Objective: Through treatment based on differentiation of symptoms and signs and classification of defi nited patients of maternofetal blood group incompatibility, detecting anti-A or Anti-B antibody and erythrocyte immune complex chaplet rate(RICR) and erythrocyte receptor chaplet rate(RC3bR) , etc, to observe the therapeutic effect and mechanism of prescriptions mainly with Yinchenhao Decoction. Methods: Patients definited maternofetal blood group incompatibility were divided into control group and observation group according to random principle in 1:3 ratio. Then, observation group was divided into moist heat group(SRG), moist heat and defi ciency of spleen qi group (SR+PQXG) and moist heat and defi ciency of kidney qi group(SR+SQXG) according to syndrome differentiation. Corresponding prescriptions were used, every 30 doses 1 course. Before and after treatment, the anti-A or anti-B antibody and RICR, RC3bR were detected in peripheral blood. Results: In Yinchenhao Decoction group with 21 cases, the anti-A or anti anti-B antibody decreased, including 5 case (1:64) and 4 case (1:32). In group of syndrome differentiation with 63 cases, the anti-A or anti anti-B antibody decreased, including 33 case(1:64) and 20 case (1:32). Before and after treatment, RICR of control group and observation group were(19.43?5.29), (19.57?6.50)and (20.59? 7.96), (23.77?5.12), respectively. RC3bR were(11.62?4.16), (12.42?6.60)and(11.93?4.10), (13.96?6.40)respectively. There was signifi cant difference of before and after treatment in obserbation group(P0.05). Conclusion: In cutting down anti-A and anti-B antibody, and increasing RICR and RC3bR fi eld, the observation groups were better than control group.

Objective To investigate the expression of p53 in human ovarian neoplasms by tissue array technique Methods The expression of p53 protein in various ovarian tissues was studied by tissue array and immunohistochemistry Results The expression rate of p53 was 33% in ovarian cancers There were no expressions in normal ovarian tissues, benign ovarian neoplasms and borderline ovarian neoplasms( P 0 05) while p53 expression was associated with tissue types( P

Objective To compare the levels of four factors between gastric mucosa of Han and Tibetan patients with chronic gastritis residing in districts at the same altitude in Qinghai Province.Methods Levels of malonic aldehyde ( MDA) , superoxide dismutase (SOD) , nitric oxide ( NO) and xanthine oxidase (XOD) in gastric mucosa of Han and Tibetan patients with chronic gastritis resident in same altitude districts were examined, and a comparative study was performed.Results Levels of MDA and SOD were significantly higher in gastric mucosa of Han patients (2 2699 ± 1.58906 nmol/mgprot and 134.6313 ±48.35329 U/mgport, respectively) than those of the Tibetan (1.7095 ± 1.19474 nmol/mgprot and 109.5056 ± 28.26794 U/mgport, respectively) (P <0.05) , which indicated there were differences in metabolism of oxygen free radicals and antioxi-dant free radicals between 2 ethnics.However, there were no differences in NO and XOD levels between two ethnical groups, which suggested no ethnical difference in metabolism of the two factors.Conclusion There is ethnical difference in MDA and SOD metabolism in gastric mucosa of Han and Tibetan patients with chronic gastritis from same altitude district, which is presumably due to the different tolerance to the hypoxia at high altitude.

OBJECTIVEMinimal deviation adenocarcinoma (MDA) is frequently underdiagnosed in pathology tests due to its benign histopathological features. Therefore, its clinical and pathological characters need to be further analyzed and to establish useful immunohistochemical markers to improve the accuracy of pathological diagnosis.

METHODSClinical pathology data were of 13 MDA cases collected and analyzed in the First and Second Hospitals attached to the University, the pathological characters were compared with matched benign hyperplastic and atypical hyperplastic controls of the glandular epithelial cells to find histochemical and immunohistochemical indices valuable for the pathological diagnosis. 8 of these 13 cases were followed and their conditions were discussed.

