The factors influencing the occurrence of post-ischemic stroke depression and its relationship with the burden score of cerebral small vessel disease.

OBJECTIVE: This study explored the determinants of post-stroke depression (PSD) in ischemic stroke (AIS) patients and its association with the burden score of cerebral small vessel disease (CSVD). PATIENTS AND METHODS: We analyzed 374 AIS patients treated between January 2020 and January 2022. Patients were categorized into 90 with PSD and 284 without PSD, enabling an investigation into PSD risk factors and the CSVD-PSD relationship. RESULTS: There was no significant difference in health factors between PSD and non-PSD patients (p>0.05). However, significant disparities were noted in age, gender, initial Barthel Index (BI), Mini-Mental State Examination (MMSE) score, plasma fibrinogen, homocysteine, red cell distribution width, National Institutes of Health Stroke Scale (NIHSS) score, and CSVD burden score (p<0.05). Regression analysis indicated that these variables were pivotal PSD predictors (OR>1, p<0.05). Surprisingly, a positive correlation with PSD occurrence was found for age, NIHSS score, plasma fibrinogen, homocysteine levels, red cell distribution width, CSVD burden score (r=0.565, 0.615, 0.482, 0.514, 0.572, 0.608, respectively; p<0.05). Meanwhile, the MMSE score and BI index were inversely related to PSD onset (r=-0.604, -0.590; p<0.05). The ROC curve analysis of the combination model based on MMSE, NIHSS and CSVD score revealed an AUC of 0.926 and Youden's index of 0.744. CONCLUSIONS: Age, MMSE score, BI index, NIHSS score, plasma fibrinogen concentration, homocysteine level, red blood cell distribution width, and CSVD burden score are all major influencing factors in the occurrence of PSD. The combination model based on MMSE, NIHSS, and CSVD scores presented a valuable approach to predicting PSD.

Microarray profiling identifies hsa_circ_0082003 as a novel tumor promoter for papillary thyroid carcinoma.

BACKGROUND: Circular RNAs (circRNAs) are non-coding RNAs that have essential regulatory roles in the development of various tumors. This study explored whether circRNAs are involved in the progression of papillary thyroid carcinoma (PTC). METHODS: Differentially expressed circRNAs (DECs) in four pairs of PTC and matched normal thyroid tissues were screened using a circRNA microarray. The potential functions of dysregulated circRNAs were predicted by bioinformatic analyses. Reverse transcription quantitative polymerase chain reaction (RT-qPCR) was used to determine hsa_circ_0082003 expression in 80 pairs of PTC and matched normal thyroid tissues. Cell counting kit-8, colony formation, wound healing, and Transwell assays were performed to evaluate the biological functions of hsa_circ_0082003 in PTC cells. The role of hsa_circ_0082003 in PTC tumorigenesis in vivo was validated in nude mice. RESULTS: In total, 3150 DECs (2317 upregulated and 833 downregulated) were identified. Pathway enrichment analyses indicated that the dysregulated circRNAs may play roles in PTC development. RT-qPCR validation demonstrated that hsa_circ_0082003 expression was significantly increased in PTC tissues and correlated with poor clinicopathological parameters. Receiver operating characteristic curve analysis showed that hsa_circ_0082003 had good performance for diagnosing PTC and judging whether it was accompanied by lymph node metastasis. Knockdown of hsa_circ_0082003 inhibited PTC cell proliferation, migration, and invasion. Tumor formation assays in vivo showed that downregulation of hsa_circ_0082003 significantly suppressed the growth of PTC. CONCLUSION: Hsa_circ_0082003 may serve as a novel diagnostic biomarker and potential therapeutic target for PTC.

Nomograms based on sonographic and clinicopathological characteristics to predict lateral lymph node metastasis in classic papillary thyroid carcinoma.

