De novo transcriptome characterisation of two auxin-related genes associated with plant growth habit in Astragalus adsurgens Pall

Astragalus adsurgens Pall., a perennial legume native to China, is commonly used as a forage crop. And it has great value for sustainable development of grasslands in arid and semi arid regions. However, to date, little is known regarding the A. adsurgens genome, and no studies have determined whether it would be possible to improve the germplasm of A. adsurgens through genetic modification. In this study, we used an RNA-seq protocol to generate a de novo transcriptome including 151,516 unigenes of A. adsurgens. We compared the transcriptomes of A. adsurgens having different growth habits (prostrate/erect) and identified 14,133 single nucleotide polymorphism sites (SNP) in 8,139 unigenes. Differential expression gene (DEG) analysis suggested that 10,982 unigenes were up-regulated in the prostrate plant relative to the erect plant, while 10,607 unigenes were down-regulated. Of the 21,589 DEG, Unigene72782_All (LAX4) and CL12494.Contig3_All (TIR1), an auxin transporter gene and an auxin transport inhibitor gene, respectively, were predicted to influence the growth habit of A. adsurgens, which were verified by qRT-PCR in these phenotypes. These results suggest that auxin transport was more active in the prostrate plant than in the erect plant, resulting in asymmetric distribution of auxin that affects the growth habit of A. adsurgens. Overall, this study may provide a basis for future research on key genes in A. adsurgens and may deepen our understanding of the molecular mechanisms regulating plant growth habit.

Piperine, a functional food alkaloid, exhibits inhibitory potential against TNBS-induced colitis via the inhibition of IκB-α/NF-κB and induces tight junction protein (claudin-1, occludin, and ZO-1) signaling pathway in experimental mice

BACKGROUND

Inflammatory bowel disease is a chronic immunoinflammatory disease of the gastrointestinal tract. Piperine, an alkaloid, has been reported to possess antioxidant, anti-inflammatory, antiapoptotic, and antiulcer potential.

AIM

To elucidate the plausible mechanisms of action of piperine on experimental trinitrobenzenesufonic acid (TNBS)-induced colitis by assessing various biochemical, molecular, histological, and ultrastructural modifications.

METHODS

Colitis was induced in male Sprague-Dawley rats via intrarectal instillation of TNBS. Then, the rats were treated with piperine (10, 20, and 40 mg/kg, p.o.) for 14 days.

RESULTS

TNBS induced significant (p < 0.05) colonic damage, which was assessed by disease activity index, macroscopic score, and stool consistency. The administration of piperine (20 and 40 mg/kg) significantly inhibited (p < 0.05) these damages. Treatments with piperine (20 and 40 mg/kg) notably inhibited (p < 0.05) the TNBS-induced elevation of oxido-nitrosative stress (superoxide dismutase, glutathione, malondialdehyde, and nitric oxide), 5-hydroxytryptamine, and hydroxyproline content in the colon. Furthermore, colonic inducible nitric oxide synthase (iNOs), tumor necrosis factor-alpha (TNF-α), interleukin (IL)-1β, IL-6, interferon-gamma, and cyclooxygenase-2 (COX-2) messenger RNA (mRNA) expressions were upregulated after TNBS instillation and piperine (20 and 40 mg/kg) significantly attenuated (p < 0.05) these elevated mRNA expressions. TNBS decreased the expressions of tight junction (TJ) protein (claudin-1, occludin, and zonula occludens-1 (ZO-1)) and increased the expressions of proapoptotic (caspase-1) protein. These expressions were markedly inhibited (p < 0.05) by piperine treatment. Histological and ultrastructural studies of transmission electron microscopy suggested that piperine significantly ameliorated (p < 0.05) TNBS-induced colonic aberrations.

CONCLUSION

Piperine ameliorated the progression of TNBS-induced colitis by modulating the nuclear factor of kappa light polypeptide gene enhancer in B-cells inhibitor-alpha/nuclear factor-kappa B signaling pathway, thus inhibiting the overexpression of proinflammatory cytokines (TNF-α and IL's), COX-2, iNOs, oxido-nitrosative stress, and proapoptotic proteins (caspase-1) that may improve the expression of TJ protein (claudin-1, occludin, and ZO-1).

