[Solid placental transmogrification of the lung: A case report and literature review].

Placental transmogrification of the lung (PTL) is a very rare benign lung lesion. There are only about 40 cases reported in the literature. The imaging and histological features of PTL cases in the publication are various, most of which are cystic and a few of which are solid. Being extremely rare, the solid PTL is unknown to major pathologists and surgeons. We reported a case of solid PTL in the anterior mediastinum. The patient was a 52-year-old male with no history of smoking and without symptoms. During physical examination, chest CT revealed a circular low-density lesion with a maximum diameter of 2.9 cm beside the spine in the posterior basal segment of the left lower lobe of the lung. The wedge resection was performed by video-assisted thoracoscopy. Grossly, a round nodule was located underneath the visceral pleura. It was about 3.0 cm×3.0 cm×1.6 cm and the cut surface was grey-red, soft and spongy. Microscopically, the nodule was constituted of papillare, which resembled placental villi at low magnification. The axis of papillae was edema, in which some mild round cells with clear cytoplasm and CD10 positive staining aggregated and transitioned to immature adipocytes and amorphous pink materials deposited with a few of inflammatory cells infiltration. The surface of papillae was covered with disconti-nuous alveolar epithelium. Combined with the typical morphology and immunohistochemical characteristics of CD10 positive, the diagnosis was PTL. The patient was followed up for 1 year without recurrence and discomfort. So far, the pathogenesis of PTL is unclear. The major hypotheses include hamartoma, variant of emphysema and clonal hyperplasia of stromal cells. Based on the study of our case and publication, we speculate that the hyperplasia of stromal cells located in the alveolar septa might be the first step to form the solid PTL. With the progression of the disease, a typical unilateral cystic nodule develops as a result of secondary cystic degeneration due to the occlusive valve effect. Surgery is the only option for diagnosis and treatment of PTL. The clinician should make an individualized operation plan according to the clinical manifestations, location and scope of the lesion, and preserve the surrounding normal lung tissue as much as possible while completely removing the lesion. There is a favorable prognosis.

[Effects of adipose-derived mesenchymal stem cells from type 2 diabetes mellitus patients on wound healing of pressure ulcers in mice].

