The role of TXNL1 in disease: treatment strategies for cancer and diseases with oxidative stress.

Thioredoxin-like protein-1 (TXNL1; also known as thioredoxin-related 32 kDa protein, TRP32) is a thioredoxin involved in the regulation of oxidative stress, which protects cells from damage through redox balance. Studies have shown that TXNL1 has a variety of functions, including cell signal transduction, cell cycle regulation, protein synthesis, modification and degradation, vesicle transport, transcriptional regulation, cell apoptosis, virus replication and oxidative stress regulation, etc., and plays an important role in the occurrence and development of human diseases. Therefore, TXNL1 has a strong correlation with the treatment of cancer and oxidative stress diseases. In this paper, the basic structure, function and potential application value of TXNL1 in diseases are reviewed, so as to open up new targets for the treatment of cancer and oxidative stress-related diseases.

Compared efficacy of University of Wisconsin and histidine-tryptophan-ketoglutarate solutions in ex-situ liver resection and autotransplantation for end-stage hepatic alveolar echinococcosis patients.

BACKGROUND: The University of Wisconsin (UW) and histidine-tryptophan-ketoglutarate (HTK) solutions are the two most frequently used liver graft preservation fluids. The present study aimed to compare their efficacy in end-stage hepatic alveolar echinococcosis patients who underwent ex-situ liver resection and autotransplantation (ELRA). METHODS: A total of 81 patients received ELRA from August 2010 to March 2018. They were allocated into UW (n = 48) and HTK groups (n = 33) based on the type of solutions used. Demographic and operational data were retrospectively analyzed. Primary outcomes included 90-day mortality, incidence of early graft loss, primary dysfunction, and postoperative complications. RESULTS: Demographic and operational characteristics were similarly distributed in the two groups. No statistically significant differences were observed with regard to 90-day mortality (12.77% vs. 12.12%) and early graft loss rate (8.51% vs. 9.09%) between the two groups. Patients in the UW and HTK groups showed a primary dysfunction rate of 27.66% and 27.27%, respectively. The UW group exhibited a higher incidence tendency of biliary complications, albeit with no statistical significance. CONCLUSIONS: This is the largest cohort study comparing the efficacy of the UW and HTK organ-preserving solutions in end-stage hepatic alveolar echinococcosis patients in ELRA settings. UW and HTK solutions presented similar efficacy and safety. A randomized clinical trial with larger scale is needed for further investigation in future clinical applications.

Genome-Wide Analysis Reveals the Role of Mediator Complex in the Soybean-Phytophthora sojae Interaction.

The mediator complex is an essential link between transcription factors and RNA polymerase II, and mainly functions in the transduction of diverse signals to genes involved in different pathways. Limited information is available on the role of soybean mediator subunits in growth and development, and their participation in defense response regulation. Here, we performed genome-wide identification of the 95 soybean mediator subunits, which were unevenly localized on the 20 chromosomes and only segmental duplication events were detected. We focused on GmMED16-1, which is highly expressed in the roots, for further functional analysis. Transcription of GmMED16-1 was induced in response to Phytophthora sojae infection. Agrobacterium rhizogenes mediated soybean hairy root transformation was performed for the silencing of the GmMED16-1 gene. Silencing of GmMED16-1 led to an enhanced susceptibility phenotype and increased accumulation of P. sojae biomass in hairy roots of transformants. The transcript levels of NPR1, PR1a, and PR5 in the salicylic acid defense pathway in roots of GmMED16-1-silenced transformants were lower than those of empty-vector transformants. The results provide evidence that GmMED16-1 may participate in the soybean-P. sojae interaction via a salicylic acid-dependent process.

Ex vivo liver resection and autotransplantation as alternative to allotransplantation for end-stage hepatic alveolar echinococcosis.

