Robot-assisted laparoscopic enucleation in the treatment of leiomyosarcoma of urinary bladder: A case report / 中南大学学报(医学版)

Leiomyosarcoma of urinary bladder (LMS-UB) is a highly malignant mesenchymal tumor, accounting for less than 0.5% of all bladder malignancies, with a predominant clinical presentation of hematuria. Here we report a case of low-grade LMS-UB. A 44-year-old male patient was admitted to the hospital with urodynia for 2 weeks. The patient's pelvis CT showed a mass on the right part of the bladder. For this reason, he was initially diagnosed with bladder cancer. We performed a robot-assisted laparoscopic enucleation of the bladder tumor and low-grade LMS-UB was diagnosed with the histopathological examination. He underwent 5 cycles of adjuvant chemotherapy after surgery. At 19months postoperative follow-up, the patient had no symptoms, recurrence, or distant metastasis. There is no report on the treatment of LMS-UB with minimally invasive enucleation worldwide. This case provides a new comprehensive treatment method of enucleation combined with adjuvant chemotherapy for early low-grade LMS-UB to reduce complications and improve patients' quality of life after surgery.

Novel biallelic loss-of-function mutations in / 亚洲男科学杂志(英文版)

Multiple morphological abnormalities of the sperm flagella (MMAF) is a specific type of asthenoteratozoospermia, presenting with multiple morphological anomalies in spermatozoa, such as absent, bent, coiled, short, or irregular caliber flagella. Previous genetic studies revealed pathogenic mutations in genes encoding cilia and flagella-associated proteins (CFAPs; e.g., CFAP43, CFAP44, CFAP65, CFAP69, CFAP70, and CFAP251) responsible for the MMAF phenotype in infertile men from different ethnic groups. However, none of them have been identified in infertile Pakistani males with MMAF. In the current study, two Pakistani families with MMAF patients were recruited. Whole-exome sequencing (WES) of patients and their parents was performed. WES analysis reflected novel biallelic loss-of-function mutations in CFAP43 in both families (Family 1: ENST00000357060.3, p.Arg300Lysfs*22 and p.Thr526Serfs*43 in a compound heterozygous state; Family 2: ENST00000357060.3, p.Thr526Serfs*43 in a homozygous state). Sanger sequencing further confirmed that these mutations were segregated recessively in the families with the MMAF phenotype. Semiquantitative reverse-transcriptase polymerase chain reaction (qRT-PCR) was carried out to detect the effect of the mutation on mRNA of the affected gene. Previous research demonstrated that biallelic loss-of-function mutations in CFAP43 accounted for the majority of all CFAP43-mutant MMAF patients. To the best of our knowledge, this is the first study to report CFAP43 biallelic loss-of-function mutations in a Pakistani population with the MMAF phenotype. This study will help researchers and clinicians to understand the genetic etiology of MMAF better.

The first two cases of transcatheter mitral valve repair with ARTO system in Asia / 世界急诊医学杂志（英文）

BACKGROUND@#MAVERIC (Mitral Valve Repair Clinical Trial) validates the safety and efficacy of the ARTO system. We here report the first two successful cases of utilizing the ARTO system in patients with symptomatic heart failure (HF) with functional mitral regurgitation (FMR) in Asia.@*METHODS@#Two patients, aged 70 and 63, had severe HF with FMR. Transesophageal echocardiography confirmed that the left ventricular ejection fractions were less than 50% with severe mitral regurgitation (MR) in both patients. Optimizing drug treatment could not mitigate their symptoms. Therefore, we used the ARTO system to repair the mitral valve for these patients on March 5 and 6, 2019, respectively.@*RESULTS@#Mitral valve repairs using the ARTO system were successfully performed under general anaesthesia for these two patients. MR was decreased immediately after the procedures in both patients. The 30-day and 3-month transthoracic echocardiography (TTE) revealed a moderate to severe MR in both patients, and the New York Heart Association (NYHA) scales were also partially improved.@*CONCLUSION@#The first two cases in Asia indicate that the ARTO system is feasible for patients with heart failure with FMR, and the patient selection appears to be crucial.