To investigate the effects of adipose-derived mesenchymal stem cells (AMSCs) from type 2 diabetes mellitus patients on wound healing of pressure ulcers in mice. Methods: (1) In September 2016, the subcutaneous adipose tissue of a 60-year-old woman with type 2 diabetes mellitus was harvested, and then AMSCs were extracted by collagenase digestion and cultured. The third passage of cells were used for subsequent experiments. The morphology of cells was observed, and their osteogenic, chondrogenic, and adipogenic differentiation abilities were identified. The expressions of cell surface markers CD90, CD105, CD73, and CD34 were detected by flow cytometer (n=3). (2) Sixteen female C57BL/6 wild-type mice aged 6-8 weeks were selected, and one pressure ulcer wound was created on each side of the spine of each mouse by pressing the skin with two magnets. The two wounds of each mouse were paired and divided into diabetic AMSCs group and negative control group, injected with 100 µL phosphate buffer solution (PBS) containing green fluorescent protein-labeled AMSCs (1×10(6) cells) and 100 µL PBS, respectively. The wound healing status of the two groups within post injection day (PID) 21 was observed, and their wound healing rates on PID 5, 13, and 17 were calculated. Three mice were sacrificed on PID 11 and 21, respectively, and tissue of three wounds was harvested from each group. The skin structure was observed by hematoxylin-eosin staining, the collagen deposition was evaluated by Masson staining, and the positive expression of CD31, i. e., the number of new blood vessels was counted by immunohistochemistry. Wound tissue samples of two groups prepared on PID 21 as above-mentioned were harvested, and the positive cell rate of S100, representing the regeneration of Schwann cells, was detected by immunohistochemistry. Wound tissue samples of diabetic AMSCs group prepared on PID 11 as above-mentioned were harvested, and the colonization of AMSCs was observed by fluorescence tracer method. Data were processed with paired t test and Bonferroni correction. Results: (1) The third passage of cells isolated and cultured from the subcutaneous adipose tissue of a type 2 diabetes mellitus patient grew adherently to the wall in a long spindle and vortex-like manner. After induction, the cells showed osteogenic, chondrogenic, and lipogenic differentiation abilities. The positive expression rates of CD90, CD105, and CD73 on the cell surface were higher than 90.00%, and the expression rate of CD34 was 0.46%. The cells were identified as AMSCs. (2) The mice wounds of diabetic AMSCs group healed quickly, and all the wounds healed completely on PID 17, while the mice wounds in negative control group were not completely closed at this time, and there was still scab on the surface. On PID 5, 13, and 17, the healing rates of mice wounds of diabetic AMSCs group were (35.6±6.5)%, (87.1±2.5)%, and 100.0%, respectively, significantly higher than (19.8±7.2)%, (66.2±5.2)%, and (86.9±5.3)% of negative control group (t=6.49, 14.31, 9.73, P<0.05). Compared with that of negative control group, the inflammatory cell infiltration was reduced in mice wounds tissue of diabetic AMSCs group on PID 11, and thicker epidermis and dermis as well as regenerated skin appendages were observed on PID 21. On PID 11 and 21, the collagen percentages of mice wounds tissue in diabetic AMSCs group was (48.3±1.3)% and (54.1±1.7)%, respectively, significantly higher than (41.4±1.7)% and (50.3±1.2)% of negative control group (t=6.98, 3.99, P<0.01). On PID 11 and 21, the numbers of new blood vessels in mice wounds tissue of diabetic AMSCs group were 17.2±1.3 and 18.0±2.1, respectively, significantly more than 8.0±1.4 and 14.0±1.5 of negative control group (t=10.69, 3.38, P<0.01). On PID 21, the S100 positive cell percentage in mice wounds tissue of diabetic AMSCs group was (1.76±0.12)%, significantly higher than (0.55±0.03)% of negative control group (t=21.68, P<0.001). On PID 11, the colonization of AMSCs in mice wounds tissue of diabetic AMSCs group was observed. Conclusions: Transplantation of AMSCs from type 2 diabetic mellitus patients can accelerate wound healing of pressure ulcers in mice by promoting angiogenesis, collagen deposition, and Schwann cell regeneration.

[Advances in the research of influence of diabetes in biological function of adipose-derived stem cells].

Adipose-derived stem cells (ADSCs) are adult mesenchymal stem cells in adipose tissue with self-renewal and multi-directional differentiation potential. The application of ADSCs in the treatment of wounds has achieved good results. Because of its extensive sources, high content in vivo, low immunogenicity, slight injury to body when obtained, the clinical application prospect of ADSCs is promising. The reasons why diabetic wound is difficult to heal may be closely related to the increase of advanced glycation end products, long-term chronic inflammatory response, and peripheral neurologic dysfunction. The abnormal internal environment of diabetic patients can affect the biological function of ADSCs, which further affects wound healing. This article reviews the general feature, differentiation, proliferation, migration, secretion, and pro-angiogenic function of diabetic ADSCs.

[Effects of local transplantation of autologous adipose-derived stromal vascular fraction on the hyperplastic scar formation in rabbit ears and the mechanism].

