OBJECTIVE To evaluate the status of the anxiety and depression in the inpatients of the otolaryngology with hospital anxiety and depression scale(HADs). METHODS A cross-sectional study was conducted from October 2014 to September 2016 at the Department of Otolaryngology, Affiliated Hospital of Yan'an University. We recruited 624 Chinese otolaryngology's inpatients to determine the prevalence of anxiety and depression using the HADs. HADs consists of 14 items, depression(seven items) and anxiety(seven times), each with four choices numbered alphabetically. Each of the subscales' scores ranges from 0 to 21, corresponding to total scores of 0 to 42, with higher scores indicating greater distress. Psychological distress was assessed for adult inpatients among the department of otolaryngology by a standardized HADs. In addition, the nasal bone fracture patients were treated as control and compared it to other diseases. Demographic data and clinical information collected from the patients and their hospital records were reviewed. RESULTS 1. Patients with sensorineural hearing loss, secretory otitis media, sudden sensorineural hearing loss, benign paroxysmal positional vertigo, peripheral facial paralysis, chronic sinusitis, polyp of vocal cord, laryngeal paralysis, fungal sinusitis and OSAHS revealed depressive and anxiety symptoms in comparison with the control. 2. Psychological distress of patients with sensorineural hearing loss and laryngeal paralysis were significantly related to education, which the anxiety or depression scores tended to increase with the education(P<0.05). CONCLUSION Depression and anxiety disorders were common in the local population of otolaryngology's inpatients. Recognizing the predictors for psychiatric morbidity could assist clinicians to identify those patients with a predisposition to developing psychiatric complications, and refer them for appropriate treatment. We recommend screening for psychological distress in patients with some otolaryngological diseases using a simple HAD tool to identify those patients who might benefit from a more psychologically based approach to therapy.

Objective To investigate the expression of RECK and MMP-9 in pancreatic cancer and to explore the relationship between RECK, MMP-9 expression and the clinicopathological characteristics.Methods PV6000 immunohistochemical method was used to detect the expression of RECK and MMP-9 in 28 cases of pancreatic cancer and 10 cases of normal pancreatic tissue. All the statistical analyses were performed by using SPSS 13.0 statistical software to determine the relationship between RECK, MMP-9 expression and the clinicopathological characteristics. Results The overall positive rate of RECK espression was 46.43% (13/28)in pancreatic cancer, which was significantly lower than that in normal pancreatic tissue (90%, 9/10). The positive rate of RECK espression in Ⅰ + Ⅱ clinical stage (75.0% ,9/12) was significantly higher than that in Ⅲ + Ⅳ stage (25.0%, 4/16 P < 0.05 ). The positive rate of RECK expression in cases without distant metastases (60.0%, 12/60) was significantly higher than that in cases with distant metastasis (12.5%, 1/8,P<0.05). The overall positive rate of MMP-9 was 75% (21/28) in pancreatic cancer, and 20% (2/10) in normal pancreatic tissue. The comparison between these two groups indicated a significant difference (P <0.01 ). The positive rate of MMP-9 in Ⅰ + Ⅱ clinical stage(50.0% ,6/12) was significantly lower than that in Ⅲ + Ⅳ stage (93.8,15/16, P < 0.05). The positive rate of MMP-9 in well differentiation group(33.3%,1/3 ) was significantly lower than that in poor differentiation group ( 100%, 12/12 ,P < 0. 01 ). The expressionof RECK was negatively correlated with the expression of MMP-9 ( r = - 0. 536, P < 0.01 ). Conclusions RECK is lowly expressed in pancreatic cancer, but MMP-9 is highly expressed. RECK and MMP-9 may serve as important markers in the evaluation of tumor stage.

