[Analysis of clinical manifestations and imaging features of facial nerve schwannomas].

Objective:To explore the clinical manifestations and imaging characteristics, and to clarify the imaging value in the diagnosis of facial nerve schwannomas. Methods:Retrospectively analyze the data of 23 patients with facial nerve schwannomas confirmed by surgery and pathology in the Department of Otorhinolaryngology of the First Affiliated Hospital of the Air Force Military Medical University from September 2020 to September 2022, including 8 males and 15 females, aged 18-66 years old. Summarize and analyze their clinical symptoms, specialized examinations, and imaging findings. Results:The clinical manifestations were facial nerve paralysis in 15 cases（2 cases of HB Ⅳ, 6 cases of HB Ⅴ, 7 cases of HB Ⅵ）, hearing loss in 14 cases（5 cases of conductive deafness, 2 cases of mixed deafness, and 7 cases of severe sensorineural hearing loss）, 8 cases tinnitus, 7 cases ear pain, 4 cases dizziness, 4 cases headache, 2 cases ear pus, and parotid gland tumors in 6 cases presenting as local masses. Endoscopic examination revealed 8 cases of external ear canal tumors and 3 cases of intratympanic tumors. Combining temporal bone HRCT, MRI enhanced scanning, and CPR imaging techniques, 1 case involved the internal auditory canal segment, 2 cases in the tympanic segment, 6 cases in the parotid gland area. A total of 14 cases involved two or more segments of the internal auditory canal segment, the labyrinthine segment, geniculate ganglion, the tympanic segment, and the mastoid segment. When the tumors were large, adjacent structures were involved. It was found that 8 cases invaded the external auditory canal and tympanic cavity, ossicles were displaced or bony destruction; 3 cases invaded the jugular foramen area, and 1 case grew to the middle cranial fossa region with temporal lobe brain parenchymal compression. Conclusion:The clinical manifestations of facial nerve schwannomas are diverse. The combination of various imaging techniques will be conducive to topical and qualitative diagnosis and provide an important basis for treatment strategies.

Lipid metabolic reprogramming mediated by circulating Nrg4 alleviates metabolic dysfunction-associated steatotic liver disease during the early recovery phase after sleeve gastrectomy.

BACKGROUND: The metabolic benefits of bariatric surgery that contribute to the alleviation of metabolic dysfunction-associated steatotic liver disease (MASLD) have been reported. However, the processes and mechanisms underlying the contribution of lipid metabolic reprogramming after bariatric surgery to attenuating MASLD remain elusive. METHODS: A case-control study was designed to evaluate the impact of three of the most common adipokines (Nrg4, leptin, and adiponectin) on hepatic steatosis in the early recovery phase following sleeve gastrectomy (SG). A series of rodent and cell line experiments were subsequently used to determine the role and mechanism of secreted adipokines following SG in the alleviation of MASLD. RESULTS: In morbidly obese patients, an increase in circulating Nrg4 levels is associated with the alleviation of hepatic steatosis in the early recovery phase following SG before remarkable weight loss. The temporal parameters of the mice confirmed that an increase in circulating Nrg4 levels was initially stimulated by SG and contributed to the beneficial effect of SG on hepatic lipid deposition. Moreover, this occurred early following bariatric surgery. Mechanistically, gain- and loss-of-function studies in mice or cell lines revealed that circulating Nrg4 activates ErbB4, which could positively regulate fatty acid oxidation in hepatocytes to reduce intracellular lipid deposition. CONCLUSIONS: This study demonstrated that the rapid effect of SG on hepatic lipid metabolic reprogramming mediated by circulating Nrg4 alleviates MASLD.

Cost-effectiveness of camrelizumab plus chemotherapy vs. chemotherapy in the first-line treatment of non-squamous NSCLC: Evidence from China.

