Mutational landscape of DNA damage response deficiency-related genes and its association with immune biomarkers in esophageal squamous cell carcinoma.

Esophageal squamous cell carcinoma (ESCC) has limited effective treatment strategies. DNA damage response (DDR) genes are of therapeutic interest in multiple cancer types. This study aimed to depict the landscape of DDR mutations in ESCC and evaluate the association between DDR mutations and known immunotherapy biomarkers. We recruited 250 Chinese patients with ESCC and performed next-generation sequencing. A total of 107 patients underwent a PD-L1 examination. Among the 250 patients, 73 (29.2%) harbored at least one DDR gene mutation and were defined as DDR-mut. Among the six functional DDR pathways, homologous recombination (HR) accounted for 12.4% (31/250). DDR-mut patients were significantly associated with higher tumor mutational burden than those in the DDR-wt group (p=7.4e-07). Patients with PDL1-H accounted for 21.2% (36/107) of the patients. PDL1-H was more prevalent in DDR-mut than DDR-wt, although the p-value did not reach a significant level (40.5% vs. 30%, p=0.29). Further analysis revealed that BRCA1, one of the most frequently mutated genes in the HR pathway, was significantly associated with PDL1-H (p=0.01). Our data revealed a subset of patients with ESCC harbored DDR gene mutations. Patients with these DDR gene mutations are significantly associated with immune biomarkers, implying the potential feasibility of combining DDR agents with immunotherapy in patients with DDR deficiency.

Homozygous mutations in SPEF2 induce multiple morphological abnormalities of the sperm flagella and male infertility.

BACKGROUND: Male infertility due to multiple morphological abnormalities of the sperm flagella (MMAF) is a genetically heterogeneous disorder. Previous studies revealed several MMAF-associated genes, which account for approximately 60% of human MMAF cases. The pathogenic mechanisms of MMAF remain to be illuminated. METHODS AND RESULTS: We conducted genetic analyses using whole-exome sequencing in 50 Han Chinese probands with MMAF. Two homozygous stop-gain variants (c.910C>T (p.Arg304*) and c.3400delA (p.Ile1134Serfs*13)) of the SPEF2 (sperm flagellar 2) gene were identified in two unrelated consanguineous families. Consistently, an Iranian subject from another cohort also carried a homozygous SPEF2 stop-gain variant (c.3240delT (p.Phe1080Leufs*2)). All these variants affected the long SPEF2 transcripts that are expressed in the testis and encode the IFT20 (intraflagellar transport 20) binding domain, important for sperm tail development. Notably, previous animal studies reported spontaneous mutations of SPEF2 causing sperm tail defects in bulls and pigs. Our further functional studies using immunofluorescence assays showed the absence or a remarkably reduced staining of SPEF2 and of the MMAF-associated CFAP69 protein in the spermatozoa from SPEF2-affected subjects. CONCLUSIONS: We identified SPEF2 as a novel gene for human MMAF across the populations. Functional analyses suggested that the deficiency of SPEF2 in the mutated subjects could alter the localisation of other axonemal proteins.

Ghrelin Affects Gastric Cancer Progression by Activating AMPK Signaling Pathway.

As the endogenous ligand for the GH secretagogue receptor (GHSR), Ghrelin is aberrant expressed in multiple malignant carcinoma, and involved in regulating a number of progression of cancer, especially in metastasis and proliferation. However, the precise role of Ghrelin in tumorigenesis of gastric cancer (GC) is still poorly understood. In this study, we extensively investigated the roles and mechanisms of Ghrelin in human gastric cancer. Ghrelin levels in cancer tissues and cell lines were analyzed by immunohistochemistry, qRT-PCR, and Western blot. Functional studies were performed after Ghrelin overexpressed or knockdown in AGS cell line. Cell proliferation was evaluated in by MTT and clone formation assays. The wound healing and Transwell system were used to assess the cell migration and invasive ability of GC cells. Cell apoptosis was detected by flow cytometry, and metabolic assays were performed to reveal the function of Warburg effect in the process. Ghrelin was lowly expressed in gastric cancer tissues and cell lines. Overexpression of Ghrelin inhibited gastric cancer cell proliferation, migration, invasion, and promoted apoptosis by activating the AMPK pathway, while D-[lys3]-GHRP-6 (a GHSR agonist) treatment relieved the effect, promoting tumorigenesis. Ghrelin knockdown increased the glucose uptake and lactic acid release, suggesting that Ghrelin elicited an anti-Warburg effect via AMPK pathway to inhibit gastric tumorigenesis. Ghrelin inhibits cell proliferation, migration, and invasion by eliciting an anti-Warburg effect via AMPK signaling pathway in gastric cancer cells.

