OBJECTIVETo investigate the reproducibility of Gleason scores for prostate cancer.

METHODSBased on the revised Gleason Scoring System of the International Society of Urological Pathology ( ISUP) , we analyzed the reproducibility and difference of Gleason scores in 49 cases of prostate cancer using the methods of combination and grouping.

RESULTSThe total reproducibility of Gleason scores among 15 pathologists was good (κ = 0.642), 62.2% by the combination method, the highest in Gleason 5 + 5 (81.2%) and 5 +4 (73.3%), then in Gleason 4 + 4 (67.5%), 3 + 3 (64.0%), 4 +3 (61.3%), and 3 + 4 (44.0%), and the lowest in Gleason 4 + 5 (38.9%) and 3 + 5 (33.3%). The total reproducibility of Gleason scores by the grouping method was 71.4%, the highest in Gleason 9-10 (84.9%) , then in Gleason 7 (76.7%) and 6 (64.0%), and the lowest in Gleason 8 (60.7%).

CONCLUSIONThe reproducibility of Gleason scores remains to be further improved in prostate cancer, mainly concerning the understanding of Gleason 3 and 4 carcinoma.

Objective To understand the incidence of abnormal glucose metabolism during pregnancy and the maternal and neonatal outcomes after standard management.Methods A retrospective study of maternal and neonatal outcomes was conducted in 1490 pregnant women who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology of First Hospital of Peking University from Jan 1995 to Dec 2004 by reviewing the medical records.The selected cases consisted of 79 women with diabetes mellitus(DM group),777 with gestational diabetes mellitus(GDM group),including 355 cases of A1,316 with A2 and 106 cases unclassified,and 634 with gestational impaired glucose test(GIGT group).Maternal and fetal outcomes were analysed in comparison with the controls of 19 013 pregnant women with normal glucose metabolism who delivered during the same period.Results(1)The total incidence of gestational abnormal glucose metabolism was 7.3% and increased gradually from 1995 to 2004.The first stage,from Jan 1995 to Dec 1999,saw a slow increase in the incidence [4.3%(376/8739)];the second stage,from Jan 2000 to Dec 2001,showed a fast increasing trend.The average incidence was 10.8%(445/4133).The incidence in the third stage kept stable at 8.9% (678/7640)from Jan 2002 to Dec 2004.(2)The incidence of macrosomia,preeclampsia and preterm birth were 12.1%(180/1490),9.5%(141/1490)and 9.4%(140/1490),which were significantly higher than those women with normal glucose metabolism(P0.05).(3)The perinatal mortality rate(PMR)of abnormal glucose metabolism group was 1.19%(18/1513)which was significantly higher in the DM group (4.93%)than GDM(1.14%)and GIGT groups(0.78%,P

Objective To assess the effect of peroxisome proliferator-activated receptor γ (PPARγ) agonist on prostate epithelial cells in vitro.Methods The expression of peroxisome proliferator-activated receptor γ(PPARγ) was studied by immunocytochemistry and immunofluorescence study.The RWPE-1 human prostate epithelial cell line was treated with PPARγ agonist rosiglitazone 100 μmol/L for 48 h.Analysis of apoptosis was performed by Caspase 3/7 activity assay.Mitochondria depolarization was measured by using the potential-sensitive color,JC-1.The expression of apoptosis-related proteins-Bax was investigated by immunohistochemistry.Results PPARγ mainly located in nucleus and perinucleus.RWPE-1 cell line treated with PPARγ agonist rosiglitazone showed higher Caspase 3/7 activity (10636±1032 RLU) than in control (5936±620 RLU),P＜0.01 and significantly upregulated Bax level (8250±694 vs.6017±563)than in control group,P＜0.01.In addition,mitochondrial membrane potential was depolarized in rosiglitazone treated cells.Conclusions PPARmay play important roles in the pathophysiology of BPH.The mechanism might be that PPARγ regulates cell apoptosis.It is suggested that the mitochondrial and Bax pathway might be involved in signaling PPARγ induced cell apoptosis.

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods

AIM: To analyze the characteristics of neurological ophthalmology manifestation of patients with neurosyphilis. · METHODS: Retrospective and nonrandomized case analysis were used. Totally 22 cases of 39 eyes were included. They were 17 males and 5 females, aged from 34 to 65 years old. The average age were 49. 6 years old. ·RESULTS: The optic nerve atrophy presented in 11 cases of 22 eyes. One eye of them accompanied by left eye oculomotor nerve palsy;5 eyes in 3 cases expressed as optic neuritis acute phase;neuroretinitis appeared in 4 cases of 6 eyes; 1 case of 2 eyes expressed as chorioretinitis accompanied by optic disc edema; central retinal artery occlusion were found in 1 case of 1 eye. Argyll-Robertson pupil was as only manifestation in 2 cases of 3 eyes. In all cases, Argyll-Robertson pupil signs can be seen in 19 eyes. Treponema pallidum particle agglutination test ( TPPA) were positive in all 22 cases. Syphilis rapid plasma reactin test ( RPR ) were positive in 19 of 21 cases. All patients underwent lumbar puncture and cerebrospinal fluid were detected for RPR, cerebrospinal fluid protein, white blood cell count. Cerebrospinal fluid RPR were positive in 13 cases. Cerebrospinal fluid protein were greater than 450mg/L in 18 cases. Cerebrospinal fluid white blood cell count were greater than 5/mm3 in 13 cases. · CONCLUSION: Neurosyphilis involving neuro -ophthalmology often occurs in middle-aged men and subacute onset. Both eyes can suffered from optic nerve disease simultaneously or sequencely. A few can be expressed as other cranial nerve palsy, which may lead to misdiagnosis. Considering medical history, clinical manifestations, ophthalmic examination, serum and cerebrospinal fluid laboratory tests can improve the diagnostic rate.

