Objective To investigate the pathologic characteristics of skip metastases of mediastinal lymph node in lung cancer. Methods Of 398 lung cancer patients who underwent radical resection and extensive lymph node dissection. 47 patients were diagnosed as with skip N 2 metastases, and their mediastinal lymph nodes were analyzed. Results The skip N 2 metastases of lung cancer appeared as single group or multi-group. The commonest metastatic site was the 7th group lymph node (28.4%), then the 4th, 3rd and 5th group, rating 24.2%, 15.8% and 10.5%, respectively. For cases with squamous cell carcinoma or adenocarcinoma, no any skip N 2 metastasis occurred for the tumor less than 1 cm in diameter, for tumor greater than 1 cm in diameter, the skip N 2 metastasis increased with tumor size. The incidence skip N 2 metastasis of low-grade differentiated adenocarcinoma was significantly higher than high-grade differentiated adenocarcinoma (P

Objective This experiment aimed to confirm whether man made porous chitosan scaffold is a appropriate scaffold for chondrocyte culutre of tissue engineering Methods Chondrocytes were seeded onto porous chitosan and chitosan collagen complex scaffolds for culture in a three dimensional environment The scaffolds in hydrophilia and adhesion to chondrocytes were observed with light microscope and scanning electron microscope The number of the cells attached to the scaffolds and the function of the cells were detected with MTT automated colormetric microassay Result Chondrocytes can multiple and secrete the matrix on the poros chitosan and chitosan collagensc scaffolds The cell adhesion rates were 81 25% and 87 50% respectively Conclusion Chitosan can be fabricated into a suitable three dimensional porous scaffold Porous chitosan collagen complex scafflold may be a more suitable scaffold for chondrocyte culutre of tissue engineering

Objective:To investigate the expression and clinical significance of PD-L1 in colorectal cancer (CRC). Methods:A total of 210 CRC patients who accepted radical surgery in our hospital from January 2015 to January 2016 were divided into three groups, namely, high-frequency microsatellite instability (MSI-H), low-frequency microsatellite instability (MSI-L), and microsatellite stable (MSS). The expression of PD-L1 was detected by immunohistochemistry, and the expression characteristics of PD-L1 in different types of CRC were analyzed. Results:CRC cases with low differentiation had a higher expression of PD-L1 than CRC patients with high differ-entiation (P<0.05). PD-L1 had a positive rate of 75.8%in the MSI-H group and a rate of 9.3%in the MSI-L and MSS groups, wherein the difference between the two groups was statistically significant (P<0.05). Conclusion:PD-L1 was positively expressed in some CRC tu-mor tissues, and its positive rate was significantly higher in MSI-H than in MSI-L and MSS. The therapeutic effect of a PD-L1 blocker for patients with MSI-H CRC might be preferable.

Objective To study PTEN protein expression and clinical significance in patients with diffuse large B cell lymphoma. Methods Immunohistochemical staining was used to determine the PTEN protein expression in 40 cases of primary diffuse large B lymphoma tissuse. The results were analyzed by Kaplan-Merie survival analysis, Log-Rank test and Logistic regression analysis. Results PTEN protein was positive in 16 cases and negative in 24 cases. There was no significant difference between two groups in twoyear overall survival rate(62.5 % vs 66.7 %, P >0.05). Survival analysis showed that patient' s survival time gradually were reduced with extended time between PTEN protein-positive group and negative group, lower in PTEN-positive group than the negative group, but there was no significant difference in survival curve (P >0.05) in the two groups. We compared characteristics of patients between PTEN protein positive and negative groups,including molecular type, patient' s age, stage, LDH, physical score and extranodular invasion, there was no significant difference among them. PTEN protein was not correlated with prognosis, while International Prognosis Index(IPI) was still a risk factor (OR >1). Conclusion PTEN protein expression may not predict the outcome in diffuse large B cell lymphoma, but IPI still is a predictor.

Objective To discuss the clinical and pathological characteristics, treatment results and prognosis of primary parotid malignant lymphoma. Methods Pathological subtypes, clinical stages and treatment of the 24 patients with primary parotid malignant lymphoma were retrospectively analysed. Kaplan-Meier method was used in the survival analysis and Log-Rank method was used in the statistic study. Results The 5-year progression free survival (PFS) and overall survival (OS) were 79.2 % and 83.3 %, respectively. The 5-year PFS and OS were 89.5 % and 94.7 % for 19 patients with low-grade malignant lymphoma (including MALTL and Ⅰ/Ⅱ grade FL). The differences of the 5-year PFS and OS of 9 patients received chemotherapy and of 10 patients with on chemotherapy had no statistical significance. Conclusion The incidence of primary parotid malignant lymphoma is low, at earlier clinical stage, and most of its pathological subtype were B-cell low-grade malignant non-Hodgkin lymphoma. Surgery and/or radiotherapy should be the first choice for patients with early stage low-grade malignant lymphoma, whereas combined modality therapy was probably the best choice for patients with DLBCL.

