The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in ...The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in the pathogenesis of the disease, based on the work of the authors(Takasugi et al., 2011;Komai et al., 2024).展开更多
Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include...Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include disturbances in sleep,gastrointestinal function,and olfaction.PD misdiagnosis rates have been reported to reach approximately 30%,partly owing to the heterogeneity of parkinsonism with non-PD pathologies,and the differential diagnosis of PD from neurodegenerative diseases such as multiple systemic atrophy(MSA)and progressive supranuclear palsy poses another unmet need.展开更多
Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have...Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.展开更多
AIM: To observe different histomorphologic changes of ulcerative colitis (UC) rats that were treated with four regulating-intestine prescriptions (FRIP), to investigate the curative effects of FRIP and to analyze thei...AIM: To observe different histomorphologic changes of ulcerative colitis (UC) rats that were treated with four regulating-intestine prescriptions (FRIP), to investigate the curative effects of FRIP and to analyze their treatment mechanism.METHODS: The UC rat model was made by the method of 2,4-dinitro chloro benzene (DNCB) immunity and acetic acid local enema. Ninety-eight SD rats were randomly divided into seven groups, namely, the normal control group, model group, salicylazosulfapyridine (SASP) group,Wumeiwan (WMW) group, Baitouwengtang (BTWT) group,Senglingbaishusan (SLBSS) group, and Tongxieyaofang (TXYF) group. Each group had 14 rats (with equal ratio of male and female). The six animal model groups of UC-SASP, TXYF, WMW, BTWT, SLBSS, TXYF-were treated by distilled water except the normal control group. Changes of the rat's general conditions after treatment were respectively observed, the colon tissue damage scores were given out, the pathology of colonic mucosa and changes of ultrastructure were analyzed.RESULTS: Different pathological changes on histology were shown after treatment by FRIP. The colon tissue damage score in model group was higher than that of FRIP groups and SASP group (q = 4.59, 4.77, P＜0.05 or q = 5.48,6.25, 5.97, P＜0.01). The scores of WMW group, BTWT group and SLBSS group were lower than that of SASP (q = 4.13, P＜0.05 or q = 5.31, 5.12, P＜0.01). There was no remarkable difference between the damage score of TXYF group and SASP group (q = 3.75, P＞0.05). In addition, some apoptosis cells were found in the pathologic control group.CONCLUSION: The model made with DNCB and acetic acid was successful, and FRIP had better curative effect and WMW was the best curative effect, BTW, SLBSS and TXYF were similar to SASP, and we discovered that apoptosis was possibly related to UC.展开更多
AIM To observe the therapeutic effect ofmoxibustion on ulcerative colitis and itsinfluence on the colonic mucosal morphology.METHODS Forty-six patients with ulcerativecolitis were randomly divided into themoxibustion ...AIM To observe the therapeutic effect ofmoxibustion on ulcerative colitis and itsinfluence on the colonic mucosal morphology.METHODS Forty-six patients with ulcerativecolitis were randomly divided into themoxibustion with herbal medicine underneathgroup and the western medicine group.Thirtypatients were treated with the abovemoxibustion and 16 patients with Salicylayefapyridine(SASP).The colonic mucosa of 13patients in the moxibustion group was observedby colonoscopy before and after the treatment.Mucin was also analyzed by H.E and AB-PASstaining.RESULTS Seventeen patients were clinicallycured,12 were improved and 1 unchanged in themoxibustion group.In the control group,5patients were clinically cured,7 improved and 4unchanged.Thirteen patients with active UCwere taken as the subjects for histopathologicanalysis in this study.The colonic mucosallesions were remarkably improved and thecharacteristic of the mucin also changed.Inmost sections,the chronic inflammation ofmucosa was geatly ameliorated(P【0.01).Theinflammatory cell infiltratation much decreased and neutrophils,disapeared in most sections(P【0.001).The goblet cells significantlyincreased(P【0.001);crypt paracrypt abscessor mucosal ulceration was seen(P【0.001).CONCLUSION The rate of cure of ulcerative colitis by moxibustion with herbal medicine beneath is superior to that by SASP. This sort of moxibustion can effectively improve the colonic mucosal lesions and restore the proportion of mucoprotein to near normal.展开更多
Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy ...Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.展开更多
Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrog...Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis.Developing effective diagnostic,preventative,and therapeutic strategies for AD necessitates the establishment of animal models that accurately recapitulate the pathophysiological processes of the disease.Existing transgenic mouse models have significantly contributed to understanding AD pathology but often fail to replicate the complexity of human AD.Additionally,these models are limited in their ability to elucidate the interplay among amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis due to the absence of spatially and temporally specific genetic manipulation.In this study,we introduce a novel AD mouse model(APP/PS1-TauP301L-Adeno mice)designed to rapidly induce pathological symptoms and enhance understanding of AD mechanisms.Neurofibrillary tangles and severe reactive astrogliosis were induced by injecting AAVDJ-EF1a-hTauP301L-EGFP and Adeno-GFAP-GFP viruses into the hippocampi of 5-month-old APP/PS1 mice.Three months post-injection,these mice exhibited pronounced astrogliosis,substantial amyloid-βplaque accumulation,extensiveneurofibrillarytangles,accelerated neuronal loss,elevated astrocytic GABA levels,and significant spatial memory deficits.Notably,these pathological features were less severe in AAVTauP301L-expressing APP/PS1 mice without augmented reactive astrogliosis.These findings indicate an exacerbating role of severe reactive astrogliosis in amyloid-βplaque and neurofibrillary tangle-associated pathology.The APP/PS1-TauP301L-Adeno mouse model provides a valuable tool for advancing therapeutic research aimed at mitigating the progression of AD.展开更多
Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Train...Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Training Content and Standards(2022 Edition),clinical pathology residents are required to master pathological diagnoses across 11 systems:skin,head and neck,mediastinum and respiratory,digestive,urinary and male reproductive,female reproductive and breast,lymphatic and hematopoietic,bone and soft tissue,cardiovascular,central nervous,and endocrine diseases.Senior pathologists specializing in each subspecialty selected classic pathological slides,which were systematically scanned and compiled into an electronic pathology library.Results:A questionnaire survey was conducted to gather feedback on the electronic pathology reading library.Residents generally found it to be convenient,efficient,and conducive to learning.Conclusion:Training in clinical pathology diagnosis is a core component of standardized resident training.The electronic pathology reading library has been well-received and recognized by resident doctors.However,further efforts are needed to explore diverse teaching methods that align with modern educational approaches,ultimately contributing to the development of highly skilled resident doctors.展开更多
AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening o...AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening of the GSE24673 and GSE125903 datasets,combined with GeneCards database analysis.A total of 102 RB patients and 62 traumaenucleated controls between January 2018 and December 2023 were enrolled,with their clinicopathological data and retinal tissues collected.The mRNA and methylation levels of MSH6 in retinal tissues were detected using real-time quantitative polymerase chain reaction(PCR)and methylation-specific PCR.Western blot analysis was conducted in one pair of RB and control tissues for preliminary protein-level validation of MSH6 expression.Based on the methylation status of MSH6,RB patients were categorized into two groups:low-methylation and highmethylation.Both univariate and multivariate analyses were conducted to identify independent factors influencing the methylation levels using clinicopathological data.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic potential of MSH6 methylation in RB.RESULTS:Bioinformatics analysis of public datasets revealed that MSH6 expression was downregulated across multiple cancers,RB.Consistently,in clinical RB tissues,MSH6 mRNA expression was significantly lower than that in control retinal tissues,whereas the promoter methylation level of MSH6 was markedly higher(both P<0.001),indicating that promoter hypermethylation may contribute to transcriptional silencing of MSH6 in RB.Patients with higher MSH6 methylation levels showed more advanced pathological classification and a higher frequency of metastasis.Multivariate logistic regression confirmed that metastatic status(P=0.008,OR=3.51)and pathological classification(P=0.005,OR=3.7)were independent factors associated with MSH6 methylation.Receiver operating characteristic(ROC)analysis demonstrated that MSH6 methylation could effectively distinguish RB tissues from non-tumorous controls(AUC=0.847,sensitivity=78.43%,specificity=80.65%),suggesting that MSH6 hypermethylation may serve as a potential diagnostic biomarker for RB.CONCLUSION:The methylation level of the MSH6 gene may be a key factor in RB pathogenesis.The methylation status of the MSH6 gene is closely associated with clinicopathological features and shows diagnostic potential.展开更多
Ovarian endometrioid carcinoma(OEC)accounts for~10%of epithelial ovarian cancers and displays broad morphologic diversity that complicates diagnosis and grading.Recent data show that the endometrial cancer molecular t...Ovarian endometrioid carcinoma(OEC)accounts for~10%of epithelial ovarian cancers and displays broad morphologic diversity that complicates diagnosis and grading.Recent data show that the endometrial cancer molecular taxonomy(DNA polymerase epsilon,catalytic subunit[POLE]-ultramutated,mismatch repair-deficient[MMRd],p53-abnormal,no specific molecular profile[NSMP])also applies to OEC,and that OEC is enriched for Lynch syndrome–associated tumors,supporting routine MMR testing.We aimed to synthesize contemporary evidence spanning epidemiology,histopathology and immunophenotype,diagnostic pitfalls and differential diagnosis,and to evaluate the clinical utility of The Cancer Genome Atlas(TCGA)-surrogate molecular classification for risk stratification;we also summarize implications for Lynch screening,genetic counseling,and therapeutic opportunities including immune checkpoint inhibitors and targeted approaches,with practical recommendations for diagnostic workflows.Integrating morphology with molecular classification refines diagnosis and prognostication:POLEmut/MMRd subsets generally have excellent outcomes and are candidates for de-escalation or immunotherapy,whereas p53abn/high-grade tumors carry a poorer prognosis and may warrant intensified management and trials of homologous recombination deficiency(HRD)-directed strategies;routine MMR immunohistochemistry(IHC)with reflex germline testing improves Lynch detection,and future priorities include prospective validation and multi-omics to refine NSMP and identify new targets.展开更多
BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in s...BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in starting appropriate patient management at the proper time.Modern medicine considers skin biopsies crucial diagnostic tools that yield histopathological and molecular evidence for examining PVD-related microvascular changes.AIM To evaluate skin biopsy applications in PVD diagnostics through artistic analysis of technical processes and examination of pathological and innovative molecular indicators.METHODS A systematic review of randomized controlled trials and original studies about skin biopsy utility in PVD diagnosis used PubMed,Scopus,and EMBASE search platforms.The reviewed studies met specific entry requirements,while all case reports and review articles remained excluded.RESULTS A total of 22 studies suited the research criteria that were evaluated.Researchers emphasized the value of skin biopsies for identifying inflammatory from non-inflammatory PVDs.At the same time,they detect systemic sclerosis and diabetic vasculopathy abnormalities of micro-vessels and identify endothelial dysfunction through measurements of vascular endothelial growth factor and intercellular adhesion molecule-1 and endothelial nitric oxide synthase markers.Skin biopsies require further improvement because they cause patient discomfort and produce variable diagnostic results that specialists must interpret.CONCLUSION Skin biopsies enable essential diagnostic findings about PVD and improve patient detection.The development of standardized biopsy procedures and molecular diagnosis techniques should be studied to advance PVD diagnoses in clinical practice.展开更多
AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressu...AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressure(IOP)reduction in angle-closure glaucoma(ACG).METHODS:Porcine eyes ex vivo and rabbit eyes in vivo were used.In porcine eyes,permeability rates of the anterior vitreous cortex(AVC)and anterior hyaloid membrane(AHM)were assessed using Schirmer’s strips.Permeability rates in the circumlental space were compared with or without TSCP bursts.Fluorescein diffusion times from the vitreous to the AC were compared between eyes with and without TSCP.In rabbit eyes,changes in IOP and AC angle structures under ultrasound biomicroscopy(UBM)were evaluated at intervals of 30min,7d,and 14d after TSCP.Vitreous pathology was examined using scanning electron microscopy(SEM)immediately and 14d after TSCP.RESULTS:In porcine eyes(n=20),the median(range)permeability rates were 10.3(range 9.8–10.8)mm/min for the AVC and 4.3(range 3.9–4.9)mm/min for the AHM(P=0.009).Permeability rates in the circumlental space were 4.2(range 3.8–4.9)mm/min in areas without TSCP,6.2(range 5.7–6.8)mm/min in areas with non-burst TSCP,and 11.3(range 10.9–11.8)mm/min in areas with burst TSCP(P=0.002).The median(range)fluorescein diffusion time was 5(range 3–8)min in eyes undergoing TSCP,whereas it was 40min(range 35–68)in eyes without TSCP(P<0.001).In rabbit eyes(n=20),SEM showed immediate localized damage to the AHM,AVC,and posterior lens zonules in areas subjected to TSCP bursts,and obvious lens zonule loss with cellular infiltration and possible vitreous liquefaction by post-op day 14.Persistent widening of AC angles was noted at postoperative days 7 and 14,although a significant reduction in IOP was only observed at postoperative day 7.CONCLUSION:TSCP-induced damage on the zonules,AHM,and AVC potentially enhances fluid outflow from the vitreous,leading to a widened AC angle and vitreous liquefaction in rabbits.These observations offer insights into mechanisms of TSCP in lowering IOP and pathogenic roles of vitreous in ACG.展开更多
One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of p...One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.展开更多
This editorial comments on the article by Wu et al in the World Journal of Gastroenterology.The article explored the relationship between mesenteric adipose tissue,creeping fat,inflammation,and gut microbiota in Crohn...This editorial comments on the article by Wu et al in the World Journal of Gastroenterology.The article explored the relationship between mesenteric adipose tissue,creeping fat,inflammation,and gut microbiota in Crohn’s disease(CD).We discussed three key aspects of the interaction between gut microbiota and inflammatory bowel disease(IBD):The physiological functions of the gut microbiota,the potential role of probiotics in IBD treatment;and the effect of fecal microbiota transplantation(FMT)in combating IBD.IBD,comprising CD and ulcerative colitis(UC),is influenced by the gut microbiota.Changes in gut microbiota composition disrupt intestinal function and promote chronic inflammation,but the exact mechanisms remain unclear.Probiotics have demonstrated some efficacy in inducing remission in UC,though their effectiveness in CD is still debated.FMT shows promise in treating IBD,especially UC,by restoring gut microbiota diversity and inducing clinical remission.As for CD,FMT has potential,but more studies are needed to confirm its long-term effectiveness and safety.Dietary approaches may help manage IBD symptoms or disease activity,but patient adherence is crucial.Clinicians and researchers must recognize the importance of the gut microbiota and the need for personalized therapies targeting microbial imbalances.展开更多
