Studies of DNA content in cervical intraepithelial neoplasia by cytologic and histologic flow cytometry

Flow cytometry was done on 82 specimens of cervical cytologic scrapings and biopsies from patients with cervical intraepithelial neoplasia or condyloma. This study yielded significant results when compared with standard cytologic (p less than 0.01) and histopathologic studies (p less than 0.05). Histologic evaluation by flow cytometry required more examinations and did not give significant results. The authors conclude that cytologic flow cytometry, though not a replacement for standard cytologic examination, may be of help in establishing therapeutic strategies and follow-up protocols for patients with cervical precancerous conditions.     

The association between thyroid neoplasia and intestinal polyps.

Recent reports have suggested an association between familial adenomatous polyposis and papillary carcinoma of the thyroid. This report describes four patients, each with intestinal polyps and thyroid or thyroglossal cyst carcinoma. One patient had a medullary rather than papillary carcinoma of the thyroid and in another the intestinal polyps were due to Peutz-Jeghers syndrome. This may indicate a wider association between thyroid carcinoma and intestinal polyps than has previously been recognised.     

Follicular cell predominance in the cytologic examination of dominant thyroid nodules indicates a sixty percent incidence of neoplasia

The interpretation of aspiration cytologic smears that contain a predominance of follicular components often presents a dilemma to the clinician who is treating a patient who has a dominant thyroid nodule, especially when thyroid-stimulating hormone suppression does not produce any significant involution of the dominant nodule. We reviewed a consecutive series of 555 fine-needle aspiration cytologic examinations of dominant thyroid nodules. All specimens that contained colloid or follicular cells mixed with lymphocytes or Hürthle cells were excluded from this review. Additionally, nine aspirates contained degenerated follicular cells with insufficient material for cytologic diagnosis. The remaining 76 specimens contained a predominance of follicular cells: 27 specimens were interpreted as containing "normal" follicular cells, and the remaining 49 specimens were read as "atypical" follicular cells. Histopathologic examination of the resected specimens indicated a 60% incidence of neoplasia (30% carcinoma, 30% adenoma) in which the aspiration cytologic study was interpreted as "normal" follicular cells. On the other hand, a 63% incidence of neoplasia (27% carcinoma, 36% adenoma) occurred in which the cytologic study was read as "atypical." In conclusion, aspirates showing a predominance of follicular cells, whether "normal" or "atypical" indicate a 60% incidence of neoplasia in dominant thyroid nodules that do not decrease significantly in size with thyroid-stimulating hormone suppression.     

HPV-DNA检测联合TCT对宫颈癌前病变筛查价值的Meta分析

目的系统评价人乳头瘤病毒DNA检测(HPV-DNA)、液基薄层细胞学检测(TCT)以及二者联合检测在宫颈癌早期筛查中的价值。方法检索有关HPV-DNA与TCT在宫颈癌早期筛查、诊断方面的文献,使用Meta分析对数据进行统计,拟合SROC曲线。结果本研究共纳入17篇文献,HPV-DNA检测的合并后敏感度为0.75,特异度为0.74,SROC曲线下面积为0.826,Q值=0.759;TCT的合并后敏感度为0.63,特异度为0.74,SROC曲线下面积为0.748,Q值=0.692;HPV-DNA联合TCT合并后敏感度为0.79,特异度为0.82,SROC曲线下面积为0.911,Q值=0.842。HPV-DNA联合TCT检测的灵敏度、特异度及SROC曲线下面积均明显高于HPV-DNA、TCT单独检测。结论 HPV-DNA联合TCT检测可以提高宫颈癌的检出率,对宫颈癌的早发现、早诊断、早治疗有重要临床意义。     

Study on association between apoptosis of endometrial cells and Bcl-2, Fas, Fas-L expressions durig menstrual cycles

IntroductionMorphologicalapoptosisinthehumanendometriumwasfirstreportedbyHopwoodandLevison[lj,butthemechanismofapoptosiswasnotstudieduntilrecentyears.ItisknownthatBcl--2inhibitsapoptosis,Fasinducesapoptosis,Fas--ListhenaturalligandofFas.SotheexpressionsofBcl--2,FasandFas--Lareallcloselyrelatedtocellapoptosis.ThecurrentstudyexaminestherelationshipsbetweenapoptosisandtheexpressionsofBcl--2,FasandFas--Linhumanendometiumduringmenstrualcycles.MaterialandMethodsTissueSamplesFourly--sixnormal…     