BACKGROUND & AIMS: Radical resection is the best treatment for patients with advanced hepatic alveolar echinococcosis (AE). Liver transplantation is considered for selected advanced cases; however, a shortage of organ donors and the risk of postoperative recurrence are major challenges. The aim of this study was to assess the clinical outcomes of ex vivo liver resection and autotransplantation for end-stage AE. METHODS: In this prospective study, 69 consecutive patients with end-stage hepatic AE were treated with ex vivo resection and liver autotransplantation between January 2010 and February 2017. The feasibility, safety and long-term clinical outcome of this technique were assessed. RESULTS: Ex vivo extended hepatectomy with autotransplantation was successful in all patients without intraoperative mortality. The median weight of the graft and AE lesion were 850 (370-1,600) g and 1,650 (375-5,000) g, respectively. The median duration of the operation and anhepatic phase were 15.9 (8-24) h and 360 (104-879) min, respectively. Six patients did not need any blood transfusion. Complications higher than IIIa according to Clavien classification were observed in 10 patients. The 30-day-mortality and overall mortality (>90 days) were 7.24% (5/69) and 11.5% (8/69), respectively. The mean hospital stay was 34.5 (12-128) days. Patients were followed-up systematically for a median of 22.5 months (14-89) without recurrence. CONCLUSION: This is the largest series assessing ex vivo liver resection and autotransplantation in end-stage hepatic AE. This technique could be an effective alternative to liver transplantation in patients with end-stage hepatic AE, with the advantage that it does not require an organ nor immunosuppressive agents. LAY SUMMARY: Ex vivo liver resection and autotransplantation were performed in a large series of patients with end-stage hepatic alveolar echinococcosis. The results showed that this surgical option was feasible, with acceptable postoperative mortality, but 100% disease-free survival in survivors. Careful patient selection, as well as precise assessment for size and quality of the remnant liver are key to successful surgery.

Is embryonic hypothermia tolerance common in birds?

Avian incubation temperatures oscillate within narrow limits to ensure proper embryonic development. However, field observations and experimental studies have found that some species can tolerate very low incubation temperatures, either regularly or occasionally. We artificially incubated eggs from five domestic species, which represent a range of egg sizes, to examine whether a diversity of avian species could exhibit an unusual hypothermia tolerance, as observed in the field. We found that eggs of the chicken (Gallus gallus domesticus), pigeon (Columba livia domestica), Japanese quail (Coturnix japonica) and budgerigar (Melopsittacus undulatus) survived the incubation period and hatched after experiencing 10°C hypothermia for 6 h each day. However, embryos of white-rumped munia (Lonchura striata) died after 10 days of hypothermia. Our results showed that unusual hypothermia tolerance occurs in several avian species. This phenomenon might have been selected through the evolutionary history of birds. Future research should identify the importance of phylogeny, egg size and embryonic stage in tolerance to hypothermia.

The preventive effect of ambroxol hydrochloride chitosan on postoperative intraperitoneal adhesion formation in a rat model.

BACKGROUND: This study aimed to investigate the effects of ambroxol hydrochloride chitosan reduced the degree of peritoneal adhesion. METHODS: A total of 120 Sprague-Dawley (SD) rats were experimented, group A: the damaged peritoneal was covered with ambroxol hydrochloride chitosan, group B: chitosan membrane only, group C: nothing. Enzyme-linked immunosorbent assay (ELISA), western blotting, and immunohistochemistry (IHC) were used to observe the expression of TNF-α and NF-κB p65. RESULTS: TNF-α and NF-κB p65 in group A significantly decreased in comparison with the controls. IHC showed TNF-α and NF-κB p65 were significantly down-regulated in group A. Adhesion grade in the treatment group was significantly lower than in controls. CONCLUSION: Ambroxol hydrochloride chitosan reduced the degree of peritoneal adhesion.

Expression of Toll-Like Receptors 2 and 4 and Related Cytokines in Patients with Hepatic Cystic and Alveolar Echinococcosis.

