Purpose To explore the clinicopathologic features,pathogenesis and differential diagnosis of Malaco-plakia.Methods The clinical features,imaging manifestations,cytopathologic features,histopathologic features,im-munohistochemistry,special staining and molecular pathological manifestations of 17 patients with Malacoplakia were analysed and the relevant literature was reviewed.Results Seventeen patients with Malacoplakia were mostly female,of which 13 lesions were located in the bladder,1 in the prostate,1 in the colon,1 in the right external auditory canal,and 1 in the retroperitoneum.Cytologic morphology varied depending on the site of the lesion,with phagocytes and MG-like microsomal analogues seen in renal puncture cytology,and small numbers of squamous epithelial cells and uroepi-thelial cells(NHGUC)seen in urinary cytology specimens.Histologic morphology showed a large number of foamy his-tiocytes and small numbers of neutrophils and eosinophils against a background of chronic inflammation dominated by lymphocytes and plasma cells;the cytoplasm of the histiocytes was eosinophilic and granular,with blue calcified vesi-cles scattered throughout,some of which were in the form of target-ring or concentric-circle-like structures,which are known as Michaelis-Gutmann bodies(MG bodies).Special stains showed PAS and iron staining(+);immunohisto-chemistry showed diffuse histiocyte CD68(+),CD163(+),CK(AE1/AE3)(-);molecular pathology showed TB-DNA(-).Conclusion Malacoplakia is a chronic granulomatous disease that can be cured.Imaging often shows occupancy,which is easily misdiagnosed as a tumour clinically,and confirming the diagnosis mainly relies on patholog-ical diagnosis,differential diagnosis includes xanthogranulomatous cystitis,xanthogranulomatous pyelonephritis,colon cancer,granulosa cell tumour and Langerhans histiocytosis.

Purpose To explore the clinicopathologic features,pathogenesis and differential diagnosis of Malaco-plakia.Methods The clinical features,imaging manifestations,cytopathologic features,histopathologic features,im-munohistochemistry,special staining and molecular pathological manifestations of 17 patients with Malacoplakia were analysed and the relevant literature was reviewed.Results Seventeen patients with Malacoplakia were mostly female,of which 13 lesions were located in the bladder,1 in the prostate,1 in the colon,1 in the right external auditory canal,and 1 in the retroperitoneum.Cytologic morphology varied depending on the site of the lesion,with phagocytes and MG-like microsomal analogues seen in renal puncture cytology,and small numbers of squamous epithelial cells and uroepi-thelial cells(NHGUC)seen in urinary cytology specimens.Histologic morphology showed a large number of foamy his-tiocytes and small numbers of neutrophils and eosinophils against a background of chronic inflammation dominated by lymphocytes and plasma cells;the cytoplasm of the histiocytes was eosinophilic and granular,with blue calcified vesi-cles scattered throughout,some of which were in the form of target-ring or concentric-circle-like structures,which are known as Michaelis-Gutmann bodies(MG bodies).Special stains showed PAS and iron staining(+);immunohisto-chemistry showed diffuse histiocyte CD68(+),CD163(+),CK(AE1/AE3)(-);molecular pathology showed TB-DNA(-).Conclusion Malacoplakia is a chronic granulomatous disease that can be cured.Imaging often shows occupancy,which is easily misdiagnosed as a tumour clinically,and confirming the diagnosis mainly relies on patholog-ical diagnosis,differential diagnosis includes xanthogranulomatous cystitis,xanthogranulomatous pyelonephritis,colon cancer,granulosa cell tumour and Langerhans histiocytosis.

Background With the increasing aging population in China, there is a significant shortage of labor force. Delaying retirement age has become a potential method to alleviate this labor shortage. Objective To estimate the healthy working life expectancy (HWLE) of individuals aged 50 years old in China. Methods This study was based on data from four waves (2011—2018) of the China Health and Retirement Longitudinal Study (CHARLS). HWLE was estimated for the overall sample of individuals aged 50 years old and above and stratified by sex, educational attainment, marital status, occupation, Hukou type, and region by using continuous-time multistate modelling. Results A total of 50991 person-times aged ≥ 50 years and older were included in the study. The average total life expectancy of the Chinese population aged 50 years old was 29.72 years (95%CI: 29.28, 30.12 years), with a HWLE of 14.05 years (95%CI: 13.76, 14.33 years). The remaining years lived in the states of healthy but not working, not healthy but working, and not healthy and not working were 8.82 years (95%CI: 8.53, 9.15 years), 2.54 years (95%CI: 2.41, 2.68 years),and 4.30 years (95%CI: 4.08, 4.54 years), respectively. The HWLE (95%CI) of individuals in the baseline states of healthy and working, healthy but not working, not healthy but working, and not healthy and not working were 14.97 (14.69, 15.23), 10.86 (10.52, 11.22), 11.73 (11.31, 12.09), and 9.51 (9.09, 9.97) years, respectively. Additionally, women had a higher total life expectancy (95%CI) than men [31.84 (31.10, 32.54) years vs 27.98 (27.35, 28.50) years], but a lower HWLE than men [12.47 (12.12, 12.82) years vs 15.62 (15.23, 15.98) years]. There was no difference in total life expectancy between rural residents and urban residents [29.43 (28.88, 29.97) years vs 30.31 (29.47, 31.02) years], but rural residents had a higher HWLE than urban residents [15.74 (15.39, 16.10) years vs 11.38 (10.97, 11.73) years]. Residents in East China [14.66 (14.22, 15.06) years] and Central China [14.15 (13.86, 14.43) years] had a higher HWLE than residents in West China [13.61 (13.27, 13.98) years] and Northeast China [13.06 (12.51, 13.63) years]. Conclusion The HWLE of Chinese residents supports the policy of raising the retirement age. There are differences in HWLE levels between urban and rural areas, as well as across different regions. Providing more flexible employment opportunities for older adults can help mitigate the labor shortages caused by population aging.

