Analysis of the efficacy and related influencing factors of pelvic packing in the treatment of intractable postpartum hemorrhage after emergency perinatal hysterectomy / 中华妇产科杂志

Objective:To investigate the effect of pelvic packing on the control of intractable postpartum hemorrhage after emergency perinatal hysterectomy (EPH).Methods:Eleven cases with complete clinical data of pelvic packing due to failure of hemostasis after EPH were collected to evaluate the outcome, complications, hospital stay of pregnant women, and to analyze the factors affecting the effect of pelvic packing. The cases included patients who were admitted to the Third Affiliated Hospital of Guangzhou Medical University after pelvic packing treatment in the other hospital due to continuous bleeding after EPH or who were referred to our hospital for pelvic packing treatment due to continuous bleeding after EPH from January 2014 to August 2021.Results:The median gestational week of 11 pregnant women was 38.3 weeks(38.0-39.9 weeks) , and the methods of termination of pregnancy were cesarean section in 7 cases (7/11) and vaginal delivery in 4 cases (4/11). The median time between postpartum hemorrhage and pelvic tamponade was 10 hours (5-57 hours), the median amount of bleeding was 8 500 ml(4 800-15 600 ml) , the median number of pelvic tamponade was 3 pieces (2-7 pieces), and the median retention time of gauze pad was 6.0 days (3.0-6.0 days). The median frequency of laparotomy in this pregnancy was 3 times (2-3 times), with a maximum of 4 among the 11 cases, the first pelvic packing was successful in hemostasis in 9 cases, and the final successful treatment in all of the 11 cases. All parturients had hemorrhagic shock (11/11) and disseminated intravascular coagulation (11/11) before pelvic packing. Other common complications were multiple organ dysfunction syndrome (9/11), cardiac arrest (4/11), deep vein thrombosis (3/11), septic shock (3/11), and intestinal obstruction (1/11). All parturients took out the gauze after the coagulation function returned to normal and there was no active bleeding. The recovery time of coagulation function in 11 cases was 3 days (3-5 days), the retention time of gauze pad was 6 days (3-6 days), the median length of stay in intensive care unit was 14 days (11-26 days), and the median total length of stay was 22 days (16-49 days).Conclusions:Pelvic packing could be used as a temporary strategy for intractable postpartum hemorrhage after EPH, which provides a key time for injury control resuscitation for patients with unstable vital signs. This technology provides an opportunity for referral to superior medical institutions and further treatment.

Clinicopathological analysis and literature review of Burkitt-like lymphoma with 11q aberration / 中国综合临床

Objective:To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of Burkitt-like lymphoma with 11q aberration (BLL-11q).Methods:The clinical manifestations,histological morphology,immunophenotype and molecular genetic changes of 2 cases of BLL-11q admitted to the department of pathology of The First People's Hospital of Lianyungang in 2020 and 2021 were analyzed retrospectively,and the relevant literatures were reviewed.Results:Patients were found with right neck masses inadvertently and grew rapidly. They presented with localized disease with Ann Arbor stages IA and IIA. Microscopically, the normal structure of the lymph node disappeared and was replaced by a diffuse proliferation of lymphocytes, with consistent morphology and medium size. And the presence of "star-sky" phenomenon was obvious, the morphological characteristics were similar to Burkitt lymphoma. Immunophenotypically, tumor cells were diffusely positive for CD20, CD79α, PAX5, CD10 and Bcl-6, partly moderately positive for C-MYC and MUM-1, however, CD3, Bcl-2, CD30 and TDT were negative,Ki-67 positive index was more than 95%, and EBER was negative. FISH detection showed that MYC, Bcl-2, and Bcl-6 were negative. Both cases had the 11q23.3 gain and 11q24.3 loss. Both patients were treated with chemotherapy and followed up for 10-22 months,and achieved complete remission and disease-free survival.Conclusion:BLL-11q is a rare germinal center B-cell lymphoma with abnormal long arm of chromosome 11 and lack of MYC gene rearrangement. It should be distinguished from Burkitt lymphoma, diffuse large B-cell lymphoma, B-lymphoblastic lymphoma, large B-cell lymphoma with IRF4 rearrangement and high-grade B-cell lymphoma. On the basis of morphology and immunophenotype, the diagnosis depends on genetic detection. There may be a better prognosis.

Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma / 肿瘤防治研究

Objective To evaluate the value of PLT and its parameters combined with AFP, CA199, CA125 and CEA on the preoperative differential diagnosis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). Methods We analyzed retrospectively 274 patients with liver cancer who underwent surgery in the Second Hospital of Lanzhou University. They were divided into 229 cases in HCC group and 45 cases in ICC group according to postoperative pathological results. The differences of PLT, its parameters and tumor markers between the two groups were compared. ROC curve was used to evaluate the differential diagnosis effect on HCC and ICC by significantly different indicators in single and combined forms. The best scheme was verified in the patients with determined and undetermined preoperative diagnosis. Results Compared with HCC group, the levels of PLT, PCT, CA199 and CA125 in ICC group were higher (P < 0.05) and the level of AFP was lower (P < 0.05). The diagnostic analysis results of ROC curve showed that in single test, the AUC of AFP for HCC diagnosis was the largest (0.827). The AUC of the combined groups was higher than the single groups of tumor markers; the AUC of the PCT+AFP+CA199+CA125 group was the highest in all combination groups, and AUC was 0.891. The verification of the best combination group showed that the AUC was 0.924 in the preoperative determined diagnosis group and 0.854 in the undetermined diagnosis group. Conclusion Tumor markers in combination with PLT and PCT can increase the preoperative differential diagnosis efficacy of HCC and ICC. The combination of PCT, AFP, CA199 and CA125 before operation is helpful to further determine the diagnosis and plan the operation scheme.

Clinical characteristics and treatment of pituitary thyrotropin mixed secreting adenoma / 中国医师进修杂志

Objective:To summarize the clinical characteristics and treatment of pituitary thyrotropin mixed secreting adenoma.Methods:The clinical data of 9 patients with pituitary thyrotropin mixed secreting adenoma from January 2008 to December 2019 in Beijing Tiantan Hospital, Capital Medical University, were retrospectively analyzed.Results:Among 9 patients, male was in 7 cases, and female in 2 cases; age was (35.7 ± 13.5) years; course of disease was (3.8 ± 3.1) years; mixed thyrotropin and growth hormone secreting adenoma was in 6 cases; most of them were accompanied with different degrees of thyrotoxicosis, 6 with acromegaly and 2 with amenorrhea and lactation. All the tumors were pituitary macroadenoma, with aggressive growth. Only 1 patient was completely relieved after operation, and most patients needed combined treatment to control the disease.Conclusions:Mixed thyrotropin and growth hormone secreting adenoma is the most common type of the disease, the clinical manifestations are complex, and the tumor is aggressive growth, surgical treatment can not be completely relieved and radiotherapy and/or combination of medicine treatment can help to improve the condition.

Research Progress of Pulmonary Epithelioid Hemangioendothelioma / 中国肺癌杂志

Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm that develops from vascular endothelial cells. It has been reported to occur many sites of body, but the most common EHE presentations are soft tissue (limbs), bone, liver and lung. Compared with other pulmonary tumors, pulmonary epithelioid hemangioendothelioma (P-EHE) is relatively rare. According to a literature review, more than 100 cases have been described all over the world. Due to the low incidence of P-EHE, lack of specificity in clinical symptoms and radiological findings, it is often misdiagnosed. Meanwhile, many patients do not receive appropriate treatment, resulting in poor prognosis in some cases. Histology and immunohistochemical methods are essential for diagnosis. However, there is no established standard treatment for P-EHE, because of the rarity of the disease. When the lesions are small and limited in number, surgical is the best treatment, achieving the purpose of diagnosis and treatment at the same time. This article tries to present the etiopathogenesis, clinical manifestations, diagnosis, treatment and prognosis of P-EHE.
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Delayed Bleeding of Coronary Artery after Thoracoscopic Intradiaphragmatic Bronchogenic Cyst Resection / 中国肺癌杂志

Bronchogenic cyst occurring in the diaphragm is rare and thoracoscopic cyst resection is mainly effective treatment. The coronary artery bleeding after video-assisted thoracoscopic surgery (VATS) has never been described; here we report a case of left coronary artery injury after thoracoscopic itradiaphragmatic bronchogenic cyst resection, which may be caused by metallic troca or chest tube.

