Ganglioneuroma (GN) is a rare benign tumor of neural crest origin usually found in the abdomen, but may occasionally present at uncommon sites including the cervical, lumbar, or sacral spine. However, GNs of thoracic spine are extremely rare. In this report, we describe a 12-year-old girl with giant GN in the thoracic spine, who underwent successful resection (T1–4 level) of the tumor. Histopathological examination confirmed the diagnosis. GN should be considered in the differential diagnosis of any paraspinal mass. A high index of suspicion and correlation of clinico-radiological findings is necessary in differentiating a large benign tumor from a malignant growth. Complete surgical excision is the treatment of choice; however tumor size and location need to be considered for the surgical approach (one-step or multiple surgeries). Close follow-up after surgery is mandatory.
Abdomen ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Follow-Up Studies ; Ganglioneuroma* ; Humans ; Neural Crest ; Spine*

PURPOSE: To investigate the distribution of CD44+/CD24- cells in breast cancers in relation to tumor size before and after the administration of neoadjuvant chemotherapy. METHODS: CD44+/CD24- tumor cells obtained from breast cancer specimens were characterized in vivo and in vitro using tumor formation assays and mammosphere generation assays, respectively. The distribution of CD44+/CD24- tumor cells in 78 breast cancer specimens following administration of neoadjuvant chemotherapy was also evaluated using immunofluorescence assays, and this distribution was compared with the extent of tumor invasion predicted by Response Evaluation Criteria in Solid Tumours (RECIST). RESULTS: In 27/78 cases, complete remission (CR) was identified using RECIST. However, 18 of these CR cases were associated with a scattered distribution of tumor stem cells in the outline of the original tumor prior to neoadjuvant chemotherapy. After neoadjuvant chemotherapy, 24 cases involved cancer cells that were confined to the tumor outline, and 21 cases had tumor cells or tumor stem cells overlapping the tumor outline. In addition, there were 6 patients who were insensitive to chemotherapy, and in these cases, both cancer cells and stem cells were detected outside the contours of the tumor volume imaged prior to chemotherapy. CONCLUSION: CD44+/CD24- tumor cells may be an additional parameter to evaluate when determining the extent of breast cancer invasion.
Breast ; Breast Neoplasms ; Fluorescent Antibody Technique ; Humans ; Neoplasm Invasiveness ; Neoplastic Stem Cells ; Stem Cells ; Tumor Burden

Objective:To understand the understanding and attitudes of psychiatric nurses, patients and caregivers to humanistic care quality of psychiatric nurses, so as to provide references for the intervention countermeasures and nursing management to improve the humanistic care quality of psychiatric nurses.Methods:In August 2018, 16 psychiatric nurses, 11 patients and 11 caregivers in Beijing Huilongguan Hospital were selected to conduct semi-structured interviews using the purposive sampling method to understand the views of nurses, patients and caregivers on the humanistic care quality of nurses.Results:Through repeated reading of interview materials, "cognition of psychiatric nurses on humanistic care quality" and "cognition of psychiatric patients and caregivers on humanistic care of nurses" were extracted as the themes of qualitative research.Conclusions:Psychiatric nurses promote the establishment of caring relationships by communicating more with caregivers and family members and provide more targeted humanistic care during special periods such as when patients are admitted to hospital, when side effects of drugs occur and after discharge.

