[Pathological characteristics and survival analysis of 355 patients with gastroenteropancreatic neuroendocrine neoplasms].

Objective: Biological behavior, pathological characteristics and prognostic factors of 355 cases with gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) were analyzed in this retrospective study. Methods: In our study, 355 patients pathologically diagnosed as GEP-NENs were identified from April 2006 to November 2017 in the Fourth Hospital of Hebei Medical University. The biological behavior, pathological characteristics and prognosis were analyzed retrospectively. Results: There were 355 patients (228 males and 127 females) with a mean age of 58.3±10.7 years. GEP-NENs were detected most frequently in the stomach (48.2%), followed by the pancreas (16.1%), colorectum (14.1%), esophagus (7.6%), duodenum/jejunum(5.6%), liver (4.2%), appendix (2.3%) and gallbladder/bile duct (2.0%). The main clinical manifestations of non-functional GEP-NENs were abdominal pain (88/350, 25.14%), ventosity (77/350, 22.00%) and dysphagia (68/350, 19.43%), which were generally lacking specificity at the first diagnosis. 295 patients were treated surgically, including 45 cases of endoscopic resection and 250 cases of laparoscopic operation. Concerning to pathological grading, there were 22.5% (80/355) patients in grade 1 (G1), 12.7% (45/355) in grade 2 (G2), and 58.9% (209/355) in grade 3 (G3). The median follow-up time was 34 months. Furthermore, the 1-, 3- and 5-year overall survival calculated by Kaplan-Meier method were 80.1%, 59.8%, and 57.5%, respectively. Univariate analysis revealed that tumor site, treatment, operation type, depth of tumor invasion, TNM staging, pathological grading, vascular embolus, lymph node metastasis, tumor size, preoperative leukomonocyte level and preoperative plasma albumin were associated with overall survival (all P<0.05). Multivariate analysis showed that treatment, operation type, depth of tumor invasion, TNM staging, pathological grading, vascular embolus, lymph node metastasis and tumor size were independent prognostic factors for GEP-NENs (all P<0.05). Conclusions: The clinicopathological characteristics of GEP-NENs should be mastered by clinicians, and the standard treatment measures were also needed to be formulated based on the prognostic factors in order to improve the prognosis of patients.

[The association of Bcl-2 gene polymorphism with the esophageal cancer and gastric cardia adenocarcinoma in Hebei Province].

Objective: To investigate the association between the promoter region-938 polymorphism of B-cell lymphoma/leukemia-2 (Bcl-2) gene and the esophageal cancer (EC) and gastric cardia adenocarcinoma (GCA) in Hebei Province. Methods: From 2007 to 2010, 145 esophageal cancer patients and 169 cardiaccancer patientsfrom the outpatient department of the Fourth Hospital of Hebei Medical Universitywereselected in a case group, and 195 non-tumor patients were selected in a control group during the same period. A questionnaire survey was used to collect information of research subjects. Pathological tissues were collected to extract genomic DNA and detect the genotype of bcl-2 gene -938. A multivariate logistic regression model was used to analyze the association between the bcl-2 gene locus 938 CC genotype and the EC and GCA. The interaction between age, gender, smoking, drinking, upper gastrointestinal family history and the bcl-2 gene locus 938 CC genotype was analyzed by likelihood ratio test. Results: The age of the esophageal and cardiac cancer groups was (56.3±8.3) and (57.1±8.4) years old, and that of the control group was (54.7±7.1) years old. The proportion of the bcl-2 gene locus 938 CC genotype in the esophageal group [48.3% (70/145)] and the cardiac cancer group [48.5% (82/169)] was higher than that in the control group [33.8% (66/195)] (both P values<0.05).Compared with the AA genotype, the risk of esophageal cancer and cardiac cancerin people with the CC genotype was 2.386 (1.20-4.76) and 2.564 (1.27-5.18) respectively. In the population with CC genotype, compared with the positive family history, drinking, and male, the negative family history, non-drinking, and female had a higher risk of esophageal cancer; compared with the non-smoking, negative family history, non-drinking and male, the smoking, positive family history, drinking, and female had a higher risk of cardiac cancer (all the P interaction values were <0.05). Conclusion: People with bcl-2 gene locus 938 CC genotype in Hebei Provincewere more likely to suffer from the esophageal and gastric cardia adenocarcinoma.

Mixture toxicity effects and uptake of titanium dioxide (TiO2) nanoparticles and 3,3',4,4'-tetrachlorobiphenyl (PCB77) in juvenile brown trout following co-exposure via the diet.

