Background Acquired immune deficiency syndrome (AIDS) is an infectious disease caused by human immunodeficiency virus (HIV).Highly active antiretroviral therapy (HAART) is an effective treatment for AIDS,but it cannot completely eliminate the viral load in the body for the existence of HIV reservoir.Previous studies demonstrated that HIV could be detected in tears of virus load negative AIDS patients who received effective HAART,suggesting that lacrimal gland is another member of HIV reservoirs.Objective The aim of this study was to explore whether lacrimal gland has a molecular basis of HIV infection and the mechanism of lacrimal gland infection of HIV.Methods Fourteen specimens of lacrimal gland were collected during the surgery from 14 patients with lacrimal gland diseases in Peking Union Medical College Hospital from November 2013 to December 2015,including 13 non-HIV-infected patients and 1 HIV-infected patient.In 13 non-HIV infected patients,lacrimal glands prolapse was in 12 patients with the normal pathological tissue structure and dacryoadenitis was in 1 patient with the histopathological diagnosis of interstitial lymphoid tissue hyperplasia.The clinical manifestation of HIV-infected patient was dacryoadenitis with the histopathological diagnosis of interstitial lymphoid tissue hyperplasia.The paraffin sections of 12 non-HIV-infected specimens and 1 HIV-infected specimen were prepared,and the expressions of CD4,C-X-C chemokine receptor 4 (CXCR4) and C-C chemokine receptor type 5 (CCR5) in lacrimal gland specimens were detected by immunohistochemistry and verified in 1 specimen of non-HIV-infected specimen by immunofluorescence technology.Results Immunohistochemistry showed that CD4 was suspiciously positive expression in non-HIV-infected specimens with the strong background staining.CXCR4 was positively expressed in cytoplasm and nuclei of most lacrimal epithelial cells of lacrimal gland epithelial cells in each specimen,and CCR5 was focally expressed in few lacrimal gland epithelial cells in each specimen.In addition,CD4,CXCR4 and CCR5 were positively expressed in intercellular scattered lymphocytes on the specimens.Immunofluorescence assay showed that CD4,CXCR4 and CCR5 were expressed in the specimens with the red fluorescence,with the linear-and patchy-like distribution mainly in cellular membrane for CD4 or spot-like distribution for CXCR4 and CCR5 in the cytoplasm.Conclusions HIV receptor CD4 and accessory receptor CXCR4,CCR5 are positively expressed in the lacrimal gland epithelial cells,which is the molecular basis of HIV infection and become a potential HIV reservoir preventing HIV eradication.

Objective To improve the recognition of intravaseular lymphoma.Methods One case of intravaseular T-cell lymphoma was reported and the related literatures were reviewed.Results Intravaseulal T-cell lymphoma presenting with fever,rash and haemophagocytie syndrome is rare.Although the patient was given chemical therapy,he was died of liver failure and gastrointestinal bleeding.Conclusion Intravascular T-cell lymphoma is rare,often diagnosed after autopsy and shows a rapidly aggressive course.

Objective:To explore blood type distribution of newborns hemolytic disease ( HDN ) caused by maternal and neonatal blood type incompatibility and analyze the value of hemolysis three trials in the diagnosis of HDN.Methods:Hemolysis three trials of type O or Rh negative maternal cord blood samples and hyperbilirubinemia of the newborn blood samples from January 2014 to 2016 were detected by micro-column gel test cards.Then the results were statistically analyzed.Results:(1) There were 918 cases of maternal and neonatal blood type incompatibility in all 1350 cases.569 cases were detected HDN positive with the rate of 62%( 569/918).Among 569 cases,the positive rate of direct anti-globulin test,free antibody test and antibody released test were 27.9%(159/569),86.5%(492/569) and 100% respectively.There was statistical difference of the combination of direct anti-globulin test negative,free antibody test positive and antibody released test positive compared with other combinations ( P<0.05 ).( 2 ) There was statistical difference of HDN positive rate between ABO 73.8%(551/747) and Rh 10.5%(18/171)in 918 cases of blood type incom-patibility.(3)There was statistical difference between A positive rate of 80%(280/350) and B positive rate of 68.3%(271/397) in 747 cases of ABO incompatibility.(4)There was statistical difference among RhD positive rate of 17.7%(14/79),RhE positive rate of 6.8%(4/59) and RhC positive rate of 0(0/33).Conclusion: Antibody released test was the most sensitive test in hemolysis three trials to diagnose HDN.The probability of HDN positive caused by maternal and neonatal ABO blood type incompatibility was significantly higher than Rh.The probability of HDN positive with type A newborns was significantly higher than type B.The probability of HDN positive caused by RhD blood type incompatibility was significantly higher than RhE and RhC.

