Objective To investigate the clinicopathologic and immunohistochemical characteristics of breast carcinosarcoma with osteosarcoma components and its differential diagnosis. Methods The pathologic features and clinical manifestations of the two patients were retrospectively reviewed. Immunohistochemistry was performed and the literature was reviewed. Results Histopathologically, the neoplasm consisted of invasive ductal carcinoma of no special type and poorly ( case 1 ) or well (case 2) differentiated osteosarcomatoid elements. The morphological transition from carcinoma to sarcomatoid elements was seen. Immunohistochemically,the carcinoma cells were positive for CK and EMA , the sarcomatoid elements were stained positive for vimentin, and a few cells of two elements were positive for S-100 protein. Ki-67 and VEGF were over expressed in both elements of Case 1.In case2 Ki-67 expression was low in both elements and VEGF over expression was only seen in sarcomatoid elements. Some of the carcinoma cells were positive for ER. Conclusions Carcinosarcoma of the breast with osteosarcomatoid elements is a rare type of mixed epithelial/mesenchymal metaplastic breast carcinoma. The types and proportion of carcinoma and sarcomatoid elements determine the diagnosis.

Objective To study the clinical characteristics of elderly sleep apnea syndrome (ASA). Methods 329 SAS patients diagnosed by 7-hour polysomnography(PSG) were classified into the aged and the middle aged groups. Results Both the body mass index(BMI) and neck circumference were significantly lower in the aged group than those in the middle aged group(P

Objective To isolate and culture the hair follicle Bulge cells of rats and study their morphological, immunological characteristics. Methods Hair follicle Bulge obtained by micromanipulation and enzyme digestion was cultured in intro. The morphological features and numbers of Bulge cells were identified and counted with light microscopy. Immunocytochemical staining was used to detect expressing of K19 and ?_ 1integrin in cultured cells. Results Bulge cells after enzyme digestion pasted rapidly. Cells were small and round, paving stone-shape, and had a large ratio of nuclear to cytoplasm. The characteristics suggested a primitive morphologic feature. Cells growth well and could maintain low differentiation and higher reproductive activity, they co-expressing K19 and ?_ 1integrin, immunofluorescence staining showed the cells expressed ?6-integrin strongly, weakly or no expressing CD71. Conclusion This culture system can amplify a lot of pure hair follicle Bulge cells in short time. We successfully isolate and culture the hair follicle Bulge cells of rats in intro and can keeping its property for a long time.

Objective:To analyze the clinical effect and safety of Lingdan tablets and Wuling capsules in the treatment of alopecia areate. Methods:Totally 84 patients with alopecia areate were divided into the observation group and the control group with 42 ones in each. Minoxidil tincture was used for external in the two groups. The control group were treated with 0. 9 g Lindan tablets, tid, for 4 months and the treatment group was additionally treated with 0. 99 g Wuling capsules,po,tid, for 4 months. The changes in the area and position of trichomadesis, light pull test, the tissue growth score and Pittsburgh Sleep Quality Index ( PSQI) score were compared before and after the treatment. Results:The efficacy of the observation group was better than that of the control group(P<0. 05). Af-ter the treatment, the evaluated indices in the two groups were lower than those before the treatment(P<0. 01), and the reduction of the observation group was more significant than that of the control group(P<0. 01) . There was no notable adverse reaction appeared in the observation group. Conclusion:Lingdan tablets and Wuling capsules can improve sleeping quality, promote the growth of halr and enhance the curative effect.

Objective To construct an scientific quality evaluation system of master academic dis-sertation in post graduates majored in professional clinical medicine, which provides the basis for measuring the level of scientific research and the quality of graduates. Method a preliminary evaluation index system of master academic dissertation in post graduates majored in professional clinical medicine was established by literature review, expert interview and panel discussion, and the given indexes were conducted on the clinical and medical education experts by a two-round Delphi methods. Result According to the character-istics of the graduate training, combined with expert opinion, 6 primary indexes, 18 secondary indexes and 42 third-level indexes were contained. With calculating the weight of all levels of indicators, the final quality evaluation system of master academic dissertation in post graduates majored in professional clinical medicine was built. Conclusion The system is a highly scientific index system and reliable, which can reflect and emphasize the master's requirements and characteristics of the training, so as to be used as a measuring stan-dard for evaluating master academic dissertation in post graduates majored in professional clinical medicine.

Objective:To study the inhibition of astragaloside on the proliferation of human keloid fibroblasts. Methods: Com-pared with that of normal skin, the expression of transforming growth factor-β( TGF-β) and its transduction factors Smad in the human keloid fibroblasts was detected. The optimal concentration was screened by MTT after HFF-1 human skin fibroblast was infected with astragaloside at different concentrations. The mRNA expression of Smad2, Smad3, Smad4 and Smad7 in the fibroblasts was studied by using real-time. The protein expression of TGF-βRⅡ, Smad2, Smad3, Smad4 and Smad7 in the fibroblasts was detected by using Western blot. Results: Compared with that of normal skin tissue, the expression of Smad protein was significantly increased ( P <0. 05) in the human keloid fibroblasts, and there was no significant difference in the TGF-βRⅡ expression (P>0. 05). The optimal concentration of astragaloside was 0. 5μg·ml-1 . The expression level of Smad2 protein in the two groups was significantly increased, and the level of Smad3 expression was significantly decreased (P<0. 05). Conclusion:Astragaloside can inhibit the formation of fi-broblast possibly through Smad2 over-expression and Smad3 inhibition in the TGF-β/Smad signal transduction pathway.