Titanium dioxide nanoparticles (n-TiO2) are among the man-made nanomaterials that are predicted to be found at high concentrations in the aquatic environment. There, they likely co-exist with other chemical pollutants. Thus, n-TiO2 and other chemical pollutants can be taken up together or accumulate independently from each other in prey organisms of fish. This can lead to dietary exposure of fish to n-TiO2-chemical pollutant mixtures. In this study, we examine if simultaneous dietary exposure to n-TiO2 and 3,3',4,4'-Tetrachlorobiphenyl (PCB77) -used as a model compound for persistent organic pollutants with dioxin-like properties- can influence the uptake and toxicological response elicited by the respective other substance. Juvenile brown trout (Salmo trutta) were fed custom-made food pellets containing n-TiO2, PCB77 or n-TiO2+PCB77 mixtures for 15 days. Ti and PCB77 concentrations in the liver were measured by ICP-MS and GC-MS, respectively. Besides, n-TiO2 uptake was assessed using TEM. Combination effects on endpoints specific for PCB77 (i.e., cytochrome P450 1A (CYP1A) induction) and endpoints shared by both PCB77 and n-TiO2 (i.e., oxidative stress-related parameters) were measured in intestine and liver using RT-qPCR and enzyme activity assays. The results show that genes encoding for proteins/enzymes essential for tight junction function (zo-1) and ROS elimination (sod-1) were significantly upregulated in the intestine of fish exposed to n-TiO2 and PCB77 mixtures, but not in the single-substance treatments. Besides, n-TiO2 had a potentiating effect on PCB77-induced CYP1A and glutathione reductase (GR) expression/enzyme activity in the liver. This study shows that simultaneous dietary exposure to nanomaterials and traditional environmental pollutants might result in effects that are larger than observed for the substances alone, but that understanding the mechanistic basis of such effects remains challenging.

Development of a Passive Sampling Technique for Measuring Pesticides in Waters and Soils.

It is essential to monitor pesticides in the environment to help ensure water and soil quality. The diffusive gradients in thin-films (DGT) technique can measure quantitative in situ labile (available) concentrations of chemicals in water, soil, and sediments. This study describes the systematic development of the DGT technique for nine current pesticides, selected to be representative of different classes with a wide range of properties, with two types of resins (HLB (hydrophilic-lipophilic-balanced) and XAD 18) as binding layer materials. The masses of pesticides accumulated by DGT devices were proportional to the deployment time and in inverse proportion to the thickness of the diffusive layer, in line with DGT theoretical predictions. DGT with both resin gels were tested in the laboratory for the effects of typical environmental factors on the DGT measurements. DGT performance was independent of the following: pH in the range of 4.7-8.2; dissolved organic matter concentrations <20 mg L-1; and ionic strength from 0.01 to 0.25 M, although it was slightly affected at 0.5 M in some cases. This confirms DGT as a sampler suitable for controlled studies of environmental processes affecting pesticides. Field applications of DGT to measure pesticides in situ in waters and controlled laboratory measurements on five different soils (prepared at fixed soil/water ratios) demonstrated DGT is a suitable tool for environmental monitoring in waters and for investigating chemical processes in soils.

Deriving in Vivo Bioconcentration Factors of a Mixture of Fragrance Ingredients Using a Single Dietary Exposure and Internal Benchmarking.

Chemicals in mixtures that are hydrophobic with Log KOW > 4 are potentially bioaccumulative. Here, we evaluate an abbreviated and benchmarked in vivo BCF measurement methodology by exposing rainbow trout to a mixture of eight test chemicals found in fragrance substances and three benchmark chemicals (musk xylene (MX), hexachlorobenzene (HCB) and PCB52) via a single contaminated feeding event followed by a 28-day depuration period. Concentrations of HCB and PCB52 in fish did not decline significantly (their apparent depuration rate constants, kT, were close to zero), whereas kT for MX was 0.022 d-1. The test chemicals were eliminated much more rapidly than the benchmark chemicals ( kT > 0.117 d-1). The bioconcentration factors (BCFA) for the test chemicals were in the range of 273 L kg-1 (8-cyclohexadecen-1-one (globanone)) to 1183 L kg-1 (α-pinene); the benchmarked BCFs (BCFG) calculated relative to HCB ranged from 238 L kg-1 (globanone) to 1147 L kg-1 (α-pinene). BCFG were not significantly different from BCFA but had smaller standard errors. BCFs derived here agreed well with values previously measured using the OECD 305 test protocol. We conclude that it will be feasible to derive BCFs of chemicals in mixtures using a single dietary exposure and chemical benchmarking.

