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Clinical and morphological characteristics of hypersensitivity pneumonitis 过敏性肺炎的临床和形态学特征
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.3.5-13
E. V. Kusraeva
Hypersensitivity pneumonitis (HP) is an immune-mediated disease that manifests in susceptible individu-als after exposure to a provoking inhalation factor. The literature review describes etiological factors of the disease, its epidemiology and pathogenesis, as well as clinical features of various disease courses. A new clinical and morphological classification of HP is also presented. We analyzed changes in functional tests (external respiration function), CT images, cellular components of bronchoalveolar lavages, and modern approaches to the disease treatment. The review includes detailed morphological criteria according to the new classification, which will facilitate the diagnosis by pathologists. Since the diagnosis of the condition presents significant challenges, there are histological criteria for differential diagnosis of the fibrotic HP and usual interstitial pneumonia (idiopathic pulmonary fibrosis), sarcoidosis, lymphoid interstitial pneumonia, and pulmonary manifestations of connective tissue diseases. Keywords: hypersensitivity pneumonitis, interstitial lung diseases
超敏性肺炎(HP)是一种免疫介导的疾病,在易感个体暴露于刺激性吸入因子后表现出来。本文综述了该病的病因、流行病学和发病机制,以及各病程的临床特点。HP的一种新的临床和形态学分类也被提出。我们分析了功能测试(外呼吸功能)、CT图像、支气管肺泡灌洗的细胞成分和疾病治疗的现代方法的变化。综述包括详细的形态学标准,根据新的分类,这将有助于病理学家的诊断。由于该病的诊断具有重大挑战,因此存在纤维化HP与通常间质性肺炎(特发性肺纤维化)、结节病、淋巴样间质性肺炎和结缔组织疾病肺部表现的鉴别诊断的组织学标准。关键词:过敏性肺炎;肺间质性疾病
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引用次数: 0
Immunohistochemical study of the effects of heavy metals on the intestinal mucosa in prepubertal rats 重金属对青春期前大鼠肠黏膜影响的免疫组化研究
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.4.45-52
P. A. Elyasin, S. Zalavina, A. Mashak, E. Ovsyanko, S. Aidagulova
Introduction. Numerous studies of pathological effects of heavy metals were mostly carried out on adult experimental animals. The aim of this work was to evaluate the markers of proliferation and apoptosis in the mucosa of the small intestine in Wistar prepubertal rats under isolated and combined exposure to cadmium and lead at subtoxic doses. Materials and methods. We used immunohistochemistry to study Ki67 and p53 expression in the mucosa of the small intestine in 40 male Wistar prepubertal rats aged 4 weeks, the animals having been exposed to isolated or combined per os subtoxic cadmium and/or lead doses for 21 days. Results. In paraffin sections, we observed a significant increase in Ki67 expression in the epithelium of the small intestine in the group of combined exposure to heavy metals compared to Ki67 expression in the control group and other groups with isolated exposure to cadmium or lead. p53 expression in the epithelium of the small intestinal crypts and villi grew in the experimental groups compared to that in the control group, the highest indices being in the combined exposure group. The number of epithelial goblet cells significantly decreased in all experimental groups compared to that in the control group, the smallest number of goblet cells being observed in isolated exposure to lead compared to that in all other groups. Conclusion. Heavy toxic metals cadmium and lead induced the proliferative activity of epithelial cells in the small intestinal mucosa combined with an increased p53 expression and reduced number of epithelial goblet cells. Keywords: small intestinal mucosa, prepubertal rats, cadmium, lead, proliferation, apoptosis, immunohis-tochemistry
