[Clinicopathological features in relapsed diffuse large B-cell lymphoma]

Objective: To study the clinical pathological features of patients with relapsed diffuse large B-celllymphoma (DLBCL) and to provide evidence for early clinical screening of recurrent cases. Methods: The clinical and pathological data of the 20 patients, who had relapsed DLBCL (relapsed group) and were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2019, were included. Meanwhile, other 34 patients with DLBCL who had achieved complete response (CR) for 36 months or more (CR group) were used as controls.Statistical methods were used to retrospectively analyze the differences in general conditions, clinical characteristics, lab resultsand pathological features between the two groups. Results: Clinically, there were 6 males and 14 females with a median age of 55.5 (33-85) years in the relapsed group and 14 males and 20 females with a median age of 53 (15-89) years in the CR group. The relapsed and CR groups had significant difference in Ann Arbor stage (P=0.001), International Prognostic Index score (P=0.006), primary lesions (P=0.003), extranodal involvement (P=0.002), and hepatitis B viral infection (P=0.046), β2-MG level (P=0.029), LDH level (P=0.005) and CRP level (P=0.006), while the age (P=0.732), gender (P=0.416), ECOG score (P=0.248), B symptoms (P=0.511), the presence of hypoalbuminemia (P=0.279), anemia (P=0.983) and A/G(P=0.416) showed no statistical difference.Pathologically, compared with the CR group, the relapsed group was mostly non-GCB type (85% vs. 59%,P=0.048), with a higher CD5 positive rate (25% vs.3%,P=0.014) and a lower bcl-6　positive rate (60% vs. 88%,P=0.017), while the expression of Ki-67, CD10, bcl-2, MUM1, CD20 and PAX5 was not different between the two groups. Conclusion: Most of the patients with relapsed DLBCL are non-GCB type. The patients with CD5 positivity, stage III-IV, International Prognostic Index score 3-5, nodal origin, often involving>1 extranodal organ, abnormally elevated LDH, CRP and β2-MG level, and HBV infection are more likely to relapse.

[Retrospective investigation of patients receiving additional surgery after endoscopic non-curative resection for early colorectal cancer]

Objective: To investigate the clinical application of additional surgery after non-curative endoscopic resection for early colorectal cancer. Methods: A retrospectively descriptive cohort study was conducted. Inclusion criteria: (1) pathologically confirmed primary colorectal adenocarcinoma;(2) receiving additional surgery after endoscopic resection; (3) semi-elective operation. Exclusion criteria: familial adenomatous polyposis, appendiceal neoplasms, anal canal neoplasms, neuroendocrine tumors, and surgery because of perforation or bleeding after endoscopic resection. Indications of additional surgery: (1) pathologically positive lateral or basal resection margin; (2) submucosal invasion depth ≥ 1000 μm; (3) lymphovascular invasion; (4) poorly differentiated, undifferentiated or mucinous adenocarcinoma; (5) more than grade G2 in tumor budding; (6) incomplete resection or piecemeal specimen with margin impossible to evaluate; (7) patient's consent due to undetermined pathology. According to the above criteria, clinical data of 92 patients at the Colorectal Surgery Department, the First Affiliated Hospital of Nanjing Medical University between January 2013 and December 2018 were collected. Demographic data, pathological examinations, operative methods and outcomes were analyzed. Results: There were 61 (66.3%) male and 31 female (33.7%) patients with an average age of (58.2±10.7) years. The average BMI was (23.8±3.5) kg/m(2). The lesions located in the right-sided colon, left-sided colon and rectum in 19, 37 and 36 patients respectively. Sixteen patients received endoscopic snare resection, 45 received endoscopic mucosal resection and 31 received endoscopic submucosal dissection. Reasons for additional surgery included endoscopic specimen with pathologically positive margin (n=22, 23.9%), submucosal invasion depth ≥ 1000 μm (n=9, 9.8%), lymphovascular invasion (n=4, 4.3%), poorly differentiated, undifferentiated or mucinous adenocarcinoma (n=5, 5.4%), piecemeal resection (n=13, 14.1%), undetermined pathology (n=52, 56.5%). The median duration from endoscopic resection to additional surgery was 16 days. Thirty-four patients (37.0%) received preoperative endoscopic localization with carbon nanoparticles suspension injection and 5 (5.4%) were marked with titanium clip. Seventy-four patients (80.4%) received laparoscopic surgery, 17 (18.5%) received open surgery, while 1 patient (1.1%) was converted to open surgery due to missing titanium clip. Three patients (3.3%) were treated with transanal excision, 2 (2.2%) with bowel resection, and 87 (94.6%) with radical excision. After additional surgery, histopathological examination of surgical specimens revealed the presence of residual tumor in 5 patients (5.4%), lymph node metastasis in 8 (8.7%), lymphovascular invasion in 1 (1.1%) and tumor deposit in 1 (1.1%). Twelve patients (13.0%) developed postoperative complications, including 4 mid-low rectal cancer patients (4.3%) with anastomostic leakage or bleeding. After surgery, according to the TNM staging system, 83 patients (90.2%) were classified as TNM stage 0-I, 9 (9.8%) as TNM stage II-IV. One patient of stage IV with liver metastasis underwent concomitant hepatectomy. One patient of stage II received regular follow-up after operation. Seven cases of stage III and 1 of stage IV received postoperative chemotherapy. Eighty-five patients (92.4%) were followed up with a median time of 12.8 (IQR: 8.1, 24.3) months. No recurrence or metastasis was observed. Conclusions: Surgery is an effective salvage measure for non-curative endoscopic resection of early colorectal cancer. Since surgery may have complications, indications of the additional surgery should be considered carefully. Preoperative endoscopic localization should be performed in order to ensure the safety and efficacy of surgery.

