Objective: To investigate the clinicopathological characteristics and diagnostic-therapeutic strategies of oncocytic mucoepidermoid carcinoma (OMEC) of the parotid gland, and to enhance awareness of this rare variant among clinicians and pathologists. Methods: The clinical data, imaging findings, histopathological features, immunophenotype, and molecular characteristics of two patients with parotid OMEC were retrospectively analyzed, and the relevant literature was reviewed. Results: Case 1 was a 50-year-old man who presented with a painless mass behind the right earlobe for more than 2 years. The patient underwent extended parotidectomy with preservation of the facial nerve. Histopathological examination revealed that the tumor was predominantly composed of oncocytic cells with a small proportion of mucous cells. Immunohistochemically, the tumor cells were partially positive for cytokeratin 5/6, cytokeratin 7, and P63. Special staining with alcian blue, periodic acid-Schiff, and phosphotungstic acid hematoxylin yielded positive results. The diagnosis of right parotid OMEC was established. No recurrence or metastasis was observed during a 1 year follow-up. Case 2 was a 61-year-old man with a 3-month history of a mass beneath the left ear. After partial parotidectomy at an outside institution, pathological consultation at the Stomatological Hospital of Jilin University demonstrated that the tumor consisted almost entirely of oncocytic cells, exhibited infiltrative growth, and lacked typical mucous, epidermoid, and intermediate cells. Fluorescence in situ hybridization confirmed positive mastermind-like transcriptional activator 2 (MAML2) gene rearrangement, establishing the diagnosis of left parotid OMEC. The patient subsequently underwent total parotidectomy with preservation of the facial nerve, and no recurrence was detected during a short-term 3 months follow-up. A review of the literature indicated that OMEC most commonly arises in the parotid gland and is generally a low-grade malignancy with favorable prognosis. When tumors are composed exclusively of oncocytic cells, exhibit minimal cytological atypia, and lack the classical cellular components of mucoepidermoid carcinoma, they are highly prone to misdiagnosis as oncocytoma, nodular oncocytic hyperplasia, or other benign oncocytic lesions. Accurate differential diagnosis relies on recognition of infiltrative growth patterns, supportive immunophenotypic markers (e.g., P63 positivity), and detection of characteristic MAML2 gene rearrangement. Complete surgical excision remains the treatment of choice. Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment Conclusion OMEC dominated by oncocytic cells carries a high risk of clinical misdiagnosis. Integrating the assessment of infiltrative histopathological features with immunohistochemistry and molecular detection of MAML2 rearrangement is crucial for accurate diagnosis, appropriate assessment of tumor behavior, and optimal surgical decision making.

Objective To explore the predictive markers of senescence-associated secretory phenotype(SASP)in osteoarthritis(OA).Methods OA datasets were screened by the Gene Expression Omnibus(GEO)database,while SASP-related genes were collected by PubMed.Three machine learning algorithms,including least absolute shrinkage and selection operator(LASSO),support vector machines recursive feature elimination(SVM-RFE),and random forest(RF),were used to screen the candidate predictive markers of SASP genes in OA,and the OA prediction model was constructed using the overlapping genes identified by the machine learning algo-rithms.CIBERSORT was used to explore the degree of peripheral blood immune cell infiltration in OA versus normal samples.The miRNA-transcription factor-mRNA regulatory network of the model genes was predicted using Cytoscape.The most valuable genes of the predic-tion model were experimentally verified by real-time quantitative polymerase chain reaction(RT-qPCR)in OA rats and normal control rats(n= 6 per group).Results One OA dataset was screened by the GEO database,and 125 OA-related SASP genes were isolated.A total of seven intersection genes were obtained by the three machine learning algorithms.The area under the curve of the prediction model was 0.891.The CIBERSORT immune infiltration results showed a significant difference in plasma cell infiltration level between OA and normal samples(P= 0.001 3).The RT-qPCR results showed that the expression level of TNFRSF1Awas significantly higher in the OA versus normal group(P<0.0001).Conclusion TNFRSF1Ais highly expressed in OA and may be a potential predictive marker for it.

