Ⅰ期非小细胞肺癌根治术后区域淋巴结微转移检出率与患者长期生存的关系

背景与目的:非小细胞肺癌(non-small cell lung cancer, NSCLC)根治术后常规病理学诊断无转移的区域淋巴结可通过免疫组织化学等方法检出微转移,其对预后可能产生影响.本研究检测NSCLC根治术后常规病理诊断无转移的区域淋巴结微转移,探讨微转移检出率与生存的关系.方法:收集我院1996年1月至2003年12月经根治术后常规病理证实为pT1～2NOMO的NSCLC 78例患者的肺门及纵隔淋巴结存检蜡块684份.选择广谱抗细胞角蛋白(cytokeratin, CK)抗体AEl/AE3,采用EnVision二步法检测CK的表达,结合临床资料分析其与预后的关系.结果:微转移检出率为26.9%(21/78),其中p- Ⅰ A、p- ⅠB期患者的检出率分别为5.9%(1/17)、32.8%(20/61).非微转移病例的1、3、5、8年生存率、中位生存期分别为90.80%、69.70%、55.76%、37.17%、87个月.微转移病例分别为60.00%、48.48%、29.09%、O.00%、23个月,差异有统计学意义(P=0.008).Cox回归分析表明CK、KPS为影响NSCLC患者生存的独立因素(P=0.014,P=0.000).术后放化疗组对比单纯手术组,放化疗干预有利于延长生存时间,但无统计学意义(P=0.063).结论:NSCLC淋巴结微转移可能随病情进展检出率增加,淋巴结微转移与患者长期生存相关.     

关节镜辅助复位内固定与切开复位内固定治疗胫骨平台骨折的疗效比较

目的:比较关节镜辅助复位内固定（ARIF）和切开复位内固定（ORIF）治疗胫骨平台骨折的疗效。方法:回顾性分析2016年1月至2018年8月华中科技大学附属协和医院骨科收治的75例胫骨平台骨折患者的资料。男58例,女17例;年龄20~54岁,平均47岁。左侧42例,右侧33例。骨折根据Schatzker分型：Ⅰ型23例...     

The kinase p38α functions in dendritic cells to regulate Th2-cell differentiation and allergic inflammation

Dendritic cells (DCs) play a critical role in controlling T helper 2 (Th2) cell-dependent diseases, but the signaling mechanism that triggers this function is not fully understood. We showed that p38α activity in DCs was decreased upon HDM stimulation and dynamically regulated by both extrinsic signals and Th2-instructive cytokines. p38α-specific deletion in cDC1s but not in cDC2s or macrophages promoted Th2 responses under HDM stimulation. Further study showed that p38α in cDC1s regulated Th2-cell differentiation by modulating the MK2−c-FOS−IL-12 axis. Importantly, crosstalk between p38α-dependent DCs and Th2 cells occurred during the sensitization phase, not the effector phase, and was conserved between mice and humans. Our results identify p38α signaling as a central pathway in DCs that integrates allergic and parasitic instructive signals with Th2-instructive cytokines from the microenvironment to regulate Th2-cell differentiation and function, and this finding may offer a novel strategy for the treatment of allergic diseases and parasitic infection.     

弥散张量成像揭示部分及全面发作癫痫患者的丘脑改变

目的分析部分发作(PS)及部分继发全面发作癫痫患者(SGC)脑弥散张量的改变情况。方法本研究纳入11例PS患者,11例SGC患者及15例正常对照者。弥散张量成像采集采用3.0T磁共振仪,用15个方向的单次激发平面回波序列。采集数据用DTI-Studio软件计算每个受试者表观弥散系数图,然后用基于体素(VBA)的方法进行分析,取校正后P<0.05为有意义区域。基于VBA的发现,本研究对双侧丘脑的表现弥散系数图(ADC)值进行感兴趣区(ROI)分析,采用SPSS 11.5统计软件包进行统计分析,以P<0.05为差异有统计学意义。结果VBA结果显示PS和SGC患者均存在双侧上纵束、胼胝体及双侧颞叶等区域白质ADC值的增加。但双侧丘脑ADC值增加只有在SGC患者才能观察到。ROI分析结果同样显示SGC患者双侧丘脑ADC值的增加。结论本研究结果支持皮质丘脑环路假说,即丘脑功能的异常导致继发全面癫痫的发作。     