Objective: We aimed to evaluate the cost-effectiveness of camrelizumab plus chemotherapy compared with chemotherapy alone as the first-line treatment for patients with metastatic or advanced non-squamous non-small cell lung cancer (NSCLC) without targetable epidermal growth factor receptor or anaplastic lymphoma kinase genetic aberrations in patients in China. Methods: A partitioned survival model was constructed to estimate the cost-effectiveness of camrelizumab plus chemotherapy vs. chemotherapy in the first-line treatment of non-squamous NSCLC from a Chinese healthcare perspective. Survival analysis was performed to calculate the proportion of patients in each state using data from trial NCT03134872. The cost of drugs was obtained from Menet, and the cost of disease management was obtained from local hospitals. Health state data were obtained from published literature. Both deterministic sensitivity analyses (DSA) and probabilistic sensitivity analysis (PSA) were adopted to verify the robustness of the results. Results: Compared with chemotherapy alone, camrelizumab plus chemotherapy provided 0.41 incremental quality-adjusted life years (QALYs) at an incremental cost of $10,482.12. Therefore, the incremental cost-effectiveness ratio of camrelizumab plus chemotherapy was $25,375.96/QALY from the Chinese healthcare perspective, much lower than three times the GDP per capita of China in 2021 ($35,936.09) as the willingness-to-pay threshold. The DSA indicated that the incremental cost-effectiveness ratio was most sensitive to the utility value of progression-free survival, followed by the cost of camrelizumab. The PSA illustrated that camrelizumab had 80% probability of being cost-effective at the threshold of $35,936.09 per QALY gained. Conclusion: The results suggest that camrelizumab plus chemotherapy is a cost-effective choice in the first-line treatment for patients with non-squamous NSCLC in China. Although this study has limitations such as short time of use of camrelizumab, no adjustment of Kaplan-Meier curves and the median overall survival that has not been reached, the difference in results caused by these factors is relatively small.

Understanding the impact of pectin on browning of polyphenol oxidation system in thermal and storage processing.

Browning of some processed fruit products was affected not only by polyphenol oxidation but also by cell wall polysaccharides (pectin). The study was performed to understand the mechanism of browning in the pectin system. The catechin/chlorogenic acid oxidation system in three pectins significantly enhanced their browning during thermal storage with pectin structure- and concentration-dependent. Particularly, the structural and physicochemical properties of pectin were examined to determine its effects on the kinetics of polyphenol oxidation and the stability of free polyphenols. Moreover, pectin impacted the fluorescence characteristics of polyphenols by cross-linking with the aromatic ring of polyphenols. In turn, the interaction between polyphenols and pectin impacted the chemical bond vibration of pectin, thereby affecting its optical features and browning. The correlation analysis revealed that the monosaccharide composition, Ratio 1, Ratio 2, Ratio 3, methyl esterification, ζ-potential, and polydispersity index of pectin were significantly correlated with the browning of the pectin-polyphenol oxidation system.

Metabolic profiling analysis for clinical urine of colorectal cancer.

AIM: To demonstrate the little-known metabolic changes and pathways in patients with colorectal cancer (CRC). METHODS: We used gas chromatography time-of-flight mass spectrometry (GC-TOF/MS) to perform metabolic profiling of urine samples from 163 consecutive patients with CRC and 111 healthy controls without history of gastrointestinal tumors. The metabolic profiles were assayed using multivariate statistical analysis and one-way analysis of variance, and further analyzed to identify potential marker metabolites related to CRC. The GC-TOF/MS-derived models showed clear discriminations in metabolic profiles between the CRC group and healthy control group. RESULTS: We demonstrated that 15 metabolites contributed to the differences. Among them, eleven metabolites were significantly upregulated, while other four metabolites were downregulated in the urine samples of CRC patients compared with healthy controls. Pathway analysis revealed changes in energy metabolism of patients with CRC, which are reflected in the upregulation of glycolysis and amino acid metabolism and the downregulation of lipid metabolism. Our study revealed the metabolic profile of urine from CRC patients and indicated that GC-TOF/MS-based methods can distinguish CRC from healthy controls. CONCLUSION: GC-TOF/MS-based metabolomics has the potential to be developed into a novel, non-invasive, and painless clinical tool for CRC diagnosis, and may contribute to an improved understanding of disease mechanisms.

Combination Use of Tegafur and Apatinib as First-Line Therapy in Treatment of Advanced Gastric Cancer: A Single-Blinded Randomized Study.

OBJECTIVE: To investigate the efficacy and safety of the combination use of tegafur and apatinib as a first-line therapy strategy in advanced gastric cancer (GC). METHODS: The present study included a total of 62 advanced GC patients. The patients were randomized into the combined group (treated with both tegafur and apatinib) and the control group (treated with only tegafur). Treatment efficacy, KPS score, nutrition condition, and progression-free survival time (PFS) were recorded. RESULTS: Both the response and disease control rates were significantly higher in the combined group. The PFS time was remarkably higher and the KPS score was significantly reduced in the combined group after treatment. After treatment, both groups showed significantly increased nutrition risk, but the rates of patients with nutrition risk or innutrition were remarkably higher in the combined group. The ADR rates were also significantly higher in the combined group. CONCLUSION: The combination use could achieve good efficacy and prolong patients' PFS time; however, apatinib also reduced the patients' quality of life and enhanced the nutrition risk and adverse drug reactions.

Effect of LncRNA MIAT on Prognosis of Hand-assisted Laparoscopic or Laparoscopic-assisted Colectomy for Colorectal Cancer.

PURPOSE: The current study aims to explore the effect of myocardial infarction associated transcript (MIAT) level on the long-term prognosis of hand-assisted laparoscopic colectomy (HALC) or laparoscopic-assisted colectomy (LAC) for colorectal cancer (CC). MATERIALS AND METHODS: A total of 320 CC patients were included. Patients were randomized into HALC and LAC group. RESULTS: MIAT level in CC tissue was upregulated, and had a significant positive association with its level in serum. MIAT levels in both CC tissue and serum were correlated with lymph node metastasis and histologic grading. Survival analysis showed that the overall survival rate in 3 years after operation was significantly lower in HALC-High MIAT group (P<0.05). When MIAT level is <10.9 in CC tissue or 8.7 in serum, 100% of patients who underwent HALC will be alive for >3 years. CONCLUSIONS: For patients with low MIAT level, both HALC and LAC are available, otherwise, LAC is more recommended.

An osteoclast-like giant cell tumor embedded in the mural nodule of a pancreatic mucinous cystic neoplasm: A case report and literature review.

RATIONALE: Mucinous cystic neoplasms (MCNs) are relatively rare lesions, accounting for 2%-5% of all exocrine pancreatic neoplasms. MCNs mainly occur in women (female:male ratio = 20:1), with a peak incidence in the 5th decade of life. Osteoclast-like giant cell tumors (OGCTs) are rare and relatively aggressive neoplasms, comprising <1% of all pancreatic carcinomas. Herein, we present a rare "combination tumor" case and discuss the impact of mural nodules in pancreatic MCNs considering malignant transformation. PATIENT CONCERNS: A 54-year-old Mongolian man, without vomiting, nausea or jaundice, presented with abdominal distention since 3 months. He had a 7-year history of diabetes. Physical examinations indicated slight middle abdominal tenderness without rebound tenderness or rigidity. Laboratory results revealed that the level of carcinoembryonic antigen (CEA) was 1.16 ng/ml (normal: <5 ng/ml); CA-199: 30.02 U/ml (normal: <27 U/ml); hemoglobin: 143 g/L; fasting glucose: 7.71 mmol/L; and albumin: 43 g/L. Abdominal enhanced computed tomography revealed a 7 × 6 cm solid neoplasm in the pancreatic body with partial enhancement and heterogeneity. Endoscopic ultrasound revealed a solid-cystic space-occupying lesion in the pancreatic body. DIAGNOSIS: The preoperative preliminary diagnosis was pancreatic solid-cystic tumor, possibly a solid pseudopapillary tumor. Postoperative pathological findings revealed a pancreatic borderline MCN with an OGCT embedded in a mural nodule of the capsule. Immunohistochemical results indicated a simultaneous dual origin from the epithelium and stroma. INTERVENTIONS: The patient underwent open distal pancreatectomy and splenectomy. Postoperative blood glucose levels were closely monitored and regulated. We intravenously administered single-agent gemcitabine (1400 mg on day 1) as the first-time chemotherapy, 1 month after surgery. After the first chemotherapy, the patient refused to receive further treatment owing to personal reasons. OUTCOMES: The patient showed uneventful recovery and was discharged 13 days after the initial surgery. Follow-up was performed 1, 3 and 6 months after surgery. At 6 months, abdominal computed tomography scan showed no signs of recurrence, regional lymphadenopathy, or other abnormalities. And laboratory tests showed a platelet count of 301 × 10/L, postprandial blood glucose of 12.9 mmol/L and CA-199 level of 20 U/ml. The patient had no obvious discomfort. LESSONS: Although pancreatic MCNs are widely accepted as borderline tumors, malignant transformations may occur due to various risk factors (cyst size, mural nodules, septations, and tumor location). The combination tumor in this case was more likely to increase the possibility of malignant biological behavior, thereby worsening overall prognosis. Therefore, long-term follow-up must be maintained with strict monitoring.

Transplantation of neuregulin 4-overexpressing adipose-derived mesenchymal stem cells ameliorates insulin resistance by attenuating hepatic steatosis.

IMPACT STATEMENT: Due to high-fat and high-sugar diets accompanied by sedentary lifestyles, diabetes has become a global epidemic. Literature findings suggest a potential therapeutic effect of Nrg4 on treating obesity-related metabolic disorders including type 2 diabetes (T2D). Adipose tissue-derived MSCs (ADSCs) were used in our study as they are abundant and can be harvested with minimally invasive procedures. In the end, our study reveals that ADSC transplantation improves glucose tolerance and metabolic balance in HFD-fed mice by multiple mechanisms, including upregulating GLUT4 expression and suppressing inflammation. More importantly, our study shows that Nrg4 overexpression could improve the efficacy of ADSCs in ameliorating insulin resistance (IR) and other obesity-related metabolic disorders, given the function of Nrg4 in attenuating hepatic lipogenesis. It would provide a new therapeutic strategy for the treatment of obesity, IR, and T2D.

Improvement in Nocturnal Hypoxemia in Obese Patients with Obstructive Sleep Apnea after Bariatric Surgery: a Meta-Analysis.

OBJECTIVE: To conduct a meta-analysis examining the effects of bariatric surgery on nocturnal hypoxemia in obese patients with obstructive sleep apnea (OSA). METHODS: PubMed, EMBASE, Cochrane Library, and Web of Science were searched (the last search date was June 10, 2018) to identify relevant clinical studies. The mean arterial oxygen saturation (MeanSaO2), nadir oxygen saturation (NadirSaO2), apnea hypopnea index (AHI), and body mass index (BMI) data during the perioperative period were extracted and analyzed using a random effects model. Then, we performed subgroup and sensitivity analyses and calculated the publication bias to assess the between-study heterogeneity. RESULTS: In total, 15 studies with 636 patients were included; 13 were prospective observational trials, 1 was a randomized controlled trial (RCT), and 1 was a retrospective trial. After surgery, the MeanSaO2 and NadirSaO2 increased by 1.36 [95% CI (0.72, 2.00)] and 1.08 [95% CI (0.68, 1.49)], respectively, and the AHI and BMI decreased by 1.11 [95% CI (0.82, 1.40)] and 1.97 [95% CI (1.67, 2.27)], respectively. However, the heterogeneity across all trials was high; we identified some of the sources of that heterogeneity through subsequent subgroup and sensitivity analyses. CONCLUSIONS: Bariatric surgery is effective at improving nocturnal hypoxemia in obese patients with OSA; it also reduces body weight and the number of apnea events. More randomized controlled and comparative trials are necessary in the future to confirm our findings and to explore the potential underlying mechanisms.

[Meta-analysis on safety of application of enhanced recovery after surgery to laparoscopic bariatric surgery].

OBJECTIVE: To systematically review the safety of application of enhanced recovery after surgery(ERAS) to laparoscopic bariatric surgery. METHODS: The randomized controlled trials (RCTs) or case-controlled trials concerning application of ERAS principles in bariatric surgery were collected by searching several national and international online databases, including PubMed, Cochrane Library, CNKI, EMBASE and Wanfang databases. Data collection was completed in October 2016. The ERAS protocol covered three phases (preoperative, intraoperative, and postoperative), including preoperative counseling, reduced fasting, early ambulation, early oral feeding, etc. The endpoints included at least one of the following parameters: length of stay (LOS), operation time, readmission rate within 30 days, morbidity of postoperative complication (major/minor), and reoperation rate within 30 days. The quality of enrolled literatures was evaluated according to Cochrane Handbook and Newcastle-Ottawa Scale. RevMan 5.2 software was applied to perform meta analysis. The weighted mean difference (WMD) was used to combine the statistics for the measurement data, and the ratio and its 95% confidence interval were used to combine the statistics for the counting data. Subgroup analysis was conducted based on the quality of the enrolled literatures for the results of high heterogeneity. RESULTS: A total of 7 studies, including 1 randomized controlled trail and 6 case-control studies, with 3264 patients were enrolled. Among the 3264 patients, 2051 received ERAS management (ERAS group) and 1213 received traditional perioperative management (control group). Meta analysis showed that compared with control group, ERAS group had shorter operative time (WMD=-17.56, 95%CI: -29.50 to -5.62, P=0.00), shorter length of hospital stay (WMD=-1.11, 95%CI: -1.31 to -0.92,P=0.00). There were no statistically significant differences between the two groups in the morbidity of postoperative major complication(OR=1.21, 95%CI:0.87 to 1.69, P=0.26) or minor complication (OR=1.25, 95%CI:0.99 to 1.58, P=0.06), re-admission rate within 30 days (OR=1.07, 95%CI: 0.81 to 1.43, P=0.63) and re-operation rate within 30 days(OR=1.33, 95%CI: 0.84 to 2.11, P=0.23). CONCLUSION: Application of ERAS protocols to bariatric surgery is safe and feasible, which can also reduce length of hospital stay and operative time, and accelerate recovery.

Feasibility of laparoscopic gastrectomy for elderly gastric cancer patients: meta-analysis of non-randomized controlled studies.

The aim of this meta-analysis was to determine the feasibility of laparoscopic gastrectomy (LG) for elderly gastric cancer patients by comparing laparoscopic and conventional open gastrectomies (OG). Comprehensive search of the PubMed, EMBASE, and Cochrane Library databases revealed nine non-randomized controlled studies that compared LG and OG in elderly gastric cancer patients We then analyzed dichotomous or continuous parameters using odds ratios (ORs) or weighted mean differences (WMDs). Overall survival was estimated using hazard ratios (HRs) with a fixed effects or random effects model. We observed that the age distribution was similar between the LG and OG patient groups (WMD -0.22 95% CI, -1.26-0.82). LG patients experienced less blood loss (WMD -119.14 95% CI, -204.17--34.11) and had shorter hospital stays (WMD -3.48 95% CI, -5.41--1.56), but endured longer operation times (WMD 10.87 95% CI, 2.50-19.24). Postoperatively, LG patients exhibited lower incidences of postoperative morbidities (OR 0.59 95% CI, 0.43-0.79), surgery related morbidities (OR 0.58 95% CI, 0.41-0.81) and systemic morbidities (OR 0.56 95% CI, 0.38-0.82). We observed no differences between the LG and OG patient groups regarding anastomotic leakage (OR 0.69 95% CI, 0.34-1.41), mental disease (OR 0.72 95% CI, 0.37-1.41) and long term effects (HR 0.98 95% CI, 0.74-1.32). We therefore conclude that laparoscopic gastrectomy might be technically feasible for elderly gastric cancer patients.

Correlation Between Circulating Tumor DNA Levels and Response to Tyrosine Kinase Inhibitors (TKI) Treatment in Non-Small Cell Lung Cancer.

BACKGROUND Clinical monitoring of EGFR-positive NSCLC patients is important to gauge treatment response. The current study addresses the usage of circulating tumor DNA (ctDNA) as a prognostic marker during treatment of first-generation TKIs. MATERIAL AND METHODS Serial samplings of peripheral blood from 200 EGFR-positive NSCLC patients were taken. Baseline ctDNA quantification was conducted by digital droplet PCR before TKI treatment was administered and compared to primary biopsies. Thereafter blood sampling at different treatment cycles were measured and assessed for its prognostic and predictive value. RESULTS ctDNA was successfully detected in a number of patients and overall concordance rate was 84%. Importantly, we observed a strong correlation to ctDNA increase with disease progression using radiographic scans. In addition to survival analysis, we noted patients with the largest ctDNA variations had worst outcome. A significant number of EGFR patients during treatment developed a secondary mutation T790M and this cohort had worst survival outcome as well. CONCLUSIONS Our study demonstrated a highly associative relation of ctDNA to NSCLC patients during treatment that can be utilized to gauge treatment response. CtDNA is an attractive means compared with conventional core needle biopsies and presents new methods for accurately profiling NSCLC disease progression.

Identification of differential metabolic characteristics between tumor and normal tissue from colorectal cancer patients by gas chromatography-mass spectrometry.

