Elevated procalcitonin levels in the absence of infection in procalcitonin-secretin hepatocellular carcinoma: A case report

BACKGROUND

Serum procalcitonin (PCT) is widely used to diagnose bacterial infection and sepsis. However, PCT may be elevated in some neoplasms. It is important to distinguish infection from no infection in such neoplasms. The relationship between hepatocellular carcinoma (HCC) and PCT is unknown.

CASE SUMMARY

A 62-year-old male was admitted due to a hepatic lesion of unknown origin. The patient had an elevated PCT level. Infectious diseases were excluded after appropriate examination. He then underwent exploratory laparotomy and a left lateral hepatectomy was performed. The patient recovered with an uneventful postoperative course and PCT level decreased gradually and was normal on day 16. HCC was diagnosed by histopathology and no evidence of infection was observed. Furthermore, immunohistochemical analyses revealed that tumor cells were positive for PCT.

CONCLUSION

HCC cells can secrete PCT in the absence of infection and PCT may be used as a marker to monitor the efficacy of tumor therapy.

[Clinical characteristics and risk factors of deaths in patients with Wiskott-Aldrich syndrome]

Objective: To explore the clinical characteristics and risk factors of pediatric patients with Wiskott-Aldrich syndrome (WAS). Methods: This was a case-control study. Clinical data of 165 cases of pediatric patients with WAS, who visited the Department of Rheumatology, Children's Hospital of Chongqing Medical University between January 2007 and August 2020 were retrospectively analyzed and divided into death group and survival group (control group) according to the prognosis in the follow-up. Two independent samples t-test, Welch approximate t-test, Mann-Whitney U test, Pearson χ² test, Yates corrected χ² test, or Fisher exact probability test were used for comparison between groups. Risk factors were analyzed by multivariate Logistic regression analysis. Results: A total of 165 patients with Wiskott-Aldrich syndrome were enrolled in this study, including 40 cases in the death group and 125 cases in the survival group. The WAS score was (4.1±0.8) score in the death group and (3.1±1.2) score in the survival group. The age was 19 (9, 28) months in the death group and 60 (36,86) in the survival group. The episode rates of recurrent infection and (or) severe infection, intracranial hemorrhage and eczema in the death group were significantly higher than those in the survival group (95.0% (38/40) vs.32.0% (40/125),25.0% (10/40) vs. 2.4% (3/125), 90.0% (36/40) vs. 72.0% (90/125), χ²=48.253, 18.325, 5.440, all P<0.05). Infection (22 cases, 55.0%) and intracerebral hemorrhage (15 cases, 37.5%) were the main causes of death, 3 cases (7.5%) died of severe graft-versus-host disease after transplantation. The Logistic regression model indicated that repeated infection and (or) severe infection and non-use of intravenous immunoglobulin (IVIG) replacement therapy were risk factors for death in Chinese WAS patients (OR values were 8.999 and 2.860, 95% CI were (2.041-39.667) and (1.375-5.950), respectively, all P<0.05). Conclusions: Recurrent and (or) severe infection is the main risk factor of death for WAS patietns. Regular IVIG treatment can improve the survival rate of patients with WAS.

Intrahepatic cholangiocarcinoma is more complex than we thought: A case report

BACKGROUND

Brain metastasis from intrahepatic cholangiocarcinoma is rare. To the best of our knowledge, only a few cases have been reported. The biological behavior was complex, and treatment requires further investigation.

CASE SUMMARY

A 62-year-old woman complained of left limb weakness. Abdominal computed tomography showed a 5.0 cm × 5.6 cm lesion in the left lobe of the liver. Tumor markers were normal. Serological analysis indicated absence of hepatitis virus. Brain magnetic resonance imaging revealed a 1.0 cm × 1.3 cm mass in the right frontal lobe. Intrahepatic cholangiocarcinoma with brain metastasis was diagnosed by our liver cancer multidisciplinary team. After sufficient preparation, the patient underwent partial frontal lobotomy and left hemihepatectomy. Histopathological results confirmed that both the lesions were cholangiocarcinoma. Six cycles of gemcitabine combined with S1 were administered. During a 39 mo postoperative follow-up, no sign of local recurrence or distant metastasis was observed.

CONCLUSION

This case expands our knowledge concerning the complex and heterogeneous nature of tumor metastasis.

