1.Clinicopathological and molecular features of metaplastic thymoma.
X WANG ; R S ZHANG ; R LI ; S B YE ; Q LI ; H CHEN ; Q Y XIA ; N WU ; Q RAO
Chinese Journal of Pathology 2023;52(12):1237-1243
<b>Objective:b> To investigate the clinicopathological features, and molecular genetic alterations of metaplastic thymoma (MT). <b>Methods:b> A total of ten MT cases, diagnosed from 2011 to 2021, were selected from the Department of Pathology of Jinling Hospital, Nanjing University Medical School, Nanjing, China for clinicopathological and immunohistochemical (IHC) examination and clinical follow-up. Fluorescence in situ hybridization (FISH), next-generation sequencing (NGS), and YAP1 C-terminus (YAP1-CT) IHC were performed to detect YAP1::MAML2 fusions. <b>Results:b> There were four males and six females, ranging in age from 29 to 60 years (mean 50 years, median 54 years). Microscopically, all tumors showed a typical biphasic morphology consisting of epithelial components and gradually or abruptly transitioning spindle cell components. The two components were present in varying proportions in different cases. Immunophenotypically, the epithelial cells were diffusely positive for CKpan, CK5/6 and p63. The spindle cells were diffusely positive for vimentin and focally positive for EMA. TdT was negative in the background lymphocytes. Ki-67 proliferation index was less than 5%. YAP1 and MAML2 break-apart FISH analyses showed that all ten cases had narrow split signals with a distance of nearly 2 signal diameters and may be considered false-negative. Using YAP1::MAML2 fusion FISH assays, abnormal fusion signals were observed in all the ten cases. NGS demonstrated YAP1::MAML2 fusions in all eight cases with adequate nucleic acids; in two cases the fusions were detected by DNA sequencing and in eight cases by RNA sequencing. All ten cases of MT demonstrated loss of YAP1 C-terminal expression in epithelioid cells. <b>Conclusions:b> MT is a rare and low-grade thymic tumor characterized by a biphasic pattern and YAP1::MAML2 fusions. Break-apart FISH assays may sometimes show false-negative results due to the proximity of YAP1 and MAML2, while YAP1 C-terminal IHC is a highly sensitive and specific marker for MT. Loss of YAP1 C-terminal expression can also be used to screen YAP1::MAML2 fusions for possible MT cases.
Male
;
Female
;
Humans
;
Adult
;
Middle Aged
;
Thymoma/genetics*
;
In Situ Hybridization, Fluorescence
;
Transcription Factors/genetics*
;
Mutation
;
Thymus Neoplasms/genetics*
2.Changes and significance of autophagy in rat lung injury induced by gas explosion.
R Y HOU ; J N WANG ; Q ZHOU ; Y GUAN ; H B LI ; X W DONG ; J LI ; W D WU ; W J REN ; S Q YAO
Chinese Journal of Industrial Hygiene and Occupational Diseases 2021;39(8):568-573
Acute Lung Injury
;
Animals
;
Autophagy
;
Explosions
;
Lung
;
Rats
;
Rats, Sprague-Dawley
3.Economic burden of hepatitis C patients and related influencing factors in Guangdong province.