Colorectal cancer (CRC) is one of the most common human malignancies and encompasses cancers of the colon and rectum. Although the gold-standard colonoscopy screening method is effective in detecting CRC, this method is invasive and can result in severe complications for patients. The purpose of this study was to determine differences in metabolites between CRC and matched adjacent nontumor tissues from CRC patients, to identify potential biomarkers that may be informative and developed screening methods. Metabolomic analysis was performed on clinically localized CRC tissue and matched adjacent nontumor tissue from 20 CRC patients. Unsupervised analysis, supervised analysis, univariate analysis and pathway analysis were used to identify potential metabolic biomarkers of CRC. The levels of 25 metabolites in CRC tissues were significantly altered compared with the matched adjacent nontumor tissues. Four metabolites (lactic acid, alanine, phosphate and aspartic acid) demonstrated good area under the curve of receiver-operator characteristic with acceptable sensitivities and specificities, indicating their potential as important biomarkers for CRC. Alterations of amino acid metabolism and enhanced glycolysis may be major factors in the development and progression of CRC. Lactic acid, alanine, phosphate, and aspartic acid could be effective diagnostic indicators for CRC.

Metformin Improves Overall Survival of Colorectal Cancer Patients with Diabetes: A Meta-Analysis.

Introduction. Diabetic population has a higher risk of colorectal cancer (CRC) incidence and mortality than nondiabetics. The role of metformin in CRC prognosis is still controversial. The meta-analysis aims to investigate whether metformin improves the survival of diabetic CRC patients. Methods. PubMed, EMBASE, and Cochrane Library were searched till July 1, 2016. Cohort studies were included. All articles were evaluated by Newcastle-Ottawa Scale. Hazard Ratios (HRs) with 95% confidence intervals (CIs) for each study were calculated and pooled HRs with corresponding 95% CIs were generated using the random-effects model. Heterogeneity and publication bias were assessed. Results. We included seven cohort studies with a medium heterogeneity (I2 = 56.1% and p = 0.033) in our meta-analysis. An improved overall survival (OS) for metformin users over nonusers among colorectal cancers with diabetes was noted (HR 0.75; 95% CI 0.65 to 0.87). However, metformin reveals no benefits for cancer-specific survival (HR 0.79, 95%, CI 0.58 to 1.08). Conclusions. Metformin prolongs the OS of diabetic CRC patients, but it does not affect the CRC-specific survival. Metformin may be a good choice in treating CRC patients with diabetes mellitus in clinical settings.

Anticancer effect of icaritin inhibits cell growth of colon cancer through reactive oxygen species, Bcl-2 and cyclin D1/E signaling.

Icaritin has an advantage in enhancing immunity. Besides, with its anticancer effect, it may be of great help in cancer treatment and recovery of cancer patients. As a result, icaritin is likely to become a novel anticancer drug. However, the anticancer effect of icaritin against colon cancer has not been elucidated thus far. The present study investigated the latent anticancer effect of icaritin on the inhibition of colon cancer cell growth by regulating reactive oxygen species (ROS), B-cell lymphoma (Bcl)-2 and cyclin D1/E signaling. The COLO-205 colon cancer cell line was used as a colon cancer cell model in the present study. First, cell growth and apoptosis were measured to analyze the anticancer effect of icaritin against colon cancer. Next, the possible mechanism of icaritin against colon cancer, including ROS, Bcl-2, cyclin D1, cyclin E and caspase-3/9, was explored. The results revealed that icaritin could inhibit cell growth and induce the apoptosis of COLO-205 cells. In addition, icaritin significantly induced ROS generation, suppressed Bcl-2, cyclin D1 and cyclin E protein expression, and activated caspase-3/9 activity in COLO-205 cells. The present findings demonstrated that icaritin exerted antiproliferative and anticancer effects against colon cancer through the activation of ROS generation and the suppression of Bcl-2, cyclin D1 and cyclin E signaling.

Primary advanced esophago-gastric melanoma: A rare case.

Primary esophageal or gastric melanoma is a very rare disease with early metastasis. Due to its atypical symptom and less efficiency of chemotherapy and radiotherapy, the prognosis of esophageal or gastric melanoma is still very poor. Surgical resection remains the preferential treatment for esophageal or gastric melanoma. Here we present an extremely rare case of primary advanced esophago-gastric melanoma. Debulking surgery was performed without chemotherapy or radiotherapy. However, abdominal recurrence and hepatic metastases were found within one month by a postoperative follow-up computed tomography. Three and a half months after surgical resection, the patient died of extensive abdominal metastasis.

