Primary highly differentiated breast angiosarcoma in an adolescent girl.

Primary angiosarcoma of the breast is very rare. Surgery is the principal mode of treatment for primary angiosarcoma of the breast and generally consists of a total mastectomy. To discuss its etiology and treatment principles, we reported a case of primary mammary angiosarcoma in an adolescent girl. The patient had been treated in other hospitals several times due to erythema of the breast as inflammatory treatment was considered, until pathological nature was determined after we performed pathological needle puncture. The case discussed here is unique in its own way, having clinical imaging and pathological features of primary angiosarcoma in an adolescent girl and it is known that primary angiosarcoma is unusual for this age group.

[Role and related mechanism of resolvin D1 in lung ischemia reperfusion injury in rats].

Objective: To investigate the role and related mechanism of resolvin D1 (RvD1) in lung ischemia-reperfusion injury (LIRI) in rats. Methods: Forty male Sprague-Dawley rats, 7-8 weeks, weighing 220-280 g, were divided into 4 groups using a random number table method: sham operation group, lung ischemia reperfusion control group, normal saline group, and RvD1 group. The rat model of LIRI was produced by 45 min of occlusion of the left hilum of lungs followed by 150 min reperfusion. In sham group, no blocking of the left hilum of lung after thoracotomy; Normal saline 2 ml/kg and RvD1 100 µg/kg were injected respectively at 10 min of reperfusion in normal saline group and RvD1 group. Blood samples were collected from the femoral vein for determination of interleukin (IL)-6, tumor necrosis factor (TNF)-α, soluble inter-cell adhesion molecules (sICAM-1) concentrations at 150 min of reperfusion. The rats were sacrificed after collection of blood samples and then lung tissues were taken for observation of the pathological changes and for measurement of lung wet/dry weight ratio (W/D). The the contents of malondialdehyde (MDA), monocyte chemoattractant protein (MCP)-1, macrophage inflammatory protein (MIP)-2 and the activity of myeloperoxidase (MPO) in lung tissues were determined. The protein relative expression of nuclear factor (NF)-κB in lung tissues was detected by Western blot. Lung tissue cell apoptosis was detected with TUNEL method. Results: The plasma level of IL-6, TNF-α, sICAM-1 in normal saline group and RvD1 group were significantly higher than those in the Sham group [(110±7), (100±4) vs (72±3) ng/L, (151±8), (153±6) vs (104±5) ng/L, (2 690±133), (2 760±167) vs (1 953±125) ng/L]. Besides, NF-κB protein relative expression level of lung tissues up-regulated [(0.681±0.033), (0.664±0.024) vs (0.292±0.011)] (all P<0.05). The W/D, apoptosis index, MDA, MCP-1, MIP-2 contents and MPO activity in lung ischemia reperfusion control group, normal saline group and RvD1 group were significantly higher than those in the Sham group [(5.92±0.31), (5.85±0.24), (5.06±0.08) vs (4.14±0.10), (32.9±1.5)%, (31.9±1.3)%, (17.7±1.8)% vs (8.1±0.6)%, (72.1±2.3), (66.7±3.7), (34.0±1.4) vs (22.0±0.8) nmol/mg, (3.99±0.28), (3.86±0.25), (2.66±0.16) vs (1.47±0.17) pg/mg, (9.45±0.53), (9.68±0.62), (7.62±0.22) vs (4.70±0.41) pg/mg, (3.01±0.18), (2.92±0.19), (1.58±0.11) vs (0.98±0.07) U/g] (all P<0.05). The plasma levels of the cytokines mentioned above, the W/D, the apoptosis index, MDA, MCP-1, MIP-2 contents and MPO activity in RvD1 group were significantly lower than those in the lung ischemia reperfusion control group [(63±4) vs (110±7) ng/L, (90±8) vs (151±8) ng/L, (1 835±182) vs (2 690±133) ng/L, (5.06±0.08) vs (5.92±0.31), (17.7±1.8)% vs (32.9±1.5)%, (34.0±1.4) vs (72.1±2.3) nmol/mg, (2.66±0.16) vs (3.99±0.28) pg/mg, (7.62±0.22) vs (9.45±0.53) pg/mg, (1.58±0.11) vs (3.01±0.18) U/g]. Besides, NF-κB protein relative expression level of lung tissues down-regulated [(0.313±0.012) vs (0.681±0.033)] (all P<0.05). Inflammatory cell infiltration in LIRI groups increased significantly, while it was significantly reduced in RvD1 group. Conclusion: RvD1 can effectively alleviate the tissue damage caused by lung ischemia-reperfusion through down-regulating NF-κB expression, relieving inflammatory reaction and oxidative stress, reducing apoptosis in rats.

[Granulomatous lobular mastitis: a clinicopathological analysis of 300 cases].

Objective: To investigate the clinicopathologic features and possible causes of granulomatous lobular mastitis(GLM). Methods: Three hundred cases of GLM were collected from surgical specimens diagnosed at Longhua Hospital, Shanghai University of Traditional Chinese Medicine from January 2015 to November 2017. Morphologic features were reviewed using HE staining. A total of 116 cases were investigated by Gram staining. The expression of CD3, CD20, CD68, IgG, IgG4, CD38 and CD138 was detected by immunohistochemical staining. Results: The age of the patients was 23 to 47 years and the median age was 32 years. All patients were female, 96.7% (290/300) had a history of lactation.There were 143 cases of left breasts, 138 cases of right breast and 19 cases of bilateral breasts. Serum prolactin increased in 39.7%(119/300) patients. Within 15.7%(47/300) of patients were associated with nodular erythema or joint swelling and pain of the lower extremities. Pathological observation showed that lobular-centric suppurative granulomatous inflammation, accompanied by dilatation of intralobular and interlobular ducts. There were 16 cases accompanied with duct ectasia. Immunohistochemistry showed CD3-positive lymphocytes were more than CD20-positive lymphocytes in the peripheral aggregation zone of neutrophils within granulomatous lesions. Gram positive bacteria were found in the lipid vacuoles of the 51.7%(60/116) patients. Conclusions: GLM has distinctive histologic features. It may be related to corynebacterium infection, or accompanied by the increase of serum prolactin and erythrocyte sedimentation rate. The age, location and history of the disease are importance in the diagnosis and differential diagnosis.

