Bench to bedside: recent advances in lung cancer pathological research with implications for diagnostic clinical practice

After decades of relative stagnation lung cancer is emerging as a disease type where rapid progress is being made in diagnosis and therapy, as well as in our understanding of disease biology. Much of this progress is of immediate impact to diagnosticians, and more is likely to affect diagnostic practice in the near future. In this review we seek to briefly summarize several key areas of active research of immediate or probable imminent value to trainee and consultant pulmonary pathologists alike. We cover some major changes in tumour classification, grading, and patient stratification, as well as considering the state of the art in machine-assisted interpretation of lung cancer histology, and the use of genetically modified lung cancer models.     

知母种子质量分级标准的研究

目的:研究制定知母种子的质量分级标准。方法:通过对不同产地20个批次知母种子的净度、千粒质量、含水量、生活力、发芽率等指标测定和外观形态观察,利用Excel 2010、SPSS 20.0软件对以上数据进行相关分析、主成分以及K-均值聚类分析,初步确定知母种子质量分级指标和分级标准,且以各等级知母种子分别在田间对比种植,通过测定1年产苗量,2年药材产量及有效成分含量,验证知母种子质量分级标准的合理性。结果:Ⅰ级知母种子发芽率不低于85%,千粒质量不低于7.5 g,净度不低于95%;Ⅱ级知母种子发芽率不低于70%,千粒质量不低于7.0 g,净度不低于85%;Ⅲ级知母种子发芽率不低于65%,千粒质量不低于6.0 g,净度不低于80%;各级种子含水量均小于10%。结论:发芽率和千粒质量为知母种子质量分级标准的主要指标,净度和含水量为参考指标。不同等级知母种子种植后对知母种苗产量、药材产量及质量会有显著影响。该研究制定的知母种子质量分级标准科学可行、符合生产实际,为知母的种子质量评价和规范化栽培提供参考依据。     

Pathological variables determining the prognosis of non-Hodgkin''s lymphomas

The aim of the study was to assess the role of pathological grade, cell proliferation, ploidy, immunophenotype and site in determining the prognosis of non-Hodgkin's lymphomas. Of particular interest was the relative value of grades derived from the Kiel classification as opposed to the National Cancer Institute (NCI) working formulation. The study consisted of 181 cases, treated in a relatively uniform way over an 18-month period spanning 1986. Using life table analysis, both NCI working formulation grade and Kiel grade correlated strongly with survival. However, the differences between grades were entirely due to an excess of early deaths in the high-grade and intermediate-grade categories. In patients surviving greater than 0.1 years (37 days), phenotype, site, ploidy and cell proliferation had no effect on survival. There was no evidence that intermediate-grade tumours, when subdivided into Kiel low- and high-grade types, differed in survival from tumours graded as low- or high-grade by both methods. However, NCI working, formulation high-grade tumours, especially those with a high proliferation rate, formed a group with a very high likelihood of death within 0.1 years.     

颈前路Interfix与Syncage-C的临床应用比较

目的比较两种颈椎椎间融合器前路减压融合术后椎体颈前柱高度、生理曲度及融合时间。方法采用Interfix及Syncage-C两种颈椎椎间融合器行颈椎病及颈椎间盘突出症前路减压后椎体间融合141例,其中Interfix38例,Syncage-C103例。术后摄X线片,观察手术节段的稳定性、颈前柱高度、生理曲度,以及融合时间。结果随访6~12个月,手术节段稳定,两种椎间融合器骨融合时间无显著性差异;术后颈前柱高度,除单节段外,多节段Interfix与Syncage-C有显著性差异。结论Syncage-C在术后颈前柱高度恢复及恢复生理曲度等方面均优于Interfix。     

Grading static versus dynamic images of contact lens complications

Background: This study was conducted to investigate grading performance when estimating the severity of static versus dynamic images of contact lens‐related ocular pathology. Methods: Thirty‐eight subjects used the Efron Grading Scales for Contact Lens Complications to grade the severity of ocular pathological changes depicted in static and dynamic (movie clip) computer‐displayed images of each of the following contact lens complications: bulbar conjunctival redness, limbal redness, papillary conjunctivitis, corneal staining, corneal infiltrates and meibomian gland dysfunction. The viewing of static and dynamic images was separated by seven weeks. Results: Grades assigned to dynamic images were 0.6 and 0.7 grading scale units higher than those assigned to static images for limbal redness and papillary conjunctivitis, respectively (p < 0.0001 for both). No difference was observed for the other four complications. There was an apparent trend for grading variability to be reduced (that is, observers grading in closer agreement) when grading dynamic versus static images. Conclusions: Absolute grades based on an assessment of signs of pathology represented in static images may, in some instances, underestimate the true severity of the condition.     