Objective: To explore the effects of local transplantation of autologous adipose-derived stromal vascular fraction (SVF) on the hyperplastic scar (HS) formation in rabbit ears and the mechanism. Methods: Twenty-four New Zealand white rabbits were used to reproduce HSs by making four full-thickness skin defect wounds with a diameter of 1 cm on the ventral surface of left ear of each rabbit. Wound epithelization and local-tissue proliferation were observed, and wound healing (complete epithelization) time and formation time of HS were recorded. The 24 rabbits were divided into SVF group, pure DMEM group, and pure HS group according to the random number table, with 8 rabbits and 32 wounds in each group. On post injury day (PID) 25 (after the complete epithelization of wounds), 0.2 mL of low glucose DMEM medium containing CM-Dil labeled autologous SVF was injected into HSs of rabbits in SVF group, while the same amount of low glucose DMEM medium was injected into HSs of rabbits in pure DMEM group. The frequency of injection was once every 5 days, totally for 3 times. HSs of rabbits in pure HS group did not receive any treatment. On PID 40, HSs of rabbits' ears in each group were harvested, then the histological form was observed by hematoxylin and eosin staining, the arrangement of collagen in HS was observed by Van Gieson staining, the distribution of CM-Dil-labeled SVF in the HS was observed with fluorescence microscope, and the mRNA expression and the protein expression of transforming growth factor ß(1) (TGF-ß(1)), Smad3, and Smad7 in HS were determined by real-time fluorescent quantitative reverse transcription-polymerase chain reaction and Western blotting, respectively. Data were processed with one-way analysis of variance and Tukey test. Results: (1) Complete epithelization time of wounds of rabbits' ears was (20.0±2.0) d post injury, and HSs were formed on PID 25. On PID 40, HSs of rabbits' ears in pure DMEM group and pure HS group were still in hyperplasia, while those in SVF group became smaller, flat, soft, and light colored. (2) On PID 40, compared with those in pure DMEM group and pure HS group, the number of epithelium foot like structures was more and the amount of inflammatory cells was less. The collagen of HSs of rabbits' ears in SVF group was arranged more regularly with broader gap between collagens. (3) On PID 40, CM-Dil-labeled SVF could still be observed in the HSs of rabbits' ears in SVF group. (4) On PID 40, compared with those in pure DMEM group and pure HS group, the mRNA expressions of TGF-ß(1) and Smad3 in the HSs of rabbits' ears in SVF group were significantly down-regulated (P<0.05), while the mRNA expression of Smad7 was significantly up-regulated (P<0.05). There were no significant differences in the mRNA expressions of TGF-ß(1), Smad3, and Smad7 in the HSs of rabbits' ears between pure DMEM group and pure HS group (P>0.05). (5) On PID 40, compared with those in pure DMEM group (0.74±0.03, 0.73±0.10, 0.54±0.09) and pure HS group (0.72±0.08, 0.71±0.12, 0.53±0.06), the protein expressions of TGF-ß(1) and Smad3 in the HSs of rabbits' ears in SVF group (0.57±0.06, 0.42±0.09) were significantly down-regulated (P<0.05), while the protein expression of Smad7 (0.71±0.05) was significantly up-regulated (P<0.05). The protein expressions of TGF-ß(1), Smad3, and Smad7 in the HSs of rabbits' ears in pure DMEM group and pure HS group were close (P>0.05). Conclusions: Autologous SVF transplantation can inhibit the formation of HS in the early stage of scar formation of rabbit, the mechanism may be related to the TGF-ß(1)/Smad signaling pathway.

Aberrant expression of Rab1A and its prognostic significance in human colorectal cancer.

