Distribution characteristics of tumor infiltrating lymphocytes in EBV-associated lymphoepithelioma-like carcinoma and their clinical significance / 中华病理学杂志

Objective: To investigate the association between the distribution of tumor infiltrating lymphocytes (TIL) in EBV associated lymphoepitheliomatoid carcinoma (LELC) and the pathological subtypes of LELC, as well as the clinical significance of TIL distribution. Methods: The LELC patients with sufficient tumor tissues, complete clinical data and positive EBER, who visited Zhejiang Cancer Hospital, Hangzhou, China from January 2006 to October 2018, were selected. Various immunohistochemical markers (CD20, CD138, CD4, CD8, CD56 and FOXP3) were examined for TIL typing. Two pathologists reviewed the hematoxylin and eosin (HE) staining sections and interpreted the immunohistochemical results. Correlation analysis was used to evaluate the relationship between the distribution of TIL subgroups and LELC's pathological characteristics. Survival analyses were conducted to study the prognostic values of TIL subgrouping. Results: A total of 102 patients with EBV related LELC were included. 46 of them were classic LELC (c-LELC) with rich interstitial TIL, and 56 were non-classic LELC (n-LELC) with relatively fewer interstitial TIL. The results of TIL analysis showed that all subtypes of c-LELC were rich in TIL, with B lymphocytes as the dominant subgroup. The number of TIL in n-LELC was fewer than that in c-LELC, with T lymphocytes as the dominant subgroup. There was no significant difference in the distribution of plasma cells between the two groups. Survival analysis showed that the total number of TIL, and the infiltrations of CD20+B cells, CD4+T cells, and FOXP3+Treg cells were associated with better overall survivals (P=0.004, 0.003, 0.008 and 0.025, respectively) and disease-free survivals (P=0.011, 0.003, 0.038 and 0.041, respectively) in patients with LELC. Conclusions: The morphologic subtypes of EBV-related LELC have different tumor immune characteristics. The total number of TIL in the stroma of c-LELC is significantly higher than that of n-LELC. Interestingly, B lymphocytes are the dominant TIL in c-LELC, while T lymphocytes are the dominant TIL in n-LELC. The infiltration of TIL, CD20+B cells, CD4+T cells and FOXP3+Treg cells in LELC may suggest a better prognosis.

Roles of aryl hydrocarbon receptors in diesel exhaust inhalation-induced cardiopulmonary toxicities during initiation of pulmonary respiration in chicken / 环境与职业医学

Background Due to the limited availability of established research models, very few studies addressed the health effects and underlying mechanisms following exposure to diesel exhaust during the initiation of pulmonary respiration. It is highly demanded to elucidate such health effects and underlying mechanisms, so as to exert protective measures during the early stages of life. Objective To evaluate the health effects of diesel exhaust very-early-in-life inhalation in hatchling chicken with a novel chicken embryo air cell inhalation exposure model, and to explore the potential roles of aryl hydrocarbon receptor signaling pathways in the observed effects with a specific aryl hydrocarbon receptor inhibitor. Methods Fertilized chicken eggs were assigned into five groups randomly (15 eggs per group): control group, air control group, aryl hydrocarbon receptor inhibitor (PDM2) group, diesel exhaust group, and diesel exhaust + aryl hydrocarbon receptor inhibitor (PDM2) group. Fertilized eggs were incubated with standard procedure. At embryonic day 17 (ED17), aryl hydrocarbon receptor inhibitor was administered to the corresponding animals. During embryonic day 18-19 (ED18-19), chicken embryos were exposed to diesel exhaust via air cell inhalation, then placed back to incubator until hatch. The air control group received clean air infusion during ED18-19, while the control group did not receive any treatment. Within 24 h post-hatch, 26 hatchling chickens were anesthetized with sodium pentobarbital, subjected to electrocardiography, and sacrificed to harvest tissue samples of heart and lung. Cardiopulmonary toxicities were evaluated by histopathology, and potential changes in the protein expression levels of aryl hydrocarbon receptor pathway molecule cytochrome P450, family 1, subfamily A, polypeptide 1 (CYP1A1) and fibrosis-related pathway molecule phosphorylated SMAD family member 2 (pSMAD2) were assessed by Western blotting. The remaining 29 hatchling chickens were reared until two weeks old, and then subjected to identical treatments. Results The inhalation exposure to diesel exhaust at initiation of pulmonary respiration resulted in thickened right ventricular wall (by 220.3% relative to the control group, same hereafter) and elevated heart rate (17.4%) in one-day-old hatchling chickens. Although no remarkable fibrotic lesions were observed at this point, the expression levels of CYP1A1 and phosphorylation levels of SMAD2 in the lung tissues significantly increased (by 81.3% and 71.6%, respectively). Such changes were effectively abolished by the aryl hydrocarbon receptor inhibitor PDM2 pretreatment. In the two-week-old animals, the thickened right ventricular wall (by 339.3%) and elevated heart rate (by 18.9%) persisted, and significant fibrotic lesions were observed in the lung tissue samples under Masson staining. Again, the aryl hydrocarbon receptor inhibitor PDM2 pretreatment effectively abolished such changes. In addition, no statistically significant changes in CYP1A1 expression levels were observed in the two-week-old chicken lung samples, and a remarkable down-regulation of SMAD2 phosphorylation was observed. The aryl hydrocarbon receptor inhibitor PDM2 pretreatment independently decreased the phosphorylation levels of SMAD2 in the two-week-old chicken lung samples. Conclusion Inhalation exposure to diesel exhaust at initiation of pulmonary respiration could result in persistent cardiopulmonary injury in hatchling chickens, and the underlying mechanism might be associated with the regulation of pSMAD2 by the aryl hydrocarbon receptor signaling pathway.

