前列腺基底细胞增生的诊断与鉴别

目的：探讨前列腺基底细胞增生的诊断及鉴别，以免误诊为癌。方法：选择原诊断有疑义的６ 个中国病例，应用组织病理学和免疫组化标记方法观察。结果：没有不典型增生，５ 例３４βＥ１２ 全部强阳性。结论：此病变需与不典型增生、上皮内瘤、腺癌、腺病和腺体萎缩鉴别     

The role of Toll‐like receptors in periodontitis

Periodontitis is a common infectious disease. Recent studies have indicated that the progression of periodontitis may be regulated by interactions between host immunity and periodontopathic bacteria. Although periodontopathic bacteria can destroy periodontal tissue, a dysfunctional host immune response triggered by the bacteria can lead to more severe and persistent destruction. Toll‐like receptors (TLRs), a type of pattern recognition receptor (PRR) that recognizes pathogens, have been implicated in host innate immune responses to periodontopathic bacteria and in the activation of adaptive immunity. TLR‐targeted drugs may hold promise to treat periodontal disease. This review summarizes recent studies on the role of TLRs in periodontitis and discusses areas needing further research. We believe TLRs may be an effective biomarker for the prevention, diagnosis, and treatment of periodontitis in the near future.     

Kartagener's syndrome: A re-visit with Chinese perspectives

Abstract The objective of this study was to evaluate the clinical, radiological investigation profiles, and ciliary function and ultrastructure in Chinese patients with Kartagener's syndrome (presence of dextrocardia, sinusitis and bronchiectasis). All patients with dextrocardia were assessed for the presence of sinusitis and bronchiectasis in our hospital network. Patients identified with Kartagener's were assessed when they were at steady state for their bronchiectasis. Seven cases (4 males; mean age 34.9 years) were identified and systematically reviewed. The mean 24 h sputum volume was 26.6±32.77 mL/day and the patients suffered from a mean of 2.9 exacerbations/year. Nasal symptoms (anosmia in one, obstruction in six and persistent discharge in three patients) were common. Only two cases (1 M) were married and both had normal fertility. Lung function assessment showed a mean FEV₁/FVC of 83.3±38.78/86.5±36.72 (% predicted) with little reversibility. High resolution computerized tomography (HRCT) revealed bronchiectactic involvement of the lower lobes in seven and middle lobe/lingula in four cases. Assessment of α-1-anti-trypsin, aspergillus precipitins, auto-antibodies and serology for Pseudomonas pseudomallei was normal. Sputum culture yielded Pseudomonas aeruginosa in three, Haemophilus influenzae in three and commensals in one case. Phase contrast microscopy assessment of respiratory cilia, obtained by brushing the inferior turbinate, revealed that most of the mucosa was unciliated. The mean ciliary beat frequency was 5.2 ± 6.76 Hz (range 0–13.7; normal range 12–18 Hz). Four patients had immotile cilia whilst the rest had normal ciliary movement. Transmission electron microscopy showed the absence of dynein arms in four patients. The results of this study show that patients with Kartagener's syndrome may have normal ciliary ultrastructure and the absence of dynein arms is not necessarily associated with ciliary immotility. The presence of ciliary immotility might have prognostic value as these patients appear to have more active bronchiectasis. Our experience on this series should help clinicans in the investigation and management of these patients.     

Interracial differences in prostate cancer progression among patients from the United States, China and Japan

Although previous studies indicate interracial differences in prostate can-cer epidemiology based on gene expression profiles among patients from the United States, China and Japan, evidence at the ge- netic and phenotypic levels that these diffe-rences exist and manifest along ethnic lines has been sparse. Recent studies, however, suggest that genetic differences, such as the lower incidence of Chinese pros-tate cancers harboring TMPRSS2-ERG translocations compared to patients from Western countries, should be carefully con-sidered in the context of genotypic and phenotypic differences among interracial groups. New, more efficient technologies need to be developed to validate genetic, gene expression and/or phenotypic differ-ences associated with prostate cancer tissue specimens obtained from interracial groups, to establish reliable clinical standards that take racial/ethnic data into account to improve the diagnosis, prognosis and treat-ment of patients with prostate cancer.     

Palliative enteral feeding for patients with malignant esophageal obstruction: a retrospective study

Background

Malignant esophageal obstruction leads to dysphagia, deterioration in quality of life, and malnutrition. Traditional bedside nasogastric (NG) tube placement is very difficult under these circumstances. However, endoscopically assisted NG tube placement under fluoroscopic guidance could be an alternative option for establishing palliative enteral nutrition. This study aimed to compare the clinical outcomes of enteral tube feeding and esophageal stenting for patients with malignant esophageal obstruction and a short life expectancy.

Methods

Thirty-one patients were divided into 3 groups according to their treatment modality: NG tube (n?=?12), esophageal stent group (n?=?10), and supportive care with nil per os (NPO) (n?=?9). Enteral nutrition, clinical outcomes, length of hospital stay, and median survival were evaluated.

Results

There were no significant baseline differences among the groups, except in age. The tube and stent groups had significantly higher enteral calorie intake (p?=?0.01), higher serum albumin (p?<?0.01), shorter hospital stay (p?=?0.01), and longer median survival (p?<?0.01) than the NPO group. The incidence of dislodgement in the tube group was significantly higher than in the stent group (58 % vs. 20 %, respectively; p?=?0.01). However, stenting costs more than NG tube placement.

Conclusions

Palliative enteral feeding by NG tube is safe, inexpensive, and has a low complication rate. Endoscopically assisted NG tube placement under fluoroscopic guidance could be a feasible palliative option for malignant esophageal obstruction for patients who have a short life expectancy.