Neoplasms characterized by the expression of markers of neuroendocrine differentiation in neoplastic cells are defined as neuroendocrine neoplasms. A case of neuroendocrine carcinomas (NECs) with a small amount of papillary adenocarcinoma and significantly vacuolar nucleus at the esophagogastric junction was reported in this article. A 77-year-old male had dysphagia for one week. Endoscopy revealed early-stage esophagogastric junction carcinoma, and biopsy was diagnosed as poorly differentiated carcinoma. Endoscopic submucosal dissection was performed. Histologically, the papillary adenocarcinoma progresses from typically branching papillary structures (well-differentiated) to hyperplasia of the lining epithelium of the papilla to form a cribriform structure (moderately differentiated), to solid area lacking papillary structures (poorly differentiated). There was a continuous process, and during this process, the vacuoles in the nuclei of tumor cells showed progressive changes from mild to obvious and finally to significant vacuoles. The tumor was mainly composed of solid areas (about 95%), with single cell, large cell, round or oval to irregular nuclei, and significantly vacuolar nuclei, nuclei with larger vacuoles appeared in a loop, a few thin weakly basophilic or weakly eosinophilic fine particles could be seen in the vacuoles, and the vacuoles had rough edges. The nucleus chromatin at the outer edge of the vacuoles was fine particles, and mitosis was common (20-30/mm²), atypical mitosis could be seen, and nucleoli could be seen easily, the cytoplasm was weakly eosinophilic, and the boundaries of cells were unclear. The cells were arranged in a nested, trabecular, or diffuse sheet shape, with some arranged in a glandular tube shape. Tumor thrombus was found in the vein of submucosa; the interstitial tissue rich in capillaries within the tumor was accompanied by a large number of neutrophil infiltration. Immunohistochemical staining showed that the solid area of the tumor was positive for synaptophysin (Syn) and chromogranin A (CgA), while papillary adenocarcinoma was negative. Mucin 5AC (MUC5AC) was diffusely positive in papillary adenocarcinoma, while the proportion of positive cells in the solid area of the tumor was about 10% to 15%. In a word, this case showed the extreme situation of the vacuolar nuclear characteristics of NECs, extremely rare, in a sense, this case expanded the boundary of the morphological spectrum of NECs. Understanding the extreme vacuolar features of this nucleus is helpful to make a correct pathological diagnosis.
Humans ; Male ; Esophagogastric Junction/pathology* ; Aged ; Carcinoma, Neuroendocrine/pathology* ; Vacuoles/pathology* ; Esophageal Neoplasms/pathology* ; Cell Nucleus/pathology* ; Adenocarcinoma, Papillary/pathology* ; Stomach Neoplasms/pathology*

Purpose/Significance Disease description texts are analyzed to reach a deeper understanding of the current status of on-line consultations for sleep disorders and the thematic characteristics of users with sleep disorders.Method/Process Data about sleep dis-orders from"haodf.com"website is collected by using a web crawler.Furthermore,the main themes about patients'description are i-dentified by the latent Dirichlet allocation(LDA)model.Result/Conclusion The departments of sleep disorders are more dispersed,and the main treatment is drug therapy.Online consultations could improve 83.2％of patients'condition.The themes of patients's disease descriptions include medication and consultation,external environment,description of symptoms,surrogate questions and causes.It is suggested that the platform and doctors should pay attention to the prognosis of patients'medication and mental health status,and pay at-tention to the popularization of comorbidities.

Background/Aims: To evaluate the causal correlation between complement components and non-viral liver diseases and their potential use as druggable targets. Methods: We conducted Mendelian randomization (MR) to assess the causal role of circulating complements in the risk of non-viral liver diseases. A complement-centric protein interaction network was constructed to explore biological functions and identify potential therapeutic options. Results: In the MR analysis, genetically predicted levels of complement C1q C chain (C1QC) were positively associated with the risk of autoimmune hepatitis (odds ratio 1.125, 95% confidence interval 1.018–1.244), while complement factor H-related protein 5 (CFHR5) was positively associated with the risk of primary sclerosing cholangitis (PSC;1.193, 1.048– 1.357). On the other hand, CFHR1 (0.621, 0.497–0.776) and CFHR2 (0.824, 0.703–0.965) were inversely associated with the risk of alcohol-related cirrhosis. There were also significant inverse associations between C8 gamma chain (C8G) and PSC (0.832, 0.707–0.979), as well as the risk of metabolic dysfunction-associated steatotic liver disease (1.167, 1.036–1.314). Additionally, C1S (0.111, 0.018–0.672), C7 (1.631, 1.190–2.236), and CFHR2 (1.279, 1.059–1.546) were significantly associated with the risk of hepatocellular carcinoma. Proteins from the complement regulatory networks and various liver diseaserelated proteins share common biological processes. Furthermore, potential therapeutic drugs for various liver diseases were identified through drug repurposing based on the complement regulatory network. Conclusions Our study suggests that certain complement components, including C1S, C1QC, CFHR1, CFHR2, CFHR5, C7, and C8G, might play a role in non-viral liver diseases and could be potential targets for drug development.

Non-typhoid Salmonella(NTS)is widely distributed around the world, mainly infected children under 5 years of age.Salmonella Enteritidis and Salmonella Typhimurium are the main serotypes.NTS are major cause of acute gastroenteritis, but the invasive diseases such as bacteremia and meningitis are more serious.The antibiotic resis-tance of NTS is severe, and irrational use of antibiotics is ubiquitous.Now, the epidemiology, clinical characteristics, susceptible factor and antibiotic therapy of NTS infection in children were summarized, which helps early diagnose and rational antibiotic therapy.

Objective To discuss the correlation of serum TNFR level with renal function injury in patients with type 2 diabetes mellitus (T2DM)and normal albumin excretion.Methods 90 T2DMpatients with normal albu-min excretion(24h urine albumin excretion rate <20μg/min)were divided into three groups according to the esti-mated glomerular filtration rate level:eGFR >90mL · min -1 · (1.72m2 )-1 ,eGFR 60 -90mL · min -1 · (1.72m2 )-1 and eGFR <60mL·min -1 ·(1.72m2 )-1 ,30 cases in each group.The serum TNFRs level and related clinical data were measured and analyzed statistically.Results The levels of serum TNFR1,TNFR2 were negatively correlated with eGFR(r =-0.428,-0.335,all P <0.05),and positively correlated with Scr(r =0.476,0.225,all P <0.05)in patients with T2DM and normal albumin excretion.The course of disease and the levels of BUN,Scr, CysC,α1 -MG,β2 -MG were increased as the degree of renal function injury.All these index had statistically signifi-cant differences in three groups(F =3.758,5.851,71.738,25.751,7.530,13.735,all P <0.05).Logistic regres-sion analysis showed that the levels of serum TNFR1,TNFR2 were independent risk factors for renal impairment in patients with T2DMand normal albumin excretion(OR =2.009,1.143,all P <0.05).Conclusion TNFRs may be involved in the development and progression of renal impairment,and may become a new conventional indicator for DN because of reflecting the degree of renal function injury in some extent in T2DMpatients with normal albumin excretion.