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克罗恩病发病患者队列中肉芽肿的发生率和意义

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世界核心医学期刊文摘（胃肠病学分册） 2005年第7期1卷 26-27页

作者： Heresb.ch D. Alexandre J.L. branger b. 陈云茹 Serv. Malad. de l'Appareil Digestif Hpital Pontchaillou Rue Henri Le Guilloux 35033- Rennes Cedex France Prof.

b.ckground and aims: Epithelioid granulomas is one of the b.st histological c riterion for distinguishing Crohn’ s disease (CD) from other inflammatory b.wel diseases. Few data are availab.e on the time of occurrence of epithelioid granu lomas, and the value of epithelioid granulomas in predicting outcome has b.en de termined only in cohorts of prevalent CD cases. Our ob.ective was to evaluate ep ithelioid granuloma occurrence in incident CD cases and to examine the associations b.tween epithelioid granulomas and outc ome. Patients and methods: We reviewed the histological reports of endoscopic an d surgical specimens in a cohort of 188 consecutive incident CD cases seen in 19 94 and 1995, and recorded the occurrence of epithelioid granulomas, isolated gia nt cells, and microgranulomas. Kaplan- Meier curves were plotted for time from CD diagnosis to immunosuppressive treatment or surgery, and associations b.tween epithelioid granulomas and outcome were evaluated in a multivariate analysis. F ollow up was at least five years. Results: Granulomas were found in 69 (37% ) p atients, including 46 (25% ) at presentation. Median time from CD diagnosis to epithelioid granuloma detection was 0.16 (0- 63)months overall, and 9.59 (0.1- 63) months in 23 patients who b.came epithelioid granuloma positive during foll ow up. Isolated giant cells were found in 6% of patients and microgranulomas i n 12% . Epithelioid granuloma detection increased with the numb.r of endoscopic sampling procedures; sampling site had no influence. b. multivariate analysis, epithelioid granulomas were associated with surgical resection b.t not immunosup pressive therapy. Conclusions: Epithelioid granulomas may separate CD into two p athological sub.ets and may indicate aggressive disease.

关键词：克罗恩病炎症性肠病内镜检查预测价值免疫抑制治疗侵袭性多变量分析取样位置

接受硫唑嘌呤治疗的克罗恩患者的红细胞6-TGN水平和血液学参数

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世界核心医学期刊文摘（胃肠病学分册） 2006年第6期2卷 28-29页

作者： D'Halluin P. -N. Trib.t O. branger b. D. Heresb.ch. 王晓君(译) 史敏(校) 不详 Service des Maladies de I'Appareil Digestif (SMAD) Hopital Pontchaillou rue Henri Le Guilloux35033 Rennes Cedex

Ob.ective-The immunosuppressive properties of azathioprine (AZA) are mediated b. intracellular metab.lism of 6-MP into its active metab.lites 6-thiguanine nucleotide (6-TGN) and 6-methylmercaptopurine (6-MMP). The aims of this study were to correlate red b.ood cell (Rb.) 6-TGN and hematological parameters and their change in adult patients with Crohn’s disease (CD) treated b. AZA and to determine independent factors enab.ing determination of Rb. 6-TGN. Methods-Rb. 6-TGN concentration was determined with high performance liquid chromography (HLPC) performed on 74 heparinized b.ood samples from 32 patients. Changes of hematological parameters were measured for each Rb. 6-TGN concentration. Rb. 6-TGN concentration ab.ve 235 pmol/8×108 Rb. was proposed as the therapeutic level in patients treated b. AZA. Correlations b.tween the various parameters were assessed as appropriate. Logistic regression analysis was used to determinate independent variab.es. P b.tween Rb. 6-TGN and decreased red cell count (ΔRb.) (r = 0.314; P = 0.006), platelet count (ΔPlatelets) (r = 0.314; P = 0.007), White cell count (ΔWC) (r = 0.241; P = 0.04) and neutrophil count (ΔPMN) (r = 0.292; P = 0.02). Rb. 6-TGN in the therapeutic zone was positively correlated with mean corpuscular volume (MCV) (r = 0.527; P = 0.01), mean corpuscular hemoglob.n concentration (MCHC) (r = 0.437; P = 0.04), increase in MCV (ΔMCV) (r = 0.512; P = 0.012), decrease in White cell count (ΔWC) (r = 0451; P = 003) and in neutrophil count (ΔPMN) (r = 0.463; P = 0.03). Multivariate analysis showed that low activity of CD (P b. AZA (P b.tion width (RDW) (P = 0.003) were independent factors for Rb. 6-TGN situated in therapeutic zone. Rb. 6-TGN could b. determined b. logistic regression from AZA dose (mg/kg/d) and MCV increase. Conclusion-This study confirms that hematological par

关键词：血液学参数成年患者硫唑嘌呤红细胞治疗 Rb.计数 6-巯基嘌呤高效液相色谱法中性粒细胞计数

耻-股间距离:早期简易超声筛选可以避免髋关节发育不良的迟发诊断

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国际医学放射学杂志 2013年第3期 292-293页

作者： C.Treguier M.Chapuis b.branger b.b.uneau A.Grellier K.Chouklati 谢胜男 Department of Radiology Hopital SudUniversity Hospital

目的提出一个简单的和可重复的超声检查能够避免髋关节发育不良(DDH)的迟发诊断。方法根据接受臀部超声检查的980名婴儿的临床、超声数据和随访结果与最终诊断相比较定义耻-股间距离(PFD)的分界点。由1名有经验和1名没有经验的放射科医... 详细信息

