Primary retroperitoneal angiosarcoma: A case report.

Angiosarcoma is a rare subtype of soft tissue sarcoma with identifiable vascular differentiation. It can occur at any age and develop throughout the body, but it is most commonly found in skin, soft, and breast tissues. Primary retroperitoneal angiosarcoma is rarely reported in the relevant literature. This article reports a case of primary retroperitoneal angiosarcoma in a middle-aged man, with the relevant literature reviewed in detail. A 46-year-old male had experienced left waist pain for 2 months. An ultrasonic examination revealed a mass in the left retroperitoneum, and left retroperitoneal lesions were confirmed via computed tomography (CT) and magnetic resonance imaging (MRI). The tumor was removed surgically, and the CT scan revealed local tumor recurrence after 1 month when the first adjuvant therapy was performed. The patient died of a massive hemorrhage from a ruptured tumor. Angiosarcoma has high malignancy and a poor prognosis. Its early diagnosis and treatment significantly impact the long-term survival rate of patients.

MCTS1 as a Novel Prognostic Biomarker and Its Correlation With Immune Infiltrates in Breast Cancer.

Multiple copies in T-cell lymphoma-1 (MCTS1) plays an important role in various cancers; however, its effects on patient prognosis and immune infiltration in breast cancer remain unclear. In this study, the expression profiles and clinical information of patients with breast cancer were obtained from the Cancer Genome Atlas (TCGA) database. Using the Wilcoxon rank-sum test, the MCTS1 expression levels were compared between breast cancer and normal breast tissues. Functional enrichment analyses were performed to explore the potential signaling pathways and biological functions that are involved. Immune cell infiltration was assessed using single-sample gene set enrichment analysis. The UALCAN and MethSurv databases were used to analyze the methylation status of the MCTS1. The Kaplan-Meier method and Cox regression analysis were used to identify the prognostic value of MCTS1. A nomogram was constructed to predict the overall survival (OS) rates at one-, three-, and five-years post-cancer diagnosis. MCTS1 was overexpressed in breast cancer and significantly associated with the M pathological stage, histological type, PAM50, and increased age. MCTS1 overexpression contributes to a significant decline in OS and disease-specific survival. Multivariate Cox analysis identified MCTS1 as an independent negative prognostic marker of OS. The OS nomogram was generated with a concordance index of 0.715. Similarly, the hypomethylation status of MCTS1 is also associated with poor prognosis. Functional enrichment analysis indicated that the enriched pathways included the reactive oxygen species signaling pathway, MYC targets, interferon alpha response, immune response regulating signaling pathway, and leukocyte migration. Moreover, the overexpression of MCTS1 was negatively correlated with the levels of immune cell infiltration of natural killer cells, CD8+ T cells, effector memory T cells, and plasmacytoid dendritic cells. Therefore, MCTS1 maybe a novel prognostic biomarker.

Superior trichloroethylene removal from water by sulfide-modified nanoscale zero-valent iron/graphene aerogel composite.

Sulfide-modified nanoscale zero-valent iron (S-nZVI) is a promising material for removal of organic pollutants from water, but S-nZVI nanoparticles (NPs) easily agglomerate and have poor contact with organic contaminants. Herein, we propose a new S-nZVI/graphene aerogel (S-nZVI/GA) composite which exhibits superior removal capability for trichloroethylene (TCE) from water. Three-dimensional porous graphene aerogel (GA) can improve the efficiency of electron transport, enhance the adsorption of organic pollutants and restrain the agglomeration of the core-shell S-nZVI NPs. The TCE removal rates of FeS, nZVI, GA and S-nZVI were 27.8%, 42%, 63% and 75% in 2 hr, respectively. Furthermore, TCE was completely removed within 50 min by S-nZVI/GA. The TCE removal rate increased with increasing pH and temperature, and TCE removal followed the pseudo-first-order kinetic model. The results demonstrate the great potential of S-nZVI/GA composite as a low-cost, easily separated and superior monolithic adsorbent for removal of organic pollutants.

[Analysis of HPA gene Polymorphisms in Children with Acute or Chronic ITP].

