Comparison study of clinical features between persistent hyperplastic primary vitreous and congenital fibrovascular pupillary membrane / 国际眼科杂志(Guoji Yanke Zazhi)

AIM: To analyze the similarities and differences of the clinical features between persistent hyperplastic primary vitreous(PHPV)and congenital fibrovascular pupillary membrane(CFPM).METHODS: Retrospectively analyze the ocular biometric parameters, clinical features and morphological changes in children with PHPV(PHPV group)and CFPM(CFPM group)who received surgery at the department of ophthalmology, Xijing Hospital from March 2006 to December 2021.RESULTS: The study included 56 cases(61 eyes)of PHPV and 24 cases(25 eyes)of CFPM. There were no differences on the gender and age of onset between PHPV and CFPM, and both of them were mainly unilaterally affected, with the ratio of 91% and 96%. Children with PHPV and cataract combined with other complications and ocular developmental abnormalities. CFPM was mainly presented different degrees of blockage and morphological abnormalities of pupillary area. In unilateral cases of PHPV and CFPM, the anterior chamber depth(ACD)of affected eyes was smaller than that of the fellow eyes, and in subgroups with age of operation ≤24mo, the axial length(AL)of affected eyes was smaller than that of the fellow eyes(P<0.05). The corneal diameter(CD)of the affected eyes in PHPV group was smaller and the intraocular pressure(IOP)was higher than those of the fellow eyes(all P<0.05); while there were no significant differences on CD and IOP between affected eyes and the fellow eyes in CFPM group(P>0.05). The ACD of affected eyes in PHPV group was significantly smaller than that of CFPM group(P<0.05). The fibrovascular membrane in PHPV group was located in the posterior part of the lens and vitreous cavity; while the fibrovascular membrane in CFPM group was located between the iris and the anterior capsule of the lens, rarely involving the lens.CONCLUSION: PHPV and CFPM had the similar clinical features, suggesting that they may belong to the different variants of persistent fetal vasculature(PFV). However, PHPV had a wider range of lesions and more complex conditions.

Giant hyperplastic gastric polyp: A diagnostic dilemma!!

Gastric hyperplastic polyps (GHP) account for a majority of benign gastric polyps. Most of the GHPs are <2 cm, asymptomatic, and incidentally detected on endoscopy or radiologically. With increasing size, these polyps manifest as upper gastrointestinal bleeding, iron deficiency anemia, and gastric outlet obstruction (GOO). We report an unusual case of giant GHP simulating gastric carcinoma and posing as a diagnostic challenge for the surgeons emphasizing the diagnostic role of histopathology. A 46-year-old female presented with clinical features of progressive GOO for 1 year. Endoscopy revealed an eccentric proliferative lesion in the antrum. Computed tomography showed a polypoidal, enhancing mural thickening involving distal body and antro-pyloric region measuring 8.4 cm × 6.6 cm × 1.8 cm. Subtotal gastrectomy was done in view of clinical features of GOO and having a clinical suspicion of malignancy. Gross examination showed a giant sessile hyperplastic polyp with lobulated surface. Microscopy revealed features of a large, sessile hyperplastic polyp without any evidence of dysplasia. The patient was symptomatically relieved and is on follow-up. To conclude, giant GHPs can mimic gastric carcinoma on endoscopy and radiology. The possibility of giant GHP should be kept in mind in the presence of an intensely contrast-enhancing polypoidal lesion in the gastric antrum. Long-term endoscopic follow-up is recommended.

Axenfeld-Rieger syndrome � report of a rare case and review

A typical case of Axenfeld-Rieger syndrome (ARS), a rare autosomal dominant condition manifesting with ocular, craniofacial, and dental abnormalities, is presented. The patient showed dental features such as oligodontia, microdontia, abnormally shaped teeth, hyperplastic maxillary labial frenum, and maxillary retrognathism. Early diagnosis of the syndrome from its dentofacial manifestations and a multidisciplinary approach is required for the management of patients with ARS.

