OBJECTIVETo explore cytological parameters that may identify the primary sites of metastatic adenocarcinomas in serous fluid.

METHODSSerous fluid specimens from 89 cases of metastatic adenocarcinomas (40 metastatic adenocarcinomas of lung, 6 metastatic adenocarcinomas of breast, 21 metastatic ovary adenocarcinomas, 22 metastatic gastrointestinal and pancreatic adenocarcinomas) were studied by using multiple morphologic parameters. Immunocytochemical S-P method was used to detect the expression of CA125, CA199, SPB and TTF-1 in 75 cases.

RESULTSMetastatic adenocarcinomas of different primary sites displayed certain different morphologic features, including the total amount of tumor cells, size of clusters, ratio of clusters over single cells, configuration of tumor clusters and the background of the smear. Cell clusters of small to medium sizes represented 95% and 100% in the metastatic adenocarcinomas of lung and breast, respectively. Most of the ovarian metastatic adenocarcinomas (85.7%) presented some large cell clusters and larger amount of cells, whereas certain metastatic gastrointestinal and pancreatic adenocarcinomas (45.5%) presented smaller number of cells and predominantly to be single cell in distribution (40.9%). Psammoma bodies were found in metastatic adenocarcinomas of lung and ovary. SPB and TTF-1 expression supported the diagnosis of adenocarcinoma of pulmonary origin. CA125 expression supported an ovarian origin. Although CA199 was seen in all groups of metastatic adenocarcinomas, nevertheless, its appearance in tumor cells in ascitic fluid specimens supported gastrointestinal and pancreatic origins.

CONCLUSIONMorpho-logic features of the cytological smear, immunohistochemical staining and clinical history are equally important in determining the primary sites of metastatic adenocarcinomas in serous fluid.

Adenocarcinoma ; metabolism ; secondary ; Ascitic Fluid ; metabolism ; pathology ; Breast Neoplasms ; metabolism ; pathology ; Colonic Neoplasms ; metabolism ; pathology ; Female ; Humans ; Lung Neoplasms ; metabolism ; pathology ; Male ; Nuclear Proteins ; metabolism ; Ovarian Neoplasms ; metabolism ; pathology ; Pancreatic Neoplasms ; metabolism ; pathology ; Pleural Effusion, Malignant ; metabolism ; pathology ; Proteins ; metabolism ; Stomach Neoplasms ; metabolism ; pathology ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

OBJECTIVESTo investigate the incidence of intra- and extrauterine growth retardation (EUGR) and growth restriction in premature infants, and to illustrate the growth pattern of them in postnatal and infantile period.

METHODSAll premature infants were admitted to our neonatal intensive care unit (NICU) during the recent 7 years. The criteria for enrollment were (1) gestational age < 37 weeks; (2) single fetus; (3) admitted within the first 24 hours of life; (4) hospitalization period ≥ 14 days; (5) clinical follow-up persisted till ≥ 3 months of corrected gestational age. Intrauterine growth restriction (IUGR), EUGR and growth restriction were defined as having a measured growth value (weight) that was ≤ 10(th) percentile of Chinese infants' growth curve in corrected age on admission, discharge and follow-up period. Results were analyzed by using SPSS 12.0 statistical software package by chi-square test, rank-sum test, and t test.

RESULTSTwo hundred and thirty nine infants were involved, 134 were boys and 105 girls. The incidence of IUGR and EUGR assessed by weight was 25.5% and 40.6%, respectively. The lower the birth weight was, the higher the incidence of IUGR and EUGR was. The percentile of body weight in the growth curve at discharge was lower than that at birth (Z = -7.784, P = 0.000). The incidence of growth restriction assessed by weight was 20.5%, 15.0%, 8.8%, 17.0%, 10.4%, 10.1%, 11.9%, 7.0% at corrected gestational age of 38 - 40 weeks, corrected age of 28 d, 61 d, 91 d, 122 d, 152 d, 183 d, and 274 d, respectively. The incidences of growth restriction were stable when the corrected age was older than 91 days. The incidence of growth restriction in female premature infants at 183 days' corrected age was higher than that in male children (χ(2) = 6.181, P = 0.017), the incidence was 19.3% and 3.8% respectively. During the follow-up period, most of the average body weight of premature infants whose gestational age was < 32 weeks or birth weight ≤ 1500 g were lower than the 50(th) percentile of the growth curve except the average body weight of boys whose gestational age < 32 weeks at corrected age of 2 and 4 months.

