[Interpretation of "Proliferative verrucous leukoplakia: an expert consensus guideline for stadardized assessment and reporting"].

Proliferative verrucous leukoplakia (PVL) is a special oral leukoplakia, which has the characteristics of high recurrence and canceration rate. In 2021, the American Society of Oral and Maxillofacial Pathology and the North American Association of head and neck Pathologists published "Proliferative verrucous leukoplakia: an expert consensus guideline for standardized assessment and reporting", and divided PVL into four categories: ①Corrugated ortho(para)hyperkeratotic lesion, not reactive; ②Bulky hyperkeratotic epithelial proliferation, not reactive; ③Squamous cell carcinoma, or suspicious for squamous cell carcinoma; and ④Does not fit any above category. This paper intends to interpret the new classifications of PVL in the guidelines in order to provide guidance for clinical diagnosis and treatment.

[Clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors].

Objective: To explore the clinical value of ultrasound-guided radiofrequency ablation in the treatment of retroperitoneal tumors. Methods: The clinical data of 13 patients with retroperitoneal tumors treated with ultrasound-guided radiofrequency ablation in the First Affiliated Hospital of Zhengzhou University from January 2018 to January 2020 were analyzed retrospectively. The ablation effect was evaluated and the postoperative complications were observed. The changes of tumor volume before and after radiofrequency ablation were compared. Results: The symptoms of pain and dyspepsia were significantly improved after radiofrequency ablation, and the hospital stay was (9.2±2.9) days. The tumor was ablated completely in 10 cases, tumor residual in 1 case and tumor metastasis in 2 cases. One patient had postoperative duodenal perforation complicated with intra-abdominal infection, and no serious complications occurred in other patients. There were 20 lesions in 13 patients. The maximum diameter of 20 lesions before operation and 1, 3, 6 months after operation were (39.5±15.9) mm, (30.6±4.9)mm, (15.6±7.7) mm and (9.9±3.1) mm, respectively, the maximum diameters of 1, 3 and 6 months after operation were smaller than that before operation (P<0.05). Conclusion: Ultrasound-guided radiofrequency ablation is a real-time, accurate, safe and effective minimally invasive treatment with few complications, and has a high clinical value for retroperitoneal tumors.

MiR-20b is implicated in preeclampsia progression via the regulation of myeloid cell leukemin-1.

Preeclampsia (PE) may induce gestational failure, threatening a significant number of pregnant women. Recently, microRNAs (miRNAs) have been reported to participate in PE progression, whereas the precise functions and potential mechanisms of miR-20b in placental trophoblast cells as well as in PE progression remain poorly understood. In the present study, real-time quantitative polymerase chain reaction (RT-qPCR) analysis was used to detect expressions of miR-20b and myeloid cell leukemin- 1(MCL-1) mRNA. Cell viability was investigated by cell counting kit-8(CCK-8) assays. Cell invasion and migration abilities were determined by Transwell assays. Western blot was performed to detect MCL-1 protein expressions. The interaction between miR-20b and MCL-1 was investigated by bioinformatics analysis and luciferase activity assay. The results of the study demonstrated that miR-20b was highly expressed in placental tissues of patients with PE. Moreover, miR-20b overexpression inhibited HTR8/ SVneo cell proliferation, invasion and migration. Furthermore, MCL-1 was targeted by miR-20b, and MCL-1 restoration could partially attenuate the effect of miR-20b on HTR8/SVneo cells. In conclusion, the results indicate that miR-20b may contribute to PE through inhibiting proliferation, invasion and migration of placental trophoblast cells by targeting MCL-1. Therefore, miR-20b may be used as a notable biomarker for the diagnosis, prevention, and treatment of PE. MiR-20b targeting MCL-1 deserves further investigation in order to explore their potential role in PE.

Clinical features of 17 patients with 2019-nCoV.