RESULTSThe main clinical symptoms were watery leucorrhagia, enlargement of the cervix with erosion and hardening. Thickened ligaments were also detected in some cases. The pathological findings included hyperplasia and mild abnormality of the glands, invasion effects into the stroma could be observed in some glands and abortive glands with desmoplastic changes, or edema and inflammatory infiltration around the glands were also observed. The invasion presented in the deep part of the cervix as well, some were found near larger blood vessels or in the small vessels. Compared with benign glands, the immunohistochemical indices of most MDA glands were demonstrated as cancer embryo antigen (CEA) + + +, Ki-67 +--+ + +, P53 +--+ + +, AB/PAS +/+ +, and focal defect on the basement membrane.

CONCLUSIONSOnce any of the diagnostic characters summarized as above was determined, the probability of MDA should be seriously considered, at least atypical hyperplasia in cervical glands must be diagnosed, and follow-up on the patients and histological biopsy of deep tissues (> 5 mm) of the cervix will be necessary to determine the inclusion/exclusion of MDA. Obviously, a correct pathological diagnosis is extremely important for the patient to receive proper treatment in time and thereby improve her quality of life.

Adenocarcinoma ; pathology ; Adult ; Aged ; Cervix Uteri ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Middle Aged ; Uterine Cervical Neoplasms ; pathology

Objective To explore the effect of nursing of Traditional Chinese Medicine on cognitive function among aged people with mild cognitive impairment in elderly care institution. Methods A total of 66 cases with mild cognitive impairment elderly that previously were screened out from two pension institutions in Taiyuan city as the research objects. According to the endowment institutions where the objects of study dwelled was divided into control group (34 cases) and intervention group (32 cases). The intervention group accepted nursing of Traditional Chinese Medicine plan for four months. The control group received the disease related knowledge health education. The cognitive function of the two groups were assessed using the Montreal Cognitive Scale (MoCA) before and after the intervention. Results Before the intervention, two groups had no statistical significance in each dimension score and total score of MoCA. After the intervention, four dimensions scores including ability of visual spatial and execute , attention , delayed recall , directional force and the total score of the intervention group respectively were (2.67±1.09) points, (4.07±1.08) points, (1.97±0.81) points, (4.83±0.99) points, (18.80±1.74) points while the control group were (2.15 ± 0.71) points, (3.30 ± 0.63) points, (1.39 ± 0.97) points, (4.24 ± 1.41) points, (15.06 ± 2.98) points, and the difference was statistically significant (t=1.91-6.06, P < 0.05 or 0.01) ;Before intervention the language score, delayed recall score and the total score of the intervention group were (1.43±0.77) points, (1.57±1.10) points, (17.27±1.99) points, respectively while after the intervention were (1.80 ± 0.66) points, (1.97 ± 0.81) points, (18.80 ± 1.74) points, there was statistically significant difference (t =-2.16,-2.11,- 4.34, P < 0.05 or 0.01). Conclusions Nursing of Traditional Chinese Medicine can delay the process of cognitive decline of mild cognitive impairment in the elderly, and have a certain effect on prevention and treatment of patients with mild cognitive impairment.

