Objective:To investigate the clinical characteristics and therapy of laryngeal neuroendocrine carcinoma(LNEC).Method:Ten cases of LNEC treated in our department were retrospectively analyzed.Result:Eight out of 10 cases were were atypical carcinoid:1 case treated as supraglottic horizontal partial laryngectomy died 22 months after operation; 1 case was lost;the other 6 cases were followed up for more than 2 years. Two cases were small cell type,one received supra-cricoid partial laryngectomy-cricohyoidopexy (SCPL-CHP) ,neck dissection,and radiotherapy,but died after 14 months;the other was receiving radiotherapy.Conclusion:LNEC is a rare malignant tumor and the diagnosis relies on clinical characteristics, histopathological and immunohistochemistry examination. The different types of LNEC should give different treatment protocols.

Objective To observe the apoptosis of retina and the expression of caspase-3 in mice with premature myopia and to explore the pathogenesis of premature myopia.Methods Together 60 newborn C57BL/6J mice were selected and divided randomly into three groups (n =20):P6 group (opening the eyelid on day 6 after birth),P10 group (opening the eyelid on day 10 after birth) and normal group (opening the eyelid naturally).The right eyes of mice in the P6 and P10 group were subjected to lighting exposure,and the left eyes were left untreated serving controls with its right eyes;while the eyes in the normal group open naturally without any treatment.Then the refraction was checked on day 15 through retinophotoscopy,and ocular axial length was measured by micrometer with electronic digital display.TUNEL assay was used to determine retinal apoptosis.Immunohistochemistry and Western blot were used to detect the expression of caspase-3 in mice retina.Results The right eyes developed significant myopia in the P6 group [(-7.55 ±0.15)D] and P10 group [(-5.25 ±0.10)D],while the eyes in the normal group did not suffer from myopia,and there was significant difference in the three groups (P ＜0.05).The average axial length of right eyes in the P6 group [(2.49 ± 0.08) mm] and the P10 group [(2.51 ±0.03)mm] was shorter than that in the normal group [(2.58 ± 0.04) mm],with significant difference (P ＜ 0.05).Immunohistochemistry showed that the expression of caspase-3 had a dramatically increase in ganglion cell layer and inner nuclear layer of retina of mice in P6 group and P10 group.TUNEL results showed that brown-stained positive apoptotic cells appeared in ganglion cell layer in the P6 and P10 group,while Western blot showed that the expression of caspase-3 protein in mouse retina in P6 group (gray value 52.70％) and P10 group (gray value 35.76％) was upregulated.Conclusion Early lighting exposure can induce premature myopia of mice,and the earlier the mice receive light,the higher the relative degree of myopia is;meanwhile during the process of premature myopia,ganglion cells and nuclear layer cells suffer apoptosis,as well as caspase-3 protein involves in the occurrence of apoptosis.

Carcinoma, Non-Small-Cell Lung ; genetics ; Exons ; genetics ; Genes, erbB-1 ; genetics ; Humans ; Lung Neoplasms ; pathology

Purpose To analyze the clinicopathologic and immunohistochemical features, differential diagnosis and prognosis of papil-lary renal cell carcinoma (PRCC). Methods Thirty-two cases of PRCC diagnosed were reviewed. A retrospective study was per-formed including reviewing the clinical documents, pathological sections and immunohistochemical stainning and follow-up was made of 32 cases of PRCC. Twenty-one patients were treated with radical nephrectomy, eleven patients were treated with partial nephrectomy. Results Among 770 cases of renal epithelial tumors 32(4. 2%) cases of PRCC were detected. Histologically, the PRCC were charac-terized by varying proportions of papillary and tubular architecture covered by single or multiple layer of tumor cells with scanty or volu-minous basophilic or eosinophilic cytoplasm. Foam cells and psammoma bodies were seen in some papillary cores and stroma, and the cytoplasm of some tumor cells contained hemosiderin. Of these 32 patients, 18 and 14 were diagnosed type-Ⅰand type-IIPRCC, re-spectively. Type-I, with small cuboid cell and pale cytoplasm, 16 of them were low in Fuhrman grading, Type-II, with large colunmar cells, rich in eosinophilic cytoplasm, 12 of them were high in Fuhrman grading. Immunohistochemically, the PRCC showed positive immunostaining for vimentin, EMA, CK(AE1/AE3), CK7, CD10 and AMACR. All the tumors studied were negative for CK (34βE12) and TFE-3. Follow-up data were available for 31 cases, 4 patients died of cancer specific causes, 1 with type-Ⅰand 3 with type-II tumors after surgery. The other 27 patients were alive without recurrence or metastasis. High Fuhrman grading, intravascular tumor emboli, lymph node metastasis and high clinical stage were prognostic indicators in PRCC. Conclusions PRCC with unique pathological features is not a common subtype of renal cell carcinoma in China. The presence of higher nuclear grade, sarcomatoid ele-ments or clear cell carcinoma structure may indicate an aggressive biologic behavior and poor prognosis. Close attention to the cytologic and growth pattern characteristics will allow us to arrive at the proper diagnosis in most cases, although sometimes immunohistochemis-try and rarely molecular genetic evaluation may be needed.

Objective To investigate the clinical features and prognostic factors of Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis (EBV-HLH) in adults.Methods Clinical data of 40 adult patients with EBV-HLH admitted in the First Affiliated Hospital of Nanjing Medical University during January 2010 and September 2013 were retrospectively analyzed.The patients were divided into fatal group or survival group based on the results of 1-month follow-up.Logistic regression analysis was performed to identify risk factors of early death.Results EBV-HLH in clinic were characterized by fever,hepatosplenomegaly and lymphadenopathy.The incidences of peripheral blood cytopenias in 2 or 3 lines,hepatic dysfunction and hyperferritinemia in EBV-HLH patients were 60.0％ (24/40),95.0％ (38/40) and 94.9％ (37/39),respectively.Hemophagocytic phenomenon in bone marrow was observed in 83.8％ patients (31/37).Soluble CD25 (sCD25) was detected in 12 patients,and all were higher than 2 400 pg/mL.Nineteen patients died 1 month after fiual diagnosis with a fatality rate of 47.5％.Univariate logistic regression analysis indicated that EBV-DNA ＞ 105 copies/mL (OR =4.85,95％ CI:1.14-25.83,P ＜ 0.05),PLT ＜ 50 × 1012/L (OR =6.81,95 ％ CI:1.41-32.83,P ＜ 0.05),total bilirubin ＞ 50 μmol/L (OR =6.91,95％ CI:1.24-38.52,P ＜0.05),albumin ＜ 30 g/L (OR =7.50,95％ CI:1.80-31.28,P ＜ 0.01),serum ferritin ＞5 000 μg/L (OR =8.75,95％ CI:2.03-37.67,P ＜0.01) and polyserositis (OR =5.40,95％ CI:1.18-24.64,P ＜0.05) were risk factors of death within 1 month after final diagnosis,while chemotherapy was a protective factor of early death (OR =0.15,95％ CI:0.03-0.81,P ＜ 0.05).Conclusions EBV-HLH in adult has a poor prognosis.Significant elevated EBV-DNA,total bilirubin or serum ferritin,and notable decrease of peripheral blood platelet count or albumin level may indicate a poor prognosis,while chemotherapy may reduce the risk of early death.

The aims of microbiology experiment teaching are not only to cultivate the students’ capacity of basic operation,but also to expanse their knowledge scope.We applied the bacterial diversity on the teach-ing class to make the students understand the progress of microorganism genomics research.It is helpful to cultivate the students’ innovative spirit and ability.Easy to work,clear result and low cost facilitated the spread of this experiment in the university.