Ambliopia severa na infância relacionada à persistência da vasculatura fetal / Severe childhood amblyopia associated to persistence of fetal vasculature

RESUMO A persistência do vítreo primário hiperplásico, atualmente referida como persistência da vasculatura fetal, é uma anomalia congênita que resulta da não regressão do vítreo vascular primário e do sistema da artéria hialoide durante a embriogênese. Trata-se de uma anomalia unilateral na maioria dos casos, esporádica e comumente não associada a nenhum outro achado sistêmico. Clinicamente, essa condição pode ser classificada em persistência anterior e em persistência posterior da vasculatura fetal. A condição anterior está relacionada ao sistema da artéria ciliar, enquanto a persistência da vasculatura posterior associa-se à artéria hialoide e pode apresentar anormalidades, com desfecho visual desfavorável. A detecção da persistência do vítreo primário hiperplásico é de suma importância, visto que é um diagnóstico diferencial para retinoblastoma. O relato de caso a seguir descreve o acompanhamento ambulatorial em um Serviço de Oftalmologia de uma criança do sexo masculino com persistência da vasculatura fetal unilateral e sem alterações sistêmicas.

ABSTRACT Hyperplastic primary vitreous persistence, currently referred to as fetal vasculature persistence, is a congenital anomaly that results from non-regression of the primary vascular vitreous and hyaloid artery system during embryogenesis. It is a unilateral anomaly in the vast majority of cases, sporadic and commonly not associated with any other systemic finding. Clinically, this condition can be classified into anterior and posterior persistence of fetal vasculature. The anterior condition is related to the ciliary artery system, while the persistence of the posterior vasculature is associated with the hyaloid artery, which may present abnormalities with an unfavorable visual outcome. Detecting persistent hyperplastic primary vitreous is of paramount importance, as it is a differential diagnosis for retinoblastoma. The following case report describes the outpatient follow-up at the ophthalmology service of the Federal University of Triângulo Mineiro (UFTM) of a male child with persistent unilateral fetal vasculature and no systemic changes.

Surgical treatment and current advances of persistent fetal vasculature syndrome / 中华眼底病杂志

Persistent fetal vasculature syndrome (PFVS) is a rare congenital vitreous dysplasia, which is classified as anterior, posterior and combined types according to the location of the vascular abnormalities. The clinical manifestations of PFVS are diverse, and early surgical intervention is very important. The main objective of surgical treatment is to remove the anterior and posterior traction between fibrovascular membranes and retina as well as lens, and to reconstruct clear visual axis. Surgical treatments include pupilloplasty, lensectomy with or without intraocular lens implantation and vitrectomy via limbal or scleral approach. For new technologies, the applications of ophthalmic viscosurgical device and femtosecond lasers have desirable results . In addition to focusing on improving the success rate of surgery, it is also necessary to systematically and comprehensively assess the overall preoperative condition and postoperative visual function of the patients. PFVS eyes have limited improvement in postoperative vision, which is related to the extent of lesion involvement and the occurrence of complications. Eyes with macular dysplasia and tractional retinal detachment, as well as elongated ciliary process, have a poor prognosis of vision after surgery. How to improve postoperative vision in the eye affecting the posterior segment of the eye with PFVS from the microscopic anatomical relationship between the fibrous vascular pedicle and the retina is worth further study. On the other hand, reducing surgical trauma and optimizing surgical procedures in order to improve postoperative visual acuity and reduce postoperative complications are also the key research directions of future PFVS treatments.

Histopathological Evaluation of Solitary Nodules of Thyroid

Introduction: Solitary Thyroid nodules (STNs) can be ofboth non-neoplastic or neoplastic in nature and it is difficultto assess whether an STN is neoplastic or non-neoplasticby clinical examination alone. Imaging technique mayhelp in differentiating them preoperatively but histologicalexamination offers the final diagnosis. This study was aimedat studying the incidence rates of various types of STNs as itvaries from one geographical area to another.Material and methods: A total of 58 cases of STNsreceived over the period of 18 months were studied andhistopathological features were analysed.Results: In this study, non-neoplastic STNs were 32 (55.17%)and neoplastic were 26 (44.82%), the former being morecommon. There was a female preponderance in both nonneoplastic and neoplastic STNs with an incidence of 90.62%and 84.61% respectively. Mean age of presentation of STNswas 42.09 years. Non-neoplastic lesions of thyroid were; 18cases of colloid nodules, 10 cases of hyperplastic nodulargoitre, 04 cases of Hashimoto Thyroiditis and the neoplasticlesions were; 05 cases of follicular adenoma, 11 cases oftypical/conventional papillary carcinoma of thyroid (PTC),6 cases of papillary carcinoma thyroid variants, 01 case offollicular carcinoma 01 case of Undifferentiated carcinoma,01 case of Squamous cell carcinoma and 01 case of medullarycarcinoma.Conclusion: STNs are not so uncommon and comprise of agamut of both non-neoplastic and neoplastic lesions. Colloidnodule and PTC are the most common of non-neoplastic andneoplastic STNs respectively.

