青年胰腺恶性肿瘤33例临床病理分析

目的 探讨青年胰腺恶性肿瘤（pancreatic malignant tumor,PMT）的临床病理表现,以提高其诊治水平.方法 回顾33例青年PMT的临床病理资料,结合文献综合分析.结果 33例PMT中,实性假乳头状瘤10例,导管腺癌8例,内分泌肿瘤7例,黏液性囊腺癌4例,导管内乳头状黏液癌3例,淋巴瘤1例;TNM分期：Ⅰ期13例,Ⅱ期6例,Ⅲ期6例,Ⅳ期8例.临床表现以腹痛、腹胀、腹部包块、食欲减退等为主,4例内分泌肿瘤出现血糖增高等内分泌症状,10例出现皮肤黄染.手术治疗26例,其中根治性手术21例.随访9～ 33个月,14例死亡,17例存活,2例失访.结论 青年胰腺恶性肿瘤早期多无特殊症状,且预后不良,应重视对青年胰腺恶性肿瘤的早期诊治.     

鼻咽癌颈淋巴结转移1例误诊分析

<正> 1 病例资料 男,36岁,咽干,低热,进行性消瘦,颈部无痛性肿块半年,他院诊断“颈淋巴结结核病”,抗痨治疗4月余,因无明显疗效,来我院就诊。查体,体温37.4℃,呼吸117/min,心率88/min,血压125/80mmHg,慢性消耗性病容,中度消瘦,右侧颈部有约0.3～3.0cm大小,不规则成串之肿物,质硬;X线见:左肺上叶有约0.5cm大小之钙化灶(入院提示,     

丙泊酚干预脊髓损伤模型脊髓水肿及后肢电生理的变化

BACKGROUND: A large number of studies have verified that propofol could effectively reduce secondary nerve injury by improving microenvironment of spinal cord injury. OBJECTIVE: To study the effects of propofol on spinal cord edema and electrophysiology of the hind limb in rats with spinal cord injury. METHODS: Rat models of acute spinal cord injury were established by using the modified Allen method. A total of 40 rat models were randomly divided into spinal cord injury group and propofol group (n=20). Rats in the propofol group were injected with propofol through the caudal vein. The spinal cords of an additional 20 rats were exposed in the sham surgery group. Motor function was evaluated using BBB score and inclined plate test before modeling, 1, 3 days, 1-4 weeks after modeling. Neuronal apoptosis was detected after spinal cord injury using TUNEL assay at 72 hours after modeling. AQP4/9, matrix metalloproteinases 9/2 mRNA and protein expressions were measured using RT-PCR and western blot assay. At 4 weeks after modeling, pathological changes of the spinal cord were observed using immunohistochemistry and hematoxylin-eosin staining. Neurophysiological recovery was analyzed using motor evoked potentials and somatosensory evoked potentials. RESULTS AND CONCLUSION: (1) At 1-4 weeks after modeling, BBB score and inclined plate test score were higher in the propofol group than in the spinal cord injury group (P < 0.05), but lower than in the sham surgery group (P < 0.05). (2) The number of apoptotic cells was significantly more in the spinal cord injury group than in the propofol group (P < 0.05). No apoptotic cells were found in the sham surgery group. (3) At 72 hours after spinal cord injury, AQP4/9 and matrix metalloproteinases 9/2 mRNA and protein expression was higher in the propofol group than in the sham surgery group (P < 0.05). AQP4/9 and matrix metalloproteinases 9/2 mRNA and protein expression was significantly reduced in the propofol group (P < 0.05). (4) At 4 weeks after modeling, the spinal cord was loose, and the cavity was small. Partial neuronal necrosis could be seen. The degree of nerve fiber density in the propofol group was between the sham surgery group and spinal cord injury group. (5) Motor evoked potentials and somatosensory evoked potentials were obviously recovered, the latency was short, amplitude was increased in the propofol group, which showed significant differences as compared with the sham surgery group and the spinal cord injury group (P < 0.05). Results suggested that propofol can reduce apoptosis in rat neurons after spinal cord injury, reduce spinal cord edema-related gene expression, and improve electrophysiological function and limb motor function.       

