Network pharmacology and molecular docking analysis reveal insights into the molecular mechanism of Gualou Qumai Wan in clear cell renal cell carcinoma

Background:To initially clarify the potential therapeutic targets and pharmacological mechanism regarding Gualou Qumai Wan(GQW),a kind of traditional Chinese medicine(TCM),in clear cell renal cell carcinoma(ccRCC)by virtue of the network pharmacology analysis and molecular docking analysis.Methods:The screening of bioactive components and targets of GQW was based on the Traditional Chinese Medicine System Pharmacology(TCMSP)and the UniProt platform served for standardizing their targets.Online Mendelian Inheritance in Man(OMIM),PharmGkb,TTD,DrugBank and GeneCards databases were searched to collect the disease targets of ccRCC.Cytoscape assisted in constructing herb-compound-target(H-C-T)networks.The STRING database was searched for constructing the target protein-protein interaction(PPI)networks,while the R programming language served for analyzing GO functional terms and the KEGG pathways related to potential targets.Analyses of core genes related to survival and tumor microenvironment(TME)were conducted respectively based on the GEPIA2 database and TIMER 2.0 database.Human Protein Atlas(HPA)and The Cancer Genome Atlas(TCGA)helped to obtain core genes’protein expression as well as transcriptome expression level.Autodock Vina software validated the molecular docking regarding GQW components and pivotal targets.Results:The constructed H-C-T networks mainly had 33 compounds and 65 targets.A topological analysis of the PPI network identified that ESR1,AKT1,HIF1A,PTGS2,TP53 and VEGFA serve as core targets in the way GQW affects ccRCC.According to the GO and KEGG pathway enrichment analyses,the effects of GQW are mediated by genes related to hypoxia and oxidative stress as well as the Chemical carcinogenesis-receptor activation and PI3K-Akt signaling pathways.AKT1 shows a close relation to the recruitment of various immune cells and can remarkably affect disease prognosis according to reports.Molecular docking and molecular dynamics simulations showed that diosgenin has higher affinity with core targets.Conclusion:The study makes a comprehensive explanation of the biological activity,potential targets,as well as molecular mechanism regarding GQW against ccRCC,which promisingly assists in revealing the action mechanism of TCM formulae in disease treatment and the respective and scientific basis.

Predicting the electromechanical properties of small caliber projectile impact igniter using PZT dynamic damage constitutive model considering crack propagation

Block piezoelectric ceramics(PZTs)are often used in impact igniters to provide activation energy for electric initiators.Under the action of strong impact stress,PZTs release electric energy accompanied by crack initiation,propagation and crushing.At present,the electrical output performance of PZTs in projectile is usually calculated by quasi-static piezoelectric equation without considering the dynamic effect caused by strong impact and the influence of crack propagation on material properties.So the ignition parameters are always not accurately predicted.To tackle this,a PZT dynamic damage constitutive model considering crack propagation is established based on the dynamic impact test and the crack propagation theory of brittle materials.The model is then embedded into the ABAQUS subroutine and used to simulate the electromechanical response of the impact igniter during the impact of a small caliber projectile on the target.Meanwhile,the experiments of projectile with impact igniter impact on the target are carried out.The comparison between experimental and numerical simulation results show that the established dynamic damage model can effectively predict the dynamic electromechanical response of PZTs in the missile service environment.

Evaluation of bronchoscopic direct vision glottis anesthesia method in bronchoscopy