The first four cases of successful NeoChord procedure in Chinese mainland / 世界急诊医学杂志（英文）

BACKGROUND@#Transapical off-pump NeoChord procedure is a novel minimally invasive surgical repair of degenerative mitral regurgitation (MR). Here, we report the first four cases of NeoChord procedure in patients with mitral valve prolapse in Chinese mainland.@*METHODS@#Four patients, aged 86, 84, 80 and 60 years, with severe MR due to posterior middle scallop prolapse (P2), underwent transapical off-pump artificial chordae implantation on April 9 and 10, 2019. The procedure was performed by left mini-thoracotomy under general anaesthesia and guided by 2D and 3D dimensional transoesophageal echocardiography (TEE).@*RESULTS@#Mitral valve repair via NeoChord procedure was successfully performed with implantation of 3 artificial chordae in the first patient and 3, 2, and 3 artificial chordae in the following patients, respectively. Intraoperative TEE and pre-discharge transthoracic echocardiography (TTE) showed only mild to moderate MR of these four patients and no postoperative complications were noted. There were no changes of TTE finding between one-month follow-up and pre-discharge.@*CONCLUSION@#The successful NeoChord procedures in four Chinese indicate that the valve repair using the NeoChord system for Chinese population is feasible.

Secondary metabolites of petri-dish cultured Antrodia camphorata and their hepatoprotective activities against alcohol-induced liver injury in mice / 中国天然药物

Antrodia camphorata, a well-known and highly valued edible medicinal mushroom with intriguing activities like liver protection, has been traditionally used for the treatment of alcoholic liver disease. A. camphorata shows highly medicinal and commercial values with the demand far exceeds the available supply. Thus, the petri-dish cultured A. camphorata (PDCA) is expected to develope as a substitute. In this paper, nineteen triterpenes were isolated from PDCA, and thirteen of them were the unique anthroic acids in A. camphorata, including the main content antcin K, which suggested that PDCA produced a large array of the same anthroic acids as the wild one. Furthermore, no obvious acute toxicity was found suggesting the edible safety of PDCA. In mice alcohol-induced liver injury model, triglyceride (TG), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and malondialdehyde (MDA) had been reduced by the PDCA powder as well as the main content antcin K, which indicated that the PDCA could protect alcoholic liver injury in mice model and antcin K could be the effective component responsible for the hepatoprotective activities of PDCA against alcoholic liver diseases.

Expression of Cyclin D2 and its clinicopathological significance in diffuse large B cell lymphoma / 临床与实验病理学杂志

Purpose To investigate the expression of Cyclin D2 in diffuse large B cell lymphoma (DLBCL) and its relationship with clinicopathological classification and prognosis. Methods (1) Immunohistochemistry (IHC) of EnVision twostep staining for CD3, CD20, CD10, BCL-6, MUM1, Ki-67 and Cyclin D2 was carried out in 79 cases of DLBCL specimens using tissue microarray constructed from tumor paraffin block.(2) The relative expression of Cyclin D2 mRNA in 79 cases of DLBCL was observed by realtime quantitative PCR (qRT-PCR) in fresh frozen tissue. The relationship between the expression of Cyclin D2 mRNA and survival rate was analyzed by Kaplan-Meier test. Results 79 patients of DLBCL were classified into26 (32.9％) case of germinal center B-cell-like (GCB) sub-types and 53 (67.1％ ) cases of nongerminal center B-cell-like(non-GCB) subtypes. Cyclin D2 protein was expressed in 2(15.4％) cases of GCB subtypes and 11 (84.6％) cases of non-GCB subtypes, respectively. The difference between the GCB subtypes and the non-GCB subtypes was statistically significant (P＜ 0.05). The expression of Cyclin D2 mRNA in non-GCB subtypes was significantly higher than that in GCB subtypes(P＜ 0.05 ). The high clinical stage and the expression of Cyclin D2 mRNA were associated with lower overall survival rate. Conclusion The detection of Cyclin D2 expression can improve the accuracy of clinicopathological classification of DLBCL. The level of Cyclin D2 mRNA may be an important reference for prognosis of DLBCL.