BACKGROUNDTo investigate pathologically the characteristics of proximal bronchial invasion of lung cancer, and to provide the theoretic basis for the selection of a proper operation mode.

METHODSA total of 398 patients with lung carcinoma underwent radical pulmonectomy and systematic lymphadenectomy. The proximal bronchi and the hilar and mediastinal lymph nodes of their operatively resected specimens were selected for pathological study.

RESULTS(1)The direct invasion of cancerous cells through mucous, submucous or multiple layers was the most frequent way during lung cancer spread, rating 9.3%, 21.8% and 68.9% respectively. 96.4% of the cancerous invasion occurred at the proximal bronchial wall less than 1.5 cm apart from the cancer margin. The extension of invasion correlated with the histopathologic type of cancer, mode of invasion and TNM classification. (2)The cancer infiltration by the nodes metastasizing into the bronchus wall (bronchial external tunica or cartilage) was also an important way for the cancer to spread, especially in adenocarcinoma. The poor differentiated adenocarcinoma has significantly higher metastatic rate and infiltration rate than the well differentiated ( P < 0.01, P < 0.01). There were 22 such cases, including 3 of lobar bronchus wall invaded by N1 metastasis and 19 of main bronchus wall by N2 metastasis.

CONCLUSIONSFor radical removal of tumor, the key point for selecting a rational operation mode is to keep a distance of 1.5 cm or more between the excision margin of the bronchus and the tumor, to pay attention to the bronchial wall invasion caused by the metastatic lymph nodes, even in peripheral adenocarcinoma, and to dissect extensively and completely the lymph nodes of the hilar and upper and lower mediastinum at the homolateral thoracic cavity.

Objective:To investigate the clinicopathological and molecular characteristics of pulmonary enteric adenocarcinoma (PEAC).Methods:The clinical and pathological data of 19 cases of PEAC in the Affiliated Cancer Hospital of Zhengzhou University were retrospectively collected from 2015 to 2019. Immunohistochemistry (IHC) was used to detect the relevant immunophenotypes, amplification refractory mutation system (ARMS) and fluorescence in situ hybridization (FISH) were used to detect the expression of EGFR, KRAS and ALK genes. The patients were followed up, and the relevant literature was reviewed and analyzed.Results:There were 19 cases, including 10 males and 9 females, with a mean age of 58 years (range 33-71 years). Microscopically, the tumors showed moderately to highly differentiated adenoid and/or papillary growth patterns. The tumor cells were highly columnar and sometimes showed pseudostratification. Inflammatory necrosis and scattered nuclear fragmentation were seen in some glandular lumens. IHC showed variable expression of CK7 (19/19), TTF1 (8/19), Napsin A (6/19), villin (17/19), CK20 (16/19) and CDX2 (10/19). Molecular testing showed KRAS mutation in nine cases (9/19), EGFR mutation in one case (1/19), and positive ALK split signal in one case (1/19). In the literature, the reported mutation rate of KRAS in PEAC was much higher than that of EGFR and ALK. All 19 cases underwent surgical resection and 11 cases were subjected to chemotherapy or radiotherapy.Conclusions:PEAC is a rare variant of invasive pulmonary adenocarcinoma, and has similar histological and cytological features to that of colorectal adenocarcinoma. However, detailed medical history, histologic heterogeneity, an IHC combination of CK7 +/villin + and high KRAS mutation rate are the key points of diagnosis. The prognosis needs long-term follow-up and big data statistics.

OBJECTIVETo investigate the feasibility of chondrogenic phenotype differentiation of adult swine bone marrow stem cells(MSCs) in a defined medium as seeding cells in cartilage tissue engineering.

METHODSA volume of 5 ml bone marrow was aspirated from swine iliac crest and cultured in the complete medium of DMEM-LG for two weeks. The growth and ultrastructure of the cultured MSCs were observed. Immunohistochemistry and in situ hybridization were applied to detect the expression of collagen type II.

RESULTSThe MSCs changed from a spindle-like fibroblastic appearance to a polygonal shape when transferred from the complete medium of DMEM-LG to a defined medium. A large amount of endoplasmic reticulum was observed in large Golgi ccmplex and mitochondria. The differentiation of MSCs toward chondrogenic phenotype was verified by the positive result of collagen type II through immunohistochemistry and in situ hybridization respectively.

