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Transformation of marginal zone lymphoma into high-grade B-cell lymphoma expressing terminal deoxynucleotidyl transferase:A case report

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World Journal of Clinical Cases 2024年第15期12卷 2655-2663页

作者： Zhi-Min Fan Dao-Lei Wu Neng-Wen Xu Li Ye Li-Ping Yan Lin-Jie Li Jun-Yu Zhang Department of Hematology Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of Ophthalmology Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of general Practice Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of Pathology Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina

BACKGROUND High-grade B-cell lymphoma(HGBL)is an unusual malignancy that includes myelocytomatosis viral oncogene(MYC),B-cell lymphoma-2(BCL-2),and/or BCL-6 rearrangements,termed double-hit or triple-hit lymphomas,and HGBL-not otherwise specific(HGBL-NOS),which are morphologically characteristic of HGBL but lack MYC,BCL-2,or BCL-6 *** is partially transformed by follicular lymphoma and other indolent lymphoma,with few cases of marginal zone lymphoma(MZL)*** often has a poor prognosis and intensive therapy is currently mainly advocated,but there is no good treatment for these patients who cannot tolerate *** SUMMARY We reported a case of MZL transformed into HGBL-NOS with TP53 mutation and terminal deoxynucleotidyl transferase *** analysis revealed the gene expression profile was identical in the pre-and post-transformed tissues,suggesting that the two diseases are homologous,not secondary *** chemotherapy was ineffective and the side effect was severe,so we tried combination therapy including venetoclax and *** patient tolerated treatment well,and reached partial *** patient had recurrence of hepatocellular carcinoma and died of multifunctional organ *** survived for 12 months after *** Venetoclax combined with obinutuzumab might improve the survival in some HGBL patients,who are unsuitable for chemotherapy.

关键词： Marginal zone lymphoma High-grade B-cell lymphoma Terminal deoxynucleotidyl transferase Venetoclax TP53 mutation Case report

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Clinical review and literature analysis of hepatic epithelioid angiomyolipoma in alcoholic cirrhosis: A case report

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World Journal of Clinical Cases 2024年第14期12卷 2382-2388页

作者： Jing-Qiang Guo Jia-Hui Zhou Kun Zhang Xin-Liang Lv Chao-Yong Tu Department of Hepatobiliary and Pancreatic Surgery Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of Pathology Lishui Municipal Central HospitalLishui 323000Zhejiang ProvinceChina Department of general Surgery The Fifth Affiliated Hospital of Wenzhou Medical UniversityLishui 323000Zhejiang ProvinceChina

BACKGROUND Hepatic epithelioid angiomyolipoma(HEA)has a low incidence and both clinical manifestations and imaging lack ***,it is easy to misdiagnose HEA as other tumors of the liver,especially in the presence of liver diseases such as hepatitis *** article reviewed the diagnosis and treatment of a patient with HEA and alcoholic cirrhosis,and analyzed the literature,in order to improve the understanding of this *** SUMMARY A 67-year-old male patient with a history of alcoholic cirrhosis was admitted due to the discovery of a space-occupying lesion in the *** on the patient’s history,laboratory examinations,and imaging examinations,a malignant liver tumor was considered and laparoscopic partial hepatectomy was *** pathology showed *** outpatient follow-up,the patient showed no sign of *** HEA is difficult to make a definite diagnosis before *** has the poten-tial for malignant *** conditions permit,surgical treatment is recom-mended.

关键词： Hepatic epithelioid angiomyolipoma Alcoholic cirrhosis Magnetic resonance imaging Computed tomography Immunohistochemistry Misdiagnose analysis Case report

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Exosomes derived from microglia overexpressing miR-124-3p alleviate neuronal endoplasmic reticulum stress damage after repetitive mild traumatic brain injury

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Neural Regeneration Research 2024年第9期19卷 2010-2018页

