Objective:To evaluate the effect of humanistic care for medical care integration on quality of life in elder patients with mild cognitive impairment. Method:Seventy patients with mild cognitive impairment in our hos-pital were randomly divided into experimental group ( n=35 ) and control group ( n=35 ) using random number ta-ble. The patients in the control group were given routine care, while those in the experimental group were given hu-manistic care for medical care integration and home visiting once a month besides routine care. All the patients were evaluated by the Montreal Cognitive Assessment Scale ( MoCA) , Activities of Daily Living ( ADL) , and the MOS Item Short from Health Survey ( SF-36 ) during hospitalization, three months and six months after hospital discharge. Result:Three and six months after hospital discharge, the scores of these three scales of all subjects in two groups were significantly higher than those during hospitalization ( P<0 . 05 ) . The scores of the subjects in the experimental group also significantly higher than those of the control group, and the differences were statistically significant (P<0. 05). Conclusion: For the elder patients with mild cognitive impairment, humanistic care for medical care integration can significantly improve the cognitive function, self -care ability and quality of life. Therefore, it is worthy using in clinical treatment.

Objective :To detect peripheral serum levels of matrix metalloproteinase (MMP)—2 ,MMP—9 and tissue in—hibitor of metalloproteinases (TIMP)—1 in CHF patients ,and analyse their relationship with CHF prognosis .Meth—ods : A total of 200 CHF patients ,who were hospitalized in our hospital from Mar 2015 to Mar 2017 ,were enrolled as CHF group ;according to NYHA classification ,they was further divided into class II group (n＝ 78 ) ,class III group (n＝68) and class IV group (n＝ 54 ) ;according to prognostic condition ,CHF group was divided into good prognosis group (n＝126) and poor prognosis group (n＝74).Another 150 healthy subjects were enrolled as healthy control group .Peripheral serum levels of MMP—2 ,MMP—9 and TIMP—1 were measured and compared among all group .Results : Compared with healthy control group , there were significant rise in peripheral serum levels of MMP—2 and MMP—9 ,and significant reduction in TIMP—1 level in CHF group , P＝ 0.001 all.Along with NYHA class rose , peripheral serum levels of MMP—2 and MMP—9 gradually increased , and TIMP—1 level gradually de—creased ,there existed significant difference between any two subgroups , P＝0.001 all.Compared with good prog—nosis group ,there were significant rise in peripheral serum levels of MMP—2 [ (47.72 ± 9.57) ng／ml vs.(57. 42 ± 8.63) ng／ml] ,MMP—9 [ (50. 63 ± 8. 95) ng／ml vs.(62.83 ± 9. 67) ng／ml] ,and significant reduction in TIMP—1 level [ (29. 68 ± 6. 43) ng／ml vs.(20.74 ± 4.07) ng／ml] , P＝0.001 all.AUCs of MMP—2 ,MMP—9 and TIMP—1 judging poor prognosis was 0.689 ,0.683 and 0. 871 respectively ;sensitivity and specificity of MMP—2≥51. 13ng／ml , MMP—9≥57. 67ng／ml ,TIMP—1＜24. 79ng／ml predicting poor prognosis in CHF patients were 59.12% and 80. 93%, 67. 57% and 73.86%,94.19% and 81.79% respectively ,and their Youden＇s indexes were 0. 616 ,0.623 and 0. 516 respectively .Kaplan—Meier analysis indicated that according to two—year poor prognosis rate ,the high level MMP—2 patients was significantly higher than that of low level patients (78.05% vs.8.47%) ,and that of high level MMP—9 patients was significantly higher than that of low level patients (72.09% vs.10.53%) ,and that of low level TIMP—1 patients was significantly higher than that of high level patients (87.18% vs.4.92%) , P＝0.001 all.Con—clusion : There are significant rise in MMP—2 and MMP—9 levels ,and significant reduction in TIMP—1 level in periph—eral blood of CHF patients .They significantly affect patients＇prognosis ,which may be effective markers predicting prognosis of CHF .

