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ObjectiveTo reveal the differences of the related pathogenicity gene mutations between sebaceous adenocarcinoma （SC） of scalp and sebaceous adenoma （SA） of scalp on whole exome level. MethodsWhole exome sequencing was performed on a SC sample and a SA sample by Illumina Hiseq 2500 platform. Suspicious single nucleotide variation sites were selected for mutation conservation and functional analysis. SciClone was used to track subclone evolution and clonal map information was obtained for each tumor sample. The high-frequency significant gene mutations in the tumor sample were screened by MutSigCV software， and compared with the known driver genes. ResultsTwo driver genes TFDP1 and ACVR1B harboring mutations in scalp SC compared to SA were found. ConclusionsThe finding of mutation in driver genes TFDP1 and ACVR1B should be confirmed in a large cohort， which might reveal the mechanism of scalp SC development and find a therapeutic target for SC.
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OBJECTIVE： To investigate the pratice of pharmaceutical care provided by clinical pharmacists in orthopedics department. METHODS： Based on the characteristics of orthopedic diseases and clinical drug use， combined with case analysis， the content， work focus and working methods of pharmaceutical care provided by clinical pharmacists were summarized in orthopedics department of our hospital. RESULTS： Clinical pharmacists of our hospital provided basal pharmaceutical care， such as pharmacy consultation， drug reforming， medication education. Focusing on the application standardization of antibiotics in perioperative period， pain evaluation， analgesic regimen optimization， hemostasis and anticoagulation medication safety monitoring of patients undergoing orthopaedic surgery， clinical pharmacists went deep into ward work to assist physicians in formulating treatment plans. Results of case analysis showed that the work of clinical pharmacists was recognized by doctors and promoted rational drug use in clinic. CONCLUSIONS： Clinical pharmacists should combine different specialty characteristics to carry out pharmacy services for specific groups， continuously improve the professional level and their ability to work， and improve the level of pharmaceutical care.
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Objective@#To investigate the clinicopathologic features of Rasmussen syndrome (RS) and to raise awareness of this rare disease.@*Methods@#Clinicopathologic data of 4 cases of RS were retrospectively analyzed at Beijing Haidian Hospital from 2008 to 2016.@*Results@#The clinical manifestations included epilepsia partialis continua and progressive neurologic deficits in all patients.MRI demonstrated unihemispheric focal cortical atrophy in all cases. The histopathologic changes included variable degrees of lymphocytic infiltrate within the cortex, subarachnoid space and perivascular cuffing.Microglial nodules and neuronophagia were seen. Mild to severe neuronal loss was noted with variable degrees of reactive gliosis. Spongy edema and cavitation were observed in focal cortex. Inflammation involving hippocampus was seen in one case. Three cases were accompanied by focal cortical dysplasia (FCD) Ⅲd. Immunohistochemical staining showed that the infiltrative lymphocytes were positive for CD3, CD8, granzyme B and TIA1 and the proliferating microglial cells were positive for CD68. NeuN positive neurons decreased significantly and reactive astrocytes were GFAP positive.@*Conclusions@#Pathologic changes of RS are similar to viral encephalitis and the inflammation is progressive and multifocal involving the hemisphere. The diagnosis of RS relies on pathologic features combined with clinical findings and neuroradiological examinations.
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Purpose To study the clinicopathologic features of ganglioglioma. Methods The clinicopathologic data of the cases pathologically diagnosed as ganglioglioma that underwent resection of epileptic focus were retrospectively analyzed. Results In the 19 cases studied, the mean onset age was 9.1 years, and the duration of disease was 9.3 years. MRI images showed abnormal signals. The majority of the site was temporal lobe (14/19, 73.7％). The tumors showed heterogeneity and often accompanied by focal cortical dysplasias (13/19, 68.4％). Immunohistochemical staining showed CD34 positive in 18 cases, Nestin positive in 16 cases, and BRAF-V600E positive in 6 case. The positive expression rate of CD34 and Nestin did not have significant differences. Conclusion The diagnosis of ganglioglioma relies on pathological observations combined with clinical features and neuroradiological examinations. Differential diagnosis should be done from other tumors or cortical dysplasia. Immunohistochemical staining of CD34 and Nestin can help diagnosis.
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Objective To study one male patient with cirrhosis for spironolactone induced gynecomastia and promote clinical pharmacists providing better pharmaceutical cares .Methods Based on the patient′s diseases and medication history , clinical pharmacists searched related literature and analyzed the cause of gynecomastia for the patient .Results The patient′s breast pain was relieved and finally disappeared after termination of spironolactone .Therefore ,spironolactone was suspected to be the drug to cause gynecomastia .Conclusion Clinical pharmacists can improve pharmaceutical cares by carefully monitoring the adverse reactions and selecting appropriate medications .
