Objective To study the clinical characteristics, diagnosis, treatment and prognosis of primary pulmonary peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS). Methods Two cases of primary pulmonary PTCL-NOS were studied and relevant literature were reviewed. Results Case 1 diagnosed as primary pulmonary PTCL-NOS was a 44 years old woman and disease progressed after GLD (Gem+L-OHP+DXM) chemotherapy regimen. At last, the patient died of respiratory failure after one month. Case 2 diagnosed as primary pulmonary PTCL-NOS was a 46 years old man and reach partial response after CHOP regimen, and still alive now.Conclusion Primary pulmonary PTCL-NOS is very rare. It is easy to be misdiagnosed due to non-specific clinical and imaging manifestations. Acquiring enough tissue specimens for pathologic examination is the key to a definitive diagnosis. At present, there is no standard chemotherapy regimen for these patients, the prognosis is relatively poor.

Objective To investigate the changes of circulating miRNAs expression profiles in different subtypes of ischemic stroke according to the Trial of Org 10 172 in Acute Stroke Treatment.Methods We selected 16 patients diagnosed as acute ischemic stroke at first time in the Department of Neurology,the Affiliated Hospital of Medical College Qingdao University from November to December in 2012.They were divided into large artery atherosclerosis (LAA) stroke group (n =8) and small artery occlusive (SAO) stroke group (n =8).At the same time,8 healthy checkup subjects were selected as control.High-throughput sequencing was used to detect the expression profiles of miRNAs in the plasma,and the high-throughput sequencing results were validated by quantitative real-time polymerase chain reaction.We performed the miRNAs variance analysis and associated bioinformatics analysis.Results Thirty hundred and sixty-nine miRNAs were detected in LAA group,SAO group and the control group.We found remarkable differences (fold change ＞2,P ＜0.01) in the expression of 12 miRNAs,including let-7a-5p,miR-744-5p,etc.,between any two groups of the three groups.Thirty-four miRNAs,containing miR-126-5p,miR-23a-3p,miR-143-3p,etc.,had a lower expression (fold change ＞2,P ＜0.01)in LAA group than that in the control group.In comparison with the control group,miR-1304-3p and miR-451a were significantly down-regulated (fold change ＞ 2,P ＜ O.01),while 27 miRNAs were significantly up-regulated (fold change ＞2,P ＜0.01) in SAO group.The expression levels of miR-146b-5p,miR-23a-3p and miR-451 a were validated in accordance with the results of real-time PCR.Target gene prediction and functional analysis revealed that target genes regulated by differential expression of miRNAs were mainly associated with cell proliferation,adhesion,metabolism and other biological functions.Conclusion miRNAs are differently expressed in the plasma of LAA group,SAO group and healthy control group,which suggest that miRNAs might play different roles in the pathogenesis of LAA stroke and SAO stroke by regulating downstream target genes.

Objective To study PTEN protein expression and clinical significance in patients with diffuse large B cell lymphoma. Methods Immunohistochemical staining was used to determine the PTEN protein expression in 40 cases of primary diffuse large B lymphoma tissuse. The results were analyzed by Kaplan-Merie survival analysis, Log-Rank test and Logistic regression analysis. Results PTEN protein was positive in 16 cases and negative in 24 cases. There was no significant difference between two groups in twoyear overall survival rate(62.5 % vs 66.7 %, P >0.05). Survival analysis showed that patient' s survival time gradually were reduced with extended time between PTEN protein-positive group and negative group, lower in PTEN-positive group than the negative group, but there was no significant difference in survival curve (P >0.05) in the two groups. We compared characteristics of patients between PTEN protein positive and negative groups,including molecular type, patient' s age, stage, LDH, physical score and extranodular invasion, there was no significant difference among them. PTEN protein was not correlated with prognosis, while International Prognosis Index(IPI) was still a risk factor (OR >1). Conclusion PTEN protein expression may not predict the outcome in diffuse large B cell lymphoma, but IPI still is a predictor.

