Comparison of the diagnostic efficacy between transrectal and transperineal cognitive fusion combined systematic prostate biopsy / 中华泌尿外科杂志

Objective:This study aimed to compare the detection efficacy of transrectal ultrasound-guided transrectal cognitive fusion targeted+ systematic prostate biopsy and transperineal cognitive fusion targeted + systematic biopsy in patients with suspected prostate cancer (PCa). In addition, the relative clinical characteristics of PCa were evaluated.Methods:A total of 385 patients with suspected prostate cancer in the affiliated hospital of Qingdao University from May 2019 to November 2019 were retrospectively analyzed. All patients met the prostate biopsy criterion, who underwent transrectal(n=275)and transperineal(n=110)prostate biopsy respectively. There were no significant differences of mean age [(70.7±7.3)years vs.(69.2±8.4) years], PSA [(55.12±116.96)ng/ml vs. (63.41±315.34)ng/ml], prostate volume [(55.96±35.26)ml vs. (64.35±55.99)ml] between two groups. According to preoperative prostate magnetic resonance imaging combined with intraoperative ultrasound, 2-4 needles targeted puncture of suspected lesion were performed, followed by 12 needle systematic prostate biopsy. The detection rate of prostate cancer between two biopsy ways were compared. The related factors of PCa including age, prostate volume and PSA level were collected for univariable and multivariable logistic analysis. The cancer detection rate was compared and logistic regression was used to assess the impact of patient characteristics on PCa detection.Results:For all patients, the detection rate with cancer between transrectal group and transperineal group were 121/275(40.0%) and 67/110(60.9%), respectively. The transperineal group detected a higher rate of PCa ( P=0.003)and more clinically significant prostate cancers (csPCa) (54.6% vs.36.7%, P=0.001) than that of the transrectal group, there were significant differences between two groups ( P<0.05). Univariate and multivariate logistic regression analysis revealed that PSA( OR=1.025, P=0.001) and prostate volume( OR=0.984, P=0.001)were two independent factors for the detection rate of prostate cancer between two biopsy ways( P<0.05). The effect of age on the detection rate of PCa in the transperieal group was significantly lower than that of the transrectal group( OR=0.037, P=0.238 vs. OR=0.053, P=0.002). Conclusion:The transperieal biopsy could find more PCa than the transrectal biopsy. PSA level and prostate volume could affect the detection rate of cancer between two prostate biopsy ways.

Renal cell carcinoma in patients with end-stage renal disease: a clinicopathological analysis / 中华病理学杂志

Objective@#To investigate the clinicopathological characteristics and prognosis of renal cell carcinoma (RCC) in patients with end-stage renal disease (ESRD).@*Methods@#The clinicopathological data of patients of renal cell carcinoma arising in end-stage renal disease were collected from the Affiliated Hospital of Qingdao University (ten cases) and 971 Hospital of PLA Navy (five cases) from January 2009 to August 2018.@*Results@#Among 15 patients, 14 were male and 1 was female, and the age ranged from 38 to 78 years (mean 51 years, median 49 years). All patients had history of chronic renal failure (7-192 months), including 9 patients treated with hemodialysis for 6 to 132 months. In 12 cases the tumor border was distinct and the tumor size ranged from 1.8 to 11.0 cm. Two cases were multifocal and one case showed extensive renal hemorrhage with an inconspicuous tumor mass. Microscopically, 9 cases were clear cell reanl cell carcinoma including one with sarcomatoid differentiation, 4 were acquired cystic kidney disease-associated(ACKD-RCC) and two were papillary renal cell carcinoma. All patients had a follow-up of 3 to 120 months. Four patients died during a follow-up of 6 to 60 months (mean 30 months) as a result of extensive distant metastases (two cases) and renal failure (two cases), while other eleven patients were alive without tumor recurrence or metastasis (median 40.8 months of follow-up ranging from 3 to 120 months).@*Conclusions@#ESRD-RCC is more often seen in younger male patients. The time intervals from the onset of chronic renal failure to the diagnosis of renal cell carcinoma differ and tumors are frequently incidental findings. The histological types can be sporadic renal cell carcinoma or unique ACKD-RCC. Tumors are often hemorrhagic and necrotic. Routine physical examination and early detection could benefit ESRD-RCC patients. ESRD-RCC may have a favorable prognosis despite of a large tumor size or the presence of sarcomatoid differentiation.

