目的 分析老年泌尿道感染(UTI)患者中段尿培养病原菌分布及其耐药性,为临床抗生素经验用药提供参考.方法 回顾性选取2019年1—12月就诊于江苏省老年病医院>60岁UTI患者1879例的临床资料,所有患者均行中段尿培养,分析致病菌分布及耐药性.结果 1879份中段尿标本中,检出病原菌801株,阳性率为42.63％;主要病原菌:大肠埃希菌、肺炎克雷伯菌、奇异变形菌、金黄色葡萄球菌、屎肠球菌等;革兰阴性杆菌占72.91％(584/801),最常见的为大肠埃希菌;革兰阳性球菌占24.84％(199/801),最常见的为金黄色葡萄球菌;真菌占2.25％(18/801),最常见的为白色念珠菌;多重耐药菌188株占23.47％(188/801).革兰阴性杆菌对阿米卡星、美罗培南耐药率低,对环丙沙星、左氧氟沙星、氨苄西林耐药率高;革兰阳性球菌对万古霉素、利奈唑胺、达托霉素均敏感,对环丙沙星、左氧氟沙星、红霉素耐药率高;真菌对所测药物均敏感.结论 老年患者病原菌以革兰阴性杆菌为主,以大肠埃希菌多见,多重耐药菌检出率较高,应根据药物敏感试验结果调整治疗方案.

Objective To study the expression and significance of EZH2/34βE12/p63 in needle biopsy specimen of prostatic lesions.Methods Expression of EZH2,34βE12 and p63 were detected using immunohistochemical method in the biopsy specimen of 53 cases of prostate cancer (PCa), 60 cases of benign prostatic hyperplasia (BPH), 10 cases of prostatic high grade intraepithelial neoplasia (HGPIN) and 14 cases of prostatic atypical adenomotous hyperplasia (AAH) with mixed type antibody in a single paraffin section.Results EZH2 was mainly expressed in the prostatic epithelia nuclear and the positive rate was 98.1% in 52 cases of PCa.34βE12 was mainly expressed in the prostatic basal plasma and the positive rate in 60 cases of BPH,10 cases of HGPIN and 14 cases of AAH was 96.7%, 100% and 85.7% respectively.P63 was mainly expressed in the prostatic basal nuclear and the positive rate in BPH, HGPIN and AAH was 98.3%, 90.0% and 92.9% respectively.There were significant differences in expressions of EZH2,34βE12 and p63 among PCa, BPH, HGPIN and AAH (P<0.05).Conclusions Immunohistochemical detection of EZH2,34βE12 and p63 in single paraffin sections could improve diagnostic and differential diagnostic accuracy in needle biopsy specimen of prostate lesion.

Melanoma-associated antigens (MAGE)-A9 has been reported to play important roles in the development of human cancers. However, the association between MAGE-A9 expression and the clinicopathological characteristics of hepatocellular carcinoma (HCC) is not well understood. The study was to detect the expression of MAGE-A9 in human HCC and investigate the association between its expression and the clinicopathological characteristics of HCC. Reverse transcription-polymerase chain reaction (RT-PCR), one-step quantitative -PCR (qPCR) and immunohistochemistry (IHC) analyses were performed to characterize the expression of MAGE-A9 in HCC cell lines and tissues. Kaplan-Meier survival and Cox regression analyses were employed to evaluate the prognosis of 100 HCC patients. The results showed that the expression of MAGE-A9 in HCC was significantly higher than that in non-cancerous cells and tissues. Moreover, the expression level of the MAGE-A9 protein in HCC was related to the pathological grade (p = 0.003), portal vein invasion (p = 0.001), distant metastasis (p = 0.022) and TNM stage (p = 0.005). Cox regression analysis further revealed that MAGE-A9 expression is an independent prognostic factor for disease-free survival (p = 0.006) and overall survival (p = 0.022). These data are the first to indicate that MAGE-A9 expression is a valuable prognostic biomarker for HCC and that high MAGE-A9 expression suggests unfavorable survival outcomes in HCC patients.

