Exosome-Transmitted miR-128 Targets CCL18 to Inhibit the Proliferation and Metastasis of Urothelial Carcinoma

Objective: To investigate the regulatory function of exosome-transmitted miR-128 and chemokine (C-C motif) ligand 18 (CCL18) on urothelial carcinomas (UCs).Methods: Tumor tissues, paracancerous tissues, and serum were collected from 20 patients with UCs (diagnosed at Beijing Friendship Hospital, Capital Medical University). CCL18 was detected by immunohistochemistry and ELISA. PCR was used to measure the expression levels of CCL18 and mir-183, miR-128, mir-33a in UCs. We acquired exosomes from mesenchymal stem cells and synthesized exosomes overexpressing miR-128 (HMSC-128-EV). The effects of miR-128 on the migration and invasion abilities, apoptosis and epithelial-mesenchymal transition of BUC T24 cells were investigated by co-culturing HMSC-128-EV. The therapeutic potential of miR-128 on disease models was explored by injecting HMSC-128-EV into nude mice.Results: The expression of CCL18 in UCs was significantly higher than that in normal tissues (p < 0.05), and the serum level of CCL18 in patients with UC was significantly increased compared with those in healthy controls (p < 0.05). CCL18 overexpression or downregulation enhanced or suppressed the proliferation, migration and invasion of BUC T24 cells, resectively (p < 0.05). The exosome-transmitted miR-128 can inhibit cell proliferation (p < 0.05), invasion (p < 0.05), and migration (p < 0.05) in UCs, and these effects can be reversed by CCL18. In terms of apoptosis, miR-128 was able to promote the occurrence of BUC T24 apoptosis (p < 0.05), which can also be reversed by CCL18. In addition, miR-128 can inhibit the proliferation (p < 0.05) and metastasis (p < 0.05) of UCs in nude mice.Conclusion: The miR-128 inhibits the proliferation, invasion, migration of UCs, and promotes its apoptosis by regulating CCL18 secretion.

Clinical Features and Prognostic Risk Prediction of Non-Hodgkin Lymphoma-Associated Hemophagocytic Syndrome

BackgroundMalignancies, especially lymphoma, are a common cause of adult secondary HLH and an independent risk factor for the prognosis of HLH patients.MethodsPatients with lymphoma alone or concurrent lymphoma-associated phagocytic syndrome (LAHS) admitted to Beijing Friendship Hospital from January 2016 to December 2020 were enrolled in this study.FindingsThere were 348 lymphoma patients, 104 concurrent with LAHS. The pathological type of lymphoma without LAHS was dominated by B-cell lymphoma, while those with LAHS were T/NK-cell lymphoma predominantly (p < 0.001). Superficial lymph node enlargement was more significant in patients with B-LAHS (p = 0.006), while patients with T/NK-LAHS had lower neutrophil counts (p = 0.005), lower fibrinogen levels (p < 0.001), higher transaminase levels, and more co-infection with EBV (p < 0.001). B-LAHS had significantly higher IL-10 levels than with T/NK-LAHS (p = 0.006), and NK/T-LAHS had significantly higher IP-10 levels than other T-LAHS (p = 0.008). Age, platelet count, IPI, history of NK/T lymphoma, and no remission of HLH were independent risk factors for prognosis in patients with non-Hodgkin lymphoma-associated phagocytic syndrome (NHL-LAHS), and a prognostic risk score model for NHL-LAHS was developed.ConclusionLAHS is a life-threatening disease with a poor prognosis. The prognostic risk score model for NHL-LAHS with a good fit and validation for the test has value for clinical application.

Diagnosis and Management of Occult Cervical Tuberculous Lymphadenopathy

Objective: Some cervical tuberculous lymphadenopathy (CTL) presents no evidence of tuberculosis (TB), even after thorough examination of a fine-needle aspiration (FNA) specimen. After the examination of excisional specimens, when the polymerase chain reaction (PCR) analysis identifies the nucleic acid of Mycobacterium tuberculosis (Mtb) or the culture results are positive, then the diagnosis of CTL is established. We refer to this condition as occult CTL (OCTL). Patient and Methods: The present work is a retrospective review of a consecutive series of OCTL cases that were treated at the Department of Otolaryngology-Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, between June 2015 and September 2020. When the diagnosis of OCTL was established, the patients received the standard anti-TB chemotherapy. Results: Fourteen cases of OCTL, including 9 female and 5 male patients, aged 24 to 71 years (median age 42 years), were included in the present study. The most commonly observed levels of lymph node involvement were level V and level II. Each level of the involved lymph nodes was removed entirely through en bloc surgical resection. An evaluation of the excisional specimens led to positive PCR results in all 14 cases, with 2 cases presenting positive culture and 3 cases exhibiting positive acid-fast bacilli (AFB) staining. Recovery was uneventful, and the anti-TB chemotherapy was completed in all cases. The median duration of follow-up was 29 months, during which no case of TB relapse was observed. Conclusions: Wide surgical excision is crucial for the diagnosis and management of OCTL, and when used in combination with anti-TB chemotherapy, it results in satisfactory patient outcomes.

