Prognostic impact of dissected lymph node count on patients with node-negative gastric cancer

AIM:To investigate the long-term effect of the number of resected lymph nodes (LNs) on the prognosis of patients with node-negative gastric cancer.METHODS: Clinical data of 211 patients with gastric cancer, without nodal involvement, were analyzed retrospectively after D2 radical operation. We analyzed the relationship between the number of resected LNs with the 5-year survival, the recurrence rate and the post-operative complication rate.RESULTS: The 5-year survival of the entire cohort was 82.2%. The total number of dissected LNs was one of the independent prognostic factors. Among patients with comparable depth of invasion, the larger the number of resected LNs, the better the survival (P<0.05). A cut-point analysis provided the possibility to detect a significant survival difference among subgroups. Patients had a better long-term survival outcomes with LN counts ≥15 for pT1-2, ≥20 for pT3-4, and ≥15 for the entire cohort. The overall recurrence rate was 29.4% within 5 years after surgery. There was a statistically significant, negative correlation between the number of resected LNs and the recurrence rate (P>0.01). The post-operative complication rate was 10.9% and was not signif icantly correlated with the number of dissected LNs (P>0.05).CONCLUSION: For node-negative gastric cancer, sufficient number of dissected LNs is recommended during D2 lymphadenectomy, to improve the long-term survival and reduce the recurrence. Suitable increments of the dissected LN count would not increase the post-operative complication rate.

Genetic diagnosis strategy of hereditary non-polyposis colorectal cancer

AIM: To study the characteristics of mismatch repair gene mutation of Chinese hereditary non-polyposis colorectal cancer (HNPCC) and hMLH1 gene promoter methylation, and to improve the screening strategy and explore the pertinent test methods. METHODS: A systematic analysis of 30 probands from HNPCC families in the north of China was performed by immunohistochemistry, microsatellite instability (MSI), gene mutation and methylation detection. RESULTS: High frequency microsatellite instability occurred in 25 probands (83.3%) of HNPCC family. Loss of hMLH1 and hMSH2 protein expression accounted for 88% of all microsatellite instability. Pathogenic muta-tion occurred in 14 samples and 3 novel mutational sites were discovered. Deletion of exons 1-6, 1-7 and 8 of hMSH2 was detected in 3 samples and no large fragment deletion was found in hMLH1. Of the 30 probands, hMLH1 gene promoter methylation occurred in 3 probands. The rate of gene micromutation detection combined with large fragment deletion detection was 46.7%-56.7%. The rate of the two methods in combination with methylation detection was 63.3%. CONCLUSION: Scientific and rational detection strategy can improve the detection rate of HNPCC. Based on traditional molecular genetics and combined with epigenetics, multiple detection methods can accurately diagnose HNPCC.

Expression of thymidylate synthase and glutathione-stransferase π in patients with esophageal squamous cell carcinoma

AIM:To investigate the expression of thymidylate synthase(TS)and glutathione-s-transferaseπ(GST-π) in esophageal squamous cell carcinoma and their association with the clinicopathologic characteristics. METHODS:Immunohistochemical methods were used to detect the expression of TS and GST-πin surgically resected formalin-fixed,paraffin-embedded esophageal squamous cell carcinoma(ESCC)tissue sections from 102 patients(median age,58 years)and in 28 normal esophageal mucosa(NEM)samples.The relationship between TS and GST-πexpression and clinicopathologic factors was examined. RESULTS:The expression of TS and GST-πwas not statistically significantly associated with age of the patients,tumor size,lymph node metastasis,depth of invasion or tumor stage.TS staining was positive in 17.86%of normal esophageal mucosa and in 42.16% of ESCC samples(P<0.05).The expression level of TSwas not only significantly lower in well-differentiated (21.88%)than in poorly-differentiated carcinomas (51.43%,P<0.05),but was also significantly higher in samples from male patients(46.51%)than from female patients(18.75%,P<0.05).GST-πwas positively stained in 78.57%of normal esophageal mucosa and in 53.92%of ESCC samples(P<0.05).The expression level of GST-πwas also significantly higher in welldifferentiated carcinomas(65.63%)than in poorlydifferentiated carcinomas(35.00%,P<0.05). CONCLUSION:The expression of TS and of GST-πmay be used as molecular markers for the characterization of ESCC.Poorly-differentiated cells showed increased expression of TS and reduced expression of GST-π.

