Metabolic dysfunction-associated steatohepatitis(MASH)is the progressive form of metabolic dysfunction-associated steatotic liver disease(MASLD),and closely associated with a high risk of liver-related morbidity and m...Metabolic dysfunction-associated steatohepatitis(MASH)is the progressive form of metabolic dysfunction-associated steatotic liver disease(MASLD),and closely associated with a high risk of liver-related morbidity and mortality.Although enhanced neutrophil infiltration of the liver is a histological hallmark of MASH,the morphological pattern of hepatic neutrophils and their relevance to the definition of MASH remain unknown.This clinicopathological study aimed to determine the association of neutrophilic crown-like structures(CLSs)in liver biopsies and evaluate their relevance to the histological diagnosis of MASH.A total of 483 morbidly obese adults who underwent bariatric surgery were recruited.Neutrophilic CLSs in liver biopsies were detected by immunohistochemistry for neutrophil elastase and proteinase 3.All participants were classified into 4 histological subgroups:no MASLD(118,24.4%),MASLD(76,15.7%),borderline MASH(185,38.3%),and definite MASH(104,21.5%).In the discovery cohort(n=379),the frequency of neutrophilic CLSs increased in line with the severity of liver disease.The number of neutrophilic CLSs was positively correlated with established histological characteristics of MASH.At a cutoff value of<0.3 per 20×microscopic field,the number of neutrophilic CLSs yielded a robust diagnostic accuracy to discriminate no MASLD and MASLD from borderline MASH and definite MASH;a cutoff at>1.3 per 20×microscopic field exhibited a statistically significant accuracy to distinguish definite MASH from other groups(no MASLD,MASLD,and borderline MASH).The significance of neutrophilic CLSs in identifying borderline MASH and definite MASH was confirmed in an external validation cohort(n=104).The frequency of neutrophilic CLSs was significantly higher than that of macrophagic CLSs.In conclusion,neutrophilic CLSs in the liver represent a typical histological characteristic of MASH and may serve as a promising indicator to improve the diagnostic accuracy of MASH during histological assessment of liver biopsies.展开更多
Objective To investigate the prevalence rate of heart valve calcification and its relativity with pathological changes and clinical pathogenic factors in elder patients at autopsy.Methods Pathology data at autopsy of ...Objective To investigate the prevalence rate of heart valve calcification and its relativity with pathological changes and clinical pathogenic factors in elder patients at autopsy.Methods Pathology data at autopsy of 1047patients with age from 60 to 106 years in Beijing Hospital from November 1954 to March 2016 were collected.Cases of heart valve calcification verified at autopsy展开更多
Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and e...Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and etiology of erythroderma.Methods:We collected the data on 136 patients diagnosed with erythroderma with respect to the epidemiological,clinical,biological,and histological data,treatments,and outcomes in The First Affiliated Hospital of Ningbo University from 2011 to 2021.The analyses of qualitative data were performed with the chi-square test or Fisher’s exact test.The groups of quantitative data were compared using a t-test or analysis of variance.Results:The patients’mean age in this study was 65.00±16.51 years,with a male:female ratio of 5.8:1.0.Acute onset occurred in 27 patients(19.9%)and was associated with drug reactions(P=0.002).The mean length of stay was 19.18±9.75 days.Clinical characteristics were dominated by pruritus(135,99.3%),fever(44,32.4%),edema(82,60.3%),nail changes(14,10.3%),arrhythmia(16,11.8%),and superficial lymphadenopathy(57,41.9%).Combined with biopsy,history inquiry and laboratory testing,this study found that most common causative factor was pre-existing dermatoses(107,78.7%),followed by drug reactions(15,11.0%),malignancies(8,5.9%),and undetermined etiology(6,4.4%).Among the pre-existing dermatoses,eczema was the most common etiology(33.9%).We also found that psoriasis,solar dermatitis,hypereosinophilic syndrome,atopic dermatitis,scabies,pemphigus foliaceus,and pityriasis rubra pilaris were causes of erythroderma.In the drug-induced group,anticonvulsants were the most frequently implicated drug.Compared to other cause diseases,patients with psoriasis had a significant higher rate of fever(P=0.022),nail changes(P<0.001),arthralgia(P<0.001),and infection(P=0.007).Eosinophilia and an increased immunoglobulin E concentration were associated with hypereosinophilic syndrome(P=0.005)and eczema(P=0.032),respectively compared to other cause diseases.The infection rate was significantly higher in patients with abnormal liver function compared to the patients with normal liver function(P<0.001).Conclusion:Most of the clinical features of erythroderma are unspecific with the exception of fever,nail changes,and arthralgia,which were mostly found in patients with psoriasis.Clinicohistopathological examination helps to establish the etiology of erythroderma and reminder doctors to focus on high-risk populations.展开更多
基金financially supported by NSFC(82374171 and 81570701)the Natural Science Foundation of Guangdong Province(2024A1515012945)the Key Laboratory of Model Animal Phenotyping and Basic Research in Metabolic Diseases(2018KSYS003).
