Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of T-cell lymphoma. Despite the scarcity of reported BIA-ALCL cases in Asia, it is imperative to research early diagnosis. The crucial diagnostic criteria for BIA-ALCL include the presence of ALK - and CD30 + T cells exceeding 10% in the delayed seroma fluid. Furthermore, laboratory tests, such as histological examination of capsulectomies and analysis of clonal T-cell receptor (TCR) gene rearrangements, serve as important auxiliary diagnostic indicators. This article reported the case of a 56-year-old female patient who underwent bilateral breast augmentation with implants over 20 years ago. She presented with hardness, enlargement, and mild discomfort in her left breast. She was admitted to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in January 2023. MRI suggested implant rupture. Therefore, bilateral implant removal surgery was performed on February 2, 2023. Pathological examination of the fluid within the capsule of the left implant revealed a small number of ALK - and CD30 + T cells, with monoclonality observed in TCRγ gene rearrangement, indicating early changes suggestive of BIA-ALCL. Long-term follow-up is needed. The authors suggest that patients suspected of BIA-ALCL should undergo TCR gene rearrangement testing in addition to cytological and immunological examinations, which can provide guidance for the diagnosis, treatment, and necessary long-term follow-up of these patients.

Chemical cleaning and disinfection are crucial steps for eliminating infection in root canal treatment.However,irrigant selection or irrigation procedures are far from clear.The vapor lock effect in the apical region has yet to be solved,impeding irrigation efficacy and resulting in residual infections and compromised treatment outcomes.Additionally,ambiguous clinical indications for root canal medication and non-standardized dressing protocols must be clarified.Inappropriate intracanal medication may present side effects and jeopardize the therapeutic outcomes.Indeed,clinicians have been aware of these concerns for years.Based on the current evidence of studies,this article reviews the properties of various irrigants and intracanal medicaments and elucidates their effectiveness and interactions.The evolution of different kinetic irrigation methods,their effects,limitations,the paradigm shift,current indications,and effective operational procedures regarding intracanal medication are also discussed.This expert consensus aims to establish the clinical operation guidelines for root canal irrigation and a position statement on intracanal medication,thus facilitating a better understanding of infection control,standardizing clinical practice,and ultimately improving the success of endodontic therapy.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of T-cell lymphoma. Despite the scarcity of reported BIA-ALCL cases in Asia, it is imperative to research early diagnosis. The crucial diagnostic criteria for BIA-ALCL include the presence of ALK - and CD30 + T cells exceeding 10% in the delayed seroma fluid. Furthermore, laboratory tests, such as histological examination of capsulectomies and analysis of clonal T-cell receptor (TCR) gene rearrangements, serve as important auxiliary diagnostic indicators. This article reported the case of a 56-year-old female patient who underwent bilateral breast augmentation with implants over 20 years ago. She presented with hardness, enlargement, and mild discomfort in her left breast. She was admitted to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in January 2023. MRI suggested implant rupture. Therefore, bilateral implant removal surgery was performed on February 2, 2023. Pathological examination of the fluid within the capsule of the left implant revealed a small number of ALK - and CD30 + T cells, with monoclonality observed in TCRγ gene rearrangement, indicating early changes suggestive of BIA-ALCL. Long-term follow-up is needed. The authors suggest that patients suspected of BIA-ALCL should undergo TCR gene rearrangement testing in addition to cytological and immunological examinations, which can provide guidance for the diagnosis, treatment, and necessary long-term follow-up of these patients.

