妊娠期肝内胆汁淤积症病人的护理

妊娠期肝内胆汁淤积症(intrahepatic cholestasis of prenancy,ICP)是妊娠期特有的一种并发症,多发生于妊娠中期、晚期,表现为皮肤瘙痒和黄疸,主要危害胎儿,可导致早产、羊水胎粪污染及胎儿宫内窘迫,甚至死胎.目前已受到产科临床工作者的高度重视.我院自2000年1月-2004年11月收治ICP病人173例,经过积极治疗、严密监护、适时终止妊娠,母婴情况良好.现将有关护理总结如下.……     

恶性胸膜间皮瘤：3例尸解病例的组织化学和免疫组织化学研究

本文报告8例恶性胸膜间皮瘤尸解病例,上皮型2例,1例纤维型大体改变为巨大结节,并推挤膈肌至脐平面。对此3例进行了PAS、D-PAS,CM、AB、H-AB、CI、H-CI和CEA、Keratin、Vimentin等组化和免疫组化研究,并结合文献复习对人体胸膜间皮的组化和免疫组化特征进行了讨论,提出了人体胸膜间皮瘤的临床病理诊断与鉴别诊断意见。本组3例均合并DIC,推测本病有产生DIC的倾向性,临床对此病应警惕DIC发生的危险。     

放疗同期卡莫氟化疗治疗局部中晚期鼻咽癌的Ⅲ期临床观察

目的:探讨患者对联合应用诱导化疗和放疗同期口服卡莫氟治疗局部中晚期鼻咽癌疗效和不良反应.方法:收治66例局部中晚期鼻咽癌患者,随机分为两组,诱导化疗随后放疗组简称为对照纽,诱导化疗随后放疗同期卡莫氟治疗组简称为治疗组.两组患者数均为33例.进行根治性放疗前两组患者均接受两个疗程诱导化疗.治疗组在放疗期间同时口服卡莫氟.结果:诱导化疗有效率高,平均有效率高达87%,其中平均完全缓解率(CR)为8.7%、不完全缓解率(PR)为78.4%.对照组鼻咽肿瘤、颈部转移淋巴结全消平均剂量均高于治疗组,统计学有差异.放疗后3个月治疗组鼻咽、颈部转移淋巴结CR均高于对照组(p=0.016,P=0.042).随访期内治疗组患者局部复发率和远处转移率有降低趋势.临床治疗中出现的主要毒副反应为白细胞下降、口腔粘膜炎、急性放射性皮炎及由卡莫氟引起的热感、尿频、头昏等.结论:放疗同期口服卡莫氟治疗局部中晚期鼻咽癌,降低了鼻咽和颈部肿瘤完全消退的照射剂量,提高了鼻咽肿瘤和颈部转移灶的完全缓解率,局部复发率和远处转移率有下降趋势.尽管加卡莫氟患者毒的副作用加重,但可以耐受,经对症处理绝大部分患者能按计划完成治疗.在鼻咽癌同步化放疗方案中卡莫氟的推荐剂量为600mg/d,分3次口服.放疗同期口服卡莫氟治疗的远期疗效有待于进一步观察.     

不明原因不孕不育妇女子宫内膜沙眼衣原体检测

用ＰＣＲ检测３２例不明原因不孕、不育妇女子宫内膜沙眼衣原体，结果发现：２１例不明原因不孕妇女有７例阳性；８例不明原因自然流产２次以上妇女有３例阳性；３例不明原因死胎史妇女中１例阳性。结果揭示：子宫内膜的沙眼衣原体感染是引起不孕、不育的重要因素。     

呼和浩特市农区首次发现流行性出血热报告

呼和浩特市历史上未曾发现流行性出血热自然疫源地，也未见到流行性出血热疫情报告。1995年3月，本市中文齐镇发生1例临床表现典型并经血清学证实的流行性出血热病例。病家及其周围居民区家鼠密度为3.61％，以褐家鼠为优势种。送检捕获鼠鼠肺51份，阳性率21.57％。病家周围健康人群流行性出血热隐性感染调查，阳性率2.71％（1/37）。流行病学调查表明，病人病前1周－2个月内无外出史，故病人系本地感染。动物流行病学调查证实，呼和浩特农区存在流行性出血热自然疫源地。     

