OBJECTIVE: Aim of the study is to report the unique clinicopathologic feature, treatment outcome and prognostic factors of head and neck hemangiopericytoma (HNHPC). METHOD: A retrospective data collection of reported HNHPC cases, in which therapy, follow-up and outcome data were available, was performed from the electronic database of PubMed, Embase, Google scholar, China National Knowledge Infrastructure, Wan Fang and Wei Pu until on December 31, 2013. RESULT: A total of 213 HNHPC cases were identified from 122 peer-reviewed articles. The recurrence rate was 24.4% (51/209). The positive surgical margin (OR= 3. 977, P<0. 01) and poor pathologic differentiation (OR=l. 890, P<0. 01) were associated with increased local recurrence. The metastasis rate was 15.8% (22/139). The positive surgical margin (OR=13. 833, P<0. 01), poor pathologic differentiation (OR=4. 661, P<0. 01) and non-surgical treatment (OR=2. 000, P<0. 01) were associated with increased distant metastasis. The mortality rate was 15. 0% (32/213). The tumor size >5. 0 cm in diameter (OR= 2. 860, P<0. 05), positive surgical margin (OR=9. 833, P<0. 01), poor pathologic differentiation (OR=4. 061, P<0. 01) and non-surgical treatment (OR=2. 032, P<0. 01) were associated with worse mortality. The treatment included surgery alone 139 cases, multiple treatments 64 cases and non-surgical treatment 10 cases. The overall survival (OS) of the 213 cases was 85%, and the 3-year, 5-year and 10-year OS were 86%, 78% and 74%, respectively. The 3-year, 5-year and 10-year OS for surgery alone were 95%, 88% and 84%, respectively. The 3- year, 5-year and 10-year OS for surgery plus radiotherapy were 90%, 80% and 80%, respectively. The 3-year, 5- year and 10-year OS for surgery plus chemotherapy were 75%, 25% and 25%, respectively. The 3-year, 5-year and 10-year OS for surgery plus radio-chemotherapy were 67%, 58% and 46%, respectively. There were signifi- cant survival difference in recurrence-free survival (RFS), metastasis free survival (MFS) and OS depending on surgical margins (P<0. 01). RFS, MFS and OS difference were identified depending on pathologic differentiation (P<0. 01). MFS and OS differences were observed on the different treatment modality (P<0. 01). OS differences was observed on the different tumor sizes (P<0. 05). Positive surgical margins was correlated with disease recurrence (HR= 3. 680, P<0.01), while poor pathologic differentiation was correlated with metastasis and death (HR=2. 619, P<0. 05 and HR=3. 188, P<0. 05). The tumor size >5. 0 cm in diameter and non-surgical treatment was correlated with death (HR= 5. 461, P<0. 01 and HR= 8. 563, P<0. 01, respectively). CONCLUSION The surgical resection was the mainstream treatment and it was superior to multiple treatments. The tumor size, surgical margins, pathological differentiation and non-surgical treatment were independent prognostic factors.
Head and Neck Neoplasms ; mortality ; pathology ; therapy ; Hemangiopericytoma ; mortality ; pathology ; therapy ; Humans ; Neoplasm Recurrence, Local ; Prognosis ; Retrospective Studies ; Treatment Outcome

Objective To explore the impact of cardio cerebral vascular diseases (CVD) on life expectancy among residents in Shandong Province,develop effective preventive measures for the high-risk population and provide guidance for the health care resource allocation.Methods Based on the death monitoring data of the disease in Shandong Province in 2012,we calculated the crude mortality and standardized the mortality rate of the disease.We designed life tables with all causes of death and with eliminating causes of CVD death and analysed life expectancy with and without them examined.Results In 2012,crude mortality rate of CVD was 320.16/100 000 (SMR 252.85/100 000) in Shandong Province.The death rate of CVD was of 46.30％ of all deaths reported by monitoring system.The mortality rate of CVD in male and female were 332.99/100 000 and 307.02/100 000,respectively.The mortality rate of CVD in rural and urban areas were 341.84/100 000 and 267.28/100 000,respectively.The mortality of CVD increased with age and growed rapidly after the age of 60.Life expectancy of urban and rural areas was 79.20 years and 78.14 years,respectively.After eliminating causes of CVD death,life expectancy for eliminating causes of CVD death in urban and rural areas increased 8.51 years and 10.02 years,respectively.Life expectancy for eliminating causes of CVD death in male and female increased 8.02 years and 11.10 years,respectively.Conclusions Life expectancy of urban and rural areas,the male and female for eliminating causes of CVD death than that of all causes of death were greatly extended.Reducing the death caused by CVD to increase health life expectancy have important public health significance.

Objective To investigate the feasibility of Wilms’tumor gene 1 (WT1)-specific CD8+T cells from periph?eral blood for the treatment of breast cancer by detecting the killing activity of WT1 specific CD8+T cells on breast cancer cells. Methods Flow cytometry was used to detect WT1-specific CD8+T cells in the peripheral blood of 20 samples from HLA-A2 seropositive healthy donors, which were isolated by WT1/MHC streptamer magnetic beads and cultured. The func?tion of WT1-specific CD8+ T cells were analysis by cytotoxicity assay. Results Twelve of 20 healthy donors had naive WT1-specific CD8+T-cell frequencies of>0.5%, and 4 of 20 even>1.0%of all CD8+T cells. After positive selection by magnetic cell separation, a purity of up to 80%can be achieved. WT1 specific CD8+T cells can specifically kill breast can?cer cell line with WT1 polypeptide. Conclusion WT1 specific CD8+T cells can be detected in peripheral blood of healthy volunteers. WT1 specific CD8+T cells have killing effect on breast cancer cells, suggesting the feasibility of adoptive immu?notherapy for breast cancer.

Objective: To investigate differentially expressed protein profiles in B16-F10 grafted melanoma and its metastasis in the lung in order to identify molecular markers of melanoma metastasis. Methods: Differentially expressed proteins in B16-F10 grafted melanoma and its metastatic lesion in the lung were isolated and identified by fluorescence two-dimensional differential gel electrophoresis(2D-DIGE)coupled with matrix assisted laser desorption ionisation time-of-flight mass spectrometry(MALDI-TOF-MS).Some of identified proteins were further confirmed by Real-time PCR analysis. Results: High resolutional images of differential gel electrophoresis were obtained and 9 of 30 differentially expressed proteins (IRatiol≥2,P<0.01)were identified by MALDI-TOF-MS.The expression of Myoglobin(MB),vimentin(VIM),phosphoglycerate kinase 1(PGK1),Triosephosphate isomerase(TPI or TIM),heavy-chain binding protein(BiP),α-enolase,β-actin,γ-actin,and laminin-binding protein were up-regulated in the experimental group compared with the control group.These proteins were involved in the cytoskeletal formation,glycolysis and so on.Real-time PCR analysis showed up-regulation of mRNA expression of PGK1 and TPI in the experimental group(P=0.001 and 0.003),which was in consistent with the resuits of proteomic analysis. Conclusion: A variety of abnormally expressed proteins contribute to the metastasis of mice melanoma.Glycolytic enzymes PGK1 and TPI may be involved in this process.

Objective: To study the prognostic significance of the subtype of SYT-SSX fusion gene, E-cadherin, β-Catenin and clinicopathologicel parameters for the metastasis of synovial sarcomas. Methods: A total of 98 synovial sar-coma patients with complete clinical and follow-up data were reviewed. RT-PCR was used to detect the subtype of SYT-SSX fusion geneo The expression of E-cadherin and β-catenin was detected by immunohistochemistry. Univariate and multivariate analyses were performed to analyze the influence of the above factors and clinicopathological parameters on the metastasis free survival to explore the factors affecting the metastasis of synovial sarcoma. Results: Of all the pa-tients, 69.4% (68/98) had metastasis during follow-up. The median metastasis free survival was 48 months. The metastasis free 1-, 2-, 3-, 4-, and 5-year survival rate after surgery was 97.5%, 75.5%, 63.5%, 54.0%, and 48.5%, respectively; 31.6% (31/98) patients were found with SYT-SSX1 and 68.4% (67/98) patients with SYI-SSX2. The positive rate of E-cadherin ex-pression was 38.8% (38/98), the positive rate of β-catenin expression was 39.8% (39198) on cellular membrane and 53.1% (52/98) in cellular nucleus/cytoplasm. Univariate analysis showed that age (P=0.003), mitotic figure (P=0.002), histological grade (P=0.001), the subtype fusion gene of SYT-SSX (P=0.014), E-cadherin expression (P=0.015) and β-catenin expres-sion on cellular membrane (P=0.020) were significantly correlated with metastasis free survival of synovial sarcoma pa-tients. Sex (P=0.190), tumor location (P=0.105), tumor size (P=0.180), histological type (P=0.354), necrosis (P=0.451), β-catenin expression in cell nucleus/cytoplasm (P=0.911), radiotherapy (P=0.193), and chemotherapy (P=0.249) had no sig-nificant correlation with metastasis free survival of synovial sarcoma patients. Multivariate analysis revealed that the sub-type of SYT-SSX1 fusion gene (RR=2.505, P=0.003), negative expression of E-cadherin (RR=3.282, P=0.000), patient age (RR=2.157, P=0.004), and grade Ⅲ (RR=1.784, P=0.030) were independent risk factors for metastasis of synovial sarco-ma. Conclusion: The subtype of SYT-SSX, expression of E-cadherin, histological grade and the age of patients are impor-tant factors for evaluating the metastasis and prognosis of synovial sarcoma.

