周围型肺癌的征象学研究

<正>所谓周围型肺癌是指肿瘤发生于肺段以下支气管的肺癌。可见于各种组织学类型.其中主要是细支气管肺泡癌和原癌,也见于鳞状上皮癌、小细胞癌、大细胞癌及类癌.周围型肺癌的基本大体病理形态为肺内结节或肿块.肿瘤内可形成瘢痕或坏死。最大径小于2cm的周围型肺癌是小肺癌;空洞型肺癌及肺上沟瘤也     

肺硬化性血管瘤临床特点与病理分析

目的探讨肺所谓硬化性血管瘤(SHL)的临床特点与病理组织学特征。方法对5例SHL的临床资料、影像特点、病理组织HE及免疫组织化学染色切片进行回顾性研究。结果 SHL有两种细胞成分(圆形或多角形间质细胞及表面立方细胞),由实性、乳头状、硬化性、出血等4种结构区构成,偶尔可见黄色瘤细胞区、砂砾体、胆固醇裂隙等结构;免疫组织化学两种细胞均表达Vimentin、EMA、TTF1,表面细胞表达CK(AE1/AE3),少数病例部分表达ER、Syn及CgA。结论 SHL是起源于肺的一种少见良性肿瘤,需与肺乳头状肿瘤、支气管肺泡癌炎性假瘤、类癌及透明细胞肿瘤(原发/转移)鉴别;预后良好。     

唾液腺嗜酸细胞型黏液表皮样癌临床病理分析

目的探讨唾液腺嗜酸细胞型黏液表皮样癌的临床病理特征、诊断及鉴别诊断。方法对1例唾液腺嗜酸细胞型黏液表皮样癌进行临床病理学观察及组织化学、免疫组织化学染色标记,并通过相关文献复习,对病理诊断及鉴别诊断等进行分析。结果肿瘤由嗜酸性细胞、表皮样细胞、黏液细胞及中间型细胞构成,部分区域仅见被纤维结缔组织分隔呈片状、巢状或腺状排列的嗜酸性细胞,瘤细胞大小～致、形态温和,内含丰富的嗜酸性颗粒。组织化学染色：黏液分泌细胞及部分表皮样细胞PAS染色阳性。免疫组织化学染色：细胞角蛋白7（CK7）、细胞角蛋白20（CK20）阳性,CEA肿瘤细胞灶状显示阳性,神经元特异性烯醇化酶（NSE）、嗜铬蛋白A（CgA）阴性。结论唾液腺嗜酸细胞型黏液表皮样癌是黏液表皮样癌的一种亚型,极为罕见。组织学检查对本病的诊断具有重要作用,需要与唾液腺嗜酸性细胞腺瘤、多形性腺瘤及黏液性囊腺瘤进行鉴别。     

儿童支气管类癌的病理诊断(附2例报告)

目的探讨儿童支气管类癌的临床病理学特征及病理诊断。方法结合我院2例临床资料及组织学观察和免疫组化研究复习有关文献进行分析讨论。结果2例均为中央型支气管类癌,瘤细胞排列成实性片状、小梁状及乳头状;细胞大小一致,胞浆嗜酸性,胞核圆形,核分裂罕见。免疫组化标记CK、Syn、CgA及NSE均阳性。结论儿童支气管典型类癌为高分化神经内分泌癌。由于支气管肿瘤在儿童较罕见,临床症状缺乏特异性,极易引起临床误诊,延误治疗,须引起高度重视。     

3例胎盘部位滋养细胞瘤的临床病理分析

目的分析胎盘部位滋养细胞肿瘤（placental site trophoblastic tumor,PSTT）的病理形态特征及与其他肿瘤的鉴别诊断要点。方法对3例PSTT进行组织形态学、免疫组织化学和血清β-hCG水平分析,结合文献对其临床表现、病理形态特点及鉴别诊断进行探讨。结果PSTT的主要临床症状为月经不调、阴道不规则出血等。肿瘤由形态多样的上皮样细胞构成,胞质嗜酸性或透亮,来源于中间型滋养细胞。免疫组织化学瘤细胞表达CK、MBP、HCG、HPL等。结论PSTT是一种极少见的肿瘤,临床表现缺乏特异性,早期诊断十分困难。根据其组织学改变,免疫组化染色结果及血清β—hCG水平,可与其他肿瘤鉴别。     