Epstein-Barr virus negative primary hepatic leiomyoma: Case report and literature review

Primary hepatic leiomyoma is a neoplasm of mesenchymal origin and occurs only rarely. Secondary to benign smooth muscle proliferation, it is usually found in adult women and is associated with Epstein-Barr virus (EBV) infection. Here, we report the 29^th case of primary hepatic leiomyoma with its unique features related to diagnosis, treatment and developmental biology. A 48-year-old man, with an immunocompromised status, complained of pain in the upper quadrant of the abdomen. Serological analysis indicated no presence of hepatitis virus, no human immunodeficiency virus, and no EBV infection. The levels of α-fetoprotein and carcinoembryonic antigen were normal. A mass was detected in segment III of the hepatic lobe by ultrasonography and an abdominal computed tomography scan. Endoscopy had negative findings. Exploratory laparotomy found no existing extrahepatic tumor and left lateral lobectomy was performed. Pathological examination showed the mass to be a typical leiomyoma. The cells were positive for α-smooth muscle actin and desmin, and negative for the makers of gastrointestinal stromal tumor (GIST), including CD117, CD34 and DOG1 (discovered on GIST1). In situ hybridization revealed negative status for EBV-encoded small RNA. After left lateral lobectomy, the patient was not given chemotherapy or radiotherapy. During a 2-year follow-up, no sign of local recurrence or distant metastasis was observed. In conclusion, we report a rare case of primary hepatic leiomyoma in a male patient without EBV infection. Hepatic resection was curative. This case presents data to expand our knowledge concerning the complex and heterogeneous nature of primary liver leiomyoma, indicating that EBV infection is important but neither necessary nor sufficient for the development of primary liver leiomyoma.

Effect of earthworm loads on organic matter and nutrient removal efficiencies in synthetic domestic wastewater, and on bacterial community structure and diversity in vermifiltration

In this paper, we studied the effect of earthworm loads on the removal rates of chemical oxygen demand (COD), ammonia nitrogen (NH3-N), total nitrogen, and total phosphorus from synthetic domestic sewage and on the bacterial community structure and diversity of substrates in earthworm packing beds. The different vermifiltrations (VFs), including the control, are successful in removing both organic matter (OM) and nutrients. The removal rate of NH3-N at 12.5 g of earthworm/L of soil VF is higher compared with that at 0 and 4.5 earthworm load VFs. The highest Shannon index, in the earthworm packing bed, occurred at 16.5 earthworm load VF. Furthermore, the COD removal rate is significantly correlated with the Shannon index, which reveals that OM removal for synthetic domestic sewage treatment at VF might be more dependent on bacterial diversity at the earthworm packing bed. The band distributions and diversities of the bacterial community for samples from different earthworm loads in VFs suggest that the bacterial community structure was only affected within the earthworm packing bed when the earthworm load reached a certain level. The present study adds to the current understanding of OM and nutrient degradation processes in VF domestic wastewater treatment.

[Chemical constituents in volatile oil from fruits of Alpinia oxyphylla Miq]

OBJECTIVE

To study the chemical constituents in the volatile oil from fruits of Alpinia oxyphylla.

METHOD

Using GC-MS to identify the constituents.

RESULT AND CONCLUSION

Sixty-four compounds were identified on the basis of GC-MS, the main ones being p-cymene, valence, linalool, myrtenal, alpha-pinene, beta-pinene, furopelargone A and terpinen-4-ol. Three sesquiterpenes valencene, nootkanone and nootkanol have been isolated from the CHCl3 extract as check, of these 64 identified compounds linalyl oxide, valencene, bakkenolide A, furopelargone A and 3-hydroxycalamenene are reported for the first time.

[Studies on the chemical constituents of the seeds from Artabostrys hexapetalus (Annonaceae)]

AIM

To study the chemical constituents of the seeds from Artabotrys hexapetalus (L.f.) Bhandari (Annonaceae).

METHODS

Various chromatographic techniques were used to separate and purify the constituents. Their structures were elucidated on the physico-chemical properties and spectral data.

RESULTS

Eight compounds were isolated from the seeds of A. hexapetalus. They were identified as four neolignans: isoamericanin A (1), isoamericanol A (2), americanin B (3) and artabotrycinol (4), a semiterpenoid: (R)-artabotriol (5) and others: palmitic acid (6), beta-sitosterol (7) and daucosterol (8).

CONCLUSION

Artabotrycinol (4) and (R)-artabotriol (5) are new compounds. Three other neolignans were isolated from this plant for the first time.

Annonaceous acetogenins of the seeds from Annona muricata

Muricatenol (1) is a new C37 non-THF ring acetogenin with four hydroxyls and one isolated double bond in the long aliphatic chain. 2,4-cis-Gigantetrocinone (2) and 2,4-trans-gigantetrocinone (3) have been isolated as their acetates by preparative TLC. 2,4-trans-Isoannonacin-10-one (4) and 2,4-trans-isoannonacin (5) have been isolated as only 2,4-trans-form for the first time (no cis-form). Also four known acetogenins, gigantetrocin-A (6), gigantetrocin-B (7), annomontacin (8), gigantetronenin (9) and a mixture of N-fatty acyl tryptamines have been isolated (10). Their structures have been established on the basis of spectral analyses. The CHCl3 fraction of the seeds showed strong antitumor activities.

[Studies on the chemical constituents of Kaempferia marginata]

AIM

To study the chemical constituents of the rhizomes of Kaempferia galanga L. (Zingiberaceae).

METHODS

Various chromatographic techniques were used to separate and purify. Their physico-chemical properties and spectral data were used to elucidate the structures.