CONCLUSIONSPremature and/or low birth weight infants are at high risk of growth restriction, especially very low birth weight infants. The incidence of growth restriction decreased with growth. Long-term prognosis requires further investigation.

Body Weight ; Female ; Fetal Growth Retardation ; Follow-Up Studies ; Humans ; Infant, Newborn ; Infant, Premature ; growth & development ; Male ; Weight Gain

OBJECTIVETo investigate the expressions of vascular endothelial growth factors (VEGF)-A, -C and -D and their prognostic significance and relation to angio- and lymphangiogenesis in gastric cancer.

METHODSThe expression of VEGF-A, -C and -D in 123 primary gastric cancers was detected by immunohistochemical staining. The lymphatic vessel density (LVD) and microvessel density (MVD) were assessed after immunohistochemical double-staining with D2-40 and CD34, respectively. The correlation between the expression of those VEGF factors and clinicopathological parameters were analyzed by univariate method. The overall survival was evaluated by Kaplan-Meier method and log-rank test. Multivariate analysis was carried out using Cox proportion hazard model.

RESULTSThe positive expression rate of VEGF-A, -C and -D in primary gastric cancer samples were 64.2%, 65.9% and 41.5%, respectively. High expression of VEGF-A, or -C or -D, or any two of them was correlated with high LVD (P < 0.05). High expression of both VEGF-A and -C was associated with high MVD, lymph node metastasis, LVI and MVI (P < 0.05). Both VEGF-C and -D high expression was correlated with LVI and lymph node metastasis (P < 0.05). The patients with high expression of these factors had a statistically shorter overall survival (P < 0.05). The patients with both VEGF-A and -C expression had the shortest survival (56 months). Multivariate analysis showed that VEGF-A high expression, MVD, lymph node metastasis and depth of tumor invasion were independent survival predictors (P = 0.033, 0.002, 0.019 and P < 0.001, respectively).

CONCLUSIONHigh expression of both VEGF-A and -C imply high potential of lymphangiogenesis, metastasis and poorer survival in gastric cancer patients. High expression of VEGF-C and -D may induce lymphangiogenesis and promote lymph node metastasis, but only VEGF-A is an independent predictor of survival.

Adult ; Aged ; Aged, 80 and over ; Female ; Follow-Up Studies ; Humans ; Lymphangiogenesis ; Lymphatic Metastasis ; Lymphatic Vessels ; pathology ; Male ; Microvessels ; pathology ; Middle Aged ; Neovascularization, Pathologic ; Proportional Hazards Models ; Stomach Neoplasms ; metabolism ; pathology ; Survival Rate ; Vascular Endothelial Growth Factor A ; metabolism ; Vascular Endothelial Growth Factor C ; metabolism ; Vascular Endothelial Growth Factor D ; metabolism

Objective:To study the characteristics of neonatal fungal sepsis and the difference between bacterial sepsis and fungal sepsis.To improve the understanding of neonatal fungal sepsis.Methods:Clinical data of neonatal fungal sepsis in neonatal intensive care unit (NICU) were collected from 2011 to 2016 in Peking University first Hospital.The clinical characteristics were analyzed retrospectively.The difference between neonatal fungal sepsis and bacterial sepsis was also analyzed.Results:Fifteen cases of neonatal fungal sepsis were recruited.Over the study period,the incidence of neonatal fungal sepsis was 0.52％,while it was 2.5％ in very low birth weight infants.Clinical characteristics were nonspecific.All the infants were treated with parenteral nutrition and broad spectrum antibiotics.Peripheral inserted central catheter (PICC) was placed in thirteen patients.Pathogenic analyses indicated Candida glabrata was the main pathogen in our study.All the pathogens were sensitive to amphotericin B.Only one Candida glabrata was resistant to fluconazole.Thirty-four cases of bacterial sepsis were included.The clinical characteristics and laboratory examination results were compared.The platelet count was 61 × 109/L in fungal group,while the platelet count was 178 × 109/L in bacterial group.There was statistical difference between the fungal group and bacterial group (P =0.004).The rate of thrombocytopenia was 80.0％ in fungal group,while it was 29.4％ in bacterial group.It was much higher in fungal group than in bacterial group (P =0.001).The rate of PICC placement was 86.7％ in fungal group,while it was 55.7％ in bacterial group.It was much higher in fungal group than in bacterial group (P =0.037).Receiver operating characteristic (ROC) curve analysis showed that the cut-off value of the platelet count for the diagnosis of neonatal fungal sepsis was 145 × 109/L (sensitivity 61.8％,specificity 92.9％).All the patients were cured after standardized antifungal therapy.The indicators of liver and renal function were also measured before and after antifungal therapy.No significant difference was observed before and after treatment.Conclusion:The clinical characteristics of neonatal fungal sepsis was nonspecific.Candida glabrata was the main pathogen in our NICU.It can be cured as the result of standardized treatment.Decreased platelet count and PICC placement may indicate the possibility of fungal sepsis in neonates.