Construction of clinical efficacy evaluation system based on optimal clinical experience / 中国中药杂志

Evidence-based medicine plays an important role in promoting the scientific nature of clinical decision-making. Howe-ver, there is a problem where evidence derived from clinical research may not necessarily be applicable to individual patients. Evidence-based medicine has been introduced into the field of traditional Chinese medicine(TCM) for over 20 years, and although certain achievements have been made, the overall level of clinical research evidence based on the principles of evidence-based medicine in TCM is not high. The acceptance of TCM diagnosis and treatment guidelines developed based on evidence-based medicine methods is generally low. As revealed by the analysis of the problems in the application of evidence-based medicine in the field of TCM, it is found that there is a structural contradiction between clinical randomized controlled trial(RCT) of TCM and the characteristics of TCM clinical practice. They cannot comprehensively, objectively, and truthfully reflect the clinical efficacy and safety of TCM. Conducting clinical RCTs of TCM in pursuit of "evidence" actually means giving up the advantages of TCM in clinical treatment based on syndrome differentiation, prescription changes along with syndromes, and treatment in accordance with three categories of disease cause, which leads to sacrificing some clinical effectiveness of TCM. Based on the concept of evidence-based medicine, this article proposed the construction of "clinical syndrome-based medicine" based on the optimal clinical experience, which was suitable for the characteristics of TCM clinical practice. The key to clinical syndrome-based medicine is the optimal clinical experience, and the core elements of the optimal clinical experience are regularity and reproducibility. Real-world research methods are recommended as a reference for obtaining the optimal clinical experience. Clinical syndrome-based medicine, combining the characteristics of TCM clinical practice and incorporating the concept of evidence-based medicine, is the product of integrating TCM into evidence-based medicine. It is dedicated to improving the clinical efficacy of TCM along with evidence-based medicine.

Quality requirements of human use experience research on traditional Chinese medicine / 中国中药杂志

