Gastric cancer is one of the most common malignant gastrointestinal tumors with a high mortality in China. However, the pathogenesis of gastric cancer is not clear. Recently, with the development of cancer stem cell research, more and more studies have been focused on the gastric cancer stem cell. In this review, we will discuss the conception and the study status of the gastric cancer stem cells in addition to the treatment for the cancer stem cell.

Objective To explore the imaging characteristics of seminomas and nonseminomatous germ cell tumors (NSGCT) and its pathological foundation. Methods CT and MR imaging manifestations in 25 cases of testicular germ cell tumors proved by pathological examinations were analyzed retrospectively. All tumors were divided into seminomas group (12 cases) and NSGCT group (13 cases). In the seminomas group, 5 cases were examined by CT and 4 of those also had contrast enhanced CT. Seven cases had MRI and 4 of those had dynamic enhanced MRI. In the NSGCT group, 5 were examined by plain CT in which two were by contrast enhanced CT, eight were by MRI in which 4 were by dynamic enhanced MRI. CT or MRI characteristics (morphology, density or intensity, enhancement) in both groups were analyzed by Fisher test. Results Histological examination revealed 25 intratesticular lesions. In 12 seminomas, 10 showed a nodular/lobulated shape, 5 showed a mixed density or intensity. In 13 NSGCT, only one lesion showed a lobular shape, 11 showed a mixed density or intensity. Seven seminomas showed a low signal on T2WI on MRI while only two NSGCT showed this sign. In four lesions underwent dynamic MRI scanning, 3 showed fibrous septum enhancement while no lesions in NSGCT showed this sign. The occurrence rate of the above imaging characteristics in both group was significantly different (P<0.05). Conclusion Seminomas and NSGCT may have their own CT and MRI characteristics, which may be of great value for differential diagnosis .

Objective To investigate the relationship between apparent diffusion coefficient (ADC)value of rectal adenocarcinoma on DWI and its pathological grading.Methods The ADC values of 46 rectal adenocarcinomas were measured and compared with their histopathological grades.Results The 46 rectal adenocarcinomas included well differentiated adenocarcinomas in 14,moderate-ly differentiated ones in 20,and poorly differentiated ones in 12.The ADC values of well,moderately and poorly differentiated ade-nocarcinomas were (1.125±0.103)×10 -3 mm2/s,(1.030±0.098)×10 -3 mm2/s and (0.922±0.091)×10 -3 mm2/s,respective-ly,exhibiting a statistical difference (χ2 =1 7.35 1,P =0.000).Mann-Whitney U test showed that difference in ADC value between different histopathological grades was statistically significant.Conclusion ADC value of rectal adenocarcinoma can be used as a bio-marker for cell grading to guide treatment decision and prognosis assessment.

Objective To observe the cardiosomatic motor reflex (CMR)of rats, and to clarify the descending modulation of nucleus raphes magnus (NRM)in cardiac nociception and its pathway.Methods 34 male healthy SD rats were randomly divided into NRM electrical stimulation group (n=8 ), NRM stimulation combined with dorsolateral funiculus (DLF ) transection group (n= 8 ), NRM stimulation combined with antagonist of 5-hydroxytryptamine (5-HT)methysergide intrathecal administration group (n=18).The rat model of CMR was established through inj ecting capsaicin into the pericardial sac of the rats in various groups. The electromyogram (EMG) response of dorsal spinotrapezius muscle was used as detection index, and by placing the stimulation electrode in NRM and (or)intrathecal catheterization, the descending inhibitory modulation of NRM in CMR and the influence of DLF tansection or methysergide intrathecal administration in descending inhibitory modulation of NRM were observed.Results Compared with before stimulation,the EMG response was decreased after NRM electrical stimulation (75 μA) (P<0.05 );after bilateral DLF transection, the EMG response after NRM stimulation was significantly increased compared with before DLF transection (P<0.05 ), and there was no significant difference compared with its control (P> 0.05 ). In addition, after intrathecal administration of methysergide,the EMG response after NRM stimulation was significantly increased compared with before intrathecal treatment of methysergide (P<0.05),but it was still significantly smaller than that of its control (P<0.05). Conclusion Cardiac nociception evoked by capsaicin stimulation is subject to descending inhibitory modulation from NRM,and the descending inhibition from NRM is conveyed via the DLF and partially mediated by endogenous 5-HT system.

