Objective To explore the clinical and pathological characteristics of ovarian endometriosis and malignant cases, and to improve our recognition of this disease. Methods A total of 1 289 cases of ovarian endometriosis were divided into two groups: the benign group (1 275 cases)and the malignant group (14 cases). They were analyzed on: dysmenorrhea, infertility, features of ultrasound examination,site of tumour,pathological types and complications. Results Malignancy arising from ovarian endometriosis was 1.09%. As far as degree of dysmenorrhea, size of cyst >10 cm, CA125 >500 U/L, features of ultrasound were concerned, difference between the two groups was statistically significant. Conclusions In the present study, the malignant rate of ovarian endometriosis was about 1%. Malignancy should be considered seriously when the following situations occured: change in the degree of dysmenorrhea, size of cyst larger than 10 cm, CA125 higher than 500 U/L, mamilla observed by ultrasound examination.

OBJECTIVETo compare the difference in clinical efficacy on bronchial asthma at chronic persistent stage between acupuncture for warming yang and benefiting qi and seretide.

METHODSOne hundred and eighty patients of bronchial asthma at chronic persistent stage were randomized into an acupuncture group and a western medication group, 90 cases in each one. In the acupuncture group, acupuncture for warming yang and benefiting qi was applied at Dazhui (GV 14), Feishu (BL 13), Danzhong (CV 17), Dingchuan (EX-B 1), Jianshi (PC 5), Zhigou (TE 6), Taixi (KI 3) and Zusanli (ST 36), once every two days. In the western medication group, inhalation therapy with seretide was applied, 1 to 2 inhalations each time, twice a day. The treatment for 20 days was as one session in the two groups, at the intervals of 2 days after each session. Four sessions of treatment were required. The immune function indices were observed before and after treatment in the patients of two groups, named immunoglobulin IgG, IgM and IgE; peripheral T lymphocytes (CD3+), helper T lymphocytes (CD4+), inhibitory T lymphocytes (CD8+) and the ratio of CD4+ and CD8+; as well as the pulmonary ventilation function indices, named maximum pulmonary expiratory flow (PEF), forced expiratory volume in one second (FEV1) and forced vital capacity (FVC). The clinical efficacy was compared between the two groups.

RESULTSThe total effective rate was 93.3% (84/90) in the acupuncture group, better than 88.9% (80/90) in the western medication group (P < 0.05). After treatment, the immune function indices and pulmonary ventilation function indices were apparently improved as compared with those before treatment in the two groups (all P < 0.05). The improvements in the acupuncture group were much more significant (all P < 0.05).

CONCLUSIONAcupuncture for warming yang and benefiting qi effectively controls the symptoms of bronchial asthma at chronic persistent stage and improves immune and pulmonary functions. The efficacy is better than that of seretide.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Asthma ; immunology ; physiopathology ; therapy ; Female ; Forced Expiratory Volume ; Humans ; Immunoglobulins ; immunology ; Male ; Middle Aged ; Qi ; T-Lymphocytes ; immunology ; Treatment Outcome ; Young Adult

Objective To explore the clinical significance of expression of soluble mesothelin relatedprotein(SMRP)and carbo-hydrate antigen (CA125)in the serum and tumor tissues of the patients with ovarian cancer.Methods The preoperative and post-operative levels of SMRP and CA125 in serum and ovarian cancer tissues were detected in 82 patients with ovarian cancer (group A),76 cases of benign ovarian tumor (group B)and 53 healthy women (group C)by using ELISA and the immunohistochemical method respectively.Serum levels of SMRP and CA125 in the ovarian cancer patients were measured after one year by ELISA.The correlation among the various statistical indexes was analyzed.Results The positive expression rates of SMRP and CA125 in the group A were significantly higher than those in the group B(P <0.05);compared with the group B and C,the preoperative serum level of CA125 and SMRP in the group A was significantly increased (P <0.001);the preoperative serum CA 125 level in the group B was higher than that in the group C;compared with the stage Ⅰ and Ⅱ,the serum CA125 and SMRP in the stage Ⅲ and Ⅳ of o-varian cancer were significantly increased(P <0.05 );compared with before operation,the postoperative SMRP and CA125 levels were significantly decreased(P <0.05).After 1 year of discharge from hospital,compared with the basically stable patients,serum CA125 and SMRP levels in the patients with ovarian cancer recurrence were significantly increased(P <0.05).The sensitivity and specificity for diagnosing ovarian cancer,any single detection was inferior to the combination detection of CA125 and SMRP.Conclu-sion The combination detection of CA125 and SMRP has an important value for increasing the sensitivity and specificity of ovarian cancer diagnosis,early diagnosis,illness condition monitoring and effect evaluation.

