目的 观察雷公藤甲素(Triptolide,TP)连续给药小鼠整个生精周期(35 d)对睾丸组织的损伤效应、产生损伤的量效关系及与氧化应激机制之间的联系.方法 将 36 只雄性C57 小鼠分为正常组及雷公藤甲素不同剂量组(TP 0.05 mg/kg组;TP 0.1 mg/kg组;TP 0.2 mg/kg组;TP 0.4 mg/kg组;TP 0.8 mg/kg组),每组各6 只.根据分组分别以DMSO/0.9%NaCl溶液及TP不同剂量组溶液连续灌胃 5 周.计算睾丸脏器指数、观察病理结果及生精细胞凋亡情况,检测睾丸组织的活性氧(ROS)及氧化酶(MDA、NO)/抗氧化酶(CAT、GSH-PX、T-SOD)表达水平.结果 与正常组比较,TP 0.05 mg/kg组睾丸脏器指数下降;部分生精小管出现损伤(生精细胞排列紊乱、间隙增加、精子减少等);凋亡细胞数增加;ROS及氧化酶(MDA、NO)表达水平上升,差异无统计学意义(P＞0.05);抗氧化酶(CAT、GSH-PX、T-SOD)活性下降,差异无统计学意义(P＞0.05).与TP 0.05 mg/kg组比较,TP 0.1 mg/kg组～TP 0.8 mg/kg组睾丸脏器指数随着剂量增加而下降,其中TP 0.2 mg/kg～TP 0.8 mg/kg组较正常组,差异有统计学意义(P＜0.05);TP 0.1 mg/kg组～TP 0.8 mg/kg组生精功能损伤随着给药剂量增加逐渐加重,其中TP 0.4 mg/kg组及TP 0.8 mg/kg组管腔内未见生精细胞、仅存在支持细胞;TP 0.1 mg/kg组凋亡细胞增加,TP 0.2 mg/kg组～TP 0.8 mg/kg组因各级生精细胞大量丢失,凋亡细胞反而较少(其中TP 0.2 mg/kg组较TP 0.1 mg/kg组凋亡细胞减少,TP 0.4 mg/kg 组、TP 0.8 mg/kg 组几乎无凋亡细胞存在);TP 0.1 mg/kg 组～TP 0.8 mg/kg组ROS及氧化酶(MDA、NO)表达水平呈上升趋势,差异无统计学意义(P＞0.05);抗氧化酶(CAT、GSH-PX、T-SOD)活性呈下降趋势,差异无统计学意义(P＞0.05).结论 在小鼠整个生精周期(35 d)内,TP给药建立生精功能损伤模型的最合适剂量为0.1 mg/(kg·d),这种损伤与氧化应激引起的细胞凋亡相关.

IntroductionTo investigate the clinical, radiographic and pathological features of interstitial lung disease (ILD) in patients with anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis (anti-MDA5+DM).MethodsWe retrospectively analysed the medical records of patients with anti-MDA5+DM who had undergone radiological examination, and lung histopathology was performed on 17 of them.ResultsThis study examined 329 patients with anti-MDA5+DM, of whom 308 (93.6%) were diagnosed with ILD and 177 (53.8%) exhibited rapidly progressive ILD (RPILD). The most common radiographic patterns were organising pneumonia (OP) (43.2%), non-specific interstitial pneumonia (NSIP) (26.4%) and NSIP+OP (18.5%). Histological analysis showed NSIP (41.2%) and NSIP+OP (47.1%) to be the predominant patterns. However, in the 17 patients who underwent lung histopathology, the coincidence rate between radiological and histopathological diagnoses was only 11.8%. Compared with patients without RPILD, those with RPILD showed a higher prevalence of NSIP+OP (26.6% vs 10.7%, p=0.001) and a lower prevalence of NSIP pattern (21.5% vs 37.4%, p=0.002) on high-resolution CT. Furthermore, patients with radiographic patterns of NSIP+OP or diffuse alveolar damage (DAD) had more risk factors for poor prognosis, with 12-month mortality rates of 45.9% and 100%, respectively.ConclusionsRPILD was commonly observed in patients with anti-MDA5+DM. OP was identified as the predominant radiographic pattern, which corresponded to a histopathological pattern of NSIP or NSIP+OP. Notably, patients exhibiting radiographic patterns of NSIP+OP or DAD were shown to have a poor prognosis.

