Application of artificial intelligence in renal pathology / 中华肾脏病杂志

In recent years, artificial intelligence has received extensive attention in the field of kidney pathology, such as identifying kidney tissue structure and evaluating the degree of lesions. Renal pathology is the gold standard for the diagnosis of renal diseases, and histochemistry staining is the prerequisite for the assessment of renal lesions. Renal biopsy is usually evaluated by various staining methods, including hematoxylin-eosin staining, periodic acid-Schiff reaction, Masson's trichrome staining and immunol staining, among that, different staining methods focus on different structures. The paper reviewed the application and progress of artificial intelligence in renal pathology, especially in different staining methods.

Survival of Hybrid Laminate Veneers using two different tooth preparation techniques: Randomized Clinical Trial

Abstract The aim of this study was to evaluate the survival of laminate veneers constructed using a recent polymer-infiltrated ceramic network material following the aesthetic pre-evaluative temporary (APT) technique of tooth preparation in comparison to traditional technique. Six patients received 54 laminate veneers. They were divided into two equal groups (n=27) according to the technique of tooth preparation: group T: traditional technique and group A: aesthetic pre-evaluative temporary technique. VITA ENAMIC material was used for CAD/CAM construction of laminate veneers. Cementation was performed using a light cured resin cement. The laminate veneers were evaluated at baseline, after 3, 6 and 12 months according to the modified United States Public Health Service (USPHS) criteriea. The data was collected, tabulated and statistically analyzed. Secondary caries, endodontic complications, cracks and loss of retention were not noted in any laminate veneer. Extensive fractures were not detected in both study groups through the study period. There was a statistically significant decrease of color match criteria between the two groups at the 6 and 12 months recalls. Based on this study, both preparation techniques resulted in successful clinical performance. After 12 months, all the veneers in both groups showed no post-operative sensitivity and all patients were highly satisfied regarding their veneers. However, there was a deterioration in color match criteria through the study period in both study groups.

Resumo O objetivo deste estudo foi avaliar a sobrevivência de facetas laminadas construídas utilizando um material recente de rede de cerâmica impregnada de polímero, seguindo a técnica estética pré-avaliadora temporária (APT) de preparação de dentes em comparação com a técnica tradicional. Seis pacientes receberam 54 facetas de laminados. Foram divididos em dois grupos iguais (n=27) de acordo com a técnica de preparação do dente: grupo T: técnica tradicional e grupo A: técnica temporária pré-avaliativa estética. O material VITA ENAMIC foi utilizado para a construção de facetas de CAD/CAM de laminados. A cimentação foi realizada utilizando um cimento de resina fotopolimerizável. Os laminados foram avaliados na linha de base, após 3, 6 e 12 meses de acordo com os critérios modificados do Serviço de Saúde Pública dos Estados Unidos (USPHS). Os dados foram recolhidos, tabulados e analisados estatisticamente. Cáries secundárias, complicações endodônticas, fissuras e perda de retenção não foram observadas em nenhuma faceta laminada. Não foram detectadas fraturas extensas em ambos os grupos de estudo durante o período do estudo. Verificou-se uma diminuição estatisticamente significativa dos critérios de correspondência de cor entre os dois grupos nos 6 e 12 meses. Com base neste estudo, ambas as técnicas de preparação resultaram num desempenho clínico bem sucedido. Após 12 meses, todos os laminados de ambos os grupos não mostraram qualquer sensibilidade pós-operatória e todos os pacientes ficaram altamente satisfeitos com os seus laminados. No entanto, houve uma deterioração dos critérios de correspondência de cor durante o período de estudo em ambos os grupos de estudo.