Hemorragia vítrea como causa de pérdida de la visión en una paciente con Dengue / Vitreous hemorrhage as a cause of vision loss in a patient with dengue

RESUMEN La hemorragia vítrea secundaria a una arteria hialoidea persistente íntegra es una anomalía infrecuente. Se presenta el caso de una mujer de 65 años con antecedentes personales conocidos de esta anomalía congénita en el ojo derecho, la cual presentó disminución de visión de ese ojo de forma repentina, 10 días después de haber presentado cuadro febril agudo con diagnóstico de Dengue. La biomicroscopía posterior reveló una arteria hialoidea persistente rellena de sangre con inserción en la cristaloides posterior. En la oftalmoscopia indirecta se observó una hemorragia vítrea parcial, que permitía visualizar las estructuras de la retina. Se realizaron como pruebas diagnósticas y de seguimiento la ecografía ocular y la retinofoto.

ABSTRACT Vitreous hemorrhage secondary to a complete persistent hyaloid artery is an uncommon anomaly. The case of a 65-year-old woman with a known personal history of this congenital anomaly in the right eye is presented, who had a sudden decrease in vision of that eye, ten days after presenting an acute febrile condition with a diagnosis of dengue. Posterior biomicroscopy revealed a persistent hyaloid artery filled with blood with insertion into the lens posterior portion or hyaloid fossa. In indirect funduscopy a partial vitreous hemorrhage was observed, which allowed visualizing the structures of the retina. Ocular ultrasound and retinophoto were performed as diagnostic and follow-up tests. The vitreous hemorrhage was completely reabsorbed at 15 days and the patient recovered her vision at 0.5 due to the presence of an ongoing cataract. There was no recurrence of bleeding in six months' follow-up.

Incidence of reactive hyperplastic lesions in the oral cavity: a 10 year retrospective study in Santa Catarina, Brazil / Incidência de lesões hiperplásicas reativas na cavidade bucal: estudo retrospectivo de 10 anos em Santa Catarina, Brasil

Abstract Introduction Reactive hyperplastic lesions develop in response to a chronic injury simulating an exuberant tissue repair response. They represent some of the most common oral lesions including inflammatory fibrous hyperplasia, oral pyogenic granuloma, giant cell fibroma, peripheral ossifying fibroma, and peripheral giant cell lesions. Objective The incidence of those lesions was investigated in an oral pathology service, and the clinical characteristics, associated etiological factors, concordance between the clinical and histopathological diagnostic was determined. Methods A total of 2400 patient records were screened from 2006 to 2016. Clinical features were recorded from biopsy reports and patients' files. Results A total of 534 cases of reactive hyperplastic lesions were retrieved and retrospectively studied, representing 22.25% of all diagnoses. The most frequent lesion was inflammatory fibrous hyperplasia (72.09%), followed by oral pyogenic granuloma (11.79%), giant cell fibroma (7.30%), peripheral ossifying fibroma (5.24%), and peripheral giant cell lesions (3.55%). Females were predominantly affected (74.19%), the gingiva and alveolar ridge were the predominant anatomical site (32.89%), and chronic traumatism was presented as the main etiological factor. The age widely ranges from the 1st decade of life to the 7th. Clinically, the reactive hyperplastic lesions consisted of small lesions (0.5-2 cm) and shared a strong likeness in color to the oral mucosa. The concordance between the clinical and histopathological diagnostic was high (82.5%). Conclusion Reactive hyperplastic lesions had a high incidence among oral pathologies. The understanding of their clinical features helps to achieve a clearer clinical and etiological diagnosis, and the knowledge of factors related to their development. This may contribute to adequate treatment and positive prognosis.