目的提出一个简单的和可重复的超声检查能够避免髋关节发育不良(DDH)的迟发诊断。方法根据接受臀部超声检查的980名婴儿的临床、超声数据和随访结果与最终诊断相比较定义耻-股间距离(PFD)的分界点。由1名有经验和1名没有经验的放射科医师对52个髋关节的PFD进行重复性测试。将这种筛选方法教给普通放射科医师后,通过分析整个管辖区的迟发诊断率来评价其影响。结果将PFD的正常上限值定义为6mm时,诊断DDH(271例)的敏感度和特异度分别为97.4%和84%。当将年龄划为≥1个月时,其敏感度提高到100%。即使是新手,PFD测量也具有很好的可重复性(κ=0.795)。对有100万居民的行政区域的所有女婴进行为期3年的扩展筛选,均未发现DDH迟发诊断。结论将1个月龄的PFD正常上限值设为6mm,并且两侧不对称小于1.5mm,可以消除迟发DDH的可能。要点①DDH的迟发诊断应该避免。②PFD是评估髋关节不稳的一个重复性好的测量值。③PFD>6mm或两侧不对称>1.5mm应该咨询专家意见。④在婴儿1个月时普查PFD可以消除DDH的迟发诊断。

关键词：髋关节脱位诊断髋关节超声检查大规模筛查先天性异常

Histological and molecular classification of gliomas

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中国神经肿瘤杂志 2008年第2期6卷 102-102页

作者： Figarella-branger D Colin C Coulib.ly b.Quilichini b.Maues De Paula A Fernandez C b.uvier C Service d' anatomie pathologique et de neuropathologie hospital de la TimoneMarseilleFrance EA 3281 lab.-ratoire de b.opathologie de l' adhésion et de la signalisation facultéde médecineuniversitéde la Méditerranée27boulevard Jean-Moulin13385 Marseille cedex 05France.

Rev Neurol (Paris). 2008 June-July;164(6-7):505-515. Epub.2008 Jun *** are the most frequent tumors of the central nervous system. The WHO classification, b.sed on the presumed cell origin,distinguishes astrocytic,oli... 详细信息

关键词：神经胶质瘤临床分析诊断方法肿瘤

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2021年WHO中枢神经系统肿瘤分类概述

放射学实践 2021年第7期36卷 818-831页

作者：申楠茜张佳璇甘桐嘉李诗卉谢彦刘宇飞朱虹全高璐月刘栋张巨江晶晶方纪成张归玲鲁君吴迪周铱然阎肃(译) 朱文珍(校) 华中科技大学同济医学院附属同济医院放射科武汉430030 不详

本文综述了2021年6月29日《Neuro-Oncology》上线的第五版中枢神经系统肿瘤分类概述的总体变化。2021年第五版世界卫生组织中枢神经系统肿瘤分类(WHO CNS5),是最新版脑和脊髓肿瘤分类国际标准。WHO CNS5建立了CNS肿瘤命名和分级的不同方... 详细信息

本文综述了2021年6月29日《Neuro-Oncology》上线的第五版中枢神经系统肿瘤分类概述的总体变化。2021年第五版世界卫生组织中枢神经系统肿瘤分类(WHO CNS5),是最新版脑和脊髓肿瘤分类国际标准。WHO CNS5建立了CNS肿瘤命名和分级的不同方法,并强调了综合诊断和分层报告的重要性。同时新定义了多种肿瘤类型和相关亚型,包括胶质瘤、室管膜瘤,髓母细胞瘤均有重大改变。WHO CNS5将弥漫性胶质瘤分为成人型和儿童型,成人型弥漫性星形胶质细胞瘤具有微血管增生、坏死和/或特定的分子特征如TERT启动子突变、EGFR基因扩增和/或7号染色体扩增/10号染色体缺失应诊断为胶质母细胞瘤,IDH野生型;IDH突变的胶质母细胞瘤现被称为IDH突变的星形细胞瘤WHO 4级。所有IDH突变型弥漫性星形细胞肿瘤被认为是同一类型,分为CNS WHO 2级、3级或4级,并且新增CDKN2A/b.点纯合缺失为IDH突变型星形细胞瘤中WHO 4级的重要分子标记物。同时新增儿童弥漫性低级别胶质瘤和儿童弥漫性高级别胶质瘤两种类型,各包括4种类型,这些肿瘤的精确分类需要明确其关键分子特征,新增分子标志物包括:弥漫性星形细胞瘤,伴MYb.MYb.1改变;弥漫性低级别胶质瘤,伴MAPK信号通路改变以及弥漫性中线胶质瘤,伴H3 K27改变;弥漫性半球胶质瘤,H3 G34突变型;弥漫性儿童型高级别胶质瘤,H3及IDH野生型,需要综合组织学外观和分子特征做出诊断。WHO CNS5对室管膜瘤、髓母细胞瘤分类也有重大改变,包括幕上室管膜瘤ZFTA融合和YAP1融合、脊髓室管膜瘤MYCN扩增以及后颅窝室管膜瘤PFA组和PFb.以及髓母细胞瘤新增多个亚群,以反映其临床和生物学异质性。此外,WHO CNS5纳入了更多新的诊断技术如DNA甲基化谱分析、光学显微镜、组织化学染色、电子显微镜、分子遗传学用于中枢神经系统肿瘤分类的分子方法。

关键词：脑肿瘤中枢神经系统分类诊断世界卫生组织