Blood flow and oxygenation status of human tumors

Purpose  There is a large body of evidence suggesting that blood flow and oxygenation of human tumors are important research topics which may explain, in particular, resistance to radiation and to many antineoplastic drugs, which can limit the curability of solid tumors by radiotherapy and chemotherapy. Materials and Methods  This manuscirpt reviews the clinical investigations which have been performed regarding blood flow and oxygenation status of human tumors in radiation oncology. Results  The possible uses and limitations of the prognostic significance and the changes under therapy measuring blood flow and oxygenation in human tumors were discussed. In addition, several aproaches were summarized, which can improve the microvascular O₂ availability and perfusion-limited O₂ delivery. Conclusion  The clinical data concerning the prognostic significance of blood flow, vascular function and oxygenation of human tumors are relevant for patient selection in clinical oncology. Strategies to improve traditional cancer therapy by modulation of the oxygenation status remain quite promising but more critical research and sophisticated clinical studies are necessary before its true potential is known.      

穴位按压腕带对缓解妇科术后患者胃肠道不适的Meta分析

目的 系统评价穴位按压腕带作用于内关穴对缓解成年女性妇科术后胃肠道不适的作用与效果。方法 计算机检索PubMed、Embase、Cochrane、Proquest、中国期刊全文数据库（CNKI）、中国生物医学文献数据库（CBM）、维普和万方数据库，收集国内外相关的临床随机对照试验（RCT），检索时限为建库至2020 年12 月，采用RevMan 5.3 软件进行Meta 分析。结果 共纳入8 个RCT 910 例患者。Meta 分析结果显示，与安慰剂组相比，试验组穴位按压腕带作用于内关穴可以有效减少妇科术后呕吐的发生（OR=0.53，95%CI：0.30～0.95，P＜0.05）与止吐药使用率（OR=0.32，95%CI：0.22～0.47，P＜0.00001）。而对于术后恶心的发生率，试验组和安慰剂组比较，差异无统计学意义（OR=0.70，95%CI：0.47～1.04，P＞0.05）。结论 穴位按压腕带作用于内关穴可以有效降低妇科术后患者呕吐的发生率和止吐药的使用率，而对改善恶心效果不显著，尚需大样本、高质量的临床随机对照试验予以验证。     

Giant aneurysmal benign fibrous histiocytoma (dermatofibroma)

Aneurysmal benign fibrous histiocytomas are variants of dermatofibromas. These benign blood‐filled lesions can mimic malignancies due to their rapid and recurrent growth. Our patient is a 42‐year‐old Caucasian female with a past medical history of morbid obesity, diabetes, and hypertension, who presented with a mass on her left shoulder for 5 years’ duration. The mass oozed occasionally and would appear to regress but then recur replaced with progressively larger masses. Upon inspection, the patient had a large pedunculated exophytic mass with vascularity. The mass was surgically removed under general anesthesia via wide local excision. Grossly, the excised skin was purple‐tinged with an underlying fungating solid mass measuring 8.5 cm. Serial sections revealed a hemorrhagic, spongy, and granular cut surface. Histologically, the epidermis was hyperplastic, with underlying hyaline collagen bundles. The remainder of the mass was chronically inflamed and composed of spindled histiocytes, hemosiderin‐laden macrophages, and blood‐filled spaces lacking an endothelial lining. There was focal pleomorphism but no significant atypia. Immunohistochemical stains were strongly positive for vimentin and negative for CD31, CD34, and desmin. The overall architecture and immunophenotype are consistent with the diagnosis of aneurysmal benign fibrous histiocytoma.     

PRACTICE OF PALLIATIVE SEDATION IN CHILDREN WITH BRAIN TUMORS AND SARCOMAS AT THE END OF LIFE

Despite progress in the treatment of pediatric cancer, approximately 25% of these children will die of the disease. The last period of life is characterized by profound physical and psychological suffering, both of the children and their loved ones. Adequate alleviation of this suffering becomes the priority in the management of these patients. The authors retrospectively evaluated the indications, incidence, and characteristics of palliative sedation (PS) in 19 children with brain tumors (BT) and 18 with sarcomas (S) at the end of life. Twelve of the 18 S patients received PS, as did 13 of the 19 BT patients. Indications for initiation of PS for those with BT were seizures and/or pain, for those with S were pain and/or respiratory insufficiency. It was concluded that PS may be the only efficacious and safe treatment for the alleviation of suffering in these children at the end of life, despite differing indications.     

