川芎嗪注射液联合西药治疗急性脑梗死随机平行对照研究

[目的]观察川芎嗪注射液联合西药治疗急性脑梗死疗效。[方法]使用随机平行对照方法,将100例住院患者按病志号抽签法简单随机分为两组。阿司匹林、清除脑自由基、脑细胞活化剂、血管内皮保护剂;颅内高压甘露醇或甘油果糖等脱水剂。对照组50例丹参注射液30mL+0.9%氯化钠250mL,1次/d,静滴。治疗组50例川芎嗪240mg+0.9%氯化钠250mL,1次/d,静滴。连续治疗14d为1疗程,间隔5d后行第2个疗程。观测临床症状、爱丁堡-斯堪的那维亚评分(MESS)、总胆固醇、同型半胱氨酸、血小板聚集率、纤维蛋白原、不良反应。连续治疗2疗程,判定疗效。[结果]治疗组治愈18例,有效16例,显效11例,无效3例,恶化1例,总有效率92.00%。对照组治愈14例,有效12例,显效10例,无效10例,恶化4例,总有效率72.00%。治疗组疗效优于对照组(P0.05)[结论]川芎嗪注射液联合西药治疗急性脑梗死效果显著,值得推广。     

Increased phosphorylated CREB1 protein correlates with poor prognosis in clear cell renal cell carcinoma

BackgroundThis study aims to investigate the level of cAMP response element-binding protein 1 (phospho S133) (p-CREB1) protein in clear cell renal cell carcinoma (ccRCC) and evaluates its prognosis significance.MethodsImmunohistochemistry (IHC) method was performed to detect p-CREB1 staining in 233 ccRCC patients. Three or more high-power fields per tissue section were equally captured by a Leica DMRXA microphotographic system, and average staining intensity (optical density, OD) was analyzed by Leica Qwin Standard V2.6 system. Univariate and multivariate Cox proportional regression model was performed to assess the correlation of p-CREB1 staining and clinical outcomes.ResultsIHC proved that the level of p-CREB1 protein was significantly higher in tumor tissues than in adjacent normal tissues, and gradually increased from normal to tumor sections. On the basis of the receiver operating characteristic curve, patients were divided into low p-CREB1 staining (OD ≤0.28) and high p-CREB1 staining subgroup (OD >0.28) according to p-CREB1 protein staining intensity of tumor cells. Multivariate analyses showed that high p-CREB1staining was an independent risk factor for cancer-specific free survival, overall survival and progression-free survival.Conclusionsp-CREB1 protein is an independent prognostic biomarker for ccRCC patients.     

Primary clear cell meningioma of the orbit mimicking a metastatic carcinoma: usefulness of immunohistochemistry and cytogenetic analysis

Clear cell meningiomas (CCM) are rare tumors of the nervous system that usually occur in young patients and display high recurrence rates and potentially aggressive behavior. In this report, we describe a primary CCM of the orbit in an 84-year-old man with a previous history of a clear cell carcinoma of the kidney. Histologically, the tumor demonstrated a sheet-like proliferation of clear polygonal cells. Differential diagnosis includes metastasis of clear cell carcinomas. Immunohistochemistry, by showing that tumor cells expressed vimentin, epithelial membrane antigen, and progesterone antigens, and cytogenetic analysis, by identifying a monosomy 22, confirmed the diagnosis of CCM.     

鼻腔原发性透明细胞癌1例报告并文献复习

目的探讨鼻腔原发性透明细胞癌的临床病理特点和鉴别诊断要点。方法结合文献对1例鼻腔透明细胞癌的临床资料、病理特征、免疫表型及治疗预后进行分析。结果典型的组织学特征表现为多边形上皮样瘤细胞组成,排列成巢状,由富含薄壁毛细血管的纤维组织分隔。瘤细胞大小不一,胞质丰富透亮,呈空泡状,核小,核分裂罕见。免疫组化:肿瘤细胞显示EMA(+)、CKpan(+)、CD10(-)、CK7(-)、HMB45(-)、S-100(-)、Calponin(-)、SMA(-)、GFAP(-)、TG(-)。结论鼻腔原发透明细胞癌是罕见的肿瘤,其诊断和鉴别诊断主要依靠病理组织学、免疫组织化学。     

Evaluation of BPA uptake in clear cell sarcoma (CCS) in vitro and development of an in vivo model of CCS for BNCT studies

Clear cell sarcoma (CCS), a rare malignant tumor with a predilection for young adults, is of poor prognosis. Recently however, boron neutron capture therapy (BNCT) with the use of p-borono‐L‐phenylalanine (BPA) for malignant melanoma has provided good results. CCS also produces melanin; therefore, the uptake of BPA is the key to the application of BNCT to CCS. We describe, for the first time, the high accumulation of boron in CCS and the CCS tumor-bearing animal model generated for BNCT studies.     

Pediatric clear cell sarcoma of the kidney with cavoatrial thrombus

Clear cell sarcoma of the kidney (CCSK) is a rare renal tumor. Only 4 cases of CCSK with vascular thrombus have been reported, and 2 of these were pediatric cases. One of the children had an intraatrial thrombus as well. We describe a 3-year-old boy who was diagnosed as having a Wilms tumor but did not respond to preresection chemotherapy. He underwent complete resection of the tumor under cardiopulmonary bypass. Histologic examination indicated that the tumor was a CCSK. The patient was then managed with appropriate chemotherapy and radiation therapy and is well 16 months after diagnosis.     

肾透明细胞癌不同CT影像学征象对患者术后康复情况的影响

目的探究肾透明细胞癌不同CT影像学征象对患者术后康复情况的影响。方法选取2010年1月到2014年4月我院收治的50例肾透明细胞癌患者的CT征象,进行T分期,并分析不同CT征象与患者预后关系。结果利用CT征象进行T分期区别主要在T3a期,T3a期分为T3a-CT(10例)和T3a-仅病理(6例),T3a-仅病理CT分期可分为T1期2例,T2期4例;单因素分析显示,肿瘤大小、肿瘤是否侵及肾被膜外、是否侵及肾窦集合系统、是否侵及肾静脉及分支、是否侵及下腔静脉、有无广泛性坏死、是否存在囊性改变、瘤周是否受侵、瘤周是否存在新生血管与5年生存率具有一定相关性(P<0.05);多因素回归分析显示,肿瘤≥7cm、肿瘤穿透肾被膜、肾静脉及分支受侵、下腔静脉受侵、肿瘤无囊变、瘤周受侵及瘤周新生血管是影响肾透明细胞癌预后的独立危险因素(P<0.05)。结论肾透明细胞瘤患者肿瘤大于7cm、肿瘤穿透肾被膜、肾静脉及分支受侵、下腔静脉受侵、肿瘤无囊变、瘤周受侵及瘤周新生血管是影响肾透明细胞癌预后的独立危险因素,肿瘤周围受侵及瘤周新生血管形成可降低患者5年生存率,而肿瘤囊变可作为预测术后康复情况较好的标志之一。