SUMMARY Marginal zone B-cell lymphoma of the pulmonary mucosa-associated lymphoid tissue type (pulmonary MALT-MZL), a common kind of primary pulmonary lymphoma, is rare in pulmonary malignant tumors. One patient in our hospital was diagnosed by bronchoscope and the literatures on the subject were reviewed. The patient presented with periodical fever, cough and chest pain, and antibiotic therapy had no use. Chest CT scan showed the consolidation of right middle lobe and left lower lobe with CT angiogram signs, air bronchograms and distended bronchi. Pleural effusion in the left thorax mainly consisted of monocytes. Monoclonal protein was found in the electrophoresis of serum protein. Bronchial stenosis and swollen mucosa were seen with bronchoscope. The tissue section of transbronchial lung biopsy (TBLB) specimens showed diffusedly infiltrated small lymphocytes and a lymphoepithelial lesion. CD20 was positive and CD3, CD5, CD10, CD21, CD23, bcl2, bcl6 were negative in immunohistochemical stain. The clinical manifestations of pulmonary MALT-MZL are nonspecific and misdiagnosis is common, Appropriate invasive biopsy procedures are necessary for early diagnosis. Presentations such as periodical fever, distended bronchi in pulmonary consolidation, monoclonal protein might indicate diagnosis. Treatment includes surgical resection, radiotherapy and chemotherapy. Pulmonary MALT-MZL belongs to inert lymphoma and prognosis is relatively good.

Objective To improve the diagnosis and treatment of pulmonary cryptococcosis.Methods The clinical data of 3 cases of pulmonary cryptococcosis were analyzed and reviewed.Results The cases were tested by percutaneous lung biopsy and were confirmed by histopathologic examination.The sputum cultures were negative and serum latex cryptococcal antigen agglutination tests were positive.Two of them had mild to moderate symptoms and were treated by fluconazol;the other with meningitis had severe symptoms and was treated by amphotericin B.All of them were clinically cured.Conclusion Percutaneous lung biopsy combined with latex cryptococcal antigen agglutination tests is helpful for diagnosis of pulmonary cryptococcosis.Patients with mild to moderate symptoms should be firstly treated by fluconazol and those with severe symptoms or meningitis,by amphotericin B.

PRECEDE-PROCEED model is a new research hotspot in the field of health education in recent years, which has been widely used in many education fields and has achieved good results. This article discussed in detail the theoretical framework, advantages and application status of PRECEDE-PROCEED model in the field of health education, so as to enhance the medical and nursing staff's understanding of this model, and provide a reference for applying this model to clinical work scientifically.

Objective To examine the expression and clinical significance of MyD88 in ovarian carcinomas.Methods Specimens from 115 patients with ovarian carcinomas managed in our hospital between Augest 2000 and February 2010 were included in this study.Immunohistochemical staining was used to detect the expression of MyD88 in ovarian carcinomas and normal tissues.All the specimens were confirmed by pathology for ovarian carcinomas and normal tissues by HE staining.The correlation between the expression and clinical significance of patients was analyzed.Results The positive expression rate of MyD88 in ovarian carcinomas and normal tissues was 70.4％ and 23.5％,respectively.MyD88 expression was significantly associated with tumor stage and distant metastasis (P ＜ 0.05).According to the survival analysis of 115 ovarian carcinomas patients,cases in the MyD88 positive-expression group showed poorer overall survival rate when compared with negative-expression group (P ＜ 0.001).Conclusion These results indicate that the expression of MyD88 was related with in the progression of ovarian carcinomas and may have clinical utility in the prediction of prognosis of ovarian carcinomas.

