Next-generation diagnostic pathology / 中华病理学杂志

With the technological progresses and applications of human genome sequencing, bioinformatics analysis and data mining, and molecular pathology and artificial intelligence-assisted pathological diagnosis, the development of clinical medicine is moving towards the era of precision diagnosis and treatment. In the context of this era, the traditional diagnostic pathology is facing unprecedented opportunities and challenges in our history and is striving towards the "next-generation diagnostic pathology" (NGDP). NGDP is based on histomorphology and clinical data, and characterized by the combination of molecular detection and bioinformatics analysis, intelligent sampling and process quality control, intelligent diagnosis and remote consultation, lesion visualization and "non-invasive" pathology as well as other innovative cutting edge interdisciplinary technologies. The NGDP reports will include the results from multi-omics and cross-scale integrated diagnosis for final diagnosis. NGDP will also be applied for predicting disease progression and outcomes, and determining optional therapeutics as well as assessing treatment responses, so that a novel "golden standard" of disease diagnosis can be established. In the near fature, it is necessary to stimulate the innovative vitality of pathology disciplines, accelerate the maturity and application for NGDP, update the theory and technical system of pathology, and perform its important applicable role in the prevention, diagnosis, treatment of diseases so that the futher development of clinical medicine will be promoted and the strategy for maintenance of being healthy in China will be served.

Effect of performance appraisal through third party survey on improving the compliance of hand hygiene among health care workers / 中国感染控制杂志

Objective To understand the actual implementation of hand hygiene(HH)of health care workers(HCWs), and provide evidence for improving HH management.Methods HH performance appraisal began to implement in a hospital in 2016, at the same time, third party(healthcare-associated infection management professionals in other hospitals)was invited to carry out 4 times of anonymous survey on HH among HCWs in the hospital, change in HH compliance rate among HCWs was compared.Results HH compliance of HCWs surveyed by the third party was 60.68％, HH rates in the first half and second half year were 52.72％and 68.62％respectively, difference was statistically significant(P＜0.001).Compliance rate of HH in key departments(intensive care unit and neonatal department, 87.44％)was higher than surgical departments(64.71％)and internal medicine departments(53.74％), difference was statistically significant(both P＜0.05).HH compliance rates of HCWs before and after contact with patients and after contact with the surrounding environment of patients were all low(53.59％, 58.07％, 43.97％, respectively).Conclusion HH surveyed by the third party can effectively reduce the Hawthorne effect during the observation process.HH performance appraisal can significantly improve the compliance of HH among HCWs.

Detection of chromosomal translocations involving ALK gene in anaplastic large cell lymphoma by fluorescence in-situ hybridization and its clinical significance / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate clinicopathologic features and clinical value of the chromosomal translocation involving anaplastic lymphoma kinase (ALK) in anaplastic large cell lymphoma (ALCL) by fluorescence in situ hybridization (FISH).</p><p><b>METHODS</b>A total of 55 cases, including 45 cases of ALCL and 10 reactive lymphoid hyperplasia, were collected during 1999 to 2006 in the Department of Pathology, Fudan University Shanghai Cancer Center, and Xinhua Hospital Affiliated to Shanghai Jiaotong University. All cases were studied by FISH using dual color break apart probes of ALK for detection of chromosomal translocation, compared with the previous results of immunohistochemistry (IHC) and reverse-transcriptase polymerase chain reaction (RT-PCR) for the detection of ALK aberrations.</p><p><b>RESULTS</b>The result of FISH showed that the clear red and green fluorescence signals were detected in 38 cases of ALCL, in which conspicuous split signals were observed in tumor cells in 24 cases (63.2%), suggesting the rearrangement of the ALK locus, with multiple copies of ALK gene in one case. In addition, the rearrangement of the ALK locus was not identified in 14 of 38 cases (36.8%); and the FISH results were unable to be evaluated in 7 cases, because no fluorescent signals involving ALK gene were found or signals were too weak to be analyzed. The concordance for the detection ALK aberrations in ALCL between FISH and RT-PCR, FISH and IHC were both statistically significant (P < 0.01). Chromosomal translocation involving ALK gene was not found in all 10 cases of reactive lymphoid hyperplasia.</p><p><b>CONCLUSIONS</b>ALCL is an entity of lymphoma characterized by special clinical presentation, morphology, and ALK aberrations. FISH is helpful for detection of the chromosomal translocations involving ALK in ALCL, however, the detection efficiency by FISH may be affected by storage time of the paraffin-embedded tissue; and therefore combined detection with IHC and RT-PCR could complement each other and help for differential diagnosis of ALK(+)ALCL from ALK(-)ALCL.</p>