Diagnosis and Management of Giant Esophageal Fibrovascular Polyp With Hypopharyngeal Pedicle

Background: Fibrovascular polyps (FVPs) with hypopharyngeal pedicles (hFVPs) are the rare intraluminal benign tumours of the upper aerodigestive tract, and their accurate diagnosis and optimal management are challenging. Purpose: The present retrospective study attempted to explore the optimal diagnosis and treatment of hFVPs. Research Design: The clinical records of 2 patients with giant, irregularly shaped hFVPs, who underwent several failed surgical procedures after inaccurate diagnosis, were reviewed. Finally, the patients were correctly diagnosed and successfully treated at Capital Medical University Beijing Friendship Hospital in different years, 2018 and 2020. Results: Case 1 was of a 43-year-old woman with 2 months of progressive dysphagia. Gastroenterologists overlooked the origin of her FVP, and decided to sever its narrowest point in the oesophagus through endoscopy. However, upon unsuccessful removal of the mass, a gastrotomy procedure was performed to extract the mass 7 days later. Symptoms recurred 3 months after the treatment, and a fibreoptic laryngoscopy confirmed hFVP in the patient at our department. A transcervical approach was used to sever the hypopharyngeal pedicle, achieve haemostasis and remove the oesophageal tumour. No recurrence was detected during the 2-year follow-up period after the treatment. Case 2 was of a 32-year-old man with dysphagia who had previously undergone transthoracic and transcervical oesophagotomy procedures within a gap of 3 months for the removal of FVP causing dysphagia. The hypopharyngeal pedicle was not diagnosed in the patient. The symptoms of dysphagia recurred 4 years after the treatment, and a fibreoptic laryngoscope confirmed hFVP at our department. The tumour was removed successfully through the transcervical approach. No recurrence was detected during the 6-months follow-up after surgery. Conclusion: In conclusion, the transcervical approach is suitable for achieving haemostasis and removing giant, irregularly shaped hFVPs.

Đặc điểm lâm sàng, cận lâm sàng và một số yếu tố nguy cơ đến mức độ nặng ở bệnh nhân thoái hóa khớp gối nguyên phát

TÓM TẮT Mục tiêu: Mô tả đặc điểm lâm sàng, cận lâm sàng và xác định một số yếu tố nguy cơ liên quan đến mức độ nặng thoái hóa khớp trên X-quang, siêu âm. Đối tượng và phương pháp nghiên cứu: Nghiên cứu mô tả cắt ngang trên 96 bệnh nhân thoái hóa khớp gối nguyên phát theo tiêu chuẩn ACR 1991 tại bệnh viện Hữu nghị Đa khoa Nghệ An. Kết quả: Độ tuổi trung bình trong nghiên cứu là 76,8 ± 10,24, nhóm tuổi trên 70 chiếm tỷ lệ cao nhất là 54,71%. Nữ giới chiếm tỷ lệ 75%. BMI trung bình là 23,2 ± 1,08 kg/m2, trong đó BMI ≥ 23kg/m2 chiếm 75%. Triệu chứng đau cơ học chiếm 94,7%, cứng khớp buổi sáng dưới 30 phút 84,1%, lạo xạo khi cử động 88,74%, dấu hiệu bào gỗ 87,42%, bập bềnh xương bánh chè 5,3%. Gai xương khe đùi chè chiếm tỷ lệ cao nhất 81,48%, lệch trục khớp 52,98%, đặc xương dưới sụn 33,11%, siêu âm tràn dịch chiếm 20,53%, kén Baker 19,82%, Nhóm tuổi trên 60 có nguy cơ tổn thương trên X-quang cao gấp 12,72 lần và trên siêu âm cao gấp 14,6 lần so với nhóm tuổi dưới 60. Những bệnh nhân có BMI ≥ 23kg/m2 có nguy cơ tổn thương trên X-quang mức độ nặng cao gấp 2,24 lần nhóm có BMI < 23kg/m2. Kết luận: Thoái hóa khớp gối rất phổ biến ở người cao tuổi, đặc biệt ở nữ giới và tình trạng thừa cân béo phì. Các yếu tố như tuổi cao, tình trạng thừa cân béo phì có liên quan đến mức độ nặng của thoái hóa khớp gối trên X-quang và siêu âm. ABSTRACT CLINICAL, PARACLINICAL CHARACTERISTICS AND SOME RISK FACTORS FOR THE SEVERITY OF PRMARY KNEE OSTEOARTHRITIS Objetive: To describe clinical, paraclinical characteristics and expolore some risk factors regarding the severity of osteoarthritis based on X-ray and ultrasound findings. Methods: A prospective cross - sectional descriptive study was conducted on 96 patients with primary Results: The average age in the study was 76.8 ± 10.24, the age group of over 70 accounted for the highest rate of 54.71%. Women ratio made up 75%. The average BMI was 23.2 ± 1.08 kg/m2, of which the BMI ≥ 23kg/m2 accounted for 75%. Symptoms of mechanical pain accounted for 94.7%, knee stiffness in the morning less than 30 minutes 84.1%, knee crunch 88.74%, signs of wood plank 87.42%, patellar fluttering 5.3 %. The highest percentage of femoral cleft spines accounted for 81.48%, joint axis deviation 52.98%, subchondral solidification 33.11%, ultrasound effusion accounted for 20.53%, Baker’s cocoon 19.82%, The age group of over 60 had a 12.72 times higher risk of lesions on X-ray and on ultrasound 14.6 times higher than the age group under 60. The group of patients with BMI ≥ 23kg/m2 had the risk of severe lesions on X-ray 2.24 times higher than the group of patients with BMI < 23kg/m2. Conclusion: Osteoarthritis of the knee is very common in the elderly, especially female and obese subjects. Risk factors such as advanced age, overweight and obesity had the relation to the severity of the degeneration on radiographs and ultrasound. Keywords: Kneeosteoarthritis, X-ray, ulstrasonography knee osteoarthritis according to clinical criteria ACR 1991 at Nghe An general friendship hospital.