CONCLUSIONSBone marrow stem cells obtained from adult swine can differentiate to be chondrogenic phenotype when cultured in vitro. MSCs can likely be served as optimal autogenous cell source for cartilage tissue engineering.

Animals ; Bone Marrow Cells ; physiology ; ultrastructure ; Cell Differentiation ; Cells, Cultured ; Chondrocytes ; physiology ; Collagen Type II ; genetics ; Phenotype ; RNA, Messenger ; analysis ; Stem Cells ; physiology ; ultrastructure ; Swine ; Tissue Engineering ; Transforming Growth Factor beta ; physiology

Objective To investigate the relationship between the plasma level of interleukin 15 (IL-15) and the quantitative myasthenia gravis (QMG) score in late-onset myasthenia gravis (MG).Methods The blood samples of 86 patients (over 50 years old) who admitted to Henan Provincial People's Hospital between 2010 and 2016 were collected at two different stages:pre-treatment and six months post-treatment.The diagnosis was verified by characterizing clinical manifestation,neostigmine testing,electromyographic recording,thymic imaging and plasma anti-acetylcholine receptor (AchR).All the patients were divided further by modified Osserman classification and treated with cholinesterase inhibitor and glucocorticoid.The blood samples of 42 healthy controls were also collected from their physical examination at the end of 2016.Enzyme linked immunosorbent assay was used to evaluate the levels of IL-15 in plasma.Thymectomy was performed on patients with MG accompanied by thymoma.The possible correlation between the expression of IL-15 and the QMG scores,different types were analyzed.Results Before treatment,the levels of IL-15 in the plasma were much higher in the late onset MG patients (both ocular and generalized) than in the healthy controls ((5.75± 1.57) pg/ml vs (4.40±0.50) pg/ml,t=2.925,P＜0.01).And the late onset MG patients with thymoma showed higher level of IL-15 compared to the healthy controls ((7.39±0.84) pg/ml vs (4.40±0.50) pg/ml,t=3.925,P＜0.01).Further analysis showed that the IL-15 levels in all the MG patients with different pathological types of thymoma were higher than in the healthy controls.In the mild type of late-onset MG patients without thymoma,the IL-15 level was not increased ((4.49±0.74)pg/ml vs (4.40±0.50) pg/ml,t=1.752,P＞0.05) and in the severe type of late-onset MG patients without thymoma,the IL-15 level was mildly increased ((4.76±0.75) pg/ml vs (4.40±0.50) pg/ml,t=2.462,P＜0.05) compared to the healthy controls.Furthermore,the IL-15 level decreased dramatically upon the therapy in all the MG patients,especially in the late-onset MG patients with thymoma.Moreover,IL-15 was positively correlated with QMG scores before treatment (r=0.375,P＜0.01),especially in the late-onset MG patients with thymoma (r=0.823,P＜0.01),but not in the late-onset MG patients without thymoma (r=0.039,P＞0.05).IL-15 and QMG scores returned to normal six months after treatment.Conclusions IL-15 is increased in the plasma of late-onset MG patients,and is positively correlated with the QMG scores,especially in the late-onset MG patients with thymoma.In addition,IL-15 is decreased upon the therapy in the MG patients.

OBJECTIVETo explore a feasible method to repair full-thickness skin defects with tissue engineered techniques.

METHODSThe skin specimens were cut from the Changfeng hybrid swines' abdomen, then keratinocytes and fibroblasts were isolated and harvested by trypsin, EDTA and type II collagenase. The cells were seeded in petri dishes for primary culture. When the cells were in logarithmic growth phase, they were treated with dispase II (keratinocytes) or trypsin (fibroblasts) to separate them from the floor of the tissue culture dishes. A biodegradable material-pluronic F-127 was prefabricated and mixed with these cells, and then the cells-pluronic compounds were seeded evenly into polyglycolic acid (PGA). Tinally the constructs were replanted to autologous animals to repair full-thickness skin defects. Histological changes were observed in 1, 2, 4 and 8 weeks postsurgery.

RESULTSThe cells-pluronic F-127-PGA compounds could repair autologous full-thickness skin defects. Histologically, the tissue engineered skin was similar to normal skin with stratified epidermis overlying a moderately thick collageneous dermis.

CONCLUSIONTissue engineered skin can repair autologous full-thickness skin defects with primary-cultured keratinocytes and fibroblasts as seed cells and PGA as a cell carrier.

Animals ; Female ; Fibroblasts ; physiology ; Male ; Polyglycolic Acid ; pharmacology ; Skin Transplantation ; Skin, Artificial ; Swine ; Tissue Engineering