Objective To investigate the protein expression and genetic alterations of c-myc in primary systemic anaplastic large cell lymphoma (ALCL) and discuss its relationship with clinicopathologic features and immunophenotypes.Methods 87 cases of ALCL were selected.Immunohistochemical method was used to detect the protein expression of c-myc,ALK,CD3,CD10,CD20,CD30 and EMA.c-myc and ALK genetic alterations were detected by using fluorescence in situ hybridization (FlSH).The interrelationships between protein expression,genetic alterations and clinicopathological parameters were analysed statistically.Results Immunohistochemical results:of 87 cases,ALK protein was expressed in 54 cases (62.1％).c-myc protein was expressed in 27 cases (31.0 ％).ALK and c-myc were co-expressed in 20 cases (23.0 ％).c-myc protein expression,ALK and c-myc co-expression increased with the upgrade of ALCL clinical stages,and the expression was higher in International Prognostic Index (IPI) high-risk groups than in low-risk groups (P ＜ 0.05).FISH test results:of 87 ALCL cases,there were 50 cases (57.5 ％) of ALK rearrangements and 19 cases (21.8 ％) of ALK aneuploidy.c-myc rearrangement was detected in none of 87 ALCL cases,but there was aneuploidy in 19 cases (21.8 ％).The differences of c-myc aneuploidy in ALK positive and negative groups were statistically insignificant (P ＞ 0.05),while they were statistically significant in c-myc groups (P ＜ 0.05) and in different IPI groups (P ＜ 0.05).Conclusion c-myc protein expression and aneuploidy were related with ALCL clinical stages and IPI,which could be used as an indicator of estimating ALCL malignant degree and predicting prognosis.

Objective To investigate the dysregulation of HER-2 protein and gene in non-small cell lung cancer (NSCLC), and to identify the association between clinicopathological features,prognosis and HER-2 aberrations amongst protein and gene. Methods 140 NSCLC tissues (89 squamous cell carcinoma, 51 adenocarcinoma) with operative section and detailed case were taken from pathology department of Shanxi Cancer Hospital from Jan 2006 to Feb 2007, while 70 normal tissues were set as control group. Immunohistochemistry was applied to detect the state of HER-2 protein expression,and fluorescence in situ hybridization (FISH) was applied to test the status of gene amplification. Results In normal and NSCLC tissues, over-expression of HER-2 was detected in 0 case and 17 (12.14 %) cases (P < 0.05), respectively. The over-expression of HER-2 was associated with the pathological type of NSCLC, which was detected more frequently in adenocarcinoma (χ2 = 4.19, P = 0.04), rather than the gender, age, smoke history, clinical stages, and lymphatic metastasis of patients. 40 (28.57 %) cases presented HER-2 gene copy number ≥3, including 6 (4.29 %) patients with HER-2 gene amplification, 34 (24.29 %) patients with HER-2 gene multicopy. HER-2 gene amplification was associated with the pathological type (P = 0.024), smoke history (P = 0.048) and age (P = 0.015), rather than lymphatic, gender, clinical stages. None clinicopathological features were presented correlation with HER-2 gene multicopy (P > 0.05). There was no significantly difference in survival between patients with and without HER-2 protein over-expression and HER-2 gene dysregulation (P > 0.05). HER-2 protein over-expression was associated with HER-2 gene amplification (P > 0.05), while no relationship between HER-2 protein overexpression and HER-2 gene multicopy (P < 0.01). Conclusions The over-expression of HER-2 is related to pathological type of NSCLC with more frequent expression in adenocarcinoma. The incidence rate of HER-2 gene amplification in patients with adenocarcinoma histology, never-smokers, and young age is high. The HER-2 protein over-expression and gene dysregulation show no relation with the prognosis of NSCLC.

Objective To investigate the expression level and clinical significance of long non-coding RNA(LncRNA) growth arrest specific gene-antisense 1(GAS8-AS1) in papillary thyroid microcarcinoma(PTMC) patients. Methods We investigated the expression profile of GAS8-AS1 in tissue samples of patients with PTMC as well as nodular goiter(NG) by quantitative real-time polymerase chain reaction(RT-qPCR). Results GAS8-AS1 in cancer tissue was down-regulated in PTMC patients compared with adjacent thyroid tissue and NG samples(P<0.05). Lower level of GAS8-AS1 was also correlated with central cervical lymph node metastasis(CLNM, P<0.05). The area under the ROC curve for GAS8-AS1 was up to 0.717 3 in CLNM prediction(P<0.05). Conclusion GAS8-AS1 may act as a potential biomarker for PTC diagnosis and CLNM prediction.

