原发性脾血管肉瘤临床病理特征分析

目的 探讨原发性脾血管肉瘤的临床病理学特征及鉴别诊断.方法 收集2例原发性脾血管肉瘤患者的临床病理资料,进行组织学形态、免疫组织化学染色,并复习相关文献.结果 患者男女各1例,年龄分别为55岁和64岁,其中1例表现为左上腹持续性绞痛;CT示脾内低密度占位性病变,1例伴脾破裂及骨、肝转移.镜下肿瘤与脾组织分界不清,呈浸润性生长;瘤细胞卵圆形、梭形,部分上皮样,呈血窦样、裂隙状生长,细胞异型明显,核分裂易见.免疫组化主要表达Vim、CD34、CD31和F8.结论 原发性脾血管肉瘤罕见且临床症状不典型,需与脾脏其它肿瘤相鉴别,确诊依靠其特征性的组织学形态和免疫组化标记.     

脾血管肉瘤1例报道

通过分析既往文献报道,结合我院收治的1例脾血管肉瘤患者的临床资料,整理出脾血管肉瘤的临床病理特点及临床诊治经验,以提高脾血管肉瘤的疗效。由于脾血管肉瘤缺乏特异性症状,诊断主要依靠影像学检查,多数病变在影像学上酷似海绵状血管瘤,确诊主要依靠病理及免疫组化检查,提示血管分化的免疫组化检测指标,如CD34、CD31、SMA、Vim、F8、UEA-1、CDl05、VEGFR3等至少两项为阳性;提示组织细胞分化的免疫组化检测指标,如CD68、CD8和S100蛋白等至少有一项为阳性。本病首选的治疗方法是脾脏切除,术后是否需要放化疗目前尚未有统一意见。     

磁共振检查对脾脏淋巴瘤的诊断价值

目的探讨磁共振检查对脾脏原发性淋巴瘤（PSL）的诊断价值。方法经手术病理证实的脾脏PSL患者3例,均采用磁共振检查,分析其影像学表现及诊断情况。结果3例手术后病理诊断均为B细胞型非霍奇金淋巴瘤,磁共振检查表现为多发肿块型2例,巨块型1例;磁共振平扫表现为脾脏不规则增大,呈等／稍长T1稍短T2信号巨大肿块影像,脾周围见线样长T1、长T2信号,脾门血管被包绕;增强扫描后,脾脏病变不均匀强化,呈等、低混杂信号,腹膜后病变呈中等均匀强化。免疫组化提示弥漫大B细胞型2例,肿瘤细胞CD20及CD19α弥漫（＋）、CD3、CD5散在（＋）、CD43（＋）、CD45RO（＋）、CD10（＋／-）、Mum（＋）、MAC387散在（＋）,B系淋巴浆细胞型1例,CD79eL（＋）、CD23（＋）、CD38（＋）、λ（＋）。结论PSL的磁共振表现具有特征性,有助于明确诊断,确诊依靠手术病理和免疫组化检查。     

骨原发上皮样血管肉瘤临床病理学分析

目的：探讨骨原发上皮样血管肉瘤（ PEAB）的临床病理特点。方法报道1例骨原发上皮样血管肉瘤临床资料、组织学及免疫组化染色结果及随访结果。结果该例骨原发上皮样血管肉瘤的临床症状为局部疼痛,查体发现局部压痛,镜下示上皮样肿瘤细胞排列成假腺样、乳头状,可见原始血管结构形成。免疫组化显示瘤细胞高表达CD31、CKpan、Vimentin,并表达CD34,而EMA、SMA、S-100、Myogenin及HMB45等均阴性。结论骨的原发上皮样血管肉瘤罕见,其组织结构极易被误诊为转移癌,诊断需结合临床及影像学资料,对组织病理学的详细观察及免疫组化染色的协助,对于正确诊断和鉴别诊断有重要意义。     

