Complete atrioventricular septal defect: a clinicopathologic study of 35 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the autopsy characteristics, pathologic type, malfomation and genetic characteristics of complete atrioventricular septal defect (CAVSD).</p><p><b>METHODS</b>Thirty five cases of CAVSD were collected from Maternal and Child Hospital of Haidian District during Jan.2003 to Jan.2015. Autoptic material, clinical history and chromosome examination were reviewed.</p><p><b>RESULTS</b>Among 35 cases of CAVSD between 18-38 gestational weeks, there were 26 cases with CAVSD A (74.3%, 26/35), 1 case with CAVSD B (2.8%, 1/35) and 8 cases with CAVSD C (22.8%, 8/35). Only CAVSD malformation was seen in 4 cases (11.4%, 4/35). Multiple malformations were seen in 31 cases (88.6%, 31/35). Combined malformations most frequently occurred in cardiovascular, respiratory and locomotor system. Among 15 cases with chromosome examination, chromosome aberrations was found in 13 cases (13/15) and trisomy-21 was found in 11 cases (11/15).</p><p><b>CONCLUSIONS</b>CAVSD is a rare disease and CAVSD A is the most common type. CAVSD is usually combined with other malformations and chromosome aberrations.</p>

Clinicopathologic study of 25 cases of placental chorioangioma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics, diagnostic criteria and differential diagnosis of placental chorioangioma.</p><p><b>METHODS</b>Twenty-five cases of placental chorioangioma were analyzed for their clinical data, histomorphology and immumohisto chemical staining. Relevant literature was reviewed.</p><p><b>RESULTS</b>The average age of the 25 patients was 29 years. Fourteen patients had full-term pregnancy, 10 had preterm labor, and 1 had intrauterine fetal death. Nineteen patients had pregnancy complications. The tumors presented as red or dusty pink nodules with clear borders. The tumor size ranged from 1 to 16 cm. Microscopically, the tumors possessed abundant capillaries or cavernous blood spaces lined by hyperplastic endothelial cells. These cells were positive for CD34 and Ki-67 index < 10%.</p><p><b>CONCLUSIONS</b>Placental chorioangioma is a rare benign tumor of the placenta, and is associated with various pregnancy complications. Misdiagnosis of cell-rich type tumor should be avoided.</p>

Early and late onset severe preeclampsia: a clinicopathologic study of 178 placentas / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the pathologic features and prognosis of early and late onset severe preeclampsia.</p><p><b>METHODS</b>An observational study was conducted in 178 cases of severe preeclampsia collected during January 2010 to December 2014 from Haidian Maternal and Child Health Hospital.The cases were divided into two groups according to the onset of gestational age of the severe preeclampsia, with 54 cases of namely early onset (onset ≤ 34 weeks) and 124 cases of late onset (onset >34 weeks). Clinical characteristics of the patients, perinatal outcome and the pathologic characteristics of the placentas in each group were evaluated.</p><p><b>RESULTS</b>Decidual vascular disease, placental infarction, abruptio placentae and placental villi dysplasia were seen in both groups. The incidence of placental villi dysplasia was the highest, followed by placental infarction. Incidence of severe decidual vascular disease of early and late onset severe decidual vascular disease were 16.7% (9/54) and 5.6% (7/124), respectively.Incidence of placental infarction of early and late onset severe preeclampsia were 48.1% (26/54) and 61.3% (76/124). Incidence of placental villi dysplasia of early and late onset severe preeclampsia were 79.6% (43/54) and 50.8% (63/124). Incidence of Severe decidual vascular disease, placental infarction and placental villi dysplasia were significantly different between early and late onset severe preeclampsia cases (P<0.05), while there was no difference in decidual vascular disease and placenta thrombi (P>0.05). Fetal survival rate of every group was 81.5% (44/54) and 93.5% (116/124). Incidence of fetal growth retardation was 55.6% (30/54) and 38.7% (48/124). The fetal survival rate and incidence of fetal growth retardation were different between two groups (P<0.05).</p><p><b>CONCLUSIONS</b>The incidence of decidual vascular disease and placental villi dysplasia in early onset severe preeclampsia is higher than those in late onset severe preeclampsia. Neonatal outcome and prognosis in early onset severe preeclampsia are worse than those in late onset severe preeclampsia.</p>

