Cetuximab combined with chemotherapy for simultaneous esophageal squamous cell carcinoma and colon adenocarcinoma: A case report.

BACKGROUND: Multiple primary carcinomas (MPCs) are defined as two or more independent primary cancers that occur simultaneously or sequentially in the same individual. Synchronous MPCs are rarer than solitary cancers or metachronous MPCs. Accurate diagnoses of synchronous MPCs and the choice of treatment are critical for successful outcomes in these cases. CASE SUMMARY: A 64-year-old patient presented with dysphagia, without obvious cause. A diagnosis of synchronous esophageal squamous cell carcinoma and colon adenocarcinoma with liver metastasis was confirmed based on examination and laboratory results. After multi-disciplinary consultations, combination chemotherapy (a 3-wk cycle with oxaliplatin 212 mg administered on day 1 and capecitabine 1.5 g twice daily on days 1-14) and esophageal cancer radiotherapy were initiated. Based on the results of genetic testing, we switched to a regimen of leucovorin + fluorouracil + oxaliplatin and cetuximab regimen for 8 cycles. Subsequently, capecitabine and bevacizumab were administered until the most recent follow-up, at which the tumor remained stable. CONCLUSION: Successful cetuximab chemotherapy treatment provides a reference for the non-operative and homogeneous treatment of different pathological types of synchronous MCPs.

Bioactives and metabolites of Tetrastigma hemsleyanum root extract alleviate DSS-induced ulcerative colitis by targeting the SYK protein in the B cell receptor signaling pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Tetrastigma hemsleyanum is an endemic Chinese herb with a wide range of pharmacological activities, including anti-inflammatory, antiviral, antioxidant, antitumor, and immunomodulatory activities. However, the effect and mechanisms of the anti-inflammatory activity of T. hemsleyanum root extract against dextran sodium sulfate (DSS)-induced ulcerative colitis (UC) have not yet been fully investigated. AIM OF THE STUDY: This study aimed to explore the therapeutic effect and molecular mechanisms of T. hemsleyanum root extract in DSS-induced UC mice and knockdown cells. MATERIALS AND METHODS: T. hemsleyanum root extract was obtained and analyzed by high-performance liquid chromatography (HPLC). The therapeutic effects of T. hemsleyanum root extract on DSS-induced UC mice were evaluated by the disease activity index (DAI) score, colon length, serum inflammatory cytokines and oxidant/antioxidant levels, and histopathological features of the ileum and colon. Genome-wide gene expression profiles of ileal and colonic tissues were collected by transcriptomics, and signaling pathways were analyzed by the KEGG database. UC-related pathways were uploaded to the STRING database, then the protein-protein interactions (PPIs) were determined by Cytoscape, and the enriched genes were evaluated by real-time quantitative PCR (qPCR). The protein-ligand complexes were docked by AutoDock, and the genes were knocked down in Caco-2 cells by shRNA. The non-targeted metabolomic profiling of ileal contents was analyzed by ultra-high-performance liquid chromatography (UHPLC), and gut microflora were sequenced by an Illumina MiSeq System. RESULTS: Ten components that alleviated UC symptoms in mice by decreasing the DAI and serum inflammatory cytokines and oxidant levels, promoting intestinal development, and increasing serum antioxidant levels were identified in T. hemsleyanum root extract. T. hemsleyanum root extract activated the B cell receptor signaling pathway in the colon tissue of UC mice, in which two components, rutin and astragaline, bound to the spleen tyrosine kinase (SYK) protein but also restored gut microflora diversity and increased the proportion of probiotics. Furthermore, metabolites of T. hemsleyanum root extract were involved in vitamin metabolism, fatty acid metabolism, and ferroptosis. CONCLUSIONS: The rutin and astragaline components of T. hemsleyanum root extract, by binding to SYK protein, activated the B cell receptor signaling pathway and restored gut microflora diversity to alleviate UC symptoms in mice.

A Population-Based Study: How to Identify High-Risk T1-2 Esophageal Cancer Patients?

