Genetic diagnosis of MN and ABO hemolytic disease of the newborn complicated with pyruvate kinase deficiency: a case report and literature review / 中国输血杂志

【Objective】 To investigate the clinical and genetic characteristics of hemolytic disease of the newborn(HDN) induced by anti-M complicated with pyruvate kinase deficiency (PKD) disease. 【Methods】 The clinical data of a pregnant woman with unexplained adverse pregnancy outcome in the third trimester were retrospectively analyzed, and neonate anemia status and blood transfusion were followed up. With informed consent, peripheral blood of the neonate and her parents were collected for serological tests and disease-related gene target sequence capture and sequencing. The clinical and genetic characteristics of HDN induced by anti-M or PKD were reviewed. 【Results】 The neonate presented severe anemia, hepatosplenomegalism, hyperbilirubinemia at birth, and was confirmed MN combined with ABO neonatal hemolysis by serological tests. The neonate recovered by receiving blood exchange and phototherapy treatments, but he needed to receive blood transfusion each month because of hemolytic anemia. Genetic analysis showed that the neonate had compound heterozygous mutations (c. 1096C>T; c. 941T>C) of PKLR gene inherited from her parents. 【Conclusion】 The clinical manifestations of PKD are similar to that of HDN caused by anti-M in the early stage of the disease. Clinicians should exclude the metabolic diseases of red blood cells when diagnosing severe HDN caused by anti-M.

Establishment of the maximum surgical blood order schedule for cesarean sections / 中国输血杂志

【Objective】 To establish the catalog of maximum surgical blood order schedule(MSBOS) for cesarean sections with different obstetric complications, so as to guide the doctors of clinical and Blood Transfusion Department to prepare blood reasonably. 【Methods】 The blood transfusion data during cesarean sections from January to October 2021 in our hospital were collected via medical record information system and blood bank system.The blood recipients were classified according to the main obstetric complications. The incidence of blood transfusion, per capita RBC transfusion units, blood transfusion index (TI) and other indicators were calculated, the literature and the risk of massive hemorrhage were referred, and the actual situation of Obstetrics Department was considered to formulate the obstetric MSBOS of our own. 【Results】 1) The blood recipients during cesarean sections were mainly diagnosed as placental abruption, placental implantation, central placenta previa and severe preeclampsia; the incidence of blood transfusion of them was 17.9%(20/112), 17.7%(15/85), 16.8% (27/161)and 5.2%(9/173), respectively, and TI indexes was 0.9, 1.3, 1.0 and 0.3, respectively. 2) The MSBOS of Obstetrics Department in our hospital had been established, and the blood preparation for obstetric surgery was divided into three categories: T(blood typing)/S(antibody screening), T(blood typing)/S(antibody screening)/C(crossmatch) 2 U, and T/S/C 4 U. 【Conclusion】 The establishment of MSBOS in Obstetrics Department of our hospital provides references for preparing blood reasonably.

Synthesis and evaluation on triglyceride inhibitory activities of novel indole alkaloids / 药学学报

Three tricyclic [6,5,7] and six tetracyclic [6,5,5,5] novel indole alkaloids were synthesized and evaluated on triglyceride inhibitory activities for the first time. Among them, compound 4c showed the most potent activity with IC50 value of 6.35 μmol·L-1. Meanwhile, compound 4c also exhibited a good safety profile at the cellular level. Preliminary mechanism study indicated that 4c might increase intracellular lipid metabolism by activating AMPK. These results provide a novel family of lead compounds for the discovery of anti-NAFLD candidates.