BACKGROUND Fibrobronchoscopy is a common adjunct tool that requires anesthesia and is widely used in the diagnosis and treatment of various respiratory diseases.However,current anesthesia methods,such as spray,nebulized inhalation,and cricothyroid membrane puncture,have their own advantages and disadvantages.Recently,studies have shown that bronchoscopic direct-view glottis anesthesia is a simple and inexpensive method that shortens the examination time and provides excellent anesthetic results.AIM To evaluate the effectiveness of bronchoscopic direct vision glottis anesthesia for bronchoscopy.METHODS The study included 100 patients who underwent bronchoscopy during thoracic surgery.A random number table method was used to divide the patients into control and observation groups(50 patients each).The control and observation groups were anesthetized using the nebulized inhalation and bronchoscopic direct vision glottis method,respectively.Hemodynamic indices[systolic blood pressure(SBP),diastolic blood pressure(DBP),heart rate(HR),and oxygen saturation(SpO_(2))before(T1),5 min after anesthesia(T2),and at the end of the operation(T3)]serum stress hormone indices[norepinephrine(NE),epinephrine(E),adrenocorticotropic hormone(ACTH),and cortisol(Cor)before and after treatment]were compared between the 2 groups.Adverse effects were also RESULTS At T2 and T3,SBP,DBP,and HR were lower in the observation group than the control group,whereas SpO_(2) was higher than the control group[(119.05±8.01)mmHg vs(127.05±7.83)mmHg,(119.35±6.66)mmHg vs(128.39±6.56)mmHg,(84.68±6.04)mmHg vs(92.42±5.57)mmHg,(84.53±4.97)mmHg compared to(92.57±6.02)mmHg,(74.25±5.18)beats/min compared to(88.32±5.72)beats/min,(74.38±5.31)beats/min compared to(88.42±5.69)beats/min,(97.36±2.21)%vs(94.35±2.16)%,(97.42±2.36)%vs(94.38±2.69%],with statistically significant differences(all P<0.05).After treatment,NE,E,ACTH,and Cor were significantly higher in both groups than before treatment,but were lower in the observation group than in the control group[(68.25±8.87)ng/mL vs(93.35±14.00)ng/mL,(53.59±5.89)ng/mL vs(82.32±10.70)ng/mL,(14.32±1.58)pg/mL vs(20.35±3.05)pg/mL,(227.35±25.01)nmol/L vs(322.28±45.12)nmol/L],with statistically significant differences(all P<0.05).The incidence of adverse reactions was higher in the control group than in the observation group[12.00%(12/50)vs 6.00%(3/50)](P<0.05).CONCLUSION The use of bronchoscopic direct vision glottis anesthesia method for bronchoscopy patients is beneficial for stabilizing hemodynamic indices during bronchoscopy and reducing the level of patient stress,with good safety and practicality.

Thymic lipofibroadenomas:Three case reports

BACKGROUND Thymic lipofibroadenomas are extremely rare.In this study,we investigated the clinicopathological characteristics of thymic lipofibroadenomas.CASE SUMMARY This study included three patients with thymic lipofibroadenomas.We retrospectively analyzed the patient data to determine the clinicopathological characteristics of thymic lipofibroadenomas.The study included one man and two women[mean age,43(33–59)years].All patients were non-smokers and presented with well-defined anterior mediastinal tumors.The cut surfaces of the tumors were solid,with a mixture of yellow and white areas.Microscopic evaluation of resected specimens showed scattered cord-like structures of epithelial cells embedded within abundant fibrotic and hyaline stroma admixed with variable quantities of adipose tissue.One patient showed hyperplastic thymic tissue in a part of the tumor.CONCLUSION Thymic lipofibroadenomas are an extremely rare type of benign thymic tumor.Surgical removal of lipofibroadenomas is usually curative.

Flowback and early-time production modeling of unconventional gas wells using an improved semi-analytical method

Multiple fractured horizontal wells (MFHWs) currently are the only possible means of commercial production from the low and ultra-low permeability unconventional gas reservoirs. In early production time, flowback fluid, which constitutes of hydraulic water and gas flow within fractures, is collected and analyzed. Flowback analysis has been shown to be a useful tool to estimate key properties of the hydraulic fracture such as conductivity and pore volume. Until date, most tools of flowback analysis rely on empirical and approximate methods. This study presents an improved Green-function-based semi-analytical solution for performance analysis of horizontal gas wells during flowback and early production periods. The proposed solution is derived based on coupling the solutions of two domains: a rigorously derived Green’s function-based integral solution for single-phase gas flow in matrix, and a finite-difference, multiphase solution for gas–water two-phase flow in the fracture. The validity of proposed semi-analytical solution is verified by finely gridded numerical models built in a commercial simulator for a series of synthetic cases considering a variety of fluid and reservoir property combinations, as well as various different production constraints. Comparisons against available empirical and approximate methods are also provided for these cases.