Using the curriculum of horticultural plant pathology as a starting point,this paper investigates the collaborative education model of"curriculum ideology and politics+innovation and entrepreneurship".It exp...Using the curriculum of horticultural plant pathology as a starting point,this paper investigates the collaborative education model of"curriculum ideology and politics+innovation and entrepreneurship".It expounds the necessity of constructing this model,proposes implementation paths from aspects such as the integration of ideological and political elements,the cultivation of innovation and entrepreneurship capabilities,and the construction of a collaborative education mechanism.Furthermore,it analyzes the practical effects,challenges encountered,and corresponding response strategies,thereby offering a valuable reference for the training of professionals in horticulture.展开更多
A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic a...A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic accuracy for PC,we have several concerns regarding its generalizability,cohort selection,imaging variability,statistical methods,and potential confounding factors.We recommended that future research adopt multi-center,prospective designs to improve representation and minimize bias.Additionally,incorporating advanced imaging techniques such as radiomics and artificial intelligence and conducting more comprehensive statistical analyses would be valuable.By implementing these strategies,future studies can yield more reliable and externally validated findings that improve the clinical applicability of imaging-based differentiation of PC.Addressing these methodological issues could significantly advance the field of gastrointestinal oncology and improve patient management and outcomes.展开更多
Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was sched...Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was scheduled for suspected urothelial carcinoma of the distal ureter in a 60-year-old woman.The patient involved in the present research signed a dedicated form to consent to the publication of images and/or information about her.Past medical history included Brugada syndrome diagnosed in 2015,and hypercholesterolemia.Past surgical history included one cesarean section only.Family history included ovarian cancer(sister),colorectal cancer(mother),and kidney cancer(father).展开更多
Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen...Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.展开更多
BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate se...BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
基金supported by a grant from the Japan Foundation for applied enzymology (to NT)the Grant-in-Aid for Scientific Research (C) from the Japan Society for the Promotion of Science (26430059, 17K08272, and 20K07014 to NT)+1 种基金the establishment of university fellowships toward the creation of science technology innovation (JPMJFS2128)a Grant-in-Aid for JSPS Fellows (23KJ1603)(to MK)。
文摘The purpose of this perspective is to discuss the future development of a potential treatment of glial pathology in Alzheimer's disease(AD) and a new regulatory mechanism, nuclear lipids, which may be involved in the pathogenesis of the disease, based on the work of the authors(Takasugi et al., 2011;Komai et al., 2024).
基金supported by Swiss Center for Applied Human Toxicology(SCAHT AP22-01)(to RN)。
文摘Parkinson's disease(PD)is the second most common neurodegenerative disorder.The clinical manifestations of PD include motor symptoms,such as bradykinesia,resting tremor,rigidity,and nonmotor symptoms,which include disturbances in sleep,gastrointestinal function,and olfaction.PD misdiagnosis rates have been reported to reach approximately 30%,partly owing to the heterogeneity of parkinsonism with non-PD pathologies,and the differential diagnosis of PD from neurodegenerative diseases such as multiple systemic atrophy(MSA)and progressive supranuclear palsy poses another unmet need.
基金supported by the Canadian Institutes of Health Research Project grant (PJT-169197) to QYsupported by a CGS-M fellowship from the Canadian Institutes of Health Research
文摘Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.
基金Supported by the Hubei Provincial Department of Education, No.99Z014
文摘AIM: To observe different histomorphologic changes of ulcerative colitis (UC) rats that were treated with four regulating-intestine prescriptions (FRIP), to investigate the curative effects of FRIP and to analyze their treatment mechanism.METHODS: The UC rat model was made by the method of 2,4-dinitro chloro benzene (DNCB) immunity and acetic acid local enema. Ninety-eight SD rats were randomly divided into seven groups, namely, the normal control group, model group, salicylazosulfapyridine (SASP) group,Wumeiwan (WMW) group, Baitouwengtang (BTWT) group,Senglingbaishusan (SLBSS) group, and Tongxieyaofang (TXYF) group. Each group had 14 rats (with equal ratio of male and female). The six animal model groups of UC-SASP, TXYF, WMW, BTWT, SLBSS, TXYF-were treated by distilled water except the normal control group. Changes of the rat's general conditions after treatment were respectively observed, the colon tissue damage scores were given out, the pathology of colonic mucosa and changes of ultrastructure were analyzed.RESULTS: Different pathological changes on histology were shown after treatment by FRIP. The colon tissue damage score in model group was higher than that of FRIP groups and SASP group (q = 4.59, 4.77, P＜0.05 or q = 5.48,6.25, 5.97, P＜0.01). The scores of WMW group, BTWT group and SLBSS group were lower than that of SASP (q = 4.13, P＜0.05 or q = 5.31, 5.12, P＜0.01). There was no remarkable difference between the damage score of TXYF group and SASP group (q = 3.75, P＞0.05). In addition, some apoptosis cells were found in the pathologic control group.CONCLUSION: The model made with DNCB and acetic acid was successful, and FRIP had better curative effect and WMW was the best curative effect, BTW, SLBSS and TXYF were similar to SASP, and we discovered that apoptosis was possibly related to UC.
