胎儿多囊泡肾的产前诊断研究

胎儿多囊泡肾有典型的超声影像学特点,但其病因复杂,致病因素可作用于肾的各个发育阶段而致其发育阻滞。     

Cerebral abscesses in hereditary haemorrhagic telangiectasia: a clinical and microbiological evaluation

Objectives

Hereditary haemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder that can lead to neurological manifestations including strokes and cerebral abscesses. Our objectives were to describe clinical, radiological, bacteriological, and outcome characteristics of patients with cerebral abscess and HHT, and to concurrently compare this group with a control group with cerebral abscess, but without HHT.

Patients and methods

Patients with HHT and cerebral abscess in 5 French medical centers were included. Their clinical, radiological, biological data and prognosis were compared to the data of unselected patients with cerebral abscesses but without HHT included during the same period of time.

Results

Twenty-six patients (13 men and 13 women; 44.7 ± 17.2; range 12–79 years), with HHT and cerebral abscess were included. A pulmonary arteriovenous malformation (AVM) was present in all cases. Cerebral abscesses were solitary, supratentorial, and mostly lobar. In all cases, pathogens were anaerobic or facultative anaerobic germs (particularly streptococcus). No death was observed, but various sequels were present in up to two-thirds of the patients. We observed a recurrence of the cerebral abscess in 4 patients with a mean delay of 81 months. In comparison with the control group, cerebral abscesses were generally of later recurrence and significantly more often unique and less often due to staphylococcus.

Conclusion

HHT cerebral abscesses are particularly linked to pulmonary arteriovenous malformations and anaerobic germs. Their clinical, radiological and bacteriological characteristics are quite different than in a control group with more solitary brain localizations, no staphylococcus infection and a significantly longer interval to recurrence.     

外伤性慢性硬脑膜下血肿发生机理探讨

目的：探讨慢性硬脑膜下血肿（CSDH）的发生机理,方法：对我科1997年至1999年治疗的17例急性硬脑膜下血肿（ASDH）,11例CSDH及9例硬脑膜下积液病人进行观察分析,结果：17例ASDH非手术治疗后无1例发展成为CSDH,9例硬脑膜下积液有2例发展成为CSDH,1例发展为张力性硬脑膜下积液。11例CSDH病人中,在第一次外伤后72h内头部CT示6例硬脑膜下积液,4例脑挫伤,1例无特殊显示,无一例为硬膜下血肿,结论：CSDH的发生可能与硬脑膜下积液有密切关系。     

The relationship between target,targetoid, and targetoid/core fibers in severe neurogenic muscular atrophy

Summary In the m. tibialis anterior of a 68-year-old man with rapidly developing denervation atrophy in the legs since 1/2 year prior to death from heart stroke, abundant unifocal concentric fiber changes, such as target, targetoid/core, and targetoid fibers could be observed. Besides, large vacuolized fibers with multiple changes resembling cytoplasmic bodies in the peripheral zone were present as well; they are interpreted as fibers with multicentric target or targetoid formations. The target fibers displayed a broad variation of their outer appearance suggesting a continuous transition to targetoid/core fibers (with a dense center) and targetoid fibers (with a central change to aquous sarcoplasm showing a paucity of fibrillar structures). Very few fibers with a central densification of fibrillar material with or without a thin intermediate zone were fairly akin to core fibers of central core disease; others were more alike the type of targetoid fibers, previously described in the literature, showing a dense target-like center; both were summarized under the term, inaugurated by Engel et al. (1966), targetoid/core fibers. Simultaneous occurence of the different kinds of concentric fiber changes suggested a strong relation between all of them in the sense of representing different developmental stages of the same pathogenetic process. Thus, the central core disease, for instance, might be a disorder with a generalization of concentric fiber changes having come to arrest in the earliest stage of development.