INTRODUCTIONThis study aimed to determine the early growth patterns of preterm infants who required prolonged hospitalisation in terms of body weight Z-score, and to explore the influencing factors and predictors of their growth.

METHODSThe criteria of enrolment included preterm birth, singleton pregnancy, hospitalisation within the first 24 hours of life, hospital stay ≥ 28 days and clinical follow-up beyond 91 days of corrected age. Body weight Z-scores and the incidence of underweight infants were reviewed periodically, and the influencing factors and possible predictors of growth analysed.

RESULTSBody weight Z-scores of all infants of gestational age (GA) groups kept decreasing, with a trough seen at 36 weeks corrected gestational age (CGA). At corrected full-term, body weight Z-scores for all birth weight groups achieved birth level and were higher than that at 36 weeks CGA. Body weight Z-scores at 61 days corrected age was (-0.300 × GA [weeks] + 0.210 × birth weight [g] + 0.682 × body weight Z-score) at 40 weeks CGA. The cut-off values for body weight Z-score at birth (cut-off, -1.79; sensitivity, 100%; specificity, 91.3%) and 61 days corrected age (cut-off, -1.95; sensitivity, 100%; specificity, 97.1%) were selected to predict the risk of being underweight at 183 days corrected age.

CONCLUSIONEarly growth restriction is a practical problem in preterm infants with prolonged hospitalisation. Body weight Z-scores at 40 weeks CGA and 61 days corrected age can be used to predict body weight gain prior to 183 days corrected age in these infants.

Female ; Follow-Up Studies ; Gestational Age ; Growth Disorders ; epidemiology ; etiology ; Humans ; Incidence ; Infant, Newborn ; Infant, Premature ; growth & development ; Infant, Premature, Diseases ; epidemiology ; etiology ; Length of Stay ; trends ; Male ; Pregnancy ; Retrospective Studies ; Singapore ; epidemiology

OBJECTIVE: To observe the effect and the mechanism of Chrysanthemum morifolium Ramat on apoptosis of bovine aortic smooth muscle cells. METHODS: Vascular smooth muscle cells were isolated from thoracic aorta of fetal calf and cultured, then incubated with different concentration of Chrysanthemum morifolium Ramat. Apoptosis was measured by flow cytometry. SOD and MDA were measured by spectrophotometer. RESULTS: We found that: (1) the number of apoptotic cells was reduced from (4.425+/-0.624)% to (2.875+/-0.640)% in Chrysanthemum morifolium Ramat group, in a concentration dependent manner; (2) the value of SOD was increased from (1.683+/-0.149)X10(4) U/L to (2.297+/-0.230)X104 U/L and the value of MDA was reduced from(166.454+/-56.805)&mgr;mol/L to (73.068+/-27.203)&mgr;mol/L in Chrysanthemum morifolium Ramat group, also in a concentration dependent manner. CONCLUSION: Chrysanthemum morifolium Ramat can inhibit apoptosis of vascular smooth muscle cells in a concentration-dependent manner.

OBJECTIVETo study the relationship of protein intake and energy supply with the physical growth in very/extremely low birth weight infant at their early life.

