Progress in studies on pathological changes and future treatment strategies of obesity-associated female stress urinary incontinence: a narrative review

With the increasing prevalence of obesity worldwide, obesity-related female stress urinary incontinence (FSUI) has become a key health problem. Recent studies indicated that FSUI is primarily caused by obesity-related pathological changes, such as fat droplet deposition, and results in pelvic floor nerve, vascular, and urethral striated muscle injury. Meanwhile, treatments for obesity-associated FSUI (OA-FSUI) have garnered much attention. Although existing OA-FSUI management strategies, including weight loss, pelvic floor muscle exercise, and urethral sling operation, could play a role in symptomatic relief; they cannot reverse the pathological changes in OA-FSUI. The continued exploration of safe and reliable treatments has led to regenerative therapy becoming a particularly promising area of researches. Specifically, micro-energy, such as low-intensity pulsed ultrasound (LIPUS), low-intensity extracorporeal shock wave therapy (Li-ESWT), and pulsed electromagnetic field (PEMF), have been shown to restore the underlying pathological changes of OA-FSUI, which might be related by regulation endogenous stem cells (ESCs) to restore urine control function ultimately in animal experiments. Therefore, ESCs may be a target for repairing pathological changes of OA-FSUI. The aim of this review was to summarize the OA-FSUI-related pathogenesis, current treatments, and to discuss potential therapeutic options. In particular, this review is focused on the effects and related mechanisms of micro-energy therapy for OA-FSUI to provide a reference for future basically and clinical researches.     

肾透明细胞癌的CT诊断

目的通过分析肾透明细胞癌患者的CT表现,提高对肾透明细胞癌的认识和CT诊断的正确性。方法结合既往相关文献,回顾性分析手术前行CT检查,后经手术病理证实的1例肾透明细胞癌患者的CT表现及病理特征、临床特点。结果肾透明细胞癌患者大多为大于40岁的成年男性,伴有血尿、腰痛、腹部占位的“三联征”表现中的一项或几项,肾透明细胞癌患者的CT表现大多数为实性肿块,伴有出血、坏死、囊变、钙化,增强表现可进一步提高该病的诊断,增强呈富血供“快进快出”的特点。结论肾透明细胞癌的CT表现有一定的特征性,CT对此病有一定的诊断价值。     

The various pathological manifestations of a lightning strike exemplified in a single four-fatality incident – A case report and review of a literature

The lightning strike is one of leading cases of weather-related death worldwide. We present an unusual case of four fatality-lightning strike with various pathological manifestations. All victims died from a single lightning strike in the mountains that also caused injury to 156 other people. All victims had mechanical damage and rock damage that are typical for lightning strikes in the mountainside. Another lesions indicative of lightning strike and electrical damage were, among others: burnt and torn clothes (all cases) current marks (Cases 1, 2 and 3) and Lichtenberg figures along with flashover marks on Case 1. In the review we described the pathophysiological mechanisms of lightning-induced lesions and injuries and epidemiological trends of lightning-strike deaths. Our study exemplifies various manifestations of lightning strikes on forensic examination and underlines the necessity to take lightning strike into consideration when investigating open-air deaths of unclear origin.     

重症肺炎与肺梗死

肺梗死是儿童重症肺炎的少见并发症，多累及下叶近胸膜处，常常继发于肺血栓栓塞，诊断依靠于胸部增强CT检查。关于儿童重症肺炎并发肺梗死的研究较少，相关病因学、流行病学、临床特点等数据缺乏。基于成人的研究提示肺梗死与肺血栓栓塞的临床表现、治疗及预后类似。儿科医师应提高对本病的认识，通过真实世界研究方法发掘客观规律，积累儿科诊治经验。     

The effect of ethanol or long-time reaction on the diatom test in water samples using sodium hypochlorite

BackgroundThe diatom test method using sodium hypochlorite (NaClO) was equivalent to the conventional method in water samples. However, the method using NaClO was inferior to the conventional method in lung samples, in which ethanol was used and the reaction with NaClO was longer compared with the method in water samples. Using water samples, we aimed to clarify whether these differences affect the diatom test result.Materials and methodsThirteen water samples from natural water sources were each divided into four parts corresponding to four (2 × 2) digestion methods: 3 “digestion” vs. 1 “digestion” and with ethanol vs. without ethanol. After the base-2 logarithmic transformation, the diatom counts were analyzed using three-way analysis of variance (ANOVA); factor 1 was “digestion times,” factor 2 was “ethanol,” and factor 3 was “sample number,” and the interaction between factors 1 and 2 was also analyzed.ResultsThe geometric means of the diatoms from the 3 “digestion” with ethanol method, the 3 “digestion” without ethanol method, the 1 “digestion” with ethanol method, and the 1 “digestion” without ethanol method were 373.5, 551.8, 436.6, and 522.0, respectively. ANOVA showed a significant difference in factor 2 (P = 1.7 × 10^-4). There was no significant difference in factor 1 (P = 0.46), and no significant interaction between factors 1 and 2 (P = 0.13).ConclusionEthanol may decrease the diatom count in the diatom test using NaClO. In contrast, the diatom frustules do not dissolve through three-times digestion using NaClO.     