Rhabdomyosarcoma of the breast: a clinicopathologic study and review of the literature / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Rhabdomyosarcoma (RMS) is an uncommon malignancy of the breast. The aim of this study was to summarize its clinicopathologic features and biological behavior.</p><p><b>METHODS</b>Five primary or secondary breast RMSs were collected. Their clinicopathological characteristics and all published literature about breast RMS were reviewed. Immunohistochemical study of desmin, myogenic differentiation 1 (MyoD1), myogenin, leukocyte common antigen (LCA), vimentin, cytokeratin (AE1/AE3), E-cadherin, neuron specific enolase (NSE), CD99, chorioallantoic membrane 5.2 (CAM5.2) and epithelial membrane antigen (EMA) expression were performed.</p><p><b>RESULTS</b>The five patients were all female with ages ranging from 16 to 46 years old (mean, 30 years). Three were metastatic breast RMSs, two embryonal and one solid variant alveolar, with the primary tumor sites the right labium majus, left nasal meatus and nasopharynx, respectively. The other two, one embryonal and one alveolar, were primaries. Grossly, the surgical specimens revealed round or oval, well-demarcated but nonencapsulated masses. Their cut surfaces consisted of homogeneous grayish yellow or white tissue. Microscopically, most tumor cells were poorly differentiated small round, oval or small polygons with eosinophilic cytoplasm. All cases were positive for vimentin, desmin, MyoD1 and myogenin. One embryonal RMS also had a few cells with perinuclear staining of AE1/AE3. The other markers were negative.</p><p><b>CONCLUSIONS</b>Although primary or metastatic RMS in breast was almost confined to young adolescent females, our cases suggested that it can also happen to the middle-aged women. Embryonal RMS has a certain metastatic potential. MyoD1 and myogenin are two useful markers when making differential diagnosis. Axillary lymph node status and age may play a role in the prognosis of primary breast RMS patients.</p>

Contribution of cancer stem cells to tumor vasculogenic mimicry

Vasculogenic mimicry (VM), a newly-defined pattern of tumor blood supply, provides a special passage without endothelial cells and is conspicuously different from angiogenesis and vasculogenesis. The biological features of the tumor cells that form VM remain unknown. Cancer stem cells (CSCs) are believed to be tumor-initiating cells, capable of self-renewal and multipotent differentiation, which resemble normal stem cells in phenotype and function. Recently CSCs have been shown to contribute to VM formation as well as angiogenesis. These findings challenge the previous understanding of the cellular basis of VM formation. In this review, we present evidence for participation of CSCs in VM formation. We also discuss the potential mechanisms and possible interaction of CSCs with various elements in tumor microenvironment niche. Based on the importance of VM in tumor progression, it constitutes a novel therapeutic target for cancer.

