丙型肝炎六例报告及随访观察

本文首次报告新疆6例丙型肝炎。对20例病毒性肝炎病人血清进行抗HCV检测,结果6例阳性。结合临床及化验检查,可诊断为丙型肝炎。对此6例进行分析,结果表明:本病多发生在输血后,临床表现不重,肝功能检查主要是ALT反复波动不降,易致慢性。     

卵巢性腺母细胞瘤的病理特点及鉴别诊断

目的:探讨卵巢性腺母细胞瘤的病理特点及鉴别诊断。方法:对2例病理诊断为卵巢性腺母细胞瘤的病例进行临床病理分析。结果:两例均见卵巢性腺母细胞瘤结构。结论:对46XY组型、呈纤维条索状胚条性腺者要特别注意多取材、多切片可以防止漏诊。卵巢性腺母细胞瘤有其特殊的组织形态学特点。纯性腺母细胞瘤为良性,但具有恶性潜能,需与无性细胞瘤、伴环状小管的性索肿瘤及混合性生殖细胞-性索间质性肿瘤相鉴别。     

BTA在膀胱癌诊断中的应用

为了探求对膀胱肿瘤诊断及术后复发监测的理想手段，从１９９５年９月～１９９６年６月，采用ＢＴＡ试剂检测方法对２０２例血尿患者及７１例膀胱肿瘤术后的患者进行了诊断检测，诊断膀胱癌的敏感度为９６％、特异度为８３％、准确度为８６％，２６例膀胱肿瘤患者中仅６例（２３％）尿脱落细胞阳性，正常对照均为阴性。认为ＢＴＡ试剂是一种快速、有效、无创性诊断膀胱肿瘤的方法。     

Liver transplantation for chronic hepatitis B with lamivudine-resistant YMDD mutant using add-on adefovir dipivoxil plus lamivudine.

Lamivudine treatment in patients with chronic hepatitis B virus (HBV) infection may improve clinical state and suppress viral replication before liver transplantation. Emergence of lamivudine-resistant YMDD mutant is common. We report the results of liver transplantation in 16 patients with pretransplantation YMDD mutants after receiving lamivudine treatment for a median of 738 days (range, 400-1799 days). Adefovir dipivoxil (10 mg daily) was added on to lamivudine for a median of 20 days (range, 8-271 days) before (n = 11) or at (n = 5) liver transplantation, and the combination was continued indefinitely thereafter. Eight patients received additional intravenous hepatitis B immune globulin (HBIG) for a median of 24 months. Fifteen patients with known pre-adefovir HBV DNA levels had a median titer of 14,200 x 10(3) copies/mL (2 x 10(3) to 4,690,000 x 10(3) copies/mL), and 14 had HBV DNA >10(5) copies/mL. All but 1 patient remained positive for HBV DNA (by quantitative polymerase chain reaction [qPCR]) at the time of liver transplantation, and the titer was greater than10(5) copies/mL in 8 patients. The median follow-up after liver transplantation was 21.1 (range, 4.4-68.9) months. One patient (6%) died of an unrelated cause 12.2 months after transplantation, and 15 patients (94%) were alive with the original graft. All patients cleared HBV DNA and had no detectable HBV DNA by qPCR at the latest follow-up. Fourteen patients had cleared hepatitis B surface antigen (HBsAg), but 2 patients who received only adefovir dipivoxil and lamivudine without HBIG remained HBsAg positive after 7.7 and 9.5 months. Serum HBV DNA, however, was negative, and there was no biochemical or histological evidence of recurrence. Adefovir dipivoxil was well tolerated with no significant renal toxicity. In conclusion, a combination of add-on adefovir dipivoxil plus lamivudine therapy provides effective prophylaxis in patients with pretransplantation YMDD mutant that may be actively replicating. The cost effectiveness of additional passive immunoprophylaxis remains to be defined.     