OBJECTIVE: This study aims to discuss the unique clinical features of patients with 2019-nCoV in Zhengzhou City to provide references for clinical diagnosis and treatment. PATIENTS AND METHODS: Seventeen patients with 2019-nCoV in Zhengzhou People's Hospital from February to March 2020 were collected. Their epidemiology, clinical symptoms, laboratory examinations, and chest CT images were reviewed. All 17 patients were aged between 12-83 years, with an average age of 47 years, and consisted of 10 males (58.8%) and 7 females (41.2%). Two patients had histories of living or traveling in Wuhan, and 9 patients were attacked locally. The 6 remaining patients were unknown about incidence reasons. RESULTS: The average incubation period was 10 days, and the average time of the course of the disease was 9 days. Among the participants, 12 patients had fever as the first symptoms and 5 patients had normal body temperature. One patient was symptom-free carrier, and one patient had serious symptoms. One patient developed from mild symptoms to severe symptoms, and 14 patients had mild symptoms. Moreover, 7 patients had complications of cardiovascular and cerebrovascular diseases and hypertension, 1 patient was in the advanced stage of squamous cell lung carcinoma, and 1 patient had diabetes mellitus, renal failure, and late-stage uremia. According to novel coronavirus nucleic acid test, 8 patients were positive, accounting for 47.1%. All patients were negative in the novel coronavirus IgM antibody test and negative in other common respiratory pathogen detection. All 17 patients had ground glass-like high-density shadow or stripped high-density shadow on lung CT images, accompanied with many affected lesions on two lungs. The average stay in hospital was 10 days, and the average time of the course of the disease was 9 days. After hospitalization, 15 patients were discharged from the hospital upon recovery, 1 patient was transferred to superior hospital for continuous treatment, and 1 patient died. Patients with 2019-nCoV in Zhengzhou People's Hospital were mainly attacked in local areas, and most of them had mild symptoms. The positive rate of the nucleic acid test was 47.1%. CONCLUSIONS: The main clinical characteristics are increased neutrophil granulocytes, increased C-reactive proteins, decreased lymphocytes, ground glass-like or stripped lesions on lung CT image, common complications of cardiovascular and cerebrovascular diseases, and favorable prognosis.

[Lung non-terminal respiratory unit type adenocarcinoma: a clinicopathologic study].

Objective: To evaluate the clinicopathologic characteristics of lung non-terminal respiratory unit (non-TRU) type adenocarcinoma. Methods: Seventy-two cases of lung non-TRU type adenocarcinoma that underwent complete resection and diagnosed at Departments of Pathology, Affiliated Suzhou Hospital of Nanjing Medical University and Nanjing General Hospital of the PLA from January 2005 to December 2016 were retrospectively studied. The histomorphological changes and precursor lesions were observed under microscope. The expression of lineage-specific markers and tumor stem cell markers was detected by immunohistochemistry (IHC). The major driver mutations of lung adenocarcinoma were tested by ARMS and directive gene sequencing. Results: Non-TRU type adenocarcinomas were more commonly found in male (65.3%, 47/72), former or current smokers (68.1%, 49/72), the elder (mean 61 years old), central adenocarcinoma (75.0%, 54/72), tumors with necrosis (61.1%, 44/72) and higher grade (73.6%, 53/72). Histologically, non-TRU type adenocarcinoma displayed complex histomorphology and was often composed of large irregular gland-like and acinar pattern accumulating extracellular mucin, necrotic tumor cell debris and neutrophils, or invasive adenocarcinoma with mucin production. The tumor cells were composed of bronchial surface epithelial cells, mucinous column cells, polygonal cells and goblet cells. Eighteen (25.0%), 23 (31.9%) and 28 (38.9%) cases exhibited ciliated columnar cell metaplasia (CCCM), mucous columnar cell change (MCCC) and bronchiolar columnar cell dysplasia (BCCD) (precursor lesion of lung adenocarcinoma). IHC showed the expression of CK7 (100.0%, 72/72), TTF1 (12.5%, 9/72), Napsin A (5.6%, 4/72), MUC5AC (81.9%, 59/72), MUC5B (87.5%, 63/72), p53 (66.7%, 48/72), CK5/6 (12.5%, 9/72), p63 (18.1%, 13/72), CK20 (19.4%, 14/72) and CDX2 (16.7%, 12/72) in the tumor cells. The expression of tumor stem cell markers was detected in 43.1% cases (31/72) for CD44, 31.9% (23/72) for CD133, 58.3% (42/72) for ß-catenin, 36.1% (26/72) for ALDH1, 12.5% (9/72) for GATA6, 20.8% (15/72) for SOX2 and 29.2% (21/72) for OCT4. The driver mutations were 26.4% (19/72) for KRAS, 2.8% (2/72) for EGFR and 1.4% (1/72) for EML4-ALK, and none for BRAF and ROS1. Conclusion: Non-TRU type adenocarcinoma is an uncommon subtype of lung adenocarcinoma with distinct clinicopathologic characteristics, histologic appearances, immunophenotype and molecular genetic alterations.

