羊水细胞培养宫内诊断的应用(附120例分析)

报告120例羊膜腔穿刺羊水细胞培养结果:在成功的99例中,发现二例染色体异常,核型为47,xy,+18和46,xx/47,xx,+F,在21例失败中出现一例眼球畸形。培养成功率为82.5%;染色体异常检出率为2.02%。无一例因羊膜腔穿刺而导致流产,但出现一例轻度羊水栓塞合并症。并对羊水细胞培养在产前宫内诊断中应用价值及术后并发症进行了讨论。     

病毒性肝炎60例临床与病理分析

对６０例病毒性肝炎患者进行肝穿刺活检，结果发现，临床与病理诊断的符合率为４６．６％，其中，急性肝炎的诊断符合率最低（２３．８％），慢性迁延型肝炎（慢迁肝）为４４．８％；ＨＢｓＡｇ阳性首次发病的患者中，急性乙型肝炎仅为１１．２％（２／１８）；临床诊断的慢性活动型肝炎（慢活肝）仅为病理检出的２５．７％（９／３５）；肝炎患者中脾肿大，凝血酶元时间延长、Ａ／Ｇ值＜１．２、抗ＨＢｃＩｇＭ阳性可作为慢活肝与慢迁肝鉴别的重要指标。这些对提高病毒性肝炎临床分型诊断的准确率及指导临床治疗有意义。     

A Study on Using Improved Methenamine-silver Stain to Diagnosis of Pneumocystis carinii

ＡＳｔｕｄｙｏｎＵｓｉｎｇＩｍｐｒｏｖｅｄＭｅｔｈｅｎａｍｉｎｅ－ｓｉｌｖｅｒＳｔａｉｎｔｏＤｉａｇｎｏｓｉｓｏｆＰｎｅｕｍｏｃｙｓｔｉｓｃａｒｉｎｉｉＣｈｅｎＸｉｗｅｉ（陈锡慰）（ＤｅｐａｒｔｍｅｎｔｏｆＰａｒａｓｉｔｏｌｏｇｙ，ＮａｎｊｉｎｇＭｅ...     

28例青年人胃癌的临床及病理分析

对２８例青年人胃癌的临床及病理分析结果表明，其发病具有症状隐匿、病程短、进展快的特点，本组病例从出现症状到漏诊在６个月内为５７．１％（１６例），首发症状以上腹部疼痛、吐血、黑便多见，病理特征以结节蕈伞型、高分化腺癌多见。     

Clinical aspects and immune reactions in sarcoidosis*

Introduction: Sarcoidosis is a granulomatous disorder of unknown aetiology, affecting young adults and frequently involving the lungs. Objective: The aim of the present review was to give an overview of the clinical aspects in sarcoidosis. Results: The majority of patients recover, but some develop a chronic disease that may result in fibrosis and respiratory failure. Besides the lungs, peripheral lymph nodes, the skin, the liver and the eyes are commonly affected as well. The genetic background, as well as environmental factors, is of importance for developing sarcoidosis. The incidence varies in different populations, in the Nordic countries approximately with 20/100 000 new patients yearly. Sarcoidosis is diagnosed when clinical and radiological findings are supported by histological evidence in the form of non‐caseating epithelioid cell granulomas, and when other causes of these features are excluded. Patients in need of treatment are usually treated with corticosteroids, topically or as oral steroids. A clinical effect of immunomodulatory drugs blocking tumour necrosis factor (TNF)α has been suggested from several case reports, while two controlled studies showed only minor effects; however, with a tendency to a more pronounced effect on patients with a more severe disease. The immune response in sarcoidosis, with a typical accumulation of CD4+ T‐cells to the lungs, indicate the existence of specific antigens in this disease. Recently, antigens derived from infectious agents such as Mycobacteria and Proprionibacterium acnes have come into focus. Lymphocyte populations with immunoregulatory functions have recently been investigated and seem to be dysfunctional in sarcoidosis, opening the possibility of developing new treatment strategies in this disease. Conclusion: Recent technical developments have provided better tools, enabling detailed and more thorough analyses of the inflammatory process in sarcoidosis. Please cite this paper as: Grunewald J. Clinical aspects and immune reactions in sarcoidosis. The Clinical Respiratory Journal 2007; 1:64–73.     

眼眶动静脉畸形致眼上静脉扩张的影像学表现

目的探讨眼眶动静脉畸形(AVM)致眼上静脉(SOV)扩张的影像学及血管造影表现。设计回顾性病例系列。研究对象6例临床表现与硬脑膜海绵窦瘘(CCF)相似的眼眶AVM患者。方法总结分析所有患者的影像学检查结果,如CT、MRI和选择性脑血管造影。主要指标影像学征象及血流动力学。结果CT和MRI均可显示所有患者的SOV扩张。另外,尚存在眼球突出、AVM畸形血管团等征象。所有6例AVM均位于眼眶内,1例尚合并颅内AVM。所有患者的主要引流静脉均为SOV,动脉包括脑膜中动脉、上颌动脉和眼动脉。结论眼眶AVM可引起与CCF相似的临床和影像学征象,但AVM通常不引起海绵窦膨大,血管造影仍是确诊的必需手段,而无创技术是辅助血管造影进行明确诊断的重要手段。(眼科,2007,16:395-398)     

The predictive value of specific immunoglobulin E levels for the first diagnosis of cow''s milk allergy. A critical analysis of pediatric literature

Investigators have tried to identify a level of seric specific immunoglobulin E (IgE) that had a sufficient predictive value to diagnose a food allergy without having will resort to the food challenge. To search in literature, all the studies that have estimated the possibility to identify a level of seric specific cow milk IgE with a positive predictive value (PPV) of 95% for the first diagnosis of cow's milk allergy (CMA) in pediatric age. We have identified six studies, nearly all studies suffer from relevant methodological bias. Proposed cut-off are all different. The studied pediatric populations were highly selected. Also neglecting the methodological bias of the studies and the great difference of value between the proposed cut-off, it always remains to consider that the pre-test probability of having a CMA between the children enrolled in the six studies included in this review is particularly high. The likelihood ratio helps to transfer the results of a study on a diagnostic test just to our population, and it is more realistic rather than to entrust itself to the PPV or the negative predictive value, that are much influenced from the prevalence of the disease in the studied population.