Clinicopathological analysis of malignant pleural effusion cell masses from 105 cases / 中国基层医药

Objective:To analyze the pathological types, tissue sources and clinical features of malignant pleural effusion.Methods:Cell masses were collected from 105 cases of malignant pleural effusion diagnosed by immunohistochemical examination after liquid-based cytology between May 2017 and October 2019 in Qidong People's Hospital, China. The pathological, morphological, immunohistochemical and clinical characteristics of the cell masses were analyzed.Results:Immunohistochemistry results showed that pleural effusion malignant cells were from lung adenocarcinoma tissue in 94 (89.52%) cases because they were positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen, from small cell lung cancer tissue in one (0.95%) case because they were positive for neural cell adhesion molecule 1 and synaptophysin,from lung squamous cell carcinoma tissue in 2 (1.90%) cases because they were positive for cytokeratin 5/6 and P40, from ovarian adenocarcinoma tissue in 1 (0.95%) case because they were positive for CA125, from breast adenocarcinoma tissue in 4 (3.81%) cases because they were positive for estrogen receptor, progesterone receptor and gross cystic disease fluid protein 15, from the gastrointestinal tract adenocarcinoma tissue in 2 (1.90%) case because they were positive for caudal-type homeobox 2, and from the pancreatic adenocarcinoma tissue in 1 (0.95%) case because they were positive for cancer antigen 19-9 (CA199).Conclusion:Lung adenocarcinoma is the most common cause of malignant pleural effusion. Lung adenocarcinoma cells are positive for thyroid transcription factor-1, Napsin A and carcinoembryonic antigen. The combined use of the three markers can help the diagnosis of lung adenocarcinoma. In addition, lung adenocarcinoma should be differentiated from other types of lung cancer and the tumors from other regions.

Consistency of diagnosis between cervical cytology and colposcopic biopsy diagnosis / 中华病理学杂志

Objective@#To identify underlying reasons for discrepant cases of positive cytology but negative histology.@*Methods@#Cases with positive cytology and negative histology from 2008 to 2016 were retrieved from Department of Pathology, Obstetrics and Gynecology Hospital of Fudan University. Low grade squamous intraepithelial lesion or higher grade lesions were considered as positive cytology test in the study. Consecutive follow-up biopsies and as well as sites of biopsy were documented for analysis.@*Results@#Overall positive rate of biopsy followed positive cytology was 74.3%(8 990/12 097). Of the negative biopsies, 675 cases were followed-up with multiple biopsy. Two-hundred and eighty-seven cases (42.5%, 287/675) were confirmed to have lesions. Comparing with those with initial positive biopsiews, patients of the latter group were significantly older and had other specimen types including vaginal biopsy, cone biopsy and hysterectomy. The final histological diagnoses were well correlated with cytological results (Kappa=0.505, P<0.01).@*Conclusions@#Qualified cervical cytology is complimentary to histological diagnosis. Clinicians should not ignore the positive cytological result prior to a normal histological diagnosis. In contradictory cases, repeated colposcopy and biopsy at extended anatomic sites may reveal additional lesions.

The study of the feasibility of detecting EGFR,KRAS and PIK3CA genes by ROSE cytological slides in non-small cell lung cancer / 天津医药

Objective To explore the feasibility of EGFR, KRAS and PIK3CA mutation analysis on rapid on-site evaluation (ROSE)cytological slides in patients with non-small cell lung cancer and its clinical value. Methods Seventy-five cases of ROSE cytological slides and paired histological specimens were collected in Tianjin Medical University General Hospital. xTAG70plex liquidchip technology was used to analyze the gene mutations of the samples.Results The KRAS mutation was found in histological specimen but not in ROSE cytological slides in one case. The mutation results were the same in histological specimen and ROSE cytological slides in other cases.The consistent rates of the EGFR mutation and KRAS mutation were 100% and 98.7%,respectively. Conclusion Our study demonstrates that xTAG70plex liquidchip technology can be used for the mutation analysis of EGFR,KRAS and PIK3CA genes in non-small cell lung cancer on ROSE cytological slides.

