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Rationale and Objectives The purpose of this study was to investigate the role of computed tomography (CT) radiomics for the prediction of the human epidermal growth factor 2 (HER2) status in patients with gastric cancer. Methods One hundred and thirty two consecutive patients with advanced gastric cancer undergoing radical gastrectomy were retrospectively reviewed. All patients received preoperative contrast CT examination, and immunohistochemistry results of their HER2 status were available. All the subjects were randomly divided into a training cohort (n = 90) and a test cohort (n = 42). Arterial phase (AP) and portal phase (PP) contrast CT images were retrieved for tumor segmentation and feature extraction. Receiver operating characteristics (ROC) curves and area under the curve (AUC) were used to evaluate the performance of the radiomics classifiers. Results Among the 132 patients, a total of 99 patients were HER2 negative, and the remaining 33 patients were border line or positive. The AP radiomics model could distinguish HER2-negative cases with an AUC of 0.756 (95% confidence interval [CI]: 0.656–0.840) in the training cohort, which was confirmed in the test cohort with AUC of 0.830 (95% CI: 0.678–0.930). The PP radiomics model showed AUCs of 0.715 (95% CI: 0.612–0.804) and 0.718 (95% CI: 0.554–0.849) in the training and test cohort for distinction of negative HER2 cases, respectively. Conclusion Radiomics models based on standard-of-care CT images hold promise for distinguishing HER2-negative gastric cancer.

Rationale and Objectives The aim of this study was to investigate the value of computed tomography (CT) radiomics for the differentiation between T2 and T3/4 stage lesions in gastric cancer. Materials and methods A total of 244 consecutive patients with pathologically proven gastric cancer were retrospectively included and split into a training cohort (171 patients) and a test cohort (73 patients). Preoperative arterial phase and portal phase contrast enhanced CT images were retrieved for tumor segmentation and feature extraction by using a dedicated postprocessing software. The random forest method was used to build the classifier models. Results The performance of single phase radiomics models were favorable in the differentiation between T2 and T3/4 stage tumors. Arterial phase-based radiomics model exhibited areas under the curve of 0.899 (95% CI: 0.812–0.955) in the training cohort and 0.825 (95% CI: 0.718–0.904) in the test cohort. Portal phase-based radiomics model showed areas under the curve of 0.843 (95% CI: 0.746–0.914) and 0.818 (95% CI: 0.711–0.899) in the training and test cohort, respectively. Conclusion CT radiomics approach has a potential role in differentiation between T2 and T3/4 stage tumors in gastric cancer.

To determine the optimal keV for the visualization of gastric cancer and to investigate its value in depicting lesions and in identifying depth invasion using virtual monoenergetic images (VMIs) on a novel dual-layer spectral detector CT.Eighty-two gastric cancer patients were retrospectively enrolled, and 41 patients who did not undergo surgery were evaluated for image quality in VMIs at different keVs (40 keV-70 keV with 10 keV increments) and in conventional 120 kVp polyenergetic images (PEIs) reconstructed from the portal venous phase. Objective image quality was assessed by the contrast-to-noise ratio of the gastric cancer, while subjective performance was compared using a 5-point Likert scale. Another 41 patients who underwent surgery were examined to compare the diagnostic performance of the VMIs taken at the optimal keV and that of the 120 kVp-PEIs.The contrast-to-noise ratio of gastric cancer at 40 keV (10.4 ± 4.6) was the highest among all the VMIs and was significantly superior to that of the 120 kVp-PEIs (3.5 ± 1.5, p0.001). Gastric-specific image quality was rated highest for the 40 keV-VMIs (4.92 ± 0.26), which was significantly superior to that of the 120 kVp-PEIs (4.15 ± 0.82, p0.001). In the diagnostic group, there were 13 pT1, 10 pT2, 9 pT3, and 9 pT4 gastric cancer patients. Compared with the 120 kVp-PEIs, the VMIs at 40 keV tended to have a higher detection rate of gastric cancer (82.9% vs. 92.7%, respectively, p = 0.125) and a significantly improved diagnostic accuracy in the T stage (from 41.5% to 78.11%, respectively) (p0.001), particularly in pT1 patients, whose diagnostic accuracy was improved by 53.8% (7.7% vs. 61.5%, respectively, p = 0.016).VMIs at 40 keV performed the best, both objectively and subjectively, for gastric cancer, leading to improved lesion depiction and higher T stage accuracy.

