原发性脾脏恶性淋巴瘤6例

1　临床资料　　本组 6例病人采用 Kehoe提出诊断原发性脾脏恶性淋巴瘤 (PSL )的标准 :病变首发于脾门淋巴结 ,可有少数的腹腔淋巴结、骨髓及肝受侵。其主要临床资料见表 1。表 1　本组 6例 PSL的临床资料例号 临床诊断临床表现 淋巴结肿大肝 (cm)(肋下 )脾 (cm)(肋下 )Hb(g/ L)WBC× 1 0 9/ LBPC× 1 0 9/ L 骨髓象病理结果 分期 治疗方案转归1脾脏占位左上腹肿块无 0 81 30 5.81 2 0 增生性骨髓象巨块型NHL弥漫型大细胞型 手术切除BACOPF方案CR无病存活 4年2 脾功能亢进发热、乏力左上腹肿痛 无 3 5 691 .7 58-均匀弥漫型NHL…     

小儿急性淋巴细胞白血病长期生存2例

例1:患儿,女,9岁,因“乏力、面色苍白14天”而于1997年10月27日住院。入院时查体:一般状态差,贫血貌,全身皮肤无出血点,淋巴结肿大(O．5cm×0．5cm)。肝右肋下6．0cm,质中度硬,脾左肋下2．0cm、当时血常规:WBC12．7×109/L,Hb86g/L,BPC75×109／L。末梢血象:可见大量原幼淋巴细胞,骨髓象示骨髓增生明显活跃,原幼淋巴细胞占0．80,诊断为急性淋巴细胞白血病(简称ALL),L2型,标危型。     

尼曼-匹克病11例报告

我院血液科于 1 994年 6月至 2 0 0 1年 1 0月共诊治尼曼 -匹克病 1 1例。根据病史资料 ,对其临床表现和体征及实验室检查进行分析 ,现报告如下。临床资料1　一般资料　 1 1例患儿 ,其中男 6例 ,女 5例 ,年龄最小的 8个月 ,最大的 1岁 8个月 ,平均年龄 1岁 3个月。其中≤ 1岁 5例 ,1～ 2岁 6例。2　临床症状与体征　 1 1例患儿均以肝、脾肿大为首发症状 ,并伴有反复腹泻 ,轻至中度贫血 ,发热及生长发育迟滞 ,智力减退的临床表现。体征 :面色苍白示轻至中度贫血者 1 0例 ,淋巴结肿大 9例 ,1 1例患儿肝脾均肿大。肝肋下 3～5 cm2例 ,肋下 8～ …     

持续发热伴肝脾肿大

病史摘要患者男性,24岁,于1982年7月骤起发热(38℃)、咳嗽。肝肋下7cm,剑突下8cm,脾肋下1.5cm,血白细胞数4×10~9/L,血沉10mm/h,骨髓报告为感染性骨髓相。7月下旬转     

肝糖原沉积病1例

患儿男 ,2岁。以间断性鼻出血 2年 ,腹部膨隆 1年之主诉入院。否认家族性遗传病史及传染病接触史。查体 :一般情况好 ,皮肤、巩膜无黄染及出血点 ,心肺未闻及异常 ,腹壁静脉怒张 ,肝右肋下 1 2 cm,脾左肋下 7cm,质中边锐 ,表面光滑 ,无触痛 ,移动性浊阴性。B超 :肝光点细密 ,肝内血管内径细。肝功 :谷丙转氨酶 88U/L,谷草转酶 1 0 7U/L(正常值 0～4 0 U /L) ,铜蓝蛋白 :5 .74 U(正常值 3.3～ 6 .1 U)。临床诊断 :1肝糖原沉积病 ;2肝豆状核变性。病理检查 :肝脏穿刺标本镜下观察 :肝小叶结构存在 ,小叶内肝细胞明显肿胀 ,淡染 ,肝细胞排…     

慢性粒细胞性白血病伴有Gaucher细胞1例报告

慢性粒细胞性白血病(简称慢粒)骨髓涂片见到Gaucher细胞,文献报道较少。我们曾遇到1例,报告如下。病历摘要男患,49岁。因左上腹肿块并隐痛20天,加重伴持续疼痛数日及劳动时气短、乏力,于1982年1月15日入院。查体:颈淋巴结稍肿大,肝肋下3cm,剑下5cm,脾肋下9cm,质硬有触痛,胸骨明显压痛.余均正常。实验室检查:红细胞3.23×10~(12)/L,     

羟基脲导致多发性顽固性皮肤溃疡1例

患者 ,男 ,35岁 ,因腹胀、消瘦、乏力 2个月 ,咳嗽 1个月 ,发热 1 0d于 1 996年 7月 9日入院。体查 :皮肤无出血点 ,浅淋巴结无肿大。胸骨无压痛 ,心肺未见异常。脾肋下A线 1 0cm ,B线 1 4cm ,C线 0cm ;WBC 2 1 7× 1 0 9/L ,Hb 77g/L ,Plt 81×1 0 9/L ;白细胞分类 :原粒 0 0 0 ,早幼粒0 0 3;骨髓增生极度活跃 ,原粒细胞0 0 2 5 ,早幼粒细胞 0 0 2 5 ,中性中幼粒细胞 0 36 ,晚幼粒细胞 0 2 8,杆状核中性粒细胞 0 0 6 ,分叶核中性粒细胞 0 0 35 ,骨髓活检 :符合慢性粒细胞白血病骨髓改变。诊断为慢性粒细胞性白血病 (慢性期 )…     

华支睾吸虫病1例报道

华支睾吸虫病在我国分布于 2 5个省、市、自治区 ,其中以广东省感染最高 ,但我省仅有散在少数病例报道。 2 0 0 2年 1 0月在本院发现 1例 ,报告如下。患者 ,男 ,61岁 ,因上腹持续性隐痛反复发作1 0余年 ,再发 (加重 ) 7d ,于 2 0 0 2年 7月 8日入院。入院查体 :T 36 7°C ,P 84次 /min ,R 2 1次 /min ,神清 ,急性痛苦面容 ,皮肤黏膜及巩膜均未见黄染 ,腹平软 ,上腹剑下压痛 ,无反跳痛 ,肝、脾未扪及。B超检查 :肝脏左叶增厚 5 6cm。胆囊增大为 8 5cm× 3 8cm ,囊壁粗厚 ,可见多个米粒大小强光点 ,颈部见一 1 3cm大小强光团。肝内胆管轻…     

原发性门静脉高压症1例报告

原发性门静脉高压症 (IPH) [1 ] 临床上较为少见 ,1999年3月 2 0日我院收治 1例 ,报告如下。1　病历报告　　患者 ,男 ,10岁。因腹胀逐渐加重并发现脾大 1年 ,外院诊为布加综合征于 1999年 3月 2 0日转入我院。否认有肝炎病史及血吸虫疫区生活史 ,无呕血黑便史。查体 :发育中等 ,营养欠佳 ,无肝掌及蜘蛛痣 ,胸腹壁有浅静脉轻度曲张 ,腹略胀 ,肝肋缘下 3cm,剑突下 5 cm,脾肋缘下 4cm,腹水征阳性 ,双下肢不肿。食管钡餐 X线示 :食管中下段管壁增厚 ,粘膜皱壁轻度不均匀增粗。下腔静脉造影示下腔静脉通畅 ,无狭窄及阻塞。肝穿刺肝静脉造影示…     

新生儿钩虫性贫血1例报告

患男 ,3 5 d,因黑便半月于 1 998年 9月 1 1日入院 ,患儿于生后 2 0 d不明原因黑色稀便 ,每日 6～ 8次 ,量多 ,开始有少量粘液 ,继之成柏油样 ,无发热、呕吐、腹胀及拒乳现象 ,在当地治疗 5～ 6 d无效来我院。患儿系 G2 P2 ,足月顺产 ,旧法接生。生后一般情况良好 ,母乳喂养 ,曾在污水中洗尿布 ,其母孕期无贫血病史 ,家族中也无出血性病史。查体 :T3 6 .5℃ ,发育营养一般 ,神志清 ,精神差 ,面色苍白 ,呈严重贫血貌 ,皮肤黏膜苍白 ,心肺无异常发现 ,肝右肋下 2 cm,剑突下 1 .5 cm,质软 ,脾肋下未触及。实验室检查 :Hb3 0 g/L,Rb C1 .5×1…     

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.     

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.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.