Objective To study the preventive and therapeufic effect of sheep bone collagen peptide (SBCP) on osteoporosis of ovariectomized rats. Method Thirty-two 3.5 mon unmated SD female rats were randomly divided into 4 groups by weight:blank group (sham operation), control group (ovariectomized), sample 1 group (ovariectomized and fed freeze drying SBCP) and sample 2 group (ovariectomized and fed spray drying SBCP). Seven days after ovariectomy,the blank group and ovariectomized group were given distilled water (1 ml/100 g?d), the sample 1 and sample 2 group were given sample 1 and sample 2 (1000mg/kg.d). Body weight, feed efficiency, serum bone metabolizing index and bone density (BD), length and diameter of femur were measured 10 w later. Results The alkaline phosphatase (ALP) of ovariectomized or control group was significantly increased, but the increase was restrained in sample 1 and sample 2 group. The BGP of ovariectomized group was significantly higher than that of the blank group, and the BGP of sample 1 and sample 2 group was lower than that of the ovariectomized group, nearly equal to the blank group. The BD of ovariectomized group was declined significantly, but that of sample 1 and sample 2 group was declined slowly. The BD of sample 2 group washigher than that of ovariedomized group, even similar to the blank group. The length and diameter of femur in the sample groups were larger than those of ovariectomized group. The effect of sample 1 and sample 2 on serum bone metabolism indices and femur size was not significantly different. Conclusion Sheep bone collagen polypeptide can reduce the resorption of bone, promote bone growth, and also reduce postmenopausal osteoporosis effectively. The different drying methods have no difference in the anti-osteoporosis effect.

OBJECTIVETo study the pathologic features of pulmonary carcinomas with spindle and/or giant cells.

METHODSTwenty cases of pulmonary carcinomas with spindle and/or giant cells were studied by using lightmicroscopy and immunohistochemical staining.

RESULTSOf 20 cases, 15 cases were pleomorphic carcinoma (10 cases with adenocarcinoma, 3 cases with large cell carcinoma, 1 case with squamous cell carcinoma and 1 case with giant cell carcinoma) , 4 cases were spindle cell carcinoma, and 1 case was giant cell carcinoma. Immunohistochemical results showed AE1/AE3 was positive in the spindle and/or giant cell component of 19 cases, Vimentin was positive in the spindle and/or giant cell component of 20 cases, P53 was positive in 10 cases and thyoid transcription factor-1 (TTF-1) was negtive in all cases.

CONCLUSIONSPulmonary carcinomas with spindle and/or giant cells is definded as a group of poorly differentiated non-small cell carcinoma that contains a component of spindle and/or giant cells. The diagnosis is based on histopathology and immunohistochemical staining of AE1/AE3 and Vimentin.

Adenocarcinoma ; pathology ; Adult ; Aged ; Aged, 80 and over ; Female ; Giant Cells ; pathology ; Humans ; Lung ; pathology ; Lung Neoplasms ; pathology ; Male ; Middle Aged

Adenocarcinoma, Follicular ; classification ; metabolism ; pathology ; Adenoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Carcinoma, Papillary ; metabolism ; pathology ; Diagnosis, Differential ; Humans ; Signal Transduction ; Thyroid Neoplasms ; classification ; metabolism ; pathology

