[Integrin α5 promotes the proliferation, invasion and adhesion of gastric cancer by regulating the FAK/Src/Rac1 signaling pathway].

Objective: To elucidate the biological role and potential mechanism of integrin α5 (ITGA5) in gastric cancer (GC). Methods: From January 2019 to December 2020, 35 pairs of GC tissue [21 males and 14 females, aged (53.8±5.4) years] and matched adjacent tissue samples were collected from GC patients who underwent surgical resection in Zhejiang Provincial People's Hospital. GC and normal gastric mucosa cells were purchased from Beijing Biobw Biotech Company. Quantitative real-time PCR (qRT-PCR), immunohistochemistry, Western blotting were performed to detect the mRNA and protein expression levels of ITGA5, cell adhesion-related genes (pFAK, pSrc, aRac1) in GC cells. Cell Counting Kit-8 (CCK-8), Transwell invasion, wound healing and cell adhesion assays were conducted for GC cell phenotype detection. Results: ITGA5 was highly expressed in GC compared with normal gastric mucosa cells (relative expression increased from 1.00±0.26 to 1.23±0.27,P<0.05). In addition, ITGA5 overexpression promoted the cell proliferation [from (1.14±0.14) OD to (1.61±0.14) OD], migration ability [from (20.3±2.3)% to (56.4±6.1)%], invasion ability (from 144.0±4.6 to 216.7±6.6), and adhesion ability of matrix protein (from 99.0±8.5 to 152.0±12.3) through FAK/Src/Rac1 signaling pathway in GC.(all P<0.05) Conclusions: ITGA5 acts as a cancer-promoting factor in GC. The current study provides theoretical evidence for probing the novel molecular targets for the treatment of GC.

[Jiangsu Province Coronary Artery Bypass Grafting Registry study: a report of 4 661 patients in 13 centers].

Objective: To examine the overall status of the Jiangsu Province Coronary Artery Bypass Grafting Registry database. Methods: The patients date of Jiangsu Province Coronary Artery Bypass Grafting Registry database from October 2017 to December 2019 was collected retrospectively.Risk factors, history, cardiac function (New York Heart Association class), extent of coronary artery lesion, European system for cardiac operative risk evaluation Ⅱ (EuroSCORE Ⅱ), cardiopulmonary bypss, arterial grafts, the numbers and flow of grafts and postoperative major adverse cardiac and cerebrovascular event(MACCE) information were analyzed. The clinical data of patients underwent on-pump CABG(ONCABG) or off-pump CABG (OPCAB) were compared by t test or χ(2) test. Results: Up till December 2019, the database enrolled 7 138 patients, in which 4 661 patients receiving primary isolated CABG. There were 3 486 males and 1 175 females with the age of (64.6±8.1) years (range:31 to 87 years). There were coronary left main disease in 960 patients, triple vessel disease in 3 934 patients, both left main and triple vessel disease in 837 patients, ejection fraction>50% in 3 841 patients, cardiac function class Ⅲ to Ⅳ in 1 664 patients. EuroSCORE Ⅱ was (2.3±0.7)% (range: 0.5% to 35.8%). There were 2 731 patients (58.59%) underwent ONCABG and 1 930 patients (41.41%) underwent OPCAB. There were 4 144 patients (88.91%) for whom the left internal thoracic artery was harvested. Seven centers (2 centers routinely) used left radial artery, 5 centers (3 centers routinely) used the transit time flow meter. The graft was 3.4±0.7 (range:1 to 7), the aortic crossclamp time was (65.0±20.4) minutes (range: 21 to 196 minutes), the cardiopulmonary bypass time was (90.0±24.2) minutes (range: 33 to 227 minutes). In-hospital death ocurred in 84 patients(1.80%), while re-operation in 93 patients (2.00%), myocardial infarction in 71 patients (1.52%), cerebral infarction in 33 patients (0.71%) and dialysis in 56 patients (1.20%). There were 2 936 patients prescribed with secondary prevention drugs(62.99%).Comparing with OPCAB group, ONCABG group had younger age, more female, more diabetes mellitus, more history of myocardial infarction and percutaneous transluminal coronary angioplasty, poorer cardiac function and coronary lesions, higher EuroSCORE Ⅱ, preoperatively (all P<0.05), and was associated with higher MACCE (135/2 731 vs. 71/1 930, χ(2)=4.280, P=0.039), and of more grafts, transfusion and intra-aortic balloon counterpulsation application (all P<0.05). Conclusions: Jiangsu Province Coronary Artery Bypass Grafting Registry database is generally in good operation, and some parameters still need to be improved. Comparing with OPCAB group, ONCABG has more severe preoperative general conditions, while the outcomes is acceptable.

