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Objective@#To investigate clinical, pathological and immunohistochemical features of pancreatic acinar cell carcinoma.@*Methods@#A retrospective review of surgical and pathological databases between 2011 and 2016 at PLA General Hospital was collected and 14 cases of acinar cell carcinoma (ACC) of the pancreas were identified. EnVision immunohistochemistry was used to detect the expression of Trypsin, bcl-10 and cytokeratin(CK) proteins.@*Results@#The patients included nine cases of pure ACC, 3 cases of mixed acinar ductal carcinoma, 1 case of mixed acinar-neuroendocrine carcinoma and acinar-ductal-neuroendocrine carcinoma, respectively. Tumors involved different anatomic locations of the pancreas, including eight involving the head of pancreas, four in the body and tail, one in the uncinate process and one in a heterotopic pancreas. Two patients had lymph node and liver metastases before surgery. Microscopically, the tumor was hypercellular with less fibroblastic proliferation and tumor cells arranged in acinar or solid pattern. The well differentiated tumor cells showed eosinophilic, granular cytoplasm with single prominent nucleoli, while the poorly differentiated tumor cells tended to grow in solid sheets. Immunohistochemically, the tumor cells were positive for pan-cytokeratin (14/14), Trypsin (12/14) and bcl-10 (11/14). Stains for CK7 and CK19 were negative (11/14 and 3/4). According to the pTNM staging, there were 7 cases at stageⅠ, 3 at stage ⅡA, 3 at stage Ⅲ and 1 at stage Ⅳ. With average postoperative follow-up of 6-58 months, the median disease-free survival time was 16 months.@*Conclusions@#Pancreatic acinar cell carcinoma is a rare and relatively indolent malignant tumor with characteristic histopathological and immunohistochemical features. Accurate pathological diagnosis plays an important role in patients′ treatment and evaluation of prognosis.
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Objective@#To investigate clinicopathologic features and prognosis of adenoid cystic carcinoma (ACC) involving external auditory meatus.@*Methods@#The clinical presentation and follow-up data of 63 patients with ACC of external auditory canal were collected from January 2006 to February 2017 at PLA General Hospital and Hainan Branch of PLA General Hospital. The clinicopathologic features and prognostic factors of external auditory canal ACC were analyzed.@*Results@#(1) There were 28 males and 35 females and the average age of the first diagnosis was 48.9 years (22-81 years). The tumors showed cribriform pattern in 35 cases (15 cases of late stage), tubular pattern in 14 cases (8 cases of late stage), and solid pattern in 14 cases (9 cases of late stage). Cases with solid pattern was relatively more frequent than that of cribriform pattern and tubular pattern, but the difference was not statistically significant (P>0.05). (2) The average follow-up time was 62.4 months (2-228 months) in the 57 available cases. Among the 33 cases with recurrence, 18 cases had local recurrence and 15 cases had distant metastasis. The mean recurrence time was 40.6 months (2-204 months). Nine patients died of ACC: 2 cases in early stage (died at 48 and 102 months after the first treatment), 7 cases in late stage and 57 with (died at 9, 30, 32, 60, 72, 94 and 228 months). (3) Among the 37 patients with perineural invasion, there were 21 cases of cribriform pattern, 4 cases of tubular pattern and 12 cases of solid pattern; the number of cases in early stage and late stage were 15 and 22, respectively; and the differences were statistically significant (P<0.05). In addition, 31 cases had otalgia among the 37 patients with perineural invasion, where differences were not significant (P>0.05). (4) Thirty of 45 cases with tumor resection or partial resection of temporal bone had recurrence, whereas 3 of 12 cases of tumor combined with superficial lobectomy of parotid gland had recurrence. The difference was statistically significant (P<0.05). Postoperative adjuvant radiotherapy was given in 19 cases, including 7 cases of early stage (2 cases of recurrence), and 12 cases of late stage (8 cases of recurrence), among which there was no significant difference (P>0.05).@*Conclusions@#ACC occurring in external auditory canal frequently recurs. Superficial parotid lobectomy at the first operation is necessary to prevent tumor recurrence. Postoperative adjuvant radiotherapy has certain curative effect on patients with early stage tumor, but it does not affect the recurrence rate. Patients at late stage are more prone to perineural invasion than those in early stage. In addition, cribriform and solid patterns are more common that tubular pattern, and there is no significant correlation between perineural invasion and otalgia.
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A child case of acute myocardial ischemia induced by symptomatic myocardial bridge (SMB)was reported and relevant literatures were reviewed in this article.The case and literatures indicate that myocardial bridge is a rare congenital coronary artery anomaly in children.The pathogenesis may be related to stenosis,spasm,arteriosclerosis of coronary artery because of myocardial bridge compression during systole.Clinical manifestations include chest pain,malignant arrhythmia,syncope,cardiac arrest and myocardial infarction.The diagnosis of myocardial bridge is based on cardiac imaging.SMB patients should be first treated with β-adrenergic; if ineffective,surgical treatment or implantable automated cardiac defibrillator shonld be chosen.The patients complicated with hypertrophic cardiomyopathy have worse conditions with high mortality.
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OBJECTIVE:To study the chemical constituents of the root of Rumex japonicus. METHODS: The root of Rumex japonicus was separated by different methods such as organic solvent method and column chromatography, and its structure was identified by spectrum technology. RESULTS: A total of seven compounds were isolated from the root of Rumex japonicus, which were identified to be as ?-sitosterol, quercetin, rumizin, emodin, physcion, chrysophanol and 1,6,7-trihydroxy-3-methoxyanthraquinone. Among them, quercetin and 1,6,7-trihydroxy-3-methoxyanthraquinone were isolated from this plant for the first time. CONCLUSION: This study provides scientific evidences for further study of the root of Rumex japonicus.