[Special histopathological variants and potential diagnostic traps of classical follicular dendritic cell sarcoma].

Objective: To investigate the clinicopathological features, special morphologic variants and potential diagnostic traps of classical follicular dendritic cell sarcoma (FDCS). Methods: A total of 25 cases of classical FDCS diagnosed in the First Hospital Affiliated to Army Medical University from 2006 to 2018 were examined by hematoxylin-eosin staining, immunohistochemistry and in situ hybridization for Epstein-Barr virus-encoded mRNA (EBER). Meanwhile, the types and characteristics of the special variants of FDCS were summarized along with those reported in the literature. Results: The age of patients ranged from 23 to 77 years (mean 52 years), the male to female ratio was 1.5, and the maximum diameter of tumor was 1.5 to 20 cm (mean 7.4 cm). Twelve cases (48%) were misdiagnosed at the initial evaluation. Follow-up information was available for 17 patients, and the follow-up time was 5 to 96 months. The propotion of patients having recurrence, metastasis and mortality was 3/17, 5/17 and 2/17, respectively. Microscopically, besides the typical morphology, 10 cases of FDCS showed special histomorphologies and/or structures, including those mimicking lymphoepithelioma-like carcinoma, desmoplastic infiltrating carcinoma, classical Hodgkin's lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and hemangiopericytoma. These morphologic variants were potential diagnostic pitfalls and warranted attention. Immunohistochemistry showed that more than two markers of follicular dendritic cells (such as CD21, CD23, CD35, etc.) were expressed in cases showing typical morphology and the special variants. All 25 cases were all negative for EBER by in situ hybridization. Conclusions: Classical FDCS is rare, besides the typical morphologic features, there are many special variants. In particular, these may be confused with lymphoepithelioma-like carcinoma in the nasopharynx, CHL or ALCL in the mediastinum/lymph node. Awareness of these variants is essential for accurate diagnosis.

Clinical analysis of hyperkalemic renal tubular acidosis caused by calcineurin inhibitors in solid organ transplant recipients.

WHAT IS KNOWN AND OBJECTIVE: Calcineurin inhibitor (CNI)-based immunosuppressive regimen is widely used for preventing rejection in solid organ transplantation. Hyperkalemic renal tubular acidosis (RTA) caused by CNI is uncommon and potentially underappreciated. We reported four such cases to increase awareness of this risk and to provide recommendations for its management based on our experience. CASE SUMMARY: Four middle-aged males underwent solid organ transplant (two kidneys, one liver, one heart) and were treated with CNI-based immunosuppressive regimen (one cyclosporine A, three tacrolimus). On post-operative day 13-35, hyperkalemic hyperchloremic non-gap metabolic acidosis developed. All patients had relatively preserved renal function, normal urine output and plasma aldosterone level. Reduction in CNI dosage was partly effective; the patient on cyclosporine A was treated with fludrocortisone, and two others temporarily switched to sirolimus (SRL). WHAT IS NEW AND CONCLUSION: We should alert for CNI-induced hyperkalemic RTA in transplant recipients. By CNI dosage reduction or adding low dose fludrocortisone, or temporarily switching to SRL, the prognosis of CNI-induced hyperkalemic RTA is favourable.

Laparoscopic kidney transplant by extra peritoneal approach: the safe transition from laboratory to the clinic.

The aim of this study is to develop a novel laparoscopic surgery by extra-peritoneal approach for kidney transplant and pave the way of safe transition from laboratory to the clinic. The study was established to explore the feasibility and safety of human laparoscopic kidney transplant. The experiment was first conducted on the deceased animals, then live animals and human cavader before human kidney transplant was approved. The study patient was a 49-year-old male who received the kidney for laparoscopic kidney transplant by extra-peritoneal approach. The control patient received the contralateral kidney for open kidney transplant. The estimated blood loss was minimal during surgery. Both kidneys experienced delayed graft function but the kidneys started function on Day 6 postoperation. The analgesia consumption was significantly less in the study patient. There is no surgical complication during 6-month follow-up. This study has developed a new technique for laparoscopic kidney transplant by extra-peritoneal approach. It has retained the advantages of open kidney transplant, which allows the graft located in the extra-peritoneal space without violating peritoneum. This study has also paved the way of safe transition for a novel laparoscopic surgery from laboratory to the clinic.

A triple SLC12A3 heterozygous mutations in Gitelman syndrome with renal calculi.