Several studies have demonstrated the important role of Toll-like receptors in various parasitic infections. This study aims to explore expression of Toll-like receptors (TLRs) and related cytokines in patients with human cystic echinococcosis (CE) and alveolar echinococcosis (AE). 78 subjects including AE group (N = 28), CE group (N = 22), and healthy controls (HC, N = 28) were enrolled in this study. The mRNA expression levels of TLR2 and TLR4 in blood and hepatic tissue and plasma levels related cytokines were detected by using ELISA. Median levels of TLR2 mRNA in AE and CE groups were significantly elevated as compared with that in healthy control group. Median levels of TLR4 expression were increased in AE and CE. Plasma concentration levels of IL-5, IL-6, and IL-10 were slightly increased in AE and CE groups compared with those in HC group with no statistical differences (p > 0.05). The IL-23 concentration levels were significantly higher in AE and CE groups than that in HC subjects with statistical significance. The increased expression of TLR2 and IL-23 might play a potential role in modulating tissue infiltrative growth of the parasite and its persistence in the human host.

Surgery vs. observation for liver hemangioma: a systematic review and meta-analysis.

BACKGROUND/AIMS: To conduct a systematic review of observational studies to evaluate effectiveness of surgery for liver hemangioma. METHODOLOGY: Related studies were identified using different searching engines. Two reviewers independently extracted data on mortality, morbidity and symptoms recurrence and/or aggravation. RESULTS: Sixteen studies with a total of 1485 patients (402 in surgery and 1085 in observation group) were included in the analysis. Two deaths in surgical group (8.0%, 2/25) and two deaths in observation group (1.4%, 2/143) were reported. The RRs for mortality were not homogeneous (χ2=3.40, 1 d.f., P=0.07, I2=71 per cent). The RRs for morbidity were homogeneous across studies (x2=5.55, 12 d.f., P=0.94, I2=0 per cent). Morbidity in surgery group was significantly higher than that in observation group (RR=14.7, 95 per cent c.i. 9.56 to 45.63). Eight studies reported the symptom aggravation and RRs were heterogeneous (x2=31.03, 7 d.f., P<0.0001, I2=77 per cent), However, showed no statistical difference. CONCLUSION: The currently involved retrospective cohort studies of surgical series were likely to imply that surgery may take more risks than the benefits for non-emergency hemangioma patients.

[Effect of Echinococcus granulosus cyst fluid on the proliferation of HepG2 cells].

OBJECTIVE: To investigate whether Echinococcus granulosus cyst fluid-infected host liver cells had differential expression of mitogen-activated protein kinases (MAPKs) or differential cell cycle activity. METHODS: Human liver cells cultured with different concentrations of hydatid cyst fluid (HCF) were tested by the MTT method to determine effects on proliferation. The cell cycle was assessed by flow cytometry. Western blotting was used to detect changes in protein expressions of p-ERK, PCNA, cyclin-A, cyclin-B1, cyclin-D1, and cyclin-E. RESULTS: Forty-eight, 72 and 96 h of HCF at 15%, 30% and 60% concentrations in the cell media significantly promoted cell proliferation (F=67.845, P less than 0.01) and compared to controls (P less than 0.05). Cells exposed to 15% HCF for 48 h showed significantly induced expression of p-ERK (F=1.916, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 24 h showed significantly induced expression of cyclin-Dl (F=3.901, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 48 h or 30% HCF for 72 h showed significantly induced expression of PCNA (F=91.140, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 15% HCF for 48 h or 30% HCF for 72 h shed significantly induced expression of cyclin-A (F=18.587, P=0.002), higher than controls (P less than 0.01). Cells exposed to 15% HCF for either 48 h or 72 h showed significantly induced expression of cyclin-B1 (F=2.064, P less than 0.01), higher than controls (P less than 0.01). Cells exposed to 30% HCF for 96 h showed significantly induced expression of cyclin-E (F=1.068, P less than 0.01), higher than controls (P less than 0.01). CONCLUSION: Hydatid cyst fluid exerts no inhibitory effect on primary cultured host liver cells, but may promote cellular proliferation.

Surgical management strategy for leiomyosarcoma of Zone I-II inferior vena cava: A case series.

