Pleomorphic hyalinizing angiectatic tumor originating in the nasal cavity: A CARE case report.

INTRODUCTION: Pleomorphic hyalinizing angiectatic tumor (PHAT) is a rare low-grade malignant mesenchymal neoplasm. It commonly occurs in the limbs and trunk, with limited occurrences in the head and neck region. Only five cases of PHAT occurring in the head and neck have been reported in the literature to date. The etiology of PHAT remains unclear. We described a case of nasal cavity PHAT following CARE guidelines. CASE SUMMARY: A 32-year-old male with PHAT originating in the nasal cavity recurred after two surgeries. Adjuvant radiotherapy was performed after the third surgery. The patient has been regularly followed up for 36months, and no tumor recurrence or metastasis has been observed. DISCUSSION: PHAT is a rare soft tissue tumor known for its local aggressiveness. Because of a high risk of recurrence, extensive resection should be implemented, possibly completed by radiotherapy if resection cannot be complete because of proximity to at-risk structures.

Study on stability of formation for gravity field exploration subjected to disturbance based on prescribed performance control.

Double satellite formation for gravity field exploration is a complex space virtual instrument system with high-precision, whose normal manner is threatened by the space debris environment. The normal manner of the formation based on control with prescribed performance is studied. Based on the random impact of space debris, nonlinear dynamical equations with 20 variables are established considering the relative attitude of the double satellite. The interferential characteristics and expected stability under certain disturbance conditions by the space debris in low Earth orbit are analyzed. To simplify the relative motion of the formation and the motion of the test mass (TM) relative to the cage, a prescribed performance function is introduced to constrain the relative attitude errors of transient and steady states. An adaptive attitude control design method based on a prescribed performance function is proposed. Finally, the analysis is carried out. The results show that the probability of normal manner of the formation is about 78.45% in the first year and about 45.59% in the first three years. The normal manner of the double satellite formation for gravity field exploration can be effectively simulated and analyzed based on the prescribed performance control methods.

Neuroprotective Effects of IVIG against Alzheimer' s Disease via Regulation of Antigen Processing and Presentation by MHC Class I Molecules in 3xTg-AD Mice.

BACKGROUND: The results of clinical trials for Alzheimer's disease (AD) patients treated with Intravenous immunoglobulin (IVIG) revealed inconsistency in efficacy. OBJECTIVE: To explore the neuroprotective effects and possible mechanisms of different IVIG in 3xTg-AD mice. METHODS: 3-month-old 3xTg-AD mice were administered intraperitoneally with different IVIG (A/B/C) for 3 months and then the therapeutic effects were observed and tested at 9 months of age. The bioavailability of IVIG and Aß40/42 concentrations in parietotemporal cortex was measured by ELISA. Behavioral tests were performed to examine cognitive functions. Immunohistochemistry was utilized to examine the deposition of Aß, the phosphorylation of tau, the levels of GFAP and Iba-1 in the hippocampus. Proteomics, Luminex assay and parallel reaction monitoring were performed to identify and verify the proteins that showed a marked change in the hippocampus. RESULTS: IVIG-C was more effective than IVIG-A and IVIG-B in counteracting cognitive deficits, ameliorating Aß deposits and tau phosphorylation, attenuating the activation of microglia and astrocytes in the hippocampus and inhibiting the secretion of pro-inflammatory factors. IVIG-C affected innate immunity and suppressed the activation of antigen processing and presentation by MHC class I molecule (APP-MHC-I). CONCLUSION: The efficacy of different IVIG on AD was significantly different, and only IVIG-C has been confirmed to possess significant neuroprotective effects, which are related to the inhibition of APP-MHC-I. IVIG may be a potential therapeutic for AD but further research is needed to evaluate the functional of IVIG before clinical trials of AD treatment.

[CIC-rearranged sarcoma with rhabdoid features: a clinicopathological analysis].

