The potential relationship between uric acid and the recovery in sudden sensorineural hearing loss

Abstract Objective Serum uric acid is proven to be associated with chronic hearing loss, but its effect on Sudden Sensorineural Hearing Loss (SSNHL) is unclear. This study aims to evaluate the prognostic values of serum uric acid levels in SSNHL patients. Methods The clinical records of SSNHL patients were retrospectively reviewed. Patients were divided into different groups based on hearing recovery and audiogram type, and uric acid levels were compared. Based on uric acid levels, patients were categorized into normouricemia and hyperuricemia groups, and clinical features and hearing recovery were evaluated. Univariate and multivariate analyses were performed to identify prognostic factors. Results In total, 520 SSNHL patients were included in this study, including 226 females and 294 males. In female patients, 186 patients were included in the normouricemia group, and 40 patients were enrolled in the hyperuricemia group. Significant differences were observed in uric acid levels, Total Cholesterol (TC), rate of complete recovery, and slight recovery between the two groups. In male patients, 237 subjects were categorized into the normouricemia group, and 57 patients were included in the hyperuricemia group. The rate of complete recovery and slight recovery was lower in the hyperuricemia group compared to the normouricemia group. All patients were further divided into good recovery and poor recovery groups based on hearing outcomes. The uric acid levels, initial hearing threshold, rate of hyperuricemia, and TC were lower in the good recovery group than the poor recovery group both in female and male patients. Binary logistic regression results showed that uric acid levels, initial hearing threshold, and hyperuricemia were associated with hearing recovery. Conclusion Hyperuricemia might be an independent risk factor for hearing recovery in SSNHL patients. Serum uric acid and initial hearing threshold possibly affected the hearing outcome in males and females with SSNHL. Level of evidence Level 4.

Gene mutation profiling and clinical significances in patients with renal cell carcinoma

Abstract Objectives The pathological mechanisms of patients with Renal Cell Carcinoma (RCC) remain defined. This study aimed to evaluate relationships between the landscape of gene mutations and their clinical significance in RCC patients. Methods Tissue and peripheral blood samples of 42 patients with RCC were collected and performed for the Next Generation Sequencing (NGS) with Geneseeq PrimeTM 425-gene panel probes. Their landscapes of gene mutation were analyzed. We also carried out an evaluation of Tumor-Node-Metastasis (TNM) staging, RENAL nephelometry score, surgery, and targeted drug treatment of patients. Then we compared the correlations of landscape in gene mutations and the prognosis. Results The most common gene alternations, including BAP1, PBRM1, SETD2, CSF1R, NPM1, EGFR, POLE, RB1, and VHL genes, were identified in tissue and blood samples of 75% of patients. EGFR, POLE, and RB1 gene mutations frequently occurred in relapsed and metastatic patients. BAP1, CCND2, KRAS, PTPN11, ERBB2/3, JAK2, and POLE were presented in the patients with > 9 RENAL nephelometry score. Univariable analysis indicated that SETD2, BAP1, and PBRM1 genes were key factors for Disease-Free Survival (DFS). Multivariable analysis confirmed that mutated SETD1, NPM1, and CSF1R were critical factors for the Progression Free Survival (PFS) of RCC patients with target therapy. Conclusions Wild-type PBRM1 and mutated BAP1 in patients with RCC were strongly associated with the outcomes of the patient. The PFS of the patients with SETD2, NPM1, and CSF1R mutations were significantly shorter than those patients without variants.

Automated classification of ICD-O-3 morphology code from pathology reports using text-mining and support vector machine / 预防医学

Objective@#To evaluate the accuracy of automated classification of ICD-O-3 morphology code from pathology reports by text-mining and support vector machine ( SVM ) , in order to provide basis for automated tumor coding in Chinese. @*Methods@#The tumor report cards of Zhejiang residents from 2017 to 2019 were collected from Chronic Disease Surveillance Information Management System of Zhejiang Province. According to ICD-O-3, the keywords of the pathology reports were extracted, and SVM was used for automatic classification. The classification results were compared with those of 16 professionals with more than two years of experience in tumor coding, and the accuracy rate, recall rate and F-score were calculated for effect evaluation. @*Results@#Totally 83 082 cases from 2017 to 2019 were included and were categorized into 17 morphological classifications, with 52 877 ( 63.65% ) cases of adenocarcinoma, squamous carcinoma and transitional cell carcinoma. A total of 1 090 keywords were enrolled into main corpus. The total F-score, accuracy rate and recall rate are 85.69, 77.20% and 96.27%, respectively. @*Conclusion@#Text-mining combined with SVM can improve the efficiency of ICD-O-3 morphology coding; however, the accuracy needs to be further improved.