Application of CFD mesh generation technology in finite element modeling of skeleton / 医用生物力学

Objective To study high-quality and high efficient meshing methods for skeleton. Methods Based on characteristics of bone structure, the mesh generation technology of computational fluid dynamics (CFD) was applied in mesh generation for bone biomechanics. Hexahedron elements and tetrahedron elements were used to simulate cortical bone and cancellous bone, respectively. Results By using CFD mesh generation technology, high-quality hexahedral elements could be obtained, the structure characteristics of skeleton could be preferably simulated, and computer automatic meshing could be implemented. The amount of time for meshing bones by the new method was only about 1/5 of that by the traditional method, and the calculation results obtained from the finite element model were basically consistent with the results from the cadaver experiment. Conclusions The CFD mesh generation technology can be applied in the field of bone biomechanics, which provides an effective approach to reconstruct complex human skeleton.

Effect of Point Neiguan(PC6) Electroacupuncture Pretreatment on NO, NOS and Mitochondrial Membrane Potential in Rats with Myocardial Ischemia/Reperfusion Injury / 上海针灸杂志

Objective To explore the effect of point Neiguan(PC6) electroacupuncture pretreatment on nitric oxide (NO), nitric oxide synthase (NOS) and mitochondrial membrane potential by determining NO, NOS and mitochondrial membrane potential in rats with myocardial ischemia/reperfusion injury (MIRI).Method Forty male SD rats were randomized to sham operation, ischemia/reperfusion model, point Neiguan electroacupuncture and point Huantiao(GB30) electroacupuncture groups, 10 rats each. The model was made by coronary artery ligation. Before model making, electroacupuncture was given to the point Neiguan electroacupuncture and point Huantiao electroacupuncture groups, 20 min/d for a total of 7 d. T wave value in ECG leadⅡ was measured before and after model making. Myocardial pathomorphological changes were examined by HE staining. Serum NO and NOS contents were measured by a colorimetric nitrate reductase assay. Cardiomyocyte mitochondrial membrane potential was determined by fluorescence techniques.Result Serum NO and NOS contents and mitochondrial membrane potential decreased significantly in the model group compared with the sham operation group (P<0.05). Serum NO and NOS contents increased significantly in the point Neiguan electroacupuncture group compared with the model, sham operation and point Huantiao electroacupuncture groups (P<0.01,P<0.05). Mitochondrial membrane potential increased significantly in the point Neiguan electroacupuncture group compared with the model, point Huantiao electroacupuncture and sham operation groups (P<0.01,P<0.05). There was no statistically significant difference in mitochondrial membrane potential between the model and point Huantiao electroacupuncture groups (P>0.05). Conclusion Point Neiguan electroacupuncture pretreatment has a preventive protecting effect on MIRI rats. It produces a protecting effect on myocardium by increasing the NO content, strengthening NOS activity, reducing a decrease in cardiomyocyte mitochondrial membrane potential and inhibiting apoptosis.

