Currently, thyroid-associated ophthalmopathy (TAO) lacks effective treatment due to our lack of clarity in its immunopathogenesis. Orbital fibroblasts play a key role in altering inflammation and immune response in TA...Currently, thyroid-associated ophthalmopathy (TAO) lacks effective treatment due to our lack of clarity in its immunopathogenesis. Orbital fibroblasts play a key role in altering inflammation and immune response in TAO, and are considered as the key target and effector cells in its pathogenesis. The orbit infiltrating CD34+ fibrocytes add on to the process by expressing high levels of autoantigens and inflammatory cytokines, while also differentiating into myofibroblasts or adipocytes. This review focuses on the role of orbital fibroblasts and CD34+ fibrocytes in the pathogenesis of TAO, highlighting the basis of emerging treatments.展开更多
BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the endometrium is an uncommon and highly aggressive tumor that has not been comprehensively characterized.We report a case of pure endometrial LCNEC and review ...BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the endometrium is an uncommon and highly aggressive tumor that has not been comprehensively characterized.We report a case of pure endometrial LCNEC and review the current literature of similar cases to raise awareness of the histological features,treatment,and prognosis of this tumor.CASE SUMMARY We report the case of a 73-year-old woman who presented with irregular postmenopausal vaginal bleeding.Ultrasonography showed an enlarged uterus and a 5.1 cm×3.3 cm area of medium and low echogenicity in the uterine cavity.Biopsy by dilatation and curettage suggested poorly differentiated carcinoma.Magnetic resonance imaging revealed a heterogeneously enhanced uterine tumor with diffuse infiltration of the posterior wall of the uterine myometrium and enlarged pelvic lymph nodes.The patient underwent a hysterectomy and bilateral adnexal resection.Gross observation revealed an ill-defined white solid mass of the posterior wall of the uterus infiltrating into the serosa with multiple solid nodules on the serous surface.Microscopically,the tumor cells showed neuroendocrine morphology(organoid nesting).Immunohistochemistry revealed the tumor cells were diffusely positive for the neuroendocrine markers CD56,chromogranin A,and synaptophysin.Thus,the tumor was diagnosed as stage IIIC endometrial LCNEC.CONCLUSION Pathologic findings and immunohistochemistry are essential in making a diagnosis of endometrial LCNEC.展开更多
Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children w...Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children with severe mycoplasma pneumonia who were treated in Huai'an Second People's Hospital between June 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, the intervention group received routine treatment combined with Singulair and methylprednisolone, and control group received routine treatment. Before and after treatment, serum was collected to detect the contents of inflammatory cytokines and corresponding cytokines of T lymphocyte subsets, and peripheral blood was collected to determine the contents of T cell subsets.Results:3 d and 7 d after treatment, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of both groups were significantly lower than those before treatment while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those before treatment, and serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of intervention group were significantly lower than those of control group while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those of control group.Conclusion: Singulair combined with methylprednisolone treatment of mycoplasma pneumonia can inhibit the inflammatory response and regulate the balance of Th1/Th2 and Th17/Treg cells.展开更多
BACKGROUND The clinicopathological features,immunohistochemical characteristics,and genetic mutation profile of two unusual cases of distal bronchiolar adenoma are retrospectively analyzed and the relevant literature ...BACKGROUND The clinicopathological features,immunohistochemical characteristics,and genetic mutation profile of two unusual cases of distal bronchiolar adenoma are retrospectively analyzed and the relevant literature is reviewed.CASE SUMMARY Case 1 was a 63-year-old female patient who had a mixed ground-glass nodule,with mild cells in morphology,visible cilia,and bilayer structures in focal areas.Immunohistochemical staining for P63 and cytokeratin(CK)5/6 revealed the lack of a continuous bilayer structure in most areas,and no mutations were found in epidermal growth factor receptor,anaplastic lymphoma kinase,ROS1,Kirsten rat sarcoma,PIK3CA,BRAF,human epidermal growth factor receptor-2(HER2),RET,and neuroblastoma RAS genes.Case 2 was a 58-year-old female patient who presented with a solid nodule,in which most cells were observed to be medium sized,the nuclear chromatin