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目的 探讨记忆抱怨主诉(SMC)与客观认知功能、抑郁和肝郁证候的关系.方法 临床招募SMC组受试者95例,无SMC的对照组19例.计算简易智能精神状态检查量表(MMSE)评分、蒙特利尔认知评估量表北京版(MoCA)评分、汉密尔顿抑郁量表(HAMD)评分和肝郁证候评分.然后分别以SMC及记忆力自评得分(SMC-VAS)为因变量,回归分析影响记忆抱怨主诉的因素.结果 SMC组的MMSE和MoCA得分明显低于对照组(P<0.05),HAMD得分明显高于对照组(P<0.05).Logstic回归显示,MMSE分值越低,HAMD分值越高,SMC的可能性越大.线性回归显示,更低的MMSE得分、更高的HAMD得分、直系家属痴呆和独居预示着更差的记忆力自评.SMC组肝郁证相关症状积分、肝郁证诊断积分明显高于对照组(P<0.05).结论 SMC与客观认知水平和抑郁关系密切.肝郁症状与主观认知损害自评和客观认知表现关系密切,肝郁可能是SMC中医病机之一. 相似文献
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Rationale:Gastric adenocarcinoma of fundic gland (chief cell predominant type) (GA-FG-CCP) is a new, rare variant of gastric adenocarcinoma, which is characterized by mild nuclear atypia and specific immunohistochemical markers.Patient concerns:An 84-year-old Chinese man was referred to our hospital for endoscopic resection of a gastric lesion.Interventions:We performed endoscopic submucosal dissection, and successfully removed the lesion.Diagnosis:Esophago gastroduodenoscopy showed a slightly elevated lesion with a diameter of 22 mm in the posterior wall of cardia. Magnifying endoscopy with narrow band imaging revealed an abnormal microsurface and microvessels on the tumor surface. Endoscopic ultrasonography revealed a hypoechoic mass located in the first layer. The pathological diagnosis of the biopsy specimens indicated that the tumor was high grade intraepithelial neoplasia. The pathological diagnosis differed between the superficial and deeper part of the lesion. The superficial part was composed of a tubular structure with prominent atypia and was diagnosed as well differentiated intestinal adenocarcinoma. The deeper part was composed of a well-differentiated tubular adenocarcinoma mimicking the fundic gland cells, mainly the chief cells. The tumor cells showed mild nuclear atypia and was positive for pepsinogen-I (PG-I) and mucin-6 (MUC6). This deeper part was diagnosed as GA-FG-CCP.Outcomes:The tumor was successfully removed. This patient had no discomfort during the follow-up period (10 months).Lessons:We present a rare case of GA-FG-CCP coexisted with well-differentiated tubular adenocarcinoma. GA-FG-CCP exists in the deep mucosal layer and the muscularis mucosa, which could not be found under endoscopy, but could be discerned in pathology with mild nuclear atypia and special biomarkers. 相似文献
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Hirofumi Matsumoto Tomoshi Tsuchiya Koh-ichiro Yoshiura Tomayoshi Hayashi Shigekazu Hidaka Atsushi Nanashima Takeshi Nagayasu 《ACTA HISTOCHEMICA ET CYTOCHEMICA》2014,47(3):85-94
ATP-binding cassette (ABC) transporters are involved in chemotherapy resistance. Multidrug-resistance protein 8 (ABCC11/MRP8) is also involved in 5-fluorouracil (5-FU) metabolism. 5-FU and its derivatives are widely used in the treatment of gastrointestinal tract cancers, but little is known about the contribution of ABCC11/MRP8 to gastrointestinal tract and related cancers. Here, we report our investigation of ABCC11/MRP8 expression in normal and cancerous gastrointestinal tract tissues and reveal its novel role in the gastric mucosa. In tissue microarray and surgically resected cancer specimens, immunohistochemical (IHC) staining revealed significantly reduced expression of ABCC11/MRP8 in gastrointestinal tract cancers compared with other cancers. In contrast, strong ABCC11/MRP8 expression was observed in normal gastric mucosa. Additional immunofluorescence assays revealed co-localization of ABCC11/MRP8 and pepsinogen I in normal gastric chief cells. Quantitative PCR and Western blot analysis also revealed significant expression of ABCC11/MRP8 in fundic mucosa where the chief cells are mainly located. Furthermore, the ABCC11 mRNA-suppressed NCI-N87 gastric cancer cell line failed to secret pepsinogen I extracellularly. Thus, low expression of ABCC11/MRP8 is consistent with chemotherapeutic regimens using 5-FU and its derivatives in gastrointestinal tract cancers. Our results indicated a novel function of ABCC11/MRP8 in the regulation of pepsinogen I secretion in the normal gastric chief cells. 相似文献
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《Annals of physical and rehabilitation medicine》2020,63(2):116-122
