乳腺浸润性导管癌免疫表型分化规律及临床意义

目的:探讨乳腺癌免疫表型分化规律及临床意义。方法:采用免疫组化SP法检测CK5、CK8及P63在136例乳腺浸润性导管癌中的表达,分析乳腺癌免疫表型分化规律及其与临床病理特征的关系。结果:CK5在乳腺浸润性导管癌中表达较弱,CK8在乳腺浸润性导管癌表达较强;109例(80.15%)乳腺浸润性导管癌呈现CK5-/CK8+腺腔表型,9例(6.62%)呈现CK5+/CK8-干细胞表型,15例(11.03%)呈现CK5+/CK8+混合表型,3例(2.21%)呈现CK5-/CK8-表型,且这种表达与患者的年龄、肿瘤分化程度、淋巴结转移以及临床分期相关;P63在乳腺浸润性导管癌中有11例(8.81%)呈现少量的肿瘤细胞阳性,并且主要表达于低分化的乳腺癌中。结论:CK5+/CK8+、CK5+/CK8-或P63+表型乳腺癌恶性程度高、预后差,免疫表型可作为评价预后的生物学指标。     

乳腺基底细胞样癌的临床病理分析

目的对乳腺基底细胞样癌进行临床病理分析,探讨其免疫学特征、病理学特征以及预后.方法?选取该院自2008年1月—2010年12月收治的基底细胞样乳腺癌患者100例,并从中筛选出30例组织学Ⅲ级患者.探寻导致乳腺基底样细胞癌的病理因素.结果?在30例女性乳腺基底细胞样癌患者中,经免疫组化染色,有22例患者的ER、PR以及HER-2呈阴性,而CK5/6、CK14以及EGFR等呈阳性.结论?乳腺基底细胞样癌是乳腺癌的一种新的亚型,其病理组织学特征、免疫学特征独特,且预后较差,是今后临床研究的重点,应当引起广大医学者关注.     

异位错构瘤性胸腺瘤

目的 探讨异位错构瘤性胸腺瘤(EHT)的临床病理特征,提高对此病的认识.方法:观察分析1例EHT患者的临床病理特点、免疫组化表型并进行相关文献复习.结果 肿物表面光滑,切面实性,有光泽,灰白、灰黄,质软;镜下瘤组织以束状、编织状排列的梭形细胞为主,混有灶状分布的成熟脂肪细胞和呈条索状、巢状、囊腔或腺腔样排列的上皮岛.瘤细胞无明显异型性,核分裂象未见.免疫组化显示梭形细胞CK和Vimentin弥漫阳性,上皮细胞CK弥漫阳性,囊腔内分泌物及其表层上皮细胞CEA阳性,两种瘤细胞NSE、S-100、desmin、actin、CD34、CD45RO和CD20均呈阴性.结论 EHT是罕见的良性肿瘤,认识其组织学表现和免疫表型的特点可做出正确诊断.     

乳腺腺样囊性癌7例临床病理特征分析

目的 回顾性分析乳腺腺样囊腺癌的临床病理特征,探讨其发病特点,为临床诊治提供经验.方法 收集复旦大学附属华山医院2007年1月 ～2019年12月收治的7例乳腺腺样囊性癌患者的临床及病理资料,分析临床表现、肿瘤组织形态学及免疫组化特点.结果 7例女性患者平均发病年龄64岁,中位随访时间65个月(49～147个月),1例...     

腮腺基底细胞腺瘤恶变为腺样囊性癌2例报道

基底细胞腺瘤并不多见,是一种由基底样细胞组成的涎腺良性上皮性肿瘤.基底细胞腺瘤恶变为基底细胞腺癌已得到确认,而基底细胞腺瘤是否可以恶变为腺样囊性癌则认识不一.我院遇见2例腮腺基底细胞腺瘤恶变为腺样囊性癌的病例,分析如下.     

头颈部腺样囊性癌58例临床病理及预后分析

目的 研究头颈部腺样囊性癌的临床病理及预后因素.方法 回顾性收集1999年1月至2007年12月治疗的头颈部腺样囊性癌患者58例,通过对其临床病理资料的收集和预后随访,分析影响腺样囊性癌预后的因素.结果 单因素分析发现,组织病理类型、嗜神经侵袭、血管侵袭、肿瘤复发、肿瘤远处转移以及TNM分期与腺样囊性癌的预后有关(P＜0.05).多因素分析显示TNM分期、组织病理类型筛孔型以及嗜神经侵袭是腺样囊性癌的独立预后因子(P＜0.05).结论 组织病理类型、TNM分期、嗜神经侵袭、血管侵袭、肿瘤复发以及肿瘤远处转移是腺样囊性癌重要的预后因子.

Abstract：

Objective To approach the prognostic factors of head and neck adenoid cystic carcinoma.Methods Fifty-eight head and neck adenoid cystic carcinomas were treated from January 1999 to December 2007.The demographic and clinicopathological data were obtained from a retrospective chart review.The follow-up and survival analysis were carried out to analyze the significant prognostic factors.Results Using the univariate analysis,the variables,such as histologic type,perineural invasion,vascular invasion,recurrence,metastasis and TNM stage were found significantly associated with a worse prognosis (P ＜ 0.05 ).Multivariate analysis showed that histologic type,perineural invasion and TNM stage had an independent prognostic effect on survival (P ＜ 0.05 ).Conclusion The variables including histologic type,TNM stage,perineural and vascular invasion,recurrence and metastasis are important prognostic factors for head and neck adenoid cystic carcinoma.     

