Objective:To preliminarily explore the zoning of inflammatory lesions in patients with acute necrotizing pancreatitis (ANP) based on the peripancreatic membrane anatomy, and its impact on treatment outcome of ANP.Methods:Clinical data of 197 patients with ANP treated at Hunan Provincial People's Hospital from January 2021 to June 2022 were retrospectively analyzed, including 133 males and 64 females, aged (47.2±13.3) years old. Basic information, characteristics of pancreatitis, and imaging data were collected. The inflammatory lesions were partitioned based on the peripancreatic membrane anatomy. Patients were followed-up via outpatient visits or telephone reviews. According to the prognosis, patients were divided into the poor-prognosis group ( n=93), including patients with postoperative multi-organ failure, severe local complications, and death; and the non-poor-prognosis group ( n=104), including patients without these adverse outcomes. Multivariate logistic regression analysis was used to identify factors influencing prognosis. Receiver operating characteristic (ROC) curves were plotted to assess the predictive power of the number of involved regions for poor prognosis. Results:The inflammatory lesions of pancreas were divided into 13 regions: the lesser sac, pancreatic head and duodenum, left anterior renal, right anterior renal, left posterior renal, right posterior renal, left perirenal fat sac, right perirenal fat sac, left lateral abdominal wall, right lateral abdominal wall, left pelvic wall, right pelvic wall, and other regions. Significant differences were observed between the poor-prognosis group and the non-poor-prognosis group in terms of body mass index (BMI), pancreatic necrosis area, and the number of inflammatory lesion regions (all P<0.05). Multivariate logistic regression analysis showed that high BMI ( OR=1.723, 95% CI: 1.457-2.038, P<0.001), pancreatic necrosis area ≥50% ( OR=3.221, 95% CI: 1.073-9.668, P=0.037), and a higher number of inflammatory lesion regions ( OR=1.388, 95% CI: 1.110-1.735, P=0.004) were associated with a higher risk of poor prognosis in patients with ANP. Based on the number of inflammatory lesion regions, the ROC curve analysis revealed that the optimal cut-off value was 5.5 for predicting poor prognosis in patients with ANP, with an area under the curve of 0.747(95% CI: 0.680-0.815) and a sensitivity and specificity of 0.387 and 0.962, respectively. Conclusion:The peripancreatic membrane anatomy facilitates a relatively fixed partitioning of inflammatory lesions in patients with acute necrotizing pancreatitis, and the number of inflammatory lesion regions is associated with poor prognosis.

0.05),but the MLD values at the tumor margin were significantly higher than that of normal mucosa(P

Objective　To investigate the relationship between the pathological changes and the early anastomosis of the blood vessels in blast-wounded maxillofacial region. Methods　A total of 20 dogs were regionally exploded in the left maxillofacial region by KTY-04 electric detonator. Specimens of blood vessels were removed at different distance from the edge of the wounded area at both right after (group A) and 72 h (group B ) after wounded and observed. Free skin flaps with saphenous artery were transplanted to the wounded areas. One week, 2 weeks and 3 months after anastomosis, specimens were taken from the site of anastomosis and observed. Results　Falling off of most vascular endothelial cells and the disappearance of most internal elastic membrane of the artery were observed 3 cm from the wounded area in group A with 5 free flaps died. However in group B almost normal condition was seen at the same region. 12 from 15 flaps survived successfully. Conclusion　The blood vessels begin to proliferate and repair 3 d after blast wound and this may provide the pathological basis for the possible success in the transplantation of the free flaps with blood vessels.

Objective　To investigate whether the expression of vascular endothelial growth factor (VEGF) and inducible nitric oxide synthase (iNOS) are asscoiated with angiogenesis and malignancy of astrocytomas. Methods　Immunohistochemistry, semiquantitation and image analysis were used to study the expression features of VEGF and iNOS in 61 cases of astrocytomas having follow-up data. Factor Ⅷ related antigen (FⅧ RAg) was also analysed in reflecting the epithelial cell amount and the microvessel density. Results　Microvessels in astrocytomas could be divided into seven types. The positive reaction areas and IA values of FⅧRAg expression in the endothelium were significantly increased with the increase of tumor grade （P<0.001）and VEGF labeling index (LI) （P<0.05）. The patients with high VEGF LIs （LI≥25%） had a poor prognosis. VEGF expression was significantly related to that of iNOS（P<0.001), i.e., VEGF level was reduced along with the decrease of iNOS reaction. Conclusion　Detection of FⅧRAg could reflect the angiogenesis activities in astrocytomas. VEGF and iNOS could up-regulate each other to promote angiogenesis and are of importance in determining the malignancy degree of astrocytomas.

