Objective To investigate the correlation of bone mineral density (BMD) with plasma Klotho levels and its related factors in type 2 diabetic patients (T2DM) . Methods BMD was measured by Dual-energy X-ray absorptiometry (DEXA) in 159 T2DM patients. The patients were divided into three groups:normal bone mass, reduced bone mass and osteoporosis. The fasting plasma levels of Klotho were detected in these patients using enzyme linked immuno sorbent assay (ELISA), clinical and biochemical parameters also were tested, the difference and related factors were compared and analyzed in each group. Results Plasma Klotho levels were not significantly different among the three groups (4.95±0.48 vs 4.96±0.47 vs 4.91±0.49,P>0.05) . BMD at the first, second, third, fourth and total lumbar spine, femoral neck, trochanter and total body were not associated with plasma Klotho levels in these patients (P>0.05) . Age, diabetic duration, HDL-C and BMI were independent determinants for BMD in T2DM patients. Conclusions BMD might be not associated with plasma Klotho level in T2DM patients. But age,diabetic duration,HDL-C and BMI are associated with reduced BMD and osteoporosis in T2DM patients.

Objective: To compare the diagnostic performance between panoramic radiography(PR)and cone beam computed tomography(CBCT)in the assessment of external root resorption(ERR)of mandibular second molars associated with impacted third molars. Methods: A total number of 832 patients with 1 074 mesially and horizontally impacted mandibular third molars treated at our institution from January 2019 to December 2020 were retrospectively analyzed. Presence of ERR on the adjacent second molar was investigated with PR and CBCT. Factors affecting the diagnostic accuracy of PR were determined. Results: The overall incidence of ERR in second molars was 33.15%(356/1 074)as detected by CBCT images. The accuracy of PR was 66.39%. Multivariate Logistic regression analyses further revealed that middle and Class Ⅲ impaction, crown contact or overlap with the root of adjacent tooth were risk factors for inaccurate diagnosis of PR(P<0.05). Conclusion The accuracy of detection on ERR of mandibular second molar associated with impacted third molar using panoramic radiography is lower. CBCT is recommended for this clinical scenario.

Objective To observe the changes in plasma leptin in type 2 diabetic patients after treatment with ?-glucosidase inhibitor (Acarbose) and investigate the relationships between them.Methods A 8-week randomized double-blind was performed to compare the effects of treatment with Acarbose (50mg, tid) in 43 type 2 diabetic patients. Results (1) When type 2 diabetics compared with non-diabetic controls, fasting plasma glucose(FPG), 2-hr of postprandial plasma glucose (2hBG), A1C, fasting insulin(FIns), triglyceride(TG) and cholesterol(TC)were elevated significantly,2-hr of postprandial insulin(PIns), HDL-C were decreased(P0.05).(3)In type 2 diabetes, there were positive relationships between leptin and BMI, leptin and fasting insulin , leptin and 2-hr of postprandial insulin.(4)After 8 weeks of treatment with acarbose, FPG, 2hBG, A1C, FIns, PIns,Ch and TG decreased significantly (P0.05).Conclusions: When age, gender, and BMI were matched with the controls, the level of leptin in type 2 diabetic patients still has no difference. Acarbose may lower the change in leptin and improve hyperinsulinemia.

Objective To investigate the clinical distribution and antimicrobial resistance of Streptococcus agalactiae(S.agalactiae) in neonatal intensive care unit(NICU), and provide reference for antimicrobial use and intervention measures.Methods Specimens from neonates in the NICU of a hospital in 2010-2014 were collected, the department sources and antimicrobial susceptibility testing results of 62 strains of S.agalactiae isolated from children were analyzed.Results 62 strains of S.agalactiae were mainly distributed at full-term NICU, accounting for 64.52％;the main source of specimens was blood, accounting for 90.33％, followed, by cerebrospinal fluid (6.45％), sputum, and secretion(both were 1.61％).S.agalactiae had the highest resistance rate to tetracycline(79.03％);resistance rates to erythromycin and clindamycin were both 74.19％, resistance rate to levofloxacin was 40.32％, susceptibility rates to penicillin and ampicillin were both 100％.Conclusion S.agalactiae infection mainly occurred in neonates in full-term NICU, and has high resistance rate to multiple antimicrobial agents, penicillin and ampicillin can be used as the preferred antimicrobial agents for the treatment of S.agalactiae infection.

