Single-cell RNA sequencing reveals tumor heterogeneity within salivary gland pleomorphic adenoma: A preliminary study.

BACKGROUND: Salivary gland pleomorphic adenoma (SPA) is a common neoplasm of salivary glands that displays remarkable histological diversity. Previous studies have demonstrated the involvement of gene rearrangements and cytoskeleton-remodeling-related myoepithelial cells in SPA tumorigenesis. Cytoskeleton remodeling is necessary for epithelial-mesenchymal transition (EMT), a key process in tumor progression. However, the heterogeneity of tumor cells and cytoskeleton remodeling in SPA has not been extensively investigated. METHODS: An analysis of single-cell RNA sequencing (scRNA-seq) was performed on 27 810 cells from two donors with SPA. Bioinformatic tools were used to assess differentially expressed genes, cell trajectories, and intercellular communications. Immunohistochemistry and double immunofluorescence staining were used to demonstrate FOXC1 and MYLK expression in SPA tissues. RESULTS: Our analysis revealed five distinct cell subtypes within the tumor cells of SPA, indicating a high level of intra-lesional heterogeneity. Cytoskeleton-remodeling-related genes were highly enriched in subtype 3 of the tumor cells, which showed a close interaction with mesenchymal cells. We found that tumoral FOXC1 expression was closely related to MYLK expression in the tumor cells of SPA. CONCLUSION: Tumor cells enriched with cytoskeleton-remodeling-related genes play a crucial role in SPA development, and FOXC1 may partially regulate this process.

Comprehensive analysis of 65 patients with Castleman disease in a single center in China.

This study aimed to investigate the epidemiologic, clinical, pathological characteristics, and treatment of patients with Castleman disease (CD) in a single center in China. We retrospectively analyzed the data of 65 Chinese CD patients, divided into unicentric CD (UCD) and multicentric CD (MCD) groups, and also microscopic subtypes as hypervascular (HV), plasmacytic (PC) and Mixed. Based on whether HHV-8 infection existed, MCD was subdivided into HHV-8-associated MCD and idiopathic Castleman disease (iMCD). Detailed epidemiologic, clinicopathological, and treatment data were analyzed and discussed. Of total 65 patients (UCD 33, MCD 32), HV (81.8%) accounted for the most of UCD and total. More females in UCD (60.6%) and more males in MCD (65.6%) were observed. CD occurred in all age groups, most commonly in 40-49 years. The mean age of onset of total was 38.5 years with PC higher than HV (45.5 vs. 35.1 years, P = 0.0413). The median diagnosis delay of MCD was longer than that of UCD (3.00 vs. 1.25 months, P = 0.0436). Abdomen (39.4%) and neck (30.3%) were the most-seen locations of lymphadenopathy in UCD, with neck (65.6%) being predominant in MCD. Mean major diameter of specimens of UCD was greater than MCD (6.4 vs. 3.1 cm, P < 0.0001). These results provided the featured and detailed profile of Castleman disease in Henan province in China with a considerable number of cases, which presented distinct evidence with other studies.

Syngnathia Between the Palate and Mouth Floor, Cleft Palate, and Funnel Chest.

Syngnathia is a rare malformation involving soft tissue and/or bony adhesions between the maxilla and mandible. Less than 40 patients have been reported in the literature. Here the authors report a 6-month-old infant diagnosed as syngnathia of the palate and mouth floor combined with cleft palate and funnel chest in the Department of Oral and Maxillofacial Surgery at Henan Provincial People's Hospital in January 2015. The authors discussed and evaluated the diagnostic and treatment difficulties on surgical and anesthetic procedure. There is no standard treatment protocol, but early treatment is necessary to improve airway functions and infant feeding, and to support proper nutrition for the growth of maxillofacial region.

[Single-lung transplantation for end-stage pulmonary parenchymal diseases with pulmonary hypertension].

OBJECTIVE: To observe the outcome of single-lung transplantation (SLT) for end-stage pulmonary parenchymal diseases in combination with pulmonary hypertension (PH). METHODS: From September 2002 to November 2005, there were 22 lung transplantation recipients, suffering from emphysema (10/22), pulmonary fibrosis (10/22), pneumosilicosis (1/22) and vascular leiomyoma (1/22), and all of them were complicated with pulmonary hypertension to different extent. Operative techniques: 10 patients received left-lung transplantations, and 12 patients received right-lung transplantation. In all the patients echocardiography (ECHO) was performed before transplantation, and arterial blood was collected to determine oxygenation index (PaO(2)/FiO(2)). RESULTS: The systolic pulmonary artery pressure (Ppa, syst) was monitored by Swan-Gans catheterization one week post-transplantation, and it was found to have decreased significantly [from (50.00+/-13.00) mm Hg (1 mm Hg=0.133 kPa) to (39.5+/-7.36) mm Hg,P<0.05]. Simultaneously, PaO(2)/FiO(2) was improved [from (241.26+/-79.54) mm Hg to (348.23+/-99.31) mm Hg, P<0.05]. CONCLUSION: Single lung transplantation is an efficient way to deal with end-stage pulmonary parenchymal disease combined with pulmonary hypertension.

