肺孢子虫肺炎一例病理报告

本文报道一例肺孢子虫肺炎的尸解材料,着重讨论了本病的组织病理学特征、诊断和鉴别诊断,并对渗出物的形成机理略加讨论。     

肝泌碘性与非泌碘性占位性病变的CT延迟增强扫描

肝ＣＴ延迟增强扫描的机理与肝组织的泌碘、聚碘功能有关。自１９８５年至１９９４年，作者对１２０例肝占位性病变的患者进行了ＣＴ延迟增强扫描，根据病变延迟增强扫描的特征，将之分为泌碘性病变与非泌碘性病变两种类型：肝癌、转移瘤、血管瘤、囊肿属非泌碘功能占位病变；肝腺瘤样增生结节、肝局灶性结节状增生属泌碘功能占位病变；并讨论上述病变延迟增强征象。机理及临床意义。     

播散性组织胞浆菌病的临床及影像学表现

目的：分析讨论播散性组织胞浆菌病的影像学表现及价值。方法：回顾收集32例播散性组织胞浆菌病的临床及影像学资料(包括胸部X线及CT、B超)。结果：胸部影像异常表现19例，表现为：(1)肺间质炎症；(2)渗出性肺实变，可伴胸腔积液；(3)肺门淋巴结肿大；(4)结节增殖样病灶。肝脾肿大32例。结论：播散性组织胞浆菌病表现呈多样性，尽管缺乏特异性，但影像学在诊断、鉴别诊断、对病变分型及了解病变范围和程度上有重要意义。     

马根维显磁共振增强扫描诊断脑与脊髓肿瘤

通过静脉注射马根维显诊断并经手术病理证实的４０例颅内椎管内肿瘤。马根维显是一种顺磁物质它通过缩短Ｔ１、改变病变部位组织特征参数提高ＭＲＩ时比度，为病变定位、定性诊断提供更多的信息。其应用价值为：（１）提高病变发现率；（２）增加病变与周转组织对比，使病变更加清晰；（３）有助于病变的定性诊断。结合文献对马根维显的增强机制、临床应用加以讨论。     

聚丙烯酰胺凝胶对实验兔局部组织的影响研究

目的 观察聚丙烯酰胺凝胶对；实验兔局部组织的影响。方法 电镜观察凝胶及周围组织在不同的时间变化。结果 凝胶注射１周后在其周围产生包膜，１月后周围组织中成纤维细胞内织网扩张明显，吞噬达高峰，凝胶渗出物可溶解和被吞噬，后期（４月）凝胶内将有疑难及成纤维细胞长入。结论 注射凝胶短期内对抗体无明显影响，但须关注长期在体内可能会导致经。     

