Histological and cytological criteria in the diagnosis of malignant melanomas by cryostat sections

Summary Although cryostat sections in general allow a distinction to be made between malignant melanomas and other pigmented lesions in clinically doubtful cases, the differential diagnosis may be difficult. The histological and cytological criteria taken into account can be classified as major, minor, and insufficient. Knowing the diagnostic value of each makes a conventionally established diagnosis safer. Variance analysis does not contribute to the problem but it can nevertheless be shown that the evaluation of six major criteria makes a quick and reliable cryostat section diagnosis possible. If these results are confirmed in a prospective study it would be a decisive step on the way to a quicker and safer cryostat section diagnosis of malignant melanoma, even for the less experienced histopathologist.The results published here were presented in part at the DDG meeting 1980 at Westerland/SyltWe are grateful to Miss Schubert, Institute of Biomathematics of the University of Munich, for the statistical evaluations     

立体定向治疗中靶心定位的算法

本文介绍了在立体定向放射神经外科中，根据病人配戴头环和ＣＴ定标架作ＣＴ扫描所得的ＣＴ断层图像或配戴ＡＶＭ定位箱做血管造影得到的两张Ｘ光片确定病人颅内病灶的三维坐标的方法。     

Usefulness of immunohistochemistry in delineating renal spindle cell tumours. A retrospective study of 31 cases

AIMS: To assess the usefulness of immunohistochemistry in delineating tumour diagnoses on a series of morphologically diagnosed renal spindle cell tumours (RSCTs). METHODS AND RESULTS: Formalin-fixed paraffin-embedded tissues from 31 morphologically diagnosed tumours were reinterpreted in light of newly obtained immunohistochemical information. By morphology, six had originally been classified as sarcomatoid carcinoma, five as spindle cell tumour (NOS), four as sarcoma (NOS), three as leiomyoma, three as leiomyosarcoma, and one each as fibrous polyp, hamartoma, neurilemmoma, mesoblastic nephroma, medullary fibroma, angiomyolipoma, haemangiopericytoma, malignant rhabdoid tumour, malignant Triton tumour, and carcinosarcoma. The application of immunohistochemistry verified the original diagnosis in 18 cases (18/31, 58%), confirming the diagnosis of sarcomatoid renal carcinoma (4/6), leiomyoma (2/3), leiomyosarcoma (3/3), sarcoma (NOS) (2/4), carcinosarcoma (1/1), malignant rhabdoid tumour (1/1), malignant Triton tumour (1/1), fibrous polyp (1/1), mesoblastic nephroma (1/1), hamartoma (1/1), and angiomyolipoma (1/1). Different tumour designations were suggested in 13 cases (13/31, 42%), including carcinosarcoma, sarcoma (NOS), leiomyosarcoma, solitary fibrous tumour, monomorphic/biphasic angiomyolipoma, endometrial stromal tumour, and congenital mesoblastic nephroma. CONCLUSIONS: Our data indicate that although morphology is most important in formulating the initial differential diagnosis, the addition of immunohistochemistry is vital in arriving at the correct classification of RSCTs.     

骨重建数值仿真中的控制方程

人体骨组织有着复杂的结构和生理机制,骨重建理论经历了定性分析、定量计算和计算机定量数值模拟三个阶段。目前,存在力学模型和现象模型两类成熟的骨重建模型,力学模型的共性就是表观密度随一定的力学刺激而变化,现象模型由基本多细胞单元的损伤状态和孔隙度变化来决定。大多数股骨重建仿真模型仍然将骨量的分布看作是各向同性的,这就不能完全反映骨组织微构造的本构关系。本文是对骨重建仿真模型的控制方程进行综述。     

乳腺微浸润癌的临床病理学特征及生物学特性

目的探讨乳腺微浸润癌（microinvasive carcinoma，MIC）的临床病理学特征及生物学特性和其病理诊断标准。方法回顾性研究40例MIC，按文献报道诊断标准分为两个亚型，并对病理学特征、分子生物学指标及预后进行比较。结果MIC占同期乳腺癌的1．5％，乳腺钼靶拍片85．0％的病例（34例／40例）显示不同程度的泥沙样钙化。粉刺型和高核分级的导管内癌更易形成间质浸润。淋巴结转移2．5％（1例／40例）。31例平均8个月随访显示无复发及转移。两亚型各指标比较结果差异均无显著性。结论MIC是一种少见、淋巴结转移率低、预后较好的恶性肿瘤。建议诊断标准：单个浸润灶时，最大径应〈2mm；出现几个浸润灶时，其中单个浸润灶的最大径应〈1mm，且几个浸润灶面积总和不应超过整个肿瘤组织面积的10％。     

Effects of ethanol on murine aggression assessed by biting of an inanimate target

The effects of acutely administered ethanol (0, 0.5, 1.0 and 2.0 g/kg, IP) were studied in a tube-restraint/target biting model of aggressive responding using naive group-and individually-housed male Swiss mice. Behavioural measures were the latency to the first bite and the biting frequency. In saline-injected control animals, the levels of responding were significantly higher in group-housed than isolated mice. Animals given alcohol exhibited a dose-dependent suppression of biting frequency, and an increase in biting latency. Mice experienced in the tube-testing situation showed reduced baseline levels of biting, but alcohol produced similar effects to those in naive mice. There was no evidence of a biphasic action of alcohol.     

