卵巢卵黄囊癌18例临床病理分析

本文介绍卵黄囊癌18例的临床病理分析结果。病人的年龄为9～64岁,其中9～18岁9例(50％),入院前病程1周至2年,肿瘤最大直径8～29cm。镜下观察,单纯卵黄囊癌13例,合并种子细胞瘤3例,合并胚胎性癌、囊性畸胎瘤各1例。8例术后随诊,其中6例1～6个月死亡;1例晚期病人,肿瘤切除后加联合化疗,术后15个月死亡;另1例,肿瘤切除加放疗,随诊4.5年,健在。     

卵巢卵黄囊瘤27例临床与病理分析

目的:探讨卵巢卵黄囊瘤临床与病理特点。方法:分析研究27例卵巢卵黄囊瘤临床资料、病理检查并随访其发病规律与特点。结果:临床I期13例及临床Ⅱ期2例(以上均为单纯型)随访2~21年均健在;临床I期(混合型)1例术后3年死亡,临床Ⅱ期3例(内有混合型1例)术后1年内死亡,1例术后3年死亡。临床Ⅲ期术后1年死亡及术后2年死亡各2例,临床Ⅳ期1例术后1个月死亡;失访2例。结论:卵巢卵黄囊瘤属恶性肿瘤,预后与临床分期及组织学类型密切相关,手术治疗并配合VAC或PVB化疗可以明显改善预后。     

Quantitative Immunoglobulin Levels (IgG, IgA and IgM) in Children, Determined by the Hyland Immunoplate Technique

Quantitative immunoglobulin levels (IgG, IgA and IgM) were determined in 200 infants and children ranging in age from 2 months to 15 years, using the Hyland “Immunoplate” technique. The mean values obtained ranged from 346 mg. % for IgG in the youngest age group to 814 mg. % in the oldest; for IgA the mean values ranged from 49 mg. % in the youngest age group to 114 mg. % in the oldest; for IgM the mean values ranged from 47 mg. % in the youngest age group to 97 mg. % in the oldest age group. The method used proved to be reproducible from day to day and was much more rapid than a previously used double-diffusion technique.     

颅内室管膜瘤40例分析

本文报告40例颅内室管膜瘤,位于大脑半球26例,侧脑室5例,第三脑室2例,第四脑室4例,小脑半球2例,小脑蚯蚓部1例。发病年龄:最小者1.5岁,最大者60岁,平均年龄30.5岁。40例均经手术治疗,其中全切除及近全切除34人次,大部分切除8人次,术后复发2例。手术死亡6例,手术死亡率15％。术后随诊34例,生存7年以上者3例,5年以上者7例,其余均生存半年至5年以内,2例复发。本文着重讨论诊断与手术问题。     

122例手足口病的流行病学分析

目的了解本地区的手足口病流行情况，分析流行因素并寻找控制的方法。方法收集本院2008年接诊的所有手足口病病例，进行流行病学的分析。结果122例手足口病患者中最小的发病年龄是7个月，最大14岁，0～5岁的发病人数占所有病例的84．4％，男童81例占66．4％，女童41例占33．6％，男女比例为1．98：1，发病的高峰季节是夏季，5、6月占全年病例的77．8％；散居儿童53例占43.3％，幼托学童69例占56．6％。结论手足口病是主要侵犯儿童的传染病，特别是学龄前儿童，发病呈明显的季节性，在流行季节中托幼机构的儿童由于密切接触会有增加发病的机会。因此流行期间应加强卫生管理。     

广西博白县1999～2008年流行性乙型脑炎监测分析

目的分析博白县1999～2008年流行性乙型脑炎(简称乙脑)流行趋势,为制订乙脑防治策略提供依据。方法采用描述性流行病学方法分析材料。结果1999～2008年博白县共发生乙脑病例152例,死亡30例。其中1999年84例、2004年38例,发病率分别为6.03/10万、2.54/10万,其余年份呈低水平散发。病例地区分布较平均,男女比例为1.27:1,最小发病7个月,最大年龄10岁,以2～6岁多见118例占77.63%。免疫史不详及空白为109例,占71.71%。5～7月发病151例,占99.34%。结论博白县乙脑流行季节较早,在预测流行年份提前对低年龄儿童进行乙脑疫苗普种具有现实意义。     

