Association between KLB gene and susceptibility to sarcopenia among the elderly / 预防医学

Objective@#To examine the associations of fibroblast growth factor 19 (FGF19), its co-receptor KLB gene and its receptor FGFR4 with susceptibility to sarcopenia, so as to provide insights into elucidation of sarcopenia pathogenesis and formulation of precision interventions for sarcopenia.@*Methods@#A case-control study was conducted. Patients with sarcopenia at ages of 60 years and older included in the Zhejiang Provincial Elderly Health Surveillance Cohorts were selected as the sarcopenia group, and normal residents at ages of 60 years and older were served as controls. Subjects' demographics were collected using questionnaire surveys, and the height, body weight, appendicular skeletal muscle mass and grip strength were measured. Genomic DNA was extracted from blood samples for multiplex PCR targeted capture. The associations between the KLB gene single-nucleotide polymorphisms (SNPs) and susceptibility to sarcopenia were evaluated using multivariable logistic regression models. @*Results@#There were 200 cases in the sarcopenia group, including 91 men and 109 women, and 180 cases in the control group, including 70 men and 110 women. All SNPs satisfied the Hardy-Weinberg equilibrium, and the minor allele frequencies were all > 0.05. There were no significant differences in the distribution of SNPs between the sarcopenia and control groups (all P>0.05). Multivariable logistic regression analysis showed that the SNP rs2687968 locus in the KLB gene was significantly associated with the susceptibility to sarcopenia among the elderly men (superdominant model), and individuals carrying the AC allele had a 2.332-fold higher risk of sarcopenia than those carrying the AA/CC allele (95%CI: 1.882-3.313). @*Conclusions@#KLB gene may correlate with the susceptibility to sarcopenia among the elderly men.

Factors affecting cataract among the elderly population / 预防医学

Objective@#To investigate the factors affecting cataract among the elderly, so as to provide insights into cataract control.@*Methods@#Based on the major public health monitoring project of Zhejiang Province, residents at ages of 60 years and older were selected from 7 districts (counties) using a multi-stage stratified cluster random sampling method, and were followed up every other year from 2014 to 2020. Demographics, lifestyle, dietary habits and cataract incidence were collected, and factors affecting the incidence of cataract were identified using a multivariable Cox proportional hazard regression model.@*Results@# Totally 9 642 residents were investigated, with a mean age of (68.89±7.39) years, and including 4 635 males (48.07%). There were 828 incident cataract cases, with an incidence rate of 20.946/1 000 person-years. Multivariable Cox proportional hazard regression analysis showed that women (HR=1.695, 95%CI: 1.377-2.088), age of 65 years and older (HR=1.707-5.044, 95%CI: 1.400-7.327), overweight/obesity (HR=1.313, 95%CI: 1.131-1.524), educational level (primary school, HR=1.642, 95%CI: 1.400, 1.926; junior high school, HR=1.553, 95%CI: 1.148-2.102), annual family income (10 000 to 50 000 Yuan, HR=1.353, 95%CI: 1.155-1.585; 50 000 to 100 000 Yuan, HR=0.663, 95%CI: 0.500-0.881; 100 000 to 150 000 Yuan, HR=0.340, 95%CI: 0.204-0.565), smoking (HR=0.649, 95%CI: 0.494-0.853), frequency of vegetable intake of >3 days/week (HR=0.693, 95%CI: 0.527-0.912), frequency of fruit intake of >3 days/ week (HR=0.833, 95%CI: 0.694-0.899), frequency of egg intake of >3 days/week (HR=0.579, 95%CI: 0.450-0.745), frequency of soy products intake of >3 days/week (HR=0.706, 95%CI: 0.588-0.849), frequency of dairy products intake of >3 days/week (HR=1.510, 95%CI: 1.199-1.901) and frequency of nut intake of >3 days/week (HR=1.733, 95%CI: 1.162-2.586) were statistically associated with the development of cataract among the elderly. @*Conclusion @#Gender, age, body mass index, educational level, income, smoking, and frequency of vegetables, fruits, eggs, soy products, dairy products and nuts intake are associated with the development of cataracts.

