Pathology is a subject that studies the etiology,pathogenesis,pathological changes,progression and outcome of diseases.Pathology links the basic research and clinical practice and is an important part of translational medicine.In order to cultivate qualified pathological graduates with solid pathological theories and the abilities of proposing and addressing scientific hypotheses from pathological morphology changes,we employ modularized special training to divide the pathology training courses into morphology learning module,article searching and reading module,project design module,experiment operation module and scientific presentation module.The training contents among these modules are relatively independent but closely connected,and compose a strategy that aims to improve the scientific innovation ability of pathological graduates.

ObjectiveTo observe the hong-huang antioxidant on oxidative stress in patients with breast cancer during chemotherapy, including their related blood indexes, blood rheology changes, and the effects on TCM clinical symptoms and symptoms of stress.MethodsA total of 60 cases of breast cancer patients during chemotherapy from Jiangsu Province Hospital of TCM was randomly divided into treatment group and control group, 30 cases in each group. On the basis of conventional therapy, patients in treatment group were given hong-huang antioxidant (100 mL per bag) from the 1st day to the 14th day of chemotherapy, 2 bags for each day (morning and evening). Patients in control group were given foundation treatment the same as the treatment group. Patients in the two groups had their serum NO, the content of SOD, and blood rheology tested on the day before chemotherapy, and the 4th, 7th, 14th days during chemotherapy. Meanwhile, their symptom score and the integral of stress reaction and TCM symptoms were also assessed. ResultsOn the 4th day, serum NO of treatment group decreased, while SOD content increased,without statistical significance between the two groups (P>0.05). Serum NO on the 7th, 14th days was significantly lower than that in the control group, but the content of SOD was higher than that in the control group, with statistical significance between the two groups (P<0.05). Hemorheology on the 4th day significantly decreased after treatment (P<0.05), and was significantly better than that in the control group (P<0.05); Clinical symptoms and stress symptoms integral in the treatment group were significantly lower than those in the control group on the 4th, 7th, 14th days of chemotherapy, with statistical significance (P<0.05).Conclusion Hong-huang antioxidant can significantly improve the oxidative stress status, serological indexes, related blood rheology indexes, and clinical symptoms in patients with breast cancer.

BACKGROUND:This study was undertaken to observe the characteristics of blood pressure variability (BPV) and sepsis and to investigate changes in blood pressure and its value on the severity of illness in patients with sepsis. METHODS:Blood parameters, APACHE Ⅱ score, and 24-hour ambulatory BP were analyzed in 89 patients with sepsis. RESULTS:In patients with APACHE Ⅱ score>19, the values of systolic blood pressure (SBPV), diasystolic blood pressure (DBPV), non-dipper percentage, cortisol (COR), lactate (LAC), platelet count (PLT) and glucose (GLU) were significantly higher than in those with APACHE Ⅱ score ≤19 (P<0.05 ), whereas the values of procalcitonin (PCT), white blood cell (WBC), creatinine (Cr), PaO2, C-reactive protein (CRP), adrenocorticotropic hormone (ACTH) and tumor necrosis factor α(TNF-α) were not statistically significant (P>0.05). Correlation analysis showed that APACHE Ⅱ scores correlated significantly with SBPV and DBPV (P<0.01, r=0.732 and P<0.01, r=0.762). SBPV and DBPV were correlated with COR (P=0.018 and r=0.318; P=0.008 and r=0.353 respectively). However, SBPV and DBPV were not correlated with TNF-α, IL-10, and PCT (P>0.05). Logistic regression analysis of SBPV, DBPV, APACHE Ⅱ score, and LAC was used to predict prognosis in terms of survival and non-survival rates. Receiver operating characteristics curve (ROC) showed that DBPV was a better predictor of survival rate with an AUC value of 0.890. However, AUC of SBPV, APACHE Ⅱ score, and LAC was 0.746, 0.831 and 0.915, respectively. CONCLUSIONS:The values of SBPV, DBPV and non-dipper percentage are higher in patients with sepsis. DBPV and SBPV can be used to predict the survival rate of patients with sepsis.

In line with the worldwide trend in population aging, China has stepped into an aging society since 2000. The outstanding features of aging, including a large proportion of the older population, rapid growth, dramatic expansion of the oldest-old, and uneven aging distribution, have put China in a unique position. Besides, older population is expanding in parallel with the escalating burden of disease, high prevalence of disability, and low social involvement. However, China is not prepared to solve these problems in terms of the economy, awareness, geriatric care system, geriatric team, social security, or age-friendly environment. From the perspective of public health, we summarized the major challenges and proposed the following policy recommendations: (1) strengthening the top-level design and building a "government-leading, multi-sectoral-cooperating, and society-participating" pattern; (2) enhancing health services by implementing the "comprehensive health" strategy; (3) developing home and community care, coordinately enhance institutional care, promote integration of medical and care systems, and establish a multidimensional tailored care system; (4) optimizing geriatric the supporting system, included the construction of geriatric team and the long-term care insurance system; and (5) establishing a physical and socially age-friendly environment.