BACKGROUND: Lateral lymph node metastasis (LLNM) has been considered a risk factor of recurrence in papillary thyroid cancer (PTC). Preoperative detecting LLNM accurately is difficult. Solitary lateral lymph node metastasis is a special type of LLNM. We aimed to develop nomograms for predicting LLNM and multiple lateral lymph node metastasis (MLLNM). METHODS: We retrospectively retrieved 528 classic PTC patients that underwent surgery between March 2019 and May 2020. Sonographic and clinicopathological features were collected. Risk factors of LLNM and MLLNM were determined by univariate and multivariate analysis. Nomograms for predicting LLNM and MLLNM were developed. RESULTS: LLNM was independently associated with tumor size, the number of foci, location, margin, central lymph node metastasis, and lymph node ratio. Independent predictors of MLLNM were age, margin, and the number of metastatic lymph nodes in central compartment. By using above variables, we constructed nomograms for predicting LLNM and MLLNM, with area under curves of 0.864 and 0.748, respectively. CONCLUSION: Through these accurate and easy-to-use nomograms, we can detect the risk of residual LLNM postoperatively for classic PTC patients who did not receive lateral neck dissection and provide an individualized plan for postoperative management of classic PTC patients.

[Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in 13 children].

Objective: To analyze the clinical characteristics, treatment and prognosis of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children. Methods: A retrospective analysis was performed on the clinical features, laboratory tests, neuroelectrophysiological examination, imaging, treatment and outcomes of 13 patients with Hashimoto's encephalopathy presenting with isolated cerebellar ataxia, who were admitted to the Department of Pediatric Neurology of Guangzhou Women and Children's Medical Center from January 2016 to May 2021. Results: Among the 13 cases, 6 were males and 7 were females. The onset age was 2.6 (2.0,3.3) years, 9 children had precursor infection or vaccination before the first course of disease. All the 13 children had gait abnormalities or unsteady sitting, 10 had intentional tremor, 6 had dysarthria, 3 had body tremor, 2 had nystagmus, 3 had fatigue, 3 had hypotonia, 2 had vomiting and 1 had irritability. Thyroglobulin antibody (TgAb) was 500.0 (298.9,587.2) kU/L and thyroid peroxidase antibody (TPOAb) was 621.9 (449.6,869.4) kU/L in 13 cases. Autoantibodies were positive in 9 cases, and cerebrospinal fluid leukocytosis was seen in 4 cases. Regarding electroencephalography result, 4 cases had background slowing and 1 case had occasional sharp waves. Among the 3 patients who had relapses, 1 had cerebellar atrophy shown on cranial magnetic resonance imaging (MRI) during the recurrence. All the patients received intravenous immunoglobulin (IVIG) and intensive methylprednisolone therapy during the first onset, followed by the disappearance of the symptoms, 1 patient had repeated episodes which was decreased after immunosuppressive treatment with Rituximab.Followed up for 25.0 (22.5,33.3) months after the last episode, 12 achieved complete remission and 1 had a wide base gait. Conclusions: Trunk ataxia is the common symptom of Hashimoto's encephalopathy presenting with isolated cerebellar ataxia in children.Children with cerebellar ataxia should be tested for TgAb and TPOAb to detect Hashimoto's encephalopathy, avoiding missed diagnosis and treatment delays; IVIG and intensive steroid therapy is effective, and immunosuppressive therapy for patients with multiple relapses could reduce the recurrence.

[Role of ubiquitin-specific peptidase 22 in multidrug resistance of colorectal cancer and its correlation with multidrug resistance gene P-gp].

