1.Pediatric giant cell tumor of bone: a clinicopathological analysis of 35 cases
Yanrui PANG ; Juan ZHOU ; Chunyan CHEN ; Qianqian ZHAO ; Keyang SUN ; Zhiyan LIU
Chinese Journal of Pathology 2024;53(11):1122-1126
		                        		
		                        			
		                        			Objective:To investigate the clinicopathological characteristics of giant cell tumor of bone (GCTB) in children.Methods:A total of 35 cases of GCTB diagnosed at Shanghai Sixth People′s Hospital Affiliated to Shanghai Jiaotong University School from 2016 to 2023 were collected, and a retrospective analysis of clinicopathological features and imaging findings was conducted.Results:Pediatric GCTB accounted for approximately 4.6% of total GCTB cases during the study period. There were 11 males and 24 females. The onset age ranged from 9 to 18 years (mean age 15 years, median age 16 years), with 8 cases (8/35, 22.9%) experiencing postoperative recurrence. Twenty-eight cases (28/35, 80%) primarily affected long bones, while 7 cases involved small or irregular bones. Imaging revealed osteolytic changes as the predominant feature, with 3 cases exhibited open physis, one of which had the tumor primarily at the diaphysis without crossing the physis. Histologically, pediatric GCTB resembled adult cases, characterized by mononuclear cells and osteoclast-like giant cells. Seven cases with denosumab treatment demonstrated degrees of giant cell disappearance, increased fibrous tissue and reactive bone proliferation in the stroma. One case was diagnosed as pediatric multicentric GCTB, and three cases as pediatric primary malignant GCTB, with malignant transformation into osteosarcoma. In all 35 cases, mutations in the H3F3A gene were identified, comprising 32 cases with H3.3 p.G34W mutations, one case with H3.3 p.G34V mutation, and 2 cases with H3.3 p.G34L mutations. Notably, the former two categories were successfully validated at the protein level through immunohistochemical staining, utilizing highly specific antibodies tailored for these mutation types: H3.3 p.G34W antibody and H3.3 p.G34V antibody. However, immunohistochemical staining was not available for the last category.Conclusions:Pediatric GCTB predominantly affects females and occurs primarily in long bones, mainly around the knee joint, the majority of tumors predominantly arise in the epiphysis and extend into the metaphysis; however, in cases where the epiphyseal plates are still unclosed, the tumors may be restricted to the metaphysis. Detection of H3F3A gene mutation is crucial for the diagnosis and differential diagnosis of pediatric GCTB.
		                        		
		                        		
		                        		
		                        	
2.Retrospective analysis of chest and abdominal CT presentations after endoscopic full-thickness resection
Keyang FAN ; Zuqiang LIU ; Liyun MA ; Weifeng CHEN ; Quanlin LI ; Pinghong ZHOU
Chinese Journal of Digestive Endoscopy 2023;40(7):550-555
		                        		
		                        			
		                        			Objective:To summarize the thoracic and abdominal CT presentations after endoscopic full-thickness resection (EFR) and to analyze its significance in the evaluation and management of postoperative complications.Methods:Data of 82 patients who underwent gastrointestinal EFR at the Endoscopy Center of Zhongshan Hospital, Fudan University and received a chest and/or abdominal CT within 1 week from September 2016 to September 2021 were collected retrospectively. The patients were divided into the intervention group ( n=38) and the control group ( n=44) according to the presence or absence of special postoperative interventions or prolonged hospital stays. The differences in the incidence of abnormal CT presentations between the two groups were analyzed. Risk factors for abnormal CT presentation were explored by multifactorial analysis. Results:Among the 82 patients, the main CT presentations were pneumoperitoneum in 51 patients (62.2%), abdominal and pelvic effusion in 30 patients (36.6%), pneumothorax in 5 (6.1%), pleural effusion in 43 (52.4%), and pulmonary inflammation in 16 (19.5%). The incidence of pelvic and abdominal effusions ( W=637.48, P=0.031) and pleural effusions ( W=622.06, P=0.031) in CT was higher in the intervention group than that in the control group. Age was an independent risk factor for air-related complications after EFR (>60 years old VS ≤60 years old: OR=0.17, 95% CI: 0.05-0.56, P=0.002). Conclusion:CT presentations of pelvic and abdominal effusion and pleural effusion after EFR is of great significance in suggesting complications, while patients with other CT presentations often do not require special intervention or prolonged hospital stay. Postoperative CT in elderly patients is less likely to detect air-related complications.
		                        		
