Screening of characteristic genes in early-onset pre-eclampsia and analysis of their association with immune cell infiltration based on bioinformatics analysis and machine-learning algorithms / 中华围产医学杂志

Objective:To screen the characteristic genes of early-onset pre-eclampsia (EOSP) and to analyze their association with immune cell infiltration based on bioinformatics analysis and machine learning methods.Methods:In the Gene Expression Omnibus (GEO) database, the mRNA sequences of placental tissues from women with EOSP and normal pregnancy were retrieved using the term "early-onset pre-eclampsia". The R language was used for background correction, standardization, summarization, and probe quality control. Annotation packages were downloaded for ID conversion and the expression matrices were extracted. The differentially expressed genes (DEGs) between the EOSP and the normal pregnancy in the metadata were analyzed after correcting for batch effects using the limma package. Characteristic genes were identified through the support vector machine (SVM) -recursive feature elimination (RFE) method and the LASSO regression model. The area under the curve (AUC) was calculated to judge the diagnostic efficiency of the characteristic genes. Placental tissues were retrospectively collected for verification from 15 patients with EOSP and 15 with normal pregnancy who were delivered at Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 1, 2022, to February 28, 2023. The expression of characteristic genes was verified using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot, which were further validated in the validation dataset. Finally, the CIBERSORT algorithm was used to analyze the relative proportion of infiltrating immune cell in EOSP. A t-test was used for differential analysis. Results:Three gene datasets were downloaded, including GSE44711 (eight cases each for EOSP and normal pregnancy), GSE74341 (seven cases for EOSP and five cases for normal pregnancy), and GSE190639 (13 cases each for EOSP and normal pregnancy). A total of 29 DEGs were screened after combining the GSE44711 and GSE74341 datasets, including 27 upregulated and two downregulated genes. Gene ontology enrichment analysis showed that these genes are mainly involved in the secretion of gonadotropins, female pregnancy, regulation of endocrine processes, secretion of endocrine hormones, and negative regulation of hormone secretion. Eight characteristic genes ( EBI3, HTRA4, TREML2, TREM1, NTRK2, ANKRD37, CST6, and ARMS2) were screened using the LASSO regression algorithm combined with SVM-RFE algorithm and the expression differences of these characteristic genes were verified as statistically significant by qRT-PCR and Western blot (all P<0.05, except for CST6). Logistic regression algorithm showed that the AUC (95% CI) of TREML2, ANKRD37, NTRK2, TREM1, HTRA4, EBI3, and ARMS2 were 0.979 (0.918-1.000), 0.969 (0.897-1.000), 0.969 (0.892-1.000), 0.979 (0.918-1.000), 0.990 (0.954-1.000), 0.990 (0.954-1.000), and 0.903 (0.764-1.000). Immune cell infiltration analysis indicated that the infiltration ratio of M2 macrophages in the placental tissue from EOSP was significantly lower than that in the normal pregnancy (0.167±0.074 vs. 0.462±0.091, P=0.002), but the infiltration ratios of monocytes and eosinophils were significantly higher (0.201±0.004 vs. 0.085±0.006; 0.031±0.001 vs. 0.001±0.000, both P<0.05). The correlation analysis between characteristic genes and infiltrating immune cells found that the seven characteristic genes were closely related to the immune cells (all P<0.05). Conclusion:Seven characteristic genes that are critical for the prediction and early diagnosis of EOSP are screened using bioinformatics analysis and machine-learning algorithms in this study, which provides new research targets and a basis for the prevention and treatment of preeclampsia in the future.

Expression of CXCR5 and its significance of clinical and pathological in classical Hodgkin lymphoma / 临床与实验病理学杂志

Purpose To investigate the expression of Che-mokine(C-X-C Motif)receptor 5(CXCR5)and its clinico-pathological significance in classic Hodgkin lymphoma(CHL).Methods The expression of CXCR5 was assessed in 33 pa-tients by immunohistochemistry(IHC),and retrospectively ana-lyzed the expression and clinical significance of CXCR5 in the four subtypes of CHL.Meanwhile,10 cases of ALK-positive an-aplastic large cell lymphoma(ALCL)and 10 cases of ALK-neg-ative ALCL were collected as the control group.ResultsThere were 31 cases with CXCR5-positive in all 33 cases(93.94％),including 15/16(93.75％)in nodular sclerosis CHL,12/13(92.31％)in mixed cellularity CHL,2/2 in lymphocyte-rich CHL,and 2/2 in lymphocyte-depleted CHL.The positive ex-pressions of CXCR5 in different immunophenotypes of CHL were as follow,31/33(93.94％)in CD30 positive and PAX5 weakly positive CHL.12/14(85.71％)in CD15 negative CHL,24/26(92.31％)in CD20 negative CHL,10/11(90.91％)in EBER-negative CHL and 5/6 in LMP1-negative CHL.CXCR5 were not expressed in all 20 cases of ALCL.Conclusion The positive expression rate of CXCR5 in CHL is high.When the tumor cells are negative for CD15,LMP1 and CD20 or EBER,CXCR5 also has a high positive expression rate,which is helpful for the diagnosis of CHL.CXCR5 can be used to differentiate CHL from ALCL,especially the cases lacking typical morpholo-gy and immunohistochemistry.