Effect of Point Neiguan(PC6) Electroacupuncture Pretreatment on NO, NOS and Mitochondrial Membrane Potential in Rats with Myocardial Ischemia/Reperfusion Injury / 上海针灸杂志

Objective To explore the effect of point Neiguan(PC6) electroacupuncture pretreatment on nitric oxide (NO), nitric oxide synthase (NOS) and mitochondrial membrane potential by determining NO, NOS and mitochondrial membrane potential in rats with myocardial ischemia/reperfusion injury (MIRI).Method Forty male SD rats were randomized to sham operation, ischemia/reperfusion model, point Neiguan electroacupuncture and point Huantiao(GB30) electroacupuncture groups, 10 rats each. The model was made by coronary artery ligation. Before model making, electroacupuncture was given to the point Neiguan electroacupuncture and point Huantiao electroacupuncture groups, 20 min/d for a total of 7 d. T wave value in ECG leadⅡ was measured before and after model making. Myocardial pathomorphological changes were examined by HE staining. Serum NO and NOS contents were measured by a colorimetric nitrate reductase assay. Cardiomyocyte mitochondrial membrane potential was determined by fluorescence techniques.Result Serum NO and NOS contents and mitochondrial membrane potential decreased significantly in the model group compared with the sham operation group (P<0.05). Serum NO and NOS contents increased significantly in the point Neiguan electroacupuncture group compared with the model, sham operation and point Huantiao electroacupuncture groups (P<0.01,P<0.05). Mitochondrial membrane potential increased significantly in the point Neiguan electroacupuncture group compared with the model, point Huantiao electroacupuncture and sham operation groups (P<0.01,P<0.05). There was no statistically significant difference in mitochondrial membrane potential between the model and point Huantiao electroacupuncture groups (P>0.05). Conclusion Point Neiguan electroacupuncture pretreatment has a preventive protecting effect on MIRI rats. It produces a protecting effect on myocardium by increasing the NO content, strengthening NOS activity, reducing a decrease in cardiomyocyte mitochondrial membrane potential and inhibiting apoptosis.

Application of CFD mesh generation technology in finite element modeling of skeleton / 医用生物力学

Objective To study high-quality and high efficient meshing methods for skeleton.Methods Based on characteristics of bone structure,the mesh generation technology of computational fluid dynamics (CFD) was applied in mesh generation for bone biomechanics.Hexahedron elements and tetrahedron elements were used to simulate cortical bone and cancellous bone,respectively.Results By using CFD mesh generation technology,high-quality hexahedral elements could be obtained,the structure characteristics of skeleton could be preferably simulated,and computer automatic meshing could be implemented.The amount of time for meshing bones by the new method was only about 1/5 of that by the traditional method,and the calculation results obtained from the finite element model were basically consistent with the results from the cadaver experiment.Conclusions The CFD mesh generation technology can be applied in the field of bone biomechanics,which provides an effective approach to reconstruct complex human skeleton.

Mechanism of bradykinin on inflammations of retinal pigment epithelium cells / 国际眼科杂志(Guoji Yanke Zazhi)

Abstract?AIM: To investigate mechanism of bradykinin ( BK) on inflammations of retinal pigment epithelium ( RPE) cells.?METHODS: ARPE -19 cells were cultured in vitro, stimulated by 100nM BK for 24h. Cell morphology changes were observed by microscope, and BK receptor localization was detected through cell immunofluorescence. Changes of Ca2+in BK and BR antagonist stimuli were detected by laser scanning confocal microscopy.The expressions of COX-1, COX-2, eNOS and iNOS protein in control group and BK group were detected by Western Blot.?RESULTS: After the stimulation of BK, there was no significant changes of ARPE-19 cells in morphology.Kinin B1 receptors ( B1R ) and B2 receptors ( B2R ) could be detected in ARPE-19 cells.Compared with control group, Ca2+concentrations significantly increased in BK group; in B1R antagonist group and B2R antagonist group Ca2+concentrations increased less than BK group; B1R and B2R antagonist group showed no obvious changes in Ca2+concentrations.Compared with control group, COX-2 and iNOS protein concentrations were significantly increased in BK group (P<0.001).?CONCLUSION:BK induces the increasing expression of COX-2 and iNOS in the cultured ARPE cells through binding with either B1R or B2R.

