Objective:To investigate the combined application of cytology, cell block histology and immunohistochemistry to improve the diagnostic accuracy of solid pancreatic lesions in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples.Methods:The pathological data of EUS-FNA in 311 cases of solid pancreatic lesions submitted to the Second Hospital of Hebei Medical University, Shijiazhuang, China from May 2019 to September 2023 were retrospectively analyzed. The cases included pancreatic ductal adenocarcinoma (PDAC, 172 cases), solid pseudopapillary neoplasm (SPN, 12 cases), neuroendocrine tumors (PNET, 14 cases) and chronic pancreatitis (113 cases). The cytological features of smears, the histology of cell block sections and the diagnostic markers in PDAC, SPN and PNET were analyzed. The diagnostic accuracies of cytology, cell block histology/immunohistochemistry and combination of the two methods for classifying these pancreatic solid lesions were evaluated.Results:Irregular arrangement of atypical (cancer) cells, anisonucleosis and nuclear atypia were the typical cytological features of PDAC, while presence of pseudopapillae with a myxoid/hyalinized fibrovascular core and low adhesion/salt-and-pepper chromatin were diagnostic features of SPN and NET, respectively. Immunohistochemical results showed that CK7 and CK19 were the most sensitive markers of pancreatic ductal epithelia, and the diffuse strong expression of S-100P (102/111, 91.9%) and aberrant expression of p53 (80/111, 72.1%) were important immunophenotypic markers of PDAC. Various degrees of CDX2 expression could be found in 66.4% PDAC. The expression of CD10, PR, vimentin, CD99 and cyclinD1 and the aberrant expression of β-catenin were the immunophenotypic features of SPN, while the expression of CgA, Syn and CD56 were indispensable immunemarkers for the diagnosis of PNET. Overall, cytology had higher sensitivity than cell block histology (93.9% versus 82.8%) and lower specificity (92.9% versus 99.1%), while the combination of the two methods significantly improved the sensitivity to 96.9% in solid pancreatic lesions. The combination of cytology and cell block histology could significantly improve the diagnostic efficacy of EUS-FNA in PDAC.Conclusions:Integrated diagnosis based on cytology (including rapid on-site evaluation), cell block histology and immunohistochemical findings could significantly improve the diagnostic yield of EUS-FNA in classifying solid pancreatic lesions.

Objective:To investigate the combined application of cytology, cell block histology and immunohistochemistry to improve the diagnostic accuracy of solid pancreatic lesions in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) samples.Methods:The pathological data of EUS-FNA in 311 cases of solid pancreatic lesions submitted to the Second Hospital of Hebei Medical University, Shijiazhuang, China from May 2019 to September 2023 were retrospectively analyzed. The cases included pancreatic ductal adenocarcinoma (PDAC, 172 cases), solid pseudopapillary neoplasm (SPN, 12 cases), neuroendocrine tumors (PNET, 14 cases) and chronic pancreatitis (113 cases). The cytological features of smears, the histology of cell block sections and the diagnostic markers in PDAC, SPN and PNET were analyzed. The diagnostic accuracies of cytology, cell block histology/immunohistochemistry and combination of the two methods for classifying these pancreatic solid lesions were evaluated.Results:Irregular arrangement of atypical (cancer) cells, anisonucleosis and nuclear atypia were the typical cytological features of PDAC, while presence of pseudopapillae with a myxoid/hyalinized fibrovascular core and low adhesion/salt-and-pepper chromatin were diagnostic features of SPN and NET, respectively. Immunohistochemical results showed that CK7 and CK19 were the most sensitive markers of pancreatic ductal epithelia, and the diffuse strong expression of S-100P (102/111, 91.9%) and aberrant expression of p53 (80/111, 72.1%) were important immunophenotypic markers of PDAC. Various degrees of CDX2 expression could be found in 66.4% PDAC. The expression of CD10, PR, vimentin, CD99 and cyclinD1 and the aberrant expression of β-catenin were the immunophenotypic features of SPN, while the expression of CgA, Syn and CD56 were indispensable immunemarkers for the diagnosis of PNET. Overall, cytology had higher sensitivity than cell block histology (93.9% versus 82.8%) and lower specificity (92.9% versus 99.1%), while the combination of the two methods significantly improved the sensitivity to 96.9% in solid pancreatic lesions. The combination of cytology and cell block histology could significantly improve the diagnostic efficacy of EUS-FNA in PDAC.Conclusions:Integrated diagnosis based on cytology (including rapid on-site evaluation), cell block histology and immunohistochemical findings could significantly improve the diagnostic yield of EUS-FNA in classifying solid pancreatic lesions.

