BACKGROUND Perivascular epithelioid cell tumor(PEComa)is a rare mesenchymal neoplasm that predominantly affects the kidney and uterus.The occurrence of this tumor in the liver,particularly with simultaneous involvemen...BACKGROUND Perivascular epithelioid cell tumor(PEComa)is a rare mesenchymal neoplasm that predominantly affects the kidney and uterus.The occurrence of this tumor in the liver,particularly with simultaneous involvement of the liver and kidney,is exceedingly uncommon.Pathological diagnosis is the gold standard.PEComas usually show positive immunohistochemical staining for melanocytic(HMB-45,Melan-A)and myoid(SMA,muscle-specific actin)markers.CASE SUMMARY We presented a noteworthy case of malignant PEComa affecting both the liver and kidney in a 53-year-old man with tuberous sclerosis complex(TSC).FAT2 and TP73 mutations in the kidney were identified and positive expression of diagnostic markers including HMB-45,Melan A,and TFE3 were detected.In addition,we demonstrated that hepatic artery perfusion chemotherapy was ineffective for hepatic PEComa,while surgery remained the most effective approach.Everolimus showed an excellent efficacy in the postoperative treatment of the tumor.CONCLUSION Surgical treatment is preferred for malignant PEComa affecting liver and kidney,especially with TSC;everolimus is effective postoperatively.展开更多
There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery(MIS)for hypertensive intracerebral haemorrhage(ICH),and little is known about the r...There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery(MIS)for hypertensive intracerebral haemorrhage(ICH),and little is known about the relationship between satellite sign on computed tomography(CT)scans and postoperative rebleeding after MIS.This study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic MIS.We retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following admission.Postoperative rebleeding occurred in 14 of 65(21.5%)patients with the satellite sign on baseline CT,and in 5 of the 40(12.5%)patients without the satellite sign.This diiTerence was statistically significant.Positive and negative values of the satellite sign for predicting postoperative rebleeding were 21.5%and 87.5%,respectively.Multivariate logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative rebleeding.In conclusion,the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.展开更多
AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A tota...AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A total of 20 patients who underwent 3T magnetic resonance imaging(MRI) without bowel preparation and colonoscopy within 24 h were recruited.Biochemical indexes,including C-reactive protein(CRP),erythrocyte sedimentation rate,hemoglobin,leucocytes,platelets,serum iron and albumin,were determined.Biochemical examinations were then performed within 24 h before or after MR colonography was conducted.DWI was performed at various b values(b = 0,400,600,800,and 1000 s/mm2).Two radiologists independently and blindly reviewed conventional- and contrast-enhanced MR images,DWI and ADC maps; these radiologists also determined ADC in each intestinal segment(rectum,sigmoid,left colon,transverse colon,and right colon).Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance of DWI hyperintensity from various b factors,ADC values and different radiological signs to detect endoscopic inflammation in the corresponding bowel segment.Optimal ADC threshold was estimated by maximizing the combination of sensitivity and specificity.MRfindings were correlated with endoscopic results and clinical markers; these findings were then estimated by ROC analysis.RESULTS: A total of 100 segments(71 with endoscopic colonic inflammation; 29 normal) were included.The proposed total magnetic resonance score(MR-score-T) was correlated with the total modified Baron score(Baron-T; r = 0.875,P < 0.0001); the segmental MR score(MR-score-S) was correlated with the segmental modified Baron score(Baron-S; r = 0.761,P < 0.0001).MR-score-T was correlated with clinical and biological markers of disease activity(r = 0.445 to 0.831,P < 0.05).MR-score-S > 1 corresponded to endoscopic colonic inflammation with a sensitivity of 85.9%,a specificity of 82.8% and an area under the curve(AUC) of 0.929(P < 0.0001).The accuracy of DWI hyperintensity was significantly greater at b = 800 than at b = 400,600,or 1000 s/mm2(P < 0.05) when endoscopic colonic inflammation was detected.DWI hyperintensity at b = 800 s/mm2 indicated endoscopic colonic inflammation with a sensitivity of 93.0%,a specificity of 79.3% and an AUC of 0.867(P < 0.0001).Quantitative analysis results revealed that ADC values at b = 800 s/mm2 differed significantly between endoscopic inflamed segment and normal intestinal segment(1.56 ± 0.58 mm2/s vs 2.63 ± 0.46 mm2/s,P < 0.001).The AUC of ADC values was 0.932(95% confidence interval: 0.881-0.983) when endoscopic inflammation was detected.The threshold ADC value of 2.18 × 10-3 mm2/s indicated that endoscopic inflammation differed from normal intestinal segment with a sensitivity of 89.7% and a specificity of 80.3%.CONCLUSION: DWI combined with conventional MRI without bowel preparation provides a quantitative strategy to differentiate actively inflamed intestinal segments from the normal mucosa to detect UC.展开更多
