32例小儿横纹肌肉瘤生肌因子的表达

目的探讨小儿横纹肌肉瘤中生肌因子(MyoD1、Myogenin)的表达及意义.方法应用免疫组化Envision法检测32例小儿横纹肌MyoD1、Myogenin、Des、Sr-A、MG标记物的表达.结果5种标记物在小儿RMS表达的阳性率依次为:Myogenin 90.6%、MyoD1 81.1%、Des 65.5%、Sr-A 50.0%、MG 46.8%. 结论Myogenin与MyoD1较Des、Sr-A、MG在诊断小儿RMS中灵敏度及特异性方面具有显著的优越性,有很高的诊断价值.Myo-genin特异性略高于MyoD1,是目前诊断小儿RMS的最佳免疫组化标记物.     

胚胎性和腺泡型横纹肌肉瘤中MyoD1、Myogenin蛋白的表达及其意义

目的：检测胚胎性和腺泡型横纹肌肉瘤中MyoD1、Myogenin蛋白的表达状况。方法：应用免疫组化方法检测MyoD1、Myogenin的表达。结果：在胚胎性和腺泡型横纹肌肉瘤中存在MyoD1、Myogenin蛋白的表达,并且两种蛋白的表达在横纹肌肉瘤中明显高于恶性淋巴瘤和尤文氏肉瘤,差异具有统计学意义（P〈0.05）;两种蛋白在RMS中的表达水平与组织学分级成正相关,组织学分级越高,MyoD1、Myogenin的阳性表达就越强,但不具有统计学意义（P〉0.05）。结论：MyoD1、Myogenin可以作为辅助鉴别RMS及其他小细胞恶性肿瘤的依据;检测RMS中MyoD1、Myogenin的表达情况对RMS恶性程度及预后的判断有一定的临床指导意义。     

MyoD1、Myogenin在儿童横纹肌肉瘤中的表达及其临床意义

目的:探讨MyoD1、Myogenin在儿童横纹肌肉瘤(Rhabdomyosarmma,RMS)及其他3种儿童小细胞恶性肿瘤中的表达情况及其临床意义.方法:选取胚胎型横纹肌肉瘤(Embryonal rhabdomyosarcoma,ERMS)11例,腺泡型横纹肌肉瘤(Alveolar rhab domyosarcoma,ARMS)5例,神经母细胞瘤、恶性淋巴瘤、尤文肉瘤各10例,行HE染色,并应用S-P免疫组织化学染色法检测MyoD1、Myogenin蛋白在这4种儿童小细胞恶性肿瘤中的表达水平.结果:MyoD1、Myogenin在RMS中阳性表达率分别为:75%,68.75%,在其他3种肿瘤中阳性表达率均为0%,MyoD1、Myogenin在RMS组中的表达与其他肿瘤组比较差异有统计学意义(P＜0.05),2种蛋白在ARMS中的阳性表达率明显高于ERMS(P＜0.05),其恶性程度越高,MyoD1和Myogenin阳性表达越强(P＜0.05).MyoD1、Myogenin在预后差组中的阳性表达率明显高于预后中组(P＜0.05).结论:MyoD1、Myogenin可以作为辅助鉴别RMS及其他小细胞恶性肿瘤的依据;MyoD1、Myogenin基因可以作为辅助诊断儿童RMS的综合指标,也可作为鉴儿童ERMS和ARMS有用的分子生物学标志;检测儿童RMS中MyoD1、Myogenin的表达情况对RMS恶性程度及预后的判断有一定的临床指导意义.     