肝内血管病变及血管内皮生长因子与乙型炎关系的病理学研究

目的：研究肝内血管病变及血管内皮生长因子（VEGF）与乙型肝炎（乙肝）的关系。方法：选取300例乙肝患者（急性乙肝，慢性乙肝G1－G4及肝硬变患者各50例）肝活检组织及52只SD大鼠（CCl4诱导模型组40只及正常对照组12只）不同时间（2，5，8，12周）肝组织，采用：（1）动物实验；（2）肝活检随访观察及体视学分析技术；（3）组织化学（组化）染色：对肝组织中胶原，网状及弹力纤维进行染色；（4）免疫组织化学（免疫组化）染色；用纤维连接蛋白（FN），层连蛋白（LN），IV－型胶原（Ⅳ－Co)，平滑肌肌动蛋白（α－SMA）及VEGF等单克隆抗体对肝组织进行染色；（5）酶联免疫吸附法（ELISA）定量检测：定量检测75例乙肝患者血清中VEGF含量。结果：（1）CCl4大鼠实验中，在实验不同时间内，其组织肝内血管病变，肝组织病变及VEGF的表达各不相同，早，中期（2－5周），肝组织炎症反应显著，中央静脉周围肝细胞脂肪变，VEGF阳性肝细胞主要分布在脂肪变区域；晚期（8－12周）则肝组织炎症反应轻微，但肝细胞病变显著，血管破坏，血管及成肌纤维细胞增生更趋明显，并见有局部纤维瘢痕形成，假小叶内肝组织肝窦扩张或毛细血管化，其VEGF示阳性；（2）乙肝肝细胞的变性坏死等与肝内血管病变导致的肝血供障碍密切相关，肝内血管病变主要有血管炎症，血管塞，血管破坏，血管增生及肝窦狭窄，阻塞，扩张和肝窦毛细血管化，其贯穿于乙肝的整个病程中并发挥着非常重要的作用。（3）乙肝肝组织中VEGF的表达及血清中VEGF含量变化与其肝炎分级（G），分期（S）及血管病变关系密切，在急性乙肝，VEGF呈弥漫性强阳性表达，血清VEGF含量显著升高（P＜0．001），在慢性乙肝及肝硬变（LC），其血清VEGF含量并无升高，到LC反而下降（P＜0．01），肝组织中VEGF散在表达，以扩张肝窦的内皮细胞及周围肝细胞较显著，其表达在血管形成前期最明显，而在肝血管生成期则逐渐降低。结论。肝内血管病变在乙肝的整个病程中发挥着非常重要的作用；VEGF与乙肝肝细胞的再生及肝病主的程度有关，在肝内血管增生及改建中担当一最重要的角色，其在肝组织中内增强表达发生于乙肝病变的始发阶段。     

应用冷冻割断扫描电镜技术观察兔实验性单纯疱疹病毒性角膜炎的病理变化

应用二甲基亚砜冷冻割断扫描电镜技术，首次动态观察了不同感染阶段实验性单纯疱疹病毒性角膜炎、兔角膜、三叉神经节、泪腺等组织的病变情况。初步报告并分析了各组织病变的扫描图像结果，并对冷冻判断法观察扫描电镜技术的原理及特点予以讨论，认为该技术应用于眼部单纯疱疹病毒感染的研究图像清晰、直观、简便易行，是一种有实用价值的方法。     

改良的牙龈瘤切除术

对40例牙龈瘤者，用改良的方法作软组织及骨组织病变切除。其中，仅作病变切除者23例；病变切除后立即作龈粘骨膜复位瓣术者17例。40例均进行随访。无1例复发，术后保留牙齿功能良者28例，占70%（28/40），并对本法适应证和存在的问题进行了讨论。     

结核性脑膜炎CT，MRI诊断

目的 总结结核性脑膜炎的CT、MRI表现。方法 应用西门子somatonARC型CT与O．5T Philips MRI检查，35例结核性脑膜炎中，25例做过头颅CT检查，10例行MRI检查。结果 CT平扫对脑结核的检出率为80％，CT增强扫描与MRI检查对脑结核的检出率均为100％。结核性脑膜炎的CT，MRI表现呈多样件，其病损类型主要为基底池、环池、侧裂池、脑沟的渗出物；脑积水；脑梗塞；脑白质水肿；结核瘤；结核性脓肿。结论 CT，MRI均可显示结核性脑膜炎的病变部位，范围，病损类型，在继发脑梗塞及脑积水改变，MRI较CT显示更明确。     

腺性膀胱炎的诊断与治疗

目的探讨腺性膀胱炎的临床特点及有效的治疗方法。方法对13例腺性膀胱炎患者进行诊断及抗感染、经尿道气化电切病变组织、膀胱药物灌注治疗方法的分析。结果本组13例均获得随访，1例4个月后复发；1例术后1年恶变，其余均治愈。结论膀胱镜检查结合组织活检，对诊断腺性膀胱炎有重要意义；经尿道电切或电灼病变组织，需去除导致腺性膀胱炎的病因；腺性膀胱炎有恶变倾向，需定期随访复查。     

