Arteriocolonic fistula of inferior mesenteric artery aneurysm: A case with lower gastrointestinal and intra-abdominal hemorrhage.

Introduction: Arteriocolonic fistula of Inferior Mesenteric Artery Aneurysm (IMAA) refers to a spontaneous formation of pathological communication between the artery and the adjacent gastrointestinal tract. It is a rare, life-threatening condition primarily manifesting as abdominal pain, gastrointestinal bleeding, abdominal pulsating masses. However, its clinical manifestations are usually atypical with a difficult diagnosis and treatment. Case presentation: We report a rare case of a 50-year-old male with a hemorrhagic shock due to primary arteriocolonic fistula of IMAA. Instead of sigmoidectomy, super selective transcatheter arterial embolization (TAE) was performed after diagnostic angiography. Postoperatively, dynamic contrast-enhanced abdominal computed tomography (CT) demonstrated no recanalization of the aneurysm, absence of abnormal collateral vessels, no active hemorrhage. The patient was discharged uneventfully after 2 weeks without abdominal pain or tension. Discussion: Colorectal tumor rupture is a major cause of lower gastrointestinal bleeding (LGIB), with IMAA being an uncommon etiology. Because of the high mortality of explorative laparotomy with an unclear bleeding site, diagnostic angiography and therapeutic TAE are viable options for diagnosing hemodynamic instability. Conclusion: Arteriocolonic fistulas commonly occur secondary to a pseudoaneurysm formed at the anastomosis of the transplanted blood vessel after an artery surgery, which ruptures and penetrates into the intestine. We reported a unique case of primary arteriocolonic fistula of IMAA: aneurysm rupture and bleeding from the abdomen into the hematochezia. After multidisciplinary consultations, our patient obtained the best outcome using the most minimally invasive surgical methods. With an abdominal artery aneurysm presenting with colorectal hemorrhage, arteriocolonic fistula of IMAA should be suspected.

MiR-29c-3p represses gastric cancer development via modulating MEST.

Gastric cancer (GC) triggers a great number of deaths worldwide. Although great efforts have been made in treating this cancer, GC patients' survival rate remains unsatisfactory. An increasing amount of evidence indicates that miR-29c-3p inhibits cancer progression. However, the mechanism of miR-29c-3p in GC remains to be fully defined. Hence, this work aimed to analyze the underlying mechanism of miR-29c-3p in GC. Outcomes showed marked downregulation of miR-29c-3p in GC tissue and cell lines. Functional experiments exhibited that miR-29c-3p repressed GC cell malignant behaviors. Moreover, bioinformatics analysis and dual-luciferase reporter gene detection indicated that MEST was targeted by miR-29c-3p. Rescue assay further proved that MEST participated in functions of miR-29c-3p in GC. To sum up, miR-29c-3p/MEST signaling pathway suppressed formation of malignant phenotypes of GC, and targeting the signaling pathway may be a new method for treating GC.

The Relationship Between Reading Strategy and Reading Comprehension: A Meta-Analysis.

This study synthesized the correlation between reading strategy and reading comprehension of four categories based on Weinstein and Mayer's reading strategy model. The current meta-analysis obtained 57 effect sizes that represented 21,548 readers, and all selected materials came from empirical studies published from 1998 to 2019. Results showed that reading strategies in all the four categories had a similar correlation effect size with reading comprehension. The correlation between monitoring strategy and reading comprehension was significantly larger in first language scripts than second language scripts. Affective strategy and elaboration strategy had an independent effect on reading comprehension, which was not significantly moderated by selected moderators. Results suggested that the reading strategies of all the four categories may have a similar contribution to text comprehension activities.

Effectiveness of Metacognitive Regulation Intervention on Attention-Deficit-Hyperactivity Disorder Students' Scientific Ability and Motivation.

This study investigated the effect of metacognitive regulation (McR) intervention on attention-deficit-hyperactivity disorder (ADHD) students' astronomy knowledge acquisition and learning motivation. Through a cognitive-behavioural treatment design, this study selected 97 ADHD learners who had poor academic performance. This study divided ADHD students randomly into one experimental group and one control group. After 15 weeks of intervention, results showed that the experimental group students performed significantly better than the control group in scientific abilities, learning motivation, and metacognition. Results suggested that the McR intervention is an effective approach for improving the ADHD students' science knowledge learning abilities.

Clinicopathological significance of SMAD4 loss in pancreatic ductal adenocarcinomas: a systematic review and meta-analysis.