Objective: To investigate the histopathologic, immunohistochemical, molecular genetic characteristics of CIC-rearranged sarcoma (CRS) with rhabdoid features. Methods: The clinical and pathologic data of two cases of CRS diagnosed between 2019 and 2021 at the Department of Pathology, Jiangsu Province Hospital were analyzed. Immunohistochemical study and fluorescence in situ hybridization (FISH) were performed. The relevant literature was reviewed. Results: Both patients were female, one was 58 years old, with tumor located in left thigh; the other was 43 years old, with tumor located in left pelvic cavity. Microscopically, both tumors were composed of small to medium-sized round, oval cells, arranged in nodules or sheets. The tumor cells showed irregular nuclear outline, coarse chromatin with prominent nucleoli and brisk mitotic activity. Both cases showed rhabdoid phenotype with myxoid stromal changes. Immunohistochemically, both cases were positive for CD99 and c-myc. High WT1 reactivity was seen in classic area, with low reactivity in rhabdoid area. There was no INI1 lost in both cases. Both were negative for NKX2.2 and NKX3.1. By FISH both cases demonstrated convincing break-apart signals of CIC gene. One patient died of disease after 1 month, and the other died of disease after 3 months. Conclusions: CRS is a small round cell undifferentiated sarcoma of the bone and soft tissue defined by molecular genetic characteristics, and may show atypical morphologic and immunophenotypic characteristics such as rhabdoid features. A correct understanding of its rare morphologic and immunophenotypic characteristics, combined with molecular pathologic detection, is conducive to correct diagnosis.

[Complicated lymphatic anomaly: a clinicopathological analysis of four cases].

Objective: To investigate the clinicopathological features, clinical manifestations and different diagnosis of patients with complicated lymphatic anomaly. Methods: The clinical and pathologic data of four patients with complicated lymphatic anomaly diagnosed and treated in Peking Union Medical College Hospital from January 2000 to December 2021 were collected and analyzed. Results: One Gorham-Stout disease case and three generalized lymphatic anomaly cases were included in this cohort. Patients' ages ranged from 7 to 32 years. There were three males and one female. The positions of biopsy included three bone biopsy and one bronchus biopsy. Microscopically, all cases showed diffuse enlarged lymphatic channels. At the same time, osteogenesis was obvious in Gorham-Stout disease case. Radiologically, cortical loss was seen in Gorham-Stout disease, and lytic bone confined to the medullary cavity presented in generalized lymphatic anomaly. The three generalized lymphatic anomaly cases also had coagulopathy, and two had effusion. Conclusions: The histologic feature of complicated lymphatic anomaly was diffuse lymphatic malformation, and the diagnosis depends on clinical and pathologic information. The treatment and prognosis of these diseases are different, and therefore it is necessary to understand their clinical and pathologic features and make the correct diagnosis.

Unambiguous Experimental Verification of Linear-in-Temperature Spinon Thermal Conductivity in an Antiferromagnetic Heisenberg Chain.

The everlasting interest in spin chains is mostly rooted in the fact that they generally allow for comparisons between theory and experiment with remarkable accuracy, especially for exactly solvable models. A notable example is the spin-1/2 antiferromagnetic Heisenberg chain (AFHC), which can be well described by the Tomonaga-Luttinger liquid theory and exhibits fractionalized spinon excitations with distinct thermodynamic and spectroscopic experimental signatures consistent with theoretical predictions. A missing piece, however, is the lack of a comprehensive understanding of the spinon heat transport in AFHC systems, due to difficulties in its experimental evaluation against the backdrop of other heat carriers and complex scattering processes. Here we address this situation by performing ultralow-temperature thermal conductivity measurements on a nearly ideal spin-1/2 AFHC system copper benzoate Cu(C_{6}H_{5}COO)_{2}·3H_{2}O, whose field-dependent spin excitation gap enables a reliable extraction of the spinon thermal conductivity κ_{s} at zero field. κ_{s} was found to exhibit a linear temperature dependence κ_{s}∼T at low temperatures, with κ_{s}/T as large as 1.70 mW cm^{-1} K^{-2}, followed by a precipitate decline below ∼0.3 K. The observed κ_{s}∼T clarifies the discrepancies between various spin chain systems and serves as a benchmark for one-dimensional spinon heat transport in the low-temperature limit. The abrupt loss of κ_{s} with no corresponding anomaly in the specific heat is discussed in the context of many-body localization.