作者： Yan Wang Dai Li Lan Zhang Zhenyu Yin Zhaoli Han Xintong Ge Meimei Li Jing Zhao Shishuang Zhang Yan Zuo Xiangyang Xiong Han Gao Qiang Liu Fanglian Chen Ping Lei Department of Geriatrics Tianjin Medical University General HospitalTianjinChina Tianjin Geriatrics Institute Tianjin Medical University General HospitalTianjinChina Tianjin Neurological Institute Tianjin Medical University General HospitalTianjinChina

We previously reported that miR-124-3p is markedly upregulated in microglia-derived exosomes following repetitive mild traumatic brain ***,its impact on neuronal endoplasmic reticulum stress following repetitive mild traumatic brain injury remains *** this study,we first used an HT22 scratch injury model to mimic traumatic brain injury,then co-cultured the HT22 cells with BV2 microglia expressing high levels of *** found that exosomes containing high levels of miR-124-3p attenuated apoptosis and endoplasmic reticulum ***,luciferase reporter assay analysis confirmed that miR-124-3p bound specifically to the endoplasmic reticulum stress-related protein IRE1α,while an IRE1αfunctional salvage experiment confirmed that miR-124-3p targeted IRE1αand reduced its expression,thereby inhibiting endoplasmic reticulum stress in injured ***,we delivered microglia-derived exosomes containing miR-124-3p intranasally to a mouse model of repetitive mild traumatic brain injury and found that endoplasmic reticulum stress and apoptosis levels in hippocampal neurons were significantly *** findings suggest that,after repetitive mild traumatic brain injury,miR-124-3 can be transferred from microglia-derived exosomes to injured neurons,where it exerts a neuroprotective effect by inhibiting endoplasmic reticulum ***,microglia-derived exosomes containing miR-124-3p may represent a novel therapeutic strategy for repetitive mild traumatic brain injury.

关键词： apoptosis C/EBP homologous protein endoplasmic reticulum stress exosome inositol-requiring enzyme 1α microglia miR-124-3p neuron repetitive mild traumatic brain injury X-box binding protein 1

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Lone-Star retractor perineal exposure method for laparoscopic abdominal perineal resection of rectal cancer

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World Journal of Gastrointestinal Surgery 2024年第8期16卷 2528-2537页

作者： Jun Ma Dai-Bin Tang Yu-Quan Tang Da-Tian Wang Peng Jiang Ya-Ming Zhang Department of general Surgery Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina Department of Anesthesiology Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina

BACKGROUND The abdominal perineal resection(APR),historically referred to as Mile’s proce-dure,stands as a time-honored surgical intervention for rectal cancer *** in surgical techniques and the advent of neoadjuvant therapies have significantly improved the rate of sphincter preservation among patients afflicted with rectal cancer,including those with ultralow rectal *** these improvements,APR maintains its irreplaceable role in the clinical landscape,particularly for cases involving low rectal cancer with encroachment on the external anal sphincter or levator ani *** perineal exposure stands as a pivotal phase in APR,given that the precision of this maneuver is directly correlated with both the safety of the surgery and the patient’s subse-quent long-term *** To evaluate the value of Lone-Star retractor(LSR)perineal exposure method in the treatment for laparoscopic APR of rectal *** We reviewed the records of 38 patients with rectal cancer at Anqing municipal hospital from January 2020 to December 2023,including 20 patients who underwent the APR procedure with a LSR perineal exposure method(LSR group)and 18 patients who underwent the APR procedure with a conventional perineal exposure method(control group).In the LSR group,following incision of the skin and subcutaneous tissue,the LSR was placed and dynamically adjusted according to the surgical plane to fully expose the perineal operative *** A total of 38 patients underwent laparoscopic APR,none of whom were found to have distant metastasis upon intraoperative *** blood loss,the postoperative hospital stays and the wound pain scores in the LSR group were significantly lower than those in the control group.A single surgeon completed the perineal operation significantly more often in the LSR group than in the control group(P<0.05).The incidence of infection via the perineal incision in the LSR group was significantly lower

关键词： Rectal cancer Lone-Star retractor Abdominal perineal resection Perineal exposure method Technique

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Misdiagnosed Meckel's diverticulum with internal hernia mimicking appendicitis:A case report

