目的:不同相位角水平对老年慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者预后的评估价值.方法:回顾性分析2020年6月至2022年3月苏州大学附属第二医院收治的210例老年COPD患者临床资料,对所有患者进行出院后3个月随访.将135例低相位角水平患者纳入低相位角组,将75例正常相位角水平患者纳入正常相位角组,并将患者出现急性加重症状、全因死亡作为2个终点事件,对不同相位角水平评估老年COPD患者预后情况的价值进行单因素、多因素回归分析.结果:正常相位角组年龄、体重指数、吸烟比例、入住重症监护病房(intensive care unit,ICU)比例、改良英国医学研究学会呼吸困难指数(modified British Medical Research Council,mMRC)量表评分、过去3个月COPD急性加重次数、慢性阻塞性肺疾病全球倡议(Global Initiative for Chronic Obstructive Lung Disease,GOLD)分级、病情等级、第1秒用力呼气量(forced expiratory volume in one second,FEV1)、动脉血二氧化碳分压(partial arterial pressure of carbon dioxide,PaCO2)、动脉血氧分压与吸入氧浓度的比值(ratio of the partial arterial pressure of oxygen to the fraction of inspired oxygen,PaO2/FiO2)、相位角水平与低相位角组比较,差异均有统计学意义(均P<0.05).随访3个月,COPD急性加重症状者139例,死亡25例.将随访3个月内出现急性加重症状作为终点事件,经log-rank法分析,低相位角组出现COPD急性加重症状的时间短于正常相位角组(P<0.05).将随访3个月内全因死亡作为终点事件,经log-rank法分析,低相位角组生存率低于正常相位角组(P<0.05).单因素分析与多因素Cox回归分析显示:年龄、mMRC评分、病情等级、过去3个月COPD急性加重次数、低相位角水平均是老年COPD患者随访3个月内出现急性加重的危险因素(均P<0.05).单因素分析与多因素Cox回归分析显示:mMRC评分、病情等级、低相位角水平均是老年COPD患者随访3个月内全因死亡的危险因素(均P<0.05).结论:低相位角水平是老年COPD患者随访3个月内发生疾病急性加重及死亡的独立危险因素,其对于患者预后的预测具有一定价值.
Objective:To investigate the risk factors of refeeding syndrome(RFS)in patients with severe acute pancreatitis(SAP)and analyze the relationship between RFS and prognosis. Methods:Clinical data of 102 SAP patients admitted to the Wuhan First Hospital from January 2020 to October 2022 were retrospectively selected to analyze the incidence of RFS.The occurrence of RFS was recorded,and the patients were divided into a RFS group(n=52)and a non-RFS group(n=50).Multiple logistic regression was used to analyze factors affecting the occurrence of RFS in SAP patients.The Kaplan-Meier and Log-Rank were used to compare the in in-hospital survival rates between the RFS and non-RFS groups. Results:There were 52 cases of RFS.The RFS group had a higher average age than the non-RFS group(P<0.05).The body mass index and serum PO3-4 level at admission were lower in the RFS group than those in the non-RFS group(both P<0.05).The RFS group had a higher proportion of chronic alcoholism history,fasting time≥5 days,higher Nutritional Risk Screening 2002(NRS 2002)score,higher Acute Physiological Assessment and Chronic Health Evaluation II(APACHEII)score,and higher Sequential Organ Failure Assessment(SOFA)score compared to the non-RFS group(all P<0.05).The daily caloric intake was higher in the RFS group compared to the non-RFS group(P<0.05).Multivariate logistic regression analysis showed that the chronic alcoholism history and fasting time≥5 days were risk factors for RFS in the SAP patients(both P<0.05),while higher body mass index and serum PO3-4 level at admission were protective factors(both P<0.05).The in-hospital mortality rate was higher in the RFS group than that in the non-RFS group(χ2= 5.220,P<0.05). Conclusion:Chronic alcoholism history,fasting time,low body mass index and serum PO3-4 level at admission are the related factors for the occurrence of RFS in SAP patients,and the RFS increases the risk of in-hospital mortality in SAP patients.
