膀胱间质瘤3例分析

目的 探讨膀胱间质瘤的临床特点及治疗方法,提高诊治水平。方法回顾性分析总结3例膀胱间质瘤的临床资料。结果本组膀胱间质瘤3例,其中1例行经尿道膀胱肿瘤电切术,3个月后复发,后行膀胱部分切除,随诊2年无复发,2例直接行膀胱部分切除术,其中1例2年无复发,另1例半年内无复发。结论对于B超提示低回声或等回声团块,边界清晰,膀胱粘膜表面光滑,无血流或少血流的膀胱肿瘤,应行膀胱镜检查,若膀胱粘膜光滑,应高度怀疑膀胱间质瘤,宜行膀胱部分切除。     

口腔黏膜天疱疮临床诊断与治疗病例分析

口腔黏膜天疱疮临床非常多见,是一种严重的慢性皮肤黏膜大疱性自身免疫疾病,病因不明.寻常型天疱疮是临床最为多见的损害类型,口腔损害最早出现,口腔黏膜天疱疮的早期诊断对本病的治疗有着非常重要的意义.本研究选取我院2008-2011年间收治的56例资料完整的天疱疮患者的临床资料作一回顾性分析.     

Toxicological evaluation of nitrosamines in condoms.

Volatile N-nitrosamines have been found in rubber products including gloves, balloons, toys, baby bottle teats, soothers, and condoms. N-Nitrosamines are potent carcinogens, and therefore, European legislation has limited the release of N-nitrosamines and N-nitrosatable compounds in teats and soothers to 0.01-0.1 mg/kg rubber, respectively. Previously, endogenous nitrosamine formation in the vagina has been suggested as a cause of cervical cancer. It was speculated that exogenous N-nitrosamines and N-nitrosatable compounds from condoms may also lead to genital cancer. Therefore, we reviewed the literature and calculated the risk for the induction of tumors by nitrosamines from condoms. In vitro Biaudet et al. (1997) found up to 88 ng nitrosatable compounds migrating from condoms to cervical mucous within 24 hrs. During sexual intercourse about 0.6 ng may migrate in the female genital mucous membranes because of the short contact to the condom, e.g. 10 min. Comparable amounts of nitrosamines may also migrate in the penile skin. Estimating 1500 contacts to condoms during lifetime (50 condoms/year for 30 years) this may result in the adsorption of up to 0.9 microgram nitrosamines in total. Animal studies in Syrian hamsters showed the induction of local and/or systemic tumors, in particular liver tumors, after topical application of nitrosamines to the skin or mucous membrane at a total dose of about 1 g. This dose exceeds the dose to be expected from contact with condoms by more than 1 million. Also, epidemiological studies do not support a role for condoms in the induction of cancer. The incidence of cervical cancer and liver tumors is high in developing countries, where condoms are seldom used. In addition, humans are regularly exposed to nitrosamines from food and tobacco smoke at a dose which is 1,000 to 10,000 fold higher than expected from condom use. In summary, the risk for the induction of tumors from nitrosamines in condoms is very low.     

结肠息肉样早癌患者早期血清炎症因子变化

目的探求结肠息肉样早癌的早期相关性炎症因子及抑癌基因指标,以期为临床早期诊断提供指导。方法通过结肠镜检查结肠息肉样变350例患者,电子结肠镜下息肉行粘膜切除（EMR）或剥离（ESD）后病理学检查证实结肠息肉样早癌变病例120例,检测血清促炎因子TNF-a、IL-6、Cox2及抑炎因子IL-10水平,并检测组织抑癌基因APC、PTEN、PHLPP的表达及230例单纯腺息肉患者与200例查结肠镜提示结肠粘膜正常对照组以上指标进行比较分析。结果病理活检证实结肠息肉癌变组与单纯结肠腺息肉组、正常结肠组比较,血清促炎因子IL-6、Cox2表达量增高（P〈0.05）,抑炎因子IL-10检测量减低（P〈0.01）,抑癌基因APC、PTEN、PHLPP,表达水平减低（P〈0.01）,血清TNF-a无统计学意义。结论对血清一些促炎症因子及抑炎症因子检测水平变化,与结肠息肉组织抑癌基因表达基本相一致,能对部分结肠早癌筛查及诊断提供临床指导,促炎症因子及抑炎症因子可能参与结肠息肉向早癌的演进。     

