Intervention of Tongxinluo Capsule (通心络胶囊) against Vascular Lesion of Atherosclerosis and Its Effect on Lectin-like Oxidized Low Density Lipoprotein Receptor-1 Expression in Rabbits

Objective.- To investigate the prevention by Tongxinluo capsule （通心络胶囊, TXL） of vascular lesions and its effect on the levels of protein and gene expression of lectin-like oxidized low-density lipoprotein receptor-1 （LOX-1） of vascular wall in rabbits with atherosclerosis （AS）, and to explore its possible mechanism against AS. Methods： AS models were established by feeding New Zealand white rabbits with high-cholesterol diet, and 24 immature rabbits were randomly divided into the control group, model group and treated group （treated with TXL capsule）. The indexes of total cholesterol （TO） and low density lipoprotein （LDL） levels were measured at the 16th week. The intima thickness and the plaque area of abdominal aorta were quantitatively analyzed by pathological morphological analysis, the expression of macrophage and smooth muscle cell （SMC） in intima were detected by immunohistochemical method and histologic segments were stained by Hematoxilin-Eosin （HE） to identify the degree of atherosclerotic lesion in the model group and the prevention by TXL. The LOX-1 gene and protein expression in abdominal aorta was detected by semi-quantitative RT-PCR and immunohistochemistry, respectively. Results： In the model group, the levels of TC and LDL were significantly elevated, aortic intima thickened extensively, the intima area enhanced, and macrophages expression increased; the levels of LOX-1 gene and protein expression was up-regulated in endothelium and neo-intima of the abdominal aorta. The treatment with TXL reduced blood lipids, attenuated arterial intimal proliferation, markedly inhibited the expression of macrophage and excessively expressed the level of LOX-1. Conclusion：TXL has an inhibitory effect on blood lipids, and it can prevent the occurrence of vascular lesion and cure its development, and its protection against AS was possibly associated with a crucial endothelial protective action through lowering the expression of LOX-1 in vascular walls.

Portal Hypertensive Vascular Lesions

The aim of present study is to assess the pathological changes of gastric coronary vein in cirrhotic patients (n= 30) by immunohistochemical and morphological observation. The damage to endothelium, hypertrophy and hyperplasia of smooth muscle and increament of ECM were found in gastric coronary vein of cirrhotic patients. The vessel wall hardened and thickened with decrease of elasticity. The results showed that the portal hypertension could accompany with ' portal hypertensive vascular lesions'.

Bulbar conjunctival vascular lesion combined with spontaneous retrobulbar hematoma:A case report

BACKGROUND Orbital hemorrhage can be classified as traumatic or spontaneous depending on its cause.Spontaneous orbital hemorrhage refers to an internal orbital hemorrhage without apparent cause.Therefore,we aimed to describe a case of an orbital hematoma after a severe cough the night before due to inhalation of cooking oil fumes.CASE SUMMARY A 46-year-old woman was referred to our hospital with a complaint of exophthalmos accompanied with blurred vision,pain,binocular diplopia,and dizziness lasting for 5 h noted on waking in the morning.She also experienced nausea and vomiting due to high pressure of orbit and dizziness.Based on the auxiliary examination and her medical history,the patient was finally diagnosed with bulbar conjunctival vascular lesion combined with spontaneous retrobulbar hematoma.The patient was administered tobramycin and dexamethasone eye ointment,and applied pressure dressing on the left eye to stop the bleeding.Simultaneously,we administered intravenous etamsylate,oral Yunnan Baiyao capsule,intravenous mannitol to reduce orbital pressure,and intravenous dexamethasone injection at 10 mg/dL combined with neurotrophic therapy to reduce tissue edema.Among them,the Yunnan Baiyao capsule is a traditional Chinese herbal medicine to remove stasis and stop bleeding;thus,it promotes blood circulation and relieves pain resulting in reduced edema of the lesion site.The symptoms did not improve significantly during the first 2 d of treatment.We speculate that high orbital pressure and binocular diplopia induced frequent nausea and vomiting in the patient,causing increased pressure on the superior vena cava and leading to repeated orbital bleeding.After the second day,the symptoms started gradually improving.CONCLUSION This case further emphasizes the importance of comprehensive,detailed medical history and careful ophthalmic examination of the patient.

