[Analysis of changes in reporting and diagnosis of pulmonary tuberculosis among children in Liangshan Yi Autonomous Prefecture, Sichuan Province from 2019 to 2021].

Objective: To compare the characteristics of children's pulmonary tuberculosis (PTB) cases reported from 2019 to 2021 before and during the implementation of the Action Plan to Stop Tuberculosis. Methods: Based on the reported incidence data and population data of child pulmonary tuberculosis (PTB) notified to the Chinese Center for Disease Control and Prevention (CDC) Tuberculosis Information Management System (TBIMS) from 2019 to 2021, the population information and clinically relevant information in different years were compared. Results: From 2019 to 2021, the reported cases of PTB in children were 363, 664 and 655, respectively. The number of reported cases increased significantly. The median age of the cases in children increased from 10.4 years in 2019 to 11.7 years in 2021 (P=0.005) over a three-year period. The etiological positive rate increased significantly from 11.6% (42/363) in 2019 to 32.2% (211/655) in 2021 (P<0.001). The positive rate of molecular testing increased most significantly, which became the main means of etiological detection and accounted for 16.7% (7/42), 62.0% (57/92) and 75.4% (159/211) of the children with positive etiological results, respectively. The resistance rates of isoniazid and rifampicin were analyzed in children with PTB who underwent drug sensitivity tests. The results showed that the resistance rates of isoniazid and/or rifampicin were 2/9, 3.9% (2/51) and 6.7% (11/163), respectively, with an average of 6.7% (15/223) over three years. The median patients' delay was 27 (12, 49) days in 2019. It was reduced to 19 (10, 37) days in 2020 and 15 (7, 34) days in 2021, both significantly lower than 2019 (P=0.009 and 0.000 2, respectively). Conclusion: From 2019 to 2021, the reported numbers of children with PTB and children with positive etiological results increase significantly in Liangshan Prefecture, while the diagnosis delay of patients significantly reduces.

Protein-protein interaction between ezrin and p65 in human breast cancer cells.

Our study aimed to investigate the co-localization and protein-protein interactions between ezrin and p65 in human breast cancer cells. Liquid chromatography-mass spectrometry (LCMS) was used to uncover novel protein interactions with ezrin in MDA-MB-231 cells. Endogenous co-immunoprecipitation was used to validate protein-protein interactions between ezrin and p65 in MDA-MB-231. Exogenous interactions between ezrin and p65 were validated in MDA-MB-231 cells via Flag-ezrin and HA-p65 co-transfection and followed by co-immunoprecipitation. Immunofluorescence staining was used to visualize ezrin and p65 co-localization in MDA-MB-231. LCMS results showed that there were 1000 proteins interacting with ezrin in MDA-MB-231 cells. Ezrin and p65 interactions were confirmed with both endogenous and exogenous methods. We were also able to visualize ezrin and p65 co-localization in MDA-MB-231. In summary, we found protein-protein interactions between Ezrin and p65 in human breast cancer cells.

Differentiation of infiltrative cholangiocarcinoma from benign common bile duct stricture using three-dimensional dynamic contrast-enhanced MRI with MRCP.