Neuropeptide S promotes wakefulness through activation of the posterior hypothalamic histaminergic and orexinergic neurons.

In spite of the initial and pivotal findings that the newly identified neuropeptide S (NPS) promotes arousal associated with locomotor and anxiolytic-like effects, the mechanisms through which NPS acts to modulate sleep-waking states remain unclear. The present study was undertaken to investigate in the rat the effects of i.c.v. injection of NPS on the EEG, sleep-wake cycle, and brain c-Fos expression. NPS at 0.1 and 1 nmol increased significantly wakefulness (W) during the first 2 h (54.7 ± 3.2 and 64.9 ± 2.1 min, respectively, vs. 41.4 ± 2.5 min seen with saline injections, P<0.01 and P<0.001), accompanied by an increase in EEG high frequency activities (14.5-60 Hz). In the meanwhile, slow wave sleep (SWS) and paradoxical sleep (PS) decreased significantly. Ex-vivo Fos immunohistochemistry in the posterior hypothalamus revealed that, as compared with saline-treated rats, NPS enhanced c-Fos expression in histaminergic neurons by 76.0% in the ventral tuberomammillary nucleus (TMN) and 57.8% in the dorsal TMN, and in orexinergic neurons by 28.2% in the perifornical nucleus (PeF), 24.3% in the dorsomedial hypothalamic nucleus (DMH), and 13.7% in the lateral hypothalamic area (LH) of the posterior hypothalamus. The NPS-induced c-Fos expression in histaminergic neurons and orexinergic neurons where NPS receptor (NPSR) mRNA is highly expressed, suggests that NPS activates histaminergic and orexinergic neurons to promote W.

The characteristics of placental transfer and tissue concentrations of nickel in late gestational rats and fetuses.

The dynamics of nickel (Ni) uptake, transfer, retention and clearance in fetuses and late gestational rats were investigated by assessing its distributions in placenta, maternal and fetal organs and tissues during the 24 h period after a single dose of (63)Ni intraperitoneal injection on gestational day 20. Peak (63)Ni radioactivity was detected at 0.5 h in maternal blood, at 3 h in placenta, fetal membranes, fetal blood, fetal heart, maternal kidney, lung, stomach, liver and brain, at 9 h in fetal kidney, stomach, liver and brain, and lastly at 24 h in fetal lung and amniotic fluid. The maximal (63)Ni radioactivity among all samples was detected consistently in the fetal membranes and placenta. The (63)Ni radioactivity in fetal blood was higher than that in maternal blood from 3 to 24 h. The fetal liver, heart, stomach and brain exhibited higher (63)Ni radioactivity than the corresponding maternal organs from 6 to 24 h. However, maternal kidney consistently exhibited significantly higher (63)Ni radioactivity than the fetal kidney. The (63)Ni in fetal lung and amniotic fluid increased throughout the period of experimental observation. These observations corroborated previous finding that nickel is actively transferred across the blood-placenta-barrier into fetus, but hardly from fetus to mother. Moreover, these results suggest that the placenta has a high affinity for nickel and its barrier does not protect the fetus from nickel exposure. The fact that nickel concentrations are higher in most fetal organs and tissues than in corresponding maternal organs and tissues in late gestation indicates that, unlike the dam, fetuses lack effective means for getting rid of excessive nickel due to its confined environment and relatively weak kidney functions. The situation is exacerbated by mother-to-fetus unidirectional transfer. Consequently, the fetuses are particularly vulnerable to the damaging effects of nickel.

The clinical value of serum CEA, CA19-9, and CA242 in the diagnosis and prognosis of pancreatic cancer.