Effect of Danzhijiangtang capsule on monocyte chemoattractant protein-1 mRNA expression in newly diagnosed diabetes subclinical vascular lesions

AIM:To investigate the effect of Danzhijiangtang capsule(DJC) on monocyte chemoattractant protein-1(MCP-1) mRNA expression in newly diagnosed type 2 diabetes mellitus(T2DM) subclinical vascular lesions.METHODS:Sixty-two patients with newly diagnosed T2DM subclinical vascular lesions were randomly divided into a control group and treatment group of 31 cases each.Oral antidiabetic therapy with routine western medicine was conducted in both groups,and the treatment group was additionally treated with DJCs.The treatment course for both groups was 12 wk.Before and after treatment,the total efficiency and traditional Chinese medicine(TCM) syndrome score were calculated.The fasting plasma glucose(FPG),2-h plasma glucose(2hPG),fasting insulin(FINS),insulin resistance index(IRI),hemoglobin(Hb)A1c,blood lipids,and hemorheology indices were determined.In addition,the levels of vascular endothelial growth factors including thrombomodulin(TM),von Willebrand factor(vWF),P-selectin and MCP-1 mRNA were determined.RESULTS:After 12 wk of treatment,the TCM syndrome score was significantly decreased compared to before treatment in both groups.After treatment,FPG,2hPG,HbA1c,FINS,IRI,total cholesterol,triglycerides,low-density lipoprotein,high-density lipoprotein,whole blood low shear specific viscosity,plasma specific viscosity,TM,vWF,P-selectin and MCP-1 mRNA were significantly improved compared to before treatment in both groups.After treatment,the total efficiency and TCM syndrome score in the treatment group were better than in the control group.FINS,IRI,whole blood high shear specific viscosity,plasma specific viscosity,TM,vWF,P-selectin and MCP-1 mRNA level in the treatment group were significantly reduced after treatment compared with control group.CONCLUSION:DJCs are efficacious in supplementing qi,nourishing yin and invigorating blood circulation,and upregulate MCP-1 mRNA expression in patients with T2DM subclinical vascular lesions.

Early Onset Post-Radiation Cutaneous Angiosarcoma of the Breast with Features of Atypical-Vascular Lesion: A Diagnostic Pitfall and Its Biologic Significance

Vascular proliferations may arise in the breast following radiation treatment for a primary breast adenocarcinoma. A post-radiation vascular proliferation can usually be classified as angiosarcoma or as an atypical vascular lesion (AVL). Angiosarcomas with a “low-grade” morphology, behave aggressively but exhibit substantial histomorphologic overlap with AVLs, which have a generally benign clinical course. We present a case of a post-radiation angiosarcoma of the breast with histologic features that mimic an atypical vascular lesion and discuss this challenging differential diagnosis. In addition to histologic mimicry, the lesion exhibited only patchy amplification of the avian myelocytomatosis viral oncogene homolog (MYC) gene by present fluorescence in-situ hybridization (FISH), and patchy MYC overexpression by immunohistochemistry. These features further complicate the distinction between AVL and angiosarcoma, and would be particularly problematic on a small biopsy. We believe that the morphologic and immunohistochemical overlap between these entities is suggestive of a biologic spectrum, and thus that, at least in some instances, angiosarcoma may arise from a pre-existing AVL or AVL-like lesion.

Artificial intelligence in detection of small bowel lesions and their bleeding risk:A new step forward

The present letter to the editor is related to the study with the title“Automatic detection of small bowel(SB)lesions with different bleeding risk based on deep learning models”.Capsule endoscopy(CE)is the main tool to assess SB diseases but it is a time-consuming procedure with a significant error rate.The development of artificial intelligence(AI)in CE could simplify physicians’tasks.The novel deep learning model by Zhang et al seems to be able to identify various SB lesions and their bleeding risk,and it could pave the way to next perspective studies to better enhance the diagnostic support of AI in the detection of different types of SB lesions in clinical practice.

