Temporal and spatial stability of the EM/PM molecular subtypes in adult diffuse glioma / 医学前沿

Detailed characterizations of genomic alterations have not identified subtype-specific vulnerabilities in adult gliomas. Mapping gliomas into developmental programs may uncover new vulnerabilities that are not strictly related to genomic alterations. After identifying conserved gene modules co-expressed with EGFR or PDGFRA (EM or PM), we recently proposed an EM/PM classification scheme for adult gliomas in a histological subtype- and grade-independent manner. By using cohorts of bulk samples, paired primary and recurrent samples, multi-region samples from the same glioma, single-cell RNA-seq samples, and clinical samples, we here demonstrate the temporal and spatial stability of the EM and PM subtypes. The EM and PM subtypes, which progress in a subtype-specific mode, are robustly maintained in paired longitudinal samples. Elevated activities of cell proliferation, genomic instability and microenvironment, rather than subtype switching, mark recurrent gliomas. Within individual gliomas, the EM/PM subtype was preserved across regions and single cells. Malignant cells in the EM and PM gliomas were correlated to neural stem cell and oligodendrocyte progenitor cell compartment, respectively. Thus, while genetic makeup may change during progression and/or within different tumor areas, adult gliomas evolve within a neurodevelopmental framework of the EM and PM molecular subtypes. The dysregulated developmental pathways embedded in these molecular subtypes may contain subtype-specific vulnerabilities.

Agent's right for patients without capability of independent choice in clinical practice / 中华医院管理杂志

It is found in clinical practice that decisions made by agents on hehalf of the patients without capability of independent choice may sometimes conflict interests of the patient in question. The author summarized by categories common dilemmas faced by clinicians, and came up with the ethical principles to resolve the problems, as proven in case studies. Doctors should fully respect reasonable decisions of agents of such patients. Furthermore, to make a reasonable decision on their behalf, the agent is expected to make medical decisions in the interests of the life and health of the patient, with adequate knowledge of the disease, therapeutic measures and outcomes, and without any damage to interests of the patient they represent. Such a reasonable decision should neither violate laws of the state, nor infringe on interests of other individuals, collectives and the society at large for benefits of the patient in question. In addition, it should conform to the medical ethics of fair distribution of health resources.

Study on the correlation of IgE and GM-CSF contents with eosinophil accumulation in nasal polyp / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To study the effect of IgE, GM-CSF on eosinophil accumulation in the nasal polyps and find the relationship between them.@*METHOD@#Thirty mucosa constitution samples of nasal polyps and eleven inferior nasal concha were observed. The distribution of IgE was detected by SP immunohistochemical method, while the concentration of GM-CSF was measured by ELISA technique and the number of eosinophils were counted in the same tissues.@*RESULT@#The level of IgE, GM-CSF and eosinophils had significant different between the nasal polyps and control group (P < 0.01). There was positive correlation between IgE/GM-CSF and the number of eosinophils in the nasal polyps group (r = 0.65, 0.62, P < 0.01). The correlation between concentration of IgE and GM-CSF was also significant in nasal polyps group (r = 0.52, P < 0.01).@*CONCLUSION@#Nasal polyps is characterized by eosinophil accumulation. IgE and GM-CSF may contribute to the recruitment of eosinophils in nasal polyps. Type-I allergy mediated by IgE play an important role in the pathogenesis of nasal polyps.

Learning guidance in pathology teaching / 中华医学教育探索杂志

Learning guidance in pathology teaching can help to improve the students' learning ability. Learning guidance can be mainly done in two aspects:developing and fostering the students' learning ability on their own and guiding the students to review scientifically.