Letter to editor ‘Gastroenteropathy in gastric cancer patients concurrent with diabetes mellitus’

The present letter to the editor is related to the study titled “Diabetic gastroenteropathy: An underdiagnosed complication”. Diabetic gastroenteropathy contributes to a decline in quality of life. In addition, gastroenteropathy is generally observed in patients with concurrent gastric cancer and diabetes mellitus before surgery, and the occurrence of the symptoms might be due not only to cancer but also to the complications of diabetes mellitus.     

阑尾杯状细胞腺癌临床病理学观察

目的探讨阑尾杯状细胞腺癌(goblet cell adenocarcinomas,GCA)的临床病理学特征及免疫表型特征,分析其生物学行为。方法收集北京大学第一医院2015—2018年诊断的7例GCA的临床资料,进行形态学观察,按照2019年WHO消化系统肿瘤分类第5版重新分级,并行免疫组织化学EnVision法染色及电镜观察,随访患者并复习相关文献。结果7例患者中男性2例,女性5例;年龄48~72岁,中位年龄58岁。1例为阑尾游离端出现局限性肿物,切面灰白实性,质地中等;其余6例阑尾弥漫增粗;镜下观察均可见低级别GCA,5例同时伴有高级别GCA,3例分级为1级,3例分级为2级及1例分级为3级。6例可见神经侵犯,1例可见脉管癌栓。免疫组织化学染色嗜铬粒素A、突触素、CD56、广谱细胞角蛋白、癌胚抗原、细胞角蛋白20、MLH1、MSH2、MSH6和PMS2均阳性,Ki-67阳性指数5%~50%,p53在高级别GCA的表达强度及阳性细胞数高于低级别GCA。随访14~46个月,6例患者生存,1例患者死亡。结论GCA为阑尾较少见的肿瘤,同时具有神经内分泌及腺上皮的分化,生物学行为从惰性到高度侵袭性均可。     

H3.3 K36M突变蛋白表达在软骨母细胞瘤诊断及鉴别诊断中的价值

目的探讨组蛋白H3.3的36位赖氨酸至甲硫氨酸(K36M)突变蛋白表达在软骨母细胞瘤中的诊断及鉴别诊断价值。方法收集2016年1月至2019年12月就诊于北京积水潭医院的软骨母细胞瘤及其他骨肿瘤病例,光镜观察并结合临床影像学明确诊断。EnVision法免疫组织化学检测H3.3 K36M突变蛋白的表达。结果骨肿瘤共计196例:软骨母细胞瘤68例(包括6例复发病例),骨巨细胞瘤59例,内生软骨瘤9例,透明细胞软骨肉瘤3例,软骨肉瘤Ⅰ级9例,软骨肉瘤Ⅱ级9例,软骨肉瘤Ⅲ级2例,去分化软骨肉瘤11例,软骨黏液样纤维瘤6例,动脉瘤样骨囊肿9例,非骨化性纤维瘤9例,成软骨为主型骨肉瘤2例。免疫组织化学显示95.6%(65/68)的软骨母细胞瘤呈H3.3 K36M突变蛋白阳性表达,其余128例皆为阴性。诊断的灵敏度为95.6%,特异度为100.0%。结论免疫组织化学H3.3 K36M突变蛋白检测在软骨母细胞瘤中显示较高的特异度和灵敏度,在临床实践中具有较高的诊断及鉴别诊断价值。     

Air pollution and pregnancy outcomes based on exposure evaluation using a land use regression model: A systematic review

This review systematically assessed those studies investigating the association between air pollution and birth outcomes using land use regression (LUR) models for exposure assessment. Fifty-four studies were identified which were published between 2007 and 2019. Most of these were conducted in America, Spain and Canada, while only five were conducted in China. One hundred and ninety-seven LUR models were developed for different pollutants. The main pollutants that these studies assessed were NO₂ and PM_2.5, and the main pregnancy outcomes investigated were preterm birth (PTB), small for gestational age (SGA) and birth weight. Studies consistently found that NO₂ exposure during pregnancy was associated with reduced fetal growth and development. The effect of NO₂ on other adverse pregnancy outcomes is unclear. In addition, it was found that increased PM_2.5 (aerodynamic equivalent diameter ≤ 2.5 um) exposure during pregnancy reduced birth weight. The effect of PM_2.5 on other adverse pregnancy outcomes is also unclear. The relationship between other pollutants and adverse pregnancy outcomes is uncertain based on the existing research. Exposure assessment with LUR modeling has been widely used in Europe and North America, but used less in China. Future studies are recommended to use LUR modeling for individual exposure evaluation in China to better characterize the relationship between air pollution and adverse pregnancy outcomes. In addition, further research is required given that a lot of the associations looked at in the review were inconclusive.     

