评估放射性核素99mTc显像在Warthin瘤临床诊治中的价值。方法:运用放射性核素99mTc在Warthin瘤检查中的成像特点,对65例检查结果为"热结节"和"温结节"的病例与术后病理切片进行对照分析。结果:65例腮腺中,55例为"热结节",10例为"温结节"。术后病理证实:63例为Warthin瘤,1例为多形性腺瘤,1例为淋巴上皮病。结论:放射性核素99mTc显像对Warthin瘤有较高的诊断准确性,从而指导手术方式的选择。作为一种简便的检查方法,放射性核素99mTc显像在诊治Warthin瘤中具有重要的价值。

Objective: To evaluate the clinical value of 99mTc-pertechnetate scintigraphy in the diagnosis and therapy of Warthin''s tumor. Method:Image characteristics of 65 cases manifested with “hotnodule”(55 cases) and “warm nodule”(10 cases)examined by radionuclide 99mTc scintigraphy were compared with postoperative pathologic findings. Results:63 cases were pathologically diagnosed as Warthin tumor, one case was pleomorphic adenoma and the other one case was lymphatic epithelial disease. Conclusion: 99mTc-pertechnetate scintigraphy have high diagnostic accuracy in Warthin tumor.

目的：探讨腮腺Warthin瘤的彩色多普勒超声特征，以提高超声对腮腺肿瘤的诊断，为临床诊治提供参考。方法：回顾性分析经病理证实的24例患者31个腮腺Warthin瘤的彩色多普勒超声图像，对病灶位置、形态、大小、边界、内部回声、血流分布等特征进行分析。结果：31个病灶中①病灶多位于腮腺浅叶或下极；②形态为圆形或椭圆形，占80．65％（25／31）；③大小多在2．0～3．5 cm之间，占90．32％（28／31）；④边界清晰，占100％（31／31）；⑤病灶内部回声低回声、多呈囊实性、或夹有网格状回声，占74．19％（23／31）；⑥内部有不同程度血流信号存在，占77．42％（24／31）；⑦本组半数患者伴颈部淋巴结肿大。术前彩色多普勒超声诊断符合率为58．06％（18／31）。结论：彩色多普勒超声对术前腮腺Warthin瘤的诊断具有一定的临床价值，但规范化分析腮腺病灶图像，掌握Warthin瘤的声像图特征，对腮腺Warthin瘤检出的准确性可以得到进一步提高。

Objective:To examine the color Doppler flow imaging( CDFI) properties of Warthin′s tumor of parotid gland for improving the diagnostic accu-racy in this entity.Methods:The color Doppler flow imaging manifestations were retrospectively examined in 24 of 31 cases confirmed pathologically as Warthin′s tumor of parotid gland regarding the lesion location,tumor size and morphology,boundary,internal echo and blood flow features.Results:Totally, 31 lesions were detected in the 24 cases.①The lesions were generally located at the superficial lobe or lower point of the parotid;②The lesions exhibited round or oval shape(80.65%;25/31);③ The tumor size ranged from 2.0 to 3.5 cm in diameter(90.32%;28/31);④The boundary was clearly defined in the total cases(100%;31/31);⑤ The internal echo was very low,and presented with cystic-solid or mesh-like echoes(74.19%;23/31);⑥Vascular flow was occasionally displayed on CDFI(77.42%;24/31);⑦50% of patients showed cervical lymph node enlargeme

目的探讨Warthin瘤的MRI表现特征并结合相关文献加以分析,以提高对本病的认识。方法收集2006年6月-2013年6月我院及南京军区南京总医院共13例经病理证实的Warthin瘤患者临床和影像资料进行回顾性分析。结果 13例Warthin瘤患者中,男11例,女2例;7例单发,6例多发,共21个病灶;病灶呈圆形或类圆形14个,类椭圆4个,分叶状2个,哑铃状1个;21个病灶位于后下部16个,5个病灶位于腮腺其它部位;病灶边缘在FSE T1WI上可见低信号环,在FSE T2WI脂肪抑制序列上呈等或稍高信号;在FSE T1WI上增强扫描病灶呈轻-中度强化。结论 Warthin瘤MRI表现具有一定的特征及好发部位,术前MRI检查不但可以对肿瘤进行定位,而且还可以定性,为临床制定正确的手术方案具有一定的指导意义。

Objective To revaluate the diagnostic value of MRI in Warthin tumor in combination with related literature in order to improve our understanding .Methods Clinical data and MRI findings of 13 patients with pathologically proved War-thin tumor were observed from June 2006 to June 2013 and analyzed retrospectively .Results Among the 13 patients,11 were male and 2 were female .A total of 21 lesions included 7 cases with solitary mass ,and 6 cases with multiple mass .These lesions were round or nearly round in shape in 14,oval in 4,lobular in 2 and dumbbell shape in 1.Of the 21 lesions,16 were located in the posterior and inferior quadrant of the parotid ,and 5 in the other quadrants .All lesions had slightly low signal on FSE T1WI,and slight hyperintensity or isointensity on FSE T 2WI fat suppress.Most lesions showed mild or moderate enhancement after contrast administration on FSE T1WI.Conclusin MRI is valuable in locating the tumor,helpful in differentiating benign from malignant ,and al

