Missed diagnosis of early gastric cancer or high-grade intraepithelial neoplasia

AIM: To investigate the causes of missed diagnosis of early gastric cancer (EGC) or high-grade intraepithelial neoplasia (HGIN) in Chongqing, China. METHODS: The present study summarizes 103 cases of EGC/HGIN detected by esophagogastroduodenos-copy (EGD) and pathological analysis from January 2010 to December 2011. Dimethyl silicone oil was administrated orally 15 min before the EGD procedures. The stomach was cleaned by repeated washing with saline when the gastroscope entered the stomach cavity. Suspected EGC lesions were subject to conventional biopsy sampling and pathological examinations. The correlation between lesion locations, endoscopic morphology of cancerous sites, training level of the examiners, pathological biopsies, and missed diagnosis was analyzed. RESULTS: Twenty-three cases were missed among the 103 cases (22.23%) of EGC/HGIN. The rate of missed EGC in the gastroesophageal junction (8/19, 42.1%) was significantly higher than at other sites (15/84, 17.86%) (χ2 = 5.253, P = 0.022). In contrast, the rate of missed EGC in the lower stomach body (2/14, 14.29%) was lower than at other sites (21/89,23.6%), but there were no significant differences (χ2 = 0.289, P = 0.591). The rate of missed EGC in the gastric antrum (5/33, 15.15%) was lower than at other sites (18/70, 25.71%), but there were no significant differences (χ2 = 1.443, P = 0.230). Endoscopists from less prestigious hospitals were more prone to not diagnosing EGC than those from more prestigious hospitals (χ2 = 4.261, P = 0.039). When the number of biopsies was < 4, the rate of missed diagnosis was higher (20/23, 89.96%) than for when there were > 4 biopsies (3/23, 13.04%) (P < 0.001). In addition, there was no significant difference in the rate of missed diagnosis in patients with 1-3 biopsy specimens (χ2 = 0.141, P = 0.932). CONCLUSION: Endoscopists should have a clear understanding of the anatomical characteristics of the esophagus/stomach, and endoscopic identification of early lesions increases with the number of biopsies.

Overexpression of Twist1 in vascular endothelial cells promotes pathological retinal angiogenesis in mice

Retinal angiogenesis is a critical process for normal retinal function.However,uncontrolled angiogenesis can lead to pathological neovascularization(NV),which is closely related to most irreversible blindness-causing retinal diseases.Understanding the molecular basis behind pathological NV is important for the treatment of related diseases.Twist-related protein 1(TWIST1)is a well-known transcription factor and principal inducer of epithelial-mesenchymal transition(EMT)in many human cancers.Our previous study showed that Twist1 expression is elevated in pathological retinal NV.To date,however,the role of TWIST1 in retinal pathological angiogenesis remains to be elucidated.To study the role of TWIST1 in pathological retinal NV and identify specific molecular targets for antagonizing pathological NV,we generated an inducible vascular endothelial cell(EC)-specific Twist1 transgenic mouse model(Tg-Twist1iEC+).Whole-mount retinas from Tg-Twist1iEC+mice showed retarded vascular progression and increased vascular density in the front end of the growing retinal vasculature,as well as aneurysm-like pathological retinal NV.Furthermore,overexpression of Twist1 in the ECs promoted cell proliferation but disturbed cell polarity,thus leading to uncontrolled retinal angiogenesis.TWIST1 promoted pathological NV by activating the Wnt/β-catenin signaling pathway and inducing the expression of NV formation-related genes,thereby acting as a‘valve’in the regulation of pathological angiogenesis.This study identified the critical role of TWIST1 in retinal pathological NV,thus providing a potential therapeutic target for pathological NV.

Treatment of radiation-induced brain injury with bisdemethoxycurcumin

Radiation therapy is considered the most effective non-surgical treatment for brain tumors.However,there are no available treatments for radiation-induced brain injury.Bisdemethoxycurcumin(BDMC)is a demethoxy derivative of curcumin that has anti-proliferative,anti-inflammatory,and anti-oxidant properties.To determine whether BDMC has the potential to treat radiation-induced brain injury,in this study,we established a rat model of radiation-induced brain injury by administe ring a single 30-Gy vertical dose of irradiation to the whole brain,followed by intraperitoneal injection of 500μL of a 100 mg/kg BDMC solution every day for 5 successive weeks.Our res ults showed that BDMC increased the body weight of rats with radiation-induced brain injury,improved lea rning and memory,attenuated brain edema,inhibited astrocyte activation,and reduced oxidative stress.These findings suggest that BDMC protects against radiationinduced brain injury.

Changes in sensorimotor regions of the cerebral cortex in congenital amusia:a case-control study

Perceiving pitch is a central function of the human auditory system;congenital amusia is a disorder of pitch perception.The underlying neural mechanisms of congenital amusia have been actively discussed.However,little attention has been paid to the changes in the motor rain within congenital amusia.In this case-control study,17 participants with congenital amusia and 14 healthy controls underwent functional magnetic resonance imaging while resting with their eyes closed.A voxel-based degree centrality method was used to identify abnormal functional network centrality by comparing degree centrality values between the congenital amusia group and the healthy control group.We found decreased degree centrality values in the right primary sensorimotor areas in participants with congenital amusia relative to controls,indicating potentially decreased centrality of the corresponding brain regions in the auditory-sensory motor feedback network.We found a significant positive correlation between the degree centrality values and the Montreal Battery of Evaluation of Amusia scores.In conclusion,our study identified novel,hitherto undiscussed candidate brain regions that may partly contribute to or be modulated by congenital amusia.Our evidence supports the view that sensorimotor coupling plays an important role in memory and musical discrimination.The study was approved by the Ethics Committee of the Second Xiangya Hospital,Central South University,China(No.WDX20180101GZ01)on February 9,2019.

Effect of cold rolling deformation on microstructure evolution and mechanical properties of spray formed Al−Zn−Mg−Cu−Cr alloys

The impact of cold rolling deformation,which was introduced after solid solution and before aging treatment,on microstructure evolution and mechanical properties of the as-extruded spray formed Al−9.8Zn−2.3Mg−1.73Cu−0.13Cr(wt.%)alloy,was investigated.SEM,TEM,and EBSD were used to analyze the microstructures,and tensile tests were conducted to assess mechanical properties.The results indicate that the D1-T6 sample,subjected to 25%cold rolling deformation,exhibits finer grains(3.35μm)compared to the D0-T6 sample(grain size of 4.23μm)without cold rolling.Cold rolling refines the grains that grow in solution treatment.Due to the combined effects of finer and more dispersed precipitates,higher dislocation density and smaller grains,the yield strength and ultimate tensile strength of the D1-T6 sample can reach 663 and 737 MPa,respectively.In comparison to the as-extruded and D0-T6 samples,the yield strength of the D1-T6 sample increases by 415 and 92 MPa,respectively.