Q M WU ; Y LI ; X B FU ; F YANG ; J LI ; H Z HUANG ; J YAN ; P LIN
Chinese Journal of Epidemiology 2018;39(7):931-936
<b>Objective:b> To investigate the economic burden of hepatitis C patients and related factors in Guangdong province. <b>Methods:b> In this study, cluster sampling method was used to select cases, including acute hepatitis C, chronic hepatitis C and liver cirrhosis cases from eligible outpatients and inpatients in 1 or 2 large general hospitals in all the 21 cities in Guangdong province. Questionnaire survey was conducted for all the hepatitis C patients to analyze their economic burden, while multivariate linear regression model was used to identify the related influencing factors. <b>Results:b> A total of 356 hepatitis C patients were enrolled in the study, with 176 outpatients (49.4%) and 180 inpatients (50.6%) respectively. The average age of the study subjects was (44.79±11.73) year-olds. The annual direct economic costs of patients with acute hepatitis C, chronic hepatitis C and liver cirrhosis were 10 703.22 (IQR: 7 396.75-16 891.91), 14 886.63 (IQR: 7 274.00-30 228.25) and 28 874.00 (IQR: 13 093.69-56 350.00) Yuan (RMB) respectively. The annual indirect costs appeared as 2 426.99 (IQR: 1 912.18-7 354.52), 3 235.99 (IQR: 1 323.81-6 619.07) and 5 442.35 (IQR: 3 235.99-10 296.33) Yuan (RMB) respectively. The annual intangible costs were 5 000.00 (IQR:2 000.00-10 000.00), 10 000.00 (IQR: 4 000.00-30 000.00) and 10 000.00 (IQR: 3 000.00-100 000.00) Yuan (RMB) respectively. The annual total costs were 22 306.17 (IQR: 14 581.24-50 569.17), 38 050.33 (IQR: 17 449.57-68 319.62) and 80 152.18 (IQR: 40 856.09-228 460.79) Yuan (RMB) respectively. Results from the multiple linear regression analysis showed that factors as: annual hospitalization days, annual number of outpatient visits, annual number of hospitalization, type of disease and the levels of the hospitals were related to the economic burden of patients with hepatitis C. <b>Conclusion:b> Patients with HCV-related diseases presented serious economic problem which calls for close attention in Guangdong province.
Adult
;
China/epidemiology*
;
Cities
;
Cost of Illness
;
Female
;
Health Care Costs/statistics & numerical data*
;
Hepatitis B/epidemiology*
;
Hepatitis C/economics*
;
Hospitalization
;
Humans
;
Liver Cirrhosis/epidemiology*
;
Male
;
Surveys and Questionnaires
4.A study on the burden and causes of hospitalization and deaths in Shenzhen, between 1995 and 2014.
J ZHANG ; L C HONG ; X B WANG ; Y Z WEI ; G HU ; S H WU ; J Q CHENG
Chinese Journal of Epidemiology 2018;39(10):1309-1313
<b>Objective:b> Data from the surveillance program was collected, to analyze the situation of hospitalization and cases of death with recorded causes, in Shenzhen, from 1995 to 2014. Situation of hospitalization and causes of deaths were studied in Shenzhen which had been a fast-developing city with growing number of immigrants so as to provide reference for decision-making on related prevention and control strategies. <b>Methods:b> Data on hospitalizations and deaths collected from the surveillance program, were classified by both International Classification of Diseases (ICD)- 9 and ICD-10. A database was constructed with methods on related descriptive and trend analysis. <b>Results:b> Around 6.3 million inpatients were seen in the past two decades in Shenzhen. The top five diseases for hospitalization were pregnancy childbirth and puerperium complications, respiratory diseases, injury and poisoning, digestive system diseases and circulatory system diseases, that accounting for 68.4% of all the hospitalization burden. The number of inpatients increased annually, with an 11 times increase during the past two decades. Proportions for pregnancy childbirth and puerperium complications, circulatory system diseases and urinary system diseases all showed increasing (χ(2)=53 806.94, 6 893.95 and 15 383.14, P<0.01), while proportions for injuries and poisoning, respiratory diseases, digestive system diseases showed a declining trend (χ(2)=131 480.09,1 711.84 and 11 367.66, P<0.01). Number of cumulative inpatient deaths exceeded 60 000, with the top five causes as malignant tumor, circulatory system diseases, injury and poisoning, respiratory system diseases and digestive system diseases, that accounting for 82.28% of all the inpatient deaths. Deaths due to circulatory system diseases, injury and poisoning increased and then decreased. Malignant tumor and respiratory diseases-induced deaths showed an increasing trend (χ(2)=1 546.48, 309.55, P<0.01), while induced deaths from disease of the other systems showed slight changes. The overall case fatality rate showed an annual decline (χ(2)=4 378.63, P<0.01), from 2.23% in 1995 to 0.74% in 2014, with mortality attribute to tumor, circulatory system disease decreased significantly. <b>Conclusions:b> Shenzhen had been under an ageing transition, with relatively young population living in the city. Chronic diseases such as tumor gradually had become the major causes for heavy hospitalization burden on the population of Shenzhen.