Objective To report the clinical characteristics of prosthetic valve endocarditis (PVE).Methods All 25 cases of definite PVE (Duke criteria) diagnosed at our hospital between January 1992 to December 2008 were retrospectively analyzed. Among them, 7 cases were pathologically confirmed and the others were clinically confirmed with either 2 major criteria or 1 major and ≥3 minor criteria. Their clinical characteristics, underlying heart diseases, previous heart operations, presenting manifestations, causative microbes, echocardiographic findings and prognosis, were studied. Results (1) Although most cases underwent valve transplantations for underlying heart diseases of rheumatic heart diseases and congenital heart diseases, 10 patients were complicated with infectious endocarditis (IE) prior to the operations, 4 of them were PVE. (2) Eleven of them developed PVE within 2 months postoperatively. Fever (100%),major vessel embolism (48%), and anemia (36%) were the most frequently manifestations. Fourteen cases (56%) had positive culture results with 15 causative pathogens, including 5 coagulase-negative Staphylococcus (CNS, 3 were methicillin-resistant coagulase-negative Staphylococcus, MRSCoN), 4 fungi, 2Enterococcus faecalis, 2 Burkholderia cepacia, 1 Stenotrophomonasmal-tophilia, and 1 Streptococcus.(3)Prosthetic valve vegetations, periannular leakage, regurgitation, were the main echocardiographic findings.Transesophageal echocardiography (TEE) revealed 13 PVE who had no positive findings on previous transthoracic echocardiography (TTE). (4) Eighteen PVE (72%) developed peri-annular complications (12 leakage, 3 dehiscence, 2 abscesses, 1 fistula), major vessel embolism, congestive heart failure (16%) were frequently observed, 9 of the 17 patients died in hospital, in spite of intensive managements.Conclusions PVE has a high mortality and is a severe complication for patients who underwent heart surgery. Its causative pathogen spectrum is quite different from that of native valve endocarditis. TTE is not sensitive for some PVE cases.

OBJECTIVETo investigate the role of ventrolateral periaqueductal gray (VL-PAG) metabotropic glutamate receptors subtype 7 and 8 (mGluR 7/8) in descending modulation of cardiosomatic motor reflex (CMR) in rats.

METHODSAMN082 (agonist of mGluR 7) and DCPG (agonist of mGluR 8) were injected into the VL-PAG of a rat model of CMR to observe their effects in modulating CMR. The raphe magnus nucleus (NRM) or the gigantocellular reticular nucleus (Gi) was then damaged, and the changes in VL-PAG descending modulation were observed.

RESULTSSelective activation of mGluR 7 of the VL-PAG by AMN082 obviously facilitated capsaicin (CAP)-induced CMR (P<0.05), which was suppressed by DCPG-induced mGluR 8 activation (P<0.05). These facilitatory or inhibitory effects were completely reversed by group III mGluR antagonist MSOP. Damaging the NRM of VL-PAG main relay nucleus did not significantly affect the facilitatory effect produced by AMN082 microinjection (P>0.05), but partially attenuated the inhibitory effect of DCPG microinjection (P<0.05). Both the facilitatory effect of AMN082 and the inhibitory effect of DCPG were reduced obviously after bilateral Gi damage (P<0.05).

CONCLUSIONVL-PAG mGluR 7 and mGluR 8 mediate biphasic regulation of CMR in rats probably through activation of different sub-nuclei and different neurons in the rostroventral medulla.