The human use experience of traditional Chinese medicine(TCM) is of great significance for the development of new traditional Chinese medicine. In 2023, the National Medical Products Administration(NMPA) issued the Special Regulations on Registration Management of Traditional Chinese Medicine, which explicitly encouraged the conduct of high-quality human use experience research on TCM clinical practice to obtain sufficient evidence for registration support. It also required that human use experience research should comply with relevant requirements and undergo registration verification. The quality of human use experience research on TCM directly determines the reliability of the evidence. This article discussed the quality requirements for human use experience research on TCM from the perspectives of basic requirements, organizational management, key pharmaceutical information, scientific research, risk management, ethical compliance, and study implementation and proposed differential treatment in quality requirements and registration verification focus based on different research purposes, stages, and types of studies. While ensuring the authenticity of data, retrospective studies should pay particular attention to the integrity of the data, and prospective studies should focus on the normativity of the data, which may affect the research conclusions. Human use experience research, as part of drug registration materials, falls within the scope of relevant regulatory oversight. Researchers should have a strong awareness of regulations to avoid serious quality issues. The standardized conduct of human use experience research on TCM requires joint efforts from regulatory authorities, applicants, research institutions, and researchers to establish a research quality management system based on the clinical characteristics of TCM.

Characteristics and management of PCOS-related hyperandrogenism / 中国实用妇科与产科杂志

Hyperandrogenism is one of the major clinical characteristics of PCOS,which can be assessed either by biochemical determination of hyperan⁃drogenism or clinical manifestations of hyperan⁃drogenism to make diagnosis.Hyperandrogenism leads to ovulatory dysfunction and menstrual disorder by affecting follicular development,and causes hirsutism and acne as well;it is closely associated with the de⁃velopment of endometrial cancers,diabetes and car⁃diovascular diseases from the long-term perspective.Therefore,it is imperative to fully understand charac⁃teristics and management of PCOS-related hyperan⁃drogenism,which is an important part of the compre⁃hensive therapy for PCOS.

Influence of nifedipine combined metoprolol on blood pressure and heart rate in hypertensive patients with coronary heart disease / 心血管康复医学杂志

Objective:To study influence of nifedipine combined metoprolol sustained release tablets on blood pressure and heart rate in hypertensive patients with coronary heart disease (CHD).Methods:A total of 120 hypertensive patients with CHD were selected,randomly and equally divided into nifedipine group (n＝60,received nifedipine monotherapy) and combined treatment group (n＝60,received nifedipine combined metoprolol ),both groups were treated for 12 weeks.Blood pressure,heart rate and indexes of heart rate variability (HRV) were measured and compared between two groups.Results:Compared with before treatment,after treatment,there were significant reductions in 24h mean heart rate (24h HR AV) and mean arterial pressure (MAP),P＝0.001 both,and significant rise in standard deviation of normal to normal RR intervals calculated over the 24h period (SDNN),standard devia-tion of normal to normal RR intervals in all 5min segments of the entire recording (SDANN),root-mean square of differences between successive normal to normal intervals (rMSSD) and adjacent normal RR interval difference ＞50ms stroke accounted for a percentage of 24h total RR interval (PNN50) in two groups,P＜ 0.05 or ＜ 0.01.Compared with nifedipine group after treatment,there were significant reductions in 24hmHR [ (69.24 ± 10.67) beats/min vs.(64.08 ± 8.94) beats/min] and MAP [ (98.06 ± 5.18) mmHg vs.(92.64 ± 4.43) mmHg,P＜0.01 all],and significant rise in SDNN [ (113.89 ± 20.93) ms vs.(124.57 ± 25.34) ms,P＜0.05],SDANN [ (108.31 ± 20.26) ms vs.(119.29 ± 19.37) ms,P＝0.001],rMSSD [ (29.67 ± 11.92) ms vs.(36.23 ± 12.34) ms,P＝0.001] and PNN50 [ (11.25 ± 4.03)% vs.(15.37 ± 4.82)%,P＝0.001] in combined treatment group.There was no significant difference in total effective rate between two groups,P＝ 0.272.Conclusion:Nifedipine combined Metoprolol sustained release tablets possesses significant therapeutic effect on hypertensive patients with CHD.It can effectively control heart rate and blood pressure,and contribute to improving HRV and prognosis,which is worth extending.