类风湿关节炎肺部受累胸部高分辨CT影像学分析

目的 探讨类风湿关节炎(RA)肺部受累患者胸部高分辨CT(HRCT)的影像学分型,提高对RA肺部受累影像表现的认识。方法 收集161例确诊RA伴肺部受累的病例,回顾性分析患者的胸部HRCT影像学表现,并结合病史、肺部活检病理、肺泡灌洗或肺功能检查等将RA相关肺部病变(RA-LD)进行影像学分型,并比较其临床特点。结果 161例RA-LD患者男56例、女105例,确诊RA-LD时平均年龄(60.7±12.8)岁(14~85岁),包括寻常型间质性肺炎(UIP)样改变87例、非特异性间质性肺炎(NSIP)样改变44例、机化性肺炎样改变10例、淋巴细胞性肺炎样改变7例、小气道病变(SAD)9例、其他表现4例。UIP样改变组平均年龄最大[(63.3±12.1)岁]、吸烟比率最高(41.4%),SAD及其他组平均年龄最小[(54.7±15.1)岁]且均无吸烟史,两组差异有统计学意义(P=0.020,P<0.001)。70例(43.5%)RA-LD患者合并胸膜病变。结论 RA累及肺部影像学表现多样,最主要的表现是间质性改变,以UIP和NSIP样改变为主;RA患者应尽早做肺HRCT以了解肺部受累与否及相关类型。     

一起麻疹爆发疫情的调查分析

2005年5月,四川省邻水县幺滩镇发生一起经血清学证实的麻疹爆发疫情,疫情波及3个村,涉及3个学校,发病64例,村民罹患率达7.98‰。病例年龄最小9月龄,最大15岁。学生发病62例,占发病总数的96.88%,学生罹患率47.73‰。发病年龄主要集中在10-15岁年龄组,占70.31%;5-9岁学生占26.56%。爆发病例中有免疫史的占15.63%,无免疫史和免疫不详的分别占25%和59.38%。爆发主要原因为有效免疫接种率低和基层免疫工作疏于管理;学校校舍拥挤,通风条件差,疫情报告不及时,延误了采取应急防治措施,促进了疫情的传播,造成了疫情蔓延。     

Leiomyosarcoma of uterus: a review of 14 cases

A detailed clinicopathologic study of 14 patients with leiomyosarcoms of the uterus was made. Twelve of 14 patients were followed up for 2 or more years. The median age was 49, the youngest patient was 20, and the oldest was 68. The predominant symptoms were abnormal vaginal bleeding and abdominal pain. The preoperative dilation and curettage established the correct diagnosis was 2 of 6 patients (33%). The predominant method of treatment was total abdominal hysterectomy (TAH). Five patients had adjuvant chemotherapy, 4 had adjuvant radiotherapy, 2 patients had chemotherapy and radiotherapy for adjuvant treatment, and one had adjuvant hormonal therapy. The overall cumulative probability of survival rate at 5 years was 29.6%. The mitotic count, margin type, tumor size, and the presence of necrosis did not affect the prognosis. Favorable prognostic features are low pleomorphism, lower staging, and aggressive management.     

