Springer Science and Business Media LLC

Tanshinone IIA is a lipophilic organic compound from the root of Danshen (Salvia miltiorrhiza) and is one of the most well-known Tanshinone molecules by pharmacologists. In recent years, in addition to effects of anti-cardiovascular and neurological diseases, Tanshinone IIA has also shown some degrees of anti-prostate cancer potential. Although they do have some studies focusing on the molecular mechanism of Tanshinone IIA’s anti-prostate cancer effects, a further understanding on the transcriptomic and structural level is still lacking. In this study, transcriptomic sequencing technology and computer technology were employed to illustrate the effects of Tanshinone IIA on prostate cancer through bioinformatic analysis and molecular dynamics simulation, and PPARG was considered to be one of the targets for Tanshinone IIA according to docking scoring and dynamic calculation. Our study provides a novel direction to further understand the mechanism of the effects of Tanshinone IIA on prostate cancer, and further molecular biological studies need to be carried on to further investigate the molecular mechanism of Tanshinone IIA’s anti-prostate cancer effect through PPARG.

Combined immunomodulatory and antiviral treatment was administered to three patients with newly diagnosed HIV-associated primary central nervous system lymphoma (PCNSL) in an attempt to improve outcomes. Three patients from our institution who were recently diagnosed with HIV-associated PCNSL received intravenous azidothymidine (AZT) 1.6 gr. bid for two weeks, followed by oral AZT 250 mg bid from day 15. In addition, complementary highly active antiretroviral therapy (HAART) with a second nucleoside reverse transcriptase inhibitor (NRTI) plus one protease inhibitor (PI) and interleukin 2 (IL-2) subcutaneously 2 million units twice daily (bid) plus foscarnet 90 mg/kg bid were administered on days 1-14. One patient received anti-EpsteinBarr virus (EBV)-maintenance therapy with ganciclovir, followed by cidofovir [1]. All patients experienced progressive disease while on induction therapy, and switched early to whole-brain radiation therapy (WBRT) as second linetreatment. No grade 3 or 4 toxicities were observed. Two patients died on days 50 and 166 respectively due to progressive disease. The third patient with histologically proven lymphoproliferation and only suspected PCNSL remained alive at 53 months. He was on HAART and remained clinically and neurologically stable. Although IL-2, HAART, high-dose AZT and foscarnet are used for other HIV-related conditions, they did not demonstrate benefit in lymphoma remission for 2 HIVassociated PCNSL patients. The third patient went into delayed remission after additional radiotherapy and was in good clinical and neurological health status over 53 months after diagnosis.

This study is to examine the predictors of survival and to construct a nomogram for predicting the overall survival (OS) of primary bladder signet ring cell carcinoma (SRCC) patients based on the analysis of the Surveillance, Epidemiology, and End Results (SEER) database. A total of 219 eligible patients diagnosed with SRCC were analyzed using the 2004–2015 data from SEER database. Univariate and multivariate Cox regression were used to determine independent prognostic factors, followed by development of a nomogram based on the multivariate Cox regression models. The consistency index (C-index), receiver operating characteristic (ROC) curve, and calibration curve were used to validate the prognostic nomogram. The nomograms indicated appreciable accuracy in predicting the OS, with C-index of 0.771 and 0.715, respectively. The area under the curve (AUC) of the nomogram was 0.713 for 1 year, 0.742 for 3 years, and 0.776 for 5 years in the training set, while was 0.730 for 1 year, 0.727 for 3 years, and 0.697 for 5 years in the validation set. The calibration curves revealed satisfactory consistency between the prediction of deviation correction and ideal reference line. The prognostic nomogram developed in the analytical data of SEER it provided high accuracy and reliability in predicting the survival outcomes of primary bladder SRCC patients and could be used to comprehensively assess the risk of SRCC. Moreover, they could enable clinicians to make more precise treatment decisions for primary bladder SRCC patients.

Intraductal papillary neoplasm of the bile duct (IPNB) is a premalignant neoplasm that can involve both the intrahepatic and extrahepatic bile ducts. Owing to the low incidence and confusing nomenclature, its clinicopathological features remain controversial. Additionally, only a few studies have reported on the long-term prognosis of IPNB to date. Therefore, the present study aimed to clarify the clinicopathological characteristics and prognosis of IPNB. Medical records of patients with IPNB treated at our hospital between August 2000 and October 2021 were retrospectively reviewed. A database of demographic characteristics, test results, surgical details, pathological findings, and follow-up information was constructed for analysis. Patients were divided into intrahepatic and extrahepatic groups, and dysplasia and invasive carcinoma groups for comparison. Differences between study groups were analyzed using the χ2 test, Fisher’s exact test, t-test, or Mann–Whitney U test, as appropriate. Cumulative survival rates were estimated using the Kaplan–Meier method. In total, 43 patients (21 men and 22 women) with IPNB were included in the study. The median age at diagnosis was 62 (54–69) years. Thirty-eight patients underwent surgery. The mean operation time was (269.5 ± 94.9) min. Five patients underwent endoscopic retrograde cholangiopancreatography for biopsy. Twenty-one and 22 patients had intrahepatic and extrahepatic lesions, respectively. The extrahepatic group had more patients with intraluminal masses (p = 0.021) and abnormal bilirubin levels (p = 0.001), but fewer patients with hepatolithiasis (p = 0.021). The operation time was longer in patients with extrahepatic lesions (p = 0.002). Twenty patients had dysplasia and 23 had invasive carcinoma. The invasive carcinoma group had a longer operation time than the dysplasia group (p = 0.004). As of March 2022, 39 patients were followed up, with a mean follow-up time of (56.2 ± 38.2) months. Fifteen patients survived without tumors, two survived with tumors, and 22 patients died. The 1-, 3-, 5-, and 10-year cumulative overall survival rates were 86.9%, 65.8%, 49.8%, and 32.0%, respectively. IPNB is a rare bile duct disease that occurs mainly in patients with advanced age. Surgery is the primary treatment strategy. Intrahepatic and extrahepatic lesions, as well as dysplasia and invasive carcinoma have their own unique characteristics. The long-term prognosis of IPNB is generally poor.

