Primary acinic cell carcinoma of the breast: A case report and review of literature

BACKGROUND In the current World Health Organization classification,acinic cell carcinoma(AcCC)of the breast is considered a rare histological subtype of triple-negative breast cancer.Because of the few reports in the literature,data concerning clinical outcomes are limited.Here,we report a case of AcCC of the breast in a 48-year-old woman.A 48-year-old woman with a mass in her right breast came to our hospital for further diagnosis.Mammography and an ultrasound(US)scan showed a mass in the upper inner side of the right breast.She then underwent surgery to resect the mass in her right breast.Postoperative pathological examination revealed that the tumor had abundant acinar-like structures formed by tumor cells with prominent eosinophilic granules in the cytoplasm,consistent with acinar cell carcinoma.The results of immunohistochemical analysis supported the diagnosis of breast acinar cell carcinoma.Two months later,she underwent breast-conserving surgery and sentinel lymph node biopsy.The pTNM stage was T2N0M0.After surgery,the patient received 30 radiotherapy sessions.The patient was followed up for a period of one year,and no recurrence was found.AcCC of the breast is a rare type of malignant tumor.Because it is usually asym-ptomatic and can be detected by imaging studies,routine breast US or mamm-ograms are important.However,there are no characteristic diagnostic imaging findings or clinical manifestations,so immunohistochemical examination is critical for an accurate diagnosis of AcCC of the breast.

Limb remote ischemic postconditioning protects integrity of the blood-brain barrier after stroke

Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leakage.Therefore,studies have suggested that protecting the blood-brain barrier may be an effective method for treating acute stroke.To examine this possibility,stroke model rats were established by middle cerebral artery occlusion and reperfusion.Remote ischemic postconditioning was immediately induced by three cycles of 10-minute ischemia/10-minute reperfusion of bilateral hind limbs at the beginning of middle cerebral artery occlusion reperfusion.Neurological function of rat models was evaluated using Zea Longa’s method.Permeability of the blood-brain barrier was assessed by Evans blue leakage.Infarct volume and brain edema were evaluated using 2,3,5-triphenyltetrazolium chloride staining.Expression of matrix metalloproteinase-9 and claudin-5 m RNA was determined by real-time quantitative reverse transcription-polymerase chain reaction.Expression of matrix metalloproteinase-9 and claudin-5 protein was measured by western blot assay.The number of matrix metalloproteinase-9-and claudin-5-positive cells was analyzed using immunohistochemistry.Our results showed that remote ischemic postconditioning alleviated disruption of the blood-brain barrier,reduced infarct volume and edema,decreased expression of matrix metalloproteinase-9 m RNA and protein and the number of positive cells,increased expression of claudin-5 m RNA and protein and the number of positive cells,and remarkably improved neurological function.These findings confirm that by suppressing expression of matrix metalloproteinase-9 and claudin-5 induced by acute ischemia/reperfusion,remote ischemic postconditioning reduces blood-brain barrier injury,mitigates ischemic injury,and exerts protective effects on the brain.

Uterine tumor resembling an ovarian sex cord tumor:A case report and review of literature

BACKGROUND Endometrial stromal tumors originate from the endometrial stroma and account for<2%of all uterine tumors.Uterine tumor resembling an ovarian sex cord tumor(UTROSCT)is a rare histological class of endometrial stromal and related tumors according to the latest World Health Organization classification of female genital tumors.Here,we report a case of UTROSCT in a 51-year-old woman.CASE SUMMARY A 51-year-old woman had irregular menses for 6 mo.The patient visited a local hospital for vaginal bleeding.Pelvic computed tomography(CT)showed a mass in the pelvic cavity.Five days later,she came to our hospital for further diagnosis.The results of contrast-enhanced CT and pelvic ultrasound at our hospital suggested a malignant pelvic tumor.She then underwent total removal of the uterus with bilateral salpingectomy.Postoperative histological examination showed that the tumor cells had abundant cytoplasm,ovoid and spindle-shaped nuclei,fine chromatin,a high nucleoplasm ratio,and a lamellar distribution.The findings were consistent with UTROSCT,and the results of immunohistochemical analysis supported that diagnosis.The tumor was International Federation of Gynecology and Obstetrics stage IB.No adjuvant therapy was administered after radical surgery.The patient was followed up for 58 mo,and no recurrence was found.CONCLUSION We report a case of UTROSCT with abnormal menstruation as a symptom,which is one of the most common symptoms.In patients with vaginal bleeding,ultrasonography can be used as a screening test because of its convenience,speed,and lack of radiation exposure.For patients with long-term tamoxifen use,routine monitoring of the endometrium is recommended.As UTROSCT may have low malignant potential,surgery remains the primary management strategy.Additionally,fertility preservation in patients of childbearing age is a vital consideration.

Machine learning-assisted ensemble analysis for the prediction of urinary tract infection in elderly patients with ovarian cancer after cytoreductive surgery

BACKGROUND Urinary tract infection(UTI)is a common type of postoperative infection following cytoreductive surgery for ovarian cancer,which severely impacts the prognosis and quality of life of patients.AIM To develop a machine learning assistant model for the prevention and control of nosocomial infection.METHODS A total of 674 elderly patients with ovarian cancer who were treated at the Department of Gynaecology at Jingzhou Central Hospital between January 31,2016 and January 31,2022 and met the inclusion criteria of the study were selected as the research subjects.A retrospective analysis of the postoperative UTI and related factors was performed by reviewing the medical records.Five machine learning-assisted models were developed using two-step estimation methods from the candidate predictive variables.The robustness and clinical applicability of each model were assessed using the receiver operating characteristic curve,decision curve analysis and clinical impact curve.RESULTS A total of 12 candidate variables were eventually included in the UTI prediction model.Models constructed using the random forest classifier,support vector machine,extreme gradient boosting,and artificial neural network and decision tree had areas under the receiver operating characteristic curve ranging from 0.776 to 0.925.The random forest classifier model,which incorporated factors such as age,body mass index,catheter,catheter intubation times,blood loss,diabetes and hypoproteinaemia,had the highest predictive accuracy.CONCLUSION These findings demonstrate that the machine learning-based prediction model developed using the random forest classifier can be used to identify elderly patients with ovarian cancer who may have postoperative UTI.This can help with treatment decisions and enhance clinical outcomes.

Early diagnosis of acute kidney injury in aged patients undergoing percutaneous coronary intervention

In aged patients, acute kidney injury （AKI） is a common clinical complication after percutaneous coronary intervention （PCI）, highlighting the need for timely and certain diagnosis of this disease. A single centre, nested case-control study was conducted, which assessed the usefulness of urinary liver-type fatty acid-binding protein （uL-FABP）, neutrophil gelatinase-associated lipocalin （uNGAL）, and kidney injury molecule-1 （uKIM-1） for early detection of AKI. One hundred and thirty-two patients at or over 60 years old undergoing PCI were included.