Objective:To explore the influences of trait anxiety and social support on fatigue and the mediating role of trait anxiety, and to provide data support for maintaining mental care of military flying personnel.Methods:One hundred military flying personnel in recuperation were randomly selected according to the method of random numder table. Fatigue Scale-14 (FS-14), Trait Anxiety Inventory (T-AI) and Perceived Social Support Scale (PSSS) were used to analyzed the influences of trait anxiety and social support on fatigue.Results:Different ages, years of military service, flying hours, military rank, marital status, educational level and only child or not had no statistical significance on fatigue (all P>0.05). Fatigue was positively correlated with trait anxiety ( r=0.412, 0.311, both P<0.001), but negatively correlated with social support ( r=-0.247, -0.236, -0.226, -0.314, -0.337, -0.235, P=0.013, 0.018, 0.024, 0.001, 0.001, 0.019). Trait anxiety was negatively correlated with social support ( r=-0.345, -0.350, -0.325, P<0.001,<0.001, P=0.001). Trait anxiety not only had a direct path effect on fatigue ( β=0.423, 0.246, P<0.001, P=0.012), but also had an indirect path effect as a mediator of social support on fatigue ( β=-0.143, -0.088, P=0.026, 0.037). Conclusions:Fatigue of military flying personnel is influenced by trait anxiety and social support, and trait anxiety plays a multiple intermediary role in such influences.

Objective:To explore the influences of trait anxiety and social support on fatigue and the mediating role of trait anxiety, and to provide data support for maintaining mental care of military flying personnel.Methods:One hundred military flying personnel in recuperation were randomly selected according to the method of random numder table. Fatigue Scale-14 (FS-14), Trait Anxiety Inventory (T-AI) and Perceived Social Support Scale (PSSS) were used to analyzed the influences of trait anxiety and social support on fatigue.Results:Different ages, years of military service, flying hours, military rank, marital status, educational level and only child or not had no statistical significance on fatigue (all P>0.05). Fatigue was positively correlated with trait anxiety ( r=0.412, 0.311, both P<0.001), but negatively correlated with social support ( r=-0.247, -0.236, -0.226, -0.314, -0.337, -0.235, P=0.013, 0.018, 0.024, 0.001, 0.001, 0.019). Trait anxiety was negatively correlated with social support ( r=-0.345, -0.350, -0.325, P<0.001,<0.001, P=0.001). Trait anxiety not only had a direct path effect on fatigue ( β=0.423, 0.246, P<0.001, P=0.012), but also had an indirect path effect as a mediator of social support on fatigue ( β=-0.143, -0.088, P=0.026, 0.037). Conclusions:Fatigue of military flying personnel is influenced by trait anxiety and social support, and trait anxiety plays a multiple intermediary role in such influences.

ObjectiveTo investigate the tolerance, pharmacokinetics, and antiviral activity of coblopasvir hydrochloride capsules in patients with hepatitis C. MethodsA total of 36 patients with hepatitis C who were admitted to The First Hospital of Jilin University from November 2016 to January 2017 were enrolled as subjects, and four dose groups (30 mg, 60 mg, 90 mg, and 120 mg) and one placebo group were established. The subjects were administered once daily for 3 consecutive days; tolerance was evaluated on D2 and D6, and follow-up was performed on D8 and D10. The subjects were enrolled based on single dose escalation, and a multiple-dose study was conducted under the premise of good tolerance to single dose. Liquid chromatography-tandem mass spectrometry was used to measure the plasma concentration of coblopasvir hydrochloride in human body, and WinNonlin 6.4 software was used to calculate main pharmacokinetic parameters. HCV RNA load was used to evaluate antiviral activity at different time points; a one-way analysis of variance was used for comparison between multiple groups, and the LSD t-test was used for further comparison between two groups. ResultsAfter coblopasvir hydrochloride capsules were administered orally once a day at a dose of 30-120 mg, the plasma concentration and exposure of coblopasvir hydrochloride increased with the increase in dose. There were no significant differences in plasma concentration and exposure between multiple-dose administration and single-dose administration in a fasting state, without accumulation in human body. After the oral administration of coblopasvir hydrochloride capsules once a day, the subjects with HCV genotype 1b had a reduction in HCV RNA load since baseline, with the lowest level at 120 hours, and there was a significant difference in antiviral activity between different dose groups (F=14.621, P＜0.000 1), among which the 60 mg group had a significantly greater reduction than the 30 mg group (P=0.025), while there was no significant difference between the 60 mg group and the 90/120 mg group (P＞0.05). There was no significant difference in HCV RNA load between different groups of patients with HCV genotype 2a (P＞0.05). Of all 36 subjects, 20 reported 34 cases of treatment-emergent adverse events, among which 19 cases were associated with coblopasvir hydrochloride, and no significant adverse events or serious adverse events were observed. ConclusionOral administration of coblopasvir hydrochloride capsules in a fasting state at a dose of 30-120 mg/d (for 3 consecutive days) has good safety and antiviral activity. Therefore, it has good application prospect in the treatment of HCV infection and provides a basis for dose selection in phrase 2 study.

