Objective: To study the clinical pathological characteristics, immunophenotype, molecular changes and prognosis of the papillary renal neoplasm with reverse polarity (PRNRP). Methods: Nine cases of PRNRP, diagnosed from 2013 to 2019, were retrieved from the Department of Pathology of Nanjing Jinling Hospital, Nanjing University School of Medicine. Histomorphology, immunophenotype and molecular genetics were analyzed with review of the literatures. Results: There were five male and four female patients, aged from 49 to 70 years, with an average age of 60.1 years. During a mean follow-up of 29 months, one patient died for other cause, and the others survived without disease. Microscopically, the tumor cells arranged in papillary structure with a fibrovascular core, the surface of which was covered with a single layer of cuboidal or columnar cells. The most prominent feature was that the tumor nuclei located at the top of the cytoplasm far from the basement membrane, and they were monotonous in size and arranged neatly with no or few nucleoli. Immunohistochemically, all nine cases of PRNRP showed diffuse positive expression of CK7 and E-cadherin, various degrees of P504s expression, and no expression of CD10 and CD117, with a Ki-67 index of 1%-3%. Unlike other papillary renal cell carcinoma, the nine cases of PRNRP all showed characteristic positive expression of GATA3. The fluorescence in situ hybridization assay showed that the majority of PRNRPs (8/9) did not have triploids on chromosomes 7 and 17. The sequencing of the KRAS gene confirmed the presence of a nonsense KRAS mutation in 8 of the 9 cases. Conclusions: PRNRP is a subtype of papillary renal cell carcinoma with characteristic morphological, immunophenotypic and molecular features, and indolent behaviors. More data are needed to define PRNRP as "carcinoma", and a definitive diagnosis of PRNRP is of great significance for proper treatment choice and accurate prognostication.
Biomarkers, Tumor ; Carcinoma, Renal Cell/genetics* ; Female ; Humans ; In Situ Hybridization, Fluorescence ; Kidney ; Kidney Neoplasms/genetics* ; Male ; Middle Aged ; Prognosis

Humans ; Liposarcoma/genetics* ; Liposarcoma, Myxoid/genetics* ; Transcription Factor CHOP/genetics*

Objective: To establish a metabonomics research technique based on the combination of

Trauma is the leading cause of death for people under 40 years old in the world. At present, the rescue and treatment system of trauma patients in China is not yet well established, and the mortality of trauma patients is higher than those in the developed countries. Improving the treatment system is the key to reducing the trauma mortality. In order to innovate the service mode of trauma first aid, further promote the establishment of regional trauma first aid system, improve the ability of trauma treatment, reduce the mortality and disability rate of trauma patients in Jiangxi Province, recently Health Commission of Jiangxi Province and the First Affiliated Hospital of Nanchang University have reached a consensus on the establishment of Jiangxi trauma first aid center. In order to provide reference for the construction of trauma treatment system, the author analyzes the following aspects including functional positioning, basic requirements, organization management, and evaluation of core indicators.

Aim To prepare evodiamine butyryl deriva-tive (EBD) and evodiamine butyryl derivative-loaded solid lipid nanoparticles (EBDLN), and study its re-lease in vitro,and to investigate its in situ gastrointesti-nal absorption. Methods EBD was prepared by a one-step synthetized method, and then EBDLN was prepared by a film dispersion method. Dynamic dialy-sis was used to evaluate drug release in vitro,and sin-gle-pass gastrointestinal perfusion was employed to study the gastrointestinal absorption of EDM,EBD and EBDLN. Results In identical release media, there were identical drug release tendencies of EBD and EB-DLN, but the release rate of EBDLN was faster than EBD. Compared with EDM and EBD, the Kavalues and Pappvalues of EBDLN in every perfusion segment increased significantly. The Kaof EBDLN in stomach, duodenum, jejunum, ileum and colon was 110.14-fold,56.70-fold,51.23-fold,45.70-fold and 127.23-fold of free EDM respectively. The Pappvalue of EB-DLN was 9.74-fold, 4.48-fold, 3.82-fold and 11.3-fold of that of free EDM. Conclusion EBDLN has sustained effect and can enhance the gastrointestinal absorption of EDM and EBD.

Objective To investigate the evaluation ways and effects of swallowing function after cricohyoidoepiglottopexy(CHEP). Methods Selected 92 patients of glottic carcinoma who were admitted into hospital from February 2014 to January 2017,and all the patients were given cricohyoidoepiglottopexy(CHEP)therapy and function reconstruction.Modified barium swallow(MBS),modified penetration as-piration scale(MPAS),and fiberoptic endoscopic evaluation of swallowing(FEES)were applied after the surgery.And the prognosis of patients was followed up.Results There was one patient who was not able to extubate,and the extubation time of tracheaostomy tube and stomach tube were respectively(12.04 ±5.42)week and(8.00 ±2.19)d among the remaining 91 cases.Three months after operation,the laryngeal function were good in 84 cases,moderate in 6 cases and poor in 2 cases,the incidence of complications was 6.5%.The fundamental frequency and fundamental frequency perturbation three months after operation were significantly lower than thos before operation(P<0.05). With the extension of postoperative time,the MPAS score of patients with MBS and FEES evaluation were obviously decreased(P<0.05). The MBS assessment score were respectively(3.87 ±0.98)points,(1.64 ±0.65)points,(1.09 ±0.33)points at 15 days,30 days and 60 days after operation.The FEES evaluation score were respectively(3.27 ±1.33)points,(1.73 ±1.11)points,(1.18 ±0.89)points at 15 days,30 days and 60 days after operation.With the MBS assessment as the gold standard,the sensitivity of FEES assessment to normal,false aspiration and aspiration were 100%,76.7%and 86.7%,respectively,and the specificity were 86.7%,97.1% and 98.3%,respectively. Conclusion The cricohyoidoepiglottopexy and laryngeal defect repair in the treatment of glottic carcinoma can effectively preserve the laryn -geal function,reduce the incidence of postoperative complications,improve pronunciation function,and the FEES and MBS evaluation of laryn-geal function have good accuracy,and they have good clinical significance to understand the degree of postoperative aspiration.