Estimation of invasion depth of early colorectal cancer using EUS and NBI-ME: a meta-analysis

BACKGROUND

Endoscopic ultrasonography (EUS) and narrow band imaging-magnifying endoscopy (NBI-ME) are often used as diagnostic tools to estimate the depth of invasion in early colorectal cancer (CRC). The aim of this study was to compare NBI-ME with EUS in distinguishing between slight submucosal invasion (invasion depth < 1000 μm) and massive submucosal invasion in patients with early CRC, since slight submucosal invasion is currently considered as an indication for endoscopic resection.

METHODS

For this meta-analysis, relevant studies were identified from PubMed, Embase, Web of Science, Scopus and the Cochrane Library databases between January 1997 and September 2016. Data on the yield of tumors were extracted, pooled, and analyzed by stata12.0 software. The sensitivity, specificity, positive likelihood ratio and negative likelihood ratio in differentiating slight submucosal invasion from massive submucosal invasion were calculated for both diagnostic modalities.

RESULTS

Sixteen studies involving 2197 lesions were included: nine were studies on EUS and 7 were studies on NBI-ME. The pooled sensitivity of EUS was 0.902 (95% CI 0.863-0.930), the specificity was 0.877 (95% CI 0.810-0.922), the positive likelihood ratio was 7.314 (95% CI 4.551-11.755) and the negative likelihood ratio was 0.112 (95% CI 0.076-0.164). The pooled sensitivity and specificity of NBI-ME were 0.981 (95% CI 0.949-0.993) and 0.651 (95% CI 0.600-0.699), respectively, the positive likelihood ratio was 2.815 (95% CI 2.432-3.258) and the negative likelihood ratio was 0.029 (95% CI 0.010-0.080).

CONCLUSIONS

The sensitivity tended to be higher in ME-NBI than EUS for early CRC with slight submucosal invasion, whereas the specificity was significantly lower in NBI-ME than in EUS.

Clinical characteristics and treatments of patients with alpha-fetoprotein producing gastric carcinoma

Alpha-fetoprotein (AFP) is a well-known tumor marker of hepatic carcinoma and yolk sac tumor. Alpha-fetoprotein producing gastric carcinoma (AFPGC) is a rare type of gastric cancer with high malignancy and poor prognosis, which make it different from other types of gastric cancer. This rare gastric cancer patient subgroup is likely frequently misdiagnosed which may be related to lack of knowledge of the disease. The purpose of this article is to summarize the mechanism of AFP positive gastric cancer, classification, biological behavior and treatment, in order to assist clinical practitioners to detect AFPGC earlier and treat it better. Previous studies have showed that AFPGC has a complex pathophysiology mechanism. AFPGC is more aggressive and characterized by stronger proliferation, neovascularization, lymphatic invasion and distant metastasis. Furthermore, so far there has been no standard treatment for patients with AFPGC. Nevertheless, our present study summarizes some effective treatments based on previous research outcome. In conclusion, the present study demonstrates that the importance of detecting AFP routinely in serum and tissues in gastric cancer cases, which will greatly improve the diagnosis rate of AFPGC, and in regards to treatment, surgery, chemotherapy, targeted therapy and interventional treatment may have positive impacts on AFPGC treatment outcome. However, further study with a larger sample is required to confirm the reliability and validity of these methods.

Downregulated vimentin and upregulated E-cadherin in T1 stage non-small-cell lung cancer: does it suggest a mesenchymal-epithelial transition?