Objective To investigate the prevalence of chronic kidney disease (CKD) in hospitalized patients with essential hypertension (EH) and analyze the related risk factors.Methods A retrospectivc analysis of chronic kidney disease and its influencing factors was taken from March 2014 to March 2015 in the Second Affiliated Hospital of Nanjing Medical University.People were diagnosed EH patients (1 020 cases).Results (1) The detection rates of proteinuria,estimated glomerular filtration rate (eGFR) and CKD in patients with EH were 22.3％,13.3％,and 26.1％,respectively.The ratio of CKD in male and female was 26.8％ vs 25.5％ (P＞0.05);(2) With the increase in systolic blood pressure levels (as the systolic blood pressure increased 20 mmHg),the constituent ratio of CKD increased with statistically significant difference (P ＜ 0.05);(3) The risk factors of essential hypertension complicated with chronic kidney disease were high uric acid,the history of diabetes,SBP ≥ 140 mmHg and the age (OR =2.682,2.224,1.932,1.065).Conclusions The detection rate of CKD in patients with hypertension in was high,and the blood pressure,blood glucose,and serum uric acid should be controlled to prevent and delay the occurrence and development of CKD.

Objective To investigate selcnium(Se) levels of environment and human body in Gaomi City and Zichuan District of Shandong. Methods Lijiaying Township in Gaomi City of Weifang City, Zhaili Township and Longquan Township in Zichuan District of Zibo City were selected. Two farming soil samples at different spot, local wheat and corn, residents nail samples from 3 to 4 families were collected in each natural village in the investigated towns. The contents of Se were detected by 2,3-diamino naphthalene fluorescence method. Results Se level of the soil, wheat, corn, and nails in Lijiaying [(0.054 ± 0.019), (0.022 ± 0.009), (0.018 ± 0.007), (0.365 ± 0.108)mg/kg] was significantly lower than that in Zhaili [(0.425 ± 0.080), (0.130 ± 0.043), (0.098 ± 0.026), (0.751 ± 0.134)mg/kg] and Longquan[(0.487 ± 0.153), (0.112 ± 0.030), (0.097 ± 0.029), (0.735 ± 0.145)mg/kg;P < 0.01]. In Lijiaying, Se was deficient in soil, wheat, corn(< 0.200, < 0.025 mg/kg), above Se deficiency diagnosis and below Se-adequate level in the nail, while in Zhaili and Longquan, the Se level in the soil (0.425, 0.487 mg/kg), wheat(0.130, 0.112 mg/kg), corn (0.098, 0.097 mg/kg), nails (0.751, 0.735 mg/kg) was adequate (≥0.400 mg/kg). Conclusions The external environment is Se-deficient in Lijiaying, Se-adequate in Longquan and Zhaili. The selenium level in human body is consistent with the external environment.

Objective: To investigate the clinicopathologic characteristics and BRAF V600E mutation of brain tumors associated with epilepsy. Methods: Totally 250 patients with brain tumors associated with epilepsy were included from March 2008 to August 2017 retrospectively at Sanbo Brain Hospital, Capital Medical University.The clinical manifestations, histological features and BRAF V600E mutation results were collected and analyzed. Results: There were 132 males and 118 females, and the male to female ratio was 1.1∶1.0. The age of patients ranged from 2 to 67 years(mean 22 years). The tumors had obvious local space occupying effect on MRI. The temporal lobe was the most common site (44.4%, 111/250). There were 58.4% (146/250) of ganglioglioma (GG), 24.0% (60/250) of dysembryoplastic neuroepithelial tumor (DNT), 12.8% (32/250) of pleomorphic xanthoastrocytoma(PXA), 4.0% (10/250) of angiocentric glioma (AG) and 0.8% (2/250) of papillary glioneuronal tumor (PGNT). Mixed GG, PXA and DNT morphological structures were found in 9 of patients. Among 250 cases, 35 cases were accompanied by focal cortical dysplasia(FCD). BRAF V600E was seen in 43 of 74 (58.1%) GG and 13 of 28 (46.4%) PXA. The most common pathologic grade of GG, DNT, AG and PGNT was WHO I. Some of the tumor cells from GG (34 cases) showed higher proliferative activity (WHO Ⅱ/Ⅲ). Most cases of PXA were WHOⅡand high proliferative activity was seen in nine cases. Conclusions The association of low-grade glioneuronal tumors with intractable epilepsy was well-recognized. The most common low-grade glioneuronal tumors were GG.GG may occur in any part of the central nervous system, with a predilection for temporal lobe. Each type of low-grade glioneuronal tumors has its own unique histological morphology, but some may show complex features with 2 or 3 mixed components. The occurrence of BRAF V600E mutations in GG is common, and their detection may be valuable for the diagnosis and treatment in GG.

