Objective:To observe the levels of serum endothelin(ET),nitric oxide(NO),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6)in prehypertension and hypertension patients.Methods:Three groups were recruited from 3050 subjects of regular health checkup in Tangshan Railway Hospital from June to September,2007. Prehypertension (PH) group: n=106,Essential hypertension (EH) group: n=91,and Normotensive (NT) control group: n=98.The levels of ET,TNF-α,IL-6 and NO were compared by radioimmunoassay and biochemical tests. Results: ①Compared with NT group,body mass index (BMI) and serum lipids (TC,TG,LDL-C) were significantly increased in PH and EH groups (P<0.05),high-density lipoprotein cholesterol (HDL-C)was decreased in EH groups (1.59±0.15 vs. 1.77±0.19,P<0.05). ②Compared with NT group,ET,IL-6,TNF-α were increased in PH and EH groups (P<0.05).NO was increased in PH group (6.55±0.94 vs. 5.87±0.80,P<0.05) while decreased in EH group (5.28±0.81 vs. 5.87±0.80,P<0.05). ③Logistic analysis indicated that BMI,ET,NO,TNF-α and IL-6 were related to the hypertension. Conclusion: ET,NO,TNF-α,IL-6 were elevated in prehypertension patients and those might be used to predict the risk of hypertension.

[Objective] To study the relationship between syndrome patterns of traditional Chinese medicine and bcl- 2 oncogene, p53 suppression gene mRNA expressions in precancerous lesions of gastric cancer (PIGC). [Methods] Forty PLGC cases were endoscopically and pathologically confinned, including 24 cases of moderate dysplasia of gastric mucosa, 9 cases of severe dysplasia, 7 cases of incomplete colonic intestinal metaplasia. Of the 40 cases, 10 were complicated with Qi stagnation, 12 with stomach-heat, and 18 with blood stasis, mRNA expression of bcl- 2 oncogene and p53 suppression gene were detected in situ by molecular hybridization method. [Results] The mRNA overexpression of bcl- 2 oncogene and p53 suppression gene were found in PLGC, and the expression was gradually increased with the progress of lesions. In the complicated cases, the mRNA expression of bcl- 2 oncogene and p53 suppression gene were the least in the cases with Qi stagnation and less in the cases with stomach- heat than in the cases with blood stasis. [Conclusion] Abnormal mRNA expression of bcl- 2 oncogene and p53 suppression gene were found in PLGC cases and related with different complicated cases, indicating the specificity of different syndrome patterns.

OBJECTIVE:To observe therapeutic efficacy and safety of cefoperazone sodium and sulbactam sodium combined with Shenmai injection in the treatment of elderly stroke associated pneumonia(SAP). METHODS:A total of 84 SAP patients in Dazhou Municipal Central Hospital during Mar. 2016-Mar. 2017 were divided into control group(42 cases)and observation group (42 cases)according to random number table. Based on routine treatment,control group was additionally given Cefoperazone sodium and sulbactam sodium for injection 3 g added into 5% Glucose injection 100 mL,intravenously,twice a day;suitable antibiotics were selected according to the results of pathogenic examination and drug sensitivity test. Observation group was additionally given Shenmai injection 100 mL added into 5% Glucose injection 250 mL intravenously,once a day,on the basis of control group. Both groups were treated for consecutive 2 weeks. Clinical efficacies of 2 groups were observed,and the levels of T-lymphocyte subsets(CD4+,CD8+,CD4+/CD8+)and inflammatory markers(TNF-α,hs-CRP,PCT),length of hospital stay before and after treatment. The ADR was recorded. RESULTS:The total response rate(95.24%)and marked response rate (47.62%)of observation group were significantly higher than those of control group(83.33%,23.81%);length of hospital stay in observation group [(15.24±3.53)d] was significantly shorter than control group [(18.43±4.21)d],with statistical significance (P<0.05).After treatment,the levels of CD4+and CD4+/CD8+in 2 groups were significantly higher than before treatment,and the observation group was significantly higher than the control group;the levels of CD8 +,TNF-α,hs-CRP and PCT in 2 groups were significantly lower than before treatment;the observation group was significantly lower than the control group,with statistical significance(P<0.05);there was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Based on routine treatment,cefoperazone sodium and sulbactam sodium combined with Shenmai injection treat SAP significantly,can effectively improve immune function, reduce inflammation level and shorten the length of hospital stay without increasing the occurrence of ADR.

Objective Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus is a rare morphological variant of endometrioid carcinoma.The biphasic morphological features may cause confusion with carcinosarcoma of the uterus,leading to misdiagnosis.The aim of this article is to elucidate the clinicopathological characteristics of such endometrial carcinoma to avoid misdiagnosis.Methods The clinical and pathological data of 5 cases of endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus were collected and analyzed.Results The age of the 5 patients ranged from 29 to 39 years,with a mean age of 33 years.Four patients underwent surgery of radical hysterectomy,the other dilation and curettage biopsy.Among the former,3 patients were at FIGO stage Ⅰ A,the other Ⅲ C1.Microscopically,all 5 tumors contained endometrioid carcinoma components,4 of which were FIGO grade Ⅰ,the remaining one was grade Ⅱ.Each tumor was of variable proportions of corded and hyalinized areas ranging from 10％ to 60％.The cells in the corded and hyalinized areas were epithelioid,fusiform and spindle in morphology,admixed with the endometrioid carcinoma component,resulting in a biphasic pattern.The corded and hyalinized component exhibited distinctively different immunophenotypical feature from that by the conventional endometrioid carcinoma component.The results of follow-up for 4 patients of 7 to 68 months (mean =26.5 months) revealed that all patients were alive without recurrence of the malignancy.Conclusions Endometrioid carcinoma with sex cord-like formations and hyalinization of the uterine corpus presents unique morphology,and the patients are usually young with relatively favorable prognosis.The definite mechanism for the pathogenesis of the sex cord-like formations and hyalinization needs further investigation.