Analgesic dorsal root ganglion field stimulation blocks both afferent and efferent spontaneous activity in sensory neurons of rats with monosodium iodoacetate-induced osteoarthritis.

OBJECTIVES: Chronic joint pain is common in patients with osteoarthritis (OA). Non-steroidal anti-inflammatory drugs and opioids are used to relieve OA pain, but they are often inadequately effective. Dorsal root ganglion field stimulation (GFS) is a clinically used neuromodulation approach, although it is not commonly employed for patients with OA pain. GFS showed analgesic effectiveness in our previous study using the monosodium iodoacetate (MIA) - induced OA rat pain model. This study was to evaluate the mechanism of GFS analgesia in this model. METHODS: After osteoarthritis was induced by intra-articular injection of MIA, pain behavioral tests were performed. Effects of GFS on the spontaneous activity (SA) were tested with in vivo single-unit recordings from teased fiber saphenous nerve, sural nerve, and dorsal root. RESULTS: Two weeks after intra-articular MIA injection, rats developed pain-like behaviors. In vivo single unit recordings from bundles teased from the saphenous nerve and third lumbar (L3) dorsal root of MIA-OA rats showed a higher incidence of SA than those from saline-injected control rats. GFS at the L3 level blocked L3 dorsal root SA. MIA-OA reduced the punctate mechanical force threshold for inducing AP firing in bundles teased from the L4 dorsal root, which reversed to normal with GFS. After MIA-OA, there was increased retrograde SA (dorsal root reflex), which can be blocked by GFS. CONCLUSIONS: These results indicate that GFS produces analgesia in MIA-OA rats at least in part by producing blockade of afferent inputs, possibly also by blocking efferent activity from the dorsal horn.

[Identification and validation of hub genes in prostate cancer progression based on weighted gene co-expression network analysis].

OBJECTIVE: To identify the key hub genes in prostate cancer metastasis based on weighted gene co-expression network analysis (WGCNA) and verify the identified genes. METHODS: Whole-genome chip data GSE6919 of prostate cancer study were analyzed using principal component analysis (PCA), and the differentially expressed genes (DEGs) were analyzed using R software. WGCNA was performed to construct a gene co-expression network for screening the key genes. TCGA database was used to explore the expressions of the DEGs and their association with the prognosis. To validate the results, we designed siRNA fragments targeting the metastasis-related gene HNRNPA2B1, and observed its effect on growth, apoptosis, clone formation, migration and invasion of prostate cancer cell lines using MTT assay, flow cytometry, clone formation assay, and Transwell assay. RESULTS: PCA analysis showed obvious clustering of significant DEGs in metastatic cancer group. The modules obtained by WGCNA analysis in metastasis group involved stem cell differentiation, amino acid metabolism and immune response. Further screening of the genes identified 3 genes related with prostate cancer occurrence (BDH1, PAK4 and EXTL3) and another 3 with prostate cancer metastasis (NKTR, CTBP2 and HNRNPA2B1), which were shown to have differential expressions in TCGA database and were correlated with the patient's overall survival. In the cell experiment, PC3 and LNCap cells transfected with the siRNA fragment targeting HNRNPA2B1 showed obvious growth inhibition with increased cell apoptosis, lowered clone formation ability, and suppressed capacities for migration and invasion. CONCLUSION: We identified 3 hub genes related with the occurrence (BDH1, PAK4 and EXTL3) and another 3 with metastasis of prostate cancer (NKTR, CTBP2 and HNRNPA2B1) using WGCNA, which provides a new approach for studying the regulatory mechanisms of prostate cancer.

[Prognosis and related risk factors of acute respiratory distress syndrome in elder patients].

Objective: To study the risk factors associated with the hospital survival rate of elder patients with acute respiratory distress syndrome (ARDS) in Medical/Respiratory Intensive Care Units (MICUs/RICUs) by evaluating the prognosis, and therefore to provide insight into patient treatment strategy. Methods: Twenty MICUs/RICUs of 19 general hospitals in mainland China participated in the multicenter prospective cohort study carried out from Mar 1st, 2016 to Feb 28th, 2018. Patients who met the criteria of Berlin ARDS and older than 65 years were recruited. Baseline data, risk factors of ARDS, ventilator setup and prognosis data were collected from all patients. Univariant and multivariant regression analysis were conducted to analyze the factors associated with the prognosis. Results: 170 elder ARDS patients (age≥65 years) met the Berlin ARDS criteria, among whom 8.8% (15/170), 42.9% (73/170) and 48.2% (82/170) patients had mild, moderate and severe ARDS, respectively. The most common predisposing factor for elder ARDS was pneumonia, which was present in 134 patients (78.8%). 37.6% (64/170) patients were treated with noninvasive mechanical ventilation (NIV), but 43.8% (28/64) cases experienced treatment failure. 76.5% (130/170) patients were treated with invasive mechanical ventilation. All patients 80 years or older were given invasive mechanical ventilation. 51.8% (88/170) cases had complications of non-pulmonary organ failure. 61.8% (105/170) patients deceased during hospital stay. Multivariant logistic analysis showed that the independent risk factors for hospital survival rate in elder patients with ARDS were SOFA score (P=0.030, RR=0.725, 95% CI 0.543-0.969), oxygen index after 24 hours of ARDS diagnosis (P=0.030, RR=0.196, 95% CI 0.045-0.853), accumulated fluid balance within 7 days after diagnosis of ARDS (P=0.026, RR=1.000, 95% CI 1.000-1.000) and shock (P=0.034, RR=0.140, 95% CI 0.023-0.863). Conclusion: Among 20 ICUs, the high mortality rate of elder patients with ARDS was correlated with higher 24 hour SOFA score, lower 24 hour oxygen index after ARDS diagnosis, more positive fluid balance within 7 days and concomitant shock. The conservative fluid strategy within 7 days of ARDS diagnosis may benefit the elder ARDS patients.

[Comparison of two methods for detection of Chlamydia trachomatis and Ureaplasma urealyticum in male reproductive tract].

OBJECTIVE: To investigate the value of clinical application of simultaneous amplification and testing of RNA (SAT-RNA) for detecting Chlamydia trachomatis (CT) and Ureaplasma urealyticum (UU) by comparing with the polymerase chain reaction testing of DNA (PCR-DNA) method. METHODS: Specimens from both urethra swab and the first avoid urine which should be at least one hour after the previous urination were collected from 163 men who were scheduled for in vitro fertilization and embryo transfer (IVF-ET) treatment due to female factors at Center for Reproductive Medicine, Shengjing Hospital of China Medical University during the period of April 2016 to April 2017. Among the 163 men, 109 simultaneously provided semen that was collected after 3-7 days of sexual abstinence for the testing. Urine and semen specimens were detected for CT and UU with SAT-RNA, while urethra swab specimens were detected for CT and UU with standard PCR-DNA. Detection results of the SAT-RNA were compared with those of the PCR-DNA method. RESULTS: The positive rate of UU in the urethra swab detected with PCR-DNA and that of UU in the urine with SAT-RNA were 47.24% and 47.85%, respectively, and the coincidence rate was 93.25%. In addition, the positive and negative coincidence rates were 93.51% and 93.02%, respectively, and the concordance between the two methods was very good (Kappa=0.865). On the other hand, the positive rate of CT in the swab specimen tested with PCR-DNA was 3.07% and that of CT in urine with SAT-RNA was 4.29%, and the coincidence rate was 97.55%. Moreover, the positive and negative coincidence rates were 80.00% and 98.10%, respectively, and the concordance between the two methods was good (Kappa=0.654). Regarding SAT-RNA detection of UU in the urine and semen specimen of the 109 patients, the positive rates of UU in the urine and semen specimens were 50.46% and 44.95%, respectively; and the coincidence rate between the two specimens was 88.99%. In addition, the positive coincidence rate and the negative coincidence rate was 93.88% and 85.00%, respectively, and the concordance between the two specimens was good (Kappa=0.780). Similarly, SAT-RNA detection of CT in the urine and semen specimens showed the positive rate was 5.50% and 3.67%, respectively; and the two specimens showed 98.17% coincidence rate. The positive and negative coincidence rates were 100.00% and 98.10%, respectively, and the concordance was also good (Kappa=0.791). CONCLUSION: SAT-RNA detection of CT and UU in the urine specimen showed good concordance with the PCR-DNA detection of CT and UU in the urethra swab specimen. In addition, the concordance was also good between the urine and semen specimens detected with SAT-RNA. These results indicate that, as a less invasive and equally accurate procedure, SAT-RNA may be more suitable for clinical application.

[Choices of emergency treatment and surgical method for ruptured abdominal aortic aneurysms].

Objective: To investigate the emergency management process of ruptured abdominal aortic aneurysm (RAAA), and analyze the perioperative mortality factors of different surgical methods. Methods: The emergency data and hospitalization data of 91 patients with ruptured abdominal aortic aneurysm in Xiangya Hospital of Central South University from June 2010 to June 2019 were retrospectively analyzed.Twelve of the patients died preoperatively due to excessive blood loss, and the remaining 79 patients were hospitalized for open surgery (OSR) or endovascular repair (EVAR).The differences in age, time to hospital arrival, emergency preparation time, first creatinine value, emergency infusion volume, preoperative drop in blood pressure, preoperative use of vasoactive drugs and iliac artery involvement were compared between preoperative death group (n=12) and preoperative survival group (n=79), OSR group (n=50) and EVAR group (n=29), postoperative death group (n=23) and postoperative survival group (n=56). Results: Seventy-nine patients received open surgery or endovascular repair, and 23 died after operation. Age, time to hospital arrival, first creatinine value and emergency infusion volume were (77±11) years, (18±5)h, (469±150) µmol/L, (4 140±1 743) ml in the preoperative death group and (70±10) years, (12±8) h, (228±174) µmol/L, (1 358±1 211) ml in the preoperative survival group, respectively, and the differences were statistically significant (all P<0.05). There were no significant differences in preoperative data, intraoperative treatment and postoperative perioperative mortality between the open surgery group and the endovascular repair group (all P>0.05). The intraoperative blood loss, operation time and aortic occlusion rate in the endovascular repair group were 100 (50, 175) ml, (3.2±0.9) h, 13.8%, respectively, which were better than that in the open surgery group 1700 (600, 3425) ml, (5.2±1.1) h, 100%. The differences were statistically significant (all P<0.05). Age, emergency preparation time, first creatinine value, emergency infusion volume, blood pressure decline rate and vasoactive drug utilization rate in the death group were (77±8) years, (4.1±1.7) h, (456±172) µmol/L, (2 024±1 687) ml, 100%, 100%, respectively, and (68±10) years, (2.7±2.2) h, (135±26) µmol/L, (1 085±825) ml, 21.4%, 12.5% in the survival group, respectively. The differences were statistically significant (all P<0.05). Conclusions: Age, emergency preparation time, first creatinine value, emergency infusion volume, decreased blood pressure and use of vasoactive drugs are all associated with perioperative death in patients with ruptured abdominal aortic aneurysm. EVAR surgery is a better choice if conditions exist.

Effect and mechanism of propofol in hepatic ischemia/reperfusion injury of rat.

The article "Effect and mechanism of propofol in hepatic ischemia/reperfusion injury of rat, by L. Wei, W.-Y. Chen, T. Hu, Y.-X. Tang, B.-B. Pan, M. Jin, G.-Y. Kong, published in Eur Rev Med Pharmacol Sci 2017; 21 (15): 3516-3522-PMID: 28829487" has been withdrawn from the authors due to some technical reasons in the preparation of figures. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/13224.

Giant isotropic magneto-thermal conductivity of metallic spin liquid candidate Pr2Ir2O7 with quantum criticality.

Spin liquids are exotic states with no spontaneous symmetry breaking down to zero-temperature because of the highly entangled and fluctuating spins in frustrated systems. Exotic excitations like magnetic monopoles, visons, and photons may emerge from quantum spin ice states, a special kind of spin liquids in pyrochlore lattices. These materials usually are insulators, with an exception of the pyrochlore iridate Pr2Ir2O7, which was proposed as a metallic spin liquid located at a zero-field quantum critical point. Here we report the ultralow-temperature thermal conductivity measurements on Pr2Ir2O7. The Wiedemann-Franz law is verified at high fields and inferred at zero field, suggesting no breakdown of Landau quasiparticles at the quantum critical point, and the absence of mobile fermionic excitations. This result puts strong constraints on the description of the quantum criticality in Pr2Ir2O7. Unexpectedly, although the specific heats are anisotropic with respect to magnetic field directions, the thermal conductivities display the giant but isotropic response. This indicates that quadrupolar interactions and quantum fluctuations are important, which will help determine the true ground state of this material.

[Differentiate between the reference interval and the clinical diagnosis and treatment decision threshold for alanine aminotransferase].

The debate about whether the upper limit of normal for ALT should be lowered has been going on for nearly 20 years. However, the concept, the establishment method, and the application scope of reference interval are different from those of the clinical diagnosis and treatment decision threshold. We will differentiate the two concepts and review the related publications to help clinicians better apply the reference interval and the decision threshold for disease diagnosis and treatment.

Heat Transport in Herbertsmithite: Can a Quantum Spin Liquid Survive Disorder?

One favorable situation for spins to enter the long-sought quantum spin liquid (QSL) state is when they sit on a kagome lattice. No consensus has been reached in theory regarding the true ground state of this promising platform. The experimental efforts, relying mostly on one archetypal material ZnCu_{3}(OH)_{6}Cl_{2}, have also led to diverse possibilities. Apart from subtle interactions in the Hamiltonian, there is the additional degree of complexity associated with disorder in the real material ZnCu_{3}(OH)_{6}Cl_{2} that haunts most experimental probes. Here we resort to heat transport measurement, a cleaner probe in which instead of contributing directly, the disorder only impacts the signal from the kagome spins. For ZnCu_{3}(OH)_{6}Cl_{2}, we observed no contribution by any spin excitation nor obvious field-induced change to the thermal conductivity. These results impose strong constraints on various scenarios about the ground state of this kagome compound: while certain quantum paramagnetic states other than a QSL may serve as natural candidates, a QSL state, gapless or gapped, must be dramatically modified by the disorder so that the kagome spin excitations are localized.

[Application of antigen-free porcine peritoneum as carrier of autologous microskin grafting in patients with extensive burn].

Objective: To investigate the effects of microskin transplantation with antigen-free porcine peritoneum (AFPP) as substitutive carrier for allogeneic skin graft in treating patients with extensive deep burns. Methods: Medical records of 32 patients with extensive deep burns, hospitalized in Changhai Hospital of Naval Medical University meeting the inclusion criteria were investigated from January 2014 to December 2017. Twenty patients [12 males and 8 females, aged (35.4±2.2) years]with microskin transplantation using allogeneic skin graft as microskin carrier were included in allogeneic skin graft group and 12 patients [6 males and 6 females, aged (32.1±4.8) years] with microskin transplantation using AFPP as microskin carrier were included in AFPP group. On post injury day 3-7, the vital signs of patients were stable and escharectomy and autologous microskin grafting of head were performed. The expansion ratio of microskin, the application time of albumin and antibiotics, the percentage of infectious autologous microskin grafting area, the survival rate of microskin, and dressing change times of patients in 2 groups were recorded. Data were statistically analyzed with t test. Results: The expansion ratio of microskin of patient in AFPP group was 14.8±0.6, which was close to 13.5±0.6 of allogeneic skin graft group (t=1.531, P>0.05). The application time of albumin and antibiotics of patients in AFPP group were close to those of allogeneic skin graft group (t=0.027, 1.121, P>0.05). The percentage of infectious autologous microskin grafting area of patients in AFPP group was (8.5±1.2)%, which was significantly lower than (18.1±0.6)% in allogeneic skin graft group in 4 weeks after surgery(t=7.593, P<0.01), the survival rate of microskin of patients in AFPP group was (82.5±1.1)%, which was significantly higher than (72.5±0.6)% in allogeneic skin graft group (t=8.689, P<0.01). The dressing change time of patients in AFPP group was significantly less than that in allogeneic skin graft group (t=4.743, P<0.01). Conclusions: Compared with allogeneic skin graft, microskin transplantation with AFPP as carrier can reduce wound infection, improve the survival rate of microskin graft, and reduce dressing change time, so that AFPP is a good carrier of microskin.