Focus on laboratory tests related to the pathological types of lupus nephritis to implement renal biopsy as early as possible:clinical and pathological analysis of 217 cases of single center lupus nephritis

Objective:To analyze the clinical and laboratory indices of patients with lupus nephritis(LN)of different pathological types and explore the related factors of LN pathological classification,it is helpful to grasp the timing of renal biopsy.Methods:The clinical manifestations,laboratory parameters and renal pathological types of LN patients in recent 20 years were analyzed retrospectively by SPSS 26.0 software.Results:In this study,the first three pathological types were V,IV,V+IV;latent nephritis was common in type II and V;nephritic syndrome was common in type V;nephrotic syndrome was common in type V+IV;chronic renal insufficiency group was mostly type IV;pathological types were correlated with serum creatinine,C3,albumin and erythrocyte sedimentation rate(r=0.315,P<0.001),and serum creatinine was moderately correlated(r=0.315,P<0.001);AI,CI and SLEDAI scores were significantly different among LN patients of different pathological types.Conclusion:LN is closely related to clinical pathology,clinical manifestations,comprehensive analysis of laboratory indicators and SLEDAI score to make a preliminary prediction of LN pathological type,help to initially assess the severity of pathology,improve the timing of renal biopsy implementation,optimize the timing of treatment.

Pathologic and Clinical Analysis of Carcinosarcoma of Esophagus (20 Cases)

Objective:Carcinosarcoma of esophagus is an infrequent disease. Here, the pathologic data of larger specimens of this disease are reviewed and analyzed for studying its clinical characteristics in order to provide support information for clinical diagnosis. Methods: To review and study the clinical data of 20 patients of esophageal carcinosarcoma. Results: Most of esophageal carcinosarcoma grew like pileus or polypus in esophagus, a few of them were infiltrating. Microscopic examination of the resected specimens indicated that the tumor is composed of sarcomatous element and carcinomatous element (the main element), and the surface of such tumor was covered mostly by carcinoma tissues. The result of biopsy showed that the tumor is squamous cell carcinoma. X-ray examination indicated that there was polypus-like smooth and tidy filling defect in the esophagus of such patient, and its mucous membrane showed “daubing-trace” like characteristics. Conclusion: Carcinosarcoma of esophagus is a tumor of low invasion, which grows mainly in the esophageal lumen. The clinical symptoms of this tumor are different from those of esophagus carcinoma in certain degree. The “daubing-trace” like characteristics is typical of X-ray picture. The results of most endoscopic biopsies demonstrate squamous cell carcinoma or lower differentiation carcinoma, which are difficult for confirmed diagnosis before operation.

Demand and Analysis of Clinical Research Curriculum in Medical Universities

Objective:To investigate the needs of medical students regarding clinical research curricula to provide scientifically sound offerings and cultivate their clinical research thinking.Methods:From June to October 2022,medical students at medical universities in Shaanxi Province were surveyed using online questionnaires.The survey covered their demographic information,awareness of their major,understanding of clinical research,and preferences for curriculum content.Results:A total of 341 valid questionnaires were analyzed.Medical students demonstrated a strong awareness of their majors but a relatively low awareness of clinical research.There was significant demand for clinical research courses,with preferences for professionally oriented(81.8%),market-oriented(100%),theoretically and practically integrated teaching(78.6%),and application-focused(73.0%)courses.Conclusion:Medical colleges and universities should align clinical research curricula with the actual needs of medical students and clinical practice.Reforms in curriculum design and teaching methods are essential to better prepare students for careers in public health.

