骨上皮样血管内皮瘤4例及文献复习

目的探讨4例骨上皮样血管内皮瘤(epithelioid hemangioendothelioma,EHE)的临床病理特点、诊断和鉴别诊断。方法对4例原发于骨的EHE临床资料、组织学、免疫组化进行观察分析并随访,结合文献讨论。结果 4例骨EHE中男性和女性各2例,中位年龄24岁,发生部位包括右肩胛骨、腰4～5椎体、胫骨下段和左足。临床症状主要为疼痛,影像学资料提示溶骨性改变;镜下示上皮样的肿瘤细胞呈巢状、索状或小梁状排列,肿瘤细胞呈圆形、多边形间或梭形,常见明显的胞质内空泡并伴有周围间质的玻璃样或黏液样变性。免疫表型:瘤细胞CD31、CD34、α-SMA均阳性(100%),CKpan有1例阳性(25%),EMA均阴性(100%),肿瘤增殖标记Ki-67呈低表达。结论原发于骨的EHE是一种少见的低度恶性的血管源性肿瘤,它的诊断要结合临床和影像学资料,依据其病理学特征及相关的免疫组化特点综合判断,需与骨转移性癌、上皮样血管瘤、上皮样血管肉瘤(epithelioid angiosarcoma,EAS)等鉴别。     

Epithelioid hemangioendothelioma of bone: a study of 4 cases and review of literature

目的 探讨4例骨上皮样血管内皮瘤(epithelioid hemangioendothelioma,EHE)的临床病理特点、诊断和鉴别诊断.方法 对4例原发于骨的EHE临床资料、组织学、免疫组化进行观察分析并随访,结合文献讨论.结果 4例骨EHE中男性和女性各2例,中位年龄24岁,发生部位包括右肩胛骨、腰4～5椎体、胫骨下段和左足.临床症状主要为疼痛,影像学资料提示溶骨性改变;镜下示上皮样的肿瘤细胞呈巢状、索状或小梁状排列,肿瘤细胞呈圆形、多边形间或梭形,常见明显的胞质内空泡并伴有周围间质的玻璃样或黏液样变性.免疫表型:瘤细胞CD31、CD34、α-SMA均阳性(100%),CKpan有1例阳性(25%),EMA均阴性(100%),肿瘤增殖标记Ki-67呈低表达.结论 原发于骨的EHE是一种少见的低度恶性的血管源性肿瘤,它的诊断要结合临床和影像学资料,依据其病理学特征及相关的免疫组化特点综合判断,需与骨转移性癌、上皮样血管瘤、上皮样血管肉瘤(epithelioid angiosarcoma,EAS)等鉴别.     

原发性甲状腺上皮样血管肉瘤1例报告

目的:观察1例原发性甲状腺上皮样血管肉瘤患者的临床病理特征,并结合相关文献进行讨论。方法和结果:本例原发性甲状腺上皮样血管肉瘤患者行术中快速冰冻切片及常规石蜡切片,HE染色和网状纤维染色、并行免疫组化检查。镜下见,肿瘤主要由实性片状或巢状排列的上皮样细胞组成,肿瘤细胞核较大,呈空泡状,核仁明显,部分肿瘤细胞胞质内可见含有红细胞的空泡或小管腔形成;可见迷路状血管,网状纤维染色能清晰显示这些管腔结构。免疫组化染色,肿瘤细胞CD31、CD34、AE1/AE3阳性,TG、TTF-1、calcitonin、CK19、S-100、EMA和HMB45阴性,Ki-67高表达。结论:原发性甲状腺上皮样血管肉瘤是一种少见的恶性肿瘤,致死率高。确诊主要依靠组织学和免疫组化检查,临床要与未分化癌、低分化癌及上皮样血管内皮瘤等鉴别。     

肝原发性恶性血管肿瘤临床病理分析

目的探讨肝原发性恶性血管肿瘤的临床病理学特点、鉴别诊断及预后。方法采用HE和免疫组化EnV ision法对7例血管肉瘤和4例上皮样血管内皮瘤(epthelioid hem angioendotheliom a,EHE)进行免疫组化染色和形态学观察。结果患者年龄23~80岁,男性8例,女性3例。临床症状及实验室检查无特殊表现。6例肿瘤呈单结节,位于肝右叶;5例多结节者,其中4例累及肝左叶,肿瘤最大径为2~6.5 cm。7例血管肉瘤组织学表现多样,肿瘤细胞可呈梭形或上皮样细胞形态。4例EHE组织学特征:以纤维硬化区为中心,周边富于细胞,肿瘤细胞呈上皮样分化及特征性的胞质内血管腔形成。免疫组化染色至少表达CD31、CD34、FⅧRAg中的1项,其中4例3项指标均表达。1例EHE和5例血管肉瘤表达nestin。结论肝原发性恶性血管肿瘤极少见,结合组织学形态并联合应用多项血管内皮标记物可作出明确诊断。早期发现、局部手术切除和结合术后化疗有助于延长患者生存期。     

