OBJECTIVE To establish a content determination method for multiple components in Sophora flavescens from different origins and to evaluate its quality by combining with chemometrics. METHODS Thirteen batches （No. K1-K13） of S. flavescens from different origins were selected as test samples. A high-performance liquid chromatography-tandem triple quadrupole mass spectrometry （HPLC-MS/MS） method was established to determine the contents of 12 components， including matrine， oxymatrine， betaine， cytisine， N-methylcytisine， sophoridine， genistein， sophoricoside， sophorone， formononetin， sophorolone Ⅰ and norkurarinone in S. flavescens. Chromatographic separation was performed on a Shim-pack GIST-HP C18 column with a mobile phase consisting of methanol （A） and water containing 0.1% formic acid （B）， using gradient elution at a flow rate of 0.25 mL/min， column temperature of 35 ℃， and an injection volume of 3 μL. Mass spectrometry was conducted using an electrospray ionization source with positive and negative ion scanning. Data were collected in segments using the multiple reaction monitoring mode. Technique for order preference by similarity to ideal solution （TOPSIS） and grey relational analysis （GRA）methods were employed to compare and comprehensively evaluate the 13 batches of S. flavescens from different origins. RESULTS The methodological validation for the content determination met the relevant regulatory requirements. The contents of the 12 components were 490.66-1 231.00， 11 088.10- 18 021.50， 7.91-25.38， 903.97-1 713.64， 336.08-1 485.54，1 065.33-2 075.50， 27.52-71.80， 109.36-517.83， 6 034.55-10 632.73， 21.26-145.35， 814.84-1 911.32， 1 040.87-3 446.37 μg/g）， respectively. TOPSIS results showed that the top 7 samples in Euclidean distance ranking were K6， K12， K11， K3， K5， K10， K13. The GRA results showed that the top 7 samples in the relative correlation ranking were K12， K11， K10， K6， K13， K5， K3. CONCLUSIONS The established HPLC-MS/MS method is rapid， accurate， highly sensitive， stable and reliable. Combined with chemometrics methods， it can be used for the quality control and evaluation of S. flavescens. The comprehensive quality of samples K3， K5， K6（ from Hebei）， K10（ from Sichuan）， K11-K13（ from Shanxi）， etc. is relatively superior.

Objective:To investigate the clinicopathological and molecular genetic characteristics of well-differentiated/dedifferentiated liposarcoma (WDLPS/DDLPS) with myxoid-like morphology, and to distinguish them from myxofibrosarcoma (MFS) with similar morphology.Methods:Twenty-nine cases of myxoid-like liposarcoma and 5 cases of MFS were collected from Henan Provincial People′s Hospital, Zhengzhou, China and the First Medical Center of PLA General Hospital, Beijing, China from January 2015 to March 2023. Relevant markers were detected using immunohistochemistry and fluorescence in situ hybridization (FISH). The literature was also reviewed.Results:There were 24 males and 10 females, with ages ranging from 41 to 73 years. The tumor sites included retroperitoneum ( n=17), abdomen ( n=9), lower limbs ( n=5), scrotum ( n=1), upper limb ( n=1) and axilla ( n=1). WDLPS was commonly seen as lipomatoid type (12 cases), while the dedifferentiated components of DDLPS included low-grade (13 cases) and high-grade (2 cases) morphology, with low-high grade myxofibrosarcoma, dermatofibrosarcoma protuberans, and low-grade fibrosarcoma structures. Twenty-nine liposarcomas had various proportions of myxoid-like morphology, while 16 showed various degrees of tumor necrosis. The myxoid-like component showed myxoid pleomorphic liposarcoma (MLPS)-like morphology, lobulated growth, characteristic slender, ramified capillary network,"chicken claw-like"morphology, mucus-rich stroma and lung edema-like morphology. Tumor cells were spindle and oval, with many variable vacuolar lipoblasts. MDM2 gene amplification was detected using FISH and present in all tested cases (29/29). DDIT3 break-apart mutation was not detected, but its cluster amplification was present (24/29). Among the MFS cases, one showed cluster amplification (1/5), but no cases showed break-apart or amplification of MDM2 gene. Conclusions:WDLPS/DDLPS with myxoid-like morphology is most commonly seen in the retroperitoneum and abdominal cavity and mostly harbors DDIT3 break-apart probe amplification, while this amplification is not specific to liposarcoma. For core biopsy specimens or very rare tumors in the limbs, when histology has mucinous stroma and MLPS-like morphology, misdiagnosis of MLPS or other non-lipomatous neoplasms with myxoid morphology should be avoided.

