[Related factors of high-volume lymph node metastasis in multifocal papillary thyroid carcinoma].

Objective: To explore the related factors of high-volume lymph node metastasis (HVM) in multifocality papillary thyroid carcinoma (MPTC). Methods: The clinical and pathological data of multifocality papillary thyroid carcinoma (MPTMC, d≤10 mm) and MPTC (d>10 mm) collected from Hangzhou First People's Hospital from January 2010 to March 2023 were retrospectively analyzed. Univariate and multivariate logistic regression analysis were used to analyze the relevant factors of HVM. Results: Among 566 cases of MPTMC and 381 cases of MPTC, there were 72 males and 494 females in MPTMC, 106 males and 275 females in MPTC, respectively. The median age of the patients was 47 (39, 54) and 47 (34, 56) years, respectively, and the incidence of HVM was 4.6% (26/566) and 21.5% (82/381), respectively (χ2=64.588, P<0.001). Univariate analysis showed that in patients with MPTMC and MPTC, the incidence of HVM in males was higher than that in females [15.3% (11/72) vs 3.0% (15/494) (χ2=21.487, P<0.001) in MPTMC, 33.2% (35/106) vs 17.1% (47/275) (χ2=11.492, P=0.001) in MPTC]. The age of the HVM group was lower than that of the non-HVM group [41 (33, 50) vs 48 (39, 54) years (Z=-2.128, P=0.033) in MPTMC, 38 (29, 48) vs 48 (36, 57) years (Z=-4.987, P<0.001) in MPTC]. The maximum diameter of tumors in the HVM group were higher than those in the non-HVM group [7.0 (5.0, 10.0) mm vs 6.0 (5.0, 8.0) mm (Z=-2.558, P=0.011) in MPTMC, 17.5 (13.0, 25.0) mm vs 15.0 (12.0, 20.0) mm (Z=-2.871, P=0.004) in MPTC]. Multivariate logistic regression analysis showed that larger tumor size (OR=3.027, 2.378; 95%CI: 1.287-7.117, 1.404-4.030; P=0.011, 0.001), male (OR=5.398, 1.909; 95%CI: 2.284-12.758, 1.113-3.274; P<0.001, P=0.019), and younger age (OR=3.889, 3.136; 95%CI: 1.686-8.969, 1.837-5.355; P=0.001, P<0.001) were all risk factors for the occurrence of HVM in MPTMC and MPTC. Conclusion: The proportion of HVM in MPTC patients was higher than that in MPTMC, and larger maximum diameter, male gender and younger age are related factors for HVM in MPTMC and MPTC.

[Clinicopathological analysis of nuclear protein in testis midline carcinoma].

Objective: To investigate the clinicopathological features, immunophenotype and prognosis of nuclear protein in testis (NUT) midline carcinoma. Methods: Twenty-four resection cases of NUT midline carcinoma diagnosed at the Department of Pathology, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China from January 2018 to September 2022, were collected, and retrospectively analyzed for their clinicopathological characteristics. Relevant literature was reviewed. Results: All 24 cases of NUT midline carcinoma occurred in the chest or head and neck, including 14 men and 10 women, with a median age of 40 years. Histological examination showed that the tumors were poorly differentiated, with solid nested or sheet-like arrangement, small to medium-sized cells, sparse cytoplasm and coarse granular chromatin, including 5 cases with abrupt squamous epithelial differentiation. Immunohistochemistry showed that all 24 cases were positive for NUT protein, while 16 cases were p63 positive, 19 cases were p40 positive, 15 out of 18 cases were CK5/6 positive. Follow-up data were obtained for 21 patients (follow-up time range, 1-21 months), of which 11 survived, 10 died, and 3 were lost to follow-up. Conclusions: NUT midline carcinoma is a rare and highly aggressive malignancy with unique histological, immunophenotypic and molecular features. It has a poor prognosis.

[Clinicopathological features and prognostic impact of MELF pattern in 512 endometrioid adenocarcinoma].

