Extraskeletal Ewing sarcoma of thyroid gland: A case report / 中南大学学报(医学版)

Extraskeletal Ewing sarcoma is a rare event, and extraskeletal Ewing sarcoma of the thyroid gland is even rarer. It has non-specific clinical manifestation and difficulty in early diagnosis. The diagnosis mainly depends on histology and immunohistochemistry. It possesses the features of high malignancy, high rate of local recurrence, and distant metastasis. Currently, the aggressive multimodal treatment contains surgery, chemotherapy, and radiotherapy. This study presented a case of extraskeletal Ewing sarcoma arising in the thyroid gland of a 30-year-old woman, who presented with supraclavicular mass and sense of dysphagia obstruction in Department of Otolaryngology, Head and Neck Surgery, Second Xiangya Hospital, Central South University in 2018. Imaging studies demonstrated a cystic-solid mass in inferior of the left leaf of thyroid gland and in the posterior of the trachea and esophagus. The patient underwent localized tumor resection. The pathological diagnosis revealed that it was a small round cell tumor, and the immunohistochemistry results were considered to be extraskeletal Ewing sarcoma. Subsequently, the patient was given chemotherapy and local radiation therapy. There was no evidence of tumor recurrence or metastasis.

Efficacy of targeted care for sleep in patients with depressive disorder / 中国实用护理杂志

Objective To explore the efficacy of targeted care for sleep by analyzing polysomnography (PSG) of the different stages of night sleep in patients with depressive disorder. Methods 80 depressive patients met the recruited criteria from Feb 2015 to Feb 2016 were sample-randomly divided into research group with targeted care and controlled group with routine nurse by random number table. PSG of each case was analyzed and Hamilton Depression Scale (HAMD) and Self-Rating Depression Scale (SDS) were used to assess at baseline and endpoint during 4 weeks period. Results Total sleep time, sleep efficiency, N3 and rapid eyes movement ratio of PSG were (395.74 ± 29.31) min, (80.42±1.92)%, (19.11±2.29)%and (16.01±2.55)%in research group, (372.34±24.37) min, (72.61 ± 1.64)%, (13.61 ± 2.38)%and (13.87 ± 2.03)%in controlled group (t=2.892-13.361, P<0.05). SDS at 2nd week and 4th week were (45.28 ± 6.28) points and (32.62 ± 4.65) points in research group, (48.63±7.54) points and (36.32±4.34) points in controlled group (t=-4.12,-4.43, P<0.05). HAMD at 2nd week and 4th week were (15.92 ± 2.62) points, (9.94 ± 2.32) points in research group, (18.27 ± 3.41) points and (12.45 ± 2.21) points in controlled group (t=-3.51,-4.35, P<0.05). Conclusions Efficacy of targeted care for sleep in patients with depressive disorder is better and sooner, and the intervention is good for both sleep quality and mood level.

Discussion of quantitative criteria of grading nursing in psychiatric department / 中国实用护理杂志

ObjectiveTo discuss the quantitative criteria of grading nursing of three common psychiatric diseases in psychiatric department. MethodsUsing SI、N-BPRS,BRMS and HAMD scales to evaluate180 patients with schizophrenia,mania and depression upon admission and after admission.The quantitative evaluation of grading nursing of these three diseases was compared. ResultsFor the three common mental diseases N- BPRS scale scores were as follows.Superfine nursing:schizophrenia (80.66+11.22)points; mania (80.05± 15.44)points; depression (76.88±9.82)points.Primary care:schizophrenia (67.47± 10.18)points; mania ( 62.91 ± 10.19 )points; depression ( 56.63±9.52 )points; Secondary nursing:schizophrenia ( 44.04 ±8.67 )points;mania( 39.57±9.47 )points ;depression( 37.73±7.75 )points.The three- level nursing:schizophrenia( 27.97±2.19 )points;mania(27.89±2.28)points;depression(27.45±1.31 )points. ConclusionsUsing evaluating scores of NBPRS scale to determine the quantitative criteria of grading nursing of three common psychiatric diseases is a feasible choice,after training,nurses of high qualification can grasp skillfully the operation process.

Podocyte injury and its association with proteinuria in IgA nephropathy / 中华肾脏病杂志

Objective To investigate the injury of podocyte and its association with proteinuria in IgA nephropathy (IgAN). Method Thirty-five patients of IgA nephropathy with proteinuria more than 1.0 g/24 h were enrolled in the study, and eight cases of renal harmatomaeetomy or renal cancinomaectomy were as controls. Cell cycle regulatory proteins (p21, p27), podocyte-associated molecules (integrin-β1, nephrin, α-actinin 4, nestin), foot process width (FPW) and the amount of podocyte were examined by immunohistochemistry and real-time PCR, respectively. Patients were divided into two groups according to podocyte number per volume (Nv): podocytopenia group (n=15, Nv<52.49×106/μm3) and normal number group (n=20, Nv≥52.49× 106/μm3). Proteinuria was followed up for eighteen months. Results Compared with the controls, podocyte p21 was re-expressed, while the expression of p27 was decreased (0.71±0.12 vs 0.91±0.07, P<0.05) in IgAN. The nestin protein level was markedly decreased in IgAN (13.4%± 0.04% vs 17.6%±0.04%, P<0.05). The mRNA expression of integrin-β1 was significantly increased (12.54±5.20 vs 1.02±0.30, P<0.05), while the amount of nephrin, α-actinin4 remained unchanged. Effacement of foot processes and podocyte detachment from the glomerulax basement membrane were observed in some cases. Nv was significantly less than that of controls (161.27± 225.92 vs 323.22±138.12, P<0.05), which was associated with the Lee's grade of IgA nephropathy. The integrin-β1 mRNA expression and Nv were negatively correlated with baseline proteinuria by univariate analysis (r=-0.840, P=0.034; r =-0.4483, P=0.014, respectively). Proteinuria in podocytopenia group was decreased more slowly than that in normal number group. Conclusions Podocyte injury exsists in IgAN with proteinuria, which manifests alterations in cell cycle regulatory protein and some podocyte-associated molecules, as well as foot process effacement and loss of pedocyte. Podocyte injury may be involved in proteinuria by affecting the progression of proteinuria in IgAN.

