我国病理技术学的发展

病理技术学实际上是将医学或生命科学领域的多学科技术融合发展后与传统病理技术相结合,或者将其他学科的理论和技术应用于病理学,从而产生了病理技术学,是一个集传统病理技术和现代病理技术大成的学科。随着我国科学技术的进展,可以预见病理技术学也将有一个更快、更好的发展。

医学技术学术型硕士培养体系构建的实践探索

医学技术专业是一门随着医学技术学科向分子水平、精准医学和高端技术设备应用发展孕育而生的新兴专业。医学技术学术型硕士研究生教育是医学模式中的高层次教育,培养高素质医学人才和发展医学科学技术,需要提高硕士研究生的科学思维和科研能力。研究通过构建线上和线下一体化教学路径、建立适合医学技术学术型硕士的培养方案、逐步完善其考核评价体系、发挥桂林医学院病理技术培训基地优势、实现数字化资源的综合使用、采用课程思政协同育人模式、培养多元人才等途径,旨在培养一批具有临床病理技能、科研能力、创新能力和良好综合素质,并满足地方和基层医院岗位胜任能力的医学技术学术型硕士。

Molecular landscape in acute myeloid leukemia: where do we stand in 2016

Acute myeloid leukemia(AML) is a clonal disorder characterized by the accumulation of complex genomic alterations that define the disease pathophysiology and overall outcome. Recent advances in sequencing technologies have described the molecular landscape of AML and identified several somatic alterations that impact overall survival. Despite all these advancement, several challenges remain in translating this information into effective therapy. Herein we will review the molecular landscape of AML and discuss the impact of the most common somatic mutations on disease biology and outcome.

Key details of the duodenal-jejunal bypass in type 2 diabetes mellitus rats

AIM: To investigate which surgical techniques and perioperative regimens yielded the best survival rates for diabetic rats undergoing gastric bypass. METHODS: We performed Roux-en-Y gastric bypass with reserved gastric volume, a procedure in which gastrointestinal continuity was reestablished while excluding the entire duodenum and proximal jejunal loop. We observed the procedural success rate, long-term survival, and histopathological sequelae associated with a number of technical modifications. These included: use of anatomical markers to precisely identify Treitz's ligament; careful dissection along surgical planes; careful attention to the choice of regional transection sites; reconstruction using full-thickness anastomoses; use of a minimally invasive procedure with prohemostatic pretreatment and hemorrhage control; prevention of hypo-thermic damage; reduction in the length of the procedure; and accelerated surgical recovery using fast-track surgical modalities such as perioperative permissive underfeeding and goal-directed volume therapy. RESULTS: The series of modif ications we adopted reduced operation time from 110.02 ± 12.34 min to 78.39 ± 7.26 min (P < 0.01), and the procedural success rate increased from 43.3% (13/30) to 90% (18/20) (P < 0.01), with a long-term survival of 83.3% (15/18) (P < 0.01). CONCLUSION: Using a number of fast-track and damage control surgical techniques, we have successfully established a stable model of gastric bypass in diabetic rats.

Omentum facilitates liver regeneration

AIM:To investigate the mechanism of liver regeneration induced by fusing the omentum to a small traumatic injury created in the liver. We studied three groups of rats. In one group the rats were omentectomized; in another group the omentum was left in situ and was not activated,and in the third group the omentum was activated by polydextran particles. METHODS:We pre-activated the omentum by injecting polydextran particles and then made a small wedge wound in the rat liver to allow the omentum to fuse to the wound. We monitored the regeneration of the liver by determining the ratio of liver weight/body weight,by histological evaluation (including immune staining for cytokeratin-19,an oval cell marker),and by testing for developmental gene activation using reverse transcription polymerase chain reaction (RT-PCR). RESULTS:There was no liver regeneration in the omentectomized rats,nor was there significant regeneration when the omentum was not activated,even though in this instance the omentum had fusedwith the liver. In contrast,the liver in the rats with the activated omentum expanded to a size 50% greater than the original,and there was histologically an interlying tissue between the wounded liver and the activated omentum in which bile ducts,containing cytokeratin-19 positive oval cells,extended from the wound edge. In this interlying tissue,oval cells were abundant and appeared to proliferate to form new liver tissue. In rats pre-treated with drugs that inhibited hepatocyte growth,liver proliferation was ongoing,indicating that regeneration of the liver was the result of oval cell expansion. CONCLUSION:Activated omentum facilitates liver regeneration following injury by a mechanism that depends largely on oval cell proliferation.

