AIM:To evaluate the clinical,radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. METHODS:Thirty-one patients diagnosed as abdominal TB between...AIM:To evaluate the clinical,radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. METHODS:Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital, Istanbul,Turkey were evaluated prospectively.Complete physical examination,medical and family history,blood count erythrocyte sedimentation rate,routine biochemical tests, Mantoux skin test,chest X-ray and abdominal ultrasonography (USG) were performed in all cases,whereas microbiological examination of ascites,upper gastrointestinal endoscopy,colonoscopy or barium enema,abdominal tomography,mediastinoscopy,laparoscopy or laparotomy were done when needed. RESULTS:The median age of patients (14 females,17 males) was 34.2 years (range 15-65 years).The most frequent symptoms were abdominal pain and weight loss. Eleven patients had active pulmonary TB.The most common abdominal USG findings were ascites and hepatomegaly.Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2%).Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients.Colonoscopy performed in 20 patients showed ulcers in 9 (45%),nodules in 2 (10%) and,stricture,polypoid lesions,granulomatous findings in terminal ileum and rectal fistula each in one patient (5%). Laparoscopy on 4 patients showed dilated bowel loops, thickening in the mesentery,multiple ulcers and tubercles on the peritoneum.Patients with abdominal TB were divided into three groups according to the type of involvement. Fifteen patients (48%) had intestinal TB,11 patients (35.2%) had tuberculous peritonitis and 5 (16.8%) tuberculous lymphadenitis.The diagnosis of abdominal TB was confirmed microbiologically in 5 (16%) and histo- pathologically in 19 patients (60.8%).The remaining nine patients (28.8%) had been diagnosed by a positive response to antituberculous treatment. CONCLUSION:Neither clinical signs,laboratory,radiological and endoscopic methods nor bacteriological and histopathological findings provide a gold standard by themselves in the diagnosis of abdominal TB.However,an algorithm of these diagnostic methods leads to considerably higher precision in the diagnosis of this insidious disease which primarily necessitate a clinical awareness of this serious health problem.展开更多
AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and...AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P<0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P<0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (>80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P<0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.展开更多
OBJECTIVE To discuss the pathologic characteristics and theprognosis of neuroendocrine carcinoma of the bladder(NECB)in order to assist in making a precise diagnosis and to effectivelytreat the disease.METHODS Clinico...OBJECTIVE To discuss the pathologic characteristics and theprognosis of neuroendocrine carcinoma of the bladder(NECB)in order to assist in making a precise diagnosis and to effectivelytreat the disease.METHODS Clinicopathologic features of the 6 cases with NECBwere analyzed retrospectively.The personal data of the patientsand the pathologic and immunohistochemical characteristics ofthe tumor were investigated.The follow-up of these patients wasconducted over a time period ranging from 3 months to 9 years.RESULTS Transurethral resection of the bladder tumorwas performed in all 6 patients.Based on the results of thepathologic examination,4 of the cases were diagnosed as smallcell neuroendocrine carcinoma and the other 2 were diagnosedas atypical carcinoid tumor.On immunohistochemical stainingall tumors expressed neuroendocrine markers includingneuronspecific enolase(CD56),synaptophysin(Syn)andchromogranin(CgA).In patients receiving partial cystectomyfollowed by postoperative chemotherapy,relapse was found in 4of the 6 cases on follow up.CONCLUSION NECB is a rare entity and a tumor with highmalignant potential and characteristic pathologic features.Hematuria is the cardinal symptom of NECB.Metastasis mayoccur at an early stage and the prognosis of the disease is poor.Final diagnosis of NECB depends on histopathologic examinationand immunohistochemical assays.Surgical excision combinedwith radiotherapy and chemotherapy is considered an effectivetreatment.展开更多
AIM: To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS: Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and e...AIM: To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS: Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and endoscopic ultrasound (EUS) were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios. RESULTS: Endoscopically, esophageal gastrointestinal stromal tumors (GISTs) and leiomyomas (LMs) had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells: spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcornas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisher's exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 (P 〉 0.05). All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 (P 〈 0.005). All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 115 (P 〈 0.005). CONCLUSION: The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs are less common. Most of esophageal LMs and GISTs are benign. Endoscopy and EUS are the effective methods to diagnose esophageal mesenchymal tumors and they can provide useful information for the treatment of these tumors. However, they cannot exactly differentiate esophageal GISTs from LMs. Pathological, especially immunohistochemical features are useful to differentiate GISTs from leiomyomas.展开更多
