OBJECTIVETo study the clinicopathologic characteristics, immunophenotype and differential diagnosis of superficial acral fibromyxoma (SAF).

METHODSThe clinical, pathologic and immunohistochemical features of a case of SAF occurring in left middle finger was studied, with review of literature.

RESULTSThe patient was a 62-year-old male who presented with a solitary painful nodule located in the distal aspect of his left middle finger. The nodule lied close to the nail bed and deep to the underlying periosteum. Grossly, the tumor was poorly circumscribed, measured 2 cm in greatest dimension and had a greyish-white cut surface and rubbery consistency. On low-power examination, the tumor was centred in the dermis and displayed a vague lobular pattern. The tumor cells were spindled to stellate in shape and associated with myxoid matrix. Focal fascicular or loose storiform patterns were also noted. A delicate vascular network was identified in the myxoid stroma. Mast cells were readily observed. On high-power examination, the tumor cells were relatively bland-looking and showed at most a mild degree of nuclear atypia. Mitotic figures were rare and coagulative tumor necrosis was absent. Immunohistochemical study showed that the tumor cells were positive for vimentin, CD34 and CD99. Focal staining for CD10 was also demonstrated. Other immunomarkers including actins, desmin and epithelial membrane antigen were negative.

CONCLUSIONSSAF is a distinctive soft tissue tumor occurring mainly in the digits of adults. Awareness of this entity is helpful in distinguishing SAF from other myxoid soft tissue tumors occurring there. Complete excision with clear resection margins is the mainstay of treatment.

12E7 Antigen ; Antigens, CD ; metabolism ; Antigens, CD34 ; metabolism ; Cell Adhesion Molecules ; metabolism ; Dermatofibrosarcoma ; metabolism ; pathology ; Diagnosis, Differential ; Fibroma ; diagnostic imaging ; metabolism ; pathology ; surgery ; Fingers ; pathology ; Follow-Up Studies ; Ganglion Cysts ; metabolism ; pathology ; Humans ; Male ; Middle Aged ; Nerve Sheath Neoplasms ; metabolism ; pathology ; Radiography ; Skin Neoplasms ; metabolism ; pathology ; Soft Tissue Neoplasms ; diagnostic imaging ; metabolism ; pathology ; surgery ; Vimentin ; metabolism

Objective To elucidate the association of genetic polymorphisms of key molecules in JAK/STAT signaling pathway with susceptibility of hepatocellular carcinoma (HCC).Methods A total of 367 HCC patients and 367 healthy controls were recruited in this sex- and age-matched case-control study.Genetic polymorphisms of IL-6 (rs1800796,-572C＞G),STAT3 (rs744166,+ 26312T＞C; rs3816769,+ 42240T＞C; rs6503695,+ 40980T＞C),EGFR (rs11543848,+ 142530A＞G),and mTOR (rs7211818,+ 170278A＞G; rs9674559,+ 196983A＞G; rs11653499,+65678G＞A) were genotyped using a mass spectrometry method.Odds ratio (OR) and 95％ confidence interval (CI) were calculated.Results Genotype frequency of the 8 polymorphisms of IL-6,STAT3,EGFR,and mTOR were not significantly different between the patients with HCC and the controls.When stratified by sex,the female subjects who carried STAT3 +26312CC,+ 42240CC,or + 40980CC had a decreased risk of HCC when compared to those who carried TT allele (OR=0.192,95％CI:0.047-0.784; OR=0.180,95％CI:0.045-0.725;OR=0.198,95％ CI:0.049-0.806,respectively).When compared with AA genotype on the site of EGFR + 142530,the (AG+ GG) genotype reduced the risk of HCC in women (OR=0.422,95％CI:0.179-0.994).Conclusion The polymorphisms of IL-6 (rs1800796) and mTOR (rs7211818,rs9674559,and rs11653499) were not associated with the HCC susceptibility.Those carrying CC allele in three loci (rs744166,rs3816769,and rs6503695) of STAT3 and (AG + GG) in rs11543848 of EGFR had a decreased risk of HCC in women.However,these results need to be validated using larger sample size.

