Role of Notch signaling pathway in gastric cancer: A meta-analysis of the literature

AIM: To perform a meta-analysis to quantitatively summarize the evidence for the association between the Notch signaling pathway and gastric cancer ( GC). METHODS: An electronic search of the MEDLINE, EMBASE and Chinese National Knowledge Infrastructure, which contain articles published from 1966 onwards, was conducted to select studies for this meta-analysis. RESULTS: Fifteen studies with a total of 1547 gastric cancer cases and 450 controls were included in this meta-analysis. Overall, the expression of Notch1, Notch2, Delta-like 4 and Hes1 was significantly higher in tumor tissues of GC compared to normal tissues. Specifically, stratified analyses showed that significantly increased expression of Notch1 was associated with non-cardia location, > 5 cm size, diffuse type, positive lymphovascular invasion and distal metastasis. Statistically significant higher expression of Notch3 was found in diffuse type GC. Jagged1 was also significantly over-expressed in diffuse type and poor differentiation type of GC. DLL4 was significantly over-expressed in advanced T stage, N stage and TNM stage in GC patients. However, the stratified analysis showed that there was no statistically significant difference in Hes1 expression between different subgroups. Sporadic reports showed that Notch1 and Jagged1 were independent poor prognostic predictors in GC. CONCLUSION: The Notch signaling pathway plays an important role in tumor progression of gastric cancer. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.

Overexpression of connective tissue growth factor WISP-1 in Chinese primary rectal cancer patients

AIM： To clarify the expression change of Wnt-induced secreted protein-1 （WISP-l） in human rectal cancer and to determine whether it is correlated with invasion and metastasis of human rectal cancer.METHODS： Eighty-six paired samples of rectal cancer and surgically resected distant normal rectal tissue were collected and allocated into cancer group and control group respectively. WISP-1 mRNA was detected by relative quantitative real-time RT-PCR and WISP-1 protein was examined by immunohistochemical staining.RESULTS： WISP-1 gene overexpression was found in 65% （56/86） primary rectal cancers, 2-30 times that of the level in normal matched rectal tissues （P = 0.001）. The mRNA expression level was correlated with Duke＇s staging, histological differentiation grade and lymph node status. The WISP-1 protein expression was in accordance with mRNA expression level. The positive degree of immunohistochemical staining in the cancer group （1.40±0.35） was different from that in control group （1.04± 0.08, P 〈 0.001）. Moreover, in cancer group the positive staining degree in high-level mRNA cancers （1.46 ±0.37, n = 56） was higher than that in low-level mRNA （1.28 ± 0.28, n = 30, P = 0.018）.CONCLUSION： Aberrant levels of WISP-1 expression may play a role in rectal tumorigenesis. WISP-1 may be used as a specific clinical diagnosis and prognosis marker in rectal cancer.

Identification of differently expressed genes in human colorectal adenocarcinoma

AIM： To investigate the differently expressed genes in human colorectal adenocarcinorna.METHODS： The integrated approach for gene expression profiling that couples suppression subtractive hybridization, high-throughput cDNA array, sequencing, bioinformatics analysis, and reverse transcriptase real- time quantitative polymerase chain reaction （PCR） was carried out. A set of cDNA clones including 1260 SSH inserts amplified by PCR was arrayed using robotic printing. The cDNA arrays were hybridized with florescent-labeled probes prepared from RNA of human colorectal adenocarcinoma （HCRAC） and normal colorectal tissues.RESULTS： A total of 86 genes were identified, 16 unknown genes and 70 known genes. The transcription factor Sox9 influencing cell differentiation was downregulated. At the same time, Heat shock protein 10 KDis downregulated and Calmoulin is up-regulated.CONCLUSION： Downregulation of heat shock protein 10 KD lost its inhibition of Ras, and men attenuated the Ras GTPase signaling pathway, increased cell proliferation and inhibited cell apoptosis. Down-regulated transcription factor Sox9 influences cell differentiation and cell-specific gene expression. Down-regulated Sox9 also decreases its binding to calmodulin, accumulates calmodulin as receptor-activated kinase and phosphorylase kinase due to the activation of PhK.

Expression of platelet endothelial cell adhesion molecule-1 between pancreatic microcirculation and peripheral circulation in rats with acute edematous pancreatitis

OBJECTIVE: To study the ehanges of platelet endothelial cell adhesion molecule-1 (PECAM-1) expression on polymorphonuclear leukocytes (PMNs) in peripheral circulation anti pancreatic microcirculation in rats with acute edematous pancreatitis (AEP). METHODS: The model of AEP was established with 50 Wistar rats, and the changes of PECAM-1 expression on PMNs from the splenic vein and inferior vena cava were determined by flow cytometry. RESULTS: PECAM-I expression on PMNs showed no significant difference between pancreatic microcirculation and peripheral circulation at AEP2h and AEP4h time points. From the AEP4h to the AEP8h time point, PECAM-1 expression in peripheral circulation was up-regulated, but PECAM-1 expression in pancreatic microcirculation was down-regulated. PECAM-1 expression had a significant difference between pancreatic microcirculation and peripheral circulation at the AEP8h time point (P<0.05). CONCLUSION: PECAM-1 expression on PMNs is in a converse way between pancreatic microcirculation and peripheral circulation in AEP.

