Cytopathological characterization of ascites for the diagnosis of serous ovarian carcinoma / 中华肿瘤杂志

Objective: To investigate the cytomorphological and immunocytochemical features of tumor cells in the ascites of ovarian plasmacytoma (SOC). Methods: Specimens of serous cavity effusions were collected from 61 tumor patients admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University from January 2015 to July 2021, including ascites from 32 SOC, 10 gastrointestinal adenocarcinomas, 5 pancreatic ductal adenocarcinomas, 6 lung adenocarcinomas, 4 benign mesothelial hyperplasia and 1 malignant mesothelioma patients, pleural effusions from 2 malignant mesothelioma patients and pericardial effusion from 1 malignant mesothelioma. Serous cavity effusion samples of all patients were collected, conventional smears were made through centrifugation, and cell paraffin blocks were made through centrifugation of remaining effusion samples. Conventional HE staining and immunocytochemical staining were applied to observe and summarize cytomorphological characteristics and immunocytochemical characteristics. The levels of serum tumor markers carbohydrate antigen 125 (CA125), carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) were detected. Results: Of the 32 SOC patients, 5 had low-grade serous ovarian carcinoma (LGSOC) and 27 had high-grade serous ovarian carcinoma (HGSOC). 29 (90.6%) SOC patients had elevated serum CA125, but the difference was not statistically significant between them and patients with non-ovarian primary lesions included in the study (P>0.05); The serum CEA was positive in 9 patients with gastrointestinal adenocarcinoma and 5 patients with lung adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.001); The serum CA19-9 was positive in 5 patients with gastrointestinal adenocarcinoma and 5 patients with pancreatic ductal adenocarcinoma, and the positive rate was higher than that in SOC patients (P<0.05). The serum CA125, CEA and CA19-9 were within the normal range in 4 patients with benign mesothelial hyperplasia. LGSOC tumor cells were less heterogeneous and aggregated into small clusters or papillary pattern, and psammoma bodies could be observed in some LGSOC cases. The background cells were fewer and lymphocytes were predominant; the papillary structure was more obvious after making cell wax blocks. HGSOC tumor cells were highly heterogeneous, with significantly enlarged nuclei and varying sizes, which could be more than 3-fold different, and nucleoli and nuclear schizophrenia could be observed in some cases; tumor cells were mostly clustered into nested clusters, papillae and prune shapes; there were more background cells, mainly histiocytes. Immunocytochemical staining showed that AE1/AE3, CK7, PAX-8, CA125, and WT1 were diffusely positively expressed in 32 SOC cases. P53 was focally positive in all 5 LGSOCs, diffusely positive in 23 HGSOCs, and negative in the other 4 HGSOCs. Most of adenocarcinomas of the gastrointestinal tract and lung had a history of surgery, and tumor cells of pancreatic ductal adenocarcinoma tend to form small cell nests. Immunocytochemistry can assist in the differential diagnosis of mesothelial-derived lesions with characteristic "open window" phenomenon. Conclusion: Combining the clinical manifestations of the patient, the morphological characteristics of the cells in the smear and cell block of the ascites can provide important clues for the diagnosis of SOC, and the immunocytochemical tests can further improve the accuracy of the diagnosis.

WU Lian-zhong's experience in treating spasmodic torticollis by Kaiqiao Shunjin method / 中国针灸

Professor WU Lian-zhong's experience in treating spasmodic torticollis by Kaiqiao Shunjin method (resuscitation and regulating muscle) is summarized in this paper. The pathogenesis of spasmodic torticollis is the occluded brain orifices and delirium, qi disorder of meridian tendons, specifically divided into five categories: damp-heat, liver-yang hyperactivity, liver-kidney yin deficiency, deficiency of the governor vessel, excess of the governor vessel. The treatment should be based on the symptoms and the root causes, the symptoms should be the main treatment, and the root cause should be treated based on syndrome differentiation. The main treatment is Kaiqiao Shunjin method (resuscitation and regulating muscle), and to take the chief (five heart acupoints-Shuigou [GV 26], Laogong [PC 8], Yongquan [KI 1]), deputy (Yintang [GV 24+], Shangxing [GV 23] through Baihui [GV 20], Ximen [PC 4]), assistant (Fenglong [ST 40], Lianquan [CV 23], combined with tongue needle prick), envoy (Hanyan [GB 4]) as the basic main acupoints, at the same time cooperate with local acupoints to remove knots and accumulation. Finally, syndrome differentiation is adopted to dredge meridians and disperse knots, regulate the governor vessel, and nourish yin and dispel wind.