Challenging surgical treatment of giant retroperitoneal liposarcoma: A case report

Liposarcoma is a rare malignant tumor type and surgical resection is the gold standard treatment. The present study reported on the case of a 51-year-old woman who presented with a mass in the left upper abdomen. Computed tomography revealed a 32-cm giant retroperitoneal liposarcoma. Complete tumor resection was performed without the removal of other organs. Postoperative pathological examination indicated retroperitoneal well-differentiated liposarcoma and immunohistochemistry revealed S-100(−), MDM2(+), vimentin(+), CDK4(+), p16(+) and STAT6(+) results. The patient recovered well after the surgery. Complete tumor resection during the first surgery is key to cure liposarcoma. The present case report will be helpful for clinical oncologists to fully understand giant retroperitoneal liposarcoma and treat it accordingly.     

剪切波弹性成像与FNA-Tg对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值

目的：探讨剪切波弹性成像(shear wave elastography,SWE)与细针穿刺洗脱液甲状腺球蛋白(fine-needle aspiration washout thyroglobulin,FNA-Tg)对甲状腺乳头状癌侧颈部淋巴结转移的诊断价值。方法：回顾性分析159例经病理证实为甲状腺乳头状癌(papillary thyroid carcinoma,PTC)的患者资料,对颈部211枚可疑淋巴结进行常规超声、SWE参数平均值(E_mean)、FNA-Tg检查,以术后病理结果为金标准,比较各检测方法的诊断效能。结果：(1)SWE E_mean转移组[(50.96±27.66) kPa]高于非转移组[(32.20±17.34) kPa],差异有统计学意义(t=8.761,P<0.01)。受试者工作特征(receiver operating characteristic,ROC)曲线分析表明,SWE E_mean最佳诊断阈值为40.42 kPa时对PTC颈部淋巴结转移预测价值较高,曲线下面积(area under...     

B cell lymphoma with IRF4 rearrangement: A clinicopathological study of 13 cases

Interferon regulatory factor 4 (IRF4) rearrangement is commonly detected in patients with a range of lymphoproliferative malignancies, including myelomas, large B cell lymphomas and low-grade B cell neoplasms. However, IRF4 rearrangement is generally a relatively rare finding in these latter two cancer types. In the present article, we describe and summarize the clinicopathological and genetic features of 13 cases of B cell lymphoma with IRF4 rearrangement, including 12 cases of large B cell lymphoma and one case of low-grade lymphoma exhibiting such rearrangement. These cases were detected in six females and seven males between 14 and 71 years of age. From a morphological perspective, large B cell lymphoma tumors included in this analysis exhibited large neoplastic cells in diffuse or follicular patterns, while the case of low-grade lymphoma mainly composed of small lymphocytes. All analyzed cases exhibited a split in the IRF4 gene consistent with IRF4 translocation. Three of six analyzed large B cell lymphoma cases harbored IGLL5 mutations. Mutations in SAMHD1 were detected in the low-grade lymphoma with IRF4 rearrangement case. In summary, our results offer further insight into the morphological and molecular heterogeneity of cases of B cell lymphoma exhibiting IRF4 rearrangements.     