肝上皮样血管内皮瘤2例临床病理分析

目的 探讨肝上皮样血管内皮瘤(hepatic epithelioid haemangioendothelioma,HEH)的临床病理特点及诊断和鉴别诊断.方法 回顾分析2例HEH的临床病理和免疫组化特征.结果 2例均为女性,年龄分别为51、55岁.临床均表现为右上腹疼痛不适,均为单发,位于肝右叶,大小分别为5 cm×4 cm×3 cm、5 cm×4 cm×4 cm.例2伴肝门淋巴结转移.光镜下肿瘤细胞呈上皮样或梭形,伴胞质内管腔,腔内可见红细胞,间质黏液透明变,瘤细胞浸润周围肝组织,例1伴钙化,脉管腔内见乳头状生长瘤细胞,似瘤栓样结构;例2淋巴结转移瘤细胞异型明显,伴局灶坏死,除淋巴结转移瘤细胞仅CD31阳性外,2例瘤组织CD31、CD34、FⅧRAg因子均为阳性,其中例2表达部分上皮标记如CK8和LCK.结论 HEH少见,易误诊为转移癌.在遇到胞质内管腔含红细胞、间质黏液玻璃样变性时应考虑HEH.     

骨上皮样血管内皮瘤临床病理学观察

目的 探讨骨上皮样血管内皮瘤的临床病理特征和诊断。方法 对3例骨上皮样血管内皮瘤进行临床资料分析、光镜观察和免疫组织化学检测，并结合文献进行讨论。结果 3例病变部位均为下肢。最常见的临床症状是局部疼痛。X线表现为溶骨性骨破坏，1例伴有病理性骨折。组织形态学特征是上皮样瘤细胞形成较原始的小血管腔，呈巢状、索状、不规则形分布于有黏液样变或透明变性的间质中，肿瘤组织内或边缘散布成熟的骨小梁组织。3例肿瘤均表达vimentin、FⅧRAg和CD34。随访结果2例未见肿瘤复发，1例失访。结论 原发于骨的上皮样血管内皮瘤是较少见中间型血管源性肿瘤，其组织形态学要与骨上皮样血管瘤、上皮样血管肉瘤和转移性癌等鉴别。     

肺上皮样血管内皮瘤的临床病理观察

目的探讨肺上皮样血管内皮瘤(pulmonaryepithelioidhemangioendothelioma,PEH)的临床病理特征、诊断及鉴别诊断。方法对3例PEH进行光镜观察和免疫组化标记,并结合文献进行分析。结果镜下见肿瘤细胞具有上皮样或组织细胞样形态,瘤细胞为圆形或多角形,呈小巢状、索状甚至腺样结构或不规则状,分布于黏液间质中;间质可见少量黏液样变或玻璃样变;瘤细胞内含有原始血管腔,核分裂象、多形性及坏死少见。肿瘤细胞表达CD34、FⅧRAg、CD31等血管内皮细胞标记,部分病例同时表达CK和(或)Vim。结论PEH是一种低度恶性肿瘤,其病理形态具有一定的特征性,诊断时需要与肺转移癌、肺上皮样血管肉瘤、肺淋巴管肌瘤病鉴别。     

腮腺滤泡性树突状细胞肉瘤1例及文献复习

目的探讨滤泡性树突状细胞肉瘤的病理诊断及鉴别诊断。方法对1例腮腺滤泡性树突状细胞肉瘤进行HE切片、免疫组化等观察,并复习文献进行讨论。结果镜检肿瘤细胞呈梭形、卵圆形、多边形,胞质淡染,边界不清,核染色质颗粒状并见明显小核仁,可见散在核分裂象,呈片状、束状、编织状、旋涡状排列。较多淋巴细胞浸润及围绕血管形成袖套状结构。肿瘤细胞特异性地表达CD21、CD23、CD35、S-100蛋白、CD68、vim entin、EMA。结论滤泡性树突状细胞肉瘤是极少见的低中度恶性肿瘤,可出现多种组织结构,有一定的特征性,确诊需要免疫组化帮助。应与异位脑膜瘤、异位胸腺瘤、恶性纤维组织细胞瘤、淋巴上皮样癌及指突性树突状细胞肿瘤等相鉴别。     