Clinicopathological characteristics of fumarate hydratase-deficient renal cell carcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic characteristics, molecular and genetic features, differential diagnoses and prognosis of fumarate hydratase-deficient renal cell carcinoma (FH-RCC).@*Methods@#The immunohistochemical (IHC) expression of FH in 391 renal neoplasms in tissue chips collected from the Affiliated Hospital of Qingdao University and 971 Hospital of PLA Navy from January 2011 to December 2017 was evaluated. The clinicopathologic data of eight FH negative cases were collected.Polymerase chain reaction (PCR) and sequencing were used to detect the changes in FH gene in three cases. Interphase FISH with a dual color and break-apart probe was applied to detect the TFE3 gene alteration in the cases showing TFE3 protein expression.@*Results@#Among the eight patients, seven were male and one was female, and age ranged from 28 to 50 years (mean 39 years). Tumor size ranged from 3.5 cm to 12.0 cm (mean 7.9 cm). Renal pelvis invasion was identified in six cases, and the tumor emboli in renal vein and inferior vena cava were found in four patients. The cut surface of most tumors was solid, colorful, grayish white or yellow with no clear border showing invasive growth pattern. Microscopically, the tumors showed different proportions of papillary, tubular cystic, cribriform and solid structures. The tumor cells were rounded or polygonal with eosinophilic or amphotropic cytoplasm, round or oval nuclei, and focal large and prominent nucleoli (WHO/ISUP grade 3-4). Two cases had sarcomatoid or rhabdoid components. Intravascular tumor emboli were found in five cases. IHC staining showed most tumors expressed PAX8(7/8), CK19(7/8), vimentin (6/8) and P504s(8/8). However, other immunomarkers including CK7, CD10, CD117, RCC, 34βE12, HMB45 and Melan A were all negative. Sequencing showed all three cases had FH gene mutations in exon 1. FISH revealed no TFE3 gene translocation or amplification in the two cases with TFE3 IHC expression. Follow-up data were available in seven patients with the follow-up period from 11 to 66 months. Among them, five patients died between 11 to 31 months after the surgery because of extensive distant metastases of the tumor to the lung, liver and lymph nodes. The other two patients were alive at the 36th and 66th month after the surgery.@*Conclusions@#Morphologically, FH-RCC overlaps with papillary RCC, collecting duct carcinoma and tubular-cystic RCC, showing a mixture of papillary, tubular cystic, cribriform or tubular papillary structures with at least focal large and prominent nucleoli. The negative expression of FH and the detection of FH gene mutation could facilitate the diagnosis of the tumor. FH-RCC is a high aggressive tumor, prone to metastasize, and is associated with poor prognosis. The timely diagnosis of FH-RCC could benefit the patients and their relatives as well.

Acquired cystic kidney disease-associated renal cell carcinoma: a clinicopathologic study of three cases / 中华病理学杂志