Partial Recovery of Mitochondrial Function of Vitrified Porcine MII Stage Oocytes During Post-Thaw Incubation.

　　The survival of porcine oocytes is still very low after cryopreservation. OBJECTIVE: To investigate whether and when the mitochondrial function of vitrified porcine oocytes could be recovered post-thaw. MATERIALS AND METHODS: Mitochondrial potential, ROS level, ATP content, apoptotic rate, caspase activity, and parthenogenetics developmental ability of thawed porcine oocytes were measured after culture in vitro for 0, 1, 2 or 4 h. RESULTS: Mitochondrial potential after 2 h and 4 h post-thaw culture were 1.19 and 1.26, significantly lower than that of fresh oocytes but much higher than the groups cultured for 0 h and 1 h (P<0.05). Cryopreservation increased the ROS level in oocytes considerably, which decreased only after 2 to 4 h incubation following thaw. ATP content increased gradually over time and recovered to the level comparable to that of fresh oocytes after 4 h. Pan caspase levels increased after cryopreservation and reached the highest level at 1 h incubation. Thereafter it decreased to a low value, but still higher than fresh oocytes. Oocytes showing an early apoptotic event decreased upon 2 to 4 h incubation. The parthenogenetic cleavage and blastocyst rates were the highest (19.8% and 5.6%) after 2 h incubation. CONCLUSION: The recovery of mitochondrial function could complete after 2 to 4 h post-thaw incubation. Post-thaw incubation for 2 to 4 h reduced apoptotic events and improved parthenogenetic developmental ability of vitrified porcine MII stage oocytes.

[Risk factors for central neck lymph node metastases of papillary thyroid carcinoma].

Objective: To investigate the impact factors for central neck lymph node metastases(CLNM) of papillary thyroid carcinoma(PTC). Methods: A total of 498 patients with PTC who underwent total or hemi-thyroidectomy plus central neck lymph node dissection between January 2014 and July 2016 were included. Univariate and multivariate analyses were performed to identify clinicopathological characteristics, thyroid function parameters and US findings that associated with CLNM of PTC. A nomogram was developed to predict the probability of CLNM. The receiver operating characteristic curve(ROC) was used to estimate the efficiency of the nomogram. Results: Among 498 patients, 284 patients were affected by CNLM. The sensitivity and specificity of US in predicting PTC metastasis in the central neck were 31.3% and 88.3%, respectively. Univariate and multivariate analyses showed that gender, age, number and size of suspicious malignant nodules in thyroid, and suspicious lymph node metastasis detected by ultrasonography were independently correlated with CLNM. The ROC showed that the AUC was 0.748, with sensitivity of 80.8%, and specificity of 59.8%. Conclusions: Gender, age, number and size of suspicious malignant nodules in thyroid, suspicious lymph node metastasis were predictive factors for CLNM in patients with PTC. The nomogram developed based on related factors with CLNM is more sensitive than sonographic central neck lymph node features in predicting the probability of CLNM.

[Evaluation of disease free survival after radical resection for primary duodenal adenocarcinoma].

Objective: To investigate the risk factors associated with the disease free survival (DFS) for primary duodenal adenocarcinoma patients undergoing radical resection. Methods: The clinicopathological data of 101 primary duodenal adenocarcinoma patients who underwent radical resection from January 2001 to October 2014 were retrospectively reviewed. Using SPSS 13.0 software, the survival curve was drawn by Kaplan-Meier method, and the survival rates were analyzed by Log-rank test.COX regression model was used to identify independent risk factors. Results: Among 101 patients, the main clinical manifestation were upper abdomen discomfort, abdominal pain, jaundice, gastrointestinal obstruction, hemorrhage, emaciation and so on. A total of 87 patients had the tumor located at the descending part of the duodenum. All the 101 patients underwent radical resection, and 85 patients received pancreatoduodenectomy while 16 patients underwent segmental resection. The median disease free survival time was 26 months and the postoperative 1, 3, 5 year DFS rate were 79.7%, 60.3% and 53.6%, respectively. The univariate analyses identified elevated preoperative CEA and CA19-9 level, T stage, lymph node state, vascular invasion and perineural invasion predicting a worse DFS(P<0.05). On multivariate analysis, positive lymph node state was an independent risk factor for DFS (RR=5.394, 95% CI: 1.624-17.913). Conclusion: Radical resection is the best therapeutic method for primary duodenal adenocarcinoma; the positive lymph node state is the independent risk factor affecting the disease free survival of patients after radical resection.