Objective To investigate the distribution of pathogens causing pulmonary infection after lung cancer chemotherapy and the changes and diagnostic value of serum cytokeratin 19 fragment antigen (CYFRA21-1), high mobility group box 1 protein (HMGB1), and soluble hemoglobin scavenger receptor (sCD163) levels. Methods A total of 83 lung cancer patients with chemotherapy from July 2022 to November 2023 were divided into non-infected group (n=43) and infected group (n=40) based on their pulmonary infection status, sputum samples were collected from lung cancer chemotherapy patients, and the source of the samples was recorded for bacterial identification.The changes in serum CYFRA21-1, HMGB1 and sCD163 levels were compared between the two groups; a multivariate Logistic regression model was used to analyze the factors influencing pulmonary infection after lung cancer chemotherapy; the diagnostic values of serum CYFRA21-1, HMGB1 and sCD163 levels for pulmonary infection after lung cancer chemotherapy were analyzed. Results Among the 83 patients with lung cancer chemotherapy, 40 cases had pulmonary infections; a total of 55 strains of pathogens were detected, including 34 Gram-negative bacteria and 18 Gram-positive bacteria, accounting for 61.82% and 32.73% respectively, while only 3 strains of fungi were detected, accounting for 5.45%.Serum levels of CYFRA21-1, HMGB1 and sCD163 in the infected group were significantly higher than those in the non-infected group (P < 0.05).Age, history of lung diseases, CYFRA21-1, HMGB1 and sCD163 were factors influencing pulmonary infection in patients with lung cancer chemotherapy (P < 0.05).The areas under the curve for the diagnostic value of serum CYFRA21-1, sCD163 and HMGB1 levels for pulmonary infection after lung cancer chemotherapy were 0.677, 0.763 and 0.819, respectively (P < 0.05). Conclusion The main pathogens causing pulmonary infection after lung cancer chemotherapy are Gram-negative bacteria, and the serum levels of CYFRA21-1, HMGB1 and sCD163 increase significantly, which can be used as biological indicators for early diagnosis and assessment of infection.

Presently, nonalcoholic fatty liver disease has become the most common pathogenic factor of chronic liver disease worldwide that can lead to the occurrence of hepatocellular carcinoma (HCC). Lipid metabolism in cancer cells is closely related to tumorgenesis, invasion and metastasis, and thus acts as one of the hallmark of cancer cells. Lipolipomics is an important branch of metabolomics, which has been adapted recently in the study of HCC for analysis of the structure and function of lipid components by chromatography and mass spectrometry. Fatty acids, glycerides, glycerophospholipids, sphingolipids, and sterol are significantly different in HCC tissues or serum. Therefore, it contributes to the diagnosis, determination of prognosis, mechanistic study and targeted therapy of HCC.

Objective To investigate the effect of tripterygium glycosides (TG) contained serurn on the pathological boneforming related inflammatory markers and miR-21.Methods Previous isolated and cultured AS fibroblasts were stimulated using IL-1 of 1ng/ml for 24h,different concentrations of blank serum (5％,10％,and 15％) and TG contained serum (5％,10％,and 15％) were added for 48h.PGE-2,IL-17,IL-22,IL-23,CCL19 and CCL21 proteins were examined by Western blot.The osteogenesis marker BMP and microRNA-21 mRNAs were tested.Results 48 h after intervention,the expressions of inflammatory markers were obviously inhibited by TG contained serum;the boncforming related inflammatory markers,expressions of BMP-2 and miR-2t were all inhibited in a dose-dependent manner.Conclusions TG could inhibit the expressions of boneforming related inflammatory markers,BMP-2 and miR-21,thus providing theoretical basis to treat AS pathological boneforming.

Objective To investigate the effects of β adrenergic receptor blocker carvedilol and cholinergic receptor blocker scopolamine on the biological behaviors of prostate cancer in C57BL/6 mice.Methods From June 2014 to November 2014, sixty male C57BL/6 mice, 10 weeks old, were injected with RM-1 cells (0.5 × 106) into bilateral dorsal prostate capsules of each mice by microsyringe and were randomly divided into three groups, including carvedilol group (K), scopolamine group (D) and saline group (N) after modeling.In K group, the carvedilol (10 mg/kg) was given to mice through gastric tube.The normal saline was given to them by subcutaneous injection.In D group, the normal saline was given to mice through gastric tube.Meanwhile, the scopolamine (1 mg/kg) was injected subcutaneously.In N group, daily normal saline was given by through gastric tube and subcutaneous injection.At the seventh day of postoperation, five mouse were sacrificed in each group every three days to observe the local growth,invasion and metastasis of prostate cancer to pelvic nodes and liver.Immunohistochemical determination of prostate tumor was made by TH staining and VAChT staining in each group.Results The volume of the prostate cancer was gradually increased in three groups.There was no statistical difference of prostate volume among three groups on the day 7 and 10 post-operatively (all P ＞ 0.05).The prostate volume of K group, D group and N group on the day 13 were 0.05 ± 0.04, 0.18 ± 0.08, 0.14 ± 0.05 cm3, respectively (P ＜0.05).However, the statistical significance existed between K and N group (P ＜ 0.05).There was no statistical difference of AOD between TH and VAChT among three groups on the day 7 (all P ＞ 0.05).The AOD of TH and VAChT in prostate cancer of K group, D group and N group on the day 10 were [(0.0114±0.016), (0.114±0.002), (0.059±0.008)] and [(0.025 ±0.011), (0.0226±0.003), (0.009±0.003)], respectively (P ＜0.05).Those values on the day 13 were [(0.147 ±0.036),(0.129 ±0.025), (0.071 ±0.022)] and [(0.020 ±0.005), (0.020 ±0.002), (0.010 ±0.002)],respectively (P ＜0.05).TH and VAChT expression of K and D in 10th and 13th is higher than in N (all P ＜ 0.05).At the 7th day, no metastasis of pelvic nodes was detected in all groups.At 10th day, 2 cases of K, no case of D and 3 cases of N were detected the lymph node metastasis.At the 13th day, 3 cases of K, 1 case of D and 4 cases of N were recorded the lymph node metastasis.At the 7th day, no metastasis of liver was detected.At 10th day, 1 case of K, no case of D and 2 cases of N were found the liver metastasis.At the 13th day, 3 cases of K, 1 case of D and 4 cases of N were recorded the liver metastasis.The lifesapn of tumor-bearing mice in K group, D group and N group was 16.8 ±0.8, 17.6 ±0.5, 15.8 ±0.1, respectively (P ＞ 0.05).Conclusions β adrenergic receptor blocker carvedilol can suppress the growth of prostate cancer and cholinergic receptor blocker scopolamine may can inhibit metastasis of prostate cancer.