以神经系统症状首发的恶性肿瘤37例临床分析

恶性肿瘤以神经系统症状起病的并非少见,但许多原发肿瘤症状不表现或隐匿.常以神经系统症状就诊从而被误诊.故现将自2001年10月至2006年11月南京军区总医院神经内科收治的以神经系统症状首发且均经CT、MRI或活检等检查后确诊的37例恶性肿瘤患者的临床资料报道如下,以期提高其诊断正确率.     

盘状结构域受体1与脑肿瘤研究进展

盘状结构域受体1(discoidin domain receptor 1,DDR1)是一种跨膜的酪氨酸激酶受体,其特异性配体为胶原蛋白,活化过程不同于经典的RTK,激活后参与细胞内外信号传导,促进肿瘤细胞的黏附与迁移,与肿瘤的增值、侵袭、转移密切相关.     

腱鞘巨细胞瘤的影像学诊断价值

目的：探讨腱鞘巨细胞瘤的X线、CT及MRI诊断价值。方法：回顾性分析35例经手术病理证实的腱鞘巨细胞瘤病例资料。男16例，女19例；年龄7～66岁，平均39．4岁。所有病例行X线检查，8例行CT检查，16例行MR检查。结果：病变位于膝关节2例，踝关节6例，桡骨小头1例，腕关节2例，14例手部，10例足部。病变呈弥漫型10例，局灶型25例。X线：32例表现为骨旁稍高密度软组织肿块，3例正常。相应骨质受压侵蚀或小囊样破坏9例，明显骨质破坏5例。CT：能清晰显示软组织肿块及骨质破坏。MRI：在T1WI上接近于骨骼肌信号9例，稍低于骨骼肌信号7例，在T2WI上以低信号为主，混杂斑片状等高信号，6例可见少量积液改变。结论：X线可初步发现病灶及骨质破坏，CT观察骨质破坏较好，MRI特征性长T1短T2低信号，能清晰显示病灶范围及分型。     

手部恶性腱鞘巨细胞瘤临床研究

目的 研究恶性腱鞘巨细胞瘤的临床、病理、免疫组织化学特点及临床转归.方法 1991年1月至2001年12月对我院诊断的10例恶性腱鞘巨细胞瘤患者的临床资料进行分析.复习患者HE切片及X线片,对石蜡包埋组织进行免疫组织化学染色和流式细胞检测.结果 10例患者中3例证实为其他类型肉瘤.其余7例患者中仅有1例临床表现出明显的恶性行为:多次复发,最后出现肺部转移死亡,此患者免疫组织化学染色结果符合腱鞘巨细胞瘤的免疫表型,流式细胞检测显示异倍体;其余6例患者组织病理表现显示为恶变,其中4例有免疫组织化学检测结果,显示符合腱鞘巨细胞瘤的免疫特征,流式细胞检测显示1例DNA倍体类型为异倍体类型,3例为二倍体,S期细胞百分比分别为4.5%,11.6%和2.6%.对其肿物切除和扩大切除后,未经化疗和放疗,随访1.5～7.5年,平均4.5年,未见复发和转移.结论 恶性腱鞘巨细胞瘤极为罕见,一些患者预后极差.但一些组织病理表现恶性的腱鞘巨细胞瘤,如能彻底切除,仍有较好的临床结果.     

Antiestrogen binding sites in microsomal fractions of malignant and nonmalignant human breast tissues

Antiestrogen binding sites (AEBS) were measured in microsomal fractions of 102 malignant breast tumors and 24 nonmalignant breast tissues. The number of AEBS was determined by Scatchard analysis. The cytosol contents of estrogen and progesterone receptors were also analyzed in these tissues. Overall, 50% of the malignant tumors and 33% of the nonmalignant normal breast tissues had detectable contents of AEBS. No correlation was observed between cytosol estrogen receptor (ER) content and microsomal AEBS in the tumors. Detailed data analysis in patients at Stage IV disease revealed that 60% of estrogen receptor positive tumors had no detectable microsomal AEBS contents whereas in the remaining 40% tumors, high affinity AEBS were observed. On the other hand, AEBS were also detected in 35% of ER-poor tumors. Antiestrogen binding sites were higher in tumors obtained from premenopausal women than in those of postmenopausal women. The incidence of AEBS-positive tumors or AEBS concentration was not influenced by either the patients' obesity or their disease stage.