[Comparison of visual effects after LASIK in myopia between centered on the coaxially sighted corneal light reflex and line of sight].

OBJECTIVE: To compare visual acuity, refractive outcome, high order aberrations, contrast sensitivity and subjective symptom of myopia with laser in situ keratomileusis (LASIK) centered on the coaxially sighted corneal light reflex (CSCLR group) and the conventional ablation of line of sight (LOS group). METHODS: With prospective, double-blind, randomized, controlled trial, the right eyes of patients were included and divided into two groups according to random stratified grouping. Two hundred and ten myopic eyes were treated with centration on the coaxially sighted corneal light reflex and 210 myopic eyes treated with centration on pupil center(line of sight). The parameters of visual acuity, refractive outcome, ablation center distance from visual axis, corneal high order aberrations, subjective discomfort glare and shadowing incidence rate, contrast sensitivity between the two groups were measured and compared up to 6months post operation. Consistent with the measurement data, normal distribution using the group t-test, non-normal distribution of measurement data using the group wilcoxon rank-sum test and count data using chi-square test. RESULTS: The data of postoperative UCVA, BCVA, MRSE efficacy index and safety index showed no statistical difference between the CSCLR and the LOS group up to 6months post operation(P> 0.05). 3% lost one line or more of BCVA in the CSCLR group,and 9% in the LOS group postoperatively, χ(2)= 6.38, P=0.01. The ablation center deviation was (0.19±0.15) mm from visual axis(pentacam system default setting) in CSCLR group and (0.43±0.22) mm in the LOS group. Ablation center deviation was statistically significantly shorter in the CSCLR group (t=-2.59, P<0.01). The postoperative increased total cornea higher order aberrations was 0.150 µm in CSCLR group and 0.193 µm in LOS group, the difference was statistically significant, Z=3.21, P=0.03. The increased corneal vertical coma of CSCLR group was 0.321 µm,smaller than in the LOS group(0.464 µm), Z=4.33, P<0.01. The increased horizontal coma was 0.242 µm in CSCLR group and also smaller than the LOS group(0.353 µm), Z=4.54,P<0.01. Subjective discomfort glare and shadowing incidence rates were 8.5% and 17.5% respectively in the CSCLR and LOS group, χ(2)=7.16,P< 0.01. The one month postoperative contrast sensitivity visual acuity in the CSCLR was 1.157 ± 0.253, significantly higher than the LOS group (0.797±0.218) on 18 c/d spatial frequency, t=- 2.55, P=0.01, but with no significant difference between the two groups at 3 and 6 months. CONCLUSIONS: Myopic LASIK centered on the CSCLR achieved significant lower induction of lost of BCVA, lower induction of high order aberrations, lower risk of subjective discomfort glare and shadowing and lower decline of early contrast sensitivity by comparison to centration on the LOS, improving the quality of vision after operation. (Chin J Ophthalmol, 2016, 52: 499-506).

[Up-regulation of DLK1 in non-small cell lung cancer and the relevant molecular mechanism].

OBJECTIVE: To explore the expression of delta-like 1 homolog (DLK1) gene in non-small cell lung cancer (NSCLC) and its regulatory mechanism. METHODS: The expression levels of DLK1 protein in 204 NSCLC tissues were examined by immunohistochemical (IHC) staining, and the correlation between DLK1expression and clinicopathological features was analyzed. Bisulfate sequencing PCR (BSP) of DNA samples from the tumor tissues of 18 NSCLC patients was performed to evaluate the DNA methylation status of CpG island in the DLK1 promoter region, and also compared with the corresponding IHC staining of DLK1 protein in the same samples. RESULTS: Among the 102 squamous cell carcinoma (SCC) tissue specimens and their adjacent normal bronchial epithelia, DLK1 was up-regulated in 72 and 37 samples, respectively (P=0.001), and among 102 adenocarcinomas (ADC) tissues and their adjacent alveolar tissues, DLK1 was up-regulated in 77 and 7 samples, respectively (P<0.001). In addition, overexpression of DLK1 was significantly associated with histological type, clinical stage and tumor size of NSCLC (P<0.05 for all). The expression of DLK1protein was inversely correlated with its promoter methylation (P<0.05). CONCLUSION: DLK1 expression is up-regulated in NSCLCs, which may be due, at least in part, to the DNA hypomethylation in the promoter region of theDLK1 gene.

Effects of immunological challenge induced by lipopolysaccharide on skeletal muscle fiber type conversion of piglets.

The objective of this study was to investigate the effects of immunological challenge on the skeletal muscle fiber type conversion of piglets. Sixteen Large White weaned barrows (28 ± 3 d, 8.22 ± 0.89 kg BW) were allotted by weight and litter to 2 groups: the control group and the lipopolysaccharide (LPS) group. Saline (control) or LPS was injected intravenously via a jugular catheter on d 1, 3, 5, 7, 9, 11, 13, and 15 at an initial dosage of 80 µg/kg BW, which was increased by 30% at each subsequent injection. Blood samples were collected via the jugular catheter 3 h after the LPS challenge on d -1, 1, 5, 9, and 13. Muscle tissue samples were collected from the LM after exsanguination on d 15. The LPS challenge increased the plasma IL-6, tumor necrosis factor-α (TNF-α), cortisol, IL-1ß, and haptoglobin concentrations on d 1 and 5 ( < 0.01) and increased the plasma IL-6 ( < 0.05), TNF-α ( < 0.05), and haptoglobin ( < 0.01) levels on d 9. Compared with that of the control group, the ADG of the LPS group decreased by 40.00% ( < 0.01), 29.52% ( < 0.05), and 19.30% ( < 0.05), and the ADFI decreased by 25.09% ( < 0.01), 23.15% ( < 0.05), and 19.47% ( < 0.05) during d 1 to 4, d 5 to 8, and d 9 to 15, respectively. In the LM of LPS-challenged piglets, myosin heavy chain 1 (MyHC1) mRNA and protein expression tended to be reduced ( = 0.08, 0.09), whereas mRNA, mRNA, and MyHC2 protein expression increased ( < 0.05). The LPS challenge reduced succinic dehydrogenase (SDH) activity ( < 0.05) and increased lactate dehydrogenase (LDH) activity ( < 0.05) in the LM of piglets. Compared with those in the control group, transcriptional peroxisome proliferator-activated receptor coactivator-α () mRNA ( < 0.05), calcineurin (CaN) mRNA, and protein expression were reduced ( < 0.05), and PGC-α protein expression tended to be reduced ( = 0.08) in the LM of LPS-challenged piglets. These results show that immunological challenge induced by LPS resulted in a shift from type I to type II fibers in the LM of piglets, which may be mediated by the downregulation of the CaN/PGC-α signaling pathway.

Role of IL-17 gene polymorphisms in the susceptibility to gastric cancer.

We conducted a study to investigate the role of three IL-17 gene single nucleotide polymorphisms (SNP) (rs2275913G>A, rs3748067C>T, and rs763780 T>C) in the development of gastric cancer. A total of 252 patients with gastric cancer and 252 control subjects were collected between May 2012 and May 2014. The SNP genotyping of IL-17A rs2275913G>A and rs3748067C>T and IL-17F rs763780 T>C was performed using the Sequenom MassARRAY platform (Sequenom, San Diego, CA, USA) according to the manufacturer instructions. By conditional regression analysis, individuals carrying the AA and the GA+AA genotypes of rs2275913G>A were correlated with an elevated risk of gastric cancer when compared with those carrying the GG genotype, and the adjusted ORs (95%CIs) were 2.05 (1.13-3.76) for the AA genotype and 1.45 (1.03-2.08) for the GA+AA genotype. In conclusion, our results suggest that the IL-17A rs3748067C>T and IL-17F rs763780 T>C polymorphisms play an important role in the risk of gastric cancer in a Chinese population.