基金the National Science Foudation of China,No.39670899.39970922
文摘AIM To observe the therapeutic effect ofmoxibustion on ulcerative colitis and itsinfluence on the colonic mucosal morphology.METHODS Forty-six patients with ulcerativecolitis were randomly divided into themoxibustion with herbal medicine underneathgroup and the western medicine group.Thirtypatients were treated with the abovemoxibustion and 16 patients with Salicylayefapyridine(SASP).The colonic mucosa of 13patients in the moxibustion group was observedby colonoscopy before and after the treatment.Mucin was also analyzed by H.E and AB-PASstaining.RESULTS Seventeen patients were clinicallycured,12 were improved and 1 unchanged in themoxibustion group.In the control group,5patients were clinically cured,7 improved and 4unchanged.Thirteen patients with active UCwere taken as the subjects for histopathologicanalysis in this study.The colonic mucosallesions were remarkably improved and thecharacteristic of the mucin also changed.Inmost sections,the chronic inflammation ofmucosa was geatly ameliorated(P【0.01).Theinflammatory cell infiltratation much decreased and neutrophils,disapeared in most sections(P【0.001).The goblet cells significantlyincreased(P【0.001);crypt paracrypt abscessor mucosal ulceration was seen(P【0.001).CONCLUSION The rate of cure of ulcerative colitis by moxibustion with herbal medicine beneath is superior to that by SASP. This sort of moxibustion can effectively improve the colonic mucosal lesions and restore the proportion of mucoprotein to near normal.
文摘Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.
基金supported by the National Research Foundation of Korea (NRF)funded by the Ministry of Science,ICT&Future Planning (2022R1A2C2006229,2022R1A6A3A01086868)Korea Dementia Research Project through the Korea Dementia Research Center (KDRC)funded by the Ministry of Health&Welfare and Ministry of Science and ICT,Republic of Korea (RS-2024-00345328)KIST Institutional Grant (2E32851)。
文摘Alzheimer'sdisease(AD)isaprogressive neurodegenerative disorder characterized by cognitive impairment and distinct neuropathological features,including amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis.Developing effective diagnostic,preventative,and therapeutic strategies for AD necessitates the establishment of animal models that accurately recapitulate the pathophysiological processes of the disease.Existing transgenic mouse models have significantly contributed to understanding AD pathology but often fail to replicate the complexity of human AD.Additionally,these models are limited in their ability to elucidate the interplay among amyloid-βplaques,neurofibrillary tangles,and reactive astrogliosis due to the absence of spatially and temporally specific genetic manipulation.In this study,we introduce a novel AD mouse model(APP/PS1-TauP301L-Adeno mice)designed to rapidly induce pathological symptoms and enhance understanding of AD mechanisms.Neurofibrillary tangles and severe reactive astrogliosis were induced by injecting AAVDJ-EF1a-hTauP301L-EGFP and Adeno-GFAP-GFP viruses into the hippocampi of 5-month-old APP/PS1 mice.Three months post-injection,these mice exhibited pronounced astrogliosis,substantial amyloid-βplaque accumulation,extensiveneurofibrillarytangles,accelerated neuronal loss,elevated astrocytic GABA levels,and significant spatial memory deficits.Notably,these pathological features were less severe in AAVTauP301L-expressing APP/PS1 mice without augmented reactive astrogliosis.These findings indicate an exacerbating role of severe reactive astrogliosis in amyloid-βplaque and neurofibrillary tangle-associated pathology.The APP/PS1-TauP301L-Adeno mouse model provides a valuable tool for advancing therapeutic research aimed at mitigating the progression of AD.
文摘Objective:To enhance the reading skills of clinical pathology residents,it is essential to establish a well-structured electronic pathology reading library.Methods:In accordance with the Resident Standardization Training Content and Standards(2022 Edition),clinical pathology residents are required to master pathological diagnoses across 11 systems:skin,head and neck,mediastinum and respiratory,digestive,urinary and male reproductive,female reproductive and breast,lymphatic and hematopoietic,bone and soft tissue,cardiovascular,central nervous,and endocrine diseases.Senior pathologists specializing in each subspecialty selected classic pathological slides,which were systematically scanned and compiled into an electronic pathology library.Results:A questionnaire survey was conducted to gather feedback on the electronic pathology reading library.Residents generally found it to be convenient,efficient,and conducive to learning.Conclusion:Training in clinical pathology diagnosis is a core component of standardized resident training.The electronic pathology reading library has been well-received and recognized by resident doctors.However,further efforts are needed to explore diverse teaching methods that align with modern educational approaches,ultimately contributing to the development of highly skilled resident doctors.