Objective: To investigate the relationship of microcystic elongated fragmented (MELF) and clinicopathological features of patients with low grade endometrial endometrioid carcinoma, and to analyze its impact on prognosis. Methods: The clinical pathological data of 512 cases with low grade endometrial endometrioid adenocarcinoma were collected. The MELF invasive pattern in all of the sections were reappraised. The correlations between MELF pattern and clinicopathological features were analyzed by chi-square test, and the independent risk factor of lymph node metastasis were evaluated by Logistic multivariate regression analysis. Survival curves was drawn by Kaplan-Meier method, and Log-rank test was used to compare progression free survival (PFS) between patients with or without MELF pattern. Disease progression-related multivariate analysis was carried out by Cox proportional hazards model. Results: MELF pattern was observed in 12.9% (66/512) low grade endometrioid adenocarcinoma. It was significantly associated with cervical stroma invasion, more than half of the depth of myometrial invasion, lymph node metastasis and vessel invasion (P<0.05). In addition, MELF pattern was an independent risk factor for lymph node metastasis (P<0.05). The 5-year PFS of patients with and without MELF pattern were 95.0% and 96.0% respectively (P>0.05). Conclusions: The patients with MELF pattern are more likely accompany with cervical stroma and deeper myometrium invasion, vessel invasion, and lymph node metastasis, and it is an independent risk factor of lymph node metastasis. However, MELF pattern has no significant impact on prognosis of patients with endometrioid carcinoma.

[Regional distribution and clinicopathological characteristics of Epstein-Barr virus associated gastric cancer].

Objective: To investigate regional distribution and clinicopathological features of Epstein-Barr virus associated gastric cancer (EBVaGC). Methods: Epstein-Barr virus encoded RNA (EBER)was detected in 4 081 cases of gastric adenocarcinoma in Cancer Hospital, Chinese Academy of Medical Sciences by using in situ hybridization. EBVaGCs were identified and their proportions in different provinces, autonomous regions and municipalities were compared. The correlation between EBVaGC and clinicopathological features was also analyzed. Results: A total of 3.0% (123/4 081) patients with gastric adenocarcinoma are EBVaGCs. Among the areas with cases more than 90, the highest proportion of EBVaGC was found in Jilin province, accounting for 7.6%, and then followed by 5.4% in Liaoning province, 4.1% in Anhui province, 3.9% in Beijing, 3.7% in Inner Mongolia Autonomous Region, 3.4% in Shanxi province, 3.0% in Heilongjiang province, 2.1% in Shandong province, 1.6% in Hebei province, and no EBVaGC was found in Henan province. EBVaGC proportions are significantly different in these provinces, autonomous regions and municipalities (P<0.05). Multivariate analysis of logistic regression revealed that gender (OR=2.231, 95%CI: 1.290~3.858), WHO classification (OR=2.338, 95%CI: 2.051~2.664) and N stage (OR=0.420, 95%CI: 0.284~0.621) were independent impact factors for EBVaGC. The proportion of EBVaGC was higher in males, gastric carcinomas accompanied with lymphoid stroma and patients without lymph node metastasis. Conclusions: The proportion of EBVaGC in gastric adenocarcinoma displays area distribution disparity in China. The gender, WHO classification and N stage are closely associated with EBVaGC.

LncRNA NR027113 promotes malignant progression of gastric carcinoma via EMT signaling pathway.