Objective:To investigate the clinicopathological features and genevariation of sporadic arteriovenous malformation (AVM) in soft tissue.Methods:Eighty cases of soft tissue sporadic AVM diagnosed in Henan Provincial People′s Hospital from January 2017 to March 2022, were retrospectively collected. The relevant indicators were detected by immunohistochemistry and fluorescent quantitative PCR, and the relevant literature was reviewed.Results:There were 42 males and 38 females patients, aged from 4 to 71 years, with a mean age of 26 years.The sites of the disease included head and neck (34 cases), limbs (24 upper limbs, 17 lower limbs) and trunk (5 cases). The main clinical manifestations were characteristic pulsation, tremor, temperature rise, local pain, ulcer or repeated bleeding, and heart failure in severe cases due to long-term hemodynamic abnormalities.Color Doppler ultrasound (CDFI) can detect the high flow characteristics of AVM.Multiple cavitary vascular shadows were seen on MRI. Microscopically, the pathological tissue involved the skin appendages, deep fat and muscle tissue, in which abnormal vascular proliferation was seen, mostly scattered, the lumen was irregularly expanded, the wall thickness was different, but most of them were thick, the vascular wall was glassy and myxoid, inflammatory cell infiltration, bleeding, thrombosis and organization were visible, and calcification was rare.Clustered proliferative muscular small vessels were found around the abnormal blood vessels.No vascular endothelial cell proliferation was found in the blood vessels of the lesion. Immunohistochemistry showed that vascular endothelial cells expressed CD31, CD34 and ERG, and muscle fibers and smooth muscle tissues in the wall expressed SMA.Elastic fiber staining showed incomplete elastic layer in the wall of the malformed artery.PIK3CA gene was detected in 15 cases, and 1 case (1/15) had mutation (mutation rate 6.7%). All cases underwent surgical resection, 73 cases were followed up for 3 months to 5 years, and 15 cases recurred.Conclusions:Sporadic AVM in soft tissue is a typical lesion of vascular malformation with high flow velocity. There are abnormal arteries and clusters of proliferating small vessels.Because of the significant difference in clinical manifestation, treatment and prognosis, pathological diagnosis should be distinguished from congenital hemangioma, intramuscular hemangioma capillary type, PTEN soft tissue hamartoma and common venous malformation.Very few cases may involve PIK3CA gene mutation, suggesting that there may be abnormal PI3K signal pathway in AVM and may participate in the occurrence and development of the disease. AVM has a high recurrence rate and needs long-term follow-up.

Interstitial lung disease (ILD) is a frequent complication of patients with connective tissue disease (CTD) and significantly affects morbidity and mortality. Disease course may vary from stable or mildly progressive to more severe, with rapid loss of lung function. At present, there are great challenges and poor prognosis in the diagnosis and treatment of CTD-ILD. Based on the evidence and guidelines from China and other countries, experts from the Chinese Rheumatology Association developed standardization of diagnosis and treatment of CTD-ILD. The aim is to strengthen the early identification of, standardize the diagnosis and treatment of CTD-ILD, and delay the progress of the disease.