Pancreatic transection from blunt trauma associated with vascular and biliary lesions: A case report

Major injuries of the pancreas may result in considerable morbidity and mortality when associated with vascular and visceral injuries. In such cases, a right diagnosis and a prompt surgical intervention are necessary to give a chance to the patient. We herein describe a case of blunt abdominal trauma in a 29-year- old man whose pancreatic rupture was associated with hepatic artery, splenic vein and extrahepatic bile duct damage. Immediate surgery was performed after computer tomograghy (CT), the haemorrhagic lesions dictat the emergency transfer to the operating room. Spleno-pancreatic resection was done with reconstruction of the hepatic artery, ligation of the splenic vein and a Roux-en-Y bilio-jejunal diversion. The early post-operative course was complicated by stenosis of the arterial reconstruction, which was treated by endovascular angioplasty followed by percutaneous drainage of symptomatic pseudocyst, rest and antibiotics. Finally, the patient was discharged and was alive without clinical problems at the time when we wrote this case report. The present case underlines the clinical relevance of vascular and visceral injuries associated with pancreatic trauma and the problems arising in the diagnostic evaluation and the surgical strategy of complex multiple visceral and vascular lesions in blunt abdominal trauma.

Expression of p-STAT3 and vascular endothelial growth factor in MNNG-induced precancerous lesions and gastric tumors in rats

AIM: To investigate the dynamic expression of p-signal transducer and activator of transcription 3(STAT3) and vascular endothelial growth factor(VEGF) in the formation of gastric tumors induced by drinking water containing N-methyl-N'-nitro-N-nitrosoguanidine(MNNG) in Wistar rats.METHODS: One hundred and twenty Wistar rats were randomly divided into two groups(60 in each group): Control group and Model group. The rats in each group were then randomly divided into three groups(20 in each group): C/M15, C/M25 and C/M40(15, 25 and 40 represent the number of feeding weeks from termination). Rats in the control group received normal drinking water and rats in the model group received drinking water containing 100 μg/m L MNNG. Stomach tissues were collected at the end of the 15 th, 25 th and 40 th week, respectively, for microscopic measurement using hematoxylin and eosin staining. The expression of p-STAT3 and VEGF in different pathological types of gastric tissue, including normal, inflammation, atrophy, hyperplasia and gastric stromal tumor, was observed by immunohistochemistry and Western blot, and the corelation between p-STAT3 and VEGF was analyzed. RESULTS:(1) The expression of p-STAT3 in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor were significantly increased in the model group compared with the control group(2.5 ± 1.0, 2.75 ±0.36, 6.2 ± 0.45, 5.67 ± 0.55 vs 0.75 ± 0.36, P = 0.026, 0.035, 0.001, 0.002, respectively); the expression of p-STAT3 in tissue with dysplasia was higher than that in samples with gastritis or atrophy(6.2 ± 0.45 vs 2.5 ± 1.0, P = 0.006; 6.2 ± 0.45 vs 2.75 ± 0.36, P = 0.005, respectively); however, the expression of p-STAT3 in gastritis and atrophy was not significantly different(P > 0.05);(2) the expression of VEGF in tissue with gastritis, atrophy, dysplasia and gastric stromal tumor was significantly increased in the model group compared with normal gastric mucosa; and the expression of VEGF in tissue with dysplasia was higher than that in tissue with inflammation and atrophy(10.8 ± 1.96 vs 7.62 ± 0.25, P = 0.029; 10.8 ± 1.96 vs 6.26 ± 0.76, P = 0.033, respectively); similarly, the expression of VEGF in tissue with gastritis and atrophy was not significantly different(P > 0.05); and(3) the expression of VEGF was positively correlated with p-STAT3. CONCLUSION: p-STAT3 plays an important role in gastric cancer formation by regulating the expression of VEGF to promote the progression of gastric tumor from gastritis.

hs-CRP、NT-proBNP及NAR对急性冠状动脉综合征患者诊断价值分析

目的 探讨超敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)及中性粒细胞与白蛋白比值(NAR)对急性冠状动脉综合征(ACS)患者的诊断价值。方法 选取2020年6月—2022年9月收治的ACS 71例作为研究组,同期健康体检者56例作为对照组,并依照不同疾病类型和血管病变支数将研究组分为ST段抬高型心肌梗死(STEMI)组、非ST段抬高型心肌梗死(NSTEMI)组、不稳定型心绞痛(UAP)组及单支、双支、多支病变组各3个亚组。比较研究组与对照组、不同疾病类型和血管病变支数各3个亚组hs-CRP、NT-proBNP及NAR,探讨hs-CRP、NT-proBNP及NAR单独或联合对ACS的诊断价值。结果 研究组hs-CRP、NT-proBNP及NAR均高于对照组;STEMI组、NSTEMI组和UAP组hs-CRP、NT-proBNP及NAR逐渐降低,单支、双支和多支病变组hs-CRP、NT-proBNP及NAR逐渐升高(P<0.05)。受试者工作特征曲线分析显示,hs-CRP、NT-proBNP和NAR单独或联合诊断ACS的曲线下面积分别为0.820、0.815、0.883及0.914,三者联合诊断ACS的曲线下面积高于单独诊断(P<0.05,P<0.01)。结论 hs-CRP、NT-proBNP及NAR三者联合对ACS的诊断价值较高。