Congenital pulmonary airway malformation of lung in fetus: a clinicopathological analysis / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the etiology, pathogenesis, clinicopathologic characteristics, prognosis and treatment of congenital pulmonary airway malformation (CPAM).</p><p><b>METHODS</b>Eighteen cases of CPAM were enrolled into the study. The clinical history, autopsy findings and immunohistochemical results were evaluated, with review of literature. The pathogenetic mechanism, pathologic features and differential diagnosis of CPAM were studied.</p><p><b>RESULTS</b>Histologic examination showed that 2 cases were classified as Stocker type I, 12 cases as type II, and 4 cases as type III. The lesion was unilateral and involved single lobe in 13 cases. The remaining 5 cases had bilateral diseases. Of the 18 cases studied, 12 cases showed single organ involvement and 6 cases had malformations affecting multiple organs. The associated malformations included cardiac anomalies (4 cases), polycystic kidney with gastrointestinal atresia (1 case) and nuchal cystic hygroma with hydrothorax (1 case).</p><p><b>CONCLUSIONS</b>CPAM is a rare pulmonary disorder. The etiology of this non-neoplastic condition is unknown. Imaging analysis is a valuable tool to suggest CPAM, while definite diagnosis requires pathologic examination. The overall prognosis is determined by the presence of associated malformations, fetal hydrops and pulmonary hypoplasia.</p>

Evidence-based nursing on improving compliance of COPD patients with noninvasive positive pressure ventilation / 现代临床护理

Objective To explore the effect of evidence-based nursing on improving the compliance of chronic obstructive pulmonary disease (COPD) patients with noninvasive positive pressure ventilation. Methods Forty-five patients hospitalized in the first half of the year were assigned as control group and another 45 patients hospitalized in the second half of the year were as experiment group. The control group was treated with traditional nursing methods. In the experiment group, a nursing panel was set up to analyze the causes of noncompliance of COPD patients with noninvasive positive pressure ventilation and gave care to the patients based on the analyses. The two groups were compared in terms of adverse reactions and the compliance with treatment. Result The rates of compliance with treatment and adverse reactions such as fear and anxiety , the man-machine confrontation and flatulence in the experiment group were significantly lower than those of the control group obviously (P<0.05). Conclusion The evidence-based nursing can reduce the incidence of adverse reactions , and enhance the compliance of COPD patients with noninvasive positive pressure ventilation effectively.

Application of p16 and Ki67 protein in diagnosis of cervical lesions / 中国基层医药

Objective To investigate the diagnosis value of p16 combined with Ki67 protein in cervical lesions.Methods Totally 1 542 women with previous liquid-based cytology smear result of abnormality underwent a colposcopy-directed biopsy excision procedure.Biopsy specimens were detected by p16 and Ki67 immunostaining alongside hematoxylin and eosin (H&E) staining.A four-semiquantitative class was used to describe the immunohistochemical results.Results Biopsy results revealed 1 542 women included 473 women with negative for dysplasia (NEG),629 women with cervical intraepithelial neoplasia (CIN) Ⅰ,206 women with CIN Ⅱ,206 women with CINⅢ and 28 women with cervical squamous cell carcinoma (SCC).The averageage of this study population was 34.47 years.CINs mainly occurred in women aged 20-29 years and 30-39 years.The positive rates of p16 in NEG,CIN Ⅰ,CIN Ⅱ,CINⅢ and SCC were 15.22％,60.25％,98.06％,99.51％,100.00％ respectively,and the positive rates of Ki67 were 12.05％,63.12％,96.12％,98.06％,100.00％ respectively.p16 expression and Ki-67 expression significantly increased with disease progression (p16:r =0.758,P =0.000 ; Ki67:r =0.773,P =0.000).Expression level of p16 was positively related with Ki-67 (r =0.774,P =0.000).The positive expression rates of p16 and Ki-67 of NEG were significantly lower than those of CIN and SCC (p16:x2 =1 127.46,P =0.000;Ki67:x2 =1 316.85,P =0.000).The positive expression rates of p16 and Ki-67 were markedly higher in CIN Ⅰ than those in CINⅡ,CINⅢⅢ and SCC (p16:x2 =500.19,P =0.000;Ki67:x2 =603.23,P=0.000).Conclusion Women aged 20-39 years are key subjects for cervical cancer screening.p16 and Ki67 immunohistochemistry is important in the ancillary diagnosis of cervical lesions.

