Objective　To study the clinico-pathological features of primary adrenal lymphoma (PAL).　Methods　2 cases of PAL were reviewed and studied.　Results　The age of the 2 patients was 45 and 57.The presenting symptoms were nonspecific.Histologically,the neoplasm was composed of numerous medium-sized cells with round nucleus,usually 1-2 in number and with relatively abundant basophilic cytoplasm.The neoplastic cells showed frequent mitosis.Immunohistochemically,the tumor cells were strongly positive for LCA,L26 and CD74 while negative for UCHL-1,S-100 protein and CK. One case was discharged 3 months after operation because of dyscrasia and the other was lost on follow up.Prognosis of PAL was poor.　Conclusions　PAL is extremely rare with a high grade of malignancy.The diagnosis could be made on histopathological studies and immunohistochemical studies.

Objective:To investigate the clinicopathological and immunohistochemical features, histogenesis and biologic behaviors of choroids plexus tumors of the cerebellopontine(CP) angle. Methods:Four cases of choroids plexus tumors of the CP angle were studied by histopathological analysis, immunohistochemical staining and electron microscopic examination. The literatures were review emphasising the diagnostic criteria, differential diagnosis and histogenesis. Results:The histopathologic features of choroid plexus tumors of the CP angle were identical to that in the ventricular system. Immunohistochemical analysis showed that S-100, vimentin and CK of the tumor cells express positive. Choroid plexus papilloma expressed GFAP. The carcinoma of choroid plexus expressed CEA as well. Conclusion:Choroid plexus tumors arising in and occupying the CP angle are rare. The final diagnosis can be made by pathologic examination. The histogenesis may be the small choroid tuft protruding from the foramen of Luschka into the CP angle.

Abstract:Objective To detect the expression of hepatic function indices and autoantibodies in patients with chronic hepatitis B patients, patients with autoimmune liver disease and patients with chronic hepatitis B combined with autoimmune liver disease, and to evaluate the clinical significance of autoantibodies and hepatic function indexes in the early diagnosis of chronic hepatitis B combined with autoimmune liver disease.Methods A total of 109 healthy controls (HC), 72 patients with chronic hepatitis B (CHB), 74 patients with autoimmune liver disease (AILD), and 24 patients with chronic hepatitis B combined with autoimmune liver disease (CHB+AILD) in the Fifth People’s Hospital of Suzhou from 2013 to 2021 were enrolled in this study. Basic information and the value of admission hepatic function indexes and autoantibodies were collected for all enrolled samples, while no autoantibody test was performed for healthy volunteers. All data were processed using GraphPad Prism and SPSS software.Results There were no significant differences in age and gender among the four groups. The detection rates of anti-mitochondrial antibody M2 (AMA-M2) and anti-soluble acidic phosphorylated nuclear protein antibody (anti-SP100 antibodies) in CHB+AILD group [29.2%(7/24), 17.4%(4/23)] were significantly higher than those in CHB group [5.1%(3/59), 0(0/59)], suggesting that the detection of these two autoantibodies is helpful to the differential diagnosis of CHB and CHB+AILD. In addition, eight hepatic function indexes displayed significant differences among the four groups. The levels of total bilirubin and direct bilirubin in CHB+AILD group were significantly higher than those in CHB and AILD groups, while the levels of total protein and albumin were significantly lower than those in CHB and AILD groups. Alkaline phosphatase and glutamyltranspeptidase in AILD group and CHB+AILD group were significantly higher than those in CHB group. The logistic regression analysis showed that total bilirubin, direct bilirubin, albumin, alanine aminotransferase and alkaline phosphatase could form a promising prediction model, which was useful for clinicians in the differential diagnosis of CHB and CHB+AILD (area under the curve, AUC=0.902).Conclusion The combination of autoantibody and hepatic function index detection can be helpful for clinicians in the differential diagnosis of CHB, AILD and CHB+AILD, thus contributing to the early and correct diagnosis of CHB+AILD and providing theoretical basis for patients to obtain reasonable treatment and clinical cure earlier.

