Liver transplantation for a giant mesenchymal hamartoma of the liver in an adult: Case report and review of the literature

Mesenchymal hamartomas of the liver(MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography(CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen includedintraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg(dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.     

补阳还五汤生物碱有效部位对人脐血干细胞体外增殖的影响

背景：研究表明补阳还五汤对各种细胞均有保护作用,但机制尚不清楚,有研究推测是它的生物碱有效部位起作用。 目的：观察补阳还五汤生物碱有效部位对人脐血干细胞体外增殖的影响。 方法：获取临床健康产妇的新鲜脐血,制备人脐血干细胞悬液,将纯化的人脐血干细胞接种于40个培养皿中进行传代。分组：川芎嗪组给予100 g/L川芎嗪,阿魏酸组给予50 g/L阿魏酸,生物碱有效部位组(川芎嗪+阿魏酸组)给予100 g/L川芎嗪+ 50 g/L阿魏酸;对照组：继续用含体积分数为20%小牛血清的DMEM培养液培养。培养2,4,6,8,10 d观察人脐血干细胞增殖情况;24,72 h后流式细胞仪测定S期细胞的比例,培养10 d后电流钳模式记录细胞静息膜电位变化。 结果与结论：川芎嗪组和阿魏酸组人脐血干细胞的增殖作用不明显,培养10 d时生物碱有效部位组细胞增殖情况明显高于川芎嗪组、阿魏酸组和对照组(P < 0.01)。生物碱有效部位组在培养24,72 h后处于S期的人脐血干细胞明显增多;川芎嗪+阿魏酸组细胞静息膜电位高于川芎嗪组、阿魏酸组和对照组(P < 0.01)。提示补阳还五汤生物碱有效部位能促进人脐血干细胞的体外增殖。     

股骨近端结构测量指导髋部骨折术前方案

背景：髋部骨折在临床上很常见,治疗后常有骨质疏松和深静脉血栓形成等多种并发症,因此需要制定细致的治疗前计划。 目的：对老年女性患者股骨近端结构进行测量,以帮助制定髋部骨折术前计划。 方法：纳入2010年1月至2012年5月于福建医科大学附属第二医院就诊的临床需要拍骨盆平片的50岁或以上女性患者204例,应用实达易联众医用后处理软件对患者骨盆平片上股骨颈轴长、股骨颈中段宽度、股骨颈中段髓腔宽度、颈干角及髓腔闪烁指数进行测量。有股骨颈骨折的患者测量健侧,并依据患者的年龄进行分层分析。 结果与结论：髋部平片测量结果显示,老年女性患者股骨颈轴长(97.14±6.16) mm,股骨颈中段宽度(33.76±3.03) mm,股骨颈中段髓腔宽度(28.28±3.48) mm,颈干角(127.05±3.43)°;髓腔闪烁指数为(3.50±0.55)。分层分析结果显示,随着患者年龄的增大,髓腔闪烁指数逐渐减小,且股骨颈骨折患者明显小于非股骨颈骨折患者(P < 0.01)。股骨近端结构测量有助于制定髋部骨折术前计划,选择内固定安放的最佳位置,根据髓腔闪烁指数有助于选择合适的股骨假体。     

Accuracy of early detection of colorectal tumours using stool methylation markers: A meta-analysis

AIM: To evaluate the accuracy of methylation of genes in stool samples for diagnosing colorectal tumours. METHODS: Electronic databases including PubMed, Web of Science, Chinese Journal Full Text Database and Wanfang Journals Full-text Database were searched to find relevant original articles about methylated genes used in diagnosing colorectal tumours. Quality assessment of diagnostic accuracy studies items were used to evaluate the quality of the included articles, and the Meta-disc 1.4 and SPSS 13.0 software programs were used for data analysis. RESULTS: Thirty-four articles met the inclusion criteria, and 4151 patients were included. Pooled diagnostic performances of SFRP2 methylation for colorectal cancer (CRC) provided the following results: the sensitivity was 79% (95%CI: 75%-82%), the specificity was 93% (95%CI: 90%-96%), the diagnostic odds ratio (DOR) was 47.57 (95%CI: 20.08-112.72), and the area under the curve was 0.9565. Additionally, the results of accuracy of SFRP2 methylation for detecting colorectal adenomas were as follows: the sensitivity was 43% (95%CI: 38%-49%), the specificity was 94% (95%CI: 91%-97%), the DOR was 11.06 (95%CI: 5.77-21.18), and the area under the curve was 0.9563. CONCLUSION: Stool-based DNA testing may be useful for non-invasively diagnosing colorectal tumours, and SFRP2 methylation is a promising marker that has great potential in early CRC diagnosis.     

Gastric hepatoid adenocarcinoma: A computed tomography report of six cases

We describe the computed tomography (CT) imaging findings in six cases (five males and one female; age range 61-78 years; mean age 67.3 years) with histologically proven hepatoid adenocarcinoma of the stomach (HAS). Five of the six patients had elevated serum alpha-fetoprotein levels. The most common type of gross appearance HAS on CT is a polypoid mass (83%, 5/6). The most common contrast enhancement pattern was heterogeneous. All six patients had a regional lymphadenopathy larger than 6 mm in its short axis. Liver metastases (n = 3) were noted. Venous tumor thrombosis was identified in the portal vein (n = 2) of the regions near primary gastric tumors or metastatic masses. Our findings suggest in an elderly, male patients with a large heterogeneous enhancement tumor, the presence of distant metastases, regional lymphadenopathy and characteristically increased serum alpha-fetoprotein levels indicates a high likelihood of HAS.     