Objective: To investigate the role of ubiquitin-specific peptidase 22 (USP22) in colorectal cancer multidrug resistance and its correlation with multidrug resistance genes P-gp and MRP1, and to preliminarily explore the mechanism of USP22 affecting colorectal cancer resistance. Methods: USP22 over-expression plasmid was transfected into colorectal cancer cells (RKO, SW480)with low expression of USP22. Cell counting kit (CCK-8) assay was used to detect the effect of USP22 on oxaliplatin resistance in colorectal cancer cells. The cells were treated with oxaliplatin of the same concentration. Western blot method was used to detect the expression of apoptosis-related proteins cleaved-caspase3, Bcl-2, and drug resistance proteins MRP1, P-gp in the cells. The cell efflux test was used to detect the effect of up-regulated USP22 on Calcein-AM and rhodamine123. Immunohistochemical methods were used to detect the expressions of USP22 and P-gp in the oxaliplatin chemotherapy-sensitive group and the drug-resistant group and to analyze the correlation between USP22 and MRP1, P-gp. Results: CCK-8 assay showed that the IC50 values of SW480-USP22 (SW480 cells overexpressing USP22) treated with oxaliplatin for 24 h and 48 h was (4.62±0.05)µmol/L and (2.32±0.04)µmol/L respectively; which was 2.7 times and 3.0 times higher than that in control cells, respectively. After treating with 1.25 µmol/L oxaliplatin for 48 h, USP22 overexpression can inhibit SW480 cells apoptosis. The fluorescence intensity of calcein-AM and rhodamine123 in the SW480-USP22 group were significantly increased when compared with that in the control cells (both P<0.01). The protein expression levels of MRP1 and P-gp in SW480-USP22 cells were significantly increased when compared with that in the control cells(both P<0.01). Immunohistochemistry showed that the positive expression rates of USP22, MRP1, and P-gp in the oxaliplatin chemotherapy-sensitive group were significantly lower than those in the chemotherapy-resistant group, the difference was statistically significant (all P<0.05), and USP22 was positively correlated with the expressions of MRP1 and P-gp in colorectal cancer tissues (r1=0.377, r2=0.423, both P<0.05). Conclusions: The up-regulation of USP22 is related to the acquired resistance of colorectal cancer cells to oxaliplatin. USP22 may be involved in the process of platinum-based chemotherapy resistance of colorectal cancer by regulating the expressions of P-gp and MRP1.

[Pathological diagnosis and clinical significance of appendiceal epithelial neoplasms].

Appendiceal epithelial neoplasms including benign and malignant, are clinically rare. There were quite a lot of changings in classification systems for them and different pathological diagnostic terminologies were used, resulted in confusions of understanding and communication for both pathologists and clinicians. Basically, appendiceal epithelial neoplasms include adenoma, serrated lesion and polyps, mucinous neoplasms, carcinoma and neuroendocrine neoplasms. Appendiceal mucinous neoplasms and goblet cell carcinoma are exclusively seen in the appendix. Though some appendiceal neoplasms are similar to those in large bowl, however, the molecular mechanism is different. The classification, pathological diagnosis and clinical significance of appendiceal epithelial neoplasms were summarized based on the fifth edition of WHO classification on digestive system tumors and other related literatures.

[Expression and pathological role of galectin-10 in different types of nasal polyps].

Objective: To investigate the different expression of galectin-10 in nasal polyps with different degrees of eosinophil infiltration, and to explore whether galectin-10 can be used as a new biomarker of eosinophilic chronic rhinosinusitis with nasal polyps (ECRSwNP) and its possible role in the pathogenesis of ECRSwNP. Methods: A total of 36 patients (20 males, 16 females, aged from 14 to 74 years old) who underwent functional endoscopic sinus surgery at the Second Affiliated Hospital of Nanchang University from November 2018 to April 2019 were enrolled into the retrospective study, including 11 cases of ECRSwNP, 15 cases of non-ECRSwNP and 10 cases in control group (deviation of nasal septum). The patients were divided into allergic rhinitis and non-allergic rhinitis groups, atopy and non-atopy groups according to whether patients in the experimental group and control group had allergic rhinitis and atopy. HE staining was performed for histological assessment of CRSwNP which was classfied as ECRSwNP and non-ECRSwNP. Immunohistochemistry (IHC) was used to determine the positive localization and semi-quantitative expression level of galectin-10 protein in ERSwNP, non-ECRSwNP and control groups. The expression levels of galectin-10 protein in three groups were determined by Western Blot. The expression levels of galectin-10 mRNA in three groups were determined using real-time quantitative polymerase chain reaction (qRT-PCR). Analyzing the correlation between the expression of galectin-10 and clinical factors including the allergic rhinitis and atopy, SPSS 19.0 software and Graphpad prism 7.0 were used for statistical analysis and mapping. Results: By using IHC method, it was found that galectin-10 was mainly localized in eosinophils in the polyp tissues. The semi-quantitative expression of the galectin-10 in the ECRSwNP group (0.051±0.003) was significantly higher than that of non-ECRSwNP (0.028±0.004) and control groups (0.025±0.004, t value was 3.862 and 5.137, both P<0.01). There was no significant difference between the control and non-ECRSwNP groups (t=0.560, P>0.05). The expression of galectin-10 in the ECRSwNP group was significantly higher than that of non-ECRSwNP and control groups (t value was 25.351 and 27.376, both P<0.01). However, there was no significant difference between the non-ECRSwNP and control groups (t=1.071, P>0.05). Compared with the non-ECRSwNP (1.188±0.054) and control groups (1.020±0.142), the expression of galectin-10 mRNA was higher in the ECRSwNP group (2.413±0.303), the differences were significant (t value was 3.973 and 4.156, both P<0.05). There was no significant difference between the non-ECRSwNP and control groups (t=1.110, P>0.05). There was no significant difference in the expression of galectin-10 between the allergic rhinitis group and the non-allergic rhinitis group (all P>0.05), so as to the atopy group and non-atopy group(all P>0.05). Conclusion: The expression level of galectin-10 is elevated in ECRSwNP, and not influenced by allergic status, suggesting that galectin-10 may be a new biomarker for ECRSwNP and play an important role in the pathogenesis of ECRSwNP.