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World Journal of Clinical Cases 2024年第20期12卷 4391-4396页

作者： Qi Zhang Xiu-Juan Xu Jun Ma Ya-Ming Zhang Department of general Surgery Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina Department of Critical Medicine Anqing Municipal HospitalAnqing 246000Anhui ProvinceChina

BACKGROUND Meckel's diverticulum is a common congenital anomaly of the gastrointestinal tract,with a higher incidence rate in children under 7 years *** condition is characteristically asymptomatic but may become a clinical concern when complications such as intestinal obstruction,bleeding,perforation,or diverticulitis precipitate acute abdominal *** SUMMARY This report describes the case of a middle-aged man initially suspected of having acute appendicitis,which rapidly progressed to acute peritonitis with concomitant intestinal obstruction observed during preoperative *** exploration confirmed the diagnosis of Meckel's diverticulum-induced internal hernia,accompanied by intestinal obstruction and *** addition,the hernial ring base exhibited entrapment resembling a surgical *** Meckel's diverticulum is a rare cause of small bowel obstruction in adults,and it should be considered in a differential diagnosis.

关键词： Meckel's diverticulum Internal hernia Intestinal necrosis Peritonitis Case report

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Bronchobiliary fistula in a patient with liver cancer

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Hepatobiliary & Pancreatic Diseases International 2024年第5期23卷 523-525页

作者： Yao-Xin Chen Zhi-Hua Deng Hao Zhao Bi-Ying Zhou Jing-Jing Guo Gang Zeng Jin-Xian Qian Department of Respiratory and Critical Care Medicine Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversitySuzhou 215000China

Bronchobiliary fistula(BBF) is a pathologic channel between the biliary tract and bronchial tree. In general, congenital BBF is relatively rare in adult patients. There are a few case reports suggesting that BBF is mainly secondary to hepatobiliary diseases, such as biliary obstruction, tumor, surgery, or liver abscess, and liver tumor is the predominant causative factor [1]. In addition, with the increasing number of liver and biliary surgeries and interventional therapies in recent years, more cases of BBF were reported as a postoperative complication [ 2, 3 ]. In this case, we presented a patient who underwent interventional treatment for liver tumor and was treated for his respiratory symptoms but diagnosed with BBF finally. Here, we summarized the clinical features and main diagnostic procedures of the case, aiming to provide evidence for early identification and diagnosis of BBF.

关键词： biliary fistula diagnosis

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Standard-definition White-light,High-definition White-light versus Narrow-band Imaging Endoscopy for Detecting Colorectal Adenomas:A Multicenter Randomized Controlled Trial

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Current Medical Science 2024年第3期44卷 554-560页

作者： Chang-wei DUAN Hui-hong ZHAI Hui XIE Xian-zong MA Dong-liang YU Lang YANG Xin WANG Yu-fen TANG Jie ZHANG Hui SU Jian-qiu SHENG Jun-feng XU Peng JIN Chinese PLA general hospital and Medical School Beijing100853China Department of Gastroenterology Xuanwu HospitalCapital Medical UniversityBeijing100053China Department of Gastroenterology The Seventh Medical Center of Chinese PLA General HospitalBeijing100700China Senior Department of Gastroenterology The First Medical Center of Chinese PLA General HospitalBeijing100853China

