目的 探讨血浆细胞周期依赖性激酶9（CDK9）水平与大动脉粥样硬化（LAA）型脑梗死病情进展及预后的相关性，评估其作为疾病风险分层及预后评估生物标志物的临床价值。方法 选取2020年1月—2024年12月期间于本院就诊的400例急性LAA型脑梗死患者作为观察组，并同期纳入100名健康体检者作为对照组。发病90 d后，采用改良Rankin量表（mRS）对所有患者进行预后评估。根据评估结果，将观察组进一步划分为预后不良组（152例）与预后良好组（248例）。检测患者血浆CDK9水平并收集临床资料。分析CDK9水平与美国国立卫生研究院卒中量表（NIHSS）评分、梗死灶体积的相关性；分析预后不良的影响因素。结果 观察组CDK9水平高于对照组［（185.6±42.3） pg/mL vs （62.4±18.5） pg/mL，P＜0.001］，且与梗死体积（r=0.586）、NIHSS评分（r=0.628）、高敏C反应蛋白（r=0.452）及白介素6（r=0.418）呈正相关（均P＜0.001）。多因素Logistic回归分析显示，CDK9升高是90天预后不良的独立危险因素。受试者工作特征曲线（ROC）曲线分析显示，CDK9预测预后不良的曲线下面积（AUC）为0.854（最佳截断值为198.6 pg/mL，灵敏度为78.3%，特异度为82.5%），联合NIHSS评分及梗死体积后AUC提升至0.912（P＜0.001）。结论 血浆CDK9水平可作为急性LAA型脑梗死病情进展及预后的独立预测标志物，联合传统指标可提高预后评估效能。

      Objective To investigate the correlation between plasma cyclin-dependent kinase 9（CDK9）level and disease progression and prognosis in patients with acute large artery atherosclerosis（LAA）cerebral infarction，and to evaluate its clinical value as a biomarker for disease risk stratification and prognostic assessment．Methods This study enrolled 400 patients with acute LAA-type cerebral infarction who visited our hospital between January 2020 and December 2024 as the observation group，along with 100 healthy individuals as the control group during the same period．After 90 days of symptom onset，all patients were assessed using the modified Rankin Scale（mRS）for prognostic evaluation．Based on the assessment results，the observation group was further divided into two subgroups：the poor prognosis group（152 cases）and the good prognosis group（248 cases）．Plasma CDK9 levels were measured，and clinical data were collected．The correlation between CDK9 level and National Institutes of Health Stroke Scale（NIHSS）score and infarct volume，and the factors affecting poor prognosis were analyzed．Results Plasma CDK9 levels in the observation group were higher than those in the control group（［185.6±42.3］ pg/mL vs ［62.4±18.5］ pg/mL，P＜0.001），and were positively correlated with infarct volume（r=0.586），NIHSS score（r=0.628），high-sensitivity C-reactive protein（r=0.452），and interleukin-6（r=0.418）（all P＜0.001）．Multivariate Logistic regression analysis showed that elevated CDK9 level was an independent risk factor for poor prognosis at 90 d．Receiver Operating Characteristic（ROC）curve analysis revealed that the area under the curve（AUC）of CDK9 for predicting poor prognosis was 0.854（optimal cut-off value：198.6 pg/mL，sensitivity：78.3%，specificity：82.5%），and the AUC increased to 0.912 when combined with NIHSS score and infarct volume（P＜0.001）．Conclusions Plasma CDK9 level may serve as an independent predictive biomarker for disease progression and prognosis in acute LAA cerebral infarction，and combining it with traditional indicators can improve the efficacy of prognostic assessment．

