Background Studies indicate that the decline of androgen level affects the secretion function of epithelial cells of meibomian glands and lacrimal glands ,which results in the abnormality of tear quality and quantity.However,whether androgen level regulates the mucin adhesion to ocular surface is still not elucidated.Objective This study was to investigate the tear functional changes and corneal ultrastructural changes in castrated male mice.Methods Fifty-six SPF male BALB/c mice were devided into normal control group, sham group, and orchectomy 1-week group, orchectomy 2-week group, orchectomy 4-week group, orchectomy 6-week group, orchectomy 8-week group according to random number table.Orchectomy was performed in the mice of the orchectomy 1-,2-,4-,6-and 8-week group,and only incision rather than enucleation of testis was carried out in the mice of the sham group.Peripheral venous blood samples were collected during eyeball enucleation in all the mice and serum androgen concentration was detected by radioimmunoassay.Tear secretion level was measured with phenol red thread.Break-up time of tear film (BUT) was tested,and corneal inflorescence staining was scored based on the criterion of Toshida.The corneas of all the mice were collected for ultrastructural examination under the transmission electron microscope.The study complied with the Regulations for the Administration of Affairs Concerning Experimental Animals by State Science and Technology Commission.Results Mouse serum androgen concentration was (573.87±6.74) ng/μl in the normal control group and (579.74-±8.24)ng/μl in the sham group, and there was no significant difference between these two groups (t =1.432, P =0.251) , however, the serum androgen concentration was 0 ng/μl in all castrated mice after orchectomy.The tear secretion levels were (5.26 ± 0.99), (4.89 ± 0.56), (4.62 ± 0.83), (4.28 ± 0.63), (3.36 ± 0.56),(2.60±0.27) and (2.08 ±0.35) mrn/5 minutes in the normal control group, sham group and orchectomy 1-, 2-, 4-,6-and 8-week groups, respectively, and the tear secretion levels were significantly lower in the orchectomy 2-, 4-,6-and 8-week groups than those in the normal control group (all at P＜0.05).The BUT were (68.33±12.86), (62.47± 3.75),(58.67±10.03), (47.17±7.64) ,(39.51±3.39),(32.67±3.88) and (31.00±2.36) seconds in the normal control group, sham group and orchectomy 1-, 2-, 4-, 6-and 8-week groups, respectively, and the BUTs were significantly shorter in the orchectomy 2-,4-, 6-and 8-week groups than those in the normal control group (all at P＜0.05).The fluorescein stain score of corneal epithelium was gradually increased with the lapse of castrated time.The decrease of number,shortening and edema of microvilli as well as separation of desmosomes of corneal epithelial cells were found under the transmission electron microscope in castrated mice.Conclusions Decreasing of serum androgen level, declining of aqueous tears,instability of tear film and damage of corneal epithelial cell ultrastructures occur in castrated male mice, and these manifestations are similar to dry eyes.

Objective To analyze and summarize the CT features of medullary thyroid carcinoma (MTC).Methods 30 patients with MTC proved by surgery and pathology were scanned by CT.And the CT manifestations were analyzed retrospectively.Results In a total of 30 patients,a single lesion in 25 (83.3%)patients and multiple ones in 5 (16.7%)were found with irregular shape in 27 (90.0%),unclear border in 26 (86.7%),heterogenous enhancement with irregular internal hypodensity in 27 (90.0%),cal-cifications in 4 (13.3%)and invasion of trachea in 4 (13.3%).As for the 29 patients underwent the neck surgery ,26 (89.7%) were pathologically confirmed with lymph nodes metastasis.CT showed the metastatic lymph nodes with well-defined border in 1 2 (46.2%)and ill-defined one in 14 (53.8%),calcifications in 5 (19.2%)and heterogenous enhancement with irregular internal hy-podensity in all (100.0%).Conclusion CT features of MTC and metastatic lymph nodes appeared as heterogenous enhancement with irregular internal low attenuation area,which can improve the accuracy of preoperative diagnosis.

