夏枯草口服液治疗乳腺增生症的临床及超声观察

目的观察肝郁气滞证乳腺增生病经夏枯草口服液治疗前后的临床及彩色超声图像变化。方法选择120例符合肝都气滞证乳腺增生患者作为研究对象,治疗前后均进行临床症状及彩色超声图像采集,对临床疗效与声像图变化进行统计学分析。结果治疗后,临床有效率为83．33％,且有效患者的收缩期峰值流速、导管直径和肿块最大径、腺体厚度在治疗前后的变化有显著性差异（P〈0．01）。结论夏枯草口服液治疗肝郁气滞证乳腺增生症临床疗效显著,超声声像图部分指标在治疗后亦有相应改善。     

Ex vivo perfusion of human lymph nodes†

In a recent study published in The Journal of Pathology, Barrow-McGee et al described a feasibility study of a real-time ex vivo perfusion model of the axillary lymph nodes (ALNs) from breast cancer patients for immune-oncological investigations. The study showed that perfused ALNs remain viable for up to 24 h, and perfusion of therapeutic antibodies confirmed the ability to reach ALN-resident cells. This work is a highly encouraging demonstration of feasibility for further research into lymphatic system function, with applications to immune function, vaccinations, and cancer. © 2020 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of Pathological Society of Great Britain and Ireland.     

肿瘤间质比和肿瘤浸润淋巴细胞对淋巴结转移乳腺癌预后的影响

目的探讨肿瘤间质比(tumor-stroma ratio,TSR)和肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TIL)对淋巴结阳性非特殊型浸润性乳腺癌预后的影响。方法采用HE染色法评估260例乳腺原发癌和相应淋巴结转移癌中TSR和原发癌中的TIL对患者预后的影响。结果乳腺原发癌中TSR≥50%(低间质组)148例,TSR<50%(高间质组)112例,低间质组患者总生存率和无瘤生存率明显高于高间质组(P均<0.05);TIL低表达组(TIL<10%)155例,高表达组(TIL≥10%)105例,两组患者总生存率和无瘤生存率差异无统计学意义(P均>0.05)。淋巴结转移癌中TSR≥50%(低间质组)163例,TSR<50%(高间质组)97例,低间质组患者无瘤生存率明显高于高间质组(P<0.05);原发癌和淋巴结转移癌同为低间质组时,原发癌低间质组提示预后更好(P<0.05)。原发癌与淋巴结转移癌中TSR呈明显的正相关(r=0.726,P<0.01)。原发癌低间质组中TIL的表达对预后影响,差异无统计学意义(P均>0.05);高间质组中TIL高表达组无瘤生存率明显高于TIL低表达组(P=0.012)。患者总生存率和无瘤生存率与年龄、肿块直径、组织学分级和阳性淋巴结个数无关(P均>0.05)。结论TSR是判断淋巴结转移的乳腺癌患者预后重要指标,且在原发癌和转移癌之间呈正相关,但原发癌TSR对判断预后更有意义。联合TSR和TIL分析,可为淋巴结阳性的乳腺癌患者预后和临床治疗提供帮助。     

早期子宫内膜癌诊疗研究

多数子宫内膜癌早期可有症状,根据发病的危险因素、临床症状、体征、辅助检查及术中的相关手段进行评估,及早发现并治疗,预后良好。低危患者实施淋巴结的切除,对其预后可能无影响,还可能增加术中及术后并发症。而子宫内膜癌淋巴结转移的特征为跳跃性转移,术前诊断存在局限性,手术病理分期仍是评估其转移状态的最佳方法,并为其预后及辅助治疗提供了一定的帮助。本文就子宫内膜癌的诊断及淋巴结切除指征、手术、预后及保留生育功能的治疗作一综述。     

乳腺癌前哨淋巴结活检术中不同染色淋巴结与肿瘤转移的关系

目的探讨乳腺癌前哨淋巴结活检术(SLNB)中不同染色情况的淋巴结与肿瘤转移的关系。方法选择我院2014年1月至2018年1月行前哨淋巴结活检的乳腺癌患者92例,以亚甲蓝为示踪剂,根据92例乳腺癌患者SLNB中淋巴结染色情况的不同分为无染色组、完全染色组和染色不均组,病理检测3组患者淋巴结的肿瘤转移情况并作比较。结果92例乳腺癌SLNB共取得淋巴结256枚,平均每例患者2.8枚,无染色组(80枚)肿瘤转移率为13.8%,完全染色组(112枚)肿瘤转移率为43.8%,染色不均组(64枚)肿瘤转移率为62.5%,3组间肿瘤转移率差异有统计学意义(P<0.05)。结论乳腺癌SLNB中染色不均的淋巴结最易出现肿瘤转移,其次为完全染色的淋巴结,染色淋巴结附近看到的未染色淋巴结也有肿瘤转移的可能,宜一并切除送检,有利于降低假阴性率。     