Objective: To study the prognostic significance of cell proliferation and apoptosis, MVD and clinicopathologi-cal parameters for the recurrence of synovial sarcoma. Methods: We analyzed the clinical and follow-up data of 56 synovial sarcoma patients without metastasis. RT-PCR was used to detect the subtype of SYT-SSX fusion gene. The expression of Ki67 and MVD was detected by immunohistochemistry. Univariate analysis was employed to analyze the influence of the above factors and clinicopathological parameters on the recurrence free survival and to explore the influencing factors for the recurrence of synovial sarcoma. Results: Of all the patients, 73.2% (41/56) had recurrence during the follow-up. The median recurrence free survival was 19.5 months. The recurrence free 1-, 2-, 3-, 4-, and 5-year survival rates after surgery were 45.0%, 41.0%, 34.0%, 28.0%, and 28.0%, respectively. Ki-67 labeling index (LI) was 19.98%±11.64% and MVD was 51.83±21.92 per ×400. There was no significant difference in apoptotic index (AI) between the two groups (P=0.607). Χ~2 analysis showed that histological type (P=0.000) and MVD (P=0.045) were significantly correlated with the recurrence of sy-novial sarcoma. Univariate analysis showed that Ki67 LI (P=0.009), histological type (P=0.012) and radiotherapy (P= 0.014) were significantly correlated with the recurrence free survival of synovial sarcoma patients. Sex (P=0.015), tumor lo-cation (P=0.411), tumor size (P=0.801), necrosis (P=0.486), MVD (P=0.454), chemotherapy (P=0.272), and apoptotic grade (P=0.899) were not correlated with the recurrence free survival of synovial sarcoma patients. Multivariate analysis re-vealed that higher expression of Ki67 (RR=1.944, P=0.045), radiotherapy (RR=0.482, P=0.04), and histological type (RR= 0.207, P=0.031) were independent risk factors for the recurrence of synovial sarcoma. Conclusion: The expression of Ki67, radiotherapy and histological type are important factors for evaluating the recurrence and prognosis of synovial sarcoma.

Objective: To study the relationship of LPPCN with neovascularization and to analyze its clini-copathologic significance, in an effort to find a new target for anti-vascular therapies. Methods: Sixty-eight ma-lignant melanoma specimens were analyzed to observe the distribution of LPPCN and to examine the expres-sion of CD105 and TGFβ1 using immunohistochemistry. The distribution of vasculogenic mimicry (VM) was observed by immunohistochemical and histochemical double staining of CD31 and PAS. Results: (1) The tu-lines and networks. Of the 68 cases of melanoma, 55.89% (38/68) were recognized as having LPPCN. (2) In malignant melanoma specimens, the rate of vasculogenic mimicry density (VMD) and microvessel density (MVD) labeled by CD105 in LPPCN-positive group were higher than those in LPPCN-negative group, with sig-nificant differences (P<0.05). VMD and MVD were positively-correlated with the density of LPPCN. The posi-tive expression of TGFβ1 in LPPCN-positive group was higher than that in LPPCN-negative group and its ex-pression in the regions of LPPCN was obviously higher than that in circumambient tumor cells, with a signifi-cant difference (P<0.05). The expression of TGFβ1 was positively correlated with MVD labeled by CD105. (3) There was no relationship between LPPCN and gender, age, site, tumor embolus, lymph node metastasis or distant metastasis (P>0.05), but LPPCN was correlated with tumor size, mitosis figure count and Breslow depth (P<0.05). Kaplan-Meier survival analysis showed the survival rate of patients with LPPCN was lower than that of patients without LPPCN, with a statistical significance (P<0.05). The presence of LPPCN indicat-ed poor prognosis. Conclusion: LPPCN exists in malignant melanoma and is associated with VM and angio- genesis. Some tumor cells undergoing LPPCN have a spacial foundation for VM and angiogenesis. LPPCN can be an index for the evaluation of the prognosis of melanoma patients.

Objective:At present, the postgraduate education of emergency medicine in China mainly relies on the internal medicine system and lacks specialty pertinence. The purpose of this study is to establish a compulsory curriculum system for professional postgraduates of emergency medicine.Methods:Modified Delphi method was used to subscribe questionnaires to experts, and the contents were mainly about medical education management and research of emergency in the affiliated teaching hospitals of Peking University. Microsoft Excel 2016 was used for double entry of questionnaire contents, and SPSS 22.0 software was used for statistics.Results:The panel was consisted of 14 experts in total and two rounds of Delphi questionnaires were completed. The response rate of the two rounds were both 100%. The authority coefficient of experts was > 0.9 and the average score of each evaluation index was 4.07-5.00 points. The coefficient of variation of each index was 0-0.22 and the Kendall coefficient of concordance was 0.07-0.10.Conclusion:As a result, a comprehensive emergency professional postgraduate curriculum system has been established.

High performance liquid chromatography coupled with on-line electrospray tandem mass spectrometry (HPLC/ESI-MS/MS) was used to identify C21 steroidal glycosides in the roots of Cynanchum atratum. The structures of C21 steroidal glycosides were deduced from mass fragments features in positive and negative mode. The constituents of C. atratum were separated and detected. 7 compounds were identified by comparing their ESI-MS/MS data with the reference compounds and 2 compounds were inferred solely by the ESI-MS/MS data. The method is sensitive, and provides good separation and rapid qualitative characterization of C21 steroidal glycosides in the roots of C. atratum.
Chromatography, High Pressure Liquid ; Cynanchum ; chemistry ; Glycosides ; analysis ; chemistry ; Spectrometry, Mass, Electrospray Ionization ; Steroids ; chemistry ; Tandem Mass Spectrometry