Purpose To investigate clinicopathologic fea-tures of sacral cellular schwanoma and the difference from sacral conventional schwanoma.Methods Eight cases of sacral cellular schwanoma were collected.Microscopic examination and immunohistochemistry were performed for studying the clinical feature,radiologic appearance,pathologic characteristic,immunophenotyping,differential diagnosis and postoperative prognosis.Results There were 5 females and 3 males,whose mean age was 46.4 years.The majority of patients complained of pain in sacrococcygeal region.Radiographically,there was an endosacral or endosacral and presacal mass.Histologically,cellular schwannoma was composed of spindle cells,arranged in interlacing fascicles without nuclear palisading and Verocay bodies.Antoni A and Antoni B were not seen overtly.The destruction of bone was found.Immunohistochemically,tumor cells were diffusely and strongly positive for S-100 protein and vimentin.The mean of Ki-67 index was 6％.Tumor recurrence of 4 cases occurred several years after initial surgical resection.The mean interval to recurrence was 6.5 years.Conclusion Sacral cellular schwanoma is a rare tumor.Compared with sacral conventional schwanoma,it shows different growth pattern and pathologic features.So pathological diagnosis of the tumor should be noted for clinical follow-up and treatment.

Objective To investigate the diagnosis and treatment of cervical intraepithelial neoplasia and their clinical effect Methods The cases who were diagnosed as CIN through cytology, colposcopy biopsy and histopathological diagnosis were collected from January 2004 to June 2009 in Songjiang Hospital Affiliated to Shanghai Jiaotong University School. Drug therapy, physical therapy, cervical conization and hysterectomy were performed according to the lesion degree of CIN and patients' willingness. Some cases were further treated with surgery, radiotherapy or chemotherapy according to the pathological findings of the initial excision specimens. With long-term follow-up at 6,24 months after the treatment,we performed a comparative analysis on pathological diagnosis and therapeutic effects. Results Seven hundred and fifty cases of CIN were diagnosed after cervical cancer screening,among which,460 cases of CIN Ⅰ ,180 cases of CINⅢⅡ and 110 cases of CIN Ⅲ. Five hundred and Senventy-eight cases received treatment, among which, 46 cases received drug treatment After 6 months, focus disappeared in 32 cases, sustained in 10 cases, upgraded in 2 cases and canceration occurred in 2 cases. 13 cases received physical therapy,no recurrence occured. Four hundred and thirty-five cases received conization treatment, 34 cases with focus upgraded and 4 case recurred after the operation. 84 cases received hysterectomy, of which, 11 cases focus upgraded after the operation and no recurrence. The cases with focus upgraded or recurred all received additional treatment. The effective rate of physical therapy,conization treatment and hysterectomy on all grades of CIN was more than 98% at 2 years, and 69. 7% of drug treatment. The omission diagnostic rate of colposcopy guided biopsy on invasive carcinoma was 2. 2% , and the residual rate of focus of hysterectomy specimens after conization was 16. 2% . Conclusion Colposcopy including multi-point biopsy has high accuracy and specificity in early diagnosis of CIN . Cervical conization is the main method of the treatment of CIN. Patients with CIN Ⅲ and without desire of fertility should consider the removal of the uterus after cervical conization. Drug conservative therapy of CIN should be chosen carefully.