Astrometric Reduction of Saturnian Satellites with Cassini-ISS Images Degraded by Trailed Stars

The Imaging Science Subsystem(ISS)mounted on the Cassini spacecraft has taken a lot of images,which provides an important source of high-precision astrometry of some planets and satellites.However,some of these images are degraded by trailed stars.Previously,these degraded images cannot be used for astrometry.In this paper,a new method is proposed to detect and compute the centers of these trailed stars automatically.The method is then performed on the astrometry of ISS images with trailed stars.Finally,we provided 658 astrometric positions between 2004 and 2017 of several satellites that include Enceladus,Dione,Tethys,Mimas and Rhea.Compared with the JPL ephemeris SAT427,the mean residuals of these measurements are 0.11 km and 0.26 km in R.A.and decl.,respectively.Their standard deviations are 1.08 km and 1.37 km,respectively.The results show that the proposed method performs astrometric measurements of Cassini ISS images with trailed stars effectively.

PhaseⅡstudy of oxaliplatin combined with S-1 and leucovorin(SOL)for Chinese patients with metastatic colorectal cancer

Background:Fluoropyrimidine and oxaliplatin are widely used for patients with colorectal cancer.This phase II study was conducted to evaluate the efficacy and safety of the combination of S-1,oxaliplatin,and leucovorin(SOL) in the treatment of Chinese patients with metastatic colorectal cancer(mCRC).Methods:Eligible patients with untreated mCRC from four hospitals in China received intravenous oxaliplatin(85 mg/m2) on day 1,oral S-1 twice daily(80-120 mg per day) on day 1-7,and leucovorin twice daily(50 mg per day)simultaneously with S-1,every 2 weeks.Results and discussion:Forty patients were enrolled in our study.In total,296 cycles of SOL were administered.The overall response rate was 50.0%.At a median follow-up of 27 months,progression-free survival and overall surviva were 7.0 months(95%confidence interval[CI]6.0-10.6 months) and 22.2 months(95%CI 15.1-29.3 months),respectively.The most common grade 3/4 non-hematological adverse events were diarrhea(n = 8,20.0%),nausea(n = 3,7.5%),and vomiting(n = 3,7.5%).The most common grade 3/4 hematological toxicities were thrombocytopenia(n = 3,7.5%),neutropenia(n = 1,2.5%),and abnormal alanine transaminase/aspartate transaminase levels(n = 1,2.5%).There was one treatment-related death.Conclusions:The data indicate that the SOL regimen is effective and moderately tolerated in Chinese patients with mCRC.Trial registration:Clinical trial

Yes相关蛋白、哺乳动物不育系20样激酶1、细胞周期蛋白D1在鼻咽癌中的表达及临床意义

目的探讨Yes相关蛋白(YAP)、哺乳动物不育系20样激酶1(MST1)及细胞周期蛋白D1(CyclinD1)在鼻咽癌中的表达及与鼻咽癌临床病理特征的关系。方法应用免疫组织化学染色方法检测YAP、MST1、CyclinD1在鼻咽黏膜慢性炎组织和鼻咽癌组织中的表达。结果 YAP及CyclinD1在鼻咽癌组织中的表达均高于鼻咽黏膜慢性炎组织(P <0.05),MST1在鼻咽癌组织中的表达低于鼻咽黏膜慢性炎组织(P <0.05)。YAP、CyclinD1与病理分型相关(P <0.05),而MST1与病理分型无相关性(P>0.05);三者与患者的性别、年龄、生存时间、淋巴结转移、临床分期、远处转移、复发及生存状态无相关性(P>0.05)。在鼻咽癌组织内,YAP与CyclinD1、MST1与CyclinD1呈正相关(P <0.05),YAP与MST1无相关性(P>0.05)。结论 YAP和CyclinD1蛋白的高表达、MST1蛋白的低表达可能与鼻咽癌的发生、发展有关,三者有望成为治疗鼻咽癌的新靶点。

Antiviral therapy delays esophageal variceal bleeding in hepatitis B virus-related cirrhosis

AIM:To investigate the effect of antiviral therapy with nucleoside analogs in hepatitis B virus(HBV)-related cirrhosis and esophageal varices.METHODS:Eligible patients with HBV-related cirrhosis and esophageal varices who consulted two tertiary hospitals in Beijing,China,the Chinese Second Artillery General Hospital and Chinese PLA General Hospital,were enrolled in the study from January 2005 to December 2009. Of 117 patients,79 received treatment with different nucleoside analogs and 38 served as controls. Bleeding rate,change in variceal grade and non-bleeding duration were analyzed. Multivariate Cox proportional hazard regression was used to identify factors related to esophageal variceal bleeding.antiviral group compared to the control group(29.1%vs 65.8%,P < 0.001). Antiviral therapy was an independent factor related to esophageal bleeding in multivariate analysis(HR = 11.3,P < 0.001). The mean increase in variceal grade per year was lower in the antiviral group(1.0 ± 1.3 vs 1.7 ± 1.2,P = 0.003). Nonbleeding duration in the antiviral group was prolonged in the Kaplan-Meier model. Viral load rebound was observed in 3 cases in the lamivudine group and in 1 case in the adefovir group,all of whom experienced bleeding. Entecavir and adefovir resulted in lower bleeding rates(17.2% and 28.6%,respectively) than the control(P < 0.001 and P = 0.006,respectively),whereas lamivudine(53.3%) did not(P = 0.531).CONCLUSION:Antiviral therapy delays the progression of esophageal varices and reduces bleeding risk in HBV-related cirrhosis,however,high-resistance agents tend to be ineffective for long-term treatment.