Research progress on solid dispersion technique in preparative field / 药物评价研究

Solid dispersions (SD) as a preparation of intermediates have played an important role in improving the dissolution of insoluble drugs and its bioavailability.SD technique is one of the most promising techniques to improve the dissolution and solubility of insoluble drugs,and the development of SD technique will promote the gradual perfection in preparative field.This review focuses on the carrier materials of SD,various new preparation techniques and their comparisons,application of solid dispersion formulations,and stability problems of SD.The factors influencing the stability of SD are described,and the effective measures to prevent the aging of SD are put forward.Finally,the review puts forward the practical suggestions of the solid dispersion technique.

Research progress on solid dispersion technique in preparative field / 药物评价研究

Solid dispersions (SD) as a preparation of intermediates have played an important role in improving the dissolution of insoluble drugs and its bioavailability.SD technique is one of the most promising techniques to improve the dissolution and solubility of insoluble drugs,and the development of SD technique will promote the gradual perfection in preparative field.This review focuses on the carrier materials of SD,various new preparation techniques and their comparisons,application of solid dispersion formulations,and stability problems of SD.The factors influencing the stability of SD are described,and the effective measures to prevent the aging of SD are put forward.Finally,the review puts forward the practical suggestions of the solid dispersion technique.

Canal Preparation and Filling Techniques do not Influence the Fracture Resistance of Extensively Damaged Teeth

The purpose of this study was to assess the fracture resistance of extensively damaged teeth after two root canal preparation techniques (hand and rotary files) and after two filling techniques (active and passive compaction). Sixty-eight maxillary canines roots with an apical diameter equal to that of a #25 K-file were embedded in acrylic resin and the periodontal ligament was simulated by using a polyether impression material. The roots were randomly distributed into four groups (n=17): hand preparation and active compaction (HA), hand preparation and passive compaction (HP), rotary preparation and active compaction (RA), and rotary preparation and passive compaction (RP). All roots were restored with glass fiber post and metallic crown. The specimens were mechanically cycled (500,000 cycles, 45°, 37°C, 133 N, 2 Hz) and then subjected to a fracture resistance test. A single blinded examiner analyzed the external root surface and classified the failure pattern as favorable or unfavorable. The fracture resistance values ranged between 621.15 N (HP) and 785.71 N (HA). However, the Kruskal-Wallis test did not reveal differences in the fracture resistance values among the four groups (p =0.247). Under the tested conditions, root canal preparation and filling techniques had no influence on the fracture resistance of extensively damaged teeth restored with fiber post and metallic crown.

O objetivo deste estudo foi avaliar a resistência à fratura de dentes amplamente destruídos após duas técnicas de preparo (limas manual e rotatória) e após duas técnicas obturadoras (compactação ativa e passiva). Sessenta e oito raízes de caninos superiores com diâmetro apical igual a uma lima K #25 foram embutidas em resina acrílica e o ligamento periodontal foi simulado utilizando um material de moldagem à base de poliéter. As raízes foram distribuídas aleatoriamente em quatro grupos (n=17): preparo manual e compactação ativa (MA), preparo manual e compactação passiva (MP), preparo rotatório e compactação ativa (RA) e preparo rotatório e compactação passiva (RP). Todas as raízes foram restauradas com pino de fibra de vidro e coroa metálica. Os espécimes foram ciclados mecanicamente (500.000 ciclos, 45°, 37°C, 133 N, 2 Hz) e depois submetidos ao teste de resistência à fratura. Um único examinador cego analisou a superfície externa das raízes e classificou o padrão de falha em favorável ou desfavorável. Os valores de resistência à fratura variaram entre 621,15 N (MP) e 785,71 N (MA). Entretanto, o teste de Kruskal-Wallis não revelou diferença nos valores de resistência à fratura entre os quatro grupos (p=0,247). Diante das condições testadas, as técnicas de preparo e de obturação do canal radicular não influenciam na resistência à fratura de dentes amplamente destruídos restaurados com pino de fibra de vidro e coroa metálica.

