至1993年间经术后病理证实的消化道平滑肌肿瘤79例报告如下：临床资料1．性别与年龄本组79例中男48例、女31例。最小年龄22岁．最大年龄73岁．其中30岁以下4例．31－40岁16例．41－50岁21例．51－60岁22例，61岁以上16例。2．发病部位食道12例，占15％；胃22例．占28％；十二指肠8例，占10％；小肠19例．占24％；大肠18例，占23％（升结肠3例，根结肠1…     

椎管内肿瘤的发病情况及临床病理特点

目的：分析椎管内肿瘤的发病情况及临床病理特点。方法：总结327例椎管内肿瘤,就其发病年龄、性别、部位及病理类型进行分析。结果：脊髓肿瘤发病率为脑瘤的1110,胸颈腰段分别为57．5％．20.49％和20.18％。神经鞘瘤,脊膜瘤,胶质瘤和先天性肿瘤分别占29．05％,25．38％,14．69％和18.05％。良性肿瘤占3／4。结论：脊髓肿瘤发病率低,胸腰段多发,多为神经鞘瘤,脊膜瘤,胶质瘤和先天性肿瘤。良性肿瘤多见。     

205例恶性淋巴瘤临床、病理组织分类

目的 探讨恶性淋巴瘤的临床、病理特点。方法 根据WHO(2000)淋巴造血组织肿瘤分类标准，回顾分析205例恶性淋巴瘤的临床特点并进行组织分类。结果 恶性淋巴瘤205例中。霍奇金病(HD)7例，占3．41％．均位于淋巴结内；非霍奇金淋巴瘤(NHL)198例，占96．59％。NHL按细胞起源分类：(1)B细胞淋巴瘤138例。占69．21％。其中以下几种类型多见：弥漫大B细胞淋巴瘤78例，占56．9％；小淋巴细胞性淋巴瘤27例。占19．7％；粘膜相关淋巴组织细胞淋巴瘤12例。占8．9％。(2)T细胞淋巴瘤58例，占29．70％。其中鼻／鼻型．NK／T细胞淋巴瘤23例．占38．9％；周围T细胞淋巴瘤15例，占25．9％；前驱T淋巴母细胞淋巴瘤9例．占15．5％；间变性大细胞淋巴瘤8例，占13．8％。(3)朗格罕斯细胞组织细胞增生症及滤泡树突状细胞肉瘤各1例，占O．99％。NHL发病部位：位于结内73例，占35．9％；结外12S例，占64．1％。结论 应用WHO(2000)淋巴造血组织肿瘤分类标准对恶性淋巴瘤进行分类有重要的临床病理意义。     

卢旺达儿童疟疾406例临床分析

目的：了解中非国家卢旺达儿童疟疾现状，临床特征及治疗方法。方法：对406例确诊为疟疾的患儿流行病学特点和临床特征进行分析，对疗效进行观察。结果：全年住院患儿766例，其中疟疾患儿406例，患病率53．0％，各月疟疾患病人数间无明显差异。406例疟疾患儿学龄前303例，占74．6％；年长儿103例，占25．4％。不规则发热218例，占53．7％；稽留热109例，占26．8％；出现贫血者126例，占31．3％；有吐泻者199例，占49．0％；有呼吸道症状体征者106例，占26．1％；脾大123例，占30．3％；肝大86例，占21．2％；昏迷4例，占1．0％；死亡21例，占5．1％。406例经静脉滴注二盐酸奎宁及对症治疗5～7d，治愈385例，有效率94．8％。结论：卢旺达儿童疟疾患病率高，发病无明显季节性，恶性疟疾呈现高发病率，死亡率高。住院患儿以学龄前儿童居多，临床以不规则发热和稽留热占大多数。胃肠型、贫血和肝脾肿大发生率高，部分患儿有呼吸道症状体征是一特点，静脉用奎宁是抗疟疾治疗的主要方法。     

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.