AIM: Serum tumour markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) and CA242 were investigated to evaluate the values of single and combined test in the diagnosis and prognosis of pancreatic cancer. METHODS: Pre-operative serum CEA, CA19-9 and CA242 were measured in 105 pancreatic cancers, 70 non-pancreatic malignancies and 30 benign pancreatic diseases. RESULTS: The sensitivity of CA19-9 alone was the highest in pancreatic cancer patients (80%), but the specificity was significantly lower than that of CEA and CA242 (P<0.01). The combination of CEA and CA242 could increase the specificity to 92%. In serum CA242 positive patients, the survival time was remarkably shorter than that of patients with negative result (P<0.01). The survival time in patients with more than two markers positive expression of CEA, CA19-9 and CA242 was obviously shorter than that of only one or no marker positive expression (P<0.05). CONCLUSION: The diagnostic rate of CA19-9 in pancreatic cancer is better than that of CEA and CA242. Combined detection of CEA and CA242 can improve the diagnostic specificity obviously. High levels of serum markers are associated with advanced stage of the disease. Patients with two or three markers positive expression of CEA, CA19-9, and CA242 simultaneously had a shorter survival time.

Dietary variables and glucose tolerance in pregnancy.

OBJECTIVE: To investigate relationships between dietary macronutrient intakes and glucose tolerance in pregnancy RESEARCH DESIGN AND METHODS: Nulliparous pregnant Chinese women diagnosed with gestational diabetes mellitus (GDM) (n = 56) were compared to age-, gestational age-, height-, and parity-matched groups with normal glucose tolerance (n = 77) and glucose intolerance (IGT) (n = 38) based on the results of an oral glucose tolerance test (National Diabetes Data Group criteria), performed between 24 and 28 weeks of pregnancy. A 24-h recall dietary assessment was also obtained at the time of screening. RESULTS: Subjects with IGT and GDM were significantly heavier (66.1 +/- 1.4 and 68.6 +/- 1.2 kg, respectively, mean +/- SEM) (P < 0.0001) than the normal group (61.2 +/- 1.8 kg) and had a higher BMI. Overall energy intake was similar between groups, as were the intakes of each macronutrient (%kcal). However, there was a highly significant reduction in polyunsaturated fat intake in the IGT and GDM groups whether expressed as %kcal, % of total fat, or fat kcal. This effect was independent of body weight or BMI whether assessed by ordinal logistic regression or by analysis of a weight- and BMI-matched subgroup of the subjects (P = 0.002 for %kcal; n = 47 normal, 26 IGT, and 43 GDM subjects). In logistic regression analysis of the complete data set, increased body weight (P < 0.0001) and decreased polyunsaturated fat intake (P = 0.0014) were both independent predictors of glucose intolerance (IGT and GDM), as were increased body weight and a low dietary polyunsaturated to saturated fat ratio. CONCLUSIONS: Increased polyunsaturated fat intake is associated with a reduced incidence of glucose intolerance during pregnancy. This finding may have major implications for dietary management of women with or at risk of developing GDM.

[Assay of DNA content and estrogen receptor status in human breast cancer].

Cellular DNA content of 72 samples was analyzed by flow cytometry. The results showed that 20 benign tumors and 10 normal breast tissue specimens were found to be DNA diploidy. 26 (62%) of 42 cases of breast cancer were DNA aneuploidy and the remainders were DNA diploidy. The median s-phase cell percentage was significantly higher in aneuploid tumors (28%) than diploid tumors (13%) and benign tumors (4%). Estrogen receptors were also investigated in 42 breast cancer specimens. There were 31 ER positive (74%) cases and 11 negative (26%) cases. The aneuploid DNA content was usually associated with lack of estrogen receptors. DNA content correlated significantly with age and ER status. The results suggest that flow cytometric analysis of cellular DNA content of breast cancer and status of estrogen receptors can provide an objective quantitative and reproducible new parameter for predicting prognosis of breast cancer.

[Occult breast cancer: 9 cases report and review].

From 1977 to 1994, 9 breast cancer were treated. All patients presented axillary node enlargement as first sign. Six patients were treated by radical or modified radical mastectomy and 3 by axillary node excision. All patients received postoperative adjuvant radiotherapy and chemotherapy. Among the 6 patients treated by radical or modified radical mastectomy, 4 survived over 10 years after surgery, 1 died of heart disease at 8 years, and 1 on chemotherapy is for 4 months. The three patients treated by axillary node excision, all died of the disease at 8-32 months. It is considered that radical or modified radical mastectomy with adjuvant radiotherapy and chemotherapy is a suitable treatment selection for occult breast cancer.

[Case-control study on intrauterine growth retardation and vitamin nutritional status in late pregnancy].

