Objective: To introduce the diagnosis and treatment of a case of male primary mediastinal choriocarcinoma, and to summarize the diagnosis and treatment of the disease by literature review. Methods: The diagnosis and treatment process of a male patient with primary mediastinal choriocarcinoma was reported. The clinical characteristics, diagnosis and treatment of 132 cases of primary mediastinal choriocarcinoma were retrospectively analyzed, in order to summarize the experience of diagnosis and treatment of this disease. Results: A 19-year-old male was admitted to hospital in September 2017 due to “chest pain and dyspnea for 1 week”. After 2 times of CT-guided mediastinal punctures, he was diagnosed with “choriocarcinoma”. After 8 times of chemotherapy and local radiotherapy for mediastinal and lung masses were completed in the hospital from October 2017 to March 2018, the response evaluation was partial remission. Following up to December 2018, the patient was generally in good condition, and no progression of tumor was observed; but he died in March 2019 due to suspected tumor recurrence. The literature review showed that the disease was rare in clinical practice, lacking of large-scale clinical studies and consensus on treatment options, so the median survival time of patients was generally short. Conclusion: Primary mediastinal choriocarcinoma in male is a rare disease that lacks specific clinical features. The treatment mainly relies on the comprehensive treatment including surgery, chemotherapy and radiotherapy, but the disease progresses rapidly with poor prognosis.

Objective To investigate the value of MR perfusion imaging in early detection of findings following arterial chemoembolization of hepatocellular carcinoma Methods Twenty eight consecutive patients with pathologically-confirmed HCC were evaluated. All patients underwent MR perfusion imaging at pre-TACE and 3 to 10 days after TACE. The negative enhancement integral (NEI) ,the time to peak(TTP) ,the maximum slope of decrease (MSD) , the signal enhance ratio (SER) were acquired from MRI software FuncTool 2. 5.36a Version. Statistical analysis using SPSS 14, least significant difference test (t test) were utilized. Results The time intensive curve of tumor was observed to descend rapidly to reach the peak at pre-TACE studies, whereas it descended slowly to reach the peak on post TACE studies. The Value of TTP and SER prior to TACE were(51.2 ± 10. 3) s, 60. 6 ± 36. 3 respectively, and post TACE (43.7 ± 12. 0)s, 41.2 ±27. 5 respectively. The values of TTP and SER post TACE were lower than those prior to TACE (P ＜ 0. 05). The value of NEI prior to TACE was 108.7 ± 58.9, and after TACE 149. 6 ±80. 1 and there was statistically significant difference (P ＜0. 05). The Value of MSD post TACE were lower than those prior to TACE, but there was no statistical significance (P ＞ 0. 05). Conclusion PWI is a very sensitive imaging technique that can be used to monitor early dynamic changes of HCC following TACE.

[ ABSTRACT] AIM:To investigate the role of encapsulated protein transfected into human bone marrow mesen-chymal stem cells ( hBMSCs) by polyethyleneimine ( PEI) , and to optimize the best mole ratio of PEI-proteins.METH-ODS:6 groups of DNase I-PEI complexes were constructed and the best mole ratio was explored by laser scattering analy-sis.The appearance of complexes was presented under transmission electron microscope.Meanwhile, 4 groups of construc-ted GFP-PEI complexes were utilized to transfect into the hBMSCs, which were isolated and expand in vitro.The fluores-cence intensity of transfected cells was observed under confocal microscope.In addition, the cytotoxicity of the complexes on the cell proliferation was detected by MTT assay.The activity of the intracellular proteins was testified by aβ-galactosi-dase staining experiment.RESULTS:When the mole ratio of PEI and protein was adjusted to 4∶1, the complex transfec-tion efficiency was the best, and β-galactosidase color test turned blue.CONCLUSION:PEI has the character of encap-sulating various proteins to nano-complexes.The proteins transfected into bone marrow mesenchymal stem cells are con-firmed to have functional activity.As a protein carrier, PEI is of high efficiency and low toxicity, thus providing a new way for stem cell reprogramming.

