New genetic insights into immunotherapy outcomes in gastric cancer via single-cell RNA sequencing and random forest model.

OBJECTIVE: The high mortality rate of gastric cancer, traditionally managed through surgery, underscores the urgent need for advanced therapeutic strategies. Despite advancements in treatment modalities, outcomes remain suboptimal, necessitating the identification of novel biomarkers to predict sensitivity to immunotherapy. This study focuses on utilizing single-cell sequencing for gene identification and developing a random forest model to predict immunotherapy sensitivity in gastric cancer patients. METHODS: Differentially expressed genes were identified using single-cell RNA sequencing (scRNA-seq) and gene set enrichment analysis (GESA). A random forest model was constructed based on these genes, and its effectiveness was validated through prognostic analysis. Further, analyses of immune cell infiltration, immune checkpoints, and the random forest model provided deeper insights. RESULTS: High METTL1 expression was found to correlate with improved survival rates in gastric cancer patients (P = 0.042), and the random forest model, based on METTL1 and associated prognostic genes, achieved a significant predictive performance (AUC = 0.863). It showed associations with various immune cell types and negative correlations with CTLA4 and PDCD1 immune checkpoints. Experiments in vitro and in vivo demonstrated that METTL1 enhances gastric cancer cell activity by suppressing T cell proliferation and upregulating CTLA4 and PDCD1. CONCLUSION: The random forest model, based on scRNA-seq, shows high predictive value for survival and immunotherapy sensitivity in gastric cancer patients. This study underscores the potential of METTL1 as a biomarker in enhancing the efficacy of gastric cancer immunotherapy.

Combined dilute alkali and milling process enhances the functionality and gut microbiota fermentability of insoluble corn fiber.

In this study, we developed a process combining dilute alkali (NaOH or NaHCO3) and physical (disk milling and/or ball milling) treatments to improve the functionality and fermentability of corn fiber. The results showed that combining chemical with physical processes greatly improved the functionality and fermentability of corn fiber. Corn fiber treated with NaOH followed by disk milling (NaOH-DM-CF) had the highest water retention (19.5 g/g), water swelling (38.8 mL/g), and oil holding (15.5 g/g) capacities. Moreover, NaOH-DM-CF produced the largest amount (42.9 mM) of short-chain fatty acid (SCFA) during the 24-hr in vitro fermentation using porcine fecal inoculum. In addition, in vitro fermentation of NaOH-DM-CF led to a targeted microbial shifting to Prevotella (genus level), aligning with a higher fraction of propionic acid. The outstanding functionality and fermentability of NaOH-DM-CF were attributed to its thin and loose structure, decreased ester linkages and acetyl groups, and enriched structural carbohydrate exposure.

Clostridium perfringens Liver Abscess Disguised as Biliary Disease: A Report of Two Cases and a Review of the Literature.

Liver abscesses caused by Clostridium perfringens are rare but rapidly fatal. In only a few days, patients progress from liver abscess to sepsis, intravascular hemolysis, multiple organ failure, and even death. These abscesses often occur in patients after trauma or surgery or in those with immunodeficiency. Because patients only show non-specific symptoms such as fever and abdominal pain in the early stage, they can easily be misdiagnosed and miss the therapeutic window, resulting in a poor prognosis. The diagnosis of Clostridium perfringens liver abscess mainly depends on computed tomography (CT), needle aspiration, and/or blood culture. After diagnosis, treatments such as antibiotic therapy, surgical abscess drainage, blood transfusion as needed, and correction of metabolic disturbances must be immediately administered to prevent severe complications. Here, we present two cases of liver abscess due to Clostridium perfringens infection. Both patients initially presented only with fever, abdominal pain, and jaundice, symptoms that were easily confused with cholangitis caused by cholelithiasis. The patients then progressed rapidly and, despite receiving antimicrobial and multimodal sepsis treatment, both eventually died of multiple organ dysfunction syndrome. Clinicians should be on high alert for Clostridium perfringens liver abscesses disguised as biliary disease. Early diagnosis and treatment with the appropriate antibiotics and surgery are fundamental for the survival of the affected patients.

Safety and immunogenicity of inactivated SARS-CoV-2 vaccines in people with gastrointestinal cancer.

