Practical research of diversified laboratory open training to improve clinical skills of medical students / 中华医学教育探索杂志

Objective:To improve the clinical skills of medical students, and explore the implementation plan and effect of diversified laboratory open training.Methods:A total of 808 undergraduate students of clinical medicine in Batch 2015 were selected for diversified laboratory open training in the 5th, 6th and 7th semesters. Multiple reservation methods were adopted including: personal independent network reservation, written reservation, "registered" network reservation; diversified open model: students practice independently, "workshop" special operation training, team make-up lessons; diversified practice modules: basic skills, specialist skills, and comprehensive skills. The results of the questionnaire survey on the two stages of students' diversified laboratory open training and the end of the internship were analyzed; and the Batch 2015 and Batch 2014 graduation skills test scores were compared. SPSS 20.0 software was used for t-test. Results:After the opening of the diversified laboratory: 92.61% (664/717) of the students were satisfied with the open model; 93.58% (671/717) of the students were satisfied with the reservation method; 94.42% (677/717) of the students thought that it could promote learning motivation; 97.35% (698/717) of the students thought that it could stimulate learning interest; 96.51% (692/717) of the students thought that it could help knowledge and skills grasp. After the internship and the return to the school, the questionnaire showed that 98.02% (741/756) of the students thought it could improve clinical skills; 92.33% (698/756) of the students thought it could cultivate clinical thinking; 95.63% (723/756) of the students thought it could enhance self-confidence in the internship; 94.18% (712/756) of the students thought it could increase a sense of professional belonging. The students' graduation skills (90.33±5.59) and single skill exam scores of Batch 2015 were better than Batch 2014 (82.22±7.19), with a statistically significant difference ( P<0.001). Conclusion:The opening of diversified laboratory could stimulate the interest and motivation of learning, help to improve clinical skills and clinical thinking, and enhance confidence in internship and sense of professional belonging.

Expression and regulation of keratin 6B in CD44+ bladder cancer stem cells / 中国组织工程研究

BACKGROUND: Bladder cancer stem cells could promote the recurrence and drug resistance of bladder cancer. Numerous studies have shown that keratin 6B (KRT6B) is involved in the production and progression of tumors, and is closely related to the prognosis of tumors. OBJECTIVE: To observe the expression of keratin 6B in CD44+ bladder cancer stem cells and to show the influence of keratin 6B on proliferation, migration, and self-renewal of bladder cancer stem cells, and to further explore the effect of keratin 6B expression on the prognosis of bladder cancer patients. METHODS: (1) CD44+ 5637 bladder cancer stem cells were isolated by magnetic active cell sorting. Cancer stem cell-related gene expression of SOX2, OCT4, and NANOG was detected via real-time polymerase chain reaction. The spheroid formation assay was used to detect the ability of self-renewal of cancer stem cells in CD44+ cells. Keratin 6B expression was detected in CD44+ bladder cancer stem cells by real-time polymerase chain reaction. (2) The CD44+5637 bladder cancer stem cells were divided into two groups. In the keratin 6B siRNA group, keratin 6B small interfering RNA was transfected into CD44+ bladder cancer stem cells. Untransfected CD44+ bladder cancer stem cells were used as the black control group. Cells were collected at 2 days post-transfection. The proliferation, migration, and self-renewal capacity of keratin 6B siRNA CD44+ bladder cancer stem cells were detected by the colony and wound healing assay and spheroid formation respectively. (3) Totally 24 bladder cancer tissues were used by immunohistochemistry to analyze the expression of CD44v6 and keratin 6B. (4) ONCOMINE database was used to analyze the effect of keratin 6B expression on the overall survival of bladder cancer. RESULTS AND CONCLUSION: (1) Cancer stem cell-related genes (SOX2, OCT4, NANOG) and keratin 6B expression was higher in CD44+ cells isolated by magnetic active cell sorting compared with CD44- cells (P < 0.05). Cell proliferation, migration, and in vitro spheroid formation were significantly increased (P < 0.05). Keratin 6B small interfering RNA down-regulated the expression of keratin 6B in CD44+ bladder cancer stem cells (P < 0.05). (2) Compared with the blank control group, the proliferation and migration of CD44+ bladder cancer stem cells after transfection of keratin 6B small interfering RNA (P < 0.05), and the number of tumorsphere significantly diminished (P < 0.05); the expression of Notch1 and Hes1 mRNA increased (P < 0.05). (3) Keratin 6B and CD44v6 were significantly different in bladder cancer tissue (P=0.006). The overall survival rate of bladder cancer patients with high expression of keratin 6B was lower than that of patients with low expression of keratin 6B. (4) The results showed that keratin 6B was highly expressed in CD44+ bladder cancer stem cells, and could promote the proliferation, migration, and self-renewal capacity of bladder cancer stem cells. The high expression of keratin 6B contributes to improving the survival of bladder cancer patients.

