The Comparison of Short- and Long-Term Outcomes for Laparoscopic Versus Open Gastrectomy for Patients With Advanced Gastric Cancer: A Meta-Analysis of Randomized Controlled Trials.

Objectives: The effect of laparoscopic gastrectomy (LG) for the treatment of advanced gastric cancer (AGC) is still controversial. The aim of this meta-analysis was to contrast the short- and long-term outcomes of laparoscopic versus conventional open gastrectomy (OG) for patients with AGC. Methods: Databases including PubMed, Embase, Scopus, and Cochrane Library were systematically searched until December 2021 for randomized controlled trial-enrolled patients undergoing LG or OG for the treatment of AGC. Short-term outcomes were overall postoperative complications, anastomotic leakage, number of retrieved lymph node, surgical time, blood loss, length of hospital stay, and short-term mortality. Long-term outcomes were survival rates at 1, 3, and 5 years. Results: A total of 12 trials involving 4,101 patients (2,059 in LG group, 2,042 in OG group) were included. No effect on overall postoperative complications (OR 0.84, 95% CI 0.67 to 1.05, p = 0.12, I2 = 34%) and anastomotic leakage (OR 1.26, 95% CI 0.82 to 1.95, p = 0.30, I2 = 0%) was found. Compared with the open approach, patients receiving LG had fewer blood loss (MD -54.38, 95% CI -78.09 to -30.67, p < 0.00001, I2 = 90%) and shorter length of hospital stay (MD -1.25, 95% CI -2.08 to -0.42, p = 0.003, I2 = 86%). However, the LG was associated with a lower number of retrieved lymph nodes (MD -1.02, 95% CI -1.77 to -0.27, p = 0.008, I2 = 0%) and longer surgical time (MD 40.87, 95% CI 20.37 to 54.44, p < 0.00001, I2 = 94%). Furthermore, there were no differences between LG and OG groups in short-term mortality and survival rate at 1, 3, and 5 years. Conclusions: LG offers improved short-term outcomes including shorter hospital stays and fewer blood loss, with comparable postoperative complications, short-term mortality, and survival rate at 1, 3, and 5 years when compared to the open approach. Our results support the implementation of LG in patients with AGC. Systematic Review Registration: PROSPERO (CRD 42021297141).

Citrinadin C, a new cytotoxic pentacyclic alkaloid from marine-derived fungus Penicillium citrinum.

A new cytotoxic pentacyclic alkaloid, citrinadin C (1), together with four known compounds (2-5), were isolated from deep-sea-derived fungus Penicillium citrinum. The structure of new compound 1 was elucidated by extensive 1D and 2D NMR and Mass spectroscopic data, and its absolute configuration was determined by CD spectrum. All the compounds were evaluated for their cytotoxic and antibacterial activities. Compound 1 showed cytotoxic activities against human liver cancer cell line MHCC97H, with IC50 value of 16.7 µM. Compound 4 displayed significant antibacterial activity against phytopathogen Xanthomonas campestris, with MIC value of 25 µM.

Upregulated EBI3 Correlates with Poor Outcome and Tumor Progression in Breast Cancer.

BACKGROUND AND AIM: So far, the understanding of the role of Epstein-Barr virus-induced gene 3 (EBI3) in breast cancer has been limited. This study uncovers the functional role and clinical significance of EBI3 in breast cancer patients. PATIENTS AND METHODS: The expression levels of EBI3, IL-27p28, and IL-12p35 were measured by quantitative real-time reverse transcription (RT)-polymerase chain reaction (PCR). Correlations of EBI3 expression with IL-27p28 and IL-12p35 expression were analyzed using Pearson's correlation assay. The prognostic performance of EBI3 was assessed via Kaplan-Meier survival assay and Cox regression analysis. RESULTS: EBI3 expression was increased in cancerous tissues compared with the controls (P < 0.05). This overexpression of EBI3 was correlated with lymph node metastasis and clinical stage (both P < 0.05). Besides, elevated expression of EBI3 was usually found in patients with positive lymph node metastasis (P < 0.05), and similar results were obtained in advanced clinical-stage breast cancer cases (P < 0.05). Increases in both IL-27p28 and IL-12p35 expression were identified in breast cancer tissues (all P < 0.05), and IL-12p35 expression was found to be associated with EBI3 expression (R = 0.888, P < 0.001). Survival curves revealed that high EBI3 expression was correlated with poor overall survival (log-rank P < 0.05). The Cox analysis indicated that EBI3 was an independent prognostic factor in breast cancer. CONCLUSION: Taken together, overexpression of EBI3 was associated with poor prognosis and might be involved in the progression of breast cancer.

Diaphanous-related formin-3 overexpression inhibits the migration and invasion of triple-negative breast cancer by inhibiting RhoA-GTP expression.