Objective@#To study the clinicopathologic, immunohistochemical (IHC), histogenetic and prognostic features of acquired cystic kidney disease-associated renal cell carcinoma (ACKD-RCC).@*Methods@#Three cases of ACKD-RCC, including two from 401 Hospital of PLA and one from the Affiliated Hospital of Qingdao University were studied by clinical, histological and IHC analysis with review of relevant literature.@*Results@#All the three patients were male, ranging from 46 to 78 years old. All patients had history of chronic renal failure; two patients were treated with hemodialysis for 9 years and 11 years, respectively. In two cases the tumor sizes were 2.5 cm and 3.5 cm, respectively, and the tumor border was distinct. The remaining case showed extensive renal hemorrhage with an inconspicuous mass. Microscopically, the tumor cells were arranged in cribriform, microcystic or acinar structures, with variable papillary structure in one case. Hemorrhage of varying degrees was seen in all three cases, and obvious necrosis was noted in two. The tumor cells had deeply eosinophilic cytoplasm, indistinct cell border, round or oval nuclei, and prominent nucleoli (WHO/ISUP grade 3). Mitoses were rare. Abundant oxalate crystals were seen in two cases. The renal mesenchyme of all three cases were atrophic with variable cystic changes of the renal tubules, the lining cells showed atypical hyperplasia. IHC staining showed all tumors were diffusely positive for vimentin, CD10, RCC, CAM5.2, P504s and mitochondria in the cytoplasm, and were variably positive for EMA (2/3), CK7 (1/3), CA9 (1/3) and PAX8 (3/3). All cases were negative for CD117, HMB45, Melan A and TFE3. After 3-14 months follow-up, one patient died from renal failure six months after surgery. The other two patients were alive without tumor recurrence or metastasis.@*Conclusions@#ACKD-RCC is a very rare renal cell carcinoma. The specific cribriform structure, deeply eosinophilic cytoplasm, prominent nucleoli (WHO/ISUP grade 3), and oxalate crystals deposition, associated with the history of ACKD could aid the diagnosis. ACKD-RCC arises from the proximal renal tubule and its histogenesis might be associated with proliferation and malignant change of the atypical epithelial cells of the cystic renal tubules. ACKD-RCC may have a favorable prognosis except for tumors with sarcomatoid differentiation.

Clinicopathologic features of primary renal neuroendocrine carcinoma / 中华病理学杂志

Objective@#To investigate the clinicopathologic characteristics, diagnostic features and prognosis of primary renal neuroendocrine carcinoma (NEC). @*Methods@#The clinicopathologic data of eight cases of renal NEC was collected from January 2008 to December 2017 from Affiliated Hospital of Qingdao University. Immunohistochemical staining was performed, and follow-up information was analyzed, and the relevant literature reviewed. @*Results@#The patients′ mean age at diagnosis was 45 years (range, 27-66 years); five were women, and three were men. The tumors located on the left side in five patients, and on the right side in three. Five cases were detected incidentally, and three patients presented with loin pain. Microscopically, these cases included five well-differentiated NECs (three carcinoids, two atypical carcinoids), two small cell NECs, and one large cell NEC according to the World Health Organization classification of 2016. The tumors infiltrated the renal capsule in six cases. Necrosis was found in five cases. Vascular invasion with tumor emboli was seen in three cases. Lymph node metastasis was identified in one case. Immunohistochemically, the expression rates of neuroendocrine markers CD56, chromogranin A (CgA) and synaptophysin (Syn) were 6/8, 4/8, and 8/8 respectively. Some of the NECs were positive for epithelial markers CKpan (6/8, with three cases showing focal positivity) and CAM5.2 (4/8) of variable degrees. The Ki-67 proliferation index was≤3% in the carcinoids; ≥50% in the small cell carcinoma and large cell carcinoma; and 5% and 8% for the two cases of atypical carcinoid, respectively. All cases were negative for EMA, CK7, CA9, CD10, CD117, PAX2, PAX8, WT1, p63, S-100 and TTF1. Three patients (two with small cell carcinoma and one with large cell carcinoma) died of extensive metastases at 3 months, 4 months and 9 months after operation, while five patients were well, without recurrence or distant metastasis for follow-up period of one to nine years. @*Conclusions@#Primary renal NEC is rare. Carcinoid is the most common histological type. The pathomorphological features and neuroendocrine markers (CD56, CgA, Syn), epithelial markers (CKpan, CAM5.2) and nephrogenic markers (PAX2, PAX8) are important for the diagnosis. Renal carcinoid tumors are indolent and prone to early metastasis, but are associated with prolonged survival. The small cell renal cell carcinoma and large cell carcinoma are highly malignant renal tumors with poor prognosis and short survival.

