肾周膜

Mitochondria was relatively little in size. Round primary lysosome with high electron-densed granules and secondary lysosome with high or low electron-densed granules were seen frequently. DCs contained many rough endoplasmic reticulum, the Golgi apparatus and ribosomes. The vacuoles with flocculent electron-densed granules were rare. Some special granules in cytoplasm were seen, whose surface like earphone were covered with a membrane. High electron-densed contents in the granules were near one side and the other side was bright. The nucleus became markedly small in volume, nephroid or hoofed in shape. The nucleus had little euchromatin and lots of heterochromatin under nuclear membrane.

子宫内膜癌组织DC超微结构特征如下：细胞形态不规则，与正常子宫内膜组织DC相比，胞膜较光滑，胞膜表面树突状胞浆突起显著减少，部分突起呈粗短状；胞质中线粒体相对少，圆形而电子密度高的初级溶酶体和不规则形且电子密度高低不一的次级溶酶体多见；高尔基体、粗面内质网、核糖体丰富；含微量絮状电子致密物的胞饮小泡显著减少；胞质中可见形态特殊的颗粒，该颗粒外周膜包裹，略呈圆形，中间部位稍弯曲，如耳机状，颗粒中由高电子致密物居于一侧，而另一侧则呈透亮状；胞核显著减小，居于胞质一侧，常呈肾形或马蹄形，核内常染色质较少，异染色质多边集于核膜下。

Methods Surgical specimens/cell suspensions wore transplanted into the various tissues of BALB/c node mice (subcutis, cellular orthotopic injection into renal capsule, perinephrium, surgical orthotopic implantation into renal capsule). Tumorigenicity and metastasis were subsequently cvaluated. Immunohistochemical analysis was employed to determine the expression of VFGF, bFGF, P16, Bcl-2 and C-met in the metastatic and non-metastatic RCC xenograft.

采用皮下移植法、细胞悬液原位注射法、肾周筋膜内法、组织块原位移植肾包膜下法对BALB/c裸小鼠接种RCC组织块，观察各种方法的成瘤及转移情况，并采用免疫组化方法初步对比分析了VEGF、bFGF、P16、Bcl-2、C-met在裸小鼠体内的转移性和非转移RCC的表达情况。

Methods: Between November 2003 and December 2005, 67 patients with renal cell carcinoma underwent retroperitoneal laparoscopic radical nephrectomy (34 patients, group A) and open radical nephrectomy (33 patients, group B). Operating time, blond loss, amount of postoperative drainage, time to ambulation, recovery of intestinal function after operation, the postoperative hospital stay, use of antalgesic and transfusion blood and plasma were compared between group A and group B, retrospectively. Results: In group A, the operations of 31 patients were successful and 3 cases failed, then conversed to open surgery. Firstly, one case were not decented the prerenal fascia and the other two cases occurred complications, one case was due to injurying genital gland vein, with blood loss of 500m1, another fatty renal capsula was too thick to explose the renal pedicle. The operations of group B were all successful, only one case was died of intracerebral hemorrhage after two monthes.

回顾性分析和比较后腹腔镜肾癌根治性切除术(Retroperitoneal laparoscopic radical nephrectomy， RLRN)34例与开放性肾癌根治性切除术(Open radical nephrectomy， ORN)33例，比较两种方法的手术时间、术中出血、术后引流、术后最早下床活动时间、肠功能恢复情况、术后住院时间、术后镇痛剂使用量、术中术后输血、血浆量、术后随访时间及手术效果结果：A组中1例因最初对解剖结构难于辨认，无法分离肾前筋膜至肾门而改行开放手术，1例因损伤精索静脉出血难以控制而改行开放手术，1例因肾周脂肪过多，无法将肾脏掀起显露肾蒂而行开放手术，31例手术成功。B组手术均获成功，1例术后2个月因大面积脑出血死亡，余均无瘤生存。

The diffusive XGPN shows cystic-solid multi-occupying with the whole kidney involved and kidney renal pelvis and calices enlarged. The lesions were extensive with unclear border which made the perirenal space dim renal fasciae thicken and with the abscess formation of psoas and abdominal wall. The localized XGPN shows mass in the renal parenchyma with low density clear border after enhancement and rim enhancement.

弥漫型累及全肾，肾影增大，肾盂肾盏扩大积液，肾实质幕粥发囊实性占位，病变分界不清，向肾外扩展，肾周间隙模糊，肾筋膜增厚并累及腰大肌，腹壁脓肿形成；局灶型表现为肾实质内局限性占位，病灶区呈略低密度灶，增强后边界清晰，病灶内见环形强化，而略低密度灶者强化较明显，但仍低于肾实质。

Results: The renal perfusion was increased in diabetes group after the injection of alloxan. The PSI, AUC and ascending slope rate of the curve of the time-intensity curve were increased in 1w and 2w with decreased of HPT; the pathological examination exhibited glomeruli hypertrophy and no thickening of basal lamina. The PSI and AUC in 4w and 6w were more than that of control group; the PIT and ascending slope rate of the curve got closed to normal in 4w and 6w; the intercapillary cells increased. The speed of ascending slope rate of the curve in 8w, 10w and 12w was slower, shown as PIT and HPT delayed; the pathological examination showned increasing of mesangial cell, hyperplasia of mesangial matrix and thickening of basal lamina, followed with obliteration of partial micrangium, glomerular sclerosis and reduce of PSI in 12w.