Objective:To compare the diagnosis and respiratory outcomes of preterm infants with bronchopulmonary dysplasia (BPD) based on two criteria and to analyze the criteria's predictive value for adverse respiratory system outcomes.Methods:Clinical data of preterm infants with gestational age less than 32 weeks admitted to the First Affiliated Hospital of Sun Yat-sen University from January 2014 to September 2020 were retrospectively analyzed. The diagnosis and classification of all the subjects were based on two definitions developed by the American National Institute of Child Health and Human Development (NICHD) in 2001 and 2018. The severity of pulmonary diseases in eligible infants was quantified with pulmonary scores. The incidence of BPD and respiratory outcomes in infants diagnosed with the two criteria were compared. The logistic predictive model was adopted to analyze the predictive value of the two criteria for adverse long-term respiratory outcomes.Results:The study enrolled 240 infants, among which 138 (57.5%) were male. Infants who met the 2001 and 2018 definitions of BPD accounted for 52.9% (127/240) and 24.0% (57/237), respectively. The rate of pneumonia, mechanical ventilation duration, and overall oxygen duration of the infants who met the 2018 definition were significantly higher or longer than those who met the 2001 definition [84.2% (48/57) vs. 63.7%(79/124), χ2=7.84; 24.0 d (7.0-34.5 d) vs. 9.0 d (4.0-26.0 d), Z=－3.01; 66.0 d (49.0-81.5) vs. 47.0 d (38.0-63.8 d), Z=－3.86, P<0.01]. The incidence of adverse respiratory system outcomes and death of the infants who met the 2018 definition were significantly higher than those who met the 2001 definition [38.6% (17/44) vs. 20.9% (19/91), P<0.05]. Of the 180 infants diagnosed with BPD using the 2001 definition, 67 did not meet the 2018 definition and were all discharged before a corrected age of 45 weeks without oxygen requirement. Only 4.3% (2/47) of those with follow-up data were re-hospitalized twice or more due to pulmonary diseases. The predicted value of the 2018 definition for early death or adverse respiratory outcomes in infants was significantly higher than that of 2001, with the areas under the curves of 0.871 and 0.840, respectively. The area difference under the curve was 0.031 ( Z=2.09, P=0.037). Conclusions:Compared with the one in 2001, the 2018 definition of BPD is stricter, which could be able to identify BPD infants with severer pulmonary status and outcomes and is unlikely to miss cases with adverse respiratory outcomes. The 2018 definition performs well in predicting death or adverse respiratory outcomes in early infancy.

Objective: To investigate the clinicopathologic features and grading of adenoid cystic carcinoma (ACC) of the breast. Methods: Sixteen cases of ACC of the breast were analyzed and graded according to the previous report. Immunohistochemical (IHC) staining was used to detect the immunophenotype, Ki-67 proliferative index and expression of EZH2, and the association with tumor grade and outcome was analyzed. Results: Of the 16 cases, 11 were grade Ⅰ, with the epithelial and myoepithelial cells being arranged into tubular and cribriform structure with no solid component; three were grade Ⅱ, which were composed of mixed tubular, cribriform and solid component (<30%); and two were grade Ⅲ, which showed mainly solid component (>90%) and the tumor cells showed basaloid features with scanty cytoplasm and hyperchromatic nuclei, and mitotic count was>5/10 HPF. Immunophenotypically, the epithelial cells expressed CK7, CK8/18 and CD117; the myoepithelial cells expressed p63 and CK5/6; while the basaloid cells were positive for CK5/6 and CD117.Tubular and cibriform ACC showed low Ki-67 and EZH2 expression, while the two cases of solid variant with basaloid features showed high level of Ki-67 and EZH2 expression. Follow-up data were available in 13 cases with a median follow-up period of 42 months. Lung metastasis occurred after 12 months in one grade Ⅱ case and the patient died of disease after 34 months. Vertebral metastasis occurred after 12 months in one grade Ⅲ case and axillary lymph node metastasis occurred in another grade Ⅲ case. All other patients were free of disease at the end of the follow-up periods. Conclusions ACC shows morphologic spectrum varying from low to high grade, the latter can may give rise to local and distant metastasis. ACC should not be regarded simply as low malignant potential, and should be graded for optimal treatment.