OBJECTIVES: This study aimed to evaluate the safety and immunogenicity of inactivated COVID-19 vaccines in patients with gastrointestinal cancer (GI) cancer. The role of memory B cells (MBCs) in the humoral response to COVID-19 vaccination was also investigated. METHODS: In this prospective observational study, GI cancer patients and healthy individuals who had received 2 doses of inactivated COVID-19 vaccines were included. The data regarding adverse effects, serum anti-receptor binding domain (RBD)-IgG, neutralizing antibodies (NAbs), and frequencies of MBCs were collected prospectively. RESULTS: The inactivated COVID-19 vaccines were safe and well tolerated. Serum anti-RBG-IgG and NAbs were lower for cancer patients. Old age, high ASA score, and receiving active chemotherapy were risk factors for lower antibody titers. The frequencies of activated and resting MBCs decreased in (17.45% vs 38.11%, P = 0.002; 16.98% vs 34.13%, P = 0.023), while the frequencies of intermediate and atypical MBCs increased in cancer patients (40.06% vs 19.87%, P = 0.010; 25.47% vs 16.61%, P = 0.025). The serum antibody titer decreased gradually during follow-up but increased when a booster vaccine was given. CONCLUSION: The inactivated COVID-19 vaccines were well tolerated in patients with GI cancer but with lower immunogenicity. The subpopulations of MBCs were disordered in cancer patients, and a booster vaccine may be prioritized for them.

Genome-Wide Association Study and Genomic Selection for Proteinogenic Methionine in Soybean Seeds.

Soybean [Glycine max (L.) Merr.] seeds have an amino acid profile that provides excellent viability as a food and feed protein source. However, low concentrations of an essential amino acid, methionine, limit the nutritional utility of soybean protein. The objectives of this study were to identify genomic associations and evaluate the potential for genomic selection (GS) for methionine content in soybean seeds. We performed a genome-wide association study (GWAS) that utilized 311 soybean accessions from maturity groups IV and V grown in three locations in 2018 and 2019. A total of 35,570 single nucleotide polymorphisms (SNPs) were used to identify genomic associations with proteinogenic methionine content that was quantified by high-performance liquid chromatography (HPLC). Across four environments, 23 novel SNPs were identified as being associated with methionine content. The strongest associations were found on chromosomes 3 (ss715586112, ss715586120, ss715586126, ss715586203, and ss715586204), 8 (ss715599541 and ss715599547) and 16 (ss715625009). Several gene models were recognized within proximity to these SNPs, such as a leucine-rich repeat protein kinase and a serine/threonine protein kinase. Identification of these linked SNPs should help soybean breeders to improve protein quality in soybean seeds. GS was evaluated using k-fold cross validation within each environment with two SNP sets, the complete 35,570 set and a subset of 248 SNPs determined to be associated with methionine through GWAS. Average prediction accuracy (r 2) was highest using the SNP subset ranging from 0.45 to 0.62, which was a significant improvement from the complete set accuracy that ranged from 0.03 to 0.27. This indicated that GS utilizing a significant subset of SNPs may be a viable tool for soybean breeders seeking to improve methionine content.

Conversion of Food Waste into 2,3-Butanediol via Thermophilic Fermentation: Effects of Carbohydrate Content and Nutrient Supplementation.

Fermentation of food waste into 2,3-butanediol (2,3-BDO), a high-value chemical, is environmentally sustainable and an inexpensive method to recycle waste. Compared to traditional mesophilic fermentation, thermophilic fermentation can inhibit the growth of contaminant bacteria, thereby improving the success of food waste fermentation. However, the effects of sugar and nutrient concentrations in thermophilic food waste fermentations are currently unclear. Here, we investigated the effects of sugar and nutrients (yeast extract (YE) and peptone) concentrations on 2,3-BDO production from fermenting glucose and food waste media using the newly isolated thermophilic Bacillus licheniformis YNP5-TSU. When glucose media was used, fermentation was greatly affected by sugar and nutrient concentrations: excessive glucose (>70 g/L) slowed down the fermentation and low nutrients (2 g/L YE and 1 g/L peptone) caused fermentation failure. However, when food waste media were used with low nutrient addition, the bacteria consumed all 57.8 g/L sugars within 24 h and produced 24.2 g/L 2,3-BDO, equivalent to a fermentation yield of 0.42 g/g. An increase in initial sugar content (72.9 g/L) led to a higher 2,3-BDO titer of 36.7 g/L with a nearly theoretical yield of 0.47 g/g. These findings may provide fundamental knowledge for designing cost-effective food waste fermentation to produce 2,3-BDO.