Resumo Introdução As lesões hiperplásicas reativas se desenvolvem em resposta a uma lesão crônica que estimula uma resposta acentuada de reparo tecidual. Elas representam uma das lesões orais mais comuns, inclusive hiperplasia fibrosa inflamatória, granuloma piogênico oral, fibroma de células gigantes, fibroma periférico ossificante e lesão periférica de células gigantes. Objetivo A incidência dessas lesões foi investigada em um serviço de patologia bucal e as características clínicas, os fatores etiológicos associados e a concordância entre os diagnósticos clínico e histopatológico foram determinados. Método Foram selecionados 2.400 registros de pacientes entre 2006 e 2016. As características clínicas foram registradas a partir de laudos de biópsia e dos prontuários dos pacientes. Resultados Um total de 534 casos de lesões hiperplásicas reativas foram recuperados e retrospectivamente estudados, representando 22,25% de todos os diagnósticos. A lesão mais frequente foi hiperplasia fibrosa inflamatória (72,09%), seguida por granuloma piogênico oral (11,79%), fibroma de células gigantes, (7,30%), fibroma periférico ossificante (5,24%) e lesão periférica de células gigantes (3,55%). O sexo feminino foi predominante (74,19%), a gengiva e a crista alveolar foram o local anatômico predominante (32,89%) e o traumatismo crônico foi demonstrado como o principal fator etiológico. A idade variou desde a 1ª década de vida até a 7ª. Clinicamente, as LHR consistiram em pequenas lesões (0,5 a 2 cm) que apresentaram uma forte semelhança de cor com a mucosa oral. A concordância entre o diagnóstico clínico e histopatológico foi alta (82,5%). Conclusão As lesões hiperplásicas reativas apresentaram alta incidência entre as patologias bucais. A compreensão das características clínicas ajuda na realização de um diagnóstico clínico e etiológico mais claro, bem como determinar os fatores relacionados ao seu desenvolvimento. Dessa forma contribui para um tratamento adequado e um prognóstico positivo.

A clinicopathological study of persistent fetal vasculature

Purpose: To study the clinicopathological findings of Persistent Fetal Vasculature (PFV) in patients with congenital cataract and PFV. Methods: Six eyes with anterior or combined PFV with cataract underwent phacoaspiration with primary posterior capsulotomy with anterior vitrectomy with intraocular lens implantation followed by histopathological evaluation of the PFV stalk and membrane. Results: Four and two patients had combined and anterior PFV respectively. There was no postoperative hyphema, vitreous haemorrhage, glaucoma or retinal detachment in six months. Haematoxylin and eosin staining showed inflammatory cells predominantly with extramedullary hematopoeisis and vascularisation. Conclusion: We recommend IOL implantation in PFV, with early and aggressive amblyopia therapy.

Study of expression of PTEN and Cyclin D1 in endometrium at a tertiary care centre

Background: To study the expression of PTEN (Phosphatase and Tensin homologue) and Cyclin D1 in normal, hyperplastic and neoplastic endometrium by immunohistochemistry and to corroborate the interrelationship between PTEN and Cyclin D1 in normal to neoplastic endometrial disorders including endometrial carcinoma.Methods: Formalin fixed paraffin embedded (FFPE) sections of spectrum of endometrium in fifty different cases were taken from secretory phase to endometrial carcinoma and subjected to Immunohistochemistry using PTEN and Cyclin D1 .Results: Immunoreactivity was regarded as positive when brown staining was localized in the nuclei or cytoplasm. The intensity of nuclear staining was graded from 0 to 3+ and the extent was semi quantitatively estimated. If less than 10% of cells were positive a score of 0 was given, 11 % to 30% cell positivity was scored as 1+, 31% to 60 % positivity was scored as 2+ and more than 60% positive cells was labelled as 3+. Statistical analysis was performed with Chi-Square test and significant differences were noted between these 3 groups (p value < 0.05).Conclusions: The present study supports that an inverse correlation exists in the expression of PTEN and Cyclin D1 in normal, hyperplastic and neoplastic endometrium. The decreased PTEN expression is a marker of the earliest endometrial premalignant lesions, and we propose that use of PTEN immunostaining may be informative in identifying premalignant lesions that are likely to progress to carcinoma. Cyclin D1 expression in endometrial glands increases progressively in intensity and extent from normal endometrium to hyperplasia to carcinoma.

