Interobserver variation in the morphological evaluation of nuclear features of noninvasive follicular thyroid neoplasm with papillary like nuclear features / 中华内分泌代谢杂志

Objective:To evaluate the interobserver variation of pathologists in the morphological evaluation of non-invasive follicular thyroid neoplasm with papillary-like nuclear features(NIFTP).Methods:Nine pathologists from different regions in China were selected to evaluate the digital slides of 30 cases of NIFTP. Three score system was applied, including nuclear size and shape, membrane irregularity, and chromatin features. Individual histologic features were scored as either present(1)or absent(0). A total score of 0 or 1 was considered inadequate for the diagnosis of NIFTP and a total score of 2 or 3 was considered sufficient for the diagnosis of NIFTP.Results:Overall, 9 doctors had weak consistency in the interpretation of the 30 cases(Kappa value 0.081 4), in which the interpretation of the membrane irregularity had the best consistency(Kappa value 0.193 6)and the interpretation of nuclear size and shape revealed the worst consistency(Kappa value 0.102 2). The overall consistency of the evaluation from the 7 senior pathologists was better than that of all the pathologists(Kappa value 0.134 1), but it was still weak. The consistency of nuclear membrane irregularity(Kappa value 0.267 4)and nuclear chromatin features(Kappa value 0.257 3)was weak, but much better than that of nuclear size and shape(Kappa value 0.073 0). The interobserver consistency in our study was lower than that in Asian study generally. However, the judgement on membrane irregularity in our senior pathologists was better than that in Asian study.Conclusion:The interobserver variation on the evaluation of the nuclear features of NIFTP is probably due to the education level, working experience, personal understanding of the diagnostic criteria, the regional difference, and some uncertain reasons. There is overall a weak consistency in the interpretation of NIFTP by Chinese pathologists, and it is necessary to popularize the diagnostic criteria and specify the criteria in detail. It is important to exclude high-risk genetic mutation using immunohistochemical staining or molecular examination on those patients with morphology of NIFTP.

Determination of potential genotoxic impurity in ecabet sodium active pharma-ceutical ingredient by HPLC-MS/MS / 中国药科大学学报

To develop a sensitive analytical method for the determination of the genotoxic impurity mono ethyl ester of ecabet (Imp-I),an HPLC-MS/MS technique was employed. Imp-I was synthesized according to the previ-ous literatures. MS/MS and NMR were used to confirm the structure of Imp-I. A Thermo C18column was used for chromatographic separations. The mobile phase consisting of A:5 mmol/L ammonium acetate (pH adjusted to 3. 0 with formic acid)and B:acetonitrile,with a gradient program:0 min 50%B,4 min 50%B,12 min 80%B,16 min 80%B,16. 1 min 50%B and 20 min 50%B. The column was maintained at 40 °C throughout the analysis.All measurements were carried out with the mass spectrometer operated under the negative ESI mode. The selective reaction monitor (SRM)transition was used. Good linearity was obtained for Imp-I over the concentration range of 4 150 ng/mL with the coefficient of determination (r)of 0. 999. And the LOQ was 4 ng/mL. A rapid and sensi-tive HPLC-ESI-MS/MS method was developed for quantitative analysis of Imp-I in ecabet sodium APIs. This method can be of used for quality assurance of ecabet sodium in bulk commercial drugs.

Significance of measuring roundness of gastric gland lumens in differential diagnosis of well-differentiated gastric adenocarcinoma / 中华消化杂志

Objective To investigate the diagnostic value of computer image analysis assisted aroundness measurement of gastric gland lumens in well-differentiated gastric adenocarcinoma.Methods From January 2016 to July 2016,10 hematoxylin-eosin (H-E) stained slides of pathologically diagnosed well-differentiated gastric adenocarcinoma were collected.At the same period,H-E stained slides of gastric epithelial hyperplasia and normal gastric mucosa,six slides of each,were collected as controls.All of them were scanned into high resolution.Digital data roundness,long diameter and short diameter were measured and compared.Kruskal-Wallis rank sum test was used for statistical analysis.Results The median values of lumen roundness of normal gastric mucosa,gastric epithelial hyperplasia and welldifferentiated gastric adenocarcinoma were 79.7°(10.6°),73.0°(12.3°) and 58.6°(15.2°),respectively,and the difference among three groups was statistically significant (H=494.827,P＜0.01).The values of gland roundness of normal gastric mucosa were higher than those of gastric mucosal hyperplasia and welldifferentiated gastric adenocarcinoma,and the differences were statistically significant (T=156.007 and -508.579,both P＜0.01).The value of gland roundness of gastric mucosal hyperplasia was higher than that of well-differentiated gastric adenocarcinoma,and the difference was statistically significant (T=-352.572,P＜0.01).The values of long diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 24.1 μm(11.8 μm),43.1 μm (28.8 μm),and 96.0 μm(79.3 μm),respectively,and the difference among three groups was statistically significant (H=744.987,P＜0.01).The values of short diameter of gland lumens in normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma were 16.0 μm (8.7 μm),22.7 μm (13.1 μm) and 33.5 μm (38.0 μm),respectively,and the difference among three groups was statistically significant(H=248.170,P＜0.01).Conclusion The roundness of gastric gland lumens can be used as an effective parameter for the differential diagnosis of normal gastric mucosa,gastric mucosal hyperplasia and well-differentiated gastric adenocarcinoma.