The epidemiology of bloodstream infections in Fuxing Hospital in 2012 in Beijing / 中华内科杂志

Objective To investigate the etiology,clinical features and outcome of hospitalized patients with bloodstream infections (BSIs) in a tertiary hospital.Methods Positive blood cultures were obtained from the microbiological laboratory in Fuxing Hospital,Capital Medical University from January 1,2012 to December 31,2012.BSIS events were identified and the epidemiology data were collected.Results A total of 149 patients and 154 BSIs events were confirmed by pathogenic and clinical evidence.The inpatients' BSIs rate was 0.8％ in our hospital in 2012.According to the disease entities of the first BSIs onset,15 patients (10.1％) were from surgical departments,83 patients (55.7％) from the medical departments,and 51 patients (34.2％) from ICU.Thirty-three patients (22.1％) were diagnosed as septic shock.Sixty-eight patients died during hospital stay.The in-hospital mortality rate was 45.6％.Among the 154 BSIs events,125 (81.2％) were nosocomial and 29 (18.8％) were community-acquired.A total of 188 strains were isolated from all BSIs,including 106 strains of (56.4％) gram-negative bacilli,67 (35.6％) strains of gram-positive bacteria,and 15 (8.0％) strains of fungi.One hundred and fifty-nine strains of bacteria (84.6％) were isolated from 125 events of hospital-acquired BSIs.Twenty-six strains of bacteria were from catheter related bloodstream infections (CRBSIs).In gram-negative BSIs,there were more enterobacteriaceae in community-acquired BSIs.More non-fermentative bacteria were found in hospitalacquired BSIs than in community-acquired ones.The distribution of gram-negative bacilli was quite different between surgical departments,non-surgical departments and ICU (P =0.049).Conclusions Pathogens of BSIs are quite different according to disease entities and where the patients are from.Local epidemiology of BSIs and distribution of related pathogens are helpful to physicians searching the optimal empirical antibiotics and improving the outcome.

pharmacodynamic simulation to evaluate tigecycline in treatment of nosocomial pneumonia caused by multidrug-resistant Acinetobacter baumannii

The shortage of effective antibiotics against multidrug-resistant Acinetobacter baumannii [MDR-Ab] has posed great threat to the public health. But the advent of tigecycline gives us new hope. The goal of our research was to assess the clinical efficacy of tigecycline at different doses by using a pharmacokinetic/pharmacodynamic [PK/PD] model which can incorporate pharmacokinetic data of tigecycline from patients with pneumonia and MICs of MDR-Ab from a tertiary hospital. A 10000-patient Monte-Carlo Simulation based on the PK/PD model was conducted to calculate the probability of target attainment [PTA] and the cumulative fraction of response [CFR] of tigecycline. 97% isolates displayed susceptibility and 3% were tigecycline-intermediate strains and the values of MIC ranged from 0.125 to 4microg/ml. A CFR of 61.62% was predicted for tigecycline at current dosage [50 mg q12h]. When the dosage was increased, the predicted CFRs for 75 mg q12h, 100 mg q12h, 125 mg q12h, 150 mg q12h were 81.00%, 89.86%, and 94.57%, 96.77%, respectively. Despite presented higher susceptibility, the CFR obtained was not optimal at current dosage. A higher CFR indicating a better clinical efficacy can be gained by the increased dosage.

ASPP2 gene silence promotes hepatocellular carcinoma cell proliferation via regulating autophagy under starvation / 第二军医大学学报

