Search

新型HER2抗体耦联药物对于HER2低表达晚期乳腺癌显示出良好的临床获益，HER2低表达指的是免疫组织化学检测HER2 1+或HER2 2+且原位杂交未扩增。HER2低表达的准确检测，不仅为乳腺癌治疗提供新的机遇，也为HER2精准的病理检测带来挑战。本文基于HER2低表达概念的提出，就HER2检测前、检测中及检测后应注意的问题，HER2低表达的异质性及人工智能辅助判读的进展展开讨论，以期促进HER2低表达病理检测的标准化和规范化。.

随着冠状动脉血流储备分数（FFR）的问世与普及，冠心病介入治疗已从冠状动脉造影指导的解剖学时代进入功能学时代。冠状动脉功能学评估可以提高介入治疗的精准性，但FFR的使用也带来了手术时间延长、操作并发症以及医疗费用增加等其他问题。近年来，新兴的无导丝冠状动脉功能学评估技术——定量血流分数（QFR）不需要额外介入操作和使用腺苷等药物诱导冠状动脉充血，评估时间更短，经过多项研究的验证与FFR具有较好的一致性。该文就QFR的对比验证和临床应用研究进展进行综述。.

中肾管癌是一种罕见的女性生殖道恶性肿瘤，目前认为起源于退化的中肾管残件，常与中肾管增生相关，其最常见的发生部位是子宫颈，其他部位（阴道、子宫体、卵巢门及阔韧带等处）也可发生。发生于子宫内膜，组织学形态类似于中肾管癌的中肾样癌的病例报道极罕见，本文报道子宫内膜中肾样癌1例。.

BackgroundAdvanced maternal aging has become a worldwide public health issue that contributes to female fertility decline and significant risk to embryo development. Despite transcriptional and epigenetic alterations reported in oocyte maturation and development, the dynamics of gene expression and DNA dynamics associated with aging remain elusive. Here we generated simultaneous transcriptome and methylome profiles of mouse oocytes during aging and maturation at single-cell and single-base resolution to examine key biological processes and identify the key targets for novel treatment options.ResultsWe report the dynamics in transcriptome and DNA methylome in mouse oocytes during maternal aging and oocyte maturation. Age-associated gene expression changes showed mitochondrial dysfunction in GV oocytes and defects of chromosome segregation and spindle assembly in MII oocytes. EIF2 signaling protein synthesis pathway was also impaired during aged oocyte maturation. Moreover, distinctive DNA methylation patterns were demonstrated during maternal aging in GV and MII oocytes. A positive correlation between gene expression and methylation in gene body was characterized. Furthermore, we identified several promising biomarkers, including IL-7, to assess oocyte quality, which are potential therapeutic targets for improve oocyte maturation. More importantly, we built the first mouse oocyte maturation and age prediction model using transcriptome data and validated its feasibility in published data.ConclusionsThis work provides a better understanding of molecular and cellular mechanisms during mouse oocyte aging, points a new direction of oocyte quality assessment, and paves the way for developing novel treatments to improve oocyte maturation and quality in the future.

第5版WHO乳腺肿瘤分类已于2019年底正式出版，本文就新版分类中的主要更新内容进行解读。内容主要涉及新版WHO乳腺肿瘤分类的总体情况，以及浸润性癌、非浸润性癌、上皮-肌上皮肿瘤和纤维上皮性肿瘤内容的更新。.

报道1例伴有YWHAE基因易位的高级别子宫内膜间质肉瘤（HGESS）。患者女，36岁。子宫后壁肿物局部切除术后复发，肿瘤形态及分子病理学改变均具有特征性。伴有YWHAE基因易位的HGESS是一种独立性疾病，明确诊断该病有重要的临床病理学意义。.