OBJECTIVE To investigate the effect of berberine on differentiation of rat bone marrow mesenchymal stem cells (MSCs) to adipocytes and its mechanism. METHODS Rat MSCs were isolated and cultured, adipocytic differentiation was induced with adipogenesis-inducing medium (AIM). Cells were assigned into 6 groups:normal control, AIM group, AIM+berberine 0.1, 0.3, 1 and 3 μmol·L-1 groups, respectively. Morphology characteristics of mesenchymal stem cells were observed under an inverted microscope and adipocyte levels were analyzed by oil O staining. Alkaline phosphatase (ALP) activity was detected using p-nitrophenyl phosphate as a substrate. The cell survival was determined by MTT assay. Expressions of peroxisome proliferator activated receptor γ (PPARγ), fatty acid binding protein (aP2) and CCAAT enhancer-binding protein α (C/EBPα) mRNA were detected by semiquantitative RT-PCR. RESULTS Compared with normal control group, MSCs adipogenic differentiation, PPARγ, aP2 and C/EBPα mRNA expression significantly increased in AIM group (P<0.01), ALP activity in AIM group significantly decreased (P<0.01). Compared with AIM group, berberine inhibited MSCs adipogenic differentiation (P<0.01) and berberine 0.1, 0.3, 1 and 3 μmol·L-1 increased ALP activity by 26%, 54%, 81% and 122%, respectively. Berberine 3 μmol·L-1 significantly downregulated PPARγ expression (0.91±0.10 vs 1.34±0.06) (P<0.01), aP2 (1.05±0.10 vs 1.53±0.09) (P<0.01) and C/EBPα mRNA (1.24±0.06 vs 1.54±0.09) (P<0.01). Berberine had no effect on proliferation of MSCs. CONCLUSION Berberine inhibits differentiation of MSCs into adipocytes, which might be closely related to the downregulation of PPARγ, aP2 and C/EBPα mRNA.

Objective To explore the different probability of carcinoma and the necessity of treatment in cervical columnar ectopy (CCE),normal smooth cervix and cervical intraepithelial neoplasia(CIN) by investigating the different expression of matrix metalloproteinase-9(MMP-9).Methods The expression of MMP-9 was detected by using immunohistochemical method in 30 cases of CCE,28 cases of CIN and 30 cases of normal smooth cervix from 2007 to 2012.Results The positive expression of MMP-9protein in CIN was 96.4％ (27/28),CCE was 23.3％ (7/30) and normal smooth cervix was 20.0％ (6/30)respectively.The positive expression of MMP-9 protein was higher in CIN than CCE and normal smooth cervix,the difference has statistical significance (P＜ 0.01),there was no significant difference between CCE and normal smooth cervix (P ＞ 0.05).Conclusions CCE,which was a physiological performance of cervical erosion,should not be overtreated.But the women of childbearing age should be routinely performed in cervical cancer screening.

Objective To investigate the relationship between p53,COX-2,Bax,c-myc genes and colorectal carcinoma complicated with chronic schistosomiasis. Methods One hundred and sixty patients with colorectal carcinoma were selected and divided into two groups;a schistosomiasis group(colorectal carcinoma complicated with chronic schistosomiasis,n=80)and a non-schistosomiasis group(colorectal carcinoma uncomplicated with chronic schistosomiasis,n=80). The tissue microarray tech-niques and immunohistochemistry method were used in all the patients to detect the expressions of p53,COX-2,Bax and c-myc proteins. Results The positive rate and level of p53 protein expression in the schistosomiasis group were lower than those in the non-schistosomiasis group,but there were no significant differences between the two groups(both P>0.05). The COX-2 protein in both groups was positive,but the positive expression level of COX-2 in the schistosomiasis group was higher than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). The positive rate and level of Bax protein expression were not significantly different between the two groups(both P>0.05). The positive rate of c-myc expression in the schistosomiasis group was higher than that in the non-schistosomiasis group,with a significant difference(P<0.01),but the positive expression level was lower than that in the non-schistosomiasis group,and there was a significant difference between the two groups(P<0.01). Conclusions Schistosome infection may impact on the deficiency of p53 of human colorectal cancer cells. It may promote the excessive expression of COX-2 protein,which is an indirect carcinogenic factor. The expression of Bax gene has no correlation with schistosome infection. The schistosome chronic infection may cause a persistent low level expression of c-myc gene.

