Intracranial synovial sarcoma: A clinical,radiological and pathological study of 16 cases

IntroductionSynovial sarcoma (SS) is a tumor of unknown origin and is extremely rare in the central nervous system. Most studies on intracranial SS included only one or two cases. To better understand the disease, we review a series of primary intracranial SS.Method and materials16 primary intracranial SS in Tiantan Hospital during 2008–2017 were included. The clinical characteristics, including radiological and histological examination, operative records, and prognoses were reviewed.ResultThe case series included nine male and seven female patients with an average age of 23.8 years. Radiological results showed that the supratentorial region (81.25%) was the most common site of the brain involved. All patients were misdiagnosed as non-SS tumors. Gross total resection (GTR) was achieved in 12 cases (75.0%), and subtotal resection (STR) was achieved in 4 cases. All cases showed the characteristic SYT-SSX fusion gene, as detected by RT-PCR. The mean progression-free survival time (PFS) was 10.0 months and the mean overall survival time (OS) was 15.5 months. Multivariate analysis revealed that GTR and postoperative adjuvant radiotherapy were independent factors for PFS (HR = 6.143, 95% CI = 1.491–25.312; P = 0.012, HR = 6.143, 95% CI = 1.491–25.312; P = 0.012 respectively) and OS (HR = 9.000, 95% CI = 1.627–49.773; P = 0.012, HR = 0.017, 95% CI = 0.001–0.213; P = 0.002 respectively).ConclusionIntracranial SS were more frequently observed in the supratentorial region and in young patients without sex predilection. We recommend adjuvant radiation regardless of the extent of resection. More patients and longer follow-up periods were needed to further elucidate the biological features of intracranial SS.     

五岁以下重症肺炎患儿预后的危险因素

目的 探讨五岁以下重症肺炎患儿的临床治疗及影响预后的危险因素，为临床小儿重症肺炎的防治、诊治及预后提供理论依据。方法 收集2016年10月～2018年10月徐州医科大学第二附属医院住院部115例重症肺炎患儿的临床资料，回顾性分析所有患儿的临床资料、并发症及相关治疗，并采用Logistic回归分析其预后的危险因素。 结果 115例重症肺炎患儿中，呼吸性酸中毒42例（36.52%）；低钠血症38例（33.04%）和低钙血症37例（32.17%）；呼吸合胞病毒33例（28.69%）；肺炎克雷伯杆菌11例（9.57%）；胸部X线检查示斑片状阴影105例（91.30%），经治疗无效或加重者，80例行胸部CT检查示肺节段性不张44例（55.00%）。106例患儿出现并发症，其中47.17%患儿出现一种并发症，5283%患儿出现两种及以上并发症，所有患儿均使用抗生素治疗。使用与未使用机械通气患儿的预后比较，差异有统计学意义(P＜0.05)。经单因素分析，入院前病程、转入重症监护室、有基础疾病、有并发症、贫血、电解质酸碱平衡紊乱、低白蛋白的患儿治疗有效率显著降低（P＜0.05）。经多因素Logistic回归分析，入院前病程、转入重症监护室、有基础疾病、有并发症、贫血、电解质酸碱平衡紊乱、低白蛋白均为影响重症肺炎患儿预后的独立危险因素（P＜0.05）。结论 重症肺炎患儿的病情复杂多样，入院前病程、转入重症监护室、基础疾病、并发症、贫血、电解质酸碱平衡紊乱、白蛋白均为影响重症肺炎患儿预后的独立危险因素，应积极治疗，有效给予对症干预，以改善患儿预后，降低患儿病死率。     