Objective:To investigate the role of metabolites of gut microbiota metabolites in the pathogenesis of hyperuricemia. Methods:Gut microbiota metabolites were collected from the Target Genes of Gut Microbes and Microbial Metabolites(gutMGene)database,and their targets were obtained.The disease targets of hyperuricemia were obtained from the DisGeNET,Drugbank,Genecard,and OMIM databases.The intersection of gut microbiota metabolites targets and disease targets was obtained to identify common targets.These common targets were then intersected with the 223 known human gut microbiota metabolites targets in the gutMGene database to obtain the targets of gut microbiota metabolites involved in hyperuricemia.A target protein-protein interaction(PPI)network was constructed using STRING,and core proteins were obtained using cytoscape 3.8.0 software,gene ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)enrichment analysis was performed using the DAVID database.A gut microbiata-metabolite-target-pathway-disease(MMTPD)network was constructed and molecular docking using AutoDockVene was performed to validate the interaction between active metabolites and core targets. Results:A total of 208 gut microbiota metabolites and their corresponding 668 targets,827 disease targets,and the intersection of the two yielded 99 targets were obtained.By intersecting with the 223 known human gut metabolite targets in the gutMGene database,20 key targets were identified.The PPI network showed that cytochrome P450 family 3 subfamily A member 4(CYP3A4),peroxisome proliferator-activated receptor gamma(PPARG),and interleukin 6(IL-6)were core targets.GO function and KEGG pathway enrichment analysis revealed that gut microbiota metabolites were mainly involved in biological processes such as gene regulation,inflammatory response,and cellular response to lipopolysaccharide,through IL-17 signaling pathway,Toll-like receptor signaling pathway,etc.The MMTPD network showed a close relationship between short-chain fatty acid-like metabolites and hyperuricemia,with butyric acid playing a prominent role.Molecular docking results showed that acetic acid,propionic acid,and butyric acid bound well with CYP3A4,PPARG,and IL-6,with butyric acid showing the strongest binding affinity to IL-6. Conclusion:Short-chain fatty acids may be an important class of gut microbiota metabolites affecting hyperuricemia,and their intervention pathway may be achieved through butyric acid modulation target of the IL-6 and Toll-like receptor signaling pathways.
Objective:The role of miR-148b-3p in breast cancer(BC)progression through the regulation of forkhead box O4(FOXO4)remains incompletely elucidated.This study investigates the effects of miR-148b-3p-mediated regulation of FOXO4 expression on BC cell proliferation,apoptosis,and autophagy. Methods:The expression of miR-148b-3p and FOXO4 in BC patient tumor specimens(BC tissues)and adjacent non-tumor specimens(normal tissues),as well as in normal human breast epithelial cells(MCF-10A)and human BC cells(MCF7,SKBR3,MDA-MB-231 cells)were assessed by real-time reverse transcription polymerase chain reaction(real-time RT-PCR).MDA-MB-231 cells were transfected and divided into a control group,a inhibitor-NC group,a miR-148b-3p inhibitor group,a si-NC group,a si-FOXO4 group,a miR-148b-3p inhibitor+si-NC group,and a miR-148b-3p inhibitor+si-FOXO4 group.Cell proliferation was detected by cell counting kit 8(CCK-8)assay.Apoptosis was detected by flow cytometry.Autophagy was observed by transmission electron microscope.The expressions of FOXO4,proliferation,apoptosis,and autophagy-related proteins were detected by Western blotting.Dual luciferase reporter gene assay and miRNA pull-down assay were used to verify the targeting relationship between miR-148b-3p and FOXO4. Results:Compared to normal tissues,miR-148b-3p expression was upregulated,and FOXO4 mRNA expression was downregulated in BC tissues(P<0.05).Pearson correlation analysis revealed a negative correlation between miR-148b-3p and FOXO4 mRNA levels in BC patient tumor tissues(r=−0.774,P<0.01).Compared to MCF-10A cells,miR-148b-3p expression increased,while FOXO4 protein and mRNA expression decreased in MCF-7,SKBR3,and MDA-MB-231 cells(P<0.05),with MDA-MB-231 cells showing more significant changes.MiR-148b-3p negatively regulated the expression of FOXO4.Knocking down miR-148b-3p in MDA-MB-231 cells reduced cell viability and proliferating cell nuclear antigen(PCNA)protein levels,increased apoptosis rate,autophagosome number,FOXO4 mRNA and protein levels,as well as cleaved-caspase-3,cleaved-PARP-1,LC3-II/LC3-I,and Beclin-1 protein levels(P<0.05).Knocking down FOXO4 reversed these effects.Knockdown of FOXO4 attenuated the effects of knockdown of miR-148b-3p on MDA-MB-231 cell proliferation,apoptosis,and autophagy. Conclusion:MiR-148b-3p may promote MDA-MB-231 cell proliferation,inhibit apoptosis and autophagy by targeting FOXO4.
