Validation the clinical value of good outcome following attempted resuscitation scores in Chinese populations in predicting the prognosis of in-hospital cardiac arrest / 中华危重病急救医学

Objective:To verify the clinical value of the good outcome following attempted resuscitation (GO-FAR) score in predicting the neurological status of patients with in-hospital cardiac arrest (IHCA) in the Chinese population.Methods:The clinical data of patients with IHCA who were admitted to the Zigong Fourth People's Hospital from January 1 to December 31, 2020 were retrospectively analyzed. Used Glasgow-Pittsburgh cerebral performance category (CPC) score 1 point as the end point, the subjects were divided into 4 groups according to the score: ≤ 0 group, 1-8 group, 9-20 group and ≥ 21 group. Taken the group which GO-FAR score ≤ 0 as the reference group, the odds ratio ( OR) of the other three groups compared with this group was calculated. The receiver operator characteristic curve (ROC curve) was performed to evaluate the predictive value of the GO-FAR score in favorable neurological outcome. A calibration curve was drawn for the Hosmer-Lemeshow test to analyze the degree of calibration of the GO-FAR score for predicting good neurological outcome. Results:A total of 230 IHCA patients were enrolled in the study, including 130 males, aged 74 (65, 81) years old, and 23 case (10.0%) had good neurological prognosis. There were statistically significant differences in GO-FAR-related variables, including age, a normal neurological function on admitted, acute stroke, metastatic cancer, septicemia, medical noncardiac admission, hepatic insufficiency, hypotension, renal insufficiency or dialysis, respiratory insufficiency, pneumonia, etc (all P < 0.05). Taken the GO-FAR score ≤ 0 group as the reference group, the OR values of good neurological prognosis in the GO-FAR score 1-8 group were 0.54 [95% confidence interval (95% CI) was 0.17-1.53, P = 0.250], 9-20 group were 0.17 (95% CI was 0.02-0.67, P = 0.009) and ≥ 21 group were 0.25 (95% CI was 0.05-0.85, P = 0.025). The area under the ROC curve (AUC) of the GO-FAR score for predicting favorable neurological outcome in IHCA patients was 0.653 (95% CI was 0.529-0.777, P = 0.015) and there was no significant difference in Hosmer-Lemeshow test ( P = 0.311). All these suggested that there was no significant difference between the predicted value and the actual value. Conclusions:GO-FAR score can be applied to predict neurological prognosis of IHCA patients in Chinese population. It can help clinicians to predict the prognosis of cardio-pulmonary resuscitation (CPR) and propose critical recommendations in treatment for these patients or their families.

68Ga-PSMA PET/CT-targeted biopsy for the diagnosis of clinically significant prostate cancer in patients with serum PSA levels <20.0 ng/ml / 中华泌尿外科杂志

Objective:To evaluate the feasibility and efficacy of 68Ga-PSMA PET/CT-guided targeted prostate biopsy for the diagnosis of clinically significant prostate cancer(csPCa). Methods:This retrospective analysis allocated 89 patients with elevated PSA levels between 4.0-20.0 ng/ml to PET group(n=48) or TRUS group(n=41) between September 2017 and June 2019. Patients with PSMA-avid lesions (SUV max≥8.0) underwent PET-TB via a single-puncture percutaneous transgluteal approach (n=19), while patients with negative PSMA-PET underwent systematic TRUS-GB (n=29). Patients in the TRUS group who did not get 68Ga-PSMA PET/CT examination underwent TRUS-GB directly (n=41). The mean age, prostate volume, PSA value of PET group and TURS group were (71.2±9.1) years vs. (68.0±12.0) years, (62.9±29.1)ml vs. (65.4±38.9)ml , 8.8(6.6, 13.6) ng/ml vs. 9.8(7.1, 13.1)ng/ml, respectively (all P>0.05). The diagnostic efficacy and difference of PCa and csPCa between the two groups were compared. PET-TB adopts a new mode of percutaneous gluteus approach and carries out precise image fusion of PSMA-PET/CT and pelvic CT in the same machine and in the same position (prone position). Under the direct guidance of CT, the biopsy is performed with only one precise puncture. Results:PCa and csPCa were detected in 27/89(30.3%)and 20/89(22.5%)in all patients. PET group detected significantly more cases of PCa and csPCa than those of TRUS group [PCa: 41.7%(20/48) vs. 17.1%(7/41), χ2=6.328; csPCa: 33.3%(16/48) vs. 9.8%(4/41), χ2=7.055, P<0.01]. Of 19 patients with PSMA-PET positive, PET-TB detected 16 cases of PCa(84.2%) by a single needle puncture, and the proportions of cancer tissues were ≥80% in 2, 50%-79% in 8, and <50% in 6 cases. Among these, Gleason score was underestimated by biopsy histopathology in 2 patients. Of 3 patients with PET-TB negative, 1 case of low-risk PCa(Gleason 3+ 3) was detected by complementary TRUS-GB. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy of 68Ga-PSMA PET/CT(SUV max≥8.0) for the diagnosis of csPCa were 73.9%(14/19), 93.1%(27/29), 87.5%(14/16), 81.3%(26/32)and 85.4%(41/48), respectively. For PET-TB, only one patient had slight symptoms of haematuria after the puncture, no cases of hematochezia, hemospermia, urinary retention or pelvic infection were observed. Conclusions:68Ga-PSMA PET/CT is a feasible novel puncture technique that may serve as a triage tool for prostate biopsy, and PET-TB may improve the detection rate of csPCa compared with TURS-GB, especially in patients with serum PSA 4.0-20.0 ng/ml.

