Clinicopathological characteristics and computed tomography features of mucinous gastric carcinoma

This study investigated the clinicopathological characteristics of mucinous gastric carcinoma (MGC) and assessed whether multidetector-row computed tomography (MDCT) could differentiate MGC from non-mucinous gastric carcinoma (NGC). Clinicopathological data from 542 patients with gastric carcinoma (23 MGC, 519 NGC), who underwent pre-operative MDCT examination and curative or palliative gastrectomy, were analysed. Only seven of the 23 patients with MGC were correctly diagnosed pre-operatively by endoscopic biopsy. The MGC patients had larger tumours, a higher frequency of lymph node metastases, were more likely to have tumours of tumour, node, metastasis stages III and IV, and were less likely to have a curative resection than NGC patients. In addition, five MGC patients had calcifications in the thickened gastric wall. In conclusion, MGC is rare and is detected mostly at an advanced stage. The diagnostic sensitivity of MGC by endoscopic biopsy was relatively low, whereas MDCT was helpful in distinguishing MGC from NGC.

Therapeutic Effects of Intravenous Infusion of Hyperoxygenated Solution on Acute Haemorrhagic Shock in Rabbits

Tissue anoxia is the main mechanism of the shock reaction. Here, the effect of hyperoxygenated solution (HOS) on acute haemorrhagic shock was studied in rabbits. At 60 min after shock, rabbits were infused intravenously with hyperoxygenated solution at 10 (HOS1 group) or 20 ml/kg (HOS2 group) or with Ringer's solution at 10 ml/kg (RS group). Compared with values before shock, values after shock were lower for mean arterial pressure (MAP), more negative for base excess (BE) and higher for blood lactate (BL) and blood viscosity. After infusion, MAP declined more slowly in the HOS1 and HOS2 groups than in the RS group. At 30 and 60 min after infusion, arterial partial pressure of oxygen (PaO2) and oxygen saturation (SaO2) were higher and BE was less negative in the HOS1 and HOS2 groups than in the RS group, BL was lower in the HOS1 and HOS2 groups than in the RS group, and PaO2 and SaO2 were higher in the HOS2 group than in the HOS1 group. It was concluded that HOS infusion can rectify changes in vital signs more effectively than Ringer's solution after acute haemorrhagic shock in rabbits.

A prospective randomized study comparing open versus laparoscopy-assisted D2 radical gastrectomy in advanced gastric cancer

BACKGROUND

In recent years, many clinical studies have confirmed the value of laparoscopy-assisted gastrectomy (LAG) in gastric cancer surgery, especially in early stages. But the safety and oncologic adequacy of laparoscopy-assisted D2 radical gastrectomy for advanced gastric cancer are still in debate. We conducted a prospective randomized trial to compare open versus laparoscopy-assisted D2 radical gastrectomy in advanced gastric cancer.

METHODS

For this study, 123 patients who had been diagnosed endoscopically with gastric cancer were randomly assigned to either LAG (n = 61) or open gastrectomy (OG) (n = 62) which ran from March 2008 to December 2009. Clinical characteristics, operative findings, postoperative recovery, morbidity, pathological report and survival rate were compared. D2 lymph node dissection was performed in 49 patients in the LAG group and 47 patients in the OG group with advanced gastric cancer. We adopt sub-group analysis in this paper.

RESULTS

The clinical characteristics of patients in the LAG and OG groups who were in the advanced stage, included age, sex, BMI and concurrent illness, and their ECOG scores were well matched. Operative findings, postoperative recovery, morbidity, pathological findings including tumor location, depth of invasion, TNM stage, histological grade and surgical extension in the two groups were also similar. Compared to the OG group, the mean operating time was significantly longer for the LAG group (267.88 ± 54.284 min in the LAG group vs. 182.02 ± 41.016 min in the OG group, p = 6.383 × 10(-13)); the mean number of days when body temperature exceeded 37°C was significantly shorter in the LAG group (p = 6.34 × 10(-8)). There were no postoperative deaths in both the groups. The postoperative morbidity rate was 12.24% in the LAG group and 19.15% in the OG group with no significant difference (p = 0.357). However, pulmonary infection was observed more frequently in the OG group (p = 0.038). After a mean follow-up of 22.1354 months (from 4 to 36 months), 14 and 15 patients died of gastric cancer in the LAG and OG groups, respectively. Two and one patient died of nongastric cancer in the LAG and OG groups, respectively. The overall survival rates were 67.1% and 53.8% in the LAG and OG groups, respectively. The estimated mean survival time was 29.387 months in the LAG group and 28.978 months in the OG group. There was no statistically significant difference in the overall survival rate for patients in both groups - LAG and OG (log-rank test, p = 0.911, Tarone Ware test, p = 0.994, and Breslow test, p = 0. 961).

