CD97 promotes gastric cancer cell proliferation and invasion through exosome-mediated MAPK signaling pathway

AIM: To investigate the mechanism underlying the promoting role of CD97 in gastric cancer cell proliferation and invasion. METHODS: Two types of exosomes released by gastric cancer cells with high(SGC/wt) or low(SGC/kd) CD97 expression were isolated by ultracentrifugation and identified by electron microscopy and western blot analysis. The influences of the two exosomes on gastric cancer cell proliferation and invasion were investigated by proliferation and Matrigel invasion assays. Exosomal mi RNAs were subsequently isolated from the two samples and their mi RNA profiles were compared via microarray assay analysis. Reverse transcriptionquantitative real-time polymerase chain reaction was used to validate the microarray assay. Target genes of the differently expressed micro RNAs were predicted based on five independent algorithms and were then subjected to gene oncology enrichment and Kyoto encyclopedia of genes and genomes(KEGG) pathway analysis. After identifying the pathway that was the most likely altered, tumor cells were treated with the two exosomes at different concentrations, and the pathway activation was identified through western blot analysis.RESULTS: Exosomes isolated from SGC/wt cells significantly promoted tumor cell proliferation in a dose-dependent manner in vitro. SGC/wt exosomesalso significantly elevated the invasiveness of both SGC/wt(129.67 ± 8.327 vs 76.00 ± 5.292, P < 0.001) and SGC/kd(114.52 ± 9.814 vs 45.73 ± 4.835, P < 0.001) cells as compared to the exosomes released by SGC/kd cells. Microarray assay of the two exosomes revealed that 62 mi RNAs were differently regulated with a signal intensity of > 500 and a false discovery rate < 0.05. The following KEGG analysis defined the MAPK signaling pathway as the most likely candidate pathway that regulated tumor cell proliferation and invasion. Through western blot analysis, significant up-regulations of phosphorylated MAPKs, including extracellular signal-regulated kinase, Jun NH2-terminal kinase, and p38 mitogen-activated protein kinase, were detected in a dose-dependent manner in the SGC/wt exosomes treated groups, confirming activation of the MAPK signaling pathway stimulated by SGC/wt exosomes.CONCLUSION: CD97 promotes gastric cancer cell proliferation and invasion in vitro through exosomemediated MAPK signaling pathway, and exosomal mi RNAs are probably involved in activation of the CD97-associated pathway.

Reinforcing effect of calcium sulfate cement bovine bone morphogenetic protein on vertebral in the rabbit model of osteoporosis

Objective:To observe reinforcing effect of calcium sulfate cement(CSC) bovine bone morphogenetic protein(bBMP) on vertebral in the rabbit model of osteoporosis.Methods:A total of 48 New Zealand white rabbits were randomly divided into group Ⅰ(blank control group),groupⅡ(CSC injection group),group Ⅲ(CSC/bBMP injection group) and control group.White rabbit osteoporosis model was established rapidly by using castration mcthod+methylprcdnisolone candidate.After modeling,groups Ⅱ.Ⅲ were given corresponding vertebral body injection material,and 4 animals were sacrificed respectively at 24 h,6 weeks,12 weeks after vertebral plasty.Tissue pathological status,vertebral mineral density and vertebral body bone mechanical strength were observed.Results:Vertebral body structure form was normal in the groups Ⅱand Ⅲ.Trabecular bone coarsens,connection and repair were observed in micro fracture and bone defects,bone trabecular connectivity was superior to group I significantly;vertebral body compression strength in the group I was on the decline,vertebral compression strength in the groups Ⅱ and Ⅲ was on the rise,the largest vertebra.Postoperative BMC and BMD in groups Ⅱand Ⅲ were incresed,and significantly higher than group I after 6 weeks(P<0.05),BMC and BMD in group Ⅲ after 12 weeks were higher than the other three groups.Conclusion:Compound bBMP CSC has good bone induction.It can improve the three-dimensional construction effect for osteoporosis vertebral trabecula,and can significantly improve the vertebral strength,as a vertebral packing material with good application prospect.

Detection of pancreatic cancer with normal carbohydrate antigen 19-9 using protein chip technology

AIM:To develop a method to differentiate pancreatic cancer patients from healthy or benign individuals when carbohydrate antigen(CA)19-9 is normal.METHODS:Forty-one serum samples from patients with pancreatic lesions and blood samples from 20 healthy individuals were collected at the first stage of the experiment according to the enrolment criteria.General characteristics and some clinical features were carefully compared to ensure that the results were reasonable.All the blood samples were analyzed by surface-enhanced laser desorption/ionization time-of-flight mass spectrometry(SELDI-TOF-MS)combined with CM10 chips and a related bioinformatics analysis program to generate diagnostic models with different proteins.Forty-seven consecutive samples were tested at the next stage to verify the veracity and efficiency of the models.RESULTS:The sex,age,and serum CA19-9 levels among the three groups(malignant,benign,and healthy)were statistically matched(P values were 0.957,0.145,and 0.382,respectively).Two patterns were generated.Pattern 1 with four proteins theoretically had a specificity and sensitivity of 100%in distinguishing pancreatic cancer from healthy individuals,while it was 86.7%and86.4%,respectively,in the subsequent practical verification.The positive predictive value(PPV)of the model was86.4%.One of the four proteins was expressed highly in pancreatic cancer while the other three were expressed weakly.Pattern 2 consisted of six proteins that showed a specificity of 70.0%and sensitivity of 77.3%for differentiating malignancy from benign tumors.Its PPV reached85.0%.Only one of these six proteins showed high expression in the malignant group.CONCLUSION:SELDI-TOF-MS may facilitate diagnosis or differential diagnosis of pancreatic cancer when CA19-9 is normal.Pattern 1 may serve as a useful screening tool.

