Objective　To identify the clinical characteristics of a case of abdominal multiple cystic echinococcosis in Shenzhen City, Guangdong Province, and to characterize the molecular biology of pathogen, in order to provide a basis for control and prevention of echinococcosis. Methods　Clinical and epidemiological data of 1 case of echinococcosis in Shenzhen City in January 2024 were collected. The pathological sections of the cyst tissue removed by surgery were examined by microscopy after staining. Nucleic acids were extracted from cyst tissue samples, and the ND1 and Cox1 gene sequences were amplified and sequenced by PCR. Sequence comparison and phylogenetic tree analysis were performed using Mega X, BLAST and other software. Results　The patient, male, 29 years old, a resident of Nyerong County, Nagqu City, Xizang Autonomous Region, had a history of exposure to domestic dogs and hepatic echinococcosis. Imaging showed abdominal multiple placeholder, consider echinococcosis recurrence; 12 pieces of cystic lesions from different parts of the abdominal cavity were surgically removed, and the pathological sections of cystic tissues showed cuticle layer, germinal layer, protoscolex of echinococcosis. PCR amplification of the specific genes ND1 and Cox1 were positive, and the amplified fragments were about 510 bp and 285 bp, respectively. Sequence comparison and phylogenetic tree analysis results showed that the homology between the sequences in this study and the ND1 gene of Echinococcus granulosus type G1 (JX217890.1, Qinghai), and Cox1 gene (MH050610.1, Xizang) in the GenBank database was 99%. It is closely related to the epidemic strains of Echinococcus granulosus in Xizang, Qinghai and Xinjiang in the phylogenetic tree, and is in the same evolutionary branch (type G1). Conclusion　The patient was an imported case of abdominal multiple cystic echinococcosis, and the genotype was G1, with a high probability that the infection originated in Xizang. It is recommended to enhance the surveillance and management of echinococcosis in non-endemic areas, and to strengthen the inspection and quarantine of livestock and agricultural by-products imported from endemic areas to prevent the spread of echinococcosis.

Objective To study the effect of roxadustat on peritoneal fibrosis.Methods The human peritoneal mesothelial cells(HPMCs)were cultured with 5.6 mmol/L(N group),138 mmol/L(C group)or 138 mmol/L glucose solution combined with 5 μmol/L roxadustat(R group).A total of 24 SD adult male rats aged 8-10 weeks from the same batch were selected as the study subjects.4.25％high-glucose peritoneal di-alysis solution was intraperitoneally injected to construct the rat peritoneal fibrosis model,which was divided into the normal group(RN group),model group(RC group),roxadustat conventional dose group(RR-N group)and roxadustat high-dose group(RR-H group).The morphology of peritoneal tissues was observed,and the expression levels of HIF-1α,Col-1,VEGF and E-cadherin were detected.Results Compared with the group N,the expression levels of HIF-1α,Col-1 and VEGF in HPMCs in the group C and group R were increased and the expression level of E-cad was decreased(P＜0.05);compared with the group C,the expression levels of HIF-1α,Col-1 and VEGF in the group R were increased and the expression level of E-cad was decreased(P＜0.05).Com-pared with the RN group,the peritoneal structure in the group RC was disordered,a large number of collagen fibers were deposited,and the dense layer was thickened;the angiogenesis in the RR-N group and RR-H group was obvious,but there was no significant difference in the thickness of the dense layer compared with the RC group;compared with the RN group,the expression levels of HIF-1α,Col-1 and VEGF in the peritoneal tissue of the group RC were increased,and the expression level of E-cad was decreased(P＜0.05);compared with the group RC,the expression levels of HIF-1α,Col-1,VEGF and E-cad in the RR-N group had no significant difference;compared with the group RC group and RR-N group,the expression levels of HIF-1α and VEGF in peritoneal tissue in the RR-H group were increased,the expression level of E-cad was decreased,and the differences were statistically significant(P＜0.05).Conclusion Roxadustat could cause an increase of HIF-1αexpression level in peritoneal cells and increase the expression level of fibrosis signaling proteins;while con-ventional dose roxadustat does not increase the peritoneal tissue fibrosis in rats,while high-dose roxadustat may have the risk of aggravating peritoneal fibrosis.

Objective:To investigate the clinicopathological, immunohistochemical and molecular genetic characteristics of TFE3-rearranged perivascular epithelioid cell tumor (PEComa).Methods:Eight cases of PEComa with TFE3 rearrangement diagnosed in the First Affiliated Hospital of Air Force Medical University from January 2014 to July 2022 were collected. Three were consultation cases and 5 were collected from our hospital; 7 cases were resection specimens and 1 case was a needle biopsy specimen. Routine histolopathological analysis, immunohistochemical staining, fluorescence in situ hybridization (FISH) and the next-generation sequencing were performed. Clinical data were collected and the prognosis was assessed.Results:The 8 patients consisted of 5 females and 3 males with a median age of 45 years (ranged from 25 to 65 years). The tumor location included 1 uterus, 1 liver, 1 urachus, 2 kidneys, 1 abdominal cavity, 1 colon, and 1 retroperitoneum (3 subsequent recurrences in the abdominal cavity, pelvis and ovary, and abdominal cavity, respectively). Morphologically, the tumor cells were uniform and epithelioid with translucent or eosinophilic cytoplasm. They were arranged in nests or sheets, most of which were separated by thin-walled blood vessels. There were no papillary structures, and no overt smooth muscle or fat components. Atypical features were seen in 3 cases, with bizarre nuclei and tumor giant cells. Large areas of necrosis were visible, and mitosis was common (up to 28/50 HPF). Melanin deposition was present in 3 cases. Immunohistochemical staining showed diffuse and strong positivity for TFE3 in 8/8 cases and for HMB45 in 6/8 cases; focal positivity for Cathepsin K and Melan-A in 6/8 cases and for SMA in 2/8 of cases. All cases were negative for CKpan, PAX8 and Desmin. TFE3 gene break-apart was detected by FISH in all 8 cases, 4 of which underwent next-generation sequencing, and it revealed that 2 cases presented with SFPQ::TFE3 fusion, 1 case with ASPSCR1::TFE3 fusion, and 1 case with no chimeric fusion. Seven cases were followed up for 4—94 months. All cases were alive; 4 cases were disease-free, 2 cases showed recurrence, and 1 case had metastasis at initial diagnosis.Conclusions:TFE3-rearranged PEComa has unique histomorphological, immunohistochemical and molecular characteristics. The biological behavior is aggressive, which could lead to recurrence and metastasis, and warrants close clinical follow-up.

Objective:To investigate the clinicopathological features,immunophenotype,and prognosis of head and neck spindle cell squamous cell carcinoma(SCSCC)to improve the understanding and diagnosis of this tumor.Methods:Clinicopathological data collected from January 2012 to December 2022 at the First Affiliated Hospital,Air Force Military Medical University from 20 patients with head and neck SCSCC were retrospectively reviewed for histological morphology and immunophenotype.In situ and fluorescence in situ hybridization were performed to detect EBV-encoded ribonucleic acid(EBER)status and MDM2 gene amplification,respectively.Results:The median age among the 20 SCSCC cases was 67 years with a male-to-female ratio of 4∶1.Tumor locations were laryngeal(35.0%)and sinonasal(30.0%).SCSCC presented as polypoid or exogenous growths(61.5%),often with surface ulceration(90.0%).Histologically,sarcomatoid growth pat-terns were exhibited in 75.0%of the patients(n=15),while the remainder showed granular tissue-like or angiosarcomatoid patterns.Most tumors(65.0%)displayed components of conventional squamous cell carcinomas,with a predominant occurrence of high to moderate dif-ferentiation(91.7%).In terms of immunohistochemistry,AE1/AE3 was expressed in 83.3%(15/18)of cases,while p63 and p40 expression rates were 62.5%and 66.7%,respectively.All cases were negative for EBER.The Ki-67 proliferation index ranged 10%-70%.Overall,33.3%(1/3)of the cases showed MDM2 gene amplification.Among these,the median follow-up time for 18 patients was 18.3 months(range:1-92 months),with 6 survivors and 12 deaths.Conclusions:Head and neck SCSCC is more prevalent among elderly male smokers,predominantly exhibits a polypoid growth pattern,and does not display human papillomavirus or Epstein-Barr virus infection.Diagnosis requires a compre-hensive evaluation of clinical and pathological features and immunophenotype.Surgical resection is the primary treatment method.

