报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检...报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检查示纵隔内淋巴结增大,腰3~腰5椎体等多处骨质破坏;锝亚甲基二膦酸盐(^(99m)Tc-MDP)全身骨显像示全身骨骼多处异常放射性浓聚灶。皮损组织病理检查:表皮大致正常,真皮全层致密增生的胶原束间肿瘤细胞呈单个或条索状、列兵样排列,部分肿瘤细胞核大、深染,有明显异形性。免疫组化:细胞角蛋白(CK)、CK7、绒毛蛋白(villin)均阳性表达。腰4椎体针吸组织病理检查符合转移性腺癌,免疫组化示CK及低分子质量细胞角蛋白(CAM)5.2均阳性表达。诊断:腺癌多发转移合并Sister Mary Joseph结节。治疗:患者拒绝接受治疗,随访至13个月时死亡。展开更多
BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer...BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer.Diagnosis suggests a poor prognosis with a median survival of approximately 8 mo after detection.Managing patients with SMJNs is challenging,as most receive limited palliative care only.The optimal strategy for long-term survival of these patients remains unclear.CASE SUMMARY A 58-year-old female,previously diagnosed with right breast cancer 17 years ago and underwent breast-conserving surgery,adjuvant radiotherapy,and endocrine therapy,presented with a 2-cm umbilical nodule.Thirteen years previously,metastases were detected in the right supraclavicular,infraclavicular,hilar,and mediastinal lymph nodes.An umbilical nodule emerged four years before the date of presentation,confirmed as a skin metastasis of primary breast cancer upon excisional biopsy.Despite initial removal,the nodule recurred and grew,leading to her referral to our hospital.The patient underwent extensive excision of the umbilical tumor and immediate abdominal wall reconstruction.Endocrine therapy was continued postoperatively.Five years later,no local recurrence was observed,and the patient continued to work full-time,achieving over 9 years of survival following SMJN diagnosis.CONCLUSION This case study aimed to identify the optimal strategy for achieving extended survival outcomes in patients with SMJN through comprehensive treatment.We presented a case of the longest survival in a patient after undergoing a multidisciplinary treatment regimen.Our findings underscore the significance of adopting a multimodal treatment approach comprising timely and wide excision along with adjunctive therapy.This approach can control the disease,prolong survival,and improve the quality of life in patients with SMJN.展开更多
针对基本的快速拓展随机树算法(rapidly-exploring random tree,RRT^(*))存在搜索随机性大、效率低、路径非最优的缺点,提出一种引入人工势场法算法(artificial potential field method,APF)和Douglas-Peucker算法的改进RRT^(*)-APF-DP...针对基本的快速拓展随机树算法(rapidly-exploring random tree,RRT^(*))存在搜索随机性大、效率低、路径非最优的缺点,提出一种引入人工势场法算法(artificial potential field method,APF)和Douglas-Peucker算法的改进RRT^(*)-APF-DP路径规划算法.在RRT*算法的采样点生成阶段引入变采样范围偏置搜索与步长自适应调整策略,融合重新设计的APF算法的引力与斥力函数,增强路径扩展导向性与绕过障碍物能力.采用重采样策略改进DP算法,优化避障代价与控制点数量.实验结果表明,本算法规划的避障路径满足机械臂的运动要求,且算法规划的避障路径代价、规划时间和路径控制节点数均得到有效改善.展开更多
十八世纪法国地图学家、版画家及建筑师勒胡日(Georges Louis Le Rouge)出版的《英中式园林》(Jardins anglo-chinois)系列图册提供了大量中国园林图像,其中57幅中国皇帝南巡行宫铜版画翻刻自法国来华传教士钱德明从中国寄出的画作。这...十八世纪法国地图学家、版画家及建筑师勒胡日(Georges Louis Le Rouge)出版的《英中式园林》(Jardins anglo-chinois)系列图册提供了大量中国园林图像,其中57幅中国皇帝南巡行宫铜版画翻刻自法国来华传教士钱德明从中国寄出的画作。这两套收藏于法国国家图书馆的南巡行宫图尚未见于已有研究,且与目前已知南巡行宫图均有所不同,是还没有被认知和利用的新材料。鉴于此,有必要核定行宫图基本信息,追踪行宫图来源及流传过程,本文综罗图文史料重新梳理康乾南巡历史和图像涉及的南巡行宫园林建置沿革,考证图绘背景和年代,揭示了行宫图分别绘于乾隆首次及第四次南巡前,弥补了康熙至乾隆中期南巡行宫图像的缺失,具有重要的史料和艺术价值。展开更多
Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐...Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐部转移可以与腹腔内肿瘤同时出现或异时出现,是预后极差的表现。SMJN最常见原发肿瘤为胃癌及卵巢癌,结肠癌特别是右侧结肠癌引起的SMJN极其罕见。另外右侧结肠癌转移至腹股沟淋巴结未见文献报道。本文报道一例右侧结肠癌同时伴有SMJN及腹股沟淋巴结转移,并对相关文献进行综述。展开更多
