Objective To explore the efficacy and safety of platelet-derived growth factor(PDGF)combined with allograft bone transplantation in the treatment of spinal tuberculosis.Methods A total of 177 patients with lumbar tuberculosis admitted to the 4th People's Hospital of Qinghai Province from August 2018 to August 2023 were selected as the research subjects.Patients were divided into control group(n=49)and observation group(n=128)based on the source of the transplanted bone.All patients underwent at least 2 weeks of standard quadruple anti-tuberculosis chemotherapy before surgery.Patients in the control group received PDGF combined with autograft bone transplantation,while patients in the observation group received PDGF combined with allograft bone transplantation.The surgical duration,intraoperative blood loss,and length of hospital stay of patients in the two groups were recorded;the erythrocyte sedimentation rate(ESR)and serum C-reactive protein(CRP)levels of patients in the two groups were compared before surgery and at 1,3,6 months after surgery.Preoperative CT and magnetic resonance imaging(MRI)examinations were performed,and postoperative CT and MRI were performed after bone fusion was completed to compare the changes in Cobb angle before and after surgery.The visual analogue scale(VAS)was used to assess the pain degree in the lumbar region before surgery and at 1,3,6 months after surgery.The VAS scores of patients in the two groups,VAS scores of male patients in the two groups,and VAS scores of female patients in the two groups were compared before and after surgery,respectively.Results There was no statistically significant difference in surgical duration and length of hospital stay between the observation group and the control group(P＞0.05).The intraoperative blood loss of patients in the observation group was significantly less than that in the control group(P＜0.05).There was no statistically significant difference in Cobb angle before and after surgery between the two groups(P＞0.05).The postoperative Cobb angle significantly decreased in both groups when compared to preoperative values(P＜0.05).The VAS scores of patients in both groups decreased sequentially before surgery and at 1,3,6 months after surgery,with statistically significant differences in intra-group pairwise comparisons(P＜0.05).The VAS scores of male patients in both groups decreased sequentially before surgery and at 1,3,6 months after surgery,with statistically significant differences in intra-group pairwise comparisons(P＜0.05).The VAS scores of female patients in both groups also decreased sequentially before surgery and at 1,3,6 months after surgery,with statistically significant differences in intra-group pairwise comparisons(P＜0.05).There was no statistically significant difference in VAS scores between the observation group and the control group before surgery and at 1,6 months after surgery(P＞0.05);the VAS score of patients in the observation group was significantly lower than that in the control group at 3 months after surgery(P＜0.05).There was no statistically significant difference in VAS scores between male patients in the observation group and male patients in the control group before surgery and at 1,3,6 months after surgery(P＞0.05);the VAS score of male patients in the observation group was significantly lower than that in the control group at 3 months after surgery(P＜0.05).There was no statistically significant difference in VAS scores between female patients in the observation group and female patients in the control group before surgery and at 1,6 months after surgery(P＞0.05);the VAS score of female patients in the observation group was significantly lower than that in the control group at 3 months after surgery(P＜0.05).The ESR of patients in both groups decreased sequentially before surgery and at 1,3,6 months after surgery,with statistically significant differences in intra-group pairwise comparisons(P＜0.05).The serum CRP levels of patients in both groups also decreased sequentially before surgery and at 1,3,6 months after surgery,with statistically significant differences in intra-group pairwise comparisons(P＜0.05).There was no statistically significant difference in ESR between the observation group and the control group before surgery and at 1,3,6 months after surgery(P＞0.05).There was no statistically significant difference in serum CRP level between the observation group and the control group before surgery and at 1,6 months after surgery(P＞0.05);the serum CRP level of patients in the observation group was significantly higher than that in the control group at 3 months after surgery(P＜0.05).Conclusion The effect of PDGF combined with allograft bone transplantation in the treatment of spinal tuberculosis is comparable to that of autograft bone transplantation,but PDGF combined with allograft bone transplantation can significantly reduce postoperative pain degree,improve patient comfort,avoid additional damage caused by autograft bone transplantation,and reduce the physical burden on patients.It can be considered a safe and reliable surgical method for bone grafting in lumbar tuberculosis surgery.