结果：糖尿病组兔注射四氧嘧啶后肾皮质血流灌注增大，1周、2周表现为时间-强度曲线参数中峰值强度升高、曲线下面积增大、达峰时间缩短、曲线上升斜率升高，此时病理可见肾小球肥大，系膜基质正常，基底膜无增厚；4周、6周，峰值强度、曲线下面积高于对照组，达峰时间、曲线上升斜率接近正常，系膜细胞增多。8周、10周、12周，达峰时间延长、曲线上升斜率减慢、峰值强度减半时间延长，病理出现肾小球系膜细胞明显增多，系膜基质增生，基底膜增厚，至12周病理出现部分毛细血管管腔闭塞，肾小球节段性硬化，峰值强度测值减低。

Results The enhancement features of PRCC on contrast CT was homogeneous or inhomogeneous enhancement,and was light to moderate strengthening. CT features of perinephric space abnormalities included nodus, trabs,spinelike process and thickening of the perirenal fascia.

结果：CT主要特点为：增强扫描肿瘤呈较均匀或不均匀轻中度强化；肾周间隙受侵征象有结节、条索状影、棘状突起和肾周筋膜增厚。

Objective: To describe the anatomy of the superior and inferior aspect of the perirenal space as well as the renal fascia with CT radiography in vivo.

目的：通过对正常成人活体肾周间隙和肾筋膜的多层螺旋CT及三维重建图像的观察和测量分析，探讨肾筋膜的附着、肾周间隙的纵向通连情况等相关指标，以及多层螺旋CT对肾周间隙通连研究的诊断价值。

CT Findings were as follows : pancreas enlargement in 24 cases , focal and diffused hypodense in 39 cases , hemorrhage and necrosis of pancreas in 3 cases, peripancreatic effusion in 39 cases , prerenal fascia thickening in 39 cases , pleural effusion in 24 cases , with thrombosis in portal and SMV in 1 case . A case of pancreas head enlargement misdiagnosed for tumor,a case pancreatitis effusion was through superficial inguinal canal into scrotum.

CT影像学征象如下：胰腺体积增大24例；局限性及弥漫性密度减低39例；胰体及尾部出血坏死3例；胰周间隙渗出39例；肾旁筋膜增厚及脾肾间隙模糊39例，特别是左侧肾前筋膜均累及；少量胸腔积液24例；出血性胰腺炎伴门脉及肠系膜上静脉血栓1例；炎性渗出物通过腹股沟管蔓延到阴囊1例；单纯胰头增大，误诊为胰头肿瘤1例；本组40例中合并胆石12例。

CT Findings were as follows : pancreas enlargement in 24 cases , focal and diffused hypodense in 39 cases , hemorrhage and necrosis of pancreas in 3 cases, peripancreatic effusion in 39 cases , prerenal fascia thickening in 39 cases , pleural effusion in 24 cases , with thrombosis in portal and SMV in 1 case . A case of pancreas head enlargement misdiagnosed for tumor,a case pancreatitis effusion was through superficial inguinal canal into scrotum.

CT影像学征象如下：胰腺体积增 24例；局限性及弥漫性密度减低39例；胰体及尾部出血坏死3例；胰周间隙渗出39例；肾旁筋膜增厚及脾肾间隙模糊39例，特别是左侧肾筋膜均累及；少量胸腔积液24例；出血性胰腺炎伴门脉及肠系膜上静脉血栓1例；炎性渗出物通过腹股沟管蔓延到阴囊1例；单纯胰头增大，误诊胰头肿瘤1例；本组40例中合并胆石12例。

The expressions of VEGF mRNA in renal cortex in B and group C increased greatly compared with A group at 8th week(P.01), And the expression was decreased more in C group than that in B group at the 8th week;④The light microscopes results showed that no pathological changes in group A; pathological changes were much obvious in group B:glomerular capillary lumen tumbling,lumens blocked,mesangial region widened,basal lamina thicking,mesenterium base inceased,the volume of glomerulus become large,cell population increased,renal tubule vacuolization, renal interstitium was infiltrated by lots of lymphocyte and mononuclear macrophage; pathological changes in group C was light,only see glomerular capillary lumen lightly stegnosis,few lymphocyte infiltrating.

免疫组化结果显示第8周B组大鼠肾皮质VEGF蛋白含量较A组显著增加(P.01)，C组VEGF含量较B组有明显减少(P.01)，C组较A组表达量仍然增加(P.01)；③第8周B组肾皮质VEGF mRNA表达较A组有明显上调(P.01)，与B组相比，辛伐他汀可以明显减少C组肾皮质VEGF mRNA表达；④光学显微镜下A组肾小球毛细血管腔均匀一致，无狭窄，肾小管-间质无炎症细胞浸润。B组则病变较明显：大鼠肾小球毛细血管袢塌陷，管腔闭塞，系膜区增宽，基膜增厚和系膜基质增多，肾小球体积增大，出现玻璃样变；肾小管尤其是近区小管肿胀、变性、空泡形成，肾间质可见大量淋巴细胞和单核巨噬细胞浸润。C组病变较轻，可见肾小球毛细血管管腔轻度狭窄，肾小管-间质见少量淋巴细胞浸润。

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Yang yinshu、Wang xiangsheng、Li decang,The first discovery of haemaphysalis conicinna.

1〕 杨银书，王祥生，李德昌。安徽省首次发现嗜群血蜱。