骨原发性上皮样血管肉瘤2例报道并文献复习

目的提高对骨原发性上皮样血管肉瘤(epithelioid angiosarcoma,EA)的认识,避免误诊。方法对2例原发于骨的EA进行临床病理、组织学及免疫组化分析,并进行文献复习。结果 2例均为男性,为骨组织内的多灶性、溶骨性病变,组织学上肿瘤主要由实性片状排列的上皮样细胞组成,瘤细胞核大,空泡状,含有明显核仁,可见细胞内空泡和血管腔样结构形成。免疫组化标记显示瘤细胞表达CD31、FⅧRAg、CK、vimentin。分别进行单纯化疗和手术治疗。1例失访,1例2个月后死亡。结论骨原发性EA是一种具有上皮样特征的高度恶性血管源性肿瘤,必须与转移癌等鉴别,CD31、CK等血管标记物对鉴别诊断具有重要的意义。     

Epithelioid angiosarcoma of bone:a report of two cases and review of literatures

目的 提高对骨原发性上皮样血管肉瘤(epithelioid angiosarcoma,EA)的认识,避免误诊.方法 对2例原发于骨的EA进行临床病理、组织学及免疫组化分析,并进行文献复习.结果 2例均为男性,为骨组织内的多灶性、溶骨性病变,组织学上肿瘤主要由实性片状排列的上皮样细胞组成,瘤细胞核大,空泡状,含有明显核仁,可见细胞内空泡和血管腔样结构形成.免疫组化标记显示瘤细胞表达CD31、FⅧRAg、CK、vimentin.分别进行单纯化疗和手术治疗.1例失访,1例2个月后死亡.结论 骨原发性EA是一种具有上皮样特征的高度恶性血管源性肿瘤,必须与转移癌等鉴别,CD31、CK等血管标记物对鉴别诊断具有重要的意义.     

Level of functioning of siblings and parents of probands of varying degrees of retardation

A further analysis of already published data supports the position that retardates of low ability level less frequently have retarded siblings, retarded parents, and parents low in occupational level than do retardates higher in ability level. The analysis supports the position that there are two types of retarded individuals, persons retarded as a result of gene or chromosomal anomalies, brain injury, etc., who more frequently occur in the lower-level retardate group, and persons whose retardation represents polygenic segregation, who more frequently occur in the higher-level group.     

局部注射辛伐他汀对骨质疏松大鼠股骨髁骨小梁的改建效应

背景：局部注射具有成骨作用的辛伐他汀,可显著增加骨质疏松大鼠股骨颈及股骨髁部的骨密度及力学强度,分析局部注射辛伐他汀对股骨髁骨小梁的影响。 目的：进一步研究骨质疏松大鼠股骨内局部注射辛伐他汀对股骨髁骨小梁的影响。为将辛伐他汀应用于临床骨质疏松局部治疗提供实验基础。 方法：18只雌性SD大鼠双侧卵巢切除后3个月,制备大鼠骨质疏松模型。实验大鼠随机数字表法均分为3组,分别在实验大鼠的右侧股骨髓腔内单次注射辛伐他汀溶液5 mg、10 mg,对照组单纯注射空白载体。分别在注射后1个月处死大鼠并取材。Micro-CT扫描并定量分析骨组织形态变化。 结果与结论：给药后1个月,Micro-CT扫描结果显示,辛伐他汀治疗组的骨微结构参数如骨皮质厚度、骨小梁密度及连接率明显优于对照组。说明疏松骨骼单次注射小剂量辛伐他汀可显著促进股骨髁部骨小梁改建,改善骨骼微结构,可为强化局部、防治骨质疏松骨折的新选择进一步提供实验基础。     

石斛属民族药用植物的分类及生药学研究

中药石斛早在《神农本草经》中就被列为上品,其应用历史悠久,具有养阴生津、补肾益气、润喉护嗓、活血明目、抗癌防老等功效。本文对国内外石斛属民族药用植物的分类及生药学研究进行了综述。     