平顶山市2001～2005年麻疹实验室监测结果分析

目的 分析平顶山市近年麻疹实验室监测情况。方法 麻疹血清学检测采用酶联免疫吸附试验（EusA）捕捉法检测麻疹IgM抗体。结果 5年共计报告麻疹病例1326例，采集麻疹疑似病例血清731例，实验室确诊365倒，主要分布在全市10个县（市）区。呈高度散发与局部爆发并存的流行病学模式，检测爆发病例共233例，占全部病例的31．9％。3-6月为高发。麻疹发病最小年龄为4个月龄。最大50岁，主要集中在7-15岁的中小学生。结论 检测麻疹IgM抗体对爆发点的快速确定、及时采取控制措施起到关键作用，要着重提高麻疹疫苗的接种覆时性和接种质量，加强麻疹的常规免疫、强化免疫，适时开展学龄儿童的强化免疫，预防和控制麻疹的爆发。     

CLlOS,ED TREATMENT OF DISPLACED FRACTURE OF LATERAL HUMERAL CONDYLE

From June 1970 to September 1975, 94 cas;es of displaced fracture of the lateral condyle of the humerus were treated by closed reduction and short splint fLxation by combined tradi- tional Chinese and western method. Of the 94 cases, 68 were boys and 26 girls, the youngest was 2 years old and the oldest 15. 87% were 3-8 years olcL 44 cases involved the left lateral condyle and 50 the right lateral condyle. An- terior displacement occurred in 22 cases and posterior displacement in 72. Rotational dis- placement was less than 900 in 10 cases and more than 90° in 84. On reduction, the anteriorly displacecl typc should be first changed into posteriorly displaced one by pressing the distal bone fragment back- ward. The posteriorly displaced type was treat- ed by 2 methods. X-ray films taken imme- diately after reduetion shcnvecl satisfactory ap- position ui 55 cases, latcral displaceme4t in 33 and mild oblique displacement in 6. Roent- genograms made 3-4 weeks after short splint fixation revealed that all cases except one in which the patient discontinued treatment were in apposition and obtained clinical union withi:ti 4 weeks. 54 cases were followed up for 3 months to 5 years, averaging 2.6 years. X-ray findings showed osscous union in 53 ca.ses. Among them, 12 had the appea.rance of excessive long capi- tuluni, especially among the laterally or obli- quely djsplaced cases. 3 cases had concave "fish fin" deformity between capitulum and trochlea. No secondary displacement occurred in the 51 follow-up cascs.     

早期食管癌内镜下特点分析

目的总结胃镜检查发现早期食管癌镜下表现的特点。方法采用电子胃镜、内镜下染色、内镜窄带成像技术,超声内镜发现早期食管癌患者的镜下图像特征。15例患者均进行内镜黏膜切除术、内镜黏膜剥离术或外科手术,并经病理学证实。结果发现、证实15例早期食管癌,男性8例,女性7例。年龄最大者80岁,最小者45岁,平均年龄60.02岁。结论提高国内内镜下食管癌早期辨认能力,是目前食管癌早诊早治的重要手段。     

Treatment outcome of rhabdomyosarcoma in Hong Kong Chinese children.

OBJECTIVES: To review the treatment outcome of rhabdomyosarcoma in Hong Kong Chinese children. DESIGN: Retrospective review. SETTING: University teaching hospital, Hong Kong. PATIENTS: Consecutive cases of rhabdomyosarcoma diagnosed and treated by the Department of Paediatrics and Adolescent Medicine of Queen Mary Hospital between 1989 and 2005. Each patient was staged and treated according to the Intergroup Rhabdomyosarcoma Study guidelines. MAIN OUTCOME MEASURES: Overall and event-free survival rates, and toxicity data. RESULTS: Of 19 patients (8 males and 11 females), 14 (74%) were younger than 10 years old. The median age at diagnosis was 6 (range, 0.5-17) years. Primary sites of rhabdomyosarcoma included: the head and neck (n=8; 6 classified as cranial parameningeal), genitourinary (3), extremity (3), pelvis (3), and trunk (2). Thirteen (68%) had embryonal and six (32%) had alveolar histology. Two, 2, 9, and 6 were classified as belonging to Intergroup Rhabdomyosarcoma Study groups 1, 2, 3, and 4, respectively. Respective 5-year overall and event-free survival rates of the entire cohort were 49% (95% confidence interval, 26-73%) and 32% (10-55%), with a median follow-up of 3.4 (range, 0.2-16.7) years. In non-metastatic cases (Intergroup Rhabdomyosarcoma Study groups 1-3), the 5-year overall survival rate was 66% (95% confidence interval, 39-93%) and in metastatic cases (group 4) it was 17% (0-46%). The 5-year overall survival rate for patients aged less than 10 years was 60% (95% confidence interval, 33-87%) compared to 20% (0-55%) in those aged 10 years and over. Significant treatment-related toxicities including myelosuppression, infections, peripheral neuropathy, and second cancers were encountered. CONCLUSIONS: Treatment outcome of rhabdomyosarcoma in this cohort of Chinese children was less favourable than that reported in international studies. Whilst the main reason could have been related to the high proportion of metastatic cases, also non-metastatic cases faired worse. Improved outcomes may be achieved by advances in multidisciplinary (paediatric oncology, pathology, radiotherapy, and surgery) management and supportive care.     

