Which is the appropriate surgical procedure for appendiceal adenocarcinoma: appendectomy, partial colectomy or right hemicolectomy?

OBJECTIVE: The purpose of this study was to explore the appropriate surgical procedure and clinical decision for appendiceal adenocarcinoma. METHODS: A total of 1,984 appendiceal adenocarcinoma patients from 2004 to 2015 were retrospectively identified from the Surveillance, Epidemiology, and End Results (SEER) database. All patients were divided into three groups based on the extent of surgical resection: appendectomy (N = 335), partial colectomy (N = 390) and right hemicolectomy (N = 1,259). The clinicopathological features and survival outcomes of three groups were compared, and independent prognostic factors were assessed. RESULTS: The 5-year OS rates of patients who underwent appendectomy, partial colectomy and right hemicolectomy were 58.3%, 65.5% and 69.1%, respectively (right hemicolectomy vs appendectomy, P < 0.001; right hemicolectomy vs partial colectomy, P = 0.285; partial colectomy vs appendectomy, P = 0.045). The 5-year CSS rates of patients who underwent appendectomy, partial colectomy and right hemicolectomy were 73.2%, 77.0% and 78.7%, respectively (right hemicolectomy vs appendectomy, P = 0.046; right hemicolectomy vs partial colectomy, P = 0.545; partial colectomy vs appendectomy, P = 0.246). The subgroup analysis based on the pathological TNM stage indicated that there was no survival difference amongst three surgical procedures for stage I patients (5-year CSS rate: 90.8%, 93.9% and 98.1%, respectively). The prognosis of patients who underwent an appendectomy was poorer than that of those who underwent partial colectomy (5-year OS rate: 53.5% vs 67.1%, P = 0.005; 5-year CSS rate: 65.2% vs 78.7%, P = 0.003) or right hemicolectomy (5-year OS rate: 74.2% vs 53.23%, P < 0.001; 5-year CSS rate: 65.2% vs 82.5%, P < 0.001) for stage II disease. Right hemicolectomy did not show a survival advantage over partial colectomy for stage II (5-year CSS, P = 0.255) and stage III (5-year CSS, P = 0.846) appendiceal adenocarcinoma. CONCLUSIONS: Right hemicolectomy may not always be necessary for appendiceal adenocarcinoma patients. An appendectomy could be sufficient for therapeutic effect of stage I patients, but limited for stage II patients. Right hemicolectomy was not superior to partial colectomy for advanced stage patients, suggesting omission of standard hemicolectomy might be feasible. However, adequate lymphadenectomy should be strongly recommended.

Effects of nitric oxide on C2C12 cell inflammatory responses and notexin-induced muscle injury / Efectos del óxido nítrico en las respuestas inflamatorias de las células C2C12 y la lesión muscular inducida por notexina

SUMMARY: Skeletal muscle injury is an acute inflammatory condition caused by an inflammatory response. To reduce inflammatory cell infiltration and relieve skeletal muscle injury, efficient treatment is urgently needed. Nitric oxide is a free radical molecule reported to have anti-inflammatory effects. In this study, we showed that NO could inhibit the inflammatory response of C2C12 cells in vitro and protect rat skeletal muscle injury from notexin in vivo. NO synthase inhibitor (L-NG-Nitroarginine Methyl Este?L-NAME) and NO donor (sodium nitroprusside dehydrate ?SNP) were used to explore the vital role of lipopolysaccharides (LPSs) in LPS-stimulated C2C12 myoblasts.The expression of IL-18 and IL-1b was upregulated by L-NAME and downregulated by SNP, as indicated by the ELISA results. NO can reduce ASC, Caspase-1, and NLRP3 mRNA and protein levels. Furthermore, NO was detected in the rat model. The results of immunohistochemical staining showed that the production of DMD decreased. We conducted qRT-PCR and western blotting to detect the expression of Jo-1, Mi-2, TLR2, and TLR4 on day 6 post injury following treatment with L-NAME and SNP. The expression of Jo-1, Mi-2, TLR2, and TLR4 was upregulated by L-NAME and significantly reversed by SNP. NO can alleviate C2C12 cell inflammatory responses and protect rat skeletal muscle injury from notexin.

