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1.
BackgroundSinonasal mucosal melanoma (SNMM) is a rare tumour with a poor prognosis. The purpose of this study was to identify independent predictors of outcome in SNMM and to examine the expression of PD-L1 and the relationship between expression and clinicopathological characteristics.MethodsA total of 117 patients with SNMM were reviewed in the Department of Pathology of Beijing Tongren Hospital (115 cases) and Beijing Chuiyangliu Hospital (2 cases) from June 2007 to June 2018. We evaluated the expression of PD-L1 in SNMM and investigated whether there was an association between the expression of the marker and clinicopathological characteristics.ResultsSex, age, side, location, size, histological type, melanin particles, nuclear fission and tumour infiltrating lymphocytes (TILs) were not significantly related to survival. The median survival times at the T3, T4a, and T4b stages were 23, 19, and 6 months, respectively. The difference between overall survival (OS) and AJCC stages was statistically significant. The tumour cells (TCs) were PD-L1 positive in 14/117 (12.0%) cases, and tumour-associated immune cells (ICs) were PD-L1 positive in 23/117 (19.7%) cases. A statistically significant correlation was observed between the positive expression rate of PD-L1 in ICs and TILs grading; however, there was no significant correlation between the positive expression rate of PD-L1 in TCs and TILs grading.ConclusionThe AJCC stages were the only independent predictors of survival. There was no correlation between the positive expression rate of PD-L1 and OS. A statistically significant correlation was observed between the positive expression rate of PD-L1 in ICs and TILs grading.  相似文献   
2.
刘兰秋  赵越 《中国全科医学》2022,25(19):2320-2324
21世纪的日本"少子高龄化"特征明显,发展居家安宁疗护、构建完备的居家安宁疗护服务体系,是日本卫生服务提供体制改革的重要方向。本文介绍了日本居家安宁疗护的含义与理念,以及关于居家安宁疗护服务提供机构、提供人员、提供内容及费用保障的法律规定,提示我国在条件成熟时应尽快健全安宁疗护相关立法,在卫生服务提供体系框架下实现居家安宁疗护的稳定发展,建立并强化安宁疗护过程中的协作机制,并为居家安宁疗护提供必要的经费保障,通过完善的制度设计保障老年人"居家善终"的权益。  相似文献   
3.
BackgroundFocal liver lesions with spindle cell morphology are rare in the daily practice of pathology. The differential diagnosis is broad, including both tumors and tumor-like lesions. Initial radiologic assessment is sometimes inaccurate. Histopathology is needed to arrive at the correct diagnosis. This study analyzed discrepancies between histopathology and radiologic findings of focal liver lesions with spindle cell morphology.MethodsA six-year retrospective analysis was conducted at a tertiary hospital in Thailand. All focal liver lesions with spindle cell morphology were retrieved. Clinicopathologic features of these cases were analyzed. The pathological diagnosis was rendered primarily based on routine histopathology, using other ancillary studies as an adjunct.Results287 biopsies and 151 resection specimens with focal liver lesions were identified. In 12 (2.7%) cases, tumors or tumor-like lesions with spindle cell morphology were retrieved. A total of five cases had discrepancies between histopathology and radiologic findings. These lesions encompassed primary liver tumors (EBV-associated smooth muscle tumor and leiomyosarcoma); metastatic tumors (gastrointestinal stromal tumor, small cell neuroendocrine carcinoma); and a tumor-like lesion (endometriosis). Several morphologic findings (i.e., cytologic grades, dense and loose areas, intratumoral lymphocytes, distinct perinuclear vacuoles, and hemosiderin) are important clues to diagnose these spindle cell lesions.ConclusionsPathologists play a critical role in diagnosing focal liver lesions with spindle cell morphology, particularly those with limited clinical data at the initial presentation. A thorough evaluation of histomorphology on routine hematoxylin and eosin-stained slides is essential for correct diagnosis.  相似文献   
4.
