伴胸腺样成分的甲状腺癌八例报告

研究伴有胸腺样成甲状腺癌的组织发生，形态学和生物学牧场生，以区别于一般鳞状细胞。方法分析患者的临床资料，包括主要体征，手术记录及生存时间，并复习全部病理切片。结果伴有ＣＡＳＴＬＥ的甲状腺癌不同于鳞癌，不仅有典型的鳞状分化特点，亦伴有胸腺分化特征，如哈氏小体，淋巴上皮样结构和间质淋巴组织增生。     

The role of a critical care unit in an epidemic

The role of a critical care unit in life-threatening situations is well established. The management of 52 children with acute gastroenteritis and 22 children with acute paralytic poliomyelitis as part of recent epidemics is described. The solutions to the problems in the critical care management of these 74 victims (out of a total of 6197 patients admitted during the epidemics) are discussed.     

Femoral capital osteonecrosis: MR finding of diffuse marrow abnormalities without focal lesions

Six painful hips in five patients were examined with magnetic resonance (MR) imaging and were found to have diffuse signal abnormalities in the marrow of the femoral head and neck, which extended into the intertrochanteric area in five cases. The abnormal regions were low in signal intensity on images obtained with a short repetition time (TR) and a short echo time (TE) and were isointense or hyperintense on long TR/TE images--findings that have been attributed by others to bone marrow edema. Edema was also seen in marrow just above the acetabulum in two cases. No focal abnormalities characteristic of osteonecrosis were seen. Osteonecrosis was subsequently shown to be present in all six femoral heads at core biopsy (three cases) or by subsequent development of focal MR abnormalities reported to be highly specific for osteonecrosis (three cases). The affected hips had been radiographically normal or subtly osteopenic and had shown intense radionuclide uptake in the femoral head at scintigraphy, with lesser abnormality in the neck and intertrochanteric region. Follow-up MR examinations of five of the six femoral heads showed the diffuse abnormalities to have been transient. Although diffuse MR abnormalities in the proximal femur are not specific, they may indicate the presence of osteonecrosis of the femoral head.     

不断提高异基因造血细胞移植的疗效

1957年美国著名血液学家Thomas教授首先成功地应用异基因骨髓移植（allogeneic bone marrow transplantation，allo-BMT）治疗恶性血液病，并以此获得诺贝尔医学奖。此后allo-BMT技术不断改进，并在世界范围内迅速开展，目前已成为治愈恶性血液病的重要方法。亚洲的骨髓移植首先于20世纪60年代初在北京获得成功，为应用同基因骨髓移植治愈1例重型再生障碍性贫血患者。经历了十年动乱暂时无奈中断研究后，80年代初作者等又成功地将allo-BMT应用于恶性血液病的治疗，之后该项技术在全国不断开展，逐渐成熟，并已形成规模，且在许多方面已达到或超过国际水平。     

The Treatment of Septicemia in Pacemaker Patients

The authors analyzed the data of seven patients who had undergone open heart surgery because of pacemaker endocarditis in the past 4 years. Repeated surgical interventions on the pacemaker system were found to be the most common predisposing factors. Staphylococcus aureus and Staphylococcus epidermidis were the most common causative organisms. Two-dimensional echocardiography was important in the diagnosis of cases with atypical clinical picture and negative blood cultures. We concluded that: (1) any pacemaker patient with fever should be considered to have a pacemaker endocarditis; (2) all of these patients should be examined by two-dimenensional echocardiography; and (3) the total removal of the infected hardware seems to be the only way to achieve complete recovery.     

急性移植物抗宿主病病人血清IL-2、IL-8、IL-10及TNF-α水平变化的研究

为了探讨细胞因子IL-2、TNF—α、IL-10、IL-8在异基因造血干细胞移植后aGVHD发病中的作用，观察33例Allo-HSCT患者aGVHD的发病情况。aGVHD的诊断主要依据临床表现，部分病例还依据皮肤、肠粘膜活检的病理学变化。移植前后定期采集患者血清，采用放射免疫法检测细胞因子IL-2、TNF—α、IL-10、IL-8的浓度的变化。结果发现，异基因造血干细胞移植后33例患者均获得造血功能重建，13例发生aGVHD，其中8例Ⅰ度aGVHD，5例Ⅱ-Ⅳ度aGVHD。IL-2、TNF—α水平在aGVHD阳性组明显高于aGVHD阴性组，而IL-10的水平在aGVHD阳性组明显低于aGVHD阴性组，IL-8水平的变化无统计学意义。结论：细胞因子IL-2、TNF—α在临床aGVHD的发病中起重要的正向调节作用，定期检测患者血清的IL-2、TNF—α水平有助于预测aGVHD的发生。