Aqueous multivariate phototransformation kinetics of dissociated tetracycline: implications for the photochemical fate in surface waters.

Antibiotics are ubiquitous pollutants in aquatic systems and can exist as different dissociated species depending on the water pH. New knowledge of their multivariate photochemical behavior (i.e., the photobehavior of different ionized forms) is needed to improve our understanding on the fate and possible remediation of these pharmaceuticals in surface and waste waters. In this study, the photochemical degradation of aqueous tetracycline (TC) and its dissociated forms (TCH20, TCH-, and TC2-) was investigated. Simulated sunlight experiments and matrix calculations indicated that the three dissociated species had dissimilar photolytic kinetics and photooxidation reactivities. TC2- photodegraded the fastest due to apparent photolysis with a kinetic constant of 0.938 ± 0.021 min-1, followed by TCH- (0.020 ± 0.005 min-1) and TCH20 (0.012 ± 0.001 min-1), whereas TCH- was found to be the most highly reactive toward •OH (105.78 ± 3.40 M-1 s-1), and TC2- reacted the fastest with 1O2 (344.96 ± 45.07 M-1 s-1). Water with relatively high pH (e.g., ~ 8-9) favors the dissociated forms of TCH- and TC2- which are most susceptible to photochemical loss processes compared to neutral TC. The calculated corresponding environmental half-lives (t1/2,E) in sunlit surface waters ranged from 0.05 h for pH = 9 in midsummer to 3.68 h for pH = 6 in midwinter at 45° N latitude. The process was dominated by apparent photolysis (especially in summer, 62-91%), followed by 1O2 and •OH oxidation. Adjusting the pH to slightly alkaline conditions prior to UV or solar UV light treatment may be an effective way of enhancing the photochemical removal of TC from contaminated water. Graphical abstract Aqueous multiple photochemical behavior of dissociated tetracycline (TCH20, TCH-, and TC2-) is first comprehensively reported on revealing the phototransformation kinetics and implications for the fate in surface waters.

Investigation and application of diffusive gradients in thin-films technique for measuring endocrine disrupting chemicals in seawaters.

Endocrine disrupting chemicals (EDCs) can be released to coastal waters and affect the endocrine system of marine organisms. To monitor their levels in seawaters, a simple, robust passive sampling method, the diffusive gradients in thin-films (DGT) technique, was developed with XDA-1 resin as a binding agent. Six EDCs (including three estrogens, two pesticides and bisphenol A) were used to assess the performance of the DGT. The XDA-1 binding gel showed adequate ability for adsorbing EDCs in seawaters. The DGT sampler exhibited linear accumulation for the EDCs during a 15-day deployment and diffusion coefficients and sampling rates were calculated. The DGT measurement was independent of pH in the range 7.0-9.0 and ionic strength in the range 0.4-0.8 M. Field applications of this DGT in a coast of Dalian (China) showed comparable results to those from grab sampling. Five EDCs were detected with concentrations ranging from 0.7 to 19.4 ng L-1. This study is a first attempt to apply DGT sampler for determining EDCs in seawaters.

Development and evaluation of diffusive gradients in thin films technique for measuring antibiotics in seawater.

As coastal waters in many regions of the world have been polluted by organic micro-pollutants such as antibiotics that can promote the development of resistance genes, it is of importance to monitor the levels of antibiotics in coastal waters. For this purpose, a reliable and robust sampling approach based on diffusive gradients in thin films (DGT) was developed in this study. The DGT measurement can provide a time weighted average concentration of pollutants. A binding material (resin XDA-1) with a high adsorption capacity for antibiotics, which can resist the pH and ionic strength of seawaters, was selected. The DGT sampler exhibited linear accumulation for 20 antibiotics during a 12h deployment. The antibiotic measurement by the sampler was not affected by pH in the range of 7.3 to 8.9 and ionic strength in the range of 0.5 to 0.8M. After an 8-hour in situ DGT sampling, 10 antibiotics were detected in Dalian coastal seawaters with the concentrations ranging from 2.6 to 44.8ngL-1, which was comparable to the results measured by an active sampling method. This study can be a first attempt to construct DGT sampler for determining antibiotics in seawaters.

Quinazoline-based tricyclic compounds that regulate programmed cell death, induce neuronal differentiation, and are curative in animal models for excitotoxicity and hereditary brain disease.

