an-unusual-case-of-tuberculosis-infection-of-the-hand-with-peritonitis

An Unusual Case of Tuberculosis Infection of the Hand with Peritonitis

Tuberculosis (TB), primarily a pulmonary disease, manifests extrapulmonary involvement in 20% of cases, though concurrent infections in distant sites like ...

Zhejiang University School of Medicine

The metabolism of bone tumors is extraordinarily complex and involves many signaling pathways and processes, including the tumor necrosis factor (TNF) signaling pathway, which consists of TNF factors and the TNF receptors that belong to the TNF receptor superfamily (TNFRSF). It is appreciated that signaling events and pathways involving TNFRSF components are essential in coordinating the functions of multiple cell types that act as a host defense network against pathogens and malignant cells, the implications of TNFRSF-related signaling pathways on bone tumor metabolism remain to be summarized, which is one of the significant obstacles to the application of TNF-related treatment modalities in the domain of bone oncology. This review will discuss and summarize the anti-tumor properties of important TNFRSF components concerning osteosarcoma, chondrosarcoma, and Ewing sarcoma.

The Roles of TNF Signaling Pathways in Metabolism of Bone Tumors.

Bone fracture healing is a complex process involving various signaling pathways. It remains an unsolved issue the fast and optimal management of complex or multiple fractures in the field of orthopedics and rehabilitation. Bone fracture healing is largely a four-stage process, including initial hematoma formation, intramembrane ossification, chondrogenesis, and endochondral ossification followed by further bone remodeling. Many studies have reported the involvement of immune cells and cytokines in fracture healing. On the other hand, the Tumor Necrosis Factor (TNF) family and TNF receptor superfamily (TNFRSF) play a pivotal role in many physiological processes. The functions of the TNF family and TNFRSF in immune processes, tissue homeostasis, and cell differentiation have been extensively studied by many groups, and treatments targeting specific TNFRSF members are in progress. In terms of bone fracture management, it has been discovered that several members of TNFRSF have very distinct functions in different stages of fracture healing, including TNFR1, TNFR2, and receptor activator of nuclear factor kappa-B (RANK) pathways. More specifically, TNFR1 is associated with osteoclastogenesis and TNFR2 is associated with osteogenic differentiation, while RANK is in association with bone remodeling. In this review, we will discuss and summarize the involvement of members of TNFRSF including TNFR1, TNFR2, and Receptor activator of nuclear factor kappa-B (RANK) pathways in different stages of fracture healing and bone remodeling and the current treatment trend involving TNFRSF agonists and antagonists.

Alterations in bone fracture healing associated with TNFRSF signaling pathways.

Schwannomas are the most common neoplastic lesions of the peripheral nerves when growing on the extremities, they usually have adverse effects on patients due to the exposed and functional nature of the region.

Clinical characteristics and management experience of schwannoma in extremities: Lessons learned from a 10-year retrospective study.

Peripheral nerve diseases are significantly correlated with severe fractures or trauma and surgeries, leading to poor life quality and impairment of physical and mental health. Human dental pulp stem cells (DPSCs) are neural crest stem cells with a strong multi-directional differentiation potential and proliferation capacity that provide a novel cell source for nerve regeneration. DPSCs are easily extracted from dental pulp tissue of human permanent or deciduous teeth. DPSCs can express neurotrophic and immunomodulatory factors and, subsequently, induce blood vessel formation and nerve regeneration. Therefore, DPSCs yield valuable therapeutic potential in the management of peripheral neuropathies. With the purpose of summarizing the advances in DPSCs and their potential applications in peripheral neuropathies, this article reviews the biological characteristics of DPSCs in association with the mechanisms of peripheral nerve regeneration.

The potential roles of dental pulp stem cells in peripheral nerve regeneration.

Traumatic neuromas are infrequent in clinical settings but are prevalent following trauma or surgery. A traumatic neuroma is not a true malignancy, rather, it is a hyperplastic, reparative nerve reaction after injury and typically manifests as a nodular mass. The most common clinical manifestations include painful hypersensitivity and the presence of a trigger point that causes neuralgic pain, which could seriously decrease the living standards of patients. While various studies are conducted aiming to improve current diagnosis and management strategies  the induction of emerging imaging tools and surgical or conservative treatment. However, researchers and clinicians have yet to reach a consensus regarding traumatic neuromas. In this review, we aim to start with the possible underlying mechanisms of traumatic neuromas, elaborate on the diagnosis, treatment, and prevention schemes, and discuss the current experiment models and advances in research for the future management of traumatic neuromas.