Diagnostic accuracy of a deep learning approach to calculate FFR from coronary CT angiography

Background The computational fluid dynamics(CFD)approach has been frequently applied to compute the fractional flow reserve(FFR)using computed tomography angiography(CTA).This technique is efficient.We developed the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value out of CTA images in five minutes.This study is to evaluate the DEEPVESSEL-FFR platform using the emerging deep learning technique to calculate the FFR value from CTA images as an efficient method.Methods A single-center,prospective study was conducted and 63 patients were enrolled for the evaluation of the diagnostic performance of DEEPVESSEL-FFR.Automatic quantification method for the three-dimensional coronary arterial geometry and the deep learning based prediction of FFR were developed to assess the ischemic risk of the stenotic coronary arteries.Diagnostic performance of the DEEPVESSEL-FFR was assessed by using wire-based FFR as reference standard.The primary evaluation factor was defined by using the area under receiver-operation characteristics curve(AUC)analysis.Results For per-patient level,taking the cut-off value<0.8 referring to the FFR measurement,DEEPVESSEL-FFR presented higher diagnostic performance in determining ischemia-related lesions with area under the curve of 0.928 compare to CTA stenotic severity 0.664.DEEPVESSEL-FFR correlated with FFR(R=0.686,P<0.001),with a mean di&ference of-0.006士0.0091(P=0.619).The secondary evaluation factors,indicating per vessel accuracy,sensitivity,specificity,positive predictive value,and negative predictive value were 87.3%,97.14%,75%,82.93%,and 95.45%,respectively.Conclusion DEEPVESSEL-FFR is a novel method that allows efficient assessment of the functional significance of coronary stenosis.

HBV infection decreases risk of liver metastasis in patients with colorectal cancer:A cohort study

AIM:To evaluate the effect of hepatitis B virus (HBV) infection on liver metastasis of colorectal cancer.METHODS:A total of 1298 colorectal cancer patients were recruited from January 2001 to March 2005 in this study.Enzyme-linked immunosorbent assay was used to test serum HBV markers for colorectal cancer.Patients were divided into study (infection) group and control (non-infection) group.Clinical features of patients in two groups were compared.RESULTS:Liver metastasis was found in 319 out of the 1298 colorectal cancer patients.The incidence of liver metastasis was significantly lower in study group than in control group (14.2% vs 28.2%,P < 0.01).HBV infection significantly decreased the risk of liver metastasis [hazard ratio (HR):0.50,95% confidence interval (95% CI):0.38-0.66],but the incidence of extrahepatic metastasis was significantly higher in study group than in control group (31.9% vs 17.0%,P < 0.01).The HR was the lowest in chronic hepatitis B group (HR:0.29,95% CI:0.12-0.72).The number of liver metastatic lesions was significantly less in study group than in control group with a higher surgical resection rate.However,no significant difference was found in survival rate between the two groups (P=0.95).CONCLUSION:HBV infection decreases the risk of liver metastasis in patients with colorectal cancer and elevates the surgical resection rate of liver metastatic lesions.