Ninety-seven cases of pregnant women with intrauterine growth retardation (IUGR) and 133 controls were investigated on their dietary intake and blood vitamin levels in late pregnancy. Results showed insufficient calorie and protein intake, deficiency in calcium and vitamin B2, and low intake of vitamins A and B1 in pregnant women with IUGR. Their serum level of vitamin E was only half as that in controls (P < 0.01). Mothers' serum level of vitamin E correlated positively to several indicators reflecting infant growth with multiple stepwise regression analysis. There was no significant difference of activity of erythrocytic transketonas activity (TPP%) and activity coefficient (AC) of glutathione reductase between the two groups. It suggested pregnant women in both groups suffered from deficiency in thiamine and riboflavin (TPP% > 16%, AC > 1.2).

[Local excision of cancer of the rectum].

Conservative treatment of 35 patients with rectal cancer by local excision is reported. Limited surgery of rectal cancer can be a part of treatment of this tumor. Selection of the patient for limited surgical procedure should be strictly in accordance with the following criteria: tumor diameter less than 3 cm, clinical staging I and II, histologically well differentiated type, tumor invasion no deeper than the submucosa and patients with severe cardiopulmonary diseases who could not withstand radical surgery. A transanal local excision is the most straightforward approach. Local excision was by per anal full-thickness disc excision and trans-sphincteric disc excision. Prognosis and further treatment were based on the histopathologic results of operative specimen. The overall 5-year survival rate was 71.4% (18/21) and 10-year survival rate 33% (7/21).

[Treatment of proximal biliary duct carcinoma].

During the past 30 years, 21 patients suffering from proximal biliary duct carcinoma were treated by surgery. The resectability rate was 14%. Three patients had radical resection, 2 surgical bypass, 3 surgical catheterization for drainage, 4 PTCD, and 2 intraluminal radiotherapy with Iridium-192 delivered by a remote afterloading system through catheters introduced intraoperatively. The survivals ranged from 3 to 13 months. Due to the proximity of this portion of biliary duct to the hepatic hilus, invasion of the adjacent structures such as the portal vein and hepatic artery is common. Hence, complete resection is difficult and palliative surgical approach is usually adopted. Results of our treatment and review of relevant documents are presented.

[Multiple carcinomas of large bowel].

Thirty-eight patients with multiple carcinomas of large bowel were encountered during 32 years period in our hospital. The incidence of synchronous carcinomas (SC) was 1.5% (22/1430) and metachronous carcinomas (MC) 1.1% (16/1430). Thirty-one patients were found to have two primary carcinomas and seven patients have three primary malignancies. Among the 38 patients, six also had cancers in ether organs. The authors discussed the diagnosis, tumor distribution, the cancer association with familial colonic polyposis, and hereditary colon cancer. The 5 years survival rate with SC treated by surgery was 35.7% (5/14), and was 93% (15/16) with MC. It is the authors' opinion that surgical resection should always be attempted in patients with SC and MC.

Evaluation of prenatal nutrition counseling: maternal nutrition status and infant birthweight.

A prospective study on the effect of prenatal nutrition counseling on maternal nutrition status and infant birthweight was conducted at an antenatal care clinic by comparing a group of 80 women who attended nutrition counseling sessions with another group of 63 women who did not participate in nutrition counseling (controls). The daily intake of protein, calcium, iron, retinol, and riboflavin in the counseled group was higher than that in the control group. Moreover, the daily intake of nutrients of the counseled women met the recommended dietary allowance. Blood constituent determinations revealed that the levels of serum total protein, albumin, vitamin A, vitamin E, zinc, copper, magnesium, and hemoglobin in the blood of mothers and in umbilical blood at delivery were higher in the counseled group than in the control group (P less than 0.01). The women receiving counseling had fewer low-birthweight infants (1.52% vs 2.70%) and the incidence of maternal anemia was 39.1% against 55.6%, a significant difference (P less than 0.01).

[Hereditary site-specific colon cancer--report of two families].

Five cases of hereditary site-specific colon cancer (HSSCC or Lynch syndrome I) from two families are reported. The main features of HSSCC are: an autosomal dominant model of heredity, the absence of associated polyposis, the average age being younger, vulnerable site being the right colon (4/5 cases), multiple colon cancers (3/5 cases) and long survival. These 5 cases possessed the above mentioned features. Having no special detection method, the authors suggest that the members of these families be registered and the high risk members regularly checked.

[Extra-abdominal desmoid tumor--analysis of 26 patients].