Physical and chemical properties of edamame during bean development and application of spectroscopy-based machine learning methods to predict optimal harvest time.

This study aims to investigate the changes in physical and chemical properties of edamame during bean development and apply a spectroscopy-based machine learning (ML) technique to determine optimal harvest time. The edamame harvested at R5 (beginning seed), R6 (full seed), and R7 (beginning maturity) growth stages were characterized for physical and chemical properties, and pods were measured for spectral reflectance (360-740 nm) using a handheld spectrophotometer. The samples were categorized into 'early', 'ready', and 'late' based on the characterized properties. The results showed that pod/bean weight and pod thickness peaked at R6 and remained stable thereafter. Sugar, starch, alanine, and glycine also peaked at R6 but proceeded to decline. The ML method (random forest classification) using pods' spectral reflectance had a high accuracy of 0.95 for classifying 'early' and 'late' samples and 0.87 for classifying 'early' and 'ready' samples. Therefore, this method can determine the optimal harvest time of edamame.

Genome-wide association analysis of sucrose and alanine contents in edamame beans.

The sucrose and Alanine (Ala) content in edamame beans significantly impacts the sweetness flavor of edamame-derived products as an important attribute to consumers' acceptance. Unlike grain-type soybeans, edamame beans are harvested as fresh beans at the R6 to R7 growth stages when beans are filled 80-90% of the pod capacity. The genetic basis of sucrose and Ala contents in fresh edamame beans may differ from those in dry seeds. To date, there is no report on the genetic basis of sucrose and Ala contents in the edamame beans. In this study, a genome-wide association study was conducted to identify single nucleotide polymorphisms (SNPs) related to sucrose and Ala levels in edamame beans using an association mapping panel of 189 edamame accessions genotyped with a SoySNP50K BeadChip. A total of 43 and 25 SNPs was associated with sucrose content and Ala content in the edamame beans, respectively. Four genes (Glyma.10g270800, Glyma.08g137500, Glyma.10g268500, and Glyma.18g193600) with known effects on the process of sucrose biosynthesis and 37 novel sucrose-related genes were characterized. Three genes (Gm17g070500, Glyma.14g201100 and Glyma.18g269600) with likely relevant effects in regulating Ala content and 22 novel Ala-related genes were identified. In addition, by summarizing the phenotypic data of edamame beans from three locations in two years, three PI accessions (PI 532469, PI 243551, and PI 407748) were selected as the high sucrose and high Ala parental lines for the perspective breeding of sweet edamame varieties. Thus, the beneficial alleles, candidate genes, and selected PI accessions identified in this study will be fundamental to develop edamame varieties with improved consumers' acceptance, and eventually promote edamame production as a specialty crop in the United States.

Complexing hemp seed protein with pectin for improved emulsion stability.

Hemp seed protein has the potential to be used in food systems as an emulsifying agent; however, there are still some shortcomings associated with hemp seed protein, such as poor solubility and tendency to aggregate. This study aims to improve the dispersibility of hemp seed protein as an emulsifier by complexing with pectin, driven by electrostatic force. Three protein to pectin ratios were used for complexation, from 1:1, 2:1 to 4:1. The complexation improved the polydispersity of hemp seed protein when dispersed in the aqueous phase. The hemp seed protein displayed multimodal size distribution in water at pH = 3.0 due to aggregation, while the incorporation of pectin helped to diminish those aggregated proteins. When the hemp seed protein was used to stabilize the oil-in-water emulsion, its stabilized emulsion showed promising homogenous droplet size distribution after emulsification. However, during the accelerated storage conditions (55°C), the emulsion stabilized solely by hemp seed protein was subjected to extensive coalescence. From day 0 to 9, the droplet size (d4,3 ) increased by 50 folds from 3.215 to 161.6 µm. In contrast, the hemp seed protein-pectin complex exhibited extraordinary stability during the storage test, where size evolution in all three samples was negligible compared to the emulsion stabilized by hemp seed protein. Rheological characterization suggests that pectin provided physical strength, which may help the emulsion droplets to maintain structural integrity under environmental stress. The underlying mechanism could be associated with the formation of a three-dimensional structure by pectin through bridging adjacent emulsion droplets. PRACTICAL APPLICATION: Hemp seed protein is gaining more and more attention as an emerging plant protein. Recently, hemp seed protein has been explored as an emulsifier, but its stabilized emulsion encounters instability issues during storage. Our study suggests pectin could be used as a co-stabilizer for hemp seed protein emulsions.

