女性外阴鲍温样丘疹病8例临床病理分析

本文探讨鲍温(Bowen)样丘疹病的临床病理特征、鉴别诊断及原因：对8例Bowen样丘疹病进行临床病理分析，用免疫组化S—P法检测HPV16／18抗原及P53蛋白。结果表明，Bowen样丘疹病的诊断应该结合临床特征及镜下表现，排除Bowen样病，该病属于良性病变，但需要密切临床随访。     

鲍温样丘疹病42例分析

目的 探讨鲍温样丘疹病的临床特点、鉴别诊断及诊治方法。方法 回顾性分析42例鲍温样丘疹病患者的临床表现、组织病理、人乳头状瘤病毒（HPV）检测情况。结果 42例患者具有以下特点：青、中年；损害主要发生于外阴皮肤，表现为色素沉着的扁平丘疹或斑片，表面光滑，边界清晰，无尖锐湿疣乳头状外观，也无鲍温病样鳞屑、结痂、糜烂或溃疡等病变，单发或多发，很少累及黏膜；在组织学上，其鳞状上皮的异型变化程度比鲍温病轻，异常细胞侵犯上皮不多且范围局限，HPV检测对其有一定诊断价值，醋酸自试验可阳性；发展缓慢，多无自愈倾向，少数可恶变。结论 鲍温样丘疹病临床上相对少见，但其发病率逐渐增高，鉴别诊断对临床诊治很重要。     

鲍温样丘疹病42例分析

目的探讨鲍温样丘疹病的临床特点、鉴别诊断及诊治方法。方法回顾性分析42例鲍温样丘疹病患者的临床表现、组织病理、人乳头状瘤病毒(HPV)检测情况。结果42例患者具有以下特点:青、中年;损害主要发生于外阴皮肤,表现为色素沉着的扁平丘疹或斑片,表面光滑,边界清晰,无尖锐湿疣乳头状外观,也无鲍温病样鳞屑、结痂、糜烂或溃疡等病变,单发或多发,很少累及黏膜;在组织学上,其鳞状上皮的异型变化程度比鲍温病轻,异常细胞侵犯上皮不多且范围局限,HPV检测对其有一定诊断价值,醋酸白试验可阳性;发展缓慢,多无自愈倾向,少数可恶变。结论鲍温样丘疹病临床上相对少见,但其发病率逐渐增高,鉴别诊断对临床诊治很重要。     

外阴鲍温样丘疹4例临床分析

目的　探讨鲍温样丘疹病的临床表现、病理特征及治疗。方法　对 4例患者进行临床特征及病理分析 ,采用CYP -Ⅲ微波治疗仪治疗。结果　鲍温样丘疹病多发于青壮年女性外生殖器皮肤 ,临床上有典型的形态特征 ,镜下改变类似鲍温氏病 ,HPV检出率高 ,微波治疗简单有效。结论　鲍温样丘疹病组织学改变类似鲍温氏病 ,但临床经过良性 ,治疗宜保守     

Alzheimer氏病基因突变及病理改变的研究进展

Alzheimer氏病(Alzheimer's disease,AD)是目前引起老年性痴呆(senile dementia,SD)最重要的原因,该病的主要病理改变为多个脑区尤其是海马、皮层和颞叶出现大量的老年斑(Senile plaques,SPs)、神经原纤维缠结(neuro fibrillary tangles,NFTs)以及大量神经元的丢失:其临床表现为进行性的近期记忆力障碍及认知功能的改变,同时也会出现抑郁、失眠、幻觉妄想等一系列神经精神症状.     

99mTc-TRODAT-1脑半定量分析鉴别帕金森氏病与血管帕金森样征的研究

目的 应用99mTc-TRODAT-1脑SPECT半定量分析鉴别血管性帕金森样征与帕金森氏病.方法 11例VP病人、26例PD病人、12例健康志愿者接受740MBq(20mCi)99mTc-TRODAT-1静脉注射3～4h后,作脑SPECT显像和半定量分析.通过计算机处理获得纹状体99mTc-TRODAT-1特异结合比率,即S/O摄取比值.结果 通过对VP病人、PD病人和健康志愿者脑SPECT感兴趣区半定量分析,S/O比值在VP病人略低于健康对照者但无明显统计学差异;在PD病人,S/O比值则明显下降(P<0.01).PD病人双侧纹状体摄取99mTc-TRODAT-1明显不对称, VP病人无此现象(P<0.05);VP病人组与健康志愿组S/O摄取比值随年龄增长而下降(P<0.05);PD病人组则无此现象.结论 99mTc-TRODAT-1脑SPECT半定量分析是一种帕金森氏病早期诊断、用于鉴别VP和PD的可靠而实用的方法 .     

