Objective:Reporting a rare case with Kimura's disease and angiolymphoid hyperplasia with eosinophilia (ALHE), who also has nephrotic syndrome resulting from minimal change glomerulopathy. Methods: Histological manifestations, immunohistochemical staining, immunofluorescence staining, and electron microscope were performed. Results: One 37-year-old male patient with recurrent erythra, cutaneous node, painless cervical lymph node enlargement and nephrotic syndrome in 5 years. It's confirmed through biopsies that the subcutaneous node is ALHE, the cervical lymph node is kimura disease, and renal lesion is minimal change glomerulopathy. Conclusion: Kimura disease and ALHE may be different features of the same disease, and may complicate glomerulopathy.

Objective:To assess the expression of specific virulence-associated Helicobacter pylori (Hp) genotypes, (cag A, vac A, and ice A status) in primary gastrointestinal B cell lymphoma. Methods: Forty-nine paraffin wax embedded tissues were analyzed by immunohistochemical staining and poly-merase chain reaction. Results:There were 14 cases of mucosa associated lymphoid tissue lymphoma ( MALT-L) (8 in stomach, and 6 in intestine) and 35 cases of diffuse large B cell lymphoma (DLBCL) (21 in stomach, and 14 in intestine) in all. The positive rates of vac A s1 ,vac A s2 ,vac A m2,ice A 1 and cag A were 50. 0% ,42. 9% ,50. 0% , 14. 3% and 85. 7% in MALT-L; 57. 1% ,40. 0% ,25. 7% , 5.7% and91.4% in DLBCL, respectively. Conclusion:High toxicity cag A + Hp strains.seem to play a role in the pathogenesis of gastrointestinal B cell lymphoma, whereas vac A m2 may be more associated with MALT-L. Clinical stage was not associated with virulence-associated Hp genotypes.

Objective:Primary nodal and extranodal diffuse large B-cell lymphoma(DLBCL)were investigated for the heterogeneity of histopathology and immunophenotype,and their relation to clinical stage,comparatively.Whether E2F1 can be used as a germinal center B cell(GCB)DLBCL marker was also discussed.Methods:Classification of histopathology and immunophenotype of 98 cases were studied by immunohistochemistry in tissue microarray.Results:Histopathologic morphology presented as:centroblastic(CB,88.8%,87/98),immunoblastic(IB,5.1%,5/98),anaplastic(ALCL,3.1%,3/98),and T cell rich B cell lymphoma(TCRBCL,3.1%,3/98).Of which,31 cases were GCB DLBCL,10(20.8%,10/48)nodal,and 21 extranodal(42%,21/50,P=0.024).The rates of Stages Ⅰ/Ⅱ in nodal and extranodal area were 48.5% and 70%,respectively(P=0.015).The rate of Stage Ⅰ/Ⅱ in GCB DLBCL(74.2%)were higher than in non-GCB DLBCL(50.7%,P=0.029).The CD10 positive rates were 36.8% and 17.1% in Stages Ⅰ/Ⅱ and Ⅲ/Ⅳ,respectively,and had significant differences(P=0.033).The CD10 positive rates were 18.8% and 38% in nodal and extranodal area,respectively(P=0.035).The positive rates of E2F1 were 38.8% and 16.5% in GCB and non-GCB DLBCL,respectively,and had significant differences(P=0.016).The positive rate of E2F1 had positive relation with the expression of CD10 and Bcl-6(P

Objective To discuss the clinical effects of locking proximal humerus plate (LPHP)for humeral proximal fractures in elderly patients.Methods A total of 84 elderly patients with humeral proximal fractures were retrospectively analyzed.Patients were randomly divided into LPHP group and control group (n=42,each group).Patients in LPHP group were treated with open reduction and internal fixation using LPHP.Patients in control group were treated with open reduction and Kirschner wire fixation.All patients were followed up for 1 year and the shoulder joint function was evaluated.Results There were no significant differences in bleeding volume and the wound healing time between LPHP group and control group [(189.2±27.5) ml vs.(177.6±28.2) ml,(102.3±6.2) days vs.(99.9±6.8) days,t=1.78,1.33,P=0.079,0.105,respectively].One year after the follow-up,there were 22 cases (52.4％,22/42) with excellent clinical evaluation,18 cases (42.9％,18/42) with good clinical evaluation and 2 cases (4.8％,2/42) with poor clinical evaluation in LPHP group,and 15 cases (35.7％,15/42) with excellent clinical evaluation,22 cases (52.4％,22/42) with good clinical evaluation,and 5 cases (11.9％,5/42) with poor clinical evaluation in control group.There was a significant difference in the evaluation rate of excellent and good clinical efficacy between in LPHP group and in control group (95.2 ％ vs.88.1 ％,x2 =3.18,P 0.028).Conclusions The internal fixation using LPHP has a good clinical effect in elderly patients with humeral proximal fractures,and it can well improve the recovery of shoulder joint function.

