Medullary thyroid cancer is a kind of rare malignancy arising from unregulated replication of parafollicular C cells of the thyroid gland. Therapeutic approaches to patients with medullary thyroid cancer have their own features,which are different from those to patients with papillary thyroid cancer,the most com-mon type of thyroid cancer. The targeted therapy using tyrosine kinase inhibitors has brought new hope for the management of aggressive medullary thyroid cancer in recent years.

The tumor metastasis is the major cause of the death of cancer patients.S-100A4 is a member of the S100 family of calcium-binding proteins and has been categorized as a metastasis-associated protein.S-100A4 is a candidate as a molecular marker for metastatic potential with high prognostic significance.An increase in S-100A4 protein expression has been correlated with poor prognosis of patients with breast,colorectal,gallbladder,bladder,esophageal,nonsmall-cell lung,gastric,medulloblastoma,pancreatic and hepatocellular cancers.The overexpression of S-100A4 protein can induce the increase of invasion and mobility of the tumor cells.It has been considered that S-100A4 is secreted by the tumor and stroma cells as a regulator of tumor metastasis.S-100A4 can regulate the progress of cell cycle,change cell adhesion,cell mobility and increase the survival ability of the tumor cells.

Objective To report a case of pulmonary alveolar microlithiasis ( PAM) in Peking Union Medical Col-lege Hospital and to summarize the clinical features and genetic characters .Methods The clinical features , ima-ging results , pathology findings and SLC34 A2 gene mutation was analyzed and reported .Results The patient was a 35 years old male, presenting with cough and sputum for 10 years and worsen with short of breath for 3 weeks. Computed tomography of lung and pathology findings support the diagnose of pulmonary alveolar microlithiasis .And a heterozygous mutation c .A910 T in exon 8 of SLE34 A2 gene was discovered through genetic testing .Conclusions Since to the treatment is non-specific in this rare disease , it's significantly important to recognize this disease through early non-specific clinical features but typical imaging findings .And the finding that c .A910 T is more common in Asia population may provide us a potential target for screening and possible genetic engineering therapy .

0.05).Conclusion:The lymphoid tissues can not only express the ACTH-R?5-HT_ 1A-R protein but also synthesize their mRNA.ACTH and 5-HT can regulate the functions of the immune system through their receptors on the membrane of the immunocytes.

Objective To study lobular involution of tissues around breast tumor,and to assess the consistency of lobular involution of tissues from different parts of the breast.Methods 22 patients receiving breast conservation surgery in Breast Surgery Department of Peking Union Medical College Hospital from Dec.1 st,2010to Dec.1 st,2011 were collected.88 pieces of HE staining were measured in terms of lobular area and number of acini per lobular,and lobular involution was evaluated.Bivatiate correlation analysis was applied to explore correlation between lobular area and acini per lobular.ANOVA,crosstabs and reliability analysis were applied to explore involution consistency of different parts of breast (P ＜ 0.05).Results The average area of lobuli was (90 248.5 +56 909.4) μm2 and the number of acini was 25.68 ± 18.86 per lobular.The lobular area and number of acini were correlated with each other significantly(Pearson r =0.78,P ＜ 0.01).Involution status of different parts of breast had good consistency(for lobular area 19 cases showed no difference in ANOVA analysis and for lobular area/number of acini 18 cases showed no difference; Kappa coefficient =0.65; ICC =0.73).Conelusions Lobuli around breast tumor have comparatively poor involution,with big lobuli and large number of acini,which are correlated with each other.Involution status of different parts of a breast has good consistency.Biopsy from one site to evaluate involution extent of the whole breast is practicable.

Diagnosis, Differential ; Humans ; Neoplasms, Glandular and Epithelial ; diagnosis ; Thymus Neoplasms ; diagnosis

OBJECTIVETo study the expression of EpCAM and E-cadherin in papillary thyroid carcinoma and to analyze its correlation with various clinicopathologic parameters.

METHODSImmunohistochemical study for EpCAM and E-cadherin was carried out in 91 cases of papillary thyroid carcinoma. Twenty-four cases of papillary hyperplasia of thyroid were used as controls.