The application of National AIDS spending assessment in a county of Dehong prefecture, Yunnan province, China / 中华预防医学杂志

<p><b>OBJECTIVE</b>To calculate the actual expenditures in a county of Dehong prefecture, Yunnan province, China by using the method of National AIDS Spending Assessment (NASA) in 2010.</p><p><b>METHODS</b>Data were collected through NASA data collection form based on adapted NASA classification in the county of Dehong prefecture from October to December, 2011, and complemented by semi-structured interview with 16 well trained programmatic and financial representatives in 8 spending units. Data were entered in Resource Tracking Software (RTS) V 2009.3.0, and SPSS 13.0 was used for data processing and analysis.</p><p><b>RESULTS</b>The NASA estimations showed that the county spent a total of ¥16 235 954 on HIV/AIDS in 2010. Public funds constituted 96.3% of the total expenditure (¥15 630 937), followed by Global Fund which accounted for 3.0% (¥484 585) and private sources which accounted for 0.7% (¥120 432). Findings based on NASA categories showed that AIDS spendings were mainly on 4 areas, and expenditure on Care & Treatment was ¥12 401 382 (76.4% of total expenditure), followed by Prevention which accounted for 14.3% (¥2 325 707), Program Management & Administration which accounted for 7.8% (¥1 268 523) and human resources which accounted for 1.5% (¥240 342). The most beneficial population group was People Living with HIV (PLHIV), accounting for 84.7% of total expenditure. (¥13 753 428), followed by 4.8% for high risk population, including female sex workers and their partners (¥297 333), injection drug users and their partners (¥293 143), men having sex with men and their partners (¥185 136) and 1.5% (¥241 429) for the general population.</p><p><b>CONCLUSION</b>The local funds for HIV/AIDS in this county was insufficient. The local government should increase corresponding funds based on central government funding. Care and treatment was the first spending priority in the county and the investment of prevention services needs to be increased. Prevention and treatment and care should be combined to ensure the effectiveness of comprehensive prevention and treatment of AIDS.</p>

Rhabdomyosarcoma of the breast: a clinicopathologic study and review of the literature / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Rhabdomyosarcoma (RMS) is an uncommon malignancy of the breast. The aim of this study was to summarize its clinicopathologic features and biological behavior.</p><p><b>METHODS</b>Five primary or secondary breast RMSs were collected. Their clinicopathological characteristics and all published literature about breast RMS were reviewed. Immunohistochemical study of desmin, myogenic differentiation 1 (MyoD1), myogenin, leukocyte common antigen (LCA), vimentin, cytokeratin (AE1/AE3), E-cadherin, neuron specific enolase (NSE), CD99, chorioallantoic membrane 5.2 (CAM5.2) and epithelial membrane antigen (EMA) expression were performed.</p><p><b>RESULTS</b>The five patients were all female with ages ranging from 16 to 46 years old (mean, 30 years). Three were metastatic breast RMSs, two embryonal and one solid variant alveolar, with the primary tumor sites the right labium majus, left nasal meatus and nasopharynx, respectively. The other two, one embryonal and one alveolar, were primaries. Grossly, the surgical specimens revealed round or oval, well-demarcated but nonencapsulated masses. Their cut surfaces consisted of homogeneous grayish yellow or white tissue. Microscopically, most tumor cells were poorly differentiated small round, oval or small polygons with eosinophilic cytoplasm. All cases were positive for vimentin, desmin, MyoD1 and myogenin. One embryonal RMS also had a few cells with perinuclear staining of AE1/AE3. The other markers were negative.</p><p><b>CONCLUSIONS</b>Although primary or metastatic RMS in breast was almost confined to young adolescent females, our cases suggested that it can also happen to the middle-aged women. Embryonal RMS has a certain metastatic potential. MyoD1 and myogenin are two useful markers when making differential diagnosis. Axillary lymph node status and age may play a role in the prognosis of primary breast RMS patients.</p>

