Objective: To investigate the tumor immunity-related pathologic features and clinical significance in pancreatic ductal adenocarcinoma (PDAC). Methods: All pathologic materials and clinical information of 192 PDAC patients from the Cancer Hospital of the University of Chinese Academy of Sciences from January 2010 to December 2020 were collected. The onco-immune microenvironment associated morphologic features were evaluated, and MHC-Ⅰ, PD-L1, CD3, and CD8 expression were detected by immunohistochemistry (IHC). Then the correlation between the factors and their influence on prognosis was analyzed. Results: There were 163 cases of non-specific adenocarcinoma (163/192, 84.90%), 18 cases of adeno-squamous carcinoma (18/192, 9.37%), and 11 cases of other rare subtypes (11/192, 5.73%). Perineural invasion was observed in 110 cases (110/192, 57.29%) and vascular invasion in 86 cases (86/192, 44.79%). There were 84 cases (84/182, 46.15%) with severe chronic inflammation. Tumor infiltrating immune cell numbers (TII-N) were increased in 52 cases (52/192, 27.08%). Lymphocytes and plasma cells were the main infiltrating immune cells in 60 cases (60/192, 31.25%), whereas in 34 cases (34/192, 17.71%) the tumors were mainly infiltrated by granulocytes, and 98 cases (98/192, 51.04%) showed mixed infiltration. CD3⁺T cells were deficient in 124 cases (124/192, 66.31%). CD8⁺T cells were deficient in 152 cases (152/192, 79.58%). MHC-Ⅰ expression was down-regulated in 156 cases (156/192, 81.25%), and PD-L1 was positive (CPS≥1) in 46 cases (46/192, 23.96%). Statistical analysis showed that TII-N was negatively correlated with vascular invasion (P=0.035), perineural invasion (P=0.002), stage (P=0.004) and long-term alcohol consumption (P=0.039). The type of immune cells correlated positively with chronic pancreatic inflammation (P=0.002), and negatively with tumor differentiation (P=0.024). CD8⁺T cells were positively correlated with CD3⁺T cells (P=0.032), MHC-Ⅰ expression (P<0.001) and PD-L1 expression (P=0.001), and negatively correlated with long-term smoking (P=0.016). Univariate analysis showed that histological nonspecific type (P=0.013) and TII-N (P<0.001) were the factors for good prognosis. Vascular invasion (P=0.032), perineural invasion (P=0.001), high stage (P=0.003) and long-term alcohol consumption (P=0.004) were adverse prognostic factors. COX multivariate risk analysis found that TII-N was an independent favorable factor for PDAC, while perineural invasion was an independent adverse risk factor. Conclusions: TII-N is an independent superior prognostic factor for PDAC, and significantly correlated with many factors; chronic alcohol consumption and smoking may inhibit onco-immunity in PDAC patients.
Adenocarcinoma/pathology* ; B7-H1 Antigen/metabolism* ; Biomarkers, Tumor/metabolism* ; Carcinoma, Pancreatic Ductal/pathology* ; Humans ; Inflammation/pathology* ; Lymphocytes, Tumor-Infiltrating/metabolism* ; Pancreatic Neoplasms/pathology* ; Prognosis ; Tumor Microenvironment

ObjectiveTo investigate the expression of exosome microRNAs (miRNAs) in bile of hepatic alveolar echinococcosis (HAE) patients with biliary tract invasion and the regulatory mechanism of differentially expressed miRNAs on target genes. MethodsBile samples were collected from 12 HAE patients who attended Qinghai University Affiliated Hospital from August 2017 to October 2018, with 6 patients in observation group (with the manifestation of biliary tract invasion) and 6 in control group (without the manifestation of biliary tract invasion). Ultracentrifugation extraction and Western blot were used to identify the structure of exosomes, the Trizol method was used to extract total RNA in exosomes, and miRNA expression profile microarray was used to identify differentially expressed miRNAs. The pathway enrichment analysis was performed to predict the target genes of biliary tract invasion based on differentially expressed miRNAs. ResultsA total of 74 differentially expressed miRNAs were identified between the observation group and the control group, among which 9 were upregulated and 65 were downregulated (｜Fold Change｜＞2). The pathway analysis showed that the target genes were mainly enriched in the pathways for tumorigenesis, phosphatidylinositol signaling system, and PTEN (FDR＜0.05). The GO annotation and enrichment analysis showed that the target genes were mainly enriched in the biological processes such as positive regulation of gene repression and regulation of cell differentiation (FDR＜0.05). ConclusionThe established expression profile of differentially expressed exosome miRNAs in bile of HAE patients with biliary tract invasion can be used as biomarkers for biliary tract invasion of HAE and preliminarily elaborate on the regulatory mechanism of differentially expressed miRNAs on target genes after HAE invades the biliary tract.