目标管理在医疗设备维修管理中的应用与效果分析

分析目标管理在医疗设备维修管理中的应用效果,选取2019年1月至2020年12月医疗设备维修数据,对比分析实施目标管理前后的设备整体平均维修时长、维修关单良好率、基础性设备(病床、监护仪及泵类)平均维修时长和工程师维修关单良好率,为医院维修管理精细化实践提供参考。     

不同阻滞阶段非梗阻性无精子症的生物信息学分析

目的：利用生物信息学筛选不同阻滞阶段非梗阻性无精子症（NOA）相关的调控因子及其调控途径,为后续的功能研究提供依据。方法：从GEO（Gene Expression Omnibus）数据库中获得GSE45885的基因表达谱矩阵,筛选其中的正常样本以及不同阻滞阶段NOA样本,包括4例正常生精样本和20例NOA患者样本,20例NOA患者中有2例患者处于减数分裂前期阻滞阶段（PRE）,7例处于减数分裂期阻滞阶段（MEI）,11例处于减数分裂后期阻滞阶段（POST）。将正常生精样本设置为对照组（CON）,使用GEO2R在线工具鉴定正常生精样本与不同阻滞阶段NOA样本之间的差异基因,对GEO芯片中不同阻滞阶段的NOA数据整合归一化并进行矫正后取交集。对差异表达的基因以及其靶基因进行GO（Gene Ontology）和KEGG（Kyoto Encyclopedia of Genes and Genomes）富集分析,获取关键通路;基于在线工具（STRING）构建蛋白质相互作用（PPI）网络图。然后利用Cytoscape中的CytoHubba插件对枢纽基因进行筛选。结果：在PRE中筛选出463个上调基因,12个下调基因;在MEI和POST中分别发现2个和3个下调基因,无上调基因。PRE中上调基因通过一些重要途径,如精子发生、精子细胞发育、精子的运动、纤毛运动和微管形成等功能来调控生精过程。在上述的3个阻滞阶段NOA中筛选出2个共同差异基因,均为微小RNA（miRNA）,2个miRNA有58个共同靶基因。利用在线生物信息学工具STRING成功构建PRE中上调基因的PPI网络图,并使用Cytoscape筛选出网络中前10个枢纽基因,包括DNAI1、DNAI2、PGK2、ROPN1L、ARMC4、DRC1、DNAAF3、CABYR、ZMYND10和CCDC65。结论：识别枢纽基因和共同差异基因及其通路为后续研究NOA的发生机制提供了有价值的参考,DRC1、ARMC4、MIR15A和MIR509-3可作为后续NOA发病机制研究的潜在靶点。     

Axillary management based on American college of surgeons oncology group Z0011 criteria makes it possible to omit intraoperative diagnosis of sentinel lymph nodes in early breast cancer patients

The ACOSOG Z0011 trial has resulted in the omission of axillary lymph node dissection (ALND) in early breast cancer patients with one or two metastatic sentinel lymph nodes (SLNs). There has been increasing interest in the necessity of intraoperative assessment of SLNs in patients treated based on the Z0011 criteria. We evaluated the utility of intraoperative assessment in these eligible patients. A total of 1396 patients were treated following the Z0011 criteria from April 2012 to December 2019. We examined the proportion and clinicopathological features of patients who underwent ALND due to three or more metastatic SLNs and the sensitivity of intraoperative assessment. Only 16 (1.1%) patients had three or more metastatic SLNs diagnosed by intraoperative assessment, and they immediately underwent ALND. Of the clinicopathological factors, high clinical tumor stage (p = 0.002) and high Ki-67 labeling index value (p = 0.056) were more likely to be associated with the presence of three or more metastatic SLNs. The major independent risk factor for three or more metastatic SLNs was high clinical tumor stage (OR 3.94 [95% CI 1.42–11.0]; p = 0.009). Intraoperative assessment had low sensitivity (70.5%) and a high false-negative rate (29.5%) in detecting SLN metastases. The main finding of our study was the small proportion of patients who required ALND due to three or more metastatic SLNs according to the Z0011 criteria. The Z0011 strategy enables intraoperative assessment of SLNs to be omitted in early breast cancer patients.     

胆管癌免疫检查点抑制剂治疗研究进展

胆管癌是一种罕见的恶性肿瘤,总体预后较差。根治性手术治疗是目前唯一可使早期胆管癌病人获得长期生存的策略。对于多数晚期胆管癌病人,系统治疗成为主要手段,但目前可用于治疗胆管癌的一线药物选择有限,疗效有限。近年来,免疫检查点抑制剂等免疫治疗策略利用宿主免疫系统进行有效的抗肿瘤反应,在多种实体肿瘤中取得令人鼓舞的结果。笔者回顾并总结免疫检查点抑制剂在治疗胆管癌中的研究进展。