Objective To explore the effect of humanistic care on quality of life and self-efficacy of diabetic patients. Methods According to the principle of convenience sampling, 135 patients with diabetes mellitus from January 2016 to June 2016 were randomly divided into two groups according to the random number table method. The patients in the observation group were treated with fishbone analysis to analyze the quality of life and the self-efficacy, and the patients were given humanistic nursing care. The patients in the control group were treated with routine diabetes care. After 6 months of care, the quality of life and self-efficacy were analyzed between the two groups. Results After treatment, the quality of life scores in the observation group (50.33 ± 3.02, 30.55 ± 2.03, 17.20 ± 2.01, 12.35 ± 0.87) were significantly higher than those in the control group (41.57 ± 3.46, 23.60±2.17,13.55±2.34, 9.02±0.64) , the difference between the two groups was statistically significant (t=8.112-21.137, all P <0.01); The score of self-efficacy in the observation group (30.52 ± 2.33) was significantly higher than that in the control group (24.69 ± 1.98), the difference between the two groups was statistically significant (t=13.072, P<0.01). Conclusions Humanistic care can significantly improve the quality of life and self-efficacy of patients with diabetes mellitus. The application of the nursing model in patients with diabetes has significant effect, which is worthy of clinical application.

OBJECTIVEWe aims to evaluate the therapeutic effect of maxillary protraction on maxillary maldevelopment using Coben analysis to illustrate the advantages of Coben analysis in identifying pathogenic mechanisms and in designing treatment plans for Class III malocclusions.

METHODSA total of 120 patients were diagnosed to have skeletal Class I maloc- clusions with maxillary maldevelopment. These patients were selected as the subjects of the present research. Maxillary protraction was exerted to promote maxilla growth. Cephalometric analysis was conducted by using Coben analysis and angle analyses of Beijing Medical University to collect data before and after maxillary protraction.

RESULTSAccording to Coben analysis measurements, the height of facies cranii increased after maxillary protraction. The depth of lower face decreased, whereas that of mid-face increased and the Ptm-A value increased significantly in the mid-face (P < 0.001). In the angle ana- lysis of Beijing Medical University, SNA, ANB, U1/NA, U1/SN, MP/SN, and Y-axis angles increased significantly (P < 0.001), whereas SNB, U1/L1 (P < 0.001), and L1/MP (P < 0.05) decreased.

CONCLUSIONMaxillary protraction has a significant effect on growing skeletal Class III malocclusions withthe chief mechanism of Ptm-A value just diagnosed as minor by Coben analysis. Coben analysis is visual and clear in identifying pathogenic mechanisms of Class III malocclusions.

Cephalometry ; Face ; Humans ; Malocclusion, Angle Class III ; Maxilla

Objective: To investigate the effect of gross motor skills on physical activity of children aged 3-6 years, and to provide basis for children’s health behavior intervention. Methods: A total of 332 young children in Shanghai Xiangyin kindergarten were selected as survey objects. The development of gross movements of young children was measured by TGMD-2. Caregivers reported children’s physical activity using the International Physical Activity Questionnaire (IPAQ-SF). Results: The development level of gross movements of children aged 3-6 in Shanghai was relatively low(54.76±13.86). The physical activity of children was mainly light-intensity physical activity, and the daily moderate-to-vigorous intensity physical activity time was (58.62±52.73) minutes every day. Locomotor skills had the greatest effect on children’s VPA (β=0.19) and TPA(β=0.12), with a contribution rate of 3.3% and 1.1%, respectively; Object control skills has the greatest effect on children’s MVPA (β=0.17) and MPA (β=0.12) had the largest effect(P<0.05), with contribution rates of 2.5% and 1.2%, respectively. The relationship between gross motor skills and physical activity had nothing to do with gender and age. Conclusion Children’s gross motor skills in the 3-6 year-old population should be improved and may be an effective way to promote physical activity.

Objective We aims to evaluate the therapeutic effect of maxillary protraction on maxillary maldevelopment using Coben analysis to illustrate the advantages of Coben analysis in identifying pathogenic mechanisms and in designing treatment plans for Class Ⅲ malocclusions. Methods A total of 120 patients were diagnosed to have skeletal Class Ⅲ maloc-clusions with maxillary maldevelopment. These patients were selected as the subjects of the present research. Maxillary protraction was exerted to promote maxilla growth. Cephalometric analysis was conducted by using Coben analysis and angle analyses of Beijing Medical University to collect data before and after maxillary protraction. Results According to Coben analysis measurements, the height of facies cranii increased after maxillary protraction. The depth of lower face decreased, whereas that of mid-face increased and the Ptm-A value increased significantly in the mid-face (P<0.001). In the angle ana-lysis of Beijing Medical University, SNA, ANB, U1/NA, U1/SN, MP/SN, and Y-axis angles increased significantly (P<0.001), whereas SNB, U1/L1 (P<0.001), and L1/MP (P<0.05) decreased. Conclusion Maxillary protraction has a significant effect on growing skeletal Class Ⅲ malocclusions with the chief mechanism of Ptm-A value just diagnosed as minor by Coben analysis. Coben analysis is visual and clear in identifying pathogenic mechanisms of Class Ⅲ malocclusions.