RESUMEN: La lesión del músculo esquelético es una afección inflamatoria aguda causada por una respuesta inflamatoria. Para reducir la infiltración de células inflamatorias y aliviar la lesión del músculo esquelético es necesario un tratamiento eficaz. El óxido nítrico es una molécula de radicales libres que tiene efectos antiinflamatorios. En este estudio, demostramos que el ON podría inhibir la respuesta inflamatoria de las células C2C12 in vitro y proteger la lesión del músculo esquelético de rata de la notexina in vivo. El inhibidor de ON sintasa (L-NG-nitroarginina metil este, L-NAME) y el donante de ON (nitroprusiato de sodio deshidratado, SNP) se utilizaron para explorar el papel vital de los lipopolisacáridos (LPS) en los mioblastos C2C12 estimulados por LPS. La expresión de IL- 18 e IL-1b fue regulada positivamente por L-NAME y regulada negativamente por SNP, como indican los resultados de ELISA. El ON puede reducir los niveles de proteína y ARNm de ASC, Caspasa-1 y NLRP3. Además, se detectó ON en el modelo de rata. Los resultados de la tinción inmunohistoquímica mostraron que disminuyó la producción de DMD. Realizamos qRT-PCR y transferencia Western para detectar la expresión de Jo-1, Mi-2, TLR2 y TLR4 el día 6 después de la lesión después del tratamiento con L-NAME y SNP. La expresión de Jo-1, Mi-2, TLR2 y TLR4 fue regulada positivamente por L- NAME y significativamente revertida por SNP. El ON puede aliviar las respuestas inflamatorias de las células C2C12 en ratas, y proteger la lesión del músculo esquelético de la notexina.

Effects of exhaustive exercise and contusion on autophagy-related factors in skeletal muscle of rats / Efectos del ejercicio exhaustivo y de contusión sobre factores relacionados a la autofagia en el músculo esquelético de ratones / Efeitos de exercício exaustivo e de contusões sobre fatores relacionados com autofagia no músculo esquelético de ratos

ABSTRACT Objective: To study the effects of exhaustive exercise and contusion on autophagy-related factors Beclin1, LC3 and PINK1 expression in the skeletal muscle of rats. Methods: Forty-two male SD rats were randomly divided into 7 groups, 6 rats in each group: C, D0, D24, D48, E0, E24, and E48. Each group of rats was killed and dissected at the different respective time points specified above. The whole quadriceps femoris of the left hind limbs were removed and divided into two parts, one for mRNAs of Beclin1, LC3 and PINK1 by real-time fluorescent quantitative PCR, and the other for LC3 protein by Western blotting. Results: Compared with group C, the contents of Beclin1 mRNA, PINK1 mRNA, and LC3 mRNA in the immediate exhaustive exercise group (E0) were significantly reduced p<0.01. However, the levels of PINK1 mRNA, LC3 mRNA, and LC3 protein in skeletal muscle cells increased significantly in the 48 hours after exhaustion (E48) p<0.05, suggesting that cell autophagy had an increasing trend during the recovery period. Meanwhile, compared with the C group, the contents of Beclin1 mRNA, PINK1 mRNA, and LC3 mRNA in the immediate blunt contusion group (D0) increased significantly p<0.01 and were followed by a downward trend. Conclusion: Generally, there were differences between the blunt contusion and exhausted exercise models at each recovery phase. The gene expression of the autophagy-related factors was not high in the early exhaustive exercise recovery phase and subsequently followed an upward trend. But the above factors increased significantly in the immediate and early recovery phases after blunt contusion. Injury from blunt contusion may be more severe than exhaustive exercise-induced-injury, so the autophagy starts earlier according to the changes in autophagy-related factors. Level of evidence III; Therapeutic studies investigating the results of treatment.