Hotair mediates tumorigenesis through recruiting EZH2 in colorectal cancer.

Long noncoding RNAs (lncRNA)  have been demonstrated to extensively participate in a wide spectrum of biological activities ranging from embryogenesis and cancer progression. HOX transcript antisense RNA (Hotair), an lncRNA located in the HOXC locus, has been reported to play an important role in carcinogenesis. As a well-known oncogene, it potentiates cancer metastasis and tumor progression. And it also serves as a biomarker for poor prognosis and tumor recurrence. In this study, Hotair was found to be upregulated in colorectal cancer (CRC) cells and clinical specimens. Further investigation showed that knockdown of Hotair dramatically suppressed cell proliferation and colony formation, suggesting that Hotair may stimulate tumorigenesis of CRC. The enhancer of zeste homolog 2 (EZH2), a regulator of epigenetic modification, was upregulated in CRC cells and clinical samples. And the silence of EZH2 significantly suppressed cell viability and colony formation. Furthermore, the RNA immunoprecipitation assay revealed that Hotair directly bound EZH2 in CRC cells. In conclusion, Hotair mediated tumorigenesis via recruiting EZH2, which might shed light on the development of a novel therapeutic approach for patients with CRC.

Sequential Therapy or Standard Triple Therapy for Helicobacter pylori Infection: An Updated Systematic Review.

The effectiveness of standard triple therapy (STT) for the eradication of Helicobacter pylori has decreased recently. Sequential therapy (SQT) is a new regimen proposed to address this problem. The aim of this study was to compare the efficacy of SQT versus STT for H. pylori eradication. We searched The Cochrane Library, MEDLINE, Web of Science, and EMBASE databases up to July 2014. The risk ratios (RRs) of eradication rate were pooled, with a 95% confidence interval (CI). Thirty-six randomized clinical trials including a total of 10,316 patients met the inclusion criteria. The RR for eradication of H. pylori with SQT compared with STT was 1.14 (95% CI: 1.09-1.17), the eradication rates were 84.1% and 75.1%, respectively. There was significant heterogeneity between trial results (I = 73%; P < 0.00001). Subgroup analyses showed that SQT was superior to both 7- and 10-day STT, but not significantly better than 14-day STT. This superiority existed when patients were treated with either metronidazole or tinidazole. Patients with single clarithromycin-resistant strain showed a greater benefit of SQT over STT (eradication rates 80.9% vs. 40.7%), RR = 1.98 (95% CI: 1.33-2.94). There was no significant difference between groups in terms of the risk of adverse effects. In conclusion, SQT is more efficacious than STT (7 days and 10 days) in the eradication of HP, but the pooled rate seemed suboptimal. Further research is needed to develop more effective therapeutic approaches. Surveillance of resistance rates should be performed to guide treatment.

[Effect of hypoxia on the activation and visfatin expression in rat hepatic stellate cells].