Predictive effect of minute ventilation/carbon dioxide production slope on heart failure after acute myocardial infarction / 中国医师杂志

Objective:To evaluate the independent prognostic value of minute ventilation/carbon dioxide production slope (VE/Vco 2 slope)on heart failure after acute myocardial infarction. Methods:131 patients with acute myocardial infarction (AMI) treated in the cardiology department of China-Japan Friendship Hospital from September 2018 to September 2019 were collected and followed up 3 months after discharge. They were divided into heart failure (HF) group and non-heart failure (NHF) group. All the patients underwent cardiopulmonary exercise test (CPET) before discharge.Results:Three months after discharge, the VE/Vco 2 slope was higher in HF group than in NHF group (36.7±3.8 vs 29.7±4.0, P=0.014). The best VE/Vco 2 slope cutoff for the prediction of heart failure after 3 month was 33.05 with a sensitivity of 81.4% and a specificity of 80.6% [area under curve (AUC) was 0.844, P<0.001]. VE /Vco 2 slope level was an independent predictor of heart failure in patients with acute myocardial infarction after discharge ( OR=1.245, 95% CI: 1.021-1.366, P=0.019). Other independent indicators related to heart failure included N-terminal pro-B type natriuretic peptid (NT-proBNP) level ( OR=1.283, 95% CI: 1.019-1.399, P=0.033). Conclusions:VE/Vco 2 slope yielded strong, independent predictive value for heart failure at 3 month after discharge to AMI patients.

Establishment of a platelet production model by bone marrow cavity transplantation of mouse primary megakaryocytes / 中华血液学杂志

Objective: To establish an intramedullary transplantation model of primary megakaryocytes to evaluate the platelet-producing capacity of megakaryocytes and explore the underlying regulatory mechanisms. Methods: Donor megakaryocytes from GFP-transgenic mice bone marrow were enriched by magnetic beads. The platelet-producing model was established by intramedullary injection to recipient mice that underwent half-lethal dose irradiation 1 week in advance. Donor-derived megakaryocytes and platelets were detected by immunofluorescence staining and flow cytometry. Results: The proportion of megakaryocytes in the enriched sample for transplantation was 40 to 50 times higher than that in conventional bone marrow. After intramedullary transplantation, donor-derived megakaryocytes successfully implanted in the medullary cavity of the recipient and produce platelets, which showed similar expression of surface markers and morphology to recipient-derived platelets. Conclusion: We successfully established an in vivo platelet-producing model of primary megakaryocytes using magnetic-bead enrichment and intramedullary injection, which objectively reflects the platelet-producing capacity of megakaryocytes in the bone marrow.

Total serum IgE in people immunized with human diploid cell rabies vaccines with different production processes / 中华微生物学和免疫学杂志

Objective:To investigate the effects of different production processes on sensitization responses to human diploid cell rabies vaccines.Methods:This study randomly collected 360 serum samples in clinical trials of four rabies vaccines with different production processes. Total IgE levels at different time points were detected by ELISA. SPSS19.0 software was used for statistical analysis.Results:Total IgE test results showed that the seropositive rate was 20% (6/30) for all four vaccines. The lowest mean value of total IgE was 9 IU/ml and the highest was 210 IU/ml. Repeated measures analysis of variance showed that there was no significant difference in total IgE levels at different sampling time points ( P=0.284), and the total IgE level in people injected with multistep concentrated human diploid cell rabies vaccine was significantly below that in people immunized with Vero cell rabies vaccine ( P=0.024). Conclusions:Increasing the immune dosage of human rabies vaccine could not result in a rise in total IgE. Human diploid cell rabies vaccines had good safety as the production process could remove most of allergenic impurities.

