Multiple cutaneous carcinoma arising from arsenic-containing traditional Chinese medicine in a patient with psoriasis: A case report.

Background: Arsenic exposure is closely related to keratosis and cutaneous carcinoma, but a few studies have focused on patients with psoriasis presenting carcinoma after long-term medication of arsenic-containing traditional Chinese medicine (TCM). Case description: We presented a psoriasis patient showing multiple cutaneous carcinoma arising from arsenic containing TCM. A 60-year-old gentleman with psoriasis for nearly 30 years presented to our department with severe keratosis in hands, trunk and feet. He received oral administration of realgar (with As4S4 as the major component) for at least 15 years. There were keratotic plaques, ulcer and exudate in the middle finger and forefinger of left hand, and middle finger, forefinger and ring finger of the right hand. Moreover, brown papule was seen in right sole, together with keratotic plaques and ulcer in the left heel. Pathological analysis revealed basal cell carcinoma (BCC) in the anterior chest, right hand and right foot, Bowen disease in left hand and right hand, as well as squamous cell carcinomas (SCC) in right hand. Conclusion: This is a rare arsenic-exposure psoriasis patient showed coexistence of Bowen disease in left hand and right hand, BCC in the thoracic site, right hand and right foot, as well as SCC in right hand.

Multiple synchronous primary malignant neoplasms: A case report and literature review.

Multiple primary malignant neoplasms (MPMN) are defined as two or more primary malignancies diagnosed in an individual. There is no association between these cancers, which can be classified into synchronous and heterochronous cancers depending on the time of diagnosis. The present study presented a rare case of bilateral breast, endometrial, cervical and ovarian cancers. Through thorough physical examination, pathology and immunohistochemistry, it could be determined that bilateral breast, endometrial and cervical cancers were primary malignant tumors and that ovarian cancer cannot be excluded as a result of metastasis. the present study also summarized the definitions, risk factors, prevalence characteristics, diagnostic ideas and treatment options for MPMN by reviewing the literature.

Tamibarotene targets heparin-binding protein for attenuating lung injury in sepsis.

BACKGROUND: Excessively active pulmonary inflammation is a hallmark of sepsis-induced lung damage. A synthetic retinoid drug called tamibarotene reduces inflammation in a variety of conditions, including acute promyelocytic leukemia (APL), renal fibrosis, and neuroinflammation. Its effect on sepsis-related lung injury, however, has not been explained. PURPOSE: The purpose of the study was to investigate how tamibarotene affected lung damage induced by cecal ligation and puncture (CLP) procedure. METHODS: A CLP sepsis mouse model was developed, and tamibarotene was pretreated to determine whether it improved lung injury and survival. The degree of lung injury was evaluated using the Hematoxylin and eosin staining and lung injury score. In order to determine pulmonary vascular permeability, measurements were taken for total protein and cell content of bronchoalveolar lavage fluid (BALF), wet/dry ratio of the lung, and Evans blue stain. The BALF inflammatory mediators, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1ß, and IL-17A were discovered by enzyme-linked immunosorbent serologic assay (ELISA). Then, the levels of heparin-binding protein (HBP), and phospho-nuclear factor kappa-B (p-NF-κB) P65, and NF-κB P65 were determined using ELISA and Western blot analysis, respectively. RESULTS: Tamibarotene considerably increases survival and lessens lung damage stimulated by sepsis. Specifically, tamibarotene significantly relieves pulmonary vascular permeability and inhibits inflammation response in sepsis. Moreover, we further confirmed that these ameliorating effects of tamibarotene on sepsis may be exerted by targeting HBP and regulating the activation of NF-κB signaling pathway. CONCLUSION: These findings demonstrated that tamibarotene lessens sepsis-induced lung injury, and the effect could be exerted by targeting HBP and thereby deregulating the NF-κB signaling pathway.

