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25 December 2018, Volume 17 Issue 06 Previous Issue    Next Issue

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Multicenter study on rpoB mutation in rifampicin-resistant Mycobacterium tuberculosis isolates of initial retreatment pulmonary tuberculosis CHENG Qijian, CHEN Ling, DU Wei, LIU Yahui, YANG Hua, XIAO Heping, SHI Guochao 2018, 17 (06):  635-639.  DOI: 10.16150/j.1671-2870.2018.06.003 Abstract ( 236 )   PDF (485KB) ( 98 )   Objective: To observe the association between mutation of rifampicin resistance determining regions (RRDR) of rpoB gene and rifampicin resistance in rifampicin-resistant Mycobacterium tuberculosis(Mtb) strains isolated from initial retreatment pulmonary tuberculosis. Methods: Mtb isolates from pulmonary tuberculosis patients who had previous treated were collected. Drug susceptibility was identified through BACTEC 960 and Roche medium; rpoB gene mutation was analyzed by polymerase chain reaction (PCR). Results: A total of 141 isolates from 141 patients in 19 hospitals from 12 provinces across the country were tested for drug sensitivity and analysis of RRDR loci sequencing. Point mutations were identified in 72 strains by sequencing and 71 were in RRDR. The main mutation sites included codon 531 (42 strains), 526 (11 strains) and 516 (10 strains). Seventy-five strains were resistant to rifampicin (RFP), of which 70 (93.3%) had rpoB mutation and 69 were in RRDR. Only two strains with RRDR mutation (L511P and H526N mutant Mtb) were sensitive to rifampicin, and 70 rpoB mutation strains were resistant to rifampicin. Conclusions: The rifampicin-resistance in Mtb isolates from initial retreatment pulmonary tuberculosis is associated with rpoB gene RRDR mutation. RRDR mutation detection can be used for rapid identification of rifampicin-resistant Mtb in retreated patients. References | Related Articles | Metrics

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Plasmids typing of genes carrying blaKPC-2 in Klebsiella pneumoniae isolated at a tertiary hospital in Shanghai SHEN Pinghua, ZHANG Xianhua, JIANG Xiaofei, CHEN Huifen 2018, 17 (06):  640-644.  DOI: 10.16150/j.1671-2870.2018.06.004 Abstract ( 185 )   PDF (744KB) ( 65 )   Objective: To investigate the plasmids typing of genes carrying blaKPC-2 in carbapenemase resistant Klebsiella pneumoniae for exploring its epidemiological evolution. Methods: Thirty-eight carbapenem -resistant Klebsiella pneumoniae isolates obtained consecutively from Huashan Hospital were collected, all carrying blaKPC-2-bearing plasmids. All the strains were subjected to multilocus sequence typing (MLST). Relaxase analysis was used to classify these plasmids. Results: Eight of the blaKPC-2-bearing plasmids belonged to the MOBP3 and 30 blaKPC-2-bearing plasmids belonged to the MOBF12. Phylogenetic analysis revealed that the MOBF12 plasmids were located at two different branches, respectively, suggesting they had different biological origin. Conclusions: It is the first time that relaxase has been used for plasmids typing of genes carrying blaKPC-2 in carbapenemase resistant Klebsiella pneumoniae, and found 8 belonged to the MOBP3 and 30 belonged to the MOBF12, and the MOBF12 having different biological origin, denoting the epidemiological evolution of blaKPC-2 bearing plasmid in carbapenemase resistant Klebsiella pneumoniae. References | Related Articles | Metrics