AIM: To retrospectively evaluate the criteria for discriminating infiltrative cholangiocarcinoma from benign common bile duct (CBD) stricture using three-dimensional dynamic contrast-enhanced (3D-DCE) magnetic resonance imaging (MRI) combined with magnetic resonance cholangiopancreatography (MRCP) imaging and to determine the predictors for cholangiocarcinoma versus benign CBD stricture. MATERIALS AND METHODS: 3D-DCE MRI and MRCP images in 28 patients with infiltrative cholangiocarcinoma and 23 patients with benign causes of CBD stricture were reviewed retrospectively. The final diagnosis was based on surgical or biopsy records. Two radiologists analysed the MRI images for asymmetry, including the wall thickness, length, and enhancement pattern of the narrowed CBD segment, and upstream CBD dilatation. MRI findings that could be used as predictors were identified by univariate analysis and multivariable stepwise logistic regression analysis. RESULTS: Malignant strictures were significantly thicker (4.4 ± 1.2 mm) and longer (16.7 ± 7.7 mm) than the benign strictures (p < 0.05), and upstream CBD dilatation was larger in the infiltrative cholangiocarcinoma cases (20.7 ± 5.7 mm) than in the benign cases (16.5 ± 5.2 mm; p = 0.018). During both the portal venous and equilibrium phases, hyperenhancement was more frequently observed in malignant cases than in benign cases (p < 0.001). The results of the multivariable stepwise logistic regression analysis showed that both hyperenhancement of the involved CBD during the equilibrium phase and the ductal thickness were significant predictors for malignant strictures. When two diagnostic predictive values were used in combination, almost all patients with malignant strictures (n = 26, 92.9%) and benign strictures (n = 21, 91.3%) were correctly identified; the overall accuracy was 92.2% with correct classifications in 47 of the 51 patients. CONCLUSION: Infiltrative cholangiocarcinoma and benign CBD strictures could be effectively differentiated using DCE-MRI and MRCP based on hyperenhancement during the equilibrium phase and bile wall thickness of the involved segment.

Structural and physiological characterization during wheat pericarp development.

KEY MESSAGE: The cytological and physiological features of developing wheat pericarp were clearly characterized in this report. Our results may be helpful to articulate the functions of pericarp during the seed development. Although wheat pericarp has been well studied, knowledge of the sequence of events in the process of pericarp development is incomplete. In the present study, the structural development process of wheat (Triticum aestivum L.) pericarp was investigated in detail using resin microtomy and microscopy. Chlorophyll contents, and photosynthetic and respiratory rates, in pericarp were determined using spectrophotometer and an oxygen electrode, respectively. Mineral nutrient contents were also determined using scanning electron microscopy. The main results are as follows: (1) based on the structures and physiological characteristics observed, the developmental process of pericarp was divided into four stages, growth, formation, extinction and maturation stages, pericarp exhibited specific features at each stage. (2) Pericarp development differed in different parts, or varieties, of wheat. The dorsal pericarp had fewer starch grains and slower rates of apoptosis than the abdominal mesocarp. The cross cells in dorsal pericarp had an irregular outline. When compared with soft wheat cv. Yangmai 11, mesocarp cells in hard wheat cv. Xumai 30 had more starch grains, larger cell size and longer development duration. (3) The chlorophyll content, photosynthesis rate and respiratory rate in pericarp increased gradually, reaching a maximum about 16 days after anthesis, and later decreased continually. The photosynthetic rate in pericarp was lower than the respiration rate. (4) The contents of mineral elements in pericarp, such as calcium, zinc, iron and potassium were higher than those in the inner endosperm. The data indicate that wheat pericarp has many functions, e.g. protection, photosynthesis, mineral accumulation, synthesis and degradation of starch.

Propofol and memory: a study using a process dissociation procedure and functional magnetic resonance imaging.

Thirty volunteers randomly received either mild or deep propofol sedation, to assess its effect on explicit and implicit memory. Blood oxygen level-dependent functional magnetic resonance during sedation examined brain activation by auditory word stimulus and a process dissociation procedure was performed 4 h after scanning. Explicit memory formation did not occur in either group. Implicit memories were formed during mild but not deep sedation (p = 0.04). Mild propofol sedation inhibited superior temporal gyrus activation (Z value 4.37, voxel 167). Deep propofol sedation inhibited superior temporal gyrus (Z value 4.25, voxel 351), middle temporal gyrus (Z value 4.39, voxel 351) and inferior parietal lobule (Z value 5.06, voxel 239) activation. Propofol only abolishes implicit memory during deep sedation. The superior temporal gyrus is associated with explicit memory processing, while the formation of both implicit and explicit memories is associated with superior and middle temporal gyri and inferior parietal lobule activation.

[Blocking PAK1 kinase activity promotes the differentiation of acute megakaryocytic leukemia cells and induces their apoptosis].

