肝未分化（胚胎性）肉瘤的临床病理分析

目的：探讨肝未分化（胚胎性）肉瘤的临床病理特征及其鉴别诊断。方法：对2例肝未分化（胚胎性）肉瘤标本通过光镜、电镜及免疫组织化学等方法进行病理组织学观察。结果：组织学特征为：肿瘤与正常肝组织之间隔以纤维性假包膜;肿瘤细胞大小不等,形态多样,呈星芒状和（或）梭形,细胞界限不清,有明显的黏液样背景;在肿瘤外周可见卷入的胆管样结构;瘤细胞内外可见一些PAS阳性的嗜酸性球形小体;有明显的出血、坏死及囊性变、免疫组化及超微结构没有明显的形态学分化特征。结论：肝未分化（胚胎性）肉瘤的组织发生仍然不清楚,免疫组化和电镜研究支持是间叶起源,但没有一定的分化模式,是一种罕见的肝原发肿瘤,根据其组织学和病理形态学特征,结合腹部包块、CT等临床表现,可以作为明确的病理诊断。     

去分化脂肪肉瘤11例临床病理分析

目的探讨去分化脂肪肉瘤(dedifferentiated liposarcoma,DDLPS)的临床病理学特征。方法采用HE染色和免疫组化法对11例DDLPS进行临床病理分析并复习相关文献。结果 11例DDLPS均由非典型脂肪瘤样肿瘤/高分化脂肪肉瘤(atypical lipomatous tumor/well-differentiated liposarcoma,ALT/WDLPS)和非脂肪源性肉瘤的去分化成分构成,其中2例伴脂肪源性肉瘤的去分化成分,形态分别类似于多形性脂肪肉瘤(pleomorphic liposarcoma,PLPS)和黏液样脂肪肉瘤(myxoid liposarcoma,MLPS)。ALT/WDLPS可出现三种亚型形态。去分化成分形态多样。2例因鉴别诊断需要联合应用MDM2、CDK4、p16免疫组化标记,出现特征性阳性。结论 DDLPS由分化性和去分化成分构成,病理形态范围广,当去分化成分占优或出现脂肪源性去分化成分时易误诊,必要时需联合MDM2、CDK4和p16免疫组化标记以鉴别多形性未分化肉瘤、PLPS等。     

未分化子宫内膜肉瘤6例临床病理观察

目的 探讨未分化子宫内膜肉瘤(undifferentiated endometrial sarcoma,UES)的临床病理特点、诊断及鉴别诊断.方法 对6例未分化子宫内膜肉瘤的临床资料、组织学形态及免疫组化结果进行观察分析.结果 患者年龄49～71岁,平均年龄59岁,临床主要表现为宫腔内占位和阴道出血;肿瘤大体呈息肉样,突入宫腔;镜下见肿瘤组织分化差,细胞异型明显,核分裂象丰富(＞10个/10 HPF),坏死常见;免疫组化标记,肿瘤细胞CD10、ER、PR、desmin、SMA、CK、EMA阴性,vimentin、EGFR阳性;6例随访6个月～4年,3例死于肺转移.结论 未分化子宫内膜肉瘤是一种少见的子宫内膜间质肿瘤,具有高度恶性.肿瘤组织分化差,细胞异型明显,常见坏死,免疫组化标记有助于诊断与鉴别.     

伴肉瘤分化的甲状旁腺癌1例临床病理学分析

目的探讨伴肉瘤分化的甲状旁腺癌的临床病理特点、病理诊断及预后。方法对1例伴肉瘤分化的甲状旁腺癌进行HE和免疫组化染色,并复习相关文献。结果患者女性,62岁,肿块位于左侧颈部,大小3.5 cm×3.5 cm×2.5cm。肿瘤由巢状透明的细胞组成,间隔带为伴肉瘤分化的异型梭形细胞。免疫表型:透明细胞显示Cg A阳性,间隔带梭形细胞vimentin阳性,Ki-67增殖指数为80%。结论伴肉瘤分化的甲状旁腺癌是甲状旁腺原发肿瘤的罕见类型,明确诊断需结合组织病理学形态及免疫表型,伴肉瘤分化是甲状旁腺癌预后差的因素之一。     

