Objective:To investigate the pathological characteristics of listeria monocytogenes infection in the placenta during mid-pregnancy. Methods:A retrospective review was conducted on the clinical and placental pathological examination data of a patient admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University in October 2022, who experienced intrauterine fetal death and maternal sepsis due to listeria monocytogenes infection. Results:(1) Clinical data: The 25-year-old patient had 22 weeks of amenorrhea and was admitted to the hospital for 2 days of fever and 1 day of intrauterine fetal death. The patient had a dietary habit of consuming raw seafood. Upon admission, a large amount of purulent vaginal discharge was observed, and obstetric ultrasound indicated the disappearance of fetal heart sounds. The following day, a cesarean section was performed. A female stillborn fetus weighing 470 g was delivered, which had a distended abdomen with no other malformations. Postoperatively, the patient continued anti-infective treatment for one week and was discharged after correction of infectious shock. She continued to take oral anti-infective drugs for one week after discharge. At 10 months postpartum outpatient follow-up and 18 months postpartum telephone follow-up, the patient recovered satisfactorily, reported no discomfort, and was preparing for pregnancy. (2) Placental examination: The placental surface was covered with grayish-white areas ranging from the size of a needle tip to about 2 cm in diameter. Edema of the umbilical cord was observed. Various-sized abscesses were seen in the placental parenchyma, involving several villi, with many neutrophil infiltrations. There were many acute inflammatory cell infiltrations in the chorionic villous space with abscess formation, acute chorioamnionitis, and infarcts visible in the surrounding chorionic villi. Acute inflammation of the local chorionic interstitial blood vessels with thickening of the blood vessel wall was observed. Many neutrophils were seen in the amniotic membrane-chorioamnionic membrane gap, with a stage 3, level 2 maternal inflammatory response. Cord umbilical venous inflammation was noted, with no inflammatory cell infiltration of arteries. Wharton jelly edema was seen, with neutrophil infiltration in the interstitium. (3) Microbiological examination: Blood, vaginal secretion, uterine secretion, abdominal secretion, and placental bacterial cultures all showed listeria monocytogenes. Mass spectrometer bacterial identification confirmed listeria monocytogenes infection. After silver staining of the placenta, microorganisms were seen in the center of the abscess and in the amniotic epithelial cells. (4) Pathologic diagnosis showed placental acute chorioamnionitis with maternal inflammatory response stage 3 grade 2, accompanied by umbilical cord phlebitis and fetal inflammatory response stage 1 grade 1, acute intervillositis with abscess formation, and acute villositis with abscess formation. Combined with clinical presentation, this is consistent with listeria monocytogenes infection. Conclusion:The pathological characteristics of listeria monocytogenes infection in the placenta include various-sized abscesses in the placenta involving multiple villi and chorionic interstitial spaces, thickening of the interstitial vascular wall of the chorionic villi, and chorioamnionitis with umbilical cord phlebitis.

