An autopsy case of acute interstitial pneumonia

An autopsy case of a 77-year-old male with acute interstitial pneumonia (AIP) is reported. The patient died of respiratory failure in the extremely rapid course of 8 days. The histogenesis of the thickening of the alveolar wall and the intraluminal lesions were noticed. Incorporation of the hyaline membrane as well as the intraseptal edema and septal cell proliferation played an important role in the fibrous thickening of the alveolar wall. The intraluminal granulation tissue was observed in the alveolar space and the alveolar duct, often extending into the respiratory bronchioles. Intraluminal granulation tissues in the alveoli frequently had the appearance of intraluminal buds of mesenchymal cells, so-called Masson's bodies, and there was little remodeling of pulmonary structures in this case. These findings suggest an acute, diffuse and severe damage of the peripheral respiratory tract and are consistent with bronchiolitis obliterans with classical interstitial pneumonia (BIP) by Liebow and AIP by Katzenstein. This patient had suffered from suspected "Bronchiolitis obliterans organizing pneumonia" (BOOP) one and half years ago. The relationship between AIP, BIP and BOOP is discussed.     

急性乙醇中毒合并吸入性肺炎1例报告

目的　评估HBV相关慢加急性肝衰竭（acute-on-chronic liver failure, ACLF）和失代偿期肝硬化（decompensatory cirrhosis, DC）患者发生急性肾损伤（acute kidney injury, AKI）事件及预后的差异。方法　选取2016年12月—2018年7月延安市人民医院收治的252例HBV相关ACLF（HBV-ACLF）患者和119例HBV相关DC（HBV-DC）患者作为研究对象，检测上述患者尿液中肾小管损伤生物标志物的水平，并比较分析患者预后情况。结果　252例HBV-ACLF患者中发生AKI 63例（25.00%），119例HBV-DC患者中发生AKI 25例（21.01%），2组发病率相比较，差异无统计学意义（P＞0.05）。与HBV-ACLF-非AKI组患者相比，HBV-ACLF-AKI组患者尿液中肾小管损伤生物标志物水平均显著升高，90 d生存率显著降低（P均＜0.05）；与HBV-DC-非AKI组患者相比，HBV-DC-AKI组患者90 d生存率也显著降低（P＜0.05）。HBV-ACLF-AKI组患者平均中位生存时间为49.4 d，HBV-DC-AKI组患者平均中位生存时间为48.1 d。多因素分析结果显示，与HBV-DC-非AKI患者相比，HBV-ACLF-非AKI、HBV-DC-AKI、HBV-ACLF-AKI患者90 d死亡风险HR依次为3.442、5.249、7.294（P均＜0.05）。此外，年龄增大、肝性脑病和腹水增加了患者90 d死亡风险（P均＜0.05）。结论　HBV-ACLF、HBV-DC患者AKI发病率无显著区别。HBV-ACLF、HBV-DC患者发生AKI后生存时间更短、死亡风险更高，其中HBV-ACLF患者发生AKI后预后最差。在临床救治中应对上述两种患者给予更多关注，以不同方式进行管理。     

急性乙醇中毒合并硬膜外血肿1例报道

急性乙醇中毒与急性硬膜外血肿的临床症状存在相似之处,如均可出现恶心、呕吐、头痛、烦躁不安等症状,需要早发现、早诊断、早治疗,以免延误最佳救治时机。2021年9月本院曾收治1例急性乙醇中毒合并急性硬膜外血肿患者,经硬膜外血肿清除+颅内压探头置入术治疗,10 d后好转出院。     

让食物的主干道畅通无阻--食管癌的防治

食管癌在我国是常见病．是指原发于食管黏膜的癌症病变。以食管鳞状细胞癌居多．发病率居全世界恶性肿瘤的第6位。我国是食管癌高发国家．死亡率居第4位(17．38／10万)．但居世界第一。近年来．虽然肿瘤诊断、治疗等方面已取得许多进展．但食管癌的预后却很差．总的5年生存率在10％～20％．其中50％患者     

Legionnaire's disease complicated by acute renal failure due to rhabdomyolosis: a case report

The infectious origin of non-traumatic rhabdomyolysis is rare (5% of cases). An elevated muscle enzyme level is often reported in the legionnaire's disease. We report the case of a 39-year-old male, with no previous medical history, admitted for renal failure (creatininemia=977 micromol/l) secondary to rhabdomyolysis and a twelve-day history of infectious syndrome with pneumonia in the left base. Legionella pneumophila was considered responsible for these symptoms because of a positive serology. The other microbial assessments were negative. After rehydration and three weeks of antibiotics, the outcome was favorable: the renal failure resolved completely and the muscle enzyme level returned to normal.     

