拉萨地区血行播散型肺结核100例临床X线分析

本文对我院30余年来资料完整的100例血行播散型肺结核进行回顾对比分析。结果显示,急性血播占87例、亚急性10例、慢性3例。患病年龄0～14岁34例,成人66例。性别差异不明显。合并全身结核者63例,其中结脑39例。成人患病之多与西藏结核的患病率高、涂阳率高、人群自然感染率低之流行上升阶段有关外,且与人群结核免疫力低,对结核之变态反应增高有关。     

脊柱转移瘤在椎骨上的分布与血行播散模式(附68例分析)

目的：分析脊柱转移瘤的CT表现，探讨转移瘤在椎骨上的分布与血行播散模式的相关性。方法：68例经临床及组织学证实的脊柱转移瘤病人，每个椎骨在CT横断面上被分成18个部分，每个部分的病灶数被统计。结果：68例患者167个椎骨受累，共210个病灶，其中。196个定位于椎体，168个定位于椎体中后部，49个椎骨的椎弓根受到侵犯。结论：转移瘤在椎骨上的分布与血行播散模式相关(尤其是Batson静脉丛)，并且在鉴别诊断中也有意义。     

Isolated brain metastases of osteosarcoma in a patient presenting with a patent foramen ovale

We report the case of a patient in whom brain MR imaging was requested for initial symptoms of intracranial hypertension. The presence of multiple intracranial hemorrhagic lesions suggested brain metastases. Body screening showed periosteal osteosarcoma of the left fibula with no lung metastases, but with a patent foramen ovale which probably allowed neoplastic cells to reach the brain without being filtered through the lungs. The conclusion of this study was that a left–right cardiac communication is to be considered in cases of isolated brain metastases from osteosarcoma. Received 21 February 1996; Revision received 29 May 1996; Accepted 19 July 1996     

Effect of oral adjuvant therapy with Carmofur (HCFU) for distant metastasis of colorectal cancer

Background. The effectiveness of adjuvant chemotherapy for colorectal cancers after curative resection has been reported recently; this study was performed to clarify the reasons of for this effectiveness, which have been unclear. Methods. Two joint prospective clinical randomized studies were performed. In the first study, of patients operated on between July 1, 1981 and June 30, 1983, at 41 Centers in the Tokai district, 172 patients with colorectal cancer were allocated to two groups. In the control group, mitomycin C (MMC) was given eight times intravenously in the 4 weeks after surgery. The other group, in addition to receiving the same regimen as the controls, received oral administration of 1-hexylcarbamoyl-5-fluorouracil (HCFU) at 600 mg/day for at least 6 months after the 4-week MMC treatment. In the second study of patients operated at 7 Centers in the Tokai district between October 1, 1987 and September 30, 1990, 173 patients with colorectal cancer were allocated to two groups after surgery, a control group receiving no HCFU, the other group receiving HCFU at 0.8 mg/kg per day orally, for 1 year, beginning 4 weeks after the operation. Results. In the first study, the cumulative 10-year survival rate of the MMC + HCFU group was higher than that of the MMC-alone group (P < 0.05). In the second study, the cumulative 5-year disease-free survival rate of the HCFU group was higher than that of the control group (surgery alone; P < 0.05). In patients with colon cancers, the rate of distant metastases for all evaluable patients was lower in the MMC + HCFU group than in the MMC-alone group in the first study (P < 0.05), and the rate was lower in the HCFU group than in the surgery-alone group in the second study (P < 0.02). Conclusion. The effectiveness of HCFU in reducing the disease-free survival rate appeared to be mainly due to its preventive effect on distant metastases. Received: July 13, 1999 / Accepted: September 20, 1999     

血行播散性结核病并发骨髓增生异常综合征一例——文献复习及临床诊治过程分析

血行播散性结核病是一种重症结核病,临床症状常不典型,影像学诊断报告也常常滞后,早期诊断困难。骨髓增生异常综合征(MDS)是一种恶性血液病,早期临床症状和血液系统异常表现一般不具有特异性。血行播散性结核病并发MDS常导致病情互相掩盖,易漏诊、误诊。笔者报道2017年4月首都医科大学附属北京胸科医院以“头晕、乏力3个月,发热2个月” 收治入院的1例患者,初步诊断为血行播散性结核病并发全血细胞严重减少,早期经抗结核药物治疗后临床症状、肺部病变及血液系统表现均一度好转,但后期在肺部病变进一步好转的同时,血液系统异常却再次加重,最终经多次骨髓穿刺检查诊断为血行播散性结核病并发MDS。笔者希望通过对诊治过程的分析讨论,提高临床医生对两病并存的诊断认识,分享治疗经验。     

手术室护士对血源性传播疾病的自我防护

随着社会的发展,职业安全也越来越受到医务人员的关注.由于医院工作环境和服务对象的特殊性,医务人员常常暴露于职业危害中.常见的乙肝、丙肝、爱滋病还有梅毒等,这些疾病都可以通过血液来传播.因此,我国医务人员正面临着严重的职业暴露危险,特别是手术室的工作人员,工作上与血液接触机会多.再加上工作节奏紧张,造成职业暴露的危险性更大,若不注意个人防护,极易造成职业性损伤,所以加强防护工作,势在必行.     

Emerging evidence of the molecular landscape specific for hematogenous metastasis from gastric cancer

Gastric cancer (GC) is one of the most frequently diagnosed cancers in the world. Most GC patients are diagnosed when the cancer is in an advanced stage, and consequently, some develop metastatic lesions that generally cause cancer-related death. Metastasis establishment is affected by various conditions, such as tumor location, hemodynamics and organotropism. While digestive cancers may share a primary site, certain cases develop hematogenous metastasis with the absence of peritoneal metastasis, and vice versa. Numerous studies have revealed the clinicopathological risk factors for hematogenous metastasis from GC, such as vascular invasion, advanced age, differentiation, Borrmann type 1 or 2 and expansive growth. Recently, molecular mechanisms that contribute to metastatic site determination have been elucidated by advanced molecular biological techniques. Investigating the molecules that specifically participate in metastasis establishment in distinct secondary organs will lead to the development of novel biomarkers for patient stratification according to their metastatic risk and strategies for preventing and treating distinct metastases. We reviewed articles related to the molecular landscape of hematogenous metastasis from GC.     

血源播散性肺结核继发噬血细胞综合征1例

<正>1病例资料患者男性,28岁,主因“发热2个月,鼻衄及双下肢出血性皮疹10天”入院。2个月前,患者无明显诱因出现发热,体温39℃,弛张热型,伴乏力,不伴咳嗽、咳痰、腹痛、腹泻、尿急、尿频、尿痛等不适。自行口服退热药(具体不详)后可短暂退热,但效果不佳,遂于当地医院就诊,予“头孢菌素”及“地塞米松”静脉输液(具体剂量不详) 6 d,体温恢复正常,但停药后再次出现发热,体温波动于38.5～40℃,未再诊治。1个月余前就诊于外院,查血常规未见异常,胸片示“双肺纹理增多”,予莫西沙星口服2 d(具体剂量不详),患者体温波动于38.5～40℃。     

Analysis of postoperative and hematogenous prosthetic joint-infection microbiological patterns in a large cohort

Objectives

This study was undertaken to analyze prosthetic joint infection (PJI)-causing microorganisms and compare their distribution patterns according to PJI classification.