简介:摘要目的探讨黏蛋白4(MUC4)在脑膜瘤诊断中的应用。方法收集2011—2017年中国科学技术大学附属第一医院诊断的脑膜瘤258例以及其他中枢神经系统肿瘤165例,使用免疫组织化学检测肿瘤组织MUC4、上皮细胞膜抗原(EMA)、孕激素受体(PR)、SSTR-2蛋白的表达,比较MUC4、EMA、PR、SSTR-2在肿瘤组织中表达的情况。结果258例脑膜瘤患者中男性85例,女性173例,年龄20~81岁,平均年龄69岁。其中WHO Ⅰ级脑膜瘤192例,WHO Ⅱ级脑膜瘤54例,WHO Ⅲ级脑膜瘤12例。MUC4在脑膜瘤的总表达率为67.8%(175/258),在各型脑膜瘤的阳性率由高到低依次分别为上皮型46/46(100.0%)、分泌型3/3、血管瘤型44/45(97.8%)、不典型37/41(90.2%)、化生型3/4、微囊型2/3、沙砾体型7/11、脊索样型7/11、过渡型14/28(50.0%)、透明细胞型1/2、乳头型1/2、间变型4/9、纤维型7/52(13.5%)、横纹肌样型0/1。PR、EMA、SSTR-2分别在149例(57.7%)、173例(67.1%)、235例(91.1%)脑膜瘤中表达。另外44例EMA阴性脑膜瘤表达MUC4,4例SSTR-2阴性脑膜瘤表达MUC4。在中枢神经系统的其他肿瘤如神经鞘瘤、神经纤维瘤、孤立性纤维性肿瘤/血管外皮瘤(SFT/HPC)、血管母细胞瘤、胶质瘤及室管膜瘤等MUC4均不表达。结论MUC4广泛表达于脑膜瘤,在脑膜瘤与其他非脑膜上皮来源的中枢神经系统肿瘤的鉴别上具有较大的价值。
简介:摘要在全球范围内,结直肠癌的发病率和病死率约为10%。T4期结肠癌预后较差,T4b期更甚,5年生存率仅为15.8%~27.9%。目前T4期结肠癌外科诊疗缺乏准确的临床分期评估手段以及系统的围手术期诊疗体系。笔者认为,分期评估仍应以传统CT为主,CT结肠成像可以应用于因肿瘤梗阻结肠镜无法探及全程的患者以及传统CT不易判断的患者。围手术期诊疗方面,T4a期结肠癌患者可采用根治性手术+术后化疗的治疗策略,T4b期患者可采用术前新辅助化疗+根治性手术+术后化疗的治疗策略,新辅助放疗可考虑应用于肿瘤较为固定的患者。此外,应成立多学科合作小组针对复杂T4期结肠癌患者进行讨论。
简介:摘要IgG4相关眼病(IgG4-related ocular disease,IgG4-ROD)是近年新发现的一种自身免疫性疾病,组织学上可见大量淋巴细胞和浆细胞浸润、闭塞性静脉炎及席文状或旋涡状纤维化。该病可以累及多个眼部组织或器官,如泪腺、眼外肌、眼眶脂肪以及三叉神经等,其主要临床表现是双侧或单侧眼眶慢性无痛性肿胀、眼球突出,可伴有外周淋巴结肿大,通常视力损害不明显,但严重时可使被累及的组织器官功能丧失而影响患者日常生活。IgG4-ROD的发病机制尚不明确,推测可能与自身抗体产生、微生物感染和基因遗传等因素有关。对于IgG4-ROD的治疗,目前主要是采用糖皮质激素、免疫抑制剂、生物制剂以及手术治疗等,这些治疗方式虽可以取得一定疗效,但存在一定的局限性如高复发率、严重的副作用及术后并发症等。(国际眼科纵览,2020, 44: 256-261)
简介:AbstractObjective:To assess the clinical features of fetal growth restriction (FGR) in women with hypertensive disorders of pregnancy in China.Methods:This is a retrospective cohort study. The clinical data of 4 451 women with hypertensive disorders of pregnancy were retrospectively collected from 11 tertiary hospitals across ten provinces in China during January 2015 to December 2015. The mean maternal age was (31.0±5.4) years old. Participants were divided into FGR group (n= 670) and non-FGR group (n= 3 781). The incidence and clinical features of FGR, and its correlation with gestational age, previous FGR history, 24-hour urinary protein excretion, and hemolysis, elevated liver enzyme and low platelet count (HELLP) syndrome were analyzed. Student’s t-test and Chi-square test were used when comparing clinical features between FGR and non-FGR groups.Results:The overall incidence of FGR was 15.1% (670/4 451). The FGR incidence was 22.4% (433/1 937) in women with severe preeclampsia and 18.6% (68/365) in women with chronic hypertension with superimposed preeclampsia, respectively. FGR was more prevalent in women who had