Uterine tumor resembling an ovarian sex cord tumor: A case report and review of literature.

BACKGROUND: Endometrial stromal tumors originate from the endometrial stroma and account for < 2% of all uterine tumors. Uterine tumor resembling an ovarian sex cord tumor (UTROSCT) is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors. Here, we report a case of UTROSCT in a 51-year-old woman. CASE SUMMARY: A 51-year-old woman had irregular menses for 6 mo. The patient visited a local hospital for vaginal bleeding. Pelvic computed tomography (CT) showed a mass in the pelvic cavity. Five days later, she came to our hospital for further diagnosis. The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor. She then underwent total removal of the uterus with bilateral salpingectomy. Postoperative histological examination showed that the tumor cells had abundant cytoplasm, ovoid and spindle-shaped nuclei, fine chromatin, a high nucleoplasm ratio, and a lamellar distribution. The findings were consistent with UTROSCT, and the results of immunohistochemical analysis supported that diagnosis. The tumor was International Federation of Gynecology and Obstetrics stage IB. No adjuvant therapy was administered after radical surgery. The patient was followed up for 58 mo, and no recurrence was found. CONCLUSION: We report a case of UTROSCT with abnormal menstruation as a symptom, which is one of the most common symptoms. In patients with vaginal bleeding, ultrasonography can be used as a screening test because of its convenience, speed, and lack of radiation exposure. For patients with long-term tamoxifen use, routine monitoring of the endometrium is recommended. As UTROSCT may have low malignant potential, surgery remains the primary management strategy. Additionally, fertility preservation in patients of childbearing age is a vital consideration.

VP1 of Enterovirus 71 Protects Mice Against Enterovirus 71 and Coxsackievirus B3 in Lethal Challenge Experiment.

Enterovirus and Coxsackievirus are the major viruses that cause hand, foot, and mouth disease (HFMD) outbreaks worldwide. Several studies have shown the potential of viral envelope protein 1 (VP1) on providing protective effects from viral strains of different genotypes. However, whether VP1 has the cross-protection in Enteroviruses or Coxsackievirus has not been studied in-depth. In this study, the vp1 gene of Enterovirus 71 (EV71) and Coxsackievirus B3 (CB3) was inserted into the vector pET22b (+) to form the respective expression plasmids pEVP1 or pCVP1, and then transformed into Escherichia coli strain BL21 (DE3). The recombinant EVP1 or CVP1 protein was overexpressed successfully and effectively purified to homogeneity. Then, we identified that EVP1 and CVP1 protein could generate effectively specific humoral immunity and cellular immunity in mice, what's more, we determined the cross-protection of VP1 between EV71 and CB3 in a murine model. The results showed that immunization with EVP1 could effectively induce specific IgG and secretory IgA against CVP1 and the sera from EVP1-immunized mice could neutralize CB3 with mean titers 1:440. In contrast, no measurable neutralizing antibodies to EV71 were detected in CVP1-immunized mice. Then, newborn BALB/C mice, whose mother was immunized with EVP1 or CVP1, were administered with different lethal doses of EV71 or CB3. The EVP1 immunized group showed a 90% protective efficacy for a CB3 dosage of 120 LD50, but the CVP1 immunized group showed no significantly different protective efficacy against 15 LD50 of EV71 compared with the BSA immunized group. Hence, EVP1 is a promising subunit vaccine candidate against Enterovirus 71 and Coxsackievirus B3 caused HFMD.

Molecular epidemiology of bla OXA-23 -producing carbapenem-resistant Acinetobacter baumannii in a single institution over a 65-month period in north China.

BACKGROUND: Carbapenem-resistant Acinetobacter baumannii poses a significant threat to hospitalized patients, as few therapeutic options remain. Thus, we investigated the molecular epidemiology and mechanism of resistance of carbapenem-resistant A.baumannii isolates in Beijing, China. METHODS: Carbapenem-resistant A.baumannii isolates (n = 101) obtained between June 2009 and November 2014 were used. Multilocus sequence typing (MLST) and PCR assays for class C and D ß-lactamase were performed on all isolates. S1 nuclease pulsed-field gel electrophoresis (PFGE) and Southern blot hybridization were performed to identify the resistance gene location. RESULTS: All 101 A.baumannii isolates were highly resistant to frequently used antimicrobials, and were considered multidrug resistant. A total of 12 sequence types (STs) were identified, including 10 reported STs and 2 novel STs. Eighty-seven isolates were classified to clonal complex 92 (CC92), among which ST191 and ST195 were the most common STs. The bla OXA-23 gene was positive in most (n = 95) of the A.baumannii isolates. Using S1-nuclease digestion PFGE and Southern blot hybridization, 3 patterns of plasmids carrying bla OXA-23 were confirmed. ST191 and ST195 (both harboring bla OXA-23 ) caused outbreaks during the study period, and this is the first report of outbreaks caused by ST191 and ST195 in north China. CONCLUSION: bla OXA-23 -producing A.baumannii ST191 and ST 195 isolates can disseminate in a hospital and are potential nosocomial outbreak strains. Surveillance of imipenem-resistant A.baumannii and antimicrobial stewardship should be strengthened.