头面部恶性黑色素性神经鞘瘤2例及文献复习

目的 了解恶性黑色索性神经鞘瘤的临床病理特征及其鉴别诊断及预后．方法 收集2例恶性黑色索性神经鞘瘤观察其临床病理特点并进行组织化学及免疫组化染色分析。结果 所有肿瘤均具有恶性黑色素瘤的临床与组织学特征且都伴有多少量不等的黑色素。结论 恶性黑色索性神经鞘瘤少见，恶性度高，临床诊断较困难但有其病理特征．依靠镜下观察及配以组织化学染色、免疫组化染色可确诊。复习文献该肿瘤瘤细胞同时显示神经鞘瘤和黑色素细胞的分化，提示该肿瘤来自神经蝽，进一步单克隆培养实验表明神经嵴细胞具有异质性，可由全潜能细胞，多潜能细胞组成，黑色素性神经鞘瘤可以被认为是具有两种潜能细胞的增生而形成的。     

胸腺神经内分泌癌3例临床病理特征分析

目的 探讨胸腺神经内分泌癌(TNC)的临床病理特征及鉴别诊断.方法 报道3例胸腺神经内分泌癌并结合文献从临床病理、免疫表型等方面进行探讨.结果 巨检肿瘤呈结节状,切面灰红灰白相间.镜检2例肿瘤组织呈岛状、小梁状及器官样排列.1例燕麦细胞样弥漫分布,可见出血坏死.免疫组化:NSE、Syn、CgA、EMA、PCK呈阳性表达.结论 胸腺神经内分泌癌具有复杂多样的组织学形态,免疫组化有助于与纵隔其他原发肿瘤相鉴别.     

肺硬化性血管瘤4例临床病理分析

目的探讨肺硬化性血管瘤（SHL）的临床病理组织学特点。方法对4例SHL进行回顾性分析。采用Envision二步法进行免疫组化染色。结果SHL由2种细胞（表面立方状细胞、间质圆形或多角形细胞）组成，有实性、乳头状、硬化性和出血性4种组织学结构。2种细胞均表达甲状腺转录因子-1（TTF-1），表面立方状细胞表达表面活性蛋白B（SPB）、单克隆抗细胞角蛋白AE1／AE3，间质圆形或多角形细胞表达单克隆抗体波形蛋白（vimentin）。结论SHL是起源于原始肺上皮细胞的一种良性肿瘤或恶性度很低的肿瘤，需与细支气管肺泡癌、肺类癌、肺炎性假瘤、肺乳头状腺瘤等鉴别。预后良好。     

所谓肺硬化性血管瘤2例报道并文献复习

目的探讨所谓肺硬化性血管瘤的病理组织学、免疫组织化学的表型、超微结构特征及鉴别诊断要点。方法对2例所谓肺硬化性血管瘤病理组织学及免疫组织化学进行研究,并结合文献复习。结果组织学上此瘤有4种基本构型:乳头状、实性片状、"血管瘤"样、硬化区;两种瘤细胞:一种为圆形或多边形细胞,另一种为立方形细胞。免疫组织化学:共同表达:EMA、TTF-1、AE1/AE3,不表达CD34、Ⅷ因子、CD68。结论所谓肺硬化性血管瘤在肺肿瘤中少见,组织学形态呈多样性,主要以混合型结构为主,免疫组织化学在诊断与鉴别诊断中有重要作用。     

子宫腺瘤样瘤的病理与免疫组化观察

为探讨子宫腺瘤样瘤的病理学特点及组织来源和发病机制，对子宫腺瘤样瘤22例观察其临床病理特征，应用免疫组化和组织化学方法进行染色观察，结果表明，22例中8例见瘤组织与浆膜面间皮相移行，14例见瘤组织与周围平滑肌组织有连续：免疫组化显示瘤细胞波纹蛋白，细胞角蛋白，间质细胞抗原阳性表达，表达膜抗原，癌胚抗原，血管相关因素和HHF35阴性表达，组织化学染色显示粘液染色有阳性表达，嗜银染色见瘤细胞周围嗜银纤维少，糖原染色阴性。结论：子宫腺瘤样瘤为良性病变，起源于间皮组织，为浆膜间皮细胞异位浆膜下肌间所致。组织化学，免疫组化结果可作为诊断及鉴别诊断的重要参考依据。     