Comparative assessment of the strength properties of the mucous membrane of the stomach in patients with peptic ulcer and the effect of quamatel on ulcer cicatrization in experiment

The article reviews the research work of the authors on the strength properties of the mucous membrane of the stomach in patients with peptic ulcer and in experiment with quamatel application. Experiments were performed in laboratory animals and resected stomachs of patients with duodenal or stomach ulcer and complications requiring scheduled surgical treatment. The results of the research into the maximum tension (durability) of the stomach mucous membrane, antrum, and the periulcer area are described. For both localizations of the ulcer, the mucous membrane of the antrum was found to exhibit the least durability, while the highest durability was exhibited by the mucous membrane of the periulcer area. In the case of bulbar ulcer, the durability of the mucous membrane was shown to decrease with an increase in the number of aggravations. An inverse relationship between the strength properties and the intensity of hydrochloric acid production was observed.     

Intracranial actinomycosis in a child with dental caries

A diagnosis of intracranial actinomycosis was made in a 9-year-old boy with headache, cranial nerve dysfunction and ataxia. Poor dental hygiene leading to caries and an inflammation in his right upper jaw probably was the cause of cervicofacial actinomycosis with intracranial extension. A full recovery was achieved by treatment with benzylpenicillin. Actinomyces is a gram-positive bacterium belonging to the endogenous flora of the mucous membranes of the oropharynx, gastrointestinal tract, and female genital tract. Disruption of the mucous membrane is the portal of entry for an extremely destructive infective process that is effectively treated with penicillin. Good orodental hygiene is important for the prevention of actinomycosis.     

生长抑素受体在结直肠癌和正常黏膜表达及与细胞增殖和凋亡的关系

目的:研究生长抑素受体 (SSTR)在结直肠癌和相应正常黏膜中的表达以及与临床病理的关系,指导临床结直肠癌病人应用生长抑素及其类似物治疗. 方法:应用免疫组化法分别检测42例结直肠癌及其附近正常黏膜生长抑素受体,并同时检测细胞凋亡指数和增殖指数. 结果:免疫组化结果表明,结直肠癌中生长抑素受体蛋白表达率为83.3%(35/42),正常黏膜为92.9%(39/42),<0.001,表达阳性率差异无显著性意义,但表达强度差异明显,结直肠癌生长抑素受体表达明显低于正常黏膜,生长抑素受体表达阴性或弱阳性的肿瘤,相应的正常黏膜生长抑素受体表达中等强度或强阳性,而生长抑素受体中等强度阳性或强阳性表达的肿瘤,相应的正常黏膜均呈强阳性表达.而且不同表达强度的结直肠癌增殖指数和凋亡指数差异有显著性意义(P<0.001,P<0.001).生长抑素受体的表达强度与肿瘤病理分期、分化程度相关(P<0.001,<0.001),与病人年龄、性别、肿瘤大小无显著相关性(P=0.682,P=0.789,P=0.342). 结论:生长抑素受体在结直肠癌中有阳性表达,但表达强度明显低于相应正常黏膜.     

气钡双重对比造影在消化道疾病诊断中的应用价值

目的：探讨气钡双重对比造影在消化道疾病诊断中的应用价值。方法：收集某院2008-01—06经消化道气钡双重对比造影检查阳性并经临床随访或手术证实的消化道疾病患者197例,对其影像学资料进行回顾性分析。结果：197例患者中,源于黏膜的病变83例（包括炎症、肿瘤、溃疡）,源于黏膜下的病变24例（包括间质瘤、淋巴瘤、硬皮病）,以器官形态、结构、位置改变为主的病变38例（包括食管裂孔疝、腹股沟斜疝、憩室、肠旋转不良、巨结肠）,以器官动力、功能改变为主的病变29例（包括食管功能紊乱、肠系膜压迫综合征、小肠功能紊乱、结肠过敏）,因管腔外因素的影响而引起的改变17例（包括食管移位、胃移位、小肠移位）,其他病变6例（包括食管纵隔瘘、直肠阴道瘘、食管异物、小肠蛔虫症）。结论：气钡双重对比造影检查准备简单,操作方便,患者痛苦小,检查范围全面,诊断结论可靠,是消化道疾病首选的检查方法。     

