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Objective: To investigate the expression of glycoprotein non metastatic melanoma protein B (GPNMB) in renal eosinophilic tumors and to compare the value of GPNMB with CK20, CK7 and CD117 in the differential diagnosis of renal eosinophilic tumors. Methods: Traditional renal tumor eosinophil subtypes, including 22 cases of renal clear cell carcinoma eosinophil subtype (e-ccRCC), 19 cases of renal papillary cell carcinoma eosinophil subtype (e-papRCC), 17 cases of renal chromophobe cell carcinoma eosinophil subtype (e-chRCC), 12 cases of renal oncocytoma (RO) and emerging renal tumor types with eosinophil characteristics [3 cases of eosinophilic solid cystic renal cell carcinoma (ESC RCC), 3 cases of renal low-grade eosinophil tumor (LOT), 4 cases of fumarate hydratase-deficient renal cell carcinoma (FH-dRCC) and 5 cases of renal epithelioid angiomyolipoma (E-AML)], were collected at the Affiliated Drum Tower Hospital of Nanjing University Medical School from January 2017 to March 2022. The expression of GPNMB, CK20, CK7 and CD117 was detected by immunohistochemistry and statistically analyzed. Results: GPNMB was expressed in all emerging renal tumor types with eosinophil characteristics (ESC RCC, LOT, FH-dRCC) and E-AML, while the expression rates in traditional renal eosinophil subtypes e-papRCC, e-chRCC, e-ccRCC and RO were very low or zero (1/19, 1/17, 0/22 and 0/12, respectively); the expression rate of CK7 in LOT (3/3), e-chRCC (15/17), e-ccRCC (4/22), e-papRCC (2/19), ESC RCC (0/3), RO (4/12), E-AML(1/5), and FH-dRCC (2/4) variedly; the expression of CK20 was different in ESC RCC (3/3), LOT(3/3), e-chRCC(1/17), RO(9/12), e-papRCC(4/19), FH-dRCC(1/4), e-ccRCC(0/22) and E-AML(0/5), and so did that of CD117 in e-ccRCC(2/22), e-papRCC(1/19), e-chRCC(16/17), RO(10/12), ESC RCC(0/3), LOT(1/3), E-AML(2/5) and FH-dRCC(1/4). GPNMB had 100% sensitivity and 97.1% specificity in distinguishing E-AML and emerging renal tumor types (such as ESC RCC, LOT, FH-dRCC) from traditional renal tumor types (such as e-ccRCC, e-papRCC, e-chRCC, RO),respectively. Compared with CK7, CK20 and CD117 antibodies, GPNMB was more effective in the differential diagnosis ( P <0.05). Conclusion: As a new renal tumor marker, GPNMB can effectively distinguish E-AML and emerging renal tumor types with eosinophil characteristics such as ESC RCC, LOT, FH-dRCC from traditional renal tumor eosinophil subtypes such as e-ccRCC, e-papRCC, e-chRCC and RO, which is helpful for the differential diagnosis of renal eosinophilic tumors.

Objective: To analyze three different integrated scoring schemes of prostate biopsy and to compare their concordance with the scoring of radical prostatectomy specimens. Methods: A retrospective analysis of 556 patients with radical prostatectomy performed in Nanjing Drum Tower Hospital, Nanjing, China from 2017 to 2020. In these cases, whole organ sections were performed, the pathological data based on biopsy and radical prostatectomy specimens were summarized, and 3 integrated scores of prostate biopsy were calculated, namely the global score, the highest score and score of the largest volume. Results: Among the 556 patients, 104 cases (18.7%) were classified as WHO/ISUP grade group 1, 227 cases (40.8%) as grade group 2 (3+4=7); 143 cases (25.7%) as grade group 3 (4+3=7); 44 cases (7.9%) as grade group 4 (4+4=8) and 38 cases (6.8%) as grade group 5. Among the three comprehensive scoring methods for prostate cancer biopsy, the consistency of global score was the highest (62.4%). In the correlation analysis, the correlation between the scores of radical specimens and the global scores was highest ( R =0.730, P <0.01), while the correlations of the scores based on radical specimens with highest scores and scores of the largest volume based on biopsy were insignificant ( R =0.719, P <0.01; R =0.631, P <0.01, respectively). Univariate and multivariate analyses showed tPSA group and the three integrated scores of prostate biopsy were statistically correlated with extraglandular invasion, lymph node metastasis, perineural invasion and biochemical recurrence. Elevated global score was an independent prognostic risk factor for extraglandular invasion and biochemical recurrence in patients; increased serum tPSA was an independent prognostic risk factor for extraglandular invasion; increased hjighest score was an independent risk factor for perineural invasion. Conclusions: In this study, among the three different integrated scores, the overall score is most likely corresponded to the radical specimen grade group, but there is difference in various subgroup analyses. Integrated score of prostate biopsy can reflect grade group of radical prostatectomy specimens, thereby providing more clinical information for assisting in optimal patient management and consultation.

Objective: To investigate the prevalence of atrial cardiomyopathy in patients with different types of acute ischemic stroke and its relationship with cryptogenic stroke. Methods: Patients with acute ischemic stroke within 7 days of onset who were admitted to the Department of Neurology of the First Affiliated Hospital of Zhengzhou University from January to September 2019 were prospectively and consecutively enrolled. All included patients were classified according to TOAST classification of ischemic stroke. Chi-square test was used to compare the prevalence of atrial cardiomyopathy among patients with different TOAST classifications. Multivariate logistic regression model was used to analyze the related factors of cryptogenic stroke. Results: A total of 1 098 patients with acute ischemic stroke were enrolled in the study, including 661 males and 437 females, with a median age [ M ( Q 1 , Q 3 )] of 61 (53, 68) years. The prevalence of atrial cardiomyopathy in patients with cryptogenic stroke[53.5% (46/86)] was higher than that in patients with large artery atherosclerosis [38.0%(63/166), P =0.018] and small vessel occlusion [19.4%(37/191), P <0.001], but was lower than that of patients in the cardioembolic group [97.3% (72/74), P< 0.001]. Multivariate logistic regression analysis showed that atrial cardiomyopathy was an associated factor for cryptogenic stroke ( OR =2.945, 95% CI : 1.766-4.911, P <0.001). Conclusions: Atrial cardiomyopathy is associated with cryptogenic stroke. The prevalence of atrial cardiomyopathy in patients with cryptogenic stroke is higher than that in patients with large artery atherosclerosis and small vessel occlusion, but lower than that in patients with cardiac embolism.

Objective: To investigate the relationship between plasma heat shock proteins 90α(Hsp90α) levels and the white matter hyperintensity(WMH) in patients with cerebral small vessel disease(SVD). Methods: Patients admitted to the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from March to August 2021 and diagnosed with WMH by magnetic resonance examination (MRI) were selected as the case group, matched with physical examination patients who visited the Department of Medical Examination during the same period and showed no WMH on MRI and no history of neurological diseases as the control group, and the level of plasma Hsp90α was quantitatively detected by enzyme-linked immunosorbent assay. Mann-Whitney U test was used to compare whether there was a difference in plasma Hsp90α levels between the control group and the case group.Multivariate logistic regression analysis was used to explore the related factors of WMH in patients with SVD. Results: Of the 183 subjects, the control group ( n =73) consisted of 28 males and 45 females, aged (54±10) years, while the case group ( n =110) consisted of 71 males and 39 females, aged (64±10) years old. Plasma Hsp90α level was higher in the case group than that of the control group [53.33(35.33, 70.09) ng/ml vs 35.02(18.51, 54.95) ng/ml, P <0.001]. After adjusting for confounding factors by multivariate analysis, the results showed that plasma Hsp90α levels greater than 58.34 ng/ml was associated with WMH ( P= 0.002, OR =5.931, 95% CI :1.955-17.995). Conclusion: Higher level of plasma Hsp90α is associated with WMH in patients with SVD.

Patients with dementia with Lewy body(DLB), Alzheimer disease (AD), frontotemporal dementia (FTP), progressive supranuclear palsy (PSP) and healthy controls in the Department of Neurology, the First Affiliated Hospital of Zhengzhou University from August 2019 to March 2021 were recruited, with 3 in each group. Phosphorylated α-synuclein from the skin of DLB patients was detected by skin micro-biopsy and compared with patients with AD, FTP, PSP and health controls. Phosphorylated α-synuclein was found in the skin nerves of the DLB patients, while no α-synuclein were detected in the skin samples of others. Skin phosphorylated α-synuclein may potentially become a diagnostic biomarker of DLB, however further studies are warranted to assess its sensitivity and specificity.

Objective: To further improve socket shield technique. The treatment outcome and the key related factors in Asian population are evaluated by measuring the root fragment and alveolar crest parameters in immediate implant placement cases with socket shield. Methods: A total of 18 patients, with 21 implants placed using socket shield technique were included in this retrospective study. Fourteen implants of 11 cases were recruited from West China Hospital of Stomatology, Sichuan University, 7 implants of 7 cases were recruited from Stomatological Hospital of Chongqing Medical University. The relationship between the thickness of the root fragment, the vertical height of the root fragment and the dimensional changes of buccal alveolar bone in 6 months was analyzed respectively. The pink-white esthetic scores were evaluated. The complications were recorded, analyzed and preventive measures were put forward. Results: There is a negative correlation between the vertical height of tooth fragment and the buccal crest height reduction ( r =-0.458, P =0.037). There were negative correlations between the thickness of the tooth fragment with the vertical dimensional changes ( r =-0.574, P =0.007) and horizontal dimensional changes ( r =-0.619, P =0.003) of buccal alveolar bone. Three cases with internal exposure were recorded during the treatment. No severe complications were observed. Every case achieved a satisfying pink-white esthetic outcome according to the existing treatment protocols. Conclusions: Rigorous case screening, delicate surgical procedures, and maintaining adequate thickness of the root are the key to achieve a good esthetic outcome of implant treatment with socket shield technique.

Objective: To explore the therapeutic efficacy of nasal Continuous Positive Airway Pressure (CPAP) and aerobic exercise of different intensity in patients with Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) and Type 2 Diabetes Mellitus (T2DM). Methods: A total of 112 patients with OSAHS and T2DM, including 53 males and 59 females, with a mean age of (66.9±7.8) years old, from the Fourth Rehabilitation Hospital of Shanghai and the Second Affiliated Hospital of Soochow University from January 2017 to December 2018 were enrolled prospectively. There were divided into two groups based on whether received nasal CPAP therapy: 50 cases in nasal CPAP+aerobic exercise group and 62 cases in aerobic exercise group. Subsequently, patients in nasal CPAP+aerobic exercise group were randomly divided into two subgroups: moderate and low intensity aerobic exercise (26 and 24 cases respectively). All patients completed nasal CPAP and (or) aerobic exercise of different intensity for 20 weeks. The therapeutic efficacy of polysomnography (PSG) parameters, glycolipid metabolism, 6 minutes walking distance (6 MWD), and rate of perceived exertion (RPE) were compared between each group before and after treatment. Results: Pre-and post-intervention, PSG parameters, body mass index (BMI) [(26.6±3.7) vs (24.3±2.8) kg/m(2)], RPE [(16.4±1.3) vs (12.2±2.6) score], 6 MWD [(372.6±59.7) vs (441.5±75.6) m] and glucolipid metabolism indexes were improved significantly in nasal CPAP+aerobic exercise group (all P< 0.05), such as fasting blood glucose [(7.4±2.4) vs (6.2±1.6) mmol/L], glycosylated hemoglobin [(7.6±1.2)% vs (6.6±0.7)%], fasting insulin [(10.8±4.4) vs (6.9±3.4) μU/L], insulin resistance index [(3.5±1.9) vs (1.9±1.2)], total cholesterol [(4.0±0.9) vs (3.5±0.9) mmol/L], low density lipoprotein cholesterol [(4.2±0.6) vs (3.1±0.8) mmol/L]; BMI, exercise endurance, some glucolipid metabolism indexes and PSG parameters were also improved in aerobic exercise group ( P< 0.05). After 20 weeks' intervention, it showed statistically significant differences in PSG parameters, glycometabolism, some lipid metabolism indexes and RPE (all P< 0.05), and no significantly difference in BMI [(24.3±2.7) vs (24.3±2.8) kg/m(2)] between the two groups. Compared with the low intensity subgroup, there were significant improvement in 2 hours' postprandial insulin, insulin resistance index, low density lipoprotein cholesterol, lipoprotein A, RPE, 6 MWD in moderate subgroup ( P< 0.05). Conclusion: Nasal CPAP combined with moderate intensity aerobic exercise can effectively improve the glucolipid metabolism, insulin resistance and exercise tolerance in patients with OSAHS and T2DM.