发泡镍对激波衰减作用的研究

探讨发泡镍对激波的衰减作用。方法采用激波管分别对单层，双层和三层发泡镍及单层泡沫塑料进行冲击波试验。结论发泡镍具有明显衰减激波的作用，是一种较为理想的冲击波波防护材料。     

富铬酵母抗动脉粥样硬化的研究

本文观察了富铬酵母对早期动脉粥样硬化大鼠的预防及治疗作用。病理结果表明：在大鼠高脂饲料中接重量比加入０．１％的甲基硫氧嘧啶，在透射电镜下，大鼠主动脉内皮细胞可见大少；模型鼠改食普通饲料４０天，内皮下仍可见不典型泡沫细胞，内有空泡，而改食基础饲料并给富铬酵母治疗（０．２５ｇ／ＫｇＢｗ／ｄ），内皮下可见泡沫细胞，但空泡消失。在扫描电镜下，模型鼠主动脉内皮细胞肿胀、萎缩、排列紊乱，出现斑块状病变；给予富     

Histological changes during healing of experimental amebic liver abscess treated with metronidazole.

Morphological changes during the healing of amebic liver abscess (ALA) in hamsters treated with metronidazole were studied. Animals with ALA of 4 days of evolution were treated orally with metronidazole (5 mg/100 g for 10 days). Liver samples were studied at different times from the beginning of treatment up to 22 days. The resolution of ALA was accompanied by chronic inflammatory reaction, increased number of foamy macrophages and gradual disappearance of the granulomas. Neoformed hepatocytes and blood vessels, and proliferation of biliary ducts were also observed. Foamy macrophages play an important role in the adequate healing of ALA.     

发泡镍对胸部冲击伤的防护效果

本文介绍了一种新型发泡金属材料——发泡镍对冲击波的防护效应。以狗、豚鼠、大鼠作为实验对象,模拟激波管作致伤源,TNT炸药电雷管引爆后致伤。根据致伤后大体解剖及光、电镜观察所见的形态学变化,充分肯定了该材料对冲击波的防护效果。     

GASTRIC XANTHELASMA

Gastric xanthelasmas are macroscopically well demarcated yellow or yellow-white plaques, and microscopically composed of typical foamy macrophages. Of 3870 patients who underwent upper gastrointestinal panendoscopic examinations, 30 (0.8%) were found to have gastric xanthelasma. A moderate predominance of males over females (M:F = 3.3:1) was noted. The age ranged between 21 and 69 years (mean 46.7). Frequency peaked in those from 40 to 60 years of age (53.3%). Single lesions were found in 26 patients and multiple in 4, with diameters of 1-6 mm, nearly 66.7% of which were 2-3 mm. Gastric xanthelasmas are most frequently found in the antrum (67.8%), especially along the lesser curvature. Associated chronic gastritis in the xanthelasma surrounding mucosa was found in the 30 patients and intestinal metaplasia in 4 (13.3%). The cause of gastric xanthelasma is unknown, but chronic gastritis may be the most plausible etiologic factor.     

原发结肠何杰金氏病的X线诊断

原发结肠何杰金氏病少见,发病率明显低于非何杰金氏淋巴瘤。本文报告了我院二十年来所获共七例,侧重于X线改变进行了讨论。X线改变有以下几个特征:①病变范围较大,通常累及末端回肠;②排钡后肠管收缩受限;⑧粘膜改变呈网状,皂泡状或脑回状。     

Light and electron microscopic study of peripheral nerve damage in patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL)