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Zusammenfassung Im M. tibialis anterior eines 68 Jahre alt gewordenen Mannes, der 1/2 Jahr vor seinem Tode am Herzinfarkt eine rasch progrediente neurogene Muskelatrophie in den Beinen entwickelte, fanden sich außerordentlich zahlreiche unifokal-konzentrische Muskelfaserveränderungen wie Target-, Targetoid/Core- und Targetoidfasern. Außerdem sah man große vacuolisierte Faserquerschnitte mit multiplen fokalen Veränderungen in der Randzone, die an die früher beschriebenen cytoplasmic bodies erinnerten; im vorliegenden Zusammenhang wurden sie allerdings als Fasern mit multizentrischen Target- und Targetoidformationen interpretiert. Die Targetfasern zeigten eine weitläufige Variation in der äußeren Erscheinungsform, die in der Zusammenschau kontinuierliche Übergänge zu Targetoid/Corefasern (mit dichter Zentralzone) und Targetoidfasern (mit zentraler Auflösung und Vermehrung aquösen Sarkoplasmas mit wenigen fibrillären Strukturen) erkennen ließ. Wenige Fasern mit einer zentralen Verdichtung fibrillären Materials mit oder ohne schmaler Intermediärzone waren Corefasern des Central-Core-Disease auffallend ähnlich; andere glichen mehr dem Typ von Targetoidfasern mit strukturdichtem Zentrum, wie sie in der früheren Literatur beschrieben wurden. Beide Formen wurden wegen ihrer großen Ähnlichkeit von Engel et al. (1966) unter dem Begriff Targetoid/Core Fibers zusammengefaßt. Das gleichzeitige Auftreten der verschiedenen Formen konzentrischer Faserveränderungen in einem Muskel legt die Annahme nahe, daß zwischen allen eine enge Beziehung im Sinne unterschiedlicher Manifestationsstufen des grundsätzlich gleichen pathogenetischen Prozesses besteht. So wäre unter dieser Annahme beispielsweise das Central-Core-Disease eine Erkrankung mit einer Generalisation konzentrischer Faserveränderungen, die im frühesten morphologischen Entwicklungsstadium zum Stillstand gekommen sind.

     

763例肺结核患者下呼吸道病原菌分布及耐药性分析

目的分析肺结核合并下呼吸道感染的菌种分布及耐药情况,为临床合理使用抗生素提供依据。方法统计安徽省胸科医院2011年度肺结核合并下呼吸道感染763例痰标本的培养和药敏实验结果。结果 3 881份痰标本共检测出763株菌株,其中革兰阴性菌447株(58.59%)、革兰阳性菌154株(20.18%)和真菌162株(21.23%)。主要病原菌依次为肺炎克雷伯菌、白色假丝酵母菌、鲍曼不动杆菌和铜绿假单胞菌。不论是革兰阴性杆菌还是革兰阳性球菌均表现出极高的多耐药性,革兰阴性杆菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦和亚胺培南的耐药率较低,金黄色葡萄球菌对万古霉素未出现耐药现象。结论下呼吸道分离病原菌耐药现象普遍存在,临床应重视病原学检查,开展病原菌耐药性监测,合理使用抗菌药物。     

VEGF在犬恒牙胚发育中的表达及意义

目的：探讨犬乳恒牙替换过程中血管内皮生长因子（VEGF）在犬恒牙胚发育中的表达及意义。方法：分别对乳牙期、替牙期、恒牙期本地犬取牙胚及其周围组织，制备石蜡切片，进行HE染色和牙胚内VEGF的免疫组化染色，用彩色病理图像分析系统分析各组染色强度灰度值。结果：乳牙期、替牙期犬牙胚的成牙本质细胞VEGF的免疫组化强度明显高于另外一组，成釉细胞中也有阳性信号。结论：VEGF可能参与恒牙胚的发育。     