PROBLEM A reference range for uterine natural killer (uNK) cell density in the peri-implantation period has recently been established in natural cycles. However, it is uncertain whether the results can be applied to hormonal replacement therapy (HRT) cycles, used increasingly in frozen-thaw embryo replacement cycles and which is known to be capable of supporting implantation. METHOD OF STUDY A total of 183 women from two IVF centers participated in this study, including 75 women in natural cycles and 108 women in HRT cycles. All endometrial biopsies were collected precisely on the putative day of embryo implantation, namely 7 days after LH surge (LH+7) of the natural cycles or 5 days after initiation of progesterone (P+5) of the HRT cycles. Endometrial sections were immunostained for CD56 for uNK cells. Cell counting was performed by a standardized protocol, and results were expressed as percentage of positive uNK cells/total stromal cells. RESULTS There was no significant difference (P > 0.05) in uNK cell density between natural cycles (median 2.28%, range 0.99%-4.78%) and HRT cycles (median 2.55%, range 0.69%-5.02%) in women undergoing IVF-ET treatment on the putative day of blastocyst transfer. Using reference range from 1.2% to 4.5% for uNK cell density, there was no significant difference (P > 0.05) in high uNK cell density proportion between natural cycles (8%, 6/75) and HRT cycles (10.2%, 11/108). CONCLUSION The results indicated that the reference range for uNK cell density derived from natural cycles may apply to HRT cycles.

患者女，53岁，因发现"右乳肿块1个月余"就诊。肿物直径约1.3 cm，灰白色，质韧。镜下病变界尚清，2/3的区域为硬化性腺病，另1/3的区域硬化性间质中杂乱分布着小腺管以及鳞状分化细胞巢，鳞化细胞巢多呈实性条索状，部分形成大小不等的角化囊肿；病变细胞形态温和，核分裂象罕见，并见淋巴细胞聚集灶，局灶浸润周围组织。免疫组织化学显示该区域内大部分细胞巢周围缺乏p63、calponin及CD10染色，部分鳞状分化巢CK5/6和p63阳性，诊断为乳腺硬化性腺病基础上的低级别腺鳞癌。.

自中国《乳腺癌HER2检测指南（2014版）》颁布以来，关于乳腺癌的HER2临床实践及研究出现了不少新的进展。我国乳腺癌HER2检测指南编写组以2014版指南为基础，结合相关领域的更新在本期发布了《乳腺癌HER2检测指南（2019版）》，旨在提高乳腺癌HER2检测和判读的准确性，以更好地适用于临床。本文拟对2019版指南更新的背景及重点更新内容做进一步的解读和讨论。.

SUMMARYToxocariasis is a very prevalent zoonotic disease worldwide. Recently, investigators have focused more on Toxocara spp. seroprevalence in humans. Information regarding Toxocara seroprevalence in people from different ethnic backgrounds in China is limited. For this study, blood samples were collected from a total of 802 Han, 520 Korean, 303 Manchu, and 217 Mongol subjects from Jilin and Shandong provinces. The overall Toxocara seroprevalence was 16·07% (14·21% Han, 20·58% Korean, 11·22% Manchu, 18·89% Mongol). Living in suburban or rural areas, having dogs at home, exposure to soil, and consumption of raw/undercooked meat were risk factors for Toxocara infection. Exposure to soil was identified as the major risk factor for Toxocara seropositivity in all of the tested ethnicities. To the best of our knowledge, this is the first report concerning Toxocara infection in Manchus and Mongols in China. The present study provided baseline data for effective prevention strategies of toxocariasis in northeast China and recommends improvements in personal hygiene standards to achieve this goal.

乳腺不典型妊娠样增生是一种极为少见的乳腺病变，国内外报道甚少，现报道1例。中年女性患者，体检时发现左乳肿块，影像学检查提示左乳占位性病变，伴有不定形钙化BI-RADS 4B级。临床诊断：左乳腺病伴纤维腺瘤，遂行左乳肿块切除。大体检查可见一粗糙颗粒区，光镜下该病变局限于乳腺小叶内，与囊性高分泌性增生合并存在，部分腺上皮细胞核轻度增大，核仁明显，核质比轻度升高，有异型性，可见少量核分裂象，诊断为乳腺不典型妊娠样增生。.