Objective To retrospectively analyze the diagnosis and treatment of multicentric Castleman's disease (MCD) ,and review related literatures. Methods A total of six patients were first-ever diagnosed as MCD and treated with combination chemotherapy and/or interferon α. The clinical manifestation, laboratory findings and therapeutic strategies were recorded in detail. Results In the six HIV-negative patients, histologically, four of them were diagnosed with plasma cell type of Castleman's disease, two with mixed type. All the six patients showed multiple lymphadenopathy, polyclonal hypergammaglobulinemia and hypoalbuminemia. One of the two patients treated with interferon α achieved complete remission, and the other,who showed no effects with hormone and combination chemotherapy ,achieved sustained partial remission after treatment with interferon α for 3 months. Of the four patients treated with combination chemotherapy, three achieved partial remission, and one died of no effects. Conclusions Interferon α and combination chemotherapy might be the most effective and convenient therapeutic methods for MCD. Serum albumin level may be used as a diagnostic and monitoring index for MCD.

Objective To study the changing of vertebral body marrow fat fraction(FF) in different age and sex and the relation-ship between FF and bone mineral densities (BMD). Methods Eighty-five healthy volunteers aged from 21 to 70 years old and twenty patients with osteoporosis based on T score after dual X-ray absorptionmetry examination underwent proton magnetic reso-nance spectroscopy (MRS) in L_3 vertebral bodies. The volunteers were divided into five groups according to the age(10 years and 16～18 cases in each group). Results The FF values in 21～30 years group,31～40 years group,41～50 years group,51～60 years group , >60 years group and the osteoporotic group were 30.7%±4.4%, 35.5%±6.8% , 41.9%±6.6%, 46.8%±5.5%, 51.7%±5.2% and 59.2%±7.4%, respectively. The FF values in L_3 vertebral bone marrow in men were high than that in women in the same age group (P<0.05) except >60 years group. There was negative correlation between marrow fat content and T score in osteoporotic group(γ=-0.6, P<0.01). Conclusion The vertebral marrow fat content in healthy adults was significantly in-creased with the aging. MRS may be used as a new way to evaluate the physiological and pathological process of bone marrow.

In recent years, researches about liquid biopsies which contain circulating tumor cells (CTC), circulating tumor DNA (ctDNA) and exosomes in the body fluids of patients with solid tumor have caused great concern. Compared with traditional biopsies, liquid biopsies have many advantages as they are real time, noninvasive and comprehensive. With the progress in the detecting techniques of CTC, ctDNA and exosomes, liquid biopsies can be applied to the early screening, diagnosis, treatment, prognostic evaluation of tumor. This review focuses on the recent advances in detection methods and clinical applications of CTC, ctDNA and exosomes.(Chin J Lab Med, 2018, 41: 621-626)

OBJECTIVETo explore the impacts on the life quality and the effect mechanism in the patients of allergic rhinitis (AR) treated with warm acupuncture in winter and summer.

METHODSTwo hundred and forty patients of AR were randomized into a summer and winter acupuncture group, a non-summer and winter acupuncture group and a western medication group, 80 cases in each one. In the two acupuncture groups, Dazhui (GV 14), Fengmen (BL 12), Feishu (BL 13), Pishu (BL 20) and Shenshu (BL 23) were selected. In the summer and winter acupuncture group, the warm acupuncture started at the first day of the three periods of hot season and the first day of the third nine-day period after the winter solstice. The treatment was given once every two days, continuously for 15 times. Totally, 30 treatments were required a year. In the non-summer and winter acupuncture group, the warm acupuncture was applied out of the three periods of the hot season and the third nine-day period after the winter solstice. The treatment was given once every two days and 30 treatments for a year. In the western medication group, cetirizine was taken orally, continuously for 30 days as one session. In the three groups, the treatment for 1 year was taken as one session. The second session started in the next year. Totally, 2 sessions were required. The score of rhinoconjunctivitis quality of life questionnaire (RQLQ) and the level of serum immunoglobulin E (IgE) were compared in the patients' of each group before treatment and in 1 and 2 sessions of treatment.

RESULTSAfter treatment, the scores of 7 domains, named activities, common complaints, practical problems, sleep, ocular symptoms, nasal symptoms and emotions were all improved as compared with those before treatment, in the patients of the three groups (all P < 0.05). After 2 sessions treatment, the results in the summer and winter acupuncture group were better than those in the other two groups (all P < 0.05), and the results in the non-summer and winter acupuncture group were better than those in the western medication group (all P < 0.05). After treatment, serum IgE level was lower averagely than that before treatment in the three groups (all P < 0.05). After 2 sessions treatment, the result in the summer and winter acupuncture group was lower than that in the other two groups (both P < 0.05), and the result in the non-summer and winter acupuncture group was lower than that in the western medication group (P < 0.05). After treatment, the total effective rate was 92.3% (72/78) in the summer and winter acupuncture group, better than 80.5% (62/77) in the non-summer and winter acupuncture group and 69.7% (53/76) in the western medication group (both P < 0.05).

CONCLUSIONThe warm acupuncture in both summer and winter achieves the definite efficacy on AR and the effect mechanism is relevant with reducing serum IgE level.