OBJECTIVE: To investigate the frequency distribution of human platelet antigen allele HPA-2 and HPA-15 among the pediatric patients with acute or chronic idiopathic thrombocytopenic purpura (ITP) in Chinese Guangxi area, and to explore the potential correlation of ITP with HPA-2 and HPA-15 gene polymorphisms. METHODS: The clinical and laboratorial data of 46 children diagnosed as acute ITP and 46 children diagnosed as chronic ITP between January 2007 and December 2014 were collected. Genotyping of HPA-2 and HPA-15 in 92 ITP patients and 48 healthy controls was performed by using polymerase chain reaction (PCR) combined with direct sequencing. RESULTS: The allele frequencies of HPA-2 and HPA-15 were significantly different among the acute, chronic and control groups; the allele frequencies were significantly different between the chronic ITP group and the control group (P<0.0167), while the difference was not statistically significant between the acute and chronic ITP groups as well as between the acute ITP and the control group (P>0.0167). CONCLUSION: The gene polymorphism of HPA-2 and HPA-15 may correlate with the risk of chronic ITP, but may not correlate with acute ITP in children.

Prognostic factors of early outcome in pediatric hemophagocytic lymphohistiocytosis: an analysis of 116 cases.

Early mortality remains a major challenge for the treatment of hemophagocytic lymphohistiocytosis (HLH), which warrants the need for prompt risk stratification in the early phase of the disease. We retrospectively analyzed clinical features of a cohort of pediatric patients managed at a tertiary hospital in southern China from 2005 to 2015. A total of 116 patients (median age 27.5 months) with predominantly secondary HLH were included. In a multivariate Cox regression model, neutrophils <0.5 × 10(9)/L (risk ratio (RR) = 5.01; 95 % confidence interval (CI) 1.55-16.20; P = 0.007), total bilirubin over twofold upper limit of normal value (RR = 2.86; 95 % CI 0.83-9.88; P = 0.097), and albumin ≤20 g/L (RR = 5.79; 95 % CI 1.70-19.73; P = 0.005) at diagnosis were independent risk factors for 30-day mortality. The 30-day overall survival rate (OS) of patients with three risk factors was significantly lower than that of patients with zero to two risk factors (0 vs 90.7 %; P<0.001). Patients with three risk factors were 64-fold more likely to have early adverse outcome as compared to patients with zero to two risk factors (RR = 64.45; 95 % CI 18.35-226.33; P<0.001). Platelet count normalization in 2 weeks was an independent predictor for resolution after initial therapy with an odds ratio (OR) of 18.4 (95 % CI 2.7-122.9; P = 0.003). Our results indicate that severe neutropenia and liver function damage are prognostic factors for early death in HLH and platelet count normalization in 2 weeks is a critical predictor for resolution after initial therapy.

[Association between gene polymorphisms of Perforin 1 and hemophagocytic lymphohistiocytosis].

OBJECTIVE: To investigate frequency distribution of gene polymorphisms of PRF1 gene in children with hemophagocytic lymphohistiocytosis (HLH), and to explore whether the possible gene polymorphisms of PRF1 gene confer an increased risk of susceptibility to HLH. METHODS: Forty-eight children who were diagnosed with HLH between January 2009 and December 2013 (HLH group) and 100 healthy children (control group) were enrolled in this study. The gene polymorphisms in the coding region of PRF1 gene, which consists of three exons and two introns, were genotyped by PCR, followed by direct sequencing. RESULTS: Three single nucleotide polymorphisms (SNPs) were revealed in the coding sequence of PRF1 in the 48 children with HLH. Seven SNPs were detected in the noncoding sequence. Other two SNPs in the noncoding sequence including rs10999426 and rs10999427 were detected only in 5 healthy children (5%). There was no significant difference in allelic frequencies of all the SNPs above between the HLH and control groups (P>0.05). Haplotype analysis showed there was a pair-wise linkage disequilibrium between rs10999426 and rs10999427 (D=1, r2=1), but there was no significant difference in the distribution of A-T haplotype between the HLH and control groups (P>0.05). CONCLUSIONS: There is no association between gene polymorphisms of PRF1 gene and the susceptibility to HLH. There is a pair-wise linkage disequilibrium between rs10999426 and rs10999427, but a low detection rate of A-T haplotype in healthy children indicates that it might not play a protective role in the development of HLH.

Two symptomatic cases of dysfibrinogenemia in China: one with gamma-chain Arg275Cys mutation and another without detectable mutation in fibrinogen genes.

