Comparison of clinicopathological features and prognosis of gastric cancer located in the lesser and greater curve

PURPOSE

Little is known about the features of gastric cancer located in the lesser and greater curve. This study aims to investigate the clinicopathological features and prognosis of gastric cancer located in the lesser and greater curve.

PATIENTS

From September 2008 to March 2015, 780 gastric cancer patients were enrolled in the present study. The associations between locations and features of patients were analyzed.

RESULTS

There were 571 male (73.2 %) and 209 female (26.8 %) patients. The median age was 56 years (ranged 21-86). There were 684 tumors located in the lesser curve (87.7 %) and 96 located in the greater curve (12.3 %). The incidence of melena was significantly lower in patients with tumors located in the lesser curve than that in the greater curve (8.5 vs 15.6 %, P = 0.024). The median size of tumors in the lesser curve was significantly larger than that in the greater curve (5.0 (0.3-15) vs 4.0 cm (0.5-15), P = 0.001). The remaining clinicopathological features were comparable between the two groups (all P > 0.05). Tumor location was not a risk factor for the prognosis of gastric cancer by univariate and multivariate analysis (both P > 0.05). The postoperative complications (all P > 0.05) and prognoses (P = 0.279) were comparable between tumors located in the lesser and greater curve.

CONCLUSIONS

The ratio of gastric cancer located in the lesser to greater curve was 7.1:1. Compared with tumors located in the greater curve, the incidence of melena was significantly lower and the tumor size was significantly larger in tumors located in the lesser curve. The prognoses were comparable between tumors located in the lesser and greater curve.

[Relationship between body weight status in early adulthood and body weight change to middle age and high-density lipoprotein cholesterol level in middle aged Chinese people]

OBJECTIVE

To explore the relationship between early adulthood weight status and body weight changes from early adulthood to middle age and high-density lipoprotein cholesterol (HDL-C) level.

METHODS

Data were obtained from China Multicenter Collaborative Study of Cardiovascular Epidemiology Study, which was conducted in 1998, 15 participants population samples aged from 35-59 years old from 12 provinces were selected by random cluster sampling. Approximately 1 000 men and women in each sample population were surveyed for cardiovascular disease risk factors, body weight at age 25 from all participants were also obtained. Body mass index (BMI) at the age of 25 years was calculated with the weight at 25 years and the height measured during the survey, participants were divided into underweight (BMI<18.5 kg/m(2), n=1 331), normal-weight (18.5 kg/m(2)≤BMI <24 kg/m(2), n=10 400), overweight (24 kg/m(2)≤BMI<28 kg/m(2), n=2 019) and obesity (BMI≥28 kg/m(2), n=133) groups. Weight change was defined as the difference between the body weight at the age of 25 and at the survey and was grouped into<-7.5 kg (n=903), -7.5--2.6 kg (n=1 883), -2.5-2.5 kg (n=2 573), 2.6-7.5 kg (n=2 786), 7.6-12.5 kg (n=2 674) and>12.5 kg (n=3 064). The association of body weight status in early adulthood and body weight change from early adulthood to middle age with HDL-C level was examined by logistic regression model.

RESULTS

The prevalence of low HDL-C in underweight, normal weight, overweight and obesity groups at age of 25 years were 10.7%(143/1 331), 15.5%(1 612/10 400), 16.3%(330/2 019) and 24.8%(33/133), respectively(P for trend <0.01). The prevalence of low HDL-C for adult weight change were 8.8%(79/903), 8.0%(151/1 883), 10.5%(269/2 573), 13.4%(373/2 786), 19.1%(511/2 674), and 24.0%(735/3 064)(P for trend <0.01)for weight change of <-7.5 kg, -7.5--2.6 kg, -2.5-2.5 kg, 2.6-7.5 kg, 7.6-12.5 kg and>12.5 kg, respectively. Multivariate logistic regression showed that overweight and obesity at age of 25 years and subsequent weight gain till middle age were positively correlated with low HDL-C after adjusted other risk factors(all P for trend <0.01).