Purpose To investigate the expression of mismatch repair proteins MLH1,MSH2,MSH6 and PMS2 and their clinical significance in colorectal cancer.Methods Immunohistochemical analysis was used to detect MLH1,MSH2,MSH6 and PMS2 protein expression in formalin-fixed paraffin-embedded tissues from 102 colorectal cancer patients,and microsatellite instability (MSI) was tested in 20 cases.The relationship between MMR protein expression and clinical pathological features was also analyzed.Results 15 cases (14.7％) had MMR protein loss.The loss rate of MLH1,MSH2,MSH6 and PMS2 protein was 12.7％ (13/102),3.9％ (4/102),4.9％ (5/102) and 10.8％ (11/102),respectively.MLH1,MSH2,MSH6 and PMS2 protein losses were not related with gender,age,tumor size,depth of invasion and lymph node metastasis (P ＞ 0.05).MLH1 and PMS2 protein losses were related to histological differentiation (P ＜0.05).MSI was detected in 10 Lynch syndrome candidates.2 cases (2.0％)of high-frequency microsatellite instability (MSI-H) were identified,and the remaining 8 cases were MSS.However,10 cases without MMR expression abnormality all showed MSI-L/MSS.Conclusion Immunohistochemical detection of MLH1,MSH2,MSH6 and PMS2 can be used as primary screening for Lynch syndrome and its combination with MSI test can effectively increase the diagnostic rate in Lynch syndrome.

Objective To investigate the incidence and influencing factors of aggressive behavior in adolescent inpatients with mental disorders.Methods A total of 372 patients with mental disorders admitted to the Department of Child and Adolescent Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University from January to December 2022 were selected as research subjects.The occurrence of aggressive behavior and its influencing factors were analyzed.Results Among the 372 patients,38(10.2％)cases had aggressive behavior during hospitalization.Univariate and multivariate logistic regression results showed that the history of aggressive behavior,only child,and high irritation factor scores were the risk factors of aggressive behavior in hospitalized adolescents with mental disorders(P＜0.05).Mild,outgoing,insecure and isolated personalities before the onset were protective factors of aggressive behavior in hospitalized adolescents with mental disorders(P＜0.05).Conclusion Adolescent inpatients with mental disorders are likely to have aggressive behavior.Those who have aggressive behavior before,are the only child in their family and get a high score of irritant factors need more attention.Corresponding nursing interventions should be taken in time through nursing assessment to reduce the occurrence of aggressive behavior.

Purpose To investigate the clinicopathological features,molecular genetics and prognosis of high grade B cell lymphoma with concurrent MYC rearrangement and 11q aberra-tions(HGBCL-MYC-11q).MethodsThree cases of HGBCL-MYC-11q were reviewed and analyzed using hematoxylin-eosin staining,immunohistochemistry,EBER in situ hybridization and fluorescence in situ hybridization.Clinical data were collected with follow-up.Results All three patients were male,age was 10,61,and 74 years,respectively.All patients had Ann Arbor stage Ⅳ disease.All three cases were biopsies occurring in the nasopharynx,upper pharynx and ileocecus,respectively.Three cases were morphologically similar to diffuse infiltrative growth of tumor cells,moderate or moderately large cells,round to slightly irregular nuclei and easily visible mitotic figures.Focal necrosis was noted in one case.One case exhibited the distinct"starry sky"pattern.All cases expressed CD20,BCL6 and MUM1 and high Ki67 index,two cases expressed CD10 and two cases ex-pressed BCL2.CD3,CD30 and TDT were all negative.EBER in situ hybridization was all negative.FISH analyses using C-MYC break-apart probes were all positive and all cases had 11q aberrations.One case only had the 11q23.3 amplification;and one case only had the 11q24.3 loss.After a follow-up for 1-18 months,one patient died and two patients survived with disease.ConclusionHGBCL-MYC-11q is rare,morphologically similar to BL/HGBCL,with MYC rearrangement and 11q abnormali-ties.We should enhance awareness of the disease and improve more accurate diagnosis and differential diagnosis of the disease.

Although there is insufficient evidence supporting the link between septate uterus and infertility, there are many studies demonstrated the effect of spetal incision on pregnancy in women diagnosed with septate uterus associated with infertility. Hysteroscopic metroplasty can significantly improve the reproductive performance of those with septate uterus. Some Müllerian malformations can be healed by surgery. The accurate diagnosis and appropriate therapeutic approch are fundamental for successful treatment. Any attempt at surgical correction of uterine abnormalities must be aimed at preserving or improving reproductive function. Among congenital uterine anomalies, septate uterus is the most amenable to simple hysteroscopic treatment. The resection of the septum is performed as standard treatment worldwide.
Female ; Humans ; Septate Uterus

