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Objective To summarize the clinical features, diagnosis and differential diagnosis of a case of meningioma associated with reactive hyperplasia and colonization of melanocytes. Methods and Results A 24⁃years⁃old female was discovered a left occipital lobe occupying occasionally by the head CT and MRI. The tumor revealed heterogeneous hyperintense and hypointense signals on T1WI and heterogeneous isointense and hypointense signals on T2WI with enhancement obviously. The left occipital lobe tumor was diagnosed clinically, and the left occipital posterior approach craniotomy was performed under general anesthesia. During operation, there was a smooth capsule on the surface of the tumor partially, which was dark in color and extremely rich in blood supply. Histological findings revealed the tumor cells were distributed in patches, and some of them were around blood vessels characterized by a prominent pseudopapillary architecture. Tumor cells were medium in size and eosinophilic cytoplasm was abundant. Giant tumor cells, intranuclear inclusion and scattered psammoma bodies were visible. A large number of pigmented cells consisted of dark, fine pigment granules. Immunohistochemical staining showed tumor cells expressed vimentin (Vim), E⁃cadherin, progesterone receptor (PR). Somatostatin receptor 2 (SSTR2), glial fibrillary acidic protein (GFAP), S⁃100 protein (S⁃100) presented partially positive. Melanosome⁃associated antigen (HMB45), Melan⁃A, epithelial membrane antigen (EMA), cytokeratin (CK), low molecular weight cytokeratin (LCK), high molecular weight cytokeratin (HCK), SOX10, L1⁃cell adhesion molecule (L1CAM), D2⁃40 and oligodendrocyte transcription factor⁃2 (Olig⁃2) were negative, but the pigmented cells were immunopositive for HMB45, SOX10. Genetic test revealed deletion of NF2 gene. The final diagnosis was meningioma associated with reactive hyperplasia and colonization of melanocytes. No chemoradiotherapy was performed after operation, and no recurrence of tumor was found by MRI. Conclusions Meningioma associated with reactive hyperplasia and colonization of melanocytes is a rare neoplasm. The diagnosis relies on its morphological characteristics, immunophenotype and genetic test. It should be differentiated from other tumors with melanocytes in the central nervous system.

A 16‐year‐old male was admitted to the hospital for weakness of both lower extremities. Magnetic resonance imaging revealed an intraspinal extramedullary subdural mass at the thoracic 9 level. Microscopically, the tumor cells were small to medium sized and round to ovoid in shape. They were distributed in diffuse sheets or showed nodular appearance. The nucleus of the tumor had mild‐to‐moderate atypia, with vesicular chromatin and prominent nucleoli. A smaller proportion of tumor cells demonstrated rhabdoid morphology. Focal myxoid stromal change was present, in which tumor cells exhibited spindle shapes. Approximately two mitoses were counted per 10 high‐power fields. No necrosis was observed. The tumor cells were focal positive for CD99; multifocal positive for WT1; diffuse positive for nestin, synaptophysin, and D2‐40; partial positive for GFAP; focal positive for desmin and SSTR2; and scattered positive for S‐100 protein. The Ki‐67 labeling index was approximately 20%. Genetic testing revealed CIC‐LEUTX gene fusion. Considering the patient's history, clinical data, pathological findings and genetic findings, we rendered a rare tumor named CIC‐rearranged sarcoma with CIC‐LEUTX gene fusion. [ABSTRACT FROM AUTHOR]

