Hybrid Renal Cell Carcinomas Containing Histopathologic Features of Chromophobe Renal Cell Carcinomas and Oncocytomas Have Excellent Oncologic Outcomes

Background

Modern histopathology is able to differentiate chromophobe renal cell carcinomas (cRCCs), oncocytomas, and chromophobe–oncocytic hybrid RCCs; however, the true frequency and clinical courses of these tumors remain unclear.

Objective

To determine the clinical course of hybrid RCC.

Design, setting, and participants

Ninety-one surgically treated tumors, originally classified as oncocytoma or cRCC, were slide reviewed and reclassified by an experienced uropathologist. Immunohistochemical cytokeratin-7 (CK7) staining was used to distinguish oncocytoma (CK7 positive in <10% of the cells) and hybrid RCCs (CK7 positive in >10% of the cells).

Interventions

Radical tumor nephrectomy or nephron-sparing surgery.

Measurements

Recurrence-free and tumor-specific survival.

Results and limitations

Overall, 16 tumors (17.6%) were hybrid RCCs, 32 tumors were cRCCs, and 43 tumors were pure oncocytomas. Perinephric tissue invasion (pT3a) was found in one pure oncocytoma and in two hybrid RCCs. The pathologic stage for cRCC was pT1 in 50% of tumors (n = 17), pT2 in 23.5% of tumors (n = 8), and pT3a in 26.5% of tumors (n = 9). Low-grade RCC was found in 76.5% of tumors (n = 26), and vascular invasion was found in 11.8% of tumors (n = 4). After a mean follow-up of 50 mo, no oncocytomas or hybrid RCCs were found, but two cRCCs had recurred. The 3-yr tumor-specific survival rates for patients with oncocytoma, hybrid RCCs, and cRCC were 100%, 100%, and 97%, respectively.

Conclusions

Hybrid RCCs are more common than expected. The survival rate is 100% for both hybrid RCCs and oncocytomas. Hybrid RCCs may be candidates for active surveillance, and surgery may be unnecessary. CRCCs should be treated because a small proportion of these tumors exhibit aggressive clinical courses.     

如何建立一个杂交手术室

Due to increasing life expectancy, the number of patients presenting with any form of degenerative aortic valve and aortic disease which should be treated （surgically）, growths constantly. In the past elderly people having an age related spectrum of comorbidity had a high risk to be excluded from surgical treatment of aortic diseases. Considering the individual risks in those cases,     

杂合抗菌药物等的研发新进展

本文对杂合药物概念的来源和分类,正在临床试验的抗菌杂合药物,具有潜在的多种药物用途的杂合分子和微生物产生的杂合分子的类别和产物进行了综述.     

高能聚焦电流场对u14宫颈癌荷瘤小鼠的治疗实验研究

目的观察高能聚焦电流场对u14小鼠宫颈癌杀伤作用以及对荷瘤小鼠生存转归状况的影响。方法取64只雌性ICR小鼠,制备u14宫颈癌皮下移植瘤模型。对治疗前后组织进行形态学观察、肿瘤体积变化曲线及小鼠体重变化分析,同时对照观察两组生存期和肿瘤转归状况,探讨高能聚焦电流场治疗肿瘤的有效性和安全性。结果组织学、术后肿瘤体积变化曲线及手术前后小鼠体重变化证实:高能聚焦电流场可直接杀死肿瘤细胞;组织形态学观察发现,肿瘤细胞变性坏死等征象,随时间推移坏死愈加明显。两组荷瘤小鼠术后31 d肿瘤转归状况:治疗组完全应答(CR)占69.56%。对照组全部为进展性疾病,死亡率为39.13%,两组差异有统计学意义(P<0.05)。生存期分析表明两组差异有高度统计学意义(P<0.01)。结论高能聚焦电流场对u14小鼠宫颈癌细胞具有杀灭作用,可延长荷瘤小鼠的生存期。     

组合式外固定器在复杂四肢骨折治疗中的应用

目的探讨分析组合式外固定器在复杂四肢骨折治疗中的临床疗效。方法回顾性分析2010年1月～2012年1月在笔者所在医院接受治疗的94例骨折患者,所有患者采用组合式外固定器手术治疗,观察患者手术后的临床效果及并发症情况。结果对患者进行随访3～20个月,骨折部位愈合情况良好,达到100%。结论临床使用组合式外固定器手术治疗复杂四肢骨折,创伤小,安全可靠,治愈率高,并发症少,值得临床推广。     

主动脉弓部病变杂交手术后并发症的原因分析及处理

目的 对主动脉弓部病变杂交手术后常见并发症的发生原因进行分析.方法 对2001年1月至2008年12月接受杂交手术的34例主动脉弓部病变患者的资料进行回顾性分析.其中男性28例,女性6例,年龄34～75岁,平均年龄56.7岁.主动脉央层27例,其中A型21例,B型6例;主动脉弓部真性动脉瘤7例.杂交手术包括升主动脉-无名动脉-左颈总动脉Y形旁路3例,升主动脉-左颈总动脉-左锁骨下动脉Y形旁路2例,升主动脉-左颈总动脉旁路连同冠状动脉旁路移植1例,左颈总动脉-右颈总动脉旁路13例,右颈总动脉-左颈总动脉及左颈总动脉-左锁骨下动脉旁路3例,左锁骨下动脉-左颈总动脉-右颈总动脉Y形旁路2例,左颈总动脉-左锁骨下动脉旁路9例.一期行腔内修复26例,分期行腔内修复8例.结果 总的并发症发生率为32.4%(11/34),其中致死性并发症发生率11.8%(4/34).并发症包括主动脉央层破裂1例,脑卒中2例,吻合口漏并假件动脉瘤2例,心肌梗死1例,肺栓塞1例,颈部血肿1例,内漏3例.除4例围手术期死亡外,其余病例随访6～50个月,平均28.6个月,均健康生存.结论 肤主动脉弓部病变杂交手术后的并发症较一般腔内修复术更为多见,降低致死性并发症的发生率是该手术获得进一步推广的关键.     