图像分析DNA含量对判断膀胱移行细胞癌分级和预后的意义

采用IBAS图像分析系统检测37例膀胱移行细胞癌病人的肿瘤细胞DNA含量，其中35例随访18个月至7年（平均5l个月），结果显示DNA含量和AN出现率增加与肿瘤的恶性程度有关（P＜0.01和P＜0.05）；肿瘤复发亦与非整倍体细胞（AN）出现率密切相关，AN出现率小于10％无复发，＜30％5例复发，＞30％9例复发。研究资料表明，图像分析技术测定细胞核的DNA含量对判断膀胱移行细胞癌病人的分级和预后有重要意义。     

计算机体层成像多平面重建在评价椎间融合中的作用

目的 探讨计算机体层成像多平面重建(CTMPR)在评价椎间融合中的作用,寻找定量评价椎间融合的新方法.方法 13例行腰椎间融合的患者术后1周、3个月、6个月行CTMPR,行椎间融合器(Cage)内植骨CT值定量测量.结果 术后1周Cage内植骨CT值为(619.52±26.97)Hu,术后3个月为(628.69±42.60)Hu,术后6个月为(657.77±37.43)Hu.术后1周与术后3个月相比无显著性差异,与术后6个月相比有显著性差异.结论 CT值的测量在椎间融合的判断中具有高准确性.     

近年火车创伤中关节损伤变化的特点

目的 探讨与分析快速列车所致火车创伤中关节损伤的变化特点。方法 集1997～2000年火车提速后10214例火车创伤中1279例关节损伤病例，分析在特定条件下的致伤因素、损伤严重程度、损伤类型特点，经AIS-ISS评分证实与预后的关系。结果 提速后关节损伤发生率由提速前33.54％上升到34.12％，死亡率由28.88％上升到30.33％，多关节离断伤由19.84％上升到34.13％，开放性关节损伤由31.71％上升到63.65％，关节离断伤的死亡率由21.19％上升到49.07％。结论 火车创伤无疑是十分严重的损伤，多发伤率远高于其他损伤，治疗棘手，多器官功能不全综合征(MODS)是致死的主要因素。     

羟基磷灰石/多聚左旋乳酸椎间融合器的力学评价

目的:评价羟基磷灰石和多聚左旋乳酸(hydroxyapatite/poly-L-lacticacid,HA/PLLA)制成的可吸收性腰椎椎间融合器(cage)的力学特性。方法:形状相同的HA/PLLAcage和Brantigan碳纤维cage及与cage外径相同的人尸体髂骨块各16枚,在材料实验机MTS上分别将3种椎体间置入体行压缩破坏(n=8)和压缩疲劳(n=8)试验,记录置入体压缩破坏时的最大压力、弹性系数以及1万次压力负荷后的高度变形率,并加以比较。结果:在瞬间破坏压力和弹性系数方面,HA/PLLAcage和碳纤维cage均显著高于髂骨块(P<0.05),但两种cage间差异无显著性(P>0.05)。1万次压力负荷后,两种cage的高度压缩率均显著小于髂骨块(P<0.05),且HA/PLLAcage的平均压缩率显著小于碳纤维cage(P<0.05)。结论:HA/PLLAcage和碳纤维cage较髂骨块具有更强的力学稳定性;与碳纤维cage相比,HA/PLLAcage不仅具有同等的瞬间抗破坏强度,而且具有更强的抗重复负荷变形的能力。     

记忆合金网球与单纯减压植骨治疗股骨头坏死的对照研究

目的对比研究记忆合金网球植入与单纯减压植骨两种方法治疗成人股骨头缺血性坏死的疗效.方法成人股骨头缺血性坏死(FicatⅡ～Ⅲ期)45例,分别采用记忆合金网球植入和单纯减压植骨+股方肌骨瓣移植治疗,网球组23例26髋,减压植骨组22例26髋,分别观察两组病例的手术时间,术中出血量,术后髋关节的功能评分.结果网球组和减压植骨组的手术时间和出血量,分别为62.4±20.5 min、50.8±16.6 min(P＜0.05)和180.6±38.5 ml、169.9±45.8 ml(P＞0.05),术后所有病例经平均32个月随访,采用百分评分法评价,网球组的优良率为88.4%,减压植骨组的优良率为53.8%(P＜0.05).结论记忆合金网球植入能增加股骨头的机械支撑力,重建股骨头血运,延长股骨头的使用年限.