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Despite the clear link between nonalcoholic fatty liver disease (NAFLD) and type 2 diabetes mellitus, little is understood about how glycemic control impacts histological severity. We aimed to investigate the deeper association between hemoglobin A1c (HbA1c) and the histologic severity of liver fibrosis.

Some Ophiocordycepsspecies infecting ants are able to manipulate the host behavior. The hosts are manipulated in order to move to location that are advantageous for fungal spore transmission. Ophiocordycepsspecies that are able to manipulate the ant's behavior are called "zombie-ant fungi". They are widespread within tropical forests worldwide, with relatively few reports from subtropical monsoon evergreen broad-leaf forest. Zombie-ant fungi have been described and reported in different countries worldwide. However, there were a few reports from China. This study proposed six new species of zombie-ant fungi from China based on multi-gene (SSU, LSU, TEF, RPB1and RPB2) phylogenetic analyses and morphological characteristics. Six novel species of Ophiocordycepsfrom China were identified as the Ophiocordyceps unilateraliscore clade, forming a separate lineage with other species. Six novel species of Ophiocordycepswith hirsutella-like asexual morphs exclusively infecting ants were presented herein, namely, Ophiocordyceps acroasca, Ophiocordyceps bifertilis, Ophiocordyceps subtiliphialida, Ophiocordyceps basiasca, Ophiocordyceps nuozhaduensisand Ophiocordyceps contiispora. Descriptions and illustrations for six taxon were provided. Five of these species were collected from the subtropical monsoon evergreen broad-leaf forest, and one was collected from the rainforest and subtropical monsoon evergreen broad-leaf forest. This work proposes that the same host of Camponotuscan be infected by multiple ant pathogenic fungi, while multiple ants of Polyrhachiscan be infected by the same pathogenic fungi at the same time. This study contributes towards a better understanding of the evolutionary relationship between hosts and fungi, and provides novel insights into the morphology, distribution, parasitism, and ecology of Ophiocordyceps unilateralis sensu lato. We have provided a method for obtaining living cultures of Ophiocordyceps unilateraliscomplex species and their asexual morphs based on the living cultures, which is of significant value for further studies of Ophiocordyceps unilateraliscomplex species in the future.

•We identified two potential damaging ZP4 mutationsin three out of 152 (2.0%, 3/152) patients with ovarian endometriosis, for the first time.•Our results suggested that mutations in ZP4, but not ZP1, ZP2 and ZP3, might play positive roles inovarian endometriosis.•The potential role of ZP4 mutations on human fertility might be more complex than we thought, other factors might play certain roles.

To determine whether imaging and clinicopathologic features could predict false‐positive axillary ultrasound (US) results in the selection of patients with breast cancer who had a heavy axillary tumor burden (≥3 tumor‐involved nodes). Among 788 patients with histologically confirmed invasive breast cancer at Ruijin Hospital from October 2014 to September 2015, 162 patients (cT1‐T2, cN0) with 167 axillae had suspicious axillary US findings. Ultrasound findings were considered suspicious for metastasis if cortical thickening of greater than 3 mm or effacement of the fatty hilum was present. The false‐positive rate of suspicious axillary US results for identifying 3 or more positive lymph nodes in the final pathologic examination was calculated. Univariate and multivariate analyses were used to evaluate imaging and clinicopathologic factors related to the false‐positive results. Axillary US showed a false‐positive rate of 60.5% (101 of 167) in the patients with breast cancer and a heavy nodal burden. By logistic regression analyses, we found false‐positive axillary US results more frequently in patients who had a T1 stage tumor (P= .005), an estrogen receptor/progesterone receptor–negative tumor (P< .001), solitary suspicious nodes identified on axillary US (P< .001), and a cortical thickness of the most suspicious lymph node of 3.5 mm or less (P= .015). Imaging and clinicopathologic features can be used to identify axillae with less than 3 metastatic nodes in patients with early‐stage breast cancer who have positive axillary US results. In the post–American College of Surgeons Oncology Group Z0011 trial era, conducting a secondary evaluation either clinically or by axillary imaging before the use of a US‐guided biopsy of suspicious nodes can potentially avoid the additional morbidity of axillary lymph node dissection and reduce the preoperative workload.

•For the first time, somatic mutations in multiple cancer driver genes were identified in ovarian endometriosis.•The co-occurrence of KRAS and ARID1A mutations was identified in a single individual for the first time.•The present study further support the notion that endometriosis is a premalignant disorder.

