Objective:To characterize the histopathological subtypes and their clinicopathological parameters of gender and onset age by common, rare and sparse primary esophageal malignant tumors (PEMT).Methods:A total of 272 437 patients with PEMT were enrolled in this study, and all of the patients were received radical surgery. The clinicopathological information of the patients was obtained from the database established by the State Key Laboratory of Esophageal Cancer Prevention & Treatment from September 1973 to December 2020, which included the clinical treatment, pathological diagnosis and follow-up information of esophagus and gastric cardia cancers. All patients were diagnosed and classified by the criteria of esophageal tumor histopathological diagnosis and classification (2019) of the World Health Organization (WHO). The esophageal tumors, which were not included in the WHO classification, were analyzed separately according to the postoperative pathological diagnosis. The χ 2 test was performed by the SPSS 25.0 software on count data, and the test standard α=0.05. Results:A total of 32 histopathological types were identified in the enrolled PEMT patients, of which 10 subtypes were not included in the WHO classification. According to the frequency, PEMT were divided into common (esophageal squamous cell carcinoma, ESCC, accounting for 97.1%), rare (esophageal adenocarcinoma, EAC, accounting for 2.3%) and sparse (mainly esophageal small cell carcinoma, malignant melanoma, etc., accounting for 0.6%). All the common, rare, and sparse types occurred predominantly in male patients, and the gender difference of rare type was most significant (EAC, male∶ female, 2.67∶1), followed with common type (ESCC, male∶ female, 1.78∶1) and sparse type (male∶ female, 1.71∶1). The common type (ESCC) mainly occurred in the middle thoracic segment (65.2%), while the rare type (EAC) mainly occurred in the lower thoracic segment (56.8%). Among the sparse type, malignant melanoma and malignant fibrous histiocytoma were both predominantly located in the lower thoracic segment (51.7%, 66.7%), and the others were mainly in the middle thoracic segment.Conclusion:ESCC is the most common type among the 32 histopathological types of PEMT, followed by EAC as the rare type, and esophageal small cell carcinoma and malignant melanoma as the major sparse type, and all of which are mainly occur in male patients. The common type of ESCC mainly occur in the middle thoracic segment, while the rare type of EAC mainly in the lower thoracic segment. The mainly sparse type of malignant melanoma and malignant fibrous histiocytoma predominately occur in the lower thoracic segment, and the remaining sparse types mainly occur in the middle thoracic segment.

Objective The recurrence rate of atrial fibrillation (AF) after radiofrequency catheter ablation (RFCA) remains relatively high. The aim of this study was to investigate the predictive value of rs2200733 polymorphism for AF recurrence after RFCA. Methods Fifty-three AF patients underwent RFCA guided by the magnetic navigation system between July 2015 and September 2016 in Wuxi People’s Hospital. We obtained the baseline data on the patients, conducted genotyping for rs2200733 variants, and followed up the patients for symptoms and complications by electrocardiography (ECG) and dynamic ECG. Using Cox survival analysis, we determined the independent predictors of AF recurrence after RFCA and the sensibility and specificity of predicting AF recurrence at 12 and 24 months post-operatively. Results All the patients were Han Chinese, followed-up for 21.6 ± 9.5 months, and 25 (47.2%) of them experienced AF recurrence at 6.6 ± 5.3 months after RFCA. Kaplan-Meier survival analysis revealed a significant association between rs2200733 polymorphism and AF recurrence in the additive and recessive models (P < 0.001), and multivariate Cox analysis showed the rs2200733 polymorphism (recessive model) to be an independent predictor of post-RFCA AF recurrence (OR = 3.184, 95% CI: 1.378-7.357, P = 0.007). The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of rs2200733 TT in predicting AF recurrence at 12 months were 64%, 81%, 70%, 76% and 74%, and those at 24 months were 60%, 82%, 75%, 70%, and 72%, respectively. Conclusion The rs2200733 polymorphism is an independent predictor of AF recurrence after RFCA, and its high specificity indicates that it could be used as a tool for screening Han Chinese patients with AF for RFCA.

Objective The mechanisms of docosahexaenoic acid (DHA) protecting the cardiovascular system have not yet been clarified. This study was to investigate the vasorelaxative effect of 13,14-epoxy docosapentaenoic acid (13,14-EpDPE) on coronary arterioles in normal rats and its action mechanisms.Methods We isolated coronary artery smooth muscle cells (CASMCs) from normal rats by enzyme digestion, examined the open probabilities of the large conductance calcium-activated potassium (BK) channels in inside-out single channel configuration in the presence of different concentrations (0, 1, 10 and 100 pmol/L) of 13,14-EpDPE, and recorded the BK currents with the patch clamp in whole cell configuration. Then we assessed the coronary arterial relaxation by measuring dilatory responses to 13,14-EpDPE in pre-contracted tissues with or without pre-treatment with iberiotoxin.Results In the presence of 0, 1, 10 and 100 pmol/L of 13,14-EpDPE, the open probabilities of the BK channels were 0.25±0.03, 0.34±0.03, 0.44±0.06 and 0.85±0.16 (n=6), respectively, significantly increased at 100 pmol/L as compared with 0, 1 and 10 pmol/L (P<0.05). The BK channels were activated by 13,14-EpDP in a concentration-dependent manner and its half-effect concentration was (15.94±1.21) pmol/L. The current density was increased from (58.27±16.35) to (95.94±23.00) pA/pF (P=0.002) after 10 pmol/L 13,14-EpDP perfusion when the stimulation voltage was 100 mV. 13,14-EpDPE dilated the isolated coronary arterioles in a dose-dependent manner, and its effects were abolished after pre-treatment with iberiotoxin (100 nM).Conclusion 13,14-EpDPE can dilate coronary arterioles by activating BK channels in CASMCs, which might be one of the mechanisms underlying its protective effect on the cardiovascular system.

Human diphyllobothriasis is a parasitic disease caused by ingestion of larvae (plerocercoids) in raw or undercooked fish and commonly found in temperate areas. Rare cases were reported in tropical or subtropical areas especially in children. The first documented case of pediatric diphyllobothriasis in Taiwan had been reported 11 years ago. Here, we report another 8-year-old girl case who presented with a live noodle-like worm hanging down from her anus, with no other detectable symptoms. We pulled the worm out and found the strobila being 260 cm in length. Examination of gravid proglottids showed that they were wider than their lengths, containing an ovoid cirrus sac in the anterior side and the rosette-shaped uterus. Eggs extracted from the uterus were ovoid and operculated. Diphyllobothrium latum was confirmed by molecular analysis of the mitochondrial DNA cytochrome c oxidase subunit 1 (cox1) gene. The girl was treated with a single oral dose of praziquantel, and no eggs or proglottids were observed from her stool in the subsequent 3 months. The reemergence of human diphyllobothriasis in non-endemic countries is probably due to prevalent habit of eating imported raw fish from endemic areas. This pediatric case raised our concern that human diphyllobothriasis is likely underestimated because of unremarkable symptoms.
Anal Canal ; Child ; Diphyllobothriasis ; Diphyllobothrium* ; DNA, Mitochondrial ; Eating ; Eggs ; Electron Transport Complex IV ; Female ; Humans ; Larva ; Ovum ; Parasitic Diseases ; Praziquantel ; Taiwan* ; Uterus

BACKGROUNDDiabetes mellitus is associated with coronary dysfunction, contributing to a 2- to 4-fold increase in the risk of coronary heart diseases. The mechanisms by which diabetes induces vasculopathy involve endothelial-dependent and -independent vascular dysfunction in both type 1 and type 2 diabetes mellitus. The purpose of this study is to determine the role of vascular large conductance Ca(2+)-activated K(+) (BK) channel activities in coronary dysfunction in streptozotocin-induced diabetic rats.

METHODSUsing videomicroscopy, immunoblotting, fluorescent assay and patch clamp techniques, we investigated the coronary BK channel activities and BK channel-mediated coronary vasoreactivity in streptozotocin-induced diabetic rats.

RESULTSBK currents (defined as the iberiotoxin-sensitive K(+) component) contribute (65 ± 4)% of the total K(+) currents in freshly isolated coronary smooth muscle cells and > 50% of the contraction of the inner diameter of coronary arteries from normal rats. However, BK current density is remarkably reduced in coronary smooth muscle cells of streptozotocin-induced diabetic rats, leading to an increase in coronary artery tension. BK channel activity in response to free Ca(2+) is impaired in diabetic rats. Moreover, cytoplasmic application of DHS-1 (a specific BK channel b(1) subunit activator) robustly enhanced the open probability of BK channels in coronary smooth muscle cells of normal rats. In diabetic rats, the DHS-1 effect was diminished in the presence of 200 nmol/L Ca(2+) and was significantly attenuated in the presence of high free calcium concentration, i.e., 1 mmol/L Ca(2+). Immunoblotting experiments confirmed that there was a 2-fold decrease in BK-b(1) protein expression in diabetic vessels, without altering the BK channel α-subunit expression. Although the cytosolic Ca(2+) concentration of coronary arterial smooth muscle cells was increased from (103 ± 23) nmol/L (n = 5) of control rats to (193 ± 22) nmol/L (n = 6, P < 0.05) of STZ-induced diabetic rats, reduced BK-b(1) expression made these channels less sensitive to intracellular Ca(2+), which in turn led to enhanced smooth muscle contraction.

CONCLUSIONSOur results indicated that BK channels are the key determinant of coronary arterial tone. Impaired BK channel function in diabetes mellitus is associated with down-regulation of BK-b(1) expression and reduction of the b(1)-mediated BK channel activation in diabetic vessels.

Animals ; Blotting, Western ; Coronary Vessels ; metabolism ; Diabetes Mellitus, Experimental ; metabolism ; physiopathology ; Diabetes Mellitus, Type 1 ; metabolism ; physiopathology ; Electrophysiology ; Large-Conductance Calcium-Activated Potassium Channels ; metabolism ; Male ; Muscle, Smooth, Vascular ; metabolism ; Rats ; Rats, Sprague-Dawley

Objective To evaluate left ventricular (LV) function and twist in patients with diabetic cardiovascular autonomic neuropathy (CAN) by two-dimensional speckle tracking imaging (STI).Methods STI was performed in 56 subjects with type 2 diabetes mellitus (DM) (35 with DM only:group A,21 with CAN:group B) and 34 normal subjects (Control) from LV short-axis view.LV peak systolic,peak early (E′) and peak late (A′) diastolic circumferential strain in 18 myocardial segments were measured at the levels of mitral annulus,papillary muscle and apex and the rotation at mitral annulus and apex levels were also measured.LV peak systolic and the ratio of E′ and A′ of global and three levels,twist,untwisting rate and untwisting half-time were calculated.Results In group A,compared with control group,LV peak systolic radial circumferential strain has no significant difference ( P ＞ 0.05 ),E'/A' was reduced ( P ＜0.05),twist at aortic valve closure and twist at mitral valve opening were significantly increased ( P ＜0.05),untwisting rate reduced,and untwisting half time delayed.In group B,compared with control group and group A,circumferential strain parameters [( - 12.64 ± 6.49)％ vs.( - 19.11 ± 9.98)％ and (-21.14±10.13)％,P＜0.05] andE′/A′ [(0.90 ±0.35) vs.(1.24 ±0.47) and (1.98 ±0.63),P ＜ 0.05 ] were significantly decreased,twist at aortic valve closure [ ( 19.08 ± 5.62) ° vs.( 16.57 ± 2.84) °and ( 14.36 ±4.06) °,P ＜0.05] and twist at mitral valve opening [ ( 13.99 ± 2.31 ) ° vs.( 11.36 ± 2.63 ) °and (9.04 ± 5.63 ) °,P ＜ 0.05 ] were significantly increased,untwisting rate [ ( 0.40 ± 0.28 ) ％/ms vs.(0.46 ±0.14)％/ms and (0.53 ±0.21 )％/ms,P ＜0.05 ] reduced,and untwisting half time[ (489.61 ±97.14)ms vs.(445.21 ±54.53)ms and(410.60 ±50.23)ms,P ＜0.05] delayed.Conclusion Speckle tracking imaging could be used to evaluate early changes on LV twist deformation and LV systolic function in patients with type 2 diabetes mellitus.

Objective To investigate the changes of open probability (Po) of large conductance Ca2+ -activated K + channel (BK channel ) in diabetic coronary smooth muscle cells and elucidate the underlying cellular electrophysiology mechanisms of coronary dysfunction.Methods Rat coronary smooth muscle cells were isolated from control group and diabetic group.BK single channel currents were recorded by patch clamp technique in inside-out configuration.Open probabilities were calculated and compared between two groups.After exposure to DHS-1,a specific BK channel activator,Po at 0.2 and 1 μmoL/L free Ca2+ were compared between control and diabetic groups.Results In the presence of 0.2 μmol/L free Ca2+,the Po at baseline was significantly lower in diabetic rats than in control rats (0.0032 ± 0.0012 vs.0.095 ±0.036,P ＜ 0.05).Cytoplasmic application of DSH-1 significantly increased the Po to 0.335 ±0.096 (P ＜0.05 vs.baseline) in control rats,whereas DSH-1 had no effect in diabetic rats ( Po =0.022 ±0.018,P＞0.05 vs.baseline).In the presence of 1 μmol/L free Ca2+,the Po at baseline was also significantly lower in diabetic rats than in control rats (0.210 ± 0.055 vs.0.458 ± 0.077,P ＜ 0.05 ).Cytoplasmic application of DHS-1 further robustly enhanced Po to 0.823 ± 0.019 (P ＜ 0.05 vs.baseline) in control rats and to 0.446 ± 0.098 in diabetic rats ( P ＜ 0.05 vs.baseline of diabetic rats; P ＜ 0.05 vs.control rats with DHS-1 ).Conclusion The decrease of Po of BK single channel in coronary smooth muscle cells may be a potential cause for coronary dysfunction in diabetic rats.

OBJECTIVESTo investigate the correlation between scoliosis angle and the asymmetric index of degenerative lumbar scoliosis, the degree of intervertebral disc degeneration, decreased bone density.

METHODSAs a retrospectively study, a total of 96 patients with degenerative lumbar scoliosis were retrospectively enrolled from January 2002 to August 2010 as scoliosis group, meanwhile 96 patients with lumbar spinal stenosis matched in gender, age and body mass index (BMI) were selected as control group. All patients were studied with plain radiographs, MRI and dual energy X-ray absorptiometry at presentation. Radiographic measurements include Cobb angle, the height of the convex and concave side of the apical disc and the contiguous disc superiorly and inferiorly, the height of the convex and concave side of the apical and the contiguous vertebral body superiorly and inferiorly in scoliosis group, the height of L(2-3), L(3-4), L(4-5) discs and the height of L(2-4) vertebral body in control group. The average relative signal intensity of lumbar intervertebral disc and cerebrospinal fluid in T2WI sagittal image was measured in apex intervertebral disc and adjacent discs by Adobe Photoshop 6.0 in scoliosis group, which was measured in L(2-3), L(3-4), L(4-5) disc in control group. The bone density of lumbar, femoral neck, trochanter, and Ward's triangle regions were measured with dual-energy X-ray absorptiometry.

RESULTSThe intervertebral disc height in convex side was greater than the height in the concave side [(40 ± 7) mm vs. (28 ± 7) mm, P < 0.01], the vertebral body height in convex side was greater than the height in the concave side [(76 ± 12) mm vs. (72 ± 10) mm, P = 0.016] in scoliosis group. There was significant statistically difference in the degenerative degree of intervertebral discs between two groups (P = 0.003). There was significant statistically difference of the average T-value and the rate of osteoporosis between two groups (P < 0.01). Multiple linear regression analysis showed that the asymmetric disc index, the degenerative degree of intervertebral disc and osteoporosis were the predominant correlative factors, which affected the development of degenerative lumbar scoliosis.

CONCLUSIONSDegenerative lumbar scoliosis is always accompanied by the height asymmetry of intervertebral discs and vertebral body from convex and concavity sides. There is positive correlation between the angle of scoliosis and the asymmetric disc index, the degeneration of intervertebral disc, and negative correlation between the angle of scoliosis and the bone density (T-value).

Aged ; Bone Density ; Female ; Humans ; Intervertebral Disc ; pathology ; Linear Models ; Lumbar Vertebrae ; pathology ; Male ; Middle Aged ; Retrospective Studies ; Spinal Stenosis ; pathology

OBJECTIVETo investigate the mechanism of enhanced large conductance calcium-activated potassium channel currents (BK) in coronary smooth muscle cells (SMCs) by docosahexaenoic acid (DHA).

METHODSCoronary SMCs were isolated by enzyme digestion. Potassium channels in coronary SMCs were identified by applications of different potassium blockers. Effects of DHA and its metabolite 16, 17-epoxydocosapentaenoic acid (16, 17-EDP) on BK channels in the absence and presence of cytochrome P450 epoxygenase inhibitor SKF525A were studied by patch clamp in whole-cell configuration.

RESULTSBK channels were widely distributed in SMCs, and BK currents in normal SMCs accounted for (64.2 ± 2.7)% of total potassium currents (n = 20). DHA could activate BK channels, and its 50% effective concentration (EC(50)) was (0.23 ± 0.03) µmol/L, however, the effect of DHA on BK channels was abolished after SMCs were incubated with cytochrome P450 epoxygenase inhibitor SKF525A. 16, 17-EDP, a metabolite of DHA, could reproduce the effects of DHA on BK channels, and its EC(50) was (19.7 ± 2.8) nmol/L.

CONCLUSIONDHA and metabolites can activate BK channels and dilate coronary arteries through activating cytochrome P450 epoxygenase pathway.

Animals ; Coronary Vessels ; cytology ; drug effects ; metabolism ; Cytochrome P-450 Enzyme Inhibitors ; Docosahexaenoic Acids ; pharmacology ; Fatty Acids, Unsaturated ; pharmacology ; Large-Conductance Calcium-Activated Potassium Channels ; metabolism ; Muscle, Smooth, Vascular ; drug effects ; metabolism ; Myocytes, Smooth Muscle ; drug effects ; metabolism ; Proadifen ; pharmacology ; Rats ; Rats, Sprague-Dawley

Objective To investigate the clinical features of severe chronic heart failure patients with normal B-type natriuretic peptide (BNP). Methods A total of 57 patients with severe chronic heart failure ( New York Heart Association class Ⅲ and Ⅳ ) were included in this prospective control study from Dec. 2002 to Oct. 2009. Group A included 13 patients with normal BNP ( ＜ 100 ng/L) and group B included 44 patients with increased BNP ( ＞ 100 ng/L). Group A patients were followuped for ( 19. 6 ±14. 7)months and group B patients for (72. 5 ± 17. 1 ) months. Results The baseline clinical characteristics of two groups were comparable. Left ventricular end diastolic diameter (LVEDd) of group A was larger than group B [ (70. 56 ± 4. 33 ) mm vs. ( 63.73 ± 3.75 ) mm, P ＜ 0. 05 ], the left ventricular ejection fraction (LVEF) of group A was lower than group B [ (24. 16 ± 2. 50) % vs. (28.49 ± 2.63 ) %, P ＜ 0. 05 ]. The number of patents tolerating metoprolol in group A is lower than in group B (7/13 vs. 39/44,P ＜0. 05),and the tolerant dose of metoprolol in group A is lower than in group B [ ( 12. 5 ±6. 25)mg/d vs. (24. 20 ±11.22)mg/d,P ＜ 0. 05 ]. The level of BNP in group B were significantly higher at acute stages than at remission stages [(962.73 ± 165.00) ng/L vs. (876.24 ± 167.70) ng/L, P ＜ 0.05], but remained unchanged in group A [ (74. 03 ± 11.18) ng/L vs. ( 71.38 ± 11.68) ng/L, P ＞ 0. 05 ]. The mortality of group A was higher than group B( 11/12 vs. 6/44, P ＜0.05). The binary logistic regression analysis (backward) showed that normal B-type natriuretic peptide was an independent predictor of cardiovascular mortality in patients with severe chronic heart failure ( OR = 45.488, 95% CI = 5. 322 - 388. 791 ).Conclusion Normal BNP in patients with severe chronic heart failure suggests the exhaustion of BNP secretion and associated poor prognosis.