The residents who had lived for at least 5 years and aged over 20 years old were sampled from urban to rural districts of Jiangsu Province with a stratified cluster sampling technique. B mode ultrasonography and thyroid function determination were carried out in 6 128 persons. The location, diameter, number, boundary, and calcification in thyroid nodules were described by using 7.5 MHz/50 mm transducer of thyroid ultrasonography. TSH was measured by chemiluminescence immunoassay. Free triiodothyronine(FT3)and free thyroxin(FT4)were measured when TSH was abnormal. The crude prevalence of thyroid nodules was 21.12% in total population, 14.55% in male, and 25.24% in female. The standardized prevalence was 15.69%, 11.20%, and 20.40%, respectively. The prevalence was lower in male than in female, and increased with age(P＜0.05). Thyroid nodules in Jiangsu Province were highly prevalent and more attention should be paid to the follow-up, early diagnosis, and treatment.

Objective To investigate the clinical characteristics and risk factors of mixed connective tissue disease associated with pulmonary arterial hypertension(MCTD-PAH).Methods Twelve MCTD-PAH patients diagnosed by right heart catheterization(RHC)at Tianjin Medical University General Hospital were retrospectively included,and 36 MCTD patients without pulmonary arterial hypertension(MCTD-non-PAH)were randomly selected from the same period of hospitalization based on gender and age.The clinical features and auxiliary examination of the two groups were compared,and the survival status of the two groups was compared.Results The proportion of dyspnea after activity,myositis and pericardial effusion were higher in the MCTD-PAH group than those of the control group.Serum sedimentation rate and immunoglobulin G(IgG)levels were higher in the MCTD-PAH group.Multivariate Logistic regression analysis showed that dyspnea after activity and high level of IgG were risk factors for predicting the occurrence of PAH in MCTD.Three patients(16.7%)died in the MCTD-PAH group,and no patients died in the control group.Conclusion Pulmonary arterial hypertension is one of the serious complications of MCTD.MCTD patients have shortness of breath after activity and high level of IgG should be wary of concomitant PAH.

Objective To investigate the expressions of programmed death-ligand 1 (PD-L1) and PD-L2 and phosphorylated protein kinase B (p-AKT) in diffuse large B-cell lymphoma (DLBCL) patients and their correlations with clinicopathological features and prognosis. Methods A total of 68 paraffin-embedded specimens of DLBCL patients diagnosed in Shanxi Provincial Cancer Hospital with detailed follow-up record from January 2010 to December 2012 were included in the study. The expressions of PD-L1, PD-L2 and p-AKT proteins in DLBCL were detected by using immunohistochemistry (IHC). Results The positive rate of PD-L1 protein in DLBCL patients was 22.1％ (15/68), which was related to germinal center B-cell (GCB) subtype or not (χ2= 5.591, P= 0.018), clinical stage (χ2= 3.969, P= 0.046), international prognostic index (IPI) grades (χ2=4.178, P=0.041) and treatment remission rate (χ2=6.587, P=0.010). The positive rate of PD-L2 protein in DLBCL patients was 14.7％ (10/68), which was related to extranodal metastasis or not (χ2=6.772, P= 0.009). The positive rate of p-AKT for DLBCL patients was 61.8％ (42/68), which was correlated with age (≥60 years old) or not (χ2=6.227, P=0.013), Eastern Cooperative Oncology Group (ECOG) grades (χ2=4.005, P=0.045), B symptoms (χ2=10.187, P=0.001) and treatment remission rate (χ2=4.096, P=0.043). Univariate survival analysis showed that the overall survival (OS) rate and progression free survival (PFS) rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P< 0.05). In the patients with non-GCB subtype, OS rate and PFS rate of PD-L1 protein positive expression group were lower than those of PD-L1 protein negative expression group (both P<0.05). p-AKT protein positive expression group had poorer OS rate and PFS rate compared to p-AKT negative expression group (both P< 0.05). Correlation analysis showed that PD-L1 protein expression was correlated with PD-L2 and p-AKT proteins expressions (r= 0.380, P= 0.001;r= 0.273, P= 0.025). The prognosis was worse when p-AKT and PD-L1 proteins was co-expressed (P< 0.05). Multivariate analysis suggested high expressions of PD-L1 and p-AKT proteins were independent prognosis risk factors in DLBCL (both P<0.05). Conclusions The expressions of PD-L1 and p-AKT proteins may be involved in the occurrence and development of DLBCL. Blocking PD-1 and PD-L1 access or combined blocking could provide a promising future for the clinical therapy.

