细针穿刺细胞学诊断胃食管交界处SMARCA4缺失型未分化癌转移1例

细针穿刺细胞学在诊断淋巴结转移癌上, 具有简单、微创、快速等优点。本文报道1例胃食管交界处SMARCA4缺失型未分化癌, 左锁骨上细针穿刺细胞学作出最初诊断的病例。患者男, 65岁。主因间断性上腹部不适2个月余就诊, 体检左锁骨上可触及肿大淋巴结, 直径1.5 cm, 质硬。随后进行了细针穿刺细胞学检查, 细胞学显示:肿瘤细胞单个散在或成团分布, 肿瘤细胞异型性大, 多呈圆形, 胞质量多少不等, 嗜酸性, 核圆形, 空泡状, 核仁明显。免疫细胞化学染色显示广谱细胞角蛋白阳性, CDX2、癌胚抗原、CK5/6、villin、突触素、波形蛋白、MART1、HMB45、SMARCA4/BRG1阴性。细胞病理学诊断为SMARCA4缺失型未分化癌转移。最终胃镜下的病理活检证实了本例的诊断。本文描述了该例的细胞学及免疫细胞化学染色特点, 着重讨论了细胞病理学的鉴别诊断。     

BRAF基因突变在甲状腺乳头状癌中的临床意义

目的：探讨BRAF V600E基因突变与甲状腺乳头状癌的临床相关性。方法：采用PCR技术和直接测序法,对63例甲状腺乳头状癌患者和45例其他类型甲状腺疾病患者石蜡组织BRAF V600E基因突变进行检测。结果：甲状腺乳头状癌组中32例存在突变;而在其他类型甲状腺疾病组中未发现突变。BRAF V600E基因突变在甲状腺乳头状癌不同肿瘤直径组之间的比较差异以及在有无区域淋巴结转移组之间的比较差异均具有统计学意义(P<0.05)。结论：BRAF V600E基因突变与甲状腺乳头状癌的发生、肿瘤的大小和区域淋巴结的转移有关。     

细胞转移技术在细针穿刺细胞学诊断中的应用

目的:探讨应用细胞转移技术,解决细针穿刺细胞学涂片因数量有限无法进行多种免疫细胞化学染色等辅助检查的问题,为细胞学精准诊断提供可能性。方法:收集2020年1至5月北京医院病理科行细针穿刺细胞学病例34例,将一张涂片上丰富的细胞分割到若干张载玻片上,进行细胞转移。转移片褪染后行EnVision法免疫细胞化学染色,比较细胞...     

S100A4及CEACAM-1蛋白与甲状腺乳头状癌淋巴结转移的相关性

目的探讨S100A4及CEACAM-1蛋白在甲状腺乳头状癌中的表达及其与淋巴结转移的关系。方法收集整理102例手术切除的甲状腺乳头状癌病例标本,分析其相关临床病理因素并应用免疫组织化学EnVision及Histofine Simple Stain MAX两步法检测癌组织中S100A4、CEACAM-1、cyclinD1及p27Kip1蛋白的表达,运用单因素及多因素分析研究上述因素与甲状腺乳头状癌淋巴结转移的相关性。结果 S100A4及CEACAM-1蛋白在甲状腺乳头状癌标本中的阳性率分别为79.4%(81/102)和51.0%(52/102);通过单因素分析,发现年龄45岁、肿物直径1cm、S100A4阳性表达及CEACAM-1阴性表达与甲状腺乳头状癌淋巴结转移相关。性别、纤维化、肿物包膜完整、组织学亚型(滤泡型或其他亚型)、伴发桥本甲状腺炎、多灶、侵及甲状腺包膜外(镜下),cyclinD1及p27Kip1的阳性表达与淋巴结转移无关。进一步的多因素分析发现:年龄45岁、S100A4阳性表达及CEACAM-1阴性表达为甲状腺乳头状癌淋巴结转移的独立性危险因素。结论 S100A4的阳性表达及CEACAM-1的阴性表达与甲状腺乳头状癌淋巴结转移相关,可作为甲状腺乳头状癌淋巴结转移的预测因素。     

针吸细胞学对甲状腺乳头状癌的诊断价值

目的探讨甲状腺乳头状癌的细针细胞学核的特征,提高甲状腺乳头状癌的诊断准确性。方法回顾性分析121例经组织学证实为甲状腺乳头状癌的细针穿刺细胞学标本。结果 121例中,细胞学诊断无法诊断或标本不满意3例,良性病变2例,非典型病变2例,滤泡性肿瘤2例,可疑乳头状癌12例,乳头状癌100例。核沟在甲状腺乳头状癌细胞学中阳性率最高,但其特异性不足。核内假包涵体、砂砾体在甲状腺乳头状癌的阳性率低于核沟,但特异性很高。结论超声引导下细针穿刺细胞学检查对甲状腺乳头状癌的诊断有较高的敏感性,核沟、核内假包涵体、砂砾体是诊断甲状腺乳头状癌的重要指标。     