[The role of high-mobility group box protein 1 in the signaling pathways of myocardial ischemia-reperfusion injury in rats].

Objective: To investigate the role of high-mobility group box protein 1 (HMGB1) in the signaling pathways of myocardial ischemia-reperfusion injury (MIRI) in rats. Methods: Forty male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into 4 groups (n=10) using a random number table: sham operation group (group sham), MIRI group (group IR-C), anti-HMGB1 antibody group (group IR-H-Ig), contrast antibody control group (group IR-Ig). The rat model of MIRI was established by 30 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 180 min reperfusion. In sham group, no blocking of LAD was adopted after thoracotomy. Anti-HMGB1 antibody and contrast antibody immunoglobulin G (IgG) (2 mg/kg) were injected respectively at 30 min of reperfusion in IR-H-Ig and IR-Ig groups. Blood samples were collected from the femoral vein for determination of interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), HMGB1, creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations at 180 min of reperfusion. The rats were then sacrificed after blood samples were taken and the pathological changes of myocardial tissue were observed. The mRNA and protein expressions of HMGB1, toll-like receptor 4(TLR4) and nuclear factor (NF)-κB in myocardial tissues were detected by Western blot and real-time quantitative PCR respectively. Results: Compared with the Sham group, the plasma level of IL-6, TNF-α, HMGB1 increased significantly and HMGB1, TLR4 and NF-κB mRNA and protein levels of myocardial tissues up-regulated in IR-C and IR-Ig groups (all P<0.05). The plasma level of CK-MB and cTnI increased significantly in IR-C, IR-H-Ig, IR-Ig group (all P<0.05). Compared with the IR-C group, the levels of the plasma HMGB1, the cytokines mentioned above, CK-MB and cTnI were significantly decreased, and mRNA and protein expressions of HMGB1, TLR4 and NF-κB of myocardial tissues down-regulated in IR-H-Ig group (all P<0.05). Inflammatory cell infiltration in MIRI groups increased significantly, while it was significantly reduced in IR-H-Ig group. Conclusion: Blocking the combination of HMGB1 and TLR4 can effectively alleviate the tissue damage caused by myocardial ischemia-reperfusion in rats.

[Prenatal diagnosis of chromosome abnormalities and nine microdeletion syndromes using both traditional karyotyping and BoBs].

OBJECTIVE: To evaluate a new prenatal diagnosis model of chromosomal abnormalities and nine microdeletion syndromes by using both traditional karyotyping and a newly-developed rapid prenatal diagnosis technology, BACs-on-Beads (BoBs) technique. METHODS: From June 2012 to December 2014, 807 pregnant women with high risk after screening or with other indicators, were performed amniocentesis. Traditional karyotyping and BoBs were employed simultaneously for prenatal diagnosis. RESULTS: Thirty-two cases with chromosome aneupoidies were successfully detected both by BoBs and karyotyping, including 18 cases of trisomy 21, 6 cases of trisomy 18, 1 case of trisomy 13, and 7 cases with sex chromosome abnormality. All 8 fetuses with chromosome structural abnormalities detected by karyotyping were missed by BoBs; while BoBs contributed more in detection of five microdeletion syndrome cases, including 3 cases of DiGeorge syndromes (two with microduplication and one with microdeletion), one case of Miller-Dieker syndrome, and one case of Wolf-Hirschhorn syndrome. CONCLUSION: Combined use of traditional karyotyping and BoBs, is a rapid and effective prenatal diagnosis model that may enlarge our horizon on chromosomal diseases and should be widely used in future clinical service.

Betulin inhibits pro-inflammatory cytokines expression through activation STAT3 signaling pathway in human cardiac cells.

OBJECTIVE: Signal transducer and activator of transcription 3 (STAT3) is an important regulator of cardiac survival pathways. Decreased expression or activity of STAT3 in patients with end-stage heart failure demonstrated a clinical relevance of STAT3 in cardiac diseases. Betulin, a pentacyclic triterpene, has drawn extensive attention towards its beneficial effects. However, little is known about its roles in cardiac cells. MATERIALS AND METHODS: We investigated the effects of betulin on the pro-inflammatory processes in human cardiac AC16 cells. Genes expression of pro-inflammatory cytokines and activation of NF-κB signaling were analyzed. Besides, levels of phosphorylated STAT3 and its down-stream target genes were measured to evaluate the activation of STAT3. Finally, STAT3 inhibitor and small interfering RNA (siRNA) oligos were used to determine the roles of STAT3 in AC16 cells treated with betulin. RESULTS: Our results revealed that betulin inhibited pro-inflammatory cytokines expression and NF-κB signaling activation through STAT3 signaling. Besides, betulin treatment also induced the expression of Bcl-xL, an anti-apoptotic downstream effector of STAT3. CONCLUSIONS: Our results, for the first time, uncovered the cardioprotective roles of betulin, which may be useful to reduce the occurrence of adverse cardiovascular events.