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Objective@#To understand the consistency of ALK Ventana-D5F3 immunohistochemistry (IHC) interpretation in Chinese lung adenocarcinoma among histopathologists from different hospitals, and to recommend solution for the problems found during the interpretation of ALK IHC in real world, with the aim of the precise selection of patients who can benefit from ALK targeted therapy.@*Methods@#This was a multicenter and retrospective study. A total of 109 lung adenocarcinoma cases with ALK Ventana-D5F3 IHC staining were collected from 31 lung cancer centers in RATICAL research group from January to June in 2018. All cases were scanned into digital imaging with Ventana iSCANcoreo Digital Slide Scanning System and scored by 31 histopathologists from different centers according to ALK binary (positive or negative) interpretation based on its manufacturer′s protocol. The cases with high inconsistency rate were further analyzed using FISH/RT-PCR/NGS.@*Results@#There were 49 ALK positive cases and 60 ALK negative cases, confirmed by re-evaluation by the specialist panel. Two cases (No. 2302 and No.2701) scored as positive by local hospitals were rescored as negative, and were confirmed to be negative by RT-PCR/FISH/NGS. The false interpretation rate of these two cases was 58.1% (18/31) and 48.4% (15/31), respectively. Six out of 31 (19.4%) pathologists got 100% accuracy. The minimum consistency between every two pathologists was 75.8%.At least one pathologist gave negative judgement (false negative) or positive judgement (false positive) in the 49 positive or 60 negative cases, accounted for 26.5% (13/49), 41.7% (25/60), respectively, with at least one uncertainty interpretation accounted for 31.2% (34/109).@*Conclusion@#There are certain heterogeneities and misclassifications in the real world interpretation of ALK-D5F3 IHC test, which need to be guided by the oncoming expert consensus based on the real world data.
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Yishen Juanbi Method for Treating Rheumatism began from Mr. ZHANG Ci-gong to the formation and development of Mr. ZHU Liang-chun, and by the evidence-based source, innovation and perfection of the third and fourth generations of successors, has formed the unity of the principle, rule, method, medicine, and the unique diagnosis and treatment of rheumatism of integration of the internal treatment and external treatment. All of these provide original insights for rheumatology of TCM theory and the application of insect medicine, and provide valuable treatment technology for China's young rheumatology disciplines.
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<p><b>OBJECTIVE</b>To examine the associations of apparent diffusion coefficient (ADC) value from MR diffusion-weighted imaging (DWI) with Ki-67 expression and differentiation grade in gastric cancer.</p><p><b>METHODS</b>Images and pathologic data of 68 gastric cancer patients between September 2013 and February 2015 in Affiliated Changshu Hospital of Soochow University were analyzed retrospectively. The expression of Ki-67 antigen in cancer tissue sample was determined by immunohistochemistry. Ki-67 labeling index(LI) was calculated to divide the cases into low Ki-67 group(Ki-67 LI <50%) and high Ki-67 group (Ki-67 LI ≥ 50%). Associations of ADC value with differentiation grade and Ki-67 LI were examined.</p><p><b>RESULTS</b>Mean ADC value of low Ki-67 LI group was significantly higher than that of high Ki-67 LI group [(0.977 ± 0.100) × 10(-3) mm(2)/s vs. (0.859 ± 0.064) × 10(-3) mm(2)/s, P=0.000]. The ADC value was negatively correlated with Ki-67 LI (r=-0.685, P=0.000). Mean ADC value of well differentiated adenocarcinoma, moderately differentiated adenocarcinoma, poorly differentiated adenocarcinoma, and signet-ring cell carcinoma was (1.124 ± 0.080) × 10(-3) mm(2)/s, (0.950 ± 0.064) × 10(-3) mm(2)/s, (0.899 ± 0.091) × 10(-3) mm(2)/s, and (0.894 ± 0.081) × 10(-3) mm(2)/s respectively. Difference of ADC value among differentiation grades was significantly different (F=11.405, P=0.000). Difference of ADC value between well differentiated adenocarcinoma and non-well differentiated adenocarcinoma was significantly different(P=0.000).</p><p><b>CONCLUSION</b>ADC value is associated with differentiation grade and Ki-67 LI of gastric cancer, which may be used as a noninvasive predictor for evaluating the proliferation and differentiation grade of gastric cancer.</p>
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Humanos , Adenocarcinoma , Diagnóstico , Imagem de Difusão por Ressonância Magnética , Antígeno Ki-67 , Metabolismo , Estudos Retrospectivos , Neoplasias Gástricas , DiagnósticoRESUMO
Objective To analyze the blood pressure,heart rate,the US national institutes of health stroke scale(NIHSS) score,Glasgow coma scale(GCS) score for cerebral infarction patients with cerebral hemorrhage after recombinant human tissue-type plasminogen activator (rt-PA) therapy.Methods From April 2011 to April 2013,48 cases with cerebral infarction after intravenous rt-PA thrombolysis were collected.These cases were divided into two groups:the first group (32 cases):without cerebral hemorrhage after thrombolysis; the second group (16 cases):with cerebral hemorrhage after thrombolysis.The systolic blood pressure,diastolic blood pressure,heart rote,NIHSS score and GCS score were compared between the two groups before and after thrombolysis.Results After thrombolysis,the systolic and diastolic blood pressure were significantly increased in cerebral hemorrhage cases compared with before thrombolysis and patients without cerebral hemorrhage.After thrombolysis,the NIHSS score was significantly reduced in the cases without cerebral hemorrhage compared with that before thrombolysis,while the NIHSS score was significantly higher in the cases with cerebral hemorrhage compared with that before thrombolysis.After thrombolysis,the heart rate and GCS score showed no significant difference between the patients with and without cerebral hemorrhage.Conclusions The rising of systolic blood pressure,diastolic blood pressure and NIHSS score helps us determine the early cerebral hemorrhage after thrombolysis in cerebral infarction patients.
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Objective To explore the effect of general intervention in improving the psychological condition of healthy pregnant women. Methods Totally 96 pregnant women who made prenatal visits in our obstetrics and outpatient department were divided into the control and the intervention group stochasti-cally. The intervention group started from first prenatal visit. The general intervention measures included cognitive intervention, the behavioral intervention, family coping intervention and psychological intervention with self-designed relaxation exercises. While conventional prenatal visit, propaganda and nursing were im-plemented to the control group.Self-made general questionnaire and symptom checklist 90 (SCL-90)were used to survey and analyze the results. Results Post-natal depression and anxiety of the control group was obviously higher than that of the prenatal. The Post-natal obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility, terror and bigotry in the intervention group were greatly alleviated. Com-pared with the control group, obsessive-compulsive symptom, interpersonal sensitivity, depression, hostility and terror of the intervention group were significantly different (P<0.05). The depression improved while the difference was not evidently differenL Conclusions Delivery had great influence on the psychological status of women,especially anxiety and depression. General intervention measures like psychological relax-ation exercises can improve the psychological condition of healthy pregnant women obviously,especially de-pression.