Diagnostic value of endoscopic ultrasonography for pancreatic cystic lesions / 中华胰腺病杂志

Objective:To explore the diagnostic value of endoscopic ultrasonography (EUS) for pancreatic cystic lesions (PCLs).Methods:Clinical data of 211 patients with PCLs, who underwent EUS at least once and were pathologically confirmed in First Affiliated of Naval Medical University from January 2011 to December 2021 was retrospectively analyzed. EUS imaging characteristics, biochemical analysis of cystic fluid and pathological data were recorded. The pathological diagnosis results of intraductal papillary mucinous neoplasms and mucinous cystic neoplasms were included in the mucinous lesion group, while pancreatic pseudocyst, serous cystic neoplasms, solid pseudopapillary neoplasms and pancreatic neuroendocrine tumors were included as non-mucinous lesions group; those with pancreatic ductal adenocarcinoma, adenocarcinoma or with atypical or cancer cells were included as malignant lesion group, and the else were included as benign lesions group. The level of CEA in cyst fluid between mucinous and non-mucinous lesions and the level of amylase in cyst fluid between benign and malignant lesion groups were compared, and the area under the curve (AUC) was calculated by drawing receiver operating characteristic curve (ROC), which was used to analyze the differential diagnosis efficiency of cyst fluid CEA and amylase test indexes. The basic characteristics and EUS imaging characteristics, and the diagnostic efficiency of EUS and liquid-based cytology and histopathology between benign and malignant lesions were studied and analyzed.Results:Among the 211 PCL patients, cyst fluid was obtained in 201 patients, of which 188 patients (93.5%) underwent cytological examination, and 33 patients were diagnosed with an accuracy rate of 17.6%; 41 cases were obtained for histological examination, and 23 cases were confirmed, with an accuracy rate of 56.1%. Among all confirmed cases, 45 cases had benign lesions, including 22 cases of mucinous lesions and 23 cases of non-mucinous lesions, with the cyst fluid CEA of 1458.16(19.80, 1500.00), 4.4(0.50, 341.14)ng/ml respectively, and the difference of cyst fluid CEA level between mucinous and non-mucinous lesions was statistically significant( P<0.05). The cyst fluid CEA<10.15 ng/ml could be used to diagnose non-mucinous PCLs with the sensitivity of 89.5%(95% CI0.686-0.981), and the specificity of 66.7%(95% CI0.438-0.837). The cyst fluid amylase levels in benign and malignant lesions were 379.00(50.00, 18405.50), 42.00(13.50, 340.00)U/L, and the difference was statistically significant ( P<0.05). The cyst fluid amylase>747.50 U/L might help to identify benign PCLs with the sensitivity of 91.7%(95% CI0.646-0.996), and the specificity of 48.0%(95% CI0.300-0.665). EUS showed that the proportion of cyst wall thickening, main duct dilatation and cystic solid components in patients with malignant lesions was significantly higher than that in patients with benign lesions, and the differences were statistically significant ( P<0.05), while there was no significant difference in the proportion of cyst wall nodules and cystic septum between the two groups. The accuracy of EUS combined with liquid-based cytology or histopathology in malignant lesions was over 80%. Conclusions:The cyst fluid CEA level can help to differentiate non-mucinous PCLs from mucinous PCLs, and the cystic amylase level could be useful to identify the benign and malignant PCLs. EUS combined with cytology or histology had high diagnostic value for malignant or potentially malignant PCLs, and EUS-FNA examination can be recommended as soon as possible for those with high-risk factors.