Objective:To analyze the screening results for chronic obstructive pulmonary disease (COPD) among residents aged 40 years and above in Shanghai Jiading Town, and to explore the influencing factors of COPD.Methods:The study was a cross-sectional study. Four hundred residents aged 40 years and above in Jiading Town were selected to attend COPD screening by multi-stage stratified random sampling method from 10 to 18 July, 2023. Information on demographic characteristics, disease history and family history, disease behavior and risk factors were collected by a questionnaire survey. Physical examination and pulmonary function tests were performed for all participants. Patients showing<70% FEV 1/FVC in pulmonary function and excluded of other cardiorespiratory diseases were diagnosed as the COPD. The SPSS 25.0 software was used for statistical analysis; and logistic regression was used to analyze the related factors of COPD. Results:There were 166 (41.5%) males and 234 (58.5%) females in the participants. The results of screening showed that 181 (45.3%) individuals were identified as high risk of COPD and 32 cases of COPD was diagnosed with a prevalence rate of 8.0%. The prevalence rate of COPD in males were significantly higher than that in females ( P<0.05). There were no significant differences in the age ( P=0.993), education level ( P=0.158), body mass index ( P=0.776), and waist-to-hip ratio ( P=0.833) between COPD patients and non-COPD participants. Logistic regression analysis showed that frequent coughing at 14 years of age and before ( OR=7.763, 95% CI: 2.898-20.791, P<0.05), Hospitalization for pneumonia or bronchitis at or before 17 years of age ( OR=4.359, 95% CI: 1.343-14.1462, P<0.05), asthma ( OR=11.800, 95% CI: 2.001-69.573, P<0.05), chronic bronchitis ( OR=72.748, 95% CI: 20.501-258.144, P<0.05), emphysema ( OR=23.600, 95% CI: 1.407-395.756, P<0.05),and other respiratory diseases, immediate family members with chronic bronchitis ( OR=6.112, 95% CI: 1.960-19.058, P<0.05) and family history of COPD ( OR=100.920, 95% CI: 14.625-696.390, P<0.05), smoking behavior ( OR=7.017, 95% CI: 2.605-18.906, P<0.05), living with daily smokers ( OR=35.481, 95% CI: 1.609-782.310, P<0.05), and second-hand smoking ( OR=3.448, 95% CI: 1.271-9.352, P<0.05) were independent risk factors for the development of COPD. Conclusion:The study shows the prevalence of COPD and related risk factors in residents over the age of 40 in Shanghai Jiading town, indicating that more attention should be paid for high risk population in COPD screening.

Lung squamous cell carcinoma (LSCC) accounts for approximately 30% of non-small cell lung cancer (NSCLC) cases and is the second most common histological type of lung cancer. Anaplastic lymphoma kinase (ALK)-positive NSCLC accounts for only 2%-5% of all NSCLC cases, and is almost exclusively detected in patients with lung adenocarcinoma. Thus, ALK testing is not routinely performed in the LSCC population, and the efficacy of such treatment for ALK-rearranged LSCC remains unknown. Echinoderm microtubule associated protein like 4 (EML4)-ALK (V1) and TP53 co-mutations were identified by next generation sequencing (NGS) in this patient with advanced LSCC. On December 3, 2020, Ensatinib was taken orally and the efficacy was evaluated as partial response (PR). The progression-free survival (PFS) was 19 months. When the disease progressed, the medication was changed to Loratinib. To our knowledge, Enshatinib created the longest PFS of ALK-mutant LSCC patients treated with targeted therapy since literature review. Herein, we described one case treated by Enshatinib involving a patient with both EML4-ALK and TP53 positive LSCC, and the relevant literatures were reviewed for discussing the treatment of this rare disease.
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Humans ; Carcinoma, Non-Small-Cell Lung/drug therapy* ; Lung Neoplasms/pathology* ; Anaplastic Lymphoma Kinase/metabolism* ; Carcinoma, Squamous Cell/genetics* ; Mutation ; Cytoskeletal Proteins/genetics* ; Lung/pathology* ; Oncogene Proteins, Fusion/genetics* ; Protein Kinase Inhibitors/therapeutic use* ; Tumor Suppressor Protein p53/genetics*