Clinicopathological study of thinprep cytologic test on 4234 patients with cervical lesion / 肿瘤研究与临床

Objective To estimate the clinical value of thinprep cytologic test (TCT) in screening cervical lesion. Methods 4234 TCT samples were interpreted according to the Besthesda System (TBS), 272positive cases (ASC-US or above) were taken colposcopic examination and biopsy. Results The coincidence of the results between TCT and biopsy in low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), squamous cell carcinoma (SCC), adenocarcinoma (AC) were 85.71%(12/14), 100 % (20/20), 75 % (3/4) and 100 % (2/2), respectively. The positive rates of over ASC-H by TCT and of over CIN Ⅰ by biopsy were 23.16 % (63/272) and 24.26 % (66/272), respectively. There is no difference between two positive rates (x2 = 0.868, P = 0.581). Conclusion TCT and histopathological diagnosis had a high coincidence, a combination of both can greatly enhance HSIL and cervical cancer and reduce the incidence of missed diagnosis. TCT would be a rapid and convenient method for screening cervical cancer.

The diagnosis value of morphology changes of pleomorphic megakaryocytes in bone marrow smears and bone marrow sections in chronic myeloproliferative disorders / 中华检验医学杂志

Objective To explore the diagnosis value of morphology changes of pleomorphic megakaryocytes in the bone marrow (BM) smears and BM sections in chronic MPD(CML-CP, ET,PV and PMF). Methods BM aspiration was taken in 182 patients of MPD aspiration and biopsy examination was performed synchronously to obtain the BM smears and BM sections samples. The BM smears were subjected to Wright/Giemsa stain and immunohistochemistry stain, while the BM sections were subjected to Haematoxylin-Giemsa-Fuchsin stain. The morphology of pleomorphic megakaryocytes was classified into five groups, which were Ⅰ type ( inclusion type), Ⅱtype ( hypolobulated muclei type), Ⅲ type ( giant hyperlobulated nuclei type), IV type (micro pyknotic type), and V type(extrusion type). The size of megakaryocytes clusters was recorded as no clusters(0) , predominantly small clusters of fewer than 6 cells (1) or predominantly large clusters of at least 6 cells (2) . The detection rates of various types of pleomorphic megakaryocytes and megakaryocytes clusters were both analyzed in the BM smears and BM sections. Results In CML-CP group, the detection rates were (3. 73±3. 84)% , (14.19 ±7. 62)% ,(5.99 ±4.67)%, (34. 37 ±10.79)%, (9.45 ±6. 87)%, (32. 28 ±7. 67)% and 3.13 ±2. 30)% ,(12.61 ± 9.28)%,(4.94±4.27)%,(35.26±9.63)%,(9.47 ±5.89)%,(34.58 ±6.81)% for I tⅠype,Ⅱ type,Ⅲ type, Ⅳtype and Ⅴ type pleomorphic megakaryocyte in BM smears and BM sections. There were no significantly differences between the BM smears and BM sections(t value were 0.524,0.510,0.645, 0.239,0.011,0. 869,all P>0.05). In ET group, the detection rate of I type [ (6.17 ±2. 89)% ] in BM smears was significantly higher than that in BM sections [ 2.42 ± 1. 28) % ] (t = 7. 183, P < 0. 01) , while the detection rate of V type [ (6. 28 ± 3. 34) % ] in BM smears was significantly lower than that in BM sections [ (10. 18± 4.03) % ] (t = 3.940, P < 0.01). Besides these, the detection rates of other types were not significantly different between the BM smears and BM sections(t value were 0.079,0. 122,1.643, 1. 638,all P>0. 05). In PV group, the detection rate of V type in BM smears [ (6. 55 ±4. 11)% ] was significantly lower than that in BM sections [ (10. 30±3. 34) % ] (t = 2. 351, P < 0.05 ). However, the detection rates of the other types were not significantly different between the BM smears and BM sections (t value were 1. 635,0. 301,0. 132,0. 704,0. 681 ,all P' >0. 05). In PMF group, the detection rate of IV type in BM smears [(13.05 ±5.24)%] was significantly lower than that in BM sections [(29.14± 8. 72) % ] (t = 5. 245, P < 0. 01). And the detection rate of normal type in BM smears [ ( 33. 58 ± 14.39)% ] was significantly higher than that in BM sections [(23. 01±7.96)%] (t =2. 132,P<0. 05). Besides these, the detection rates of the other types were not significantly different between BM smears and BM sections( t value were 0. 787,0.646,2.062,0. 869, P > 0. 05 ) . In CML-CP and PV groups, the detection rates of size of clusters were not significantly different between the BM smears and BM sections (x~2 = 2. 772, P > 0. 05 ). In ET group, the detection rate of small clusters (1) in BM smears was obviously higher than that in BM sections, however, the detection rate of larger clusters (2) in BM smears was obviously lower than that in BM sections (x~2 = 13. 748, P < 0.01). In PMF group, the detection rate of no clusters(0) in BM smears was obviously higher than that in BM sections, however, the detection rate of large clusters(2) in BM smears was obviously lowers than that in BM sections (x~2 =18.741 ,P<0. 01). Conclusions Both BM smears and BM sections can be applied to observe pleomorphic megakaryocytes. The morphology changes of pleomorphic megakaryocytes have certain reference values for identification of MPD subtypes and differential diagnosis.

