液基薄层细胞检测及TBS分类在宫颈癌筛查中的应用

目的 :对液基薄层细胞检测系统 Autocyte Prep L iquid based Cytology Test (L CT)及 the Bethesda sytem(TBS)细胞学分类法在宫颈癌筛查中的应用价值进行综合评价。方法 :采用液基薄层细胞检测系统检测宫颈细胞并进行 TBS细胞学分类诊断 ,将诊断意义不明的不典型鳞状细胞 (ASCUS)以上病变均列为阳性病例 ,且在阴道镜下行活检 ,将细胞学检测结果与活检结果作对比分析。结果 :液基薄层细胞检测法标本满意率 95 % ,180 0例涂片中阳性病例 76例 ,阳性率 4 .2 2 % (76 / 180 0 ) ,对 76例异常者行阴道镜下活检与组织病理学诊断总符合率 81.5 % (6 2 / 76 )。结论 :L CT技术应用于宫颈细胞涂片筛查 ,明显提高了涂片的满意率及宫颈异常细胞检出率。 TBS报告方式内容直观、易懂、具体。 L CT检查异常的病例配合阴道镜病理检查进行最后诊断 ,能及早发现宫内早期病变 ,是防治宫颈癌发生的关键     

全反式视黄酸对体外培养的人体大隐静脉内膜平滑肌细胞增殖与凋亡的影响

目的研究全反式视黄酸(atRA)对体外培养的人体大隐静脉内膜增厚、平滑肌细胞增生与凋亡的影响。方法30小段(1 cm长)人体大隐静脉(HSV),随机分成HSV组、atRA组和对照组(n=10),atRA组和对照组均体外培养14 d。atRA组:培养液中含atRA100μM;对照组:培养液中含同等量无水酒精(atRA溶剂)。对HSV组及培养后的atRA组、对照组标本进行取材固定,M asson染色,免疫组化测定增殖细胞核抗原(PCNA)及TUNEL法检测平滑肌细胞凋亡,计算机图象分析仪测量血管内膜厚度、计算内膜增生指数及细胞增殖和凋亡百分比。结果体外培养人体大隐静脉能产生明显的内膜增生和平滑肌细胞增殖(P<0.05);atRA组内膜厚度、增生指数及PCNA阳性细胞百分数均明显低于对照组(P<0.05)。而凋亡细胞百分数则明显高于对照组(P<0.05)。结论atRA可以抑制体外培养人体大隐静脉内膜增厚及平滑肌细胞增生,促进平滑肌细胞凋亡。     

宫颈细胞学的临床价值

目的:探讨宫颈细胞学筛查的准确性和对临床的指导意义。方法:收集2003年四川大学附属华西第二医院筛查出382例宫颈细胞为ASC/AGC及以上病变患者的阴道镜检查、病理诊断等资料和同期住院1 147例宫颈细胞学为阴性患者的组织学结果,并将部分细胞学标本进行再次诊断,比较二次细胞学诊断结果。结果:细胞学异常的患者中,年轻患者(<35岁)占30.6%,宫颈细胞学诊断的一致性不够理想(k=0.39);ASC、LSIL和HSIL对于C INⅡ及以上病变的阳性预测值分别为40.1%、36.2%和72.0%,宫颈细胞学阴性预测值为98.9%。结论:应重视年轻女性的宫颈细胞学筛查,包括ASC在内的异常细胞学均应行阴道镜检查和组织学诊断。     

液基薄层细胞学检测及TBS分类在宫颈病变诊断中的应用

目的 探讨液基薄层细胞学（TCT）检测在宫颈病变诊断中的价值。方法 对648例宫颈异常的患者进行液基薄层细胞学检测，将诊断意义不明的不典型细胞（ASCUS）以上病变者行阴道镜下活检，将细胞学检测结果与活检结果作对比分析。结果 658例TET检测的患者中，宫颈病变发生率迭80．7％，其中良性病变348例，占53．7％，宫颈上皮内病变183倒，占28．2％，对183倒异常者进行阴道镜下活检与组织病理学诊断比较，符合率为90．7％。宫颈上皮内病变高发年龄为30．40岁，占37．8％。结论 TCT技术在宫颈病变的诊断中，具有简便、实用，准确率高的特点，配合阴道镜检查能及时发现官颈早期病变，是防止宫颈癌的关键。     

