With the increase of radiotherapy and various interventional therapies for tumor, the number of patients with chronic radiation ulcers is increasing gradually. Chronic radiation ulcers mostly involve the deep subcutaneous layers, accompanied by fibrosis of the surrounding skin. The ulcers persist and develop progressively and irreversibly. It is difficult to achieve good curative effects by routine dressing change and skin grafting, seriously affecting the patients' quality of life. This article systematically discusses the pathogenesis, clinical characteristics, pathological changes, wound assessment, and repair strategies of chronic radiation ulcers to provide a reference for the clinical diagnosis and treatment of chronic radiation ulcers.

OBJECTIVETo observe and summarize the morphologic features that may suggest submucosal invasive adenocarcinoma in colorectal mucosa biopsy specimens.

METHODSThe study cohort included 432 colorectal biopsy specimens were obtained from 2006 to 2012. All the cases had radical surgery. Basing on the pathologic diagnoses, the cases were divided into 366 invasive adenocarcinoma (IAC) and 66 high-grade intraepithelial neoplasms (HGIN). These two groups were compared.

RESULTSIn the IAC group, the percentage of tumor forming cribriform structures, acute angle-shaped glands, diffuse carcinoma cell proliferation was 61.2% (224/366) , 33.8% (124/366) and 7.4% (27/366) , respectively. In the HGIN group, cribriform gland structures appeared in 6.0% (4/66) of the cases, while no acute angle-shaped gland or diffuse carcinoma cell proliferation was detected. The difference of these three characteristics in the two group was statistically significant (all P < 0.01). Glandular branching was detected in 89.9% (329/366) of IAC cases and 66.7% (44/66) of HGIN cases; this difference was not significant. There was no difference in cellular atypia between the two groups. Interstitial fibrosis was detected more frequently in the IAC group (85.5%, 313/366 in IAC versus 0 in HGIN, P < 0.01). In biopsy specimens of IAC, a few cases showed neoplastic glands in close contact with large lymphatics, adipose tissue, and ganglion.

CONCLUSIONSIn colorectal biopsy specimen, the five features that suggest submucosal invasion of the neoplastic glands including the formation of cribriform structure, angular gland, diffuse carcinoma cells, interstitial fibrosis and neoplastic glands in close contact with the thick-walled vessels.

Adenocarcinoma ; pathology ; Biopsy ; Carcinoma in Situ ; pathology ; Cell Proliferation ; Diagnosis, Differential ; Humans ; Intestinal Mucosa ; pathology ; Neoplasm Invasiveness

Objective To observe and summarize the morphologic features that may suggest submucosal invasive adenocarcinoma in colorectal mucosa biopsy specimens .Methods The study cohort included 432 colorectal biopsy specimens were obtained from 2006 to 2012.All the cases had radical surgery.Basing on the pathologic diagnoses , the cases were divided into 366 invasive adenocarcinoma (IAC) and 66 high-grade intraepithelial neoplasms (HGIN).These two groups were compared.Results In the IAC group, the percentage of tumor forming cribriform structures , acute angle-shaped glands, diffuse carcinoma cell proliferation was 61.2%(224/366), 33.8%(124/366) and 7.4%(27/366), respectively.In the HGIN group, cribriform gland structures appeared in 6.0%(4/66)of the cases, while no acute angle-shaped gland or diffuse carcinoma cell proliferation was detected.The difference of these three characteristics in the two group was statistically significant ( all P<0.01 ).Glandular branching was detected in 89.9%(329/366) of IAC cases and 66.7%(44/66)of HGIN cases;this difference was not significant.There was no difference in cellular atypia between the two groups.Interstitial fibrosis was detected more frequently in the IAC group (85.5%,313/366 in IAC versus 0 in HGIN, P<0.01).In biopsy specimens of IAC , a few cases showed neoplastic glands in close contact with large lymphatics , adipose tissue , and ganglion.Conclusions In colorectal biopsy specimen , the five features that suggest submucosal invasion of the neoplastic glands including the formation of cribriform structure , angular gland , diffuse carcinoma cells , interstitial fibrosis and neoplastic glands in close contact with the thick-walled vessels.

ObjectiveTo observe the efficacy of simethicone, mosapride combined with flupentixol-meiltracen in the treatment for functional dyspepsia(FD). MethodsThe diagnosis of functional dyspepsia patients treated according to Zung Self-rating Anxiety Scale (SAS) ＞ 40, Hamilton Depression Scale(HAMD) ＞ 17 for inclusion criteria,a total of 64 patients were selected and randomly divided into two groups. The treatment group( simethicone,mosapride combined with flupeentixol-meiltracen) in 33 cases and the control group ( single flupenthixol melitracen) in 31cases. 2 groups of the period of treatment was 4 weeks. Evaluation before and after treatment with mood disorder scale score changes and syndrome efficacy and adverse reactions. ResultsThe treatment group after treatment, regardless of scale score change of mood disorders, syndrome treatment efficacy were significantly better than the control group,especially in the syndrome efficacy difference was significant( P ＜0.05 ,P ＜0.01 ) ;after the treatment without obvious adverse reaction. ConclusionThe simethicone, mosapride combined with flupentixol-meiltracen treatment with anxiety and depression in patients with functional dyspepsia could effectively relieve the symptoms of functional dyspepsia,and relieve the patient's psychological disorder;certainly result in fewer adverse reactions.