Bifunctional interfacial engineering enabled efficient and stable carbon-based CsPbIBr2 perovskite solar cells.

Carbon-based inorganic CsPbIBr2 perovskite solar cells (C-IPSC) have attracted widespread attention due to their low cost and excellent thermal stability. Unfortunately, due to the soft ion crystal nature of perovskite, inherent bulk defects and energy level mismatch at the CsPbIBr2/carbon interface limit the performance of the device. In this study, we introduced aromatic benzyltrimethylammonium chloride (BTACl) as a passivation layer to passivate the surface and grain boundaries of the CsPbIBr2 film. Due to the reduction of perovskite defects and better energy level arrangement, carrier recombination is effectively suppressed and hole extraction is improved. The champion device achieves a maximum power conversion efficiency (PCE) of 11.30% with reduces hysteresis and open circuit voltage loss. In addition, unencapsulated equipment exhibits excellent stability in ambient air.

Unveil the origin of voltage oscillation for sodium-ion batteries operating at -40 °C.

Voltage oscillation at subzero in sodium-ion batteries (SIBs) has been a common but overlooked scenario, almost yet to be understood. For example, the phenomenon seriously deteriorates the performance of Na3V2(PO4)3 (NVP) cathode in PC (propylene carbonate)/EC (ethylene carbonate)-based electrolyte at -20 °C. Here, the correlation between voltage oscillation, structural evolution, and electrolytes has been revealed based on theoretical calculations, in-/ex-situ techniques, and cross-experiments. It is found that the local phase transition of the Na3V2(PO4)3 (NVP) cathode in PC/EC-based electrolyte at -20 °C should be responsible for the oscillatory phenomenon. Furthermore, the low exchange current density originating from the high desolvation energy barrier in NVP-PC/EC system also aggravates the local phase transformation, resulting in severe voltage oscillation. By introducing the diglyme solvent with lower Na-solvent binding energy, the voltage oscillation of the NVP can be eliminated effectively at subzero. As a result, the high capacity retentions of 98.3% at -20 °C and 75.3% at -40 °C are achieved. The finding provides insight into the abnormal SIBs degradation and brings the voltage oscillation behavior of rechargeable batteries into the limelight.

Small-Molecule Copper Chloride Modulating the Buried Interfaces of Perovskite Solar Cells.

In perovskite solar cells (PSCs), tin dioxide (SnO2) is a highly effective electron transport material. On the other hand, the low intrinsic conductivity of SnO2, the high trap-state density on the surface and bulk of SnO2, and inadequate interface contacts between SnO2 and perovskite significantly impact device performance. Herein, small-molecule copper(II) chloride (CuCl2) is introduced into the SnO2 dispersion, which inhibits the agglomeration of SnO2 colloids and improves the quality of the electron transport layer. Furthermore, the introduction of CuCl2 optimizes the energy-level array between the ETL and perovskite layer (PVK) and passivates the anion/cation defects in SnO2, perovskite, and their interface, realizing the systematic modulation of the photoelectronic properties of the ETLs and PVKs as well as the PVK/ETL. As a result, the CuCl2-opmized PSC exhibits an impressive power conversion efficiency of 23.71%, along with improved stability.

CircPRDM5 inhibits the proliferation, migration, invasion, and glucose metabolism of gastric cancer cells by reducing GCNT4 expression in a miR-485-3p-dependent manner.

Circular RNA (circRNA) plays a key part in the pathological process of gastric cancer (GC). The study is organized to analyze the function of circPRDM5 in GC cell tumor properties. Expression levels of circPRDM5, miR-485-3p, glucosaminyl (N-acetyl) transferase 4 (GCNT4), ki67, E-cadherin, N-cadherin, and hexokinase 2 (HK2) were analyzed by quantitative real-time polymerase chain reaction (PCR), Western blotting or immunohistochemistry assay. Cell proliferation was assessed by cell colony formation assay and 5-ethynyl-2'-deoxyuridine assay. Cell migration and invasion were investigated by transwell assay. Glycolysis was evaluated by the Seahorse XF Glycolysis Stress Test Kit. Dual-luciferase reporter assay and RNA pull-down assay were performed to identify the associations among circPRDM5, miR-485-3p, and GCNT4. Xenograft mouse model assay was conducted to determine the effects of circPRDM5 on tumor formation in vivo. CircPRDM5 and GCNT4 expression were downregulated, while miR-485-3p expression was upregulated in GC tissues and cells when compared with paracancerous tissues or human gastric epithelial cells. CircPRDM5 overexpression inhibited proliferation, migration, invasion, and glucose metabolism of GC cells; however, circPRDM5 depletion had the opposite effects. CircPRDM5 repressed tumor properties of GC cells in vivo. MiR-485-3p restoration relieved circPRDM5-induced effects in GC cells. GCNT4 overexpression remitted the promoting effects of miR-485-3p mimics on GC cell malignancy. CircPRDM5 acted as a sponge for miR-485-3p, and GCNT4 was identified as a target gene of miR-485-3p. Moreover, circPRDM5 regulated GCNT4 expression by interacting with miR-485-3p.CircPRDM5 acted as a miR-485-3p sponge to inhibit GC progression by increasing GCNT4 expression, proving a potential target for GC therapy.

