Ampulla of Vater carcinoma: advancement in the relationships between histological subtypes, molecular features, and clinical outcomes.

The incidence of ampulla of Vater carcinoma, a type of periampullary cancer, has been increasing at an annual percentage rate of 0.9%. However, patients with ampulla of Vater carcinoma have quite different prognoses due to the heterogeneities of the tissue origin of this carcinoma. In addition to TNM staging, histological subtypes and molecular features of ampulla of Vater carcinoma are the key factors for predicting the clinical outcomes of patients. Fortunately, with the development of testing technology, information on the histological subtypes and molecular features of ampulla of Vater carcinoma is increasingly being analyzed in-depth. Patients with the pancreaticobiliary subtype have shorter survival times. In immunohistochemical examination, high cutoff values of positive MUC1 staining can be used to accurately predict the outcome of patients. Mutant KRAS, TP53, negative SMAD4 expression, and microsatellite stability are related to poor prognosis, while the clinical value of BRCA1/BRCA2 mutations is limited for prognosis. Testing the histological subtypes and molecular characteristics of ampulla of Vater carcinoma not only is the key to prognosis analysis but also provides extra information for targeted treatment to improve the clinical outcomes of patients.

A Novel Gene Signature Based on CDC20 and FCN3 for Prediction of Prognosis and Immune Features in Patients with Hepatocellular Carcinoma.

Long-term survivals of patients with hepatocellular carcinoma (HCC) remain unfavorable, which is largely attributed to active carcinogenesis. Growing studies have suggested that the reliable gene signature could act as an independent prognosis factor for HCC patients. We tried to screen the survival-related genes and develop a prognostic prediction model for HCC patients based on the expression profiles of the critical survival-related genes. In this study, we analyzed TCGA datasets and identified 280 genes with differential expressions (125 increased genes and 155 reduced genes). We analyzed the prognosis value of the top 10 dysregulated genes in HCC patients and identified three critical genes, including FCN3, CDC20, and E2F1, which were confirmed to be associated with long-term survival in both TCGA and ICGC datasets. The results of the LASSO model screened CDC20 and FCN3 for the development of the prognostic model. The CDC20 expression was distinctly increased in HCC specimens, while the FCN3 expression was distinctly decreased in HCC. At a suitable cutoff, patients were divided into low-risk and high-risk groups. Survival assays revealed that patients in high-risk groups exhibited a shorter overall survival than those in low-risk groups. Finally, we examine the relationships between risk score and immune infiltration abundance in HCC and observed that risk score was positively correlated with infiltration degree of B cells, T cell CD4+ cells, neutrophil, macrophage, and myeloid dendritic cells. Overall, we identified three critical survival-related genes and used CDC20 and FCN3 to develop a novel model for predicting outcomes and immune landscapes for patients with HCC. The above three genes also have a high potential for targeted cancer therapy of patients with HCC.

Avoiding misdiagnosis of duodenal papilla adenocarcinoma in a situs inversus totalis patient via laparoscopic pancreaticoduodenectomy: A rare case report.

Situs inversus totalis is a rare congenital anatomical anomaly that causes some difficult problems for surgeons when performing an operation. However, without histopathology specimens from surgery, a misdiagnosis of cancer may be unavoidable, in addition to affecting the improvement of prognosis. This study reports a rare patient with situs inversus totalis who presented with the main complaints of pruritus and vague abdominal pain. She was first misdiagnosed with cholangiocarcinoma and was finally diagnosed with duodenal papilla adenocarcinoma via laparoscopic pancreaticoduodenectomy. Situs inversus totalis was not a contraindication for surgery. Skilled surgeons and complete preparation during the perioperative period are two important keys to successful surgeries. Performing laparoscopic pancreaticoduodenectomy for patients with situs inversus totalis to avoid misdiagnosis of cancer and tailor appropriate therapy plans is cost-effective.

Blockade of the Notch1/Jagged1 pathway in Kupffer cells aggravates ischemia-reperfusion injury of orthotopic liver transplantation in mice.