Stereotaxic Interstitial Laser Therapy of Early-Stage Breast Cancer

Abstract: Coagulation leading to fibrosis of mammo-graphically detected breast cancers by interstitial laser therapy was tested as an alternative to surgical removal. Availability of computerized stereotaxic digital imaging allows the precise placement of laser and thermal needles into the target tumor and its controlled ablation by heat. The methodology of interstitial laser therapy (ILT), evolution of the subsequently removed tumors, and their histologic appearance are outlined.
Eight patients with mammographically well-defined tumors were selected. Definitive diagnosis and receptor evaluation were made on core biopsies. Under local anesthesia, stereotaxically guided diode laser energy at 5–10 w was delivered via a 400 xm fiber in a 19-gauge needle placed into the center of the tumor until the peripheral temperature exceeded 60°C. Patients experienced transient pain and pyrexia. Subsequent to ILT, seven invasive carcinomas were excised while one case of multiple papillomas was kept under surveillance. Histologic study revealed central necrosis but some peripheral residual tumor in the first five cases. In the last two, central necrosis surrounded by concentrically arranged, recognizable but severely injured, focally "windswept" and "ghostlike" tumor and granulation tissue were noted. The multiple papillomas showed radiologic shrinkage at 5 months and extensive fibrosis on needle biopsy.
ILT is an attractive new method of treating small, well-defined breast tumors and offers a potentially significant alternative to surgical removal; further exploration is warranted.     

舰船员慢性荨麻疹与马拉色菌相关性研究

OBJECTIVE: To investigate the association of Malassezia furfur with chronic urticaria in the crew members of ships. METHODS: A comparative mycological study of 126 crew members of ships with chronic urticaria and 45 normal control subjects was carried out. The 82 urticaria patients identified as positive for Malassezia furfur were divided into groups A and B to receive treatment with antihistaminics (group A) and antihistaminics combined with 2% ketoconazole shampoo(group A). RESULTS: The carrier rates of Malassezia furfur were significantly higher in urticaria patients than in the normal control subjects (P<0.01), but in view of the case ratios of the final cure or improvement, no significant difference was observed between the two groups by the end of the treatment courses (P>0.05). But 6 to 8 weeks from the end of the treatment course, better therapeutic effect was noted in group B (P<0.01), with higher rate of negative Malassezia furfur findings (P<0.01). CONCLUSION: Malassezia furfur may play an important role in the prevalence of chronic urticaria among the crew members, and anti-fungal treatment may produce better long-term therapeutic effect.     

几种化合物对石棉诱发肺泡巨噬细胞产生一氧化氮的抑制作用

为了寻求一种适宜的石棉表面改性剂，利用体外细胞培养技术，通过测定培养液中亚硝酸根（ＮＯ－２）含量，观察了茫崖产温石棉对豚鼠肺泡巨噬细胞（ＡＭ）产生一氧化氮（ＮＯ）的诱导作用以及混合稀土、亚硒酸钠、柠檬酸铝对石棉诱发ＡＭ产生ＮＯ的影响。结果显示，温石棉纤维可使培养液中ＮＯ－２浓度升高，并呈明显的剂量反应关系；混合稀土、亚硒酸钠、柠檬酸铝均可抑制石棉诱发ＡＭ产生ＮＯ，而且随上述化合物浓度的升高，抑制作用增强。提示用混合稀土和亚硒酸钠拮抗石棉的致病作用有实际应用的可能。     

改良Richard钉在髋部骨折中的应用

髋部骨折是常见骨折之一，且逐年增多。多发生于老年人，并发症多，死亡率高。应用Ｒｉｃｈａｒｄ钉治疗是目前最佳方法之一。我们将Ｒｉｃｈａｒｄ钉进行了改进，一是增加了松质骨螺钉粗螺纹长度；二是根据不同类型的粗隆下骨折，增加了套筒钢板的长度。经５２例粗隆间骨折和２１例粗隆下骨折患者的临床应用，无死亡，无髋内翻及机械装置并发症的发生。术后病人无需外固定，可早期床上及下地活动。经随访８～３８个月，平均随访时间１５．６个月，骨折全部愈合。我们认为改良Ｒｉｃｈａｒｄ钉是治疗髋部粗隆间和粗隆下骨折更为理想的内固定装置。