Clinicopathological features of very well-differentiated adenocarcinoma of the stomach / 中华病理学杂志

Objective: To investigate the clinicopathological features of very well-differentiated adenocarcinoma (VWDA) of the stomach. Methods: The clinicopathological data of 12 cases of VWDA of the stomach were collected retrospectively at the People's Liberation Army Joint Logistics Support Force 989 Hospital (formerly 152 Hospital), Pingdingshan, China, from January 2013 to May 2021. The histological characteristics and immunophenotypes were observed and analyzed with review of current literature. Results: There were 8 males and 4 females with a median age of 63 years (range 47 to 80 years). The tumor involved in the upper part of the stomach in 6 cases, the middle part in 2 cases, and the lower part in 4 cases. The median diameter of the tumors was 17 mm (range 5-65 mm). The tumor cells were similar to absorbent cells, Paneth cells, foveolar epithelial cells, and goblet cells. The cells were arranged in a single layer, and the nuclei were slightly enlarged and located at the base. The nuclei were fusiform to slightly irregular, with loss of nuclear polarity. Early tubular VWDA was found in 9 cases, and the tumor glands were similar to intestinal metaplasia. In two cases the tumors infiltrated into the submucosa. The lesions in the mucosa and submucosa showed the glands with cystic expansion, bending, branching, spiky and abortive growth pattern. One case of early papillary tubular VWDA was confined to the mucosal layer and composed of foveolar-type epithelial cells. There were two cases of advanced papillary tubular VWDA, which consisted of foveolar-type epithelial, pyloric glands, or mucinous neck cells and were associated with intra-lymphatic cancer embolus and lymph node metastases. Background mucosal atrophy and intestinal metaplasia were observed in all cases. Immunohistochemical staining showed intestinal type VWDA in 1 case, mixed gastrointestinal type VWDA in 9 cases, and gastric type VWDA in 2 cases. The Ki-67 proliferation index of 8 cases limited to the mucosa was 40%-70%, 2 cases of infiltration into the submucosa and 2 cases of advanced carcinoma was 10%-25%. All the tumors showed a wild type of p53 protein expression pattern and negative HER2. Adenocarcinoma or high-grade dysplasia was diagnosed on preoperative biopsy in 5 cases, and chronic atrophic gastritis with intestinal metaplasia in 7 cases. The median follow-up time was 28 months (range 12-72 months). No recurrence was found in the 10 patients with early cancer. Of the two patients with advanced carcinoma, one patient had lung metastases and the other died. Conclusions: Gastric VWDA is a rare low-grade malignancy with structural features of highly differentiated adenocarcinoma and extremely low cytological atypia. The diagnostic value of structural abnormality is significantly greater than cytological atypia. The invasive growth of irregular glands in the deep mucosa and submucosa is reliable evidence for diagnosis. The diagnosis of intramucosal VWDA is challenging and very difficult in some biopsy specimens.

3D digital image microscope system-assisted vasovasostomy and vasoepididymostomy in rats / 亚洲男科学杂志(英文版)

Optimal vision and ergonomics are essential factors contributing to the achievement of good results during microsurgery. The three-dimensional (3D) digital image microscope system with a better 3D depth of field can release strain on the surgeon's neck and back, which can improve outcomes in microsurgery. We report a randomized prospective study of vasoepididymostomy and vasovasostomy using a 3D digital image microscope system (3D-DIM) in rats. A total of 16 adult male rats were randomly divided into two groups of 8 each: the standard operating microscope (SOM) group and the 3D-DIM group. The outcomes measured included the operative time, real-time postoperative mechanical patency, and anastomosis leakage. Furthermore, a user-friendly microscope score was designed to evaluate the ergonomic design and equipment characteristics of the microscope. There were no differences in operative time between the two groups. The real-time postoperative mechanical patency rates were 100.0% for both groups. The percentage of vasoepididymostomy anastomosis leakage was 16.7% in the SOM group and 25.0% in the 3D-DIM group; however, no vasovasostomy anastomosis leakage was found in either group. In terms of the ergonomic design, the 3D-DIM group obtained better scores based on the surgeon's feelings; in terms of the equipment characteristics, the 3D-DIM group had lower scores for clarity and higher scores for flexibility and adaptivity. Based on our randomized prospective study in a rat model, we believe that the 3D-DIM can improve surgeon comfort without compromising outcomes in male infertility reconstructive microsurgery, so the 3D-DIM might be widely used in the future.