Characteristics of endoscopic and pathological findings of amebic colitis

Background The clinical features of amoebic colitis resemble those of inflammatory bowel disease (IBD), and therefore the risk of misdiagnosis is very high. The aim of this study was to analyse the characteristics of the endoscopic and pathological findings of amebic colitis and the lessons from our patients, which were useful for diagnosing the amebic colitis timely and avoiding the serious complication. Methods We retrospectively reviewed data of all amebic colitis admitted to Beijing Friendship Hospital from January 2015 to January 2020. Cases were diagnosed by clinical presentation, laboratory examinations, and colonoscopy with biopsy and histological examination, no ELISA stool antigen or PCR tests were used. Results 16 patients were diagnosed with amebic colitis by the colonoscopy accompanied by biopsy and microscopic examination. At first time, 12 (75%) patients were misdiagnosed as IBD. Cecum was the most common site of amebic colitis (100%), and the caecum and rectum were also involved in many lesions (68.75%). Multiple lesions of erosion and/or ulcer were recognized in all patients (100%).The endoscopic findings included multiple irregular shaped ulcers and erosions with surrounding erythema, and the ulcers and erosions were covered by the white or yellow exudates. The intervening mucosae between the ulcers or erosions were normal. The features of rectums can be divided to 2 types: in 6 patients (54.5%), the irregular ulcer or erosions covered with white or yellow exudates were observed in rectum and cecum, and the bloody exudates in rectum were more severe than those in cecum; in other 5 patients (45.5%), rectal lesions were much less severe than those in cecum, the small superficial erosion or reddened mucosa were observed in the rectal ampulla. All patients were diagnosed as detection of amebic trophozoites from HE-stained biopsy specimens. The number of trophozoites ranged from 1/HPF to > 50/HPF. Among 16 cases, mild architectural alteration of colon crypt were observed in 10 cases (62.5%), and serious architectural alteration of colon crypt was found which had crypt branch in 1 case (16.7%). Cryptitis was observed in 12 cases (75%) and its severity was mild or moderate. No crypts abscess was observed in all cases. Conclusions The colonoscopy with histological examination are very important to diagnose the amebic colitis. Detect the amoebic trophozoites in the exudates by histological examination is the vital. Sometimes a negative biopsy does not rule out amebiasis, repeated biopsies may be needed to make the diagnosis.

DESCRIPTION OF CLINICAL AND PARACLINICAL RESULTS OF LAPAROSCOPIC RETROPERITONEAL RESECTION OF BENIGN ADRENAL ADENOMA AT VIET DUC FRIENDSHIP HOSPITAL IN 2018

The study was conducted with objectives: Describe the clinical and paraclinical results of laparoscopic retroperitoneal resection of benign adrenal tumors at Viet Duc Friendship Hospital in 2018 on 67 patients diagnosed as benign adrenal tumor and was treated with retroperitoneal endoscopic surgery at Viet Duc hospital in 2018. The study design was retrospective. Results: The clinical syndromes of the patients were mainly Cushing's syndrome (3%), Conn's syndrome (29,8%), Pheochromocytome (17,9%) and 49,3% of patients with nonsecretory tumors. . Specific biochemical tests: hypercortisolemia (4,48%); increased blood catecholamines (16,42%) and increased urinary catecholamines (14,93%). Ultrasound: The average tumor size was 20.37 ± 16.05mm; The diagnostic sensitivity was 74,6%. CT or MRI: The mean tumor size was 26.63 ± 12.7mm; highly sensitive and is the gold standard on diagnostic imaging. Conclusion: The clinical and laboratory results of patients undergoing laparoscopic resection of benign adrenal tumors are highly sensitive.

