Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .

Objective To investigate the relationship between apparent diffusion coefficient (ADC)value of rectal adenocarcinoma on DWI and its pathological grading.Methods The ADC values of 46 rectal adenocarcinomas were measured and compared with their histopathological grades.Results The 46 rectal adenocarcinomas included well differentiated adenocarcinomas in 14,moderate-ly differentiated ones in 20,and poorly differentiated ones in 12.The ADC values of well,moderately and poorly differentiated ade-nocarcinomas were (1.125±0.103)×10 -3 mm2/s,(1.030±0.098)×10 -3 mm2/s and (0.922±0.091)×10 -3 mm2/s,respective-ly,exhibiting a statistical difference (χ2 =1 7.35 1,P =0.000).Mann-Whitney U test showed that difference in ADC value between different histopathological grades was statistically significant.Conclusion ADC value of rectal adenocarcinoma can be used as a bio-marker for cell grading to guide treatment decision and prognosis assessment.

Objective:To explore the clinical application of Bushen-Jianpi-Huoxue Decoction combined with western medicine in the treatment of diabetes mellitus with osteoporosis. Methods:A total of 180 patients with diabetes mellitus complicated with osteoporosis in Pudong Hospital from November 2017 to June 2019 who met the inclusion criteria were divided into two groups according to the random number table method, with 90 patients in each group. The control group was treated with conventional western medicine, the study group was treated with Bushen-Jianpi-Huoxue Decoction on the basis of the control group, and both groups were treated for 3 months. The TCM symptom scores were performed before and after treatment. Fasting blood glucose (FPG) and serum calcium levels were determined by a fully automated biochemical analyzer, HbAlc levels were determined by glycosylated hemoglobin analyzer, and TNF-α, monocyte chemoattractant protein-1 (MCP-1), and insulin-like growth factor-1 (IGF-1) and Chemerin levels were determined by a double-antibody sandwich ELISA. Bone mineral density (BMD) was measured by dual-energy X-ray apparatus and clinical efficacy was evaluated. Results:The total effective rate of the study group was 95.6% (86/90), and that of the control group was 76.7% (69/90), where the difference between the two groups was statistically significant ( χ2=13.425, P<0.01). After treatment, the main symptom, secondary symptom and total score of the study group were significantly lower than those in the control group ( t=20.851, 15.365, 27.339, respectively, all Ps<0.01). After treatment, FPG and HbAlc in the study group were significantly lower than those in the control group ( t=5.287, 10.304, P<0.01), BMD and serum calcium were significantly higher than those in the control group ( t=3.644, 3.964, P<0.01). After treatment, the levels of serum TNF-α (6.30 ± 2.05 pg/m vs. 10.43 ± 3.26 pg/m, t=10.174), MCP-1 (324.38 ± 20.05 pg/ml vs. 411.14 ± 27.67 pg/ml, t=24.087), Chemerin (57.74 ± 8.35 ng/ml vs. 63.34 ± 10.64 ng/ml, t=3.928) in the study group were significantly lower than those in the control group ( P<0.01); IGF-1 (167.79 ± 11.31 μg/L vs. 142.21 ± 9.34 μg/L, t=16.544) were significantly higher than that of the control group ( P<0.01). Conclusions:Bushen-Jianpi-Huoxue Decoction combined with conventional western medicine therapy can improve the blood glucose level and BMD of patients with diabetes mellitus complicated with osteoporosis, and improve the clinical effect.

Glucagon like peptide-1(GLP-1) is a category of peptide secreted by intestine. The finding of GLP-1 was originated from the observation of "Incretin" phenomenon in 1960s. Besides lowering plasma glucose, GLP-1 can protect pancreas,improve cardiovascular outcome,and play a role in regulating appetite,as well as lower body weight. Given that food intake regulation mechanism modulated by GLP-1 remains uncertain,it is postulated that the central nervous system has played a vital role in this mechanism. In the present review,we focused on the following aspects about central nervous system's role in GLP-1's regulation of appetite:(1)The brain nuclei related to appetite regulation;(2) The brain nuclei related to blood glucose regulation; (3) The brain nuclei related to food intake reward behavior;(4) the role of food-related peptides and GLP-1;(5) How the GLP-1 receptor expression nuclei regulates the food intake.

