Left lower lobe sleeve resection for the clear cell variant of pulmonary mucoepidermoid carcinoma:A case report

BACKGROUND Pulmonary mucoepidermoid carcinoma(PMEC)is a rare malignancy that arises from minor salivary glands within the tracheobronchial tree.The clear cell variant of PMEC is exceptionally uncommon and presents notable diagnostic challenges,primarily attributable to its morphological similarity to other tumors containing clear cells.CASE SUMMARY A 22-year-old male,formerly in good health,came in with a two-month duration of persistent cough and production of sputum.Subsequent imaging and bronchoscopy examinations revealed a 2 cm tumor in the distal left main bronchus,which resulted in complete atelectasis of the left lung.Further assessment via positron emission tomography/computed tomography scans and endoscopic biopsy confirmed the primary malignant nature of the tumor,charac-terized by clear cell morphology in most of the tumor cells.The patient underwent a left lower lobe sleeve resection accompanied by systematic mediastinal lymph node dissection.Molecular pathology analysis subsequently revealed a CRTC3-MAML2 gene fusion,leading to a definitive pathological diagnosis of the clear cell variant of PMEC,staged as T2N0M0.After surgery,the patient experienced a smooth recovery and exhibited no signs of recurrence during the one-and-a-half-year follow-up period.CONCLUSION This article describes an unusual case of a clear cell variant of PMEC characterized by the presence of a CRTC3-MAML2 gene fusion in a 22-year-old male.The patient underwent successful left lower lobe sleeve resection.This case underscores the distinctive challenges associated with diagnosing and treating this uncommon malignancy,underscoring the importance of precise diagnosis and personalized treatment strategies.

Surgical resection of a giant thymolipoma causing respiratory failure: A case report

BACKGROUND Thymolipoma is a rare benign tumor arising from the anterior mediastinal thymus and is composed of mature fatty tissue and interspersed nonneoplastic thymic tissue. This tumor accounts for only a small percentage of mediastinal masses, and the majority of them are asymptomatic and found incidentally. To date, fewer than 200 cases have been published in the world literature, of which most excised tumors weighed less than 0.5 kg and the largest weighed 6 kg.CASE SUMMARY A 23-year-old man presented with a complaint of progressive breathlessness for 6mo. His forced vital capacity was only 23.6% of the predicted capacity, and his arterial partial pressure of oxygen and carbon dioxide were 51 and 60 mmHg,respectively, without oxygen inhalation. Chest computed tomography revealed a large fat-containing mass in the anterior mediastinum that measured 26 cm × 20cm × 30 cm in size and occupied most of the thoracic cavity. Percutaneous mass biopsy revealed only thymic tissue without signs of malignancy. A right posterolateral thoracotomy was successfully performed to remove the tumor along with the capsule, and the excised tumor weighed 7.5 kg, which to our knowledge, was the largest surgically removed tumor of thymic origin. Postoperatively, the patient’s shortness of breath was resolved, and the histopathological diagnosis was thymolipoma. No signs of recurrence were observed at the 6-mo follow-up.CONCLUSION Giant thymolipoma causing respiratory failure is rare and dangerous. Despite the high risks, surgical resection is feasible and effective.

Chronic pulmonary mucormycosis caused by rhizopus microsporus mimics lung carcinoma in an immunocompetent adult:A case report

BACKGROUND Pulmonary mucormycosis is a rare but life-threatening invasive fungal infection that mostly affects immunocompromised patients.This disease usually develops acutely and progresses rapidly,often leading to a poor clinical prognosis.Chronic pulmonary mucormycosis is highly unusual in immunocompetent patients.CASE SUMMARY A 43-year-old man,who was a house improvement worker with a long history of occupational dust exposure,presented with an irritating cough that had lasted for two months.The patient was previously in good health,without dysglycemia or any known immunodeficiencies.Chest computed tomography revealed a mass in the left lower lobe,measuring approximately 6 cm in diameter,which was suspected to be primary lung carcinoma complicated with obstructive pneumonia.Thoracoscopic-assisted left lower lobectomy was performed,and metagenomic next-generation sequencing detection,along with special pathological staining of surgical specimens,suggested Rhizopus microsporus infection.Postoperatively,the patient’s respiratory symptoms were relieved,and no signs of recurrence were found during the six-month follow-up.CONCLUSION This article reports a rare case of chronic pulmonary mucormycosis caused by Rhizopus microsporus in a middle-aged male without dysglycemia or immunodeficiency.The patient’s surgical outcome was excellent,reaffirming that surgery remains the cornerstone of pulmonary mucormycosis treatment.

Seco-sativene and Seco-longifolene Sesquiterpenoids from Cultures of Endophytic Fungus Bipolaris eleusines

Two new seco-sativene sesquiterpenoids,bipolenins D(1)and E(2),a new seco-longifolene sesquiterpenoid,bipolenin F(3),together with three known analogues(4–6),were obtained from cultures of endophytic fungus Bipolaris eleusines.Their structures were established by MS and NMR data.Compounds 1–6 showed no activity to five human cancer cell lines.