Objective To investigate the clinicopathological characteristics and the diagnosis of multilocular cystic renal cell carcinoma ( MCRCC).Methods The clinicopathological data of 19 MCRCC cases were collected and immunohistochemical staining assays were carried out .Forty-six cases of other cystic kidney lesions within the same period were collected as controls , including extensively cystic clear cell RCC (12 cases), clear cell tubulopapillary renal cell carcinoma (6 cases), tubulocystic carcinoma (2 cases), simple cortical cysts (22 cases), multilocular cystic nephroma (1 cases) and multicystic kidney (3 cases). Results The patients included 14 males and 5 females.The ages ranged from 31 to 66 years ( median age=50 years ).Most of the MCRCC cases were detected incidentally in physical examination , occasionally accompanied with hematuria , back pain or other symptoms.The follow-up period of 17 patients ranged from 6 to 170 months.All patients were alive without evidence of tumor recurrence or metastasis.Pathological findings showed that macroscopically , tumor size ranges from 1.5 to 7.0 cm in the maximum diameter , generally a entirely of various sized.The cysts contain serous , hemorrhagic or turbid fluid.Solid areas or substantially discernible mural nodules were absent; histologicallly , single layer of cuboidal and flattened epithelial tumor cells were lined in the cysts , described as clear cytoplasm , small nuclear , no nucleoli and low Fuhrman nuclear grade ( I or II).Multilayer tumor cells could be observed in a few cysts , with granular cytoplasm and small intracystic papillae formed.The clear tumor cell clusters , similar as cystic lined tumor cells, were seen within pathological fibrous in almost all cases , and significant myofibroblastic proliferation was found in 14 cases.Immunohistochemically , the cysts lined epithelial cells and the clear tumor cell clusters were positive for epithelium markers , including CKpan(19/19), EMA(16/19) and CK7 (15/19);higher percentage of CAⅨ(17/19)and PAX8(15/19) than control groups, but lower percentage of CD10 (7/19), RCC (6/19) and AMACR (2/19); and all were negative for 34βE12, CD117 and CD68.Conclusions Multilocular cysts , clear cells clusters of low Fuhrman grade within fibrous septa and capillary vessel proliferation under epithelium are important features of MCRCC.The united using of CAⅨ, CK7, CD10 and RCC is helpful for differentiating variable cystic renal tumor.MCRCC usually has an excellent prognosis, nephron sparing surgery is first recommended as a therapeutic strategy.

Objective To investigate the clinicopathological characteristics and the prognosis of bladder neuroendocrine carcinoma ( NEC) .Methods Clinicopathological data from 17 NEC of the bladder cases were collected , and immunohistochemical staining was performed with follow-up analysis and literature review.Results The recruited included 13 male and 4 female patients, aged from 48 to 86 years old ( average 61 years;14 patients >60 years ) .Gross hematuria of the whole urination course or intermittent was the initial symptom .Macroscopically , the outer surface of the tumor presented with polypoid , lobulated , fungating or ulcerous structures . Histologically, according to the criteria of WHO classification of neuroendocrine tumor of the lung , our NEC cases were divided into three histological types: 13 cases of small cell carcinoma , 3 cases of large cell neuroendocrine carcinoma and 1 case of atypical carcinoid .The urothelial carcinoma was concurrent with NEC in 6 cases, and adenocarcinoma was concurrent with NEC in 2 cases.Most tumor tissue infiltrated to the muscular layer , some infiltrated to the outer membrane . Immunohistochemically , the positive expression rates of CD 56, Syn and CgA were 16/17, 16/17 and 12/17, respectively.The epithelial markers, including CK7 and CKpan, were also expressed with positive rates of 12/17 and 15/17, respectively.TTF-1 was positively expressed in 11 cases.The follow-up data were available in 14 cases, of which 9 patients died of the tumor 1-34 months after surgery ( average, 11 months).Five patients lived uneventfully for 1-12 months after surgery.Conclusions NEC is a rare malignant tumor of the bladder .Immunohistochemical markers such as CD 56, Syn, CgA and CKpan could be helpful in determining the diagnosis and differential diagnosis of the tumor .NEC is a highly invasive malignant tumor with poor prognosis .Based on its biological behavior , radical cystectomy is the preferred method of treatment for the tumor .

