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Objective To summarize and analyze the disease spectrum of testicular and adnexal lesions in Tibetan patients in Tibet Autonomous Region. Methods The relevant data of all Tibetan patients with testicular and adnexal lesions diagnosed by pathology in Tibet Autonomous Region People's Hospital from January 2012 to March 2021 were collected retrospectively, including age, clinical manifestations, general manifestations of diseased tissues, and diagnostic results. Results There were 317 cases of testicular and adnexal lesions diagnosed by pathology, with the mean age of (38.72±19.74) years and the clinical manifestations mainly characterized by swelling and pain in the scrotum area (88.01%, 279/317). There were 85 cases of neoplastic diseases (26.81%, 85/317), in which malignant tumors accounted for 96.47%, with an average age of (38.09±14.52) years. There were 232 cases of non-neoplastic diseases (73.19%, 232/317), with an average age of (38.94±21.36) years. The gross manifestations of the lesions were as follows: the lesions of the neoplastic disease were 2-17 cm in diameter and were nodular or lobulated, the sections were solid or cystic-solid, and bleeding or necrosis could be seen in some areas; the lesions of non-neoplastic diseases were 0.6-8 cm in diameter and were mostly cystic with smooth cystic wall, and some lesions were solid nodules. Among neoplastic diseases, the tumor types were germ cell tumors (88.24%, 75/85), lymphohematopoietic tumors (4.71%, 4/85), mesenchymal tumors (4.71%, 4/85), leyding cell tumor(1.18%, 1/85), and papillary cystadenoma of the epididymis (1.18%, 1/85). Among germ cell tumors, seminoma were mainly type (66.67%, 50/75), followed by mixed germ cell tumor (14.67%, 11/75), embryonal carcinoma (12.00%, 9/75). All 4 cases of lymphohematopoietic tumor were diffuse large B-cell lymphoma. Among non-neoplastic diseases, hydrocele accounted for 56.03% (130/232), followed by inflammatory diseases (31.03%, 72/232) and testicular dysplasia (8.62%, 20/232), testicular torsion/infarction (3.88%, 9/232) and testicular adnexal cyst (0.43%, 1/232) accounted for a lower proportion. Testicular and epididymal tuberculosis (77.78%, 56/72) was the main type of inflammatory diseases. Conclusions Testicular and adnexal lesions in Tibetan people maybe more common among middle-aged people, with a complex and diverse disease spectrum, dominated by non-neoplastic disease. Hydrocele and tuberculosis are the most common non-neoplastic diseases. About 1/4 of the lesions are neoplastic diseases, and germ cell tumors are the dominant type.

Objective To summarize the clinical manifestations and pathological features of alveolar echinococcosis (AE) in Tibet, China. Methods Complete pathological data of all patients with surgical resection of AE in the Tibet Autonomous Region People's Hospital from September 2013 to April 2021 were retrospectively studied. Clinical and imaging findings, pathological results, treatment methods, and prognosis information were extracted through the electronic case system. The pathological sections were re-read by microscope to observe the pathological changes. Results A total of 44 AE patients were included. There were 17 males and 27 females; the average age was (36.2±12.3) years; 32 cases were farmers or herdsmen. The most common clinical manifestations were gastrointestinal symptoms (54.5%), followed by respiratory symptoms (13.6%), and 29.5% of patients had no obvious clinical symptoms. CT examination showed that 23 cases had a single lesion and 21 cases had multiple lesions (15 cases with multiple intrahepatic lesions and 6 cases with multiple organ involvement); 33 cases were diagnosed as AE by CT. The specimens for histopathological examination were mainly masses, with a diameter of 1.0-23.0 cm, and the sections were honeycombed. Microscopically, there were small vesicles of different sizes and shapes in the lesions, and the outer wall of the vesicles was a thin layer of pink stratum corneum. The proliferation of vesicles was mainly exogenous. In the early stage, a large number of eosinophils infiltrated around necrotic vesicles with the formation of granuloma; dust-like calcification and massive necrosis were seen in late old lesions. Early granulomatous lesions and late old lesions were mixed in all 44 cases, of which 5 cases were accompanied by abscess formation. A total of 31 cases underwent radical surgery, and 13 cases underwent palliative surgery and drug treatment. After a follow-up of 2-82 months, 3 cases died and 41 cases survived. Conclusions AE patients in China's Tibet are mainly young farmers and herdsmen, mostly women. The liver is the main organ involved, and a few cases can involve the lung or multiple organs. The clinical manifestations are related to the affected organs, and symptoms of the digestive system are more common. Imaging examination has a good reference value for the auxiliary diagnosis of typical cases, but atypical cases or cases complicated with abscess must be confirmed by pathology. Pathological examination shows that the body of alveolar echinococcus with a spherical vesicular structure, and the lesions of different periods often exist together. Most patients have a good prognosis by radical surgical treatment.

This paper characterizes the effects of ambiguity aversion under dispersed information. The equilibrium outcome is observationally equivalent to a Bayesian forecast of the fundamental with increased sensitivity to signals and a pessimistic bias. This equivalence result takes a simple form that accommodates dynamic information and strategic interactions. Applying the result, we show that ambiguity aversion helps rationalize the joint empirical pattern between the bias and persistence of inflation forecasts conditional on household income. In a policy game à la Barro and Gordon (1983) with ambiguity-averse agents, the policy rule features higher average inflation and increased responsiveness to fundamentals. (JEL D81, D83, E31, E37, E71) [ABSTRACT FROM AUTHOR]

We propose a theory of gradualism in the implementation of good policies, suitable for environments featuring time consistency. We downplay the role of the initial period by allowing agents both to wait for future agents to start equilibrium play and to restart the equilibrium by ignoring past history. The allocation gradually transits toward one that weighs both short- and long-term concerns, stopping short of the Ramsey outcome but greatly improving upon Markovian equilibria. We use the theory to account for the slow emergence of both climate policies and the reduction of global tariff rates. (JEL C73, E21, E61, F13, H30) [ABSTRACT FROM AUTHOR]

“Team-based” Medical Aid and Mentorship Program for Tibet have been implemented for six years. The Department of Pathology at Peking Union Medical College Hospital (PUMCH) initiated a point-to-point aids to the Department of Pathology of Tibet Autonomous Region People's Hospital (TARPH) with six team members.With different teaching methods, the aids covered development of management regulations and technology training focusing on the capacity building of local hospital staff. The experts of PUMCH team contributed their wisdom and their experience to support training of local pathologists and improved their professional level. As a result, good social and economic benefits have been obtained.