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.     

我院开展全成本核算工作的探索与体会

医院实行全成本核算,对提高医院资金的利用率、降低成本、增收节支具有重要意义.本文介绍了我院开展全成本核算工作的主要做法以及目前取得的主要成效.并总结了我院推行全成本核算工作的几点体会.     

46,XX,del(7),inv ins(6,7)伴流产一例

病例:患者,女,23岁,因3次妊娠均于60天左右难免流产而来就诊。男女双方非近亲婚配,孕期无有害毒物和放射线接触史,夫妻双方作外周血细胞遗传学检查,丈夫核型正常。计数50个核型,患者核型为46,XX,del(7)inv ins(6;7)(6pter→6q16::7q11→7q22::6q21→6qter)(7pter→7q11::7q31→7qter)。讨论:染色体易位是习惯性流产最常见的染色体异常。本例为7号染色体部分长臂断裂插入至6号染色体长臂内侧,而7号染色体远端两段又依次连接。患者为女性,其生殖细胞成熟分裂时只形成1个卵子和3个极体,非同源染色体在进行分裂时理论上可形成18种类型的配子,只…     

聚甲基丙烯酸羟乙酯水凝胶人工晶状体材料的合成与性能

以甲基丙烯酸羟乙酯为原料,过硫酸铵/偏重亚硫酸钠为引发体系,二甲基丙烯酸三乙二醇酯为交联剂,采用溶液聚合法制备了聚甲基丙烯酸羟乙酯水凝胶(PHEMA)人工晶状体材料。系统考察了聚合反应时间、温度及引发剂和交联剂的用量等对该水凝胶材料机械强度、平衡水含量(EWC)的影响,并对PHEMA水凝胶的结构和光学性能进行了表征。实验结果表明,PHEMA水凝胶的最佳合成条件为:引发剂0.5wt%,交联剂1.0wt%,反应温度40℃,反应时间36h。在此条件下制备的PHEMA水凝胶的拉伸强度达到0.57MPa,邵氏A硬度为23.0,平衡含水量超过40%,透光率≥97%。     

铁过负荷与非酒精性脂肪性肝病

当机体出现铁过负荷时 ,肝脏是首先受到损害并且损害最严重的靶器官。铁过负荷在非酒精性脂肪性肝病 (NAFLD)中的作用尚不十分明确。目前认为 ,铁过负荷是NAFLD疾病进展的一个辅助因素 ,其中HFE基因起重要作用 ,该过程可能由胰岛素抵抗所激发 ,免疫机制也可能参与其中。     

电刺激与脑卒中后运动功能恢复

脑的可塑性是包括脑血管病在内的中枢神经系统损伤后功能的恢复 ,急性脑卒中患者的运动障碍的可塑性现象是康复治疗的基础。自著名的神经科学家Bach　Y　Ritap1930年提出脑的可塑性 (plasticity)这一概念以来 ,国内外学者对脑的可塑性进行不断深入的研究 ,脑卒中后运动功能的康复治疗已受到神经病学界的广泛关注。研究证实 ,脑卒中后运动功能的恢复主要基于脑的可塑性和功能重组中的细胞、分子与基因调控作用[1] ,同时发现电刺激在脑卒中后运动功能的恢复中有一定促进作用 ,现简述如下。1　脑卒中后的可塑性变化脑的可塑性[2 ] 是指脑在环…     

采用MDA-MB-231细胞膜进行表皮生长因子受体活性的检测

目的　探讨能否直接利用肿瘤细胞膜进行表皮生长因子受体 (Epidermalgrowthfactorreceptor,EGFR)催化活性检测。方法　首先筛选出EGFR基因表达水平相对较高的细胞株MDA MB 2 31,通过差速离心制备细胞膜 ,采用Westernblotting检测EGFR催化磷酸化的程度。结果　底物被磷酸化 ,加入特异性拮抗剂AG14 78后 ,磷酸化被抑制。结论　利用肿瘤细胞膜检测EGFR活性的设想是成立的 ,并且其方法简便、经济。     

国医大师刘祖贻治疗帕金森病验案3则

<正>帕金森病(Parkinson’s disease,PD)是临床常见于中老年人的神经系统退行性疾病,以运动迟缓、静止性震颤、肌强直和姿势异常等运动症状及睡眠障碍、嗅觉障碍、自主神经功能障碍、认知和精神障碍等非运动症状为主要表现^[1]。西医学认为其发病机制是大脑黑质中的多巴胺能神经元退行性病变,导致纹状体中多巴胺神经递质降低、多巴胺与乙酰胆碱递质失衡,从而引发一系列运动与非运动症状。     

介入治疗肝癌并发肝性脑病的原因分析及护理

肝动脉插管化疗栓塞术(trans arterial embolization,TAE)问世以来,使许多肝癌晚期的患得到了治疗,并取得了显疗效。我院1997年8月~2000年3月,为98例肝癌患进行了TAE术,其中有9例患在TAE术后出现肝性脑病,现将其原因分析及护理报告如下。