Objective To study the clinical and CT findings of bronchiolar adenoma. Methods Patients diagnosed with bronchiolar adenoma confirmed by surgical pathology at Linyi People's Hospital and Yantai Yuhuangding Hospital from 2016 to 2021 were collected. Their clinical and CT imaging features were retrospectively analyzed. ResultsFinally, 25 patients were collected, including 6 males and 19 females, aged 32-73 (58.6±10.1) years. The immunohistochemical Ki-67 (MIB1) of all lesions was <5%. The lesions were located in the upper and middle lobe of both lungs in 9 patients, lower lobes in 16 patients, extrapulmonary zone in 22 patients, intrapulmonary middle zone in 3 patients, round in 11 patients, irregular in 14 patients, well-defined in 22 patients, pure ground-glass/mixed ground-glass nodules in 6 patients, solid nodules in 19 patients. There were 11 patients with central small cavity, 18 patients with single bronchioles sign, 19 patients without adhesion with adjacent pleura, and 24 patients without mediastinal lymph node enlargement. ConclusionBronchiolar adenomas usually occur in the middle-aged and elderly, mostly in the lower lobe of both lungs and the distribution of the peripheral lung field, most of the patients do not have any clinical symptoms, and the postoperative prognosis is good. CT may show large nodules or masses, pure ground-glass/mixed ground-glass nodules, irregular solid nodules and central small cavities. Irregular stellate nodules, central small cavity shadow, and single bronchiolar vascular bundle connected with the lesions are relatively specific imaging findings of bronchiolar adenoma.
目的 探討肝細胞腺瘤的診斷與外科治療方法。方法 對5例肝細胞腺瘤患者進行回顧性分析。結果 術前行B超檢查4例，行CT檢查2例及行MRI檢查2例均未確診。術前4例成人均誤診為原發性肝癌； 1例幼兒誤診為肝母細胞瘤。全部病例均做了肝葉或聯合肝段切除術。結論 成人肝細胞腺瘤須與原發性肝癌相鑒別； 幼兒肝細胞腺瘤須與肝母細胞瘤相鑒別。肝細胞腺瘤誤診原因與其發病率低，缺乏典型的臨床表現、生化檢查指標和影像學特征有關。肝葉或聯合肝段切除是肝細胞腺瘤的主要外科治療方法。
目的 全面介紹先天性囊性腺瘤樣畸形(CCAM)其可能的病因，臨床、病理特點及診斷手段，循證探討針對CCAM的治療方法及預后。 方法 對我院2011年11月收治的1例罕見的CCAM患者的臨床資料進行分析，并對相關文獻進行復習。 結果 患者數次誤診后最終診斷為CCAM，予手術治療后痊愈，隨訪1年無復發。 結論 CCAM是一種少見的、非遺傳性的、錯構瘤樣的肺發育異常，為一種良性的肺部畸形，其特點是局部肺終末呼吸性細支氣管過度生長。CCAM多通過產前影像學檢查、活組織檢查或術后病檢診斷。手術為治愈該病的最根本、最重要措施。
【摘要】 目的 探討凋亡抑制蛋白Livin與凋亡蛋白Caspase-3在結直腸腺瘤-癌序列中的表達變化及其相關性。 方法 2006年7月—2009年12月，采用免疫組織化學染色鏈霉菌抗生物素蛋白-過氧化物酶鏈接法streptavidin-peroxidese，SP）法檢測18例正常黏膜、84例結直腸腺瘤、72例結直腸癌中Livin及Caspase-3的表達情況。 結果 結直腸腺瘤組織中Livin蛋白的陽性表達率明顯高于正常黏膜組織（Plt;0.05），而低于腺癌組（Plt;0.05）；腺瘤組內絨毛狀腺瘤與管狀腺瘤相比較，Livin蛋白表達率差異有統計學意義（Plt;0.05）。結直腸腺瘤組織中Caspase-3的陽性表達率明顯高于正常黏膜組織（Plt;0.05）；而腺瘤組織與癌組織之間Caspase-3陽性表達率差異（Plt;0.05）；腺瘤組內絨毛狀腺瘤與管狀腺瘤相比較，Caspase-3蛋白陽性表達率差異無統計學意義（Pgt;0.05）。Livin表達與Caspase-3表達呈負相關（Plt;0.05）。 結論 凋亡抑制蛋白Livin參與了大腸腫瘤的發生，且在大腸腺瘤-腺癌階段起到了重要作用；凋亡抑制蛋白Livin與Caspase-3表達呈負相關，抑制Caspase-3蛋白的活性可能是Livin促進結腸癌發生的途徑之一。【Abstract】 Objective To investigate the expression of Livin and Caspase-3 among colorectal adenoma-carcinoma sequence, and to identify the relationship between Livin and Caspase-3 expression in colorectal adenoma-carcinoma sequence. Methods Formalin-fixed paraffin embedded colorectal tissues from 174 patients, including 84 adenomas, 72 carcinomas, and 18 normal mucosa, were examined for expression of Livin and Caspase-3 by streptavidin-peroxidase (SP) immunohistochemistry between July 2006 and December 2009. Results The positive rates of Livin protein expression in colorectal adenoma was significantly higher than that in normal mucosa (Plt;0.05), but lower than that in adenocarcinoma (Plt;0.05); the expression of Livin in tubular adenoma was significantly higher than that in villous adenoma (Plt;0.05). The positive rates of Caspase-3 protein expression in colorectal adenoma were significantly higher than that in normal mucosa and carcinoma (Plt;0.05), and the difference in positive rate of Caspase-3 expression was not significant between the villous adenoma and tubular adenoma (Pgt;0.05). Livin expression had negative correlation with the Caspase-3 expression (Pgt;0.05). Conclusion The difference in expression of Livin between adenoma and adenocarcinoma indicates the potential value of it in carcinogenesis of colorectal cancer, which suggestes that suppressing Caspase-3 protein activity is one of the channels by which livin promotes colorectal carcinogenesis.