AIM to investigate the molecular mechanisms of gastric carcinogenesis.METHODS We used label-free quantification technology integrated with liquid chromatography-tandem mass spectrometry(Lc-m S/m S) analysis to identif...AIM to investigate the molecular mechanisms of gastric carcinogenesis.METHODS We used label-free quantification technology integrated with liquid chromatography-tandem mass spectrometry(Lc-m S/m S) analysis to identify differentially expressed proteins in 160 specimens of normal gastric mucosa,gastric mucosa with mild dysplasia,moderate dysplasia,severe dysplasia,and early mucosal gastric cancer(Gc) collected at the Second Hospital of Lanzhou University from 2010 to 2015. Immunohistochemistry was used to verify the differentially expressed proteins detected by Lc-m S/m S.RESULTS With a threshold of a 1.2-fold change and a P-value< 0.05 between mild dysplasia,moderate dysplasia,severe dysplasia or early mucosal Gc and matched normal gastric mucosa tissues,proteomic analysis identified 365 significantly differentially expressed proteins. Er GIc1 expression decreased,while DNAPKcs expression increased gradually along with different stages of Gc initiation based on the tendency of fold change. the expression patterns of Er GIc1 and DNA-PKcs revealed by immunohistochemistry were consistent with the Lc-m S/m S results.CONCLUSION the results suggest that aberrant Er GIc1 and DNAPKcs expression may be involved in Gc initiation.展开更多
BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a...BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma.We also present a brief literature review on lower esophageal schwannomas.CASE SUMMARY A 62-year-old man presented with severe dysphagia lasting 6 mo.A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm.Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors.Endoscopic ultrasound findings demonstrated a 4.5 cm×5.0 cm hypoechoic lesion.Chest computed tomography revealed a mass of size approximately 53 mm×39 mm×50 mm.Initial tests revealed features indicative of leiomyoma.After multidisciplinary discussions,the patient underwent a video-assisted thoracoscopic partial esophagectomy.Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma.There was no tumor recurrence or metastasis during follow-up.CONCLUSION The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination.The early appropriate surgery favors a remarkable prognosis.展开更多
Objective To evaluate the impact of hypertension on the clinical outcome of COVID-19 patients aged 60 years old and older.Methods This single-center retrospective cohort study enrolled consecutive COVID-19 patients ag...Objective To evaluate the impact of hypertension on the clinical outcome of COVID-19 patients aged 60 years old and older.Methods This single-center retrospective cohort study enrolled consecutive COVID-19 patients aged 60 years old and older,who were admitted to Liyuan Hospital from January 1,2020 to April 25,2020.All included patients were divided into two groups:hypertension and nonhypertension group.The baseline demographic characteristics,laboratory test results,chest computed tomography(CT)images and clinical outcomes were collected and analyzed.The prognostic value of hypertension was determined using binary logistic regression.Results Among the 232 patients included in the analysis,105(45.3%)patients had comorbid hypertension.Compared to the nonhypertension group,patients in the hypertension group had higher neutrophil-to-lymphocyte ratios,red cell distribution widths,lactate dehydrogenase,high-sensitivity C-reactive protein,D-dimer and severity of lung lesion,and lower lymphocyte counts(all P<0.05).Furthermore,the hypertension group had a higher proportion of intensive care unit admissions[24(22.9%)vs.14(11.0%),P=0.02]and deaths[16(15.2%)vs.3(2.4%),P<0.001]and a significantly lower probability of survival(P<0.001)than the nonhypertension group.Hypertension(OR:4.540,95%CI:1.203–17.129,P=0.026)was independently correlated with all-cause in-hospital death in elderly patients with COVID-19.Conclusion The elderly COVID-19 patients with hypertension tend to have worse conditions at baseline than those without hypertension.Hypertension may be an independent prognostic factor of poor clinical outcome in elderly COVID-19 patients.展开更多
