Objective:To analyze the clinicopathological features of giant ovarian masses(mean diameter≥10 cm)and analyze the clinical characteristics of patients in different age groups.Methods:The clinicopathological characteristics of 311 patients diagnosed with giant ovarian masses by surgery at Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University from January 2014 to December 2022 were retrospectively analyzed.Patients were further stratified by age and mass size to compare the differences of clinical and patho-logical features among different age groups and different mass diameter groups.Results:①The median age of thepatients were 44(24,60)years old.The first symptoms were as follows:ovarian mass discovered during physi-cal examination,abdominal pain,bloating,conscious abdominal distension,and symptoms of compression.②The surgical methods were as follows:unilateral oophorectomy(30.5％,95/311),ovarian cystectomy(28.9％,90/311),tumor staging or cytoreductive surgery(28.0％,87/311),total hysterectomy with bilateral adnexectomy(12.5％,39/311).③The pathological types were benign(49.5％,154/311),malignant(31.8％,99/311)and borderline(18.7％,58/311).④ Patients complained abdominal distension in＜20 years old group were signifi-cantly higher than the other two groups(P＜0.05).The ovarian resection rate in the＞50-year-old group was higher than that of the other two groups(P＜0.05),and the rate of unilateral ovarian resection in the＜20-year-old group was still as high as 30.1％(15/49).⑤ The size of the mass correlated with the duration of the disease.When the disease course was between 1 to 6 months,the mass diameter line＞30 cm was the most common(P＜0.05).The incidence of borderline tumors in the＞30 cm group was significantly higher than that in the other two groups,and the difference was statistically significant(P＜0.05).Conclusions:Ovarian mucinous and mucinous borderline tumors are the most common types of giant adnexal masses.The size of the mass tends to increase with the prolongation of the disease course.The incidence of borderline tumors increases with the in-crease of mass.Health education for young people should be strengthened.When abdominal pain,abdominal bloating,especially lower abdominal distension occurs,they should seek medical treatment in time to avoid adnex-ectomy due to borderline tumors.

This study aimed at investigating the effects of Chinese herbal compound Qi Kui granules on urine protein and inflammatory markers in patients with type 2 diabetic nephropathy (DN) based on the treatment of regular western medication.A randomized,parallel controlled method was involved in the present trial,and patients diagnosed with type 2 DN were randomly divided into the Chinese herb group and the control group.Regular treatment of angiotensin Ⅱ receptor blocker (ARB) in western medicine was administered in the two groups with the additional treatment of Qi Kui granules for the Chinese herb group.All the patients revisited the doctor every 4 weeks during the observation period within a 12-week course of the observation.Urinary albumin to creatinine ratio (UACR),urinary albumin excretion rate (UAER) and inflammatory cytokines in the two groups were determined.As a result,seventy-two patients in aggregate were included in the study,while 32 patients of the control group and 31 patients of the Chinese herb group effectively accomplished the observation.After the 12-week treatments,UACR and UAER were significantly decreased in the two groups (P ＜ 0.01),while the efficacy of the Chinese herb group was better than that of the control group (P ＜ 0.05).Compared with the control group,the levels of serum IL-6,tumor necrosis factor α (TNF-α),transforming growth factor f1 (TGF-f1) and urinary monocyte chemoattractant protein (MCP-1) / Cr significantly decreased after the 12-week treatment (P ＜ 0.01).It was concluded that the Chinese herbal compound Qi Kui granules successfully mitigated proteinuria in DN patients.The improvement of glomerular inflammation for renoprotection should be the mechanism behind this.

Objective To explore the effects of knowledge-attitude-practice (KAP) education model on standardization in using dry powder inhaler (DPI) and quality of life among patients with COPD. Methods A total of 120 COPD patients with DPI during follow-up period in Department of Respiratory for Adults at the Second Affiliated Hospital of Wenzhou Medical University were selected as study subjects by convenience sampling from March 2014 to March 2016. They were randomly divided into observation group (n=60,conventional education) and control group (n=60,conventional education + health education based on KAP model). The standardization in using DPI and scores of COPD assessment test (CAT) were compared between two groups before and after intervention. Results Compared with that before intervention,the standardization in using DPI after health education in observation group improved with a significant difference (P< 0.05). There were statistically significant differences in entries except for device handling after medication between two groups after health education (P<0.05). Scores of CAT of both group after health education were significantly lower than those before intervention (P<0.05). The score of CAT in observation group was lower than that in control group after health education with a significant difference (P<0.05). Conclusions The health education based on KAP model can significantly improve the standardization in using DPI among COPD patients. It can also make family members understand a lot of disease-related knowledge so as to establish confidence to overcome disease,improve coping capacity of disease and quality of life.

OBJECTIVETo profile the clinicopathologic features of a series of grey zone lymphoma (GZL) cases with hybrid features of diffuse large B-cell lymphoma (DLBCL) and classical Hodgkin lymphoma (CHL), with a purpose to gain an in-depth understanding of the borderline B-cell neoplasm.