Evaluation of dual-parameter 3D-ASL on blood-supply of patients with CMCAO and the relationship between that and cerebral infarction area / 中国医学装备

Objective:To explore the evaluation of dual-parameter three dimension arterial spin labelling(3D-ASL)perfusion imaging on blood-supply situation of patients with chronic middle cerebral artery occlusion(CMCAO)and the relationship between that and cerebral infarction area.Methods:A total of 112 patients with unilateral CMCAO admitted to Handan Central Hospital from April 2019 to December 2021 were selected,and all of them were divided into a compensatory group(50 cases)with anterior cerebral artery(ACA)leptomeningeal anastomoses(LMA)and an uncompensated group(62 cases)according to the results of digital subtraction angiography(DSA)examination.The results of diffusion weighted imaging(DWI),magnetic resonance angiography(MRA)and dual-parameter 3D-ASL detection were respectively analyzed,and the clinical data,3D-ASL parameters and the incidence of cerebral infarction between the two groups were compared.The influence factors of compensation were further analyzed.The receiver operating characteristics(ROC)curve of LMA diagnostic value of CMCAO patients was drawn according to cerebral blood flow values[post label delay(PLD)=1.5 s,2.5 s)].The 3D-ASL parameters of patients with different cerebral infarction areas were compared,and the relationship between 3D-ASL parameters and cerebral infarction area was compared.Results:The apparent diffusion coefficient(ADC)at the side of lesion of CMCAO patients was(0.31±0.10),and cerebral blood flow values at 1.5s and 2.5s were respectively(25.67±4.25)and(54.09±4.49),which were significantly lower than those at the side of healthy,and the differences were statistically significant(t=27.591,34.210,3.913,P<0.05),respectively.The differences of cerebral blood flow values(1.5s and 2.5s)between compensatory group and uncompensated group were significant(t=5.584,4.090,P<0.05),respectively.The results of logistic regression analysis showed that age,stroke,cerebral infarction area and cerebral blood flow values(1.5 s and 2.5 s)were influencing factors on LMA compensation of CMCAO patients(OR=4.187,6.604,0.482,5.681,5.807,P<0.05),respectively.The ROC values showed that the area under curve(AUC)of 3D-ASL were respectively 0.720 and 0.812 in diagnosing LMA when PLD were respectively 1.5s and 2.5s.The proportion of normal and lacunar infarctions in the compensatory group was significantly higher than that in the uncompensated group,while the proportions of middle and small infarction,and large area infarctions of the compensatory group were significantly lower than those of the uncompensated group,and the difference was statistically significant(t=28.062,P<0.05).The difference in cerebral blood flow values(1.5s)among patients with different infarct areas was statistically significant(t=0.202,P<0.05).The cerebral blood flow value(1.5s)of 3D-ASL was negatively correlated with the area of cerebral infarction(r=-0.261,P<0.05).Conclusion:Dual parameter 3D-ASL can non-invasively and visually assess the compensatory status of LMA of patients with unilateral CMCAO.The blood flow perfusion of middle cerebral artery(MCA)at the side of lesion is related to the area of cerebral infarction.When the PLD is 1.5s,the sensitive response can be conducted on this,so as to provide objective and reliable basis for clinical diagnosis and treatment and curative effect.

Clinical study of Peiyuan Kangai Decoction combined with acupuncture in the treatment of advanced liver cancer with qi deficiency and blood stasis syndrome / 国际中医中药杂志