表面活性物质对分泌性中耳炎咽鼓管粘膜病变的电镜观察

目的　从病理学角度来阐明表面活性物质对降低咽鼓管表面张力的作用及在治疗分泌性中耳炎中的作用。方法　将已制成分泌性中耳炎的豚鼠分成二组 ,各组 12只 ,分别用表面活性物质和地塞米松注入鼓室治疗 ,并以常规光镜、电镜程序制作标本 ,观察咽鼓管粘膜上皮的超微结构的改变。结果　发现二组在病理方面有显著的差异 ,表面活性物质治疗组咽鼓管粘膜上皮的纤毛微绒毛病变轻 ,纤毛表面可见稀薄的粘液毯 ,而地塞米松治疗组咽鼓管粘膜上皮的纤毛断裂、脱落或“细胞糜烂”等。结论　表面活性物质有保护咽鼓管粘膜上皮的作用 ,其机理主要是表面活性物质可降低纤毛粘液毯的表面张力 ,防止管壁粘着 ,有助于分泌物的排出。     

新生儿早期基础保健项目实施对正常分娩足月儿患病的影响

目的 探讨新生儿早期基础保健(EENC)项目实施对渭南市妇幼保健院正常分娩足月儿72小时内入院率、新生儿24小时内肺炎(吸入性肺炎)发生率、7天内高胆红素血症住院率、皮肤黏膜感染发生率的影响.方法 选取EENC项目实施5个月以来即2016年10月1日至2017年3月1日的1316例正常分娩足月儿作为观察组,选取实施开展EENC项目前一年同时间段即2015年10月1日至2016年3月1日正常分娩足月儿1520例作为对照组,分别对两组72小时内的入院率、24小时内肺炎发生率、72小时内皮肤黏膜感染发生率、7天内高胆红素血症发生率进行统计对比.结果 EENC项目实施后,观察组的24小时内肺炎(吸入性肺炎)发生率、72小时内皮肤黏膜感染发生率、72小时内入院率均低于对照组,差异均有统计学意义(χ2值分别为5.030、4.030、8.890,均P<0.05);7天内高胆红素血症的诊断率两组比较无统计学差异(P>0.05).结论 EENC项目实施后渭南市妇幼保健院正常分娩足月儿的72小时内入院率、24小时内肺炎发生率、72小时内皮肤黏膜感染发生率均有明显降低,且7天内高胆红素血症的住院率增加不显著,此项目在该院适用性良好.     

氨溴索治疗豚鼠分泌性中耳炎后咽鼓管黏膜的超微结构研究

目的应用氨溴索治疗豚鼠分泌性中耳炎后,用超微细胞化学方法观察豚鼠咽鼓管黏膜细胞超微结构。方法用已制成分泌性中耳炎的豚鼠分成2组,分别用氨溴索及生理盐水注入鼓室,电镜及光镜下观察咽鼓管黏膜上皮超微结构的变化。结果2组在病理方面有显著差异,氨溴索治疗组咽鼓管上皮的纤毛及微绒毛病变轻。结论应用氨溴索治疗豚鼠分泌性中耳炎前后咽鼓管黏膜上皮板层体样结构的数量增加,结构迅速恢复。     

电镀业职业性皮肤、鼻、咽部病变的调查——附上海两家电镀厂的调查和随访

本文报告1980年上海两家电镀厂261名职工职业性皮肤及鼻、咽部损害发病情况及1986年对其中104名随访结果。皮肤反应方面以接触皮炎最多见。通过随访以认识 一些发展规律，并藉皮肤斑试以探讨皮炎发生的因素和致敏特点。鼻、咽部经随访有增多趋势，而鼻中隔粘膜糜料往往导致鼻中隔穿孔，应予重视。结合实际提出初步防治建议。     

Health impacts on workers in wastewater treatment plants in jeddah city, saudi arabia