Triple-negative breast cancer (TNBC) is associated with a high risk of metastasis, recurrence, and poor prognosis. TNBC is insensitive to existing endocrine and targeted breast cancer therapies because it lacks the expression of estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2. Therefore, there is an urgent need for identifying novel targets to improve the efficacy of TNBC treatment. Diaphanous-related formin-3 (DIAPH3) regulates cytoskeleton formation to regulate cell adhesion, migration, and differentiation. A previous study showed that DIAPH3 promoted the metastasis of prostate cancer. However, DIAPH3 expression in TNBC and its effect on TNBC development have not been reported to date. In present study, we investigated the expression and functions of DIAPH3 in TNBC. Results of immunohistochemical staining showed that DIAPH3 expression significantly decreased in breast cancer tissues, especially TNBC tissues, compared with that in paired non-tumor tissues. In addition, DIAPH3 expression was associated with TNM stage and lymph node metastasis, but not with tumor size in patients with TNBC. Further, DIAPH3 overexpression clearly suppressed the migration and invasion of MDA-MB-231 cells and decreased the expression of Ras Homolog Family Member A (RhoA), RhoA-GTP, Matrix Metallopeptidase 2 (MMP-2), and MMP-9. Thus, we predict that DIAPH3 overexpression inhibits the migration and invasion of TNBC by inhibiting RhoA-GTP expression and the results of the present study provide new insights for developing DIAPH3-targeting therapies for TNBC.

Does hospital-based transitional care reduce the postoperative complication in patients with enterostomy? A meta-analysis.

OBJECTIVE: The objective of the study is to investigate whether hospital-based transitional care can reduce the postoperative complication in patients who received enterostomy or not by pooling the published prospective clinical studies. MATERIALS AND METHODS: Prospective clinical studies related to hospital-based transitional care for reducing the postoperative complication in patients with enterostomy were searched in the electronic databases of PubMed, Medline, EMBASE, CNKI, and Wanfang. The postoperative complications in the experiment and control groups were extracted from the original studies and pooled by fixed effects model. The publication bias was evaluated by Begg's funnel plot and Egger's line regression test. RESULTS: After searching through the electronic databases of PubMed, Medline, EMBASE, CNKI, and Wanfang, we finally included in eight studies with 600 cases related to hospital-based transitional care and postoperative complication in patients with enterostomy. The pooled result showed that hospital-based transitional care could significantly reduce the postoperative complication in patients with enterostomy (risk ratio = 0.42, 95% confidence interval: 1.0.32, ~0.55, P = 0.005) by fixed effects model. The Begg's funnel plot demonstrated a litter left-right asymmetry, which indicated potential publication bias. Moreover, Egger's line regression test showed that there were significant publications (t = -3.04, P = 0.023). CONCLUSION: Hospital-based transitional care can significantly reduce the postoperative complication in patients with enterostomy.

Inhibition of WWP2 suppresses proliferation, and induces G1 cell cycle arrest and apoptosis in liver cancer cells.

Primary liver cancer is one of the most common and aggressive human malignancies worldwide. As numerous studies have revealed that WW domain containing E3 Ub­protein ligase 2 (WWP2) exerts cancer­specific functions, the present study assessed the role of WWP2 in liver cancer. WWP2 was revealed to be significantly overexpressed in liver cancer tissues compared with paired normal tissues at the mRNA as well as at the protein level. Furthermore, small interfering RNA-mediated WWP2 knockdown in liver cancer cell lines was demonstrated to inhibit cell proliferation, cause cell cycle arrested in G1 phase and to induce apoptosis as revealed by a Cell Counting Kit-8 assay and flow cytometric analysis. In addition, western blot analysis revealed that WWP2 knockdown significantly increased the expression of apoptosis-associated markers caspase­7, caspase­8 and B-cell lymphoma 2 (Bcl-2)-associated X in liver cancer cell lines, while Bcl­2 was significantly decreased. In conclusion, the present study suggested that WWP2 may exert important functions in the over­proliferation and evasion of apoptosis of liver cancer, likely through regulating the expression of apoptosis-associated markers. Furthermore, WWP2 may represent a novel diagnostic marker and molecular therapeutic target for liver cancer.

Silencing of WWP2 inhibits adhesion, invasion, and migration in liver cancer cells.