Objective:To investigate the clinical efficacy of pentoxifylline sequential therapy combined with rasagiline and levodopa in the treatment of elderly patients with symptoms of Parkinson disease (PD), and the influence on hemorheology and serum Toll-like receptor 4 (TLR4) signaling pathway downstream related inflammatory factors.Methods:A prospective study method was used to select 90 elderly patients with PD with fluctuating symptoms who were admitted to the Eighth People′s Hospital of Hebei Province from June 2021 to October 2022 as research objects. The patients were divided into observation group and control group with 45 cases in each group according to random number table method. The observation group was treated with pentoxifylline sequential therapy combined with rasagiline and levodopa. The control group was treated with rasagiline combined with levodopa. The clinical efficacy of the two groups was compared. The unified Parkinson disease rating scale (UPDRS), Montreal cognitive assessment scale (MoCA), Berg balance scale (BBS) and 39-item Parkinson disease quality of life questionnaire (PDQ-39) were scored before and after treatment. Hemorheology indexes and serum levels of related inflammatory factors downstream of TLR4 signaling pathway, including whole blood high viscosity (HBV), whole blood low shear viscosity (LBV), plasma viscosity (PV), fibrinogen (FIB); TLR4, interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF) -α, were detected before and after treatment in both groups. The adverse reactions of the two groups were compared.Results:The total effective rate in observation group was significantly higher than that in control group: 93.33% (42/45) vs. 77.78% (35/45), and there was statistical difference ( P<0.05). After treatment, the UPDRS mental activity and emotional disorders, daily living ability, motor function, motor complications scores and PDQ-39 score of the two groups were significantly lower than before treatment, the MoCA and BBS scores were significantly higher than before treatment, and the improvement was more significant in the observation group, there were statistical differences ( P<0.05). After treatment, HBV, LBV, PV and FIB in the observation group were significantly decreased compared with those before treatment: (6.52 ± 0.92) mPa·s vs. (7.25 ± 1.24) mPa·s, (11.45 ± 1.24) mPa·s vs. (14.13 ± 1.64) mPa·s, (1.55 ± 0.17) mPa·s vs. (1.88 ± 0.22) mPa·s, (3.25 ± 0.47) g/L vs. (3.82 ± 0.52) g/L, and there were statistical differences ( P<0.05). There were no significant differences in hemorheology indexes of control group before and after treatment ( P>0.05). After treatment, serum levels of TLR4, IL-1β, IL-6 and TNF-α in both groups were significantly decreased compared with those before treatment, and the indexes in observation group were significantly lower than those in control group: (2.07 ± 0.18) ng/L vs. (2.58 ± 0.21) ng/L, (1.42 ± 0.17) ng/L vs. (2.28 ± 0.25) ng/L, (1.56 ± 0.22) ng/L vs. (2.42 ± 0.28) ng/L, (46.31 ± 3.17) ng/L vs. (54.34 ± 3.65) ng/L, and the differences were statistically significant ( P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P>0.05). Conclusions:Pentoxifylline sequential therapy combined with rasagiline and levodopa can effectively improve the hemorheology of elderly patients with PD accompanied by symptom fluctuations, reduce the levels of related inflammatory factors downstream of serum TLR4 signaling pathway, and improve clinical efficacy.

Continuous renal replacement therapy (CRRT) has become an effective multiple organ support therapy instead of single renal replacement as initially expected, and it is widely used in intensive care unit (ICU). After the outbreak of coronavirus disease 2019 (COVID-19), a series of expert recommendation or consensus have been developed to diagnose and treat the disease, including CRRT in acute kidney injury (AKI) and hyper inflammatory response. However, CRRT in COVID-19 is extraordinarily different from regular one due to different pathophysiology and infectious clinical scenarios. Accordingly, the paper aims to elaborate the similarities and differences between CRRT in COVID-19 and routine treatment in terms of safety and accessibility, indications and timing, clinical operation, anticoagulation, fluid management, prevention and control of infectious diseases, etc.