Gold nanoparticle-directed autophagy intervention for antitumor immunotherapy via inhibiting tumor-associated macrophage M2 polarization

Tumor-associated macrophages (TAMs), one of the dominating constituents of tumor microenvironment, are important contributors to cancer progression and treatment resistance. Therefore, regulation of TAMs polarization from M2 phenotype towards M1 phenotype has emerged as a new strategy for tumor immunotherapy. Herein, we successfully initiated antitumor immunotherapy by inhibiting TAMs M2 polarization via autophagy intervention with polyethylene glycol-conjugated gold nanoparticles (PEG-AuNPs). PEG-AuNPs suppressed TAMs M2 polarization in both in vitro and in vivo models, elicited antitumor immunotherapy and inhibited subcutaneous tumor growth in mice. As demonstrated by the mRFP-GFP-LC3 assay and analyzing the autophagy-related proteins (LC3, beclin1 and P62), PEG-AuNPs induced autophagic flux inhibition in TAMs, which is attributed to the PEG-AuNPs induced lysosome alkalization and membrane permeabilization. Besides, TAMs were prone to polarize towards M2 phenotype following autophagy activation, whereas inhibition of autophagic flux could reduce the M2 polarization of TAMs. Our results revealed a mechanism underlying PEG-AuNPs induced antitumor immunotherapy, where PEG-AuNPs reduce TAMs M2 polarization via induction of lysosome dysfunction and autophagic flux inhibition. This study elucidated the biological effects of nanomaterials on TAMs polarization and provided insight into harnessing the intrinsic immunomodulation capacity of nanomaterials for effective cancer treatment.

Effects of Benzoxazole Derivative PO- 296 on Dendritic Cell Differentiation and Related Indexes / 中国药房

OBJECTIVE： To investigate the effects of benzoxazole derivative 2-（chlorobenzoxazolyl-2-yl）-4，5，6，7-tetrahydro- dihydro-indazole-3-ol （PO-296） on the differentiation of murine bone marrow-derived dendritic cells（DC） and their related indexes as specific surface molecules and inflammatory cytokines. METHODS： Bone marrow nuclear cells of mice were isolated， and immature DC （imDC） was obtained by recombinant mice granulocyte macrophage colony-stimulating factor and recombinant mice IL-4. After pretreated with low-dose， medium-dose and high-dose （1， 5， 25 μmol/L） of PO-296， DC was obtained by lipopolysaccharide induction. Flow cytometry was used to detect the expression of DC specific surface molecules [i.e. the proportion of class Ⅱ major histocompatibility complex （MHC Ⅱ）， CD80， CD86 and chemokine receptor 7 （CCR7） positive cells]， imDC phagocytosis （i.e. the proportion of dextran positive cells） and DC survival （i.e. the proportion of survival cells）. ELISA method was used to detect the levels of inflammatory cytokines （IL-10， IL-12 and TNF-α） in cell culture medium. RESULTS： Compared with imDC group， the proportion of MHC Ⅱ， CD80 and CD86 positive cells were increased significantly in non-loading group （P＜0.05）. Compared with non-loading group， the levels of IL-10 in cell culture medium were increased significantly in PO-296 groups. The proportions of MHC Ⅱ， CD80 and CD86 positive cells in positive group and PO-296 medium-dose and high-dose groups as well as the levels of IL-12 and TNF-α in cell culture medium in administration groups were decreased significantly （P＜0.05）. There was no statistical significance in the proportion of CCR7 positive cells， dextran positive cells and survival cells in administration groups， compared with non-loading group （P＞0.05）. CONCLUSIONS： PO-296 has no obvious cytotoxicity and does not affect the phagocytic function of imDC. At the same time， the compound can inhibit the expression of DC specific surface molecules and regulate the secretion of inflammatory cytokines.

Safety of different tip positions for umbilical vein catheterization / 中华围产医学杂志

Objective To analyze the safety of indwelling neonatal umbilical vein catheter (UVC) at high or low tip positions.Methods We retrospectively analyzed 155 neonates with indwelling UVC in Guangdong Women and Children Hospital from March 2015 to May 2016.According to the position of the catheter tip,these infants were divided into high position group (the tip was at the same level as the central vein) or low position (the tip was below the portal vein) group.Several parameters including indwelling time,liver function,liver B-ultrasound and catheter-related bloodstream infections in the two groups were analyzed.Data were statistically analyzed using Mann-Whitney U test,Wilcoxon signed rank sum test or Chi-square test.Results (1) A total of 155 infants were enrolled in this study.Their gestational age ranged from 25 to 41 weeks and their birth weight were 700 g to 4 690 g.UCV was inserted at the age of 0.5-8.0 d for 0-12 d.In the low position group,seven cases ended in early extubation due to fluid extravasation caused by shallow insertion.The indwelling time of the low position group was shorter than that of the high position group [M (P25-P75),6 (4-7) d and 7 (5-7) d,Z=-2.580,P=0.010].There were no significant differences in gender,gestational age,birth weight,and age at catheterization between the two groups.(2) No abnormality in the two groups was revealed by liver ultrasound.Complications such as neonatal necrotizing enterocolitis,thrombosis and embolism,air embolism and liver abscess were not reported.The proportion of liver function abnormalities in the high group was 6.9％ (6/87),which was not statistically significant as compared with 4.4％ (3/68) in the low position group (3x2=0.431,P=0.512).(3) Blood culture was performed for all cases,of which 116 (74.8％) were catheter culture (including 71 in the high position group and 45 in the low position group).The incidence of catheter-related bloodstream infection in the high position group was 5.6％ (4/71) and the infection rate was 7.4 per thousand catheter days,while in the low position group these figures were 6.7％ (3/45) and 8.0 per thousand catheter days,respectively.There was no significant difference between the two groups (x2=0.052,P=0.820).(4) Results of catheter culture showed that seven cases were positive,including three for Staphylococcus haemolyticus (two in low position group and one in high position group),one for yeast-like fungus (high position group),one for Enterococcus faecium (high position group),one for Staphylococcus aureus (high position group) and one for Candida albicans (low position group).Conclusions The indwelling time of UVC at high tip position is longer than that at low position,and although there are no differences between the complications and the incidence of catheter-related bloodstream infection in the two groups,but its safety needs further study.

Correlation between mismatch-repair protein expression and clinicopathologic features in 658 colorectal cancers / 中华病理学杂志

Objective@#To investigate the expression of mismatch repair (MMR) proteins (MLH1, MSH2, MSH6 and PMS2) in colorectal cancers and to explore the relationship between MMR expression and clinicopathologic features.@*Methods@#Six hundred and fifty-eight colon cancers were collected from January 2016 to January 2017 at Shengjing Hospital of China Medical University. Of the 658 patients there were 409 male and 249 female. The patients were 20 to 92 years old, with average age of (63±5) years old. Expression of MLH1, MSH2, MSH6 and PMS2 protein was detected by immunohistochemical method. Immunohistochemistry for BRAF V600E was performed in colorectal cancers with loss of MLH1 protein expression. Relationship between MMR protein expression and clinicopathologic features was analyzed statistically. @*Results@#Forty-four cases of 658 cases (6.7%) lost at least one MMR protein expression. Expression deficiency rates of MLH1, MSH2, MSH6 and PMS2 were 4.1%(27/658), 2.3%(15/658), 2.4% (16/658), and 4.3% (28/658), respectively. MMR expression deficiency mainly consisted of combined loss of MLH1/PMS2 (61.4%, 27/44) and MSH2/MSH6 (34.1%, 15/44). Two unique mutations were identified including one MSH6-deficient(2.3%, 1/44) and PMS2-deficient(2.3%, 1/44). Seven cases (25.9%, 7/27) had positive BRAF V600E expression, suggesting BRAF gene mutation related sporadic colorectal cancers. No correlation was observed between the expression of MMR and depth of tumor infiltration, lymph node metastasis, vascular tumor emboli, clinical stage or hematogenous metastasis (P>0.05). MMR status was associated with tumor cell differentiation, histological type and tumor location (P<0.01). Tumors with combined MLH1 and PMS2 loss were associated with mucinous differentiation (P=0.049, P=0.013) and located in the right hemi-colon (P=0.006, P=0.002). Combined MSH2 and PMS2 loss was related to gender, while loss of MSH2 protein was observed more frequently in female patients (P=0.048) and loss of PMS2 protein was seen more frequently in male patients (P=0.031). @*Conclusions@#Patients with MMR protein deficiency have a younger onset age and poorly differentiated tumors. Most tumors are located in the right hemi-colon and have mucinous differentiation.