CONCLUSION

LAG with D2 lymph node dissection is a safe and feasible procedure with adequate lymphadenectomy, good curability and survival rate for the treatment of advanced gastric cancer.

An x-ray scattering study of the structural phase transition in La(2-x)Sr(x)Cu0.99Fe0.01O4 (x = 0.20)

We report a comprehensive x-ray scattering study of the low-temperature orthorhombic (LTO)-high-temperature tetragonal (HTT) structural phase transition in 1% iron-doped La(2-x)Sr(x)CuO(4) (x = 0.2). The superlattice (032) peak intensity and the width are investigated in detail for a wide temperature range. We found that the structural phase transition is not sharp and the tilt ordering of the CuO(6) octahedra persists above the transition temperature T(S) (≈77 K). Even at room temperature, the superlattice peak is still observable. The structural phase transition is identified as an order-disorder type phase transition. We found that the tilt ordering in our iron-doped material is always short-ranged, and in the HTT phase the correlation between the tilts along the b axis is better preserved than that along the a axis. Moreover, we identify the role of the Fe as the nucleation centers of the LTO domains in the structural phase transition.

A genome-wide association study on common SNPs and rare CNVs in anorexia nervosa

Anorexia nervosa (AN) is a mental illness with high mortality that most commonly afflicts adolescent female individuals. Clinical symptoms include chronic food refusal, weight loss and body image distortions. We carried out a genome-wide association study on 1033 AN cases and 3733 pediatric control subjects, all of whom were of European ancestry and were genotyped on the Illumina HumanHap610 platform (Illumina, San Diego, CA, USA). We confirmed that common single-nucleotide polymorphisms (SNPs) within OPRD1 (rs533123, P=0.0015) confer risk for AN, and obtained suggestive evidence that common SNPs near HTR1D (rs7532266, P=0.04) confer risk for restricting-type AN specifically. However, no SNPs reached genome-wide significance in our data, whereas top association signals were detected near ZNF804B, CSRP2BP, NTNG1, AKAP6 and CDH9. In parallel, we performed genome-wide analysis on copy number variations (CNVs) using the signal intensity data from the SNP arrays. We did not find evidence that AN cases have more CNVs than control subjects, nor do they have over-representation of rare or large CNVs. However, we identified several regions with rare CNVs that were only observed in AN cases, including a recurrent 13q12 deletion (1.5 Mb) disrupting SCAS in two cases, and CNVs disrupting the CNTN6/CNTN4 region in several AN cases. In conclusion, our study suggests that both common SNPs and rare CNVs may confer genetic risk to AN. These results point to intriguing genes that await further validation in independent cohorts for confirmatory roles in AN.

Age trends for hip geometry in Chinese men and women and the association with femoral neck fracture

Hip dual-energy X-ray absorptiometry (DXA) images were used to calculate hip bone mineral density (BMD) and hip geometry parameters of 18,502 healthy Chinese people (14,435 women and 4,067 men), 254 subjects sustained a femoral neck fracture and 254 age- and sex-matched controls. Our study showed that thinning of the cortical shell and deterioration of the strength index (SI) in femoral neck with aging in both Chinese men and women. SI may be a risk factor for hip fracture in Chinese women.

INTRODUCTION

The purpose of this study was to evaluate age-related trends in the hip geometry of healthy Chinese men and women and to examine whether changes in hip geometric parameters is one of the risk factors of hip fracture.

METHODS

We recruited 14,435 women and 4,067 men as the study population. There were 254 subjects (216 women, 38 men) who had sustained a femoral neck fracture; 254 age- and sex-matched healthy persons served as controls. Hip DXA images were used to calculate hip BMD and hip geometry parameters, including the hip axis length (HAL), cross-sectional moment of inertia (CSMI), cross-sectional area (CSA), neck-shaft angle (NSA) and femoral SI.