BackgroundCognitive dysfunction is common in multiple sclerosis (MS). Deficits can affect attention, concentration, planning, and memory. They can have severe functional consequences in many domains. Cognitive complaints are frequently associated with other confounding factors (fatigue, anxiety, depression, or treatment side effects). In most cases, cognitive assessment is proposed after a spontaneous complaint, but determining the extent of discomfort perceived by the patient, the influence of coexisting factors, or the optimal timing for a more complete neuropsychological assessment is difficult.ObjectiveThe objective of this work was to evaluate the feasibility and relevance of a fast global assessment of both objective and subjective cognitive dysfunction in MS.MethodsMS patients underwent a brief cognitive assessment including 7 visual analogue scales (VASs) asking about the patient's subjective level of discomfort in various domains, a memory test (Barbizet's lion story), a commonly used test of information processing speed (Symbol Digit Modalities Test [SDMT]) and self-reporting questionnaires for fatigue and mood (Fatigue Severity Scale [FSS] and Hospital Anxiety and Depression Scale [HADS]). Spearman correlation coefficients among scores were estimated.ResultsThe mean age of the 73 patients included was 48.3 (SD 11.1) years; 78% were females and 52.8% had the remittent-recurrent MS form, 8.3% the primary progressive form, and 38.9% the secondary progressive form. In less than 20 min, this brief cognitive assessment was able to identify symptoms and quantify discomfort level. Symptoms of fatigue and anxiety frequently coexisted with cognitive complaints. We found modest correlations between scores on the VAS fatigue and the FSS and between scores on the VAS mood and the HADS. Analytical evaluation revealed that most patients had similar SDMT and recall profiles; however, a small proportion showed a dissociation between these 2 tests, which validated the inclusion of both tests in the assessment. Accounting for coexisting factors (e.g., anxiety and fatigue) and their functional repercussions is essential for prioritizing these problems within the context of multidisciplinary patient treatment.ConclusionConsidering the possible multifactorial character of cognitive dysfunction in MS, it is essential to ask patients about their experiences and to take into account cognitive complaints in the follow-up of patients. The assessment tool we propose is simple and easy to use in a clinical setting and provides the information necessary for requesting (or not) a more complete neuropsychological assessment. 相似文献
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Tatsuo Tomita 《Endocrine pathology》1999,10(2):145-156
Parathyroid glands (PGs) contain less secretory granules with presumably less stored parathyroid hormone (PTH) than many other
endocrine glands. Immunocytochemical staining for PTH has been hindered by the lack of commercially available, reliable antibodies
against human PTH. By treating deparaffinized tissue sections with an antigen-retrieval procedure, immunocytochemical staining
for PTH and chromogranin A (CHA) was performed using commercially available monoclonal antibodies to investigate the functional
activity of hyperfunctioning PGs, including chief cell hyperplasia (CCH), adenoma, and carcinoma, compared with that of normal
PGs. In normal PGs, PTH and CHA immunostaining was diffusely granular in the chief cell cytoplasm, but was weak in oxyphil
cells. The immunostaining in hyperfunctioning PGs was less dense in CCH, and adenomas were less intensely stained than the
densely stained peripherally located normal rim. The one carcinoma case studied showed less staining at the periphery and
in the mid-portion of the tumor. Thus, immunocytochemical staining for PTH and CHA provides further information on stored,
immunoreactive PTH status and will improve functional analysis of hyperfunctioning parathyroid glands. 相似文献
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Ryoji Kushima Shigeki Sekine Akiko Matsubara Hirokazu Taniguchi Masahiro Ikegami Hitoshi Tsuda 《Pathology international》2013,63(6):318-325
Gastric adenocarcinoma of the fundic gland type (GAFG) and pyloric gland adenoma (PGA) have recently been recognized as rare types of neoplasia. We performed comparative immunohistochemical and genetic analyses of 3 GAFGs and 12 PGAs. All of the 3 GAFGs were diffusely positive for pepsinogen‐I, MIST1 and MUC6, indicating the predominantly chief cell/mucous neck cell differentiation of these tumors. A small number of H.K‐ATPase‐positive parietal cells were also scattered. PGAs invariably exhibited diffuse MUC6 and TFF2 expression, consistent with the pyloric gland differentiation of these tumors. Ten of the 12 PGAs also unexpectedly exhibited focal expression of pepsinogen‐I and MIST1, suggesting that PGAs often show focal chief cell differentiation and phenotypically resemble mucous neck cells rather than pyloric glands. The mutation analyses revealed activating GNAS mutations, which have been reported to be frequently detected in PGAs, in two of the GAFGs. While GAFGs and PGAs are morphologically distinct lesions, our observations showed their partially overlapping immunohistochemical profiles and shared presence of GNAS mutations, in addition to their common occurrence in the fundic gland mucosa. Based on these observations, we suggest that both GAFGs and PGAs are closely related lesions characterized by a mucous neck cell/chief cell lineage phenotype. 相似文献