Objective:To investigate the clinicopathological, molecular pathological features, and family genetic pedigree of small cell carcinoma of the ovary, hypercalcemic type (SCCOHT).Methods:A total of 16 cases of SCCOHT diagnosed in Obstetrics and Gynecology Hospital of Fudan University from January 2013 to January 2023 were collected. The clinicopathologic features, SMARCA4/2/B1 protein expression, outcomes and SMARCA4 gene detection were reported. A follow-up study was also carried out.Results:The average age at diagnosis was 28.7 years (range 17-38 years). The preoperative calcium level was evaluated in 3 of 6 patients. The tumor was unilateral in all 16 cases, ranged from 8 to 26 cm (average 15.8 cm) in the greatest dimension. Extraovarian spread was present in 7 cases. In 10 cases, the tumors were initially misinterpreted as other ovarian neoplasms. BRG1 and BRM expression by immunohistochemistry were all lost in detected cases, while INI1 exhibited retained nuclear expression. All BRM-negative SCCOHTs also lacked BRG1 protein,but retained INI1 expression. SCCOHTs were only focally positive for EMA, CKpan, Calretinin, SALL4, and diffusely positive for WT1. Two of nine cases exhibited mutation-type p53 immunoreactivity. Ki-67 index was 58% on an average. ER, PR, FOXL2, α-inhibin, chromogranin A and LCA were negative in all the cases. SMARCA4 sequencing was available in 8 cases of SCCOHT, which revealed a germline SMARCA4 mutation in one patient, and others carried somatic mutation. Furthermore, two daughters, mother and an aunt of a patient with germline mutation were reported to be SMARCA4 mutation carriers. Follow-up was available for 15 patients, and the 6-month, 1-year and 2-year survival rate was 65.8%, 45.1%, and 22.6%, respectively. For patients in FIGO stages Ⅱ+Ⅲ, 6-month, 1-year survival rate was 53.6% and 35.7% respectively, compared to 80% (6-month) and 60% (1-year) in patients of staged I ( P=0.358). Conclusions:With dismal prognosis of SCCOHT, accurate diagnosis is necessary. The typical age distribution, a panel of various staining results, especially concomitant loss of BRG1 and BRM may be of diagnostic aid and can be used to distinguish SCCOHT from its histological mimics. After the diagnosis of SCCOHT, genetic testing and genetic counseling are recommended.

OBJECTIVE: To diagnose a 46,XN,del(11)(q14q22) fetus by non-invasive prenatal testing (NIPT), karyotype analysis and whole genome sequencing (WGS). METHODS: Peripheral blood sample of the gravida was taken for NIPT screening. Blood samples of the gravida, her husband, and umbilical cord blood were also taken for chromosome karyotyping and whole genome sequencing (WGS). RESULTS: NIPT screening indicated the fetus has carried partial deletion of chromosome 11, while no chromosomal abnormality was found with the cord blood sample due to the low resolution of G-banding analysis. WGS analysis of the cord blood indicated 46,XN,del(11q14.3q22.1). seq[GRCh37/hg19] (90 623 404-97 469 319)×1, 6.85 Mb. The karyotype of the fetus was eventually determined as 46,XN,del(11)(q14q22). Karyotyping analysis suggested that the gravida and her husband were 46,XX,del(11)(q14q22)[8]/46,XX[92] and 46,XY, respectively. However, neither of them was found to harbor the del(11)(q14q22) by WGS. CONCLUSION The abnormal karyotype of the fetus has derived from its mother's low percentage mosaicism. Combined NIPT, karyotyping analysis and WGS can detect chromosomal disorders with accuracy.