Foamed propellants based on polymer bonded nitramine explosives show high burning rates due to their porous structure and showed great potential for combustible cartridge case. Thus, the in-depth study of the co-combustion behavior of the foamed propellant and matching propellant is necessary. In this paper, closed bomb tests were used to study the co-combustion performance of nitramine propellant (RGD7) and surface coated nitramine propellant (SC-RGD7) mixed with foamed propellant. The influence of foamed propellant’s proportion in mixed charges on the combustion behavior was studied and analysed. It was found that the maximum dynamic vivacity and the value of B at maximum dynamic vivacity of mixed charge increased with the increase of added foamed propellant, resulting in better combustion progressivity. Meanwhile, the ignition delay of foamed propellant influenced the first stage of combustion, and the penetration combustion of foamed propellant influence the middle stage.

Summary Background Clearance of hepatitis B surface antigen (HBsAg) indicates clinical control of hepatitis B virus (HBV) infection. However, little is known about the impact of viral genomic variations on HBsAg loss. Methods We explored the association between viral genomic factors and HBsAg loss in 2121HBeAg-negative patients. HBV pre-core stop codon (1896) and basal core promoter (BCP) (1762/1764) sequences were determined in patients with HBV DNA ≥200 IU/mL (N = 1693). The effect of HBV genotype on HBsAg loss was further validated in the whole cohort of 3445 HBsAg carriers. Results The cumulative lifetime (age 28–75 years) incidence of HBsAg loss was 50.4% in 2121 HBeAg-negative patients. We found that genotype C, but not pre-core stop codon or BCP mutants, was associated with HBsAg loss. Compared to genotype B patients, genotype C patients had higher lifetime chance of HBsAg loss, with hazard ratio of 1.8 (95% confidence interval: 1.4–2.4). Multivariable analysis showed that male sex, elevated ALT levels, lower serum HBV DNA and HBsAg levels, and genotype C infection were associated with higher chance of HBsAg loss independently. We then performed sensitivity analysis, which re-included HBeAg-positive, cirrhotic and treatment-experienced patients, and confirmed the robustness of our results in 3445 HBsAg carriers. Conclusion Genotype C infection, compared to genotype B, is associated with a higher lifetime chance of HBsAg loss in Asian HBV carriers.

BACKGROUND Fibrosis-4 index (FIB-4) is a surrogate marker for hepatic fibrosis in hepatitis B virus (HBV) carriers. AIM To investigate whether FIB-4 index stratifies the risks of adverse liver events. METHODS A total of 2075 treatment-naive, noncirrhotic the patients with chronic HBV infection were included. Most of them (82.1%) were HBeAg-negative patients and their baseline FIB-4 levels were explored to stratify the risks of cirrhosis, cirrhosis-related complications and liver-related mortality. RESULTS During a mean follow-up period of 15.47 years, we found a higher baseline FIB-4 index was associated with increased incidence rates of cirrhosis in addition to the common host and viral factors. Patients with FIB-4 >1.29, compared to those with FIB-4

Background: There has been an increasing rate of synchronous bilateral breast cancers, mainly because of the increased morbidity, improved detection abilities, better prognosis and higher life expectancy of breast cancer patients. However, evidences in the literature regarding the risk factors of bilateral breast cancers are scare, and the survival of synchronous bilateral breast cancers still remain controversies. The purpose of the present study is to investigate the risk factors and prognosis of bilateral breast cancers in a Chinese cohort. Methods: The present study included 181 patients with synchronous bilateral breast cancer and 10,831 patients with unilateral breast cancer treated in Fudan University Shanghai Cancer Center between Jan 2007 and Dec 2012. Patients with metastases or inflammatory diseases, or metachronous bilateral breast cancer (after 6 months of first cancer) were excluded. Age of the cases, family history, menopausal status, histology types, pathological stages, types of accompanied benign lesions, and patterns of surgeries and adjuvant therapies were examined to investigate the risk factors of bilateral breast cancers. Results: Patients with synchronous bilateral breast cancer were significantly elder than those with unilateral breast cancer (mean age 53 yrs vs. 51yrs, p Conclusion: The rate of synchronous bilateral breast cancer was higher in patients with sclerosing adenosis or lobular carcinoma component. The prognosis for early-stage synchronous bilateral breast cancer was similar to those with early-stage unilateral breast cancer. However, among patients with N3 disease or previously received neoadjuvant therapy, synchronous bilateral cohort was associated to worse survival compared with unilateral cohort. Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P5-13-09.