Clinicopathological significance of poorly differentiated clusters in colorectal adenocarcinoma / 中华病理学杂志

Objective@#To investigate the correlation between poorly differentiated clusters (PDCs) in colorectal adenocarcinomas with clinicopathological parameters and its clinicopathological significance.@*Methods@#One hundred and eighty-three colorectal adenocarcinomas resected by radical proctocolecomy were collected at Nanjing Hospital(Nanjing First Hospital), Nanjing Medical University, from January to December 2017. There were 122 male and 61 female patients with age ranging from 42 to 89 years (mean of 68 years). Tumor diameter ranged from 2 to 14 cm (mean 4.5 cm). There were 124 colon cancers and 59 rectal cancers. The number and grade of PDCs in the colorectal adenocarcinoma were evaluated by H-E staining. The overall peritumoural inflammatory reaction was also evaluated. The relationship between PDCs and tumor grades and clinicopathological features and overall peritumoural inflammatory reaction of colorectal adenocarcinoma was analyzed.@*Results@#Of 183 cases of colorectal adenocarcinoma, PDCs were seen in 104 cases (56.8%), of which 36 cases (19.7%) were grade 1, 28 cases (15.3%) were grade 2, and 40 cases (21.9%) were grade 3. PDCs were positively correlated with lymph node metastasis, vascular invasion, degree of differentiation, depth of invasion, and pTNM staging(P<0.05). The detection rate of PDCs in colon cancer was higher than that of rectal cancer(P<0.05). PDCs was unrelated to age, gender, tumor size, and degree of overall peritumoural inflammatory reaction (P>0.05). Among clinicopathological parameters, the grade of PDCs was correlated with lymph node metastasis and vascular invasion (higher than those without lymph node metastasis and vascular invasion, P<0.05); There was a positive correlation between the grade of PDCs and age, tumor differentiation and pTNM staging(P<0.05), and no significant difference between the grade of PDCs and gender, tumor size, tumor location, and depth of invasion was seen (P>0.05). There was no correlation between the grade of PDCs and the degree of overall peritumoural inflammatory reaction (P>0.05).@*Conclusions@#PDC is a histological feature that predicts the aggressiveness of colorectal adenocarcinoma. Evaluation of PDC grade can better predict the biological behavior of colorectal cancer and more accurately guide the treatment and evaluate prognosis.