SH2-containing inositol 5′-phosphatase 2 (SHIP2), which generally regulates insulin signaling, cytoskeleton remodeling, and receptor endocytosis, has been suggested to play a significant role in tumor development and progression. However, the associations between SHIP2 expression and the clinical features to evaluate its clinicopathologic significance in colorectal cancer (CRC) have not been determined yet. In the present study, one-step quantitative real-time polymerase chain reaction (qPCR) test and immunohistochemistry (IHC) analysis with CRC tissue microarrays (TMA) were employed to evaluate the mRNA and protein expression of SHIP2 in CRC. The results showed that SHIP2 expression in the mRNA and protein levels was significantly higher in CRC tissues than that in corresponding noncancerous tissues (bothP<0.05). The expression of SHIP2 protein in CRC was related to lymph node metastasis(P=0.036), distant metastasis(P=0.001), and overall survival(P=0.009). Kaplan-Meier method and Cox multifactor analysis suggested that high SHIP2 protein level(P=0.040)and positive distant metastasis(P=0.048)were critically associated with the unfavorable survival of CRC patients. The findings suggested that SHIP2 may be identified as a useful prognostic marker in CRC and targeting CRC may provide novel strategy for CRC treatment.

The tissue inhibitors of metalloproteinases (TIMPs) are proteins that specifically inhibit the proteolytic activity of the matrix metalloproteinases (MMPs). TIMP-3, the only member of the TIMPs that can tightly bind to the extracellular matrix, has been identified as a unique tumor suppressor that demonstrates the ability to inhibit tumor angiogenesis, invasion, and metastasis. This study aimed to detect the expression of TIMP-3 in hepatocellular carcinoma (HCC) and investigate the association between TIMP-3 expression and its clinicopathological significance in HCC patients. In the current study, reverse transcription-polymerase chain reaction (RT-PCR) and Western blotting of HCC cell lines and one-step quantitative reverse transcription PCR (qPCR) and immunohistochemistry (IHC) analyses in HCC tissues were performed, to characterize the TIMP-3 expression. Kaplan-Meier survival and Cox regression analyses were utilized to evaluate the prognosis of 101 HCC patients. The results showed that the expression of TIMP-3 in HCC was significantly decreased relative to that of non-cancerous cells and tissues. Furthermore, the TIMP-3 expression was statistically associated with malignant behaviors of HCC, including portal vein invasion (p = 0.036) and lymph node metastasis (p = 0.030). Cox regression analysis revealed that TIMP-3 expression was an independent prognostic factor for disease-free survival (p = 0.039) and overall survival (p = 0.049). These data indicate that TIMP-3 expression is a valuable prognostic biomarker for HCC and that TIMP-3 expression suggests a favorable prognosis for HCC patients.

Inositol polyphosphate phosphatase-like 1 (INPPL1), also known as SH2-containing inositol 5'-phosphatase 2 (SHIP2), has been suggested to act downstream of the PI3K/AKT pathway and play an important function in tumor development and progression. However, the associations between SHIP2 expression and the clinical features to determine its clinicopathologic significance in hepatocellular carcinoma (HCC) have not been investigated. In the present study, one-step quantitative PCR reverse transcription-polymerase chain reaction (qPCR) and immunohistochemistry (IHC) analysis with HCC tissue microarrays (TMA) were employed to evaluate the expression of SHIP2 in HCC. The results showed that SHIP2 expression in the mRNA and protein levels was significantly higher in HCC tissue than in corresponding non-cancerous tissue (p = 0.0014 and p < 0.001, respectively). The expression of SHIP2 protein in HCC was related to tumor differentiation, α-fetoprotein level, liver cirrhosis, and five-year survival rate (all p < 0.05). Kaplan-Meier method and log-rank test indicated that high expression of SHIP2 (p = 0.017) and tumor differentiation (p = 0.036) showed significant correlations with poor prognosis of HCC patients. The data indicate that SHIP2 expression is correlated with significant characteristics of HCC, and it may be useful as an unfavorable prognostic factor in HCC.

Objective To study the reliability of tissue chip in the research of human prostate cancer. Methods Tissue microarray (TMA) with 2.0 mm in diameter tissue core was constructed from forty-eight cases of human prostate cancer. Gleason score was reevaluated by HE staining. EZH2 was detected by immunohistochemical (IHC) technique, and in situ hybridization(ISH) technique. At the same time the stains on the tissue microarrays were compared with that from the routine paraffin section. Results Comparing the Gleason scores of prostate cancer tissue chip with that of routine paraffin section, the overall coincidence rate was 89.58%.Immunohistochemical results showed that the consistent rate of TMA and routine paraffin section was 95.65% (Kappa=0.810). The result in situ hybridization suggested that the consistent rate of TMA and routine paraffin section was 90.90% (Kappa=0.727). Conclusions Tissue microarrays with 2.0 mm in diameter tissue core can represent full tissue section,if the tissue microarrays are constructed as standard method. As a reliable and high-throughout tool it could be set on large sample and retrospective clinipathological research in the application of human prostate cancer.