Protective effect of amlodipine combined enalapril antihypertension on renal function in aged EH +CHD patients / 心血管康复医学杂志

Objective:To study influence of amlodipine combined enalapril antihypertensive therapy on renal function in aged patients with essential hypertension (EH) complicated coronary heart disease (CHD).Methods:A total of 120 aged EH + CHD patients in our hospital from Feb 2014 to Apr 2016 were enrolled.Patients were randomly and equally divided into amlodipine group,enalapril group and combined treatment group (received amlodipine com-bined enalapril treatment ),all groups were treated for 12 weeks.Total effective rate,standard-reaching condition of blood pressure,urinary albumin excretion rate (UAER),levels of serum creatinine (Scr),cystatin C (CysC) and blood urea nitrogen (BUN) before and after treatment,and incidence of adverse reactions were measured and com-pared among three groups.Results:There was no significant difference in total effective rate among three groups,P＝0.139.Compared with amlodipine group and enalapril group,there was significant reduction in standard-reaching time of blood pressure [ (10.84 ± 2.79) months vs.(10.75 ± 3.31) months vs.(8.20 ± 1.46) months] in com-bined treatment group,P＝0.001 all.Compared with before treatment,after 12-week treatment,there were sig-nificant reductions in UAER,levels of Scr,serum CysC and BUN in amlodipine group and combined treatment group,P＜0.05 or ＜ 0.01;compared with amlodipine group and enalapril group after 12-week treatment,there were significant reductions in UAER [(130.55 ± 12.72) μg/min vs.(135.63 ± 17.64) μg/min vs.(112.25 ± 13.34) μg/min],levels of Scr [ (79.32 ± 6.13) μmol/L vs.(80.25 ± 5.97) μmol/L vs.(68.04 ± 5.56) μmol/L],serum CysC [ (1.14 ± 0.23) mg/L vs.(1.21 ± 0.26) mg/L vs.(0.76 ± 0.17) mg/L] and BUN [ (5.16 ± 1.13) mmol/L vs.(5.79 ± 1.03) mmol/L vs.(4.23 ± 0.56) mmol/L] in combined treatment group,and BUN level of amlodip-ine group was significantly lower than that of enalapril group,P＜0.05 or ＜0.01.There was no significant differ-ence in incidence rate of adverse reactions during treatment among three groups,P＝0.757.Conclusion:Small dose amlodipine combined enalapril is effective on controlling blood pressure in aged EH + CHD patients.Compared with monotherapy,it possesses better protection on renal function with high safety,which is worth extending.

Clinicopathologic and molecular features of myoepithelial tumors of salivary glands / 中华病理学杂志

Objective@#To investigate the clinicopathological, and molecular characteristics of myoepithelial tumors (MTs) of salivary glands.@*Methods@#A total of 37 MTs cases including 13 malignant epithelial tumors (MMTs) and 24 benign epithelial tumors (BMTs) of salivary glands were identified from the archives of the Department of Pathology, General Hospital of Eastern Theater Command, dating from 2006 to 2016. Clinical features, histological patterns, immunohistochemical characteristics and status of EWSR1 gene rearrangement by fluorescence in situ hybridization (FISH) analysis were reviewed in all cases.@*Results@#Clinically, 37 MTs cases mainly occurred in the parotid glands, when most of the patients presented with painless masses. Of the 13 MMTs cases, male to female ratio was 7∶6, and the median age was 62 years old. Of the 24 BMTs cases, male to female ratio was 5∶7, and the median age was 54 years old. Immunohistochemically, 37 MTs cases were positive for CKpan, and at least one myoepithelial marker. Twenty six of 37 MTs cases were analyzable for the EWSR1 gene break by FISH. Based on the previous evaluation criterion, the EWSR1 translocation was detected in 4 cases of 11 MMTs, and 4 cases of 15 BMTs. According to the main histological composition of tumor cells, 4 EWSR1-positive MMTs covered 2 clear-cell cases and 2 epithelioid-cell cases, when 4 EWSR1-positive BMTs covered 2 clear-cell cases, 1 plasmacytoid-cell case, and 1 spindle-cell case.@*Conclusions@#Males and females are affected equally. MTs express immunoreactivity for CKpan, and at least one myoepithelial marker. The EWSR1 rearrangement is present in a subset of MTs, with variable morphological characteristics, and has no statistical significance on clinical behavior.

