Diagnostic value of thyroid imaging report and data system combined with BRAF V600E mutation detection for thyroid fine needle puncture cytological uncertain nodules / 肿瘤研究与临床

Objective:To investigate the diagnostic value of thyroid imaging report and data system (TIRADS) combined with BRAF V600E mutation detection in differentiating uncertain thyroid nodules by using fine needle aspiration cytology (FNAC), and to analyze the role of TIRADS classification in screening the nodules needed to be routinely detected for BRAF V600E mutation.Methods:The clinicopathological data of 337 thyroid nodules patients diagnosed with TIRADS classification, FNAC Bethesda classification, BRAF V600E mutation detection and postoperative histopathology from the Second Hospital of Hebei Medical University between January 2018 and August 2021 were retrospectively analyzed. The role of TIRADS classification, FNAC Bethesda classification and BRAF V600E mutation detection alone and the combined detection in the differentiation of benign and malignant thyroid nodules was also analyzed.Results:The postoperative histopathological result was regarded as the gold standard. The sensitivity of TIRADS classification, FNAC Bethesda classification and BRAF V600E mutation for thyroid cancer diagnosis was 76.0%, 88.1% and 80.4% respectively, and the corresponding specificity was 84.0%, 96.0% and 100.0%, respectively. Histologically, 37 (62.7%) of 59 nodules with FNAC uncertainty were malignant nodules after the surgery. The sensitivity and accuracy of BRAF V600E mutation detection in the diagnosis of FNAC uncertain nodules were 51.4% and 69.5%, respectively, while the sensitivity and accuracy of BRAF V600E mutation detection combined with TIRADS classification were 86.5% and 84.7%, respectively. The sensitivity and accuracy of BRAF V600E mutation detection combined with TIRADS classification were both improved ( P values were 0.002 and 0.049, respectively). The positive rate of BRAF V600E mutation in thyroid nodules increased step by step with the rise of risk degree in TIRADS classification, and the type 3 cases were lower than those in type 4a cases [14.3% (1/7) vs. 68.6% (24/35), P = 0.012], and there were no statistically significant differences among the adjacent groups above 4a (all P > 0.05). Conclusions:TIRADS combined with BRAF V600E mutation detection can improve the sensitivity and accuracy in the diagnosis of FNAC uncertain thyroid nodules. The BRAF V600E mutation rate of TIRADS 4a and above nodules is high, so routine detection is recommended.

Exploration and practice of holistic medicine and integrated medicine in the teaching of forensic pathological cause analysis of deaths / 中华医学教育探索杂志

Based on the characteristics of forensic pathology, this paper explains the concept, connotation and advantages of holistic medicine and integrated medicine in the teaching of forensic pathology. Then, through the introduction of the specific teaching process design and effect analysis of the death cause analysis practical cases, it clarifies the necessity and effectiveness of integrated medicine and holistic medicine in the teaching of forensic pathology, and provides new ideas for the reform of the overall teaching of forensic pathology.

Efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in preschool children / 中华麻醉学杂志

Objective To evaluate the efficacy of combination of multiple measures in preventing agitation during recovery from general anesthesia in the preschool children. Methods Four hundred and fifty preschool pediatric patients of both sexes, aged 3-6 yr, weighing 16-25 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective monocular strabismus surgery, were di-vided into 3 groups ( n=150 each) using a random number table method: routine prevention group ( groupⅠ) , midazolam-routine prevention group ( groupⅡ) and cartoon video-assisted admission to operating room-family members accompanying in postanesthesia care unit ( PACU)-routine prevention group ( groupⅢ) . Dexmedetomidine 0. 3μg∕kg was intravenously infused over 10 min in groupⅠ. On the basis of groupⅠ, midazolam 0. 05 mg∕kg was intravenously infused in the holding area in group Ⅱ, and children were admitted to the operating room while they were watching cartoons selected by themselves when accompanied by family members, and they were also accompanied by family members in PACU in group Ⅲ. The modi-fied Yale Preoperative Anxiety Scale score on admission to the operating room, Induction Compliance Checklist score, occurrence and degree of agitation during the recovery period, emergence time and dura-tion of PACU stay were recorded. Results Compared with groupⅠ, the modified Yale Preoperative Anxi-ety Scale score on admission to the operating room and Induction Compliance Checklist score were signifi-cantly decreased, and the incidence of agitation during the recovery period ( 25. 3％ in group Ⅰ, 12. 0％in group Ⅱ, 3. 3％ in group Ⅲ) was decreased in Ⅱ and Ⅲ groups , and the emergence time and dura-tion of PACU stay were significantly prolonged in groupⅡ( P<0. 05) . The incidence of agitation during the recovery period was significantly lower in group Ⅲ than in groupⅡ (P<0. 05). There was no significant difference in the constituent ratio of the degree of agitation among the three groups ( P>0. 05) . Conclusion Cartoon video-assisted admission to operating room-family members accompanying in PACU-routine pre-vention can effectively prevent the occurrence of agitation during recovery from general anesthesia in the pre-school children.

