Pulmonary pathology of early-phase COVID-19 pneumonia in a patient with a benign lung lesion.

AIMS: An ongoing outbreak of 2019 novel coronavirus (CoV) disease (COVID-19), caused by severe acute respiratory syndrome (SARS) CoV-2, has been spreading in multiple countries. One of the reasons for the rapid spread is that the virus can be transmitted from infected individuals without symptoms. Revealing the pathological features of early-phase COVID-19 pneumonia is important for understanding of its pathogenesis. The aim of this study was to explore the pulmonary pathology of early-phase COVID-19 pneumonia in a patient with a benign lung lesion. METHODS AND RESULTS: We analysed the pathological changes in lung tissue from a 55-year-old female patient with early-phase SARS-CoV-2 infection. In this case, right lower lobectomy was performed for a benign pulmonary nodule. Detailed clinical, laboratory and radiological data were also examined. This patient was confirmed to have preoperative SARS-CoV-2 infection by the use of real-time reverse transcription polymerase chain reaction and RNA in-situ hybridisation on surgically removed lung tissues. Histologically, COVID-19 pneumonia was characterised by exudative inflammation. The closer to the visceral pleura, the more severe the exudation of monocytes and lymphocytes. Perivascular inflammatory infiltration, intra-alveolar multinucleated giant cells, pneumocyte hyperplasia and intracytoplasmic viral-like inclusion bodies were seen. However, fibrinous exudate and hyaline membrane formation, which were typical pulmonary features of SARS pneumonia, were not evident in this case. Immunohistochemical staining results showed an abnormal accumulation of CD4+ helper T lymphocytes and CD163+ M2 macrophages in the lung tissue. CONCLUSION: The results highlighted the pulmonary pathological changes of early-phase SARS-CoV-2 infection, and suggested a role of immune dysfunction in the pathogenesis of COVID-19 pneumonia.

Case report: Innovative treatment for one metastatic thyroid-like follicular carcinoma of the kidney with ATM and POLE mutations.

Thyroid-like follicular renal cell carcinoma (TLFRCC), also known as thyroid-like follicular carcinoma of the kidney or thyroid follicular carcinoma like renal tumor, is an exceedingly rare variant of renal cell carcinoma that has only recently been acknowledged. This neoplasm exhibits a distinct follicular morphology resembling that of the thyroid gland. Immunohistochemical analysis reveals positive expression of PAX8, Vimentin, and EMA, while thyroid-specific markers TG and TTF1 are consistently absent. Furthermore, there is a notable absence of any concurrent thyroid pathology on clinical evaluation. Previous reports have suggested that TLFRCC is an indolent, slow-growing malignancy with infrequent metastatic potential. In this report, we present a case of TLFRCC characterized by remarkable ossification and widespread metastasis, including multifocal pulmonary lesions, involvement of the abdominal wall, and infiltration into the psoas muscle. To our knowledge, this represents only the third documented instance of distant metastasis in thyroid follicular renal carcinoma. The current case demonstrates a therapeutic approach that combines radiotherapy with the utilization of toripalimab, a programmed cell death 1 (PD-1) receptor inhibitor, and pazopanib. This treatment regimen was tailored based on comprehensive genomic profiling, which identified mutations in the POLE (catalytic subunit of DNA polymerase epsilon) and ATM (ataxia-telangiectasia mutated) genes, both of which have been implicated in the pathogenesis of various malignant tumors. These findings represent a novel discovery, as such mutations have never been reported in association with TLFRCC. Thus far, this therapeutic approach has proven to be the most efficacious option for treating metastatic TLFRCC among previously reported, and it also marks the first mention of the potential benefits of radiotherapy in managing this particular subtype of renal cell carcinoma.

Effects of quercetin on diabetic retinopathy and its association with NLRP3 inflammasome and autophagy.

