Objective To analyze the biochemical effect of cryosugery on residual bronchial tissue and the adjacent organs in dogs. Methods Bronchial stumps of 18 dogs after lobectomy and the adjacent tissues and organs(including 4 samples of esophagi, 3 diaphragms, 3 stomachs, 2 livers, 7 tracheae and 3 superior saphenous vein sinuses) of 22 dogs after thoracectomy were frozen. The observation from 1～212 d was conducted after surgery. Results Cryonecrosis and fibrosis were found in all 18 samples of the frozen bronchial stumps, but no fistula of bronchial stump was found. Three cryodamaged esophagi in 4 dogs developed fine sheet of fibrous membrane like scars in the situs of cryosurgery. Perforation was found in 2 dogs, one in the esophagus, another in stomach. No perforation was found in dogs with diaphragm cryosurgery. Cartilaginous ring disappeared in 7 dogs by cryosurgery of the trachea and a membrane like scar developed in the inner wall of trachea. There were yellow scars on the liver after cryosurgery. Conclusion Exfoliation of the necrotic tissues is slow due to the slowly developed cryonecrosis and good tolerance to cryosurgery of the fibrotic tissues. The original construction disappears but fibrosis develops. At the edge of cryo necrotic area, proliferation of capillary can be found.

The pathological changes of the lungs after a single exposure to an atmosphere containing 100?15 ppm of hydrogen sulfide(H2S)for 3 hours were observed with optical and electron microscopy in rats.It was found that bronchial epitheliem,alveolar epithelium,pulmonary vessels and pulmonary interstitium were extensively involved.Pulmonary edema,focal pulmonary hemorrhage,exfoliation of the damaged epithelium,and infiltration of neutrophils occurred mainly in the 3rd hour to the 3rd day after H2S intoxication.Chronic inflammatory response and proliferation of fibrous tissue occurred mainly from the 7th to the 15th day after intoxication.Ultrastruc-turally,there were marked changes of alveolar epithelium,phagocytes,vascular endothelium,fi-broblasts,and inflammatory cells.Initial pulmonary edema emerged in the pulmonary interstitium and gradually affected the alveoli.Fragments of alveolar surfactant could be seen in the 3rd hour to the 3rd day after intoxication.These findings indicate that H2S inhalation exerts extensive injurious effects on the lungs in the rats.

Nineteen cases of cardiac myxoma were studied immunohistochemically in order to elucidate the histogenesis of the tumor.It was found that the blood vessels and the stromal cells of all the tumors were positive to vimentin.the matured endothelial cells of blood vessels were positive to UEA.the stromal cells and the smooth muscle cells of blood vessels of a part of the tumors were positive or weak-positive to desmin or myosin.a part of the tumor cells of several myxomas were weak-positive or positive to S-100 protein,and the epithelial markers of AE1 and AE3 were negative in all the cardiac myxomas.Our study revealed that there were various kinds of mesenchymal cells in cardiac myxomas and they might originate from multipotential primeval mesenchymal tissues.The difference of im-munohistochemical reactions of tumor cells reflects the difference of the maturity and differentiation of the tumor tissues.The histopathology and histochemistry of cardiac myxoma were also observed and analyzed.

Objective To explore the diagnosis and treatment of phyllodes tumor of the breast. Methods Clinical data from 30 patients with phyllodes tumor confirmed surgically and pathologically were analyzed retrospectively. Results Of the 30 cases of phyllodes tumor, there were 16 cases of benign tumor, 9 cases of borderline tumor and 5 cases of malignant tumor according to the standard histological criteria. Local mass excision, total mastectomy, modified radical mastectomy and tumor mass excision were performed in 8, 8 and 13 patients, and 1 patient, respectively. A follow up of 20 cases for 1-24 years found 1 death, but all the others survived. Four patients out of the 20 patients underwent total mastectomy or modified radical mastectomy due to tumor recurrence. Conclusion The preoperative diagnosis of phyllodes tumor is difficult. Intraoperative frozen section examination of the suspicious lesions should be conducted. Multiple slices of the specimen should be performed. Surgical options are closely associated with the prognosis. Wide local excision or total mastectomy is recommended in surgical options.