妊娠合并肛管癌1例并文献复习

妊娠合并肛管癌临床上少见,预后较差,国内外至今尚未有报道,我院近期收治了 1例妊娠合并肛管癌患者,现将诊疗经验结合相关文献报道如下. 1 病例资料 患者,女,37岁,G2P1,农民.因"停经35周,发现肛管肿物10周"于2020年6月2日入青岛大学附属医院.患者停经25周因排便时肛门疼痛就诊于肛肠科,大便规律,每日1次...     

Malignant tumors associated with thyroid cancer in an autopsy material

In the Department of Pathology of Albert Szent-Gy?rgyi Medical University at Szeged in Hungary 37,504 autopsies were performed in the last 30 years and double multiple primary malignant tumours were found in 385 cases (4.2%). In thyroid cancer cases the tumours of other organs were more frequent (22.7%), and these tumour-associations were observed mainly simultaneously, there were no important sex differences. In the most of cases the thyroid cancer was only a side diagnosis beside other malignancies, in the more rare metachronous cases the thyroid cancer was secondary following postoperative irradiation of the first tumour (4 cases of 5). We have seen thyroid cancers most frequently together with lung, breast and digestive system tumours.     

氢氟酸烧伤合并急性化学性肺炎1例

回顾1例氢氟酸烧伤合并急性化学性肺炎患者的临床表现及诊治过程.患者被体积分数40％的氢氟酸溶液喷溅至面颈部、躯干及左上肢,伤后立即进行清水冲洗、送医.人院后早期、快速行静脉补钙、创面清创、钙剂创面局部注射及湿敷,经气管切开、雾化吸入、使用激素等治疗后患者痊愈,提示患者伤后及时人院就诊,综合运用各种治疗措施能发挥更加有效...     

Fatal hemoperitoneum from traumatic gallbladder avulsion: an autopsy case report

This report describes a rare autopsy case of death due to gallbladder injury. The victim was a 63-year-old man, with a clinical history of liver cirrhosis and alcohol abuse. The postmortem examination revealed fatal hemoperitoneum from traumatic gallbladder avulsion. Related injuries were observed in the right hypochondriac region. Normal distended gallbladder, liver cirrhosis and alcohol abuse were considered to be the predisposing factors. The gradual development of bleeding from the small vessels of the gallbladder and the liver bed may have caused extensive hemoperitoneum.     

一例肛门周围脓肿合并急性弛缓性麻痹的调查

目的调查某一病例发生肛门周围脓肿合并急性弛缓性麻痹与服用脊髓灰质炎减毒活疫苗的关联性。方法成立预防接种异常反应调查诊断专家组,对病例开展个案调查、资料收集、汇总分析等,并出具相关报告结论等。结果该病例有明确的脊髓灰质炎减毒活疫苗接种史,主要症状有发热、呕吐、左下肢无力等,先后在菏泽市立医院和省立医院住院治疗,主要诊断为肛门周围脓肿,急性弛缓性麻痹;病例粪便标本中未检出I、II、III型脊髓灰质炎病毒和其他肠道病毒;市级预防接种异常反应调查诊断专家组诊断意见为急性弛缓性麻痹,不支持服苗者疫苗相关麻痹型脊髓灰质炎诊断。结论现有资料尚不能支持该病例发生急性弛缓性麻痹与服用脊髓灰质炎减毒活疫苗有关。     

三氯乙烯药疹样皮炎合并多脏器功能衰竭死亡1例报告

报告与分析了1例职业性三氯乙烯药疹样皮炎合并多脏器功能衰竭死亡病例的发病经过、临床诊治和作业现场调查情况。结果表明,中毒原因系因厂方未采取有效的通风排毒和个人防护措施引起,提示加强有毒物品使用的防护和管理至关重要,同时要做好三氯乙烯操作人员的职业健康监护工作。