Clinicopathological features of gastric alpha-fetoprotein-producing adenocarcinoma with SWI/SNF complex deletion / 中华病理学杂志

Objective: To investigate the clinicopathological features and treatment of gastric alpha-fetoprotein (AFP)-producing adenocarcinoma with SWI/SNF complex deletion. Methods: Four cases of gastric AFP-producing adenocarcinoma with SWI/SNF complex deletion diagnosed in Zhongshan Hospital of Fudan University from January 2021 to December 2022 were collected, and their histomorphological characteristics, immunohistochemical (IHC), in situ hybridization of Epstein-Barr virus-encoded RNA (EBER), next-generation sequencing results, clinicopathological features and treatment were summarized, and literature review was conducted. Results: Among the 4 patients, there were three males and one female. They presented with abdominal pain, belching and melena. Serum AFP was significantly elevated in three patients, and endoscopy showed ulcerative lesions. Microscopically, the tumor cells showed mainly diffuse flaky or nest-like growth and typical characteristics of hepatoid adenocarcinoma. In two cases there were adenoid growth, and the tumor cells in these areas possessed clear cytoplasm, suggesting enteroblastic differentiation. The tumor cell nuclei were pleomorphic with large nucleoli and brisk mitoses. The IHC results showed that the tumor cells expressed AFP, GPC3 and SALL4, and there was retained expression of broad-spectrum keratin (CKpan) and E-cadherin. IHC detection of SWI/SNF complex subunits, namely INI1 (SMARCB1), BRG1 (SMARCA4), BRM (SMARCA2), ARID1A protein was performed. In all four cases the hepatoid adenocarcinoma region and enteroblastic differentiation region showed SMARCA2 deletion, and one case with enteroblastic differentiation also showed ARID1A deletion. SMARCB1 and SMARCA4 deletions were not seen. All the four cases were diffusely positive for p53 protein, and the Ki-67 proliferation index was 80%-90%. There were no mismatch repair deletion detected; one cases showed HER2 was strongly positive (3+), and EBER was negative. None of the four cases had mutations in the SWI/SNF complex-related subunits detected by next-generation sequencing. Among the four patients, two underwent palliative surgery due to distant metastasis at the time of surgery, two underwent radical resection. Postoperative adjuvant chemotherapy was given to three patients. Conclusions: AFP-producing adenocarcinoma is a rare subtype of gastric cancer, which can be combined with SWI/SNF complex deletion, and the pathomorphological manifestations are different from the classical SWI/SNF complex deletion of undifferentiated carcinoma with rhabdoid phenotype.

Clinicopathological features of esophageal carcinoma with ductal differentiation of esophageal gland / 中华病理学杂志

Objective: To investigate the clinicopathological characteristics of esophageal carcinoma with gland duct differentiation. Methods: The clinical, morphologic and immunohistochemical (IHC) features of eight cases of esophageal carcinoma with gland duct differentiation diagnosed from 2012 to 2022 at the First Affiliated Hospital of Soochow University were summarized. Results: There were four males and four females, with a mean age of 68.5 (range 59-82) years. Two tumors were located in middle esophagus, five in the lower esophagus, and one in the cardia. The mean diameter was 2.4 cm (range 0.6-4.5 cm). The tumor had a bilayer epithelial structure, including the inner luminal epithelium and the outer basal epithelium. Immunohistochemistry showed that CK7 (8/8) and CK18 (8/8) were positive in the inner epithelium. p40 (8/8), p63 (8/8) and CK5/6 (8/8) were positive in the outer epithelium. SMA, calponin and CD117 were all negative. p53 mutants were found in all eight cases (strong and diffuse positivity in 6/8; complete loss of expression in 2/8). No columnar metaplasia, intestinal metaplasia and ectopic gastric mucosa were observed in the surface squamous epithelium in the cases. The mean follow-up time was 21.5 months (range 5-51 months). Seven patients survived and one patient died 31 months after surgery due to recurrence and liver metastasis. Conclusion: Esophageal carcinoma with esophageal gland duct differentiation is a rare tumor with unique histologic and IHC characteristics.

Perivascular epithelioid cell tumor of the lung: a clinicopathological analysis of eight cases / 中华病理学杂志

