OBJECTIVE: Lymphoepithelial carcinoma (LEC) of salivary glands is a rare malignant neoplasm. The purpose of this research was to investigate the clinicalpathologic features and treatment methods of this rare disease. METHOD: The clinical data and treatment outcomes of 17 patients from 2006 to 2012 were reviewed retrospectively. RESULT: Ten males and seven females with a ratio of 1. 43:1 were involved. The II, III, IV stage cases were 7 (41.2%), 4 (23.5%), 6 (35.3%), respectively. The average follow-up duration was 2.56 years, and 12 patients had no evidence of recurrence. Five patients had local recurrence and (or) distant metastases within three years after surgery, including 4 deaths. CONCLUSION LEC in salivary gland is a high grade malignant tumor in oral and maxillofacial region, occurring predominately in parotid gland and submandibular gland. To prevent distant metastasis, radical surgery combined with chemoradiotherapy should be adopted.
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Neoplasms, Squamous Cell ; pathology ; secondary ; Parotid Neoplasms ; pathology ; Rare Diseases ; pathology ; Retrospective Studies ; Salivary Gland Neoplasms ; pathology ; Salivary Glands ; pathology ; Submandibular Gland Neoplasms ; pathology ; Treatment Outcome

BACKGROUND:With the development of modern pathological techniques, the misdiagnosis rate has been reduced remarkably, but special stains are still the most important method for pathological diagnosis. OBJECTIVE:To compare the advantages and disadvantages of different special stains used for observing the structure of human lumbar facet joints. METHODS:The specimens of facet joint cartilage at L4/5 level were collected from patients undergoing lumbar surgery, and then stained with hematoxylin-eosin, safranin O, toluidine blue, Masson, and saranin-O-fast green for structure observation. RESULTS AND CONCLUSION:The structure of the articular cartilage could be observed clearly through hematoxylin-eosin, toluidine blue, and saranin-O-fast green staining. The cartilage surface, tidemark, and subchondral bone were shown by the hematoxylin-eosin staining, with the presence of violet chondrocyte nuclei. Safranin-O-fast green staining showed the four layers of the cartilage clearly, including the shallow layer (cartilage surface), middle layer (spherical cells arranged in disorder), columnar cell layer (large and multinucleated chondrocytes arranged neatly), tidemark, subchondral bone layer; and the cartilage matrix was reddish uniformly, the subchondral bone was green, and the cartilage and bone tissue showed a striking contrast. The cartilage structure was unclear in toluidine blue staining, with clear nuclei and almost no coloring cytoplasm, but the matrix appeared with slight purplish blue. Safranin O staining showed that the cartilage was red, which had no obvious boundary with the cartilage matrix, and chondrocytes were stained lightly. Masson staining showed clear collagen fibers, but the structures of the cartilage and subchondral were obscure. To conclude, safranin-O-fast green staining can achieve the best results, followed by hematoxylin-eosin staining and Masson staining in turn.

Objective To observe the effects ofJingui Shenqi Pills on the expressions of TGF-β1, CYP19, sex hormone level and sperm quality;To discuss its mechanism for the treatment of male sterility.Methods Forty adult male SD rats were randomly divided into normal group, model group, retardant group andJingui Shenqi Pills group, 10 rats in each group. Except for the normal group, adenine was used to induce healthy rats to kidney yang deficiency and sterility model rats. Normal group was given normal saline for gavage;retardant group was injected with testicular mesenchyme TGF-β1;Jingui Shenqi Pills group was givenJingui Shenqi Decoction for gavage. Blood was taken through caudal vein. Immunohistochemical, radioimmunoassay and electron microscopy observation were used to detect the expressions of TGF-β1, CYP19, sex hormone level, sperm density and motility rate and testicular morphological changes.Results Compared with normal group, the expression of TGF-β1 in the model group increased and CYP19 decreased (P<0.05). Compared with model group, the expression of TGF-β1 decreased and the expression of CYP19 increased (P<0.05). Compared with normal group, the number of sperm quantity was small and paramorphia in model group (P<0.05). Compared with model group, T, E2, sperm density and motility rate increased significantly inJingui Shenqi Pills group and retardant group (P<0.05). There was no statistical significance among indexes in retardant group andJingui Shenqi Pills group.ConclusionJingui Shenqi Pills can improve sperm quality and sex hormone level of model rats with kidney-yang-deficiency, which mechanism is probably realized by inhibiting the expression of TGF-β1R and promoting the expression of CYP19 in testis to effect development and proliferation of sperm.