Lung cancer has been a major threat to human health worldwide. Vimentin (VIM) and E-cadherin (E-cad) are molecular markers that play important roles in epithelial-mesenchymal transition (EMT), which has been shown to be correlated with tumor progression. Herein, we investigated the associations between clinicopathological parameters and VIM/E-cad expression in primary T1 stage non-small cell lung cancer (NSCLC). Real-time PCR was performed on RNA extracted from tumor tissue isolated from 54 patients with T1 stage NSCLC. Immunohistochemistry was used to measure the protein levels of VIM and E-cad. The paired-samples t-test, independent-samples t- test, Kappa test, and nonparametric test were used to perform statistical analyses. The expression of VIM were lower (P<0.001) and that of E-cad was higher (P<0.001) in tumor tissue when compared with the normal tissue at the transcriptional level. The RNA of VIM in adenocarcinomas was significantly higher than that found in squamous cell carcinomas (P<0.01). Moreover, the level of metastasis observed in the lymph node was significantly higher than that observed in metastasis outside of the lymph node (P<0.05). Vimentin protein had a lower profile in the tumor tissue, and the protein level of E-cad was higher in the tumor tissue. The IHC score of VIM in tumor tissue was found associated with both the pathological type and smoke index, and the score of E-cad was found to be related to visceral pleura involvement. In conclusions, VIM is downregulated and E-cad is upregulated in T1 stage NSCLC. Our study results suggest that a mesenchymal-epithelial transition may take place in the early-stage of tumor development, and that EMT occurs when the tumor develops into a certain stage.

[The role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma]

Objective: To evaluate the role of anatomical hepatectomy in the treatment of intrahepatic cholangiocarcinoma. Methods: The cases of intrahepatic cholangiocarcinoma who received curative surgery in two hospitals from 2010 to 2015 were analyzed retrospectively. Among the 98 patients enrolled in this study, 55 were male and 43 were female. The median age was 61 years. According to receiving anatomical hepatectomy or not, the 98 cases were divided into two groups: non-anatomical hepatectomy(n=30) and anatomical hepatectomy(n=68). The surgical results were compared between the two groups.Survival curves were plotted by the Kaplan-Meier method and compared by the log-rank test. The influence of each prognostic factor identified by univariate analysis was multivariate analysis by Cox's proportional hazard regression. Results: The duration of surgery was significantly prolonged in the anatomical hepatectomy group((196.4±94.9)minutes vs. (166.2±65.7)minutes, P=0.027), while there was no significant difference in terms of other surgical results such as intraoperative blood transfusion, postoperative morbidity and mortality rate. Compared to non-anatomical hepatectomy, anatomical hepatectomy significantly improved long-term survival results(14 months vs. 11 months)(χ²=4.641, P=0.031). Single variable analysis indicated that tumor differentiation, tumor numbers, T stage, N stage, anatomical hepatectomy and adjuvant therapy significantly affected overall survival. Multivariate analysis demonstrated that tumor numbers(HR=0.522, 95% CI: 0.259-0.974, P=0.042) and anatomical hepatectomy(HR=1.858, 95%CI: 1.092-3.161, P=0.022) were two independent prognostic factors for overall survival. Conclusion: Compared to non-anatomical hepatectomy, anatomical hepatectomy performed for intrahepatic cholangiocarcinoma is not only safe but also beneficial for long-term survival.

[Diagnosis and treatment for unexpected gallbladder carcinoma(a retrospective study of 45 cases)]

Objective: To investigate the rationale for appropriate diagnostic methods and treatment protocols for unexpected gallbladder carcinoma(UGC). Methods: The clinical and pathological data of 45 patients with UGC admitted at Department of General Surgery, Xin Hua Hospital, Shanghai Jiao Tong University School of Medicine,from January 2008 to December 2017 were retrospectively collected and analyzed.There were 11 males(28.9%) and 34 females(71.1%),aged 68 years(range:27 to 68 years).And there were 20 cases who aged above 70 years. Twenty-four cases were diagnosed preoperatively as cholecystolithiasis plus chronic cholecystitis.Ten cases were diagnosed preoperatively as cholecystolithiasis plus actue cholecystitis.Six cases were diagnosed preoperatively as cholecystolithiasis plus choledocholith.Six cases were admitted because of gallbladder polyp and 1 case was admitted because of gallbladder adenomyomatosis. Results: Thirty-four patients with UGC received radical surgery.Among them,11 patients experienced postoperative complication and no posterative mortality occoured during hospital stay.Thirteen patients were diagnosed with T1b UGC, the harvested lymph node of Nx, N0, N1 and N2 was 2, 9, 1 and 1, respectively.In addition, 2 cases were identified to have local-regional tumor recurrence during our rescue radical surgery.The median overall survival time of the patients who did not receive radical surgery was 7 months(range:2-56 months).Nevertheless,the median overall survival time for patients diagnosed with T1, T2 and T3 tumors who received radical surgery, was 41 months(range: 19-82 months), 33.5 months(range: 31-36 months) and 17 months(range: 7-46 months), respectively. Conclusions: For patients with UGC, rescue radical surgery can achieve a better survival time.Furhtermore, our experience proved that rescue radical surgery for UGC is safe and feasible.Therefore,rescue radical surgery should be performed in patients with diagnose with UGC especially those T1b patients.

[Research progress of dyskeratosis congenita]

Dyskeratosis congenita (DC) is a rare disease and a genetic heterogeneity of bone marrow failure, characterized by muco-cutaneous triad of mucosal leukoplakia, abnormal skin pigmentation, nails dystrophy and often involving multiple organs or systems. The inheritance patterns of DC include X-linked recessive, autosomal dominant and recessive patterns. However, the inheritance patterns in 30%-40% of DC patients remained unknown. Dyskeratosis congenita is difficult to diagnose because of its genetic and clinical heterogeneity. This article will review and discuss the state-of-the-art progresses in genetics, clinical manifestation, diagnosis, differential diagnosis, treatment and prognosis of DC.

Intraoperative adjunctive techniques to reduce seroma formation in laparoscopic inguinal hernioplasty: a systematic review

BACKGROUND

Seroma formation is the most common postoperative complication after laparoscopic inguinal hernia repair. Recurrence and seroma formation may be difficult to distinguish. Many adjunctive techniques with which to reduce the incidence of seroma formation after laparoscopic inguinal repair have been described in the literature; however, the evidence for using intraoperative adjunctive techniques is limited. Therefore, the present systematic review was performed to evaluate the effects and limitations of adjunctive techniques used during laparoscopic inguinal hernia repair.

METHODS

Major databases (PubMed, Embase, Springer, and Cochrane Library) were searched using the terms "seroma," "laparoscopic inguinal hernia", "TAPP", "TEP", "inguinal hernia", "tack", "barbed suture", "drainage", "Endoloop technique", and "fibrin sealant". All studies involving adults undergoing laparoscopic/endoscopic inguinal hernioplasty with at least one intervention designed to reduce seroma formation were included.

RESULTS

Of the 965 studies identified, 8 met the inclusion criteria. Six adjunctive techniques were described in the literature. Transversalis fascia (TF) inversion with tacking: one prospective non-randomized controlled study revealed a lower incidence of postoperative seroma after TF inversion with tacking for direct inguinal hernias (4.17% vs. 14.29%, P < 0.05). Endoloop technique: one prospective study of 76 cases involving this technique revealed a low incidence of seroma formation (3.9% at 2 weeks) in direct hernias. Barbed suture closure of TF: one prospective study of 36 direct hernias reported only one clinical palpable seroma that resolved 1 month later. Surgical drains: three trials reported the results of drains, and the pooling results demonstrated significantly less seroma formation in patients with surgical drains (2.1 vs. 23.8%; odds ratio 0.12; 95% confidence interval 0.08-0.19; P < 0.0001). Fibrin sealant: one prospective clinical study of 40 patients with indirect inguinal hernias reported a lower volume (P < 0.001) and lower incidence (5% vs. 15%) of seroma formation in the fibrin group. Distal sac fixation technique: in one prospective study of six patients with large inguinoscrotal hernias, one patient developed a seroma on postoperative day 8.

CONCLUSION

Seroma formation is a natural process that cannot be completely prevented following laparoscopic inguinal hernioplasty, especially in patients with direct and large indirect inguinal hernias. Some intraoperative adjunctive techniques are effective in reducing clinically palpable seroma formation in select patients. More randomized controlled trials are needed for further evaluation.