52例Alzheimer氏病的临床分析

收集上海市精神卫生中心52例住院Alzheimer氏病人资料。通过探讨这些病例，分析病例的一般资料、临床表现。证实了一些有关病因与家庭遗传、慢性毒感染、免疫机制、生化改变、人格特征等因素的观点。提出由于各种原因的影响，发病年龄有提前的趋势，进入中老年后，适宜的社会活动，培养高尚的情操和良好的性格对预防此病有一定作用。     

4例勒-雪氏病临床病理分析

目的:探讨勒-雪氏病(Letterer-S iwe D isease,LS)临床病理特点。方法:采用组织病理学方法对1990~2005年间收集的LS患儿进行分析。结果:4例中,男性2例,女性2例。发病年龄最小2个月,最大9个月,平均4.75个月,3例在出生后9个月内发病。4例患者临床症状及病理结果均典型。结论:LS为朗格罕斯组织细胞增生症的一种类型,较少见,预后差,以多形性皮疹及早期出现系统损害为其特征。0     

浅谈美尼尔氏病的临床治疗

美尼尔氏病即是内耳膜迷路积水 ,具有发作性眩晕、波动性耳聋、耳鸣以及患耳和同侧头部胀满感等表现。患者发病后 ,天旋地转、恶心呕吐、苍白出汗 ,感到非常痛苦 ,无法进行正常的工作、学习 ,笔者从 2 0 0 1～ 2 0 0 2年对 3 0例患者进行了治疗 ,现报告如下。1　临床资料1.1　一般资料　 3 0例患者 ,男 18例 ,女 12例。1 2　治疗　西药治疗 :谷维素 3 0ｍｇ ,眩晕停 5 0ｍｇ ,山菪莨碱片10ｍｇ ,维生素Ｃ10 0ｍｇ ,双氢氯噻嗪片 5 0ｍｇ(使用时注意补钾 ) ,桂利嗪片 5 0ｍｇ ,连用 3～ 5ｄ。中药治疗 :属肝阳上亢型 ,宜平肝潜阳 ,滋养肝肾 ,…     

重度子痫前期胎盘的免疫组化改变与围产儿预后的关系

目的:研究重度子痫前期胎盘的免疫组织化学改变,探讨白细胞抗原CD146、CD31在胎盘组织中的表达及其与围产儿预后的关系。方法:20例重度子痫前期患者为研究组,孕周接近的无合并症的流产、早产的胎盘、孕早期流产的绒毛共20例为对照组。应用间接免疫组化法结合计算机辅助图像分析技术,分析胎盘组织白细胞抗原CD146、CD31的表达及对围产儿预后的影响。结果:对照组20例胎盘组织中间滋养层都有CD146的表达,但是没有CD31的表达。研究组20例标本中2例展示微弱的CD146着色,18例中间滋养层CD146染色为阴性,CD31在研究组标本的中间滋养层细胞上也没有表达,染色阴性,差异具有显著性。研究组围产儿死亡、HIE、新生儿窒息、SGA发生率均明显增高,脐动脉血流异常、胎心监护异常和妊娠图异常发生率明显增高,差异具有极显著性。结论:与正常妊娠比较,重度子痫前期胎盘CD146的异常表达,可能反应体内CD146的功能,为重度子痫前期的病因学提供重要线索,认为异常滋养层浸润(滋养层浸润过少过浅)是子痫前期发病的潜在因素;同时造成围产儿预后不良。     

腹膜后血管平滑肌脂肪瘤临床病理观察及文献复习

目的 探讨腹膜后血管平滑肌脂肪瘤（RAML）的临床病理学特征、诊断及鉴别诊断、治疗、预后等,以提高临床认识.方法 回顾性分析2012-2014年收治的4例RAML患者的临床病理资料,运用全自动免疫组化仪进行AE1/AE3、Vimentin、HMB45、Melan-A、S-100、SMA、CD10、CD34、Ki-67免疫标记染色,同时进行随访调查,并复习相关文献.结果 4例RAML患者中女3例,男1例.3例有腹部疼痛不适的临床症状,1例体检时发现.肿物均大于10 cm,与肾脏界限不清.临床均行“肿物＋患侧肾脏切除术”.光镜下肿瘤由脂肪、平滑肌细胞及厚壁血管构成,但三种成分比例相差较大,其中1例腹膜后肿物合并肾脏病变.免疫表型：AE 1/AE3均阴性;Vimentin、HMB45、Melan-A、SMA、CD34均阳性;S-100 3例阳性,1例阴性,Ki-67增殖指数均＜5％.结论 RAML是一种少见的腹膜后良性间叶性肿瘤,具有复杂多样的组织学形态,特殊的免疫表型结合镜下表现可明确其诊断.     