To analyze the impact of the revised 2013 American Society of Clinical Oncology/College of American Pathologist(ASCO/CAP)HER2 testing guidelines on the status of HER2 and its clinical significance in invasive breast cancers by fluorescent in situ hybridization(FISH).One thousand seven hundred and eighty invasive breast cancer cases with equivocal 2+ immunostaining detected by FISH were retrospectively selected from 2010 to 2014, and the HER2/CEP17 dual-probe results were evaluated according to both the 2007 and 2013 ASCO/CAP guidelines for comparative analysis.Among the 1 780 IHC HER2 (2+ ) invasive breast cancers, the number of HER2 positive, equivocal and negative case were 310(17.41%), 66(3.71%)and 1 404(78.88%) respectively, basing on the 2007 guidelines; whereas basing on the 2013 ASCO/CAP HER2 guidelines, the number of HER2 positive, equivocal and negative case was 360 (20.22%), 182 (10.23%)and 1 238 (69.55%) respectively. Compared with the 2007 guidelines, the proportion of positive and equivocal cases were higher in the 2013 guidelines (17.41% versus 20.22%, 3.71% versus 10.23% respectively), while the proportion of negative cases was lower(78.88% versus 69.55%).Using the 2013 ASCO/CAP guidelines could lead to an increase in positive and equivocal cases, and a decrease in negative cases. The increase can probably be attributable to the inclusion of HER2 copy number besides HER2/CEP17 ratio as positive criteria, and it improves the accuracy and may be of important value for screening more population who benefit from HER2 targeting treatment; however the benefits for HER2 positive with low HER2 copy number and the clinical significance of the equivocal cases need to be further investigated.

The aim of this study is to evaluate the safety and efficacy of partial pancreatectomy as part of primary cytoreductive surgery in advanced epithelial ovarian cancer (EOC).A total of 8 patients were recruited in this study who underwent partial pancreatectomy during the primary cytoreductive surgeries for advanced EOC in Fudan University Shanghai Cancer Center from April 2009 to July 2015. Their clinicopathological characteristics, diameter of metastatic tumors, the scope of cytoreductive surgeries, residual diseases after cytoreductive surgeries, postoperative complications and survival situation were retrospective analyzed.(1) Clinicopathological characteristics: the median age of these patients was 58 years old (range: 39-63 years old) . The median value of preoperative serum CA125 was 1 688 kU/L (range: 119-5 000 kU/L) . The median diameter of metastatic tumors involved in pancreatic body or tail was 4.5 cm (range: 3-10 cm). All the tumors from the 8 patients were confirmed to be high-grade serous carcinoma. Four patients were staged as International Federation of Gynecology and Obstetrics (FIGO) Ⅳ, and the other 4 patients were staged as FIGO Ⅲc. (2) Tumor metastases and the scope of cytoreductive surgeries: all of these 8 patients had widely disseminated ovarian cancer, with involvement of upper abdominal, middle abdominal and pelvic cavity. Each patient underwent extensive intra-abdominal cytoreductive surgeries, including hysterectomy, bilateral salpingo-oophorectomy, omentectomy, pelvic peritonectomy, splenectomy, partial pancreatectomy. Each patient had cytoreductive surgeries of 9.6 different sites on average. Of all 8 patients who underwent partial pancreatectomy, 7 patients had pancreatic tails removed; the other 1 patient had pancreatic body and tail removed. The median volume of blood loss during surgery was 1 350 ml (range: 300-3 500 ml) , blood transfusion was performed in 7 patients with the median volume of 1 150 ml (range: 500-1 800 ml). (3) Residual diseases after cytoreductive surgeries: optimal cytoreduction was achieved in all patients, with microscopic residual disease in 3 patients, residual tumors diameter0.5 cm in 3 patients, and residual tumors diameter between 0.5 and 1 cm in 2 patients. (4) Postoperative complications: 4 patients suffered from complications including pancreatic leakage (2/8), intraperitoneal hemorrhage (1/8) and pancreatic pseudocyst accompanied by infection (1/8). These complications were treated successfully by conservative managements. (5) Survival situation: during the median follow-up duration of 17 months (ranged from 2 to 46 months), 5 patients were still alive until the end of follow-up, including 4 cases under treatment and 1 case survived 29 months without relapse after treatment. Three patients were respectively died in 5, 20 and 46 months after surgery.There is a higher risk of postoperative complications of pancreas resection as part of primary cytoreductive surgery in advanced epithelial ovarian cancer, but the resection of pancreatic metastases and part of the pancreas is feasible and necessary.