Analysis of the Current Situation of Drug Clinical Trial Institutions in Shaanxi Province

To understand the current situation of institutional registration in Shaanxi Province after the implementation ofregistration system management in drug clinical trial institutions.Relevant information was collected on the“Announcement on the Accreditation of Drug Clinical Trial Institutions”issued by the National Medical Products Administration from 2005 to August 2022,the record management information system of drug and medical device clinical trial institutions,and the drug clinical trial registration and information publicity platform.A retrospective analysis was carried out in terms of institutional development,regional distribution,registered majors,principal investigators,and the number of drug clinical trials.After the implementation of institution registration,the number of drug clinical trial institutions in Shaanxi Province increased by 47.4%,884 principal investigators were registered,the number of registered majors expanded from 58 qualified to 117,and the professional scope increased by 50.4%.The policy of institution registration is conducive to promoting the rational use of medical resources and the development of drug clinical trial institutions and improving the healthy development of the pharmaceutical industry in Shaanxi Province.

Clinical Pathological Analysis of Synovial Sarcoma

OBJECTIVE To investigate the clinical diagnosis and differential diagno- sis of synovial sarcoma (SS). METHODS A total of 41 paraffin-embedded synovial sarcoma samples were examined by H&E staining, immunohistochemistry staining and the re- verse transcriptase polymerase chain reaction (RT-PCR), in order to provide a scientific bases for diagnosis and differential diagnosis. RESULTS Twelve cases were a biphasic type, 22 cases were a mono- phasic fibrous type, and 7 cases were a poorly differentiated type. Thirty-six cases were both CK (and/or EMA) and Vim positive. Five cases were only Vim positive. A SYT-SSX fusion gene was detected in 18 cases by RT-PCR. CONCLUSION By observation of the histomorphology, immunohisto- chemistry markers and detection of a SYT-SSX fusion gene, we can make a clinical pathological diagnosis of synovial sarcoma.

Clinical Pathological Analysis in 104 Ductal Breast Cancer Cases

Ductal breast cancer is a clinically heterogeneous disease;we investigate the correlation between tumor size, comedo necrosis, number of cell mitoses and axillary lymph node metastasis in ductal breast cancer. In this study, 104 ductal breast cancer specimens were collected and divided into 3 groups: T1 group (tumor size ≤ 2 cm), T2 group (2 5.0 cm). Among those specimens, 95 cases were diagnosed with invasive ducted carcinoma, and 9 cases were ductal carcinoma in-situ (DCIS). Results show that T3 group has a higher rate of axillary lymph node metastasis than T2 group and T1 group;T2 group has a higher rate of lymph node metastasis than T1 group. The patients with the number of cell mitoses (≥10) were also has a higher rate of axillary lymph node metastasis (P = 0.0139) than the patients with the number of cell mitoses (<10). No significance was found between comedo necrosis lesions and axillary lymph node metastasis, though the frequency of comedo necrosis lesions in patients with axillary lymph node metastasis was higher than those in non-metastatic patients. It is concluded that the tumor size and the number of cell mitoses were risk factors for axillary lymph node involvement in ductal breast cancer.

Clinical pathologic analysis of urologic primary primitive neuroectodermal tumor

Objective To explore clinico-pathological features,immunophenotype,treatment and prognosis of urologic primary primitive neuroectodermal tumor ( PNET) . Methods The clinical data of 3 patients with urologic PNET were analyzed retrospectively. All patients were male,aged 29,32 and 75 years respectively.

Multilevel analysis of the central-peripheral-target organ pathway:contributing to recovery after peripheral nerve injury

Peripheral nerve injury is a common neurological condition that often leads to severe functional limitations and disabilities.Research on the pathogenesis of peripheral nerve injury has focused on pathological changes at individual injury sites,neglecting multilevel pathological analysis of the overall nervous system and target organs.This has led to restrictions on current therapeutic approaches.In this paper,we first summarize the potential mechanisms of peripheral nerve injury from a holistic perspective,covering the central nervous system,peripheral nervous system,and target organs.After peripheral nerve injury,the cortical plasticity of the brain is altered due to damage to and regeneration of peripheral nerves;changes such as neuronal apoptosis and axonal demyelination occur in the spinal cord.The nerve will undergo axonal regeneration,activation of Schwann cells,inflammatory response,and vascular system regeneration at the injury site.Corresponding damage to target organs can occur,including skeletal muscle atrophy and sensory receptor disruption.We then provide a brief review of the research advances in therapeutic approaches to peripheral nerve injury.The main current treatments are conducted passively and include physical factor rehabilitation,pharmacological treatments,cell-based therapies,and physical exercise.However,most treatments only partially address the problem and cannot complete the systematic recovery of the entire central nervous system-peripheral nervous system-target organ pathway.Therefore,we should further explore multilevel treatment options that produce effective,long-lasting results,perhaps requiring a combination of passive(traditional)and active(novel)treatment methods to stimulate rehabilitation at the central-peripheral-target organ levels to achieve better functional recovery.