Colonic diverticular disease (diverticulosis) is one of the most common gastrointestinal disorders in Western countries. This disorder is strictly related to aging and fibre intake, and still bears a discrete amount o...Colonic diverticular disease (diverticulosis) is one of the most common gastrointestinal disorders in Western countries. This disorder is strictly related to aging and fibre intake, and still bears a discrete amount of morbidity. Numerous etiological co-factors have to date been implicated in the pathogenesis of the disease, yet the supporting evidence is still far from absolute. The present review considers the pathophysiology of colonic diverticular disease, with a special emphasis on factors related to abnormal colonic motility.展开更多
Physical literacy (PL), as embodied within physical education (PE), has been vaunted as having increasing importance as a disposition for students of all abilities to establish lifelong adherence to physical activ...Physical literacy (PL), as embodied within physical education (PE), has been vaunted as having increasing importance as a disposition for students of all abilities to establish lifelong adherence to physical activity. The purpose of this paper was to provide a discussion of how the pedagogical features of a contemporary pedagogical model, Sport Education (SE), may be used to operationalize PL in PE and what empirical evidence currently exists to validate this claim. Substantial empirical evidence exists that the attributes associated with the development of PL (Whitehead, 2010) can be operationalized in PE with the effective implementation of the model. SE has distinct pedagogical features which positively contribute to many of the dimensions of PL and can further an individuals' journey towards greater PL and having an embodied self within PE. That stated, there remains concern that the context for this embodiment remains too narrow to be viewed as a panacea for the development of lifelong physical activity. SE must be developed as a connective specialism if these PL attributes are to transform the motivation and confidence for individuals to capitalize on their innate physical potential and make a more significant contribution to the quality of life.展开更多
AIM: To compare the clinical outcome and pathologic features of non-alcoholic steatohepatitis (NASH) patients with hepatocellular carcinoma (HCC) and hepatitic C virus (HCV) patients with HCC (another group in...AIM: To compare the clinical outcome and pathologic features of non-alcoholic steatohepatitis (NASH) patients with hepatocellular carcinoma (HCC) and hepatitic C virus (HCV) patients with HCC (another group in which HCC is commonly seen) undergoing liver transplantation. METHODS: Patients transplanted for HCV and NASH at our institution from January 2000 to April 2011 were analyzed. All explanted liver histology and pre-trans- plant liver biopsies were examined by two specialist liver histopathologists. Patient demographics, disease free survival, explant liver characteristics and HCC features (tumour number, cumulative tumour size, vascular invasion and differentiation) were compared between HCV and NASH liver transplant recipients. RESULTS: A total of 102 patients with NA^SH and 283 patients with HCV were transplanted. The incidence of HCC in NASH transplant recipients was 16.7% (17/102). The incidence of HCC in HCV transplant recipients was 22.6% (64/283). Patients with NASH-HCC were statisti- cally older than HCV-HCC patients (P 〈 0.001). A signif- icantly higher proportion of HCV-HCC patients had vas- cular invasion (23.4% vs 6.4%, P = 0.002) and poorly differentiated HCC (4.7% vs 0%, P 〈 0.001) compared to the NASH-HCC group. A trend of poorer recurrence free survival at 5 years was seen in HCV-HCC patients compared to NASH-HCC who underwent a Liver trans- plantation (P = 0.11). CONCLUSION: Patients transplanted for NASH-HCC appear to have less aggressive turnout features com- pared to those with HCV-HCC, which likely in part ac- counts for their improved recurrence free survival.展开更多
Words are the basic material of language. Vocabulary is one of the important standards for measuring English levels. Mastering a certain amount of vocabulary is the key to learning English well. However, the obstructi...Words are the basic material of language. Vocabulary is one of the important standards for measuring English levels. Mastering a certain amount of vocabulary is the key to learning English well. However, the obstructions of learning vocabulary still exist. According to students' psychological features, the author discusses fresh and flexible ways of English vocabulary teaching. It makes vocabulary teaching vivid and easy to understand and memorize. This paper discusses some methods that how the teachers learn to teach words and how the students learn to grasp words, which based on the importance and the current situation of vocabulary teaching in middle school.展开更多
This paper discussed a method to judge and to reject the mistake and error of the monitoring strategies for English teaching and learning, and alsopresented a classification of mistake and error according to the follo...This paper discussed a method to judge and to reject the mistake and error of the monitoring strategies for English teaching and learning, and alsopresented a classification of mistake and error according to the following factors: the definition and analysisofmistake and error.With the development of theanalysis theories, more attention has been paid to the characteristic and the principle of mistake and error in the second language teaching and learning. By analyzing the differences between mistake and error, the teachers and learners can get clear of the study of English and improve the ability of using English.展开更多