Galectin-3 induces differentiation of rat bone marrow mesenchymal stem cells into hepatocyte-like cells / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of galectin-3 in inducing the differentiation of rat bone marrow mesenchymal stem cells (BMSCs) into hepatocyte- like cells and explore the involvement of the signaling pathways in the induced cell differentiation.</p><p><b>METHODS</b>The third passage of cultured rat femoral BMSCs were treated with 0.5 μg/mL galectin-3, 20 ng/mL hepatocyte growth factor (HGF) or both to induce their differentiation, with untreated rat BMSCs and hepatocytes as controls. At 7, 14, 21 and 28 days of induction, the cells were examined for morphological changes followed by glycogen staining, quantitative real-time PCR and Western blotting. Gene microarray technique was used to examine the mRNA expression profile of the BMSCs induced with galectin-3. The BMSCs were also induced with galectin-3 in combination with XMU-MP-1, a Hippo signaling pathway inhibitor, after which Western blotting was performed to detect the expressions of YAP, P-YAP, ALB, AFP and CK-18 in the cells.</p><p><b>RESULTS</b>The cells isolated from the femoral bone marrow of SD rats showed a consistent surface marker phenotype with the BMSCs. Induction with galectin-3, HGF, or both all resulted in gradual morphological changes of the BMSCs into hepatocyte-like cells, and the cells with a combined induction for 28 days showed the highest morphological similarity with hepatocytes. The cells induced with galectin-3, HGF, or their combination for 28 days all showed increased positivity rate of glycogen staining, which was the highest in the cells with combined induction ( < 0.05) without significant difference between the cells induced with galectin-3 and HGF alone ( > 0.05). Induction with galectin-3 and HGF alone both increased the expressions of AFP, ALB and CK-18 mRNAs in the cells, and their expression levels were similar between the cells at 28 days ( > 0.05). Galectin-3 and HGF did not show an interactive effect on the mRNA expressions of AFP (=0.236, =0.640) or ALB (=50.639, =0.000), but had a synergistic effect on CK-18 mRNA expression (=50.639, =0.000). The protein expressions of AFP, ALB and CK18 were also increased in the induced cells but not detected in the cells without induction. Gene microarray results revealed 27 up-regulated genes and 62 down-regulated genes in galectin-3-induced BMSCs involving TGF-β, PI3K-Akt and Hippo signal pathways. Induction with galectin-3 and galectin-3+XMU-MP-1 increased YAP expression in the cells, and galectin-3+XMU-MP-1 was more efficient to induce the differentiation of the BMSCs.</p><p><b>CONCLUSIONS</b>Galectin-3 can induce the differentiation of rat BMSCs into hepatocyte-like cells, and the combination with HGF increases the efficiency of induced differentiation of the cells. TGF-β, PI3K-Akt and Hippo pathways are involved in the induced differentiation of the BMSCs, and inhibiting Hippo pathway can improve the induction efficiency.</p>

Evaluation of the invisible bracketless appliance on maxillary molar distalization / 实用口腔医学杂志

Objective:To evaluate the clinical effects of invisible bracketless appliance on the upper molar distalization.Methods:15 patients with class Ⅱ malocclusion(at the average age of 25.3 years) were treated by invisible bracketless appliance,the pre and post three-dimensional digital models were superimposed and measured,the effects of molar distalization were analysed.Results:After treatment,the maxillary first molars were distalized by 2.58 mm on both sides.The left and fight second molars were distalized by 2.57 mm and 2.68 mm respectively.Bilateral central incisors were moved mesially by 0.34 mm.There was no significant difference in the horizontal movement of central incisor.But the left and fight first molars were moved buccally by 0.96 mm and 0.97 mm respectively,the left and fight second molars were moved buccally by 1.01 mm and 1.11 mm separately.Bilateral first molars were intruded by 0.26 mm,the left and right second molars were intruded by 0.37 mm and 0.36 mm,respectively.But the central incisors had no significant vertical movement.There was no significant difference in the buccally or palatally rotation of bilateral first and second molars.Conclusion:Invisible bracketless appliance is efficient for distalization of upper molar,but it may result in mild molar intrusion and anterior anchorage loss.

Analysis of laboratory examination, diagnosis and treatment of 57 cases of acute promyelocytic leukemia / 中国医师杂志

Objective To investigate the laboratory examination,diagnosis and treatment of 57 cases of Acute Promyelocytic Leukemia.Methods The clinical manifestation,laboratory morphology-immunology-cytogenetics-molecular (MICM) classification,treatment and follow-up were analyzed retrospectively among 57 newly diagnosed cases of acute pmmyelocytic leukemia (APL) patients from January 2011 to December 2013 in Xiangya Hospital,Central South University.Results In 57 patients,the first symptom was given priority to with bleeding (73.7％),fever (26.3％),and the organ infiltration accounted for 29.8％.The phenotype of CD13 + CD33 + CD34-HLD-RA-was 59.6％ in 57 patients,CD13 + CD33 +CD34 + HLD-RA + was 8.8％,and the remaining 18 cases were not classic phenotypes.The positive percentage of PML/RARa was 93.0％ by fluorescence in situ hybridization (FISH),and the remaining 4 cases were other rare abnormal.Except one case gave up the treatment,the other 56 cases of APL patients reached 100％ complete remission rate under early screening and diagnosis,relatively standardized and effective treatment.Conclusions Hemorrhage is the most common clinical symptoms of M3.MICM classification,especially the FISH technology,is the main laboratory basis for diagnosis of M3.After the treatment of early specifications currently,M3 can almost be cured.