背景 严重精神障碍发病报告制度作为精神卫生监测的重要一环已运行实施多年,实施效果需要进一步探知。 目的 分析北京市三类精神卫生医务人员对严重精神障碍发病报告制度重要性、主要作用、实施效果、存在问题及完善措施的认知,为促进该制度的完善提供建议。 方法 2019年3—6月,采用方便抽样方法选择234例市级精神专科医院医务人员,采用分层抽样方法选择183例区级精神专科医院医务人员,采用分层抽样方法选择214例社区精神卫生防治医务人员作为研究对象,采用"北京市精神卫生法治状况调查问卷"进行问卷调查,问卷主要内容包括医务人员基本信息及对严重精神障碍发病报告制度的认知。 结果 对于制度重要性,56.3%(103/183)的区级精神专科医院和54.7%(117/214)的社区精神卫生防治医务人员认为其"非常重要",66.7%(156/234)的市级精神专科医院医务人员认为其"比较重要"。对于主要作用,76.9%(180/234)的市级精神专科医院医务人员和82.7%(177/214)的社区精神卫生防治医务人员认为该制度主要作用为"风险预警",80.9%(148/183)的区级精神专科医院医务人员认为该制度主要作用为"社区管理"。对于实施效果,44.4%(104/234)的市级精神专科医院医务人员、50.3%(92/183)的区级精神专科医院医务人员和50.9%(109/214)的社区精神卫生防治医务人员认为严重精神障碍发病报告制度实施效果比较好。对于存在问题,77.8%(182/234)的市级精神专科医院医务人员、78.1%(143/183)的区级精神专科医院医务人员和83.2%(178/214)的社区精神卫生防治医务人员认为该制度主要存在的问题为"报告涉及患者隐私信息的收集"。对于完善措施,73.5%(172/234)的市级精神专科医院医务人员和76.6%(164/214)的社区精神卫生防治医务人员认为严重精神障碍发病报告制度完善措施为"规范信息录入、登记、更正、汇总制度",68.9%(126/183)的区级精神专科医院医务人员认为制度完善措施为"规范信息共享及对患者隐私保护的制度"。 结论 三类医务人员对严重精神障碍发病报告制度的作用及实施效果表示肯定,为实现风险防控与隐私保护并重,兼顾患者管理与服务,应当对该制度予以完善,包括:在法律层面细化相关规定;对患者坚持服务保障与管理并重,完善精神卫生服务体系,落实基本与重大公共卫生服务项目;增加政策宣传力度,提高患者及家属对该制度的认可度。  相似文献   
5.
医学生的责任心体现在其一定行为表现上,是医学生职业精神培养的重要内涵,因此对影响医学生责任心的负向行为进行一定的干预具有重要意义。分析国内外医学院校应用责任指数考核在医学生行为督导养成的评价研究,遵循我国口腔医学专业人才培养的规律,结合口腔医学生成长的特点,借鉴职业精神考核的相关指标——责任指数考核法,试设计口腔医学生行为责任指数测评方案,并预设可行性,为拓宽口腔医学生职业精神的培养提供思路。  相似文献   
6.
目的:考察黑豆汁炖制时间对制何首乌外观性状及各类有效成分含量变化规律的影响。方法:采用HPLC同时测定不同炮制时间制何首乌样品中二苯乙烯苷、大黄素、大黄素甲醚、大黄素-8-O-β-D-葡萄糖苷、大黄素甲醚-8-O-葡萄糖苷的含量,选择Agilent ZORBAX Extend-C_(18)色谱柱(4. 6 mm×250 mm,5μm),甲醇(A)-水(B)为流动相梯度洗脱(0~30 min,5%~100%A; 30~40 min,100%A),流速1. 0 mL·min~(-1),柱温35℃,检测波长280 nm。结果:随炖制时间的增加,二苯乙烯苷含量逐渐降低,与8 h时相比,至64 h时含量降低76%;大黄素-8-O-β-D-葡萄糖苷和大黄素甲醚-8-O-葡萄糖苷2种蒽醌苷含量先上升后下降,至24 h时达最高值,炖制40 h时降至与8 h近似的水平,之后略有波动;大黄素、大黄素甲醚2种蒽醌苷元含量先上升后下降,炖制32 h时达最大值,之后缓慢降低并趋于稳定。结论:炖制时间对制何首乌中各类成分含量的影响显著,且变化趋势不尽相同,应规范制何首乌饮片的炮制时间;同时,仅以二苯乙烯苷及蒽醌类成分作为制何首乌的指标性成分依据不够充分,应考虑增加多糖类等质量控制指标。  相似文献   
7.
8.