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Objective To study the clinicopathologic features of brain tumors in patients with medically intractable epilepsy. Methods The clinical, radiologic and pathologic features of brain tumors in thirty-six patients with intractable epilepsy encountered during the period from 2008 to 2014 in the Epilepsy Center of Haidian Hospital were retrospectively reviewed. Results There were 18 males and 18 females in thirty-six patients. The mean age of seizure onset and disease duration were (14.05 ± 1.67) years and (10.04 ± 1.19) years respectively. The histological types of brain tumors included ganglioglioma (12/36, WHO gradeⅠ,1/36, WHO gradeⅡ), dysembryeplastic neuroepithelial tumor (2/36, WHO gradeⅠ), pleomorphic xanthoastrocytoma (1/36, WHO gradeⅡ), angiocentric glioma (1/36, WHO gradeⅠ), astrocytoma (4/36, WHO gradeⅡ), oligoastrocytoma (1/36, WHO gradeⅡ, 2/36, WHO gradeⅠ-Ⅱ), oligodendroglioma (1/36, WHO gradeⅠ-Ⅱ,1/36, WHO grade Ⅱ), cavernous hemangioma (4/36) and Sturge-Weber syndrome (1/36). Most of these tumors were located in temporal lobe (25/36, 69.4%). Patients were followed up for 0.5-7 years after operation. One patient was lost for follow up. Seizure outcome after the epilepsy operation revealed that 28 patients (77.8%) had Engel gradeⅠ, 4 patients (11.1%) had Engel gradeⅡ,2 patients (5.6%) had Engel gradeⅢ,1 patient (2.8%) had Engel gradeⅣ. Conclusion Brain tumors in patients with medically intractable epilepsy are almost low grade tumors of the nervous system. Focal cortical dysplasia is existed in most brain tissues from the epilepsy operation. Low grade tumors of the nervous system have close relation with focal cortical dysplasia in patients with medically intractable epilepsy. It is possible that the classifications of pathology diagnosis has connection with prognosis.
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OBJECTIVE:To investigate the cognition,evaluation and demands of medical staff to the clinical pharmacy work in the secondary and tertiary medical and health institutions in Xi’an city,and provide reference for further promoting the develop-ment of the local clinical pharmacy work. METHODS:20 secondary and tertiary medical and health institutions in Xi’an city were randomly selected to conduct a random sampling questionnaire for physicians,nurses (senior nurses),pharmacists (non-clinical pharmacist)and other medical technicians. And the results were statistically analyzed. RESULTS:Totally 1 020 questionnaires were sent out,851 were effectively received with effective recovery of 83.4%. 45.9% respondents knew clinical pharmacy,and“Col-league”was the main channel;34.3% thought clinical pharmacy“only maintained normal operation. 74.7% surveyed medical staff,92.6% surveyed pharmacists and 70.6% surveyed physicians thought clinical pharmacists“should”take round with the doc-tors and nurses;44.3% respondents showed“dissatisfaction”and“general satisfaction”with the clinical pharmacy work in their hospitals. 48.5% respondents would take the initiative to consult the clinical pharmacist for medication;45.5% respondents partial-ly accepted the drug information provided by clinical pharmacists. There were significant differences in the investigation results in aspects of respondents’understanding level and channel for clinical pharmacy,cognition for development situation of clinical phar-macy,evaluation for clinical pharmacists participating round,demand for consulting the medication,acceptance for drug informa-tion provided by clinical pharmacists,and other items(P<0.05). CONCLUSIONS:The cognition and effect of clinical pharmacy work on medical staff need to be further strengthened,clinical pharmacists should also have solid clinical knowledge and the knowl-edge of medicine to meet the demand of medical staff in different positions,the acceptance of medical staff to the pharmaceutical care needs to be further improved. Clinical pharmacists should earnestly fulfill their job functions through various efforts to promote rational drug use.