结直肠原发性粒细胞肉瘤临床病理分析及鉴别诊断

目的探讨结直肠原发性粒细胞肉瘤(GS)的临床病理学特征及鉴别诊断方法。方法分析20例结直肠原发性粒细胞肉瘤患者的临床表现、组织病理学特征和免疫组化,并在复习相关文献后进行临床病理分析和鉴别诊断总结。结果患者镜下观察肠壁中等大小的瘤细胞弥漫浸润,细胞核卵圆形或不规则,可见核仁,核分裂像不明显,中等量胞浆,有的胞浆嗜酸或纤细颗粒状。免疫组化:波形蛋白(Vim)、分化簇(CD)34、CD43、髓过氧化酶(MPO)、CD117、CD99、CD68、CD163均阳性,Ki67(+)为60%~70%。治疗结束36个月后,20例患者中有13例患者病症稳定,体内肿瘤细胞未出现扩散现象,有2例患者出现了肿瘤细胞转移的情况,剩下5例患者均死亡。结论粒细胞肉瘤缺乏特异性的临床表现,并且与多种肿瘤以及病灶部位的肿瘤病症具有一定的类似性,病理检测的准确率较低。粒细胞肉瘤若在早期得到诊断并进行早期全身的系统化疗,患者的生存率会获得明显的提高,因此,应当对体检或疑似患者进行巨检+镜检+免疫组化检测的方式进行病理检测,并着重观察MPO和CD68两项指标。     

孤立性纤维性肿瘤2例临床病理分析

目的探讨孤立性纤维性肿瘤（SFT）的临床病理学特征及诊断、鉴别诊断。方法对2例SFT行临床病理学分析及免疫组化研究。结果镜下见肿瘤由增生的梭形细胞或卵圆形细胞和胶原纤维组成,形成交替分布的丰富细胞区和疏松细胞区,并可见血管外皮瘤样结构,肿瘤细胞间血管丰富。免疫组织示CD34、CD99、Vimentin均（＋）,S-100、Desmin、SMA均（-）。结论孤立性纤维性肿瘤大部分为良性,少数可为恶性。完整手术切除是良好的预后因素。其诊断与鉴别诊断主要依据临床资料、组织学形态特征及免疫组化标记。     

肱骨变异类型软骨肉瘤的临床病理分析

目的探讨肱骨变异类型软骨肉瘤的临床病理特征、诊断及鉴别诊断要点。方法对1例肱骨变异类型软骨肉瘤的临床资料、影像学、组织学形态和免疫表型进行分析。结果左肱骨肿物的组织学镜下示瘤组织侵犯骨膜及骨髓腔,其中骨周肿块以粘液样软骨肉瘤为主,骨髓腔内可见分化好的软骨岛,血管外皮瘤样区和尤文氏瘤样区,组织学图像倾向于间叶性软骨肉瘤。免疫组化显示瘤细胞Vimentin、CD99、S-100阳性。结论肱骨变异类型软骨肉瘤较罕见,组织学形态表现多样,诊断较为困难。应认真观察HE染色切片,加以免疫组化标记辅助检查。其确诊有待临床、影像、组织形态学和免疫组化四结合。     

原发性中枢神经系统恶性淋巴瘤临床病理分析

目的：探讨原发性中枢神经系统恶性肿瘤的临床病理特点、诊断及鉴别诊断。方法：对10例原发性中枢神经系统恶性淋巴瘤进行临床资料分析及光镜和免疫组化研究。结果：临床上以颅内压高为主要症状,组织学特征：瘤细胞单一、异型、围绕血管呈套袖样排列,无滤泡形成；免疫组化：LCA、CD20或CD43阳性,CK、GFAP阴性,提示多为B细胞性。结论：原发性中枢神经系统恶性淋巴瘤有其独特的临床病理特点,需与其他颅内小圆形细胞肿瘤鉴别,光镜结合免疫组化染色可以确诊。     

乳腺原发性血管肉瘤误诊1例报道并文献复习

目的探讨乳腺血管肉瘤的临床病理特点、治疗和预后。方法对1例原发于乳腺的高分化血管肉瘤并再次复发进行组织形态学和免疫组化分析,并复习文献。结果乳腺血管肉瘤几乎均发生于女性,主要为20～30岁。临床表现不典型,组织学变化大,肿瘤通常CD31、CD34、UEA-1和F8（＋）,B72.3对上皮样血管肉瘤具有特异性。目前主要采取手术行单纯乳腺切除治疗,一般不主张腋窝清扫,术后放、化疗效果不肯定。结论乳腺原发性血管肉瘤较少见,肿瘤分化程度与预后密切相关。     

原发性脾脏占位性病变13例临床分析

目的探讨原发性脾脏占位性病变的临床特点和诊治体会。方法对13例原发性脾脏占位性病变的临床资料进行回颐性分析。结果13例原发性脾脏占位性病变全部经脾切除手术和病理确诊,良性10例,恶性3例;术后均痊愈出院。结论原发性脾脏占位性病变的定位诊断依靠影像学检查（B超、CT等）,定性诊断需病理确诊,本病宜及早手术,脾切除是基本术式。     

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.

     

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.     

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.     

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.     

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.