Objective To explore the surgical strategy and effects for treating complex malignant tumors of the inferior vena cava (IVC) or/and the tumors extending into right atrium/ventricle.Methods Between Dec 2004 and Jul 2008, eight patients underwent surgical resections, among those seven patients with tumors of IVC or the tumors extending into right atrium/ventricle were operated on under deep hypothermia with cardiopulmonary bypass( CPB), and one patient with recurrence of leiomyosarcoma of the IVC successfully underwent en bloc resection and caval reconstruction. The prosthetic graft was used for IVC reconstruction in two patients and vascular patch in the other two patients. Preoperative chest roentgenography, computed tomography, ultrasonography, or magnetic resonance imaging was used to exclude the presence of metastatic disease, to assess local resectability of the tumour and the extent of involvement and obstruction of the IVC. Results One patient died of liver failure postoperatively. The postoperative course was uneventful in other 7 patients. On follow-up two patients died 2 and 5 months later due to functional disorder of the liver. Three patients have been followed up for 14 - 24 months and were

Objective:To evaluate the curative effect of computed tomography (CT)-guided percutaneous implantation of 125I radioactive seeds on inoperable early-stage non-small cell lung cancer (NSCLC). Methods:From January 2003 to December 2012, we selected 48 patients who had pathologically confirmed early-stage NSCLC (stageⅠ, 18 cases;stageⅡ, 30 cases with N0). We treated the nidus by CT-guided percutaneous implantation of 125I radioactive seeds. Six months after implantation, the chest CT-scan was reviewed, and the effect of the treatment was evaluated according to the international standards. Final follow-up was performed in December 2013. Results:All operations were successfully completed. The target tumor matched peripheral doses (MPDs) were 215.8±14.3 Gy (D100), 106.8±11.6 Gy (D90), and 148.6± 17.3 Gy (D90>MPD). Six months after implantation, chest CT was reviewed, and treatment effects were evaluated. The percentages of stage I patients achieving complete relief (CR), partial relief (PR), stable disease (SD), and progressive disease (PD) were 27.8%(5 cases), 72.2%(13 cases), 0%, and 0%, respectively. Among stageⅡpatients, CR, PR, SD, and PD percentages were 0%(3 cases), 73.3%(22 cases), 13.3%(4 cases), and 3.3%(1 case), respectively. The effective rate was 89.6%. The 1-year local control rate was 85%. Until December 2013, the 1-, 2-, and 5-year cumulative survival rates up to the end of the interval were 95.8%(46/48), 81.3%(39/48), and 56.3%(27/48), respectively. Conclusion:CT-guided percutaneous implantation of 125I radioactive seeds is an effective micro-invasive method for treating inoperable early-stage NSCLC.

A 49-year-old male was admitted to Peking Union Medical College Hospital presented with fever for more than half a year. The patient was diagnosed as Sjogren′s syndrome at local hospital. After oral prednisone 60 mg per day was given, the fever alleviated, but recurred after prednisone tapered to 40 mg/d. Both blood culture and stool culture were positive for Salmonella enteritidis. Antibiotics including ceftazidime, ceftriaxone, cilastatin-imipenem were sequentially administrated for 4 weeks, yet not effective. Although there were not respiratory symptoms or certain abnormalities on high-resolution chest CT, arterial blood gas indicated hypoxemia. Serum lactate dehydrogenase and β2 micro-globulin were elevated, and the lung function test demonstrated significant impairment of diffusion function. Positron emission tomography-computed tomography (PET/CT)scan suggested that high fluorodeoxyglucose uptake was diffusely seen in both lungs. The patient was finally diagnosed as pulmonary intravascular large B-cell lymphoma (IVLBCL) by transbronchial lung biopsy. This case aims to emphasize the differentiation diagnoses of pulmonary intravascular lymphoma from common situations.

Objective To evaluate the application of fibrobronchoscopy in the management of severe brain injury with concurrent pulmonary infection. Methods Forty-three procedures of fibrobronchoscopic sputum clearance or bronchoalvelar lavage were performed in 26 patients with severe brain injury and concurrent pulmonary infection. The effect of fibrobronchoscopic treatment was assessed by observing the changes in the respiratory symptoms, arterial oxygen saturation (SaO2) and partial pressure of oxygen (PaO2) in these patients. Results The symptoms of the respiratory system, SaO2, and PaO2 of the 26 patients were significantly improved after fibrobronchoscopic treatment, which caused no serious complications. Conclusion Fibrobronchoscopy can be safely and effectively used in patients with severe brain injury complicated by pulmonary infection.