Objective: To discuss the affect of glycosylated hemoglobin (HbA1c) level for the onset of nonalcoholic fatty liver disease (NAFLD) in cohort population. Methods: An epidemiological survey of the relationship between HbA1c and NAFLD conducted in 2012 was based at cohort baseline, and three follow-up sessions conducted in 2013, 2014 and 2015. In total 2 811 subjects were included in the study after exclusion of NAFLD patients at baseline and those who lost their lives due to relocation, and death. The Cox proportional hazard model was used to analyze the relationship between glycosylated hemoglobin and other risk factors of NAFLD. Continuous variables were compared using the t -test or the Mann-Whitney test. χ (2)-test was used for the measurement of categorical data. Results: A total of 2 811 subjects with mean age of 59 (58.2±9.8) years old, including 1 664 males and 1 147 females. Age, waist circumference, body mass index, systolic blood pressure, γ-glutamyltransferase and fasting blood glucose level of HbA1c abnormal group were higher than normal group. The incidence of NAFLD in the abnormal HbA1c level group (25.4%) was higher than normal group (14.9 %), and diastolic blood pressure, high-density lipoprotein cholesterol was lower than normal group and the differences were statistically significant. During the three follow-up intervals, there were 440 new cases of NAFLD, consisting 285 males and 155 females with cumulative incidence of 15.7% (440/2 811). Multivariate Cox regression analysis showed that patients with elevated HbA1c had a higher risk of developing NAFLD ( HR 1.796; 95% CI 1.335~2.418; P < 0.01), and the increased HbA1c level after adjustment for gender, age, and metabolic syndrome-related factors remained an independent risk factors for NAFLD ( HR 1.580; 95.0% CI 1.161-2.152; P < 0.01). Conclusion: An elevated HbA1c levels have a positive predictive value for the onset of NAFLD.

Objective: To explore correlation between chest CT score and oxygenation index in patients with acute hydrogen sulphide poisoning, whether CT score can be applied to assess acute lung injury after acute hydrogen sulfide poisoning and provide basis and reference. Methods: The clinic and a series of CT datas of 32 acute hydrogen sulphide poisoning cases were retrospectively analysed and compared, According to GBZ31-2002 (the diagnostic standard of occupational H(2)S acute poisoning) , these patients were divided into 2 grouds including moderate groud and severe groud; The CT score were improved, referenceing the scoring criteria of the chest X-ray; The difference of the CT score and the oxygenation index were analyzed between moderate and severe group in the acute phase and the disperse phase; The correlation between CT score and oxygenation index were analyzed. Results: The CT score in moderate poisoning group were lower than severe group (2.26±1.37 vs 10.44±2.55, 1.34±0.65 vs 4.55±2.45, all P<0.05) in the acute phase and the dissipation phase.The oxygen index of the 19 cases in the acute phase were 307.55±28.29, and the oxygen index of the 8 cases in the dissipation phase was 435.75±37.00; The oxygen index of the 9 cases in the acute phase and the dissipation phase were respectively 193.17±36.41, 347.67±44.49. The oxygen partial pressure and oxygenation index in severe group were significantly lower than those in moderate group (all P<0.01) in the acute phase and the dissipation phase. Pearman correlation analysis showed that the CT score were negatively correlated to the oxygen index in the acute phase and the dissipation phase, respectively (r=-0.97、-0.75, all P<0.01) . Conclusions: The CT score of lung injury and oxygenation index is negatively correlated. The CT score can be used to evaluate the degree of lung injury, and can be used in the evaluation of acute lung injury after acute hydrogen sulfide poisoning.

OBJECTIVE:To explore the value of three-dimensional (3D) computed tomography (CT) to diseases of the skull base.METHODS:Twenty-five cases with various skull base diseases were examined with 3D CT.All cases received surface shaded display (SSD) method for reconstruction and analysis of 3D reconstruction images in showing the change of skull base bones.RESULTS:In 4 cases with skull base fractures,3D CT demonstrated the fracture lines which were not showed by skull plain films,and provided more informations than those in axial scans.In 15 cases with skull base diseases and 6 cases with trigeminal neuralgia,3D CT helped plan the preoperative approach or the postoperative follow up evaluation,treatment. CONCLUSION:3D CT which based on two dimensional CT scan was very useful for skull baseimaging.

