做好病理组织切片的方法

<正>病理技术是病理学的重要组成部分,并广泛应用于临床和科研工作中。病理制片的质量直接影响着病理诊断的准确性,为保证病理医师的诊断准确,结合20余年实际工作经验,谈谈做好病理组织切片的体会。     

耳源性脑疝25例临床分析

耳源性脑疝25例,抢救成功者19例。采用单纯脑脓肿穿刺抽脓抢救脑疝6例,仅1例成功;开颅减压术抢救脑疝20例,18例抢救成功。本组临床实践和文献报道都说明耳源性脑疝一旦发生应即刻行开颅减压术,能卓有成效地抢救生命     

全营养素混合液(TNA)在肠外营养的应用

脂肪乳剂、葡萄糖、氨基酸、电解质、维生素及微量元素按一定程序混合配成10种全营养素混合液。在4℃14天贮存期内,10种混合液的pH和渗透压变化不大,不同混合液在不同时期的脂粒平均直径变化为0.3135±0.1012μm～0.4813±0.1893μm,94.93％脂粒的直径<0.6μm,无直径>6μm的脂粒,细菌培养阴性。74例共输全营养素混合液1,796次,无不良临床反应和异常实验室检查结果;用1周以上者大都显示氮平衡改善,用2周以上者血清转铁蛋白和白蛋白浓度可有不同程度升高。     

Acute Cellular Rejection with CD20-Positive Lymphoid Clusters in Kidney Transplant Patients Following Lymphocyte Depletion

Lymphoid clusters (LC) containing CD20-positive B cells in kidney allografts undergoing acute cellular rejection (ACR) have been identified in small studies as a prognostic factor for glucocorticoid resistance and graft loss. Allograft biopsies obtained during the first episode of ACR in 120 recipients were evaluated for LC, immunostained with CD20 antibody, and correlated with conventional histopathologic criteria, response to treatment and outcome. LC were found in 71 (59%) of the 120 biopsies. All contained CD20 positive B cells that accounted for 5-90% of the LC leukocyte content. The incidence of LC was highest in the patients who had no lymphoid depletion or had been treated with Thymoglobulin preconditioning (79% vs. 75%, respectively) compared to 37% in patients pretreated with Campath (p = 0.0001). Banff 1a/1b ACR were more frequent in the LC-positive than the LC-negative group (96% vs. 80%, respectively; p = 0.0051). With a posttransplant follow-up of 953 +/- 430 days, no significant differences were detected between LC-postitive and LC-negative groups in time to ACR, steroid resistance, serum creatinine and graft loss. CD20+LC did not portend glucocorticoid resistance or worse short to medium term outcomes. CD20+LC may represent a heterogenous collection in which there may be a small still to be fully defined unfavorable subgroup.     

提壶揭盖法治疗前列腺增生症82例

笔者自1995年以来，宗提壶揭盖法，用补中益气汤加减治疗前列腺增生82例疗效满意，报告如下。     

保留齿状线加皮桥重建闭合切口治疗环状混合痔32例疗效观察

目的探讨保留齿状线加皮桥重建闭合切口治疗环状混合痔的可行性及疗效。方法治疗组选用保留齿状线加皮桥重建闭合切口32例，与对照组采用传统外剥内扎治疗34例在术后疼痛、水肿、出血、痔残留等并发症及住院时间、愈合时间等方面进行比较。结果治疗组在术后疼痛、水肿、出血、痔残留等及住院时间、愈合时间等方面均优于对照组。结论保留齿状线加皮桥重建闭合切口治疗环状混合痔安全、有效、可行。     

Synergistic effects of Nell-1 and BMP-2 on the osteogenic differentiation of myoblasts.