CONCLUSION

Overweight and obesity in early adulthood and significant adult weight gain from early adulthood to middle age were both independently associated with marked increases in the risk of low HDL-C in middle-aged Chinese men and women. Thus, body weight control at early adulthood could be a key strategy to reduce the incidence of low HDL-C at middle-aged population.

Real-life effectiveness of omalizumab in severe allergic asthma above the recommended dosing range criteria

BACKGROUND

Omalizumab (Xolair) dosing in severe allergic asthma is based on serum IgE and bodyweight. In Australia, patients eligible for omalizumab but exceeding recommended ranges for IgE (30-1500 IU/mL) and bodyweight (30-150 kg) may still receive a ceiling dose of 750 mg/4 weeks. About 62% of patients receiving government-subsidized omalizumab are enrolled in the Australian Xolair Registry (AXR).

OBJECTIVES

To determine whether AXR participants above the recommended dosing ranges benefit from omalizumab and to compare their response to within-range participants.

METHODS

Data were stratified according to dose range status (above-range or within-range). Further sub-analyses were conducted according to the reason for being above the dosing range (IgE only vs. IgE and weight).

RESULTS

Data for 179 participants were analysed. About 55 (31%) were above recommended dosing criteria; other characteristics were similar to within-range participants. Above-range participants had higher baseline IgE [812 (IQR 632, 1747) IU/mL vs. 209 (IQR 134, 306) IU/mL] and received higher doses of omalizumab [750 (IQR 650, 750) mg] compared to within-range participants [450 (IQR, 300, 600) mg]. At 6 months, improvements in Juniper 5-item Asthma Control Questionnaire (ACQ-5, 3.61 down to 2.01 for above-range, 3.47 down to 1.93 for within-range, P < 0.0001 for both) and Asthma Quality of Life Questionnaire (AQLQ mean score (3.22 up to 4.41 for above-range, 3.71 up to 4.88 for within-range, P < 0.0001) were observed in both groups. Forced expiratory volume in one second (FEV₁ ) improved among above-range participants. There was no difference in response between above-range and within-range participants. Above-range participants due to either IgE alone or IgE and weight had similar improvements in ACQ-5, AQLQ and FEV₁ .

CONCLUSIONS AND CLINICAL RELEVANCE

Patients with severe allergic asthma above recommended dosing criteria for omalizumab have significantly improved symptom control, quality of life and lung function to a similar degree to within-range participants, achieved without dose escalation above 750 mg.

Simvastatin monotherapy as a potential option for statin-associated muscle symptoms: a case report

WHAT IS KNOWN AND OBJECTIVES

Choosing an alternative statin is recommended when managing statin-associated muscle symptoms (SAMS) and new hydrophilic statins are often suggested. We report on a case of statin-associated muscle damage that was successfully managed by simplifying the patient's combination therapy with simvastatin-ezetimibe to simvastatin alone.

CASE SUMMARY

The patient experienced SAMS when he was successively treated with atorvastatin, rosuvastatin, Xuezhikang capsule and combined simvastatin/ezetimibe therapy. However, the patient tolerated simvastatin therapy well even at a dose of 40 mg/day.

WHAT IS NEW AND CONCLUSION

Our case suggests that patients with SAMS who are intolerant to a wide variety of statins may be successfully managed with simvastatin monotherapy.