In polyglutamine(PolyQ)diseases,mutant proteins cause not only neurological problems but also peripheral tissue abnormalities.Among all systemic damages,skeletal muscle dystrophy is the severest.Previously by studying...In polyglutamine(PolyQ)diseases,mutant proteins cause not only neurological problems but also peripheral tissue abnormalities.Among all systemic damages,skeletal muscle dystrophy is the severest.Previously by studying knock-in(KI)mouse models of spinal cerebellar ataxia 17(SCA17),it was found that mutant TATA box binding protein(TBP)decreases its interaction with myogenic differentiation antigen,thus reducing the expression of skeletal muscle structural proteins and resulting in muscle degeneration.In this paper,the role of mutant TBP in myogenesis was investigated.Single myofibers were isolated from tibialis anterior muscles of wild type(WT)and SCA17KI mice.The 1TBP18 staining confirmed the expression of mutant TBP in muscle satellite cells in SCA17Ki mice.In the BaCl2-induced TA muscle injury,H&E cross-section staining showed no significant change in myofibril size before and after BaCl2 treatment,and there was no significant difference in centralized nuclei between WT and SCA17KI mice,suggesting that mutant TBP had no significant effect on muscle regeneration.In the cultured primary myoblasts from WT and SCA17KI mice in vitro,representative BrdU immunostaining showed no significant difference in proliferation of muscle satellite cells.The primary myoblasts were then induced to differentiate and immunostained for eMyHC,and the staining showed there was no significant difference in differentiation of primary myoblasts between WT and SCA1KI mice.Our findings confirmed that mutant TBP had no significant effect on myogenesis.展开更多
Solid pseudopapillary tumor (SPT) of the pancreas is a rare pancreatic disease. Generally, it is considered a benign or low-grade malignant tumor. SPT of the pancreas with liver metastasis or invasion to adjacent orga...Solid pseudopapillary tumor (SPT) of the pancreas is a rare pancreatic disease. Generally, it is considered a benign or low-grade malignant tumor. SPT of the pancreas with liver metastasis or invasion to adjacent organs is usually uncommon.展开更多
基金Supported by Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital,No.CY2022-QN-A13 and No.CY2023-QN-A02Lanzhou Science and Technology Plan Project,No.2023-4-26+1 种基金Gansu Provincial Natural Science Foundation Project,No.23JRRA1630 and No.24JRRA331Gansu Provincial Health Research Program Project,No.GSWSKY-2019-32.
文摘BACKGROUND Perivascular epithelioid cell tumor(PEComa)is a rare mesenchymal neoplasm that predominantly affects the kidney and uterus.The occurrence of this tumor in the liver,particularly with simultaneous involvement of the liver and kidney,is exceedingly uncommon.Pathological diagnosis is the gold standard.PEComas usually show positive immunohistochemical staining for melanocytic(HMB-45,Melan-A)and myoid(SMA,muscle-specific actin)markers.CASE SUMMARY We presented a noteworthy case of malignant PEComa affecting both the liver and kidney in a 53-year-old man with tuberous sclerosis complex(TSC).FAT2 and TP73 mutations in the kidney were identified and positive expression of diagnostic markers including HMB-45,Melan A,and TFE3 were detected.In addition,we demonstrated that hepatic artery perfusion chemotherapy was ineffective for hepatic PEComa,while surgery remained the most effective approach.Everolimus showed an excellent efficacy in the postoperative treatment of the tumor.CONCLUSION Surgical treatment is preferred for malignant PEComa affecting liver and kidney,especially with TSC;everolimus is effective postoperatively.
文摘There are few studies regarding imaging markers for predicting postoperative rebleeding after stereotactic minimally invasive surgery(MIS)for hypertensive intracerebral haemorrhage(ICH),and little is known about the relationship between satellite sign on computed tomography(CT)scans and postoperative rebleeding after MIS.This study aimed to determine the value of the CT satellite sign in predicting postoperative rebleeding in patients with hypertensive ICH who undergo stereotactic MIS.We retrospectively examined and analysed 105 patients with hypertensive ICH who underwent standard stereotactic MIS for hematoma evacuation within 72 h following admission.Postoperative rebleeding occurred in 14 of 65(21.5%)patients with the satellite sign on baseline CT,and in 5 of the 40(12.5%)patients without the satellite sign.This diiTerence was statistically significant.Positive and negative values of the satellite sign for predicting postoperative rebleeding were 21.5%and 87.5%,respectively.Multivariate logistic regression analysis verified that baseline ICH volume and intraventricular rupture were independent predictors of postoperative rebleeding.In conclusion,the satellite sign on baseline CT scans may not predict postoperative rebleeding following stereotactic MIS for hypertensive ICH.