41例横纹肌肉瘤临床病理特征分析

目的 分析横纹肌肉瘤(RMS)的临床、病理学特征,以提高临床对此病的认识及诊断水平。方法 回顾性分析2011年1月至2019年4月中国科学技术大学附属第一医院(安徽省立医院)确诊的41例RMS患者的临床资料,统计分析RMS的临床特征(年龄、性别、发病部位)、病理特征(组织形态、免疫组化表型)等。结果 41例患者中,男女发病比例1.16∶1,发病年龄2~79岁,年龄<40岁者25例(60.97%);发病部位:头颈部23例(56.09%)、四肢9例(21.95%);病理亚型:胚胎性横纹肌肉瘤(ERMS)、腺泡状横纹肌肉瘤(ARMS)、多形性横纹肌肉瘤、梭形细胞/硬化性横纹肌肉瘤及上皮样横纹肌肉瘤,其中以ARMS多见,有20例(48.78%),其次为ERMS,有10例(24.39%)。ARMS和ERMS的病理组织形态由原始间叶小圆细胞和横纹肌母细胞组成,ARMS易见腺泡样结构,ERMS肿瘤细胞围绕血管生长并易受挤压。RMS患者免疫组化共同表达结蛋白(Desmin)、肌调节蛋白(MyoD1)、肌浆蛋白(Myogenin)和神经细胞黏附分子(CD56),MyoD1在ERMS中强表达,而Myogenin在ARMS中阳性率表达更高,强度更强,CD56在RMS中敏感性较高。结论 RMS好发于儿童和中青年人群,发病部位常见于头颈部和四肢;RMS病理亚型以ARMS和ERMS最为常见,并共同表达肌源性标志物Desmin、MyoD1、Myogenin和CD56;MyoD1、Myogenin表达的差异和病理组织形态特征可帮助鉴别诊断ERMS和ARMS。     

梭形细胞/硬化性横纹肌肉瘤9例临床病理研究

目的：探讨2013版WHO新分类梭形细胞/硬化性横纹肌肉瘤的临床病理特征。方法：结合文献对福建医科大学附属第一医院病理科9例梭形细胞/硬化性横纹肌肉瘤临床、组织学形态及免疫组化结果进行分析。结果：梭形细胞/硬化性横纹肌肉瘤单独或混合存在,梭形细胞区呈漩涡状排列,免疫组化Desmin、MyoD1、Myogenin、CD56强表达,SMA、CD34、S-100弱表达;硬化区以玻璃样变的硬化基质为特点,可呈现小圆或梭形细胞形态,排列方式多样,核分裂数和KI-67阳性指数高于梭形细胞区。浅表部位梭形细胞横纹肌肉瘤预后最好,硬化性横纹肌肉瘤易复发或转移,核分裂计数及KI-67免疫组化对二者预后评估有帮助。结论：形态学梭形细胞/硬化性横纹肌肉瘤可混合存在,均表达横纹肌肉瘤特异性标记物,但硬化可能提示肿瘤侵袭性增强,预后不好。     

肾脏横纹肌肉瘤临床病理分析并文献复习

目的：探讨肾脏横纹肌肉瘤的临床病理学特点、诊断、鉴别诊断、治疗及其预后。方法：回顾性对1例肾脏横纹肌肉瘤患者的临床表现、影像学特点、病理学特点及免疫组化结果进行研究,并复习相关文献。结果：镜下肿瘤细胞由圆形、长梭形和多形性细胞组成,呈弥漫性巢状、条索状或腺泡状的排列,瘤细胞胞浆丰富,嗜酸性,部分可见横纹,瘤细胞异型性不明显,核分裂象少见。免疫表型：Vim（＋）、SMA（＋）、MyoD1（＋）、Myogenin（＋）、Des（＋）,病理诊断左肾脏横纹肌肉瘤。结论：肾脏横纹肌肉瘤是一种少见的肾脏恶性肿瘤,在病理学上主要应与发生于肾脏的横纹肌样瘤、神经母细胞瘤、外周原始神经外胚层瘤、尤文肉瘤、淋巴瘤等相鉴别。治疗上以手术切除为主,辅以放化疗及术后多靶点酪氨酸激酶抑制剂治疗。     