AVALIAÇÃo MUSCULO-ARTICULAR DOS EFEITOS DA HIDROTERAPIA NA RECUPERAÇÃo PÓS-TREINO EM JOGADORES DE BASQUETEBOL / Musculoarticular evaluation of the hydrotherapy effects on basketball players post-training recovery / Evaluación musculo-articular de los efectos de la hidroterapia en la recuperación post-entrenamiento en jugadores de baloncesto

ABSTRACT Objective: To evaluate the effects of hydrotherapy on post-training recovery of basketball players. Methods: 60 basketball players from the sports representative team were divided equally into test and control group for evaluation according to the Partridge method. The experimental group received hydrotherapy for 15 minutes after intense winter training. Pain degrees in joint flexion and extension, adduction, external rotation, and internal rotation were evaluated. Results: The HL value of blood immediately after 800m hydrotherapy swimming was not significantly different between the experimental group and the control group by t-test (P>0.05). Before treatment, there was no significant difference in the Partridge score between the two groups (P<0.01). The improvement of the Partridge score in the two groups of patients was significantly reduced after treatment (P<0.01), and the improvement of the experimental group was significantly better than that of the control group (P<0.01). Before treatment, there was no significant difference between the two groups (P<0.01). After treatment, it was significantly reduced (P<0.01), but the experimental group's improvement was significantly better than the control group (P<0.01). Conclusion: The method of introducing hydrotherapy as post-workout swimming has a significant effect on relieving swelling of the brachial and quadriceps muscles. However, intense swimming may affect the effect of muscle recovery. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Objetivo: Avaliar os efeitos da hidroterapia sobre a recuperação pós-treinamento dos jogadores de basquete. Método: 60 jogadores de basquetebol da equipe de representantes esportivos foram divididos igualmente em grupo teste e controle para avaliação de acordo com o método Partridge. O grupo experimental recebeu hidroterapia por 15 minutos após o treino intenso de inverno. Foram avaliados os graus de dor em flexão e extensão das articulações, adução, rotação externa e rotação interna. Resultados: O valor de HL do sangue imediatamente após a natação hidroterápica de 800m não foi significativamente diferente entre o grupo experimental e o grupo controle por teste t (P>0,05). Antes do tratamento, não houve diferença significativa na pontuação de Partridge entre os dois grupos (P<0,01). A melhora da pontuação de Partridge nos dois grupos de pacientes foi significativamente reduzida após o tratamento (P<0,01), e o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0,01). Antes do tratamento, não houve diferença significativa entre os dois grupos (P<0,01). Após o tratamento, foi significativamente reduzido (P<0.01), mas o desenvolvimento do grupo experimental foi significativamente melhor que a do grupo controle (P<0.01). Conclusão: O método de introduzir a hidroterapia como natação pós-treino tem um efeito significativo no alívio do inchaço dos músculos braquial e quadríceps. No entanto, a natação intensa pode afetar o efeito de recuperação muscular. Nível de evidência II; Estudos terapêuticos - investigação de resultados de tratamento.

RESUMEN Objetivo: Evaluar los efectos de la hidroterapia en la recuperación post-entrenamiento de los jugadores de baloncesto. Método: 60 jugadores de baloncesto del equipo de representación deportiva fueron divididos equitativamente en grupo de prueba y grupo de control para su evaluación según el método Partridge. El grupo experimental recibió hidroterapia durante 15 minutos después de un entrenamiento invernal intenso. Se evaluaron los grados de dolor en la flexión y extensión de la articulación, la aducción, la rotación externa y la rotación interna. Resultados: EL valor de HL de la sangre inmediatamente después de 800 m de natación con hidroterapia no fue significativamente diferente entre el grupo experimental y el grupo de control mediante la prueba t (P>0,05). Antes del tratamiento, no hubo diferencias significativas en la puntuación Partridge entre los dos grupos (P<0,01). La mejora de la puntuación Partridge en ambos grupos de pacientes se redujo significativamente después del tratamiento (P<0,01), y la mejora del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Antes del tratamiento, no hubo diferencias significativas entre los dos grupos (P<0,01). Después del tratamiento, se redujo significativamente (P<0,01), pero el desarrollo del grupo experimental fue significativamente mejor que la del grupo de control (P<0,01). Conclusión: El método de introducción de la hidroterapia como natación post-entrenamiento tiene un efecto significativo en el alivio de la hinchazón de los músculos braquiales y del cuádriceps. Sin embargo, la natación intensa puede perjudicar el efecto de recuperación muscular. Nivel de evidencia II; Estudios terapéuticos - investigación de resultados de tratamiento.

