Objective To explore the clinico-pathological features, immunophenotype, treatment and prognosis of urologic primary primitive neuroectodermal tumor (PNET). Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male, aged 29, 32 and 75 years respectively. Two of the lesions were located in the kidney, and the third was located in the bladder. The sizes of renal tumors were 7.7 cm×6.2 cm and 12.6 cm×9.4 cm respectively. Imaging examinations revealed a well-defined mass with inhomogeneous echo inside. The size of bladder tumor was 10.0 cm×10.0 cm. CT scan demonstrated irregular thickening of the bladder wall, and the density of the wall was inhomogeneous. In the 2 cases of renal PNET radical surgery was performed, while an emergency palliative surgery to remove a blood clot and biopsy were performed in the bladder PNET case. Results In light microscope, the tumors were characterized by uniform small round or oval cells and nest-like or dense sheet structures surrounded by sparse fibrovascular stroma. Homer-Wright rosettes or pseudorosettes were observed, as well as mitoses. Immunohistochemical study revealed that all cases showed positive staining for CD99, synaptophysin and vimentin. One of the renal tumor cells showed positive for CD56, and the other renal tumor and urocystic tumor cells were focally positive for chromogranin A. Additionally, in 1 of the cases of renal tumor there was a high positive rate of 80% for Ki67 staining while the other case showed less than 5%. All 3 cases were eventually diagnosed as PNET. The first renal tumor case was not treated with radiotherapy and chemotherapy postoperatively, and the patient died of recurrence 14 months after surgery. Both the second renal tumor case and the bladder tumor case underwent chemotherapy postoperatively, and they died 4 and 6 months after surgery respectively. Conclusions The urologic primary PNET is a very rare, highly malignant soft tissue tumor, and the diagnosis must be based on pathologic findings and immunohistochemical phenotypes. The multimodal treatment for urologic primary PNET consists of surgery, chemotherapy and radiotherapy.

OBJECTIVETo explore changes of B and T lymphocyte attenuator (BTLA), superoxide dismutase (SOD), catalase (CAT), total antioxidant capacity (TAOC), reactive oxygen species (ROS), reactive nitrogen species (RNS), malondialdehyde (MDA) in ankylosing spondylitis (AS) patients, and the effect of Xinfeng Capsule (XFC) on them.

METHODSTotally 120 AS patients were assigned to two groups according to random digit table method, the XFC group (3 XFC pills each time, 3 times a day) and the SASP group (4 SASP tablets each time, twice a day), 60 in each group. All patients were treated for 3 months. Another 60 healthy subjects were recruited as a healthy control group. The expression frequency and activation levels of BTLA were detected using flow cytometry. Serum oxidative stress indices (such as SOD and CAT, TAOC, ROS, RNS, MDA) and contents of cytokines [tumor necrosis factor α (TNF-α), IL-1β, IL-4, and IL-10] were detected using enzyme-linked immunoassay (ELISA). Erythrocyte sedimentation rate (ESR) was detected using Westergren method. High-sensitivity C-reactive protein (Hs-CRP) was detected using HITACHI 7060 type automatic biochemical analyzer. Clinical efficacies of ASAS 20 and BASDAI50 were assessed using VAS. Correlation analysis between scoring for quality of life and BTLA expression frequency was performed.