The critical nature of artwork is owed, according to Adorno, to the fact that it opposes its assimilation by reason and that it does not yield to the imposition of its established principles. This character which Heid...The critical nature of artwork is owed, according to Adorno, to the fact that it opposes its assimilation by reason and that it does not yield to the imposition of its established principles. This character which Heidegger, too, through a paradoxical convergence with Adorno, and in opposition to Lukacs, recognizes as its ontological component, permits the work of art to represent a force of resistance to dominance in general, in the prospect of the salvation of a humanized society. As such, it makes possible the radical rejection of political and, pertinent to it, pedagogical activity, when converted into primarily authoritiarian activity. Such a responsibility does art assume, according to Adorno, when it represents a spirituality, which is embodied in exemplary fashion both in the work of art itself, making the experience of the sublime possible, and in the aesthetic of the sublime, which is concentrated intensively on whatever remains unapproachable through concepts. In this way, we could say that the aesthetic of the sublime is converted into "first philosophy," in the sense that it provides the rule for every theoretical approach. Concurring with this reading of Adorno, we consider how the sublime, as shown in the context of his aesthetic theory, is governed, furthermore, by a paideutic principle of exceptional significance, which we must necessarily activate through aesthetic education, so that western man may understand that he must uproot himself from the nihilistic social context in which he lives, rupturing the delusion of his omnipotence. In a world governed by a permanent crisis of democracy in public and private life, since the weakening of political imagination unites with the retreat from political ethos and an generalization of the unprecedented will for dominance, we consider this aesthetic theory to be exceptionally essential and useful to us both as pedagogical theory and as political theory, since it allows us to understand that the experience of the sublime through art is in opposition to this condition of destruction, and indeed represents the ideal of justice.展开更多
Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological e...Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.展开更多
Psychological and physiological characteristics of preschool children determine their lives should be the main game, but because of the content and the way too pre-primary school of teachers and parents give their chi...Psychological and physiological characteristics of preschool children determine their lives should be the main game, but because of the content and the way too pre-primary school of teachers and parents give their children pressure of learning early, they often give children physical and cause a series of adverse consequences of psychological, so that children lively nature is destroyed. In the development context of pre-primary schools it will not only hinder enhance children' s thinking ability, but also devoid of the child' s talent and mettle, for children to learn and live very unfavorable late. Preschool Primary School, out of the office park on the right track, is serious impediment to the normal development of preschool children and grow. This paper describes the dangers of pre-school, pre-primary schools and the causes are analyzed and we proposed the removal of the primary effective strategy, in order to fully mobilize the child' s lively and good mobility and lay its future development a solid foundation.展开更多
The use of literature, logical reasoning and other research methods are used in this thesis, classification and analysis of the definition of incentive methods, motivation methods are also stated in this paper, and th...The use of literature, logical reasoning and other research methods are used in this thesis, classification and analysis of the definition of incentive methods, motivation methods are also stated in this paper, and this article also combine with students' psychological characteristics, different teaching content, teaching methods together, discussed how to stimulate students' interest in sports and mobilize students' enthusiasm, initiative by motivation methods in the sports teaching, thus promoting teaching effectiveness, improve teaching quality, provide some theoretical reference for improving the quality of teaching physical education. The results showed that: we have already made some researches in the stimulation methods in teaching sports, but few are studied combining with the psychological characteristics of students展开更多
One hundred and eleven cases of oral squamous cell carcinoma (OSCC) were examined for overexpression of p53 protein by using immunohistochemical technique. Association between p53 protein overexpression and clinical a...One hundred and eleven cases of oral squamous cell carcinoma (OSCC) were examined for overexpression of p53 protein by using immunohistochemical technique. Association between p53 protein overexpression and clinical and pathological parameters as well as prognosis of patients were also analyzed. p53 protein overexpression was commonly observed (69. 4%) in OSCC and may be used as a marker of carcinogenesis of OSCC. The level of p53 protein overexpression is correlated with the lower three and five-year survival rate of OSCC. The presence or absence of p53 overexpression was not correlated with sex, age, site of tumor, size of tumor, degree of differentiation,node status,and clinical stage in OSCC. Single factor COX proportional hazards regression model analysis indicated that there was no significant association between p53 overexpression and prognosis of OSCC. Multivariable COX model analysis failed to establish effective life function or risk rate function. These showed that all the parameters analyzed in this study as well as p53 overexpression were not significant and effective risk factors of prognosis for patients with OSCC.展开更多