ObjectiveTo investigate the anti-inflammatory effect and mechanism of Danggui Shaoyaosan （DSS） in ameliorating vascular dementia （VaD）. MethodsSeventy 8-week-old C57BL/6J male mice were randomized into 7 groups： control， model， sham， positive control （donepezil， 10 mg·kg^-1）， and low-， medium-， and high-dose （12， 24， 36 g·kg^-1， respectively） DSS groups （n=10）. After drug administration， behavioral tests and cerebral blood flow detection were carried out. Enzyme-linked immunosorbent assay was used to assess the levels of interferon （IFN）-α， tumor necrosis factor （TNF）-α， interleukin （IL）-6， and CXC motif chemokine ligand 10 （CXCL10） in the brain tissue. Hematoxylin-eosin staining was employed to observe the changes in hippocampal morphology. Transcriptomics was used to predict the potential signaling mechanisms of DSS in ameliorating neuroinflammation， and Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were conducted to verify the expression changes of related genes. ResultsCompared with the control group and the sham group， the model group showed deceases in recognition index in the new object recognition test， movement distance and time in the target quadrant， and number of crossings in the Morris water maze test （P<0.01）. In addition， the model group showed slow cerebral blood flow and down-regulated protein levels of postsynaptic density protein 95 （PSD95） and occludin （P<0.05， P<0.01）， and there was no significant difference between the control group and the sham group. Compared with the model group， the DSS at each dose increased the new object recognition index， the distance and time in the target quadrant， the number of crossings， and cerebral blood flow （P<0.05， P<0.01）. In terms of brain tissue injury-related protein expression and inflammatory factor content， the medium-dose DSS group had the best effect， with higher protein levels of PSD95 and occludin （P<0.05） and lower levels of IFN-α， TNF-α， and IL-6 （P<0.01） than the model group. The hippocampus of model mice showed pathological manifestations such as cell loss and disarrangement， which were alleviated after administration of DSS at each dose. Transcriptomic results indicated that interferon regulatory factor 7 （IRF7）， signal transducer and activator of transcription 3 （STAT3）， and bone marrow stromal cell antigen 2 （BST2） were differentially expressed genes （down-regulated） in control group and medium-dose DSS group compared with the model group. The KEGG pathway enrichment analysis showed that RIG-Ⅰ-like receptor signaling pathway， Toll-like receptor signaling pathway， cytosolic DNA-sensing pathway， and downstream stimulator of interferon genes （STING） were both upstream signaling pathways affecting IFN expression. Real-time PCR results indicated that the mRNA levels of cyclic good manufacturing practice（GMP）-adenosine monophosphate（AMP） synthase （cGAS）， STING， IRF7， STAT3， and BST2 in the model group were higher than those in the sham group （P<0.05， P<0.01）. The mRNA levels of all the genes in the medium-dose DSS group were down-regulated compared with those in the model group after administration （P<0.05， P<0.01）. Western blot results indicated that the relative expression levels of cGAS， STING， p-IRF7， p-STAT3， and BST2 in the model group were higher than those in the sham group （P<0.05， P<0.01）. The protein levels of cGAS， STING， p-IRF7， p-STAT3， and BST2 in the medium-dose DSS group were decreased compared with those in the model group （P<0.05， P<0.01）. ConclusionDSS ameliorates cognitive impairment in the VaD model mice by inhibiting the cGAS-STING/IRF7/STAT3-mediated neuroinflammation.