ObjectiveTo evaluate the diagnostic performance of bone SPECT and CT fusion imaging in bone metastases from pediatric neuroblastoma.MethodsTwenty-four pediatric patients with neuroblastoma were included in this retrospective study.All patients underwent planar imaging and SPECT integrated with CT.Lesion visibility,diagnostic certainty and diagnostic performance were evaluated with KolmogorovSmirnov test andx2 test.ResultsLesion visibility of SPECT alone,SPECT integrated with CT were significantly better than that of planar imaging ( both H =69.000,P ＜ 0.05 ).SPECT and CT fusion imaging,SPECT alone both detected five more bone lesions than planar bone imaging (77 vs 72).The diagnostic accuracy of SPECT imaging (62.34％,48/77 )was significantly higher than that of planar imaging (45.45％,35/77; x2 =4.416,P ＜ 0.05 ).The sensitivity,specificity and accuracy of SPECT and CT fusion imaging for diagnosing malignant bone lesions were significantly higher than those of planar imaging:82.35％ (42/51) vs 53.19％ ( 25/47),88.46％ ( 23/26 ) vs 40.00％ ( 10/25 ),84.42％ ( 65/77 ) vs 45.45％ (35/77 ; x2 =12.571,14.016,25.667,all P ＜ 0.01 ).The diagnostic specificity and accuracy of SPECT and CT fusion imaging were significantly higher than those of SPECT alone ( 53.85％,14/26 ;62.34％,48/77) (x2 =7.589,9.606,both P ＜0.01 ).However,there was no significant difference of sensitivity between the two methods (x2 =2.942,P ＞ 0.05 ).Diagnostic certainty by SPECT and CT fusion imaging was significantly higher than that by SPECT alone ( H =28.000,P ＜ 0.05 ) and by planar imaging (H =21.000,P ＜ 0.05).ConclusionSPECT and CT fusion imaging can detect more bone lesions in patients with pediatric neuroblastoma.It is helpful for diagnosing bone metastases from pediatric neuroblastoma.

Objective To evaluate the clinical value between peritoneal lavage cytology (PLC) and prognosis of gastric cancer. Methods The peritoneal lavage fluid of 60 gastric cancer patients and 12 noncancer patients were collected,different methods were used to examine the exfoliated cancer cells,and relationships between positive results and relative clinico-pathological parameters were evaluated.Results The positive rate of PLC was 31.8%,and was positively correlated with the degree of histologic differentiation of gastric cancer (P0.05). The postoperative one-year recurrence and survival rates of the positive and negative groups were significantly different(P

Colchicine ; Forensic Medicine

Objective To explore the effect and mechanism of electroacupuncture at Baihui(GV20) and Zusanli(ST36) of patients with depression.Methods90 patients were randomly divided into group A electroacupunctured at Baihui(GV20) and Zusanli(ST36), group B electroacupunctured at Taichong(LR3), Sanyinjiao(SP6), Neiguan(PC6), and Shenmen(H7) and group C treated with Fluoxetine (20 mg/d, 6 weeks). The therapeutic effect was assessed by the Hamilton Depression Rating Scale (HAMD) before and after treatment. Serum cytokine levels (IL-2, IL-4, and IFN-γ) were measured by ELISA assay at admission and after treatment (6 weeks).ResultsCompared to pre-treatment, the mean levels of HAMD ( P<0.01)and IL-4 (P <0.01) decreased significantly in all groups after treatment. Rank distribution of HAMD scores had obvious difference between all groups. The mean levels of IL-2 and IFN-γ had no significant difference in group C after treatment (P>0.05). And the mean levels of IL-2 and IFN-γ increased significantly in groups A and B after treatment(P<0.01, P<0.05).ConclusionElectroacupuncture takes effect earlier than fluoxetine for depression. Electroacupuncture at Baihui(GV20) and Zusanli(ST36) was more effective than the other two methods. The three types of treatments can restore three types of cytokines and improve depressive syndrome.

Objective To explore the changes of neutrophil elastase (NE) and surfactant protein A (SP-A) in acute lung injury(ALI) rats,and the effect of antioxidant. Methods Sixty healthy mature Wister rats were divided into 2 groups, the control group and treatment group. The rats in two groups all received peritoneal injection of E. coli to establish the ALI animal model. 30 minutes after injection of E. coli,the rats in treatment group were injected reduced glutathione from vena caudalis. The levels of NE in blood and expressions of SP-A in lung tissue were detected at 3,6 and 12 hours after injection of E. coli. Results ALI symptom appeared 3 hours after injection of E. coli in the control group, obvious after 6 hours, the rats vomi-ted pink secretion after 12 hours. Lung edema and bleeding were found by pathologic examination. No obvious symptom was found in treatment group after 3 hours, slight tachypnea after 6 hours, slight edema in pulmonary tissue after 12 hours. After administration of reduced glutathione,levels of NE at 3,6 and 12 hours in the treatment group were lower than those in the control group,and indicated statistical significance in 6 and 12 hours(P <0. 05) ;Levels of SP-A in 3,6 and 12 hours in the treatment group were higher than those in the control group, and indicated statistical significance in 3,6 and 12 hours (P < 0. 05). Conclusion Dysfunction of pulmonary surfactant is secondary in ALI, degradation of SP-A is the one of reasons, the application of reduced glutathione as antioxidant, could effectively suppress NE to decompose basosexine elastin of cells and destroy surface active protein, has protective effect on ALI.