was pale and homogeneous,local cells had atypia,and cilia were found locally.Immunohistochemical staining for P63 and CK5/6 showed no expression of these proteins in mild cell morphology whereas the heteromorphic cells showed a bilayer structure.The same nine genes as above were analyzed,and HER2 gene mutation was identified.CONCLUSION Some unresolved questions remain to be answered to determine whether the lesion is a benign adenoma or a part of the process of malignant transformation from benign adenoma of the bronchial epithelium.Furthermore,whether lesions with atypical bilayer structures are similar to atypical hyperplastic lesions of the breast remains to be elucidated.Moreover,clarity on whether these lesions can be called atypical bronchiolar adenoma and whether they are invasive precursor lesions is needed.Future studies should examine the diagnostic significance of HER2 gene mutation as a prognostic indicator.展开更多
Objective: To explore the therapeutic effect of montelukast sodium + methylprednisolone+ azithromycin therapy for patients with mycoplasma pneumonia. Methods: A total of 88 patients with mycoplasma pneumonia who were ...Objective: To explore the therapeutic effect of montelukast sodium + methylprednisolone+ azithromycin therapy for patients with mycoplasma pneumonia. Methods: A total of 88 patients with mycoplasma pneumonia who were treated in our hospital between July 2015 and June 2017 were collected and divided into group A (oral azithromycin), group B (oral azithromycin + methylprednisolone), group C (oral azithromycin + montelukast sodium) and group D (oral montelukast sodium + methylprednisolone + azithromycin), and they were continuously treated for 1 week. The differences in therapeutic effect, systemic inflammatory response and stress response were compared among the four groups of patients. Results:After 1 week of treatment, the overall response rate of group D was higher than that of group A, group B and group C, and the overall response rate of group B and group C were higher than that of group A respectively;serum inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), cortisol (COR), malondialdehyde (MDA) and advanced oxidation protein product (AOPP) levels of group D were lower than those of group A, group B and group C, and serum CRP, IL-6, TNF-α, COR, MDA and AOPP levels of group B and group C were lower than those of group A respectively. Conclusion:Montelukast sodium + methylprednisolone + azithromycin therapy can significantly improve the therapeutic effect and inhibit the systemic inflammatory and stress response in patients with mycoplasma pneumonia.展开更多
基金Supported by National Natural Science Foundation of China(No.81200719)China Postdoctoral Science Foundation(No.2013M543579+1 种基金 No.2014T71013)Key Specialized Projects in Nanjing(No.SZDZK2016008)
文摘Currently, thyroid-associated ophthalmopathy (TAO) lacks effective treatment due to our lack of clarity in its immunopathogenesis. Orbital fibroblasts play a key role in altering inflammation and immune response in TAO, and are considered as the key target and effector cells in its pathogenesis. The orbit infiltrating CD34+ fibrocytes add on to the process by expressing high levels of autoantigens and inflammatory cytokines, while also differentiating into myofibroblasts or adipocytes. This review focuses on the role of orbital fibroblasts and CD34+ fibrocytes in the pathogenesis of TAO, highlighting the basis of emerging treatments.
文摘BACKGROUND Large cell neuroendocrine carcinoma(LCNEC)of the endometrium is an uncommon and highly aggressive tumor that has not been comprehensively characterized.We report a case of pure endometrial LCNEC and review the current literature of similar cases to raise awareness of the histological features,treatment,and prognosis of this tumor.CASE SUMMARY We report the case of a 73-year-old woman who presented with irregular postmenopausal vaginal bleeding.Ultrasonography showed an enlarged uterus and a 5.1 cm×3.3 cm area of medium and low echogenicity in the uterine cavity.Biopsy by dilatation and curettage suggested poorly differentiated carcinoma.Magnetic resonance imaging revealed a heterogeneously enhanced uterine tumor with diffuse infiltration of the posterior wall of the uterine myometrium and enlarged pelvic lymph nodes.The patient underwent a hysterectomy and bilateral adnexal resection.Gross observation revealed an ill-defined white solid mass of the posterior wall of the uterus infiltrating into the serosa with multiple solid nodules on the serous surface.Microscopically,the tumor cells showed neuroendocrine morphology(organoid nesting).Immunohistochemistry revealed the tumor cells were diffusely positive for the neuroendocrine markers CD56,chromogranin A,and synaptophysin.Thus,the tumor was diagnosed as stage IIIC endometrial LCNEC.CONCLUSION Pathologic findings and immunohistochemistry are essential in making a diagnosis of endometrial LCNEC.
