A 65-year-old Woman With Persistent Dyspnea,Arthritis, and Raynaud's Phenomenon

Antisynthetase syndrome (AS) is a rare disease that affects patients with inflammatory myopathies such as polymyositis (PM) and dermatomyositis (DM). In patients with AS, up to 95% of patients develop antisynthetase syndrome-associated interstitial lung disease (AS-ILD). Although AS-ILD commonly occurs in patients with a well-established diagnosis of AS, it can be the first or only manifestation of an occult AS. The frequency of interstitial lung disease (ILD), myopathy, and skin involvement are often dependent on the type of myositis-specific antibodies present. AS-ILD patients who are positive for both anti-Jo-1 and anti-SSA/RO-52 autoantibodies often present with a severe degree of lung restriction on pulmonary function tests and radiologic imaging with an inadequate response toward immunosuppressive therapies. We describe a 65-year-old woman who presents with chronic dyspnea. She was initially diagnosed with corticosteroid-resistant cryptogenic organizing pneumonia based on the radiological findings on her CT chest. Her symptoms did not improve, and she suffered from intolerable corticosteroid-related side effects. Reviews of systems were positive for arthritis and Raynaud's phenomenon. She was found to have elevated inflammatory markers and autoantibodies such as anti-Jo-1, anti-RO-52, and anti-SSA. A diagnosis of AS-ILD resistant to corticosteroid therapy was made. Her lung function improved with combination therapy of mycophenolate and rituximab. Our case highlights that a detailed history and physical exam, compatible radiologic imaging, and autoantibodies are essential for the diagnosis of AS-ILD.     

Two cases of rt-PA with dual antiplatelet therapies with capsular warning syndrome

Rationale:Capsular warning syndrome (CWS) is a term to describe stereotyped lacunar transient ischemic attacks (TIAs). Patients with CWS are at high risk of developing completed stroke. However, the exact pathophysiology of CWS is still unclear, and there is no conclusive clinical strategy for CWS patients.Patient symptoms:Two cases of middle-aged men with hypertension, hyperlipidemia, and diabetes mellitus presented with fluctuating right-sided weakness, numbness, and dysarthria.Diagnoses:These two patients were diagnosed with CWS.Interventions:Recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis (0.9 mg/kg) was administered first and treated with aspirin (100 mg) and clopidogrel (75 mg) after 24 h of rt-PA for 21 days following by aspirin (100 mg) alone.Outcomes:Both cases got favorable clinical outcomes of somatic symptoms. In addition, diffusion-weighted imaging (DWI or DW-MRI) showed that ischemic injury disappeared in case 1 while maintained within a reasonable range in case 2.Lessons:Early recognition and rt-PA/dual antiplatelet treatment may be an effective strategy for patients with CWS.     

Triclosan exhibits a tendency to accumulate in the epididymis and shows sperm toxicity in male sprague‐dawley rats

Triclosan (TCS) is considered a potent endocrine disruptor that causes reproductive toxicity in non‐mammals, but it is still unclear exactly whether TCS has adverse effects on the sperm or reproductive organs in mammals. In this study, we aimed to evaluate the distribution status of TCS in male reproductive organs of rats, and seek the correlation with the TCS‐induced sperm toxicity or reproductive organ damage. Male rats were intragastrically administered with TCS at a dose of 50 mg/kg, the kinetics of TCS in the plasma and reproductive organs were investigated. TCS in testes and prostates both showed a lower‐level distritbution compared to that in the plasma, which indicates it has no tendency to accumulate in those organs. However, TCS in the epididymides showed a longer elimination half‐life (t_1/2z), a longer the mean retention time (MRT), and a lower clearance (CL_Z/F) compared with those in the plasma. Besides, the ratios of mean area under the concentration‐time curve (AUC)_{0–96h(epididymides/plasma)} and AUC_{0–∞(epididymides/plasma)} were 1.13 and 1.51, respectively. These kinetic parameters suggest TCS has an accumulation tendency in the epididymides. Based on this, we investigated the TCS‐induced sperm toxicity and histopathological changes of reproductive organs in rats. TCS was given intragastrically at doses of 10, 50, and 200 mg/kg for 8 weeks. Rats treated with the high dose (200 mg/kg) of TCS showed a significant decrease in daily sperm production (DSP), changes in sperm morphology and epididymal histopathology. Considering the histopathological change in the epididymides, TCS may induce the epididymal damage due to the epididymal accumulation of that. © 2013 Wiley Periodicals, Inc. Environ Toxicol 30: 83–91, 2015.     

