Endoscopic ultrasound features of gastric schwannomas with radiological correlation:A case series report

Gastric schwannomas are rare mesenchymal tumors of the gastrointestinal tract.They are usually misdiagnosed as other submucosal tumors preoperatively.Experience of the imaging features of gastric schwannomas is extremely limited.In this report,we summarize the features of a series of endoscopic ultrasound(EUS) images of gastric schwannomas in an effort to improve the diagnosis and differential diagnosis rate.We retrospectively reviewed the endosonographic features of four patients with gastric schwannomas and their computed tomography imaging results.Gastric schwannomas had heterogeneous hypoechogenicity or isoechogenicity,and a well-demarcated margin.The tumors originated from the fourth layer.Cystic changes and calcification were uncommon.Marginal hypoechoic haloes were observed in two patients.The results described here were different from those of previous studies.In the EUS evaluation,the internal echogenicity of gastric schwannomas was heterogeneous and low,but slightly higher than that of muscularis pro-pria.These features might help us differentiate gastric schwannomas from other submucosal tumors.Further investigation is needed to differentiate these mesenchymal tumors.

Renal protective effect of Ganoderma lucidum

OBJECTIVE Non-alcoholic fatty liver disease(NAFLD) encompasses a series of patho.logic changes ranging from steatosis to steatohepatitis,which may progress to cirrhosis and hepatocel.lular carcinoma.The purpose of this study was to determine whether Ganoderma lucidum polysaccha.ride peptide(GLPP) has therapeutic effect on NAFLD.METHODS ob/ob mouse model and ApoC3 transgenic mouse model were used for exploring the effect of GLPP on NAFLD.Key metabolic path.ways and enzymes were identified by metabolomics combining with KEGG and PIUmet analyses and key enzymes were detected by Western blotting.Hepatosteatosis models of HepG2 cells and primary hepatocytes were used to further confirm the therapeutic effect of GLPP on NAFLD.RESULTS GLPP administrated for a month alleviated hepatosteatosis,dyslipidemia,liver dysfunction and liver insulin resistance.Pathways of glycerophospholipid metabolism,fatty acid metabolism and primary bile acid biosynthesis were involved in the therapeutic effect of GLPP on NAFLD.Detection of key enzymes revealed that GLPP reversed low expression of CYP7 A1,CYP8 B1,FXR,SHP and high expression of FGFR4 in ob/ob mice and ApoC3 mice.Besides,GLPP inhibited fatty acid synthesis by reducing the expression of SREBP1 c,FAS and ACC via a FXR-SHP dependent mechanism.Additionally,GLPP reduced the accumulation of lipid droplets and the content of TG in HepG2 cells and primary hepato.cytes induced by oleic acid and palmitic acid.CONCLUSION GLPP significantly improves NAFLD via regulating bile acid synthesis dependent on FXR-SHP/FGF pathway,which finally inhibits fatty acid synthesis,indicating that GLPP might be developed as a therapeutic drug for NAFLD.

Adiponectin levels are associated with the number and activity of circulating endothelial progenitor cells in patients with coronary artery disease

Objective:To study the relationship between plasma adiponectin concentration and the functional activities of circulating endothelial progenitor cells(EPCs) in patients with coronary artery disease(CAD).Methods:Circulating EPCs were enumerated as AC133+/KDR+ cells via flow cytometry and identified by co-staining with DiI-acLDL and fluorescein isothiocy-anate(FITC)-conjugated lectin under a fluorescent microscope.The migratory capacity of EPCs was measured by modified Boyden chamber assay.Adhesion capacity was performed to count adherent cells after replating EPCs on six-well culture dishes coated with fibronectin.Results:The number of circulating EPCs(AC133+/KDR+ cells) decreased significantly in CAD patients,compared with control subjects [(74.2±12.3) vs(83.5±12.9) cells/ml blood,P<0.01].In addition,the number of EPCs also decreased in CAD patients after ex vivo cultivation [(54.4±8.6) vs(71.9±11.6) EPCs/field,P<0.01].Both circulating EPCs and differentiated EPCs were positively correlated with plasma adiponectin concentration.The functional activities of EPCs from CAD patients,such as migratory and adherent capacities,were also impaired,compared with control subjects,and positively correlated with plasma adiponectin concentration.Conclusion:The study demonstrates that the impairment of the number and functional activities of EPCs in CAD patients is correlated with their lower plasma adiponectin concentrations.

Aorta-to-right atrium fistula,an unusual complication of endocarditis

Infective endocarditis(IE) remains a serious disease. Aorta-to-right atrium fistula is a rare but very serious complication of IE and predicts a higher mortality. This report describes a 50-year-old man with endocarditis,vegetation,perforation of noncoronary sinus,and formation of two aorta-to-right atrium fistulas with native valves detected by transthoracic echocardiography. This disease is lethal despite developments in cardiac imaging and antibacterial therapy. Early diagnosis,aggressive antibacterial therapy,and surgical treatment may improve the prognosis.