265 例神经内分泌肿瘤的临床病理特征及预后分析

目的 探讨神经内分泌肿瘤（NETs）的发病特点、临床表现、诊断和治疗方法及预后。方法 回顾性分析 2006 年 1 月—2015 年 8 月天津市人民医院 265 例 NETs 患者的临床资料,包括性别、年龄、入院临床症状、原发部 位、病理诊断、治疗情况和预后随访情况。结果 265 例 NETs 患者中男 160 例,女 105 例,平均发病年龄（55.8±2.7） 岁,发病高峰 55~65 岁。发病部位主要位于结直肠 127 例（47.9%）,肺部 59 例（22.3%）,胃 21 例（7.8%）,阑尾 15 例 （5.7%）,小肠（特别是十二指肠及胰腺）10 例（3.8%）,乳腺 11 例（4.2%）,颈部 10 例（3.8%）,其他部位 12 例（4.5%）。 各个不同部位患者的就诊症状各不相同。结直肠患者主要是排便习惯改变,如腹泻、便秘、便血等。肺原发患者多 表现为咳嗽或痰中带血。胃、阑尾或小肠原发患者多表现为腹痛、腹胀等不适。病理诊断 G1 期 186 例（70.2%）,G2 期 54 例（20.4%）,G3 期 25 例（9.4%）。免疫组化显示突触素（Syn）阳性 228 例（86.4%）,嗜铬粒蛋白 A（CgA）阳性 102 例（38.5%）,CD56 阳性 74 例（27.9%）。232 例患者进行了手术治疗（87.5%）,28 例患者接受了放疗或化疗治疗 （10.6%）,5 例患者未行治疗。198 例患者完成至少 1 次随访,随访率 74.7%,中位随访时间为 38 个月,G1 期随访患 者中无肿瘤相关性死亡;G2 期有 6 例肿瘤相关性死亡;G3 期中有 19 例肿瘤相关性死亡。所有肿瘤相关性死亡患者 中 23 例发生了转移。神经内分泌瘤（G1+G2）的生存率明显高于神经内分泌癌（G3）（Log rank χ2=13.774,P＜0.01）。 结论 NETs 患者男性多于女性,不同部位的患者发病临床表现各不相同,消化道特别是结直肠是高发部位;病理分 期越晚的患者预后越差。     

Oncocytic thyroid neoplasms: from histology to molecular biology

The recent update of the 4th edition of the World Health Organization's Classification of Tumors of Endocrine Organs introduced important changes in the nomenclature of follicular-cell thyroid tumors, namely, regarding mitochondrion-rich neoplasms (In this review, for the practical purposes, the words Hürthle and oncocytic are synonymous in the field of thyroid pathology.) According to the last edition, oncocytic thyroid neoplasms, with follicular architecture and no typical nuclei of papillary carcinoma, – are now included in a separate group - the Hürthle cell neoplasms. Whenever thus categorized-while keeping oncocytic variant of papillary, medullary and poorly differentiated carcinoma-, a sort of tidal phenomenon has occurred about oncocytic tumors known for decades. Through this categorization, pathologists and researchers need to progress in the discussion about etiopathogenesis of oncocytic neoplasms (ONs). This review provides an attempt to balance the facts and doubts by questioning the recent changes based on what is known about oncocytic tumors.     

Molecular genetic testing in the diagnosis of myeloid neoplasms

Recent advances in molecular technologies have led to an expanding catalogue of diagnostic, prognostic, and predictive biomarkers in myeloid neoplasms, contributing to the complexity of pathology classification. This article is intended as a guide to the molecular hematopathology of myeloid neoplasms for practicing pathologists and trainees. We review the relevance and limitations of common molecular technologies, and discuss the integration of molecular genetic biomarkers in the current (revised 4^th edition) WHO classification that was published in 2017. The topic of clonal hematopoiesis is also addressed.     

单细胞碱性凝胶电泳用于检测小鼠胸腺细胞DNA链断裂

目的 引进单细胞凝胶电泳(SCGE)实验方法,用以检测小鼠胸腺细胞DNA链断裂。方法 载有经紫外线和H2O2作用过的胸腺细胞和凝胶的玻片首先在pH10的弱碱性裂解液中作用1h,在电泳缓冲液中解旋30min,电泳30min,胸腺细胞核用20mg／L的EB染色5min,用荧光显微镜和显微细胞图像分析系统观察和分析H2O2和紫外线在体外条件下对正常胸腺细胞的DNA损伤作用。结果 紫外线和不同浓度H2O20．001、0．01、0．1、1．0mmoL／L均可导致小鼠胸腺细胞DNA损伤,且随着H2O2浓度的增加DNA损伤逐渐加重。结论 SCGE可用于检测小鼠胸腺细胞DNA链断裂,使用这一实验方法成功地检测出H2O2和紫外线引起的胸腺细胞DNA损伤。