腹膜后脂肪肉瘤相关多原发恶性肿瘤4例临床病理分析

目的探讨腹膜后脂肪肉瘤相关多原发恶性肿瘤(multiple primary malignant neoplasms, MPMN)的临床病理学特征。方法收集2015年1月～2018年11月北京大学国际医院收治的4例腹膜后脂肪肉瘤相关MPMN的临床病理资料,包括临床表现、组织学形态、诊断、治疗及预后,并复习相关文献。结果腹膜后脂肪肉瘤相关MPMN占同期收治的腹膜后脂肪肉瘤的1.3%(4/301)。4例患者均为男性,发病年龄54～77岁,平均62岁。均为双原发恶性肿瘤,其组合方式分别为腹膜后高分化脂肪肉瘤和肾透明细胞性肾细胞癌、腹膜后去分化脂肪肉瘤和肾透明细胞性肾细胞癌、腹膜后高分化脂肪肉瘤和直肠中分化管状腺癌、腹膜后去分化脂肪肉瘤和乙状结肠中分化管状腺癌。首发肿瘤与次发肿瘤的平均间隔时间为5.5个月(0～12个月)。免疫表型:4例脂肪肉瘤细胞S-100、p16、CDK4和MDM2均阳性,均可见MDM2基因扩增。2例透明细胞性肾细胞癌CD10阳性;1例直肠中分化管状腺癌和1例乙状结肠中分化管状腺癌均呈CDX2、Villin阳性。肿瘤均行手术切除,2例高分化脂肪肉瘤复发,其中1例复发为去分化脂肪肉瘤。结论腹膜后脂肪肉瘤相关MPMN极其罕见,其另一肿瘤易发生于肾脏,常见的组织形态是透明细胞性肾细胞癌。腹膜后脂肪肉瘤相关MPMN应与腹膜后脂肪肉瘤的复发相鉴别。     

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。     

恶性小圆细胞肿瘤免疫组织化学及病理组织学分析

本文分析57例恶性小凶细胞肿瘤(MSRCT)免疫组化表型及病理形态。结果表明:兔抗鸡结蛋白及(或)兔抗人肌红蛋白可作为横纹肌肉瘤的标志;神经母细胞瘤、嗅神经母细胞瘤及原始外周神经外胚层瘤的免疫组化特征为NSE阳性,而Vim阴性;抗NSE抗血清特异性差,其他MSRCT亦可与之反应。尤文肉瘤Vim阳性,有些病例NSE阳性。未分化滑膜肉瘤Vim阳性;部分病例Ker及(或)EMA阳性,可有假阴性。LCA是恶性淋巴瘤特异性标记。α_1-ACT对MSRCT鉴别诊断无价值。     

乳腺血管肉瘤8例临床病理分析

目的探讨乳腺血管肉瘤的临床病理特征、诊断及鉴别诊断。方法依据WHO(2012)乳腺肿瘤组织学分类标准,回顾性分析8例乳腺血管肉瘤的临床病理特征,并复习相关文献。结果 8例乳腺血管肉瘤中6例为原发性血管肉瘤(primary breast angiosarcoma,PBA),均以乳腺无痛性肿物为首发症状;2例为继发性血管肉瘤(secondary breast angiosarcoma,SBA),其中1例为乳腺癌根治术并放疗后胸壁和皮肤血管肉瘤,另1例为乳腺癌根治术并放疗后继发淋巴水肿的上肢和胸壁皮肤血管肉瘤。组织学分级:Ⅰ级2例,Ⅱ级3例,Ⅲ级3例。肿瘤不同区域分化程度不同,可呈多样性改变。免疫表型:8例肿瘤细胞表达CD31和CD34,7例表达FⅧRAg,6例表达Fli-1,均不表达CKpan、ER和PR。FISH检测2例SBA MYC基因见异常扩增,免疫组化标记cmyc核强阳性;3例PBA MYC基因未见异常扩增,免疫组化标记c-myc阴性。结论乳腺血管肉瘤罕见,临床症状缺乏特异性,组织学可有多样性改变,应充分取材,在与形态相似的乳腺肿瘤鉴别时血管内皮相关抗原呈阳性有助于血管肉瘤的诊断。     

卵巢原发性未分化肉瘤1例及文献复习

目的 探讨卵巢原发性未分化肉瘤(undifferentiated o-varian sarcoma,UOS)的病理组织学特征、诊断及鉴别诊断.方法 应用光镜观察和免疫组化标记,对1例卵巢原发性UOS进行观察,同时复习相关文献.结果 本例原发性UOS的瘤细胞,与发生在子宫内的间质肉瘤(endometrial stromalsarcoma,ESS)形态极为相似,属未分化型;经多部位取材未见子宫内膜的原发病灶,支持卵巢原发.结论 ESS是常发生于子宫的恶性病变,卵巢原发很少见,须与卵巢性索间质肿瘤,如成人型颗粒细胞瘤、转移性卵巢子宫内膜样问质肉瘤、卵巢肉瘤、卵巢苗勒管癌肉瘤等疾病相鉴别.     

间叶性软骨肉瘤6例临床病理分析

目的 探讨间叶性软骨肉瘤(mesenchymal chondrosarcoma,MC)的临床特点、病理特征、诊断及鉴别诊断.方法 采用HE及免疫组化EnVision两步法对6例MC进行观察,并复习相关文献.结果 6例MC分别位于股骨、骶骨、肱骨、锁骨、颈部和腹股沟.临床表现主要是疼痛和肿胀.影像学表现与普通软骨肉瘤无明显差别.组织学显示肿瘤由原始未分化小细胞和分化较成熟的透明软骨小岛构成,即双相图像.免疫组化显示未分化小细胞CD99呈不同程度的膜阳性,vimentin也有阳性表达,软骨区S-100蛋白可有阳性表达.结论 MC是一种少见的高度恶性肿瘤,其诊断要点是在未分化的小细胞区找到分化较成熟的软骨组织,结合临床资料、免疫组化等特点进行诊断.     

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