Problems related to dorsal root entry zone lesions

Summary Several clinical problems related to the dorsal root entry zone lesions (DREZLs) in 15 patients with chronic pain are presented and discussed in terms of ratings of pain relief following surgery, development of sensory or motor weakness and postmortem histologies. Subjective pain relief exceeding 70% was achieved at around 2 weeks after the operations in most patients (13/15), and then decreased in some to 30 from 70% in the follow-up observations. Our new objective pain relief score was tested in these patients. A significant positive correlation between subjective pain relief and our objective pain relief scale was found, but some discrepancies between them were also found during the follow-up. Sensory loss, motor weakness, paraesthesia and a new pain were found as complications in 12, 7, 4 and 6 patients, respectively. Postmortem histological findings of the spinal cord in two patients with systemic lupus erythematosus and uterine cancer, who received bilateral DREZLs twice and bilateral DREZLs plus commissural myelotomy, respectively, indicate that care should be taken to avoid extension of the coagulation beyond the dorsal horn.     

Suprasellar arachnoid cysts in children report of three cases

Summary Three cases of suprasellar arachnoid cysts in children are reported. Incidence, aetiology, pathogenesis, symptomatology, diagnosis, treatment, and other problems of these uncommon lesions are discussed.Communication presented at the XXXIst Meeting of the Portuguese-Spanish Neurosurgical Society. Santiago de Compostela, Spain. May 1979.     

老年颅脑损伤234例临床特点及诊治探讨

目的探讨老年颅脑损伤的临床特点和诊治经验.方法回顾性分析2 34例年龄大于6 0岁颅脑损伤患者的临床特点及诊治情况.结果存活109例,死亡125例,老年颅脑损伤其合并伤、合并症、并发症较多见.结论针对老年人颅脑损伤临床特点积极并重诊治处理颅脑损伤、合并伤及合并症,以期减少并发症,提高本类病人的治疗效果.     

环磷酰胺对鼠根尖周炎中IL-1α、TNF-α基因表达的影响

目的　观察环磷酰胺对IL 1α和TNF αmRNA在鼠根尖周炎组织中表达的影响 ,了解免疫抑制在根尖周炎中的作用。方法　 16只SD大鼠开髓术前每周 1次腹腔注射环磷酰胺 ,共 3wk ,另 16只大鼠作对照 ;用原位杂交技术 ,测定免疫抑制鼠根尖周炎组织中IL 1α和TNF αmRNA表达 ,并对其进行半定量分析 ,与免疫正常组进行比较。结果　免疫抑制鼠根尖周组织阳性染色细胞计数 ,1～ 3wk逐渐2 0 0 2 0 6 13收稿 ,2 0 0 3 0 6 2 8修回 安徽省教育厅资助课题 ,No 2 0 0 1kj1181 上海第二医科大学附属第九人民医院 ,上海　 2 0 0 0 11作者简介 :梅陵宣 ,男 ,39岁 ,医学博士 ,副教授 ,硕士生导师。Tel:0 5 5 1 5 118677 82 0 1;刘　正 ,女 ,71岁 ,教授 ,博士生导师增加 ,4wk后降低 ,并与根尖阴影面积呈正相关关系 (IL 1α :r=0 881,P <0 0 1;TNF α:r =0 85 5 ,P <0 0 1) ;各时间段IL 1α和TNF αmRNA表达量与免疫正常组无差别 ,阳性表达细胞类型亦无差别。结论　外周血白细胞减少对鼠根尖周炎的发生及局部IL 1α和TNF α表达无影响     

菲立磁增强MRI对肝脏局灶性病变的诊断价值

目的:探讨菲立磁增强MRI检查在肝脏局灶性病变诊断中的应用价值.方法:对34例临床怀疑有肝脏占位性病变,行常规MR或CT检查诊断困难的患者行菲立磁增强MR检查.用定量的方法研究增强前后T1WI及T2WI图像上病灶信号强度的变化,采用配对t检验分析其变化的显著性.结果:增强后肝脏实质T2WI信号明显降低,良、恶性病变的信号变化不同.病变的检出量增加,显示更清楚.结论:菲立磁增强MR检查可明显提高肝脏局灶性病变的检出率及鉴别诊断的准确性.     

