[Comparison of the efficacy of different surgical strategies in the treatment of patients with initially resectable gastric cancer liver metastases].

Objective: To examine the impact of varied surgical treatment strategies on the prognosis of patients with initial resectable gastric cancer liver metastases (IR-GCLM). Methods: This is a retrospective cohort study. Employing a retrospective cohort design, the study selected clinicopathological data from the national multi-center retrospective cohort study database, focusing on 282 patients with IR-GCLM who underwent surgical intervention between January 2010 and December 2019. There were 231 males and 51 males, aging (M(IQR)) 61 (14) years (range: 27 to 80 years). These patients were stratified into radical and palliative treatment groups based on treatment decisions. Survival curves were generated using the Kaplan-Meier method and distinctions in survival rates were assessed using the Log-rank test. The Cox risk regression model evaluated HR for various factors, controlling for confounders through multivariate analysis to comprehensively evaluate the influence of surgery on the prognosis of IR-GCLM patients. A restricted cubic spline Cox proportional hazard model assessed and delineated intricate associations between measured variables and prognosis. At the same time, the X-tile served as an auxiliary tool to identify critical thresholds in the survival analysis for IR-GCLM patients. Subgroup analysis was then conducted to identify potential beneficiary populations in different surgical treatments. Results: (1) The radical group comprised 118 patients, all undergoing R0 resection or local physical therapy of primary and metastatic lesions. The palliative group comprised 164 patients, with 52 cases undergoing palliative resections for gastric primary tumors and liver metastases, 56 cases undergoing radical resections for gastric primary tumors only, 45 cases undergoing palliative resections for gastric primary tumors, and 11 cases receiving palliative treatments for liver metastases. A statistically significant distinction was observed between the groups regarding the site and the number of liver metastases (both P<0.05). (2) The median overall survival (OS) of the 282 patients was 22.7 months (95%CI: 17.8 to 27.6 months), with 1-year and 3-year OS rates were 65.4% and 35.6%, respectively. The 1-year OS rates for patients in the radical surgical group and palliative surgical group were 68.3% and 63.1%, while the corresponding 3-year OS rates were 42.2% and 29.9%, respectively. A comparison of OS between the two groups showed no statistically significant difference (P=0.254). Further analysis indicated that patients undergoing palliative gastric cancer resection alone had a significantly worse prognosis compared to other surgical options (HR=1.98, 95%CI: 1.21 to 3.24, P=0.006). (3) The size of the primary gastric tumor significantly influenced the patients' prognosis (HR=2.01, 95%CI: 1.45 to 2.79, P<0.01), with HR showing a progressively increasing trend as tumor size increased. (4) Subgroup analysis indicates that radical treatment may be more effective compared to palliative treatment in the following specific cases: well/moderately differentiated tumors (HR=2.84, 95%CI 1.49 to 5.41, P=0.001), and patients with liver metastases located in the left lobe of the liver (HR=2.06, 95%CI 1.19 to 3.57, P=0.010). Conclusions: In patients with IR-GCLM, radical surgery did not produce a significant improvement in the overall prognosis compared to palliative surgery. However, within specific patient subgroups (well/moderately differentiated tumors, and patients with liver metastases located in the left lobe of the liver), radical treatment can significantly improve prognosis compared to palliative approaches.

[Research progress on the histological scoring system for nonalcoholic fatty liver disease].

Non-alcoholic fatty liver disease (NAFLD) has replaced chronic hepatitis B as the most common chronic liver disease in China and has now been renamed metabolic dysfunction-associated fatty liver disease (MAFLD). The Brunt, the American NASH Clinical Research Network (NASH-CRN), the European Steatosis, Activity, and Fibrosis/Fatty Liver Inhibition of Progression (SAF/FLIP), and the Pediatric NAFLD are currently the four semi-quantitative grading systems for histological evaluation. This paper reviews these four scoring systems for the clinical selection of appropriate systems for diagnosis and prognosis assessment. This article is a review, and in order to coordinate the evaluation criteria of various scoring systems, the old name "NAFLD" is used.

Efficacy of Kanglaite against radiotherapy-induced mucositis in head and neck cancer, a phase II trial.