Objective:Acute ischemic stroke(AIS)is characterized by a high incidence,disability,mortality,and recurrence rate.Post-stroke cognitive impairment(PSCI)has a high occurrence rate.Recent studies have found a correlation between the triglyceride-glucose(TyG)index and dementia.This study explores the relationship between the TyG index and the occurrence of PSCI in patients with AIS. Methods:Clinical data from AIS patients with confirmed diagnoses who were admitted to the Department of Neurology of the Hospital from January to June 2021 were retrospectively analyzed.The Montreal Cognitive Assessment(MoCA)assessed cognitive function,and the enrolled patients were divided into the PSCI group(n=92)and the non-PSCI group(n=31).The receiver operator characteristic(ROC)curve was used to evaluate the predictive value of the TyG index for PSCI.Patients were divided into low and high TyG index groups according to the optimal truncation value of the TyG index.Binary Logistic regression was used to analyze the correlation between the TyG index and PSCI. Results:The TyG index level in the PSCI group was significantly higher than that in the non-PSCI group(9.22±0.53 vs 8.80±0.65,P<0.05).The area under the ROC curve was 0.71(95%CI 0.59 to 0.85,P<0.05),and the optimal truncation value of the TyG index for predicting PSCI was 8.72,with a sensitivity of 53.30%,and specificity of 87.10%.Logistic regression showed a positive correlation between the TyG index and the risk of PSCI. Conclusion:The TyG index is associated with cognitive impairment caused by AIS and is an independent factor for the occurrence of PSCI.
Hypoxemia is a common complication in the post-anesthetic care unit,with a high incidence that affects postoperative outcomes and rapid recovery of patients.There is extensive research both domestically and internationally on the risk factors for hypoxemia.However,due to variations in study variables and objects,the identified risk factors for hypoxemia differ.The occurrence of hypoxemia in the post-anesthetic care unit after general anesthesia is related to intraoperative factors,such as anesthesia drugs,ventilation methods,infusion conditions,surgical methods,surgical positions,surgical sites,basic medical histories,and overall physiological functions.Patient's preoperative physical status is an uncontrollable factor,and intraoperative factors such as the type and dosage of anesthesia drugs,ventilation methods,and infusion conditions can affect the occurrence of postoperative hypoxemia.In addition,the surgical method and the lavage fluid used during surgery can also affect postoperative oxygenation.Therefore,an in-depth discussion of various risk factors for hypoxemia after general anesthesia can provide a reference for reducing the incidence of postoperative hypoxemia in clinical patients.