Objective: To explore the therapeutic effect of subcutaneous negative pressure drainage and absorbable suture in preventing postoperative complications of cranioplasty. Methods: The clinical data of 175 cases of skull defect admitted and treated in Department of Neurosurgeryof the Affiliated Hospital of Binzhou Medical University from January 2012 to February 2018 were retrospectively analyzed.According to the different intraoperative treatment methods, 97 cases were treated with thread suture to the galea aponeurotica combined with general drainage(the general drainage group), and 78 cases were treated with absorbable suture to the galea aponeurotica combined with negative pressure drainage(the negative pressure drainage group). The galea aponeurotica were sutured intermittently with both silk thread and absorbable suture, and the drainage tube was placed outside the metal titanium plate under the skin, and removed after 48-72 hours.The postoperative complications of the two groups were compared. Results: The incidence rates of subcutaneous hemorrhage, knotting reaction, infection of incision in the negative pressure drainage group were 1.3%(1/78), 0.0%(0/78), and 0.0%(0/78), respectively, which were significantly lower than those in the average drainage group[11.3%(11/97), 20.6%(20/97), 7.2%(7/97)], the differences were statistically significant(χ²=6.85, 18.16, 4.13, all P<0.05). Conclusion The application of absorbable suture suturing galea aponeurotica and subcutaneous negative pressure drainage in skull repair can significantly reduce and prevent postoperative complications of cranioplasty.

[Objective]To summarize the experience in treating malignant tumors based on the syndrome differentiation of the six meridians and the usage characteristics of classic formulas in the Treatise on Febrile and Miscellaneous Diseases.[Methods]Based on the analysis of the disease classification method of"six channels differentiation of syndromes"in Treatise on Febrile Diseases and Miscellaneous Diseases and the process of malignant tumor onset,advance and prognosis is dynamized and the possibility of traditional Chinese medicine in the prevention and treatment of malignant tumors by"preventing the disease before it changes"is explored.At the same time,the common clinical strategies for the treatment of malignant tumor adverse reactions are listed,the modern application of classic formulas in the treatment of malignant tumor according to the clinical characteristics of the disease and literature research is summarized.[Results]As a positioning method in the process of disease development,the differentiation of six meridians can indicate the depth of the disease and the state of the struggle between positive and evil Qi during the development of malignant tumors,providing theoretical reference for the formation mechanism,site of onset,and prognosis of malignant tumors.Classic formulas have the characteristics of clinical universality,standardization of addition and subtraction methods,and comprehensive participation in anti-tumor treatment,reflecting the potential advantages of traditional Chinese medicine in treating malignant tumors.Classical formulas have practical value in treating cancer fever,cancer pain,radiation inflammation,nerve damage,digestive tract reaction and so on.[Conclusion]The application of classic formulas can effectively improve the quality of life of patients with malignant tumors,with the characteristics of full process,overall,and flexibility.The role of classic formulas in the treatment of malignant tumors is worth further exploration.

BACKGROUND:Lumbar facet arthritis is one of the main causes of low back pain.At present,MRI is mainly used for preliminary diagnosis,and there is still a certain probability of missed diagnosis and misdiagnosis.Therefore,MR T2* mapping imaging technology is expected to become an important means of quantitative detection of cartilage damage in lumbar facet arthritis. OBJECTIVE:To investigate the application value of MR T2* mapping imaging technique in quantitative analysis of cartilage damage and degeneration of lumbar facet joint. METHODS:A total of 110 outpatient or inpatient patients with low back pain in Fourth Affiliated Hospital of Nanjing Medical University from April 2020 to March 2022 were collected and set as case group.At the same time,80 asymptomatic volunteers were recruited as the control group.T2* mapping transectal images and T2WI images were obtained by 3.0T MR Scanning for the facet joints of all included subjects L1-S1.Weishaupt grading and T2* value measurement were performed for all facet joint cartilage,and the data were collected for parallel statistical analysis.The comparison of T2* values of facet joint cartilage between different articular Weishaupt grades was performed by one-way analysis of variance. RESULTS AND CONCLUSION:(1)Statistical analysis found that the T2* value of lumbar facet joint cartilage in the case group(17.6±1.5)ms was significantly lower than that in the control group(21.4±1.3)ms(P<0.05).(2)In the case group,with the hierarchical increase of lumbar facet joint Weishaupt,the T2*value of facet joint cartilage also showed a gradual decreasing trend,and the difference was statistically significant(P<0.05).(3)It is concluded that T2*mapping can better display the early pathological changes of lumbar facet joint cartilage injury,and T2* value of lumbar facet joint cartilage can quantitatively evaluate the degree of lumbar facet joint cartilage injury.T2* mapping imaging technique can provide a good theoretical basis for the imaging diagnosis of the early cartilage injury induced by lumbar facet arthritis and has important clinical application value.