Purpose To investigate and summarize the clinicopathological features,immunophenotype,diagnosis and differential diagnosis of anaplastic thyroid carcinoma(ATC).Methods The clinicopathological features and follow-up data of 15 patients with ATC were reviewed and retrospectively ana-lyzed,and the histological features,immunophenotypic,and molecular features were observed.Results There were 8 males and 7 females with a mean age of 63.5 years.The largest tumor diameter was 45.9 mm(range,20-73 mm).Macroscopically,the tumors appeared nodular or lobulated,mostly firm to hard,with a cut surface of gray-white or gray-yellow in color,and were accompanied by hemorrhage,necrosis,and cystic changes.Mi-croscopically,the tumor exhibited diverse structures and cellular morphology mainly composed of epithelioid,spindle,multinu-cleated giant cells,rarely rhabdoid morphology(2 cases)and heterologous osteosarcomtoid differentiation(1 case).Two cases showed squamous cell carcinoma morphology as well.Among them,there were pure ATC in 11 cases while three cases had mixed papillary thyroid carcinoma components and one case had coexisting high-grade differentiated thyroid carcinoma compo-nent.Cervical lymph node metastasis was present in 6 cases.CK(AE1/AE3)expression was observed in 80%of the cases while PAX8 expression was seen in53.3%.Varying degrees of BRAF(VE1)expression were found in 42.9%whereas weak focal TTF-1 expression occurred only in two cases;and all cases did not express TG.Overall,genetic testing was performed in 8 cases(53.3%).The TP53 gene was the most frequently muta-ted gene(5/8,62.5%),followed by the RAS(3/8,37.5%)and BRAF(3/8,37.5%)genes,while the TERT combined with PIK3CA gene was mutated in only one case.Moreover,multiple gene mutations occurred simultaneously in five cases.Of the total fourteen patients who underwent follow-up,the mean and median survival times were 13.9 and 5.0 months,respec-tively.The disease-specific mortality rate reached 78.6%.Conclusion ATC is extremely rare,displaying unique histolog-ical characteristics,often accompanied by various gene muta-tions.It has a poor prognosis;therefore,establishing a defini-tive pathological diagnosis provides valuable evidence for predic-ting patient outcomes and guiding clinical management.

Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.

Medical magnetic nanoparticles are nano-medical materials with superparamagnetism, which can be collected in the tumor tissue through blood circulation, and magnetic particle imaging technology can be used to visualize the concentration of magnetic nanoparticles in the living body to achieve the purpose of tumor imaging. Based on the nonlinear magnetization characteristics of magnetic particles and the frequency characteristics of their magnetization, a differential detection method for the third harmonic of magnetic particle detection signals is proposed. It was modeled and analyzed, to study the nonlinear magnetization response characteristics of magnetic particles under alternating field, and the spectral characteristics of magnetic particle signals. At the same time, the relationship between each harmonic and the amount of medical magnetic nanoparticle samples was studied. On this basis, a signal detection experimental system was built to analyze the spectral characteristics and power spectral density of the detected signal, and to study the relationship between the signal and the excitation frequency. The signal detection experiment was carried out by the above method. The experimental results showed that under the alternating excitation field, the medical magnetic nanoparticles would generate a spike signal higher than the background sensing signal, and the magnetic particle signal existed in the odd harmonics of the detected signal spectrum. And the spectral energy was concentrated at the third harmonic, that is, the third harmonic magnetic particle signal detection that meets the medical detection requirement could be realized. In addition, the relationship between each harmonic and the particle sample volume had a positive growth relationship, and the detected medical magnetic nanoparticle sample volume could be determined according to the relationship. At the same time, the selection of the excitation frequency was limited by the sensitivity of the system, and the detection peak of the third harmonic of the detection signal was reached at the excitation frequency of 1 kHz. It provides theoretical and technical support for the detection of medical magnetic nanoparticle imaging signals in magnetic particle imaging research.
Magnetics ; Magnetite Nanoparticles