Progress on exosome and effect on regulatory T cells / 中国免疫学杂志

Regulatory T (Treg) cells is an indispensable subset of T lymphocyte with the ability of immunosuppression in the periphery.Thymus-derived Treg cells(CD4+CD25+FOXP3+Treg cells) play a fundamental role in maintaining immune homeostasis in vivo.Treg cells have been actively involved in the onset and development of major human diseases including malignant tumors, autoimmune diseases,infectious diseases,allergic diseases and graft versus host disease(GVHD).Exosomes are membranous vesicles of endosomal origin that released from multiple cells into the extracellular space.They are currently considered to be vehicles containing protein,RNA and MicroRNA which can been transferred to recipient cells to modulate their activity by cell-contact-independent mecha-nism.Exosomes have a great impact on the induction and proliferation of Treg cells,understanding the relation of them will lead to novel therapeutic approaches for cancer immunotherapy,treating autoimmunity,infection,allergy and organ transplantation.

A retrospective analysis of clinical characteristics and prognostic factors for primary breast diffuse large B cell lymphoma / 临床与实验病理学杂志

Purpose To study the clinical features, immunophenotypes and prognostic factors of primary breast diffuse large B-celllymphoma (PBDLBCL). Methods The clinical pathological data of 49 cases of PBDLBCL during January 2006 to December 2016 were retrospectively analysed, and the basic clinical and pathologic data, pathologic types and the immunohistochemical slides by EnVision method for staining were summarized. Results 47 cases were women and 2 cases were men. The age ranged from 24 to 79 year old with the median age of 48 year old. On microscopic observation, tumor cells were large to medium-sized which characterized as diffuse infiltration between the lobules of mammary gland, around the duct, interstitial and fat tissue, some were single file cord pattern. The immunophenotype showed 37 cases were of non-GCB, 12 cases were GCB type. Ki-67 index were greater than 40％. According to Ann Arbor staging, 16 cases were stage I EA, 28 cases were stage Ⅱ EA, 5 cases were stage Ⅳ E. IPI score: 30 cases with 0 ～1 score, 10 cases with 2 score, 9 cases with 3 score. Patients were followed up from 5 to 146 months, The 3-year overall survival (OS) rate was 51.2％ and 5-year OS rate was 36.7％, Single factor analysis showed that there were statistically significant difference in clinical stage, levels of LDH, IPI score, BCL-2 protein expression, and BCL-6 protein expression in 3 and 5 years of OS rate. The multiple factor analysis of Cox regression showed that the increase of IPI risk classification was the independent adverse prognostic factor of primary breast diffuse large B-cell lymphoma. Conclusion The diagnosis of PBDLBCL is confirmed by pathological biopsy and immunohistochemical markers. The immunophenotype was mainly non-GCB type. Comprehensive treatment including surgery, chemotherapy and radiotherapy is appropriate. The prognosis should be comprehensively evaluated by multiple factors. IPI increase risk classification is the independent adverse prognostic factor.

Clinicopathologic features of mammary analogue secretory carcinoma of salivary glands / 中华病理学杂志

Objective@#To investigate the clinicopathological features of mammary analogue secretory carcinoma (MASC) of salivary glands, and its diagnosis, differential diagnosis, immunohistochemistry and molecular pathology.@*Methods@#Seventeen cases of MASC were enrolled, with 9 cases of salivary acinar cell carcinoma and 18 cases of adenoid cystic carcinoma as control groups from Nanjing General Hospital from 1997 to 2014 were included in this retrospective study, combined with immunohistochemistry and molecular detection of ETV6-NTRK3 gene fusion. All cases were histologically reviewed with immunohistochemical staining (EnVision) for S-100 protein, SOX10, GATA3, CD117 expression in each group. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 gene fusion.@*Results@#The age of MASC patients ranged from 27 to 74 years with mean age of 47 and ratio of male and female was 4∶3. All cases showed infiltrative growth and diverse cytology and histology, including lobular (8 cases), cystic papillary (3 cases), cribriform mixed with papillary and glandular structures (6 cases) at various proportions. Some tumors of MASC also exhibited solid growth areas with occasional microcystic honeycombed pattern composed of small cysts merged into larger cysts resembling thyroid follicles. S-100 protein and SOX10 were strongly positive in all MASC cases (17/17). In addition, there was insignificant positivity for GATA3 (3/17) and CD117 (4/17). ETV6 gene fusion detection was informative in 12 MASC cases by FISH with 10 positive cases and 2 negative cases.@*Conclusions@#Combined immunohistochemical positivity of S-100 protein, CD117 and SOX10 are useful in the diagnosis and differential diagnosis of MASC. FISH detection of ETV6-NTRK3 fusion offers an additional molecular diagnostic marker for the diagnosis.