Accurately assessing the volume status of maintenance hemodialysis(MHD)patients can effectively reduce the incidence of dialysis-related cardiovascular events,lowering readmission and mortality rates among patients.Currently,clinical evaluation,bioimpedance analysis,biomarkers detection,and ultrasound(measuring inferior vena cava diameter,pulmonary ultrasound)are commonly used to assess volume status.However,the assessment methods have limitations in clinical practice and lack a universally accepted standard.Pulmonary ultrasound can monitor extravascular lung water content with high sensitivity,detecting early asymptomatic pulmonary congestion,and thereby guide volume assessment and prognosis in patients with MHD,and is receiving increasing clinical interest.This study summarizes the current clinical volume assessment methods and compare the differences between pulmonary ultrasound and other assessment methods,so as to provide guidance in finding more accurate,objective,and practical methods for assessing volume status in dialysis patients in clinical practice.
Diabetes,as a major medical problem of this century,causes damage to major organs,including kidneys,heart,eyes,nerves,and blood vessels,eventually leading to diabetic complications,posing a serious threat to individual health.Epigenetics has an important impact on the occurrence and progression of diabetes mellitus through various mechanisms and promotes the generation and maintenance of metabolic memory,thus ultimately leading to a poor prognosis.Substantial studies have explored the relationship between DNA and protein modification in epigenetic regulation and diabetes,but research on RNA modification in diabetes remains limited.N6-methyladenosine(m6A)-mediated regulation of gene expression is essential for both normal physiological and pathophysiological states.Several recent studies have shown that m6A methylation modification is involved in the occurrence and development of diabetes and its complications,making it a potential disease-specific therapeutic target.An in-depth investigation of the biological functions of m6A methylation modification in diabetes and its complications can provide a therapeutic reference for the future application of m6A methylation modification in the treatment of diabetes and its complications.
Objective:The incidence of respiratory distress syndrome(RDS)in premature infants is relatively high,and it is a major cause of respiratory failure and death in premature infants.Choosing an appropriate nursing plan can reduce the incidence of complications and mortality.This study observed the application effect of targeted nursing combined with airway hierarchical management in premature infants with RDS. Methods:Clinical data of 132 premature infants with RDS admitted to Anhui Province Maternity&Child Health Hospital from February 28,2020,to December 31,2022,were retrospectively collected.Among them,66 cases who received routine nursing from February 28,2020,to June 30,2021,were included in a control group,and 66 cases who received targeted nursing combined with airway hierarchical management from July 1,2021,to December 31,2022,were included in an observation group.The respiratory machine indicators[application times of pulmonary surfactant(PS),oxygenation index(OI),respiratory rate(RR)],mechanical ventilation time,and the length of hospital stay between the 2 groups were compared.Blood gas indicators[arterial partial pressure of oxygen(PaO2),arterial partial pressure of carbon dioxide(PaCO2),pH],and Acute Physiology and Chronic Health Evaluation(APACHE)Ⅱ scores before and after intervention were compared.The occurrence of complications during the intervention period in both groups was also recorded. Results:The number of PS applications in the observation group was less than that in the control group(P<0.05).After the intervention,the maximum OI of the 2 groups increased compared to before the intervention,and the observation group was higher than the control group(P<0.05);RR decreased compared to before the intervention,and the observation group was lower than the control group(P<0.05).The mechanical ventilation time and hospital stay in the observation group were lower than those in the control group(both P<0.05).After the intervention,PaO2 and pH increased compared to before the intervention,and the observation group was higher than the control group(P<0.05);PaCO2 decreased compared to before the intervention,and the observation group was lower than the control group(P<0.05).After the intervention,the APACHE II score in the observation group was lower than that in the control group(all P<0.05).The total incidence of complications during the intervention period in the observation group was 6.06％,lower than 18.18％in the control group(P<0.05). Conclusion:Targeted nursing combined with airway hierarchical management can effectively improve respiratory quality and blood gas indexes in premature infants with RDS,reduce the duration of mechanical ventilation time and hospital stay,improve the condition,and reduce the incidence of complications.