四川省德阳农村7～15岁儿童性发育调查研究

作者调查了1063例农村儿童性发育,结果表明:女性性发育以乳房发育开始,高峰年龄为11岁,继之是阴毛和腋毛发育,月经初期年龄为13岁。男性性发育以睾丸增大开始,继之为阴毛、腋毛和面毛发育,首次遗精年龄以15岁最多。作者进一步研究了它们之间的关系。     

The incidence of malignant mesothelioma in Australia, 1947-1980

Details of patients with malignant mesothelioma that was diagnosed in Australia before 1981 were obtained by searching all possible sources throughout Australia as far into the past as possible and up to and including 1980. The earliest patient with mesothelioma who was identified was diagnosed in Victoria in 1947. By 1980, 535 (81%) men and 123 (19%) women had been diagnosed with the disease; only 14 persons were aged less than 35 years at the time of diagnosis (the youngest person was 15 years of age). The incidence rate in subjects who were 35 years or older at diagnosis was less than 1.0 cases per million person-years until 1964-1968, and then it rose progressively to 15.5 cases per million person-years in 1979-1980. The highest rate (69.7 cases per million person-years) was observed in 65- to 74-year-old men in 1979-1980. The incidence rate in Western Australia was greater than were the rates in other states of Australia after the mid 1960s. Pleural mesotheliomas accounted for 88% of cases in which the site of the tumour was known; peritoneal mesotheliomas accounted for 10% of such cases and "other" sites for 2% of such cases. In 6% of cases the site was not specified. The exposure to asbestos was stated as "definite" in 59% of the cases with a recorded history of exposure: 8% of all the cases in the study had been exposed to crocidolite (blue asbestos) from Wittenoom Gorge in Western Australia. The age at diagnosis of patients with known exposure to asbestos was similar to that in those without known exposure. The increases in the incidence of malignant mesothelioma in Australia follow the published trends in the production and use of the amphibole varieties of asbestos in this country after a lag period of between 20 and 30 years.     

心脏黏液瘤15例临床病理和免疫组化研究

目的探讨原发性心脏粘液瘤的发病特点及临床病理特征。方法应用HE染色、PAS特染及免疫组化SP法对15例原发性心脏粘液瘤进行病理形态学观察,并对其进行回顾性总结分析和随访。结果15例心脏粘液瘤中,女性12例,男性3例,女男之比为4：1,年龄17-68岁,平均36．7岁。肿瘤部位是左心房13例（86．7％）,右心房1例（6．7％）,左心房及右心房同时生长1例。随访病人均健在无复发。结论原发性心脏粘液瘤不多见,以中青年女性发病为主,好发于左心房,几乎均为良性,推测起源于原始多潜能间叶细胞,手术摘除肿瘤加蒂部心内膜及心肌彻底切除干净。很少复发,预后良好。     