目的 研究淫羊藿和女贞子配伍对绝经后骨质疏松症(postmenopausal osteoporosis,PMOP)大鼠转化生长因子(transforming growth factor,TGF)-β1/Smads信号通路的影响。方法 将48只SPF级8月龄雌性SD大鼠,随机分为假手术组、模型组、淫羊藿组、女贞子组、淫羊藿和女贞子配伍组(配伍组)、雷洛昔芬组。对大鼠行双侧卵巢切除术造模,术后1周开始给予相应的药物治疗至术后13周结束。运用酶免法检测血清TGF-β1含量、蛋白免疫印迹法(western blot,WB)和免疫荧光法(immunofluorescence staining,IF)检测骨组织中TGF-β1、p-Smad2/3和Smad7蛋白表达,通过实时荧光定量PCR(quantitative real-time PCR,qRT-PCR)法检测骨组织中TGF-β1、Smad2、Smad3和Smad7 mRNA的表达。结果 与模型组比较,淫羊藿、女贞子配伍组能增加大鼠血清TGF-β1含量(P<0.05),上调骨组织中TGF-β1、Smad2、Smad3的mRNA表达和TGF-β1、p-Smad2/3的蛋白表达(P均< 0.01),下调骨组织中Smad7的mRNA和蛋白表达(P均< 0.01),且配伍组对上述指标的调节作用优于淫羊藿或女贞子单用。结论 淫羊藿和女贞子配伍可以调节PMOP大鼠TGF-β1/Smads信号通路中细胞因子的表达,从而调节骨代谢。  相似文献   
9.
Background and aimsReducing dietary cholesterol is generally acceptable for the prevention of cardiovascular disease (CVD). Eggs are nutrient-dense and common food items across the world, while rich in cholesterol. The potential effects of egg intake on cardiovascular health remain uncertainty and have been under debate in past decades.Methods and resultsA nationwide cohort of 20,688 participants aged 16–110 years without CVD at baseline were derived from the China Family Panel Studies. Egg consumption was assessed by a semi-quantitative food frequency questionnaire. We adopted stratified Cox proportional hazards model with random intercepts for provinces to evaluate associations of egg intake with CVD incidence. During a median follow-up of 6.0 years, we identified 2395 total CVD incidence and mean egg consumption was 3 times/week. Egg intakes were associated lower risks of CVD incidence in the multivariate-adjusted model. Compared with the non-consumers, the corresponding HRs (95% confidence interval) for total CVD events were 0.84 (0.74–0.94) for 1–2 times per week, 0.78 (0.69–0.88) for 3–6/week, and 0.83 (0.72–0.95) for ≥7/week. Similar relationships were found in hypertension. Approximately non-linear relationships were observed between egg consumption with total CVD and hypertension incidence, identifying the lowest risk in 3–6 times/week. Subgroup analyses estimated lower risks of total CVD and hypertension in females only, with significant effect modification by sex (P for interaction = 0.008 and 0.020).ConclusionEgg consumption may be associated with lower risks of CVD incidence among Chinese adults. Our findings could have implications in CVD prevention and might be considered in the development of dietary guidelines.  相似文献   
10.
AimGenomic-based ancillary assays including immunohistochemistry (IHC) for BRCA-1 associated protein-1 (BAP1) and methylthioadenosine phosphorylase (MTAP), and fluorescence in situ hybridization (FISH) for CDKN2A are effective for differentiating pleural mesothelioma (PM) from reactive mesothelial proliferations. We previously reported a combination of MTAP and BAP1 IHC effectively distinguishes sarcomatoid PM from fibrous pleuritis (FP). Nevertheless, cases of sarcomatoid PM with desmoplastic features (desmoPM) are encountered where the IHC assessment is unclear.Methods and resultsWe evaluated assessment of MTAP IHC, BAP1 IHC, and CDKN2A FISH in 20 desmoPM compared to 24 FP. MTAP and BAP1 IHC could not be assessed in 11 (55 %) and 10 (50 %) cases, respectively, due to loss or faint immunoreactivity of internal positive control cells, while CDKN2A FISH could be evaluated in all cases. The sensitivities for MTAP loss, BAP1 loss, and CDKN2A homozygous deletion in desmoPM were 40 %, 10 %, and 100 %. A combination of MTAP loss and BAP1 loss yielded 45 % of sensitivity.ConclusionsMTAP IHC is a useful surrogate diagnostic marker in differentiating ordinary sarcomatoid PM from FP, but its effectiveness is limited in desmoPM. CDKN2A FISH is the most effective diagnostic assays with 100 % sensitivity and specificity in discriminating desmoPM from FP in the facilities where the FISH assay is available.  相似文献   
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