Breast Density Analysis Using an Automatic Density Segmentation Algorithm

Breast density is a strong risk factor for breast cancer. In this paper, we present an automated approach for breast density segmentation in mammographic images based on a supervised pixel-based classification and using textural and morphological features. The objective of the paper is not only to show the feasibility of an automatic algorithm for breast density segmentation but also to prove its potential application to the study of breast density evolution in longitudinal studies. The database used here contains three complete screening examinations, acquired 2 years apart, of 130 different patients. The approach was validated by comparing manual expert annotations with automatically obtained estimations. Transversal analysis of the breast density analysis of craniocaudal (CC) and mediolateral oblique (MLO) views of both breasts acquired in the same study showed a correlation coefficient of ρ = 0.96 between the mammographic density percentage for left and right breasts, whereas a comparison of both mammographic views showed a correlation of ρ = 0.95. A longitudinal study of breast density confirmed the trend that dense tissue percentage decreases over time, although we noticed that the decrease in the ratio depends on the initial amount of breast density.     

明胶微冰胶支架有利于脂肪来源间充质干细胞体外干性维持并提高其体内应用价值

目的研究人脂肪来源间充质干细胞(ADSCs)与明胶微冰胶材料体外联合培养时,材料是否能维持间充质干细胞的生物学特性。方法 ADSCs种植于明胶微冰胶材料后进行Calcein-AM和PI活细胞染色检测细胞活力,细胞滴度蓝法检测细胞增殖能力,定量PCR检测干性基因OCT4、Nanog、SOX2表达情况,以及在成脂成骨诱导过程比较ADSCs在二维环境和种植于明胶微冰胶材料后的分化潜能。结果 ADSCs在三维明胶微冰胶支架材料中能保持较高活性,增殖能力不受影响,干性基因表达上调,成脂成骨分化相关基因表达水平比二维诱导环境低。结论明胶微冰胶可以为ADSCs提供一个较二维培养更好的微环境,有利于ADSCs体外干性维持,从而在干细胞移植法治疗相关疾病时以非侵入性的细胞传递方式发挥更长期的应用价值。     

胃癌中VEGF、NRP1和干细胞标志物CD44的表达及相关性

目的探讨VEGF、NRP1和干细胞标志物CD44在胃癌组织中的表达及三者间的相关性。方法应用高通量组织芯片技术和免疫组化SP法检测72例胃癌和52例正常胃组织中VEGF、NRP1和CD44蛋白的表达,并分析三者之间的相关性以及与胃癌临床病理特征的关系。结果 (1)胃癌组织中VEGF、NRP1和CD44蛋白阳性率分别为76.4%、66.7%、83.3%,三者在胃癌组织中的表达显著高于正常胃组织,差异均具有统计学意义(P均<0.01)。(2)VEGF、NRP1蛋白表达与胃癌浸润深度、淋巴结转移、临床分期有关(P均<0.05);CD44表达与Lauren分型、分化程度、淋巴结转移、临床分期有关(P均<0.05)。(3)胃癌组织中VEGF、NRP1和CD44蛋白的表达均呈正相关(rs=0.578,rs=0.278,rs=0.316,P均<0.05)。结论 VEGF、NRP1和干细胞标志物CD44在胃癌中均呈高表达,且与胃癌的恶性生物学行为密切相关。VEGF与NRP1之间可能存在协同作用,二者均与干细胞标志物CD44的表达密切相关,其具体机制有待进一步研究。     

肺硬化性血管瘤120例临床病理分析

目的探讨肺硬化性血管瘤(pulmonary sclerosing hemangioma,PSH)的临床病理特征及免疫表型。方法收集120例PSH的临床病理资料,探讨其临床特点、组织学特征及免疫表型。结果 PSH肿块与周围肺组织界限清楚,切面多为灰棕色,常伴出血灶。镜下可见两种肿瘤细胞、四种组织结构,多以混合形式存在(92/120,76.67%),并常发现泡沫样细胞灶性聚集及肥大细胞散在分布(83/120,69.17%)。免疫表型:表面立方细胞及间质多角形细胞TTF-1、EMA阳性,表面细胞SP-A、CK、Napsin A阳性,间质细胞vimentin阳性。结论 PSH大体表现及镜下典型的"两种细胞,四种结构"组织特点是诊断PSH的重要依据,泡沫样细胞灶性聚集及肥大细胞散在分布对PSH诊断及鉴别诊断有重要提示意义。     