COVID-19 Omicron variant infection has minimal impact on maternal and neonatal outcomes: A cross-sectional cohort study.

AIM: To explore the impact of the Omicron variant on maternal and neonatal outcomes. DESIGN: Cross-sectional cohort study of women giving live birth in a single hospital in Shanghai in December 2022. METHODS: Demographic characteristics, maternal and neonatal outcomes and laboratory testing results were retrieved from medical records. Propensity score matching was used to match COVID-19-positive and -negative women. Differential analysis was used to assess associations between COVID-19 and in-hospital maternal and neonatal outcomes. RESULTS: A total of 1508 women were included, comprising 729 natural births, 741 caesarean sections and 38 forceps deliveries. After 1:1 matching, 310 clients were included for analysis with each 155 in COVID-19-positive and -negative groups. Higher maternal fever was found in all modes of delivery, and higher preterm birth and lower pH value of blood gas of the umbilical artery in the vaginal delivery subgroup (p < 0.05). Other maternal and neonatal outcomes showed no significant difference between COVID-19-positive and -negative clients.

Poly(3-hexylthiophene)/perovskite Heterointerface by Spinodal Decomposition Enabling Efficient and Stable Perovskite Solar Cells.

The best research-cell efficiency of perovskite solar cells (PSCs) is comparable with that of mature silicon solar cells (SSCs); However, the industrial development of PSCs lags far behind SSCs. PSC is a multiphase and multicomponent system, whose consequent interfacial energy loss and carrier loss seriously affect the performance and stability of devices. Here, by using spinodal decomposition, a spontaneous solid phase segregation process, in situ introduces a poly(3-hexylthiophene)/perovskite (P3HT/PVK) heterointerface with interpenetrating structure in PSCs. The P3HT/PVK heterointerface tunes the energy alignment, thereby reducing the energy loss at the interface; The P3HT/PVK interpenetrating structure bridges a transport channel, thus decreasing the carrier loss at the interface. The simultaneous mitigation of energy and carrier losses by P3HT/PVK heterointerface enables n-i-p geometry device a power conversion efficiency of 24.53% (certified 23.94%) and excellent stability. These findings demonstrate an ingenious strategy to optimize the performance of PSCs by heterointerface via Spinodal decomposition.

Research Advance of Chinese Medicine in Treating Atherosclerosis: Focus on Lipoprotein-Associated Phospholipase A2 / 中国结合医学杂志

As a serious cardiovascular disease, atherosclerosis (AS) causes chronic inflammation and oxidative stress in the body and poses a threat to human health. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a member of the phospholipase A2 (PLA2) family, and its elevated levels have been shown to contribute to AS. Lp-PLA2 is closely related to a variety of lipoproteins, and its role in promoting inflammatory responses and oxidative stress in AS is mainly achieved by hydrolyzing oxidized phosphatidylcholine (oxPC) to produce lysophosphatidylcholine (lysoPC). Moreover, macrophage apoptosis within plaque is promoted by localized Lp-PLA2 which also promotes plaque instability. This paper reviews those researches of Chinese medicine in treating AS via reducing Lp-PLA2 levels to guide future experimental studies and clinical applications related to AS.