The clinical and pathological materials of 83 cases of prostatic carcinoma (PC) were reviewed retrospectively and the tissue specimens of PC were marked with prostate-specific antigen (PSA). According to the criteria of Dhom's classification of prostatic carcinoma. 66 cases out of the 83 (79. 5%) were of the common variety of PC, 14 cases (10. 9%) were of the rare variety and 3 cases (3. 6%) could not be classified with Dhom's method. Among the 66 cases of common prostatic carcinoma, 41 cases (49. 4%) exhibited a pathological structure of u-riiforrn pattern and 25 cases (30. 1%) of pluriform pattern. Well-differentiated adenocarcinoma, cribriform carcinoma and carcinoid of the prostate were strongly positive to PSA marking; poorly-differentiated adenocarcinoma and almost all the prostatic carcinomas of the rare variety and with the structure of pluriform pattern were positive or weakly positive; undifferentiated solid carcinoma and small cell carcinoma were very weakly positive; and squamous cell carcinoma was negative. In addition, other methods for the pathological classification of prostatic carcinoma used currently at home and abroad were compared and discussed.

Objective To explore the relationship between proliferation activity-related factors and androgen receptor (AR) expression in 113 cases of human prostate cancer (PCa). Methods AR and the proliferation activity-related factors (PCNA, Ki67, EGFR) in PCa were detected by immunohistochemistry and light/(electron) microscopy. Results Cell proliferation in AR-negative groups of PCa was significantly stronger than in AR-positive groups. Conclusion AR aberrant expression may promote proliferative ability of PCa, cell growth and heterogeneity significantly, which may be one of reasons that PCa is difficult to be cured.

U1 trastuctrural changes of myocardium and lungs from 6 cases died of cranioce-rebral penerating gunshot wound 2 hours after injury is reportcd.In all cases theelectron microscopy of the myocardial and lung tissue samples showed the similar ultrastructural morphological changes of the cells and interstitial tissues.The mostpr-ominent ultrastructural changes of myocardium were disorderly arrangement of the Zband.focal dissociation of the myofibrills,mitochondrial swelling with decreasing ofmatrix density and disruption of cristae,and interstial edema.The changes of theung tissue were increasing of width of alveolar septa with decreasing of the electron density.Aggregation of neutrophils in the capillaries of alveolar septa and some alveolar space was observed.The significance and the pathogenesis of the mainpathological changes were discussed.It is suggested that the pulmonary interstitialedema was neurogenic.The pulmonary edema may be manifested as interstitial edemaor intra-lveolar edema depending upon the time elapsed after the gunshot injury.

Objective To explore the relationship between the expressions of vascular endothelial growth factor(VEGF) and matrix metalloproteinase-9(MMP-9) in prostate cancer.Methods The expression of VEGF and MMP-9 in 148 samples of pathologically verified human prostate cancer(PCa) and 10 samples of benign prostatic hyperplasia(BPH) were detected by immunohistochemical staining.Results VEGF was overexpressed in 98 of 148 tumor tissues(66.2%) and MMP-9 was overexpressed in 58 of 148 tumor tissues(39.2%).Both of them were significantly higher than those in BPH(P0.05).But the expression of VEGF was correlated with that of MMP-9.Conclusion The expressions of VEGF and MMP-9 are closely associated with the development of prostate cancer.Therefore VEGF and MMP-9 may be clinically useful as predictor of patients'survival.

BACKGROUNDIncreasing evidences have shown that vascular endothelial growth factor C (VEGF-C) is involved in the tumor lymphangiogenesis via combining with its ligand, vascular endothelial growth factor receptor-3 (VEGFR-3), which is the most important factor contributing to lymph node metastasis. Futhermore, lymph node metastasis is the most familiar metastatic pathway in non-small cell lung cancer (NSCLC). Based on this knowledge, the present study aims to explore the relationship between VEGF-C and lymphangiogenesis and lymph node metastasis in NSCLC with the use of podoplanin, a novel lymphatic vessel endothelium marker to detect lymphatic vessel.

METHODSThe expression of VEGF-C and podoplanin were detected in 66 paraffin sections of NSCLC and 8 inflammatory pseudotumor tissues by immunohistochemistry (SP). Assessments of podoplanin+ lymphatic vessel density (LVD) and positive rates of VEGF-C were performed and their relationship was analysed.