Survey on contact tracing of newly reported HIV infections in 2009 in Dehong prefecture, Yunnan province / 中华预防医学杂志

<p><b>OBJECTIVE</b>To explore a new method for finding more HIV/AIDS.</p><p><b>METHODS</b>In September 2009, newly reported HIV-infected individuals from May to August, 2009 in Dehong prefecture were asked to participate in a survey which requested demographic characteristics, history of high-risk behaviors and contact information of individuals with whom they had high risky contacts. People with risky contacts with HIV-infected cases (index cases) were also approached to participate in this survey and HIV testing was provided.</p><p><b>RESULTS</b>A total of 342 HIV-infected individuals were newly reported and served as index cases from May to August, 2009. Among them, 47.1% (161/342) were transmitted by regular sexual partners. Through three-round surveys, 218 contacts were traced and among them, 84.9% (185/218) were traced by regular heterosexual partners. HIV positive rate of the tested was 34.7% (60/173) in the first-round tracing and 12.5% (1/8) in the second one. Among the 560 individuals (index cases and their high-risk contacts), the proportions of having regular heterosexual partners, non-regular and non-commercial sexual partners, commercial sexual heterosexual partners and men having sex men were 87.9% (492/560), 18.9% (106/560), 22.3% (125/560) and 0.3% (1/318), respectively, while the proportion of having never used condoms when having sex with the above four types sexual partners were 73.8% (363/492), 72.6% (77/106), 63.2% (79/125) and 0.0% (0/1), respectively.</p><p><b>CONCLUSION</b>As an epidemiological method for HIV/AIDS finding, contact tracing identified a large number of HIV infectors who were traced by newly reported HIV-infected individuals.</p>

Establishment and characterization of a nude mice model of human diffuse large B-cell lymphoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To establish a diffuse large B-cell lymphoma (DLBCL)-mice model using human DLBCL cell line LY8, to investigate its characteristics of growth and to provide a model for in vivo study of DLBCL pathogenesis and treatment.</p><p><b>METHODS</b>LY8 cells were injected subcutaneously into the right flank of nude mice. Harvested tumor tissues were cut into small pieces of 1.5 mm × 1.5 mm × 1.5 mm and implanted subcutaneously into nude mice. Tumor growth was visualized and the histologic characteristics were documented. Expression of LCA, CD20, CD79α, Ki-67, CD3, CD45RO, bcl-6, MUM-1, CD10 and bcl-2 were examined by using immunohistochemistry. IgH clonal rearrangement and status of three microsatellite loci (D14S68, D18S69, D20S199) in the xenografted tumor samples and the parental cell line LY8 were detected using PCR amplification followed by PAGE.</p><p><b>RESULTS</b>The subcutaneous xenograft DLBCL model was successfully established by using cell line LY8, and a stable growth was achieved up to the 9th generation. The tumor in each generation showed similar growth characteristics and the rate of subcutaneous tumor formation was 91.9% (114/124). The tumor growth was observed from the 2nd week after implantation, reaching 1.3 cm in major diameter at the 3rd week and 2.0 cm at the 4th week. The tumor had identical morphological characteristics with those of human DLBCL, and expressed LCA, CD20, CD79α, bcl-6, MUM-1, CD10 and bcl-2. The tumor of xenograft mice and cell line LY8 showed identical IgH rearrangement and microsatellite length.</p><p><b>CONCLUSIONS</b>A human DLBCL bearing mouse model was successfully established. The mice model is similar to human counterpart with high stability and repeatability. Therefore, it provides an ideal animal model for in vivo studies of the biological characteristics and treatment of DLBCL.</p>