Historical evolution and clinical application of classical prescription Yigongsan / 中国药房

Yigongsan， derived from QIAN Yi’s Key to Therapeutics of Children’s Diseases in the Song Dynasty， is a classic pediatric prescription that is included in the Catalogue of Ancient Classic Prescriptions （the Second Batch of Pediatrics） released by the National Administration of Traditional Chinese Medicine in 2022. This paper verifies and analyzes the historical origin， composition， dosage， processing， decoction method and efficacy of Yigongsan by systematically combing ancient books and modern documents. As a result， Yigongsan is composed of five herbs： Panax ginseng， Poria cocos， Atractylodes macrocephala， Citrus reticulata and Glycyrrhiza uralensis， of which P. cocos should be peeled， A. macrocephala is fried with soil， G. uralensis is roasted with honey while P. ginseng and C. reticulata are raw products. According to the dosage of ancient and modern times， each medicinal herb must be ground into fine powder， 1.6 g for each， added with 300 mL of water， 5 pieces of Zingiber officinale， and 2 Ziziphus jujuba， decocted together to 210 mL， and taken before meals. In ancient books， Yigongsan is used to treat vomiting， diarrhea， spleen and stomach deficiency， chest and abdominal distension， and lack of appetite， etc. Modern research showed that Yigongsan could also be used in the diseases of immune system， respiratory system， blood system， etc.， involving infantile anorexia， asthma， anemia， tumors and so on.

Maimendong decoction regulates M2 macrophage polarization to suppress pulmonary fibrosis via PI3K/Akt/FOXO3a signalling pathway-mediated fibroblast activation.

ETHNOPHARMACOLOGICAL RELEVANCE: Mai Men Dong decoction (MMDD), a traditional Chinese medicine formula, is relevant to ethnopharmacology due to its constituents and therapeutic properties. The formula contains herbs like Ophiopogon japonicus (Thunb.) Ker Gawl., Pinellia ternata (Thunb.) Makino, Panax ginseng C.A.Mey, Glycyrrhiza uralensis Fisch, and Ziziphus jujuba Mill, Oryza sativa L., which have been used for centuries in Chinese medicine. These herbs provide a comprehensive approach to treating respiratory conditions by addressing dryness, cough, and phlegm. Ethnopharmacological studies have explored the scientific basis of these herbs and identified active compounds that contribute to their medicinal effects. The traditional usage of MMDD by different ethnic groups reflects their knowledge and experiences. Examining this formula contributes to the understanding and development of ethnopharmacology. AIM OF THE STUDY: In the case of pulmonary fibrosis (PF), treating it can be challenging due to the limited treatment options available. This study aimed to assess the potential of MMDD as a treatment for PF by targeting macrophages and the PI3K/Akt/FOXO3a signaling pathway. MATERIALS AND METHODS: In a mouse model of PF, we investigated the effects of MMDD on inflammation, fibrosis, and M2 macrophage infiltration in lung tissue. Additionally, we examined the modulation of pro-fibrotic factors and key proteins in the PI3K/Akt/FOXO3a pathway. In vitro experiments involved inducing M2-type macrophages and assessing the impact of MMDD on fibroblast activation and the PI3K/Akt/FOXO3a pathway. RESULTS: Results demonstrated that MMDD improved weight, reduced inflammation, and inhibited M2 macrophage infiltration in mouse lung tissue. It downregulated pro-fibrotic factors, such as TGF-ß1 and PDGF-RB, as well as markers of fibroblast activation. MMDD also exhibited regulatory effects on key proteins in the PI3K/Akt/FOXO3a signaling pathway. CONCLUSIONS: MMDD inhibited M2 macrophage polarization and released profibrotic factors that inhibited pulmonary fibrosis. As a result, the PI3K/Akt/FOXO3a signaling pathway is suppressed. MMDD is proving to be a successful treatment for PF. However, further research is needed to validate its effectiveness in clinical practice.

Potassium-Based Dual-Ion Batteries Operating at -60 °C Enabled By Co-Intercalation Anode Chemistry.

Battery performance at subzero is restricted by sluggish interfacial kinetics. To resolve this issue, potassium-based dual-ion batteries (K-DIBs) based on the polytriphenylamine (PTPAn) cathode with anion storage chemistry and the hydrogen titanate (HTO) anode with K+ /solvent co-intercalation mechanism are constructed. Both the PTPAn cathode and the HTO anode do not undergo the desolvation process, which can effectively accelerate the interfacial kinetics at subzero. As revealed by theoretical calculations and experimental analysis, the strong K+ /solvent binding energy in the dilute electrolyte, the charge shielding effect of the crystal water, and the uniform SEI layer with high content of the flexible organic species synergically promote HTO to undergo K+ /solvent co-intercalation behavior. The special co-intercalation mechanism and anion storage chemistry enable HTO||PTPAn K-DIBs with superior rate performance and cycle durability, maintaining a capacity retention of 94.1% after 6000 cycles at -40 °C and 91% after 1000 cycles at -60 °C. These results provide a step forward for achieving high-performance energy storage devices at low temperatures.

