15例软组织透明细胞肉瘤的临床病理分析

ED 50 of Intrathecal Isobaric Bupivacaine with Epidural Volume Extension for Cesarean Delivery

中文关键词:  Ki-67 核分裂象 胃肠间质瘤 预后

中文摘要:

      目的 探讨软组织透明细胞肉瘤（CCS）的临床病理特征与治疗方法。方法 对我院既往诊治的15例CCS患者的临床病理学资料进行回顾性分析，并复习文献。结果 男性8例，女性7例，平均年龄35岁，40%肿瘤位于肢体末端。镜下：肿瘤细胞被增生的网织纤维组织分隔成大小不等的巢状、束状或泡状结构。可见散在多核巨细胞，可伴坏死及黑色素。免疫标记：S-100、HMB45及Melan-A/MART-1阳性。所有患者均接受手术，6例患者接受以放化疗、干扰素等为基础的辅助治疗方案。结论 CCS是一种恶性程度较高的肉瘤，同时表现出黑色素瘤和软组织肉瘤的特点。诊断应结合临床、病理与免疫组化。彻底地手术结合放化疗有一定的治疗效果。

英文摘要:

      Objective To investigate the preventive effects of thymosin-α1 against early ventilator-associated pneumonia (VAP) in the patients with mechanical ventilation. Methods Fifty two patients with expectancy of mechanical ventilation over 48 h were divided into routine therapy group (n=26) and thymosin therapy group (n=26) in random. The patients in routine therapy group were given intensive care unit (ICU) conventional treatment, and the patients in thymosin therapy group were given thymosin treatment additionally (1.6 mg subcutaneous injection, qd×7 d). The incidence and occurrence time of VAP were observed, and the time of mechanical ventilation and ICU stay were recorded. The levels of CD3⁺,CD4⁺,CD4⁺/CD8⁺T lymphocyte, CD14⁺ mononuclear cell human leukocyte antigens-DR (CD14⁺ HLA-DR) and procalcitonin (PCT) were detected before mechanical ventilation and at the 3^rd and 7^th d after mechanical ventilation. Results The base line including the level of immunologic function had no difference between the two groups ( P>0.05). The incidence of VAP in thymosin therapy group was lower than that in routine therapy group，but it was not significant difference ( P>0.05). The durations of machine ventilation and ICU stay in thymosin therapy group were shorter than those in routine therapy group ( P<0.05). The occurrence time of VAP in thymosin therapy group was significantly later than that in routine therapy group （ P<0.05）. At the 3^rd and 7^th d after mechanical ventilation, thymosin therapy group achived higher levels of CD3⁺, CD4⁺, CD4⁺/CD8⁺T lymphocyte and CD14⁺ HLA-DR than routine therapy group did （ P<0.05）. Conclusion Thymosin-α1 may be able to improve immunologic function and prevent the incidence of early VAP in the patients with mechanical ventilation.