OBJECTIVE: Colorectal cancer (CRC) is one of the most common types of cancer worldwide. Emerging evidence has verified that Rab1A plays an oncogenic role in several human malignancies including breast cancer, lung cancer, and hepatocellular carcinomas. However, the clinical significance and prognostic impact of Rab1A in CRC is still unclear. PATIENTS AND METHODS: We initiated our investigation by immunohistochemistry and Western blot analysis to confirm Rab1A expression in CRC tissues. Meanwhile, the correlation of Rab1A expression and clinicopathologic features, as well as outcome in CRC patients, were retrospectively analyzed. RESULTS: In the issue, Rab1A is overexpressed in CRC tissues compared with matched noncancerous tissues. Meanwhile, high Rab1A expression was significantly associated with the TNM stage, lymph node metastasis, and peritoneal metastasis. In addition, multivariate analyses identified Rab1A expression and TNM stage as independent predictors for CRC patients. Moreover, Kaplan-Meier survival analysis showed that patients with high Rab1A expression had a significantly worse survival time than those with low Rab1A expression, which especially affected the survival in CRC patients with advanced stage. Spearman analysis suggested that there was a positive relationship between Rab1A expression and preoperative serum carcinoembryonic antigen (CEA) for CRC patients. CONCLUSIONS: These results suggested that Rab1A is an important diagnostic marker for CRC, and Rab1A can be used as a valuable biomarker for prognosis as well as peritoneal metastasis in CRC patients. Rab1A may prove to be clinically useful for developing a new therapeutic target of CRC treatment.

[Different posterior decompression for patients with spinal canal stenosis in the upper thoracic and cervical spine].

OBJECTIVE: To retrospectively investigate the clinical manifestation of patients with spinal stenosis in the upper thoracic and cervical spine by posterior decompression in different ways. METHODS: From January 2010 to December 2015, 18 patients of that complicated phenomenon were studied in Department of Orthopaedic Surgery, China-Japan Union Hospital, Jilin University.Ten patients received one-stage combined decompression (group A); while the other 8 received multi-stage posterior decompression(group B). The Visual analogue scale (JOA), thoracic Cobb and range of motion(ROM) were compared. RESULT: No statistically significant inter-group difference existed in preoperative JOA score[(9.1±2.6)vs (9.1±2.2)]and postoperative JOA score[(15.4±1.2)vs(13.8±4.5)], but the mean recovery rate of nerve function of group A(79%±15%)is better than that of group B(69%±34%). CONCLUSION: All the approaches are effective for the treatment of patients with spinal stenosis in the upper thoracic and cervical spine, while one-staged combined decompression was better than double-staged operation.

Role of survivin in the pathogenesis of papillary thyroid carcinoma.

The purpose of this study was to assess the correlation between the survivin gene and the occurrence and pathogenesis of papillary thyroid carcinoma (PTC). Sixty patients with PTC and no preoperative chemotherapy were recruited for the study and 30 thyrophyma patients receiving operative treatment in Drum Tower Hospital (Nanjing, China) were included as the control group. The protein expression levels of survivin were assessed by immunoblotting and immunohistochemical analysis of tissues from both patient groups. For survivin gene knockdown experiments, two target sequences were selected based on the mRNA sequence of survivin and two pairs of siRNA interference sequences were designed and synthesized accordingly. The siRNAs were shown to be successfully transfected into SW579 carcinoma cells and the resulting survivin knockdown was assessed by RT-PCR and immunofluorescence. Survivin was shown by immunohistochemistry to be distributed in the cytoplasm of PTC and thyrophyma cells, with the signal being significantly stronger in PTC cells than in thyrophyma cells and statistical analysis of immunostaining data further showed survivin to be more highly expressed  (P < 0.05) in the PTC tissue than in the thyrophyma tissue. Transfection of SW579 cells with siRNA was found to be effective in knocking down the expression levels of survivin: 87.3 and 76.2% knockdown was achieved with sh-Survivin-1 and sh-Survivin-2, respectively. The findings reported here show that survivin is highly expressed in PTC and may therefore play a role in the occurrence, lymph node metastasis, and clinical staging of PTC.

Determinants of spironolactone binding specificity in the mineralocorticoid receptor.