胃肠道交界性病变/肿瘤和相关病变的临床病理特点及其治疗原则

交界性病变／交界性肿瘤是目前诊断病理面临的最大难题之一。病理和临床医师应正确认识胃肠道的一些交界性病变／交界性肿瘤及相关病变如胃肠道间质瘤、胃肠道淋巴组织增生和粘膜相关淋巴组织淋巴瘤、免疫增生性小肠病、胃肠道腺瘤和阑尾类癌。     

中药糖脉通片治疗糖尿病周围神经病临床研究

应用糖脉通片治疗糖尿病周围神经病中医辨证属气阴两虚、痰瘀阻络证患者103例，并与西药弥可保组99例进行随机对照。结果：糖脉通片在缓解患者肢痛、麻木症状，改善血流变，升高SOD活性，降低MDA含量，改善神经传导速度等方面均有较好作用，部分指标改善情况优于弥可保。     

EXPRESSION OF p16,CYCLIN D1 AND RB PROTEIN IN GASTRIC CARCINOMA AND PREMALIGNANT LESIONS

Gastric carcinoma is one of the most serious diseases in mankind. Its pathogenesis has not been understood very clearly. Recent researches suggested that oncogenes (such as cyclin D1), antioncogenes (ie., p16, Rb) and cell cycle played an important role in the pathogenesis of gastric carcinoma. But there are few reports about the relationship between these genes in gastric carcinoma and gastric premalignant lesions. In this study, we will discuss these problems. MATERIALS AND METHO…     

食管鳞状上皮非典型增生细胞核的形态计量研究

本文用计算机图像分析仪对73例食管鳞状上皮非典型增生的细胞核进行形态计量测量，检测了胞核面积、周长、形态因子、异形指数、园球等5个指标，并与正常组相对照，结果表明，传统的组织学分级与形态定量分级基本一致，有其客观性。同时发现组织学诊断与形态计量诊断间有一些病例交叉，即下级病变的测量指标高于上级病变均值或上级病变的测量指标低于下级病变均值的情况。如果具体到某一病人，多指标形态定量可能比组织学诊断更准确，更能代表病变的现状。本文从食管鳞癌发生学的角度，对组织学诊断、细胞学诊断及形态定量诊断相互之间的关系及意义作了深入的分析，认为对食管非典型增生细胞核进行多指标形态分析，可为临床诊疗及估计预后提供帮助。     

Phenotypic shift in human differentiated gastric cancers from gastric to intestinal epithelial cell type during disease progression

Background. The phenotypic expression of tumor cells is widely thought to resemble that of the tissue of origin. In the present study, to assess phenotypic changes that occur with disease progression, we investigated human differentiated gastric cancers at different depths of invasion for component cancer cell types. Methods. Using a combined mucin histochemical and immunohistochemical approach, we classified surgical specimens of 301 differentiated gastric cancers into three types: gastric epithelial cell (G) type, intestinal epithelial cell (I) type and mixed gastric and intestinal (GI) type, according to the phenotypic differentiation of the component cancer cells. The relation between the phenotypic type of cancer and their depth of invasion was evaluated. Results. The proportion of G type cancers was 41.4% in early (tumor invasion of mucosa or submucosa) cases, decreasing to 22.2% in advanced (tumor invasion of muscularis propia or deeper) cases, whereas the proportion of I type cancers increased with progressive disease from 23.5% to 31.1% (P < 0.01). Cancers invading the subserosa or deeper included more I type cases and fewer G type than cancers limited to the mucosa (P < 0.01). In most cases of each phenotypic type, intestinal metaplasia was recognized in the surrounding background mucosa, but no clear relation was shown between the phenotype of cancers and the degree of intestinal metaplasia in the background mucosa, suggesting that intestinal metaplasia is not always a preneoplastic lesion. Conclusions. A phenotypic shift from G to I type expression was observed with the progression of human differentiated gastric cancers. Intestinalization may occur independently in cancerous and noncancerous gastric mucosa. Received for publication on May 1, 1998; accepted on Oct. 22, 1998