Objective To investigate the clinical characteristics and surgical treatment for primary presacral tumors.Methods The clinical data of 42 patients of primary presacral tumors from January 2013 to May 2015 were analysed retrospectively.Results Of the 42 patients,16 cases were asymptomatic while 26 patients had discomfort at the sacral or abdominal region,or difficulty in urinating or defecation.90％ of the cases were digital rectum examination (DRE) positive.Among the 42 patients 36 cases underwent surgical treatment,1 case underwent radiotherapy,5 cases refused surgical treatment.Among those receiving surgical resection,28 cases had trans-abdominal surgery and 4 cases had trans-sacral surgery,while 3 cases had trans-abdominal & trans-sacral surgery,1 case had trans-abdominal and perineal surgery.Tumors were completely resected in 31 cases,and palliatively resected in 5 cases.3 cases suffered from intra-operative presacral hemorrhage.1 case with delayed hemorrhage required surgical intervention.2 cases from incision infection recovered after wound disinfection and dressing.3 cases had postoperative hip or leg numbness;1 case with high fever was cured by intensive antibiotics treatment.Conclusion The low incidence of presacral tumors makes early detection difficult.A diagnosis can be obtained by a positive DRE combined with CT or MRI results.Resection is a therapy of choice after biopsies.

Child ; Ectodermal Dysplasia ; diagnosis ; genetics ; Family Health ; Genes, Recessive ; genetics ; Humans ; Male ; Sex Factors

Objective To explore clinical effect of repairing soft tissue defect in forearm, hand and foot with free super-thin anterolateral thigh perforator flaps. Methods At first the site of perforator vessels were determined by Doppler, then the flaps were designed and harvested with the site as center; the fascia lata and subcutaneous fat were removed by sandhill-likely only the 4.0 cm × 3.0 cm - 3.0 cm×2.5 cm disc-like fascia lata and dermis layer were reserved. 15 traumatic soft tissue defects including forearm, hand and foot were repaired with the ree super-thin antemlateral thigh perforator flaps. Results No vascular crisis happened and all skin grafts survived in donor sites. 2.0 cm×1.2 cm of the distal of flap was necrosis in 1 case and it was healed by dress changing. 15 cases were followed up 3 months-2 years and the average is 6 months. The contour and texture of all flaps were good and two point discrimination (2-PD) was about 8-10 mm of. Conclusions The contour and texture of free super-thin anterolateral thigh perforator flap are good, the feeling of recipient site recovered well, it's less injury for donor site and there is no reshaping for flap. It is a fineness donor site for repairing soft tissue defects in hand and foot.

A new modification method for glass slides was developed and applied to make ThinPrep Pap smears,in order to increase the adhesion ability of cervical exfoliative cells.3-glycidyloxypropyl trimethoxysilane (GOPS) was coated on the glass slides firstly on the slides,then poly-L-lysine (PLL)was covalently modified onto the above epoxy-terminated slides to form GOPS-PLL double decorated slides.The modified slides were characterized using X-ray photoelectron spectroscopy (XPS) and atomic force microscopy (AFM).The cell adhesion ability effect was tested and compared with traditional PLL coated slides by fixing the cervical exfoliative cells on the double adorned slides.The control test was conducted by the bare glass slides unmodified.The cell morphology of cervical exfoliative cells adhered on different slides was observed under the microscope after Papanicolaou staining.The number of cervical exfoliative cells on the unmodified slides,PLL coated slides and GOPS-PLL coated slides was 1030±300,3283±226 and 4119±280 (n=12),respectively.The data among the three different modification methods showed significant differences (one-way analysis of variance,ANOVA test,P＜ 0.05).The cell capturing effect of the GOPS-PLL slide was the best among the three different modified slides.In addition,the GOPS-PLL slide could enhance the uniformity of the adhered cells and be widely applied to the ThinPrep system for cervical carcinoma screening to increase the accuracy rate of diagnosis.