Cardiovascular Diseases/epidemiology*
;
Cause of Death
;
China/epidemiology*
;
Female
;
Global Burden of Disease
;
Hospitalization/statistics & numerical data*
;
Humans
;
Neoplasms/epidemiology*
;
Pregnancy
;
Pregnancy Complications/epidemiology*
;
Respiratory Tract Diseases/epidemiology*
5.Clinicopathological features of olfactory carcinoma.
C C ZHANG ; H LI ; L Q CHENG ; H B WU
Chinese Journal of Pathology 2023;52(11):1138-1143
<b>Objective:b> To investigate the clinicopathological features and differential diagnosis of olfactory carcinoma (OC). <b>Methods:b> Twenty-one cases of sinonasal tumors, including those initially diagnosed as olfactory neuroblastoma (ONB) and those with uncertain diagnosis, were collected from the Department of Pathology, the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) from January 2016 to August 2022, among which 3 cases were reclassified as OC. The clinicopathological features were investigated, and the remaining 18 cases were used as control. <b>Results:b> Of the three OC patients, 2 were male and 1 was female, with an average age of 57 years ranging from 35 to 74 years. Microscopically, the tumor cells were arranged in solid, nested or lobulated patterns with occasional palisading around the solid nests. The stroma was highly vascular with focal neurofibrillary areas. There were prominent rosettes or pseudorosettes formation. The tumor cells were mainly ovoid to spindly with scant to moderate amount of cytoplasm, one or several small nucleoli, and fine chromatin content. Brisk mitotic figures were seen. In all 3 cases of OC, there were scanty atypical glands and some were ciliated. Immunohistochemically, at least one epithelial marker and neuroendocrine marker were diffusely expressed in the tumor. Some of the tumor cells were positive for p40 and p63, and the sustentacular cells showed the expression of S-100 protein. All cases tested were negative for NUT, CD99 and desmin, with intact expression of SMARCA4 (BRG1) and SMARCB1 (INI-1). Ki-67 proliferation index varied from 20% to 80%. Follow-up after 16-18 months showed no mortality with tumor recurrence from 1 patient after 16 months. <b>Conclusion:b> OC is a rare sinonasal tumor with neuroepithelial differentiation, its histomorphology is diverse, and the combination of immunohistochemical markers is essential for appropriate diagnosis.
Humans
;
Male
;
Female
;
Middle Aged
;
Paranasal Sinus Neoplasms/chemistry*
;
Biomarkers, Tumor/metabolism*
;
Carcinoma/chemistry*
;
Diagnosis, Differential
;
S100 Proteins
;
DNA Helicases/metabolism*
;
Nuclear Proteins/metabolism*
;
Transcription Factors/metabolism*
6.Development and validation of a prognostic prediction model for patients with stage Ⅰ to Ⅲ colon cancer incorporating high-risk pathological features.
