[The effect of complement C3a receptor antagonist in the kidney immune injury in trichloroethylene-sensitized mice].

Objective: To explore the effect of complement C3 a-C3a receptor in the kidney immune inju-ry in trichloroethylene-sensitized mice by using C3a receptor specific antagonist C3aRA and discuss the patho-genesis of kidney injury in occupational dermatitis medicamentosa-like of trichloroethylene (ODMLT) . Methods: 42 female 6~8 weeks old BALB/c mice of specific pathogen free were randomly divided into blank control group (5) , solvent control group (5) , TCE treatment group (16) and TCE+C3aRA treatment group (16) . The TCE treat-ment group and TCE+C3aRA treatment group were further divided into the sensitized group and the non-sensi-tized group according to the skin sensitization test score. Renal function was detected by biochemical detection kit; expression of C3aR in kidney tissue was detected by qPCR; expression of IL-1ß and TNF-α protein were de-tected by immunohistochemical. Results: Compared with solvent control group and corresponding non-sensitized group, CRE and BUN in TCE sensitized group and TCE + C3aRA sensitized group were significantly increased (P<0.05) . Compared with TCE sensitized group, CRE and BUN in TCE+C3aRA sensitized group were signifi-cantly decreased (P<0.05) . Compared with solvent control group and TCE non-sensitized group, the expression level of C3aR gene in kidney tissue in TCE sensitized group was significantly increased (P<0.05) . There was a large number of IL-1ß and TNF-α protein expression in kidney tissue in TCE sensitized group and TCE+C3aRA sensitized group. Compared with the TCE sensitized group, the expression level of IL-1ß and TNF-α protein in kidney tissue in TCE+C3aRA sensitized group was significantly decreased (P<0.05) . Conclusion: C3a-C3aR may be involved in the kidney immune injury in TCE sensitized mice, C3aRA has a protective effect on the kid-ney immune injury in TCE sensitized mice.

[Role of complement regulatory protein CD55 in the liver immune injury of trichloroethylene-sensitized mice].

Objective: To explore the expression of CD55 in liver tissue of trichloroethylene-sensitized mice and discuss the role of CD55 in the liver immune injury of trichloroethylene-sensitized mice. Methods: 6-8 weeks specific pathogen free female BALB/c were randomly divided into blank control group, solvent control group and TCE treatment group to establish BALB/c mice sensitized model. According to mouse skin sensitization reaction score, TCE treatment mice were divided into sensitized and non-sensitized group at 24 h after the last challenge. At 48 h after the last challenge, the blood and aseptic livers were collected. The level of serum ALT was tested by automatic biochemical analyzer and pathology of the liver was observed. C5b-9 deposition was studied by immunohistochemistry (IHC) . CD55 protein expression level in liver tissue was studied by immunohistochemistry and Western blotting. The expression of CD55 mRNA in liver tissue was detected by qRT-PCR. Results: Liver function test result showed level of serum ALT in TCE sensitized group was significantly higher than solvent control group and TCE non-sensitized group (P<0.05) . There was ballooning degeneration and necrosis of liver cells in TCE sensitized group. IHC demonstrated that TCE sensitized group had obviously increased content of C5b-9 but had reduced content of CD55 compared with solvent control group and TCE non-sensitized group (P<0.05) . Western blotting also showed that TCE sensitized group had lower expression of CD55 than solvent control group and TCE non-sensitized group (P<0.05) . qRT-PCR showed that CD55 mRNA expression level in liver tissue of TCE sensitized group was apparently lower than solvent control group and TCE non-sensitized group (P<0.05) . Conclusion: Complement activation may be involved in TCE-induced liver injury, and the expression change of complement regulatory protein CD55 may play essential role in the process.

Update on desmoid tumors.

Desmoid tumors (DTs) are histologically benign proliferations of stromal cells but may grow locally aggressive. Overall, DTs are rare (0.03% of all neoplasms). A minority of DTs is associated with Gardner syndrome and mutations of the familial adenomatous polyposis (FAP) gene. Most spontaneous DTs are associated with mutations of the beta-catenin gene. This mutation results in the activation of Wnt/catenin signaling. Due to their variable clinical presentation and behavior, no standard approach for DTs can be recommended. In most cases of DTs of the extremities surgical extirpation is indicated, whereas in many other cases, a multimodal and multidisciplinary concept should be followed. In this review article, we discuss the diagnosis, pathogenesis, and treatment options for DTs, including targeted therapy with tyrosine kinase inhibitors.

[Analysis on genetic characteristics of H9N2 avian influenza virus isolated from human infection and external environment in Gansu province].