Serous borderline tumor of ovary (SBT)includes two subtypes of typical serous borderline tumor andmicropapillary variant, which have different histopathologyfeatures. Although SBTs behave in either way of the benignco...Serous borderline tumor of ovary (SBT)includes two subtypes of typical serous borderline tumor andmicropapillary variant, which have different histopathologyfeatures. Although SBTs behave in either way of the benigncounterparts or malignant serous carcinomas, microinvasion,peritoneal implants, and nodal involvement are all very commonin both subtypes of typical SBT and the micropapillary variant.The prognosis of the patients with serous borderline tumorof ovary and the mechanism of the microinvasion, peritonealimplantation and nodal involvement are still being debated, noris there universal agreement about the management of SBT. Toidentify the histopathologic features, prognostic predictors ofthe SBT, and its association with ovarian serous carcinomas, wereviewed the majority of the relevant papers published in recentliterature.展开更多
Malakoplakia is a rare granulomatous disease probably caused by infection and characterized histologically by Michaelis-Gutmann bodies.We report a more rarely seen case esophageal malakoplakia in a 54-year-old woman.S...Malakoplakia is a rare granulomatous disease probably caused by infection and characterized histologically by Michaelis-Gutmann bodies.We report a more rarely seen case esophageal malakoplakia in a 54-year-old woman.She presented with coughing while eating and drinking.Gastroscopy showed yellow nodules in the esophagus,and endoscopic ultrasonography showed a space-occupying lesion in the substratum of the esophageal mucosa.All findings highly resembled esophageal cancer.Histopathological examination finally indentified this space-occupying lesion as malakoplakia and not cancer.Immunohistochemistry showed that she had human papillomavirus(HPV) infection in the esophagus,which indicates that infection was responsible for the malakoplakia.This is believed to be the first case of malakoplakia in the esophagus,and more importantly,we established that HPV infection was the initiator of esophageal malakoplakia.展开更多
Water quality criteria (WQC) are threshold limits for pollutants or other hazard factors in the ambient water environment, which are based on scientific experiments and extrapolations. Until now, there is limited info...Water quality criteria (WQC) are threshold limits for pollutants or other hazard factors in the ambient water environment, which are based on scientific experiments and extrapolations. Until now, there is limited information available regarding the study of water quality criteria in China. It is imperative to launch national-level systematic WQC studies that focus on the regional characteristics of China and provide scientific support for the enactment or revision of water quality standards and environmental management. This article reviews the concept of WQC and discusses the methodology and global progress of WQC research. The article also summarizes the key scientific issues in WQC research, including species sensitivity distribution, toxicological endpoint selection, and models selection. Furthermore, we can adopt the derivation method used in the USA and divide WQC into acute and chronic criteria. Finally, considering the current status of WQC research in China, we point out important directions for future national studies, including the selection of native species and the comprehensive use of models.展开更多
文摘AIM:To evaluate the clinical,radiological and microbiological properties of abdominal tuberculosis (TB) and to discuss methods needed to get the diagnosis. METHODS:Thirty-one patients diagnosed as abdominal TB between March 1998 and December 2001 at the Gastroenterology Department of Kartal State Hospital, Istanbul,Turkey were evaluated prospectively.Complete physical examination,medical and family history,blood count erythrocyte sedimentation rate,routine biochemical tests, Mantoux skin test,chest X-ray and abdominal ultrasonography (USG) were performed in all cases,whereas microbiological examination of ascites,upper gastrointestinal endoscopy,colonoscopy or barium enema,abdominal tomography,mediastinoscopy,laparoscopy or laparotomy were done when needed. RESULTS:The median age of patients (14 females,17 males) was 34.2 years (range 15-65 years).The most frequent symptoms were abdominal pain and weight loss. Eleven patients had active pulmonary TB.The most common abdominal USG findings were ascites and hepatomegaly.Ascitic fluid analysis performed in 13 patients was found to be exudative and acid resistant bacilli were present in smear and cultured only in one patient with BacTec (3.2%).Upper gastrointestinal endoscopy yielded nonspecific findings in 16 patients.Colonoscopy performed in 20 patients showed ulcers in 9 (45%),nodules in 2 (10%) and,stricture,polypoid lesions,granulomatous findings in terminal ileum and rectal fistula each in one patient (5%). Laparoscopy on 4 patients showed dilated bowel loops, thickening in the mesentery,multiple ulcers and tubercles on the peritoneum.Patients with abdominal TB were divided into three groups according to the type of involvement. Fifteen patients (48%) had intestinal TB,11 patients (35.2%) had tuberculous peritonitis and 5 (16.8%) tuberculous lymphadenitis.The diagnosis of abdominal TB was confirmed microbiologically in 5 (16%) and histo- pathologically in 19 patients (60.8%).The remaining nine patients (28.8%) had been diagnosed by a positive response to antituberculous treatment. CONCLUSION:Neither clinical signs,laboratory,radiological and endoscopic methods nor bacteriological and histopathological findings provide a gold standard by themselves in the diagnosis of abdominal TB.However,an algorithm of these diagnostic methods leads to considerably higher precision in the diagnosis of this insidious disease which primarily necessitate a clinical awareness of this serious health problem.