Occupational, educational and residential factors are associated with the outcomes of in vitro fertilization-embryo transfer / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the associations of occupational, educational and residential factors with the outcomes of in vitro fertilization -embryo transfer (IVF-ET).</p><p><b>METHODS</b>A retrospective analysis was conducted among 3998 patients undergoing the first treatment with IVF-ET and 3064 perinatal infants in our center between January, 2010 and June, 2014. The relation of the patients' occupation, educational background, and residence registry with IVF-ET outcomes was analyzed.</p><p><b>RESULTS</b>The risk of abortion in the first trimester was significantly higher in female patients engaged in agriculture (OR=4.319, P=0.047). Occupation and educational background of the patients and their spouse were related with the incidence of ectopic pregnancy following IVF-ET. The total incidence rate of perinatal birth defects was 2.1% in this cohort, and was the highest in Shenzhen (5.5%) but this difference was not statistically significant (P>0.05).</p><p><b>CONCLUSION</b>The patients' occupation and educational background are related with the outcomes of IVF-ET, suggesting the importance of health education and prenatal examination.</p>

Ovarian response and pregnancy outcome in hyper-responders during repeated in vitro fertilization and embryo transfer / 南方医科大学学报

<p><b>OBJECTIVE</b>To evaluate the ovarian response and pregnancy outcomes in patients with excessive ovarian response receiving long-protocol pituitary down-regulation during repeated in vitro fertilization and embryo transfer (IVF-ET).</p><p><b>METHODS</b>Sixty IVF-ET cycles from January 2008 to December 2011 were analyzed retrospectively. The clinical characteristics were compared between the various treatment cycles.</p><p><b>RESULTS</b>Compared with those with the first treatment cycle, the patients receiving repeated cycles had a significantly older age (P<0.001), reduced initial doses of Gn (P=0.049), and moderately lowered estrogen level on the day of hCG administration (E₂) (P=0.027) and the number of oocytes retrieved (P=0.030). The high-quality embryo formation rate (P<0.001) and clinical pregnancy rate (P=0.009) were both significantly higher in patients with repeated cycles. The dose for down-regulation, total Gn dose, duration of Gn stimulation, number of two pronuclei (PN), number of fertilized oocyte, and the cancellation rate for a high risk of ovarian hyperstimulation syndrome (OHSS) were all comparable between the two groups (P>0.05). The recurrence rate of ovarian excessive respond was 40% (12/30).</p><p><b>CONCLUSIONS</b>For patients receiving repeated IVF treatment cycle with a high ovarian response, a smaller initial dose of Gn should be used to minimize the risk of hyper-response and improve the outcome of assisted reproductive treatment.</p>

Clinicopathological features and prognostic analysis of esophageal sarcomatoid carcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the clinicopathological characteristics and prognosis of a rare histological type of esophageal cancer-sarcomatoid carcinoma.</p><p><b>METHODS</b>Clinicopathological data of 31 patients with esophageal sarcomatoid carcinoma who underwent surgery in the Department of Thoracic Surgery of Zhejiang Cancer Hospital from Jan 2000 to Dec 2009 were collected and analyzed. The survival analysis was performed using Kaplan-Meier method.</p><p><b>RESULTS</b>All the patients underwent surgery. Of the 31 patients, one received preoperative chemoradiotherapy and postoperative chemotherapy, and 8 received postoperative chemotherapy. All the tumors were located in the middle or lower esophagus. Microscopically, the tumors were composed of both carcinomatous and sarcomatous components, and there was a transition between the two components, but no obvious heterogenous elements such as osteosarcoma, chondrosarcoma or rhabdomyosarcoma were found. In the carcinomatous components, positive expression of CK and EMA was found in all the 31 cases, and positive expression of vimentin in 5 of the 31 cases. In the sarcomatous components, positive expression of CK, EMA and vimentin was found in 29, 28 and 23 cases, respectively. The 1-, 3-, and 5-year survival rates were 80.6%, 55.9% and 33.4%, respectively, and the median survival time was 40 months.</p><p><b>CONCLUSIONS</b>Esophageal sarcomatoid carcinoma is a particular type of esophageal malignancy with unique clinicopathological features. The diversity and complexity of the carcinomatous and sarcomatous components and their potential of transformation and differentiation lead to different prognosis from each other.</p>