To study the expression of mismatch repair protein in a series of endometrial carcinomas and its correlation with clinicopathologic features.The clinical data of 150 consecutive cases of endometrial carcinoma were collected during the period from December, 2014 to August, 2015 in Fudan University Cancer Center. Morphologic features including tumor infiltrating lymphocytes (TIL), peritumoral lymphocytes and tumor heterogeneity were reviewed. Immunohistochemistry for expression of mismatch repair proteins was performed. The correlation with clinicopathologic features was analyzed.Loss of mismatch repair protein expression was observed in 43 cases (28.7%), including loss of MLH1/PMS2 in 27 cases (18%), loss of MSH2/MSH6 in 7 cases (4.7%), loss of MSH6 in 6 cases (4%) and loss of PMS2 in 3 cases (2%). There were 23.3% and 27.1% of mismatch repair protein-deficient endometrial carcinomas in women under and above 50 years of age, respectively, which was not statistically significant. Amongst the 12 cases with family history of tumors, 4 of the 6 mismatch repair protein-deficient cases were under 50 years of age, which was higher than that in the 6 cases with mismatch repair protein expression (P=0.014). The mismatch repair protein-deficient group showed significantly more prominent TIL and peritumoral lymphocytes than protein-expression group (P=0.033 and0.001). Moreover, there were also significant differences in depth of myometrial invasion and occurrence of synchronous malignancy (2 cases of ovarian clear cell carcinoma and 1 case of colonic carcinoma) between the two groups (P=0.039 and 0.022). However, there were no significant differences in lymph node metastasis, tumor heterogeneity, lower uterine segment involvement and tumor stage between the two groups.Prominent TIL and peritumoral lymphocytes characteristically occur in mismatch repair protein-deficient endometrial carcinomas. Patient age does not significantly correlate with the loss of mismatch repair protein expression, but individuals under 50 years of age are more likely to have no expression if there is family history of tumors.

To study the morphologic features, immunophenotype and significance of expression of JAZF1-SUZ12 and YWHAE-FAM22 fusion genes in endometrial stromal sarcoma (ESS).Fifty-three cases of ESS were retrieved and the pathologic features were reviewed. Immunohistochemical study for estrogen receptor, progesterone receptor, CD10, cyclin D1, smooth muscle actin, desmin and H-caldesmon were carried out using tissue microarray technology. Reverse transcription-polymerase chain reaction (RT-PCR) was applied for detection of expression of JAZF1-SUZ12 and YWHAE-FAM22 fusion genes in 47 cases of ESS and 12 cases of other spindle cell neoplasia in uterus (including 2 cases of undifferentiated sarcoma, 3 cases of leiomyosarcoma, 3 cases of leiomyoma, 4 cases of adenosarcoma and 2 cases of uterine tumor resembling ovarian sex cord tumor).The 53 cases of ESS studied included 43 cases of low-grade ESS and 10 cases of high-grade ESS. As for low-grade ESS, in addition to the classic morphologic features, smooth muscle differentiation was present in 7 cases (16.3%), sex cord-like differentiation in 2 cases (4.7%), rhabdoid differentiation in 1 case (2.3%), clear cell changes in 1 case (2.3%) and schwannoma-like palisading pattern in 1 case (2.3%). As for high-grade ESS, sex cord-like differentiation (1 case), mucinous microcystic changes (1 case) and focal clear cell changes (1 case) were also observed. The expression rate of estrogen receptor, progesterone receptor, CD10, cyclin D1, smooth muscle actin, desmin and H-caldesmon was 86.0%, 81.4%, 74.4%, 2.3%, 23.3%, 23.3% and 4.7% in low-grade ESS, respectively, and was 1/10, 6/10, 6/10, 7/10, 1/10, 1/10 and 0 in high-grade ESS, respectively. RNA extraction was successful in 47 cases of ESS, including 39 cases of low-grade ESS and 8 cases of high-grade ESS. The positive rate of JAZF1-SUZ12 fusion gene was 30.8% (12/39) in low-grade ESS. The positive rate of YWHAE-FAM22 fusion gene was 12.5% (1/8) in high-grade ESS. The 14 control cases were all negative for JAZF1-SUZ12 and YWHAE-FAM22 fusion genes.As uncommon pathologic pattern may occur in both low-grade ESS and high-grade ESS, detection of JAZF1-SUZ1 and YWHAE-FAM22 fusion genes by RT-PCR would be helpful in diagnosis and differential diagnosis of ESS, especially for those tumors which lack typical morphologic features.