Objective Investigate the effect of valsartan combined with statins on coronary heart disease and its effect on BNP and CRP.Methods 92cases of patients with coronary heart disease were selected, which were treated in hospital from March 2015to March 2017, and were divided into the study group (46cases) and control group (46cases) .The patients of all two groups were treated with conventional treatment.The patients of control group were treated with valsartan (40mg/d, oral;if no hypotension after 3days of treatment, the dose increased to 80mg/d) , and on the basis of control group, the patients of study group were treated with atorvastatin calcium capsules (20mg/d, in 0.5hafter dinner) .The patients of two groups were all treated for 6months in a row.Compare the adverse reactions and changes of the levels of blood lipids, coronary plaques, BNP, CRP and LVEF of two groups.Results After the appropriate treatment, the TG, TC, LDL-C levels of the study group were significantly lower than those of the control group, and the HDL-C, LVEF levels of the study group were significantly higher than those of the control group (P<0.05);the lipid plaque, fibrous plaque, calcified plaque, mixed plaque levels of the study group were significantly lower than those of the control group (P<0.05);The BNP, CRP levels of the study group were significantly lower than those of the control group (P<0.05);There were acute myocardial infarction, unstable angina, heart failure and other adverse events occurred in both two groups, and the difference was statistically significant between the two groups (P<0.05) .Conclusion Valsartan combined with statins in the treatment of patients with coronary heart disease can improve blood lipid levels, reduce coronal plaque area, inhibit inflammatory response, which makes it worthy of clinical promotion.

To explore the feasibility of CT-based image radiomics signature in identification of primary gastric lymphoma and Borrmann type IV gastric cancer.
 Methods: A retrospective analysis of 71 patients with primary gastric lymphoma or Borrmann type IV gastric cancer confirmed by pathology in our Hospital from January 2009 to April 2017 was performed. There were 28 patients with primary gastric lymphoma and 43 patients with Borrmann type IV gastric cancer. The feature extraction algorithm based on Matlab 2017a software was used to extract the features of image, and the logistic regression model was used to screen the features to establish radiomics signature. The CT sign diagnosis model was established, which included the periplasmic fat infiltration, softness of the stomach wall, abdominal lymph node and peripheral organ metastasis, ascites, mucosal white line sign and lesion thickness. The classification of the two models was evaluated by receiver operating characteristic curve.
 Results: A total of 32 3D features were extracted from CT image for each patients. Two features were found to be the most important differential diagnosis factors, and the radiomics signature was established. The CT sign diagnosis model consisted of ascites, periplasmic fat infiltration, stomach wall softness and mucosal white line. For the radiomics signature and the CT subjective finding model, the AUCs were 0.964 and 0.867 with the accuracy at 94.4% and 80.2%, the sensitivity at 93.0% and 74.4%, the specificity at 96.4% and 89.3%, respectively. After Delong test, the diagnostic efficacy of the radiomics signature was higher than the CT sign diagnosis model (P<0.001).
 Conclusion: CT-based image radiomics signature can accurately identify primary gastric lymphoma and Borrmann type IV gastric cancer, and can potentially provide important assistance in clinical diagnosis for the two diseases.
Humans ; Lymphoma, Non-Hodgkin ; Neoplasm Staging ; Retrospective Studies ; Stomach Neoplasms ; Tomography, X-Ray Computed