Wastewater workers are exposed to various job-related hazards. This work was carried out in the period from November, 2004 to January, 2005. All workers (one hundred and ninety two workers) in the Jeddah Municipal Wastewater Treatment Plants (MWTP) were interviewed. They were asked to answer a precoded questionnaire that included personal data and complete medical (present, past, and family) history. They were also asked about history of previous medical examinations in details. Psychological problems were the most common health problems as they formed 84.4% followed by mucous membranes' irritation which constituted 42.2%. The percentage of workers following the safety precautions: wearing anti-slide shoes; the use of personal protective tools for the protection of the skin and eyes; the use of safety precautions in mixing chemicals; the safe storage, transfer, and circulation of chemicals; and ensuring the safety of electrical appliances were 14.6%, 75%, 13.5%, 91.7%, and 95.8%, respectively. The T-test was carried out between those having mucous membrane irritation and those who didn't have mucous membrane irritation as regards the duration of work and it was found to be statistically significant (p=0.000). Those who suffered from mucous membrane irritation have mean work duration of 5.04 years whereas those without irritation have a mean of 6.75 years. Finally, t-test was carried out between those having psychological problems and those who didn't have psychological problems and it was found to be significant (p=0.007). The mean work duration for those suffering from psychological problems was 6.2 years whereas those who didn't suffer from psychological problems had a mean work duration of 5.1 years.     

Transbronchial biopsy in diffuse infiltrative lung diseases]

224 transbronchial biopsies were made between 1990 and 1997 in 208 patients suffering diffuse, bilateral, disseminated pulmonary diseases with unidentified origin. The examinations were carried out by flexible bronchoscope with X-ray control after local anaesthesia. The obtained patterns yielded mucous membrane in 15, intact alveoli in 19 percent. In 25 percent of biopsies (57 cases) definitive diagnosis were verifiable. The histological examinations verified the diagnosis of sarcoidosis, hemosiderosis, TB, malignancies, eosinophil pneumonitis etc. In 71 biopsies (62 cases) according to histological opinion were pulmonary fibrosis or some synonyms of these (alveolitis, interstitial fibrosis). From these latter cases the documentation of 18 patients were insufficient, but the data of 44 cases were available. 7/44 carcinosis, 3/44 inactive TB, 8/44 regressive X-ray patterns were verifiable in this group. The idiopathic pulmonary fibrosis as final diagnosis only in 18/44 (41%) cases were established. Further diagnostic procedures are needed if the clinical data, the results of HRCT and histological examinations are not in correlation.     

No consistent risk factor pattern for symptoms related to the sick building syndrome: a prospective population based study

Objectives: To examine associations between perceived indoor environment at work and the non-specific symptoms that are often referred to as the sick building syndrome (SBS), using cross-sectional and prospective analyses for a large cohort from the general population. Methods: The sample comprised 2,164 adults in employment, who completed a postal questionnaire in April 2001. Of these 1,402, who were still working and living in the same place, completed a second questionnaire a year later. The outcome measures were the prevalence of mucous membrane symptoms and general symptoms at baseline and the incidence and persistence of these symptoms at follow-up. Self-reports of the indoor environment from the baseline questionnaire were used as predictors in the analyses. Results: Inconsistent results were found between the cross-sectional and the longitudinal analyses for the associations between perceived indoor environment factors at work and symptoms. Whereas mucous membrane symptoms in the cross-sectional analysis were significantly associated with self-reported high temperature and dry air, the prospective analyses showed that onset of mucous membrane symptoms was associated with the sensation of draught, dry air, and noise. Persistent mucous membrane symptoms were associated only with stuffy air. General symptoms were associated with self-reported stuffy air and dry air in the cross-sectional analysis, while draught was the only predictor of onset of general symptoms. We found no predictors in the indoor environment for the persistence of general symptoms. Conclusions: The symptoms that are often connected with SBS are very common symptoms in the general population among manual workers as well as non-manual workers. Our study gives only limited support to the hypothesis of causal relationships between the indoor environment and these symptoms. We found no evidence of persistent mucous membrane symptoms and general symptoms related to specific factors in the indoor environment.     