Relationship between the Syndrome Differentiation and total fibrinolytic activity (TFA), superoxide dismutase (SOD), serum albumin (Alb) was observed in 118 pediatric patients with nephrosis syndrome. The results suggested that there was significant difference between Damp-Heat type and Spleen Deficiency type in terms of blood TFA, SOD and serum Alb. Very significant positive correlation was found between serum Alb and TFA, P < 0.01. The level of TFA in pediatric patients with edema was significantly lower than that in normal children, the more the degree of edema, the more the level of TFA activity. It was shown that there would be possibility to find intrinsic connection between Syndrome Differentiation and laboratory findings.

A study of the chemical changes of phospholipid in crude and seven processed samples of Dioscorea opposita was carried out by molybdenum blue colorimetry and TLCS. The result shows that the total phospholipid content in the sample processed by honey bran comes out the highest (180.31 mg/100g).

In this paper, circular dichroism (CD), sector projection and reverse octant rule projection of four diterpenoid dilactones and five tylophorines (two of them, 6, 8, are new compounds) are reported in which reverse octant rule projection is the first application to the configuration determination of diterpenoid dilactone. By using these rules, the predicted Cotton effects of these compounds coincided with the result of previous determinations, so, their absolute configurations are assigned.

Polysaccharides extracted from the root of Isatis indigotica (IIP, 50 mg/kg.d, ipx8d) significantly increased the weight of spleen and number of white blood cell and lymphocyte in peripheral blood in normal ICR mice, and antagonized the immunosuppressive actions of hydrocortisone. There were marked potentiating effects on delayed hypersensitivity reaction induced by 2, 4-dinitrochlorobenzene in normal NIH mice treated with IIP as well as in immunodepressed mice induced by cyclophosphamide. By administration of IIP, the percentage of ANAE+ lymphocytes stained with acid alpha-naphthyl acetate esterase method were significantly increased in peripheral blood of normal ICR mice, and the decreases in number of ANAE+ lymphocytes in mice induced by hydrocortisone were prevented to a certain extent. But IIP could not enhance Con A-induced lymphocyte proliferation of C57BL mouse spleen cells in vitro measured with MTT colorimetric assay. In addition, the plaque forming cells in 5 x 10(6) splenocytes of NIH mice treated with IIP were higher than that of the control group (P less than 0.01). IIP could also elevate the clearance rate of intra-venous charcoal particles in normal mice, i.e., stimulated the phagocytic activity of macrophages. The result indicates that IIP is capable of increasing humoral and cellular immune functions and enhancing the functions of reticuloendothelial system, and might be a good immunopotentiator.

Microsurgical techniques were carried out in reanastomosis of the vas deferens, autotransplantation and replantation of the testis, adrenal autotransplantation with attached blood vessels, anastomosis between the internal spermatic lymphatic vessel and vein, and internal spermatic venous diversion. Double-layer and single-layer anastomosis were adopted in vasovasostomy. It was observed that the former technique seemed a little better but the difference was not statistically significant in regard to the patency and pregnancy rate (P greater than 0.05). Testicular autotransplantations were carried out in two cases, each with bilateral cryptorchism and they were both adults at the time of operation. Postoperative follow-up turned out that spermatogenesis didn't happen. Replantation of a testis was applied to a case with complete traumatic severance of both funiculi within the scrotum. The patient regained his normal endocrine and spermatogenetic functions postoperatively. The techniques of adrenal autotransplantation with attached blood vessels and that of the anastomosis between lymphatic vessel and vein are discussed.

Crystals in medical plants are classified into organic and inorganic according to their chemical components. This paper gives an account of the types, chemical compositions, appearances structures and existing ways in plant tissue and distribution patterns in plant kingdom of various kinds of crystals.

Thirty-three cases with clinical symptoms and signs suspecting prostatic cancer or other prostatic entities with abnormal ultrasonic reflection were diagnosed by transperineal prostatic biopsy guided by intrarectal ultrasonic probing. This procedure more accurate and safer than the conventional one. It seems quite useful clinically in the differential diagnosis of prostatic carcinoma, particularly the early cases from the other prostatic diseases.