Background: Gitelman syndrome (GS) is a rare autosomal recessive salt-losing tubulopathy. Mutations in the SLC12A3 gene encoding the renal thiazide-sensitive Na/Cl cotransporter in the distal renal tubule, cause GS. Identifying biallelic inactivating mutations in the SLC12A3 gene is the most common finding in GS, while the detection of renal calculi is relatively rare. Case presentation: We report the case of a 33-year-old man admitted with recurrent limb weakness for six years. Laboratory tests showed hypokalemic alkalosis, hypocalciuria and renal potassium wasting; serum magnesium and aldosterone were normal, and ultrasound and computed tomography scans showed right-sided renal calculus. A hydrochlorothiazide test was performed, which showed a blunted response to hydrochlorothiazide. Next-generation sequencing identified triple mutations in SLC12A3, including novel splicing heterozygous mutations (c.2285+2T>C). He was administered with oral potassium chloride and spironolactone and maintained mild symptomatic hypokalemia during his follow-up. Conclusions: The patient was diagnosed with Gitelman syndrome by genetic testing, accompanied by kidney stones. Although kidney stones are rare in Gitelman syndrome, they are not excluded as a criterion. The composition of kidney stones may be of significance for diagnosis and treatment. HIPPOKRATIA 2023, 27 (2):64-68.

[Artificial intelligence technology enables ultrasonography in precision diagnosisand treatment of liver diseases].

Liver disease is one of the major problems affecting human health. Ultrasound plays an important role in diagnosis and treatment of diffuse and focal liver diseases. However, conventional ultrasound evaluation is subjective and provides limited information. Artificial intelligence (AI) technology may supplement the disadvantages of conventional ultrasound and has been widely used in the field of ultrasound in liver diseases. To date, remarkable progress has been achieved for the use of AI technology in the diagnosis, assessment of therapeutic efficacy and prognosis prediction of liver diseases. This paper reviews the research progress of ultrasound image-based AI technology in the diagnosis and treatment of diffuse and focal liver diseases.

Preliminary dosimetric analysis of DOTA-folate radiopharmaceutical radiolabelled with 47Sc produced through natV(p,x)47Sc cyclotron irradiation.

47Sc is one of the most promising theranostic radionuclides, thanks to its low energy γ-ray emission (159 keV), suitable for single photon emission computed tomography imaging and its intense ß - emission, useful for tumour treatment. Despite promising preclinical results, the translation of 47Sc-therapeutic agents to the clinic is hampered by its limited availability. Among different 47Sc-production routes currently being investigated, the natV(p,x)47Sc reaction has proved to be of particular interest, thanks to the low-cost and easy availability on the market of natV material and the diffusion of medium energy proton cyclotrons. However, the cross section of this specific nuclear reaction is quite low and small amounts of Sc-contaminants are co-produced at energies E P ≤ 45 MeV, namely 48Sc and 46Sc. The main concern with these Sc-contaminants is their contribution to the patient absorbed dose. For such a reason, the absorbed dose contributions to healthy organs and the effective dose contributions by the three radioisotopes, 48Sc, 47Sc and 46Sc, were evaluated using DOTA-folate conjugate (cm10) as an example of radiopharmaceutical product. Considering as acceptable the limits of 99% for the radionuclidic purity and 10% for the contribution of radioactive Sc-contaminants to the total effective dose after 47Sc-cm10 injection, it was obtained that proton beam energies below 35 MeV must be used to produce 47Sc through irradiation of a natV target.

No association of interleukin-1 receptor antagonist VNTR polymorphism and rheumatoid arthritis susceptibility: a meta analysis.

OBJECTIVES: Interleukin-1 receptor antagonist (IL-1Ra) is a natural anti-inflammatory molecule that blocks the action of IL-1 signaling. A variable-number tandem repeat polymorphism (VNTR) in IL-1Ra gene (IL-1RN) intron 2 has been reported to be associated with rheumatoid arthritis (RA), with inconsistent results. Here, we perform a meta-analysis to assess the common effect size of this polymorphism on RA susceptibility. METHODS: Case-control studies on IL-1RN VNTR association with RA were searched up to January 2010. The effect summary odds ratio (OR) and 95% confidence intervals was obtained by meta- analysis. RESULTS: A total of 15 studies involving in IL-1RN VNTR with RA susceptibility were included in this meta-analysis. No association between A2/A2 genotype and risk of RA to other genotypes (odds ratio [OR], 0.96; 95% CI =0.75-1.24, p=0.77), and between A2 allele and risk of RA (OR, 0.98; 95% CI=0.83-1.16, p=0.85), were demonstrated in the total meta-analysis. In both Asian and European subgroups, the overall effect of A2/A2 genotype and A2 allele also showed no significant difference. CONCLUSIONS: This meta-analysis demonstrates that the IL-1RN VNTR polymorphism is not related to susceptibility to RA.

