Radiographic manifestations and pathologic basis of parosteal osteosarcoma. Analysis of 17 cases.

The authors reviewed the radiographic manifestations of 17 cases of parosteal osteosarcoma, with pathologic correlation in 15. There were two types of parosteal osteosarcoma radiologically. The majority of cases were type I with uniformly dense masses which had regular borders. They often adhered to the cortex and showed no evidence of soft-tissue invasion which correlated with low-grade pathologic malignancy and a relatively benign clinical course. Type II involved the bone, soft-tissue and the medullary cavity. These lesions were poorly differentiated and frequently accompanied by metastatic lesions.

     

膝交叉韧带重建术的护理配合

随着社会经济的不断发展，由于交通及运动损伤引起的膝关节损伤目趋增多。交叉韧带是维持膝关节稳定的重要结构，韧带的断裂会引起关节不稳，若时间长会发展成创伤性关节炎，严重影响病人的工作与生活。膝交叉韧带重建术，尤其在关节镜监视下重建是近年来发展起来的一项新技术，通过手术能有效地恢复关节的稳定与功能，但手术的效果优劣在很大程度上取决于手术技术及术中医护配合的好坏。2000年7月-2003年7月，我院共行膝交叉韧带重建术236例，现将护理配合报告如下。     

Renal Transplantation in Patients With Pre-Transplant Donor-Specific Antibodies and Negative Flow Cytometry Crossmatches

The clinical significance of pre-transplant donor-specific antibodies (DSA), despite negative cytotoxicity and flow cytometry crossmatches (FCXMs), is unknown. We performed a retrospective cohort study of 60 living donor renal transplant recipients, all with pre-transplant cytotoxicity and T-cell and B-cell FCXMs that were negative. Twenty recipients had pre-transplant DSA detected by enzyme-linked immunosorbent assays (ELISA) and/or microbead methods. Forty contemporaneous DSA-negative controls were selected. In the DSA-positive group, after a median follow-up of 8.2 months (25-75% range, 5.4-22.8 months), patient survival was 100% and allograft survival was 95.0%. Acute humoral rejection (AHR) developed in four patients (20.0%). Three of the AHR episodes occurred within the first month post-transplant. Median serum creatinine at last follow-up was 1.3 mg/dL (25-75% range, 1.0-1.6 mg/dL), versus 1.1 mg/dL (25-75% range, 0.9-1.4 mg/dL) in the DSA-negative controls (p = 0.29). Only one of the 40 controls developed AHR (2.5%). Pre-transplant DSA was associated with a significantly increased incidence of AHR (p = 0.02 by log-rank test). In conclusion, despite negative pre-transplant cytotoxicity and FCXMs, renal transplant recipients with pre-transplant DSA detected by solid-phase methods may have an increased incidence of AHR and require close monitoring post-transplant.     

发挥远程教育优势推进医学继续教育发展

《教育部关于加强高校网络教育学院管理提高教学质量的若干意见》中强调指出：高校网络教育学院要以在职人员的继续教育为主，要充分发挥网络教育的优势，为在职人员更新知识、增强技能、不断学习、不断提高提供良好的服务。然而，要使医学院校在开展继续教育中发挥更大的作用，推进医学继续教育的发展，远程教育不仅是解决这一问题的有效途径，而且将成为开展医学继续教育的强大动力。     

12种中草药的乙醇提取液对印鼠客蚤的毒效研究

目的:探讨中草药灭蚤的可行性。方法:用乙醇提出12种中草药的可溶成分,以瓶膜法测定其对印鼠客蚤的毒力。结果:在0.5g/ml(生药)的浓度下,10种中草药对印鼠客蚤有速效击倒作用,其中鸡血藤、巴豆仁、除虫菊花的10min击倒率大于50％;5种中草药的KD_(50)小于15min,比2％DDVP为优;巴豆仁接触30min恢复24h死亡率为70％。结论:除虫菊花、黎芦、鸡血藤、巴豆仁、贯众用于杀蚤有一定价值。     

核素显像对小儿消化道出血的病因诊断

目的探讨核素显像对小儿消化道出血，特别是对Ｍｅｃｋｅｌ憩室、肠重复畸形的病因诊断的价值。方法对２６例腹痛、便血为主要症状的患儿行９９ｍ锝酸盐（９９ｍＴｃＯ－４）显像，其中１２例显像阴性者于检查后２４小时有活动性出血者，再行９９ｍ锝标记红细胞显像。所有病例的诊断均经手术、病理及内窥镜等检查所证实。结果９９ｍＴｃＯ－４显像诊断Ｍｅｃｋｅｌ憩室和肠重复畸形的敏感性、特异性、准确性分别为８５．７％（１２／１４）、９１．７％（１１／１２）及８８．５％（２３／２６）。结论核素显像具有无创、方法简单易行等特点，特别是对异位胃粘膜诊断具有较好的灵敏性和特异性。核素显像可作为下消化道出血病因诊断的有效方法。     

慢性肺心病左心功能探讨

通过42例重型肺心病、7例轻型肺心病、16例肺心病伴发冠心病患者和30例正常人在静息状态下的左右心脏射血分数及其临床资料的分析表明,重型肺心病患者在病情的急性发作期,存在有不同程度的左心功能不全,而轻型肺心病患者则无左心功能不全的表现。表明慢性肺心病仅在病程晚期,才由以右心为主的疾病发展成为全心病。本文还对重型肺心病与肺心病伴发冠心病患者的左心功能进行比较,结果表明,肺心病伴发冠心病患者左室功能受损程度更为明显,双重病因导致的左室功能减退,常造成心肌更严重的损害而且不容易恢复。