Efficacy of gut lavage,hemodialysis, and hemoperfusion in the therapy of paraquat or diquat intoxication

Clinical and in vitro investigations were carried out to test the efficacy of gut lavage, hemodialysis, and hemoperfusion in the treatment of poisoning with paraquat or diquat. In a patient suffering from diquat intoxication 130 times more diquat was removed by gut lavage 30 h after ingestion than was removed by complete aspiration of the gastric contents.Determination of in vitro clearances for paraquat and diquat by hemodialysis showed that, at serum concentrations of 1–2 ppm, such as are frequently encountered in poisoning in man, toxicologically relevant quantities of herbicide cannot be removed from the body. At a concentration of 20 ppm, on the other hand, hemodialysis proved to be effective, the clearance being 70 ml/min at a blood flow rate of 100 ml/min. The efficacy of hemoperfusion with coated activated charcoal was on the whole better. Especially at concentrations around 1–2 ppm, the clearance values for hemoperfusion were some 5–7 times higher than those for hemodialysis.In a patient suffering from paraquat poisoning, both hemodialysis as well as hemoperfusion were carried out. The in vitro results could be confirmed: At serum concentrations of paraquat less than 1 ppm no clearance could be obtained by hemodialysis while by hemoperfusion with activated charcoal quite high clearance values were measured and the serum level dropped down to zero.

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Zusammenfassung Klinische Untersuchungen und Laboratoriumsversuche wurden durchgeführt, um die Wirksamkeit von Darmspülung, Hämodialyse und Hämoperfusion bei Paraquat- und Deiquat-Vergiftungen zu prüfen.Bei einem Patienten wurde 30 Std nach Deiquat-Aufnahme durch Darmspülung 130mal mehr Deiquat entfernt als durch vollständige Aspiration des Mageninhaltes. In vitro-Versuche ergaben, daß bei Blutserumkonzentrationen von 1–2 ppm, die bei Vergiftungen oft gemessen werden, durch Hämodialyse keine toxikologisch relevanten Paraquat- oder Deiquat-Mengen entfernt werden können. Dagegen erwies sich die Hämodialyse bei 20 ppm und einer Blutumlaufgeschwindigkeit von 100 ml/min mit einer Clearance von 70 ml/min als wirksam. Die Hämoperfusion mit beschicheter Aktivkohle war in diesen Versuchen aber eindeutig überlegen, denn insbesondere bei Konzentrationen um 1–2 ppm waren die Clearance-Werte 5–7mal höher als bei der Hämodialyse.Die in vitro-Ergebnisse wurden bei einem Patienten mit einer Paraquat-Vergiftung bestätigt: Bei Konzentrationen unter 1 ppm war die Hämodialyse wirkungslos, während durch Hämoperfusion relativ hohe Clearance-Werte erreicht wurden, so daß der Serumspiegel rasch unter die Nachweisgrenze abfiel.

     

In vitro studies on sterically stabilized liposomes (SL) as enzyme carriers in organophosphorus (OP) antagonism

This study describes a new approach for organophosphorous (OP) antidotal treatment by encapsulating an OP hydrolyzing enzyme, OPA anhydrolase (OPAA), within sterically stabilized liposomes. The recombinant OPAA enzyme was derived from Alteromonas strain JD6. It has broad substrate specificity to a wide range of OP compounds: DFP and the nerve agents, soman and sarin. Liposomes encapsulating OPAA (SL)* were made by mechanical dispersion method. Hydrolysis of DFP by (SL)* was measured by following an increase of fluoride ion concentration using a fluoride ion selective electrode. OPAA entrapped in the carrier liposomes rapidly hydrolyze DFP, with the rate of DFP hydrolysis directly proportional to the amount of (SL)* added to the solution. Liposomal carriers containing no enzyme did not hydrolyze DFP. The reaction was linear and the rate of hydrolysis was first order in the substrate. This enzyme carrier system serves as a biodegradable protective environment for the recombinant OP-metabolizing enzyme, OPAA, resulting in prolongation of enzymatic concentration in the body. These studies suggest that the protection of OP intoxication can be strikingly enhanced by adding OPAA encapsulated within (SL)* to pralidoxime and atropine.     

Aquatic Insects and Trace Metals: Bioavailability,Bioaccumulation, and Toxicity

Abstract

The uptake of metals from food and water sources by insects is thought to be additive. For a given metal, the proportions taken up from water and food will depend both on the bioavailable concentration of the metal associated with each source and the mechanism and rate by which the metal enters the insect. Attempts to correlate insect trace metal concentrations with the trophic level of insects should be made with a knowledge of the feeding relationships of the individual taxa concerned. Pathways for the uptake of essential metals, such as copper and zinc, exist at the cellular level, and other nonessential metals, such as cadmium, also appear to enter via these routes. Within cells, trace metals can be bound to proteins or stored in granules. The internal distribution of metals among body tissues is very heterogeneous, and distribution patterns tend to be both metal and taxon specific. Trace metals associated with insects can be both bound on the surface of their chitinous exoskeleton and incorporated into body tissues. The quantities of trace meals accumulated by an individual reflect the net balance between the rate of metal influx from both dissolved and particulate sources and the rate of metal efflux from the organism. The toxicity of metals has been demonstrated at all levels of biological organization: cell, tissue, individual, population, and community. Much of the literature pertaining to the toxic effects of metals on aquatic insects is based on laboratory observations and, as such, it is difficult to extrapolate the data to insects in nature. The few experimental studies in nature suggest that trace metal contaminants can affect both the distribution and the abundance of aquatic insects. Insects have a largely unexploited potential as biomonitors of metal contamination in nature. A better understanding of the physico-chemical and biological mechanisms mediating trace metal bioavailability and exchange will facilitate the development of general predictive models relating trace metal concentrations in insects to those in their environment. Such models will facilitate the use of insects as contaminant biomonitors.     

Alzheimer’s disease – current trends in basic and clinical research. Highlights from the 16th ECNP

Advances in the molecular biological knowledge of neuronal nicotinic acetylcholine receptors (nAChRs) have led to a growing interest by the pharmaceutical industry in the development of novel compounds that selectively modulate nAChR function. The ability of (-)-nicotine, an activator of nAChRs, to enhance attentional aspects of cognition in animals and humans, to exert neuroprotective and anxiolytic-like effects, and presumably to mediate the negative correlation between smoking and Alzheimer's (and Parkinson's) Disease, has focused interest on the potential therapeutic utility of modulators of nAChR function for treatment of some of the deficits associated with these progressive, neurodegenerative conditions. Numerous compounds are known which activate nAChRs and which might serve as lead compounds toward the development of such agents. The pharmacologic diversity of neuronal nAChR subtypes suggests the possibility of developing selective compounds which would have more favourable side-effect profiles than existing agents. This broader class of agents, collectively called cholinergic channel modulators (ChCMs), is anticipated to encompass compounds which would have more favourable side-effect profiles than existing agents, which generally exhibit low selectivity. This selectivity may be achieved by preferentially activating some subtypes of nAChRs (i.e., Cholinergic Channel Activators, ChCAs) or inhibiting the function of other subtypes (Cholinergic Channel Inhibitors, ChCIs). An overview of the biology of nAChRs and the rationale for the use of ChCMs for the treatment of dementia related to neurodegenerative diseases are presented, followed by a discussion of lead compounds and compounds under consideration for clinical evaluation.     

Steroidal sapogenin contents in some domestic plants

In order to find out the values of the steroid resources for the future use. the compositions and contents of steroidal sapogenins from 13 domestic plants have been investigated. As a result,Dioscorea nipponica, D. quinqueloba andSmilax china were found to have large amount of diosgenin. And pennogenin inTrillium kamtschaticum andParis verticillata, yuccagenin inAllium fistulosum, hecogenin inAgave americana and neochlorogenin inSolanum nigum were appeared to be major steroidal sapogenins.     

Pharmacological treatment of COVID-19: an opinion paper

The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.