鼻咽癌颈淋巴结转移EB病毒基因的检测

目的　观察鼻咽癌(NPC)颈淋巴结转移EB病毒基因情况。方法　采用细针穿刺结合聚合酶链反应(PCR)技术对50例颈部肿块穿刺液进行EBVDNA检测。结果　30例鼻咽癌颈淋巴结转移者EBVDNA阳性数27例,阳性率为900%。7例恶性淋巴瘤者EBVDNA阳性数1例,阳性率143%。8例非NPC颈部转移癌者EBVDNA阳性数1例,阳性率为125%。5例鼻咽部炎症伴颈淋巴结增生者均未检测到EBVDNA。结论　细针穿刺结合PCR方法快速灵敏,所取标本量少,特异性高,尤其对于临床难以确认的隐匿性鼻咽癌及原发灶不明的颈部转移癌,具有一定的临床诊断价值,值得推广应用。     

甲状腺弥漫性滤泡型乳头状癌2例临床病理分析

目的探讨甲状腺弥漫性滤泡型乳头状癌(diffuse follicular variant of papillary thyroid carcinoma,DFVPTC)的临床病理特征。方法回顾性分析2例DFVPTC的临床病理特点、免疫表型及分子检测结果,并复习相关文献。结果 2例患者为青少年女性,彩超、大体及镜下检查均显示甲状腺内多结节性弥漫受累,肿瘤细胞呈小至中等大小滤泡状排列,小灶呈实体状,具有经典型乳头状癌细胞核特征。均显示甲状腺周围组织明显侵犯及颈部淋巴结广泛转移。免疫表型:TTF-1、Galectin-3、CK19、HBME-1均阳性,Ki-67增殖指数5%。BRAF V600E基因检测均阴性。结论 DFVPTC属于罕见的具有高侵袭性的乳头状癌亚型,确诊需结合形态学特征。     

Warthin瘤样甲状腺乳头状癌的临床病理学分析

目的探讨Warthin瘤样甲状腺乳头状癌(WLPTC)的临床病理学特征。方法收集北京市顺义区医院WLPTC病例5例,对其临床资料、病理形态、免疫标记和分子遗传学特征进行分析,同时复习文献。结果5例WLPTC组织大体观察,肿瘤切面呈灰白色或灰褐色,实性,质地硬,边界尚清。镜下见肿瘤组织形态似涎腺的Warthin瘤,呈乳头状结构,间质可见大量淋巴细胞、浆细胞浸润,但无明显滤泡形成;表面被覆复层上皮,肿瘤细胞呈多角形,胞质嗜酸性细颗粒状;肿瘤细胞核呈毛玻璃样,并可见核沟及核内包涵体。5例均伴发慢性淋巴细胞性甲状腺炎。1例有颈部淋巴结转移。免疫组织化学染色显示,肿瘤间质内增生的淋巴组织以CD3阳性的T细胞为主,亦可见少量CD20阳性B细胞及CD138阳性的浆细胞。4例患者浆细胞表达IgG4。Ki-67阳性指数为1%~10%。即时荧光定量PCR结果显示,5例患者中,有3例存在BRAF V600E突变,但无一例RAS突变。术后随访1~10年,5例患者均无进展,其中4例无复发和转移,1例曾有淋巴结转移的病例,未见新的转移灶。结论WLPTC是一种特殊类型的甲状腺乳头状癌,预后良好。正确认识和诊断对临床医师的治疗、预测患者预后具有提示意义。     

抗胃癌单克隆抗体的免疫细胞化学研究

在临床上用针吸材料及手术材料中应用了抗胃癌单克隆抗体作免疫细胞化学研究,在19例腺癌病例的取材涂片上,均显示癌细胞浆有相当强的染色反应,4例淋巴结转移性鳞癌上皮也有一定的阳性反应,胚胎癌分化好的腺上皮细胞也阳性。甲状腺、乳腺、腮腺等良性腺     

甲状腺乳头状癌颈部淋巴结转移特点及相关危险因素分析

目的 探讨甲状腺乳头状癌（PTC）临床病理特征及影响颈部淋巴结转移的危险因素。方法 回顾性分析我院2015年1月~2017年12月收治的515例PTC的临床资料,分析颈部淋巴结转移特点及相关危险因素。结果 PTC颈部淋巴结转移率为44.27%,中央组（Ⅵ区）淋巴结转移率高于侧区（P＜0.05）。单因素分析结果示性别、年龄、多灶、癌灶最大径、侵犯被膜和颈部淋巴结转移有关（P＜0.05）。多因素分析结果示男性、年龄＜55岁、多灶病变、癌灶最大径＞10 mm、被膜受侵犯是发生颈部淋巴结转移的独立危险因素（P＜0.05）。结论 Ⅵ区转移率最高,行颈淋巴结清扫时应将Ⅵ区作为常规清扫区域。对于男性、年轻、多灶病变、癌灶最大径＞10 mm、被膜受侵犯的患者应高度警惕颈部淋巴结转移的可能。     

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