Influence of Addition and Subtraction Therapy of Guyinjian to Ovarian Reserve Function for Patients with Poor Ovarian Response with Kidney Yin Deficiency Syndrome / 中国实验方剂学杂志

Objective:To observe the effect of addition and subtraction therapy of Guyinjian on oocyte quality, pregnancy outcome and ovarian reserve function in patients with poor ovarian response (POR) with kidney Yin deficiency syndrome. Method:Ninety patients were randomly divided into control group (45 cases) and observation group (45 cases) by random number table. The patients in both groups got antagonist. Based on such treatment, the patients in observation received additional addition and subtraction therapy of Guyinjian. The using time and amount of gonadotropin (Gn), ovum taking cycle, cycle canceling rate, fertilization rate, available embryo rate, quality embryo rate, ovulation cycle clinical pregnancy rate were recorded. Levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), serum estradiol (E2) and endometrial thickness, anti mullerian hormone (AMH), resistance index (RI), pulsation index (PI), end diastolic velocity (EDV) and peak systolic velocity (PSV) were detected. Ratio of PSV/EDV (S/D) was calculated, and scores of kidney yin deficiency syndrome were graded before and after treatment. Result:Total amount of Gn in observation group was less than that in control group (PP2 were higher than those in control group (PPPχ2=5.124, Pχ2=5.767, PPPPPConclusion:Addition and subtraction therapy of Guyinjian can increase ovarian blood supply, improve high ovarian reserve function, reduce Gn consumption, increase number of acquired eggs, alleviate symptoms of kidney yin deficiency, and can ameliorate ovarian responsiveness and pregnancy outcome.

Status and strategies of oral health service demand and medical treatment utilization among 3- to 5-year-old preschool children in Jiangxi province / 华西口腔医学杂志

OBJECTIVE@#This study aimed to investigate the oral health service needs and dental treatment among 3-year-old to 5-year-old preschool children in Jiangxi province and provide data to support the development of relevant oral health policies, enhance the oral health service utilization and visit rate, and optimize oral manpower and service resources.@*METHODS@#A total of 2 880 preschool children were selected via stratified cluster sampling. Dental examination methods and criteria according to the fourth national oral health epidemiological survey were adopted. Excel 2007 and SPSS 19.0 softwares were used for statistics analysis. Chi-square test and logistic regression analysis were performed.@*RESULTS@#The caries prevalence was 49.13% (1 415/2 880) among the 2 880 cases of 3-
year-old to 5-year-old preschool children in Jiangxi province, approximately 53.37% (1 537/2 880) of which possessed oral health service needs. The parents of younger children assessed the oral situation better in older age than in their younger years (P<0.05), which was better in urban children than in rural children (P<0.05). The visiting rate of all the respondents was 12.33% (355/2 880), while the visiting rate of children with oral diseases was 17.31% (266/1 537). The top three reasons why patients did not visit the dentist were as follows: children's teeth have no problem, the teeth damage in teeth was considerably minimal, and primary teeth would be replaced without the need for treatment. The influencing factors included lower visiting rate in females than in males (OR=0.499, 95%CI: 0.411-0.606) and lower visiting rates in rural areas than in urban areas (OR=0.428, 95%CI: 0.353-0.519). Subjects with poor oral health and high oral knowledge scores possessed high dental service visit rates.@*CONCLUSIONS@#The prevalence of caries in 3-year-old to 5-year-old preschool children in Jiangxi province is at a lower level than that in the national level. The proportion of the population actively seeking medical services is low, and their main purpose of treatment is to treat rather than prevention. Oral health education should be strengthened, and it should be incorporated to the contents of the kindergarten teacher training program to improve residents' awareness regarding children's oral health.

HER2 gene status and mRNA expression in immunohistochemistry 1+ breast cancer / 中华病理学杂志