METHODRetrospective survey was performed in Neonatal Intensive Care Unit (NICU) in Peking University First Hospital. Inclusion criteria were preterm infant, birth weight < 1500 g, hospitalization for longer than 2 weeks, discharge with body weight greater than 1800 g. The infants were divided into two groups according to gestational age (GA). GA < 32 weeks and ≥ 32 weeks. Physical growth and its relation with the protein intake and energy supply were analyzed. The predictive value of serum blood urea nitrogen (BUN) on protein intake was studied.

RESULTNinety-three very/extremely low birth weight infants were involved, 69 in GA < 32 weeks group and 24 in GA ≥ 32 weeks group.Compared with GA ≥ 32 group, GA < 32 weeks preterm infants had more weight loss, (9.2 ± 4.4)% vs. (5.0 ± 3.1)%, P = 0.000; slower birth weight recovery (10.6 ± 3.8) d vs. (7.1 ± 2.6) d, P = 0.000; poorer weight gain at 1, 4, 5 weeks of life, (-4.5 ± 9.3) g/ (kg·d) vs. (3.4 ± 6.9) g/ (kg·d), P = 0.000 , (13.5 ± 7.3) g/ (kg·d) vs. (19.2 ± 4.9) g/ (kg·d), P = 0.001, (14.6 ± 5.6) g/ (kg·d) vs. (18.2 ± 4.5) g/ (kg·d), P = 0.031; less energy supply at 1 to 5 weeks (P value was 0.000,0.000,0.025,0.001,0.008 respectively) and less protein intake at 1, 4, 5 weeks of life (P value was 0.009,0.006,0.032). Extrauterine growth retardation (EUGR) was still predominant in our subjects, 47.8% in GA < 32 weeks group, and 95.8% in GA ≥ 32 weeks group, P = 0.000. The incidence increased greater in GA < 32 weeks infants, 43.5% vs. 20.8%, P = 0.000.The duration of weight loss and mechanical ventilation correlated negatively with weight gain rate, respectively β = -0.591, P = 0.000 and β = -0.281, P = 0.005; the average energy supply and time taken to reach full enteral feeding were factors improving weight gain, respectively β = 0.202, P = 0.021 and β = 0.354, P = 0.000. After birth, serum BUN declined gradually. Positive relation showed between average protein intake at 3(rd) week and BUN level at the end of 3 weeks, r = 0.420, P = 0.000. Serum BUN 1.44, 1.49 mmol/L at the end of 3(rd) and 4(th) week were cut-off predictors for protein intake less than 3 g/(kg·d) at related period, sensitivity and specificity were 65.3%, 83.3% and 60%, 80% respectively.

CONCLUSIONNo enough protein intake and energy supply, poor weight gain are critical problems in the management of very/extremely low birth weight infants. Prevention from NEC, appropriate parenteral/enteral nutrition transforming will benefit their physical growth. Low serum BUN after 3 weeks of life is a valuable predictor of low protein intake.

Blood Urea Nitrogen ; Dietary Proteins ; administration & dosage ; Energy Intake ; Enteral Nutrition ; Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Infant, Low Birth Weight ; growth & development ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; epidemiology ; etiology ; Infant, Very Low Birth Weight ; growth & development ; Intensive Care Units, Neonatal ; Nutritional Status ; Parenteral Nutrition ; Retrospective Studies ; Weight Gain

OBJECTIVETo investigate the effect of ceftriaxone on the intestinal epithelium and microbiota in mice in the early-life stage, as well as the recovery of the intestinal epithelium and reconstruction of intestinal microbiota in adult mice.

METHODSA total of 36 BALB/C neonatal mice were randomly divided into control group and experimental group, with 18 mice in each group. The mice in the experimental group were given ceftriaxone 100 mg/kg every day by gavage within 21 days after birth. Those in the control group were given an equal volume of normal saline by gavage. Immunohistochemistry was used to measure the expression of Ki67, Muc2, and ZO-1 in the intestinal epithelium. qPCR and next-generation sequencing were used to analyze the overall concentration and composition of fecal bacteria.

