Hep par1单抗在肝细胞癌中的表达

本文对56例肝细胞癌进行抗体标记，探讨鼠抗人肝细胞单克隆抗体（monoclonal mouse anti-hcpatocyte，HEP）地肝细胞癌（hepatocellular carcinoma，HCC）诊断的价值。     

乳腺间质假血管瘤样增生的组织学观察

目的 观察乳腺间质假血管瘤样增生（PHMS）的病理组织学改变。方法 对9例乳腺活检标本作常规苏木精－伊红染色及免疫组织化学染色并进行组织学观察。结果 PHMS的组织学表现为乳腺间质内出现特征性的裂隙样的假血管腔隙，内衬无明显异型的梭形细胞。结论 PHMS是乳腺间质的一种良性增生性病变，它的重要性在于组织学上需要与乳腺高分化血管肉瘤相鉴别。     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

转化生长因子β_1及其受体在主动型海曼肾炎发生中的作用

目的 研究转化生长因子 β 1(TGF - β 1)及其受体TβRⅠ在不同病变阶段主动型海曼肾炎 (AHN)大鼠肾组织内的表达情况 ,进而探讨TGF - β 1 在AHN病变发生及发展中的作用。 方法 提取SD大鼠肾近曲小管的抗原FxlA ,建立免疫SD大鼠AHN ,并分为实验组和对照组。第4、6、8及12周分别处死实验组及对照组大鼠 ,用免疫组化SP法检测TGF- β 1、TβRⅠ在不同病变阶段AHN大鼠肾组织内的表达情况 ,用计算机图像分析系统比较上述成分在实验组及对照组大鼠肾组织内的相对含量。 结果 自AHN诱发后第4周开始 ,随大鼠尿蛋白的升高 ,TGF- β 1、TβRI在大鼠肾组织内的表达即开始上调 ,至第8周达最高峰 ,第12周有所下调。定量测得TGF -β 1、TβRⅠ在AHN大鼠肾小球内的表达明显高于对照组 (P<0.05)。结论 TGF- β 1、TβRI在不同病变阶段AHN大鼠肾组织内的表达均上调。TGF- β1 可能通过刺激肾小球上皮细胞分泌过量的细胞外基质 (ECM) ,使AHN大鼠肾小球毛细血管基底膜内ECM的含量增加 ,提示TGF- β 1 在AHN病变的发生及发展中起着重要作用。     

Bcl—2,PCNA在子宫内膜增生及腺癌中的表达

目的 探讨Ｂｃｌ－２、增殖细胞核抗原（ＰＣＮＡ）与子宫内膜良性及内膜腺癌的关系。方法 应用免疫组化ＳＰ法对５９例子宫内膜良性病变及内膜腺癌进行Ｂｃｌ－２、ＰＣＮＡ检测。结果 增生过长的上皮细胞ＰＮＣＡ染色强度明显低于高分化子宫内膜腺癌，但病例阐染色强度的交叉性提示此指标不具有诊断价值。Ｂｃｌ－２表达；增生中期及腺囊型增生过长患者表达为１００％，腺瘤型增生过长表达为７５％，子宫内膜腺瘤为５２％。结论     

奥曲肽联合普萘洛尔治疗肝硬化上消化道出血临床价值探析

目的探讨肝硬化上消化道出血采用奥曲肽联合普萘洛尔治疗的临床效果。方法选取我院2012-01-2013-06间收治的110例肝硬化上消化道出血患者,按照数字抽取分为研究组与对照组,对照组应用常规对症支持治疗,研究组患者在此基础上应用奥曲肽联合普萘洛尔治疗,分析对比两组患者血流动力学变化及治疗效果。结果研究组总有效率明显高于对照组,差异有统计学意义（P〈0.05）;研究组心率降低,止血时间缩短,与对照组比较,差异有统计学意义（P〈0.05）。结论肝硬化上消化道出血采用奥曲肽联合普萘洛尔治疗具有明显效果,安全性高,临床应用价值高。     

肾混合性上皮间质肿瘤和成人囊性肾瘤的临床病理学观察

Objective To study the clinicopathologie features,immunophenotype and differential diagnosis of mixed epithelial and stromal tumor of kidney ( MEST) and adult cystic nephroma ( CN).Methods Five cases of MEST and 4 cases of CN were retrospectively analyzed.Immunohistochemical study was carried out and the literature was reviewed.Results All of the five patients with MEST were females.Their median age was 45 years.For CN,there were 3 males and 1 female and their median age was 41 years.All patients presented with loin pain and hematuria.On gross examination,MEST was well-circumscribed but non-encapsulated.There was no evidence of haemorrhage or necrosis.Three of the cases were solid in nature.One was composed of a mixture of solid and cystic elements,while the remaining case showed a multicystic cut surface bridged by thick fibrous septa.On the other hand,CN were well-circumscribed and encapsulated.They were multiloculated cystic in nature.The cystic spaces were separated by thin septa and there was no significant solid or necrotic component.Histologically,MEST consisted of proliferation of cystically dilated glands admixed with spindly stromal cells with various cellularity and growth patterns.Both the glandular and stromal elements were well-differentiated with no cytologic atypia identified.The glandular structures in 2 of the cases were partially lined by endometrial or tubal epithelium.In contrast,the thin-walled cystic spaces in CN were lined by a single layer of epithelium.Immunohistochemical　study showed that the epithelial cells were positive for pan-cytokeratin and epithelial membrane antigen.The spindle cells in MEST expressed vimentin (5/5 ) ,smooth muscle actin (3/5 ),desmin (4/5 ),CD10 (5/5),estrogen receptor (4/5) and progesterone receptor (4/5).They were negative for HMB45,CD34,CD117 and S-100 protein.On the other hand,the spindle cells in CN were variably positive for vimentin (4/4),smooth muscle actin (4/4),desmin (1/4),estrogen receptor (3/4) and progesterone receptor (1/4).They were negative for CD10,HMB45,CD34,CD117 and S-100 protein.Conclusions Both MEST and CN are uncommon renal neoplasm.Most of them run a benign clinical course.The stromal cells in MEST show smooth muscle or myofibroblastic differentiation.Areas demonstrating Miillerian features also existed in some cases.MEST and CN share overlapping histological and immunohistochemical features,and may represent spectrum of the same group of lesions.     

全身皮肤潮红、肿胀、脱屑伴白细胞进行性升高

病历摘要患者女,74岁,1个月前因帕金森病加重服用卡马西平治疗,服药半月后,全身皮肤出现红斑,伴瘙痒、口腔糜烂,临床考虑多形红斑给予激素等对症治疗,皮疹消退,半个月前再次服用卡马西平2 d后全身红斑加重,逐渐发展为皮肤潮红、肿胀、脱屑,以双下肢非凹陷性浮肿为主.