丙泊酚联合骨髓间充质干细胞移植对脊髓损伤大鼠后肢功能及电生理的影响

背景：研究发现,骨髓间充质干细胞具有修复神经元的作用,但单纯骨髓间充质干细胞移植对神经系统损伤的修复作用仍不理想。 目的：探讨骨髓间充质干细胞移植联合丙泊酚对脊髓损伤大鼠后肢功能和电生理的影响。 方法：80只成年的Wistar大鼠,建立脊髓损伤模型,按照随机数字表法分为4组(n=20)：骨髓间充质干细胞组、对照组、联合组、丙泊酚组。建模后6 h通过1 mL注射器经尾静脉注入骨髓间充质干细胞悬液、细胞培养液、骨髓间充质干细胞悬液+丙泊酚注射液、丙泊酚注射液。分别于造模前、造模后1,3 d与1-4周通过BBB评分、改良Tarlov评分、斜板试验进行运动功能评定。造模后4周取材用荧光显微镜观测PKH-26标记的骨髓间充质干细胞存活及分布情况,病理切片进行苏木精-伊红染色。第4周进行辣根过氧化物酶示踪分析神经纤维的再生情况,运动诱发电位和体感诱发电位分析大鼠神经电生理恢复情况。 结果与结论：①大鼠下肢运动功能评价联合组优于骨髓间充质干细胞组及丙泊酚组,骨髓间充质干细胞组和丙泊酚组优于对照组。②丙泊酚组和骨髓间充质干细胞组损伤区可见少量神经轴索样的结构,该脊髓空洞比较小,联合组可见较多的神经轴索样结构,未见脊髓空洞。对照组可见脊髓组织缺失及脊髓空洞形成,无神经轴索通过。③辣根过氧化物酶阳性神经纤维数和PKH-26阳性细胞：对照组<丙泊酚组、骨髓间充质干细胞组<联合组,各组之间差异均有显著性意义(P < 0.05)。④运动诱发电位和体感诱发电位的潜伏期：对照组>丙泊酚组、骨髓间充质干细胞组>联合组,各组之间差异均有显著性意义(P < 0.05)。⑤运动诱发电位和体感诱发电位的波幅：对照组<丙泊酚组与骨髓间充质干细胞组<联合组,各组之间差异均有显著性意义(P < 0.05)。⑥结果表明丙泊酚、骨髓间充质干细胞均能促进脊髓损伤大鼠神经突触的再生,改善大鼠电生理功能及肢体运动功能,二者联用效果更好。 中国组织工程研究杂志出版内容重点：干细胞;骨髓干细胞;造血干细胞;脂肪干细胞;肿瘤干细胞;胚胎干细胞;脐带脐血干细胞;干细胞诱导;干细胞分化;组织工程     

FAP蛋白在卵巢癌组织中的表达及临床意义

目的 探讨成纤维细胞激活蛋白(fibroblast activationprotein,FAP)在卵巢癌组织中的表达及与微血管密度(microvessel density,MVD)的关系.方法 通过体外实验研究,用免疫组化法检测FAP在卵巢正常组织、卵巢交界性肿瘤和卵巢癌组织中的表达并分析FAP与卵巢癌的分化程度、侵袭程度的相关性.结果 FAP在卵巢癌间质成纤维细胞中有表达,而在卵巢癌细胞和正常卵巢组织及卵巢交界性肿瘤中未见表达,且FAP表达与卵巢癌的分化程度和侵袭程度有关.间质中的MVD与卵巢癌的分化程度有关,且随着FAP表达水平的增加、MVD表达阳性率则逐渐上升,差异有统计学意义(P＜0.05).结论 FAP的异常表达可能与卵巢癌(浆液性囊腺癌)的发生、发展有关,其可通过促进肿瘤微血管的生成,诱导癌组织产生反应性间质,加快肿瘤的演进.     

低度恶性潜能多房囊性肾肿瘤的MRI表现及临床分析

目的 探讨低度恶性潜能多房囊性肾肿瘤的MRI表现及临床特点.方法 回顾性分析5例经病理学证实的低度恶性潜能多房囊性肾肿瘤的MRI表现及临床资料.结果 5例均为单发,3例呈类圆形,2例呈分叶状.肿瘤边界均较清晰,最大直径约15 ～54 mm.MRI平扫囊壁及囊内分隔较薄而欠均匀,厚约1～3 mm,呈T1 WI等及稍高信号,T2WI为较低信号;囊液T2WI均为高信号,T1WI 4例为不均匀较低信号,1例低信号中见絮状稍高信号.DWI显示,2例囊壁及囊内分隔见点、条状较高信号,3例为等信号.动态增强囊壁及囊内分隔2例皮质期见较明显强化点、条状影,实质期及排泄期强化减弱;其余3例不均匀中等强化弱于肾皮质,实质期及排泄期均明显延迟强化.5例均未见邻近侵犯及转移.临床3例出现腰部隐痛及镜下血尿,2例无明显症状.5例术后随访18 ～36个月,均未见复发及转移.结论 低度恶性潜能多房囊性肾肿瘤恶性程度低,手术治疗效果好.MRI对其诊断具有较大价值.     

胆囊转移性肿瘤2例诊治分析并文献复习

正胆囊肿瘤以原发性腺癌最常见~([1]),而转移性肿瘤罕见,国内外文献均以个案报道居多~([2-4])。笔者对2例资料完整的胆囊转移性肿瘤(原发肿瘤分别为结肠癌及肾透明细胞癌)进行回顾性分析,并复习有关文献,以提高对该类疾病的认识。1病例病例1:男,51岁,因反复右上腹隐痛不适伴恶心、食欲减退3个月余于2014年11月10日就诊。2011年6月因"降结肠癌"行根治手术,本次发病后按"胆囊炎"药物治疗2个