Effectiveness of Chinese herbal medicine combined with Western medicine on deferring dialysis initiation for nondialysis chronic kidney disease stage 5 patients: a multicenter prospective nonrandomized controlled study.

BACKGROUND: In clinical practice, Chinese herbal medicine (CHM) purportedly has beneficial therapeutic effects for chronic kidney disease (CKD), which include delaying disease progression and dialysis initiation. However, there is a lack of high-quality evidence-based results to support this. Therefore, this study aimed to evaluate the efficacy of CHM combined with Western medicine in the treatment of stage 5 CKD. METHODS: This was a prospective nonrandomized controlled study. Stage 5 CKD (nondialysis) patients were recruited form 29 AAA class hospitals across China from July 2014 to April 2019. According to doctors' advice and the patients' wishes, patients were assigned to the CHM group (Western medicine + CHM) and the non-CHM group (Western medicine). Patient demographic data, primary disease, blood pressure, Chinese and Western medical drugs, clinical test results, and time of dialysis initiation were collected during follow-up. RESULTS: A total of 908 patients were recruited in this study, and 814 patients were finally included for further analysis, including 747 patients in the CHM group and 67 patients in the non-CHM group. 482 patients in the CHM group and 52 patients in the non-CHM group initiated dialysis. The median time of initiating dialysis was 9 (7.90, 10.10) and 3 (0.98,5.02) months in the CHM group and non-CHM group, respectively. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis [adjusted hazard ratio (aHR): 0.38; 95% confidence interval (CI): 0.28, 0.53] compared to those in the non-CHM group. After 1:2 matching, the outcomes of 160 patients were analyzed. The multivariate Cox regression analysis showed that patients in the CHM group had a significantly lower risk of dialysis (aHR: 0.32; 95% CI: 0.21, 0.48) compared to patients in the non-CHM group. Also, the Kaplan-Meier analysis demonstrated that the cumulative incidence of dialysis in the CHM group was significantly lower than that in the non-CHM group (log-rank test, P<0.001) before and after matching. CONCLUSIONS: This study suggest that the combination of CHM and Western medicine could effectively reduce the incidence of dialysis and delay the time of dialysis initiation in stage 5 CKD patients.

Non-sterile fermentation of food waste using thermophilic and alkaliphilic Bacillus licheniformis YNP5-TSU for 2,3-butanediol production.

Conversion of food waste into 2,3-butanediol (2,3-BDO) via microbial fermentation provides a promising way to reduce waste disposal to landfills and produce sustainable chemicals. However, sterilization of food waste, an energy- and capital-costly process, is generally required before fermentation to avoid any contamination, which reduces the energy net output and economic feasibility of food waste fermentation. In this study, we investigated the non-sterile fermentation of food waste to produce 2,3-BDO using a newly isolated thermophilic and alkaliphilic B. licheniformis YNP5-TSU. Three unitary food waste samples (i.e., pepper, pineapple, cabbage wastes) and one miscellaneous food waste mixture were respectively inoculated with B. licheniformis YNP5-TSU under non-sterile conditions. At 50 °C and an initial pH of 9.0, B. licheniformis YNP5-TSU was able to consume all sugars in food waste and produce 5.2, 5.9, 5.9 and 4.3 g/L of 2,3-BDO within 24 h from pepper, pineapple, cabbage and miscellaneous wastes, respectively, corresponding to a yield of 0.40, 0.38, 0.41 and 0.41 g 2,3-BDO/g sugar. These 2,3-BDO concentrations and yields from the non-sterile fermentations were comparable to those from the traditional sterile fermentations, which produced 4.0-6.8 g/L of 2,3-BDO with yields of 0.31-0.48 g 2,3-BDO/g sugar. Moreover, B. licheniformis was able to ferment various food wastes (pepper, pineapple and miscellaneous wastes) without any external nutrient addition and produce similar 2,3-BDO quantities. The non-sterile fermentation of food waste using novel thermophilic and alkaliphilic B. licheniformis YNP5-TSU provides a robust and energy-efficient approach to convert food waste to high-value chemicals.

