恶性肿瘤患者的皮肤转移（附50例报告）

恶性肿瘤的皮肤转移确与患者的病种、病理类型、术前后淋巴结转移情况、临床分期、手术类型、放疗及化疗的剂量、遗传因素有关。其出现于任何部位均提示预后不佳。     

良、恶性肿瘤患者血清铜蓝蛋白放射免疫测定及其临床意义探讨

本文用放射免疫分析法测定了１６８例良、恶性肿瘤患者的空腹血清铜蓝蛋白含量，结果显示良性肿瘤患者高于正常对照组（Ｐ＜０．０５），恶性肿瘤患者显著高于正常对照组和良性肿瘤患者（Ｐ＜０．０１）．提示用放射免疫分析法测定血清铜蓝蛋白可作为恶性肿瘤的一项重要辅助诊断指标，有助于良、恶性肿瘤的诊断与鉴别诊断。     

Boundary Ambiguity in Parents With Chronically Ill Children: Integrating Theory and Research

Abstract: This article integrates theory and research related to boundary ambiguity in parents of children with a chronic health condition. We propose that boundary ambiguity is a risk factor for psychological distress in these parents. Clinical applications and a case example highlight how boundary ambiguity can be assessed and managed in clinical settings by professionals working with parents with chronically ill children. Questions are provided for assessing boundary ambiguity in clinical and research settings, and implications for research are discussed.     

Infantile chronic tubulo-interstitial nephritis with cortical microcysts: variant of nephronophthisis or new disease entity?

Over a 15-year period we observed seven children (four girls, three boys) who presented within the first months of life with severe renal failure and acidosis, associated with hypertension in five patients and polyuria in four. In addition, one patient had a severe cholestatic liver disease. In two families, a similarly affected sibling had died previously. Four patients were referred with the clinical diagnosis of polycystic kidney disease because of moderate enlargement of kidneys, but renal imaging (intravenous pyelography and ultrasonography) did not confirm this diagnosis. A renal biopsy, performed in all patients, showed similar features characterized by a diffuse chronic tubulo-interstitial nephritis (TIN) and particularly by the presence of microcystic dilatation of proximal tubules and Bowman's space. Liver pathology was normal in two patients, including one with hepatomegaly. However, in the patient with cholestasis there was inflammatory portal fibrosis with mild duct proliferation. Progression of the renal disease was extremely rapid and all patients reached end-stage renal failure (ESRF) before the age of 2 years (11–22 months). Two children had successful renal transplants. Although this chronic TIN shares some features with nephronophthisis, we suggest that it represents a distinct entity both on clinical and morphological grounds. The specific clinical features of this disease are its early onset and rapid progression to ESRF. Pathologically, it differs from nephronophthisis by the absence of medullary cysts and thickened tubular basement membranes and by the presence of cortical microcysts.     

Reduction in acute rejections decreases chronic rejection graft failure in children: a report of the North American Pediatric Renal Transplant Cooperative Study (NAPRTCS).

Chronic rejection accounted for 32% of all graft losses in 7123 pediatric transplants. In a previous study acute, multiple acute and late acute rejections were risk factors for the development of chronic rejection. We postulated that the recent decrease in acute rejections would translate into a lower risk for chronic rejection among patients with recent transplants. We reviewed our data on patients transplanted from 1995 to 2000, and using multivariate analysis and a proportional hazards model developed risk factors for patients whose grafts had failed due to chronic rejection. A late initial rejection increased the risk of chronic rejection graft failure 3.6-fold (p < 0.001), while a second rejection resulted in further increase of 4.2-fold (p < 0.001). Recipients who received less than 5 mg/kg of cyclosporine at 30 days post-transplant had a relative risk (RR) of 1.9 (p = 0.02). Patients transplanted from 1995 to 2000 had a significantly lower risk (RR = 0.54, p < 0.001) of graft failure from chronic rejection than those who received their transplants earlier (1987-94). Since we were able to demonstrate that there is a decreased risk of chronic rejection graft failure in our study cohort, we would conclude that the goal of future transplants should be to minimize acute rejections.     