Study on the preparation of granular alum sludge adsorbent for phosphorus removal

Alum sludge is the sludge discharged from a sedimentation tank in a drinking water treatment plant when polymerized with poly-aluminum chloride (PAC). In this paper, granular alum sludge adsorbent (GASA) was manufactured using powdery alum sludge (PAS) as the raw material and methods such as gluing and pore-forming. The effects of different binders, pore-forming agents, roasting temperatures, and roasting times on the formation of GASA and its dephosphorization performance were investigated. Results showed that the optimum binder was AlCl₃ at a mass ratio of 8%, and the best pore-forming agent was starch at a 4% dosage ratio. Meanwhile, the optimum roasting temperature and time were 500 °C and 2 hours, respectively. The specific surface area of GASA was 23.124 m²/g. Scanning electron microscopy suggested that GASA's surface became rough, particles became tight, and average pore size increased, with additional pore channels. P adsorption by GASA reached 0.90 mg/g. The effluent phosphorus concentration of actual tail water decreased to 0.49 mg/L and the removal rate reached 73.5% when the GASA dosage was 20 g/L. The findings of this study are important for the further development of a low-cost adsorbent material for P removal in the future.

[Activation of GPER inhibts proliferation and autophagy in prostatic epithelial cells]

Objective: To investigate the effect of G protein-coupled estrogen receptor (GPER) on proliferation and autophagy in prostatic epithelial cells. Methods: Cell Counting Kit-8 (CCK8) assay was used to observe the growth of BPH-1 and RWPE-1 cells after treating with or not with estradiol or GPER selective agonist G1. Autophagy was quantified with Western blot and Cyto-ID autophagy detection kit after treating with estradiol, G1 or both G1 and G15 in the same cells. Results: The OD value in estrogen group and G1 group was significantly lower than those in control group (P<0.01). Compared with control group, Western blot and Cyto-ID green reagent staining revealed that the ratio of LC3Ⅱ/LC3Ⅰ and the relative fluorescence intensity of BPH-1 and RWPE-1 cells were decreased in G1 group and estradiol group (P<0.01). Pretreatment with G15 reversed the effect of G1 (P<0.05). Conclusion: The activation of GPER leads to the inhibition of autophagy and cell proliferation.

[Comparison of the efficacy of decitabine combined with micro-transplantation or priming regimen as consolidation treatment for older patients with acute myeloid leukemia]

目的

探索老年急性髓系白血病（AML）第1次完全缓解（CR₁）后采用地西他滨联合微移植巩固治疗的疗效与安全性。

方法

回顾性分析2012年11月至2015年9月诊治的37例CR₁老年（≥60岁）AML患者病例资料，比较分析地西他滨联合微移植（微移植组，19例）与地西他滨联合预激方案巩固治疗（化疗组，18例）的疗效和不良反应。

结果

两组患者起病时的年龄、WBC水平、疾病状态差异均无统计学意义（P值均>0.05）。两种巩固治疗方案的耐受性均良好，微移植组与化疗组的CTC 3~4级非血液学不良反应发生率差异无统计学意义[36.8%（7/19）对27.8%（5/18），χ²=0.347，P=0.728]。微移植组与化疗组中性粒细胞恢复的中位时间分别为12和13 d（z=1.599，P=0.110），血小板恢复的中位时间分别为14和12 d（z=−1.314，P=0.189）。微移植组患者均未发生移植物抗宿主病。微移植组与化疗组的2年无白血病生存率分别为50.7%和24.3%（P=0.047），2年总生存率分别为54.9%和30.0%（P=0.071）。