颈椎生理曲度异常对颈椎病发病作用的病例对照研究

目的:探讨颈椎生理曲度异常对颈椎病发病的作用,为颈椎病的临床诊治提供思路。方法:研究设颈椎病和无颈椎病两组,其中颈椎病组(来源于2006年3月至2008年12月曙光医院骨伤科门诊患者)333例,男119例,女214例;平均年龄(48.11±12.21)岁。无颈椎病组受试者73例(来源于上海中医药大学在校大学生、曙光医院研究生及进修生、部分社区人员),男18例,女55例;平均年龄(45.99±11.47)岁。对两组受试者的颈椎侧位X线片进行颈椎生理曲度观测,比较两组中颈椎生理曲度异常的发生率的差异性,并对两组颈椎生理曲度异常改变的临床特点进行分析。结果:与无颈椎病组相比,颈椎病组患者颈椎生理曲度异常发生率高达95.50%(318/333),二者之间具有统计学差异(P=0.0000.01);且颈椎病组颈椎生理曲度异常形式较复杂和多样化,其中颈椎生理曲度减小占23.12%(77/333),变直占40.84%(136/333),增大占0.60%(2/333),反弓占12.01%(40/333),S形占4.20%(14/333),反S形占2.70%(9/333),上曲下直(以C4为分界点)占4.50%(15/333),上直下曲(以C4为分界点)占7.51%(25/333)。结论:颈椎生理曲度异常是各型颈椎病早期X线征象,且颈椎生理曲度异常形式较复杂和多样化,临床不能笼统称之为"颈椎生理曲度异常",而应重视颈椎生理曲度异常分型的研究,这将对颈椎病的临床诊治具有指导意义。     

Evaluating the association between obesity and discharge functional status after pediatric injury

BackgroundChildren with obesity frequently have functional impairment after critical illness. Although obesity increases morbidity risk after trauma, the association with functional outcomes in children is unknown.ObjectiveTo evaluate the association of weight with functional impairment at hospital discharge in children with serious injuries.MethodsThis secondary analysis of a multicenter prospective study included children <15 years old with a serious injury. Four weight groups, underweight, healthy weight, overweight, and obesity/severe obesity were defined by body mass index z-scores. The functional status scale (FSS) measured impairment across six functional domains before injury and at hospital discharge. New domain morbidity was defined as a change ≥2 points. The association between weight and functional impairment was determined using logistic regression adjusting for demographics, physiological measures, injury details, presence of a severe head injury, and physical abuse.ResultsAlthough most patients discharged with good/unchanged functional status, new domain morbidity occurred in 74 patients (17%). New FSS domain morbidity occurred in 13% of underweight, 14% of healthy weight, 15% of overweight, and 26% of obese/severe obese patients. Compared to healthy weight patients, those with obesity had more frequent new domain morbidity (p = 0.01), while the other weight groups had similar morbidity. However, after adjustment for confounders, weight was not associated with new functional morbidity at discharge.ConclusionPatients with obesity have greater frequency of new domain morbidity after a serious injury; however, after accounting for injury characteristics, weight group is not independently associated with new functional morbidity at hospital discharge after injury in children.Level of EvidenceIII     

The association between cervical spine curvature and neck pain

Degenerative changes of the cervical spine are commonly accompanied by a reduction or loss of the segmental or global lordosis, and are often considered to be a cause of neck pain. Nonetheless, such changes may also remain clinically silent. The aim of this study was to examine the correlation between the presence of neck pain and alterations of the normal cervical lordosis in people aged over 45 years. One hundred and seven volunteers, who were otherwise undergoing treatment for lower extremity problems in our hospital, took part. Sagittal radiographs of the cervical spine were taken and a questionnaire was completed, enquiring about neck pain and disability in the last 12 months. Based on the latter, subjects were divided into a group with neck pain (N = 54) and a group without neck pain (N = 53). The global curvature of the cervical spine (C2–C7) and each segmental angle were measured from the radiographs, using the posterior tangent method, and examined in relation to neck complaints. No significant difference between the two groups could be found in relation to the global curvature, the segmental angles, or the incidence of straight-spine or kyphotic deformity (P > 0.05). Twenty-three per cent of the people with neck pain and 17% of those without neck pain showed a segmental kyphosis deformity of more than 4° in at least one segment—most frequently at C4/5, closely followed by C5/6 and C3/4. The average segmental angle at the kyphotic level was 6.5° in the pain group and 6.3° in the group without pain, with a range of 5–10° in each group. In the group with neck pain, there was no association between any of the clinical characteristics (duration, frequency, intensity of pain; radiating pain; sensory/motor disturbances; disability; healthcare utilisation) and either global cervical curvature or segmental angles. The presence of such structural abnormalities in the patient with neck pain must be considered coincidental, i.e. not necessarily indicative of the cause of pain. This should be given due consideration in the differential diagnosis of patients with neck pain.     

