小探头超声（MPS）检查在消化道疾病临床应用的初步探讨

目的传统内镜尚难对消化道粘膜隆起病灶的性质以及肿瘤浸润深度作出判断。本文旨在评估小探头超声（ＭＰＳ）检查在此方面的应用价值。方法对６０例（手术患者３９例）常规内镜检查发现病灶的患者，于内镜检查的同时行ＭＰＳ检查，其结果与常规内镜下的肉眼诊断、病理活检以及手术后病理结果作对比。结果对粘膜隆起病灶且内镜下病理活检阴性的患者，与手术发现比较。ＭＰＳ的诊断准确率为９０．５％（１９／２１）；而对于消化道肿瘤的浸润深度，ＭＰＳ的判断均与手术后结果相符１００％（２３／２３）。结论对消化道粘膜隆起病灶的性质鉴别，ＭＰＳ显著优于常规内镜及病理活检，具有一定临床诊断价值；对消化道肿瘤，ＭＰＳ仅对肿瘤浸润消化道壁的深度能作出准确判断，而对周围淋巴结累及与邻近脏器转移的诊断仍有其局限性。     

The use of thoracoscopy in the diagnosis and treatment of chest diseases]

The procedure and results of thoracoscopy by using a fiberoptic bronchoscope and rigid cold-light thoracoscope in 76 cases with chest diseases of unknown causes were reported. The positive diagnostic rate was 89.5% (68/76). The histologic diagnosis following thoracoscopic biopsy in 65 patients was compared with the findings at follow-up, the results showed the sensitivity being 87.7%, specificity 100% and diagnostic accuracy 89.2%. 3 cases with persistent or recurrent spontaneous pneumothorax were cured by Nd-YAG laser transendoscopically. 5 patients with malignant pleural effusion were treated with intrapleural talcum powder under thoracoscopic control, 4 of them obtained complete pleurodesis. There were only minor complications: transient fever in 40 cases and local subcutaneous emphysema in 7. It was concluded that thoracoscopy is simple, safe, reliable and practical in the diagnosis and treatment of chest diseases. It should be popularized clinically.     

The use of ultrasound in the diagnosis of gastrointestinal tumors (author's transl)

In 19 patients with gastrointestinal tumors the diagnosis was made by ultrasound. 7 patients were examined for further investigation of an abdominal mass; 12 patients, presented with symptoms suggesting malignants, e. g. weight loss, vomiting, fever, abdominal pain, and/or anaemia from bloodloss were first investigated by ultrasound. In 5 patients with colon tumors, diagnosed by ultrasound, a resection and anastomosis was possible. 13 cases were found to be inoperable during laparotomy, one patient had an ileocolitis Crohn with stenosis. Ultrasonic examination with real-time scanning technique proved to be a valuable method as a screening procedure for patients with suspected gastrointestinal tumors. During the same procedure local (mesenteric) or liver metastases can be detected. A normal abdominal ultrasonography does not exclude malignant intestinal lesions in any location during the early stage and in the region of cardia and rectum even in the more advanced stage.     

The use of PCR in the diagnosis of hyper-reactive malarial splenomegaly (HMS)

Between August 1997 and September 1998, 14 cases of hyper-reactive malarial splenomegaly (HMS) were diagnosed in the Instituto de Salud Carlos III in Madrid, Spain. These cases, from Equatorial Guinea and Cameroon, were identified using the diagnostic criteria established by Y. M. Fakunle in 1981: gross splenomegaly; high levels of anti-malarial antibodies; IgM in serum at least two standard deviations above the local mean; and clinical and immunological response to antimalarial treatment. Although malarial parasites were only detected in the Giemsa-stained blood films of four of the cases, these four and four others were found to have the DNA of such parasites in their blood when tested using a method based on a semi-nested, multiplex PCR. These result indicate that malarial parasitaemias may be more prevalent in HMS than is usually recognized.     

The use of quinacrine (Atabrine) in rheumatic diseases: A reexamination

Atabrine has been available for nearly 60 years. It has a variety of actions and has been administered to millions of individuals. Its antirheumatic properties have been well documented but have not been exploited optimally for a variety of reasons. The drug is generally quite safe and could be used in low doses in lupus and rheumatoid arthritis patients as a steroid-sparing agent or synergistically with hydroxychloroquine. Its bothersome side effects should not deter the clinician from using it, because they are easy to deal with or prevent (Table 5). Future studies should attempt to better characterize the immunosuppressive actions of this powerful drug, particularly in the treatment of lupus erythematosus and rheumatoid arthritis. Studies of the role of combination or single-agent antimalarial therapy in combination with other "remittive" drugs could be of great potential benefit.     

基因芯片技术在肝病诊疗中的应用

基因芯片技术是20世纪90年代末兴起的一项前沿生物技术。它是指将大量靶基因或寡核苷酸片段有序地高密度地排列固定于玻片、硅片等固相载体上,然后与待测的标记样品的基因按碱基配对原理进行杂交,通过激光共聚焦荧光检测系统等对芯片进行扫描,再经计算机软件处理,从而获取大量生命信息。自从1995年美国斯坦福大学的Schena和Brown     

Appropriate use of the microbiology laboratory in the diagnosis of infectious diseases

The collection and processing of clinical specimens in the diagnosis of infectious diseases is reviewed. Available culture methods, other laboratory tests, and their appropriate use and interpretation are discussed. Particular emphasis is placed on selection of those tests most likely to give a specific diagnosis while avoiding unnecessary laboratory use.