Purpose To evaluate the application of fluorescence in situ hybridization ( FISH) in detection of EWSR1 gene translocation in formalin-fixed paraffin-embedded tissue samples of Ewing family tumor ( EFT) . Methods Four cases of EFT were collected and their clinical pathological features were obsered. Interphase FISH was carried out in paraffin-embedded tissue of EFT cases, using a EWSR1 dual colar break-apart probe. Fifteen cases of other soft tissue tumor were selected as negative control. Results Translocation of EWSR1 was detected in four EFT cases, which may be a adjuvantly diagnositic value for the diagnosis of atypical cases. Conclu-sions FISH may serve as an adjunctive diagnostic tool in problematic cases of EFT, however, FISH results should be interpreted con-cerning clinical pathological features, morphological patterns and immunohistological results.

Objective To evaluate the effectiveness and feasibility of web-based lifestyle Or behavior intervention on Chinese urban adults.Methods Six hundred and eighty-one adult subjects were rand omly assigned to the intervention group (n=341) or the control group (n=340).The intervention group was encouraged to visit a specified interactive web site at 1east once a month to submit self-report health diaries.and provided with individualized health promotion instructions and tailored counseling at the chat room or through email.The control group received routine medical services.The primary outcomes were changes in cigarette smoking,alcohol consumption,fruit or vegetable intake,and physical exercise duration at 6 month from baseline.Intention-to-treat method was used for data analysis.Results At 6 month,smoking cessation rate was 23.6% in intervention group and 4.6% in control group (X2=22.4,P<0.05),and daily alcohol consumption decreased by 28.6 g in intervention group compared to 6.1 g in control group (t=14.9.P<0.05).There Was no significant change in physical exercise duration for those with sub-optimal physical activities between the two groups.In contrast to the control group.mean systolic blood pressure,fasting blood glucose,and body mass index of the hypertensive,diabetic,or overweight/obese subjects in the intervention group showed statistically significant decrease.There was no significant change in serum cholesterol level for the participants with hypercholestemlemia in both groups.The attrition rate was 6.7% in the intervention group.Conclusion Web-based health management services may be helpful in promoting healthy lifestyle and behavior and enhancing the care of chronic conditions including hypertension,diabetes,overweight and obese.

Objective To investigate the mRNA and protein expression of GPX3 gene in non-small cell lung cancer (NSCLC) patients, and then discuss the clinical significance of GPX3 in NSCLC patients. Methods Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to detect the GPX3 mRNA and protein levels in NSCLC tissues and adjacent non-cancerous normal lung tissues from 60 patients undergoing surgical treatment. The correlation between the expression levels of GPX3 and clinicopathological features was analyzed. Results The relative expression value of GPX3 mRNA was higher in adjacent non-cancerous tissues than in non-small cell lung cancer tissue (P < 0.05). GPX3 mRNA expression was significantly correlated with TNM stage、differentiation and lymph node metastasis. The integral optical density value of GPX3 protein confirmed was lower in adjacent non-cancerous tissues than in non-small cell lung cancer tissues (P < 0.05). In additional, the expression of GPX3 was related to TNM stage and lymph node metastasis. Conclusion The expression of GPX3 gene may play an important role in the carcinogenesis and progression of NSCLC.

Objective:To investigate the influence of different decoction containers on the chemical components in Fufang Baidu decoctions to provide scientific evidence for the establishment of rational decoction method for traditional Chinese medicine decoctions. Methods:The method of UPLC was adopted to study the influence of different decoction containers on the content of astilbin, forsytho-side A and forsythoside in Fufang Baidu decoctions. Results:With the different containers, the content change regularity was as fol-lows:porcelain pot >stainless steel pot> decocting machine of Chinese herbs> earthen pot> glass pot. Conclusion:Decocting ma-chine for Chinese herbs can be an substitute for traditional boiling utensils.