RESUMEN Objetivo: Estudiar los efectos del ejercicio exhaustivo y de la contusión sobre la expresión de los factores relacionados a la autofagia de las proteínas Beclina 1, LC3 y PINK-1 en el músculo esquelético de ratones. Métodos: Cuarenta y dos ratones SD machos fueron divididos aleatoriamente en 7 grupos con 6 ratones cada uno: C, D0, D24, D48, E0, E24 y E48. Los ratones de cada uno de los grupos fueron sometidos a eutanasia y disecados en los diferentes puntos de tiempo de acuerdo con los grupos encima. Cada músculo cuádriceps femoral de los miembros posteriores izquierdos fue removido y dividido en dos partes, una para RNAm de Beclina 1, LC3 y PINK-1 por PCR cuantitativa fluorescente en tiempo real y la otra para la proteína LC3 por Western blotting. Resultados: En comparación con el grupo C, el tenor de RNAm en Beclina 1, PINK-1 y LC3 en el grupo ejercicio exhaustivo inmediato (E0) fue significativamente reducido (p < 0,01). Con todo, los niveles de RNAm en PINK-1 y LC3 y la proteína LC3 en células del músculo esquelético aumentaron significativamente en las 48 horas post-depleción (E48) (p < 0,05), sugiriendo que la autofagia celular tendió a aumentar durante el período de recuperación. En comparación con el grupo C, el tenor de RNAm de Beclina 1, RNAm de Pink-1 y RNAm de LC3 en el grupo contusión inmediata (D0) aumentó significativamente (p < 0,01) lo que fue seguido por tendencia de caída. Conclusión: En general, fueron encontradas diferencias entre los modelos de contusión y de ejercicio exhaustivo en cada fase de recuperación. La expresión génica de los factores relacionados con la autofagia no fue alta en la fase de recuperación del ejercicio exhaustivo inicial y, subsecuentemente, siguió tendencia ascendente. Sin embrago, los factores encima aumentaron significativamente en las fases de recuperación inmediata e inicial después de contusión. El trauma contuso puede ser más grave que la lesión inducida por ejercicio exhaustivo, de modo que la autofagia tiene inicio más temprano, de acuerdo con los cambios en los factores relacionados a la autofagia. Nivel de Evidencia III; Estudios terapéuticos - Investigación de los resultados del tratamiento.

RESUMO Objetivo: Estudar os efeitos do exercício exaustivo e da contusão sobre a expressão dos fatores relacionados com a autofagia das proteínas Beclina 1, LC3 e PINK-1 no músculo esquelético de ratos. Métodos: Quarenta de dois ratos SD machos foram divididos randomicamente em 7 grupos com 6 ratos cada um: C, D0, D24, D48, E0, E24 e E48. Os ratos de cada um dos grupos foram submetidos à eutanásia e dissecados nos diferentes pontos de tempo de acordo com os grupos acima. Cada músculo quadríceps femoral dos membros posteriores esquerdos foi removido e dividido em duas partes, uma para RNAm de Beclina 1, LC3 e PINK-1 por PCR quantitativa fluorescente em tempo real e a outra para a proteína LC3 por Western blotting. Resultados: Em comparação com o grupo C, o teor de RNAm em Beclina 1, PINK-1 e LC3 no grupo exercício exaustivo imediato (E0) foi significativamente reduzido (p < 0,01). Contudo, os níveis de RNAm em PINK-1 e LC3 e a proteína LC3 em células do músculo esquelético aumentaram significativamente nas 48 horas pós-depleção (E48) (p < 0,05), sugerindo que a autofagia celular tendeu a aumentar durante o período de recuperação. Em comparação com o grupo C, o teor de RNAm de Beclina 1, RNAm de Pink-1 e RNAm de LC3 no grupo contusão imediata (D0) aumentou significativamente (p < 0,01) o que foi seguido por tendência de queda. Conclusão: Em geral, foram encontradas diferenças entre os modelos de contusão e de exercício exaustivo em cada fase de recuperação. A expressão gênica dos fatores relacionados com a autofagia não foi alta na fase de recuperação do exercício exaustivo inicial e, subsequentemente, seguiu tendência ascendente. Porém, os fatores acima aumentaram significativamente nas fases de recuperação imediata e inicial depois de contusão. O trauma contuso pode ser mais grave do que a lesão induzida por exercício exaustivo, de modo que a autofagia tem início mais cedo, de acordo com as mudanças nos fatores relacionados com a autofagia. Nível de Evidência III; Estudos terapêuticos -Investigação dos resultados do tratamento.