介绍。大量关于重金属病理效应的研究大多是在成年实验动物身上进行的。本研究的目的是评价Wistar青春期前大鼠在亚毒性剂量镉和铅的分离和联合暴露下小肠粘膜增殖和凋亡的标志物。材料和方法。我们使用免疫组织化学方法研究了40只4周龄雄性Wistar青春期前大鼠小肠黏膜中Ki67和p53的表达,这些大鼠暴露于单独或联合亚毒性镉和/或铅剂量21天。结果。在石蜡切片中,我们观察到,与对照组和其他单独暴露于镉或铅的组相比,重金属联合暴露组小肠上皮中Ki67的表达显著增加。实验组小肠隐窝上皮和绒毛中P53表达均较对照组升高,且以联合暴露组最高。与对照组相比,所有实验组的杯状上皮细胞数量都显著减少,与所有其他组相比,在单独接触铅时观察到的杯状细胞数量最少。结论。重金属镉和铅诱导小肠黏膜上皮细胞增殖活性,同时p53表达增加,上皮杯状细胞数量减少。关键词:小肠黏膜,青春期前大鼠,镉,铅,增殖,细胞凋亡,免疫组化
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引用次数: 0
Role of skin dendritic and mast cells communications in triggering immune reactions 皮肤树突状细胞和肥大细胞通讯在触发免疫反应中的作用
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/CEM2021.10.1.5-10
N. Yaglova, S. Obernikhin, V. Yaglov, S. Nazimova
Skin represents a natural barrier and a site of contact with antigens. Skin demonstrates higher intensity of immune reactions compared to other organs, which implies the additional cell interactions. Dendritic cells are traditionally considered as the main antigen­presenting cells of the skin, however, in recent years, some data on the ability of another population, mast cells, to perform antigen­presenting functions have appeared. The review presents novel data on the interaction of skin dendritic and mast cells, including formation of immune synapses, exchange of surface molecules, and transfer of secretory material. The authors have developed and presented a new concept for the initiation and modulation of immune responses provided by the functional dendritic cell–mast cell complex. Keywords: dendritic cells, mast cells, skin, immunological synapse, degranulatory synapse, immune response
皮肤是一种天然屏障,也是与抗原接触的部位。与其他器官相比,皮肤表现出更高强度的免疫反应,这意味着额外的细胞相互作用。传统上,树突状细胞被认为是皮肤的主要抗原提呈细胞,然而,近年来,关于另一种细胞群肥大细胞执行抗原提呈功能的能力的一些数据已经出现。本文综述了皮肤树突状细胞和肥大细胞相互作用的新数据,包括免疫突触的形成、表面分子的交换和分泌物质的转移。作者已经发展并提出了一个新的概念,为启动和免疫反应的调节提供了功能性树突状细胞-肥大细胞复合物。关键词:树突状细胞,肥大细胞,皮肤,免疫突触,脱颗粒突触,免疫反应
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引用次数: 1
Epithelial-mesenchymal transition in main types of gastric carcinoma 胃癌主要类型的上皮-间质转化
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.2.13-20
I. Vasilenko, R.B. Kondratyk, I. S. Grekov, A. M. Yarkov
Introduction. The rapid development of basic science enabled us to significantly expand our understanding of various intercellular interactions. Epithelial-mesenchymal transition (EMT) is known to play a key role in certain tissue formation in the embryonic period. However, recent data show that EMT can also be observed in some pathological conditions, in particular, in various neoplasm development. This suggests that there are a number of alternative and fundamentally new mechanisms for the tumor formation and progression. Thus, EMT, which occurs in carcinomas, increases the invasiveness, immunoresistance, immunity to therapy, and the metastatic potential. Knowledge of EMT features and their timely recognition in morphological tumor diagnosis is of great predictive importance for patients. The aim of the research was to study the morphologi-cal features of epithelial-mesenchymal transition in the main types of gastric