Objective: To investigate the morphologic, immunohistochemical, genetic, clinical features and prognosis of Ewing-like BCOR-CCNB3 gene fusion undifferentiated sarcoma (BCOR-CCNB3 fusion sarcoma). Method: Seventeen Ewing-like sarcoma cases were screened for CCNB3 expression and BCOR-CCNB3 fusion transcripts by immunohistochemistry and RT-PCR among 260 cases of Ewing-like sarcomas collected during Jan, 2006 to Dec, 2015. Three cases of BCOR-CCNB3 fusion sarcoma were found among 17 atypical Ewing sarcomas, and follow-up were conducted. Results: The harboring of BCOR-CCNB3 fusion transcript was confirmed by RT-PCR and directly sequencing results. The three patients aged between 8 and 11 years old. Two of them were male and the other one was female. One patient achieved a complete response after chemotherapy, the other two died without chemotherapy after surgical excision in 12 months. Tumor cells in all 3 cases showed diffuse nuclear CCNB3, TLE1 and cyclin D1 positivity, while CCNB3 (0/12), TLE1 (1/12) and cyclin D1 (4/12) positivity was infrequent in the 12 cases of classical Ewing′s sarcoma. The oval or plump spindle tumor cells with fine chromatin arranged in solid pattern, the nucleoli was inconspicuous. The delicate capillary networks were obvious in the tumor. Conclusion With a detailed description of the histological spectrum, immunohistochemical features and clinical characteristic of BCOR-CCNB3 sarcoma, justify distinction from Ewing sarcoma could be possible.

Langerhans-cell histiocytosis (LCH), the most common histiocytic disorder, is a reactive clonal proliferation and accumulation of CD1a+ / CD207+ dendritic cells in inflammatory lesion, characterized by its strong heterogeneity and changeable complexity including apparent inflammation and tumor features, which should be redefined as an inflammatory myeloid neoplasia. Recent research has shown that LCH is the consequence of misguided myeloid differentiation on account of genomic aberrances in the RAS-RAF-MEK-ERK pathway. These gene inhibitors may present more curative effects for the treatment of LCH. With further prospective clinical trial, molecular targeted therapy may combine with or even replace the traditional surgery plus chemotherapy as the first-line regimen in LCH.

Objective To screen the potential biomarkers in plasma of rats with acute paraquat (PQ) poisoning using gas chromatography-mass spectrometry (GC-MS) based metabonomics technology,and to provide concrete evidence for early diagnosis.Methods Eight Sprague-Dawley (SD) rats were randomly divided into PQ poisoning group (intragastricly administrated with PQ solution 100 mg/kg) and control group (intragastricly administrated with the same volume of normal saline) according to the random number table,with 4 rats in each group.The general situation of rats was observed at 2,24 and 48 hours after administration.The blood of eye sockets was collected,the endogenous small molecule metabolites in plasma were determined with GC-MS method,and metabolic profile analysis and random forest analysis were performed to filter the potential biomarkers.Results ① The rats in PQ poisoning group gradually appeared lack movement,tachypnea,abdominal seizure and other symptoms of poisoning.In control group,the vital signs were stable.② The metabolites in plasma of rat were analyzed with GC-MS analysis,and the diagrammatic figure was plot as combined with principal component analysis (PCA) and partial least squares-discriminated analysis (PLS-DA) model,which showed that the distribution of plasma metabolism in PQ poisoning group was more diffuse but in the control group was more intensive,indicating that the metabolic patterns in two groups were different.From 2 hours after PQ administration,the metabolic trajectory in PQ poisoning group was significantly deflected compared with that of the control group,which was similar to control group until 48 hours,indicating that the metabolites in plasma of rat showed obvious difference in the early period.Five kinds of potential biomarkers with large weights were selected by random forest method which were serine,L-asparagine,hexadecanoic acid,octadecanoic acid,and arachidonic acid,the retention time was 15.259,24.345,33.334,37.695,and 40.254 minutes,respectively.The levels of serine,L-asparagine,arachidonic acid in PQ poisoning group were significantly higher than those of the control group,peaked at 48,48 and 24 hours,respectively (40.884-5.38 vs.28.85±2.32,6.61±1.31 vs.0.76±0.65,14.21±4.28 vs.4.42±1.19,all P ＜ 0.01),and the levels of hexadecanoic acid and octadecanoic acid were significantly lowered,reached tough at 48 hours (39.09 ± 10.23 vs.83.99 ± 20.49,44.03 ± 3.60 vs.140.76 ± 73.91,P ＜ 0.05 and P ＜ 0.01).The changes in these biomarkers were related to the toxicity of PQ,indicating that PQ could interfere the energy and lipid metabolism in rats.Conclusion Combine with the metabonomics analysis,screened plasma serine,L-asparagine,arachidonic acid content in PQ poisoning rats increased significantly,and hexadecanoic acid and octadecanoic acid content decreased significantly,which can preliminary diagnose acute PQ poisoning with animal general performance.

