[Clinical and immunohistopathologic study of phosphaturic mesenchymal tumor].

Objective: To study the clinicopathological characteristics and immunohistochemical phenotype of phosphaturic mesenchymal tumor (PMT) . Methods: The clinicopathological data and immunohistochemical profiles were obtained retrospectively from 206 patients diagnosed with PMT at Peking Union Medical College Hospital (PUMCH) during July 2008 to September 2017, with a review of literature. Results: The mean age of PMT patients was 42 years (range 13 to 70 years), with a male to female ratio of 1.1∶1.0. All patients presented with different degree of bone pain, muscle weakness, shorten of stature, thoracic deformity and pathological fractures, with hypophosphatemia and high serum ALP. Phosphatemia returned to normal within 1 week after operation in all cases underwent complete tumor resection. The duration of osteomalacia before resection (documented in 197 cases) ranged from 20 days to 40 years (average 5.7 years). The average blood phosphorus concentration raised from 0.49 mmol/L to 0.92 mmol/L before and after tumor resection (P<0.01), with 147 cases (84.0%, 147/175) returned to normal range within 2 weeks. The rate or blood phosphorus concentration recovery in 15 days after operation was 79.6% in average, displayed significant differences between patients with complete resection and those with partial resection (85.4% vs. 21.1%, P<0.01). PMT lesions mainly involved lower extremities (55.8%), followed by head and neck (29.1%). In immunohistochemical study, all cases were positive for vimentin (100.0%), while most cases were positive for NSE (96.3%), CD56 (94.2%), FGF23(88.4%), CD68 (88.3%), D2-40 (70.9%), CD34 (23.1%), SMA (55.5%), bcl-2 (59.8%) and CD99 (47.1%). The Ki-67 positive index of tumor varied from less than 2% (51.4%), 3% to 10% (41.3%) to >10% (7.2%). Conclusions: PMT mainly occurs in lower limbs or head and neck, with unique clinical characteristics and blood biochemical indexes. The tumor expresses a variety of immunohistochemical markers, indicating the potential of multi-directional differentiation. Clinical profile, blood biochemistry testing and immunohistochemical phenotype is helpful for diagnosis of PMT.

[From traditional population-based approach to individualized precision medicine: the interpretation of update on The AJCC Colorectal Cancer Staging System, Eighth Edition].

The eighth edition of cancer staging system published by AJCC will be implemented all over the world in January 1, 2018. In addition to strengthening the traditional TNM staging system, the introduction of new molecular markers, is a major advance in the eighth edition, and is expected to play a more valuable role in the"individualized" clinical practice. The most important update in the eighth edition of AJCC colorectal cancer staging system is"non-anatomic" prognostic and predictive evaluation system based on the molecular detection. The system is useful for better understanding the pathogenesis of colorectal cancer, and guide clinicians to provide individualized treatment for the patients even in the same stage of colorectal cancer.

Impact of supplement with Lactobacillus- and Bifidobacterium-containing yogurt on triple therapy for Helicobacter pylori eradication.

AIM: To test whether supplements of Lactobacillus- and Bifidobacterium-containing yogurt (AB-Yogurt) affect the success of Helicobacter pylori eradication. METHODS: One hundred and sixty H. pylori-infected patients were randomized into a triple-plus-yogurt group or a triple-only group, receiving 1 week of triple therapy with and without supplements of AB-Yogurt, respectively. In the triple-plus-yogurt group, AB-Yogurt was continued for 4 weeks after triple therapy. Eight weeks later, patients were assessed for the success of H. pylori eradication. The stool samples of 22 randomly selected patients, 11 from each group, were provided on enrolment, at the first week and at the fifth week for evaluation of the percentage of Bifidobacterium in anaerobes. RESULTS: By intention-to-treat analysis, the triple-plus-yogurt group had a higher H. pylori eradication rate than the triple-only group (91% vs. 78%, P < 0.05). The per protocol H. pylori eradication rates were similar for both groups (93.5% vs. 89%, P = N.S.). Only patients supplemented with AB-Yogurt showed restoration of the percentage of Bifidobacterium in the anaerobes of stools at the fifth week to the level in the stools on enrolment. CONCLUSIONS: Supplement with AB-Yogurt can improve the intention-to-treat eradication rates of H. pylori, and can restore the depletion of Bifidobacterium in stools after triple therapy.

Protective effects of dried flower extracts of Hibiscus sabdariffa L. against oxidative stress in rat primary hepatocytes.

Dried flower extracts of Hibiscus sabdariffa L., a local soft drink material and medical herb, was found to possess antioxidant activity in the present study. In the preliminary studies, antioxidant potential of three fractions of the ethanol crude extract (HS-C: chloroform-soluble fraction; HS-E: ethyl acetate soluble fraction; HS-R: residual fraction) obtained from the dried flowers of Hibiscus sabdariffa L. were evaluated by their capacity of quenching 1,1 -diphenyl-2-picrylhydrazyl (DPPH) free radical and inhibiting xanthine oxidase (XO) activity. HS-E showed the greatest capacity of scavenging free radical (EC50=0.017mg/ml), and HS-C showed the strongest inhibitory effect on XO activity (EC5o=0.742 mg/ml). Furthermore, antioxidant bioactivities of these crude extracts were investigated using a model of tert-butyl hydroperoxide (t-BHP)-induced oxidative damage in rat primary hepatocytes. All fractions were found to inhibit significantly the unscheduled DNA synthesis (UDS) induced by t-BHP at a concentration of 0.20 mg/ml. HS-C and HS-E also decreased the leakage of lactate dehydrogenase (LDH) and the formation of malondialdehyde (MDA) induced by t-BHP (1.5 mM) considerably at a concentration of 0.10 and 0.20 mg/ml in the rat primary hepatocyte cultures. These results indicated that the dried flower extracts (HS-C and HS-E) of H. sabdariffa L. protect rat hepatocytes from t-BHP-induced cytotoxicity and genotoxicity by different mechanisms.

[A clinical analysis of 13 cases of adult osteomalacia].

13 cases of renal tubular osteomalacia, consisting of 5 cases of Vitamin D resistant rickets (VDRR), 6 cases of renal tubular acidosis(RTA) and 2 cases of Fanconis syndrome were reported. The biochemical findings of the serum and urine from the 13 cases were compared with those from normal controls. The clinical findings, diagnosis and treatment of renal tubular osteomalacia were reviewed. The differential diagnosis of osteomalacia with laboratory methods and the mechanism of its pathogenesis were discussed.

[Hypercalcemia and hyperphosphatemia in thyrotoxoicosis and the therapeutic effect of propranolol].

Measured levels of serum calcium, phosphate, alkaline phosphatase, and urinary hydroxyproline were measured and calcium-phosphate product was calculated in 20 hyperthyroid patients and 20 normal controls. Eleven of the patients took propranolol 160 mg per day for 28 days. We found that the serum level of calcium was higher than that of normal controls. The incidence of hypercalcaemia in hyperthyroid patients was 10%. The serum level of phosphate and the calcium-phosphate product increased (P less than 0.01). Elevation of alkaline phosphatase and bone alkaline phosphatase were also observed (P less than 0.01). The urinary hydroxyproline was also elevated (P less than 0.01). After treatment with propranolol serum calcium and triiodothyronine decreased (P less than 0.05). It is suggested that the major mechanism of hypercalcaemia and hyperphosphatemia in hyperthyroidism was increase of bone absorption stimulated by triiodothyronine. Propranolol decreased the serum level of calcium through decreasing triiodothyronine level and through beta-receptor blocking effect as well as its direct effect on bone.

[Effect of magnetic water on urinary calculi--an experimental and clinical study]. / Der Einfluss von magnetischem Wasser auf Harnsteine--eine experimentelle und klinische Studie.

In recent years, many hospitals in China have employed magnetized water in the treatment of urolithiasis with quite satisfactory results. Since 1979, we have carried out the following basic researches: (1) We compared the effectiveness of several different types of apparatus producing magnetized water and found that the best type was the Shanghai JW-1 mode apparatus with 1,350 gauss and to-and-fro magnetizing for 12 times. (2) We had tested the solubility of oxalate, uric acid and phosphate urolith both in ordinary and in magnetized water and found that phosphate urolith had better solubility in the latter. (3) The physical and chemical characteristics of magnetized water were studied, and the calcium crystals were found to be also soluble in it. (4) Experiments on fishes living in magnetized water showed that in their kidneys the amount of calcium crystals and tissue calcium level were lower than those in ordinary water. The basic theory of treatment of urolithiasis with magnetized water is discussed.