Objective: To observe the changes of PD-1 expression, mRNA level and cytotoxic activity of CD19 CAR-T cells during the culture process of CAR-T cells. Methods: The peripheral blood T cells of 6 lymphoma patients with high expression of PD-1 and 6 healthy volunteers were the source of CAR-T cells. The expression of PD-1 was analyzed by flow cytometry. The mRNA level of PD-1 was analyzed by PCR. The cell proliferation was analyzed by CCK-8 assay. The cytotoxicity was analyzed by LDH assay. Results: ①The transfection efficiency of high PD-1 expression T cells and healthy volunteer T cells were as the same (P>0.05) . ②The cell proliferation capacity of CD19 CAR-T cells from high PD-1 expression T cells or healthy volunteer T cells, with or without PD-1 inhibitor were as the same (P>0.05) . ③The cytotoxicity to lymphoma cells of high PD-1 expression T cells and CAR-T cells were lower than that of these two T cells combined with PD-1 inhibitor and the CAR-T cells from healthy volunteer T cells (P<0.001) . There was no difference of the cytotoxicity between the CAR-T cells from high PD-1 expression T cells combined with PD-1 inhibitor and the CAR-T cells from healthy volunteer (P>0.05) . ④There was no difference of the expression of PD-1 in all CAR-T cell groups during the culture process (P>0.05) . There was no difference of mRNA level of PD-1 in all groups during the culture process (P>0.05) . ⑤The PD-1 expression of CAR-T cells increased by the time of culture after contacting with lymphoma cells (P<0.001) . The PD-1 inhibitors could antagonize this effect. There was no difference of mRNA level of PD-1 in all groups after contacting with lymphoma cells (P>0.05) . Conclusion The PD-1 expression of CAR-T cells from high PD-1 expression T cells increased by the time of culture after contacting with lymphoma cells. However, the mRNA level of PD-1 of all groups did not change, even if PD-1 inhibitor was applied.

Objective: To observe the changes of PD-1 expression, mRNA level and cytotoxic activity of CD19 CAR-T cells during the culture process of CAR-T cells. Methods: The peripheral blood T cells of 6 lymphoma patients with high expression of PD-1 and 6 healthy volunteers were the source of CAR-T cells. The expression of PD-1 was analyzed by flow cytometry. The mRNA level of PD-1 was analyzed by PCR. The cell proliferation was analyzed by CCK-8 assay. The cytotoxicity was analyzed by LDH assay. Results: ①The transfection efficiency of high PD-1 expression T cells and healthy volunteer T cells were as the same (P>0.05) . ②The cell proliferation capacity of CD19 CAR-T cells from high PD-1 expression T cells or healthy volunteer T cells, with or without PD-1 inhibitor were as the same (P>0.05) . ③The cytotoxicity to lymphoma cells of high PD-1 expression T cells and CAR-T cells were lower than that of these two T cells combined with PD-1 inhibitor and the CAR-T cells from healthy volunteer T cells (P<0.001) . There was no difference of the cytotoxicity between the CAR-T cells from high PD-1 expression T cells combined with PD-1 inhibitor and the CAR-T cells from healthy volunteer (P>0.05) . ④There was no difference of the expression of PD-1 in all CAR-T cell groups during the culture process (P>0.05) . There was no difference of mRNA level of PD-1 in all groups during the culture process (P>0.05) . ⑤The PD-1 expression of CAR-T cells increased by the time of culture after contacting with lymphoma cells (P<0.001) . The PD-1 inhibitors could antagonize this effect. There was no difference of mRNA level of PD-1 in all groups after contacting with lymphoma cells (P>0.05) . Conclusion: The PD-1 expression of CAR-T cells from high PD-1 expression T cells increased by the time of culture after contacting with lymphoma cells. However, the mRNA level of PD-1 of all groups did not change, even if PD-1 inhibitor was applied.
Antigens, CD19 ; Humans ; Programmed Cell Death 1 Receptor/genetics* ; RNA, Messenger ; Receptors, Antigen, T-Cell ; T-Lymphocytes

OBJECTIVETo investigate the effects of losartan, a specific angiotensin II receptor blocker, on slowing progression of renal insufficiency in patients with biopsy-proven chronic allograft nephropathy (CAN) and the molecular mechanism of the therapy.

METHODSTwenty-two renal transplant recipients with biopsy-proven CAN (group A) were treated with losartan within two months after renal dysfunction for at least one year. Losartan was administered at a dose of 50 mg/d. Twenty-four recipients in the same fashion (group B) who never received angiotensin II receptor antagonist were studied as control. The investigation time for each patient lasted one year. Renal functions and concentrations of plasma and urine transforming growth factor-beta1 (TGF-beta1) were compared between the two groups at the initiation and end of the study. In group A, expressions of TGF-betal mRNA and immunofluorescence intensity of TGF-betal protein and pathological alterations in renal biopsy specimens were compared between before losartan therapy and after one year of the therapy.