CO_(2)storage with enhanced gas recovery(CSEGR):A review of experimental and numerical studies

CO_(2)emission mitigation is one of the most critical research frontiers.As a promising option of carbon capture,utilization and storage(CCUS),CO_(2)storage with enhanced gas recovery(CSEGR)can reduce CO_(2)emission by sequestrating it into gas reservoirs and simultaneously enhance natural gas production.Over the past decades,the displacement behaviour of CO_(2)—natural gas has been extensively studied and demonstrated to play a key role on both CO_(2)geologic storage and gas recovery performance.This work thoroughly and critically reviews the experimental and numerical simulation studies of CO_(2)displacing natural gas,along with both CSEGR research and demonstration projects at various scales.The physical property difference between CO_(2)and natural gas,especially density and viscosity,lays the foundation of CSEGR.Previous experiments on displacement behaviour and dispersion characteristics of CO_(2)/natural gas revealed the fundamental mixing characteristics in porous media,which is one key factor of gas recovery efficiency and warrants further study.Preliminary numerical simulations demonstrated that it is technically and economically feasible to apply CSEGR in depleted gas reservoirs.However,CO_(2)preferential flow pathways are easy to form(due to reservoir heterogeneity)and thus adversely compromise CSEGR performance.This preferential flow can be slowed down by connate or injected water.Additionally,the optimization of CO_(2)injection strategies is essential for improving gas recovery and CO_(2)storage,which needs further study.The successful K12—B pilot project provides insightful field-scale knowledge and experience,which paves a good foundation for commercial application.More experiments,simulations,research and demonstration projects are needed to facilitate the maturation of the CSEGR technology.

Role of Removing Stasis and Reducing Heat Formula in Clearance of Proximal Ureteral Calculi after Ureteroscopic Ho:YAG Laser Lithotripsy: A Prospective Randomized Study

Objective To prospectively evaluate the efficacy of Removing Stasis and Reducing Heat Formula in accelerating calculus clearance and improving lower urinary tract symptoms of patients with proximal ureteral calculi after ureteroscopic Ho:YAG laser lithotripsy. Methods A total of 138 patients with proximal ureteral calculi underwent ureteroscopic Ho:YAG laser lithotripsy by a single endocrinologist. Stone size varied from 10 to 15 mm. After operation, the patients were randomly divided into three groups: the control group(group A), tamsulosin group(group B), and Removing Stasis and Reducing Heat Formula group(group C). The treatment lasted for 4 weeks or until stone clearance. The primary and secondary outcomes of the three groups at follow-up were assessed. Results Of the 131 patients available for follow-up, 44 cases were in the group A, 45 in the group B, and 42 in the group C, respectively. The stone free rate at 2 weeks in the groups B and C were significantly higher than that in the group A(95.56%, 97.62% vs. 79.55%; all P<0.05). The ureteral colic rate and mean time of fragment expulsion were significantly reduced in the groups B(4.44% and 7.86±4.99 days) and C(2.43% and 6.76±4.37 days) compared with the group A(22.73% and 11.54±9.89 days, all P<0.05). On the day of double-J ureteric stent removal, the group C differed significantly from the group A in the total International Prostate Symptom Score, irritative subscore, obstructive subscore, and quality of life score(all P<0.05). Conclusion Removing Stasis and Reducing Heat Formula in the medical expulsive therapy might be an effective modality for patients with calculus in the proximal uretera after ureteroscopic Ho:YAG laser lithotripsy.

Pathologic response after preoperative therapy predicts prognosis of Chinese colorectal cancer patients with liver metastases

Background: Pathologic response is evaluated according to the extent of tumor regression and is used to estimate the efficacy of preoperative treatment. Several studies have reported the association between the pathologic response and clinical outcomes of colorecal cancer patients with liver metastases who underwent hepatectomy.However, to date, no data from Chinese patients have been reported. In this study, we aimed to evaluate the association between the pathologic response to pre-hepatectomy chemotherapy and prognosis in a cohort of Chinese patients.Patients and methods: In this retrospective study, we analyzed the data of 380 liver metastases in 159 patients.The pathologic response was evaluated according to the tumor regression grade(TRG).The prognostic role of pathologic response in recurrence-free survival(RFS) and overall survival(OS) was assessed using Kaplan-Meier curves with the log-rank test and multivariate Cox models. Factors that had potential influence on pathologic response were also analyzed using multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests.Results: Patients whose tumors achieved pathologic response after preoperative chemotherapy had significant longer RFS and OS than patients whose tumor had no pathologic response to chemotherapy(median RFS: 9.9 vs.6.5 months, P = 0.009; median OS: 40.7 vs. 28.1 months, P = 0.040). Multivariate logistic regression and Kruskal-Wallis/Mann-Whitney U tests showed that metastases with small diameter, metastases from the left-side primary tumors,and metastases from patients receiving long-duration chemotherapy had higher pathologic response rates than their control metastases(all P < 0.05). A decrease in the serum carcinoembryonic antigen(CEA) level after preoperative chemotherapy predicted an increased pathologic response rate(P < 0.05). Although the application of targeted therapy did not significantly influence TRG scores of all cases of metastases, the addition of cetuximab to chemotherapy resulted in a higher pathologic response rate when combined with irinotecan-based regimens rather than with oxaliplatin-based regimens.Conclusions: We found that the evaluation of pathologic response may predict the prognosis of Chinese colorectal cancer patients with liver metastases after preoperative chemotherapy. Small tumor diameter, long-duration chemotherapy, left primary tumor, and decreased serum CEA level after chemotherapy are associated with increased pathologic response rates.