Epidemiological features of infectious disease related public health emergencies in Zhejiang Province, 2010-2018 / 预防医学

Objective@#To learn the epidemiological characteristics of infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 for the prevention and control. @*Methods@#The surveillance data was extracted from National Public Health Emergency Management Information System. Descriptive epidemiology method was used to analyze main diseases as well as distribution characteristics of time and places. @*Results@#A total of 445 events were reported, which caused 14362 cases and 34 deaths, with a attack rate of 0.69% and mortality rate of 0.24%. There were 298 events with less than 30 cases, accounting for 66.97%. The event classification was dominated by general events ( 242 events, 54.38% ) and ungraded events ( 201 events, 45.17% ). The main diseases were chickenpox ( 134 events, 30.11% ), hand foot mouth disease ( 59 events, 13.26% ) and other infectious diarrhea ( 51 events, 11.46% ). The incidence peaked from April to June ( 129 events, 28.99% ) and from November to December ( 131 events, 29.44% ). Ningbo ranked the top in the number of reported events ( 141 events, 31.69% ). Most events ( 322 events, 72.36% ) occurred in schools.@*Conclusions@#The infectious disease related public health emergencies in Zhejiang Province from 2010 to 2018 were mainly caused by chickenpox, hand-foot-mouth disease and other infectious diarrhea. The two peaks of the emergencies occurred from April to June and from November to December. Ningbo was the main area reporting infectious diseases, and schools were the main places.

Construction of evaluation index system for public health performance of county medical community / 预防医学

Objective@#To construct the public health performance evaluation index system for the county medical community, so as to provide reference for the assessment of the public health work in the county medical community.@*Methods@#According to the 2019 Public Health Tasks of Zhejiang Province and the current status of the county medical community's public health work, a framework was developed. Twenty experts from universities, CDCs, and county medical community were invited to construct the index system after two rounds of Delphi expert consultation, and the index weight was determined by the analytic hierarchy process. @*Results @#The experts aged ( 46.10±6.41 ) years and worked for ( 23.85±7.37 ) years, all of whom had a bachelor degree or above, and 18 had associate senior titles or above. The response rates of two rounds of consultation was both 100.00%; the authority coefficient was 0.811; the values of Kendall's W all had statistical significance ( P<0.05 ) , which in the second round were higher than those in the first round. The public health performance evaluation index system for county medical community finally included 10 first-level indexes, among which priority diseases surveillance and management weighed most ( 0.165 7 ) ; 32 second-level indexes, among which food-borne diseases surveillance, infectious diseases/public health emergencies reporting and infectious diseases/public health emergencies response weighed the top three ( 0.071 5, 0.064 7, 0.063 8 ); 120 third-level indexes, among which the timely reporting rate of food safety incidents, the reporting rate of infectious diseases and the information response rate of infectious diseases/public health emergencies weighed the top three ( 0.039 4, 0.022 1, 0.021 7 ). @*Conclusion @#The public health performance evaluation index system of the county medical community has been established, which can provide reference for the health administrative departments.

Clinicopathological features of dedifferentiated liposarcomas with meningothelial-like whorls: report of six cases / 中华病理学杂志

To investigate the histopathologic, immunohistochemical, molecular genetic characteristics of dedifferentiated liposarcomas with meningothelial-like whorls(DDLMW). Six cases of DDLMW diagnosed at Jiangsu Province Hospital(the First Affiliated Hospital of Nanjing Medical University) from March 2012 to August 2018 were enrolled. The cases were analyzed by routine HE staining, immunohistochemistry(MDM2, CDK4 and p16) and fluorescent in-situ hybridization(FISH) on MDM2 gene. Related literatures were also reviewed. Three of the 6 patients were male.The patient ages ranged from 40 to 77 years (mean, 58 years). Four tumors occurred in the retroperitoneum and two in the mediastinum. Histologically, the tumors showed, in addition to foci of well-differentied liposarcoma, characteristic, scattered meningothelial-like concentrical whorls. The whorls were composed of tightly, concentrically arranged, spindle to ovoid cells with mild to mederate cytological atypia. Metaplastic bone was present within or in their immediate vicinity in four case. The tumors cell also showed strong and diffuse immunoreactivity to MDM2, CDK4 and p16, but no immunoreactivity to S-100 protein, SMA, SOX10, EMA, CD21, CD23 or CD35. The Ki-67 labeling indexes were low, while FISH showed high levels of MDM2 amplification in all cases. DDLMW is a rare morphologic variant of dedifferentiated liposarcoma. The whorls in DDLMW do not represent perineurial or follicular dendritic differentiation. Recognition and familiarity with its existence, as well as combined application of immunohistochemical staining and MDM FISH, are important to avoid confusion with other lesions.

