Cytological findings of appendiceal mixed adenoneuroendocrine carcinoma in pleural effusion: Morphological changes evident after metastasis

Goblet cell carcinoid (GCC) of the appendix is now regarded as a malignant tumor, and mixed adenoneuroendocrine carcinoma (MANEC) is a carcinoma progressing from GCC. We describe a man initially diagnosed with GCC of the appendix who died 4 years after diagnosis. Pleural fluid due to metastasis was noted in the terminal phase. Histological findings of the initial tumor indicated that cells with signet‐ring morphology were predominant, but the cytological morphology of the fluid was more atypical, making it difficult to diagnose as metastatic GCC by cellular morphology alone. The cells in the pleural fluid were immunopositive for synaptophysin, which was compatible with GCC, but p53 and ki67 staining indicated that the metastatic tumor was more aggressive. These findings suggested a final diagnosis of poorly differentiated adenocarcinoma‐type MANEC, which we define as a tumor with typical GCC characteristics and foci that cannot be distinguished from a poorly differentiated adenocarcinoma. This case, which we believe is reported here for the first time, indicates the cytological features of GCC cells may change at metastatic sites to be more atypical and aggressive as the tumor progresses, and these changes should be considered in diagnosis. Diagn. Cytopathol. 2015;43:577–580. © 2014 Wiley Periodicals, Inc.     

补阳还五汤及有效组分对大鼠增生血管内膜细胞外基质蛋白表达的影响

目的:探讨补阳还五汤有效组分生物碱和苷对大鼠主动脉球囊损伤后增生内膜中细胞外基质(ECM)及其调节因子基质金属蛋白酶-9(MMP-9)、组织基质金属蛋白酶抑制物-1(TIMP-1)表达的影响,揭示该方作用的物质基础及其机制。方法:大鼠随机分为假手术组、模型组、生物碱治疗组、苷治疗组、补阳还五汤原方治疗组和阿托伐他汀治疗组,以球囊导管损伤主动脉内膜后第2d开始灌胃给药,连续14d,未次给药后第2d(术后第16d)取胸主动脉损伤段,以免疫组化法测定增生内膜中Ⅰ型胶原(Col-Ⅰ)、纤维连接蛋白(FN)、层黏连蛋白(LN)和MMP-9、TIMP-1的表达。结果:(1)模型组Col-Ⅰ表达增强(P0.01);补阳还五汤原方治疗组、生物碱治疗组、苷治疗组和阿托伐他汀治疗组Col-Ⅰ表达显著低于模型组(P0.01)。模型组FN表达增强(P0.01);生物碱治疗组和阿托伐他汀治疗组FN表达强度显著低于模型组(P0.01)。而各组LN表达强度的变化差异均无显著(P0.05)。(2)模型组TIMP-1表达增强(P0.05);生物碱治疗可使TIMP-1表达降低(P0.05);而原方、苷和阿托伐他汀对TIMP-1表达的增强无显著影响(P0.05)。模型组MMP-9表达无显著变化(P0.05);生物碱治疗组、苷治疗组和阿托伐他汀治疗组MMP-9表达强度显著高于模型组(P0.05);而补阳还五汤原方治疗组MMP-9表达无显著变化(P0.05)。结论:补阳还五汤及其2种有效组分生物碱和苷可抑制增生内膜中Col-Ⅰ的表达,生物碱还可抑制FN的表达。生物碱和苷可增强MMP-9的表达,生物碱还可抑制TIMP-1的表达。提示补阳还五汤及其2种有效组分生物碱和苷可能通过抑制增生内膜中ECM的合成,促进ECM成分的清除和降解以对抗血管内膜增生。     

白头翁汤治疗宫颈癌放射性直肠炎临床观察

目的:探讨白头翁汤治疗宫颈癌放疗后放射性直肠炎有效性及恢复时间。方法:对98例子宫颈癌放疗后所致放射性直肠炎随机分为两组。一组配以白头翁汤(研究组)加以治疗,另一组不配以白头翁汤(对照组)加以治疗。比较两组治疗方法的总有效率和恢复时间。结果:研究组治疗的总有效率88.46%,恢复时间(8.35±2.03)d;对照组治疗的总有效率69.57%,恢复时间(13.56±2.16)d。结论:白头翁汤治疗放射性直肠炎有效率高,缩短了恢复时间。     