RESULTSAfter 21 days of ceftriaxone intervention, the experimental group had a significant reduction in body weight, a significant reduction in the expression of Ki67 and ZO-1 and a significant increase in the expression of Muc2 in intestinal epithelial cells, a significant reduction in the overall concentration of fecal bacteria, and a significant increase in the diversity of fecal bacteria compared with the control group (P<0.05). Firmicutes was the most common type of fecal bacteria in the experimental group, and there were large amounts of Staphylococcus and Enterococcus. The experimental group had a certain degree of recovery of the intestinal epithelium, but there were still significant differences in body weight and the structure of intestinal microbiota between the two groups at 56 days after birth (P<0.05).

CONCLUSIONSEarly ceftriaxone intervention significantly affects the development of the intestinal epithelium and the construction of intestinal microbiota in the early-life stage. The injury of the intestinal microbiota in the early-life stage may continue to the adult stage and affect growth and development and physiological metabolism.

Animals ; Animals, Newborn ; Anti-Bacterial Agents ; pharmacology ; Ceftriaxone ; pharmacology ; Female ; Gastrointestinal Microbiome ; drug effects ; Intestinal Mucosa ; drug effects ; Ki-67 Antigen ; analysis ; Mice ; Mice, Inbred BALB C ; Mucin-2 ; analysis ; Zonula Occludens-1 Protein ; analysis

Leigh syndrome is a genetically heterogeneous disease caused by defects in enzymes involved in aerobic energy metabolism and the Krebs' cycle. Deficiency of pyruvate dehydrogenase complex E1 alpha subunit (PDHA1) is the common cause of Leigh syndrome. In this study, one Chinese case of PDHA1 deficiency was reported. The patient was a boy with normal mental development, retarded motor development, general weakness, hypotonia and areflexia. Muscle histopathological findings suggested axonal peripheral neuropathy. Brain magnetic resonance imaging at 5 years of age revealed bilateral putamina lesions and periventricular white matter demyelination, supporting the diagnosis of Leigh syndrome. A C214T mutation in exon 3 of the PDHA1 gene was detected. After the treatment of thiamin, coenzyme Q10, Lcarnitine and carbohydrates-restricted diet, his movement ability improved significantly. At present, the patient is 8 years old and has normal school life. PDHA1 deficiency is an X-linked inherited metabolic disease, which shares various clinical manifestations and leads to difficult diagnosis. This patient predominately presented with progressive weakness and was diagnosed by gene analysis.
Child, Preschool ; Diagnosis, Differential ; Humans ; Leigh Disease ; diagnosis ; genetics ; therapy ; Male ; Mutation ; Pyruvate Dehydrogenase (Lipoamide) ; genetics

OBJECTIVEPelizaeus-Merzbacher disease (PMD) is a rare X-linked recessive leukoencephalopathy. Few reports of PMD patients without genetic confirmation have been published in the mainland of China. The clinical and genetic features of a family with PMD were analyzed, which may contribute to definite diagnosis, genetic counseling and prenatal diagnosis of this rare hereditary disease in China.

METHODSClinical data of the proband and other family members as well as 14 DNA samples were collected. Clinical features including symptoms, signs and cranial MRI were analyzed. Multiplex ligation-dependent probe amplification (MLPA) assays were performed to detect PLP1 duplication, which helps identify the type of PLP1 mutation in this family and the genotype-phenotype correlations.

RESULTS(1) The proband and the other 3 male patients in the family presented with nystagmus, motor retardation followed by regression. The cranial MRI of proband showed evidence of poor myelination with diffused high signal in white matter region on T2-weighed image and reduced amount of white matter in volume, which is consistent with the typical features of cranial MRI in PMD. (2) PLP1duplication was identified in the proband. Combined with the clinical features of the proband and other patients in this family, the diagnosis of classic form of PMD was confirmed. Another 3 females with normal phenotype in the family were proved to be carriers of PLP1duplication.

CONCLUSIONS(1) The Classic form of PMD in this pedigree is resulted from the PLP1 duplication, which is consistent with the previously reported genotype-phenotype correlations; (2) The results serve as an evidence for reliable genetic counseling and prenatal diagnosis for this family. (3) MLPA, which is a newly developed method, is a rapid and reliable technique to detect the whole gene duplication of PLP1.

Adult ; DNA Probes ; Genes ; Genetic Association Studies ; Humans ; Infant ; Male ; Mutation ; Myelin Proteolipid Protein ; genetics ; Pedigree ; Pelizaeus-Merzbacher Disease ; genetics ; Phenotype