文摘AIM:To explore the methylation status of MSH6 in retinoblastoma(RB)and its impact on clinicopathological features and diagnosis.METHODS:Differentially expressed genes were identified through bioinformatics screening of the GSE24673 and GSE125903 datasets,combined with GeneCards database analysis.A total of 102 RB patients and 62 traumaenucleated controls between January 2018 and December 2023 were enrolled,with their clinicopathological data and retinal tissues collected.The mRNA and methylation levels of MSH6 in retinal tissues were detected using real-time quantitative polymerase chain reaction(PCR)and methylation-specific PCR.Western blot analysis was conducted in one pair of RB and control tissues for preliminary protein-level validation of MSH6 expression.Based on the methylation status of MSH6,RB patients were categorized into two groups:low-methylation and highmethylation.Both univariate and multivariate analyses were conducted to identify independent factors influencing the methylation levels using clinicopathological data.Receiver operating characteristic(ROC)curves were applied to evaluate the diagnostic potential of MSH6 methylation in RB.RESULTS:Bioinformatics analysis of public datasets revealed that MSH6 expression was downregulated across multiple cancers,RB.Consistently,in clinical RB tissues,MSH6 mRNA expression was significantly lower than that in control retinal tissues,whereas the promoter methylation level of MSH6 was markedly higher(both P<0.001),indicating that promoter hypermethylation may contribute to transcriptional silencing of MSH6 in RB.Patients with higher MSH6 methylation levels showed more advanced pathological classification and a higher frequency of metastasis.Multivariate logistic regression confirmed that metastatic status(P=0.008,OR=3.51)and pathological classification(P=0.005,OR=3.7)were independent factors associated with MSH6 methylation.Receiver operating characteristic(ROC)analysis demonstrated that MSH6 methylation could effectively distinguish RB tissues from non-tumorous controls(AUC=0.847,sensitivity=78.43%,specificity=80.65%),suggesting that MSH6 hypermethylation may serve as a potential diagnostic biomarker for RB.CONCLUSION:The methylation level of the MSH6 gene may be a key factor in RB pathogenesis.The methylation status of the MSH6 gene is closely associated with clinicopathological features and shows diagnostic potential.
基金supported by the Japan Society for the Promotion of Science(JSPS KAKENHI Grant Number 24K12615).
文摘Ovarian endometrioid carcinoma(OEC)accounts for~10%of epithelial ovarian cancers and displays broad morphologic diversity that complicates diagnosis and grading.Recent data show that the endometrial cancer molecular taxonomy(DNA polymerase epsilon,catalytic subunit[POLE]-ultramutated,mismatch repair-deficient[MMRd],p53-abnormal,no specific molecular profile[NSMP])also applies to OEC,and that OEC is enriched for Lynch syndrome–associated tumors,supporting routine MMR testing.We aimed to synthesize contemporary evidence spanning epidemiology,histopathology and immunophenotype,diagnostic pitfalls and differential diagnosis,and to evaluate the clinical utility of The Cancer Genome Atlas(TCGA)-surrogate molecular classification for risk stratification;we also summarize implications for Lynch screening,genetic counseling,and therapeutic opportunities including immune checkpoint inhibitors and targeted approaches,with practical recommendations for diagnostic workflows.Integrating morphology with molecular classification refines diagnosis and prognostication:POLEmut/MMRd subsets generally have excellent outcomes and are candidates for de-escalation or immunotherapy,whereas p53abn/high-grade tumors carry a poorer prognosis and may warrant intensified management and trials of homologous recombination deficiency(HRD)-directed strategies;routine MMR immunohistochemistry(IHC)with reflex germline testing improves Lynch detection,and future priorities include prospective validation and multi-omics to refine NSMP and identify new targets.
文摘BACKGROUND The heterogeneous group of disorders called peripheral vascular diseases(PVDs)occurs outside the heart and brain tissue to cause ischemia and severe health complications.Diagnosis accuracy is essential in starting appropriate patient management at the proper time.Modern medicine considers skin biopsies crucial diagnostic tools that yield histopathological and molecular evidence for examining PVD-related microvascular changes.AIM To evaluate skin biopsy applications in PVD diagnostics through artistic analysis of technical processes and examination of pathological and innovative molecular indicators.METHODS A systematic review of randomized controlled trials and original studies about skin biopsy utility in PVD diagnosis used PubMed,Scopus,and EMBASE search platforms.The reviewed studies met specific entry requirements,while all case reports and review articles remained excluded.RESULTS A total of 22 studies suited the research criteria that were evaluated.Researchers emphasized the value of skin biopsies for identifying inflammatory from non-inflammatory PVDs.At the same time,they detect systemic sclerosis and diabetic vasculopathy abnormalities of micro-vessels and identify endothelial dysfunction through measurements of vascular endothelial growth factor and intercellular adhesion molecule-1 and endothelial nitric oxide synthase markers.Skin biopsies require further improvement because they cause patient discomfort and produce variable diagnostic results that specialists must interpret.CONCLUSION Skin biopsies enable essential diagnostic findings about PVD and improve patient detection.The development of standardized biopsy procedures and molecular diagnosis techniques should be studied to advance PVD diagnoses in clinical practice.
