Purpose:To investigate the expression and clinical significance of estrogen receptor and Cyclin D1 in the differentiated thyrord carcinoma. Methods:We investigated the expression of ER and Cyclin D1 in thyroid normal tissue, thyroid adenoma and DTC by SP immunohistochemical technique. We have collected 89 specimens from surgical resections, and all the sections were formalin-fixed and paraffin-embedded, each has detailed clinical data, two pathologists classified the histopathologic types. DTC 43 cases (papillary thyroid carcinoma, 39 cases, follicular thyroid carcinoma, 4 cases); thyroid follicular adenoma 30 cases, and 16 cases of normal thyroid tissues taken from around the thyroid adenoma. Results:The positive rates of ER and CyclinD1 in the DTC were 53.5%(23/43), 65.1%(28/43) respectively; the positive rates of ER and CyclinD1 in the thyroid adenoma were 26.7%(8/30), 36.7%(11/30) respectively; the positive rates of ER in normal thyroid tissues were 12.5%(2/16), while CyclinD1 were negative. The ER expression in DTC was significantly higher than that in the thyroid adenoma and the normal thyroid tissues(P

Objective To detect the expression levels of vascular endothelial growth factor D ( VEGF-D) , D2-40 and MMP-7 in papillary thyroid carcinoma ( PTC) and to explore their relationship with micro lymphat-ic density, distribution,and cervical lymph node metastasis .Methods SP immunohistochemistry was used to study the expression of VEGF-D, D2-40 and MMP-7 in 38 cases of PTC with cervical lymph node metastasis , 45 cases of PTC without cervical lymph node metastasis , and 22 cases of normal thyroid tissues .Micro lymphatic density ( MLD) was counted .Results The expression level of VEGF-D in PTC with cervical lymph node metasta-sis and normal thyroid tissues had significant difference (χ2 =13.074, P=0.000, P<0.0167).The expression level of D2-40 in PTC with and without cervical lymph node metastasis had significant difference ( P<0.05 ) . MMP-7 expression in PTC with and without cervical lymph node metastasis had statistical significance ( 91.67%vs 73.33%, P<0.05).MLD in PTC with and without cervical lymph node metastasis and in normal thyroid tis-sues had statistical difference (11.7 ±3.5 vs 8.9 ±3.1 vs 3.9 ±2.7, P<0.05).Conclusion VEGF-D, D2-40 and MMP-7 are highly expressed in PTC and they are possibly related with cervical lymph node metastasis of PTC.

Objective:To study the applied value of CREG Zygosity Principles in kidney transplantation.Methods:Relationship between HLA CREG zygosity and acute rejection incidence was analyzed in 173 kidney transplantation and the concerned principles were discussed.Results:HLA-A,B,DR antigens of 0 mismatch (MM) were 7.51%,4.04%,3.46%;and those of 2 MM were 39.88%,65.31%,58.38% respectively.Compared in CREGs,A,B,and DR,the 0 MMs were 49.71%,30.63% and 24.27%;whereas 2MMs were only 5.20%,12.14% and 8.67%.In HLA-A,B and DR antigens 0 MM,the incidence of acute rejection was 21.96%,21.38% and 7.51% respectively;and in 2MMs,those were 22.54%,20.23%,and 66.67% respectively.Compared by CREGs A,B and DR 0 MM,acute rejection reached 21.83%,20.21% and 6.14%;and in 2MMs the incidence of acute rejection were 22.22%,20.00% and 69.82%.Conclusion:CREGs model is a novel method of choosing kidney transplantation donor-recipients’s matching.

Objective To evaluate the safety and efficacy of endoscopic retrograde cholangiopancreatography (ERCP) for the diagnosis and treatment of pancreas divisum(PD) associated with recurrent acute pancreatitis(RAP) in children and teenagers. Methods Data of patients with symptomatic PD associated with RAP under 18 years old who were diagnosed and treated with ERCP from January 2011 to January 2015 were retrospectively analyzed. Patients with complete pancreas divisum underwent endoscopic minor sphincterotomy combined with dorsal duct stenting ( ESCS ) , and those with incomplete pancreas divisum underwent bi?papilla endoscopic sphincterotomy combined with dorsal duct stenting ( Bi?ESCS ) . ERCP?related data, complications were recorded. Long?term follow?up was conducted for procedure related complications. Results Nine patients with symptomatic PD associated with RAP were firstly diagnosed. A total of 18 ERCP procedures were performed in these patients, with success rate of 100. 0% ( 18/18) in the minor papilla cannulation, and mild ERCP?related complication rate of 11. 1% ( 2/18) . One was acute mild pancreatitis and the other was hyperamylasemia. During follow?up from 3 to 60 months, all patients had pain relief, among whom 7 were asymptomatic, with no onset of acute pancreatitis. Dorsal ducts of all patients were not obviously dilated in MRCP or CT scan. All patients gained weight and presented normal physical and intelligence development. Conclusion Symptomatic PD associated with RAP can be completely diagnosed with ERCP . ESCS and Bi?ESCS are safe and effective endoscopic treatment techniques for pediatric cases.

