Purpose To investigate the role of combined immunohistochemical expression of SATB2 and p16 and pathological histomorphological features in the diagnosis and differential diagnosis of atypical polypoid adenomyoma(APAM),myometrial infiltrating endometrioid carcinoma(MIEC)and interstitial fibrotic endometrial polyps(IFEP).Methods A total of 32 cases of APAM,20 cases of MIEC and 25 cases of IFEP were collected.The expression of SATB2 and p16 in the stromal cells of the three groups of cases was detected by immunohistochemical EnVision two-step method.Four morphological features were evaluated in the three groups:complex glandular structure,squamous and mulberry metaplasia,fibromuscular stroma and cellular atypia.Results The expression of SATB2 in the stroma of APAM(31/32)was significantly higher than that of MIEC(1/20)and IFEP(0/25),and the difference was statisti-cally significant.The expression of p16 in APAM(32/32)stroma was significantly higher than that in MIEC(3/20),and the difference was statistically significant,while compared with IFEP(21/25),the difference was not statistically significant.Histomorphological characteristics:compared with the MIEC group,APAM had obvious squamous and mul-berry metaplasia(APAM group 31/32,MIEC group 4/20),and the difference was statistically significant;However,there was no statistically significant difference between the two groups in terms of complex glandular structure(APAM group 22/32,MIEC group 20/20),fibromuscular stroma(APAM group 32/32,MIEC group 20/20),and cellular at-ypia(APAM group 32/32,MIEC group 20/20).Compared with the IFEP group,APAM had typical complex glandu-lar structure(APAM group 20/32,IFEP group 0/25),squamous and mulberry metaplasia(APAM group 32/32,IF-EP group 2/25),and cellular atypia(APAM group 32/32,IFEP group 0/25),and the difference was statistically sig-nificant.However,there was no statistically significant difference in fibromuscular stroma(APAM group 32/32,IFEP group 25/25)between the two groups.Conclusion The combined immunohistochemical analysis of SATB2 and p16 and histomorphological features is helpful for the diagnosis of APAM and the differential diagnosis of MIEC and IFEP.

Purpose To investigate the role of combined immunohistochemical expression of SATB2 and p16 and pathological histomorphological features in the diagnosis and differential diagnosis of atypical polypoid adenomyoma(APAM),myometrial infiltrating endometrioid carcinoma(MIEC)and interstitial fibrotic endometrial polyps(IFEP).Methods A total of 32 cases of APAM,20 cases of MIEC and 25 cases of IFEP were collected.The expression of SATB2 and p16 in the stromal cells of the three groups of cases was detected by immunohistochemical EnVision two-step method.Four morphological features were evaluated in the three groups:complex glandular structure,squamous and mulberry metaplasia,fibromuscular stroma and cellular atypia.Results The expression of SATB2 in the stroma of APAM(31/32)was significantly higher than that of MIEC(1/20)and IFEP(0/25),and the difference was statisti-cally significant.The expression of p16 in APAM(32/32)stroma was significantly higher than that in MIEC(3/20),and the difference was statistically significant,while compared with IFEP(21/25),the difference was not statistically significant.Histomorphological characteristics:compared with the MIEC group,APAM had obvious squamous and mul-berry metaplasia(APAM group 31/32,MIEC group 4/20),and the difference was statistically significant;However,there was no statistically significant difference between the two groups in terms of complex glandular structure(APAM group 22/32,MIEC group 20/20),fibromuscular stroma(APAM group 32/32,MIEC group 20/20),and cellular at-ypia(APAM group 32/32,MIEC group 20/20).Compared with the IFEP group,APAM had typical complex glandu-lar structure(APAM group 20/32,IFEP group 0/25),squamous and mulberry metaplasia(APAM group 32/32,IF-EP group 2/25),and cellular atypia(APAM group 32/32,IFEP group 0/25),and the difference was statistically sig-nificant.However,there was no statistically significant difference in fibromuscular stroma(APAM group 32/32,IFEP group 25/25)between the two groups.Conclusion The combined immunohistochemical analysis of SATB2 and p16 and histomorphological features is helpful for the diagnosis of APAM and the differential diagnosis of MIEC and IFEP.