Objective:To evaluate the efficacy of Peiyuan Kangai Decoction combined with acupuncture in the treatment of advanced liver cancer with qi deficiency and blood stasis syndrome.Methods:Randomized controlled trial. From May 2019 to May 2021, 162 advanced liver cancer patients with qi deficiency and blood stasis syndrome in Shizhong District Cancer Hospital of Leshan were randomly divided into three groups by random drawing method, with 54 in each group. All patients were given FOLFOX4 chemotherapy regimen. Based on the chemotherapy, the 1st control group was given Peiyuan Kangai Decoction, and the 2nd control group was given acupuncture therapy, and the combined group was given decoction and acupuncture therapy. All three groups were treated for 6 weeks. Traditional Chinese Medicine syndrome score was performed before and after treatment, Piper fatigue scale was used to evaluate the fatigue degree of patients. Vimentin (VIM), Golgi transmembrane glycoprotein 73 (GP73) and chemokine ligand 1 (CXCL1) were determined by ELISA. The adverse reactions during treatment were observed and the clinical efficacy was evaluated.Results:The combined group showed the response rate was 61.11% (33/54), the disease control rate was 72.22% (39/54), the 1st control group showed the response rate was 40.74% (22/54), the disease control rate was 53.70% (29/54), and the 2nd control group showed the response rate was 38.89% (21/54), and the disease control rate was 51.85% (28/54). The response rate and disease control rate of the combined group were significantly higher than either the control group 1 and 2 ( χ2 values were 6.59, 5.68, respectively, and P values were 0.037, 0.043, respectively). After treatment, the scores of liver swelling and pain, fatigue and shortness of breath, anorexia, sallow and emaciation in the combined group were significantly lower than those in the control group 1 and the control group 2 ( F values were 13.90, 15.69, 13.20, 10.55, respectively, P<0.01); the scores of emotions, feeling, behavior and cognition were significantly lower than those in the control group 1 and control group 2 ( F values were 49.55, 27.42, 19.69, 20.55, respectively, P<0.01). After treatment, the levels of serum VIM [(52.54±6.69) ng/L vs. (61.29±7.89) ng/L, (65.11±7.92) ng/L, F=39.63], GP73 [(19.72±3.90) ng/L vs. (24.42±4.23) ng/L, (25.12±4.76) ng/L, F=25.05], CXCL1 [(3.12±0.72) ng/L vs. (4.85±0.95) ng/L, (4.98±0.91) ng/L, F=77.67] in the combined group were significantly lower than those in the control group 1 and the control group 2 ( P<0.01). During the treatment, the incidence of toxic and side effects in the combined group was 18.52% (10/54), the control group 1 was 27.78% (15/54), and the control group 2 was 24.07% (13/54). There was no statistically significant difference in the incidence of toxic and side effects among the three groups ( χ2=1.31, P=0.520). Conclusion:On the basis of FOLFOX4 chemotherapy, combined therapy with Peiyuan Kangai Decoction and acupuncture treatment can improve the symptoms and fatigue of patients with advanced liver cancer, reduce the levels of serum VIM, GP-73, CXCL1, improve the efficacy safely.

Combined treatment of hyperthyroidism crisis with extracorporeal membrane oxygenation, plasma exchange, and continuous renal replacement therapy: One case report / 中华内分泌代谢杂志

To investigate the clinical features,treatment methods,and prognosis of a patient with hyperthyroidism crisis.The clinical characteristics,treatment methods,and prognosis of patients with hyperthyroidism crisis in our department were retrospectively analyzed.The application of adjuvant therapy and its influence on prognosis were summarized.Hyperthyroidism crisis is the most serious complication of those patients.The onset is urgent and the prognosis is poor,which requires the clinician to be vigilant and to interfere as early as possible.The extracorporeal circulation technique removes excessive free thyroxine,reduces the high metabolic state,and ensures safe of the heart.Brain,kidney,and other important organ functions which play important roles in the treatment on proper time.In this case,we finally achieved clinical cure,providing some new ideas for the diagnosis and treatment of hyperthyroidism crisis.

The effect of adhesive with different unsealing time on the microleakage of adhesive interface / 实用口腔医学杂志

Objective: To investigate the effect of self-etching adhesive with different unsealing time on the microleakage of the adhesive interface between tooth and resin. Methods: Unopened self-etching adhesives, Scotchbond Universal (S) and Xeno V+ (X) were respectively used to adhere Z350 resin for restoration of the prepared occlusal cavities sized 4 mm × 4 mm × 4 mm (n = 40) . The methylene blue staining method was used to observe the microleakage of the adhesive interface between the tooth and filling material at the instant moment, 1, 2 and 3 months after the self-etching adhesives was opened (n = 10) . Results: (1) Increase of microleakage in S group was found with the time span after unsealing, and there was a statistical difference between the instant moment and 3 months after unsealing (P＜0. 05) . (2) There was no significant difference at the 4 test time points in X group (P＞0. 05), although the microleakage value of the samples were increased with the increase of the time after unsealing. (3) The microleakage of X group was greater than that of S group at the instant moment and 1 month after unsealing (P＜0. 05) . Conclusion: Unsealing time may increase the microleakage of the adhesive interface between the tooth and the filling material, the effect varies with the types of the adhesives.