Management of cN0 papillary thyroid microcarcinoma patients according to risk-scoring model for central lymph node metastasis and predictors of recurrence.

BACKGROUND: The role of routine prophylactic central neck dissection (pCND) in clinically lymph node-negative (cN0) papillary thyroid microcarcinoma (PTMC) patients remains controversial. This retrospective study aimed to identify the clinical and pathologic factors of central lymph node metastasis (CLNM) and recurrence in PTMC patients. METHODS: A total of 371 cN0 PTMC patients from two hospitals were retrospectively analyzed. All patients underwent thyroidectomy plus pCND between January 2010 and January 2018. Clinicopathological features were collected, univariate and multivariate analyses were performed to determine the risk factors of CLNM. A scoring model was constructed on the basis of the results of independent risk factors of CLNM. The Cox proportional hazards model was used to analyze the risk factors of recurrence. RESULTS: CLNM occurred in 123 (33.2%) patients. Multivariate analysis showed male, tumor size > 0.75 cm, multifocality, extrathyroidal extension (ETE) and tumor in the middle/lower pole were independent risk predictors of CLNM (P < 0.05). A seven-point risk-scoring model was established to predict the stratified CLNM in cN0 PTMC patients. Multivariate Cox regression model showed ETE, vascular invasion and CLNM were independent risk predictors of recurrence (P < 0.05). CONCLUSION: Our study suggested that routine pCND should be performed for cN0 PTMC patients with score ≥ 3 according to the risk-scoring model. Moreover, patients with risk factors of recurrence should consider more complete treatment and more frequent follow-up.

[Diagnosis and treatment of eosinophilic rhinosinusitis].

Chronic rhinosinusitis (CRS), a chronic inflammation of the nasal sinus mucosa, is based on a simplified classification of a single clinical phenotype (with or without nasal polyps) that does not adequately reflect the heterogeneity of the pathogenesis of chronic rhinosinusitis complexity. Currently, according to the lesion mucosa or polyps eosinophil infiltration,this type of chronic rhinosinusit is known as eosinophilic chronic rhinosinusitis (ECRS). The curative effect of ECRS is poor than non-eosinophilic rhinosinusitis. This article summarizing the diagnosis and treatment of eosinophilic rhinosinusitis status, is to provide help for clinical diagnosis and treatment.

[To explore the role of CT scan in the diagnosis of eosinophilic chronic rhinosinusitis].