儿童泌尿生殖系统横纹肌肉瘤临床病理分析

目的探讨儿童泌尿生殖系统横纹肌肉瘤(RMS)的临床病理学特征、免疫表型、发病机制、影像学特点、诊断和鉴别诊断、治疗及预后。方法回顾昆明医科大学第二附属医院收治的3例儿童泌尿生殖系统RMS患者,分析其临床病理学特点、免疫表型并复习相关文献。结果 3例儿童泌尿生殖系统RMS均为男性,年龄3~14岁;发生部位:睾丸旁1例,膀胱2例;组织学:梭形细胞RMS 2例,葡萄簇状RMS 1例;免疫表型:3例RMS均不同程度的表达Desmin、MyoD1、Myoglobin,少部分表达Myogenin,Ki67指数为30%~60%均行手术切除,未进行放疗及化疗。结论儿童泌尿生殖系统RMS是一种少见软组织肿瘤,恶性程度高,预后差。     

Survivin和Ki-67在横纹肌肉瘤中的表达及意义

目的 :探讨横纹肌肉瘤 (RMS)中凋亡调控因子Survivin和Ki 6 7的表达及其意义。　方法 :采用免疫组化技术 (S P法 )和图像分析技术检测 4 3例横纹肌肉瘤及 10例正常横纹肌组织中Survivin和Ki 6 7表达水平 ,并结合病理特征进行分析。　结果 :Survivin在 86 % (37/ 4 3)的RMS中表达 ,且表达水平高于正常横纹肌组织 (P <0 .0 5 )。在胚胎性横纹肌肉瘤 (ERMS)和腺泡状横纹肌肉瘤 (ARMS)中Survivin的表达无显著差异 (P >0 .0 5 ) ,而在不同分化程度的RMS之间差异显著 (P <0 .0 5 )。在复发或转移的RMS中和无复发或转移的RMS中Survivin的表达差异显著 (P <0 .0 5 )。RMS的Ki 6 7指数 (2 1.4 % )显著高于正常横纹肌组织的Ki 6 7指数 (0 .1% ) ,ERMS和ARMS的Ki 6 7指数差异不显著 (P >0 .0 5 ) ,而在不同分化程度的RMS中 ,Ki 6 7指数差异显著 (P <0 .0 5 )。同样 ,Ki 6 7指数在复发或转移的RMS和无复发或转移的RMS之间的差异显著 (P <0 .0 5 )。　结论 :Survivin表达水平和Ki 6 7指数在RMS中增加 ,其与瘤细胞分化有关 ,可作为预后不良的指标     

图像分析仪对横纹肌肉瘤和非肌性肿瘤及其组织的肌红蛋白的免疫组化检测

由于横纹肌肉瘤(rhabdomyosarcoma,RMS)组织形态表现的多样性和不典型性,常使低分化RMS的诊断有一定困难。以肌红蛋白(Mb)为横纹肌源性肿瘤的特异性标志以来,用免疫组化染色检测瘤细胞内Mb就成为辅助诊断RMS的重要方法^[1].但这种检测基本上是定性的,缺乏精密的定量数据^[2].这是因为显微观察的传统方法不能适应高精度的要求,对阳性着色及其程度缺乏客观评定指标,更无法进行色值分析。本研究使用真彩色图像分析仪,利用像素色值定量检测肿瘤细胞内Mb成分的含量,以探讨其在用免疫组化染色诊断RMS方面的应用价值及意义。     

腺泡状横纹肌肉瘤10例临床病理分析

目的分析10例腺泡状横纹肌肉瘤(alveolar rhabdomyosarcoma,ARMS)的临床病理及免疫表型特点。方法收集10例ARMS临床资料和标本,应用免疫组化SP法检测MyoD1、Myoglobin、Desmin等。结果 ARMS以青少年和年轻人常见,常发生于四肢,均由圆形细胞构成,形成特征性腺泡状结构,不同程度表达MyoD1、Myoglobin、Desmin。结论 ARMS是一种少见的横纹肌肉瘤,应与其它圆形细胞肿瘤鉴别,其组织学特点和免疫组织化学可以帮助鉴别。     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.