Hemostatic clips to facilitate intubation during ERCP with ampulla around duodenal diverticulum / 中国内镜杂志

Objective To investigate the effectiveness of hemostatic-clip-assisted method during ERCP with ampulla around duodenal diverticulum. Methods 25 patients with ampulla around duodenal diverticulum encountered cannulation difficulty, 11 cases underwent with clip-assisted method, 14 cases with ordinary ways. Number of successful cases, cannulation time, post-operation complication were analyzed. Results All the 11 cases succeeded in clip group. 12 patients succeeded in none-clip group. Cannulation time between the two groups were discrepant. There was no difference in number of successful cases and post-operation complication rate. Conclusion Successful application of hemostatic clip help to expose and facilitate cannulation of an ampulla around a duodenal diverticulum.

Purse-string suture with single channel gastroscopy for the gastric wall perforation during endoscopic submucosal dissection of gastric fundus / 中国内镜杂志

Objective To evaluate the perforation repair method of purse-string suture with single channel after gastroscopy endoscopic submucosal resection (ESD) in treating gastric submucosalal stromal tumor originating from muscularis propria lay of gastric fundus. Methods 15 patients with GIST from gastric fundus muscularis propria were treated with ESD. The diameters of tumors were from 1.5 ～ 3.5 cm. Purse-string suture with single channel gastroscopy was performed for the gastric wall perforation during ESD. Results All patients underwent repair successfully. The procedure time was 10 ～ 15 min. No severe complications occurred. Conclusion Purse-string suture with single channel gastroscopy is a feasible and effective perforation repair method during ESD of gastric fundus.

Clinicopathologic study of pimary paget disease in esophagus / 临床与实验病理学杂志

Purpose To investigate the clinicopathological and diagnostic characteristics of primary Paget disease (PD ) in esophagus. Methods The clinical presentation, histological observation and immunohistochemical staining were analyzed in four cases of primary PD involved esophagus and related literatures were reviewed. Results The patients were all male, aged from 61 to 74 years old. All the tumors were originated from the mucosa of the esophagus. Histologically, the Paget cells showed a single or small nesting and acinar distribution in the esophage-al mucosa. Adenocarcinoma in situ were seen in 2 cases and squamous cell carcinoma was seen in one of them. Immunohisto-chemically, the Paget cells were typically strongly positive for Ckpan, CKL, and CK7, while negative for CKH, CK5/6, CK14, p63. Conclusion Primary esophagus PD is rare. It can develop alone in esophagus or accompanied with adenocarcinoma in situ, invasive squamous cell carcinoma. The correct diagnosis need detailed pathological observation, immunohistochemical ev-idence and medical history.

Standardization of names in prescriptions of traditional Chinese medicines / 中国中药杂志

Chinese medicine prescriptions are a type of medical documents written by doctors after they understand the patients' conditions for syndrome differentiation. Chinese medicine prescriptions are also the basis for pharmacy personnel to dispense medicines and guide patients to use drugs. It has the legal, technical and economic significances. Chinese medicine prescriptions contain such information of names, quantity and usage. Whether the names of drugs in Chinese medicine prescriptions are standardized or not is directly related to the safety and efficacy of the drugs. At present, nonstandard clinical prescriptions are frequently seen. With "Chinese medicine prescription", "names of drug in Chinese medicine prescription" and "standards of Chinese medicine prescription" as key words, the author searched CNKI, Wanfang and other databases, and consulted nearly 100 literatures, so as to summarize current names of drugs in traditional Chinese medicine prescription, analyze the reasons, and give suggestions, in the expectation of standardizing the names of drugs used in traditional Chinese medicine prescriptions.