A meta-analysis on the association of genetic polymorphism of the angiotensin-converting enzyme and coronary artery disease in the chinese population.

OBJECTIVE: To investigate the association between genotype insertion or deletion polymorphism of the angiotensin-converting enzyme gene (ACE) and susceptibility to coronary artery disease (CAD) in Chinese Han population. METHODS: We conducted a comprehensive search for the OR value of contrast between the group of genotype insertion or deletion polymorphism of the ACE and the group of CAD as an effective index. A meta-analysis (Stata 12.0) was used to test the heterogeneity of the results, combine the values for effect, conduct sensitivity analysis, and basic evaluation. RESULTS: A total of 638 studies were found on the association between polymorphisms of the angiotensin-converting enzyme gene and CAD, of which 44 studies met the inclusion criteria. In total, our study included 5619 cases and 4865 controls. The heterogeneity test of each study (P < 0.001) was carried out using a random effect model. The OR value of DD/ID+II was 1.95, 95% confidence interval (95%CI) (1.66-2.29). The OR value of II/DI+DD was 0.63, 95%CI (0.55-0.72). The funnel figure is basically symmetrical and the results of the sensitivity analysis were stable. CONCLUSION: The DD genotype of the angiotensin converting enzyme gene may be a weaker risk factor for CAD in the Chinese Han population.

A meta-analysis on the association of genetic polymorphism of the angiotensin-converting enzyme and coronary artery disease in the chinese population

SUMMARY OBJECTIVE: To investigate the association between genotype insertion or deletion polymorphism of the angiotensin-converting enzyme gene (ACE) and susceptibility to coronary artery disease (CAD) in Chinese Han population. METHODS: We conducted a comprehensive search for the OR value of contrast between the group of genotype insertion or deletion polymorphism of the ACE and the group of CAD as an effective index. A meta-analysis (Stata 12.0) was used to test the heterogeneity of the results, combine the values for effect, conduct sensitivity analysis, and basic evaluation. RESULTS: A total of 638 studies were found on the association between polymorphisms of the angiotensin-converting enzyme gene and CAD, of which 44 studies met the inclusion criteria. In total, our study included 5619 cases and 4865 controls. The heterogeneity test of each study (P < 0.001) was carried out using a random effect model. The OR value of DD/ID+II was 1.95, 95% confidence interval (95%CI) (1.66-2.29). The OR value of II/DI+DD was 0.63, 95%CI (0.55-0.72). The funnel figure is basically symmetrical and the results of the sensitivity analysis were stable. CONCLUSION: The DD genotype of the angiotensin converting enzyme gene may be a weaker risk factor for CAD in the Chinese Han population.

RESUMO OBJETIVO: Investigar a associação entre o polimorfismo de inserção ou deleção do genótipo do gene da enzima conversora da angiotensina (ACE) e a susceptibilidade da etnia Han chinesa para a doença arterial coronariana (DAC). Métodos: Foi realizada uma pesquisa abrangente para o valor de OR (Odds Ratio) de contraste entre o grupo de polimorfismo de inserção ou deleção do genótipo do gene da enzima conversora da angiotensina (ACE) e o grupo de doença arterial coronariana (DAC) como um índice de eficácia. Uma meta-análise (Stata 12,0) foi utilizada para testar a heterogeneidade dos resultados, combinar os valores de eficácia, realizar análises de sensibilidade e de avaliação básica. RESULTADOS: Um total de 638 estudos foram encontrados sobre a associação entre polimorfismos do gene da enzima conversora da angiotensina e doença arterial coronariana, dos quais 44 satisfaziam os critérios de inclusão. Nosso estudo incluiu 6246 casos e 5713 controles. O teste de heterogeneidade de cada estudo (p < 0,001) foi realizado seguindo o modelo de efeito randômico. O valor de OR para DD/ID+II foi 1,95, com 95% de intervalo de confiança de (95%CI) (1,66-2,29). O valor de OR para II/DI+DD foi 0,63, com 95% IC (0,55-0,72). A figura do funil é basicamente simétrica e os resultados da análise de sensibilidade foram estáveis. CONCLUSÃO: O genótipo DD do gene da enzima conversora da angiotensina podem ser um fator de risco mais fraco para doença coronariana na população chinesa Han.