急性淋巴细胞白血病患儿MTHFR基因多态性与大剂量甲氨蝶呤毒副反应的关系

目的：探讨亚甲基四氢叶酸还原酶（MTHFR）基因单核苷酸多态性对急性淋巴细胞白血病（ALL）患儿使用大剂量甲氨蝶呤（HD-MTX）化疗后毒副反应的影响。方法：应用RT-PCR-变性梯度凝胶电泳结合DNA测序技术,对52例ALL患儿MTHFR C677T、A1298C和G1793A基因型进行检测。按照国立癌症研究所常规毒性判定标准（NCI-CTC）对患儿HD-MTX化疗后的不良反应统一评价。结果：MTHFR 1298AC基因型患儿发生血小板减少的风险较AA型提高了13.7倍（OR=13.7,95%CI=1.18～159.36,P=0.036）。MTHFR C677T和G1793A各基因型发生各类HD-MTX化疗不良反应的差异无统计学意义（P>0.05）。结论：MTHFR A1298C多态性可能与ALL患儿HD-MTX化疗后的毒副反应相关。     

Double-stranded RNA-specific adenosine deaminase-knockdown inhibits the proliferation and induces apoptosis of DU145 and PC3 cells by promoting the phosphorylation of H2A.X variant histone

Double-stranded RNA-specific adenosine deaminase (ADAR1) is a member of the adenosine deaminases acting on RNA family that catalyze the adenosine-to-inosine editing of double-stranded RNA substrates. Several studies have reported that ADAR1 is closely associated with numerous malignancies. However, the functional roles of ADAR1 in prostate cancer (PCa) have not been fully elucidated. Thus, the present study aimed to investigate the effects of ADAR1 on PCa. The results demonstrated that ADAR1 was highly expressed in PCa tissues compared with normal tissues. Furthermore, the protein expression level of ADAR1 was significantly increased in castration-resistant PCa (CRPCa) tissues and CRPCa cell lines. Thus, these findings indicated that ADAR1 may act as a tumor promoter for PCa development. Next, the potential effects of ADAR1-knockdown on the proliferation of DU145 and PC3 cells were investigated. ADAR1 was knocked down via small interfering RNA transfection, which was found to exert antitumor effects on DU145 and PC3 cells at 24 and 48 h post transfection. Furthermore, a significant positive association was observed between ADAR1-knockdown and the apoptosis of DU145 and PC3 cells, which increased the phosphorylation of H2A.X variant histone. The results of the present study indicated a positive association between ADAR1 expression and PCa, which may promote the development of CRPCa. Moreover, ADAR1-knockdown may serve as a tumor suppressor and represent a potential target for the treatment of PCa.     

Reduced telomere length in colorectal carcinomas

Purpose: Telomeres play a key role in the maintenance of chromosome integrity and stability, and telomere shortening is involved in initiation and progression of malignancies. The aim of this study was to determine whether telomere length is associated with the colorectal carcinoma. Patients and methods: A total of 148 colorectal cancer (CRC) samples and corresponding adjacent non-cancerous tissues were evaluated for telomere length, P53 mutation, and cyclooxygenase-2 (COX-2) mutation detected by fluorescent immunohistochemistry. Telomere length was estimated by real-time PCR. Samples with a T/S>1.0 have an average telomere length greater than that of the standard DNA; samples with a T/S<1.0 have an average telomere length shorter than that of the standard DNA. Results: Telomeres were shorter in CRCs than in adjacent tissues, regardless of tumor stage and grade, site, or genetic alterations (P=0.004). Telomere length in CRCs also had differences with COX-2 status (P=0.004), but did not differ with P53 status (P=0.101), tumor progression (P=0.244), gender (P=0.542), and metastasis (P=0.488). There was no clear trend between T/S optimal cut-off values (<1 or > 1) and colorectal tumor progression, metastasis, gender, P53 and COX-2 status. Conclusion: These findings suggesting that telomere shortening is associated with colorectal carcinogenesis but does not differ with tumor progression, gender, and metastasis.     

Serum miR-21 expression in human esophageal squamous cell carcinomas

To investigate the relationship between serum miRNA-21 (miR-21) expression in esophageal squamous cell carcinomas (ESCCs) and their clinicopathologic features, a 1:1 matched case-control study including 21 patients with ESCC and 21 age- and gender-matched healthy controls was carried out. Serum specimens were taken from all subjects. Total RNA was extracted and the stem-loop real time polymerase chain reaction was used to measure serum miR-21 in both groups. Clinical parameters were assessed to determine associations with serum miR-21 concentrations. Serum miR-21 expression in ESCC samples was significantly higher than in paired cancer-free samples (P <0.05). Metastasis was associated with mir-21 expression in serum (P <0.05), ESCC patients with metastasis having 8.4-fold higher serum miR-21 concentrations than healthy controls. There were no statistically significant associations between miR-21 expression and clinicopathologic parameters, such as gender (P >0.05), age (P >0.05), tumor location (P >0.05), cell differentiation (P >0.05), TNM staging (P >0.05), whether chemo/radiotherapy had been administered (P >0.05), or whether surgery had been performed (P >0.05). These findings suggest that the detection of microRNA-21 in serum might serve as a new tumor biomarker in diagnosis and assessment of prognosis of ESCCs.