RESULTSThe positive rate of VEGF-C in the inflammatory pseudotumor group (12.5%) was significantly lower than that in the NSCLC group (75.8%) (P < 0.01), the positive rate of VEGF-C in the positive lymph node group was significantly higher than that in the negative lymph node metastasis group (86.5% vs 62.1%, P < 0.05) and there was no difference between the well differentiated group and the poor differentiated group (76.3% vs 75.0%, P > 0.05). LVD in the positive VEGF-C group was significantly higher than that in the negative VEGF-C group (21.3±6.0 vs 17.7±5.1, P < 0.05), LVD in the inflammatory pseudotumor group (10.9±4.9) was distinctly lower than that in the NSCLC group (20.4±5.9) (P < 0.01) and compared with the negative lymph node metastasis group (18.5± 5.5), LVD (21.9±5.9) in the positive lymph node metastasis group increased significantly (P < 0.05).

CONCLUSIONSLymphangiogenesis is a significant factor for tumor lymphatic metastasis, VEGF-C may mediate lymphatic metastasis of NSCLC by the way of inducing lymphangiogenesis.

Objective:To investigate the effects of breast milk to total milk intake ratio during hospitalization on the duration of antibiotic therapy in preterm infants less than 34 weeks of gestation.Methods:Clinical data of preterm infants ( n=1 792) less than 34 gestational weeks were retrospectively collected in 16 hospitals of Jiangsu Province Neonatal-Perinatal Cooperation Network from January 1, 2019, to December 31, 2021. The days of therapy (DOT) were used to evaluate the duration of antibiotic administration. The median DOT was 15.0 d (7.0-27.0 d). The patients were divided into four groups based on the quartiles of DOT: Q 1 (DOT≤7.0 d), Q 2 (7.0 d27.0 d) groups. According to the breast milk intake ratio (breast milk intake to total milk intake during hospitalization×100%), they were also divided into four groups: very-low-ratio breastfeeding group (breast milk intake ratio≤25%), low-ratio breastfeeding group (25%75%). Univariate analysis ( Chi-square test and Kruskal-Wallis rank-sum test) was used to analyze the factors influencing DOT. Spearman correlation analysis and trend Chi-square test were used to explore the relationship between breast milk intake ratio and DOT. After using multiple imputations to address missing data, two models were constructed after adjusting for different factors, and multinomial logistic regression model was applied to evaluate the effects of the breast milk intake ratio on DOT. Finally, sensitivity analysis was conducted to assess the stability of the models. Results:(1) Of the 1 792 preterm infants, there were 507 (28.3%) in the Q 1 group, 422 (23.5%) in the Q 2 group, 438 (24.4%) in the Q 3 group and 425 (23.7%) in the Q 4 group. (2) The median values of DOT in the very-low-ratio, low-ratio, medium-ratio and high-ratio breastfeeding groups were 20.0 d (11.0-31.0 d), 20.0 d (11.0-32.0 d), 13.0 d (6.0-25.8 d) and 10.0 d (4.0-21.0 d), respectively. Compared with the very-low-ratio and low-ratio breastfeeding groups, the medium-ratio and high-ratio breastfeeding groups had shorter DOT (all P<0.05). (3) After adjusting for factors with P<0.1 (prenatal glucocorticoid exposure, antimicrobial use within 24 h before delivery, gestational age at delivery, birth weight, Apgar score≤7 at 1 min, neonatal respiratory distress syndrome, infectious pneumonia and early-onset neonatal sepsis) between the DOT quartile groups, it showed that medium-ratio and high-ratio breastfeeding were protective factors in contrast to very-low-ratio breastfeeding in the Q 2, Q 3 and Q 4 groups as compared with the Q 1 group [Q 2 group: OR=0.50 (95% CI: 0.30-0.85) and OR=0.36 (95% CI: 0.26-0.51); Q 3 group: OR=0.31 (95% CI: 0.18-0.55) and OR=0.20 (95% CI: 0.14-0.29); Q 4 group: OR=0.22 (95% CI: 0.12-0.42) and OR=0.17 (95% CI: 0.12-0.26)]. Conclusion:Breast milk intake accounting for over 50% of total milk intake has a positive impact on reducing DOT in premature infants requiring antibiotics, which suggests that breastfeeding should be actively encouraged.