Objective:To investigate the pathological characteristics of listeria monocytogenes infection in the placenta during mid-pregnancy. Methods:A retrospective review was conducted on the clinical and placental pathological examination data of a patient admitted to the Affiliated Wuxi People's Hospital of Nanjing Medical University in October 2022, who experienced intrauterine fetal death and maternal sepsis due to listeria monocytogenes infection. Results:(1) Clinical data: The 25-year-old patient had 22 weeks of amenorrhea and was admitted to the hospital for 2 days of fever and 1 day of intrauterine fetal death. The patient had a dietary habit of consuming raw seafood. Upon admission, a large amount of purulent vaginal discharge was observed, and obstetric ultrasound indicated the disappearance of fetal heart sounds. The following day, a cesarean section was performed. A female stillborn fetus weighing 470 g was delivered, which had a distended abdomen with no other malformations. Postoperatively, the patient continued anti-infective treatment for one week and was discharged after correction of infectious shock. She continued to take oral anti-infective drugs for one week after discharge. At 10 months postpartum outpatient follow-up and 18 months postpartum telephone follow-up, the patient recovered satisfactorily, reported no discomfort, and was preparing for pregnancy. (2) Placental examination: The placental surface was covered with grayish-white areas ranging from the size of a needle tip to about 2 cm in diameter. Edema of the umbilical cord was observed. Various-sized abscesses were seen in the placental parenchyma, involving several villi, with many neutrophil infiltrations. There were many acute inflammatory cell infiltrations in the chorionic villous space with abscess formation, acute chorioamnionitis, and infarcts visible in the surrounding chorionic villi. Acute inflammation of the local chorionic interstitial blood vessels with thickening of the blood vessel wall was observed. Many neutrophils were seen in the amniotic membrane-chorioamnionic membrane gap, with a stage 3, level 2 maternal inflammatory response. Cord umbilical venous inflammation was noted, with no inflammatory cell infiltration of arteries. Wharton jelly edema was seen, with neutrophil infiltration in the interstitium. (3) Microbiological examination: Blood, vaginal secretion, uterine secretion, abdominal secretion, and placental bacterial cultures all showed listeria monocytogenes. Mass spectrometer bacterial identification confirmed listeria monocytogenes infection. After silver staining of the placenta, microorganisms were seen in the center of the abscess and in the amniotic epithelial cells. (4) Pathologic diagnosis showed placental acute chorioamnionitis with maternal inflammatory response stage 3 grade 2, accompanied by umbilical cord phlebitis and fetal inflammatory response stage 1 grade 1, acute intervillositis with abscess formation, and acute villositis with abscess formation. Combined with clinical presentation, this is consistent with listeria monocytogenes infection. Conclusion:The pathological characteristics of listeria monocytogenes infection in the placenta include various-sized abscesses in the placenta involving multiple villi and chorionic interstitial spaces, thickening of the interstitial vascular wall of the chorionic villi, and chorioamnionitis with umbilical cord phlebitis.

Objective:To explore the screening scheme of gastric cancer in large-scale natural population in Wuxi.Methods:From December 2016 to December 2019, 105 865 residents of 19 communities (villages) in six streets of Xinwu District, Wuxi were randomly enrolled in this study by random number table. A household epidemiological questionnaire survey was conducted among 50 063 target population subjects (aged 40-69), and then, respondents were divided into four categories, category Ⅰ: HP (-), PG (-); category Ⅱ: HP (+ ), PG (-); category Ⅲ: HP (+ ), PG (+ ); category Ⅳ: HP (-), PG (+ )according to the serological Helicobacter pylori ( HP) antibodies and pepsinogen (PG) test results. People in category Ⅲ and Ⅳ were all selected into group C and group D respectively, then individuals 3 times of group D were randomly selected from category Ⅰ to assign to group A, and individuals 3 times of group C from category Ⅱwere assigned to group B in the same way. Remaining individuals in category Ⅰ and Ⅱ who had first-degree family history of gastric cancer were also included in group A and group B, respectively. Endoscopic and pathological examination were performed on the above enrolled subjects for high grade intraepithelialneoplasia (HGIN), early gastric cancer and gastric cancer. Results:Of the 50 063 target subjects, 31 508 questionnaires were finally collected, with a participation rate of 62.9%. A total of 19 745 people were tested for serology, and the participation rate was 39.4% (19 745/50 063). Serological results showed that there were 11 152 people (56.48%) in category Ⅰ, 8 170 (41.38%) in category Ⅱ, 124 (0.63%) in category Ⅲ, and 299 (1.51%) in category Ⅳ. According to the exclusion criteria and principle of voluntariness, 3 400 individuals were candidates to undergo gastroscopy. Finally, a total of 2 389 people came to the hospital for gastroscopy, 1 263 in group A, 814 in group B, 86 in group C and 226 in group D, with an overall response rate of 70.3% (2 389/3 400), target population participation rate of 4.8% (389/50 063), and the overall population participation rate of 2.3% (2 389/105 865). In the 2 389 cases, there were 32 cases (1.34%) of HGIN and gastric cancer by gastroscopy and biopsy pathology, among which 1 case (3.125%) aged 40-49, 9 (28.125%) aged 50-59, and 22 (68.750%) aged 60-69. Among the 32 cases, 25 cases (78.13%)were pathologically confirmed as having HGIN or early gastric cancer by endoscopic submucosal dissection or surgical operation. By eliminating 810 people (including 3 gastric cancer) without first-degree family history with gastric cancer in group Ⅰ and Ⅱ, and increasing the gastroscopy screening age to 50 years (exluding 214 people aged 40-49, including 1 gastric cancer), the number of people who should undergo gastroscopy could be reduced from 2 389 to 1 365, and 28 cases of HGIN or gastric cancer were still detected, including 22 HGIN or early gastric cancer.Conclusion:Gastroscopy after the screening with epidemiological, serological tests, age and first-degree relative with gastric cancer family history is suitable for gastric cancer screening in Wuxi. Based on Chinese national conditions, a new community gastric cancer screening program is recommended in Wuxi considering cost-effectiveness, which includes those over 50 years old, serological PG (+ ) and first-degree relatives with family history of gastric cancer.