preterm births than those who had term births (22.8% (432/1 898) vs. 9.3% (238/2 553), P < 0.001). It was also more prevalent in women with early-onset preeclampsia than those with late-onset preeclampsia (18.4% (189/1 025) vs. 14.0% (481/3 426), P= 0.001). Women with a previous FGR history had a significantly higher FGR incidence than those without an FGR history (66.7% (4/6) vs. 15.7% (250/1 596), P= 0.007). The presence of abnormal results of the umbilical artery Doppler (13% (87/670) vs. 2.4% (89/3 781), P < 0.001) and the middle cerebral artery Doppler (3.3% (22/670) vs. 0.4% (15/3 781), P < 0.001) was higher in the FGR group compared with the non-FGR group, while the presence of increased uterine artery resistance was not statistically different (1.5% (10/670) vs. 0.8% (29/3 781), P= 0.072). The FGR group delivered earlier than the non-FGR group ((35.3±3.0) weeks vs. (36.4±4.3) weeks, P < 0.001) with lower birth weight (1 731.0±574.5) g vs. (2 753.9±902.1) g, P < 0.001, higher fetal or neonatal death (9.4% (63/670) vs. 4.2% (157/3 781), P < 0.001), and higher cesarean section rate (82.5% (553/670) vs. 70.2% (2 656/3 781), P < 0.001). In the FGR group, more neonates had 5-minute Apgar score ≤7 (7.9% (53/670) vs. 3.9% (149/3 780), P < 0.001), with higher neonatal intensive care unit admission rate (48.1 % (322/670) vs. 23.3% (881/3 781), P < 0.001). More cases of HELLP syndrome occurred in the FGR group (6.9% (46/670) vs. 3.2% (122/3 781), P < 0.001). Women with FGR had heavier 24-hour urinary protein excretion than those without FGR ((3.9±3.7) g vs. (3.1±4.2) g, P= 0.005).Conclusion:In pregnancies with hypertensive disorders, increased risks of FGR are associated with preterm birth, birth before 34 weeks, and a previous FGR history. FGR is related to higher occurrence of abnormal uterine artery Doppler and umbilical artery Doppler. When hypertensive disorders is complicated by FGR, there appears to be higher maternal morbidity including higher rate of HELLP syndrome, cesarean section, and heavier proteinuria, as well as worse neonatal outcomes.
简介:摘要:该文介绍了民航PAE T6系列甚高频设备新配置的R4 MARC远程监控系统的系统结构,分析了该系统的参数配置要点,为后续广州地区所有PAE T6系列设备接入远程监控系统实现设备集中监控工作中提供配置案例。
简介:摘要2019新型冠状病毒(2019-nCoV)感染的肺炎具有高度传染性,本文结合4S(simple,safe,satisfy,save)呼吸康复内容和2019新型冠状病毒肺炎的诊治标准,对2019-nCoV所致的肺炎患者提供可行的呼吸康复指引。
简介:摘要:以云计算作为实际的基础,结合分组承载网的网络特点,对移动通信4G网络进行全面的优化,其在当前阶段属于一项非常重要的工程,不仅如此,实际的工作内容相对复杂,具体的技术难度相对较大,对于网络实际的运行要求也非常高。基于此,本篇文章主要介绍分组承载网络技术特点,对云计算的移动通信4G网络的优化措施进行深入的分析和探讨。