Tamibarotene targets heparin-binding protein for attenuating lung injury in sepsis

Background: Excessively active pulmonary inflammation is a hallmark of sepsis-induced lung damage. A synthetic retinoid drug called tamibarotene reduces inflammation in a variety of conditions, including acute promyelocytic leukemia (APL), renal fibrosis, and neuroinflammation. Its effect on sepsis-related lung injury, however, has not been explained. Purpose: The purpose of the study was to investigate how tamibarotene affected lung damage induced by cecal ligation and puncture (CLP) procedure. Methods: A CLP sepsis mouse model was developed, and tamibarotene was pretreated to determine whether it improved lung injury and survival. The degree of lung injury was evaluated using the Hematoxylin and eosin staining and lung injury score. In order to determine pulmonary vascular permeability, measurements were taken for total protein and cell content of bronchoalveolar lavage fluid (BALF), wet/dry ratio of the lung, and Evans blue stain. The BALF inflammatory mediators, including tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), IL-1β, and IL-17A were discovered by enzyme-linked immunosorbent serologic assay (ELISA). Then, the levels of heparin-binding protein (HBP), and phospho-nuclear factor kappa-B (p-NF-κB) P65, and NF-κB P65 were determined using ELISA and Western blot analysis, respectively. Results: Tamibarotene considerably increases survival and lessens lung damage stimulated by sepsis. Specifically, tamibarotene significantly relieves pulmonary vascular permeability and inhibits inflammation response in sepsis. Moreover, we further confirmed that these ameliorating effects of tamibarotene on sepsis may be exerted by targeting HBP and regulating the activation of NF-κB signaling pathway. Conclusion: These findings demonstrated that tamibarotene lessens sepsis-induced lung injury, and the effect could be exerted by targeting HBP and thereby deregulating the NF-κB signaling pathway (AU)

BJBN： BERT-JOIN-BiLSTM Networks for Medical Auxiliary Diagnostic.

This study proposed a medicine auxiliary diagnosis model based on neural network. The model combines a bidirectional long short-term memory（Bi-LSTM）network and bidirectional encoder representations from transformers (BERT), which can well complete the extraction of local features of Chinese medicine texts. BERT can learn the global information of the text, so use BERT to get the global representation of medical text and then use Bi-LSTM to extract local features. We conducted a large number of comparative experiments on datasets. The results show that the proposed model has significant advantages over the state-of-the-art baseline model. The accuracy of the proposed model is 0.75.

Intensive Care Unit-Acquired Weakness: A Review of Recent Progress With a Look Toward the Future.

Intensive care unit-acquired weakness (ICU-AW), a common neuromuscular complication associated with patients in the ICU, is a type of skeletal muscle dysfunction that commonly occurs following sepsis, mobility restriction, hyperglycemia, and the use of glucocorticoids or neuromuscular blocking agents. ICU-AW can lead to delayed withdrawal of mechanical ventilation and extended hospitalization. Patients often have poor prognosis, limited mobility, and severely affected quality of life. Currently, its pathogenesis is uncertain, with unavailability of specific drugs or targeted therapies. ICU-AW has gained attention in recent years. This manuscript reviews the current research status of the epidemiology, pathogenesis, diagnosis, and treatment methods for ICU-AW and speculates the novel perspectives for future research.

Tumor budding, myofibroblast proliferation, and fibrosis in obstructing colon carcinoma: the roles of Hsp47 and basic fibroblast growth factor.

This study was designed to assess the mechanism of obstruction in obstructing colorectal carcinomas. Thirty-five cases of obstructing colorectal carcinoma and 34 cases of non-obstructing carcinoma were studied. The lesions were immunohistochemically analyzed using antibodies for pan-cytokeratin, α-smooth muscle actin, matrix metalloproteinase-7, 47-kDa heat shock protein (Hsp47), basic fibroblast growth factor (bFGF), myeloperoxidase, and CD68. Compared with non-obstructing cases, obstructing carcinoma cases included lesions of poorer differentiation. A higher value of tumor budding was observed in obstructing than in non-obstructing carcinoma. A higher number of α-smooth muscle actin-positive myofibroblasts, a higher expression of Hsp47 in stromal spindle cells, and a higher expression of bFGF in inflammatory cells were also significant in obstructing carcinoma. Therefore, obstructing colon carcinomas were characterized by poorer differentiation of cancer cells, a high level of tumor budding, and stromal myofibroblast proliferation resulting in fibrosis. Correlative Hsp47 expression in fibroblasts with bFGF in inflammatory cells may contribute to stromal fibrosis.

Age-related differences in microstructure, density and biomechanics of vertebral cancellous bone of Chinese males.