BACKGROUND: Due to individualized conditions of lymph node metastasis (LNM) and distant metastasis (DM), the following therapeutic strategy and diagnosis of T1-2 esophageal cancer (ESCA) patients are varied. A prediction model for identifying risk factors for LNM, DM, and overall survival (OS) of high-risk T1-2 ESCA patients is of great significance to clinical practice. METHODS: A total of 1,747 T1-2 ESCA patients screened from the surveillance, epidemiology, and end results (SEER) database were retrospectively analyzed for their clinical data. Univariate and multivariate logistic regression models were established to screen out risk factors for LNM and DM of T1-2 ESCA patients, while those of OS were screened out using the Cox regression analysis. The identified risk factors for LNM, DM, and OS were then subjected to the establishment of three nomograms, respectively. The accuracy of the nomograms was evaluated by depicting the calibration curve, and the predictive value and clinical utility were evaluated by depicting the clinical impact curve (CIC) and decision curve analysis (DCA), respectively. RESULTS: The age, race, tumor grade, tumor size, and T-stage were significant factors for predicting LNM of T1-2 ESCA patients (p < 0.05). The age, T-stage, tumor grade, and tumor size were significant factors for predicting DM of T1-2 ESCA patients (p < 0.05). The age, race, sex, histology, primary tumor site, tumor size, N-stage, M-stage, and surgery were significant factors for predicting OS of T1-2 ESCA patients (p < 0.05). The C-indexes of the three nomograms constructed by these factors were 0.737, 0.764, and 0.740, respectively, suggesting that they were clinically effective. CONCLUSIONS: The newly constructed nomograms can objectively and accurately predict the LNM, DM, and OS of T1-2 ESCA patients, which contribute to the individualized decision making before clinical management.

Prognostic significance of LncRNA GHET1 expression in various cancers: a systematic review and meta-analysis.

BACKGROUND: Dysregulated expression of long non-coding RNA gastric carcinoma high expressed transcript 1 (lncRNA GHET1) has been observed in several cancers, however, definite conclusion on the prognostic value of lncRNA GHET1 expression in human cancers has not been determined. The aim of this meta-analysis was to evaluate the prognostic significance of lncRNA GHET1 expression in cancers. METHODS: PubMed, Web of Science and Embase were comprehensively searched for relevant studies. Meta-analyses of overall survival (OS) and clinicopathological features were conducted. RESULTS: Ten studies were finally analyzed in the present study. High lncRNA GHET1 expression was associated with shorter OS than low lncRNA GHET1 expression in cancers (hazard ratio (HR) = 2.59, 95% CI = 1.93-3.47, P<0.01). Online cross-validation using The Cancer Genome Atlas (TCGA) data observed similar results (HR = 1.10, P<0.05). When compared with low lncRNA GHET1 expression, high lncRNA GHET1 expression was related to larger tumor size (P<0.01), worse differentiation (P<0.01), earlier distant metastasis (P=0.02), earlier lymph node metastasis (P<0.01) and more advanced clinical stage (P<0.01). CONCLUSION: High lncRNA GHET1 expression is associated with worse cancer prognosis and can serve as a promising prognostic factor of human cancers.

Frontal Alpha EEG Asymmetry Before and After Positive Psychological Interventions for Medical Students.

Subjective well-being (SWB) refers to traits concerned with happiness, fulfillment and enrichment and is a substantial predictor of a flourishing life. Interest in the promotion of well-being has blossomed in recent years, and it is widely reported that positive psychological interventions (PPIs) can effectively improve SWB. However, to date, the neural correlates of PPIs remain elusive. Since previous research has suggested that emotion regulation might be the theoretical foundation for potential working mechanisms, here we used electroencephalography (EEG) techniques to identify whether the intentional increase of subjective well-being through PPIs was associated with greater tonic left frontal activation. Fifty-five students met the inclusion criteria and were allocated to a randomized controlled trial that was single blinded. The intervention group received PPIs once a week for 10 weeks (n = 28). Meanwhile, students in a placebo control group (CG, n = 27) were asked to write down early memories every day for 10 weeks and were invited to share voluntarily at the weekly meeting. Measures of subjective well-being, depression and anxiety were assessed at pre-test and post-test. Forty-eight students completed the post-test, and the collected data were analyzed across time (PPIs, n = 25; CG, n = 23). It was found that students undergoing the 10-week PPIs reported larger improvement in SWB, and greater relief in self-rated depression and anxiety from pre-intervention to post-intervention than did those in the control group. As expected, in conjunction with the promotion of subjective well-being and the amelioration of emotional distress from pre- to post-treatment in the intervention group, a significantly increased coefficient of frontal alpha EEG asymmetry was found. In summary, these findings suggest that adaptive emotion regulation, which is characteristic of greater tonic left frontal activation, reflects the efficiency of PPIs and highlights the frontal alpha EEG asymmetry as a neural substrate linking PPIs and mental health. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-ROC-17012636.