Pin1 inhibitor juglone induces apoptosis in human cervical cancer SiHa cells / 中国病理生理杂志

AIM:To explore the effect of peptidyl-prolyl cis/trans isomerase (Pin1) inhibitor juglone on apop-tosis of human cervical cancer SiHa cells.METHODS:Cultured SiHa cells were incubated with juglone at concentrations of 10, 20, 50, 80 and 100 μmol/L for 24 h.The SiHa cell activity was detected by methyl thiazolyl tetrazolium ( MTT) assay.The cell apoptosis was analyzed by flow cytometry with Hoechst 33258 staining.The protein levels of cleaved caspase-3,8,9 and PTEN was determined by Western blotting.RESULTS:In different doses of juglone groups, the SiHa cell growth was greatly inhibited ( P<0.05) in a dose-dependent manner as compared with control group.The IC50 of ju-glone was 20.4 μmol/L.After treatment with juglone at concentration of 20 μmol/L for 12 h, the apoptosis of SiHa cells was induced, and the typical morphological changes of cell apoptosis such as karyopyknotic pyknic hyperfluorescence bolus, nuclear fragmentation and apoptotic body were observed by Hoechst 33258 staining.The early apoptotic rate was increased significantly as compared with the control.The protein levels of cleaved caspase-3, 8, 9 and PTEN were also increased sig-nificantly as compared with control group.CONCLUSION:Juglone significantly inhibits the cell activity and induces the apoptosis of SiHa cells in vitro by inhibiting the caspase pathway and increasing the expression of anti-oncogene.

Significance of Serum Galactomannan Detection in Invasive Pulmonary Aspergillosis Diagnosis / 中国医科大学学报

Objective To evaluate the value of serum galactomannan (GM) detection for invasive pulmonary aspergillosis (IPA) diagnosis. Methods The suspicious IPA patients were divided into proven,clinical and possible IPA groups. The patients excluded of IPA were recruited as controls. The serum GM concentration was detected by Platelia Aspergillus double?sandwich enzyme linked immunosorbent assay(ELISA). Re?sults In the 103 patients,there were seven cases diagnosed as proven,nineteen cases diagnosed as clinical and forty cases diagnosed as possible IPA patients. Setting 0.5 as the optimal result for GM detection,the sensitivity,specificity,positive predictive values and negative predictive values of GM were 85.7%,86.5%,55%and 97%,respectively. In non?neutropenia patients combinded with the pulmonary chronic diseases,the sensitivity, specificity,positive predictive values and negative predictive values of GM detection were 71.4%,84.4%,66.75%and 87.1%,respectively. Conclu?sion Index>0.5 for GM test could increase the sensitivity without obvious decreased specificity. GM detection could provide valuable information in patients of non?neutropenia underlying the pulmonary chronic diseases,which had a better sensitivity and specificity versus conventional diagnostic tests.