cancer. Materials and methods. We studied specimens of gastric carcinomas (N=64) including 31 cases of diffuse type, 19 cases of intestinal type, and 14 cases of mixed type. Results. All cases of the diffuse carcinoma group showed spread EMT features, which appeared already in the mucosa and completed with positive vimentin expression in 93.5% of cases. The malignant cell prolifera-tive activity was low; however, in 29% of cases we detected areas of moderate or even high activity. In the intestinal type gastric cancer, EMT developed as a result of tumor progression, it arose more often in the deeper layers and was incomplete and focal. As a rule, the proliferative activity of tumor cells was high and moderate. Vascular invasion occurred more often in diffuse type (90.3%), less often in mixed type (71.4%), and even less often in the intestine type (55.8%) gastric carcinoma. Conclusion. The variety of morphological features of EMT, its frequency, prevalence, completeness, and sequence in the development of various types of gastric cancer determines the features of their clinical manifestation and influences their further management. Keywords: gastric cancer, diagnosis, histological main types, EMT, morphopathology
介绍。基础科学的快速发展使我们对各种细胞间相互作用的理解大大扩展。上皮间质转化(Epithelial-mesenchymal transition, EMT)在胚胎期的某些组织形成中起着关键作用。然而,最近的数据显示,EMT也可以在一些病理条件下观察到,特别是在各种肿瘤的发展中。这表明肿瘤的形成和发展有许多可选择的和根本的新机制。因此,发生在肿瘤中的EMT增加了侵袭性、免疫抗性、对治疗的免疫力和转移潜力。了解EMT特征并及时识别其在形态学肿瘤诊断中的作用对患者具有重要的预测意义。本研究的目的是研究主要类型胃癌上皮-间质转化的形态学特征。材料和方法。我们研究了64例胃癌标本,其中弥漫型31例,肠型19例,混合型14例。结果。弥漫性癌组均表现为弥漫性EMT特征,EMT已出现在粘膜中,93.5%的病例完成了vimentin阳性表达。恶性细胞增殖活性低;然而,在29%的病例中,我们发现了中度甚至高度活跃的区域。在肠型胃癌中,EMT是肿瘤进展的结果,EMT多发生在较深层,不完整和局灶性。一般情况下,肿瘤细胞的增殖活性是高而中等的。弥漫性胃癌多见血管浸润(90.3%),混合性胃癌少见血管浸润(71.4%),肠型胃癌更少见血管浸润(55.8%)。结论。不同类型胃癌发生发展过程中EMT形态特征的多样性、发生频率、发生率、完全性和先后顺序决定了其临床表现的特点,并影响其进一步的处理。关键词:胃癌,诊断,组织学主要类型,EMT,形态病理
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引用次数: 1
Clinical and morphological heterogeneity of diffuse gastric cancer 弥漫性胃癌的临床及形态学异质性
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.s4.34-41
K. Midiber, A. E. Biryukov, V. Pechnikova, N. A. Gracheva, N. Shakhpazyan, Z. Gioeva, L. Mikhaleva
Introduction. Despite various diagnostic testing and treatment options, stomach cancer ranks 5th in terms of global morbidity among all cancers. Diffuse gastric cancer occurs more frequently in younger patients and has a more aggressive course than the intestinal type. Modern ideas about the etiology, pathogenesis, and molecular structure of a tumor allow us to take a new look at diffuse gastric cancer in the light of revised classifications, recommendations, as well as approaches to the interpretation of morphological research data. Therefore, the study aimed to conduct a multifactorial analysis of patients with diffuse gastric cancer. Materials and methods. The study included 124 patients with diffuse gastric cancer. Clinical data (medical histories, protocols of endoscopic and surgical operations, sex, and age groups) and the primary tumor localization were analyzed. We formed a group of 25 observations out of 124 patients. In the group, we carried out a range of diagnostic measures: histological, histochemical, immunohistochemical, and molecular assays, as well as PCR testing. Results. In the group of 124 patients, the age of men averaged 67.5 (±12.4) years