Objective To analyze the characteristics of PSA related indexes in the patients with incidentally discovered prostatic carcinoma(IDPC) . Methods A retrospective study of the data of serum PSA,F/T-PSA,PSAD,PSAD-TZD,PSAED of 153 patients with IDPC who accepted TURP was analyzed. Results There were no significant differences in serum PSA and PSAD between the patients with benign prostate hyperplasia(BPH) and the patients with IDPC. While there were significant differences in f/t-PSA,PSAD-TZD,PSA-TPD,PSAED(P < 0. 05) . Conclusions The value of f/t-PSA,PSA-TZD,PSAED and PSAD-TZD might be used to screen prostate cancer from BPH.

Objective To explore the expression of EZH2 and p53 protein in primary prostate cancer (Pca) and its clinical significance.Methods High-throughput tissue microarray technique and immunohistochemistry was used to detect the expression of EZH2 and p53 protein in 48 human prostate cancer specimens without a history of chemo-radiation therapy and 15 cases of benign prostate hyperplasic (BPH) tissues. The pathological characteristics and the relationship of the expression of EZH2 and p53 protein in primary prostate cancer was analyzed. Results Immunohistochemical results showed that the positive rates of EZH2 and p53 protein in prostate cancer were 87.50 ％ (42/48) and 33.33 ％ (16/48), respectively, which were significantly higher than that in BPH tissues[13.33 ％ (2/15) and 0 (0/15)](x2=26.429, x2=5.058,P ＜0.05). The expression of EZH2 and p53 protein was significantly related to Gleason score, TNM stage (P ＜0.05), but not to age and serum prostate-specific antigen (PSA) level (P ＞0.05). The positive expression in patients with Gleason＞6 was higher than that with Gleason≤6 (P ＜0.05). The positive expression in patients with T3-T4 stage was higher than that with T1-T2 stage (P ＜0.05). Spearman rank correlation showed a significantly positive correlation between EZH2 and p53 protein (r=0.294, P ＜0.05). Conclusion EZH2 and p53 protein may participate in the pathogenesis of prostate cancer. The overexpression of EZH2 and p53 protein could become an index for the evaluation of the level of malignancy and progression of prostate cancer.Furthermore, combining detection of EZH2 and p53 protein may provide a new theoretical basis for the treatment of prostate cancer.

Objective To determine the expression of P504S,EZH2 and pim-1 in prostate cancer and its correlation with Gleason score.Methods Immunohistochemical stain was used to study the expression of P504S,EZH2 and pim-1 in prostate cancer and benign prostate hyperplasia.Its expression level was analysed with respect to Gleason score.Results P504S,EZH2 and pim-1 was overexpressed in prostate cancer.And Gleason score was positively correlated with P504S(0.418,Ρ0.05),EZH2(0.268,Ρ0.05)and pim-1(0.567,Ρ0.01).Conclusions P504S,EZH2 and pim-1 are sensitive and specific marker for prostate cancer.The expression level of P504S,EZH2 and pim-1 was related to Gleason score.

Objective To analyze nuclear morphological parameters between pseudohyperplastic prostaic adenocarcinoma (PHPA) and benign prostatic hyperplasia (BPH) in elderly patients. Methods Nineteen cases of PHPA and 19 cases of BPH were selected. The areas and perimeters of 10-12 nuclei were measured under high multiple microscope in every case by PAS-9000 pathological image analysis system.The form factors, sphericities and atypical indexes were also counted. Results The areas, perimeters and sphericities of nuclei in PHPA were higher than those in BPH(P<0.05), while the form factors and atypical indexes of nuclei in PHAP were lower than those in BPH(P<0.05). Conclusions The form of cell nuclear in PHAP was not inerratic. The parameters may be useful in morphological differential diagnosis between PHAP and BPH. It could be used as a new idea for prostatic needle biopsy in the differentiation of prostate diseases in the elderly patients.