OBJECTIVE： To study the effects of cimetidine on low dose rate irradiation-induced liver cell apoptosis in Beagle dogs. METHODS： Healthy male Beagle dogs were randomly divided into normal control group， model control group， positive drug group （lentinan， 21.33 mg/kg） and cimetidine low-dose， medium-dose and high-dose groups （5.33， 10.67， 21.33 mg/kg）， with 4 Beagle dogs each. Except for normal control group， other groups were given 60Co-γ accumulative irradiation （dosage rate： 0.040 8 mGy/min） for 23 d； the medication groups were given relevant medicine orally before irradiation， once a day. Twenty-four hours after stopping irradiation， TUNEL method was used to detect the apoptosis of liver cells in Beagle dogs. The percentage of apoptotic cells was calculated. The expression level of apoptosis-related proteins （Bax， Bcl-2， Caspase-3， p53） in liver tissue was detected by immunohistochemistry. RESULTS： Compared with normal control group， apoptotic cells and Bax， Caspase-3， p53 positive cells were increased significantly in liver tissue of Beagle dogs in model control group； the percentage of apoptotic cells， protein expression levels of Bax， Caspase-3 and p53 were increased significantly； Bcl-2 positive cells were decreased significantly， and its protein expression level was decreased significantly （P＜0.05 or P＜0.01）. Compared with model control group， above positive cells of liver tissue in Beagle dogs were changed to different extents in medication groups； the percentage of apoptotic cells and protein expression levels of p53 in medication groups， protein expression levels of Bax in positive drug group， cimetidine low-dose and high-dose groups as well as protein expression levels of Caspase-3 in cimetidine groups were decreased significantly； protein expression levels of Bcl-2 were increased significantly in cimetidine groups. The percentage of apoptotic cells in cimetidine medium-dose and high-dose groups as well as protein expression levels of Caspase-3 in cimetidine groups were all lower than positive control group. Protein expression level of p53 in cimetidine low-dose group was significantly higher than positive drug group （P＜0.05 or P＜0.01）. CONCLUSIONS： Cimetidine can inhibit the low dose rate irradiation-induced apoptosis of liver cells in Beagle dogs， and certainly protect liver cells against irradiation. The mechanism of it may be associated with up-regulating the protein expression of Bcl-2 and down-regulating the protein expression of Bax， Caspase-3 and p53 in liver cells.

Objective To investigate the radioprotective effect of cimetidine on survival rate and hematopoietic system in acutely irradiated mice.Methods The total body irradiation doses were 6.0Gy and 8.0Gy respectively at 1.01Gy/min rate. Sixty healthy male C57BL/6 mice were randomly divided into control group, model group, positive-drug (523) group and cimetidine groups (33.3mg/kg, 100mg/kg and 300mg/kg). Each group had ten mice. The mice were given intragastric administration of cimetidine for 6d before the irradiation in cimetidine groups, and 523 was administered before irradiation once a day for one day in 523 group, and at 5h after irradiation, was given again. The 30d survival rate after 8.0Gy irradiation was recorded. The peripheral blood cells, bone marrow DNA content and frequency of micronucleated polychromatic erythrocytes (fMNPCE) were determined 30d after 6.0Gy irradiation.Results After 8.0Gy irradiation, all the mice died on 21th day in model control group. The survival rates in cimetidine groups were 50%, 20% and 30%, respectively. After 6.0Gy irradiation on 30th day, compared with control group, the peripheral white blood cells (WBC) and bone marrow DNA content were decreased significantly (P<0.01,P<0.05) in model group, and fMNPCE was increased significantly (P<0.05). Compared with model group, WBC was significantly increased in 300mg/kg cimetidine group (P<0.01). In cimetidine groups, the bone marrow DNA content was increased significantly after irradiation (P<0.01 orP<0.05), and the fMNPCE was decreased significantly (P<0.01 orP<0.05) and tended towards normal.Conclusion Cimetidine could improve 30d survival rate of acutely irradiated mice and has good protective effect on hematopoietic system.

Objective To study the application value of endoscopic purse-string sutures with titanium clips and endoloops for the gastric wall defect during endoscopic full-thickness resection (EFTR). Methods Data of iffteen hospitalized patients with gastric submucosal tumor (SMT) undergone EFTR was reviewed. The patients were all applied with endoscopic purse-string sutures with titanium clips and endoloops, which was performed after the EFTR when the gastric walls were perforated artiifcially. Results The gastric tumors were complete successfully resected in the iffteen patients through endoscopic surgery, applied the purse-string sutures with titanium clips and endoloops after the EFTR when the gastric walls were perforated artiifcially. Approximately, ifve clips were utilized on average. Postoperative surgical wound healing was followed up for 6 months, no tumors recurred. Conclusion It is safe, minimally invasive treatment method for rapid rehabilitation in endoscopic full-thickness resection utilized purse-string sutures with titanium clips and endoloops.

High altitude polycythemia (HAPC) had become one of the main common chronic diseases, which had seriously threatened the health of Plateau people. In the Tibetan medicine classic bookSi-Bu Yi-Dian, there were recordings on HAPC treatment methods and medications, which had the unique advantages of identified therapeutic effect with little side effect. This article analyzed Tibetan medicine in the prevention and treatment of HAPC from aspects such as etiology and pathogenesis, clinical treatment advantages and modern innovation study. Questions were also raised on lacking of standardization on HAPC clinical effectiveness, as well as Tibetan medicine compound material basis and action mechanisms were unclear. It was proposed that based on the inheritance of Tibetan medicine theoretical basis and clinical therapeutic effect, the Tibetan medicine original thinking should be combined with modern science and technology, in order to strengthen the analysis of ancient literature collection in HAPC treatment and data mining in medication experiences. The clinical treatment standards and medication plan should be standardized. Methods of systems biology, such as metabolomics, can be used in the further study of the scientific connotation of HAPC treatment by Tibetan medicine.