and that of women, 71 (±15.41) years. The malignant tumors were more frequently detected in distal parts of the stomach. In the group of 25 patients, Helicobacter pylori were present only in 2 cases. We detected the Epstein-Barr virus in 11 patients out of 25 using real-time PCR method. A study of the immunophenotype of diffuse gastric cancer using a wide panel of antibodies demonstrated heterogeneity of expression in both components of a malignant tumor. The expression of CK7, Muc1, Muc2, and Muc5AC markers in patients with a microsatellite unstable molecular subtype was noteworthy. Conclusion. The immunophenotypic heterogeneity of diffuse gastric cancer requires further research. It is necessary to create a standardized pathology evaluation protocol, including molecular and immunohistochemical tests that is the basis for modern management of cancer patients with diffuse gastric cancer. Keywords: gastric cancer, surgical pathology, immunohistochemistry, molecular genetics
介绍。尽管有各种各样的诊断测试和治疗选择,胃癌在全球所有癌症中发病率排名第五。弥漫性胃癌多见于年轻患者,病程比肠型更具有侵袭性。关于肿瘤的病因、发病机制和分子结构的现代观念使我们能够根据修订的分类、建议以及形态学研究数据的解释方法来对弥漫性胃癌进行新的观察。因此,本研究旨在对弥漫性胃癌患者进行多因素分析。材料和方法。该研究包括124例弥漫性胃癌患者。分析临床资料(病史、内镜和外科手术方案、性别和年龄组)和原发肿瘤定位。我们对124名患者进行了25组观察。在该组中,我们进行了一系列诊断措施:组织学,组织化学,免疫组织化学和分子分析,以及PCR检测。结果。124例患者中,男性平均年龄67.5(±12.4)岁,女性平均年龄71(±15.41)岁。恶性肿瘤多见于胃远端。25例患者中仅有2例出现幽门螺杆菌。利用实时荧光定量PCR技术,在25例患者中检测出11例eb病毒。一项利用广泛的抗体小组对弥漫性胃癌免疫表型的研究表明,在恶性肿瘤的两个组成部分中表达的异质性。CK7、Muc1、Muc2和Muc5AC标记物在微卫星不稳定分子亚型患者中的表达值得注意。结论。弥漫性胃癌的免疫表型异质性有待进一步研究。有必要建立一个标准化的病理评估方案,包括分子和免疫组织化学测试,这是现代癌症患者弥漫性胃癌管理的基础。关键词:胃癌,手术病理,免疫组织化学,分子遗传学
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引用次数: 0
Prognostic significance of programmed cell death receptor ligand PD-L1 expression in chordoma 脊索瘤中程序性细胞死亡受体配体PD-L1表达的预后意义
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.s4.61-67
O. Kovaleva, I. Boulytcheva, A. N. Gratchev, N. S. Babkin, E. R. Musaev, N. Kushlinskii
Introduction. Chordomas are rare malignant neoplasms that are highly recurrent and with limited treatment options. Invasion of the vital structures of the nervous system complicates their treatment. The search for new methods of drug therapy for chordomas is an urgent problem. The aim of the research was to study PD-L1 expression in tumor cells and tumor infiltrating lymphocytes (TILs) in chordoma samples and its interrelation with tumor characteristics and prognosis. Materials and methods. We analyzed PD-L1 expression in 30 primary chordomas using immunohistochemistry and differences in independent groups using Chi-square and Kruskal–Wallis tests. Survival analysis was performed by constructing Kaplan–Meier survival curves. We compared the significance of differences with the logarithmic rank test. Differences were considered significant at p<0.05. Results. PD-L1 expression was detected in tumor cells in 43% of samples and in TILs in 80%. PD-L1 expres-sion in tumor cells and TILs was not associated with the clinical features of the disease. However, PD-L1 expression in tumor cells in all samples correlates positively with the content of this marker in TILs (r=0.409, p=0.028). Different histological variants of chordomas were shown to differ in the content of PD-L1 in both tumor cells and TILs. PD-L1 expression in tumor cells is not a predictor of the disease, while its expression in TILs tends to be a marker of a favorable prognosis (HR=0.1429; p=0.0570). Conclusion. We found the lowest level of PD-L1 expression in both tumor cells and TILs in dedifferentiated chordoma. PD-L1 expression in TILs is associated with a favorable prognosis of chordomas and indicates the potential for the use of checkpoint inhibitors in therapy. Keywords: chordoma, PD-L1, lymphocytes, prognosis, survival
