Associations Between Life's Essential 8 and Abdominal Aortic Calcification Among Middle-Aged and Elderly Populations.

BACKGROUND: Abdominal aortic calcification (AAC) is an independent risk factor for cardiovascular disease. We aim to examine the associations between Life's Essential 8 (LE8), the recently updated measurement of cardiovascular health (CVH), and AAC among participants aged ≥40 years. METHODS AND RESULTS: This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey in 2013 to 2014. AAC (AAC score>0) and severe AAC (AAC score>6) were quantified by the Kauppila score system. Multiple linear, multivariable logistic, and restricted cubic spline models were used to assess the associations. A total of 2369 participants were included with a mean AAC score of 1.41 (0.13). Participants in the high-cardiovascular-health group had lower AAC scores, lower prevalence of AAC, and lower prevalence of severe AAC. After the adjustment of potential confounders (age, sex, race and ethnicity, education levels, marital status, poverty income ratio, estimated glomerular filtration rate, serum creatinine, serum uric acid, serum phosphorus, and serum total calcium), higher cardiovascular health was significantly associated with lower risk of AAC. Meanwhile, elevated nicotine exposure score, blood glucose score, and blood pressure score within the LE8 components were significantly associated with lower risk of AAC. Also, nonlinear dose-response relationships were observed. Subgroup analyses (age strata, sex, poverty income ratio, education levels, marital status) indicated the inverse associations of LE8 and AAC were generally similar in different populations. CONCLUSIONS: LE8 was negatively and nonlinearly related to the risk of AAC among middle-aged and older populations. Meanwhile, LE8 components should prioritize higher scores for nicotine exposure, blood glucose, and blood pressure evaluations.

Effects of the tumor suppressor PTEN on the pathogenesis of idiopathic pulmonary fibrosis in Chinese patients.

Idiopathic pulmonary fibrosis (IPF) is characterized by progressive interstitial fibrosis, and is associated with a fatal outcome. The critical pathological mechanisms underlying IPF are largely unknown; however, accumulating evidence has indicated similarities between IPF and cancer. Therefore, the present study examined the expression levels of the tumor suppressor phosphatase and tensin homolog deleted on chromosome 10 (PTEN) in Chinese patients with IPF, using an enzyme­linked immunosorbent assay. To determine the effects of PTEN on the development of pulmonary fibrosis, PTEN was overexpressed in transforming growth factor (TGF)­ß1­treated human embryonic lung fibroblasts (HFL­I cells). The serum levels of PTEN were significantly lower in 42 patients with IPF, as compared with in the healthy controls. In addition, PTEN overexpression enhanced apoptosis, and suppressed basal levels of proliferation and migration in fibroblasts. Notably, PTEN was able to specifically inhibit TGF­ß1­induced proliferation and migration of the cells. Overexpression of PTEN also suppressed phosphorylation of Akt and Smad3, and decreased the expression levels of numerous proteins with critical roles in TGF­ß1­induced fibrosis, including α­smooth muscle actin, matrix metalloproteinase (MMP)­2 and MMP­9. These results indicated that PTEN may inhibit TGF­ß1­mediated myofibroblast differentiation of fibroblasts by attenuating signaling via the phosphatidylinositol 3­kinase/Akt and TGF­ß/Smad3 pathways.

[Peripheral primitive neuroectodermal tumor of trachea: a case report and review of literatures].

OBJECTIVE: To improve the understanding of tracheal peripheral primitive neuroectodermal tumor (PNET). METHODS: A case of tracheal PNET diagnosed in July 2010 was reported and the related literatures were reviewed. The literature review was carried out respectively with "primitive neuroectodermal tumor", "peripheral" as the search terms in Wanfang med online and PubMed database by September 2011. RESULTS: A case of 63 year-old female patient, who had been misdiagnosed as having chronic pharyngitis, chronic bronchitis and bronchial asthma, was admitted to the hospital because of cough and sputum production for 50 days, and anhelation for 1 month. After admission, the chest computerized tomography showed a space-occupying lesion in the middle of the trachea. Bronchoscopy showed a pedicle neoplasm 4 cm under the subglottic, with integral capsule, smooth surface and rich vascellum. Subsequently, tumor resection under bronchoscope was performed. Pathology report after operation showed infiltration of flake small round malignant cells under bronchial mucosa. Immunohistochemistry showed CD(99)(+), Syn(+) and S-100(+). EWS-FLI-1 fusion transcript was detected by RT-PCR. Accordingly, it was diagnosed as PNET. The symptoms of cough and anhelation were disappeared after operation. So far, there was no local recurrence and distant metastasis with 14 months follow-up. A total of 111 literatures were received in Pubmed, including one of prospective study, one of review, 22 of retrospective study and 87 of case report. Forty literatures and 187 cases in all were received in Wanfang Med Online, including 24 of retrospective study and 16 of case report. But, there were no reports about tracheal PNET. CONCLUSIONS: PNET can occur in the trachea and is easy to be misdiagnosed. To make a definite diagnosis, histopathology and immunohistochemistry are needed and detection of EWS-FLI-1 fusion transcript is a reliable marker for molecular diagnosis. The tracheal pPNET may be different with the pPNETs in other parts, and has a lower-grade invasion and less distant metastasis.