Radioisotopic purity and imaging properties of cyclotron-produced 99mTc using direct 100Mo(p,2n) reaction.

Evaluation of the radioisotopic purity of technetium-99m (99mTc) produced in GBq amounts by proton bombardment of enriched molibdenum-100 (100Mo) metallic targets at low proton energies (i.e. within 15-20 MeV) is conducted. This energy range was chosen since it is easily achievable by many conventional medical cyclotrons already available in the nuclear medicine departments of hospitals. The main motivation for such a study is in the framework of the research activities at the international level that have been conducted over the last few years to develop alternative production routes for the most widespread radioisotope used in medical imaging. The analysis of technetium isotopes and isomeric states (9xTc) present in the pertechnetate saline Na99mTcO4 solutions, obtained after the extraction/purification procedure, reveals radionuclidic purity levels basically in compliance with the limits recently issued by European Pharmacopoeia 9.3 (2018 Sodium pertechnetate (99mTc) injection 4801-3). Moreover, the impact of 9xTc contaminant nuclides on the final image quality is thoroughly evaluated, analyzing the emitted high-energy gamma rays and their influence on the image quality. The spatial resolution of images from cyclotron-produced 99mTc acquired with a mini-gamma camera was determined and compared with that obtained using technetium-99m solutions eluted from standard 99Mo/99mTc generators. The effect of the increased image background contribution due to Compton-scattered higher-energy gamma rays (E γ > 200 keV), which could cause image-contrast deterioration, was also studied. It is concluded that, due to the high radionuclidic purity of cyclotron-produced 99mTc using 100Mo(p,2n)99mTc reaction at a proton beam energy in the range 15.7-19.4 MeV, the resulting image properties are well comparable with those from the generator-eluted 99mTc.

Diagnostic value of joint detection of homocysteine and RDW CV on acute myocardial infarction.

The article "Diagnostic value of joint detection of homocysteine and RDW CV on acute myocardial infarction" by G.-X. Hu, J. Zhang, Y.-G. Tian, Y.-H. Li, L. Mou, L.-J. Qiao, published in Eur Rev Med Pharmacol Sci 2016; 20 (19): 4124-4128 has been withdrawn.

Diagnostic value of joint detection of homocysteine and RDW CV on acute myocardial infarction. Retracted.

OBJECTIVE: We discussed the diagnostic value of joint detection of homocysteine (HCY) and red blood cell volume distribution width variable coefficient on acute myocardial infarction (AMI). PATIENTS AND METHODS: We collected 300 coronary heart disease cases, among which there were 121 cases of stenocardia, 65 cases of ischemic heart failure, and 114 cases of AMI at the Department of Cardiology of our hospital during the period from January 2012 to June 2013. At the same time, we took 100 normal physical examinees as the control group, used the full-automatic cell-analyzer and the immunization to measure HCY and red blood cell distribution width (RDW) CV respectively and analyze their value in diagnosing AMI. RESULTS: The differences among the four groups of HCY and RDW CV were statistically significant (p < 0.05). The HCY and RDW CV level in the AMI group were significantly higher than those of the other three groups (p < 0.05); the differences between the positive diagnosis rate of HCY, the RDW CV and their joint diagnosis in the AMI group were statistically significant (p < 0.05) while the differences between the positive diagnosis rate of HCY, the RDW CV and their joint diagnosis in the control group were not statistically significant (p > 0.05). The detection sensitivity and specificity of HCY alone were respectively 68.42% and 86.00% with those of the RDW CV alone being 64.91% and 84.00%. The joint detection sensitivity and specificity were 83.33% and 93.00%, statistically different (p < 0.05). The concordance rate, the positive predictive value and the negative predictive value were 87.85%, 93.14% and 83.04%, respectively. CONCLUSIONS: The HCY and RDW CV joint diagnosis of AMI had relatively high sensitivity, specificity, concordance rate, positive predictive value and negative predictive value.

Inhibition of mTOR suppresses human gallbladder carcinoma cell proliferation and enhances the cytotoxicity of 5-fluorouracil by downregulating MDR1 expression.