Effect of Tamsulosin in Medical Expulsive Therapy for Proximal Ureteral Calculi After Ureteroscopic Holmium Laser Lithotripsy

THE technical achievements during the past decade have changed the modalities for the removal of ureteral calculi.The introduction of small-caliber semirigid ureteroscopes,as well as the development of holmium:yttrium-aluminum-garnet(Ho:YAG)laser and NTrap stone occlusion device,has improved the stone-free rate of ureteroscopy and reduced the incidence of complications.Recently,medical expulsive therapy has shown encouraging results in

Effects of neutrophil elastase inhibitor in patients undergoing esophagectomy:A systematic review and meta-analysis

AIM: To evaluate the benefit and safety of sivelestat(a neutrophil elastase inhibitor) administration in patients undergoing esophagectomy. METHODS: Online databases including Pub Med, EMBASE, the Cochrane Library, Web of Knowledge, and Chinese databases(Wanfang database, VIP and CNKI) were searched systematically up to November 2013. Randomized controlled trials and high-qualitycomparative studies were considered eligible for inclusion. Three reviewers evaluated the methodological quality of the included studies, and Stata 12.0 software was used to analyze the extracted data. The risk ratio(RR) was used to express the effect size of dichotomous outcomes, and mean difference(MD) or standardized mean difference was used to express the effect size of continuous outcomes.RESULTS: Thirteen studies were included in this systematic review and nine studies were included in the meta-analysis. The duration of mechanical ventilation was significantly decreased in the sivelestat group on postoperative day 5 [I2 = 76.3%, SMD =-1.41, 95%CI:-2.63-(-0.19)]. Sivelestat greatly lowered the incidence of acute lung injury in patients after surgery(I2 = 0%, RR = 0.27, 95%CI: 0.08-0.93). However, it did not decrease the incidence of pneumonia, intensive care unit stay or postoperative hospital stay, and did not increase the incidence of complications such as anastomotic leakage, recurrent nerve palsy, wound infection, sepsis and catheter-related fever. CONCLUSION: A neutrophil elastase inhibitor is beneficial in patients undergoing esophagectomy. More high quality, large sample, multi-center and randomized controlled trials are needed to validate this effect.

Impurity distribution in distillate of terbium metal during vacuum distillation purification

The distribution rules of impurities in distilled terbium metal were investigated by vacuum distillation purificationexperiment and theoretical analysis.It is found that Ti impurity in distilled terbium is220mg/kg in the initial stage of the distillationpurification,increases slowly in the middle stage,and increases rapidly in the last stage,reaching2260mg/kg,and the modifiedseparation coefficient of Ti is1/19.02.The diffusion of the impurity Ti in liquid metal can reach a quasi-equilibrium state in theinitial stage of distillation purification and the calculated results agree well with experimental results;the distribution profile ofimpurity Cu is opposite to Ti,being380mg/kg in the initial stage,decreasing linearly to290mg/kg in the last stage,and themodified separation coefficient is17.99,and the theoretical calculated results are inconsistent with the experimental result.

Rare case of Helicobacter pylori -related gastric ulcer: Malignancy or pseudomorphism?