objective:To investigate the relationship between magnetic resonance spectroscopy (MRS) metabolism and Ki-67 expres-sion in high-(HGG) and low-grade gliomas (LGG) by analyzing Ki-67 expression and HGG and LGG metabolites. Methods:We consid-ered 56 pathologically confirmed glioma cases in our hospital. The Ki-67 expression and the MRS metabolism parameters in the tu-mors were analyzed simultaneously. Results:The tumor solid value of Cho was positively correlated with the Ki-67 expression level (rs=0.714, P<0.05). By contrast, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA (rs=?0.708, P<0.05) in 35 cases of the LGG group. The tumor solid value of Cho was also positively correlated with the Ki-67 expression level (rs=0.624, P<0.05). By comparison, the Ki-67 expression level was negatively correlated with the tumor solid value of NAA in the HGG group (rs=?0.769, P<0.05). Conclusion:The MRS metabolism was correlated with the Ki-67 expression in high-and low-grade gliomas.

OBJECTIVESTo investigate the immunophenotypes of primary nasopharyngeal non-Hodgkin lymphoma (NPL) and their relationship to Epstein-Barr virus (EBV) infection.

METHODSThe clinical data and biopsies of 73 patients with NPL were collected in Guangzhou. In situ hybridization was performed to detect the EBV-encoded small non-polyadenylated nuclear RNAs (EBERs) on biopsy slides. Immunohistochemistry was used to classify the immunophenotypes of NPL and detect EBV antigen expression.

RESULTSForty-four (60.27%) of the 73 NPLs were of B cell lineage (CD79alpha(+)/CD3(-)/CD56(-)) while the 29 others (39.73%) were of non-B cell lineage. Seventy-three NPLs could be classified into 3 major immunophenotypes: B cell (CD79alpha(+)/CD3(-)/CD56(-), 44 cases), peripheral T cell (CD79alpha(-)/CD3(+)/CD56(-), 22) and NK/T cell (CD79alpha(-)/CD3(+)/CD56(+), 7). The percentages of EBV infection differed among the 3 major immunophenotypes (B cell: 11.36%, 5/44; peripheral T cell: 81.82%, 18/22; NK/T cell: 100%, 7/7). Both CD56(-) positive and CD56(-) negative immunophenotypes could further be divided into 4 subtypes: CD8(-)/CD4(-), CD8(+)/CD4(-), CD8(-)/CD4(+) and CD8(+)/CD4(+). All the CD8(-)/CD4(-) NPLs with CD56(-) positivity (7) or CD56(-) negativity (2) were infected with EBV. The neoplastic cells of a nasopharyngeal Burkitt's lymphoma expressed EBV nuclear antigen 1 (EBNA1) and EBV RNA (EBERs) only. In the other 29 EBV-infected NPLs, most of the lymphoma cells harboring EBV also expressed EBNA1 and EBERs; 21 of the 29 NPLs had a considerable number of neoplastic cells expressing latent membrane protein 1 (LMP1) (21/29, 72.41%) and 23 of 29 NPLs expressed latent membrane protein 2A (LMP2A) (23/29, 79.31%). A few lymphoma cells in 17 (17/29, 58.62%), 23 (23/29, 79.31%) and 22 NPLs (22/29, 75.86%) expressed Zta (Bam HI Z transactivator), viral capsid antigen (VCA) and membrane antigen (MA), respectively.

CONCLUSIONSThe prevalence ratio of the 3 immunophenotypes, namely, B cell, peripheral T cell and NK/T cell lymphoma, is about 6:3:1. However, the EBV infection ratio is reversed, 1:8:10. All the NK/T cell (CD56(+)) and peripheral immature T cell (CD3(+)/CD8(-)/CD4(-)) NPLs were EBV-infected. Except for one Burkitt's lymphoma, the EBV harbored in both B cell and non-B cell NPLs was mainly latent infection, type II, expressing EBNA1, LMP1 and LMP2A. However, the EBV found in a few lymphoma cells could become replicative, expressing lytic proteins.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; CD56 Antigen ; analysis ; Child ; Epstein-Barr Virus Infections ; complications ; Epstein-Barr Virus Nuclear Antigens ; analysis ; Female ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunophenotyping ; Lymphoma, Non-Hodgkin ; etiology ; immunology ; virology ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; etiology ; immunology ; virology ; RNA, Viral ; analysis

OBJECTIVETo compare the detection rates of Epstein-Barr virus (EBV) DNA in the serum/plasma between apparently healthy adults (AHAs) and nasopharyngeal carcinoma (NPC) patients in attempt to evaluate the efficiency of EBV DNA assay for serodiagnosis of NPC.

