山东省中小学生麻疹爆发原因的病例对照研究

为探讨山东省中小学生麻疹爆发的原因 ,采用 1∶2配比的病例对照方法对中小学生麻疹疫苗 (MV)效力进行了研究 ,同时对近年来中小学生MV接种率进行了估算。结果显示 :中小学生MV效力为 74 % ,95 %可信区间为4 7%～ 88% ;小学生MV效力明显高于中学生 ,分别为 82 %和 6 8% ;1999～ 2 0 0 1年学龄儿童的估算接种率分别为75 4 %、75 6 %和 5 5 7%。较低的MV效力和接种率是计划免疫工作薄弱地区中小学生麻疹爆发的主要原因。     

Benign giant cell tumor of bone with osteosarcomatous transformation (”dedifferentiated” primary malignant GCT): report of two cases

 It is not uncommon for sarcomatous transformation of giant cell tumor (GCT) of bone to occur after radiation, but rarely does malignant transformation occur spontaneously, with less than 15 cases reported up to 1995. Only four of these cases have been documented in detail. We report two additional cases of GCT of bone spontaneously transforming or ”dedifferentiating” into osteosarcoma without radiation therapy. The first case is absolutely unique and most interesting in that the dedifferentiation process occurred in one of multiple GCT lung metastases 6 years after successful eradication of a primary tibial tumor. The right lung was resected due to development of a large tumor, and at pathologic examination, demonstrated several small nodules of conventional GCT and a much larger, 14-cm mass composed of a mixture of GCT and high-grade osteosarcoma. The second case involved a physician, who had a large tumor in the sacrum with vague symptoms for 8 years. Open biopsy revealed conventional, benign GCT of bone with a secondary aneurysmal bone cyst. Complete curettage 2 weeks later revealed, in addition to areas of conventional, benign GCT a second component of very high grade osteosarcoma. Both patients died less than 1.5 years from diagnosis. This report of osteosarcomatous transformation of a conventional GCT of bone strengthens the theory that there is a mesenchymal cell line in GCT that may spontaneously tansform to sarcoma.     

Extramedullary plasmocytoma of the bronchial system

Summary. We present a case of primary plasmocytoma of the left upper bronchus. Occlusion led to atelectasis of the left upper lobe and subsequent poststenotic pneumonia. Therapy consisted of local excision of the bronchus and postoperative radiotherapy. This type of lung-conserving therapy in a case of primary plasmocytoma has not been described before.      

66例成人原发肾病综合征临床治疗与病理分析

本对６６例原发肾病综合征患进行病理类型与临床疗效分析。最常见病理类型为系膜增殖性肾炎，占４２．５％，其次为膜性肾病，占３２．５％，ＩｇＡ肾病占１５．０％。微小病变型及系膜增殖性肾炎对激素及免疫抑制剂治疗效果好，膜性肾病治疗效果差。不同病理类型患病理损害程度与疗效相关。伴肾小管间质病变治疗效果差（Ｐ〈０．０５）。ＮＳⅠ型疗效明显优于ＮＳⅡ型（Ｐ〈０．０５）。５０岁以下原发肾病综合征（ＰＮＳ）     

原发全身性癫痫遗传流行病学研究

本文报道１００例原发全身性癫痫家系的遗传流行病学研究结果。先证者一级亲属患病率为６．８６％，二级亲属为１．０３％；分别是对照组一级亲属的１３．８３倍和２．０８倍。原发全身性癫痫的遗传度为：一级亲属０．７５２１±０．０６７８，二级亲属０．３５９２±０．０７４６；加权平均０．５７４３±０．０５０２。说明遗传因素起重要作用。发病年龄影响因素分析表明：原发全身性癫痫有一定年龄依从性。ＥＥＧ家系分析显示，该型癫痫一级亲属癫痫样放电明显高于对照组一级亲属，提示癫痫样放电的遗传倾向。     

