原发性卵巢平滑肌肉瘤1例并文献复习

目的 探讨原发性卵巢平滑肌肉瘤的临床特点、病理特征及诊断。方法 回顾性分析收治的1例原发性卵巢平滑肌肉瘤患者的诊疗经过,并复习相关文献。结果 患者77岁,症状为腹痛和盆腔包块,影像学检查发现巨大盆腔肿物约20 cm,接受初始肿瘤细胞减灭术,术后病检为卵巢平滑肌肉瘤,术后生存至今,达10个月。结论 原发性卵巢平滑肌肉瘤是一种罕见的高度侵袭性肿瘤,临床症状不典型,诊断主要依靠组织病理学,预后差。     

男性肺癌女性化乳房1例

患者男性,64岁.因双侧乳房乳头增大3mo,咳嗽、发热、消瘦2mo入院.查体:消瘦、浅表淋巴结无肿大.双侧乳房增大10cm×1Ocm,柔软无压痛无包块.双乳头增大如哺乳期妇女.左肺第二肋间叩浊,呼吸音减弱.腹软无压痛,肝脾无肿大.胸片提示:右肺上叶中心型肺癌并肺不张.     

CT对肺原发性淋巴瘤征象的分析探讨

分析肺原发性淋巴瘤的CT表现,提高诊断水平。方法:2003年5月至2012年8月经病理及免疫组织化学证实的肺原发性淋巴瘤7例患者的CT征象进行分析。结果:CT表现:团块型2例,呈肿块样改变,密度较均匀,其中1例表现支气管充气相,边缘较清晰;结节、斑点片型2例,均有支气管充气相;多形态混合型3例,结节、斑点片状、团块、条索状、蜂窝样混杂影,病变呈单一或多种形态改变,病变内支气管充气相2例,多肺叶、肺段表现3例,蜂窝样改变2例。其中5例结节、团块病变增强检查时表现为轻至中度强化,3例病灶内可见走形正常的血管影。结论:肺原发性淋巴瘤CT影像表现可为单一形态或多种形态同时存在,以团块型和混合型多见,支气管充气相,多肺叶、肺段分布,蜂窝样改变,结节、团块轻至中度强化,病变内可见血管正常走形,病变形态与单纯炎症、肺癌影像表现不完全一致,与患者临床表现不相符,对诊断该疾病有一定的临床意义。     

以急性脑梗死为首发表现的伴重度血小板减少的老年男性抗磷脂综合征1例报告并文献复习

探讨急性脑梗死为首发表现的伴重度血小板减少的老年男性抗磷脂综合征(antiphospholipid syndrome,APS)患者临床特点、诊断及治疗,进一步提高对该类疾病的认识.报道1例首发表现为急性脑梗死的伴重度血小板减少的老年男性抗磷脂综合征的患者的临床资料,并复习相关文献.该患者以急性脑梗死为首发表现,同时伴重...     

热性感染相关性癫痫综合征1例病例报道并文献复习

目的总结热性感染相关性癫痫综合征(FIRES)的临床表现、脑电图及头颅MRI特征,探讨其发病机制及目前治疗进展。方法分析武汉儿童医院神经内科收治1例FIRES患儿的临床表现、脑电图、头颅MRI特征,复习文献资料,总结其临床、脑电图、头颅MRI特征及诊治进展。结果患儿为学龄期男性儿童,急骤起病,表现为发热、意识障碍及药物难治性的癫痫持续状态。脑电图显示背景为弥漫性慢波活动,监测到左侧额极、前颞区起始的部分性发作。头颅MRI信号未见异常。经生酮饮食(KD)治疗3天后,发作较前明显减少并转入普通病房,出院后继续予KD及抗癫痫药物治疗,1个月后复诊,患儿偶有惊厥发作,意识较前好转,智能较发病前明显减退。文献显示该病主要发生在既往健康的学龄期儿童,常由发热诱导,继而出现难治性癫痫持续状态或丛集样癫痫发作。FIRES预后不良,幸存者多遗留药物难治性癫痫和严重的认知障碍,普遍认为KD对FIRES患者疗效显著。结论FIRES的病因不明,可能由免疫介导所致。好发于学龄期儿童,常由发热诱导,癫痫发作呈暴发性、药物难治性,KD对控制急性期癫痫发作及改善预后有效。     