Nurses' perception on nursing work environment:gender difference analysis / 中华护理杂志

Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.

Nurses' perception on nursing work environment:gender difference analysis / 中华护理杂志

Objective To compare the difference of perception on nursing work environment between male and female nurses in secondary and tertiary hospitals in Guangdong Province.Methods Practice Environment Scale of the Nursing Work Index was used to measure nurses' perception on nursing work environment.Propensity score matching was used to control confounders when comparing the gender difference of nurses' perception on nursing work environment.Results Totally 3 456 nurses in secondary and tertiary hospitals in Guangdong Province were surveyed,and 190 of them were male nurses who were distributed with a significant higher proportion in tertiary hospitals,ICUs and emergency departments.Compared with female nurses,male nurses were significantly younger in age,had shorter working years and higher proportion of being single,contract employed,having associate degree or above for initial educational degree.Controlling confounders with propensity score matching,male nurses' perception on nursing work environment was significantly worse than females for three subscales:collegial nurse-physician relations,nursing foundations for quality of care,nurse manager ability,leadership,and support of nurses.Conclusion The proportion of male nurses in Guangdong Province should be raised.Distributed more in tertiary hospitals,ICUs and emergency departments,male nurses were characterized as being less experienced,more contract employed and having higher initial educational degree compared to female nurses.Worse perception on nursing work environment from male nurses indicated that nursing managers should attach more importance to male nurses to improve their orientation and in-service training,professional development support and collegial nurse-physician relations for their better perception on nursing work environment and retention.

Male genital schwannoma, review of 5 cases / 亚洲男科学杂志(英文版)

<p><b>AIM</b>To study the clinical features of male genital schwannoma.</p><p><b>METHODS</b>Five male patients with genital schwannoma admitted from 1991 to 2000 were reviewed. The lesions were located in the prostate, spermatic cord, testis or penis. Tumors were simply resected in 3 patients and radically eradicated in 2.</p><p><b>RESULTS</b>The average age of the cohort was 37 years. The most common sign at presentation was a palpable genital mass accidentally discovered by the patient or detected by the physician during a physical check. Diagnosis was made through postoperative pathological examination. Follow-up ranged from 2 years to 6 years (mean 4.5 years). Four cases were cured by simple excision and 1 patient with malignant testis schwannoma died of recurrence 1 year after surgery.</p><p><b>CONCLUSION</b>Owing to the lack of characteristic clinical manifestation, the final diagnosis relies on postoperative pathological examination. S-100 and vimentin are useful markers for the diagnosis of these tumors.</p>

Retroperitoneal iaparoscopic partial nephrectomy(report of 23 cases) / 中华泌尿外科杂志

Objective To report initial experience and the indications of retroperitoneal laparoscop- ic partial nephrectomy.Methods From December 2001 to October 2005,23 patients (including 14 cases of renal cell carcinoma,5 of hamartoma and 4 of duplex kidney) underwent retroperitoneal laparoscopic par- tial nephrectomy.One of the patients had solitary kidney.Results All the operations were successful ex- cept for only 1 requiring conversion to laparoscopic nephrectomy because of bleeding resulting from blocking anterior branch of renal artery.The mean operative time was 121 min (60-240 min),and mean ischemic time was 32 min (20-55 min).The estimated bleeding volume ranged from 100 ml to 300 ml,and no pa- tient needed blood transfusion.Pathology showed negative surgical margins in 14 cases of renal cell carcinoma and confirmed the diagnosis of hamartoma in 5 cases.One patient with duplex kidney required open partial nephrectomy because of renal cystic mass resulting from incomplete resection.Conclusions Retroperito- neal laparoscopic partial nephrectomy offers a new effective and minimally invasive treatment for selected pa- tients with renal mass.The long-term effects of the procedure need further investigation.