Objective To explore the prognostic significance of p53 mutation protein in patients with diffuse large B-cell lymphoma for the purpose of individualized therapy. Methods Newly diagnosed 62 cases were randomly chosen from our hospital, p53 mutation protein and CD10, bcl-6, MUM1 were tested by immunohistochemistry. Correlation of p53 mutation protein with patients ' characteristics, genotype and survival were analysed in the study. Results p53 mutation protein was found in 48.4 % (30/62) of patients.Its expression was only related to initial treatment response (x2 =20.365, P =0.040), including complete remission rate of 33.3 % (10/30) in positive group and 59.4 % (19/32) in negative group, and non-germinal center genotype (x2=31.023, P =0.021) with 83.3 % in positive group and 56.2 % in negative group. No other correlation was not verified with clinical features. Multivariate survival analysis showed that p53 mutation protein was an independent predictor for shorter progress-free and overall survival in positive group (x2 =30.784, P =0.005 and x2 =35.276, P =0.006). Conclusion p53 mutation protein should be an independent predictor with poor prognosis and to direct personalized therapy.

Objective To discuss the clinical and pathological characteristics, treatment results and prognosis of primary parotid malignant lymphoma. Methods Pathological subtypes, clinical stages and treatment of the 24 patients with primary parotid malignant lymphoma were retrospectively analysed. Kaplan-Meier method was used in the survival analysis and Log-Rank method was used in the statistic study. Results The 5-year progression free survival (PFS) and overall survival (OS) were 79.2 % and 83.3 %, respectively. The 5-year PFS and OS were 89.5 % and 94.7 % for 19 patients with low-grade malignant lymphoma (including MALTL and Ⅰ/Ⅱ grade FL). The differences of the 5-year PFS and OS of 9 patients received chemotherapy and of 10 patients with on chemotherapy had no statistical significance. Conclusion The incidence of primary parotid malignant lymphoma is low, at earlier clinical stage, and most of its pathological subtype were B-cell low-grade malignant non-Hodgkin lymphoma. Surgery and/or radiotherapy should be the first choice for patients with early stage low-grade malignant lymphoma, whereas combined modality therapy was probably the best choice for patients with DLBCL.

BACKGROUND: There is an intimate temporal and spatial relationship between growth of primitive cardiac cells, septum transversum mesenchyme and liver development. The signal from primitive cardiac cells and septum transversum mesenchyme induces the ventral foregut endoderm cells specialize toward hepatocytes. While the septum transversum mesenchyme provides a suitable environment for forming the liver bud and promoting the growth and differentiation. However, the molecular mechanism of this induction is not yet delineated.OBJECTIVE: Using alpha-fetal protein (AFP), c-Met and cytokeratin (CK) 19 as markers of hepatic stem cells, the growth of early human embryo of 3-5 weeks and morphologic characteristic of hepatic stem cells were observed to demonstrate the characteristic and factors that affected the proliferation and differentiation of hepatic stem cell, which provided experimental evidence for basic research and clinical application of hepatic stem cells.DESIGN: An opening experiment was designed.SETTING: Department of Anatomy, Weifang Medical College.MATERIALS: The experiment was carried out at the Scientific Research Center of Chengdu Medical College between September 2004 and January 2005. Twenty cases fresh human embryos aged less than 2 months were collected with signed agreements of the pregnant women suffering from pregnancy termination with mifepristone. The samples were fixed with 40 g/L polymerisatum in 20 minutes and embedded routinely in paraffin, and then 5 μm thick series sections were continuously made. After hematoxylin-eosin staining, the embryonicage was determined under the microscope according to the length of embryos, the number of somites and the development of organs, which was referring to the Jirasek's staging standard of human embryo.METHODS: The immunohistochemical staining was conducted with SABC method on one of every ten sections, which were incubated overnight at 4 ℃ with polyclonal antibodies against hepatocyte growth factor (HGF),c-Met, insulin-like growth factor (IGF-Ⅰ), IGF-Ⅰ receptor (IGF-IR), transforming growth factor (TGFβ1), TGFβR1, TGFβR2 or monoclonal antibodies against proliferating cell nuclear antigen (PCNA), AFP and CK19.The following day, the sections were incubated for 2 hours at room temperature with biotinylated anti-mouse or anti-rabbit IgG and SABC liquid respectively, and then diaminobenzidine (DAB) was used to color them. The negative control was conducted with the phosphate buffer, then the sections were observed and photographed under light microscope.MAIN OUTCOME MEASUERS: ①the morphologic characteristic of human hepatic stem cells and immunohistochemical staining of markers②the expression of HGF, IGF-Ⅰ, TGFβ1 and their receptors on human embryonic livers of 3-5 weeks, primitive cardiac cells and septum transversum mesenchyme.RESULTS: ①The morphologic characteristic of human hepatic stem cells and immunohistochemical staining of markers: The hepatic bud formed at the end of 3rd week and migrated into the septum transversum mesenchyme to form the hepatic cords at the 4th week. The cells structuring the hepatic cords displayed the typical characteristic of immature cells. At the 5th week, the number of cells within the hepatic cords, the size of cell body,the cytoplasmic acidophilia all increased, whereas the basophilia of nuclei decreased. However the cellular forms were still homogeneous and displayed the typical characteristic of immature cells. The cells of hepatic cords were negative for PCNA response during 3rd-4th week but began to express positive at the 5th week, mainly in the nucleus and minority cellular cytoplasm showed weak positive. Most hepatic cells during 3rd-5th weeks were positive for AFP, c-Met and negative for CK19. The immunologic reaction depositors of AFP positive cells were located in the nuclei, cytoplasm and membrane of the hepatocytes, and c-Met presented mainly in the nuclei and the positive signal was weak in the cytoplasm. ②Expressions of HGF, IGF-Ⅰ, TGFβ1 and their receptors in the embryonic human liver, primitive heart and septum transversum mesenchyme: At the 4th week,the c-Met expressed only in all hepatocytes, whereas the other growth factors and their receptors were undetectable. At the 5th week, all the growth factors, except HGF, were expressed in the hepatocytes. The immunologic reaction depositors of TGFβ1, TGFβ1R1 and TGFβ1R2 were located in the cytoplasm and cell membrane. The positive response of IGF-Ⅰ and IGF-IR were present at nuclei, cytoplasm and cell membrane. At the 3rd-5th week, myocardial cells surrounding liver bud or hepatic cord and the septum transversum mesenchyme were positive for HGF, TGFβ1 and IGF-Ⅰ,with the signals were aggregated mainly in cytoplasm and minority nucei.CONCLUSION: ①It was at the end of 3rd week that part of endoderm cells in foregut ventral were specialized to hepatic stem cells. ②The undifferentiated hepatic stem cells could be drawn to develop to the liver stem cells with bi-directional differentiation potentials by using specific markers for studying human embryonic liver stem cells. According to the corresponding relation of embryonic age between human and rats, the time studying the rat hepatic stem cells could be calculated. ③HGF, IGF-Ⅰ,TGFβ1 and their receptors promoted the early development of human embryonic liver.