Clinical and endoscopic analysis of gastric Dieulafoy’s lesion

AIM:To investigate the incidence,location,clinical presentation,diagnosis and effectiveness of endoscopic treatment of gastric Dieulafoy's lesion(DL)in China. METHODS:All patients who received emergency upper gastrointestinal(GI)endoscopy due to gastric DL from February 2000 to August 2008 at GI endoscopy center of Renmin Hospital of Wuhan University were included in this study.The clinical presentation,medical history,location and characteristics of DL methods and effectiveness of therapy of patients with DL were retrospectively analysed by chart reviews.Long-term follow-up data were collected at outpatient clinics or telephone interviews. RESULTS:Fifteen patients were diagnosized with DL,which account for 1.04%of the source of bleed- ing in acute non-variceal upper GI bleeding.Common comorbidities were found in one patient with hypertension and diabetic mellitus.Hemoclip or combined therapy with hemoclip produced primary hemostasis in 92.8%(13/14) of patients. CONCLUSION:DL is uncommon but life-threatening in China.Hemoclip proved to be safe and effective in controlling bleeding from DL.

A clinicopathological analysis in unsuspected gallbladder carcinoma: A report of 23 cases

AIM： To study the clinicopathological characteristics of unsuspected gallbladder carcinoma （UGC）. METHODS： We retrospectively studied 23 cases of UGC in Tongji Hospital, and compared their clinicopathological characteristics with 33 cases of preoperatively diagnosed gallbladder carcinoma （PDGC）. RESULTS： The proportion of UGC coexisting with cholecystolithiasis was significantly higher than that of PDGC （x^2 = 13.53, P 〈 0.01）. The infection rate of hepatitis B virus was 21.74% （5/23） in UGC and 30.30% （10/33） in PDGC. Nine （39.13%） of 23 patients with UGC and 8/33 （24.24） PDGC had contact with schistosome pestilent water. The rate of multiple pregnancies was 56.52% （13/23） in the patients with UGC and 42.42% （14/33） in PDGC. The primary location of the UGC was mostly in the neck and body of the gallbladder, and that of the PDGC was often in the body and bottom. The incidence of Nevin stage I and 11 UGC was significantly higher than that of PDGC （x^2 = 4.44, P 〈 0.05 and 2 = 4.96, P 〈 0.05） while that of Nevin stage V UGC was significantly lower than that of PDGC （x^2 = 7.59, P 〈 0.01）. According to the grading of carcinoma, the incidence of well-differentiated UGC was significantly higher than that of PDGC （2 = 4.16, P 〈 0.05）, and that of poorlydifferentiated UGC was significantly lower than that of PDGC （x^2 = 4.48, P 〈 0.05）.CONCLUSION： There are different characteristics between UGC and PDGC, such as in primary location, malignant degree and incidence of coexistence with cholecystolithiasis. Cholecystolithiasis, hepatitis B, schistosome and multiple pregnancies were high risk factors for gallbladder carcinoma.