OBJECTIVE To investigate the expressions of the EZH2 protein and EZH2 mRNA in human prostate cancer (PCa) and their correlation with the clinicopathologic parameters. METHODS A tissue microarray (TMA) was constructed, which contained 48 dots of formalin-fixed paraffin-embedded tissue samples of human PCa. The expressions of the EZH2 protein and EZH2 mRNA in the samples were detected by immunohistochemistry (EnVision) and in situ hybridization (ISH). Another 15 cases of human benign prostate hyperplasia (BPH) and 12 cases of human prostate intraepithelial neoplasia (HGPIN) were taken as controls. RESULTS The positive rates of the EZH2 protein and mRNA were significantly higher in PCa than in BPH and HGPIN (87.5% vs 13.33% and 16.67%, 81.25% vs 6.67% and 16.67%, P < 0.05). The positive expression of the EZH2 protein was 96.67% and 72.22% in the Gleason score > or = 7 and Gleason score < or = 6 groups, respectively, with significant differences between the two groups (P < 0.05). The positivity of the EZH2 protein was significantly related to the TNM stage, increasing with tumor progression (P < 0.05), but not to age and serum PSA (P > 0.05), and so was that of EZH2 mRNA to TNM stage (P < 0.05), but not to age, serum PSA and Gleason score (P > 0.05). When the above characteristics were regarded as two-level discrete variables, both the EZH2 protein and EZH2 mRNA showed statistically significant differences in the positive expression rate (P < 0.05). CONCLUSION The over-expressions of the EZH2 protein and EZH2 mRNA may play an important role in the pathogenesis and progression of PCa and provide some reference indexes for estimating the malignancy, progression and prognosis of PCa.

Purpose To investigate the expression of EZH2 mRNA and protein,and its relationship with tumor cell proliferation in human prostate carcinoma(PCa).Methods A tissue microarray was constructed,which contained 68 dots of formalin-fixed,paraffinembedded tissue samples,including 48 cases of human PCa.lmmunohistochemical markers,including EZH2 and Ki-67,were used on the tissue microarray sections by the immunohistochemical staining method.In situ hybridization(ISH) using an EZH2 oligonucleotide probe was also performed on the tissue microarray sections.Additional 15 cases of benign prostate hyperplasia(BPH) and 12 cases of high grade prostate intraepithelial neoplasia(HGP1N) were used as controls.Results The positive rates of EZH2 protein and mRNA expression were 87.50%and 81.25%in the PCa,16.67%and 16.67%in the HGPIN,13.33%and 6.67%in the BPH,respectively. There were statistical difference between PCa,HGPIN and BPH,respectively(P0.05).The expression of EZH2 protein and mRNA had no statistical difference(P0.05).The expression of EZH2 protein was related to Gleason score,TNM stage(P0.05), but not to age and serum prostate-specific antigen(PSA) level(P0.05).The expression of EZH2 mRNA was related to TNM stage (P0.05),but not to age,PSA and Gleason score(P0.05).The staining intensity of EZH2 was positively correlated with the Ki- 67 indexes(r=0.746,P0.05).Conclusions Over-expression of EZH2 which is involved in accelerating proliferation may play an important role in the pathogenesis and progression of human prostate carcinoma.As a molecular marker of prostate carcinoma,EZH2 may serve as a new index for estimating the level of malignancy and progression of the prostate cancer.

现将1例去顶减压术肾囊肿标本诊断囊性肾细胞癌临床病理分析如下. 1 病历摘要 男,41岁.右腰酸痛1 a.B超、CT示:右肾囊肿.行右肾囊肿去顶减压术,术中见囊肿为多房性,囊内见少许血性液体.(1)巨检:灰白色囊壁样组织1.5 cm×1.0 cm×0.5 cm,壁厚0.2 cm,内壁较粗糙,部分囊壁有微小突起.(2)镜检:囊壁由纤维组织构成,囊壁内衬附单层至数层透明细胞,囊壁突起处见透明细胞巢.(3)免疫组化:透明细胞CK、EMA阳性,CD68阴性.病理诊断:(右肾)囊性肾细胞癌.

The histological diagnosis of borderline lesions has always been difficult. To base on the system theory suggests the thinking for their diagnosis. These lesions are analyzed through the whole, relativity, arrangement and trend of the system itself. To hope that this system theory could direct the methodology of pathological diagnosis with a new idea.