肝移植术后并发症的影像学评价

目的:采用多种影像学措施评价肝脏移植术后并发症。材料和方法:16例背驮式原位肝移植术患者,术后7天内每日行胸片及胸腹部超声检查。术后2周～12个月,当患者出现发烧、皮肤巩膜黄染及异常B型超声发现时,行上腹部CT检查5例8次、同时行胸部CT检查2例、上腹部MRI及MRCP检查6例、ERCP检查4例、PTC检查2例、“T”管造影2例和下腔静脉造影1例。结果:术后1周内诊断胸腔积液14例(14/16);术后1～2周诊断肺部感染7例(7/16);肺不张4例(4/16)。术后4个月和8个月诊断右肺和移植肝多发转移瘤各1例(2/6);术后3周～10个月诊断胆总管吻合口狭窄、胆管炎、胆泥形成等5例(5/16)。术后2周诊断下腔静脉狭窄1例(2/16)。结论:运用多种影像学检查方法有助于及时诊断肝移植术后并发症。     

门诊老年冠心病患者用药知识需求的调查

冠心病是老年人的常见病、多发病,致残或死亡率已居常见病之首[1]。目前,药物治疗仍是冠心病二级预防的主要措施。近年来研究发现,83·3%的冠心病患者无法正确使用药物,用药依从性差[2]。分析原因,87%的门诊老年慢性病患者包括冠心病患者在内,主观不遵医用药是由于在用药过程中出现诸多用药问题时得不到相关知识信息支持所导致[3]。另外,通过调查证实冠心病患者对用药知识的需求亦居前列,尤其是出院后用药知识是首要需求[2,4-6]。由此表明,对门诊老年冠心病患者进行用药知识教育十分必要。依据健康教育学方法,分析患者的教育需求是制定教育…     

呼出气氢测定试验对飞行人员乳糖酶缺乏症的研究

对66名汉族飞行人员进行乳糖呼出气氢测定试验,乳糖吸收不良的发生率为83.3％,其中乳糖不耐受者占34.6％;与一般汉族人群无明显差别。对10名确定为中度以上乳糖吸收不良的飞行人员进行250ml鲜牛奶的试验结果,有50％呼出气氢含量在正常范围,并无一例出现胃肠道症状。提示较长期食用牛奶未能使乳糖酶缺乏状态发生改变,但每日食用适量牛奶属合理营养。     

Genetic imbalances in pleomorphic xanthoastrocytoma detected by comparative genomic hybridization and literature review.

Pleomorphic xanthoastrocytoma (PXA) is a rare, low-grade astrocytic tumor found in the central nervous system. Histologically, the tumor is characterized by markedly pleomorphic and lipidized cells. Although most of the patients have a favorable prognosis, a small number of cases undergoing recurrence or progression to anaplastic astrocytoma were reported. Very few genetic studies have been performed on PXA because of its rarity and the pathogenesis of this neoplasm is largely unknown. In order to provide an overview of genetic alterations in PXA, we performed comparative genomic hybridization to identify chromosomal imbalances (DNA gains and losses) in three cases of PXA. Genetic imbalance was detected on at least one chromosome for each case. One case, which revealed multiple genetic alterations, showed a poor prognosis. DNA gain on chromosome 7 and loss on 8p were demonstrated in two of three cases, suggesting that the candidate gene(s) located on these regions may play a role in the development of PXA. Further studies are needed to identify the residing candidate genes that are involved in the tumorigenesis of PXA. In addition, the histopathological features and previous genetic studies on PXA are reviewed.     

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。     

结核性淋巴结炎的组织细胞反应性增生变型

应用结核杆菌ＤＮＡ１２３ｂｐ特异性序列片段为靶序列的多聚酶链反应（Ｍ·ＴＢ－ＰＣＲ）技术、ＢＣＧ免疫组化（ＢＣＧ－ＩＨＣ）技术和抗酸染色（ＡＦ）方法，对３８例呈现组织细胞反应性增生－碎屑样坏死－嗜中性白细胞渗出病变的淋巴结石蜡包埋组织进行了分支杆菌／结核杆菌的回顾性检测。三种方法的综合阳性率为５２．６％（２０／３８例）。ＡＦ、ＢＣＧ－ＩＨＣ和Ｍ·ＴＢ－ＰＣＲ的各自阳性率分别为０．８％、２６．３％和５０％。研究结果表明：（１）在按本文标准选择的淋巴结“组织细胞反应性增生”病变中，有半数病例与结核杆菌的感染有关，即结核性淋巴结炎可呈现“组织细胞反应性增生”之类的变型；（２）ＰＣＲ技术在结核性淋巴结炎的病原学诊断上具有重要价值。     

血清抗果蝇唾腺染色体抗体测定及临床意义探讨

以果蝇唾腺作为基质,用间接免疫荧光法检测血清抗果蝇唾腺染色体抗体[简称抗染色体抗体(Anti—chromosome antibody AchrA)]。正常人及其它风湿性疾病患者共151例,均为阴性,而系统性红斑狼疮(SLE)患者44例,AchrA阳性者占16例(36.4%)。揭示AchrA对SLE有高度特异性及一定的敏感性。对比SLE患者的AchrA及抗核抗体(ANA),双阳性占15例(34.1%),提示与两种抗体起反应的核成分不尽相同。