Traumatic neuromas of peripheral nerves: Diagnosis, management and future perspectives.

An intraosseous epidermoid cyst at the distal phalanx of the index finger is extremely rare. These cysts are asymptomatic unless ruptured, severely infected, or transformed into malignant squamous cell carcinoma. We present a case of a single clubbing finger in an adult diagnosed with an intraosseous epidermoid cyst in the distal phalanx of the left index finger with no history of pulmonary or cardiovascular diseases. Preoperative MRI showed an expansile lytic lesion with a sclerotic margin. Histopathological examination indicates that there is keratinous cell debris in the cyst with a wall of stratified squamous epithelium, which was the key to the correct diagnosis of an intraosseous epidermoid cyst. Written informed consent was obtained from the patient for publication of this case report and any accompanying images.

The first case report of an intraosseous epidermoid cyst in the distal phalanx of the index finger with infection resulting in single clubbing finger: A case report and review of the literature.

Brachial plexus injury (BPI) is one of the most destructive peripheral nerve injuries and there is still a lack of effective treatment.

The effects of melatonin in the treatment of acute brachial plexus compression injury in rats.

Autologous human fibroblasts have the potential to differentiate into the osteogenic lineage under specific conditions and can be utilized for bone regeneration. However, their efficiency is currently unsatisfactory. Recently, low-intensity nanosecond pulsed electric field (nsPEF) stimulation has been demonstrated to enhance cell pluripotency by activating epigenetic regulatory pathways. In this study, human dermal fibroblasts were exposed to different intensities of nsPEF to assess whether these exposures resulted in changes in proliferation rate, calcium salt deposition, and expression of differentiation-related markers in different experimental groups. The results showed a significant increase in cell proliferation, pluripotency, bone marker expression, and osteogenic differentiation efficiency when stimulating cells with 5 kV/cm of nsPEF. However, cell proliferation and differentiation significantly decreased at 25 kV/cm. Additionally, the proliferation and efficiency of osteogenic differentiation were reduced when the nsPEF intensity was increased to 50 kV/cm. Treatment with a 5 kV/cm of nsPEF led to increased and concentrated expression of Yes-Associated Protein (YAP) in the nucleus. These observations suggest that human dermal fibroblasts possess a heightened potential to differentiate into osteogenic cells when activated with nsPEF at 5 kV/cm. Consequently, the nsPEF strengthening strategy shows promise for fibroblast-based tissue-engineered bone repair research.

Low-Intensity Nanosecond Pulsed Electric Field Accelerates Osteogenic Transformation of Human Dermal Fibroblasts by Enhancing Cell Pluripotency.

Acral melanoma (AM) is the most common histologic subtype of melanoma in dark-skinned patients and is associated with a worse prognosis and a high mortality rate, largely due to the inconspicuous nature of early-stage lesions, which can lead to late diagnosis. Because of the overlapping clinical and histopathological features of AM with other forms of cutaneous melanomas, early detection of AM requires a multidisciplinary approach that integrates various diagnostic modalities, including clinical examination, dermoscopy, histopathology, molecular testing, radiological imaging, and blood tests. While surgery is the preferred method of treatment for AM, other therapeutic options may be employed based on the stage and underlying etiology of the disease. Immune checkpoint inhibitors, molecular targeted therapy, radiotherapy, chemotherapy, and oncolytic virotherapy represent promising advanced treatment options for AM. In this review, we provide an overview of the latest advancements in diagnostic and therapeutic methods for AM, highlighting the importance of early detection and the prompt, individualized management of this challenging disease.

Recent advancements in the diagnosis and treatment of acral melanoma.

This article emphasizes the essential role of radiological imaging in high-pressure injection injury (HPII) management and assesses the results of Magnetic Resonance Imaging (MRI) examinations in providing better details about foreign material extension and assisting surgeons in visualizing operational movement during surgery. Additionally, it shares the authors' experience in managing 16 HPII patients and investigates the application of bone cement in the treatment of injection injuries.

Advanced Diagnosis and Treatment Methods of High-Pressure Injection Injury: A Single-Center Retrospective Case Series Study.

