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Skin photoaging is exogenous aging caused by long-term ultraviolet radiation, which not only affects skin appearance, but also has a close relationship with the development of skin cancer. Saponins, flavonoids, polyphenols, polysaccharides, and extracts of Chinese medicine have been found to have anti-skin photoaging effects in recent studies. Various mechanisms such as anti-oxidative stress damage, inhibition of matrix metalloproteinase expression, promotion of collagen synthesis, inhibition of inflammatory response, DNA damage repair, enhancement of cell autophagy, and inhibition of melanin synthesis can improve the symptoms of skin photoaging and delay the photoaging process. With the active ingredients of Chinese medicine for anti-skin photoaging as the entry point, the study systematically discussed the research progress of the mechanisms underlying the anti-photoaging effects of active ingredients of Chinese medicine in recent years, in order to provide theoretical reference for the development of new anti-photoaging drugs and methods.

An analytical method for the detection of glucose in human exhaled breath by non-invasive condensation collection coupled with ion chromatography was developed. A self-designed exhaled breath condensation device was constructed, through which human exhaled breath was condensed and collected. And the glucose in collected human exhaled breath condensate (EBC) was analyzed by ion chromatography with a pulsed amperometric instrument. The standard EBC collection method was established, and the key factors such as cooling temperature and sampling flow rate during condensation collection were investigated deeply, and a good linear correlation between blood glucose levels and exhaled breath glucose levels was obtained. The intra-day precision was 3.37%, and the inter-day precision was 3.83%. Furthermore, EBC from healthy people and diabetic patients was collected in fasting state and after meal. We found the breath glucose level in healthy volunteers was 0.11-2.34 ng/L and that in diabetic patients was 0.23-135.92 ng/L. In after meal samples, the breath glucose level is 10-100 times higher than that of healthy subjects, which offering the prospect of a non-invasive approach to the monitoring of diabetes.

Background Suprapancreatic lymphadenectomy is the essence of D2 radical gastric cancer surgery. The present study aimed to describe clockwise modularized laparoscopic lymphadenectomy in the suprapancreatic area. Methods The data from gastric cancer patients who underwent surgical treatment from September 2016 to December 2018 were collected. Patients were divided into clockwise modularized lymphadenectomy (CML) and traditional open gastrectomy (OG) groups according to the surgical treatment strategy. The propensity score matching method was utilized to balance the baseline characteristics between the two groups. Results Finally, 551 gastric cancer patients were included in the present study. Following propensity score matching, 106 pairs of patients in the CML group and OG group were included in the final analysis. The CML group had more total examined lymph nodes (36, IQR 28–44.74 vs. 29, IQR 29–39.5, p = 0.002) and no. 9 station nodes (2, IQR 1–5 vs. 2, IQR 1–3, p = 0.007) than the OG group. There was less intraoperative blood loss (30, IQR 20–80 ml vs. 80, IQR 50–80 ml, p p p = 0.591) and postoperative hospital stay (8, IQR 7–9 days vs. 8, IQR 7–9 days, p = 0.452) were comparable between the CML and OG groups. Conclusion Laparoscopic lymphadenectomy for gastric cancer surgery is technically demanding. Clockwise modularized laparoscopic lymphadenectomy in the suprapancreatic area can attain similar effects as traditional open surgery and without an increase in postoperative adverse events.

Glycosidic linkage structure, physical-chemical properties and in vitro digestibility of pyrodextrins prepared using different reaction conditions were characterized. Intensification of reaction condition promoted starch hydrolysis and transglucosidation until the solubility of pyrodextrin reached 100%. New branch points were formed including α-1,2, β-1,2, β-1,4, β-1,6 and α-1,6 linkages. Majority of the branch points was α-1,6 and β-1,6 linkages which in together accounted for more than 70% of the total branches. The degree of branching increased at intensified reaction conditions and plateaued at approximately 24%. Exhaustively hydrolyzing pyrodextrin by α-amylase and amyloglucosidase significantly decreased the degree of α-1,4 but not α-1,6 linkages. The retained α-1,4 and α-1,6 linkages were probably protected from enzyme hydrolysis by the non-starch linkages due to steric hindrance. The resistant starch content was positively correlated with the degree of branching of pyrodextrin. The decreased in vitro digestibility of pyrodextrin was attributed to the formation of new glycosidic linkages.

A new and recyclable protocol was developed for Pd(OAc) 2 -catalyzed the cross-coupling reaction of terminal alkynes with arylboronic acids using environmentally friendly H 2 O/TBAB as reaction medium. A series of cross-coupling products containing internal acetylenic bond can be obtained with good selectivity and yield. The Pd(OAc) 2 /H 2 O/TBAB system was stable in the Sonogashira-type cross-coupling reaction and could be used at least three cycles without considerable decrease in catalytic performance. The results suggest that the unsupported and recyclable systems can be extended to the other realm of C C bond formation in synthetic organic chemistry.

The role of extranodal metastasis (ENM) in TNM stage in gastric carcinoma (GC) is controversial. This study was aimed to make a detailed investigation of the prognostic significance and the role in TNM stage of ENM in GC. The patients with primary GC, who underwent gastrectomy with curative intention in West China Hospital from January 2005 to December 2011, were retrospectively enrolled. The prognosis and clinicopathological traits were compared between ENM positive (ENMP) and negative (ENMN) groups in all patients, TNM I-II, III and IV stages, respectively. The significance of the number and the role in TNM stage of ENM were also assessed. In our study, 1457 patients were enrolled, with 1324 (90.9%) in ENMN group and 133 (9.1%) in ENMP group. ENMP group had significantly more advanced GC and worse prognosis (all p2 subgroup had remarkably larger tumor size (p=0.002) and more advanced N stage (p=0.016) than ENM=1-2 subgroup. The number of ENM was an independent prognostic factor in ENMP group (p=0.029). The prognosis of ENM>2 in TNM I-III stages was significantly worse than ENMN patients in TNM III stage. The C-index of TNM stage plus the number of ENM was significantly higher than that of current TNM stage alone (p=0.005). In conclusion, the patients in ENMP subgroup had more advanced GC and worse prognosis than those in ENMN subgroup. It might be more reasonable to categorize ENM>2 into TNM IV stage.

