微载体6复合脂肪干细胞移植在肛瘘治疗中的应用

目的 探讨微载体6复合脂肪干细胞(Microcarrier 6-ADSC)治疗肛瘘的疗效,为肛瘘微创化治疗探索新途径.方法 采用日本大耳兔建立兔肛瘘模型,造模成功后随机分成4组:Microcarrier 6-ADSC复合组、ADSC治疗组、手术组和对照组,每组6只,病理HE染色观察不同治疗方法的效果.结果 Microcarrier 6-ADSC复合组和ADSC治疗组的瘘管组织中有散布的横纹肌细胞和上皮组织,少量淋巴细胞聚集在微载体6周围,在ADSC治疗组中可见到脂肪细胞聚集;对照组可见肉芽组织和淋巴细胞浸润并可见大量坏死组织.与手术组相比,Microcarrier 6-ADSC复合组和ADSC治疗组的治愈时间明显缩短(P<0.05);结论 Microcarrier 6有利于AD-SC的多向分化,可为ADSC的生存提供良好环境,促进瘘管的愈合.     

Wound,pressure ulcer and burn guidelines – 4: Guidelines for the management of connective tissue disease/vasculitis-associated skin ulcers

The Japanese Dermatological Association prepared guidelines focused on the treatment of skin ulcers associated with connective tissue disease/vasculitis practical in clinical settings of dermatological care. Skin ulcers associated with connective tissue diseases or vasculitis occur on the background of a wide variety of diseases including, typically, systemic sclerosis but also systemic lupus erythematosus (SLE), dermatomyositis, rheumatoid arthritis (RA), various vasculitides and antiphospholipid antibody syndrome (APS). Therefore, in preparing the present guidelines, we considered diagnostic/therapeutic approaches appropriate for each of these disorders to be necessary and developed algorithms and clinical questions for systemic sclerosis, SLE, dermatomyositis, RA, vasculitis and APS.     

宁波市北仑区2013-2014年儿童哮喘流行病学调查

目的调查宁波市北仑区0~14岁儿童哮喘发病率、发病规律及危险因素,为制定防治措施提供参考。方法2013年1月-2014年1月,采用整群抽样法抽取北仑区19所学校0~14岁儿童为调查对象进行问卷调查,对筛查出的疑似哮喘儿童进行确诊,并对其人口学特征进行分析,采用logistic回归方程分析危险因素。结果调查收回有效问卷23 781份,共检出哮喘患儿534例,发病率为2.25%,男女发病率比例为1.92:1。其中发病较轻患儿占44.01%,中度占31.46%,重度占24.53%。发病时间以换季、冬季为主,分别占35.96%、32.02%。多因素logistic回归分析显示,呼吸道感染、药物过敏史、家族过敏史和食物过敏史是儿童哮喘发病的危险因素(P<0.05)。结论北仑区儿童哮喘发病率较高,具有性别和季节发病差异,应加大对患病危险因素的宣传,规范标准化治疗方案,减少儿童哮喘疾病的发生。     