Spironolactone is a mineralocorticoid receptor (MR) antagonist in clinical use. The compound has a very low affinity for the glucocorticoid receptor (GR). Determinants of binding specificity of spironolactone to the MR were investigated using chimeras created between the ligand-binding domains (LBDs) of the MR and the GR. These chimeras had previously been used to investigate aldosterone binding specificity to the MR. Spironolactone was able to compete strongly for [(3)H]-aldosterone and [(3)H]-dexamethasone binding to a chimera containing amino acids 804-874 of the MR, and weakly for [(3)H]-dexamethasone binding to a chimera containing amino acids 672-803 of the MR. Amino acids 804-874 were also critical for aldosterone binding specificity. Models of the MR LBD bound to aldosterone and spironolactone were created based on the crystal structure of the progesterone receptor LBD. The ligand-binding pocket of the MR LBD model consisted of 23 amino acids and was predominantly hydrophobic in nature. Analysis of this model in light of the experimental data suggested that spironolactone binding specificity is not governed by amino acids in the ligand-binding pocket.

[Spectrum analysis of cat si neurone discharges].

Spontaneous firing and the discharges evoked by A- and/or C-fiber inputs (A-ED, C-ED, AC-ED) of saphenous nerve were recorded in the somatosensory cortical (SI) neurons (n = 128) of the cats anesthetized with chloralose and paralysed by gallamine. Normalized power spectrum density function (NPSDF) was used to analyse the neuron discharges. The results showed that 1) all the NPSDFs for the spontaneous discharges were single-peak with a peak frequency of 3.91 +/- 1.63 Hz (spontaneous rhythm) and a peak value of 0.0154 +/- 0.0045; 2) the NPSDFs of A-ED showed a single peak (peak value 0.021 +/- 0.0054) and an overlapped double-peak (with spontaneous discharge) or a separate multi-peak (without spontaneous discharge); 3) the NPSDFs of C-ED showed a single peak (peak value 0.020 +/- 0.007) or a separate double-peak; 4) the NPSDFs of AC-ED have two patterns: a single peak (peak value 0.023 +/- 0.004) and an overlapped multi-peak. It is suggested that A-fiber input can potentiate the rhythms of the spontaneous discharge and induce specific rhythm; that C-fiber input can potentiate the spontaneous rhythm and induce characteristic C-rhythm. It is also observed that both spontaneous rhythm and evoked rhythm affect each other; that the evoked rhythms by A-fiber and C-fiber inputs also affect each other.

[CEA in lung cancer: CEA immunohistochemical study of 150 cases].

CEA (Carcinoembryonic Antigen) was examined histochemically with PAP method in 150 lung cancer cases. Positive stainings were observed in 89% of adenosquamous cancers, 79.2% of adenocarcinomas (ACs), 63.3% of squamous cell cancers (SCCs), 55.6% of large cell cancers (LCCs) and 51.6% of small cell lung cancers (SCLCs). In ACs and SCCs, the higher cancer cells differentiated, the higher positive rates were observed. The intensities from high to low as followings: ACs and adenosquamous cancers; SCLCs and SCCs; and LCCs. Cytoplasmic staining was predominantly found in ACs (76%) and adenosquamous cancers (68.8), membranous in SCCs (63%) and LCCs (60%), and intercellular in SCLCs (68.8%). The results suggests that CEA is significantly related to differential degree of lung cancers. The different staining patterns and positive rates and intensities of CEA may be helpful for the pathological classification of lung cancers. Finally, the author indicates that CEA immunohistochemical examination will be a useful measure for exactly selecting lung cancer cases suitable for radioimmunodetection and antibody-mediated therapy.

[Re-radiation of recurrent nasopharyngeal carcinoma--analysis of 58 cases].

Fifty-eight patients with recurrent nasopharyngeal carcinoma in nasopharynx and/or regional areas were re-radiated from 1972 to 1979 after initial irradiation. 70.7% of the recurrence appeared within 3 years after initial treatment. 90.9% of the recurrent tumor disappeared after re-radiation. The 3-and 5-year survival rates were 29.3% (17/58) and 12.1% (7/58). The factors influencing the prognosis are: the interval between the treatment and the recurrence; dose of re-radiation; and initial stage of the primary lesions. The authors suggest that the dose of re-radiation should be 70 Gy/7 weeks.