// Lin-Yong Zhao 1,2,3,* , Xiao-Long Chen 1,2,* , Yi-Gao Wang 1,2,3,* , Yue Xin 3 , Wei-Han Zhang 1,2,3 , Yin-Su Wang 3 , Xin-Zu Chen 1,2 , Kun Yang 1,2 , Kai Liu 1,2 , Lian Xue 1,2,3 , Bo Zhang 1 , Zhi-Xin Chen 1 , Jia-Ping Chen 1 , Zong-Guang Zhou 1 and Jian-Kun Hu 1,2 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, China 2 Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, Chengdu, China 3 West China School of Medicine, Sichuan University, Chengdu, China * These authors have contributed equally to this work Correspondence to: Jian-Kun Hu, email: // Keywords : predictive model; gastric cancer; tumor size; lymphovascular invasion; lymph nodes count Received : February 15, 2016 Accepted : July 18, 2016 Published : August 04, 2016 Abstract Background: Various factors may affect the clinical prognosis of lymph node-negative gastric cancer (GC) patients. This study aimed to provide evaluable prognostic information of combination of tumor size (Ts), lymph nodes count (LNs) and lymphovascular invasion (LVI) in lymph node-negative GC patients. Methods: A total of 1,019 node-negative GC patients were enrolled in this retrospective study from 2000 to 2010. The cutoff points of Ts and LNs were determined using X-tile and patients were randomly categorized into training and validation sets by the sample size ratio 1:1. The clinicopathologic characteristics were analyzed and survival prognostic factors were identified, whereas the survival prediction accuracy was also compared by C-index during the different independent prognostic factors. Results: The cutoff points for Ts were 3cm and 5cm, while 14 was the cutoff point for LNs. Age, T stage, Ts, LNs and LVI were identified as independent prognostic factors in node-negative GC patients, and a new prognostic predictive model, TsNL staging system which was composed of Ts, LNs and LVI, was proposed in this study. Compared with T staging system, significant improvement of predictive accuracy for TsNL system was found. Furthermore, nomogram based on TsNL was more accurate in prognostic prediction than that based on Ts, LNs and LVI, separately. Conclusions: Age, T stage, Ts, LNs and LVI were independent prognostic factors in lymph node-negative GC patients. The TsNL staging system, composed of Ts, LNs and LVI, which was closely associated with clinicopathologic features, may improve the prognostic prediction accuracy in node-negative GC patients.

// Lin-Yong Zhao 1, 2, 3, * , Yuan Yin 1, * , Xue Li 3 , Chen-Jing Zhu 3 , Yi-Gao Wang 1, 2, 3 , Xiao-Long Chen 1, 2 , Wei-Han Zhang 1, 2, 3 , Xin-Zu Chen 1, 2 , Kun Yang 1, 2 , Kai Liu 1, 2, 3 , Bo Zhang 1 , Zhi-Xin Chen 1 , Jia-Ping Chen 1 , Zong-Guang Zhou 1 , Jian-Kun Hu 1, 2 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, China 2 Laboratory of Gastric Cancer, State Key Laboratory of Biotherapy/Collaborative Innovation Center of Biotherapy, West China Hospital, Sichuan University, China 3 West China School of Medicine, Sichuan University, China * These authors have contributed equally to this work Correspondence to: Jian-Kun Hu, email: hujkwch@126.com Keywords: early gastric cancer, nomogram, lymph node metastasis, prediction, tumor markers Received: April 12, 2016 Accepted: July 10, 2016 Published: July 20, 2016 ABSTRACT Predicting lymph node metastasis (LNM) accurately is of great importance to formulate optimal treatment strategies preoperatively for patients with early gastric cancer (EGC). This study aimed to explore risk factors that predict the presence of LNM in EGC. A total of 697 patients underwent gastrectomy enrolled in this study, were divided into training and validation set, and the relationship between LNM and other clinicopathologic features, preoperative serum combined tumor markers (CEA, CA19-9, CA125) were evaluated. Risk factors for LNM were identified using logistic regression analysis, and a nomogram was created by R program to predict the possibility of LNM in training set, while receiver operating characteristic (ROC) analysis was applied to assess the predictive value of the nomogram model in validation set. Consequently, LNM was significantly associated with tumor size, macroscopic type, differentiation type, ulcerative findings, lymphovascular invasion, depth of invasion and combined tumor marker. In multivariate logistic regression analysis, factors including of tumor size, differentiation type, ulcerative findings, lymphovascular invasion, depth of invasion and combined tumor marker were demonstrated to be independent risk factors for LNM. Moreover, a predictive nomogram with these independent factors for LNM in EGC patients was constructed, and ROC curve demonstrated a good discrimination ability with the AUC of 0.847 (95% CI: 0.789-0.923), which was significantly larger than those produced in previous studies. Therefore, including of these tumor markers which could be convenient and feasible to obtain from the serum preoperatively, the nomogram could effectively predict the incidence of LNM for EGC patients.

