成人肾母细胞瘤的诊断与治疗(附9例报告及文献复习)

目的探讨成人肾母细胞瘤的诊断和治疗方法。方法回顾性分析9例成人肾母细胞瘤的临床表现、分期、治疗及预后。结果9例患者按照美国国家肾母细胞瘤研究组（National Wilms Tumor Study,NWTS）分期：Ⅰ期3例,Ⅱ期3例,Ⅲ期2例,Ⅳ期1例。9例均行肾切除术,其中术前分别辅以化疗1例、放疗1例、肾动脉介入栓塞化疗2例。9例术后辅以放疗和化疗。8例获得随访,随访1-6年,7例生存。结论成人肾母细胞瘤是一种比较少见的恶性肿瘤,早期诊断、手术治疗、辅以放疗和化疗等可明显提高治愈率并改善其预后。     

5-溴脱氧尿嘧啶核苷标记示踪脂肪成体干细胞体内成骨分化的研究

目的 观察经成骨诱导后的脂肪成体干细胞(ADASCs)在体内的成骨分化行为.方法 分离培养兔ADASCs,用5-溴脱氧尿嘧啶核苷(BrdU)标记,并通过免疫组织化学方法检查标记结果.将标记的ADASCs体外成骨诱导培养2周后与脱钙骨基质(DBM)复合,共培养7d后植入自体肌袋内.术后8周取材,固定、脱钙、包埋后切片染色,镜下观察.结果 大量ADASCs被标记,标记率达(82.3±8.6)%;体外标记后的ADASCs可以向成骨方向分化;切片苏木素-伊红(HE)染色示体内有新生骨形成,切片BrdU免疫组织化学染色示新生骨处有阳性细胞.结论 ADASCs经体外成骨诱导后植入体内能够继续维持成骨分化,并进一步形成新生骨.     

Ectopic Ureterocele with a Horseshoe Kidney in an Adult

A rare adult case of a left ectopic ureterocele associated with a duplex horseshoe kidney is reported. To the best of our knowledge, only one pediatric case of horseshoe kidney with an ectopic ureterocele has been reported. The present case was successfully treated by ureteropyelostomy, upper ureterectomy and unroofing of the ureterocele. The patient is currently followed with excretory urograms and renograms.     

日本血吸虫成虫31/32KD抗原的纯化及其免疫化学特性

本文采用超凝胶柱层析法分离纯化日本血吸虫成虫31/32KD抗原。分离的抗原经银染色及免疫印迹法分析证明已达免疫纯及生化纯级。该抗原PAS染色呈阴性,经过碘酸钠处理后不失去活性,在琼脂糖凝胶电泳中趋向阳极。鉴于血吸虫成虫31/32KD组分是一种主要血清学抗原,它的分离纯化为改进和标化血吸虫病的诊断提供了条件。     

Two Autopsied Cases of Familial Sudanophilic Leukodystrophy

Abstract: Two autopsied female sibling cases of sudanophilic leukodystrophy are reported. Case A and case B were the second and third of seven siblings, and a sister and a brother died from severe progressive neurological disease with similar symptoms. Consanguineous marriages were noted in the family of both cases through the past three generations. Case A gradually developed intellectual deterioration and tetraplegia at the age of 29, progressed to akinetic mutism within one year and thereafter survived for 14 years. Neuropathologically, a severe atrophy and degeneration were noted in the white matter of the whole cerebrum, sparing the subcortical U-fibers. Myelin and axons were severely damaged with peripheral astrocytic gliosis. Case B developed similar clinical symptoms at the age of 20 and survived for 7 years in the state of akinetic mutism. Similar postmortem findings as those of case A were found in the white matter of the cerebrum with formation of sudanophilic breakdown products and with thick fibrillary gliosis. The pyramidal tract was completely degenerated. There was no accumulation of abnormal lipid in the brains of both cases.     

PETHEMA ALL-93研究结果:成人高危急性淋巴细胞白血病缓解后维持治疗、异基因和自体造血干细胞移植的疗效比较

4背景 近年，成人急性淋巴细胞白血病（acute lymphoblastic leukemia，ALL）诱导完全缓解（complete remission，CR）率可达80％～85％．5年无病生存率（diseases-free survival，DFS）30％-40％。成人ALL预后的改善可能与采用了包括以大剂量甲氨蝶呤联合阿糖胞苷的强烈巩固治疗方案有关．并与根据疾病危险度进行分级分层治疗、根据疾病亚型制定个体化的治疗方案有关。     

Medulloblastoma in adulthood: Prognostic factors influencing survival and recurrence

Summary Thirty adult patients presenting with medulloblastoma between 1974 and 1991 were studied and treated at Puerta de Hierro Clinic. After diagnosis, all patients were treated by surgery followed by radiotherapy and eight of them received adjuvant chemotherapy. We have studied the influence of some factors such as age, sex, location of tumour in the cerebellum, amount of surgical resection and histological variants on survival and recurrence of the disease. Only the histological type has a statistically significant influence on survival and recurrence: we have found that patients presenting classic medulloblastoma have a long survival and a long relapse-free interval.     

Neurotrophin-like immunoreactivity in the human pre-term newborn, infant, and adult cerebellum

The immunohistochemical occurrence of the neurotrophin (NT) proteins nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-4 (NT-4), and neurotrophin-3 (NT-3) is shown in the pre-term newborn, infant, and adult human post-mortem cerebellum. The NT-like immunoreactive structures were unevenly distributed and showed regional differences among cerebellar lobules and folia. NGF-, NT-4-, and NT-3-positive neuronal perikarya were observed in all specimens examined. At variance with the other neurotrophins, the BDNF antiserum labelled neuronal cell bodies only in newborn life and infancy, as well as extensive nerve fibre systems, whose density increased with age. The NT-antibodies, tested by Western blot on human cerebellum homogenates, revealed immunoreactive bands corresponding to proteins of heterogenous molecular weight. The results obtained provide a first demonstration of the tissue localization of the NTs in the human cerebellum from perinatal to adult age, thus suggesting their involvement in the development, differentiation and maintenance of the cerebellar connectivity. Codistribution of the four NTs or sets of them was observed in cortical and deep nuclei neurons. Multiple trophic roles for NTs, encompassing the classic target-derived and local mechanisms of support, are envisaged as significant in development, differentiation, and maintenance of the human cerebellar connectivity.     

Case Report: Giant choledochal cyst

We report an adult female with a rare giant choledochal cyst. The patient presented following a normal pregnancy with the classical triad of an abdominal mass associated with jaundice and right upper quadrant abdominal pain. The cyst was excised using an intramural technique and biliary reconstruction achieved with a Roux-en-Y hepaticojejunostomy. Our patient has remained well with no evidence of malignancy over a 12 year review period. The aetiology and current management of this condition are discussed.     

各型成人高原心脏病的临床特点

本文报告了303例各型成人高原心脏病的临床分析结果。成人高原心脏病单纯型比混合型具有发病急、心脏传导系统损害重、病变累及全心及治疗反应较好的特点。混合型系继发于高原红细胞增多症与高原高血压的慢性心脏损害。其消化系统与神经系统损害重。心高型以左心损害为主,左室扩大、左室肥厚、主动脉增宽弯曲及心律失常率分别高于心红型(P<0.05～0.01);心红型以右心损害为主,右室扩大、右室肥厚、肺动脉段与圆锥隆突率分别高于心高型(P<0.05～0.01);心红高型全心损害常见而且严重。根据各型成人高原心脏病的病理机制而采用不同治疗方法对提高该病的治愈率有重要意义。