Value of serum estradiol concentration in predicting the clinical outcome of IVF-ET in patients receiving long protocol of GnRHa / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the value of serum estradiol increment and serum estradiol/follicles on the day of hCG administration in predicting the clinical outcomes of in vitro fertilization-embryo transfer (IVF-ET).</p><p><b>METHODS</b>A retrospective analysis of the IVF-ET data was conducted involving 121 patients who received a long gonadotrophin-releasing hormone agonist (GnRHa) protocol. According to the increment of serum estradiol on the day of hCG administration (relative to the level on the day before hCG administration), the patients were divided into 3 groups (A1, A2 and A3) with a increment ratio below 30%, between 30% and 50%, and over 50%, respectively. In addition, according to the ratio of serum estradiol level on hCG day to mature follicle (diameter ≥ 14 mm) number, these patients were divided into three groups (B1, B2 and B3) with the ratio below 250 pg/ml, between 250 and 350 gp/ml, and over 350 pg/ml, respectively. The hormonal characteristics and clinical outcomes of the IVF-ET cycles were analyzed comparatively.</p><p><b>RESULTS</b>Both the clinical pregnancy rate (71.05%) and embryo implantation rate (52.63%) were significantly higher in group A3 than in groups A1 and A2 (P<0.05). The best clinical pregnancy rate (67.86%) and embryo implantation rate (49.14%) were significantly higher in group B2 than in groups B1 and B3 (P<0.05).</p><p><b>CONCLUSION</b>The variation of serum estradiol shows an important impact on the clinical outcomes of IVF-ET in patients receiving long GnRH-a protocol. Favorable outcomes can be expected with a hCG day serum estradiol increment ratio above 50% and E(2)/follicle ratio between 250 and 350 pg/ml.</p>

Analysis of the clinical outcomes of 160 patients undergoing repeated IVF/ICSI-ET treatment / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the clinical factors affecting the outcomes of repeated assisted reproductive technology (ART) cycles.</p><p><b>METHODS</b>A retrospective analysis of the clinical data and outcomes was conducted among 160 patients undergoing repeated IVF/ICSI-ET treatment between January 2006 and April 2009.</p><p><b>RESULTS</b>The patients with successful clinical pregnancy after two ART cycles (group A) had a younger age and shorter duration of infertility, and had more antral follicles (AFC), more eggs and good-quality embryos with more transferred embryos available and higher good-quality embryo rate (P<0.05) than those who failed to have pregnancy after the cycles (group B). In the second cycle, the patients in group A had higher doses of short-acting GnRHa, r-HCG and HMG and at the same time more good eggs and embryos than in the first cycle.</p><p><b>CONCLUSIONS</b>Female age is one of the most important factors affecting the pregnancy rate after repeated ART cycles. The clinical pregnancy rate can be enhanced by administering short-acting GnRHa, HMG, oral contraceptives and adjusting the dose of Gn as well as changing the culture medium of embryos.</p>