OBJECTIVE: The aim of this study was to explore the characteristics of long noncoding RNA (lncRNA) NR027113 in gastric carcinoma, and to further investigate whether it could promote the development of gastric carcinoma via epithelial mesenchymal transition (EMT) signaling pathway. PATIENTS AND METHODS: Quantitative Real-time polymerase chain reaction (qRT-PCR) was performed to analyze the expression of NR027113 in 68 paired of gastric carcinoma and para-carcinoma tissues. Subsequently, the relationship between NR027113 expression and clinical indexes of gastric carcinoma as well as the prognosis of patients was analyzed. NR027113 expression in gastric carcinoma cells was detected by qRT-PCR as well. NR027113 knockdown model was constructed by lentivirus transfection in gastric carcinoma cells (including AGS and SGC-7901). Meanwhile, the effects of NR027113 on the biological functions of gastric carcinoma cells were analyzed by cell counting kit-8 (CCK-8), wound healing, transwell invasion and migration assay, respectively. Furthermore, the correlation between NR027113 and EMT signaling pathways was studied. RESULTS: QRT-PCR results showed that the expression level of NR027113 in gastric carcinoma tissues was significantly higher than that of para-carcinoma tissues. Compared with patients with low expression of NR027113, the incidence of lymph node metastasis and distant metastasis was significantly higher in patients with high NR027113 expression. Meanwhile, the survival rate of patients with low NR027113 expression was significantly lower. Compared with control group, the invasion and migration abilities of cells in NR027113 knockdown group were significantly decreased. Subsequent qRT-PCR results demonstrated that the expression of EMT signaling pathway-related proteins was significantly changed after transfection of sh-NR027113. The above finding indicated that NR027113 could inhibit the malignant progression of gastric carcinoma. Moreover, the addition of transforming growth factor-ß (TGF-ß) cytokines synergistically promoted the malignant progression of gastric carcinoma with NR027113. CONCLUSIONS: NR027113 expression was significantly increased in gastric carcinoma. Meanwhile, it was positively correlated with lymph node metastasis, distant metastasis and poor prognosis of gastric carcinoma patients. Furthermore, NR027113 could accelerate the invasion and migration abilities of gastric carcinoma cells via EMT signaling pathway.

Research on mechanism of PCS in damaging vascular endothelial cells and promoting formation of atherosclerosis via TLR4/TREM-1.

OBJECTIVE: The study aimed to explore the effects of p-cresyl sulfate (PCS) of damaging vascular endothelial cells and promoting the formation of atherosclerosis in mice. MATERIALS AND METHODS: The apolipoprotein E (ApoE)-/- mice were fed normally and with a high-fat diet; the ApoE-/- mice fed with high-fat diet were divided into two groups and treated with blank control and PCS, respectively. The aortic arch in each group was taken and underwent the oil red O staining, and the serum PCS content in each group was detected. The basic components of plaque were observed, including foam cells, lipid deposition, and cholesterol crystal. Moreover, human umbilical vein endothelial cells were cultured and divided into control group, PCS treatment group (PCS), PCS treatment with TLR4 overexpression group (PCS+TLR4+), and PCS treatment with TLR4 knock-out group (PCS+TLR4-). The degree of endothelial cell damage was detected using a cluster of differentiation CD42b-/CD31+ endothelial microparticles (EMPs), and expressions of Toll-like receptor 4 (TLR4), triggering receptor expressed on myeloid cells-1 (TREM-1), phosphorylated-endothelial nitric oxide synthase (p-eNOS), and tumor necrosis factor-α (TNF-α) in cells were detected via Polymerase Chain Reaction (PCR) and Western blotting. RESULTS: The serum PCS concentration in high-fat ApoE-/- mice was increased, and the aortic arch sections of ApoE-/- mice treated with PCS displayed the evident atherosclerotic plaques. Experimental results of human umbilical vein endothelial cells showed that the activity of human umbilical vein endothelial cells treated with PCS declined, the expression levels of TLR4, TREM-1, and TNF-α were increased, while that of p-eNOS was decreased. After the TLR4 knockout, the above effects of PCS were reversed. CONCLUSIONS: PCS damages vascular endothelial cells through TRL4/TREM-1, thereby accelerating the formation of atherosclerosis.

[Risk factors of postoperative major complication after spine deformity surgery].