Liver ischemia-reperfusion injury (IRI) represents a risk factor for early graft dysfunction and an obstacle to expanding donor pool in orthotopic liver transplantation (OLT). Kupffer cells (KCs) are the largest antigen-presenting cell (APC) group and the primary modulators of inflammation in liver tissues. The vital role of Notch1/Jagged1 pathway in mouse OLT model has been reported, however, its potential therapeutic mechanism is unknown. Here, we made use of short hairpin RNA-Jagged1 and AAV-Jagged1 to explore the effects of Notch1/Jagged1 pathway in OLT. In vitro, blockade of Notch1/Jagged1 pathway downregulated the expression of Hairy and enhancer of split-1 (Hes1) gene, which in turn increased the proinflammatory effects of KCs. Moreover, the anti-inflammatory effects of Notch1/Jagged1 pathway were induced by inhibiting Hes1/gene of phosphate and tension/protein kinase B/Toll-like receptor 4/nuclear factor kappa B (Hes1/PTEN/AKT/TLR4/NF-κB) axis in KCs. In vivo, we used a well-established mouse model of OLT to mimic clinical transplantation. Mice were stochastically divided into 6 groups: Sham group (n = 15); Normal saline (NS) group (n = 15); Adeno-associated virus-green fluorescent protein (AAV-GFP) group (n = 15); AAV-Jagged1 group (n = 15); Clodronate liposome (CL) group (n = 15); CL+AAV-Jagged1 group (n = 15) . After OLT the liver damage in AAV-Jagged1 group were significantly accentuated compared to the AAV-GFP group. While blockade of Jagged1 aftet clearence of KCs by CL would not lead to further liver injuries. Taken together, our study demonstrated that blockade of Notch1/Jagged1 pathway aggravates inflammation induced by lipopolysaccharide (LPS) via Hes1/PTEN/AKT/TLR4/NF-κB in KCs, and the blockade of Notch1/Jagged1 pathway in donor liver increased neutrophil/macrophage infiltration and hepatocellular apoptosis, which suggested the function of Notch1/Jagged1 pathway in mouse OLT and highlighted the protective function of Notch1/Jagged1 pathway in liver transplantation.

[Study on three-dimension spatial variability of regional soil salinity based on spectral indices].

In order to illustrate the three-dimension spatial variability of soil salinity in central China flood area of the Yellow river, integrated soil sampling data and remote sensing data, spectral indices and inverse distance weighting (IDW) method were applied to the estimation and simulation of three-dimension spatial distribution of soil salinity. The study was carried out in typical central China flood area of the Yellow river in Fengqiu County, Henan Province, China. The electrical conductivity of the saturation extract (EC1: 5) of 505 soil samples collected at 101 points was measured. The results indicated that the coefficient of variation of soil salinity at each soil layer is from 0.218 to 0.324 and exhibited the moderate spatial variability. The average of soil electrical conductivity is from 0.121 to 0.154 ds x m(-1). The 2 820 three-dimension spatial scattered data for soil electrical conductivity were taken at soil salinity mapping interpreted by spectral indices and soil electrical conductivity. Three-dimension IDW interpolation showed that a large area of high soil salinity mainly located in the region of Tianran canal and the along of the Yellow river. The shape of the soil salinity profile was downward flowed, revealing soil salinity increasing with depth in whole soil profile and soil salinity accumulated in the subsoil. The accuracy of the predictions was tested using 20 soil sampled points. The root mean square error (RMSE) of calibration for three-dimension distribution of soil salinity showed that the IDW method based on spectral indices was ideal. The research results can provide theoretical foundations to the management and utilization of salt-affected land in China flood area, especially in the Yellow river zone.

[Study on spatial variability of soil salinity based on spectral indices and EM38 readings].

Taking Feng-qiu County as a case of soil salinization widely existing in the semiarid region, the spatial variability of soil salinity was investigated by using remote sensing and EM (electromagnetic induction) technologies in the present study. Descriptive statistics was applied to soil salinity data interpreted from EM38 measurements using field sampling method. Spectral indices (soil index and plant index) were derived from 25-resolution Landsat TM image taken in April 2005, and proved to be significantly correlated with soil salinity interpreted by EM38 readings. Regression models were further established between the interpreted soil electrical conductivity and spectral indices (soil index and plant index), and'spatial distribution patterns across the study area were finally mapped based on the above regression models. Results indicated that soil salinity at each soil layer is from 0.259 to 0.572 and exhibits the moderate spatial variability owing to compound impact of intrinsic and extrinsic factors. Spatial distribution maps of soil salinity were obtained with the application of plant index, soil index and EM38 measurements. It was shown that soil salinization, mainly located in the north and south of the study area, exhibited obvious trend effect. Salinity at surface soil was the greatest and showed the trend of a decrease at subsoil layer and then an increase at deep layer in the whole soil profile. The accuracy of the predictions was tested using 40 soil sampled points. The root mean square error (RMSE) of calibration for soil salinity in each layer was 0.094, 0.052, 0.071 and 0.067 ds x m(-1) respectively, showing that the precision is ideal. The change trends of RMSE were the same as soil salinity in soil profile. The trends indicated that soil salinity had effect on the salinity prediction by spectral indices, and showed better accuracy at low soil salinity.