易误诊为多发性肌炎的肌营养不良临床及病理分析

目的 明确肢带型肌营养不良2B(LGMD2B)与多发性肌炎(PM)的鉴别诊断.方法 分析LGMD2B临床表现、骨骼肌病理学特点及与PM的关系.结果 LGMD2B 临床表现为四肢近端肌无力,血清肌酸激酶显著增高,肌电图呈肌源性损害,与PM相似.组织化学染色:呈不同程度肌纤维变性、坏死、再生和炎性细胞浸润,与PM相似.免疫组织化学染色:抗-Dysferlin单克隆抗体染色,5例LGMD2B患者Dysferlin蛋白在肌膜上完全缺失,PM均表达正常.结论 LGMD2B临床表现、骨骼肌病理学特点与PM相似,抗-Dysferlin单克隆抗体免疫组织化学染色是鉴别二者的关键.     

儿童亚急性坏死性淋巴结炎临床病理分析

目的:探讨儿童亚急性坏死性淋巴结炎(subacute necrotizing iymphadenitis)的临床病理特点。方法:回顾性分析19例儿童亚急性坏死性淋巴结炎病例的临床资料,全部病例切片进行组织学观察,并行免疫组化染色,随访全部病例。结果:19例中男性14例,女性5例,平均年龄7.3岁,临床主要表现为发热、颈淋巴结肿大和白细胞减少,抗生素治疗无效。组织学显示淋巴结内出现程度不同的碎片状坏死,伴有多种形态的组织细胞增生,坏死灶边缘可见浆样单核细胞、多形核细胞及免疫母细胞,无或很少有中性粒细胞浸润。随访5月~3年,全部存活。结论:儿童亚急性坏死性淋巴结炎是一种良性自限性疾病,具有特殊的临床表现和独特病理特点;掌握其临床和病理形态学特点,有助于与其他病变相鉴别。     

54例浸润性年轻宫颈癌临床病理特征分析

目的:探讨年轻宫颈癌患者(≤35岁)临床病理特点。方法:对2003年1月～2005年4月在我院住院治疗的323例宫颈癌患者进行回顾性分析。结果:本院≤35岁宫颈癌病例数占全部同期住院治疗的宫颈癌患者总人数的比例高达16.7%,主要临床表现为接触性出血,55.6%的年轻患者为Ⅰ期,在组织病理学类型及分级、淋巴结转移方面与中老年组无差别。结论:宫颈癌患者发病有年轻化趋势,年轻宫颈癌临床分期以早期为主,无预后不良的病理特征。宫颈细胞学检查应作为妇科的1项常规检查,以早期确诊。     

慢性病毒性肝炎临床病理研究(附81例报告)

目的 探讨研究慢性病毒性肝炎临床与病理诊断上的一些问题。方法 对1990年以来收治的8l例慢性病毒性肝炎患进行了较系统地回顾性分析、总结。结果 8l例病例中，我们发现大多数病例的临床与病理诊断相符，但在部分病例，临床与病理诊断出入较大。结论 在慢性肝炎的鉴别诊断上，尤其是临床较轻微的慢性活动性肝炎与慢性迁延性肝炎的鉴别，需要详尽地从临床、生化、病理等多方面综合分析，方能做出正确诊断。     

病理状态新生儿血清唾液酸水平分析

目的：探讨病理状态新生儿血清唾液酸（sialic acids, SIA）水平及其与胎龄和日龄的关系。方法将因病理状态住院的新生儿（987例）分早产儿（238例）和足月儿（743例）两组,每组又根据日龄分24 h以内、25 h～7 d和大于7 d亚组,SIA测定采用神经氨酸苷酶法。结果早产儿各亚组血清SIA水平显著低于足月儿相应亚组（ P＜0．05）;早产儿≤24h亚组血清SIA水平显著低于25 h～7 d亚组（t＝4．70,P＜0．01）;早产儿组和足月儿组中≤24 h亚组血清SIA水平均显著低于25 h～7 d亚组或＞7 d亚组。结论本组新生儿血清唾液酸水平与日龄相关联,早产儿血清唾液酸水平低于足月儿组。     