Toxicity study of ochratoxin A using HEK293 and HepG2 cell lines based on microRNA profiling

Ochratoxin A (OTA) induced DNA damage, cytotoxicity, and apoptosis in mammalian cell lines. Micro RNAs (miRNAs) are involved in physiological and developmental processes and contribute to cancer development and progression. In our study, high-throughput miRNA profiling and Kyoto Encyclopedia of Genes and Genomes analysis were applied to comparatively study the toxicity of OTA in HEK293 cells and HepG2 cells treated with 25 μM OTA for 24 h. In these two cells, the same changing miRNAs were mostly related to signal transduction pathways, whereas the different changing miRNAs were mostly related to human cancer pathways. DGCR8, Dicer1, and Drosha were significantly suppressed in HEK293 cells, indicating an impairment of miRNA biogenesis. The damage seemed more extensive in HEK293 cells. Cell models and in vivo models were also compared. Many miRNAs in vitro were markedly different from those in vivo; however, OTA toxicity was observed both in vitro and in vivo. The classification of deregulated pathways is similar. The biogenesis of miRNA was impaired in both lines. In conclusion, deregulated miRNAs in vitro are mostly related to human cancer and signal transduction pathways. The deregulated pathways in vivo are similar to those in vitro.

Pooled analyses of eribulin in metastatic breast cancer patients with at least one prior chemotherapy

Eribulin is indicated in the EU for advanced/metastatic breast cancer patients following ≥1 prior chemotherapy for advanced disease, and anthracycline and taxane in adjuvant/metastatic setting. We pooled 1644 patients from two phase III trials and found that eribulin significantly increased survival versus control, particularly in some subgroups of interest like HER2- and triple-negative disease.

Background

Based on data from two multicenter, phase III clinical trials (Studies 301 and 305), eribulin (a microtubule dynamics inhibitor) is indicated in the European Union (EU) for patients with locally advanced or metastatic breast cancer (MBC) after ≥1 prior chemotherapy for advanced disease, including an anthracycline and a taxane in either the adjuvant or metastatic setting. Data from Studies 305 and 301 were pooled to investigate the efficacy of eribulin in various subgroups of patients who matched the EU label, including those with human epidermal growth factor receptor 2 (HER2)-negative and triple-negative disease.

Patients and methods

In Study 305 (NCT00388726), patients were randomized 2:1 to eribulin mesylate 1.4 mg/m² (equivalent to eribulin 1.23 mg/m² [expressed as free base]) intravenously on days 1 and 8 every 21 days] or treatment of physician's choice after 2–5 prior chemotherapies (≥2 for advanced disease), including an anthracycline and a taxane (in early/advanced setting). In Study 301 (NCT00337103), patients were randomized 1:1 to eribulin (as above) or capecitabine (1.25 g/m² orally twice daily on days 1–14 every 21 days) following ≤3 prior chemotherapies (≤2 for advanced disease), including an anthracycline and a taxane. Efficacy end points were investigated in the intent-to-treat population and subgroups, pooled as discussed above.

Results

Overall, 1644 patients were included (eribulin: 946; control: 698); baseline characteristics were well matched. Overall survival was significantly longer with eribulin versus control (P < 0.01), as were progression-free survival and clinical benefit rate (both P < 0.05). Significant survival benefits with eribulin versus control were observed in a wide range of patient subgroups, including HER2-negative or triple-negative disease (all P < 0.05).

Conclusion

Our findings underline the survival benefit achieved by eribulin used according to EU label in the overall MBC population and in various subgroups of interest, including patients with HER2-negative and triple-negative disease.

Rapid Degradation and High Renal Clearance of Cu3BiS3 Nanodots for Efficient Cancer Diagnosis and Photothermal Therapy in Vivo

A key challenge for the use of inorganic nanomedicines in clinical applications is their long-term accumulation in internal organs, which raises the common concern of the risk of adverse effects and inflammatory responses. It is thus necessary to rationally design inorganic nanomaterials with proper accumulation and clearance mechanism in vivo. Herein, we prepared ultrasmall Cu3BiS3 nanodots (NDs) as a single-phased ternary bimetal sulfide for photothermal cancer therapy guided by multispectral optoacoustic tomography (MSOT) and X-ray computed tomography (CT) due to bismuth's excellent X-ray attenuation coefficient. We then monitored and investigated their absorption, distribution, metabolism, and excretion. We also used CT imaging to demonstrate that Cu3BiS3 NDs can be quickly removed through renal clearance, which may be related to their small size, rapid chemical transformation, and degradation in an acidic lysosomal environment as characterized by synchrotron radiation-based X-ray absorption near-edge structure spectroscopy. These results reveal that Cu3BiS3 NDs act as a simple but powerful "theranostic" nanoplatform for MSOT/CT imaging-guided tumor ablation with excellent metabolism and rapid clearance that will improve safety for clinical applications in the future.