Research Progress on Hierarchical Structure of Cortical Bone and Its Toughening Mechanisms / 医用生物力学

Cortical bone is a kind of natural biological composite materials, which is mainly composed of tropocollagen molecules and nanoscale hydroxyapatite mineral crystals. It possesses high strength, stiffness and fracture toughness and has the ability to tolerate damage and self-heal. In the long process of evolution, bone tissues form the biomechanical strength and toughness to meet its functional needs. The excellent mechanical properties of cortical bone are closely related to its hierarchical microstructure. This paper reviewed the hierarchical microstructure of cortical bone and its toughening mechanisms, which would contribute to understanding the diagnosis, prevention and treatment of aging-related osteoporosis and the pathological mechanism of bone diseases.

Inflammatory bowel disease complicating with pancreatic abnormalities: a single center analysis / 中华胰腺病杂志

Objective To investigate the inflammatory bowel disease (IBD) complicating with pancreatic abnormalities in China.Methods A retrospective analysis for clinical data of 592 IBD cases hospitalized in Changhai hospital from June 2009 to May 2017 were conducted,and the incidence of ulcerative colitis (UC) and Crohn disease (CD) complicating with pancreatic abnormalities was analyzed.Cases were divided into two groups according to whether anti TNF-α bodies therapy for treating IBD was given,and the incidence of acute pancreatitis (AP) in UC and CD patients complicating with pancreatic abnormalities was compared.Results There were 2 patients with pancreatic abnormalities in 310 CD cases including one with AP and pancreatic cystic lesions(PCL),and one with PCL.There were a total of 14 patients with pancreatic abnormalities in 282 UC cases including 4 cases with AP,4 cases with chronic pancreatitis (CP),4 cases with pancreatic cancer (PC),one case with CP and PC and one case with type 2 autoimmune pancreatitis (AIP).The incidence of pancreatic abnormalities in UC was significantly higher than that in CD (P ＜0.01).No AP happened (0/62) in patients receiving anti TNF-α bodies therapy.There were 5 AP cases in patients without anti TNF-α bodies therapy group (5/449),and the difference was not statistical significant.Conclusions UC is more closely associated with pancreatic abnormalities,especially CP and PC.Whether anti TNF-αtherapy could decrease the AP risk in IBD patients has not yet been determined.

3D electrical impedance finite element joint modeling and simulation using COMSOL and Visual C++ / 医疗卫生装备

Objective To put forward a method for 3D electrical impedance finite element joint modeling and simulation using COMSOL for visual modeling and Visual C++ for programming.Methods A model was established with COMSOL,and then transformed into a.stl file and introduced into Visual C++ simulation platform.Delaunay tetrahedral mesh generation algorithm was used for finite element meshing,calculation and simulation,and joint modeling and simulation were realized finally.Results Simulation result showed that the method could be used to introduce COMSOL model and complete 3D finite element simulation.Conclusion The method proves its compatibility with the models generated by multi software and practicability for joint modeling and simulation.

3D electrical impedance finite element joint modeling and simulation using COMSOL and Visual C++ / 医疗卫生装备

Objective To put forward a method for 3D electrical impedance finite element joint modeling and simulation using COMSOL for visual modeling and Visual C++ for programming.Methods A model was established with COMSOL,and then transformed into a.stl file and introduced into Visual C++ simulation platform.Delaunay tetrahedral mesh generation algorithm was used for finite element meshing,calculation and simulation,and joint modeling and simulation were realized finally.Results Simulation result showed that the method could be used to introduce COMSOL model and complete 3D finite element simulation.Conclusion The method proves its compatibility with the models generated by multi software and practicability for joint modeling and simulation.

Effect of the combination of miR-34a and miR-let7 on the biological properties of pancreatic cancer cells / 中华胰腺病杂志

Objective To investigate the influence on biological characteristics in human pancreatic cancer cells after beding transfected by two anti-carcinoma miRNAs at the same time.Methods Pancreatic cancer cells PANC1,SW1990 and normal pancreatic cells AR42J were transfected by miR-34a and(or) miR-let7 by liposome.Cells transfected with negative control miRNA (miR-NC) and untransfected were as controls.The expression of miR-34a and miR-let7 were detected by real-time fluorescent quantitative RT-PCR.The cell proliferation was detected by MTT test and the migration and invasion were evaluated by transwell assay.The apoptosis rate was measured by flow cytometric analysis.Results After being transfected with miRNAs,the expression of miR-34a and miR-let7 in double transfection group (miR-34a and miR-let7 were transfected at the same time),miR-34a transfection group,miR-let7 transfection group was significantly up-regulated than those in miRNA-NC transfection group and untransfected group in PANC1 cells,SW1990 cells and AR42J cells,repectively.The difference which was statistically significant (P ＜0.05)indicating that cells were successfully transfected.The cell proliferation in double transfection group of PANC1 cells and SW1990 cells were (0.665 ± 0.01,0.6375 ± 0.03),which were significantly inhibited compared with (0.974 ± 0.03,0.971 ±0.05) in miR-NC group and (0.8875 ±0.05,0.8625 ±0.06) in miR-let7 group.The difference was statistically significant(P ＜ 0.05).The cell proliferation activity in double transfection group was lower than those in miR-34a group (0.795 ±0.06,0.7925 ±0.06),but did not have statistically significant difference.There was no significant change in AR42J cells.Cell invasion assay showed that the number of PANC1 cells permeating substrate membrane in miR34a group (103.7 ± 3.28) and miR-let7 group (100.7 ± 1.76) were significantly fewer than miR-NC group (231.3 ±2.6) and untransfected group (153.7 ±2.6).The number of cells permeating substrate membrane in double transfection group(61.67 ± 3.18)was fewer than miR-34a group and miR-let7 group,respectively.The difference was statistically significant (P ＜ 0.01).The migration test had consistent results with invasion test.The changes of invasion and migration in SW1990 cells were similar to those in PANC1 cells.The apoptosis rate of PANC1 cells in miR-34a group,miR-let7 group,double transfection group,miR-NC group and untransfected group was (16.66 ± 1.27) ％,(15.46 ± 0.33) ％,(23.35 ± 1.80) ％,(9.33 ± 0.31) ％ and (8.83 ± 0.36) ％ respectively.Single transfection group had higher apoptosis rate than miR-NC group and untransfected group (P ＜0.05).Double transfection group had a significantly higher apoptosis rate than miR-let7 group (P ＜ 0.05),while there was no significant difference between double transfection group and miR-34a group.Conclusions The cell proliferation,invasion and migration in double miRNAs transfected pancreatic cancer cells were significantly down-regulated compared with those in single miRNA transfected cells,while apoptosis rate in double miRNAs transfection group was higher than single miRNA transfection group.Thus,the combination of two anti-cancer miRNAs may exert a more significant synergistic antitumor effect.

Research progress of bone microarchitecture and microdamage detection / 中国组织工程研究

BACKGROUND:Bone fragility and poor bone quality due to osteoporosis are a major and increasing concern. Bone microarchitecture and microdamage, the important factors of bone quality, their detection technology and instrument have experienced a long development process. OBJECTIVE:To give a brief introduction of the concept of the bone microarchitecture and microdamage, then to summarize the research progress of their detective methods. METHODS:PubMed and CNKI databases were retrieved for reviews and articles related to bone microarchitecture and microdamage published from January 1990 to June 2016 using the keywords of“bone microarchitecture, bone microdamage and detect/detective/detecting”in Chinese and English, respectively. Finaly a total of 65 articles were selected for overview. RESULTS AND CONCLUISON:(1) Bulk staining is a quick and useful way to confirm and assess linear microcracks and diffuse damage. Micro-CT and confocal microscopy al ow visualization at the micron scale, and are useful tools to understand the three-dimentional nature of bone microdamage. Scanning electron microscope lacks the ability to investigate large regions of microdamage, but al ows users to probe in extensive details at the nano scale. (2) Ultimately, we recommend the use of multiple imaging modalities according to the experimental needs to obtain useful information about bone quality and microdamage formation, across the scales of hierarchy in bone.

The design and application of electronic preoperative preparation checklist / 中国实用护理杂志

Objective To design and formulate a electronic preoperative preparation checklist for applying in the preoperative preparation,to reduce missing rate in preoperative preparation and transfer,to improve patient satisfaction,to avoid operation delay and medical accident caused by inappropriate preparation.Methods A total of 145 patients with surgery from March 2013 to February 2013 were as experimental group,and 158 patients with surgery from March 2012 to February 2012 were as control group.The experimental group was used electronic preoperative preparation checklist for preoperative preparation and transition,and the control group was used conventional methods.The incidence of mistake for preoperative preparation and transfer and both surgeon's and patient's satisfactory were compared between two groups.Results After applying the electronic preoperative preparation checklist,the incidence of mistake for preoperative preparation and transfer in experimental group reduced significandy to 1.37％(2/145) and 4.83％ (7/145),compared with the incidence of control group 6.33％(10/158),11.39％(18/158),and the differences between two groups were statistically different (x2=4.870,4.305,P ＜ 0.05).Both surgeon's and patient's satisfactory were improved dramatically,the satisfactory in experimental group improved to 100.00％(50/50)and 97.93％(142/145),compared with the satisfactory of control group 90.00％(45/50) and 90.51％(143/158),and the differences between two groups were statistically different(x2=5.263,7.459,P ＜ 0.05).Conclusions Implementing the electronic preoperative preparation checklist can reduce the incidence of mistake before operation and ensure patient operation schedule.Therefore,it could improve nursing care quality and efficiency.

Application of Endoscopic Ultrasonography in Diagnosis and Treatment of Early Esophageal Cancer / 胃肠病学

Early esophageal cancer is derived from mucosa and submucosa without lymph node metastasis. They are detected generally during endoscopy or physical examination without clinical symptoms. Main treatment of early esophageal cancer is endoscopic resection,and the 5-year survival rate is over 90% . Once symptoms occur,local lymph node metastasis is often present and the prognosis is poor with a markedly reduced 5-year survival rate. Thus it is vital to diagnose and treat esophageal cancer at an early stage. With the development of endoscopic techniques,especially the proficiency of endoscopic ultrasonography(EUS),the detection rate of early esophageal cancer has been increased greatly. EUS also plays an important role in the staging of early esophageal cancer. This article reviewed the application of EUS in diagnosis and treatment of early esophageal cancer.

The risk factors and prognosis of capsule retentions of capsule endoscopy examinations / 中华消化内镜杂志

Objective To evaluate the risk factors,treatment and follow-up of capsule retentions after capsule endoscopy examination.Methods A total of 1 100 capsule enteroscopic examinations,performed at our hospital from October 2006 to March 2013,were retrospectively studied.The positive findings of lesions, clinical indications of capsule endoscopy,treatment and follow-ups were recorded.Results The incidence of capsule retentions was 1.18%(n =13).The rates of capsule retentions in OGIB,suspected Crohn′s disease (CD),known CD,suspected tumors and chronic abdominal pain were 0.95%,4.0%,10.5%,7.1% and 0.3%,respectively.In 11 patients,the capsule was removed by means of double-balloon enteroscopy,the cap-sule was removed surgically in one patient,and spontaneous expulsion occurred in another patient after 1 year of treatment.Risk factors for capsule retention were known or suspected CD and suspected tumor(OR =11.44, P =0.02;OR =5.59,P =0.02),and suspected tumor was also a risk factor(OR =7.42,P =0.04).Conclu-sion Capsule endoscopy is a safe procedure with low risk of capsule retentions.Advantages and disadvantages of capsule endoscopy examinations should be considered carefully when high-risk patients are involved.

The role of contrast-enhanced harmonic endoscopic ultrasonography in the diagnosis of pancreatic cancer / 中华消化内镜杂志

Objective To evaluate the diagnostic accuracy of contrast-enhanced harmonic EUS (CH-EUS)for pancreatic cancer.Methods Patients with pancreatic occupying lesion underwent CH-EUS with ultrasonic contrast medium Sonovue.Pathological diagnoses by EUS-FNA or surgery and the follow-up results were made as the final diagnosis to evaluate the accuracy of CH-EUS for pancreatic cancer.Character-istics of CH-EUS in different pancreatic tumors were analysed.Results A total of 76 patients were en-rolled,with an average age of 53. 1 ±14. 2.Thirty-five were finally diagnosed as having pancreatic cancer, 21 local mass-type pancreatitis,10 pancreatic neuroendocrine tumor,6 cystadenoma,4 intraductal papillary mucinous neoplasm.Tumor diameter was 3. 4 ±1. 4 cm and there were 18 less than 2 cm.The sensitivity and specificity,positive and negative predictive value of CH-EUS for pancreatic cancer was 97. 1%, 92. 9%,91. 7% and 97. 5% respectively.The sensitivity was 100% combined with FNA.Conclusion CH-EUS is safe,convenient for pancreatic cancer with high accuracy and can be used as an additional diag-nostic method to EUS-FNA.

The current situation and problem of mental health and social support on clinical and English undergraduates of Chongqing medical university / 重庆医学

Objective To understand the status and existing problems of psychological health and social support of medical students ,analyze its influencing factors and provide basis for targeted education and management measures .Methods The social support scale(SSRS) ,symptom self-assessment scale (SCL-90) ,the quality of life questionnaire (SF -36)were used as question-naire survey for 120 college students .Results Positive rate of psychological problems in 91 undergraduates was 24 .18% ,obsessive compulsive disorder appeared the most ,phobia appeared the least .Positive rate of psychological problems in 29 English major un-dergraduates was 41 .38% ,the most frequent symptom was forcing symptoms ,followed by human and depressive symptoms .The interpersonal score of English major undergraduates was higher than that of clinical undergraduates ,with a statistically significant difference (P=0 .039) .Mental health between medical and English major students had a statistical difference (P=0 .010) .Objec-tive support scores between medical and English major students had a statistical significance (P=0 .014) .The highest score was the subjective support ,and the lowest scores was the use of social support .Conclusion The mental health of most of the medical un-dergraduates is not optimistic and there exist different psychological problems .At the same time ,the lower level of social support comes along with the higher level of health problems and vice versa .Therefore ,we suggest that society ,schools ,families and relat-ed management departments should further carry out mental health intervention for medical students .

Association between arterial stiffness and risk of coronary artery disease

To investigate the role of Brachial ankle Pulse Wave Velocity [baPWV] and cfPWV on the risk of Coronary artery disease and the interaction between baPWV and risk factors of Coronary artery disease [CAD]. A case-control study was conducted at Department of Emergency, SunYat-Sen memorial Hospital, China. We collected 332 cases with coronary artery disease and 328 subjects without CAD between February 2012 and October 2013. A multivariate logistic regression analysis was performed to analyze the risk factors of CAD. CAD subjects were more likely to be old age, and have higher BMI, waist-hip ratio, hypertension, fasting glucose, TG, carotid-femoral PWV [cfPWV] and baPWV, and CAD subjects had a lower TC, HDL-C and LDL-C. We found that older age, smoking, higher hypertension, TC, TG, HDL-C, LDL-C, carotid-femoral PWV [CfPWV] and baPWV were associated with risk of CAD. baPWV had significant interaction with age, TC, TG, HDL-C and LDL-C, carotid-femoral PWV [cfWV] was correlated with age, HDL-C and LDL-C. This study showed that baPWV and cfPWV are two independent factors for the risk of Coronary artery disease, and baPWV and cfPWV have interaction with age, TC, TG, HDL-C and LDL-C

Differential diagnosis of pancreatic cancer based on parameter analysis of ultrasonographic features / 中华消化内镜杂志