Corneal biomechanical properties in different anterior chamber angle of glaucoma / 中华实验眼科杂志

Background Recent studies have demonstrated that glaucoma progression had great relationship with corneal biomechanical properties.However,there are not enough studies about corneal biomechanical properties in different types of glaucoma.Objective This study was to evaluate the corneal biomechanical properties in chronic primary angle-closure glaucoma (CPACG) and primary open angle glaucoma (POAG).Methods Prospective observational study was adopted.Sixty-eight cases (68 eyes) with CPACG and 69 POAG patients (69 eyes) from Zhongshan Ophthalmic Center were investigated by a novel technique named Corvis-ST which can measure corneal deformation.The Cronbach's αt coefficient and intraclass correlation coefficient (ICC) were used to evaluate the repeatability of the parameters from Corvis-ST.The differences of corneal biomechanical properties between POAG and CPACG were evaluated by independent-samples t test.Multiple regression analysis was used to assess the association between parameters of deformation response and clinical factors.This study protocol was approved by Ethic Committee of Zhongshan Ophthalmic Center and complied with Helsinki Declaration.Written informed consent was obtained from each patient prior to any medical examination.Results There were no statistic differences about age,sex and intraocular pressure (IOP) between CPACG and POAG patients (all at P＞0.05).However,differences existed in the number of anti-glaucoma medications (t =-2.388,P =0.020).Measurements of central corneal thickness (CCT),deformation amplitude (DA),and peak distance (PD) demonstrated excellent repeatability (ICC≥ 0.8).There were no statistic differences about CCT,first applanation time/length/velocity (A1 T,A1 L,A1V),second applanation time/length/velocity (A2T,A2L,A2V),DA between CPACG and POAG patients (all at P＞ 0.05).The highest concavity time was shorter (t =2.920,P =0.005),PD was bigger (t =-2.453,P =0.017),and central curvature radius (CCR) was smaller (t =1.997,P =0.050) in POAG than those in the CPACG patients.DA,A1V,A2T and PD were negatively associated with IOP (r =-0.709,-0.531,-0.645,-0.554;all at P＜0.001).However,A1T and A2V were positively associated with IOP (r=0.744,0.546;both at P＜0.001).And CCR was positively associated with CCT (r =0.181,P =0.039).Conclusions It is useable to evaluate corneal biomechanical properties of glaucoma by Corvis ST.Under the same level of IOP,the corneal concavity of POAG is easier than that of CPACG,which indicates that cornea in POAG patients is more deformable.

A nonrandomized controlled study of inflammatory response between uveitic glaucoma and other refractory glaucoma following Ahmed glaucoma valve implantation / 中华实验眼科杂志

Background The aqueous flare is obvious in uveitic glaucomatous eye due to the damage of blood-aqueous barrier,especially following intraocular surgery.How to quantitatively determine the aqueous flare is important for us to understand the severity of inflammatory response.Objective This study was to assess inflammatory response following Ahmed glaucoma valve implantation in uveitic glaucomatous eye.Methods A nonrandomized controlled study was carried out under the approval of Ethic Committee of Zhongshan Ophthalmic Center of Sun Yat-sen University.Twenty-nine eyes of 29 subjects with refractory glaucoma were enrolled this hospital from October 2011 through July 2012.The patients were divided into the uveitic glaucoma group (10 eyes) and the other refractory glaucoma group (19 eyes) with the matched demography,and Ahmed glaucoma valve implantation was performed on all the eyes under the informed consent of each patient.The aqueous flare value was determined with FC-2000 flare-cell photometry and intraocular pressure (IOP) was measured with Goldmann tonometer before surgery and 1 day,3 days,1 week,2 weeks,1 month and 3 months after surgery.The outcomes were compared between the two groups,and the correlation of aqueous flare value with IOP was analyzed.Results In the uveitic glaucoma group,the aqueous flare values were 21.10 (10.50,38.58) photoparticles/ms,88.00 (23.55,168.63) photoparticles/ms and 29.90 (8.90,65.18)photoparticles/ms 1 day,3 days and 1 week after surgery,which were significantly higher than 13.53 (7.60,24.00) photoparticles/ms before surgery (all at P＜0.01).The same trend was found in the other refractory glaucoma group.In addition,the aqueous flare value was higher in the uveitic glaucoma group than that in the other refractory glaucoma group in 3 months after surgery (q=-3.445,P＜0.01).No significant differences were seen in IOP between the two groups at various time points (all at P＞0.05).Also,no significant correlations were seen between IOP and aqueous flare value in all patients at various time points (preoperation:rs =0.136,P =0.481; postoperative 1 day:rs =0.019,P =0.922 ; postoperative 3 days:rs =-0.035,P =0.858 ; postoperative 1 week:rs =0.317,P=0.094; postoperative 2 weeks:rs =0.034,P =0.861 ; postoperative 1 month:rs =-0.094,P =0.628 ; postoperative 3 months:rs =0.065,P =0.738).Conclusions FC-2000 flare-cell photometry can reflect the inflammatory reaction of the anterior chamber following Ahmed glaucoma valve implantation in various types of refractory glaucomatous eyes.The postoperative inflammatory response is more serious and lasting in uveitic glaucomatous eye.