OBJECTIVES: Leiomyosarcoma of inferior vena cava (IVC) is a rare clinical entity with severe vascular involvement. Surgical management of leiomyosarcoma is still challenging. METHODS: This a retrospective study of consecutive patients referred to our hospital from January 2017 to June 2019. Depending on the anatomical site of affected IVC, leiomyosarcomas were categorized into zone I-II. The clinical data including baseline information, surgical parameters, peri-operative management, short- and mid-term outcomes were observed. RESULTS: Four patients with leiomyosarcoma of zone I-III underwent radical resection without intraoperative mortality. Prosthetic grafts were interpositioned in all patients to instruct vena cava. Renal vein reconstruction was perfumed in two patients due to involvement to renal veins. Median blood loss was 450 mL (200-600 mL), median operative time was 215 minutes (150-240 minutes). No Clavien-Dindo IIIa or higher complication was observed. No organ dysfunction and recurrence were observed with median follow-up of 25.5 months. CONCLUSIONS: Curative resection of zone I-II leiomyosarcoma is associated with longer survival in selected cases, en-bloc resection with complex vascular reconstruction could be considered.

Risk factors of early liver dysfunction after liver transplantation using grafts from donation after citizen death donors.

BACKGROUND: As an early complication after liver transplantation, early allograft dysfunction (EAD) indicates a poor prognosis. This study analyzes the risk factors related to early allograft dysfunction (EAD) after liver transplantation using grafts from donation after citizen death (DCD) to provide a reference for the prevention of EAD after DCD liver transplantation. METHODS: A total of 32 patients who underwent DCD liver transplantation in the organ transplantation center of our hospital from September 2013 to January 2021 were enrolled in this study. The patients were divided into the EAD group and non-EAD group according to whether they developed EAD after transplantation. The general data of the donors and recipients before transplantation, intraoperative conditions, and clinical data within one week after transplantation were compared between the two groups, and related complications were statistically analyzed. The follow-up time was one week postoperatively or, if they died within the first week postoperatively, until the patient died. RESULTS: The subjects included 10 females and 22 males, and the incidence of postoperative EAD was 25% (8/32). Four patients (12%) had primary malignant tumors (primary liver cancer and cholangiocarcinoma), and five donors (15%) had fatty liver. The univariate analysis revealed that the donor BMI (P = 0.005), degree of fatty liver (P = 0.025), aspartate aminotransferase (P = 0.001), alanine aminotransferase (P < 0.001), and total bilirubin (P = 0.009) were related to the occurrence of EAD after DCD liver transplantation. By analyzing the correlation between the incidence EAD and postoperative complications after liver transplantation using grafts from DCD donors, it was shown that the incidence of primary nonfunction (PNF) is related to EAD (P = 0.024). CONCLUSION: Donor BMI, the degree of fatty liver, and preoperative liver function are risk factors for EAD after DCD liver transplantation, and the occurrence of EAD after DCD liver transplantation significantly increases the probability of PNF.

Determination of barium sulfate in barite ore by phase conversion-partial pressure-corrected headspace gas chromatography.

Barium sulfate (BaSO4) content is used to evaluate the grade of barite ore. In the present study, we report a method to determine the BaSO4 content in barite ore by phase conversion-headspace gas chromatography with partial pressure correction. In this method, the ore sample is roasted with sodium carbonate and potassium carbonate after pretreatment with hydrochloric acid. The roasted product is subsequently placed in a closed headspace bottle to react with hydrochloric acid. The ratio of CO2 to O2 signals is detected by a thermal conductivity detector for gas chromatography. Finally, the BaSO4 content in barite ore is calculated using this ratio. The method demonstrates good precision (relative standard deviation < 0.84%) and accuracy (relative error < 3.40%), with the uncertainty at 95% confidence interval at approximately +/- 0.57%. Moreover, this approach is expected to be used for the batch testing of BaSO4 content in barite ores in industrial applications.

[Effect of different drugs on Echinococcus multilocularis metacestodes in vitro ].