文摘AIM: To compare the racial differences of anatomical distribution of colorectal cancer (CRC) and determine the association of age, gender and time with anatomical distribution between patients from America (white) and China (oriental).METHODS: Data was collected from 690 consecutive patients in Cleveland Clinic Florida, U.S.A. and 870consecutive patients in Nan Fang Hospital affiliated to the First Military Medical University, China over the past 11years from 1990 to 2000. All patients had colorectal adenocarcinoma diagnosed by histology and underwent surgery.RESULTS: The anatomical subsite distribution of tumor,age and gender were significantly different between white and oriental patients. Lesions in the proximal colon (P<0.001) were found in 36.3 % of white vs 26.0 % of oriental patients and cancers located in the distal colon and rectum in 63.7 % of white and 74 % of oriental patients (P<0.001). There was a trend towards the redistribution from distal colon and rectum to proximal colon in white males over time, especially in older patients (>80 years).No significant change of anatomical distribution occurred in white women and Oriental patients. The mean age at diagnosis was 69.0 years in white patients and 48.3 years in Oriental patients (P<0.001).CONCLUSION: This is the first study comparing the anatomical distribution of colorectal cancers in whites and Chinese patients. White Americans have a higher risk of proximal CRC and this risk increased with time. The proportion of white males with CRC also increased with time.Chinese patients were more likely to have distal CRC and developed the disease at a significantly earlier age than white patients. These findings have enhanced our understanding of the disease process of colorectal cancer in these two races.
文摘OBJECTIVE To discuss the pathologic characteristics and theprognosis of neuroendocrine carcinoma of the bladder(NECB)in order to assist in making a precise diagnosis and to effectivelytreat the disease.METHODS Clinicopathologic features of the 6 cases with NECBwere analyzed retrospectively.The personal data of the patientsand the pathologic and immunohistochemical characteristics ofthe tumor were investigated.The follow-up of these patients wasconducted over a time period ranging from 3 months to 9 years.RESULTS Transurethral resection of the bladder tumorwas performed in all 6 patients.Based on the results of thepathologic examination,4 of the cases were diagnosed as smallcell neuroendocrine carcinoma and the other 2 were diagnosedas atypical carcinoid tumor.On immunohistochemical stainingall tumors expressed neuroendocrine markers includingneuronspecific enolase(CD56),synaptophysin(Syn)andchromogranin(CgA).In patients receiving partial cystectomyfollowed by postoperative chemotherapy,relapse was found in 4of the 6 cases on follow up.CONCLUSION NECB is a rare entity and a tumor with highmalignant potential and characteristic pathologic features.Hematuria is the cardinal symptom of NECB.Metastasis mayoccur at an early stage and the prognosis of the disease is poor.Final diagnosis of NECB depends on histopathologic examinationand immunohistochemical assays.Surgical excision combinedwith radiotherapy and chemotherapy is considered an effectivetreatment.