METHODSThe clinical, morphologic and immunophenotyical characteristics of 16 cases were retrospectively analyzed.

RESULTSThe patients were mostly male adults, with a male to female ratio of 1.7: 1.0 and a mean age of 40.2 years. Eight patients presented with peripheral nodal lesions and five cases with mediastinal involvement. Histologically and immunophenotypically, the 16 cases were classified into three sub-categories. In 4 cases, the morphologic features resembled CHL more closely, but the neoplastic cells showed uniform and intense positive staining of CD20 (pattern 1). Although the initial impression of the other 8 cases was that of DLBCL, the expression levels of CD20 and PAX5 were variable, and CD30 or CD15 was positive (pattern 2). A characteristic feature of pattern 3, observed in the remaining 4 cases, demonstrated a broad spectrum of morphology with hybrid features of both CHL and DLBCL. The neoplastic cells in pattern 3 were positive for CD20, CD30 and CD15. EBV-LMP1 was detected in 6 of the 11 tested cases. Clinically, most patients with GZL seemed insensitive to immuno-chemotherapy of the R-CHOP regimen.

CONCLUSIONSThe diagnostic criteria for GZL with features intermediate between DLBCL and CHL is proposed by the three histologic patterns commonly seen in these lesions. Cases presented with peripheral lesions might differ from those with mediastinal presentation pathologically. At current time, there is no effective treatment for these borderline B-cell lymphomas and the prognosis is poor.

Adolescent ; Adult ; Aged ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antigens, CD20 ; metabolism ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Female ; Hodgkin Disease ; drug therapy ; metabolism ; pathology ; Humans ; Ki-1 Antigen ; metabolism ; Lewis X Antigen ; metabolism ; Lymphoma, Large B-Cell, Diffuse ; drug therapy ; metabolism ; pathology ; Male ; Middle Aged ; PAX5 Transcription Factor ; metabolism ; Prednisone ; therapeutic use ; Prognosis ; Retrospective Studies ; Rituximab ; Vincristine ; therapeutic use ; Viral Matrix Proteins ; metabolism ; Young Adult

Objective To survey the state of internet addiction of vocational college students and explore the effect of perceived social support and loneliness on Internet addiction.Methods In accordance with random cluster sampling,this research used the Revised Chen Internct Addition Scale,Perceived Social Support scale,and UCLA Loneliness Scale to study lnternet addiction among a total of 1 602 vocational college students from three higher vocational colleges in Guangzhou.Results [nternet addiction rate was 9.87％,and Internet dependence rate was 24.78％.Internet addiction had a higher incidence rate among male students than that among female students (x2=19.775,P＜0.01).The perceived social support group of vocational college students was low,which indicated serious loneliness based on the Loneliness Scale,and their scores on Internet addiction tendency were higher than those of other groups (P＜0.01).The total scores in Internet addiction tendency and perceived social support were negative (r=-0.183,P＜ 0.01),which indicates positive correlation with loneliness (r=0.243,P＜ 0.01).The mediating effect of perceived social support and Internet addiction on loneliness was significant,with a mediation rate of 69.63％.Conclusion Internet addiction tendency of vocational college students is a problem that deserves more attention.Low social support and loneliness can increase the incidence rate of internet addiction tendency.Loneliness is also found to be a strong predictor of internet addiction.

Objective To investigate the impact of maternal health education on the mode of delivery and pregnancy outcome. Methods All 385 pregnant women had been chosen, were randomly divided into observation group of 194 cases and control group of 191 cases,of which 24 cases exit off observation group,27 cases exit off the control group,included the observation group of 170 cases and the control group of 164 cases, the observation group used stages of maternal health education, control group used conventional health education. Results The evaluation of health knowl-edge scores in observation group were significantly higher, the number of prenatal significantly more than the control group,complete check-rate rate were significantly higher(P<0.05).The vaginal delivery rate in observation group were significantly higher than control group,cesarean section own volition choose the ratio in observation group were signifi-cantly lower than the control group(P<0.05). The incidence of adverse pregnancy outcomes between groups were signifi-cantly different(χ2=4.242,P<0.05),in which the observation group gestational diabetes,preterm birth were significantly higher incidence of postpartum hemorrhage, lactation period were significantly less than the control group, nursing satisfaction were significantly higher(P<0.05). Conclusion Maternal health education helps to improve maternal health and prenatal knowledge of the number of times to reduce the cesarean section rate, reduce the incidence of adverse pregnancy outcomes.