目的 探讨不同胃病变患者的发生发展直至恶变过程中c-myc mRNA的表达与幽门螺杆菌(Hp)感染的相关性及其与胃组织细胞程序性死亡的关系.方法 通过实时荧光定量逆转录-聚合酶链反应(FQ-PCR)检测72例慢性浅表性胃炎(CSG)、55例慢性萎缩性胃炎(CAG)、52例肠化生(IM)、46例不典型增生(AH)、65例胃癌(GC)组织(分别为CSG、CAG、IM、AM、AH、GC组)中c-myc mRNA的表达；快速尿素酶法、Warthin-Starry银染法和甲苯胺蓝染色联合检测胃黏膜Hp感染；原位末端标记法(TUNEL)检测胃黏膜细胞程序性死亡指数(AI).结果 CSG、CAG、IM、AM、AH、GC组胃黏膜组织中c-myc mRNA的阳性率分别为21.5％ (7/31)、31.0％(8/27)、41.0％(10/26)、59.1％ (14/24)、69.1(23/33),c-myc mRNA相对表达水平分别为0.089±0.002、0.0113±0.014、0.168 ±0.028、0.226±0.040、0.367±0.037,IM、AH、GC组c-myc mRNA表达量均高于CSG、CAG组(P＜0.01),AH组高于IM组(P＜0.01),GC组高于IM、AH组(P＜0.01).c-myc mRNA表达量与胃黏膜细胞AI呈负相关(L=-0.700,P＜0.05)；IM、AH、GC组Hp阳性患者胃黏膜细胞中c-myc mRNA的表达均高于Hp阴性患者(P＜0.05或0.01).结论 胃黏膜癌变过程中,Hp感染能上调胃黏膜细胞中c-myc mRNA的表达,而抑制异形细胞程序性死亡而发挥致癌作用.

Objective To discuss different stomach trouble change occurred in the process of development until the progression in patients with c-myc mRNA expression in correlation with helicobacter pylori (Hp) infection and its relationship with gastric tissue programmed cell death.Methods By real-time fluorescent quantitative reverse transcription-olymerase chain reaction (FQ-PCR) to detect 72 cases of chronic superficial gastritis (CSG),55 cases of chronic atrophic gastritis (the CAG),52 cases of intestinal metaplasia (IM),46 cases of atypical hyperplasia (AH),65 cases of gastric cancer (GC) group (CSG group,respectively,the CAG group,IM,AM group,AH,the GC group) in the c-myc mRNA expression;Rapid enzymatic urea,Warthin Starry silver staining and toluidine blue staining assay for gastric mucosa Hp infection;In situ end labeling (TUNEL) method to detect gastric mucosal cell apoptosis index (AI).Results CSG group,the CAG group,IM,AM group,AH,the GC group c-myc in gastric mucosa tissue mRNA positi

目的 研究中国儿童肉芽肿性关节炎的临床特点、实验室及辅助检查、治疗用药及远期预后,使本病能早期诊断和及时治疗.方法 回顾性分析北京儿童医院2006-2013年住院的中国儿童肉芽肿性关节炎患者26例,归纳总结其临床表现、实验室检查、治疗用药及转归和随访结果.结果 患儿生后早期发病,最早者为生后1个月内,最晚者生后3岁6个月起病;临床表现为关节炎、皮疹、虹膜睫状体炎,肝脾淋巴结肿大、大动脉炎、神经性耳聋和肾脏肉芽肿和1例中枢神经系统脱髓鞘病变;实验室检查可见轻度贫血,炎性指标不同程度升高,自身抗体检测均为阴性;所有患儿病理检查提示有多核巨细胞形成的非干酪样肉芽肿;NSAIDs联合糖皮质激素和甲氨蝶呤是基本用药,对于有虹膜睫状体炎和大动脉炎的患者早期使用TNF-α抑制剂效果较好;如规律治疗和随访,病情控制基本稳定,2例合并严重虹膜睫状体炎的患几经积极治疗视力有所恢复.结论 儿童肉芽肿性关节炎是一种早期发病的遗传性自身炎症性疾病,早期诊断和积极治疗可明显改善预后.

Objective To analyze the clinical features,laboratory data,treatment and outcome of patients with granulomatous arthritis of Chinese children.Methods Twenty-six children with granulomatous arthritis hospitalized in Beijing Children''s Hospital between 2006 to 2013 were retrospectively analyzed.Results The onset age of granulomatous arthritis in these children was between 1 month and 3.5 years.The most common clinical features were arthritis,skin rash and iridocyclitis.Hepatomegaly,lymphadenopathy,Takayasu''s arteritis,neurological deafness and renal granuloma were common clinical features.Demyelinating disease of central nervous system was also detected in one patient.Mild anemia,high-level inflammatory indexes,negative auto-antibody were found.The pathology of these children showed non-caseous granuloma with Warthin-Finkeldey giant cells.NSAIDs,glucocorticosteroid and methotrexate were basic drugs for treatment.Earlier use of TNF-α inhibitor for patients with iridocyclitis