文摘AIM: To evaluate the accuracy of diffusion-weighted imaging(DWI) without bowel preparation,the optimal b value and the changes in apparent diffusion coefficient(ADC) in detecting ulcerative colitis(UC).METHODS: A total of 20 patients who underwent 3T magnetic resonance imaging(MRI) without bowel preparation and colonoscopy within 24 h were recruited.Biochemical indexes,including C-reactive protein(CRP),erythrocyte sedimentation rate,hemoglobin,leucocytes,platelets,serum iron and albumin,were determined.Biochemical examinations were then performed within 24 h before or after MR colonography was conducted.DWI was performed at various b values(b = 0,400,600,800,and 1000 s/mm2).Two radiologists independently and blindly reviewed conventional- and contrast-enhanced MR images,DWI and ADC maps; these radiologists also determined ADC in each intestinal segment(rectum,sigmoid,left colon,transverse colon,and right colon).Receiver operating characteristic(ROC) analysis was performed to assess the diagnostic performance of DWI hyperintensity from various b factors,ADC values and different radiological signs to detect endoscopic inflammation in the corresponding bowel segment.Optimal ADC threshold was estimated by maximizing the combination of sensitivity and specificity.MRfindings were correlated with endoscopic results and clinical markers; these findings were then estimated by ROC analysis.RESULTS: A total of 100 segments(71 with endoscopic colonic inflammation; 29 normal) were included.The proposed total magnetic resonance score(MR-score-T) was correlated with the total modified Baron score(Baron-T; r = 0.875,P < 0.0001); the segmental MR score(MR-score-S) was correlated with the segmental modified Baron score(Baron-S; r = 0.761,P < 0.0001).MR-score-T was correlated with clinical and biological markers of disease activity(r = 0.445 to 0.831,P < 0.05).MR-score-S > 1 corresponded to endoscopic colonic inflammation with a sensitivity of 85.9%,a specificity of 82.8% and an area under the curve(AUC) of 0.929(P < 0.0001).The accuracy of DWI hyperintensity was significantly greater at b = 800 than at b = 400,600,or 1000 s/mm2(P < 0.05) when endoscopic colonic inflammation was detected.DWI hyperintensity at b = 800 s/mm2 indicated endoscopic colonic inflammation with a sensitivity of 93.0%,a specificity of 79.3% and an AUC of 0.867(P < 0.0001).Quantitative analysis results revealed that ADC values at b = 800 s/mm2 differed significantly between endoscopic inflamed segment and normal intestinal segment(1.56 ± 0.58 mm2/s vs 2.63 ± 0.46 mm2/s,P < 0.001).The AUC of ADC values was 0.932(95% confidence interval: 0.881-0.983) when endoscopic inflammation was detected.The threshold ADC value of 2.18 × 10-3 mm2/s indicated that endoscopic inflammation differed from normal intestinal segment with a sensitivity of 89.7% and a specificity of 80.3%.CONCLUSION: DWI combined with conventional MRI without bowel preparation provides a quantitative strategy to differentiate actively inflamed intestinal segments from the normal mucosa to detect UC.
基金Supported by National Natural Science Foundation of China,No.31270532 and No.81670594
文摘AIM to investigate the molecular mechanisms of gastric carcinogenesis.METHODS We used label-free quantification technology integrated with liquid chromatography-tandem mass spectrometry(Lc-m S/m S) analysis to identify differentially expressed proteins in 160 specimens of normal gastric mucosa,gastric mucosa with mild dysplasia,moderate dysplasia,severe dysplasia,and early mucosal gastric cancer(Gc) collected at the Second Hospital of Lanzhou University from 2010 to 2015. Immunohistochemistry was used to verify the differentially expressed proteins detected by Lc-m S/m S.RESULTS With a threshold of a 1.2-fold change and a P-value< 0.05 between mild dysplasia,moderate dysplasia,severe dysplasia or early mucosal Gc and matched normal gastric mucosa tissues,proteomic analysis identified 365 significantly differentially expressed proteins. Er GIc1 expression decreased,while DNAPKcs expression increased gradually along with different stages of Gc initiation based on the tendency of fold change. the expression patterns of Er GIc1 and DNA-PKcs revealed by immunohistochemistry were consistent with the Lc-m S/m S results.CONCLUSION the results suggest that aberrant Er GIc1 and DNAPKcs expression may be involved in Gc initiation.
基金Supported by National Natural Science Foundation of China,No.81770525.
