Objective To study the pathomorphological f eatures of prostatic adenocarcinoma from biopsy. Methods Of 1147 cases of prostatic biopsy specimens,112 cases were adenocarcinoma,1030 cases benign prostatic hyperplasia and 5 cases nonspecific granulomatous prosta titis.Histological grades and the differential diagnosis between well-different iated adenocarcinoma and hyperplasia were conducted.Immunohistochemical analysis (34?E12) were done in some cases. Results 112 cases of adenocarcinoma were diagnosed according to the architectural changes, cytologic al atypia and invasion. 23 cases(20.5%)were of well-differentiated carcinoma ,38 cases(33.9%)moderately-differentiated carcinoma and 51 cases(45.5%) po or-differentiated carcinoma. 21 cases(18.8%) were of low grade prostatic intrae pithelial neoplasia(PIN Ⅰ)and 75 cases(67.0%)of high grade PIN(PIN Ⅲ) were found with in tumor tissue.With immunohistochemical stain,98 in 102 cases of BP H were positive reactive for 34?E12 in the basal layer,while 36 of 40 cases of prostatic adenocarcinoma were negative. Conclusions Ro utine pathological morphological features,combined with immunohistochemical test s is valuable for the pathological diagnosis of prostatic adenocarcinoma.

Objective To study the short-term prognosis of laparoscopic splenectomy combined with lower esophagus transection in the treatment for hepatic cirrhosis induced portal hypertension.Methods The clinical data of 7 cases of portal hypertension treated by laparoscopic eplenectomy combined with lower esophagus transaction were retrospectively analysisd.Results Among of the patients,six cases were undertaken with total laparoscopic technique and only one case done with hand-assisted laparoscopic operation and one case turned to open surgery.Average operation time was 330 min and operation hemorrhage was 780 ml.None of cases died,bled or occurred pancreatical fistula.Mean time of bowel function recovery(70 h) and postoperative hospitalization(12.7 d).1 case complicated with hydrothorax recovered after conservative therapy.Conclusion Cincial short-term effects of patients treated with laparoscopic splenectomy combined with lower esophagus transection for hepatic cirrhosis induced portal hypertension is satisfied,so it is a safe and feasible way for future clinical practice if conducted by the skilled and competent surgeon.

Objective To explore the use and advantages of the Hem-o-lok ligating clip in laparoscopic cholecystectomy (LC). Methods A 3-port approach laparoscopic cholecystectomy by applying the Hem-o-lok ligating clip was performed in 288 patients with cholecystolithiasis or cholecystic polypoid lesion. Results All the operations were successfully fulfilled, without conversions to open surgery. A middle-to-large sized clip was used in 264 patients (92%), who almost had no painful feeling in the xiphoid process incision and had a mean postoperative hospital stay of 2.7 days(1~3 days). A large sized clip was successfully utilized in 24 patients because of the difficulty encountered during the ligation using the middle-to-large sized clip. No hemorrhage, biliary leakage, or bile duct injuries happened. Conclusions Laparoscopic cholecystectomy using the middle-to-large sized ~Hem-o -lok ligating clip and other routine laparoscopic devices can minimize the xiphoid process incision as short as 5 mm.

Objective To explore the clinical value and feasibility of the open bile duct operative instruments in laparoscopic common bile duct exploration.Methods 43 operations of laparoscopic common bile duct exploration were accomplished by using open bile duct operation instruments for exploring common bile duct and removing stones without choledochofiberscopy.Results 43 operations of laparoscopic common bile duct exploration were achieved successfully by exploring common bile duct and removing stones with open bile duct operative instruments with no postoperative remanent stones of the common bile duct and no open operation was needed.The follow-up in 38 patients for 6 months showed that there was no postoperative complication.Conclusions This method has the advantages of convenient manipulation,safety and better effect,low cost.It was deserved to be extended.