OBJECTIVE: To test the effect of 6 drugs or combination on the in vitro cultured Echinococcus multilocularis (Em) metacestodes. METHODS: The drugs used included albendazole (ABZ), itraconazole (ITZ), ivermectin, miltefosine, nitazoxanide (NTZ), and rifampin. The Em metacestodes were cultured for 5 weeks and divided into 17 groups each with 120-140 cysts: ABZ groups (1 microg/ml and 10 microg/ml), ITZ group (0.7 mg/ml), ivermectin group (1.75 mg/ml), miltefosine groups(0.5 microg/ml, 2.5 microg/ml and 7.5 microg/ml), NTZ groups (0.1 microg/ml, 1 microg/ml and 10 microg/ml) and rifampin group (10 microg/ml); groups of NTZ combined with ABZ at respective concentration (10 microg/ml + 10 microg/ml, 10 microg/ml + 1 microg/ml, 1 microg/ml + 10 microg/ml, 1 Igg/ml + 1 microg/ml); and 2 groups of control: (1) experiment culture containing 40 microl of dimethyl sulfoxide (DMSO) per 20 ml and (2) blank culture medium. In the 6 weeks culture period, the drug effect on the Em cysts was observed. Drug combination groups were continually observed for 3 weeks, 3 months and 6 months after discontinuation of drugs. In order to determine the viability of metacestodes, the cysts were injected intraperitoneally into female BALB/c mice, and 8 weeks later, the mice were sacrificed for collecting the parasites. RESULTS: Ivermectin, miltefosine and rifampin showed no effect on metacestodes. Albendazole, itraconazole, nitazoxanide and albendazole combined with nitazoxanide all inhibited or killed the parasites in the in vitro culture system (P < 0.05). High dose of nitazoxanide (10 microg/ml) was more effective in the destroying parasites than others. No regrowth of cysts was observed in the 4 groups of combination treatment with nitazoxanide and albendazole continually cultured for 3 weeks, 3 months, or 6 months after drug discontinuation. In the in vivo viability test, no metacestodes were found in all mice in the nitazoxanide group (10 microg/ml) and 2 mice in albendazole group, but the parasites developed in all mice at 8 weeks after injection in other single drug groups. Also, no metacestodes from all the combination treatment groups were found re-developed in mice. CONCLUSION: This investigation indicates certain inhibitory effect of itraconazole and nitazoxanide on Em cysts, and a combination of albendazole with nitazoxanide may enhance the parasitocidal effect.

Corrigendum: Gastric Cancer Cell-Derived Exosomal MicroRNA-23a Promotes Angiogenesis by Targeting PTEN.

[This corrects the article DOI: 10.3389/fonc.2020.00326.].

Laparoscopic Versus Open Appendectomy for Appendicitis in Pregnancy: Systematic Review and Meta-Analysis.

OBJECTIVES: The clinical safety, efficacy and feasibility of laparoscopic appendectomy (LA) compared with open appendectomy (OA) in pregnancy are still controversial. Herein, we are aiming to compare the clinical outcomes of LA and OA in patients with acute appendicitis during their pregnancy. MATERIALS AND METHODS: This was a systematic review and meta-analysis of studies comparing laparoscopic and OA in pregnancy identifying using PubMed, Web of science, Embase, The Cochrane Library, Ovid and Scopus. Two independent reviewers extracted data on surgical complication, fetal loss, preterm delivery, hospital stay, Apgar score in both groups. RESULTS: Twenty-seven studies with total of 6497 patients (4464 in open and 2031 in laparoscopic group) were included. LA was associated with lower rate of wound infection [odds risk (OR)=3.13, 95% confidence interval (CI): 1.77-5.56, P<0.0001] overall complications (OR=2.15, 95% CI: 1.47-3.14, P<0.0001) and shorter hospitalization (mean difference=0.72, 95% CI: 0.43-1.02, P<0.00001) compared with open group. LA was in a lower risk for 5-minute Apgar score (mean difference=0.09, 95% CI: 0.02-0.17, P=0.01) group than open group. No difference was found regarding preterm delivery between 2 groups. LA was associated with higher fetal loss (OR=0.57, 95% CI: 0.41-0.79, P=0.0007) compared with open surgery. However, laparoscopy was not associated with increased fetal loss after 2010 (OR=0.74, 95% CI: 0.44-1.24, P=0.26) compared with open group. CONCLUSIONS: LA in pregnancy seems to be feasible with acceptable outcome, especially in patients with early and mid-trimester period, with sophisticated hands and experienced centers.

