Giant myoepithelial carcinoma of the nuchal region: a case report and literature review / 临床耳鼻咽喉头颈外科杂志

Myoepithelioma, also known as malignant myoepithelioma, is a rare malignant tumor originating from myoepithelial cell. This article reports a patient with a huge tumor in the neck and left elbow who underwent fine needle aspiration under local anesthesia. The pathological diagnosis was a myoepithelioma. Under general anesthesia, giant tumors in the lower neck, posterior cranial fossa, neck, and left elbow were removed, and postoperative pathology showed that they were all myoepithelial tumors. Immunohistochemistry showed AE1/AE3 (+), P63 (+), CK7 (+), CK5 (+), and CD138 (+). The clinical characteristics and diagnosis and treatment process of this case are reported and relevant literature is reviewed.

Poorly differentiated neuroendocrine carcinoma of the tongue base: a case report / 临床耳鼻咽喉头颈外科杂志

Neuroendocrine carcinoma(NEC) is a malignant tumor derived from neuroendocrine cells, with distinct clinical, morphological and immunohistochemical characteristics. Neuroendocrine carcinoma of the head and neck is very rare in clinic. Larynx is the most common affected site, and the root of the tongue is extremely rare. The clinical manifestations are mainly eating pain, cauliflower like mass in the mouth, and ulcerative lesions that have not healed for a long time. Maxillofacial MRI and contrastenhanced CT are the most commonly used examination tools for such diseases, which can detect the spaceoccupying lesions of tumors. Neuroendocrine granules found in the cytoplasm under pathological light microscope can be diagnosed as neuroendocrine carcinoma. However, for most cases, it is difficult to make a diagnosis only under light microscope, and it is often necessary to make a diagnosis by means of immunohistochemistry and other technical means. This paper reports a case of neuroendocrine carcinoma of the root of the tongue, introduces its characteristics, diagnosis and treatment, and reviews the relevant literature of this case.

Application of Microhaplotypes in Sibling Kinship Testing / 法医学杂志

OBJECTIVES@#To investigate the efficacy of different numbers of microhaplotype (MH) loci and the introduction of different reference samples on the identification of full sibling, half sibling and differentiation between full sibling and half sibling kinships, and to explore the effect of changing mutation rate on sibling testing.@*METHODS@#First, a family map involving three generations was established, and four full sibling identification models, five half sibling identification models and five models distinguishing full and half siblings were constructed for different reference samples introduced. Based on the results of the previous study, two sets of nonbinary SNP-MH containing 34 and 54 loci were selected. Based on the above MH loci, 100 000 pairs of full sibling vs. unrelated individuals, 100 000 pairs of half sibling vs. unrelated individuals and 100 000 pairs of full sibling vs. half sibling were simulated based on the corresponding sibling kinship testing models, and the efficacy of each sibling kinship testing model was analyzed by the likelihood ratio algorithm under different thresholds. The mutant rate of 54 MH loci was changed to analyze the effect of mutation rate on sibling identification.@*RESULTS@#In the same relationship testing model, the systematic efficacy of sibling testing was positively correlated with the number of MH loci detected. With the same number of MH loci, the efficacy of full sibling testing was better than that of uncle or grandfather when the reference sample introduced was a full sibling of A, but there was no significant difference in the identification efficacy of the four reference samples introduced for full sibling and half sibling differentiation testing. In addition, the mutation rate had a slight effect on the efficacy of sibling kinship testing.@*CONCLUSIONS@#Increasing the number of MH loci and introducing reference samples of known relatives can increase the efficacy of full sibling testing, half sibling testing, and differentiation between full and half sibling kinships. The level of mutation rate in sibling testing by likelihood ratio method has a slight but insignificant effect on the efficacy.

Examples of Professor MA Kun's treatment of infertility caused by hyperprolactinemia with kidney deficiency and blood stasis / 中国中药杂志

Hyperprolactinemia(HPRL) is one of the diseases leading to anovulatory infertility, which is a refractory gynecological disease and seriously affects female reproductive function. Professor MA Kun has summarized his experience in clinical and scientific studies for many years. And believes that kidney deficiency is the pathogenesis of HPRL and blood stasis is the dominant pathological manifestation of HPRL and can promote the progress of the disease. In view of this, Professor MA Kun took the therapy of kidney-tonifying and blood-activating as the principle for treating anovulatory infertility caused by HPRL, with soothing the liver and promoting Qi as adjuvant therapies. She has also summarized and refined the prescriptions for tonifying kidney and inducing ovulation, which have a remarkable clinical efficacy.