This study aimed to evaluate the prognostic significance of node ratio (Nr), the ratio of metastatic to retrieved lymph nodes, and to investigate whether a modified staging system based on Nr can improve prognostic ability for gastric cancer patients following gastrectomy. A total of 2572 patients were randomly divided into training set and validation set, and the cutoff points for Nr were produced using X-tile. The relationships between Nr and other clinicopathologic factors were analyzed, while survival prognostic discriminatory ability and accuracy were compared among different staging systems by AIC and C-index in R program. Patients were categorized into four groups as follows: Nr0, Nr1: 0.00-0.15, Nr2: 0.15-0.40 and Nr3: > 0.40. Nr was significantly associated with clinicopathologic factors including macroscopic type, tumor differentiation, lymphovascular invasion, perineural invasion, tumor size, T stage, N stage and TNM stage. Besides, for all patients, Nr and TNrM staging system showed a smaller AIC and a larger C-index than that of N and TNM staging system, respectively. Moreover, in subgroup analysis for patients with retrieved lymph nodes < 15, Nr was demonstrated to have a smaller AIC and a larger C-index than N staging system. Furthermore, in validation analysis, Nr, categorized by our cutoff points, showed a larger C-index and a smaller AIC value than those produced in previous studies. Nr could be considered as a reliable prognostic factor, even in patients with insufficient (< 15) retrieved lymph nodes, and TNrM staging system may improve the prognostic discriminatory ability and accuracy for gastric cancer patients undergoing radical gastrectomy.

Capillary invasion (CI) has been found to play an important role in metastasis and recurrence of gastric adenocarcinoma (GAC). However, the prognostic significance of CI is still controversial. From January 2005 to December 2011, 1398 patients with GAC who underwent gastrectomy were retrospectively enrolled and divided into CI (+) and CI (−) groups. Clinicopathological features and survival outcomes were compared between these groups. In our study, 227 (16.2%) patients were CI (+). Patients with CI (+) had significantly more advanced tumors and worse prognosis than those with CI (−) (p < 0.001). CI was demonstrated as an independent prognostic factor (p = 0.023) in patients with GAC. When stratified by TNM stage, the prognosis of CI (+) group in stage III was remarkably worse than CI (−) group (p = 0.006), while the differences were not significant in stage I–II and stage IV (both p > 0.05). The nomograms indicated that CI was part of the individual prognostic prediction system. The predictive accuracy of CI and other characteristics was better than TNM alone (p < 0.001). Our finding suggested that CI was an independent prognostic factor in patients with GAC, and the nomogram based on CI and other clinicopathological factors was a valuable and accurate tool in individual prognostic prediction.

Background. The impact of perioperative blood transfusion on the prognosis of gastric adenocarcinoma patients is still controversial. The aim of this study was to elucidate the impact of perioperative blood transfusion on postoperative complications and prognosis of patients who underwent gastrectomy for gastric adenocarcinoma with different levels of preoperative hemoglobin value (POHb).Method. From 2003 to 2011, 1199 patients who underwent curative gastrectomy were retrospectively enrolled and followed up to December 2014. Clinicopathological features and survival outcomes were compared between transfused and nontransfused patients.Results. In this study, transfused patients had more postoperative complications than nontransfused ones (P=0.002). In survival analysis, the difference was not significant between transfused and nontransfused patients with POHb between 70 and 100 g/L (P=0.191). However, in patients with POHb >100 g/L, transfused patients had significantly worse prognosis (P<0.001), especially in TNM III stage patients (P=0.002). And intraoperative blood transfusion predicted poor prognosis (P=0.001).Conclusion. Perioperative blood transfusion might lead to poor survival in gastric adenocarcinoma patients with POHb >100 g/L and transfused patients had more postoperative complications; thus it is better to refrain from unnecessary perioperative blood transfusion especially intraoperative transfusion.

Gastric and esophageal cancers are 2 of the most common malignancies in the world. More than 70% of gastric cancer cases and deaths occur in developing countries, and most occur in Eastern Asia.1 There have been distinct changes in the incidences of cancer at different anatomical subsites of the stomach in Western countries.2–4 Many population-based studies showed that the incidence rates of adenocarcinoma of the esophagus and esophagogastric junction (EGJ) were increased in Western countries and Asian countries, such as Japan and Korea.2–8 Although squamous cell carcinoma of the esophagus is still predominant, more than half of newly diagnosed tumors are adenocarcinoma of distal esophagus and EGJ in Western countries and Japan.2–4,6 Incidence of adenocarcinoma at the upper third of the stomach and EGJ has increased over the past 2 decades, with a rate which has exceeded that at any other site of stomach.2,4 In contrast, incidence of adenocarcinoma at distal stomach has gradually declined over the past 50 years.3 However, investigations on changes of esophagogastric junction adenocarcinoma (EGJA) in China remains sparse. Gastroesophageal reflux disease (GERD) was one of the most common gastrointestinal diseases in Europe and the United States with prevalence rates of 10% to 25% in population-based studies.9,10 Reports from many other regions have also demonstrated an increase in the prevalence of GERD.11,12 Some of those with GERD may develop Barrett esophagus, which can lead to esophageal adenocarcinoma. In addition, the prevalence of GERD was also found to be closely associated with the risk of EGJA in some Asian countries.13 Patients with Barrett esophagus need more intensive screening and surveillance for EGJA. Therefore, it is necessary to understand the changes of GERD and EGJA in China over time. However, there were rare reports that simultaneously assessed the trends of EGJA and GERD in China over time. A study by Zhou et al14 showed that there was an increasing trend of gastric cardia cancer over a 12-year period in a northwest province of China. With the increasing acceptance of Siewert's definition of EGJA, more and more researchers have studied this kind of clinicopathological entity.15 However, there have been few investigations into the change over time of 3 subtypes of EGJA in China. The volume of surgeries done for gastric and esophageal cancers at our institution is large, and the sources of patients come from the Western China, which may serve as a reference for a large population-based study. In this study, we aimed to evaluate the changes of clinicopathological features and surgical treatment of EGJA on the basis of the Siewert classification16 and the prevalence of GERD among the surgical patients with EGJA in a high-volume Chinese hospital during 1988–2012.

Objective To compare the survival outcomes of transabdominal (TA) and transthoracic (TT) surgical approaches in patients with Siewert-II/III esophagogastric junction adenocarcinoma. Methods This retrospective study was conducted in patients with Siewert-II/III esophagogastric junction adenocarcinoma who underwent either TT or TA operations in the West China Hospital between January 2006 and December 2009. Results A total of 308 patients (109 in the TT and 199 in the TA groups) were included in this study with a follow-up rate of 87.3%. The median (P25, P75) number of harvested perigastric lymph nodes was 8 (5, 10) in the TT group and 23 (16, 34) in the TA group (P

Nutritional and immune status is important to the prognosis of patients with gastric carcinoma (GC). Here, we evaluated the prognostic significance of the combination of preoperative hemoglobin, albumin, lymphocyte and platelet (HALP) in patients with GC. From January 2005 to December 2011, 1332 patients with GC who underwent gastrectomy were randomly divided into the training (n = 888) and the validation sets (n = 444) by X-tile according to the sample size ratio 2:1. The cut-point of HALP was 56.8 and the patients were subsequently subdivided into HALP < 56.8 and HALP ≥ 56.8 groups in both two sets. Multivariate analysis revealed that gender (p < 0.001, p < 0.001), tumor size (p = 0.003, p = 0.035) and T stage (p < 0.001, p = 0.044) were independently related to HALP both in the training and the validation sets. Kaplan-Meier (p < 0.001, p = 0.003) and Cox regression (p = 0.043, p = 0.042) showed that the prognosis of HALP ≥ 56.8 group was significantly better than that of HALP < 56.8 group both in two sets (p < 0.001, p < 0.001). Nomograms of these two sets based on HALP were more accurate in prognostic prediction than TNM stage alone. Our findings suggested that HALP was closely associated with clinicopathological features and was an independent prognostic factor in GC patients. Nomogram based on HALP could accurately predict the prognosis of GC patients.

Whey protein is associated with improvement of metabolic syndrome. This study aimed to evaluate effects of whey protein on atherosclerosis in ApoE

The prognosis of remnant gastric cancer (RGC) is significantly poor. However, the mechanism and some clinical features of RGC have not been fully understood and are still under debate.From January 2000 to January 2014, 90 RGC patients were enrolled in this retrospective study. Patients were divided into two groups according to primary disease. Clinicopathological features and survival outcomes were compared between two groups.A total of 34 (37.8%) patients were diagnosed with remnant gastric cancer following benign disease (RGCB) and 56 (62.2%) were diagnosed with remnant gastric cancer following malignant disease (RGCM). The mean time interval from the primary operation to the development of RGC was 12.5 ± 13.3 years in all RGC patients. The mean time interval in RGCB was significantly longer than that in RGCM (P 0.01). The 1-, 2-, and 3- year overall survival rates of all patients were 56.1%, 38.2% and 33.2%, respectively. Univariate analysis indicated that tumor size, curability, histology type, serosa invasion, nodal involvement and distant metastasis were prognostic factors for RGC. The multivariate Cox regression analysis revealed that distant metastasis was an independent prognostic factor for RGC.RGC occurred earlier in patients with gastrectomy for primary malignant disease than for primary benign disease, even though the primary disease made no difference to the survival of RGC. Nonetheless, RGC patients experienced dismal overall survival. Therefore, early diagnosis plays a significant role in successfully carrying out curative resection and improving the prognosis for RGC.

// Chaoyong Shen 1, * , Haining Chen 1, * , Yuan Yin 1 , Jiaju Chen 1 , Luyin Han 2 , Bo Zhang 1 , Zhixin Chen 1 , Jiaping Chen 1 1 Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China 2 Intensive Care Unit, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China * These authors have contributed equally to this work Correspondence to: Bo Zhang, e-mail: hxwcwk@126.com Keywords: gastrointestinal stromal tumors, synchronous neoplasm, digestive tract malignancies, elderly Received: December 07, 2014 Accepted: January 08, 2015 Published: February 27, 2015 ABSTRACT Background/Aims Elderly patients with gastrointestinal stromal tumors (GISTs) synchronous with other digestive tract malignancies have been rarely reported. In this study, clinicopathological characteristics were evaluated among elderly patients with GISTs with or without coexisting digestive tract malignancies. Methods A total of 161 patients (≥65 years) were retrospectively reviewed at the West China Hospital, Sichuan University from January 2009 to June 2014. Results Sixty-one patients were diagnosed with synchronous digestive tract malignancies (synchronous group), whereas 100 patients were diagnosed with no synchronous condition (no-synchronous group). The synchronous group exhibited a higher percentage of males (70.49% vs. 53.00%, P = 0.028) and poorer Eastern Cooperative Oncology Group performance status than the no-synchronous group ( P = 0.029). The three-year overall survival (OS) rate was significantly lower among patients with synchronous digestive tract malignancies than that among patients without synchronous condition (64.5% vs. 84.0%, P = 0.003). Multivariate analysis showed that the presence of synchronous digestive tract malignancies ( P = 0.002), co-morbidity ( P = 0.004), and mitotic count ≥10 mitoses/50 high power fields ( P = 0.012) were associated with poor OS. Conclusions A synchronous condition with other digestive tract malignancies is common in elderly patients with GISTs. OS primarily depends on synchronous digestive tract malignancies, mitotic count, and co-morbidity.