文摘报告1例腺癌多发转移合并Sister Mary Joseph结节。患者男,49岁。脐部斑块、结节6个月,腰痛2个月。皮肤科检查:脐部一直径3.5 cm的淡红色浸润性斑块,表面可见多个直径1~5 mm淡红色丘疹、结节,簇集呈菜花样外观,质地坚韧,活动度差。CT检查示纵隔内淋巴结增大,腰3~腰5椎体等多处骨质破坏;锝亚甲基二膦酸盐(^(99m)Tc-MDP)全身骨显像示全身骨骼多处异常放射性浓聚灶。皮损组织病理检查:表皮大致正常,真皮全层致密增生的胶原束间肿瘤细胞呈单个或条索状、列兵样排列,部分肿瘤细胞核大、深染,有明显异形性。免疫组化:细胞角蛋白(CK)、CK7、绒毛蛋白(villin)均阳性表达。腰4椎体针吸组织病理检查符合转移性腺癌,免疫组化示CK及低分子质量细胞角蛋白(CAM)5.2均阳性表达。诊断:腺癌多发转移合并Sister Mary Joseph结节。治疗:患者拒绝接受治疗,随访至13个月时死亡。
文摘BACKGROUND A Sister Mary Joseph nodule(SMJN)is an uncommon cutaneous metastasis found in the umbilicus,indicating an advanced malignancy.SMJNs typically originate from intra-abdominal sources,rarely from breast cancer.Diagnosis suggests a poor prognosis with a median survival of approximately 8 mo after detection.Managing patients with SMJNs is challenging,as most receive limited palliative care only.The optimal strategy for long-term survival of these patients remains unclear.CASE SUMMARY A 58-year-old female,previously diagnosed with right breast cancer 17 years ago and underwent breast-conserving surgery,adjuvant radiotherapy,and endocrine therapy,presented with a 2-cm umbilical nodule.Thirteen years previously,metastases were detected in the right supraclavicular,infraclavicular,hilar,and mediastinal lymph nodes.An umbilical nodule emerged four years before the date of presentation,confirmed as a skin metastasis of primary breast cancer upon excisional biopsy.Despite initial removal,the nodule recurred and grew,leading to her referral to our hospital.The patient underwent extensive excision of the umbilical tumor and immediate abdominal wall reconstruction.Endocrine therapy was continued postoperatively.Five years later,no local recurrence was observed,and the patient continued to work full-time,achieving over 9 years of survival following SMJN diagnosis.CONCLUSION This case study aimed to identify the optimal strategy for achieving extended survival outcomes in patients with SMJN through comprehensive treatment.We presented a case of the longest survival in a patient after undergoing a multidisciplinary treatment regimen.Our findings underscore the significance of adopting a multimodal treatment approach comprising timely and wide excision along with adjunctive therapy.This approach can control the disease,prolong survival,and improve the quality of life in patients with SMJN.
文摘针对基本的快速拓展随机树算法(rapidly-exploring random tree,RRT^(*))存在搜索随机性大、效率低、路径非最优的缺点,提出一种引入人工势场法算法(artificial potential field method,APF)和Douglas-Peucker算法的改进RRT^(*)-APF-DP路径规划算法.在RRT*算法的采样点生成阶段引入变采样范围偏置搜索与步长自适应调整策略,融合重新设计的APF算法的引力与斥力函数,增强路径扩展导向性与绕过障碍物能力.采用重采样策略改进DP算法,优化避障代价与控制点数量.实验结果表明,本算法规划的避障路径满足机械臂的运动要求,且算法规划的避障路径代价、规划时间和路径控制节点数均得到有效改善.
文摘十八世纪法国地图学家、版画家及建筑师勒胡日(Georges Louis Le Rouge)出版的《英中式园林》(Jardins anglo-chinois)系列图册提供了大量中国园林图像,其中57幅中国皇帝南巡行宫铜版画翻刻自法国来华传教士钱德明从中国寄出的画作。这两套收藏于法国国家图书馆的南巡行宫图尚未见于已有研究,且与目前已知南巡行宫图均有所不同,是还没有被认知和利用的新材料。鉴于此,有必要核定行宫图基本信息,追踪行宫图来源及流传过程,本文综罗图文史料重新梳理康乾南巡历史和图像涉及的南巡行宫园林建置沿革,考证图绘背景和年代,揭示了行宫图分别绘于乾隆首次及第四次南巡前,弥补了康熙至乾隆中期南巡行宫图像的缺失,具有重要的史料和艺术价值。
文摘Sister Mary Joseph’s结节(Sister Mary Joseph’s nodule,SMJN)是指腹腔内恶性肿瘤导致的脐部转移性结节,1949年由Hamilton Bailey命名以纪念St.Mary’s Hospital的护士Sister Joseph。SMJN并不多见,但个案报道屡屡见诸文献。这种脐部转移可以与腹腔内肿瘤同时出现或异时出现,是预后极差的表现。SMJN最常见原发肿瘤为胃癌及卵巢癌,结肠癌特别是右侧结肠癌引起的SMJN极其罕见。另外右侧结肠癌转移至腹股沟淋巴结未见文献报道。本文报道一例右侧结肠癌同时伴有SMJN及腹股沟淋巴结转移,并对相关文献进行综述。