BACKGROUND:Leukocytic infiltration induced by release of inflammatory cytotkines and up-regulation of adhesion molecules is closely associated with the formation of cerebral infarcted focus. The related factors have been widely studied.OBJECTIVE: To explore influence of estrogen on inflammatory reaction in rats after focal ischemia/reperfusion injury.DESIGN: Randomized controlled experiment.SETTING: Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA.MATERIALS:The experiment was performed at the Department of Neurology, Department of Pathology, Nanjing General Hospital, Nanjing Military Area Command of Chinese PLA. Adult male SD rats were selected to establish cerebral ischemic models, with the body mass of 280-350 g.METHODS:The rats were assigned into 3 groups: control group,ovariectomized group and estrogen treatment group (estradiol, 200 μg/kg,subcutaneous injection, once a week for 4 weeks). Four weeks later, models with right middle cerebral artery occlusion (MCAO) for 1 hour and 2 hours as well as reperfusion for 0, 1, 3, 6, 22 and 70 hours were established with thread embolism method. Mean number of infiltrative neutrophils in brain tissue was calculated under microscope with 10 high power fields in ischemic hemisphere with hematoxylin and eosin staining. Expression of nuclear factor-κB was determined with immunohistochemical method.MAIN OUTCOME MEASURES:Infiltration of neutrophils and expression of nuclear factor-κB in brain parenchyma.RESULTS: ①Expression of nuclear factor-κB: There was expression of nuclear factor-κB in the ovariectomized group at hour 1 after ischemia.Positive cells appeared at hour 2 after ischemia in the control group and estrogen treatment group. The expression was in the peak at ischemia for 2hours and reperfusion for 3 hours in the three groups, and decreased gradually. There was slight expression at reperfusion for 70 hours in the ovariectomized group, while there was no clear factor-κB positive cell at reperfusion for 22 hours in the control group and estrogen treatment group.②Infiltrative neutrophils in cerebral ischemic region in the ovariectomized group significantly increased at ischemia for 2 hours and reperfusion for 22 hours. Compared with the estrogen treatment group, there was significant difference (P=0.045). At ischemia for 2 hours and reperfusion for 70 hours,infiltrative neutrophils in the ovariectomized group were more than those in the control group and estrogen treatment group, but there were significant differences only between ovariectomized group and control group.CONCLUSION: Estrogen can inhibit inflammatory reaction after cerebral ischemia/reperfusion injury.

Objective To investigate the relationship among A-type behavior,job burnout and psychosomatic health in grassroots officers and soldiers stationed in Xinjiang, which provides the theoretical basis to maintain their psychosomatic health.Methods Evaluation was carried out with A-type behavior questionnaire, military job burnout scale and simple soldiers psychosomatic health scale in 1 939 grassroots officers and soldiers chosen by random cluster sampling method from army stationed in Xinjiang.Results ①The total scores and each factor scores of the scale had significant positive correlation among the physical scale, the job buruout scale and time hurry (TH) ,competitive and hostility (CH) (r=0.170-0.716, P＜0.01).②Job burnout entered into the physical and mental health regression equation and could explain 68.6％ of the variance(β=0.195, t=32.211, P＜0.01);TH, CH entered the regression equation of job burnout and could explain 29.5％ of the variance(t=4.925,4.427).③ TH indirectly affected physical and mental health through job burnout, the mediating effect of the amount was 0.27 ×0.83=0.2241;CH indirectly affected physical and mental health by job bumout,the mediating effect of the amount was 0.30×0.83 =0.2490.Conclusion Job burnout has fully mediated effect between TH, CH and physical and mental health.

Objective To develop recruits training burnout self-reported questionnaires, and test the reliability and validity.Methods 780 recruits(360 for first test ,420 for second test) in Xinjiang were randomly assesscd with training burnout self-reported questionnaires.Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were applied to the data, and tested the reliability and validity of recruits training burnout self-reported questionnaires.Results The questionnaires consisted of 13 items and 3 dimensions.One of the dimensions (physically and psychologically exhausted situation, training-alienation, low accomplishment) , explained 61.599％ of the total variance.Cronbach's α coefficient of the whole questionnaire was 0.837, Cronbach's α coefficient of each partial scale were between 0.775 and 0.807.Split-half reliability of the whole scale reached to 0.817, split-half reliability of each partial were between 0.758 and 0.793.The correlation coefficient among each dimensions were 0.267 to 0.569 (P＜0.01) ,and the coefficient between each dimensions and the total score were between 0.671 and 0.857(P＜0.01).Confirmatory factor analysis showed that three factor model was optimal (GFI =0.935, AGFI =0.902, NFI =0.907, CFI =0.936, IFI =0.935, RMSEA =0.050).The three dimensions and the total questionnaire had significant positive correlations with mental stress (r=-0.215--0.313, P＜ 0.01) and significant negative correlations with depression(r=0.319-0.602, P＜0.01).Conclusion The recruits training burnout self-reported questionnaires meets the requirements of psychological surveying, and could be used to text recruits training burnout.