Objective:We explored the role of CT scan in the diagnosis of eosinophilic chronic rhinosinusitis (ECRS) in sinus osteitis for a better guidance of clinic and treatment. Method:A total of 127 patients with chronic rhinosinusitis who underwent primary surgery were collected(52 patients were ECRS). Seventy-five patients with NonECRS performed global osteitis scoring scale (GOSS) osteitis score on the patient's preoperative sinus CT. Mamn-Whitney U analysis was used to compare the GOSS osteitis scores between the two groups. A binary logistic regression analysis was performed on the statistically significant indicators to find predictive GOSS osteitis scores. Receiver operating characteristic curve (ROC curve) analysis was performed on meaningful indicators to analyze the relationship among the cutoff values the sensitivity and the specificity to find the best cutoff value. Result:The osteitis evaluation index GOSS osteitis total score,ethmoid osteitis scores(GOSS-E), ethmoid osteitis score compared with the maxillary osteitis score (GOSS-E/M), posterior group ethmoid sinus osteitis score compared with the former group ethmoid sinus osteitis score (GOSS-PE/AE), anterior ethmoid osteitis scores (GOSS-AE), posterior ethmoid osteitis scores (GOSS-PE), sphenoid osteitis scores (GOSS-S), ECRS significantly higher than NonECRS(P<0.05); binary logistic regression analysis and ROC curve analysis were performed. When the cut-off value of the ethmoid osteitis score was >4.5 (area under the curve was 0.690), the corresponding sensitivity and specificity were 62% and 71%, respectively. Conclusion:When the ethmoid sinus CT is used to obtain a ethmoid osteitis score of >4.5,the ECRS can be diagnosed clinically.

[Cross-sectional survey of autism spectrum disorders in children aged 0-6 years in Hainan province].

Objective: To understand the prevalence of autism spectrum disorders (ASD) in children aged 0-6 years old and influencing factors in Hainan province. Methods: A total of 37 862 children aged 0-6 years were selected from 18 counties in Hainan province for a screening by using questionnaire of"warning signs in child development", then field diagnosis was made, and general descriptive statistic analysis was conducted. The prevalence of ASD and related factors were analyzed with χ(2) test and unconditional logistic regression model. Results: Among 37 862 children aged 0-6 years, 235 were diagnosed with ASD, the prevalence of ASD was 0.62% (0.99% in boys, 0.17% in girls), the differences was significant (χ(2)=101.91, P=0.000). The prevalence of ASD increased with age (χ(2)=288.62, P=0.000). The prevalence of ASD was significantly higher in urban area than in other areas (χ(2)=114.77, P=0.000). Factors such as full term pregnancy or not, neonatal asphyxia, father's characteristics, father's habit of chewing areca or smoking, mother's general mood, and mother's induced abortion history were the influencing factors for ASD. Conclusion: The prevalence of ASD in children aged 0-6 years was high in Hainan and was influenced by genetic factors, pregnancy and delivery process, parents unhealthy habit before and during pregnancy and other factors.

[Expression and clinical significance of Ser10 phosphorylated p27(kip1) protein in human breast carcinoma].

Objective: To explore the expression and clinicopathological significance of Ser10 phosphorylated p27(kip1)(P-p27Ser10) protein in human breast carcinoma tissue. Methods: Tissue specimens were obtained from 111 cases with breast carcinoma from January 2004 to December 2005. And the expression of P-p27Ser10 protein for each specimen was detected by immunohistochemical (EnVision) analysis. Six representative paired samples of cancerous and paired adjacent normal tissues were collected and detected by Western blot. The relationships between the expression levels of P-p27Ser10 protein and its clinicopathological characteristics in primary breast carcinoma were retrospectively analyzed.The association of P-p27Ser10 and Jab1 protein was detected by co-immunoprecipitation method. Results: A high-level expression of P-p27Ser10 was present in cancerous tissues but not in paired adjacent normal tissues. The positive expression rate of P-p27Ser10 protein was as high as 88.3% (98/111) and 7.2% (8/111) in cancerous and paired adjacent normal tissues respectively (P<0.05). P-p27Ser10 expression was correlated with tumor size, lymph node metastasis and TNM stage (all P<0.05). P-p27Ser10 expression was significantly correlated with Ki-67 (r=0.582, P<0.05), and inversely correlated with p27 (r=-0.426, P<0.05). Co-immunoprecipitation revealed that the association of P-p27Ser10 and Jab1 protein was increased in breast carcinoma. Conclusion: Over-expression of P-p27Ser10 protein might play an important role in the pathogenesis of breast carcinoma. P-p27Ser10 protein therefore represents a novel diagnostic marker and therapeutic target in patients with breast carcinoma.