绝经后阴道出血852例临床分析

探讨经经后阴道出血的原因，相关因素来指导临床实践。方法；对我院收治的８５２例绝经后阴道出血的临床资料进行回顾性分析。结果；以阴道炎最多２６９例、慢性宫颈炎１８８例，功能失调性子宫出血１０２例，宫内节育器９８例，恶性肿瘤５９例，以内膜癌 ３３例，卵巢恶性肿瘤次之１６例。     

气管与主支气管肿瘤的影像诊断（附32例报告）

作者对３２例经病理证实的气管与主支气管良、恶性肿瘤的影像学表现进行分析，归纳为３型：腔内型、壁增厚型和腔内外型。后２种类型提示恶性，而无蒂的腔内型表现者不能鉴别良，恶性。作者还评价了常规体层、ＣＴ及ＭＲＩ诊断气管与主支气管肿瘤的优、缺点，讨论了影像诊断的作用。     

第Ⅲ段肝管空肠吻合解除肝门部胆管恶性梗阻

肝门部胆管恶性梗阻的治疗仍然十分困难。若不解除胆道梗阻,病人很快因肝细胞功能衰竭而死亡。由于肿瘤在肝门部侵润性生长,直接经肝门的手术往往不可能实现。1980～1993年间,我们采用第Ⅲ段肝管空肠吻合术姑息治疗28例肝门部胆管恶性梗阻的黄疸病人。24例为肝门部胆管癌,2例为胆囊癌,2例为胃癌肝门部淋巴结转移。术后19例病人恢复顺利;5例发生并发症,4例病人手术后死亡。24例存活病人中,19例黄疸完全消退3月以上,手术有效率为79％。4例黄疸再次出现,2例因胆管炎需要入院治疗。作者认为:第Ⅲ段肝管空肠吻合术能有效解除不能切除的肝门部恶性肿瘤病人的胆道梗阻。     

Ultrastructural and immunohistochemical study of Ewing's sarcoma and related tumors: Morphological neural markers suggesting neural histogenesis in 32 small round-cell sarcomas

The purpose of this study was to validate the hypothesis of neural histogenesis of Ewing's sarcoma of bone and related tumors by light microscopic, electron microscopic, and immunohistochemical analysis. We studied 32 round-cell sarcomas (19 cases of Ewing's sarcoma of bone, 3 extraskeletal Ewing's sarcomas, 5 peripheral primitive neuroectodermal tumors (PNET) and 5 cases of unclassified small round-cell type of neurogenic sarcoma (NS). Immunoreactivity for MIC2 was observed in all cases of Ewing's sarcoma and PNET, and in 1 cases of NS. Positive immunoreactivity for neural markers (NSE, synaptophysin, S-100) was found frequently in some tumors. Ultrastructurally, some specific features of neural differentiation, such as a fragmented basal lamina and neurosecretory granule-like particles, were found even in typical cases of Ewing's sarcoma of bone, which presented without a rosette arrangement and were almost negative for neural immuno-markers, but positive for MIC2. These ultrastructural neural features were observed less frequently in Ewing's sarcoma of bone than in PNET and NS. However, no significant correlation was demonstrated between the immunoreactivity for neural markers and the ultrastructural and histological neural features. These results support the hypothesis of a neural origin of Ewing's sarcoma and related neoplasms, and suggest that some overlapping entity could persist in PNET and Ewing's sarcoma and that this entity could be seen in histological and immunohistochemical studies of both tumors.     

A study of blood supply of liver tumors using duplex Doppler ultrasound and color Doppler flow imaging

Summary With the use of duplex Doppler ultrasound and color Doppler flow imaging(CDFI), the characteristics of blood supply in neoplasma were studied in 51 cases of 60 liver tumors, and compared with the results of surgery, pathological examination and hepatic anerial angiography. The result showed that: 1. Doppler blood flow signals could be detected in all hepatic carcinomas, and in 10 cases of 18 hemangiomas, significant difference was observed (P<0.001); 2. Doppler blood flow spectra showed pulsatile pattern in 41 of 42 hepatic carcinomas, and in 6 of 10 hemangiomas (P<0.01); and 3. the peak flow velocity was obviously lower in hemangioma group than in hepatic carcinoma group (20.34±23.93 vs 64.74±30.18 cm,P<0.001). The characteristics of CDFI show that hemangiomas and hepatocellular carcinomas are different. It can, therefore, be concluded that the blood supply of hepatic carcinomas mainly comes from hepatic arterial system, and is of value in duplex Doppler ultrasound and CDFI.     