Expression and Significance of Foxa2 in Colorectal Polyps and Colorectal Cancer / 胃肠病学

Background: Forkhead box A2 (Foxa2) plays an important role in the proliferation and distant metastasis of colorectal cancer, but the expression of Foxa2 in colorectal polyps has not been reported yet. Aims: To investigate the expression and significance of Foxa2 in colorectal polyps and colorectal cancer. Methods: A total of 45 patients with hyperplastic polyps, 135 patients with adenomatous polyps and 45 patients with colorectal cancer and corresponding adjacent tissue from January 2018 to May 2019 at Renmin Hospital of Wuhan University were collected. Immunohistochemical SP staining was used to detect the expression of Foxa2. Expressions of Foxa2 mRNA and protein were determined by real-time fluorescence quantitative PCR and Western blotting, respectively. The relationships between the expression of Foxa2 and colorectal polyps, colorectal cancer were analyzed. Results: The positive expression rate of Foxa2 in normal colorectal mucosal tissue, hyperplastic polyps, adenomatous polyps and colorectal cancer was gradually increased (13.3%, 31.1%, 62.2%, 86.7%, respectively), and the difference was statistically significant (P<0.05). The expressions of Foxa2 mRNA and protein were also increased, and the differences were statistically significant (P<0.05). The expression of Foxa2 in adenomatous polyps was related to size of polyps and presence of pedicle (P<0.05); the expression of Foxa2 in colorectal cancer was related to differentiation, lymph node metastasis and TNM staging (P<0.05). Conclusions: The expression of Foxa2 is high in adenomatous polyps and colorectal cancer, and increases with the increase of risk of canceration. Therefore, detecting the expression of Foxa2 in colorectal polyps is helpful for the early detection of colorectal cancer.

Relationship between colorectal polyps and Helicobacter pylori typing and serum gastrin 17 / 中国综合临床

Objective To investigate the relationship between Helicobacter pylori infection and serum gastrin 17 levels and colorectal polyps. Methods The clinical data of 214 patients with colorectal polyps who underwent gastrointestinal endoscopy at the Affiliated Hospital of Xuzhou Medical University from June 2017 to April 2019 were collected. The specimens were divided into two groups after pathological diagnosis. The group included 126 cases with adenomatous polyps (adenomatous polyps group) and 88 cases with hyperplastic polyps( hyperplastic polyps group) . Another 89 patients without obvious abnormality were selected as the control group. Serum Hp antibody was detected by western blot,and serum gastrin 17 levels were quantitatively detected by ELISA. Hp infection rate and serum gastrin 17 levels were compared between the groups. Results The infection rate of 74. 2%( 66 ／ 89) type I HP in adenomatous polyp group was significantly higher than that of 55. 6%( 30 ／ 54) in proliferative polyp group and 48. 7%( 19 ／ 39) in control group,the difference was statistically significant( χ2＝5. 271,P＝0. 022; χ2＝7. 867,P＝0. 005). The infection rate of type I HP in proliferative polyp group was not statistically significant ( P＞0. 05) . The HP infection rate in colorectal polyp group was 66. 8%(143 ／ 214) and 67. 1%(96 ／ 143) respectively,which was significantly higher than that in control group (43. 8%(39 ／ 89) and 48. 7%(19 ／ 39),the difference was statistically significant ( χ2 ＝ 13. 87, 4. 467, all P＜0. 05 ) . The infection rate of Hp in colorectal proliferative polyp group was 61. 4%(54／88) and adenomatous polyp group was 70. 6%(89／126) higher than that in control group (43. 8%(39／89),the difference was statistically significant( χ2＝5. 46,15. 57,all P＜0. 05) . The serum gastrin 17 level in adenomatous polyp group (11. 35 ( 6. 67,20. 87) pmol／L) was significantly higher than that in proliferative polyp group (7. 88(3. 11,13. 07) pmol／L) and control group (5. 69 (2. 94,11. 37) pmol／L), the difference was statistically significant ( Z＝4. 91, all P＜0. 05) . The serum gastrin 17 level in adenomatous polyps group with type I Hp infection (14. 35 (8. 12,23. 68) pmol／L) was significantly higher than that of Hp-negative patients ( 8. 42 ( 2. 42, 20. 84) pmol／L), and the difference was statistically significant (Z＝2. 87,P＜0. 05). Conclusion HP infection is closely related to colorectal polyps,especially adenomatous polyps. The increased level of serum gastrin 17 is a risk factor for colorectal adenomatous polyps. Type I HP infection can increase the level of serum gastrin 17,and it is more closely related to adenomatous polyps.