Diagnostic utility of S100A1, GLUT-1 and Caveolin-1 in renal tumors with oncocytic features: a comparative study / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the immunohistochemical expression of S100A1, GLUT-1 and Cavolin-1 and its diagnostic significance in renal tumors with oncocytic features.</p><p><b>METHODS</b>Tissue microarray and immunohistochemical staining for S100A1, GLUT-1 and Cavolin-1 were carried out in 59 cases of renal tumors with oncocytic features, including 19 cases of renal oncocytoma, 15 cases of clear cell renal cell carcinoma (CCRCC) with eosinophilic cells, 11 cases of eosinophilic variant of chromophobe renal cell carcinoma, 7 cases of oncocytic papillary renal cell carcinoma and 7 cases of epithelioid angiomyolipoma.</p><p><b>RESULTS</b>S100A1 was expressed in renal oncocytoma, with a positive propotion of 16/19 (including 14 cases showing widespread and strong positivity). On the other hand, the rate of expression of S100A1 was 2/11 in eosinophilic variant of chromophobe renal cell carcinoma, 10/15 in CCRCC with eosinophilic cells, 3/7 in oncocytic papillary renal cell carcinoma and 6/7 in epithelioid angiomyolipoma (P>0.05). The difference of S100A1 expression between renal oncocytoma and eosinophilic variant of chromophobe renal cell carcinoma was statistically significant. GLUT-1 was located in cell membrane, with a positive rate of 13/15 in CCRCC with eosinophilic cells, 7/19 in renal oncocytoma, 4/7 (weak) in oncocytic papillary renal cell carcinoma, 1/11 in eosinophilic variant of chromophobe renal cell carcinoma and 0/7 in epithelioid angiomyolipoma. The rate of expression of Cav-1 was 6/15 in CCRCC with eosinophilic cells, 2/7 in oncocytic papillary renal cell carcinoma, 5/7 in epithelioid angiomyolipoma, 2/11 (weak) in eosinophilic variant of chromophobe renal cell carcinoma and 0/19 in renal oncocytoma. S100A1 showed high sensitivity and 50% specificity in the diagnosis of renal oncocytoma. GLUT-1 and Cav-1 showed high specificity and sensitivity in the diagnosis of CCRCC and epithelioid angiomyolipoma.</p><p><b>CONCLUSIONS</b>S100A1 is widely expressed in various oncocytic renal neoplasms and helpful in differential diagnosis of renal oncocytoma from eosinophilic variant of chromophobe renal cell carcinoma, but not from other 3 oncocytic renal tumors. Overexpression of GLUT-1 can be used in distinction between CCRCC and renal oncocytoma. Cav-1 is widely expressed in CCRCC and epithelioid angiomyolipoma but not in renal oncocytoma. Cav-1 expression thus rules out renal oncocytoma.</p>

Clinicopathological features and prognosis of renal cell carcinoma with sarcomatoid differentiation / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the clinicopathological features and prognosis of renal cell carcinoma with sarcomatoid differentiation (RCCS).</p><p><b>METHODS</b>The clinical data and pathological materials of 18 RCCS cases were retrospectively reviewed.The follow up data were available in 13 RCCS cases, and were compared with the follow up data of 20 cases of clear cell renal cell carcinoma (RCC).</p><p><b>RESULTS</b>The 18 RCCS patients included 14 males and 4 females, and were 49-79 years old (mean age: 62 years old). On gross examination, the tumor size was 3-19 cm in diameter (mean diameter: 9.8 cm). Histologically, all tumors were composed of a mixture of typical RCC with sarcomatoid component, including 9 clear cell RCC, 3 chromophobe RCC and one papillary RCC. The sarcomatoid components included 9 cases of fibrosarcoma, 3 cases of leiomyosarcoma, 5 cases of malignant fibrous histocytoma and one case of undifferentiated sarcoma. Immunohistochemistry showed that the sarcomatoid components were strongly vimentin-positive in 18 cases, and one or more epithelial markers (EMA, AE1/AE3, CK7, CK18) were expressed to varying degrees in 14 cases, but the high-molecular weight keratin 34βE12 was scarcely expressed. The sarcomatoid components presented positive expressions of CAIX in 88.9% (16/18) and CD10 in 72.2% (13/18) cases. Among the 18 RCCS patients, 13 patients were followed-up: 9 patients died in 1-25 months after the surgery, of which 5 cases died of lung or bone metastasis, and 4 patients died of systemic failure. The twenty RCC cases without sarcomatoid differentiation were followed up for 3-65 months after the surgery, and the majority of them was alive uneventfully except for 2 cases who died of lung or bone metastasis of the tumor. The Kaplan-Meier survival analysis showed that the median survival time of the 18 RCCS patients was 8 months, while that of the 20 RCC cases without sarcomatoid differentiation was 62 months (P<0.001).</p><p><b>CONCLUSIONS</b>The presence of sarcomatoid differentiation in renal cell carcinoma indicates highly aggressive behavior and poor prognosis. The positive expressions of the immune markers CAIX and CD10 may play important roles in the transformation from renal cell carcinoma to sarcomatoid component.</p>