OBJECTIVE: To analyze risk factors of major complications after spinal deformity surgery. METHODS: From January 2011 to December 2014, 254 consecutive patients undergone spinal deformity surgery , 68 male and 186 female, average age 22.1(3-73) years, were divided into two groups based on if they had major complications after surgery.Univariate and multivariate analysis (Logistic regression) were used to identify the risk factors. RESULTS: Among them, 29 patients had major complications after surgery.Univariate risk factors showed that medical history, scoliosis operation history, preoperative nerve injury, vertebral number of major curve, cobb of major curve, Kyphosis(>90°), time of operation, operative bleeding and osteotomy of group Ⅰ were higher or longer than those of group Ⅱ.Maximal voluntary ventilation (MVC) and orthopaedic rate of group Ⅰ were worse than those of group Ⅱ[(63.5%±23.9%)vs(76.7%±21.9%), (53%±23%) vs(68%±21%), P<0.05]. Logistic regression identified that preoperative nerve injury(OR=5.976), medical history>10 years (OR=4.095), MVC observed/predicted<50(OR=7.405), time of operation>5 h (OR=3.510), osteotomy(OR=3.472)were final risk factors for major complications. CONCLUSIONS: Major complications after surgery to treat spinal deformity can be predicted through preoperative nerve injury, medical history, maximal voluntary ventilation observed/predicted, time of operation and osteotomy during the surgery.The patients with these risk factors need more preoperative care and postoperative care to reduce the occurrence of major complications.

The role of 3D computed tomography (CT) imaging in the diagnosis of foreign body aspiration in children.

OBJECTIVE: The aim of this study was to improve the understanding of FBA in children and to decrease the rate of misdiagnosis, missed diagnosis and morbidity. PATIENTS AND METHODS: We analyzed the clinical features and the three-dimensional reconstructed CT images of 590 children with foreign body aspiration (FBA) in the Xuzhou area of the Jiangsu province. RESULTS: CT imaging revealed common complications of FBA including emphysema (n = 379), pneumonia (n = 174), and atelectasis (n = 26). The remaining 120 patients had no visible complications on the three-dimensional reconstructed CT images. Serious complications including pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumatorrhachis could also be observed. The types of foreign bodies were diverse: the most common were peanuts and sunflower seeds. The diagnostic accuracy of the three-dimensional CT imaging was high, with a sensitivity and specificity of 99.83% and 99.89%, respectively. CONCLUSIONS: 3D CT imaging is an accurate, non-invasive technique to evaluate children with suspected FBA that can help decrease the rate of misdiagnosis and eliminate a delay in treatment for this potentially life-threatening condition.

Magnetic resonance venography in the diagnosis of inferior vena cava obstruction in Budd-Chiari syndrome.

OBJECTIVE: To evaluate the informativeness of magnetic resonance venography (MRV) in the diagnosis of different types of inferior vena cava (IVC) obstruction. PATIENTS AND METHODS: 56 patients with IVC obstruction underwent MRV scans. These scans were evaluated for morphology of the obstruction and compared with digital subtraction angiography (DSA) images. RESULTS: Using DSA, we determined that 47 patients had complete obstruction and 9 had partial obstruction. MRV scans revealed 6 cases of partial obstruction. Using MRV, we determined the morphology of the proximal and distal ends of the complete obstructions in the IVC. We classified our observations into cone, plateau, and irregular subtypes. Both DSA and MRV scans were compared to assess the consistency between two methods. MRV demonstrated high sensitivity (100%) for diagnosing a complete obstruction of the IVC, and its specificity was 66.7%. The positive and negative predictive values of MRV were 94% and 100%, respectively. CONCLUSIONS: MRV imaging is a valuable alternative to DSA for detection of obstructions in the IVC in Budd-Chiari syndrome, particularly in the distal end, which could expedite the decision making for interventional treatment programmes. However, MRV imaging is less suitable for observing the morphology of the proximal ends of obstructions due to the limitations of the scanning plane and the influence of pseudo shadows.

The role of central arginine vasopressin in corticotropin releasing hormone-induced fever in rats.

