Ectopic hamartomatous thymoma: report of a case and review of literature

Ectopic hamartomatous thymoma (EHT) is an exceedingly rare lesion that usually arises in the lower neck and mainly affects adult men. We present the clinicopathological features of a case of EHT in a 28-year-old Chinese male, together with a literature review. Ultrasound imaging and a computed tomography (CT) scan of the neck demonstrated a 3.0-cm well-defined nodule of heterogeneous density located within the left sternocleidomastoid muscle. The patient underwent a gross total resection of the tumor. Grossly, the well-demarcated, encapsulated mass had a predominantly solid and gray-white appearance admixed with microcystic foci filled with serous content and yellowish regions. The lesion consisted of an irregular admixture of spindle cells, epithelium, and mature adipose tissue. Immunohistochemistry showed that both the spindle cell and epithelial components were diffuse and had intense nuclear positivity for p63 and cytoplasmic reactivity for pan-cytokeratin, CK7, and CK19. The patient was followed for 18 months without any evidence of metastasis or recurrence.     

尿清蛋白检测性能评价及尿清蛋白/肌酐比值联合肾小球滤过率对2型糖尿病患者肾损伤的诊断价值

目的评价免疫透射比浊法检测尿清蛋白(Alb)的性能,探讨尿Alb/肌酐(Cr)比值(ACR)联合估算肾小球滤过率(e GFR)在2型糖尿病(T2DM)患者肾损伤评价中的诊断价值。方法对免疫透射比浊法检测尿Alb的精密度、正确度、分析测量范围(AMR)、检测限、参考区间进行验证,并分析其与免疫散射比浊法的相关性和偏差。选取220例T2DM住院患者,检测尿Alb、尿Cr、血Cr,计算ACR和e GFR并进行分析。结果尿Alb在11.11~298.76 mg/L范围内批内、批间不精密度均小于厂家声明的标准。正确度验证显示两种诊断系统尿Alb校准品测定结果符合验证要求;CAP室间质评物(U-A、U-B)、校准验证/线性评价物(LN20-B)结果符合CAP校准验证/线性评价误差界限所规定的标准,相对偏倚小于基于生物学变异设定质量规范中的适当允许偏倚(<16.4%)。AMR验证显示尿Alb在5.08~347.93 mg/L范围内线性良好。方法学比对显示透射比浊法与散射比浊法检测尿Alb结果相关性较好,平均绝对偏差为8.6 mg/L,平均相对偏差为14.52%,在医学决定水平处的预期偏差在可接受范围内。220例T2DM患者按照正常Alb、微量Alb、大量Alb尿分组,分别有10.9%、45.7%、66.7%的患者e GFR<60m L·min-1·1.73 m-2;在e GFR≥90 m L·min-1·1.73 m-2的患者中,15.7%有微量Alb尿,7.1%有大量Alb尿。结论免疫透射比浊法检测尿Alb的各项性能指标基本满足实验室要求,联合应用ACR和e GFR有助于评估T2DM患者肾脏损伤状况。     

妊娠期肥胖妇女的营养治疗

妊娠期肥胖是指妊娠期妇女体内脂肪组织过度蓄积的状态。近年来妊娠期肥胖的发生率呈快速增长趋势,肥胖程度的增加可对孕妇及围生儿造成严重危害,从而对人类健康产生深远影响。只有了解其多方面的影响因素,认识到妊娠期肥胖对母儿的危害,并制定科学有效的治疗和管理方案,才能在保证孕妇及胎儿营养供应的前提下控制孕妇体质量,保障母婴健康。综述妊娠期肥胖妇女的代谢特点,分析肥胖对妊娠并发症、产程及对胎儿的影响,探讨妊娠期肥胖妇女的孕期营养需求及饮食处方,供医务工作者在临床工作中参考。     

人工周期冻融胚胎移植妊娠结局影响因素分析

目的探讨影响采用人工周期准备内膜冻融胚胎移植(frozen embryo transfer,FET)妊娠结局的相关因素,以期为临床提高FET妊娠率提供一定的指导。方法回顾分析武汉大学人民医院生殖中心2011年1月—2014年12月按人工周期准备内膜行FET的930例的临床资料,受精方式包括体外受精(IVF)和卵胞浆内单精子注射(ICSI),采用阴道B超监测内膜厚度,记录人工周期准备内膜行冻融胚胎移植的不孕妇女决定移植日血清雌二醇(E2)、孕酮(P)水平,并计算E2/P比值,分析不孕原因、不孕年限、年龄、促排卵用药方案、受精方式、内膜厚度、优质胚胎数、E2、P及E2/P等与FET临床妊娠结局的关系,并进一步采用多因素logistic回归模型分析影响妊娠结局的相关因素。结果不孕年限、年龄、子宫内膜厚度、P水平、E2/P及优质胚胎数与临床妊娠结局有一定相关性(P0.05,P0.01);logistic回归分析显示,年龄、子宫内膜厚度、E2/P为临床妊娠结局的影响因素(P0.05,P0.01)。结论对采用人工周期准备内膜行FET的患者重点调控子宫内膜厚度、E2/P可提高临床妊娠率;筛选适龄患者亦是提高妊娠率的重要手段。     