OBJECTIVES:To determine the efficacy and safety of nintedanib in patients with anti-melanoma differentiation-associated gene 5 antibody positive dermatomyositis-associated interstitial lung disease (anti-MDA5+ DM-ILD). METHODS:The study was a retrospective cohort design that evaluated patients with anti-MDA5+ DM who either received or did not receive nintedanib. Clinical symptoms, laboratory tests, and survival were compared in the two groups using a propensity score-matched analysis. The primary endpoint was mortality, while adverse events were recorded descriptively. RESULTS:After propensity score matching, 14 patients who received nintedanib (nintedanib+ group) and matched 56 patients who did not receive nintedanib (nintedanib- group) were enrolled. Compared with the nintedanib- group, the nintedanib+ group had a lower incidence of heliotrope and arthritis, higher lymphocyte counts, lower serum ferritin levels, and greater 12-month survival (all p<0.005). Although lung function, HRCT score, and lung VAS were not statistically different between the two groups, the longitudinal study showed significant improvement in HRCT scores (p=0.028) and pulmonary VAS (p=0.019) in the nintedanib+ group. Adverse events occurred in 28.6% of patients, with the most common adverse event with nintedanib being diarrhoea. CONCLUSIONS:Nintedanib may be effective for improving clinical symptoms, laboratory parameters, lung lesions, and survival in anti-MDA5+ DM. Diarrhoea was the most common adverse event associated with nintedanib, although the drug was well tolerated by most patients.

Decreased calcium-sensing receptor (CaSR) has been observed in hyperparathyroidism (HPT) without a known mechanism. The purpose of this study was to evaluate the expression of CaSR in primary (PHPT) and secondary (SHPT) subtypes. Immunohistochemical (IHC) staining and quantitative real-time PCR (qRT-PCR) assay were used to measure the differences in expression of CaSR protein and gene in PHPT and SHPT human samples, compared to matched controls. CaSR protein was differentially downregulated in SHPT and PHPT compared to normal parathyroid tissues (2.42 ± 0.5 vs. 3.2 ± 0.62, P < 0.05; 1.8 ± 0.83 vs. 3.2 ± 0.62, P < 0.05, respectively). Furthermore, SHPT tissues exhibited significantly higher levels of CaSR mRNA (0.29 ± 0.23 vs. 0.01 ± 0.12, P < 0.05) and protein (2.42 ± 0.5 vs. 1.8 ± 0.83, P < 0.05) than those in PHPT tissue samples. Depressed CaSR expression was a critical pathological hallmark of HPT. We found a differential decline of CaSR, in terms of both mRNA and protein levels, in PHPT and SHPT human samples. We think that CaSR dysregulation occurred at the very beginning of disease onset in PHPT, while a similar pathological scenario appeared at the later stage of SHPT. Future studies should be directed to dissect the mechanistic involvement of CaSR in PHPT and SHPT in order to bring treatment precisions in HPT management.

Breast implant associated-anaplastic large cell lymphoma (BIA-ALCL) is very rare. This 39-year-old female patient, more than 10 years after breast augmentation surgery, had suffered left breast swelling and pain for more than 1 year. The original implant (domestic anatomic shape silicone implant, 260 ml) was surgically removed and the capsule of the left breast implant was completely removed. Postoperative pathology confirmed the diagnosis of BIA-ALCL. The patient recovered well after the surgery. This case is the first reported in China mainland, suggest that doctors should attach great importance to the diseases, and diagnose and treat it timely and accurately.

Objective To study the protein and mRNA expressions of regulator of G-protein signaling 5 (RGS5) in the pathogenesis of hyperparathyroidism. Methods The expression of RGS5 protein in 20 primary hyperparathyroidism (PHPT), 31 secondary hyperparathyroidism (SHPT), and 20 control cases were studied by immunohistochemistry (IHC). The expression of RGS5 mRNA in 15 PHPT, 102 SHPT, and 7 normal parathyroid tissue were measured by quantitative real-time PCR (qRT-PCR) method. Results The expressions of RGS5 in PHPT tissues were significantly higher than that in SHPT and normal parathyroid tissues ( P < 0.05). While the differences in RGS5 protein expressions between SHPT and respective control samples were not statistically significant ( P > 0.05). Likewise, the RGS5 mRNA expression in PHPT was significantly higher than that in SHPT ( P < 0.05) and normal parathyroid ( P < 0.05) samples. In a similar line, the differences in RGS5 gene expressions between SHPT and control tissues were not statistically significant ( P > 0.05). Conclusions The characteristic RGS5 protein and mRNA levels in hyperparathyroidism might be helpful in discovering the pathomechanism of hyperparathyroidism and novel therapeutic targets as well.