雌激素结合中药汤剂预防宫腔镜分离后宫腔粘连的疗效分析

目的：探讨雌激素结合中药汤剂预防官腔镜分离后宫腔粘连的疗效与安全性。方法：将40例宫腔镜电切术后患者随机分为治疗组和对照组，每组20例。对照组术后口服戊酸雌二醇预防官腔粘连，而治疗组在对照组基础上加用中药汤剂预防宫腔粘连。结果：治疗组与对照组的宫腔粘连发生率分别为10％（2／20）和30％（6／20），治疗组与对照组比较，官腔粘连的发生率明显减少（P〈O．05），并且治疗组术后官腔粘连的程度和范围均低于对照组；两组不良反应情况，治疗组发生不良反应1例，对照组无不良反应发生，两组比较，差异无统计学意义（P〉0．05）。结论：雌激素结合中药汤剂预防官腔镜分离后官腔粘连的疗效好，预防范围广，安全性强，值得推广应用。     

Using constrained optimal control to model a socially sustainable fishery

In the so‐called sole‐owner‐case of a renewable resource harvesting, it is known that the optimal policy includes a period with no harvesting, if the population is insufficiently small. Therefore, the fishermen have no income in this phase. To avoid this problem, the optimal control problem was enhanced in two different ways. First, the capital accumulation rate was bounded from below what generated a global mixed constraint. Second, lower bounds for the capital stock at a finite number of time points were introduced, which at first led to one and afterwards several isolated inequality constraints. For the resulting constrained optimal control problems, the necessary conditions were derived and an iterative algorithm was implemented to calculate the solutions in several numerical examples. Copyright © 2010 John Wiley & Sons, Ltd.     

补阳还五汤及有效组分生物碱和苷对大鼠血小板聚集及血小板环核苷酸的影响

目的探讨补阳还五汤及其有效组分生物碱和苷抗血小板聚集机制。方法大鼠分别给予补阳还五汤原方、生物碱、苷和噻氯匹定，进行ADP诱导的血小板聚集实验。取聚集前、后的血小板提取cAMP、cGMP，采用放免法检测血小板cAMP、cGMP。结果各组血小板聚集比较，生物碱组、苷组和噻氯匹定组血小板聚集强度与空白组相比显著降低（P〈0．01）。原方组血小板聚集强度与空白组相比显著降低（P〈0．05）。血小板聚集后cAMP含量降低（P〈0．01）．而原方、生物碱、苷和噻氯匹定均可抑制ADP诱导的血小板cAMP下降（P〈0．05，P〈0．01）。血小板聚集后cGMP含量降低（P〈0．01），原方、生物碱、苷和噻氯匹定也可抑制聚集后血小板cGMP下降（P〈0．05，P〈0．01）。结论生物碱、苷、原方和噻氯匹定可抑制ADP诱导的大鼠血小板聚集，各药可抑制血小板聚集后血小板内cAMP、cGMP的下降，提示其抗血小板聚集作用是通过抑制聚集后血小板内环核苷酸降低而实现的。     

微波法与传统法煎煮葛根芩连汤有效成分含量的比较

目的：研究微波法与传统法煎煮中药效果。方法：用微波法与传统法分别制取供试汤剂，用紫外分光光度法测定葛根芩连汤中有效成分盐酸小檗碱、总黄酮含量，以此含量及总固体量为考察指标，比较两种方法煎煮中药效果。结果：微波法与传统法煎煮效果相同（P〉0．05），但微波法与传统法相比有高效、节能、省时的优势。结论：微波煎煮法可代替传统煎煮法煎煮中药。     

益气通脉煎剂治疗冠心病心绞痛的临床疗效观察

目的:观察益气通脉煎剂治疗冠心病心绞痛的临床疗效及对患者血清血脂水平的干预作用。方法:将96例冠心病心绞痛患者随机分为2组:治疗组48例,服用益气通脉煎剂,每日1剂;对照组48例,服用冠心Ⅱ号,每日1剂。2组疗程均为4周。结果:治疗组缓解心绞痛临床症状及心电图改善的有效率均显著优于对照组(P<0.01或P<0.05);2组治疗后的血脂水平有显著性差异(P<0.05)。结论:益气通脉煎剂治疗冠心病心绞痛有较好临床疗效。     