Bone marrow biopsy combined bone marrow smear for diagnosis of 86 MDS / 白血病·淋巴瘤

Objective To explore the clinical significance of the union between marrow smear and marrow biopsy in the myelodysplastic syndrome(MDS) diagnosis. Methods Bone marrow aspirate and smear were initially abtained, then bone tissues encircled drill and section at the same point which is called as. easy one-step technology to 86 MDS patients were analysed. Results In 86 cases of MDS patients, there were 30 cases of hyperplasia extreme degree of reduction by 34.88 %, 56 eases of active, obvious and extremely active active (65.12 %), 43 cases for red RCMD (50.00 %), 32 cases for the granulocyte dysplasia (37.21%), 22 cases for megakaryocyte RCMD (25.58 %) in bone marrow aspiration smears; compared with 15 cases of hyperplasia extreme degree of reduction and the reduction (17.44 %), 71 eases of active, obviously active and extremely active (82.56 %); 16 cases for red RCMD (18.61%), 52 cases for the granulocyte dysplasia (60.47 %), 56 cases for megakaryocyte RCMD (65.12 %) in bone marrow biopsy sections. 66 cases in 86 cases of bone marrow biopsy and bone marrow smear of WHO classification were in line with the rate of 76.74 %.Conclusion The biopsy slide and the puncture smear synchronization observation is more advantageous than the conventional puncture smear morphology observation and combining two method may increase the accuracy in the MDS diagnosis.

A comparative study of antimicrobial efficacy of three different instruments and mechanical preparation techniques in single infected root canals / 实用口腔医学杂志

Objective: To compare and analyze the antimicrobial efficacy of three different mechanical preparation techniques in single infected root canals. Methods; Forty-five single root canals with chronic periapical periodontitis were selected. The specimens were divided into three groups randomly, 15 root canals per group. Croup A: preparation with stainless steel K-files (step-back technique), Croup B: preparation with HERO 642 NiTi rotary files (crown-down technique) and Group C: preparation with Mtwo NiTi rotary files ( modified crown-down technique). The sterile normal saline was used as irrigation. Samples were taken before and after canal preparation. The difference of CFU was calculated as well as the bacterial species. Results; All groups were effective to reduce bacteria within the infected root canals greatly(P<0.01). Croup A and Group C were statistically better than Group B(P<0.05). Group A was more effective than Group C but there was no statistically difference between them(P>0.05). Conclusion; Mechanical preparation can greatly reduce the intracanal bacteria, but can not obtain bacteria-free canals. The mechanical preparation must be aided by chemical irrigation to improve the success of root canal therapy.