Background: Unfortunately, the eradication rate of Helicobacter pylori (H. pylori) treatment is markedly decreasing in recent years and the major reason is antibiotic resistance. Our study was designed to determine the effect and safety of H. pylori eradication treatment based on the molecular pathologic antibiotic resistance. Methods: 261 patients were analyzed retrospectively, including 111 patients who were treated for the first time (one group as First-treated) and 150 patients who failed at least once in bismuth quadruple therapy (another group as Re-treatment). Antibiotic resistance was examined by Real-time PCR detection and conventional PCR and sequencing method. The eradication rate (ER) was compared per intention to treat (ITT) and per protocol (PP) between the two groups. Results: The resistance rates to amoxicillin, clarithromycin, fluoroquinolone and tetracycline were 5.5%, 42.1%, 41.7% and 12.9% in the 111 first-treated patients, and 11.7%, 79.7%, 70.7% and 30.0% in the 150 re-treatment patients. The ERs in the ITT and PP analyses were 92.79% (95% CI, 87.98-97.60%, n=111) and 98.10% (95% CI, 95.48-100%, n=105), respectively, in the first-treated patients and 90.67% (95% CI, 86.01-95.32%, n=150) and 95.10% (95% CI, 91.57-98.64%, n=143), respectively, in the re-treatment patients. No significant differences were shown in the ERs between two group patients, and no serious adverse events were found. Conclusion: H. pylori eradication treatment based on molecular pathologic antibiotic resistance showed good effect and safety in both first and re-treated patients.

AbstractBackgroundThe BRAFV600E mutation is valuable for the diagnosis, prognosis, and therapy of papillary thyroid cancer (PTC). However, studies related to this mutation have involved only a small number of patients. Therefore, we performed a large‐scale analysis from a single institute to evaluate the accuracy of combined fine‐needle aspiration (FNA) and BRAFV600E mutation tests for PTC diagnosis.MethodsA total of 4600 patients with thyroid nodules who underwent both FNA cytology and BRAFV600E mutation analysis on FNA specimens were enrolled. The association between the BRAFV600E mutation and clinicopathological features was analyzed. A separate analysis was performed for the 311 patients who underwent repeated FNA for comparison of cytological evaluation and BRAFV600E mutation results. The diagnostic efficacy of the BRAFV600E mutation test and cytologic diagnoses was evaluated for 516 patients who underwent preoperative FNA tests in comparison with conclusive postoperative histopathologic results.ResultsThe cytology results of all 4600 FNA samples were categorized according to The Bethesda System for Reporting Thyroid Cytology (TBSRTC) stages I–VI, which accounted for 11.76%, 60.02%, 6.46%, 3.61%, 6.71%, and 11.43% of the samples, respectively. The BRAFV600E mutation was detected in 762 (16.57%) FNA samples, with rates of 1.48%, 0.87%, 20.20%, 3.01%, 66.02%, and 87.81% for TBSRTC I–VI lesions, respectively. Among the 311 repeat FNA cases, 81.0% of the BRAFV600E‐positive and 4.3% of the BRAFV600E‐negative specimens with an initial indication of cytological non‐malignancy were ultimately diagnosed as malignant by repeat FNA (p < 0.001). Among the 516 patients who underwent thyroidectomy, the sensitivity and specificity of the BRAFV600E mutation test alone for PTC diagnosis were 76.71% and 100.0%, respectively, which increased to 96.62% and 88.03%, respectively, when combining the BRAFV600E mutation test with cytology. BRAFV600E mutation was significantly associated with lymph node metastasis (p < 0.001), but not with age, gender, or tumor size.ConclusionsThe BRAFV600E mutation test in FNA samples has potential to reduce false negatives in PTC diagnosis, and therefore plays an important role in the diagnosis of thyroid nodules, especially those with an indeterminate or nondiagnostic cytology, which should be considered for repeat FNA.