Objective: To analyze the genomic characteristics of human infection with H9N2 avian influenza virus in Gansu province. Methods: The etiological analysis was conducted for human infection with H9N2 avian influenza virus detected in influenza like illness cases in northwestern China in 2016. Molecular bioinformatics Mega 7.0 software was used to analyze the full genomic sequences of the viral isolate. Results: The gene fragments of HA, NA, MP, NP, NS, PA, PB1 and PB2 of the isolate were highly similar (>90%) to those of H9N2 avian influenza virus strain isolated in external environment in Gansu from 2014 to 2019. The HA gene belonged to BJ/94-like branch, PB2 and MP belonged to G1/97-like branch, and the PB1, PA, NS, and NP genes belonged to F/98-like branch. MP and PB2 were closely related to H7N9, H10N8 and H5N6 viruses. Amino acid sequence alignment showed that the HA cleavage site was arranged in PSRSSR ↓ GLF, H183N and Q226L mutated which included 7 HA glycosylated sites; 62-64 sites of NA absented 3 amino acids (ITE); and M2-31N, NS1-42S, PA-356R, and PA-409N mutated. Conclusions: Apparently, this case of human infection with human infection with H9N2 avian influenza virus was an incidental. However, the isolates of H9N2 influenza virus in external environment of Gansu had a series of mammalian adaptive molecular markers, suggesting that the risk of human infection is higher. It is necessary to strengthen the surveillance by multi departments to deal with influenza pandemic.

[Study on seasonal characteristics and pathogenic distribution of influenza in Gansu province of China].

Objective: To study the epidemiologic characteristics of influenza in Gansu province of China and to optimize the related vaccination program. Methods: Weekly influenza surveillance data from the first week of 2010 to the fortieth week of 2016 were collected, in Gansu province. χ(2) test was used to compare the differences of nucleic acid positive rate and the virus types in the four seasons. Time series seasonal decomposition (TSSD) was used to explore seasonal patterns and characteristics of influenza epidemics in Gansu. Results: 59 791 specimens were tested, with 8 501 positive for influenza virus and positive rates as 14.22%. Types A(H1N1)pdm09, A(H3N2) and type B were accounted for 98.76% of all the positive specimens. Proportions of the positive rate of influenza virus appeared in spring, summer, autumn and winter were 15.12%, 0.98%, 4.02% and 24.26% respectively. The predominant type of virus in autumn and winter was A(H3N2), with B mainly in spring. Influenza in Gansu province showed typical single-peak type distribution, with epidemic peak appeared from December to next January. The type A(H3N2) related peak appeared the earliest, followed by A(H1N1) pdm09, with type B the latest. Conclusions: Peaks and the duration of influenza seasonal epidemics were related to the types of dominant strains. Annual influenza vaccination campaigns should start in October, to provide effective protection during the epidemic period.

Detection of the proto-oncogene eIF4E in surgical margins may predict recurrence in head and neck cancer.

Head and neck squamous cell cancers (HNSCC) have a high local recurrence rate due to incomplete tumor resection. The use of molecular markers to establish surgical margins may decrease local recurrence. Surgical margins are determined by histopathologic analysis on frozen sections. We postulate that genetic and molecular changes precede gross histologic alterations. Tumor markers may improve the reliability of pathology examination, but those evaluated to date lack the sensitivity needed for routine clinical use. Western blot analysis showed elevated eIF4E in all 26 HNSCC in contrast to its low expression in benign lesions. Surgical margins were analysed for eIF4E in 23 patients. Twelve patients showed elevated eIF4E in histologically negative margins. Cancer has recurred in 5 of the 12 patients as opposed to none of the 11 patients with eIF4E negative margins (P= 0.02, Log rank test). This is the first report of eIF4E in HNSCC, as a sensitive and specific marker for HNSCC, with potential for defining clear resection margins. The correlation between elevated levels of eIF4E at the margins and recurrence highlights its ability to detect malignant cells prior to clear-cut alterations in morphology. The accuracy and simplicity of these assays underscore the usefulness of eIF4E in managing HNSCC.

Elevated expression of eIF4E and FGF-2 isoforms during vascularization of breast carcinomas.

The translation initiation factor eIF4E is a novel protooncogene found over expressed in most breast carcinomas (Kerekatte et al., 1995), but the pathology where this elevation is initially manifested and its possible role in cancer progression are unknown. We report that eIF4E is markedly increased in vascularized malignant ductules of invasive carcinomas, whereas necrotic and avascular ductal carcinomas in situ display significantly lower levels. eIF4E facilitates the synthesis of FGF-2, a powerful tumor angiogenic factor. Conversely, reducing eIF4E with antisense RNA in MDA-435 cells suppresses their tumorigenic and angiogenic properties, consistent with loss of FGF-2 synthesis. These findings suggest a causal role for eIF4E in tumor vascularization.

Thoracic metastases from breast cancer: a single-institution's experience.

OBJECTIVE: Thoracic metastasis from breast cancer (TMBC) is a relatively uncommon condition, and few reports of its therapeutic palliation and patient outcomes exist. We therefore reviewed retrospectively our radiotherapeutic experience of TMBC. METHODS: Between 1981 and 2003, 19 patients were treated with radiation (with doses raging from 10 Gy to 50 Gy) for palliation of TMBC. RESULTS: The mean age was 55.4 years. Mediastinal lymph node disease was the most common form of TMBC. TMBC developed within five years of breast cancer diagnoses in 11 patients (58%). Among the evaluable symptomatic individuals, subjective palliation was complete in 78% of the cases. The complete objective response (e.g., complete resolution of clinically manifested superior vena caval obstruction or imaging-demonstrated atelectasis) rate was 50%. There was no significant difference in survival between patients presenting with airway obstruction and women who were not in respiratory distress, asymptomatic and symptomatic patients, and women with and without concurrent extrathoracic metastases. CONCLUSION: Although the prognosis of women with TMBC was quite ominous, radiotherapy should be considered in very symptomatic patients because justifiable palliation can be effected in some individuals.

Computed tomographic staging of esophageal cancer and prognosis.

The purpose of this retrospective study was to examine whether computed tomography (CT)-determined staging of esophageal cancer (EC) has prognostic correlation. The results showed a strong relevance of staging of EC by CT to survival (p<0.01).

Supraclavicular nodal relapse of breast cancer: prevalence, palliation, and prognosis.

PURPOSE: To determine the frequency, palliative effects of radiotherapy (RT) and survival of patients developing supraclavicular nodal relapse (SNR) after definitive surgery for non-disseminated breast cancer (BCa). METHODS: A retrospective study of individuals treated by breast conserving surgery or modified radical mastectomy for Stage I to III BCa at a single institution during a 17-year period (1980-96) was undertaken. RESULTS: Of the 536 patients studied, 22 (4%) developed SNR. Among the seven symptomatic women, the complete subjective response rate after RT was 71%. Of the 18 evaluable patients with manifest SNRs, tumor regression was complete in 12 (66.6%), partial in one (5.6%), and absent in five (27.8%). The overall median survival was 11.5 months; five patients (23%) survived for at least two years. CONCLUSION: Supraclavicular nodal relapse in breast cancer patients occurs infrequently. The application of radiotherapy for palliation of SNR was fully justified by the perceived results even though long-term survival was not often observed.

Radiotherapy with and without chemotherapy after breast conservation surgery for early stage breast cancer: a review of timing.

PURPOSE: To evaluate the effects in women of the timing of breast irradiation (BI) in relation to the application or non-application of adjuvant chemotherapy after breast conservation surgery (BCS) for early stage cancer. METHODS: Between October 1981 and June 1995, 47 women with stage I and II breast cancer underwent BCS. Twenty-six patients did not receive adjuvant chemotherapy (NAC) and 21 women did (AC). In the NAC group, BI commenced within (n = 9) or after (n = 17) seven weeks following BCS; in the AC group, 18 women received BI more than 24 weeks after BCS and three patients within 24 weeks. RESULTS: In the NAC group, there was a trend toward more local and systemic failures plus a definite correlation with poorer survival (p = 0.05) when BI was initiated more than 7 weeks after BCS. In the AC group, the locoregional and systemic failures occurred only in women with a delay of BI exceeding 24 weeks; survival was not different between the subgroups. CONCLUSION: An undue delay of BI should be avoided in patients after BCS whether they require adjuvant chemotherapy for early stage breast cancer or not.

Management of the incidentally discovered adrenal mass or "incidentaloma".

The prevalence of an incidentally discovered adrenal mass or "incidentaloma" by abdominal computerized tomography (CT) scan is 1% to 2%. The majority of patients with incidentalomas do not have clinical manifestations nor require further treatments of their incidentalomas. Thus the goal for their management is two-fold: 1) To identify and treat the hormonally hyperactive adrenal adenoma and the rare adrenal carcinoma, and 2) To avoid creating an iatrogenic disease of medical progress. An adrenal mass > or = 6 cm, excluding metastatic malignant disease, needs to be surgically resected due to the risk for carcinoma. The risk of primary adrenal cancer for a hormonally inactive lesion < or = 3 cm is extremely low and can be safely observed. Treatment for the hormonally inactive lesion between 3 and 6 cm must be individualized, based on age, specific scan characteristics (irregular border, local invasion, metastasis), and clinical status of the patient. All hormonally active adrenal adenomas should be surgically resected. In this article, we review the data to support the above recommendations.

Cystic neoplasms of the pancreas--a review.

Cystic neoplasms of the pancreas are rare entities, representing approximately 5% to 10% of all pancreatic malignancies. Seventy-five percent to 90% of all cystic lesions of the pancreas are pancreatic pseudocysts. Thus cystic neoplasms of the pancreas can be easily misdiagnosed and inappropriately treated by drainage. A persistent cystic lesion in the pancreas may pose a considerable diagnostic and therapeutic dilemma for the practicing clinician. This article reviews the various cystic neoplasms of the pancreas and their distinction from pancreatic pseudocysts.

[The age composition of the urban population of China: its changes and trends].

PIP: The authors examine projected future trends in Chinese urban population characteristics using data from a 1975 survey of 400,000 individuals from over 60 cities. Changes in the relative sizes of the age groups 0-16 years, 17-55 years, and over 56 years in 1976, 1985, and 1995 are considered by sex, and the implications of these changes for urban planning are examined.^ieng

Potential utility of sentinel node biopsy in the original surgical assessment of Hürthle cell tumors of the thyroid: 23-year institutional review of Hürthle cell neoplasms.

BACKGROUND AND OBJECTIVES: Great difficulty still exists in determining the potential malignancy of Hürthle cell tumors of the thyroid gland. Indications for the extent of resection vary greatly in the reported literature. Sentinel node biopsy has shown its usefulness as a prognostic indicator in both melanoma and breast cancer. The feasibility of using it as an integral part of Hürthle cell tumor surgery was investigated and is discussed. METHODS: Eleven patients diagnosed with Hürthle cell tumors between the years of 1975 and 1998 were reviewed. The last three patients had sentinel node biopsy with isosulfan blue dye as an integral part of their procedure. RESULTS: Sentinel node biopsy was accomplished without difficulty or complication in our last three patients. Two patients were considered to be benign by frozen section and final pathology. Their sentinel nodes were benign. One patient was considered malignant on both frozen and final pathology. His sentinel nodes as well as central node dissection revealed no lymphatic spread. CONCLUSIONS: Malignancy of Hürthle cell tumors of the thyroid is difficult to determine even on final pathological examination. The addition of nodal sampling may add valuable prognostic information. Sentinel node biopsy with isosulfan blue dye, although not previously reported for these tumors, appears to be a logical next step in the evolution of surgical management.

"Routine" weekly blood counts during breast irradiation for early stage cancer: are they really necessary?

The present investigation analyzed the weekly blood count assays of 73 women receiving breast irradiation after organ-preserving surgery for early stage cancer. With regard to leucopenia and anemia, grade 1 toxicity occurred in 26% and 21%, respectively, of the cases. Thrombocytopenia of any degree and grades 2-4 leucopenia or anemia were either not seen or were minimally observed. Most of the patients who experienced grade 1 or grade 2 toxicity had received preirradiation chemotherapy. We stress the importance of a baseline blood count recording prior to breast irradiation and the need for further study to define better the population for whom continuous weekly blood count determinations might prove to be useful.

Estrogen and progesterone receptor concordance between primary and recurrent breast cancer.

Estrogen and progesterone receptor status in breast cancer can determine therapeutic options and may provide prognostic information. The purpose of this study is to compare the concordance of the primary breast cancer steroid hormone receptor status to that of the recurrent breast cancer and to determine whether the type of second lesion (local recurrence, second primary, or metastatic lesion) and adjuvant therapy received changed the receptor concordance. The records of eighty-three patients with estrogen receptor (ER) analysis available for primary (p) and recurrent (r) breast cancer for 1976-1990 were reviewed. In addition, 32 of these patients also had available progesterone receptor (PR) values for primary and recurrent breast cancers. Statistical evaluation was performed by chi-square, Student's t-test, and Wilcoxon signed-rank test. ER concordance (primary/recurrent, p/r) was identified in 59/83 (71%) patients; PR concordance was identified in 18/32 (56%) patients. Whether the second lesion was a local recurrence, second primary, or a metastatic lesion did not affect ER concordance or PR concordance. Adjuvant chemotherapy, hormonal therapy, or radiation therapy, either alone or in combination, did not affect ER or PR concordance. The disease-free survival (DFS) for patients with ER (p+)/(r-) (primary receptor positive/recurrent receptor negative) was significantly shorter than those with ER (p-)/(r+)(27.6 +/- 7.4 months versus 50.6 +/- 7.6 mo, P = 0.04). The DFS for PR (p+)/(r-) patients was 28.8 +/- 7.9 months compared to the DFS of 46.8 +/- 11.8 months for PR (p-)/(r+) patients (P = NS). A significantly shorter DFS for ER (p+)/(r-) patients compared to ER (p-)/(r+) patients and a trend towards a shorter DFS for PR (p+)/(r-) patients compared to PR (p-)/(r+) patients may reflect a loss of hormonal regulation or an increase in cancer aggressiveness.