Down-regulation of nestin expression in the glomeruli with foot process effacement and its correlation with the degree of proteinuria / 中华肾脏病杂志

Objective To investigate the expression of nestin, a type Ⅵ intermediate filament protein in the glomeruli with foot process effacement and the potential relationship between nestin expression in the kidney and the degree of proteinuria. Method Immunohistochemistry was used to determine the localization of nestin in the kidney samples obtained from needle biopsies of normal human and patients with minimal change disease (MCD). Puromycin aminonucleoside (PAN) nephrosis rat models were established by a single intraperitoneal injection of PAN. Both real time quatitative reverse PCR and Western blot methods were applied to evaluate the levels of nestin expression at day 1, 4, 10 and 20 after PAN injection. Results Immunohistochemistry showed that the expression of nestin in glomeruli of MCD patients was significantly reduced compared with normal samples (0.93±0.08 vs 1.65±0.12, P<0.05) . The mRNA and protein expressions of nestin in the rat kidney were transitorily increased by 1.23 folds and 1.48 folds of control group (NC) after 1 day of PAN injection (P<0.05), then decreased quickly in the following days. The mRNA levels of nestin in the kidney were 35.8% and 12.1% of NC after 4 days and 10 days of PAN injection, respectively, (P<0.01) as determined by real time PCR. After 20 days of PAN injury, nestin mRNA expression partly recovered to 65.8% of NC (P< 0.05 ). The protein levels of nestin detected by Western blot presented the similar trend, which were 77.0%, 58.0% and 83.4% of NC after 4 days, 10 days and 20 days of PAN injection, respectively (P<0.05). The degree of proteinuria in puromycin aminonucleoside nephrosis rats was negatively correlated with both mRNA and protein levels of nestin in the kidney(r=-0.667,P<0.05 and r=-0.621 ,P<0.05, respectively). Conclusions The expression of intermediate filament protein nestin is down-regnlated in the kidney characterized with foot process effacement and negatively correlated with the degree of proteinuria in puromycin aminonucleoside nephrosis rats. Nestin may play a potential role in modulating the structure and function of podocyte.

Endothelin receptor antagonist combined with a calcium channel blocker attenuates renal injury in spontaneous hypertensive rats with diabetes / 中华医学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the effects of the mixed endothelin receptor antagonist, bosentan, combined with the long-acting calcium channel blocker, amlodipine, compared to the angiotensin-converting enzyme inhibitor, cilazapril, on the progressive renal injury in spontaneous hypertensive rats (SHR) with diabetes.</p><p><b>METHODS</b>Diabetic hypertensive rats (SHR-DM) were induced by streptozotozin injected in male SHR (7-week-old),and divided into an untreated and three treated groups: 1) cilazapril treated group; 2) bosentan+amlodipine treated group; and 3) amlodipine treated group. Wistar Kyoto rats (WKY) and SHR rats served as normotensive and hypertensive control, respectively. The mean arterial blood pressure, renal function, endothelin and angiotensin II levels as well as the protein expression of renal extracellular matrix components and transforming growth factor (TGF)-beta1 were determined at the end of the 4th week.</p><p><b>RESULTS</b>Mean arterial blood pressure significantly increased in SHR and SHR-DM rats compared to WKY rats. All the therapies reduced the blood pressure to normal levels. However, the enhanced urinary protein excretion, the decreased creatinine clearance as well as the increased plasma and intrarenal endothelin and angiotens in II levels were found in the untreated SHR-DM and prevented by treatment with bosentan+amlodipine and cilazapril. Similarly, these two kinds of therapies in SHR-DM abolished the overexpression of renal TGF-beta1 by Western blot analysis and reduced the accumulation of collagen type IV, laminin and fibronectin proteins by an immunochemical approach. Amlodipine monotherapy had no detectable effects on the above parameters.</p><p><b>CONCLUSION</b>Bosentan combined with amlodipine can offer similar renoprotective effects on that of cilazapril and may be a potent therapy to attenuate renal injury by reducing renal protein levels of TGF-beta1 in diabetes with a hypertensive state.</p>

Study on gene expression of PTH/PTHrP receptor in patients with renal impairment / 中华肾脏病杂志

Objective To investigate the changes of parathyroid hormone receptor in patients with different stages of renal disease and its possible underlying mechanisms. Methods Relatively quantitative RT/PCR method was used to detect PTH receptor mRNA expression in renal specimens obtained through biopsy or operation. Results The levels of PTH receptor mRNA were significantly decreased in all patients with chronic glomerulonephritisx moderate renal failure severe renal failure and acute renal failure, which was correlated with the extent of renal impairment. Conclusion The downregulation of renal PTH receptor occurs much earlier than the changes of renal function., plasma PTH., serum phosphate and calcium in the course of human renal disease.