持续性植物状态（PVS）动物模型的研制（论著）

目的：建立持续性植物状态的动物病理模型。方法；用１８０只新西兰家兔，切除其大脑皮层Ｂｒｏｄｍａｎｎ氏１，２，３，４，５，６，７，２３，２４以及部分３２及５０区。结果；以上手术后的动物在多种生理指标，反射活动，高级神经系统功能活动，昼夜节街以及大脑神经病理学的变化各主要表现方面与临床ＰＶＳ患者相似或一致。结论；本实验所建立的动物模型的表现与一般临床ＰＶＳ患者的症状及鉴定标准内容一致。     

Diagnosis and excision of breast multi-focal lesions by ultrasound-guided vacuum-assisted biopsy: a comparative evaluation

Objective To compare and evaluate the efficacy of diagnosis and excision for appropriately selected breast multi-focal lesions and solitary lesion by ultrasound-guided vacuum-assisted biopsy (UGVAB). Methods Among 392 appropriately selected patients, 187 patients with multi-focal lesions and 205 patients with solitary lesion were treated by the 8-gauge UGVAB from May 2007 to June 2009. All lesions were removed as completely as possible. The patients with benign pathology underwent physical and ultrasound examinations at one week and 6 months after procedure. Results During the procedure, only three patients had vasovagal syncope and twenty others complained of other intraoperative discomfort. An accurate pathological diagnosis was obtained in all lesions. There was no apparent false-negative result among the 696 lesions with benign pathology at a follow-up of 6 months after procedure. The rates of malignant or premalignant pathology, postoperative complications and residual lesions in patients with multi-focal lesions were higher than those in patients with solitary lesion. If each lesion was considered as a subject of study, there was no significant difference between the two groups. Conclusion UGVAB is an effective method for diagnosis and excision of appropriately selected breast multi-focal lesions and can be used routinely.     

肾上腺肿瘤超声与病理相关性探讨

目的　探讨肾上腺肿瘤声像图特征及与病理结构的相关性。方法　回顾性分析经二维及彩色多普勒超声诊断并经手术病理证实的 99例肾上腺肿瘤患者。结果　低回声组占 35 %(35 /99) ;混合回声组占 2 3% (2 3/99) ;强回声占 2 1 % (2 1 /99) ;等回声组占 1 6 % (1 6 /99) ;无回声组 4例占 4%。B超定位诊断符合率 92 9% (92 /99) ;定性诊断率为 86 9% (86 /99)。结论　嗜铬细胞瘤、肾上腺皮质腺瘤、髓样脂肪瘤 ,肾上腺囊肿图像特异性强 ,较易诊断 ;肿瘤的回声高低取决于肿瘤细胞、血管、纤维组织的含量多少和分布状态。     

108例年轻胃癌患者临床病理特征分析

目的探讨年轻胃癌患者的临床、病理和预后特征。方法回顾性收集兰州大学第一医院2012-2017年所有胃癌患者,将发病年龄用五分位间距法对年轻胃癌和中老年胃癌进行区分(45岁被确定为年轻胃癌和中老年胃癌的年龄截断值),分析两组的人口学、临床病理、分子病理和预后特征。结果分析所获取的年轻胃癌组(n=108)和中老年胃癌组(n=216)患者的性别信息,性别比分别为1.4∶1和3.5∶1(P<0.001);年轻胃癌和中老年胃癌家族史的比例分别为8.33%和2.78%,但差异无统计学意义(P=0.062);与中老年患者组相比,年轻患者组以胃窦部发生病变为主,多部位发生更为常见,更多胃溃疡病史,诊断所需时间更长,以低分化腺癌为主,印戒细胞癌比例较高,BorrmannⅢ型和Ⅳ型更为多见,生存时间更短(P<0.05)。但两组在Her-2、雌激素受体(ER)、孕激素受体(PR)和EB病毒相关RNA(EBER)表达方面未见差异(P>0.05)。结论年轻胃癌患者在性别比例、临床病理及预后特征等方面不同于中老年胃癌患者,恶性度更高,预后更差,可以考虑作为一个独特的临床群体。进一步研究年轻胃癌患者的病因和高危因素具有重要意义。     