膝关节骨性关节炎的关节镜治疗体会

目的我科自2001～2005年4月对59例67膝的骨性关节炎（0A），进行关节镜检查及镜下清理术。方法镜检：膝关节骨性关节炎伴不同程度滑膜炎，滑膜皱壁粘连纤维片，关节软骨不同程度破坏。镜下清除增生滑膜，松解粘连，去除剥脱软骨、修复关节面。结果随访2月～4年，平均1.5年，术后综合评估2月～1年，优良率94％；1～2年，优良率79.2％；2年以上优良率54.8％。结论关节镜对膝关节骨性关节炎诊断能提供了比较全面的资料，并对骨性关节炎早期有良好疗效，具有创伤小、恢复快、并发症少和重复治疗等优点。     

Anatomical study of distribution of valves of the cutaneous veins of adult''s limbs

Since the cutaneous veins of the four limbs have been used as autogenous grafts in the treatment of cardiovascular disorders, knowledge of distribution of the valves is increasingly required depending upon the use. In the gross anatomical study of distribution of valves of the trunci venae, there has been argument about locational relationships between the venous roots and the valves in the vicinity of the roots and the inter-valvular distance. However, there have been only few reports discussing detailed information about valves of the cutaneous veins of the four limbs. The authors observed patterns of distribution of the cutaneous venous valves of the four limbs of cadavers prepared for practice in anatomy. The following parts were excised from each cadaver: the cephalic, basilic, and the great saphenous veins, which originate from the acral venous network and flow into the proximal deep veins, and the venous roots communicating with these veins. An incision was made on each excised vein in the direction of the long axis under observation with a stereoscopic microscope, and the inter-valvular distance and the distance between the valve and the orifice of venous root in the vicinity of the valve were measured. The inter-valvular distance varied with type of the truncus venae, and it varied according to area even in the same truncus venae.     

Pathways of the realization of immunomodulating effects of neurotransmitters

Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 115, N ^o 4, pp. 401–404, April, 1993     

Characterization of sterols of three digenetic trematodes of buffalo

Sterols of three digenetic trematodes were isolated and characterized by infrared and 1H nuclear magnetic resonance spectroscopies, and gas-liquid chromatography and gas chromatography-mass spectrometry. Sterols identified were cholesterol, cholestanol, 24-methylcholesterol, 24-methylcholestanol, 24-ethyl-22-dehydrocholesterol, 24-ethyl-22-dehydrocholestanol, 24-ethylcholesterol and 24-ethylcholestanol.     

Mechanisms of generation of slow components of bioelectric activity in diagnostics of functional state of the gastrointestinal tract

New electrophysiologic devices were used for the diagnostics of the state of excitable structures in the gastrointestinal tract and correction of their motor functions. Bioelectrical and biomechanical activities form the basis of functioning of internal organs. The mechanisms of generation of slow bioelectrical activity that are important for clinical and physiological studies are described. One of these mechanisms is a capacitance parametric transducer converting the energy of contractions into specific electric signals reflecting muscle functions. Another mechanism results from slow oscillations of resting potentials of interrelated excitable cells in large neuromuscular structures of internal organs. The elaborated procedure is efficient for preventing early postoperative paresis of the gastrointestinal tract. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 128, No. 10, pp. 448–452, October, 1999     

胃小弯侧血管弓的MDCT解剖

目的：研究正常胃小弯侧血管弓及其属支血管的多排螺旋CT表现。方法：回顾性分析51例正常成人的上腹部CT资料,观察胃小弯侧血管弓及其属支血管的显示情况、血管弓形态及其与胃壁的关系。结果：51例均显示胃小弯侧血管弓,血管弓贲门部属支、胃体部属支和幽门部属支分别显示46例、15例和10例;血管弓与胃壁紧邻41例。结论：MDCT检查可良好显示正常胃小弯侧血管弓及其属支血管。     

Assessment of the efficacy of treatment of hemangiomas

Assessment of the aftereffects of cryoexposure and ultrahigh-frequency cryoexposure on hemangioma tissue of various types, cavernous and squamous, showed a higher cryogenic effect in hemangiomatous tissue preexposed to ultrahigh-frequency waves. A quantitative criterion is proposed for assessing the efficacy of the studied methods of exposure. Translated fromByulleten' Eksperimental'noi Biologii i Meditsiny, Vol. 119, N ^o 6, pp. 669–672, June, 1995