Acupuncture Points ; Acupuncture Therapy ; instrumentation ; methods ; Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Rhinitis, Allergic ; therapy ; Seasons ; Treatment Outcome ; Young Adult

Objective To evaluate the efficacy of interventional MRI in radiofrequency ablation (RFA)of breast cancer.Methods 12 patients with breast carcinoma proven by core-needle biopsy-were enrolled in this study.Among them, 7 patients were in phase Ⅳ(6 with lung metastasis, 1 with bone metastasis),and 5 patients were in phase Ⅲ(all of them rejected the surgical operation because of various contraindications,including severe hypertension,diabetes mellitus,liver or kidney dysfunction,and advanced age).Moreover, all of the tumor size could not be further shrunk after medical treatment (such as 4-6 cycles chemotherapy, endocrine therapy or targeted therapy).Additionally,breast lesions were still remained to be confirmed by imaging examination and biopsy pathology.Then the tumor and surrounding breast tissue were ablated with radiofrequency,followed by clinical follow-up and imaging examination after 1, 3, 6 and 12 months.Results All the patients completed 18 times RFA treatment.MRI showed that all the tumor lesions were necrotic, blood supply was disappeared and therewas no enhancement.Radiographic examination showed the original breast lesions were fuzzy or disappeared.All the tumors were achieved complete remission (CR) examined by imaging,and the effective rate was 100%.All the postoperative patients survived 1 year according to the follow-up data.Conclusion Interventional MRI is safe and effective method in the radiofrequency ablation of breast cancer.

Objective To compare the efficacy and adverse effects of bortezomib+adriamycin+dexamethasone (PAD) and vincristine + adriamycin + dexamethasone (VAD) regimens in untreated multiple myeloma (MM). Methods There were 26 and 28 new diagnosed MM patients in PAD and VAD groups. Both clinical effects and adverse effects were observed. Patients accepted VAD or PAD regimens for 2-4 cycles and followed up for 7-27 months. Results There were 10, 5 and 11 patients accepted 2, 3 and 4 cycles in PAD group, and 6, 11 and 11 in VAD group. In PAD group, there were 2, 14, 9, 1 and 0patients achieved complete remission (CR), very good partial remission (VGPR), partial remission (PR),stable disease (SD) and progressive disease (PD); in VAD group, the number were 0, 4, 12, 10 and 2.The rate of patients who achieved good efficacy (CR+VGPR) in PAD group was 61.5%, which was higher than that in VAD group (14.3%).The incidences of infection and gastrointestinal symptoms were similar in the two groups, while the incidences of peripheral neuropathy, thrombosis and Herpes Zoster infection in PAD group were higher than those in VAD group. Conclusions Compared with the conventional VAD chemotherapy, PAD may improve CR and VGPR rates in new diagnosed MM, while it may bring more and severer toxicities in peripheral neuropathy, thrombosis and Herpes Zoster infection. Preventive medical care is necessary in PAD protocol.

Objective To evaluate the diagnostic value of circulating tumor cells(CTCs) in prostate cancer (Pca) through studying the relationship between CTCs and Gleason scores and pathological TNM stage in Pca patients. Methods A total of 238 patients including 161 Pca patients as cancer group, 35 male patients with benign prostatic diseases as benign group and 42 male with non-prostate disease as control group, who were treated in our hospital from July 2016 to January 2018,were enrolled. Venous blood of every patient was collected and CTCs were enriched and identified by immunocytochemistry CD45 capturing leukocyte and fluorescence in situ hybridization with chromosome 8 (CEP8-FISH). Cells displaying CD45-/DAPI+/CEP8>2 were characterized as CTCs. One-way ANOVA was used to exam the correlations of the number of CTCs with Gleason scores and pathological TNM stage. Results CTCs ≥2 were detected in 74.53％(120/161) of Pca patients and 20.00％(7/35)of benign prostatic diseases patients and 7.14％(3/42)of control group (χ2=79.605,P<0.05). In group Gleason scores 6, the numbers of CTCs were 2.00 ± 2.42, the ratios of CTCs≥5 and tetraploid were 13.33％ (2/15)and 26.67％(4/15) respectively. In 7 scores group, the results were 3.14±2.68,17.72％(14/79) and 34.18％(27/79)respectively;In 8 scores group, the results were 3.57 ± 2.70, 33.33％(7/21)and 42.86％ (9/21)respectively; In 9 scores group, these three results were 4.65±4.41, 43.48％(20/46) and 45.65％(21/46)respectively. The numbers of CTCs in the≤pT2b (20), pT2c(27), pT3a(19), pT3b(16)and≥pT4(12) groups were 2.25±2.45, 3.56±2.79, 4.05±3.47, 4.69±2.12 and 5.17±3.21 respectively. The ratios of CTCs≥5 were 25.00％(5/20), 25.93％(7/27), 26.32％(5/19), 50.00％(8/16) and 58.33％ (7/12)respectively. The proportions of tetraploid were 20.00％(4/20), 25.93％ (7/27), 31.58％(6/19), 50.00％(8/16) and 58.33％(7/12) respectively. There were significant differences between CTC and Gleason scores (F=3.200, P<0.05)and pathological stage (F=2.673, P<0.05). The ratios of CTCs≥5 increased with the increase of Gleason scores (χ2=11.592, P<0.05). Conclusions The detection of CTCs could be used for the differential diagnosis of Pca and benign prostatic disease. There were notable correlations between the numbers of CTCs and Gleason scores and pathological stage in Pca patients, especially between CTCs≥5 and Gleason scores.