Objectives The influence of body composition on clinical outcomes in individuals with gastric cancer (GC) undergoing radical gastrectomy after neoadjuvant treatment (NT) remains unclear. The purpose of this retrospective study was to investigate the association between body composition before NT or after NT and clinical outcomes in individuals with GC receiving multimodal treatments. Methods This retrospective study included individuals with GC who received NT followed by radical gastrectomy between January 2016 and December 2018. Skeletal muscle, visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) were measured by cross-sectional areas at the level of third lumbar vertebra based on single-slice computed tomography scan prior to NT and prior to the surgical operation. Sarcopenia, high VAT, and high SAT were defined using cutoff points of skeletal muscle index, visceral fat area, and subcutaneous fat area. Univariate and multivariate analyses were performed to evaluate risk factors of NT-related adverse events, postoperative complications and predictors of long-term survival. Results A total of 110 individuals with GC were enrolled in this study. Sarcopenia was present in 62.7% of them before NT and in 56.4% after NT. Sarcopenia before NT was associated with more NT-related adverse events (odds ratio, 2.901; 95% confidence interval [CI], 1.205–6.983; P = 0.018). High VAT after NT (≥106 cm2) was associated with an increasing incidence of postoperative complications (odds ratio, 4.261; 95% CI, 1.332–13.632; P = 0.015). No body-composition parameter was relevant to tumor pathologic response to NT. As for long-term survival, poor overall survival was associated with both low VAT before NT ( Conclusions Body composition measured by computed tomography could predict NT-related adverse events, postoperative complications, and long-term survival in multimodal treatments for GC. More meaningfully, adipose-tissue status has significant prognostic value for individuals with advanced GC.

Gastric cancer (GC) is a prevalent malignant cancer worldwide and is highly lethal because of its fast growth. Currently, the clinical therapy options for GC remain limited. MiR-32 has been reported as an oncogenic microRNA in many cancers, but its role in GC is unclear. Here, we found that miR-32 was overexpressed in GC tissues compared with adjacent normal tissue, and miR-32 was higher in GC patients' plasma compared with healthy individuals. Furthermore, we have identified miR-32 to be oncogenic, by promoting gastric cell proliferation, migration and invasion. We also identified Kruppel-like factor 4 (KLF4) as a direct target of miR-32. Knockdown of KLF4 promoted proliferation, migration and invasion of GC cells. We conclude that miR-32 promotes GC cell proliferation, migration and invasion by targeting KLF4, suggesting that the miR-32-KLF4 pathway may be useful in clinical diagnosis and therapeutics.

OBJECTIVE: To investigate the protective effects of synbiotics on intestinal barrier function, and its priority to probiotics and prebiotics on intestinal barrier function in rat models. METHODS: We randomly divided 32 rats into four groups: control group (n = 8), probiotics group (n = 8), prebiotics group (n = 8) or synbiotics group (n = 8). All rats received cecectomy and gastrostomy, and tube feeding amoxicillin 50 mg and metronidazole 20 mg on operation day and the first operative day (POD1). After the establishment of impaired intestinal barrier model, rats in the 4 groups received intact protein enteral nutrition, intact protein enteral nutrition+ bifid-triple viable, intact protein enteral nutrition with dietary fiber, intact protein enteral nutrition with dietary fiber+ bifid-triple viable respectively. Samples of blood, urine and tissues of colonic mucose were collected on POD6. Thereafter we measured lactulose/mannitol (L/M) ratio, concentration of certain gut microflora, bacterial translocation rate, endotoxin level of portal vein serum and thickness of colonic mucose. RESULTS: Concentration of lactobacilli in probiotics group [(0.828 ± 0.366) × 107 CFU/g] and synbiotics group [(1.424 ± 0.928) × 107 CFU/g] were significantly higher than those in control group [(0.046 ± 0.037) × 107 CFU/g] and prebiotics group [(0.074 ± 0.046) × 107 CFU/g], P < 0.05. Concentration of bifidobacteria in probiotics group [(0.876 ± 0.701) × 107 CFU/g] and synbiotics group [(2.246 ± 1.112) × 107 CFU/g] were significantly higher than those in control group [(0.072 ± 0.051) × 107 CFU/g] and prebiotics group [(0.072 ± 0.051) × 107 CFU/g], P < 0.05, meanwhile concentration of bifidobacteria in synbiotics group was significantly higher than that in the probiotics group, P < 0.05. L/M ratio in synbiotics group (0.78 ± 0.43) was significantly lower than those in control group (1.45 ± 0.40), probiotics group (1.08 ± 0.22) and prebiotics group (1.35 ± 0.38), P < 0.05. Colonic mucosa thickness in synbiotics group (228.2 ± 13.9 μm) was significantly higher than those in control (198.5 ± 10.3 μm), probiotics (199.8 ± 11.8 μm) and prebiotics group (206.2 ± 11.7 μm), P < 0.01. Bacterial translocation rate in synbiotics group is significantly lower than that in control group (34.38% vs 80%, P < 0.05), but no significant difference compared to probiotics group (40.63%) and prebiotics group (53.13%) was found. CONCLUSIONS: Probiotics can improve the concentration of colonic probiotics, while synbiotics can improve probiotics concentration and mucosa thickness in colon, decrease L/M ratio and bacterial translocation. Synbiotics shows more protective effects on intestinal mucosal barrier in rats after cecectomy and gastrostomy and the intervention of specific antibiotics.

Objective Compared with soybean oil, a fish oil–enriched emulsion can improve the clinical outcomes of patients requiring parenteral nutrition. However, the superiority of fish oil emulsion to medium-chain triacylglycerols/long-chain triacylglycerols for short-term administration has seldom been discussed. Methods Sixty-four adult patients with gastrointestinal diseases were randomly assigned to receive isocaloric and isonitrogenous total parenteral nutrition with an ω-3 fatty acid–enriched emulsion (Lipoplus; study group, n = 32) or medium-chain triacylglycerols/long-chain triacylglycerols (Lipofundin; control group, n = 32) for 5 d after surgery. Safety and efficacy parameters were assessed on postoperative days 1, 3, and 6. Results Clinical outcomes including infectious complications and systemic inflammatory response syndrome were comparable between the two groups. Total bilirubin decreased over time in the study group versus an increase in the control group ( P = 0.017). Activated partial thromboplastin time in the study group was prolonged significantly compared with the control group from days 1 to 3 ( P = 0.002), although the prolongation stopped at the study termination. There were no differences in changes of C-reactive protein, interleukin (IL)-1, IL-8, IL-10, vascular endothelial growth factor (VEGF), and the distribution of the T-cell subpopulation between the two groups. However, fish oil consumption led to an increase in leukotriene B5/ leukotriene B4 and significant decreases in IL-6, tumor necrosis factor-α, and nuclear factor-κB. Furthermore, the overall changes in tumor necrosis factor-α and nuclear factor-κB were positively associated ( R 2 = 0.295, P Conclusions Gastrointestinal surgery patients benefited from a fish oil–enriched emulsion rather than medium-chain triacylglycerols/long-chain triacylglycerols in the amelioration of liver function and immune status. The positive association of tumor necrosis factor-α and nuclear factor-κB might be involved in the potential anti-inflammation mechanism of fish oil.