RESULTS

Hip BMD, CSMI, CSA and SI showed significantly negative correlations with age. However, after adjustment for height and weight, HAL increased with age, and there was no strong correlation between CSMI and age in either sex. In both genders, hip BMD and CSA were significant lower in fracture cases compared with controls. After adjustment for hip BMD, in women only smaller SI (odds ratio [OR] 1.53; 95% confidence interval [CI], 1.04-2.26) was predictive of hip fracture but in men, none of the geometry parameters was associated with hip fracture risk.

CONCLUSIONS

This study demonstrated thinning of the cortical shell and deterioration of the resistance to bending and SI with aging in femoral neck in Chinese men and women. SI may be a risk factor for hip fracture that is independent of BMD measurement in Chinese women.

Analysis of properties and proinflammatory functions of cockroach allergens Per a 1.01s

Cockroaches have been identified as one of the major indoor allergens inducing perennial rhinitis and asthma. Per a 1s are a group of the major allergens from American cockroach. Although Per a 1s are major allergens from American cockroach, factors contributing to the allergenicity of Per a 1s are still poorly defined. To investigate the effects of Per a 1s on the expression of PARs and the release of proinflammatory cytokines from mast cells. Per a 1.0101 and Per a 1.0104 were cloned from American cockroach and then expressed in Eschericia coli. The purified allergens were used to stimulate P815 mast cells, and the expression of protease-activated receptors (PARs) was determined by real-time RT-PCR and flow cytometry. The levels of IL-4 and IL-13 in culture media were detected with ELISA. Sera from 80 and 77.3% of cockroach allergy patients reacted to recombinant Per a (rPer a) 1.0101 and rPer a 1.0104, confirming they are major allergens. Both rPer a 1.0101 and rPer a 1.0104 had no enzymatic activity, but rPer a 1.0101 upregulated the expression of PAR-1 and PAR-2, and rPer a 1.0104 enhanced the expression of PAR-1 and PAR-4 proteins. Both recombinant allergens were able to increase the release of IL-4 and IL-13 from P815 mast cells. This is the first study aiming to investigate functions of group 1 allergens of American cockroach. rPer a 1.0101 and rPer a 1.0104 have the capacity to upregulate the expression of PARs and to enhance Th2 cytokine production in mast cells.

Novel hormone-regulated genes in visceral adipose tissue: cloning and identification of proinflammatory cytokine-like mouse and human MEDA-7: implications for obesity, insulin resistance and the metabolic syndrome

AIMS/HYPOTHESIS

We sought to characterise novel genes dysregulated by sex hormonal imbalances that induce obesity and metabolic disorder in a setting of oestrogen deficiency and androgen dominance in follicle-stimulating hormone receptor (For [also known as Fshr]) knockout female mice.

METHODS

Transcriptome analysis of mesenteric adipose tissue (MAT) of mutants revealed novel genes. One novel gene named Meda-7 was selected for study. Meda-7 was cloned from mouse and human adipose tissue; its expression, hormonal regulation and function were characterised.

RESULTS

Mouse Meda-7 is richly expressed in deep visceral adipose tissue and encodes a 22 kDa secreted protein with 71% homology to human mesenteric oestrogen-dependent adipose gene- 7 (MEDA-7) protein. Both have six conserved cysteines like many cytokines. In obese patients, MEDA-7 is more abundant in omental than subcutaneous fat. Meda-7 is downregulated in For-knockout female MAT at 5 months (obese state) followed by steep upregulation at 9 months (prediabetic condition) when mutants progress towards the metabolic syndrome. Meda-7 is expressed predominantly in the stromal-vascular cell fraction. In this fraction,M1-proinflammatorymacrophages are rich in Meda-7. Meda-7 dysregulation in 5-month-old For-knockout MAT is restored by oestrogen, but treatment has no effect in older mutants. Overabundance of MEDA-7 in HEK-293 cells enhances cell proliferation via p42/44 mitogen-activated protein kinases. Secreted MEDA-7 attenuates insulin-stimulated glucose uptake in 3T3-L1 adipocytes, while downregulating glucose transporter-4 and upregulating both monocyte chemotactic protein-1 and suppressor of cytokine signalling-3. Downstream activity of the insulin signalling mediator, phospho-AKT, is also downregulated.

CONCLUSIONS/INTERPRETATION

MEDA-7 is a hormone-regulated adipokine/proinflammatory cytokine that is implicated in causing chronic inflammation, affecting cellular expansion and blunting insulin response in adipocytes.