Objective To investigate the optimal methods of detecting micrometastasis of sentinel lymph node(SLN) in papillary thyroid carcinoma(PTC).Methods Data of 51 consecutive PTC patients without clinical evidence of cervical lymph node metastasis were analyzed.They were conducted with SLN localization with blue dye,technetium-labeled sulfur colloid or the combination of them from Aug.2007 to Sep.2010.55 SLNs from 18 cases were selected.No metastasis was found to these 55 SLNs by routine pathological section.The 55 SLNs were serially sectioned at a 50 μm interval and stained by both HE and immunohistochemistry for detecting micrometastasis.Results SLN was successfully identified in all the 51 cases,with SLN identification rate of 100％.Among the 18 cases without metastasis to SLN by routine pathological section,5 cases were found micrometastasis by step sectioning plus immunohistochemically stains.The false negative rate was reduced from 15.4％ by routine pathological section to 2.6％ by step sectioning plus immunohistochemically stains.Conclusion Cytokeratin immunohistochemistry on series sections is a reliable method in detecting SLN micrometastasis in PTC.

The purpose of this study was to pool information in epithelial ovarian cancer by combining studies using Affymetrix expression microarray datasets made at different laboratories to identify novel biomarkers. Epithelial microarray expression information across laboratories was screened and combined after preprocessing raw microarray data, then ANOVA and unpaired T test statistical analysis was performed for identifying differentially expressed genes (DEGs), followed by clustering and pathway analysis for these DEGs. In this work, we performed a combination analysis on microarrays from three different laboratories using gene expression data on ovarian cancer and obtained a list of differential expression profiles identified as potential candidate in aggressiveness of ovarian cancer. The clustering and pathway analysis explored the different molecular basis of different ovarian cancer stages and potential important regulatory pathways in ovarian cancer development. Our results showed that combination of microarray data from different laboratories in the same platforms may overcome biases derived from probe design and technical features, thereby accelerating the identification of trustworthy DEGs, and demonstrating the advantage of integrative analysis in gene expression studies on epithelial ovarian cancer research.

ObjectiveTo evaluate combined radioisotope and methylene blue dye method for identifying sentinel lymph node (SLN) for modified radical neck dissection of papillary thyroid carcinoma (PTC). MethodFifty-one consecutive PTC patients without clinical evidence of locoregional lymph node involvement were enrolled in the study between August 2007 and September 2010.5 h ( rangel.5 - 8 h) before the surgery,one single intratumoral injection of 74 MBq in a volume of 0.4 ml 99mTc -Dextran was administered under ultrasound guidance and 1％ methylene blue dye was injected into the parenchyma surrounding the primary tumor intraoperatively.Preoperative lymphoscintigraphy,intra-operative hand-held gamma probe detecting and blue dyed lymph node were used to identify the SLN.All SLNs were sent for frozen-section and the specimens of routine selective neck dissection were stained with haematoxylin and eosin (H&E). ResultsSLNs were identified in 48 of 51 cases (94.1％ ) with combination method.SLN identification rate were 66.7％by methylene blue dye method and 90.2％by radioisotope method respectively.Final pathologic examination revealed that 30 cases ( 58.8％ ),including 3 cases who had negative SLNs,had lateral neck occult lymph node metastasis.The rate of occult lymph node metastasis in level Ⅱ,level Ⅲ,level Ⅳ and level Ⅴ were 17.6％,52.9％,29.4％ and 0％.Thus,the sensitivity,specificity,accuracy, and positive and negative predictive values of SLN biopsy were 90％, 100％,94.1％,100％ and 87.5％,respectively. ConclusionsSLNB is feasible and safe,the findings correlate with lateral lymph node status.Therefore,SLN biopsy is a good method for estimating the status of lateral lymph node in patients with clinical negative lymph node papillary thyroid carcinoma.

OBJECTIVETo investigate the significance of thyroid transcription factor-1 (TTF-1) in the histogenesis of pulmonary sclerosing hemangioma (PSH).

METHODSWith clinicopathologic data of 36 PSH patients obtained, all specimens were stained by immunohistochemical method with a panel of antibodies including TTF-1, SpA, CK, EMA, F-VIII, CD34, Claretinin, HBME, synaptophsin, chromogranin, actin and S-100.