Objective To study the feasibility and clinical significance of internal tourniquet (temporary arterial lumen blood flow occlusion by balloon catheter) for controlling the hemorrhage from traumatic neck and adjacent trunk arteries by temporarily occluding the arterial lumen blood flow.Methods The study involved 35 patients with traumatic neck and near trunk arteries who were firstly managed by internal tourniquet during operation to temporarily occlude the proximal aorta blood flow from May 1987 to February 2009.Each blocking time ranged from 30 to 70 minutes and the blocking was performed at an interval of 15 to 20 minutes.Then,surgical therapy was taken.Results After temporary proximal aorta blood flow occlusion with internal tourniquet,the operation presented few bleeding,with a clean operating field and clear anatomic structures.The total intraoperative blood loss was 100-400 ml.All patients were healed without ischemia of brains and limbs or relapse during the 3-14 years of followup.Conclusion Internal tourniquet,which can effectively reduce intraoperative blood loss and improve operation safety by temporarily occluding the proximal aorta blood flow,is an auxiliary approach for treating hemorrhage from traumatic neck and adjacent trunk arteries.

Objective To describe the prevalence and risk factors of insomnia among adults in YiBin City. Meth?ods Using multi-stage stratified cluster sampling, 12000 subjects over 18 years old were identified in YiBin City. The subjects were screened using the insomnia survey self-edited and risk factors of insomnia were identified through logistic analysis. Results A total of 11227 subjects completed the survey in which 1671 people (14.9%, 95%CI:14.2%~15.5%) were diagnosed insomnia using ICD-10. Among them, 9.4% (157 patients) had seeked for professional help. The multi?variate logistic analysis showed that low level of life quality(OR=2.42,P<0.01), jobless(OR=1.87,P<0.01), over 60 years old(OR=1.69,P<0.01), fewer years of education(OR=1.41,P<0.01), female(OR=1.41,P<0.01)and lower annu?al per capita income(OR=1.15,P=0.01)were risk factors in insomnia people. Conclusion The incidence of insomnia is high in YiBin city. Sleep quality in high-risk group needs more attention and corresponding measures should be taken in order to increase the rate of asking for help in insomnia people.

Tumor drug resistance is currently one of the most difficult clinical problems. There are many theories on the mechanism of tumor drug resistance, and metabolic reprogramming is one of its mechanisms. Tumor cells undergo metabolic reprogramming to meet the energy requirements of proliferation, especially the changes in the glucose metabolism. This article reviews the glucose metabolism reprogramming-related enzymes and the associated small molecule inhibitors that reverse tumor drug resistance.

To evaluate the implementation of Survey of oncomelanid snails (WS/T 563—2017) in schistosomiasis-endemic foci, two schistosomiasis-endemic counties were selected from two provinces of Sichuan and Anhui. Professional staff working in province-, city-, county- and township-level disease control and prevention institutions, parasitic disease control institutions or medical institutions were recruited, and the understanding, use and implementation of Survey of oncomelanid snails (WS/T 563—2017) were investigated using questionnaires and interviews. The awareness, use, proportion of propagation and implementation and correct rate of answering questions pertaining to Survey of oncomelanid snails (WS/T 563—2017) were analyzed. A total of 270 questionnaires were allocated, and 269 were recovered, including 254 valid questionnaires. The overall awareness of Survey of oncomelanid snails (WS/T 563—2017) was 84.64% (215/254), and propagation and implementation of Survey of oncomelanid snails (WS/T 563—2017) was not performed in 23.28% (17/73) of the survey institutions following implementation of Survey of oncomelanid snails (WS/T 563—2017), with meeting training and allocation of propagation materials as the main type of propagation and implementation. Among 254 respondents, 77.16% (196/254) were familiar with the standard, 66.14% (168/254) understood the conditions for use of the standard during snail surveys, and 96.85% (246/254) had the approach for identifying snails. In addition, there were 41.73% (106/254), 50.78% (129/254) and 7.48% (19/254) of respondents that considered the operability of Survey of oncomelanid snails (WS/T 563—2017) was very good, good and general, respectively. The findings demonstrate that the issue and implementation of Survey of oncomelanid snails (WS/T 563—2017) has filled the gap for the standardization of snail control techniques, and which plays an importang guiding role in the national schistosomiasis control program.