The objective of this study is to quantitatively analyze the predictive strength among the conventional serological tumor biomarkers for gastric cancer in Chinese population. Thirty-three hospital-based case-control studies were searched out through Chinese databases and PubMed during 1999-2009. Gastric cancer cases and healthy volunteers or benign gastric diseases controls were detected of any of serological CA724, CA242, CEA, CA199, CA125, or CA153. Areas under the curve (AUC) and optimal Q indexes of summary receiver operating characteristics (sROC) curves were quantitatively compared. The summary positive and negative likelihood ratios (sLR + and sLR-) were pooled. Totally, 2,390 gastric cancer cases and 2,893 controls were analyzed. CA724 and CA242 both had the greatest AUCs (0.88), respectively, followed by the combination CA724 + CEA + CA199 (0.85), CA125 (0.82), CEA (0.80), and CA199 (0.76), but all of them had no statistical significance to CA153 (negative control) by Z tests, possibly due to relatively great standard errors. The results of Q index analyses were similar to those of AUCs, that CA724 and CA242 had the optimal strength. The sLR + of CA724 (16.08, 95 % confidence interval (CI) 7.86-32.86) or CA242 (11.03, 95 % CI 7.12-17.08) was strong to judge the gastric cancer status based on its positive result. The combination of CA724 + CEA + CA199 had the prior sLR- (0.33, 95 % CI 0.25-0.43) to the others. Serological CA724 or CA242 has predictive effect for screening gastric cancer and can be recommended into the screening program of population-based or symptomatic cases. However, prospective epidemiological studies are required before confirmative conclusion.

The hypersensitive response (HR) is one of the most-efficient forms of plant defense against biotrophic pathogens. However, the molecular mechanisms leading to HR remain largely unknown. A putative hypersensitive-induced response (HIR) protein gene TaHIR4 cDNA (919 bp) and a DNA sequence (2520 bp) including at least five exons were isolated and identified from wheat. Phylogenetic analysis showed that TaHIR4 was highly homologous to HvHIR4 from barley at both the cDNA and deduced amino-acid levels. Reverse transcription quantitative polymerase chain reaction (qRT-PCR) results showed that TaHIR4 transcripts were highly upregulated by infection of the leaf rust pathogen and expressed in all tested samples except the mature seeds. Western blotting results also showed that TaHIR4 protein was upregulated in wheat leaves infected with the leaf rust pathogen. Characterization and expression profiles at the gene and protein levels suggested that TaHIR4 plays a role in wheat HR, caused by the leaf rust pat...

Facing with the high incidence rate and the poor outcomes of the postoperative pulmonary complications (PPCs), we sought to evaluate potential risk factors for developing the PPCs of gastric cancer patients.Retrospective study was carried out to analyze consecutive gastric cancer patients who had a preoperative pulmonary function test and underwent gastrectomy in the West China Hospital (January, 2000 - December, 2009). Potential risk factors to the development of the PPCs and the survival outcomes of these patients were also analyzed.Totally, one hundred and twenty four patients (18.1%) were developed the PPCs after gastrectomy. For the development of the PPCs, univariate analysis identified the following risk factors is associated with the development of the PPCs: age ≥ 70 years (p0.001); male patients (p = 0.041); FEV1/FVC60 (p0.001); with the history of pulmonary disease (p0.001); hemoglobin90g/L (p = 0.025); serum albumin35g/L (p = 0.002); combined organoectomy (p = 0.036). Multivariate analysis identified FEV1/FVC60 (p = 0.004); with the history of pulmonary disease (p0.002); serum albumin35g/L (p = 0.004) were risk factors for the incidence of the PPCs.For the early detection of the PPCs, extra attention should be paid to those gastric cancer patients with FEV1/FVC60; history of pulmonary disease and .serum albumin35g/L.

Hypersensitive-induced reaction (HIR) proteins and more specific members of the proliferation, ion and death superfamily participate in response to pathogen attacks and development of spontaneous hypersensitive lesions in maize and barley leaves. In the present study, a full-length TaHIR3 (1,246-bp) was cloned and characterized from wheat near-isogenic line Thatcher-Lr15 infected by Puccinia triticina isolate 05-19-43② through a homology cloning strategy. A 4,203-bp sequence of TaHIR3 including five exons was also obtained from wheat Thatcher-Lr15 genomic DNA. TaHIR3 shared higher similarity with HIR3 isolated from wheat, barley, and maize. Gene expression of TaHIR3 was spatially measured in young wheat leaves, young roots, young stems, mature seeds, and temporally in wheat leaves inoculated with virulent and avirulent P. triticina. TaHIR3 was expressed in all samples except mature seeds and was upregulated in both combinations. More transcripts accumulated in the incompatible than compatible combination, implying a role in wheat growth and resistance to pathogens attack. A polyclonal antibody was prepared with recombinant protein purified from a prokaryotic expression system with the open reading frame of TaHIR3, and it detected the target protein in wheat leaves by Western blotting. Detection results at the protein level also showed that TaHIR3 was upregulated expression in wheat leaves infected with the leaf rust pathogen. Characterization of TaHIR3 and its expression profiles at the DNA and protein levels suggest that TaHIR3 and its deduced protein play a role in wheat HR causing by the leaf rust pathogen.

