[Comparative study of medical common data models for FAIR data sharing]

The common data model (CDM) is an important tool to facilitate the standardized integration of multi-source heterogeneous healthcare big data, enhance the consistency of data semantic understanding, and promote multi-party collaborative analysis. The data collections standardized by CDM can provide powerful support for observational studies, such as large-scale population cohort study. This paper provides an in-depth comparative analysis of the data storage structure, term mapping pattern, and auxiliary tools development of the three international typical CDMs, then analyzes the advantages and limitations of each CDM and summarizes the challenges and opportunities faced in the CDM application in China. It is expected that exploring the advanced technical concepts and practical patterns of foreign countries in data management and sharing will provide references for promoting FAIR (findable, accessible, interoperable, reusable) construction of healthcare big data in China and solving the current practical problems, such as the poor quality of data resources, the low degree of semantization, and the inabilities of data sharing and reuse.

[Clinicopathological features of de novo CD5-positive diffuse large B-cell lymphoma]

Objective: To investigate the relationship between the protein expression of C-MYC, bcl-2 and bcl-6 and the clinicopathological characteristics in patients with de novo CD5-positive diffuse large B cell lymphoma (CD5(+)DLBCL). Methods: Fifty seven cases of de novo CD5(+)DLBCL were collected at Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine from February 2013 to September 2018. The hematoxylin-eosin stained slides were reviewed, and immunohistochemical (IHC) staining and FISH were used to analyze the relationship between C-MYC, bcl-2, bcl-6 expression and the clinicopathologic characteristics of patients. Results: Among these 57 cases, 27 were male and 30 were female. The age of onset was 35-99 years old. The IHC expression rates of C-MYC, bcl-2 and bcl-6 were 50.9% (29/57), 84.2% (48/57), and 75.4% (43/57) respectively; and co-expression rate of C-MYC and bcl-2 proteins was 40.4 (23/57). There was no significant correlation between protein expression and patients' genders, clinical stage, the level of serum LDH,β2 microglobulin, IPI,B symptoms, bone marrow involvement and central nervous system recurrence (P>0.05). Univariate analysis showed that the median OS of C-MYC negative patients was significantly longer than C-MYC positive patients (P<0.05); and the median OS of patients without double expression was significantly longer than that of patients with positive expression (P<0.05), and bcl-6 positive patients had longer median OS than bcl-6 negative patients (P<0.05). There was no significant correlation between prognosis and bcl-2 protein expression (P>0.05) . Cox multivariate analysis showed C-MYC protein expression was an independent predictor of OS in de novo CD5(+)DLBCL (P<0.05). Conclusions: Bcl-2 protein expression has no effect on the prognosis in de novo CD5(+)DLBCL whereas bcl-6 expression is correlated with good prognosis. C-MYC protein expression could be used as an independent and effective index to predict the prognosis of patients with de novo CD5(+)DLBCL.However, the relationship between protein expression and gene rearrangement of C-MYC, bcl-2 and bcl-6 needs to be further explored.

[Efficacy of esophageal cancer screening in high risk population: results of 105 561 subjects in Sichuan province]

Objective: To analyze the efficacy of endoscopic screening for esophageal cancer in high risk population from high risk areas in order to provide scientific basis for evaluation of the results of early diagnosis and treatment of esophageal cancer. Methods: Ten high incidence cities and counties of esophageal cancer in Sichuan province were included in this study. Subjects aged 40-69 years were selected to participate in the endoscopic screening based on the cluster sampling, and the screening-positive subjects were further confirmed by pathological examination. Results: A total of 105 561 subjects were screened during 2006-2014 in 10 cities and counties in Sichuan Province. The detection rate of precancerous lesions was 5.53% (5 841/105 561), and the positive detection rate was 1.13% (1 193/105 561). The overall detection rates of low-grade hyperplasia, moderate hyperplasia, high-grade hyperplasia/carcinoma in situ, early esophageal cancer and invasive carcinoma were 3.87% (4 089/105 561), 1.66% (1 752/105 561), 0.77% (816/105 561), 0.08% (84/105 561) and 0.28% (293/105 561), respectively. The detection rates of all lesions in males were significantly higher than those in females (P<0.05), and were gradually increased with age (P<0.05). Conclusions: At these ten cities and counties in Sichuan Province with high incidence of esophageal cancer, the endoscopic screening has good effect. There are considerable numbers of patients aged 40-69 with precancerous lesions from the high risk areas. Improving the follow-up work of the population with precancerous lesions will achieve better results of early diagnosis and early treatment.