Placenta accreta is a rare obstetric condition but can lead to life-threatening complications that was mainly diagnosed in the third trimester. We present a case of acute trophoblastic pulmonary embolism (PE) during conservative treatment of placenta accreta. A 24-year-old patient who delivered vaginally at 40+4 weeks gestation. The placenta was retained despite the use of oxytocics and attempts of manual removal. Conservative management including uterine arteria embolism, hysteroscopic resection and mifepristone was used but failed and finally the patient died from acute trophoblastic PE and allergic shock when infusing povidone-iodine into her uterine cavity. Although conservative treatment of placenta accreta can retain reproductive potential and trophoblastic PE is rare, clinicians should consider hysterectomy when conservative treatment failed and infusion of povidone-iodine or other liquid into the cavity should be prohibited.

Circulating thyroid-stimulating hormone (TSH) levels within the normal reference range can affect the cardiovascular system. The present study investigated the prognostic value of normal TSH levels in patients presenting with acute myocardial infarction (AMI) following percutaneous coronary intervention (PCI). Between January 2013 and July 2019, 1240 patients with AMI and normal thyroid function were enrolled and classified according to TSH tertile. The trial endpoint was all-cause mortality. The integrated discrimination index (IDI) and the net reclassification index (NRI) were used to assess the combined predictive values of the TSH levels and the Global Registry of Acute Coronary Events (GRACE) scores. After a median 44.25-month follow-up, 195 individuals died. Even after covariate adjustment by multivariate Cox regression (HR: 1.56; 95% CI 1.08–2.25; P = 0.017), the patients in the third TSH tertile were at the highest risk of all-cause mortality. A subgroup analysis revealed significant interactions between the TSH levels and the GRACE scores (high risk vs. low/medium risk) (P = 0.019). The addition of the TSH levels to the GRACE scores substantially improved the prediction of all-cause mortality, especially for high-risk patients (NRI = 0.239; IDI = 0.044; C-statistic value range 0.649–0.691; all significant). The third TSH tertile is associated with a higher incidence of all-cause mortality than the first TSH tertile in high-risk patients presenting with AMI after PCI.

Orbital inflammatory pseudotumor (OIP) is a benign, non-specific inflammatory disorder that commonly occurs in middle-aged adults and is usually unilateral but can occur bilaterally. Its clinical manifestations have tremendous clinical heterogeneity and vary according to the site of infiltration and the degree of lesions, including orbital pain, swelling, diplopia, proptosis, restricted eye movement, and decreased visual acuity. Clinical features, Image characteristics and pathological examinations often need to be evaluated to confirm the diagnosis. Currently, there is no systematic research on the pathogenesis of OIP, which may be related to immunity or infection. The first-line treatment is glucocorticoids. Radiotherapy, immunosuppressants, and biologics can be considered for treatment-resistant, hormone-dependent, or intolerant patients. In this review, we aim to summarize and focus on new insights into OIP, including new diagnostic criteria, pathogenesis, and discoveries in new drugs and treatment strategies. In particular, we highlight the literature and find that T cell-mediated immune responses are closely related to the pathogenesis of OIP. Further exploration of the mechanism and signaling pathway of T cells in the immune process will help to identify their therapeutic targets and carry out targeted therapy to treat refractory OIP and reduce the side effects of traditional treatments.

Khuyết tật thể chất nổi tiếng là kéo dài trong nhiều năm sau một chấn thương nghiêm trọng, và có ảnh hưởng lớn đến chất lượng cuộc sống của người sống sót. Mục đích của nghiên cứu này là xem liệu điều này cũng đúng với khuyết tật tâm lý có triệu chứng của rối loạn stress sau chấn thương hoặc trầm cảm sau đa chấn thương. Nghiên cứu kết quả theo dõi hồi cố. Trung tâm chấn thương cấp I. 637 bệnh nhân đa chấn thương đã được điều trị tại trung tâm chấn thương cấp I của chúng tôi từ 1973 đến 1990. Thời gian theo dõi tối thiểu là 10 năm sau khi bị chấn thương. Bệnh nhân được yêu cầu điền vào bảng câu hỏi, bao gồm các phần của Thang đo Chẩn đoán Stress Posttraumatic, Thang đo Tác động của Sự kiện - Phiên bản sửa đổi và Thang đo Lo âu và Trầm cảm tại Bệnh viện Đức, để đánh giá sức khỏe tâm thần. Kết quả lâm sàng đã được đánh giá trước đó bằng các điểm số tiêu chuẩn hóa. Ba trăm hai mươi bốn bảng câu hỏi đã được đánh giá. Một trăm bốn mươi chín (45,9%) bệnh nhân có triệu chứng khuyết tật tâm thần. Chất lượng cuộc sống cao hơn một cách đáng kể ở nhóm tâm thần khỏe mạnh, trong khi nhóm bị khuyết tật đạt được trạng thái phục hồi thấp hơn. Khuyết tật tâm thần có thể được tìm thấy ở các nạn nhân chấn thương đa chấn thương, thậm chí sau 10 năm hoặc lâu hơn. Các bác sĩ điều trị không chỉ nên tập trung vào phục hồi thể chất sớm mà còn cần chú trọng vào phục hồi tâm thần sớm để ngăn ngừa các vấn đề lâu dài trong cả khuyết tật thể chất và tâm thần.