介绍。脊索瘤是一种罕见的恶性肿瘤,极易复发,治疗方法有限。对神经系统重要结构的侵犯使其治疗复杂化。寻找新的药物治疗脊索瘤的方法是一个迫切的问题。本研究旨在探讨脊索瘤标本中肿瘤细胞和肿瘤浸润淋巴细胞(tumor浸润淋巴细胞,til)中PD-L1的表达及其与肿瘤特征和预后的关系。材料和方法。我们使用免疫组织化学分析了30例原发性脊索瘤中PD-L1的表达,并使用卡方检验和Kruskal-Wallis检验分析了独立组之间的差异。通过构建Kaplan-Meier生存曲线进行生存分析。我们用对数秩检验比较差异的显著性。p<0.05认为差异有统计学意义。结果。PD-L1在43%的肿瘤细胞中表达,在80%的TILs中表达。肿瘤细胞和til中PD-L1的表达与疾病的临床特征无关。然而,在所有样本中,肿瘤细胞中PD-L1的表达与til中该标志物的含量呈正相关(r=0.409, p=0.028)。脊索瘤的不同组织学变异显示肿瘤细胞和til中PD-L1的含量不同。肿瘤细胞中PD-L1的表达不是疾病的预测因子,而其在til中的表达往往是预后良好的标志(HR=0.1429;p = 0.0570)。结论。我们发现PD-L1在去分化脊索瘤的肿瘤细胞和TILs中表达水平最低。TILs中的PD-L1表达与脊索瘤的良好预后相关,并表明在治疗中使用检查点抑制剂的潜力。关键词:脊索瘤,PD-L1,淋巴细胞,预后,生存
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引用次数: 0
The role of Yamanaka cocktail transcription factors (OCT4, SOX2, KLF4, c-Myc) in the differentiation of somatic cells, their malignant transformation, and tumor progression 山中鸡尾酒转录因子(OCT4、SOX2、KLF4、c-Myc)在体细胞分化、恶性转化和肿瘤进展中的作用
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.s4.7-22
L. Gurevich, E. Bondarenko, O. Vasyukova, L. Mikhaleva
The paper reviews the role of transcription factors that are part of the Yamanaka cocktail (OCT4, SOX2, KLF4, and c-Myc) in the mechanisms of tumor stem cell (TSC) differentiation (a pool of pluripotent cells), their participation in the malignant transformation of somatic cells, and in tumor progression. Their increased proliferative activity, which determines their malignant potential, was believed to be the main feature of tumor cells. Currently, there is more evidence supporting another concept that explains the continued tumor growth, metastasis, and resistance to therapy of most malignant tumors with a small, rest-ing, and rarely dividing population of pluripotent tumor cells. Year 2006 is considered to be the beginning of a new direction in developmental biology when Japanese researchers K. Takahashi and S. Yamanaka published the results of their studies on the properties of embryonic stem cells and experiments on direct reprogramming of somatic terminally differentiated cells.The research proved that four transcription factors were sufficient to maintain the pluripotent properties of cells, namely Oct4, SOX2, KLF4, and c-Myc, which were later called the Yamanaka cocktail. Such factors as SOX2and Oct4 are at the top of the hierarchy of transcription factors that regulate the pluripotent proper-ties of cells, their differentiation, and dedifferentiation. TSCs represent, albeit a complex, but very promising target for the development of innovative products for the diagnosis of and targeted therapy for neoplasms. From this point of view, the factors of pluripotency, which are parts of the Yamanaka cocktail, could be such promising targets, whose effect will probably be able to suppress or reduce the malignant potential of the most aggressive tumors and even prevent carcinogenic transformation in cases of precancerous pathology. Keywords: Yamanaka cocktail, OCT4, SOX2, KLF4, c-Myc, malignant transformation