两种术式治疗多囊卵巢综合征的远期疗效追踪比较

[目的]评价开腹卵巢楔形切除(OWR)和腹腔镜下双侧卵巢电灼开窗术(LOD)两种术式对多囊卵巢综合征(PCOS)的远期疗效.[方法]1981至2001年在我院诊断为PCOS并接受手术治疗的妇女共151例,其中行OWR 61例、LOD 90例,追踪分析两组妇女术后妊娠率、术后妊娠时间的分布及术前后月经模式变化.[结果]两组的临床特征具有可比性,OWR组累积妊娠率84%,LOD组累积妊娠率72%,两组间没有明显差异,绝大部分妊娠发生在术后18个月内;OWR组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是81.3%、81.3%、77.3%、77.6%、78.9%、85.2%,明显高于术前的31.1%(P值＜0.05);LOD组术后3个月、半年、1年、3年、5年及10年月经规律的妇女所占的比例分别是80.6%、63.5%、56.7%、58.0%、57.6%、42.9%,明显高于术前的35.6%(P值＜0.05);术后OWR组月经规律妇女占的比例明显高于LOD组(P均＜0.05).[结论]两种术式的术后妊娠率相似.OWR比LOD更好、更长远地改善PCOS妇女的月经异常.     

晚期卵巢癌理想肿瘤细胞减灭术的可行性研究

目的探讨晚期卵巢癌理想肿瘤细胞减灭术的可行性. 方法对22例Ⅲ、Ⅳ期晚期卵巢癌患者行肿瘤细胞减灭术,手术中尽可能多地切除盆腹腔内原发或继发癌灶,清扫盆腔和腹主动脉旁淋巴结,其中16例行理想肿瘤细胞减灭术(残留灶<2 cm). 结果切除前≥2 cm转移癌主要位于大网膜、盆腔和大肠;术后≥2 cm的残留灶主要位于盆腔,其次在胃结肠韧带、肝门和脾门.术后平均随访10(2～14)个月,达到理想手术的16例均无复发,未达理想减灭术的6例患者中复发及存活各1例,死亡3例,失访1例. 结论理想的肿瘤细胞减灭术对晚期及复发卵巢癌是安全可行的.     

A BLIND RANDOMIZED CROSS -OVER TRIAL COMPARING BETAXOLOL WITH TIMOLOL IN OPEN-ANGLE GLAUCOMA AND OCULAR HYPERTENSION

Purpose: To compare the short-term efficacy and side effects of betaxolol and timoloi in treatment of primary open angle glaucoma or ocular hypertension. Methods: Fourteen patients with newly diagnosed early primary open angle glaucoma or ocular hypertension were included.Each patient received 0.5% timoloi and 0.5% betaxolol twice daily for four weeks in two phases. Between two courses of treatment there was four weeks wash out period. At the end of study the effect of these two drugs on intraocular pressure, mean arterial blood pressure,pulse rate,basic tear secretion and ocular symptoms were evaluated and statistically analyzed,using wilcoxon and chi-squar test.RESULTS:The study was performed on fourteen patients with baseline IOP of 26.7 ±1.5 mmHg.After four weeks treatmem,timoiol and betax-olol reduced IOP by 7.8±1.2mmHg or 29% and 6.1±1.3mmHg or 23%, respectively (P<0.001). The difference between two groups was significant(P<0.001). Mean arterial blood pressure was reduced with betaxolol and tim     

肝癌患者血清P-选择素测定及临床意义

目的：研究肝癌患血清P-selection(P-sel)在肝癌复发和转移中的作用。方法：采用ELISA法分别测定原发性肝癌患和对照组血清P-选择素的含量，同时测定AFP含量。结果：肝癌患P-sel含量显高于正常人，且与AFP含量呈线性正相关，术后2周浓度降低；P-sel含量以Ⅰ、Ⅲ和Ⅳ期肝癌患显高于Ⅰ期患；且大肝癌患显高于小肝癌患，有癌栓组、有肝内转移组明显高于无癌栓组和无转移组。结论：P-选择素测定在原发性肝癌的诊断和检测术后复发方面有重要价值，联合检测AFP和sP-sel可提高诊断敏感性。     

Aortic valve injury 10 years after tetralogy of Fallot repair

Summary Although recognized by pediatric cardiac surgeons, aortic insufficiency as a technical complication after tetralogy of Fallot repair is poorly documented, especially if it occurs late. The case of a boy with aortic insufficiency 10 years after complete tetralogy repair is described. No documentation in the literature other than summary statements in textbooks of this occurence was found.