Paediatric nodal marginal zone lymphoma: a clinicopathological study of seven cases / 中华病理学杂志

Objective@#To investigate the pathological features and clinical manifestation of pediatric nodal marginal zone lymphoma(NMZL).@*Methods@#Histological morphology and immunophenotype of 7 cases of pediatric NMZL were retrospectively reviewed at Beijing Friendship Hospital Affiliated to Medical University between January 2008 to October 2018. Clonal rearrangement analysis was performed. Clinical information including patient follow-up data were analyzed.@*Results@#All 7 patients were male with a median age of 15 years aged from 10 to 26 years. All patients presented with only lymph node enlargement without B symptoms, including cervical lymph node (5 cases), preauricular lymph node (1 case) and retroauricular lymph node (1 case). Histologically, all cases showed irregular large follicles on the edges with widened marginal areas and intervesicular areas, and lesional cells were uniform with progressive transformation of germinal center centers along with a small amount of intrinsic lymphoid tissue. All 7 cases showed diffuse CD20 positivity both follicle and interfollicular region along with 30%-40% positivity in the interfollicular region (pathological region). Markers of other B-cell lymphomas werenot expressed. All 7 cases were positive for immunoglobulin(Ig) gene rearrangement. None of the patients showed no recurrence up on after follow-up for an average of 13 months.@*Conclusions@#Pediatric NMZL is a rare type of lymphoma that has a unique morphology and occurs almost exclusively in male children and young adults and often in head and neck lymph nodes. It has an excellent prognosis. Therefore, awareness of the disease with accurate diagnosis is important.

Professor 's thoughts and methods of penetration needling / 中国针灸

As a vital part of acupuncture and moxibustion,the theory of penetration needling obviously lags behind the practice. This article summarizes the thoughts andmethods of penetration needling by professor . Based on the three basic elements of penetrating acupuncture, including the acupoint, needle and manipulation, the academic origins, the application of penetrating acupuncture at present and the clinical cases are reviewed; the essential content and the extension meaning of needle penetration are summarized, which is based on the identification of the location, pathology and characteristics of disease, combined with the characteristics of acupoints and the tissue structure of the part, we quantify the intensity of stimulation, so as to provide featured reference clinical practice.

Clinicopathologic characteristics and prognositic indicators of tonsillar mantle cell lymphoma / 中华病理学杂志

Objective@#To investigate clinicopathological features and prognosis of tonsillar mantle cell lymphoma(TMCL).@*Methods@#Clinical data of 25 patients with TMCL at Beijing Friendship Hospital, Capital Medical University from 2002 to 2016 were included. All the cases were reviewed microscopically. Various immunohistochemical stains were performed using the MaxVision two-step method. IgH/CCND1 gene fusion was detected by fluorescent in situ hybridization(FISH). Additionally, randomly selected 40 cases of non-tonsil MCL of the same period were compared.@*Results@#Among all mantle cell lymphomas (MCL), TMCL accounted for 5.6%(25/449). The median age of the patients was 60 years(range: 44-82 years) with a M∶F ratio of 5.3 to 1.0. The main symptoms were sore throat and foreign body sensation and patients usually presented with enlargement or mass of tonsil. At the early stage of the disease, 18 cases(72.0%) were clinically misdiagnosed as tonsillitis. Lymph node involvement was present in 76.0%(19/25) of the patients. There were 4 cases(16.0%)with current splenic involvement, 11 cases(44.0%) with pharyngeal focal recidivism, and 3 cases(12.0%) with involvement of other non-lymphoid organs. Morphologically, tonsillar architectures were effaced at various degrees. Eighteen MCL cases showed classical type and 7 cases were blastoid variant. All tumors were positive for CD20 and cyclin D1. 92.0%(23/25) tumors showed weakly positive or positive expression for CD5. FISH test that IgH/CCND1 gene fusion was positive in two CD5 negative classical cases. 18 patients(72.0%) had a median follow-up time of 26 months(range: 6-81 months). The difference of survival rate between stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ patients was not statistically significant(P>0.05). Compared with NTMCL, TMCL was found to have higher proportion of stage Ⅰ-Ⅱ disease (χ2=12.789, P<0.01), lower the proportion of non-lymphatic organ involvement (χ2=8.125, P<0.01), and better prognosis (χ2=4.351, P=0.037).@*Conclusion@#The incidence of TMCL is low and prone to be misdiagnosed as tonsillitis. Patients with TMCL are more likely at stage Ⅰ-Ⅱ at presentation and the prognosis is better than that of NTMCL.

Clinicopathologic characteristics of Burkitt-like lymphoma with chromosome 11q aberration / 中华病理学杂志

Objective@#To analyze clinical, pathological, molecular and genetic characteristics of Burkitt-like lymphoma with chromosome 11q aberration.@*Methods@#A case of Burkitt-like lymphoma with 11q aberration was presented at Beijing Friendship Hospital in November 2016 with detailed clinicopathological features, immunophenotypes, Epstein-Barr virus(EBV) status and molecular genetic characteristics.@*Results@#The patient was a 38-year-old man presenting with the cervical lymphadenopathy. In morphology, the tumor had the similar characteristics of Burkitt lymphoma, including diffuse infiltration of medium to large lymphoid cells, and presence of"starry sky"phenomenon. Immunophenotypically, the tumor cells were positive for CD20, CD10, bcl-6, but negative for bcl-2. MUM-1 showed weak and patchy positivity. Ki-67 index was more than 95%. C-MYC expression was seen in about 50% of tumor cells. EBV in situ hybridization was negative. IgH and IgK genes were clonally rearranged.Fluorescence in situ hybrization detection using MYC break probe was negative but ATM gene amplification on chromosome 11q was detected. The patient did not receive any chemotherapy or radiotherapy and had not recurrence during the 10 months follow-up.@*Conclusion@#Burkitt-like lymphoma with chromosome 11q aberration has similar clinical, morphological and immunological characteristics to classic Burkitt′s lymphoma.