RESULTSThe patients were mostly women with a mean age of 46.7 years and a median age of 48 years. All lesions were solitary and well circumscribed with a mean size of 3.3 cm and a median size of 3 cm. No multiple or metastasis was found. Surface cells (SC) and round cells (RC) were showed in PSH, with more than 90% showing TTF-1 and EMA by immunohistochemical method. CK and SpA were showed in SC, which were not showed in RC. Neuroendocrine cells scattered within RC of PSH were detected in a few cases. Mesothelial, vascular endothelial, neuroendocrine, and myoepithelial markers by immunohistochemical method were negative.

CONCLUSIONPulmonary sclerosing hemangioma, a benign tumor, originates from the alveolar pneumocytes. Its surface cells are more mature, while the round cells, being primitive respiratory epithelia, may undergo phenotypic differentiation and evolve into mucinous glands or neuroendocrine structure among other components.

Adult ; Aged ; Female ; Hemangioma ; metabolism ; pathology ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Male ; Middle Aged ; Nuclear Proteins ; metabolism ; Sclerosis ; etiology ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

Objective To investigate the correlation between blood pressure variability (BPV) and early neurological deterioration (END) in patients with acute anterior circulation large artery atherosclerotic (LAA)stroke. Methods From January 2015 to June 2018, consecutive patients with anterior circulation acute ischemic stroke admitted to the Department of Neurology, the Affiliated Hospital of Yangzhou University were enrolled prospectively. According to the etiological classification, they were divided into LAA group and non-LAA group. By monitoring the blood pressure within 72 h of hospitalization, the mean, maximum (max)and minimum (min) values, and the difference between max and min (max-min), standard deviation (SD),and coefficient of variation (CV; CV = SD × 100/mean) were calculated. END was defined as the highest score of the National Institutes of Health Stroke Scale (NIHSS) within 72 h of admission increased by ≥2than the baseline. Multivariate logistic regression analysis was used to determine the correlation between BPV parameters and END. Results A total of 271 patients with anterior circulation acute ischemic stroke were enrolled, including 101 females (37. 3％) and 170 males (62. 7％), with an average age of 64. 99 ± 11. 51 years. There were 95 patients (35. 1％) with LAA and 176 (64. 9％) with non-LAA. In the LAA group and non-LAA group, 36 patients (37.9％) and 50 patients (28.4％) developed END respectively. The comparison between END patients and non-END patients in the LAA group showed that there were significant differences in age, sex, diabetes mellitus, baseline NIHSS score and C-reactive protein, as well as SBPmax , SBPmax-min , SBPSD , SBPCV, DBPmax , DBPmax-min , DBPSD , and DBPCV in BPV indices (all P < 0. 05).Multivariate logistic regression analysis showed that many BPV indices were the independent risk factors for END, including SBPmax (odds ratio [OR] 1. 027, 95％ confidence interval [CI] 1. 003-1. 052; P = 0. 027),SBPmax-min (OR 1. 041, 95％CI 1. 015-1. 068; P = 0. 002), SBPSD (OR 1. 177, 95％ CI 1. 048-1. 322; P =0. 006), SBPCV (OR 1. 226, 95％ CI 1. 036-1.451; P = 0. 018), DBPmax (OR 1. 073, 95％ CI 1. 017-1. 133;P = 0. 010), DBPmax-min (OR 1. 107, 95％CI 1. 044-1. 174; P = 0. 001), DBPSD (OR 1. 693, 95％CI 1. 268- 2. 260; P < 0. 001), and DBPCV(OR 1. 726, 95％CI 1. 311-2. 271; P < 0. 001). In the non-LAA group, there were no significant association between all BPV parameters and the occurrence of END. Conclusion BPV was significantly correlated with END in patients with anterior circulation LAA.