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Preparation of recombinant protein acyl carrier protein 1(Acp1) of Candida albicans MENG Lingning, LIU Jinyan, WANG Yuting, XIANG Mingjie 2018, 17 (06):  645-649.  DOI: 10.16150/j.1671-2870.2018.06.005 Abstract ( 135 )   PDF (609KB) ( 46 )   Objective: To prepare a high purity target protein by expressing Candida albicans acyl carrier protein Acp1 in E. coli BL21. Methods: The target gene Acp1 was amplified by PCR, and then the 6XHis tag and terminator were ligated into the C-terminus of the sequence. After splicing, the sequence was inserted into the plasmid to form the prokaryotic expression vector pET30a-ACP1, which was then transferred into E. coli BL21. IPTG was added to induce the expression. The expression product was collected and purified by the column Ni, and finally the target protein content was measured by the Bradford method. Results: The Candida albicans acyl carrier protein Acp1 was highly expressed in E. coli BL21. The electrophoresis results showed that there were two bands of Acp1 under reducing conditions. After reduction and non-reduction electrophoresis and Western blotting, the results showed that the protein was aggregated in a non-reduced state. The protein Acp1 concentration was determined to be 2.68 mg/mL by the Bradford method. Conclusions: The Candida albicans acyl carrier protein Acp1 is successfully prepared, which provides a basis for the later screening of clinical drugs targeting Ppt2 by fluorescence polarization. References | Related Articles | Metrics

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Preliminary establishment of a flowchart for diagnosis, treatment of patients with autoimmune hemophilia-like coagulation factorⅩⅢ deficiency, review of literature MA Siyu, LIANG Qian, CHEN Changming, WANG Xuefeng, DING Qiulan 2018, 17 (06):  650-657.  DOI: 10.16150/j.1671-2870.2018.06.006 Abstract ( 136 )   PDF (943KB) ( 70 )   Objective: To test and diagnose definitely three patients with suspected autoimmune hemophilia-like coagulation factor ⅩⅢ (AH ⅩⅢ) deficiency and establish a flowchart for the laboratory diagnosis of AH ⅩⅢ deficiency. Methods: The clinical data of these 3 patients were recorded. FⅩⅢ: Act was detected by ammonia release assay. F ⅩⅢ-A: Ag and F ⅩⅢ-B: Ag were assayed by ELISA. Laboratory mixing tests and Bethesda method were used to detect anti-F ⅩⅢ neutralizing antibody, and ELISA was used to detect the autoantibodies against F ⅩⅢ-A. Results: For the 3 patients, positive results were shown by ammonia release assay. FⅩⅢ: Act <5%, F ⅩⅢ-A: Ag <3% and FⅩⅢ-B: Ag were 65.40%, 116.28% and 138.81%, respectively. Laboratory mixing tests were positive in all the 3 patients, and Bethesda method revealed that the neutralizing antibody were 1.83 BU, 1.67 BU and 1.75 BU, respectively. Autoantibodies against F ⅩⅢ-A were detected by immunological assay in all the 3 patients. Conclusions: A flowchart for laboratory diagnosis of AH ⅩⅢ deficiency is established. All the 3 patients were diagnosed as AH ⅩⅢ deficiency caused by low titer autoantibodies against F ⅩⅢ-A. Relevant literature about the diagnosis, treatment and prognosis of AH ⅩⅢ deficiency is reviewed. References | Related Articles | Metrics