Objective: To investigate the clinical and pathologic features, diagnosis and differential diagnosis of hypertrophic port-wine stain (PWS). Methods: Cases of hypertrophic PWS, collected from Henan Provincial People′s Hospital between 2012 and 2018, were retrospectively analyzed for their clinical and pathologic features, immunophenotype and histochemical data, and the relevant literature was reviewed. Results: Twenty-four cases of PWS were included in this cohort, located in the head and neck region (20 cases), limbs (2 cases), and trunk (2 cases). The clinical presentations were mainly red or purple-red plaques or slow growing, painless nodules, or thickened and raised above the skin surface. Microscopically, deformed blood vessels showed honeycomb-like, plexiform or cluster-like growth pattern, and diffusely involved the dermis, skin appendages, subcutaneous fat tissue, and deep skeletal muscles; The vascular lumen of the deformed vessels was dilated (≥100 μm in diameter), and in 18 cases the lumen was greater than 400 μm. The superficial dermis mainly contained few deformed capillaries. The deep wall showed thickening of blood vessel wall and fibrous tissue hyperplasia. Elastic fiber and Masson staining indicated abnormal venous vessel, which in some cases contained small amount of abnormal arterioid vessel,without vascular endothelial cell proliferation in all cases. In 24 cases, 19 cases had epidermal atrophy, 6 with vascular chronic inflammation or epidermal ulcer, 4 with capillary hemangioma, 4 with sebaceous gland hyperplasia, 2 with epidermal papillary hyperplasia and 2 with vascular keratomas. Conclusions PWS is a common congenital capillary malformation. The number of histologically deformed capillaries is reduced and they usually locate in the superficial part. The deep vascular wall is increased with thick venous malformation, diffusely involving the dermis and deep skeletal muscle. Furthermore, PWS needs to be differentiated from infantile hemangioma, cavernous hemangioma and vascular keratomas.

Objective To explore the relationship among peer relationship,self-consciousness and social anxiety in HIV-infected children. Methods Peer Relationship Scale,Piers-Harris Children's Self-con-cept Scale and Social Anxiety Scale for Children were applied to 126 HIV-infected children. Results The score of peer relationship was 53. 0(45. 0,62. 0),the score of self-concept was 52. 0(42. 0,60. 0),and the score of social anxiety was 6. 0(2. 0,9. 0). Peer relationship was positively correlated with social anxiety( r=0. 196,P=0. 029) and negatively correlated with self-consciousness(r=-0. 628,P<0. 01). Self-conscious-ness was negatively correlated with social anxiety(r=-0. 504,P<0. 01). Bootstrap analysis showed that self-consciousness played a complete mediating role between peer relationship and social anxiety,and the media-ting effect value was 0. 377. Conclusion Peer relationship,self-consciousness and social anxiety are closely related. Furthermore,self-consciousness plays a complete mediating role between peer relationship and social anxiety in HIV-infected children.

investigate the clinical and pathologic features, diagnosis and differential diagnosis of hypertrophic port?wine stain (PWS). Methods Cases of hypertrophic PWS, collected from Henan Provincial People′s Hospital between 2012 and 2018, were retrospectively analyzed for their clinical and pathologic features, immunophenotype and histochemical data, and the relevant literature was reviewed. Results Twenty?four cases of PWS were included in this cohort, located in the head and neck region (20 cases), limbs (2 cases), and trunk (2 cases). The clinical presentations were mainly red or purple?red plaques or slow growing, painless nodules, or thickened and raised above the skin surface. Microscopically, deformed blood vessels showed honeycomb?like, plexiform or cluster?like growth pattern, and diffusely involved the dermis, skin appendages, subcutaneous fat tissue, and deep skeletal muscles; The vascular lumen of the deformed vessels was dilated (≥100 μm in diameter), and in 18 cases the lumen was greater than 400 μm. The superficial dermis mainly contained few deformed capillaries. The deep wall showed thickening of blood vessel wall and fibrous tissue hyperplasia. Elastic fiber and Masson staining indicated abnormal venous vessel, which in some cases contained small amount of abnormal arterioid vessel, without vascular endothelial cell proliferation in all cases. In 24 cases, 19 cases had epidermal atrophy, 6 with vascular chronic inflammation or epidermal ulcer, 4 with capillary hemangioma, 4 with sebaceous gland hyperplasia, 2 with epidermal papillary hyperplasia and 2 with vascular keratomas. Conclusions PWS is a common congenital capillary malformation. The number of histologically deformed capillaries is reduced and they usually locate in the superficial part. The deep vascular wall is increased with thick venous malformation, diffusely involving the dermis and deep skeletal muscle. Furthermore, PWS needs to be differentiated from infantile hemangioma, cavernous hemangioma and vascular keratomas.