RESULTSIn all of the 24 cases of papillary hyperplasia, EpCAM was located on the cell membrane, while in the 91 cases of papillary thyroid carcinoma studied, EpCAM was located within the cytoplasm, with 36.3% (33/91) showing nuclear localization as well. In all the papillary hyperplasia cases studied, E-cadherin showed membranous expression. E-cadherin expression was reduced in 84.6% (77/91) of papillary thyroid carcinoma, as compared with the surrounding native thyroid parenchyma. Amongst the 33 cases of papillary thyroid carcinoma which showed nuclear localization of EpCAM, 30 cases also showed reduced E-cadherin expression. There was a positive correlation between nuclear expression of EpCAM and loss of E-cadherin expression (P = 0.000; Spearman correlation coefficient = 0.857). Nuclear expression of EpCAM correlated with follicular variant of papillary thyroid carcinoma and presence of extrathyroidal extension ( P = 0.037 and 0.033, respectively). Loss of E-cadherin expression correlated with age of patients and presence of lymph node metastasis (P = 0.018 and 0.010, respectively).

CONCLUSIONSE-cadherin expression is reduced in papillary thyroid carcinoma, as compared with native thyroid parenchyma and papillary hyperplasia. Papillary thyroid carcinoma shows loss of EpCAM membranous expression and increased cytoplasmic/nuclear accumulation. Detection of these two markers may provide a valuable reference in defining the biologic behaviors of papillary thyroid carcinoma, including extrathyroidal extension and lymph node metastasis.

Antigens, Neoplasm ; metabolism ; Cadherins ; metabolism ; Carcinoma, Papillary ; metabolism ; secondary ; Cell Adhesion Molecules ; metabolism ; Cell Membrane ; metabolism ; Cytoplasm ; metabolism ; Epithelial Cell Adhesion Molecule ; Humans ; Lymphatic Metastasis ; Neoplasm Proteins ; metabolism ; Thyroid Neoplasms ; metabolism ; pathology

This article provided an overview of the basic concepts and historical development of hernias.The introduction of the concept of"tension-free hernioplasty"marked a milestone in hernia surgery,while the establishment of the concept of"abdominal domain"has propelled its development.This article introduced the introduction and promotion of hernia repair techniques in China,with a focus on discussing the stages of development for Chinese hernia surgical repair techniques including open surgery,laparoscopic surgery,robotic surgery,as well as the application and development of minimally invasive techniques.It emphasized that surgical methods should be selected based on the classification of abdominal wall hernia and the 3R(repair,reconstruction,restoration)principle for abdominal wall reconstruction.Additionally,this article explored advancements in materials science and the promotion of day surgery models.

Hernia and abdominal wall surgery has developed rapidly in nearly 20 years in China. Its diagnosis and treatment has reached a high level worldwide nowadays. On the topic of how to make a brand-new development in this field, the authors demonstrate that we need to improve in many aspects, including the innovation and optimization of surgical technology and the standardization of surgical operation, as well as the exploration of biological mesh and other hernia repair materials, quality control system, registration system, adverse events reporting system, real world research for the stable development of hernia surgery. This can promote the diagnosis and treatment of hernia and abdominal wall surgery personalized principles and innovative develop-ment in the future.

Objective To analyze the clinical value of laparoscopic and hybrid technique for the repair of incisional hernia.Methods The clinical data of 70 cases of incisional hernia undergoing laparoscopic and hybrid repair from Jan 2014 to Dec 2015 in Huadong Hospital were analyzed retrospectively.Results All cases were operated on successfully and recovered.The operation time was (60 ± 27) min for laparoscopic and (120 ± 32) min for hybrid repair.The length of incision was (6 ± 4) cm for laparoscopic repair and (8 ± 6) cm for hybrid.Postoperative complications included seroma in 1 case in laparoscopic group,incisional fat liquefation in 1 case in hybrid group.All were cured with conservative treatment.Hospital stay was (8 ± 5) days in hybrid group and (14 ± 16) days in hybrid group.No recurrence was observed during 6-30 months of follow-up.Conclusion Both laparoscopic and hybrid technique for incisional hernia repair are safe and effective.