The role and clinical implication of the WWP2 E3 ubiquitin ligase in liver cancer are poorly understood. In the current study, we investigated the expression level of WWP2 and its functions in cell adhesion, invasion, and migration in liver cancer. We used real-time PCR to detect the expression of WWP2 in liver cancer and adjacent samples from the People's Hospital of Lishui and also analyzed The Cancer Genome Atlas (TCGA) RNA-seq data by bioinformatics. Migration and invasion were detected by transwell analysis. We detected a strong WWP2 expression in tumor tissues of the People's Hospital of Lishui, and the survival rate was significantly higher in patients with lower WWP2-expressing tumors. WWP2 small hairpin RNA (shRNA) lentivirus stably infected cells (shWWP2), Huh7, showed slower growth speed compared with scramble control-infected cells in a xenograft mouse model. Knockdown of WWP2 Huh7 and BEL-7404 cells demonstrated a reduction in adhesion, invasion, and migration. Gene set enrichment analysis (GSEA) showed that WWP2 is positively correlated to cancer-related pathways including the chemokine signaling pathway. WWP2 also regulated MMP-9, caspase-9, CXCR3, and CCR5 expression in liver cancer cells. In addition, knockdown of CXCR3 and CCR5 significantly inhibited cell proliferation, adhesion, invasion, and migration in Huh7 and BEL-7404 cells. Our data suggest that targeting of WWP2 may be a therapeutic strategy for liver cancer treatment.

Topical lipophilic epigallocatechin-3-gallate on herpes labialis: a phase II clinical trial of AverTeaX formula.

OBJECTIVE: Previous in vitro and in vivo studies indicated that catechins from the tea plant (Camellia sinensis) have a therapeutic effect on herpes simplex virus infections. The aim of this study was to clinically evaluate a topical proprietary formulation containing lipophilic catechins (AverTeaX, Camellix, LLC, Evans, GA, USA) on recurrent herpes labialis. STUDY DESIGN: A double-blind, placebo-controlled, randomized trial with 40 participants, initially in two groups. RESULTS: Compared with the vehicle (100% glycerin USP, CVS Pharmacies, Inc., Woonsocket, RI, USA) group, AverTeaX applied topically six to eight times daily resulted in a significant reduction in clinical episode duration (median 4.5 days vs. 9 days; P = .003) and shortened blistering and ulceration stages within an episode from a median of 3 days to 1 day (P = .0003). Median quality-of-life scores, based on a multiquestion survey, showed significant differences between the groups with respect to duration of itching, from a median of 4 days to 1 day (P = .0021), and duration until symptom free, from a median of 8 days to 4 days (P = .0016). Significant differences were not found for median scores for itching, pain, burning, swelling, bleeding, and stress. Adverse effects were not reported. CONCLUSION: AverTeaX formulation containing lipophilic catechins effectively inhibited herpes simplex labialis infection with clinical significance.

Effect of DAPK1 gene on proliferation, migration, and invasion of carcinoma of pancreas BxPC-3 cell line.

DAPK1 can induce apoptosis in several cells; to determine the effect of DAPK1 would provide a new potential therapeutic strategy for treating pancreatic cancer. The aim of the present study was to investigate the effect of DAPK1 gene on proliferation, migration, and invasion of carcinoma of pancreas BxPC-3 cell line and explore the possible mechanisms. In our study, DAPK1 over-expressed cells were established by using the lentiviral transfection method, and DAPK1 obviously increased in BxPC-3 cells after transient transfection. Cell Counting Kit-8 (CCK-8) assay was used to determine the BxPC-3 cells proliferation after transfection. Apoptosis of the BxPC-3 cells was determined by using flow cytometry analysis. In addition, cell adhesion assay and in vitro invasion assay were performed. Western blotting was used to determine the protein expressions of caspase-3, DAPK1, VEGF, PEDF, MMP2, AKT, P-AKT, P-ERK, Bcl2, and Bax. Our results demonstrated that DAPK1 gene over-expression can suppress the proliferation, migration, and invasion of carcinoma of pancreas BxPC-3 cell line, and the possible mechanisms may be correlated to induction of mitochondria-mediated apoptosis, down-regulations of MMP-2 and VEGF, up-regulations of PEDF, through the PI3K/Akt and ERK pathways.

Multimodal therapy for adult Wilms' tumour: an experience from one centre.

INTRODUCTION: Wilms' tumour (WT) is very rare in adults but very common in children. Treatment guidelines for adult patients with WT are still insufficient. Some study groups recommend that therapeutic protocols for adults with WT (AWT) should follow the guidelines that have been established for children. OBJECTIVE: To describe the clinical and pathological characteristics of AWT as well as the treatment protocols and outcomes for AWT at our treatment centre. MATERIAL AND METHODS: Seven patients (5 females and 2 males) were diagnosed with AWT in our hospital between 2002 and 2009. The tumours were staged and the patients were treated according to the paediatric regimen recommended by the National Wilms' Tumor Study Group. RESULTS: The median patient age at the time of diagnosis was 29 years (range, 16-37 years). Flank pain was the most common clinical presentation. One patient was in Stage I of disease development, two were in Stage II, two were in Stage III and two were in Stage IV. Anaplasia was present in 3 patients with Stage III or Stage IV disease. All of the patients but one underwent nephrectomy and 2 incomplete surgeries were performed. Seven patients received 2-drug or 3-drug chemotherapy (dactinomycin and vincristine and/or doxorubicin). Two patients with Stage III disease also received radiation therapy (a total dose of 3600 or 3960 cGy). Complete remission was achieved in 4 patients. Three patients (one with Stage III disease, 2 patients with Stage IV disease) died of their disease and those patients were all classified with an unfavourable histological type called anaplasia. With a median follow-up of 53.5 months (range, 40-102 months), the 3-year and 5-year overall survival rates were 57.1% (95% confidence interval, 20.4-93.8%). CONCLUSIONS: The results of this report suggest that histological anaplasia might be an adverse prognostic factor for AWT. Proper application of the diagnostic and therapeutic regimens established for children may improve the prognosis of adult patients with WT.