SUMMARYA cross-sectional study was conducted from June 2013 to August 2015 to determine the seroprevalence and possible risk factors for humanToxoplasma gondiiinfection in Korean, Manchu, Mongol and Han ethnic groups in eastern and northeastern China. A total of 1842 serum samples, including Han (n= 802), Korean (n= 520), Manchu (n= 303) and Mongol (n= 217) groups, were analysed using enzyme-linked immunoassays to detect IgG and IgMT. gondiiantibodies. The overallT. gondiiIgG and IgM seroprevalences were 13·79% and 1·25%, respectively. Of these groups, Mongol ethnicity had the highestT. gondiiseroprevalence (20·74%, 45/217), followed by Korean ethnicity (16·54%, 86/520), Manchu ethnicity (13·86%, 42/303) and Han ethnicity (11·35%, 98/802). Multiple analysis showed that the consumption of raw vegetables and fruits, the consumption of raw/undercooked meat and the source of drinking water were significantly associated withT. gondiiinfection in the Han group. Likewise, having a cat at home was identified as being associated withT. gondiiinfection in the Korean, Manchu and Mongol groups. Moreover, the consumption of raw/undercooked meat was identified as another predictor ofT. gondiiseropositivity in the Mongol group. The results of this survey indicate thatT. gondiiinfection is prevalent in Korean, Manchu, Mongol and Han ethnic groups in the study region. Therefore, it is essential to implement integrated strategies with efficient management measures to prevent and controlT. gondiiinfection in this region of China. Moreover, this is the first report ofT. gondiiinfection in Korean, Manchu, and Mongol ethnic groups in eastern and northeastern China.

Nontuberculous mycobacteria are ubiquitous in outside environment and animals. As for nontuberculous mycobacteria infection, there is only limited information in humans regarding infection and the subsequent immune response, especially for Mycobacterium neoaurum. Here, haematoxylin-eosin and Ziehl-Neelsen staining were used to observe pathological changes and detect acid-fast bacilli in organ samples in mouse model. Flow cytometry and quantitative real-time polymerase chain reaction were performed to analyze the contribution of Th1, Th17 and Tregs to the host immune response. M. neoaurum caused chronic infection in mice, resulting in infiltrates with large aggregates of inflammatory cells, especially macrophages, in lung tissues. Our results indicated that 72% of CD4+ T cells appeared in the early days of infection, which was followed by a decrease to 47% by day 32, and then a rise to 76% by day 56. Moreover, we found higher frequency of IFN-g-producing CD4+ T cells and elevated mRNA expression of the transcription factor T-bet in the lungs; however, we observed lower mRNA expression of the transcription factor RORgt and lower frequency of IL-17-producing CD4+ T cells. A transient relative decrease in the number of Treg cells was observed in the lungs; however, the number of Tregs did not change significantly between the first and last day following infection. Thus, M. neoaurum causes chronic infection in C57BL/6 mice, with Th1, Th17, and Tregs playing a prominent role in the host response. The present study may lay the basis for further studies on the mechanisms underlying infection with nontuberculous mycobacteria.