		                        		
		                        		
		                        	
3.Clinicopathological and molecular features of 25 cases of the oncocytic carcinoma of the thyroid
Juan TANG ; Chunyan CHEN ; Shuyi LIU ; Qianqian WANG ; Likun ZHANG ; Keyang SUN ; Zhiyan LIU
Chinese Journal of Clinical and Experimental Pathology 2023;39(12):1436-1440,1447
		                        		
		                        			
		                        			Purpose To investigate the clinicopathological and molecular genetic features of oncocytic carcinoma of the thy-roid(OCA).Methods The clinicopathological and immuno-histochemical data of 25 patients with oncocytic carcinoma of the thyroid were retrospectively reviewed.Genetic features were determined by fluorescence quantitative PCR.Results The male to female ratio of the 25 patients was 1 ∶ 1.8,and the aver-age age was 49 years.The tumor was confined to the thyroid gland.Of the 22 cases with a single nodule,5 cases were ill-de-marcated and 3 cases were multiple nodular lesions.The average size was 2.7 centimeter in diameter.Cytologically,the tumor cells were arranged in detached clusters with abundant eosino-philic and granular cytoplasm and hyperchromatic nuclei with prominent nucleoli.Histologically,the oncocytic tumor cells mainly arranged in trabecular and solid architecture.Capsular,blood and lymphoid vascular invasion could be observed in a cer-tain extent.Among 25 cases of OCA,8 cases were minimally in-vasive,14 cases were encapsulated angio-invasive and 3 cases were widely invasive.Positive immunoreaction with TTF-1,thy-roglobulin and CD56 supported the thyroid epithelial origination of the tumour.One recurrent case was found to have cervical lymph node metastasis,and another case was presented with bone metastasis,which was determined to harbor TERT promoter mu-tation(C228T)in each case.Different point mutation of RAS gene was determined in 2 cases(8%),respectively.Conclu-sion Oncocytic carcinoma of the thyroid shows typical eosino-philic and granular cytoplasm,immunohistochemical staining is helpful in differential diagnosis with other oncocytic lesions.It lacks BRAF-like mutation.Low frequency of RAS mutations could be found.Rare TERT promoter mutation has significant mutation with clinical behavior of OCA.
		                        		
		                        		
		                        		
		                        	
4.Hypothyroidism during pregnancy in mice induces lipid dysregulation in female offspring's early life
Chengcheng Li ; Yan Lin ; Juan Liu ; Keyang Chen
Acta Universitatis Medicinalis Anhui 2023;58(10):1622-1626,1633
		                        		
		                        			Objective     :
		                        			To  evaluate  the  effect  of maternal  hypothyroidism  on lipid  metabolism in the  early life of emale offspring by constructing a murine model during pregnancy.
		                        		
		                        			Methods     :
		                        			 Female  mice  C57BL /6J were  ran- domly divided into  normal  control  group   ( NC0 ) ,hypothyroidism  complicated  with  pregnancy  group   ( PH0 )  and  pregnancy complicated with hypothyroidism group  ( GH0) .Firstly,PH0 group was given 0.15%  propylthiouracil di- et for 28 days,while NC0 and GH0 groups were given normal diet.After the successful modeling of PH0 was con- firmed,female mice in GH0  and PH0  groups were given 0.15%  propylthiouracil diet during pregnancy,and NC0  group was still given normal diet.After delivery,the levels of free triiodothyronine  ( FT3) ,free thyroxine  ( FT4) , thyroid stimulating hormone  (TSH) and total cholesterol  (TC) ,triglyceride  (TG) in each group were detected at 3  weeks of age for female offspring.The pathological changes of thyroid and liver were observed by HE staining.West- ern blot detected the levels of proteins associated with lipid metabolism.
		                        		