Background and Aims The onco-protein c-fos was previously linked to favorable prognosis of gastric cancer (GC) without further validations. The present study was designed to address the issue based on a cohort of Chinese patients. Methods Expression of c-fos was determined by immunohistochemical staining in specimens from 58 patients with GC who underwent surgical resection. The relationships between c-fos expression and clinicopathological and prognostic variables were further evaluated. Results Expression of c-fos in tumor epithelia was observed in 39 (67.2%) patients. The protein was also positively expressed in lymphocytes within tumors and para-tumor epithelia. Tumors with positive expression of c-fos in tumor epithelia had a smaller size and marginally earlier T stage in all patients and/or those who underwent curative resection. Univariate analysis showed that patients with positive c-fos expression in tumor epithelia had significantly prolonged overall and tumor-free survival. Cox regression analysis revealed that c-fos expression in tumor epithelia was an independent or potential independent indicator of improved prognosis in different subgroups of patients. Expression of c-fos in para-tumor epithelia and intra-tumor lymphocytes was not associated with clinicopathological variables and long-term outcomes in patients. Conclusions Our data demonstrated that c-fos expression was negatively associated with tumor progression and was predictive for favorable survival in patients with GC.

Background The overexpression of LAPTM4B -35 in gallbladder carcinoma (GBC) and its clinicopathologic and prognostic significance have been previously shown. Thus, this gene may play a role in the growth of GBC cells. Methods The pcDNA3-AE containing the complete open reading frame of LAPTM4B (lysosome-associated protein transmembrane-4β) and mock (pcDNA3) plasmids were transiently transfected into GBC-SD cells. Cell proliferation, cell cycle distribution, and protein expression were evaluated by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyl-tetrazolium assay, flow cytometry, and Western blot, respectively. Results Cells transfected with pcDNA3-AE revealed accelerated proliferation, less serum dependence, and significant cell cycle progression compared with cells transfected with mock plasmid and parent cells. These phenotypes were accompanied by upregulated expression of C-myc, c-Fos, c-Jun, cyclin D1, and cyclin E and downregulated expression of P16 and P-27. Conclusions LAPTM4B overexpression promotes the growth of GBC cells in vitro by regulating the expression levels of some proliferation-associated proteins. Therefore, the LAPTM4B gene might be used as a novel therapeutic target of GBC.

Objective To explore the mechanism of acupuncture for delaying aging. Methods Using the senescence accelerated mouse pattern SAMP10 and the normal aging mice SAMR1 as models and applying RT-PCR and digoxin (DIG)-labeled Northern blot technique to observe expressions of NF-E2, YB-1, LRG47 genes in the forebrain, cortex and hippocampus in a 8-month old SAMR1 control group, a 8-month old SAMP10 control group, a 8-month old SAMP10 acupuncture group and a 8-month old SAMP10 non-point stimulation group. Results In the SAMP10 control group, the expressions of NF-E2, YB-1 and LRG47 were down-regulated in the forebrain, cortex and hippocampus, and after acupuncture they were up-regulated and tended to normal. Conclusion The brain aging of the SAMP10 mice is related with abnormal expressions of NF-E2, YB-1 and LRG47 genes; and acupuncture can regulate the expressions of NF-E2, YB-1 and LRG47 genes, strengthening the functions of erythrocyte series, increasing the proliferation of cells and enhancing the cellular immune function in anti-bacteria, hence delaying aging.

LAPTM4B was proven to overexpress in hepatocellular carcinoma and relate to differentiation. We immunohistochemically investigated the expression and potential clinicopathological and prognostic significance of LAPTM4B encoded protein, LAPTM4B-35, in extrahepatic cholangiocarcinoma (EHCC) for specimens from consecutive 81 patients. LAPTM4B-35 staining was positive in cancer tissues from 59 patients (72.8%), including 12 with score 1, 22 with score 2 and 25 with score 3. No positive staining was found in non-cancer epithelia. The staining score in cancer tissues was not only significantly associated with TNM staging, histological grade, perineural and lymph node invasion (P < 0.05), but also of comprehensive prognostic implications, including integrated estimation with CA19-9. These data established that LAPTM4B-35 positively expressed in a great portion of EHCC and might be a novel molecular maker of progression, invasiveness and poor prognosis.