Background Subependymal giant cell astrocytoma (SEGA) is a rare kind of central nervous system tumor typically occurring in children or adolescents under the age of 20. The tumor commonly arises in the region of the foramen of Monro. Most SEGA patients present distinctive histopathological and immunohistochemical characteristics. Methods The clinical features, histopathological findings and immunohistochemical staining in one case of SEGA were analyzed, and the diagnosis and differential diagnosis of this disease with literature review were studied. Results A 13-year- old female patient presented dizziness, headache and vomiting. Cranial MRI examination showed abnormal signals in the left lateral ventricle near the foramen of Monro, and exhibited heterogeneous enhancement after contrast. Histologically, the tumor was composed of clustering of fibrillated spindle cells and giant cells with abundant cytoplasm, and they were mixed. Glassy hyaline cytoplasm and eccentric vesicular nuclei with prominent nucleoli were frequently seen in the giant tumor cells. Some of the giant cells appeared to resemble gemistocytic astrocytes or ganglion cells. Considerable nuclear pleomorphism and multinuclear cells were frequently seen. There was no significant microvascular proliferation or necrosis. Immunohistochemical findings showed diffuse and strong positivity in tumor cells for vimentin (Vim), and partial positivity for S-100 protein (S-100), epithelial membrane antigen (EMA) and glial fibrillary acidic protein (GFAP). A few giant tumor cells were positive for synaptophysin (Syn), but negative for neurofilament protein (NF), neuronal nuclei (NeuN) and cytokeratin (CK). Ki-67 labeling index was very low (< 1%). Conclusions SEGA is a benign central nervous system tumor (WHO I). It has distinctive clinical and histopathological features, and should be differentiated from gemistocytic astrocytoma, ependymoma, gangliocytoma and giant cell glioblastoma. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the therapeutic efficacy of Yinxing Damo (..., YXDM) combined with Betahistine Hydrochloride Injection (BHI) on vertebra basilar artery ischemic vertigo (VBIV). Methods: Ninety patients with VBIV were randomly divided into two groups; 45 patients (the treated group) were treated with YXDM and BHI intravenous dripping, once a day for 14 days. Another 45 patients (control group) were treated with Xueshuantong (...) and BHI intravenous dripping, once daily for 14 days. The clinical syndromes and the index of the transcranial Doppler (TCD) and hemorheology were observed. Results: The total effective rate was 100% in the treated group, which was better than that in the control group 90.5%, (P<0.05). The indexes of TCD and hemorheology in the treated group were obviously improved after treatment, (P<0.01). Conclusion: YXDM combined with BHT injection had better effect in treating patients with VBIV is an ideal drug for VBIV. [ABSTRACT FROM AUTHOR]

Objective: To explore the aging-related changes of insulin secretion and insulin sensitivity among normal glucose tolerance (NGT) individuals in China., Methods: A total of 34 293 individuals were recruited. All of them were described as NGT by 75 g oral glucose tolerance test (75 g OGTT) according to the diagnostic criterion of WHO, 1999. HOMA-β, ΔI(30)/ΔG(30), InsAuc30/GluAuc30, InsAuc120/GluAuc120 were calculated to estimate insulin secretion; HOMA-IR and Matsuda index measured to estimate insulin sensitivity; Disposition index: DI(30) and DI(120) were used to estimate β-cell function., Results: HOMA-β, ΔI(30)/ΔG(30), InsAuc30/GluAuc30 and InsAuc120/GluAuc120 were all lower in the elder group then the younger group (P trend < 0.05). The mean HOMA-β dropped from 192 ± 16 (20 - 29 years) to 115 ± 7 (70 or elder) among men and from 162 ± 8 (20 - 29 years) to 120 ± 12 (70 or elder) among women. The mean ΔI(30)/ΔG(30) dropped from 20.0 ± 2.0 (20 - 29 years) to 8.6 ± 0.6 (70 or elder) among men and from 22.4 ± 1.6 (20 - 29 years) to 12.5 ± 1.7 (70 or elder) among women. The above index were negatively correlated with age in univariate linear regression (P < 0.05), the results among men and overall still existed after adjusted for BMI and waist circumference in multivariate linear regression, while the relation between HOMA-β and age disappeared among women. Matsuda Index was positively correlated with age (β = 0.02, P = 0.001) and HOMA-IR were negatively correlated with age (β = -0.01, P = 0.001) among men even after adjusted for BMI and waist circumference and the above correlation between Matsuda Index/HOMA-IR and ageing was not significant until adjusted for BMI and waist circumference in multivariate linear regression. Among women HOMA-IR (β = -0.01, P = 0.000), Matsuda index (β = 0.03, P = 0.000). DI(30) and DI(120) were negatively correlated with age in both univariate and multivariate linear regression., Conclusions: The basal, postchallenge insulin secretion and postchallenge islet compensatory function decreases with ageing, while insulin sensitivity does not deteriorate with ageing and its related change of body composition and weight gain.