Prognostic value of the age-adjusted Charlson comorbidity index in patients over 60 years old with laryngeal squamous cell carcinoma / 中华耳鼻咽喉头颈外科杂志

Objective: To evaluate the value of the age-adjusted Charlson comorbidity Index (ACCI) in predicting the prognosis and guiding the clinical treatment of laryngeal squamous cell carcinoma (LSCC) in patients over 60 years old. Methods: Retrospective analysis of 249 cases of LSCC in Shanxi Provincial Cancer Hospital and First Hospital of Shanxi Medical University from 2008 to 2015 was performed. There were 234 males and 15 females, aged from 60 to 88 years. The clinical characteristics, treatment information and follow-up data were collected. ACCI was used to score the comorbidities of the patients. Receiver operating characteristic (ROC) curve was drawn and the patients were divided into high ACCI group and low ACCI group according to the cut-off value of ACCI. Prognostic factors were analyzed. Kaplan-Meier method was used for survival analysis, rank sum test was used for comparison between groups, χ2 test was used for enumeration data. Results: Overall survival (OS) was 54.6%, progression-free survival (PFS) was 59.4%, and cancer-specific survival (CSS) was 58.6%. Both the median survival time and PFS time were 60 months. The best cutoff point of the ACCI group was 5. Cox multivariate analysis showed that ACCI was an independent risk factor for OS, PFS and CSS (OR=1.553, 1.499 and 1.534,respectively, all P<0.05). In the high ACCI group, OS (χ2=4.120 and 4.115,P<0.05) and CSS (χ2=4.510 and 5.009,P<0.05) of patients treated with surgery plus radiotherapy and patients with radiotherapy alone were better than those of patients with surgery alone (P<0.05). But in the low ACCI group, there was no significant difference in prognosis among the three treatment regimens (P>0.05). Conclusion: High ACCI offors important prognostic information for LSCC in patients over 60 years old, and can guide clinical treatment options.

An analysis on the present situation of post setting in CDCs of Zhejiang Province / 预防医学

Objective To analyze the present post setting situation of CDCs in Zhejiang Province, and to provide evidence for further improvement and standardization of post setting. Methods The data of post setting were collected by questionnaires from all levels of CDCs in Zhejiang Province. The compliance and rationality of post setting structure were evaluated by national and provincial normative policy documents. Results Ninety seven CDCs had implemented the post setting. Professional technical posts had the highest proportion (above 80%) among three kinds of posts. As the approved proportions of posts classification and professional titles were approved by the local government, there were differences between different levels of CDCs. The approved proportion of ground skilled posts and management posts between municipal and county CDCs had a relatively higher degree of dispersion, and the CVs of ground skilled posts and management posts of municipal CDCs were 72.3% and 65.6%, and the CVs of county CDCs were 101.6% and 82.1%. In terms of the approved professional titles structural proportion, the degree of dispersion appeared to be higher in senior titles and primary titles approved proportion of municipal CDCs (CV=29.1%, 28.5%), while the degree of dispersion was higher in senior titles and vice-senior titles of county CDCs (CV=58.9%, 21.8%) . Meanwhile, the approved proportions of senior titles in municipal and county CDCs were lower with the averages of 32.2% and 17.0%. The posts of infectious disease prevention and control and laboratory detection were accounting for the majority posts in municipal and county CDCs with average percentages of 47.8% and 45.1% . Conclusion The present situation of post structural proportion meets the relevant requirements generally. However, there are some phenomena of non-standard approved proportion of ground skilled posts and management posts and low senior titles approved proportion. Meanwhile, the percentage of infectious disease prevention and control and laboratory detection posts appears to be lower in county CDCs.