Objective@#To investigate human epidermal growth factor 2 (HER2) gene status and in situ mRNA expression in breast cancers with immunohistochemistry(IHC) 1+ , and to reveal HER2 positive rate in these patients to provide reference data for obtaining precise HER2 results and modifying relevant clinical strategy to breast cancer.@*Methods@#Sixty-five IHC 1+ formalin-fixed and paraffin-embedded samples of invasive breast carcinoma of no special type (IBC-NST) were collected by surgical operation at Peking Union Medical College Hospital during 2011 to 2013. HER2 status and in situ mRNA expression were tested by fluorescence in situ hybridization (FISH) and RNAscope, respectively, by using tissue microarray. Metastatic lymph node was re-tested by FISH if HER2 status was equivocal or negative and with high expression of mRNA in the primary lesion.@*Results@#Four of 65 samples (6.2%) were FISH positive, which included 2 cases of HER2/CEP17>2 and average HER2 copy number>4 and 2 cases of HER2/CEP17<2 and average HER2 copy number>6. In the 4 samples of HER2 positive, 2 patients showed high in situ mRNA expression (3 scores by RNAscope), 2 patients showed moderate in situ mRNA expression (2 scores by RNAscope). In addition, 3 specimens with HER2/CEP17>2 and average HER2 copy number<4 were found in all patients, which included 2 cases of high in situ mRNA expression (3 and 4 scores by RNAscope) and 1 cases of moderate in situ mRNA expression (2 scores by RNAscope). There was no significant association between HER2 status or mRNA expression and clinicopathological characteristics, including tumor size, histopathological differentiation, lymph node metastasis and lymphovascular invasion (P>0.05).@*Conclusions@#A small number of HER2 IHC 1+ patients exist mRNA expression by using FISH method, which suggested that these patients might benefit from anti-HER2 therapy potentially. Since the importance for patients with breast cancers to develop diagnostic and therapeutic strategies from accurate molecular typing, further studies based on a larger cohort are needed to validate our findings.

The mediating effects of neuropeptide S receptor 1 and negative coping on chronic psychological stress / 中华行为医学与脑科学杂志

Objective To explore the mediating effects of neuropeptide S receptor 1 and negative coping in chronic stress induced emotional responses. Methods A survey of 366 local residents who were chosen from County of Nandan in Guangxi Province by stratified random sampling method. Questionnaires of the life events scale (LES),the simplified symptom checklist and the Simplified Coping Style Questionnaire (SCSQ) were used. The level of NPSR1 was measured by Elisa. Data was analyzed by SPSS 21 and AMOS 21 statistical software for statistical analysis. Results The level of chronic psychological stress was (25. 24± 29. 26) and score of negative coping was(14. 84±4. 35). Somatic factor,anxiety factor,depressive factor and hostile factor were (1. 58±0. 58),(1. 43±0. 56),(1. 44±0. 55),(1. 23±0. 37). The total score of life e-vents was positively correlated with negative coping,somatic factor score,anxiety factor score,depression fac-tor score(r=0. 23-0. 46,P<0. 05),while negatively correlated with the expression level of detection of NPSR1 in plasma(r=-0. 26,P<0. 05). NPSR1 level was negatively correlated with body factor score,anxiety factor score,depression factor score and hostility factor score(r=-0. 18--0. 61,P<0. 05). Negative coping was positively correlated with body factor score,anxiety factor score,depression factor score and hostility fac-tor score(r=0. 12- 0. 27,P<0. 05). Both neuropeptide S receptor 1 and negative response had significant me- diating effects on emotional responses induced by chronic psychological stress (P<0. 05),and the effect val-ues were -0. 08 and 0. 05,respectively. According to the Bootstrapping method,the results of the mediation model showed that Bias-Corrected of 95% CI of the total standardization effect,the indirect standardization effect,the direct standardization effect were not including 0. Conclusion NPSR1 and negative coping plays a dual mediating effect on stress induced emotional responses.

Design, synthesis and evaluation of anti-inflammatory effect of novel berberine derivatives on IL-6/STAT signaling pathway / 药学学报

Interleukin-6 (IL-6)/signal transducers and activators of transcription (STAT) signaling pathway is closely related to the development and progression of atherosclerosis (AS). Taking Chinese natural product berberine (BBR) as the leading compound, a series of novel BBR analogues defined on different types of substituents on position 3 or/and 9 were designed, synthesized and evaluated for their inhibitory activities on phosphorylation of STAT-1 and STAT-3 induced by IL-6. The structure-activity relationship indicated that introduction of rigid fragment on position 3 or 9 was beneficial for enhancing their activities. Among them, compounds 2b and 9 exhibited the most satisfactory potency. The study revealed that the compounds 2b and 9 exhibit anti-inflammatory potencies via activating AMPK, and down-regulation of phosphorylation of STAT1 and STAT3 induced by IL-6 in HUVEC cells. These results suggest that BBR derivatives may inhibit the inflammatory response mediated by the IL-6/STAT signaling pathway through regulation of AMPK, which provides useful insight into the development of BBR derivatives for treatment of atherosclerosis.