Objective: To retrospectively evaluate the diagnostic accuracy of ultrasonographic (US) features for the pre-operative differentiation of benign and malignant thyroid nodules by using pathological diagnosis as the reference standard., Methods: A total of 1501 patients with 2123 thyroid nodules (1864 malignant, 259 benign) diagnosed intra-operatively and undergoing pre-operative ultrasonography at our hospital were recruited. The following characteristics of US images were evaluated: nodule size, shape, margin, echotexture, echogenicity, presence and type of calcification, blood flow inside or around nodules and the presence of ipsilateral cervical lymphadenectasis., Results: (1) The risk of malignancy was higher in a solitary nodule than in a non-solitary nodule [16.7% (109/653) vs 10.2% (150/1470), P=0.000]. The mean diameter of benign nodules was larger than that of malignant nodules [(2.4±1.4) vs (2.1±1.9) cm, P=0.009]. (2) Microcalcification, irregular shape, ill-defined border, solid and hypoechogenicity were more common in malignant nodules. Irregular shape had the highest sensitivity and positive predictive value while microcalcification had the highest diagnostic accuracy. (3) Nodules with a rich blood flow inside tended to have a higher risk of malignancy. The distribution pattern of blood flow around the nodules was not associated with the differentiation of benign and malignant thyroid nodules. Nodules with the presence of ipsilateral cervical lymphadenectasis had a higher risk of malignancy than those without lymphadenectasis [28.3% (80/283) vs 9.6% (92/963), P<0.01]. (4) If microcalcification, irregular shape, ill-defined border, solid, hypoechogenicity and the presence of ipsilateral cervical lymphadenectasis were treated as the characteristics of malignancy, a higher frequency of these characteristics was correlated with a higher risk of malignancy., Conclusion: Despite a lack of specific US imaging characteristics in malignant thyroid nodules, microcalcification and irregular shape appear closely correlated with malignancy. A combined use of conventional US characteristics may improve the accuracy of differential diagnosis.

Background: A satisfactory animal model of breast cancer metastasizing to bone is unavailable. In this study, we used human breast cancer stem-like cells and human bone to build a novel "human-source" model of human breast cancer skeletal metastasis., Methods: Human breast cancer stem-like cells, the CD44+/CD24-/lower subpopulation, was separated and cultured. Before injection with the stem-like cells, mice were implanted with human bone in the right or left dorsal flanks. Animals in Groups A, B, and C were injected with 1 x 10(5), 1 x 10(6) human breast cancer stem-like cells, and 1 x 10(6) parental MDA-MB-231 cells, respectively. A positive control group (D) without implantation of human bone was also injected with 1 x 10(6) MDA-MB-231 cells. Immunohistochemistry was performed for determination of CD34, CD105, smooth muscle antibody, CD44, CD24, cytokine, CXC chemokine receptor-4 (CXCR4), and osteopontin (OPN). mRNA levels of CD44, CD24, CXCR4, and OPN in bone metastasis tissues were analyzed by real-time quantitative polymerase chain reaction (PCR)., Results: Our results demonstrated that cells in implanted human bones of group B, which received 1 x 10(6) cancer stem-like cells, stained strongly positive for CD44, CXCR4, and OPN, whereas those of other groups showed no or minimum staining. Moreover, group B had the highest incidence of human bone metastasis (77.8%, P = 0.0230) and no accompaniment of other tissue metastasis. The real-time PCR showed an increase of CD44, CXCR4, and OPN mRNA in metastatic bone tissues in group B compared with those of groups C and D, however the expression of CD24 mRNA in group B were the lowest., Conclusions: In the novel "human source" model of breast cancer, breast cancer stem-like cells demonstrated a higher human bone-seeking ability. Its mechanism might be related to the higher expressions of CD44, CXCR4, and OPN, and the lower expression of CD24 in breast cancer stem-like cells.