Goblet cell adenocarcinoma of the anal canal with perianal Paget disease: A rare case report with literature review.

INTRODUCTION: AS an uncommon neoplasm, goblet cell adenocarcinoma (GCA) is characterized by mixed endocrine-exocrine features. It is almost exclusively found in the appendix. Primary GCA of the anal canal is extremely rare. CASE PRESENTATION: Herein we describe a novel rare case of 74-year-old Chinese female who is diagnosed with GCA in the anal canal with perianal Paget disease, including a brief review of the literature. In the lesion of anal canal, the tumor was composed of signet-ring-like cells on confluent growth model and copious mucin was produced as well. Simultaneously, the results of immunohistochemistry showed signet-ring-like cells were positive for CK20, CDX2, synaptophysin (Syn), CD56, carcinoembryonic antigen (CEA) and Villin. Meanwhile, the Ki67-labeling index reached 40%. In the lesion of perianal Paget disease, the small groups of atypical neoplastic cells were present in the epidermis. Immunohistochemically, the neoplastic cells were positive for CK20, CDX2 and epithelial membrane antigen, but negative for CK7, GCDFP15, S100, HMB45, and P63. The Ki67-labeling index reached 60% in the most concentrated spot. CONCLUSIONS: Extra-appendiceal GCA was rare and easily under-recognizable. The diagnosis of GCA was seldom made preoperatively. Occasionally, GCA could occur in the anal canal accompanied by perianal Paget disease. So careful rectal examination was important in the patient with perianal Paget disease for avoid missing diagnosis of GCA on anal canal. GCA may show aggressive clinical behavior compared with typical well-differentiated neuroendocrine tumors. Therefore, we should pay more attention on the recognization of this rare disease.

FMR1 promotes the progression of colorectal cancer cell by stabilizing EGFR mRNA in an m6A-dependent manner.

FMR1, a new m6A reader, is known to be involved in the regulation of cancer progression. However, its role, regulatory mechanism, and clinical significance in colorectal cancer (CRC) are elusive. Here, we showed that FMR1 was upregulated in CRC, and it promoted proliferation and metastasis of CRC cells in vitro and in vivo. Mechanically, FMR1 recognized the m6A-modification site in EGFR mRNA, a key molecule in cancer occurrence and targeted therapy, sustained its stability and maintained its expression in an m6A-dependent manner, thereby promoting the tumorigenesis and metastasis of CRC. And the effect of FMR1 knockdown in CRC cells could be abolished by METTL3. Furthermore, FMR1 shRNA plasmid carried by attenuated Salmonella has an effective anti-tumor effect in vivo. Collectively, we identified the METTL3/FMR1/EGFR axis in the progression of CRC. This novel mechanism indicated that the METTL3/FMR1/EGFR axis is a potential target for early therapeutic intervention in CRC progression.

Necroptosis-Related Genes Signatures Identified Molecular Subtypes and Underlying Mechanisms in Hepatocellular Carcinoma.

Background: Although emerging evidence supports the relationship between necroptosis (NEC) related genes and hepatocellular carcinoma (HCC), the contribution of these necroptosis-related genes to the development, prognosis, and immunotherapy of HCC is unclear. Methods: The expression of genes and relevant clinical information were downloaded from TCGA-LIHC, LIRI-JP, GSE14520/NCI, GSE36376, GSE76427, GSE20140, GSE27150, and IMvigor210 datasets. Next, we used an unsupervised clustering method to assign the samples into phenotype clusters base on 15 necroptosis-related genes. Subsequently, we constructed a NEC score based on NEC phenotype-related prognostic genes to quantify the necroptosis related subtypes of individual patients. Results: We divided the samples into the high and low NEC score groups, and the high NEC score showed a poor prognosis. Simultaneously, NEC score is an effective and stable model and had a good performance in predicting the prognosis of HCC patients. A high NEC score was characterized by activation of the stroma and increased levels of immune infiltration. A high NEC score was also related to low expression of immune checkpoint molecules (PD-1/PD-L1). Importantly, the established NEC score would contribute to predicting the response to anti-PD-1/L1 immunotherapy. Conclusions: Our study provide a comprehensive analysis of necroptosis-related genes in HCC. Stratification based on the NEC score may enable HCC patients to benefit more from immunotherapy and help identify new cancer treatment strategies.

