A rare case of thyroid carcinosarcoma arising from recurrent papillary thyroid cancer: Case report and review of the literature.

BACKGROUND: Thyroid carcinosarcoma represents a rare subtype of thyroid cancer, distinguished by its unique histopathology-simultaneous malignant epithelial and mesenchymal cells. The occurrence of thyroid carcinosarcoma arising from recurrent papillary thyroid cancer is exceptionally infrequent. METHODS: Study outlines a patient's thyroid carcinosarcoma journey, covering presentation, recurrence, diagnostics, surgeries, and follow-up. A PubMed search gathered data on pathological features and treatment approaches for thyroid carcinosarcoma. RESULTS: The patient initially diagnosed with papillary thyroid cancer underwent thyroidectomy, neck dissection, and radioactive iodine therapy. Recurrence revealed thyroid carcinosarcoma, featuring papillary carcinoma, squamous cell carcinoma, and spindle cell components. Total laryngectomy followed by adjuvant radiotherapy and chemotherapy. The patient was followed for 17 months with no evidence of disease. CONCLUSIONS: This extraordinary case exemplifies a rare instance of local relapse in form of thyroid carcinosarcoma following an initial diagnosis of papillary thyroid carcinoma. Surgical resection and chemoradiotherapy show promising outcomes in managing this challenging condition.

Risk model-guided identification of MTDH expression as a marker for ferroptosis induction therapy in head and neck squamous cell carcinoma.

Head and neck squamous cell carcinoma (HNSCC) are a prevalent malignancy with high mortality and morbidity rates. Therefore, in this study, we aimed to develop a novel risk score model by using a DNA methylation signature associated with ferroptosis to enhance the prognosis prediction of HNSCC. The transcriptome, methylome, and clinical data of HNSCC patients were collected from The Cancer Genome Atlas (TCGA) database. Additionally, data from a methylation dataset in the Gene Expression Omnibus (GEO) database were used for validation. The ferroptosis score (FS) in each patient was calculated using the transcriptome data, and the single-sample gene set enrichment analysis (ssGSEA) was performed to assess ferroptosis activity. Furthermore, a series of biochemical experiments including CCK8, colony formation, wound healing, and ROS detection were carried out to evaluate the influence of MTDH on the malignancy of HNSCC. Our results revealed that the FS was associated with patient prognosis, as the patients with high FS had a poor prognosis. The receiver operating characteristic (ROC) curve established based on the ferroptosis-associated DNA methylation signature, demonstrated the excellent predictive power of FS for the 1-, 3-, and 5-year survival of HNSCC. Importantly, this predictive model was successfully validated in the GEO dataset. The nomogram also demonstrated excellent accuracy and reliability, as determined by the calibration curves and the decision curve analysis (DCA) plot. Interestingly, the risk score model was found to be correlated with immune cell infiltration and immunotherapy-related biomarkers, suggesting its potential in predicting the immunotherapy response in HNSCC treatment. Moreover, we found that the expression of two risk score model component genes, SETD1B and MTDH, was significantly different between tumor and the adjacent tissues in patients with LSCC, which was also significantly correlated with patient prognosis. Further experimental validation showed that the upregulated expression of MTDH significantly inhibited ferroptosis through regulating GPX4 expression and enhanced the cytotoxicity of ferroptosis inducers in HNSCC cells. In conclusion, we have developed a risk score model by using a ferroptosis-related DNA methylation signature, which can be used as an alternative tool to predict the prognosis of patients with HNSCC. SETD1B and MTDH were identified as the pivotal genes in this model and might play important role in the progression of HNSCC.

Nomogram Model Based on Iodine Nutrition and Clinical Characteristics of Papillary Thyroid Carcinoma to Predict Lateral Lymph Node Metastasis.