Objective To describe the status of breast reconstruction patients′decision regret, self-efficacy and satisfaction with information in the preoperative period, and discuss the correlation among them. Methods Four instruments were used to investigate 100 breast reconstruction patients in one tertiary hospital in Guangzhou, including participants′ personal profile, Decision Regret Scale, Modified Stanford Self-Efficacy Scale and the subscale of Information Satisfaction of Breast Reconstruction-Questionnaire. Results The mean score of Decision Regret Scale was (10.8 ± 2.5)points in breast reconstruction patients, and the minority of patients experienced decision regret (30%, 30/100). The mean score of self-efficacy and satisfaction with information in the preoperative period were (6.6±1.9) and (2.9± 0.6) points. The study also found that decision regret was negatively correlated with self-efficacy and satisfaction with information in the preoperative period (P < 0.01). Conclusions Totally 30 percent of patients experienced decision regret to undergo breast reconstruction. However, patients who had lower levels of self-efficacy and satisfaction with information in the preoperative period were at greater risk to experience decision regret to undergo breast reconstruction. The results may assist health care professionals to provide appropriate psychological support, care and information.

Objective To investigate the difference of expression profiling of plasma miRNAs (microRNA) between the patients with small artery occlusive stroke (SAO) and the healthy subjects.Methods Eight patients with SAO classified by TOAST were selected and 8 healthy subjects were used as a control group.High-throughput sequencing technology was used to detect the expression profiling of plasma miRNAs.The differentially expressed miRNAs were screened.Real-time fluorescent quantitative polymerase chain reaction was used to validate the results,and the target gene prediction and bioinformatics analysis were performed.Results The miRNA difference analysis showed that the expression profilings of miRNA-127,miRNA-99b-5p,miRNA-320,and other 19 miRNAs in the SAO group were significantly upregulated compared with those in the control group (all P＜0.01),while miRNA-451a and other 5 miRNAs in the SAO group were significantly downregulated compared with those in the control group (all P ＜0.01).The validated results of miRNA-127,miRNA-99b-5p,miRNA-320,and miRNA-451a with real-time fluorescent quantitative polymerase chain reaction were consistent with those of the high-throughput sequencing.Bioinformatics analysis showed that the miRNA-regulated target genes expressed differentially were mainly correlated with cell proliferation,adhesion,phylogenetic development,macromolecule metabolism,and other biological functions.Conclusions There are significant differences in the expression profiling of plasma miRNAs between the patients with SAO and the healthy subjects,suggesting that miRNAs may play a regulatory role via target genes in pathogenesis of SAO.

