ObjectiveTo study the cause of different prognosis in typical medullary carcinoma and atypical medullary carcinoma. MethodsThe immunohistochemical staining method was used to evaluate the positivity of Ecadherin,βcatenin, in 30 cases of atypical medullary carcinoma and 18 cases of typical medullary carcinoma and 10 cases of normal breast. ResultsThe positive rate and staining intensity of Ecadherin and βcatenin oncoprotein were significantly higher in typical medullary carcinoma than in atypical medullary carcinoma(Plt;0.01).ConclusionExpression of Ecadherin and βcatenin is one of the causes of similar morphology and different prognosis in medullary breast carcinoma.
Objective To study the diagnostic and prognostic value of serum soluble triggering receptor expressed on myeloid cell-1 (sTREM-1) and cyclooxygenase-2 (COX-2) in abdominal infection-caused sepsis. Methods A total of 170 patients with abdominal infection treated in the First Hospital of Qinhuangdao between January 2019 and March 2022 were retrospectively selected and divided into sepsis group (n=76) and non-sepsis group (n=94) according to whether they were combined with abdominal infection-caused sepsis. In addition, 80 healthy people in the same period were selected as the control group. The levels of serum sTREM-1 and COX-2 in the three groups were detected and the differences were compared. The laboratory indexes, including white blood cell count, high-sensitivity C-reactive protein, and procalcitonin of patients with abdominal infection-caused sepsis were detected. The Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ and prognosis (survival or death) of patients with abdominal infection-caused sepsis were evaluated. The correlations of serum sTREM-1 and COX-2 with the severity of sepsis were analyzed, and the diagnostic and prognostic value of sTREM-1 and COX-2 in abdominal infection-caused sepsis was assessed. Results The levels of serum sTREM-1 and COX-2 in the sepsis group were higher than those in the control group and the non-sepsis group (P<0.05). The levels of serum sTREM-1 and COX-2 in the sepsis group were positively correlated with white blood cell count, high-sensitivity C-reactive protein, procalcitonin, Sequential Organ Failure Assessment score, Acute Physiology and Chronic Health Evaluation System Ⅱ score (P<0.05). The serum levels of sTREM-1 and COX-2 of patients who died during hospitalization in the sepsis group were higher than those of the surviving patients. The areas under the receiver operating characteristic curves of the serum sTREM-1 and COX-2 levels for diagnosing sepsis caused by abdominal infection were 0.814 [95% confidence interval (CI) (0.746, 0.882), P<0.001] and 0.848 [95%CI (0.788, 0.905), P<0.001], respectively, with critical values of 1.879 pg/mL and 18.75 ng/mL, respectively, and those for predicting the prognosis of patients with sepsis caused by abdominal infection were 0.775 [95%CI (0.659, 0.890), P<0.001] and 0.784 [95%CI (0.679, 0.889), P<0.001], respectively, with critical values of 2.283 pg/mL and 23.02 ng/mL, respectively (P<0.05). Conclusion The serum levels of sTREM-1 and COX-2 have certain value in the diagnosis and prognosis prediction of abdominal infection-caused sepsis.
【摘要】 目的 探讨高三尖杉酯碱（HHT）联合三氧化二砷（As2O3）、羟基脲治疗高白细胞慢性粒细胞白血病（CML）的疗效和毒副作用。 方法 对2004年11月-2009年12月行高三尖杉酯碱联合As2O3、羟基脲治疗高白细胞CML患者21例的疗效和不良反应进行分析。 结果 经高三尖杉酯碱联合As2O3、羟基脲治疗后3～6个疗程，21例CML患者中完全缓解15例，占71%；部分缓解2例，占10%；总有效率81%；未缓解4例，占19%。不良反应仅表现乏力、纳差、恶心、脱发。 结论 HHT联合As2O3、羟基脲是治疗高白细胞CML一种有效率高，临床容易开展，安全性好的方法。【Abstract】 Objective To investigate the effects and side effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide on hyperleukocytic chronic myelocytic leukemia (CML). Methods The therapeutic effects and adverse effects of homoharringtonine combined with arsenic trioxide or hydroxycarbamide administered in 21 cases with CML from November 2004 to December 2009. Results In 21 patients with CML, the CR rate was 71% (15/21) and PR rate was 10% (2/21). The total respondence rate was 81% and the side effects were slight. The side effect only shows short of strength, appetite decrease, naupathia, hair loss and no heart side effect. Conclusion Homoharringtonine combined with arsenic trioxide or hydroxycabamide has a high effect rate on CML with good safety.