The purpose of this study was to analyze the characteristic features of Castleman disease in the abdomen and pelvis as suggested by imaging findings in order to deepen the recognition and understanding of this rare disease.A group of ten patients with pathologically proven Castleman disease in the abdomen (n = 9) and pelvis (n = 1) were included in this study. Patients were 18 approximately 56-year-old (mean = 40); seven of them were men and three were women. Imaging findings (CTMRI, n = 4; only CT, n = 4; only MRI, n = 2) were retrospectively reviewed and correlated with clinical and pathologic findings.The lesions were divided into those with localized Castleman (n = 9) and disseminated Castleman (n = 1). The pathologic subtype of all nine cases of localized disease was hyaline vascular with six patients showing a solitary mass and three having a single dominant mass surrounded by small satellite nodules. On nonenhanced CT images, the lesions were manifested as homogeneous masses of soft tissue attenuation, which was isoattenuated relative to normal muscle. On MRI, the lesions were isointense or slightly hypointense compared with that of normal muscle on T1-weighted images and hyperintense on T2-weighted images. After intravenous injection of contrast media, most of the masses (7/9) showed marked enhancement and slow washout with the degree of enhancement approaching that of the large arteries. And in the interior of four cases of larger masses (5 cm) was observed fissured and radial patterns in both low-density area on CT and low-signal area on MRI. These patterns were pathologically proved to be fibrous. The pathological subtype of a sole disseminated case was plasma-cell type, where imaging findings showed a lining of well defined, sharply enhanced soft-tissue nodules in retroperitoneal zone.Imaging findings of Castleman disease in the abdomen and pelvis are closely related to pathological type diagnosed. The characteristic features of localized and hyaline vascular type of Castleman disease include a solitary mass or a dominant mass surrounded with small satellite nodules, and high enhancement and slow washout with the degree of enhancement approaches that of large arteries. The presence of central areas of fibrosis of the larger tumors is one of the characteristic features of this disease.

SUMMARY Aims: The association between inhaled corticosteroid (ICS) use and pulmonary tuberculosis (TB) development is uncertain. We conducted a population-based case–control study to investigate whether ICS use increases the risk of developing TB. Methods: Tuberculosis patients aged 18 years and older were identified using the National Health Insurance Research Database (NHIRD) in Taiwan between 2002 and 2010. Each TB patient was frequency matched to four control patients according to age, sex and index year. We retrospectively followed up the medications and comorbid medical conditions for the 5 years prior to the index date. We calculated the odds ratios (ORs) and 95% confidence intervals (CIs) of TB development using multiple logistic regression models. Results: Most of the study participants were men (68.7%), and the mean age among the 8091 TB patients and 32,364 comparison participants was 61.3 18.6 years. After adjusting for potential covariates, ICS use caused a 2.04-fold increased risk of developing TB (adjusted OR: 2.04, 95% CI: 1.78–2.33). When considering dose-response and adjusting for potential covariates, ICS and oral corticosteroids (OCS) use remained independent risk factors and exhibited a dose-response relationship of TB development. The multiplicative increased risk of TB was also significant in patients using ICS and OCS compared with patients not using ICS and OCS (adjusted OR: 4.31, 95% CI: 3.39–5.49). Previous TB history exhibited the greatest risk of TB development among the comorbidities (adjusted OR: 8.50, 95% CI: 7.52–9.61). Conclusion: Long-term ICS use may increase the risk of TB. What’s known  Long-term oral steroids (OCS) and disease-modifying anti-rheumatic drugs increase the risk of pulmonary tuberculosis (TB).

Objective: The aim of this study was to evaluate whether High Resolution Ultrasound (US) along with Fine Needle Aspiration Cytology (FNAC) can provide the surgeon with adequate preoperative information for masses in the submandibular triangle.Subjects and methods: Eighty-two consecutive patients with suspected masses of the submandibular triangle had US with guided FNAC (49 patients) and final histological correlation (47 patients).Results: Compared to final histology, US had a sensitivity of 97%, specificity 83%, positive predictive value 91% and a negative predictive value of 95% while FNAC had sensitivity of 100%, specificity 90%, positive predictive value 94% and negative predictive value of 100%.Conclusion: US combined with a FNAC is an ideal initial investigation for evaluating masses in submandibular area. It is quick, inexpensive, easily available, and provides the surgeon with relevant information preoperatively obviating the need for further expensive imaging.