[History, current situation and bottleneck of the diagnosis and treatment system of hepatic hilar cholangiocarcinoma in Japan]

Hilar cholangiocarcinoma is one of the most difficult malignant tumors to treat in the biliary system. In Japan, 5-year survival rate of the disease has increased from 32.5% to 67.1% during the past 30 years. The impressive progress reflects the solid efforts in preoperative endoscopic diagnosis, innovation in surgery such as PTPE as well as hepato-pancreatoduodenectomy and perioperative treatment including replacement of the bile and synbiotic treatment, which have finally formed a set of standardized diagnosis and treatment systems. The present review intends to report the history, current status and remaining bottlenecks of the diagnosis and treatment system of hilar cholangiocarcinoma in Japan as follows.

[Association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease]

Objective: To explore the association between hypothyroidism and sleep breathing disorders in patients with coronary heart disease (CHD). Methods: A total of 784 patients with CHD were consecutively enrolled at the Emergency & Critical Care Center of Beijing Anzhen Hospital from June 2015 to May 2017. According to thyroid function test results, patients were divided into hypothyroidism group (79 cases) and non-hypothyroidism group (705 cases). All patients had undergone sleep monitoring. The sleep apnea status was compared between the two groups. Multivariate logistic regression and linear regression models were used to analyze the association between hypothyroidism and sleep breathing disorders in patients with CHD. Results: The proportion of females, mean body weight and body mass index in the hypothyroidism group were higher than those in the non-hypothyroidism group [26.6% vs.16.2%, (78.6±11.6) kg vs. (75.7±12.0) kg, (27.7±3.2) kg/m(2) vs. (26.6±3.5) kg/m(2), all P<0.05]. Patients in hypothyroidism group had a decreased average oxygen saturation (SaO(2)) compared with patients in non-hypothyroidism group [ (93.2±2.9) % vs. (93.9±2.0) %, P=0.030]. In addition, events of hypoventilation in hypothyroidism group were significantly higher than those in non-hypothyroidism group[92.5 (45.8, 758.3) times vs. 68.0 (33.0, 125.0) times, P=0.013]. There were no significant differences in apnea hypopnea index, diagnosis of obstructive sleep apnea and other sleep breathing parameters between the two groups (P>0.05). A multiple linear regression analysis found that in patients with CHD, the correlation between hypothyroidism and average sleep SaO(2) was significant (β=-0.508, 95%CI -0.989--0.026, P=0.039). Conclusions: CHD patients with hypothyroidism had a lower sleep average SaO(2), and a higher sleep hypopnea events. There is a correlation between hypothyroidism and sleep hypoxia in patients with CHD. Clinical trial registration: clinicalTrials.gov, NCT03362385.

Retrospective study of porcine circovirus 3 infection in China

PCV3 is an emerging swine virus associated with porcine dermatitis and nephropathy syndrome (PDNS), reproductive failure, respiratory diseases and systematic inflammation. Although first identified in 2015, the earliest case has been traced back to 2009 in the United States. In China, PCV3 infection was first detected in 2015, but little information has been available about its occurrence and prevalence there before 2015. In this study, 200 porcine clinical samples collected from 20 provinces, five autonomous regions and four municipalities between 1990 and 1999 were analysed for PCV3 infection by PCR. Results showed that 6.5% of the porcine samples collected from eight provinces and one autonomous region were PCV3 positive, with the earliest cases occurring in 1996. Nucleotide sequence analysis showed that PCV3 strains obtained in this study shared 96.6%-99.7% and 97.1%-99.4% sequence identity at the ORF2 gene and genome levels with all available reference strains from China and other countries, indicating the high genetic stability of PCV3 over the past 20 years.

Retrospective study of porcine circovirus type 2 infection reveals a novel genotype PCV2f

Porcine postweaning multisystemic wasting syndrome (PMWS) caused by porcine circovirus type 2 (PCV2) is a disease causing severe economic losses annually worldwide to the pig industry. PCV2 infection was first reported in China in 2000, and currently has three major genotypes, PCV2a, b and d, circulating in this country. To further elucidate the origin and prevalence of PCV2 in China, 123 clinical pig tissue samples collected in 25 provinces between 1990 and 1999 were analysed by PCV2-specific PCR, resulting in identification of 23 PCV2 strains collected between 1996 and 1999. Phylogenetic analysis based on the nucleotide sequences of open reading frame 2 (ORF2) showed that 20 of the 23 grouped within PCV2a, while the remaining three strains formed an independent clade, so far unreported and therefore named PCV2f. This genotype shared lower sequence identity with other known genotypes. This study provides further understanding of the genetic diversity and evolution of PCV2 and has tracked PCV2 infection in China back to 1996 rather than 2000.