The aim of this study was to investigate causative mutations of two unrelated symptomatic Chinese children with dysfibrinogenemia and their family members.Fibrinogen genes, including FGA, FGB and FGG of all participants were PCR-amplified, followed by direct sequencing. Precipitated plasma fibrinogen of some family members was analyzed by western blotting, fibrin polymerization and scanning electron microscopy (SEM).Proband 1 associated with frequent epistaxis was identified to harbor a heterozygous Arg275Cys mutation in FGG, along with a polymorphism Arg448Lys in FGB. Proband 2 with apparently prolonged thrombin time and very low functional fibrinogen had undergone both spontaneous intracranial hemorrhages and deep venous thrombosis. Sequencing of all proximal promoters, coding regions, introns and 3'-untranslated region using genomic DNA of Proband 2 yielded no mutation in three fibrinogen genes. Western blotting of this patient's precipitated plasma fibrinogen detected no truncated protein. Fibrinogen polymerization curve showed prolonged lag phase and severely decreased final turbidity, and SEM observations of fibrin clots made from Proband 2 revealed an abnormal sponge-like mass with large pores. We speculate that other underlying mechanisms responsible for dysfibrinogenemia such as abnormal posttranscriptional processing or posttranslational modification, which are independent of detectable mutations in the genomic DNA sequence, may exist.

Role of polymorphisms of GSTM1, GSTT1 and GSTP1 Ile105Val in Hodgkin and non-Hodgkin lymphoma risk: a Human Genome Epidemiology (HuGE) review.

Glutathione S-transferases (GSTs) are postulated to be involved in the detoxification of potential carcinogens, and gene variation may alter susceptibility to lymphomas. Results from several previous epidemiologic studies have been inconsistent. Hence a meta-analysis was conducted to verify the role of GST genetic polymorphisms in lymphoma risk. Eleven trials involving 1626 patients and 2892 controls were analyzed. Pooled results showed that the GSTT1 null polymorphism might increase the risk of lymphoma (odds ratio [OR] 2.26, 95% confidence interval [CI] 1.20, 4.24; p = 0.01; random-effects model), whereas the impact of GSTM1 and GSTP1 Ile105Val polymorphisms was not significant. Subgroup analysis showed the GSTT1 null genotype to be a risk factor for non-Hodgkin lymphoma (NHL) (OR 2.75, 95% CI 1.17, 6.45; p = 0.02; random-effects model) but not for Hodgkin lymphoma (HL), and the effect remained evident in females (OR 1.43, 95% CI 1.04, 1.97; p = 0.03; I(2) = 41.0%, p for heterogeneity = 0.15; fixed-effects model). An effect of GSTM1 and GSTT1 double null genotype on lymphoma risk was also shown (OR 2.09, 95% CI 1.31, 3.33; p = 0.01; random-effects model). In conclusion, the GSTT1 null genotype appears to be associated with a modest increase in the risk of NHL, whereas the GSTM1 and GSTP1 Ile105Val polymorphisms are unrelated to lymphoma risk.

The role of vitamin E (tocopherol) supplementation in the prevention of stroke. A meta-analysis of 13 randomised controlled trials.

It was the objective of this work to systematically evaluate the role of vitamin E supplementation in the prevention of stroke. Eligible studies were identified from Medline, Embase and Cochrane Library. The efficacy data is the relative risk (RR) for the events of stroke. Thirteen randomised controlled trials (RCTs), with 166,282 participants in total, were analysed. The pooled results showed no significant benefit in the vitamin E group with respect to stroke of any type (RR 1.01; 95% confidence interval [CI]: 0.96, 1.07); ischaemic stroke (RR 1.01; 95% CI: 0.94, 1.09), haemorrhagic stroke (RR 1.12; 95% CI: 0.94, 1.33), fatal stroke (RR 0.94; 95% CI: 0.77, 1.14), and non-fatal stroke (RR 0.99; 95% CI: 0.91, 1.08). Administration of vitamin E 300 IU/day or more also gain no benefit (RR 0.99; 95% CI: 0.92, 1.06), as well as vitamin E less than 300 IU (RR 1.05; 95% CI: 0.96, 1.15). Vitamin E supplementation gained benefit of preventing stroke for neither healthy people (0.92; 0.83, 1.03) nor others at high risks in baseline (RR 1.05; 95% CI: 0.98, 1.12). Administration of synthetic vitamin E gain no benefit (RR 1.02; 95% CI: 0.96, 1.09), as well as the natural source vitamin E (RR 0.99; 95% CI: 0.89, 1.09). In conclusion, there is a lack of statistically significant or clinically important benefit of vitamin E supplementation in the prevention of stroke.

Chronomodulated chemotherapy versus conventional chemotherapy for advanced colorectal cancer: a meta-analysis of five randomized controlled trials.