自身免疫性肝炎与病毒性肝炎的临床病理特点对照研究

Objective To explore the character of clinical manifestations and liver pathological features of autoimmune hepatitis (AIH) and improve the diagnostic accuracy in early stage of AIH patients. Methods 78 patients with AIH,31 patients with acute viral hepatitis(AH) and 31 patients with chronic hepatitis B (CHB) were collected. The liver function and immunoglobulins were compared among them as well as the comparison of chronic and acute onset AIH groups. A part of patients underwent liver, biopsy and HBsAg immunohistochemistry examination. Results AIH patients were dominated by female (94.87%) over 40 years old (78.21%). The level of AST/ALT, γ-glutamyl transferase (CGT), alkaline phosphatase(ALP), IgG, IgM and γ-globulin in AIH group were significantly higher than those in CHB and AH groups. Furthermore, the level of γ-globulin in chronic AIH group was higher than that in acute onset AIH group (P< 0.05). The positive rate of smooth muscle antibody(SMA) was 6.41%, and the positive rate of anti-nuclear antibody(ANA) was 79.49% in AIH patients. There was no difference in the titer of ANA between acute and chronic AIH groups(P> 0.03). Regarding the appearance of liver pathology, it was easy to distinguish AIH from AH, but difficult to differentiate AIH from CHB. liver tissues, loose degeneration, spotty necrosis and piecemeal necrosis accompanying with bridging necrosis were very common in AM. There were great numbers of lymphocyte infiltration in portal area that was often accompanied with varying degrees of fibrosis. The degree of hepatic inflammation and fibrosis were similar in acute and chronic AIH ( P > 0.05). Ihe degree of hepatic lesions in 2 AIH patients suffered with subacute liver failure didn' t agree with the severe clinical manifestations. Conclusions AIH patients are dominated with female over 40-year-old who often accompanied with elevation of AST/ALT, GGT, ALP and y-globulin as well as the appearance autoantibodies. The appearance of liver pathology is multiplicity that piecemeal of necrosis accompanying with bridging necrosis and lymphocytes infiltration is common. The degree of hepatic lesions is similar in aeute and chronic AIH. It's important to check the liver tissue for diagnose in early stage correctly.     

自身免疫性肝炎与病毒性肝炎的临床病理特点对照研究

Objective To explore the character of clinical manifestations and liver pathological features of autoimmune hepatitis (AIH) and improve the diagnostic accuracy in early stage of AIH patients. Methods 78 patients with AIH,31 patients with acute viral hepatitis(AH) and 31 patients with chronic hepatitis B (CHB) were collected. The liver function and immunoglobulins were compared among them as well as the comparison of chronic and acute onset AIH groups. A part of patients underwent liver, biopsy and HBsAg immunohistochemistry examination. Results AIH patients were dominated by female (94.87%) over 40 years old (78.21%). The level of AST/ALT, γ-glutamyl transferase (CGT), alkaline phosphatase(ALP), IgG, IgM and γ-globulin in AIH group were significantly higher than those in CHB and AH groups. Furthermore, the level of γ-globulin in chronic AIH group was higher than that in acute onset AIH group (P< 0.05). The positive rate of smooth muscle antibody(SMA) was 6.41%, and the positive rate of anti-nuclear antibody(ANA) was 79.49% in AIH patients. There was no difference in the titer of ANA between acute and chronic AIH groups(P> 0.03). Regarding the appearance of liver pathology, it was easy to distinguish AIH from AH, but difficult to differentiate AIH from CHB. liver tissues, loose degeneration, spotty necrosis and piecemeal necrosis accompanying with bridging necrosis were very common in AM. There were great numbers of lymphocyte infiltration in portal area that was often accompanied with varying degrees of fibrosis. The degree of hepatic inflammation and fibrosis were similar in acute and chronic AIH ( P > 0.05). Ihe degree of hepatic lesions in 2 AIH patients suffered with subacute liver failure didn' t agree with the severe clinical manifestations. Conclusions AIH patients are dominated with female over 40-year-old who often accompanied with elevation of AST/ALT, GGT, ALP and y-globulin as well as the appearance autoantibodies. The appearance of liver pathology is multiplicity that piecemeal of necrosis accompanying with bridging necrosis and lymphocytes infiltration is common. The degree of hepatic lesions is similar in aeute and chronic AIH. It's important to check the liver tissue for diagnose in early stage correctly.