Objective To investigate the value of dual-exponential model intravoxel incoherent motion (IVIM) DWI and conventional single-exponential DWI model based on readout segmentation echo-planar (RS-EP) sequence in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis.Methods Totally,20 patients confirmed by pathology were enrolled in this study and all of them underwent IVIM DWI and conventional DWI.The pure diffusion (D),pseudo-diffusion (D*),perfusion fraction (f) and conventional ADC maps were obtained respectively.The quantitative parameters of anterior,middle,posterior regions of inferior nasal concha mucosa were measured.Comparative statistical analysis was performed for comparing two groups and three regions.ROC analysis was conducted to assess the diagnostic performance.Results The ADC and D values in the simple rhinitis group were (1 938.84 ± 170.46) × 10-6 mm2/s,and (1 698.91 ±145.17) × 10-6 mm2/s.In chronic hypertrophic rhinitis group,the ADC value was (1 681.76± 132.21) × 10-6 mm2/s,and the D value was (1 439.39 ± 101.26)× 10-6 mm2/s.There were significant differences between the two groups (both P＜0.05).No significant differences were found for D* and f values between two groups (both P＞0.05).ADC values increased significantly from anterior region,middle region to posterior region (all P＜0.05).No significant difference was found for D* value among three regions (P＞0.05).ROC analysis demonstrated a higher area under the curve (AUC) for D value than ADC value (0.932±0.044 vs 0.896±0.058) with sensitivity,specificity,accuracy,positive and negative predictive values of 92.31％,93.75％,90.00％,93.75％,85.71％.Conclusion Based on RS-EP sequence,both IVIM DWI model and conventional single-exponential DWI model demonstrated great value in differential diagnosis of simple rhinitis and chronic hypertrophic rhinitis,and the IVIM-derived D value exhibited a higher diagnostic performance than the conventional ADC value.

Objective:To explore the feasibility of using pulse oxygen saturation (SpO 2) to evaluate the condition of patients with acute respiratory distress syndrome (ARDS) in the Lijiang region. Methods:Patients with ARDS who visited the department of emergency of People's Hospital of Lijiang from August to December 2020 were selected as study subjects. Patients were divided by severity into mild ARDS group [200 mmHg (1mmHg = 0.133 kPa)≤oxygenation index (PaO 2/FiO 2, P/F)≤300 mmHg] and moderate to severe ARDS group (P/F≤200 mmHg). The general condition, clinical diagnosis, arterial blood gas analysis results of the patients were recorded, and the differences of the above indexes between the two groups of ARDS were compared. Spearman correlation analysis was used to analyze the correlation between SpO 2 and arterial oxygen saturation (SaO 2). SpO 2 was carried into the Ellis equation and the Rice equation to calculate the derived P/F and analyze the correlation between the derived P/F and the P/F measured in arterial blood gas analysis; receiver operator characteristic curve (ROC curves) were plotted, the sensitivity and specificity of SpO 2/fraction of inspiration oxygen (SpO 2/FiO 2, S/F) instead of P/F to assess oxygenation in patients with ARDS was calculated. To evaluate the feasibility of SpO 2 for the condition evaluation of patients with ARDS in the Lijiang region. Results:Compared with the mild ARDS group, the arterial partial pressure of oxygen (PaO 2), SaO 2 and hemoglobin (Hb) were significantly decreased in the moderate to severe ARDS group [PaO 2 (mmHg): 50.5 (39.3, 56.5) vs. 60.0 (55.0, 67.5), SaO 2: 0.86 (0.73, 0.91) vs. 0. 93 (0.90, 0.96), Hb (g/L): 142±27 vs. 156±24, respectively, all P < 0.05]. Correlation analysis revealed a significant positive correlation between SpO 2 and SaO 2 in ARDS patients residing at high altitude ( R = 0.650, P = 0.000). The P/F derived by the Rice formula was significantly and positively correlated with the P/F derived from arterial blood gas analysis ( R = 0.802, P = 0.000). The deduced P/F in mild and moderate to severe ARDS groups were all significantly correlated with the measured P/F ( R values were 0.562, 0.647, both P = 0.000). The P/F derived using the Ellis formula showed a significant positive correlation with the P/F derived from arterial blood gas analysis ( R = 0.822, P = 0.000). The deduced P/F of mild ARDS group and moderate to severe ARDS group were all positively correlated with the measured P/F ( R values were 0.556, 0.589, P values were 0.000, 0.010). There was a significant positive correlation between S/F and P/F in ARDS patients ( R = 0.828, P = 0.000), and the regression equation was S/F = 1.33 P/F+52.41. ROC curve analysis showed that S/F had some predictive value for patients with mild and moderate to severe ARDS, and area under ROC curve (AUC) and 95% confidence interval (95% CI) were 0.903 (0.829-0.977), 0.936 (0.870-1.000), both P = 0.000. When the cut-off value was 452 mmHg, S/F had a sensitivity of 100% and a specificity of 80.9% for predicting mild ARDS. When the cut-off value was 319 mmHg, S/F predicted moderate to severe ARDS with 95.1% sensitivity and 86.2% specificity. Conclusions:At high altitude, SpO 2 and SaO 2 have been correlated in patients with ARDS, and P/F derived using SpO 2 and measured P/F were significantly correlated in patients with ARDS, especially in those with moderate to severe ARDS. SpO 2 may be useful in the assessment of severity of illness in patients with ARDS at high altitude.