Ultrasound (US)‐guided fine‐needle aspiration cytology (FNAC) is able to identify patients with extensive node involvement before surgery. In this study, we aimed to establish the optimal US criterion to identify abnormal lymph nodes on US‐guided FNAC for detection of patients with 3 or more metastatic axillary nodes. A total of 445 axillae from 443 patients with histologically confirmed invasive breast cancer (cT1–2 cN0) were examined with US at Ruijin Hospital from August 2013 to August 2014. Ultrasound‐guided FNAC was performed on suspicious nodes when the cortex was eccentrically or concentrically thickened to greater than 2 mm; 269 axillae (60.4%) met the criterion and underwent US‐guided FNAC. We retrospectively analyzed the US characteristics of axillary lymph nodes, the US‐guided FNAC results, and the extent of axillary nodal involvement. For diagnostic performance, the sensitivity, specificity, and receiver operating characteristic curves were obtained. Eighty‐six patients (19.4%) were confirmed to have 3 or more positive lymph nodes by pathologic analysis. There was a significant association between the morphologic change in the most suspicious node and the extent of axillary nodal involvement (P< .001). When we applied the cutoff point (cortical thickness >3.5 mm) at which the maximal sum of sensitivity and specificity for diagnosis of 3 or more axillary lymph node metastases was achieved, we found that the sensitivity and specificity were 75.6% and 82.7%, respectively. When combining this criterion with US‐guided FNAC of the most suspicious nodes, the sensitivity and specificity were 64.2% and 94.5%, and 36.1% of cases could be spared an unnecessary 1‐step axillary lymph node dissection. Cortical thickness of greater than 3.5 mm in the most suspicious nodes is appropriately predictive of patients with 3 or more tumor‐involved axillary nodes. When this criterion for US‐guided FNAC was adopted, a group of patients with 1 or 2 metastatic nodes could be spared unnecessary 1‐step axillary lymph node dissection.

A high throughput metabolite fingerprinting tool based on wooden-tip electrospray ionization mass spectrometry (WT-ESI-MS) has been established for the serum metabolic profiling study of endometriosis with little sample pre-treatment, no chromatography and instrument cycle times of less than 5 min. Serum samples from endometriosis patients and healthy controls were analyzed by direct WT-ESI-MS with a high resolution ESI-Q-TOF-MS. The resulting data were analyzed by multivariate data analysis. MS/MS experiments were carried out to identify potential biomarkers. Global metabolic profiling and subsequent multivariate analysis clearly distinguished endometriosis patients from healthy controls. A total of ten metabolites, up-regulated or down-regulated, were identified which contribute to the progress of endometriosis. These promising identified biomarkers underpin the metabolic pathway including steroid hormone biosynthesis, glycerophospholipid metabolism, sphingolipid metabolism, pyruvate metabolism, bile acid biosynthesis, and androgen and estrogen metabolisms. Considering that a much higher throughput can be obtained without a chromatographic step, the present WT-ESI-MS method could be developed as a fast prognostic or diagnostic method for endometriosis.

A rapid and sensitive method based on wooden-tip electrospray ionization mass spectrometry (WT-ESI-MS) has been established for the quantitative detection of neopterin and biopterin in urine with only little sample preparation required. The limits of detection (LODs) for the analyses of neopterin and biopterin were determined to be 30 ng mL−1and 50 ng mL−1(S/N≥ 3), respectively. Acceptable relative standard deviation (RSD) values (6.3–9.5%) and recovery values (90–133.6%) were obtained for direct measurements of neopterin and biopterin in raw urine. Moreover, neopterin and biopterin were directly detected from 9 clinical urine samples by WT-ESI-MS. A single sample analysis was completed within a few minutes, indicating that the present WT-ESI-MS method is a promising strategy for the rapid analysis of clinical samples.

Wooden-tip electrospray ionization (wooden-tip ESI) is applied to the rapid, in situ, direct qualitative and quantitative trace analysis of toxic and hazardous compounds in food samples. To evaluate the potential of wooden-tip ESI mass spectrometry (MS) in food analysis, pesticides, toxicants, date-rape drugs, and illicit additives were detected in various food samples. Wooden-tip ESI-MS experiments were performed using wooden tip sampling and ionization, with examination using MS and tandem mass spectrometry (MS/MS). The results proved that wooden-tip ESI allows the detection and confirmation of traces of toxic and hazardous compounds in food. In addition, selected analytes in beverages were obtained at absolute levels as low as ∼10 pg. Quantitation of analytes in liquid and powder samples was also evaluated. Single sample analysis was completed within 2 min. The data obtained shows that the wooden-tip ESI-MS is a promising tool for rapid analysis of food samples.

