Atypical choroid plexus papilloma: clinicopathological and neuroradiological features.

Background Atypical choroid plexus papilloma (APP) is a rare, newly introduced entity with intermediate characteristics. To date, few reports have revealed the magnetic resonance (MR) findings. Purpose To analyze the clinicopathological and MR features of APP. Material and Methods The clinicopathological data and preoperative MR images of six patients with pathologically proven APP were retrospectively reviewed. The MR features including tumor location, contour, signal intensity, degree of enhancement, intratumoral cysts, and necrosis; and flow voids, borders, peritumoral edema, and associated hydrocephalus were analyzed. Results The APP were located in the ventricle (n = 4) and cerebellopontine angle (CPA, n = 2). Tumor dissemination along the spinal subarachnoid space was found in one patient. The tumors appeared as milt-lobulated (n = 5) or round mass (n = 1), with slightly heterogeneous signals (n = 5) or mixed signals (n = 1) on T1-weighted and T2-weighted images. Heterogeneous and strong enhancement were found in five cases on contrast-enhanced images. Three of four intraventricular tumors had a partly blurred border with ventricle wall. Four tumors had mild to moderate extent of surrounding edema signals. A slight hydrocephalus was seen in four patients. Incomplete capsule was seen in four tumors at surgery. Histopathologically, mild nuclear atypia was seen in all tumors with a mitotic rate of 2-5 per 10 high-power fields. Conclusion APP should be included in the differential diagnosis when an intraventricular or CPA tumor appearing as a multi-lobulated solid mass with slight heterogeneity, heterogeneous strong enhancement, partly blurred borders, mild to moderate peritumoral edema, or slight hydrocephalus are present.

Bilateral versus unilateral radioactive stent insertion for hilar cholangiocarcinoma.

Introduction: Radioactive stent insertion (RSI) is widely used for patients with obstructive hilar cholangiocarcinoma (HC) to increase the stent patency and overall survival (OS). However, one controversy of treating HC patients is determining whether to use unilateral or bilateral stenting. General knowledge on unilateral and bilateral RSI efficacy is still lacking. Aim: To evaluate the clinical efficacy and long-term prognoses of unilateral and bilateral RSI in HC patients. Material and methods: Between January 2016 and December 2020, all HC patients who received unilateral and bilateral RSI at our hospital were selected for this study. We compared the treatment efficacy and long-term prognosis of patients undergoing these two procedures. Results: Overall, 65 HC patients received either unilateral (n = 33) or bilateral (n = 32) RSI. There were no significant differences in the technical (both 100%) and functional (97.0% vs. 90.6%, p = 0.584) success rates between the 2 groups. Stent re-obstruction occurred in 6 and 9 patients in the unilateral and bilateral groups, respectively (p = 0.341). Median stent patency was 214 and 233 days in the unilateral and bilateral groups, respectively (p = 0.650). Median OS was 240 and 281 days in the unilateral and bilateral groups, respectively (p = 0.068). Lastly, the total complication rate was significantly lower in the unilateral group, as compared to the bilateral group (12.1% vs. 34.4%, p = 0.033). Conclusions: Unilateral and bilateral RSI provided comparable clinical efficacy and long-term prognoses of HC patients. However, unilateral stenting exhibited a markedly lower complication rate.

Ultrasonic Image Feature Analysis under Deep Learning Algorithm to Evaluate the Efficacy of Drug-Coated Balloon for Treatment of Arteriosclerotic Occlusion.

