Combined goblet cell carcinoid and mucinous cystadenoma of the vermiform appendix

Goblet cell carcinoid is an uncommon primary tumor of the vermiform appendix, characterized by dual endocrine and glandular differentiation. Whether goblet cell carcinoid represents a morphological variant of appendiceal classical carcinoid or a mucin-producing adenocarcinoma is a matter of conjecture. Rare cases of goblet cell carcinoid with other concomitant appendiceal epithelial neoplasms have been documented. In this report, we describe a rare case of combined appendiceal goblet cell carcinoid and mucinous cystadenoma, and discuss the possible histopathogenesis of this combination.

Prognostic Nomogram for Patients with Hepatitis E Virus-related Acute Liver Failure:A Multicenter Study in China

Background and Aims:Timely and effective assessment scoring systems for predicting the mortality of patients with hepatitis E virus-related acute liver failure(HEV-ALF)are urgently needed.The present study aimed to establish an effective nomogram for predicting the mortality of HEV-ALF patients.Methods:The nomogram was based on a cross-sectional set of 404 HEV-ALF patients who were identified and enrolled from a cohort of 650 patients with liver failure.To compare the performance with that of the model for end-stage liver disease(MELD)scoring and CLIF-Consortiumacute-on-chronic liver failure score(CLIF-C-ACLFs)models,we assessed the predictive accuracy of the nomogram using the concordance index(C-index),and its discriminative ability using time-dependent receiver operating characteristics(td-ROC)analysis,respectively.Results:Multivariate logistic regression analysis of the development set carried out to predict mortality revealed that γ-glutamyl transpeptidase,albumin,total bilirubin,urea nitrogen,creatinine,international normalized ratio,and neutrophil-to-lymphocyte ratio were independent factors,all of which were incorporated into the new nomogram to predict the mortality of HEV-ALF patients.The area under the curve of this nomogram for mortality prediction was 0.671(95%confidence interval:0.602-0.740),which was higher than that of the MELD and CLIF-C-ACLFs models.Moreover,the td-ROC and decision curves analysis showed that both discriminative ability and threshold probabilities of the nomogram were superior to those of the MELD and CLIF-C-ACLFs models.A similar trend was observed in the validation set.Conclusions:The novel nomogram is an accurate and efficient mortality prediction method for HEV-ALF patients.

Quzhi Formula Alleviates Nonalcoholic Steatohepatitis by Impairing Hepatocyte Lipid Accumulation and Inflammation via Bip/eIF2α Signaling

Background and Aims:The Quzhi formula,a Chinese med-icine compound prescription,relieves nonalcoholic steato-hepatitis(NASH)symptoms.This study aimed to explore the mechanism of the Quzhi formula against NASH.Methods:A choline-deficient,L-amino acid-defined,high-fat diet induced a NASH mouse model and a free fatty acid-induced mouse hepatocyte cell model were used to evaluate the function of Quzhi formula in vivo and in vitro.Network pharmacol-ogy and molecular docking technology were performed to uncover the possible protective mechanisms of the Quzhi formula against NASH.Key factors in liver lipid metabolism and endoplasmic reticulum(ER)stress pathway were evalu-ated to verify the mechanism.Results:The positive contri-bution of the Quzhi formula on NASH was confirmed in vivo and in vitro.Abnormal accumulation of lipid in the liver and inflammatory responses were significantly decreased by the Quzhi formula.Network pharmacological analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis showed that the Quzhi formula protected against NASH by regulating ER stress and inflammatory responses,which was enhanced by further molecular docking analy-sis.In addition,mechanism exploration showed that Quzhi formula mainly reduced ER stress by downregulating Bip/eIF2αsignaling.Conclusions:The Quzhi formula protected against NASH by inhibiting lipid accumulation,ER stress,and inflammatory responses,which supports the potential use of Quzhi formula as an alternative treatment for NASH.