老年住院患者反三碘甲腺原氨酸水平与病情及预后的相关性研究

目的分析老年住院患者反三碘甲腺原氨酸(reverse triiodothyronine,rT_2)水平与病情及预后的相关性,为老年住院患者预后的早期评估提供参考指标。方法选取本院2012年5月至2015年5月收治的304例老年住院患者为研究对象,分别检测患者血清甲状腺激素、清蛋白、胆固醇水平,并按照rT_3水平进行分组,比较不同rT_3水平,不同清蛋白、胆固醇水平患者一般资料、死亡率、病情、血清学指标差异,分析rT_3水平与患者病情及预后的相关性。结果304例老年住院患者中,甲状腺功能异常137例(45.07%)。rT_3水平升高87例(28.62%),其余217例(7I.38&%名)患者rT_3水平正常。rT_3水平升高组与rT_3水平正常组患者年龄、性别比例比较差异均无显著性(P>0.05),rT_3水平升高组患者死亡率、急性重症疾病构成比均显著高于rT_3水平正常组,血清清蛋白、胆固醇、游离三碘甲腺原氨酸(FT_3)水平均显著低于rT_3水平正常组(P<0.05)。随着rT_3水平升高程度的增加,患者死亡率显著上升(P<0.05),Pearson相关分析示,rT_3水平与患者死亡率变化呈显著正相关(r=0.719,P<0.05)。低清蛋白、胆固醇水平患者游离甲状腺素(FT_4)、FT_3水平均显著低于高清蛋白、胆固醇水平患者,rT_3水平显著高于高清蛋白、胆固醇水平患者(P<0.05):不同清蛋白、胆固醇表达水平患者血清促甲状腺激素(TSH)水平比较差异具有显著性(P>0.05)。结论血清rT_3水平升高提示老年住院患者营养状态差、病情危重、死亡率较高,应加强对老年住院患者rT_3水平的定期监测,为制订治疗方案与评估预后提供参考。     

A study of PD‐L1 expression in intravascular large B cell lymphoma: correlation with clinical and pathological features

Intravascular large B cell lymphoma (IVLBCL) is a rare, aggressive, extranodal large B cell lymphoma characterised by growth of tumour cells within the lumen of vessels, particularly capillaries. Programmed cell death ligand 1 (PD‐L1) is a cell surface glycoprotein that interacts with programmed death 1 (PD‐1) on the T cell surface, leading to modulation of the immune response. PD‐L1 is a targetable immune check‐point molecule that is expressed on neoplastic cells in various cancers, including a subset of lymphomas. We correlated the expression of PD‐L1 with clinical and pathological findings in this rare disease. Eleven cases of IVLBCL were identified in the archives of Laboratory of Pathology at the National Cancer Institute, NIH. A panel of immunostains (CD20, CD3, CD5, PD‐L1) was performed. The cases were classified as the classic form or the variant associated with haemophagocytic syndrome (HPS) based on published 2017 WHO criteria. Three cases (27.3%) were HPS variant and eight cases (72.7%) were the classic form. Five (45.5%) of 11 cases were CD5‐positive; two of three (66%) were HPS variants and three of eight (37.5%) were classic form. Overall, four of nine evaluable cases (44.4%) were positive for PD‐L1, three of which were classic. Only one CD5‐positive case was PD‐L1‐positive, a classic variant. In summary, a subset of IVLBCL express PD‐L1. Although limited, these data suggest that PD‐L1 is expressed in both the so‐called classic form as well as the HPS variant. PD‐L1 is expressed irrespective of CD5 expression. Finally, detection of PD‐L1 expression in a subset of IVLBCL lymphoma cases may identify patients who might benefit from targeted immunotherapy.     

含微乳头结构肺腺癌CT重建征象特征及上皮间质转化相关基因表达

目的 探讨含微乳头结构（MPP）肺腺癌具有的CT重建征象特征,上皮间质转化（EMT）相关分子表达情况以及它们之间的关系。 方法 选取含MPP侵袭性肺腺癌（IAC）37例、不含MPP 80例及其对应的癌旁组织,比较临床病理特征、CT重建征象;应用Real-time PCR及Western blotting检测EMT有关标识分子表达变化情况。 结果 含MPP组淋巴结转移比例较高、毛刺、胸膜凹陷征、实性及分叶比例较高（均P<0.001）。 含MPP组E-钙黏蛋白（cadherin）及β-连环蛋白（β-catenin）表达均下调（P<0.05）,N-cadherins、波形蛋白（vimentin）、Snail及转化生长因子（TGF）-β表达均上调（P<0.05）。有毛刺组E cadherin及β-catenin表达下调者所占比例较高,而vimentin表达上调者所占比例较高（均P<0.05）;实性结节组E-cadherin表达下调者所占比例较高,而N-cadherin及vimentin表达上调者所占比例较高（均P<0.05）。 结论 含MPP浸润性肺腺癌具有特征性CT重建征象,发生了EMT改变。其CT重建征象与EMT相关分子表达存在联系。