Interleukin-17 promotes prostate cancer via MMP7-induced epithelial-to-mesenchymal transition

Chronic inflammation has been associated with a variety of human cancers including prostate cancer. Interleukin-17 (IL-17) is a critical pro-inflammatory cytokine, which has been demonstrated to promote development of prostate cancer, colon cancer, skin cancer, breast cancer, lung cancer, and pancreas cancer. IL-17 promotes prostate adenocarcinoma with a concurrent increase of matrix metalloproteinase 7 (MMP7) expression in mouse prostate. Whether MMP7 mediates IL-17’s action and the underlying mechanisms remain unknown. We generated Mmp7 and Pten double knockout (Mmp7^−/− in abbreviation) mouse model and demonstrated that MMP7 promotes prostate adenocarcinoma through induction of epithelial-to-mesenchymal transition (EMT) in Pten-null mice. MMP7 disrupted E-cadherin/β-catenin complex to up-regulate EMT transcription factors in mouse prostate tumors. IL-17 receptor C and Pten double knockout mice recapitulated the weak EMT characteristics observed in Mmp7^−/− mice. IL-17 induced MMP7 and EMT in human prostate cancer LNCaP, C4-2B, and PC-3 cell lines, while siRNA knockdown of MMP7 inhibited IL-17-induced EMT. Compound III, a selective MMP7 inhibitor, decreased development of invasive prostate cancer in Pten single knockout mice. In human normal prostates and prostate tumors, IL-17 mRNA levels were positively correlated with MMP7 mRNA levels. These findings demonstrate that MMP7 mediates IL-17’s function in promoting prostate carcinogenesis through induction of EMT, indicating IL-17-MMP7-EMT axis as potential targets for developing new strategies in the prevention and treatment of prostate cancer.

Expression and activity analysis reveal that heme oxygenase (decycling) 1 is associated with blue egg formation

Biliverdin is responsible for the coloration of blue eggs and is secreted onto the eggshell by the shell gland. Previous studies confirmed that a significant difference exists in biliverdin content between blue eggs and brown eggs, although the reasons are still unknown. Because the pigment is derived from oxidative degradation of heme catalyzed by heme oxygenase (HO), this study compared heme oxygenase (decycling) 1 (HMOX1), the gene encoding HO expression and HO activity, in the shell glands of the Dongxiang blue-shelled chicken (n = 12) and the Dongxiang brown-shelled chicken (n = 12). Results showed that HMOX1 was highly expressed at the mRNA (1.58-fold; P < 0.05) and protein levels in blue-shelled chickens compared with brown-shelled chickens. At the functional level, blue-shelled chickens also showed 1.40-fold (P < 0.05) higher HO activity than brown-shelled chickens. To explore the reasons for the differential expression of HMOX1, an association study of 6 SNP capturing the majority of HMOX1 variants with the blue egg coloration was performed. Results showed no significant association between SNP and the blue egg coloration in HMOX1 (P > 0.05). Taken together, these results show that blue egg formation is associated with high expression of HMOX1 in the shell gland of Dongxiang blue-shelled chickens, and suggest that differential expression of HMOX1 in the 2 groups of chickens is most likely to arise from an alteration in the trans-acting factor.

PGP9.5: a marker for cellular neurothekeoma

Neurothekeomas are benign, predominantly cutaneous neoplasms that are divided histologically into myxoid, intermediate, and cellular types. Although it is generally agreed that the myxoid type of neurothekeoma has a neural origin, the lack of consistent immunoreactivity to neural markers and insufficient ultrastructural evidence of neural differentiation in cellular neurothekeoma have brought the origin of cellular neurothekeoma into question. In this report the authors show that immunoreactivity to protein gene product 9.5 (PGP9.5)--a broad neural marker--is positive in 100% of cases of cellular neurothekeoma using microwave antigen retrieval, as well as in all cases of myxoid and intermediate neurothekeoma. In contrast, immunoreactivity to S-100 protein is only positive in 3 of 12 cases of cellular neurothekeoma. These results show that PGP9.5 is a useful marker for identifying cellular neurothekeoma, as well as other types of neurothekeomas using the antigen retrieval method. The results are consistent with the notion that cellular neurothekeoma has a neural differentiation.