Mechanism of apoptosis induced by juglone in human cervical cancer SiHa cells / 中国药理学与毒理学杂志

OBJECTIVE To explore the pro-apoptotic mechanism of juglone in SiHa cells and to in?vestigate its associated signal transduction pathways. METHODS SiHa cells were treated with juglone 20μmol·L-1 for 24,48 and 72 h. Cellular morphology was detected by inverted microscopy.The cell viability was detected by methyl thiazolyl tetrazolium (MTT) assay. After 24 h treatment with juglone 20μmol·L-1,the cell apoptosis was detected by flow cytometry while the expressions of apopto?sis-related protein BCL-2,BAX and cleave-caspase-3,PI3K/AKt pathway-related protein PTEN,AKT and pAKT were detected by Western blotting. RESULTS After treatment with juglone for 24, 48 and 72 h,the growth of SiHa cells was significantly inhibited. Compared with cell control group,cells in juglone treated gruop were sparse,slipped off the wall,became round and the cell proliferation inhibitory rate was 43.3%,63.0%and 73.1%(P<0.05,P<0.01),respectively. Twenty-four hours post treatment, the early apoptosis rate of juglone treated gruop cells was increased by(6.47±1.79)%(P<0.01)compared with cell control group. Western blotting results showed that the expression of BCL-2 decreased by 53.0%while the expression of BAX and caspase-3 increased by 85.5%and 183.3%,respectively. The expression of PTEN was increased by 75.0% but the pAKt was decreased by 45.8%(P<0.01). CONCLUSION Juglone can upregulate the expression of PTEN, thus inhibiting PI3K/AKt pathway and promoting apoptosis of SiHa cells.

Influence of the therapy of calcitriol combined with prolonged hemodialysis on refractory secondary hyperparathyroidism in maintenance hemodialysis patients / 中国医师进修杂志

Objective To observe the influence of calcitriol combined with prolonged hemodialysis on parathyroid hormone (PTH),phosphorus and calcium in maintenance hemodialysis patients with refractory secondary hyperparathyroidism.Methods Twenty-two maintenance hemodialysis patients received prolonged hemodialysis (3 times per week and 6 hours each session) and therapy with calcitriol (3 times per week and 1 μ g each time) for 3 months.The levels of serum PTH,calcium and phosphorus of these patients were recorded before and after treatment.Results Compared with that before treatment,the level of serum PTH and phosphorus was decreased significantly[(484.21 ± 230.18) nmol/L vs.(750.53 ± 327.41) nmol/L,(1.49 ±0.27) mmol/L vs.(2.37 ±0.76) mmol/L],but calcium was increased after treatment [(2.35 ±0.32) mmol/L vs.(1.81 ±0.53) mmol/L],and there was significant difference (P ＜0.05).Conclusions The treatment of calcitriol combined with prolonged hemodialysis not only effectively clear phosphorus and PTH but also increase calcium in maintenance hemodialysis patients.The therapeutic schedule is good to maintenance hemodialysis patients with refractory secondary hyperparathyroidism.