Humans ; Receptors, Chimeric Antigen ; Immunotherapy, Adoptive ; Hematologic Neoplasms/therapy* ; Cell- and Tissue-Based Therapy

In this study, untargeted metabolomics technology based on ultra-high-performance liquid chromatography-quadrupole/time of flight mass spectrometry (UPLC-Q-TOF-MS/MS) was used to analyze and identify the overall chemical components of Juniperri Caulis et Folium. Chemical markers for the identification of different Juniperri Caulis et Folium species were screened by integrated principal component analysis and partial least squares discriminant analysis. A total of 58 chemical components were detected and 46 of them were identified, including 26 flavonoids, 8 organic acids and their derivatives, 4 phenylpropanoids, 3 terpenoids, and 5 other components. Among them, methylsyringin and ekersenin were identified for the first time. In the positive ion mode, 12 markers were screened, and in the negative ion mode, 13 markers were screened for species identification. In summary, UPLC-Q-TOF-MS/MS metabonomics technology combined with chemometrics method can effectively reveal the chemical composition differences of different Juniperri Caulis et Folium species, and provide reference for its species identification and quality control.

OBJECTIVES: To investigate the risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture and establish a nomogram model for predicting the risk of neonatal asphyxia. METHODS: A retrospective study was conducted with 613 cases of neonatal asphyxia treated in 20 cooperative hospitals in Enshi Tujia and Miao Autonomous Prefecture from January to December 2019 as the asphyxia group, and 988 randomly selected non-asphyxia neonates born and admitted to the neonatology department of these hospitals during the same period as the control group. Univariate and multivariate analyses were used to identify risk factors for neonatal asphyxia. R software (4.2.2) was used to establish a nomogram model. Receiver operator characteristic curve, calibration curve, and decision curve analysis were used to assess the discrimination, calibration, and clinical usefulness of the model for predicting the risk of neonatal asphyxia, respectively. RESULTS: Multivariate logistic regression analysis showed that minority (Tujia), male sex, premature birth, congenital malformations, abnormal fetal position, intrauterine distress, maternal occupation as a farmer, education level below high school, fewer than 9 prenatal check-ups, threatened abortion, abnormal umbilical cord, abnormal amniotic fluid, placenta previa, abruptio placentae, emergency caesarean section, and assisted delivery were independent risk factors for neonatal asphyxia (P<0.05). The area under the curve of the model for predicting the risk of neonatal asphyxia based on these risk factors was 0.748 (95%CI: 0.723-0.772). The calibration curve indicated high accuracy of the model for predicting the risk of neonatal asphyxia. The decision curve analysis showed that the model could provide a higher net benefit for neonates at risk of asphyxia. CONCLUSIONS The risk factors for neonatal asphyxia in Hubei Enshi Tujia and Miao Autonomous Prefecture are multifactorial, and the nomogram model based on these factors has good value in predicting the risk of neonatal asphyxia, which can help clinicians identify neonates at high risk of asphyxia early, and reduce the incidence of neonatal asphyxia.
Infant, Newborn ; Humans ; Male ; Pregnancy ; Female ; Nomograms ; Retrospective Studies ; Cesarean Section ; Risk Factors ; Asphyxia Neonatorum/etiology*

