Journal of International Medical Research最新文献

Objectives: Strontium (Sr²⁺) is a crucial trace element in humans, mainly present in the bones. We investigated the effects of Sr²⁺ on human periodontal ligament stem cell (hPDLSC) proliferation and osteogenesis and the relevant pathways.

Methods: hPDLSCs were harvested from extracted premolars and characterized by flow cytometry, then cultured and treated with various Sr²⁺ concentrations. Cell-counting kit-8 (CCK-8) assays were used to assess hPDLSC proliferation, with alkaline phosphatase (ALP) staining, Alizarin red S staining, and ALP activity assays used to analyze their osteogenic capacity. Quantitative reverse transcription polymerase chain reaction and western blots were used to examine the expression levels of relevant factors, such as collagen I (COL-1), ALP, and Runx family transcription factor 2 (RUNX2). Moreover, tankyrase inhibitor XAV939 treatment was used to investigate the role of Sr²⁺ in the canonical Wnt/β-catenin signaling pathway.

Results: The hPDLSCs were successfully isolated and cultured in vitro. A 0.01 mM Sr²⁺ concentration significantly enhanced hPDLSC proliferation and osteogenic differentiation. However, XAV939-mediated inhibition of the canonical Wnt/β-catenin pathway could reverse the Sr²⁺-induced osteogenic effects.

Conclusions: Sr²⁺ can enhance hPDLSC proliferation and osteogenesis by stimulating canonical Wnt/β-catenin signaling, suggesting it may play a critical role in periodontal regeneration and has clinical application potential.

Objectives: To analyze differences in programmed cell death protein 1/ligand 1 (PD-1/PD-L1) expression, as well as the relationships between ultrasound/contrast-enhanced ultrasound characteristics and PD-1/PD-L1 expression, among invasive breast cancer molecular subtypes.

Methods: The study included 172 invasive breast cancer patients with surgical resection and pathological confirmation at the First Affiliated Hospital of Xinjiang Medical University from June 2016 to April 2022. PD-1/PD-L1 expression was detected by immunohistochemistry. All patients underwent conventional ultrasound and some underwent contrast-enhanced ultrasound examination before resection.

Results: PD-1 and PD-L1 were expressed in 112 and 121 cases, respectively. The luminal B and HER-2 subtypes had the lowest and highest PD-1 expression rates, respectively. The luminal B and triple-negative subtypes had the lowest and highest PD-L1 expression rates, respectively. Among 112 PD-1-positive cases, most luminal B cases exhibited ill-defined margins, while distant metastasis was more common in triple-negative cases. Among 121 PD-L1-positive cases, many HER-2-positive and triple-negative cases presented as large masses (diameter ≥ 2 cm), while luminal B cases were more likely to show calcification. Most luminal B PD-L1-positive cases displayed indistinct margins on contrast-enhanced ultrasound.

Conclusions: PD-1 expression differed among molecular subtypes of invasive breast cancer. Ultrasound/contrast-enhanced ultrasound features correlated with PD-1/PD-L1 expression in different breast cancer subtypes.

Early diagnosis and timely management are critical for determining disease outcomes and prognoses. To date, certain methods for developing disease-specific biomarkers have been reported; however, strategies for musculoskeletal disease-specific biomarker development have rarely been studied. Recent studies have highlighted the potential application of extracellular vesicles (EVs) as disease-specific biomarkers. EVs encapsulate proteins, lipids, messenger RNAs, and microRNAs derived from their cellular origin; these constituents remain stable within the EVs and can traverse the blood-brain barrier. Because of these distinctive characteristics, EVs have been actively investigated as diagnostic tools for various conditions, including cancer, inflammatory diseases, and musculoskeletal disorders. Although EVs have many advantages for biomarker development, they have not yet been fully researched in the context of musculoskeletal pathologies. The current review aimed to highlight the potential of EVs in the development of disease-specific biomarkers, summarize the processes of EV biomarkers, and discuss current limitations and future perspectives of EVs as biomarkers.

Fallopian tube carcinoma has a rare incidence and dismal prognosis. Sister Mary Joseph's nodule is an intra-abdominal tumor that metastasizes to the umbilicus. To date, fewer than 10 cases of fallopian tube carcinoma with Sister Mary Joseph's nodule have been reported, with most of them exhibiting a very poor prognosis. Herein, we described a case of fallopian tube carcinoma with Sister Mary Joseph's nodule. A 57-year-old woman was referred to the Affiliated Hospital of Shandong Second Medical University in May 2020 owing to a mass in the middle of her umbilicus. She was first diagnosed with an umbilical mass and underwent a resection of the umbilical mass, which revealed adenocarcinoma, most likely of reproductive origin. One month after the first surgery, she underwent laparoscopic cytoreductive surgery, and pathological examination revealed fallopian tube adenocarcinoma with pelvic lymph node metastasis. She was diagnosed with fallopian tube carcinoma (stage IIIC) and then underwent 10 cycles of chemotherapy. She achieved a complete response, and no recurrence or progression has been reported until now. The overall survival time exceeded 50 months. Thus, for patients with umbilical masses, physicians should consider the possibility of Sister Mary Joseph's nodule. When a malignancy is suspected in the abdominal or pelvic cavity but the physical examination and imaging studies reveal no abnormality, laparoscopic surgery should be used for determining the primary tumor. For patients with fallopian tube carcinoma and Sister Mary Joseph's nodule, surgery and adjuvant chemotherapy can achieve good results.