Objective To explore the association of CD22 gene T＞A locus (SNPrs2267574) with the development of systemic lupus erythematosus (SLE) and SLE phenotypes in Southern Chinese Han people.Methods Two hundreds fifteen cases and 216 normal controls were enrolled with the aim of case-control design,and the genotype was determined by PCR-RFLP.We calculated X2 and ORs for association study.Results In CD22 gene T＞A locus,there was significant difference of genotypes distribution between cases and controls (X2=6.086,P＜0.05).The frequency of AT genotype was higher in cases than in controls (OR=1.68,95%CI:1.08～2.60,P=0.021 ),and A allele had a higher proportion in cases (OR=1.58,95%CI:1.09～2.29,P=0.015).Meanwhile,the frequency of A allele in patients with positive anti-SSA was higher than in patients with negative anti-SSA (OR=3.69,95%CI:2.08～6.52,P＜0.01 ).Conclusion In Southern Chinese Han population,CD22 gene T＞A locus is associated with the development of SLE and the A allele has positive association with anti-SSA.

Objective:To observe the optical coherence tomography angiography (OCTA) image characteristics of polypoid choroidal vascular disease (PCV) after intravitreal injection of anti-vascular endothelial growth factor drugs, and to discuss its significance in the diagnosis and follow-up of PCV.Methods:A retrospective case study. From August 2018 to January 2020, 22 eyes of 22 patients with PCV diagnosed in the ophthalmological examination of Affiliated Hospital of Weifang Medical University were included in the study. Among them, there were 10 males with 10 eyes and 12 females with 12 eyes; the average age was 67.75±9.53 years. Best corrected visual acuity (BCVA), OCTA, and indocyanine green angiography (ICGA) were performed. All the affected eyes were injected vitreously with 10 mg/ml Conbercept 0.05 ml (including Conbercept 0.5 mg) once a month for 3 consecutive months.Tthe macular area of 3 mm×3 mm and 6 mm×6 mm with an OCTA instrument was scanned, and the foveal retinal thickness (CRT) was measured, the area of abnormal branch blood vessels (BVN). pigment epithelial detachment before and 12 months after treatment (PED) height, foveal choroid thickness (SFCT) were performed. The diagnosis rate of PCV by OCTA was observed, as well as the changes of various indicators of BCVA and OCTA. Before and after treatment, BCVA and CRT were compared by paired t test; BVN area, PED height, and SFCT were compared by variance analysis. The changes in imaging characteristics of OCTA before and after treatment were analyzed. Results:Among the 22 eyes, 8 eyes were BVN; 5 eyes were polypoid lesions (polyps); 5 eyes were BVN combined with polyps; 3 eyes were not found with BVN and polyps; 1 eye with small vascular network structure, this eye was ICGA Appears as strong nodular fluorescence (polyps). The detection rate of PCV by OCTA was 86.36% (19/22). Twelve months after treatment, BVN was significantly reduced or disappeared in 16 eyes (72.72%, 16/22); polyps disappeared in 17 eyes (77.27%, 17/22). Compared with before treatment, 12 months after treatment, BCVA increased ( t=3.071), CRT decreased ( t=2.440), the difference was statistically significant ( P<0.05); the average BVN area, PED height, and SFCT decreased. The difference in average BVN area and PED height was statistically significant ( F=2.805, 3.916; P<0.05), and the difference in SFCT was not statistically significant ( F=0.047, P>0.05). Conclusions:The detection rate of PCV by OCTA is 86.36%. After PCV anti-vascular endothelial growth factor drug treatment, BVN area decrease and polyps subside. OCTA is an effective means for PCV diagnosis and follow-up after anti-VEGF drug treatment.