Objective To analyze the technical features of spherical,cuboid and flat-bottomed oxygen chambers,so as to provide reference for the hospital in the selection of oxygen chamber types.Methods Key main technical indexes of air pressurized oxygen chamber were analyzed and fundamental basis and evidences for chamber selection were identified,through comparison of the main technical advantages and disadvantages of oxygen chamber with different shapes.Results Traditional spherical oxygen chamber has the features of simple structure and low manufacturing cost.However,it must meet the requirements of the sunken chamber installation and is usually difficult in site selection of chamber construction.Furthermore,huge cost is often involved in the construction of basement with low comprehensive cost effectiveness.Cuboid shape oxygen chamber has higher chamber capacity per capita and more effective chamber length,as compared with those of same size spherical chamber,and vision inside the chamber is identical to that of the ward.However,shortcomings of sunken chamber installation and huge cost of capital construction are avoidable.Furthermore,there are disadvantages of lower chamber pressure capacity,huge dead weight of the chamber body and high cost of chamber construction.Flat-bottomed oxygen chambers could be directly installed on the first floor of the building with a load capacity of 1 ton per square meter,so that the pre-requirement and the cost of basement construction of the oxygen chamber could be avoided.Though the flat-bottomed oxygen chamber has the disadvantages of lower chamber capacity per capita,more complicated chamber structure and partial increase in manufacturing cost,as compared with the same size spherical chamber,it possesses the advantages of good spatial chamber vision and effective chamber length.Therefore,comprehensive cost effectiveness of the flatbottomed oxygen chamber is better than that of the spherical one.The building condition of the oxygen chamber is the key factor for the selection of the oxygen chamber.Conclusion In view of the strains in hospital medical spaces and better comprehensive cost effectiveness of the flat-bottomed oxygen chamber,the flat-bottomed oxygen chamber promises a better prospect,when compared with the spherical and cuboid ones.

Objective To analyze the technical features of spherical,cuboid and flat-bottomed oxygen chambers,so as to provide reference for the hospital in the selection of oxygen chamber types.Methods Key main technical indexes of air pressurized oxygen chamber were analyzed and fundamental basis and evidences for chamber selection were identified,through comparison of the main technical advantages and disadvantages of oxygen chamber with different shapes.Results Traditional spherical oxygen chamber has the features of simple structure and low manufacturing cost.However,it must meet the requirements of the sunken chamber installation and is usually difficult in site selection of chamber construction.Furthermore,huge cost is often involved in the construction of basement with low comprehensive cost effectiveness.Cuboid shape oxygen chamber has higher chamber capacity per capita and more effective chamber length,as compared with those of same size spherical chamber,and vision inside the chamber is identical to that of the ward.However,shortcomings of sunken chamber installation and huge cost of capital construction are avoidable.Furthermore,there are disadvantages of lower chamber pressure capacity,huge dead weight of the chamber body and high cost of chamber construction.Flat-bottomed oxygen chambers could be directly installed on the first floor of the building with a load capacity of 1 ton per square meter,so that the pre-requirement and the cost of basement construction of the oxygen chamber could be avoided.Though the flat-bottomed oxygen chamber has the disadvantages of lower chamber capacity per capita,more complicated chamber structure and partial increase in manufacturing cost,as compared with the same size spherical chamber,it possesses the advantages of good spatial chamber vision and effective chamber length.Therefore,comprehensive cost effectiveness of the flatbottomed oxygen chamber is better than that of the spherical one.The building condition of the oxygen chamber is the key factor for the selection of the oxygen chamber.Conclusion In view of the strains in hospital medical spaces and better comprehensive cost effectiveness of the flat-bottomed oxygen chamber,the flat-bottomed oxygen chamber promises a better prospect,when compared with the spherical and cuboid ones.