同基因混合G-CSF动员的异基因骨髓移植物诱导的抗白血病效应

Objective:To explore whether the graft-versus-leukemia (GVL) effects could be enhanced and acute graft-versus-host disease (aGVHD) could be relieved by syngeneic bone marrow mixed with G-CSF-primed H-2 haploidentical marrow grafting.Methods:Female L615 (H-2k) mice were recipient mice and male (615×BALB/c) F1 (6BF1) (H-2k×H-2d) mice were donors respectively.Donor mice were injected subcutaneously with G-CSF daily at 0.01 μg/g for 6 days,and splenocytes were harvested on day 7.A total of 615 mice were loaded with L615 tumor cells and received 8.5 Gy (60Co γ-ray) irradiation three days later,followed by a mixed bone marrow transplantation (MBMT).The allo-grafts consisted of a mixture of syngenetic plus G-CSF-mobilized (control diluents) H-2 haploidetical marrow cells.GVL effects were monitored by survival time and survival rate of recipient mice.GVHD was assessed by clinical signs of weight loss,ruffled fur,diarrhea and histological changes of skin,liver and small intestines.Allogeneic chimerism was detected using cytogenetic analysis.Enzyme-linked immunosorbent assay (ELISA) method was used to detect cytokines (IL-2,IL-4 and IFN-γ).Fluorescence-activated cell sorting (FACS) analysis was used to detect T-cell phenotype.Results:(1) The mice merely received L615 leukemia cells were all died of leukemia.The L615 mice of 3∶1 and 4∶1 MBMT groups survived longer than those post syngeneic BMT (P＜0.01).(2) The survival time of mice in the G-CSF-treated MBMT groups was longer than that of non-primed MBMT groups (P＜0.05).Administration of G-CSF-treated 6BF1 mice could markedly increase the survival rate of 3:1 and 4:1 MBMT mice (P＜0.01) with little or a little GVHD.(3) As the post-transplanted time prolonged,the rates of allogeneic chimerism were decreased.The chimerism rates decreased to zero when the mice died of leukemia relapse.(4) L3T4 cells and relative ratio in both subsets were significantly reduced in G-CSF-treated donor mice.After G-CSF-treated donors,splenocytes from recipients at day 14 post-MBMT showed an increased production of IL-4 and a decreased production of IL-2 and IFN-γ.Conclusion:Syngeneic bone marrow mixed with H-2 haploidentical marrow grafts had a potential way to increase GVL effects,and this GVL effects could be enhanced with little or a little GVHD by G-CSF preetreatment of donors.Improved survival in recipients of G-CSF-mobilized donors is associated with increased IL-4 production and decreased IL-2 and IFN-γ production.     

粒细胞集落刺激因子减轻混合骨髓移植后移植物抗宿主病的实验研究

Objective: How to reduce the incidence and severity of acute graft-versus-host disease (aGVHD) is a crucial step to improve the overall survival of allogeneic bone marrow transplantation (allo-BMT). The low incidence of severe aGVHD observed in allogeneic peripheral blood stem cell transplantation (allo-PBSCT), which may be related to modulating immune function of T lymphocytes by granulocyte colony-stimulating factor (G-CSF) primed donors. The study aimed to explore whether aGVHD could be alleviated by syngeneic bone marrow mixed with G-CSF-mobilized H-2 haploidentical marrow grafting. Methods: Female BALB/c mice and neonatal BALB/c mice were recipients and male (BALB/c × C57BL/6)F1(BCF1) mice were donor mice respectively. Donor mice were injected subcutaneously with G-CSF daily at 0.01 μg/g body weight or saline for 6 days, and splenocytes were harvested on day 6. Spleen index (SI) represented GVHD in neonatal mice after the intraperitoneal injection of mixed spleen cells. Lethally irradiated (60Co, 8.5 Gy) adult mice were transplanted with a mixture of syngeneic plus G-CSF-mobilized (control diluents) H-2 haploidentical marrow cells. Survival time and survival rate of the recipients were observed after mixed marrow transplantation (MBMT). GVHD was assessed by observing signs of weight loss, ruffled fur, diarrhea and histological change of skin, liver and small intestines. Enzyme-linked immunosorbent assay (ELISA) method was used to detect cytokines (IL-2, IL-4 and INF-γ). Fluorescence-activated cell sorting (FACS) analysis was used to detect T cells phenotype. Results: (1) The neonatal mice subject to injection of 2:1 and 1:1 mixed spleen cells and H-2 haploidentical spleen cells all suffered from aGVHD. The severity of aGVHD in recipient mice receiving G-CSF-mobilized splenocytes was dramatically reduced. (2) The aGVHD signs and histological change were observed in most mice of 2:1 and 1:1 MBMT groups. However, the survival time of G-CSF-mobilized MBMT was longer than in control groups and these mice had signs of moderate GVHD. (3) L3T4 cells and relative ratio in both subsets was significantly reduced in G-CSF-treated donor mice. The total number of Thy1.2 and lyt2 cells was increased after G-CSF pretreatment of donors, but no statistical difference. (4) The supernatants from a primary MLR were collected at 48 h for cytokine measurement. The results showed an increased production of IL-4 and a decreased production of IL-2 and INF-γ after stimulating with concanavalin A for 48 h. Conclusion: The GVHD could be reduced using syngeneic bone marrow mixed with H-2 haploidentical marrow cells. The severity of aGVHD in recipient mice receiving G-CSF-mobilized splenocytes or marrow cells could be further moderated, which is associated with increased IL-4 production and decreased IL-2 and INF-γ production.