Objective:To study the clinicopathological features of mixed epithelial and stromal tumor of the kidney(MESTK). Methods:Clinical and pathological characteristics of one case of MESTK was stu-died. Results:A case of MESTK which uncommonly occurred in a 16-year old adolescent male presented with dysuria and a large mass in the right renal region without a history of estrogen/progestogen treatment and/or obesity or urogenital surgery. Radiology revealed a large cystic/solid mass within the right kidney. Grossly, it was well demarcated and had a solid and cystic appearance on sectioning. Microscopically, the tumor was composed of a mixture of stromal and epithelial components. The epithelial component was composed of flat to columnar cells forming glands or tubules. The stromal components essentially consisted of bland, loosely packed spindle cells in an edematous and myxoid background. In some areas, there were smooth muscle cells forming bands and fascicles but no ovarian-type stroma was present. Immunohistochemical staining revealed that the epithelial components were positive for AE1/AE3 and focally positive for estrogen receptor(ER),progesterone receptor(PR), CD10 and Vimentin, whereas the stromal components were positive for ER, PR, Desmin and smooth muscle actin(SMA). Both epithelial and stromal components were negative for HMB-45, S-100,?-inhibin and WT-T. Five months after resection, the patient was well without evidence of recurrence. Conclusion:MESTK occurred in a pubertal male, as in the current case, supports the hypothesis that proliferation of remnants of the primitive mesenchyme in the kidney in situation of sex-steroid abnormity may play an important role in the pathogenesis of male MESTK.

Objective To investigate the necessity and feasibility of setting up elective course of children's paychological problems in medical colleges and universities.Methods The course was practiced by using varied teaching methods such as theory teaching,psychological chat show video,seminar,students speaking,writing paper and etc.Results The attendance was more than 95％ and more than 90％ students submitted the lesson summary and spoke positively in classroom.The scores of 90％ students were more than 80 points and the course evaluation results were good.Conclusion It's important to set up this elective course and this course is worth further developing.

Mesoporous silica nanoparticles as drug carrier have become the new hot point in the field of biomedical application in recent years. This review focuses on the more recent developments and achievements on experimental design aspect of mesoporous silica nanoparticles with cancer diagnosis and therapy. The key advances of functionalization strategies of mesoporous silica nanoparticles with controlled release, tumor targeting and overcoming multidrug resistance are discussed in particular. Mesoporous silica nanoparticles as unique delivery systems have the potential to provide significantly a sound platform for cancer theranostic application.

Objective:To evaluate right heart remodeling and right heart function change after pulmonary resection by echocardiography (ECG) .Methods:A total of 50 patients undergoing pneumonectomy received ECG examination to evaluate right ventricular structure and right heart function change before and after partial pulmonary resection .Re-sults:(1) Compared with before operation , there were no significant changes in right ventricular anterior free wall thickness ,right ventricular ejection fraction on 7d and 30d after operation;(2) Compared with before treatment , there were significant rise in pulmonary artery systolic pressure [PASP ,(20.52 ± 2.46) mmHg vs .(49.65 ± 2.17) mmHg] ,pulmonary artery diastolic pressure [PADP ,(10.82 ± 2.04) mmHg vs .(21.93 ± 1.26) mmHg] and pul-monary artery mean pressure [PAMP ,(13.78 ± 3.67) mmHg vs .(26.67 ± 3.28) mmHg] ,and significant rise in pulmonary vascular resistance [PVR ,(187.69 ± 12.46) dyn .s .cm-1 vs .(368.72 ± 11.94) dyn .s .cm-1 ] on 7d after pulmonary resection , P<0.05 all;all above indexes recovered to normal on 30d after treatment ;(3) Com-pared with before operation ,right ventricular Tei index significantly rose [ (0.36 ± 0.05) vs .(0.69 ± 0.13) , P=0.04] on 7d after operation ,the Tei index recovered to normal on 30d after treatment ,P=0.20. Conclusion:Com-pared with before operation , the PASP ,PADP and PAMP significantly rise on 7d after operation ,they recover to normal on 30d after treatment ;there are no significant change in right ventricular structure .