踝肱指数联合血清25-羟维生素D水平对2型糖尿病下肢血管病变的诊断价值

目的 探讨踝肱指数(ABI)联合血清25-羟维生素D[25(OH)D]水平对2型糖尿病下肢血管病变的诊断价值。方法 选择2018年7月至2021年1月安徽省亳州市人民医院收治的179例2型糖尿病患者,根据是否发生下肢血管病变将其分为未病变组(106例)与病变组(73例)。分析2型糖尿病患者发生下肢血管病变的影响因素,分析ABI联合血清25(OH)D水平对其的诊断价值。结果 病变组年龄、糖化血红蛋白、低密度脂蛋白胆固醇高于非病变组,白蛋白、ABI、血清25(OH)D水平低于非病变组(P<0.05)。多因素分析结果显示,年龄(OR=2.843,95%CI:1.250~6.468)、糖化血红蛋白(OR=3.056,95%CI:1.343~6.951)、ABI (OR=2.724,95%CI:1.197~6.196)、血清25(OH)D水平(OR=3.979,95%CI:1.749~9.051)为2型糖尿病患者发生下肢血管病变的影响因素(P<0.05)。ABI、血清25(OH)D水平联合预测2型糖尿病下肢血管病变的曲线下面积高于二者单独预测(P<0.05)。结论 ABI联合血清25(OH)D水平对2型糖尿病患者发生下肢血管病变具有一定的诊断价值,临床中应予以重视。

MRI应用于阿尔茨海默病、血管性痴呆、混合型痴呆患者中血管损伤与脑萎缩评估的研究

目的对比血管损伤与脑萎缩在阿尔茨海默病(AD)、血管性痴呆(VD)或混合性痴呆(MD)患者中的分布,探究MRI在AD、VD、MD鉴别诊断中的价值。方法76例患者分别诊断为AD34例、VD31例和MD 22例。分别对三组通过分析MRI图像进行独立视觉评分量表和Evans's指数评估。结果与AD相比,MD的脑室周围白质病变PVL(P=0.002)、深部白质病变DWML(P=0.006)、皮质下微出血Juxtacortical MB(P=0.007)、深部白质微出血Deep MB(P=0.003)评分更高,VD的深部灰质病变DGML(p=0.016)、血管周围间隙PVS BG-CS(P=0.005)明显更多。VD与MD比较,血管性病变视觉评分结果无统计学差异,但VD患者内侧颞叶萎缩MTA(P<0.001)评分显著高于MD。脑皮层萎缩和Evans's指数的分布在组间无显著差异。结论MRI在痴呆患者的评估中可以更准确地检测血管病变及评估脑萎缩情况。研究证实血管病变在VD或MD患者中比AD更多,其中MD以深部和皮层旁微出血为主,这表明淀粉样脑血管病(CAA)可能是其主要的潜在病理机制。

基于内脏脂肪面积的2型糖尿病下肢血管病变预测模型的研究

目的 构建基于内脏脂肪面积(VFA)的2型糖尿病下肢血管病变的预测模型。方法 选取2019年7月至2022年9月广西壮族自治区柳州市工人医院住院的257例2型糖尿病患者,根据是否有下肢动脉硬化、狭窄或闭塞性病变将其分为病例组(115例)和对照组(142例),比较两组临床相关资料,采用logistic回归分析法构建2型糖尿病下肢血管病变的预测模型,Hosmer-Lemeshow拟合优度检验评价模型校准度,使用受试者操作特征曲线下面积(AUC)评价模型区分度。结果 两组高血压病史、病程、年龄、体重指数、尿素氮、肌酐、尿酸、谷草转氨酶、VFA比较,差异有统计学意义(P<0.05)。多因素分析结果显示,病程、年龄、VFA均为2型糖尿病患者下肢血管病变的独立影响因素(OR>1,P<0.05)。2型糖尿病下肢血管病变的预测模型为Logit(P)=-11.605+0.986×病程(≥10年)+2.075×年龄(≥45岁)+0.103×VFA,模型AUC为0.929,灵敏度为80.9%,特异度为88.7%。结论基于VFA构建的2型糖尿病患者下肢血管病变风险预测模型具有较好的预测效能,对2型糖尿病下肢血管病变高危人群的识别和干预具有临床应用价值。