Mechanical Performance of 3D Printed Concrete in Steam Curing Conditions.

Three-dimensional (3D) concrete printing (3DCP) technology attracts significant attention from research and industry. Moreover, adequate mechanical performance is one of the primary properties for materials, meeting the demand of structural safety using 3DCP technology. However, research on curing conditions as the significant influence factor of mechanical capacity is required to accelerate the practical application of 3DCP technology. This study aims to explore the impact of various steam curing conditions (heating rate, constant temperature time, and constant temperature) on the mechanical performance of printed concrete containing solid wastes. Moreover, the optimal steam curing conditions are obtained for compressive, tensile, and flexural properties in different directions. Subsequently, anisotropies in the mechanical properties of printed composites and interlayer bonding behaviors are investigated when various curing conditions are employed. The result shows that steam curing conditions and solid waste incorporation improves the interlayer bond for 3D printed cement-based composites.

Enhanced biological phosphorus removal from wastewater by current stimulation coupled with anaerobic digestion.

The integrated wastewater discharge standard for phosphorus has become increasingly strict. In this study, a synergetic current stimulation system coupled with anaerobic digestion was used to enhance phosphorus removal from wastewater. The effects of current intensity, pH, and methane (CH4) synthesis on phosphorus removal were investigated. As direct current was supplied to an anaerobic bioreactor, the removal of sewage total phosphorus was significantly enhanced. The conditions of weak acid and low negative oxidation-reduction potential facilitated the phosphorus removal from wastewater. The optimal parameters for the dephosphorisation process were a current intensity of 100 mA and a pH of 6.0. When the anaerobic digestion process was inhibited by the reagent 2-bromoethanesulphonic acid sodium (BES), abundant metabolic intermediates accumulated and methanogenesis clearly decreased. Affected by the current stimulation and the inhibition of CH4 synthesis, the formation of gaseous phosphine (PH3) was greatly improved, and then PH3 escaped from the digestion mixture after it was absorbed by microbial cells. The maximum PH3 content of the digestion gas was 41.8 mg m-3 in the reactor supplied with a current of 100 mA and BES addition of 10 mmol L-1, and the phosphorus removal in this digestion system reached 55.2% at 6 d; however, the removal in the conventional anaerobic digestion system was only 17.7% after the same amount of time. Finally, a pathway of enhanced anaerobic biological phosphorus removal was proposed to better understand the inherent synergistic mechanism.

Effects of reactive oxygen species scavengers on thermophilic micro-aerobic digestion for sludge stabilization.

In thermophilic digestion systems, sludge stabilization may be adversely impacted by high concentrations of ammonia nitrogen or the rapid accumulation of fatty acids; however, few studies have focused on the mitigation of the inhibition of reactive oxygen species (ROS). In this study, fulvic acids or tea polyphenols were introduced to a thermophilic digestion system and the effects of ROS scavengers on sludge stabilization were investigated. As fulvic acids or tea polyphenols were added to sludge, they reacted with metal cations, such as Cu2+ and Zn2+, to form stable complexes that enabled active metal ions to be transported into cells to enhance the oxidase activities. Therefore, the digestion systems presented a lower O2•- content compared with that of a control group with no additive. Both fulvic acids and tea polyphenols mitigated the adverse effects of the ROS and enhanced the reduction of volatile solids (VS), however, fulvic acids better facilitated the sludge stabilization. The optimal dosage was 0.3% of the total solids as fulvic acids were added to the sludge every 48 h. The VS reduction in the digester reached 38.2% at 14 d, which was clearly higher than that in the control group. The pathway of ROS scavengers affecting sludge stabilization was proposed, and it may be helpful to gain deeper insight into the characteristics of thermophilic digestion processes as well as the mechanism of sludge stabilization.

Use of Nanosilica and Cement in Improving the Mechanical Behavior of Disintegrated Carbonaceous Mudstone.