基金Supported by National Natural Science Foundation of China(No.82201171,No.82171050,No.82471072).
文摘AIM:To describe the alterations of the vitreous pathology and anterior chamber(AC)angle structures following transscleral cyclophotocoagulation(TSCP)and better understand the mechanism of post-laser intraocular pressure(IOP)reduction in angle-closure glaucoma(ACG).METHODS:Porcine eyes ex vivo and rabbit eyes in vivo were used.In porcine eyes,permeability rates of the anterior vitreous cortex(AVC)and anterior hyaloid membrane(AHM)were assessed using Schirmer’s strips.Permeability rates in the circumlental space were compared with or without TSCP bursts.Fluorescein diffusion times from the vitreous to the AC were compared between eyes with and without TSCP.In rabbit eyes,changes in IOP and AC angle structures under ultrasound biomicroscopy(UBM)were evaluated at intervals of 30min,7d,and 14d after TSCP.Vitreous pathology was examined using scanning electron microscopy(SEM)immediately and 14d after TSCP.RESULTS:In porcine eyes(n=20),the median(range)permeability rates were 10.3(range 9.8–10.8)mm/min for the AVC and 4.3(range 3.9–4.9)mm/min for the AHM(P=0.009).Permeability rates in the circumlental space were 4.2(range 3.8–4.9)mm/min in areas without TSCP,6.2(range 5.7–6.8)mm/min in areas with non-burst TSCP,and 11.3(range 10.9–11.8)mm/min in areas with burst TSCP(P=0.002).The median(range)fluorescein diffusion time was 5(range 3–8)min in eyes undergoing TSCP,whereas it was 40min(range 35–68)in eyes without TSCP(P<0.001).In rabbit eyes(n=20),SEM showed immediate localized damage to the AHM,AVC,and posterior lens zonules in areas subjected to TSCP bursts,and obvious lens zonule loss with cellular infiltration and possible vitreous liquefaction by post-op day 14.Persistent widening of AC angles was noted at postoperative days 7 and 14,although a significant reduction in IOP was only observed at postoperative day 7.CONCLUSION:TSCP-induced damage on the zonules,AHM,and AVC potentially enhances fluid outflow from the vitreous,leading to a widened AC angle and vitreous liquefaction in rabbits.These observations offer insights into mechanisms of TSCP in lowering IOP and pathogenic roles of vitreous in ACG.
基金supported by Princess Nourah bint Abdulrahman University Researchers Supporting Project number(PNURSP2025R104),Princess Nourah bint Abdulrahman University,Riyadh,Saudi Arabia.
文摘One in every eight men in the US is diagnosed with prostate cancer,making it the most common cancer in men.Gleason grading is one of the most essential diagnostic and prognostic factors for planning the treatment of prostate cancer patients.Traditionally,urological pathologists perform the grading by scoring the morphological pattern,known as the Gleason pattern,in histopathology images.However,thismanual grading is highly subjective,suffers intra-and inter-pathologist variability and lacks reproducibility.An automated grading system could be more efficient,with no subjectivity and higher accuracy and reproducibility.Automated methods presented previously failed to achieve sufficient accuracy,lacked reproducibility and depended on high-resolution images such as 40×.This paper proposes an automated Gleason grading method,ProGENET,to accurately predict the grade using low-resolution images such as 10×.This method first divides the patient’s histopathology whole slide image(WSI)into patches.Then,it detects artifacts and tissue-less regions and predicts the patch-wise grade using an ensemble network of CNN and transformer models.The proposed method adapted the International Society of Urological Pathology(ISUP)grading system and achieved 90.8%accuracy in classifying the patches into healthy and Gleason grades 1 through 5 using 10×WSI,outperforming the state-of-the-art accuracy by 27%.Finally,the patient’s grade was determined by combining the patch-wise results.The method was also demonstrated for 4−class grading and binary classification of prostate cancer,achieving 93.0%and 99.6%accuracy,respectively.The reproducibility was over 90%.Since the proposedmethod determined the grades with higher accuracy and reproducibility using low-resolution images,it is more reliable and effective than existing methods and can potentially improve subsequent therapy decisions.