Objective: To investigate the effect of blocking P21 activated kinase 1 (PAK1) activity on the proliferation, differentiation, and apoptosis of acute megakaryocytic leukemia (AMKL) cell lines (CHRF and CMK) . Methods: Cell counts were used to detect the effects of PAK1 inhibitors (IPA-3 and G5555) on AMKL cell proliferation inhibition and colony formation, and flow cytometry was used to detect its effects on AMKL cell cycle. The effect of PAK1 inhibitor on the expression of cyclin D1 and apoptosis-related protein Cleaved caspase 3 was detected using Western blot, while interference with the protein expression level of PAK1 in AMKL cells was assessed using lentivirus-mediated shRNA transfection technology. Flow cytometry was used to detect the effects of knockdown of PAK1 kinase activity on the ability of polyploid DNA formation and cell apoptosis in AMKL cells. Results: PAK1 inhibitors inhibited the proliferation of AMKL cells in a dose-dependent manner and reduced the ability of cell colony formation, and the difference was statistically significant when compared with the control group (P<0.05) . Moreover, they also reduced the percentage of AMKL cells in S phase, and Western blot detection showed that the expression levels of phosphorylated PAK1 and cyclin D1 decreased significantly. Finally, PAK1 inhibitors induced AMKL cell apoptosis by up-regulating Cleaved caspase 3 and showed different abilities to increase the content of polyploid DNA in megakaryocytes. Only high concentrations of IPA-3 and low doses of G5555 increased the number of polyploid megakaryocytes, while knockdown of PAK1 kinase activity promoted AMKL cell differentiation and increased the apoptosis rate. Conclusion: PAK1 inhibitor significantly arrests AMKL cell growth and promotes cell apoptosis. Knocking down the expression of PAK1 promotes the formation of polyploid DNA and induces AMKL cell apoptosis. The above findings indicate that inhibiting the activity of PAK1 may control AMKL effectively.

Novel cancer suppressor gene for esophageal cancer: manganese superoxide dismutase.

OBJECTIVES: To explore the expression of manganese superoxide dismutase (MnSOD) in esophageal squamous cell carcinoma (ESCC) and its relationship with clinicopathological characteristics and biological behavior. METHODS: On 45 patients with ESCC, immunohistochemistry (SP method), reverse transcription-polymerase chain reaction (RT-PCR), and Western blot were used to detect MnSOD protein and mRNA expression in ESCC and in its adjacent normal tissue 5 cm apart from the edge of cancer lesion and without documented microscopic invasive cancer. Meanwhile, the relationship between the pathological features of esophageal cancer and its biological behavior was analyzed. RESULTS: In ESCC and normal esophageal tissue, MnSOD protein expression was identified 31.1% (14/45) and 86.7% (31/45) (P= 0.000), respectively, with the relative expression levels of MnSOD mRNA 0.310 ± 0.036 and 0.482 ± 0.053 (P= 0.000), relatively. Western blot study showed that the relative expressions of MnSOD protein in cancer lesion and in adjacent normal tissue were 0.384 ± 0.038 and 0.766 ± 0.041, respectively (P= 0.000). With longer lesion, deeper invasion, and poorer differentiation, the expression of MnSOD would get lower, indicating that the levels of MnSOD protein and mRNA expression were closely related to the length of lesion, depth of invasion, and degree of differentiation in ESCC (P < 0.05). Nevertheless, the result showed no association with the presence of lymph node metastasis, cancer location, and macroscopic classification (P > 0.05). CONCLUSIONS: MnSOD protein and mRNA expression both decreased in ESCC, which may be related to carcinogenesis and the development of esophageal cancer. Therefore, detecting the expression of MnSOD in esophageal carcinoma would be of clinical significance in understanding its biological behavior and in guiding therapeutic strategy of esophageal cancer.

[Robotic-assisted supraomohyoid neck dissection via retroauricular hairline incision].