This study aims to examine the mechanical behavior of disintegrated carbonaceous mudstone modified with nanosilica and cement (DCMNC). Many DCMNC specimens with various nanosilica contents were prepared. The X-ray diffraction (XRD) analyses and scanning electron microscopy (SEM) observations were performed on some of the specimens. Afterwards, triaxial tests were carried out on the remaining specimens to determine the mechanical behavior of DCMNC. The results showed that the cohesion exhibited a positive correlation with nanosilica content while the angle of internal friction presented a negative correlation with nanosilica content. The peak deviatoric stress, residual deviatoric stress and brittle modulus of DCMNC showed an increase followed by a decrease as nanosilica content varied from 0 to 8%, and all of them reached corresponding maximums at a nanosilica content of 2%. Thus, 2% was considered to be the optimum nanosilica content. The modification mechanism of DCMNC could be explained by the pozzolanic reaction related to nanosilica and the filling effect of nanosilica.

A comparative study of two liquid-based preparation methods: membrane-based and sedimentation in fine needle aspiration cytology diagnosis in thyroid nodules.

BACKGROUND: As thyroid fine needle aspiration (FNA) shows a certain limitation in the diagnosis of conventional smears, novel approaches like liquid-based cytology (LBC) have been gradually applied recently. Studies have shown the difference between the conventional smears (CSs) and liquid-based smears on fine needle aspiration cytology (FNAC) diagnosis, but the impacts of different liquid-based preparation (LBP) methods, including membrane-based and sedimentation, on diagnosis are still not clear. In this study, the effects of liquid-based smears prepared by different methods on the cytological interpretation were studied. METHODS: A total of 221 thyroid liquid-based FNAC cases from January 2017 to October 2018 were collected. We retrospectively studied and compared the effects of the membrane-based and sedimentation LBP methods through The Bethesda System for Reporting Thyroid Cytopathology (TBS) diagnosis and risk of malignancy assessment. Besides, we made an evaluation on the diagnostic differences in the effects of different preparation methods on the cell morphology and tissue structure of papillary thyroid carcinoma (PTC) for more accurate FNAC diagnosis. RESULTS: Among the 221 cases reviewed, membrane-based method was applied in 153 cases and sedimentation in 68 cases. According to the diagnostic criteria of 2017 TBS, TBSVI and TBSV thyroid could be cytologically diagnosed by membrane-based (49.0% (75/153) and 25.5% (39/153)) and sedimentation (52.9(36/68) and 25(17/68)) methods, and both were confirmed as PTC through histopathological diagnosis after operation, with the malignancy degree as high as 100%. In addition, of the 30 cases that were diagnosed as TBSIII thyroid nodules with the membrane-based method, 15 cases were pathologically malignant after an operation, with the malignancy degree of 50% (15/30), while that in 11 cases using the sedimentation method was 45.4% (5/11). PTC could be detected in both the TBSIV and TBSII thyroid nodules diagnosed by membrane-based method, with the sensitivity of 87.0% (114/131) lower than that by sedimentation method (91.4% (53/58)), showing the lower consistency with the histopathological result (K = 0.635 vs K = 0.757). Among the membrane-based smears, 23.5% (36/153) had fewer follicular epithelial cells, 55.6% (20/36) of which were considered to be suspicious for PTC from cell karyotype and tissue arrangement. While among the sedimentation smears, 16.2% (11/68) had fewer follicular epithelial cells, and 63.6% (7/11) was suspicious for PTC. In 72.5% (95/131) membrane-based smears of PTC, the papillary and swirling structures were not obvious, showing as crowded syncytial cell masses, while in 55.2% (32/58) sedimentation smears, both structures were visible with obvious three-dimensional papillary structure, and the fibrovascular axis still remained. CONCLUSION: LBP technique is feasible for FNAC diagnosis, and the sedimentation shows more advantages, like higher PTC detection rate and good consistency with postoperative histopathological diagnosis. A clear understanding of the subtle differences in the effects of membrane-based and sedimentation methods on the cell morphology and tissue structure could be conducive to the definitive diagnosis of PTC before operation.

Effects of pH on the biodegradation characteristics of thermophilic micro-aerobic digestion for sludge stabilization.