Distrbution and risk factors analysis of infections caused by extended-spectrum β-lactamase-producing Escherichia coli / 国际检验医学杂志

Objective To analyze the specimen types,ward distribution and risk factors for infections caused by extended-spectrum β-lactamase(ESBLs)-producing-Escherichia coli(ECO) in recent two years,so as to provide bacteriological basis for both hospital infection control and clinical anti-infection treatment.Methods Non-repetitive 443 ECO strains isolated from the hospitalized patients in the Third People′s Hospital of Shenzhen were collcted,and the phoenix100 system was employed for bacterial identification and antimicrobial susceptibility tests.ESBLs-ECO was further confirmed by the double-disk synergy test,and the risk factors caused ESBLs-ECO were statistically analyzed.Results A total of 115 strains of ESBLs-ECO were identified among the 443 strains of ECO,which accounted for 26.0%.The ESBLs-ECO strains were mainly isolated from the sputum,urine,and blood specimens.Among the isolated ESBLs-ECO strains,20.9% were isolated from the department of Tuberculosis,13.9% from the department of pediatric,12.2% from the department of live disease,and 8.7% from the department of infection.The male sex,surgery and use of the third generation cephalosporins were independent risk factors of ESBLs-ECO infection.Conclusion The isolation rate of ESBLs-ECO in this hospital is high.It is necessary for the hospital to strengthen the control of nosocomial infections according to the risk factors.More attention should be payed on male patients,the standardization of surgical operation and disinfection,and the restriction of using the third generation cephalosporins,so as to reduce the incidene of ESBLs-ECO infections.

Bacterial culture and drug resistance of vaginal discharge in perinatal pregnant women / 中国感染控制杂志

Objective To investigate the distribution and drug susceptibility of vaginal pathogens in pregnant women during perinatal period.Methods Vaginal discharge specimens of 10 800 women (5 400 were pregnant women during perinatal period,5 400 were non-pregnant women) were performed bacterial culture and drug susceptibility testing.Results The isolation rate of pathogens from 5 400 perinatal pregnant women was 26.00％ (n =1 404),including 759 strains of fungi,611 strains of gram positive cocci,32 strains of gram-negative bacilli,2 strains of Neisseria gonorrhoeae;among 5 400 non-pregnant women,the isolation rate of pathogens was 7.87％ (n=425),including 232 strains of fungi,182 strains of gram-positive cocci,5 strains of gram negative bacilli,and 6 strains of Neisseria gonorrhoeae.Resistance rates of Streptococcus agalactiae isolated from perinatal pregnant women to erythromycin and clindamycin were 84.85％ and 80.81 ％ respectively,resistance rate of Staphylococcus aureus to erythromycin was 40.91 ％,resistance rates of Escherichia coli to tetracycline and sulfamethoxazole/trimethoprim were 69.23 ％ and 53.85 ％ respectively,resistance rate of Neisseria gonorrhoeae to penicillin and sulfamethoxazole/trimethoprim was 100.00％.Conclusion Vaginal infection rate in perinatal pregnant women is higher than non-pregnant women,screening of vaginal pathogens in perinatal pregnant women should be strengthened,so as to ensure the safety of mothers and infants.