BackgroundDermatomyositis (DM) associated rapidly progressive interstitial lung disease (RP-ILD) has high mortality rate and poor prognosis. Galectin-9 (Gal-9) plays multiple functions in immune regulation. We investigated Gal-9 expression in DM patients and its association with DM-ILD.MethodsA total of 154 idiopathic inflammatory myopathy patients and 30 healthy controls were enrolled in the study. Cross-sectional and longitudinal studies were used to analyze the association between serum Gal-9 levels and clinical features. Enzyme-linked immunosorbent assay and qRT-PCR were used to examine Gal-9 expression in the sera and isolated peripheral blood mononuclear cells (PBMCs) from DM patients. Immunohistochemistry was performed to analyze the expression of Gal-9 and its ligand (T-cell immunoglobulin mucin (Tim)-3 and CD44) in lung tissues from anti-melanoma differentiation-associated gene 5 (MDA5)-positive patients. The effect of Gal-9 on human lung fibroblasts (MRC-5) was investigated in vitro.ResultsSerum Gal-9 levels were significantly higher in DM patients than in immune-mediated necrotizing myopathy patients and healthy controls (all p < 0.001). Higher serum Gal-9 levels were observed in anti-MDA5-positive DM patients than in anti-MDA5-negative DM patients [33.8 (21.9–44.7) vs. 16.2 (10.0–26.9) ng/mL, p < 0.001]. Among the anti-MDA5-positive DM patients, serum Gal-9 levels were associated with RP-ILD severity. Serum Gal-9 levels were significantly correlated with disease activity in anti-MDA5-positive DM patients in both cross-sectional and longitudinal studies. PBMCs isolated from anti-MDA5-positive DM patients (3.7 ± 2.3 ng/mL) produced higher levels of Gal-9 than those from immune-mediated necrotizing myopathy patients (1.1 ± 0.3 ng/mL, p = 0.022) and healthy controls (1.4 ± 1.2 ng/mL, p = 0.045). The mRNA levels of Gal-9 were positively correlated with the levels of type-I interferon-inducible genes MX1 (r = 0.659, p = 0.020) and IFIH1 (r = 0.787, p = 0.002) in PBMCs from anti-MDA5-positive DM patients. Immunohistochemistry revealed increased Gal-9 and Tim-3 expression in the lung tissues of patients with DM and RP-ILD. In vitro stimulation with Gal-9 protein increased CCL2 mRNA expression in MRC-5 fibroblasts.ConclusionsAmong anti-MDA5-positive DM patients, Gal-9 could be a promising biomarker for monitoring disease activity, particularly for RP-ILD severity. Aberrant expression of the Gal-9/Tim-3 axis may be involved in the immunopathogenesis of DM-ILD.

目的:总结磷酸盐尿性间叶组织肿瘤(PMT)的临床与影像学特点并进行文献复习.方法:回顾分析2014年1月～2019年1月中日友好医院病理科诊断为PMT患者的临床、病理及影像学资料,进行相关文献的复习.结果:4例患者中男3例、女1例,平均年龄为47.2岁.患者均具有不同程度的乏力、骨痛、关节痛等临床表现,血磷减低,平均值为0.5mmol/L(正常值为0.81～1.78mmol/L).病变部位:1例位于上肢,1例位于下肢,2例位于头颈部.影像学表现:CT表现为软组织密度结节或肿块,平均CT值为47Hu,病变较小时边界清楚,病变较大时可合并骨质破坏;MRI表现为T1Wl等及低信号,T2WI脂肪抑制图像不均匀高信号,内部可见低信号区,增强扫描病变中度到明显强化,较大病变内部强化欠均匀.结论:PMT发病率低,其临床及影像学具有一定的特点,掌握这些特点有助于临床早期诊断和治疗.

Background: Calcium-sensitive receptor (CASR) plays an important role in the pathogenesis and progression of secondary hyperparathyroidism (SHPT). The purpose of this study is to examine the protein and gene expression characteristics of CASR in SHPT.Methods: Immunohistochemistry and real-time PCR were used to detect and compare the expression of CASR protein and genes in SHPT and primary hyperparathyroidism (PHPT) tissues.Results: CASR protein was down-regulated in SHPT and PHPT compared with normal parathyroid tissues (2.42±0.5 vs. 3.2±0.62, P<0.05; 1.8±0.83 vs. 3.2±0.62, P<0.05). Further, SHPT tissue showed higher expression of both CASR protein (2.42±0.5 vs. 1.8±0.83, P<0.05) and CASR gene (0.29±0.23 vs. 0.01±0.12, P<0.05) than PHPT tissue, respectively.Conclusion: The expression of CASR protein and gene in SHPT is higher than that in PHPT. This feature provides a theoretical basis and further ideas for studying the mechanism of CASR down-regulation.