For a thermophilic micro-aerobic digestion (TMAD) system, the pH is closely related to the production of short-chain fatty acids and ammonia release. Batch experiments at different pH values were carried out to elucidate the effects of pH on the biodegradation characteristics of TMAD processes. A digester at pH 9.0 maintained better performance of sludge stabilization than acidic and neutral digestion systems, and the reduction of volatile solids reached ≤41.3% on day-10. We proposed a pathway of proton transfer in the TMAD system. An acidic digestion environment, in general, resulted in K+ deficiency, low enzyme activity, and oxidative stress. An alkaline digestion environment facilitated substrate oxidation, accelerated humification, and prevented the inhibition caused by the accumulated acids or ammonia nitrogen. The pH and digestion time affected the microbial population and species richness significantly. An alkaline digestion system presented lower bacterial diversity and maintained a higher richness of functional microbes such as Paenalcaligenes and Pseudogracilibacillus. Hence, an alkaline digestion system maintained a relatively high oxidase activity, and mitigated the potential oxidative stress for thermophiles.

Impacts of ammonia nitrogen on autothermal thermophilic micro-aerobic digestion for sewage sludge treatment.

The concentration of ammonia nitrogen is relatively high during autothermal thermophilic micro-aerobic digestion (ATMAD), which could significantly affect the sludge stabilization. This paper aims to investigate the impacts of ammonia nitrogen on ATMAD process, batch experiments were carried out with dosage of certain amount of NH4HCO3 into digestion system. The total ammonia nitrogen (TAN) was considered as a suitable indicator to characterize the ammonia inhibition. As the TAN reached to approximately 1000 mg L-1, the sludge digester presented a relatively low removal of volatile solids, due to adverse effects of ammonia nitrogen on sludge digestion. Three pathways that closely related to ammonia inhibition were investigated in this research. Digestion system could be inhibited by high TAN due to K+ deficiency of the cells and the decline of Mg2+ in the cytoplasm, and the accumulations of reactive oxygen species lead to oxidative stress for the microbes. Ammonia inhibition can be mitigated by the increase of oxidative enzyme.

Clinicopathological Features of Low-Grade Thyroid-like Nasopharyngeal Papillary Adenocarcinoma.

PURPOSE: Primary low-grade thyroid-like papillary adenocarcinomas are extremely rare neoplasms that generally originate in the nasopharynx. Here, we describe a novel case of a 15-year-old Chinese girl who was diagnosed with low-grade thyroid-like papillary adenocarcinoma, including a brief review of the literature to reveal the clinicopathological features of low-grade thyroid-like nasopharyngeal papillary adenocarcinoma. MATERIALS AND METHODS: Immunohistochemistry was used to evaluate the expression of pan-cytokeratin (CKpan), cytokeratin (CK) 7, thyroid transcription factor 1 (TTF-1), vimentin, epithelial membrane antigen (EMA), thyroglobulin, CD15, S100, P40, CK20, CDX-2, glial fibrillary acidic protein (GFAP), and Ki-67. Additionally, in situ hybridization investigation was utilized to identify the presence of small Epstein-Barr virus (EBV)-encoded RNA. RESULTS: Histopathological analysis revealed florid proliferation of papillary structures lined by columnar epithelial cells with fibrovascular cores. Immunohistochemically, the neoplastic cells were positive for CKpan, CK7, TTF-1, vimentin, and EMA, but negative for thyroglobulin, CD15, S100, P40, CK20, CDX-2, and GFAP. The Ki-67-labeling index reached 5% in the most concentrated spot. In situ hybridization for EBV was negative. CONCLUSION: Due to the distinct rarity of low-grade thyroid-like papillary adenocarcinomaswith a favorable clinical outcome, a nationwide effort to raise public awareness of this neoplasm is required.

Primary myoepithelial carcinoma of the lung: a case report and review of literature.

Primary myoepithelial carcinoma of the lung is a very rare tumor arising from the salivary glands of the respiratory epithelium. Since it was first described by Higashiyama et al. in 1998, to the best of our knowledge, only eight actual cases reported in the English-language literature so far. The diagnosis is based entirely on histological and immunohistochemical evaluations. We report a primary myoepithelial carcinoma in a smoker 47-year-old Chinese man, who was referred to our institution for hemoptysis. Computed tomography revealed a 65 mm × 78 mm solid mass in the left lower lobe of lung. The patient underwent the left lower lobe resection. The final histopathological diagnosis was primary myoepithelial carcinoma of the lung. Given the rare occurrences of this tumor, appropriate recommendations for treatment are difficult to formulate. Although classified as low-grade tumor, it has a significant rate of distant metastasis. Herein we report a case of a primary myoepithelial carcinoma of the lung and present a brief review of the literature.