Effects of Huaier Extract on Ameliorating Colitis-Associated Colorectal Tumorigenesis in Mice.

BACKGROUND: Huaier extract has been a part of traditional Chinese medicine (TCM) for roughly 1600 years and may serve as a potential anti-cancer drug as it is associated with good efficacy and low toxicity. Individuals with inflammatory bowel disease (IBD) are at a higher chance of being diagnosed with colorectal cancer (CRC) and as Huaier extract may potentially influence tumorigenesis, we set out to determine the effect of Huaier extract on colitis-associated CRC. METHODS: The CRC mouse model, established through azoxymethane (AOM) and dextran sulfate sodium (DSS), was administered Huaier extract. Weight loss, colon length, tumor number and tumor size were evaluated macroscopically. Pro-inflammatory cytokine expression and STAT3 phosphorylation were assessed in the colon using ELISA, Western blot and/or immunohistochemistry. RESULTS: Huaier extract improved the severity of colitis-associated tumorigenesis compared with control group, with attenuated weight loss and longer colons. Tumor number, size and load were drastically decreased in mice treated with Huaier. Histological assessment suggested that Huaier could decrease histological injury of the colon tissue. Additionally, Huaier extract treatment led to reduced pro-inflammatory cytokine levels (TNF-α, IL-6, IFN-γ and IL-1ß) and a decrease of STAT3 phosphorylation in colon tissue. Additionally, present findings demonstrated that Huaier extract inhibited cell proliferation and induced apoptosis in CRC cells HCT116 and HCT8. The migration and invasion of CRC cells were markedly inhibited upon exposure to Huaier treatment. The apoptosis-associated protein levels (P53, Bax, Bcl-2, pro-caspase-3 and cleavage caspase-3) showed significant differences after the administration of Huaier extract in HCT116 and HCT8 cells. In vivo, the administration of Huaier extract to mice inhibited tumor growth and yielded a similar profile of apoptotic proteins expression p53, Bcl-2, pro-caspase-3 and cleaved caspase-3 while no significant differences in Bax were observed. Moreover, the ratio of TUNEL-positive/apoptotic cells was markedly increased in the Huaier-treated mice. CONCLUSION: Huaier extract may reduce the IBD-associated tumor development by suppressing pro-inflammatory cytokine levels and STAT3 stimulation.

Misdiagnosis of Intrahepatic Biliary Cystadenoma Located in the Caudate Lobe: A Case Report.

BACKGROUND: Intrahepatic Biliary Cystadenoma (IBC) is rare but has a high incidence of misdiagnosis, especially for experienceless surgeons. CASE: We report a case of IBC located in the caudate lobe and described a typical procedure of misdiagnosing this disease. Finally, the patient was successfully cured, but the procedure of misdiagnosis should attract attention. IBC and atypical biopsy for histological examination are the most important causes of misdiagnosis. Recurrent cystic lesions of the liver and repeated increases in CA 19-9 may suggest a "liver cyst", which is a misdiagnosis. CONCLUSION: The experience and lessons of misdiagnosis, in this case, may help other clinicians diagnose the rare disease accurately.

Gastric fistula secondary to drainage tube penetration: A report of a rare case.

Cases of gastric fistula secondary to drainage tube penetration have rarely been reported. The current study presents a case of gastric penetration caused by misplacement of a drainage tube after a splenectomy. The patient was admitted to the Department of Hepatobiliary Surgery, (Shaoxing People's Hospital, Shaoxing Hospital of Zhejiang University, Shaoxing, Zhejiang, China) for blunt abdominal trauma due to injuries sustained in an automobile accident. A ruptured spleen was found and successfully removed surgically. On post-operative day 7, the patient complained of slight discomfort and tenderness in the left upper quadrant of the abdomen. In addition, 500 ml of bile-colored fluid with small food particles was noted in the drainage tube. Barium X-ray revealed a gastric fistula in the upper gastrointestinal tract. Gastroscopy indicated infiltration of the drainage tube into the gastric cavity. No significant peritoneal effusion was observed, as revealed by abdominal ultrasound examination. These results confirmed the diagnosis of a gastric fistula secondary to perforation by the drainage tube. Following conservative treatment with antibiotics and total parenteral nutrition, the general condition of the patient improved significantly. The drainage tube was withdrawn progressively, as the amount of fluid being discharged was decreasing. Gastroenterography confirmed perforation closure and the tube was finally removed on post-operative day 44.

A huge adenosquamous carcinoma of the pancreas with sarcomatoid change: an unusual case report.

Adenosquamous carcinoma rarely occurs in the pancreas, and is characterized by the presence of cellular components from both duct adenocarcinoma and squamous carcinoma. Here, we describe a rare case of pancreatic adenosquamous carcinoma with sarcomatous change. Immunohistochemistry showed that the sarcomatous lesion lost the epithelial marker and aberrantly expressed of acquired mesenchymal markers, which indicated that this special histological phenotype may be attributed to epithelial-mesenchymal transition. This case also indicated that a routine radical surgery without aggressive treatment strategies was still appropriate for adenosquamous carcinoma of the pancreas with sarcomatoid change.

[Clinical monitoring of tissue oxygen pressure on acupoint Zusanli (ST36) of patients in critical condition].

OBJECTIVE: To observe the local tissue oxygenation in acupoint Zusanli (ST36) of patients in critical condition, and to assess the value of applying tissue oxygen measurement via acupoint in clinical practice. METHODS: Thirty-six patients with severe illness undergoing invasive positive pressure ventilation (IPPV) were divided into the infected group (n=13) and the non-infected group (n=23). Tissue oxygen pressure (PtO2) in the right acupoint Zusanli was measured with tissue oxygen tension detector when the concentration of inspired oxygen (FiO2) was 40% and 100% respectively, meanwhile, the arterial blood oxygen pressure (PaO2) was also determined to calculate PtO2 index (the ratio of PtO2/PaO2). RESULTS: There was a positive correlation between PtO2 and PaO2 (P < 0.05); PaO2 in the infected group was lower, and PtO2 index and PtO2 were higher significantly, as compared with those in the non-infected group (all P < 0.05). As FiO2 adjusted from 40% to 100%, the increment of PtO2 in the infected group was significantly higher than that in the non-infected group (P < 0.05). CONCLUSION: For the severely infected patients with obstacle of systemic oxygen delivery, the local tissue oxygen demand of acupoints increases significantly, and the tissue oxygen delivery dependence is enhanced, in this time, the tissue might fulfill the oxygen demand itself through elevating PtO2 index. It is of great significance to monitor tissue oxygen pressure in acupoint to determine the state of local tissue oxygenation in critically illed patients.