Objective To compare the clinical outcomes between two different femur rotating osteotomy methods for kneeling ability recovery after total knee arthroplasty (TKA).Methods From January 2012 to December 2014,88 patients underwent TKA were selected for a retrospective study and were divided into two groups based on the methods to determine femoral rotation.Forty-eight patients were in measured resection group,while 40 patients in gap balancing group.The patients in both groups underwent fixed-bearing tibia prosthesis.There were no statistical significance between the two groups in gender,age,BMI and knee varus angle (P＞0.05).The knee varus angle,ROM,Oxford knee score (OKS) and American Knee Society (KSS) knee score were collected to assess malformation correction,kneeling ability and functions at pre-operation,one and two years postoperatively.Results The operation duration and blood loss in measured resection group were 80±19 min and 348±121 ml,while these data in gap balancing group were 82±23 min and 315 ± 100 ml respectively (P＞0.05).Patients in measured resection group were followed up 24-59 months (mean 43± 11 months),while the followed-up duration in gap balancing group was 25-58 months (mean 47±10 months).No major complications such as infection loosen and instability were occurred.Varus angles in measured resection group at postoperative 1 year and 2 year postoperative were 1.2°±0.4° and 1.0°±0.2° respectively,while those in gap balancing group were 0.9°±0.2° and 0.8°±0.3° (P＞0.05).The scores of the seventh item of OKS in measured resection group at 1 year and 2year follow-ups were 2.79±1.02 and 2.75± 1.03 respectively,while those in the gap balancing group were 1.90±0.85 and 1.80±0.83 (P＜0.01).ROM in the measured resection group at 1 year and 2 year postoperative were 102.08°± 15.60° and 102.08°±15.60° respectively,while those in the gap balancing group were 112.50°±18.32° and 113.00°±18.09° (P＜0.05).KSS in measured resection group at postoperative 1 year and 2 years were 154.63±31.12 and 154.63±31.26 respectively,while those in the gap balancing group were 170.55±22.67 and 173.45±22.52 (P＜0.05).Conclusion The method of measured resection and gap balancing to confirm femoral rotation during TKA can both achieve favorable kneeling ability and clinical outcomes,while gap balancing show superiority on kneeling ability recovery,ROM and clinical outcomes at 2-year postoperative improvement.

Objective:To investigate the influence ofpidotimod combined with budesonide aerosol inhalation on the IL-4,IFN-γ,immunoglobulin and T cell subsets of children with bronchial asthma.Methods:92 cases of children with bronchial asthma in our hospi tal from June 2015 to June 2016 were selected as the research objects and randomly divided into the observation group and the control group.The control group was given budesonide suspension treatment,and the observation group was treated by pidotimod oral liquid on the base of the control group.The changes of serum IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+CD8+ before and after treatment were de tected and compared between the two groups.Results:Before treatment,there was no significant difference in the serum IL-4,IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ between two groups (P＞0.05).Compared with those before treatment,the serum level of IL-4 was significantly decreased,in the observation group,while the IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD4+/CD8+ levels were significantly increased afrer treatment (P＜0.05).The IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ of control group showed no significant change before and after treatment (P＞0.05),only the serum IL-4 level was significantly decreased (P＜0.05).After treatment,the IL-4,IFN-γ,IgA,IgG,IgM,CD3+,CD4+,CD8+ and CD4+/CD8+ of observation group were better than those of the control group (P＜0.05).Conclusion:Compared with budesonide alone,pidotimod combined with budesonide could significantly regulate the immune function of children with bronchial asthma.

Objective To analyze clinicopathologic features and treatment strategy of postsurgical incidental papillary thyroid microcarcinoma(PTMC).Methods A total of 305 patients undergoing surgery for thyroid diseases from Apr.2012 to Mar.2013 were retrospectively analyzed.Results Among the 305 patients,19 patients(18 females and 1 male)showed PTMC incidentally after surgery.The mean age was (43.2 ± 12.8)years (ranging from 23 to 67 years old).All patients underwent subtotal thyroidectomy,including 17 endoscopic surgery and 2 open surgery.All frozen sections were benign during operation while pathologic results were PTMC after surgery.The average size of tumors was(2.2 ± 1.5) mm which all was unicentric with no lymph node enlargement intraoperatively.Immunohistochemistry showed that the positive rate of cytokeratin 19,galectin-3,mesothelial cell,and CD56 was 87.5％,43.8％,81.3％ and 18.8％,respectively.There were 4 cases of B-raf V600E mutation found in 6 patients.All patients discharged 1 to 3 days after surgical treatment with no complication and received levothyroxine therapy with a suppressive dose of thyrotropin(TSH).131I therapy was not given.Conclusions PTMC is found more common in female and younger age under 45 years.Tumor is usually unicentric and less than 5 mm.Lymph node metastasis is rare.Immunohistochemistry and B-raf V600E mutant test can help the diagnosis.Initial endoscopic subtotal thyroidectomy is effective.There is no need of further surgery and 131I therapy.