基金Supported by the Scientific and Technological Foundation of the Jiangxi Provincial Department of Science and Technology
文摘AIM: To study the endoscopic, pathological and immunoo histochemical features of esophageal mesenchymal tumors. METHODS: Twenty-nine patients diagnosed as esophageal rnysenchymal tumors by electronic endoscopy and endoscopic ultrasound (EUS) were observed under light microscopes, and all tissues were stained by the immunohistochemical method. The expression of CD117, CD34, SMA and desmin were measured by staining intensity of cells and positive cell ratios. RESULTS: Endoscopically, esophageal gastrointestinal stromal tumors (GISTs) and leiomyomas (LMs) had similar appearances, showing submucosal protuberant lesions. They all showed low echo images originated from the muscularis propria or muscularis mucosa on EUS. Endoscopy and EUS could not exactly differentiate esophageal GISTs from LMs. Microscopically, there were two kinds of cells: spindle cell type and epitheloid cell type in esophageal GISTs. Leiomyomas and leiomyosarcornas were only of spindle cell type. One malignancy was found in five cases of esophageal GISTs, and one malignancy in 24 cases of leiomyomas and leiomyosarcomas. Using Fisher's exact method, the differences of malignant lesion proportion were not significant between esophageal LMs and GISTs, 1/5 vs 1/24 (P 〉 0.05). All cases of esophageal GISTs were positive for CD117, and 3 cases were also positive for CD34. The 24 cases of leiomyomas and leiomyosarcomas were all negative for CD117 and CD34. The differences of positive rates of CD117 and CD34 were significant between esophageal GISTs and LMs, 5/5 vs 0/24, 3/5 vs 0/24 (P 〈 0.005). All leiomyomas and leiomyosarcomas were positive for SMA, and desmin. Among 5 cases of esophageal GISTs, 2 cases were SMA positive, and 1 case was desmin positive. The differences in positive rates and expression intensity of SMA and desmin were significant between esophageal LMs and GISTs, 24/24 vs 2/5, 24/24 vs 115 (P 〈 0.005). CONCLUSION: The most common esophageal mesenchymal tumors are leiomyomas, and esophageal GISTs are less common. Most of esophageal LMs and GISTs are benign. Endoscopy and EUS are the effective methods to diagnose esophageal mesenchymal tumors and they can provide useful information for the treatment of these tumors. However, they cannot exactly differentiate esophageal GISTs from LMs. Pathological, especially immunohistochemical features are useful to differentiate GISTs from leiomyomas.
文摘Colonic diverticular disease (diverticulosis) is one of the most common gastrointestinal disorders in Western countries. This disorder is strictly related to aging and fibre intake, and still bears a discrete amount of morbidity. Numerous etiological co-factors have to date been implicated in the pathogenesis of the disease, yet the supporting evidence is still far from absolute. The present review considers the pathophysiology of colonic diverticular disease, with a special emphasis on factors related to abnormal colonic motility.
文摘Physical literacy (PL), as embodied within physical education (PE), has been vaunted as having increasing importance as a disposition for students of all abilities to establish lifelong adherence to physical activity. The purpose of this paper was to provide a discussion of how the pedagogical features of a contemporary pedagogical model, Sport Education (SE), may be used to operationalize PL in PE and what empirical evidence currently exists to validate this claim. Substantial empirical evidence exists that the attributes associated with the development of PL (Whitehead, 2010) can be operationalized in PE with the effective implementation of the model. SE has distinct pedagogical features which positively contribute to many of the dimensions of PL and can further an individuals' journey towards greater PL and having an embodied self within PE. That stated, there remains concern that the context for this embodiment remains too narrow to be viewed as a panacea for the development of lifelong physical activity. SE must be developed as a connective specialism if these PL attributes are to transform the motivation and confidence for individuals to capitalize on their innate physical potential and make a more significant contribution to the quality of life.
文摘AIM: To compare the clinical outcome and pathologic features of non-alcoholic steatohepatitis (NASH) patients with hepatocellular carcinoma (HCC) and hepatitic C virus (HCV) patients with HCC (another group in which HCC is commonly seen) undergoing liver transplantation. METHODS: Patients transplanted for HCV and NASH at our institution from January 2000 to April 2011 were analyzed. All explanted liver histology and pre-trans- plant liver biopsies were examined by two specialist liver histopathologists. Patient demographics, disease free survival, explant liver characteristics and HCC features (tumour number, cumulative tumour size, vascular invasion and differentiation) were compared between HCV and NASH liver transplant recipients. RESULTS: A total of 102 patients with NA^SH and 283 patients with HCV were transplanted. The incidence of HCC in NASH transplant recipients was 16.7% (17/102). The incidence of HCC in HCV transplant recipients was 22.6% (64/283). Patients with NASH-HCC were statisti- cally older than HCV-HCC patients (P 〈 0.001). A signif- icantly higher proportion of HCV-HCC patients had vas- cular invasion (23.4% vs 6.4%, P = 0.002) and poorly differentiated HCC (4.7% vs 0%, P 〈 0.001) compared to the NASH-HCC group. A trend of poorer recurrence free survival at 5 years was seen in HCV-HCC patients compared to NASH-HCC who underwent a Liver trans- plantation (P = 0.11). CONCLUSION: Patients transplanted for NASH-HCC appear to have less aggressive turnout features com- pared to those with HCV-HCC, which likely in part ac- counts for their improved recurrence free survival.