Impact of Albendazole on Cytokine and Chemokine Response Profiles in Echinococcus multilocularis-Inoculated Mice.

OBJECTIVE: Alveolar echinococcosis (AE) is a zoonosis caused by the larval stage of the metacestode Echinococcosis multilocularis with a tumor-like behavior in the targeted organ, especially in the liver. Surgery with albendazole is first-line modality for AE. Drug discontinuation is usually based upon the parasitic viability shown by the positron emission tomography (PET) scan. However, as a demanding and expensive method, it is not widely practiced in majority of the endemic regions. Further understanding on the cytokine and chemokine response profiles in AE patients may provide an interesting insight for potential markers in viability assessment. METHODS: Mice were inoculated with Echinococcus multilocularis intrahepatically to develop the hepatic AE murine model. Oral albendazole administration was then applied for three months after the first inoculation, and peripheral and regional immune cells including type 1 T helper cells (Th), Th2, Th17, regulatory T (Treg) cells, related cytokines, and chemokines were examined. RESULTS: The hepatic AE lesion was confirmed by ultrasound examination resulting in a successful rate of 70%. Among the 17 cytokines and chemokines detected, plasma levels of IL-23 were significantly higher in E. multilocularis-infected mice when compared to the control group; furthermore, more obvious increasing levels were found after albendazole treatment (p < 0.05). All chemokine levels other than eotaxin and MCP-3 were slightly higher in E. multilocularis-infected mice compared to the control group (p > 0.05). Eotaxin levels were significantly decreased in mice with E. multilocularis infection followed by albendazole treatment (p < 0.05). Both IL-17A and IL-23 expressions in hepatic AE lesions were significantly higher and related with disease activity. CONCLUSION: Albendazole administration influenced the balance of immune response and promotes the secretion of proinflammatory factors which is beneficial to parasite clearance. IL-23 seems to be associated with the successful albendazole treatment in mice with E. multilocularis infection; such a change could be translated into clinical application in the near future.

Ex Vivo Liver Resection and Autotransplantation as Surgical Option for Zone II-III Leiomyosarcoma of IVC: A Case Report and Literature Review.

We report the first documented case of leiomyosarcoma at zone II-III of inferior vena cava with thrombi in three hepatic veins undergoing ex vivo liver resection and autotransplantation (ELRA) and hepatic veins thrombectomy. A 33-year-old female patient presented with abdominal distention and lower extremities edema. Abdominal wall varicosis and shifting dullness were positive on physical examination. Her liver function was classified as Child-Pugh B and a solid tumor at retro-hepatic vena cava extending to right atrium with thrombi in three hepatic veins were confirmed. The diagnosis of leiomyosarcoma with Budd-Chiari syndrome was highly suspected with preoperative ultrasound, echocardiogram, CT scan, and three-dimensional reconstruction. A zone II-III leiomyosarcoma of IVC origin was confirmed at surgery and ex vivo liver resection and autotransplantation, and hepatic vein thrombectomy with atrial reconstruction were performed under cardiopulmonary bypass (CPB). Operative time, anhepatic time, and CPB time were 12 h, 128 min, and 84 min, respectively. The patients experienced post-operative liver dysfunction and was cured with conservative therapy. Hepatic recurrence two years after surgery was managed with radiofrequency. The patient was alive with liver metastasis three years after surgery. Despite being regarded as an extremely aggressive procedure, ELRA could be considered in the treatment of advanced leiomyosarcoma with Budd-Chiari syndrome and hepatic vein thrombi.

Prognostic value of plasma IL-27 on biological viability of hepatic cystic echinococcosis.