胃间质瘤的X线、CT诊断

目的：探讨胃间质瘤的X线、CT表现及诊断价值.方法：收集X线、CT及手术病理证实为胃间质瘤的8例资料,分析其影像学检查技术及诊断价值.结果：X线表现为肿块边缘光整、清晰,周围黏膜推移,未见中断、破坏;CT扫描见软组织肿块与周围正常组织、器官分界清晰,正常组织、器官呈明显的推移征象.对肿块部位采用薄层扫描,必要时变换体位扫描显示更佳.结论：对于发生于胃的软组织肿块,利用多种影像学检查方法和手段进行综合评价,病变与周围的正常胃壁界限清晰,且正常胃壁柔软、光滑,首先考虑可能为GST.电镜和免疫组化是确诊GST的主要病理手段,其具有特定的免疫组化物质的表达,即CD34、CD117.     

内镜诊断与治疗19例消化道神经内分泌瘤分析

目的探讨消化道神经内分泌瘤(NET)的内镜诊断、治疗及预后。方法收集某院经组织病理学和免疫组化确诊的19例胃肠道NET病历资料进行分析。结果 19例中肿瘤单发17例,多发2例,内镜表现为息肉、糜烂、溃疡、隆起病变等。直径≤10 mm病变,内镜窄带成像(NBI)见病变表面毛细血管增粗或不规则,伴腺体缺失,超声内镜见病灶位于黏膜层;直径>15mm,NBI见病变表面毛细血管明显减少,超声内镜见病变已累及黏膜下层。对病变直径≤15 mm,病变局限于黏膜层,黏膜下层完整的14例患者行内镜下切除治疗,术后随访4~48个月,未见复发和转移。结论消化道NET内镜特点缺少特异性;对病变局限于黏膜及黏膜下层且直径≤10 mm病灶,内镜下切除是有效、安全的。     

医学监护在联苯胺作业膀胱癌高发人群中应用的意义

本文报道了对联苯胺作业膀胱癌高发人群实行医学监护的方法和结果。指出定期进行尿液脱落细胞检查,并对其中巴氏分级Ⅲ级以上者做膀胱镜检查,不但可以早期发现膀胱肿瘤,同时也可以对尿路粘膜上皮组织炎症及增生等病变作出一定的诊断。有利于早期治疗。尿液脱落细胞检查方法简便易行,对病人安全无痛苦,并可重复检验,诊断肿瘤的阳性率较高,可以作为普查和职业人群医学监护的主要手段。     

色素内镜诊断早期胃癌的临床应用研究

目的探讨色素内镜对早期胃癌的癌前病变的诊断价值。方法 2010年1月至2011年1月间68例常规胃镜检查下疑为早期胃癌的患者,其中38例予以色素内镜检查,30例予以单纯活检作为对照组,并与手术切除灶的病理结果进行分析比较。结果经黏膜染色后活检有31例病理结果为胃癌,诊断的阳性率为81.6%（31/38）,手术后病理结果证实有28例为早期胃癌,诊断的阳性率为73.7%（28/38）;对照组诊断胃癌以及早期胃癌的阳性率分别为43.3%（13/30）和23.3%（7/30）,两组间比较,差异显著（P〈0.05）。结论色素内镜诊断黏膜结构更清晰,对病变的定位以及目的性活检有利,可显著提高活检的阳性率,具很高的临床应用价值。     

Jn219抗轮状病毒的实验研究

目的 探讨真菌提取物Jn219在体内、外抗轮状病毒的作用.方法 利用含有Jn219的提取物,通过轮状病毒(RV)-MA104体外细胞感染模型,研究Jn219体外抗RV的作用;采用RV-乳鼠感染模型和疗效模型,以病理学、免疫组化技术探讨Jn219体内抑制病毒增殖、保护肠黏膜的作用.结果 Jn219在体外表现抑制RV SA11在MA104细胞增殖的作用,其半数抑毒浓度为1:384.92,抑毒指数为76.92;Jn219在体内抑制了病毒的复制,缓解了RV SA11感染引起的乳鼠腹泻,降低了乳鼠病死率,减轻了RV感染引起的肠道病理性变化.结论 Jn219在体外、体内均有抑制RV复制的作用.