Intravitreal injection of Conbercept-assisted vitrectomy for the treatment of proliferative diabetic retinopathy and its effects on inflammatory factors and ANGPTL4 in the vitreous / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To investigate the effects of intravitreal injection of conbercept-assisted vitrectomy(PPV)on proliferative diabetic retinopathy(PDR)and inflammatory factors and angiopoietin-like protein 4(ANGPTL4)in the vitreous. <p>METHODS: Totally 90 patients with PDR(99 eyes)who underwent PPV treatment in our hospital from January to February 2018 were selected as subjects, and were divided into PPV group and IVC/PPV group according to whether intravitreal injection of conbercept(IVC).The surgical indexes of the two groups, the best corrected visual acuity(BCVA, LogMAR)and the incidence of postoperative vitreous hemorrhage(POVCH)were observed within 3mo after surgery were observed. The levels of interleukin-6(IL-6), interleukin-10(IL-10), C-reactive protein(CRP)and other inflammatory factors and ANGPTL4 in the vitreous of the two groups were measured.<p>RESULTS: In the IVC-assisted PPV group, the operation time, intraoperative severe hemorrhage(bleeding with electrocoagulation pen), iatrogenic retinal tears and postoperative silicone oil filling rate were significantly better than those in the PPV group(<i>P</i><0.05). There was no significant difference in BVCA between the two groups(<i>P</i>>0.05). There was no significant difference in BVCA between the two groups(<i>P</i>>0.05). At 1 and 3mo after operation, BCVA decreased significantly in both groups. Visual acuity improved significantly. The BCVA(LogMAR)of the IVC combined with the PPV group was significantly lower than that of the group. Simple PPV group(<i>P</i><0.05). The occurrence of POVCH The rate was significantly decreased(<i>P</i><0.05), the contents of IL-6, IL-10 and CRP in the vitreous were significantly decreased(<i>P</i><0.05), and the content of ANGPTL4 was significantly increased(<i>P</i><0.05).<p>CONCLUSION: Preoperative vitreous injection of conbercept in the treatment of PDR can reduce the occurrence of intraoperative and postoperative complications, promote the recovery of visual acuity, reduce the inflammatory response in the vitreous and increase the content of ANGPTL4.

A Rare Case of Lymph Node Metastasis from Early Gastric Cancer

Gastric cancers that fulfill the Japanese criteria for curative endoscopic resection show a low risk of lymph node (LN) metastasis. Here, we report a case of LN metastasis from early gastric cancer that fulfilled the curative criteria. A 74-year-old Japanese woman was referred to our hospital for treatment of early gastric cancer identified at the site of a hyperplastic polyp that had been diagnosed 10 years prior to presentation. Contrast-enhanced computed tomography did not show any lymphadenopathy and laparoscopy-assisted distal gastrectomy was performed. Histopathological examination revealed a predominantly moderately differentiated adenocarcinoma that measured 15 mm in size and was confined to the mucosa. However, a single metastatic regional LN was observed. A few cancer cells showed positive staining for alpha-fetoprotein. It should be noted that early gastric cancer can be accompanied by LN metastasis even if it fulfills the criteria for curative endoscopic resection.

Gastric Xanthomas and Fundic Gland Polyps as Endoscopic Risk Indicators of Gastric Cancer

BACKGROUND/AIMS: Fundic gland polyps (FGPs), hyperplastic polyps (HPs), and xanthomas (XTs) are common benign gastric lesions that can be diagnosed by endoscopic appearance alone in most cases. The aim of this study was to evaluate associations between gastric cancer and these benign lesions. METHODS: Two expert endoscopists reviewed a series of gastroscopy images. FGPs, HPs, and XTs were diagnosed by endoscopic appearance, whereas all gastric cancers were confirmed pathologically. RESULTS: Of the 1,227 patients reviewed, 114 (9.3%) had a concurrent or past history of gastric cancer. The overall prevalences of FGPs, HPs and XTs were 9.4%, 6.3% and 14.2%, respectively. HPs and XTs coexisted in 1.6% of patients, whereas other combinations were rarer. XTs were observed in 39.3% and 11.5% of patients with and without gastric cancer, respectively (p<0.001). In contrast, no gastric cancer patients had FGPs, whereas 10.4% of patients without cancer had FGPs (p<0.001). The prevalence of HPs was similar between the two groups (8.8% and 6.0% of patients with and without cancer, respectively, p=0.29). Multivariate and Mantel-Haenszel analyses demonstrated that XTs were positively associated and FGPs were negatively associated with gastric cancer. CONCLUSIONS: XTs and FGPs might be useful as endoscopic risk indicators for monitoring gastric cancer.