Objective:To establish the quality standard for Sipunculus nudus polysaccharide. Methods:The water content, igni-tion residues and heavy metals in Sipunculus nudus polysaccharide were determined. Authrone-sulfuric acid colorimetry was used to de-termine the polysaccharide content. Results: The water content in the polysaccharide should not exceed 5. 0%, ignition residues should not exceed 1. 0%, and the content of heavy metals should not exceed 20 ppm. The polysaccharide content should exceed 80%( glucose) . Conclusion:The method is accurate and simple, and can be effectively used in the quality control of polysaccharide in Sipunculus nudus Linnaeu.

Objective:To prepare old tea buccal tablets using wet granulation method and optimize the preparation technology. Methods:The amount of each adjuvant was studied by single factor experiments, and the formula of the buccal tablets was optimized by the orthogonal experiments using taste and disintegration time as indices. Results:The optimal formula was composed of old tea ex-tract 30 g,mannitol 60g,PEG6000 20 g,aspartame 10 g,citric acid 10 g and menthol crystal 1 g. All the tested indices including ap-pearance, hardness and disintegration time met the requirements described in Chinese pharmacopeia. Conclusion: The preparation technology is reasonable and feasible for the industrial production.

Objective To investigate the influence of smoking,drinking cognition and behavior among the officers and soldiers in South China War Zone after health management,and to explore the establishrent of appropriate health management model for the army.Methods Harmfulness cognition,rate,quantity,types of drinking and smoking were investigated and analyzed before and after health management among 1 102 officers and soldiers in South China War Zone by providing a set of health education,psychological counseling service,disease and lifestyle intervention of health management as a whole.Results The harmfulness cognition rate of smoking and drinking raised from 95.6％ and 94.1％ to 98.7％ and 97.8％,the smoking and drinking rate dropped from 64.7％ and 72.6％ to 37.2％ and 61.4％ after health management.The x2 values were 18,18.9,153,20.8,and had significant difference (P＜0.001).The rate of occasional smoking,a small amount of smoking,often smoking dropped from 28.3％,25.8％,45.9％ to 18.5％,12.2％,31.5％ as well as the rate of occasional drinking,a small amount of drinking,often drinking has dropped from 56.6％,32.3％,11.1％ to 49.8％,23.4％,4.1％.The x2 values were 26.8,62.1,31,9.61,8.06,19.4,and had significant difference (all P＜0.01).Conclusion The health management improves the harmfulness cognition of smoking and drinking,and decreases the rate and quantity of smoking and driking.It has a positive effect on improving the heahh literacy and developing health way of life in officers and soldiers.

Objective To establish an appropriate health management model to improve health literacy of army men and promote and maintain physical and mental health of officers and soldiers.Methods A questionnaire survey was conducted among officers and soldiers in South China War Zone before and 2 years after health management.The x2 test was used to calculate the positive rate of officers,high-rank soldiers,soldiers,officers and soldiers in general before and after the intervention.Results After health management,most of items showed significant difference,including easy to get along with others,working under stress,being full of confidence to future life,awareness of harm of anger,anxiety and depression,easy expression of feelings,learning from hero model,being satisfied with social support system,active participation in sports activities,knowing centers that offer psychological services,awareness the necessity of psychological services in primary healthcare units (x2 values were 5.8,12.3,26.9,77.3,15.2,21.5,18.6,16.8,333.8 and 79.4,respectively; all P＜0.05).The most obvious improvement was found in the solders.There was no significant difference in satisfaction with psychological status or communication skills and being proud of military carrier in officers and soldiers (x2 values were 2.3,3.1 and 2.2,respectively; all P＞0.05).The stress from the military management was significantly increased after health management (x2=14.9,P＜0.05).The stress of high-rank soldiers from military management and daily work was also significantly increased after health management (x2 values were 21.6 and 8.3,respectively; both P＜0.05).The stress of solders from daily work was significantly decreased after health management (x2=35.7,P＜0.05).The stress of soldiers from military management and financial difficulties was significantly increased.The stress of soldier from financial difficulties was significantly decreased after health management.After health management,the rate of choosing fiiends and psychological doctors to be listener was significantly increased (x2 values were 10.2 and 32.6,respectively; both P＜0.05).The rate of choosing friends and psychological doctors to be a listener was significantly inclined among high-rank soldiers (x2 values were 9.9and 46.7,respectively; both P＜0.05).The rate of choosing parents and leaders to be listener was significantly increased in soldiers (x2 values were 17.6 and 14.3,respectively; both P＜0.05).Conclusion Health management that includes health education,psychological service,disease consulting and life style intervention may significantly improve psychological status of army men,especially the soldiers.