Effect of salvia miltiorrhiza injection adjuvant therapy on systemic inflammatory stress state and nerve injury degree of children with bacterial Encephalitis

Objective:To discuss the effect of salvia miltiorrhiza injection adjuvant therapy on systemic inflammatory stress state and nerve injury degree of children with bacterial meningitis. Methods: 68 cases of children with bacterial meningitis who were treated in our hospital from Feb. 2014 to Jan. 2017 were selected and were divided into control group (34 cases) and observation group (34 cases) based on random number table, and patients in both groups were treated with continuous treatment for 10 d. Differences of inflammatory mediator, oxidative stress index, nerve injury markers content in cerebrospinal fluid in both groups were compared. Results: Before treatment, differences of inflammatory mediator, oxidative stress index, nerve injury markers content in cerebrospinal fluid in both groups had no statistical significance. 10 d after treatment, inflammatory mediator IL-6, PCT, sVCAM-1, CRP content in cerebrospinal fluid of children in observation group was lower than that in control group;oxidative stress index MDA content in cerebrospinal fluid was lower than that in control group, and SOD content was higher than that in control group;nerve injury markers MBP, NSE, GFAP content in cerebrospinal fluid was lower than that in control group.Conclusion: salvia miltiorrhiza injection adjuvant therapy could effectively relieve the systemic inflammatory stress state and reduce the nerve damages of children with bacterial meningitis.

A biomimetic gradient porous cage with a micro-structure for enhancing mechanical properties and accelerating osseointegration in spinal fusion

Objectives:Spinal fusion is a widely employed treatment of patients with degenerative disc disease,in which a cage is used to replace the disc for spinal fusion.But it often fails for insufficient mechanical strength and poor osseointegration.Here,we designed a polyether-ether-ketone(PEEK)/tantalum(Ta)composite cage with a biomimetic gradient porous micro-structure,simultaneously enhancing mechanical properties and accelerating osseointegration in spinal fusion.Materials and methods:In the study,based on the mechanical performances of PEEK and osteogenic potential of Ta,and the three-dimensional(3D)structures of cuttlebone and vertebra,the cages were respectively 3D printed by pure PEEK,PEEK with 5 wt%Ta(PEEK/Ta-5),PEEK with 10 wt%Ta(PEEK/Ta-10)and PEEK with 15 wt%Ta(PEEK/Ta-15),then verifiedin vitroand in sheep cervical fusion model systematically.Results:Vertebral Gyroid structure PEEK/Ta-15 cage exhibited superior mechanical properties than Cuttlebone-like structure PEEK/Ta-15 cage,closer to the cervical vertebra.Furthermore,PEEK/Ta-15 cage with higher Ta microparticles in PEEK provided a biomimetic gradient porous micro-structure with higher surface energy,guiding cell biological behavior,promoting new bone penetration,and accelerating osseointegrationin vivo.Conclusion:In conclusion,the study designed a biomimetic gradient porous cage with a micro-structure for enhancing mechanical properties,accelerating osseointegration and forming an anatomical lock in the fusion segment through composites,mechanical efficiency,surface extension,and pores.

Hydrothermal synthesis method of 5-(4'-methylbiphenyl-2-yl)-1H-tetrazole

A clean and saIe synthesis method of 5-（4＇-methylbiphenyl-2-yl）-1H-tetrazole was round： under hydrothermal conditions, 1.2 equiv, of 4＇-methylbiphenyl-2-carbonitrile react with 1 equiv, of sodium azide in a mixed solvent of propane-1,2-diol/H2O, with 1.5 equiv, of ammonium chloride and 0.2 equiv. of ammonium fluoride as catalyst. After simple post-processing, the yield can be improved to 95%, and the purity of the product is 99% without further recrystaUization.

Triphenylphosphine as Reducing Agent for Copper(II)-catalyzed AGET ATRP

Triphenylphosphine （TPP） was used as reducing agent to continuously generate the Cu（I） activator in copper（II）- catalyzed activators generated by electron transfer atom transfer radical polymerization （AGET ATRP）. For example, the polymers prepared with a molar ratio of [MMA]0/[EBiB]0/[CuC12]o/[PMDETA]0/[TPP]o = 500/1/0.1/0.5/0.5 had controlled molecular weights and low molecular weight distribution （Mw/Mn） values （-1.2）. TPP as a commercial reducing agent provides a convenient copper-catalyzed AGET ATRP procedure for the preparation of well-defined polymers.

Cervical Metastasis from Renal Cell Carcinoma

To the Editor：A 43-year-old woman,having a renal cell carcinoma （RCC） treated with radical nephrectomy 15 months ago in West China Hospital,was consulted to our gynecology outpatient clinic for a 3-month history of vaginal bleeding in March 2008.Before the clinic,blood transfusion was given to the patient at a local hospital due to heavy vaginal bleeding.