		                        			Results    :
		                        			Compared  with  the  NC0  group, the levels of serum FT3 and FT4 decreased,the levels of serum TSH,serum TC,hepatic TC and TG increased in the  female offspring of the PH0 and GH0 groups,and lipid deposition was observed in their livers.The expression levels  of HMGCR , FAS  and  CD36  related  to  lipid  metabolism  in  livers  increased,while  the  expressions  of  CPT1A  and  LDL-R were down-regulated.
		                        		
		                        			Conclusion    
		                        			 Hypothyroidism  during  pregnancy  may  lead  to  the  disturbance  of lipid  metabolism in the early life of female offspring mice.
		                        		
		                        		
		                        		
		                        	
5.Mechanism of celecoxib inhibiting the expression of retinal VEGF in diabetic retinopathy rats via JAML
Mei Duan ; Fan Cao ; Yanchao Gui ; Keyang Chen ; Liming Tao ; Zhengxuan Jiang
Acta Universitatis Medicinalis Anhui 2023;58(8):1293-1299
		                        		
		                        			Objective  :
		                        			To investigate the effect and mechanism of celecoxib on retinal vascular endothelial growth factor(VEGF) in rats with diabetic retinopathy. 
		                        		
		                        			Methods   :
		                        			 Forty - five SD rats were divided into normal control group (NC) , diabetic retinopathy group (DR) , celecoxib intervention diabetic retinopathy group ( DR + C) .  The diabetic model was established by intraperitoneal injection of 1% STZ.  After one month , celecoxib (50 mg/kg) was given intragastric administration (1/day) in the DR + C group. Two months later, serum total cholesterol (TC) and insulin were detected. The histopathological changes of the retina were observed. The expression of junctional adhesion molecule⁃like protein (JAML) , VEGF and their signal pathway proteins and the distributions of interleukin⁃10 (IL⁃10) , vascular cell adhesion molecules⁃1(VCAM⁃1) were detected by Western blot. HUVEC cells were divided into normal glucose group (NG) , high glucose group (HG) and high glucose plus celecoxib group (HG + C) to detect the expression of the above proteins.
		                        		
		                        			Results  :
		                        			Compared with DR , retina in DR + C group was thinner. The retina in the DR + C group was thicker than that in the NC group. The levels of retinal JAML ,phosphatidylinositol kinase3(PI3K), phosphorylphosphatidylinositol kinase3(P⁃PI3K) , hypoxia⁃inducible factor1 ⁃α (HIF1 ⁃α ) , and VEGF in DR + C group were lower than those in DR group ,while higher than those in NC group. The expression of retinal IL⁃10 and VCAM⁃1 decreased . The content of TC in DR + C and DR group was higher than those in NC  group (P < 0. 01) , while the content of insulin in DR + C and DR group was lower than thlse in NC group (P < 0. 001) . Compared with HG group , the expressions of JAML , PI3K , P ⁃PI3K , HIF1 ⁃α , VEGF in HG + C group decreased , but was higher than those in NG group. There was no significant difference in PI3K among the three groups.
		                        		
		                        			Conclusion  
		                        			Celecoxib can decrease the expression of VEGF , IL⁃10 , VCAM⁃1 in retina of DR rats , which may be related to the PI3K/HIF1 ⁃α signaling pathway mediated by JAML.
		                        		
		                        		
		                        		
		                        	
6.Effect of light and riboflavin concentration on photodynamic inactivation of pathogens by riboflavin
Yuanyuan He ; Yanyu Li ; Yundi Yin ; Lin Li ; Keyang Chen ; Zhong Liu
Acta Universitatis Medicinalis Anhui 2023;58(6):959-962
		                        		
		                        			Objective  :
		                        			To investigate the  effect of riboflavin  on  inactivation of pathogens under different light time  conditions.
		                        		
		                        			Methods :
		                        			Plasma  containing vesicular stomatitis virus  (VSV) was divided  into 4 groups,and the final concentrations of riboflavin were 50,100,150  μmol / L and 0  μmol / L was used as the control group.The growth titers at 10,15,20 and 25 min were observed.The control group was treated with no light.The growth titers of VSV culture before and after inactivation were calculated by Reed-Muench method,and the effect of different concentrations of riboflavin on the inactivation effect was evaluated by log reduction factor after inactivation.
		                        		