Activation of CXCR4 in human glioma stem cells promotes tumor angiogenesis / 中华病理学杂志

<p><b>OBJECTIVE</b>To isolate, culture and identify glioma stem cells from human malignant glioma cell line U87, and investigate the changes of pro-angiogenic factors production by glioma stem cells followed by activation of CXCR4 and observe their tumorigenesis as well as the expression of vascular endothelial growth factor when implanted into nude mice.</p><p><b>METHODS</b>The ratio of CD133 positive cells was detected by flow cytometry. Magnetic separation of CD133 positive cells was carried out on the magnetic cell sorting system (MACS). Expression of nestin, glial fibrillary acidic protein (GFAP) and CXCR4 on tumorspheres was detected by indirect immunofluorescence under confocal laser scanning microscopy. The functional activation of CXCR4 was assessed by calcium mobilization experiments. ELISA was used to detect the production of vascular endothelial growth factor (VEGF) and interleukin-8 (IL-8) in conditioned medium. Glioma stem cells were implanted into nude mice to assess their tumorigenesis ability and the expression of VEGF.</p><p><b>RESULTS</b>The ratio of CD133 positive cells with stem cell property was 0.5% in U87 cells. Activation of CXCR4 on glioma stem cells induced calcium mobilization and increased VEGF and IL-8 protein secretion. CD133 positive cells secreted more VEGF and IL-8 than their negative counterparts in vitro. Tumors derived from CD133 positive cells grew more rapidly and expressed elevated level of VEGF than their negative counterparts.</p><p><b>CONCLUSIONS</b>There are a small fraction of glioma stem cells in human glioblastoma cell line U87. Expressing functional CXCR4 and secreting more pro-angiogenic factors may be involved in tumor angiogenesis mediated by glioma stem cells.</p>

Effect of nordy on FPR function of malignant human glioma cell line U87 / 药学学报

Nordy is a synthesized chrial compound. To investigate the effects of nordy (25 - 100 micromol x L(-1)) on the function of formylpeptide receptor (FPR) of malignant human glioma cells, human glioblastoma cell line U87 was used to detect its proliferation, migration, calcium mobilization, vascular endothelial growth factor (VEGF) mRNA and protein levels after activation of FPR by its agonist N-formyl-methionyl-leucyl-phenylalanine (fMLF). Cell proliferation, migration ability, VEGF mRNA, VEGF protein and calcium mobilization were evaluated by cell counting, chemotaxis assay, RT-PCR, ELISA and spectrometry. Nordy (50 - 100 micromol x L(-1)) potently inhibited the proliferation, migration and calcium mobilization of U87 cells induced by fMLF (P < 0.05). Moreover, 100 micromol x L(-1) nordy showed a significantly impaired VEGF mRNA expression and protein secretion induced by fMLF (P < 0.05). Nordy could inhibit FPR functioning in glioma cell proliferation, migration and angiogenesis, which might be a possible mechanism of its anti-cancer effects.

Relationship between expression of syndecan-1 and prognosis in pancreatic cancer / 上海第二医科大学学报

Objective To explore the relationship between the expression of syndecan-1 and the prognosis in pancreatic cancer. Methods The data of 30 patients with pancreatic cancer who received radical operations were retrospectively analysed.Immunohistochemical staining was performed,and the expression of syndecan-1 in tumor epithelial cells and stroma was observed by light microscopy.The relationship between immunohistochemical findings and survival was analysed.Results For those with negative,weak positive,moderate positive and strong positive expression of synecan-1 in tumor epithelial cells and stroma,there were significant differences in the case numbers between those survived for 1 to 2 years and those survived for 2 to 4 years(P

Expression of N-myc downstream regulated gene 1 in breast invasive duct carcinoma and its relationship with tumor metastasis and invasive potential / 上海第二医科大学学报

Objective To study the correlation of expression of N-myc downstream regulated gene 1(NDRG1) with invasion of breast invasive duct carcinoma and lymph node metastasis. Methods A total of 71 specimens including 26 case of primary breast invasive duct carcinoma with lymphnode metastasis,45 case of nonmetastasis breast invasive duct carcinoma were observed.NDRG1 was detected by immunohistochemistry in formalin-fixed and paraffin-embedded sections.At the same time,the correlations of NDRG1 with E-cad,MMP2,MMP9,and TIMP2 were investigated. Results The expression of NDRG1 in breast cancer with metastasis of lymph nodes(9/26) was lower than that of non-metastasis of lymph nodes(32/45)(P