Objective: To investigate primary gastrointestinal B cell non Hodgkin’s lymphoma for clinicopathological features, proliferation, apoptosis and its association with Helicobacter pylori (HP). Methods: Classification of tumors, expression of HP, proliferation and apoptosis related gene products were studied by immunohistochemistry. Apoptosis was studied by TUNEL (TdT [terminal deoxynucleotidyl transferase] dUTP nick end labeling). Results: There were 15 cases of mucosa associated lymphoid tissue (MALT) lymphoma (9 in stomach, 6 in intestine) and 42 cases of diffuse large B cell lymphoma (DLBCL) (28 in stomach, 14 in intestine) in all the 57 cases of primary gastrointestinal BCL. The average apoptotic indexes (AI) were 0.16%, 2.54% in MALT lymphoma and DLBCL respectively. The average proliferation indexes (PI) were 2.22% and 8.71%,respectively. The p53 positive rates were 6.7% and 35.7%. PI ( P =0.026) and p53 ( P =0.044) had significant differences; But Bcl 2 positive rates were 60.0% and 35.7%,and HP positive rates were 66.7% and 23.8%, respectively. HP had significant differences ( P =0.005). Conclusion: HP and gastrointestinal MALT lymphoma had significant relation. Apoptosis and proliferative activity were higher in DLBCL than in MALT. The higher Bcl 2 expression in MALT may be related to lower apoptosis. p53 promotes apoptosis and p53 gene mutation may play a role in the progression from MALT to DLBCL. HP antibody may be used in HP detection in gastrointestinal BCL.

Lymphocytic hypophysitis(LH) is a rare but increasingly recognized autoimmune endocrine condition that causes partial or total hypopituitarism and is often associated with peripartum young women.We here report a 28-year-old patient who had a spontaneous and uneventful pregnancy following LH that had been treated with transspenoidal surgery and followed by anti-inflammatory agent.The woman failed to lactate and developed frontal headaches 3 months after normal delivery of her first child 3 years ago.Lab test showed the reduced concentrations of thyroxine,estradial and cortisol,suggesting hypopituitarism.Magnetic resonance imaging of the brain with contrast was performed and showed a uniformly enhancing pituitary mass with elevated optic chiasm.She underwent transsphenoidal surgery and histological examination of the resected specimen was consistent with lymphocytic hypophysitis.Anti-inflamation was started with prednisolone 40 mg per day because of a recurrence of headache that had completely recovered after surgery and regularly withdrawn to a long term maintenance dose of 10 mg per day.Physiological thyroxine replacement therapy was maintained.Her menstruation was restored without sex hormone replacement after 3 months.Three years after surgery,she got pregnant spontaneously and had normal breastfeeding after delivery.LH did not recur during this peripartum.

Objective The effect of fertilizer application on yield and quality of Notopterygium forbesii was studied in order to provide a theoretical basis for high quality and yield planting.Methods With various nitrogenous(N) and phosphorous(P) fertilizer formula,the field tests were carried out to determine the yield,extract content,and essential oil content,from the root of N.forbesill.Results Showed that various proportion of fertilizer had a great affect on yield,extract content,and essential oil content,and the treatment with N2P2 was the highest.The yield in the treatment with N2P2 increased 43.33%,the extract content increased 17.95%,and the essential oil content increased 43.48% as compared with CK.Different rates of fertilizer application had a certain effect on weight and diameter in the root of N.forbesii,and the N2P2 was the best.Each treatment had a significant effect on diameter in the root of N.forbesii in comparision with CK.Conclusion Amount and ratio of N and P fertilizers have a greater influence on the yield and quality,while improper application could reduce the yield and quality.

Objective To observe the expression of PAX-2 and PTEN in different types of endometrial lesions, and to study their relationship with endometrial intraepithelial neoplasia (EIN). Methods 60 cases of endometrial hyperplasic lesions and 70 cases of endometrial carcinoma were enrolled. All cases were reclassified by using the diagnostic criteria of EIN, and PAX-2 and PTEN were stained to compare the difference among them. Results The deletion rates of PAX-2 in benign hyperplasia, EIN and endometrial carcinoma were 39.5 % (15/38), 72.7 % (16/22) and 78.6 % (55/70), respectively, and there was a statistical difference (χ2= 21.664, P= 0.000). The deletion rates of PTEN in benign hyperplasia, EIN and endometrial carcinoma were 47.4%(18/38), 54.5%(12/22) and 75.7%(53/70), respectively, and there was no statistical difference (χ2=2.878, P=0.411). Conclusion The staining of PAX-2 could be considered as a reliable adjuvant diagnostic method in the diagnostic criteria of EIN, however, the loss of PTEN just should be regarded as a suggestion of EIN, not a confirmed diagnostic basis.