尿路清对几种常见泌尿生殖道病原体的抑制试验

目的　为了探讨中药尿路清对几种常见泌尿生殖道病原体的抑制作用 ,为中医药治疗此类疾病提供药理学依据。方法　分别采用液体试管法和微量稀释法测定了尿路清对这些病原体的体外抑制效应。结果　尿路清对金黄色葡萄球菌、乙型溶血性链球菌、丙型链球菌、卡他球菌、大肠杆菌、绿脓杆菌、白念珠菌和表皮葡萄球菌的MIC(g/ml)分别为 0 .10、0 .0 5、0 .2 0、0 .2 0、0 .2 0、0 .2 0、0 .2 0、0 .2 0、0 .10 ;尿路清对解脲支原体和人型支原体的MIC分别为 3 .91g/L和 7.81g/L。结论　中医药在泌尿生殖道感染的治疗上有重要作用。     

THERAPY FOR CANCER—METHODS AND SUGGESTIONS

On the basis of the theory of Traditional Chinese Medicine,authors put forwathe etiopathogenesis and pathogenetic mechanism of solid tumors,and formulated a scheme for tre~ment of cancer with acupuncture therapy.     

Light microscopic, cytochemical and ultrastructural studies of a rat odontogenic epithelial cell line.

An odontogenic epithelial cell line, ROE-2B, was established by propagating disaggregated immature, unmineralized maxillary third molar tooth germs from 11-day old Sprague-Dawley rats on a feeder layer of Mitomycin-C treated NIH 3T3 embryonic mouse fibroblasts. The cell line has been maintained for more than 6 months and through 7 passages. Light microscopic examination of cells revealed colonies with epithelial morphology. Electron microscopic examination confirmed the epithelial nature by the demonstration of tonofilaments, desmosomes and basal lamina. Cells were also shown to have secretory vacuoles, an abundance of granular endoplasmic reticulum, free ribosomes, Golgi complex and mitochondria. Surface activity in the form of pseudopodia-like projections and micropinocytosis were noted. Epithelial cells forming keratin were demonstrated by a positive histochemical reaction with Rhodanile Blue. Immunohistochemical studies showed a positive reaction for CAM 5.2 indicating that the ROE-2B cells express the cytokeratins of simple or glandular epithelia. The ROE-2B cell line will be useful for studies on in vitro biological behaviour of odontogenic epithelial cells, and may allow the establishment of in vitro models of odontogenic tumours.     

不同扩弓方式对乳牙反牙合患儿软硬组织及恒切牙胚位移影响的比较研究#br#

目的    研究不同扩弓方式对乳牙反牙合患儿软硬组织及恒切牙胚位移的影响。方法    选取2008—2018年于河北医科大学第一医院口腔正畸科就诊的乳牙反牙合患儿40例进行回顾性分析,其中采用矢状扩弓矫治患儿20例（矢状扩弓组）,采用横向扩弓矫治患儿20例（横向扩弓组）。对患儿治疗前后的头颅侧位片进行测量分析,比较2组治疗前后软硬组织及恒切牙胚位置的变化。结果    2组治疗前后上颌骨长度（Ptm-A）和水平向位置（A-X）、下颌骨全长（T4-Po）和位置（T4-S）、上乳中切牙突度（D1-NA、D1-SN）和位置（D1i-X、D1a-X）、上下乳中切牙夹角（D1-L1）及上恒中切牙胚位置（G1i-X、G1i-Y、G1a-X）均有改变,差异均有统计学意义（P < 0.05）。2组上恒中切牙胚位置的改变有显著性差异,横向扩弓组G1i-X、G1i-Y、G1a-Y的改变量均大于矢状扩弓组,差异有统计学意义（均P < 0.05）。比较2组上乳中切牙位置的改变发现,横向扩弓组D1a-Y的改变量大于矢状扩弓组,差异有统计学意义（P < 0.05）。其他测量指标改变量的组间比较,差异均无统计学意义（均P > 0.05）。结论    2种扩弓方式均能有效纠正乳牙反牙合,对乳牙反牙合患儿软硬组织的影响基本一致。横向扩弓方式比矢状扩弓方式更有利于上恒中切牙胚向前向下移动。