Objective: To explore the feasibility of using da Vinci Surgical System to perform supraomohyoid neck dissection (SOND) to avoid visible scar and reduce trauma. Methods: Between September 2017 and December 2018, twenty patients (two females and 18 males, mean age, 54.8 years) with oral cancer treated in the Department of Stomatology, Hainan Hospital of General Hospital of Chinese PLA were enrolled in this study. Eight patients were assigned into robotic surgery group, and received robot-assisted SOND with retroauricular hairline incision. After the da Vinci Surgical System robotic platform was positioned, the neck dissection was performed in level Ⅱb, Ⅱa, Ⅲ, Ⅰb and Ⅰa orderly from the near region to far region. The other 12 patients were assigned into traditional surgery group, and received SOND with a traditional incision. The operation time, bleeding and amount of lymph node dissected were compared between two groups. Results: All the 8 cases of robot-assisted SOND were completed smoothly. Operation time [(4.5±1.0) h] was significantly longer in robotic surgery group than that [(2.5±1.0) h] in traditional surgery group (P<0.05). The amount of bleeding in robotic surgery group [30.0 (27.5) ml] was significantly lower than that in traditional surgery group [(100.0 (87.5) ml, P<0.05]. There's no difference in the number of lymph nodes dissected between robotic surgery group (23.6±5.2) and traditional surgery group (22.8±6.0)(P>0.05). No postoperative hemorrhage, symptoms of nerve injury, flap necrosis and secondary healing were observed in robotic surgery group. Conclusions: SOND through retroauricular hairline incision is feasible with the assistance of da Vinci Surgical System. The main advantage of this method is superior esthetic effects due to a hidden incision with minimal bleeding. There was no obvious differences in the amount of lymph nodes dissected and postoperative complications between two methods. However, robotic surgery costs a significantly longer operation time than traditional neck dissection.

Hypoxia responsive miR-210 promotes cell survival and autophagy of endometriotic cells in hypoxia.

OBJECTIVE: Hypoxia may play a role in the survival of ectopic endometrial cells. This study aimed to explore how hypoxia responsive miR-210 is involved in cell survival and autophagic response of endometriotic cells. MATERIALS AND METHODS: The expression of hypoxia-inducible factor 1-alpha (HIF-1α) and miR-210 in eutopic and ectopic endometrial tissues were measured. The expression changes of HIF-1α and miR-210 in ovarian endometriotic cell line CRL-7566 after hypoxic culture were further explored. The influence of miR-210 on cell viability and apoptosis was quantified using CCK-8 assay and flow cytometry analysis. The effect of miR-210 on Bcl-2 expression and the effect of miR-210/Bcl-2 axis on autophagy in the cells were measured by Western blot analysis. RESULTS: Ectopic lesion had stronger HIF-1α positive signals, as well as more HIF-1α positive cells per visual field than the eutopic endometrium. MiR-210 expression was also elevated in the ectopic lesions. In in-vitro models, CRL-7566 cells had significantly higher expression of HIF-1α and miR-210 after hypoxic treatment. MiR-210 overexpression partly preserved cell viability in hypoxia, while miR-210 knockdown facilitated the loss of cell viability. In addition, miR-210 significantly attenuated hypoxia-induced apoptosis in CRL-7566 cells. Enforced miR-210 overexpression significantly promoted autophagy in hypoxia. Knockdown of endogenous Bcl-2 significantly enhanced autophagy, the effect of which was similar to that of miR-210. CONCLUSIONS: The hypoxia-induced higher miR-210 expression may contribute to pathological development of endometriosis at least through enhancing cell survival and promoting autophagy via Bcl2/Beclin-1 axis.

Endocrine changes associated with the human aging process: II. Effect of age on the number and size of thyrotropin immunoreactive cells in the human pituitary.

The thyrotropin immunoreactive cells in the pituitaries of 40 patients of varying ages were quantified after immunocytochemical staining. Thyrotroph hypertrophy and relative hyperplasia were both present in aged pituitaries. No consistent relation with the histologic features of the thyroid or adrenal, or with the cause of death, was demonstrable.

Mass screening for rectal neoplasm in Jiashan County, China.