Meng Yang (  mengyang7012@163.com ) China-Japan Friendship Hospital Yao Lu China-Japan Friendship Hospital Ling Zhang China-Japan Friendship Hospital Aiping Song China-Japan Friendship Hospital Honglei Zhang China-Japan Friendship Hospital Bo Pang Centers for Disease Control and Prevention Xin Li China Japan Friendship Institute of Clinical Medicine Research Jun Liu China-Japan Friendship Hospital Xiaoliang Sun China-Japan Friendship Hospital Haoyang Ji China-Japan Friendship Hospital Linping Huang China-Japan Friendship Hospital

患者女,59岁,因“双肩关节乏力伴活动障碍2年,加重6个月”就诊;既往类风湿关节炎5年.查体:双肩关节活动障碍,以外展、内收障碍为主.实验室检查:抗环状瓜氨酸多肽抗体1 879 U/ml,血清脂蛋白1 034 mg/L,类风湿因子503 IU/ml.右肩正位X线片示右侧肱骨近端软组织增厚,密度均匀,未见钙化,肱骨骨质未见异常(图1A).MRI:右侧肩峰三角肌下滑囊明显扩张,T1WI呈均匀等信号(图1B);脂肪抑制T2WI见囊内多发结节样小体,信号强度与肌肉组织相似,边界清,周围可见液性高信号围绕,呈“铺路石样”,小体大小及形态各异,多呈长椭圆形,形似“米粒”,长径3.30～9.60 mm(图1C).影像学诊断:右肩滑膜骨软骨瘤病.行关节镜下右肩关节清理术.术后病理:米粒体中心可见无定形嗜酸性物质,周围见纤维及胶原组织(图1D),符合米粒体滑囊炎.

Small cell lung cancer (SCLC) is a type of lung cancer characterized by a rapid disease progression and poor prognosis. Its diagnosis is often accompanied by distant metastasis. A literature review revealed that metastases to the stomach from breast, lung and esophageal cancer are frequently reported. While SCLC is a common pathological subtype of lung cancer, literature on SCLC with gastric metastases is sporadic. The present study reviewed the literature using databases, including PubMed, WanFang Data and China National Knowledge Infrastructure, to analyze the clinicopathological features and outcome of patients with gastric metastases from SCLC. A total of 11 case reports and 6 retrospective studies comprising of 19 cases were compared and analyzed. In addition to the aforementioned studies, a case study describing a patient who survived for 10 months following a diagnosis of SCLC with gastric metastases is presented. The aim of the present study was to increase the understanding regarding the diagnosis and treatment of SCLC gastric metastasis.

OBJECTIVE:The objective of our study was to evaluate the intravoxel incoherent motion (IVIM)-DWI derived parameters and their relationships with tumor prognostic markers using 3-T MRI in patients with rectal cancer.SUBJECTS AND METHODS:Fifty-two patients with histopathologically proven rectal cancer who underwent preoperative pelvic MRI were prospectively enrolled in this study. Diffusion and perfusion parameters including the apparent diffusion coefficient (ADC), pure diffusion coefficient, perfusion fraction, and pseudodiffusion coefficient derived from IVIMDWI were independently measured by two radiologists. Comparisons of IVIM-DWI-derived parameters in patients with different tumor prognostic markers were made using the independent-samples t test, ANOVA, and Mann-Whitney U test. The correlations between IVIM-DWI-derived parameters and tumor grade and tumor stage were further evaluated using Spearman correlation analysis. Interobserver agreement was evaluated using the intraclass correlation coefficient (ICC).RESULTS:Excellent interobserver reproducibility was obtained for the IVIM-DWI-derived parameters (range of ICCs with 95% limits of agreement = 0.9309-0.9948, which is narrow). ADC, pseudodiffusion coefficient, and perfusion fraction tended to rise with greater tumor differentiation (r = 0.520, p < 0.001; r = 0.447, p = 0.001; r = 0.354, p = 0.010, respectively). The pure diffusion coefficient and pseudodiffusion coefficient showed a trend of decreasing with increasing tumor stages (r = 0.479, p < 0.001; r = 0.517, p < 0.001). The group of patients with extramural vascular invasion (EMVI) showed lower pseudodiffusion coefficient values than the group of patients with no EMVI (p < 0.05).CONCLUSION:IVIM-DWI-derived parameters in patients with rectal cancer, especially the pseudodiffusion coefficient, are associated with tumor grade and tumor stage and show statistically significant differences between subjects with EMVI and those without EMVI. IVIM-DWI-derived parameters would be helpful in predicting tumor aggressiveness and prognosis.