白内障超声乳化手术前后眼表的变化

目的：应用眼表综合分析仪联合结膜印记细胞学观察白内障超声乳化手术前后眼表参数的变化。

方法：选择2016-12/2017-12于福建省立医院眼科行白内障超声乳化和人工晶状体植入手术的患者39例39眼。观察和分析患者术前,术后1d,1wk,1、2mo的干眼症状评估OSDI量表。应用眼表综合分析仪(Keratograph5M)测量泪河高度、泪膜破裂时间、结膜充血以及进行结膜印迹细胞学检查。

结果：术前,术后1d,1wk,1、2mo的OSDI量表的评分：9.30±3.80、19.8±3.42、33.2±5.63、18.8±3.49、20.3±8.65分(P<0.05); 结膜杯状细胞密度分别是376.00±73.88、289±69.50、243.02±80.81、336.72±81.60、346.70±67.35个/mm²(P<0.05); 首次泪膜破裂时间分别是6.91±4.52、6.12±3.55、5.18±3.37、6.28±4.70、5.96±3.17s,平均泪膜破裂时间分别是10.21±5.20、8.89±4.47、6.87±3.68、7.35±3.52、9.00±4.23s,术后1wk的泪膜破裂时间与术前有差异(P<0.05)。

结论：白内障超声乳化手术破坏眼表,患者的泪膜稳定性和结膜细胞损害于术后1d开始,术后1wk加剧,术后2mo患者的眼表状态仍然无法完全恢复。     

Does perioperative biological therapy increase 30-day post-operative complication rates in inflammatory bowel disease patients undergoing intra-abdominal surgery? A systematic review

BackgroundBiopharmaceuticals revolutionised inflammatory bowel disease (IBD) treatment. However, it is postulated they compromise immunity, collagen production and angiogenesis resulting in infective post-operative complications and altered wound/anastomotic healing. Research has failed to agree on risks associated with perioperative biologics therefore it was anticipated that a systematic review may provide a consensus and contribute recommendations for clinical practice.MethodsA systematic review conducted as per PRISMA guidelines included a methodical search of PubMed, Google Scholar, EMBASE/Ovid and Cochrane Library using MeSH and/or keywords for papers published between 01/01/1998 and 04/02/2019.The population analysed included adult ulcerative colitis, Crohn's disease, Indeterminate Colitis or IBD unclassified patients. The intervention was intra-abdominal surgery in patients treated with biological therapy in the preceding 12 weeks compared to patients who had intra-abdominal surgery without biological therapy within the defined timeframe. The primary outcome was surgical site infection (SSI) with secondary outcomes including wound dehiscence, intra-abdominal sepsis/abscess, systemic infection and anastomotic breakdown within 30 days post-procedure. Papers were evaluated by two independent reviewers and those included were assessed for quality/bias using the Newcastle–Ottowa scale.Results2064 UC, Crohn's and IC patients were analysed across 8 included studies. Several studies' multivariate analyses demonstrated corticosteroids to be independent predictors of morbidity. There are no increased complications associated with anti-TNFα exposure while vedolizumab increased SSI and small bowel obstruction.ConclusionProspective studies and randomised control trials are required to clarify study outcomes and recommendations published to date. Presently, biologics should continue to be used and considered beneficial in this population.     

Pleomorphic rhabdomyosarcoma arising in the anterior mediastinum: A case report with cytological features of imprint and liquid‐based cytology specimens

We herein report the cytological features of a very rare case of pleomorphic rhabdomyosarcoma arising in the anterior mediastinum on imprint and liquid‐based cytology (LBC) specimens. A 58‐year‐old man had an approximately 10‐cm tumor in the anterior mediastinum as shown on computed tomography. Thymectomy with complete resection of the left lung was performed. The fresh cut surface of the tumor was used to prepare imprint and LBC specimens. The imprint specimens showed four types of tumor cells dispersed on a background of hemorrhage, necrosis, and mucus. On the other hand, only two types of tumor cells (spindle‐shaped and spiderweb cells) were scattered or present in clusters in the LBC specimens. Immunocytologically, both of these cell types were positive for desmin and myoglobin, negative for pan‐keratin and epithelial membrane antigen. Cytological and immunocytological features are useful for the correct diagnosis of pleomorphic rhabdomyosarcoma, and LBC specimens show clearer results than do imprint specimens. Diagn. Cytopathol. 2017;45:333–338. © 2016 Wiley Periodicals, Inc.