The different oscillation patterns of alpha band in the early and later stages of working memory maintenance.

A putative functional role for alpha oscillations in working memory remains controversial. However, recent evidence suggests that such oscillation may reflect distinct phases of working memory processing. The present study investigated alpha band (8-13Hz) activity during the maintenance stage of working memory using a modified Sternberg working memory task. Our results reveal that alpha power was concentrated primarily in the occipital cortex and was decreased during the early stage of maintenance (0-600ms), and subsequently increased during the later stage of maintenance (1000-1600ms). We suggest that reduced alpha power may be involved in focused attention during the working memory maintenance, whereas increased alpha power may reflect suppression of visual stimuli to facilitate internal processing related to the task. This interpretation is generally consistent with recent reports suggesting that variations in alpha power are associated with the representation and processing of information in the discrete time intervals during the working memory maintenance.

Medical high-resolution image sharing and electronic whiteboard system: A pure-web-based system for accessing and discussing lossless original images in telemedicine.

There are various medical image sharing and electronic whiteboard systems available for diagnosis and discussion purposes. However, most of these systems ask clients to install special software tools or web plug-ins to support whiteboard discussion, special medical image format, and customized decoding algorithm of data transmission of HRIs (high-resolution images). This limits the accessibility of the software running on different devices and operating systems. In this paper, we propose a solution based on pure web pages for medical HRIs lossless sharing and e-whiteboard discussion, and have set up a medical HRI sharing and e-whiteboard system, which has four-layered design: (1) HRIs access layer: we improved an tile-pyramid model named unbalanced ratio pyramid structure (URPS), to rapidly share lossless HRIs and to adapt to the reading habits of users; (2) format conversion layer: we designed a format conversion engine (FCE) on server side to real time convert and cache DICOM tiles which clients requesting with window-level parameters, to make browsers compatible and keep response efficiency to server-client; (3) business logic layer: we built a XML behavior relationship storage structure to store and share users' behavior, to keep real time co-browsing and discussion between clients; (4) web-user-interface layer: AJAX technology and Raphael toolkit were used to combine HTML and JavaScript to build client RIA (rich Internet application), to meet clients' desktop-like interaction on any pure webpage. This system can be used to quickly browse lossless HRIs, and support discussing and co-browsing smoothly on any web browser in a diversified network environment. The proposal methods can provide a way to share HRIs safely, and may be used in the field of regional health, telemedicine and remote education at a low cost.

Glycyrrhizic acid inhibits apoptosis and fibrosis in carbon-tetrachloride-induced rat liver injury.

AIM: To investigate anti-apoptotic effects of glycyrrhizic acid (GA) against fibrosis in carbon tetrachloride (CCl4)-induced liver injury and its contributing factors. METHODS: Liver fibrosis was induced by administration of CCl4 for 8 wk. Pathological changes in the liver of rats were examined by hematoxylin-eosin staining. Collagen fibers were detected by Sirius red staining. Hepatocyte apoptosis was determined by TUNEL assay and the expression levels of cleaved caspase-3, Bax, α-SMA, connective tissue growth factor (CTGF), matrix metalloproteinase (MMP) 2 and MMP9 proteins were evaluated by western blot analysis, and α-SMA mRNA, collagen type I and III mRNA were estimated by real-time PCR. RESULTS: Treatment with GA significantly improved the pathological changes in the liver and markedly decreased the positive area of Sirius red compared with rats in the CCl4-treated group. TUNEL assay showed that GA significantly reduced the number of TUNEL-positive cells compared with the CCl4-treated group. The expression levels of cleaved caspase-3, Bax, α-SMA, CTGF, MMP2 and MMP9 proteins, and α-SMA mRNA, collagen type I and III mRNA were also significantly reduced by GA compared with the CCl4-treated group (P < 0.05). CONCLUSION: GA treatment can ameliorate CCl4-induced liver fibrosis by inhibiting hepatocyte apoptosis and hepatic stellate cell activation.