Objective To review the clinical-pathological features, the tendency of incidence over 20 years, the predisposing factors, and the differences between the cases of cutaneous malignant melanoma from two hospitals. Methods A collection of 305 cases diagnosed as cutaneous malignant melanoma, among which 185 cases had complete clinical-pathological data, during 1981-2000 was analyzed. Results Acral malignant melanoma accounted for 63.3%, and the cases associated with congenital small nevi at the primary site accounted for 15.8% of 305 patients. During the period 1981-1990 and 1991-2000, cutaneous malignant melanoma constituted 0.053% and 0.094%, respectively, of all diagnoses with pathological sections, with an growth rate of 3.9% yearly. There was a tendency of the increased lesions located on face and neck, and decreased lesions on acra, over 20 years. Conclusion A rise of diagnosis of cutaneous malignant melanoma has been noticed from two hospitals over 20 years. Acra, especially planta, is the predominant anatomical site of cutaneous malignant melanoma.

The ultrastructures of 14 liposarcomas are studied. Among them 2 of the well-differentiated type. 6 of the myxoid type. 1 of the round cell type and 5 of the pieomorphic type are reported. The fine histological characteristics are described. There are different varieties about the ultrastructures owing to the various liposarcoma type. The ultrastructural distinctions from pieomorphic liposarcoma, pieomorphic rhabdomyosarcoma, pieomorphic malignant fibrous histiocytoma and pieomorphic leiomyosarcoma are briefly discussed.

Nineteen cases of cardiac myxoma were studied immunohistochemically in order to elucidate the histogenesis of the tumor.It was found that the blood vessels and the stromal cells of all the tumors were positive to vimentin.the matured endothelial cells of blood vessels were positive to UEA.the stromal cells and the smooth muscle cells of blood vessels of a part of the tumors were positive or weak-positive to desmin or myosin.a part of the tumor cells of several myxomas were weak-positive or positive to S-100 protein,and the epithelial markers of AE1 and AE3 were negative in all the cardiac myxomas.Our study revealed that there were various kinds of mesenchymal cells in cardiac myxomas and they might originate from multipotential primeval mesenchymal tissues.The difference of im-munohistochemical reactions of tumor cells reflects the difference of the maturity and differentiation of the tumor tissues.The histopathology and histochemistry of cardiac myxoma were also observed and analyzed.

Thirty-seven cases of brain glioma,confirmed by light microscopy and immuno-'histochemistry were studied with transmission electron microscopy.It was found that there were certain ultrastructural features for each type and each grade of glioma.In astrocytoma,there was certain amount of glial filaments in the tumor cells; Rosenthal fibers consisted of irregular osmiophilic masses surrounded with glial filaments,occasionally cytoplasmic annulate lamellae and intranuclear filaments could be seen,and the interstitial capillaries were characteristic.In typical oligodendroglioma,astrocytic processes containing glial filaments were quite present in different amounts.These findings suggest that observation on the ultrastructure of gliomas is of significance to establish the diagnosis,to assess the degree of differentiation,and to identify some rare structures which can reveal the essence of the tumor.In addition,ultrastructural observation is helpful for prognosis.

The ultrastructural and mucinhistochcmical study of 28 cancerous lesions is reported.They respectively associated with atrophic gastritis in 85.93%,intestinal metaplasia in 81.82%,and dysplasia in 78.59%.So high incidence suggests a close relationship between the lesions and the development of early gastric carcinoma,By means of AB-PAS and HID staining the cancerous lesions of intestinal type 20(71.42%),gaslric type 5(17.85%) and mixed type 3(10.71%) show that intestinal metaplasia of colonic type seems closely relate to carcinoma.Studying the specimens from 6 gastric carcinomas of different histological type and pcricanccrous lesions by electron microscopy,there arc microvilli of different sizes and densities on their free surfaces in the cancer cells with granule formation.Some of the signet ring carcinoma cells contain goblet type mucous granules.The ultrastructuc of severe dysplasia closely resembles,gastric cancer cells.

Twenty specimens of normal colorectal mucosa,juxtacancerous mucosa,and cancerous mucosa were studied with scanning electron microscopy,optical microscopy and histochemical method.It was found that the superficial crypts of normal colorectal mucosa were evenly distributed,orderly arranged,and covered with both absorptive cells and gobler cells;those of juxtacancerous mucosa were usually deformed in various degrees and their goblet cells were increased in number and in size;and the shape of the superficial cells of colorectal carcinoma was dependent on the histologic type of the carcinoma in certain extent.The general features were disordered arrangement and the decrease in number of the cellular microvilli,which indicated the malignant nature of the lesion.It is believed that scanning electron microscope is a useful tool in the diagnosis of colorectal carcinoma