RESULTSAt the initiation of the investigation, no significant differences were found between group A and group B in clinical data such as donor age, cold-ischemia time, HLA mismatch, levels of creatinine clearance (Ccr), plasma and urine TGF-beta1 concentrations. One year later, 14 of 22 (63.6%) patients showed stable or improved graft functions in group A, and 4 of 24 (16.7%) in group B. The difference was significant (P < 0.05). At the end of the study, urine TGF-betal concentration was 273.8 +/- 84.1 pg/mg x Cr in group A and 457.2 +/- 78.9 pg/mg x Cr in group B. During one year study period, loss of Ccr was 6.6 +/- 5.4 mL/min in group A and 16.2 +/- 9.1 mL/min in group B. Both of the differences were significant between the two groups (P < 0.01). No significant differences were found in plasma TGF-betal concentrations between the four values determined at the initiation and end of the study in the two groups (F = 2.56, P > 0.05). After one year losartan therapy, group A showed a significant decrease in expressions of TGF-beta1 mRNA and TGF-betal protein in renal biopsy specimens [from 1.59 +/- 0.35 to 0.96 +/- 0.27 and from (10.83 +/- 2.33) x l0(6) to (6.41 +/- 1.53) x 10(6), respectively; both P < 0.01], but in light microscopy the histological changes were similar to the first renal biopsy. Losartan was excellently tolerated in all patients in group A. No cases with losartan therapy showed too low blood pressure and other side effects.

CONCLUSIONThis study suggests that losartan have an effect on slowing progression of CAN. Reducing production of intrarenal TGF-betal may play a decisive role in the efficacy of losartan.

Adolescent ; Adult ; Aged ; Angiotensin II Type 1 Receptor Blockers ; pharmacology ; Creatinine ; blood ; urine ; Disease Progression ; Female ; Humans ; Kidney ; pathology ; Kidney Transplantation ; adverse effects ; Losartan ; pharmacology ; Male ; Middle Aged ; Postoperative Complications ; metabolism ; pathology ; RNA, Messenger ; biosynthesis ; genetics ; Renal Insufficiency, Chronic ; drug therapy ; pathology ; surgery ; Transforming Growth Factor beta1 ; biosynthesis ; genetics

OBJECTIVETo determine the effects of modified pull-through operation (Badenoch operation) on the treatment of posterior urethral stricture.

METHODSFrom September 2001 to December 2010 traditional pull-through operation was Modified for two times in our center. A total of 129 patients with posttraumatic posterior urethral stricture resulting from pelvic fracture injury underwent the modified urethral pull-through operation. Stricture length was 1.5 to 5.3 cm (mean 2.9 cm). Of the patients 43 had undergone at least 1 previous failed management for stricture. In phase 1 (from September 2001 to January 2008), the improving items include: (1) The distal urethral end was stitched and tied to the catheter. (2) As catheter was inserted into bladder and 20 ml water was injected into catheter balloon, the distal urethral end was fixed in the proximal urethra and an overlaying of 1.5 cm was formed between the two ends. (3) Three weeks later, it was tried to insert the catheter to bladder. After the urethral stump necrosis and the catheter separating from the urethra, the catheter was removed. In phase 2 (from February 2008 to December 2010), based on the above, irrigating catheter was used. After the surgery, urethra was irrigated with 0.02% furacillin solution through the catheter 3 times a day. All patients were followed up for at least 6 months. If patients had no conscious dysuria and maximum urinary flow rate (Qmax) > 15 ml/s, the treatment was considered successful. All complications were recorded.

RESULTSIn phase 1, the 96 patients (101 times) underwent the procedure. The treatment was successful in 88 patients (success rate 92%). Within 1 to 13 days after removal of the catheter, urethral stricture was recurred in 8 patients. They had to undergo cystostomy once more for 3 to 11 months before reoperation (the 3 patients' reoperation was in phase 2). The 8 cases were treated successfully. In phase 2, 33 patients (total 36 times) underwent the procedure. One patient was failed (success rate 97%). The actual follow-up time is 7 to 93 months (An average of 37.6 months). Qmax is (22 ± 5) ml/s. No complications such as urinary incontinence, erectile pain, urinary shortening happened.

CONCLUSIONSThe modified urethral pull-through operation is effective for the surgical treatment of posttraumatic posterior urethral stricture. It has a high success rate with durable long-term results. Complications are few. The procedure is simple, less demanding and especially suitable in patients who had previously undergone failed surgical treatments.

Adult ; Aged ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Treatment Outcome ; Urethra ; surgery ; Urethral Stricture ; surgery ; Young Adult

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; Male ; Mass Screening ; Middle Aged ; Risk Factors ; Rural Health ; statistics & numerical data ; Sampling Studies