K X LI ; Q B WU ; F Q ZHAO ; J L ZHANG ; S L LUO ; S D HU ; B WU ; H L LI ; G L LIN ; H Z QIU ; J Y LU ; L XU ; Z WANG ; X H DU ; L KANG ; X WANG ; Z Q WANG ; Q LIU ; Y XIAO
Chinese Journal of Surgery 2023;61(9):753-759
<b>Objective:b> To examine a predictive model that incorporating high risk pathological factors for the prognosis of stage Ⅰ to Ⅲ colon cancer. <b>Methods:b> This study retrospectively collected clinicopathological information and survival outcomes of stage Ⅰ~Ⅲ colon cancer patients who underwent curative surgery in 7 tertiary hospitals in China from January 1, 2016 to December 31, 2017. A total of 1 650 patients were enrolled, aged (M(IQR)) 62 (18) years (range: 14 to 100). There were 963 males and 687 females. The median follow-up period was 51 months. The Cox proportional hazardous regression model was utilized to select high-risk pathological factors, establish the nomogram and scoring system. The Bootstrap resampling method was utilized for internal validation of the model, the concordance index (C-index) was used to assess discrimination and calibration curves were presented to assess model calibration. The Kaplan-Meier method was used to plot survival curves after risk grouping, and Cox regression was used to compare disease-free survival between subgroups. <b>Results:b> Age (HR=1.020, 95%CI: 1.008 to 1.033, P=0.001), T stage (T3:HR=1.995,95%CI:1.062 to 3.750,P=0.032;T4:HR=4.196, 95%CI: 2.188 to 8.045, P<0.01), N stage (N1: HR=1.834, 95%CI: 1.307 to 2.574, P<0.01; N2: HR=3.970, 95%CI: 2.724 to 5.787, P<0.01) and number of lymph nodes examined (≥36: HR=0.438, 95%CI: 0.242 to 0.790, P=0.006) were independently associated with disease-free survival. The C-index of the scoring model (model 1) based on age, T stage, N stage, and dichotomous variables of the lymph nodes examined (<12 and ≥12) was 0.723, and the C-index of the scoring model (model 2) based on age, T stage, N stage, and multi-categorical variables of the lymph nodes examined (<12, 12 to <24, 24 to <36, and ≥36) was 0.726. A scoring system was established based on age, T stage, N stage, and multi-categorical variables of lymph nodes examined, the 3-year DFS of the low-risk (≤1), middle-risk (2 to 4) and high-risk (≥5) group were 96.3% (n=711), 89.0% (n=626) and 71.4% (n=313), respectively. Statistically significant difference was observed among groups (P<0.01). <b>Conclusions:b> The number of lymph nodes examined was an independent prognostic factor for disease-free survival after curative surgery in patients with stage Ⅰ to Ⅲ colon cancer. Incorporating the number of lymph nodes examined as a multi-categorical variable into the T and N staging system could improve prognostic predictive validity.
Male
;
Female
;
Humans
;
Prognosis
;
Neoplasm Staging
;
Retrospective Studies
;
Nomograms
;
Lymph Nodes/pathology*
;
Risk Factors
;
Colonic Neoplasms/surgery*
7.Identification and drug susceptibility testing of Mycobacterium thermoresistibile and Mycobacterium elephantis isolated from a cow with mastitis.
W B LI ; L Y JI ; D L XU ; H C LIU ; X Q ZHAO ; Y M WU ; K L WAN
Chinese Journal of Epidemiology 2018;39(5):669-672
<b>Objective:b> To understand the etiological characteristics and drug susceptibility of Mycobacterium thermoresistibile and Mycobacterium elephantis isolated from a cow with mastitis and provide evidence for the prevention and control of infectious mastitis in cows. <b>Methods:b> The milk sample was collected from a cow with mastitis, which was pretreated with 4% NaOH and inoculated with L-J medium for Mycobacterium isolation. The positive cultures were initially identified by acid-fast staining and multi-loci PCR, then Mycobacterium species was identified by the multiple loci sequence analysis (MLSA) with 16S rRNA, hsp65, ITS and SodA genes. The drug sensitivity of the isolates to 27 antibiotics was tested by alamar blue assay. <b>Results:b> Two anti-acid stain positive strains were isolated from the milk of a cow with mastitis, which were identified as non-tuberculosis mycobacterium by multi-loci PCR, and multi-loci nucleic acid sequence analysis indicated that one strain was Mycobacterium thermoresistibile and another one was Mycobacterium elephantis. The results of the drug susceptibility test showed that the two strains were resistant to most antibiotics, including rifampicin and isoniazid, but they were sensitive to amikacin, moxifloxacin, levofloxacin, ethambutol, streptomycin, tobramycin, ciprofloxacin and linezolid. <b>Conclusions:b>Mycobacterium thermoresistibile and Mycobacterium elephantis were isolated in a cow with mastitis and the drug susceptibility spectrum of the pathogens were unique. The results of the study can be used as reference for the prevention and control the infection in cows.