In situ observation of surface structures of cardiovascular endothelial cells with atomic force microscope / 老年心脏病学杂志（英文版）

Objective To observe the surface structures of cardiovascular endothelial cells in situ with atomic force microscope (AFM). Methods Fresh aorta and aortic valve were dissected from 10 healthy male New Zealand white rabbits. Before fixed in 1% formaldehyde, the fresh tissues were washed in the buffer phosphate solution. Under general microscope, the fixed aorta or valve was spread on the double side stick tape which had already been stuck on the glass slide. The intima of aorta or the aorta side of valve was towards upside. Then the specimen was dried under 37 degrees centigrade in an attemperator and was washed with pure water. After dried again, the specimen was loaded on the platform ofNanoScope llla AFM and was scanned in tapping mode with the scanning speed of 0.5 HZ. Results The surface structures of endothelial cell on the fixed and dried tissue could be obsserved clearly in situ with AFM. Aortic endothclial cells were large, branched and arranged sparsely and parallel to the direction of blood flow, whereas endothelial cells on aorta valve surface were small, less branched and arranged intensively and vertical to the direction of blood flow. When the scanning range was dwindled, granular ultra-structures could be observed on the surface of endothelial cells, and, as the scanning range was dwindled further, fissure and convolution could be seen on the surface of granules from aortic endothelial cells. Centre cavity and surrounding swelling volcano-like structure could be seen on the surface of granules from endothelial cells of aortic valve. Conclusions It's feasible to observe the surface ultra-structures of cardiovascular endothelial cells in situ with AFM and morphological information provided by A FM might be of clinical value in future histopathological diagnosis.

Clinicopathological observation and analysis of donor liver and biopsy in liver transplantation / 中华肝胆外科杂志

Objective To investigate the relationship between histopathological changes of donor liver and those after liver transplantation and explore its effects on prognosis.Methods The histopathological changes of donor liver and post-transplantation live biopsy were observed in 87 cases.Results The percentage of hepatic degeneration at immediate biopsy of donor liver was 100%,the injury of sinusoid endothelial cell accounted for 41.3%,the hepatic steatosis for 18.3%and the necrosis of liver cells for 10.3%.Conclusion Most of the pathological changes of the donor liver during and after liver transplantation are reversible.The damage of the hepatic sinusoidal cells is the important criterion for the observation of ischemia reperfusion injury.Moderate and heavy hepatic steatosis can be used in the liver transplantation. After liver transplantation,if the necrosis of liver cells gradually gets serious,the risk of transplanted liver losing its function gets bigger,so the comparative observation has very important value in diagnosis.

Functional and pathological changes of lung tissues after bullet wound of dog's hind legs / 中国组织工程研究

BACKGROUND: Knowing the pathological changes of the lungs after the wallop from the bullet wound helps to improve the method or mean of dealing with the wound or to reduce the damage to lung functions after the wound.OBJECTIVE: To probe into the functional and pathological changes of the lung tissues after bullet wound.DESIGN: Open experimental study of the animals.SETTING: Department of the Integrated Traditional Chinese and Western Medicine, General Hospital of the Chinese People's Armed Police Forces.MATERIALS: The experiment was completed from June 2003 to December 2003 at the General Hospital of the Armed Police Forces. Six healthy grown-up cross-bred dogs, half male and half female, weighing ( 16.3 ± 0.58 ) kg, aged (8 - 12) months old, were provided by the Experimental Animal Center of the Military Academy of Sciences of Chinese PLA. Animal Center's license No. Was SCXK(army)2002-001. The animals were fed with water and food with no restrictions in an environment in which the temperature was 22 to 23 ℃ and the humidity was 74% - 80%.METHODS: Grown-up healthy domestic dogs were shot at the thick muscular part of their left hind legs with a size 81 automatic rifles, 7.62 mm in caliber and bullet of type-560. Caution was taken to avoid damage to the major vessels and the bone tissues. The shooting distance was 5 meters. Immediate hemostasis and bandaging were performed after shooting. And 6 hours later, pathological examination of the lungs was carTied out.MAIN OUTCOME MEASURES: Pathological changes of the lungs.RESULTS: After the bullet wound, the main pathological manifestations of the lungs were detelectasis of the pulmonary alveoli and the decrease of air volume complicated with inflammatory alveoli infiltration, lung edema, obscure structure of pulmonary alveoli, passive congestion of the small blood vessels, etc.CONCLUSION: The lung wound was obvious after bullet wound and its mechanism was associated with stress, inflammatory reaction of the adjacent tissues and far domino effect. Blood rheological changes after the wound were one of the most important factors to affect the microcirculation of the cerebral and lung tissues. It was found that clear blood rheological changes occurred at the earlier stage after the wound, and the chief manifestations included the increase of the whole blood viscosity and the index of the erythrocyte aggregation at the time of low sheering rate. The changes reached their peaks 6hours after the wound. On the one hand, because of the increase of whole blood viscosity and the index of erythrocyte aggregation, stasis of red blood cells might happen. And embolism of micro blood vessels in the brain and lungs would change the microcirculation of the brain and lungs. On the other hand, when serious injury of local tissues happens, the body's stress reaction would be strong and secretion and the release of stress hormones and certain active biological small molecular substances would increase, such as nitrogen monoxide(NO), tumor necrosis factor(TNF), endothelin(ET), etc. Their increase would stimulate the micro blood vessels of the brain and lungs and disturb their diastole and constriction functions. After the wound by high-speed projectile, blood flow volume in the animal's cerebral and lung tissues reduced sharply. The micrangium of the brain and lung dilated, and its diameter increased, which resulted in ischemia and hypoxia of the brain and lung tissues, and therefore edema of the brain and lung tissues and hypofunction of the lungs. Therefore, for the bullet wound of the limbs, in addition to dealing with local damage, the brain, the lungs and other important organs should be protected. This provides a theoretical basis for improving the brain and lung function after the bullet wound.