Objective To systematically review the effectiveness of thoracoscopy surgery and thoracotomy for thymoma. Methods Databases including PubMed, EMbase, The Cochrane Library (Issue 3, 2016), Web of Science, CBM, WanFang Data and CNKI were searched to collect randomized controlled trials (RCTs) and cohort studies about thoracoscopy surgery versus thoracotomy for thymoma from inception to April 2016. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Results A total of 5 RCTs and 8 cohort studies involving 1?093 patients were included. The results of meta-analysis showed that, compared with thoracotomy, the thoracoscopy surgery could shorten operative time (MD= –22.2, 95%CI –32.92 to –12.52, P < 0.000?01), duration of ICU stay (MD= –0.76, 95%CI –0.21 to –0.30, P < 0.000?01), duration of hospital stay (MD= –3.71, 95%CI –4.47 to –2.96, P < 0.000?01) and duration of pleural drainage (MD= –1.80, 95%CI –2.42 to –1.18, P < 0.000?01), reduce volume of intraoperative blood loss (MD= –43.27, 95%CI –50.94 to –35.60, P < 0.000?01), and decrease the incidence of postoperative complications (OR=0.19, 95%CI 0.11 to 0.34, P < 0.000?01), but there was no significant difference in recurrence rate between two groups (OR=0.81, 95%CI 0.31 to 2.11, P=0.67). Conclusions Current evidence shows that, compared with thoracotomy, the thoracoscopy surgery for thymoma has shorter operative time, duration of ICU stay, duration of hospital stay, and duration of pleural drainage, as well as less blood loss and postoperative complications. Due to the limited quality of included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the value of bilateral inferior petrosal sinus sampling (BIPSS) for preoperative diagnosis of adrenocorticotropic hormone (ACTH) microadenomas.MethodsWe retrospectively analyzed the clinical date of patients with ACTH microadenomas, who were experienced BIPSS preoperatively from October 2013 to May 2017. The qualitative and localized diagnostic significance of BIPSS was evaluated based on the criteria of the plasma ACTH concentration ratio of inferior petrosal sinus to ulnar vein (≥2), and the ratio of left to right inferior petrosal sinuses (≥1.4).ResultsFive patients (1 male and 4 females) were involved in the study. The mean age was (49.6±9.2) years, and the mean disease course was (17.2±7.5) months. The plasma ACTH concentration of all the cases ran up to the criterition of the ratio of inferior petrosal sinus to ulnar vein (≥2). Three cases were found that the actual locations of the microadenomas were inconsistent with the indications from the results of BIPSS. After the BIPSS procedure, there was no intracranial infection or death case, except that one patient suffered from ecchymoma and another one suffered from transient nausea.ConclusionBIPSS is valuable for qualitative diagnosis, but not effective for localization diagnosis of the ACTH microadenomas preoperatively.
目的 探討十二指腸腺瘤并大出血的診斷和治療。方法 對2例十二指腸腺瘤并大出血患者進行回顧性分析，并結合文獻進行討論。結果 2例術前均行X線氣鋇雙重造影、胃鏡及腫塊活檢，但未確診。2例均行十二指腸切開、腫瘤切除術而痊愈。結論 十二指腸腺瘤早期多無臨床癥狀，隨著腫瘤的增大可并發腸梗阻或腫瘤潰瘍出血而出現相應癥狀； X線鋇餐和胃鏡可發現腫瘤，但難于確診，經內窺鏡或十二指腸切開、腫瘤切除術是治療本病的常用方法。
Objective To analyze the central visual fields and the ocular fundus changes of both eyes of patients with pituitary adenoma.Methods A total of 70 cases of pituitary adenoma received the examination of static central visual fields of all-liminal values by Humphrey instruments 750 cycloscope and the fundus exams by Topcon TRC-50X fundus photography before operations. Results There were 64.3% patients with decreased visual acuities, 80.7% with the defect of visual field, and 46 .4% with fundus changes. The decrease of the visual acuity was the first diagnostic symptom in 45.7% patients, among whom 28.6% were misdiagnosed as ocular diseases.Conclusions The misdiagnosed cause is that the first diagnostic symptom is the decrease of visual acuity without defect of visual field accompanied by ocular diseases. To avoid the misdiagnosis and the omitter of pituitary adenoma, general examination of visual field should be carried out in the patients with decreased visual acuity and optic atrophy with unknown reason in the clinical diagnosis of ophthalmology. (Chin J Ocul Fundus Dis，2003，19：18-19)