伴有软骨基质分泌的乳腺化生性癌临床病理学观察

目的分析伴有软骨基质分泌的乳腺化生性癌的临床病理学特征、免疫组化标记特点及其组织起源。方法收集5例伴软骨基质分泌的乳腺化生性癌的临床及随访资料,观察组织病理形态学及免疫组化标记,并对相关文献进行复习。结果5例患者年龄37～48岁,组织标本切面灰黄或灰褐色,结节状,界限尚清。镜下见肿瘤细胞围绕软骨粘液样或透明软骨样基质呈巢状,条索状排列,密集的瘤细胞可聚集于周边,中央区细胞稀疏,周边肿瘤细胞向基质移行中无梭形细胞肉瘤样成份。免疫组化结果显示,5例均同时表达CK、Vim及S-100,但不表达ER、PR、Her-2。结论伴有软骨基质分化的乳腺化生性癌是一种罕见肿瘤,具有特征性的病理组织形态和免疫表型,临床过程与普通非特异性浸润性乳腺癌无异。     

乳腺分泌型癌的临床病理分析

目的:观察乳腺分泌型癌的临床病理切片的特征;方法:选取2016年2月至2018年1月该院收治的乳腺分泌型癌患者26例作为主要研究对象,观察分泌型乳腺癌的病理特征(肿瘤直径、生长方式、免疫组化分析);结果:患者中有16例位于外上象限,5例位于内下象限,5例位于乳晕区。乳腺肿块直径介于1.2~3.5cm,平均(2.34±0.53)cm,肿瘤边界清楚,质硬;免疫组化分析发现,CEA(+)、S-100(+)、CK(+)、ER(-)、PR(+)、P53(+/-)、cyclin D1(+);P53(+)有4例患者出现,4例标本存在5%~10%的阳性细胞;特殊染色分析发现,淀粉酶消化后PAS染色可见,标本细胞内外分泌物呈现强(+);其病理特点呈现出质硬、推挤性生长,存在管状、巢状、微囊性的特点,在实体巢状中可见数目不等、大小不一的腺样及囊泡状结构。管腔形状无规则相互交通,内部可见红染均质的类甲状腺胶质样的分泌物和吸收空泡。本实验的标本瘤细胞基本一致,细胞核呈卵圆形,位于中央或基底部;核仁较小,未见核分裂现象;结论:乳腺分泌型癌作为临床罕见的预后较好的癌症之一,通过病理形态学及免疫组化分析可以与印戒细胞瘤相鉴别,差异明显利于确诊。     

原发性乳腺骨肉瘤一例报道及文献复习

目的 探讨原发性乳腺骨肉瘤的临床病理特征,免疫表型及预后相关因素.方法 报道1例乳腺原发性骨肉瘤临床病理表现和免疫组织化学标记,结合文献对该肿瘤的临床病理特征.诊断及鉴别诊断和预后进行讨论.结果 乳腺骨肉瘤B超呈强回声光团改变.乳腺钼靶示:左乳BI-RADS4a级;右乳BI-RADS2级.镜检见正常乳腺组织结构已被破坏,由瘤组织替代.肿瘤由瘤细胞及肿瘤性骨样基质构成,粉红色的骨样基质在瘤细胞间呈花边状、条索状及片块状,埋于其中的瘤细胞形状多样,成梭形,圆形和多角形,极大、深染,散在核分裂相,并可见瘤巨细胞.在乳腺组织及残留的乳腺组织之间,有较明显的炎性纤维结缔组织带分界.残留乳腺组织显示萎缩.纤维化和慢性炎症细胞浸润.未找到上皮成分.免疫组化标记破骨细胞表达为巨噬细胞CD68、Vimentin阳性,梭形细胞不表达ER、PR和CK.结论 原发性乳腺骨肉瘤是一种罕见的低度恶性骨外骨肉瘤.随访至今10个月,仍无病生存.     

基底细胞样型乳腺癌临床病理观察

目的分析基底细胞样型乳腺癌(basal-like breast carcinoma,BLBC)的临床病理特征、免疫表型,并探讨其诊断标准及相关文献复习。方法选择2012年8月—2014年8月收治BLBC患者13例作为研究对象,对切除标本进行病理形态学及免疫组织化学(免疫组化)分析。结果镜下特点为肿瘤细胞呈实性巢片状分布,周围存在纤维结缔组织间隔,肿瘤组织边缘表现为推进式生长方式,肿瘤细胞胞浆少,呈合体状,细胞核为圆形或者卵圆形,核浆比例高,呈高级别形态。免疫组化染色雌激素受体(estrogen receptor,ER)、孕激素受体(progesterone receptor,PR)、人表皮生长因子受体-2(human epidermal growth factor receptor-2,Her-2)均阴性(-),伴有至少一种基底细胞角蛋白和(或)肌上皮标记物CK5/6、P63等的阳性表达,11例CK5/6阳性表达,占84.62%,2例CK5/6弱阳性表达,占15.38%;4例P63阳性表达,占30.77%;6例EGFR阳性表达,占46.15%,随访3~18个月患者均存活。结论 BLBC具有独特的免疫组化特征、组织形态学特点,应作为一种独立的乳腺癌亚型加以认识。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.