In order to explore the adoption of ultrasonic images under deep learning (DL) algorithm to evaluate the efficacy of drug-coated balloon (DCB) for treatment of arteriosclerotic occlusion, 56 patients who underwent DCB surgery of lower limb artery were selected and all the patients received the examinations of algorithmic ultrasound and digital subtraction angiography (DSA) before surgery. According to the examination methods, they were classified into algorithmic ultrasound group and DSA group. One to two months after DCB surgery, ultrasound examination was performed with the region-based faster convolutional neural network (faster R-CNN) target detection algorithm to check the therapeutic effect. The results showed that the image effect processed by the target detection algorithm based on DL was signally better than that of traditional ultrasonic processing algorithm in Dice, precision (Pre), and sensitivity, with significant difference (P < 0.05). Compared with DSA, algorithmic ultrasound showed better consistency between the two groups in the diagnosis of common femoral artery, superficial femoral artery, and popliteal artery stenosis, with statistical significance (P < 0.05). However, for the diagnosis of anterior tibial artery stenosis, the consistency between algorithmic ultrasound and DSA was general. The residual stenosis of each artery segment decreased obviously in postoperative review compared with that before surgery, and the difference was statistically significant (P < 0.05). Besides, both the pulsatility index (PI) and the blood flow velocity of the dorsalis pedis artery increased after surgery, compared with those before surgery, with significant differences (P < 0.05). To sum up, ultrasound based on DL target detection algorithm had good imaging effect and good consistency with DSA, which was of the clinical reference value. Additionally, DCB surgery was helpful to treat arteriosclerosis occlusion and improve limb blood supply, which had clinical adoption value.

Application of Hydrogen Peroxide Sensitive Fluorescen Nanoparticles in Atherosclerosis.

ROS plays an important role in the formation of atherosclerotic plaque, especially hydrogen peroxide, which can stimulate macrophages to express pro-inflammatory cytokines and chemokines to enhance the inflammatory activity of macrophages. Therefore, the development of drugs with sensitive release of hydrogen peroxide is safe and effective for the treatment of atherosclerosis The side chain hydroxyl groups of pHEMA were grafted with oxalylsimvastatin (SIM), fluoropolyethylene glycol (fpeg) and macrophage target molecule ISO-1 to prepare hydrogen peroxide sensitive fluorescent drug loaded nanomicelles (phema-simfpeg-iso-1). By using hydrogen peroxide sensitive and controlled-release drug, it can target macrophage, at the same time, improve the characteristics of traditional polyethylene glycol only as hydrophilic chain, and synthesize polyethylene glycol with fluorescence function, so that the polymer can have probe ability without modifying fluorescence substance, which is suitable for the diagnosis and treatment of atherosclerosis. The results show that the water-soluble nanoparticles show good biocompatibility and peroxide Hydrogen sensitivity and fluorescence ability provide new materials for the development of a nano system for the diagnosis and treatment of atherosclerosis.

Stage IA Patients With Pancreatic Ductal Adenocarcinoma Cannot Benefit From Chemotherapy: A Propensity Score Matching Study.

Purpose: Adjuvant chemotherapy following resection is recommended by clinical practice guidelines for all patients with pancreatic ductal adenocarcinoma (PDAC). This study aimed to evaluate the efficacy of adjuvant chemotherapy among the staging groups of the American Joint Committee on Cancer (AJCC) for PDAC. Patients and Methods: This retrospective cohort analysis was performed by the Surveillance Epidemiology and End Results (SEER) (2004-2015) database and multi-institutional dataset (2010-2018). Baseline clinicopathologic characteristics of PDAC patients, including age, gender, ethnicity, marital status, education level, county income level, county unemployed rate, insurance status, grade, stage, chemotherapy, and radiotherapy, were collected. Overall survival (OS) was analyzed using the Kaplan-Meier method. The SEER and multi-institutional data were adjusted with 1:1 ratio propensity score matching (PSM). Results: In total, 6,274 and 1,361 PDAC patients were included from the SEER database and multi-institutional dataset, respectively. Regardless of the count of resected lymph nodes, adjuvant chemotherapy prolonged the long-term OS time for stage IB, IIA, IIB, and III patients in both SEER and multi-institutional cohorts. Nevertheless, adjuvant chemotherapy did not provide additional clinical benefits even after a PSM adjustment for stage IA patients in both SEER and multi-institutional cohorts. Conclusion: Adjuvant chemotherapy improved the long-term survival of stage IB, IIA, IIB, and III PDAC patients; however, it demonstrated no survival benefit in stage IA PDAC patients. Thus, adjuvant chemotherapy should not be recommended for stage IA PDAC patients. These would significantly reduce the economic burden of society and improve the life quality of stage IA PDAC patients.