Case Report and Review of Literature of Child Subcutaneous Panniculitis-Like T-Cell Lymphoma / 实用儿科临床杂志

Objective To analyze the clinical and histopathologic characteristics in children with subcutaneous panniculitis-like T-cell lymphoma(SPTCL),and explore the pathological diagnosis and differential diagnosis,in order to boost paediatricians to better understanding the disease.Methods One case was diagnosed SPTCL with over 2 years protracted course of fever and multiple skin lesions.The evolvement of clinical presentation,the misdiagnosed experience,the histopathological features,the immunohistochemical results and T cell receptor(TCR)gene cloning rearrangement were observed.The related literatures published were reviewed.Results Skin biopsy showed that the histopathologic findings were limited within subcutaneous fatty tissue,the atypical lymphocytes characteristically rimmed individual fat cells in a lace-like pattern.Immunophenotypic studies showed CD45,CD45RO,CD3,CD5,T cell intracellular antigen-1(TIA-1)and perforin usually expressed possitive,while CD10,CD20,CD56,CD68,epithelial membrane antigen(EMA)and cytokeratin(CK)were negative,implying tumor cells derived from T-cell.The results of TCR gene rearrangement as following:IgH FR2(+),FR3A(-);TCR ? JVI(-),JVII(+);TCR? JD1(-),JD2(-).Although the protocol of children's T-cell Non-Hodgkin lymphoma was administrated,the treatment outcome was poor.Conclusion SPTCL is a special primary cutaneous lymphoma with poor prognosis,skin biopsy of suffered lesion is an important method for the diagnosis of SPTCL children with unclear recurrent fever and multiple skin lesions.

Auricular acupuncture combined with iodine salt for treatment of juvenile endemic goitre / 中国针灸

<p><b>OBJECTIVE</b>To observe clinical therapeutic effect of auricular acupuncture combined with iodine salt on juvenile endemic goitre, and regulative action on thyroid hormones.</p><p><b>METHODS</b>Seventy-five cases of juvenile endemic goitre were randomly divided into a treatment group treated with auricular acupuncture combined with iodine salt, and a control group treated with iodine salt alone. The changes of T3, T4 and TSH contents were observed in the two groups.</p><p><b>RESULTS</b>After treatment, serum T3 increased and TSH decreased in the treatment group as compared with the control group (P < 0.05).</p><p><b>CONCLUSION</b>Auricular acupuncture combined with iodine salt can promote reduction of endemic goitre or elimination, and effectively regulate synthesis and metabolism of thyroid hormones.</p>

Changes in electrophysiological and morphological properties of neuron in the ventral partition of medial geniculate body during the postnatal development of rats / 生理学报

We investigated the electrophysiological and morphological characteristics of the neurons in the ventral partition of medial geniculate body (MGBv) in the rat during postnatal development (postnatal day 3-30, P3-30) with whole-cell patch clamp recording and intracellular labeling technique. The results are as follows: (1) There was an increase in the negativity of the resting membrane potential, a decrease in the input resistance and the time constant of the MGBv neurons of rats during the postnatal development; the amplitude, threshold and duration of the action potentials were also different on different postnatal days; (2) During the postnatal development, the changes in voltage-dependent ion channels dramatically influenced the waveform of action potential in the MGBv neurons. Application of 4-AP, a K(+)-channel blocker, reduced the amplitude and prolonged the durations of the action potentials in P6 neurons, and inactivated the neurons at the end of the pulse in P16 rats. Application of CdCl2 to block the voltage-dependent Ca(2+)-channel decreased the amplitude and increased the duration of the action potential in P16 rats; (3) Biocytin staining revealed that immature MGBv cell had smaller somata and short, simple dendritic aborization. During postnatal development, the matured neurons had oval somata and 3-4 primary dendrities that radiated irregularly and projected outside the section; spines also appeared on the dendrites of the mature neurons. These results reveal that the morphologic and electrophysiological properties are not matured during early postnatal development, and that the electrophysiological and morphological features of the developing MGBv neurons are interrelated.