Effect of cartoon video-assisted preoperative interview on postoperative maladaptive behaviors of preschool pediatric patients / 中华麻醉学杂志

Objective To investigate the effect of cartoon video-assisted preoperative interview on the postoperative maladaptive behaviors of preschool pediatric patients.Methods One hundred preschool pediatric patients,aged 3-6 yr,weighing 12-28 kg,of American Society of Anesthesiologists physical status Ⅰ or Ⅱ,scheduled for elective strabismus surgery,were divided into 2 groups (n =50 each) using a random number table:cartoon video-assisted preoperative interview group (group Ⅰ) and routine preoperative interview group (group Ⅱ).In group Ⅰ,accompanied by the anesthesiologist,children and their parents watched the cartoon video designed for the perioperative process,and the anesthesiologist answered the questions that their parents had.After completion of tracheal intubation,dexmedetomidine 0.3 and 0.6 μg/kg were infused intravenously over 10 min in group Ⅰ and group Ⅱ,respectively.Three percent-4％ sevoflurane was inhaled to maintain anesthesia.The development and degree of agitation during stay in the post-anesthesia care unit (PACU) were recorded.The emergence time and length of PACU stay were also recorded.Postoperative maladaptive behaviors were assessed with the Post-Hospital Behavior Questionnaire at 1 week after surgery,and the occurrence of behavioral changes was recorded.Results Compared with group Ⅱ,the incidence of emergence agitation was significantly decreased,the degree of emergence agitation was reduced,the emergence time and length of PACU stay were shortened,and the incidence of behavioral changes (4％) was decreased after surgery in group Ⅰ (P＜0.05).Conclusion Cartoon video-assisted preoperative interview can effectively decrease the development of postoperative maladaptive behaviors of the preschool pediatric patients.

Comparison of KLF4, SP1, and Cyclin D1 expressions between ad-enocarcinanoma of the esophagogastric junction and distal gastric adenocarcinoma / 中国肿瘤临床

Objective:Recent studies have shown that in contrast to decrease in distal gastric adenocarcinoma (DGA), incidence of adenocarcinoma of the esophagogastric junction (AEG) has increased noticeably in numerous counties. However, the reasons remain unclear. This study evaluated the possible differences in the expression of KLF4, SP1, and Cyclin D1 in AEG and DGA, and explored the potential carcinogenesis of AEG. Methods:Immunohistochemistry was performed on paraffin-embedded tissues to evaluate the pu-tative differences in the expressions of KLF4, SP1, and Cyclin D1 at protein level between AEG (n=58) and DGA (n=47). The patholog-ical significance of these markers between the two groups was also compared and analyzed. Results:The percentage of positive KLF4 expression was significantly lower in DGA than in AEG (P<0.05). Lower KLF4 expression was found both in well-or moderately dif-ferentiated cases and in poorly differentiated cases with DGA compared with their AEG counterparts (P<0.05). However, positive stain-ing for SP1 was significantly higher in DGA (P<0.05). No significant difference was found in the expression of Cyclin D1 between the two groups. Further analysis showed that in DGA, the positive expression of KLF4, SP1, and Cyclin D1 were significantly correlated with lymph node metastasis. In AEG, only Cyclin D1 expression was correlated with lymph node metastasis (P<0.05). No correlation was found among the expression of KLF4, SP1, and Cyclin D1 in AEG. In DGA, KLF4 was inversely correlated with SP1 and Cyclin D1 (r=-0.334 and r=-0.341, respectively, P<0.05), and SP1 was positively correlated with Cyclin D1 expression (r=0.340, P<0.05).Conclusion:Different expression patterns and clinicopathological significance of KLF4, SP1, and Cyclin D1 were observed between AEG and DGA, suggesting the putative difference in the carcinogenesis and progression of AEG and DGA.

Molecular MRI evaluation of acute thrombus in carotid artery in rabbits / 中国医学影像技术

Objective To assess the value of a fibrin-targeted contrast agent (EP-2104R) for MR detection of thrombus, and to compare this modality with non-contrast-enhanced (NCE) MRI and Gd-DTPA injection at acute period after thrombus generation. Methods Thrombus was induced with external injury and stasis in 5 rabbits. MRI was performed before and after contrast agent injection at 6.0 h after injury, and the MRI findings were compared with that of histopathologically examinations. Results EP-2104R enhanced MRI accurately detected thrombus, which was superior to both NCE and Gd-DTPA injection (P<0.001). Gd-DTPA injection was not associated with improvement of thrombus detection. Conclusion Being a fibrin-targeted MR contrast agent for in vivo detection of acute thrombus, EP-2104R is superior to NCE MRI and Gd-DTPA injection.