Effects of various organic carbon sources on the growth and biochemical composition of Chlorella pyrenoidosa.

The aim of this study was to investigate the effects of various organic carbon sources (glucose, galactose, fructose, sucrose, maltose, lactose and starch) on the growth and biochemical composition of Chlorella pyrenoidosa. Monosaccharides were found to exert stronger stimulative effects on the algal growth than disaccharides and starch. After 10-day culture, addition of 0.5-5.0 g L(-1) glucose and galactose significantly reduced the cellular protein contents by 27.7-63.7% and 22.6-60.5%, respectively, and significantly increased the carbohydrate contents by 103.2-266.5% and 91.9-240.0%, respectively. However, addition of 0.5-5.0 g L(-1) disaccharides and starch did not significantly affect the contents of lipid, protein and carbohydrate. Similar to the normal nitrogen condition, the cellular biochemical composition was not significantly affected by addition of 3.0 g L(-1) disaccharides and starch under the low nitrogen condition. Finally, the significance of this work in the biotechnological application of mixotrophic cultivation of C. pyrenoidosa was further discussed.

Diffusion-weighted magnetic resonance imaging to evaluate microvascular density after transarterial embolization ablation in a rabbit VX2 liver tumor model.

OBJECTIVE: To evaluate the correlation between findings from diffusion weighted imaging (DWI) and microvascular density (MVD) measurements in VX2 liver tumors after transarterial embolization ablation (TEA). MATERIALS AND METHODS: Eighteen New Zealand white rabbits were used in this study. VX2 tumor cells were implanted in livers by percutaneous puncture under computed tomography (CT) guidance. Two weeks later, all rabbits underwent conventional magnetic resonance imaging (MRI) (T1 and T2 imaging), DWI, (b=100, 600, and 1000s/mm(2)) and TEA. MRI was performed again1 week after TEA. Liver tissue was then harvested and processed for hematoxylin and eosin (H&E) staining and immunohistochemical staining for CD31to determine MVD. RESULTS: VX2 liver tumors were successfully established in all 18 rabbits. Optimal contrast was achieved with a b value of 600s/mm(2).The maximum pre-operative apparent diffusion coefficient (ADC)difference value was 0.28×10(-3)±0.10×10(-3)mm(2)/s, and was significantly different (P<0.001) from the maximum postoperative ADCdifference value of 0.47×10(-3)±0.10×10(-3)mm(2)/s. However, the mean ADC value for the entire tumor was not significantly correlated with MVD (r=0.221, P=0.379), nor was the ADC value for the regions of viable tumor (r=-0.044, P=0.862). However, the maximum postoperative ADCdifference value was positively correlated with MVD(r=0.606, F=12.247, P=0.003). CONCLUSION: DWI is effective to evaluate the therapeutic efficacy of TEA. The maximum ADCdifference offers a promising new method to noninvasively assess tumor angiogenesis.

Collision tumor of the esophagus: report of a case with mixed squamous cell carcinoma and gastrointestinal stromal tumor.

Esophageal cancer is mainly divided into squamous cell carcinoma and adenocarcinoma. Epidemiologically, the former contributes to 90% of worldwide esophageal cancer cases, while adenocarcinoma contributes to two-thirds of cases in developed countries. Although other rare types and collision with multiple histological types of tumors do occur in the esophagus, it is very rare for a gastrointestinal stromal tumor (GIST) to collide with an epithelial malignant tumor. To date, only three cases have been reported in the literature. The current study reported a 69-year-old male patient with squamous cell carcinoma and GIST in the middle esophagus. There was no merging of tissue components between these tumors. This study together with a literature review indicates that esophageal collision tumors have been increasingly reported in recent years. Histology and immunohistochemistry are needed to make a differential diagnosis. The exact oncogenic mechanism or the interaction of two independent neoplasms still remains to be determined, and further investigation, such as electron microscopy and genetic analysis, may help to elucidate the pathogenesis of the colliding tumors.