文摘Metabolic dysfunction-associated steatohepatitis(MASH)is the progressive form of metabolic dysfunction-associated steatotic liver disease(MASLD),and closely associated with a high risk of liver-related morbidity and mortality.Although enhanced neutrophil infiltration of the liver is a histological hallmark of MASH,the morphological pattern of hepatic neutrophils and their relevance to the definition of MASH remain unknown.This clinicopathological study aimed to determine the association of neutrophilic crown-like structures(CLSs)in liver biopsies and evaluate their relevance to the histological diagnosis of MASH.A total of 483 morbidly obese adults who underwent bariatric surgery were recruited.Neutrophilic CLSs in liver biopsies were detected by immunohistochemistry for neutrophil elastase and proteinase 3.All participants were classified into 4 histological subgroups:no MASLD(118,24.4%),MASLD(76,15.7%),borderline MASH(185,38.3%),and definite MASH(104,21.5%).In the discovery cohort(n=379),the frequency of neutrophilic CLSs increased in line with the severity of liver disease.The number of neutrophilic CLSs was positively correlated with established histological characteristics of MASH.At a cutoff value of<0.3 per 20×microscopic field,the number of neutrophilic CLSs yielded a robust diagnostic accuracy to discriminate no MASLD and MASLD from borderline MASH and definite MASH;a cutoff at>1.3 per 20×microscopic field exhibited a statistically significant accuracy to distinguish definite MASH from other groups(no MASLD,MASLD,and borderline MASH).The significance of neutrophilic CLSs in identifying borderline MASH and definite MASH was confirmed in an external validation cohort(n=104).The frequency of neutrophilic CLSs was significantly higher than that of macrophagic CLSs.In conclusion,neutrophilic CLSs in the liver represent a typical histological characteristic of MASH and may serve as a promising indicator to improve the diagnostic accuracy of MASH during histological assessment of liver biopsies.
文摘Objective To investigate the prevalence rate of heart valve calcification and its relativity with pathological changes and clinical pathogenic factors in elder patients at autopsy.Methods Pathology data at autopsy of 1047patients with age from 60 to 106 years in Beijing Hospital from November 1954 to March 2016 were collected.Cases of heart valve calcification verified at autopsy
基金the Medical Health Science and Technology Project of Zhejiang Province(No.2022PY022)We thank the patients in this study。
文摘Objective:Erythroderma is an uncommon and severe skin disorder with many underlying causes and identifying its etiology can facilitate further treatments.This study was performed to evaluate the clinical profile and etiology of erythroderma.Methods:We collected the data on 136 patients diagnosed with erythroderma with respect to the epidemiological,clinical,biological,and histological data,treatments,and outcomes in The First Affiliated Hospital of Ningbo University from 2011 to 2021.The analyses of qualitative data were performed with the chi-square test or Fisher’s exact test.The groups of quantitative data were compared using a t-test or analysis of variance.Results:The patients’mean age in this study was 65.00±16.51 years,with a male:female ratio of 5.8:1.0.Acute onset occurred in 27 patients(19.9%)and was associated with drug reactions(P=0.002).The mean length of stay was 19.18±9.75 days.Clinical characteristics were dominated by pruritus(135,99.3%),fever(44,32.4%),edema(82,60.3%),nail changes(14,10.3%),arrhythmia(16,11.8%),and superficial lymphadenopathy(57,41.9%).Combined with biopsy,history inquiry and laboratory testing,this study found that most common causative factor was pre-existing dermatoses(107,78.7%),followed by drug reactions(15,11.0%),malignancies(8,5.9%),and undetermined etiology(6,4.4%).Among the pre-existing dermatoses,eczema was the most common etiology(33.9%).We also found that psoriasis,solar dermatitis,hypereosinophilic syndrome,atopic dermatitis,scabies,pemphigus foliaceus,and pityriasis rubra pilaris were causes of erythroderma.In the drug-induced group,anticonvulsants were the most frequently implicated drug.Compared to other cause diseases,patients with psoriasis had a significant higher rate of fever(P=0.022),nail changes(P<0.001),arthralgia(P<0.001),and infection(P=0.007).Eosinophilia and an increased immunoglobulin E concentration were associated with hypereosinophilic syndrome(P=0.005)and eczema(P=0.032),respectively compared to other cause diseases.The infection rate was significantly higher in patients with abnormal liver function compared to the patients with normal liver function(P<0.001).Conclusion:Most of the clinical features of erythroderma are unspecific with the exception of fever,nail changes,and arthralgia,which were mostly found in patients with psoriasis.Clinicohistopathological examination helps to establish the etiology of erythroderma and reminder doctors to focus on high-risk populations.