Objective To observe the efficacy of medical invisible antimicrobial film to treat Ⅱ/Ⅲpressure sores .Methods Sixty patients who were infected stage Ⅱand stage Ⅲ of pressure ulcer were divided into two equal groups-treatment group and control group .After usual wound treatment , the patients in treatment group were given medical invisible antimicrobial film; while the patients in control group were used for Mabel score stickers.Results The total efficacy of the two groups was 29 cases (Z=-0.565, P>0.05).The treatment time for stage Ⅱand stage Ⅲ pressure ulcers of experimental group were (4.05 ±1.89) days and (8.73 ±1.60) days, respectively.As for control group, the treatment time of stage Ⅱand stage Ⅲ pressure ulcers were (7.89 ±1.99) days and (15.75 ±2.18) days, respectively.The differences were statistically significant (t=-5.740, -8.243; P<0.01).The frequency of changing fresh dressing for a wound was (5.82 ±1.24) times in the treatment group and (9.97 ±2.58) times in the control group, and the difference was significant ( t =-6.396, P <0.01 ).The treatment cost of experimental group was ( 184.21 ± 21.49) yuan, which was significantly lower than (491.41 ±79.92) yuan in the control group (t=-29.972, P<0.01).Conclusions The effect of medical invisible antimicrobial film treatment of pressure sores is significant, and the treatment course is shorter with lower cost.It is worthy of enhancing in the clinical situations.

Objective To profile the clinicopathologic features of a series of grey zone lymphoma (GZL) cases with hybrid features of diffuse large B-cell lymphoma ( DLBCL) and classical Hodgkin lymphoma (CHL), with a purpose to gain an in-depth understanding of the borderline B-cell neoplasm. Methods The clinical, morphologic and immunophenotyical characteristics of 16 cases were retrospectively analyzed.Results The patients were mostly male adults , with a male to female ratio of 1.7∶1.0 and a mean age of 40.2 years.Eight patients presented with peripheral nodal lesions and five cases with mediastinal involvement .Histologically and immunophenotypically , the 16 cases were classified into three sub-categories.In 4 cases, the morphologic features resembled CHL more closely , but the neoplastic cells showed uniform and intense positive staining of CD 20 ( pattern 1 ) .Although the initial impression of the other 8 cases was that of DLBCL , the expression levels of CD 20 and PAX5 were variable , and CD30 or CD15 was positive (pattern 2).A characteristic feature of pattern 3, observed in the remaining 4 cases, demonstrated a broad spectrum of morphology with hybrid features of both CHL and DLBCL .The neoplastic cells in pattern 3 were positive for CD20, CD30 and CD15.EBV-LMP1 was detected in 6 of the 11 tested cases.Clinically, most patients with GZL seemed insensitive to immuno-chemotherapy of the R-CHOP regimen.Conclusions The diagnostic criteria for GZL with features intermediate between DLBCL and CHL is proposed by the three histologic patterns commonly seen in these lesions .Cases presented with peripheral lesions might differ from those with mediastinal presentation pathologically .At current time , there is no effective treatment for these borderline B-cell lymphomas and the prognosis is poor .

Objective To evaluate the short-term and long-term efficacy of conservative laparoscopic surgery combine with goserelin in treatment of severe ovarian endometriosis.Methods From January 2004 to December 2008,206 patients with severe ovarian endometriosis underwent laparoscopy surgery in Nanjing Drum Tower Hospital,Affiliated Nanjing University Medical School were enrolled in this retrospective study.According to the revised classification American Fertility Society (r-AFS), 123( 123/206,59.7％ ) cases were at stage Ⅲ and 83 ( 83/206,40.3％ ) patients were at stage Ⅳ.Among 138 cases presented pelvic pain.All the patients underwent laparoscopic cystectomy,of which 117 patients with childbearing preserving underwent hysteroscopy and hydrotubation examination,including 7 cases with bilateral salpingectomy,2 cases with bilateral tubal obstruction and 108 cases with normal reproduction.After surgery,all cases were administered by goserelin treatment at dose of 3.6 mg per 28 days for 3 to 6 months.At 1 to 5 years following up,pelvic pain,pregnancy and recurrence were observed,those factors associated with pregnancy rate and endometriosis recurrence were analyzed.Results (1)Pelvic pain:complete remission rate of pelvic pain was 76.1％ ( 105/138 ) at 1 to 5 years after surgery.(2) Pregnancy:total pregnancy rate was 70.4％ (76/108),spontaneous pregnancy rate was 68.8％ (66/96) and pregnant rate of in vitro fertilization and embryo transfer (IVF-ET) was 10/12.Pregnancy rate at 1 year was 57.3％( 55/96 ) and accounting for 83.3％ ( 55/66 ) in all pregnant womon.Live birth rates of spontaneous pregnant and IVF-ET were 86.4％ ( 57/66 ) and 9/10,respectively.( 3 ) Recurrence:the total recurrence rate was 8.3％ ( 17/206 ) at 1 to 5 years.The recurrence rates and the cumulative recurrence rates were 3.9％(8/206) and 3.9％ (8/206) at the first year after operation,2.0％ (3/149)and 6.7％ ( 10/149 )at the second year,1.0％ (1/99) and 8.0％ (8/99) at the third year,10.9％ (5/46)and 17.4％ (8/46) at the fourth year,0 and 2/18 at the fifth year,respectively.Conclusion It was suggested that conservative laparoscopic surgery combined with goserelin in treatment of stage Ⅲ or Ⅳ ovarian endometriosis could reduce the recurrence risk of severe ovarian endometriosis and improve the pregnant rate of endometriosisassociated infertility.