RESULTS(1) Clinical efficacies of ASAS 20 and BASDAI50 were significantly better in the XFC group than in the SASP group (P < 0.01). (2) Compared with the healthy control group, BTLA expressions in the peripheral blood of AS patients decreased significantly (P <0. 05); SOD, CAT, and TAOC values significantly decreased (P < 0.01, P < 0.05); ROS, RNS, and MDA values significantly increased (P < 0.01, P < 0.05); TNF-α, IL-1β, ESR, and Hs-CRP values significantly increased (P < 0.01); IL-4 and IL-10 values decreased significantly (P < 0.01, P < 0.05). (3) Compared with pre-treatment in the same group, BTLA/CD19 + B, BTLA/CD24 + B, SOD, TAOC, IL-4, SF-36 [physical functioning (PF), social functioning (SF), role limitation due to physical problems (RP), role limitation due to emotional problems (RE), body pain (BP), mental health (MH), vitality (VT), general health (GH)] were significantly elevated; ROS, MDA, TNF-α, ESR, Hs- CRP, VAS, BASDAI and BASFI, BAS-G were significantly lower in the peripheral blood of the two groups after treatment (P < 0.01, P < 0.05). Better effect was shown in the XFC group in elevating BTLA/CD19+ B, BTLA/CD24 + B, SOD, TAOC, IL-10, BP, MH, VT, and SF; and lowering ROS, IL-1β, MDA, TNF-α, ESR, Hs-CRP, VAS, BASDAI, BASFI, and BAS-G (P < 0.01, P < 0.05). (4) Pearson correlation analysis showed, BTLA/CD19 + B expression of the peripheral blood was positively correlated with SOD, CAT, TAOC, IL-4, IL-10, GH, RP, BP, and SF (r = 0.431, 0.325, 0.318, 0.316, 0.348, 0.314, 0.358, 0.318, 0.326, respectively, P < 0.05, P < 0.01), while it was negative correlated with ROS, MDA, TNF-α, IL-1β, ESR, VAS, and BASDAI (r = -0.342, -0.368, -0.334, -0.354, -0.324, -0.372, -0.342, respectively, P < 0.05, P < 0.01). BTLA/CD24 B expression of the peripheral blood was positively correlated with SOD, TAOC, IL-4, IL-10, GH, RP, BP, SF, RE, MH, VT (r = 0.358, 0.352, 0.372, 0.436, 0.435, 0.326, 0.352, 0.345, 0.326, 0.343, 0.332, respectively, P < 0.05, P < 0.01), while it was negative correlated with ROS, RNS, MDA, ESR, Hs-CRP, VAS, BASDAI, and BASFI (r = -0.447, -0.336, -0.405, -0. 395, -0. 358, -0.436, -0.338, -0.425, respectively, P < 0.05, P < 0.01).

CONCLUSIONXFC could improve BTLA expression in the peripheral blood of AS patients, negatively regulate activation and proliferation of B cells, and reduce abnormal immune responses and oxidative stress injury, thereby effectively alleviating joint stiffness and pain.

B-Lymphocytes ; physiology ; Blood Sedimentation ; C-Reactive Protein ; metabolism ; Capsules ; Catalase ; metabolism ; Cytokines ; Drugs, Chinese Herbal ; administration & dosage ; therapeutic use ; Flow Cytometry ; Humans ; Interleukin-10 ; metabolism ; Interleukin-1beta ; metabolism ; Interleukin-4 ; metabolism ; Malondialdehyde ; metabolism ; Oxidative Stress ; Quality of Life ; Reactive Oxygen Species ; Spondylitis, Ankylosing ; drug therapy ; Superoxide Dismutase ; metabolism ; T-Lymphocytes ; physiology ; Tumor Necrosis Factor-alpha ; metabolism