PURPOSE: The purpose of this study was to systematically compare the efficacy and safety of chronomodulated chemotherapy with conventional chemotherapy in patients with advanced colorectal cancer. METHOD: Eligible studies were identified from electronic databases (Medline, Embase, and the Cochrane Library). The efficacy data included overall survival (OS) and objective response rate (ORR), and toxicities data contained diarrhea, vomiting and nausea, mucositis, asthenia, and peripheral sensory neuropathy. The meta-analysis was performed with the fixed-effect model or random-effect model according to heterogeneity. RESULT: From 79 articles screened, five randomized controlled trials (RCTs) met the inclusion criteria contributing a total of 958 participants. There was a significant OS benefit (hazard ratio (HR)=0.82; 95% confidence interval (CI) 0.69 to 0.97; P=0.023) in favor of the chronomodulated chemotherapy. The ORR was not significantly different between two arms (relative risk=1.27; 95% CI 0.88 to 1.83; P=0.196). A higher incidence of grade 3/4 mucositis (odds ratio=2.26, 95% CI 1.34 to 3.83; P=0.724), asthenia (2.15, 1.30 to 3.56; P=0.428), and a lower incidence of grade 3/4 neutropenia (0.26, 0.16 to 0.42; P=0.641) were associated with the chronomodulated chemotherapy. The two arms were similar in terms of grade 3/4 diarrhea (1.10, 0.72 to 1.69; P=0.756), vomiting and nausea (0.69, 0.42 to1.13; P=0.239), and peripheral sensory neuropathy (0.56, 0.25 to 1.27, 0.164). CONCLUSION: Chronomodulated chemotherapy showed significant improvement in OS comparing with conventional chemotherapy. Side effects of the chronomodulated chemotherapy are predictable and manageable. But these results still need more high-quality RCTs for confirmation.

[Treatment of ulcerative colitis by combined therapy of retention enema and per-colonoscopic spraying with zhikang capsule compound liquid].

OBJECTIVE: To explore the therapeutic efficacy of patients with ulcerative colitis (UC) treated by retention enema and per-colonoscopic spraying of Zhikang Compound Liquid (ZKCL). METHODS: Eighty-six patients with UC were divided into two groups. The 52 patients in the treated group were treated for 4 courses of retention enema, the drug for enema used in the 1st course was ZKCL-A (consisted of normal saline, Zhikang capsule, gentamycin and dexamethasone) and smecta, in the 2nd course ZKCL-A alone, in the 3rd and 4th course, ZKCL-B (with the same contents of ZKCL-A but without dexamethasone), the enema was carried out once a day in the evening, 15 days as one course. Besides, local spraying of ZKCL-A and smecta were given once by colonoscopy before the 1st and 3rd course. The 34 patients in the control group were treated by salicylazosulfapyridine orally. RESULTS: In the treated group, 32 patients got complete remitted, 15 were treated effectively, 5 ineffectively, the total effective rate being 90.38% while the corresponding number in the control group were 8, 14, 12, and 64.71%, respectively. Significant difference was seen when compared with the therapeutic effects of the two groups. CONCLUSION Good efficacy was got in treating patients with UC by retention enema and per-colonoscopic spraying with ZKCL.

Treatment of ulcerative colitis by combined therapy of retention enema and per-colonoscopic spraying with zhikang capsule compound liquid / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the therapeutic efficacy of patients with ulcerative colitis (UC) treated by retention enema and per-colonoscopic spraying of Zhikang Compound Liquid (ZKCL).</p><p><b>METHODS</b>Eighty-six patients with UC were divided into two groups. The 52 patients in the treated group were treated for 4 courses of retention enema, the drug for enema used in the 1st course was ZKCL-A (consisted of normal saline, Zhikang capsule, gentamycin and dexamethasone) and smecta, in the 2nd course ZKCL-A alone, in the 3rd and 4th course, ZKCL-B (with the same contents of ZKCL-A but without dexamethasone), the enema was carried out once a day in the evening, 15 days as one course. Besides, local spraying of ZKCL-A and smecta were given once by colonoscopy before the 1st and 3rd course. The 34 patients in the control group were treated by salicylazosulfapyridine orally.</p><p><b>RESULTS</b>In the treated group, 32 patients got complete remitted, 15 were treated effectively, 5 ineffectively, the total effective rate being 90.38% while the corresponding number in the control group were 8, 14, 12, and 64.71%, respectively. Significant difference was seen when compared with the therapeutic effects of the two groups. CONCLUSION Good efficacy was got in treating patients with UC by retention enema and per-colonoscopic spraying with ZKCL.</p>