Overexpression of eukaryotic initiation factor 4E (eIF4E) in breast carcinoma.

BACKGROUND: Eukaryotic initiation factor 4E (eIF-4E) is a 25-kilodalton phosphoprotein that binds specifically to mRNA as the initial step for mRNA translation. An elevated level of eIF4E has been associated with the up-regulation of various protooncogene products. Transfection of cell lines by viral vectors with eIF4E overexpression has resulted in malignant transformation. The objective in this study was twofold: to examine benign and malignant breast specimens for eIF4E expression, and to determine whether eIF4E overexpression may have prognostic potential. METHODS: Western blot analysis was performed on benign and malignant breast specimens using anti-eIF4E rabbit antiserum. Quantification was accomplished by developing blots with nitroblue tetrazolium and 5-bromo-4-chloro-3-indolyl phosphate and densitometry. Confirmation of eIF4E overexpression at the cellular level was performed using immunohistologic staining in situ. RESULTS: The authors examined 112 breast specimens for eIF4E protein expression. Of the 52 benign breast specimens examined, none showed eIF4E overexpression. All 12 ductal carcinoma in situ specimens were found to overexpress eIF4E in the intermediate range (mean elevation: 2.5-fold). Of the 48 breast carcinoma specimens examined, all had eIF4E elevation at levels of 3-30-fold (mean: 10.5 +/- 0.9-fold). Charts from 39 patients with Stage I, II, and III breast carcinoma were reviewed. In ten patients with eIF4E overexpression of < sevenfold, there was no recurrence or death from breast carcinoma. In the 29 breast carcinoma patients with > or = 7-fold eIF4E overexpression, 9 patients had breast carcinoma recurrences and 5 had died from disease at last follow-up. The median follow-up in this study was 34.5 months. CONCLUSIONS: Overexpression of eIF4E was observed in malignant breast specimens but not in normal or benign breast tissues. In patients with breast carcinoma, the group with high eIF4E overexpression (> or = 7-fold) experienced a worse clinical outcome (higher recurrences and death) compared with the group with low eIF4E overexpression (< 7-fold).

Polymorphic CA repeats in the IGF-I gene and breast cancer.

Insulin-like growth factor (IGF)-I is a potent mitogen for breast cancer cells and may play a role in the disease. Although the involvement of IGF-I phenotype in breast cancer has been studied extensively, little is known about IGF-I genotype in relation to the disease. The IGF-I gene contains a polymorphic region composed of multiple cytosine-adenine dinucleotides (CA repeats). Studies of other genes indicate that the CA-repeat region in the promoter of a gene may affect transcription activity and that the length of the repeat is inversely correlated with transactivation. To examine if the IGF-I polymorphism is associated with breast cancer, we compared the length of CA repeats in the IGF-I gene between 53 breast cancer patients and 53 controls. Genomic DNA extracted from peripheral blood was used to determine the number of CA repeats through PCR amplification and DNA sequencing. Associations between CA repeats and breast cancer were assessed using unconditional logistic regression analysis. The results showed that the median number of CA repeats was 19, ranging from 15 to 23, and that compared to women without 19 CA repeats, women with 19 CA repeats were more likely to be breast cancer patients (OR = 2.87, 95%CI: 1.16-7.06) after adjusting for age, race, menopausal status, age at menopause, and alcohol use. The study also suggested possible synergistic interplay between IGF-I genotype and phenotype as women with 19 CA repeats and high plasma IGF-I had a much higher odds ratio for breast cancer (OR = 5.12, 95%CI: 1.42-18.5) than those with only one of the conditions. If our observations can be confirmed in larger studies, the findings will provide further evidence to support the role of IGF-I in breast cancer and the link between genetic polymorphism and cancer susceptibility.