Clinical classification and gene mutation of Chinese probands with Charcot-Marie-Tooth disease Analysis of 57 cases

Charcot-Marie-Tooth （CMT） disease is the most common inherited peripheral neuropathic disorder. CMT is clinically and genetically heterogeneous. To date, 27 genes associated with the disease have been cloned. The present study carried out clinical classification according to clinical, electrophysiological and pathological features, conducted inheritance classification according to inheritance patterns, and performed mutation analysis of 13 CMT disease genes （PMP22, CX32, HSPB1, MNF2, MPZ, HSPB8, GDAP1, NFL, EGR2, SIMPLE, RAB7, LMNA, MTMR2） in 57 Chinese probands with CMT. Five cases of AD-CMT1 and 13 cases of sporadic CMT1 were diagnosed as CMT1A; five cases of X-CMT1, one case of X-CMT2 and one case of sporadic CMT1 were diagnosed as CMTXl; four cases of AD-CMT2 were diagnosed as CMT2F; one case of AD-CMT2 and one case of sporadic CMT2 were diagnosed as CMT2A2; one case of AD-CMT2 was diagnosed as CMT2L; one case of AD-CMT2 was diagnosed as CMT2J; one case of AR-CMT1 was diagnosed as CMT4A. Among the 57 CMT probands, seven genotypes were determined among 34 patients, with a detection rate of 59.6%. The results indicated that the clinical classification and inheritance classification are indispensable for selecting potential disease genes for mutation detection, and for efficient molecular diagnosis.

A study of clinical psychological nursing research hotspots in China and variation trends based on word frequency analysis and visualization analysis

Objective: To analyze clinical psychological nursing research hotspots in China and variation trends in order to provide reference points on the current state of development of clinical psychological nursing and future research hotspots.Method: Clinical psychological nursing research literature sourced from Wanfang Data for the three periods of 2007-2009, 2010-2012, and 2013-2015 were selected as the research sample. A bibliographic co-occurrence analysis system(BICOMB software) was used to perform keyword word frequency analysis and generate a keyword co-occurrence matrix. In addition, Ucinet software's Netdraw tool was used to create visualized network diagrams.Results: A total of 27890 articles were retrieved, and word frequency analysis revealed that the highestfrequency keywords consisted of anxiety, depression, the elderly, expectant women, coronary heart disease, diabetes, breast cancer, perioperative period, quality of life, and psychological intervention.Research hotspot analysis revealed that consistent hotspots comprised anxiety, depression, health education, and perioperative period; expectant women became a hotspot during 2010-2012, and quality of life and efficacy became hotspots during 2013-2015.Conclusions: In addition to the care process, clinical psychological nursing research hotspots in China have increasingly included the effectiveness of psychological nursing and impact on patient quality of life. In addition, research hotspots have been influenced by the incidence of illnesses and people's health consciousness.

Application of Statistical Tools for Data Analysis and Interpretation in Rice Plant Pathology

There has been a significant advancement in the application of statistical tools in plant pathology during the past four decades. These tools include multivariate analysis of disease dynamics involving principal component analysis, cluster analysis, factor analysis, pattern analysis, discriminant analysis, multivariate analysis of variance, correspondence analysis, canonical correlation analysis, redundancy analysis, genetic diversity analysis, and stability analysis, which involve in joint regression, additive main effects and multiplicative interactions, and genotype-by-environment interaction biplot analysis. The advanced statistical tools, such as non-parametric analysis of disease association, meta-analysis, Bayesian analysis, and decision theory, take an important place in analysis of disease dynamics. Disease forecasting methods by simulation models for plant diseases have a great potentiality in practical disease control strategies. Common mathematical tools such as monomolecular, exponential, logistic, Gompertz and linked differential equations take an important place in growth curve analysis of disease epidemics. The highly informative means of displaying a range of numerical data through construction of box and whisker plots has been suggested. The probable applications of recent advanced tools of linear and non-linear mixed models like the linear mixed model, generalized linear model, and generalized linear mixed models have been presented. The most recent technologies such as micro-array analysis, though cost effective, provide estimates of gene expressions for thousands of genes simultaneously and need attention by the molecular biologists. Some of these advanced tools can be well applied in different branches of rice research, including crop improvement, crop production, crop protection, social sciences as well as agricultural engineering. The rice research scientists should take advantage of these new opportunities adequately in adoption of the new highly potential advanced technologies while planning experimental designs, data collection, analysis and interpretation of their research data sets.