ObjectiveTo investigate the anti-inflammatory effect and mechanism of Danggui Shaoyaosan （DSS） in ameliorating vascular dementia （VaD）. MethodsSeventy 8-week-old C57BL/6J male mice were randomized into 7 groups： control， model， sham， positive control （donepezil， 10 mg·kg^-1）， and low-， medium-， and high-dose （12， 24， 36 g·kg^-1， respectively） DSS groups （n=10）. After drug administration， behavioral tests and cerebral blood flow detection were carried out. Enzyme-linked immunosorbent assay was used to assess the levels of interferon （IFN）-α， tumor necrosis factor （TNF）-α， interleukin （IL）-6， and CXC motif chemokine ligand 10 （CXCL10） in the brain tissue. Hematoxylin-eosin staining was employed to observe the changes in hippocampal morphology. Transcriptomics was used to predict the potential signaling mechanisms of DSS in ameliorating neuroinflammation， and Western blot and Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR） were conducted to verify the expression changes of related genes. ResultsCompared with the control group and the sham group， the model group showed deceases in recognition index in the new object recognition test， movement distance and time in the target quadrant， and number of crossings in the Morris water maze test （P<0.01）. In addition， the model group showed slow cerebral blood flow and down-regulated protein levels of postsynaptic density protein 95 （PSD95） and occludin （P<0.05， P<0.01）， and there was no significant difference between the control group and the sham group. Compared with the model group， the DSS at each dose increased the new object recognition index， the distance and time in the target quadrant， the number of crossings， and cerebral blood flow （P<0.05， P<0.01）. In terms of brain tissue injury-related protein expression and inflammatory factor content， the medium-dose DSS group had the best effect， with higher protein levels of PSD95 and occludin （P<0.05） and lower levels of IFN-α， TNF-α， and IL-6 （P<0.01） than the model group. The hippocampus of model mice showed pathological manifestations such as cell loss and disarrangement， which were alleviated after administration of DSS at each dose. Transcriptomic results indicated that interferon regulatory factor 7 （IRF7）， signal transducer and activator of transcription 3 （STAT3）， and bone marrow stromal cell antigen 2 （BST2） were differentially expressed genes （down-regulated） in control group and medium-dose DSS group compared with the model group. The KEGG pathway enrichment analysis showed that RIG-Ⅰ-like receptor signaling pathway， Toll-like receptor signaling pathway， cytosolic DNA-sensing pathway， and downstream stimulator of interferon genes （STING） were both upstream signaling pathways affecting IFN expression. Real-time PCR results indicated that the mRNA levels of cyclic good manufacturing practice（GMP）-adenosine monophosphate（AMP） synthase （cGAS）， STING， IRF7， STAT3， and BST2 in the model group were higher than those in the sham group （P<0.05， P<0.01）. The mRNA levels of all the genes in the medium-dose DSS group were down-regulated compared with those in the model group after administration （P<0.05， P<0.01）. Western blot results indicated that the relative expression levels of cGAS， STING， p-IRF7， p-STAT3， and BST2 in the model group were higher than those in the sham group （P<0.05， P<0.01）. The protein levels of cGAS， STING， p-IRF7， p-STAT3， and BST2 in the medium-dose DSS group were decreased compared with those in the model group （P<0.05， P<0.01）. ConclusionDSS ameliorates cognitive impairment in the VaD model mice by inhibiting the cGAS-STING/IRF7/STAT3-mediated neuroinflammation.

Closed-loop hospital management can effectivly cope with the COVID-19 pandemic. In order to ensure the continuity of treatments for hemodialysis patients under closed-loop management and minimize possible medical and infection risks, Huashan Hospital affiliated to Fudan University and 9 hospitals in Shanghai established a hemodialysis alliance in January 2021.The alliance optimized hemodialysis resources within the region through overall planning by preparing sites, materials and personnel shifts in advance, and establishing management systems and work processes to ensure that patients could be quickly and orderly diverted to other blood dialysis centers for uninterrupted high-quality hemodialysis services, in case that some hemodialysis centers in the alliance under closed-loop management.From November 2021 to April 2022, 317 of 1 459 hemodialysis patients in the alliance were diverted to other centers for treatment, accumulating 1 215 times/cases of treatments without obvious adverse reactions. The practice could provide a reference for medical institutions to quickly establish mutual support mode under major public health events.

