Thursday, February 11, 2021

Expression of silent information regulator 1 in chronic rhinosinusitis and regulatory effects of inflammatory factors.

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Expression of silent information regulator 1 in chronic rhinosinusitis and regulatory effects of inflammatory factors.

Int J Clin Exp Pathol. 2021;14(2):170-178

Authors: Gong J, Qi W, Wang W

Abstract
We aimed to investigate the expression of silent information regulator 1 (Sirt1) in chronic rhinosinusitis (CRS) and the regulatory effects of inflammatory factors. The mucosal epithelial tissues of the nasal ethmoid sinus were collected from 30 patients with CRS from March 2017 to March 2019, and tissues from patients undergoing functional rhinoplasty were included as a control group. H&E staining and immunohistochemistry were performed to detect the histopathologic changes in the nasal mucosa and the expression of Sirt1. Epithelial cells in the control group were extracted from the ethmoid sinus mucosa and cultured in vitro. After the cells were treated with 0, 1, 10, and 100 ng/mL interleukin-5 (IL-5) and interferon-gamma (IFN-γ) for 24 h, qRT-PCR and western blotting were carried out to detect the mRNA and protein expressions of Sirt1. Nasal mucosal tissues of the control group were complete in structure, whereas large quantities of inflammatory cells infiltrated in nasal mucosa of the CRS group. Compared with the control group, the CRS group had significantly decreased protein and mRNA expression levels of Sirt1 (P<0.05), which significantly declined with increasing concentrations of IL-5 and IFN-γ (P<0.05). Thus, expression of Sirt1 in the nasal mucosa tissues of CRS patients is decreased, and inflammatory factors can reduce such expression in a dose-dependent manner. Sirt1 may participate in the inflammatory stress process of CRS.

PMID: 33564349 [PubMed]

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Osteoclast-like giant cell undifferentiated carcinoma of the pancreas: a case report.

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Osteoclast-like giant cell undifferentiated carcinoma of the pancreas: a case report.

Int J Clin Exp Pathol. 2021;14(2):179-185

Authors: Jiang J, Luo J

Abstract
The objective was to investigate the diagnosis and related clinical criteria of undifferentiated carcinoma of the pancreas with osteoid giant cells, and to analyze its treatment and prognosis. we report a case of this disease in a A 62 year old male, who had upper left abdominal pain for more than 10 days, had pain that was aggravated 1 day prior to visit. The pancreas showed a mass with volume 10 cm × 8 cm × 6 cm. On cut section, the mass was fish-fleshy like and necrotic with hemorrhage, and had a close relationship to the residual pancreatic tail. Microscopically, tumor was clearly found around osteoclastic giant cells, and tumor cells invaded the colon and spleen. This is a rare pancreatic tumor with no specific clinical manifestation or serologic marker, composed of undifferentiated osteoid giant cells. Rarely, patients may havelymph node metastasis. The diagnosis should rely on imaging data such as CT and MRI combined with immunohistochemistry. The treatment can be su rgical resection, but the prognosis is poor.

PMID: 33564350 [PubMed]

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Effect of the orientation of microskin on the survival rate of transplantation and improving the method.

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Effect of the orientation of microskin on the survival rate of transplantation and improving the method.

