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.     

肾移植术后卡氏肺孢子虫肺炎1例报告并文献复习

目的探讨肾移植术后卡氏肺孢子虫肺炎的临床特征、诊断方法及治疗措施。方法回顾分析1例确诊卡氏肺孢子虫肺炎并急性呼吸窘迫综合征(ARDS)的肾移植术后患者并结合文献分析。结果肾移植术后,免疫抑制剂治疗3月,无原因发热、咳嗽,咳白粘痰;血巨细胞病毒抗体阳性,血白细胞计数低,胸部X-线及CT:两肺斑片状浸润影伴间质改变,治疗病情无改善。支气管肺泡灌洗液细菌培养为洋葱伯霍尔德菌,肺活检病理:卡氏肺孢子虫感染。予大剂量复方新诺明(SMZco)针剂,盐酸氨溴索、甲基强的松龙静脉注射,无创机械通气,调整免疫抑制剂应用等对症支持治疗17 d治愈。结论卡氏肺孢子虫肺炎是肾移植术后常见机会性感染疾病,易引起ARDS。早期诊断,静脉使用大剂量SMZco的综合治疗是减少病死率的有效方法。     

早期胃癌的临床病理特点

观察了192例早期胃癌的临床病理特点，其中粘膜内癌103例,粘膜下癌89例。结果显示，早期胃癌多位于胃窦部（42．71％），以凹陷型为主（67．19％），且多为髓样癌（53．13％），组织类型以分化型管状腺癌及印戒细胞癌为主，分别为41．67％及25．52％。浸润型占比例较低（9．90％），但易引起胃壁淋巴管浸润及淋巴结转移。本组早期胃癌胃壁淋巴管浸润率为30．73％，淋巴结转移率为12．50％。女性发病年龄及出现淋巴结转移的年龄均较男性提前。     

颗粒细胞肌母细胞瘤的临床病理分析

6例颗粒细胞肌母细胞瘤的临束特点为小、无包膜、无痛性的包块,好发于舌,肿块直径大小为0.5～3cm,切除病检前难以诊断。作者报道的食管1例和肿块直径为5cm的1例均为少见病例。组织学特征为瘤细胞体大,胞浆丰富,含有均匀分布的嗜酸性颗粒,排列成巢或索状。本文从形态学上支持肿瘤的神经起源。     

血清SCC与宫颈癌生物学行为的相关性及临床意义

目的　探讨宫颈癌患者放射治疗前后血清鳞状上皮细胞癌抗原 (SCC Ag)与其生物学行为的相关性及临床意义。方法　采用全自动快速粒子酶免疫分析系统 ,检测 5 0 0例宫颈癌患者治疗前后SCC Ag值 ,分析SCC Ag检测值与宫颈癌临床病理特征之间的关系。结果　宫颈癌患者治疗前血清SCC Ag水平与肿瘤组织学类型、临床分期呈正相关 (P <0 .0 0 5 ) ,与肿瘤组织分化程度无关 (P >0 .0 5 ) ;且治疗前的水平高于治疗后 (P <0 .0 0 5 )。结论　治疗前后血清SCC Ag值对估计宫颈癌的生物学行为和预后有重要的临床参考价值     

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.     

新型冠状病毒肺炎的病理机制及治疗药物研究进展

新型冠状病毒肺炎已构成全球大流行.其病原体严重急性呼吸综合征冠状病毒2(SARS-CoV-2)传播力强,人群普遍易感.病毒通过细胞受体血管紧张素转换酶2进入靶细胞,经跨膜丝氨酸蛋白酶2激活棘突蛋白,可引起多器官损害.目前尚无特异性治疗药物,但已开展多项评估与研究.当前我国疫情得到有效控制,但境外感染人数迅速增加,境外疫...     

胆囊癌组织中Cyr61和β-catenin的表达及临床意义

目的研究Cyr61、β-catenin在胆囊癌组织及癌旁正常组织中的表达差异及相关性,探讨其在胆囊癌发生发展过程中的作用。方法应用免疫组织化学SP法,检测50例胆囊癌组织及19例癌旁正常组织中Cyr61和β-catenin蛋白的表达,并与其临床病理特征进行比较分析。结果 1Cyr61在胆囊癌组织中的阳性表达率为66.0%(33/50),明显高于正常组织中的26.3%(5/19)(P<0.05);Cyr61的表达与胆囊癌的肿瘤分化程度、TNM分期、淋巴结转移有关(P=0.010、P=0.014、P=0.007,P<0.05);2β-catenin在胆囊癌组织中的阳性表达率为84.0%(42/50),明显高于正常组织中的15.7%(3/19)(P<0.05);β-catenin的表达与胆囊癌的肿瘤分化程度、TNM分期、淋巴结转移有关(P=0.018、P=0.002、P=0.024,P<0.05);3相关性检验显示,Cyr61和β-catenin在胆囊癌组织和癌旁正常组织中呈正相关(r=0.378,P<0.05)。结论 Cyr61和β-catenin在胆囊癌组织中存在显著高水平表达;Cyr61和β-catenin阳性表达与胆囊癌患者的临床病理特征(肿瘤分化程度、TNM分期和淋巴结转移)密切相关;两者在胆囊癌的发生发展过程中可能有协同促进作用,联合检测这两种蛋白的表达对胆囊癌的临床诊断及预后判断有一定的指导意义。     

中药复方清化饮对慢性萎缩性胃炎大鼠血清IL-10、NO、GAS及血浆MTL的影响

目的探讨中药复方清化饮对大鼠慢性萎缩性胃炎(CAG)胃黏膜病理与血清白细胞介素-10(IL-10)、一氧化氮(NO)、胃泌素(GAS)及血浆胃动素(MTL)的影响。方法将53只Wistar大鼠随机分为空白组8只和CAG造模组45只,予建立病证结合CAG大鼠模型。抽检大鼠确认造模成功后,将CAG造模组余下40只大鼠随机分为模型组、维酶素组、中药低、中、高剂量组各8只。予相应药物干预30d后处死大鼠,腹主动脉取血并留取胃组织,分析各组大鼠胃黏膜病理与血清IL-10、NO、GAS及血浆MTL浓度。结果与空白组比较,模型组大鼠见不同程度的胃黏膜萎缩,血清IL-10、GAS浓度降低,血清NO、血浆MTL含量升高(P<0.01)。与模型组比较,清化饮可不同程度改善胃黏膜病理情况,升高血清IL-10、GAS浓度,降低血清NO、血浆MTL含量(P<0.05或P<0.01),且高剂量组疗效更为显著(P<0.01)。结论中药复方清化饮可调控血清IL-10、NO、GAS及血浆MTL的表达失衡,有效逆转CAG大鼠胃黏膜病变。