ObjectiveTo investigate the managements of complications during and after peroral endoscopic myotomy (POEM) for esophageal achalasia (EA).MethodsData of 119 EA patients who underwent POEM from October 2010 to July 2011 were collected.Complications during and after POEM and during follow-up were analyzed.Results Complications during operation included bleeding in 19 patients ( 16.0％ ),mucosa rupture in 9 (7.6％),mediastinal and subcutaneous emphysema in 27 (22.7％ ) and pneumothorax in 3 (2.5％ ).Complications occurred at the night of procedure included pain in 43 (36.1％ ) patients and pneumothorax in 7 ( 5.9％ ).Postoperative complications included asymptomatic pneumothorax in 23 patients (19.3％),delayed hemorrhage in 1(0.8％),pleural effusion in 58 (48.7％ ),minor pulmonary inflammation or segmental atelectasis in 59 (49.6％),emphysema of mediasti-na and subcutaneous tissue in 76 (63.9％ ),and gas under diaphragm or aeroperitoneum in 47 (39.5％ ).Complications during follow-up included one case of dysphagia caused by stricture of mucosa and one case of dehiscence at the tunnel entry with food retention.No POEM-correlated death occurred.All the complications were cured by conservative treatments.No additional surgery was needed.ConclusionMain complications as emphysema of mediastina and subcutaneous tissue,pneumothorax,aeroperitoneum and bleeding during and after POEM can be treated timely and effectively with conservative treatment.

Objective To observe the effects of early intravenous administration of Astragalus on brain inju-ry in neonates with severe asphyxia. Methods According to hospital serial number, 80 neonates with severe as-phyxia were divided into conventional treatment group (control group) (n=40), which was on the basis of symp-tomatic support treatment for the use of cerebrolysin and citicoline treatment; Astragalus injection treatment group (n=40), which, apart from the conventional treatment, Astragalus injection was given as soon as possible (within six hours after birth). The incidence of convulsions or frequent seizures convulsions and the mortality in two groups, the clinical degree of hypoxic ischemic encephalopathy (HIE) and the behavior nerve score determination were ob-served and compared. Results The incidence of convulsions or frequent seizures convulsions was significantly lower in the Astragalus treatment group than in the control group (45.00% vs 67.50%, χ24.501,P<0.05). The per-centage of the behavior nerve score determination in 7 d-8d and 12 d-14d after birth was obviously lower in the for-mer group than the latter one (48.57% vs 74.19%, χ2 4.642,P<0.05; 31.42% vs 58.06%, χ24.601, P<0.05). The mortality was not significant different between the two groups (12.50 % vs 22.50%, χ22.000, P>0.05). Conclusion For severe asphyxia neonates, on the basis of the symptomatic support treatment, the use of Astragalus injection, as soon as possible, can significantly reduce the hypoxic ischemic brain injury.

Objective To analyze risk factor of bile duct injury (BDI) during laparoscopic cholecystectomy (LC). Methods A retrospective population-based cohort study was carried out on 13878 patients undergoing LC from Apr 1994 to Dec 2003. Patients were divided into BDI group and non-BDI group. Factors with statistically significant differences between groups in anivariable analysis were selected to construct a multivariate logistic regression mode. Result Among 13878 LC procedures 38 BDI (0.27%) were identified. Factors which were of significant differences between groups in anivariable analysis includ diameter of common bile duct(?~2=5.92, P

To study the relationship between the late postmortem interval (PMI) and trimethylamine-nitrogen (TMA-N) in postmortem tissues of cadaver, TMA-N in muscles, livers and kidneys of rats was measured at different postmortem intervals (PMI) by using a modified spectrophotometric method. The results indicated that the detection sensitivity of TMA-N was 1 mg/L, and there was a good linear correlation between the value of absorbance (A value) and TMA-N at the concentration of 1-10 mg/L (R (2) = 0.9991). Although TMA variation in muscles was different from that in inner organs during the time since death, TMA-N changes in cadaver tissues was positively correlated with PMI. During 2 to 7 d since death, the best correlation between PMI and TMA-N concentration was found in muscles. With PMI as an independent variable, the cubic polynomial regression equation was y= -0.457x(3)+6.519x(2)-24.574x+27.207 (R (2)=0.969). During 3 to 8 days since death, PMI was best correlated with TMA-N concentration in inner organs. With PMI as the independent variable, the cubic polynomial regression equation was y=0.509x(3)-9.153x(2)+55.727x-95.819 (R (2)=0.953). It was concluded that TMA-N in tissues could be used as a new estimator for late PMI. The method used in this study offered advantages such as accuracy, sensitivity, little samples required and wide PMI estimation.
Cadaver ; Forensic Pathology ; Methylamines/*analysis ; Nitrogen/*analysis ; Pilot Projects ; Postmortem Changes ; Random Allocation ; Rats, Sprague-Dawley ; Spectrophotometry ; Time Factors