Aim To explore the anti-apoptotic function of cardiac progenitor cells(CPCs)-derived exosome in vitro.Method CPCs were isolated from mouse heart using Magnetic Cell Sorting(MACS)system.Flow Cy-tometry(FC)determine the purity of stem cell surface antigen-1 positive(Sca-1 +)CPCs.Exosome was puri-fied from conditional medium,and confirmed by West-ern blot using CD63 as a marker,Nanoparticle Traffic-king Analysis(NTA)was used to detect the diameters and concentration of exosome.Then the cells were di-vided into control groups and CPC-exosome pre-protec-tion groups.H2 O2 was added into H9c2 cells to induce oxidative stress.Western blot was adopted to determine the expression of cleaved caspase-3.Results ① Im-munofluorescence showed that CPCs isolated by MACS were positively expressing Sca-1 protein;FC analysis showed that typical purity of Sca-1 +CPCs from the first
preparations was more than 95%.② WB demonstrated that CD63 of exosome isolated from CCMwas positively expressed,and NTA results showed that the diameters of exosome were (82.33 ±3.06)nm(n =3).Micro-scope detected PKH-26 labeled exosome appeared in the cytoplasma of H9c2 cells.③ Western blot showed the CPC-exosome pre-protection groups significantly down-regulated the levels of cleaved caspase-3 com-pared to the control groups(P <0.05).Conclusion CPC can secrete exosome which carries many important cargos,which can effectively gather in H9c2 cells. CPC-exosome can protect H9c2 cells from the oxidative stress induced by H2 O2 .Our results highlight a new perspective strategy for cardiac disease.

Orthostatic hypertension (OHT) is a common type of syncope in children, characterized by a highly complex neural reflex mechanism.It is closely associated with abnormalities in vascular endothelial function, disruptions in the renin-angiotensin-aldosterone system, and reduced or deficient levels of vitamin D. However, the exact pathogenesis of OHT remains unclear.OHT has a relatively high incidence and may be a risk factor for hypertension and cardiovascular diseases in children, significantly impacting their physical and mental health.Nevertheless, the etiology and treatment of OHT are still in the exploratory stage.Therefore, a thorough exploration of OHT is essential.This review provided a brief overview of the pathogenesis and clinical diagnosis and treatment of OHT.

Objective To observe the change of MR perfusion value in patients with hepatocellular carcinoma (HCC) before and after transcatheter arterial chemoembolization (TACE). Methods A total of 22 patients with HCC underwent MR perfusion weighted imaging (MR PWI) before TACE and 3-10 days after TACE. The mean time to enhance (MTE), negative enhancement integral (NEI), time to peak (TTP) and maximum slope of decrease (MSD) before and after TACE were acquired and compared. Results The time intension curve (TIC) of HCC region was observed to descend rapidly before TACE, while descended slowly after TACE. The value of MTE and TTP after TACE were lower than those before TACE (P<0.05), and the value of NEI after TACE was higher than that before TACE (P<0.05). The value of MSD after TACE were lower than that before TACE, but no statistical significance was found (P>0.05). Conclusion MR PWI is a very sensitive imaging technique that be used to monitor blood flow changes of HCC before and after TACE and evaluate efficacy of TACE.

Objective To explore the clinical variables associated with the shrinkage modes of primary breast tumor in women after neoadj uvant chemotherapy (NAC ), and to develop a nomogram for predicting non-concentric shrinkage mode(NCSM).Methods Sixty-one women with pathologically proven solitary invasive ductal carcinoma (ⅡA-ⅢC)were recruited. Breast specimen was prepared with PMSS, and residual tumors were microscopically outlined,scanned and registered by Photoshop CS 5 software.The 3D model of residual tumors was reconstructed with 3D-DOCTOR 4.0 software to evaluate the shrinkage mode.17 factors such as age and body mass index and menopausal status were chosen as independent variables,and the clinic-pathologic shrinkage mode was considered as dependent variable. A Logistic regression model was used to construct the nomogram. Results Primary tumor stage,lymph node down-staging, PR and mammographic malignant calcification before NAC were independent predictors of clinic-pathologic shrinkage mode (β:1.538,OR:4.656,95%CI:1.414-15.328,P=0.011;β:1.555,OR:4.735, 95%CI:1.082-20.722,P=0.039;β:-1.707, OR:0.181, 95%CI:0.044-0.741,P = 0.017;β:- 1.405, OR:3.808, 95% CI:0.06 - 0.998,P = 0.048, respectively ). The nomogram predicting the risk of NCSM showed a good concordance index(0.869),and its conformity of mean absolute error was 0.039. Conclusion Based on the clinicopathological findings of primary breast tumor, a nomogram to predict shrinkage modes after NAC in breast carcinoma patients is constructed.The statistical tool is helpful for individually selecting the patients who can be treated with BCT after NAC.