AIM: To investigate the effects of quercetin on diabetic retinopathy (DR) and its association with nucleotide-binding oligomerization domain-like receptors 3 (NLRP3) inflammasome and autophagy using retinal endothelial cell as an experimental model. METHODS: Human retinal microvascular endothelial cells (HRMECs) were cultured in vitro and assigned into the control group, high-glucose (HG) group, and HG+different concentrations of quercetin groups. Cellular viability, migration, and tube formation in these groups was detected by MTT, transwell and matrigel assay, respectively. Expressions of NLRP3, apoptosis-associated speck-like protein (ASC), cysteiny aspartate-specific protease-1 (Caspase-1) as well as microtubule-related protein 1 light chain 3 (LC3) and Beclin-1 were detected by Western blotting. Expressions of IL-1ß and IL-18 were detected by ELISA and cellular autophagy was detected by Cyto-ID® autophagy detection kit. RESULTS: Under an HG condition, the viability, migration, tube formation of HRMECs, and the protein expressions of NLRP3, ASC, Caspase-1, IL-1ß, IL-18, LC3, and Beclin-1 as well as autophagy were all increased. Quercetin inhibited angiogenesis of HRMECs as well as the expressions of NLRP3, ASC, Caspase-1, IL-1ß, IL-18, LC3, Beclin-1, and autophagy of HRMECs under a HG condition. The inhibitory effects of quercetin on angiogenesis, NLRP3 inflammasome and autophagy increased with the increase of its concentration. CONCLUSION: The therapeutic potential of quercetin in retinal neovascularization of DR, and inhibition of NLRP3 inflammasome and autophagy signaling pathway may be involved.

Mucinous variant of invasive micropapillary carcinoma of breast: report of two cases and literature review.

Invasive micropapillary carcinoma (IMPC) is a rare type of malignant tumor of breast with a poor prognosis. There is controversy in the identification of mucinous variant of IMPC with mucinous carcinoma. In the past, it always be diagnosed as micropapillary variant of mucinous carcinoma, but in this study, the author has a different opinion. Here, we report two cases diagnosed as mucinous variant of IMPC. Histological morphologies were similar in the two cases. In difference from mucinous carcinoma, mucinous variant of the IMPC is characterized by micropapillary structure of the tumor cells, higher nuclear atypia, more frequent HER2/Neu overexpression, high proliferation index of Ki-67, increased lymph node metastasis, and poor prognosis. A distinct feature of the 2 cases was that the tumor cells were present as micropapillary or tubular-solid clusters floating in the extracellular mucin pools and most of the floating tumor cells were surrounded by the hyaline lacunae, which can clearly be appreciated even in the background of mucin. Both patients were managed by the standard chemotherapy and radiotherapy combined with simple mastectomy. Up to the time of preparation of this report, both patients have survived for over 4 years. It is important to differentiate a mucinous variants of IMPC from a pure mucinous carcinoma due to their significantly different prognosis and, thereafter, different choices of patient management.

Myxoid adrenocortical adenoma with a pseudoglandular pattern: a case report and literature review.

Adrenocortical adenoma is a benign neoplasm derived from cells of the adrenal cortex. The myxoid variant of this tumor is extremely rare. To our knowledge, only 23 cases of myxoid adrenocortical adenoma have been reported so far and 19 of them mentioned the pseudoglandular pattern. We reported a new case of 56-year-old Chinese female patient whose left adrenal gland was shown a neoplastic lesion by computed tomography (CT) and magnetic resonance (MR) imaging. Histopathological study showed that the mass was a myxoid adrenocortical adenoma with a pseudoglandular pattern. Then, we performed immunohistochemistry with 28 biomarkers to make differential diagnosis and found that tumor cells were diffusely positive for vimentin, melan-A, CD56, NSE and USP10, and focally positive for cytokeratin pan, cytokeratin 8/18 and VEGF. The labeling index of Ki-67 and Cyclin D1 were about 1% and 50%, respectively. No immunoreactivity was found for EMA, cytokeratin 7, HMB45, S-100, alpha-inhibin, calretinin, synaptophysin, chromogranin A, P53, EGFR, MMP2, DNA topo II alpha, CA125, E-cadherin, P63, P16 and Her-2. The patient has been followed up for 37 months after tumor resection and no evidence was found to suggest any local recurrence or any metastatic disease. Myxoid adrenocortical adenoma with a pseudoglandular pattern is extremely rare. The accurate diagnosis should be based on combined consideration of clinical characteristics, CT, MR imaging and pathological features, and should be distinguished from other retroperitoneal myxoid tumors.

Infralimbic Endothelin1 Is Critical for the Modulation of Anxiety-Like Behaviors.