Objective To observe and summarize the morphologic features that may suggest submucosal invasive adenocarcinoma in colorectal mucosa biopsy specimens .Methods The study cohort included 432 colorectal biopsy specimens were obtained from 2006 to 2012.All the cases had radical surgery.Basing on the pathologic diagnoses , the cases were divided into 366 invasive adenocarcinoma (IAC) and 66 high-grade intraepithelial neoplasms (HGIN).These two groups were compared.Results In the IAC group, the percentage of tumor forming cribriform structures , acute angle-shaped glands, diffuse carcinoma cell proliferation was 61.2%(224/366), 33.8%(124/366) and 7.4%(27/366), respectively.In the HGIN group, cribriform gland structures appeared in 6.0%(4/66)of the cases, while no acute angle-shaped gland or diffuse carcinoma cell proliferation was detected.The difference of these three characteristics in the two group was statistically significant ( all P<0.01 ).Glandular branching was detected in 89.9%(329/366) of IAC cases and 66.7%(44/66)of HGIN cases;this difference was not significant.There was no difference in cellular atypia between the two groups.Interstitial fibrosis was detected more frequently in the IAC group (85.5%,313/366 in IAC versus 0 in HGIN, P<0.01).In biopsy specimens of IAC , a few cases showed neoplastic glands in close contact with large lymphatics , adipose tissue , and ganglion.Conclusions In colorectal biopsy specimen , the five features that suggest submucosal invasion of the neoplastic glands including the formation of cribriform structure , angular gland , diffuse carcinoma cells , interstitial fibrosis and neoplastic glands in close contact with the thick-walled vessels.

Objective To analyze serum characteristics and determine the reference range for thyroid function among healthy 11～16 year-old teenagers in Xi'an in order to offer a theoretical basis for clinical diagnosis and therapy.Methods A sum of 1 378 healthy 11～16 year-old teenagers who met the inclusion criteria from the First Affiliated Hospital of the Air Force Medical University(Xijing Hospital)between January 2020 and December 2022 were selected as research subjects,including 628 males and 750 females.They were divided into three groups based on age:Group 1:11～＜13 year-olds(433 cases),Group 2:13～＜15 year-olds(425 cases),and Group 3:15～≤16 year-olds(520 cases).Differences in serum thyroid function indices among different genders and age groups were analyzed,the reference ranges for these indices were established,and 99 healthy 11-16 year-old teenagers who met the inclusion criteria were chosen for verification.Results There were no significant differences between different genders in thyroid stimulating hormone[TSH,2.56(1.80,3.63)μIU/ml vs 2.43(1.68,3.48)μIU/ml]and total thyroxine[TT4,97.84(85.34,111.00)nmol/L vs 98.20(87.16,111.23)nmol/L],the differences were statistically significant(Z=-1.881,-0.638,all P＞0.05).Meanwhile,the differences in free thyroxine[FT4,16.93(15.49,18.60)pmol/L vs 16.26(14.80,17.83)pmol/L],free triiodothyronine[FT3,6.21(5.66,6.80)pmol/L vs 5.59(4.98,6.19)pmol/L],and total triiodothyronine[TT3,2.24(1.96,2.55)nmol/L vs 2.04(1.78,2.34)nmol/L]between different genders were significant(Z=-5.368,-11.994,-6.417 all P＜0.01).The differences in thyroid function indices were significant among different age groups(Z=10.649～261.003,all P＜0.05).The reference ranges for thyroid function indices across different age groups and genders were established,in which thyroid function indicators were verified to be within the established reference range by 99 samples.Conclusion Teenage hormone secretion varies greatly,and the secretion of thyroid hormones is influenced by various factors.Thus,the diagnosis and treatment of teenage thyroid diseases cannot fully rely on the reference ranges provided by adults or manufacturers.This study established the reference range of the thyroid function indices of 11～16 year-old teenagers in Xi'an,offering clinical doctors'diagnosis and treatment data support.