Synergistic Effect of 2-(Trifluoromethyl) Benzimidazole on the Stability and Performance of Perovskite Solar Cells.

The quality of the perovskite active layer directly impacts the photovoltaic performance of perovskite solar cells (PSCs). Unfortunately, perovskite films produced through solution methods often have a significant number of defects on their surface, which lead to a substantial degradation in the performance of devices. For this reason, a multifunctional additive 2-(trifluoromethyl) benzimidazole (TFMBI) is introduced into perovskite films. Based on the Lewis acid/base coordination principle, the TFMBI double site cooperatively passivates surface defects, inhibiting carrier non-radiative recombination. Simultaneously, the hydrophobic solid group (-CF3) of TFMBI covers the surface, establishing a moisture-oxygen barrier and improving the environmental stability of the devices. In consequence, the power conversion efficiency (PCE) of TFMBI-modified PSCs reached 23.16%, significantly higher than the pristine one with a PCE of 20.62%. Additionally, the unencapsulated target device retained 90.32% of its initial PCE even after being reserved in the air with a relative humidity of 20-30% for 60 days.

High-Efficiency Carbon-based CsPbI2 Br Perovskite Solar Cells from Dual Direction Thermal Diffusion Treatment with Cadmium Halides.

In recent years, carbon-based CsPbI2 Br perovskite solar cells (PSCs) have attracted more attention due to their low cost and good stability. However, the power conversion efficiency (PCE) of carbon-based CsPbI2 Br PSCs is still no more than 16%, because of the defects in CsPbI2 Br or at the interface with the electron transport layer (ETL), as well as the energy level mismatch, which lead to the loss of energy, thus limiting PCE values. Herein, a series of cadmium halides are introduced, including CdCl2 , CdBr2 and CdI2 for dual direction thermal diffusion treatment. Some Cd2+ ions thermally diffuse downward to passivate the defects inside or on the surface of SnO2 ETL. Meanwhile, the energy level structure of SnO2 ETL is adjusted, which is in favor of the transfer of electron carriers and blocking holes. On the other hand, part of Cd2+ and Cl- ions thermally diffuse upward into the CsPbI2 Br lattice to passivate crystal defects. Through dual direction thermal diffusion treatment by CdCl2 , CdI2 and CdBr2 , the performance of devices has been significantly improved, and their PCE has been increased from 13.01% of the original device to 14.47%, 14.31%, and 13.46%, respectively. According to existing reports, 14.47% is one of the highest PCE of carbon-based CsPbI2 Br PSCs with SnO2 ETLs.

Congenital pulmonary alveolar proteinosis in a neonate / 中国当代儿科杂志

The male patient was referred to the hospital at 44 days old due to dyspnea after birth and inability to wean off oxygen. His brother died three days after birth due to respiratory failure. The main symptoms observed were respiratory failure, dyspnea, and hypoxemia. A chest CT scan revealed characteristic reduced opacity in both lungs with a "crazy-paving" appearance. The bronchoalveolar lavage fluid (BALF) showed periodic acid-Schiff positive proteinaceous deposits. Genetic testing indicated a compound heterozygous mutation in the ABCA3 gene. The diagnosis for the infant was congenital pulmonary alveolar proteinosis (PAP). Congenital PAP is a significant cause of challenging-to-treat respiratory failure in full-term infants. Therefore, congenital PAP should be considered in infants experiencing persistently difficult-to-treat dyspnea shortly after birth. Early utilization of chest CT scans, BALF pathological examination, and genetic testing may aid in early diagnosis.

Heart failure caused by congenital hepatic hemangioma complicated with arteriovenous fistula in a neonate / 中国当代儿科杂志

The three-day-old female infant was admitted to the hospital due to respiratory distress after birth. She was born premature at 36+2 weeks gestational age. Prenatal ultrasound suggested abnormal development of the fetal liver vessels, and she had dyspnea that required respiratory support after birth. Chest X-ray indicated an enlarged cardiac silhouette, and cardiac ultrasound revealed enlargement of the right atrium and right ventricle. Diagnosis of hepatic hemangioma with arteriovenous fistula was confirmed through liver ultrasound and abdominal enhanced CT. At 19 days old, she underwent ligation of the hepatic artery under general anesthesia, which led to an improvement in cardiac function and she was subsequently discharged. Genetic testing revealed a mutation in the ACVRL1 gene, which was inherited from the mother. The article primarily introduces a case of neonatal heart failure caused by hepatic hemangioma with arteriovenous fistula, and multi-disciplinary diagnosis and treatment of this disease.