Objective To compare the MRI features of focal nodular hyperplasia (FNH) and inflammatory hepatocellular adenoma (Ⅰ-HCA),with an aim to improve the diagnostic accuracy in the two lesions.Methods Patients who underwent dynamic-enhanced MRI with histopathologically confirmed FNHs (21 patients with 21 tumors) and Ⅰ-HCAs (10 patients with 12 tumors) were included in this retrospective study.The clinical and the imaging features,including the T2-and T1-weighted,diffusion weighted images,and the dynamic enhanced imagings were analyzed.Results No significant difference was observed in the clinical data between the 2 groups of patients,except in the serum levels of C-reactive protein.The serum C-reactive protein levels were significantly elevated in Ⅰ-HCA than in FNH.Significant differences between patients with FNHs and Ⅰ-HCAs were also found in the morphologic findings and the signal intensities (including shape,centre scar,necrosis,signal intensity of T2WI and DWI,and lesion signal intensity compared to those of the liver in the portal venous phase and delayed phase).The differences in lesion to liver signal in FNH were significantly lower than those in Ⅰ-HCA in the T2WI and the delayed phases.The area under the curve (AUC) for the 2 groups of patients were 0.843 and 0.743,respectively,with no significant difference between them.Conclusions The MRI appearances of atypical FNHs overlapped with Ⅰ-HCA.MRI features of isointensity on T2 Wl and DWI,and isointensity to the liver in the delayed phase were valuable to differentiate FNHs from Ⅰ-HCAs.Most Ⅰ-HCAs showed moderate and marked high signal intensity on T2WI and DWI.These features,when combined with an elevated serum C-reaction protein,necrosis in the lesion and hyperintensity in the delayed phase,were valuable in differentiating Ⅰ-HCAs from FNH.

Objective To investigate the variations of elastic modulus and hardness of human dentin with aging and location.Methods The non-carious third molars were collected and divided into youth group,middle-aged group and elderly group.Nanoidentation test was conducted on the dentin specimens from multiple regions to test their mechanical properties.Results The elastic modulus and hardness in outer and middle dentin were greater than those in inner dentin;the elastic modulus and hardness increased with the aging in each region of the dentin.Conclusions The dentin shows a gradient mechanical property.The stiffness and hardness in middle and outer dentin are greater than those in inner dentin.The deformation resistance in middle and outer dentin is stronger than that in inner dentin.Meanwhile,elastic modulus and hardness of the dentin increase with the aging.

Objective To investigate the variations of elastic modulus and hardness of human dentin with aging and location. Methods The non-carious third molars were collected and divided into youth group, middle-aged group and elderly group. Nanoidentation test was conducted on the dentin specimens from multiple regions to test their mechanical properties. Results The elastic modulus and hardness in outer and middle dentin were greater than those in inner dentin; the elastic modulus and hardness increased with the aging in each region of the dentin. Conclusions The dentin shows a gradient mechanical property. The stiffness and hardness in middle and outer dentin are greater than those in inner dentin. The deformation resistance in middle and outer dentin is stronger than that in inner dentin. Meanwhile, elastic modulus and hardness of the dentin increase with the aging.

Objective To analyze the contact failure of monolithic lithium disilicate CAD/CAM crowns by experiment and numerical simulation, and explore the influences of adhesives aging in water on load-bearing capacity of the crowns. Methods The specimens of sectioned monolithic lithium disilicate crowns were designed and manufactured, and evenly divided into two groups and stored in the air and in the distilled water for 30 days, respectively. The specimens were then subjected to monotonic contact loads to compare and analyze their load-bearing capacity. The fractured surfaces and adhesive interfaces of the specimens were observed by scanning electronic microscope. Meanwhile, the stress distribution on the crowns was calculated by numerical simulation to analyze the adhesives aging influence on load-bearing capacity of the crowns. Results The fracture loads on crowns stored in the air and in the water were (561.51 ± 65.66) N and (398.09 ± 90.20) N, respectively, indicating a significant difference. The tensile stress increased considerably at lower surface of the ceramic crown due to the reduction of adhesive strength at the interface of ceramic crown and substrate, which could increase the propensity of contact failure. Conclusions The adhesives aging in water reduces the bonding strength, and accordingly changes the tensile stress distributions, which can lower the load bearing capacity of the lithium disilicate crowns. The research finding provides references for the design and manufacturing of all-ceramic CAD/CAM restored crowns in clinic.