Objective To explore the relationship between glycated albumin ( GA ) in 2 consecutive months and hemoglobin A1c ( HbA1c) in diabetes patients.Methods Totally 100 consecutive patients with main diagnosis of diabetes mellitus were enrolled retrospectively from April 2015 to January 2016 in outpatient clinic of endocrinology of Peking Union Medical College Hospital, who had undertaken GA tests every 4 weeks for 2 successive months and had HbA1c test in the second month.GA was measured with liquid enzymatic method. HbA1c was measured by ion-exchange high performance liquid chromatography.The relationship between HbA1c and GA for the 2 successive months was determined.Results A total of 85 patients were enrolled.The regres-sion equation between HbA1c (y) and average GA (j) for successive 2 months was y=3.187+0.218j (adjusted R2 =0.520, P=0.000), which showed a similar effect as the regression equation for HbA1c and the levels of GA tested for the 2 successive months (adjusted R2 =0.514, P=0.000), and both had more significant regressive effect than the regression equation for HbA1c and single measurement of GA (adjusted R2 =0.392, P=0.000). Conclusions The regressive effect between HbA1c and GA (or the average of GA) in successive 2 months is bet-ter than that with single measurement of GA, hence could better predict HbA1c in clinical practice.

Objective To analysis the genomic sequence of a novel human leukocyte antigen (HLA)-B*3818 allele.Methods Full length genomic sequence of an unknown HLA-B allele was cloned,followed by bi-directional sequencing and the specificity of the antigen coded by this novel allele was defined by microcytotoxicity assay.The frequency and haplotype of this novel allele was acquired by population census and parentage analysis.Results The full length genomic sequence of this novel HLA-B*3818 allele with accession number FJ561482 differs from HLA-B*380201 by two nucleotide changes in exon 4 and intron 5,respectively.One change is located at nt 660 in exon 4 where C→A alternation,which results in an amino acid substitution from Asp(GAC)to Glu(GAA)at codon 196.This alternation is a new single nucleotide polymorphism compared with all other HLA-B alleles.Another is located at genomic position 2133 in intron 5(A→C).Except for this substitution,the intron sequences of HLA-B*3818 allele are identical to those of other HLA-B*38 alleles including HLA-B*380101,B*380201 and B*3814.The serological specificity of HLA-B*3818 is B38 and the frequency of this new allele is less than 0.000 5 in Chinese Han population.The parentage analysis showed the haplotype of novel allele is A*030101-Cw*010201-B*3818-DRB1*1312-DOB1*060101.Conclusion The simultaneous mutations in exon and intron were found in the Hovel HLA-B*3818 allele,and so it can present more sequence information for studies and applications associated with HIA genes by analyzing the genomic sequences of novel HLA alleles.

BACKGROUND: The incidence and the mortality of lung cancer rank first among all malignant tumors and it seriously affects human health. The common types of non-small cell lung cancer (NSCLC) are adenocarcinoma and squamous carcinoma with clinical research and more attention, while adenosquamous carcinoma is a rare pathological subtype of lung cancer, which clinical features and prognostic factors are not yet fully understood. The purpose of this study is to analyze the clinical features and prognosis of lung adenosquamous carcinoma, and construct a nomogram to predict the patients' prognosis. METHODS: We obtained the data of adenosquamous carcinoma patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database of the United States, and compared their clinical features and prognosis with those of lung adenocarcinoma and lung squamous cell carcinoma patients in the same period. Then we used univariate and multivariate analyses to explore the independent prognostic factors of adenosquamous carcinoma. Finally, we constructed and validated a nomogram to visually predict the outcomes of lung adenosquamous carcinoma. RESULTS: 1,453 patients with lung adenosquamous carcinoma were finally included. Compared with patients with lung adenocarcinoma and lung squamous cell carcinoma, the distributions of lung adenocarcinoma patients in most of the variables were medium between lung adenocarcinoma and squamous cell carcinoma. The prognosis of adenosquamous carcinoma was better than that of lung squamous cell carcinoma, but worse than that of lung adenocarcinoma. Multivariate analysis showed that age, differentiation, tumor-node-metastasis (TNM), surgery, and chemotherapy were independent prognostic factors (all P were less than 0.001). We constructed a nomogram with a C-index of 0.783 (0.767-0.799). The distinction test and consistency test showed that the nomogram could predict the patient's prognosis effectively. CONCLUSIONS Lung adenosquamous carcinoma has unique clinical, pathological, and prognostic characteristics. Age, differentiation, T, N, M, surgery, and chemotherapy status are independent predictors of prognosis in patients with adenosquamous carcinoma. Our nomogram can efficiently predict the prognosis of patients.
Aged ; Aged, 80 and over ; Carcinoma, Adenosquamous ; diagnosis ; epidemiology ; pathology ; therapy ; Databases, Factual ; Female ; Humans ; Lung Neoplasms ; diagnosis ; epidemiology ; pathology ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Survival Analysis