颈部血管超声检查对2型糖尿病患者颈动脉病变的诊断效能

目的 探讨在2型糖尿病患者颈动脉病变方面采用颈部超声检查的诊断效果。方法 按照本研究制定目标,将2022年6月至2022年12月作为研究开展时段,抽选在该时段内我院体检中心进行检查的确诊为2型糖尿病的240例患者为试验对象,作为研究组,同时选择在同一时段前来我院体检中心进行健康体检的240例健康患者,作为对照组,两组患者均接受颈部血管超声检查,对比颈动脉内中膜(IMT)增厚率、血管斑块形成率、血管狭窄率、血管阻力指数(RI)、以及颈部血管收缩期和舒张期的血液峰值流速等检查结果。结果 研究组IMT增厚率、斑块形成率、血管狭窄率、RI高于对照组(P <0.05)。研究组与对照组血流情况存在差异(P <0.05),且组内不同情况血流相关指标存在差异(P <0.05)。结论 在2型糖尿病的临床诊断中,颈部超声血管能够观察到疾病变化,提示临床患者存在颈动脉内中膜增厚、血管狭窄和斑块生成等异常情况,还可收获颈部血管收缩期、舒张期的峰值流速情况,利于临床判断颈动脉血管病变方向,为后续的治疗提供影像学支持。

冠心病患者血清TGF-β_(1)、NT-proBNP的变化及其对冠脉狭窄的影响

目的探讨冠心病(coronary heart disease,CHD)患者血清转化生长因子-β_(1)(transforming growth factor-β_(1),TGF-β_(1))、氨基末端B型脑钠肽前体(nitrogen terminal B type natriuretic peptide precursor,NT-proBNP)水平对冠状动脉病变严重程度的影响。方法选取2019年7月—2022年6月在山东省潍坊市第二人民医院心内科诊治的85例CHD患者作为观察组,同期健康体检者39名作为对照组。均采用双抗体夹心酶联免疫吸附试验(enzyme linked immunosorbent assay,ELISA)法检测TGF-β_(1);采用电化学发光法检测NT-proBNP。比较2组患者生化指标、血清TGF-β_(1)、NTproBNP水平,以及观察组冠状动脉病变不同程度时血清TGF-β_(1)、NT-proBNP水平,分析评估血清TGF-β_(1)、NTproBNP诊断CHD的价值。结果2组三酰甘油(triacylglycerol,TG)、总胆固醇(total cholesterol,TC)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C)比较,差异无统计学意义(P>0.05)。观察组TGF-β_(1)为(326.04±181.75)ng/L,低于对照组的(926.42±156.47)ng/L,观察组血清NT-proBNP为(134.94±22.16)pg/mL,高于对照组的(65.25±3.35)pg/mL,差异有统计学意义(P<0.01)。单支血管病变血清TGF-β_(1)高于两支血管病变、多支血管病变,差异有统计学意义(P<0.01);单支血管病变NTproBNP低于两支血管病变、多支血管病变,差异有统计学意义(P<0.01)。结论观察组血清TGF-β_(1)水平降低,NTproBN水平升高,与冠状动脉病变严重程度密切相关,两者联合检测可作为CHD早期诊断、病情评估的检测指标。