Objective To investigate the morphological features and immunophenotypes of eosinophilic renal tumors in order to provide references for the differential diagnosis of this tumor.Methods A cohort of 75 cases of eosinophilic renal tumors were collected.The morphological features of the tumors were observed under microscope, and the immunophenotypes of the tumors were detected using tissue microarray and immunoshistochemistry.Results There were some overlaps between the different types of eosinophilic renal tumors in morphology, but each had its distinct characteristics.Immunohistochemically, renal oncocytoma ( RO) and eosinophilic chromophobe renal cell carcinoma ( ChRCC) shared some common immumophenotypes, except for the expression of CK7, with the expression rates of 2/19 in RO and 17/20 in eosinophilic ChRCC, respectively.Eosinophilic clear cell renal cell carcinoma mainly showed positive immunostaining for Vimentin and CAⅨ, whereas negative for CK7 and CD117 in most cases ( 10/15 ).AMACR was diffusely expressed in the majority of eosinophilic papillary renal cell carcinoma ( PRCC, 10/13).Furthermore, vimentin, CK7 and CD10 were positively expressed in eosinophilic PRCC with the expression rates of 8/13, 9/13 and 6/13, respectively;while CAⅨ, CD117 and TFE3 were all negatively expressed in eosinophilic PRCC.Epithelioid angiomyolipoma generally showed positive expression of vimentin,SMA and HMB45, but negative expression of CAⅨ and CK7.Vimentin, CD10, AMACR and TFE3 were strongly expressed in XP11.2 translocation renal cell carcinoma;on the contrary, CK7, CD117and HMB45 were not expressed in the majority of the tumor.Conclusion With full understanding of the morphology of different types of eosinophilic renal tumors, the immunostaining of vimentin, CAⅨ, CK7, CD10, AMACR, CD117, TFE3 and HMB45 could play a crucial role in the differential diagnosis of these tumors.

Objective:To investigate the clinicopathological features and differential diagnosis of eosinophilic vacuolated tumor (EVT).Methods:Seven cases of EVT with characteristic morphology and unequivocal diagnosis from the Affiliated Hospital of Qingdao University (6 cases), Qingdao, China and the 971 Hospital of PLA Navy (1 case), Qingdao, China between January 2010 and December 2021 were subject to morphological and immunohistochemical analyses. Additionally, whole exome sequencing (WES) was performed in two cases. Twenty-two cases of renal oncocytoma (RO) and 17 cases of eosinophilic chromophobe renal cell carcinoma (eChRCC) diagnosed at the same time were used as controls.Results:Four males and three females with a mean age of 42 years (range: 29-61 years) were included in the study. The tumors were nodular and well-circumscribed, with sizes ranging from 1.5 to 4.5 cm. On cross-section, they appeared gray-red or gray-white, solid, and soft. Tumor cells were arranged in nests, solid sheets, and acinar or small vesicular structures. These cells exhibited eosinophilic cytoplasm with large, prominent clear vacuoles and round nuclei with prominent nucleoli. Perinuclear halos were focally present in four cases, while small tumor cells with sparse cytoplasm and hyperchromatic nuclei were seen in one case. No necrosis or mitosis was noted. Edematous stroma was detected in three cases. All tumors were positive for CD117 and Cathepsin K, but negative for vimentin and CK7. CK20 was positive in scattered individual cells, and Ki-67 positivity ranged from 1% to 4%. Point mutations in MTOR were identified in both patients who were subject to the molecular analysis. Statistical differences in the expression of Cathepsin K, CD10, S-100A1, and Cyclin D1 between EVT and RO ( P<0.05) were significant, so were the differences in the expression of Cathepsin K, CD10, CK7 and claudin 7 between EVT and eChRCC ( P<0.001). Seven patients were followed up for 4 to 96 months (mean, 50 months), with no recurrences or metastases. Conclusions:EVT is a rare renal tumor that shares morphological and immunophenotypic features with RO and eChRCC, and it is closely linked to the TSC/MTOR pathway. The presence of large prominent transparent vacuoles in eosinophilic cytoplasm along with conspicuous nucleoli is its key morphological characteristics. The use of combined immunohistochemical stains greatly aids in its diagnosis. Typically, the tumor exhibits indolent biological behaviors with a favorable prognosis.

OBJECTIVETo investigate the clinicopathological characteristics and the prognosis of bladder neuroendocrine carcinoma (NEC).

METHODSClinicopathological data from 17 NEC of the bladder cases were collected, and immunohistochemical staining was performed with follow-up analysis and literature review.