The purpose of the present study was to investigate the role of central arginine vasopressin (AVP) in corticotropin releasing hormone (CRH) induced fever in the rat. Guide cannulae were inserted into the third ventricle and placed over the ventral septal area (VSA). The content of arginine vasopressin in the VSA of the brain was determined by radioimmunoassay. Colon temperature was monitored in lightly restrained rats by insertion of a catheter mounted thermistor probe 5 cm in the rectum. The results demonstrated that intracerebroventricular (icv) injection of CRH increased AVP level in the VSA and the colonic temperature of the rats. Microinjection of AVP V(1) antagonist into the VSA 10 min before CRH administration significantly enhanced CRH-induced febrile response, while AVP V(1) antagonist itself did not have a significant effect on the colonic temperature. Furthermore, injection of AVP into the VSA 5 min before CRH administration (icv) suppressed the fever evoked by CRH. These findings suggest that CRH is an important factor that stimulates the release of AVP in the VSA during fever, and endogenous AVP in the VSA has an antipyretic action on the CRH-induced fever.

[Studies on the mechanism of alpha-MSH in reducing IL-1 beta-induced fever].

The effect of alpha-melanocyte-stimulating hormone (alpha-MSH) on IL-1 beta-induced fever and release of hypothalamic cAMP was observed in the present work. The results showed that alpha-MSH markedly suppressed febrile response (P < 0.05) and decreased the cAMP content in hypothalamus in response to icv injection of IL-1 beta (P < 0.01). The cAMP content of the medium in which the hypothalamic was incubated for 40 min in the presence of IL-1 beta was significantly increased (P < 0.01). However, this increase action could be prevented by a pretreatment with alpha-MSH. The results indicate that the inhibitory effect of alpha-MSH on the enhanced synthesis and release of cAMP in hypothalamus exposed to IL-1 beta might be one of the mechanisms of suppressing fever induced by IL-1 beta.

Role of carbohydrate moieties in peanut (Arachis hypogaea) peroxidases.

The activities of a cationic (C.PRX) and an anionic peroxidase isolated from peanut (Arachis hypogaea)-cell suspension culture were drastically reduced when they were deglycosylated with glycopeptidase F or oxidized by 10 mM-periodate. In contrast with the controls, the deglycosylated or the oxidized peroxidases were much more susceptible to proteolytic degradation. In radiolabelling experiments with [35S]methionine, the non-glycosylated C.PRX was synthesized in the tunicamycin-treated cultures and secreted into the medium. Examination of the C.PRX polypeptides by SDS/polyacrylamide-gel electrophoresis followed by fluorography showed that the non-glycosylated form had an Mr of approx. 31,000, which is about 78% of that of the glycosylated form. Our results suggest that carbohydrates may not be essential for peroxidase secretion, but that stabilization of the peroxidase molecules and acquisition by these isoenzymes of a catalytically active conformation is linked directly or indirectly to glycosylation.

Immunological similarity of the cationic and the anionic peanut peroxidase isozymes.

Antibodies against both the native and the deglycosylated cationic peanut peroxidase (C.PRX) were used to probe the structural relationship of this isozyme with its anionic counterpart. Not only the native but also the deglycosylated forms of the cationic and the anionic peroxidases reacted with both antibodies. The activity of the cationic isozymes was inhibited by anti-native C.PRX. Similar but nevertheless distinct immunodetection patterns resulted from reaction of the partially digested cationic and anionic peroxidase peptides with antibodies directed to the deglycosylated as well as to the native C.PRX, suggesting a similarity in their polypeptide structures.

Characterization of epitopes on the cationic peanut peroxidase by four monoclonal antibodies.

The epitope sites on the cationic peanut peroxidase were characterized by four monoclonal antibodies raised against this isozyme. Evidence is presented showing that the epitope for monoclonal antibody 1B is located on the polypeptide. Sensitivity of the epitopes recognized by 1M and 2F to 0.1M HCl, boiling, 10 mM periodate and trifluoromethane sulfonic acid treatment indicate that they occur at regions where oligosaccharides are linked to the polypeptide backbone. The antigenic specificity of 2A is, in addition, dependent on the conformation of the epitope site which is destroyed after partial proteolysis of the peroxidase.