Multiple epithelial cysts of the spleen and on the splenic capsule, and high serum levels of CA19-9, CA125 and soluble IL-2 receptor

An 18-year-old woman with abdominal pain was diagnosed as having splenic cysts by computed tomography scan. She had high serum levels of CA19-9 (2886.8 U/mL; normal value, <35 U/mL), CA125 (131.1 U/mL; normal value, <35 U/mL) and soluble IL-2 receptor (1490 U/mL; normal range, 220-530 U/mL). The resected spleen weighed 1050 g, was 14 x 28 cm, and had more than 10 macroscopic cysts up to 10.3 x 9.5 cm. There were numerous microscopic cysts in the spleen and several on the splenic capsule. The levels of CA19-9 and CA125 in the cyst fluid were 2165550 U/mL and 160400 U/mL, respectively. After the surgery, the serum levels of the tumor markers decreased gradually. The inside of the largest cyst was mainly covered by granulation tissue with a focal lining of epithelial cells, and the other macroscopic cysts had stratified squamous epithelium. The microscopic splenic cysts and cysts on the splenic capsule were lined by either attenuated single-layered or multilayered epithelial cells. The lining epithelial cells of these cysts were positive for epithelial membrane antigen and cytokeratins. CA19-9 and CA125 were detected in the lining cells of the splenic cysts. In the present case, it is suspected that the splenic cysts were derived from the capsular lining cells that showed migration from the capsule or formed microcysts on the splenic capsule, as in the case of ovarian inclusion cysts.     

脾的形态及其应用解剖

本文测量统计了己固定的正常脾200例,结果如下:脾的度量,测得均值。成人脾长9.70±2.68,宽6.89±1.28。厚3.5±1.18厘米;儿童脾长6.41±1.24,宽3.91±1.03.厚1.93±0.59cm.脾的外形受各种因素影响变化较大,按外形投影图分为三角形106例(53.0±3.53％)。长圆形85例(42.5±3.50％),圆形9例(4.5±1.50％),脾的切迹与分叶,前上缘切迹1个者42例(21.0±2.88％),2个者66例(33.0±3.32％)3个者47例(23.5±2.99％),4个者19例,(9.5±2.10％),无切迹者15例(7.5±1089％),后下缘无切迹者124例(62.0±3.25％)。1个者54例(27.0±3014％)。多者达3个;脾分叶者24例(12.0±2.3％),副脾在脾门处出现8个(4％)。     

补肾健脾法治疗胎怯的临床研究

目的:研究补肾健脾法治疗胎怯的临床疗效。方法:以补肾健脾方药制成助长口服液为治疗组,以不用药为对照组,进行治疗胎怯的临床对照观察。结果:治疗组疗效(78%)显著优于对照组(52%),P<0.001;治疗组在改善体重、身长、头围、胸围、上臂围等方面显著优于对照组,P<0.05～0.01;治疗组治疗后血清T3升高,T4下降,与对照组相比,P<0.05;在降低患病率方面,治疗组(43%)优于对照组(72%),P<0.05;治疗组远期疗效优于对照组,P<0.05。结论:补肾健脾法治疗胎怯有显著的临床疗效。     

中老年人脾肾虚证与血脂及抗氧化物关系的探讨

采用前瞻性设计方案,利用现代先进的有针对性的指标,应用单因素及多因素综合分析方法,对７７３例中老年人进行脾肾虚证实质的研究。结果发现：中老年人肾虚证与脂质代谢紊乱、机体经物质减少、过氧化脂质增密切相关。同时发现,脾虚证到肾虚证是一个逐渐发展的病理过程,且有层次性。认为肾虚证脂质代谢紊乱程度高于脾虚证,脾虚证与机体抗氧化物减少无密切关系。     

Early splenectomy and polychemotherapy versus polychemotherapy alone in chronic myeloid leukemia

The effect of early splenectomy and of polychemotherapy with hydroxyurea, busulfan, and alternate bimonthly courses of arabinosyl cytosine and vincristine plus prednisone, was evaluated in 139 previously untreated patients with chronic myeloid leukemia (CML), consecutively admitted to 18 hospitals from March 1973 to October 1974. Fifty-six patients were splenectomized and 83 patients were not splenectomized. Splenectomy did not influence the duration of chronic and blastic phase, and did not prolong survival. The prognosis of high risk patients was not improved. During the chronic phase, high platelet counts were more frequent in splenectomy group, and five patients developed thrombotic or thromboembolic complications, 5 to 19 months after the operation. The median survival of the whole group was 50 months, with 32 of 139 patients (actuarial proportion 30%) remaining alive 72 months after diagnosis, but the slope of the survival curve was similar to that of historical controls. The results of this trial suggests that new strategies should be developed for the therapy of CML.     

