中国人甲状腺乳头状癌中ret基因重排及类型的分析研究

目的 建立ret基因重排的分析方法，提示中国人甲状腺乳头状癌中是否存在原癌基因ret重排及重排类型。方法 应用RT—PCR方法对65例甲状腺乳头状癌石蜡切片标本进行ret基因重排检测，并对扩增结果进行测序鉴定。结果 在提取RNA成功的38例甲状腺乳头状癌(PK)标本中，有71％发生ret重排，其中10．5％表达RTC1；5．3％表达PTC3；5．3％表达PTC4，以PTC1发生的频率较高。仅1例表达PTC2与PTC3／PTC4混合型重排，中国人PTC可能与ret和H4及ELE1重排激活相关。结论 中国人PTC组织中存在4种重排，且以PTC1较为常见。单一标本中有多种重排形式并存，PTC1 3重排形式10例、3例PTC1 4、1例PTC2 3 4、1例PTC1 4、4例PTC1 3 4，单一标本中多种重排形式并存的比例高达50％，但与癌症的恶性程度、转移等无必然联系。     

甲状腺微小癌的影像诊断与治疗

根据WHO确定的标准,直径≤1.0cm的甲状腺乳头状腺癌(papillary thyroid carcinoma,PTC)称为甲状腺乳头状微小腺癌(papillary thyroid microcarcinoma,PTMC)是甲状腺乳头状癌的亚型[1]。随着高频超声检查的普遍开展和术中冰冻病理检查广泛深入,甲状腺微小癌的临床检出率有明显上     

甲状腺冷冻切片与石蜡切片的病理诊断

目的:总结冷冻切片诊断的经验,探讨误诊及延迟诊断原因,提高甲状腺冷冻切片的准确率。方法:回顾性对比分析284例甲状腺冷冻切片和石蜡切片。结果:冷冻切片诊断良性病变245例,恶性肿瘤29例,延迟10例;石蜡切片对照良性病变249例,恶性肿瘤35例。其中冷冻切片假阴性诊断3例(1.06%),冷冻切片确诊率为95.42%。结论:重视大体检查,提高切片质量,提高对甲状腺良、恶性病变的鉴别力,可提高甲状腺冷冻切片诊断的准确率。     

甲状腺乳头状癌多层螺旋CT诊断与影像分析

目的通过对有完整资料的患者颈部甲状腺CT平扫及增强扫描后的影像分析,有助于提高CT对甲状腺乳头状癌诊断的检出率,减少误诊,为临床提供最佳的治疗方案。方法对59例病理证实的有完整临床资料的甲状腺乳头状癌多层螺旋CT(MSCT)征象进行分析、总结、整理。结果 59例甲状腺乳头状癌,有63个乳头状癌性灶。病灶包膜破损的有39个,占62%。镶嵌征有23个,占36%。钙化有18个,占29%,其中粗钙化(除砂砾样钙化外)有12个,占总钙化灶67%。结论甲状腺MSCT征象中,病灶包膜破损、镶嵌征、钙化(特别是大钙化),对甲状腺乳头状癌诊断有重要价值。     

淋巴细胞性甲状腺炎合并甲状腺乳头状癌18例分析

目的探讨淋巴细胞性甲状腺炎(HT)合并甲状腺乳头状癌(PTC)患者的病因、病理相关性及诊断与治疗。方法回顾性分析我科自2006年2月—2011年2月收治的18例HT合并PTC患者的临床资料。结果 18例患者术前彩超均发现甲状腺低回声团块,发现伴钙化灶7例,提示恶性者2例。术前甲状腺球蛋白抗体(TG-Ab)升高7例,甲状腺过氧化物酶抗体(TPO-Ab)升高4例,两者均升高3例。1例行细针穿刺活检(FNA)确诊为乳头状癌。所有患者均行手术治疗。结论 HT与PTC病因、病理上呈明显的相关性,术前结合TG-Ab、TPO-Ab、超声检查、FNA综合分析有助于HT合并PTC的诊断,手术治疗是针对HT合并PTC的有效治疗方法,我们应打破传统HT内科治疗,高度警惕HT合并PTC。     

乳腺导管内乳头状瘤病46例冷冻切片诊断分析

为不断提高对乳腺导管内乳头状瘤病术中冷冻切片的诊断水平,加强冷冻切片与石蜡切片的比较分析十分重要。现对我院2002年8月～2005年8月的乳腺导管内乳头状瘤病冷冻切片作一回顾性分析。     