Objective To investigate the effects of CD24 on CCl4-induced murine liver fibrosis and to analyze the possible molecular mechanism.Methods Wild type (WT) and CD24 knockout (CD24-/-) C57BL/6 mice were treated with CCl4 through intraperitoneal injection.Levels of ALT in serum samples were detected and liver tissues were stained with hematoxylin and eosin (HE) to assess liver tissue injury.Sirius Red staining was used to observe liver fibrosis.Real-time PCR was performed to detect the expression of α-SMA (α-smooth muscle actin), Col1a1 (Collagen, typeⅠ, alpha 1), TGF-β1 (transforming growth factor-β1) and CD24 at mRNA level in liver tissues.Western blot was performed to analyze the expression of α-SMA and Col1a1 at protein level.Flow cytometry analysis was used to detect the macrophages in liver tissues.ELISA was used to detect the expression of TGF-β1 in the culture supernatants of M1 and M2 macrophages.Results The expression of CD24 at both mRNA and protein levels were up-regulated in mice with CCl4-induced liver fibrosis.HE staining showed that liver inflammation in CD24-/-mice was more severe than that in WT mice after treated with CCl4.Sirius Red staining of paraffin-embadded liver sections revealed that compared with WT mice, CD24-/-mice presented with more severe liver fibrosis.Moreover, α-SMA and Col1a1, indicators of liver fibrosis, in CD24-/-mice were significantly higher than those in WT mice.Flow cytometry analysis showed that murine hepatic macrophages significantly increased in CD24-/-mice than in WT mice following CCl4 treatment.Real-time PCR analysis also confirmed that significantly enhanced expression of TGF-β1 at mRNA level in liver tissues was observed in CD24-/-mice than in WT mice.TGF-β1 secreted in the culture supernatant of M2 macrophages derived from CD24-/-mice group was more than that of the WT mice group.No significant difference in TGF-β1 secretion in culture supernatant of M1 macrophages was observed between the two groups.Conclusion Taken together, these data suggest that CD24 plays an important role in attenuating CCl4-induced chronic inflammation and hepatic fibrosis in mice.The mechanism of CD24 in alleviating liver fibrosis might be through regulating intrahepatic macrophages, inhibiting the secretion of TGF-β1 by M2 macrophages and suppressing the activation of hepatic stellate cells.

Objective To investigate the clinical efficacy of laparoscopic hepatectomy for the treatment of large hepatocellular carcinoma (HCC).Methods From January 2009 to January 2011,84 patients with large hepatocellular carcinoma received laparoscopic hepatectomy at the Southwest Hospital,and their clinical data were retrospectively analyzed.Lesions were located at the left lobe in 12 cases,left lateral lobe in 9 cases,right lobe in 3 cases,right posterior lobe in 11 cases,right anterior lobe in 11 cases,segment Ⅴ in 8 cases,segment Ⅵ in 6 cases,segment Ⅶ in 6 cases,segment Ⅴ/Ⅵ in 8 cases,segment Ⅶ/Ⅷ in 4 cases,segment Ⅳ in 5 cases and segment Ⅰ in 1 case.According to the results of preoperative ultrasonography,the tumor diameter ranged between 5.1-6.0 cm in46 cases,6.1-7.0 cm in 12 cases,7.1-8.0 cm in9 cases,8.1-9.0 cm in7 cases,9.1-10.0 cm in 10 cases.Anatomical or non-anatomical hepatectomy was performed according to the results of preoperative assessment and operative exploration.Abdominal imaging examination and serologic examination were done once every 3 months at postoperative year 1,once every 4 months at postoperative year 2,once every 6 months at postoperative year 3.The follow-up ended in January 2014.The survival rate was calculated by Kaplan-Meier method.Results Eight patients were converted to laparotomy,and the rate of conversion to laparotomy was 9.5％ (8/84).Seventy-six patients received laparoscopic hepatectomy,including 30 patients received anatomical hepatectomy and 54 received non-anatomical hepatectomy.The operation time,volume of blood loss,perioperative blood transfusion rate,tumor diameter,resection margin,time for gastriontestinal function recovery,duration of postoperative hospital stay,incidence of postoperative complications were (240 ± 132) minutes,(432 ± 340) mL,10.7％ (9/84),(6.5±1.5)cm,(1.6±0.9)cm,(3.0±0.5)days,(11 ±3)days and 19.0％(16/84),respectively.All thepatients were comfirmed with HCC including 18 cases of high differentiated HCC,57 cases of moderate differentiated HCC and 9 cases of low differentiated HCC.One patient died perioperatively.Eighty-three patients were followed up for 2-48 months,the median follow-up time was 24 months,and the overall 1-and 3-year survival rates and the 1-and 3-year tumor-free survival rates were 91％,80％,70％ and 56％,respectively.Conclusion Laparoscopic hcpatcctomy is safe and feasible for selected patients with large hepatocellular carcinoma.

