Objective To study the clinicopathological characteristics,diagnosis and prognosis of anaplastic large cell lymphoma,lymphohistiocytic variant(ALCL-LH).Methods Two cases of ALCL-LH were diagnosed according to the WHO standard of lymphoma classification.Their clinical manifestations were analyzed.Lymphoma sample sections were prepared for pathological features and immunohistochemical assays,and examined by in situ hybridization for Epstein-Barr virus(EBV)DNA.Concerning literatures were reviewed.Results Both 2 cases occurred in children.The clinical manifestations presented with fever and enlarged lymph nodes as well as hepatomegaly and splenomegaly.Microscopically,the neoplastic cells,with irregular nuclei,were more often medium to large in size but smaller than those in the common type,and sparsely intermixed with a large number of histiocytes and lymphocytes that exceeded and masked the tumor cell population.The tumor cells clustered around blood vessels.Case 1 showed evidence of erythrophagocytosis.Immunohistochemical stainings showed that tumor cells of 2 cases were positive to CD30,anaplastic lymphoma kinase(ALK),EMA,and Granzyme B,as well as case 1 to CD43,and case 2 to CD7.But both cases were negative to CD45,CD2,CD3,CD4,CD5,CD8,CD45RO,CD56,CD20,CD79a,CD15,MPO,CK,TdT,and LMP1.In addition,the EBV DNA was not detected in the lymphoma.Case 1 and case 2 died 10 d and 3 months after pathological diagnosis respectively.Conclusion ALCL-LH variant is rare subtype,and often occurs in pediatric patients.Morphologically,ALCL-LH is characterized by a few medium to large size cells admixed with a large number of histiocytes and lymphocytes that exceed and mask the tumor cell population.The expressions of CD30,ALK,EMA and cytotoxic granule associated proteins contribute to diagnosis and differential diagnosis.

The latest WHO classification of tumors is the most important standard for clinicpathologic diagnosis of pathologists in medical practice.We should study,grasp,and apply it to medical practice for need of patients and ourselves.

Objective To investigate the relationships between expressions of HPV and EBV in larynge-al carcinoma. Methods DNA flow-through hybridization and gene chip genotyping technology(HybriMax)and real-time quantitative PCR were used for 37 subtypes of HPV detection and quantitative detection of EBV in 101 cases of laryngeal cancer paraffin embedded tissue specimens. 43 cases of vocal cord polyp of paraffin embedded tissue specimens were used as the controls. Results The positive rate of laryngeal carcinoma was 13.86% in group HPV and 9.3% in the control group ,with no statistically significant difference between the positive expres-sions of HPV in the laryngeal carcinoma group and control group(P>0.05). The positive rate of laryngeal carci-noma was 63.37% and 13.95%,respectively ,in group EBV ,and the control group ,with significant difference between them(P < 0.05). In respect of the positive rate by comparing differently differentiated EBV in laryngeal carcinoma ,there was no significant difference in the positive expression of EBV in well differentiated and differen-tiated laryngeal carcinoma(P>0.05),but the difference was statistically significant in highly differentiated EBV as compared with those with low differentiation type,medium differentiation and poor differentiation(P < 0.05). There was no significant difference between the groups in view of sex ,age and course of disease in the patients (P > 0.05). Conclusions The incidence of laryngeal carcinoma is closely related with EBV infection ,possibly relationed with HPV and high-risk subtypes of HPV have a certain role in the process of induced laryngeal carcino-ma. The gender ,age and duration of disease have no significant correlation with EBV infection. This study will provide a basis for further invesgitation of pathogenesis of laryngeal cancer and prevention and treatment of larynge-al cancer.

