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关键词： B细胞淋巴瘤   基因   IRF4   病理学   荧光原位杂交   二代基因测序  

摘要： 目的探讨伴1RF4重排的大B细胞淋巴瘤的临床、病理学、遗传学特征.方法收集中国医学科学院血液病医院淋巴瘤诊疗中心2017年12月至2021年10月收治的6例伴1RF4重排的大B细胞淋巴瘤患者的临床资料,包括病理学、荧光原位杂交、二代基因测序检测,并复习相关文献.结果①6例患者中男3例,女3例,中位发病年龄33岁.6例患者中3例起病部位为扁桃体,2例为淋巴结,1例为背部肿物.6例患者均采取了RCDOP(利妥昔单抗、环磷酰胺、脂质体阿霉素、长春新碱、泼尼松)方案治疗,随访至2021年11月,6例患者全部存活.②形态学:5例为弥漫性生长,1例为滤泡性生长,瘤细胞体积均为中等至大,病灶多呈膨胀性生长,5例核分裂象易见,6例均未见"星空现象".③免疫组化:4例为生发中心B细胞(GCB)型,2例为non-GCB型;6例均为CD20、PAX5、MUM1、BCL6阳性,CD5阴性;4例CD10阴性;3例BCL2阳性,2例c-MYC阳性.④荧光原位杂交:6例患者IRF4分离探针检测均呈阳性;5例进行BCL6基因重排检测,2例重排阳性;各有5例进行了BCL2、MYC基因重排检测,均为阴性.⑤二代测序:3例患者应用石蜡组织标本进行了二代测序,可见IRF4、TP53、IGLL5、MYD88等淋巴瘤相关基因突变.结论伴IRF4重排的大B细胞淋巴瘤是一种具有独特临床、病理学、遗传学特征的罕见的大B细胞淋巴瘤.对该类型淋巴瘤的发病机制、治疗选择、长期预后仍需进一步探索.

关键词： 滑鼠蛇   横纹肌肉瘤   脓性增生   钙化  

摘要： 应用临床诊断、血液学、X光、病理剖检及病理组织学方法对1例圈养滑鼠蛇(Ptyas mucosus)体表肿物进行检测分析。X光检查显示该蛇体侧后有2个肿物,与周围组织界限明显,内有实质及钙化灶生成。剖检发现肿物包膜破溃,小肿物切面呈白色,质地较硬,大肿物质软,有恶臭气味,内部呈现分层结构,外部层腐烂部分伴有少量脓性增生;镜下可见大量具有嗜酸性胞浆的、组织细胞样细胞的增生,局部可见大量粉色的、具有多核的巨细胞及大量钙化灶,结构疏松,大量毛细血管扩张。经病理学诊断,结合临床检查分析,该蛇确诊为横纹肌肉瘤。研究结果可为兽医对异宠临床横纹肌肉瘤的诊断提供参考。

关键词： 慢性乙型肝炎   白细胞介素-2受体   半胱氨酸蛋白酶裂解细胞角蛋白18   高尔基体蛋白73   肝组织病理学  

摘要： 目的探讨慢性乙型肝炎(CHB)患者血清白细胞介素-2受体(IL-2R)、半胱氨酸蛋白酶裂解细胞角蛋白18(CK18)、高尔基体蛋白73(GP73)与肝组织病理学改变和肝功能指标的相关性。方法选取本院2018年1月至2021年12月收治的145例CHB患者作为研究组,另取同期健康体检者100例作为对照组,检测并比较两组血清IL-2R、CK18、GP73水平差异。将CHB患者根据肝组织病理学差异分为炎症较轻组(G_(0)~G_(2)期)、炎症较重组(G_(3)~G_(4)期)以及纤维化较轻组(S_(0)~S_(2)期)、纤维化较重组(S_(3)~S_(4)期),比较不同肝脏炎症和纤维化程度患者血清IL-2R、CK18、GP73及肝功能指标水平差异。分析CHB患者血清IL-2R、CK18、GP73水平与肝脏炎症、肝纤维化严重程度以及肝功能指标的相关性。结果研究组血清IL-2R、CK18、GP73水平均高于对照组,差异均有统计学意义(均P<0.05)。炎症较重组血清IL-2R、CK18、GP73、ALT及AST水平均高于炎症较轻组,差异均有统计学意义(均P<0.05)。纤维化较重组血清IL-2R、CK18、GP73、ALT以及AST水平均高于纤维化较轻组,差异均有统计学意义(均P<0.05)。经Spearman或Pearson相关性分析发现,CHB患者血清IL-2R、CK18、GP73水平与肝脏炎症分级、肝脏纤维化分级以及ALT、AST水平均呈正相关(均P<0.05)。结论CHB患者血清IL-2R、CK18、GP73水平均异常升高,与患者肝组织病理学改变及肝功能指标密切相关。