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Value of combining ELISA and CLIFT in detection of anti-dsDNA IgG antibody for diagnosis of systemic lupus erythematosis GE Jianhua, GONG Wen, SHI Xinming, GONG Huiyun, MA Longxin, ZHOU Jinfeng, SHI Hui 2018, 17 (06):  658-663.  DOI: 10.16150/j.1671-2870.2018.06.007 Abstract ( 228 )   PDF (624KB) ( 73 )   Objective: To analyze the occurrence of anti-double-stranded DNA (dsDNA) IgG antibody in SLE (systemic lupus erythematosus) and non-SLE patients and the efficacy of combined use of ELISA and CLIFT (crithidia luciliae immunofluorescence test) in detection of anti-dsDNA IgG antibody for diagnosis of SLE. Methods: The clinical data of 4 726 patients undergoing anti-dsDNA IgG antibody detection by ELISA and 830 of them receiving CLIFT were collected. Receiver operating characteristic curve (ROC) was used to evaluate the performance of each or combined use of the two in detection of anti-dsDNA IgG antibody for the diagnosing of SLE. Results: Among the 4 726 patients tested by ELISA, 398 cases were anti-dsDNA IgG antibody positive. Of them 183 patients were diagnosed as SLE (46.0%). The non-SLE patients included liver disease (28.4%), other connective tissue diseases (7.5%), hematological disease(5.3%) and respiratory di-sease(3.8%). For 830 cases undergoing CLIFT, 134 cases were anti-dsDNA IgG antibody positive, and 94% of them were diagnosed as SLE; the non-SLE patients included 3 cases of autoimmune liver disease, 1 case of liver cirrhosis, 1 case of nephritis, 1 case of psoriasis and 1 case of anti-phospholipid syndrome. In the cohort of 830 patient with both detection of anti-dsDNA IgG antibody by both ELISA and CLIFT, 197 patients were diagnosed as SLE, and 633 patients diagnosed as non-SLF. ELISA had a sensitivity of 74.6% and a specificity of 92.9%, while CLIFT had a specificity of 98.7% and a sensitivity of 64%. The combined detection by ELISA and CLIFT could significantly improve the efficacy of diagnosing SLE, with the highest AUC of 0.8 690. Conclusions: When ELISA is applied alone for detection of anti-dsDNA IgG antibody,a high false positivity should be paid attention to. The detection of anti-dsDNA IgG antibody by both ELISA and CLIFT could significantly improve the diagnostic efficacy for SLE than by CLIFT alone. References | Related Articles | Metrics

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Correlation between nutritional risk and exercise tolerance in patients with idiopathic pulmonary arterial hypertension DONG Fang, ZHANG Yihui, GUO Jian, LIU Jinming 2018, 17 (06):  664-669.  DOI: 10.16150/j.1671-2870.2018.06.008 Abstract ( 154 )   PDF (599KB) ( 65 )   Objective: To explore the correlation between nutritional risk and exercise tolerance in patients with idiopathic pulmonary hypertension (IPAH）. Methods: Nutritional risk was assessed in 96 IPAH patients according to the nutritional risk screening 2002 (NRS-2002). Based on the results of the assessment, they were divided into with nutritional risk group (group A, n=46) and without nutritional risk group (group B, n=50). Arterial blood gas analysis (ABG) was performed in the two groups. The pulmonary function test (PFT) and cardiopulmonary exercise test (CPET) were performed, respectively. Results: ① There were no significant differences in height and age between two groups (P>0.05). The weight and BMI in group A were lower than those in group B. There were no significant differences in blood gas parameters PaO2 and PaCO2 between two groups (P>0.05). ② Pulmonary function tests showed that the FVC, FEV1 in group A were significantly lower than those in group B (P<0.05). The FVC%pred, FEV1%pred, DLCO, DLCO%pred in group A were significantly lower than that in group B (P<0.01). There were no significant differences in other indices (FEV1/FVC, IC, TLC, RV, RV/TLC) between two groups (P>0.05). ③ In cardiopulmonary exercise test, peak VO2%pred, peak load, peak VO2, peak VO2/kg, peak VE in group A were significantly lower than those in group B (P<0.05 or P<0.01). There were no significant differences in peak O2 pulse between the two groups (P>0.05). Of the 96 IPAH patients, the NRS score showed a significant negative correlation with peak VO2 and peak load (r=-0.342 and -0.335, P<0.01), and showed a negative correlation with peak VO2/kg (r=-0.213, P<0.05). Conclusions: The nutritional risk of patients with IPAH can worsen pulmonary ventilation function and diffusion, and decrease exercise tolerance significantly. Nutritional risk assessment may help to understand the severity of patients with IPAH and predict the clinical risk. References | Related Articles | Metrics

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Effect of silencing information regulator factor 1 on mice with acute myocardial infarction CHEN Yafen, CHEN Yuanyuan, WU Liping, XUE Qiqi, YANG Ke, LU Lin, CAO Jiumei 2018, 17 (06):  670-675.  DOI: 10.16150/j.1671-2870.2018.06.009 Abstract ( 132 )   PDF (896KB) ( 67 )   Objective: To investigate the effect of silencing information regulator factor 1 (Sirtuin1, Sirt1) on acute myocardial infarction in mice and its mechanism. Methods: Model of acute myocardial infarction in mice were constructed by ligating the left anterior descending coronary artery. The infarcted and peripheral tissue were collected at different time after myocardial infarction (1, 3, 5 and 7 days) (the myocardial tissue of the sham operation group was taken as the control), and the expression of Sirt1 was detected by RT-PCR. In addition, in another series of model of myocardial infarction in mice, when successful ligation of coronary artery was established the Sirt1 overexpression lentivirus was injected into the tissue surrounding the infarction by microinjection (negative group of lentiviral injection served as the control). Myocardial infarction area was detected by 2, 3, 5-triphenyltetrazolium chloride (TTC) staining seven days after operation. Mouse primary myocardial cells were cultured in vitro under hypoxia (2%O2), and resveratrol (Res) of different concentrations (25, 50 and 100 μmol/L) were used to stimulate the primary myocardial cells. The expression levels of Sirt1 and cysteine protease-3 shear bodies (cleaved caspase3) were detected by Western blotting, and cell apoptosis was detected by TUNEL method. Results: mRNA levels of Sirt1 in myocardial infarction and peripheral tissues were significantly decreased 1-7 days after infarction (P<0.05). Meanwhile, compared with the negative control group, the Sirt1 overexpression lentiviral injection group significantly decreased the area of infarction [(15.68±3.28)% vs (29.50±5.56)%, P<0.05)]. As the concentration of resveratrol increased, Sirt1 protein expression increased in a dose-dependent manner, while cleaved caspase-3 protein expression was decreased. The apoptosis of myocardial cells decreased gradually with the increase of concentration of resveratrol stimulation. Conclusions: The expression of Sirt1 declines in acute myocardial infarction. Overexpression of Sirt1 reduces the myocardial infarction area after acute myocardial infarction. References | Related Articles | Metrics

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Correlation of sonographic features of non-mass ductal carcinoma in situ with clinicopathological findings and biomarkers YAO Jiejie, ZHU Ying, ZHAN Weiwei, CHEN Xiaosong, FEI Xiaochun 2018, 17 (06):  676-681.  DOI: 10.16150/j.1671-2870.2018.06.010 Abstract ( 166 )   PDF (714KB) ( 23 )   Objective: To evaluate the ultrasonographic (US) features of non-mass ductal carcinoma in situ (DCIS) of the breast and their correlation with clinical, pathological characteristics and biomarkers. Methods: A total of 68 non-mass DCIS patients were enrolled in this study. Clinical and pathological characteristics, biomarkers including estrogen receptor(ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2) and Ki-67 index and preoperative ultrasound imaging data were collected. The sonographic features were classified as four types: type Ⅰ: ductal type; type Ⅱ: glandular type; type Ⅲ: calcification type; type Ⅳ: architectural distortion type.Correlations between various US features and clinicopathological characteristics, biomarkers were analyzed. Results: For US, type Ⅰ was 21cases (30.9%); type Ⅱ 10 cases（14.7%）, type Ⅲ 31 cases (45.6%), and type Ⅳ 6 cases(8.8%). There were no significant differences in age, menopausal status, sentinel lymph node metastasis, clinical symptoms, ER, PR and Ki-67 index in the 4 groups. Type Ⅰ groupwas more likely to have low grade DCISand HER2 negative expression, and type Ⅲ groupwas more likely to have HER2 positive expression (all P<0.05). Low and intermediate grade DCIS, HER2 negative expressionwere associated significantly withtype I (P<0.05). High grade DCIS and HER2 positive expressionwere associated significantly with typeⅢ (P<0.05). Conclusions: Our findings suggest that some of theultrasound features of non-mass DCIS are associated with the histopathologic characteristics andbiomarkers. References | Related Articles | Metrics

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The value of 99mTc-MIBI SPECT/CT parathyroid imaging and ultrasound in incidental detection of neck carcinoma FENG Guowei, CHEN Gang 2018, 17 (06):  682-686.  DOI: 10.16150/j.1671-2870.2018.06.011 Abstract ( 176 )   PDF (1121KB) ( 59 )   Objective: To investigate the value of 99mTc-MIBI SPECT/CT parathyroid imaging and ultrasound in incidental detection of neck carcinoma. Methods: A total of 952 patients with clinically suspected primary hyperparathyroidism (PHPT) undertaken ultrasonography and 99mTc-MIBI SPECT/CT of base of skull, neck and thorax were enrolled. Each case with suspected lesion was analyzed and correlated with pathological finding. The frequency of carcinoma on SPECT/CT performed for PHPT was calculated. Sensitivity, specificity and accuracy for head and neck carcinoma, especially thyroid carcinoma of both the SPECT/CT and ultrasound were calculated. Results: Among the 952 patients, a total of 304 patients were treated with surgery and 352 pathological results were obtained. And finally, 64 carcinoma (83 sites) were found. The anatomical distribution was as follows: 22 (34.38%) were parathyroid carcinoma, 24 (37.50%) were papillary thyroid carcinoma, 4 (6.25%) were follicular thyroid carcinoma, 7 (10.94%) were medullary thyroid carcinoma and 7 (10.94%) were other tumors. The sensitivity of SPECT/CT and ultrasound for neck carcinoma were 46.99% and 74.70%, respectively. Specificity was 91.21% for SPECT/CT and 94.79% for ultrasound. Accuracy was 81.79% for SPECT/CT and 90.51% for ultrasound. The sensitivity of SPECT/CT and ultrasound for thyroid carcinoma were 39.31% and 80.43%, respectively. Specificity was 90.12% for SPECT/CT and 92.73% for ultrasound. Accuracy was 84.10% for SPECT/CT and 91.28% for ultrasound. Conclusions: The concomitant occurrence of PHPT and neck carcinoma is not uncommon. Although 99mTc-MIBI SPECT/CT plays an important role for the diagnosis and location of PHPT lesions, ultrasound is a better choice for detecting neck carcinoma, such as thyroid carcinoma accompanied the PHPT. References | Related Articles | Metrics

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Analysis of KRAS, NRAS and BRAF mutations in colorectal cancer and their correlation with clinicopathologic features and p53 protein expression WANG Ziyuan, LIANG Tingyu, CHEN Jia, HAN Zhihong, WU Lili 2018, 17 (06):  687-693.  DOI: 10.16150/j.1671-2870.2018.06.012 Abstract ( 270 )   PDF (879KB) ( 213 )   Objective: To examine the mutation frequencies of KRAS, NRAS and BRAF in colorectal cancer (CRC) among Chinese population, and to investigate their correlation with clinicopathological parameters and p53 protein expression. Methods: Tissue samples and pathological data of 110 CRC patients undergoing surgical excision were collected, and the clinical pathological features were summarized. Mutations in KRAS (codon 12/13 at exon 2, codon 61 at exon 3 and codon 117/146 at exon 4), NRAS (codon 12/13 at exon 2, codon 61 at exon 3 and codon 146 at exon 4) and BRAF (codon 600 at exon 15) genes were examined with ARMS-PCR. p53 protein expression was detected by immunohistochemistry. Results: 45.4% (50/110) patients carried KRAS mutations; among them, almost all individuals had mutation in KRAS codon 12/13 at exon 2, except one individual had codon 117/146 at exon 4 mutated. 6.3% (7/110) patients carried NRAS mutations; among them, 3/110 patients had mutation in NRAS exon 2 (condon 12/13), 3/110 patients had mutation in NRAS exon 3 (condon 61), 1/110 patient had mutations in both NRAS exon 4 (condon 146) and KRAS. BRAF mutations were detected in 3 patients (2.7%), and were found to have V600E mutations. p53 expression was observed in 63 (57.3%) of 110 CRC patients. Within these 63 positive samples, 27 cases showed KRAS mutations, 7 cases showed NRAS mutations and 2 cases showed BRAF mutations. KRAS mutation was significantly associated with lymph node metastasis (P<0.05) while NRAS mutation was significantly associated with histological type and p53 protein expression (P<0.05). BRAF mutation was significantly associated with right colon cancer (P<0.05). Conclusions: KRAS is closely related to the molecular mechanism of occurrence and development of colorectal cancer. BRAF mutation is only found in right colon cancer, suggesting that the mechanism of right hemicolon cancer may have its particularity. The interaction between p53 protein expression and NRAS mutation is worthy of further study. References | Related Articles | Metrics

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Identification of genes associated with distinguished Gleason patterns of prostate cancer by analyzing TCGA database WANG Tao, DENG Yu, ZHAO Ping, YÜ Baohua, WANG Xiang, WANG Chaofu 2018, 17 (06):  694-700.  DOI: 10.16150/j.1671-2870.2018.06.013 Abstract ( 201 )   PDF (962KB) ( 76 )   Objective: To investigate the differentially expressed genes involved in distinguished Gleason patterns of prostate cancer (PC) and to reveal the potential molecular mechanisms by applying integrated bioinformatics. Methods: The expression profiles and information for Gleason score were downloaded from the cancer genome atlas (TCGA) database. The differentially expressed genes (DEGs) were obtained and were further analyzed for their interaction and biological processes involved by bioinformatics methods. The gene ontology(GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichments of DEGs were used for processing by DAVID online analyses. The protein-protein interaction (PPI) networks of the DEGs were constructed from the STRING database. Results: A total of 312 DEGs were identified in the TCGA datasets, of which 157 genes were upregulated and 155 genes were downregulated, in the Gleason pattern 4 PC. The 22 most closely related genes among DEGs were identified from the PPI network and were focused primarily on cell cycle and mitotic division. Conclusions: This study indicated that cancer cells in Gleason pattern 4 PC are more dynamic in the process of mitotic cell cycle. In clinical practice, detection of protein associated with cell cycle may allow the more rational prediction for risk and prognosis of PC. Meanwhile, for patients with Gleason score ≥7 PC, genes associated with cell cycle may provide the effective targets for treatment of prostate cancer. References | Related Articles | Metrics

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Expression of SOX-2 in breast invasive carcinoma of no special type and its clinical and pathological significance LU Shuxiong, CHENG Kai, CAI Li, ZHOU Xiaodie, WANG Jianjun, WANG Xuan, SHI Qunli 2018, 17 (06):  701-706.  DOI: 10.16150/j.1671-2870.2018.06.014 Abstract ( 150 )   PDF (997KB) ( 51 )   Objective: To study the expression of SOX-2 (sex determining region Y-box) in breast invasive carcinoma of no special type (ICNST) and analyze its significance and relationship with ER, PR, Her-2, Ki-67 and clinicopathological features. Methods: Normal breast tissue specimens (30 cases) and ICNST specimens of 179 patients and their complete clinical and pathological data during the period from January 2005 to December 2012 at Nanjing General Hospital of Nanjing Military Command were collected. The clinicopathological features included age, menstrual status, clinical stage, recurrence, metastasis, death, and expressions of ER, PR, Ki-67 and Her-2. The expressions of SOX-2, ER, PR, Ki-67 and Her-2 were detected by immunohistochemistry. Analysis of the clinicopathological features in association with SOX-2 expression was performed. Results: The expression of SOX-2 was significantly higher in ICNST cancer tissues than that in normal breast tissue (P<0.05). SOX-2 expression in ICNST was correlated with recurrence, lymph node metastasis and clinical staging (P<0.05), while had no significant correlation with histological grade, age, menopausal status, tumor size, ER, PR, Her-2, Ki-67 and molecular typing. Kaplan-Meier analysis showed that disease free survival time and total survival time in SOX-2 positive group were shorter than that in SOX-2 negative group (P<0.05). COX analysis revealed that SOX-2 was an independent prognostic factor affecting disease-free survival of ICNST(P<0.05). Conclusions: The expression of SOX-2 is closely correlated with occurrence, progression, recurrence and metastasis of ICNST. It may become an important biological marker for evaluating the prognosis of breast cancer and create new ideas for breast cancer research. References | Related Articles | Metrics

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The discrepancy of thrombin time results between two kinds of thrombolyzer in a patient associated with heparin like anticoagulant XU Mengyang, HE Bin, HUA Baolai, JI Wei, SHEN Lianjun, SHI Qingqing, SUN Xing, YU Ju, XIE Xiaoyan, SUN Mei, GU Jian 2018, 17 (06):  707-710.  DOI: 10.16150/j.1671-2870.2018.06.015 Abstract ( 126 )   PDF (464KB) ( 39 )   Objective: To explore the cause of discrepancy in results of thrombin time(TT) between two kinds of thrombolyzer in a 4-year-old male child with glandular hypertrophy. Methods: A series of plasma samples were obtained during 7 months follow-up periods, one stage clotting assay was used for coagulation factors tests, protamine sulfate neutralization test was performed, and three fibrinogen genes were sequenced. Results: The significant difference in TT results between thrombolyzer A (magenetic beads) and B (transmission turbidimetry) was further confirmed by two reference labs with a prolonged TT in A and normal TT in B. Activated partial thromboplastin time (APTT) were 52.4 s and 36.6 s, TT were 88.7 s and 16.7 s by A and B thrombolyzer, respectively. The prolonged TT was corrected by 50 μg/ml (final concentration) protamine sulfate, and the reptilase time was normal. No mutation was found in fibrinogen genes by gene analysis. Thus, the presence of endogenous heparin like anticoagulant in this boy was confirmed. Conclusions: Endogenous heparin like anticoagulant is rare and existed in this boy, causing the discrepancy of TT results between the two kinds of thrombokyzer. Therefore, if a discrepancy of TT results is found, other causes such as heparin like anticoagulant should be considered. References | Related Articles | Metrics

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Endolymphatic sac tumor: Clinicopathological features and review of literature HAN Dongyan, FU Huijun, HE Yanyan, XI Hao, WEI Qing 2018, 17 (06):  711-714.  DOI: 10.16150/j.1671-2870.2018.06.016 Abstract ( 157 )   PDF (1025KB) ( 34 )   Objective: To study the clinnicopathological features and differential diagnosis of endolymphatic sac tumorfor improving the understanding of this rare tumor. Methods: Tumor specimen from a case of endolymphatic sac tumor was observed under light microscope. Immunohistochemistry examination was performed and relevant literatures were reviewed. Results: Histopathologic examination presented a papillary-glandular pattern, and was covered by a single layer columnar epithelium cells containing clear cytoplasm. There were minimal cellular atypia. The stroma was rich in large number of proliferative fibrous connective tissue. Immunohistochemically,the tumor cells were diffusely positive for AE1/AE3, EMA, vimentin, focally positive for GFAP, S-100, andnegative for Syn, CgA, NSE, TTF-1, TG. The proliferating index Ki-67 was about 1%. Conclusions: Endolymphatic sac tumor is rare, and lacks specific clinical manifestations. The pathological diagnosis depends on morphologic characteristics in paraffin-embedded tissue section and immunohistochemical staining. Whole intact tumor resection is the most effective treatment ofendolymphatic sac tumor. References | Related Articles | Metrics