文摘BACKGROUND Esophageal schwannomas originating from Schwann cells are extremely rare esophageal tumors.They commonly occur in the upper and middle esophagus but less frequently in the lower esophagus.Herein,we report a rare case of a large lower esophageal schwannoma misdiagnosed as a leiomyoma.We also present a brief literature review on lower esophageal schwannomas.CASE SUMMARY A 62-year-old man presented with severe dysphagia lasting 6 mo.A barium esophagogram showed that the lower esophagus was compressed within approximately 5.5 cm.Endoscopy revealed the presence of a large submucosal protuberant lesion in the esophagus at a distance of 32-38 cm from the incisors.Endoscopic ultrasound findings demonstrated a 4.5 cm×5.0 cm hypoechoic lesion.Chest computed tomography revealed a mass of size approximately 53 mm×39 mm×50 mm.Initial tests revealed features indicative of leiomyoma.After multidisciplinary discussions,the patient underwent a video-assisted thoracoscopic partial esophagectomy.Further investigation involving immunohistochemical examination confirming palisading spindle cells as positive for S100 and Sox10 led to the final diagnosis of a lower esophageal schwannoma.There was no tumor recurrence or metastasis during follow-up.CONCLUSION The final diagnosis of esophageal schwannoma requires histopathological and immunohistochemical examination.The early appropriate surgery favors a remarkable prognosis.
文摘Objective To evaluate the impact of hypertension on the clinical outcome of COVID-19 patients aged 60 years old and older.Methods This single-center retrospective cohort study enrolled consecutive COVID-19 patients aged 60 years old and older,who were admitted to Liyuan Hospital from January 1,2020 to April 25,2020.All included patients were divided into two groups:hypertension and nonhypertension group.The baseline demographic characteristics,laboratory test results,chest computed tomography(CT)images and clinical outcomes were collected and analyzed.The prognostic value of hypertension was determined using binary logistic regression.Results Among the 232 patients included in the analysis,105(45.3%)patients had comorbid hypertension.Compared to the nonhypertension group,patients in the hypertension group had higher neutrophil-to-lymphocyte ratios,red cell distribution widths,lactate dehydrogenase,high-sensitivity C-reactive protein,D-dimer and severity of lung lesion,and lower lymphocyte counts(all P<0.05).Furthermore,the hypertension group had a higher proportion of intensive care unit admissions[24(22.9%)vs.14(11.0%),P=0.02]and deaths[16(15.2%)vs.3(2.4%),P<0.001]and a significantly lower probability of survival(P<0.001)than the nonhypertension group.Hypertension(OR:4.540,95%CI:1.203–17.129,P=0.026)was independently correlated with all-cause in-hospital death in elderly patients with COVID-19.Conclusion The elderly COVID-19 patients with hypertension tend to have worse conditions at baseline than those without hypertension.Hypertension may be an independent prognostic factor of poor clinical outcome in elderly COVID-19 patients.
基金This project was supported by grants from the fundamental Research Funds for the Central Universities(No.2019kfyXKJC075)National Key R&D Program of China(No.2017YFC1310000)National Natural Science Foundation of China(No.81671064,and No.81371222).
文摘In polyglutamine(PolyQ)diseases,mutant proteins cause not only neurological problems but also peripheral tissue abnormalities.Among all systemic damages,skeletal muscle dystrophy is the severest.Previously by studying knock-in(KI)mouse models of spinal cerebellar ataxia 17(SCA17),it was found that mutant TATA box binding protein(TBP)decreases its interaction with myogenic differentiation antigen,thus reducing the expression of skeletal muscle structural proteins and resulting in muscle degeneration.In this paper,the role of mutant TBP in myogenesis was investigated.Single myofibers were isolated from tibialis anterior muscles of wild type(WT)and SCA17KI mice.The 1TBP18 staining confirmed the expression of mutant TBP in muscle satellite cells in SCA17Ki mice.In the BaCl2-induced TA muscle injury,H&E cross-section staining showed no significant change in myofibril size before and after BaCl2 treatment,and there was no significant difference in centralized nuclei between WT and SCA17KI mice,suggesting that mutant TBP had no significant effect on muscle regeneration.In the cultured primary myoblasts from WT and SCA17KI mice in vitro,representative BrdU immunostaining showed no significant difference in proliferation of muscle satellite cells.The primary myoblasts were then induced to differentiate and immunostained for eMyHC,and the staining showed there was no significant difference in differentiation of primary myoblasts between WT and SCA1KI mice.Our findings confirmed that mutant TBP had no significant effect on myogenesis.
基金supported by a grant from International Cooperation Project of Ministry of Science and Technology of China(2015DFA31650)
文摘Solid pseudopapillary tumor (SPT) of the pancreas is a rare pancreatic disease. Generally, it is considered a benign or low-grade malignant tumor. SPT of the pancreas with liver metastasis or invasion to adjacent organs is usually uncommon.