EVALUATING THE RESULTS OF LAPAROSCOPIC SURGERY CUT BENIGN ADRENAL TUMOR RETROPERITONEAL ROAD IN VIETNAM GERMAN FRIENDSHIP HOSPITAL IN 2018

A descriptive regression study evaluating surgical outcomes of 67 patients diagnosed with benign adrenal tumors and treated with retroperitoneal laparoscopic surgery at Viet Duc Hospital in 2018.Results: For Surgical subjects mainly belonged to ASA group I or II, the average surgery time of the study subjects was 71.04 ± 23.50. In the group of pathological tumors, the surgical time of the group of patients with non-secretory tumours was the longest (74.2 ± 23.2 minutes); The operative time of the group of patients with Conn’s disease was the shortest (67.5 ± 26.1 minutes). The averageoperating time of the group of tumors from 1-10mm in size was 60 minutes. 66/67 patients with total thoracic resection due to tumor accounted for 98.5%. Only 1/67 patients with selective resectionof TTT. Out of a total of 67 patients studied, there were 2 patients with subcutaneous emphysema, accounting for 3.0%.

Beijing Friendship Hospital Osteoporosis Self-Assessment Tool for Elderly Male (BFH-OSTM) vs Fracture Risk Assessment Tool (FRAX) for identifying painful new osteoporotic vertebral fractures in older Chinese men: a cross-sectional study

Background To compare the validation of four tools for identifying painful new osteoporotic vertebral compression fractures (PNOVCFs) in older Chinese men: bone mineral density (BMD), Asian osteoporosis self-assessment tool (OSTA), World Health Organization fracture risk assessment tool (FRAX) (without BMD) and Beijing Friendship Hospital Osteoporosis Self-Assessment Tool (BFH-OSTM). Methods A cross sectional study was conducted from 2013 to 2019. A total of 846 men aged ≥50 were included and were divided into two groups: Fracture Group (patients with PNOVCFs underwent percutaneous vertebroplasty surgery) and Non-Fracture Group (community dwelled subjects for healthy examination). All subjects accepted a dual-energy X-ray BMD test and a structured questionnaire. The results of BMD, OSTA, FRAX and BFH-OSTM scores were assessed and receiver-operating characteristic (ROC) curves were generated to compare the validity of four tools for identifying PNOVCFs. Optimal cutoff points, sensitivity, specificity, and areas under the ROC curves (AUCs) were determined. Results There were significant differences including BMD T score (femoral neck, total hip and L1-L4), OSTA, FRAX and BFH-OSTM scores between Fracture group and Non-fracture group. Compared to BMD and OSTA, BFH-OSTM and FRAX had better predictive value, the sensitivity, specificity and AUC value are 0.841, 81.29%, 70.67% and 0.796, 74.85%, 78.52%, respectively. Compared with FRAX, the BFH-OSTM has a better AUC value. Conclusions Both BFH-OSTM and FRAX can be used to identify POVCFs, However, BFH-OSTM model may be a more simple and effective tool to identify the risk of POVCFs in Chinese elderly men.

Acute generalized peritonitis of appendicular origin: Epidemiological, clinical and therapeutic aspects at the Sino-Guinean Friendship Hospital

Introduction: The aim of this study is to investigate, the etiologies, the results of management of acute generalized peritonitis of appendicular origin. Acute generalized peritonitis of appendicular origin is defined as acute inflammation of the peritoneum resulting from either perforation of the appendix or spread of a peri-appendicular abscess. Methodology: The visceral surgery department of the Sino-Guinean Friendship Hospital served as the framework for this work. All patients admitted and operated on for acute generalized peritonitis of appendicular origin whose records were complete were included in this study. Results: During our study we recorded 23 cases of appendicular peritonitis, the sex ratio of nearly 3.6 reflected a clear male predominance of the condition. We noted 15 cases of appendicular perforation, 8 cases of appendicular gangrene, 2 cases of surgical site infection, 2 cases of evisceration and 2 cases of death. Conclusion: Appendicular peritonitis is a frequent disease, the management is medico-surgical.