Distribution of traditional Chinese medicine syndrome types and elements in liver cirrhosis patients with dysplastic nodules: An analysis of 138 cases / 临床肝胆病杂志

Objective To investigate the distribution of traditional Chinese medicine (TCM) syndrome types and elements in liver cirrhosis patients with dysplastic nodules (DN), and to provide a basis for exploring the connotation and pattern of TCM syndrome types of DN in liver cirrhosis. Methods A total of 138 patients who attended The First Affiliated Hospital of Henan University of Chinese Medicine from March 2013 to January 2021 and were diagnosed with liver cirrhosis and DN were enrolled. General data such as age of onset and sex were collected, as well as the data on etiology, TCM syndrome types, and Child-Pugh class for liver function, and the distribution characteristics of TCM syndrome types and elements were summarized. The chi-square test or the Fisher's exact test was used for comparison of categorical data between groups. Results The liver and the spleen were the main syndrome elements of disease location in liver cirrhosis patients with DN, accounting for 97.83% and 94.93%, respectively, followed by the kidney (23.91%); Qi deficiency and Qi stagnation were the main syndrome elements reflecting the nature of disease, accounting for 73.91% and 58.70%, respectively, followed by dampness (34.78%). The main TCM syndrome types included stagnation of liver Qi and spleen deficiency, damp-heat internal excess syndrome, blood stasis and toxin accumulation syndrome, and water-dampness retention syndrome, among which stagnation of liver Qi and spleen deficiency was more common and accounted for 58.70% ( P 0.05). There was a significant difference in Child-Pugh class between the liver cirrhosis DN patients with different TCM syndrome types ( χ 2 =34.320, P < 0.05), and Child-Pugh class A was more common in the patients with stagnation of liver Qi and spleen deficiency (59.8%), while Child-Pugh class C was more common in the patients with damp-heat internal excess syndrome (39.1%). Conclusion This article summarizes the distribution characteristics of common TCM syndrome types and elements of DN in liver cirrhosis, which provides a reference for the syndrome differentiation-based TCM treatment of DN in liver cirrhosis.

Association between sleep and obesity in adults / 预防医学

Objective@#To examine the associations of sleep with overweight/obesity and central obesity in adults, so as to provide insights into improving sleep quality and preventing obesity in adults.@*Methods@#Demographics, height, body weight, waist circumstance and sleep status were collected from the Hubei Provincial Surveillance Program for Adult Chronic Diseases and Their Risk Factors in 2020. Subjects' sleep condiction, overweight/obesity and central obesity were descriptively analyzed. The associations of sleep with overweight/obesity and central obesity were examined using a multivariable logistic regression model.@*Results@#A total of 17 789 participants were recruited, with an average age of (56.21±13.05) years, 61.50% women, and mean duration of (7.18±1.56) h/d. There were 7 019 participants with snoring/asphyxia/suffocation (39.46%), 6 108 participants with sleep difficulty (34.34%), 8 064 participants with night waking at least twice (45.33%), 268 participants taking hypnotics (1.51%), and 6 267 participants with early morning awakening and difficulty in sleep again (35.23%), and there were 8 960 participants with overweight/obesity (50.37%) and 6 148 participants with central obesity (34.56%). Multivariable logistic regression analysis showed that sleep duration of <7 h/d (OR=1.081, 95%CI: 1.007-1.159), snoring/asphyxia/suffocation (OR=2.367, 95%CI: 2.222-2.521), and night waking at least twice (OR=1.106, 95%CI: 1.028-1.191) significantly correlated with overweight/obesity, and sleep duration of >8 h/d (OR=0.834, 95%CI: 0.761-0.913), snoring/asphyxia/suffocation (OR=2.153, 95%CI: 2.019-2.297), and night waking at least twice (OR=1.193, 95%CI: 1.105-1.288) were statistically associated with central obesity.@*Conclusion@#Sleep duration, snoring/asphyxia/suffocation and night waking are associated with overweight/obesity and central obesity.