The Long Non-Coding RNA NEAT1 Promotes Gastric Cancer Cell Proliferation and Invasion by Regulating miR-103a/ STAMBPL1 Axis.

BACKGROUND: Gastric cancer (GC) is a common malignancy with high morbidity. Long non-coding RNAs (LncRNAs) have been demonstrated to be critical post-transcriptional regulators in tumorigenesis. This study aimed to investigate the effect of LncRNA NEAT1 on the proliferation and metastasis of GC. MATERIAL AND METHODS: The expression of LncRNA NEAT1 was examined in clinical samples and GC cell lines. GC cell lines (SGC-7901 and BGC-823) and human normal gastric epithelial cell line (GES-1) were employed. The correlation between NEAT1, miR-103a and STAMBPL1 was determined by luciferase reporter assay. Cell viability was determined by CCK8 assay. Cell invasion capacity was examined by Transwell assay. The protein level of STAMBPL1 was analyzed by western blotting. RESULTS: LncRNA NEAT1 was found to be up-regulated in GC cell lines. Further studies identified LncRNA NEAT1 as a direct target of miR-103a. Moreover, NEAT1 knockdown and miR-103a overexpression inhibited cell proliferation and cell invasion. NEAT1 knockdown and miR-103a overexpression also decreased STAMBPL1 levels. CONCLUSION: Our study indicated that LncRNA NEAT1 was up-regulated in GC cells and tissues. NEAT1 was targeted and inhibited by miR-103a and acted as an oncogene, which promoted the malignant behavior of GC cells. This regulatory effect of NEAT1 may be associated with STAMBPL1. Therefore, NEAT1 could be used as a biomarker for predicting the progression of GC.

Left-sided portal hypertension caused by peripancreatic lymph node tuberculosis misdiagnosed as pancreatic cancer: a case report and literature review.

BACKGROUND: Left-sided portal hypertension (LSPH) is an extremely rare clinical syndrome, and it is the only form of curable portal hypertension. It is primarily caused by pancreatic disease, and is associated with complications that cause spleen vein compression. Specific symptoms are often lacking, rendering it difficult to diagnose. Splenectomy is the main treatment for cases complicated by variceal bleeding, and the effects of treatment primarily depend on the condition of the primary disease. CASE PRESENTATION: The patient was a 29-year-old woman who was admitted to the hospital for repeated hematemesis and black stool. She had been misdiagnosed with pancreatic cancer 7 years prior. Combined imaging and endoscopic examination indicated varicose gastric fundus veins, a pancreatic mass, and enlarged peripancreatic lymph nodes. Laboratory investigations revealed reduced erythrocyte, platelet, and leukocyte counts, the interferon gamma release assay was positive, and liver function was normal. Abdominal exploration, splenectomy, varicose vein dissection, and lesion resection were performed via laparotomy. Postoperative biopsy analysis confirmed the diagnosis of lymph node tuberculosis. Based on the above-described factors, LSPH caused by peripancreatic lymph node tuberculosis was a diagnosed. CONCLUSIONS: Herein we describe the first reported case of LSPH caused by peripancreatic lymph node tuberculosis. When left portal hypertension occurs simultaneously, peripancreatic lymph node tuberculosis is often misdiagnosed as pancreatic cancer. Further studies are necessary to develop a more favorable diagnostic method for pancreas masses and more advantageous therapy for LSPH, especially in cases caused by mechanical compression.

Compositional variability of food wastes and its effects on acetone-butanol-ethanol fermentation.

Converting food waste into butanol via acetone, butanol, and ethanol (ABE) fermentation provides the potential to recover energy and value-added chemicals from food waste. However, the high variability of food waste compositions has hindered the consistency and predictability of butanol production, impeding the development of a robust industrial fermentation process. This study characterized the compositional variation of collected food wastes and determined correlations between food waste compositional attributes and butanol yields for a better prediction of food waste fermentation with Clostridium. The total sugar, starch, fiber, crude protein, fat and ash contents (on dry basis) in the food waste samples were in a range of 0.5-53.5%, 0-25.2%, 0.6-26.9%, 5.5-21.5%, 0.1-37.9%, and 1.4-13.7%, respectively. The high variability of food waste composition resulted in a wide range (3.5-11.5 g/L) of butanol concentrations with an average of 8.2 g/L. Pearson's correlation analysis revealed that the butanol concentrations were strongly and positively correlated with equivalent glucose and starch contents in food waste, strongly and negatively correlated with fiber content, and weakly correlated with total sugar, protein, fat, and ash contents. The regression models constructed based on equivalent glucose and fiber contents reasonably predicted the butanol concentration, with the R2 of 0.80. Our study investigated the variability of food waste composition and, for the first time, unveiled relationships between food waste compositional attributes and fermentation yields, contributing to a greater understanding of food waste fermentation, which, in turn, assists in developing new strategies for increased consistency and predictability of food waste fermentation.