Condylar displacement can lead to temporomandibular joint (TMJ) symptoms and relapse after orthognathic surgery. To minimize condylar displacement, numerous condylar positioning techniques have been applied in clinical practice. To verify the effectiveness of condylar positioning techniques in preventing postoperative TMJ symptoms and relapse, we reviewed the literature related to all types of intraoperative condylar positioning techniques in the past 20 years. According to a literature review, positioning techniques aim to seat the condyles at a preoperative position during surgery and are divided into noncomputer-aided and computer-aided condyle positioning methods. At present, computer-aided design/computer-aided manufacturing condylar positioning devices (CAD/CAM CPDs) are the most superior positioning methods and are composed of teeth-supported and bone-supported guidance. The sequence of the remaining technology positioning effect from high to low is as follows: CAD/CAM titanium plate positioning > manual positioning > computer-aided navigation system > image positioning system. Different techniques reach considerable accuracy within 1-2 mm and 1°-2° in locating the preoperative condylar position and preventing TMJ symptoms or disorders and surgical relapse to provide a clinical reference for different levels of surgeons and cases. However, this study lacks randomized controlled trials with large samples and long-term follow-up. Future studies should upgrade the current methods, improve the clinical utility, and develop new positioning techniques.

Objective To investigate the chemical constituents of the marine sponge Theonella swinhoei collected from the Xisha Islands in the South China Sea .Methods The petroleum ether and dichloromethane extract of the marine sponge T . swinhoei were purified by solvent extraction and chromatographic methods including vacuum liquid chromatography (VLC) , medium pressureliquidchromatography(MPLC),thinlayerchromatography(TLC)onsilicagel,highperformanceliquidchro-matography(HPLC) ,and Sephadex LH-20 .The chemical structures were determined by spectroscopic analysis and comparison with the reported data .Results Eight compounds were isolated and their structures were determined as cholest-7-ene-3β,5α, 6β-triol (1) ,ergosta-7 ,22-diene-3β,5α,6β-triol (2) ,25-norcycloartane-3β,6α,16β,24-tetraol (3) ,sinuflexibilin D (4) ,14-de-oxycrassin (5) ,N-(2-phenylethyl)-(9Z)-tetradecanamide(6) ,N-(2-phenylethyl)-tetradecanamide (7) ,7 ,8-dimethyl-isoallox-azine (8) .Conclusion Compounds 1～ 7 were isolated from the sponge of genus Theonella for the first time .

Objective: To evaluate the expression of OCT4 and SALL4 in testicular diffuse large B-cell lymphoma (DLBCL), and the utility of an immunohistochemical (IHC) panel of OCT4, SALL4 and CD20 in the differential diagnosis of DLBCL and GCT of the testis. Methods: Eighteen cases of testicular DLBCL were selected.IHC method was used to detect the protein expression of CD20, CD3, CD5, CD10, bcl-6, MUM1, Ki-67, bcl-2, c-MYC, OCT4 and SALL4. Results: Among the 18 cases, CD20 and PAX5 were strongly and diffusely expressed in all cases, while CD21, CD3, cyclinD1, SALL4, CD117 and PLAP were all negative. CD5, bcl-2 and c-myc were expressed in 3, 16 and 8 cases, respectively. Ki-67 proliferation index ranged from 40%-95%. Bcl-2 and c-MYC were co-expressed in seven cases. Four cases were GCB-DLBCL and the remaining 14 cases were non-GCB-DLBCL, according to Hans algorithm. Nuclear OCT4 expression was present in two cases, which demonstrated moderate expression in >50% of neoplastic cells. Univariate analysis showed that clinical stage, CD5 and OCT4 expression were relevant to prognosis. Multivariate Cox regression analysis further confirmed that clinical stage, CD5 and OCT4 were independent prognostic factors in patients with testicular DLBCL. Conclusions Care should be exercised in using OCT4 as the sole marker of germ cell differentiation in the testis. The association of OCT4 and CD5, bcl-2 co-expression raises the question of whether OCT4 expression in DLBCL may reflect more aggressive biology.