Surgical treatment of special thoracic solitary fibrous tumors / 中国肿瘤临床

Objective:To summarize the surgical treatment experience of thoracic solitary fibrous tumors(SFTs),especially some spe-cial SFTs.Methods:Patients with SFTs in our department between January 2009 and May 2017 were recruited in this study and the clinical characteristics were summarized.Results:Twenty-one patients(11 men and 10 women)with an average age of 48.3 years were included.Tumor sizes ranged from 3 to 30 cm and 13 patients(61.9%)harbored pleural tumors,while 8 patients harbored tu-mors from other special thoracic sites (including 1 case of trachea SFT and 1 case of pulmonary SFT). Surgical treatment was per-formed in 19 patients,17 of whom underwent complete tumor resection and two patients underwent palliative resection.One patient did not undergo surgery and was lost to follow-up,and another patient who did not undergo surgery died because of a heart attack af-ter discharge.The 19 patients who underwent surgery were followed up for 1-96 months,3 patients of whom underwent reoperation for tumor recurrence at 12,26,and 72 months after surgery,respectively,while the remaining patients had no recurrence.Seven pa-tients(33.3%)were confirmed with malignancy after operation or biopsy.Conclusions:Thoracic SFTs are mainly from the pleura and the surgical results are favorable.Resection after recurrence can achieve favorable results.

Comparison of the Improved Method and the Traditional Method for Toluidine Red Unheated Serum Test in Syphilis Screening / 现代检验医学杂志

Objective To compare the detection performance of the modified serum test (TRUST) method and the traditional method in syphilis screening.Methods A series of TRUST high titer syphilis serum was diluted,and the positive rate of each method was calculated by using the improved method and the traditional method.Comparison of two detection methods of C50,C5 ～ C95 interval,as well as the accuracy of the density curve,and the consistency of the two methods were compared,and diagnostic performance were compared.Results The improved method of C50 was less than the traditional method of C50,and the improved method of C5 ～ C95 range was narrower than the traditional method,compared with the traditional method.The improved method of the non precision density curve was steeper than the traditional method,and the two confidence interval of the consistency degree of the 95％ methods was 73.4％ to 95.8％.The diagnostic sensitivity (SEN),diagnostic specificity (SPE),positive predictive value (PPV),negative predictive value (NPV) and diagnostic efficiency(DF) of the improved method were 64.29 ％,99.1％,85.71％,97.05 ％ and 96.39 ％,respectively.The SEN,SPE,PPV,NPV and DF of the traditional methods were 3.75 ％,98.49 ％,75 ％,96.18 ％ and 95 ％,respectively.The improved method was superior to the traditional methods in the two aspects of SEN and PPV (x2 =8.25,10.03,all P＜0.05),with the statistically significant difference.The improved method was slightly higher than the traditional method in SPE,NPV and DF (x2 =2.39,3.45,4.03,all P＞0.05),with the no statistically significant difference.Conclusion The precision,diagnostic sensitivity and diagnostic specificity of the improved method was higher than that of the traditional method,and it can be applied to the detection of large batch samples with the aid of the full automatic enzyme immunoassay instrument.The improved method can be used to replace the traditional method for syphilis screening.

Clinical features and experience of perioperative managements of thymomas with and without myasthenia gravis / 中华胸心血管外科杂志

Objective To explore different clinical and pathological features of thymomas with and without myasthenia gravis(MG),and accumulate the experience of perioperative managements.Methods Patients with thymoma admitted by our department between June 2010 and June 2016,were retrospectively reviewed.Results Of the 273 patieuts,150 were males and 143 were fenales(median age:48 years).115 of all patients(42.1％) were combined with paraneoplastic diseases.There was no mortality during perioperative period.Video-assisted Thoracoscopic surgery was successfully performed for 246 cases(90.1％).The female thymoma patients with with MG(TMG) were more than those without MG and thymic hyperplasia (53.0％ VS 39.5％,P =0.036).Compared to the thymoma patients without MG and thymic hyperplasia,the TMG was associated with younger age of onset [(46.6 ± 12.9) years VS.(50.6 ± 14.32) years,P =0.026],longer hospital stay [(18.3 ± 9.4)days VS.(14.6 ±5.7) days,P =0.000],higher postoperative complications morbidity(22.0％ VS.11.6％,P =0.027).Although the TMG has a lower recurrence rate,there was no significant difference between the two groups for recurrence rate(0 VS.2％,P =0.274).Conclusion Extended thymectomy should be recommended for thymoma and thymic hyperplasia whether combined with or without paraneoplastic diseases.

Qualification and Validation in EU-GMP / 中国药师

Objective:To study the content in the new version of EU-GMP ANNEX 15 (draft) to find the changes of the new and the old version and help the domestic pharmaceutical enterprises meet the requirements of the EU-GMP and complete verification and validation activities.Methods:The new version and the old version of EU-GMP ANNEX 15 were compared,and the changes in the new ANNEX 15 were analyzed in order to understand the changes deeply.Combined with the current implementation status of verification and validation activities in domestic pharmaceutical enterprises,some suggestions on qualification and validation work were provided for domestic pharmaceutical enterprises.Results and Conclusion:The new revision of EU-GMP ANNEX 15 (draft) emphasizes qualification and validation activities during the life cycle of products,and processes,and risk management methods should be used in qualification and validation activities.