Objective To analyze the clinical characteristics of papillary thyroid microcarcinoma (PTMC).Methods One hundred and twenty nine patients preoperatively diagnosed as papillary thyroid carcinoma (PTC) or suspicious PTC by fine needle aspiration biopsy (FNAB) underwent thyroidectomy,and 127 cases were confirmed as PTC histopathologically,among whom 77 cases were microcarcinoma (60.6％).The clinical data of 77 PTMC cases were retrospectively analyzed with SPSS (20.0) statistical software.Results In 77 PTMC cases,BRAF gene detection was performed in 69 cases,51 cases showed positive BRAF (73.9％) and 18 cases were negative.Among patients with positive BRAF,17 cases had cervical lymph node metastasis (33.3％);and in those with negative BRAF,5 cases had metastasis (5/18,x2 =0.189,P ＞ 0.05).In 31 patients with multiple lesions,14 had cervical lymph node metastasis (45.2％);while in 46 patients with single lesion,9 had metastasis (19.6％) (x2 =5.792,P ＜ 0.05).Conclusion Although PTMC growth is slow and occult,early lymph node metastasis is not rare,particularly for patients with multiple lesions.

BackgroundMany locally advanced rectal cancer (LARC) patients can benefit from neoadjuvant chemotherapy (NACT), with some achieving a pathological complete response (pCR). However, there is limited research reporting on the value of intravoxel incoherent motion (IVIM) in monitoring pCR in patients with LARC.PurposeTo identify whether IVIM parameters derived from whole‐tumor volume (WTV) before and after NACT could accurately assess pCR in patients with LARC.Study TypeProspective patient control study.PopulationFifty‐one patients with LARC before and after NACT, prior to surgery.Field Strength/SequenceIVIM‐diffusion imaging at 3T.AssessmentApparent diffusion coefficient (ADC), slow diffusion coefficient (D), fast diffusion coefficient (D*), and perfusion‐related diffusion fraction (f) values were obtained on diffusion‐weighted magnetic resonance images (DW‐MRI) using WTV methods and calculated using a biexponential model before and after NACT.Statistical TestsDWI‐derived ADC and IVIM‐derived parameters and their percentage changes (ΔADC%, ΔD%, ΔD*%, and Δf%) were compared using independent‐samples t‐test and Mann–Whitney U‐test between the pCR and non‐pCR groups. The diagnostic performance of IVIM parameters and their percentage changes were evaluated using receiver operating characteristic curves.ResultsCompared with the non‐pCR group, the pCR group exhibited significantly lower pre‐ADCmean (P = 0.003) and pre‐D values (P = 0.024), and significantly higher post‐f (P = 0.002), ΔADCmean% (P = 0.002), ΔD% (P = 0.001), and Δf% values (P = 0.017). Receiver operating characteristic curves showed that the pre‐D value had the best specificity (95.12%) and accuracy (86.27%) in predicting the pCR status, and ΔD% had the highest area under the curve (0.832) in assessing the pCR response to NACT.Data ConclusionsThe IVIM‐derived D value is a promising tool in predicting the pCR status before therapy. The percentage changes in D values after therapy may help assess the pCR status prior to surgery.Level of Evidence: 2Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2017.

Irinotecan is a well-known chemotherapy drug for the treatment of various cancers. However, delayed-onset diarrhea is a common adverse reaction, limiting the application of the drug. The study presented was designed to evaluate the preventive effects of Shengjiang Xiexin decoction (SXD) on irinotecan-induced diarrhea and to explore the possible mechanisms of this action. We established a diarrhea rat model. The condition of the rats was observed. The proliferation and apoptosis of intestinal cells were measured using immunohistochemical assays and a caspase-3 activity assay, respectively. The expression of Lgr5 and CD44 staining were used to observe intestinal stem cells (ISCs). In addition, the activity of β-glucuronidase in the rats' feces was measured. Our results showed that the number of proliferating intestinal cells in the SXD groups was obviously higher, while the activity of caspase-3 was lower. The expression of Lgr5 and the integrated option density (IOD) of CD44 stain were increased significantly by SXD. Additionally, SXD decreased the activity of β-glucuronidase after irinotecan administration. In conclusion, SXD exhibited preventive effects on irinotecan-induced diarrhea, and this action was associated with an inhibitory effect on intestinal apoptosis and β-glucuronidase and a promotive effect on intestinal cell proliferation due to increased maintenance of ISCs.