Reproducibility of Gleason scores in prostate cancer / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the reproducibility of Gleason scores for prostate cancer.</p><p><b>METHODS</b>Based on the revised Gleason Scoring System of the International Society of Urological Pathology ( ISUP) , we analyzed the reproducibility and difference of Gleason scores in 49 cases of prostate cancer using the methods of combination and grouping.</p><p><b>RESULTS</b>The total reproducibility of Gleason scores among 15 pathologists was good (κ = 0.642), 62.2% by the combination method, the highest in Gleason 5 + 5 (81.2%) and 5 +4 (73.3%), then in Gleason 4 + 4 (67.5%), 3 + 3 (64.0%), 4 +3 (61.3%), and 3 + 4 (44.0%), and the lowest in Gleason 4 + 5 (38.9%) and 3 + 5 (33.3%). The total reproducibility of Gleason scores by the grouping method was 71.4%, the highest in Gleason 9-10 (84.9%) , then in Gleason 7 (76.7%) and 6 (64.0%), and the lowest in Gleason 8 (60.7%).</p><p><b>CONCLUSION</b>The reproducibility of Gleason scores remains to be further improved in prostate cancer, mainly concerning the understanding of Gleason 3 and 4 carcinoma.</p>

Age correlates with Gleason score in patients with prostate adenocarcinoma / 中华男科学杂志

<p><b>OBJECTIVE</b>To investigate the correlation between age and Gleason score (GS) in patients with prostate adenocarcinoma.</p><p><b>METHODS</b>This study included 674 patients with pathologically confirmed prostate adenocarcinoma. We determined the GS, primary grade, and secondary grade of the cases, and compared them among different age groups.</p><p><b>RESULTS</b>The mean age of the patients was (70.22 ± 8.26) yr, ranging from 25 to 96 years, (69.06 ± 8.35) yr in those with GS 6, (70.55 ± 8.16) yr in GS 7, (70.99 ± 6.54) yr in GS 8, (71.56 ± 9.18) yr in GS 9, and (72.79 ± 11.36) in GS 10. The mean GS, primary grade, and secondary grade were 7.08 ± 1.09, 3.54 ± 0.72, and 3.53 ± 0.66, respectively, and the mean GSs in the < 60 yr, 60-69 yr, 70-79 yr, and ≥ 80 yr groups were 6.86 ± 1.10, 6.99 ± 1.10, 7.08 ± 1.04, and 7.38 ± 1.23, respectively. Those with GS 6, 7, and ≥ 8 accounted for 37.7%, 34.3%, and 28.0%, respectively. The patients aged < 60, 60-69, 70-79, and ≥ 80 years constituted 10.5% (71/674), 30.6% (206/674), 47.6% (321/674), and 11.3% (76/674), respectively. The age of the patients was significantly correlated with GS (r2 = 0.013, P = 0.003) and the primary grade (r2 = 0.014, P = 0.002), but not the secondary grade (r2 = 0.005, P = 0.055).</p><p><b>CONCLUSION</b>Of the prostate adenocarcinoma patients, those aged ≥ 70 years form a larger proportion, and those with GS ≥ 7 comprise a higher percentage. The age of the patient is correlated with Gleason score but has a limited value in its prediction.</p>

Basic features of the ISUP prostate carcinoma Gleason grading system: a preliminary analysis / 中华男科学杂志

