Objective To investigate the characters of morphology change and protein expres-sion in progressed renal cell carcinoma after the treatment of sorafinib. Methods Clinical data of 2 cases with progressed renal cell carcinoma treated with sorafenib were collected. The HE slices were reviewed. Immunochemistry was used to detect the expression of Vimentin, AE1/AE3, CK7, CK8, CK18, CD10, VEGF, VEGFR2, p53 and Ki-67 levels. Results There was no difference in patho-logic type between before and after the therapy of sorafenib. Both of the 2 cases were showed degener-ation in tumor cell in different degree with fibrosis and necrosis. The expression of renal cell carcinoma related antigens (Vimentin, AE1/AE3, CK7, CK8, CK18 and CD10) had no difference before and af-ter the treatment of sorafinib. The expressions of VEGF, VEGFR2, p53 and Ki-67 were increased, and the expression of Bcl-2 was decreased after the therapy of sorafinib. Conclusions There may be some morphologie differences between the metastatic tumor or the recurrent tumor and primary tumor because of the treatment of sorafenib. However the pathologic type is the same before and after the treatment of sorafenib. The main differences are the degeneration of the tumor cell and fibrosis after the treatment of sorafenib. The expression changes of VEGF and VEGFR2 may be related to the sor-afenib application.

Objective To summarize the effect of predictive nursing combined with high-quality nursing in patients with pulmonary embolism or having risk factors of pulmonary embolism (PE).Methods A retrospective analysis of nursing in 57 PE patients was camied out,Nursing flow chart was established.For patients with high risk factors of PE,predictive nursingwas administered,including analysis of risk factors,health education,general nursing and pertinent nursing.For PE patients,holistic nursing was administered,including emergeney nursing,basic nursing,observation of illness,nursing of thrombolytic therapy,psychological nursing and rehabilitation nursing, Results All patients accorded with thrombolysis indication and received thrombolysis treatment. Conclusions Predictive and high-quality nursing should be used in PE patients in order to improve treatment effect.

T-6 specific IFN-γ ELISPOT has higher specificity, sensitivity, the positive and negative predicative value. Therefore, the ELISPOT warrant for further improvement and clinical application.

Objective To clarify the MUM1/IRF4 expression in follicular lymphoma (FL) and its clinical and pathological significance. Methods Ninety-six cases FL were immunostained with MUM1,CD10,bcl-2,bcl-6 and Ki-67 antibodies. The results were compared with their clinical and pathological features. Results The overall MUM1 expression rate in FL was 59.2 % (58/96),including 36.2 % (19/51) grade 1 or 2 and 86.4 %(39/45) grade 3 cases (x2 =24.406,P <0.001). 68.9 % cases with diffuse area were MUM1 positive (x2 =8.161,P =0.004). MUM 1 and CD10 expression had inverse correlation,83.3 % CD10 negative cases were MUM1 positive (x2= 12.649,P<0.001). The mitosis rate and Ki-67 label index were statistically higher in MUM1 positive cases than in negative cases (t = -3.852 & -4.610,respectively,P <0.001). Conclusion MUM1 can be used as a biomarker to divide FL into different malignancies. The MUM1 positive FL may be the feature of high grade non germinal center B cell malignant lymphoma.

Objective To investigate the pathologic features, diagnosis and differential diagnosis of inflammatory myofibroblastic tumor (IMT) in urinary bladder. Methods It was retrospectively reviewed for the characters of pathologic features and immunohistochemistry type in 3 patients diagnosed IMT in urinary bladder. Results 3 patients including 1 female and 2 male were 15, 36 and 60 years old (mean age 37),respectively. All patients underwent partial cystectomy. All cases presented single or multiple, polypoid or nodular mass(es), ranging in size from 1.8 to 5.5 cm. Microscopically, the tumor cell grew in invasive pattern, and were spindled with prominent nucleoli. The lesions varied from highly myxoid to highly cellular lesions. The mitotic rates were invisible. AE1/AE3, CK18 and ALK were positive in IMT. Follow-up was available for 3 patients (2, 18 and 18 months, respectively). None developed recurrences or metastasis. Conclusion IMT in urinary bladder are rare tumors. IMT grows in invasive pattern, and are spindled with prominent nucleoli.The main differential diagnosis of IMT includes embryonal rhabdomyosarcoma in juvenile, sarcomatoid urothelial carcinoma and leiomyosarcoma in adult.

Objective To discuss the effect of clinical nursing pathway ( CNP) on patients with acute pancreatitis ( AP) .Methods Totals of 246 patients with AP were randomly divided into the observation group (n=124) and the control group (n=122).The observation group received clinical nursing pathway while the control group was given conventional nursing methods .Nursing effect was compared between two groups . Results Patients’ satisfaction rate was 96.77% in the observation group and 87.70% in the control group, with statistically significant difference (χ2 =2.83,P<0.05).The average stay in hospital was (16.64 ±4.15)d in the observation group and (18.77 ±5.28) d in the control group.The average cost of hospitalization was (48 972.38 ±17 362.33) yuan in the observation group and (55 728.47 ±21 932.36)yuan in the control group. Both differences were statistically significant (F=2.62, 3.91, respectively;P<0.05).Conclusions CNP can significantly improve the nursing quality of AP patients and reduce the medical cost .

OBJECTIVETo evaluate the sensitivity and specificity of fully automated immunohistochemistry (IHC), with comparison to FISH, in the detection of EML4-ALK rearrangement in lung adenocarcinoma (ADC); and the use of IHC as a pre-screening tool.

METHODSA total of 404 paraffin-embedded NSCLC samples from surgical resections were tested by IHC with Ventana anti-ALK rabbit monoclonal antibody (D5F3) and ultrasensitive detection kit. ALK rearrangement was further confirmed by FISH.

RESULTSTwenty-nine of 404 lung ADCs (7.2%) were positive for ALK by IHC. ALK positive tumor cells demonstrated strong and diffused granular cytoplasmic staining. All the ALK IHC-positive cases were confirmed to harbor ALK rearrangement by FISH. None of the ALK IHC-negative cases was FISH-positive.

CONCLUSIONSIHC can effectively detect ALK rearrangement in lung cancer. It may provide a reliable and cost-effective diagnostic approach in routine pathologic laboratories for the identification of suitable candidates for ALK-targeted therapy.

Adenocarcinoma ; genetics ; metabolism ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung ; genetics ; metabolism ; Female ; Gene Rearrangement ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Lung Neoplasms ; genetics ; metabolism ; Male ; Middle Aged ; Oncogene Proteins, Fusion ; genetics ; metabolism ; Sensitivity and Specificity