Feasibility and safety of peroral endoscopic myotomy for achalasia after failed endoscopic interventions

With advances in natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) has become a novel treatment for esophageal achalasia. In this study, we investigated the feasibility and safety of POEM in patients with achalasia after failed endoscopic interventions. Data on all patients undergoing POEM treatment of achalasia were collected prospectively. We enrolled 61 patients who underwent POEM for achalasia between July 2011 and January 2014. The preoperative intervention group included patients who had undergone botulinum toxin injection or pneumatic balloon dilation before POEM. The preoperative, operative, and short-term outcome data between the groups were compared. Among preoperative intervention group, 22 patients received endoscopic therapy before being referred for operation (18 dilation only, 2 botulinum toxin only, and 2 both treatments). Procedure time in the preoperative intervention group was similar to the nonpreoperative intervention group (60.8 ± 30.9 vs. 62.0 ± 21.0 minutes, P = 0.863). Both groups demonstrated significant improvement in Eckardt scores and manometric outcomes at 1-year follow-up. There were no significant differences in pretreatment and posttreatment D-values of symptom scores and lower esophageal sphincter pressures between groups (6.2 ± 2.2 vs. 6.1 ± 1.8, P = 0.840; 27.9 ± 17.6 vs. 24.9 ± 15.2; P = 0.569). There was also no significant difference in the incidence of intraoperative complications (P = 0.958) and gastroesophageal reflux rate (23.5% vs. 20.0%, P = 0.771) between the two groups. Our study demonstrated that POEM is safe and effective, even for treating achalasia in the setting of failed endoscopic interventions.

A case report of fetal malignant immature mediastinal teratoma

PURPOSE

Fetal immature mediastinal teratoma is a rare disease. The pressure generated by the tumor mass can cause hydrops fetalis, pulmonary hypoplasia, pleural and peritoneal effusion, and polyhydramnios which cause the death of the fetus. Routine prenatal ultrasound has enabled accurate diagnosis.

MATERIALS AND METHODS

The authors report a 26-year-old patient, gravida 4 para 1, who was referred to this hospital, carrying a fetus with immature mediastinal teratoma.

RESULTS

At 27 weeks of gestation, a routine prenatal ultrasound suggested the fetus had a mass at the anterior mediastinum, accompanied by pulmonary hypoplasia, pleural and peritoneal effusion, subcutaneous edema of head and chest, and polyhydramnios. After the therapeutic abortion, the gross anatomy confirmed the mediastinal mass. The histological examination showed that the mass was a grade 2 immature teratoma.

CONCLUSIONS

The mother of the fetus had been exposed to plaster, paint, and paint-thinner in the first trimester of pregnancy, suggesting that these chemical contacts may be one of the causes of the disorder.

[Determination of bromoform in the air of workplace by solvent desorption gas chromatography]

OBJECTIVE

To establish the method of solvent desorption gas chromatography for determination of bromoform in workplace air.

METHODS

Bromoform in the air was adsorbed by activated carbon tube sampling and solvent desorption using carbon disulfide, then analyed by GC with DB-FFAP capillary column.

RESULTS

The linear regression equation is y=1.22x-0.81 (r=0.999 9)between 0.57~300.00 μg/ml of target concentration in the air. The detection limit was 0.17 μg /ml. The relative standard deviations of the batch and inter batch were 1.7%~3.6%, 2.8%~6.3%, respectively. The sampling efficiency was 100%. The overall desorption efficiency was 95.0%. The breakthrough capacity was more than 0.61 mg(100 mg activated carbon).

CONCLUSION

The method is suitable to determine bromoform in the air of workplace.