OBJECTIVE: Preoperative evaluation of lateral lymph node metastasis (LLNM) in patients with papillary thyroid carcinoma (PTC) has been one of the major clinical challenges. This study aims to develop and validate iodine nutrition-related nomogram models to predict lateral cervical lymph node metastasis in patients with PTC. METHODS: This is a retrospective study. Urinary iodine concentration (UIC) and serum iodine concentration (SIC) were measured in 187 LLNM patients and 289 non-LLNM (NLLNM) patients. All patients were randomized 3:1 into the training cohort (n = 355) and the validation cohort (n = 121). Using logistic regression analysis, we analyzed the influence of iodine nutrition-related factors and clinicopathological characteristics on LLNM in PTC patients. Lasso regression method was used to screen risk factors and construct a nomogram for predicting LLNM. The receiver operating characteristic curve (ROC curve), calibration curve, and decision curve analysis (DCA) of the nomogram models were carried out for the training and validation cohorts. RESULTS: Gender, SIC, smoking history, drinking history, family history of PTC, multifocality, bilateral or unilateral tumors, TSH, Tg, and tumor size were included in the nomogram model predicting LLNM, with an area under the curve (AUC) of .795. The nomogram model showed good calibration and clinical benefit in both the training and validation cohorts. CONCLUSION: The nomogram model based on iodine nutrition and other clinicopathological features is effective for predicting the lateral lymph node metastasis in PTC patients.

S100 calcium-binding protein A12 knockdown ameliorates hypoxia-reoxygenation-induced inflammation and apoptosis in human cardiomyocytes by regulating caspase-4-mediated non-classical pyroptosis.

Ischemic heart disease, especially myocardial infarction, poses a serious risk to human health. S100 calcium-binding protein A12 (S100A12) expression was previously reported to be upregulated in ST-segment elevation myocardial infarction. Therefore, the present study investigated the role of S100A12 in hypoxia/reoxygenation (H/R)-induced cardiomyocytes injury and the associated mechanism. An in vitro H/R-induced cardiomyocyte injury model was first established using AC16 cells. The expression level was found to be hugely upregulated in H/R-induced AC16 cells. Subsequently, cell transfection was conducted to knock down the expression level of S100A12, and the following cellular biological assays revealed that S100A12 knockdown could not only inhibit H/R-induced AC16 cell injury by improving cell viability and decreasing the release of lactate dehydrogenase, as well as reducing apoptotic cells, but also reduce the production of inflammatory cytokines (TNF-α, IL-1ß and IL-6), restore the balance of oxidation-antioxidant factors (malondialdehyde, superoxide dismutase and glutathione), and inhibit the activated pyroptosis upon H/R induction. Then, co-immunoprecipitation was used to verify the interaction between S100A12 and caspase-4 (CASP4). CASP4 overexpression reversed the inhibitory effects of S100A12 downregulation on H/R-induced cardiomyocyte injury. In conclusion, these results suggest that S100A12 knockdown can ameliorate H/R-induced cardiomyocyte injury by regulating CASP4 expression. Therefore, S100A12 serves as a potential therapeutic target for the treatment of myocardial ischemia/reperfusion injury.

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities.

BACKGROUND: To assess the prevalence and associated risk of potentially inappropriate medications (PIMs) prescribing in community-dwelling elderly patients in China and to examine the most frequently used PIMs. This will provide a reference for the formulation of medication manuals for the community-dwelling elderly and further standardize the use of medications in elderly patients. METHODS: We conducted a cross-sectional retrospective study from April 1, 2020 to April 30, 2020. Data from elderly patients aged ≥65 years were collected from the Hengjie (N=2,294), Loujiang (N=3,972), and Tongxing communities (N=1,969) in Suzhou. The frequency of PIMs was detected using the 2019 Beers criteria and the 2017 Chinese criteria. Chi-square (for categorical variables), ANOVA (for continuous variables as applicable), and logistic regression were used to describe and identify potential predictors of PIMs. RESULTS: A total of 8,235 elderly patients were examined. Using the Chinese criteria, the prevalence of PIMs was 37.07%, which was slightly higher than that found using the 2019 Beers criteria (32.16%). The most prescribed PIMs were estazolam (21.53%) and insulin (4.60%) based on the Chinese criteria. Logistic regression analysis showed that advanced age, polypharmacy, and comorbid disease of patients were associated with a high risk of PIMs. Furthermore, the educational background and professional title of physicians were also associated with PIMs. CONCLUSIONS: Given the high prevalence of PIMs in the Chinese community-dwelling elderly population, the implementation of evidence-based interventions to promote rational clinical drug use could improve their quality of life.