Objective:To explore the understanding among medical rehabilitation staff about pain in children with cerebral palsy.Methods:A questionnaire was developed by referring to the literature on children′s rehabilitation and pain. It was used to survey 856 rehabilitation personnel including 110 doctors, 313 therapists and 433 nurses from 12 hospitals in 10 provinces using an online platform at www.wjx.cn.Results:The overall rate of correct responses was (67.89±13.35) %. Doctors and therapists scored about 70% correct and nurses about 65%. There were significant differences in pain knowledge related with educational background, age, work experience and position. Gender, professional title and parent status were not significant predictors. About 93% of those surveyed thought it was necessary to provide pain-related training, and 95% were willing to receive such training.Conclusions:There is a lack of knowledge about pain in children with cerebral palsy among rehabilitation medical staff. It is urgent to provide more related training and guidance to those in clinical practice.

OBJECTIVE：To investigate th e stabilities of antitumor candid ate Gedatolisib in plasma in vitro and simulated gastric/intestinal fluids ，and to analyze the possible catabolites in plasma. METHODS ：HPLC method was adopted. Using indometacin as internal standard ，the contents of Gedatolisib incubated in plasma of SD rats （male）for 0，0.5，1.0，1.5，2.0，3.0 h and blank simulated gastric fluid （pH 1.3，no enzyme ），blank simulated intestinal fluid （pH 6.8，no enzyme ），simulated gastric fluid（pH 1.3，containing pepsin ）and simulated intestinal fluid （pH 6.8，containing trypsin ）for 0，0.5，1.0，2.0，3.0，4.0，6.0 h were determined. The remaining percentage of Gedatolisib was calculated. UPLC-Q-TOF/MS was used to analyze the TIC of blank plasma and incubated samples. The differential peaks were compared， and catabolites were inferred by MS 1Z073）.gzwjkj2019-1- chromatograms. RESULTS ： The remaining percentage in plasma of rats for 2.0 h was about 63％，and there was nosignificant change after continued incubation. The remaining percentage of Gedatolisib incubated in blank simulated intestinal fluid for different time ranged （99.18 ± 2.15）％ -（103.20 ± 3.41）％ . The remaining percentage in simulated com intestinal fluids for 2.0 h ranged （88.76 ± 1.53）％ . The remaining percentage in blank simulated gastric fluids for 2.0 h was ranged （85.63±1.55）％，and there was no significant change after continued incubation. The remaining percentage in simulated gastric fluid was from （94.94±3.52）％（0 h）to（16.19±1.17）％ （6.0 h）. TIC of UPLC-Q-TOF/MS showed that the differential peaks of incubated samples and blank plasma was 6.42 min under positive mode scanning ，molecular ion peak of m/z 616.335 1，simulated 632.327 7，630.317 0，602.278 6 [M+H]+ could be found in scanning channel. It was speculated that Gedatolisib could generate 1-（4-（3-（4，6-dimorpholino-1，3，5-triazin-2-yl）phenyl）urea） benzoyl）-N，N-dimethylpiperidin-4-amine oxide ，1-（4-（4-（dimethylamino）piperidine-1-carbonyl）phenyl）-3-（4-（4-morpholino-6- （3-oxomorpholino）-1，3，5-triazin-2-yl）phenyl）urea and 1-（4-（3-（4-（4，6-dimorpholino-1，3，5-triazin-2-yl）phenyl）urea） benzoyl）-N-methylpiperidine. CONCLUSIONS ：Gedatolisib is not stable in rat plasma ，and it may undergo terminal N oxidation， morpholine ring oxidation and terminal N demethylation. Gedatolisib is stable in artificial intestinal fluid and blank artificial gastric/ intestinal fluid ，and degrades obviously in the presence of pepsin.