OBJECTIVES: To investigate potential biomarkers for distinguishing biological viability of hepatic cystic echinococcosis. METHODS: Using Luminex assay we measured plasma concentrations of cytokine and chemokine in patients with active and non-active cysts (hepatic cystic echinococcosis (HCE), n = 47) and stable/progressive hepatic alveolar echinococcosis (HAE, n = 38), and in comparable infection-free volunteers (n = 48). Disease progression was staged according to the classification standard. RESULTS: Compared with healthy controls, enhanced elevation was found of T helper 22 type cytokine interleukin (IL)-22 and chemokines Eotaxin, interferon-γ inducible protein-10, monocyte chemoattractant protein-1, and stromal cell-derived factor-1α concentrations in HAE patients, and IL-22, growth-related oncogene α, monocyte chemoattractant protein-1, regulated on activation normal T-expressed and secreted, and stromal cell-derived factor-1α concentrations in HCE patients (P < 0.05-0.001). For HCE patients, only IL-27 concentrations in non-active HCE were significantly lower than in active HCE. In logistic regression analysis, IL-27 <20.79 pg/mL was an independent risk factor for HCE biological viability with receiver operating characteristic analysis at a 44.23 pg/mL cut-off resulting in 0.72 area under the curve. CONCLUSIONS: Our findings correlate multiple cytokine and chemokine secretion patterns in HAE and HCE patients with different disease progression stages. IL-27 could serve as a referring biomarker for distinguishing HCE biological viability and provide a preliminary foundation for clinical decision-making.

[Clinical experiences in the treatment of human multi-organ alveolar echinococcosis by surgery and drugs].

OBJECTIVE: To explore the approach of operation plus chemotherapy in the treatment and diagnosis of human complicated alveolar echinococcosis (AE) in multi-organs (liver, lung and brain). METHODS: The clinical data for 17 cases of alveolar echinococcosis were reviewed by a follow-up of 1 - 7 years between 2000 and 2009 at our hospital. RESULTS: Among 17 cases, 8 cases achieved an excellent effect after taking liposomal albendazole, 3 cases received radical hepatectomy and 1 case pneumonectomy with a better effect, 1 case of palliative liver transplantation had lung metastasis and stayed on a long-term therapy of liposomal albendazole. Another case of liver transplantation received a long-term postoperative chemotherapy. And the metastases of lung and brain were found. Three operative cases suffered serious complications in liver and brain and received a long-term chemotherapy. One of them died of serious brain complications after a 6-month follow-up. And one advanced AE patient died at home due to a refusal of any further treatment. Since more than two organs are involved by AE lesion of alveolar echinococcosis, it was rather difficult to diagnose and cure AE radically by complicated surgery. Thus the life quality and long-term survival of patients were seriously endangered. CONCLUSION: Based on surgical approaches for serious complications and a comprehensive medical therapy, the multi-organ AE patients may have a prolonged survival and an improved clinical outcome.

Gastric Cancer Cell-Derived Exosomal microRNA-23a Promotes Angiogenesis by Targeting PTEN.

Hypoxia-exposed lung cancer-released exosomal microRNA-23a (miR-23a) has been shown to enhance angiogenesis as well as vascular permeability, contributing to the close correlation between exosomal miR-23a and tumorigenesis. The current study aimed to investigate whether gastric cancer (GC) cell-derived exosomal miR-23a could induce angiogenesis and to elucidate the potential mechanisms associated with the process. Differentially expressed miRNAs in GC were initially screened from the Gene Expression Omnibus database. Target genes were selected following miRNA-mRNA prediction and subsequently verified by dual luciferase reporter assay. RT-qPCR was conducted to detect miR-23a and PTEN expression in GC tissues, cells and exosomes. Human umbilical venous endothelial cells (HUVECs) were co-cultured with GC cell-derived exosomes to assess the angiogenesis mediated by exosomes in vitro. Additionally, PTEN was overexpressed in HUVECs to analyze the mechanism by which miR-23a regulates angiogenesis. miR-23a was highly expressed in GC tissues and cells and GC cell-derived exosomes. Angiogenesis was promoted by the co-culture of HUVECs and GC cells-derived exosomes, as evidenced by the increased expression of VEGF but decreased expression of TSP-1. PTEN was targeted by miR-23a and was lowly expressed in GC tissues. In a co-culture system, miR-23a carried by GC cells-derived exosomes promoted angiogenesis via the repression of PTEN. Collectively, GC cell-derived exosomal miR-23a could promote angiogenesis and provide blood supply for growth of GC cells. This study contributes to advancement of miRNA-targeted therapeutics.