Preoperative intestinal stent decompression with primary laparoscopic surgery to treat left-sided colorectal cancer with obstruction: a report of 21 cases

Objective: This work aimed to study the safety and efficacy of preoperative intestinal stent decompression combined with laparoscopic surgery to treat left-sided colorectal cancer with obstruction (LCCO). Methods: Retrospective analysis was conducted on data obtained from 21 LCCO patients admitted to The First Affiliated Hospital of Zhejiang Chinese Medicine University during March 2008 and December 2011. To remove the intestinal obstruction, preoperative intestinal stent placement under colonoscopic guidance was performed. Approximately 7 to 10 days after the operation, laparoscopic radical surgery of colorectal cancer was conducted. Results: Among the 21 cases studied, laparoscopic surgery was successful in 20 patients. Emergent laparotomy was conducted in one patient because of tumor invasion in the ureter. The duration of the operation ranged from 180 to 320 min, and the average time was 220 min. The recovery time for bowel function ranged from 2 to 5 days with an average time of 3 days. Postoperative infection of the incision occurred in one case. No anastomotic leakage was observed in any of the cases. Conclusion: Preoperative intestinal stent decompression, combined with primary stage laparoscopic surgery, is a safe and effective method for the treatment of LCCO.

Resection of non-cystic adenocarcinoma in pancreatic body and tail

AIM: To report the outcome of Chinese patents with non-cystic adenocarcinoma in pancreatic body and tail (NCAPBT) after resection and to discuss its surgical strategy. METHODS: Resection of NCAPBT was performed in eight Chinese patients with complete clinical-pathological data in our hospital from January 2000 to May 2004. The surgical strategy was explored by analyzing the results of these patients. RESULTS: The resection rate of NCAPBT in patients without back pain was higher than that in patients with back pain (66.67% vs 20%, 2/3 vs 1/5). The prognosis in the group receiving palliative resection was poorer than that in the group receiving curative resection. The median survival time was 12 mo in the curative resection group and 6 mo in the palliative resection group, respectively. CONCLUSION: The overall survival time of the Chinese patients with NCAPBT is dismal. The Chinese patients after curative resection of NCAPBT have a longer survival time. The Chinese NCAPBT patients with back pain trend to have a lower curative resection rate, but back pain should not be considered a contraindication for curative resection.

Ion exchange coupled biomineral self-sacrificial template synthesis of N-enriched porous carbon as robust electrocatalyst for rechargeable Zn-air battery

To realize the commercialize of rechargeable Zn-air battery(RZAB),developing metal-free bifunctional electrocatalysts with satisfactory activity for oxygen reduction reaction(ORR)and oxygen evolution reaction(OER)is one of the emerging issues.Herein,a prawn shells-derived N-enriched porous carbon(PSNC)is synthesized via an ion exchange coupled biomimetic selfsacrificing template strategy.The resulting PSNC displays unique functional components,including the interconnected macro-meso-micropores structure to shorten charge and mass transfer pathway,high content of pyridinic and graphitic nitrogen to construct rich catalytic active site and improve conductivity.As electrocatalysts in alkaline condition,the optimized PSNC-0.8 achieves excellent bifunctional catalytic propriety with a narrow potential gap(ΔE)value of 0.80 V.Meanwhile,PSNC-0.8-based RZAB displays a high peak power density of 176.5 mW·cm^(-2)and considerable cycling durability with a small battery efficiency delay of 6.5%after 480 cycles(320 h).This study enlightens a simple and effective conception to design high-performance metal-free bifunctional electrocatalysts from seafood waste.

Acute pancreatitis associated left-sided portal hypertension with severe gastrointestinal bleeding treated by transcatheter splenic artery embolization:a case report and literature review

Left-sided portal hypertension(LSPH)followed by acute pancreatitis is a rare condition with most patients being asymptomatic.In cases where gastrointestinal(GI)bleeding is present,however,the condition is more complicated and the mortality is very high because of the difficulty in diagnosing and selecting optimal treatment.A successfully treated case with severe GI bleeding by transcatheter splenic artery embolization is reported in this article.The patient exhibited severe uncontrollable GI bleeding and was confirmed as gastric varices secondary to LSPH by enhanced computed tomography(CT)scan and CT-angiography.After embolization,the bleeding stopped and stabilized for the entire follow-up period without any severe complications.In conclusion,embolization of the splenic artery is a simple,safe,and effective method of controlling gastric variceal bleeding caused by LSPH in acute pancreatitis.