ObjectiveTo explore the clinical diagnosis and surgical treatment of primary retroperitonealneurilemoma(schwannoma). MethodsClinicaldataof 47patientsof primary retroperitoneal schwannoma admitted and surgically treated from January 1995 to December 2009 were retrospectivelly reviewed.ResultsAs diagnosed by pathology there were 36 cases of Benign schwannoma,with a median age at onset of 41years, among those 11 patients were symptomatic, and 25 were asymptomatic. There were 11 malignant 11 cases, the median age was 38 years, among those 6 patients were symptomatic, and 5 were asymptomatic. The positive diagnostic rate of preoperative CT and MRI were 36. 2％ ( 17/47 ) and 58. 3％ ( 7/12 ) respectively. Immunohistochemically positive rates of S-100 were 100％ and 81.8％(9/11) in benign and malignant group respectively.All cases underwent surgical treatment. Surgical resection rates for benign and malignant groups were 100％ and 90. 9％(10/11)respectively. There was no perioperative death, Overall 5-year survival rates were 100％ and 45.5％ for benign and malignant tumors groups respectively. In benign group 2 cases recurred, in malignant group 4 cases recurred, and 3 had distant metastasis.ConclusionsPrimary retroperitoneal schwannomas are less common. It is difficult to make an accurate preoperative diagnosis. Surgery is the most effective therapy.Prognosis is good for benign and poor for malignant retroperitoneal neurilemomas.

Objective To investigate the surgical treatment strategies and prognostic factors of cT4bM0 primary rectal cancer.Methods The clinical data of 53 patients with cT4bM0 primary rectal cancer who were admitted to the First Hospital of Peking University from January 2000 to December 2010 were retrospectively analyzed.All the patients received en-bloc multivisceral resection and postoperative chemotherapy.The survival and prognostic factors were analyzed.The patients were followed up via out-patient examination,phone call or mail,and the follow-up was ended till December 2012.The survival curve was drawn using the Kaplan-Meier method,and the survival was analyzed using the Log-rank test.Uni-and multivariate analysis were done using chisquare test and COX's proportional hazard model.Results Of all the 53 patients,20 received posterior pelvic exenteration (PPE),20 received total pelvic exenteration (TPE),3 received low anterior resection (LAR) +local resection of ballder,2 received LAR + ovariectomy,2 received LAR + local resection of ureter,1 received LAR + local resection of posterior vaginal wall,1 received LAR + vesiculectomy and vesectomy,3 received abdominoperineal resection (APR) + local resection of posterior vaginal wall,1 received APR + sacrectomy.R0 resection was achieved in all the patients.No intraoperative death was observed,and the incidence of postoperative complication was 9.4％ (5/53).The results of postoperative pathological examination showed that 2 patients were with well-differentiated adenocarcinoma,41 with moderate-differentiated adenocarcinoma,and 10 with poorly differentiated adenocarcinoma.Twenty-four patients were with lymph node metastasis.Four patients were in TNM stage Ⅰ,25 in TNM stage Ⅱ and 24 in TNM stage Ⅲ.Fifty-three patients were followed up postoperatively,and the median time for follow-up was 33 months (range,4-116 months).The overall 5-year survival rates was 57.3％.The 5-year survival rate for patients with or without lymph node metastasis were 77.1％ and 30.4％,respectively,with significant difference between the 2 groups (x2 =7.374,P ＜ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion mere 51.0％ and 68.5％,with no significant difference (x2=1.148,P ＞0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅱ were 74.6％ and 85.7％,with no significant difference between the 2 groups (x2=0.118,P ＞ 0.05).The 5-year survival rates of patients with malignant infiltration and inflammatory adhesion in stage Ⅲ were 28.8％ and 37.5％,with no significant difference between the 2 groups (x2 =0.959,P ＞ 0.05).The results of univariate analysis showed that lymph node metastasis and TNM stage were the risk factors influencing the prognosis of patients with cT4bM0 primary rectal cancer (x2=6.468,6.596,P ＜ 0.05).The results of multivariate analysis showed that lymph node metastasis was the independent risk factor (RR =3.797,P ＜ 0.05).Conclusions En-bloc multivisceral resection should be the first surgical treatment choice for patients with cT4bM0 primary rectal cancer,and lymph node metastasis is the independent risk factor.Under the same N stage,the prognosis of patients with malignant infiltration or inflammatory adhesion is similar if R0 resection is achieved.