Structural insights into a dual-specificity histone demethylase ceKDM7A from Caenorhabditis elegans

Histone 离氨酸 methylation 能被 JmjC 包含域的蛋白质在 sequence-state-specific 和 methylation-state-specific 举止移开。然而，底层特性怎么样，决定，酶怎么被调整，大部分是未知的。我们最近发现了那 ceKDM7A，一个哲学博士 -- 并且 JmjC 包含域的蛋白质，是为 H3K9me2 特定的 histone demethylase， H3K27me2，和 PHD 摸绑定到 H3K4me3 指南在 vivo 的 demethylation 活动。为了为酶的活动和 PHD 的功能提供结构的卓见进分子的机制，摸，我们与包含 H3K4me3， H3K9me2，和 H3K27me2 修正的各种各样的联合的单身者或二肽一起在 apo 形式并且在建筑群解决了酶的六水晶结构。结构显示 H3K9me2 和 H3K27me2 以一种类似的方式与 ceKDM7A 交往，并且肽绑定特性被特定的相互作用的一个网络决定。结构的几何测量也揭示了与 PHD 手指和 H3K9me2 界限联系到 JmjC 领域的那 H3K4me3 从二个分开的分子，建议 trans-histone 肽绑定机制。因此，我们的全身的结构的研究重要地由催化领域而且更多揭示底层识别不仅，为 H3K9me2 和 H3K27me2 的 ceDKM7A 的双特性的分子的机制。

Baicalin protects neonatal rat brains against hypoxicischemic injury by upregulating glutamate transporter 1 via the phosphoinositide 3-kinase/protein kinase B signaling pathway

Baicalin is a flavonoid compound extracted from Scutellaria baicalensis root.Recent evidence indicates that baicalin is neuroprotective in models of ischemic stroke.Here,we investigate the neuroprotective effect of baicalin in a neonatal rat model of hypoxic-ischemic encephalopathy.Seven-day-old pups underwent left common carotid artery ligation followed by hypoxia（8% oxygen at 37°C） for 2 hours,before being injected with baicalin（120 mg/kg intraperitoneally） and examined 24 hours later.Baicalin effectively reduced cerebral infarct volume and neuronal loss,inhibited apoptosis,and upregulated the expression of p-Akt and glutamate transporter 1.Intracerebroventricular injection of the phosphoinositide 3-kinase/protein kinase B（PI3 K/Akt） inhibitor LY294002 30 minutes before injury blocked the effect of baicalin on p-Akt and glutamate transporter 1,and weakened the associated neuroprotective effect.Our findings provide the first evidence,to our knowledge that baicalin can protect neonatal rat brains against hypoxic-ischemic injury by upregulating glutamate transporter 1 via the PI3 K/Akt signaling pathway.

Preoperative Chemoradiotherapy for Inflammatory Breast Cancer

OBJECTIVE To observe the effect of preoperative chemoradiotherapy for inflammatory breast cancer. METHODS From December 1996 to December 2000, we received and treated 21 patients with inflammatory breast carcinoma with a combined-modality treatment. The chemotherapy protocol consisted of cyclophos-phamide (CTX), pirarubicin (THP-ADM) and 5-fluorouracil (5-FU) or CTX, 5-Fu and methotrexate (MTX). The same infusion scheme was repeated on day 21. After 3-4 cycles the patients were treated with radiotherapy. When the radiation dose reached 40 Gy, the patients who were unable or unwilling to under go an operation received continued radiotherapy. When the radiation dose to the supra clavicular fossa and internal mammary lymph nodes reached 60 Gy and 50 Gy respectively, the radiotherapy was stopped. Chemotherapy was then continued with the original scheme. Patients who had indications for surgery and were willing to under go an operation received no treatment for 2 weeks, after which a total mastectomy was performed. Chemotherapy and radiotherapy was resumed with the original scheme after the operations. When the radiation dose reached 50 Gy, radiotherapy was stopped. RESULTS All patients were followed-up for more than 5 years with a follow-up rate of 100%. The overall 3 and 5-year survival rates of these patients were 42.9%, and 23.8% respectively. For patients in Stage IIIB the 3 and 5-year survival rates were 50.0% and 27.8% respectively, and for patients in Stage IV, the 3 and 5-year survival rates were both 0.0%. There was a significant difference between the 2 stage groups (P<0.05, x2=11.60). For patients who received an operation, the 3 and 5-year survival rates were 80.0% and 33.3% respectively, For patients who were not treated with an operation, the 3 and 5 -year survival rates were both 0.0%, There was a significant difference between the operated and non-operated groups (P<0.05, x2=11.64). CONCLUSION The prognosis of inflammatory breast carcinoma is poor. Before operation, a combined -modality treatment (first chemotherapy, then local therapy, finally chemotherapy and radiotherapy) is the best treatment method.

Laparoscopic Omohyoid Muscle Transection Surgery： A Novel Procedure Against Omohyoid Muscle Syndrome

Omohyoid muscle syndrome （OMS）, also called omohyoid sling syndrome, is a rare disease. The first OMS case was reported in 1980. OMS is presented by a mass without pain on the neck when the patient swallows and disappears after swallow. The patient often feels discomfort and dysphasia when the mass appears.