Relación citohistológica en mujeres con diagnóstico de papiloma virus humano / Cytohistologic relation in women with diagnosis of human papilloma virus of Camagüey municipality

Fundamento: En la actualidad el cáncer cérvicouterino es la segunda causa de cáncer ginecológico a nivel mundial después del de mama. Objetivo: Describir la relación citohistológica en mujeres con diagnóstico de papiloma virus humano (PVH) por biopsia del municipio Camagüey. Método: Se realizó un estudio descriptivo en el Hospital Docente Gineco-Obstétrico Ana Betancourt de Mora en los años 2005-2006. La muestra la constituyeron 159 mujeres con diagnóstico de PVH en las que se estudió la edad y los resultados citológicos e histológicos. Los resultados seexpresaron en números absolutos y relativos y se expusieron en tablas, gráficos y texto. Resultados: El 42,7 por ciento de las pacientes tenían edades comprendidas entre 30 y 39 años y el 24,5 por ciento estaban entre 20 y 29 años. Se observó coincidencia diagnóstica en 84 (52,8 por ciento ) mujeres, principalmente entre las que presentaron PVH asociado a NIC I y NIC II. En 25 (15,7 por ciento ) se encontraron resultados negativos falsos en la citología. Conclusiones: La infección por PVH predominó en las mujeres con edades entre 30 y 39 años. Los resultados citológicos e histológicos coincidieron en más de la mitad de las enfermas con diagnóstico de PVH asociado a NIC I y NIC II, no así en las restantes.

Background: At the present time cervix uteri cancer is the second cause of worldwide gynaecological cancer after the mamma´s. Objective: To describe the cytohistologic relation in women with diagnosis of human papilloma virus (HPV) by biopsy in Camagüey municipality. Method: A descriptive study at Ana Betancourt de Mora Gyneco-Obstetric Teaching Hospital in 2005-2006 years. The sample was constituted by 159 women with diagnosis of HPV in which age, cytologic and histological results were studied. Results in absolute and relative numbers were expressed and exposed in tables, charts and text. Results: The 42,7 percent of the patients had ages between 30 and 39 years and the 24,5 percent were between 20 and 29 years. Diagnostic coincidence in 84 (52.8 percent ) women was observed, mainly among who presented HPV associated to NIC I and NIC II. In 25 (15.7 percent ) false negative results were found in the cytology. Conclusions: The infection by HPV predominated in women with ages between 30 and 39 years. Cytologic and histological results coincided in over the half of sick persons with diagnosis of HPV associated to NIC I and NIC II, no like this in the remaining.

Combination of frozen section and touch imprint cytology for the intraoperative diagnosis of sentinel lymph node in breast cancer / 肿瘤研究与临床

Objective Frozen section(FS)and touch imprint cytology(TIC)were common methods for intraoperative evaluation of sentinel lymph node(SLN)biopsy in breast cancer,with low sensitivity when used separately.The purpose of this study was to evaluate the value of combination of these two techniques.Methotis This study included 400 sentinel nodes from 150 patients with breast cancer.352 sentinel nodes were bisected along the long axis.Each sectioned surface of SLN was imprinted onto the surface of a slide and was analyzed by cytologist;meanwhile SLN were analyzed with intraoperative FS.The other 48 SLN were only analyzed with intraoperative PS due to their small size.Results of intraoperative P3 and TIC were compared with final pathology.Results Eighty-nine positive SLN from 55 patients were identified by final pathology.The specificity of FS and TIC were both 100%.According to the number of SLN.the sensitivity of TIC and FS was 71.9%(64/89)and 83.1%(74/89),respectively(P＞0.05).The sensitivity of TIC compared with FS was 96.6%(86/89),significantly higher than that of TIC and FS separately(both P＜0.001).According to the number of patients,the sensitivities of TIC and FS were 80.0%(44/55)and 81.8%(45/55),respectively(P＞0.05).The sensitivity of TIC compared with FS was 94.5%(52/55).significantly higher than that of TIC and FS separately (both P＜0.001).Conclusion Combination of FS and TIC for the intraoperative diagnosis of SLN biopsy in breast cancer was reliable,with hish sensitivity and specificity,and could avoid the second axillary operation efficiently.