Progress of anticoagulant therapy of the patients with mechanical prosthetic valve replacement / 中国胸心血管外科临床杂志

@#The patients with mechanical prosthetic valve replacement need anticoagulant therapy for all their life. The incidence of thromboembolism and anticoagulation-related bleeding events still account for major postoperative complications after mechanical heart valve replacement. Most of the complications happen in the first half year after operation. Therefore, early anticoagulation therapy is very important. Of course, so far most guidelines focus stating their opinions on long-term anticoagulant therapy. However, there is no consensus about anticoagulant therapy in the early period of postoperation. In this review, we summarize early anticoagulant therapy of the patients with mechanical heart valve replacement through consulting domestic and abroad relevant research in recent years and give an overview of the present situations of early anticoagulant therapy.

Determination of nine kinds of nucleosides in Spirodelae Herba from different habitats by UPLC-MS/MS / 中草药

Objective: To establish a UPLC-MS/MS method for the simultaneous determination of nine kinds of nucleosides in Spirodelae Herba, and analyze and investigate the difference of nucleosides ingredients in samples from 13 habitats. Methods: The determination was performed on the Waters XbridgeTM Amide-C18 (150 mm × 4.6 mm, 3.5 μm), the 0.1% formic acid-water (A) and 0.1% acetonitrile-water (B) in gradient elution as mobile phase. The flow rate was 0.5 mL/min. The column temperature was 30 ℃. MS instrument was equipped with ESI+ ion source. Gaining the extracted ion chromatograms, then the peak area for quantitative, principal component analysis (PCA), and hierarchical clustering analysis (HCA) were used to comprehensive evaluation. Results: All nine kinds of nucleoside showed good linearity (r ≥ 0.998 9). The RSD of the precision, repeatability, and stability tests were less than 3.5%. The average recovery rates were in the range of 94.4%-101.9%, RSD were in the range of 1.73% - 3.58%. There are differences in the composition and content from different habitats. The content of 2'-deoxyuridine and 2'-deoxyinosine in the lower levels, cytosine was the lowest, while the contents of uridine, inosine, and xanthine were in higher levels. The largest content was in Spirodelae Herba from Huangshan, Anhui province. Conclusion: The method for the simultaneous determination of the nine kinds of nucleosides is simple, accurate, and reproducible, that will provide the basis for the formulation of herbs Spirodelae Herba for quality control standards.

Multi-level identification and analysis about infrared spectroscopy of lophatheri herba / 中国中药杂志

Based on the infrared spectra of Lophatheri Herba and Commelinae Herba, one-dimensional infrared spectra, second derivative spectra and two-dimensional correlated spectra were used to find out the differences between Lophatheri Herba and its imitations, respectively. The common peak ratio and variant peak ratio dual-indexes sequential were calculated and established according to infrared spectra of eleven batches of herbs. Infrared spectral data of Lophatheri Herba cluster analysis was applied to explore the similarity between each sample. The grouping results trend of sequential analysis of dual-indexes and cluster analysis was accordant. The results showed that the differences could be found by multi-level identification, and the source and the quality of the herbs could be effectively distinguished by the two analysis methods. Infrared spectroscopy, used in the present work exhibited some advantages on quick procedures, less sample required, and reliable results, which could provide a new method for the identification of traditional Chinese medicine with the imitations and adulterants, and the control of quality and origin.

Comparison of stroke volume variation with pulse pressure variation as a diagnostic indicator of fluid responsiveness in mechanically ventilated critically ill patients

To compare the diagnostic accuracy of stroke volume variation [SVV] and pulse pressure variation [PPV] in studies that examined both parameters in the same patient population. Literature search was conducted in PubMed, EMBASE, CINAHL, and Google Scholar. Receiver operator characteristic [ROC] curves were examined, and summary ROC curves were plotted. The study was conducted from January to July 2013 in The Second Affiliated Hospital of Fujian Medical University, Quanzhou, Fujian, China. The meta-analysis of 19 studies published during the years 2005 and 2013 revealed a high degree of diagnostic accuracy of both SVV and PPV in predicting fluid responsiveness. The sensitivity and specificity of both the parameters were observed above 80% in a heterogeneous group of over 850 patients of which 55% responded to fluid challenge. The following values along with 95% confidence interval were noticed: SVV - sensitivity 82 [59-93%] and specificity 84 [62-95%], PPV - sensitivity 84 [62-95%] and specificity 83 [58-94%]. Area under the curve values obtained in the pooled analysis were 0.84 [0.79-0.89] for SVV, and 0.88 [0.84-0.92] for PPV. Both SVV and PPV exhibit a high degree of diagnostic accuracy in predicting the success or failure of a fluid challenge in hemodynamically unstable critically ill patients under controlled mechanical ventilation