PURPOSE: To explore the potential protective effect of Kanglaite injection against radiotherapy-induced mucositis in patients with head and neck cancer. PATIENTS AND METHODS: This was an open-label, single-arm, and phase II trial. The primary endpoint was the incidence of grade 3-4 radiation-induced mucositis. The secondary endpoints were hematological toxicity, non-hematological toxicity, nutritional status, and quality of life. All patients received 20g Kanglaite daily concurrently with radiotherapy. RESULTS: The data of 46 patients were available for analysis. The incidence rates of grade 3 mucositis, pain, dysphagia, and neutropenia were 10.9%, 2.2%, 10.9%, and 6.5%, respectively, while the incidence of grade 4 acute toxicities was zero. The rate of opioid use was 2.2%. Radiotherapy dose reduction was 2.2% and no irradiation field was modified. The nutritional supports were oro-enteral nutritional supplements (13.0%), TPN (10.9%), and feeding tubes (0%) during radiotherapy. After radiotherapy, 52.2% of patients lost weight, and the weight loss was <10%. The mean pain score in the QLQ-H&N35 and QLQ-C30 was <50. Patients had nearly normal physical, emotional, and cognitive functions. CONCLUSIONS: A low incidence of grade 3-4 radiation-induced mucositis and no severe acute toxic events, with favorable nutritional status and quality of life, were observed in cancer patients after Kanglaite injection. Our findings highlight the need for a prospective, multicenter, and randomized study to investigate the effect of Kanglaite injection on the reduction of radiation-induced mucositis in patients with head and neck cancer.

[Epithelioid hemangioendothelioma with TFE3 translocation in soft tissue:a clinicopathological study].

Objective: To investigate the clinicopathological and molecular features, diagnosis and differential diagnosis of TFE3-rearranged epithelioid hemangioendothelioma (EHE). Methods Two cases of TFE3-rearranged EHE arising from soft tissues, diagnosed by the Pathology Department of the First Affiliated Hospital of Nanjing Medical University from 2013 to 2020 were observed. EnVision method was used for immunophenotyping, fluorescence in situ hybridization (FISH) was used to test TFE3 gene rearrangements and WWTR1-CAMTA1 fusion gene,and next-generation sequencing (NGS) was used to delineate the fusion transcripts. Results: Details of these two cases were as follows: case 1, male, 51 years old, with tumor in the right temporal region; case 2, female, 42 years old, with tumor in the right neck. The tumors showed progressive painless enlargement. Grossly, the tumor of case 1 was multinodular with unclear boundary and grayish red cut surface, while the tumor of case 2, originating from a vein, appeared as a firm, tan mass within vessel wall. Microscopically, both tumors showed moderate cellularity and were consisted of plump, epithelioid, or histiocytoid cells with eosinophilic cytoplasm and mild-to-moderate nuclear pleomorphism. Most of the tumor cells were arranged in solid or alveolar growth patterns, while some tumor cells showed intraluminal papillary growth pattern in case 1 and anastomosing vascular channels and extramedullary hematopoiesis in case 2. Immunohistochemically, the tumor cells showed diffuse positivity for CD31, CD34, ERG, and TFE3. FISH revealed TFE3 break-apart signals in two cases, but WWTR1-CAMTA1 gene fusion was not detected. NGS identified YAP1 (exon1)-TFE3 (exon6) fusion gene in case 2. Clinical follow-up information was available in both cases for a follow-up period of 15 and 59 months respectively. Patient 1 had a relapse 22 months after surgery, and was currently alive with the tumor. Patient 2 remained disease-free. Conclusions: TFE3-rearranged EHE is a rare molecular subtype of EHE, with accompanying characteristic morphologic features. However the morphologic spectrum remains under-recognized, and more experience is needed. Immunohistochemical and molecular examinations are helpful for the diagnosis and differential diagnosis of the disease.

[Atypical epithelioid hemangioendothelioma: a clinicopathological analysis of eight cases].