Effects of intranasal administration of tripterygium glycoside-bearing liposomes on behavioral cognitive impairment of mice induced by central nervous system inflammation / 中国中药杂志

Tripterygium glycosides liposome(TPGL) were prepared by thin film-dispersion method, which were optimized accor-ding to their morphological structures, average particle size and encapsulation rate. The measured particle size was(137.39±2.28) nm, and the encapsulation rate was 88.33%±1.82%. The mouse model of central nervous system inflammation was established by stereotaxic injection of lipopolysaccharide(LPS). TPGL and tripterygium glycosides(TPG) were administered intranasally for 21 days. The effects of intranasal administration of TPG and TPGL on behavioral cognitive impairment of mice due to LPS-induced central ner-vous system inflammation were estimated by animal behavioral tests, hematoxylin-eosin(HE) staining of hippocampus, real-time quantitative polymerase chain reaction(RT-qPCR) and immunofluorescence. Compared with TPG, TPGL caused less damage to the nasal mucosa, olfactory bulb, liver and kidney of mice administered intranasally. The behavioral performance of treated mice was significantly improved in water maze, Y maze and nesting experiment. Neuronal cell damage was reduced, and the expression levels of inflammation and apoptosis related genes [tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), BCL2-associated X(Bax), etc.] and glial activation markers [ionized calcium binding adaptor molecule 1(IBA1) and glial fibrillary acidic protein(GFAP)] were decreased. These results indicated that liposome technique combined with nasal delivery alleviated the toxic side effects of TPG, and also significantly ameliorated the cognitive impairment of mice induced by central nervous system inflammation.

Historical Evolution and Clinical Application of Famous Classical Formulas Zhulingtang / 中国实验方剂学杂志

The classic formula Zhulingtang, derived from the medical work Treatise on Cold Damage (《伤寒论》) compiled by ZHANG Zhongjing, a medical sage in the Eastern Han Dynasty, has been included in the Catalogue of Ancient Classic Formulas (First Batch) published by the National Administration of Traditional Chinese Medicine in 2018. Using the method of textual research, this study systematically reviewed ancient and modern literature to conduct a historical and textual analysis of Zhulingtang, including its origin, composition, dosage, processing, decoction methods, efficacy, and applications. A total of 733 pieces of relevant information related to Zhulingtang were collected, involving 206 ancient Chinese medical texts, with 52 of them providing detailed records of the composition, dosage, processing, and efficacy of Zhulingtang. The results of the analysis showed that Zhulingtang was composed of Polyporus, Poria, Alismatis Rhizoma, Asini Corii Colla, and Talcum. Polyporus and Poria should be used without their peels, Asini Corii Colla should be stir-fried with clam powder, and Talcum should be ground into powder or soaked in water. Based on the conversion of ancient and modern dosages, Polyporus, Poria, Alismatis Rhizoma, and Talcum, 15.63 g for each one, were decocted with 800 mL of water to 400 mL. Then the drug residue was removed, and 15.63 g of Asini Corii Colla was added to the drug juice for melting by heating. The decoction should be taken warm, 140 mL each time, three times a day. Zhulingtang has the effects of promoting diuresis, nourishing yin, and clearing heat, and it is mainly used to treat water-heat combination syndrome, characterized by symptoms such as difficult urination, fever, and thirst. Modern research indicates that Zhulingtang is commonly used to treat diseases such as cirrhotic ascites, chronic glomerulonephritis, nephrotic syndrome, diarrhea, and urinary tract infections. This study provides key information about the famous formula Zhulingtang, which can serve as a reference for further development and research on its application.

Mammary myofibroblastoma: a clinicopathological analysis of fifteen cases / 中华病理学杂志