Clinical implications for BRCA gene mutation in breast cancer.

To investigate the mutations of BRCA1 and BRCA2 and determine whether clinic-pathological factors related to BRCA gene mutation. Mastectomy specimens from 360 breast cancers were enrolled and examined in the study. The relationship between BRCA gene mutation and clinic-pathological factors was evaluated. Overall, 280 patients were BRCA negative and 80 got BRCA gene mutation. Triple-negative breast cancers--i.e., breast cancers that do not express estrogen receptors (ER), progesterone receptors (PR) or human epidermal growth factor receptor 2 (HER2/neu)--was observed in 53.85% of the BRCA1 mutation patients, in 28.57% of the BRCA2 mutation cases, while 14.29% of BRCA negative patients. BRCA1 mutation patients got a heavy lymph node metastasis and higher nuclear grade tumors than the others (P = 0.004, 0.007). Furthermore, BRCA mutation was also found to be significantly related to ER, PR and HER2/neu status (P < 0.05). BRCA1 expression was not associated with breast cancer-specific survival in the triple-negative breast cancers (P = 0.742). After Cox regression, BRCA1 mutation was not shown to be an independent prognostic factor for breast cancer. These findings substantiated the possibility of tumors associated with BRCA1 mutations divided into two distinct groups, triple-negative and non-triple-negative groups requires further investigation.

[Sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) of the airway: a case report and review of the literature].

OBJECTIVE: To improve the awareness of sinus histiocytosis with massive lymphadenopathy (Rosai-Dorfman disease) involving the airways. METHODS: The clinical presentations, endoscopic findings in the airways, pathological characteristics, and diagnosis and treatment of a case of Rosai-Dorfman disease was reported, and related literatures were reviewed. RESULTS: A 60-year-old female patient was admitted to this hospital because of recurrent wheezing for 18 months and aggravated for 1 month on March 6, 2007. The diagnosis of "bronchial asthma" had been made and oral prednisolone and inhaled budesonide resulted in symptom improvement. One month ago, she had wheezing again with inspiratory dyspnea, which was more obvious at recumbent position.She had been found to have high blood pressure and left adrenal adenoma 23 years ago, and as the diagnosis of "primary aldosteronism" was made but underwent no surgery. Left parotid gland tumor and left submandibular lymph nodes had been found, and surgical resection implemented in 1999. Lacrimal gland tumor resection of her eyes had been performed in 2000. Multiple subcutaneous nodules, rising and disappearing spontaneously, had been demonstrated in 2001. After admission, physical examination revealed nodules of 3.0 cm x 2.0 cm in her left submandibular area, and soybean sized nodules at both arms, back, chest, abdomen, buttocks and thighs. Chest CT scan and tracheal reconstruction showed that there were multiple nodules in the tracheal wall with narrow lumen, with no obvious enlargement of mediastinal lymph nodes. Lymph node biopsy showed faintly stained areas and the formation of plasma cells and lymphocytes of the deeply stained area, presenting as a sinus-like structure, and plasma cells and lymphocytes were engulfed in the plasma of the histiocytes, consistent with the diagnosis of Rosai-Dorfman disease. CONCLUSIONS: Rosai-Dorfman disease involving the airway was a rare disease often misdiagnosed. Bronchoscopy was very helpful for the diagnosis. Histiocytosis with phagocytosis of plasma cells and lymphocytes was the pathological feature, and immunohistochemical staining positive for S100 protein and CD(68) was suggestive of the diagnosis. Surgical resection combined with corticosteroids or radiotherapy was effective treatment of the airway diseases.