[Pathological characteristics of coronary artery disease in elderly patients aged 80 years and over].

OBJECTIVE: To define the pathological changes of coronary artery and compare the clinical diagnosis and pathological diagnosis differences in elderly patients aged 80 and over. METHODS: A total of 909 autopsy cases aged 60-100 years in our hospital from April 1st 1969 to October 31th 2013 were analyzed. The prevalence and pathological features of coronary artery disease (CAD) in cases aged 80 years and over were compared with those aged 60-79 years old. The misdiagnosis and missed diagnosis rate were calculated. RESULTS: The prevalence of CAD by autopsy (63.8% (289/453) vs. 39.9% (182/456), P<0.01), old myocardial infarction (OMI) by autopsy (63.0% (182/289) vs. 51.6% (94/182), P<0.05) and chronic myocardial ischemia by autopsy (22.5% (65/289) vs. 7.1% (13/182), P<0.01) were significantly higher while the prevalence of acute myocardial infarction (AMI) by autopsy was significantly lower (22.1% (64/289) vs. 42.9% (78/182), P<0.01) in aged 80 and over group compared to 60-79 years old group. The misdiagnosis rate of CAD was 65.2% (107/164), the missed diagnosis rate of OMI was 62.1% (113/182) and the missed diagnosis rate of AMI was 37.5% (24/64) in the aged 80 and over group. CONCLUSIONS: The prevalence of CAD and misdiagnosis and missed diagnosis rate are high in dead inpatients aged 80 years and over. OMI is more common but often missed in this group. Thus, the diagnosis and evaluation of CAD should be enhanced in this patient group.

[Cytodiagnosis and cytomorphologic analysis of hematolymphoid malignancy in serous effusion: a study of 23 cases].

OBJECTIVE: To evaluate the value of cytomorphologic and immunocytochemical approaches in the diagnosis of hematologic neoplasms in serous effusion. METHODS: The cytospin and Thinprep smears of effusion specimens were prepared from 23 cases of lymphoid malignancies with histological confirmation and 30 cases of benign effusions used as control. Morphological assessment of the cellular components was conducted, including the ratio of mesothelium to lymphocyte, karyomorphism of lymphoid cell and the presence of apoptosis and mitosis. Immunocytochemical study was performed in all the cases, with flow cytometry in one case. RESULTS: Among the 23 tumor cases, 14 represented disease relapse, and in the remaining nine cases, the serous effusion was the primary manifestation. The proportion of mesothelium was low in the tumor group, being less than 10% in 20 cases (87.0%, 20/23). It was more than 10% in most of benign cases (20/30, 66.7%). Lymphoid cells were prominent (> 80% cells) in 69.6% of the tumor cases, and the cellular component in some control cases (63.3%, 19/30) showed fewer lymphocytes. Nipple-like projection of lymphocytic nuclei could be detected in almost all the tumor cases (91.3%, 21/23), but was occasionally found in the control group (26.7%, 8/30). Apoptosis and mitosis were obvious in lymphomatous effusion, but observed in only 6.7% of the control cases. Significant difference of the previously mentioned cytomorphologic features existed between the tumor and control groups (P < 0.01). The results of immunocytochemical staining in cell block were identical to the corresponding immunohistochemistry, and one case of mantle cell lymphoma was confirmed by flow cytometry. The cytologic findings seen in all the 23 studied cases were in agreement with the corresponding histologic diagnosis. CONCLUSIONS: Some cytomorphologic features, including decreased number of mesothelium, increased number of lymphoid cells, nuclear nipple-like projection, and the presence of apoptosis and mitosis, are very useful for diagnosing lymphoid malignancy in serous effusion. Immunocytochemistry is an important approach to the cytodiagnosis and classification of lymphoma.

[Expression of cytokine IL-1α and S100ß in different types of plaques in Alzheimer's disease].

OBJECTIVE: To study the significance of cytokine IL-1α and S100ß expression in formation and evolution of different types of plaques in Alzheimer's disease. METHODS: Thirty-four autopsy cases of Alzheimer's disease encountered during the period from 1982 to 2008 were retrieved from the archival files of Department of Pathology, Beijing Hospital. Tissue blocks were taken from hippocampus for dual immunostaining for IL-1α/Aß and S100ß/Aß. RESULTS: Immunohistochemical studied for IL-1α/Aß and S100ß/Aß delineated four different types of senile plaques: diffuse non-neuritic plaques, diffuse neuritic plaques, dense-core neuritic plaques and dense-core non-neuritic plaques. The numbers of IL-1α-positive microglias and S100ß-positive astrocytes associated with diffuse neuritic plaques were (7.29 ± 3.04) per mm(2) and (6.49 ± 2.20) per mm(2), respectively. In contrast, the numbers of IL-1α-positive microglias and S100ß-positive astrocytes associated with diffuse non-neuritic plaques, dense-core neuritic plaques and dense-core non-neuritic plaques were (3.24 ± 1.53) per mm(2) and (4.14 ± 1.77) per mm(2), (2.09 ± 1.37) per mm(2) and (2.25 ± 0.83) per mm(2), and (1.38 ± 0.90) per mm(2) and (0.58 ± 0.36) per mm(2), respectively. The numbers of IL-1α-positive microglias and S100ß-positive astrocytes associated with diffuse neuritic plaques were significantly higher than those of the other three types of plaques (P < 0.05). CONCLUSION: The IL-1α-positive microglias and S100ß-positive astrocytes may be of certain significance in transformation of diffuse non-neuritic plaques to diffuse neuritic plaques in Alzheimer's disease.

Treatment of platinum-resistant recurrent ovarian cancer using a "predictive molecule targeted routine chemotherapy" system.

BACKGROUND: Correct drug selection, the key to successful chemotherapy, is one of the most difficult clinical decisions for the treatment of platinum-resistant recurrent ovarian cancer worldwide. The exact procedures for choosing drugs are undefined, currently relying on clinical trials and personal experience, which often results in disappointing outcomes. Here, we propose a new drug selection method, the "predictive molecule targeted routine chemotherapy", to choose relatively sensitive routine drugs and avoid relatively resistant routine drugs based on the specific predictive molecule expression of the individual tumor tissue. METHODS: From January 2004 to June 2008, 26 cases of platinum-resistant recurrent ovarian cancer were prospectively recruited. Their routine chemotherapy drug choice was based on the expression of 6 predictive molecules (including p53) as determined by immunohistochemistry (the predictive molecule targeted routine chemotherapy group). A further 18 cases of platinum-resistant recurrent ovarian cancer were treated by experience and formed the control group. The response rate and the overall survival were compared between the two groups. RESULTS: The response rate to second-line chemotherapy was 28% in the control group and 77% in the predictive molecule targeted routine chemotherapy group (P = 0.002). The response rate to third-line chemotherapy was 14% in the control group and 33% in the predictive molecule targeted routine chemotherapy group (P = 0.268). The median overall survival of the predictive molecule targeted routine chemotherapy group (88 weeks) was significantly longer than the median overall survival of the control group (56 weeks) (P = 0.0315). CONCLUSION: The predictive molecule targeted routine chemotherapy is a new effective protocol for choosing drugs when treating platinum-resistant recurrent ovarian cancer.

[The predictive factors for the response to platinum/paclitaxel based first-line adjuvant chemotherapy in advanced ovarian cancer].

OBJECTIVE: To investigate the predictive factors for the response to platinum/paclitaxel based first-line adjuvant chemotherapy in advanced ovarian cancer. METHODS: Forty-two patients with advanced ovarian cancer underwent complete resection plus platinum/paclitaxel as first-line adjuvant chemotherapy. The clinical outcomes were observed. Immunohistochemistry was used to detect the expression of p53, a tumor suppressor protein, and P-glycoprotein (Pgp), a multi-drug resistance associated gene product, in the specimens resected from operation. Retrospectively analysis of 42 cases r patients with. To calculate the complete response (CR) rate and early recurrence (ER) rate and to observe. The relationship between the parameters about clinical outcomes and some clinico-pathological variables, such as age, pathological type, differentiation degree, residual tumor, and molecular markers p53 and Pgp, was analyzed. RESULTS: Twenty-four patients (57%) showed CR and 7 (13%) showed ER. The CR rate of the p53 positive patients was 74%, higher than that of the p53 negative patients (44%, P = 0.065). The ER rate of the patients with residual tumor less than 2 cm was 4%, significantly lower than those with residual tumor > or = 2 cm (P = 0.018). Logistic regression analysis indicated that Pgp positivity and residual tumor > or = 2 cm were independent risk factors of ER. CONCLUSION: Residual tumor, p53, and Pgp expression are predictive factors for the response to platinum/paclitaxel first-line adjuvant chemotherapy in advanced ovarian cancer. The p53 positive patients are more sensitive to this protocol, and the Pgp positive patients and the patients with residual tumor > or = 2 cm are more resistant to this protocol.

[Predictive value of P53 expression in selecting first-line chemotherapy regimen for advanced epithelial ovarian carcinoma].

BACKGROUND & OBJECTIVE: The first-line adjuvant chemotherapy regimens of ovarian cancer mainly include TC (paclitaxel combined with carboplatin) and PC (cisplatin combined with cyclophosphamide) protocols. This study was to investigate the correlation of P53 expression to treatment outcome of ovarian cancer patients received the above 2 protocols, and explore the predictive value of P53 expression in selecting chemotherapy regimen. METHODS: Records of 53 patients with advanced epithelial ovarian cancer (stage IIIc), treated with TC or PC regimen, were analyzed retrospectively. The expression of P53 was detected by immunohistochemistry. The complete response (CR) rate and progression-free survival (PFS) were compared between TC and PC groups according to P53 status. RESULTS: Of the 53 patients, 22 were P53 positive, of which 13 received TC regimen and 9 received PC regimen; the CR rate was slightly higher in TC group than in PC group (76.9% vs. 33.3%, P=0.054), and PFS was significantly longer in TC group than in PC group (102 weeks vs. 43 weeks, P=0.040). In the subgroup of P53-negative patients, TC group had similar CR rate and PFS to PC group. Multivariate analysis showed that the size of residue was an independent prognostic factor. CONCLUSIONS: P53 detection may play a role in selecting first-line chemotherapy for advanced epithelial ovarian cancer patients: TC regimen is preference for P53-positive patients, PC regimen may be a choice for P53-negative patients. These recommendations should be tested in further trails with large samples.

[The effect of the photoelectric detector on the accuracy of the spectrometer].

An optimized photoelectric detector will increase the precision of a spectrometer, thus indicates an important way to develop high performance spectrometer. With an eye to this, a model describing the process that spectrogram is integrated and sampled by photoelectric detector and restored after low-pass filtering is developed. Based on the model, the influence of the characteristic parameters of the detector on the spectral line in the frequency domain is analyzed and the relation between the full width half maximum (FWHM) of the spectra line and the integral interval, sampling space and sensitivity of the detector is deduced. The conclusion indicates that both the integral interval and sampling space should be 1/6 of the FWHM for a spectral line with gaussian profile as a result of compromise between accuracy and feasibility. Moreover, the critical point deciding the right situation for scanner and array detector is given. Other guide line to optimize the photoelectric detector and increase accuracy is suggested also.

[Expression of apolipoprotein E in Alzheimer's disease and its significance].