Objective To explore the relationship between the stimulated thyroglobulin ( sTg) and site, number and diameter of metastatic lesions in patients with differentiated thyroid carcinoma (DTC) before the first 131 I treatment, and to evaluate the predictive value of sTg for different metastatic sites. Methods A total of 567 DTC patients (179 males, 388 females; age: (45.3±12.3) years) who received the first 131Ⅰ treatment between January 2012 and June 2017 were included. Thyroglobulin antibody (TgAb), sTg and thyroid stimulating hormone ( TSH) were determined within 1 week before 131 I treatment. Metastases were detected by ultrasonography, CT or 18 F-fluorodeoxyglucose ( FDG ) PET/CT, 131 I whole-body scan, SPECT/CT imaging and pathology. sTg levels of patients with different metastatic sites and different metasta-sis numbers or lesion diameters were compared ( Kruskal-Wallis H test) . Spearman correlation analysis was performed on the number, diameter and sTg level of metastases. The receiver operating characteristic ( ROC) curve was used to explore the predictive value of sTg before the first 131 I treatment for DTC metasta-sis. Results The median values of sTg in the bone, lung, lymph node metastases groups and non-metasta-sis group were 500.00, 104.40, 27.45, 2.39μg/L, respectively, and there were significant differences, ex-cept for bone and lung metastases groups ( H range: -294.605 to 175.162, all P<0.05) . The sTg levels of lung metastasis group and lymph node metastasis group were both decreased by the order of metastasis num- bers (≥3, =2, =1;H range:-57.887 to 48.763, all P<0.05) . As to the diameter of metastases, the sTg levels of >2.0 cm, 1.1-2.0 cm, and≤1.0 cm subgroups in the lung metastasis group and lymph node me-tastasis group were also decreased in order ( H range: -69.935 to 61.043, all P<0.05) . Spearman correla-tion analysis showed that the number ( rs=0.568, 0.606) and diameter ( rs=0.806, 0.664) of the metasta-ses in the lung and lymph node metastases group were positively correlated with sTg (all P<0.05). Areas under ROC curves for sTg to predict bone, lung and lymph node metastasis were 0.935, 0.843 and 0.791 re-spectively. The threshold values were 197. 65, 23. 21 and 10. 96 μg/L respectively. The sensitivities and the specificities were 91.70％, 79.60％, 67.20％ and 97.20％, 80.80％, 82.70％ respectively. Conclusions Tg level before the first 131 I treatment has a certain predictive value for the metastasis, metastatic site and num-ber or diameter in DTC patients.

Objective: To investigate the relationship between PD-L1 expression and the clinicopathologic features and prognosis in triple-negative breast carcinomas (TNBC). Methods: All 142 cases of TNBC were collected from the First Affiliated Hospital of Nanjing Medical University from February 2011 to December 2014, and the surgical excision or biopsy specimens from patients without chemotherapy and radiotherapy were included. Histopathologic analysis of stromal tumor infiltrating lymphocyte (sTIL) was performed on HE sections, and PD-L1 immunohistochemical staining was done with MaxVision. Results: The PD-L1 expression rate was 34.5% (49/142) in tumor cells, and was 62.0% (88/142) in sTIL. The PD-L1 expression in tumor cells was positively correlated with tumor size (r=0.181, P=0.031), Ki-67 index (r=0.211, P=0.012), sTIL (r=0.380, P<0.01) and PD-L1 expression in sTIL (r=0.447, P<0.01). The PD-L1 expression in sTIL was positively correlated with tumor grade (r=0.215, P=0.01), Ki-67 index (r=0.253, P=0.002) and sTIL (r=0.370, P<0.01). The high stromal CD8⁺ /FOXP3⁺ ratio was significantly associated with improved overall survival (χ²=4.186, P=0.041). The high percentage of sTIL was significantly associated with improved overall survival (χ²=12.427, P<0.01) and progression-free survival (χ²=4.057, P=0.044). Conclusions In TNBC, PD-L1 expression is positively correlated with Ki-67 and sTIL; the stromal CD8⁺ /FOXP3⁺ ratio and sTIL are significantly associated with prognosis. The PD-L1 expression, stromal CD8⁺ /FOXP3⁺ ratio and sTIL are biologically important in TNBC, and all these correlative factors are important potential parameters in assessing immunotherapy for TNBC.

Objective To investigate the relationship between stromal tumor-infiltrating lymphocytes (TIL) and CD8 or FOXP3 positive lymphocytes in triple-negative breast carcinoma.Methods A total of 160 triple-negative breast carcinomas were collected from the First Affiliated Hospital of Nanjing Medical University during 2012 to 2014.All were surgical excision or biopsy specimens from patients without prior chemotherapy and radiotherapy.Histopathologic analysis of stromal TIL was performed on hematoxylin and eosin-stained sections,and MaxVision immunohistochemical method was used for detection of CD8 and FOXP3 protein expression.Results Stromal TILs were positively correlated with Ki-67 labeling index (P =0.002).The density of CD8 + cytotoxic T-lymphocyte (CTL) was negatively correlated with tumor size (P =0.009),and positively correlated with Ki-67 index (P =0.021).The density of FOXP3 + regulatory T-lymphocyte (Treg) was inversely correlated with the patient age (P =0.030),and positively correlated with histological grade (P =0.026).Stromal TILs were positively correlated with the density of CD8 + CTL (P =0.014).Conclusions The percentage of stromal TILs and density of CD8 + CTL are associated with tumor cell proliferation of triple-negative breast cancers.The density of FOXP3 + Treg is significantly associated with poor prognosis.Stromal TIL is positively correlated with the density of CD8 + CTL Stromal TIL may provide a potential marker for pathological diagnosis and a target for guiding adjuvant therapy in patients with triple-negative breast cancers.