Objective To evaluate whether perinatal personalized self-efficacy can improve the rate of breastfeeding six months after delivery in primiparas by applying it in the breastfeeding by primiparas. Methods Totally 76 pregnant women who were admitted by the outpatient service of the Obstetrics Department from January to February 2016 were selected as the object of intervention by convenience sampling. Pregnant women admitted in January 2016 were divided into the control group (n=38) and received conventional nursing, while those admitted in February 2016 were divided into the observation group (n=38) and received perinatal personalized breastfeeding self-efficacy intervention. Then the breastfeeding self-efficacy one week and one month after delivery and the rate of pure breastfeeding one week, one month, three months and six months after delivery were compared between two groups.Results The pregnant women in the observation group showed higher breastfeeding self-efficacy than the pregnant women in the control group (t=25.43,22.78;P<0.05). The rates of pure breastfeeding one week, one month, three months and six months after delivery were 88.57％, 85.71％, 80.00％ and 77.14％, respectively, higher than those of the pregnant in the control group, which were 66.67％, 55.56％, 47.22％ and 36.11％, respectively (χ2=4.878, 7.749, 8.215, 12.146;P<0.05). Conclusions Perinatal personalized self-efficacy intervention can improve the breastfeeding self-efficacy and the rate of pure breastfeeding six months after delivery.

OBJECTIVETo observe and summarize the morphologic features that may suggest submucosal invasive adenocarcinoma in colorectal mucosa biopsy specimens.

METHODSThe study cohort included 432 colorectal biopsy specimens were obtained from 2006 to 2012. All the cases had radical surgery. Basing on the pathologic diagnoses, the cases were divided into 366 invasive adenocarcinoma (IAC) and 66 high-grade intraepithelial neoplasms (HGIN). These two groups were compared.

RESULTSIn the IAC group, the percentage of tumor forming cribriform structures, acute angle-shaped glands, diffuse carcinoma cell proliferation was 61.2% (224/366) , 33.8% (124/366) and 7.4% (27/366) , respectively. In the HGIN group, cribriform gland structures appeared in 6.0% (4/66) of the cases, while no acute angle-shaped gland or diffuse carcinoma cell proliferation was detected. The difference of these three characteristics in the two group was statistically significant (all P < 0.01). Glandular branching was detected in 89.9% (329/366) of IAC cases and 66.7% (44/66) of HGIN cases; this difference was not significant. There was no difference in cellular atypia between the two groups. Interstitial fibrosis was detected more frequently in the IAC group (85.5%, 313/366 in IAC versus 0 in HGIN, P < 0.01). In biopsy specimens of IAC, a few cases showed neoplastic glands in close contact with large lymphatics, adipose tissue, and ganglion.

CONCLUSIONSIn colorectal biopsy specimen, the five features that suggest submucosal invasion of the neoplastic glands including the formation of cribriform structure, angular gland, diffuse carcinoma cells, interstitial fibrosis and neoplastic glands in close contact with the thick-walled vessels.

Adenocarcinoma ; pathology ; Biopsy ; Carcinoma in Situ ; pathology ; Cell Proliferation ; Diagnosis, Differential ; Humans ; Intestinal Mucosa ; pathology ; Neoplasm Invasiveness