Two cases of pancreatic carcinosarcoma with adenosquamous carcinoma were reported in this paper.Patient 1,a 76-year-old male,had a tumor located in the body of pancreas with a maximum diameter of 3.5 cm.Patient 2,a 75-year-old male,had a tumor located in the head of the pancreas with a maximum diameter of 8.0 cm.The tumor exhibited mixed histological components,including adenocarcinoma with glandular and papillary strictures,showing marked atypia.Some areas showed nests and cords of cells with keratinization,indicative of squamous cell carcinoma.In the certain regions,there were spindle shaped cells with high nuclear-cytoplasmic ratio,frequent mitotic figures,suggestive of sarcoma.Immunohistochemistry(IHC)showed that the carcinoma components were positive for cytokeratin AE1/AE3(CK-pan),the sarcoma components were positive for vimentin,the squamous cell carcinoma components were positive for CK5/6,protein 63(P63)and P40,and the adenocarcinoma components were positive for CK7,CK19 and mucin 1.Serum carbohydrate antigen 199 were increased in both patients.Patient 1 had a 56-month follow-up and survived,while patient 2 passed away 5 months after surgery.
Breast cancer is the most common cancer in women worldwide.Postoperative radiotherapy can reduce the rate of local recurrence and distant metastasis,thereby prolonging the survival of patients.In recent years,multicatheter interstitial brachytherapy(MIB)has become the most commonly used brachytherapy technique for breast cancer.It is often applied in accelerated partial breast irradiation after breast preservation,tumor bed boost after breast preservation and accelerated partial breast reirradiation of ipsilateral breast recurrence.Compared with external radiation therapy and other brachytherapy techniques,MIB has a good local control rate and excellent cosmetic effects,as well as a low incidence of grade 3 or higher adverse events.Patients treated with MIB show good long-term prognosis.Although MIB is an invasive and highly specialized technique,it is expected to become a major modality for breast cancer radiotherapy due to its clear clinical efficacy and dosimetric advantages.
Lactophilin subfamily 3 member A2(BTN3A2)is an immunologically relevant transmembrane protein and expressed in immune cells such as B cells,monocytes,and dendritic cells.In recent years,the studies of BTN3A2 in cancer primarily focus on triple-negative breast cancer,pancreatic ductal adenocarcinoma,ovarian epithelial carcinoma,lung adenocarcinoma,and gastric adenocarcinoma,where it exhibits differential expression in various tumor tissues.Its expression can be upregulated by pro-inflammatory cytokines like interferon-γ(IFN-γ)and tumor necrosis factor-α(TNF-α).BTN3A2 enhances CD8+ and CD4+ T cells and dendritic cells in tumor microenvironment by regulating T cell mediated transcription regulator factor T-bet,signal transducer and activator of transcription(STAT)1,IFN-γ;activation/inhibition of NF-κB signaling pathway,IL-2(interleukin-2)/STAT3 signaling pathway.By inducing γδ T cells to activate into Vγ9Vδ2 T cells,anti-tumor effect can be achieved.Further analysis shows that hsa-miR-17-5p may be a miRNA target of BTN3A2,which may be provide new insights into cancer immunotherapy.
As a novel cancer treatment,chimeric antigen receptor T-cell(CAR-T)therapy has brought benefits to patients,but has caused adverse reactions distinct from conventional anti-tumor treatments like radio therapy,chemotherapy,targeted therapy,and immunotherapy.The primary adverse reactions include cytokine release syndrome,which encompasses symptoms such as fever and diarrhea,and CAR-T-related encephalopathy,which includes neurological toxicities like headache and seizures.In analyzing the adverse reactions related to CAR-T cell therapy from the perspective of traditional Chinese medicine basic theory and the theory of herbal properties,CAR-T therapy is considered to possess properties of warmth within the four qi and belongs to the sweet and pungent tastes among the five flavors.It tends to ascend and float,is associated with the heart and liver meridians,and is the result of a unique from of"autoimmune drug toxicity".The primary pathogenies involve the combination of pathogenic wind,fire,phlegm and blood stasis,meanwhile the heart,brain and gut are affected.