Jiashan county is a rural area in China with very high incidence and mortality rates of colorectal cancer. From 1980 to 1984, we conducted a mass screening for rectal neoplasm in the 11 people's communes in this county. Of the 72,879 individuals who were eligible for screening, 60,496 participated, representing an overall participation rate of 83.0%. Both the fecal occult blood (OB) test and rectoscopy were performed on 47,560 of the participants, and rectoscopy only was performed on the remaining 12,936 individuals. From the mass screening, 15 rectal cancers, 3 carcinoids, 899 polyps, 98 ulcers, and 7 inflammatory tumors were detected, a total of 1022 cases. Eight of the 15 detected cases of rectal cancer were in Dukes' stage A. We did not find any evidence for an association between schistosomiasis and colorectal cancer. Results from the OB test were found to have a negative correlation with results from rectoscopy (odds ratio = 0.8, 95% CI = 0.6, 1.1). The OB test had a high false positive rate of 32.7%, and a poor positive predictive value of 3.5%. Both its positive and negative predictive powers were below 1.0, in other words, its positive likelihood ratio was below 1.0 and negative likelihood ratio was above 1.0, indicating that the OB test is not informative and has a poor predictive accuracy for rectal neoplasm. In addition, there were a number of practical problems concerning the use of the OB test for mass screening in the rural community.(ABSTRACT TRUNCATED AT 250 WORDS)

Histological classification of schistosomal egg induced polyps of colon and their clinical significance. An analysis of 272 cases.

272 cases of schistosomal egg induced polyps collected from mass-screening for colorectal carcinoma in Jiashan County were divided into 3 types: fibrous type (FT), mixed type (MT) and epithelial proliferative type (ET). The ET was characterized by crypt elongation, hypertrophy, variation in size, disorderly arrangement, as well as the high percentage of atypical hyperplasia (64.9%). The coexistence and transition between inflammatory reactive hyperplastic and neoplastic crypts were noticed. By HID/AB staining, sialomucins were increased in ET, CEA and PNA receptors detected by the ABC method were present in 18/20 and 6/18 of ET respectively. The mucin expression of ET was similar to that of adenomas. It is likely that a spectrum of ET, atypical hyperplasia and adenoma may exist. We suggest that the patients with ET, especially those with atypical hyperplasia, should be regarded as "risk group", and close follow-up is needed.

Medical radiation usage and exposures from medical X ray diagnosis in Shandong province of China.

Shandong province is situated in the eastern part of China with a population of 88 million. A collaborative survey was conducted in 1999 to investigate the medical radiation usage and the patients' exposures from medical X ray diagnosis in this province. There were three stages in this survey: general survey, sampling survey and dose survey. Patients' entrance surface doses (ESD) were measured using thermoluminescence dosemeters (TLDs) attached to the patient's skin. All the hospitals in this province and 2153 patients were included in this survey. The frequencies of tele- and brachytherapy were 1.450 and 1.685 per 1000 population in 1996 and 1998 respectively. The frequency of diagnostic nuclear medicine was 0.325 and 0.412 per 1000 population in 1996 and 1998 respectively; for therapeutic nuclear medicine, it was 0.015 and 0.021. The total annual frequencies of every type of X ray examination and interventional radiology (IVR) in 1996 and 1998 were 179.8 and 200.0 per 1000 population respectively. The main type of X ray examination was chest fluoroscopy, which made up about 39% of the total. The average entrance surface doses were comparatively high for the examinations of CT, gastrointestinal tract, lumbarspine, urography, angiography, hip and cerebral angiography.

[Histological classification of schistosome egg polyp and its clinical significance: an analysis of 272 cases].