		                        			Results  :
		                        			Under the condition of no light,the addition of riboflavin had no pathogen inactivation effect.With the increase of light time from 15 min to 25 min,the inactivation effect of VSV in the non-riboflavin group increased.When the light was less than 15 min,there was no significant difference in the inactivation effect of 50 to 150  μmol / L riboflavin  VSV.When the light duration was 15 to 25 min,the inactivation effect of VSV was enhanced after the addition of riboflavin,but there was no difference between different concentrations of riboflavin groups.
		                        		
		                        			Conclusion 
		                        			The  inactivation effect of riboflavin pathogen within 25 min is better with the increase of light time,and has little influence  on riboflavin concentration.
		                        		
		                        		
		                        		
		                        	
7.Progress of cellular growth factors in neurorehabilitation and neuroplasticity
Xiaokun LI ; Xu LIU ; Jiahua LIU ; Zhiheng RAO ; Yingde LUO ; Keyang CHEN ; Tong ZHANG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(2):175-182
		                        		
		                        			
		                        			With potent biological activities, cellular growth factors are polypeptide factors that primarily stimulate cell growth and proliferation. They participate in the regulation of not only normal physiological functions such as human embryonic development and cell growth, but also neurorehabilitation and neuroplasticity in pathological processes such as nerve injury and recovery. Specifically, cellular growth factors have been shown to promote neuron survival, facilitate nerve regeneration and regulate synaptic plasticity, promote cell differentiation/vascular regeneration and modulate the microenvironment, promote nerve fiber myelination and improve nerve conduction. This review summarized current knowledge on the roles and various growth factors in neurorehabilitation and neuroplasticity, providing an update on potential clinical application of cellular growth factors in the field of neural rehabilitation.
		                        		
		                        		
		                        		
		                        	
8.Progress in application and detection of riboflavin singlet oxygen photochemistry
Yuanyuan HE ; Ling LI ; Keyang CHEN ; Zhong LIU
Chinese Journal of Blood Transfusion 2022;35(5):591-596
		                        		
		                        			
		                        			Photodynamic therapy (PDT), which uses photosensitizers to produce singlet oxygen to kill bacteria, was first discovered by scientists over 100 years ago and has been widely used in clinical treatment. Riboflavin is an endogenous and the most commonly used photosensitizer.A large number of studies have shown that riboflavin can produce singlet oxygen through photodynamic reaction(typeⅡ) after illumination.This method is currently widely used to kill pathogens such as bacteria and viruses in blood, and singlet oxygen is considered to be the key factor in the photodynamic effect.Singlet oxygen can induce cell apoptosis, necrosis and autophagy.At present, there are direct and indirect methods to detect singlet oxygen, but both with some limitations.This paper reviews production mechanism, action mechanism and detection of singlet oxygen produced by riboflavin during photodynamic therapy, which provides a basis for further application of photodynamic therapy in clinical practice and searching for a more suitable detection method for singlet oxygen.
		                        		
		                        		
		                        		
		                        	
9.The effect of capsaicin on the retinal vascular permeability in diabetic rats
Kou Liu ; Xia Gao ; Keyang Chen ; Zhengxuan Jiang
Acta Universitatis Medicinalis Anhui 2022;57(6):855-859
		                        		
		                        			Abstract:
		                        			To investigate the effect of capsaicin on retinal vascular permeability in diabetic rats(DM).
		                        		
		                        			Methods:
		                        			24 eight-week-old male sprague-dawley(SD) rats were randomly categorized into four groups(n=6): control group(NC), diabetic group(DM), diabetic group with 3 mg/kg capsaicin treatment(CAP3) and diabetic group with 6 mg/kg capsaicin treatment(CAP6). Type 2 diabetic rat(T2 DM) model was established by high-fat diet combined with small-dose streptozotocin(STZ)induction. The body weight and fasting blood glucose in 4 groups were monitored. Total cholesterol(TC), triglycerides(TG), low density lipoprotein(LDL), high density lipoprotein(HDL) concentrations in serum were detected according to manufacturer′s instructions. Evans blue angiography was used to observe the changes of retinal vascular permeability.Immunofluorescence was used to measure the distribution and expression of transient receptor potential vanillic 1(TRPV1) in retina. Western blot was used to detect the expression of TRPV1, vascular endothelial growth factor(VEGF) and occludin in rat retina.
		                        		
