Clinical characteristics of 42 children with focal atrial tachycardia originated from the right atrial appendage / 中华儿科杂志

Objective: To investigate the feature and treatment of atrial tachycardia (AT) originated from right atrial appendage (RAA) in children. Methods: The data of 42 children with AT originated from RAA, who were admitted the First Hospital of Tsinghua University from January 2010 to September 2022 were analyzed retrospectively.The clinical characteristics, treatment and efficacy were analyzed. The children were divided into tachycardia cardiomyopathy group and normal cardiac function group. The differences in the ablation age and the heart rate during AT between two groups were compared by independent sample t-test. Results: Among 42 children, there were 20 males and 22 females. The age of onset was 2.7 (0.6, 5.1) years. Their age at radiofrequency ablation was (6.5±3.6) years, and the weight was (23.4±10.0) kg. Thirty-two children (76%) had sustained AT. The incidence of tachycardia cardiomyopathy was 43% (18/42). Compared to that of the normal cardiac function group, the ablation age and the heart rate at atrial tachycardia of the tachycardia cardiomyopathy group were higher ((8.1±3.8) vs. (5.3±3.1) years, t=-2.63, P=0.012; (173±41) vs. (150±30) beats per minute, t=-2.05, P=0.047. Thirty-eight children (90%) responded poorly to two or more antiarrhythmic drugs. The immediate success rate of radiofrequency ablation (RFCA) was 57% (24/42), and the AT recurrence rate was 17% (4/24). Twenty-two children underwent RAA resection, and their AT were all converted to sinus rhythm after the surgery. During the RAA resection, 10 cases of right atrial appendage aneurysm were found, 9/18 of which failed the RFCA. Conclusions: The AT originated from the RAA in children tend to present with sustained AT, respond poorly to antiarrhythmic drugs, and has a low success rate of RFCA as well as high recurrence rate. Resection of the RAA is a safe and effective complementary treatment.

Secretory breast carcinoma: a clinicopathological study of 6 cases / 临床与实验病理学杂志

Purpose To describe the clinicopathologic features, diagnosis and differential diagnosis, and prognosis of secretory breast carcinoma (SBC). Methods Clinicopathological and follow-up data of six SBC patients were collected. Histopathologic analysis was performed on hematoxylin and eosinstained (HE) section. Immunohistochemical staining was performed by En Vision two-step method and ETV6 gene detected by fluorescence in situ hybridization (FISH), then relevant literatures were reviewed. Results The ages of the patients ranged from 6 to 76 years with a mean age of 38.7 years, including one male and five female patients. The right breast was involved in 4 cases, and the left, in 2 cases. Five cases showed painless breast mass while one presented with a nipple discharge. The tumor size ranged from 1.0 to 3.1 cm with a mean size of 2.0 cm. Most of the tumors were circumscribed, solid gray white to light brown. Histologically, tumor showed solid nested microcystic, glandular or papillary pattern separating by hyaline fibrous tissue and growed in multiple nodular from. The cytoplasm contains abundant eosinophilic secretions or secretory vesicles. Immunhistochemistry, all cases were positive for CK7, S-100 and CEA, but negative for estrogen and progesterone receptors (ER and PR) and HER-2, and the proliferation index Ki-67 ranged from 10％ to 40％. Molecular testing confirmed the presence of the EVT6 gene translocation in one case. Lumpectomy was performed in 2 cases and modified radical mastectomy in 4 cases, two of them had lymph node metastasis (3/15, 1/16). Five cases were followed up for 6 months to 20 years, 1 case had lung metastasis. Conclusion SBC is a rare breast tumor with relatively indolent clinical and good prognosis. It can be diagnosed according to typical pathological morphology and immunohistochemical characteristics. The characteristic EVT6 gene translocation also has important differential diagnostic value.

Effect of miR-3619-5p on proliferation and apoptosis of breast cancer cell MCF-7 and T47D and its molecular mechanism / 临床与实验病理学杂志

Purpose To investigate the effect of miR-3619-5p transfection on the proliferation and apoptosis of breast cancer cell lines MCF-7 and T47D and its molecular mechanism.Methods According to the different treatment,breast cancer cells were divided into two groups:control group (transfected with dsControl) and experimental group (transfected with miR3619-5p).5-ethynyl-2'-deoxyuridine (EdU) proliferation assay and colony forming assay were used to detect the proliferation ability of breast cancer cells.Flow cytometry (FCM) was conducted to analyze the cell cycle distribution and cell apoptosis.The expression of p21,CDK6 and Cyclin D1 mRNA were tested by qRT-PCR.The expression of p21,CDK6 and Cyclin D1 protein were detected by Western blot.Results The proliferation ability of breast cancer cells transfected with miR-3619-5p was significantly lower than that of control (P ＜ 0.05).Compared with the control group,the percentage of cells in the G0/G1 phase was significantly higher than that in the dsControl group,and the proportion of the cells in the S phase and G2/M phase was significantly decreased after miR-3619-Sp transfection,the cell apoptosis rate increased significantly.The expression of p21 mRNA was significantly up-regulated (P ＜ 0.01 both in the two cell lines transfected with miR-3619-5p compared with the control group,while the expression of CDK6 and Cyclin D1 mRNA was down-regulated (P ＜0.01).Western blot results were consistent with qRT-PCR results.Conclusion miR3619-5p can significantly inhibit the proliferation of breast cancer cells and promote cell apoptosis.Its molecular mechanism may be the activation of tumor suppressor gene p21 expression in breast cancer cells.

Mutation and protein expression of PTEN gene in cervical adenocarcinoma and glandular intraepithelial neoplasia / 中华病理学杂志

<p><b>OBJECTIVE</b>To investigate PTEN expression and mutation status in the development of cervical adenocarcinoma.</p><p><b>METHODS</b>Immunohistochemistry study of PTEN protein was performed on 42 cases of cervical adenocarcinoma, 20 cases of cervical glandular intraepithelial neoplasia and 28 cases of normal cervix tissue samples. Polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP) was used to detect the presence of mutation of exons 5 and 8 of PTEN gene.</p><p><b>RESULTS</b>Positive expression rates of PTEN protein were 54.8% (23/42), 25.0% (5/20) and 100% (28/28) in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissues, respectively. There were significant differences among the 3 groups (P < 0.05). Positive expression rates of PTEN protein were 47.4% (9/19), 20.0% (2/10) and 92.3% (12/13) in mucinous, endometrioid and the other variants of cervical adenocarcinoma, respectively. Mutation rates at exon 5 and exon 8 of PTEN gene were 19.0% (8/42), 45.0% (9/20) and 0 in cervical adenocarcinoma, cervical glandular intraepithelial neoplasia and normal cervix tissue, respectively. There were significant differences among 3 groups (chi(2) = 4.29, chi(2) = 12.70; P < 0.05). The mutation rates were 21.1% (4/19) and 40.0% (4/10) in mucinous and endometrioid variants of cervical adenocarcinoma, respectively. There was no mutation at exons 5 and 8 of PTEN gene detected in other variants of cervical adenocarcinoma.</p><p><b>CONCLUSION</b>The development of cervical adenocarcionomas is correlated with the mutation and absence of the protein expression of PTEN, likely in the early phase of their carcinogenesis.</p>