ABSTRACT
Objective@#To study the clinicopathological features, diagnosis, and differential diagnosis of atypical epithelioid hemangioendothelioma (EHE).@*Methods@#Eight cases of atypical EHEs were collected from Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University) between 2010 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect immunophenotype, WWTR1-CAMTA1 and TFE3 gene rearrangement, respectively.@*Results@#There were 4 males and 4 females, ranging from 42 to 59 years (median 47.5 years). The tumors located in soft tissue (3 cases), lung (3 cases), liver (1 case) and chest wall (1 case). One soft tissue EHE involved also adjacent fibula and pleural involvement was present in all three lung cases at the diagnosis. Regional lymph node metastases were present in two cases (one involving soft tissue tumor and one involving liver). Morphologically, the tumor cells were epithelioid with abundant eosinophilic cytoplasm, moderate to marked nuclear pleomorphism, irregular nuclear membrane, unevenly chromatin, and prominent nucleoli. The cells arranged in cords, small nests or solid pattern. The mitotic rate was 4.3 mitoses/2 mm2 on average (ranging 2 to 9). Tumor necrosis was seen in every case. Among all 8 cases, blister cells were found upon careful observation. Myxohyaline stroma was present in 6 cases. Immunohistochemically, tumor cells expressed CD31 (8/8), CD34 (7/8), ERG (8/8), CKpan (2/7), and CAMTA1 (4/6). None of the tested cases stained for TFE3 (0/6). WWTR1-CAMTA1 fusion gene by FISH was found in all tested 6 cases and TFE3 gene rearrangement was not detected in any. Available clinical follow-up was obtained in 7 cases and the intervals range from 6 to 55 months (average 19.6 months). Six patients had metastasis and 3 patients died of disease. One patient was alive with no evidence of disease.@*Conclusions@#Atypical EHE is a more aggressive tumor than classic EHE, with histological features including high nuclear grade, increased mitotic activity, the presence of solid growth pattern and tumor necrosis. The differential diagnoses include epithelioid angiosarcoma, carcinoma and epithelioid sarcoma.
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Objective To design a device for prevention of foot drop and explore the effects.Method A device was designed and made using elastic sock,elastic bandage and wools to prevent foot drops in 18 patients in bed for long term combined with motion functional deficit in lower limbs.Result None of the 18 patients contracted with foot drop,with limb function score of(66.11±9.89). There was statistical difference between discharge and admission(P<0.05).Conclusions The self-designed device is effective in the prevention of foot drop in the patients sleep in bed for long term combined with motion function deficits in lower limbs.It is easy and useful for the enhancement of the function of their limbs.
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Obtective The correlation between estrus cycle and the pathological changes of liver and lung in LPS-treated mice and the possible mechanisms were investigted.Methods The pathological lesion in liver and lung、 the content of E_2、P in plasma and the content of TNF-?、EGF in plasma and ovarian supernate were examined in various times after challenge with 12.5 mg/kg LPS in estrus、metestrus and diestrus respectively and the correlation among them was assessed.Results The plasma E_2 and p levels were the lowest in diestrus.When LPS was injected in diestrus,compared with control group,the levels of P and E_2 in plasma were decreased remarkely after ip LPS 10 h(P