The purpose of this study was to pool information in epithelial ovarian cancer by combining studies using Affymetrix expression microarray datasets made at different laboratories to identify novel biomarkers.Epithelial microarray expression information across laboratories was screened and combinedafter preprocessing raw microarray data,then ANOVA and unpaired T test statistical analysis was performed for identifying differentially expressed genes(DEGs),followed by clustering and pathway analysis for these DEGs.In this work,we performed a combination analysis on microarrays from three different laboratories using gene expression data on ovarian cancer and obtained a list of differential expression profiles identified as potential candidate in aggressiveness of ovarian cancer.The clustering and pathway analysis explored the different molecular basis of different ovarian cancer stages and potential important regulatory pathways in ovarian cancer development.Our results showed that combination of microarray data from different laboratories in the same platforms may overcome biases derived from probe design and technical features,thereby accelerating the identification of trustworthy DEGs,and demonstrating the advantage of integrative analysis in gene expression studies on epithelial ovarian cancer research.

Objective To evaluate the efficacy of endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) in diagnosis of enlarged mediastinal lymph nodes (LNs), mediastinal occupying lesion of unknown origin, as well as in N-staging for lung cancer. Methods EUS-FNA was performed via esophagus with a 22-gange needle in 61 patients, followed by pathological and cytological examinations. Results The positive diagnosis rate of EUS-FNA was 93.4% (57/61), and the cytological and pathological diagnostic accuracy were 85.2% (52/61) and 83.6% (51/61), respectively. Of 61 patients, 26 were suspected as having lung cancer with mediastinal lymph nodes metastasis, but the bronchoscopy failed to confirm the diag-nosis. EUS-FNA diagnosed lung cancer in 21 and benign lesion in 5. Of 22 patients with mediastinal occupying lesions of unknown origin, 19 (86.4%) were diagnosed by EUS-FNA. Of 7 patients with malignant tumor history and enlarged mediastinal lymph nodes, EUS-FNA confirmed mediastinal metastasis in 6 (85.7%). Six cases of lung cancer with suspected mediastinal lymph nodes metastasis were confirmed by EUS-FNA and the corresponding therapy regimen was modified. No complications related to EUS-FNA procedure occurred. Conclusion EUS-FNA is a safe and effective method for diagnosis of enlarged medistinal LNs, mediastinal lesion of unkown origin and N-stage of lung cancer.

Objective To investigate the pattern of nodal recurrence after curative resection in adenocarcinoma of the gastroesophageal junction ( AGE ) , and to provide a basis for delineation of the radiation range in the high-risk lymphatic drainage area.Methods A retrospective analysis was performed in 78 patients with locally advanced AGE who were newly treated in our hospital from January 2009 to December 2013 and had complete clinical data.All patients received curative resection and were pathologically diagnosed with stage T3/T4 or N (+) AGE.Those patients were also diagnosed with SiewertⅡor Ⅲ AGE by endoscopy, upper gastroenterography, macroscopic examination during operation, and pathological specimens.None of the patients received preoperative or postoperative radiotherapy.All patients were diagnosed by imaging with postoperative nodal recurrence.The computed tomography images of those
patients were accessible and had all the recurrence sites clearly and fully displayed.Results The median time to recurrence was 10 months ( 1-48 months) , and 90%of the recurrence occurred within 2 years after surgery.The lymph nodes with the highest risk of recurrence were No.16b1( 39%) , No.16a2( 37%) , No.9 (30%), and No.11p (26%), respectively.There was no significant difference in the recurrence rate within each lymphatic drainage area between patients with SiewertⅡandⅢAGE ( P=0.090-1.000) .The lymph nodes with the most frequent recurrence were No.16b1, No.16a2, No.9, No.16b2, No.11p, and No.7 in patients with stage N3 AGE and No.11p, No.16b1, No.16a2, No.9, No.8, and No.7 in patients with stage non-N3 AGE.Patients with stage N3 AGE had a significantly higher recurrence rate in the para-aortic regions (No.16a2-b2) than those with stage non-N3 AGE (67%vs.33%, P=0.004, OR=4.00, 95% CI=1.54-10.37) .Conclusions The lymph nodes with the highest risk of recurrence are located in the celiac artery, proximal splenic artery, and retroperitoneal areas ( No.16a2 and No.16b1) in patients with SiewertⅡorⅢlocally advanced AEG.Moreover, patients with stage N3 AGE have a higher risk of retroperitoneal recurrence.The above areas should be involved in target volume delineation for postoperative radiotherapy.