OBJECTIVE: To study the association between Alzheimer' s disease (AD) and apolipoprotein E (apoE) polymorphism and apoE epsilon4 allele; and to investigate the role of apoE in senile plaque formation. METHODS: During the period from 1982 to 2003, 27 portmortem cases of AD from the archival files of Department of Pathology of Beijing Hospital, diagnosed according to the consortium to establish a registry for Alzheimer's disease (CERAD) criteria, were enrolled into this study. Among the 27 cases studied, there were 23 cases of definite AD and 4 cases of probable AD. Postmortem brain tissues from 67 neurologically unremarkable deceased were used as age-matched controls. Immunohistochemical study for beta-amyloid (Abeta) and Tau protein, as well as immunohistochemical study for Abeta/apoE, were performed in all AD cases using streptavidin-peroxidase (SP) and double immunostaining ( SP/ABC) methods, respectively. Senile plaques and neurofibrillary tangles in the 23 cases of definite AD were further quantified. The apoE genotypes in all cases were analyzed by polymerase chain reaction and restriction fragment length polymorphism technologies. RESULTS: Immunohistochemical study for Abeta distinguished 4 different types of senile plaques: diffuse non-neuritic plaques, diffuse neuritic plaques, dense-core neuritic plaques and dense-core non-neuritic plaques. Double immunohistochemistry for Abeta/apoE showed that some senile plaques were positive for both Abeta and apoE. The expression rates for Abeta and apoE in these 4 different types of senile plaques were 4. 28%, 84. 71%, 8.50% and 2.51%, respectively. The positivity rate for Abeta/apoE in diffuse neuritic plaques were significantly higher than those in other 3 types (P < 0.01). The frequency of occurrence of apoE epsilon4 allele in AD was significantly higher than that in the control group (P < 0.01). The numbers of senile plaques and neurofibrillary tangles in AD cases with apoE epsilon4 allele were also significantly higher than those in AD cases without apoE epsilon4 allele (P < 0.01). CONCLUSIONS: ApoE polymorphism is associated with AD. The presence of apoE epsilon4 allele carries a higher risk for the development of AD. ApoE may also play an important role in the transformation of diffuse non-neuritic plaques to diffuse neuritic plaques.

[Relationship between apoptosis of neurons and microglia activation in Alzheimer's disease].

OBJECTIVE: To assess the relationship between microglia activation and apoptosis of neurons, and the significance of activated microglias in the formation and progression of senile plaques in Alzheimer's disease. METHODS: IL-1alpha and beta-amyloid immunohistochemistry, combined with TUNEL assay were used to assess brain tissue samples from 10 patients with Alzheimer's disease and 4 negative control cases without neurological disease. RESULTS: The number of resting microglias in the brains of Alzheimer's disease patients was similar to that of the control group (P > 0.05), but the number of activated microglias was significant greater in the Alzheimer's disease patients than that of the controls (P < 0.01). The activated microglias displayed altered size and morphology, and was therefore, categorized into three subtypes as primed, enlarged and phagocytic microglias. The numbers of primed, enlarged and phagocytic microglias were 5.4 +/- 0.87, 11.5 +/- 1.25, and 3.4 +/- 0.32 microglia/mm2 and represented 26.6%, 56.65%, and 16.75% of all activated microglias respectively. The number of TUNEL positive apoptotic neurons was significantly greater in Alzheimer patients than that in the control group (P < 0.05). There was a close relationship between the apoptosis of neurons and the activation of microglias (P < 0.01). The activated microglias were differentially distributed among four different plaque types in Alzheimer patients. Many primed (42.3%) and most of the enlarged and phagocytic microglias (56.2% and 70.6%) were present in the diffuse neuritic plaques. CONCLUSIONS: Hyperplasia and activation of microglias are a common phenomena in AD and may play an important role in its pathogenesis. There is a close relationship between the apoptosis of neurons and activation of microglias. The activation of microglias may play a key pathogenic role in senile plaque formation and progression of Alzheimer disease.