Objective:To analyze the outcomes of extremely preterm infants (EPIs) after the implementation and quality improvement of an intervention program from the prenatal period to delivery room and the factors influencing the mortality of EPIs.Methods:This was a retrospective study involving 185 EPIs admitted to neonatal intensive care unit (NICU) of Chongqing Health Center for Women and Children from July 1, 2014, to June 30, 2021. The intervention program from the prenatal period to delivery room was implemented in our hospital in January 2018, according to which, EPIs who were admitted before this time were grouped as the historical group ( n=45) and those who were admitted after as the program group ( n=140). The survival rate and morbidity of the two groups were analyzed and compared using t test, Mann Whitney U test, and Chi-square test. The factors influencing the mortality of EPIs were analyzed by univariate screening and logistic regression. Results:(1) The median gestational age of these EPIs was 26 +6 weeks, ranging from 23 +3 to 27 +6 weeks, and the median birth weight was 950 g, ranging from 390 g to 1 290 g. (2) After the intervention, the proportion of patients in whom the neonatologists were involved in prenatal consultation, women who received a full course of antenatal corticosteroid and magnesium sulfate, and cesarean delivery as well as the neonatal temperature on admission to NICU all increased significantly [77.1% (108/140) vs 8.9% (4/45); 67.9% (95/140) vs 35.6% (16/45); 67.1% (94/140) vs 48.9% (22/45); 44.3% (62/140) vs 17.8% (8/45); 36.6 ℃ (36.3-36.9 ℃) vs 35.2 ℃ (35.0-35.3 ℃), respectively, χ2 or Z values were 66.41, 14.81, 4.85, 10.17 and－9.34, respectively, all P<0.05]. Both delayed cord clamping (DCC) and nasal continuous positive airway pressure (nCPAP) were included in the intervention program, with implementation rates from zero before to 67.9% (95/140) and 89.3%(125/140), respectively. Compared to the historical group, the proportion of infants with 1-minute Apgar score ≤3, endotracheal intubation in the delivery room or mechanical ventilation within 72 h after birth were decreased in the program group [7.1% (10/140) vs 17.8% (8/45), 37.1% (52/140) vs 73.3% (33/45), 38.6% (54/140) vs 57.8% (26/45), χ2 values were 4.39, 17.96 and 5.12, respectively. all P<0.05]. (3) After the intervention, the overall survival rate of EPIs and that among those with gestational age from 27 to 27 +6 weeks were significantly improved [72.9% (102/140) vs 53.3% (24/45), OR=2.349, P=0.015; 84.1% (53/63) vs 56.6% (13/23), OR=4.077, P=0.007]. Although the incidence of periventricular and intraventricular hemorrhage, late-onset sepsis, and retinopathy of prematurity showed a downward trend, the differences were not statistically significant (all P>0.05) (4) Multivariate logistic regression analysis showed that 1-minute Apgar score ≤3 ( OR=8.890, 95% CI:2.005-39.412), low 5-minute Apgar score ( OR=1.468, 95% CI:1.103-1.953), and higher rate of mechanical ventilation within 72 h ( OR=7.165, 95% CI:2.942-17.449) were independent risk factors for the mortality of EPIs; and using nCPAP in the delivery room ( OR=0.314, 95% CI:0.137-0.719) and birth weight ( OR=0.996, 95% CI:0.993-0.999) were protective factors. Conclusions:Early interventions for EPIs in the prenatal period or the delivery room, the quality improvement program, including intrapartum temperature management, DCC, and nCPAP, is likely to improve the survival rate and outcome of EPIs.

ABSTRACT: Meningiomas are the most common primary intracranial neoplasm with diverse pathological types and complicated clinical manifestations. The fifth edition of the WHO Classification of Tumors of the Central Nervous System (WHO CNS5), published in 2021, introduces major changes that advance the role of molecular diagnostics in meningiomas. To follow the revision of WHO CNS5, this expert consensus statement was formed jointly by the Group of Neuro-Oncology, Society of Neurosurgery, Chinese Medical Association together with neuropathologists and evidence-based experts. The consensus provides reference points to integrate key biomarkers into stratification and clinical decision making for meningioma patients. REGISTRATION Practice guideline REgistration for transPAREncy (PREPARE), IPGRP-2022CN234.
Humans ; Meningioma/pathology* ; Consensus ; Neurosurgical Procedures ; Meningeal Neoplasms/pathology*