Objective: To investigate the clinicopathological significance of BRAF V600E and CTNNB1 gene mutations in adamantinomatous craniopharyngiomas (ACP) and papillary craniopharyngiomas (PCP). Methods: The retrospective study included a total of 67 craniopharyngiomas diagnosed from October 2009 to August 2018 at Xuanwu Hospital, Capital Medical University. The immunohistochemical staining for β-catenin and BRAF V600E expression, Sanger sequencing of exon 3 of CTNNB1, BRAF mutation analysis by scorpions amplification refractory mutation system (ARMS) fluorescence quantitative PCR were performed. Univariate survival analysis was used to correlate with tumor recurrence. Results: Of the 67 patients, 53 were ACPs and 14 were PCPs. Four patients underwent multiple operations and one of them presented with malignant transformation into squamous cell carcinoma. Histologically, ACPs were characterized by whorl-like cell clusters, peripheral palisaded layer, stellate reticulum, finger-shaped protrusions, ghost cells and wet keratinous substances. While PCPs usually consisted of mature squamous epithelium associated with fibrovascular stroma resulting in papillary appearance. The nuclear immunopositivity for β-catenin was observed in 73.6% (39/53) of ACPs, and it was absent in PCPs (0/14). The nuclear translocation of β-catenin usually presented at whorl-like structures or around ghost cells. Of all the cases, mutations analysis in exon 3 of β-catenin gene CTNNB1 were successful in 46 cases and 42.1% (16/38) of ACP showed CTNNB1 gene mutation, while none of the PCPs harbored CTNNB1 gene mutation (0/8). The cytoplasmic immunopositivity for BRAF V600E mutant protein was found in all PCPs (14/14) and negative in all ACPs (0/53). ARMS-PCR results showed that BRAF V600E mutations were observed in 13/14 of PCPs but not seen in ACPs (0/53). Follow-up data were available in 35 patients with duration of 2 to 120 months. Ten patients experienced recurrences after the first surgery. Upon univariate survival analysis, only subtotal excision was found to be associated with increased recurrence (P=0.032), while pathological type, postoperative radiotherapy and CTNNB1 gene mutation were not (P>0.05). Conclusions There is significant difference in the expression of BRAF V600E and CTNNB1 genes between ACP and PCP, and their immunohistochemical and molecular detection therefore can be used in the diagnosis and differential diagnoses of craniopharyngiomas.

ObjectiveThrough improving the potential of vascular endothelial growth factor receptor (VEGFR)-humanized mouse model (hKDR^+/+) with C57BL/6N background to allow the growth of different mouse tumor cell lines, to establish novel tumor-bearing mouse models which can support in vivo tumorigenesis of different mouse tumor cell lines and be used to evaluate drugs targeting VEGFR.MethodsFirstly, a method to evaluate the in vivo activity of antibody targeting VEGFR based on the hKDR^+/+ humanized mouse model was established. Recombinant activating gene 1 (Rag1) knockout mice (Rag1^-/-) were established using CRISPR/Cas9 technology. Then these Rag1^-/- mice were crossed with hKDR^+/+ mice to get a double gene modified homozygous hKDR^+/+/Rag1^-/- mouse model by screening. Finally, tumor cell lines derived from different mouse strains were tested on the double gene-modified mouse model to compare the differences in tumor growth. ResultsAntibodies designed for VEGFR showed significant anti-tumor activity in hKDR^+/+ mice, which significantly reduced tumor volume and weight compared with the PBS group (P<0.01, P<0.05). The number of B cells and T cells in the peripheral blood of Rag1^-/- mice and hKDR^+/+/Rag1^-/- mice decreased (P<0.05, P<0.001). Tumors were observed in hKDR^+/+/Rag1^-/-, Rag1^-/-, wild-type, and hKDR^+/+ mice after 7 d of inoculation of MC38 cells derived from C57BL/6 mice. Tumors were only observed in groups of hKDR^+/+/Rag1^-/- and Rag1^-/- mice, but not in the wild-type and hKDR^+/+ mice after 10 d of inoculation with CT26 cells derived from BALB/c mice. After 3 weeks of inoculation, the tumor volume of hKDR^+/+/Rag1^-/- mice was significantly larger than that of Rag1^-/- mice (P<0.01). ConclusionRag1 knockout mice were obtained and a novel hKDR^+/+/Rag1^-/- double genes modified mouse model was further screened. The tumor cell lines from different mouse strain origins were more prone to growth in mice with Rag1 gene deficiency. The results suggest that the reduced immune response of hKDR^+/+ humanized mice will improve the capacity of supporting the growth of mouse tumor lines in the model. As a result, more tumor-bearing mouse models may be constructed for the evaluation of drugs targeting VEGFR in this way.