The existing processing methods, commercial specification and grades, and the marketing of Coptidis Rhizoma were systematical researched, referring to ancient, modern and contemporary medical literatures with the combination of our fieldwork on main origins of Coptidis Rhizoma and some herbs markets. Results showed that Coptidis Rhizoma processing methods mainly included sun-dried method and baked method anciently. For now, the processing methods become various, including thin paper-covering under the sun drying, direct drying, oven drying and microflame-fry drying. In the literatures, the main chemical constituent berberine was determined of its content to analyze the processing methods, finding that the sun drying and baked drying affect the berberine content, so the temperature must be controlled when drying. The thin paper-covering drying method is so cumbersome for large quantities of medicinal herbs and in wind conditions that it has been eliminated. Eventually, direct drying, oven drying and microflame-fry drying are chosen to the large-scale socialized production for their convenient and simple operation, making up the current main processing methods. Coptidis Rhizoma products have 3 specifications of Weilian, Yalian, Yunlian, of each specification there are 2 levels, but in fact the market of Weilian commodities overtakes the Yunlian, which only sold in parts of Yunnan, and the no-sale Yalian. The mainstream commercial Weilian are often sold in general way, gradeless and uniformly-priced. There are regional differences of the processing methods on Coptidis Rhizoma, which needs unified research and development of relevant standard operating procedures to ensure the quality of medicine, urgently. Coptidis Rhizoma product specifications and the intrinsic quality-grade correlation need to be further improved, which could provide a more reliable standard for quality at competitive prices, and it is recommended that "medicinal commercial specification and grade standard" content be increased into the Herbs part of Chinese Pharmacopoeia.
Chemistry, Pharmaceutical ; methods ; China ; Chromatography, High Pressure Liquid ; Coptis ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Rhizome ; chemistry

Objective To evaluate the clinical significance of cytokeratin19(CK19) mRNA in the peripheral blood of patients with non-small cell lung cancer (NSCLC). Methods The expression of CK19 mRNA was detected by reverse transcription polymerase chain reaction (RT-PCR) in the peripheral blood from 98 NSCLC patients (NSCLC group), 20 benign pulmonary lesion patients (benign pulmonary lesion group) and 20 healthy adults(control group). Results The positive rate of CK19 mRNA in peripheral blood of NSCLC group, benign pulmonary lesion group and control group was 77.55 % (76/98), 3.57% (1/28),0 (0/20) respectively,and there was significant difference among three groups ( x2 = 73.680,P ＜ 0.01 ). The positive rate of CK19 mRNA in different pathological types of NSCLC had no significant difference (x2 =0.414, P ＞ 0.05 ), but had significant difference in different lymphy node metastasis status( x2 = 17.523, P ＜0.01 ) and different clinical stage ( x2 =13.453,P ＜ 0.01 ). Conclusions The higher expression of CK19mRNA in peripheral blood of NSCLC may relate to cancer metastasis. Detection of CK19 mRNA has significance in early prediction of its prognosis.

ObjectiveTo investigate the effects of caleitriol,training on balance and lower extremity muscle strength on fall risk of postmenopausal women with osleoporosis or osteopenia.Methods A total of 200 postmenopausal women with osteoporosis or osteopenia,whose balance test confirmed higher fall risk,were randondy assigned to group A or B.Those of group A received the following intervention:( 1 ) 0.25 μg calcitriol,QD; (2) general information on fall and osteoporosis; (3) balance training; (4) lower extremity muscle strength exercises.Those of group B were only treated with 0.25 μg calcitriol.All the participants were supplemented with 600 mg/d calcium and 125 IU/d vitamin D.Fall index,bone mineral density,serum levels of calcium and phosphorus,and adverse reactions were record.Results After 3 months' intervention,the fall index of both groups was significantly decreased ( group A:t =2.16,P＜0.05 ; group B:t =2.08,P＜0.05 ).After 6 months' intervention,the fall index of both groups went on decreasing,and significant difference of fall index between 6 month and baseline of group A and between group A and group B at 6 months was found.After 1-year intervention,the fall index of group A was further decreased in comparison with group B ( t =2.66,P＜0.05 ).No hypercalcemia occurred during the study period.Conclusion The fall risk of the patients with postmenopausal osteoporosis or osteopenia was reduced after 3 months' intervention.Twelve months' active vitamin D intervention could either reduce the risk of fall or improve bone mineral density.Patient education,balance training and muscle exercise may be effective intervention to reduce fall risk.