关键词： 子宫颈肿瘤   鳞状上皮内病变   间质浸润   网状纤维   基膜  

摘要： 目的探讨网状纤维染色在子宫颈高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion,HSIL)是否伴有间质浸润鉴别诊断中的临床病理学意义。方法收集中山大学肿瘤医院存档的23例HSIL和64例HSIL可疑间质浸润的石蜡组织标本,行HE和网状纤维染色,对HSIL及可疑间质浸润区域进行对比分析,以评价网状纤维染色在HSIL是否伴有间质浸润鉴别诊断中的效能。结果23例HSIL均能通过网状纤维染色得到证实;由两位医师分别对64例HSIL可疑间质浸润病灶进行回顾性诊断分析,其中确定为HSIL的例数分别为30例和29例,找到间质浸润证据的例数分别为34例和35例,两位医师诊断结果一致性极高(Kappa=0.969,P<0.001),提示网状纤维染色可辅助诊断可疑间质浸润的HSIL病例。结论对HSIL可疑间质浸润的病灶进行网状纤维染色,有助于HSIL伴有间质浸润的准确识别,指导子宫颈病变临床管理策略的制定。

关键词： cGMP signalling   heart failure   riociguat   RNA sequencing   soluble GC   TAC  

摘要： Background and Purpose Heart failure is associated with an impaired NO-soluble guanylyl cyclase (sGC)-cGMP pathway and its augmentation is thought to be beneficial for its therapy. We hypothesized that stimulation of sGC by the sGC stimulator riociguat prevents pathological cardiac remodelling and heart failure in response to chronic pressure overload. Experimental Approach Transverse aortic constriction or sham surgery was performed in C57BL/6N mice. After 3 weeks of transverse aortic constriction when heart failure was established, animals receive either riociguat or its vehicle for 5 additional weeks. Cardiac function was evaluated weekly by echocardiography. Eight weeks after surgery, histological analyses were performed to evaluate remodelling and the transcriptome of the left ventricles (LVs) was analysed by RNA sequencing. Cell culture experiments were used for mechanistically studies. Key Results Transverse aortic constriction resulted in a continuous decrease of LV ejection fraction and an increase in LV mass until week 3. Five weeks of riociguat treatment resulted in an improved LV ejection fraction and a decrease in the ratio of left ventricular mass to total body weight (LVM/BW), myocardial fibrosis and myocyte cross-sectional area. RNA sequencing revealed that riociguat reduced the expression of myocardial stress and remodelling genes (e.g. Nppa, Nppb, Myh7 and collagen) and attenuated the activation of biological pathways associated with cardiac hypertrophy and heart failure. Riociguat reversed pathological stress response in cultivated myocytes and fibroblasts. Conclusion and Implications Stimulation of the sGC reverses transverse aortic constriction-induced heart failure and remodelling, which is associated with improved myocardial gene expression.

关键词： 病理学   实验   高等学校   教学参考资料  

ISBN: (纸本)9787030714718

摘要： 病理学是一门重要的基础医学课程，是基础医学和临床医学之间的桥梁。病理学实验课教学的开展是医学生理解、掌握病理学专业知识的重要组成部分。本教材正确把握高等中医药院校本科教学内容和课程体系的改革方向，在第一版教材的基础上进行了修订，坚持“系统全面、简明实用、内容精练、突出特色”的编写原则，注重把握“科学、严谨、知识公认”等编写特点，为培养新型医学人才奠定基础。本教材分为“病理学实验”（形态学）及“病理生理学实验”（机能学）两篇，病理学实验篇系统介绍了常见疾病大体标本及病变组织切片的病理学改变特点，探讨了重要疾病现象，大部分实验末尾新增了典型的病理大体标本及切片彩图（扫描二维码即可阅览）；病理生理学实验篇重点介绍了急性肺水肿、高钾血症、缺氧、失血性休克、急性右心衰竭等实验操作过程及方法，分析了发生机制，部分实验还附有病案讨论。本教材适用于高等中医药院校各专业学生学习和参考使用。

摘要： Background Limited information is available on the relevant prognostic variables after surgery for patients with pancreatic ductal adenocarcinoma (PDAC) subjected to neoadjuvant chemotherapy (NACT). NACT is known to induce a spectrum of histological changes in PDAC. Different grading regression systems are currently available;unfortunately, they lack precision and accuracy. We aimed to identify a new quantitative prognostic index based on tumor morphology. Patients and Methods The study population was composed of 69 patients with resectable or borderline resectable PDAC treated with preoperative NACT (neoadjuvant group) and 36 patients submitted to upfront surgery (upfront-surgery group). A comprehensive histological assessment on hematoxylin and eosin (H&E) stained sections evaluated 20 morphological parameters. The association between patient survival and morphological variables was evaluated to generate a prognostic index. Results The distribution of morphological parameters evaluated was significantly different between upfront-surgery and neoadjuvant groups, demonstrating the effect of NACT on tumor morphology. On multivariate analysis for patients that received NACT, the predictors of shorter overall survival (OS) and disease-free survival (DFS) were perineural invasion and lymph node ratio. Conversely, high stroma to neoplasia ratio predicted longer OS and DFS. These variables were combined to generate a semiquantitative prognostic index based on both OS and DFS, which significantly distinguished patients with poor outcomes from those with a good outcome. Bootstrap analysis confirmed the reproducibility of the model. Conclusions The pathologic prognostic index proposed is mostly quantitative in nature, easy to use, and may represent a reliable tumor regression grading system to predict patient outcomes after NACT followed by surgery for PDAC.

关键词： Vestibular schwannoma   Epidermoid cyst   Meningioma   Brain metastases   Radiologic-pathologic correlation