Diagnostic value of HNF-1βin the diagnosis of ovarian clear cell carcinoma / 临床与实验病理学杂志

Purpose To study the expression of HNF-1β in different type ovarian carcinoma and to explore the diagnostic value of HNF-1β in the diagnosis of ovarian clear cell carcinoma. Methods Immunohistochemical EnVision method was used to detect the ex-pression of HNF-1βin 27 clear cell carcinomas, 35 high-grade serous carcinomas, 21 endometrioid adenocarcinoma, 10 mucious carci-nomas, 13 metastatic Krukenberg tumors, and 2 transitional carcinomas. Results All of ovarian clear cell carcinomas variably ex-pressed HNF-1β and the positive rate of HNF-1β in ovarian cleat cell carcinoma was 85. 2%. Of 21 ovarian serous carcinomas, the nuclear positive of HNF-1β was 4 and HNF-1βpositive rate was 2. 9%. There was 5 HNF-1βexpression in endometrioid adenocarci-noma and the positive rate of HNF-1β was 23. 8%. The positive rate of HNF-1β in mucious carcinoma and metastatic Krukenberg tumor was 60. 0% and 53. 8%, respectively. No HNF-1βexpression was seen in transtional cell carcinoma. The sensitivity and speci-ficity of HNF-1β in the diagnosis of ovarian clear cell carcinoma was 85. 2% and 76. 5%. Conclusions HNF-1β may be a higher sensitive marker for the diagnosis of ovarian clear cell carcinoma. The diffuse and strong positive of HNF-1βmay have higher specific for diagnosis of ovarian clear cell carcinoma.

Expression of podoplanin-positive stromal cells in esophageal squamous cell carcinoma and its clinical significance / 临床与实验病理学杂志

Purpose To study the correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in squamous cell carcinoma ( SCC) of esophagus, and to explore the role of podoplanin-stromal cells in the progression of SCC of e-sophagus. Methods Immunohistochemical EnVision method was used to detect the expression of podoplanin in the stromal cells of e-sophageal SCC. The correlation between the expression of podoplanin-positive stromal cells and clinicopathologic features in SCC of e-sophagus was analyzed. Results Of 69 cases of SCC, podoplanin-positive stromal cells were seen in 43 and the positive rate was 62. 3%. Lymphatic vessel density in SCCs with podoplanin-positive stromal cell was 45. 72 ± 14. 36, which was higher than that with-out podoplanin-positive stromal cell (21. 23 ± 10. 49) (P0. 05). Conclusion Podoplanin-positive stromal cells may promote the lymphangiogenesis and lymph vessel invasion of esophageal SCC.

Diagnostic value of combined detection of HNF-1β and Napsin A in the diagnosis of ovarian clear cell carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the diagnostic value of HNF-1β and Napsin A for ovarian clear cell carcinomas, serous carcinomas, endometrioid adenocarcinomas and metastatic Krukenberg tumors.</p><p><b>METHODS</b>Immunohistochemical EnVision method was used to detect the expression of HNF-1β and Napsin A in 38 cases of ovarian clear cell carcinoma, 30 cases of high-grade serous carcinoma, 22 cases of endometrioid adenocarcinoma and 16 cases of metastatic Krukenberg tumor. Expression of HNF-1β and Napsin A were compared, and sensitivity and specificity of clear cell carcinoma of the ovary were analysed.</p><p><b>RESULTS</b>The positive rate of HNF-1β in the ovarian clear cell carcinoma was 100%(38/38), higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.05), although significant difference was not observed from that of metastatic Krukenberg tumor (P>0.05). Napsin A expressed in 97.4% (37/38) of ovarian clear cell carcinoma, 6.7% (2/30) of high-grade serous carcinoma, 22.7% (5/22) of endometrioid adenocarcinoma. Napsin A expression in clear cell carcinoma was higher than those in high-grade serous carcinoma and endometrioid adenocarcinoma (P<0.01), and no expression of Napsin A was seen in metastatic Krukenberg tumor (P>0.05). The sensitivity and specificity of HNF-1β in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, those of Napsin A were 97.4% and 91.2%, those of both HNF-1β and Napsin A were 97.4% and 91.2%, respectively. The sensitivity and specificity of HNF-1β or Napsin A in the diagnosis of ovarian clear cell carcinoma were 100% and 52.9%, respectively.</p><p><b>CONCLUSIONS</b>HNF-1β is a more sensitive marker for the diagnosis of ovarian clear cell carcinoma, whereas Napsin A is a more specific marker. The combined detection of HNF-1β and Napsin A may be helpful for the diagnosis of clear cell carcinoma of the ovary.</p>

Glaucoma secondary to systemic lupus erythematosus / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Glaucoma secondary to systemic lupus erythematosus (SLE) is an uncommon but serious complication that threatens vision and therefore cannot be neglected. A few cases of secondary glaucoma resulting from lupus-induced or iatrogenic ocular impairments have been reported in association with SLE. However, a systematic analysis of the diagnosis and treatment of glaucoma secondary to SLE has not been reported in the literature. The aim of this study is to further investigate the relationship between glaucoma and SLE.</p><p><b>METHODS</b>In this study, we reviewed nine eyes of five patients diagnosed with secondary glaucoma associated with SLE, including one case of neovascular glaucoma and four cases of steroid-induced glaucoma.</p><p><b>RESULTS</b>Neovascular glaucoma was successfully treated by Ahmed glaucoma valve implantation surgery with adjunctive ranibizumab intravitreal injection, followed by panretinal photocoagulation (PRP). The steroid-induced glaucoma in eight eyes of four cases were controlled by trabeculectomy along with antiproliferative agents.</p><p><b>CONCLUSION</b>Regular follow-up ocular examinations should be conducted to ensure early diagnosis and treatment of secondary glaucoma in SLE patients to improve the prognosis of vision.</p>

Value of ERG in the diagnosis of vascular tumor / 临床与实验病理学杂志

Purpose To study the expression of ERG in various vascular tumors, and to explore the value of ERG in the diagnosis of vascular tumor. Methods Immunohistochemical EnVision method was used to detect the expression of ERG and CD31 in 30 cases of vascular tumor and 20 cases of non-vascular tumor. Results All vascular tumors diffusely expressed ERG and CD31. Expression of ERG was unrelated to tumor histologic type and benign or malignant. Expression of ERG was consistent with CD31. Of 20 non-vascular tumors, all except for one cases of epithelial sarcoma did not express ERG. The sensitivity and specificity of ERG in the diagnosis of vascular tumor were 100% and 96. 7%. Conclusion ERG is a high sensitive and specific marker for vascular-derived tumor. The combinated detection of ERG and CD31 may useful for the diagnosis and differential diagnosis of vascular tumor.

A prospective comparative study on neovascular glaucoma and non-neovascular refractory glaucoma following Ahmed glaucoma valve implantation / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Neovascular glaucoma is a refractory disease, and difficult to manage. The aim of this study was to evaluate the clinical outcomes of Ahmed glaucoma valve implantation (AGVI) in neovascular glaucoma (NVG) and non-NVG patients.</p><p><b>METHODS</b>This prospective, non-randomized study included 55 eyes of 55 patients with refractory glaucoma; 27 had NVG (NVG group) and 28 had non-NVG (non-NVG group). All of the patients underwent AGVI. The NVG group was adjunctively injected with intravitreal ranibizumab/bevacizumab (IVR/IVB) before AGVI. Intraocular pressure (IOP) was the primary outcome measure in this study. Surgical success rate, number of antiglaucoma medications used, best corrected visual acuity (BCVA), and postoperative complications were analyzed between the groups.</p><p><b>RESULTS</b>All of the patients completed the study (follow-up of 12 months). Kaplan-Meier survival curve analysis indicated that the qualified success rates in the NVG and non-NVG groups at 12 months were 70.5% and 92.9%, respectively; this difference was significant (P = 0.036). The complete success rates in the NVG and non-NVG groups at 12 months were 66.7% and 89.3%, respectively (P = 0.049). Compared with preoperative examinations, the postoperative mean IOP and use of medications were significantly lower at all follow-up time points in both groups (all P < 0.05). There were significant differences in BCVA between the two groups at the 12-month follow-up (χ(2) = 9.86, P = 0.020). Cox proportional hazards regression showed NVG as a risk factor for surgical failure (RR = 15.08, P = 0.033). Postoperative complications were similar between the two groups.</p><p><b>CONCLUSIONS</b>AGVI is a safe and effective procedure in refractory glaucoma, but the success rate of surgery was related to the type of refractory glaucoma. The complete and qualified success rates of NVG patient adjunctive anti-vascular endothelial growth factor treatment are still lower than those of non-NVG patients.</p>

Expression of E-cadherin in the tumor tissue and serum of patients with esophageal squamous cell carcinoma / 中南大学学报(医学版)

OBJECTIVE@#To survey E-cadherin (E-cad) expression in tumor tissue and serum of esophageal squamous cell carcinoma patients, and to observe the clinical significance of their expression.@*METHODS@#Forty-eight samples of esophageal squamous cell carcinoma tissue, 23 samples of erosive esophagitis tissue, 24 samples of normal esophagus tissue and the corresponding sera were obtained. We used immunohistochemistry (IHC) to detect expression of E-cad in the tissues and enzyme-linked immunosorbent assay (ELISA) to examine expression of E-cad in the serum. Furthermore, we collected complete clinicopathological data from the participating patients.@*RESULTS@#The expression level of E-cad in the esophageal squamous cell carcinoma tissue was lower than that in normal esophagus tissues and erosive esophagitis tissues (P<0.05). Moreover, the expression level of E-cad was related to the depth of invasion, the status of lymph node metastasis and the level of differentiation of esophageal squamous cell carcinoma (P<0.05). The expression level of serum E-cad of esophageal squamous cell carcinoma patients was obviously higher than that in the serum of normal esophagus controls and erosive esophagitis patients (P<0.05). But the expression level of E-Cad in the serum of esophageal squamous cell carcinoma patients was unrelated to clinicopathological features. The expression level of E-cad in the tissue was not correlated with that in the serum(P=0.134).@*CONCLUSION@#The expression of E-cad in tissues may assistin the diagnosis and prognosis of esophageal squamous cell carcinoma. The expression of E-cad in the serum may assistin the diagnostic screening of esophageal squamous cell carcinoma.

The study on the mechanim of clopidogrel in human gastric epithelial GES-1 cell line injury / 中华消化杂志

ObjectiveTo explore the mechanism of clopidogrel in human gastric epithelial cell line (GES-1) injury.MethodsSet up GES-1 cells monolayer culture model.Then the GES-1 cells were divided into negative control group,U0126 intervented group,clopidogrel intervented group and combined intervented group (U0t26 treated firstly then clopidogrel intervented).The cell proliferation and apoptosis in each group was examined by methyl thiazolyl tetrazolium (MTT) assay and Flow cytometry.TheexpressionofphosphorylatedERK1/2ineachgroupwasdetectedby immunocytochemistry method,and the expression quantity of phosphorylated ERK1/2 in each group was measured by western blot.ResultsThe result of MTT assay showed that compared with negative control group,the proliferation of GES-1 cells was inhibited in U0126 group,clopidogrel group and combined intervented group,and the inhibition percentage was 21.8％ ±2.7％,46.3％ ± 3.4％ and 82.9 ％ ± 0.8 ％ respectively ( F=615.556,P =0.000 ).The result of immunocytochemistry indicated that the expression of p-ERK in U0126 group,Clopidogrel group and combined intervented group decreased compared with negative control group,which was 10.80±1.64,7.20± 1.64,4.40±0.89and 1.40±0.55 respecitively (F=49.426,P=0.000).The result of western blot and immunocytochemistry was of the same trend.Conclusion In GES-1 cell model,clopidogrel may injureGES-1 cells through MAPK/EPK signal transduction pathway.

Protective effects of ulinastatin on phosgene-induced acute lung injury and the expression of tumor necrosis factor-alpha / 中华急诊医学杂志

Objective To observe the effects of ulinastatin on the expressions of tumor necrosis factor-α (TNF-α) in the lung tissues of rats with acute lung injmy induced by phosgene, and to explore the mechanism of ulinastafin in treating acute lung injury. Method Sixty-four clean grade healthy male SD rots were randomly divided(random number) into eight groups with eight in each group. Group A1 in which rats were exposed to air. Group A2 in which rots wereexposed to air and treated with saline. Group A3 in which rats were exposed to air and treated with dexamethasone. Group A4 in which mrs were exposed to air and treated with ulinastatin. Group B1 in which rots were exposed to phosgene without treatment. Group B2 in which rats were exposed to phosgene and treated with saline. Group B3 in which rats were exposed to phosgene and treated with dexamethasone. Group B4 in which rats were exposed to phosgene and treated with ulinastatin. The expressions of TNF-α in the lung tissues were measured by using immunohistocheistry. Lung tissues were observed grossly and under 200-fold light microscope to identify the positive expressions in kytoplasm. Results In group B1 and group B2, the wet weight, dry weight and wet/dry weight ratio og right lower lobe of lung were higher thai those in group A1 and group A4( P <0.01 ), and those in group B4 and group B3 were significantly lower than those in group B1(P<0.01 ), but still higher than those in group A1 and A4(P<0.01). The gross observation suggested that the surfaces of lung tissues in group A1and group A2 were slick and rose pink without congestion, dropsy or infarction; the surfaces of lung tissue in groups B1 and B2 appeared with congestion, dropsy and many petechia. The surfaces of lung tissue in groups B3 and B4 were similar to those in groups B1 and B2. Under the light microscope, the structure, of lungs in groups A1 and A2 were clear without congestion, effusion or inflammatory cell infiltration. In groups B1 and B2, the engorgement of lung capillary vessels, congestion and tiny thrombosis were found and there abundant edematous fluid and inflammatory cell infiltration in lung stroma and alveolus with focal pulmonary atelectasis in some lung tissue section. The tissues in groups B3 and B4 showed congestion, dropsy, tiny thrombosis and inflammatory cell infiltration, but these changes were slighter than those in groups B1 and B2. The expressions of TNF-α in groups B1, B2, B3, and B4 were significantly higher thanthose in groups A1 and A2( P < 0.01 ), but the expressions of TNF-α IN group B4 was lower than that in groups B1 and B2(P<0.01). Conclusions Ulinastatin could lessen the lung injury by reducing the expressions of pro-inflammatory cytokines such as TNF-α.