射频消融术与肝切除术治疗乳腺癌肝转移:系统回顾和meta分析（英文）

目的:评估射频消融术(RFA)和肝切除术(HR)治疗乳腺癌肝转移(BCLM)的效果。创新点:首次采用meta分析的方法,精确评估RFA和HR治疗BCLM的效果,解决不同研究产生不同结论的矛盾。方法:系统收集截止到2017年3月所有与RFA和HR治疗BCLM的效果相关文献,评价文献质量、提取数据并计算癌症预后相关指标的优势比(OR)及其95%置信区间(CI)。结论:HR比RFA对于提高BCLM患者生存率有更大优势;RFA并发症少、可重复、患者术后住院时间短,具有明显微创优势。对于不适合行切除治疗的患者可考虑行RFA治疗。

Impact of nodular size on the predictive values of gray-scale,color-Doppler ultrasound,and sonoelastography for assessment of thyroid nodules

Objective:To define the roles of gray-scale,color-Doppler ultrasound,and sonoelastography for the assessment of thyroid nodule to determine whether nodule size affects the differential diagnosis of benign and malignant.Methods:A total of 243 consecutive subjects(214 women,29 men) with 329 thyroid nodules were examined by gray-scale,color-Doppler ultrasound,and sonoelastography in this prospective study.All patients underwent surgery and the final diagnosis was obtained from histopathological examination.Results:Three hundred and twenty-nine nodules(208 benign,121 malignant) were divided into small(SNs,5-10 mm,n=137) and large(LNs,>10 mm,n=192) nodules.Microcalcifications were more frequent in malignant LNs than in malignant SNs,but showed no significant difference between benign LNs and SNs.Poorly-circumscribed margins were not significantly different between malignant SNs and LNs,but were less frequent in benign LNs than in benign SNs.Among all nodules,marked intranodular vascularity was more frequent in LNs than in SNs.By comparison,shape ratio of anteroposterior to transverse dimensions(A/T) ≥1 was less frequent in LNs than in SNs.Otherwise,among all nodules,marked hypoechogenicity and elasticity score of 4-6 showed no significant difference between LNs and SNs.Conclusions:The predictive values of microcalcifications,nodular margins,A/T ratio,and marked intranodular vascularity depend on nodule size,but the predictive values of echogenicity and elastography do not.

近端胰腺非侵袭性肿瘤剜除手术:指征及与传统标准切除手术效果比较（英文）

目的:评价近端胰腺非侵袭性肿瘤剜除手术的安全性与有效性。创新点:以目前为止最大样本量的近端胰腺非侵袭性肿瘤的剜除手术的数据分析,证实了剜除手术在这类患者中的安全性和有效性,即使肿瘤直径>3 cm或临近主胰管肿瘤。并且首次报道和证实了在这些患者剜除手术中发生主胰管损伤,进行主胰管修补与支架置入是安全有效的。分析了同期进行不同手术方式患者的肿瘤资料,阐明了肿瘤大小影响手术策略的制定。方法:详细对比了剜除手术和传统的胰十二脂肠切除术以及胰腺中段切除术的术前情况、术中情况、术后并发症资料(表1~3),尤其详细描述了临近主胰管和主胰管有损伤的患者剜除手术后并发症情况(表4)。同时,附图说明了主胰管修补手术方法(图1)。结论:近端胰腺非侵袭性肿瘤的剜除手术是安全有效的,应该是这类患者手术治疗的首选推荐方式,在大肿瘤和临近主胰管的肿瘤患者中也可施行。

Case Report:Gastric duplication cyst lined by pseudostratified columnar ciliated epithelium: a case report and literature review

Gastric duplication cyst (GDC) lined by pseudostratified columnar ciliated epithelium (PCCE) is an uncommon lesion stemming from a foregut developmental malformation.Its clinical and radiological presentation is usually nonspecific.In this study,we reported a 76-year-old man who presented with an incidentally found perigastric mass.An exploratory laparotomy revealed a non-communicating cyst below the gastroesophageal junction,measuring 4 cm×4 cm in size.Microscopically,the gastric cyst was lined merely by PCCE.Although rare,GDC lined by PCCE should be included in the differential diagnosis of gastric wall masses.Surgical intervention is warranted in patients who have clinical symptoms,or who are aged more than 50 years.

Case Report:Pancreatic somatostatinoma with obscure inhibitory syndrome and mixed pathological pattern

Somatostatinoma is a very rare neuroendocrine tumor that originates from D cells and accounts for less than 1% of all gastrointestinal endocrine tumors. The duodenum is the most frequent site for this tumor, followed by the pancreas. We here describe a 46-year-old Chinese woman who developed pancreatic somatostatinoma presenting with the characteristic "inhibitory" syndrome, but the symptoms were obscure and seemingly uncorrelated. This case is also unique for its large tumor size and mixed pathological pattern. Distal pancreatectomy was performed, and the patient has remained well since operation. As the syndromes of somatostatinoma may be obscure and atypical, clinicians should review all clinical findings to obtain an accurate diagnosis. Aggressive surgery is preferred to improve the survival.