Assessment of ¹⁸⁸Re marked anti MHC class II antibody by peripheral blood mononuclear cells stimulated by donor alloantigen / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Previous studies showed that anti MHC-II monoclone antibody (MAb) only had partial inhibiting effect of alloreactive mixed lymphocyte reaction (MLR) in vitro and it was unsteady and non-persistent. The aim of this research was to determine whether radioactive isotope (188)Re marked MHC-II antibody could benefit the allograft acceptance in transplantation as compared to normal MHC-II antibody.</p><p><b>METHODS</b>188Re was incorporated to 2E9/13F (ab')(2) which is against swine MHC class II antigen (MAb-(188)Re). Porcine peripheral blood mononuclear (PBMC) cells were examined for proliferation and cytokine mRNA expression after stimulation with MHC-II MAb or MAb-(188)Re.</p><p><b>RESULTS</b>The proliferative response of recipient PBMCs in mixed lymphocyte reaction (MLR) to donor alloantigen showed that the stimulation index of MAb-(188)Re group was significantly lower than the MHC-II MAb group and control (P < 0.05). mRNA expression of interleukin 2, interferon Υ and tumor necrosis factor α (type 1 cytokines) was lower in MAb-(188)Re group than the MHC-II MAb group, while interleukin 10 (type 2 cytokines) was higher in MAb-(188)Re group in the first 24 hours.</p><p><b>CONCLUSION</b>MAb-(188)Re could help the graft acceptance by inhibiting T cell proliferation, lowering the expression of type 1 cytokines and elevating the type 2 cytokines produced by PBMC.</p>

Cutaneous anaplastic large cell lymphoma: clinicopathologic, immunohistochemical and prognostic study of 44 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype and prognosis of primary cutaneous anaplastic large cell lymphoma (CALCL).</p><p><b>METHODS</b>Histopathologic evaluation and immunohistochemical study by Envision method were carried out in 44 archival cases of CALCL. The clinical information and follow-up data were analyzed.</p><p><b>RESULTS</b>The patients presented with skin nodules, masses or plaques, sometimes associated with ulceration. The commonest sites of involvement were the extremities. Follow-up data were available in 39 patients. The overall survival rate was 87.2% (34/39). Disease relapses were detected in 46.2% (18/39) of the patients. Statistical analysis indicated that patients older than 50 years of age or with no less than two involved anatomic sites were more likely to have disease relapses (P < 0.05). Histologically, 31 cases were classified as common variant, 6 cases as small cell variant and 7 cases as neutrophil/eosinophil-rich variant. Immunohistochemical study showed that the rates of expression of CD30, CD45, CD45RO, CD43, CD3, cytotoxic protein and epithelial membrane antigen were 100% (44/44), 91.2% (31/34), 82.6% (19/23), 94.7% (18/19), 70.0% (28/40), 73.3% (22/30) and 31.8% (7/22), respectively. The CD4(+)/CD8(-), CD4(-)/CD8(+) and CD4(-)/CD8(-) immunophenotypes were found in 58.3% (21/36), 22.2% (8/36) and 19.4% (7/36) of the CALCL cases, respectively. Only one case (3.7%) expressed CD56.</p><p><b>CONCLUSIONS</b>CALCL is a form of low-grade primary cutaneous T-cell lymphoma with a wide spectrum of clinicopathologic pattern. Special variants of CALCL should not be confused with other types of cutaneous lymphomas and inflammatory lesions. CALCL patients older than 50 years of age or with no less than two involved anatomic sites are more likely to have disease relapses.</p>