文摘Objective:To study the effect of Singulair combined with methylprednisolone treatment on inflammatory response and peripheral blood lymphocyte subset content in children with mycoplasma pneumonia.Methods:74 children with severe mycoplasma pneumonia who were treated in Huai'an Second People's Hospital between June 2014 and October 2016 were selected as the research subjects and randomly divided into two groups, the intervention group received routine treatment combined with Singulair and methylprednisolone, and control group received routine treatment. Before and after treatment, serum was collected to detect the contents of inflammatory cytokines and corresponding cytokines of T lymphocyte subsets, and peripheral blood was collected to determine the contents of T cell subsets.Results:3 d and 7 d after treatment, serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of both groups were significantly lower than those before treatment while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those before treatment, and serum MCP-1, PCT, ICAM-1, CXCL8, CRP, IFN-γ and IL-17 contents as well as peripheral blood Th1 and Th17 contents of intervention group were significantly lower than those of control group while serum IL-4 and TGF-β contents as well as peripheral blood Treg and Th2 contents were significantly higher than those of control group.Conclusion: Singulair combined with methylprednisolone treatment of mycoplasma pneumonia can inhibit the inflammatory response and regulate the balance of Th1/Th2 and Th17/Treg cells.
文摘BACKGROUND The clinicopathological features,immunohistochemical characteristics,and genetic mutation profile of two unusual cases of distal bronchiolar adenoma are retrospectively analyzed and the relevant literature is reviewed.CASE SUMMARY Case 1 was a 63-year-old female patient who had a mixed ground-glass nodule,with mild cells in morphology,visible cilia,and bilayer structures in focal areas.Immunohistochemical staining for P63 and cytokeratin(CK)5/6 revealed the lack of a continuous bilayer structure in most areas,and no mutations were found in epidermal growth factor receptor,anaplastic lymphoma kinase,ROS1,Kirsten rat sarcoma,PIK3CA,BRAF,human epidermal growth factor receptor-2(HER2),RET,and neuroblastoma RAS genes.Case 2 was a 58-year-old female patient who presented with a solid nodule,in which most cells were observed to be medium sized,the nuclear chromatin was pale and homogeneous,local cells had atypia,and cilia were found locally.Immunohistochemical staining for P63 and CK5/6 showed no expression of these proteins in mild cell morphology whereas the heteromorphic cells showed a bilayer structure.The same nine genes as above were analyzed,and HER2 gene mutation was identified.CONCLUSION Some unresolved questions remain to be answered to determine whether the lesion is a benign adenoma or a part of the process of malignant transformation from benign adenoma of the bronchial epithelium.Furthermore,whether lesions with atypical bilayer structures are similar to atypical hyperplastic lesions of the breast remains to be elucidated.Moreover,clarity on whether these lesions can be called atypical bronchiolar adenoma and whether they are invasive precursor lesions is needed.Future studies should examine the diagnostic significance of HER2 gene mutation as a prognostic indicator.
文摘Objective: To explore the therapeutic effect of montelukast sodium + methylprednisolone+ azithromycin therapy for patients with mycoplasma pneumonia. Methods: A total of 88 patients with mycoplasma pneumonia who were treated in our hospital between July 2015 and June 2017 were collected and divided into group A (oral azithromycin), group B (oral azithromycin + methylprednisolone), group C (oral azithromycin + montelukast sodium) and group D (oral montelukast sodium + methylprednisolone + azithromycin), and they were continuously treated for 1 week. The differences in therapeutic effect, systemic inflammatory response and stress response were compared among the four groups of patients. Results:After 1 week of treatment, the overall response rate of group D was higher than that of group A, group B and group C, and the overall response rate of group B and group C were higher than that of group A respectively;serum inflammatory factors C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), cortisol (COR), malondialdehyde (MDA) and advanced oxidation protein product (AOPP) levels of group D were lower than those of group A, group B and group C, and serum CRP, IL-6, TNF-α, COR, MDA and AOPP levels of group B and group C were lower than those of group A respectively. Conclusion:Montelukast sodium + methylprednisolone + azithromycin therapy can significantly improve the therapeutic effect and inhibit the systemic inflammatory and stress response in patients with mycoplasma pneumonia.