本文综述了Yamanaka鸡尾酒中的转录因子(OCT4、SOX2、KLF4和c-Myc)在肿瘤干细胞(TSC)分化(多能细胞池)机制、参与体细胞恶性转化和肿瘤进展中的作用。它们增加的增殖活性,决定了它们的恶性潜能,被认为是肿瘤细胞的主要特征。目前,有更多的证据支持另一个概念,该概念解释了大多数恶性肿瘤的持续生长、转移和对治疗的抵抗,这些肿瘤具有小的、静止的、很少分裂的多能性肿瘤细胞群。2006年,日本研究人员高桥(K. Takahashi)和山中(S. Yamanaka)发表了关于胚胎干细胞特性和体细胞终末分化细胞直接重编程的研究成果,被认为是发育生物学新方向的开始。研究证明,四种转录因子足以维持细胞的多能性,即Oct4、SOX2、KLF4和c-Myc,后来被称为Yamanaka鸡尾酒。sox2和Oct4等因子是调控细胞多能性、分化和去分化的转录因子的顶层。虽然TSCs是一个复杂的,但对于肿瘤诊断和靶向治疗的创新产品的开发来说,它是一个非常有前途的目标。从这个角度来看,作为Yamanaka鸡尾酒的一部分的多能性因子可能是如此有希望的目标,其效果可能能够抑制或减少最具侵袭性肿瘤的恶性潜能,甚至在癌前病变的情况下防止致癌转化。关键词:山中鸡尾酒,OCT4, SOX2, KLF4, c-Myc,恶性转化
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引用次数: 2
Structural dermis remodeling in a skin expansion rat model 皮肤扩张模型大鼠真皮结构重塑
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.2.50-56
E. Mishina, M. Zatolokina, M. Mnikhovich
Introduction. Skin expansion is known to be the most effective way to obtain skin for alloplastic closing of large defects, and it has proven to be successfully used in various fields of surgery, cosmetology, and traumatology. At the same time, the issues of skin flap restructuring when it is stretched and possible range of its application are still relevant. In this regard, the aim was to study the adaptive skin rearrangements of the fibrous skeleton in a murine skin expansion model. Materials and methods. We used the skin of mature male Wistar rats (N=30) after a 2-week stretching. We utilized a complex morphological light and electron microscopy approach as well as an immunohistochemi-cal method to determine the types of collagen and to study the alterations in skin samples. Results. We revealed pronounced reactive changes in the skin structural components in the skin expansion area. On day 14, we observed a decrease in the epidermal cell layer thickness as well as stretching, partial disorganization, and damage of dermal fibrous structure. At the same time, cellular mechanisms of regen-eration and activation of collagen synthesis were launched, the morphological substrate of which was (1) a significant 2.7-fold increase in the number density of fibroblasts, which produce substances for building fibrous structures, (2) a five-fold increase in macrophages, which are a catalyst for the fibroblast functional activity and (3) a collagen fiber types’ redistribution s with Type III collagen structures’ predominance. Conclusion. The results indicate, first of all, the restructuring of the dermal fibrous component, which im-plies reparative and restorative processes. These must be taken into account in clinical practice to achieve not only an esthetic effect but also the subsequent adequate functioning and vital activity of the skin flap. Keywords: skin expansion, fibrous dermis, remodeling, skin, hyperextension
介绍。皮肤扩张术被认为是同种异体修复大缺损获得皮肤的最有效方法,已被证明在外科、美容和创伤学的各个领域都有成功的应用。同时,皮瓣拉伸后的重建问题及其可能的应用范围仍有待探讨。因此,我们的目的是在小鼠皮肤扩张模型中研究纤维骨架的适应性皮肤重排。材料和方法。我们使用成熟雄性Wistar大鼠(N=30)拉伸2周后的皮肤。我们利用复杂的形态学光和电子显微镜方法以及免疫组织化学方法来确定胶原蛋白的类型并研究皮肤样品中的变化。结果。我们发现在皮肤扩张区皮肤结构成分有明显的反应性变化。在第14天,我们观察到表皮细胞层厚度减少,真皮纤维结构拉伸,部分解体和损伤。同时,启动了再生和激活胶原合成的细胞机制,其形态学底物为(1)产生构建纤维结构物质的成纤维细胞数量密度显著增加2.7倍,(2)巨噬细胞数量增加5倍,巨噬细胞是成纤维细胞功能活性的催化剂,(3)胶原纤维类型重新分布,以III型胶原结构为主。结论。结果表明,首先,真皮纤维成分的重组,这意味着修复和恢复过程。在临床实践中必须考虑到这些因素,不仅要达到美观的效果,而且要达到皮瓣随后的充分功能和重要活动。关键词:皮肤扩张,纤维性真皮层,重塑,皮肤,超伸
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引用次数: 0