Int J Clin Exp Pathol. 2021;14(2):186-195

Authors: Zheng X, Li X, Chen T, Chang F, Ji S, Hu X, Xiao S

Abstract
The direction of microskin transplantation is difficult to control, and the survival rate is critically affected. In this study, we show for the first time that survival rate of transplantation was improved by changing the direction of microskin. A human split-thickness skin graft was prepared as microskin (size of 1 mm × 1 mm), and was transplanted onto a wound in nude mice. The effect of the orientation of microskin on the survival rate of transplants was observed. The collagen membrane was first attached to the epidermal surface of pig skin, which was then cut into microskin and then they were floated on physiological saline. The effect of the collagen membrane on the orientation of microskin was observed. Then the microskin of pig with an epidermal surface attached to the collagen membrane was transplanted to the wound of the pig, and the survival rate of transplants was observed. In the 2nd, 3rd and 4th week after transplantation of nude mice, the wound healing rate in group A (all of the microskin's epidermal surface was upward) was significantly higher than in other groups (P < 0.01). The floating rate and the forward floating rate in the experimental group were significantly higher than those in the control group (P < 0.01). Four weeks after microskin transplantation of pigs, the wound contraction rate in group A, compared with group B, was significantly lower, and the wound healing rate was significantly higher (P < 0.01). In microskin grafting, the direction of microskin significantly affects the survival rate of transplantation. The method of adhering the collagen membrane to the epidermal surface of microskin may ensure complete floating of microskin on the physiological saline with the epidermal surface facing up. This is a new method to improve the survival rate of microskin grafting.

PMID: 33564351 [PubMed]

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Integrated bioinformatic analysis identifies COL4A3, COL4A4, and KCNJ1 as key biomarkers in Wilms tumor.

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Integrated bioinformatic analysis identifies COL4A3, COL4A4, and KCNJ1 as key biomarkers in Wilms tumor.

Int J Clin Exp Pathol. 2021;14(2):196-208

Authors: Guo C, Jiang X, Guo J, Wu Y, Bao G

Abstract
Wilms tumor (WT) is one of the most common pediatric solid tumors, affecting 1 in 10,000 children, worldwide. A subset of WT patients has poor prognosis, which is associated with a high risk of advanced and/or recurrent disease. Therefore, candidate markers are urgently needed for the diagnosis and effective treatment of WT. We evaluated three mRNA microarray datasets to identify the differences between normal kidney tissue and WT tissue. Gene expression profiling revealed 130 differentially expressed genes (DEGs). Enrichment analysis and gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were performed for the DEGs. Subsequently, we established a protein-protein interaction (PPI) network to reveal the associations among the DEGs and selected 10 hub genes, all of which were downregulated in WT. The expression of COL4A3, COL4A4, KCNJ1, MME, and SLC12A1 in WT tissues was significantly lower than that in normal renal tissues. Survival analyses using the Kaplan-Meier method showed that patients with WT and low expression of COL4A3, COL4A4, and KCNJ1 exhibited remarkably poor overall survival. The correlations among COL4A3, COL4A4, and KCNJ1 in WT were analyzed using cBioPortal; COL4A3, COL4A4, and KCNJ1 were positively correlated with each other. Thus, these genes were considered clinically significant and might therefore play important roles in carcinogenesis and the development of WT.

PMID: 33564352 [PubMed]

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Early changes of NLRP3 inflammasome activation after hypoxic-ischemic brain injury in neonatal rats.

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Early changes of NLRP3 inflammasome activation after hypoxic-ischemic brain injury in neonatal rats.