Regulation of DMT1 on Bone Microstructure in Type 2 Diabetes

Diabetic osteoporosis is gradually attracted people''s attention. However, the process of bone microstructure changes in diabetic patients, and the exact mechanism of osteoblast iron overload are unclear. Therefore, the present study aimed to explore the function of DMT1 in the pathological process of diabetic osteoporosis. We build the type two diabetes osteoporosis models with SD rats and Belgrade rats, respectively. Difference expression of DMT1 was detected by using the method of immunohistochemistry and western blotting. Detection of bone microstructure and biomechanics and iron content for each group of samples. We found that DMT1 expression in type 2 diabetic rats was higher than that in normal rats. The bone biomechanical indices and bone microstructure in the rat model deficient in DMT1 was significantly better than that in the normal diabetic model. The loss of DMT1 can reduce the content of iron in bone. These findings indicate that DMT1 expression was enhanced in the bone tissue of type 2 diabetic rats, and plays an important role in the pathological process of diabetic osteoporosis. Moreover, DMT1 may be a potential therapeutic target for diabetic osteoporosis.     

The antioxidative effects of acidic-, alkalic-, and enzymatic-extractable mycelium zinc polysaccharides by <Emphasis Type="Italic">Pleurotus djamor</Emphasis> on liver and kidney of streptozocin-induced diabetic mice

Background

Edible mushrooms, especially the genus of Pleurotus, have been well studied for their nutrition as well as non-toxic medicinal properties. Recently, much attention has been paid to the therapeutic values of mushrooms in genus of Pleurotus with diabetes mellitus (DM), which was a complex metabolic disorder that induced by increased oxidative stress and characterized by hyperglycemia. However, scare attention has been paid to polysaccharides from P. djamor. Meanwhile, zinc is an essential trace element in the human body and it participates in various pathways of metabolism. Therefore, the objective of present study was aimed to evaluate the protective effects of the three extractable mycelium zinc polysaccharides (MZPS), including acidic-MZPS (Ac-MZPS), alkalic-MZPS (Al-MZPS) and enzymatic-MZPS (En-MZPS), on the liver and kidneys in diabetic mice induced by streptozocin (STZ) aiming to better understand the possible hypoglycemic mechanisms and their health benefits.

Methods

The Ac-, Al-, and En-MZPS were extracted with hydrochloric acid (1 M), sodium hydroxide (1 M) and snailase (4 %) from P. djamor zinc-enriched mycelium, respectively. The diabetic mice were induced by injection of STZ. Besides the histopathological analyses of liver and kidney, the following biochemical analysis were processed to investigate the antioxidative effects, including activities of superoxide dismutase (SOD), GSH peroxide (GSH-Px) and catalase (CAT), and contents of malondialdehyde (MDA) in liver and kidney homogenate; activities of alamine aminotransferase (ALT) and aspertate aminotransferase (AST), and levels of urea nitrogen (BUN), creatinine (CRE), total cholesterol (TC), albumin (ALB), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein choles-terol (LDL-C) and very low-density lipoprotein cholesterol (VLDL-C) in serum.

Results

Results showed that the activities of SOD, GSH-Px and CAT were significantly increased, the MDA contents remarkably reduced, and the values of ALT, AST, BUN, CRE, TC, LDL-C and HDL-C observably mitigated in the liver, kidneys and serum of diabetic mice by these three polysaccharides treatment. Biochemical and histopathological analyses also showed that MZPS could alleviate liver and kidneys injury.

Conclusion

These results demonstrated that Ac-, Al-, and En-MZPS possessed potent antioxidant activities, and could be used as a potentially functional food for the prevention of diabetes and its complications induced by STZ.

     

Analysis of CD8+ Treg cells in patients with ovarian cancer: a possible mechanism for immune impairment