胃镜检查在下咽癌共病食管癌中的重要性评价及其临床特点分析

背景与目的：食管癌是常见的消化道恶性肿瘤，而当作为头颈部鳞癌中最常见的下咽癌与食管癌共病存在时预后很差，因此早期诊断对该病生存率的提高至关重要。探讨胃镜检查在下咽癌共病食管癌早期诊断中的重要性及其临床特点。方法：在2013年2月—2019年9月广西医科大学附属肿瘤医院收治的226例下咽癌患者中，回顾性分析40例进行了胃镜检查患者的临床资料及确诊为下咽癌共病食管癌患者的临床特点，比较分析进行或未进行胃镜检查下咽癌患者的生存率。结果：226例下咽癌患者中，有40例（17.7%）进行了胃镜检查，其中检出下咽癌共病食管癌36例（90.0%），其中同时性癌29例（80.6%），异时性癌7例（19.4%）。36例下咽癌共病食管癌患者中位年龄56.5（47.3~62.5）岁，男性32例（88.9%），有吸烟史25例（69.4%），有饮酒史24例（66.7%），下咽癌生长的主体部位在梨状窝区的23例（63.9%），呈结节样肿块型25例（69.4%），食管癌呈隆起型病变31例（86.1%），非隆起型病变5例，其中3例为食管鳞癌，2例为原位癌。156例未进行胃镜检查及32例进行胃镜检查的下咽癌患者生存曲线比较差异无统计学意义（P＞0.05）。186例未进行胃镜检查及40例进行胃镜检查的下咽癌患者下咽癌病理学分化程度比较差异无统计学意义（P＞0.05）。结论：胃镜检查在下咽癌共病食管癌的早期诊断中具有重要意义，建议对下咽癌患者常规开展胃镜检查并作为定期随访项目；中年、男性、吸烟、饮酒是下咽癌共病食管癌患者的重要临床特点。     

贵阳市1 000例患者25-羟维生素D缺乏及临床特征

摘要:目的 研究某医院骨科保守治疗患者25-(OH)-VitD水平及临床特征。方法 回顾性分析2016年1月-2021年6月在贵州省骨科医院接受保守治疗患者的血清 25-(OH)-VitD的结果，分析25-(OH)-VitD与正常值下限之间的差异情况,分析该类患者25-(OH)-VitD的分布特点与临床特征。结果 本地区研究对象25-(OH)-VitD均值为(18.354±6.294) ng/mL,与正常下限30 ng/mL的差值为–11.646（95 % CI：–12.037~11.255）。单样本t检验结果提示，研究对象的25-(OH)-VitD均值与25-(OH)-VitD理想下限的差异有统计学意义（t= –58.507,P=0.000）。不同性别25-(OH)-VitD水平存在显著性差异(P=0.000<0.01)。体质量指数与25-(OH)-VitD存在正相关。女性、低体质量指数、高龄是25-(OH)-VitD缺乏的危险因素。研究人群的碱性磷酸酶与25-(OH)-VitD水平存在负相关。结论 贵阳地区经骨科保守治疗颈肩腰腿痛住院的患者25-(OH)-VitD存在普遍性不足。女性、低体质量指数、高龄是25-(OH)-VitD缺乏的危险因素。研究对象的碱性磷酸酶与25-(OH)-VitD水平存在负相关     

肺泡蛋白沉积症15例临床分析

目的 分析肺泡蛋白沉积症（PAP）的临床表现、辅助检查、诊断方法及治疗效果，以提高临床医生对该疾病的认识。方法 回顾性分析2005～2019 年15 例PAP 住院患者的临床资料（包括年龄、性别、职业暴露、临床症状及体征、辅助检查、治疗方法等）。结果 患者临床表现主要为咳嗽、呼吸困难、胸闷，肺功能提示弥散功能下降，影像学检查主要表现为双肺间质性改变，典型特征为“铺路石征”“地图征”改变。确诊主要依靠肺活检或肺泡灌洗液病理明确。9 例患者进行全肺灌洗术治疗，1 例患者接受雾化吸入治疗。治疗后临床症状均有缓解。结论PAP 是一种少见的间质性肺病，由于其缺乏特异性的临床表现，在诊断PAP 时常常出现误诊漏诊。熟悉掌握PAP的临床表现及影像学特征，可以减少PAP 的误诊漏诊，更好地服务临床。     

Cortical encoding of speech acoustics: Effects of noise and amplification

Objective: To investigate speech stimuli and background-noise-dependent changes in cortical auditory-evoked potentials (CAEPs) in unaided and aided conditions, and determine amplification effects on CAEPs. Design: CAEPs to naturally produced syllables in quiet and in multi-talker babble were recorded, with and without a hearing aid in the right ear. At least 300 artifact-free trials for each participant were required to measure latencies and amplitudes of CAEPs. Acoustic characteristics of the hearing-aid-transduced stimuli were measured using in-the-canal probe microphone measurements to determine unaided versus aided SNR and to compare stimulus acoustic characteristics to CAEP findings. Study sample: Ten participants with normal hearing, aged 19 to 35 years. Results: CAEP latencies and amplitudes showed significant effects of speech contrast, background noise, and amplification. N1 and P2 components varied differently across conditions. In general, cortical processing in noise was influenced by SNR and the spectrum of the speech stimuli. Hearing-aid-induced spectral and temporal changes to the speech stimuli affected P1-N1-P2 components. Amplification produced complex effects on latencies and amplitudes across speech stimuli and CAEP components, and for quiet versus noise conditions. Conclusion: CAEP components reflect spectral and temporal characteristics of speech stimuli and acoustic changes induced by background noise and amplification.     