In this study we present our experiences with the reverse sural fasciocutaneous flap to reconstruct the distal lower limb soft tissue defects caused by traumatic injuries. These flap graftings were carried out from Oct. 2010 to Dec. 2012 in our department. The series consisted of 36 patients, including 21 men and 15 women with an average age of 46.2 years (14-83 years) and with a medium follow-up period of 18 months (12-24 months). Of all the cases of acute trauma, there were 10 cases of trauma of distal tibia, 9 cases of trauma of perimalleolus, and 17 cases of trauma of midfoot and forefoot. Related risk factors in the patients were diabetes (2 cases), advanced age (>65 years, 3 cases) and cigarette smoking (6 cases). The reverse flow sural island flap irrigation depended on lower perforators of the peroneal artery. The fasciocutaneous pedicle was 3-4 cm in width and the anatomical structures consisted of the superficial and deep fascia, the sural nerve, short saphenous vein, superficial sural artery together with an islet of subcutaneous cellular tissue and skin. The most proximal border of the flap was only 1.5 cm away from the popliteal skin crease and the pivot point was 5-7 cm above the tip of the lateral malleolus. All the flaps survived. No arterial crisis occurred in any case. The venous congestion occurred in 2 cases and got better after raising the limbs and bloodletting. Only in an old man, 1.5 cm necrosis of distal margin of his flap occurred and finally healed after continuous dressing change. One-stage skin grafting was performed, and all the donor sites were sutured and successfully healed. It was concluded that the reverse sural fasciocutaneous flap is safe and reliable to extend to the proximal third even near the popliteal skin crease. We also concluded this flap can be safely and efficiently used to treat patients with large and far soft-tissue defects from the distal leg to the forefoot with more versatility and it is easier to reach the recipient sites.

Objective To explore the relationship of estradiol(E_2),monoamine neurotransmitters 5-hydroxytryptamine(5-HT),dopamine(DA)and postpartum depression.Methods Totally 342 women within 42 days after childbirth were assessed with Edinburgh postnatal depression scale(EPDS),Beck depression inventory(BDI),and general health questionnaire(GHQ).Above or equal to 13 of overall score of EPDS was the diagnosis standard of postpartum depression,and the women tested were divided into depression group and normal group accordingly,using the reagent box of radio immunoassay to test estradiol and 5-HT and DA level in the serum.Results(1)Incidence:the incidence of postpartum depression was 16.7%(57/342).The highest incidence occurred in patients above 35(22.2%);the incidence among women under 23 years old was lowest(12.5%),with a significant difference between them(P0.05). Conclusions Evaluation scales such as EPDS,BDI,and GHQ should be used to screen for postpartum depression.The measurement of estradiol and monoamine neurotransmitter(5-HT,DA)level can be used as biological objective indicators for prevention and treatment of postpartum depression.

mutants which didnt produce red pigmen ts on malt extract agar plate were obtained.The 8 stable mutants were cultured on solid medium.Two samples wer e yellow,the others were white.The extracted samples were scanned in visible len gth.2 yellow samples showed only one absorptive peak at 370nm,the 6 white sample s showed no absorptive peak.The mutants producing only yellow pigments on solid medium were tested in liquid culture.The results indicated their ability to pro duce only yellow pigments were stable.

OBJECTIVE: To explore the feasibility of fixation characteristics to evaluate visual acuity. METHODS: The fixation characteristics were examined in 75 subjects by MP-1 microperimeter. These subjects were divided into 3 groups: central fixation group, uncertain group and eccentric fixation group, and the differences of visual acuity among them were analyzed. Pearson correlation and regression analysis were performed on visual acuity and average retinal light sensitivity. RESULTS: (1) The visual acuity was 4.80±0.16 for central fixation group; 4.20±0.45 for uncertain group; and 3.40±0.57 for eccentric fixation group, respectively. Based on the one-way ANOVA, the visual acuities in the three groups had statistically significant differences (P<0.05). (2) There was linear relationship between visual acuity (y) and average retinal light sensitivity (x). And the linear regression equations was y=-18.76+6.21x. The Pearson correlation coefficient was 0.707 (P<0.05). CONCLUSION There is significant positive correlation between visual acuity and fixation characteristics. Testing of fixation characteristics could be used to assess visual acuity objectively, which has a practical value in forensic clinical medicine.
Humans ; Retina ; Vision Disorders ; Visual Acuity ; Visual Field Tests