Cut-off value of Ki-67 labeling index in the pathologic grading of follicular lymphoma / 中华病理学杂志

Objective@#To determine the cut-off values of Ki-67 labeling index (LI) in the histological grading of follicular lymphoma (FL).@*Methods@#Clinicopathological data of 350 FL patients diagnosed at Beijing Friendship Hospital from June 2014 to January 2016 were analyzed retrospectively by quantitative evaluation and statistical analysis of Ki-67 LI.@*Results@#Of the 350 patients with FL, the male and female ratio was 1.1 and the average age was (50.2±14.0) years with a median age of 51 years (range 4 to 82 years). The tumors were graded as grade Ⅰ-Ⅱ in 215 cases (61.4%), grade Ⅲ A in 105 cases (30.0%), and grade Ⅲ B in 30 cases (8.6%). The average Ki-67 values were (22.8%±8.3%) for the FL low (grade Ⅰ-Ⅱ) and (50.4%±10.7%) for high grade (Ⅲ A and Ⅲ B) and were statistically significant by Mann Whitney U test (P<0.01). Receiver operated characteristic curve analysis showed that the best diagnostic cut-off value of low grade FL was 35% (sensitivity of 96.3% and specificity of 93.3%) with the largest area under curve (AUC=0.990, P<0.01, 95%CI for 0.982-0.998). According to the analysis of four lattice diagnostic tests, Ki-67 LI >40% was an important factor (χ2=230.733, P<0.01) in predicting high grade FL. When the cut-off value of Ki-67 LI was set at 40%, high grade LF could be diagnosed with the greatest sensitivity (98.1%) and specificity (87.7%). Moreover, a significant correlation between the Ki-67 LI and the pathological grade of FL (r=0.836, P<0.01) was observed.@*Conclusions@#Ki-67 LI of below a cut-off value of 35% is a reliable indicator of low grade FL.Ki-67 over 40% is consistent with high grade FL. These Ki-67 cut-off values may serveas an important auxiliary indicator in the grading of FL.

Clinicopathologic features and prognosis of gastrointestinal mantle cell lymphoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic features and prognosis of gastrointestinal mantle cell lymphoma (GI-MCL).@*Methods@#Clinical data of 38 GI-MCL patients diagnosed at Beijing Friendship Hospital from January 2002 to January 2016 were retrospectively reviewed morphologically and immunophenotypically. IgH/CCND1 gene fusion was assessed by fluorescent in situ hybridization (FISH). For comparison, 60 cases of non-GI-MCL were randomly selected to extract the differences inclinicopathological features and patient survival between the two groups.@*Results@#Of 38 patients with GI-MCL, the median age was 62 years (range: 35-78 years, 23 males and 15 females), of which patients of 60 years of age or older accounted for 55.3%. Patients with clinical course of less than 6 months accounted for 81.1%(30/37). The main symptoms included abdominal pain, diarrhea, anorexia and hematochezia. Those with B symptoms accounted for 32.4%(12/37). The tumor most often involved lleocecal region (57.9%, 22/38), followed by rectum (36.8%, 14/38) and sigmoid colon (28.9%, 11/37), and the stomach accounted for 18.4%(14/38). Endoscopic polypoid lesions were found in 33 cases (86.8%, 33/38), of which 22 cases (66.7%, 22/33) were multiple. Five cases (13.2%, 5/38) presented with local protuberant neoplasm. According to Ann Arbor staging, 3 cases (7.9%, 3/38) were at stage Ⅰ, 4 cases (10.5%, 4/38) were at stage Ⅱ, and 31 cases (81.6%, 31/38) were at stage Ⅳ. The number of patients with tumor involvement of abdominal and retroperitoneal lymph nodes accounted for 45.7%(16/35), including 41.7%(15/36) involving the superficial lymph node, 17.1%(6/35) involving extranodal sites, and 23.5%(8/34) having splenomegaly. All of the 38 cases were classic MCL, and the tumor was composed of uniform lymphoid cells and effacing normal mucosal structure. All tumors were positive for CD20 and CD5. 97.4% (37/38) tumors were positive for cyclin D1, and 92.0% (23/25) tumors were positive for SOX11. FISH test was positive in 1 case of cyclin D1 negative tumor. Twenty-eight patients (73.7%) had a median follow-up of 25.0 months (range: 3-79 months). The 3-year survival rate for stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ of patients were 80.0% and 69.1%, respectively (P> 0.05). The 3-year survival rate for GI-MCL and non-GI-MCL patients were 71.7% and 72.5%, respectively (P>0.05). Single factor analysis showed that age of >60 years and splenomegaly were correlated with a worse overall survival rate (P<0.05).@*Conclusions@#Gastrointestinal malaise is the most common presenting symptom in GI-MCL patients. GI-MCL more commonly involves colorectum with more frequent multiple polypoid lesions. Patients of age >60 years and with splenomegaly have poor prognosis. There is no difference in the prognosis between GI-MCL and non-GI-MCL patients.

