Astragaloside Ⅳ inhibits pathological functions of gastric cancer-associated fibroblasts

AIM To investigate the inhibitory effect of astragaloside IV on the pathological functions of cancer-associated fibroblasts,and to explore the underlying mechanism.METHODS Paired gastric normal fibroblast(GNF) and gastric cancer-associated fibroblast(GCAF) cultures were established from resected tissues. GCAFs were treated with vehicle control or different concentrations of astragaloside Ⅳ. Conditioned media were prepared from GNFs,GCAFs,control-treated GCAFs,and astragaloside Ⅳ-treated GCAFs,and used to culture BGC-823 human gastric cancer cells. Proliferation,migration and invasion capacities of BGC-823 cells were determined by MTT,wound healing,and Transwell invasion assays,respectively. The action mechanism of astragaloside Ⅳ was investigated by detecting the expression of micro RNAs and the expression and secretion of the oncogenic factor,macrophage colonystimulating factor(M-CSF),and the tumor suppressive factor,tissue inhibitor of metalloproteinase 2(TIMP2),in different groups of GCAFs. The expression of the oncogenic pluripotency factors SOX2 and NANOG in BGC-823 cells cultured with different conditioned media was also examined.RESULTS GCAFs displayed higher capacities to induce BGC-823 cell proliferation,migration,and invasion than GNFs(P < 0.01). Astragaloside Ⅳ treatment strongly inhibited the proliferation-,migration-and invasion-promoting capacities of GCAFs(P < 0.05 for 10 μmol/L,P < 0.01 for 20 μmol/L and 40 μmol/L). Compared with GNFs,GCAFs expressed a lower level of micro RNA-214(P < 0.01) and a higher level of micro RNA-301 a(P < 0.01). Astragaloside Ⅳ treatment significantly upregulated micro RNA-214 expression(P < 0.01) and down-regulated micro RNA-301 a expression(P < 0.01) in GCAFs. Reestablishing the micro RNA expression balance subsequently suppressed M-CSF production(P < 0.01) and secretion(P < 0.05),and elevated TIMP2 production(P < 0.01) and secretion(P < 0.05). Consequently,the ability of GCAFs to increase SOX2 and NANOG expression in BGC-823 cells was abolished by astragaloside Ⅳ.CONCLUSION Astragaloside Ⅳ can inhibit the pathological functions of GCAFs by correcting their dysregulation of micro RNA expression,and it is promisingly a potent therapeutic agent regulating tumor microenvironment.

Ascending colon cancer and situs inversus totalis-altered surgeon position for successful laparoscopic hemicolectomy: A case report

BACKGROUND Situs inversus totalis(SIT)is a rare congenital condition in which the structure of the abdominal and thoracic cavities is the mirror image of normal.This anatomic reversal makes laparoscopic surgery difficult when treating colorectal cancer.CASE SUMMARY We describe the successful laparoscopic hemicolectomy of a 68-year-old Chinese woman with SIT and ascending colon cancer.Based on preoperative imaging and careful consideration of the patient’s anatomy,the position of the surgeon was modified such that the surgeon stood between her legs,while the surgical assistant and endoscopist stood to the surgeon’s left.Trocar position was also adjusted appropriately.The surgery lasted 178 min,during which the patient lost 50 mL of blood.Pathology analysis of the resected tumor confirmed an adenocarcinoma in clinical stage pT3N0M0,without lymph node involvement.The patient experienced no postoperative complications and was discharged 10 d after surgery.CONCLUSION This case illustrates that careful positioning of the surgeon can facilitate laparoscopic surgery of SIT patients.