Objective:To study the risk factors for duodenal injury caused by malposition of plastic bile duct stent for the treatment of biliary stricture.Methods:Data of 1 408 patients with biliary stricture (2 607 procedures of plastic stent placement) who received plastic stent placement in Hangzhou First People's Hospital from January 2017 to December 2021 were retrospectively analyzed and duodenal injury caused by bile duct stent malposition after placement was recorded. The patients were divided into two groups: the malposition injury group ( n=23 procedures) and the non-malposition injury group ( n=2 584 procedures). The differences in the baseline data and procedure-related condition between the malposition injury group and the non-malposition injury group were compared, and the independent risk factors for duodenal injury caused by bile duct plastic stent malposition were studied by using logistic regression analysis. Results:A total of 2 607 procedures of plastic stent placement were performed in 1 408 patients with biliary stricture, and 23 cases of duodenal injury were caused by stent malposition. Logistic regression analysis revealed that a history of gastrointestinal surgery ( OR=4.278, 95% CI: 1.332-13.737, P=0.015), a history of endoscopic sphincterotomy (EST) ( OR=8.128, 95% CI: 2.382-27.738, P=0.001), and high-level bile duct stenosis ( OR=4.457, 95% CI: 1.722-11.539, P=0.002), plastic stents with a length≥ 7 cm ( OR=4.701, 95% CI: 1.708-12.938, P=0.003) and Christmas tree-shaped stent ( OR=6.890, 95% CI: 1.540-30.830, P=0.012) were independent risk factors for duodenal injury caused by bile duct plastic stent malposition. Conclusion:High-level bile duct stenosis, the use of plastic stents with a length≥ 7 cm and Christmas tree-shaped stent, a history of gastrointestinal surgery, and a history of EST could increase the risk of duodenal injury caused by bile duct plastic stent malposition in patients with bile duct stenosis.

Objective:To investigate the effects of Porphyromonas gingivalis ( P. gingivalis) fimbrillin (FimA) on the progression of esophageal squamous cell carcinoma (ESCC). Methods:Wild-type P. gingivalis and fimA gene-deleted P. gingivalis ( fimA-/-P. gingivalis) were used to infect ESCC cells after morphology and PCR identification. Immunofluorescence, CCK-8 and Transwell chamber were used to detect the effects of FimA on the infectivity of P. gingivalis and it influences on cell invasion, proliferation and migration. Western blot was used to detect pSmad2/3 changes. The growth of tumor was detected in a nude mouse model bearing subcutaneous tumor. Results:Deletion of FimA might reduce the interbacterial adhesion of P. gingivalis. Compared with wild-type P. gingivalis, less fimA-/-P. gingivalis could infect NE6-T cells. Moreover, the proliferation, migration and invasion of NE6-T and KYSE30 cells as well as the activation of pSmad2/3 induced by P. gingivalis were inhibited after deletion of FimA. The growth of KYSE30 infected by fimA-/-P. gingivalis in nude mice was significantly slower than that of the wild-type P. gingivalis group. Conclusions:FimA mediated the effects of P. gingivalis on promoting the evolution of ESCC and was a potential target molecule to block the tumor-promoting effect of P. gingivalis.

Ankylosing spondylitis （AS） is an inflammatory autoimmune disease with chronic low back pain as the main clinical manifestation， which mainly affects the axial joints， peripheral joints and various organs. In severe cases， the spine is stiff or deformed， which affects the quality of life and health of patients. The pathogenic factors of AS are complex， which are related to heredity， immunity and intestinal flora. The pathogenesis of AS is not clear yet. Among them， inflammatory reaction， bone destruction and heterotopic ossification are the main pathological features of AS， which play an important role in the disease process of AS. Traditional Chinese medicine has multi-target， multi-channel and multi-component pharmacological effects， which can prevent and treat AS by anti-inflammation， inhibiting bone destruction and preventing heterotopic ossification， and the clinical effect is remarkable， but there is no relevant literature report. Therefore， this review expounds the relationship between inflammatory reaction， bone destruction and heterotopic ossification and the occurrence and development of AS， and summarizes the latest research reports of traditional Chinese medicine in treating AS from anti-inflammatory， inhibiting bone destruction and preventing heterotopic ossification， aiming at providing reference and new ideas and directions for further research on the prevention and treatment of AS by traditional Chinese medicine.