目的 学习母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床病理及免疫表型特征,总结该少见肿瘤的病理诊断经验。方法 回顾分析2例BPDCN患者临床资料,通过苏木素-伊红(HE)染色分析肿瘤组织及细胞形态,通过免疫组织化学染色分析肿瘤免疫表型,通过流式细胞学检测骨髓有无肿瘤侵犯,并结合文献分析。结果 本报道中1例为97岁女性,临床以皮肤瘀斑结节为首发症状,肿瘤细胞真皮内弥漫浸润,不侵犯表皮,细胞中等大小,核形不规则,核仁不明显。另1例为69岁男性,临床以淋巴结肿大为首发症状,淋巴结结构完全破坏,肿瘤细胞弥漫浸润,细胞呈中等大小的母细胞样,核仁明显。2例免疫表型均表达CD123、CD4、CD56、TDT,不表达B系、T系淋巴细胞及髓系标志物,肿瘤均累及骨髓。结论 BPDCN是一种罕见的淋巴造血肿瘤,临床常以皮肤病变或淋巴结肿大为首发症状,临床过程具高度侵袭性,通常伴有骨髓侵犯。该肿瘤需与具有母细胞形态的淋巴系肿瘤和白血病相鉴别,诊断需结合临床信息、HE形态及免疫组化结果综合判断。

Objective To summarize the diagnostic experiences of blastic plasmacytoid dendritic cell neoplasm (BPDCN) based on the study of its clinicopathological features and immunophenotypes. Methods The clinical data of 2 patients with BPDCN were collected, the structure alteration and cell morphology were observed by HE staining, the immunophenotype of tumor cells were studied by immunohistochemistry staining and flow cytometry was adopted to confirm the bone marrow involvement. Results Two patients, one of whom was a 97 year-old female, presented with cutaneous ecchymosis nodules as the first symptom. The epidermis, but not the dermal, was diffusedly infiltrated by tumor cells, which were medium-sized with irregular nuclei without prominent nucleoli. The other case was a 69 year-old male with lymph node enlargement as the first symptom. The skin was normal, but the lymph nodes were invasively destroyed by tumor cells, which were medium-sized blast-like with prominent nucleoli. The immunophenotypes of the two patients were both positive for CD123, CD4, CD56 and TDT, but negative for B, T lymphocyte derived and myeloid origin markers, both of which involved bone marrow. Conclusions BPDCN is a rare form of hematological neoplasm, skin symptoms or lymph node enlargement may be presented as the initial symptom, the clinical course were highly aggressive with high frequency of bone marrow involvement. The blastic-like lymphoma and leukemia entities should be considered into account for differential diagnose. The precise diagnosis of BPDCN should be established by integrating histomorphology, immunophenotype and clinical presentation information comprehensively.

       近年来浆细胞性乳腺炎的发病率逐渐升高，已占乳腺疾病的4%~5%，该病易反复发作，经久不愈，抗生素、糖皮质激素、抗结核药、他莫昔芬等治疗效果不明显，单纯手术切除如切除范围小极易复发，而切除范围大则乳腺外形变化较大，严重者甚至需要切除乳腺。乳腺外形的缺损改变对患者身心健康造成伤害。随着研究不断深入，采用中西医结合治疗浆细胞性乳腺炎，可取得较好的治疗效果，降低复发率，而且对乳腺外观无影响。该文通过对文献的整理，对中西医结合治疗浆细胞性乳腺炎进行论述。

       In recent years，the incidence of plasma cell mastitis has gradually increased，accounting for 4 % ~ 5 % of breast diseases．The disease is prone to repeated attacks and unhealed for a long time．The treatment effect of antibiotics，glucocorticoids，anti-tuberculosis drugs and tamoxifen is not obvious．Simple surgical  resection is easy to  relapse if the  resection range is small，while the shape of the breast changes greatly，if the resection range is large．And even the breast needs to be removed in severe cases．The defect change of breast shape is harmful to the physical and mental health of patients．With the deepening of research，the combination of traditional Chinese and Western medicine in the treatment of plasma cell mastitis can achieve better therapeutic effect，reduce the recurrence rate，and has no effect on the appearance of breast．This article discusses the treatment of plasma cell mastitis with integrated traditional Chinese and Western medicine by sorting out the literature．