:目的:探讨肾上腺髓样脂肪瘤的临床、影像学及病理特点。方法:回顾性分析28例肾上腺髓样脂肪瘤患者的临床资料,结合文献分析其特点。结果:28例患者肿瘤均经手术切除,并经病理检查证实为肾上腺髓样脂肪瘤,随访至今未见复发。结论:肾上腺髓样脂肪瘤的诊断主要依靠B超、CT和MRI,术前诊断困难,确诊需经病理学检查,手术切除是有效的治疗方法。
ObjectiveTo summarize the advance of triggering receptor expressed on myeloid cells-1 (TREM-1). MethodsLiteratures about the recent studies on the TREM-1 were reviewed. ResultsTREM1 was a mediator of inflammation. It could amplify the inflammation and lead to overexpression of inflammation in final. ConclusionTREM-1 is very important in development of many diseases and provide a new molecule target to cure.
Objective To summarize the research progress on diagnostic criteria of lymph node metastasis in medullary thyroid carcinoma (MTC), and the indication and scope of lateral cervical lymph node dissection (LCLND). Method By searching PubMed and CNKI databases, the related guidelines and literature about the diagnosis and treatment of lateral cervical lymph node metastasis in MTC in recent years were obtained and reviewed. Results The metastatic rate of lateral cervical lymph nodes in MTC patients was high. The indication of LCLND was both consensus and controversy. The LCLND of MTC was also controversial, and the focus of controversy mainly focused on the survival rate, recurrence rate, distant metastasis and postoperative complications of patients receiving prophylactic LCLND. Different imaging methods had their own advantages and disadvantages in diagnosing lymph node metastasis of MTC. Nuclear medicine was effective but expensive. Fine needle puncture was also an effective method for the diagnosis of lymph node metastasis of MTC. At present, calcitonin level, tumor size and lymph node metastasis were still important indicators for evaluating MTC for prophylactic LCLND, but the application of related indications had not been unified. Many scholars recommended comprehensive consideration of various indicators to evaluate whether MTC carried out preventive LCLND. Conclusions The LCLND of MTC needs to be further explored and standardized on the basis of the existing consensus. The focus of prophylactic LCLND should be to improve the survival rate of patients while reducing complications as much as possible.
【摘要】 目的 探讨肾上腺髓样脂肪瘤的彩色多普勒超声表现和超声诊断价值。 方法 回顾性分析2005年3月-2010年9月58例61个经手术及病理证实的肾上腺髓脂肪瘤病灶的彩色多普勒超声表现，对病变的大小、内部回声特点及血流特点进行分析。 结果 在2005年3月-2007年12月的28个病灶超声诊断出肾上腺病变23个，正确率82.1%；诊断为髓脂肪瘤2个，正确率7.1%；漏诊1个，误诊4个。2008年1月-2010年9月，33个病灶超声诊断出肾上腺病变30个，正确率90.9%；诊断为髓脂肪瘤19个，正确率57.6%；无漏诊，误诊3个。52个病灶超声表现为边界清晰，形态基本规则，内部呈均匀中等强回声（与肾集合系统回声相当），内部未测及血流信号， 另8个病灶表现为中等强回声与低回声相间。 结论 肾上腺髓样脂肪瘤具有特征性的彩色多普勒超声声像图表现， 可用于发现病变并对多数肾上腺髓样脂肪瘤做出定性诊断。【Abstract】 Objective To evaluate the value of sonographic diagnosis of adrenal myelolipoma. Methods Sonographic findings from 58 patients with pathologically proved adrenal myelolipoma from March 2005 to September 2010 were retrospectively analyzed. The size of the lesion, internal echo features, and characteristics of blood flow were observed and analyzed. Results In 28 patients with pathologically proved adrenal myelolipoma from March 2005 to December 2007, adrenal lesions was diagnosed in 23 with an accurate rate of 82.1%; adrenal myelolipoma was diagnosed in two with an accurate rate of 7.1%; missed diagnosed in one; misdiagnosed was in four. In 33 patients with pathologically proved adrenal myelolipoma from January 2008 to September 2010, adrenal lesions was diagnosed in 30 with an accurate rate of 90.9%; adrenal myelolipoma was diagnosed in 19 with an accurate rate of 57.6%; no missed diagnosed occurred; misdiagnosed was in three. The sonographic features in 52 lesions were smooth borders and homogeneous hyperechoic; no color Doppler flow signal inside was detected. Conclusion Adrenal myelolipoma has special sonographic features. Ultrasonography is a reliable imaging method for the diagnosis of adrenal myelolipoma.