Objective:To investigate the safety, efficacy and survival of brentuximab vedotin (BV) monotherapy and BV combined with chemotherapy for relapsed or refractory lymphoma.Methods:A total of 47 patients with relapsed or refractory Hodgkin's lymphoma (HL) in First Medical Center of PLA general Hospital and Fourth Medical Center of PLA General Hospital from October 2011 to December 2018 were admitted, including 35 cases (BV monotherapy group) and 12 cases (BV combined with chemotherapy group); there were 8 cases of relapsed or refractory anaplastic large cell lymphoma (ALCL), 4 cases in BV monotherapy group and 4 cases in BV combined with chemotherapy group. The safety, clinical efficacy and survival of two neoplasms in different groups were compared.Results:For relapsed or refractory HL, the objective remission rate (ORR) and complete remission rate (CRR) was 67.7% (21/31) and 16.1% (5/31), and the median progressive-free survival (PFS) time was 3.5 months (1.5-24.0 months) in BV monotherapy group; ORR and CRR was 81.8% (9/11) and 27.3% (3/11), and median PFS time was 5.5 months (2.0 - 24.0 months) in BV combined with chemotherapy group; there was no statistical difference in ORR and CRR between the both groups (χ 2 = 0.788, P = 0.375; χ 2 = 0.654, P = 0.419). There were 4 cases in BV monotherapy group for ALCL, of which 3 could be evaluated for efficacy, including 1 case of complete remission (CR) and 1 case of partial remission (PR); there were 4 cases in BV combined with chemotherapy group for ALCL, of which 4 could be evaluated for efficacy, including 2 cases of CR and 2 cases of PR. The common adverse events in BV monotherapy group were anemia, leukopenia, thrombocytopenia, fever, elevated transaminase, fatigue, nausea, peripheral neuritis and cough. Grade ≥3 adverse events were mainly anemia, thrombocytopenia and leukopenia. The common adverse events of BV combined with chemotherapy group were similar to those of BV monotherapy group, and there were significant differences in bone marrow suppression (thrombocytopenia, leukopenia) between the two groups (all P < 0.05). Conclusions:The clinical efficacy of BV combined with chemotherapy is better than that of BV monotherapy in treatment of relapsed or refractory lymphoma, and the survival time is prolonged. The adverse reaction of BV combined with chemotherapy is mainly manifested in bone marrow suppression, and the safety and tolerability of patients are acceptable.

OBJECTIVETo identify a novel hemoglobinopathy applied by direct sequencing and clone sequencing.

METHODSEDTA anticoagulated blood of proband and his parents were analyzed by hematology analyzers and Capillarys hemoglobin electrophoresis (CE). Then thalassemia genetypes were screened by gap-PCR and reverse dot blot (RDB). Proband was suspected with abnormal hemoglobin combine alpha beta compound thalassemia. The mutation of beta-globin was identified by direct sequencing and clone sequencing.

RESULTSHb analysis showed that probands Hb A2 variant was eluted in Z (C) zone and his father's in Z (A2) zone on CE,and proband's mother elevated HbA2 of 4.6%. Screened by RDB, the proband was CD71-72(+A) homozygote and showed the mismatch with his parents. Through direct sequencing and clone sequencing, we deduced that our proband inherited the mutations of HBB c.[219T>A;220G>T] from his father and inherited the Southeast-Asian deletion and HBB c.216-217insA from his mother.

CONCLUSIONA novel double heterozygote of HBB c.[219T>A; 220G>T] was identified in south China. This mutation enriches the beta-thalassemia gene mutation spectrum in Chinese population.

Asian Continental Ancestry Group ; genetics ; Child, Preschool ; Hemoglobins ; genetics ; Hemoglobins, Abnormal ; genetics ; Heterozygote ; Humans ; Male ; Mutation ; genetics ; Pedigree ; Thalassemia ; genetics ; beta-Globins ; genetics

Objective To investigate the prevalence rate of healthcare-associated infection(HAI)in Xiangya Hospital,and provide reference for preventing and controlling HAI.Methods The cross sectional surveys on preva-lence rates of HAI,cross-sectional antimicrobial use,and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006)were carried out by combination of bedside investigation and medical record reviewing.Results The prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%,difference was statistically significant (χ2 = 35.14,P < 0.001 );prevalence rates of community-associated infection(CAI)were 15.61%-15.76%,there was no significant difference among each year.General intensive care unit (ICU)had the highest prevalence rate;respiratory tract was the most common site of both HAI and CAI;urinary catheterization rate showed a decreased tendency,arteriovenous catheterization rate showed a increased tendency,difference were both significant(χ2 = 5.21,96.24,respectively,both P <0.001).In 2008 - 2014,pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%,from patients with HAI were 34.00%-44.99%,detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency,difference was significant (χ2 = 22.78,10.03,26.49,respectively,all P < 0.001 ).Gram-negative bacteria were the main pathogens causing infection;both cross sectional and combination antimicrobial usage rates declined (P < 0.05 ).Conclusion Prevention and control of HAI,and antimicrobial management has achieved preliminary success,prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously,the main pathogen is gram-negative bacteria,and the major infection site is lower respiratory tract.