Objective:To investigate the expression of RASAL3 in intrahepatic cholangiocarcinoma (iCCA) and the mechanism of promoting iCCA development.Methods:Tumor and paracancerous tissues were collected from 185 iCCA patients, the expression of RASAL3 was detected by immunohistochemistry, RT-qPCR and Western blot. The expression of RASAL3 and FXYD6 mRNA and protein in human cholangiocarcinoma cell line and human bile duct epithelial cells were detected with RT-qPCR and Western blot, the cell proliferation was detected with CCK-8 assay, and the activity of Na +-K +-ATPase was also detected. Results:RASAL3 was highly expressed in cholangiocarcinoma tissues and cell lines; Survival analysis showed that RASAL3 overexpression was associated with poor prognosis of cholangiocarcinoma( P<0.05) and knockdown of RASAL3 inhibits the proliferation of cholangiocarcinoma cells; Silencing RASAL3 decreases the expression of FXYD6 inhibiting the activity of Na +-K +-ATPase. Conclusion:RASAL3 is up-regulated in human cholangiocarcinoma, which can promote the occurrence and development of cholangiocarcinoma by activating FXYD6 and affecting Na +-K +-ATPase activity.

Objective:To investigate the accurate diagnosis and differential diagnosis of non-primary solid malignant tumors in breast needle core biopsy.Methods:Twenty-three cases of breast, axilla or neck lymph nodes pathologically diagnosed as non-primary solid malignant tumors were collected at the First Affiliated Hospital of Nanjing Medical University, Nanjing, China from January 2013 to March 2023. The differential diagnoses and diagnostic features were analyzed, based on combining clinical data, histology, and expression characteristics of biomarkers.Results:All patients were female, with age ranging from 29 to 75 years (average 56 years). The average time from the diagnosis of primary tumor to the current diagnosis was 21 months (0 to 204 months).The primary sites included the ovary (9 cases), the lung (5 cases), the gastrointestinal tract (4 cases), the pancreas, intrahepatic bile duct, thyroid gland, nasal cavity and forearm skin (1 case each). No carcinoma in situ was found in any of the cases. The morphological differences were significant among the tumors, but similar to the primary tumors. The tumors of neuroendocrine and female reproductive tract had great morphological and immunophenotypic overlaps with breast cancer. Metastatic lung cancer cells showed obvious atypia and tumor giant cells. The morphology and immunophenotype of metastatic serous carcinoma of female reproductive system might resemble invasive micropapillary carcinoma of the breast. Metastatic adenocarcinoma of the gastrointestinal tract often had features of mucous secretion. Metastatic neuroendocrine tumors were bland in appearance and morphologically similar to solid papillary carcinoma of breast, but negative for ER. TRPS1 was mostly negative (18/23) and variably positive in ovarian (4/9) and intrahepatic bile duct (1/1) tumors.Conclusions:The diagnosis of breast needle core biopsy specimen should be combined with clinical history, imaging study, and careful examination of histological features, such as presence of in situ component, morphological similarity between the primary and metastatic tumors, and using appropriate markers to differentiate the primary from metastatic tumors.

The clinical data of 288 patients with gastrointestinal perforation undergoing surgical treatment from Jul 2014 to Jul 2017 were retrospectively analyzed,among whom the surgical incision infection occurred in 112 patients(38.9％).The risk factors of the incision infections were examined with logistic regression analysis.The univariate analysis showed that preoperative albumin level (≤30 g/L),body mass index (＞24.0 kg/m2),duration of abdominal pain(＞24 h),extension of incision,preoperative shock,colostomy,preoperative antibiotic use and the operation time were associated with incision infections(P＜0.05),while the gender,age,preoperative hemoglobin level,diabetes,incision length were not associated with the incision infections(P＞0.05).The multivariate logistic regression analysis showed that the body mass index(OR=1.61,P＜0.01),gastrointestinal perforation site(colon and rectum,OR=5.60,P＜0.01),extension of incision (OR=3.94,P＜0.01) and operation time(OR=1.04,P=0.02)were independent risk factors of theincision infection.The results suggest that the full preoperative preparation,intensive treatment of underlying diseases,avoiding incision extension and shortening operation time may be able to reduce the surgical incision infections for patients with the gastrointestinal perforation.