Application of rapid on­site evaluation in computed tomography­guided percutaneous transthoracic needle biopsy of pulmonary nodules of ≤2.0 cm in diameter.

Histopathological findings are the gold standard for diagnosing lung nodules, and Invasive diagnostic procedures such as percutaneous transthoracic needle biopsy (PTNB) are often inevitable for a confirmative diagnosis. However, the traditional biopsy method is inefficient for the diagnosis of small pulmonary nodules (diameter ≤2.0 cm). The present study aimed to investigate the application of rapid on-site evaluation (ROSE) in CT-guided PTNB of pulmonary nodules (≤2.0 cm in diameter). Data from patients undergoing PTNB in the Second Affiliated Hospital of Qiqihar Medical College between June 2018 and June 2021 were retrospectively analyzed. A total of 250 patients were included and divided into the ROSE (n=177) and the non-ROSE groups (n=73). The comparison of these two groups indicated significantly higher specimen adequacy [93.22% (165/177) vs. 71.23% (52/73)] and diagnostic accuracy [90.40% (160/177) vs. 68.49% (50/73)], as well as a significantly lower rate of secondary biopsies [5.08% (9/177) vs. 28.77% (21/73)], in the ROSE group. The coincidence rate between the diagnosis with ROSE and the final pathological results was 96.73%, indicating high consistency (κ=0.925). The results indicated that the application of ROSE in PTNB of pulmonary nodules with a diameter of ≤2.0 cm can ensure sufficient material sampling, improve the diagnostic accuracy and reduce the secondary biopsy rate, without increasing complications. ROSE can ensure high consistency with the results obtained from the pathological evaluation.

Comparison of CT findings and histopathological characteristics of pulmonary cryptococcosis in immunocompetent and immunocompromised patients.

Pulmonary cryptococcosis (PC) is a common fungal infectious disease, and infection can occur in patients with any immune function. To better understand PC, we compared the CT findings and histopathological results in immunocompetent and immunocompromised patients. The clinical data of 68 patients with PC were collected retrospectively and divided into the immunocompetent group and immunocompromised group. The clinical characteristics, CT manifestations and histopathological characteristics of the two groups of patients were compared. Forty-two patients (61.8%) were immunocompetent, and 26 patients (38.2%) were immunocompromised. Compared with immunocompromised patients, 57.14% (24/42) of immunocompetent patients were asymptomatic (p = 0.002). Compared with immunocompetent patients, cough (14/26, 53.9%) and fever (13/26, 50.0%) were the main symptoms in immunocompromised patients (p = 0.044, p = 0.007). Nodular lesions (97.6%, 41/42) were the most common CT type in immunocompetent patients, and the CT characteristic was a single lesion (25/42, 59.5%); the main histopathological type was nodular fibrogranuloma (30/42, 71.4%), and the main histopathological characteristic was inflammatory granuloma (31/42, 73.81%) formed by macrophage phagocytosis of Cryptococcus. Consolidation (15/26, 57.7%) was more common in the CT type of immunocompromised patients. Multiple lesions (24/26, 92.31%), air bronchial signs (19/26, 73.081%) and cavities (9/26, 34.62%) were the main CT characteristics. The mucinous colloid type (19/26, 73.1%) was its main histopathological type, which was mainly characterized by a small amount of surrounding inflammatory cell infiltration (17/26, 65.4%). There were significant differences in the classification and characteristics of CT and pathology between the two groups (p < 0.05). Through the CT manifestations and histopathological characteristics of PC under different immune function states, it was found that immune function has a significant impact on the CT manifestations and histopathological characteristics of patients with PC.

Identification of heterogeneous nuclear ribonucleoprotein as a candidate biomarker for diagnosis and prognosis of hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is the most common type of liver cancer with a high mortality rate. However, spliceosomal genes are still lacking in the diagnosis and prognosis of HCC. METHODS: Identification of differentially expressed genes (DEGs) was performed using the limma package in R software. Modules highly related to HCC were obtained by weighted gene co-expression network analysis (WGCNA), and the module genes were analyzed using the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. The biomarker for diagnosing HCC was determined by receiver operating characteristic (ROC) curve analysis, and the effect of the biomarker in the diagnosis of HCC was evaluated by performing five-fold cross-validation with logistic regression. HCC specimens from preoperatively treated patients were tested for biomarker by real-time quantitative polymerase chain reaction (RT-qPCR). Kaplan-Meier analysis was used to assess the relationship between biomarker and patient survival. The role of biomarker was evaluated using ESTIMATE analysis in the tumor microenvironment. RESULTS: In this study, 389 DEGs were screened out from three Gene Expression Omnibus (GEO) datasets. We also found that the turquoise module of 123 genes from The Cancer Genome Atlas (TCGA) data was the key module with the highest correlation with HCC traits. Then, 123 genes were analyzed using the KEGG enrichment pathway, and eight genes were found to be most significantly related to the spliceosome pathway. We selected 8 genes and 389 DEGs shared genes, and finally got the only gene, heterogeneous nuclear ribonucleoprotein (hnRNPU). The high expression of hnRNPU was associated with poor prognosis of HCC, and hnRNPU was a biomarker for diagnosing HCC. In the tissues of patients with excellent HCC treatment hnRNPU messenger RNA (mRNA) was lower than in the tissues of patients with poor HCC treatment. High expression of hnRNPU was significantly increased in HCC patients with low stromal (P<0.05), low immune (P<0.05), and low estimation scores (P<0.05), and with high tumor purity (P<0.05) and high malignant progression (P<0.05) of the HCC. CONCLUSIONS: The hnRNPU gene identified in this study may become a new biomarker for the diagnosis and prognosis of HCC.