Neuroendocrine carcinoma of the urinary bladder:clinicopathologic features analysis of 17 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate the clinicopathological characteristics and the prognosis of bladder neuroendocrine carcinoma (NEC).</p><p><b>METHODS</b>Clinicopathological data from 17 NEC of the bladder cases were collected, and immunohistochemical staining was performed with follow-up analysis and literature review.</p><p><b>RESULTS</b>The recruited included 13 male and 4 female patients, aged from 48 to 86 years old (average 61 years; 14 patients >60 years). Gross hematuria of the whole urination course or intermittent was the initial symptom. Macroscopically, the outer surface of the tumor presented with polypoid, lobulated, fungating or ulcerous structures. Histologically, according to the criteria of WHO classification of neuroendocrine tumor of the lung, our NEC cases were divided into three histological types: 13 cases of small cell carcinoma, 3 cases of large cell neuroendocrine carcinoma and 1 case of atypical carcinoid. The urothelial carcinoma was concurrent with NEC in 6 cases, and adenocarcinoma was concurrent with NEC in 2 cases. Most tumor tissue infiltrated to the muscular layer, some infiltrated to the outer membrane. Immunohistochemically, the positive expression rates of CD56, Syn and CgA were 16/17, 16/17 and 12/17, respectively. The epithelial markers, including CK7 and CKpan, were also expressed with positive rates of 12/17 and 15/17, respectively. TTF-1 was positively expressed in 11 cases. The follow-up data were available in 14 cases, of which 9 patients died of the tumor 1-34 months after surgery (average, 11 months). Five patients lived uneventfully for 1-12 months after surgery.</p><p><b>CONCLUSIONS</b>NEC is a rare malignant tumor of the bladder. Immunohistochemical markers such as CD56, Syn, CgA and CKpan could be helpful in determining the diagnosis and differential diagnosis of the tumor. NEC is a highly invasive malignant tumor with poor prognosis. Based on its biological behavior, radical cystectomy is the preferred method of treatment for the tumor.</p>

Pathology, ultra-structure and immunohistochemistry analysis of kidney oncocytoma / 中华泌尿外科杂志

Objective To study the pathological,ultrastructural and immunohistochemical features of kidney oncocytoma (RO). Methods The clinical and histological features of 13 patients (5 men and 8 women;mean age,58 years,age 44 -78 years) with RO were observed.Immunohistochemical staining was performed on paraffin-embedded tissues with a panel of antibodies including vimentin,EMA,ckpan,CK7,CK18,E-cadherin,CD10,RCC,CD117,34βE12,HMB45,s-100 and Ki-67.Of the 13 cases,10were found incidentally during a health examination while the other three cases presented with lumbago and discomfort of the lumber.Four cases were analyzed by electron microscopy.Eleven were treated with radical nephrectomy and 2 with partial nephrectomy. Results Histologically,the tumor cells were mainly arranged in closely packed nests,aciniform or tubule with an occasional microcystic pattern in loose edematous hypocellular fibrous stroma.Tumor cells had moderate to abundant granular eosinophilic cytoplasm with a small,round and uniform nucleus containing finely and evenly dispersed chromati.However,focal nuclear atypia were observed with no mitotic activity.Immunohistochemically,all cases were diffusely positive for CK18 and showed variable immunoreactivity for E-cadherin,CD117,CD10 and CK7.Twelve cases were positive for EMA. All cases were negative for vimentin,34βE12,HMB45 and s-100.The proliferative index (Ki-67) was very low in all cases,with less than 1％ of the nuclei labeled.Electronic microscopy showed the cytoplasm had abundant mitochondria with lamellar cristae.Follow-up on 10 patients ( range from 2 to 67months) showed no recurrence or metastasis. Conclusions Tumor cells arranged in nests with loose hypocellu]ar and edematous stroma is the most important histological feature of RO.The immunohistochemical features could be helpful for both diagnosis and differential diagnosis.