Objective: To investigate the clinicopathological features, diagnosis and differential diagnosis of breast myofibroblastoma. Methods: The clinicopathological data and prognostic information of 15 patients with breast myofibroblastoma diagnosed at the Department of Pathology of the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China from 2014 to 2022 were collected. Their clinical characteristics, histological subtypes, immunophenotypes and molecular characteristics were analyzed. Results: There were 12 female and 3 male patients, ranging in age from 18 to 78 years, with a median and average age of 52 years. There were 6 cases in the left breast and 9 cases in the right breast, including 12 cases in outer upper quadrant, 2 cases in inner upper quadrant and 1 case in outer lower quadrant. Most of the cases showed a well-defined nodule grossly, including pushing growth under the microscope in 13 cases, being completely separated from the surrounding breast tissue in 1 case, and infiltrating growth in 1 case. Among them, 12 cases were classic subtype and composed of occasional spindle cells with varying intervals of collagen fiber bundles; eight cases had a small amount of fat; one case had focal cartilage differentiation; one case was epithelioid subtype, in which epithelioid tumor cells were scattered in single filing or small clusters; one case was schwannoma-like subtype, and the tumor cells were arranged in a significant palisade shape, resembling schwannoma, and one case was invasive leiomyoma-like subtype, in which the tumor cells had eosinophilic cytoplasm and were arranged in bundles, and infiltrating into the surrounding mammary lobules like leiomyoma. Immunohistochemical studies showed that the tumor cells expressed desmin (14/15) and CD34 (14/15), as well as ER (15/15) and PR (15/15). Three cases with histologic subtypes of epithelioid subtype, schwannoma-like subtype and infiltrating leiomyoma-like subtype showed RB1 negative immunohistochemistry. Then FISH was performed to detect RB1/13q14 gene deletion, and identified RB1 gene deletion in all three cases. Fifteen cases were followed up for 2-100 months, and no recurrence was noted. Conclusions: Myofibroblastoma is a rare benign mesenchymal tumor of the breast. In addition to the classic type, there are many histological variants, among which the epithelioid subtype is easily confused with invasive lobular carcinoma. The schwannoma-like subtype is similar to schwannoma, while the invasive subtype is easily misdiagnosed as fibromatosis-like or spindle cell metaplastic carcinoma. Therefore, it is important to recognize the various histological subtypes and clinicopathological features of the tumor for making correct pathological diagnosis and rational clinical treatment.

Analysis of characteristics of drug resistance gene mutation in HBV RT region of hepatitis B infected patients / 中华预防医学杂志

Objective: This article investigated the clinical characteristics and distribution of drug resistance mutation sites in HBV RT region of hepatitis B infected patients. Methods: Retrospective analysis was made on 1 948 patients with HBV infection, who had been tested for NAs resistance mutation and had a medical history of NAs in the Laboratory Department of the Fifth Medical Center of the PLA General Hospital from January 2020 to December 2021. Basic clinical information and drug resistance related mutation information were recorded. Meanwhile, the serological index data of hepatitis B were collected. Drug resistance gene mutant group and non-mutated group were grouped according to whether the drug resistance genes had a mutation in HBV RT region, and the clinical characteristics and genotype distribution of the two groups were statistically analyzed. The pattern of drug resistance gene mutation, number of mutation sites, drug resistance type and mutation of NAs resistance-related sites were analyzed in 917 patients with drug resistance gene mutation in HBV RT region. χ2 Inspection was used for counting data. Meanwhile, two independent samples t-test and Wilcoxon rank sum test were used for measurement data. Results: Among the 1 948 patients with chronic HBV infection, 917 patients had drug resistance gene mutation in RT region (47.07%). The proportion of patients with acute hepatitis B and CHB in HBV RT resistance gene mutant group was lower than that in the non-mutated group, while the proportion of patients with HBV-related cirrhosis was higher than that in the non-mutated group, these differences were statistically significant. Compared with the non-mutated group in HBV RT region, the age, the positive rates of HBeAg and HBV DNA, and HBV DNA load of these patients were increased in drug resistance gene mutant group, these differences were statistically significant. Genotypes of patients in both groups were dominated by C, followed by B and D. The proportion of patients with genotype C in HBV RT drug resistance gene mutant group was higher than that of non-mutated group, the difference was statistically significant. There were 53 gene mutation patterns in 917 patients with drug resistance gene mutation in HBV RT region, and the main pattern was rtL180M+rtM204V+rtS202G (9.70%). The mutation sites were dominated by 3 (20.74%). There were 5 types of drug resistance, LAM+Ldt (21.25%) was the most. Among the 18 sites that were clearly associated with LAM, ADV, ETV and Ldt resistance in the HBV RT region, 14 sites were mutated, and the most common mutation sites were rtL180M, rtM204V, rtM204 and rtS202G. what's more, the proportion of patients with NAs drug resistance was LAM>Ldt>ETV>ADV. Conclusion: In order to prevent adverse consequences of this study such as disease recurrence or disease progression caused by HBV drug resistance, HBV infected patients, who have long-term use of NAs antiviral therapy, should monitor the level of HBV DNA and drug resistance genes in HBV RT region in order to optimize the treatment plan in time or guide individualized treatment.