Quality assessment of the inflammatory bowel disease biopsy diagnosis using digital images 用数字图像评价炎症性肠病活检诊断的质量
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.3.21-28
Kh M Akhrieva, E. A. Kogan, A.S. Tertychniy, O. Zayratyants, L. S. Selivanova
Introduction. Morphological diagnosis of inflammatory bowel diseases (IBDs) based on endoscopic biopsies remains a rather challenging task and does not always allow the pathologist to make the final conclusion. Difficulties arise due to the absence of a classical morphological picture in biopsy specimens as well as the lack of clinical and laboratory data. These issues may lead to an incorrect interpretation of the detected pathological changes and an erroneous conclusion. The aim of the study was to assess the quality of biopsy diagnosis of IBDs using Internet diagnostic tools, namely, the digitalized histological slides. Materials and methods. We created an Internet platform, which contained 100 scanned images of histologi-cal slides from 70 patients with suspected IBD. Based on our own practical experience and guidelines of international European and British societies of pathology, we arranged a survey. The diagnosis was made on the combined clinical and morphological approach, considering also a complex of clinical, laboratory, endoscopic, and morphological data. The first stage of the survey was anonymous and included a list of 25 questions. Ten pathologists, who agreed to take part in the study, completed the questionnaire. After statistical processing, the results were assessed using a Fleiss' kappa criterion. Results. The comparative analysis of morphological study showed that the participants were able to diagnose accurately only 71% of ulcerative colitis cases and 63% of Crohn’s disease cases. At the same time, the agreement coefficient demonstrated satisfactory values: the Fleiss' kappa was 0.34 and 0.25, respectively. In some cases, the participants found it difficult to perform a differential diagnosis between IBD and other forms of colitis and were not always capable of distinguishing ulcerative colitis from Crohn’s disease. A few of the individual criteria, on which the diagnosis is based, rarely reached agreement above a kappa of 0.5. The participants’ agreement was considered more often as “weak” and “satisfactory”. This is largely due to the fact that we did not discuss the exact criteria for the proposed parameters and that these parameters were divided into four degrees of severity from 0 to 3. Conclusion. The results showed the current discrepancies in the assessment of biopsies in patients with suspected IBD. The developed Internet platform provides additional significant opportunities to improve the quality of morphological diagnosis in ileal and colon biopsies by means of refining the criteria and their assessment in the final diagnosis statement. Keywords: inflammatory bowel disease, colitis, digital pathology
介绍。基于内镜活检的炎症性肠病(IBDs)形态学诊断仍然是一项相当具有挑战性的任务,并且并不总是允许病理学家做出最终结论。由于缺乏活检标本的经典形态学图像以及缺乏临床和实验室数据,困难出现。这些问题可能导致对检测到的病理变化的错误解释和错误结论。本研究的目的是评估使用互联网诊断工具(即数字化组织学切片)对ibd进行活检诊断的质量。材料和方法。我们创建了一个互联网平台,其中包含来自70名疑似IBD患者的100张组织学切片扫描图像。根据我们自己的实践经验和国际欧洲和英国病理学会的指导方针,我们安排了一次调查。诊断是结合临床和形态学的方法,也考虑了复杂的临床,实验室,内镜和形态学资料。调查的第一阶段是匿名的,包括25个问题。十位同意参与研究的病理学家完成了调查问卷。统计处理后,使用Fleiss kappa标准对结果进行评估。结果。形态学研究的比较分析表明,参与者能够准确诊断溃疡性结肠炎的71%和克罗恩病的63%。同时,一致系数也令人满意,Fleiss kappa分别为0.34和0.25。在某些情况下,参与者发现很难在IBD和其他形式的结肠炎之间进行鉴别诊断,并且并不总是能够区分溃疡性结肠炎和克罗恩病。诊断所依据的个别标准很少达到kappa值0.5以上的一致值。与会者的协议通常被认为是“弱”和“令人满意”的。这主要是由于我们没有讨论所建议参数的确切标准,并且这些参数被分为从0到3的四个严重程度。结论。结果显示目前在疑似IBD患者的活检评估中存在差异。发达的互联网平台提供了额外的重要机会,以提高形态学诊断的质量,在回肠和结肠活检通过细化标准和他们的评估在最终诊断声明。关键词:炎症性肠病,结肠炎,数字病理学