[Lung transplantation for pulmonary fibrosis: report of 10 cases].

OBJECTIVE: To discuss the operative technique, patient selection and perioperative management of lung transplantation for pulmonary fibrosis. METHODS: From September 2002 to December 2005, 31 cases of lung transplantations were performed in our hospital. There were 10 cases receiving single lung transplantation for pulmonary fibrosis, among them 2 received right lung transplantation with cardio pulmonary bypass, and one received contralateral lung transplantation-a left donor lung implanted in the recipient's right thorax. RESULTS: The in-hospital mortality was 10.0% (1/10). Nine patients were discharged from hospital, while one patient died of severe infection on the 137th postoperative day. During follow-up, one patient died of infection 9 months and another patient died of an accident 25 months after the operation. The 7 other patients were alive with improved lung functions. CONCLUSION: Lung transplantation is effective in improving the survival of selected patients with idiopathic pulmonary fibrosis.

[Perioperative care in lung transplantation: report of 18 cases].

OBJECTIVE: To evaluate monitoring and cares in the intensive care unit (ICU) after lung transplantation. METHODS: From September 2002 to April 2005, there were 18 cases of lung transplant recipients, who had suffered from emphysema (9 cases), pulmonary fibrosis (5 cases), silicosis (1 cases), bronchiectasis (1 case), pulmonary vascular leiomyoma (1 case), ventricular septal defect and Eisenmenger's syndrome (1 case), respectively. Operative procedures included 9 cases with left lung transplantation, 5 right lung transplantation, 1 case right single lung transplantation and ventricular septal defect repair, and 3 cases bilateral lung transplantations. All the patients received mechanical ventilation, immunosuppressive agents, antibacterial prophylaxis, and prevention of reperfusion injury in the ICU after operation. Preoperatively, echocardiography (ECHO), artery blood gas,and oxygenation index (partial pressure of oxygen in artery/fraction of inspired oxygen, PaO(2)/FiO(2)) were observed. RESULTS: The average weaning time from the ventilator was (7.39+/-4.89) days. The average ICU stay time was (9.72+/-8.32) days. The systolic pulmonary artery pressure (Ppa, syst) was monitored with Swan-Ganz catheterization 1 week post transplant, and it was found to have decreased significantly from (48.94+/-14.45) mm Hg (1 mm Hg=0.133 kPa) to (39.59+/-7.45) mm Hg (P<0.05). At the same time, oxygenation index was improved from (263.89+/-82.09) mm Hg to (345.56+/-92.18) mm Hg (P<0.05), partial pressure of carbon dioxide in artery (PaCO(2)) was decreased from (63.29+/-22.56) mm Hg to (38.37+/-9.19) mm Hg (P<0.05). In hospital mortality (HM) was 16.7% (3/18 cases), and an early death was due to severe infection on the 30 th postoperative day in 1 patient and acute rejection on the 15 th postoperative day in another patient, and the other patient died due to pulmonary vein embolism on the 36 th day. Fifteen patients recovered quickly and discharged from the hospital. One patient was followed up for 32 months. CONCLUSION: Lung transplantation remains the only hope for many patients with end stage pulmonary disease. It is important that the lung transplant team possesses a working knowledge of the treatment of common complications, the time of these complications mostly likely to occur and how best to treat them when they do arise, to ensure long-term survival and success.

[The operative technique selection of lung transplantation for end-stage emphysema].

OBJECTIVE: To investigate the operation of lung transplantation for end-stage emphysema. METHODS: From September 2002 to February 2005, 9 patients with chronic obstructive pulmonary disease (COPD) underwent lung transplantation. The types of surgery included single lung transplantation in 2 patients, lung transplantation with asynchronous contralateral lung volume reduction (one week later) in 1, single lung transplantation with synchronized contralateral lung volume reduction in 4, and bilateral sequential lung transplantation without cardiopulmonary bypass in 2. RESULTS: The volume of chest drainage was more than 2000 ml at the first postoperative day in 2 patients, one was reoperated for hemostasis and another was successfully responded to conservative therapy. The ventilation time was ranged from 3 to 22 days postoperatively. Two patients were received tracheotomy. Seven patients achieved good results, two of them had returned to work, and 1 patient had lived for 30 months. One patient was died of severe acute rejection (4A) at 15th postoperative day and 1 succumbed to multisystem organ failure due to severe bacterial infection combine fungal infection. CONCLUSION: End-stage emphysema is an indication for single lung transplantation. Single lung transplantation with contralateral lung volume reduction is a good way to utilize donor. If patient suffered from infection, double-lung transplantation should be considered first.