Objective To extract the texture features of endoscopic ultrasonography (EUS) by digital imaging processing(DIP) and pattern recognition,and then to investigate its value for differential diagnosis between pancreatic cancer and chronic pancreatitis.Methods Two hundred and two patients with pathologicaly confirmed pancreatic malignancy,who underwent EUS from Feb 2005 to Mar 2011,and 104 patients with chronic pancreatitis (including 34 cases of autoimmune pancreatitis),who underwent EUS from May 2002 to Aug 2011,were randomly recruited in this study.The optimal texture features of EUS images in this study were selected by the sequence forward search (SFS) algorithm.With the optimal feature combination,cases were automatically divided into pancreatic cancer and chronic pancreatitis based on the findings of support vector machine (SVM),which were compared with the real results.the sensitivity,specificity,accuracy,positive predictive value and negative predictive value were calculated.Results Nine categories and 105 texture features were extracted based on all EUS images,and 13 features were chosen as optimal combination.Images of 306 cases were randomly divided into training set ( 153 cases,101 cases of cancer,52 cases of chronic pancreatitis) and testing set ( 153 cases,101 cases of cancer,52 cases of chronic pancreatitis).The classifier was trained with the training set and tested with testing set.We proceeded 200 times randomly.the average accuracy,sensitivity,specificity,positive predictive value and negative predictive value were ( 86.08 ± 0.14) ％,(79.47 ± 0.32) ％,( 89.71 ± 0.18 ) ％,( 81.21 ± 0.26 ) ％,( 88.93 ± 0.14 ) ％,respectively.Conclusion Differential diagnosis of pancreatic cancer from chronic pancreatitis by Computer-assisted EUS image analysis,highly accurate,convenient,non-invasive and less costly,is a novel and valuable method of early diagnosis.

Inflammatory pseudotumor-like follicular dendritic cell tumor of liver and spleen: a clinicopathological study / 中华肝胆外科杂志

Objective To study the clinicopathological features and biological behavior of inflammatory pseudotumor-like follicular dendritic cell tumor.Methods We studied the clinical data,HE sections,immunohistochemical staining,Epstein-Barr virus encoded nuclear RNA(EBER)in situ hybridization and outcome of one patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver,and thirteen patients with inflammatory pseudotumor of liver and spleen treated at the Shengjing Hospital of China Medical University from 2001 to 2010.Results Among the thirteen inflammatory pseudotumors,we diagnosed 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of spleen and 1 patient with inflammatory pseudotumor-like follicular dendritic cell tumor of liver using immuno-histochemical staining and EBER in situ by hybridization.The liver case had pathological morphology consistent with those described in the literatures,but the splenic case had specific histologic features.They were both female,and were alive 2.5 and 6 years after operation.Conclusions Inflammatory pseudotumor-like follicular dendritic cell tumor should be distinguished from inflammatory pseudotumor.It is a rare tumor seen mainly in liver and spleen.The diagnosis depends on histopathological and immunohistochemical findings.Inflammatory pseudotumor-like follicular dendritic cell tumor is a low-grade malignant tumor.Surgical excision is the treatment of choice.The two cases provided evidence for its indolent behavior.

Clinicopathologic analysis of spermatocytic seminoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and biological behavior of spermatocytic seminoma.</p><p><b>METHODS</b>A retrospective analysis of patients diagnosed as seminoma, spermatocytic seminoma between January 2003 and May 2011, was performed. Clinical data, HE stained section and immunohistochemical staining (SP method) were reviewed with follow-up.</p><p><b>RESULTS</b>Sixty-six cases of seminoma and 5 cases of spermatocytic seminoma were identified. The average age at the diagnosis of 5 cases of spermatocytic seminoma was 53 years, and no patient had a history of crytorchidism or germ cell tumor. All five patients had stage pT1 tumor. Immunohistochemical studies showed that spermatocytic seminoma was negative for CK, vimentin, OCT3/4, PLAP, and LCA, and PAS staining was also negative. All five patients were well after operation. In contrast, the average age at diagnosis of the 66 cases of seminoma was 37 years, in which 12% had a history of crytorchidism and 11% were in stage pT2 or the above. Immunohistochemical studies showed that seminoma was positive for OCT3/4, PLAP, and CD117. During the follow-up, 2 patients developed metastasis and 3 patients died of the disease.</p><p><b>CONCLUSIONS</b>Spermatocytic seminoma is rare and appears to follow a benign clinical course Due to its favourable prognosis, further treatment is not necessary after orchidectomy. Accurate pathologic diagnosis is critical for patient management and for avoiding over-treatment.</p>