STAMBPL1 knockdown has antitumour effects on gastric cancer biological activities.

The present study aimed to investigate the effects and mechanisms of STAM binding protein-like 1 (STAMBPL1) knockdown in the suppression of gastric cancer activities. Pathological data and STAMBPL1 protein expression were analysed in 36 patients with gastric cancer, including 24 stage I-II and 12 stage III-IV patients, by haematoxylin and eosin staining and immunohistochemistry. In vitro cell experiments were performed to measure AGS cell proliferation, apoptosis, invasion and migration by MTT, Celigo cell count, flow cytometry, Transwell and wound healing assays following STAMBPL1 knockdown. The relative protein expression levels were evaluated by western blotting. When compared with the adjacent normal tissues, STAMBPL1 protein expression in the gastric cancer tissues with increasing stages was significantly upregulated (P<0.01 or P<0.001). STAMBPL1 gene expression was not identified to be significantly different between AGS and MGC80-3 gastric cancer cells (P>0.05). Following STAMBPL1 knockdown by short hairpin RNA (sh)STAMBPL1, cell proliferation was significantly suppressed, the cell apoptosis rate was significantly upregulated, and the numbers of invasive AGS cells and the AGS wound healing rate were significantly decreased (P<0.01 and P<0.001, respectively), compared with those in the shControl group. Additionally, STAMBPL1 and NF-κB protein expression levels were significantly downregulated in the shSTAMBPL1 group (P<0.001, respectively). STAMBPL1 may be oncogenic in gastric cancer, and STAMBPL1 knockdown may suppress gastric cancer development.

Primary extramammary Paget's disease: a clinicopathological study of 28 cases.

To analyze the clinical and histopathological manifestations, immunohistochemistry, treatment, and prognostic factors of primary, extramammary Paget's disease (EMPD), we systematically reviewed the clinical presentations, histopathology and follow-up courses of 28 patients with primary EMPD. Clinically, their symptoms and morphology mimicked various types of dermatoses, such as seborrheic dermatitis, eczema, candidiasis, tinea cruris and erythrasma, so the initial diagnosis of EMPD was often delayed or missed. Histopathology showed invasive EMPD, and the tumor cells were mostly solid nests or had a glandular structure. The cellular atypia was obvious and signet ring Paget's cells could usually be observed. The acantholysis phenomenon in the epidermis could be seen. The condition was associated with stromal invasion, lymphatic metastasis, and even vascular invasion. Adnexal involvement in primary EMPD was a very common feature. The immunohistochemical markers CK7, GCDFP-15, CEA and HER-2 positive can identify other tumors similar to Paget's disease. We concluded that invasive EMPD is a rare malignant skin neoplasm with morphological diversity. Poorly differentiated cell morphology, extensive adnexal involvement, and an invasive pattern of solid sheets are significantly associated with lymph node metastasis and a worse prognosis. Pathologists should be alert to invasive lesions and make the correct diagnosis.

[Expression of FOXC-2 and YB-1 in Gastric Carcinoma and Its Role in Invasion and Metastasis].