甲状腺乳头状癌的超声征象对评估其颈部淋巴结转移的价值

目的探讨甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的超声征象在评估其颈部淋巴结转移中的应用价值。方法对147例经手术病理证实的甲状腺乳头状癌的超声表现进行分析,根据病理结果分为有淋巴结转移组(实验组,54例)和无淋巴结转移组(对照组,93例)。对可能导致颈部淋巴结转移的甲状腺乳头状癌的超声表现进行单个因素分析,分析的超声征象包括有无晕环、有无微钙化、有无包膜侵袭及包膜侵袭程度、最大直径、纵横比、边界等。结果对可能导致甲状腺乳头状癌颈部淋巴结转移的单个因素与病理结果进行统计学分析显示,原发癌结节的晕环、微钙化、包膜侵犯、最大直径的差异对颈部淋巴结转移有统计学意义(P0.05),而原发癌结节的边界、纵横比的差异对颈部淋巴结转移无明显统计学意义(P0.05)。结论甲状腺乳头状癌的部分超声征象对于颈部淋巴结转移有相关性,分析其超声征象有助于颈部淋巴结转移的诊断。     

MASP-2在甲状腺肿瘤中的表达及其临床意义

目的探讨甘露糖结合凝集素相关的丝氨酸蛋白酶（MASP-2）在甲状腺肿瘤组织中的表达及其临床意义。方法应用免疫组化SP技术检测26例甲状腺乳头状癌（PTC）及其癌旁正常甲状腺组织,30例甲状腺腺瘤组织（TA）中MBL蛋白的表达含量;结合甲状腺乳头状癌患者的临床病理参数进行分析。结果 MASP-2在甲状腺乳头状癌、腺瘤中的表达分别为（0.332±0.046）和（0.221±0.030）,癌旁正常甲状腺组织中无表达,各组间差异有统计学意义（P〈0.01）;与性别、年龄、分期、肿瘤大小、淋巴结转移无明显相关性（P〉0.05）。结论 MASP-2在甲状腺肿瘤的发生过程中起了一定作用。     

甲状腺乳头状癌的超声特征分析

目的:探讨甲状腺乳头状癌的超声特征。方法:对经手术病理证实的90例甲状腺乳头状癌的超声表现进行回顾性分析。结果:超声检出86例89个结节,病灶检出率94.7%,提示或诊断甲状腺乳头状癌59例,未提示性质16例,误诊为腺瘤3例、结节性甲状腺肿8例;漏诊4例。甲状腺乳头状癌的超声特征为实性低回声,形态不规则,边界模糊,伴有微钙化,血供较丰富。结论:甲状腺乳头状癌具有典型的超声特征,但是部分甲状腺乳头状癌,特别是微小癌,恶性特征不明显,并且甲状腺乳头状癌易与良性病变并存。因此,掌握超声诊断特征,细致观察每一个结节,警惕微小癌的存在,是提高诊断率的关键。     

超声检查联合血清学检测对甲状腺乳头状癌侵袭性评估的研究

目的探讨超声检查联合血清学检测对甲状腺乳头状癌(papillay thyroid carcinoma, PTC)侵袭性评估的价值。方法对355例病理确诊为甲状腺乳头状癌的患者分为有淋巴结转移组及无淋巴结转移组,将两组患者的相关超声特征和血清学检测结果进行相关性分析。结果 1)355例患者术后病理中有颈部淋巴结转移者134例,无淋巴结转移者221例;2)单因素分析显示甲状腺乳头状癌≥1.5cm、多发病灶、结节内微钙化灶发生颈部淋巴结转移增多(P0.05),以结节内微钙化灶预测更有价值;3)单因素分析显示TSH、TG、TgAb、TPOAb中,TSH、TG水平升高对预测淋巴结转移有较高价值(P0.05)。结论超声指标中结节大小、结节数目和结节内微钙化灶与甲状腺乳头状癌侵袭性具有一定的相关性;血清学检测中,TSH、TG对甲状腺乳头状癌的颈部淋巴结转移有一定的预测价值。超声指标联合血清TSH、TG检测在甲状腺乳头状癌颈部淋巴结转移及结节的侵袭性预测中有重要的临床价值。     

Optimization of the system of medical service of students of Cadet Schools of the Ministry of Defense of the Russian Federation

One of the factors of the successful military career guidance Cadet schools students is preserving and promoting their health. Medical support of children and adolescents aged 10-17 years should include the full range of medical and preventive measures defined for this group. The state of providing outpatient care for pupils at the Cadet School in St. Petersburg was studied. These results show that full medical care in accordance with the standards can be based only on children's health clinics. It is important that the organization of medical support pupils cadet schools should be cooperate with civilian health care.     