Sclerosing angiomatoid nodular transformation of spleen: a clinicopathologic study of 10 cases with review of literature / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, differential diagnosis and pathogenesis of sclerosing angiomatoid nodular transformation of spleen.</p><p><b>METHODS</b>Ten cases of sclerosing angiomatoid nodular transformation of spleen were retrieved from the archival file. Histochemical and immunohistochemical (EnVision method) studies were performed. Ultrastructural findings were also available in one of them.</p><p><b>RESULTS</b>Sclerosing angiomatoid nodular transformation was characterized by micronodular appearance of vascular spaces lined by plump endothelial cells with interspersed ovoid spindle cells. Immunohistochemical study showed that the endothelial cells of vessels in the angiomatoid nodules had various expressions of immunologic phenotypes and could be mainly classified into 3 types: CD34(+)/CD31(+)/CD8⁻ endothelial cells of the capillaries, CD8(+)/CD31(+)/CD34⁻ lining cells of the sinusoids and CD31(+)/CD8⁻/CD34⁻ endothelial cells of the small veins. Collagen network and dilated lymphatic sinuses were evident under transmission electron microscope.</p><p><b>CONCLUSIONS</b>Sclerosing angiomatoid nodular transformation of spleen is a rare benign entity. It may represent a reactive condition and bears some relationship with splenic angioma. It needs to be distinguished from borderline or malignant vascular tumors of spleen.</p>

Evaluation of intraoperative molecular assay in sentinel lymph node biopsy from breast cancer patients / 中华病理学杂志

<p><b>OBJECTIVE</b>to evaluate the application of GeneSearch(TM) breast lymph node assay in intraoperative detection of metastases in sentinel lymph node (SLN) from breast cancer patients.</p><p><b>METHODS</b>a total of 225 SLN from 88 patients was prospectively studied. Each SLN was cut into 2 mm slabs which were examined by intraoperative imprint cytology (IIC) first, followed by GeneSearch assay and post-operative serial sectioning. GeneSearch used real-time fluorescence quantitative RT-PCR technology to detect the expression of CK19 and mammaglobin in SLN. The results of GeneSearch assay were correlated with those of IIC and post-operative serial sectioning.</p><p><b>RESULTS</b>amongst the 88 cases studied, 225 SLNs were found, and obvious metastatic carcinoma cells were identified in 27 SLNs and micrometastasis in 9 SLNs. One hundred and eight-nine SLNs were considered as "negative" (with "isolated tumor cells" present in 5 SLNs). The turn-around time of intraoperative GeneSearch assay ranged from 35 to 45 minutes (mean = 40 minutes). The concordance rate between GeneSearch assay and post-operative serial sectioning was 95.6% (215/225), with a sensitivity of 86.1% (31/36), compared with 94.7% (213/225) and 72.2% (26/36) respectively for IIC. The size of metastatic foci correlated with the Ct value of CK19 and mammaglobin (P < 0.01).</p><p><b>CONCLUSIONS</b>GeneSearch assay for intraoperative detection of metastase in SLN has a satisfactory performance and demonstrates a relatively higher sensitivity than IIC. The potential clinical application still requires further evaluation of larger number of cases.</p>

Melanotic epithelioid clear cell tumor of kidney: report of three cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathologic features and immunophenotype of 3 cases of melanotic epithelioid clear cell tumor of kidney.</p><p><b>METHODS</b>More than 2000 cases of renal tumors were retrospectively reviewed. Three cases of melanotic epithelioid clear cell tumor were identified. Immunohistochemical study was carried out using the paraffin-embedded tissue samples. Electron microscopy was also performed in 1 case.</p><p><b>RESULTS</b>Amongst the 3 cases studied, the male-to-female ratio is 1:2. Histologically, 2 cases showed a clear cell carcinoma-like pattern. Papillary structures covered by clear cells and eosinophilic cells were observed in 1 case. Immunohistochemical study showed that the tumor cells in all cases expressed HMB 45. Two of them were also positive for Melan A. The staining for epithelial markers and S-100 protein was negative. Melanosomes were not identified by ultrastructural examination.</p><p><b>CONCLUSIONS</b>Melanotic epithelioid clear cell tumor is a rarely seen neoplasm of kidney. There are some histologic overlaps with renal cell carcinoma, epithelioid angiomyolipoma and melanoma. Immunohistochemical study is useful in confirming the diagnosis. The tumor represents a morphologic variant of epithelioid angiomyolipoma.</p>