Objective:To investigate the clinicpathological characteristics of post-transplant lymphoproliferative disorders (PTLD) in transplanted lung, and to improve its diagnosis and treatment.Methods:The clinicopathological characteristics of PTLD in three transplanted lungs were evaluated at Wuxi People′s Hospital Affiliated to Nanjing Medical University from 2014 to 2019. HE, immunohistochemical staining and in situ hybridization were performed. The relevant literature of PTLD was reviewed.Results:All three patients had chronic obstructive pulmonary disease (COPD) before lung transplantation. After receiving both lung transplants, they were all treated with anti-rejection drugs tacrolimus or mycophenolate mofetil, and combined with antiviral and/or rituximab. The time from transplantation to diagnosis of PTLD was four years, seven months, and five months, respectively. Two patients died one month and five months after initial diagnosis, and one patient was alive with no disease after one year. Histologically, all cases were monomorphic B-cell PTLD (diffuse large B-cell lymphoma, unspecified), and the tumor cells were positive for Epstein-Barr virus by in situ hybridization; one of the late-onset patients had herpes simplex virus infection.Conclusions:PTLD in the post-transplant lung tissue shows unique morphology and clinical characteristics, and is closely related to Epstein-Barr virus infection. Patients who receive lung transplantation due to COPD are more susceptible to develop PTLD, while late-onset ones occur more commonly in the hilum of lungs, and the prognosis is relatively poor.

We report a case of a 2 200 g premature male baby born through cesarean section under maternal endotracheal intubation mechanical ventilation combined with extracorporeal membrane oxygenation at 34 +1 gestational weeks, while his mother was infected with influenza A in late pregnancy. Due to neonatal pneumonia, neonatal respiratory distress syndrome, prematurity, and low birth weight, the neonate was transferred to the neonatal intensive care unit for body temperature maintenance, respiratory support, maintenance of perfusion and internal environment, and nutritional management. The infant was discharged 17 days after birth and was well at six-month-old follow-up. His mother was discharged at 20 days post-delivery.

Objective: To study clinicopathological features,diagnosis and differential diagnosis of myxoid lipoblastoma. Methods: Four cases of myxoid lipoblastoma, from 2010 to 2017 at Wuxi People′s Hospital of Nanjing Medical University, the Affiliated Hospital of Xuzhou Medical University and Binhai People′s Hospital, were studied by clinicopathological analysis, immunohistochemistry and in situ hybridization along with a literature review. Results: The age of the patients ranged from 1 to 6 years. Histologically, all tumors had thin fibrous capsule and irregular lobules separated by fibrous septa. The individual lobules consisted of myxoid stroma,prominent plexiform capillary network and stellate or spindle mesenchymal cells. Lipoblasts (S-100 positive) and mature adipocytes varies among different lobules. FISH revealed PLAG1 disruption in all 4 cases. MDM2 or CHOP alterations were not detected. None of the patients had tumor recurrence upon follow up from 12 to 80 months. Conclusions Myxoid lipoblastoma is a very rare tumor, usually in the first 5 years of life. The clinical features of myxoid lipoblastoma and lipoblastoma are similar, while myxoid lipoblastoma has prominent myxoid change, a plexiform vascular pattern and rare mature fat cells. The patient age,S-100 positive lipoblasts and cytogenetic alteration are the key diagnostic features.