The Influence of Xylazine and Clonidine on Lung Ultrasound–Induced Pulmonary Capillary Hemorrhage in Spontaneously Hypertensive Rats

Induction of pulmonary capillary hemorrhage (PCH) by lung ultrasound (LUS) depends not only on physical exposure parameters but also on physiologic conditions and drug treatment. We studied the influence of xylazine and clonidine on LUS-induced PCH in spontaneously hypertensive and normotensive rats using diagnostic B-mode ultrasound at 7.3 MHz. Using ketamine anesthesia, rats receiving saline, xylazine, or clonidine treatment were tested with different pulse peak rarefactional pressure amplitudes in 5 min exposures. Results with xylazine or clonidine in spontaneously hypertensive rats were not significantly different at the three exposure pulse peak rarefactional pressure amplitudes, and thresholds were lower (2.2 MPa) than with saline (2.6 MPa). Variations in LUS PCH were not correlated with mean systemic blood pressure. Similar to previous findings for dexmedetomidine, the clinical drug clonidine tended to increase susceptibility to LUS PCH.     

微创心脏手术中排气研究

目的探讨微创心脏手术中的排气技术，并评价排气效果。方法选取复旦大学附属中山医院2011年6月至2013年6月收治的56例行微创心脏手术患者为微创组，男31例、女25例，年龄33～7l（57-3±7．2）岁；同期56例行常规胸骨正中切口心脏二尖瓣成形术患者为对照组，男27例、女29例，年龄51～69（53．7±6,8）岁。比较两组患者术后心腔内残留气泡量、心电图异常发生率、术后清醒时间、术后思维能力及脑部并发症发生率等指标。结果微创组心腔内残留气泡量少量占69．6％、中量占30．4％，对照组少量占73．2％、中量占26．8％，两组差异无统计学意义（P〉0．05）。微创组心电图异常发生率与对照组差异无统计学意义（32．1％VS．26．8％，P〉0．05）。微创组术后思维能力评价好85．7％、中12．5％、差1．8％，对照组好78．6％、中19．6％、差1．8％，两组差异无统计学意义（P〉0．05）。两组脑部并发症发生率差异无统计学意义（1．8％vs．1．8％，P〉0．05）。结论采取一系列心脏排气措施可使微创心脏手术的空气栓塞发生率与胸骨正中切口手术相似，在空气栓塞并发症方面无需承担更高的风险。     

The niche of hepatic cancer stem cell and cancer recurrence

Currently, surgical resection is one of only a few options for treating hepatocellular carcinoma (HCC). Unfortunately, postoperative tumor recurrence remains almost inevitable despite additional radiation or chemotherapy treatment following radical resection. Clinical observations and a growing body of experimental evidence have led to speculation that there is a population of persistent hepatic cancer stem cells (HCSCs), which are difficult to completely remove surgically. HCSCs are most often in a quiescent state and thought to reside in a specific microenvironment known as a niche that provides the cues necessary for HCSCs to maintain a balance of self-renewal and differentiation. Residual HCSCs following surgery may alter their fate by invading into the blood circulation. Furthermore, it remains to be determined if hepatectomy render the postoperative niche more favorable for the survival and growth of HCSCs, and therefore the recurrence of HCC. A better understanding of the mechanisms for HCSCs self-renewal, invasion and recurrence may provide new insights into curative strategies for treating HCC.     

脑微出血危险因素及其与认知功能的相关性研究

目的 探讨脑微出血（cerebral microbleeds，CMBs）患者认知功能损害的临床特征及其相关因素。      

Isolation and characterization of polymorphic microsatellite markers from Japanese grenadier anchovy (Coilia nasus)

We isolated and characterized 12 novel polymorphic microsatellite loci for the Japanese grenadier anchovy (Coilia nasus) using the method of PCR-based isolation of microsatellite arrays. Sixteen individuals of C. nasus from Ariake Bay in Japan were genotyped using 24 PCR primers to characterize the polymorphism at each locus. The average number of the observed alleles per locus was 11.08 (ranging from 8 to 20). The observed heterozygosity values ranged from 0.562 to 1.0, and the expected heterozygosity values ranged from 0.647 to 0.969. Only one of the twelve loci deviated significantly from Hardy?CWeinberg equilibrium, and linkage disequilibrium was not found in any pairs of the loci. These markers can be used to investigate the genetic structure of the C. nasus population.