A clinical analysis of acute pancreatitis in pregnancy

To the Editor： Acute pancreatitis in pregnancy （APIP） is one of the acute abdomen in pregnancy. Once the disease deterio- rated rapidly, it could be a serious threat to gravida and fetus. Although the incidence of APIP has been gradually increasing due to the life style change, it is still a rare disease and the mechanism is not clear. Patients with APIP were often misdiagnosed and not managed properly.

A study on clinical nursing research trends and hotspots based on bibliometric analysis

Objective: This study was conducted to understand the trends and research hotspots of clinical nursing in China and abroad, thereby to provide guidance for nursing practice and studies.Methods: We retrieved clinical nursing literature(excluding literature related to psychological nursing and traditional Chinese medicine nursing) cited in Wanfang Data(www.wanfangdata.com.cn) and PubMed between 2007 and 2015 and subsequently performed bibliometric analyses on article volume,journal, clustering of high-frequency keywords, and co-occurrence of keywords.Results: A total of 10374 publications, excluding those related to psychological nursing, were retrieved via a PubMed search. The literature displayed a rising trend in terms of annual publication volume. The journal distribution of clinical nursing publications overall was consistent with Bradford's Law. The main contents of clinical nursing literature between 2007 and 2009 included:(1) studies on effects of the midwife and midwifery methods for natural childbirth;(2) studies on emergency nursing care;(3)studies on dementia care;(4) studies on bandage dressing in trauma nursing; and(5) studies on quality of life in cancer patients nursing. The main contents of clinical nursing literature between 2010 and 2012 included:(1) studies on obstetric nurse-patient relationships;(2) studies on patients' medical team in stroke nursing;(3) studies on cancer nursing methods;(4) studies on nursing patients with trauma related to urinary incontinence; and(5) studies on the quality of life of caregivers of dementia patients.The main contents of clinical nursing literature between 2013 and 2015 included(1) studies on skin care and bandaging in trauma nursing;(2) studies on evidence-based nursing in AIDS care;(3) studies on nurses' role in obstetric nurse-patient relationships; studies on cancer nursing methods;(4) studies on nursing for Alzheimer's disease and dementia; and(5) studies on caregivers and nursing of stroke patients. A Wanfang Data search retrieved a total of 85570 publications, whose volume also exhibited an annual rising trend, in particular with regard to those in core journals. However, percentage of total publication volume, mean cited frequency per article, and total ranking of clinical nursing publications overall displayed a decreasing trend. The main contents of clinical nursing literature between 2007 and 2009 included:(1) diabetes nursing;(2) nursing for cancer;(3) nursing for senility-related diseases;(4)nursing in the event of complications;(5) nursing for hypertension;(6) studies on quality of life after nursing interventions;(7) chemotherapy nursing;(8) studies on compliance after nursing interventions;(9) constipation nursing; and(10) nursing for stroke patients. The main contents of clinical nursing literature between 2010 and 2012 included:(1) diabetes nursing;(2) nursing for cancer;(3) nursing for senility-related diseases;(4) studies on quality of life after nursing interventions;(5) nursing in the event of complications;(6) nursing for hypertension;(7) prevention nursing;(8) perioperative nursing;(9)pain nursing; and(10) studies on compliance after nursing interventions. The main contents of clinical nursing literature between 2013 and 2015 included:(1) diabetes nursing;(2) nursing in the event of complications;(3) cancer nursing;(4) studies on quality of life after nursing interventions;(5) nursing for stroke patients;(6) nursing for the elderly;(7) studies on compliance after nursing interventions;(8)nursing for hypertension;(9) constipation nursing; and(10) prevention nursing.Conclusions: Clinical nursing research in China is in a rapid development stage as defined by Price's law whereby there is a rapid growth in publication volume. By comparison, clinical nursing research in developed countries is in the stable development stage or maturation phase, which is characterized by a flat curve of publication volume and stable development rate. There is a gap of 25-30 years between China and these countries in terms of the growth phases of clinical nursing literature.