Clinicopathologic features and prognosis of mantle cell lymphoma: an analysis of 349 cases / 中华病理学杂志

Objective@#To investigate clinicopathologic features and prognostic factors of mantle cell lymphoma(MCL).@*Methods@#The clinical data of 349 MCL patients diagnosed at Beijing Friendship Hospital from January 2004 to January 2016 were retrospectively collected. Corresponding histological sections were reviewed. Additional studies included immunohistochemical staining using the MaxVision two-step method, IgH/CCND1 fusion gene detection by fluorescent in situ hybridization (FISH), and correlative statistical analysis.@*Results@#Of 349 patients with MCL, the median patient age was 61 years (range: 25-83 years, M∶F=2.7∶1.0) and the age of 243 patients ranged from 51 to 70 years (69.6%). Those with B symptoms accounted for 22.4% (70/313). Most of the patients presented with superficial lymphadenopathy and the clinical stage Ⅲ-Ⅳ accounted for 76.1% (235/309). Extranodal involvement was seen in 47.9% (148/309), among which the gastrointestinal tract accounted for 31.8% (47/148) and splenic involvement accounted for 15.4% (47/305). Three hundred and nine (88.5%) cases were of classical type and 40 (11.5%) cases were of aggressive variant type, and all were composed of proliferating lymphoid cells. All the tumors were positive for CD20 and cyclin D1, and 98.6% (344/349) tumors were weakly positive or positive for CD5. FISH test was positive in 12 cases that were CD5 negative and with cyclin D1 partial expression.Two hundred and forty-three (69.6%) patients had a median follow-up of 26 months (range: 3-108 months). The 3- and 5-year overall survival rates for patients were 63.0% and 34.8%, respectively. Single factor analysis showed that age of >60 years, splenic involvement, aggressive variant type, incompletely overlapping type [Based on the degree of overlap ≥90% and <90% between the follicular dendritic cell (FDC) meshwork and tumor cells, the tumors were divided into the completely overlapped type and incompletely overlapped type] and Ki-67 index >40% had poor prognosis (P<0.05). Multiple factor Cox proportional risk regression analysis after removing the aggressive variant type showed that age, splenic involvement, the degree of overlap between the FDC meshwork and tumor cells and Ki-67 index were independent prognostic factors for overall survival rate of MCL patients (P<0.05).@*Conclusions@#MCL is more commonly found among middle-aged and elderly men. Patient age, splenic involvement, degree of overlap between FDC meshwork and tumor cells and Ki-67 index are the independent prognostic indicators for MCL.

EB virus-positive T/NK lymphoproliferative diseases: an analysis of 156 patients / 中华病理学杂志

Objective@#To investigate the clinicopathological features of EBV-positive T/NK cell lymphoproliferative diseases (EBV+ T/NK-LPD).@*Methods@#The clinical characteristics of 156 cases of EBV+ T/NK-LPD were collected from August 2002 to March 2015 at Beijing Friendship Hospital, Capital Medical University. Immunohistochemical staining, EBER in situ hybridization and clonal analysis of TCR gene were performed. All patients were followed up.@*Results@#There were 106 male and 50 female patients; patients′ age ranged from 1 to 75 years (median 20 years). The course of the diseases before diagnosis ranged from 2 to 540 months (median 20 months). Fever was noted in 122 patients (78.2%), 108 patients had lymphadenopathy (69.2%), and 75 patients had hepatosplenomegaly (48.1%). Thirty-three cases were grade 1, 68 cases were grade 2, and 55 cases were grade 3. TCR gene arrangement analysis was performed in 45 cases, and 33 cases (73.3%) showed clonal rearrangement. The follow-up period ranged from 1-134 months, and 44 patients (28.2%) died. There was a trend of increased death rate associated with increasing grade (P>0.05).@*Conclusions@#There are many types of EBV+ T/NK-LPD, and they can be classified as systemic, relatively localized and localized. The prognosis should be based on a comprehensive analysis of pathology and clinical data. There is no significant correlation between morphological grade and mortality. An important goal of therapy is to prevent serious complications.