左、右半结肠癌骨转移病理特征及预后分析

目的:比较左半结肠癌（LSCC）和右半结肠癌（RSCC）骨转移的病理特征和临床预后差异。方法:对漯河市中心医院2007年1月至2015年12月收治的103例结肠癌骨转移病例资料进行回顾性分析，据解剖位置将64例纳入LSCC组，39例纳入RSCC组，对比分析其病理学特征,绘制并分析生存曲线,筛选预后因素。结果:RSCC骨转移相对LSCC表现为:CA199 阳性率高、年龄大、分化程度更差、分期更晚、预后更差。单因素分析结果示原发肿瘤位置、TNM分期、LDH水平、ALP水平是影响结肠癌骨转移3年生存的相关因素。Logistic多因素回归分析显示原发肿瘤位置、TNM分期、ALP水平是结肠癌骨转移的独立危险因素。结论:左、右半结肠癌在病理特点、临床表现、生物学行为、生存预后等方面存在差异，本文为区分左、右半结肠癌骨转移的不同病理特征及预后评价提供了依据。     

Go-Ichi-Ni-San 2: A potential biomarker and therapeutic target in human cancers

Cancer incidence and mortality are increasing globally, leading to its rising status as a leading cause of death. The Go-Ichi-Ni-San (GINS) complex plays a crucial role in DNA replication and the cell cycle. The GINS complex consists of four subunits encoded by the GINS1, GINS2, GINS3, and GINS4 genes. Recent findings have shown that GINS2 expression is upregulated in many diseases, particularly tumors. For example, increased GINS2 expression has been found in cervical cancer, gastric adenocarcinoma, glioma, non-small cell lung cancer, and pancreatic cancer. It correlates with the clinicopathological characteristics of the tumors. In addition, high GINS2 expression plays a pro-carcinogenic role in tumor development by promoting tumor cell proliferation and migration, inhibiting tumor cell apoptosis, and blocking the cell cycle. This review describes the upregulation of GINS2 expression in most human tumors and the pathway of GINS2 in tumor development. GINS2 may serve as a new marker for tumor diagnosis and a new biological target for therapy.     

左右半结肠癌病理特征及治疗新策略研究进展

结肠癌患者预后较差，全身系统治疗为目前常用基本策略。近年来的相关研究证据表明，发生在左半结肠和右半结肠的肿瘤病理学特征、分子发病机制及预后存在差异。目前对左、右半结肠癌之间存在的这种异质性差异尚无明确的区分对待策略，国内外指南也尚无定论，因而研究其临床病理特征及相关预后差异具有重要临床意义。笔者在复习相关文献的基础上，就此作一综述。     

36例乳房外Paget病临床特点分析

 目的:对乳房外Paget病进行回顾性研究，为临床诊治提供帮助。方法：对2013年1月至2018年12月我院确诊的36例乳房外Paget病患者的临床资料进行回顾性分析。结果：36例患者男女比例为3 ∶1；平均发病年龄(65.72±10.41)岁；病程6个月至10年，中位病程4年；皮损多为单发，阴囊常见；主要表现为红斑、糜烂；既往误诊率60.61%；免疫组化以CK7、CEA、EMA阳性表达为主；不伴有转移者30例，伴有转移者6例；30例行局部扩大切除术+术中冰冻治疗，其中27例扩切范围明确，扩大切除范围以1.0 cm、2.0 cm为主，扩切2.0 cm的一次切净率为90.91%。术后有2例复发。结论：该病男性好发，老年多见，皮损多为单发，误诊率高，免疫组化有提示原发或继发意义，病情进展缓慢但仍可发生转移，治疗以局部扩大切除术+术中冰冻为主，建议扩切范围在2.0 cm及以上。该病术后仍有较高复发率。