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer mortality. Although advances have been made in understanding the pathogenesis of PDAC, the outcome still remains poor. The aim of this study is to conduct a meta-analysis to evaluate the precise association between SMAD4 loss and clinicopathological significance in PDAC. A literature search was made in PubMed, Web of Science, Google scholar, and EMBASE for related publications. The data were extracted and assessed by two reviewers independently. Analysis of pooled data was performed, Odds Ratio or Hazard Ratio with corresponding confidence intervals was calculated and summarized. 12 relevant articles were included for full review in detail and meta-analysis. The frequency of SMAD4 protein loss was significantly increased in PDAC than in nonmalignant pancreatic tissue, Odd Ratio was 0.05 with 95% confidence interval 0.01-0.23, p<0.0001. SMAD4 loss was significantly associated with poor overall survival in patients with PDAC, Hazard Ratio was 0.61 with 95% confidence interval 0.38-0.99, p=0.05. SMAD4 loss was not correlated with the size, grades, and lymph node metastasis of PDAC. In conclusion, SMAD4 is a biomarker for the diagnosis of PDAC. SMAD4 loss is significantly related to poor prognosis in patients with PDAC.

[Effect of arterial infusion with methylene blue during total mesorectal excision on urination function and sexual function in male patients with rectal cancer].

OBJECTIVE: To explore the effect of arterial infusion with methylene blue during total mesorectal excision (TME) for better preservation of pelvic autonomic nerve on urination function and sexual function in male patients with rectal cancer. METHODS: A total of 68 male rectal cancer patients from Zhejiang Xiaoxing People's Hospital and 44 male rectal cancer patients from Guangdong Zhongshan Chenxinghai Hospital between June 2013 and June 2015 were prospectively enrolled. Patients were randomly divided into the trial group receiving arterial infusion with 8 ml of 1% methylene blue and the control group without artery infusion, with 56 cases in each group. All the patients underwent TME. Intra-operational lymph node removal and postoperative urination and sexual function (erection and ejaculation) were compared between two groups. RESULTS: The baseline data of the two groups were not significantly different (all P>0.05). As compared to the control group, the trial group had shorter operation time [(3.28±0.63) hours vs. (4.01±0.94) hours, P<0.01], less blood loss[(92.5±36.4) ml vs. (174.1±61.4) ml, P<0.01], and more lymph nodes harvested per patient (15.8±7.6 vs. 11.9±4.3, P<0.01). One year after operation, classI(, II(, III(, IIII( of urination was observed in 33 cases (58.9%), 15 cases (26.8%), 6 cases (10.7%), 2 cases (3.6%) in the trial group, while 24 (42.9%), 15 (26.8%), 12 (21.4%), 5 (8.9%) in the control group, which indicated that trial group was superior to control group(P<0.05). ClassI(, II(, III( of erection was observed in 36 cases (64.3%), 18 cases (32.1%), 2 cases(3.6%) in the trial group, while 25(44.6%), 23(41.1%), 8(14.3%) in the control group, which indicated that trial group was superior to the control group (P<0.05). ClassI(, II(, III( of ejaculation was found in 36 cases (62.5%), 18 cases (32.1%), 3 cases (5.4%) in the trial group, while 24 (42.9%), 22 (39.3%), 10(17.9%) in the control group, which also indicated that trial group was superior to the control group(P<0.05). CONCLUSIONS: In the treatment of male rectal cancer patients, TME combined with arterial infusion with methylene blue can facilitate the distinction of operation scope, which is beneficial to reduce damages to the pelvic nerve, leading to the protection of urinary function and sexual function. In addition, this procedure can result in shorter operation time, less operational blood loss and more lymph nodes harvested.

Imaging findings of primary gastric plasmacytoma: a case report.

Primary gastric plasmacytoma (GP) is a rare extramedullary plasmacytoma with clinical and imaging features that are common among other gastric tumors, such as gastric adenocarcinomas, gastric stromal tumors, and lymphomas. Here, we present a histologically confirmed case of primary GP examined with biphasic computed tomography (CT), magnetic resonance imaging (MRI), and endosonography. A well-circumscribed extraluminal mass appearing as homogeneous attenuation/intensity with gradual enhancement was identified on biphasic enhancement CT and MRI. This mass was hyperintense on diffusion-weighted imaging and hypointense on the apparent diffusion coefficient map, implying that water diffusion in the mass was restricted. In addition, endosonography indicated a low echogenic mass in the gastric wall. These imaging findings increase the available knowledge about imaging of this disease and provide valuable information for differentiating primary GP from common gastric tumors.