Undiagnosed Borrmann type IV gastric cancer despite repeated endoscopic biopsies and PET-CT examination: A case report.

Borrmann type IV gastric cancer is a particular histological type of carcinoma, which has the characteristic of diffused infiltration that invades the entire stomach, resulting in the thickening and stiffness of the stomach wall. Borrmann type IV gastric cancer is known for the difficulty of detecting tumor cells in endoscopic biopsy specimens. This is crucial in obtaining the pathological results to make a therapeutic decision. The case reported in the present study was highly suspected to be Borrmann type IV gastric cancer according to the clinical manifestations and gastrointestinal barium meal examinations, but demonstrated negative results in multiple endoscopic biopsies and positron emission tomography-computed tomography (PET-CT) examination. The patient was discharged as no affirmative diagnosis was specified. Two weeks after discharge, the patient was administered to another hospital under emergency treatment due to frequent urination. Cystoscopy examination revealed marked thickening of the right bladder wall over a large area. Biopsy specimens were sampled. Pathological consultation suggested a gastrointestinal original of the lesion, which was most likely poorly differentiated gastric adenocarcinoma with neuroendocrine metastasis to the bladder.

Gastric adenocarcinoma concurrent with paravertebral plasmacytoma: A case report.

Here, we report the case of a 77-year-old male patient who was revealed to have an unsuspected case of gastric adenocarcinoma with paravertebral plasmacytoma following biopsy. Plasmacytoma may be classified into two main groups: Multiple myeloma and plasmacytoma without marrow involvement. It comprises isolated plasmacytoma of the bone and extramedullary plasmacytoma. Extramedullary plasmacytoma (EMP) accounts for 3% of all plasmacytomas; however, ~80% are located in the upper respiratory tract and upper gastrointestinal tract. It occurs extremely rarely in paravertebral areas. Case reports of EMP and other types of malignant tumor occurring at the same time have not been identified in searches of the literature. In the present study, we describe the diagnosis and treatment process of a case of gastric adenocarcinoma concurrent with paravertebral plasmacytoma. It may be helpful for early clinical diagnosis and treatment of such cases.

[Regulatory function of Shen-reinforcing and qi-supplementing drugs on hypothalamic-pituitary-adrenal axis and interleukin-6 dysfunction in asthmatic rats].

OBJECTIVE: To evaluate the effect of Shen-reinforcing and qi-supplementing (SRQS) drugs on some ingredients of neuro-endocrine-immune (NEI) network in asthma rat model. METHODS: Asthma model was established by ovalbumin sensitization and long-term excitation. Forty healthy Brown Norway rats of clean grade were randomly divided into 4 groups by randomized digital table, the normal control group and the three treated groups treated by low, moderate and high dose of SRQS drugs respectively. Blood content of adrenocorticotrophic hormone (ACTH) was detected by RIA; interleukin-6 (IL-6) and corticosterone were determined by ELISA; and the mRNA expresion of corticosteroid release hormone (CRH) in hypothalamus was tested by Realtime-PCR. RESULTS: Eosinophile inflammation was shown in the pathology of asthma model rats, and also shown a multiple level hypothalamic-pituitary-adrenal axis (HPA axis) disorder at the repeated attack of asthma. After treatment, levels of ACTH and CRH mRNA expression in the treated groups were significantly higher than those in the control group (P <0.05), but the corticosterone only showed a rising tendency. Level of IL-6 increased during the episode, showing a significant negative correlation with ACTH (r = - 0.325, P = 0.043), and had somewhat reduction after SRQS treatment. CONCLUSION: SRQS drugs could improve the function of HPH axis independent of IL-6, suggesting that the action is possibly targeted on the neuro-endocrine axis, which might be the hypothalamus.

[Effects on herba epimedii and radix Astragali on tumor necrosis factor-alpha and nuclear factor-kappa B in asthmatic rats].

OBJECTIVE: To observe the effects of Herba Epimedii and Radix Astragali, the two Chinese herbs for replenishing Shen and strengthening qi, on tumor necrosis factor-alpha (TNF-alpha, one of the pro-inflammatory factors) and nuclear factor-kappa B (NF-kappa B) in asthmatic rats. METHODS: Rats were randomly divided into five groups: the normal saline control group, the asthma model group and the three treated groups treated with high, medium and low dose of the Chinese herbs. Serum TNF-alpha and NF-kappa B activity in pulmonary tissue were detected with enzyme-linked immunosorbent assay and immunohistochemistry respectively. RESULTS: Herba Epimedii and Radix Astragali could effectively reduce the production of TNF-alpha and inhibit NF-kappa B activity, and the efficacies in the three treated group were similar, showing insignificant difference among them. CONCLUSION: Application of Herba Epimedii and Radix Astragali in the attack or remission stage of asthma could restrain the development of inflammation by reducing the production of TNF-alpha and inhibiting NF-kappa B activity.