Objective: To systematically evaluate the incidence and influencing factors of depression in family caregivers of Alzheimer's disease (AD) patients, so as to provide the basis for the prevention and treatment of depression among the family caregivers of AD patients. Methods: Publications pertaining to depression in family caregivers of AD patients were retrieved from CNKI, Wanfang Data, PubMed and other databases from the time of their establishment to June 15, 2023. The evaluation criteria recommended by the Agency for Healthcare Research and Quality (AHRQ) and the Newcastle-Ottawa Scale were used to assess the quality of cross-sectional and cohort studies, respectively. Stata 16.0 and Revman 5.4 softwares were used to conduct a meta-analysis on the incidence and influencing factors of depression in family caregivers of AD patients. Sensitivity analysis and publication bias assessment were also performed on the results. Results: A total of 2 324 articles were retrieved, and ultimately 14 articles were included, with a total sample size of 8 313 individuals. There were 6 high-quality articles and 8 moderate-quality articles. Meta-analysis showed that the incidence of depression in family caregivers of AD patients was 37.5% (95%CI: 30.2%-45.1%). Factors associated with depression included patients' high degree of dementia (OR=1.718, 95%CI: 1.059-2.789), patients' low scores on Activities of Daily Living Scale (OR=1.344, 95%CI: 1.059-1.706), patients' psychobehavioral abnormalities (OR=1.248, 95%CI: 1.155-1.348), long duration of caregiving (OR=1.998, 95%CI: 1.637-2.437), less involvement of other family members in caregiving (OR=1.597, 95%CI: 1.237-2.061), low educational level (OR=1.191, 95%CI: 1.044-1.359), poor caregiving skills (OR=3.060, 95%CI: 2.257-4.149), poor self-rated health (OR=2.536, 95%CI: 1.114-5.771) and social support (OR=0.424, 95%CI: 0.232-0.774). The results of depression incidence demonstrated good stability with no significant publication bias. However, publication bias was observed in the influencing factors for depression, which were patients' high degree of dementia and patients' low scores on Activities of Daily Living Scale. Conclusions The incidence of depression in family caregivers of AD patients ranges from 30.2% to 45.1%. It is primarily influenced by the severity of patients' symptoms and ability to perform daily activities, and caregivers' educational level, caregiving skills, health status, caregiving duration and social support.

Objective To determine the clinicopathologic characteristics and prognostic factors that may be used to predict the poor outcome of patients with borderline ovarian tumors. Methods All cases with borderline ovarian tumors treated in the West China Second University Hospital from January 2001 to June 2007 were analyzed retrospectively for elinicopathologic features, treatment parameters and outcome of treatment. Univariate and multivariate analyses were used to assess independent prognostic factors using the logistic regression model. Results The median age of 234 patients was 40. 1 years with a range of 14 to 80 years. There were 101 (43.2%), 94 (40.2% ) , 19 (8.1% ), 12 (5.1%) , 8 (3.4%) cases of serous, mutinous, mixed, endometrioid and clear cell tumors, respectively. Out of 234 cases, 182 (77.8%) underwent laparotomy and 45 ( 19.2% ) underwent laparoscopy. Seven women underwent laparoconversion. Fertility sparing surgery was performed on 119 cases (50.9% ) and radical surgery was performed on 115 cases (49.1% ). Totally 161 (68.8% ) patients had stage Ⅰ , 19 ( 8.1% ) had stage Ⅱ, 54 ( 23.1% ) had stage Ⅲ, and none had stage Ⅳ disease. Sixty-four women received postoperative chemotherapy. The median follow-up was 40 months with a range of 8 to 78 months. Recurrence was found in 26 cases (11.1%) during follow-up, and no tumor-related death was reported. The logistic regression model showed that surgery procedure ( OR=2.304, P=0.024), cyst rupture ( OR=2.213, P=0.038 ), stage ( OR= 4.114, P<0.01 ), microinvasion ( OR=2.291, P=0.046) and peritoneal implants ( OR=2.101, P = 0.016) were the five independent prognostic factors affecting recurrence. Conclusions Although patients with borderline ovarian tumors have an excellent prognosis, the risk of recurrence remains in some patients. Emphasis should be put on these patients with high risk factors and preventive strategies should be taken to prevent their progression.

OBJECTIVETo investigate whether DTI abnormalities in patients with nondemented subcortical ischemic vascular disease (SIVD) are correlated to general cognitive function and executive function independent of conventional MRI parameters.

METHODSSixty-six SIVD patients including 30 with cognitive impairment without dementia (VCIND) and 36 with normal cognition (NCI) underwent DTI and cognitive assessment of the general cognitive function and executive function. Conventional MRI parameters and DTI parameters were measured within the white matter lesions (WMLs), normal-appearing white matter (NAWM) and normal-appearing gray matter (NAGM). The independent predictors of general cognitive function and executive function in SIVD patients was analyzed.