Helicobacter pylori (H. pylori ) is a pathogen and the most frequent cause of gastric ulcers. There is also a close correlation between the prevalence of H. pylori infection and the incidence of gastric cancer. We present the case of a 38-year-old woman referred by her primary care physician for screening positron emission tomography-computed tomography (PET-CT), which showed a nodular strong accumulation point with standardized uptake value 5.6 in the gastric fundus. Gastroscopy was then performed, and a single arched ulcer, 12 mm in size, was found in the gastric fundus. Histopathological examination of the lesion revealed chronic mucosal inflammation with acute inflammation and H. pylori infection. There was an obvious mitotic phase with widespread lymphoma. Formal anti-H. pylori treatment was carried out. One month later, a gastroscopy showed a single arched ulcer, measuring 10 mm in size in the gastric fundus. Histopathological examination revealed chronic mucosal inflammation with acute inflammation and a very small amount of H. pylori infection. The mitotic phase was 4/10 high power field, with some heterotypes and an obvious nucleolus. Follow-up gastroscopy 2 mo later showed the gastric ulcer in stage S2. The mucosal swelling had markedly improved. The patient remained asymptomatic, and a follow-up PET-CT was performed 6 mo later. The nodular strong accumulation point had disappeared. Follow-up gastroscopy showed no evidence of malignant cancer. H. pylori-associated severe inflammation can lead to neoplastic changes in histiocytes. This underscores the importance of eradicating H. pylori , especially in those with mucosal lesions, and ensuring proper follow-up to prevent or even reverse early gastric cancer.

Pancreas-sparing duodenectomy with regional lymph node dissection for early-stage ampullary carcinoma: A case control study using propensity scoring methods

AIM:To investigate the outcomes of pancreas-sparing duodenectomy(PSD)with regional lymph node dissection vs pancreaticoduodenectomy(PD).METHODS:Between August 2001 and June 2014,228 patients with early-stage ampullary carcinoma(Amp Ca)underwent surgical treatment(PD,n=159;PSD with regional lymph node dissection,n=69).The patients were divided into two groups:the PD group and the PSD group.Propensity scoring methods were used to select patients with similar disease statuses.A total of 138 matched cases,with 69 patients in each group,were included in the final analysis.RESULTS:The median operative time was shorter among the patients in the PSD group(435 min)compared with those in the PD group(481 min,P=0.048).The median blood loss in the PSD group was significantly less than that in the PD group.The median length of hospital stay was shorter for patients in the PSD group vs the PD group.The incidence of pancreatic fistula was higher among patients in the PD group vs the PSD group.The 1-,3-,and 5-year overall survival and disease-free survival rates for patients in the PSD group were 83%,70%,44%and 73%,61%,39%,respectively,and these values were not different than compared with those in the PD group(P=0.625).CONCLUSION:PSD with regional lymph node dissection presents an acceptable morbidity in addition to its advantages over PD.PSD may be a safe and feasible alternative to PD in the treatment of earlystage Amp Ca.

Carbon Monoxide Inhibits the Nuclear-cytoplasmic Translocation of HMGB1 in an In Vitro Oxidative Stress Injury Model of Mouse Renal Tubular Epithelial Cells

Carbon monoxide（CO）,as a vital small molecule in signaling pathways,is found to be involved in ischemia-reperfusion injury（IRI） in renal transplantation.CO-releasing molecule-2（CORM-2）,a CO-releasing molecule,is a type of metal carbonyl complexes which can quickly release CO in vivo.In this study,an in vitro oxidative stress injury model was established to examine the effect of CORM-2 pretreatment on the nuclear-cytoplasmic translocation of high mobility group box 1 protein（HMGB1） in mouse primary renal proximal tubular epithelial cells（RPTECs）.Immunofluorescence staining showed that HMGB1 in the medium-and CORM-2-treated groups was predominantly localized in the nucleus of the cells,whereas higher amounts of HMGB1 translocated to the cytoplasm in the H2O2-and inactive CORM-2（i CORM-2）-treated groups.Western blotting of HMGB1 showed that the total amounts of cytoplasmic HMGB1 in the H2O2-treated（0.59±0.27） and i CORM-2-treated（0.57±0.22） groups were markedly higher than those in the medium-treated（0.19±0.05） and CORM-2-treated（0.21±0.10） groups（P〈0.05）.Co-immunoprecipitation showed that the levels of acetylated HMGB1 in the H2O2-treated（642.98±57.25） and i CORM-2-treated（342.11±131.25） groups were markedly increased as compared with the medium-treated（78.72±74.17） and CORM-2-treated（71.42±53.35） groups（P〈0.05）,and no significant difference was observed between the medium-treated and CORM-2-treated groups（P〉0.05）.In conclusion,our study demonstrated that in the in vitro oxidative stress injury model of primary RPTECs,CORM-2 can significantly inhibit the nuclear-cytoplasmic translocation of HMGB1,which is probably associated with the prevention of HMGB1 acetylation.