【Abstract】ObjectiveTo investigate the relationship between tumor suppressor gene DPC4 and the development and prognosis of pancreatic carcinoma. MethodsRelevant literatures of recent years were reviewed. ResultsDPC4 was located on chromosome 18. Its product was Smad 4 protein. Smad 4 protein was the central component of the transforming growth factor-beta signaling pathway, and all the biological effect was the results of interaction of Smad 4 and different Smads. The gene was deleted or inactive in about 50% of pancreatic carcinomas. The deletion of DPC4 had a great relation to the development and prognosis of pancreatic carcinoma. ConclusionThe alteration of tumor suppressor gene DPC4 is connected with the development and prognosis of pancreatic carcinoma. However, this research should be further studied.
Objective To evaluate the urine cytology silver staining combined with ultrasonography（USG）in the detection of bladder transitional cell carcinoma （TCC） recurrence after transurethral resection of bladder tumor（TURBT）in terms of sensitivity and specificity. Methods Cystoscopy was used as “gold standard”. Urine cytology combined with USG or cystoscopy was measured separately and blindly. AgNORs protein stained by silver were used in cytology with Kappa of inter-observers 0.81. For the USG, the patients were scanned with trans-rectal probe with Kappa of inter-observers 0.76. The results of urine cytology combined with USG （Positive when urine cytology and/or USG positive. Negative when both urine cytology and USG negative） were compared with “gold standard”. Results The 148 consecutive superficial TCC patients with TURBT one year previously were included in this study. Fifty seven recurrenced cases were detected. Recurrence rate was 38.51%. The sensitivity and specificity of urine cytology silver stain were 89.47% （95% CI 0.82 to 0.98） and 87.91% （95% CI 0.81 to 0.95）. Area under ROC curve was 82.22%. The sensitivity and specificity of USG were 57.90% （95% CI 0.45 to 0.71 ） and 90. 11% （ 95% CI 0.84 to 0.96）. Area under ROC curve was 73.13% . The sensitivity was improved to 94. 74% （95% CI 0.89 to 1.00） when cytology combined with USG. But specificity decreased to 84. 62% （95% CI 0.77 to 0.92 ）. Area under ROC curve was improved to 98.28%. Conclusions Urine cytology silver stain combined with USG improves the high sensitivity for follow-up TCC patients after TURBT. The non-invasive protocol is suggested.
ObjectiveTo summarize the clinicopathologic features of hepatic epithelioid hemangioendothelioma (EHE). MethodThe clinical and histopathologic features, and follow-up data of 9 patients with hepatic EHE were analyzed retrospectively. Results①There were 4 males and 5 females in 9 patients with hepatic EHE. The age was from 25 years to 69 years.②Five patients presented with nonspecific symptoms such as right upper quadrant pain, fatigue or weight loss. Four patients were asymptomatic.③Macroscopically, the tumors were usually multiple and ranged in size from 0.5 cm to 9.0 cm.④Histologically, the tumors appeared as cords or solid nets that were characterized by epithelioid, histiocytoid, spindle or signet-ring-like cells. The cells often contained vacuoles representing intracellular lumina, in which red blood cells could be seen. The neoplastic cells invaded the surrounding liver tissue and formed papillary or glomeruloid structure in vessels. The stroma was fibrous with myxohyaline areas.⑤Immunohistochemical stain showed that all the tumors were positive for endothelial markers (factorⅧ-related antigen, CD34, CD31, and so on). ConclusionsEHE of liver is a very rare clinical entity. It might be easily misdiagnosed due to EHE without specific clinical and imaging changes. Its final diagnosis depends on pathological and immunohistochemical findings.
目的 分析朱砂莲中毒导致急性肾功能衰竭临床表现、肾脏病理学及相关文献复习。 方法 2007年3月－9月收治朱砂莲中毒急性肾功能衰竭2例，分析临床表现及肾脏病理损害。 结果 朱砂莲急性中毒易致急性肾功能衰竭，危及生命；其主要损害肾小管间质，表现为急性肾小管重度损伤，无炎性细胞浸润，而肾小球几乎无病变。 结论 朱砂莲为我国常使用中药，主要成分为马兜铃酸，易致马兜铃酸肾病，须提高对该病认识，规范使用中草药，避免药物性所致肾损害。Objective To analyze the clinical and pathological manifestations of kidney in patients with ciliatenerve knotweed root-induced acute renal failure. Methods Two patients who were admitted into our hospital for acute renal failure caused by over-dose ciliatenerve knotweed root from March to September in 2007 were included in this study. We analyzed the clinical and pathological manifestations of their kidneys. Results Over-dose ciliatenerve knotweed root could induce acute renal failure, even threaten life. The pathology of kidney is characterized by severe tubular injury,rather than glomerulus damage, without cell infiltration. Conclusions Ciliatenerve knotweed root is one of the frequently-used traditional Chinese medicines in our country, which can easily result in aristolochinc acid nephropathy. We should recognize the importance of this disease and avoid using nephrotoxic drugs.