Fluorescent markers for the Spitzenkörper and exocytosis in Zymoseptoria tritici

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We establish Z. tritici polarity markers ZtSec4, ZtMlc1, ZtRab11, ZtExo70 and ZtSpa2.

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All markers localize correctly, labeling the Spitzenkörper and sites of polar exocytosis.

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We provide 5 carboxin-resistance conveying vectors for integration of all markers into the sdi1 locus.

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We provide 5 hygromycin B-resistance conveying vectors for random integration of all markers.

Fungal hyphae are highly polarized cells that invade their substrate by tip growth. In plant pathogenic fungi, hyphal growth is essential for host invasion. This makes polarity factors and secretion regulators potential new targets for novel fungicides. Polarization requires delivery of secretory vesicles to the apical Spitzenkörper, followed by polarized exocytosis at the expanding cell tip. Here, we introduce fluorescent markers to visualize the apical Spitzenkörper and the apical site of exocytosis in hyphae of the wheat pathogen Zymoseptoria tritici. We fused green fluorescent protein to the small GTPase ZtSec4, the myosin light chain ZtMlc1 and the small GTPase ZtRab11 and co-localize the fusion proteins with the dye FM4-64 in the hyphal apex, suggesting that the markers label the hyphal Spitzenkörper in Z. tritici. In addition, we localize GFP-fusions to the exocyst protein ZtExo70, the polarisome protein ZtSpa2. Consistent with results in the ascomycete Neurospora crassa, these markers did localize near the plasma membrane at the hyphal tip and only partially co-localize with FM4-64. Thus, these fluorescent markers are useful molecular tools that allow phenotypic analysis of mutants in Z. tritici. These tools will help develop new avenues of research in our quest to control STB infection in wheat.

Fluorescent markers of the endocytic pathway in Zymoseptoria tritici

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We establish Z. tritici fimbrin (ZtFim1) and small GTPases (ZtRab5, ZtRab7) as endocytic markers.

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All markers localize correctly, proven by live cell imaging and co-staining and pharmaceutical studies.

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We provide 3 carboxin-resistance conveying vectors for integration of all markers into the sdi1 locus.

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We provide 3 hygromycin B-resistance conveying vectors for random integration of all markers.

Hyphal growth in filamentous fungi is supported by the uptake (endocytosis) and recycling of membranes and associated proteins at the growing tip. An increasing body of published evidence in various fungi demonstrates that this process is of essential importance for fungal growth and pathogenicity. Here, we introduce fluorescent markers to visualize the endocytic pathway in the wheat pathogen Zymoseptoria tritici. We fused enhanced green-fluorescent protein (eGFP) to the actin-binding protein fimbrin (ZtFim1), which is located in actin patches that are formed at the plasma membrane and are participating in endocytic uptake at the cell surface. In addition, we tagged early endosomes by eGFP-labelling a Rab5-homologue (ZtRab5) and late endosomes and vacuoles by expressing eGFP-Rab7 homologue (ZtRab7). Using fluorescent dyes and live cell imaging we confirmed the dynamic behavior and localization of these markers. This set of molecular tools enables an in-depth phenotypic analysis of Z. tritici mutant strains thereby supporting new strategies towards the goal of controlling wheat against Z. tritici.