272 cases of schistosome egg polyp collected from the mass-screening for colon carcinoma in Jiashan County have been divided into 3 groups (i.e. fibrous type, mixed type and epithelial hyperplastic type) according to the amount of fibrous stroma. The epithelial hyperplastic type (E type) was characterized by gland elongation, hypertrophy, variation in size, disorder in arrangement and high percentage of atypical hyperplasia (64.9%). Coexistence and transitional change of hyperplastic and adenomatous glands were noticed. By HID/AB staining, sialomucin increased prominently in E type. CEA and PNA receptors by ABC method were detected in 18/20 and 6/20 of E type respectively. The results of mucin expression were similar to those of adenoma. It is likely that the spectrum of E type polyp, atypical hyperplasia and adenoma exists. The authors suggest that patients with E type polyp of schistosome egg, especially those with atypical hyperplasia, should be treated as "risky" population of colon carcinoma.

PI3K/Akt and NF-κB activation following intravitreal administration of 17ß-estradiol: neuroprotection of the rat retina from light-induced apoptosis.

The neuroprotective role of 17ß-estradiol is well known; however, its mechanism of action remains unclear. In the present study, we applied light-induced apoptosis on the Sprague-Dawley rat retina to determine the neuroprotective effect of intravitreal administration of 17ß-estradiol on retinal neurons and to demonstrate its underlying mechanism of action. Fourteen days after ovariectomy, adult female Sprague-Dawley rats received light damage. The functional and morphological changes of the retina were monitored by electroretinogram and hematoxylin and eosin staining, respectively. Retinal apoptosis was characterized by the presence of DNA laddering and positive terminal deoxyuridine triphosphate (dUTP) nick-end labeling. The phosphoinositide 3-kinase (PI3K)-specific inhibitor LY294002 was used to elucidate whether the PI3K/Akt signaling pathway was activated by 17ß-estradiol. Western blotting was used to detect the activation of caspase 3 and Akt. Immunofluorescence was performed to determine the translocation of NF-κB. Our data showed that exposure to 8000lux white light for 12h resulted in functional damage to the rat retina, histological changes and retinal neuronal apoptosis. 17ß-Estradiol significantly rescued retinal function by preventing neuronal apoptosis. Moreover, the inhibition of Akt activation by LY294002 increased retinal neuronal apoptosis, demonstrating that the PI3K/Akt signaling pathway is involved. Levels of cleaved caspase-3 were suppressed in the presence of 17ß-estradiol, while LY294002 reversed the effects. It is noteworthy that NF-κB p65 also translocated from the cytoplasm to the nucleus after 17ß-estradiol administration. This translocation was inhibited by pre-injection of LY294002. Taken together, these results indicate that 17ß-estradiol intravitreal administration protects the function of the rat retina by preventing retinal neuronal apoptosis from light damage. In addition, the PI3K/Akt signaling pathway is activated, which inhibits caspase-3 activation and induces NF-κB p65 nuclear translocation.

A multivariate analysis of pathologic factors influencing prognosis of colorectal cancer in 1067 cases.

Multivariate analysis (risk state analysis) was performed to evaluate the single and joint effects of pathologic variables on the survivals of 1067 cases of colorectal carcinoma. Nineteen of the twenty-eight variables analyzed were found to have statistically significant prognostic value, with over half having a strong influence on prognosis. The first seven, ranked in order of their effects on survival, are metastasis in lymph nodes, depth of invasion, histologic grading, lymphocyte infiltration of the cancer, GH (immune response in regional lymph nodes), growth pattern and fibrous proliferation around the cancer. The joint effects of combinations of these major variables are even more striking than those of single ones.

S100 protein-positive dendritic cells and the significance of their density in gastric precancerous lesions.

Quantitative analysis of dendritic cells (DC's) was carried out in tissue specimens of normal gastric mucosa (n = 15), gastric ulcer (n = 19), chronic atrophic gastritis (n = 28), and gastric carcinoma (n = 65) by ABC immunostaining with S100 protein antibody. Significant increases in DC number were observed in chronic atrophic gastritis with type III intestinal metaplasia and/or grade II, III dysplasia. The result suggests that DC's are potentially capable of presenting neoantigens associated with malignant transformation at the precancerous stage when malignant morphological changes have not yet taken place. Combined with routine diagnostic methods, the serial monitoring of DC density in gastric mucosa may be useful in the follow-up of premalignant lesions in the stomach and the diagnosis of early gastric carcinoma.