Clinical observation on the effect of Zengse Pill in treating patients with vitiligo of qi-stagnancy and blood-stasis syndrome type / 中国结合医学杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy of Zengse Pill ( ZSP) on patients with vitiligo of qi-stagnancy and blood-stasis syndrome type (V-QB), and to preliminarily explore its mechanism of action.</p><p><b>METHODS</b>Sixty-five V-QB patients, with their diagnosis confirmed by clinical examination, were randomized by digital table method into two groups, with 31 patients in the control group and 34 in the treatment group. Cobamamide (2 tablets) was administered orally to all patients, and Psoralea tincture (a self-formulated preparation) was applied externally thrice a day. In addition, for patients in the treatment group, ZSP was given orally, at 5 pills per dose, 3 times every day. The therapeutic course for both groups was 3 months. Patients were re-examined every half-month, and changes in the skin lesions were observed and recorded. The levels of lymphocyte subsets, serum immune globulin, and complement C3 and C4 in patients were determined before and after the therapeutic course and compared with the corresponding indexes determined in 21 healthy subjects.</p><p><b>RESULTS</b>The total effective rate in the treatment group was 82.4%, which was markedly higher than that in the control group (54.8%), showing a significant difference (P<0.05). After treatment, CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and blood levels of C3 and C4 increased, while CD(8) (+) percentage decreased in the treatment group (P<0.05 or P<0.01). All these indexes remained unchanged in the control group, and the respective comparisons between groups showed significant differences (P<0.01).</p><p><b>CONCLUSION</b>ZSP has a definite clinical effect on the treatment of V-QB but with no evident adverse reactions, and it can increase the CD(4) (+) percentage, CD(4) (+)/CD(8) (+) ratio, and the levels of serum C3 and C4, thus regulating the immunity of the organism, which might be one of its mechanisms of action.</p>

A clinicopathologic analysis of 42 cases with sarcomatoid carcinoma of the lung / 肿瘤研究与临床

Objective To study the clinicopathologic characteristics of sarcomatoid carcinoma of the lung.Methods Clinicopathologic characteristics and immunohistochemical results of 42 cases with sarcoma- toid carcinoma of the lung were analyzed.Results Forty-two cases were pathologically proved to be spindle cell carcinoma,1 cases;giant cell carcinoma,1 case;carcinosarcoma,4 cases;pleomorphic carcinoma,36 cases.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was positive in 24 of 24 cases,EMA was positive in 18 of 20 cases,Vim was positive in 25 of 25 cases.Eighteen cases were survival One-year survival rate was 61.2 %,with mean survival 13.3 months. Conclusion Diagnosis of sarcomatoid carcinoma of the lung depends on pathologic and immunohistochemical results.

Clinicopathological and related gene analysis in gastric adenocarcinoma and their correlation with prognosis / 肿瘤研究与临床

Scm in volume(42/60),multiple site involvement(44/60),blood type"O"(31/41),in comparison with those of survival group,and the difference was statistically significant.C-erbB-2,p16,p53,P-gp,CD_(44) and CD_(25)expression were not significantly different in these two groups. Conclusion The clinical stage, lymph node metastasis,lymphatic tumor emboli and/or neural involvement,infiltration depth,histological dif- ferentiation,tumor volume,involvement extension are important prognostic factors in patients with gastric can- cer,while the significance of cancer-related gene expression in gastric carcinomas needs to be studied further.

Clinicopathological and immunohistochemical analysis of gastrointestinal, urinary and perineal stromal tumors / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the histogenesis and pathological characteristics of gastrointestinal stromal tumors (GIST) and GIST type stromal tumor (ST) beyond the gastrointestinal tract.</p><p><b>METHODS</b>A retrospective study was carried out on leiomyoma, leiomyosarcoma and neurilemoma (46 cases in gastrointestinal tract and l3 cases in urinary tract and perineal area). 4 antibodies (CD117, CD34, SMA, S-100) were used for immunohistochemical staining.</p><p><b>RESULTS</b>Among 45 cases of GIST, the positive rate of CD117 and CD34 was 93.3% and 88.9% respectively. Among 12 cases of GIST type ST beyond the gastrointestinal tract, the positive rate of CD117 and CD34 was 83.3% and 75.0% respectively. In 2 cases (1 in gastrointestinal tract) of leiomyomas, both CD117 and CD 34 were negative in tumor cells, while SMA was extensively positive.</p><p><b>CONCLUSIONS</b>CD117 and CD34 positivity are the most valuable factors in diagnosing ST. Both GIST and GIST type ST beyond the gastrointestinal tract are considered originating from a proto-interstitial stem cell with disoriented differentiation.</p>