Rett syndrome (RTT) is a neurodevelopmental disorder caused by mutations in the MECP2 gene, potentially disrupting lipid metabolism and leading to dyslipidemia (DLD) and steatotic liver disease (SLD). Although SLD has been described in RTT mouse models, it remains undocumented in humans. We herein describe a 24-year-old woman with RTT who was evaluated for abnormal liver enzymes. Imaging revealed hepatic steatosis, and transient elastography showed a controlled attenuation parameter of 342 dB/m and stiffness of 7.1 kPa. Laboratory investigations excluded secondary causes, including insulin resistance, metabolic syndrome, alcohol use, and new medications. Her Homeostatic Model Assessment for Insulin Resistance score was 1.8, her hemoglobin A1c concentration was 4.8%, and her lipid profile showed elevated triglycerides and low-density lipoprotein, consistent with DLD. Liver biopsy confirmed SLD. This case supports the hypothesis that MECP2 mutations in RTT disrupt lipid metabolism through a unique pathophysiologic mechanism, increasing the risk of DLD and SLD independently of traditional metabolic syndrome factors. It highlights the importance of early screening for liver disease in patients with RTT, despite their young age, to prevent complications. Additionally, it validates MECP2-null mouse models as reliable tools for investigating future therapeutic strategies in RTT.

A 70-year-old man developed intermittent fever with chills, severe anorexia, generalized weakness, and mild exertional difficulty in breathing following posterior chamber intraocular lens replacement surgery for a mature white cataract in the left eye. Laboratory tests revealed persistent negative blood cultures, normocytic and normochromic anemia, neutrophilia, and elevated inflammatory markers despite multiple courses of antibiotics. All other investigations conducted to identify the cause of prolonged fever, including transthoracic echocardiography, were negative. However, transesophageal echocardiography detected an aortic valve vegetation. The patient had no history of valvular disease or any predisposing condition for infective endocarditis. The bacteremia was strongly suspected to have resulted from cataract surgery, although no obvious signs of eye infection were observed during the postoperative period. The patient was treated with empirical antibiotics, including vancomycin and ceftriaxone, which led to significant improvement. Because infective endocarditis remains a significant public health concern with increasing incidence rates, we present this unusual case of culture-negative infective endocarditis following cataract surgery, highlighting the diagnostic and therapeutic challenges encountered.

Objective: To investigate if fibroblast growth factor 18 (FGF18) expression plays an important role in endometrial carcinoma (EC).

Methods: The clinicopathological associations and prognostic value of FGF18 expression were retrospectively analyzed in 190 patients with EC. FGF18 expression was stably knocked down in EC cell lines. Changes in cell proliferation, migration, and invasion rates were examined via cell behavior experiments. Tumor growth was investigated using a xenograft mouse model. RNA sequencing (RNA-seq) was performed to identify differentially expressed genes (DEGs) in HEC-1-B cells after FGF18 knockdown, followed by pathway enrichment analysis of the DEGs.

Results: High FGF18 expression levels were closely correlated with EC clinicopathological features, such as histological subtype, FIGO stage, depth of myometrial invasion, and tumor size. Moreover, EC patients with high FGF18 expression levels had poorer overall survival. FGF18 knockdown in EC cells revealed its role in promoting tumor cell proliferation, migration, and invasion in vitro, as well as tumor growth in vivo. RNA-seq of HEC-1-B cells revealed that the DEGs were enriched in signaling pathways related to cell proliferation and migration.

Conclusions: Overexpression of FGF18 may serve as a prognostic biomarker for EC patients and is a potential therapeutic target for treating this disease.

We report the case of a woman in her early 30 s who was diagnosed with Robert's uterus. She had been experiencing progressive dysmenorrhea for a decade and sought treatment for infertility at our hospital. Preoperative ultrasound imaging resulted in a misdiagnosis of a complete uterine septum with an accompanying ovarian cyst. However, intraoperative ultrasound-guided laparoscopy and hysteroscopy confirmed the presence of an asymmetric mediastinal uterus with a blind cavity, consistent with Robert's uterus, along with endometriosis. We performed a combined hysteroscopy and laparoscopy to excise the septum and endometrial cyst in the uterine cavity, and we inserted a uterine cavity stent to prevent postoperative intrauterine adhesions. Subsequent evaluations confirmed the success of the surgical and postoperative treatment strategies. The findings in this case suggest that despite the risk of a misdiagnosis before surgery, accurate assessment and effective surgical intervention for Robert's uterus can be achieved by the combined application of hysteroscopy and laparoscopy, with guidance by ultrasound. Furthermore, our findings highlight the importance of addressing concurrent conditions in the management of Robert's uterus.

Smith-Magenis syndrome (SMS) and Dandy-Walker malformation (DWM) are uncommon genetic conditions with nonspecific clinical features, which makes reaching a definitive diagnosis challenging. We describe here, a 2-year-old girl who was diagnosed with SMS at the age of 12 months due to delayed growth and development. The child presented to hospital with acute heart failure and respiratory failure. During the treatment process, her response was limited, and her recovery was slow. A subsequent head computed tomography (CT) scan showed abnormalities consistent with the diagnosis of comorbid DWM. We believe that this is the first reported case of a patient with SMS combined with DWM. By reporting this case, we aim to offer clinicians valuable insights into these rare diseases and provide a framework for future clinical diagnosis and treatment.