低剂量对比剂在多排CT头颈部血管造影检查诊断头颈部血管病变中的应用效果

目的:观察低剂量对比剂在多排CT头颈部血管造影检查诊断头颈部血管病变中的应用效果。方法:回顾性分析2021年6月至2023年6月于该院行多排CT头颈部血管造影的118例头颈部动脉血管病变患者的临床资料,按造影对比剂量不同将其分为观察组(注射50 mL碘海醇注射液)66例与对照组(注射70 mL碘海醇注射液)52例。两组均给予CT造影检查,比较两组头颈部血管成像对比剂显影CT值、头颈部血管成像对比剂静脉残留显影CT值、图像质量评分,以及造影不良反应发生率。结果:观察组主动脉弓、颈总动脉、颈内动脉、大脑中动脉、椎动脉、基底动脉等对比剂显影CT值均低于对照组,差异有统计学意义(P<0.05);观察组颈内静脉、头臂静脉、上腔静脉、锁骨下静脉等对比剂残留显影CT值均低于对照组,差异有统计学意义(P<0.05);两组图像质量评分比较,差异无统计学意义(P>0.05);观察组造影不良反应发生率为4.55%(3/66),低于对照组的21.15%(11/52),差异有统计学意义(P<0.05)。结论:低剂量对比剂在多排CT头颈部血管造影检查诊断头颈部血管病变的图像质量与常规剂量对比剂无明显差异,且可减少对比剂残留、降低不良反应发生率。

基于cAMP-PKA-CREB信号通路中药防治血管性痴呆的研究进展

环磷酸腺苷(cAMP)-蛋白激酶A(PKA)-cAMP响应性元件结合蛋白(CREB)是神经系统一条重要的信号途径,在血管性痴呆(Va D)的防治方面发挥重要作用。中医药是我国治疗Va D的重要手段,其主要优势在于保护脑血管、改善学习记忆与认知功能的效果显著且无明显不良反应。本文基于cAMP-PKA-CREB信号通路在脑血管病变和记忆认知功能方面的调节机制,从单味中药及中药复方的角度综述了中药防治Va D的作用机制,为今后Va D相关基础及临床研究提供理论依据。

Recurrent orbital space-occupying lesions:a clinicopathologic study of 253 cases

Objective：To analyze the clinical features,histopathologic classification and frequencies of various types of recurrent orbital space-occupying lesions.Methods：A retrospective study was carried out in 253 consecutive patients with recurrent orbital spaceoccupying lesions treated by surgical excision in the Institute of Orbital Diseases,the General Hospital of the Armed Police Force from January 2009 to December 2010.Results：The patients included 123 males and 130 females aged 2 to 78 years（mean,36.2 years）,and the last recurrence interval after operation ranged from 1 month to 40 years（median,4.75 years）.Of all the cases,159（62.8%）,65（25.7%）,20（7.9%）,8（3.2%） and 1（0.4%） had previously experienced once,twice,three,four and six times of surgeries,respectively.Among them,29（11.5%） cases had recurred 3 times or over,and 37（14.6%） cases got recurrence in 10 or more years postoperatively.Most of the patients with local recurrence presented with various clinical manifestations,while 31（12.3%） cases were symptom-free.Two hundred and thirty-one（91.3%） cases underwent surgical removal of the recurrent orbital lesions,and another 22（8.7%） cases had to receive the exenteration of orbit.Categories of these recurrent orbital lesions after operation were as follows：lacrimal gland tumors,65（25.7%） cases;vasogenic diseases,54（21.3%） cases;neurogenic tumors,42（16.6%） cases;secondary tumors,24（9.5%） cases;orbital inflammation,21（8.3%） cases;myogenic tumors,14（5.5%） cases;fibrous and adipose tumors,12（4.7%） cases;lympho-hematopoietic tumors,7（2.8%） cases;bone or cartilage tumors,7（2.8%） cases;orbital cysts,6（2.4%） cases;and indefinitely differentiated tumor,1（0.4%） case.The 10 top histopathologic diagnoses were lacrimal gland pleomorphic adenoma,hemangiolymphangioma,lacrimal gland adenoid cystic carcinoma,meningioma,inflammatory pseudotumor,neurofibroma,sebaceous gland carcinoma,vascular malformation,rhabdomyosarcoma and hemangioma.Conclusions：The variety of recurrent orbital lesions after operation includes mainly of tumors except for vascular malformation and orbital inflammatory lesions.The lacrimal gland epithelial tumor is most prone to relapse after resection,and early and longer-term postoperative follow-up is needed.