结论

对于老年AML患者，地西他滨联合微移植可能是一种安全有效的巩固方案。

Identification and differential expression of microRNAs in the ovaries of pigs (Sus scrofa) with high and low litter sizes

Litter size affects profitability in the swine industry. Mammalian ovaries play important roles during reproduction, including ovulation and hormone secretion, which are tightly regulated by specific microRNAs (miRNAs). In this study, we investigated the effects of specific miRNAs on porcine litter size. We compared the ovarian miRNAs of Yorkshire pigs with high (YH) and low (YL) litter sizes using Solexa sequencing technology. We identified 327 and 320 miRNAs in the ovaries of YH and YL pigs respectively. A total of 297 miRNAs were co-expressed; 30 and 23 miRNAs respectively were specifically expressed in the two libraries. A total of 83 novel miRNAs were predicted; 37 specific miRNAs were obtained, of which 21 miRNAs were upregulated and 16 miRNAs were downregulated in YH compared with YL. Additionally, 19 628 and 19 250 target genes were predicted in the two libraries respectively. The results revealed that specific miRNAs (i.e., miR-224, miR-99a, let-7c, miR-181c, miR-214 and miR-21) may affect porcine litter size. The results of this study will help in gaining understanding of the role of miRNAs in porcine litter size regulation.

Association between ADSL, GARS-AIRS-GART, DGAT1, and DECR1 expression levels and pork meat quality traits

In this study, meat quality traits were compared between Chinese lard- and European lean-type pigs. The association between expression of four genes (ADSL, GARS-AIRS-GART, DGAT1, and DECR1) and meat quality traits was also investigated. Meat quality traits were found to differ significantly between pig breeds. Meat color parameter values (a* and b*) and intramuscular fat content in Anqingliubai were significantly higher than those in Landrace (P < 0.01). Meat pH at 1 and 24 h following slaughter was significantly higher in Landrace than in Wei pigs, and meat inosine monophosphate (IMP) content was significantly higher in Landrace than in Wei and Anqingliubai pigs (both P < 0.01). Expression levels of ADSL, GARS-AIRS-GART, and DGAT1 were higher in longissimus lumborum muscle than in heart or liver tissues. ADSL and GARS-AIRS-GART expression levels were correlated with meat IMP content and pH levels. The results of this study will contribute to the understanding of meat quality traits in Chinese lard- and European lean-type pigs.

Relationship between polymorphisms in exon 10 of FSHR gene and litter size in swine

Follicle-stimulating hormone (FSH), a glycoprotein secreted by the anterior pituitary, can regulate ovarian function through the FSH receptor (FSHR). To evaluate the effects of the FSHR gene on reproductive traits in pigs, polymorphisms in exon 10 of the FSHR gene were observed by polymerase chain reaction-single-strand conformation polymorphism, and 3 single nucleotide polymorphisms (C1491T, G1885A, and C1977T) in exon 10 of the porcine FSHR gene, and 3 genotypes (AA, AB, and BB) for C1491T and 2 haplotypes (D and E) for G1885A and C1977T were identified. Further analysis of single nucleotide polymorphism genotypes associated with reproductive traits including total number born (TNB) and number born alive (NBA) was carried out in 3 pig populations including Berkshire, Wannan Black (a Chinese indigenous pig breed), and BW pigs (two-way crossbred pigs produced from Berkshire ♂ and Wannan Black pig ♀). The results showed that the TNB and NBA of Wannan Black pigs with the AB genotype were significantly higher than in AA genotype sows (P < 0.01) in multiparity sows and all parities. The TNB and NBA of Berkshire pigs with the DE genotype were significantly higher than the DD and EE genotype sows (P < 0.01) in gilts, sows and all parities. Overall, TNB and NBA from the 3 identified genotypes was DE > DD > EE. The results showed that polymorphisms in exon 10 of the FSHR gene had a significant effect on litter size traits of Wannan Black and Berkshire pigs. These results can be applied for marker-assisted selection in the 2 swine breeds.

Development and validation of an improved Bradford method for determination of insulin from chitosan nanoparticulate systems

CONTEXT

Blank chitosan nanoparticles are currently used as reference for the calibration curve, which fails to resolve the supernatant of the nanoparticles in the interference of Coomassie Brilliant Blue G-250 reagent; supernatants are generated at different chitosan nanoparticulate prescriptions, which have different interferences. There are notable errors in the experimental results, and the method is not feasible.

OBJECTIVE

In this study, an improved, rapid, and economic Bradford method was developed and validated.