HER2 mRNA expression in breast cancers with equivocal immunohistochemical results using in situ mRNA hybridization / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate in situ mRNA expression of HER2 oncogene in breast cancers with equivocal immunohistochemical results, and to explore the potential feasibility of RNAscope technique in evaluating HER2 status in breast cancers.</p><p><b>METHODS</b>Sixty-nine FFPE samples of invasive ductal breast cancer with equivocal HER2 immunohistochemistry results (IHC 2+) were collected from surgical excisions from Peking Union Medical College Hospital between June 2010 and June 2013. HER2 status and in situ mRNA expression were tested by fluorescence in situ hybridization (FISH) and RNAscope respectively using tissue microarray constructed from tumor paraffin blocks. The results of HER2 mRNA expression were scored 0 to 4 (from low to high levels) according to mRNA expression in 100 cancer cells. HER2 mRNA expression was evaluated in two groups of patients, with positive and negative FISH results.</p><p><b>RESULTS</b>Twenty-three of the 69 samples were FISH positive, including 16 samples that were scored 4 by RNAscope (70%, 16/23), 6 samples were scored 3 (26%, 6/23) and one sample was scored 2 (4%, 1/23). High in situ mRNA expression (score 4 or 3) were observed in 96% of HER2 FISH positive samples. All of samples that were scored 4 by RNAscope were FISH positive. Forty-six samples were FISH negative, including 17 samples that were scored 3 by RNAscope (37%, 17/46), 25 samples were scored 2 (54%, 25/46), and 4 samples were scored 1 (9%, 4/46).</p><p><b>CONCLUSIONS</b>Breast cancer with HER2 IHC 2+ could be further classified according to in situ mRNA expression status. Among them, RNAscope score of 4 could be one of the interpretation criteria for re-testing IHC 2+ samples. In situ detection of HER2 mRNA may be an additional candidate method of confirmation for HER2 gene amplification or protein overexpression, and has potential clinical utility.</p>

Diagnostic value of MYB protein expression in adenoid cystic carcinoma and status of MYB gene copy number / 中华病理学杂志

<p><b>OBJECTIVE</b>To explore the diagnostic value of MYB protein expression for adenoid cystic carcinoma and its differential diagnosis from other salivary gland tumors, and to further investigate the status of MYB gene copy number.</p><p><b>METHODS</b>MYB expression was studied by immunohistochemistry in 34 adenoid cystic carcinomas, 55 non-adenoid cystic carcinomas (other salivary gland tumors) including 10 pleomorphic adenomas, 10 basal cell adenomas, 10 epithelial-myoepithelial carcinomas, 9 basal cell adenocarcinomas, 8 mucoepidermoid carcinomas, 4 carcinoma in pleomorphic adenomas, and 4 polymorphous low-grade adenocarcinoma. MYB gene copy number status was detected by FISH in MYB protein-positive cases.</p><p><b>RESULTS</b>82.4% (28/34) of adenoid cystic carcinomas were MYB protein-positive, compared with 9.1% (5/55) of non-adenoid cystic carcinomas, and the difference between the two groups was statistically significant (P < 0.01). 2/18 of adenoid cystic carcinomas had duplication of MYB gene by FISH, and all non-adenoid cystic carcinomas were negative although the difference was not statistically significant (P = 0.435).</p><p><b>CONCLUSIONS</b>MYB protein expression is a useful diagnostic marker for adenoid cystic carcinomas in its separation from other salivary gland tumors. In addition, duplication of MYB gene is no a major mechanism for the MYB protein overexpression.</p>

Clinicopathologic correlation and ALK rearrangement in adenocarcinoma of lung / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate ALK gene rearrangements in lung adenocarcinomas in correlation with clinicopathologic parameters including prognosis.</p><p><b>METHODS</b>Fluorescence in situ hybridization (FISH) was used to detect ALK gene rearrangements in 53 cases of lung adenocarcinomas. Mutations in exons 18, 19, 20 and 21 of EGFR were analyzed by Scorpion amplification refractory mutation system (Scorpions ARMS).</p><p><b>RESULTS</b>In a cohort of 53 lung adenocarcinomas, ALK gene rearrangements were identified in 6 tumors (11.3%), including 4 male and 2 female patients. Five were acinar predominant adenocarcinomas and one was mucinous adenocarcinoma (P=1.000). All tumors with the ALK rearrangements had the wild-type epidermal growth factor receptor (EGFR) gene (P=0.023). The median time of disease-free survival (DFS) in ALK positive patients and negative patients were 14 months (95%CI 8.0-20.0) and 31 months (95%CI 24.9-37.1), respectively and the difference was significant (Log-rank test, P=0.019). ALK gene rearrangements were significantly associated with early recurrence, but not tumor size, pathologic stages, histological differentiation and lymph node metastasis.</p><p><b>CONCLUSIONS</b>ALK gene rearrangements are present at a higher frequency in lung adenocarcinomas of the Chinese patients. ALK gene rearrangements are mutually exclusive with EGFR mutations and associated with early tumor recurrence.</p>