Objective: To study the clinicopathological features, diagnosis, and differential diagnosis of atypical epithelioid hemangioendothelioma (EHE). Methods: Eight cases of atypical EHEs were collected from Jiangsu Province Hospital (the First Affiliated Hospital of Nanjing Medical University) between 2010 and 2018. EnVision method and fluorescence in situ hybridization (FISH) were used to detect immunophenotype, WWTR1-CAMTA1 and TFE3 gene rearrangement, respectively. Results: There were 4 males and 4 females, ranging from 42 to 59 years (median 47.5 years). The tumors located in soft tissue (3 cases), lung (3 cases), liver (1 case) and chest wall (1 case). One soft tissue EHE involved also adjacent fibula and pleural involvement was present in all three lung cases at the diagnosis. Regional lymph node metastases were present in two cases (one involving soft tissue tumor and one involving liver). Morphologically, the tumor cells were epithelioid with abundant eosinophilic cytoplasm, moderate to marked nuclear pleomorphism, irregular nuclear membrane, unevenly chromatin, and prominent nucleoli. The cells arranged in cords, small nests or solid pattern. The mitotic rate was 4.3 mitoses/2 mm(2) on average (ranging 2 to 9). Tumor necrosis was seen in every case. Among all 8 cases, blister cells were found upon careful observation. Myxohyaline stroma was present in 6 cases. Immunohistochemically, tumor cells expressed CD31 (8/8), CD34 (7/8), ERG (8/8), CKpan (2/7), and CAMTA1 (4/6). None of the tested cases stained for TFE3 (0/6). WWTR1-CAMTA1 fusion gene by FISH was found in all tested 6 cases and TFE3 gene rearrangement was not detected in any. Available clinical follow-up was obtained in 7 cases and the intervals range from 6 to 55 months (average 19.6 months). Six patients had metastasis and 3 patients died of disease. One patient was alive with no evidence of disease. Conclusions: Atypical EHE is a more aggressive tumor than classic EHE, with histological features including high nuclear grade, increased mitotic activity, the presence of solid growth pattern and tumor necrosis. The differential diagnoses include epithelioid angiosarcoma, carcinoma and epithelioid sarcoma.

DUSP1 promotes senescence of retinoblastoma cell line SO-Rb5 cells by activating AKT signaling pathway.

OBJECTIVE: Retinoblastoma seriously threats to human health and life. Molecular targeted therapy of retinoblastoma supplies the direction of research in the future. This study aims to investigate the impact of DUSP1 on human retinoblastoma SO-Rb5 cell senescence. MATERIALS AND METHODS: Angiotensin II (AGII) was used to induce human retinoblastoma SO-Rb5 cell senescence model. DUSP1 over-expression plasmid and small interfere RNA (siRNA) were transfected into SO-Rb5 cells by Lipofectamine. Dual specificity phosphatase 1 (DUSP1), p53, p16, and protein kinase B (Akt) signaling expressions were detected with Western blot assay. SH-6 was applied to inhibit Akt signaling in SO-Rb5 cells. Cell senescence was evaluated by using ß-galactosidase test. RESULTS: DUSP1 level increased in SO-Rb5 cells induced by AGII. Senescence protein p53 and p16 significantly upregulated in SO-Rb5 cell senescence model, together with ß-galactosidase staining. DUSP1 plasmid transfection significantly enhanced DUSP expression, triggered SO-Rb5 cell senescence, and inhibited Akt signaling activation. DUSP1 siRNA exhibited the opposite effects. SH-6 significantly increased SO-Rb5 cell senescence induced by AGII through inhibiting Akt signaling. CONCLUSIONS: DUSP1 facilitated human retinoblastoma SO-Rb5 cell senescence induced by AGII through inhibiting Akt signaling pathway.

[The latent variable growth curve model of longitudinal data and its implementation in Mplus].

To discuss the latent variable growth curve model of longitudinal data and give its implementation method in Mplus. The application of Mplus software has been used to deal with the longitudinal data of mental health status of college students in an university. Results show that the model can process the longitudinal data with latent variables, which can compare the differences of the overall development trend and individual development, also taking a covariate into the model to improve the effect of model fitting. Using Mplus software to process the longitudinal data with latent variables, the program is simple and easy to operate. This study provides the latent variable growth curve model of longitudinal data and its procedure of implementation in Mplus, and the statistical methodology guidance and reference for practical applications of epidemiological cohort study.

Are Epichloë endophytes specific to Elymus grass hosts?