Expanding on a quinazoline scaffold, we developed tricyclic compounds with biological activity. These compounds bind to the 18 kDa translocator protein (TSPO) and protect U118MG (glioblastoma cell line of glial origin) cells from glutamate-induced cell death. Fascinating, they can induce neuronal differentiation of PC12 cells (cell line of pheochromocytoma origin with neuronal characteristics) known to display neuronal characteristics, including outgrowth of neurites, tubulin expression, and NeuN (antigen known as 'neuronal nuclei', also known as Rbfox3) expression. As part of the neurodifferentiation process, they can amplify cell death induced by glutamate. Interestingly, the compound 2-phenylquinazolin-4-yl dimethylcarbamate (MGV-1) can induce expansive neurite sprouting on its own and also in synergy with nerve growth factor and with glutamate. Glycine is not required, indicating that N-methyl-D-aspartate receptors are not involved in this activity. These diverse effects on cells of glial origin and on cells with neuronal characteristics induced in culture by this one compound, MGV-1, as reported in this article, mimic the diverse events that take place during embryonic development of the brain (maintenance of glial integrity, differentiation of progenitor cells to mature neurons, and weeding out of non-differentiating progenitor cells). Such mechanisms are also important for protective, curative, and restorative processes that occur during and after brain injury and brain disease. Indeed, we found in a rat model of systemic kainic acid injection that MGV-1 can prevent seizures, counteract the process of ongoing brain damage, including edema, and restore behavior defects to normal patterns. Furthermore, in the R6-2 (transgenic mouse model for Huntington disease; Strain name: B6CBA-Tg(HDexon1)62Gpb/3J) transgenic mouse model for Huntington disease, derivatives of MGV-1 can increase lifespan by >20% and reduce incidence of abnormal movements. Also in vitro, these derivatives were more effective than MGV-1.

The prevalence of hematologic and metabolic abnormalities during chronic kidney disease stages in different ethnic groups.

We conducted an observational cross-sectional study to determine if the prevalence of hematologic and metabolic abnormalities in chronic kidney disease (CKD) varied in different ethnic groups. We used a CKD provincial database where a complete data set at the time of registration was available as well as an estimated glomerular filtration rate (eGFR), which showed using the abbreviated MDRD formula that the patients had CKD of stages 3-5. We included patients with self-reported race of Caucasian, Oriental Asian, or South Asian. Primary outcomes were the prevalence of at least one of the following: anemia, hypocalcemia, hyperphosphatemia, hyperparathyroidism, hypoalbuminemia, and three or more laboratory abnormalities. All definitions were consistent with K/DOQI guidelines. When compared with Caucasians, Oriental Asians and South Asians had a higher prevalence of many of the metabolic abnormalities during most stages of CKD and were more likely to have any abnormality at all levels of eGFR. The prevalence of three or more laboratory abnormalities was higher in Oriental Asians at all stages and in South Asians at some levels of eGFR. These results were unchanged or exaggerated when controlled for age, gender, diabetes, and a primary diagnosis of renal disease. Hence, it appears that South Asians and Oriental Asians have more laboratory abnormalities compared with Caucasians at most levels of eGFR.

Factors affecting the outcome of surgical treatment of acromegaly.

PURPOSE: To assess the results of and factors associated with the outcome of surgery for acromegaly. METHODS: We retrospectively examined the medical records of acromegalic patients who underwent trans-sphenoidal adenomectomy at our hospital during the period of January 1991 through August 1997. Preoperative evaluations included measurement of basal serum growth hormone (GH), insulin-like growth factor-I (IGF-I), prolactin (PRL), GH response to oral glucose, and GH and PRL response to bromocriptine, as well as pituitary magnetic resonance (MR) imaging. Postoperative evaluations included measurement of basal serum GH and IGF-I concentrations, and pituitary MR imaging. RESULTS: Thirty patients (14 men) with a mean age of 38 years were included. The mean follow-up period was 50 months (range, 15-90 mo). Ten of the 30 patients (33%) had early postoperative (1 mo after surgery) GH levels of less than 5 ng/mL. Twenty patients (67%) had final postoperative (last follow-up, 15-90 mo after surgery) GH levels of less than 5 ng/mL. Preoperative GH levels were positively correlated with early postoperative GH levels (r = 0.458, p = 0.011) and final postoperative GH levels (r = 0.479, p = 0.007). Early postoperative GH levels were also positively correlated with final postoperative GH levels (r = 0.595, p = 0.001). Tumor grade and stage were not significantly correlated with early or final postoperative GH levels. Thirteen of 21 patients (62%) who had postoperative MR imaging follow-up had residual tumor. There was no surgical mortality. CONCLUSIONS: These results highlight that acromegaly is not easily treated with surgery alone. The preoperative GH level was associated with the surgical outcome.