MATERIALS AND METHODS

The pH of the supernatant of blank chitosan nanoparticles was adjusted to 7-9 through adding saturated NaOH. The precipitation (free chitosan) in the solution was separated by centrifuging for about 10 min (4000 r/min).

RESULTS

The method eliminated the interference of free chitosan of different prescriptions. The results showed that the method presented a linearity in the range of 50-300 microg/mL (R(2) = 0.9992), and possessed a good inter-day and intra-day precision based on relative standard deviation values (less than 3.10%). Recovery of the supernatant of blank chitosan nanoparticles was between 98.30 and 99.93%, and the recovery of blank chitosan nanoparticles was between 95.57 and 100.27%.

DISCUSSION AND CONCLUSION

The method was further tested for determination of the association efficiency of insulin to nanoparticulate carriers composed of chitosan. Encapsulant release under simulated gastrointestinal fluids was evaluated.

The Notch pathway mediates expansion of a progenitor pool and neuronal differentiation in adult neural progenitor cells after stroke

Molecular mechanisms by which stroke increases neurogenesis have not been fully investigated. Using neural progenitor cells isolated from the subventricular zone (SVZ) of the adult rat subjected to focal cerebral ischemia, we investigated the Notch pathway in regulating proliferation and differentiation of adult neural progenitor cells after stroke. During proliferation of neural progenitor cells, ischemic neural progenitor cells exhibited substantially increased levels of Notch, Notch intracellular domain (NICD), and hairy enhancer of split (Hes) 1, which was associated with a significant increase of proliferating cells. Blockage of the Notch pathway by short interfering ribonucleic acid (siRNA) against Notch or a gamma secretase inhibitor significantly reduced Notch, NICD and Hes1 expression and cell proliferation induced by stroke. During differentiation of neural progenitor cells, Notch and Hes1 expression was downregulated in ischemic neural progenitor cells, which was coincident with a significant increase of neuronal population. Inhibition of the Notch pathway with a gamma secretase inhibitor further substantially increased neurons, but did not alter astrocyte population in ischemic neural progenitor cells. These data suggest that the Notch signaling pathway mediates adult SVZ neural progenitor cell proliferation and differentiation after stroke.

Vaginal paraganglioma presenting as a gynecologic mass: case report

Paragangliomas in the vagina are extremely rare. Unwitting surgical excision of a functional paraganglioma may precipitate life-threatening complications. We present a case of a 38-year-old woman with a vaginal mass 3.0 cm in diameter who experienced a hypertensive crisis during an unwitting attempted surgical excision of the vaginal mass. The diagnosis of a vaginal functional paraganglioma was then made based on to her 16-year history of paroxysmal headaches, chest distress, palpitation and elevated levels of urinary vannillylmandelic acid (VMA). Consequently, after thorough presurgical preparation, the patient again underwent excision of the vaginal mass uneventfully. She has been followed-up for three years since surgery without any evidence of recurrence. The clinical features and perioperative management of functional vaginal paraganglioma are described.

Another simpler bypassing dialysate technique for measuring post-haemodialysis BUN

BACKGROUND

The most popular method for estimating post-haemodialysis BUN is the low blood flow technique. The low blood flow technique with a blood flow of 50 ml/min for 3 min may encompass the first two phases of post-haemodialysis urea rebound by access and cardiopulmonary recirculations. Some patients may have risk of clotting in extracorporeal circuit while slowing blood flow. Therefore we proposed another simpler sampling technique for measuring post-haemodialysis BUN(C2).

METHODS

In the present study, 28 long-term haemodialysis patients were divided into two groups. In group 1 (n = 15), C2 sample (C2-50) was collected immediately after blood flow was slowed down to 50 ml/min for another 3 min. Then blood flow was reset to 300 ml/min. Finally, C2 sample (C2B) was obtained from arterial port at the end of bypassing dialysate for another 3 min. In group 2 (n = 13), C2 sample (C2B) was obtained from arterial port at the end of bypassing dialysate for 3 min with a blood flow of 250 ml/min. Then dialysate was reset to original flow rate and C2 sample (C2-50) was collected soon after blood flow was slowed down to 50 ml/min for another 3 min. In the meantime, recirculation rate was also checked.

RESULTS

The above two groups have similar results and there are no significant differences of post-haemodialysis BUN and calculated Kt/V between low blood flow technique and bypassing dialysate technique.

CONCLUSION

The bypassing dialysate technique is another simpler and practical technique for the routine estimation of post-haemodialysis BUN.

Lymphangioma of the middle mediastinum as an incidental finding on a chest radiograph

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