文摘Words are the basic material of language. Vocabulary is one of the important standards for measuring English levels. Mastering a certain amount of vocabulary is the key to learning English well. However, the obstructions of learning vocabulary still exist. According to students' psychological features, the author discusses fresh and flexible ways of English vocabulary teaching. It makes vocabulary teaching vivid and easy to understand and memorize. This paper discusses some methods that how the teachers learn to teach words and how the students learn to grasp words, which based on the importance and the current situation of vocabulary teaching in middle school.
文摘This paper discussed a method to judge and to reject the mistake and error of the monitoring strategies for English teaching and learning, and alsopresented a classification of mistake and error according to the following factors: the definition and analysisofmistake and error.With the development of theanalysis theories, more attention has been paid to the characteristic and the principle of mistake and error in the second language teaching and learning. By analyzing the differences between mistake and error, the teachers and learners can get clear of the study of English and improve the ability of using English.
文摘The critical nature of artwork is owed, according to Adorno, to the fact that it opposes its assimilation by reason and that it does not yield to the imposition of its established principles. This character which Heidegger, too, through a paradoxical convergence with Adorno, and in opposition to Lukacs, recognizes as its ontological component, permits the work of art to represent a force of resistance to dominance in general, in the prospect of the salvation of a humanized society. As such, it makes possible the radical rejection of political and, pertinent to it, pedagogical activity, when converted into primarily authoritiarian activity. Such a responsibility does art assume, according to Adorno, when it represents a spirituality, which is embodied in exemplary fashion both in the work of art itself, making the experience of the sublime possible, and in the aesthetic of the sublime, which is concentrated intensively on whatever remains unapproachable through concepts. In this way, we could say that the aesthetic of the sublime is converted into "first philosophy," in the sense that it provides the rule for every theoretical approach. Concurring with this reading of Adorno, we consider how the sublime, as shown in the context of his aesthetic theory, is governed, furthermore, by a paideutic principle of exceptional significance, which we must necessarily activate through aesthetic education, so that western man may understand that he must uproot himself from the nihilistic social context in which he lives, rupturing the delusion of his omnipotence. In a world governed by a permanent crisis of democracy in public and private life, since the weakening of political imagination unites with the retreat from political ethos and an generalization of the unprecedented will for dominance, we consider this aesthetic theory to be exceptionally essential and useful to us both as pedagogical theory and as political theory, since it allows us to understand that the experience of the sublime through art is in opposition to this condition of destruction, and indeed represents the ideal of justice.
文摘Objective To evaluate the clinical and pathological features of Riedel's thyroiditis(RT),and current diagnostic and treatment methods for that disease.Methods Five RT cases identified by surgery and pathological examinations at Peking Union Medical College Hospital from 1985 to 2009 were analyzed and compared with the cases reported in the literature in terms of clinical and pathological features.Immunohistochemical staining of kappa and lambda light chains was carried out for RT tissues from all the five patients.Results All the five cases were females,aged 45-55 years.Elevation of serum thyroid autoantibodies was found in only one patient,who had longer disease duration than the others.Pathological examination revealed invasive fibrosclerosis of the thyroid follicles,thyroid capsule,and the surrounding tissues.In RT tissues,the number of cells containing lambda chains was a little higher than those containing kappa chains.Conclusions RT is a rare disease which might be more common in middle-aged females than in other populations.Pathological features include the destruction of thyroid follicle,extension into surrounding tissues by inflammatory cells and fibrous tissues.Immunohistochemical staining of kappa and lambda chains could help diagnose RT.