The pathway regulation and targeted therapy of tumor stem cells regulatory and targeting therapy of tumor stem cell related signal pathway / 中国生化药物杂志

Cancer stem cells are thought to be the seed of tumor formation, through complex signalings and cytokines in the surrounding microenvironment regulate the development and metastasis of tumor.Tumor stem cells have the characteristics of self-renewal and differentiation, the intracellular signaling pathways regulating self-renewal and differentiation of cancer stem cell include Wnt, Hedgehog signaling pathway.The tumor microenvironment is the dimensional environment surrounding the tumor,including the extracellular matrix, surrounding blood capillary,stromal cells ( fibroblasts, mesenchymal stem cells, tumor-associated endothelial cells, inflammatory cells) and cytokines secreted by stromal cells.Cancer stem cells maintain a close communication with the cells in the tumor microenvironment.In this paper, the cell surface maker of cancer stem cell,cancer stem cells and regulation of cytokine in the microenvironment,intracellular signaling pathways of cancer stem cells are reviewed to show complex regulatory networks in the tumor microenvironment.This review should help providing a new direction on specific cancer therapy for cancer stem cells in cacer treatment.

Clinicopathologic characteristics and prognosis of neoplastic cell-rich mixed cellularity classic Hodgkin lymphoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic characteristics of neoplastic cell-rich mixed cellularity classical Hodgkin lymphoma(MCCHL-R) and to compare the prognosis with typical mixed cellularity classic Hodgkin lymphoma(MCCHL).@*Methods@#Fifty-four patients with MCCHL-R(the tumor cells >10%) and 65 patients with typical MCCHL identified from 1 721 Hodgkin lymphomas were reviewed to compare the clinicopathological characteristics including morphologic and immunophenotypic features, EBV infection status, clinical therapy and overall survival.@*Results@#The median age of the patients of MCCHL-R was 28.5 years(range: 9-76 years, male∶female=1.6∶1.0). Twenty-seven patients(50.0%) had B symptoms. Most patients had cervical lymph node involvement(81.5%, 44/54). Mediastinum and spleen involvement were seen in 69.2%(36/54) and 24.1%(13/54), respectively. Extranodal non-lymphoid organ involvement was seen in 41.3%(19/46) cases. Morphologically, lymph node architectures were effaced at various degree with large neoplastic cells of variable morphology, including Hodgkin/Reed-Sternberg(H/RS) cells and anaplastic large cells. There were abundant background heterogeneous admixtures of non-neoplastic inflammatory and accessory cells that were predominant mature small lymphocytes. All tumors were positive for CD30 and weakly positive for PAX5. Epstein-Barr encoded RNA(EBER)detectable by in situ hybridization was seen in 39.0% cases. Forty-six patients had a median follow-up time of 32.5 months(range: 5-128 months) and the 5-year survival rate for stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ patients were 91.7% and 50.1%, respectively(P<0.05). The 5-year survival rate for MCCHL-R was lower than typical MCCHL patients. Single factor analysis showed that age of >45 years, extranodal involvement and stage Ⅲ-Ⅳ were correlated with poorer 5-year survival rate(P<0.05). Multiple factors Cox proportional hazards regression showed that extranodal involvement was the independent prognostic factor(RR: 4.352, 95%CI: 1.122-16.879, P<0.05).@*Conclusions@#MCCHL-R is more common in young people. The tumor has pathological features of classic Hodgkin lymphoma enriched with the tumor cells(>10%) and similar immunophenotype to classical Hodgkin lymphoma. Compared with typical MCCHL, extranodal disease is an independent prognostic factor of MCCHL-R.

Indications and pregnancy outcomes of intrapartum cesarean section after the new partogram applied / 中华妇产科杂志

Objective To study the changes of intrapartum cesarean rate, cesarean indications and pregnancy outcomes after the new partogram applied. Methods Totally 3 290 pregnant women trying to vaginal delivery which were managed according to the new partogram in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from August to October in 2014 (new partogram group) were involved;2 987 pregnancy women trying to vaginal delivery from May to July in 2014 which were managed according to the old partogram (old partogram group) were involved as control. The intrapartum cesarean rate, cesarean indications and the pregnancy outcomes between the two groups were analyzed. Results The rate of intrapartum cesarean delivery was 8.50%(254/2 987) in old partogram group, and was significantly higher than that in new partogram group (6.2%, 204/3 290;P0.05), but the incidence of postpartum hemorrhage in new partogram group was higher than the old partogram group [6.9% (14/204) versus 1.6% (4/254), P<0.05]. Conclusion After the new partogram applied, the rate of intrapartum cesarean delivery is significantly decreased, but the incidence of postpartum hemorrhage is increased.