Malignant cancer is a kind of fatal disease with severe threat to human health and social development, and seeking a scientific method for the proper diagnosis, treatment and assessment has become one of the most important public health problems in recent years. With the constant development in healthcare industry, traditional methods of tumor screening, prevention and prognosis assessment have made a rapid progress. However, owing to the characteristics of tumor heterogeneity and patient individuation, precision medicine mode in disease screening, diagnosis and treatment will become a general trend in future medical development. As an important part in precision medicine, gene variation detection in the field of tumors involves several aspects, including early screening, recurrence monitoring, guidance on use of targeted drugs and assessment of efficacy and prognosis etc; However, there are still many limitations in its clinical practice. Therefore, further research is needed to promote the development of tumor precision medicine. In this paper, the development history of gene variation detection and its application progress in precision medicine of malignant tumors are comprehensively discussed.

Objective To assess the feasibility and the value of MR T2 * mapping in valuing the early degeneration of lumbar intervertebral disc quantificationally.Methods 67 patients with low back pain and 21 healthy volunteers were chosen for the study.The two groups both underwent 3.0T MR with the axial T2 WI and T2 * mapping images in 440 discs of L1-S1.We graded all intervertebral discs by Pfirrmann score,and measured the T2 * values of annulus fibrosus(AF) and nucleus pulposus(NP).Results The T2 * values of the anterior AF and the NP among different Pfirrmann grades were statistically significant (P =0.001;P =0.000,respectively).There was significant difference in T2 * values of the anterior AF at L3/L4 between patients and volunteers (P=0.043);The T2 * values of the NP at L2/L3,L3/L4,L4/L5,L5/S1 between the two groups were significant difference (P＜0.05).There was also distinct difference in T2 * values of the posterior AF at L1/L2 and L4/L5 between the two groups (P＜0.05).Conclusion The lumbar intervertebral disc degenerates from the NP to posterior AF,and mainly occurs at L4/L5.The T2 * mapping technique can provide a good basis for diagnosing in lumbar intervertebral disc degeneration.

【Objective】 To investigate the relationship between cerebrospinal fluid exosome-derived miR-630 and the function of brain microvascular endothelial cells （BMECs）. 【Methods】 The subarachnoid hemorrhage endothelial cell model was established to evaluate the effect of hemorrhagic cerebrospinal fluid （BCSF） on BMECs’ proliferation by MTT assay and cell cycle analysis. qRT-PCR and immunofluorescence staining were used to detect the expressions of endothelial cell tight junction protein （ZO-1） and adhesion molecule （ICAM-1 and VCAM-1）. Changes in NOx concentration were detected by radioimmunoassay. The cerebrospinal fluid exosomes in the experimental group （co-incubated with BCSF） and the control group （normal cerebrospinal fluid） were isolated and identified， and differences in the expressions of cerebrospinal fluid exosomal miR-630 between the two groups were compared. BMECs work changes after the intervention with miR-630 analogue were observed. 【Results】 The proliferation of BMECs was significantly inhibited in the experimental group； the mRNA and protein levels of ICAM-1， VCAM-1 and ZO-1 were significantly decreased， and the function of endothelial cells was significantly inhibited （P<0.05）. After the successful separation and identification of cerebrospinal fluid exosomes， the expression of miR-630 was significantly lower in the experimental group than in the control group （P<0.05）. The function of BMECs was significantly improved with miR-630 mimics. 【Conclusion】 The low expression of miR-630 in cerebrospinal fluid exosomes after subarachnoid hemorrhage is closely related to BMECs injury.

Marsupialization is effective in the treatment of cystic lesions of the jaw. It is a simple operation that can result in minimal trauma, the reduction of postoperative recurrence, and maximum preservation of the surrounding tissue structure and function. However, there is a certain failure rate in clinical treatment due to the improper grasp of indications and nonstandard operation. The highest failure rate reported in the literature is 32.6%. To further standardize the clinical application of marsupialization and improve the success rate of treatment, we put forward an expert consensus of marsupialization in the treatment of jaw cystic lesions by reviewing the domestic and foreign literature and summarizing the experience in marsupialization from some famous domestic experts. In this consensus, we propose three elements of marsupialization: the establishment of the opening, the maintenance of cyst plugs and regular washing. The scope of application of marsupialization includes jaw cysts and cystic ameloblastomas. It is necessary to standardize the position of the opening, the size of the opening and the manufacture of the cyst plug, and a panoramic film or cone beam computed tomography(CBCT) should be used to observe the changes in the cystic cavity before and after operation. A second-stage operation should be performed when the lesion is significantly reduced by more than 50% or at least 5 mm from important structures; furthermore, the teeth of focus should be treated according to the relationship between the lesion and tooth and the type of tooth.