Benign fibrous histiocytoma of the nasal cavity in a newborn: MR and CT findings

Benign fibrous histiocytoma of the nasal cavity in a newborn is rare, and the MR imaging appearance of this entity has not been reported. We present the MR and CT findings in such a case and review the differential diagnosis for intranasal masses in the neonate.

Interviews with psychiatric inpatients about professional intervention with regard to their children

A description of mentally ill parents' experience and points of view concerning professional intervention in relation to their young children is presented in this paper. The results are from an interview survey designed with the purpose of improving the basis for cooperation between mentally ill patients and professionals, when intervention in relation to these patients' children is needed. Fifty consecutively admitted psychiatric inpatients with children 0-10 years old were interviewed by child psychiatrists and their information constitutes the study material. Data concerning the family situations and children have been published previously. One quarter of the patients had experienced having children placed in institutions or with foster families. Forty per cent had never received professional help related to their children. One third of the patients expressed a need for support, which was not presently received. A large group of patients did not know where to go for help related to children or would not be comfortable doing so. When making a global assessment of the childrens' situation based on the study material the child psychiatrists found reason for concern in regard to approximately 80% of the children. In most cases their views were in accordance with those of the mentally ill parents. Clinical implications concerning planning of intervention in regard to children of mentally ill parents are discussed.

Interviews of psychiatric inpatients about their family situation and young children

In this study, the perception by mentally ill parents of their family situation and young children was explored with the purpose of improving the basis for cooperation between families and professionals, when intervention is needed. Fifty consecutively admitted psychiatric inpatients with children 0-10 years old were interviewed by child psychiatrists, and their information constitutes the study material. It was generally easy to approach the patients as parents. Most of them were already preoccupied with their children's situation and seemed relieved to talk about it when guaranteed anonymity. Half of the patients experienced and described having emotional difficulties in relation to their children. Half of the 64 children were reported to suffer from physical or mental health problems, and an unexpected accumulation of children with serious and relatively rare medical conditions was registered. Most of the children had parents who had been mentally ill all their life, and many had 2 parents with mental disorders. Family discord was frequent. Many women related the debut of mental symptoms to childbirth. Attention is drawn to special patterns concerning suicidal and addicted patients.

Epidemiology of anorexia nervosa and bulimia nervosa in Bornholm County, Denmark, 1970-1989

In a retrospective study of anorexia nervosa and bulimia nervosa, potential cases were traced, studied, and diagnosed according to ICD-10. Forty-two cases were found in Bornholm County, comprising the island of Bornholm in Denmark, in a population of 47,000 from 1970 to 1989. Less than half of these cases (n = 16) were registered in Danish psychiatric case registers, and 35% (n = 14) could be found only by search in primary care. The incidence rates were stable during most of the study period, but a significant increase occurred during the last 5 years. The prevalence rates, determined by counting the number of cases in the population year by year, also increased during the late part of the study period. In 1989 the incidence rate of the high-risk group of females 10 to 24 years of age was 136 per 100,000 for anorexia nervosa and 45 per 100,000 for bulimia nervosa, and the prevalence rate was 222 per 100,000 for anorexia nervosa and 89 per 100,000 for bulimia nervosa.

[Study of Ag-NOR, SCE and micronucleus in peripheral blood lymphocyte of chromate producers]

Ag-NOR, SCE and micronucleus test of peripheral blood lymphocyte obtained from 31 chromate producers had been studied. We found that (1) in the workers who had been exposed over eight years, the frequency of Ag-NOR, Ag-AA and SCE were 6.905 +/- 1.100, 0.380 +/- 0.652 and 8.190 +/- 3.727, but in the control group, 6.512 +/- 1.595, 0.215 +/- 0.529 and 7.171 +/- 2.683, respectively. So there was considerably significant difference between the exposed and the unexposed (P less than 0.01); (2) the frequency of micronuclei was 3.71 +/- 1.419% in the exposed group; however, in the control group it was 0.333 +/- 0.479%. So there was also remarkably significant difference between them (P less than 0.001). The observations lead the authors to conclude that the genetic material of the workers who have been working over eight years may be damaged because of being exposed to chromate.