RESULTS

Six compounds were isolated from the hexane extract of K. galanga. Their structures were identified as marginatol (1), 8 (14), 15-sanderacopimaradiene-1 alpha, 9 alpha-diol (2), 8 (14), 15-sanderacopimaradiene-1 alpha, 6 beta, 9 alpha-triol (3), germacrone (4), trans-ethyl p-methoxycinnamate (5) and n-pentadecane (6) on the basis of spectral data (IR, MS, 1H-1H, 13C-1H NMR, NOEs and HMBC).

CONCLUSION

Marginatol (1) is a new isopimarene diterpenoid and was elucidated as 8(14), 15-isopimaradiene-6 alpha-ol. Compounds 2, 3 and 4 were isolated for the first time from this plant.

Transgenic expression of green fluorescent protein in mouse oxytocin neurones

Routine targeting of neurones for expression of exogenous genes would facilitate our ability to manipulate their internal milieu or functions, providing insight into physiology of neurones. The magnocellular neurones of the paraventricular and supraoptic nuclei of the hypothalamus have been the objects of limited success by this approach. Here we report on the placement of the enhanced green fluorescent protein (eGFP) coding sequence at various locations within an oxytocin transgene. Placement within the first exon yielded little to no expression, whereas placement in the third exon (as an in-frame fusion with the carboxyl terminus of the oxytocin preprohormone) resulted in cell-specific expression of eGFP in oxytocin neurones. Furthermore, placement of the eGFP sequence downstream of a picornavirus internal ribosomal entry site (IRES), also in the third exon, allowed expression of the eGFP as a separate protein. Other coding sequences should now be amenable to expression within oxytocin neurones to study their physiology.

Isolation of full-length RNA from a thermophilic cyanobacterium

Isolation of full-length mRNA without degradation is critical in the study of in vivo gene regulation and transcription, cDNA synthesis and reverse transcription (RT)-PCR. It is particularly difficult to isolate full-length mRNA from thermophiles, which have higher turnover rates of mRNA degradation. Mastigocladus laminosus is a thermophilic heterocystous cyanobacterium. The assay of M. laminosus cell lysates showed that RNase activity was high and was resistant to the conventional guanidine thiocyanate and 2-mercaptoethanol denaturation methods. The mRNA isolated by several conventional methods was completely degraded. A method was developed to purify full-length mRNA by a combination of fast cooling, vanadyl-ribonucleoside-complex inhibition, phenol-chloroform-isoamyl alcohol extraction, lithium chloride precipitation and the lysing of cells with the French Press. This method produced high-quality, full-length mRNA in high yield. Purified mRNA was suitable for Northern blotting, cDNA synthesis and RT-PCR. This method could be applicable to other thermophiles in which the RNase activity is high and/or is resistant to guanidine thiocyanate.

[Studies on the chemical constituents of Annona muricata]

Annonaceous acetogenin (or polyketide) is a kind of potential antineoplastic agents from Annonaceae plants. Two new acetogenins, Muricatalicin (I) and muricatalin (VI), a mesitoate of a new acetogenin, annonacin-B mesitoate (Vb), and three known acetogenins, annonacin (II), annonacin-A (III) and annonacin-10-one (IV) have been isolated from Annona muricata L. The structures and relative stereochemistry of I, VI and Vb were elucidated on the basis of spectral analysis and examination of their acetates and/or mesitoate.

Indomethacin treatment in children with daytime frequency of micturition

Thirty children with daytime urinary frequency (DUFC) were randomly divided into two groups. The first group was given oral indomethacin, 1 mg/kg per dose, three times a day for 7 days. The frequency of urination fell from 26.3 +/- 2.3 to 11.7 +/- 2.8 at the end of the treatment period. The second group was treated with oral chloramphenicol, 30 mg/kg per day, in four divided doses for 7 days. Their urinary frequency did not change. They were then treated with a 1-week course of indomethacin and responded in a similar manner to group 1 patients. The use of indomethacin was accompanied by significant increases in plasma carbon dioxide-combining power, urine osmolality and urine pH; urine sodium and potassium levels decreased. These results show that a short course of indomethacin, in low dose, improves DUFC. We propose that it acts by inhibiting prostaglandin synthesis which modifies tubular function and increases urinary pH.

[Giant-cell tumor of the sacrum: an analysis of 10 cases]

Giant-cell tumor of the sacrum is rare. There were only a few reports of large series in the literature. From 1960-1988 a total of ten cases giant-cell tumor of the sacrum were treated in our Department. The average age of the patients was 34 years (with range of 19-49 years). The lesions located in the proximal parts of the sacrums in 8 cases, and in S3-5 in another 2 cases. of 10, 7 were treated with en bloc resection or subtotal resection. of the sacrum, and followed by irradiation in 5 of 7 cases (with range of 2000r-4500r). All the 7 cases were followed up without any evidence of local recurrence or distant metastases. The average follow-up period was 10.3 years (with range of 1.5-27.5 years). The rectal, bladder and sexual function were normal or restored. The other 3 cases, biopsied in 2, partially resected in 1, died less than one year after diagnosis. Comparing the died group with the survival group, we concluded that early diagnosis and thorough excision of the tumor are the two decisive factors for a favorable prognosis.