Objective:To investigate the role of serum hepatitis B virus RNA (HBV RNA) in predicting HBeAg serological conversion in children with chronic hepatitis B.Methods:175 children aged 1~17 years with chronic hepatitis B who received interferon α (IFNα) for 48 weeks were selected. Patients were divided into HBeAg seroconversion and non-conversion based on whether HBeAg seroconversion occurred at 48 weeks of treatment.T-test and Mann-Whitney U test were used to compare between groups; chisquare test or Fisher exact probability method was used to compare the frequency between groups of classified variables; and Pearson correlation was used to analyze the correlation between indicators. Univariate and multivariate logistic regression analyses were used to identify influencing factors associated with HBeAg serological conversion. The predictive effect of HBV RNA, HBV DNA, and HBsAg on HBeAg serological conversion was compared and analyzed by the receiver operating characteristic curve (ROC).Results:The seroconversion rate of HBeAg at 48 weeks was 36.0% (63/175). The reduction in HBVRNA levels from baseline to the 12th, 24th, 36th, and 48th weeks of antiviral therapy was significantly greater in the HBeAg serological conversion group than that in the non-conversion group, and the difference was statistically significant between the two groups (P < 0.05). Univariate and multivariate regression analyses showed that age and a decline in HBV RNA levels at week 12 were independent predictors of HBeAg serological conversion. The area under the ROC curve (AUROC) of HBV RNA decline at week 12 was 0.677(95% CI∶0.549-0.806, P = 0.012), which was significantly better than the same period of AUROC of HBV DNA (0.657, 95% CI∶0.527-0.788, P = 0.025) and HBsAg (0.660, 95% CI∶0.526-0.795, P = 0.023) decline. HBV RNA levels decreased (>1.385 log10 copies/ml) at week 12, with a positive predictive value of 53.2%, a negative predictive value of 72.2%, a sensitivity of 77.4%, and a specificity of 57.9% for HBeAg seroconversion. Conclusion:HBV RNA level lowering during the 12th week of antiviral therapy can serve as an early predictor marker for HBeAg serological conversion in children with chronic hepatitis B.

OBJECTIVE：To provide reference for clinical decision-making related to chemotherapy-induced nausea and vomiting（CINV）. METHODS ：The medical records of patients diagnosed as malignant tumor receiving multi-day cisplatin-containing chemotherapy in our hospital were collected by hospital information system from Jan.-Dec. 2012. The medical records were divided into tropisetron group ，ramosetron group and palonosetron group according to different schemes of 5-hydroxytryptamine-3 receptor antagonist. The covariates of 3 groups were balanced by propensity score matching method ；cost-utility analysis was conducted for the 3 matched antiemetic schemes ；one-way sensitivity analysis and sampling uncertainty analysis were also conducted. RESULTS ： The results of cost-utility analysis showed that treatment cost of one observation period of tropisetron group was 237.71 yuan and utility were 0.054 68 QALYs；that of ramosetron group was 242.37 yuan and utility were 0.055 26 QALYs，and that of palonosetron group was 319.24 yuan and utility were 0.055 76 QALYs. Compared with tropisetron group ，the ICER of palonosetron group was 75 155.69 yuan/QALY；Compared with ramosetron group ，the ICER of palonosetron group was 152 062.07 yuan/QALY. Both of them were lower than 3 times of China ’s 2020 per capita GDP （217 341 yuan/QALY）. The results of sensitivity analysis and sampling uncertainty analysis demonstrated that the results of basic analysis were robust. CONCLUSIONS ：Under the current drug price，the antiemetic regimen based on palonosetron is more economical for the prevention of CINV caused by multi-day chemotherapy containing cisplatin.

OBJECTIVE:To explore the multi-component,multi-target,multi-channel mechanism of Tibetan medicine Ptero-cephalus hookeri in the treatment of rheumatoid arthritis (RA). METHODS:The selected target compounds (10 chemical struc-tures of P. hookeri)were imported and stored by related software;target prediction and filtering were conducted by PharmMapper and DrugBank databases. The pathways of targets were acquired and analyzed by MAS 3.0 database. Finally P. hookeriactive com-ponent-targeting-pathwaynetwork was constructed by Cytoscape 3.4.0 software. RESULTS:The target information obtained in the PharmMapper database were compared with that of the DrugBank database for inflammation-related drugs,26 potential targets for the treatment of RA were obtained,in which MAPK14,RXRA,ALB,PDE4D,VDR may be the main potential target gene group in the treatment of RA. 57 functional pathways were obtained after 26 functional targets were annotated by pathway. In addition to 27 RA-related pathways,30 other pathways such as endocrine regulation and immune were involved. CONCLUSIONS:Base on the study of network pharmacology,P. hookeri plays the role in the treatment of RA by acting on inflammation,immune,endo-crine and related targets and pathways.