Endothelin1 (ET1) is a potent vasoconstrictor that is also known to be a neuropeptide that is involved in neural circuits. We examined the role of ET1 that has been implicated in the anxiogenic process. We found that infusing ET1 into the IL cortex increased anxiety-like behaviors. The ET(A) receptor (ET(A)R) antagonist (BQ123) but not the ET(B) receptor (ET(B)R) antagonist (BQ788) alleviated ET1-induced anxiety. ET1 had no effect on GABAergic neurotransmission or NMDA receptor (NMDAR)-mediated neurotransmission, but increased AMPA receptor (AMPAR)-mediated excitatory synaptic transmission. The changes in AMPAR-mediated excitatory postsynaptic currents were due to presynaptic mechanisms. Finally, we found that the AMPAR antagonists (CNQX) and BQ123 reversed ET1's anxiogenic effect, with parallel and corresponding electrophysiological changes. Moreover, infusing CNQX + BQ123 into the IL had no additional anxiolytic effect compared to CNQX treatment alone. Altogether, our findings establish a previously unknown anxiogenic action of ET1 in the IL cortex. AMPAR-mediated glutamatergic neurotransmission may underlie the mechanism of ET1-ET(A)R signaling pathway in the regulation of anxiety.

Delineation of three structural Y chromosome aberrations combined molecular techniques / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To delineate the structure of Y chromosome aberrations and recombinant mechanisms for three patients.</p><p><b>METHODS</b>Karyotype analysis, multiplex ligation dependent probe amplification (MLPA), fluorescence in situ hybridization (FISH), Y chromosome sequence tagged sites (STS) analysis, human whole genome-wide SNP array were used.</p><p><b>RESULTS</b>The karyotypes of the three patients were 46, X, +mar. As suggested by MLPA analysis, case 1 has increased copy numbers of SRY, ZFY and UTY genes, case 2 had increased copies of SRY and ZFY genes, and deletion of UTY gene, and case 3 had decreased copies for subtelomeric regions of X/Yp and X/Yq. By STSs analysis, case 1 has retained SRY, sY84 and sY86 in the AZFa region, sY1227 in the AZFb region, whilst lost sY1228 in the AZFb region and other STSs in the AZFc region. Its breakpoint was thereby mapped between sY1227 and sY1228. Case 2 has retained SRY and sY1200 in the centromeric region, whilst has deletion of other STSs. Case 3 has retained SRY and STSs in the AZF regions. By SNP array, case 1 had duplicated Yp11.31-p11.2 and deletion of Yq11.22-q11.23 (approximately 5.18 Mb). Case 2 had duplicated Yp11.31-p11.2 and deletion of Yq11.21-q11.23 (approximately 14.644 Mb). Case 3 had single copy number deletion of p22.33 and q28 in the subtelomeric region of X/Yp and X/Yq. By FISH, cases 1 and 2 showed two signals for SRY and DYZ3 but no signal for DYZ1 on their marker chromosomes. Combining above results, the karyotypes of cases 1, 2 and 3 were determined as 46, X, idic(Y) (q11.23), 46, X, idic(Y) (q10) and 46, X, r(Y) (p11q12), respectively.</p><p><b>CONCLUSION</b>Y chromosome aberrations are variable. Combined use of MLPA, STSs, FISH and SNP array is effective for revealing the breakpoints and recombinant mechanisms.</p>

Analysis of small supernumerary marker chromosome 15q11 in four infertile males / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To delineate the origins of small supernumerary marker chromosomes (sSMCs) identified in 4 infertile males.</p><p><b>METHODS</b>The sSMCs were analyzed with combined G-banding, N-banding, multiplex ligation-dependent probe amplification (MLPA), fluorescence in situ hybridization (FISH) and single nucleotide polymorphisms array (SNP-array) techniques.</p><p><b>RESULTS</b>G-banding analysis has suggested a 46,X,-Y,+mar karyotype in all of the 4 cases. N-banding revealed that all of the sSMCs have possessed two satellites located on both sides. By MLPA, 1 patient showed copy number gains for 15q11.2 region. SNP-array analysis suggested that all had duplication for 15q11.1-q11.2 region, spanning 3.06 Mb, 0.9118 Mb, 1.728 Mb and 0.287 Mb, respectively. By FISH analysis, all of the sSMCs showed two hybridization signals, indicating that they were dicentric chromosomes.</p><p><b>CONCLUSION</b>In all of the four cases, the marker chromosomes have derived from chromosome 15 and were bisatellited and dicentric, which gave rise to a karyotype of 47,XY,+ish,inv dup(15)(q11)(D15Z4++). sSMC 15q11 therefore may be a major cause for male infertility.</p>