RESULTSThe recruited included 13 male and 4 female patients, aged from 48 to 86 years old (average 61 years; 14 patients >60 years). Gross hematuria of the whole urination course or intermittent was the initial symptom. Macroscopically, the outer surface of the tumor presented with polypoid, lobulated, fungating or ulcerous structures. Histologically, according to the criteria of WHO classification of neuroendocrine tumor of the lung, our NEC cases were divided into three histological types: 13 cases of small cell carcinoma, 3 cases of large cell neuroendocrine carcinoma and 1 case of atypical carcinoid. The urothelial carcinoma was concurrent with NEC in 6 cases, and adenocarcinoma was concurrent with NEC in 2 cases. Most tumor tissue infiltrated to the muscular layer, some infiltrated to the outer membrane. Immunohistochemically, the positive expression rates of CD56, Syn and CgA were 16/17, 16/17 and 12/17, respectively. The epithelial markers, including CK7 and CKpan, were also expressed with positive rates of 12/17 and 15/17, respectively. TTF-1 was positively expressed in 11 cases. The follow-up data were available in 14 cases, of which 9 patients died of the tumor 1-34 months after surgery (average, 11 months). Five patients lived uneventfully for 1-12 months after surgery.

CONCLUSIONSNEC is a rare malignant tumor of the bladder. Immunohistochemical markers such as CD56, Syn, CgA and CKpan could be helpful in determining the diagnosis and differential diagnosis of the tumor. NEC is a highly invasive malignant tumor with poor prognosis. Based on its biological behavior, radical cystectomy is the preferred method of treatment for the tumor.

Adenocarcinoma ; pathology ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; Carcinoma, Large Cell ; pathology ; Carcinoma, Neuroendocrine ; classification ; complications ; pathology ; Carcinoma, Small Cell ; pathology ; Carcinoma, Transitional Cell ; classification ; complications ; pathology ; Cystectomy ; Female ; Hematuria ; etiology ; Humans ; Male ; Middle Aged ; Neuroendocrine Tumors ; classification ; pathology ; Prognosis ; Urinary Bladder Neoplasms ; classification ; complications ; pathology

OBJECTIVETo investigate the clinicopathological characteristics and the diagnosis of multilocular cystic renal cell carcinoma (MCRCC).

METHODSThe clinicopathological data of 19 MCRCC cases were collected and immunohistochemical staining assays were carried out. Forty-six cases of other cystic kidney lesions within the same period were collected as controls, including extensively cystic clear cell RCC (12 cases), clear cell tubulopapillary renal cell carcinoma (6 cases), tubulocystic carcinoma (2 cases), simple cortical cysts (22 cases), multilocular cystic nephroma (1 cases) and multicystic kidney (3 cases).

RESULTSThe patients included 14 males and 5 females. The ages ranged from 31 to 66 years (median age = 50 years). Most of the MCRCC cases were detected incidentally in physical examination, occasionally accompanied with hematuria, back pain or other symptoms. The follow-up period of 17 patients ranged from 6 to 170 months. All patients were alive without evidence of tumor recurrence or metastasis. Pathological findings showed that macroscopically, tumor size ranges from 1.5 to 7.0 cm in the maximum diameter, generally a entirely of various sized. The cysts contain serous, hemorrhagic or turbid fluid. Solid areas or substantially discernible mural nodules were absent; histologicallly, single layer of cuboidal and flattened epithelial tumor cells were lined in the cysts, described as clear cytoplasm, small nuclear, no nucleoli and low Fuhrman nuclear grade (I or II). Multilayer tumor cells could be observed in a few cysts, with granular cytoplasm and small intracystic papillae formed. The clear tumor cell clusters, similar as cystic lined tumor cells, were seen within pathological fibrous in almost all cases, and significant myofibroblastic proliferation was found in 14 cases. Immunohistochemically, the cysts lined epithelial cells and the clear tumor cell clusters were positive for epithelium markers, including CKpan(19/19), EMA(16/19) and CK7 (15/19); higher percentage of CAIX (17/19) and PAX8(15/19) than control groups, but lower percentage of CD10 (7/19), RCC (6/19) and AMACR(2/19); and all were negative for 34βE12, CD117 and CD68.

CONCLUSIONSMultilocular cysts, clear cells clusters of low Fuhrman grade within fibrous septa and capillary vessel proliferation under epithelium are important features of MCRCC. The united using of CAIX, CK7, CD10 and RCC is helpful for differentiating variable cystic renal tumor. MCRCC usually has an excellent prognosis, nephron sparing surgery is first recommended as a therapeutic strategy.

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Biomarkers ; Carcinoma, Renal Cell ; metabolism ; pathology ; Cysts ; metabolism ; pathology ; Diagnosis, Differential ; Female ; Humans ; Kidney Diseases, Cystic ; metabolism ; pathology ; Kidney Neoplasms ; metabolism ; pathology ; Male ; Neoplasm Recurrence, Local ; Prognosis ; Racemases and Epimerases ; metabolism