OBJECTIVE: Although 5-fluorouracil (5-FU) is widely used in the treatment of various cancers, drug resistance remains a limitation for its anti-cancer activity. Mammalian target of rapamycin (mTOR) is deregulated in diverse human cancers, including gallbladder carcinoma and mTOR inhibitors show promising anti-cancer activities with proliferation inhibitory effects. This study aims to clarify the benefit of the combination of 5-FU and the mTOR inhibitor, OSI-027, on gallbladder carcinoma cell proliferation. MATERIALS AND METHODS: Two gallbladder carcinoma cell lines and two agents (5-FU and OSI-027) were used in the present study. Cell counting kit-8 assays and EdU staining were performed to examine the proliferation of cancer cells. The expression of MDR1 protein was determined by western blot analysis. RESULTS: The combination of OSI-027 with 5-FU showed a synergistic anti-proliferative effect on the gallbladder cancer cells, RBE and GBC-SD cells. Upon 5-FU treatment, MDR1 expression was upregulated and OSI-027 could reverse 5-FU-induced MDR1 upregulation. Moreover, MDR1 depletion sensitized gallbladder carcinoma cells to 5-FU stimulation and attenuated the synergistic effect of OSI-027 and 5-FU. Finally, we determined that OSI-027 downregulated MDR1 expression by suppressing its synthesis rather than by promoting its degradation. CONCLUSIONS: Dual mTORC1/mTORC2 inhibitors such as OSI-027 are promising therapeutic agents in combination with 5-FU for the treatment of human gallbladder cancer.

Does live music benefits patients with brain and spinal injury?

OBJECTIVE: The purpose of this study is to examine the feasibility and prospective success associated with implementing and evaluating a six-week live music intervention on an inpatient neurorehabilitation ward. PATIENTS AND METHODS: In total 26 patients were included in this study. Out of which, 15 were patients and 11 were staff members. Staff participants completed wellbeing measures at before and after music. Patients completed an assortment of validated measures at five consecutive time points from baseline to follow-up. Staff participants experienced a minor decrease in wellbeing over time. RESULTS: The majority of the data collected from patients illustrated positive trends, with improvements in wellbeing, pain, cognition functioning, independent functioning, and mobility. The feasibility indicates that with modifications that this project is a viable venture. CONCLUSIONS: We found that live music appears to be promising new addition to neurorehabilitation.

Clinical evaluation of the efficacy of the combination of aneurysm embolization and cerebrospinal fluid replacement in the treatment of aneurysmal subarachnoid hemorrhage.

OBJECTIVE: To explore the clinical efficacy of aneurysm embolization and cerebrospinal fluid (CSF) replacement in the treatment of aneurysmal subarachnoid hemorrhage (SAH). PATIENTS AND METHODS: Seventy-nine patients with grade III-IV aneurysmal subarachnoid hemorrhage, who were treated in the hospital from Jan. 2012 to Jan. 2014, were included in this study. These patients were treated with different methods based on the cause of disease and the treatment chosen by their families. In the treatment group, 42 patients received aneurysm embolization and cerebrospinal fluid replacement, while 37 patients in the control group received simple aneurysm embolization. The treatment efficacy and the occurrence of complications in both groups were compared. RESULTS: The occurrence of cerebral vasospasm and hydrocephalus in the treatment group was significantly lower than the control group, and the difference was statistically significant. However, the mortality rate was decreased in both groups. CONCLUSIONS: Both methods had the advantage of minimal invasiveness and rapid post-operative recovery. But using combination of these two methods is clinically rational and could decrease the rate of disability and mortality.

Presence of an additional PstI fragment in intron 1 of the chicken growth hormone-encoding gene.

A previously unreported 196-bp PstI fragment was found in intron 1 of the gene encoding chicken growth hormone (cGH) when a PCR assay for an MspI restriction fragment length polymorphism was established. A pair of PCR primers was designed according to the published cGH sequence and used to amplify a fragment which contained two MspI sites, one polymorphic and another non-polymorphic. However, amplification of genomic DNA from two strains of meat-type chickens and three strains of White Leghorn chickens yielded a PCR product which was about 200 bp larger than expected. The fragment from one of the meat-type chickens was subcloned into the vector pCR-Script SK+, and sequenced. It revealed the presence of an extra fragment of 196 bp which was flanked by the PstI sites and occurred at nt +308 of the previously reported cGH sequence.

Hepatocyte growth factor is predominantly expressed by the carcinoma cells in non-small-cell lung cancer.