Skin sensitization (allergic contact dermatitis, ACD), is a serious condition caused by small reactive molecules and is characterized by a delayed-type hypersensitivity .Animal tests were usually used in the evaluation of sensitizing potential of chemical substances in the past .However , there is an increasing interest from the public for reducing and ultimately replacing animal tests .The European Union (EU) has posed a ban on animal testing of cosmetic ingredients that includes skin sensitization since 2013.Therefore, alternative in vitro tests are the main tendency in chemical substances and cosmetic sensitizing potential research in the future .In this study, different kinds of in vitro test methods that were adopted by OECD or on research (LLNA, DPRA, KeratinoSens TM, h-CLAT) were reviewed through recent years literature , comprehensive introduction and evaluation were made to obtain reliable hazard and potency information on potential skin sensitizers .

Objective To evaluate the detection of membrane neutrophilic alkaline phosphatase ( mNAP) by flow cytometry in diagnosis of bloodstream infection .Methods A total of 298 patients with suspected bloodstream infections admitted in the First People ’ s Hospital of Lianyungang during June 2013 and October 2014 were enrolled;80 healthy subjects in physical examination center were also enrolled as the control group.Bloodstream infection was diagnosed by blood culture and mNAP was detected by flow cytometry.Serum levels of procalcitonin (PCT) and C-reactive protein (CRP) were detected by electro-chemiluminescence (ECL) and immune scatter turbidimetry , respectively.The value of mNAP, PCT and CRP in diagnosing bloodstream infection was determined by receiver operating characteristic ( ROC) curve. Results Among 298 patients, 109 were confirmed with bloodstream infections , including 43 patients with Gram-positive bacterial infections and 66 with Gram-negative bacterial infections .The median levels of CRP , PCT and mNAP in bloodstream infection group were 138.71 mg/L, 7.04 ng/mL and 13 929 AB/c, which were significantly higher than those in healthy control group (1.50 mg/L, 0.12 ng/mL, 1 831 AB/c;U=5.00, 48.50 and 65.01, P<0.01).The expression of mNAP in Gram-positive bacterial infection group was 9 598 ( 6 064-11 643 ) AB/c, which was significantly lower than that in Gram-negative bacterial infection group [16 512 (11 654-22 001) AB/c] (U=250.00, P<0.01).ROC curve analysis showed that, the areas under the curve (AUCs) of mNAP, PCT and CRP in diagnosing bloodstream infection were 0.987, 0.962 and 0.901.When 4 578AB/c, 0.90 ng/mL and 13.50mg/L were taken as optimal cut-off values, the sensitivities of mNAP, PCT and CRP in diagnosis of bloodstream infection were 95.8%, 93.0%and 90.3%; the specificities were 97.8%, 95.6% and 85.5%, respectively.Conclusion Among mNAP, PCT and CRP, mNAP is of the highest value in diagnosing bloodstream infection , and may be used as a biomarker for clinical diagnosis of bloodstream infection .

Purpose To evaluate the diagnostic significance of non-contrast enhanced magnetic resonance angiography (NCE-MRA) for lower extremity arterial stenosis on a 3.0T MR scanner, in order to provide a reliable method for clinical application. Materials and Methods Thirty patients with arterial disease in lower extremity underwent NCE-MRA before contrast enhanced magnetic resonance angiography (CE-MRA). Image quality of the two methods was compared. The diagnostic accuracy for significant stenosis ( ≥50%) of NCE-MRA was assessed using CE-MRA as a golden standard. The consistency of the two methods in diagnosis of significant stenosis ( ≥ 50%) was analyzed. Results All patients successfully underwent both NCE-MRA and CE-MRA examination. There were 532 arterial segments detected by NCE-MRA. In the calf region, venous artifacts presented more frequently on CE-MRA (Z=4.92, P<0.01), while in the abdominal and the femoral regions, venous artifacts presented more frequently on NCE-MRA (Z=4.58 and 3.56, P<0.01). The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of NCE-MRA for the diagnosis of significant stenosis ( ≥ 50%) were 97.89%, 97.69%, 97.74%, 93.92% and 99.22%, respectively. There was good agreement (Kappa=0.94, P<0.05) between the two methods. Conclusion For the imaging of lower extremity arterial stenosis, NCE-MRA shows similar image quality and diagnostic accuracy with CE-MRA, thus can be used as an alternative method for lower extremity arterial stenosis in patients who have renal insufficiency or other contraindication of contrast media.