Coronavirus disease 2019 (COVID-19) is a multi-system disease that can lead to various severe complications. Acute limb ischemia (ALI) has been increasingly recognized as a COVID-19-associated complication that often predicts a poor prognosis. However, the pathophysiology and molecular mechanisms underlying COVID-19-associated ALI remain poorly understood. Hypercoagulability and thrombosis are considered important mechanisms, but we also emphasize the roles of vasospasm, hypoxia, and acidosis in the pathogenesis of the disease. The angiotensin-converting enzyme 2 (ACE2) pathway, inflammation, and platelet activation may be important molecular mechanisms underlying these pathological changes induced by COVID-19. Furthermore, we discuss the hypotheses of risk factors for COVID-19-associated ALI from genetic, age, and gender perspectives based on our analysis of molecular mechanisms. Additionally, we summarize therapeutic approaches such as use of the interleukin-6 (IL-6) blocker tocilizumab, calcium channel blockers, and angiotensin-converting enzyme inhibitors, providing insights for the future treatment of coronavirus-associated limb ischemic diseases.

COVID-19 and acute limb ischemia: latest hypotheses of pathophysiology and molecular mechanisms.

Despite their terminally differentiated state, human dermal fibroblasts (HDFs) can undergo osteogenic differentiation in vivo under certain pathological conditions, making them promising candidates for bone tissue engineering-though replicating this in vitro would be difficult. Building on prior findings that low-intensity (5 kV/cm) nanosecond pulsed electric fields (nsPEF) can partially reprogram HDFs toward pluripotency and boost their osteogenic capacity, an in vivo bone regeneration complex was fabricated by encapsulating nsPEF-treated cells in a self-healing hydrogel composed of oxidized hyaluronic acid and hydroxypropyl chitosan. In nude mice, these HDFs produced more robust ectopic bone both subcutaneously and within cranial defects, with significantly higher histological scores than untreated controls. RNA sequencing linked this enhanced osteogenesis to activation of the p38 MAPK/YAP pathway and accelerated endochondral ossification, findings that were validated by Western blot, qPCR, and immunofluorescence. The results in this study confirm that nsPEF stimulation markedly improves HDF osteogenic transformation in vitro and in vivo, highlighting its potential as a tool for advancing HDF-based bone regeneration strategies.

Article	Year
The Roles of TNF Signaling Pathways in Metabolism of Bone Tumors. Frontiers in pharmacology\| PubMed ID: 35847045	2022
Alterations in bone fracture healing associated with TNFRSF signaling pathways. Frontiers in pharmacology\| PubMed ID: 36324677	2022
Clinical characteristics and management experience of schwannoma in extremities: Lessons learned from a 10-year retrospective study. Frontiers in neurology\| PubMed ID: 36588891	2022
The potential roles of dental pulp stem cells in peripheral nerve regeneration. Frontiers in neurology\| PubMed ID: 36712432	2022
Traumatic neuromas of peripheral nerves: Diagnosis, management and future perspectives. Frontiers in neurology\| PubMed ID: 36712443	2022
The first case report of an intraosseous epidermoid cyst in the distal phalanx of the index finger with infection resulting in single clubbing finger: A case report and review of the literat... Frontiers in surgery\| PubMed ID: 36733677	2022
The effects of melatonin in the treatment of acute brachial plexus compression injury in rats. Frontiers in neurology\| PubMed ID: 36937512	2023
Low-Intensity Nanosecond Pulsed Electric Field Accelerates Osteogenic Transformation of Human Dermal Fibroblasts by Enhancing Cell Pluripotency. Cellular reprogramming\| PubMed ID: 38011697	2023
Recent advancements in the diagnosis and treatment of acral melanoma. Journal of Zhejiang University. Science. B\| PubMed ID: 38303495	2024
Advanced Diagnosis and Treatment Methods of High-Pressure Injection Injury: A Single-Center Retrospective Case Series Study. Annali italiani di chirurgia\| PubMed ID: 40234234	2025
COVID-19 and acute limb ischemia: latest hypotheses of pathophysiology and molecular mechanisms. Journal of Zhejiang University. Science. B\| PubMed ID: 40274383	2025
Enhancing fibroblast-based bone regeneration by harnessing nanosecond pulsed electric field. Bioelectrochemistry (Amsterdam, Netherlands)\| PubMed ID: 40865201	2026

Jingtian Lai

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