文摘Psychological and physiological characteristics of preschool children determine their lives should be the main game, but because of the content and the way too pre-primary school of teachers and parents give their children pressure of learning early, they often give children physical and cause a series of adverse consequences of psychological, so that children lively nature is destroyed. In the development context of pre-primary schools it will not only hinder enhance children' s thinking ability, but also devoid of the child' s talent and mettle, for children to learn and live very unfavorable late. Preschool Primary School, out of the office park on the right track, is serious impediment to the normal development of preschool children and grow. This paper describes the dangers of pre-school, pre-primary schools and the causes are analyzed and we proposed the removal of the primary effective strategy, in order to fully mobilize the child' s lively and good mobility and lay its future development a solid foundation.
文摘The use of literature, logical reasoning and other research methods are used in this thesis, classification and analysis of the definition of incentive methods, motivation methods are also stated in this paper, and this article also combine with students' psychological characteristics, different teaching content, teaching methods together, discussed how to stimulate students' interest in sports and mobilize students' enthusiasm, initiative by motivation methods in the sports teaching, thus promoting teaching effectiveness, improve teaching quality, provide some theoretical reference for improving the quality of teaching physical education. The results showed that: we have already made some researches in the stimulation methods in teaching sports, but few are studied combining with the psychological characteristics of students
文摘One hundred and eleven cases of oral squamous cell carcinoma (OSCC) were examined for overexpression of p53 protein by using immunohistochemical technique. Association between p53 protein overexpression and clinical and pathological parameters as well as prognosis of patients were also analyzed. p53 protein overexpression was commonly observed (69. 4%) in OSCC and may be used as a marker of carcinogenesis of OSCC. The level of p53 protein overexpression is correlated with the lower three and five-year survival rate of OSCC. The presence or absence of p53 overexpression was not correlated with sex, age, site of tumor, size of tumor, degree of differentiation,node status,and clinical stage in OSCC. Single factor COX proportional hazards regression model analysis indicated that there was no significant association between p53 overexpression and prognosis of OSCC. Multivariable COX model analysis failed to establish effective life function or risk rate function. These showed that all the parameters analyzed in this study as well as p53 overexpression were not significant and effective risk factors of prognosis for patients with OSCC.
文摘Serous borderline tumor of ovary (SBT)includes two subtypes of typical serous borderline tumor andmicropapillary variant, which have different histopathologyfeatures. Although SBTs behave in either way of the benigncounterparts or malignant serous carcinomas, microinvasion,peritoneal implants, and nodal involvement are all very commonin both subtypes of typical SBT and the micropapillary variant.The prognosis of the patients with serous borderline tumorof ovary and the mechanism of the microinvasion, peritonealimplantation and nodal involvement are still being debated, noris there universal agreement about the management of SBT. Toidentify the histopathologic features, prognostic predictors ofthe SBT, and its association with ovarian serous carcinomas, wereviewed the majority of the relevant papers published in recentliterature.
文摘Malakoplakia is a rare granulomatous disease probably caused by infection and characterized histologically by Michaelis-Gutmann bodies.We report a more rarely seen case esophageal malakoplakia in a 54-year-old woman.She presented with coughing while eating and drinking.Gastroscopy showed yellow nodules in the esophagus,and endoscopic ultrasonography showed a space-occupying lesion in the substratum of the esophageal mucosa.All findings highly resembled esophageal cancer.Histopathological examination finally indentified this space-occupying lesion as malakoplakia and not cancer.Immunohistochemistry showed that she had human papillomavirus(HPV) infection in the esophagus,which indicates that infection was responsible for the malakoplakia.This is believed to be the first case of malakoplakia in the esophagus,and more importantly,we established that HPV infection was the initiator of esophageal malakoplakia.
基金supported by National Basic Research Program of China(Grant No. 2008CB418200)Environmental Public Welfare Program(Grant No. 2010009032)National Natural Science Foundation of China (U0833603, 40973090)
文摘Water quality criteria (WQC) are threshold limits for pollutants or other hazard factors in the ambient water environment, which are based on scientific experiments and extrapolations. Until now, there is limited information available regarding the study of water quality criteria in China. It is imperative to launch national-level systematic WQC studies that focus on the regional characteristics of China and provide scientific support for the enactment or revision of water quality standards and environmental management. This article reviews the concept of WQC and discusses the methodology and global progress of WQC research. The article also summarizes the key scientific issues in WQC research, including species sensitivity distribution, toxicological endpoint selection, and models selection. Furthermore, we can adopt the derivation method used in the USA and divide WQC into acute and chronic criteria. Finally, considering the current status of WQC research in China, we point out important directions for future national studies, including the selection of native species and the comprehensive use of models.