The application of three color warning in obstetric disease / 中国医师杂志

Objective To investigate the effect of three-color warning management on maternal and child outcomes in high-risk pregnant women with major diseases and severe complications.Methods Retrospective analysis of hospitalized 703 cases of high risk obstetrics was included in the three color warning management of maternal data between May 2015 to July 2016 in our hospital.Maternal disease spectrum changes of three color warning,the rate of intensive care unit (ICU) admission,and maternal mortality rate were observed.Results There were 497 cases (70.70％) of blue warning,78 cases (20.48％) of yellow warning,and 62 cases (8.82％) of red warning.There was 1 case of maternal death and the rate of ICU admission was 7.85％ in blue warning;2 case of maternal death and the rate of ICU admission was 24.31％ in yellow warning;5 cases of maternal death,the rate of ICU admission was 43.55％ in red warning.Conclusions Three color warning management system can be used to assess the severity of the disease,improve the diagnosis and treatment of disease,improve patient survival,improve pregnancy outcomes,and reduce maternal complications.

The application of three color warning in obstetric disease / 中国医师杂志

Objective To investigate the effect of three-color warning management on maternal and child outcomes in high-risk pregnant women with major diseases and severe complications.Methods Retrospective analysis of hospitalized 703 cases of high risk obstetrics was included in the three color warning management of maternal data between May 2015 to July 2016 in our hospital.Maternal disease spectrum changes of three color warning,the rate of intensive care unit (ICU) admission,and maternal mortality rate were observed.Results There were 497 cases (70.70％) of blue warning,78 cases (20.48％) of yellow warning,and 62 cases (8.82％) of red warning.There was 1 case of maternal death and the rate of ICU admission was 7.85％ in blue warning;2 case of maternal death and the rate of ICU admission was 24.31％ in yellow warning;5 cases of maternal death,the rate of ICU admission was 43.55％ in red warning.Conclusions Three color warning management system can be used to assess the severity of the disease,improve the diagnosis and treatment of disease,improve patient survival,improve pregnancy outcomes,and reduce maternal complications.

Clinical effect of epalrestat combined with methylcobalamin in the treatment of diabetic peripheral neuropathy / 中国基层医药

Objective To explore the clinical effect of epalrestat combined with methylcobalamin in the treatment of diabetic peripheral neuropathy.Methods 88 patients with diabetic peripheral neuropathy were chosen from September 2014 to September 2016 in our hospital.The patients were randomly divided into two groups,The control group was treated with conventional treatment,the observation group was given epalrestat combined with methylcobalamin based on the conventional treatment.The effect of the two groups was compared.Results The total effective rate of the observation group was 95.5 ％ (42/44),which was significantly higher than 70.5 ％ (31/44) of the control group,the difference was statistically significant(x2 =9.029,P =0.007).Before treatment,the median nerve and common peroneal nerve sensory conduction velocity betweem two groups had no significant differences (t =0.293,0.920,P =0.704,0.096).After treatment,the median nerve conduction velocity and peroneal nerve total sensory conduction velocity in the observation group were (46.2 ± 4) m/s,(42.4 ± 6.3) m/s,which were significantly higher than those in the control group(t =9.038,7.039,P =0.001,0.004).Conclusion Epalrestat combined with methylcobalamin in the treatment of patients with diabetic peripheral neuropathy can effectively improve the nerve conduction velocity.

Clinicopathological analysis of nongestational choriocarcinoma in 4 cases / 重庆医学

Objective To investigate the clinical manifestations,pathological features,treatment and prognosis of nongesta-tional choriocarcinomas.Methods The clinicopathological data in 4 cases of nongestational choriocarcinoma were retrospectively analyzed and the relevant literatures were reviewed.Results All 4 patients had no confirmed diagnosis at first visit to hospital.All patients received the operative therapy and postoperative bleomycin,etoposide and cis-platinum (BEP)regimen chemotherapy.The followed up lasted for 3-32 months.One case died at postoperative 26 months due to pulmonary metastasis;one case was loss of follow up;two cases had relatively favorable condition.Conclusion Nongestational choriocarcinoma is a rare and highly invasive trophoblastic neoplasm,and is prone for early distant metastasis.The treatment is recommended to adopt operation combined with postoperative combined chemotherapy of multiple drugs.