Cytomorphology of glioblastoma metastic to a cervical lymph node diagnosed by fine needle aspiration (FNA): A case report and review of literature

Glioblastoma is an aggressive primary central nervous system tumor with a dismal prognosis. However, extracranial metastases are extremely rare. Very few cases have been reported in the literature. We present a case of a 64‐year‐old male with glioblastoma metastatic to a cervical lymph node in which the diagnosis was made on fine needle aspiration cytology (FNAC). The cytomorphologic features of glioblastoma are distinct, with pleomorphic cells in loosely cohesive clusters with prominent nucleoli, coarsely clumped chromatin and cellular processes. We suggest that FNAC, along with clinical history, is a cost effective, safe, and diagnostically accurate method of diagnosing glioblastoma metastases. Cell block is also helpful in establishing the diagnosis.     

Extramedullary multiple myeloma involving the liver and periportal lymph node,diagnosed by EUS‐FNA in a patient with cirrhosis

Extramedullary multiple myeloma (EMM) involving the liver as a focal space‐occupying lesion is very rare, especially in the patients with cirrhosis. Here, we report a case of EMM in the liver and periportal lymph node, diagnosed by endoscopic ultrasound guided‐fine‐needle aspiration (EUS‐FNA). A 57‐year‐old male patient, with history of cirrhosis, presented with abdominal pain and pancytopenia. The abdominal magnetic resonance imaging (MRI) demonstrated a 6.5 cm left hepatic mass with a 1.1 cm malignant‐appearing periportal lymph node and diffuse osseous lesions. The cytology specimens from the hepatic mass and the periportal lymph node were obtained through EUS‐FNA without rapid on‐site evaluation (ROSE). The thin‐layer preparations (ThinPrep) showed abundant plasmacytoid cells, which were confirmed to be Kappa‐restricted neoplastic plasma cells by the cell block preparations. Later, his serum level of Kappa light chain was found significantly elevated by flow cytometry, which was identified as monoclonal IgA Kappa light chain by serum protein electrophoresis (SPEP) with immunofixation. The patient was diagnosed as IgA multiple myeloma with extramedullary involvement of the liver and periportal lymph node. This is the first case showing the ThinPrep cytomorphologic features of EMM in the liver and periportal lymph node. This case highlights the importance of distinguishing plasma cells from being hepatocytes and lymphocytes on the ThinPrep and also emphasizes the utility of the cell block in the diagnosis of plasma cell neoplasm.     

Treatment of left-sided extension of AV node: A valuable integration of advance imaging modalities and cryoablation

We present a case of successful cryoablation of the left extension of the atrioventricular (AV) node for treatment of a recurrent atrioventricular nodal reentry tachycardia without the use of fluoroscopy. Three-dimensional electroanatomic mapping system and intracardiac echocardiography were used to navigate catheters in the heart and position them according to anatomical landmarks. Due to the nature of cryoablation lesion formation, lesions were able to be applied safely in right atrium, as well as in left atrium, without damaging AV node or bundle of His.     

Exogenous normal lymph reduces liver injury induced by lipopolysaccharides in rats

The liver is one of the target organs damaged by septic shock, wherein the spread of endotoxins begins. This study aimed to investigate the effects of exogenous normal lymph (ENL) on lipopolysaccharide (LPS)-induced liver injury in rats. Male Wistar rats were randomly divided into sham, LPS, and LPS+ENL groups. LPS (15 mg/kg) was administered intravenously via the left jugular vein to the LPS and LPS+ENL groups. At 15 min after the LPS injection, saline or ENL without cell components (5 mL/kg) was administered to the LPS and LPS+ENL groups, respectively, at a rate of 0.5 mL/min. Hepatocellular injury indices and hepatic histomorphology, as well as levels of P-selectin, intercellular adhesion molecule 1 (ICAM-1), myeloperoxidase (MPO), and Na⁺-K⁺-ATPase, were assessed in hepatic tissues. Liver tissue damage occurred after LPS injection. All levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in plasma as well as the wet/dry weight ratio of hepatic tissue in plasma increased. Similarly, P-selectin, ICAM-1, and MPO levels in hepatic tissues were elevated, whereas Na⁺-K⁺-ATPase activity in hepatocytes decreased. ENL treatment lessened hepatic tissue damage and decreased levels of AST, ALT, ICAM-1, and MPO. Meanwhile, the treatment increased the activity of Na⁺-K⁺-ATPase. These results indicated that ENL could alleviate LPS-induced liver injury, thereby suggesting an alternative therapeutic strategy for the treatment of liver injury accompanied by severe infection or sepsis.