Objective To study clinicopathological features,diagnosis and differential diagnosis of myxoid lipoblastoma. Methods Four cases of myxoid lipoblastoma,from 2010 to 2017 at Wuxi People′s Hospital of Nanjing Medical University, the Affiliated Hospital of Xuzhou Medical University and Binhai People′s Hospital, were studied by clinicopathological analysis, immunohistochemistry and in situ hybridization along with a literature review. Results The age of the patients ranged from 1 to 6 years. Histologically, all tumors had thin fibrous capsule and irregular lobules separated by fibrous septa. The individual lobules consisted of myxoid stroma,prominent plexiform capillary network and stellate or spindle mesenchymal cells. Lipoblasts (S?100 positive) and mature adipocytes varies among different lobules. FISH revealed PLAG1 disruption in all 4 cases. MDM2 or CHOP alterations were not detected. None of the patients had tumor recurrence upon follow up from 12 to 80 months. Conclusions Myxoid lipoblastoma is a very rare tumor, usually in the first 5 years of life. The clinical features of myxoid lipoblastoma and lipoblastoma are similar, while myxoid lipoblastoma has prominent myxoid change, a plexiform vascular pattern and rare mature fat cells. The patient age,S?100 positive lipoblasts and cytogenetic alteration are the key diagnostic features.

Objective To investigate the association between β2-adrenergic receptor gene polymorphism and coronary atherosclerotic heart disease, and to provide reference for clinical disease prevention and treatment.MethodsThe clinical data of 200 patients with coronary atherosclerotic heart disease confirmed by coronary angiography were selected and included in the study group, and 200 healthy subjects without coronary atherosclerotic heart disease group.The polymorphism of β2 adrenergic receptor gene was detected and the frequency of each gene was analyzed.ResultsThe genotype frequencies of β2-adrenergic receptor gene were in accordance with Hardy-Weinberg equilibrium, the difference was not statistically significant.According to dominant genetic model, the frequency of AA+AG was 46.0% vs 58.0% lower than that of the control group, and had statistical significance, The genotype frequency of GG genotype in study group was significantly lower than that in control group 14.0% vs 26.0%, χ2=26.20, P=0.00.The frequency of GG genotype in study group was significantly higher than that in control group 54.0% vs 42.0%, χ2=5.76, P=0.01.The frequency of A gene was 38.0% compared with 44.0% in control group, χ2=1.48, P=0.22;the frequency of AA gene in study group was 30.0%, and the frequency of gene A was 38.0%, compared with 56.0% Compared with 32.0% in the control group, χ2=0.18, P=0.66.ConclusionThe A/G polymorphism of β2-adrenergic receptor gene is closely related to the clinical pathogenesis of coronary atherosclerotic heart disease, and the A allele may be a protective factor in patients with coronary atherosclerotic heart disease.

Hamartoma ; Humans ; Splenic Diseases

It's difficult to diagnose precancerous lesion and early cancer for a long time, because both of them haven't typical morphological characteristics. As a novel diagnostic modality, fluorescence endoscopy can accurately reflect minimal changes in human's tissue, thus making a meaningful progress for cancer diagnosing. 200 patients were examined by fluorescence endoscopy to evaluate the diagnostic value. The overall accuracy, sensitivity and specificity for detecting malignant gastrointestinal tumor was 94.0%, 94.6% and 93.5%, respectively. Thus, fluorescence endoscopy can be used to diagnose malignant gastrointestinal tumors with high validity and reliability, and is advantageous over conventional white light endoscopy especially in detecting the atypical and suspicious lesions. Furthermore, fluorescence endoscopy can also guide target biopsy, is significant to improve the early cancer detection rate, has a broad development prospect.
Endoscopy ; instrumentation ; Fluorescence ; Gastrointestinal Neoplasms ; diagnosis ; Humans ; Sensitivity and Specificity