OBJECTIVES: To develop a Chinese version of the Stress Adaption Scale (SAS) and to assess its reliability and validity among Chinese patients with multimorbidity. METHODS: The Brislin model was used to translate, synthesize, back-translate, and cross culturally adapt the SAS. A total of 323 multimorbidity patients selected by convenience sampling method from four hospitals in Zhejiang province. The critical ratio method, total question correlation method, and graded response model (item characteristic curve and item discrimination) were used for item analysis. Cronbach's alpha coefficient and split-half reliability were used for the reliability analysis. Content validity analysis, structural validity analysis, and criterion association validity analysis were performed by expert scoring method, confirmatory factor analysis, and Pearson correlation coefficient method, respectively. RESULTS: The Chinese version of the SAS contained 2 dimensions of resilience and thriving, with a total of 10 items. In the item analysis, the critical ratio method showed that the critical ratio of all items was greater than 3.0 (P<0.001); the correlation coefficient method showed that the Pearson correlation coefficients for all items exceeded 0.4 (P<0.01). The graded response model showed that items of the revised scale exhibited distinct item characteristic curves and all items had discrimination parameters exceeding 1.0. In the reliability analysis, Cronbach's alpha coefficient of the revised Chinese version of the SAS scale was 0.849, and the split-half reliability was 0.873. In the validity analysis, the item-level content validity index and scale-level content validity index both exceeded 0.80. In the confirmatory factor analysis, the revised two-factor model showed satisfactory fit indices (χ²/df=3.115, RMSEA=0.081, RMR=0.046, GFI=0.937, AGFI=0.898, CFI=0.936, TLI=0.915). In the criterion-related validity analysis, the Chinese version of the SAS score was negatively correlated with the Perceived Stress Scale and the Treatment Burden Questionnaire, with correlation coefficients of －0.592 and －0.482, respectively (both P<0.01). CONCLUSIONS The Chinese version of the SAS has good reliability and validity, which can be used to evaluate the stress adaption capacity among multimorbidity patients in China, and provides a reference for developing individualized health management measures.
Humans ; Adaptation, Psychological ; Asian People ; China ; Multimorbidity ; Reproducibility of Results ; Stress, Psychological/psychology* ; Surveys and Questionnaires ; Translating ; Cross-Cultural Comparison

OBJECTIVES: To develop a Chinese version of the Long-Term Conditions Questionnaire (LTCQ) and to test its reliability and validity in Chinese patients with chronic diseases. METHODS: With the consent of the original authors, a Chinese version of LTCQ was developed according to the cultural adjustment guidelines. A questionnaire survey was conducted on 319 patients with chronic diseases in Sir Run Run Shaw Hospital, Wuyi County First People's Hospital and Hangzhou Gongchen Bridge Street Health Service Center. The questionnaire was evaluated by item analysis (including frequency analysis, total question correlation method and critical ratio method), reliability analysis (Cronbach's alpha coefficient) and validity analysis [including content validity (expert scoring method) and structural validity (exploratory factor analysis)]. RESULTS The Chinese version of the LTCQ included 20 entries, with a Cronbach's alpha coefficient of 0.926, a retest reliability of 0.829, a split-half reliability of 0.878, an entry content validity index of 1, and a content validity index at the questionnaire level of 1. Four common factors were extracted by exploratory factor analysis, namely physical state and daily life, psychological state, support and coping, and safe environment, with a cumulative variance contribution rate of 67.244%. Discussion: The Chinese version of the LTCQ developed in this study has good reliability and validity and it may be used to assess the long-term conditions of patients with chronic diseases in China.
Humans ; Asian People ; China ; Chronic Disease ; Quality of Life ; Reproducibility of Results ; Surveys and Questionnaires

Mizoribine(MZR), as an orally prescribed immunosuppressive agent, has been applied in the prevention of rejection after kidney transplantation.MZR requires individual dosing due to the variation of bioavailability.However, therapeutic drug monitoring (TDM) of MZR is not well developed in China, as compared to other clinically used immunosuppressive agents.To our knowledge, this is the first TDM review of MZR.Pharmacokinetic characteristic, concentration determination methods and sample selection of MZR were summarized, also the rational therapeutic window was proposed.Furthermore, gene polymorphism and population pharmacokinetics of MZR were estimated.This review will provide reference for TDM-based individual dosing of MZR in renal transplant recipients.