RESULTSNCI and VCIND patients showed significant differences in the periventricular WMLs, ADC valus in NAWM and WMLs of the centrum semiovale, and FA values in NAWM of the anterior periventricular. Except for ADC values of the caudate nucleus, ADC and FA values in the subcortical NAGM showed significant difference between the two groups. After controlling for age and education, PVLs and ADC values in the WMLs and NAWM of the centrum semiovale and putamen, and FA values in the anterior periventricular NAWM, WMLs and putamen showed significant correlations to MMSE; the number of lacunar infarcts, ADC values in posterior periventricular NAWM and caudate nucleus, and FA values in anterior periventricular NAWM and thalamus showed significant correlations to CDT. Multivariate analysis showed independent correlations of the ADC values in WMLs and NAWM of the centrum semiovale to MMSE, and demonstarted correlations of the ADC values of the caudate nucleus and number of lacunar infarcts to CDT.

CONCLUSIONIn nondemented SIVD subjects, the integrity of the white matter in the centrum semiovale strongly correlates to the general cognition, and the microstructural damage of the caudate nucleus head predicts executive function impairment independent of other MRI variables.

Brain Ischemia ; pathology ; physiopathology ; psychology ; Case-Control Studies ; Caudate Nucleus ; pathology ; Cerebral Cortex ; pathology ; Cognition ; physiology ; Cognition Disorders ; pathology ; physiopathology ; Diffusion Tensor Imaging ; Humans ; Magnetic Resonance Imaging

Pure ovarian choriocarcinomas are extremely rare and aggressive tumors which are gestational or non-gestational in origin. Due to the rarity of the tumor, there is a lack of information on the clinicopathologic features, diagnosis, and treatment. We report a case of a pure ovarian choriocarcinoma, likely of non-gestational origin, treated by cytoreductive surgery in combination with post-operative chemotherapy. The patient was free of disease after a 12-month follow-up.
Choriocarcinoma ; Female ; Follow-Up Studies ; Humans ; Ovary ; Pregnancy

Objective:To investigate the predictive value of platelet reactivity for early neurological deterioration (END) in patients with acute ischemic stroke.Methods:Patients with acute ischemic stroke within 48 h of onset admitted to the Department of Neurology, the Affiliated Haikou Hospital of Xiangya School of Medicine, Central South University from January 2017 to March 2019 were enrolled prospectively. Aspirin was taken on the day of admission, and the platelet aggregation rate was detected using a PL-11 Platelet Function Analyzer 7 d after taking it. END was defined as the National Institutes of Health Stroke Scale (NHISS) score at any time point within 7 d after admission increased by ≥2 or the motor function item score increased by ≥1 from baseline. The demographics, baseline data, imaging examination and laboratory findings of patients in the END and non-END groups were compared. Multivariate logistic regression analysis was used to determine the independent risk factors for END. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of platelet aggregation rate for END. Results:A total of 230 patients were included in the study. They aged 63.24±9.75 years, 126 were females (51.4%). The median baseline NIHSS score was 6 (interquartile range, 4-10). The median time from onset to admission was 15 h (interquartile range, 9-28 h). There were 54 patients (23.5%) in the END group and 176 (76.5%) in the non-END group. There were significant differences in arachidonic acid-induced maximum platelet aggregation ratio (MAR-AA), epinephrine-induced maximum platelet aggregation ratio (MAR-EPI) and collagen-induced maximum platelet aggregation ratio (MAR-COL) between the END group and the non-END group (all P<0.05). Multivariate logistic regression analysis showed that MAR-AA (odd ratio [ OR] 1.165, 95% confidence interval [ CI] 1.091-1.243; P<0.001) and MAR-EPI ( OR 1.035, 95% CI 1.006-1.067; P=0.023) were the independent risk factors for END in patients with acute ischemic stroke. ROC curve analysis showed that MAR-AA had good predictive value for END, and the area under the curve was 0.775 (95% CI 0.707-0.843; P<0.001). The optimal cut-off value was 21.80%. The sensitivity and specificity of MAR-AA for predicting END were 72.2% and 77.3%, respectively. Conclusions:The platelet function measured by PL-11 is closely related to the risk of END in patients with acute ischemic stroke. It has a better predictive value for END.