		                        			Results:
		                        			Compared with the DM group, serum total cholesterol(TC), triglyceride(TG) and low density lipoprotein(LDL) levels in the CAP3 and CAP6 groups significantly decreased(P<0.01). The results of angiography showed that the retinal vascular permeability increased in the DM group and that there were many strong fluorescent leakage areas, while the leakage was reduced in CAP3 and CAP6 groups. In CAP3 and CAP6 groups, immunofluorescence showed the activation of TRPV1 in the retinal ganglion cell layer, inner nuclear layer and outer nuclear layer. Western blot indicated that the expression of TRPV1 and occludin increased while the expression of VEGF decreased(P<0.01). 
		                        		
		                        			Conclusion
		                        			Capsaicin may exert the effect of improving diabetic retinopathy, underlying which the mechanism may be that capscicin activates retinal TRPV1, resulting in the downregulation of VEGF and upregulation of occuldin.
		                        		
		                        		
		                        		
		                        	
10.The modified single incision robot-assisted laparoscopic radical prostatectomy: initial experience and clinical efficiency
Qian LYU ; Yi WEI ; Yaoqian WANG ; Yong OU ; Qiang WANG ; Hualin FENG ; Cheng LUO ; Yu NIE ; Shangqing REN ; Fang ZHOU ; Shida FAN ; Zhengjun CHEN ; Keyang JIA ; Yang LI ; Dong WANG
Chinese Journal of Urology 2021;42(11):830-833
		                        		
		                        			
		                        			Objective:To evaluate the feasibility and clinical efficiency of robot-assisted laparoscopic radical prostatectomy (RARP) via extraperitoneal PORT-free single incision approach.Methods:The data of 33 patients with prostate cancer underwent the extraperitoneal PORT-free single incision RARP from November 2020 to January 2021 in Sichuan Provincial People's Hospital was retrospectively reviewed. The average age was 66.7 (58-78) years, the median PSA was 20.77 (2.89, 56.44) ng/m, and the mean Gleason score was 7.0 (6.0-9.0). The mean prostate volume was 48.4 (25.0-220.0) ml. Clinical stage: 32 cases was in cT 2a-2cN 0M 0, 1 case in cT 3aN 0M 0. 16 cases had a history of operation. All 33 operations were performed by the same operator. All operations were performed by extraperitoneal PORT-free single-incision approach. The surgical condition, postoperative complication, pathology, and follow-up results were observed. Results:In this study, 33 operations were successfully completed without conversion to open or additional single hole channel instruments. The average operation time was 61.3 (38.0-120.0) min, with the mean intraoperative bleeding volume of 72.2 (45.0-220.0) ml and the mean bladder neck urethral anastomosis time of 11.7 (8.5-15.7) min. The mean postoperative hospital stay was 7.9 (6.0-15.0) d, the mean postoperative indwelling time of urinary catheter was 6.8 (6.0-14.0) d, and the mean postoperative evacuation time was 1.0 (0.5-3.0) d. The average incision length was 5.2 (4.6-5.8) cm. There was no obvious complications. The postoperative pathological stage: 21 cases were in < pT 3a, 12 cases were in ≥ pT 3a, and 6 cases (18.8%) had positive resection margin. 29 cases (88.9%) acquired satisfactory urinary continence after operation, and the frequency of urinary pad use was ≤ 1 tablet/day. Conclusions:The extraperitoneal single-incision RARP surgical channel without PORT is safe and feasible with a satisfying cosmetic effect, which saves costs and requires less specific channel device. Simultaneously, the new approach has strong replicability, short-term tumor control and urinary control effect with rapid postoperative recovery. However, the sample size of this study is relatively small, which needs further research and demonstration
		                        		
		                        		
		                        		
		                        	
            

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