Diffuse midline glioma of spinal cord with H3K27M-mutation: a clinicopathological analysis / 中华病理学杂志

Objective@#To investigate the role of H3K27M mutant in spinal cord glioma, specifically the correlation between H3K27M mutation and histological grade or prognosis.@*Methods@#Twenty-four cases of paraffin-embedded spinal cord glioma tissues and clinical data were collected from November 2014 to August 2016 at the Beijing Tsinghua Changgung Hospital. There were 13 males and 11 females, and the age ranged from 3 to 66 years. All the cases were reviewed histologically, and immunohistochemical H3K27M staining and H3 gene detection were performed. The correlation between H3 gene mutation and histological grading and prognosis of spinal cord gliomas were investigated and relevant literature reviewed.@*Results@#Eleven of 24 cases showed H3K27M gene mutation, and was concordant with the result of immunohistochemistry. Gliomas in the mutant group were all high-grade gliomas with mean patients′ age of (30.0±11.5) years, and a male to female ratio of 7:4. Thirteen cases were wild-type, and these included four high-grade gliomas, with mean patients′ age (31.3±22.4) years, and a male to female ratio of 6∶7. The tumors in the mutant group were mainly located in cervical 4-7 and thoracic 11-12 segments, respectively, and the incidence of tumors in the lower thoracic segments (thoracic 11-12) was higher than that in the wild type group. Outcome data were available for all patients. The median survival of mutant group was 19.5 months, but most patients in the wild-type group were alive at the end of the follow-up period.@*Conclusion@#Gliomas of spinal cord with H3K27M mutation are high-grade and the prognosis of patients is poor.

Advances in the 8th Japan-China Hepato-Pancreato-Biliary Symposium / 中华消化外科杂志

The 8th Japan-China Hepato-Pancreato-Biliary Symposium was held in Tokyo,Japan from 22nd to 23rd November 2018.The meeting was convened coincidently with the 80th Annual Congress of Japanese Surgical Association,which attracted the participation of Chinese and Japanese hepatobiliary and pancreatic surgeons.The symposium aimed to explore the latest achievements and clinical issues of diagnosis and treatment for hepato-pancreato-biliary diseases.In this article,authors reviewed the up-to-date research information in order to share the experience,achievements and new information in the field of hepatobiliary and pancreatic diseases with colleagues.

Expressions of PAX-2 and PTEN in endometrial lesions and their correlation with endometrial intraepithelial neoplasia / 肿瘤研究与临床

Objective To observe the expression of PAX-2 and PTEN in different types of endometrial lesions, and to study their relationship with endometrial intraepithelial neoplasia (EIN). Methods 60 cases of endometrial hyperplasic lesions and 70 cases of endometrial carcinoma were enrolled. All cases were reclassified by using the diagnostic criteria of EIN, and PAX-2 and PTEN were stained to compare the difference among them. Results The deletion rates of PAX-2 in benign hyperplasia, EIN and endometrial carcinoma were 39.5 % (15/38), 72.7 % (16/22) and 78.6 % (55/70), respectively, and there was a statistical difference (χ2= 21.664, P= 0.000). The deletion rates of PTEN in benign hyperplasia, EIN and endometrial carcinoma were 47.4%(18/38), 54.5%(12/22) and 75.7%(53/70), respectively, and there was no statistical difference (χ2=2.878, P=0.411). Conclusion The staining of PAX-2 could be considered as a reliable adjuvant diagnostic method in the diagnostic criteria of EIN, however, the loss of PTEN just should be regarded as a suggestion of EIN, not a confirmed diagnostic basis.