Objective To investigate the feasibility of the transdifferentiation of hair follicle bulge cells into corneal epithelial cells in vitro. Methods The hair follicle bulge cells from 7- to 8-day SD rats were isolated and cultured in vitro, then co-cultured with rabbit corneal limbal stroma in transwell-cultured system. The differentiation and development of hair follicle bulge cells were observed, and immunocytochemical staining were used to detect expression of K19 and K12 in hair follicle bulge cells. Results The cultured bulge cells possesed high proliferation and low differentiation, co-expressed K19 and ?_ 1 integrin, but part of them expressed K12 after 2-week co-culture with rabbit corneal limbal stroma in transwell-cultured system. Conclusion Rat hair follicle bulge cells could transdifferentiate into corneal epithelial cells induced by corneal limbal stroma in vitro.

Objective The color of the syphilis quality control material adopted by most detection institutes was the same with the detected serum sample and they were all colorless,transparent or light yellow.There were cases of wrong adding,missing adding or insufficient adding due to the color of quality control materials which was hard to distinguish with naked eyes.To avoid this phenomenon,a new method was established for the distinction of quality control materials.Methods A new method of syphilis quality control materials that had been improved three concentrations control materials:0.125,0.250 and 0.500 NCU/mL.The syphilis diagnostic kit that was created by Shanghai Kehua and Xiamen Yingke was adopted to conduct detection and compare results.Results The difference between stained quality control material and unstained quality control materials had no statistical significance (P＞0.05).Two different reagents were used to detect quality control materials of different concentration for 20 times and the CV were 11.7 ％-13.4％ and 9.3 ％-12.9 ％ respectively.Two different reagents were used to detect quality control materials of different concentration for 30 days and the CV range were 10.1 ％-13.4 ％ and 8.08 ％-12.8 ％.Conclusion Citric yellow staining does not influence the properties of syphilis control materials and it can be used stably for a long time.It is suitable for clinical lab application and promotion.

Objective To study the effect of astragaloside on proliferation and apoptosis in human keloid fibroblasts.Methods The human keloid fibroblast ceils were treated with different concentration of astragaloside(10、20、40 ng/mL).Cell proliferation was detected by MTT,the gene expreesion levels and protein levels of apoptosis-related proteins,survivin,p53 and Bcl-2.were determined by real-time PCR and Western blot,respectively.Results Comparecl with control group(treated with 0 ng/mL astragaloside),the absorbance values (A490 nm) of each concentration group were significantly reduced,which suggest that the proliferation of all keloid fibroblast were markably inhibited in a dose-dependent way (P＜0.05).The gene expreesion levels and protein levels of apoptosis-related proteins,survivin、Bcl-2 were largely suppressed and P53 werelargely promoted in a dose-dependent.Conclusion The keloid fibroblasts cells proliferation and apoptosis could be regulated by astragaloside.

Objective To study the clinical significance of chromosome karyotyping in pregnant women with a history of abnormal pregnancy. Methods The fetal chromosome karyotypes of 1 193 pregnant women with a history of abnormal pregnancy in Peking University First Hospital from January 4, 2005 to December 31, 2013 were analyzed. According to the etiology of their previous abnormal pregnancy, these women were divided into four groups: 273 women had children with inherited metabolic disorders or single-gene genetic diseases (group A), 81 women had children or fetuses with chromosome abnormalities (group B), eight cases had an abnormal chromosomal karyotype in either husband or wife (group C), and 833 women had abnormal pregnancy of unknown causes(group D). Results Forty-eight [4.0%(48/1 193)] and fetuses were found to have abnormal chromosomal karyotypes, including 26 cases of chromosome polymorphism variations and 22 cases of numerical and structural abnormalities (four cases of trisomy 21, four cases of numerical sex chromosome abnormalities, three cases of trisomy 18, three cases of extra small chromosome mosaicism, three cases of reciprocal translocation, one case of Robertsonian translocation, one case of chromosome six inversion between the arms, one case of chromosome three inversion between the arms, one case of mosaicism of trisomy 14 and one case of structural abnormality of chromosome 14). In group A, four cases (1.5%) of chromosomal abnormalities of clinical significance and four cases of chromosome polymorphism variations were detected. Meanwhile, 61 fetuses with inherited metabolic disorders or single-gene genetic diseases and two cases of gene mutation carriers were detected in group A, but among whom, there were no abnormal chromosome karyotype cases. In group B, two cases (2.5%) of chromosomal abnormalities were found. In group C, two cases (2/8) of reciprocal translocation were found, whose karyotypes were the same as the parents. In group D, three cases of trisomy 21, three cases of trisomy 18, two cases of extra small chromosome mosaicism and two cases of numerical sex chromosome abnormalities were found. All the mothers in this group were of advanced age. Four cases of structural abnormalities and 22 cases of chromosome polymorphism variations were also found in this group, chromosomal analysis was subsequently performed in those couples, and found that the abnormal chromosomal karyotypes in the fetuses were the same as those in the parents. Conclusions Appropriate prenatal cell genetic diagnostic methods should be chosen according to the causes of abnormal pregnancy history.