Sonographic features of enlarged central compartment lymph nodes in thyroid microcarcinoma and its clinical significance / 中华医学超声杂志（电子版）

Objective To evaluate the ultrasonographic features of enlarged central lymph nodes in thyroid microcarcinoma and its clinical significance.Methods The data of 422 cases of thyroid microcarcinoma in Shanxi Medical University Affiliated Tumor Hospital from January 2014 to December 2014 was investigated retrospectively.For the enlarged central lymph nodes,the results of ultrasonography,intraoperative detection and surgical pathology were compared,and the ultrasound characteristics of enlarged lymph nodes were assessed.Results In 422 cases of thyroid microcarcinoma,128 cases of central compartment lymphadenopathy were identified,including 276 nodes detected by preoperative ultrasound.The ultrasonic characteristics of central lymph nodes included hypo-echoic (98.6％,272/276),L/T ≥ 2 (63.8％,176/276),absence of echogenic hilus (72.1％,199/276),poor blood supply (91.7％,253/276).Surgery detected 978 paratracheal lymph nodes,and 522 nodules were ≤ 5.0 mm in diameter (53.4％).Among 422 patients,100 cases with paratracheal lymph nodes were confirmed by pathology (23.7％).Preoperative ultrasound undetected pretracheal and prelaryngeal lymph nodes,and surgery detected 51 nodes,including 30 nodules ≤ 5.0 mm in diameter (58.8％) and 5 nodules ＞ 10.0 mm in diameter (9.8％),of whom 7 cases with pretracheal and prelaryngeal lymph nodes were identified by pathology.Conclusions Preoperative ultrasound was prone to undetected,which may be involved with the deep location,the smaller diameter and complicated anatomy.The present findings emphasize that a negative US does not obviate the need for careful exploration of the central compartment to minimize the risk of persistent or recurrent local disease.The sonographer should be familiar with the status of central lymph node metastasis and ultrasonic features.The sonographer also should expand the area of the initiative while detect the central compartment lymphadenopathy,which is important guiding for surgical removal of thyroid cancer and lymph node metastasis.

An analysis on the personnel allocation and basic quality structure of middle-level cadres in CDCs of Zhejiang Province / 预防医学

Objective Toanalyzethepersonnelallocationandbasicqualitystructureofmiddle-levelcadresinCDCsof ZhejiangProvince.Methods DatawerecollectedfromthenationalbasicinformationsystemofCDCs.Anddescriptive statistics,chi-square test and Kruskal -Wallis H test were used to analyze the differences of middle -level cadres'personnelallocationandbasicqualityamongthreelevelsofCDCs.Results Theallocationratioofmiddle-levelcadresin management departments was 25.58%,27.32% and 23.58% for provincial level,city level and county level of CDCs respectively,which was 74.42%,72.68% and 76.42% in management departments respectively.There were significant differences in ages,working years,education levels,majors and titles across different levels of CDCs (P<0.05 ).And there were significant differences in education levels across counties with different economic levels (P<0.05 ). Conclusion Thepersonnelallocationofmiddle-levelcadreswithexcellentbasicqualityindifferentlevelsofCDCsin Zhejiang Province was reasonable.

Clinical Significance of CK19, CD56 and p53 in differential diagnosis of papillary thyroid microcarcinoma and thyroid papillary hyperplasia / 肿瘤研究与临床

Objective To investigate the expression and diagnostic significance of CK19,CD56 and p53 protein in papillary thyroid microcarcinoma and thyroid papillary hyperplasia.Methods The expressions of CK19、CD56 and p53 protein were detected in 52 cases of papillary thyroid microcarcinoma and 31 of thyroid papillary hyperplasia by iImmunohistochemical methods.Results The positive rate of CK19 expression was 100 ％ (52/52) of papillary thyroid microcarcinoma and 29.0 ％ (9/31) in 31 of thyroid papillary hyperplasia.There was significant difference between two groups (P ＜ 0.001).CK56 in 2 cases (3.8 ％) of papillary thyroid microcarcinoma appeared mild positive expression,and in 20 cases (66.7 ％) of thyroid papillary hyperplasia positive expression (P ＜ 0.001).The positive expression rates of p53 were 69.2 ％(36/52) in papillary thyroid microcarcinoma and 6.5 ％ (2/31) in thyroid papillary hyperplasia (P ＜ 0.001).Conclusion CK19,CD56 and p53 may be important value on differential diagnosis of papillary thyroid microcarcinoma from thyroid papillary hyperplasia,and they are the indispensable markers of differential diagnosis.