BackgroundThe meibomian gland carcinoma is an eyelid malignant tumor with a domestic incidence after basal cell carcinoma.Meibomian gland carcinoma is not sensitive to radiation therapy and chemotherapy,and the related factors with its recurrence and metastasis are rarely reported.ObjectiveThis study was to investigate the clinical and pathologic features of meibomian gland carcinoma with multiple operations and the effectiveness of histologically controlled excision.MethodsThe clinical data and the histopathologic sections of 34 cases of the meibomian gland carcinoma diagnosed by pathology were retrospectively analyzed at Zhongshan Ophthalmic Center in September 2003 to April 2011,and the treating effectiveness of histologically controlled excision was evaluated. ResultsIn this group of cases,the appearing rate of the meibomian gland carcinoma was resemble in both lateral eyes.A higher morbidity was on the upper eyelid (26/34,76.5％) and then the lower eyelids (5/34,14.7％ ) and both (3/34,8.8％).The average ages of these cases were 57.5 years old.Sixteen of 21 misdiagnosed cases were identified as chalazion at the first visit,and no histopathological examination was performed in 11 cases after initial operation.Twenty-six cases(76.5％ )were identified as meibomian gland carcinoma in initial histopathologic diagnosis.Two cases had histologically controlled excision and 16 cases had simple excision while 16 cases had chalazion enucleation in the first operation.All the patients had histologically controlled excision in Zhongshan Ophthalmic Center with 58.8％ of the patients having pagetoid invasion.Sixteen cases were followed up for 5 months to 8 years after histologically controlled excision,in which none died of recurrence and metastasis of meibomian gland carcinoma.No significant differences were found in the pathological feature between 16 lost patients and 18 followed-up patients(P ＞ 0.05 ).Conclusions Misdiagnosis of meibomian gland as chalazion is a main cause of repeat operations of meibomian gland carcinoma.Histologically controlled excision is a feasible therapy for the recurrence and metastasis of meibomian gland carcinoma.

OBJECTIVETo investigate the prognostic factors of lymph node-negative advanced gastric cancer patients in order to guide adjunctive therapy and surveillance tragedy.

METHODSA total of 236 advanced gastric cancer patients with no less than 12 retrieved lymph nodes and without lymph node metastasis from Fujian Provincial Hospital between 1998 and 2008 were collected retrospectively. Univariate and multivariate prognostic analysis were performed.

RESULTSTwo hundred and twenty-four patients(94.9%) were followed up and 5-year overall and disease-free survival rates were 75.2% and 66.4% respectively. Univariate prognostic analysis showed that depth of infiltration, Lauren histotype and retrieved lymph nodes were associated with 5-year overall survival(all P<0.05). Multivariate prognostic analysis testified that depth of infiltration was independent prognostic predictor(P<0.05). Recurrent rates of T2 and T3 patients were 5.8%(8/138) and 14.0%(12/86),5-year overall survival rates were 82.5% and 59.0%, 5-year disease-free survival rates were 70.4% and 52.2% respectively. These differences were all statistically significant (all P<0.05).

CONCLUSIONST2N0 gastric cancer patients have a better prognosis than T3N0 patients. Depth of infiltration should be considered to stratify lymph node-negative gastric cancer patients for an adjunctive treatment and follow-up scheduling.

Female ; Follow-Up Studies ; Gastrectomy ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; pathology ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Stomach Neoplasms ; pathology ; surgery