Role of paxillin in colorectal carcinoma and its relationship to clinicopathological features / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Colorectal carcinoma is one of the most common malignant tumors. Despite advances in therapy, mortality is still very high. The aim of this study was to evaluate the expression of paxillin in the human colon adenocarcinoma cell line SW480 and its role in cell cycle and apoptosis. We also investigated the expression of paxillin in colorectal carcinoma tissues and its relationship to clinicopathological features and survival.</p><p><b>METHODS</b>Paxillin short hairpin RNA (shRNA) was constructed and transfected into the colon adenocarcinoma cell line SW480. The influence of paxillin shRNA on the cell cycle and cell apoptosis was analyzed by flow cytometry. Immunohistochemistry staining was used to assess the expression of paxillin and its association with the expression of carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 19-9, p53 and Bcl-2 in 102 patients with primary colorectal carcinoma. Western blotting was also used to investigate the expression of paxillin. Medical records were reviewed and a clinicopathological analysis was performed.</p><p><b>RESULTS</b>In vitro, the percentage of cells in S phase was (45.23±1.05)%, (43.53±1.23)%, and (36.13±0.57)% in the blank control group, negative control group, and paxillin shRNA group respectively. It was significantly decreased in the paxillin shRNA group (P = 0.000). The early apoptosis index of the paxillin shRNA group (17.2±1.18%) was significantly increased compared to the control shRNA group ((13.17±1.15)%, P = 0.013). Paxillin was positive in 71 (69.6%) patients, and it was found to be overexpressed in tumor tissues compared with normal adjacent tissues. Paxillin positive rate was higher in patients who are less than 50-years old (100.0% vs. 65.6%, P = 0.016). Paxillin expression was associated with a high histologic grade of carcinoma (81.4% vs. 61.0%, P = 0.031), a high rate of regional lymph node metastasis (22.5% vs. 13.0%, P = 0.031), mesenteric artery lymph node metastasis (100.0% vs. 64.8%, P = 0.008), distant metastasis (94.1% vs. 64.7%, P = 0.016) and a high Tumor Node Metastasis (TNM) stage (94.1%, 73.2%, 60.0%, and 50%, P = 0.030). Multivariate analyses revealed that recurrence was associated with the rate of regional lymph node metastasis (P = 0.001) and paxillin expression (P = 0.024). Multivariate analysis indicated that the overall survival is related to the TNM stage (P = 0.000).</p><p><b>CONCLUSIONS</b>In vitro, paxillin may promote cell proliferation and inhibit apoptosis in SW480 cells. Paxillin may be a potential metastasis predictor, and an independent prognosis factor of recurrence. It may also be related to poor patient outcomes, but was not an independent predictor of survival.</p>

Surgical treatment and prognosis analysis of cT4bM0 primary rectal cancer / 中华消化外科杂志

Objective To investigate the surgical treatment strategies and prognostic factors of cT4bM0 primary rectal cancer.Methods The clinical data of 53 patients with cT4bM0 primary rectal cancer who were admitted to the First Hospital of Peking University from January 2000 to December 2010 were retrospectively analyzed.All the patients received en-bloc multivisceral resection and postoperative chemotherapy.The survival and prognostic factors were analyzed.The patients were followed up via out-patient examination,phone call or mail,and the follow-up was ended till December 2012.The survival curve was drawn using the Kaplan-Meier method,and the survival was analyzed using the Log-rank test.Uni-and multivariate analysis were done using chisquare test and COX's proportional hazard model.Results Of all the 53 patients,20 received posterior pelvic exenteration (PPE),20 received total pelvic exenteration (TPE),3 received low anterior resection (LAR) +local resection of ballder,2 received LAR + ovariectomy,2 received LAR + local resection of ureter,1 received LAR + local resection of posterior vaginal wall,1 received LAR + vesiculectomy and vesectomy,3 received abdominoperineal resection (APR) + local resection of posterior vaginal wall,1 received APR + sacrectomy.R0 resection was achieved in all the patients.No intraoperative death was observed,and the incidence of postoperative complication was 9.4％ (5/53).The results of postoperative pathological examination showed that 2 patients were with well-differentiated adenocarcinoma,41 with moderate-differentiated adenocarcinoma,and 10 with poorly differentiated adenocarcinoma.Twenty-four patients were with lymph node metastasis.Four patients were in TNM stage Ⅰ,25 in TNM stage Ⅱ and 24 in TNM stage Ⅲ.Fifty-three patients were followed up postoperatively,and the median time for follow-up was 33 months (range,4-116 months).The overall 5-year survival rates was 57.3％.The 5-year survival rate for patients with or without lymph node metastasis were 77.1％ and 30.4％,respectively,with significant difference between the 2 groups (x2 =7.374,P ＜ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion mere 51.0％ and 68.5％,with no significant difference (x2=1.148,P ＞0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅱ were 74.6％ and 85.7％,with no significant difference between the 2 groups (x2=0.118,P ＞ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅲ were 28.8％ and 37.5％,with no significant difference between the 2 groups (x2 =0.959,P ＞ 0.05).The results of univariate analysis showed that lymph node metastasis and TNM stage were the risk factors influencing the prognosis of patients with cT4bM0 primary rectal cancer (x2=6.468,6.596,P ＜ 0.05).The results of multivariate analysis showed that lymph node metastasis was the independent risk factor (RR =3.797,P ＜ 0.05).Conclusions En-bloc multivisceral resection should be the first surgical treatment choice for patients with cT4bM0 primary rectal cancer,and lymph node metastasis is the independent risk factor.Under the same N stage,the prognosis of patients with malignant infiltration or inflammatory adhesion is similar if R0 resection is achieved.

Surgical resection of primary retroperitoneal schwannoma / 中华普通外科杂志

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Spontaneous pregnancy in a patient with lymphocytic hypophysitis / 北京大学学报(医学版)

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Comparative study of heterogeneity of extranodal and nodal diffuse large B cell lymphoma / 北京大学学报(医学版)

Objective:Primary nodal and extranodal diffuse large B-cell lymphoma(DLBCL)were investigated for the heterogeneity of histopathology and immunophenotype,and their relation to clinical stage,comparatively.Whether E2F1 can be used as a germinal center B cell(GCB)DLBCL marker was also discussed.Methods:Classification of histopathology and immunophenotype of 98 cases were studied by immunohistochemistry in tissue microarray.Results:Histopathologic morphology presented as:centroblastic(CB,88.8%,87/98),immunoblastic(IB,5.1%,5/98),anaplastic(ALCL,3.1%,3/98),and T cell rich B cell lymphoma(TCRBCL,3.1%,3/98).Of which,31 cases were GCB DLBCL,10(20.8%,10/48)nodal,and 21 extranodal(42%,21/50,P=0.024).The rates of Stages Ⅰ/Ⅱ in nodal and extranodal area were 48.5% and 70%,respectively(P=0.015).The rate of Stage Ⅰ/Ⅱ in GCB DLBCL(74.2%)were higher than in non-GCB DLBCL(50.7%,P=0.029).The CD10 positive rates were 36.8% and 17.1% in Stages Ⅰ/Ⅱ and Ⅲ/Ⅳ,respectively,and had significant differences(P=0.033).The CD10 positive rates were 18.8% and 38% in nodal and extranodal area,respectively(P=0.035).The positive rates of E2F1 were 38.8% and 16.5% in GCB and non-GCB DLBCL,respectively,and had significant differences(P=0.016).The positive rate of E2F1 had positive relation with the expression of CD10 and Bcl-6(P

Helicobacter pylori genotypes of gastrointestinal B cell lymphoma / 北京大学学报(医学版)

Objective:To assess the expression of specific virulence-associated Helicobacter pylori (Hp) genotypes, (cag A, vac A, and ice A status) in primary gastrointestinal B cell lymphoma. Methods: Forty-nine paraffin wax embedded tissues were analyzed by immunohistochemical staining and poly-merase chain reaction. Results:There were 14 cases of mucosa associated lymphoid tissue lymphoma ( MALT-L) (8 in stomach, and 6 in intestine) and 35 cases of diffuse large B cell lymphoma (DLBCL) (21 in stomach, and 14 in intestine) in all. The positive rates of vac A s1 ,vac A s2 ,vac A m2,ice A 1 and cag A were 50. 0% ,42. 9% ,50. 0% , 14. 3% and 85. 7% in MALT-L; 57. 1% ,40. 0% ,25. 7% , 5.7% and91.4% in DLBCL, respectively. Conclusion:High toxicity cag A + Hp strains.seem to play a role in the pathogenesis of gastrointestinal B cell lymphoma, whereas vac A m2 may be more associated with MALT-L. Clinical stage was not associated with virulence-associated Hp genotypes.