Int J Clin Exp Pathol. 2021;14(2):209-220

Authors: Li N, Liu C, Wang C, Chen R, Li X, Wang Y, Wang C

Abstract
The pathogenesis of neonatal hypoxic-ischemic (HI) brain injury may involve activation of the NOD-like receptor family pyrin domain-containing-3 (NLRP3) inflammasome and its downstream effectors, caspase-1 and interleukin (IL)-1β. The start time of therapy is associated with adverse neurodevelopmental outcome following HI injury. We performed this study investigating early dynamic changes in NLRP3, caspase-1, and IL-1β expression during the first 24 h following HI brain injury in an animal model, in order to optimize selection of treatment time after injury. Rats were randomized to an HI group (n=40) and sham group (n=40). Rats in the HI group were subjected to right common carotid artery ligation and then exposed to hypoxia (8% O2) for 2 h, and divided into 5 subgroups with 8 cases in each group at 5 postoperative time points (0, 4, 8, 12, 24 h). Brain injury during the first 24 h after surgery/hypoxia was evaluated by cranial ultrasonography. RT-PCR, western blot, and imm unohistochemistry were applied to determine protein and mRNA expressions. In the HI group, ultrasonography revealed accelerated right vertebrobasilar artery flow at 4 h, enhanced brain parenchyma echogenicity at 24 h, and blood stealing from the vertebrobasilar artery at 24 h. In the HI group, immunohistochemistry demonstrated elevated expressions of NLRP3 and IL-1β at 4, 8, 12, and 24 h and enhanced expression of caspase-1 at 8 and 12 h (all P < 0.01). Western blot and RT-PCR revealed that, compared with the sham group, the HI group exhibited elevated expression of NLRP3 at 4, 8, and 24 h, caspase-1 at 12 h, and IL-1β at 8 h (all P < 0.05). In summary, the present results suggested that activation of NLRP3/caspase-1/IL-1β signaling occurs within 4 h of HI brain injury in the neonatal rat.

PMID: 33564353 [PubMed]

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Insulin on changes in expressions of aquaporin-1, aquaporin-5, and aquaporin-8 in submandibular salivary glands of rats with Streptozotocin-induced diabetes.

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Insulin on changes in expressions of aquaporin-1, aquaporin-5, and aquaporin-8 in submandibular salivary glands of rats with Streptozotocin-induced diabetes.

Int J Clin Exp Pathol. 2021;14(2):221-229

Authors: Cui F, Hu M, Li R, Li B, Huang D, Ma W, Jia X, Lv Z

Abstract
OBJECTIVE: This study aimed to explore the relationship between diabetic xerostomia and changes in aquaporin-1 (AQP1), aquaporin-5 (AQP5), and aquaporin-8 (AQP8) expression in the submandibular glands (SMGs), to further study the pathogenesis of diabetic xerostomia and to observe the therapeutic effect of insulin (INS).
METHODS: Thirty SD rats were randomized equally into 3 groups: control group, diabetic model (DM) group and insulin (INS) group (n=10, respectively). The control group received no treatment. DM group and INS group were induced by a high-fat diet and streptozotocin intraperitoneal injection. After establishment of a diabetic rat model, the rats in INS group were treated with insulin. Then all rats were fed continuously with ordinary diet for 2 months. H&E staining was used to describe morphologic changes in the SMGs of rats. Immunohistochemistry was used to analyze the expressions and localization of AQP1, AQP5, and AQP8 in the SMGs. Computer image analysis was used to detect the mean optical density (MOD) values of AQP1, AQP5, and AQP8 expression, and changes in the diameters of acini and ducts.
RESULTS: The acini were mildly atrophied and the acinar cells were rearranged in an irregular way. The morphology of insulin-administered diabetic SMGs was similar to that of the control group. The acinar average circumference and GCT average diameter in DM group were significantly reduced (P<0.05). The acinar average circumference and GCT average diameter of INS group were significantly increased (P<0.05). The expressions of AQP1, AQP5, and AQP8 were significantly reduced in DM group (P<0.05). The expressions of AQP1, AQP5, and AQP8 in INS group were significantly increased (P<0.05).
CONCLUSION: The decreased expressions of AQP1, AQP5, and AQP8 led to decreased salivary secretion of SMGs in diabetic rats, which may be involved in the pathogenesis of diabetic xerostomia. Insulin could up-regulate the expressions of AQP1, AQP5 and AQP8, and play a protective role in the secretory function of diabetic SMGs.

PMID: 33564354 [PubMed]

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Primary pulmonary myxoid sarcoma

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Primary pulmonary myxoid sarcoma: report of one case and literature review.