Red fluorescent proteins for imaging Zymoseptoria tritici during invasion of wheat

The use of fluorescent proteins (FPs) in plant pathogenic fungi provides valuable insight into their intracellular dynamics, cell organization and invasion mechanisms. Compared with green-fluorescent proteins, their red-fluorescent "cousins" show generally lower fluorescent signal intensity and increased photo-bleaching. However, the combined usage of red and green fluorescent proteins allows powerful insight in co-localization studies. Efficient signal detection requires a bright red-fluorescent protein (RFP), combined with a suitable corresponding filter set. We provide a set of four vectors, suitable for yeast recombination-based cloning that carries mRFP, TagRFP, mCherry and tdTomato. These vectors confer carboxin resistance after targeted single-copy integration into the sdi1 locus of Zymoseptoria tritici. Expression of the RFPs does not affect virulence of this wheat pathogen. We tested all four RFPs in combination with four epi-fluorescence filter sets and in confocal laser scanning microscopy, both in and ex planta. Our data reveal that mCherry is the RFP of choice for investigation in Z. tritici, showing highest signal intensity in epi-fluorescence, when used with a Cy3 filter set, and laser scanning confocal microscopy. However, mCherry bleached significantly faster than mRFP, which favors this red tag in long-term observation experiments. Finally, we used dual-color imaging of eGFP and mCherry expressing wild-type strains in planta and show that pycnidia are formed by single strains. This demonstrates the strength of this method in tracking the course of Z. tritici infection in wheat.

Formation of the ZnFe2O4 phase in an electric arc furnace off-gas treatment system

To better understand the phenomena of ZnFe2O4 spinel formation in electric arc furnace dust, the dust was characterized with particle size analysis, X-ray fluorescence (XRF), electron backscatter diffraction (EBSD), and electron probe micro-analysis (EPMA). Different ZnFe2O4 formation reaction extents were observed for iron oxide particles with different particle sizes. ZnO particles were present as both individual particles and aggregated on the surface of larger particles. Also, the slag particles found in the off-gas were shown not to react with the zinc vapor. After confirming the presence of a ZnFe2O4 formation reaction, the thermodynamic feasibility of in-process separation - a new electric arc furnace dust treatment technology - was reevaluated. The large air intake and the presence of iron oxide particles in the off-gas were included into the thermodynamic calculations. The formation of the stable ZnFe2O4 spinel phase was shown to be thermodynamically favorable in current electric arc furnace off-gas ducts conditions even before reaching the post combustion chamber.

Association of ulcerative colitis with TNF-related apoptosis inducing ligand (TRAIL) gene polymorphisms and plasma soluble TRAIL levels in Chinese Han population

OBJECTIVE

The precise etiology of inflammatory bowel diseases (IBDs) is still unknown although dysregulation of apoptosis likely plays an important role in this pathogenesis. However, the significance of mucosal T-cell apoptosis in ulcerative colitis (UC) is unclear. In the present work we investigated the role of TNF-related apoptosis-inducing ligand (TRAIL), which is implicated in various human disorders.

PATIENTS AND METHODS

Results from a total of 393 UC patients and 1292 healthy individuals were analyzed in this study. We determined the three single nucleotide polymorphisms of TRAIL in 3' untranslated regions (UTR), and examined the plasma soluble TRAIL (sTRAIL) levels by enzyme-linked immunosorbent assay.

RESULTS

We found that the mutant genotypes of TRAIL (G1525A/G1588A/C1595T and G1525A and G1588A) were much lower in UC patients compared to the controls. Furthermore, mutant allele and genotype of TRAIL C1595T were more prevalent in severe UC patients than in other patients (p < 0.001; p = 0.005, respectively). The three polymorphic sites in 3'UTR were in a perfect linkage disequilibrium in our study. In contrast to controls, the GAT haplotype was increased (p < 0.001), while the AAT haplotype was decreased in UC patients (p < 0.001). Besides, the plasma levels of sTRAIL were significantly higher in UC patients than in controls (p < 0.001).

CONCLUSIONS

Our findings suggested that increased occurrence of the genetic mutations of TRAIL in 3'UTR and possibly decreased plasma levels of sTRAIL might lead to a lower risk of UC attack in Chinese patients.