Effect of Rumex.japonicus Houtt extracts on hemopoietic system of model mice with thrombocytopenia / 吉林大学学报(医学版)

Objective To study the treating effect of middle and high doses of acetone and aether extracts from Rumex.Japonicus Houtt on mouse thrombocytopenia.Methods 80 BACB/C mice were randomly divided into 5 groups(n=16): negative control group(salad oil),middle dose(0.5 g?kg-1) and high dose(5 g?kg-1)of acetone and aether extracts groups.All mice in various group were injected with cyclophos-phamide(0.3 mL/20 g) by hypodermic for 3 d to set up the thrombocytopenic model;after mouse thrombocytopenic model was successfully set up,the mice were given salad oil,middle and high doses of acetone and aether extracts,respectively,by gastric perfusion,20 d later the mice were executed,the numbers of the platelet,red cells and white cells were determined.Results ①The numbers of platelet numbers of all groups on the 14th day after making model decreased significantly(P0.05).Conclusion Middle and high doses of acetone and aether extracts have obviously curative effect on mouse thrombocytopenia.

Effect of xingnaojing he shengmai injection on D-dimer and endothelin in patients at acute stage of cerebral hemorrhage / 中国组织工程研究

BACKGROUND: D-dimer is the specific marker of cross-link fibers degraded by fibrinolysin. During cerebral hemorrhage, D-dimer is significantly increased; its decrease may reflect the absorption process of hematoma and be closely related with the substantial injuries of brain. Endothelin is remarkably increased during cerebral hemorrhage, which may result in ischemic necrosis of neural histiocytes. The endothelin volume in cerebral hemorrhagic patients can reflect the severity of illness and the function prognosis.OBJECTIVE: To observe the effect of xingnaojing he shengmai injection (compound injection) on D-dimer and endothelin in patients at acute stage of cerebral hemorrhage.DESIGN: A randomized and controlled trial.SETTING: Emergent Internal Department of the Affiliated Hospital of Medical College of Qingdao University and Department of Pathology of Jinan Military General Hospital.PARTICIPANTS: A total of 44 patients of inspected patients at acute stage of cerebral hemorrhage were collected in Emergent Internal Department of affiliated Hospital of Medical College of Qingdao University from September 1999 to May 2001, which were randomized into two groups, named as xingnaojing he shengmai injection(compound injection) group(23 patients) and xingnaojing group(21 patients).METHODS: ELISA method was applied to determine the level of D-dimer and endothelin of peripheral blood before and after treatment. SPSS 8.0 statistical software was applied to analyze the data.MAIN OUTCOME MEASURES: Effects of xingnaojing he shengmai injection(compound injection) on level of D-dimer and endothelin in patients at acute stage of cerebral hemorrhage, compare with xingnaojing group.RESULTS: Xingnaojing he shengmai injection(compound injection) significantly reduced the level of both D-dimer[ (0. 67 ± 0. 21), (0.34 ± 0.18) mg/L,P ＜ 0.01 ] and endothelin[ (94.52 ±30. 23), (51.30 ± 21.62) ng/L, P＜ 0.01 ] before and after treatment respectively. The improvement of which was obviously superior to those in xingnaojing group[ (0. 33 ±0. 11),(0.20±0.08)mg/L, P ＜0.01; (43.22±12.06), (26.52±8.13)ng/L respectively, concerning to the improvements in two groups, P ＜ 0. 01 ].CONCLUSION: To improve the fibrinolytic state in patients with cerebral hemorrhage may protect the substantial injuries of brain and prevent the secondary damage after cerebral hemorrhage. To inhibit cerebral vascular spasm after hemorrhage may improve ischemic oxygen deficiency in brain tissue and probably be taken as one of the ways for xingnaojing he shengmai injection giving play to its therapeutic effects.

Qualitative Identification of 4 Constituents in Qindan Granules by TLC / 中国药房

OBJECTIVE:To establish the quality standard for Qindan granules. METHODS: The constituents including Radix Scutellariae, Radix Astragali, Cortex Moutan and Fructus Gardeniae in Qindan granules were identified respectively by TLC. RESULTS: The test samples and their respective reference substances were alike in that the same color chromatographic spots were noted at the corresponding places. The color spectra of the samples were clear yet without interference of surrounding impurity. CONCLUSION: The established method has high specificity and can be used for the quality control of Qindan granule.