Development and validation of a prediction model for moderately severe and severe acute pancreatitis in pregnancy

BACKGROUND The severity of acute pancreatitis in pregnancy(APIP)is correlated with higher risks of maternal and fetal death.AIM To develop a nomogram that could predict moderately severe and severe acute pancreatitis in pregnancy(MSIP).METHODS Patients with APIP admitted to West China Hospital between January 2012 and December 2018 were included in this study.They were divided into mild acute pancreatitis in pregnancy(MAIP)and MSIP.Characteristic parameters and laboratory results were collected.The training set and test set were randomly divided at a ratio of 7:3.Least absolute shrinkage and selection operator regression was used to select potential prognostic factors.A nomogram was developed by logistic regression.A random forest model was used to validate the stability of the prediction factors.Receiver operating characteristic curves and calibration curves were used to evaluate the model’s predictive performance.RESULTS A total of 190 patients were included in this study.A total of 134 patients(70.5%)and 56 patients(29.5%)were classified as having MAIP and MSIP,respectively.Four independent predictors(lactate dehydrogenase,triglyceride,cholesterol,and albumin levels)were identified for MSIP.A nomogram prediction model based on these factors was established.The model had areas under the curve of 0.865 and 0.853 in the training and validation sets,respectively.The calibration curves showed that the nomogram has a good consistency.CONCLUSION A nomogram including lactate dehydrogenase,triglyceride,cholesterol,and albumin levels as independent predictors was built with good performance for MSIP prediction.

Rare case of drain-site hernia after laparoscopic surgery and a novel strategy of prevention:A case report

BACKGROUND Trocar site hernia(TSH)is a rare but potentially dangerous complication of laparoscopic surgery,and the drain-site TSH is an even rarer type.Due to the difficulty to diagnose at early stages,TSH often leads to a delay in surgical intervention and eventually results in life-threatening consequences.Herein,we report an unusual case of drain-site TSH,followed by a brief literature review.Finally,we provide a novel,simple,and practical method of prevention.CASE SUMMARY A 54-year-old female patient underwent laparoscopic subtotal hysterectomy and bilateral adnexectomy for uterine fibroids 8 d ago in another hospital.She was admitted to our hospital with a 2-d history of intermittent abdominal pain,nausea,vomiting,and abdominal enlargement with an inability to pass stool and flatus.The emergency computed tomography scan revealed the small bowel herniated through a 10 mm trocar incision,which was used as a drainage port,with diffuse bowel distension and multiple air-fluid levels with gas in the small intestines.She was diagnosed with drain-site strangulated TSH.The emergency exploratory laparotomy confirmed the diagnosis.A herniorrhaphy followed by standard intestinal resection and anastomosis were performed.The patient recovered well after the operation and was discharged on postoperative day 8 and had no postoperative complications at her 2-wk follow-up visit.CONCLUSION TSH must be kept in mind during the differential diagnosis of post-laparoscopic obstruction,especially after the removal of the drainage tube,to avoid the serious consequences caused by delayed diagnosis.Furthermore,all abdomen layers should be carefully closed under direct vision at the trocar port site,especially where the drainage tube was placed.Our simple and practical method of prevention may be a novel strategy worthy of clinical promotion.

Novel mutations and sequence variants in exons 3-9 of human T Cell Factor-4 gene in sporadic rectal cancer patients stratified by microsatellite instability

AIM： To establish the role of human T Cell Factor-4 （hTCF-4） gene exons 3-9 mutation status in association with sporadic rectal cancer with microsatellite instability （MSI）. METHODS： Microsatellite markers were genotyped in 93 sporadic rectal cancer patients. Eleven cases were found to be high-frequency MSI （MSI-H）. Sequence analysis of the coding region of the exons 3-9 of hTCF-4 gene was carried out for the 11 MSI-H cases and 10 controls （5 microsatellite stability （MSS） cases and 5 cases with normal mucosa）. The sequencing and MSI identification were used. RESULTS： Several novel mutations and variants were revealed. In exon 4, one is a 4-position continuous alteration which caused amino acid change from Q131T and S132I （391insA, 392 G 〉 A, 393 A 〉 G and 395delC） and another nucleotide deletion （395delC） is present in MSI-H cases （5/10 and 4/10, respectively） but completely absent in the controls.CONCLUSION： Novel mutations in exon 4 of hTCF-4 gene were revealed in this study, which might be of importance in the pathogenesis of sporadic rectal cancer patients with MSI-H.

Chaiqin Chengqi Decoction decreases IL-6 levels in patients with acute pancreatitis

Objective:In this paper,we investigated the effect of the traditional Chinese medicine Chaiqin Chengqi Decoction(CQCQD) on serum cytokines in acute pancreatitis(AP) patients.Methods:Peripheral blood samples from 107 AP patients were collected within the first 48 h of AP onset and on the 10th day of CQCQD treatment.Control samples were collected from 20 healthy individuals.Serum proinflammatory cytokines tumor necrosis factor-α(TNF-α) and interleukin-6(IL-6),and anti-inflammatory cytokines IL-10 and IL-1β receptor antagonist(IL-1ra) were examined using the Luminex 100 system.Results:Within the first 48 h of AP onset,IL-6 and IL-1ra levels in severe AP(SAP) patients were significantly higher than those in mild AP(MAP) patients,but IL-10 levels in SAP patients were significantly lower than those in MAP patients.Proinflammatory cytokine IL-6 was significantly decreased after CQCQD treatment(P<0.05),especially in SAP patients(n=25 of 36,P<0.05).The hospitalization time of SAP patients was shortened significantly when serum IL-6 decreased after CQCQD treatment(P<0.05).Conclusions:CQCQD decreased proinflammatory cytokine IL-6 levels in AP patients.