Impact of empagliflozin on peak oxygen uptake in HFmrEF patients: a randomized controlled trial / 中华心血管病杂志

Objective: To evaluate the impact of empagliflozin on peak oxygen uptake (VO2peak) in patients with heart failure with mildly reduced ejection fraction (HFmrEF). Methods: In this randomized controlled trial, consecutive HFmrEF patients admitted to the Department of Cardiology of China-Japan Friendship Hospital from September 2019 to October 2020 were screened, and randomly assigned to empagliflozin group (EG) or conventional group (CG) using a random number table. The enrolled patients were treated according to the guidelines, and patients in the empagliflozin group received additional empagliflozin (10 mg, once a day, orally) on top of the conventional treatment. The primary end points were VO2peak at 6 months after treatment, and the secondary end points included other parameters of cardiopulmonary exercise test (CPET), 6-minute walking distance, N-terminal B-type pro-natriuretic peptide (NT-proBNP) level, and Kansas City Cardiomyopathy Questionnaire (KCCQ) score. Results: A total of 112 patients were included (mean age 69 (57, 78) years, 84 male (75.0%)). There were 55 cases in CG group and 57 cases in EG group. There were no significant differences in baseline data including age, sex, body mass index, left ventricular ejection fraction, systolic blood pressure, heart rate, estimated glomerular filtration rate, glycosylated hemoglobin, hemoglobin, NT-proBNP, daily dose of tolasemi, combined medication, CPET parameters, the proportion of New York Heart Association heart function Ⅲ/Ⅳ, history of coronary heart disease, history of hypertension, history of diabetes (all P>0.05). At 6 months after treatment, VO2peak was significantly higher in EG group than in CG group(P=0.023). VE/VCO2 slope was significantly lower in EG group than in CG group(P=0.034). Oxygen uptake efficiency slope was significantly higher in EG group than in CG group(P=0.038). The level of NT-proBNP was significantly lower in EG group than in CG group(P=0.020). Six-minute walking distance was significantly higher in EG group than in CG group(P=0.037). KCCQ score was significantly higher in EG group than in CG group(P=0.048). Exercise oscillatory ventilation decreased in both groups (1 case in each group, P>0.05). Conclusion: Empagliflozin can significantly improve VO2peak in patients with HFmrEF.

Current status of digestive endoscopy diagnosis and treatment in Shanghai / 中华消化内镜杂志

To investigate the current status of digestive endoscopy diagnosis and treatment in Shanghai, and to provide decision-making support for the revision of the diagnostic and treatment standards and quality control criteria of digestive endoscopy in Shanghai. A total of 145 hospitals providing digestive endoscopy service were investigated through an online survey. The main survey contents were the situation of digestive endoscopists, the development of diagnosis and treatment technology, and the quality and safety situation. There were 1 212 digestive endoscopists in Shanghai, accounting for 1.59% of China which ranked first in all registered practioners in 2019. The annual diagnostic and treatment procedures of digestive endoscopy was 1 902.6 thousand, and endoscopists' working pressure was relatively high. In terms of quality control indicator of a single disease, detection rates of early gastrointestinal cancers and adenomas remained at a high level. The number of digestive endoscopists, endoscopic procedures and quality control indicators of a single disease in Shanghai was in a leading position in China in 2019.

Ligand fishing: a strategy for rapidly screening bioactive compounds from organism extracts / 药学学报

Natural products are valuable resources for discovering new drugs. So far, screening bioactive compounds from organism extracts is still an important and challenging task. Traditional biometric guided method involves repeated fractionation steps and bioactivity tests, which are time-consuming, labor-consuming, and inefficient. Ligand fishing is a bioanalysis method for screening ligands from complex organism extracts based on intermolecular affinity interactions. It has the characteristics of strong specificity, high efficiency, and less requirement for sample pretreatment. In this review, we summarize the classification of ligand fishing strategy and its application in enzyme inhibitors screening. Finally, the development prospects of this technology are forecasted.