Fabrication of a Novel Hybrid Heart Valve Leaflet for Tissue Engineering: An In Vitro Study

The objective of this study was to fabricate biomatrix/polymer hybrid heart valve leaflet scaffolds using an electrospinning technique and seeded by mesenchymal stem cells. Mesenchymal stem cells were obtained from rats. Porcine aortic heart valve leaflets were decellularized, coated with basic fibroblast growth factor/chitosan/poly-4-hydroxybutyrate using an electrospinning technique, reseeded, and cultured over a time period of 14 days. Controls were reseeded and cultured over an equivalent time period. Specimens were examined biochemically, histologically, and mechanically. Recellularization of the hybrid heart valve leaflet scaffolds was significantly improved compared to controls. Biochemical and mechanical analysis revealed a significant increase of cell mass, 4-hydroxyproline, collagen, and strength in the hybrid heart valve leaflets compared to controls. This is the first attempt in tissue-engineered heart valves to fabricate hybrid heart valve leaflets using mesenchymal stem cells combined with a slow release technique and an electrospinning technique.     

高危型人类乳头瘤病毒的检测在宫颈癌筛查中的应用

目的探讨高危型人类乳头瘤病毒（HPV）检测在宫颈癌筛查中的应用价值。方法收集328例门诊就诊患者的资料,同时做宫颈组织活检及杂交捕获二代实验检测高危型HPV,以宫颈组织活检结果为标准,分析高危型HPV的检测结果。结果宫颈组织活检结果分别为宫颈炎、CINⅠ、CINⅡ、CINⅢ及浸润癌的高危型HPV感染率分别为20．9％、57．6％、90．6％、96．5％和100％;CINⅡ级以上病变患者高危型HPV平均感染率为94．3％,与宫颈炎感染率20．9％相比,差异有统计学意义。结论CIN病变程度越严重,高危型HPV感染率越高;高危型HPV感染在宫颈癌早期病变的筛查中具有风险提示作用。     

杂交手术治疗累及弓部的Stanford B型主动脉夹层的疗效分析

目的:探讨杂交手术在治疗累及弓部的Stanford B型主动脉夹层（TBAD）中的有效性和安全性。方法:前瞻性描述性研究。纳入2020年1月—2021年9月蚌埠医学院第一附属医院血管外科确诊为累及弓部的TBAD患者。其中男16例,女5例;年龄32~81（59.7±12.9）岁。患者均采用外科转流术和胸主动脉腔内修复术相...     

Ilizarov methodology for infected non union of the Tibia: Classic circular transfixion wire assembly vs. hybrid assembly

Introduction:

Conventional wire fixation of Ilizarov rings often fails to provide 90-90 configuration because of vital structures, which is essential for optimum stability. Hybrid assembly with half pins is an alternative. The aim of this study is to compare the results of Hybrid assembly with that of conventional classic circular transfixion wire Ilizarov assembly in 50 cases of infected nonunion of tibia between 1994 and 2003.

Materials and Methods:

This study includes two groups with 25 patients in each group: Group (A) conventional Ilizarov assembly and Group (B) hybrid Ilizarov assembly. Thirty-five cases developed infected nonunion following road traffic accidents while others after fall (6) bullet injury (4), infected osteosynthesis (3) and assault (2). There were 45 males and five females with mean age (18 to 56 years). All active cases (n=28) were treated by debridement including removal of implants in infected osteosynthesis. Twenty out of 22 cases in the quiescent group (non draining for last three consecutive months) were treated without open debridement; only two cases required open debridement for various reasons. All the cases were finally treated as atrophic aseptic nonunion with bone defect and were classified according to ASAMI.Type B1: length of the limb maintained with bone gap (14 cases in both Group A and B) and Type B3: combined shortening with defect (five and seven cases in Group A and B respectively), were treated by bifocal osteosynthesis. Only one case in the B3 group was treated by trifocal osteosynthesis to shorten the time. Type B2: segments in contact with limb shortening (total nine cases; five and four cases in Group A and B respectively) with shortening up to 2 cm (total five cases) were treated with monofocal osteosynthesis while shortening up to 5 cm and beyond (total four cases) were treated with bifocal osteosynthesis.

Results:

The cases were followed up for two to six years and the results were evaluated by Paley criteria of bony results (union, infection, deformity and leg-length discrepancy) and Functional Results (significant limp, equinus rigidity of the ankle, soft-tissue dystrophy, pain and inactivity). In both the groups, 24 cases out of 25, had excellent to good bony result with Group B having twice more excellent result than Group A. Functional results were found to be similar in both the groups. Although persistence of infection and Grade III pin tract infection (PTI) were slightly higher in Group B, complications like delayed consolidation of regenerate, refracture, deformity and aneurysm of vessel were less in this group.

Discussion and Conclusion:

Ilizarov methodology produced a satisfactory result in infected nonunion of the tibia. Hybrid assembly was a fruitful advancement in the Ilizarov armamentarium. The results were comparable to Conventional assembly in terms of docking site problems, corticotomy site problems, PTIs and other problems.