PRKAR1α expression in non-small cell lung cancer and its clinicopathologic significance / 中南大学学报(医学版)

To evaluate the expression of cAMP-dependent protein kinase type I-alpha regulatory subunit (PRKAR1α) in non-small cell lung cancer (NSCLC) and its correlation with clinicopathological features.
 Methods: PRKAR1α expressions in 79 NSCLC patients and matched adjacent non-carcinoma tissues were analyzed by using qRT-PCR and immunohistochemistry.
 Results: The negative rates of PRKAR1α protein in NSCLC, lung squamous cell carcinoma (SCL) and lung adenocarcinoma (ACL) were 58.2%, 77.8%, 32.4%, respectively. Compared to the matched adjacent non-carcinoma tissues, there were significant differences in levels of PRKAR1α mRNA and protein in ACL (P0.05). The expression of PRKAR1α protein was positively correlated with histological type, TNM stage, and lymph node metastasis (P0.05).
 Conclusion: Low expression of PRKAR1α in ACL might be involved in the pathogenesis, which might serve as a novel diagnostic candidate.

Impact of metabolic risk factors and lifestyle on new onset hypertension in Beijing community residents / 中华心血管病杂志

<p><b>OBJECTIVE</b>To explore if the new onset hypertension was related with metabolic risk factors and lifestyle in Beijing community residents to guide the targeted prevention of hypertension.</p><p><b>METHODS</b>A population-based survey with a randomly cluster sampling was made to observe the relationship between metabolic risk factors and lifestyle with new onset hypertension by multivariate and logistic regression.</p><p><b>RESULTS</b>A total of 4 034 subjects with normal blood pressure at baseline were included and 978 (24.2%) residents developed hypertension two years later. Multiple logistic analysis demonstrated that risk factors that contributed to new onset hypertension were prehypertension, overweight, obesity, frequent alcohol drinking, metabolic syndrome (MS), age and male gender, the respective Odds Ratios(OR) and 95% confidence interval (95%CI) are as follows: 3.512 (2.965-4.168), 1.654 (1.423-1.918), 2.264 (1.633-2.951), 1.493 (1.231-1.775), 1.329 (1.227-1.414), 1.226 (1.115-1.335), 1.135(1.018-1.221). College education serves as the protective factor, and the OR (95%CI) was 0.692 (0.476, 0.897).</p><p><b>CONCLUSIONS</b>New onset hypertension in Beijing community residents is mainly related with prehypertension, overweight or obesity, MS, frequent alcohol drinking and low education level. We should pay more attention to modulating metabolic risk factors and lifestyle to reduce the new onset hypertension in China.</p>

Diagnostic utility of immunohistochemical markers SALL4, D2-40 and Glypican-3 in primary testicular germ cell tumors / 临床与实验病理学杂志

Purpose To investigate the diagnostic utility of the immunohistochemical markers SALL4, D2-40 and Glypican-3 in prima-ry testicular germ cell tumors (TGCTs). Methods The expression of SALL4, D2-40 and Glypican-3 protein was detected by EnVi-sion immunohistochemical method in 56 cases of primary testicular germ cell tumors, including 5 intratubular germ cell neoplasms ( IT-GCNs) , 10 seminomas, 14 embryonal carcinomas ( ECs) , 14 yolk sac tumors ( YSTs) , 1 choriocarcinoma, 5 immature teratomas and 12 mature teratomas. 10 normal testicular tissues and 5 lymphomas were selected as control. Results All of ITGCNs, seminomas, YSTs and ECs were diffusely strongly positive for SALL4. Focal SALL4 staining was seen in choriocarcinoma, 3 of 5 immature terato-mas and 3 of 12 mature teratomas. All of ITGCNs, seminomas showed diffusely strong D2-40 staining. ECs (4/14) were focally posi-tive for D2-40, while choriocarcinoma, YSTs and teratomas were negative for D2-40. Glypican-3 was diffusely positive in YSTs (13/14), and focally weakly positive in ECs (2/14), respectively. ITGCNs, seminomas, choriocarcinoma and teratoma were negative for Glypican-3. In contrast, 10 normal testicular tissues and 5 lymphomas showed no SALL4, D2-40 and Glypican-3 staining. Conclu-sions SALL4 is a useful diagnostic marker with high sensitivity and specificity for TGCTs. Combination of SALL4, D2-40 and Glypi-can-3 is helpful to the diagnosis and differential diagnosis for TGCTs.