Objective This study aimed to compare the performance of standard-definition white-light endoscopy(SD-WL),high-definition white-light endoscopy(HD-WL),and high-definition narrow-band imaging(HD-NBI)in detecting colorectal lesions in the Chinese *** This was a multicenter,single-blind,randomized,controlled trial with a non-inferiority *** undergoing endoscopy for physical examination,screening,and surveillance were enrolled from July 2017 to December *** primary outcome measure was the adenoma detection rate(ADR),defined as the proportion of patients with at least one adenoma *** associated factors for detecting adenomas were assessed using univariate and multivariate logistic *** Out of 653 eligible patients enrolled,data from 596 patients were *** ADRs were 34.5%in the SD-WL group,33.5%in the HD-WL group,and 37.5%in the HD-NBI group(P=0.72).The advanced neoplasm detection rates(ANDRs)in the three arms were 17.1%,15.5%,and 10.4%(P=0.17).No significant differences were found between the SD group and HD group regarding ADR or ANDR(ADR:34.5%vs.35.6%,P=0.79;ANDR:17.1%vs.13.0%,P=0.16,respectively).Similar results were observed between the HD-WL group and HD-NBI group(ADR:33.5%vs.37.7%,P=0.45;ANDR:15.5%vs.10.4%,P=0.18,respectively).In the univariate and multivariate logistic regression analyses,neither HD-WL nor HD-NBI led to a significant difference in overall adenoma detection compared to SD-WL(HD-WL:OR 0.91,P=0.69;HD-NBI:OR 1.15,P=0.80).Conclusion HD-NBI and HD-WL are comparable to SD-WL for overall adenoma detection among Chinese *** can be concluded that HD-NBI or HD-WL is not superior to SD-WL,but more effective instruction may be needed to guide the selection of different endoscopic methods in the *** study’s conclusions may aid in the efficient allocation and utilization of limited colonoscopy resources,especially advanced imaging technologies.

关键词： standard-definition white-light endoscopy high-definition white-light endoscopy narrow-band imaging colonoscopy colorectal cancer screening adenoma detection rate

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Intra-arterial tenecteplase during thrombectomy for acute stroke(BRETIS-TNK II):rationale and design

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Stroke & Vascular Neurology 2024年第1期9卷 59-65页

作者： Zi-Ai Zhao Jing Qiu Wei Li Thanh Nguyen Shouchun Wang Huaizhang Shi Ming Wei Feng Wang Di Li Hui-Sheng Chen Department of Neurology General Hospital of Northern Theater CommandShenyangLiaoning ProvinceChina Neurology RadiologyBoston Medical CenterBostonMassachusettsUSA Department of Neurology First Affiliated Hospital of Jilin UniversityChangchunJilinChina Department of Neurosurgery First Affiliated Hospital of Harbin Medical UniversityHarbinHeilongjiangChina Department of Neurosurgery Tianjin Huanhu HospitalTianjinTianjinChina Department of Interventional Therapy First Affiliated Hospital of Dalian Medical UniversityDalianChina Neurological Intervention Department Dalian Municipal Central HospitalDalianLiaoningChina

Background Our recent pilot study suggests intra-arterial tenecteplase(TNK)during the first pass of endovascular treatment(EVT)seems safe,may increase first-pass reperfusion and good outcome in acute ischaemic stroke(AIS)patients with large-vessel occlusion(LVO).Aims To determine the efficacy and safety of intra-arterial TNK administration during EVT in AIS-LVO patients presenting up to 24 hours from symptom *** size estimates A maximum of 380 patients are required to test the superiority hypothesis with 80%power according to a two-side 0.05 level of significance,stratified by age,gender,baseline systolic blood pressure,prestroke modified Rankin Scale(mRS),baseline National Institute of Health stroke scale,baseline ASPECTS,time from onset to groin puncture,intravenous thrombolysis before EVT,stroke territory and stroke *** Intra-arterial TNK during thrombectomy for acute stroke(BRETIS-TNK II)study is a prospective,randomised,adaptive enrichment,open-label,blinded end point,multicentre *** AIS-LVO patients are randomly assigned into the experimental group and control group with a ratio of 1:*** experimental group will be treated with intra-arterial infusion of TNK during *** control group will be treated with standard *** The primary end point is a favourable outcome,defined as an mRS score of 0–2 at 90 *** primary safety end point is symptomatic intracranial haemorrhage within 48 hours,which is defined as an increase in the National Institutes of Health Stroke Scale score of≥4 points as a result of the intracranial *** The results of BRETIS-TNK II will provide evidence for the efficacy and safety of intra-arterial TNK administration during EVT in AIS patients with LVO.

