原发性肺浆细胞瘤(附1例报告)

目的 了解原发性肺浆细胞瘤的临床表现、病理表现及诊治。方法 1例左上肺孤立型病灶患者，行经皮肺穿刺活检和开胸探查术，结合有关文献及本例患者的临床资料，对本病的临床表现、病理表现及诊治进行论述。结果 本病的病理表现主要为表现为弥漫性浸润的浆细胞聚集，呈嗜碱性或嗜酸性，染色质粗，核质成熟不同步，免疫组化浆细胞为单克隆的。结论 原发性肺浆细胞瘤是一种极为罕见的肿瘤，病理检查和免疫组化可确诊。     

肾移植术后红细胞增多症的治疗

目的：初步探讨肾移植术后红细胞增多症(PTE)的治疗方法。方法：回顾分析9例PTE患者的临床资料。8例分别给予不同剂量的血管紧张素转换酶抑制剂(ACEI)，1例采用放血疗法治疗。治疗期间定期复查红细胞压积(Hct)血红蛋白(Hb)、肝、肾功能等。结果：所有病例均安全耐受治疗，症状缓解，Hct及Hb均降至正常。除1例出现体位性低血压外，未发现明显不良反应。结论： ACEI及放血疗法均可有效用于PTE的治疗。前者尤其适用于合并高血压的患者，后者可用于症状明显者的治疗。     

TIP术治疗小儿尿道下裂及尿瘘

目的评价尿道板切开成管尿道成形术(TIP术)治疗小儿尿道下裂及尿瘘的疗效。方法采用TIP术治疗年龄2～10岁男童尿道下裂及尿瘘共35例，其中巨尿道1例，阴茎型14例、阴茎阴囊型7例，阴囊型1例，尿道下裂Ⅰ期伸直术后7例，尿瘘5例。结果阴茎型尿道下裂成功13例，瘘1例；阴茎阴囊型成功6例，瘘1例；Ⅰ期伸直术后成功6例，瘘1例；尿瘘成功2例，瘘复发3例，阴囊型尿道下裂及巨尿道各1例均成功。结论TIP术治疗小儿尿道下裂，其手术方法操作相对简便，取材合理，术后效果好，值得推广。     

卵巢无性细胞瘤PLAP、NSE和WT1检测的临床病理意义

目的 :评价胎盘碱性磷酸酶 (PLAP) ,神经元特异性烯醇化酶 (NSE)、催乳素(PRL)和肾母细胞瘤 (WT1)基因蛋白在卵巢无性细胞瘤中的表达及其临床病理意义。方法 :复查 1983年 1月至 2 0 0 2年 10月曾经在重庆医科大学临床学院治疗的卵巢无性细胞瘤 31例的临床及病理资料。对 31例的肿瘤组织进行PLAP、NSE、PRL和WT1免疫组织化学染色。结果 :患者年龄 12～ 4 2岁 ,平均 2 5岁。临床Ⅰ期 18例 (5 8.1% ) ,Ⅱ期 5例 (16 .1% ) ,Ⅲ期 6例 (19.4 % ) ,Ⅳ期 2例 (6 .4 % )。PLAP、NSE、PRL和WT1在无性细胞瘤组织中的阳性表达率分别为 10 0 %、70 .9%、3.2 %和 12 .9%。NSE表达与临床分期以及 5年生存率之间显著相关 (P <0 .0 5 )。WT1的阳性表达与组织学亚型明显相关 (P <0 .0 5 )。结论 :NSE阳性表达与晚期肿瘤密切相关。PLAP和NSE可看作是无性细胞瘤重要的组织标志物 ,肿瘤组织是血清PLAP和NSE的主要来源。WT1的表达与无性细胞瘤分化较差有关     

Needlescopic surgery for cryptorchidism: the initial series

PURPOSE: The aim of this study is to report the initial experience with needlescopic surgery (2-mm optics and instrumentation exclusively) for the cryptorchid testicle. METHODS: Ten patients (age 8 months to 37 years) underwent 12 needlescopic procedures: orchiopexy (n = 8), orchiectomy (n = 2), and diagnostic exploration with attempted excision of testicular remnant (n = 2). Two patients underwent bilateral needlescopic orchiopexy. Needlescopic (2 mm) optics and instrumentation were used exclusively in the pediatric patients. RESULTS: All procedures were completed successfully by needlescopic techniques. Mean surgical time was 110 minutes (range, 60 to 180 minutes), and blood loss was 6 mL (range, 0 to 20 mL). There were no intraoperative complications. All procedures were performed on an outpatient basis. In all 8 orchidopexies, the testis was successfully brought to a scrotal position. CONCLUSIONS: Needlescopic techniques allow safe performance of various procedures for a cryptorchid testicle. The cosmetic result is excellent.     

Tailgut cyst in a neonate

Tailgut cyst is a rare lesion of developmental origin located in the retrorectal space, which usually presents as a multilocular cystic mass. It is usually found in adults, and neonatal cases are extremely rare. The authors report a tailgut cyst in a neonate that was found by prenatal ultrasonogram, which was like a teratoma in gross appearance.     

长学制临床药学专业的开设

就我国临床药学教育现状提出了开展临床药学教育的重要性和必要性 ,针对该专业的特殊性提出开设长学制临床药学专业的设想 ,并对其培养目标、课程设置、实施方法、须解决的问题等方面进行了探讨