An analysis on the prevalence of thyroid nodules and risk factors among residents from coastal area / 预防医学

Objective To know the prevalence of thyroid nodules among the residents from coastal area and to explore the risk factors of thyroid nodules.Methods The residents were selected by cluster random sampling method.Questionnaire interview was conducted.Thyroid ultrasound examination was performed in all subject,salt iodine,urinary iodine and the thyroid hormone including FT3,FT4,TSH,TPOAb,TGAb were measured.The groups with or without thyroid nodules were compared and the data were analyzed by univariate and multivariate logistic regression.Results The prevalence rate of thyroid nodules among the residents from coastal area of Ningbo City was 46.51%,after standardized was 41.61%. Female (OR =1.75,95%CI =1.37 -2.24),groups of aged 40 (OR =3.82,95%CI =1.70 -8.56)and aged 65(OR =5.76,95%CI =2.28 -14.54)were significantly associated with thyroid nodules.Conclusion The prevalence rate of thyroid nodules among the surveyed population was at a high level.Female and age (aged≥ 40)were risk factors of thyroid nodules.

Clinical significance of ultrasound-assisted drawings in location of thyroid micronodule / 中华医学超声杂志（电子版）

Objective To explore the clinical significance of preoperative ultrasound-assisted drawings in location of thyroid micronodule resection .Methods A total of 88 patients ( 137 nodules ) who underwent thyroid micro-nodule resection were enrolled in the prospective randomized controlled study .All patients were randomly divided into two groups:46 patients (68 micronodules) in experimental group and 42 patients (69 micronodules) in control group.Inclusion criteria:the maximum diameter of nodule≤1.0 cm. Preoperative thyroid ultrasound was conducted .Patients in experimental group also underwent ultrasound-assisted location of thyroid micronodule .Results The diagnostic accuracy rate of US was 81.82%(69/88) in all patients .With the help of ultrasound-assisted location , all nodules in experimental group were found quickly and accurately.The resection rate of experimental group was 100%(46/46).Whereas 4 nodules (in 4 patients ) were missed in control group with a resection rate of 90.5% (38/42).The postoperative US examinations after 3 months showed that all nodules were completely removed in experimental group while 4 nodules retained in control group .Conclusions Preoperative ultrasound-assisted drawings in location of thyroid micronodule plays an important role in thyroid nodule resection .It is great value of clinical application .

Application of ultrasound-guided drawing location of thyroid micronodule / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To evaluate the application value of preoperative ultrasound-guided drawing for locating thyroid micronodule in surgery.</p><p><b>METHODS</b>A total of 88 patients (with 137 thyroid micronodules) who underwent thyroid surgery was included in the prospective study. Preoperative thyroid ultrasound was conducted in all patients. Select criteria: the maximum diameter of nodule ≤ 1 cm. All patients were randomly divided into two groups: 46 patients (68 micronoduls) in experimental group with ultrasound-guided drawing location of thyroid micronodule and 42 patients (69 micronoduls) in control group without ultrasound-guided drawing location of thyroid micronodule.</p><p><b>RESULTS</b>All thyroid micronodules of experimental group were found quickly and accurately in surgery, and 4 micronodules in 4 patients of control group were not found in surgery. US examinations 3 months after surgery showed that all micronodules in experimental group were completely removed and 4 micronodules in control group retained.</p><p><b>CONCLUSION</b>Ultrasound-guided drawing is a useful technique for locating and searching accurately thyroid micronodule in surgery.</p>

Progress in Structural and Functional Study of Ubiquitin Ligases / 生物化学与生物物理进展

Ubiquitination on target proteins is the signal of cellular protein degradation.Ubiquitin ligase E3 is one of the key enzymes in ubiquitination,it recognizes a specific substrate protein and recruits an ubiquitin conjugating enzyme E2,mediating the ubquitin transfer from the E2 to the substrate protein.Ubiquitin ligase E3 can be divided into two subfamilies according to their different structure characters and function mechanisms,the HECT(homologous to E6AP C terminus) family and the RING-finger family.Members of the HECT E3 share the common HECT catalytic domain,which can bind to an E2 and load the ubiquitin on themselves before catalyzing the transfer of ubiquitin to the target proteins.While the RING-finger E3 all contain an similar E2 binding domain and a unique substrate binding part,mediating direct ubiquitin transfer from the E2 to the substrate.The most recent progresses in the stuctural and functional studies of these two E3 famlies were summarized.