<p><b>OBJECTIVE</b>To explore the basic features of the prostate carcinoma Gleason grading system of the International Society of Urological Pathology (ISUP).</p><p><b>METHODS</b>We analyzed the means and proportions of the Gleason score (GS), primary grade (PG), secondary grade (SG) and third grade (TG) of 667 cases of prostate carcinoma.</p><p><b>RESULTS</b>The means of GS, PG, SG and TG were 7.06 +/- 1.10, 3.53 +/- 0.66, 3.53 +/- 0.72 and 4.30 +/- 0.96, respectively. The cases with GS 5, 6, 7, 8, 9 and 10 accounted for 0.4% (3/677), 37.2% (252/677), 34.4% (233/677), 13.7% (93/677), 12.0% (81/677) and 2.2% (15/677), respectively; those with GS < or = 6 and > or = 7 constituted 37.7% (255/677) and 62.3% (422/677); those with GS3 + 3, 4 + 3 and 3 + 4 made up 37.2% (252/677), 19.2% (130/677) and 15.2% (103/677); and the TG cases held 10.3% (70/677), including 30.0% (21/70) of grade 3, 10% (7/70) of grade 4 and 60.0% (42/70) of grade 5.</p><p><b>CONCLUSION</b>Our study showed a high proportion of GS, a low proportion of GS < or = 6, and a high proportion of GS > or = 7 in the ISUP prostate carcinoma Gleason grading system. TG of GS needs to be further understood.</p>

Change of hs-CRP, sVCAM-1, NT-proBNP levels in patients with pregnancy-induced hypertension after therapy with magnesium sulfate and nifedipine

OBJECTIVE@#To investigate the change of the hs-CRP, sVCAM-1, NT-proBNP levels of the patients with pregnancy-induced hypertension (PIH) syndrome.@*METHODS@#A total of 200 patients with PIH were divided into mild, moderate and severe group, and 50 healthy pregnancy patients served as the control group. The serum sVCAM-1 levels were detected by enzyme-linked immunosorbent assay, hs-CRP were detected by immunity transmission turbidity, and NT-proBNP levels were determined by the colloidal gold method. Patients were treated with magnesium sulfate and nifedipine and the contrastive analysis was performed before and after treatment. And the pathological changes in placental of PIH patients were detected by hematoxylin-eosin staining at the same time.@*RESULTS@#The hs-CRP, sVCAM-1, NT-proBNP levels of patients in the mild, moderate and severe PIH group were significantly higher than that in the control group (P<0.05). The hs-CRP, sVCAM-1, NT-proBNP levels in the severe group were significantly higher than the mild group and the moderate group, the difference was statistically significant (P<0.05). The hs-CRP, sVCAM-1, NT-proBNP of the moderate group were significantly higher than the mild group (P<0.05). There was a positive correlation between hs-CRP, sVCAM-1, NT-proBNP expression levels and the degree of the PIH. The expression of hs-CRP, sVCAM-1, NT-proBNP levels of the moderate and the severe group were significantly decreased (P<0.05). The number of placental villi and interstitial blood vessel in the moderate and severe PIH group were significantly less than the control group (P<0.05).@*CONCLUSIONS@#The increased levels of serum hs-CRP, sVCAM-1, NT-proBNP may be involved in the process of vascular endothelial cell injury of the PIH, and the hs-CRP, sVCAM-1, NT-proBNP can be used as the auxiliary index for diagnosis of PIH and determination of PIH severity.

Perivascular epithelioid cell tumor of urinary system: a clinicopathologic analysis of 21 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features and differential diagnosis of perivascular epithelioid cell tumors (PEComas) occurring in the urinary system.</p><p><b>METHODS</b>The clinicopathologic features of 21 cases of PEComa from September 2002 to September 2010 occurring in the urinary system were retrospectively reviewed. Immunohistochemical study for HMB 45, S-100 protein, smooth muscle actin, desmin, Melan A and Ki-67 was carried out.</p><p><b>RESULTS</b>Amongst the 21 cases studied, there were 5 males and 16 females. The age of patients ranged from 16 to 76 years (median = 51.3 years). Twenty cases occurred in the kidney and 1 in the bladder. The predominant histopathologic subtype of renal PEComas was classic type (10/20), followed by epithelioid type (5/20), smooth muscle type (3/20), inflammatory type (1/20) and sclerosing type (1/20). Immunohistochemical study showed that HMB 45 and smooth muscle actin were positive in 95.2% (20/21) and 80.9% (17/21) cases, respectively. Melan A, desmin and S-100 protein were expressed in 71.4% (15/21), 61.9% (13/21) and 33.3% (7/21) cases, respectively. The mean proliferative index was 1.29% (range = 0 to 5%). HMB 45 and Melan A were expressed in all of the 5 cases of epithelioid PEComas, whereas smooth muscle actin and desmin were only expressed in one of them. There was no significant difference between epithelioid PEComas and non-epithelioid PEComas in the expression of HMB 45, Melan A, smooth muscle actin and desmin. Positive staining for HMB 45 and smooth muscle actin was demonstrated in the case of bladder PEComa.</p><p><b>CONCLUSIONS</b>PEComas of the urinary system predominantly affect the kidney. Epithelioid renal PEComas and bladder PEComa are relatively rare and have unique pathologic features. It is necessary to distinguish PEComas from other malignant tumors. Immunohistochemical study for HMB 45, Melan A and smooth muscle actin is helpful for confirmation of diagnosis.</p>