ALK protein expression and gene fusion in bronchoscopic specimens of lung adenocarcinoma / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To explore ALK protein expression and gene fusion in formalin-fixed and paraffin-embedded (FFPE) specimens obtained from lung cancer by bronchoscopy, and to investigate the relationship between ALK status and clinicopathological characteristics of the patients.</p><p><b>METHODS</b>Seventy-four FFPE samples obtained from lung adenocarcinoma by bronchoscopy were tested for ALK protein expression and gene fusion respectively by immunohistochemistry (IHC) using Ventana D5F3 antibody and fluorescence in situ hybridization (FISH) using ALK break apart probe.</p><p><b>RESULTS</b>sixty-five of the 74 samples were successfully tested by FISH (87.8%, 65/74) . There were 5 FISH-positive cases (7.7%, 5/65) , all with advanced stage carcinoma. Among these five FISH-positive cases, 3 were IHC-positive (4.1%, 3/74) and 2 IHC-negative cases. All the other 69 samples were IHC-negative, including nine FISH-uninformative samples (7 samples were less than 50 tumor cells and 2 samples with weak FISH signal). Both ALK IHC and FISH results were not correlated with age, sex, history of smoking, histological classification, differentiation and lymph node metastasis.</p><p><b>CONCLUSIONS</b>Bronchoscopic specimens of lung cancer can be used to detect ALK expression and gene fusion. Immunohistochemistry in combination with FISH test may be more favorable for ALK test.</p>

Brain mappings in non-fluent late Chinese-English bilinguals / 中华外科杂志

<p><b>OBJECTIVE</b>To discuss the distribution characteristics of language areas in Chinese-English non-fluent late bilinguals.</p><p><b>METHODS</b>Six Chinese-English bilinguals with eloquent tumors underwent awake-surgeries. The activated areas of BOLD-fMRI were obtained as the patients performed pure naming, verb generation, and abstract/concrete judgment tasks. Direct cortical stimulation(DCS) as the golden standard of language mapping were performed during awake-surgeries on the exposed cortical areas. BOLD-fMRI results of 3 language tasks were compared with DCS results. The statistical method was McNemer.</p><p><b>RESULTS</b>Sixteen positive sites(22.5%) were comfirmed out of 71 stimulations. There were 3 specific language sites, in which 2 sites were specific English sites and 1 site was specific Chinese site. When activated areas of BOLD-fMRI were compared with the DCS results, verb generation task had the highest concordance rate 40.9% (95%CI:30.2%-52.5%) . There were significant differences between the results of BOLD-fMRI and DCS of all 3 bilingual tasks(P < 0.017).</p><p><b>CONCLUSIONS</b>There are specific language areas in Chinese-English non-fluent late bilinguals. The BOLD-fMRI language mapping could not substitute DCS in the context of mapping language areas in bilinguals.</p>

Clinicopathologic features and expression of epidermal growth factor receptor and vascular endothelial growth factor in adrenocortical tumors / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and expression of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) in adrenocortical tumors.</p><p><b>METHODS</b>Forty-two cases of adrenocortical tumors operated at the Beijing Union Medical College Hospital during the period from July, 2001 to July, 2010 were retrospectively reviewed. Immunohistochemical study for EGFR and VEGF was carried out. The clinical information and follow-up data were analyzed.</p><p><b>RESULTS</b>The cases included 21 adrenocortical carcinomas (ACC) and 21 adrenocortical adenomas (ACA). Nine patients suffered from primary aldosterone syndrome, including 8 cases with ACA and 1 case with ACC. The average tumor size, tumor weight, and duration between disease onset and diagnosis in the 21 cases of ACC were 11.7 cm, 542 g and 8.5 months, respectively. This was in contrast to 3 cm, 9.8 g and 45.6 months, respectively in cases of ACA. Histologically, the WEISS score in all the 21 cases of ACA was ≤ 2 (average = 0.9). None of the ACC cases had score less than 4 (average = 6.6). The presence of sinus invasion correlated with tumor metastasis (P < 0.01). Immunohistochemical study showed that EGFR was expressed in 61.9% of ACC patients (13/21), whereas EGFR staining was mostly negative in ACA (except for weak staining in 5 cases and moderate staining in 1 case). The difference of EGFR expression between ACC and ACA was statistically significant (P = 0.030). On the other hand, the positive rate of VEGF in ACC was 71.4% (15/21), including 28.6% (6/21) with strong expression and 28.6% (6/21) with moderate expression. In contrast, the expression rate of VEGF in ACA was 30.0% (7/21), including 14.3% (3/21) with moderate expression. The difference of VEGF expression between ACC and ACA was statistically significant (P = 0.013). There was correlation between VEGF expression and venous invasion (P = 0.028). The average duration of survival in patients with ACC was shorter than that in ACA. The tumor weight in ACC also correlated with prognosis.</p><p><b>CONCLUSIONS</b>Tumor size, weight and presence of endocrine symptoms may help in the differential diagnosis between ACC and ACA. A WEISS score of ≥ 3 highly suggests ACC. The presence of sinus invasion is associated with metastasis. EGFR or VEGF expression may also be important in differentiating ACC from ACA.</p>

Efficacy and clinical/molecular predictors of erlotinib monotherapy for Chinese advanced non-small cell lung cancer / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>A retrospective analysis of clinical data were conducted reviewing patients who were given erlotinib at Peking Union Medical College (PUMC) Hospital from May 2005 to December 2009. Relationships between clinical factors, epidermal growth factor receptor (EGFR) mRNA expression, EGFR gene mutations, KRAS gene mutations and clinical outcomes were investigated in Chinese patients with advanced non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Patients with stage IIIB/IV NSCLC who had not previously participated in erlotinib related clinical trials were enrolled into this study. All patients were given oral erlotinib 150 mg per day. Tumor samples of some patients were accessed with mutant-enriched polymerase chain reaction assay (EGFR, KRAS gene mutations) and multiplex branched DNA assay (EGFR mRNA expression).</p><p><b>RESULTS</b>Seventy-nine patients were enrolled in this study, 23 patients had a partial response (PR), 36 patients had a stable disease (SD), 20 patients had a PD, with an objective response rate of 29.1%, and a disease control rate of 74.7%. Females (P = 0.023), non-smokers (P = 0.013), patients with a skin rash (P = 0.047), and with highly differentiated tumors (P = 0.037) were significantly correlated with the objective response rate. Patients with a lower ECOG PS (P = 0.002), highly differentiated tumors (P = 0.014), non-smokers (P = 0.002), and patients with a skin rash (P < 0.001) were significantly correlated with the disease control rate. The median progression-free survival was 35 weeks (95%CI: 13 - 57 weeks) and 1-year survival was 72.3%. Highly-differentiated tumors (P = 0.027) and patients with a skin rash (P < 0.001) were significantly correlated with PFS. Seventeen patients were tested for EGFR/KRAS gene mutations and EGFR mRNA expression. Progression-free survival (PFS) of patients with EGFR exon 19/21 mutations was 66 weeks, longer than patients with wild type EGFR exon 19/21 (P = 0.018). No significant relationships were found between EGFR mRNA expression, EGFR exon 19/21 mutations, and KRAS mutations and objective response rate or disease control rate. The most common adverse events were skin rash (60.9%) and diarrhea (26.6%).</p><p><b>CONCLUSIONS</b>Erlotinib was safe and effective in treating Chinese patients with advanced NSCLC. The PFS of patients who had a skin rash, highly differentiated tumors, or EGFR exon 19/21 mutations was significantly longer.</p>

Analysis of chromosomal abnormalities in pancreatic cancer by spectral karyotyping / 中华病理学杂志