Proliferation and apoptosis in primary gastrointestinal B-cell non-Hodgkin’s lymphoma and its association with Helicobacter pylori / 北京大学学报(医学版)

Objective: To investigate primary gastrointestinal B cell non Hodgkin’s lymphoma for clinicopathological features, proliferation, apoptosis and its association with Helicobacter pylori (HP). Methods: Classification of tumors, expression of HP, proliferation and apoptosis related gene products were studied by immunohistochemistry. Apoptosis was studied by TUNEL (TdT [terminal deoxynucleotidyl transferase] dUTP nick end labeling). Results: There were 15 cases of mucosa associated lymphoid tissue (MALT) lymphoma (9 in stomach, 6 in intestine) and 42 cases of diffuse large B cell lymphoma (DLBCL) (28 in stomach, 14 in intestine) in all the 57 cases of primary gastrointestinal BCL. The average apoptotic indexes (AI) were 0.16%, 2.54% in MALT lymphoma and DLBCL respectively. The average proliferation indexes (PI) were 2.22% and 8.71%,respectively. The p53 positive rates were 6.7% and 35.7%. PI ( P =0.026) and p53 ( P =0.044) had significant differences; But Bcl 2 positive rates were 60.0% and 35.7%,and HP positive rates were 66.7% and 23.8%, respectively. HP had significant differences ( P =0.005). Conclusion: HP and gastrointestinal MALT lymphoma had significant relation. Apoptosis and proliferative activity were higher in DLBCL than in MALT. The higher Bcl 2 expression in MALT may be related to lower apoptosis. p53 promotes apoptosis and p53 gene mutation may play a role in the progression from MALT to DLBCL. HP antibody may be used in HP detection in gastrointestinal BCL.

One patient with Kimura's disease and angiolymphoid hyperplasia with eosinophilia also suffers from kidney injury / 北京大学学报(医学版)

Objective:Reporting a rare case with Kimura's disease and angiolymphoid hyperplasia with eosinophilia (ALHE), who also has nephrotic syndrome resulting from minimal change glomerulopathy. Methods: Histological manifestations, immunohistochemical staining, immunofluorescence staining, and electron microscope were performed. Results: One 37-year-old male patient with recurrent erythra, cutaneous node, painless cervical lymph node enlargement and nephrotic syndrome in 5 years. It's confirmed through biopsies that the subcutaneous node is ALHE, the cervical lymph node is kimura disease, and renal lesion is minimal change glomerulopathy. Conclusion: Kimura disease and ALHE may be different features of the same disease, and may complicate glomerulopathy.

Effect of different ways in applying fertilizer on yield and quality of Notopterygium forbesii / 中草药

Objective The effect of fertilizer application on yield and quality of Notopterygium forbesii was studied in order to provide a theoretical basis for high quality and yield planting.Methods With various nitrogenous(N) and phosphorous(P) fertilizer formula,the field tests were carried out to determine the yield,extract content,and essential oil content,from the root of N.forbesill.Results Showed that various proportion of fertilizer had a great affect on yield,extract content,and essential oil content,and the treatment with N2P2 was the highest.The yield in the treatment with N2P2 increased 43.33%,the extract content increased 17.95%,and the essential oil content increased 43.48% as compared with CK.Different rates of fertilizer application had a certain effect on weight and diameter in the root of N.forbesii,and the N2P2 was the best.Each treatment had a significant effect on diameter in the root of N.forbesii in comparision with CK.Conclusion Amount and ratio of N and P fertilizers have a greater influence on the yield and quality,while improper application could reduce the yield and quality.