Exploration of the relationship between tumor mutation burden and immune infiltrates in colon adenocarcinoma

Background: Tumor mutation burden (TMB) was correlated with the immunotherapeutic response in various malignancies. We aimed to evaluate the TMB immune signature in colon adenocarcinoma (COAD).Methods: Gene expression profile, mutation and clinical data of COAD patients were obtained from The Cancer Genome Atlas (TCGA) database. The samples were divided into high and low TMB level groups to identify differentially expressed genes (DEGs). Functional enrichments analyzes were performed to identify the biological functions of the DEGs. Then, immune cell infiltration signatures were calculated by the CIBERSORT algorithm. Finally, Cox proportional hazard model was constructed to estimate the prognostic value of the identified immune-related genes.Results: Gene set enrichment analysis in the high-TMB level group showed that DEGS were enriched in immune-related pathways, such as antigen processing and presentation, Toll-like receptor signaling and natural killer cell-mediated cytotoxicity. A higher infiltration level of CD8+ T cells, CD4+ T cells, activated NK cells , M1 Macrophages and T follicular helper cells was observed in the high-TMB level group. Furthermore, a Cox regression model combined with survival analysis based on the expression level of four identified prognostic genes was constructed, validated anf revealed that higher risk-score levels conferred poor survival outcomes in COAD patients.Conclusions: Our data demonstrate that the high TMB levels are associated with an immune signature in COAD and deepen the molecular understanding of TMB function in tumor immunotherapy.     

2016—2020年四川省五市饮用水源地放射性水平监测与分析

目的 了解四川省成都、宜宾、绵阳、广元、乐山五个重点市水源地的放射性水平,评价其水源地辐射水平的安全性。方法 于2016—2020年间对成都、宜宾、绵阳、广元、乐山五市饮用水源地进行布点、采样,并分析水中总α[参照《水中总α放射性浓度的测定厚源法》(EJ/T 1075-1998)]、总β[《水中总β放射性测定蒸发法》(EJ/T 900-1994)]、⁹⁰Sr[参照《水和生物灰中锶-90的放射化学分析方法》(HJ 815-2016)]、¹³⁷Cs[参照《水和生物样品样品灰中铯-137放射化学分析方法》(HJ 816-2016)]、²²⁶Ra[参照《水中镭-226的分析测定》(GB 11214-1989)]、U[参照《环境样品中微量铀的分析方法(3激光荧光法)》(HJ 840-2017)]、Th[参照《食品安全国家标准食品中放射性物质检验天然钍和铀的测定》(GB 14883.7-2016)]的放射性水平。结果 五市饮用水源地的总α放射性浓度范围值为0.011~0.076 Bq/L,总β放射性浓度范围值为0.027~0.098 Bq/L,¹³⁷Cs的放射性浓度范围值为0.21~0.45 mBq/L,⁹⁰Sr的放射性浓度范围值为1.0~2.4 mBq/L,²²⁶Ra的放射性浓度范围值为6.1~16.0 mBq/L,Th的放射性浓度范围值为0.06~0.21 μg/L,U的放射性浓度范围值为0.73~3.3 μg/L。不同水源地、不同年份之间的总α、总β、⁹⁰Sr、¹³⁷Cs、²²⁶Ra、U、Th放射性浓度之间的差异均无统计学意义(P>0.05),不同水期的总α、总β、⁹⁰Sr、¹³⁷Cs、²²⁶Ra放射性浓度之间的差异均无统计学意义(P>0.05)。不同水期的U放射性浓度差异有统计学意义(H=16.53,P<0.05),不同水期的Th放射性浓度差异有统计学意义(H=15.61,P<0.05)。结论 本次调查显示四川省成都、宜宾、绵阳、广元、乐山五个重点市饮用水源地的总α、总β、⁹⁰Sr、¹³⁷Cs、²²⁶Ra、U、Th放射性水平,与1995年国家环境保护局发布的《中国环境天然放射性水平》中的相关数据处于同一水平,均在生态环境部辐射环境监测技术中心发布的2013—2021年全国辐射环境监测质量报告的数据范围内,五个重点市的水源地放射性水平处于安全水平。