文摘This editorial comments on the article by Wu et al in the World Journal of Gastroenterology.The article explored the relationship between mesenteric adipose tissue,creeping fat,inflammation,and gut microbiota in Crohn’s disease(CD).We discussed three key aspects of the interaction between gut microbiota and inflammatory bowel disease(IBD):The physiological functions of the gut microbiota,the potential role of probiotics in IBD treatment;and the effect of fecal microbiota transplantation(FMT)in combating IBD.IBD,comprising CD and ulcerative colitis(UC),is influenced by the gut microbiota.Changes in gut microbiota composition disrupt intestinal function and promote chronic inflammation,but the exact mechanisms remain unclear.Probiotics have demonstrated some efficacy in inducing remission in UC,though their effectiveness in CD is still debated.FMT shows promise in treating IBD,especially UC,by restoring gut microbiota diversity and inducing clinical remission.As for CD,FMT has potential,but more studies are needed to confirm its long-term effectiveness and safety.Dietary approaches may help manage IBD symptoms or disease activity,but patient adherence is crucial.Clinicians and researchers must recognize the importance of the gut microbiota and the need for personalized therapies targeting microbial imbalances.
基金Supported by First-class Curriculum"Plant Immunology"Project of Tianjin Agricultural University.
文摘Using the curriculum of horticultural plant pathology as a starting point,this paper investigates the collaborative education model of"curriculum ideology and politics+innovation and entrepreneurship".It expounds the necessity of constructing this model,proposes implementation paths from aspects such as the integration of ideological and political elements,the cultivation of innovation and entrepreneurship capabilities,and the construction of a collaborative education mechanism.Furthermore,it analyzes the practical effects,challenges encountered,and corresponding response strategies,thereby offering a valuable reference for the training of professionals in horticulture.
文摘A recent study by Luo et al examined the relationship between the pathological types of pancreatic cancer(PC)and their imaging characteristics.While this study presented an important step toward improving diagnostic accuracy for PC,we have several concerns regarding its generalizability,cohort selection,imaging variability,statistical methods,and potential confounding factors.We recommended that future research adopt multi-center,prospective designs to improve representation and minimize bias.Additionally,incorporating advanced imaging techniques such as radiomics and artificial intelligence and conducting more comprehensive statistical analyses would be valuable.By implementing these strategies,future studies can yield more reliable and externally validated findings that improve the clinical applicability of imaging-based differentiation of PC.Addressing these methodological issues could significantly advance the field of gastrointestinal oncology and improve patient management and outcomes.
文摘Dear Editor,We aimed to describe the management of the intraoperative injury of the right external iliac artery that occurred during robot-assisted right nephroureterectomy with bladder cuff excision.Surgery was scheduled for suspected urothelial carcinoma of the distal ureter in a 60-year-old woman.The patient involved in the present research signed a dedicated form to consent to the publication of images and/or information about her.Past medical history included Brugada syndrome diagnosed in 2015,and hypercholesterolemia.Past surgical history included one cesarean section only.Family history included ovarian cancer(sister),colorectal cancer(mother),and kidney cancer(father).
基金Supported by the National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.
基金Supported by China Health&Medical Development Foundation,No.M2021551.
文摘BACKGROUND Inappropriate selection of patients with early gastric cancer(EGC)for endoscopic submucosal dissection(ESD)may lead to non-curative resection,necessitating additional gastrectomy.Conversely,inappropriate selection for gastrectomy may result in overtreatment,adversely affecting patients’quality of life.Few have systematically evaluated the concordance between therapeutic indications under current Japanese guidelines and pathological criteria in EGC.To minimize noncurative resection risks while sparing unnecessary surgery for low-risk patients’,we specifically assess the suitability of Japanese guidelines in non-Japanese populations.This work aims to optimize clinical practice by refining endoscopic treatment criteria for adoption beyond Japan.AIM To evaluate EGC clinical decision accuracy by comparing therapeutic indication with postoperative pathological criteria and analyzing factors influencing discrepancies.METHODS A retrospective analysis was conducted on 796 EGC cases diagnosed at Peking University Third Hospital between January 2010 and December 2022.Cases were categorized into three groups:Same-estimated(preoperative therapeutic indication with postoperative pathological criteria matched),underestimated(preoperative ESD indication but postoperative surgical criteria),and overestimated(preoperative surgical indication but postoperative ESD criteria).The rate of discrepancy and associated risk factors were assessed.RESULTS The accuracy rates of preoperative evaluation for ESD and gastrectomy indications were 73.0%(321/430)and 76.0%(278/366),respectively.The overall discrepancy rate was 25.6%(204/796).Multivariate analysis identified tumor location in the upper-third stomach(odds ratio=2.158,95%confidence interval:1.373-3.390,P=0.001)was significantly associated with a higher likelihood of being underestimated and undifferentiated histologic type on preoperative biopsy(odds ratio=2.005,95%confidence interval:1.036-3.879,P=0.039)was more likely to be overestimated.Significant differences were observed in tumor diameter(P<0.001),depth of infiltration(P<0.001),ulcerative findings(P<0.001),and histologic type(P<0.001)between preoperative and postoperative evaluations.CONCLUSION The accuracy of preoperative EGC indications is 74.4%.Upper-third stomach and undifferentiated histology are primary discrepancy predictors.Upper-third tumors are prone to underestimation,while undifferentiated tumors are prone to overestimation.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