Epithelioid hemangioma: a clinicopathologic analysis of 7 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, diagnosis and differential diagnosis of epithelioid hemangioma.</p><p><b>METHODS</b>The morphologic features of 7 cases of epithelioid hemangioma of skin, bone and venous vessels were studied.</p><p><b>RESULTS</b>There were altogether 4 male and 3 female patients (median age = 34 years; age range from 14 to 54 years). The 3 skin cases presented as single or multiple erythematous to bluish nodules or papules, with or without itchiness. The 2 bone cases appeared as osteolytic expansile lesions on radiologic examination. The remaining 2 cases involved medium-sized venous structures and presented as small isolated nodules in soft tissue. Histologically, the lesions were characterized by the presence of exuberant endothelial proliferations with various degree of inflammatory reaction. The neoplastic endothelial cells were plump, eosinophilic and polygonal, forming vascular channels. Occasional solid sheet-like arrangement was demonstrated. Intracytoplasmic vacuoles were commonly identified, indicating formation of primary lumen. The surrounding stroma contained various number of eosinophils and lymphoplasmacytic cells. Immunohistochemical study showed that the tumor cells were positive for endothelial markers (CD31 and CD34) and negative for epithelial marker (cytokeratin). Follow-up information was available in 6 cases. The duration of follow-up ranged from 5 to 36 months (median = 14 months). There was no evidence of recurrence or distant metastasis.</p><p><b>CONCLUSIONS</b>Epithelioid hemangioma is a rare benign curable lesion which can be multifocal, involving skin, soft tissue and bone. It needs to be distinguished from Kimura's disease and epithelioid hemangioendothelioma.</p>

Solid variant of angiomatoid fibrous histocytoma:report of 3 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the clinicopathologic features, immunophenotype, molecular genetics and differential diagnosis of solid variant of angiomatoid fibrous histocytoma.</p><p><b>METHODS</b>The clinicopathologic features of 3 cases of solid variant of angiomatoid fibrous histocytoma were analyzed and the literature was reviewed.</p><p><b>RESULTS</b>There were a total of 2 males and 1 female. The age of patients ranged from 9 to 12 years. The patients presented with a painless mass located in left forearm, left knee or back. The lesions were treated by complete surgical resection. On gross examination, the tumors varied from 1.6 cm to 4.5 cm in greatest dimension. They were well-circumscribed and had pale yellow to grayish-red solid cut surface. Histologically, the tumor was composed of histocytoid cells arranged in sheet-like pattern. A fibrous pseudocapsule surrounded by lymphocytes and plasma cells was identified. Immunohistochemical study showed that the tumor cells in all cases were positive for vimentin and CD68. They were negative for S100 protein, cytokeratin, CD34, CD31, smooth muscle actin, CD35, CD21 and CD30. Two cases also expressed CD99 and one of them was positive for desmin and epithelial membrane antigen. Fluorescence in-situ hybridization was positive for EWSR1 gene.</p><p><b>CONCLUSIONS</b>Solid type represents a variant of angiomatoid fibrous histocytoma and is considered as tumor of borderline malignant potential. Definitive diagnosis requires thorough histologic examination and clinical correlation. Immunohistochemistry and EWSR1 gene study are helpful in further delineation and differential diagnosis. Complete resection or wide local excision with post-operative follow up is the main modality of treatment.</p>