Expression and clinical significance of Bmi-1,Mdm2 and Ki-67 in extrahepatic biliary duct carcinoma / 肿瘤研究与临床

Objective To investigate the expression of Bmi-1,Mdm2 and Ki-67 in extrahepatic biliary duct carcinoma and to evaluate their clinical significance. Methods The expression of Bmi-1.Mdm2 and Ki-67 was detected in 10 normal extrahepatic biliary duct tissue and 30 cases of extrahepatic billary duct carcinoma with immunohistochemic0al staining and the their clinical significance were analyzed. Results No POsitlVe Bmi-1 expression was found in 10 normal extrahepatie biliary duct cages, while 18 of 30 extrahepatic biliary duct carcinoma cases showed positive Bim-1 expression.The expression of Bmi-I in extrahepatic biliary duct carcinoma(60.0%)was statistically higher than that in normal extrahepatie biliary duct(P<0.05).The positive expression rate of Mdm2 in extrahepatic biliary duct carcinoma was significantly higher than that in normal extrahepatic biliary duct (56.7%vs 20.0%,P<0.05).The cases of extrahepatic biliary duct carcinoma with Ki-67 proliferation index higher than 5%reached 60.0%,while the Ki-67 index was all lower than 1%in 10 normal extrahepatic biliary duct tissue, suggesting the higher proliferating activity of extrahepatic biliary duct carcinoma.No differences were found in the expressions of Bmi-1,Mdm2 and Ki-67 among extrahepatic biliary duct carcinoma cases with different clinical pathological features. Conclusion The results indicate that the expression of Bmi-1 and Mdm2 up-regulation may play an important role in carcinogenesis of extrahepatic biliary duct caroinoma. No clinical significances of the expressions of Bmi-1,Mdm2 and Ki-67 are found in extrahepatic biliary duct carcinomas.

Expression and significance of TIP30, VEGF and CD34 in brain astrocytoma / 肿瘤研究与临床

Objective To investigate the expression and relationship of TIP30(HIV-1 Tat interactive protein 2), vascular endothelial growth factor (VEGF) and MVD (detected by CD34) in the angiogenesis of human brain astrocytomas. Methods Expression of TIP30, VEGF and CD34 in 19 cases of normal brain tissue and 71 cases of astrocytoma were immunohistochemically examined with Elivision plus two-step method. Results The positive expression of TIP30 could be seen in cytoplasm of neuroglial cells and neurons of 19 normal brain tissues. The positive expression rate of TIP30 in 71 cases of astrocytoma was 33.80 % (24/ 71). The positive expression rate of TIP30 in astrocytoma of different grades was 52 % for grade Ⅱ, 34.78 % for grade Ⅲ and 13.04 % for grade Ⅳ. The positive expression rate of TIP30 in high grade (Ⅲ+Ⅳ) of astrocytoma was found significantly lower than that in low grade(Ⅱ) (χ2=5.71, P <0.05); The expression of VEGF and MVD detected by CD34 in astrocytomas were higher than that in normal brain tissue and increased as the tumor grade increased; In astrocytoma, the negtive correlation was found between the expression of TIP30 and VEGF (r=-0.428, P<0.05); no correlation was found between TIP30 and MVD(r=-0.065, P 0.05); the positive correlation was found between VEGF and MVD(r=0.684, P<0.01). Conclusion The positive expression rate of TIP30 in normal brain tissue is significantly higher than that in astrocytoma. The positive expression rate of TIP30 significantly decreases as the pathological grade of the astrocytoma increases; The expression of TIP30 and VEGF is negatively correlated in astrocytoma.

Expressions of beta-catenin, p53 and proliferating cell nuclear antigen in the carcinogenesis of colorectal adenoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Research was done on the possible roles of beta-catenin, p53 and proliferating cell nuclear antigen (PCNA) in the carcinogenesis of colorectal adenoma (CRA).</p><p><b>METHODS</b>beta-catenin and p53 and PCNA expressions were studied with immunohistochemical stain in 77 specimens of CRA together with mild epithelial dysplasia (CRA-MD), CRA with moderate/severe epithelial dysplasia (CRA-D/SD) and CRA with cancerous changes (CRA-C).</p><p><b>RESULTS</b>The percentage of abnormal expression of beta-catenin increased during the transition from CRA-MD to CRA-D/SD to CRA-C (P < 0.01). The nuclear expressions of beta-catenin in CRA-D/SD and CRA-C were all significantly higher than that in CRA-MD. Expression of p53 and PCNA were increased from CRA-MD to CRA-D/SD to CRA-C, with the positive rates in these three groups of 10.3%, 43.8%, 75.0% for p53 and 17.2%, 62.5%, 87.5% for PCNA, respectively. 69.7% of cases with positive nuclear beta-catenin expression showed strong PCNA positivity which was much higher than the 36.4% of cases without nuclear beta-catenin expression (P < 0.05). The percentage of strong PCNA expression in the p53 positive cases was significant higher than that in cases with negative p53 expression (72.4% vs 37.5%, P < 0.05). Nuclear beta-catenin and p53 co-expression rates in CRA-C reached 50%.</p><p><b>CONCLUSION</b>beta-catenin, p53 and PCNA may play important roles in the carcinogenesis of colorectal adenoma.</p>