Background This retrospective study investigated the therapeutic benefit of adjuvant endocrine therapy (ET) in breast cancer patients with hormone receptor (HR) status change from positive to negative after neoadjuvant chemotherapy (NAC).Methods From December 2000 to November 2010, 97 eligible patients with a positive-to-negative switch of HR status after NAC were identified. All patients were categorized into 2 groups on the basis of the administration of ET: 57 ET-administered patients and 40 ET-naïve patients. Survival analyses were performed to examine the prognostic value of ET administration as well as other clinical and pathologic variables.Results The administration of ET was significantly associated with improved disease-free survival (p=0.018) in patients with a positive-to-negative switch of HR status. The 5-year disease-free survival rates were 77.0% and 55.5%, respectively, in ET-administered patients and ET-naïve patients. The 5-year overall survival rate for ET-administered patients was also higher than that of ET-naïve patients (81.3% vs. 72.7%, p=0.053), albeit this was statistically insignificant.Conclusions This study revealed that patients with HR altered from positive to negative after NAC still benefit from ET. The HR status should be evaluated not only in specimens obtained during post-NAC surgery but also in specimens biopsied before NAC.

The catalytic subunit of DNA polymerase epsilon (POLE1) functions primarily in nuclear DNA replication and repair. Recently, POLE1 mutations were detected frequently in colorectal and endometrial carcinomas while with lower frequency in several other types of cancer, and the p.P286R and p.V411L mutations were the potential mutation hotspots in human cancers. Nevertheless, the mutation frequency of POLE1 in ovarian cancer still remains largely unknown. Here, we screened a total of 251 Chinese samples with distinct subtypes of ovarian carcinoma for the presence of POLE1 hotspot mutations by direct sequencing. A heterozygous somatic POLE1 mutation, p.S297F (c.890C>T), but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was identified in 3 out of 37 (8.1%) patients with ovarian endometrioid carcinoma; this mutation was evolutionarily highly conserved from Homo sapiensto Schizosaccharomyces. Of note, the POLE1 mutation coexisted with mutation in the ovarian cancer-associated PPP2R1A (protein phosphatase 2, regulatory subunit A, α) gene in a 46-year-old patient, who was also diagnosed with ectopic endometriosis in the benign ovary. In addition, a 45-year-old POLE1-mutated ovarian endometrioid carcinoma patient was also diagnosed with uterine leiomyoma while the remaining 52-year-old POLE1-mutated patient showed no additional distinctive clinical manifestation. In contrast to high frequency of POLE1 mutations in ovarian endometrioid carcinoma, no POLE1 mutations were identified in patients with other subtypes of ovarian carcinoma. Our results showed for the first time that the POLE1 p.S297F mutation, but not p.P286R and p.V411L hotspot mutations observed in other cancer types, was frequent in Chinese ovarian endometrioid carcinoma, but absent in other subtypes of ovarian carcinoma. These results implicated that POLE1 p.S297F mutation might be actively involved in the pathogenesis of ovarian endometrioid carcinoma, but might not be actively involved in other subtypes of ovarian carcinoma.

From November 1957 to June 1984 at Shanghai Chest Hospital, 30 cases of multiple primary lung cancers were confirmed, based on clinical characteristics, diagnostic process, histologic type, treatment, and prognosis. Out of 3,815 cases of resected primary lung cancer, the incidence of multiple primary lung cancers was 0.8 percent. There were ten synchronous cases and 20 metachronous cases. Seventeen cases were unilateral, and 13 cases were bilateral, of which only one case was synchronous, and the remaining 12 cases were postoperative resection of an opposite lesion. Among the ten synchronous cases, four cases of multiple primary lung cancers were definitely diagnosed before surgery by chest x-ray films or fiberoptic bronchoscopy. Among the 20 metachronous cases, 11 cases were definitely diagnosed before surgery as the second primary lesion by chest x-ray films taken during periodic follow-ups after the initial resection, while nine cases were proven by thoracotomy. All of the 15 cases definitely diagnosed before surgery as multiple primary lung cancers were according to our criteria. Histologically, adenocarcinoma was relatively scarce, at a rate of 13 percent (4/30); but epidermoid carcinoma was predominant, at a rate of 87 percent (26/30), of which 11 cases were accompanied by adenocarcinoma or large-cell undifferentiated carcinoma. The average postoperative survival in the ten synchronous cases was 29 months and in the 20 metachronous cases was 26.2 months, counting from the time of the second operation. The criteria of clinicopathologic findings, early diagnostic procedure, and surgery for multiple primary lung cancers were also discussed.