Isorhapontigenin protects against doxorubicin-induced cardiotoxicity

As an effective anticancer drug, the clinical limitation of doxorubicin (Dox) is the time- and dose-dependent cardiotoxicity. Yes-associated protein 1 (YAP1) interacts with transcription factor TEA domain 1 (TEAD1) and plays an important role in cell proliferation and survival. However, the role of YAP1 in Dox-induced cardiomyopathy has not been reported. In this study, the expression of YAP1 was reduced in clinical human failing hearts with dilated cardiomyopathy and Dox-induced

Application of "post competence"-oriented mixed teaching in teaching of pediatric clinical skills / 中华医学教育探索杂志

Objective:To explore the application effect of the of multiple teaching methods in the teaching of pediatric clinical skills under the guidance of "post competence".Methods:Thirty students of Pediatrics grade 2016 were selected as the experimental group in Hubei Medical University, and they were taught through multiple teaching methods, including PBL, CBL, simulation teaching, virtual simulation teaching, and TBL. Thirty-one students of Pediatrics grade 2015 were collected as the control group, who were taught with traditional teaching mode. The scores of pediatric skills examination and questionnaire survey during school and clinical internship were compared between the two groups. SPSS 20.0 was used to perform the t test and chi-square test.Results:The experimental group scores were higher than those of the control group during school ( P<0.05). The questionnaire survey showed that the experimental group was superior to the control group in terms of satisfaction with teaching results, mastery of skill operations, improvement of learning interest and self-learning ability ( P<0.05). Examination scores of after-department skills in the experimental group was higher than that in the control group in pediatric clinical practice stage ( P<0.05), and the clinical teachers' evaluation of clinical thinking, doctor-patient communication, teamwork, professional quality, and work adaptability of the experimental group were higher than those of the control group ( P<0.05). Conclusion:"Post competence" orientated multiple teaching methods were applied to the teaching of pediatric clinical skills, which can stimulate medical students' interest in learning, improve their self-learning ability, contribute to their mastery of pediatric clinical skills and the improvement of post competence, and it can be promoted and applied in the teaching of pediatric clinical skills.

Effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Model / 中国实用护理杂志

Objective@#To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode.@*Methods@#From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention.@*Results@#The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were(30.35±2.58), (33.59±2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95±2.42), (29.10±2.12) points in control group. The difference was significant (t = 3.702, 13.494, P < 0.01).@*Conclusion@#Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.

Application of flipped classroom model in theory teaching of urology / 中华医学教育探索杂志

Objective To investigate the effect of flipped classroom model in the theory teaching of urology,and to provide a reference for promoting teaching methods.Methods The clinical medicine classes 1 and 2 of 2014 in the five-year undergraduate program,with 120 students in each class,were enrolled,with class 1 as teaching reform class and class 2 as traditional teaching class.The flipped classroom model was applied in class 1,and the traditional teaching method was applied in class 2.Tests and questionnaires were used at the end of the class to evaluate teaching effect.All the data were analyzed by Graphpad Prism 6.1,t test and Chi-square test were used for stabistical analysis.Results There were significant differences between the teaching reform class and the traditional teaching class in the mean score of chapter test [(80.78± 9.02) vs.(75.03 ± 7.98),P ＜0.05] and the mean score of comprehensive quality [(82.09 ± 8.89) vs.(76.34 ± 6.45),P＜0.05].The questionnaire survey showed an overall degree of satisfaction of 98.5％ among students;81.67％ of all students actively participated in learning,91.67％ were willing to participate in the teaching with flipped classroom model,75.84％ thought this model improved learning enthusiasm,65％ thought it improved the ability of self-study,73.33％ thought it improved their understanding of the learning content,and 84.17％ thought it strengthened the communication between teachers and students.Conclusion The flipped classroom model has a better effect than the traditional teaching model in the theory teaching of urology and is easily accepted by students.Therefore,it holds promise for clinical application.

Effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Model / 中国实用护理杂志

Objective To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode. Methods From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention. Results The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were (30.35 ± 2.58), (33.59 ± 2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95 ± 2.42), (29.10 ± 2.12) points in control group. The difference was significant (t =3.702, 13.494, P<0.01). Conclusion Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.