Background::Gut-resident macrophages (gMacs) supplemented by monocytes-to-gMacs differentiation play a critical role in maintaining intestinal homeostasis. Activating transcription factor 4 (ATF4) is involved in immune cell differentiation. We therefore set out to investigate the role of ATF4-regulated monocytes-to-gMacs differentiation in sepsis-induced intestinal injury.Methods::Sepsis was induced in C57BL/6 wild type (WT) mice and Atf4-knockdown ( Atf4+/-) mice by cecal ligation and puncture or administration of lipopolysaccharide (LPS). Colon, peripheral blood mononuclear cells, sera, lung, liver, and mesenteric lymph nodes were collected for flow cytometry, hematoxylin and eosin staining, immunohistochemistry, quantitative reverse transcription polymerase chain reaction, and enzyme-linked immunosorbent assay, respectively. Results::CD64, CD11b, Ly6C, major histocompatibility complex-II (MHC-II), CX3CR1, Ly6G, and SSC were identified as optimal primary markers for detecting the process of monocytes-to-gMacs differentiation in the colon of WT mice. Monocytes-to-gMacs differentiation was impaired in the colon during sepsis and was associated with decreased expression of ATF4 in P1 (Ly6C hi monocytes), the precursor cells of gMacs. Atf4 knockdown exacerbated the impairment of monocytes-to-gMacs differentiation in response to LPS, resulting in a significant reduction of gMacs in the colon. Furthermore, compared with WT mice, Atf4+/- mice exhibited higher pathology scores, increased expression of inflammatory factor genes ( TNF-α, IL-1β), suppressed expression of CD31 and vascular endothelial-cadherin in the colon, and increased translocation of intestinal bacteria to lymph nodes and lungs following exposure to LPS. However, the aggravation of sepsis-induced intestinal injury resulting from Atf4 knockdown was not caused by the enhanced inflammatory effect of Ly6C hi monocytes and gMacs. Conclusion::ATF4, as a novel regulator of monocytes-to-gMacs differentiation, plays a critical role in protecting mice against sepsis-induced intestinal injury, suggesting that ATF4 might be a potential therapeutic target for sepsis treatment.

BACKGROUND: Advances in organoid culture technology have provided a greater understanding of disease pathogenesis, which has been rarely studied in sepsis before. We aim to establish a suitable organoids-based intestinal injury model for sepsis. METHODS: Stable passaged organoids were constructed and pre-treated with lipopolysaccharide (LPS) to mimic sepsis-induced intestinal injury. The LPS-induced sepsis model was used as a reference. We used quantitative real-time polymerase chain reaction to evaluate the RNA levels of inflammatory factors and antimicrobial peptides. Enzyme-linked immunosorbent assay was used to evaluate the protein levels, hematoxylin and eosin staining was used to evaluate the pathology of the small intestine of mice, and immunohistochemistry and immunofluorescence were used to evaluate the intestinal epithelial barrier function. Perkin Elmer Operetta™ was used to obtain high-resolution images of three-dimensional organoids. RESULTS: An LPS concentration >150 μg/mL after 24 h was identified to cause organoid growth restriction. The fluorescence intensity of zonula occludens-1 and occludins at LPS concentrations >100 μg/mL decreased significantly after 24 h. After LPS stimulation for 8 h, the RNA expression levels of interleukin (IL)-1α, tumor necrosis factor alpha, granulocyte-macrophage colony-stimulating factor, IL-6, and regenerating islet-derived protein 3 alpha, beta, and gamma increased. These results resembled those of intestinal epithelial layer alterations in a mouse sepsis model. For IL-10, the RNA expression level increased only when the LPS level >200 μg/mL for 24 h. CONCLUSIONS This study provides the primary intestinal in vitro model to study the effects of LPS-induced intestinal injury resembling sepsis. This model provides a platform for immune associated mechanism exploration and effective drug screening.
Mice ; Animals ; Lipopolysaccharides/toxicity* ; Sepsis ; Intestinal Diseases ; Tumor Necrosis Factor-alpha ; Disease Models, Animal ; Organoids ; RNA

The European Society of Cardiology (ESC) released the "2024 ESC guidelines for the management of elevated blood pressure and hypertension" on August 30, 2024. This guideline updates the 2018 "Guidelines for the management of arterial hypertension." One notable update is the introduction of the concept of "elevated blood pressure" (120-139/70-89 mm Hg). Additionally, a new systolic blood pressure target range of 120-129 mm Hg has been proposed for most patients receiving antihypertensive treatment. The guideline also includes numerous additions or revisions in areas such as non-pharmacological interventions and device-based treatments for hypertension. This article interprets the guideline's recommendations on definition and classification of elevated blood pressure and hypertension, and cardiovascular disease risk assessment, diagnosing hypertension and investigating underlying causes, preventing and treating elevated blood pressure and hypertension. We provide a comparison interpretation with the 2018 "Guidelines for the management of arterial hypertension" and the "2017 ACC/AHA guideline on the prevention, detection, evaluation, and management of high blood pressure in adults."