带状疱疹83例误诊原因分析

带状疱疹是由水痘—带状疱疾病毒引起的皮肤科常见疾病。其主要的病理损害,一是受累神经的严重炎症性浸润,继而导致受侵犯神经节内神经细胞变性、坏死;二是皮肤的水泡。迅速抑制神经节和相应的感觉神经纤维的充血、水肿和坏死,防止粘连形成,达到迅速镇痛、改善皮损,缩短病程及防止后遗症的发生是治疗的关键。因而,尽早明确诊断,     

Estimation of accumulated dose of radiation by method of ESR-spectrometry of dental enamel of mammals

ESR-spectrometry was used to investigate radiation-induced paramagnetic centers in enamel of mammals: carnivores (polar bear and fox), ungulates (reindeer, European bison, moose), and man. Values at half the microwave power saturation of the radiation signal, P_1/2, evaluated at room temperature, was found to range from 16 to 26 mW for animals and man. A new approach to discrimination of the radiation induced signal from the total ESR spectrum of reindeer enamel is proposed. ‘Dose-response’ dependencies of enamel of different species mammals were measured within the dose range from 0.48 up to 10.08 Gy. Estimations of ‘radiosensitivity’ enamel of carnivores and ungulates showed good agreement with radiosensitivity enamel of man by ESR method.     

Analysis of the results of the international comparison of activity measurements of a solution of Fe

The results of an international comparison of activity measurements of a solution of ⁵⁵Fe organized by the BIPM in 2005 are reported and analysed. This exercise, which follows the procedures of the CIPM mutual recognition arrangement to update older comparisons, is a renewal of the comparison organized by the BIPM that took place in 1978. A EUROMET comparison was organized in 1996 specifically to compare activity measurements of a ⁵⁵Fe solution by means of liquid-scintillation techniques. Results of these three comparisons are presented and discussed in this paper.

The radionuclide solution was provided by the NPL, which also distributed the samples to the participants. The activity of the ampoules was measured by 16 laboratories using 12 methods producing 25 results. Some general considerations on uncertainty assessments pertaining to the different techniques used are drawn. The outcome of four different estimators is compared from which the presence of at least one outlier can be confirmed. Further measurements should be made to try to reduce the discrepancy between the results. To date the outcome of the present comparison does not show an improvement to that of the 1996 comparison.     

Evaluation of the results of various technics of non-surgical therapy of varicocele

A new method of non-surgical treatment of varicocele syndrome is described: it consists in sclerotherapy of spermatic vein by trans-femoral percutaneous catheterization with balloon-catheters. In 8 cases venous thrombosis has been induced by direct electric clotting. The techniques and a 6 months follow-up are discussed. It is pointed out that this procedure should be considered as the method of choice for tubular lesions and sub-fertility prophylaxis in young people and in childhood.     

延迟性脾破裂误漏诊原因分析

目的探讨延迟性脾破裂误漏诊原因和预防措施.方法回顾性分析总结12例延迟性脾破裂中的诊断和误漏诊的经验与教训.结果本组延迟性脾破裂的误漏诊5例(41.66%).对多发伤与脾破裂并存可能认识不足,外伤史轻微或伤员隐瞒外伤史,缺乏腹痛-缓解-突然再腹痛的典型病史,缺乏“对冲性脾破裂”力学分析和整体化诊断思路等为其误漏诊的主要原因.结论详细的外伤史和全面系统检查,重视腹以外多发伤掩盖腹内脏器伤及延迟性脾破裂可能.确立外伤-腹内脏器伤-脾破裂整体化诊断思路.不间断地辅以B超检查脾形态学变化和腹内有无积液,腹腔穿刺确定有无血腹、X线胸腹部检查观察左侧胸肋角和膈肌运动情况、必要时CT检查以尽早发现脾包膜下血肿,降低延迟性脾破裂误漏诊率.