Objective To evaluate the significance of fiberoptic bronchoscopic brush cytology in the diagnosis and histological classification of lung carcinoma.Methods Data of 309 patients with lung carcinoma were retrospectively analyzed.Both bronchoscopic cytology and histology diagnosis were available.The positive rate of bronchoscopic cytology and tissue biopsy were calculated respectively.The classification accuracy of cytological diagnosis for lung carcinoma was evaluated.In tissue biopsy standard,evaluated the significance of bronchoscopic cytology in diagnosis and histological diagnosis.Results The positive rate of bronchoscopic cytology and tissue biopsy were 86.1％ (266/309) and 83.8％ (259/309),respectively.Bronchoscopic cytology combined with bronchial biopsy could obviously improve the positive rate to 94.2％ (291/309) in lung carcinoma diagnosis.Taking the tissue biopsy histological type as a standard,the cytotyping accuracy for brush method was 85.1％(74/87) in squamous carcinoma,82.4％(108/131) in adenocarcinoma and 100％(11/11) in small cell carcinoma for higher.However,the accuracy in diagnosing poorly differentiated carcinomas was only 12.2％ (5/ 41).Conclusion Fiberoptic bronchoscopic brush cytology plays an stable and important role in diagnosing lung carcinomas and histological type determination.However,it has limited use in diagnosing poorly differentiated carcinomas.

Purpose To analyze the clinicopathologic and immunohistochemical features, differential diagnosis and prognosis of papil-lary renal cell carcinoma (PRCC). Methods Thirty-two cases of PRCC diagnosed were reviewed. A retrospective study was per-formed including reviewing the clinical documents, pathological sections and immunohistochemical stainning and follow-up was made of 32 cases of PRCC. Twenty-one patients were treated with radical nephrectomy, eleven patients were treated with partial nephrectomy. Results Among 770 cases of renal epithelial tumors 32(4. 2%) cases of PRCC were detected. Histologically, the PRCC were charac-terized by varying proportions of papillary and tubular architecture covered by single or multiple layer of tumor cells with scanty or volu-minous basophilic or eosinophilic cytoplasm. Foam cells and psammoma bodies were seen in some papillary cores and stroma, and the cytoplasm of some tumor cells contained hemosiderin. Of these 32 patients, 18 and 14 were diagnosed type-Ⅰand type-IIPRCC, re-spectively. Type-I, with small cuboid cell and pale cytoplasm, 16 of them were low in Fuhrman grading, Type-II, with large colunmar cells, rich in eosinophilic cytoplasm, 12 of them were high in Fuhrman grading. Immunohistochemically, the PRCC showed positive immunostaining for vimentin, EMA, CK(AE1/AE3), CK7, CD10 and AMACR. All the tumors studied were negative for CK (34βE12) and TFE-3. Follow-up data were available for 31 cases, 4 patients died of cancer specific causes, 1 with type-Ⅰand 3 with type-II tumors after surgery. The other 27 patients were alive without recurrence or metastasis. High Fuhrman grading, intravascular tumor emboli, lymph node metastasis and high clinical stage were prognostic indicators in PRCC. Conclusions PRCC with unique pathological features is not a common subtype of renal cell carcinoma in China. The presence of higher nuclear grade, sarcomatoid ele-ments or clear cell carcinoma structure may indicate an aggressive biologic behavior and poor prognosis. Close attention to the cytologic and growth pattern characteristics will allow us to arrive at the proper diagnosis in most cases, although sometimes immunohistochemis-try and rarely molecular genetic evaluation may be needed.

The computer three-dimensional reconstruction of serial sections is an important research area in the world at precent. In this paper, we combine the computer graphics, image processing and biomedical techniques to reconstruct the stereo model of intra-glandular lymphatics, veins, arteries and duets with the serial semithin sections of human submandibular gland.