Primary intermediate hemangioendothelioma of bone: a study of 5 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To study the radiologic and pathologic features of primary intermediate hemangioendothelioma of the bone.</p><p><b>METHODS</b>Five cases of primary intermediate hemangioendothelioma of bone encountered in the past three years were enrolled into the study. The clinical, radiologic, pathologic and immunohistochemical features of the tumors were reviewed.</p><p><b>RESULTS</b>The patients included 3 children with Kaposiform hemangioendothelioma and 2 elderly with retiform hemangioendothelioma. Four of the cases affected long bones and the remaining case affected the clavicle. One case showed multifocal involvement of the humerus. Radiologically, the tumors showed borderline to low-grade bony destruction, with various degrees of cortical defect. Intralesional or perilesional bone formation was demonstrated in 4 cases and radial spicules were seen in 1 case. The histopathologic features of primary intermediate hemangioendothelioma of bone were similar to those of soft tissue, except for the presence of reactive bone formation. Immunohistochemically, the tumor cells were positive for CD31 (5/5), CD34 (5/5), vimentin (5/5) and smooth muscle actin (3/5) but negative for cytokeratin and epithelial membrane antigen.</p><p><b>CONCLUSIONS</b>Primary intermediate hemangioendothelioma of bone is a distinct entity and similar histologic classification applies as in its soft tissue counterparts. Comparison of the biologic behavior requires long-term follow-up studies.</p>

Renal Impairment in Multiple Myeloma: Presenting Features in Different Departments / 华中科技大学学报（医学）（英德文版）

In order to analyze the causes of delayed diagnosis and raise the level of early diagnosis of atypical multiple myeloma (MM),the differences of presenting features between the patients presented to nephrologists and those presented to hematologists were compared.MM patients in our hospital were studied retrospectively.Those who referred renal impairment were divided into two groups:group Ⅰ presented to nephrologists prior to MM diagnosis (n=29) and group Ⅱ presented to hematologists directly (n=62).The age,sex,initial symptoms,haematological and biochemical parameters,the phenotype of pamprotein,bone marrow biopsy and cytology were undertaken and analyzed.The results showed that the median time between the initial symptoms and diagnosis in the patients of group Ⅰ was longer than that in group Ⅱ (P＜0.001); patients in group Ⅰ had significantly lower incidence of bone pain (P＜0.01) and worse renal function (P＜0.05) on presentation.There were lower level of myeloma cells (P＜0.05),lower incidence of hypergammaglobulinemia (P＜0.05),lower positive rate of monoclonal immunoglobulin (M protein) (P＜0.05) and M protein level (P＜0.05) in the patients of group Ⅰ than those in group Ⅱ.The ratio of monoclonal to lambda monoclonal proteins in a population was 1:3.67 in patients of group Ⅰ,whereas 1∶0.90 in patients of group Ⅱ (P＜0.0 l).Moreover,patients with λ type had a higher degree of renal insufficiency than those with κ type (P＜0.05).It was suggested that the median time between the initial symptoms and diagnosis in the patients presented to nephrologists was longer than that in those presented to hematologists; the patients presented to nephrologists had the lower incidence of bone pain,lower level of myeloma cells and M protein,which made early diagnosis more difficult; more patients presented to nephrologists had the majority of λ light chain type,moreover,patients with λ light chain type had a higher incidence of renal insufficiency.

Adult prostate sarcoma: a clinicopathologic study of 15 cases / 中华病理学杂志

<p><b>OBJECTIVE</b>To clarify the clinical and morphological features of adult prostate sarcoma (APS) and to further improve the knowledge and diagnostic accuracy for APS.</p><p><b>METHODS</b>Fifteen cases of APS were observed and analyzed on the clinical symptom, pathological features, treatment and prognosis.</p><p><b>RESULTS</b>Age of onset ranged from 22 to 77 years (mean 46.3 years). The majority of cases were presented with dysuresia. By digital rectal examination and imaging of the prostate, APS was often identified as a large tumor mass. There were 6 cases of leiomyosarcomas, 6 embryonal rhabdomyosarcomas, and 3 fibrosarcomas in this series. Follow-up data were available for 12 cases: 7 cases died of the disease between 9 days and 360 days after surgery. Among 5 survived patients, 3 cases had recurrence after 2 to 24 months follow-up.</p><p><b>CONCLUSIONS</b>APS is a rare tumor that typically has clinical features: earlier age of onset, fast-appeared urinary tract symptoms, significant mass effects, and poor outcome. Level of prostate specific antigen (PSA) is usually normal or lower. Final diagnosis relies on the features of histology and immunohistochemistry expression profile.</p>