Regulatory T (Treg) cells may participate in mediating a suppressive microenvironment that blunts successful anti-tumor immunotherapy. Recent studies show that CD8⁺ Treg cells might impede effective immune responses to established tumors. However, there is limited research regarding CD8⁺ Treg cells in ovarian cancer (OC) patients. Here, we investigated CD8⁺ Treg cells in OC patients and their in vitro induction. The immunohistochemistry of tumor-infiltrating lymphocytes revealed a significant correlation between the intratumoral CD8⁺ T cells and the forkhead box p3 (Foxp3)⁺ cells in the intraepithelial and stromal areas of advanced OC tissues. We examined the expression of Treg markers in CD8⁺ T cells from the peripheral blood and fresh tumor tissues of OC patients using flow cytometry. Our results indicated an increase in the CD8⁺ Treg cell subsets of OC patients compared with those in patients with benign ovarian tumors and healthy controls, including an increased expression of CD25, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), and Foxp3 and decreased CD28 expression. To demonstrate whether the tumor microenvironment could convert CD8⁺ effector T cells into suppressor cells, we used an in vitro transwell culturing system. Compared with the CD8⁺ T cells cultured alone, the CD8⁺ Treg cells induced in vitro by coculture with SK-OV-3/A2780 showed increased CTLA-4 and Foxp3 expression and decreased CD28 expression. In addition, the in vitro-induced CD8⁺ Treg cells inhibited naïve CD4⁺ T-cell proliferation, which was partially mediated through TGF-β1 and IFN-γ. Our study suggests that CD8⁺ Treg cells were increased in OC patients and could be induced in vitro, which may be the way that tumors limit antitumor immunity and evade immune surveillance.     

Nasopharyngeal cancer-derived microRNA-21 promotes immune suppressive B cells

The prevalence of nasopharyngeal cancer (NPC) is high in the southern area of China and some other districts in the world. The pathogenesis of NPC is unclear. It is reported that some microRNAs (miR) are involved in the progression of NPC. This study aims to investigate the role of miR-21 in the induction of immune tolerance of NPC. In this study, NPC tissue was collected from patients with NPC. Assessment of miR was performed with real time quantitative RT-PCR. Western blotting was used to assess proteins of interleukin 10 and nuclear factor I-A (NFI-A). Immune cells were analyzed by flow cytometry. The results showed that NPC cell line C666-1 and surgically removed NPC tissue expressed miR-21, which was upregulated by the presence of the Toll-like receptor 3 ligand, Poly I: C. Exposure to miR-21 increased the expression of NFI-A and interleukin (IL)-10 in naive B cells. High frequency of IL-10⁺ B cells was detected in the NPC tissue. The NPC- or miR-21-primed B cells suppressed cytotoxic CD8⁺ T cell activities. We conclude that NPC-derived miR-21 induces IL-10⁺ B cells; the latter is capable of suppressing CD8⁺ T-cell activities. miR-21 may be a potential target in the treatment of NPC.     

Reversal of B-cell hyperactivation and functional impairment is associated with HBsAg seroconversion in chronic hepatitis B patients

B cells play an important role in the clearance of hepatitis B virus (HBV) and protection against reinfection. However, the functional characteristics of these cells that are associated with the outcome of chronic HBV infection remain unknown. We comprehensively investigated the frequency, phenotype, and function of peripheral B-cell subsets from CHB patients in different phases: immune tolerance (IT), immune activation (IA), immune clearance (IC), responders with HBsAg seroconversion (resolved patients, RP), and healthy controls (HC). IA patients displayed lower percentages of peripheral blood memory B cells compared with the other groups. Overall polyclonal activation of B cells, indicated by higher levels of activation markers and secretion of IgG and IgM, was observed in IA patients. This B-cell hyperactivation could be induced by increased IFN-α and soluble CD40 ligands in IA patients. Notably, the expression of the co-stimulator molecule CD80 and serum HBsAb and the frequency of HBsAg-specific B cells were significantly decreased in IT, IA, and IC patients compared with HC subjects. More importantly, the B-cell hyperactivation, co-stimulatory molecule downregulation and HBsAg-specific B-cell impairment were reversed in RP patients. The reversal of B-cell hyperactivation and functional impairment is associated with HBsAg seroconversion in chronic hepatitis B patients.     

肿瘤标志物检测在良恶性胸腹水鉴别价值研究

目的 研究肿瘤标志物在良恶性胸腹水的临床鉴别价值.方法 169例恶性胸腹水患者设为恶性腹水组,146例良性胸腹水设为良性组,比较两组胸腹水癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原(CA) 125、CA19-9水平,并对各肿瘤标志物对良恶性胸腹水的诊断进行方法学评价.结果 恶性组的CEA为(139.7-±56.4) ng/mL、AFP为(189.2±45.2) ng/mL、CA125为(314.7±86.2) U/mL、CA19-9为(158.5±24.2) U/mL,浓度均高于良性组,差异有统计学意义(均P＜0.05);ROC曲线分析CEA、AFP、CA125以及CA19-9曲线下面积分别为0.811、0.547、0.715和0.769,其对应的诊断切点分别为5.6 ng/mL、63.7 ng/mL、38.9 U/mL和30.4 U/mL;AFP因ROC曲线下面积过低不适于恶性胸腹水的诊断.三种肿瘤标志物单独检测方法学评价的各项指标均以CEA最好,灵敏度为75.7％,特异度为88.6％,联合检测以CEA、CA125以及CA19-9的联合检测效果较好,灵敏度为80.5％,特异度为94.0％.结论 肿瘤标志物联合检测对胸腹水的性质鉴别方面有重要的临床应用价值.