Antitumor activity of total flavonoids from Tetrastigma hemsleyanum Diels et Gilg is associated with the inhibition of regulatory T cells in mice.

OBJECTIVE: To determine the antitumor activity of Radix tetrastigmae flavonoids and their inhibitory effect on regulatory T cells (Tregs) in mice. MATERIALS AND METHODS: Total flavonoids were isolated from Radix tetrastigmae, the root of Tetrastigma hemsleyanum Diels et Gilg, and administered to C57BL/6 mice by oral gavage after inoculation with Lewis lung carcinoma (LLC) cells. The effects of total flavonoids on tumor growth in vivo were examined. Flow cytometry was used to study the effects on Tregs, and enzyme-linked immunosorbent assay was used to analyze the changes in the serum levels of transforming growth factor ß, prostaglandin E2, and cyclooxygenase 2 after tumor inoculation and flavonoid administration. RESULTS: Total flavonoids from T. hemsleyanum Diels et Gilg significantly inhibited tumor growth in C57BL/6 mice inoculated with LLCs. These flavonoids dramatically suppressed regulatory T-cell development in tumor-bearing mice. Further studies revealed that total flavonoids significantly decreased the serum levels of transforming growth factor ß, prostaglandin E2, and cyclooxygenase 2 in tumor-bearing mice, which may be responsible for the inhibition of Tregs. CONCLUSION: The antitumor activity of total flavonoids from T. hemsleyanum Diels et Gilg is associated with the inhibition of Tregs in a mouse tumor model. Total flavonoids from T. hemsleyanum Diels et Gilg may be used as antitumor agents in cancer prevention and treatment.

[Research for transcutaneous energy transfer based on PCB coreless planar circular spiral inductor coils].

In this paper is proposed a new PCB coreless planar circular spiral inductor coils-based transcutaneous energy transfer method for use in implantable biomedical devices. Firstly, the main factor, coupling coefficient k between transmitting and receiving coils, which affected the efficiency of the energy transfer, was determined by setting up the circuit model of transcutaneous energy transfer. Then, the coupling coefficient was analyzed and calculated by using the method of equivalent circular filaments. Finally, experiments were carried out to demonstrate the feasibility of the proposed method.

[Development of practicality of EEG-based brain-computer interface].

Brain-computer interface (BCI) is a system that can create direct connection between brain activity and external devices. In the past 20 years, important' achievements of research on BCI have been made. Now there are lots of research methods based on electroencephalic signals, and researchers are trying to make the BCI system possess the characteristics of real-time and become more natural and practical. This paper presents an overview of real-time and stimulating way to EEG-based BCI research. Through the discussions on the applications of DSP in BCI system, in signal preprocessing and in algorithm optimization, the high lights in real-time research are pointed out. In the discussions about the way to produce EEG signals in BCI, the researchers suggested that the imaging movement be the most ideal way in that it will reduce the discomfort in stimulation by application of the virtual reality technology in BCI system, thus it will be conducive to improvement in the performance of BCI system.

[Research progress in a wearable life signs monitoring system for a single soldier].

Wearable monitoring technology is a hot spot in biomedical engineering and military medical devices. This paper reviews the research progress about the wearable life-sign monitoring system for a single soldier.

[Research progress in telemonitoring systems and automatic analysis methods of ambulatory ECG signals].

This paper reviews the research progress in telemonitoring systems and automatic analysis of ECG signals. The key problems, urgently to be solved, about the automatic analysis in ECG telemonitoring systems are discussed.