Objective To investigate the changes of serum microRNA-27a-3p(miR-27a-3p),microRNA-126(miR-126),Semaphorin 3A,and fibrillar collagens 3(Ficolin-3)and their relationship with carotid intima-media thickness(CIMT)in patients with hypertension and to analyze the predictive value of the above indica-tors for CIMT thickening in patients with hypertensive.Methods A total of 96 hypertensive patients admitted to the hospital from July 2022 to July 2024 were selected as the study group.All patients underwent CIMT ex-amination.According to the CIMT results,they were divided into the thickening group(CIMT≥0.9 mm,35 cases)and the non-thickening group(CIMT＜0.9 mm,61 cases).Another 96 healthy individuals who under-went physical examinations during the same period were selected as the control group.The levels of serum miR-27a-3p,miR-126,Semaphorin 3A and Ficolin-3 in the study group and the control group,the thickening group and the non-thickening group were compared,as well as the differences in clinical data among each group.Logistic regression was used to analyze the risk factors of thickening of CIMT in patients with hyper-tension.The receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of ser-um miR-27a-3p,miR-126,Semaphorin 3A,and Ficolin-3 for thickening of CIMT in patients with hyperten-sion,and the area under the curve(AUC)was obtained.Results Compared with the control group,the levels of serum miR-27a-3p,Semaphorin 3A and Ficolin-3 in the study group were lower(P＜0.05),and the level of serum miR-126 was higher(P＜0.05).Compared with the non-thickening group,the levels of serum miR-27a-3p,Semaphorin 3A and Ficolin-3 in the thickening group were lower(P＜0.05),and the expression level of serum miR-126 was higher(P＜0.05).The Logistic regression score results showed that low levels of ser-um miR-27a-3p,Semaphorin 3A,Ficolin-3,and high level of serum miR-126 were all independent risk factors for thickening of CIMT in patients with hypertension(OR=1.081,1.088,1.074,1.099,all P＜0.05).ROC curve analysis showed that the AUC of the combined prediction of thickening of CIMT in patients with hyper-tension by serum miR-27a-3p,miR-126,Semaphorin 3A,and Ficolin-3 was higher than that of the single detec-tion(P＜0.05),and the corresponding sensitivity of the combined detection was 97.14％and the specificity was 83.61％.Conclusion The levels of serum miR-27a-3p,Semaphorin 3A,and Ficolin-3 were lowly ex-pressed and the expression level of serum miR-126 were highly expressed in patients with hypertensive.The changes in these levels are closely related to the thickening of CIMT in patients with hypertension,and the combined prediction of the four has a higher value in predicting the thickening of CIMT in patients with hy-pertension.

Objective:To describe our experiences in application of the 2019 revision of "CCCG-WT-2016" for the diagnosis of Wilms tumors.Methods:Ninety-one cases of Wilms tumor diagnosed at Shanghai Children′s Medical Center from January 2015 to December 2018 were collected. All cases were reviewed by two senior pathologists, including one from China and the other from Singapore, according to the 2019 revision of "CCCG-WT-2016."Results:The specimens were obtained by core biopsy ( n=21), primary nephrectomy ( n=41), post-chemotherapy nephrectomy/resection ( n=18), or biopsy/resection of metastatic/relapse/post-chemotherapy metastatic lesion(s) ( n=11). The specimens of core biopsy and primary nephrectomy ( n=62) all had favorable histology.Twelve post-chemotherapy nephrectomy cases were subdivided into three risk groups: low risk ( n=0), intermediate risk ( n=10) and high risk ( n=2). Six post-chemotherapy resection cases were subdivided into 3 risk groups:low risk ( n=0), intermediate risk ( n=5) and high risk ( n=1). The remaining 11 cases were comprised of metastatic, relapse, and post-chemotherapy metastatic lesions. The concordance rate of the two senior pathologists was 100%(91/91). Conclusions:The 2019 revision of "CCCG-WT-2016" is clearly written and easy to use. It can serve as the basis of accurate classification for clinical treatment.