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<p><b>OBJECTIVE</b>To study the clinicopathologic features of tuberous sclerosis complex (TSC).</p><p><b>METHODS</b>The clinicopathologic data of the patients diagnosed as TSC with refractory epilepsy and resection of epileptic focus were retrospectively analyzed.</p><p><b>RESULTS</b>Fourteen cases were included, the mean age was (15.8±12.9) years, with a male predominance (male to female ratio=10:4). Frontal lobe was the most common (13/14) site of involvement. MRI showed multiple patchy long T1 and long T2 signals. CT images showed multiple subependymal high density calcified nodules in nine cases. Histology showed mild to severe disruption of the cortical lamination, cortical and subcortical tubers with giant cells and/or dysmorphic neurons. The giant cells showed strong immunoreactivity for vimentin and nestin, while the dysmorphic neurons partially expressed MAP2 and NF. Vimentin also stained strongly the "reactive" astrocytes. Thirteen cases had follow-up information: Engel class I in six cases, Engel class II in six cases, and Engel class III in one case.</p><p><b>CONCLUSIONS</b>Diagnosis of TSC relies on combined pathologic, clinical and neuroradiological features. Immunohistochemical staining can be helpful. Resection of epileptic focus is an effective method to treat refractory epilepsy in TSC.</p>
Subject(s)
Adolescent , Child , Female , Humans , Male , Astrocytes , Chemistry , Pathology , Drug Resistant Epilepsy , General Surgery , Epilepsy , Metabolism , Pathology , Epilepsy, Frontal Lobe , Metabolism , Pathology , Giant Cells , Chemistry , Pathology , Magnetic Resonance Imaging , Nestin , Neurons , Metabolism , Pathology , Retrospective Studies , Tuberous Sclerosis , Metabolism , Pathology , VimentinABSTRACT
<p><b>OBJECTIVE</b>To observe the thick basement membrane-like layer under the damaged epithelium in patients with chronic rhinosinusitis (CRS) and to study its principal components.</p><p><b>METHODS</b>Patients (n = 40) with CRS undergoing functional endoscopic sinus surgery were recruited for the study. Patients (n = 10) with no evidence of sinus disease were used as control subjects. Ethmoidal sinus mucosa specimen were stained by PAS staining to measure the thickness of basement membrane-like layer. Immunohistochemical staining, picrosirius-polarization method and transmission electron microscopy (TEM) were used to analyse the nature of the layer.</p><p><b>RESULTS</b>The thickness of basement membrane-like layer in CRS type I and CRS type II were significantly increased compared with normal control subjects (t = 5. 426, P < 0. 01; t = 8. 375, P < 0.01). The thickness of CRS type II was significantly greater compared with CRS type I (t = 3. 908, P < 0.01). There was no difference between atopic group and inotropic group (t = 0.803, P> 0.05). There was no expression of fibronectin, laminin, IgA, IgG and IgM in the thick basement membrane-like layer. A thick reticular structure containing collagen fibrils and devoid of cellular elements was observed by TEM.</p><p><b>CONCLUSIONS</b>This study demonstrates that a long-standing chronic inflammation leads to deposition of collagens type I , III and IV under the damaged epithelium, resulting in an increasingly thick sub-basement membrane layer.</p>
Subject(s)
Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Young Adult , Basement Membrane , Metabolism , Pathology , Case-Control Studies , Chronic Disease , Collagen , Metabolism , Nasal Mucosa , Metabolism , Pathology , Sinusitis , Metabolism , PathologyABSTRACT
<p><b>OBJECTIVE</b>To explore the change in the distensibility of large arteries and its influencing factors in elderly patients with essential hypertension.</p><p><b>METHODS</b>Automatic measuring system for pulse wave velocity (PWV) was applied to examine carotid-femoral PWV as an index reflecting distensibility of large arteries. 118 hypertensive patients aged 64 - 83 (mean age 67.12 +/- 10.26) years were included in the study. Of them, 87 were males and 31 were females.</p><p><b>RESULTS</b>PWV of 118 hypertensive patients increased with increasing age (P < 0.001). Multivariate regressive analysis demonstrated that age and systolic blood pressure had the close relationship with PWV (P < 0.001).</p><p><b>CONCLUSION</b>Hypertension of the elderly could cause reduction of distensibility of large arteries. Age and systolic blood pressure had the close relationship with distensibility of large arteries in elderly patients with essential hypertension.</p>
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Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Age Factors , Blood Flow Velocity , Carotid Arteries , Elasticity , Femoral Artery , Hemodynamics , Hypertension , PulseABSTRACT
<p><b>OBJECTIVE</b>To observe the relationship between histomorphological changes in mucosa of chronic sinusitis (CS) and aerosol particles.</p><p><b>METHODS</b>The ethmoidal sinus mucus specimens of 60 patients with CS type I, II and III, and 16 cases of normal controls were collected. Meanwhile the pulmonary specimens in autopsy of 5 adult and 5 fetus cases were also collected. The specimens were stained by HE staining and Warthin-Starry (W-S) special aerosol particles staining method respectively, the ethmoidal sinus mucosa basement membrane were displayed by Van Gieson's (VG) special staining method, and its thickness was measured.</p><p><b>RESULTS</b>By the W-S staining, some black aerosol particles were found depositing on the epithelial cells layer of damaged mucosa and in the plasm of the epithelial cells. The degree of deposition was gradually increased in type I, II and III of CS. The number of cases of slight, medium and heavy depositing in type I were 11/20, 7/20, 2/20, in type II 5/20, 9/20, 6/20, and in type III 3/20, 6/20, 11/20 respectively; the more particles deposited, the more thickening the basement membrane. The thickness of the basement membrane in type I, II and III of CS were (12.15 +/- 4.73), (16.67 +/- 2.22), (23.75 +/- 3.48) microm respectively. There were significant differences among type I, II and III (P < 0.01). The black particles in the mucosa epithelium tissues of normal control group and non-damaged mucosa epithelium and desquamation area were seldom seen. On the other hand, the aerosol particles were not seen in the pulmonary specimens of the fetal autopsy.</p><p><b>CONCLUSION</b>In damaged mucosa epithelial cells of the CS, there are aerosol particles existing which may relate with the morphological changes of CS.</p>