OBJECTIVE: To investigate the effect of hypoxia on the visfatin and the expression of smooth muscle-actin (alpha-SMA) and hypoxia-inducible factor-1alpha (HIF-1alpha) in rat hepatic stellate cells (HSCs). METHODS: Rat primary HSCs were isolated from SD rats by in situ perfusion of collagenase and pronase and single-step Nycodenz density gradient centrifugation, and then cultured and activated. Completely activated primary HSCs were exposed to hypoxic conditions (37 degrees C, 5% CO2, 1% O2, 94% N2), or normoxic conditions (37 degrees C, 5% CO2, 21% O2, 74% N2), for 3, 6, 12 or 24 h respectively. The expression of alpha-SMA, the marker of HSC activation, and visfatin were assessed by Real time-PCR and Western blot. The Expression of HIF-1alpha was detected by Real time-PCR. RESULTS: HIF-1alpha mRNA in rat HSCs was induced after exposed to hypoxia for 3 h, and maintained elevated status up to 24 h. HSCs exposed to 1% O2 hypoxic conditions for 6 h increased alpha-SMA mRNA and protein expression. Visfatin mRNA expression was up-regulated after subjected to hypoxia for 12 h, and protein level was elevated after 6 h hypoxia. A positive linear correlation existed between alpha-SMA and visfatin expression in responsible to hypoxia (r = 0.991 (genes) and r = 0.968 (proteins), P < 0.05). CONCLUSION: Microcirculation impairment could significantly induce alpha-SMA and visfatin expression in rat HSCs, which might potentate the activation process of HSCs.

[Role of macrophage migration inhibitory factor in hepatic stellate cells activation].

OBJECTIVE: To investigate the role of macrophage migration inhibitory factor (MIF) in activation of primary hepatic stellate cells (HSC), and to explore the blocking effect of specific antisense oligonucleotides (ASONs) targeting MIF on the activation of primary HSCs. METHODS: Rat primary HSC were isolated from SD rats by in situ perfusion of collagenase and pronase and single-step Nycodenz density gradient centrifugation, and then cultured and activated. The expression of alpha-smooth muscle actin (alpha-SMA), the marker of HSC activation, was assessed by RT-PCR and immunocytochemistry (ICC). The expression of MIF was detected by RT-PCR, enzyme-linked immuno sorbent assay (ELISA), immunofluorescence (IF) or ICC. Completely activated primary HSC were transfected with MIF-specific antisense oligonucleotide (MIF-ASONs), mis-sense oligonucleotides of MIF, or blank liposome (negative-control). RESULTS: Quiescent HSC expressed very low level of MIF, while MIF gene and protein expression increased significantly during the process of HSC activation. Positive correlation was found between the expression of alpha-SMA and MIF (r = 0.944, P < 0.01). Compared with the control, activated primary Gen HSC transfected with MIF-ASONs showed lower MIF and alpha-SMA expressions at gene and protein profiles (P < 0.05). CONCLUSION: The expression of MIF was up-regulated in the process of HSC activation. Activation in culture of primarily isolated rat HSC could be inhibited by MIF-ASONs, suggesting at least in part that, MIF might be a novel and important factor involved in HSC activation and hepatic fibrosis.

[Effects of omeprazole on the proliferation and apoptosis of hepatoma cell line HepG2].

OBJECTIVE: To investigate the effects of omeprazole (OME), a proton pump inhibitor, on the proliferation and apoptosis of human hepatoma cell line HepG2. METHODS: HepG2 cells were cultured to the logarithmic phase, and then treated with OME of different concentrations (10, 20, 40, 80, 160 mg/L) for 24 h or 48 h. Cell proliferation was evaluated by MTT assay, DNA synthesis was measured with 5-ethynyl-2'-deoxyuridine (Edu) fluorescent assay and the apoptosis of cells was measured by the Hoechst33342 assay. RESULTS: MTT assay showed that OME (40, 80 and 160 mg/L concentrations) could inhibit the proliferation of HepG2 cells for 24 h or 48 h treatment (P < 0.05) and 80 mg/L group has strongest effect. Compared with that of 24 h treatment, the same concentration of OME could inhibit HepG2 more significantly with 48 h treatment. After different concentrations of OME treatment for 24 h and then incubation with Edu for 2 h, compared with the control group, the proportion of Cells in S phase in 20, 40, 80, 160 mg/L groups decreased. Hoechst33342 staining demonstrated that treatment with OME (40, 80,160 mg/L) for 24 h could significantly promote the cell apoptosis. CONCLUSION: Omeprazole could inhibit human hepatoma cell line HepG2 cell proliferation and promote apoptosis.

Deployment of self-expanding metallic stents under fluoroscopic guidance in patients with malignant esophagorespiratory fistula.

BACKGROUND/AIMS: Stent deployment for the treatment of ERFs is typically performed under endoscopic guidance. Our aim was to evaluate self-expanding metallic stent placement under fluoroscopic guidance. METHODOLOGY: The records of six patients who underwent self-expanding metallic stent placement under fluoroscopic guidance for the treatment of ERFs were reviewed. Technical data of the procedures, complications, and associated morbidity were recorded. The main outcome measures were dysphagia score, KPS, and survival. RESULTS: Stents were successfully inserted in all 6 patients without complications, and all procedures were completed within 15 minutes. The mean dysphagia score was 4 +/- 0 before treatment and 1.2 +/- 0.8 one week after stent placement. The mean KPS increased significantly from 28.0 +/- 9.8 before stent placement to 58.3 +/- 16.0 one week after placement (p = 0.001). For the patients who had KPS < or =50 one week after the surgery, the survival period was relatively short (mean, 37 days). For the patients who had KPS > or =60 one week after the surgery, the mean survival period was 192 days. CONCLUSIONS: Self-expanding metallic stent placement can be performed safely and quickly under fluoroscopic guidance alone.

The significance of MAGED4 expression in non-small cell lung cancer as analyzed by real-time fluorescence quantitative PCR.

The aim of this study was to detect differences in the expression levels of melanoma-associated antigen D4 (MAGED4) mRNA between non-small cell lung cancer (NSCLC) tissues and normal tissues, and to compare differences in the expression levels of MAGED4 in tumor patients. Patients were grouped according to age, gender, smoking history, tumor size, pathological classification, degree of lung cancer cell differentiation and presence of lymph node metastasis. The expression levels of MAGED4 were detected using real-time fluorescence quantitative PCR. MAGED4 expression was higher in squamous cell carcinomas compared to adenocarcinomas (P<0.05), in poorly differentiated tissues compared to well-differentiated tissues (P<0.05), and in patients with lymph node metastasis compared to patients without lymph node metastasis (P<0.05). MAGED4 may be used as a specific antigen for NSCLC to influence the improvement of diagnosis, prognosis and immunological therapy outcomes in lung cancer patients.

[Application of MR arthrography for diagnosis of femoral acetabular impingement syndrome].

Femora acetabular impingement (FAI) is thought as the major reason leds to hip osteoarthritis. FAI results to destruction of the arthrodial cartilage. Prognoses of hip osteoarthritis is affected by the degree of arthrodial cartilage destruction. The hip osteoarthritis could be prevented if FAI is diagnosed and treated in earlier period. How can we diagnose FAI in earlier period? Recent studies showed that MRI was the best way for FAI diagnosis. It has higher resolution and signal-noise ratio. Cartilage and gleniod labrum of hip could be shown by MRI. The paper reviewed the standard and difficulties of diagnosis about FAI. High magnet MRI maybe is one way to solve the problems.

Application of the titanium plate fixation system in sternum transverse incisions.

The purpose of this study was to review the application of the titanium plate fixation system in sternum transverse incisions and assess its advantages over the conventional methods of steel wire fixation. Sternal healing of 249 patients who underwent a thymectomy and/or excision of the thymoma with a transverse sternal incision was compared between patients who underwent titanium plate fixation or steel wire fixation. Short-term results: The stability of the sternum was significantly superior in the titanium plate group compared with the steel wire group (P < 0.01). Out-of-bed activities started earlier for patients in the titanium plate group compared with the steel wire group (P < 0.01). Long-term results: The sternal healing rate in the titanium plate group was significantly higher than the steel wire group (P < 0.05). Titanium plate fixation improves the postoperative sternal stability in patients with transverse sternal incisions for thymectomy and/or excision of a thymoma. Titanium plate fixation also reduces postoperative pain, enhances the patient's physical activity, and decreases the long-term nonunion rate of the sternum.