Twenty-six patients with extra-abdominal desmoid tumor are reported. The tumor was located in the head and neck (6 cases), chest wall (3 cases), arm and leg (9 cases), paravertebral tissue (6 cases) and in the abdomen (2 cases). Of the 26 patients, 17 were treated for the first time and 9 had recurrent lesions. This tumor, showing aggressive growth, involved peripheral nerves (7 cases), blood vessels (4 cases), bones (11 cases) or viscera (2 cases). Surgery is the treatment of choice. The recurrence rate was 11% in those who received their first treatment. Wide dissection led to lower recurrence than simple excision (23% vs 72%). The authors stress the importance of excising at least 2-3 cm beyond the tumor margin and extra-abdominal desmoid tumor should be treated as a soft tissue tumor with low malignancy.

[Subungual malignant melanoma--30 year review of cases].

Twenty-five patients with subungual malignant melanoma confirmed by pathology from 1958 to 1987 were reported. There were 19 males and 6 females. 76% of the lesions occurred on the finger and 24% on the foot. The most common site was the thumb or great toe. 16/25 of the patients had history of subungual pigmented streaks. As trauma at the lesion site might initiate subungual melanoma (28%), doctors should pay close attention to the subungual black pigmented streaks or a mass below the nail with a history of trauma in order to avoid mis-diagnosis. In these 25 patients, the diagnosis was delayed in 19, and 10 of them already had regional lymph node metastasis. Surgical treatment still played a major role for subungual melanoma. According to the clinical staging, various degrees of amputation at different levels and regional lymph node dissection were recommended. The 5-year survival rate in this group was 28% (7/25).

[Eosinophilic granuloma of the stomach].

Two patients with eosinophilic granuloma of the stomach are reported with review of associated literatures. Neither of the patients had a history of allergy. The diagnosis of these two patients was not confirmed by barium-meal examination, endoscopy and biopsy before operation. One lesion was localized to the distal part and another to the near part of the stomach. The resected specimens were microscopically typical of eosinophilic granuloma of the stomach.

[Abdominal wall desmoid tumor--analysis of 42 patients].

Forty two patients with abdominal wall desmoid tumor, including one Gardner's syndrome, are reported. All patients were female except one. The tumor occurred in various sites in the abdominal wall, 66% in the lower abdominal wall. The fascia, sheath and muscle layer were chiefly involved and a very large tumor could invade peritoneum and viscera. This tumor shows aggressive growth and is prone to recurrence. Surgery is the treatment of choice. Local recurrence rate was 5.5%. Abdominal wall desmoid tumor associated colonic polyposis is named Gardner's syndrome. The authors emphasize that a local extended resection should be performed with a safety margin at least 2-3 cm beyond the tumor. Peritoneum, if involved, should be resected together with the primary focus.

[Occult blood detector for the upper G-I tract. I. A preliminary application in cancer screening].

The traditional chemical detection of small amount of blood in the stool can not tell whether the original bleeding site is in the upper or lower part of the G-I tract. The occult blood detector, designed by the authors, having a diameter of 8 mm, can easy be swallowed into the stomach with 30 to 50 ml of water. After remaining for 3 minutes in the stomach, it is pulled out by the patient himself and its coloration read to reveal the degree of bleeding. It can be used either by the medical personnel or the patient himself, at home, for the purpose of detecting minute bleeding in the upper G-I tract and for cancer screening in the high risk population. This detector gave a positive rate of 95% in patients with malignancies in the upper gastrointestinal tract. It is highly acceptable for its lack of discomfort during application. In cancer screening, it gave a positive rate of 5% to 10% in 10000 high risk persons. Those positive in this test showed a high incidence of gastric or esophageal cancers as proved by gastroscopy. This detector is being manufactured and sold by the Baiyunshan Pharmaceutical Factory, Guangzhou, Guangdong Province. Other papers concerning this topic are to be published.

[Squamous cell carcinoma of the ascending colon--a case report and review of literature].

One case of squamous cell carcinoma of the ascending colon is reported. The patient, a sixty two year old woman, was admitted because of right abdominal pain for three months. A mass, 6 X 5 cm in size, was palpated. 13 cm colonic mucosa destruction was shown by barium enema. Right hemicolectomy was done. A squamous cell carcinoma of the ascending colon was diagnosed by light and electron microscope. Squamous cell carcinoma of the colon is rare. Squamous cell carcinoma and adenoacanthoma, occurring in the colon and upper rectum, comprise 0.5% of all colonic malignancies. 18 cases have been collected in the literature and this case is the first one reported in China. Etiology of squamous cell carcinoma of the large bowel is reviewed.