关键词： rational stratified TNK

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Systematic Review: Psychological Changes in Women Diagnosed with Breast Cancer

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 1096-1109页

作者： Hamilton Dos Prazeres Tavares Augusta Josefina Marques Sachiteque Silvina Georgina Tavares Fernando Mango Saiengue Alberto Capoco Sachiteque Cezaltina Nanduva Kahuli Job Monteiro Tavares Daniel Pires Capingana Suelma Beatriz Marques Prata Tavares Department of Gynecology and Obstetrics General Hospital of Huambo Huambo Angola Faculty of Medicine University Jos Eduardo dos Santos Huambo Huambo Angola Department of Gynecology and Obstetrics Hospital Municipal of Huambo Huambo Angola Department of Gynecology and Obstetrics Hospital Municipal of Bailundo Huambo Angola Department of Internal Medicine General Hospital of Huambo Huambo Angola Department of Gynecology and Obstetrics Hospital Municipal of Cala Huambo Angola

Breast cancer is considered one of the most common cancers among women, accounting for 25% - 29% of new cases worldwide each year. The diagnosis, living with the disease, as well as the different treatments can have important impacts on the Psychological and mental health of patients. Objective: To investigate the psychological aspects that women with breast cancer develop or may develop. Methodology: A systematic review using the PRISMA methodology was used. Results: 11 articles that met the inclusion and exclusion criteria were analysed. The largest flow of publications in relation to the effects of the patient with cancer, were carried out between the years 2000 and 2023. Conclusions: Psychological disorders (depression, anxiety, stress) are part of the lives of women diagnosed with breast cancer, and their prevalence varies from one woman to another.

关键词： Anxiety Depression Psychosis Sadness Cancer

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Honokiol Prevents Intestinal Barrier Dysfunction in Mice with Severe Acute Pancreatitis and Inhibits JAK/STAT1 Pathway and Acetylation of HMGB1

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Chinese Journal of Integrative Medicine 2024年第6期30卷 534-542页

作者： LI Jie CHEN Ya-feng GAO Lei LI Yi-jie FENG Dian-xu Department of general Surgery Putuo HospitalShanghai University of Traditional Chinese MedicineShanghai200062China

Objective To investigate the effect of honokiol(HON)and the role of high-mobility group protein B1(HMGB1)on the pathogenesis of severe acute pancreatitis(SAP).Methods Thirty mice were numbered according to weight,and randomly divided into 5 groups using a random number table,including control,SAP,SAP and normal saline(SAP+NS),SAP and ethyl pyruvate(SAP+EP),or SAP+HON groups,6 mice in each *** of pancreas,intestine,and blood were collected 12 h after SAP model induction for examination of pathologic changes,immune function alterations by enzyme linked immunosorbent assay(ELISA),and Western *** vitro experiments,macrophages were divided into 5 groups,the control,lipopolysaccharide(LPS),LPS+DMSO(DMSO),LPS+anti-HMGB1 monoclonal antibody(mAb),and LPS+HON *** tight connection level was determined by transmission electron microscopy and fluorescein *** location and acetylation of HMGB1 were measured by Western ***,pyridone 6 and silencing signal transducer and activator of the transcription 1(siSTAT1)combined with honokiol were added to determine whether the Janus kinase(JAK)/STAT1 participated in the regulation of honokiol on *** protein expression levels of HMGB1,JAK,and STAT1 were detected using Western *** Mice with SAP had inflammatory injury in the pancreas,bleeding of intestinal tissues,and cells with disrupted *** in the SAP+HON group had significantly fewer pathological *** with SAP also had significant increases in the serum levels of amylase,lipase,HMGB1,tumor necrosis factor-α,interleukin-6,diamine oxidase,endotoxin-1,and *** in the SAP+HON group did not show these abnormalities(P<0.01).Studies of Caco-2 cells indicated that LPS increased the levels of occludin and claudin-1 as well as tight junction permeability,decreased the levels of junctional adhesion molecule C,and elevated intercellular permeability(P<0.01).HON treatment blocked these *** of

关键词： severe acute pancreatitis intestinal barrier dysfunction honokiol high-mobility group protein B1 Januskinase signal transducerand activatorof transcription1

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