Controlled Clinical Trials as Topic ; Humans ; Randomized Controlled Trials as Topic

OBJECTIVETo evaluated HER2 status using immunohistochemistry (IHC) assay and fluorescence in situ hybridization (FISH) at two different time points of tissue fixation after surgical resection of gastric cancer, emphasizing the importance of standard operation and quality control in HER2 testing.

METHODSForty-one resection specimens of advanced gastric cancer were collected with tissue fixation periods of < 30 min or > 30 min after surgical resection. HER2 status was evaluated by immunohistochemistry (IHC) assay and fluorescence in situ hybridization (FISH).

RESULTSThe frequency of HER2 expression by IHC in the samples with fixation time of < 30 min was higher than that in those of > 30 min (P < 0.05). However, no significant difference was observed by FISH (P > 0.05) between the two groups. Samples of < 30 min fixation time had high concordant results between IHC and FISH (100.0% for both positive and negative cases, Rho = 0.724, P < 0.05). In addition, HER2 expression by IHC was significantly correlated with Lauren classification, histologic differentiation, TNM stage and gender (P < 0.05).

CONCLUSIONThe time to tissue fixation after surgical resection of more than 30 min has deleterious effect on the detection of HER2 by IHC although FISH testing is not affected.

Aged ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Receptor, ErbB-2 ; analysis ; Stomach Neoplasms ; chemistry ; pathology ; surgery ; Time Factors ; Tissue Fixation ; methods

ObjectiveTo investigate the efficacy of rapamycin combined with CsA/Tacrolimus (Tac) in chronic allograft nephropathy (CAN).MethodsFifty-three cases of CAN accepted the quadruple immunosuppressive drug program,which contained rapamycin combined with CsA/Tac and MMF and prednisone,and CsA/Tac and MMF were reduced to the original amount of 25％ to 50％.After treatment for 12 months,more relevant indicators,including serum creatinine,glomerular filtration rate,serum cholesterol,triglycerides,urinary protein,GPT and bilirubin and other changes were observed.ResultsIn the patients receiving quadruple regimen of rapamycin during 12 months,the blood Ccr was decreased from (161.51 ± 106.48)μmol/L before treatment to (126.51 ± 56.2)μmol/L after treatment for 6 months (P＜0.05) and to (123.43 ± 54.18)μmol/L after for 12 months (P＜0.01).The GFR was increased from (0.754 ± 0.302) ml/s before treatment to (0.952 ± 0.347)ml/s after treatment for 6 months (P＜0.05) and to (1.007 ± 0.394) ml/s after treatment for 12 months (P＜0.01).Cholesterol and triglycerides in patients had no significant change before and after treatment.The positive rate of proteinuria after treatment showed an increasing trend from 9.4％ before treatment to 26.4％ after treatment for 12 months.ConclusionThe quadruple program of rapamycin combined with CsA/FK506 and MMF can significantly improve Ccr and GFR in patients with CAN,but it can increase the incidence of proteinuria in patients: