Objective:To investigate the clinical, radiological, and pathological features of anaplastic gangliogliomas (AGGs) and to determine whether these tumors represent a distinct entity.Methods:Consecutive 667 cases of ganglioglioma (GG) diagnosed at the Xuanwu Hospital, Capital Medical University, Beijing, China between January 2015 and July 2023 were screened. Among these cases, 9 pathologically confirmed AGG cases were identified. Their clinical, radiological, treatment, and outcome data were analyzed retrospectively. Most of the tumor samples were subject to next-generation sequencing, while a subset of them were subject to DNA methylation profiling.Results:Among the 9 patients, there were five males and four females, with a median age of 8 years. Epileptic seizures (5/9) were the most frequently presented symptom. Radiological examinations showed three types of radiological manifestations: four cases showed abnormal MRI signals with no significant mass effects and mild enhancement; two cases demonstrated a mixed solid-cystic density lesion with peritumoral edema, which showed significant heterogeneous enhancement and obvious mass effects, and one case displayed cystic cavity formation with nodules on MRI, which showed evident enhancements. All cases exhibited mutations that were predicted to activate the MAP kinase signaling pathway, including seven with BRAF p.V600E mutation and two with NF1 mutation. Five AGGs with mutations involving the MAP kinase signaling pathway also had concurrent mutations, including three with CDKN2A homozygous deletion, one with a TERT promoter mutation, one with a H3F3A mutation, and one with a PTEN mutation.Conclusions:AGG exhibits a distinct spectrum of pathology, genetic mutations and clinical behaviors, differing from GG. Given these characteristics suggest that AGG may be a distinct tumor type, further expansion of the case series is needed. Therefore, a comprehensive integration of clinical, histological, and molecular analyses is required to correctly diagnose AGG. It will also help guide treatments and prognostication.

Exosomes are a subpopulation of extracellular vesicles ranging in size from 30 to 150 nm. They contain a variety of biological molecules including proteins, lipids, and genetic materials by which they can act as mediators of cell-to-cell communication. Increasing studies on exosomes have elucidate the mechanism of communication between immune cells. Mast cells are found to release exosomes in both resting and activated states, but the quantity, contents and functions of the exosomes are significantly different in different states. Mast cell-derived exosomes are involved in the maturation and antigen presentation of dendritic cells, and mediate the activation of T lymphocytes and the polarization of macrophages. These results provide new insights into the role of exosomes in mast cell function and immune regulation.

With the accelerating of aging population in China, the long-term care demand of the elderly is increasing. In recent years, extended reality technology has shown great development potential in assisting elderly chronic nursing, rehabilitation nursing, psychological nursing, palliative care, nursing personnel training. This paper reviews the application status of extended reality technology in geriatric care at home and abroad, and puts forward the problems and countermeasures of extended reality technology applied in geriatric care, so as to provide reference for promoting the application of extended reality technology in geriatric care.

OBJECTIVES: At present, the research on clear aligner of molar distalization mainly focuses on the upper jaw, while the research on mandibular molars is few.This study aims to evaluate the therapeutic effect of mandibular molars distalization with clear aligner via cone beam CT (CBCT) and Dolphin software. METHODS: Twenty cases of mandibular molars with clear aligner were included according to the inclusion and exclusion criteria. CBCT was taken before treatment (T0) and when the first molar was moved in place (T1). Dolphin software was used to measure the effectiveness of molar distalization. Three-dimensional changes in direction and the impact on the incisors and facial soft and hard tissues were evaluated. RESULTS: The effective rates of crown and root distalization of the second and first mandibular molars were 74%, 49%, and 71%, 47%, respectively. The second and first molars were both the distal buccal cusp with the largest distalization [(2.15 ± 0.91) mm and (1.85±1.09) mm], respectively, with significant difference between the T0 and T1 ( CONCLUSIONS Clear aligner can effectively move mandibular molars farther, the crown is more effective than the root, and it is tilted. The second mandibular molar is more effective than the first mandibular molar in its distant displacement and three-dimensional changes. Molar distalization causes minor changes in mandibular incisors and facial soft and hard tissues.
Cephalometry ; Maxilla ; Molar ; Orthodontic Appliances, Removable ; Tooth Movement Techniques

Objective:To analyze the clinicopathological characteristics, diagnosis and prognosis of meningioangiomatosis (MA), and to investige the possible origion of spindle cells.Methods:Seventeen cases of MA were collected at Xuanwu Hospital of Capital Medical University and the First Affiliated Hospital of Fujian Medical University, from June 2012 to March 2020. The clinical manifestations, radiologic, histopathologic, immunohistochemical features and patients′ outcome were analyzed. The presumed origin of spindle cells was evaluated by immunohistochemical staining.Results:Of the 17 patients, 9 were males and 8 were females. The age ranged from 3 to 56 years old. Thirteen patients presented with seizure as the initial symptom. The lesions were solitary and located in the cerebral cortex. Histopathologically, there were proliferation of small blood vessels and perivascular spindle cells in the cerebral cortex. The spindle cells had no obvious atypia, mitoses and necrosis. Four cases were combined with transitional meningioma. Immunohistochemically, the proliferative perivascular spindle cells were positive for vimentin in all cases, and focally positive for EMA and SSTR2. Ki-67 proliferation index was low. Neurofibrillary tangles were demonstrated by AT8. All 17 patients received surgical treatment and were followed up for one to 93 months. None had seizure attacks or tumor recurrence.Conclusions:MA is a rare slow-growing intracranial lesion, and the perivascular spindle cells could be derived from meningothelial cells, and MA is often associated with degeneration of the cerebral cortex and meningioma. The patients have good prognosis after surgical treatment.

Prostate cancer (PCa) patients who progress to metastatic castration-resistant PCa (mCRPC) mostly have poor outcomes due to the lack of effective therapies. Our recent study established the orphan nuclear receptor ROR

Objective:To analyze the clinicopathological features and probable mechanisms of high-grade gliomas with H3 G34R mutation.Methods:Five cases of high-grade gliomas with H3 G34R mutation were collected at Xuanwu Hospital, Capital Medical University, Beijing, China, from 2016 to 2019. The clinical and pathological data for each case was retrospectively reviewed.Results:The 5 patients (2 males and 3 females) aged from 15 to 45 years (mean 23 years), and had a history of headache or motor weakness. Four of them were younger than 20 years of age. Magnetic resonance imaging showed that the lesions of 3 cases were seen separately in frontal lobe, parietal lobe or temporal lobe, 1 case involved both frontal lobe and parietal lobe, and otherwise multiple lobes were involved in 1 case. Contrast enhancement could be observed in 2 cases. Pathological examination showed that glioblastoma was the most common entity, with or without primitive neuronal component. All 5 cases showed that H3 G34R was diffusely positive in tumor nuclei with ATRX loss. Moreover, p53 was overexpressed in 4 cases. None of them showed Olig2 expression. Two patients showed disease progression after surgery at 18 months and 24 months, respectively. The latter of the two deceased 3 months after tumor progression.Conclusions:The clinicopathological and molecular genetics features of high-grade gliomas with H3 G34R mutation have relatively similar clinicopathological and genetic features, and more commonly seen in young adults (vs. older adults). Thus, these tumors may be discussed further as a distinct tumor entity.

Objective　To explore the association of Cyclophilin A，cerebral related blood indexes and carotid plaque’s formation and stability as well as cerebral infarction. Methods　From December 2017 to December 2018，56 patients with acute cerebral infarction were admitted to cerebral infarction group；72 patients with carotid atherosclerotic plaques but no acute cerebral infraction were regarded as plaque group；40 healthy human who neither suffered from cerebral infarction nor carotid atherosclerotic plaques were divided into non-plague group；The degree of plaque stability in each group was expressed by plaque score. The higher the plaque score，the more unstable the plaque was；The content of CypA were determined by enzyme-linked immunosorbent assay，and the common blood indexes data were collected from the text results of medical records；Carotid artery plaque was detected by carotid artery ultrasound，and the plaque score was determined according to the morphology of carotid artery plaque in ultrasound. Results　There were statistically significant differences in CyPA levels between the non-plague group and the non-cerebral infraction group.（P<0.05）. CyPA level was regarded as a risk factor for the development of carotid atherosclerosis plagues（OR=1.002，95%CI 0.824～1.219）. There was no statistical significance between CyPA levels and carotid artery plaque score（the stability of carotid atherosclerotic plaque）in cerebral infarction and non-cerebral infraction group. （P>0.05）. There was an significant difference in carotid atherosclerotic plaque score between the cerebral infarction group and plaque group. （P<0.05）. In cerebral infraction group，the content of fibrinogen and glycosylated hemoglobin were positively correlated with carotid atherosclerotic plaque score and the hemoglobin was negatively correlated with the carotid atherosclerotic plaque score，and these differences were statistically significant. （P<0.05）. Ordinal logistic regression showed that fibrinogen level was regarded as a risk factor for the development of carotid atherosclerosis plagues（OR=8.988，95%CI 3.017～3.422），hemoglobin level was regarded as a protective factor for the development of carotid atherosclerosis plagues（OR=0.936，95%CI 134.031～144.583）. In plaque group，the content of high-density lipoprotein have positive correlation with the carotid atherosclerotic score，and the difference is statistically significant. （P<0.05）. Ordinal logistic regression showed that high-density lipoprotein level was regarded as a protective factor for the development of carotid atherosclerosis plagues（OR=0.052，95%CI 1.237～1.364）. Conclusion　The serum content of CyPA was a risk factor for the formation of carotid atherosclerosis plaque，but it was not related to the stability of the plaques. The degree of plaque instability in patients with acute cerebral infarction was significantly increased compared with the patients without cerebral infarction. For patients with acute cerebral infarction，the contents of fibrinogen and glycosylated hemoglobin were negatively correlated with the stability of carotid atherosclerotic plaques，hemoglobin content was positively correlated with the stability of carotid atherosclerotic plaques. Fibrinogen level was regarded as a risk factor for the development of carotid atherosclerosis plagues. Hemoglobin level was regarded as a protective factor for the development of carotid atherosclerosis plagues. For patients without acute cerebral infraction，the content of high-density lipoprotein was positively correlated with the stability of carotid atherosclerotic plaques and was regarded as a protective factor for the development of carotid atherosclerosis plagues.

Objective: To investigate the expression of LC3B, p-AMPKα and p27 in cortical tuberous sclerosis complex (TSC). Methods: Nineteen specimens of surgically resected TSC cortical tubers were collected at Xuanwu Hospital, Capital Medical University, from 2014 to 2017. The expression of the three proteins in the lesions and the adjacent relatively normal regions was detected by immunohistochemical staining (EnVision two-step method). Results: LC3B was mainly expressed in the dysmorphic neuron and giant cell in TSC cortical tubers and in the adjacent relatively normal neurons, and the expression was diffuse or perinuclear cytoplasmic. There was no significant difference in the average optical density between abnormal cells and neurons adjacent to the lesions (0.343±0.195 vs. 0.419±0.088, P>0.05). p-AMPKα was localized in the cytoplasm of dysmorphic neurons and giant cell in TSC cortical tubers. The average optical density of abnormal cells in the lesions was significantly higher than that of neurons adjacent to the lesions (0.306±0.123 vs. 0.233±0.654, P<0.05). P27 showed nuclear positivity, mainly expressed in the neurons and glial cells close to TSC cortical tubers, while the positive rate in the abnormal cells in TSC cortical tubers was low (15/19 vs. 7/19, P<0.05). Conclusion There is no significant decrease in the level of autophagy in dysmorphic neurons and giant cells in TSC cortical tubers, which may be related to the compensatory mechanism of AMPK signaling pathway, but without activation of downstream p27.

Objective: To investigate the prognostic impact of alterations of epidermal growth factor receptor(EGFR) and MGMT in glioblastoma. Methods: The retrospective study included 161 supratentorial glioblastomas diagnosed in the Department of Pathology, Xuanwu Hospital, Capital Medical University from 2009 to 2015. EGFR and EGFRvⅢ protein expression was detected by immunohistochemistry; EGFR amplification was detected by fluorescence in situ hybridization; MGMT promoter methylation was detected by pyrosequencing. The change of molecular genetics EGFR and MGMT and outcome were assessed statistically. Results: There were 161 patients, including 85 (52.8%) males and 76 (47.2%) females. The mean age was 53 years, and the median overall survival was 13 months. The integrated classification of glioblastoma included 16 IDH-mutant, 134 wild type, and 11 NOS. The rate of overexpression of EGFR protein was 32.9%(53/161), and that of EGFR amplification was 37.5%(18/48). There was high concordance between immunohistochemistry and FISH(85.4%, Kappa=0.475, P<0.01) and between the level of EGFR protein and EGFR amplification (P<0.01). Twelve cases showed EGFRvⅢ expression, and all also showed EGFR protein overexpression; 149 cases were EGFRv Ⅲ wild type, and EGFR protein overexpression was seen in 27.5%(41/149) of cases. There was no correlation between EGFR and EGFRv Ⅲ expression. Of all cases, 70.2%(106/151) showed MGMT promoter methylation by pyrosequencing. The changes of molecular genetics of EGFR and MGMT were not related. EGFR amplification and protein overexpression had no significant relationship with prognosis. Patients with EGFRv Ⅲ-mutant had shorter survival time than the EGFRv Ⅲ-wild type(P=0.014); patients with MGMT promoter methylation had better prognosis than without (PFS:P=0.002,OS:P=0.006),and MGMT promoter methylation was an independent predictor for overall survival (HR=0.269, 95%CI 0.124-0.583, P=0.001). Conclusions EGFR protein expression by immunohistochemistry correlates with the status of EGFR amplification. Patients with EGFRv Ⅲ-mutant tumors have poorer prognosis than that with EGFRv Ⅲ-wild type tumors. MGMT promoter methylation is closely associated with prognosis and an independent predictor for overall survival.