Identification of invasive subpopulations using spatial transcriptome analysis in thyroid follicular tumors

Background@#Follicular tumors include follicular thyroid adenomas and carcinomas; however, it is difficult to distinguish between the two when the cytology or biopsy material is obtained from a portion of the tumor. The presence or absence of invasion in the resected material is used to differentiate between adenomas and carcinomas, which often results in the unnecessary removal of the adenomas. If nodules that may be follicular thyroid carcinomas are identified preoperatively, active surveillance of other nodules as adenomas is possible, which reduces the risk of surgical complications and the expenses incurred during medical treatment. Therefore, we aimed to identify biomarkers in the invasive subpopulation of follicular tumor cells. @*Methods@#We performed a spatial transcriptome analysis of a case of follicular thyroid carcinoma and examined the dynamics of CD74 expression in 36 cases. @*Results@#We identified a subpopulation in a region close to the invasive area, and this subpopulation expressed high levels of CD74. Immunohistochemically, CD74 was highly expressed in the invasive and peripheral areas of the tumor. @*Conclusions@#Although high CD74 expression has been reported in papillary and anaplastic thyroid carcinomas, it has not been analyzed in follicular thyroid carcinomas. Furthermore, the heterogeneity of CD74 expression in thyroid tumors has not yet been reported. The CD74-positive subpopulation identified in this study may be useful in predicting invasion of follicular thyroid carcinomas.

Promotion of international relations by a short-term program for international students / 医学教育

<p>Background: The center for international relations was established in 2007 and it has organized a program for accepting international students for short periods since 2009 to enhance internationalization at the medical school.</p><p>Methods: The number of inbound and outbound students, and the number of overseas medical schools with an Academic Agreement and a Memorandum of Understanding with our institution from 2008 to 2013 were counted, and the relevant achievements were evaluated.</p><p>Results: The number of inbound students increased from 0 in 2008 to 14 in 2013, and the number of outbound students also increased from 1 in 2008 to 12 in 2013. The number of overseas medical schools with an Academic Agreement and a Memorandum of Understanding also increased from 1 to 3. The number of scholarship applications to go overseas also increased from 2 to 12.</p><p></p><p>Discussion: Organizing a well-established program for inbound students probably contributed to developing the international environment within the school for both inbound and outbound students, and to enhancing discussion of student exchange with potential partner universities. The center for international relations has functioned as a hub for the students and relevant departments by centralizing information, which has markedly communication improved.</p>

Placenta percreta with a vaginal fistula after successful management by uterine transverse fundal incision and subsequent cesarean hysterectomy

Placenta previa presents a highest risk to pregnancy, and placenta accreta is the most serious. Placenta accreta requires cesarean delivery and often results in massive obstetric hemorrhage and higher maternal morbidity. Challenges associated with cesarean delivery techniques may contribute to increased maternal blood loss and morbidity rates. Several recent obstetric studies reported the usefulness of transverse uterine fundal incision for managing placenta accreta. We present a case of placenta percreta that was treated by a transverse fundal incision. We successfully avoided cutting through the placenta and helped decrease maternal blood loss. After delivery, the patient underwent a cesarean hysterectomy. Postoperative day 48, she experienced watery discharge and was diagnosed with vaginal fistula. We present our case and review the literature.

Correlation of PBX2/ELF2 expression with prognosis of non-small cell lung cancer / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To investigate the relationship between pre B cell leukemia transcription factor 2 (PBX2)/Ets domain transcription factor 2 (ELF2) expression with prognosis of non-small cell lung cancer (NSCLC).</p><p><b>METHODS</b>Expressions of ELF2 and PBX2 were examined in 206 patients of NSCLC by immunohistochemistry. The correlation of PBX2/ELF2 expression with valosin-containing protein (VCP) expression and clinicopathologic factors of NSCLC patients was analyzed. Chi-square test, Fisher's exact test and Cox's regression were used for statistical analysis.</p><p><b>RESULTS</b>The level of PBX2/ELF2 expression was associated with VCP expression (P=0.0126). Univariate analysis showed that 5-y disease free survival and overall survival (OS) of NSCLC were correlated with expression of PBX2, PBX2/ELF2 and VCP, tumor size, histological differentiation, visceral pleural invasion, N and T in pTNM grades, and clinical stages (P<0.05). The 5-y OS was also related to vascular invasion (P=0.0322). Multivariate analysis revealed that the expression level of PBX2/ELF2 and histological differentiation were independent predictors for NSCLC.</p><p><b>CONCLUSION</b>The level of PBX2/ELF2 expression is related to VCP expression, indicating that PBX2/ELF2-VCP pathway may be associated with the prognosis of NSCLC patients.</p>