Clinical Analysis of 73 Cases of Intraspinal Nerve Sheath Tumor

Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence of the tumor and occurrence of kyphotic deformities. Preoperative clinical manifestations, imaging data, surgical records and follow-up results were comprehensively analyzed. The follow-up duration was 12-60 months with an average of 32.0 months. Out of the 73 cases enrolled, 69 had gradual recovery of sensation, motor and sphincter functions 1 week to 3 months after operation. Forty-six cases had incomplete paralysis, whose American Spinal Injury Association （ASIA） grades, however, were gradually increased during the follow-up period, 4 cases had no significant improvement of the clinical symptoms and no change in ASIA grades during the follow-up period. Two cases had postoperative recurrence of the tumor. There were no deaths, no spinal instability, and no kyphotic malformations fotmd in any cases. Our study indicated that complete removal of the tumor is important for good recovery, and an ideal surgical method may reduce the recurrence of the tumor or the occurrence of complications.

Eye-acupuncture as adjuvant therapy for stroke:A bibliometric analysis of clinical studies

Background:Eye-acupuncture(EA)is a fine-needle acupuncture therapy for systemic diseases.This bibliometric analysis aims to provide a comprehensive review of the characteristics of EA for ischemic or hemorrhagic apoplexy based on clinical studies.Methods:A total of 195 clinical studies from six databases such as CNKI,VIP,Wanfang Data,SinoMed,PubMed and the Cochrane Library from inception to December 31,2017 were included.Bibliometric information mainly including study type,participant characteristics,intervention and comparison details,and outcomes were extracted.Data was analyzed descriptively using SPSS
software to determine their distribution(range,interquartile range)and central tendency(median).Results:The studies covered 108 RCTs,36 controlled clinical trials,45 case series and 6 case reports on EA for treatment of ischemic or hemorrhagic apoplexy,involved 15466 stroke patients.EA was used at different stages of ischemic or hemorrhagic apoplexy:acute stage(n Z 38),recovery(n Z 32),sequela(n Z 13)and unclear(n Z 112).The most frequently used EA acupoints were in the upper-jiao and lower-jiao regions.The commonly used comparisons were EA alone versus traditional acupuncture,or EA plus traditional acupuncture versus traditional acupuncture.Neurological deficit scale,Modified Barthel Index,and activities of daily living were the most frequently used outcome measures.Conclusion:EA as an adjuvant therapy is effective and safe in treating stroke at acute and recovery stages,but high-quality RCTs are lacking.

Clinical characteristics of myotonia congenita in China Literature analysis of the past 30 years

AIM： To understand the distinct, clinical features of myotonia congenita in China. METHODS： Case reports of myotonia congenita were retrieved from the Chinese Journal Full-text database, dating between 1980 and 2007, and analyzed for clinical characteristics of myotonia congenita. RESULTS： There were 35 published reports and 258 cases about myotonia congenita. Six reports （62 cases） were excluded due to lack of clinical data, imprecise diagnosis, or duplication. Finally, 29 published reports and 196 cases （140 males and 56 females） were included in this analysis. About 78.6% of patients were diagnosed with myotonia congenita before the age of 20, and among these, 86.1% were classified as dominant inheritance. Lower and upper extremities were frequently affected with severe symptoms. Eyelids, mouth and lingual muscles, and trunk muscles and cervical muscles were less frequently involved. However, muscles for swallowing, sphincter muscles, and smooth muscles were not involved. There were no reports of cataracts, cardiac conduction block, or dyscrinism. myotonia congenita symptoms were induced or aggravated by cold temperatures in 71.9% of the patients and warming-up effect occurred in 95.6% of the patients. Muscle hypertrophy was observed in 69.6% and percussion of muscles in 76.5% of the patients. Myotonia potential or myotonia-like potential was detected in all patients using electromyography. Muscle fiber swelling or hypertrophy was frequently detected through muscular biopsy. CONCLUSION： Myotonia congenita frequently occurs in males before the age of 20, in particular as the autosomal dominant form of myotonia congenita. Skeletal muscles throughout the body, especially the lower and upper extremities, are involved. However, muscles for swallowing, sphincter muscles, and smooth muscles are not involved. Warming-up effect is the main characteristic of myotonia congenita.