The conventional lumbar separation was performed by removing soft tissue, subsidiary structures and leaving only the vertebral body. The vertebral body was cut into two halves along the median sagittal plane, keeping the upper and lower end plates of each half, which were subsequently used for biomechanical, morphological and density experiments. From the age of 20-29 to 30-39 years, both the horizontal trabecular thickness (Tb.Th) and vertical Tb.Th decreased; the horizontal and vertical Tb.Sp increased; the plate-like trabecular Tb.Th decreased; the apparent density and volume ratio decreased; and the elastic modulus and the ultimate stress decreased; with all changes being statistically significant (p < 0.01). Similar trends were obtained from ages 40-49 to 50-59, although the changes were not significant (p > 0.05), except for the reduction in ultimate stress (p < 0.05). With aging, the collagen cross-linking capacity declined; the thicknesses of the collagen fibrils were variable, ranging from almost the same to loose, sparse or disordered thickness; and the finer collagen fibrils between the thick filaments were disorganized. In males aged from 20 to 59 years old, the horizontal and vertical Tb.Th and the plate-like Tb.Th of the vertebral body decreased, while the horizontal and vertical Tb.Sp increased. Additionally, the density, elastic modulus and the ultimate stress of the cancellous bone decreased with age. Thus, the associated changes of bone microstructure, density and biomechanics with age may lead to an increased risk of osteoporosis and fracture.

Morphometry research of deer, sheep, and human lumbar spine: feasibility of using deerand sheep in spinal animal models / Investigación morfometríca de la columna vertebral lumbar de ciervos, ovejas y humanos: factibilidad del uso de ciervos y ovejas como modelos animales de columna vertebral

Deer and sheep are used as spinal animal models in clinical and basic research. In this paper, the anatomical morphology, curvature, and morphology index parameters were investigated to assess the feasibility of using deer and sheep as animal models of the human spine. Fresh adult male sheep, deer, and human spine specimens (n = 10 each) were screened and subjected to morphological analyses. The statistical software package SPSS (version 17.0) was used to analyze the statistical similarity and variability among the 3 species. Deer displayed good similarity to human in terms of the vertebral transverse diameter, radius vector, spinal canal transverse diameter, radius vector, and vertebral upper and lower endplate curvature radii. Sheep displayed good similarity to human in terms of the vertebral body height, pedicle height, vertebral mid-lever curvature radius, and vertebral positive curvature radius. Human, deer, and sheep each displayed unique morphological characteristics and trends for the lumbar spine. These findings indicate that deer and sheep are good spinal animal models of human in morphometry, but with specific advantages in different research fields: deer are more suitable when studying vertebrae and endplate structures, while sheep are more suitable when referring to structures such as the vertebral walls.

Los ciervos y las ovejas se utilizan como modelos animales para la investigación clínica y básica de columna vertebral. En este trabajo, fueron investigados parámetros de morfología anatómica, curvatura e índice morfológico para evaluar la viabilidad de la utilización de ciervos y ovejas como modelos animales de la columna vertebral humana. Fueron examinados y sometidos a análisis morfológicos, especímenes frescos de columna vertebral (n = 10 cada uno) de ovejas y ciervos machos adultos, y columnas de individuos adultos humanos, de sexo masculino. Se utilizó el programa estadístico SPSS (versión 17.0) para analizar la similitud estadística y la variabilidad entre las 3 especies. Los ciervos muestran similitud con el humano en términos del diámetro vertebral transversal, vector radio, diámetro del canal espinal transversal, vector radio, y los radios de curvatura vertebral superior e inferior de la placa terminal. Las ovejas muestran similitud con el humano en cuanto a la altura del cuerpo vertebral, altura del pedículo, curvatura de radio vertebral medio, y el radio de curvatura vertebral positiva. Los humanos, ciervos y ovejas muestran características morfológicas y direcciones de la columna vertebral únicas. Estos hallazgos indican que los ciervos y las ovejas son buenos modelos animales en la morfometría de la columna vertebral humana, pero con ventajas específicas en diferentes campos de investigación: los ciervos son más adecuados en el estudio de las vértebras y las estructuras de placa terminal, mientras que las ovejas son más adecuados cuando se refiere a estructuras como las paredes vertebrales.

Corticotrophin-releasing factor inhibits neuromedin U mRNA expressing neuron in the rat hypothalamic paraventricular nucleus in vitro.