OBJECTIVE: To investigate the expression of FOXC-2,YB-1 and related proteins and their influences on development,invasion and metastases in gastric carcinoma. METHODS: A total of 193 tissue samples were collected,including 50 cases of normal gastric mucosa, 50 cases of gastric mucosal intraepithelial neoplasia and 93 cases of primary gastric carcinoma. The 93 cases of primary gastric carcinoma included 74 cases of positive lymph node metastasis tissues, 19 cases of nonmetastasis tissues and 33 cases of distant metastasis tissues. Immuohistochemistry was used to detect the expression and distribution of FOXC-2,YB-1,E-cadherin, Vimentin and MMP-2 in normal and intraepithelial neoplasia,gastric carcinoma,positive lymph node metastasis tissues and distant metastasis tissues. RESULTS: The expressions of FOXC-2,YB-1,Vimentin and MMP-2 in gastric carcinoma were significantly higher than those in normal and intraepithelial neoplasia while the expression of E-cadherin was significantly lower (P<0.05).The expressions of FOXC-2,YB-1 were significantly correlated with low expression of E-cadherin and high expression of Vimentin and MMP-2 (P<0.05). The expression of FOXC-2 protein was significantly correlated with TNM stage,lymph node metastasis and distant metastases (P<0.05).The expression of YB-1 protein was significantly correlated with TNM stage,differentiation degree,invasion depth,lymph node metastasis and distant metastasis (P<0.05). The expression of MMP-2 protein was closely related to the degree of differentiation,invasion depth,lymph node metastasis and distant metastasis (P<0.05). CONCLUSION: FOXC-2, YB-1 may be related to the occurrence, development, invasion and metastasis of gastric carcinoma. The possible mechanism is to promote the invasion and metastasis of cancer cells by activating the epithelial mesenchymal transition process and up regulating the expression of MMP-2.

Metaplastic breast carcinoma: a clinical analysis of 26 cases.

Metaplastic breast carcinoma (MBC) is a rare and aggressive neoplasm. Morphologically, it is characterized by the presence of multiple cellular differentiation and heterologous elements (squamous cells, spindle cells, cartilage or bone, etc). The clinical significance, prognostic risk factors and optimal treatment modalities of MBC are limited. This study collected clinical and pathological data of 26 MBC cases in the First Affiliated Hospital of Bengbu Medical College from July 2002 to July 2012 and investigated the clinicopathological features and the prognosis data. All patients were females aged 34-76 years old. Median tumor size was 3.5 cm and 88.5% patients were triple-negative for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER-2). MBC is associated with a poor prognosis compared with conventional invasive ductal carcinoma (IDC). In our study, 5-year Overall Survival (OS) rate and 5-year Disease-Free Survival (DFS) rate were 61.5% and 53.8% respectively. Most patients in this series had high-grade, triple-negative tumors and were treated with optimal therapy.

Fibromatosis-like metaplastic carcinoma of breast: a challenge for clinicopathologic diagnosis.

Fibromatosis-like metaplastic carcinoma of breast (FLMC) is a newly described metaplastic tumor in the (4th) edition of the WHO classification of breast tumors in 2012. It is a low-grade tumor formed by spindle cells with mild or absent nuclear atypia, embedded in collagenized stroma, and it has only <5% tumor cells showing epithelial traits. Because its biological behavior is better than that of general spindle cell metaplastic cancer, this cancer type is added to the new WHO classification. Due to their mild morphology, breast FLMCs are often misdiagnosed as benign interstitial proliferative lesions or benign mesenchymal tumors. Accurate diagnosis is a challenging task particularly in needle core biopsies. We systematically reviewed 23 cases of metaplastic breast carcinoma (MBC), 8 cases of metaplastic carcinoma with squamous cell component, 12 cases of spindle cell/sarcomatoid metaplastic carcinoma, and 3 cases of FLMC. Also, we performed CK, CK high molecular weight (34ßE12), CK7, CK5/6, P63, CD10, ER, PR, HER-2, SMA, Desmin, CD34, CD117, and S-100 immunohistochemistry, using Envision staining. This study was focused on clinical and pathological features of 3 FLMC cases and assessed the immunoprofile of MBC subtypes in a large series to improve the understanding of these diseases.

Horner syndrome as a postoperative complication after minimally invasive video-assisted thyroidectomy: A case report.

RATIONALE: Horner syndrome is an unusual complication after thyroidectomy. PATIENT CONCERNS: We report a case of Horner syndrome in a 34-year-old female patient with Graves disease associated with papillary thyroid carcinoma who underwent left-side minimally invasive video-assisted thyroidectomy and neck dissection. DIAGNOSIS: Horner syndrome was diagnosed based on left myosis, eyelid ptosis, and mild enophthalmos, which developed in the patient on postoperative day 2. INTERVENTIONS: The patient was administered glucocorticoids and neurotrophic drugs on postoperative day 3. OUTCOME: The symptoms of Horner syndrome were significantly relieved 1 year later. LESSONS: Surgeons must be aware that Horner syndrome may be a source of iatrogenic complications, and patients also should be informed of these complications before surgery.