Objective:To observe the changes of blood systemic immune-inflammation index (SII) and monocyte to high-density lipoprotein cholesterol ratio (MHR) in patients with delayed encephalopathy after carbon monoxide poisoning (DEACMP) accepted transcranial direct current stimulation (tDCS) treatment, and to objectively evaluate the efficacy of tDCS in DEACMP.Methods:A total of 80 DEACMP patients admitted to our hospital from January 2020 to February 2022 were selected and randomly divided into observation group ( n=39) and routine group ( n=41). Conventional treatment was given to patients of both groups. On this basis, tDCS was given additionally to the observation group: the left dorsolateral prefrontal lobe was used as the positive stimulation site, and the right shoulder was used as the negative stimulation site; the treatment duration was 30 min/time, and the stimulation intensity was 1.5 mA, once per d; and sham stimulation was given to the routine group: the electrodes were stimulated with 1.5 mA current for 10 s and kept for 30 min, once per d. Patients of both groups were treated for 4 weeks. Before, and 4 weeks and 6 months after treatment, SII and MHR were detected; the electroencephalogram (EEG) results, and scores of Montreal Cognitive Assessment (MoCA) and activities of daily living (ADL) were observed. The total effective rate between the 2 groups after 4 weeks of treatment (total effective rate [%]=[number of cured cases+number of improved cases]/total number of cases×100%), and the correlations of SII and MHR before treatment with ADL scores and abnormal degree of EEG were analyzed. Results:The total effective rate in the observation group (92.3%, 30 were cured and 6 got improvement) was significantly higher than that in the routine group (73.2%, 22 were cured and 8 got improvement; χ2=5.070, P=0.024). Four weeks and 6 months after treatment, SII, MHR, abnormal rates of EEG and P300 latency in the observation group were significantly lower than those in the routine group, and the MoCA and ADL scores and P300 amplitude were statistically higher than those in the routine group ( P<0.05). Correlation analysis showed that SII and MHR before treatment were negatively correlated with ADL scores ( r=-0.805, P<0.001; r=-0.788, P<0.001); SII and MHR were positively correlated with abnormal degree of EEG ( r=0.803, P<0.001; r=0.719, P<0.001). Conclusion:The tDCS treatment can effectively reduce the inflammation levels and improve prognosis scores in DEACMP patients; SII and MHR can preliminarily evaluate the therapeutic effect of tDCS.

OBJECTIVETo determine the prevalence of a common GJB2 mutation in a big Chinese population of deaf children and the features of its distribution in regions all over the nation and to provide epidemiology data and expertise for genetic testing of deafness in China.

METHODSThe DNA samples of NSHI patients and normal controls were collected from different typical areas of China. The method of polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) with ApaI was used to determine the genotype of GJB2 235 site.

RESULTSTotally 16.3% of patients carried at least one 235 delC mutant allele. Among them, 7.8% was homozygous and 8.5% was heterozygous. The prevalence of GJB2 235delC mutation in China was evident, and the significant difference of 235delC mutation frequency was found in sub-population from different areas and different ethnic groups.

CONCLUSIONSBased upon the result of this screening as stated, Chinese NSHI patients appear to have 235delC frequency and the number of GJB2 related deafness was estimated to be huge. The testing of GJB2 235delC mutation would play an important role in genetic diagnosis and screening in China. As high as 15% of patients could be diagnosed as GJB2 caused deafness (bi-allelic mutation) only by means of this simple, fast and economic assay. In addition, patients were negative for 235delC mutation would be candidates for further mutational analysis of GJB2 or other deafness related genes.

Adolescent ; Adult ; Alleles ; Asian Continental Ancestry Group ; genetics ; Child ; Child, Preschool ; China ; epidemiology ; Connexin 26 ; Connexins ; genetics ; Female ; Genotype ; Hearing Loss, Sensorineural ; epidemiology ; genetics ; Heterozygote ; Homozygote ; Humans ; Male ; Point Mutation ; Prevalence ; Young Adult

OBJECTIVETo investigate the prevalence state of essential hypertension in the countryside of Zhangwu county, Liaoning province to confirm whether this county is the high prevalence region of essential hypertension.

METHODSFive thousand, two hundred and eight 15-year olds or older were sampled by means of whole population random sampling. Blood pressure was measured and the related risk factors were investigated with the uniform questionnaire. SPSS 10.0 of statistical software was used for data analysis.

RESULTSThe standardized prevalence rate of hypertension was 35.0% at this region, 40.0% in male, 32.0% in female. The prevalence rates of hypertension were increased with the increasing of the age in both males and females. There were significant statistically differences in the prevalence rates of hypertension between the different age groups, different countrysides and different villages. The standardized prevalence rate of hypertension were 43.0% the highest and 29.0% lowest respectively in the countryside, with prevalence rates, were 59.4% highest and 26.9% lowest respectively in the village. In all the patients with hypertension, 72.0% having hypertension II, III.

CONCLUSIONThe countryside of Zhangwu county was a high prevalence region of essential hypertension which was unusual in our country. The reason of this status was still unknown which called for further study.

Adolescent ; Adult ; Aged ; China ; epidemiology ; Female ; Humans ; Hypertension ; epidemiology ; etiology ; prevention & control ; Male ; Mass Screening ; Middle Aged ; Prevalence ; Risk Factors ; Rural Population ; Sampling Studies ; Surveys and Questionnaires