部分型切口妊娠的早期超声诊断

目的 探讨早期注重细节特点及近期追踪观察在部分型切口妊娠诊断、鉴别诊断中的作用.方法 对我院2010年1月至2015年8月66例经超声诊断为部分型切口妊娠的门诊及入院患者作回顾性分析.结果 我院初次超声正确诊断51例,有11例初次误诊为宫内孕经复查后诊断为部分型切口妊娠,另有4例首次误诊为部分型切口妊娠后确诊为宫内孕.回顾分析62例未经处理的部分型切口妊娠的超声图像特点发现:空囊型27例,有卵黄囊无胚芽的22例,有胚芽及有/无胎心搏动的13例.62例均位于子宫下段接近切口处,肌层厚度2.8~6.4 mm,平均4.5 mm.孕囊受牵拉形态改变40例,无明显变形20例,宫腔线偏移37例,偏移不明显的23例,有2例因图像质量欠佳孕囊变形、宫腔线偏移的情况不明确;切口附近有血流的59例,复诊均有血流增多.结论 妊娠囊的细节特点即着床部位、着床处子宫壁的厚度,孕囊变形及偏移宫腔线的情况,卵黄囊及胚芽的位置,孕囊周边的血流及其变化情况对早期诊断部分型切口妊娠很有帮助.     

The pattern of CD15, CD30 and Bcl-2 expression in diffuse large B-cell lymphoma

Diffuse large B-cell lymphoma (DLBCL) is a heterogenous entity. The pattern of CD15, CD30 and Bcl-2 expression is not well documented, especially in local population. We investigated 67 consecutive cases of DLBCL by immunohistochemistry on paraffin-embedded tissue. The male to female ratio was 1.2:1 with median age of 55 years, and more common nodal than extranodal in presentation. Only 3 of 67 cases expressed CD15. In addition, three cases showed weak membrane staining for CD30. Only one of these three cases was noted to have co-expression of CD15 and with occasional tumour cells showing weak CD30 expression. Bcl-2 protein was expressed in 43 of 67 (64%), more frequently in nodal than in extranodal tumours. In conclusion, CD15 and CD30 expressions are infrequent in DLBCL, and co-expression is rare. Bcl-2 protein expression is common in DLBCL.     

小儿卵黄囊瘤

本院1966年～1989年共收治小儿卵黄囊瘤37例,经血清甲胎蛋白(AFP)测定,光镜确定诊断又通过10例电镜观察,8例AFP免疫组化观察,文献复习,本文支持Teilum提出该瘤来源于卵黄囊瘤背壁的全能性生殖细胞的组织发生观点;1.胚胎卵黄囊有合成AFP能力,本文意儿血清AFP明显升高,免疫酶标可作AFP定位。2.超微结构观察:肿瘤形态与妊娠7周卵黄囊相似,电镜下可见到上皮性及间叶性成份相当于胚外内胚层及胚外中胚层成份。且讨论了该瘤的命名与畸胎瘤关系和免疫组化的应用     

Ovarian neoplasms in adolescence and childhood--an analysis of twenty cases

Between January, 1999 and June, 2001 consecutive twenty cases of ovarian tumours in girls below 20 years of age admitted in Burdwan Medical College, Burdwan, West Bengal were analysed. Commonest presentation was lump abdomen (80%), 15% presented with acute abdomen, one patient presented with virilisation and another with precocious puberty and 85% had single ovarian involvement. Among 5 cases of torsion of ovarian tumours, one along with the twisted uterus was detected. Conservative surgery in the form of cystectomy or unilateral oophorectomy with or without salpingectomy was possible in 85% cases. Germ cell tumours (60%) took the leading place followed by epithelial (3 0%) and sex-cord stromal tumour (10%). Fifty percent neoplasms were malignant with majority (80%) being instage I. Combination chemotherapy was considered for 7 out of 10 cases. Conservative surgery in one hand and the fear of malignancy on the other are the real problems in these cases. Early detection, optimal therapy and intense follow-up are the key points of the management.