Cutaneous branches of radial nerves in patients with lepromatous leprosy (LL) and borderline lepromatous (BL) were studied by light and electron microscopy. Foamy macrophages were found more or less in the nerve fibers of all leprosy patients and distributed in the epineurial, perineurial and endoneurial areas. In the endoneurium, the foamy macrophages were mainly located in the subperineurial and perivascular spaces. Vacuolated Schwann cells were also found in the nerve fasciculus. In electron microscopy, these foamy macrophages and vacuolated Schwann cells contained numerous small dense materials, irregular in size and shape, considered to be degenerated and fragmented mycobacterium leprae. These dense materials were found also in the cytoplasm of vascular endothelial cells. These findings suggest that mycobacteria enter into the endoneurium via the blood vessels. In our present study, on the other hand, it was very difficult to find the intact mycobacteria in the cytoplasm of the foamy macrophages, Schwann cells or endothelial cells, as well as in the Ziehl-Neelsen staining of paraffin sections. The disappearance of intact bacilli in our present study might have been caused by multi drug therapy. The myelinated nerve fibers were degenerated and disappeared in variable degrees. Degenerative changes of the myelin sheath developed from the outer layer to the inner layer with disarrangement of the lamellar structure. These findings were different from myelin destruction of peripheral nerves in Wallerian degeneration. The degenerative changes of the myelin sheath are caused by degeneration and destruction of Schwann cells in leprosy patients. Fibrosis surrounding myelinated and unmyelinated nerve fibers, i.e., periaxonal fibrosis, was found to a greater or lesser extent in the endoneurium. In the present study, it is still unclear whether the periaxonal fibrosis was due to necrosis of the Schwann cells by infection of mycobacteria or to an autoimmune mechanism such as antiperipheral nerve antibody. However, lamellated concentric fibrosis surrounding regenerative myelinated and unmyelinated nerve fibers with the disappearance of mycobacteria suggests that degenerations and regenerations of nerve axons were repeated during clinical cause. These findings indicated that autoimmune mechanisms play an important role in the pathogenesis of periaxonal fibrosis.     

骨原发性恶性纤维组织细胞瘤(附8例报告)

报告8例骨的恶性纤维组织细胞瘤。肉眼观大小形态很不一致。镜下观主要为纤维母细胞样细胞,呈车辐状排列,以及异形的单核双核和多核组织细胞。背景中常见有炎细胞及泡沫细胞,伴有出血坏死。以上特点少呈典型集中,故需多取材切片,以免误诊。并对起源、发病率、鉴别诊断等进行了讨论。     

猴泡沫病毒(SFV)RT-nestedPCR检测方法的建立及初步应用

目的建立实验猴群及相关生物制品猴泡沫病毒(SFV)的PCR检测方法。方法选择SFV-1、SFV-3、SFVCPZ前病毒序列的pol基因同源性较高的区域设计嵌套引物对SFV-1毒种进行RT-nestedPCR扩增并克隆测序,以确定其准确性,通过验证方法的特异性和敏感性,初步应用该方法对恒河猴外周血淋巴细胞(PBLs),常用猴肾传代细胞及猴源性生物制品进行检测。结果经RT-nestedPCR扩增出的片断与SFV-1 cDNA序列同源性达到99%,对10只恒河猴的检测结果为5只阳性,5只阴性,对常用猴肾传代细胞及脊髓灰质炎疫苗的检测结果均为阴性。结论所建立的SFV RT-nestedPCR检测方法能准确的检测出恒河猴SFV的感染情况,对控制实验猴群的质量具有重要意义。该方法可用于检测猴源性生物制品中SFV的污染情况,为保证生物制品应用的安全性提供一定依据。     

Successful resuscitation after carbon dioxide embolism during laparoscopic-assisted abdomino-perineal resection

We report a 67-year-old woman who underwent laparoscopic-assisted abdomino-perineal resection for rectal carcinoma. She sustained hypotension of 40/20 mmHg associated with bradycardia (heart rate 30 to 45 beats per minute) and an end-tidal carbon dioxide level of zero when she was raised to a head-up position at the end of surgery to facilitate pelvic irrigation. Pulmonary air embolism was confirmed by aspiration of 15 millilitres of foamy blood from her central venous line. Resuscitation was successful and she recovered completely with no neurological deficits.