Aim To investigate whether human umbili-cal cord mesenchymal stem cells(hUC-MSCs)exposed to inflammatory conditions could release large amounts of exosomes to induce regulatory T cells(Treg).Meth-ods hUC-MSCs were isolated by enzyme digestion method.(In vitro)interferonγ(IFN-γ)was added in-to hUC-MSCs to mimic inflammatory microenviron-ments,then exosomes were extracted from the superna-tant of normal conditional medium or IFN-γpretreated hUC-MSCs.Both sources of exosomes,Nor-hUC-exo and IFN-γ-stimulated hUC-exo, were identified by Nanoparticle Trafficking Analysis (NTA )and Western blot for the exosome-enriched protein CD63 .Next,hu-man peripheral blood mononuclear cells (PBMCs ) stimulated with PHA were respectively co-cultured with hUC-MSCs,IFN-γ-pretreated-hUC-MSCs,hUC-MSCs exosomes or IFN-γ-stimulated-hUC-MSCs exosomes for 5 days to assess the exosomes-T cells communication. The proliferation rate of PBMCs and frequency of CD4 +/CD25 +/Foxp3 + Treg were measured by flow cytometry.Results The isolated cells from human um-bilical cord tissue,which were positive for CD73, CD44,CD29,CD90 and HLA-ABC,but were nega-tive for CD31 and CD34,were mesenchymal stem cells indeed.After IFN-γtreatment,hUC-MSCs secreted nu-merous exosomes(P<0.05 ).Morerover,there was a significantly higher level of CD63 ,but no difference in diameter between Nor-hUC-exo and IFN-γ-stimulated hUC-exo.IFN-γ-stimulated hUC-exo had a superior a-bility compared with Nor-hUC-exo to suppress the pro-liferation of PHA stimulated PBMCs due to their upreg-ulation of the percentage of Treg (1 1.53 ±0.88% vs 6.60 ±0.56%,P <0.01 ).Conclusion hUC-MSCs could promote the expression of Treg to modulate im-munosuppression through exosomes,especially for IFN-γ-licenced exosomes,which might carry much immu-notherapeutic potential.

Orthostatic intolerance (OI) is the most common type of autonomic mediated syncope in children.Children with OI tend to show intolerance to the postural changes and long-term standing, thus often presenting with such clinical symptoms as dizziness, headache, blackness, and even sudden fainting.Although there is no organic lesion from OI, it can still exert serious impacts on the mental health of children.Therefore, it is of great significance to provide active and effective treatment for children with OI.There is some understanding of OI, but it is still unclear about its pathogenesis, which is believed to be related to dysautonomia and abnormal neurohumoral regulation.In this paper, the focus would be placed on the changes of renin-angiotensin-aldosterone system (RAAS) in neurohumoral regulation and their significance, and an exploration would be performed on the impacts of related treatment on RAAS in children with OI.

OBJECTIVETo investigate the difference of soluble P-selectin levels in different subtype of coronary heart disease and the relationship between soluble P-selectin levels with the severity of coronary artery lesions.

METHODSEnzyme linked immuoserbent assay (ELISA) was used to measure the plasma soluble P-selectin levels in 69 patients with angiocardiography documented coronary heart disease and 19 normal coronary arteries persons without angiocardiography detectable coronary artery disease (control group). The coronary artery lesions score was recorded according to single, double and triple-vessel lesions while the American College of Cardiology and the American Heart Association proposed type A, B, C lesion and Gensini scoring system. The relationships between plasma soluble P-selectin levels and the coronary artery score (the severity of coronary heart disease) were assessed.

RESULTS(1) The level of plasma soluble P-selectin was obviously higher in the coronary heart disease group than in the control group (180.6 +/- 60.5 ng/L vs. 145.3 +/- 21.7 ng/L, P<0.05). (2) The level of plasma soluble P-selectin was significantly higher in the acute coronary syndrome group (191.4 +/- 63.7 ng/L) than in the control group (145.3 +/- 21.7 ng/L, P< 0.01) and in the stable angina pectoris group (141.3 +/- 17.9 ng/L, P<0.01). (3) The level of plasma soluble P-selectin was high in multi-vessel coronary artery lesions group than in single-vessel group (190.1 +/- 64.2 ng/L vs. 157.2 +/- 43.4 ng/L, P < 0.05). The level of plasma soluble P-selectin was positively correlated with the Gensini score (r = 0.391, P = 0.001); the numbers of vessels lesions (rs = 0.349, P = 0.003); Type A, B and C lesions (rs = 0.358, P = 0.002).

CONCLUSIONThe positive correlation between the level of soluble P-selectin and the coronary artery score may indicate that soluble P-selectin levels might reflect the severity of coronary heart disease. The elevated soluble P-selectin level in acute coronary syndrome suggested the possible relation of P-selectin to the pathogenesis of acute coronary syndrome, which may save as a potential marker of plaque unstability.

Case-Control Studies ; Coronary Disease ; blood ; physiopathology ; Coronary Vessels ; pathology ; Female ; Humans ; Male ; Middle Aged ; P-Selectin ; blood ; chemistry ; Solubility