Analysis of serum gastric function and Helicobacter pylori infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps / 中国综合临床

Objective To analyze the serum gastric function and Helicobacter pylori ( HP ) infection in patients with gastric hyperplastic polyps and gastric fundic gland polyps.Methods From December 2017 to December 2018, 135 patients with gastric polyps and pathologically confirmed gastric hyperplastic polyps and gastric fundic gland polyps were enrolled in the hospital of Xuzhou Medical University.Among them, 68 patients with hyperplastic polyps, 67 cases of the gastric fundic gland polyps.Serum Hp antibodies ( UreA, UreB, VacA, CagA antibodies ) were qualitatively detected by immunoblotting.Eighty patients with chronic superficial gastritis were selected as the control group.Three groups of serum pepsinogen?I ( PG?I),pepsinogen?Ⅱ( PG?Ⅱ),gastrin were detected by enzyme?linked immunosorbent assay (ELISA).Gastrin?17( G?17) and calculate PGⅠ and PGⅡ ratio( PGR).Results The levels of serum PGⅡ(13.13(8.15,20.30) μg ／L) and G17 (8.44(3.72,27.17) pmol／L) in the gastric hyperplastic polyp group were higher than those in the control group (9.16(5.56,15.14) μg／L and 1.83(0.87,5.95) pmol／L) ( P＜0.05),and the PGR level was lower than the control group ( P＜0.05);serum PGI ( 120.12 ( 86.72,174.70) μg／L), PGII ( 11.92 ( 7.27,22.26) μg／L),G17 ( 5.68 ( 1.79, 14.65) pmol／L) in the gastric fundic gland polyp group was higher than the control group (( 101.32 (79.17,131.33) μg ／L,9.16 ( 5.56,15.14) μg ／L,1.83 ( 0.87,5.95) pmol／L) ( P 均＜0.05)) ( P＜0.05); serum G17 (8.44(3.72,27.17) pmol／L) level in gastric hyperplastic polyp group was higher than gastric fundus polyp group (5.68(1.79,14.65) pmol／L) ( P＜0.05); Hp infection rate in gastric hyperplastic polyp group61.76%(42／68)was higher than that in the gastric fundic gland polyp group40.30%(27／67) (P＜0.05),and type I Hp was the main one (P＜0.05).The serum PGⅡ and G17 levels in the gastric hyperplastic polyp group were higher than those of Hp negative ( all P＜0.05).There were no significant differences in serum PGI, PGⅡ, G17, and PGR levels between the HP?positive and negative?positive patients in the gastric fundus polyp group.The serum PGI and PGR levels in the hypertrophic polyp group were higher than those in the HPⅡ type ( all P＜0.05).There was no significant difference in the levels of serum PGⅠ,PGⅡ,G17,and PGR between the gastric fundic gland polyps group and the type Ⅱ.Conclusion Serum PG and G17 levels in patients with gastric hypertrophic polyps and gastric fundic gland polyps are higher than those in patients with chronic superficial gastritis.Patients with gastric hyperplastic polyps have higher HP infection rate and abnormal gastric function than gastric fundic gland polyps.

Assessment of Candidiasis Infections among Patients Visited in Hospital

Background: Candida is the shortened name used to describe a class of fungi that includes more than 150 species of yeast. The present study was conducted to assess Candidiasis infections among patients. Methods: The present study was conducted in the department of Microbiology on 114 cases. Clinical examination was done for the diagnosis. Microbiological culture assessment was done in all cases. Swab was taken from the lesion of the patients and was incubated in Sabouraud’s dextrose agar medium for assessment of culture growth characteristics. All the samples were incubated in the culture medium at 37°C for 1–2 days. Counting of the yeast colonies was done 48 hours after incubation.    Results: Age group 11-20 years had 12 males and 7 females, 21-30 years had 18 males and 16 females, 31-40 years had 24 males and 15 females and 41-50 years had 10 males and 12 females. Most common type was denture induced candidiasis (DIC) seen in 20 males and 14 females, acute atrophic candidiasis (AAC) seen in 18 males and 15 females, acute pseudomembranous candidiasis (APC) seen in 12 males and 10 females, chronic hyperplastic candidiasis (CHC) in 10 males and 8 females and angular cheilitis in 4 males and 3 females. The difference was significant (P< 0.05). Common species was C. albicans (52), C. Krusei (32), C. tropicalis (20) and C. pseudotropicalis (10). Conclusion: Candidiasis is a common opportunistic infection. Most cases were seen in males and most common type identified was Candida Albicans.

Serrated neoplasia pathway as an alternative route of colorectal cancer carcinogenesis

In the past two decades, besides conventional adenoma pathway, a subset of colonic lesions, including hyperplastic polyps, sessile serrated adenoma/polyps, and traditional serrated adenomas have been suggested as precancerous lesions via the alternative serrated neoplasia pathway. Major molecular alterations of sessile serrated neoplasia include BRAF mutation, high CpG island methylator phenotype, and escape of cellular senescence and progression via methylation of tumor suppressor genes or mismatch repair genes. With increasing information of the morphologic and molecular features of serrated lesions, one major challenge is how to reflect this knowledge in clinical practice, such as pathologic and endoscopic diagnosis, and guidelines for treatment and surveillance.

Effect of Smurf2 on Smad7, a negative regulator of TGF-β1 signaling pathway in hypertrophic scar and its mechanism / 中华整形外科杂志

Objective@#To investigate the effect and regulatory mechanism of Smurf2 on the negative regulator Smad7 of TGF-β1/Smad signaling pathway in hypertrophic scar fibroblasts.@*Methods@#From January to October 2014, 8 patients with hypertrophic scar after burn were admitted. The age of patients ranged from 1 year 8 months to 7 years, and the time of scar hyperplasia ranged from 2 to 12 months. The residual normal skin of the same patient was used as the control. The fibroblasts were isolated from hypertrophic scar and normal skin respectively and cultured. The third to fifth passage cells were used for the experiments. ① The protein expression of Smad7 in the two groups was detected by Western Blot. ② Hypertrophic scar fibroblasts and normal skin fibroblasts were treated with exogenous TGF-β1 at concentration of 10 ng/ml for 0 min, 5 min, 15 min, 30 min, 1 h, 2 h and 12 h. The expression of Smad7 protein and mRNA were detected by Western Blot and RT-PCR, respectively. ③ The cell lysates of the two groups were collected and incubated with the ubiquitin mixture for 1 h, 2 h and 6 h at 37℃, respectively. The degradation level of Smad7 protein was detected by Western Blot. ④ The cell lysate of hypertrophic scar fibroblasts was collected and incubated with ubiquitin mixture with or without proteasome inhibitor (MG132: MG115=1: 1) to study its inhibitory effect on the degradation of Smad7 in vitro. ⑤ Immunoprecipitation (IP) technique was used to detect the interaction between Smad 7 and E3 ubiquitin ligase Smurf2 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein in hypertrophic scar fibroblasts stimulated by TGF-β1 after Smurf2 silencing by small interference RNA (siRNA) technique were detected by Western blot.@*Results@#① There was no significant difference in the expression level of Smad7 protein between hypertrophic scar and normal skin fibroblasts(t=0.76, P=0.46). ② Expressions of Smad7 mRNA and protein in normal skin fibroblasts stimulated by exogenous TGF-β1 gradually increased in a time-dependent manner(P<0.05). The expression of Smad7 mRNA in the hypertrophic scar fibroblasts increased at all-time points except at 5min , (P<0.05), while there was no significant difference in the expression level of Smad7 protein at all-time points with or without TGF-β1 stimulation(P>0.05). ③ Degradation of Smad7 protein was enhanced in hypertrophic scar fibroblasts (the expression level of Smad 7 protein at each time point was compared with that of the control group and the last time point, P<0.05), while there was no significant difference in Smad7 protein degradation in normal skin fibroblasts(P=0.162). ④ Enhanced degradation of Smad7 in hypertrophic scar fibroblasts was blocked by the addition of the proteasome inhibitors MG132/MG115. ⑤ In hypertrophic scar fibroblasts, the Smurf2-Smad7 complex was detected, which indicated the interaction between Smurf2 and Smad7 in hypertrophic scar fibroblasts. ⑥ The expression of Smad7 protein was not increased in the hypertrophic scar fibroblasts stimulated by TGF-β1, whereas the stimulation of TGF-β1 increased the expression of Smad7 protein after silencing of Smurf2 gene expression.@*Conclusions@#In the hypertrophic scar fibroblasts, Smurf 2 attenuates the inhibitory effect of Smad 7 on TGF-β1 signaling pathway through the degradation of Smad7 by ubiquitination, which may be involved in the formation of hypertrophic scar.