Gut dysbiosis is linked to hypertension.

Emerging evidence suggests that gut microbiota is critical in the maintenance of physiological homeostasis. This study was designed to test the hypothesis that dysbiosis in gut microbiota is associated with hypertension because genetic, environmental, and dietary factors profoundly influence both gut microbiota and blood pressure. Bacterial DNA from fecal samples of 2 rat models of hypertension and a small cohort of patients was used for bacterial genomic analysis. We observed a significant decrease in microbial richness, diversity, and evenness in the spontaneously hypertensive rat, in addition to an increased Firmicutes/Bacteroidetes ratio. These changes were accompanied by decreases in acetate- and butyrate-producing bacteria. In addition, the microbiota of a small cohort of human hypertensive patients was found to follow a similar dysbiotic pattern, as it was less rich and diverse than that of control subjects. Similar changes in gut microbiota were observed in the chronic angiotensin II infusion rat model, most notably decreased microbial richness and an increased Firmicutes/Bacteroidetes ratio. In this model, we evaluated the efficacy of oral minocycline in restoring gut microbiota. In addition to attenuating high blood pressure, minocycline was able to rebalance the dysbiotic hypertension gut microbiota by reducing the Firmicutes/Bacteroidetes ratio. These observations demonstrate that high blood pressure is associated with gut microbiota dysbiosis, both in animal and human hypertension. They suggest that dietary intervention to correct gut microbiota could be an innovative nutritional therapeutic strategy for hypertension.

Decreased expression of chromodomain helicase DNA-binding protein 5 is an unfavorable prognostic marker in patients with primary gallbladder carcinoma.

AIM: Chromodomain helicase DNA-binding protein 5 (CHD5) plays a role in normal neural development and in tumorigenesis of various human cancers. However, its role in primary gallbladder carcinoma (PGC) is still unclear. The aim of this study was to investigate CHD5 expression in PGC and its clinical significance. METHODS: CHD5 mRNA and protein expression in 120 PGC and 20 normal gallbladder specimens was determined by quantitative reverse transcription-polymerase chain reaction (QRT-PCR) and Western blotting analysis, respectively. RESULTS: The expression levels of CHD5 mRNA and protein in PGC tissues were both significantly lower than those in the normal epithelium of the gallbladder (mRNA: P = 0.006; protein: P = 0.01). CHD5 mRNA expression was closely correlated with its protein expression (r = 0.8; P < 0.001). Additionally, the low expression of CHD5 protein was significantly associated with high pathologic T stage (P = 0.01) and clinical stage (P = 0.008), and advanced histologic grade (P = 0.009). The expression levels of CHD5 protein in PGC tissues with positive nodal metastasis were also significantly lower than those without (P = 0.01). Survival analysis showed that low CHD5 expression was associated with shorter disease-free (P = 0.01) and overall survival (P = 0.008) compared to those with high CHD5 expression in PGC patients. Furthermore, multivariate analyses showed that the decreased expression of CHD5 was an independent prognostic marker for both unfavorable disease-free (P = 0.01) and overall survival (P = 0.006). CONCLUSION: CHD5 may be involved in carcinogenesis of PGC and its down-regulation may be significantly correlated with unfavorable clinicopathologic features including poor overall and disease-free survival in patients.