Multifocal myopericytoma in the maxillofacial region: a case report.

Myopericytoma is a rare mesenchymal neoplasm with perivascular myoid differentiation. Myopericytoma arises most commonly in middle adulthood. The lesion generally involves the distal extremities; however, tumors can also arise at other sites, including the proximal extremities and head and neck. In this case report, a 43-year-old Chinese woman presented with a painless slowly growing nodule in her right cheek. Biopsy revealed a periluminal proliferation of monomorphic oval to spindle-shaped myoid-appearing cells. Immunohistochemistry showed a positive staining for smooth muscle actin. The clinical, pathologic, and immunohistochemical features are discussed. To our knowledge, this is the first case report in the medical literature of multifocal myopericytoma in the maxillofacial region.

The effect of focal adhesion kinase gene silencing on 5-fluorouracil chemosensitivity involves an Akt/NF-kappaB signaling pathway in colorectal carcinomas.

Multicellular resistance (MCR) is produced because multicellular spheroids (MCSs) are formed with a broad cell-cell connection when cultured in three-dimensions, which limits the clinical treatment efficacy in solid tumors. Focal adhesion kinase (FAK) plays an important role in apoptosis, survival and cell adhesion between cells and their extracellular matrix. In this study, we investigated the expressions of FAK, Akt and NF-kappaB in human colorectal cancer (CRC), and the effects of FAK gene silencing on MCSs formation and 5-fluorouracil (5-FU) chemosensitivity in colon carcinoma MCSs culture cells. In CRC samples, FAK, Akt and NF-kappaB were overexpressed. The positive expression of FAK correlated notably with lymph node metastasis and cellular differentiation. Positive expressions of Akt and NF-kappaB were significantly related to cellular differentiation and lymph node metastasis, respectively. Furthermore, positive expression of FAK correlated with that of Akt and NF-kappaB. The expression of FAK was inhibited significantly by a small hairpin RNA targeting FAK. Knockdown of FAK reversed the formation and aggregation of MCSs, significantly decreased the 50% inhibitory concentration of 5-FU, and markedly increased MCS culture cells apoptosis. These effects were associated with reduced levels of Akt and NF-kappaB. These results indicate that suppressing FAK expression potentiated 5-FU-induced cytotoxicity and contributed to its chemosensitizing effect by suppressing Akt/NF-kappaB signaling in colon carcinoma MCS culture cells. These data also imply that FAK mediates MCR of CRC through the survival signaling pathway FAK/Akt/NF-kappaB.

[A case of parapharyngeal soft tissue clear cell sarcoma].

Soft tissue clear cell sarcoma usually occurred in the end of the limbs, especially foot and ankle. Soft tissue clear cell sarcoma occurring in the torso and head and neck were even fewer. In this article, parapharyngeal soft tissue clear cell sarcoma was reported.

[Central mucoepidermoid carcinoma of the jaws: a clinical and pathological analysis of eight cases].

OBJECTIVE: To report eight cases of central mucoepidermoid carcinoma of the jaws (CMCJ) and to analyze its clinical and pathological features. METHODS: Eight cases of central mucoepidermoid carcinoma were diagnosed between 1989 and 2008. The clinical manifestation, radiological and histopathological changes were analyzed. RESULTS: The mean age of this group of patients was 43.3 years, with 5 male and 3 female. Seven cases occurred in mandible, mainly in the molar, angle and ramus areas, and one in maxilla. The first complain usually was local swelling, pain or paraesthesia of the jaw and loosening and pain of the tooth. X-ray displayed unilocular or multilocular radiolucent lesion with distinct or ill-distinct border, and the light microscopic findings were similar to the mucoepidermoid carcinoma originated in the salivary gland. CONCLUSIONS: To diagnose a CMCJ, it's necessary to synthetically analyze the case history, clinical examination, radiological and histopathological features. The treatment is wide local resection. Selective neck dissection and radiochemotherapy may improve curative effect and prognosis.