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引用次数: 0
Pathological investigation of neuroprotective activity of new derivatives of fused pyrazolyl-thienopyridines in Corazol-induced seizures 融合吡唑噻吩吡啶新衍生物对科拉唑致癫痫发作神经保护作用的病理研究
Q4 Medicine Pub Date : 2021-01-01 DOI: 10.31088/cem2021.10.4.53-62
H. Gasparyan, S. Buloyan, A. Pogosyan, L.M. Arshakyan, L. Harutyunyan, R. Paronikyan, I. M. Nazaryan, S. Dashyan, E. Paronikyan
Introduction. Seizures provoke several morphological alterations in the brain structures. These alterations are primarily located in the hippocampal CA1 region and the entorhinal cortex. Recurrent seizures are common in patients with epilepsy. Therapeutic options for this disease are very limited and most of them are aimed at relieving symptoms. In most cases, to treat epilepsy, anti-seizure drugs are used. Nevertheless, one-third of affected individuals have resistance to them. Thus, the study of new effective agents that can prevent epileptogenesis is still an ongoing challenge. In this work, we aimed to study the neuroprotective activity of several new derivatives of tricyclic pyrazolyl substituted thieno[2,3-c]isoquinolins (SHD-89 and SHD-91) and pyrano[4,3-d]thieno[2,3-b]pyridines (SHD-78 and SHD-85) as potential anti-seizure drugs. Materials and methods. The study was performed on mice (n=60). The action of compounds SHD-78, SHD-85, SHD-89, and SHD-91 was tested in seizures with and without Corazol administration. Histopathological examinations were performed in the hippocampus and the entorhinal cortex in different experimental groups. Results. The study showed that under the action of SHD-89 and SHD-78, there was a reduction in the number of neurons and activation of glial cells in examined regions of the brain. SHD-91 caused severe neurode-generative effects with changes in the brain structure. In contrast, under the action of SHD-85, the number of neurons was higher and with lower activation of glial cells. Conclusion. Studies showed that among the tested compounds SHD-85 possessed moderate neuroprotective activity and reduced gliosis and neuronal loss induced by Corazol. Keywords: anti-seizure drugs, pyrazolylthienopyridines, hippocampus, entorhinal cortex, histopathological examination
介绍。癫痫发作引起大脑结构的几种形态学改变。这些改变主要位于海马CA1区和内嗅皮层。反复发作在癫痫患者中很常见。这种疾病的治疗选择非常有限,其中大多数旨在缓解症状。在大多数情况下,治疗癫痫会使用抗癫痫药物。然而,三分之一的感染者对它们有抗药性。因此,研究新的有效的药物,可以防止癫痫发生仍然是一个持续的挑战。在这项工作中,我们旨在研究几种新的三环吡唑基取代噻吩[2,3-c]异喹啉衍生物(SHD-89和SHD-91)和吡喃[4,3-d]噻吩[2,3-b]吡啶衍生物(SHD-78和SHD-85)作为潜在的抗癫痫药物的神经保护活性。材料和方法。该研究在小鼠(n=60)上进行。对化合物SHD-78、SHD-85、SHD-89和SHD-91在给予和不给予科拉唑的癫痫发作中的作用进行了测试。对各组大鼠海马和内嗅皮质进行组织病理学检查。结果。研究表明,在SHD-89和SHD-78的作用下,大脑被检查区域的神经元数量减少,神经胶质细胞激活。SHD-91引起了严重的神经退行性影响,并改变了大脑结构。相反,在SHD-85的作用下,神经元数量增加,胶质细胞活化程度降低。结论。研究表明,在所测试的化合物中,SHD-85具有中等的神经保护活性,并能减轻科拉唑引起的胶质细胞增生和神经元损失。关键词:抗癫痫药物,吡唑噻吩吡啶,海马,内嗅皮质,组织病理学检查
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引用次数: 1
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Clinical and Experimental Morphology
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