Objective:To explore the impact of fracture line direction in the coronal profile on the clinical characteristics and prognosis of Gartland type Ⅲ pediatric supracondylar humeral fractures. Methods:The clinical data of 618 pediatric patients with Gartland type Ⅲ supracondylar humeral fractures,who admitted to Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from June 2019 to June 2022,were retrospectively analyzed.Based on radiological data,the patients were divided into Type Ⅲa(the distal fracture was displaced to the medial side)and Type Ⅲb(the distal fracture was displaced to the lateral side).Age,gender,affected side,neurovascular injury,operation time,fluoroscopy frequency,open reduction probability,Baumann Angle at the last follow-up,the number of cases with anterior humeral cortical line passing through the middle third of the ossification center of the capitellum under the lateral image were compared between the 2 types.The excellent and good rate of Flynn function evaluation was used to assess elbow joint function at 2 months postoperatively and the last follow-up. Results:There were 360 cases(58.25％)of Gartland type Ⅲa fractures,all of which were closed fractures,and 258 cases(41.75％)of Gartland type Ⅲb fractures,including 5 open fractures.There were no significant differences in age,gender or affected side between the 2 types of fractures(all P>0.05).Compared to the Tpye Ⅲa type fractures,Type IIIb fractures had a higher probability of neurovascular injury(1.92％vs 15.50％,P<0.05),require longer operation time[(20.30±5.05)vs(46.80±3.89)min,P<0.05],more frequent fluoroscopy(10.13±2.53 vs 26.13±3.67,P<0.05),and a higher probability of open reduction(0 vs 9.69％,P<0.05).At the last follow-up,the Baumann Angle for Type Ⅲa fractures was 80.33°±2.03°,and for Type Ⅲb fractures,it was 75.59°±1.89°,with a significant difference between the 2 types(P<0.05).On lateral imaging at the last follow-up,Type Ⅲb fractures had a higher proportion of the humeral anterior cortical line not passing through the middle one-third of the capitellum ossification center(2.78％vs 9.69％),with a significant defference between the 2 types(P<0.05).At 2 months postoperatively,the excellent and good rate of Flynn function evaluation for Type Ⅲa fractures was 89.44％,whereas for Type Ⅲb fractures,it was 39.53％,with a significant difference(P<0.05).Beyond 6 months postoperatively,at the last follow-up,the excellent and good rate of Flynn function evaluation for Type Ⅲa fractures was 98.32％,while Type Ⅲb fractures,it was 95.53％,with no significant difference(P>0.05). Conclusion:Different coronal displacement directions have a significant impact on the clinical characteristics and prognosis of Gartland type Ⅲ pediatric supracondylar humeral fractures.Gartland type Ⅲb fractures are associated with a higher probability of neurovascular injury,which is more difficult to treat,difficult to achieve anatomical reduction,has a higher rate of mild malunion,and requires longer rehabilitation time.
Gastric cancer(GC)is the most common malignant tumor in the digestive system,characterized by high incidence and poor prognosis.The chemokine ligand 12(CXCL12)-chemokine receptor(CXCR)4/CXCR7 axis and its downstream signaling pathways are involved in the initiation and progression of gastric cancer.When CXCL12 binds to CXCR4,it regulates the expression of vascular endothelial growth factor(VEGF)by inducing epithelial-mesenchymal transition(EMT),activates various signaling pathways,such as phosphatidylinositol 3-kinase/protein kinase B(PI3K/Akt),Wnt signaling pathway,and nuclear factor-kappa B(NF-κB)and other mechanisms,and enhances proliferation,invasion,and metastasis in GC.Coversely,CXCL12 binding to CXCR7 increases the expression of matrix metalloproteinases(MMP)-2 and MMP-9 in GC cells,thus promoting their migration and invasion capabilities.Furthermore,the CXCL12-CXCR4/CXCR7 axis accelerates GC progression by regulating protein kinase B(Akt),signal transducer and activator of transcription 3/myelocytomatosis viral oncogene homolog(STAT3/c-Myc)signaling pathways.Additionally,this axis is closely related to tumor immune response in GC and mediates the development of immune cells,such as T cells,B cells,NK cells,macrophages,and neutrophils,suggesting new prospects for GC immunotherapy.