Objective:To investigate the clinical and pathological features of pediatric NTRK-rearranged tumors.Methods:Four NTRK-rearranged soft tissue tumors and one renal tumor at Shanghai Children′s Medical Center, Shanghai Jiaotong University and Singapore KK Women′s and Children′s Hospital from January 2017 to September 2019 were identified. Pan-TRK immunohistochemistry, and the ALK and ETV6 gene break-apart fluorescence in situ hybridizations (FISH) were performed. NTRK gene rearrangement was detected using sequencing-based methods.Results:There were 3 males and 2 females in this study. The patients were between 3 months and 13 years of age. Histologically, the tumors were infiltrative spindle cell tumors with variable accompanying inflammatory cells. Immunohistochemistry showed positive reactivity for pan-TRK in all tumors, with nuclear staining for NTRK3 fusion, and cytoplasmic staining for NTRK1 fusion. The molecular testing revealed NTRK gene fusions (one each of TPM3-NTRK1, ETV6-NTRK3 and DCTN1-NTRK1, and two cases of LMNA-NTRK1). Two patients were receiving larotrectinib. The others were are well without disease, with follow-up durations of 9 to 29 months.Conclusions:NTRK-rearranged mesenchymal tumors from soft tissue sites and kidney are identified. A novel DCTN1-NTRK1 fusion is described. Pan-TRK immunohistochemistry is useful for diagnosis. NTRK-targeted therapy may be an option for unresectable, recurrent or metastatic cases.

ObjectiveTo investigate the clinical and pathological features of Hirschprung disease (HD), intestinal neuro-nal dysplasia (IND) and hypoganglionosis (IH) in children.MethodsThe clinical data and pathologic slices from 238 children with intestinal dysganglionosis were retrospectively analyzed. The age, sex, involved intestinal length of children and prognosis were compared.ResultsIn 238 patients, 138 (58.0%) were diagnosed by rectal mucosal biopsies. There were 122 HD patients whose median age at diagnosis was 9 months and the ratio of male to female was 4.3:1, without involvement of whole colon. There were 45 IND patients whose median age at diagnosis was 14 months and the ratio of male to female was 1.05:1, and the whole colon of 33.3% patients was involved. There were two male IH patients whose ages at diagnosis were 12 years and 18 years respectively, and their whole colon was involved. There were 59 patients with HD complicated by IND whose median age at diagnosis was 13 months and the ratio of male to female was 5.56:1 and the whole colon of 16.9% patients was involved. There were 10 male patients with HD complicated by IH whose median age at diagnosis was 11.5 months and the whole colon of 80.0% patients was involved. The ages at diagnosis, the sex ratio, the rates of whole colon involved, and the cure rates among 5 groups were signiifcantly different (allP<0.01).ConclusionsThe rectal mucosal biopsy was the main method in diagnosis of intestinal dysganglionsis in children. Patients with HD had higher incidence and mild condition and favorable prognosis. Patients with IH or patients with HD complicated by IH had lower incidence rates and severe condition and poor prognosis, followed by patients with IND or patients with HD complicated by IND.

Purpose To investigate the genetic changes of ALK gene in sporadic neuroblastoma in China, and to explore its role in neuroblastoma. Methods Total 56 cases of NB with overexpressed ALK protein were studied by fluorescence in situ hybridization ( FISH) , using interphase Vysis LSI ALK dual-color and break apart rearrangement probes. Literature under the subject was searched through PubMed. Results Of the 56 cases, ALK gain was found in 9 (16%) cases, ALK amplification was found in 1 (1. 8%) case only. No alterations of ALK were detected in the remaining 46 cases. Conclusion As a major predisposition gene as well as a poten-tial therapeutic target for neuroblastoma, the frequency of aberrant copy numbers of ALK gene in Chinese NB patients is closely similar with previously published results.