Int J Clin Exp Pathol. 2021;14(2):230-237

Authors: Wu Y, Luo Y, Gong Y, Yang R, Ding L, Guo B

Abstract
BACKGROUND: Primary pulmonary sarcoma is extremely rare and mostly metastatic, and primary pulmonary myxoid sarcoma PPMS is a rare low-grade malignant sarcoma. The clinical manifestations of PPMS patients are relatively non-specific, sometimes found by physical examination. We report a case designed to explore the clinicopathologic features, diagnosis, and differential diagnosis of primary pulmonary myxoid sarcoma (PPMS). A 44-year-old man was found to have a primary myxoid sarcoma in the upper right lung on physical examination. The patient did not have any symptoms of discomfort. Histologically, the tumors had well-defined borders, and with grayish-white or grayish red cut surfaces. Under the microscope, the tumor cells were composed of oval and spindle cells arranged in a network or strips in a mucus-like stroma. Immunohistochemically, neoplastic cells showed diffuse and strong vimentin expression and focal weak EMA, and Bcl-6 staining. The expression of AE1/AE3, ALK, CD34 , CD68, SMA, and CD99 were all negative. The Ki-67 index was low.
CONCLUSION: PPMS is a rare low-grade malignant primary pulmonary sarcoma without characteristic clinical symptoms and difficult to diagnose. It is mainly diagnosed by immunohistochemistry and genetic testing.

PMID: 33564355 [PubMed]

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Diagnostic value of beclin-1 and mTOR in ovarian cancer.

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Diagnostic value of beclin-1 and mTOR in ovarian cancer.

Int J Clin Exp Pathol. 2021;14(2):238-246

Authors: Lu H, Hu H, Li S

Abstract
This study described the expression of beclin-1 and mTOR proteins in 86 ovarian tumor tissue samples (n=25 benign ovarian tumor tissues; n=16 borderline ovarian tumor tissues; n=45 malignant epithelial ovarian tumor tissues) and 20 normal ovarian tissue samples and determined the diagnostic value of serum beclin-1 and mTOR protein levels for ovarian tumors. Serum and tissue beclin-1 and mTOR protein levels were detected with enzyme-linked immunosorbent assay, western blot, and immunohistochemistry. Receiver operating characteristic (ROC) curves were constructed to determine the significance of serum beclin-1 and mTOR protein levels for diagnosing borderline and malignant epithelial ovarian tumor. Mean beclin-1 protein levels were highest in normal ovarian tissue and were progressively decreased in benign, borderline, and malignant epithelial ovarian tumor. Mean mTOR protein levels were lowest in normal ovarian tissue and were progressively increased in benign, borderline, and malignant epithelial ovarian tumor. The area under the ROC curve was 0.93 or 0.97 when a combination of serum beclin-1 and mTOR protein levels was used to diagnose borderline or malignant epithelial ovarian tumor. There was a significant negative correlation between beclin-1 and mTOR protein expression in malignant epithelial ovarian tumor (rs=-0.78, P<0.05), but no correlation between beclin-1 and mTOR protein expression in borderline ovarian tumor. Combined detection of serum beclin-1 and mTOR protein levels may have improved diagnostic accuracy for malignant epithelial ovarian tumor compared to each marker alone.

PMID: 33564356 [PubMed]

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Fibrous dysplasia mimicking bone metastasis in nasopharyngeal carcinoma

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Fibrous dysplasia mimicking bone metastasis in nasopharyngeal carcinoma: a case report and literature review.