The study on Occludin in esophageal epithelium in gastroesophageal reflux disease / 中国医师进修杂志

Objective To investigate the distribution and expression of Oceludin in esophageal epithelium in gastroesophageal reflux disease (GERD).Method Immunohistochemistry was used to examine the distribution and expression of Occludin in esophageal epithelium from 62 cases with GERD and 10 Case with other diseases ag control.Results The Occludin was normal continuous membrane expressed in 10 contrast esophageal epithelium,while in 32 nonerosive reflux disease patients,normal expression Was seen in 4 cases,different degree of abnormal expression was seen in 28 cases,including incomplete membrane expression,cytoplasmic expression and expression depletion respectively,and in 30 reflux esophagitis patients were seen all abnormal expression including incomplete membrane expression,cytoplasmic expression and expression depletion respectively.There was significant difference between nonerosive reflux disease and normal contrast,reflux esophagitis and normal contrast(P＜0.01),no difference was seen between reflux esophagitis and nonerosive reflux disease(P＞0.05).Concision The number of esophageal epithelial Occludin in GERD patients diminished and abnormally distributed,interfered the integrity of epithelium mucosal barrier,which might be one ofthe pathogenesis of GERD,there is no difference of Occludin expression between reflux esophagitis and nonerosive reflux disease esophageal epithelium.

Expression of HPV L1 protein and p16 in cervical lesions / 临床与实验病理学杂志

Purpose To study the expression of HPV L1 protein and p16 in various cervical lesions and to explore the value of HPV L1 protein and p16 immunostaining in predicting the progression from CIN1 to CIN3 and squamous cell carcinoma (SCC).Methods Expression of HPV L1 protein and p16 in 18 cases of CIN1, 9 cases of CIN2, 8 cases of CIN3 and 6 cases of SCC was detected by immunohistochemistry.Results The average positive rates of HPV L1 protein in cervical lesions were 26.8%, and HPV L1 protein was positive in 38.9% of CIN1 and 44.4% of CIN2, but in 0 of CIN3 and SCC. In contrast, the average positive rate of p16 protein in cervical lesions was 68.3%, p16 protein was positive in 38.9% of CIN1and 77.8% of CIN2, but in 100% of CIN3 and SCC. p16-/HPV L1+ and p16-/HPV L1- cases represented 61.1% of CIN1, but 0 of CIN3 and SCCs, whereas p16+/HPV L1- cases represented 100% of CIN3 and SCC.Conclusions Expression of HPV L1 protein decreases whereas p16 protein increases with lesion progression. p16+/HPV L1- cases have the potential for progression, whereas p16-/HPV L1+ and p16-/HPV L1- cases may not be progressive lesions or potentially in remission.

Effect of sodium cantharidinate on the growth of human gastric cancer grafted onto nude mice / 中国基层医药

Objective To study the effect of sodium cantharidinate on the growth of human gastric cancer grafted onto nude mice. Methods Nude mice xenograft models of human gastric cancer were established.BGC823was injected peritoneal and the mice were weighed. The proliferating and apoptosis rates of xenografta was evaluated by TUNEL assay and immunohistochemical staining respectively. Results The xenografts were obviously inhibited with various dosage of sodium cantharidinate(P＜0.01 ), the proliferating rate of turnout cells after using sodium cantharidinate was lower than that before using sodium cantharidinate(P＜0.01 ), but apoptosis rate of tumour ceils after using sodium cantharidinate was higher than that before using sodium cantharidinate(P＜0.01 ). Conclusion Sodium cantharidinate can inhibit gastric cancer growth by inhibiting tumour cell proliferating or inducing cell apoptosls.