Objective To explore the relationship between high altitude de-adaptation syndrome and training burnout of plateau-garrisoned soldiers after returning to the plain.Methods A total of 140 plateau-garrisoned soldiers who had returned to the plain were chosen by random cluster sampling and measured with the Training Burnout Test.They were divided into two groups according to the occurrence of acute mountain sickness.We compared the differences in training burnout between the two groups and analyzed the relationship between acute mountain sickness and training burnout. Results ①The incidence of high altitude de-adaptation syndrome of plateau-garrisoned soldiers was 80.00% after returning to the plain.There was statistically significant difference between plateau soldiers after returning to the plain,the plateau stability-keeping forces that returned to the plain (78.36%) (χ2 =0.188, P=0.664) and plateau migrants who returned to the plain (75.10%) (χ2 =1.279, P=0.258).Main symptoms of high altitude de-adaptation were fatigue (12.86%), dizziness (11.43%) and meakness (10.00%).②Compared with soldiers who had no high altitude de-adaptation syndrome, victims of de-adaptation syndrome had higher scores of training burnout, physical and psychological exhaustion and training-alienation (P<0.01).Compared with soldiers who had normal body mass indexes, those who were overweight had higher incidence of altitude de-adaptation (P<0.05).③The regression equation between plateau de-adaptation syndrome and training burnout of plateau soldiers after returning to the plain (P<0.01) is:Training burnout =0.498 ×plateau de-adaptation syndrome -0.126 ×age+0.038 ×length of military service +0.069 ×educational degree+0.029 ×body mass index.Conclusion There exist correlations between high altitude de-adaptation syndrome and training burnout of plateau soldiers after returning to the plain.Reducing the occurrence of high altitude de-adaptation syndrome can help reduce the degree of training burnout.

Objectives:To investigate the pathogenesis of Chlamydia pneumoniae (C.pneumoniae) pneumoniae with immunohistochemical staining of tissue biopsies. Methods:The Icr mice were inoculated with C.pneumoniae, strain CWL 029, by the intranasal or intravenous routes. After a single inoculation, mice were killed on the 1st, 3rd, 7th, 14th, 21st, 28th and 60th day separately. Lung specimens were obtained from the acute stage of C.pneumoniae pneumonitis and stained using a C.pneumoniae specific monoclonal antibody. Results:In the intranasal inoculation of mice, the immunoperoxidase staining of C.pneumoniae in lung tissue was positive on day 3,7,14. The positive staining of inflammatory lung tissue was not even but local. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages, the interstitial cells and the lymphoid tissues surrounding the bronchi. After iv inoculation, a similarly changes were found but the degree was lighter than that of intranasal inoculation group. The positive expressions of C.pneumoniaewas were mainly in the alveolar macrophages and the interstitial cells. Conclusions:Immunohistochemistry is beneficial to the diagnosis of the acute stage of C.pneumoniae pneumonitis in the mice, and the pathogenesis of infection in intranasal inoculation group was more serious than that of iv inoculation group.

Objective:To investigate the clinicopathological features and differential diagnosis of 2 patients with renal epithelioid angiomyolipoma (AML), representing 5.4 % of a series of 37 patients undergoing biopsy for renal tumors. Methods:The histopathological, immunohistochemical and clinical characteristics of renal epithelioid angiomyolipoma were studied by immunohistochemical stain for melanoma marker (HMB45), (Pan)melanoma marker Ab-1,cytokeratin (CK), smooth muscle actin (SMA), epithelial membrane antigen (EMA),vimentin (Vim), p53, proliferating cell nuclear antigen(PCNA), Ki67 antigen. Results:Two patients,aged 31 and 39,were alive for 8 and 10 months,respectively.Microscopically, both tumors were mainly made up of diffuse sheets of epithelioid cells and scattered thick-walled blood vessels, necrosis was account for up to 30% of the mass. The epithelioid cells had huge, extremely pleomorphic nuclei with abundant eosinophilic cytoplasm. Scattered tumor giant cells with prominent nuclei were also seen. The epithelioid AML regions of these tumors were immunoreactive for HMB45, (Pan)melanoma marker Ab-1, SMA, Vim and PCNA. Neither atypical epithelioid cells nor typical AML cells were immunoreactive for cytokeratin (CK) and epithelial membrane antigen (EMA).Conclusion: The results of this study suggested that the renal epithelioid AML was a mild malignant tumor before distant metastases. The differential diagnosis between renal malignant AML and sarcomatoid renal cell carcinoma was established by immunohistochemical findings.

AIM To investigate the effect of cisplatin on apoptosis in Scaber cell. METHODS The apoptotic cells were detected by TUNEL,HE,eletronic micrpscopy. RESULTS Treatment of Scaber cells with CDDP resulted in characteristics typical of apoptosis. CDDP induced apoptosis of Scaber cells in time and concentration dependent manner. To further investigate the mechanism of apoptosis induced by CDDP, the expressions and activity of apoptosis associated proteins such as bcl 2, bax and caspase 3 were examined using S P method.The results showed: CDDP caused time and concentration dependent decreases in bcl 2 and increased in bax proteins.CDDP bcl 2 and its translocation to perinuclei and nuclei. The expression of caspase 3 in Scaber cell were determined during apoptosis induced by CDDP. CONCLUSION Our investigetion showed that the apoptosis induced by CDDP is related to the increase of bax protein, and the decrease of bcl 2 protein. and its translocation to perinuclei and nuclei.