Angiomatoid fibrous histiocytoma(AFH)is a rare undifferentiated soft tissue tumor.This study analyzed the clinical data of 2 cases of cervical solid AFH admitted to Wuhan University People's Hospital in September and December 2021.Histomorphology,immunohistochemical staining,and molecular genetic test were analyzed.Both cases were elderly males.Case 1 was admitted due to a solid mass in the neck on CT for 2 days,while case 2 was admitted due to the discovery of a subcutaneous pea-sized mass in the neck 2 years ago,which had gradually increased in size recently.Both cases underwent simple surgical resection,and the tumor was found to have a gray-white and tough cut surface.No obvious hemorrhagic cystic cavity was observed in either case.Microscopically,the periphery of the tumor was composed of a fibrous pseudocapsule with a lymphoid plasma cell sleeve.The tumor tissues mainly consisted of spindle and oval cells clustered in nodular or sheet-like shapes.The distribution of tumor cells was uneven,with mild morphology and occasional mitotic figures(1−2/10 HPF),and no hemorrhagic cystic cavities or pseudoangiomatous spaces were observed.Immunophenotypes:anaplastic lymphoma kinase(ALK)(+),epithelial membrane antigen(EMA)(+),CD99(+),desmin(−),SOX10(−),Ki-67(+,hot spot approximately 8%).Fluorescence in situ hybridization(FISH)detection showed EWSR1 cleavage in case 1.Case 1 was followed up for 11 months without recurrence or metastasis;case 2 was followed up for 19 months without recurrence or metastasis.Solid-type AFH is rare and,solid-type AFH occurring in the neck has not been reported in the literature.This study is the first to report on solid-type AFH occurring in the neck.Microscopically,solid-type AFH is prone to misdiagnosis due to its lack of characteristic pseudoangiomatous spaces.The lymphatic plasma cell sheath around the tumor is suggestive for the diagnosis of solid-type AFH.Due to the lack of a specific immune phenotype for solid-type AFH,FISH detection of EWSR1 breakage is of great diagnostic value.Both patients did not receive any adjuvant treatment and had tumor-free survival during the follow-up period.
Sleep disorders are currently common pathophysiological processes that can lead to diseases in the cardiovascular and nervous systems.Sleep disorders are becoming increasingly prevalent in children.However,research on sleep disorders in children is relatively scarce compared to adults.Through extensive clinical observations and experimental study,it has been found that sleep disorders can negatively influence children's growth and development,learning,memory,immune function,and may even increase the risk of long-term depression.Given the increasingly serious problem of sleep disorders is becoming and their impact on cognitive functions such as learning and memory,a comprehensive understanding of the causes of common sleep disorders in children and their influencing mechanism on cognitive functions is of great clinical significance.It can provide new ideas for the selection of treatment methods for sleep disorders in children in clinical practice.
