川东獐牙菜总酮指纹图谱研究

目的建立川东獐牙莱总口山酮指纹图谱测定方法。方法采用反相高效液相色谱法测定川东獐牙菜总口山酮指纹图谱，色谱柱为Hypersil C18柱（150mm×4．6mm，5μm），流动相为甲醇-水（54：46），流速1．3mL／min，检测波长338nm，柱温20℃。结果建立了川东獐牙菜总咄酮样品指纹图谱，确立了11个特征共有峰，10批样品的相似度均在0．9以上。结论所用方法简便、快速、重现性好，可作为川东獐牙菜总口山酮的一项质量控制指标。     

Validation of tissue microarray immunohistochemistry staining and interpretation in diffuse large B-cell lymphoma

Tissue microarrays (TMAs) show concordance with whole tissue sections in the immunohistochemical evaluation of tumor cells. However, potential inter-institutional variability among observers and immunohistochemical staining methods has not been fully addressed. We selected 21 cases of diffuse large B-cell lymphoma (DLBCL) to process for TMAs. Immunohistochemical stains were performed in 3 laboratories, and reviewed independently by 3 hematopathologists at the 3 institutions. Stains were scored on a 4-point scale. Statistical analyses of variation in the scoring among observers and among different institutions' stains were performed. Stains for CD3, CD10, CD20, BCL-2, BCL-6, MIB-1, and FOX-P1 revealed little variation among observers, with an average 51-82% complete agreement and 82-100% agreement +/- 1 numerical score. The rate of concordance when evaluating most stains performed in different laboratories was also relatively good, with an average of 55-72% complete agreement and 70-97% agreement +/- 1 score. However, scoring of MUM-1 and p53 stains showed wider variation, with an average of only 37 and 30% complete agreement among observers, and 11 and 45% agreement when stains from different institutions were examined. Further statistical analyses were performed to compare the observers' scoring of their own institution's stains (self-review) vs. observers' scoring of other institutions' stains (non-self). The agreement rate for the p53 stain was significantly higher when based on self-review (average 58% complete agreement) compared with an agreement rate of only 10.5% when based on a review of stains performed in another laboratory, non-self review, P < 0.01. This difference in the self- vs. non-self review was not seen when data for MUM-1 were analysed. In conclusion, most phenotypic markers used in the analysis of DLBCL can be evaluated in TMAs with adequate agreement among observers and laboratories. These include CD3, CD20, CD10, BCL-2, BCL-6, MIB-1, and FOX-P1. However, some markers, such as p53 and MUM-1, are more prone to inter-institutional variation. Variations in interpretation can be partially overcome by self-adjusted/adapt tendency, as seen with p53. Especially with newly developed markers, such as MUM-1, the development of standardized techniques for staining and interpretation is critical to reduce inter-observer variability.     

原发性干燥综合征103例血液学变化

目的 了解原发性干燥综合症（pSS)的血液学变化。方法 对103例pSS中患者外周血、骨髓象治疗前后情况进行总结分析。结果 pSS合并多种血液学异常,其中贫血最常见,占51%,单纯贫血占34%。白细胞减少占25%,血小板减少占23%,全血细胞减少占7.7%。经皮质激素治疗后,外周血及骨髓象均有不同程度的改善。结论 pSS的血液系统异常与免疫因素有关。     

幽门螺杆菌vacA基因型及其表达产物与胃十二指肠疾病关系的研究

目的 探讨幽门螺杆菌ｖａｃＡ基因型及其表达产物－ＶａｃＡ与胃十二指肠疾病之间的关系。方法 用聚合酶链反应技术测定６２株从慢性胃炎,消化性溃疡和胃癌患者中分离获得的幽门螺杆菌（Ｈｐ）菌株的ｖａｃＡ基因型,用Ｈｅｌａ细胞测定Ｈｐ菌株体外ＶａｃＡ活性。     

Light Microscopic and Ultrastructural Evidence of in Vivo Phagocytosis of Helicobacter pylori by Neutrophils

Helicobacter pylori is believed to cause chronic active gastritis. Infection/colonization of the gastric mucosal surface induces a mucosal inflammatory reaction in the form of lymphocytic aggregates, plasma cells and, particularly, neutrophils, which may, in turn, damage the mucosal epithelium. In vitro studies demonstrate that, in culture, the bacilli are readily phagocytosed by neutrophils, this evoking a neutrophilic oxidative burst. However, it has been claimed that neutrophils do not phagocytose H. pylori in vivo. In this study of 19 endoscopic biopsies of gastric mucosa with H. pylori -associated gastritis, Cresyl violet staining for light microscopy and electron microscopy areusedto demonstrate that, in vivo, neutrophils actively phagocytose and destroy the bacilli in the epithelial intercellular space and in the mucin on the surface of the mucosa. Direct contact of neutrophils with H. pylori was observed in 17 of 17 cases by light microscopy and in 4 of 15 cases by electron microscopy. Phagocytosis by neutrophils was seen in 14 of 17 cases by light microscopy and in 3 of 15 cases by electron microscopy. It was most evident in the surface mucus coat where ``wolf packs'' of neutrophils were seen attacking the microbes. Ultrastructurally, neutrophil phagolysosomes contained both intact and partially digested bacteria,convincing evidence that the primary function of neutrophils in chronic active gastritis is to destroy H. pylori organisms. This study leaves open the question of whether, or how, neutrophils damage the gastric mucosa.     

经典型滤泡树突细胞肉瘤的特殊变异形态及潜在诊断陷阱

目的探讨经典型滤泡树突细胞肉瘤(FDCS)的临床病理特征、特殊变异形态及潜在诊断陷阱,提高诊断准确性。方法对2006—2018年陆军军医大学第一附属医院诊断的25例经典型FDCS进行组织形态观察、免疫组织化学染色和EB病毒编码的小RNA(EBER)原位杂交检测,结合文献分析其特殊变异形态的类型和特点。结果25例FDCS患者年龄23~77岁(平均52岁),男女比例为1.5∶1.0,肿瘤最大径1.5~20.0 cm(平均7.4 cm),其中12例(48%)在初次诊断时被误诊。17例有随访信息,随访时间5~96个月,复发、转移、病死比例分别为3/17、5/17、2/17。除了典型组织形态外,10例FDCS可见特殊的变异形态和/或组织结构,包括淋巴上皮癌样、促结缔组织增生性浸润癌样、霍奇金淋巴瘤样、间变性大细胞淋巴瘤样及血管外皮细胞瘤样等,是需要重视的潜在诊断陷阱。免疫组织化学染色结果显示典型形态和各种特殊的变异形态均可表达2个以上滤泡树突细胞标志物(CD21、CD23、CD35等)。EBER原位杂交检测显示25例FDCS均为阴性。结论经典型FDCS罕见,除了典型的组织形态外还可出现多种特殊的变异形态,其中鼻咽部的淋巴上皮癌样、纵隔或淋巴结内的霍奇金淋巴瘤样、间变性大细胞淋巴瘤样变异型尤其值得我们重视。加强对此类罕见变异形态的认识,提高诊断警惕性,有助于避免误诊。