Clinical Study on Effect of Solution Focused Approach on the Complications, Pain, Sleep, and Quality of Life in Patients with Hepatocellular Carcinoma Undergoing TACE.

OBJECTIVE: The objective of this study is to explore the effect of solution focused approach (SFA) on the complications, pain, sleep, and quality of life in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization (TACE). METHODS: Total of 106 patients with hepatocellular carcinoma who underwent TACE in our hospital from July 2019 to June 2020 were selected. According to the admission time, they were divided into the control group (n = 53) and the observation group (n = 53). The control group implemented routine nursing intervention, and the observation group implemented SFA on the basis of the control group. The clinical data, complications, pain, sleep status, and quality of life scores were compared between the two groups. RESULTS: The total incidence of complications in the observation group (16.98%) was lower than that in the control group (33.96%) (P < 0.05). There was no significant difference in the score of pain perception between the two groups (P > 0.05). The scores of sleep status in the observation group were lower than those in the control group (P < 0.05). The quality of life scores in the observation group was higher than that in the control group (P < 0.05). CONCLUSION: SFA can effectively reduce the complications, relieve pain, improve sleep status, and improve the quality of life in patients with hepatocellular carcinoma undergoing TACE.

miR-497 targets VEGF signal pathway to regulate proliferation, invasion and migration of hepatocellular carcinoma cells: a primary study using DEC-MRI.

PURPOSE: To quantify the expression of miR-497 and its target gene VEGF-B in patients with hepatocellular carcinoma (HCC), and microvascular invasion (MVI) to identify their relationship with clinicopathological characteristics and prognosis. METHODS: Imaging data of postoperative cancer and adjacent tissues of HCC patients with MVI diagnosed by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) were retrospectively analyzed. The expression of miR-497 in clinical samples and HepG2 and SMMC-7721 cell lines was quantified by quantitative PCR (Q-PCR). Correlations between miR-497 and patient survival and VEGF-B were explored in TCGA database. The invasion and migration of SMMC-7721 cells were tested by transwell assay. The binding sites between miR-497 and its target gene VEGF-B were verified by dual-luciferase reporter (DLR) assay, and VEGF-B levels were analyzed by western blot (WB). RESULTS: miR-497 showed a lower expression in HCC patients with MVI than those without MVI. It was also lowly expressed in HCC cell lines compared to normal liver cell lines. The proliferation and migration in HCC cells were inhibited by overexpression of miR-497, which were enhanced after transfection with miR-497 inhibitor. miR-497 had an effect on VEGF-B levels and there was a regulatory relationship between them. miR-497 was able to target VEGF-B and downregulate the receptor of VEGF-B (FLT-1). CONCLUSION: miR-497 was lowly expressed in HCC tissues, and its overexpression inhibited invasion and metastasis in HCC cells by suppressing VEGF-B levels. MiR-497 and its target gene VEGF-B are closely associated with the biological function and may serve as prognostic factors of MVI in patients with HCC.

miR-539 Targeting SNAI2 Regulates MMP9 Signaling Pathway and Affects Blood-Brain Barrier Permeability in Cerebrovascular Occlusive Diseases: A Study Based on Head and Neck Ultrasound and CTA.

This study aimed to explore the expression level of miR-539 in the blood-brain barrier permeability induced by cerebrovascular occlusion and its mediated mechanism. Altogether, 48 patients with cerebral vascular occlusion lesions from March 2018 to June 2020 were collected. The expression level of miR-539 in the peripheral blood serum of the subjects was analyzed by qRT-PCR, and the participants were divided into two groups according to the results of head and neck ultrasound and CTA hemodynamics. The MCAO model of cerebral ischemia was established in rats, and the expression level of miR-539 was detected by qRT-PCR in brain tissues of different groups of rats. The effects of miR-539 on the permeability of blood-brain barrier were investigated by intraventricular injection of agomiR-539 and antagomir-539. The model of blood-brain barrier was established by culturing brain microvascular endothelial cells and pericytes in vitro, and the changes of miR-539 expression level and permeability after glucose and oxygen deprivation were detected. The expression level of SNAI2/MMP9 signaling pathway protein in cells was detected by Western blot. Compared with the healthy control group, the expression level of miR-539 in peripheral blood of patients with cerebrovascular occlusive disease decreased significantly, and the expression level of miR-539 in the MCAO rat model decreased and affected the permeability of blood-brain barrier. Glucose and oxygen deprivation treatment in brain microvascular endothelial cells can lead to downregulation of miR-539 expression and affect cell permeability. miR-539 in brain microvascular endothelial cells can target and bind to SNAI2 and participate in the regulation of endothelial cell permeability by affecting the SNAI2/MMP9 signaling pathway. The results of this study suggested that circulating miR-539 in peripheral blood may be a potential marker for predicting blood-brain barrier permeability after ischemic stroke. More detailed studies are needed to determine its diagnostic value.