Int J Clin Exp Pathol. 2021;14(2):247-251

Authors: Xiong Y, Shi L, Peng G

Abstract
Fibrous dysplasia of bone (FDB) is a rare bone disease that may be misdiagnosed as bone metastasis in terms of some symptoms and imaging features. Therefore, the differential diagnosis between FDB and bone metastasis may be a challenge. To our knowledge, there are no reports in the literature to date regarding concomitant nasopharyngeal carcinoma (NPC) with FDB. The aim of this study was to report the case of a NPC patient with FDB, to highlight correct diagnosis and treatment. A 28-year-old young woman was investigated for accidental nasal bleeding. A mass on the right neck and local pain on right femur, and she was submitted to a standard imaging examination suggesting the presence of a solitary right femur metastasis from NPC. Then the patient was submitted to four cycles of chemotherapy, with a partial response (PR) for the mass in neck but no change in the bone metastasis. Because the bone lesion was single, pathologic biopsy was taken to confirm diagnosis. Surprisingly, it was a FDB instead of tumor. At five-year follow-up, she is free of recurrent disease. In this case, we believe that although NPC with FDB is rare, it should not be omitted when bone metastasis is suspected, especially when the metastasis is solitary, because it is crucial for diagnostic staging and treatment choice.

PMID: 33564357 [PubMed]

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Pyogenic liver abscess

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Retrospective study of characteristics and management of pyogenic liver abscess during 5 years' experience.

Int J Clin Exp Pathol. 2021;14(2):252-260

Authors: Zhou Y, Lu G, Bai Y, Bao Y, Xu J

Abstract
Pyogenic liver abscess is a life-threatening disease. It is urgent to review the clinical patterns, risk factors, and management of the disease in order to improve the outcome. We retrospectively analyzed 70 cases of pyogenic liver abscess diagnosed and treated at Shanghai Ninth People's Hospital over five years, including the clinical features, management, and outcome. The average age was 63.06 ± 12.33 y. 71.4% (50/70) were males. 85.7% (60/70) patients presented with fever. The major abnormalities in laboratory were increased CRP and liver dysfunction. 77.8% (14/18) pus cultures came with positive reports, while 26.5% (9/34) blood cultures were positive. K. pneumoniae was the predominant pathogen both in blood (66.7%, 6/9) and pus (64.3%, 9/14) cultures. 42.9% (30/70) patients also had diabetes. Patients with diabetes presented with significantly larger size of abscess (P = 0.014) and were more susceptible to K. pneumoniae infection (P = 0.002). We revealed HbA1c (P = 0.04 7), accompanying malignancy (P = 0.030), and septic shock (P = 0.045) were three independent risk factors for PLA. In conclusion: pyrogenic liver abscess was atypical; microbiologic positivity of pus culture was higher than that of blood culture; K. pneumoniae was the predominant pathogen in pyrogenic liver abscesses, especially in patients with diabetes; and patients with hyperglycemia had poor outcome.

PMID: 33564358 [PubMed]

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Gastritis cystica profunda

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Gastritis cystica profunda: clinical and pathologic study of seven cases and review of literature.

Int J Clin Exp Pathol. 2021;14(2):261-266

Authors: Li C, Song S, Wu G, Zhang Z

Abstract
Gastritis cystica profunda (GCP) is a rare lesion characterized by hyperplasia and cystic dilatation of the gastric glands in the submucosal layer. Here we report seven cases of GCP. The patients are 5 women and 2 men with a mean age of 62 (range, 42-82) years at the time of diagnosis. The patients presented with abdominal distension, sour regurgitation, and heartburn. One case had the previous gastric surgery and the other six cases had no special history. The lesions were located in the fundus (4/7), corpus (1/7), cardia (1/7), and antrum (1/7). Endoscopic analysis revealed pedunculated polyps, or a dome-shaped polyp. Histologically, all cases showed dilated tubular glands, mainly located in the submucosa, among the muscularis mucosa, and occasionally in the lamina propria. The glands were lined by bland single columnar epithelium with infolding features in some areas. Mitotic activity and marked cellular atypia were not present. The stroma in some cases was mildly edematou s with infiltrated lymphocytes and plasma cells. There was no epithelial dysplasia in the overlying mucosa. Immunohistochemically, the Ki-67 index was < 1%. P53 immunostaining was generally characterized as wild type in all cases. Based on the morphology of the glands and the cells and the possible mechanism of hyperplasia and cystic dilatation of the gastric glands, it is easy to differentiate GCP from a well-differentiated adenocarcinoma.

PMID: 33564359 [PubMed]

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