Objective To observe the efficacy and safety of intravitreal injection of ranibizumab in the treatment of retinopathy of prematurity (ROP).Methods Data from 49 consecutive ROP patients (95 eyes) including type Ⅰ pre-threshold,threshold and aggressive posterior ROP who had received anti-VEGF treatment for the first time in our hospital from June 2014 to August 2015 were collected.60 eyes from the 95 eyes were confined as the zone Ⅰ disease group,while the remaining 35 eyes as zone Ⅱ disease group.The difference of birth weight,gestational age,corrected gestational age,treatment effects,recurrence and re-treatment time between two groups were compared.0.025 mL ranibizumab (10 mg · mL-1) was injected through 1.5 mm puncture after corneal limbus by using 30G 1 mL injection syringe.At the end of the injection,tobramycin and dexamethasone ophthalmic ointment eye bag was used.After the injection of 3 days,the portable slit lamp and tonometer were used to observe the intraocular pressure,intraocular hemorrhage and endophthalmitis.The indirect ophthalmoscope was used to observe the retinal vascular tortuosity and ridge regression of lesion expansion at 1 week after treatment.At the same time,the systemic adverse reactions related to treatment were observed.Results After receiving ranibizumab treatment for the first time,93 eyes (95.9％) exhibited ROP regression after single injection,including 58 eyes in zone Ⅰ disease group,35 eyes in zone Ⅱ disease group.There was no statistical difference between two groups (P ＞ 0.05).22 eyes required additional anti-VEGF injection or laser treatment for ROP recurrence,including 17 eyes in zone Ⅰ disease group,5 eyes in zone Ⅱ disease group.There was statistical difference between two groups (P ＜0.05).The time from recurrence to re-treatment was (6.50 ±2.54) weeks,which in zone Ⅰ disease group was (6.44 ± 2.74) weeks and in zone Ⅱ disease group was (6.67 ± 2.31)weeks,there was no statistical difference between two groups (P ＞ 0.05).No local or systemic adverse events associated with the treatment or drug was observed within the following period.Conclusion Intravitreal injection of ranibizumab is an effective and well tolerated method for zone Ⅰ and zone Ⅱ ROP,but the recurrence rate is high.There Is no local or systemic adverse events associated with the treatment or drug.

Objective To investigate the clinicopathologic characteristics of meningioangiomatosis ( MA).Methods Five cases of MA were evaluated morphologically by HE and immunohistochemistry on formalin-fixed paraffin-embedded tissue.Clinical information was also obtained.The literature was reviewed.The clinical pathology and biological behavior of MA were discussed.Results Five cases of MA were reported, arising in three males and two females, with an age range of 16 to 26 years at diagnosis.All five subjects had intractable seizure disorders, and the duration of illness ranged from 8 months to 18 years.The lesions were resected from the frontal lobe in four patients, and from the temporal lobe in one.All the lesions were confined to the cortex, firm in consistency, without capsules and had poor blood supply.There was focal involvement of the overlying leptomeninges.Microscopically, they showed characteristic features of MA, such as proliferating microvessels with perivascular cuffs of spindle-cell within the cortex.Some had numerous calcifications, others showed acidophilic granular bodies.The cells were positive for EMA and vimentin by immunohistochemistry, and for reticulin by histochemical staining.Conclusions MA is a rare, benign hamartomatous lesion of the central nervous system.It usually presents as plaque-like or nodular mass in the cerebral cortex and the overlying leptomeninges, consisting of meningovascular proliferation and leptomeningeal calcification.In some cases the lesion may show perivascular proliferation of elongated spindle-shaped cells.MA usually affects children and young adults, and is located in the frontal or temporal lobes with variable involvement of the overlying leptomeninges.Clinically, most of sporadic cases have a long history of intractable seizures despite multiantiepileptic drugs.MA has also been reported to coexist with arteriovenous malformations,meningiomas and other tumorous lesions.