Epichloë endophytes are widely distributed mutualists of cool-season grasses and can protect their hosts against biotic and abiotic stresses. Previous studies have shown that Epichloë endophytes are specific to their grass hosts in tall Festuca and Lolium species. However, no systematic analysis exists of host specificity of asexual Epichloë endophytes and Chinese Elymus species. We analyzed the phylogenetic relationships between Chinese Elymus species and their diploid donor Hordeum species, using their corresponding Epichloë endophyte sequences. We found that 1) the maternal donor of the Chinese Elymus species was the Chinese Pseudoroegneria (St genome) or Hordeum (H genome); and 2) Chinese Hordeum species probably contained two species of Epichloë endophytes. One Epichloë endophyte was also present in a North American Elymus species. The other Epichloë endophyte was found in a Chinese Elymus species. Our results indicate that Epichloë endophytes isolated from Elymus species did not show grass-host specificity. 3) Plant hybridization could probably transform endophyte-free plants (E-) to endophyte-infected plants (E+). Based on our data, we formulate hypotheses about which Epichloë endophytes were spread via plant hybridization.

BRMS1 inhibits expression of NF-kappaB subunit p65, uPA and OPN in ovarian cancer cells.

BACKGROUND: Breast cancer metastasis suppressor 1 (BRMS1) is a potent metastasis suppressor of various types of malignancies, including melanoma and ovarian cancer. Unfortunately, the clinical data regarding its role as a true metastatic suppressor and its efficacy as a prognostic marker and therapeutic target remain controversial. This study was designed to investigate the effect of BRMS1 on the invasion and metastasis of human ovarian cancer cells and its potential underlying mechanisms. MATERIALS AND METHODS: BRMS1 small interfering RNAs (siRNAs) or control siRNAs were transfected into the OVCAR3 human ovarian cancer cell line. Invasion and migration activities were assessed using the Transwell invasion and migration assay. Protein levels of nuclear factor-kappaB (NF-kappaB) subunit p65, osteopontin (OPN) and urokinase-type plasminogen activator (uPA) were evaluated by Western blot, immunofluorescence and immunocytochemistry methods. RESULTS: Successful knockdown of BRMS1 was verified by quantitative real-time RT-PCR and Western blot. The invasion and migration capacities of OVCAR3 cells were significantly enhanced in the BRMS1-silenced group, compared to controls (p < 0.05). Silencing of BRMS 1 significantly induced the expression of NF-kappaB subunit, p65, uPA, and OPN proteins. CONCLUSIONS: BRMS1 inhibits expression of p65, uPA and OPN protein. In turn, this leads to inhibition of ovarian cancer cell invasion and metastasis. This study unveils a potential novel mechanism by which BRMS1 inhibits metastasis of ovarian cancer cells.

Determination of the plasma pharmacokinetic and tissue distributions of swertiamarin in rats by liquid chromatography with tandem mass spectrometry.

An LC-MS/MS method was developed for the quantification of swertiamarin (CAS 17388-39-5) in rat plasma and tissues using gentiopicroside as the internal standard (IS). Swertiamarin and an IS were extracted from plasma and tissues by a simple solid-phase extraction (SPE) procedure. Separation was achieved on a Phenomenex kinetex-C18 column (100 mm×2.1 mm, 2.6 µm) with an isocratic mobile phase consisting of methanol and water (22:78, v/v) with 0.1% acetic acid at a flow rate of 0.2 mL/min. The analyte and IS were detected by negative ion electrospray ionisation in multiple-reaction monitoring mode while monitoring the transitions of m/z 433 [M + CH3COO] - →179 and m/z 415 [M + CH3COO] - →179 for swertiamarin and the IS, respectively. The method was validated with respect to selectivity, matrix effect, linearity, accuracy, precision, recovery and stability. The method was successfully applied in a pharmacokinetic study of swertiamarin after intravenous and oral administration to rats. The pharmacokinetics of swertiamarin showed rapid absorption and elimination, and its absolute bioavailability was low at 10.3%. After oral administration to rats, swertiamarin was rapidly and widely distributed in its tissues. High concentrations were found in the liver and kidney, indicating that swertiamarin was possibly absorbed in the liver and eliminated by the kidney.