脊髓型颈椎病与肌萎缩性侧束硬化的电生理对比研究

目的：探讨电生理检查对脊髓型颈椎病（CSM）与肌萎缩性侧束硬化（ALS）的签别诊断价值。方法：对124例其中52例脊髓型颈椎病和72例肌萎缩性侧束硬化症进行上、下肢肌、胸锁乳突肌肌电图检查,及C5～C8皮节体感诱发电位（DSEP）检查。结果：肌电图（EMG）检查脊髓型颈椎病上、下肢肌、胸锁乳突肌肌电图异常率分别为54％、8％、8％;肌萎缩性侧束硬化异常率分别为97％、89％、69％。DSEP检查脊髓型颈椎病异常率为92％;肌萎缩性侧束硬化异常率为l％,差异具有非常显著性意义（P〈0、001）。结论：选择上、下肢肌、胸锁乳突肌肌电图检查及C5-C8皮节体感诱发电位检查应作为两种病的常规电生理检查项目,可提高两种病的鉴别诊断率。     

月经周期子宫内膜凋亡与Bc1-2、Fas及Fas-L基因表达产物的相关研究

为探讨子宫内膜凋亡与某些相关基因表达产物的关系,应用免疫组化方法对４６份正常子宫内膜标本Ｂｃ１－２、Ｆａｓ及Ｆａｓ－Ｌ基因表达产物进行检测,并应用ＴＵＮＥＬ法对其中１３份标本同时进行凋亡检测。结果表明：分泌晚期及月经期凋亡细胞较多,血内雌二醇、孕酮水平低下;Ｂｃ１－２蛋白在增殖晚期含量高、分泌期低落、月经期消失;Ｆａｓ则在分泌期及月经期略高于增殖期,而Ｆａｓ－Ｌ表达产物低下。结论：子宫内膜的凋亡呈现周期性改变,与Ｂｃ１－２、Ｆａｓ表达相关,并受雌、孕激素显著调节,提示凋亡与月经期内膜脱落相关。     

阴道镜检查在宫颈上皮内瘤变及宫颈癌诊断中的应用价值

目的 探讨阴道镜检查在宫颈疾病诊断中的应用价值. 方法 对2006年7月至2010年10月我院5,833例进行阴道脱落细胞液基薄层细胞学检查(TCT)呈阳性的患者263例行电子阴道镜检查,并在阴道镜下行定点多点宫颈活组织病理学检查. 结果 263例TCT阳性宫颈病变患者中,阴道镜检查诊断结果为慢性宫颈炎37例;宫颈上皮内瘤变(CIN)181例,其中CIN Ⅰ 93例,CIN Ⅱ 50例,CIN Ⅲ 38例;宫颈癌45例.经宫颈活组织病理学检查诊断结果为慢性宫颈炎36例;CIN 180例,其中CINⅠ 97例,CIN Ⅱ 46例,CIN Ⅲ 37例;宫颈癌47例.阴道镜检查对诊断宫颈CIN及宫颈癌的价值显示灵敏度97.8％,特异度94.4％,准确度92.2％,阳性预测值99.1％,阴性预测值91.9％.对于宫颈CIN和宫颈癌患者,阴道镜检查结果和病理检查结果的诊断符合率均高于90％. 结论 阴道镜检查对宫颈癌前病变的早期诊断、早期治疗具有重要的价值,对降低宫颈癌的发生率有一定的应用价值.     

Head and neck neoplasia following irradiation for benign conditions

A retrospective review of 143 patients with head or neck tumors who had received radiation therapy in the head and neck area for benign conditions during childhood or adolescence was conducted. This included an analysis of 1,080 patients from the Evanston Hospital Irradiated Thyroid Evaluation Clinic, which was established to define the relationship between irradiation and the subsequent development of thyroid neoplasia. The data support the following concepts of irradiation-induced neoplasia: (1) The thyroid, parathyroid, and salivary glands can develop benign and malignant changes after irradiation for benign conditions, with latent periods averaging about 30 years; (2) Once a glandular abnormality within the irradiated field appears, the risk of other glands in the field developing neoplastic changes is significantly increased.