Objective: To study the clinicopathological features, differential diagnosis and prognosis of primary histiocytic sarcoma of central nervous system(CNS). Methods: Three cases of CNS histiocytic sarcoma were collected at Chinese People′s Liberation Army General Hospital from 2005 to 2018. Their clinicopathological characteristics were analyzed, and the related literature reviewed. Results: The three patients included two females and one male, aged 36, 44, 58 years (median 44 years). MRI showed heterogeneously enhancing lesions which were considered meningioma, high-grade glioma or metastatic carcinoma. Histopathologically there were moderately pleomorphic, mitotically active tumor cells with a loose arrangement, effacing the normal brain tissue. These cells possess abundant eosinophilic cytoplasm, highly atypical nuclei, predominant nucleoli, and hemophagocytosis; multinucleated or spindled forms were also seen, as was background reactive inflammation. The tumor cells were typically positive for CD68, CD163, vimentin and lysozyme, S-100 protein, two of three cases were positive for BRAF V600E,one of three cases was partly positive for CD45, CD45RO, CD4, CD34, and negative for GFAP, Olig-2, CK, EMA, SSTR2, CD99, CD117, MPO, CD1a, Langerin, CD21, CD23, CD35, CD15, CD30, CD38, and CD138. The index of Ki-67 was 30%-75%. Rich reticular fiber network was seen in all cases; BRAF V600E mutation was present in two cases. Conclusions CNS histiocytic sarcoma is a rare malignant tumor; histopathologic and immunohistochemical examination are necessary for the diagnosis and to exclude other primary CNS and hematolymphopoietic tumors. Primary CNS histiocytic sarcoma is treated by surgery, chemotherapy and radiation therapy, but the prognosis is poor. Complete resection combined with high dose focused radiotherapy can improve the prognosis.

Objective To investigate the influences of different matrix stiffness on proliferation ability and glucose metabolism of hepatocellular carcinoma (HCC) cells and to explore the correlation between metabolism and biological behavior changes of HCC cells resulted from the stiffness of extracellular matrix (ECM)．Methods The proliferation changes of HepG2 cells cultured on matrix with different stiffness were detected by CCK-8 assay and cell count assay. 2-NBDG and flow cytometry were used to detect the effect of matrix stiffness on glucose uptake. Real-time fluorescence quantitative polymerase chain reaction (qRT-PCR) was used to detect the expression level of Glut1. Then, 2-DG was used to inhibit glycolysis, and the influences of matrix stiffness on proliferation of HepG2 cells were detected. Results The proliferation ability, glucose uptake and the expression of Glut1 of HepG2 cells increased with the matrix stiffness increasing. When glycolysis was inhibited, the proliferation ability of HepG2 cells grown on matrix with different stiffness was similar. Conclusions The mechanical microenvironment had an important effect on proliferation of HCC cells; matrix with a larger stiffness might promote proliferation of HCC cells through regulating glycolysis. The research findings provide a corresponding experimental basis for the clinical treatment of HCC cells and drug development targeting glucose metabolism.

OBJECTIVETo investigate the incidence and associated factors of multicentricity in renal cell carcinoma (RCC) in Chinese patients.

METHODSOne hundred and two kidney samples from radical nephrectomy due to RCC were step sectioned at 3 mm intervals and examined. All tissue abnormalities were removed, stained and examined for multicentricity. Then, on each slice of the sample, both the parenchymal margin of 15 mm beyond the pseudocapsule and tissue around the renal sinus were continuously sectioned and examined for completeness of the pseudocapsule and vascular and lymph node invasion. The relationship between muliticentricity and other pathological parameters was evaluated.

RESULTSThe incidence of multicentricity was 15.7% (16/102); it was significantly lower in primary tumors < or = 4.0 cm than in tumors > 4.0 cm (4.9%, 2/41 vs 23.0%, 14/61; chi(2) = 6.055, P = 0.014). The incidence was 9.8% (8/82) in tumors without vascular invasion and 40.0% (8/20) in those with it (P = 0.003, Fisher's exact test). The incidence of multicentricity was 1.9% (1/53) in tumors with a complete pseudocapsule and 30.6% (15/49) in those without it (chi(2) = 15.885, P = 0.000). The grade, stage, subtypes and lymph node invasion of the primary tumor were not significantly associated with multicentricity. Multiple logistic regression analysis showed that pseudocapsular incompleteness and vascular invasion were two significant predictors of RCC multicentricity (P = 0.005 and 0.023).

CONCLUSIONSThe incidence of multicentricity of RCC in this group of patients was in accordance with published studies. Multifocality was significantly associated with tumor size, pseudocapsule completeness and vascular invasion. NSS should be limited to tumors less than 4.0 cm when the contralateral kidney is normal and careful long-term follow-up is necessary in tumors with positive vascular invasion and incomplete pseudocapsule.

Aged ; Carcinoma, Renal Cell ; epidemiology ; pathology ; surgery ; China ; epidemiology ; Female ; Humans ; Incidence ; Kidney Neoplasms ; epidemiology ; pathology ; surgery ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness