Comparing the antireflux effect of laparoscopic proximal gastrectomy with double-flap technique reconstruction versus laparoscopic total gastrectomy with Roux-en-Y reconstruction for proximal early gastric cancer: study protocol for a multicentre, prospective, open-label, randomised controlled trial.

INTRODUCTION: Laparoscopic proximal gastrectomy with double flap technique (LPG-DFT) reconstruction has been used for proximal early gastric cancer in recent years. However, its feasibility and safety remain uncertain, as only a few retrospective studies have contained postoperative complications and long-term survival data. LPG-DFT for proximal early gastric cancer is still in the early stages of research. Large-scale, prospective randomised controlled trials (RCTs) are necessary to assess the value of LPG-DFT for proximal early gastric cancer. METHODS AND ANALYSIS: This study is a multicentre, prospective, open-label, RCT that investigates the antireflux effect of LPG-DFT compared with laparoscopic total gastrectomy with Roux-en-Y (LTG-RY) reconstruction for proximal early gastric cancer. A total of 216 eligible patients will be randomly assigned to the LPG-DFT group or the LTG-RY group at a 1:1 ratio using a central, dynamic and stratified block randomisation method, if inclusion criteria are met. General and clinical data will be collected when the patient is enrolled in the study and keep pace with the patient at each stage of his medical and follow-up pathway. The primary endpoint is the proportion of patients with reflux esophagitis (Los Angeles Grade B or more) within 12 months postoperatively. The secondary endpoints included intraoperative outcomes, postoperative recovery, postoperative pain assessment, pathological outcomes, postoperative quality of life, postoperative nutrition status, morbidity and mortality rate, and oncological outcomes (3-year overall survival (OS), 3-year disease-free survival (DFS), 5-year DFS and 5-year OS). ETHICS AND DISSEMINATION: The protocol is approved by the Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University ethics committee (registration number: SYSKY-2022-276-02) on 28 September 2022.We will report the positive as well as negative findings in international peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT05890339.

FMO family may serve as novel marker and potential therapeutic target for the peritoneal metastasis in gastric cancer.

Objective: To explore the relationship between flavin-containing monooxygenases (FMOs) and peritoneal metastasis (PM) in gastric cancer (GC). Materials and methods: TIMER 2.0 was used to perform pan-cancer analysis and assess the correlation between the expression of FMOs and cancers. A dataset from The Cancer Genome Atlas (TCGA) was used to analyze the correlation between FMOs and clinicopathological features of GC. PM is well established as the most common mode of metastasis in GC. To further analyze the correlation between FMOs and PM of GC, a dataset was obtained from the National Center for Biotechnology Information Gene Expression Omnibus (GEO) database. The results were validated by immunohistochemistry. The relationship between FMOs and PM of GC was explored, and a novel PM risk signature was constructed by least absolute shrinkage and selection operator (LASSO) regression analysis. The regression model's validity was tested by multisampling. A nomogram was established based on the model for predicting PM in GC patients. The mechanism of FMOs in GC patients presenting with PM was assessed by conducting Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses in TCGA and GEO datasets. Finally, the potential relationship between FMOs and immunotherapy was analyzed. Results: The pan-cancer analysis in TCGA and GEO datasets showed that FMO1 was upregulated, while FMO2 and FMO4 were downregulated in GC. Moreover, FMO1 and FMO2 correlated positively with the T and N stage of GC in the TCGA dataset. FMO1 and FMO2 expression was a risk factor for GC (hazard ratio: 1.112 and 1.185). The overexpression of FMO1 was significantly correlated with worse disease-free-survival (DFS) and overall survival (OS). However, no relationship was found between FMO2 expression in GC and DFS and OS. PM was highly prevalent among GC patients and typically associated with a worse prognosis. FMO1 was highly expressed in GC with PM. FMO1 and FMO2 were positively correlated with PM in GC. We identified a 12-gene panel for predicting the PM risk signature by LASSO (Area Under Curve (AUC) = 0.948, 95%CI: 0.896-1.000). A 10-gene panel for PM prediction was identified (AUC = 0.932, 95%CI: 0.874-0.990), comprising FMO1 and FMO2. To establish a model for clinical application, a 7-gene panel was established (AUC = 0.927, 95% CI: 0.877-0.977) and successfully validated by multisampling. (AUC = 0.892, 95% CI: 0.878-0.906). GO and KEGG analyses suggest that FMO1 and FMO2 regulate the extracellular matrix and cell adhesion. FMO1 and FMO2 were positively correlated with the immune score of GC, and their expression was associated with the infiltration of immune cells. Conclusion: PM in GC is strongly correlated with FMOs. Overall, FMO1 and FMO2 have huge prospects for application as novel diagnostic and therapeutic targets.

LncRNA LINC01537 Promotes Gastric Cancer Metastasis and Tumorigenesis by Stabilizing RIPK4 to Activate NF-κB Signaling.

Many studies reported that long noncoding RNAs (lncRNAs) play a critical role in gastric cancer (GC) metastasis and tumorigenesis. However, the underlying mechanisms of lncRNAs in GC remain unexplored to a great extent. LINC01537 expression level was detected using quantitative reverse transcription-polymerase chain reaction (qRT-PCR) and immunohistochemistry (IHC). Its biological roles in GC were then investigated using functional experiments. In order to investigate the underlying mechanism of LINC01537 in GC, RNA pull-down, RNA immunoprecipitation, and ubiquitination assays were performed. LINC01537 was significantly overexpressed in GC tissues and associated with a poor prognosis. Functional experimental results revealed that LINC01537 promoted the proliferation, invasion, and migration of GC cells. The animal experiments revealed that LINC01537 promoted tumorigenesis and metastasis in vivo. Mechanistically, LINC01537 stabilizes RIPK4 by reducing the binding of RIPK4 to TRIM25 and reducing its ubiquitination degradation, thereby promoting the expression of the NF-κB signaling pathway. According to our findings, the LINC01537-RIPK4-NF-κB axis promoted GC metastasis and tumorigenesis.

A novel prognostic signature based on cuproptosis-related lncRNA mining in colorectal cancer.

Background: Colorectal cancer (CRC) is a common malignant tumor that affects the large bowel or the rectum. Cuproptosis, recently discovered programmed cell death process, may play an important role in CRC tumorigenesis. Long non-coding RNAs (lncRNAs) can alter the proliferation of colorectal cancer cells through the control and activation of gene expression. To date, cuproptosis-related lncRNAs, have not been investigated as potential predictive biomarkers in colorectal cancer. Methods: The mRNA and lncRNA expression data of colorectal cancer were gathered from The Tumor Genome Atlas (TCGA) database, and Pearson correlation analysis and univariate Cox regression analysis were used to identify the lncRNAs with differential prognosis. Colorectal cancer was classified using consistent clustering, and the clinical significance of different types, tumor heterogeneity, and immune microenvironment differences was investigated. The differential lncRNAs were further screened using LASSO regression to develop a risk scoring model, which was then paired with clinicopathological variables to create a nomogram. Finally, the copy number changes in the high-risk and low-risk groups were compared. Results: Two clusters were formed based on the 28 prognostic cuproptosis-related lncRNAs, and the prognosis of cluster 2 was found to be significantly lower than that of cluster 1. Cluster 1 showed increased immune cell infiltration and immunological score, as well as strong enrichment of immune checkpoint genes. Next, LASSO regression was used to select 11 distinctive lncRNAs, and a risk score model was constructed using the training set to distinguish between high and low-risk groups. Patients in the high-risk group had a lower survival rate than those in the low-risk group, and both the test set and the total set produced consistent results. The AUC value of the ROC curve revealed the scoring model's efficacy in predicting long-term OS in patients. Moreover, the model could be used as an independent predictor when combined with a multivariate analysis of clinicopathological features, and our nomogram could be used intuitively to predict prognosis. Conclusion: Collectively, we developed a risk model using 11 differential lncRNAs and demonstrated that the model has predictive value as well as clinical and therapeutic implications for predicting prognosis in CRC patients.

Three-dimensional versus two-dimensional laparoscopic surgery for rectal cancer: better promote postoperative sexual and urinary function of a propensity-matched study.

Laparoscopic total mesorectal excision (TME) with autonomic nerve preservation (ANP) is a common procedure for rectal cancer (RC), associated with a high prevalence of postoperative urogenital and anorectal dysfunctions. Compared to 2D laparoscopy, 3D laparoscopy provides better depth perception of the surgical field and hand-eye coordination to achieve better outcomes. We compared the performance of 2D and 3D laparoscopy on preserving urogenital and anorectal function in TME+ANP surgery for rectal cancer using propensity-score matching. Data were collected from consecutive male patients who underwent 3D or 2D laparoscopic TME+ANP for primary RC at our institution between March 2012 and December 2020. The primary outcome was sexual and urinary function 1 year after surgery. A total of 450 male patients were eligible. After 1:1 matching, 146 cases were included in each group for analysis. One year after surgery, the prevalence of sexual dysfunction (International Index of Erectile Function score <26) was 8.22% in the 3D laparoscopic group and 44.52% in the 2D laparoscopic group, respectively (P=0.000) and a significant difference in the incidence of urinary retention was observed (n=3 and 24, respectively (P=0.000)). Moreover, blood loss, operative time, duration of hospital stay, and the time to first flatus in the 3D laparoscopic group were significantly less than in the 2D laparoscopic group. In conclusion, 3D laparoscopic TME is associated with lower incidences of postoperative sexual and urinary dysfunction than 2D laparoscopic TME for rectal cancer in male patients.

Immune-Related LncRNAs to Construct a Prognosis Risk-Assessment Model for Gastric Cancer.

BACKGROUND: Gastric cancer is a prevalent cause of tumor death. Tumor immunotherapy aims to reshape the specific immunity to tumors in order to kill the tumor. LncRNAs play a pivotal role in regulating the tumor immune microenvironment. Herein, immune-related lncRNAs were used to establish a prognosis risk-assessment model for gastric cancer and provide personalized predictions while providing insights and targets for gastric cancer treatment to enhance patient prognosis. METHODS: Gastric adenocarcinoma transcriptome and clinical data were acquired from the The Cancer Genome Atlas (TCGA) database to screen the immune-related lncRNAs. Then, LASSO COX regression was utilized to construct the prognosis risk-assessment model. Afterward, the reliability of the model was evaluated the relationship between immune infiltration, clinical characteristics, and the model was analyzed. RESULTS: We identified 13 lncRNAs and constructed the prognosis assessment model. According to the median risk score of the training set, the patients were assigned to different risk groups. Overall survival time was shorter in the high-risk group. In the high-risk group, higher infiltration of mono-macrophages, dendritic cells, CD4+ T cells, and CD8+ T cells was observed. Moreover, the model was positively related to tumor metastasis. CONCLUSION: The prognosis risk-assessment model developed in this research can effectively predict the prognosis of gastric cancer patients. This tool is expected to be further applied to clinics in the future, thus providing a novel target for immunotherapy in gastric cancer patients.

Long noncoding RNA OVAAL enhances nucleotide synthesis through pyruvate carboxylase to promote 5-fluorouracil resistance in gastric cancer.

5-Fluorouracil (5-FU) is widely used in gastric cancer treatment, yet 5-FU resistance remains an important clinical challenge. We established a model based on five long noncoding RNAs (lncRNA) to effectively assess the prognosis of gastric cancer patients; among them, lncRNA OVAAL was markedly upregulated in gastric cancer and associated with poor prognosis and 5-FU resistance. In vitro and in vivo assays confirmed that OVAAL promoted proliferation and 5-FU resistance of gastric cancer cells. Mechanistically, OVAAL bound with pyruvate carboxylase (PC) and stabilized PC from HSC70/CHIP-mediated ubiquitination and degradation. OVAAL knockdown reduced intracellular levels of oxaloacetate and aspartate, and the subsequent pyrimidine synthesis, which could be rescued by PC overexpression. Moreover, OVAAL knockdown increased sensitivity to 5-FU treatment, which could be reversed by PC overexpression or repletion of oxaloacetate, aspartate, or uridine. OVAAL overexpression enhanced pyrimidine synthesis to promote proliferation and 5-FU resistance of gastric cancer cells, which could be abolished by PC knockdown. Thus, OVAAL promoted gastric cancer cell proliferation and induced 5-FU resistance by enhancing pyrimidine biosynthesis to antagonize 5-FU induced thymidylate synthase dysfunction. Targeting OVAAL-mediated nucleotide metabolic reprograming would be a promising strategy to overcome chemoresistance in gastric cancer.

Magnetic resonance neuroimaging promotes the preservation of pelvic autonomic nerves in laparoscopic total mesorectal excision: a comparative study.

BACKGROUND: How to preserve pelvic autonomic nerves system (PANS) in total mesorectal excision (TME) is still a technical challenge for gastrointestinal surgeons, and nerve preservation according to preoperative magnetic resonance imaging (MRI) is a hot topic in pelvic surgery. The purpose of this study was to assess the postoperative urogenital function of patients with rectal cancer (RC) who underwent preoperative and postoperative neuroimaging of PANS vs. patients who did not. METHODS: Patients meeting the inclusion criteria were prospectively enrolled in a magnetic resonance neuroimaging (MRN) group from June 2018, while primary RC patients from January 2016 to May 2018 who met the inclusion criteria were enrolled in a non-MRN group. Patients in the MRN group underwent MRN examination before operation and 6 months after operation, while those in the non-MRN group were collected and analyzed retrospectively. RESULTS: Based on International Prostate Symptom Score (IPSS) and International Index of Erectile Function 5 (IIEF5) scores at 6 months, the postoperative urinary and sexual function of male patients in the MRN group were significantly better than that in the non-MRN group (P<0.05). In addition, based on International Consultation on Incontinence modular Questionnaire on Female Lower Urinary Tract Symptoms (ICIQ-FLUTS) and Female Sexual Function Index (FSFI) scores at 6 months, the postoperative sexual function of female patients in the MRN group was significantly better than that in the non-MRN group (P<0.05). CONCLUSIONS: In the present study, we constructed a three-dimensional (3D) presentation of PANS based on preoperative MRN which showed in vivo pelvic autonomous innervation. This may promote the preservation of PANS during TME and reduce the postoperative urogenital dysfunction rate.

Laparoscopic versus open selective lateral pelvic lymph node dissection following total mesorectal excision for locally advanced low rectal cancer.

PURPOSES: Lateral pelvic lymph node (LPLN) dissection represents a technically challenging procedure with a high potential risk of surgical morbidity. The purpose of this study was to compare the technical feasibility, safety, and oncological efficacy of laparoscopic LPLN dissection (LPLD) following total mesorectal excision (TME) with open LPLD for locally advanced low rectal cancer (LALRC). METHODS: Between January 2010 and December 2016, consecutive patients with LALRC and swollen LPLNs who underwent laparoscopic or open TME with LPLD at our institution were enrolled in this retrospective observational study. Data regarding patient demographics, perioperative characteristics, and oncological outcomes were analyzed and compared. RESULTS: A total of 64 patients met the inclusion criteria. Thirty-four patients underwent open procedure, and 30 underwent laparoscopic procedure. The mean blood loss volume was significantly less in the laparoscopic group than in the open group (165 vs. 422 mL; P = 0.012). The mean operative time was not significantly different between the laparoscopic and the open groups (354 ± 91 vs. 315 ± 78 min; P = 0.522). The overall postoperative complication rates were 30.0% and 35.3% for the laparoscopic and open groups (P = 0.428), respectively. Postoperative urinary retention was significantly less in the laparoscopic group than in the open group (14.7 vs. 0%; P = 0.036).The duration of postoperative hospital stay was significantly shorter in the laparoscopic group (8.5 ± 3.8 vs. 13.6 ± 6.5 days; P = 0.025). The numbers of harvested lymph nodes and positive resection margin rates showed no significant differences. Pathological LPLN metastases were confirmed in 10 patients (29.4%) in the open group and 11 (36.7%) in the laparoscopic group (P = 0.537). The median follow-up duration was 41.5 months (range 3-98). The laparoscopic and open groups also showed a similar 3-year overall survival rate (88.2% vs. 85.3%; P = 0.577), relapse-free survival rate (73.3% vs. 67.6%; P = 0.889), and local recurrence rate (3.3 vs. 5.9%; P = 0.653). CONCLUSIONS: Laparoscopic TME with LPLD is technically feasible and safe in selected patients with LALRC and is associated with similar oncological outcomes as open approach.

Inactivation of the Prolyl Isomerase Pin1 Sensitizes BRCA1-Proficient Breast Cancer to PARP Inhibition.

PARP inhibitor monotherapies are effective to treat patients with breast, ovary, prostate, and pancreatic cancer with BRCA1 mutations, but not to the much more frequent BRCA wild-type cancers. Searching for strategies that would extend the use of PARP inhibitors to BRCA1-proficient tumors, we found that the stability of BRCA1 protein following ionizing radiation (IR) is maintained by postphosphorylational prolyl-isomerization adjacent to Ser1191 of BRCA1, catalyzed by prolyl-isomerase Pin1. Extinction of Pin1 decreased homologous recombination (HR) to the level of BRCA1-deficient cells. Pin1 stabilizes BRCA1 by preventing ubiquitination of Lys1037 of BRCA1. Loss of Pin1, or introduction of a BRCA1-mutant refractory to Pin1 binding, decreased the ability of BRCA1 to localize to repair foci and augmented IR-induced DNA damage. In vitro growth of HR-proficient breast, prostate, and pancreatic cancer cells were modestly repressed by olaparib or Pin1 inhibition using all-trans retinoic acid (ATRA), while combination treatment resulted in near-complete block of cell proliferation. In MDA-MB-231 xenografts and triple-negative breast cancer patient-derived xenografts, either loss of Pin1 or ATRA treatment reduced BRCA1 expression and sensitized breast tumors to olaparib. Together, our study reveals that Pin1 inhibition, with clinical widely used ATRA, acts as an effective HR disrupter that sensitizes BRCA1-proficient tumors to PARP inhibition. SIGNIFICANCE: PARP inhibitors have been limited to treat homologous recombination-deficient tumors. All-trans retinoic acid, by inhibiting Pin1 and destabilizing BRCA1, extends benefit of PARP inhibitors to patients with homologous recombination-proficient tumors.See related commentary by Cai, p. 2977.

Long Non-Coding RNA STARD13-AS Suppresses Cell Proliferation And Metastasis In Colorectal Cancer.

BACKGROUND: Dysregulation of long non-coding RNAs (lncRNAs) is closely related with the progression of cancer in humans. The functional and regulatory roles of lncRNAs in colorectal cancer (CRC) are still largely unclear. The purpose of this study is to explore the function of lncRNA STARD13-AS in CRC. METHODS: The bioinformatics tool "GEPIA" was used to predict the potential expression of STARD13-AS in CRC. qRT-PCR was used to evaluate the relative expression level of STARD13-AS in CRC cells lines and tissues samples. The functional involvement of STARD13-AS in the CRC cells was assessed using MTT assay, flow cytometry, and Transwell assay. The expression levels of cyclin D, cyclin E, E-cadherin, N-cadherin, and vimentin were assessed using Western blot. RESULTS: Bioinformatics prediction and qRT-PCR results showed that STARD13-AS expression was decreased in CRC tissues. Patients with low STARD13-AS expression exhibited distant and lymphatic metastasis as well as enhancement in tumor size. STARD13-AS expression was downregulated in CRC cell lines compared to normal human colon mucosal epithelial cell line NCM460 and STARD13-AS expression in SW620 and LoVo cell lines was lowest. Moreover, we observed that while STARD13-AS overexpression suppressed the cell cycle, proliferation, migration, and invasion, while promoted apoptosis both in LoVo and SW620 cells. In addition, STARD13-AS overexpression inhibited Cyclin E, Cyclin D, N-cadherin and vimentin expression, and promoted E-cadherin expression both in LoVo and SW620 cells. CONCLUSION: Expression of STARD13-AS suppresses cell proliferation and metastasis in CRC, suggesting that STARD13-AS might act as a potential target for CRC treatment.

Tumor deposit indicates worse prognosis than metastatic lymph node in gastric cancer: a propensity score matching study.

BACKGROUND: The prognostic value of tumor deposit (TD) in gastric cancer is controversial. This study aims to investigate the prognostic value of TD. METHODS: The consecutive patients diagnosed with gastric cancer from October 2007 to October 2012 were selected. The patients were divided by whether they suffered TD into two groups. The basic data were comparable between the two groups after propensity score matching (PSM), then survival analysis [overall survival (OS) and cancer-specific survival (CSS)] was applied in two groups. After that, all the patients were divided by pN staging and survival analysis were applied in each subgroup. At last, all patients were divided into TD group, pN1 stage group, pN2 stage group, pN3a, and pN3b stage group, OS and CSS were compared between them. Multivariable competing risk analyses tested association of TD with OS and CSS, before and after PSM. RESULTS: Eight hundred and three patients were concluded. After PSM, 137 patients with TD and 274 patients without TD were selected, the 5-year OS and CSS rates of patients with TD were significantly worse than patients without TD (OS: 19.7% vs. 42.0%, P<0.001; CSS: 22.6% vs. 45.6%, P<0.001). In all patients' survival analysis, the 5-year OS and CSS rates of TD group were comparable with pN3a group (OS: 19.7% vs. 25.3%, P=0.221, CSS: 22.6% vs. 30.1%, P=0.092) and pN3b group (OS: 19.7% vs. 19.6% P=0.349, CSS: 22.6% vs. 23.5%, P=0.452). Meanwhile, on multivariable cox regression analyses, the presence of TD significantly reduces the OS and CSS of patients in gastric cancer. CONCLUSIONS: TD has a marked impact on the prognosis of gastric cancer. Even patients with TD had the same prognosis with pN3 stage.

A Comparison of Outcomes between Lichtenstein and Laparoscopic Transabdominal Preperitoneal Hernioplasty for Recurrent Inguinal Hernia.

There remain concerns about the optimal technique for repairing recurrent inguinal hernias because of the high risks of complications and recurrence. The aim of this study was to compare Lichtenstein hernioplasty with the transabdominal preperitoneal (TAPP) laparoscopic technique in the treatment of recurrent inguinal hernias. One hundred twenty-two patients who underwent surgery for recurrent inguinal hernia were prospectively randomized to receive either Lichtenstein (n = 63) or TAPP (n = 59) hernioplasty between January 2010 and December 2014. Baseline characteristics, intraoperative complications, and short- and long-term postoperative factors were evaluated. Preoperative factors were comparable between the two groups. The average follow-up period was 46.2 ± 8.5 months. The two groups had similar intraoperative and short-term postoperative complication rates, whereas the rate of long-term postoperative complications was lower for the TAPP group than the Lichtenstein group (6.8% vs 23.8%, respectively, P = 0.012). The TAPP group had significantly lower visual analogue scale scores, fewer analgesics consumption, and faster recovery than the Lichtenstein group (P < 0.05). Chronic pain was more prevalent in the Lichtenstein group than the TAPP group (15.9% vs 3.4%, respectively, P = 0.031). The recurrence rate was 4.8 per cent for the Lichtenstein group and 1.7 per cent for the TAPP group, with no significant difference (P = 0.62). Both the Lichtenstein and TAPP procedures are safe and effective methods for repairing recurrent inguinal hernia with low incidence rates of life-threatening complications and recurrence. The TAPP procedure is superior to the Lichtenstein repair in terms of reduced postoperative pain, shorter sick leave, faster recovery, and better cosmetic results. Careful selection of the surgical procedures and implementation of technical essentials are necessary.

Extracts of endophytic fungus xkc-s03 from Prunella vulgaris L. spica inhibit gastric cancer in vitro and in vivo.

Prunella vulgaris L. belongs to the Prunella genus and has been proven effective in the treatment of gastric cancer, however, the therapeutic activity of the endophytic fungi is not yet well understood. The results of the present study suggest that the ethyl acetate extract (S03-EA) of the endophytic fungus XKC-S03, isolated from Prunella vulgaris L. spica, is a potent anticancer agent with the potential to treat gastric cancer. In the present study, the effects of S03-EA on gastric cancer in vitro and in vivo were determined using the 1-(4,5-dimethylthiazol-2-yl)-3,5-diphenylformazan assay and the human gastric cancer SGC 7901 cell xenograft model. The tumor tissue was fixed with 10% formaldehyde solution and the levels of the apoptotic proteins, B-cell lymphoma protein-2 (Bcl-2), Bcl-2-associated X protein (Bax) and pro-angiogenic vascular endothelial growth factor (VEGF), were measured by immunohistochemistry. The results indicated that treating SGC 7901 cells with petroleum ether (S03-PE), ethyl acetate (S03-EA) or dichloromethane (S03-DM) extracts from the XKC-S03 fermentation broth inhibited cell proliferation. S03-EA demonstrated the best activity, with a half maximal inhibitory concentration of 25.89 µg/ml and dose-dependent suppression of the SGC 7901 tumor cells in vivo, without any evident adverse effects. In addition, the 100-mg/kg/day S03-EA-treated tumor tissue revealed a downregulation of Bcl-2 and VEGF expression and an upregulation of Bax expression. In conclusion, the S03-EA extract of XKC-S03, isolated from Prunella vulgaris L. spica, exhibits a growth-suppressive activity on gastric cancer in vitro and in vivo.

Small metal soft tissue foreign body extraction by using 3D CT guidance: a reliable method.

OBJECTIVE: To introduce a useful and accurate technique for the locating and removal of small metal foreign bodies in the soft tissues. METHODS: Eight patients presented with suspected small metal foreign bodies retained in the soft tissues of various body districts. Under local anesthesia, 3-6 pieces of 5 ml syringe needles or 1 ml syringe needles were induced through three different planes around the entry point of the foreign bodies. Using these finders, the small metal FBs were confirmed under 3D CT guidance. Based on the CT findings, the soft tissues were dissected along the path of the closest needle and the FBs were easily found and removed according to the relation with the closest needle finder. RESULTS: Eight metal foreign bodies (3 slices, 3 nails, 1 fish hook, 1 needlepoint) were successfully removed under 3D CT guidance in all patients. The procedures took between 35 min and 50 min and the operation times took between 15 min and 25 min. No complications arose after the treatment. CONCLUSION: 3D CT-guided technique is a good alternative for the removal of small metal foreign body retained in the soft tissues as it is relatively accurate, reliable, quick, carries a low risk of complications and can be a first-choice procedure for the extraction of small metal foreign body.

[Sequential extraction experiments applied to study chemical mobility of fluorine in rocks].

Sequential extraction experiments were used to study the chemical mobility of fluorine in rocks. The results show that there are quite big differences in chemical mobility of fluorine in rocks of different types. Fluorine in carbonate rock is very active, in which the proportion of leachable fluorine is generally more than 75%. Fluorine in black rocks of Lower Cambrian is closely related to their different metamorphosed grades, in which fluorine in black carbonaceous slate with higher metamorphosed grade mostly has lower leachability than black shale and black siliceous rock. Generally speaking, the leachable percentage of fluorine is high in phosphorite rocks and low in phyllite. The leachable fluorine in diabase is in direct proportion to its fluorine concentration. There are some differences in chemical mobility of fluorine in stone coal of different ages. Fluorine in stone coal of Silurian has higher leachability than stone coal of Cambrian.

Developing environmental health indicators as policy tools for endemic fluorosis management in the People's Republic of China.

Drinking groundwater containing naturally occurring elevated concentrations of fluoride has given rise to extensive dental and skeletal fluorosis affecting many millions of people in China. This paper describes three sets of indicators useful for environmental and human fluorosis management purposes, namely, descriptive indicators (the past), response indicators (the present) and performance indicators (the future). Each of the sets of indicators was further detailed following the Organisation for Economic Co-operation and Development (OECD) pressure-state-response model modified to include an impact parameter. But as managers need more aggregated information to summarise monitoring data, two indices were constructed from identified indicators, namely, a four component (indicators) 'health impact index', and a three component (indicators) 'management capability index'. Data from 14 provinces and autonomous regions were used to illustrate the application of the two indices. Results showed major differences in the values for the indices for management actions and human health outcomes at the provincial level. Provinces with a low management capability index, for example, Inner Mongolia, had a high health impact index, while provinces with a high management capability index, for example, Shandong had a low health impact index. It was concluded that a greater emphasis should be given in China, not just to monitoring fluorosis occurrence, but to the development of indicators and indices that empower decision-makers to initiate strategies to more effectively manage this major endemic disease.

In vitro effects of metal ions on lipid peroxidation induced by alcohol in mice liver homogenate.

The study is aimed to estimate the effect of different heavy metals such as Hg2+, Cd2+, Mn2+, Cr3+, Ni2+, Se2O3(2-), As2O3 water solution and combined effects of Hg2+, Mn2+, Cr3+ on lipid peroxidation in mice liver homogenate in vitro. Lipid peroxidation was determined as thiobarbituric acid-reacting materials (TBA). We select five different concentrations of selected ions for experiments. Correlations used to identify the concentration of ions associated with lipid peroxidation. The rate of lipid peroxide formation in mice liver homogenate increased with the gradual addition of alcohol. When alcohol dose was up to 0.5 ml, the rate of lipid peroxide formation was greatest. At tested concentrations, the effects of metal ions on lipid peroxidation induced by alcohol were classified into three groups, and are as follows: (1) simulative, Hg2+. (2) inhibitory, Mn2+, Cr3+, Ni2+, Se2O3(2-). (3) ambiguous, Cd2+, As2O3 water solution. When Hg2+, Mn2+ and Cr3+ were added to the mice liver homogenate with alcohol at the same time, Hg2+, Mn2+ were the main agents for the rate of alcohol induced lipid peroxidation. The simulative effect of Hg2+ on lipid peroxidation induced by alcohol indicate that alcohol-drinkers will have further health risk when they are exposed in polluted regions than others, and Mn2+, Cr3+, Ni2+, Se2O3(2-) may act as free radical scavengers and preventive remedy for alcoholism in part. Furthermore, analysis of combined effect of Hg2+Mn2+ and Cr3+ provide us a new way to estimate the combined effect of multi-materials.

[Towards <>: idea, principle and methodology of design and research results].

<>is the first atlas with spatial analysis methods to study on plague distributions, epidemics, controls, foci characters and their relationships with environment in China. This paper briefly introduces the idea, principle and methodology of its design and the main research results from it. The atlas include ten map groups as general maps, environmental background maps, plague epidemic and foci background maps in the world, maps of plague foci and their environments, epidemic maps, distribution maps of reservoirs, distribution maps of vectors, biotype distribution maps of yersinia pestis, maps of control institutions and control result maps. All map groups are composed together to focus the research on the relationship between plague and its environment for control. The atlas not only expatriates the temporal and spatial distribution of plague in last 200 years in China, but also reveals spatial distribution of plague foci and regional difference of the plasmid combination and biochemical types of yersnia pestis. The close relationship between plague and its geochemical environment (enriched in Fe or Ca) is one of the most important discovers which provide further study and control directions of plague.