肌内血管瘤经ISSVA标准重新分类后临床及病理特征分析

目的根据国际血管瘤和脉管畸形研究学会(ISSVA)标准将肌内血管瘤患者分为血管瘤和血管畸形,比较不同类型间的临床及病理特征差异。方法收集新疆医科大学第一附属医院2013年10月至2021年5月间依据WHO骨与软组织肿瘤标准诊断为肌内血管瘤的病例资料,根据ISSVA标准重新分类为血管瘤及血管畸形,对比分析两者在临床及病理特征方面的差异。结果共纳入依据WHO骨与软组织肿瘤标准诊断为肌内血管瘤的患者40例,根据ISSVA标准可进一步分类为血管畸形36例和血管瘤4例。血管瘤患者以女性为主(男1例、女3例),好发于头颈部(4例均发生于面部)。血管畸形患者以静脉畸形为主(22例静脉畸形、1例动静脉畸形、13例混合型血管畸形),好发于四肢,尤以下肢为多见(19例发生于下肢,10例发生于上肢,4例发生于躯干,3例发生于面部)。从镜下特点来看,血管瘤镜下以血管增殖为特点,血管内皮细胞肿胀,可见核分裂象,血管增生呈分叶状分布。血管畸形镜下特点根据类型不同而存在差异,其中静脉畸形以薄壁、扩张静脉为特征,多伴血栓、静脉石;动静脉畸形血管壁厚薄不一,间质纤维、平滑肌增生;淋巴管畸形内淋巴管管腔大小不一,间质见淋巴细胞聚集灶。随访9个月至8年,血管瘤患者均无复发,血管畸形患者中有8例复发(复发率为22.2%)。结论建议结合ISSVA标准对肌内血管瘤重新分类,新分类的血管瘤和血管畸形在发病部位、预后及病理形态方面均存在明显差异。

3D-TOF-MRA对椎-基底动脉病变的诊断价值

目的 探讨磁共振三维时间飞跃动脉血管成像(3D-TOF-MRA)对颅内椎-基底动脉病变的诊断价值。方法 从2019.1至2021.12期间因头痛、眩晕、肢体麻木等症状入院的240例中,其中确诊为颅内椎-基底动脉病变的95例为疾病组(病变组),145例均为非颅内椎-基底动脉病变(非病变组)。240例同时都有3T 3D-TOF-MRA和DSA检查完整资料。采用Kappa一致性检验对比两种方法对椎动脉、基底动脉血管异常类型的一致性,最后评价3D-TOF-MRA与对颅内椎-基底动脉病变的诊断价值。结果 3D-TOF-MRA与DSA评估椎动脉、基底动脉血管异常类型的一致性检验Kappa值分别为0.874、0.862;对照DSA“金标准”3D-TOF-MRA诊断颅内椎-基底动脉病变的灵敏度、特异度准确度分别为94.74%、92.41%、93.33%。结论 3D-TOF-MRA可以清楚显示颅内椎-基底动脉及主要分支的狭窄、闭塞动脉瘤、夹层等异常,具有等同DSA的诊断价值,与DSA有良好的一致性。

缺血性脑白质病变病人血清VEGF表达水平及其临床意义

目的:探讨缺血性脑白质病变(white matter ischemic lesions,WMIL)病人血清血管内皮生长因子(vascular endothelial growth factor,VEGF)水平表达及其与WMIL的关系。方法:选取经颅脑磁共振证实的缺血性脑白质病变病人为研究对象,依据Fazekas评定量表评定脑白质病变程度。选取同期年龄和性别相匹配的颅脑磁共振正常的健康体检者作为对照组。应用酶联免疫吸附法测定病人血清VEGF水平。比较2组的一般临床资料和VEGF水平,采用Pearson相关分析分析血清VEGF水平与脑白质病变程度的关系,采用多因素logistic回归分析分析WMIL的影响因素。结果:共纳入WMIL组115例,对照组69例。WMIL组病人高血压比例、糖尿病比例和VEGF水平均高于对照组(P<0.01)。WMIL组病人血清VEGF水平与Fazekas评分呈正相关(r=0.871,P<0.01)。多因素logistic回归分析显示,高血压、糖尿病和VEGF水平升高是WMIL的独立危险因素(OR=5.350、3.010、19.382,P<0.01)。结论:血清VEGF在WMIL病人中表达水平显著升高,其水平升高是WMIL的独立危险因素,且与WMIL的严重程度呈正相关,血清VEGF水平可作为脑白质慢性损伤的有效的生物学指标之一。