Osteogenesis is synergistically enhanced by the combined effect of complimentary factors. This study showed that Nell-1 and BMP-2 synergistically enhanced osteogenic differentiation of myoblasts and phosphorylated the JNK MAPK pathway. The findings are important because of the osteochondral specificity of Nell-1 signaling and the potential therapeutic effects of coordinated BMP-2 and Nell-1 delivery. INTRODUCTION: BMPs play an important role in the migration and proliferation of mesenchymal cells and have a unique ability to alter the differentiation of mesenchymal cells toward chondrogenic and osteogenic lineages. Signaling upstream of Cbfa1/Runx2, BMPs effects are not limited to cells of the osteoblast lineage. Thus, additional osteoblast-specific factors that could synergize with BMP-2 would be advantageous for bone regeneration procedures. NELL-1 (NEL-like molecule-1; NEL [a protein strongly expressed in neural tissue encoding epidermal growth factor like domain]) is a novel growth factor believed to preferentially target cells committed to the osteochondral lineage. MATERIALS AND METHODS: C2C12 myoblasts were transduced with AdLacZ, AdNell-1, AdBMP-2, or AdNell-1+AdBMP-2 overexpression viruses. Effects were studied by cell morphology, alkaline phosphatase activity, osteopontin production, and MAPK signaling. Additionally, in a nude mouse model, viruses were injected into leg muscles, and new bone formation was examined after 2 and 8 wk. RESULTS: C2C12 myoblasts co-transduced with AdNell-1+AdBMP-2 showed a synergistic effect on osteogenic differentiation as detected by alkaline phosphatase activity and osteopontin production. Nell-1 stimulation on AdNell-1 + AdBMP-2 preconditioned C2C12 cells revealed significant activation of the non-BMP-2 associated c-Jun N-terminal kinase (JNK) MAPK signaling pathway, but not the p38 or extracellular signal-regulated kinase (ERK1/2) MAPK pathways. Importantly Nell-1 alone did not induce osteogenic differentiation of myoblasts. In a nude mouse model, injection of AdNell-1 alone stimulated no bone formation within muscle; however, injection of AdNell-1+AdBMP-2 stimulated a synergistic increase in bone formation compared with AdBMP-2 alone. CONCLUSIONS: These findings are important because of the confirmed osteochondral specificity of Nell-1 signaling and the potential therapeutic effects of enhanced BMP-2 action with coordinated Nell-1 delivery.     

Expression of CD68 CD45RO CD20 and proliferating cell nuclear antigen in nasal polyps]

OBJECTIVE: To study the cellular expression of CD45RO, CD20, CD68 and proliferating cell nuclear antigen (PCNA) in nasal polyps. METHODS: Nasal polyp tissues from 50 patients were evaluated for cellular expression of CD45RO, CD20, CD68 and PCNA using immunohistochemistry SP by counting the average number in 5 chosen high-power fields, Histopathological observations were combined with HE. Analyses were performed on SPSS10.0. RESULTS: CD68+ cells were expressed more in nasal polyps dominated by eosinophils than by neutrophils(P < 0.05). There was no difference between CD45RO and CD20, but both of them had negative correlation(P = 0.05). Significant correlation was found between CD68+ cells and eosinophils or PCNA positive cells on epithelium. PCNA positive cells on epithelium had significant correlation on fibroblast (P < 0.05). CONCLUSION: Inflammatory cell infiltration (eosinophilia CD45RO, CD20, CD68) and cell proliferating in epithelium cells, glandular cell and fibroblast are strongly correlated with formation of nasal polyps. The nasal polyps are not only characteristic of eosinophilia but also by lymphocytes dominated by CD45RO and CD68 positive cells. CD68 may be stem cell of nasal polyp.     

肱骨髁间骨折的手术治疗及疗效评价

目的 探讨肱骨髁间骨折的手术方式并评价疗效。方法 1998年1月～2004年12月共手术治疗肱骨髁间骨折28例，进行随访分析。结果 28例中26例获随访，时间6个月～4年7个月，其中22例获2年以上随访。疗效评价参照casse‰。评分系统，优良率为65％。结论 骨折类型及手术方式直接影响预后。关节良好的复位和牢固的固定，以及术后早期积极的功能锻炼是得到良好疗效的保证。     

腹茧症的影像诊断

目的探讨腹茧症的影像特点，提高术前诊断水平。方法回顾性分析经手术病理证实的腹茧症6例，术前均进行立位腹部X线平片和腹部CT检查，4例同时行胃肠道钡剂造影，复习其影像表现。结果6例立位腹部X线平片中3例诊断为肠梗阻。4例胃肠道钡剂造影，均可见小肠交错盘绕成团，呈“菜花”状或“手风琴”状表现。6例CT检查，均可见小肠聚集成团，其周围可见膜样的囊状物将其包裹。结论对患者进行胃肠道造影时观察到“菜花”状征象，或CT检查时观察到小肠聚集成团被一层膜样物包裹，应考虑到腹茧症的可能。