In this work, we investigate changes in the secretory function of Sertoli cells in diabetic rats and its correlation with testicular damage. Diabetes was induced by intraperitoneal injection of streptozotocin (55 mg/kg/i.p.) in adult rats. Eight weeks later, testicular tissue was harvested. Serum inhibin B (INHB) and testosterone (T) levels were measured by ELISA. The levels of secretory proteins, such as androgen-binding protein (ABP) and transferrin (TF), were measured by western blot analysis. Testicular damage was evaluated by hematoxylin and eosin staining, and apoptosis was identified by terminal-deoxynucleotidyl-transferase-mediated dUTP nick end labeling (TUNEL). Seminiferous tubular sperm formation was evaluated by the Johnsen's score. In diabetic rats, ABP protein levels (P = 0.038), serum INHB (P = 0.031), and T levels (P = 0.039) decreased greatly, whereas the decrease in TF protein levels (P = 0.247) was not significant. Additionally, TUNEL-positive cells (P = 0.000) increased and the Johnsen's score (P = 0.000) decreased in diabetic testes. These results suggest that the secretory function of Sertoli cells in diabetic rats was damaged. The altered secretory function of Sertoli cells may be responsible for disturbed spermatogenesis.

SESSION TITLE: Pulmonary Nodules SESSION TYPE: Case Report Slide PRESENTED ON: Saturday, April 16, 2016 at 01:00 PM - 02:00 PM INTRODUCTION: WD is a rare multi-systemic disorder caused by Thropheryma whipplei, a Gram-positive bacillus. Gastrointestinal manifestations are the most frequent, but many other organs may be involved. We report a case of WD presenting with lung nodule in which shortness of breath and wheezing were the only manifestations. CASE PRESENTATION: A 44-year-old woman with a history of tuberculosis 5 years ago, reported shortness of breath and wheezing, CT scan disclosed a nodule, did right pulmonary wedge resection, histological examination of which led to the diagnosis of WD. Postoperative pathology showed non-caseating granuloma with clustered periodic acid-Schiff (PAS)-positive macrophages. Immunoreactivity with anti-T whipplei antibodies confirmed the presence and suggested the involvement of T whipplei in the pathogenesis of the presenting lung disease. The patient was treated with oral Sulfonamides for 20 months to prevent recurrence. DISCUSSION: In addition to our case, we identified nine published cases of WD with pulmonary involvement without GI symptoms. Including the present case the ten cases comprised eight men and two women, with a mean age of 49.5 years. WD and pulmonary tuberculosis have been diagnosed in this patient. Hypothesis that patients with WD are cellular immune defects could explain the association with tuberculosis, which could partially explain why women and all races are susceptible to this disease. This patient received the diagnosis before the onset of intestinal manifestations. In patients presenting with lung involvement associatedwith arthralgia and fever, sarcoidosis is a possible alternative diagnosis. In cases of suspected WD with or without pulmonary involvement, duodenal biopsy with PAS staining is indicated, even in the absence of intestinal clinical symptoms. In our case, the bronchial location of the bacterium was confirmed by immunohistochemical analysis with anti-T whipplei antibodies. CONCLUSIONS: It is important to be aware that WD may have atypical presentations. Even with the major scientific improvements in the past decades, diagnosis of WD is still diffcult due to its rarity and nonspecific clinical presentations. It is important to be aware that PAS positivity is not specific for T. whipplei, could also be seen in mycobacterial infection. Acid‐fast stain is negative in WD and is useful to exclude tuberculosis. In conclusion, even in the absence of GI symptoms and without history of unexplained arthralgia and/or fever, a diagnosis of WD should be considered with lung nodules if they have evidence of atypical granuloma. Reference #1: Urbanski G, Rivereau P, Artru L, Fenollar F, Raoult D, Puéchal X. Whippledisease revealed by lung involvement: a case report and literature review. Chest. 2012 Jun;141(6):1595-8. doi: 10.1378/chest.11-1812. Review. PubMed PMID:22670021 DISCLOSURE: The following authors have nothing to disclose: Aiping Song, Jiping Da No Product/Research Disclosure Information