组织细胞坏死性淋巴结炎临床分析

目的探讨组织细胞坏死性淋巴结炎的临床特点。方法分析了16例组织细胞坏死性淋巴结炎的临床特征、诊断及鉴别诊断要点。结果16例NHL全部经淋巴结活检确诊，均经糖皮质激素治疗痊愈。该病以发热、淋巴结肿大、疼痛、白细胞减少为主要临床特征。结论确诊依赖于淋巴结活检，可避免误漏诊。     

组织细胞坏死性淋巴结炎临床特点及诊治分析

目的 探讨组织细胞坏死性淋巴结炎的临床特点、组织病理学改变、诊断和治疗。方法 对治疗的11例组织细胞坏死性淋巴结炎进行分析。结果 本病以发热、淋巴结肿大和粒细胞减少为特点，淋巴结活检是关键，淋巴结组织病理学改变主要为副皮质区的多处坏死，不同程度的组织细胞、免疫母细胞、浆细胞样单核细胞增生，无中性粒细胞浸润。结论 组织细胞坏死性淋巴结炎具有典型的组织病理学改变，应注意防止误诊。     

以发热、全身淋巴结肿大、全血细胞减少为主要表现的组织坏死性淋巴结炎1例

组织细胞坏死性淋巴结炎是以淋巴结肿大，发热为特征的良性自限性疾病，本例患者以高热、全身多处淋巴结明显肿大、全血细胞减少为主要表现，经淋巴结活检病理诊断为组织细胞坏死性淋巴结炎，强的松治疗后体温正常，血细胞恢复正常，肿大淋巴结明显缩小。说明本病临床表现多样，缺乏特异性，易误诊为白血病、淋巴瘤等疾病，应引起重视。     

组织细胞性坏死性淋巴结炎23例报道及文献复习

目的 探讨组织细胞性坏死性淋巴结炎的诊断和鉴别诊断。方法 23例组织细胞性坏死性淋巴结炎组织经常规制片、苏木精-伊红染色，镜下观察其病理特点，结合临床资料，进行回顾性分析。结果 组织细胞性坏死性淋巴结炎以淋巴结灶性淡染坏死灶及其边缘增生的组织细胞、转化的淋巴细胞为主要镜下表现，但偶可坏死不明显，并出现大量转化淋巴细胞及显著核分裂象。结论 组织细胞性坏死性淋巴结炎是良性自限病变，但镜下形态极易与淋巴瘤等病变混淆，应严格把握诊断标准，避免漏诊或过度诊断。     

23例坏死性淋巴结炎的临床及病理分析

分析了２３例坏死性淋巴结炎病例。此病多见于年轻女性，临床主要表现为颈部淋巴结肿大伴发热，组织学改变复杂，易误诊为其他淋巴结炎和恶性淋巴瘤；淋巴结活检是诊断本病的重要手段。本病具有自限性，抗生素治疗无效     

组织细胞性坏死性淋巴结炎12例临床分析

目的：探讨组织细胞性坏死性淋巴结炎的临床特点、组织病理学改变、诊断和治疗。方法：对12例组织细胞性坏死性淋巴结炎患者进行回顾性分析。结果：本病临床上以颈部淋巴结肿大、发热及外周血白细胞减少为主要表现；病理特征为淋巴结广泛凝固性坏死和组织细胞增生。糖皮质激素治疗有效。结论：组织细胞性坏死性淋巴结炎具有典型的组织病理学改变，但应注意防止误诊。     

1例坏死性淋巴结炎的护理

组织细胞性坏死性淋巴结炎、亦称坏死性淋巴结炎或菊池病,1972年首先由日本学者Kikuchi[1]报道,现国内陆续有报道.该病临床表现缺乏特纳福性,诊断主要依据淋巴结病理学检查.     

组织细胞坏死性淋巴结炎9例临床病理及彩超变化的探讨

目的探讨组织细胞坏死性淋巴结炎的临床病理改变、彩超改变。方法通过光镜观察分析9例组织细胞坏死性淋巴结炎,并与彩超对比。结果9例组织细胞坏死性淋巴结炎中,无一例在淋巴结活检之前明确诊断,组织学上表现为大小不等散在的或融合的病灶,病变区以坏死为主伴散在核碎片,多种组织细胞增生,缺乏中性粒细胞浸润。结论组织细胞坏死性淋巴结炎的确诊有赖于组织病理学。含有多量核碎片坏死灶的形成是组织细胞坏死性淋巴结炎的主要病理学特征,免疫组化检测有助于鉴别诊断。     

16例组织细胞性坏死性淋巴结炎临床病理分析

目的了解组织细胞性坏死性淋巴结炎的临床病理特征。方法对１６例组织细胞性坏死性淋巴结炎患者进行回顾性分析。结果本病临床上以颈部淋巴结肿大、发热及外周血白细胞减少为主要表现；病理特征为淋巴结广泛凝固性坏死和组织细胞增生。糖皮质激素治疗有效。结论组织细胞性坏死性淋巴结炎是一个自限性淋巴结病变，在临床上及组织学上易与淋巴瘤相混淆，应引起临床医师注意     

组织细胞坏死性淋巴结炎9例临床分析

<正>组织细胞坏死性淋巴结炎,又称Kikuchi(菊池)病,无粒细胞浸润的组织细胞性坏死性淋巴结炎,常简称为坏死性淋巴结炎。本病是一种良性自限性疾病,多累及颈部淋巴结,无论是临床还是病理均易误诊为淋巴瘤。现收集2005~2008年间病理诊断组织细胞坏死性淋巴结炎9例,重新复习病理     

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.     

Scientific principles and rigorous processes should be followed in developing clinical guidelines for therapeutic interventions of integrative medicine

A clinical guideline for the therapeutic interventions of integrative medicine may be defined as a written document which states a series of recommendations on therapeutic interventions of integrative medicine for a special disease or condition. The guideline may provide assistance to medical professionals in making clinical decisions aimed at improving the clinical outcome of patients and reducing the costs of medical care（~＇4~. Recommendations issued by a guideline should be based on the best available evidence in both Western and Chinese medicine. For fulfilling this purpose, the development of clinical guidelines for therapeutic interventions in the field of integrative medicine should follow scientific principles and undergo a rigorous processes.     

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.