Hypersensitive induced reaction (HIR) protein had been reported to play roles in plant resisting biotic and abiotic stress. In this study, a full length cDNA TaHIR2 , encoding a 284- amino-acid protein with deduced MW of 31.34 kDa and predicted pI of 5.42, was cloned and identified from wheat leaves infected by leaf rust pathogen. The amino acid sequence deduced from TaHIR2 shared 99% homology with HvHIR2 from barley and contained prohibitins-domain which is a member of SPFH protein domain. Temporal expression profiles indicated that the TaHIR2 transcripts in the incompatible and compatible interactions begun to increase at 18 h post-inoculation (hpi), and reached the maximum at 36 hpi, then declined, but the relative expression of TaHIR2 transcripts in the incompatible interaction was 4.11 and 1.32 times higher than that in compatible one at 24 and 36 hpi, respectively. The accumulation of TaHIR2 transcript was the highest in wheat leaf. Furthermore, Western blot showed that the maximum accumulation of the TaHIR2 at the protein level occurred at 60 and 96 hpi in the incompatible and compatible interactions, respectively. Based on the above results, we primarily concluded that a novel TaHIR2 gene was successfully cloned from wheat and may play a role in wheat resistant to the leaf rust pathogen.

Serum tumor biomarker carbohydrate antigen 724 (CA724) is noticeable for gastric cancer. Correlation between CA724 and gastric cancer was investigated based on Chinese population. Chinese Biomedical Database, Chinese Journal Full-text Database and PubMed were searched. Gastric cancer patients were proven by biopsy, and control included health volunteers or benign gastric diseases. Participants received at least one test of CA724, CA125, CA153, CA199, CA242 or CEA. Meta-analysis, summary ROC (SROC) and post hoc analysis were performed by RevMan 5.0 and SPSS 11.5. Totally, 33 eligible studies were analyzed. Meta-analysis showed CA724 had the highest odds ratio 32.86 compared to control, orderly followed by CA242, CA199, CEA, CA125 and CA153. Accumulated accuracy rate of CA724 was 77 %, superior to others. In SROC analysis, specificity of all studies was above 0.70, but sensitivity of few studies was above 0.70; CA724 was selected as the preferable single test, followed by CA242, CA199, CEA, CA125 and CA153. If threshold of both specificity and sensitivity up to 0.70, CA153 was unacceptable; if up to 0.80, only CA724 and CA242 were considerable. In CA724-combined patterns, CA724+CEA+CA199 combination performed best by increasing sensitivity to 0.74 without impairing specificity, while CA724 + CA199 pattern was not a proper combination. CA724 was the most correlative serum tumor biomarker for gastric cancer in Chinese population. Sensitivity of serum CA724 is limited, but CA724+CEA+CA199 combination is considerable to improve sensitivity without impairing specificity.

The clinical prognostic significance of tumor size (Ts) in gastric cancer remains under debate. This study aims to evaluate the prognostic value of Ts in gastric cancer patients undergoing gastrectomy. A total of 2405 patients with gastric cancer, all having received radical resection, were enrolled in this retrospective study from 2000 to 2011. Patients were categorized by minimum P value from log-rank χ2 statistics using X-tile. The relationships between Ts and other clinicopathologic characteristics were analyzed, and the survival prediction accuracy was also compared between Ts and T stage. Patients were divided into 5 groups, according to which Ts stage and TsNM stage system were proposed. Ts, an independent prognostic factor identified by univariate and multivariate survival analysis, was significantly associated with sex, age, tumor location, macroscopic type, tumor diffferentiation, vessel invasion, perineural invasion, T stage, N stage, and TNM stage. Compared with T stage system, Ts stage system was found no superiorities in survival prediction. However, for patients with lymph node metastasis and patients with age ≥60, Ts stage system revealed a significant improvement of predictive accuracy in subgroup survival analysis. Furthermore, TsNM stage (c-index = 0.783) system was found to be superior to TNM stage (c-index = 0.743) system in prognostic prediction accuracy (P

This study aimed to investigate the impact of body mass index (BMI) on the short-term and long-term results of a large cohort of gastric cancer (GC) patients undergoing gastrectomy. Recently, the “obesity paradox” has been proposed, referring to the paradoxically “better” outcomes of overweight and obese patients compared with nonoverweight patients. The associations between BMI and surgical outcomes among patients with GC remain controversial. A single-institution cohort of 1249 GC patients undergoing gastrectomy between 2000 and 2010 were categorized to low-BMI (

The prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma (GC) has been widely reported and is still under debate. Here, we evaluated the prognostic significance of preoperative serum CA125, CA19-9 and CEA in patients with GC. 1692 patients with GC who underwent gastrectomy were divided into the training (from January 2005 to December 2011, n = 1024) and the validation (from January 2012 to December 2013, n = 668) cohorts. Positive groups of CA125 (> 13.72 U/ml), CA19-9 (> 23.36 U/ml) and CEA (> 4.28 ng/ml) were significantly associated with more advanced clinicopathological traits and worse outcomes than that of negative groups (all P < 0.01). In Cox regression analysis, tumor size (P < 0.001, P = 0.005), pTNM stage (P < 0.001, P < 0.001) and CA125 (P = 0.026, P = 0.005) were independent prognostic factors both in two cohorts. Nomograms of these two cohorts based on the number of positive serum tumor markers (NPTM) were more accurate in prognostic prediction than TNM stage alone. Our findings suggested that elevated preoperative serum CA125, CA19-9 and CEA were associated with more advanced clinicopathological traits and less favorable outcomes. In addition, CA125 as an independent prognostic factor should be further investigated. Nomogram based on NPTM could accurately predict the prognosis of GC patients.