结核性淋巴结炎的“结节病”样变型

对１２例经病理学专家会诊、从病变上认定的淋巴结“结节病”石蜡包埋组织，应用结核杆菌ＤＮＡ特异性序列片段的聚合酶链反应（Ｍ．ＴＢ－ＰＣＲ）技术、ＢＣＧ免疫组化（ＢＣＧ－ＩＨＣ）技术和抗酸染色（ＡＦ）进行了分支杆菌／结核杆菌检测。在这１２例考虑为“结节病”的病例中：有１例呈ＢＣＧ－ＩＨＣ和Ｍ。ＴＢ－ＰＣＲ两项阳性；另１例呈ＡＦ、ＢＣＧ－ＩＨＣ和Ｍ．ＴＢ－ＰＣＲ三项阳性。研究结果提示：（１）某些结核性淋巴结炎可呈结节病样病变；（２）淋巴结结节病很可能与分支杆菌／结核杆菌感染有关。     

Protective efficacy in chickens, geese and ducks of an H5N1-inactivated vaccine developed by reverse genetics

We generated a high-growth H5N1/PR8 virus by plasmid-based reverse genetics. The virulence associated multiple basic amino acids of the HA gene were removed, and the resulting virus is attenuated for chickens and chicken eggs. A formalin-inactivated oil-emulsion vaccine was prepared from this virus. When SPF chickens were inoculated with 0.3 ml of the vaccine, the hemagglutinin-inhibition (HI) antibody became detectable at 1 week post-vaccination (p.v.) and reached a peak of 10log2 at 6 weeks p.v. then slowly declined to 4log2 at 43 weeks p.v. Challenge studies performed at 2, 3 and 43 weeks p.v. indicated that all of the chickens were completely protected from disease signs and death. Ducks and geese were completely protected from highly pathogenic H5N1 virus challenge 3 weeks p.v. The duration of protective immunity in ducks and geese was investigated by detecting the HI antibody of the field vaccinated birds, and the results indicated that 3 doses of the vaccine inoculation in geese could induce a 34 weeks protection, while 2 doses induced more than 52 weeks protection in ducks. We first reported that an oil-emulsion inactivated vaccine derived from a high-growth H5N1 vaccine induced approximately 10 months of protective immunity in chickens and demonstrated that the oil-emulsion inactivated avian influenza vaccine is immunogenic for geese and ducks. These results provide useful information for the application of vaccines to the control of H5N1 avian influenza in poultry, including chickens and domestic waterfowl.     

Comparison of immunohistochemical markers in the differential diagnosis of adrenocortical tumors: immunohistochemical analysis of adrenocortical tumors.

Most adrenocortical tumors (ACTs) can be diagnosed directly by a combination of morphologic features and clinical findings. However, sometimes it may be difficult to distinguish ACTs from other neoplasms such as pheochromocytomas and some metastatic tumors, particularly for small biopsy specimens because they may be morphologically similar. Expression of calretinin has recently been suggested as a valuable immunomarker for the differential diagnosis between ACTs and other tumors; however, its diagnostic value is still under debate. To determine the diagnostic value of calretinin in Chinese patients with adrenocortical and non-ACTs, we employed both polyclonal and monoclonal anticalretinin to characterize the expression of calretinin in adrenal tissues and compared its expression with that of inhibin alpha, Melan-A, cytokeratin, or CD99 by immunohistochemistry in tissue microarrays and standard tissue sections of 414 specimens. Our results revealed that calretinin was expressed by adrenocortical cells, but not by the other cells tested and the percentage of calretinin-positive ACTs reached 99% when stained with polyclonal antibodies, which was higher than that with monoclonal anticalretinin (91.3%), anti-Melan-A (90.3%), antiinhibin alpha (81.6%). In addition, our results also revealed that ACTs were stained by cytokeratin (AE1/AE3) with variable degrees (58.7%). Furthermore, unlike anti-Melan-A that stained all metastatic malignant melanoma, anticalretinin did not recognize other tested tumors. Therefore, immunohistologic staining with polyclonal anticalretinin is more sensitive than other antibodies tested for the diagnosis of ACTs. However, monoclonal anticalretinin appeared to be more specific. Importantly, our data suggested that the fried-egg-like staining pattern, but not the mere cytoplasmic staining, was characteristic of anticalretinin staining in adrenocortical tissues. Notably, a few anticalretinin negative-ACTs were stained by other immunomarkers that we tested. Thus, the combinational characterization of calretinin (either by polyclonal or monoclonal antibody), inhibin alpha, and Melan-A expression is of great significance in the differential diagnosis of ACTs.