Glycosylation is the key step of the synthesis of GM3 ,its reaction conditions are very harsh ,the stereoselec‐tivities are usually poor ,and the configuration of anomeric carbon is difficult to control .Whetherαglycosidic bond can be con‐structed efficiently in sialylation reactions is an important criteria used to evaluate the reaction quality .Studies of GM3 and de‐rivatives methods generally relates to following areas :the choice of the donor compounds and receptor compounds ,the control of stereoselectivity ,and the development of some new glycosidic reaction catalyst .In recent years ,important progress has been made in this research area .Now ,we predominately make a summary and review on the progress of methods for the synthesis of GM3 and derivatives .

BACKGROUND: Oxidative stress is one of the important mechanisms of postoperative abdominal adhesion. The nuclear factor-E2-related factor 2 (Nrf2)-antioxidant response element (ARE) signal pathway is an important endogenous anti-oxidation stress pathway. Our previous study found that ligustrazine nano-spray can inhibit the formation of postoperative abdominal adhesion in rats, and moreover, ligustrazine has an anti-oxidation effect. OBJECTIVE: To observe the effect of ligustrazine nano-spray on the expression of mRNAs and proteins related to the Nrf2-ARE signal pathway in rats with abdominal adhesion, and to investigate the mechanism by which ligustrazine nano-spray inhibits abdominal adhesion via regulating the Nrf2-ARE signal pathway. METHODS: Sprague-Dawley rats were randomly divided into sham group, model group, ligustrazine group and sodium hyaluronate group. In the sham group, only laparotomy was performed without modeling. In the model group, an abdominal adhesion model was created but no drug was used. In the ligustrazine group, ligustrazine nano-spray was used on the wound before incision suturing. In the sodium hyaluronate group, sodium hyaluronate was applied on the wound before incision suturing. RESULTS AND CONCLUSION: Compared with the model group, ligustrazine nano-spray reduced the levels of reactive oxygen species, tissue inhibitor of matrix metalloproteinase 1, but increased the level of matrix metalloproteinase 9 in the rat serum. The expression of Nrf2 and HO-1 mRNA and proteins was also up-regulated in the ligustrazine group relative to the model group. Therefore, ligustrazine nano-sprays can inhibit abdominal adhesions in rats, and its mechanism may be related to the regulation of Nrf2 and heme oxygenase 1 mRNA and proteins expression and the activation of Nrf2-ARE signaling pathway.

OBJECTIVETo analyze the complete remission (CR) rate, disease free survival (DFS) and overall survival (OS) of de novo acute myeloid leukemia (AML) patients treated with HA based three drugs induction chemotherapy and to explore the impact of cytogenetic abnormalities on the prognosis.

METHODSTwo hundred and forty-three untreated de novo AML patients were treated with HA based three drugs induction therapy. CR rate, DFS and OS were calculated. One hundred and eighty-four patients who had karyotype results were divided into four or three groups according to SWOG or MRC criteria respectively. Differences in CR rate, DFS and OS among different groups were evaluated.

RESULTSThe CR rate of all the 243 cases was 77.4%. The median DFS of the 188 CR patients was 28.5 (ranged from 1.0 to 153.0) months, DFS rates at 3 and 5 years were 45.4% and 40.2% respectively. The median OS of the 243 patients was 18.4 (range from 0.5 to 154.0) months. OS rates at 3 and 5 years were 36.9% and 31.4% respectively. According to SWOG criteria, CR rate, median DFS and OS were 97.8%, 87.4 months and 89.0 months for the favorable group; 81.9%, 17.6 months and 22.3 months for the intermediate group; 61.5%, 9 months and 11.5 months for the adverse group; and 79.3%, 29.0 months, 19.9 months for the unknown group, respectively. The differences among the four groups were statistically significant (P < 0.001). According to MRC criteria, CR rate, median DFS and OS were 96.1%, 79.9 months, 72.2 months for the favorable group; 80%, 17.6 months, 19.7 months for the intermediate group; and 43.8%, 16.5 months, 12 months for the adverse group, respectively. The differences among the three groups were statistically significant excepting for DFS between intermediate and adverse groups.

CONCLUSIONSHA based triple-drug induction regimens are highly effective in obtaining higher CR rate and longer survival time. Cytogenetics is the important prognostic factor for AML patients and SWOG karyotype subtyping criteria is more appropriate than that of MRC, the differences among the three groups being statistically significant.

Adolescent ; Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Cytarabine ; administration & dosage ; Disease-Free Survival ; Female ; Follow-Up Studies ; Harringtonines ; administration & dosage ; Humans ; Karyotyping ; Leukemia, Myeloid, Acute ; drug therapy ; genetics ; Male ; Middle Aged ; Prognosis ; Remission Induction ; Retrospective Studies ; Treatment Outcome