Hamartoma ; Humans ; Splenic Diseases

Objective To study the expression of caudal related homeodomain transcription 2 ( CDX2 ) protein in human colon cancer , and study the relationship between protein expression and colon cancer metasta -sis.Methods With immunohistochemical technique in peroxidase notation , pathological specimens of 80 cases of colon cancer were selected , including 47 cases of distal metastasis , and 33 cases without cancer metastasis . CDX2 protein expression in cancer tissue and the related data were statistically analyzed .Results Patients'sex, age and location of colon tumors had no statistical relation with CDX 2 protein expression(P>0.05).CDX2 pro-tein was statistically different in well-differentiated(100.00%), moderately-differentiated(80.00%), and poor-ly-differentiated(33.33%) tumor tissues.The difference had statistical significance (P<0.05), The expression of CDX2 protein reduced with the reduction in the degree of colorectal adenocarcinoma differentiation , rs =0.217, indicating that CDX2 protein expression was positively correlated with the malignant degree of colon canc -er.Positive CDX2 protein expression was significantly lower in metastatic colon cancer tissues (72.3%) than in non-metastatic tissues ( 90.9%) , and the difference had statistical significance .Lymph node metastasis could down regulate CDX2 protein expression in colorectal cancer .Conclusion CDX2 protein is positively correlated with the differentiation degree of colon cancer and distal metastasis can down regulate CDX 2 protein expression .

Objective:To investigate the application value of totally laparoscopic trans-abdominal-hiatal approach in the radical resection of Siewert type Ⅱ adenocarcinoma of esophago-gastric junction (AEG).Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 45 patients with Siewert type Ⅱ AEG who were admitted to the Affiliated Hangzhou First People′s Hospital, Zhejiang University School of Medicine from May 2017 to December 2020 were collected. There were 28 males and 17 females, aged from 35 to 85 years, with a median age of 64 years. All patients underwent radical resection of AEG by totally laparoscopic trans-abdominal-hiatal approach with gastrointestinal anastomosis using proximal gastrectomy with double-tract anastomosis or total gastrectomy with esophagojejunointestinal anastomosis and digestive reconstruction using transdiaphragmatic-hiatal superior overlap esophagojejunostomy. Observation indicators: (1) surgical and postoperative situations; (2) postoperative histopathological examination; (3) follow-up and survival situations. Follow-up using outpatient examination and telephone interview was performed to detect survival of patients and tumor recurrence and metastasis up to March 2021. Measurement data with normal distribution were presented as Mean± SD and measure-ment data with skewed distribution were presented as M(range). Results:(1) Surgical and post-operative situations: all 45 patients underwent radical resection of AEG by totally laparoscopic transabdominal-hiatal approach successfully, including 35 cases undergoing total gastrectomy with esophagojejunointestinal anastomosis and 10 cases undergoing proximal gastrectomy with double-tract anastomosis. The total operation time, time of lower mediastinal lymph node dissection, time of superior overlap esophagojejunostomy, volume of intraoperative blood loss, time for initial out-of-bed activities, time to first flatus, time to initial liquid diet intake, time to drainage tube removal of the 45 patients were (235±32)minutes, (25±8)minutes, (45±10)minutes, (70±13)mL, (20±8)hours, (2.3±0.2)days, (2.6±0.8)days and (6.2±1.1)days, respectively. Eleven of 45 patients under-went postoperative complications and none of patient died during perioperative period. The post-operative duration of hospital stay of 45 patients was (10±3)days. (2) Postoperative histopatho-logical examination: all 45 patients had negative upper surgical margin. The length of proximal margin, tumor diameter, total number of lymph lodes harvested and number of lower mediastinal lymph nodes harvested were (2.5±0.5)cm, (2.9±0.8)cm, 35.0±4.0 and 2.4±0.8, respectively. Patholo-gical examination showed adenocarcinoma in all 45 patients with pTNM staging as 5 cases of stage ⅠB, 8 cases of stage ⅡA, 21 cases of stage ⅡB and 11 cases of stage ⅢA. (3) Follow-up and survival situations: 45 patients were followed up for 3 to 46 months, with a median follow-up time of 26 months. During follow-up, 8 of 45 patients died. Of the 37 patients survived, 3 cases underwent liver metastasis and 3 cases underwent bone metastasis, lung metastasis or peritoneal metastasis respec-tively.Conclusion:Total laparoscopic transabdominal-hiatal approach is safe and feasible in the treatment of Siewert type II AEG with a satisfactory clinical efficacy.