Small intestinal lipomas: diagnostic value of multi-slice CT enterography.

AIM: To analyze the clinical and imaging features of the small intestinal lipomas and to evaluate the diagnostic value of multi-slice computed tomography (CT) enterography. METHODS: Fourteen cases (one had two intestinal lesions) of surgically confirmed lipomas of the small intestine were retrospectively analyzed. The location, size, clinical and radiological aspects were discussed. RESULTS: Twelve patients presented with abdominal pain, of whom three complained of paroxysmal colic. Melena or bloody stools was mentioned in five cases. One lesion was detected incidentally during routine physical examination. One lesion was found unexpectedly during the preoperational evaluation for cholecystitis. Examination of the abdomen revealed palpable masses in four cases. Precontrast CT scan showed round or oval well-defined hypo-intense intraluminal masses with the attenuation ranging from -130 HU to -60 HU. On contrast enhancement CT scan, no striking enhancement was seen. CONCLUSION: The small intestinal lipomas are rare and difficult to diagnose merely based on clinical manifestations, while the characteristic features at small intestinal CT enterography can help establish reliable prospective diagnoses.

False aneurysms at both ends of a descending thoracic aortic stent-graft: complication after endovascular repair of a penetrating atherosclerotic ulcer.

PURPOSE: To report the formation of false aneurysms at both ends of a stent-graft implanted in the descending thoracic aorta to repair a penetrating atherosclerotic ulcer. CASE REPORT: A 66-year-old woman with a penetrating atherosclerotic ulcer was treated with a 34 x 70-mm homemade Gianturco-type stent covered with polytetrafluoroethylene graft. Four months later, she developed false aneurysms at both ends of the stent-graft. The patient refused further endovascular repairs, so the stent-graft was surgically removed and the aorta repaired. CONCLUSIONS: This case demonstrates an unusual complication that should be anticipated when a stent-graft is deployed in the acute phase of thoracic aortic ulcer or its variants.

Interleukin-6 production by human bladder tumor cell lines is up-regulated by bacillus Calmette-Guérin through nuclear factor-kappaB and Ap-1 via an immediate early pathway.

PURPOSE: The expression of interleukin-6 (IL-6) by normal and malignant urothelium in response to bacillus Calmette-Guerin (BCG) may have direct and indirect effects on the antitumor activity of BCG. We evaluated the molecular signaling pathway through which BCG induces IL-6 expression in human transitional cell carcinoma lines. MATERIALS AND METHODS: We evaluated IL-6 messenger RNA and protein expression by human transitional carcinoma cell lines in response to BCG. Pharmacological inhibition of protein synthesis was used to determine if BCG mediated IL-6 induction occurred via an immediate-early or delayed pathway. We used 5' deletion analysis and site directed mutagenesis to identify BCG responsive regions in the human IL-6 promoter. Electrophoretic mobility shift assays were done to assess nuclear translocation of the putative signaling proteins AP-1 and nuclear factor-kappaB (NF-kappaB) in response to BCG. RESULTS: BCG increased IL-6 messenger RNA and protein in a time and dose dependent manner. IL-6 induction by BCG occurred via an immediate-early response. Promoter analysis identified 2 areas in the -1,200 to 14, 5' region of the IL-6 gene, which when deleted were associated with significant losses of absolute or BCG responsive activity. Site specific mutation of putative AP-1 or NF-kappaB elements associated with each region demonstrated that these elements were necessary but not sufficient for BCG induced IL-6 transcription. Gel mobility shift assays showed that AP-1 and NF-kappaB were induced in response to BCG exposure. CONCLUSIONS: Our results show that BCG induced IL-6 expression by human transitional cell neoplasms occurs as an immediate-early gene pathway that requires NF-kappaB and AP-1.