Objective To study the effects of apoptosis-stimulating protein of ρ53-2 (ASPP2) gene on hepatocellular carcinoma (HCC) cell proliferation and apoptosis under starvation and the related mechanism. Methods Lentivirus encoding shRNA against ASPP2 was constructedto knockdown ASPP2 expression in hepatoma cell HepG2. Cell proliferation and apoptosis were observed by transmission electron microscopy, MTS analysis, flow cytometry analysis and morphologic changes. The influence of silencing ASPP2 gene on the proliferation and apoptosis under amino acid-starvation and serum-deprivation culture was observed; autophagy inhibitor 3-methyladenine (3-MA) was added in the experiment so as to detect the involvement of autophagy in the changes induced by ASPP2 down-regulation. Results Transmission electron microscopy showed cytoplasmic accumulation of autophagosomes when ASPP2 was knocked down under amino acid-starvation and serum- deprivation (P<0. 05), with increased GFP-LC3 dots (P<0. 05). MTS analysis showed that silence of ASPP2 gene greatly enhanced the proliferation of HepG2 cells (P<0. 05), which could be inhibited by addition of 3-MA (P<0. 05). Microscope observation showed that silence of ASPP2 gene promoted the anti-apoptotic ability of HepG2 cells, which was reversed by treatment with 3-MA. Early sign of apoptosis was observed in shASPP2 + 3-MA group. Annexin V_PI double staining showed that ASPP2 silence decreased the apoptotic rate ofHepG2 cells from (38±5)% to(15±4)% (P<0. 05), and 3-MA treatment increased it to (36 ±3)% (P<0. 05). Conclusion Down-regulation of ASPP2 expression may facilitate the survival and proliferation of HCC cells through activating autophagy under starvation.

Iron-depletion prevents biofilm formation in Pseudomonas aeruginosa through twitching motility and quorum sensing

Influence of iron-depletion on twitching motility and quorum sensing (QS) system in P. aeruginosa was evaluated. The results demonstrated iron-depletion can retard biofilm formation and increase the twitching motility and expression of QS-related genes, suggesting a potential interaction between twitching motility and QS system in P. aeruginosa biofilm formation.

Pathologic and immunohistochemical study on lethal primary brain stem injury / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the histopathologic changes of primary brain stem injury and to investigate their significance in the diagnosis of primary brain stem injury.</p><p><b>METHODS</b>Sixty-five autopsy cases died of primary brain stem injury and other diseases were enrolled into this study. The cases were subdivided into brain stem injury group (n = 25) and control group (including 20 cases died of cardiovascular disease and 20 cases died of non-cardiovascular diseases). The brain stem tissue sections were stained with hematoxylin-eosin and silver impregnation techniques. Immunohisto chemical study for glial fibrillary acidic protein, neurofilament, amyloid-beta and myelin basic protein was carried out. The widest cross diameters of 10 axons highlighted by immunostaining were measured in each low power field (x 100) through light miscroscopy in all the cases studied.</p><p><b>RESULTS</b>In comparing with that of the control group, there were differences in the degree of contusion lesion, reactive astrocytosis, edema and pathologic changes of neuronal cells present in the brain stem injury group and was statistically significant (P < 0.05). The axons locating in the brain stem injury group showed a distinctive histology by the appearance of significantly larger diameters (P < 0.05).</p><p><b>CONCLUSIONS</b>Primary brain stem injury demonstrates certain distinctive histopathologic changes and measurement of axonal diameters provides an additional quantitative index useful in autopsy diagnosis.</p>

Expression of P504S,CK34?E12,p63 and PSA immunohistochemistry in pathological diagnosis of prostatic adenoearcinoma / 中华泌尿外科杂志

Objective To investigate the utility of P504S(?-methylacyl-COA racemase), CK34?E12,p63 and PSA immunohistochemistry in the pathological diagnosis of prostatic adenocarcinoma (PAC).Methods The specimens of 46 cases of PAC,8 cases of prostatic high-grade intraepithelial neo- plasia (HGP1N) and 35 cases of benign prostatic hyperplasia (BPH) tissues were immunohistochemically stained with P504S,CK3413E12,p63 and PSA antibody,respectively.Results Of the 46 PAC cases,42 (91.3%) cases showed positive for P504S,including 25 cases (54.3%) who showed strongly and diffusely positive (+++) for cytoplasmic staining.In 7 (87.5%) of the 8 HGPIN cases,the specimens were also positive for P504S,and only 1(2.9%)of the 35 BPH cases showed focally weakly positive (+) for P504S.All the 8 HGPIN cases (100%) and 33 (94.3%) of the 35 BPH cases showed positive for CK34?E12 and p63,while all the 46 PAC cases showed negative for CK34?E12 and p63.In 44 (95.7%) of the 46 PAC cases,the specimens were positive staining for PSA.Conclusions P504S has high sensitivity and good specificity in the diagnosis of PAC.P504S staining in combination with HE,CK34?E12,p63 and PSA staining can improve the accurate diagnosis of PAC.