METHODSThe plasma and serum were obtained from 58 AHAs and 66 untreated NPC patients. EBV DNA W-fragment was detected using nested ploymerase chain reaction (PCR). Immunoenzymatic assay for titration of IgA-VCA was also adopted.

RESULTSEBV DNA detection rate (84.85%) in the plasma/serum of 66 NPC patients was significantly higher than that (10.34%) in 58 AHAs. The sensitivity of plasma/serum EBV DNA assay (0.8485) was higher than that (0.8030) of titrating IgA-VCA (positive criterion >/= 1:40) though the specificities of these two tests were the same (0.8966). The correct rate, predictive value of a positive test, and Odds ratio of dual positivity (0.8387, 0.9792 and 141.0, respectively) were higher than those of single positivity either to plasma/serum EBV assay (0.5242, 0.7333 and 1.1423, respectively) or to IgA-VCA >/= 1:40 test (0.4839, 0.5385 and 1.0480, respectively).

CONCLUSIONThe EBV DNA detection in the plasma/serum using nested PCR may be a useful indicator for serodiagnosis of NPC.

Antigens, Viral ; blood ; DNA, Viral ; blood ; Herpesvirus 4, Human ; isolation & purification ; Humans ; Immunoglobulin A ; blood ; Nasopharyngeal Neoplasms ; diagnosis ; virology ; Serologic Tests

【Objective】 To study the expression of EB virus gene in head, neck and chest squamous cell carcinoma (HNCSCC), revealing the clinicopathological significance. 【Methods】 Using in situ hybridization and S-P immunohistochemical technique, we examined the expression of EBV and Ki67 protein in 123 cases of HNCSCC. The pathological characteristics such as sex, age, histologic grade, lymph node metastasis, distant metastasis, situation and size were analyzed retrospectively. 【Results】 The positive expression rate of EBV in HNCSCC group was significantly higher than that in the normal mucosal epithelial group(P = 0.007). EBV positive HNCSCC in female patients was 19.2%, markedly higher than 3.1%in male patients(χ² = 8.781, P = 0.011). EBV positive HNCSCC in the group under 50 years old was 18.8%(6/32), significantly higher than 2.2% in the group over 50 years old(χ² = 10.666, P = 0.004). The infection rate of EBV was 24.2% in 5 ~ 10 lymph nodes metastasis groups, significantly greater than other groups 0%(Z = -3.548, P = 0.000). EBV infection rate in the group without distant organ metastasis was 22.2%, higher than 3.8% with distant organ metastasis(χ² = 8.567, P = 0.016). The group with the Ki67 proliferation index less than 70% showed higher positivity of EBers than the group with Ki67 more than 70%(8/76 vs. 0/47, Z = -2.291, P = 0.022). There were not any statistically significant differences in histological differentiation, tumor situation and tumor diameter between EBV positive and negative groups. Regression analysis showed that age below 50 years old, the Ki67 index less than 70% and the more lymph node metastasis was elevated risk factors for EBV infection. 【Conclusion】 EBV infection is associated with HNCSCC. EBV-associated HNCSCC is more frequent in female patients under 50 years of age with more lymph node metastasis, while distant metastasis is less common.