Background Asthma is a complex disease involving genetic and environment interactions.Atopy is a strong risk factor for asthma.The airway epithelium not only forms a physical barrier but also provides immune defense against harmful materials.To explore the effects of airway epithelium on asthma,we hypothesized that environmental injuries could act on bronchial epithelial cells and damage the physical barrier,which might facilitate allergens to stimulate immunoreactions and play an important role in the pathogenesis of asthma.Methods Thirty eight-week-old male Wistar rats were randomly divided into five groups with six rats in each group:control group,asthma group,ovalbumin (OVA)+OVA group,lipopolysaccharide (LPS) group and LPS+OVA group.In the control group,0.9％ saline was injected intraperitoneally on day 1.Fourteen days later,the rats were exposed to aerosolized 0.9％ saline.In the asthma group,the rats were sensitized with an injection of 10 mg of OVA,followed by an aerosolized 2％ OVA challenge14 days later.The OVA+OVA group was sensitized by an inhalation 2％ OVA,20 minutes a day,from day 1 to day 7,and then OVA challenged in the same way as the asthma group.In the LPS group,LPS (200 μl,1 μg/μl) was given by airway on day 1 and day 3,with a simultaneous aerosol inhalation of 2％ OVA for 20 minutes a day from day 1 to day 7.Fourteen days later,the rats were challenged with saline as in the control group.While in the LPS+OVA group,LPS (200 μl,1 μg/μl) was given by airway on day 1 and day 3,with a simultaneous aerosol inhalation of 2％ OVA for 20 minutes a day from day 1 to day 7.Fourteen days later,the rats were challenged with OVA as in the asthma group.The expression of interleukin (IL)-4,interferon-gamma (IFN-y) and thymic stromal lymphopoietin (TSLP) in the lungs was detected by reverse transcription polymerase chain reaction (RT-PCR) and the pulmonary pathological changes were also observed.The level of IL-4,IFN-γ and IgE in plasma was detected by enzyme-linked immunosorbent assay (ELISA).Bronchoalveolar lavage fluid (BALF) was collected to conduct differential cell counts.Flow cytometry analysis was also used to count Th1 and Th2 cells.Results The pathological changes in the LPS+OVA group were similar to the asthma group,while in other groups,the pathological changes were not obvious.The ratio of lymphocytes in BALF,IL-4/IFN-γ in plasma and the expression of the TSLP and IL-4 in the asthma and LPS+OVA groups were higher than in the control group and the OVA+OVA group (P ＜0.05).The level of IgE was higher in the asthma,LPS and LPS+OVA groups than in the control group and the OVA+OVA group (P ＜0.05).By flow cytometry analysis,the Th1/Th2 ratio was lower in the LPS+OVA and asthma groups than in other groups (P ＜0.05).Conclusions The experiment results show that the injury to the bronchial epithelial layer may be the initial event of allergic responses.This finding implies that a rational approach to therapeutics would be to increase the resistance of the airways to environmental injuries rather than concentrating on suppressing inflammation.

In order to solve the problem of resistance of Pseudomonas aeruginosa to multiple antibiotics, it is an effective way to find inhibitors of P. aeruginosa efflux pump. In this study, 15 new ornithine peptidomimetic derivatives were designed and synthesized by changing the side chain structure of natural amino acids with PAβN, a dipeptide efflux pump inhibitor, and their synergic activity with aztreonam, a monocyclic β-lactam antibiotic, against P. aeruginosa was evaluated. Among them, the representative compound 12b not only enhanced the antibacterial activity of β-lactam antibiotics aztreonam, ceftazidime and meropenem, but also significantly enhanced the antibacterial action of macrolide antibiotics clarithromycin, showing a broad-spectrum synergic sensitization effect. In addition, compound 12b also has a good safety. Preliminary mechanisms suggest that 12b works by directly targeting the efflux transporter MexB. These results provide a new lead compound for the development of a new class of efflux pump inhibitors against P. aeruginosa.

BACKGROUNDPulmonary embolism (PE) can be difficult to diagnose in elderly patients because of the coexistent diseases and the combination of drugs that they have taken. We aimed to compare the clinical diagnostic values of the Wells score, the revised Geneva score and each of them combined with D-dimer for suspected PE in elderly patients.

METHODSThree hundred and thirty-six patients who were admitted for suspected PE were enrolled retrospectively and divided into two groups based on age (≥65 or <65 years old). The Wells and revised Geneva scores were applied to evaluate the clinical probability of PE, and the positive predictive values of both scores were calculated using computed tomography pulmonary arteriography as a gold standard; overall accuracy was evaluated by the area under the curve (AUC) of receiver operator characteristic curve; the negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were calculated.

RESULTSNinety-six cases (28.6%) were definitely diagnosed as PE among 336 cases, among them 56 cases (58.3%) were ≥65 years old. The positive predictive values of Wells and revised Geneva scores were 65.8% and 32.4%, respectively (P < 0.05) in the elderly patients; the AUC for the Wells score and the revised Geneva score in elderly was 0.682 (95% confidence interval [CI]: 0.612-0.746) and 0.655 (95% CI: 0.584-0.722), respectively (P = 0.389). The negative predictive values of D-dimer, the Wells score combined with D-dimer, and the revised Geneva score combined with D-dimer were 93.7%, 100%, and 100% in the elderly, respectively.

CONCLUSIONSThe diagnostic value of the Wells score was higher than the revised Geneva score for the elderly cases with suspected PE. The combination of either the Wells score or the revised Geneva score with a normal D-dimer concentration is a safe strategy to rule out PE.