OBJECTIVE: To review the development of adult and pediatric liver transplantation in Tianjin First Center Hospital, and to enhance academic exchanges, improve technological innovation, and jointly promote the progress and maturity in the field of liver transplantation. METHODS: The development of liver transplantation in Tianjin First Center Hospital was analyzed. The clinical data of adult and pediatric liver transplantation from September 1998 to September 2018 were collected. The important events and technological innovation achievements of liver transplantation during the 20 years were summarized. RESULTS: The first clinical liver transplantation was attempted in Tianjin First Central Hospital in April 1980. The first long-term survival adult liver transplantation in China was completed in 1994 (11 years survival after the operation). The specialized team of liver transplantation was formally established in September 1998. The 20-year clinical exploration and progress reflected the characteristics of era changes and technological innovation during the rapid development of liver transplantation in China. Our center performed liver re-transplantation in January 1999, reduced-size pediatric liver transplantation in August 2000. In May 2001, we organized the formulation for the preventive and treatment plan for hepatitis B recurrence after liver transplantation. We performed combined liver and kidney transplantation in July 2002, split liver transplantation (SLT) in April 2004, the first domino liver transplantation (DLT) in August 2005. Pediatric living donor liver transplantation (LDLT) was initiated in October 2006, adult LDLT was carried out in August 2007. In September 2007, the first living donor combined liver and kidney transplantation from the same donor in Asia was performed. The first domino+living donor double grafts liver transplantation in the world was performed in January 2009. In March 2011, we performed laparoscopically assisted right hepatic lobe liver transplantation (LDLT) with middle hepatic vein. In May 2014, living donor laparoscopic left lateral lobe procurement was successfully established. In April 2016, simultaneous liver, pancreas and kidney multi-organ transplantation was completed. Domino donor-auxiliary liver transplantation was performed in February 2017. In December 2017, extracorporeal membrane oxygenation (ECMO)-supported liver transplantation in a patient with severe pulmonary hypertension was successfully completed. Liver transplantation combined with partial splenectomy was established in April 2018. Cross-domino liver transplantation (hypersensitive kidney transplantation with auxiliary liver transplantation+pediatric liver transplantation) was performed in May 2018. During the 20 years, the team has performed or assisted other centers in Beijing, Shanghai, Guangzhou and Shenzhen to carry out more than 10 000 cases of liver transplantations. A total of 7 043 cases of various types of liver transplantation were performed in the single center of the hospital (6 005 adult liver transplantations and 1 038 pediatric liver transplantations). Concerning adult liver transplantation, the cumulative 1-year, 3-year and 5-year survival rate from September 1998 to March 2003 were 83.1%, 73.0% and 69.0%, from April 2003 to March 2009 were 85.3%, 76.2% and 72.1% and from April 2009 to September 2018 were 87.5%, 79.2% and 75.1%, respectively. The cumulative 1-year, 3-year and 5-year survival rate for pediatric liver transplantation were 93.5%, 92.2% and 90.2%, respectively. The nucleoside (acid) analogue combined with low dose hepatitis B immunoglobulin (HBIG) was developed to prevent the recurrence of hepatitis B after liver transplantation, this plan has reduced the recurrence rate of hepatitis B and the 5-year re-infection rate of hepatitis B virus (HBV) after liver transplantation significantly. The risk assessment system for tumor recurrence after liver transplantation was established and individual treatment method was established based on this assessment system. Continuous exploration and improvement of liver transplantation for liver cancer, liver re-transplantation, liver transplantation with portal vein thrombosis, SLT, DLT and multi-organ combined transplantation have significantly improved the clinical efficacy of patients and the post-operative survival rate. CONCLUSIONS The liver transplantation team of Tianjin First Center Hospital has carried out a scientific and technological exploration on the key problems and technical difficulties of clinical liver transplantation. This work strongly has initiated and promoted the rapid development of liver transplantation in China. The restrictive barrier of hepatitis B recurrence after liver transplantation has been overcome. The risk prevention and control system of tumor recurrence after liver transplantation has been established. A series of innovative achievements that can be popularized have been achieved in the field of complex liver transplantation and expansion of donor liver source. The iterative progress and sustainable development of liver transplantation have been realized.
China ; Humans ; Liver Transplantation