Humans ; Stomach Neoplasms ; pathology

Objective To investigate the relationship between expression of PDGFRA /CMYC and clinicopathologic features of extranodal NK/T-cell lymphoma .Methods Fifty-four cases of extranodal NK/T-cell lymphoma were included in the study .Immunohistochemistry was used to detect the expression of CD20, CD2, CD3, CD56, TIA1,GrB, Ki-67, PDGFRA and CMYC.In situ hybridization was performed to detect the presence of EBV encoded small RNA ( EBER).Fifty cases of nasopharyngeal mucosal lymphoid tissue hyperplasia were used as normal control .Results Among 54 cases of ENKTL,CD2, CD3, GrB, and TIA1 were expressed in all the tumors .CD56 was expressed in 47 cases ( 81.0%) and CD20 was not detectable in any cases.Ki-67 proliferative index expression of >60%was found in 45 cases (83.3%).In situ hybridization for EBER was positive in all cases (100%).The positive expression rates of PDGFRA and CMYC in extranodal NK/T-cell lymphomas were 51.9%(28/54) and 53.7%(29/54), respectively, much higher than those in nasopharyngeal mucosal lymphoid tissue hyperplasia ( 0, P <0.05 ) .There was a positive correlation between PDGFRA and CMYC (r=0.295, P<0.05).The expression of CMYC was correlated with clinical efficacy (P<0.05), but not with gender, age, Ann Arbor stage, B symptoms and therapeutic regimen ( all P >0.05 ) .The expression of PDGFRA was correlated with B symptoms ( P <0.05), while not with gender, age, Ann Arbor stage, therapeutic regimen and clinical efficacy (all P>0.05).The co-expression of PDGFRA and CMYC was not correlated with gender , age, Ann Arbor stage, B symptoms, therapeutic regimen and clinical efficacy (P>0.05).Univariate analysis showed that the stage , clinical efficacy , CMYC protein and the co-expression of PDGFRA and CMYC were significantly correlated with the prognosis.The overall survival of the patients with CMYC positive expression was shorter than of that of the patients with negative expression ( P <0.05 ) .Multivariable Cox regression analysis further confirmed that clinical stage , CMYC protein expression , and the co-expression of PDGFRA and CMYC were independent prognostic factors in patients with extranodal NK /T-cell lymphoma .Conclusion CMYC protein, and the co-expression of PDGFRA and CMYC can be as an independent prognostic factor in patients with extranodal NK/T-cell lymphoma and influence the prognosis of patients .

OBJECTIVETo study the clinicopathologic characteristics, immunophenotypes, pathologic diagnosis and differential diagnosis of gastrointestinal inflammatory fibroid polyp (IFP).

METHODSThe clinical data, histologic features and immunohistochemical results of 6 cases of gastrointestinal inflammatory fibroid polyp were analyzed, with review of literature.

RESULTSThere were altogether 5 women and a man. The age of patients ranged from 44 to 87 years (median age = 61 years and mean age = 62 years). The sites of involvement included stomach (number = 2), jejunum (number = 2), distal ileum (number = 1) and rectum (number = 1). The patients often presented with abdominal pain or discomfort and tarry stool. All the cases studied showed similar morphology, were submucosa-based and composed of bland spindle cells associated with loose collagenous stroma and perivascular edema. Prominent concentric fibroblastic proliferation ("onion-skin" appearance) and eosinophilic infiltrate were characteristics. Three of the patients underwent surgical resection. The remaining patients had the lesions removed with endoscopy. Follow-up data were available in 5 patients and none of them had disease recurrence or metastasis.

CONCLUSIONSIFP is a rare benign tumor of gastrointestinal tract. Correct diagnosis primarily relies on pathologic examination. It needs to be distinguished from gastrointestinal stromal tumors or inflammatory myofibroblastic tumor.

Adult ; Aged ; Aged, 80 and over ; Diagnosis, Differential ; Female ; Gastrointestinal Tract ; pathology ; Humans ; Immunohistochemistry ; Inflammation ; pathology ; Male ; Middle Aged ; Polyps ; pathology