Utility of pulmonary function testing in the management of chronic obstructive pulmonary disease

This study sought to measure the effect of pulmonary function testing (PFT) data on the decisions made by generalist physicians in the management of chronic obstructive pulmonary disease (COPD). 148 physicians were randomly assigned to two groups, both of which were asked to manage two identical fictitious but representative cases of COPD, which included history, physical, x-ray, and laboratory results. The experimental group received PFT results in addition. No significant difference was noted between the two groups in management based on availability of PFT data. The optimum utility of PFT data in the management of COPD may be exaggerated and has yet to be determined. Received from the Department of Medicine, Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin. Presented at the Annual Scientific Meeting of the American College of Chest Physicians, October 28, 1992, Chicago, Illinois.     

A Drosophila melanogaster hobo-white+ vector mediates low frequency gene transfer in D. virilis with full interspecific white+ complementation

Transformation of a Drosophila virilis white mutant host strain was attempted using a hobo vector containing the D. melanogaster mini-white⁺ cassette (H[w⁺, hawN]) and an unmodified or heat shock regulated hobo transposase helper. Two transformant lines were recovered with the unmodified helper (HFL1), one containing only the white⁺ marked vector, and a sibling line containing the vector as well as an HFL1 helper integration. An approximate total transformation frequency of 1% is deduced. A high frequency of wing and eye morphology mutants were also observed, suggesting that hobo may have mobilized a related element in D. virilis. The data reaffirms a relatively low transformation vector activity for the hobo transposon in D. virilis; however, nearly full interspecific expression of the white⁺ marker supports its possible function in other species as well.     

皮肤交界性平滑肌瘤的复发与恶性转化

目的探讨皮肤交界性平滑肌瘤的复发与恶性转化。方法复习2例皮肤交界性平滑肌瘤及其复发恶性转化的临床病理特征、免疫组化表型及相关文献。结果2例病变位于下肢和额部，肉瘤组织平滑肌标记阳性。结论少数病理诊断为皮肤平滑肌瘤的病例，虽然浅表且组织形态良性，但其生物学恶性潜能尚不能确定，部分病例复发后可转变为典型的平滑肌肉瘤。     

结肠回肠反流与回肠黏膜结肠化相关性的实验研究

目的探讨结肠回肠反流后回肠末端黏膜结肠化的机制.方法取SD大鼠60只,均为雄性,体重25¨3∞g,随机分为实验组和对照组,分别进行末端回肠-盲肠侧侧吻合术或回肠末端手术缝线,2个月后处死动物并取组织进行观察.结果实验组术后一般状况良好.大体形态学观察:实验组回肠末端黏膜表现为绒毛萎缩、间距增宽、沟变浅、光滑性增强.病理组织学:实验组表现为黏膜绒毛萎缩、间距增宽、沟变浅、上皮细胞变短、杯状细胞增多.电镜观察:实验组可见绒毛变小、变短或脱落;微绒毛变短、分布不均匀;杯状细胞数目在非坏死区增多.结论结肠-回肠反流后可导致回肠末端黏膜结肠化的变化,它可能是慢性末端回肠炎的发病基础或前期表现.     

慢性前列腺炎相关危险因素的调查报告

目的:探索不良生活习惯、精神、心理等相关因素与慢性前列腺炎发病的关系. 方法:对600例慢性前列腺炎患者进行流行病学调查,采用单因素及多因素条件Logistic回归法进行统计分析,判断危险因素.结果:多因素Logistic回归分析发现引起慢性前列腺炎的可能因素为尿道炎、无节制的性生活、频繁的手淫、固定体位(尤其长时间骑跨、坐位)、酗酒、生活方式改变、长时间憋尿、紧张焦虑心理等.结论:本研究结果对慢性前列腺炎的预防、治疗及防止复发具有参考价值.