HER2 and VEGF expression in breast cancer and their correlations

Objective:The aim of our study was to detect the correlation between the expressions of HER2 and VEGF in breast cancer, and their relations with some pathological factors. Methods:By immunohistochemistry technique, the expressions of HER2 and VEGF in the post-operation samples of 117 cases with breast cancer were assessed, and their relations with some pathological factors were analysed by statistical methods. Fifty samples of hyperplasia of mammary glands were observed as the control. Results: The positive expression rates of HER2 and VEGF in breast cancer were both significantly higher than those in hyperplasia of mammary gland (P<0.05). The expressions of HER2 and VEGF were both correlated to lymph node metastasis (P<0.05), but showed no relations with age, histological type, histological stage, tumor size (P>0.05). The positive expression rate of HER2 had a positive correlation with those of VEGF (P<0.05, r=0.373). Conclusion: The expressions of HER2 and VEGF have no correlations with age, histological type, histological stage, tumor size, but are closely related with lymphatic metastasis. The positive expression rates of HER2 shows a positive correlation with those of VEGF.

Small intestine contrast ultrasonography vs computed tomography enteroclysis for assessing ileal Crohn's disease

AIM:To compare computed tomography enteroclysis(CTE) vs small intestine contrast ultrasonography(SICUS) for assessing small bowel lesions in Crohn's disease(CD),when using surgical pathology as gold standard.METHODS:From January 2007 to July 2008,15 eligible patients undergoing elective resection of the distal ileum and coecum(or right colon) were prospectively enrolled.All patients were under follow-up.The study population included 6 males and 9 females,with a median age of 44 years(range:18-80 years).Inclusion criteria:(1) certain diagnosis of small bowel requiring elective ileo-colonic resection;(2) age between 18-80 years;(3) elective surgery in our Surgical Unit;and(4) written informed consent.SICUS and CTE were performed ≤ 3 mo before surgery,followed by surgical pathology.The following small bowel lesions were blindly reported by one sonologist,radiologist,surgeon and histolopathologist:disease site,extent,strictures,abscesses,fistulae,small bowel dilation.Comparison between findings at SICUS,CTE,surgical specimens and histological examination was made by assessing the specificity,sensitivity and accuracy of each technique,when using surgical findings as gold standard.RESULTS:Among the 15 patients enrolled,CTE was not feasible in 2 patients,due to urgent surgery in one patients and to low compliance in the second patient,refusing to perform CTE due to the discomfort related to the naso-jejunal tube.The analysis for comparing CTE vs SICUS findings was therefore performed in 13 out of the 15 CD patients enrolled.Differently from CTE,SICUS was feasible in all the 15 patients enrolled.No complications were observed when using SICUS or CTE.Surgical pathology findings in the tested population included:small bowel stricture in 13 patients,small bowel dilation above ileal stricture in 10 patients,abdominal abscesses in 2 patients,enteric fistulae in 5 patients,lymphnodes enlargement(> 1 cm) in 7 patients and mesenteric enlargement in 9 patients.In order to compare findings by using SICUS,CTE,histology and surgery,characteristics of the small bowel lesions observed in CD each patient were blindly reported in the same form by one gastroenterologistsonologist,radiologist,surgeon and anatomopathologist.At surgery,lesions related to CD were detected in the distal ileum in all 13 patients,also visualized by both SICUS and CTE in all 13 patients.Ileal lesions > 10 cm length were detected at surgery in all the 13 CD patients,confirmed by SICUS and CTE in the same 12 out of the 13 patients.When using surgical findings as a gold standard,SICUS and CTE showed the exactly same sensitivity,specificity and accuracy for detecting the presence of small bowel fistulae(accuracy 77% for both) and abscesses(accuracy 85% for both).In the tested CD population,SICUS and CTE were also quite comparable in terms of accuracy for detecting the presence of small bowel strictures(92% vs 100%),small bowel fistulae(77% for both) and small bowel dilation(85% vs 82%).CONCLUSION:In our study population,CTE and the non-invasive and radiation-free SICUS showed a comparable high accuracy for assessing small bowel lesions in CD.

Safety of Dams： A Pathological Approach of Qualitative and Quantitative Risks

Dams are critical and essential elements in any infrastructure and, in front of accidents occurred in many countries, it is extremely important to know the risk of these structures. Inserted in this context, it was found in the technical literature, methods and tools capable of measuring the exposure value by means of indicators. In the study, the highlights were 12 methods of qualitative, semiquantitative and quantitative risk analysis, representing an overview of risk analysis methods available in the literature with potential use in dams, that it has been done into electronic spreadsheets. The case study is performed on a sample of concrete dam and earth/rockfill built and operated by Eletrobr^s Furnas Company, supported by documentary research, projects, field inspections and interviews with experts. After applying the methods and the analysis thereof, has been prepared the Eletrobras Fumas dam risk analysis method which is characterized by adapting the criteria analyzed to the reality of the company＇s dams and it was also performed the portfolio risk analysis of 18 dams. In spite of the variety and subjectivity of qualitative and semiquantitative methods, the results show that they tend to converge on the analysis of dam based on risk. The application methodology demonstrates the feasibility assessment stage, covering the preliminary analysis for portfolio dams, followed by formal and individual risk analyzes for the most critical structures. These results confirm the applicability of risk analysis techniques, contributing to the consolidation of this toot as fundamental in the dam safety.