Gastric metastasis of small cell lung carcinoma: Three case reports and review of literature.

BACKGROUND: Small cell lung carcinoma (SCLC) is highly susceptible to metastasis in the early stages of the disease. However, the stomach is an uncommon site of metastasis in SCLC, and only a few cases of this type of metastasis have been reported. Therefore, SCLC gastric metastases have not been systematically characterized and are easily missed and misdiagnosed. CASE SUMMARY: We report three cases of gastric metastasis from SCLC in this article. The first patient presented primarily with cough, hemoptysis, and epigastric fullness. The other two patients presented primarily with abdominal discomfort, epigastric distension, and pain. All patients underwent gastroscopy and imaging examinations. Meanwhile, the immunohistochemical results of the lesions in three patients were suggestive of small cell carcinoma. Finally, the three patients were diagnosed with gastric metastasis of SCLC through a comprehensive analysis. The three patients did not receive appropriate treatment and died within a short time. CONCLUSION: Here, we focused on summarizing the characteristics of gastric metastasis of SCLC to enhance clinicians' understanding of this disease.

Prolonged Longitudinal Transcutaneous Auricular Vagus Nerve Stimulation Effect on Striatal Functional Connectivity in Patients with Major Depressive Disorder.

BACKGROUND: Transcutaneous auricular vagus nerve stimulation (taVNS) is effective for treating major depressive disorder (MDD). We aimed to explore the modulating effect of prolonged longitudinal taVNS on the striatal subregions' functional connectivity (FC) in MDD patients. METHODS: Sixteen MDD patients were enrolled and treated with taVNS for 8 weeks. Sixteen healthy control subjects (HCs) were recruited without intervention. The resting-state FC (rsFC) based on striatal subregion seed points and the Hamilton Depression Scale (HAMD) were evaluated in the MDD patients and HCs at baseline and after 8 weeks. A two-way ANCOVA test was performed on each rsFC metric to obtain the (group-by-time) interactions. RESULTS: The rsFC values between the left ventral caudate (vCa) and right ventral prefrontal cortex (vPFC), and between the right nucleus accumbens (NAc) and right dorsal medial prefrontal cortex (dmPFC) and ventrolateral prefrontal cortex (vlPFC) are lower in the MDD patients compared to the HCs at baseline, and increase following taVNS; the rsFC values between the left vCa and right, superior occipital gyrus (SOG), and between the left dorsal caudate (dCa) and right cuneus are higher in MDD patients and decrease following taVNS. CONCLUSIONS: Prolonged longitudinal taVNS can modulate the striatum rsFC with the prefrontal cortex, occipital cortex, temporal cortex, and intra-striatum, and these changes partly underlie any symptomatic improvements. The results indicate that prolonged longitudinal taVNS may produce beneficial treatment effects by modulating the cortical striatum circuitry in patients with MDD.

Diffusion tensor imaging of the hippocampus reflects the severity of hippocampal injury induced by global cerebral ischemia/reperfusion injury.

At present, predicting the severity of brain injury caused by global cerebral ischemia/reperfusion injury (GCI/RI) is a clinical problem. After such an injury, clinical indicators that can directly reflect neurological dysfunction are lacking. The change in hippocampal microstructure is the key to memory formation and consolidation. Diffusion tensor imaging is a highly sensitive tool for visualizing injury to hippocampal microstructure. Although hippocampal microstructure, brain-derived neurotrophic factor (BDNF), and tropomyosin-related kinase B (TrkB) levels are closely related to nerve injury and the repair process after GCI/RI, whether these indicators can reflect the severity of such hippocampal injury remains unknown. To address this issue, we established rat models of GCI/RI using the four-vessel occlusion method. Diffusion tensor imaging parameters, BDNF, and TrkB levels were correlated with modified neurological severity scores. The results revealed that after GCI/RI, while neurological function was not related to BDNF and TrkB levels, it was related to hippocampal fractional anisotropy. These findings suggest that hippocampal fractional anisotropy can reflect the severity of hippocampal injury after global GCI/RI. The study was approved by the Institutional Animal Care and Use Committee of Capital Medical University, China (approval No. AEEI-2015-139) on November 9, 2015.

Natural product juglone targets three key enzymes from Helicobacter pylori: inhibition assay with crystal structure characterization.

AIM: To investigate the inhibition features of the natural product juglone (5- hydroxy-1,4-naphthoquinone) against the three key enzymes from Helicobacter pylori (cystathionine gamma-synthase [HpCGS], malonyl-CoA:acyl carrier protein transacylase [HpFabD], and beta-hydroxyacyl-ACP dehydratase [HpFabZ]). METHODS: An enzyme inhibition assay against HpCGS was carried out by using a continuous coupled spectrophotometric assay approach. The inhibition assay of HpFabD was performed based on the alpha-ketoglutarate dehydrogenase-coupled system, while the inhibition assay for HpFabZ was monitored by detecting the decrease in absorbance at 260 nm with crotonoyl-CoA conversion to beta -hydroxybutyryl-CoA. The juglone/FabZ complex crystal was obtained by soaking juglone into the HpFabZ crystal, and the X-ray crystal structure of the complex was analyzed by molecular replacement approach. RESULTS: Juglone was shown to potently inhibit HpCGS, HpFabD, and HpFabZ with the half maximal inhibitory concentration IC50 values of 7.0 +/-0.7, 20 +/-1, and 30 +/-4 micromol/L, respectively. An inhibition-type study indicated that juglone was a non-competitive inhibitor of HpCGS against O-succinyl- L-homoserine (Ki=alphaKi=24 micromol/L), an uncompetitive inhibitor of HpFabD against malonyl-CoA (alphaKi=7.4 micromol/L), and a competitive inhibitor of HpFabZ against crotonoyl-CoA (Ki=6.8 micromol/L). Moreover, the crystal structure of the HpFabZ/juglone complex further revealed the essential binding pattern of juglone against HpFabZ at the atomic level. CONCLUSION: HpCGS, HpFabD, and HpFabZ are potential targets of juglone.

Nine new dammarane saponins from Gynostemma pentaphyllum.

Nine new dammarane saponins, 1-9, were isolated from the MeOH extract of the aerial part of Gynostemma pentaphyllum, an edible plant of the Cucurbitaceae family, that grows wildly in China. Their structures were elucidated by 1D- and 2D-NMR analysis, as well as by chemical degradation. Aglycons 21,24-cyclopentyldammar-25-ene of 6 and 7, and 21,24-cyclopentyldammarane of 8 and 9, were novel. Compounds 1, 4, and 8 showed moderate antitumor activities against stomach cancer cells SGC-7901 and liver cancer cells BEL-7402.