21例Castleman病的临床病理特点

目的探讨Castleman病的临床表现、病理特点、治疗方法及转归。方法回顾性分析2001年1月～2012年10月在北京大学肿瘤医院诊断的21例Castleman病患者的临床与病理资料。结果患者中位年龄为38(16～68)岁。12例单中心型Castleman病中11例(91.7%)以透明血管型为病理类型;而9例多中心型Castleman病中5例(55.6%)表现为浆细胞型或混合型。单中心型患者中无1例有发热症状,而多中心型患者中4例(44.4%)有发热症状。21例患者均给予手术切除。12例单中心型患者术后均达到持续完全缓解。9例多中心型患者中仅有1例术后达到完全缓解,其余8例均接受了化疗,1例联合放疗。接受化疗的8例患者中1例完全缓解,2例疾病稳定,5例疾病进展。2例多中心型患者转化为淋巴瘤。中位随访46.2(12.2～138.7)个月,20例患者存活,1例转化为淋巴瘤的多中心型患者死亡。结论单中心型患者的手术治疗效果好,预后佳;多中心型患者可转化为淋巴瘤,预后差。     

常规MR征象在鉴别单发大脑胶质瘤级别中的价值

目的评估单发大脑胶质瘤常规核磁共振(MR)检查征象在评价大脑胶质瘤高低级别中的价值。方法回顾性分析有手术病理结果的218例单发大脑胶质瘤患者,分为低级别组(134例)和高级别组(84例)。采用t检验、卡方检验和逻辑回归分析评价患者年龄、性别及MR征象(包括接触脑室下区(subventricular zone,SVZ)、不均匀性、肿瘤边界、坏死囊变、出血、跨越中线、占位效应、水肿程度、强化体积、强化不均匀性)在高低级别胶质瘤组间差异及相关性。结果高、低级别胶质瘤组间,年龄有统计学差异(P<0.001),性别未见统计学差异(P=0.864)。在MR征象中,接触SVZ(P=0.011)、肿瘤不均匀性(P<0.001)、坏死囊变(P=0.037)、水肿程度(P=0.017)、占位效应(P=0.009)、肿瘤边界(P<0.001)以及强化体积(P<0.001)在两组间有统计学差异。多因素逻辑回归分析显示,年龄、肿瘤坏死囊变、肿瘤边界以及强化程度是高级别胶质瘤的阳性预测值。结论常规MR征象可用于鉴别大脑胶质瘤的高低级别;患者年龄越大、肿瘤坏死囊变越严重、肿瘤边界不清和强化体积越大的,为高级别胶质瘤的可能性越大。     

1375例尸体解剖病理诊断资料分析

本文分析了该教研室1950年～1989年所做的1375例尸捡资料,结果表明,有完整资料的1266例尸检中临床和病理诊断比较,符合率79.3%,误诊率20.7%。疾病分类统计结果,50年代尸检病例中传染和寄生虫病占多数,而80年代则以恶性肿瘤和心血管系统疾病为主。婴幼儿尸检以呼吸系统疾病、传染病和源于围产期疾患占多数。作者分析了尸检数量减少和临床误诊的原因,阐明了尸检在现代医学中仍具有十分重要的意义。     

Phospholipase A2 changes and its significance on brain tissue of rat in severe acute pancreatitis

Objective To survey changes and the significance of phospholipase .42 （PLA2） on brain tissue of SD rat in acute pancreatitis. Methods With retrograde injection of 3% taurocholate sodium into pancreatic and biliary duct, rat model of severe acute pancreatitis （SAP） was made, and it included four groups： the control group, the shamoperation group, the SAP group and the PLA2 inhibitor-treated group of SAP. Serum amylases, PLA2 and PLA2 in brain tissue were measured and the brain tissue changes were observed. Results There were no significant difference in serum amylases, PLA2 and PLA2 in brain tissue between the sham-operation and the control groups; the levels of serum amylases, PLA2 and PLA2 in brain tissue in the SAP group were higher than those in the control. In the SAP group expansion and hemorrhage of meninges, intracephalic arteriolar hyperemia, in meninges and cephalic-parenchyma infiltration of inflammatory cells and interval broaden were observed, significant differences were found between two groups. Compared with the SAP group, the level of serum amylase, PLA2 and PLA2 in brain tissue were reduced significantly in the treatment group of SAP. Pathological damages in the treatment group were significantly reduced when compared with the SAP group. Conclusion PLA2 might play an important role in brain tissue damages in severe acute pancreatitis.