Objective To explore the effects of high quality nursing service mode on nursing of patients with artificial joint replacement.Methods 82 patients from January to December 2010 were set as the control group,another 82 patients from January to November 2011 were named as the observation group.The observation group was given high quality nursing service mode,while the control group received conventional nursing.The satisfaction degree of patients to nursing,average hospitalization time and cost and incidence of complications were compared between two groups.Results The satisfaction degree of the observation group was 98.78％,significantly higher than 93.90％ in the control group.The average hospitalization time was(14.68±5.88)days in the observation group,shorter than(19.22±6.78)days of the control group.The average hospitalization expense in the observation group was (25 665±528)yuan,less than (30 866± 732)yuan of the control group.The complication rate in the observation group was 21.95％,significantly lower than 46.34％ of the control group.Conclusions Targeted high quality nursing service mode can effectively improve the quality of nursing,decrease the incidence of complications,reduce the patient's hospitalization time and cost,as well as improve the patients' satisfaction degree.

The prevalence of liver and intestinal fluke infections was determined by surveying inhabitants of Hengxuan, Fusui, and Shanglin villages which were known to be endemic for liver flukes in Guangxi, China in May 2010. A total of 718 people were examined for helminth eggs by the Kato-Katz thick smear technique, ultrasonography, immunoaffinity chromatography, and DNA sequencing. The overall egg positive rate was found to be 59.6% (28.0-70.6%) that included mixed infections with liver and intestinal flukes. Cases showing higher than 20,000 eggs per gram of feces (EPG) were detected between 1.3% and 16.2%. Ultrasonographic findings exhibited overall 28.2% (72 of 255 cases) dilatation rate of the intrahepatic bile duct. Clonorchis sinensis infection was detected serologically in 88.3% (38 of 43 cases) among C. sinensis egg positive subjects by the immunoaffinity chromatography using a specific antigen for C. sinensis. For differential diagnosis of the liver and intestinal flukes, more precise PCR and nucleotide sequencing for copro-DNA were performed for 46 egg positive cases. Mixed infections with C. sinensis and Metagonimus yokogawai were detected in 8 of 46 egg positive cases, whereas 29 specimens were positive for Haplorchis taichui. Ultrasonographic findings and immunoaffinity chromatography results showed usefulness, even in a limited way, in figuring out of the liver fluke endemicity.
Animals ; China/epidemiology ; Chromatography, Affinity ; Clonorchiasis/*epidemiology/parasitology/ultrasonography ; Clonorchis sinensis/genetics/immunology/*isolation & purification ; Coinfection ; DNA, Helminth/chemistry/genetics ; Feces/parasitology ; Female ; Heterophyidae/genetics/*isolation & purification ; Humans ; Intestines/*parasitology ; Liver/*parasitology ; Parasite Egg Count ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis, DNA ; Trematode Infections/*epidemiology/parasitology/ultrasonography

Objective To explore the relationship between plasma homocysteine levels and diabetic peripheral neuropathy (DPNP). Methods A crossectional analysis was conducted on 227 patients with type 2 diabetes. Peripheral neuropathy was confirmed using electromyography (EMG). The risk factors possibly associated with diabetic neuropathy or plasma homocysteine levels were analyzed in relation to likelihood of occurrence of DPNP. Results Eighty patients with neuropathy and 147 patients without neuropathy were included. Plasma homocysteine levels were significantly higher in patients with diabetic neuropathy [( 12. 6 ± 3.6 ) μmol/ L] than without diabetic neuropathy [( 8. 2 ± 0. 9 ) μmol/L] ( P ＜0. 001 ), and the relationship remained significant after adjusting for duration of diabetes, glycosylated hemoglobin A1c (HbA1c), age, renal status, serum folate acid and vitamin B12, and metformin [OR 1.15( 1.02-1.28 ) ,P ＜ 0. 05]. In addition, per increase of 4. 0 μmol/L plasma homocysteine was closely related to the occurrence of neuropathy after controlling for per unit increase of other confounding factors [OR 1.17(0. 94-1.33), P ＜ 0. 05]. Conclusions Hyperhomocysteinemia was an independent risk factor for the occourence of diabetic peripheral neuropathy.