Anti-depression effect of acupunctrue and moxibustion based on SSRIs medication / 中国针灸

<p><b>OBJECTIVE</b>To verify the anti-depression effect of acupuncture and moxibustion based on the medication with selective serotonin reuptake inhibitors (SSRIs).</p><p><b>METHODS</b>Eighty cases of depression were randomly divided into an acupuncture-moxibustion-medication group (25 cases), an acupuncture-medication group (25 cases) and a medication group (30 cases). SSRIs medication was administered in all of the three groups. Complementarily, in acupuncture-moxibustion-medication group, the needling technique of qi conduction in the Governor Vessel was applied to Baihui (GV 20), Fengfu (GV 16), Dazhui (GV 14), etc. Additionally, mild moxibustion was added at Dazhui (GV 14) and Baihui (GV 20). In acupuncture-medication group, acupuncture for qi conduction in the Governor Vessel was only adopted. Hamilton Depression Scale (HAMD) was used for the evaluation of the total score, the score of each factor before and after treatment separately, and the therapeutic effects were observed among 3 groups.</p><p><b>RESULTS</b>Compared with medication group, the scores of the factors as retardation, sleep, and anxiety/somatization, as well as the total score were all apparently improved in the other two groups (P < 0.05, P < 0.01). Compared with acupuncture-medication group, the scores of sleep and cognition factors as well as the total score in HAMD were much improved in acupuncture-moxibustion-medication group (P < 0.05, P < 0.01). The remarkable effective rates were 100.0% (25/25), 84.0% (21/25) and 56.7% (17/30) in the three groups separately, in which, the result in acupuncture-moxibustion-medication group was superior to acupuncture-medication group (P < 0.05), and the results of these two groups were superior to medication group (both P < 0.01).</p><p><b>CONCLUSION</b>Either acupunctrure or moxibustion has a definite anti-depression effect based on SSRIs medication, but the coordination of acupuncture and moxibustion achieves a superior efficacy as compared with simple acupuncture therapy.</p>

Mutation analysis of SMN gene in a patient and his family with spinal muscular atrophy / 中华医学遗传学杂志

<p><b>OBJECTIVE</b>To perform mutation analysis and describe the genotype of the SMN gene in a patient with spinal muscular atrophy (SMA) and his family.</p><p><b>METHODS</b>Deletion analysis of the SMN1 exon 7 by conventional PCR-restriction fragment length polymorphism (RFLP) and allele-specific PCR, and gene dosage of SMN1 and SMN2 by multiplex ligation-dependent probe amplification (MLPA) were performed for the patient and his parents; reverse transcriptase (RT)-PCR and sequencing were performed for the patient. To determine whether the SMN variant was exclusive to transcripts derived from SMN1, the RT-PCR product of the patient was subcloned and multiple clones were sequenced directly; PCR of SMN exon 5 from the genomic DNA of the parents and direct sequencing were performed to confirm the mutation.</p><p><b>RESULTS</b>In SMN1 exon 7 deletion analysis, no homozygous deletion of the SMN1 was observed in the family; the gene dosage analysis by MLPA showed that the patient had 1 copy of SMN1 and 1 copy of SMN2 his father had 2 copies of SMN1 and 2 copies of SMN2, and his mother had 1 copy of SMN1 and no SMN2. A previously unreported missense mutation of S230L was identified from the patient and this mutation was also found in his father.</p><p><b>CONCLUSION</b>A novel missense mutation of S230L was identified in the SMA family and the genotype of the family members were investigated.</p>

Effects of benazepril on apoptosis and expression of Bax and Bcl-2 in kidney of diabetic rats with different blood glucose levels / 中华内分泌代谢杂志

Diabetic rats were induced by intraperitoneal injection of streptozotocin.TUNEL and immunohistochemistry results showed that the renal tubular cell apoptosis index(AI)and Bax protein expression were significantly reduced,and the Bcl-2 protein expression in glomeruli was significantly increased in diabetic rats with stable hyperglycemia treated by benazepril compared with diabetic rats with stable hyperglycemia treated by vehicle(all P