<p><b>OBJECTIVE</b>to investigate the chromosomal characteristics of pancreatic ductal adenocarcinomas by spectral karyotyping.</p><p><b>METHODS</b>cytogenetic aberrations of pancreatic cancer cell line P2 established from a Chinese patient was investigated by spectral karyotyping (SKY). Chromosomal alterations were further evaluated in 10 cases of pancreatic cancer and 10 cases of chronic pancreatitis by two color fluorescence in situ hybridization (FISH) by using EGFR/CEP7 probe and paraffin embedded tissue samples.</p><p><b>RESULTS</b>hypotriploid and 26 chromosomal aberrations were revealed in cell line P2. Recurrent chromosomal numerical alterations included loss of chromosome 4, 9, 18, 19, 22, Y, 10p, 15p, 8p, 6q and 12p, with gain of chromosome 7 and 12q. Frequent chromosomal structural abnormalities included der(9;15)(q10;q10), der(10)(3;10)(?;q26) and der(12)(8;12)(?;p13). Four of 10 cases showed EGFR copy number changes by FISH.</p><p><b>CONCLUSIONS</b>highly complex chromosomal rearrangements occur in pancreatic cancers. Additional studies of more cases are needed, including FISH analysis of EGFR copy number changes, to reach a conclusion.</p>

An outcome analysis of health education on prevention program of coal-type endemic fluorine, arsenic poisoning in Shaanxi in 2004 and 2006 / 中国地方病学杂志

Objective To evaluate the effect of health education on controlling endemic fluorosis in Shaanxi Province between 2004 and 2006. Methods Hanbin, Pingli, Ziyang and Hanyin were selected for the investigation in 2004;in addition to the four areas, Zhengping, Shiquan and Langao were also for the investigation in 2006. Two schools were selected in each area, and 2 villages as the investigation spots. Fifty pupils in the fifth grade in each school, and 30 housewives between 25 - 50 years old in each village were chosen as the research subjects. Referring to the health education questionnaire in Technique Scheme of Endemic Disease Prevention Granted by Central Government of 2004, the degree of health education of endemic fluorine, arsenic poisoning in pupils and housewives were investigated. Results In 2004 and 2006, the average mark of pupils in school was 54.7 and 83.6, the pass rate was 57.5% (230/400) and 90.2% (629/697), respectively;the average mark of housewives was 59.7 and 83.9, the passing rate was 59.6% (143/240), 87.6%(338/386) respectively, indicating that the outcome was improved obviously in 2006 compared to that in 2004. Conclusions In the past three years, health knowledge of endemic arsenic and fluorosis has been improved among pupils and housewives in these areas.

Status of gene mutation and copy number of EGFR in 290 cases of non-small cell lung carcinoma / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate EGFR mutations and gene copy number status in non-small cell lung carcinomas in the Chinese patients.</p><p><b>METHODS</b>Using formalin fixed and paraffin embedded tissue samples, EGFR mutations were investigated in 290 cases of non-small cell lung carcinomas by microdissection and scorpions amplification refractory mutation system. The status of EGFR gene copy number was investigated by FISH. Furthermore, the relationship between EGFR mutations and gene copy number, and the relationship between EGFR gene status and clinicopathological variables of non-small cell lung carcinoma were analyzed.</p><p><b>RESULTS</b>The overall mutation rate of EGFR was 41.7% (121/290). The mutation rates in adenocarcinoma, large cell carcinoma and squamous carcinoma were 48.4%, 16.7% and 0, respectively. Ninety-two of 121 cases with mutations had exon 19 deletion and L858R mutation, and 6 tumors contained both types of the mutation. The overall FISH positive rate of EGFR was 51.2% (107/209). FISH positive rates in adenocarcinoma, large cell carcinoma and squamous carcinoma were 52.1%, 75.0% and 11.1%, respectively. Therefore, EGFR mutations mainly occurred in the adenocarcinoma, and was significantly correlated with EGFR high copy number.</p><p><b>CONCLUSIONS</b>There are higher EGFR mutation rate and FISH positive rate in non-small cell lung carcinoma in Chinese patients. Combined analysis of EGFR mutation and gene copy number by FISH may provide a superior approach in selecting patients who may benefit anti-EGFR target therapy.</p>