Animals
;
Anti-Bacterial Agents/pharmacology*
;
Antitubercular Agents/pharmacology*
;
Cattle
;
Drug Resistance, Bacterial
;
Female
;
Humans
;
Mastitis, Bovine/microbiology*
;
Microbial Sensitivity Tests
;
Milk/microbiology*
;
Mycobacterium/isolation & purification*
;
Mycobacterium Infections/veterinary*
;
Mycobacterium tuberculosis/drug effects*
;
Nontuberculous Mycobacteria/isolation & purification*
;
Polymerase Chain Reaction
;
RNA, Ribosomal, 16S/genetics*
8.Willingness and influencing factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy among the household chefs in Guangzhou.
W H LIU ; Y MA ; J Y LU ; H C YAN ; J H ZHOU ; X L LIAO ; J H ZENG ; W Q LIN ; D WU ; Z B ZHANG ; Z C YANG ; Z Q CHEN ; J D CHEN ; T G LI
Chinese Journal of Epidemiology 2018;39(2):204-207
<b>Objective:b> To study the willingness and influence factors related to "centralized slaughtering, fresh poultry listing and marketing" strategy, among the household chefs, and provide reference for government to adjust and optimize the strategy on avian influenza prevention. <b>Methods:b> According to the geographical characteristics and regional functions, 6 'monitoring stations' were selected from 12 residential districts of Guangzhou, respectively. Another 21 meat markets which selling live poultry, were selected in each station and 5 household chefs of each market were invited to attend a face to face interview. Basic information, personal cognitive, willingness and influencing factors to the policy were under study. Univariate and multivariate logistic regression methods were used. <b>Results:b> A total of 664 household chefs underwent the survey and results showed that the rate of support to the "centralized slaughtering, fresh poultry listing and marketing" strategy was 44.6% (296/664). Results from the multi-factor logistic regression showed that those household chefs who were males (OR=1.618, 95% CI: 1.156-2.264, P=0.005), having received higher education (OR=1.814, 95% CI: 1.296-2.539, P=0.001), or believing that the existence of live poultry stalls was related to the transmission of avian influenza (OR=1.918, 95% CI: 1.341-2.743, P<0.001) were factors at higher risk. These household chefs also intended to avoid the use of live poultry stalls (OR=1.666, 95%CI: 1.203-2.309, P=0.002) and accept the "centralized slaughtering, fresh poultry listing and marketing" strategy. <b>Conclusion:b> Detailed study on this subject and, setting up pilot project in some areas as well as prioritizing the education programs for household chefs seemed helpful to the implementation of the 'freezing-fresh poultry' policy.
Animals
;
Attitude to Health
;
China
;
Humans
;
Influenza A Virus, H7N9 Subtype
;
Influenza in Birds
;
Influenza, Human/prevention & control*
;
Male
;
Marketing
;
Meat-Packing Industry
;
Multivariate Analysis
;
Pilot Projects
;
Poultry/virology*
;
Surveys and Questionnaires
9.Exposure to bisphenol A during maternal pregnancy and the emotional and behavioral impact on their preschool children.