Clinical analysis of misdiagnosis in 70 children with primary hypothyroidism / 中国医学科学院学报

<p><b>OBJECTIVE</b>To analyze the causes of misdiagnosis of primary hypothyroidism (PH), with an attempt to reduce the misdiagnosis or mistreatment.</p><p><b>METHODS</b>Totally 70 PH children with a history of misdiagnosis but whose conditions were confirmed in Peking Union Medical College Hospital and the First Hospital of Jilin University from July 2000 to May 2009 were enrolled in this study. The clinical data were collected and the causes of misdiagnoses were analyzed.</p><p><b>RESULTS</b>Of these 70 patients, 19 were misdiagnosed as anaemia and dystrophy, 18 as pituitary tumors, 10 as adiposities, 6 as myocarditis or pericardial effusion, 4 as Downs syndrome, 3 as hepatitis, 3 as amyasthenia, 3 as cerebral palsy, 2 as cystis thyrolingualis, and 2 as congenital megacolon. The duration of misdiagnoses ranged from 6 to 72 months. The clinical manifestations of these patients were complicated, involving multiple organs and systems.</p><p><b>CONCLUSIONS</b>PH has complicated clinical manifestations and individual variations, and therefore can be easily misdiagnosed. Good knowledge, sufficient history-taking, and cautious physical examinations can help avoid misdiagnosis. Neonatal screening is helpful for diagnosis and treatment of congenital hypothyroidism.</p>

Laryngeal electromyographic characteristics of vocal fold immobility / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To investigate the characteristics of laryngeal electromyography and evoked electromyography in vocal fold immobility.</p><p><b>METHODS</b>108 cases of vocal fold immobility were analyzed by clinical manifestation and laryngeal electromyography characteristics, including spontaneous potential activity, motor unit potential (MUP) measurement, recruitment pattern analysis and evoked electromyography evaluation.</p><p><b>RESULTS</b>Neurogenic vocal fold immobility showed a wide variety of abnormal activity. Fibrillation potentials and positive sharp waves were found in patients with laryngeal nerve injuries. For laryngeal paralysis, there was no reaction with LEMG and evoked LEMG. For laryngeal paresis, it showed decreased MUP and decreased recruitment activities with simple pattern recruitment or mixed pattern recruitment, and decreased evoked muscle response potentials were also shown with delayed latency than normal (P < 0.05) in the TA (2.2 +/- 1.0) ms(x +/- s), PCA (2.4 +/- 1.0) ms and lower amplitude in the TA (0.9 +/- 0.7) mV and PCA (1.2 +/- 1.0) mV (P < 0.05). Patients with vocal fold mechanical limitations generally yielded normal LEMG and Evoked LEMG. Patients with neoplastic infiltration of the laryngeal muscles demonstrated decreased LEMG and nearly normal Evoked LEMG with normal latency and lower amplitude.</p><p><b>CONCLUSIONS</b>General EMG and evoked EMG play a crucial role in the diagnosis of vocal fold immobility.</p>

The clinical study on the treatment of cerebral hemorrhage by minimally invasive surgery / 中国基层医药

Objective To evaluate the effectiveness of minimally invasive therapy on treating hypertensive cerebral hemorrhage.Methods 40 cases hypertensive cerebral hemorrhage were randomly divided into two groups, 20 cases were received the minimally invasive drainage therapy and 20 cases medicine therapy.Results Effective rate was high(P