Clinicopathological analysis of early-stage breast cancer patients that meet indications for BRCA 1/2 genetic testing

Objective:To investigate the clinicopathological characteristics and prognostic factors of early-stage breast cancer patients with indications for breast cancer susceptibility genes 1/2(BRCA1/2)genetic testing in China.Methods:Based on the indication criteria for BRCA genetic testing specified in the National Comprehensive Cancer Network(NCCN)clinical practice guidelines in oncology,genetic/familial high-risk assessment:Breast and ovarian(Version 2.2019),a retrospective analysis was performed on patients with early-stage invasive breast cancer treated at Breast Disease Center,Peking University First Hospital between January 2008 and December 2016.Clinicopathological characteristics of all patients were analyzed,and prognoses were calculated using the KaplanMeier method and a Cox proportionate hazards model.Results:A total of 906 early-stage breast cancer patients who had indications for BRCA genetic testing and had complete clinicopathological data and follow-up information were included in the study group,accounting for34.7%of all breast cancer patients treated in Breast Disease Center,Peking University First Hospital during the study period.Compared with breast cancer patients without indications for BRCA genetic testing,the overall survival(OS)and disease-free survival(DFS)of patients with indications were not significantly different.In the study group,patients with premenopausal status,high T stage,lymph node positive,estrogen receptor(ER)negative,Ki-67>20%and presence of a vascular tumor thrombus had worse prognosis.There were more family histories of gastrointestinal cancer in patients with related indications than in patients without such indications.Conclusions:Single-center data showed that more than 30%of patients with early-stage breast cancer had indications for BRCA genetic testing.There was no prognostic difference in patients with or without indications for BRCA genetic testing.Premenopausal status,high T stage,lymph node positive,ER negative,Ki-67>20%,and presence of a vascular tumor thrombus were associated with poor prognosis.

Clinical characteristics and prognostic analysis of gastroenteropancreatic neuroendocrine neoplasm(GEP-NEN)

Objective： The aim of the study was to analyze the clinicopathologic characteristics of gastroenteropancreatic neuroendocrine neoplasm （GEP-NEN） and to explore the prognostic factors for patients and differences of immunohisto- chemical markers between neuroendocrine tumor （NET） and neuroendocrine carcinoma （NEC）. Methods： Retrospective reviews were conducted for the charts of 119 patients with GEP-NEN at the Affiliated Hospital of Qingdao University （China） from August 2003 to December 2013. Kaplan-Meier method was used to do the overall survivals analysis for the patients at different levels of predictive factors. Meanwhile, Cox proportional hazard model was used to select independent risk factors of surJival. Analysis of variance was used to compare the expression of immunohistochemical markers among different patho- logical grades. Results：Among 119 patients, pancreas （45/119, 37.82%） and rectum （33/119, 27.73%） were mostly involved. The onset age of GEP-NEN in female group was younger than that of the male group. There were 13 deaths （10.92%） during 18.9 （0.1-133.4） months follow-up period. Multivariate analysis indicated that neural invasion, gender and pathological grades of NET and NEC were independent risk factors. In neuroendocrine neoplasm （NEN）, Syn expression in G2 was higher than G1 and G3, while CgA showed no significant difference. All markers showed no significant differences between NET and NEC. Conclusion： GEP-NEN may occur at multiple sites of digestive system and lack specific clinical manifestations. Syn expression detected for the prognosis of G1, G2 and G3 tumors have clinical significance. Neural invasion, sex and patho- logical grades were independent prognostic factors for GEP-NEN patients. No significant difference was found in different pathological grades of NET and NEC.