Comparison of Porcine Small Intestinal Submucosa versus Polypropylene in Open Inguinal Hernia Repair: A Systematic Review and Meta-Analysis.

BACKGROUND: A systematic review and meta-analysis was performed in randomized controlled trials (RCTs) to compare porcine small intestinal submucosa (SIS) with polypropylene in open inguinal hernia repair. METHOD: Electronic databases MEDLINE, Embase, and the Cochrane Library were used to compare patient outcomes for the two groups via meta-analysis. RESULT: A total of 3 randomized controlled trials encompassing 200 patients were included in the meta-analysis. There was no significant difference in recurrence (P = 0.16), hematomas (P = 0.06), postoperative pain within 30 days (P = 0.45), or postoperative pain after 1 year (P = 0.12) between the 2 groups. The incidence of discomfort was significantly lower (P = 0.0006) in the SIS group. However, the SIS group experienced a significantly higher incidence of seroma (P = 0.03). CONCLUSIONS: Compared to polypropylene, using SIS in open inguinal hernia repair is associated with a lower incidence of discomfort and a higher incidence of seroma. However, well-designed larger RCT studies with a longer follow-up period are needed to confirm these findings.

Association between murine double minute 2 T309G polymorphism and risk of liver cancer.

During the past decade, a number of studies were published to evaluate the association between murine double minute 2 (MDM2) T309G polymorphism and risk of liver cancer. However, the association between MDM2 T309G polymorphism and risk of liver cancer was still unclear owing to the conflicting results from those published studies. An undated meta-analysis of all eligible studies was carried out to comprehensively assess the association. The pooled odds ratio (OR) with 95 % confidence interval (95% CI) was used to evaluate the association between MDM2 T309G polymorphism and risk of liver cancer. Finally, ten studies with a total of 2,243 cases and 3,471 controls were finally included into the meta-analysis. Overall, there was an association between MDM2 T309G polymorphism and risk of liver cancer (G vs. T: OR=1.39, 95% CI 1.17-1.64, P<0.001; GG vs. TT: OR=1.87, 95% CI 1.34-2.62, P<0.001; GG/GT vs. TT: OR=1.61, 95 % CI 1.24-2.08, P<0.001). Subgroup analysis in Europeans showed that there was also an association between MDM2 T309G polymorphism and risk of liver cancer in Europeans (G vs. T: OR=1.81, 95% CI 1.45-2.27, P<0.001; GG vs. TT: OR=3.26, 95% CI 1.99-5.32, P<0.001; GG/GT vs. TT: OR=2.20, 95% CI 1.58-3.07, P<0.001). Subgroup analysis in Asians showed that there was also an association between MDM2 T309G polymorphism and risk of liver cancer in Asians (G vs. T: OR=1.27, 95% CI 1.06-1.52, P=0.010; GG vs. TT: OR=1.59, 95% CI 1.11-2.27, P=0.011; GG/GT vs. TT: OR=1.41, 95% CI 1.07-1.87, P=0.016). The meta-analysis provides a strong evidence for the association between MDM2 T309G polymorphism and risk of liver cancer.

PEITC reverse multi-drug resistance of human gastric cancer SGC7901/DDP cell line.

Gastric cancer is one of the leading causes of cancer death in the world and nearly all patients who respond initially to cisplatin later develop drug resistance, indicating multi-drug resistance is an essential aspect of the failure of treatment. Phenethyl isothiocyanate (PEITC) has been implicated in inhibiting metastasis of several types of human cancer. However, the effect and potential mechanism of PEITC reversed multi-drug resistance of human gastric cancer is not fully clear. We have identified the role of PEITC in multi-drug resistance reversal of human gastric cancer SGC7901/DDP cell line. PEITC inhibited cisplatin-resistant human SGC7901/DDP cell growth in a dose-dependent manner, causing increased apoptosis, ROS generation, glutathione depletion, accumulation of Rhodamine-123, decreased expression of P-glycoprotein and cell cycle arrest. mRNA and protein expression of the multi-drug resistance gene (MDR1), multi-drug resistance-associated protein (MRP1), excision repair cross-complementing gene 1 (ERCC1), survivin, and Mad2 was decreased, and phosphorylation of Akt and transcriptional activation of NF-κB were suppressed. PEITC may be useful as the therapeutic strategy for overcoming multi-drug resistance through suppressing the PI3K-Akt pathway in human gastric cancer.