Objective: To investigate androgen receptor(AR)expression in invasive breast carcinoma and the correlation with surrogate molecular breast carcinoma subtypes. Methods: Immunohistochemical staining of AR and other biomarkers was performed in a cohort of 870 cases of primary invasive breast carcinomas collected from August to December, 2016. The association of AR expression with different histological and surrogate molecular subtypes was analyzed. Results: The positive expression rate of AR in the immunohistochemistry-based surrogate subtypes was 96.3%(207/215) for Luminal A, 89.8%(378/421) for Luminal B, 82.4%(75/91) for HER2 overexpression and 37.1%(53/143) for triple negative breast carcinoma, with significant differences among the four groups (P<0.01). AR correlated positively with the expression of ER(P<0.01), PR(P<0.01), HER2(P=0.007), GATA3(P<0.01), GCDFP15(P<0.01)and mammaglobin(P<0.01), while negatively with the expression of Ki-67(P<0.01), CK5/6(P<0.01)and CK14(P<0.01). Conclusions AR exhibits a high expression in invasive breast carcinoma, which is mainly correlated with ER-positive breast carcinoma. Regardless of the relatively low expression rate, AR is a potential therapeutic target in triple negative breast carcinoma.

Objective: To describe the clinicopathologic features, diagnosis and differential diagnosis of ovarian carcinoid tumors. Methods: A retrospective chart review was performed of all patients diagnosed with primary ovarian carcinoid tumors at Fudan University Shanghai Cancer Centre from 2007 to 2017. Results: The histologic analysis of these carcinoid tumors revealed 3 were insular, 1 was trabecular, 1 was mucinous, and 10 were strumal. Histologic features of insular and trabecular carcinoid were similar to other parts of the neuroendocrine tumor. Strumal carcinoid was composed of thyroid tissue intimately admixed with carcinoid tumor, showing trabecular pattern. Mucinous carcinoid was resembles Krukenberg tumor. Most ovarian carcinoid tomours were diffusely positive with at least one neuroendocrine marker, especially synaptophysin (14/14) and CD56(9/10). The median follow-up time was 53 months, 1 patient with squamous-cell carcinoma of cervixrecur rence in vaginal after 37 months, and only 1 patient died of disease. The remaining patients were disease-free survival. Conclusions Primary carcinoid of the ovary is a very rare low grade malignant monodermal teratomas and somatic-type tumours arising from a dermoid. The diagnosis and differential diagnosis mainly relies on the histopathologic characteristics and the immuno-phenotype. Primary ovarian carcinoid almost always exhibit a benign clinical behavious except mucinous carcinoid.

Objective To elucidate the clinicopathologic characteristics, immunophenotype and differential diagnosis of ovarian seromucinous carcinoma.Methods The clinical and pathological characteristics of 7 cases of ovarian seromucinous carcinoma were analyzed.Immunohistochemical study of selected markers was performed employing the EnVision method.Literature of ovarian seromucinous carcinoma were also reviewed.Results The age of the 7 ovarian seromucinous carcinoma patients ranged from 27 to 70 years of age ( mean=48 years).Two patients had bilateral ovarian tumors.The complaint of most patients was abdominal distention.The serum concentration of CA125 and/or CA19-9 was elevated in most patients.Four patients were found to have ascites during surgery, of whom 2 were also found to have malignant cells in their ascites or peritoneal washings.The maximum dimension of these tumors ranged from 6.0 to 15.0 cm ( mean=9.3 cm).Grossly, 6 of 9 tumors were predominantly cystic with protrusions of papillae from the inside wall of the cysts.Among these 6 tumors, 2 had brown viscous material in the cyst.The other 3 tumors were predominantly solid.Microscopically, all 9 tumors contained endocervical-like mucinous cells and other Mullerian cells.The tumor cells had intermediate or severe atypia.A lot of acute inflammatory cells especially neutrophil polymorphs could be seen in the stroma and lumens of all the 9 tumors, which is an apparent feature for ovarian seromucinous tumors.Architecturally, the tumors mainly exhibited complex papillary architectures, compactly back-to-back glandular lumensforming cribriform, labyrinthine formations, or solid growth pattern, with immunophenotype of Mullerian tumors.Mucin stain was performed in 1 tumor with AB positive, PAS positive and D-PAS positive, highlighting intracytoplasmicmucin secretions.Follow-up (3-86 months with a mean of 21 month) data revealed that except 1 patient dying of the tumor at 81 months after surgery, the other 6 patients all survived the malignancy. Conclusions Seromucinous carcinoma of the ovary possesses relatively special clinicopathologic features, with some morphological and immunophenotypical overlap with endometrioid carcinoma and low grade serous carcinoma of the ovary.It is necessary to thoroughly investigate the pathogenesis and molecular changes involved in the type of tumor to determine whether it is a convincingly distinctive category of ovarian carcinoma.