Objective:To investigate the clinicopathological and molecular characteristics of metastatic protuberant dermatofibrosarcoma(DFSP)and to review the literature. Methods:A total of 174 patients with DFSP diagnosed in the Department of Pathology of Fujian Cancer Hospital from 2010 to 2022 were screened,including 5 cases of metastatic DFSP.Patient data were collected,and hematoxylin-eosin(HE)staining,immunohistochemical staining,and fluorescence in situ hybridization(FISH)were performed to observe and compare the primary lesions and metastases. Results:Among the 5 cases of metastatic DFSP,2 had lung metastasis,and 3 had abdominal metastasis.There were 4 males and 1 female,with ages ranging from 39 to 66 years.Except for 1 case,all had a history of recurrence,with an interval between initial diagnosis to metastasis ranging from 2 to 13 years.Morphologically,all of them were fibrosarcomatous DFSP.Compared with the primary lesions,the intensity of CD34 immunohistochemical staining was decreased in metastatic lesions.A rearrangement of PDGFB was detected by FISH in 4 cases,and the copy numbers in abdominal metastasis patients were more than those in lung metastasis.Compared with non-metastatic DFSP patients,the rate of PDGFB rearrangement with copy number amplification was high in metastatic DFSP patients(80.0%vs 29.4%).In terms of treatment,3 cases with metastasis underwent surgical resection,and 2 cases that were not amenable to surgery or had postoperative recurrence received imatinib therapy,both with effects. Conclusion:DFSP rarely metastasizes to distant sites,and the pathological type is often the fibrosarcoma subtype.For DFSP patients with multiple recurrences and PDGFB rearrangement with copy number amplification,enhanced follow-up is recommended to be alert to the risk of metastasis.For metastatic DFSP patients who are not amenable to surgery,imatinib therapy is recommended.
Objective:To compare the differences in detecting cervical spinal cord lesions in patients with multiple sclerosis(MS)using the 3D-phase sensitive inversion recovery(3D-PSIR),short time inversion recovery(STIR),and T2 weighted imaging(T2WI). Methods:A total of 34 MS patients who underwent cervical spinal cord MRI examinations in the Second Affiliated to Air Force Medical University from February 2022 to September 2022 were included in this study.All patients underwent magetic resonance imaging(MRI)with T2WI,STIR and 3D-PSIR.The effectiveness,quantity,localization,and acquisition time of detecting cervical spinal cord lesions were observed and compared among different sequences,and the lesion-to-cord contrast ratio differences were analyzed between the 3D-PSIR and the STIR. Results:There was a statistically significant difference in the number of lesions detected among the 3D-PSIR,T2WI and STIR(F=24.76,P<0.001).Pairwise comparisons showed that there were statistically significant differences in lesion detection between any 2 sequences(all P<0.01).The lesion detection rate of the 3D-PSIR was approximately 37.9%,which was higher than that of conventional sequences.The 3D-PSIR demonstrated advantages in all cervical spinal cord positions,and the axial localization accuracy had statistically significantly different from T2WI(P<0.05).The 3D-PSIR had a higher lesion-to-spinal cord image contrast compare with the STIR(1.68 vs 0.45,t=10.47,P<0.001).Replacing the STIR and T2WI sequences with the 3D-PSIR sequence could reduce the scan time by 4.37 minutes and improve the efficiency by 59.5%. Conclusion:The 3D-PSIR sequence is of great significance for detecting MS spinal cord lesions and can provide a valuable MRI imaging method for visualizing other cervical spinal cord lesions.
Pyroptosis,a lytic pro-inflammatory type of programmed cell death,has been widely studied in diverse models of inflammatory diseases.Membrane perforation and cell swelling induced by cleaved Gasdermin family members is the main characteristic of pyroptosis.There are 2 main molecular mechanisms of pyroptosis:the classical caspase-1-dependent pathway and the non-caspase-1-dependent pathway.Both pathways lead to cell swelling and the release of pro-inflammatory cytokines interleukin(IL)-1β and IL-18,and expand local or systemic inflammation.The relationship between pyroptosis and tumors is complex.On one hand,pyroptosis can build a microenvironment conducive to tumor cell proliferation and accelerate tumor progression.On the other hand,overactivation of pyroptosis can inhibit the progression of tumor cells.Inducing target cells to undergo pyroptosis by regulating the expression of Gasdermin family member,inflammasomes,and other pyroptosis-related factors can be a therapeutic method for various cancers,such as non-small cell lung cancer,gastric cancer,colorectal cancer,hepatocellular carcinoma,leukemia,and cervical cancer.Exploring the role of pyroptosis in tumor therapy is of great significance for the development of novel strategies in tumor treatment.