Objective: To investigate the clinicopathological features of perivascular epithelioid cell tumor (PEComa) of the lung. Methods: Eight PEComa cases of the lung diagnosed at the First Affiliated Hospital of Soochow University, Suzhou, China from July 2008 to December 2021 were collected and subject to immunohistochemical staining, fluorescence in situ hybridization and next generation sequencing. The relevant literature was reviewed and the clinicopathological features were analyzed. Results: There were 5 males and 3 females, aged from 18 to 70 years (mean 39 years). There were 3 cases of the right upper lung, 3 cases of the left lower lung, 1 case of the left upper lung and 1 case of the right middle lung. Seven cases were solitary and 1 case was multifocal (4 lesions). Seven cases were benign while one was malignant. The tumors were all located in the peripheral part of the lung, with a maximum diameter of 0.2-4.0 cm. Grossly, they were oval and well circumscribed. Microscopically, the tumor cells were oval, short spindle-shaped, arranged in solid nests, acinar or hemangiopericytoma-like patterns, with clear or eosinophilic cytoplasm. The stroma was rich in blood vessels with hyalinization. Coagulated necrosis and high-grade nuclei were seen in the malignant case, and calcification was seen in 2 cases. Immunohistochemically, the tumor cells were positive for Melan A (8/8), HMB45 (7/8), CD34 (6/8), TFE3 (4/7), and SMA (3/8). All cases were negative for CKpan and S-100. TFE3 (Xp11.2) gene fusion was examined using the TFE3 break-apart fluorescence in situ hybridization in 5 cases, in which only the malignant case was positive. The next generation sequencing revealed the SFPQ-TFE3 [t(X;1)(p11.2;p34)] fusion. Follow-up of the patients ranged from 12 to 173 months while one patient was lost to the follow-up. The malignant case had tumor metastasis to the brain 4 years after the operation and then received radiotherapy. Other 6 cases had no recurrence and metastasis, and all the 7 patients survived. Conclusions: Most of the PEComas of the lung are benign. When there are malignant morphological features such as necrosis, high-grade nuclei or SFPQ-TFE3 gene fusion, close follow-up seems necessary.

Application of spatial statistics in studying the distribution of food contamination / 中华流行病学杂志

Objective: Based on data related to arsenic contents in paddy rice, as part of the food safety monitoring programs in 2017, to discuss and explore the application of spatial analysis used for food safety risk assessment. Methods: One province was chosen to study the spatial visualization, spatial point model estimation, and kernel density estimation. Moran's I statistic of spatial autocorrelation methods was used to analyze the spatial distribution at the county level. Results: Data concerning the spatial point model estimation showed that the spatial distribution of pollution appeared relatively dispersive. From the kernel density estimation, we found that the hot spots of pollution were mainly located in the central and eastern regions. The global Moran's I values appeared as 0.11 which presented low spatial aggregation to the rice arsenic contamination and with statistically significant differences. One "high-high" and two typical "low-low" clustering were seen in this study. Conclusion: Results from our study provided good visual demonstration, identification of pollution distribution rules, hot spots and aggregation areas for research on the distribution of food pollutants. Spatial statistics can provide technical support for the implementation of issue-based monitoring programs.

Analysis of body composition and resting metabolic rate of 858 middle-aged and elderly people in urban area of Beijing / 中华流行病学杂志

Objective: To understand the overweight rate and obesity rate in middle-aged and elderly people in urban area of Beijing, and analyze the changes of body composition and resting metabolic rate with age. Methods: From November 2014 to December 2015, body composition measurement and resting metabolic rate detection were conducted among 858 people aged 51 to 99 years, including 760 men, 98 women, who received physical examination at Beijing Hospital. Results: The overweight rate was 51.4%, and the obesity rate was 16.9%. The overweight rate was 26.5% and the obesity rate was 14.3% in women, significantly lower than those in men (54.6% and 17.2%) (P<0.001). The distribution of skeletal muscle volume, muscle index, body fat percentage, visceral fat area and resting metabolic rate in different age groups were different (P<0.001). In the normal weight group, the skeletal muscle volume, muscle index and resting metabolic rate in age group ≥80 years decreased obviously (P<0.05). At the same time, the body fat percentage and visceral fat area increased obviously (P<0.05). However, the skeletal muscle volume, muscle index and resting metabolic rate of the overweight and obese groups began to decrease obviously in age group 70- years (P<0.05), and the decrease in age group ≥80 years was more obvious. At the same time, body fat percentage and visceral fat area increased significantly in age group 70- years (P<0.05). Conclusion: The overweight and obesity rates were high in the middle-aged and elderly people in the urban area of Beijing, and the rates were higher in men than in women. With the increase of age, the skeletal muscle volume, muscle index and resting metabolic rate gradually decreased, while the percentage of body fat and visceral fat area increased; Overweight and obese people had earlier changes in body composition and resting metabolic rate.