Objective To compare and study the value of multiple antigens dot immunogold filtration assay (DIGFA ) and ima-ging diagnosis for rapid diagnosis of two kinds of echinococcosises .Methods 167 cases of hydatid patients diagnosied by pathologi-cal examination were divided into the DIGFA group for diagnosis of DIGFA and the control group for imaging diagnosis .Results The diagnosis rate of cystic echinococcosis (CE) in the DIGFA group was 74 .60% and control group was 90 .48% (P<0 .01);the diagnosis of alveolar echinococcosis(AE) in the DIGFA group was 92 .68% and the control group was 73 .17% (P<0 .05);when the cystica<5 cm ,the diagnosis rate of AE and CE in the DIGFA group was 91 .67% and 61 .11% (P<0 .05) ,when the cystica 5- <10 cm ,the detection rate of AE and CE in the DIGFA group was 94 .12% and 71 .43% (P<0 .05) .When the cystica≥10 cm ,<5 cm or between 5 - < 10 cm ,the detection rate of CE in DIGFA group was 94 .12% ,61 .11% ,71 .43 ,respectively (P<0 .05);The totle detection rates of the AE and CE in DIGFA group were 92 .68% and 74 .60% (P<0 .05) .Conclusion Imaging di-agnosis for the CE was higher and the DIGFA diagnosis for the AE was higher and the DIGFA also had clinical significance espe-cially applicated to the early diagnosis of AE .With the help of the imaging diagnosis ,the DIGFA could diagnose two kinds of echi-nococcosises correctly and it provided the benefits of specificity and sensitivity and performed easily .

Objective To investigate the expression of osteopontin (OPN)and matrix metalloproteinase-2(MMP-2)in hepatic alveolar echinococcosis(HAE) ,and explore the role of OPN and MMP-2 in the invasion and metastasis of HAE infection .Methods Expression of OPN and MMP-2 in HAE tissues from 69 patients within12 nomral liver tissues .HAE were detected using SP im-munohistochemical technique ,the correlation between OPN and MMP-2 expression and clinieopahtologic features was analyzed .Re-sults OPN and MMP-2 mainly distributed in the cyst wall about granuloma inflammatory cells of HAE and and the peripheral por-tion of stromal cell and liver cells ,the positive expression rate in HAE focus and normal liver tissue at the juncti-on of the invasive margin the most obvious .The results showed that the positive rates of OPN and MMP-2 in HAE tissue were 72 .5% (50/69)and 59 .4% (41/69) ,respectively ,and in normal liver tissue were 16 .7% (2/12) and 8 .3% (1/12) ,respectively .The positive rates of OPN and MMP-2 in HAE were significantly higher than those in normal liver tissue(P<0 .01) .The positive rates of OPN and P21 in HAE tissues with metastasis were 86 .8% (33/38)and 76 .3% (29/38) ,respectively ,which were significantly higher than those without metastasis of OPN and MMP-2 positive expression rate of 54 .8% (17/31) and 38 .7% (12/31) ,(P<0 .01) .The positive expression of OPN and MMP-2 were not related to the size of tumor bulk ,HBsAg ,gender ,age and nation of tumor .Rank correlated analysis showed that OPN and MMP-2 were positive correlated(r=0 .36 ,P<0 .01) .Conclusion OPN and MMP-2 mainly distrib-utes in the cyst wall about granuloma inflammatory cells of HAE and and the peripheral portion of liver cells ,the positive expres-sion rate in HAE and normal liver tissue at the junction of the invasive margin the most obvious ,which might be invasion and me-tastasis of HAE .