原发性甲状腺功能减退致肌溶解1例及文献复习

1临床资料 患者王某:男,43岁.住院号702032.因渐进性思睡、怕冷、反应迟钝8年,加重伴浮肿一月入院.患者于1998年渐出现思睡、情感淡漠、反应迟钝、懒言少语、讲话言语不清等症状.曾被某医院诊为"贫血",未引起注意.近一年感上述症状加重,逐渐出现腹胀、双下肢浮肿、体重增加等.爬楼后有明显的气促、乏力.2007年3月16日行B超检查发现有腹水、胸水.为明确诊断于2007年3月19日以"浮肿原因待查(甲减可能)"收住院.既往有"肾结石史".查体:体温37℃,脉搏72次/min,呼吸21次/min,血压140/100mmHg(1mmHg=0.133 3kPa).一般情况较差,粘液性水肿面容.面色蜡黄,表情淡漠,讲话时言语含糊不清,语速慢.     

Sturge-Weber综合征2例报告并文献复习

目的观察Sturge-weber综合征的临床特点。方法报告2例Sturge-weber综合征,复习相关文献并探讨其病因、病理、临床表现、诊断和治疗。结果2例患者均表现为头痛和肢体抽搐,头路CT见颅内钙化,MR I等见软脑膜血管畸形等表现。结论Sturge-weber综合征是一种罕见的神经皮肤综合征,主要影响头部静脉,以颜面血管畸形、肢体抽搐和青光眼为主要表现。增强MR I是首选诊断方法,可显示病变结构和SW S病变范围。但患者的临床过程、治疗和预后各不相同。     

Gastric carcinoma with osteoclast-like giant cells: a case report and review of the literature

Gastric carcinoma with osteoclast-like giant cells (OGCs) is an extremely rare tumor. So far, only six cases have been reported in the literature. Here we report an additional case of this tumor in a Chinese 78-year-old man presented with abdominal pain, vomiting, and hematemesis. Physical examination and gastroscopy revealed a tumor in the gastric antrum. The biopsy and pathological findings indicated a gastric adenocarcinoma with OGCs, which were present in both the tumor and the metastatic lymph nodes. Further immunohistochemical staining indicated that OGCs were reactive with CD68, CD45, and vimentin protein, but not with pancytokeratin, carcinoembryonic antigen, or epithelial membrane antigen, suggesting the monocytic/histiocytic derivation of these OGCs. In situ hybridization for Epstein-Barr virus showed no nuclear positivity in either adenocarcinoma or OGCs. Postoperative follow-up showed that the patient had survived for at least 6 months without recurrence. Further investigation is warranted to clearly define the prognostic significance of OGCs in gastric carcinoma.     

Primary leiomyosarcoma of the nipple-areola complex： Report of a case and review of literature

Primary leiomyosarcoma of the nipple-areola complex is extremely rare. Less than ten such cases have been reported in English literature so far. Herein we describe a 52-year-old female presenting with a 1.5 cm×1. 1 cm×0.7 cm nodular lesion over her left nipple, and leiomyosarcoma was proved by pathological examination of the excised specimen. Positron emitted tomogram （PET） revealed no abnormal signal other than the primary site. Microscopically, this poorly circumscribed tumor was composed of interlacing bundles of smooth muscle cells with bizarre and pleomorphic nuclei, as well as prominent nucleoli. Its mitotic count was up to 7 mitoses per 10 high power fields （HPF）. Immunohistochemical study of tumor cells revealed positive stain for α-smooth muscle actin and vimentin; and negative for cytokeratin, CD34 and S-100. Left simple mastectomy was undertaken and no residual mass lesion was noted on the resected specimen. Related literatures about the diagnosis and treatment for breast leiomyosarcoma will be presented here.     