肺原发性非霍奇金淋巴瘤28例临床病理分析

目的：探讨肺原发性非霍奇金淋巴瘤( primary non-Hodgkin lymphoma, PNHL)的临床病理学特征。方法回顾性分析28例肺PNHL临床表现、影像学和病理学特征,并复习相关文献。结果28例肺PNHL中,男性18例,女性10例,年龄27~82岁,中位年龄57岁。28例均为非霍奇金淋巴瘤( non-Hodgkin lymphoma, NHL),其中黏膜相关淋巴组织结外边缘区淋巴瘤17例,弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma, DLBLC)5例,NK/T细胞淋巴瘤2例,间变性大细胞淋巴瘤(ana-plastic large cell lymphoma, ALCL)2例,套细胞淋巴瘤(mantle cell lymphoma, MCL)及外周T细胞淋巴瘤,非特指各1例。1/3肺PNHL患者无特异性临床症状,主要表现为咳嗽、胸痛、呼吸困难和乏力等。影像学检查多数表现为单肺或双肺阴影,孤立或多发结节,并可累及气管或支气管。随访16例,时间3~38个月,3例患者行肺叶切除术(2例术后辅助化疗),7例行单纯化疗,5例未行任何治疗。13例生存,2例死亡,1例术后2年出现左侧腹股沟淋巴结转移。结论肺PNHL的临床和影像学无特异性改变,以黏膜相关淋巴组织结外边缘区淋巴瘤最常见,其他少见的高度侵袭性淋巴瘤也可发生。确诊需依赖病理检查,免疫组化及分子病理学检测有助于该类型淋巴瘤的诊断。     

基于FCM聚类算法的MRI脑组织图像分割方法比较研究

目的磁共振成像(magnetic resonance imaging,MRI)对脑组织有较好的成像效果,但噪声、偏移场和部分容积效应(partial volume effect,PVE)的存在,使得全自动分割MRI图像面临一定的困难。模糊C均值(fuzzy C-means,FCM)聚类算法在脑组织分割中得到较广泛研究。本文以存在噪声和偏移场影响的脑MRI图像分割为应用背景,研究了大量相关方法,探讨FCM算法分割脑部图像的改进思想。方法本文主要研究了9种FCM算法的理论基础,并通过脑组织分割实验对各种算法进行了分析。结果比较了不同算法的优劣,给出各类算法直观及定量评价结果。结论偏移场和噪声对脑磁共振图像组织分类质量有明显影响。其中几种方法可以减弱这些不利影响,但由于难以选择合适的参数,其分类效果并不理想。如何合理利用空间信息在未来仍有较大研究价值。     

采用不同方法检测幽门螺杆菌的感染情况

目的 探讨几种不同方法检测幽门螺杆菌感染的临床效果,分析幽门螺杆菌感染与性别、年龄及疾病的相关性.方法 选取2012年8月至2014年8月在我院消化科门诊就诊的806例患者,分别采用尿素呼气试验法,免疫胶体金法以及病理组织切片染色镜检进行检测,以尿素呼气试验法作为金标准,比较免疫胶体金法与病理组织切片染色镜检法检测Hp的阳性预期值、阴性预期值、敏感度、特异性并比较不同性别、不同年龄及不同疾病Hp的感染率.结果 Hp检出率为37.5％,其中男性感染率为37.3％,女性为37.7％,差异无统计学意义(P＞0.05);随着年龄增长Hp感染率有升高趋势,差异有统计学意义(P＜0.05);确诊为慢性胃炎、消化性溃疡、胃息肉、胃癌的Hp感染率分别为48.6％、50.2％、21.6％、13.8％,慢性胃病的发生与幽门螺杆菌感染有一定的关联.免疫胶体金法以及病理组织切片染色镜检的敏感度分别为83.77％、93.05％,特异性分别为75.20％、83.53％,阳性预期值分别为66.93％、77.20％,阴性预期值为分别为88.55％、95.25％.结论 胶体金法适用于大批量的流行病学调查,病理组织切片染色镜检敏感性高,可作为Hp感染筛查的方法之一.Hp感染率与年龄、疾病种类相关,与性别无关,为幽门螺杆菌感染的流行病学资料提供依据.