[Clinical study on preventive effect of fuzheng quxie granule on respiratory viral infection].

OBJECTIVE: To evaluate the effect of Fuzheng Quxie granule (FQG) on immune cells and cytokines of populations susceptible to respiratory viral infection. METHODS: One thousand four hundred and two subjects selected from 25 hospitals in Shanghai between May and June in 2003, were divided into the FQG group treated with FQG and the control group treated with placebo. Serum levels of interleukin 2 (IL-2), interleukin 4 (IL-4), gamma-interferon (gamma-IFN), blood lymphocyte subsets (CD3+ , CD4+, CD8+), B-cell count and natural killer cell (NK) percent ratio were measured in 130 of the FQG group and 120 of the control group before treatment, by the end of the 2nd week and two weeks after treatment. RESULTS: By the end of the 2nd week of treatment, as compared with before treatment, the levels of IL-2, gamma-IFN, and NK percent in the FQG group increased significantly (P < 0.05), while IL-4 and CD3+, CD4+, CD8+ and B-cell count were unchanged. Besides, levels of Th1/Th2 ratio markedly increased at the end of the 2nd week and two weeks after treatment, in comparing with that before treatment and in the control group (P<0.05). CONCLUSION: FQG could improve immune function of population susceptible to respiratory viral infection certain extent.

[Effects of fuzheng quxie granule on immune cells and cytokines in populations with respiratory viral infection].

OBJECTIVE: To investigate the effect of fuzheng quxie granule (FQG) on immune cells and cytokines in populations with respiratory viral infection. METHODS: Fifty-nine patients were randomly divided into 3 groups, that is, 19 patients treated with conventional western medicine (WM) plus FQG in the treated group, 19 patients treated with conventional western medicine alone in the WM group, and 21 patients treated with FQG alone in the TCM group. The levels of T lymphocyte subsets, interleukine-2,4,6,10 (IL-2, IL-4, IL-6, IL-10), tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (INF-gamma) and Th1/Th2 were determined before treatment, and at the end of 1st and 2nd week of treatment respectively. RESULTS: Before treatment, levels of TNF-alpha, IL-2, IL-6, IL-10 and INF-gamma in all patients were significantly higher than normal range (P < 0.05). After being treated for 1 week, the levels of serum TNF-alpha, IL-6, and IL-10 were significantly decreased in all groups (P < 0.05), serum IL-2 and INF-gamma decreased to the normal level in the WM group, but in the treated and the FQG group by the end of the 2nd week, the two indexes still remained at the rather higher level (P < 0.05). The ratio of Th1 and Th2 in the treated group and the FQG group increased significantly by the end of 2nd week, reached the level higher than that in the WM group and that before treatment (P < 0.05). No significant difference in, T lymphocytes subsets (CD3+ , CD4+ , CD8+) and percentage of B and NK cells before and after treatment was found in all the 3 groups. CONCLUSION: FQG can positively regulate the immune function of patients with respiratory tract viral infection in certain degree.

[Experimental study on prevention and treatment of bronchial asthma by compound Chinese herbal monomer recipe].

OBJECTIVE: To observe the effect of compound Chinese herbal monomer (CHM) recipe, consisted of ligustrazin (3.75 mg/kg x d), baicalin (7.5 mg/kg x d) and ginkgolide (2 mg/kg x d), on airway atopic inflammation and hyper-responsiveness in asthma. METHODS: Model guinea pigs of asthma were randomly divided into three groups, the model group, the CHM group and the cromlyn sodium (CS) group, they were treated by atomizing inhalation with normal saline, CHM and CS respectively. The eosinophil count and eosinophil cation protein (ECP) in blood and bronchial alveolar lavage fluid (BALF), and total cell count in BALF were measured and compared. And the effect of treatment on the airway hyperresponsiveness and pathology among groups were compared. RESULTS: CHM showed significant inhibition on blood eosinophil count and BALF and total cell count in BALF, showing significant difference (P < 0.05 or P < 0.01) as compared with those in the model group. The level of ECP was not different in the various groups. Airway responsiveness determination showed that CHM has significant inhibitory action on it. And the pathology of airway inflammation in the CHM group was significantly milder than that in the model group. CONCLUSION: The compound inhalation liquid consisted of ligustrazin, baicalin and ginkgolide, has the anti-asthmatic airway atopic inflammation and depression on airway hyper-responsiveness, suggesting that components of compound CHM recipe could inhibit the multiple pathogenetic asthmatic inflammation from different angles and on multiple targets, so as to cure asthma effectively.