Dental erosion and severe tooth decay related to soft drinks: a case report and literature review

Soft drinks have many potential health problems. The inherent acids and sugars have both acidogenic and cariogenic potential, resulting in dental caries and potential enamel erosion. In this report we present a 25-year-old man complaining with the severe worn-out of the front teeth during the past 3 years. He had a history of drinking cola for more than 7 years and had a poor oral hygiene. Severe decays were present in the incisors and the canines, while less severe lesions were noted on the premolars and the molars. The review is to show the relationship between dental erosion and caries and soft drinks. Some efforts have been taken to reduce the harmful effect of soft drinks.     

Ciliated hepatic foregut cyst： report of first case in China and review of literature

Objective: To report the first case of ciliated hepatic foregut cyst in China, and review of literature to introduce the characteristics of this disease for doctors to recognize this disease.Method: Report the clinical procedure of diagnosis and treatment for the first case of ciliated hepatic foregut cyst in China, and to review the embryologic genesis, incidence,clinical manifestation, radiologic features and therapeutic principle of this disease. Results: We performed the resection for ciliated hepatic foregut cyst under laparoscopy; the patient recovered well after the procedure. Conclusion: Ciliated hepatic foregut cyst is quite rare clinically, belongs to non-parasitic,solitary and unilocular cystic lesion, is always less than 4cm in diameter, mostly seen in the left lobe, and has the tendency of malignant change. It should be removed as soon as diagnosed.     

原发性输尿管癌的诊治体会(附23例报告)

目的提高原发性输尿管癌的诊治水平。方法回顾性分析23例经病理证实的原发性输尿管癌病例的临床病理特征。结果血尿和腰痛是本病主要临床表现,CT和B超检查的阳性率分别为73.3%和52.2%,IVU不显影73.9%,18例获得随访,5年生存率为31%。结论重视老年人单侧腰痛和血尿可能早期诊断原发性输尿管癌,特别是对不明原因的IVU不显影应追查其原因。     

因体而异引导想象--叙事类文学作品中人物形象的教学

叙事类文学作品的叙述形象都是作者根据典型化原则，以人物的性格发展为轴心，运用想象创造的成果。但不同体裁的叙事作品塑造形象时具有不同的想象特点，因而在叙事类文学作品教学中，要引导学生根据不同体裁作品所包含的不同想象特点，去展开想象翅膀，把握作品形象，以实现读者与作者心灵的沟通。     

《陕西师范大学学报》(自然科学版)高被引论文分析

通过检索CNKI中国引文数据库,对1974—2008年登载在《陕西师范大学学报》(自然科学版)的论文特别是高被引论文进行了分析.研究发现:1974—2008年《学报》共刊发论文(包括增刊、简讯等)4132篇,有1689篇被引用,约占总发文数的40.9%;在被引文献中,被引频次≥5的占31.1%、1～4次的占68.9%;高被引论文主要集中在数学、地理学、生物学、物理学领域,高被引论文的发表年限(距2009年)为5～13a和21～24a.     

雷帕霉素的免疫药理学（综述）

雷帕霉素是一种高效低毒的大环内酯类免疫抑制药,它在细胞外的受体为FK506结合蛋白FKBP－12,胞浆内的激酶mTOR是雷帕霉素已知的主要靶体,它是mRNA翻译的启动调控因子,Kipl是一种周期素依赖性激酶的抑制剂,能降低活化的T细胞内G1期的周期素与其依赖性激酶复合物的水平,mTOR对p70 s6k的活性,真核启努因子4E依赖性蛋白合成及Kip1的下调所需调节信号具有诱变作用,它与FKBP12与雷帕霉素复合物的相互作用干扰了它的功能,雷帕霉素因素阻断了Kipl的下调而将细胞阻滞于G1期。     

Primary structure and expression of bovine poly(A) polymerase

Poly(A) polymerase has a critical role in the synthesis of messenger RNA in eukaryotic cells. The isolation and characterization of complementary DNAs encoding bovine poly(A) polymerase is described here. The predicted sequences of the mRNA and protein reveal features that provide insights into how the enzyme functions and how it might be regulated. Poly(A) polymerase expressed from a cloned cDNA is fully functional in in vitro assays, and mutational analyses have identified a putative regulatory domain that enhances, but is not essential for, activity.