Granular cell tumors of the breast: A report of two cases

Granular cell tumors (GCT) are rare neoplasms, and only 173 cases of benign GCT of the breast have been documented. We report herein the cases of two patients with this tumor and discuss the methods of diagnosis and treatment. The first patient was a 60-year-old woman who presented with a firm ill-defined mass in her left breast. Mammography showed a dense shadow with spicula and skin thickness, and ultrasonography revealed a hypoechoic mass with an irregular border. Radical mastectomy was performed under the wrong preoperative diagnosis of breast cancer. The second patient was a 31-year-old woman who presented with an elastic-hard mass in her left breast. Mammography showed a well-demarcated dense mass, and ultrasonography revealed a well-defined hypoechoic mass with a large depth-width ratio. Fine-needle aspiration cytology (FNAC) showed a large number of histiocytic cells with abundant granular cytoplasm. An excisional biopsy was performed, and histological examination confirmed a diagnosis of GCT. GCT is benign, but often misdiagnosed as breast cancer both clinically and radiologically. Therefore, histological examination is essential for making a correct diagnosis, while FNAC is also useful. Local resection is still the treatment of choice, and surgeons should do their utmost to avoid performing needless radical mastectomy.     

大鼠腹腔肥大细胞肿瘤坏死因子合成与释放的研究

应用免疫细胞化学技术及酶联免疫吸附试验（ELISA）对大鼠腹腔肥大细胞合成和释放肿瘤坏死因子（TNF）的状况进行了观测。结果:新鲜分离纯化的大鼠腹腔肥大细胞胞浆呈TNF蛋白阳性。单纯肥大细胞培养早期（2～4 h）,上清液中未能检测到TNF,随着培养时间延长,上清液中TNF含量增多;盐酸吗啡与肥大细胞共同培养2h时,上清液中出现可测TNF。四甲基偶氮唑盐（MTT）比色分析试验表明,肥大细胞培养上清液具体有TNF的抗肿瘤活性中。提示:大鼠腹腔肥大细胞能合成和释放TNF,盐酸吗啡能促进肥大细胞释放TNF。     

神经内镜治疗脑室内病变

目的探讨脑室内病变的神经内镜治疗。方法应用神经内镜对68例脑室内病变进行治疗,其中松果体区肿瘤16例,囊性颅咽管瘤15例,丘脑肿瘤14例,脑室内囊肿16例,侵及室管膜下的胼胝体肿瘤3例,侧脑室脉络丛乳头状瘤2例,侧脑室猪囊尾蚴病1例,侧脑室内分流管脱落1例。结果随访17～69个月,56例有效,12例死于肿瘤扩散。无严重并发症。结论对脑室内病变选择性应用神经内镜治疗安全、有效。     

纳米技术在肿瘤诊断与治疗中的现状与展望

目的介绍21世纪前沿科技--纳米技术在肿瘤诊断与治疗中的现状与展望.方法通过检索国内外文献,从肿瘤的诊断与治疗两方面分别论述.结果纳米技术在肿瘤诊断与治疗中有其巨大优势.结论尚处初级阶段,广泛应用于临床还需多方努力.     

肝癌病人血浆和癌组织中血栓调节蛋白的检测

目的　检测肝癌病人血浆和肝癌组织中血栓调节蛋白 (TM )的表达 ,探讨TM与肝癌临床病理特征的关系。方法　用酶联免疫吸附夹心法检测 45例肝癌和 6例肝良性占位病人手术前后的血浆TM水平 ;用免疫组织化学法检测肝癌及肝良性占位组织中的TM蛋白表达水平。结果　术前肝癌组血浆TM水平 ( 10 .2± 5 .7)ng/mL明显高于肝良性占位组 ( 6.1± 2 .2 )ng/mL和正常人对照组 ( 5 .7± 1.0 )ng/mL ,P <0 .0 5 ;术前TM血浆水平肝癌伴门静脉癌栓组 ( 6.9± 4.5 )ng/mL和多发肝癌结节组 ( 8.1± 4.6)ng/mL明显低于无门静脉癌栓组( 11.4± 5 .6)ng/mL和单发肝癌结节组 ( 11.5± 5 .9)ng/mL ,P <0 .0 5 ;40例肝癌病人肝癌切除术前TM水平( 10 .8± 5 .3 )ng/mL与肝癌切除术后 ( 7.6± 4.2 )ng/mL相比差异显著 ,P <0 .0 5。肝良性占位组术前与术后相比差异无显著性 ,P >0 .0 5。肝癌组织中TM蛋白表达阳性的病人术前血浆TM水平明显高于TM表达阴性者 ,P <0 .0 5 ;而术后血浆TM水平两者则无显著性差异 ,P >0 .0 5。结论　肝癌病人血浆中TM水平升高 ,TM水平的高低与门静脉癌栓的形成有关