Clinicopathologic features of fetal nuchal cystic hygroma: report of 40 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the pathogenesis, pathologic features and prognosis of fetal nuchal cystic hygroma.</p><p><b>METHODS</b>Forty autopsied cases of fetal nuchal cystic hygroma were collected during January 2003 to December 2012. The clinical history, pathologic changes and immunohistochemical (EnVision method) findings were reviewed, and the pathogenesis and pathologic characteristics were analyzed.</p><p><b>RESULTS</b>Of the 40 cases, 16 (40.0%) showed single malformation and 24 (60.0%) were associated with multiple malformations in other organs and/or systems.Nineteen cases were septated and 21 were not. The associated malformations occurred in the respiratory system, skeletal system and urinary system.In the cases of combined malformations of umbilical cord, 3 were single umbilical artery malformations and 1 was torsion and stricture of umbilical cord.Four cases had chromosomal analysis, and all were trisomy-21.</p><p><b>CONCLUSIONS</b>Fetal nuchal cystic hygroma is a rare disease. The etiology is unknown, but it is not neoplastic.Lymphangioma is divided into 3 types:capillary lymphangioma, cavernous lymphangioma and cystic hygroma according to their expansile growth pattern. The overall prognosis is determined by any co-existing chromosomal anomalies, associated malformations and the time of diagnosis of the cystic hygroma.</p>

An analysis on the clinicopathological characteristics of 79 cases atypical endometrial hyperplasia / 中华妇产科杂志

Objective To explore the clinicopathological characteristics in atypical endometrial hyperplasia patients. Methods A retrospective study was carry out on 79 cases with atypical endometrial hyperplasia patients admitted to Department of Gynecology, Peking University People's Hospital from Mar.2007 to Jul. 2010. All patients were divided into two groups, hyperplasia group (merely atypical endometrial hyperplasia, 49 cases, 62%) and cancerization group (atypical endometrial hyperplasia accompanying endometrial carcinoma, 30 cases, 38%). Results The mean age of 79 cases were (50 ± 11) years old ,while they were (50 ± 10) and (51 ± 11) years old for hyperplasia group and cancerization group, there were not difference (P = 0.994). The gravidity and delivery frequencies were also not differently between two groups. The rates of complicated other diseases were 47% (23/49) and 43% (13/30), which was not significantly different (P = 0.755). The body mass index (BMI) of cancerization group was higher than that of hyperplasia group [(27.9 ± 5.4) vs. (25.2 ± 2.9) kg/m2, P = 0.024]. There were 50% (15/30) and 31% (15/49) menopause cases in two groups, respectively. Among them there were 13/15 and 8/15 cases showed vaginal bleeding. Among premenopausal patients, there were 12/15 and 68% (23/34) showed abnormal vaginal bleeding, but there were not significantly different between two groups (all P ＞ 0.05). The uterine cavity mass found by ultrasonography in the cancerization group patients was more than that in hyperplasia group [73% (22/30) vs. 51% (25/49), P = 0.050]. There were 23 cases (29%), 44 cases (56%) and 12 cases (15%) were diagnosed by dilatation and curettage (D&G), hysteroscopy and hysterectomy, respectively. The rates of diagnosing atypical endometrial hyperplasia by D&G and hysteroscopy were 87 % (21/23) and 93 % (41/44), respectively. The rate of diagnosis of canceration were 6/12 and 12/16, respectively. While, the rate of missed diagnosis of canceration in the atypical endometrial hyperplasia patients by D&G and hysteroscopy were 6/13 and 19% (4/21) ,respectively. Which all did not shown significantly different (P ＞ 0.05). Conclusion Hysteroseopy or D&G should be chosen on those peri-menopausal patients with abnormal bleeding, while those atypical endometrial hyperplasia patients with high BMI and uterine cavity mass diagnosed with D&G and ultrasonography should consider the possibility of canceration.