Inhibition of KLF7-Targeting MicroRNA 146b Promotes Sciatic Nerve Regeneration / 神经科学通报·英文版

A previous study has indicated that Krüppel-like factor 7 (KLF7), a transcription factor that stimulates Schwann cell (SC) proliferation and axonal regeneration after peripheral nerve injury, is a promising therapeutic transcription factor in nerve injury. We aimed to identify whether inhibition of microRNA-146b (miR-146b) affected SC proliferation, migration, and myelinated axon regeneration following sciatic nerve injury by regulating its direct target KLF7. SCs were transfected with miRNA lentivirus, miRNA inhibitor lentivirus, or KLF7 siRNA lentivirus in vitro. The expression of miR146b and KLF7, as well as SC proliferation and migration, were subsequently evaluated. In vivo, an acellular nerve allograft (ANA) followed by injection of GFP control vector or a lentiviral vector encoding an miR-146b inhibitor was used to assess the repair potential in a model of sciatic nerve gap. miR-146b directly targeted KLF7 by binding to the 3'-UTR, suppressing KLF7. Up-regulation of miR-146b and KLF7 knockdown significantly reduced the proliferation and migration of SCs, whereas silencing miR-146b resulted in increased proliferation and migration. KLF7 protein was localized in SCs in which miR-146b was expressed in vivo. Similarly, 4 weeks after the ANA, anti-miR-146b increased KLF7 and its target gene nerve growth factor cascade, promoting axonal outgrowth. Closer analysis revealed improved nerve conduction and sciatic function index score, and enhanced expression of neurofilaments, P0 (anti-peripheral myelin), and myelinated axon regeneration. Our findings provide new insight into the regulation of KLF7 by miR-146b during peripheral nerve regeneration and suggest a potential therapeutic strategy for peripheral nerve injury.

A case of Huntington disease first presenting with psychotic symptoms / 中国心理卫生杂志

This was a case of 32-year-old HAN woman admitted to psychiatric hospital presenting for social withdraw,deluded ideas,unexplained runaways and suicide behaviors.She was diagnosed as schizophrenia and brought to the psychiatrist for unbearable behavior problems by her family.When admitted to hospital the patient showed significant depressive symptoms and delusions with influent speech,hypotonia,involuntary movements of distal limb and ataxia.Cognitive tests revealed multiple deficits.Consulted with the neurologist,a diagnosis of organic mental disorder was suggested.Magnetic resonance imaging showed slight widen of lateral ventricles and mild atrophy of caudate nucleus and cortex of frontal lobe.The family history was re-collected and found three family members shared the influent speech and ataxia.Then the clinical diagnose of Huntingdon Disease was made and validated with gene tests.

Application of new-type cardio-pulmonary resuscitation marking table in large scale group examination / 中华医学教育探索杂志

Objective To explore the application of new-type cardio-pulmonary resuscitation (CPR) marking table in CPR teaching and assessment of new students.Method The students were divided into five-year group and four-year group based on different cultivation durations;the five-year group received conventional teaching while the four-year group received targeted teachingfocusing on key points on that basis.The assessment of both groups applied this marking table to compare average score,failure rate,full mark rate and error rate of 13 operations in marking table between the two groups.With the help of SPSS 19.0 software,the results were analyzed by t-test and chi-square test.Result The four-year group was higher than five-year group in average score and full mark rate (t=3.118,P=0.002;x2=26.798,P=0.000),but it was lower than five-year group in failure rate (x2=14.159,P=0.000),the difference was statistically significant.The error rate of 9 operations in five-year group,including on-sitesafety assessment (x2=44.764,P=0.000),calling for help (x2=8.854,P=0.003),press part (x2=10.236,P=0.001),press depth (x2=140.775,P=0.000),press interruption＜10 s (x2=7.377,P=0.007),opening airway (x2=20.209,P=0.000),twice effective artificial respiration (x2=37.669,P=0.000),evaluation (x2=20.898,P=0.000) and humanistic care (x2=45.673,P=0.000),were higher than that in four-year group;the difference of error rate of 4 operations between two groups was not statistically significant,including recognizing sudden cardiac arrest (x2=3.316,P=0.069),press frequency (x2=0.234,P=0.629),full resilience (x2=0.18,P=0.671) and press point movement (x2=3.614,P=0.057).Conclusion The new-type CPR marking table objectively reflects students' operation,summarizes operation errors and gives feedback of guidance teaching,so it is applicable for mass assessment with convenient use and less teaching load.