Objective To study the application of microelectrode stereotactic functional nucleus lesioning operation in the treatment of Parkinson′s disease(PD) ,and to explore its clinical value .Methods The clinical data in 84 cases of PD treated with‐out using the microelectrode stereotactic functional nucleus lesioning operation(observation group) and 74 cases of PD treated by u‐sing microelectrode guided stereotactic functional nucleus lesioning in our hospital were retrospectively analyzed .At the same time the Unified Parkinson′s Disease Rating Scale (UPDRS) scores before the nucleus lesioning and at postoperative different medication states were obtained in the observation and the control group .Furthermore the difference of the UPDRS motor scores before and af‐ter operation were compared between the two groups .Results The UPDRS motor scores at postoperative 3 ,6 months and 1 year in the observation group were significantly improved compared with before operation(P<0 .05) ,meanwhile the postoperative anti‐PD drug dosage was significantly decreased compared with before operation(P<0 .05) .Among them ,70 cases(83 .3% ) in the control group were obviously effective ,14 cases(16 .7% ) were effective ,and the total effective rate was 100% ;while 62 cases(83 .7% ) in the observation group were obviously effective ,12 cases (16 .3% ) were effective ,and the total effective rate was 100% .The differ‐ence in improving the UPRDS motor scores before and after operation had no statistical difference between the two groups(P>0 .05) .Conclusion Stereotactic nucleus lesioning in treating PD has satisfactory effect and can significantly improve the UPRDS motor scores .Accurate positioning is the key to the operation success ,whether microelectrode recording can significantly improving the operation accuracy needs further discussion .

OBJECTIVETo investigate the value of functional magnetic resonance imaging (MRI) in sequential evaluation of patients with Leigh syndrome.

METHODSTwo patients with Leigh syndrome underwent diffusion weighted imaging (DWI), perfusion weighted imaging (PWI) and proton magnetic resonance spectroscopy ((1)H-MRS).

RESULTSThe brain lesions showed hyperintensity on DWI, lactate doublet peak on MRS and hyperperfusion in the patients at baseline, and maintained a hyperintensity on DWI and hyperperfusion in the absence of lactate doublet peak on MRS at follow-up 1 year later. DWI still revealed persistent hyperintensity in the brain lesions in one patient 2 years later.

CONCLUSIONFunctional MRI can sensitively highlight the characteristics of brain lesions in patients with Leigh syndrome, and can therefore be used to evaluate the sequential changes of the brain lesions.

Brain ; pathology ; Child ; Child, Preschool ; Female ; Humans ; Leigh Disease ; pathology ; Magnetic Resonance Imaging ; methods

Objective To explore the diagnostic value of optic diffusion tensor imaging (DTI) in detecting the impairment of optic nerve in neuromyelitis optica (NMO) patients.Methods Conventional MRI and optic DTI were performed in 28 NMO patients and 38 normal controls (NC).Fractional anisotropy (FA) values were measured in the anterior part,middle part and posterior part of intraorbital segment of optic nerve.The patients were classified into 3 groups based on the impairment of vision and visual evoked potential (VEP): monocular impairment (MI) group,10 eyes; biocular impairment (BI) group,36 eyes;and normal-appearing (NA) group,10 eyes.All patients were performed with the evaluation of expanded disability status scale (EDSS).One-way analysis of variance (ANOVA),receiver operating characteristic (ROC) curve,and Spearman correlation analysis were performed among the subgroups of NMO and normal controls.Results There was significantly statistical difference between the four groups (F =43.54,P ＜0.01).Decreased FA values were demonstrated in the MI group (0.29 ±0.08),BI group (0.27 ±0.08),and NA group (0.35 ±0.13) compared with NC (0.45 ±0.07) (P ＜0.01).FA value in BI group was significantly lower than that of NA group(P ＜0.01).Area under curve by ROC analysis in NC vs MI,NC vs BI,NC vs NA,and NC vs NMO was 0.92,0.95,0.74,and 0.91,respectively.The diagnostic sensitivity of ROC was 80％,86％,50％,and 79％,respectively.The diagnostic specificity of ROC was 95％ for the each compared groups.FA value showed no correlation with EDSS for each NMO groups,and showed negative correlation with disease duration for BI group (r =-0.371,P ＜ 0.05).Conclusions Various degrees of optic nerve injuries,indicated by decreased FA value,are present in NMO patients,and optic DTI may be a simple and effective tool for the quantitative evaluation of optic nerve in NMO patients.