Hepatocyte growth factor (HGF) exerts multifunctional regulatory roles in the growth, morphogenesis, differentiation, and motility of epithelial cells, and putatively plays important roles in tumor angiogenesis and metastasis. Aside from the full-length protein, 2 naturally occurring truncated HGF isoforms (NK1 and NK2) have been identified. Recent evidence suggests that a high level of HGF in surgically resected non-small-cell lung carcinoma (NSCLC) is a negative prognostic marker for NSCLC patients' survival. The origin of HGF in these tumors remains uncertain. We show here by in situ hybridization and immunohistochemistry that HGF messenger RNA (mRNA) and protein were predominantly expressed by the tumor cells in a high percentage of primary NSCLC. Stromal cell expression of HGF was limited to some lymphocytes and endothelial cells. Normal bronchial and bronchiolar epithelial cells also expressed HGF mRNA and immunoreactive protein. The mRNA transcripts and putative proteins of all 3 known HGF isoforms were detected in both normal lung and lung cancer tissues, but the full-length HGF was predominantly expressed. Our findings indicate that both autocrine and paracrine functions of HGF are likely to contribute to the pathobiology of lung cancer in vivo.

[Synthesis and vasodilative activities of alpha-phenylcinnamide].

AIM: To search for compounds having strong vasodilating effect. METHODS AND RESULTS: The mixed anhydride and alpha-phenylcinnamyl halide were used. Twenty-two alpha-phenylcinnamide derivatives were synthesized. The strutures were elucidated on the basis of MS and 1HNMR. Compounds 1-22 are new compounds. CONCLUSION: Vasodilative activity assays were conducted for the target compounds and the results indicated that several compounds (3, 9 and 11) demonstrated superior pharmacological profiles to the lead compound, among which compound 11 was further evaluated and found to be indicative of potential KCO activity. Preliminary SAR of alpha-phenylcinnamides was discussed herein.

[Studies on non-protected fluid room temperature phosphorescence of phenanthrine].

A strong and stable room temperature phosphorescence (RTP) signal of phenanthrine aqueous solution in the absence of a protecting medium can be induced only by using Na2SO3 as deoxygenator and KI as heavy atom pertuber. The maximum phosphorescence intensity wavelengths are lambda ex/lambda em = 283/482,504 nm. It is also found that the kind and amount of organic solvent added to the luminescent system effects obviously the RTP properties. Under the present of 1% acetonitrile the RTP intensity is linear to phenanthrine concentration in the rage of 8.0 x 10(-7)-6.0 x 10(-6) mol.L-1 and 6.0 x 10(-6) mol.L(-1)-4.0 x 10(-5) mol.L-1, respectively. The detection limit is 2.6 x 10(-8) mol.L-1.

[Fluorometric determination of trace Shachongdan with calcein-Pd2+].

A fluorometric determination of trace Shachongdan (SCD) [(CH3)2NHCH (CH2S2O3- )CH2S2O3Na x H2O] is described. The method is based on the calcein display fluorescence in pH6-7 phosphate buffer solution, it react with Pd2+ to the fluorescence disappeared. The complex of SCD-Pd2+ is more stability than the complex of calcein-Pd2+, when SCD react with calcein -PdZ+, the calcein can be freed and its fluorescence appears once again. The fluorescence excitation and emission wavelenghts are 494 and 514nm. The linear range is 2 x 10(-7) mol/L-3 x 10(-6)mol/L and the detection limit is 6 x 10(-8)mol/L.

[Study on properties of fluorescence and room temperature phosphorescence of 2-bromomethyl naphthalene].

The properties of fluorescence and room temperature phosphorescense (RTP) of 2-Bromomethyl naphthalene (2-BrMN)were studied. The results show that the wavelength for maximum fluorescence of 2-BrMN is lambda(ex/lambda(em) = 274/334 nm. The fluorescence intersity is proportional to the concentration of 2BrMN in the range of 1.0 x 10(-6) - 1.2 x 10(-4) mol x L(-1), and the detection limit is 4.7 x 10(-8) mol x L(-1). The RTP signal of 2-BrMN was induced by beta-cyclodextrin (beta-(CD) in the presence of dibromopropane (DBP) acting as a heavy atom perturbation. The RTP intensity is linear for 2-BrMN/beta-CD/DBP systems of 2-BrMN concentration in the range of 1.0 x 10(-5) - 1.2 x 10(-4) mol x L(-1) (lambda(ex)/lambda(em) = 271/493,521 nm), and the detection limit is 2.7 x 10(-6) mol x L(-1).