In recent years, mutations in glucocerebrosidase gene (GBA), which encodes the lysosomal enzyme glucocerebrosidase (GCase) deficient in Gaucher disease (GD), were found to be the most widespread genetic for the development of Parkinson disease.In this work, we investigated the possibility of a biological linkage between GCase and alpha-synuclein.siRNA was used to knockdown the GBA, then the related proteins such as alpha-synuclein were detected, additionally, the mutations of GBA were also detected. We also provide evidence that a mouse model of Gaucher disease (GBAD409H/D409H) to detect the gene types of GBA.The results showed functional knockdown (KD) of GBA in neuroblastoma cells culture causes a significant accumulation of alpha-synuclein and alpha-synuclein-mediated neurotoxicity. Furthermore, KD of GBA in rat primary neurons expressing the A53T mutation of alpha-synuclein, decreases cell viability. In addition, we observed that overexpression of several GBA mutants (N370S, L444P, D409H, D409V) significantly raised human alpha-syn levels of vector control. Glucosylceramide (GlcCer), the GCase substrate, influenced formation of purified a-syn by stabilizing soluble oligomeric intermediates. We also provide evidence that a mouse model of Gaucher disease (GBAD409H/D409H) exhibited alpha-syn aggregates in substantia nigra, cortex and hippocampus regions. ELISA analysis showed a significant rise in membrane-associated α-syn and western blot analysis showed that two forms of alpha-syn oligomers were present in brain homogenates from the hippocampus D409H mice.These studies support the contention that both WT and mutant GBA can cause Parkinson disease-like alpha-synuclein pathology.

Single-crystal Co(11 2 0) Cr(100) superlattices (SLs) have been successfully grown on MgO (100) and Al2O3 (1 1 02) substrates with 100 A Mo as buffer layers by molecular beam epitaxy (MBE). Excellent epitaxial growth was evidenced by reflection high-energy electron diffraction (RHEED). Magneto-resistance (MR) measurements have been performed using a conventional four-point technique. We have observed negative MR (NMR ≈ 4.8%) for [ Co (40 A ) Cr (5 A ) ] 70 SLs, giant positive MR (PMR ≈ 30%) for [ Co(5 Co ) Cr (5 A ) ] 100 SLs. It is likely that the NMR effect is introduced by the Co Cr SL while PMR is induced by the Mo buffer layers. Interestingly, PMR samples show a distinct roughness effect compared to NMR samples. Systematically we have found that NMR increases with increasing interfacial roughness, while PMR samples show the opposite behavior.

In the past decade, Mn rich Ni-Mn based alloys have attained considerable attention due to their abundant physics and potential application as multifunctional materials. In this paper, polycrystalline Ni50Mn38−xPdxSn12 (x = 0, 2, 4, 6) Heusler alloys have been prepared, and the martensitic phase transformation (MPT) together with the shape memory effect and the magnetocaloric effect has been investigated. The experimental result indicates that the MPT evidently shifts to a lower temperature with increase of Pd substitution for Mn atoms, which can be attributed to the weakness of the hybridization between the Ni atom and excess Mn on the Sn site rather than the electron concentration. The physics properties study focused on the sample of Ni50Mn34Pd4Sn12 shows a good two-way shape memory behavior, and the maximum value of strain Δ L/L reaches about 0.13% during the MPT. The small of both entropy change Δ ST and magnetostrain can be ascribed to the inconspicuous influence of magnetic field induced MPT.

Based on an infinite network gel model, using Graph theory and Probability as investigative tools, first of all, advanced a new theory about predicting the gel point Pc The critical state equations of gelation for three kinds of non-linear polymerization have been derived. The Pc obtained by these equations lies between the results from Carothers equation and Statistical theory, and is in good agreement with experimental results.