Aged ; Aged, 80 and over ; Angiography ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Male ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; metabolism ; Retrospective Studies

Objective To investigate the correlation between circulating uncoupling protein 2(UCP2) level and severity of coronary artery disease(including Gensini score and criminal vessel counts)in patients with stable coronary artery disease(SCAD),and to analyze the predictive value of circulating UCP2 and urine acid (UA)for SCAD. Methods Three hundred and thirty patients from June 2015 to June 2017 were enrolled. Two hundred and forty patients with SCAD(SCAD group),90 patients without coronary artery disease(control group) were diagnosed. The circulating UCP2 level was detected by enzyme linked immunosorbent assay (ELISA) sandwich method. Results The levels of circulating UCP2 and UA in SCAD group were higher than those in the control group(UCP2[1.60(0.67,4.60)ng/mL]vs.[0.42(0.28,0.59)ng/mL](P<0.01),UA[(365.74 ± 66.06) μmol/L] vs. [(268.11 ± 45.81)μmol/L],P < 0.01). Multivariate logistic regression analysis showed that UCP2 (OR = 1.010 ,95% CI :1.001 ~ 1.020 ,P = 0.025)and UA(OR = 1.039 ,95% CI :1.007 ~ 1.072 ,P < 0.05)were independently associated with SCAD. Correlation analysis showed that the circulating UCP2 level was positively correlated with Gensini score(r=0.780,P<0.01)and criminal vessel counts(r=0.543,P<0.01). The receiver operating characteristic curve(ROC)showed that the optimal cutoff point of the circulating UCP2 level predicting SCAD was 0.64 ng/mL,and the sensitivity was 0.833 and the specificity was 0.944. No significant difference was observed in area under the curve between circulating UCP2 and UA(ΔAUC). Conclusion The high circulating UCP2 level indicates more severe coronary lesions in patients with SCAD. Circulating UCP2 level may be a new indicator of predicting SCAD,equal to the traditional oxidative stress related indicator of serum UA.

OBJECTIVETo study the clinicopathologic features, immunohistochemical findings and prognosis of primary diffuse large B-cell lymphoma (DLBCL) of testis.

METHODSFourteen cases of primary DLBCL of testis, diagnosed according to the 2001 World Health Organization staging standards for hematopoietic and lymphoid tumors, were retrospectively studied. Immunohistochemical study was performed and follow-up information analyzed.

RESULTSThe median age of the patients was 62 years. There were 10 patients in stage I, 3 in stage II and 1 in stage IV. Follow-up information was available in 11 patients (78.6%). Three of which were still alive and eight died (with duration of survival ranging from 5 to 19 months). The patients usually presented with unilateral painless enlargement of testis. Histologically, the lymphoma cells of all cases showed a centroblastic appearance. One case belonged to the germinal center B cell-like subtype on immunohistochemical study, while the remaining 13 cases were classified as non-germinal center B cell-like subtype. Ten of the 14 cases (71.4%) showed overexpression of p53 protein. Most cases demonstrated high proliferation index. Six of the 14 cases (42.9%) were positive for bcl-2 protein. The overall 1-year, 2-year and 5-year survival rates were 45.5%, 17.0% and 17.0%, respectively.

CONCLUSIONSMost cases with primary DLBCL of testis were of peripheral activated B-cell origin. The prognosis is usually not favorable, with propensity of local relapse and systemic dissemination. Accurate pathologic diagnosis relies on detailed histologic examination and immunohistochemical study.

Adult ; Aged ; Aged, 80 and over ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Germinoma ; drug therapy ; metabolism ; pathology ; surgery ; Humans ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; surgery ; Male ; Middle Aged ; Neprilysin ; metabolism ; Orchiectomy ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins c-bcl-2 ; metabolism ; Retrospective Studies ; Seminoma ; pathology ; Survival Rate ; Testicular Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; Tumor Suppressor Protein p53 ; metabolism ; Vincristine ; therapeutic use