Effect of different hemostatic methods on ovarian function for patients undergoing laparoscopic ovarian endometriosis cyst enucleation / 中华内分泌外科杂志

Objective To explore the effect of different hemostatic methods on ovarian function in la-paroscopic ovarian endometriosis cyst enucleation. Methods 200 cases of stage I and II ovarian endometriosis cyst admitted to our hospital from Jan. 2012 to Apr. 2014 were selected. All patients underwent conventional la-paroscopic ovarian endometrial endometriosis cyst enucleation. According to intraoperative hemostasis methods, patients were divided into 3 groups: suture group (n=70), electric coagulation group (n=70), and ultrasonic scalpel group (n=60). Follicle-stimulating hormone (FSH) and antibody forming cells (AFC) on admission and at 1, 3, 6, and 12 months after surgery were recorded. Peak systolic blood flow of ovarian stromal artery (PSV) was also observed. Results FSH for all the three groups were improved compared with that on admission, and the difference had statistical significance (P0.05). however, AFC of the suture group at 3, 6, and 12 months after surgery was significantly im-proved compared with those of the the electric coagulation group and ultrasound knife group. The difference had statistical significance (P<0.05). Vaginal type B ultrasonic examination after operation showed that PSV of the su-ture group was higher than that of the electric coagulation group and ultrasound knife group at the second menstru-ation and at the 6-month menstruation after surgery. The difference of PSV between the 3 groups had statistical significance (P<0.05). Conclusion Compared electric coagulation hemostasis and ultrasonic scalpel hemostasis, the suture method can reduce damage of ovarian function in patients with ovarian endometriosis cyst, which is worth to promote.

Mechanism of L-Ca2+/calpain signal transduction in verapamil inversing resistance of papillary thyroid carcinoma to doxorubicin / 中国病理生理杂志

[ ABSTRACT] AIM:To investigate the mechanism of L-type calcium channel ( L-Ca2+)/calpain signal transduc-tion pathway in verapamil inversing resistance of papillary thyroid carcinoma to doxorubicin .METHODS:Human papillary thyroid carcinoma TPC-1 cells were cultured for 2 d.For determining the appropriate concentrations and treatment time of verapamil and doxorubicin , a compatibility test was conducted to detect the cell viability by CCK-8 assay.The cells were divided into control group , doxorubicin group , verapamil group and doxorubicin +verapamil group .The techniques of whole-cell patch-clamp was used to record L-Ca2+currents.The protein expression levels of calpain 1 and LC3 were detec-ted by Western blot .RESULTS: Compared with control group , the density of L-Ca2+current decreased in doxorubicin group and verapamil group (P<0.05).Compared with verapamil group , the density of L-Ca2+current decreased in doxo-rubicin+verapamil group (P<0.01).Compared with control group, the expression of calpain 1 decreased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of calpain 1 decreased in doxo-rubicin+verapamil group (P<0.05).Compared with control group , the expression of LC3 increased in doxorubicin group and verapamil group (P<0.05).Compared with doxorubicin group , the expression of LC3 increased in doxorubicin +ver-apamil group ( P<0.01) .CONCLUSION:The drug resistance of TPC-1 cells to doxorubicin may be related to the in-crease in autophagic activity .Verapamil further increases autophagic activity of TPC-1 cells, resulting in autophagic death and inversing the resistance of TPC-1 cells to doxorubicin .The mechanism may be involved in L-Ca2+/calpain 1 signal transduction pathway of autophagy .

CT and MRI findings of granulomatosis with polyangiitis of the nasal cavity and paranasal sinus / 实用放射学杂志

Objective To investigate the CT and MRI findings of granulomatosis with polyangiitis of the nasal cavity and paranasal sinus. Methods The CT and MRI features of eight patients of granulomatosis with polyangiitis in the nasal cavity and paranasal sinus confirmed by histo-pathology were analyzed retrospectively.CT scanning was performed in all eight patients.Routine MRI scanning was performed in seven patients.Dynamic contrast MRI was performed in three cases.SImax ,SIpeak ,Tpeak and MSI of the time-intensity Curves(TICs)were calculated.Results On CT scanning,bilateral middle turbinate,uncinate process and nasal septum were defected in 8 cases.Medial wall of bilateral maxillary sinus showed destruction and other walls of bilateral maxillary sinus showed sclerosis in 8 cases.The ethmoid labyrinth were involved in 6 cases in which the volume of maxillary sinus reduced.The collapse of nasal dorsum and flat nasal bone occured in 4 cases.Nasopharyngeal soft tissue was thicken in 2 cases.Theorbit was involved in 1 case.The mucosal thickness of all group of sinuses were showed in all 8 cases.On MRI scanning,peripheric mucosal of the lesions showed iso or long T1 and long T2 signal in 7 cases.Dynamic-enhanced MRI showed heterogeneous enhancement.TICs showed flat.But in one to four periods showed a slow rising gradient.SIpre was 1 030, SImax 2 500,SIpeak 2 353,Tpeak 100 s,and MSI 1.28%.Conclusion Granulomatosis with polyangiitis of the nasal cavity and paranasal sinus shows some typical CT and MRI features.To summarize the features is helpful to the diagnosis and therapy of the lesion.