Significance of changes in local immunity in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To assess the local immune response in patients with hepatocellular carcinoma after percutaneous microwave coagulation therapy (PMCT).</p><p><b>METHODS</b>Seventy-eight patients with hepatocellular carcinoma underwent PMCT. Both cancerous and adjacent liver tissue were taken before, and 3, 17 and 30 days after PMCT using ultrasound-guided liver biopsy. Specimens were stained by immunohistochemical techniques for detecting CD3, CD45RO, CD56, CD68, and CD20 positive cells.</p><p><b>RESULTS</b>A few CD3, CD45RO, CD56, CD68 and CD20 positive cells were observed in the cancer stroma and surrounding sinusoids in liver tissue pre-PMCT. The number of immunocytes, except for CD20 positive cells, was significantly increased both within the cancer and the adjacent liver tissue, with a larger increase in tumor tissue at day 3 post-PMCT compared with pre-PMCT. These immunocytes were enlarged in size. The number of CD3, CD45RO and CD56 positive cells peaked at day 17 and CD68 positive cells peaked at days 3 post-PMCT. At day 30 post-PMCT, this increase still existed. These infiltrating immunocytes distributed in the parenchyma of the tumor, and within the lumen of small blood vessels after PMCT. In addition, more infiltrated immune cells were seen in cancer cell spaces.</p><p><b>CONCLUSIONS</b>A change in immunocyte infiltration takes place in number, configuration and location after patients with HCC are treated with percutaneous microwave coagulation, suggesting that local immune function is enhanced post-PMCT.</p>

Hepatic adenomas: comprehensive imaging diagnosis / 中华放射学杂志

Objective To describe the US, CT, and MR imaging findings and diagnosis of hepatic adenomas. Methods The comprehensive imaging features in 6 patients with 6 hepatic adenomas confirmed pathologically were reviewed retrospectively and correlated with pathologic findings. Results One case was diagnosed correctly, four cases were mistaken for hepatocellular carcinomas (HCC), and one case was mistaken for focal nodular hyperplasia. US: six lesions were hypoechoic with hypohalo in four lesions, and there was low velocity arterial and venous flow within the six lesions. CT: six lesions were hypodense with pseudocapsule in four lesions, and the four lesions showed slight enhancement during arterial and portal venous phases, and one lesion showed moderate enhancement during arterial phase and slight enhancement during portal venous phase. MRI: six lesions had heterogeneously high signal intensity on T 1WI and T 2WI, and the high intensity on T 1WI remained unchanged after using fat saturation. Two lesions showed strong enhancement during arterial phase and slight enhancement during portal venous and delayed phases, and three lesions showed slight enhancement during arterial, portal venous, and delayed phases. Pseudocapsule detected in six lesions showed slight enhancement on portal venous or delayed phases. Conclusion The comprehensive imaging findings of hepatic adenomas were nonspecific. The presence of pseudocapsule, heterogeneous high signal intensity on T 1WI, and the high intensity remained unchanged after using fat saturation may help make a correct diagnosis of hepatic adenoma.

RELATION BETWEEN HELICOBACTER PYLORI INFECTION AND GASTRIC MUCOSA-ASSOCIATED LYMPHOID TISSUE / 解放军医学杂志

Eighty six patients with chronic superficial gastritis, atrophic gastritis and peptic ulcer without autoimmune diseases underwent gastroscopy and biopsy in the gastric antrum and body. Hp was identified by histopathological analysis (Warthin Starry silver stains) and rapid urease test (RUT). Lymphoid tissue was observed by HE stain and immunohistochemistry method. Results showed that Hp infection was found in 68 6% of the patients.Lymphoid follicles were present in 35 6% of the Hp positive patients ,and no lymphoid follicles were found in the Hp negative patients.In six Hp positive patients,Lymphoepithelial lesions were found.Hp infection was closely associated with gastric mucosal lymphoid infiltration,lymphoid follicles and active inflammation( P