BACKGROUND/AIMS: Previous studies have revealed that mast cells (MCs) may activate the protease-activated receptors and release of neuropeptides involved in the pathogenesis of irritable bowel syndrome (IBS). The levels of protease-activated receptor 2 (PAR-2) and tryptase can contribute to understanding the pathogenesis of IBS. METHODS: Colonoscopic biopsies were performed of 38 subjects (20 with IBS-diarrhea [IBS-D], eight with IBS-constipation [IBS-C], and 10 healthy volunteers). The mRNA and protein levels of tryptase and PAR-2 were assessed by real-time PCR and Western blot. The levels of vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) were measured by immunohistochemistry, and MCs were counted by toluidine blue staining. RESULTS: Significant increases in the mRNA expression of tryptase (p<0.05, IBS-D, IBS-C vs control) and PAR-2 (p<0.05, IBS-D, IBS-C vs control) and in the tryptase protein level (p<0.05, IBS-D, IBS-C vs control) were detected in IBS. Elevations of MCs, CGRP, VIP and SP (p<0.05, IBS-D vs control) were observed for IBS-D only. CONCLUSIONS: Tryptase levels may upregulate the function of PAR-2, resulting in the release of neuropeptide and they were correlated with clinical symptoms associated with IBS.
Biopsy ; Blotting, Western ; Calcitonin Gene-Related Peptide ; Immunohistochemistry ; Inflammation ; Irritable Bowel Syndrome* ; Mast Cells ; Neuropeptides ; Real-Time Polymerase Chain Reaction ; Receptor, PAR-2* ; Receptors, Proteinase-Activated ; RNA, Messenger ; Substance P ; Tolonium Chloride ; Tryptases* ; Vasoactive Intestinal Peptide

BACKGROUNDAsthma is a complex disease involving genetic and environment interactions. Atopy is a strong risk factor for asthma. The airway epithelium not only forms a physical barrier but also provides immune defense against harmful materials. To explore the effects of airway epithelium on asthma, we hypothesized that environmental injuries could act on bronchial epithelial cells and damage the physical barrier, which might facilitate allergens to stimulate immunoreactions and play an important role in the pathogenesis of asthma.

METHODSThirty eight-week-old male Wistar rats were randomly divided into five groups with six rats in each group: control group, asthma group, ovalbumin (OVA) + OVA group, lipopolysaccharide (LPS) group and LPS + OVA group. In the control group, 0.9% saline was injected intraperitoneally on day 1. Fourteen days later, the rats were exposed to aerosolized 0.9% saline. In the asthma group, the rats were sensitized with an injection of 10 mg of OVA, followed by an aerosolized 2% OVA challenge 14 days later. The OVA + OVA group was sensitized by an inhalation 2% OVA, 20 minutes a day, from day 1 to day 7, and then OVA challenged in the same way as the asthma group. In the LPS group, LPS (200 µl, 1 µg/µl) was given by airway on day 1 and day 3, with a simultaneous aerosol inhalation of 2% OVA for 20 minutes a day from day 1 to day 7. Fourteen days later, the rats were challenged with saline as in the control group. While in the LPS + OVA group, LPS (200 µl, 1 µg/µl) was given by airway on day 1 and day 3, with a simultaneous aerosol inhalation of 2% OVA for 20 minutes a day from day 1 to day 7. Fourteen days later, the rats were challenged with OVA as in the asthma group. The expression of interleukin (IL)-4, interferon-gamma (IFN-γ) and thymic stromal lymphopoietin (TSLP) in the lungs was detected by reverse transcription polymerase chain reaction (RT-PCR) and the pulmonary pathological changes were also observed. The level of IL-4, IFN-γ and IgE in plasma was detected by enzyme-linked immunosorbent assay (ELISA). Bronchoalveolar lavage fluid (BALF) was collected to conduct differential cell counts. Flow cytometry analysis was also used to count Th1 and Th2 cells.

RESULTSThe pathological changes in the LPS + OVA group were similar to the asthma group, while in other groups, the pathological changes were not obvious. The ratio of lymphocytes in BALF, IL-4/IFN-γ in plasma and the expression of the TSLP and IL-4 in the asthma and LPS + OVA groups were higher than in the control group and the OVA + OVA group (P < 0.05). The level of IgE was higher in the asthma, LPS and LPS + OVA groups than in the control group and the OVA + OVA group (P < 0.05). By flow cytometry analysis, the Th1/Th2 ratio was lower in the LPS + OVA and asthma groups than in other groups (P < 0.05).

CONCLUSIONSThe experiment results show that the injury to the bronchial epithelial layer may be the initial event of allergic responses. This finding implies that a rational approach to therapeutics would be to increase the resistance of the airways to environmental injuries rather than concentrating on suppressing inflammation.

Animals ; Bronchi ; pathology ; Cell Count ; Cytokines ; physiology ; Disease Models, Animal ; Epithelial Cells ; pathology ; Hypersensitivity ; etiology ; Immunoglobulin E ; blood ; Interferon-gamma ; blood ; Interleukin-4 ; blood ; Lipopolysaccharides ; toxicity ; Male ; Ovalbumin ; immunology ; Rats ; Rats, Wistar