Effects of temperature and additives on stability and spectrum of a therapeutic fibroblast growth factor

Human fibroblast growth factor 20 [FGF20] is a 16.5 kDa protein containing 154 amino acid residues with reportedly poor thermal stability, and low stability, which are considered to be major factors that can limit its pharmacological applications. Thus, the aim of this study was to enhance the thermal stability and bio activity of a therapeutic FGF20 by addition of sucrose or heparin as additives and also at different temperatures. A variety of biophysical techniques such as far-UV circular dichroism [CD], fluorescence and high resolution derivative UV absorption spectroscopy, were employed to characterize FGF20 and study the effects of heparin and sucrose on its thermal stability and bio activity at pH 7.0. Results of this study suggest that human FGF20 is significantly unstable and induction of heat by increased temperatures results in aggregation and precipitation at pH 7.0. Great changes in the fluorescence intensity and shape were achieved by addition of heparin and sucrose at different temperatures compared to the control. From 10 °C to 60 °C, no significant changes were observed in far-UV CD spectrum compared to the control, but significant changes were observed by adding sucrose when these temperatures are above 45 °C. Upon addition of heparin and sucrose, the mitogenic activity increased significantly at all tested temperatures, and these changes may be related to the roles of heparin and sucrose on the structure and conformation of FGF20. Results of this study suggest that heparin and sucrose as additives seems to benjm sufficient to prevent thermal inactivation of FGF20 and also maintain its conformation stability and bio activity

Calcium response in osteoblastic pattern without gap junction under flow shear stress / 医用生物力学

Objective To investigate the specific roles of gap junction and ATP in mechanical stimulation induced calcium transfer in osteoblasts. Methods The isolated osteoblastic pattern without gap junctions was established by using the micropatterning method. Then fluid shear stress was applied on cells using the flow chamber to observe and analyze the characteristic parameters of calcium response. Results Multiple calcium response still occurred in osteoblastic pattern without gap junction, but the response time to the first responsive peak was much longer than that with gap junction. When the intracellular and extracellular calcium ions were removed, only 40% cells responded to the mechanical stimulation, with single peak and multiple peaks accounting for 50%, respectively. If ATP pathway was blocked, only 20% cells responded, most of which showed single peak. Conclusions ATP was the major pathway mediating intercellular calcium transfer, while the gap junction was not the necessary one.

randomized trail of ligustrazini hydrochlorioi in the treatment of viral encephalitis

Chuanxiong is a herb used in traditional Chinese medicine for the Treatment of viral encephalitis. In animal studies it has shown to inhibit the synthesis and activity of Thromboxane [TXA2] and abate the imbalance between Thromboxane [TXA2] and Prostacyclin [PGI2]. As a result, cerebral edema, ischemia and hypoxia could be improved. The aim of this study is to evaluate its effect in the treatment of viral encephalitis in children

Methodology: ninety-nine patients with viral encephalitis were randomly divided into two groups. Ligustrazini Hydrochlorioi [LH] consisting of 51 cases [males 30, females 21; age 5 years and nine month +/- 8 years and 2month] was given LH 4mg/kg per day in 100- 300mls of 10% glucose and infused intravenously over a three to four hour period, for 7 days as a course of treatment. A control groups of 48 cases [males 31, females 17; age 5 years and three month +/- 4 years and three month] received the conventional treatment of Vitamin C[2.0-3.0g], Coenzyme A[100u] and Adenosine Triphosphate [ATP] [40mg] in 100-300 mls of 10% glucose infused intravenously daily for 7 days

Results: the total response rate in the LH group and the control group were 94.12% and 68.75% respectively [u=3.271 p<0.05]. The average time to improvement was 4.29 +/- 1.41 days and 7.31 +/- 2.66 days respectively. No adverse effect was observed in both groups

Conclusion: we conclude that LH is an effective, safe and well tolerated treatment for children encephalitis

Influence of dissolved oxygen concentration and aeration time on nitrite accumulation in partial nitrification process

This study investigated the influence of dissolved oxygen concentration and aeration time on nitrification and nitrite accumulation in an attempt to optimize the recently developed biological-partial-nitritation process for the treatment of strong nitrogen wastewaters. Investigation of dissolved oxygen concentration on ammonium and nitrite oxidation was carried out in a batch reactor. The dissolved oxygen concentration of 0.5 mg O2/L inhibited both ammonium as well as nitrite oxidation, while increase of dissolved oxygen concentration to tilde1 mg O2/L increased the ammonium oxidation rate and was comparable to that at higher dissolved oxygen concentrations. Experiments were carried out in a sequencing batch reactor for more than 100 days to investigate the influence of aeration time on nitrite accumulation. The dissolved oxygen concentration was controlled at tilde1.0 mg O2/L [in the range of 0.8-1.5 mg/L] during the aeration stage, and volatile suspended solid was maintained at 2.0 g/L while temperature and pH were 30 +/- 1§C and 8.3 +/- 0.1, respectively. In a typical cycle, complete nitrification occurred at aeration time longer than 6 h. When the aeration time was reduced to 4 h., tilde80% of partial nitritation was achieved. With a further reduction in aeration time to 3 h., nearly 1:1 nitrite/ammonium ratio was yielded. This result revealed that for the reactor design, aeration time determined by feasibility experiments must be considered based on the nitrogen strength in wastewater and biomass concentration in the reactor with dissolved oxygen concentration of tilde1.0 mg O2/L for satisfactory partial nitrification with subsequent processes such as anaerobic ammonium oxidation