【Objective】To evaluate the role of serum antimullerian hormone （AMH） concentration in predicting clinical outcomes in controlled ovarian stimulation and intrauterine insemination （IUI）. 【Methods】 A retrospective analysis of IUI data from patients with polycystic ovary syndrome and infertility in our reproductive center from January 2014 to August 2017. According to the clinical outcomes，data was divided into three groups：clinical pregnancy group，non-pregnant group，and cancellation cycle group due to multiple follicular or no dominant follicular develop. The ovarian function evaluation indexes were compared such as serum AMH，basal FSH and basal sinus follicle（AFC）. The cutoff values of the AMH to predict multi- follicular development or no dominant follicular development which IUI cycles were cancelled，and to predict obtain cumulative clinical pregnancy outcomes were calculated according to the ROC curve to cancel the cycle. 【Results】 The clinical pregnancy rates of PCOS patients were from 15.9% to 17.1% ，while the cumulative clinical pregnancy rate increased in repeat cycles （≤3 cycles） was 21.6% ，significantly higher than the average clinical pregnancy rate（16.7%）during the first cycle. AMH levels in the cancelled cycle group were significantly higher than those in the non-cancelled cycle group［（14.1±6.5）vs（10.3±4.3）ng/mL，（14.1±6.5）vs（9.3±4.3）ng/mL， P<0.025］. Compared with the clinical pregnancy group，cancel cycle group and non- pregnant group，the mean AFC of the former two groups were significantly higher［（34.5±11.4）vs（30.7±11.3），（7.8±10.8）vs（30.7±11.3），P<0.025］. In addition，we found that women′ s age，baseline FSH were negatively correlated with the cumulative pregnancy rate of repeated IUI cycles，and women′s baseline BMI，baseline LH，AFC，and AMH were positively correlated with cumulative pregnancy rates. The number of mature follicles on the HCG triggering day，as well as the value of AMH，may be the influencing factor of IUI cumulative clinical pregnancy. By ROC curve analysis，we assume that AMH is more suitable than the AFC to predict IUI cycle cancellation rate and the cumulative pregnancy rate.【Conclusion】Repeated IUI cycles can be improved cumulative pregnancy rate of PCOS infertile couples. AMH，as an important index to measure ovarian reserve function，can be used to predict the the IUI cumulative clinical pregnancy outcomes and cancelled cycle rates：as AMH increased to more than 6.56 ng/mL，the pregnancy rate increased；but when AMH ≥14.72 ng/mL，the risk of cancelled IUI cycles was increased，becasues of multi-follicular developing and absence of dominant follicle development.

【Objective】Through summarizing the clinical manifestations and gene mutations of 5 types of RASopathies in childhood including Neurofibromatosis type1（NF1），Noonan syndrome（NS），Noonan syndrome with multiple lentigines（NSML），Costello syndrome（CS）and cardio-facio-cutaneous syndrome（CFC）and analyzing their commonalities and characteristics，to deepen the clinician′s understanding of the RASopathies and improve the domestic doctors′ diagnosis and treatment level of RASopathies.【Methods】The clinical data and gene mutation types of 11 patients of RASopathies who were diagnosed in Sun Yat- Sen Memorial Hospital from January 2015 to May 2018 were retrospectively analyzed. 【Results】The age of onset ranged from 6 months to 12 years and the main clinical manifestations of 11 patients included： short stature，craniofacial features，congenital heart defect，café-au-lait macules，developmental delay，thrombocytopenia， seizures and dystonia，cryptorchidism，etc. Five gene mutations were detected including NF1 gene，PTPN11 gene， RAF1 gene ，BRAF gene and HRAS gene.【Conclusions】The RASopathies are a clinically defined group of medical genetic syndromes caused by germline mutations in genes that encode components or regulators of the Ras/MAPK pathway. The RAS/MAPK pathway plays an important role in regulating growth development，promoting cell proliferation，differentiation，metabolism，and signal transduction of various hormones. Therefore，they share many overlapping characteristics，including craniofacial features，growth retardation，cardiac malformations，cutaneous and musculoskeletal abnormalities，neurocognitive impairment and tumor susceptibility. However ，each RASopathy exhibits different degree phenotypes because of mutations at different points in the pathway. In addition ，tumor susceptibility is one of the typical clinical features of RASopathies. Therefore，tumor monitoring is one of the most important contents in the follow-up process.