In the present study, we examined the effects of corticotrophin-releasing factor (CRF) on neuromedin U (NMU) mRNA-expressing neurons in the rat paraventricular nucleus (PVN) by whole-cell patch-clamp recordings and single-cell reverse transcription-multiplex polymerase chain reaction (single-cell RT-mPCR) techniques. In total, of 116 PVN putative parvocellular neurons screened for NMU mRNA, 14.7% (17/116) of them expressed NMU mRNA. The electrophysiological properties observed in the NMU mRNA-expressing neurons were generation of a low-threshold Ca(2+) spike (LTS) and robust low voltage-activated (T-type) Ca(2+) currents. Under current-clamp conditions, CRF (100 nM) induced a reversible decrease in spike firing and significantly diminished the LTS in 88.2% (15/17) of NMU mRNA-expressing neurons. Extracellular application of 1 µM α-helical CRF-(9-14) (α-hCRF), a selective CRF receptor antagonist, completely blocked the CRF-induced decrease in spike firing in the NMU mRNA-expressing neurons. Under voltage-clamp conditions, CRF (100 nM) significantly decreased the peak value of the T-type Ca(2+) currents by 35.6±7.8%. These findings suggest that CRF decreases neuronal excitability and diminishes T-type Ca(2+) currents in a population of rat PVN NMU phenotype neurons in vitro.

In vivo study of extracellular matrix coating enhancing fixation of the pedicle screw-bone's interface.

BACKGROUND: Based on in vivo research on the effect of the coating of the extracellular matrix composition of pedicle screws on the conduction and induction of bone formation in young sheep, the aim of this study was to investigate the application of coated pedicle screws in sheep with scoliosis whose spines are under constant development. METHODS: Four groups of pedicle screws were randomly implanted into bilateral L2-L5 pedicles of 2.5- to 3-month-old sheep. A static experiment was performed on one side and a loading test was performed on the other side by implanting connecting rods at the L2-L3 and L4-L5 segments. The changes in the force on the coated screws and the combination of the surface of the coated screws with the surrounding bone in the growth process of young sheep's spines with aging were observed. After 3 months, the lumbar vertebrae with the screws were removed and examined by micro-CT, histological, and biomechanical analyses. RESULTS: Under nonloading conditions, there is bone formation around the surfaces of coated screws. The bone forming on the surface of collagen/chondroitin sulfate/hydroxyapatite coating of pedicle screws is the most, the one of the collagen/chondroitin sulfate coating and hydroxyapatite coating is followed, and no significant difference between the two groups. In terms of the trabecular bone morphology parameters of the region of interest around the surface of the pedicle screws, such as bone mineral content, bone mineral density, tissue mineral content, tissue bone mineral density, bone volume fraction, and connection density, those associated with collagen/chondroitin sulfate/hydroxyapatite coatings are largest and those unassociated with coatings are smallest. Under nonloading conditions, the pullout strength of the collagen/chondroitin sulfate/hydroxyapatite-coated screws was largest, and that of the uncoated screws was minimal (P < 0.01). Under loading conditions, the maximum pullout strength of each group of pedicle screws was less than that of the pedicle screws in the nonloading state (P < 0.01) with no significant difference between the groups (P > 0.05). CONCLUSIONS: Under nonloading conditions, the coatings of both organic and inorganic components of the extracellular matrix of titanium pedicle screws can conduct or induce bone formation around the surface of the screws. The ability of collagen/chondroitin sulfate/hydroxyapatite coatings to induce bone formation is stronger; under loading conditions, a large amount of connective tissue formed around the surfaces of the screws in each group. No significant differences were found between the groups.

Feasibility of vertebral internal fixation using deer and sheep as animal models.

BACKGROUND: Studies on new vertebral internal fixations of animals are very important prior to clinical application. This study aimed to determine the feasibility of vertebral internal fixation on morphologic and biomechanical properties using deer and sheep as animal models and comparing to human data. METHODS: Thirty sets of fresh Sika deer lumbar, 30 sets of fresh sheep lumbar, and 20 sets of fresh lumbar from male cadavers were used. We examined the morphology of the centra and pedicles of the three groups, and determined the cancellous bone density and biomechanical properties in all groups. RESULTS: There were marked differences in all parameters measured between the different species. The sizes of the upper, middle, and lower transverse diameter were largest in the human, followed by the deer, then the sheep. The index of centrum transverse diameters and sagittal diameters were less than 0.8 (a triangle), and the deer was more similar to the human. The heights of the right vertebral pedicles and the anterior disc heights (IDH) were largest in the human, followed by the deer, then the sheep. The apparent density, elastic modulus, and ultimate load were largest in the sheep, followed by the deer, then the human. The range of motion (ROM) of functional lumbar units (FLUs) with a combined flexion-extension moment was largest in the human, followed by the deer then the sheep. CONCLUSIONS: The deer lumbar is more similar to that of human in anatomical form and biomechanics than the sheep lumbar. As such, deer is more appropriate as an animal model for use in vertebral internal fixation studies.