Objective: To investigate the clinicopathologic features of micronodular thymoma with lymphoid stroma(MNT). Methods: Five cases of MNT diagnosed from January 2007 to December 2016 in Henan Provincial People′s Hospital were collected.Hematoxylin-Eosin staining and immunohistochemistry were used to evaluate the histological and immunophenotypic characteristics in 5 MNT cases. Epstein-Barr virus (EBV) status was detected by in situ hybridization for EBV-encoded small RNA (EBER). Polymerase chain reaction was used to detect the rearrangement of immunoglobulin genes. Results: Five cases were MNT, including 3 male and 2 female patients, mean aged 59 years (from 43 to 63 years). All patients had ananterior mediastinal mass, with no myasthenia gravis and autoimmune diseases, and underwent surgical resection.Half to ten years follow-up showed no recurrence.Grossly, the tumors were solid in 4 cases, and cystic and solid in 1 case; the border was clear. Histologically, the tumors presented as a distribution of micronodules separated by abundant lymphoid stroma with prominent germinal centers. The nodules were composed of neoplastic spindle, oval cells containing bland, oval nuclei.Immunohistochemical study showed strong positivity of the tumor cells for CKpan, CK19, CK5/6 and p63. Stains for EMA, CD117, calretinin, TTF1 were negative in the tumor cells.Scattered CD3, CD1a, and TdT positive immature T lymphocytes were noted in and around tumor nodules. Many lymphocytes in the stroma, including germinal centers, were positive for CD20.The bcl-2 was also detected in lymphocytes in the stroma, mantle and marginal zone of lymphoid follicles, and in part of tumor cells. Tumor cells and lymphocytes were negative for EBER. Immunoglobulin genes rearrangement analysis showed that B lymphocytes were polyclonal. Conclusions MNT is a rare thymoma, which occurs in the elderly and has no obvious symptom. After complete resection, the prognosis is very good. The diagnosis should be based on a combination of clinicopathologic features, and other types of thymoma should be excluded.

Objective:To understand the cognitive differences and its influential factors of medical dispute and physician′s professionalism between medical personnel and patients, and further to provide evidence for the preven-tion and treatment of medical dispute. Methods:In the case of quality control, we surveyed on the cognitive of medical dispute and physician′s professionalism in medical personnel and patients using self-designed question-naire. Stratified cluster sampling method was used in this study, which recruited 847 medical workers and 577 pa-tients. Data analysis was conducted with SPSS 16. 0. The two sample rates were compared using Chi squaretest (α=0. 05). Results:There is a statistically significance in doctor-patient relationship evaluation, dispute pre-vention, dispute responsibility, fair treatment,impact on the doctors and patients, causes of medical disturbance, attitude tomedical disturbance, medical disturbance elimination, physician′s professionalism evaluation, improve-ment approach, and the physician′s professional value between the two samples, having a direct impact on the con-struction of physician′s professionalism. Conclusion:For medical personnel, they should strengthen the construc-tion of physician′s professionalism and establish effective mechanism to prevent medical dispute. For patienes, they should understand, trust and respect the doctors, and solve medical dispute rationally. For government, they should establish a reasonable mechanism for the settlement of medical dispute, create a rational atmosphere respon-ding to the medical dispute, and reduce the intensification of medical dispute.

Central Nervous System ; pathology ; Humans ; Lymphoma, T-Cell, Peripheral ; diagnosis