Objective To investigate the clinical features and influencing factors of somatic symptoms in patients with acute stroke.Methods Patients with acute stroke were enrolled in the study.Using the scores of symptom checklist 90 (SCL-90)-somatization factor part,the patients were divided into either a somatic symptom group (≥24) or a control group (＜24).Their age,gender,economic level,education level,underlying diseases,Hamilton Anxiety Scale (HAMA),Hamilton Depression Scale (HAMD),NEO Five-Factor Inventory scores,Social Support Rating Scale scores-simplified Chinese version,Mini-Mental StateExamination (MMSE) scores,National Institute of Health Stroke Scale (NIHSS) scores were documented and analyzed.Results A total of 70 patients with acute stroke were enrolled,and 33 (47.1％) of them had somatic symptoms.There were no significant differences in demographic characteristics,education level,family income,occupation,marital status,living alone,residence,medical expenses payment methods and social support scores between the somatic symptom group and the control group.There were also no significant differences in the types of stroke,lesion side,baseline NIHSS score,MMSE score,and NEO Five-Factor Inventory score between the 2 groups.There was significant difference in lesion side between the somatic symptom group and the control group (x2 =0.161,P=0.006).The comparison of neuropsychological test results showed that the proportion of patients with an anxiety state of the somatic symptom group was significantly higher than that of the control group (24.2％ vs.5.4％;x2 =5.055,P =0.025),but there was no significant difference in the proportion of patients with depression status;after excluding the cases who met the anxiety and depression criteria,HAMA (8.08 ± 3.12 vs.5.58 ± 3.06;t =-3.059,P =0.003) and HAMD (10.80 ± 4.81 vs.7.73 ± 3.88;t =-2.694,P =0.009) scores of the somatic symptom group (n =25) were significantly higher than those of the control group (n =33).The number of somatic symptoms of the somatic symptom group was significantly more than that of the control group (Z =-5.817,P ＜ 0.001),and was more likely to have pain symptoms (97.0％ vs.73.0％;x2 =7.584,P =0.006).The correlation analysis showed that there was a significant positive correlation in the 12-item scores of the SCL-90 somatic factors and HAMA (r =0.494,P ＜0.001) and HAMD (r=0.369,P=0.002) scores in patients.Multivariate logistic regression analysis showed that HAMA score was an independent risk factor for somatic symptoms after stroke.(odds ratio 1.286,95％ confidence interval 1.060-1.560;P=0.011).Conclusions The incidence of somatic symptoms is high after acute stroke,especially in patients with cortical stroke.The somatic patients after stroke are prone to have pain-related symptoms.The patients with anxiety and depression status after stroke are prone to have somatic symptoms after stroke;HAMA score is an independent risk factor for having somatic symptoms after stroke.