X CHEN ; H H BAO ; W K WU ; S Q YAN ; J SHENG ; Y Y XU ; C L GU ; K HUANG ; H CAO ; P Y SU ; F B TAO ; J H HAO
Chinese Journal of Epidemiology 2018;39(2):188-193
<b>Objective:b> To explore the long-term effects of maternal pregnancy bisphenol A (BPA) exposure on emotional and behavioral problems appeared in their preschool children. <b>Methods:b> The study sample was a subset of the China-Anhui Birth Cohort Study (C-ABCS). A unified questionnaire was used to collect basic information on both pregnant women and their children. Free BPA concentration in maternal serum was determined by high-performance liquid chromatographytandem mass spectrometry (HPLC-MS/MS). The parent-report version of the Strengths and Difficulties Questionnaire (SDQ) was used to estimate the emotional and behavioral problems in preschool children. A total of 1 713 pairs of mothers and children were included in this study. Association between BPA exposure during pregnancy and the emotional and behavioral problems in preschool children was evaluated with multinomial logistic regression model. <b>Results:b> Prevalence rates in 1 713 preschool children appeared as: 6.48% of emotional problems, 8.11% for conduct problems, 8.35% for hyperactivity/inattention, 2.86% for peer problems, 11.38% for prosocial behaviors and 7.94% for total difficulties. Subjects were divided according to the degrees of exposure and the results showed as: low exposure group (≤0.120 ng/ml), medium exposure group (0.120
Benzhydryl Compounds/toxicity*
;
Child Behavior Disorders/etiology*
;
Child, Preschool
;
China/epidemiology*
;
Cohort Studies
;
Emotions/physiology*
;
Environmental Exposure
;
Environmental Pollutants
;
Female
;
Gas Chromatography-Mass Spectrometry
;
Humans
;
Male
;
Maternal Exposure
;
Mothers
;
Phenols/toxicity*
;
Pregnancy
;
Prenatal Exposure Delayed Effects
;
Prevalence
;
Risk Factors
;
Surveys and Questionnaires
;
Tandem Mass Spectrometry
10.A novel prognostic index for oral cancer in Fujian province.
J F WU ; L S LIN ; F CHEN ; F Q LIU ; L J YAN ; X D BAO ; J WANG ; R WANG ; L K LIN ; Y QIU ; X Y ZHENG ; Z J HU ; L CAI ; B C HE
Chinese Journal of Epidemiology 2018;39(6):841-846
<b>Objective:b> To explore the survival factors and construct a prognostic index (PI) for oral squamous cell carcinoma (OSCC). <b>Methods:b> From January 2004 to June 2016, a total of 634 patients with pathologically confirmed OSCC were recruited in a hospital of Fujian. The clinical and follow-up data of all the patients with pathologically confirmed OSCC were collected to identify the factors influencing the prognosis of OSCC. All the patients were randomly divided into two groups: modeling group (modeling dataset, n=318) and validation group (validation dataset, n=316). Randomization was carried out by using computer-generated random numbers. In the modeling dataset, survival rates were calculated using Kaplan-Meier method and compared using the log-rank test. Cox regression model was used to estimate the hazard ratio (HRs) and 95% confidence intervals (CIs) of prognosis factors. An PI for OSCC patients prognostic prediction model was developed based on β value of each significant variable obtained from the multivariate Cox regression model. Using the tertile analysis, patients were divided into high-risk group, moderate-risk group, and low-risk group according to the PI, the Akaike information criterion (AIC) and Harrell's c-statistic (C index) were used to evaluated the model's predictability. <b>Results:b> Results from the multivariate Cox regression model indicated that aged ≥55 years (HR=2.22, 95%CI: 1.45-3.39), poor oral hygiene (HR=2.12, 95%CI: 1.27-3.54), first diagnosis of lymph node metastasis (HR=5.78, 95%CI: 3.60-9.27), TNM stage Ⅲ-Ⅳ (stage Ⅰ as reference) (HR=2.43, 95%CI: 1.10-5.37) and poor differentiation (well differentiation as reference) (HR=2.53, 95%CI: 1.60-4.01) were the risk factors influencing the prognosis of OSCC. The PI model had a high predictability in modeling group and validation group (AIC and C index were 1 205.80, 0.700 2 and 1 150.47, 0.737 3). <b>Conclusion:b> Age, poor oral hygiene, first diagnosis of lymph node metastasis, TNM stage and histological grade were factors associated with the prognosis of OSCC, and the PI model has a certain significance in the clinical treatment of OSCC.
Carcinoma, Squamous Cell/therapy*
;
China/epidemiology*
;
Humans
;
Lymphatic Metastasis
;
Middle Aged
;
Mouth Neoplasms/therapy*
;
Prognosis
;
Proportional Hazards Models
;
Risk Factors
;
Survival Rate
;
Treatment Outcome