Objective: To compare the perioperative systemic immunity of laparoscopy-assisted and open radical gastrectomy for gastric cancer. Methods: Patients with gastric adenocarcinoma proven by endoscopy and biopsy were eligible, while patients with preoperative staging of T4, N2–3, or M1 were excluded. Eligible patients willing to undertake laparoscopic surgery in the consecutive cohort were assigned to the laparoscopy-assisted gastrectomy (LAG) group, while concurrent patients were assigned to the conventional open gastrectomy (OG) group. All operations were performed with the intention of radical resection. Various immunological parameters were tested in peripheral venous blood collected at preoperative 1st day and postoperative 2nd day (POD2) and 7th day (POD7). SPSS 13.0 software was used for statistical analysis. Results: Thirty patients were included, 15 each in the LAG and OG groups. The general characteristics and short-term outcomes (harvested lymph nodes number, hospital stay, complications, and mortality rate) of the two groups were comparable, but the operation time was significantly longer in LAG (P = 0.001). Moreover, intergroup comparisons indicated no significant differences between the groups in levels of neutrophils, T-lymphocytes, natural killer cells, IgG, IgM, IgA, C3, C4, interleukin-6, or interleukin-10 at any time point (P > 0.05). However, there was a gradual decrease in natural killer cell count in the LAG group up to POD7 (P = 0.008). Conclusion: The changes in systemic immunity markers were comparable between laparoscopy-assisted and open gastrectomy for gastric cancer. However, there was a trend of suppression of natural killer cells in the laparoscopy-assisted gastrectomy group.

(1) Background: Dietary fiber intake may provide beneficial effects on the components of metabolic syndrome (MetS); however, observational studies reported inconsistent results for the relationship between dietary fiber intake and MetS risk. We conducted a meta-analysis to quantify previous observational studies and a narrative review to summarize mechanisms involved in the potential relationship. (2) Methods: The literature was searched on PubMed and Web of Science until 28 November 2017. A random-effects model was used to calculate the summary risk estimates. Eleven cross-sectional studies and three cohort studies were included in the meta-analysis. Results from the original studies were reported as odds ratios (ORs) or relative ratios (RRs) of the MetS associated with different levels of dietary fiber intake, and the ORs/RRs comparing the highest with lowest categories of the intake were pooled. (3) Results: For the cross-sectional studies, the pooled OR was 0.70 (95% confidence interval (CI): 0.61–0.82) with evidence of high heterogeneity (I2 = 74.4%, p < 0.001) and publication bias (p for Egger’s test < 0.001). After removing four studies, results remained significant (OR = 0.67, 95% CI: 0.58–0.78) and the heterogeneity was largely reduced (I2 = 32.4%, p = 0.181). For the cohort studies, the pooled RR was 0.86 (95% CI: 0.70–1.06). (4) Conclusion: Although the meta-analysis suggests an inverse association between dietary fiber intake and risk of MetS, and the association was supported by a wide range of mechanism studies, the findings are limited by insufficient cohort data. More prospective studies are needed to further verify the association between dietary fiber intake and the risk of MetS.

This article presents a watermarking algorithm based on one-dimensional (1-D) chaotic map in wavelet transform (WT) domain. Traditional encryption and watermarking technologies in the WT domain are combined in this algorithm. First, the watermark is encoded by a chaotic sequence, which is generated by a key. On the basis of human visual system (HVS), it is then divided into two parts and embedded into the low- and intermediate-frequency bands of three-layer WT domain. The encryption of the watermark and the choice of embedded areas based on the perceptivity not only confer the watermark with good invisibility but also with good robustness. Meanwhile, it is difficult to decrypt the watermark extracted from the WT domain.

Background Duodenal gastrointestinal stromal tumors (DGIST) are rare, and data on their management is limited. We here report the clinicopathological characteristics, different surgical treatments, and long-term prognosis of DGIST. Methods Data of 74 consecutive patients with DGIST in a single institution from June 2000 to June 2014 were retrospectively analyzed. The overall survival (OS) and recurrence/metastasis-free survival rates of 74 cases were calculated using Kaplan–Meier method. Results Out of 74 cases, 42 cases were female (56.76 %) and 32 cases (43.24 %) were male. Approximately 22.97, 47.30, 16.22, and 13.51 % of the tumors originated in the first to fourth portion of the duodenum, respectively, with a tumor size of 5.08 ± 2.90 cm. Patients presented with gastrointestinal bleeding (n = 37, 50.00 %), abdominal pain (n = 25, 33.78 %), mass (n = 5, 6.76 %), and others (n = 7, 9.76 %). A total of 18 patients (24.3 %) underwent wedge resection (WR); 39 patients (52.7 %) underwent segmental resection (SR); and 17 cases (23 %) underwent pancreaticoduodenectomy (PD). The median follow-up was 56 months (1–159 months); 19 patients (25.68 %) experienced tumor recurrence or metastasis, and 14 cases (18.92 %) died. The 1-, 3-, and 5-year recurrence/metastasis-free survival rates were 93.9, 73.7, and 69 %, respectively. The 1-, 3- and 5-year OS were 100, 92.5, and 86 %, respectively. The recurrence/metastasis-free survival rate in the PD group within 5 years was lower than that in the WR group (P = 0.047), but was not different from that in the SR group (P = 0.060). No statistically significant difference was found among the three operation types (P = 0.294). Conclusions DGIST patients have favorable prognosis after complete tumor removal, and surgical procedures should be determined by the DGIST tumor location and size.

To study the safety and survival outcome of surgical management for elderly gastric cancer patients.Patients proven of gastric cancer who aged 80 years during November 2002 to July 2011 were retrospectively analyzed. The detailed information of patients' characteristics and surgical management was retrieved. Follow-up of overall survival status was performed to analyze the surgical effectiveness.Totally, 92 (48 in surgery and 44 in non-surgery group) out of 187 eligible patients recorded adequate information and analyzed finally. Median ages were 81 years in surgery group and 83 year in non-surgery group. There were 34 patients undergone radical gastrectomy, 6 palliative gastrectomy, 1 gastrojejunostomy and 7 exploratory laparotomy. Median follow-up durations were 25 (9-111) and 28 (8-114) months in surgery and non-surgery groups, respectively (p = 0.797). Clinical-pathological T stage was 6 T1, 5 T2, 14 T3 and 23 T4 cases for surgery and 7 T1, 6 T2, 3 T3, 7 T4 and 21 TX cases for non-surgery. Clinical-pathological node status was 18 N0, 7 N1, 6 N2, 7 N3 and 10 NX cases for surgery and 10 N0, 3 N1, 3 N2, 3 N3 and 25 NX cases for non-surgery. Clinical-pathological distal metastasis status was 15 and 26 M1 cases for surgery and non-surgery, respectively (p = 0.006). Incidence of postoperative complications was 25.0% and postoperative hospital mortality was 2.1%. The 2-year survival rates were 30.8% and 8.0% for surgery and none-surgery, respectively (HR = 3.023, p = 0.001), and the 3-year survival rates were 17.6% and 0% for surgery and non-surgery, respectively (HR = 3.680, p = 0.001). In M0 subgroup, 2-year survival rate was 35.7% and 0.0% for surgery and non-surgery groups, respectively (HR = 3.98, p = 0.022).The safety of surgery for well-selected ≥ 80-year elderly gastric cancer patients was potentially acceptable and the patients of early or locally advanced diseases could obtain survival benefits by surgery.

Compare the postoperative quality of life between the anastomosis of anterior gastric wall to the esophagus (AGE) and posterior gastric wall to the esophagus (PGE) for gastric tube reconstruction of proximal gastrectomy.Retrospectively matched-pair study collected patients who underwent anterior and posterior gastric wall anastomosis to the esophagus after proximal gastrectomy. Surgical related parameters and postoperative 3-month, 6-month, 9-month, 12-month quality of life were according to EORTC QLQ-C30 and EORTC QLQ-STO22 questionnaires during the out-patient visit.Eleven pair cases included in the study and finished postoperative quality of life evaluation. General characteristics, such as age, surgical duration, blood loss, postoperative complications existed no significant difference between the two groups. The AEG reconstruction existed advantage in the pain scale (EORTC QLQ-C30 and EORTC QLQ-STO22) and reflux symptom scale (EORTC QLQ-STO22) at the 3-month postoperative evaluation. However, there was no difference between the two groups in the assessment of quality of life in the postoperative 6-month, 9-month, 12-month.Although there were some subtle differences between the two reconstruction methods. Both of these two reconstruction methods can as a selection of gastric tube reconstruction. Further study and other reconstruction method are expected for the proximal gastrectomy.

Background Primary gastric adenosquamous carcinoma (ASC) is a rare subset of ASC. This study aims to investigate the clinicopathological features, diagnosis, treatment, and outcomes of primary gastric ASC. Methods The medical records of 13 consecutive patients with primary gastric ASC between January 2010 and July 2014 from a single institutional database were reviewed. Results Male predominance was observed (M/F = 10/3) among the patients, and their median age was 62 years (range: 43 to 79 years). The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm). Ten patients underwent radical resections (R0 resection, 76.9%), while three patients had palliative resections (R1/R2 resection, 23.1%). Twelve patients had lymph node metastasis at the time of surgery. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components. In terms of the TNM staging system, stages IIB, IIIA, IIIB, IIIC, and IV were detected in 2 (15.4%), 2 (15.4%), 1 (7.7%), 5 (38.5%), and 3 (23.1%) patients, respectively. The median follow-up period was 22 months (range: 5 to 52 months); during which, four patients were still alive and eight patients died because of tumor progression. The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively. Conclusions Primary gastric ASC has a very poor prognosis, and both squamous cell carcinoma and adenocarcinoma components have distant metastasis potential.

Endoscopic resection has been performed to treat small gastric neoplasms. However, this technique for small gastric gastrointestinal stromal tumors (GISTs) remains controversial. This study aims to compare the safety and surgical outcomes of endoscopic versus open resection of small gastric GISTs. The medical records of 54 consecutive gastric GISTs patients with tumor size of ≤2 cm, who were surgically treated with endoscopic resection (endoscopic group) or open surgery (laparotomy group) in a single institution from March 2010 to June 2014, were retrospectively analyzed. The clinical and tumor characteristics, surgical safety, and tumor-related outcomes were evaluated. Of 54 patients, 32 and 22 patients underwent endoscopic resection and laparotomy, respectively. Patients who underwent endoscopic resection yielded a significantly shorter hospital stay compared with patients who underwent laparotomy (P

The aim of this study was to investigate the association of human epidermal growth factor receptor 2 (HER2) expression with clinicopathological characteristics of resectable gastric cancer patients.A total of 394 stage I-III surgical gastric cancer patients who were detected of immunohistochemical (IHC) HER2 expression postoperatively were included in this retrospective study. Association of IHC HER2 over-expression (3+) rate with clinicopathological characteristics was tested by univariate and multivariate analyses.IHC HER2 over-expression rate was 5.1% (95% CI 3.1%-7.7%). By univariate analyses, none of the clinicopathological characteristics was associated with the IHC HER2 over-expression compared to negative expression (0/1+) (p0.05), with the exception of a higher rate (12.2%) of IHC HER2 (3+) in moderate differentiation subset (p=0.02). However, the multivariate analyses didn’t selected any characteristic as an independent risk factor of IHC HER2 over-expression or the combination of IHC HER2 (2/3+).IHC HER2 over-expression rate is relatively low among stage I-III gastric cancer patients, and might be generally not associated with clinicopathological characteristics.