健脾通络法治疗中晚期肝癌22例观察

 应用中医药健脾通络法组成相对固定方药治疗22例中晚期肝癌(Ⅱ期1例、Ⅲ期3例、Ⅳ期18例),结果显示对改善主要症状肝痛(14/18,77.8%),腹胀(13/17,76.5%),精神差(11/15,73.3%),乏力(9/14,64.3%),厌油(6/8,75%)及增加食量(7/15,46.7%)效果较好,对稳定肿瘤病灶(12/18,66.7%)、减轻腹水及维护肝功能也有较好效果.     

谢广茹从脾胃论治肿瘤经验举要

谢广茹主任认为肿瘤多由脾胃虚弱，邪毒乘虚而入所致，脾胃虚弱是肿瘤发生的主要因素。临证当顾护脾胃，补养胃阴。用药当升清降浊同施，补通兼顾，清化湿热，并多用甘味补益，临证化裁提倡机圆活法，不拘一方一法。     

中药内服结合外敷治疗脾虚血瘀型肝癌腹水疗效观察

目的观察中药内服结合外敷治疗原发性肝癌腹水的临床疗效。方法将60例脾虚血瘀型原发性肝癌腹水患者随机分为治疗组和对照组,各30例。对照组口服安体舒通,治疗组采用健脾活血利水内服方及逐水药外敷,疗程均为15天。观察两组腹水、生活质量、中医症状改善情况。结果治疗组腹水的改善优于对照组(P<0.05);治疗后治疗组Karnofsky评分较治疗前提高(P<0.05),对照组降低(P<0.05);两组治疗前后差值比较有统计学意义(P<0.05);治疗后治疗组患者腹胀、腹痛等症状明显改善(P<0.05),且较对照组改善显著(P<0.05)。结论中药内服结合外敷治疗原发性肝癌腹水疗效显著,并可改善临床症状,提高患者生活质量。     

中医综合疗法治疗脾胃湿热型雄激素源性脱发的临床研究

目的观察中医综合疗法治疗脾胃湿热型雄激素源性脱发的临床疗效。方法将65例脾胃湿热型雄激素源性脱发患者随机分为治疗组(33例)与对照组(32例)。对照组予中药内服及针刺疗法,治疗组同时加用七星针叩刺。两组疗程均为3个月,观察临床疗效,并比较治疗前后临床症状总积分及各分项积分的变化情况。结果 1治疗组、对照组总有效率分别为90.91%、84.38%;组间临床疗效比较,差异有统计学意义(P0.05)。2治疗前后组内比较,两组掉发情况、头皮情况、新发再生情况积分及总积分差异均有统计学意义(P0.05);组间治疗后比较,掉发情况、头皮情况、新发再生情况积分、总积分及其变化差值的差异有统计学意义,治疗组优于对照组(P0.05)。结论中医综合疗法治疗脾胃湿热型雄激素源性脱发的疗效满意,可显著改善患者的临床症状,促进毛发新生。     

人类免疫缺陷病毒首犯后天阳之本

人类免疫缺陷病毒（HIV）感染人体后,主要侵犯肺、脾二经,但首犯肺经。肺为后天阳之本,脾为后天阴之本。根据肺的生理功能和HIV病毒侵袭人体的特点,肺经的临床表现出现最早,出现的几率也最大。脾为后天阴之本,当肺脏卫外功能减退或不足的时候,病邪即可深入,引起脾经病变。同时HIV病毒对肺脾的侵犯具有较大的特异性,需要结合其他各期的病机进行综合分析,完整地认识病毒的发病特性。