Aim To investigate the impact of CYP3 A5 genetic polymorphism on modified releasing tacrolimus pharmacokinetics in Chinese stable renal transplant re-cipients. Methods Pharmacokinetics of once daily-ta-crolimus( tac-q. d. ) and twice daily-tacrolimus( tac-b. i. d. ) were determined by CLIA, CYP3A5 genotype was measured by PCR-RFLP. Each 10 patients receiv-ing tac-q. d. and tac-b. i. d. respectively were en-rolled, and each 5 patients receiving tac-q. d. were matched to poor metabolizer ( PM ) and extensive me-tabolizer ( EM ) group respectively according to CYP3A5 genotypes. Results AUC0~24 h for tac-q. d. was 1. 78 folds higher than AUC0~12 h for tac-b. i. d. , and dose-adjusted C0 was 40% lower for tac-q. d. than for tac-b. i. d. There were no significant differences for other parameters between the two groups; Cmax, AUC0~24 h and C0 were 1. 75, 1. 96 and 2. 49 folds higher for PM than for EM, and dose-adjusted Cmax, AUC0~24 h and C0 were 1. 80, 2. 34 and 2. 64 folds higher for PM than for EM. There were good correla-tions between AUC0~24 h and C0 for tac-q. d. Conclu-sion Conversion from tac-b. i. d. to tac-q. d. results in requirement of increased tacrolimus dose and detec-tion of CYP3A5 genotype, which is necessary for ensu-ring C0 in the range of therapeutic window.

Objective To observe the injury of some chief organ induced by paraquat (PQ) poisoning in rats, and to explore the mechanism. Method A total of 60 inbred line SD rats were randomly divided into experimental group (n = 30) and control group (n = 30), and each group was further divided into 6 subgroups (n =5) as per the sacrifice of rats at different intervals. The rats of experimental group received the intra-abdominal injection of paraquat (1 mg/mL, 18 mg/kg), and the rats of control group were treated with the same amount of saline solution instead. The rats of each subgroup were sacrificed separately 2 h,6 h, 12 h,24 h,72 h and 120 h after administration of PQ or saline. Lungs, livers and kidneys were taken for histopathological study. Results There was noticeable exudate in lung tissue of rats in experimental group in the early stage. And then the cystic changes in the liver of rats in experimental group were found. A noticeable hemoglobin was found in the renal tubules 24 h after modeling. But the exudation in lung decreased 24 h later, and in the mean time, the disorganization of pulmonary alveoli was obvious and some remarkable collagen appeared in the interstitial tissue of lung, and it was significantly obvious 72 h after modeling. In the liver of rats in experimental group, the injured tissue had some extent of repair in 72 h after modeling, and recovered gradually. But the injury of kidney was exacerbated 72 h after modeling. In the control group, the lung, liver and kidney were not changed in all stages after modeling.Conclusions The paraquat could induce failure of some chief organs in SD rats. The injury was most remarkable in the lung in a progressive way. The kidney injury was not more severe than that of lung tissue, but the pathological changes of the kidney became worse and worse as time taken. The injury of liver induced by paraquat was slight, and the injury could heal up gradually.

Objective Rab11 GTPases play an essential role in regulating membrane trafficking pathways in eukaryotic cells. Nonetheless, there has been little work done on characterizing the transport machinery of Trichomonas. The aim of this study is to clone and characterize a Rab11 gene of Trichomonas vaginalis.Methods A cDNA expression library was constructed with T. vaginalis total RNA. A cDNA clone, which showed a high degree of homology with Rab proteins of different species, was isolated and sequenced. Sequence analysis was performed using BLASTP, RPS-BLAST and ClustalW programs. The genomic DNA corresponding to the cDNA sequence was amplified using PCR techniques and following by sequencing. Results cDNA with a length of 710 base pairs and an open reading frame of 636 bp was obtained. The deduced amino acid sequence from the open reading frame was found to possess 211 residuals. Sequence analysis demonstrated that this cDNA clone was homologous to the Rab11 subfamily of different species (60% identity and 79% similarity with Arabidopsis thaliana Rab11c, 58% identity and 78% similarity with human Rab11b), and that the amino acid sequence contains all the well known conserved sequence elements of Rab family. Specific Rab motifs were also detected in the deduced amino acid sequence. Phylogenetic analysis showed that its closest homologues are Rab11 proteins from other species. Sequencing of the PCR product of genomic DNA revealed that the genomic DNA sequence encompassing the putative 5'-ATG and 3'-stop codon is identical to the cDNA sequence.Conclusion A cDNA clone corresponding to the T. vaginalis Rab11 gene was obtained.The function of this gene in regulating membrane trafficking pathways of the parasitic protist is still under investigation.