Advance in Rehabilitation for Parkinson's Disease (review) / 中国康复理论与实践

@#The core symptoms of Parkinson's disease include motor symptoms and non-motor symptoms. For the motor symptoms, the rehabilitation includes the basic training of joints, gait training, the training of core muscle group and posture balance, the training of oral, facial, neck muscle and pharyngeal reflex, the training of lip movement, vocalization, sound volume, rhythm and speed, and the training of deep breathing exercises and abdominal pressure. For the non-motor symptoms, the rehabilitation includes the training of memory, attention, problem solving ability, activities of daily living and others, psychotherapy, family support, social participation, and other comprehensive treatments combined with medicine.

The construction and implementation of disaster relief medical teaching system / 中华医学教育探索杂志

To cultivate a strong comprehensive ability and literacy of the rescue medical talent, our school built a "one popular two professional three open training" trinity of the teaching system, opened the first aid course for freshmen and set up basic disaster rescue medicine professional courses for the senior medical students.Three student volunteer service teams carried out first aid training for the social population. The teaching system was combined with a disaster relief knowledge, ability and professional accomplish-ment and carried out multi-form disaster rescue simulation scenarios practice teaching,disaster relief school teaching and service society combined, which were all the characteristics of this teaching system. After five years of practice,medical students' disaster relief capacity and quality improved significantly.

Non-medical students first aid awareness and training needs survey of Shiyan city / 重庆医学

Objective In order to know first aid awareness and training needs of non-medical college students in Shiyan city,and to provide the basis for an efficient first-aid training.Methods A total of 1063 non-medical colleges in Shiyan city were surveyed by random sampling method.Results 64.61％ of students awared of their own lack of knowledge of first aid,only 3.8 ％ feel rich;based on the first aid knowledge they obtained at present,46.92 ％ did not hesitate to rescue the stranger.After receiving systematic training,the rate rise to 78.9 ％,68.09 ％ of students worried about their lack of first aid skills were the biggest obstacle for them to implement of rescue;98.3％ of the students asked to undergo first aid training,92.27％ of students like approach first aid skills was hands-on model.33.03％ of students believe that medical schools were the best institutions to undertake emergency training,23.46％ of students chose the hospital.Conclusion Non-medical college students in Shiyan city have a bad awareness for firstaid knowledge and a strong desire for training.It is necessary that relevant departments will formulate targeted training programs to improve college students' first-aid response and improve regional emergency level.

Clinicopathologic study of cervical adenoid basal carcinoma / 临床与实验病理学杂志

Purpose To study the clinicalpathologic features,diagnosis,differential diagnosis and prognosis of cervical adenoid basal carcinoma (ABC) for improving further recognition and avoiding the likelihood of unnecessarily aggressive treatment to this disease.Methods Clinical presentations and pathological features of 4 cases of cervical ABC were analyzed by hematoxylin and eosin staining,immunohistochemical EnVision staining and in situ hybridization technology.The relevant literatures were reviewed.Results The age of 4 cases with cervical ABC ranged from 53 to 67 years (mean:61.5 years).All of the 4 patients underwent hysterectomy with bilateral salpingo-oophorectomy.Microscopically,the tumors were composed of small,well-differentiated and uniform basaloid cells and the tumor cells formed rounded nests or cords.The tumor cells arranged in palisading at the periphery of the nests.Some of the nests had central cystic spaces and there may also be focal glandular or squamous differentiation in the centre of the nests.Cervical intraepithelial neoplasia (CIN) lesions were observed in all 4 cases.Immunohistochemically,all the tumor cells were negative for CK7,ER,CEA,CD117 and S-100,while CK5/6,CK8/18,CK19,p16,p53,BCL-2 and p63 were positive.HPV 16/18 DNA were positive by in situ hybridization.The patients remained alive without recurrence and metastasis after follow-up 19 to 62 months.Conclusion ABC of the uterine cervix is a rare neoplasm with excellent prognosis.Differentiation of ABC from adenoid cystic carcinoma,basaloid squamous carcinoma,neuroendocrine carcinoma and adenosquamous carcinoma is important due to their different prognosis.Treatment is predominantly hysterectomy or laser electrocantery excision procedure (Leep).Radiotherapy or chemotherapy is not recommeded.