Animals ; Benzhydryl Compounds ; pharmacology ; Benzoates ; pharmacology ; Glycine ; analogs & derivatives ; pharmacology ; Male ; Medulla Oblongata ; metabolism ; Periaqueductal Gray ; metabolism ; Physical Conditioning, Animal ; Rats ; Rats, Sprague-Dawley ; Receptors, Metabotropic Glutamate ; agonists ; metabolism ; Reflex ; physiology

OBJECTIVETo observe the descending modulation of cardiac nociception by the rostral ventromedial medulla (RVM) in rats.

METHODSA rat model of cardiosomatic motor reflex (CMR) was established by injecting capsaicin into the pericardial sac to induce cardiac nociception, and the electromyogram (EMG) response of the dorsal spinotrapezius muscle was studied. The RVM was electrically stimulated (25, 75 and 100 µA) or destroyed to examine whether RVM exerted descending modulation on cardiac nociception.

RESULTSElectrical stimulation of the RVM at 8 sites produced intensity-dependent inhibition of EMG responses to noxious cardiac stimulus (F[2,21]=43.188, P=0.001). Electrical stimulation at 3 sites caused facilitated EMG responses, but the increased magnitude of the EMG was not dependent on stimulation intensity (F[2,6]=0.884, P=0.461). Stimulation at 11 sites produced biphasic effects: at a low intensity (25 µA), the elicited EMG magnitude was significantly larger than baseline (P<0.05), and at greater intensities (75/100 µA), the stimulation caused suppression of the EMG magnitude to a level significantly lower than the baseline (P<0.05). Electrolytic lesion of the RVM resulted in significantly increased EMG responses compared with the baseline and sham lesion group.

CONCLUSIONCardiac nociception evoked by capsaicin stimulation is subjected to descending biphasic modulation by the RVM, which produces predominantly descending inhibition on heart pain.

Animals ; Capsaicin ; pharmacology ; Electric Stimulation ; Electromyography ; drug effects ; Male ; Medulla Oblongata ; physiology ; Nociception ; Nociceptors ; drug effects ; physiology ; Pain ; physiopathology ; Pericardium ; drug effects ; physiology ; Rats ; Rats, Sprague-Dawley ; Sensory System Agents ; pharmacology

Objective To explore the risk factors of bile leakage in patients with laparoscopic common bile duct exploration and primary suture for the purpose of providing clues for reducing occurrence of bile leakage.Methods The clinic data of 193 choledocholithiasis patients with laparoscopic common bile duct exploration and primary suture from October 2012 to March 2017 were retrospective analysed.All patients were divided into bile leakage group (23 patients) and non-bile leakage group (170 patients).Risk factors influencing the incidence of bile leakage were determined by analyzing 21 relevant factors with one-way analysis of variance and Logistic multivariate regression analysis.Count data and ordinal data was expressed as frequency or a percentage.Chi-square test was used to compare with groups of count data,rank-sum test was for comparison between groups of ordinal data,and Logistic regression was for multivariate analysis.Results Among all the patients,the incidence of bile leakage was 11.92％ (23/193).The results of univariate analysis revealed that cholangitis,jaundice,bile characteristics,muddy stone,number of stones,incarcerated stone,open and close peristalsis of duodenal papilla were correlated with bile leakage (x2/Z =2.537,2.122,81.834,50.709,13.242,26.958,90.207,P ＜0.05).The result of multivariate analysis revealed that bile characteristics,muddy stone,incarcerated stone,open and close peristalsis of duodenal papilla was correlated with bile leakage (Wals =14.002,8.899,6.577,5.582,P ＜0.05).Conclusion Bile characteristics,muddy stone,incarcerated stone,open and close peristalsis of duodenal papilla were main risk factors of bile leakage in patients with laparoscopic common bile duct exploration and primary suture.

The central nervous system (CNS) plays a key regulatory role in glucose homeostasis. In particular, the brain is important in initiating and coordinating protective counterregulatory responses when blood glucose levels fall. This may due to the metabolic dependency of the CNS on glucose, and protection of food supply to the brain. In healthy subjects, blood glucose is normally maintained within a relatively narrow range. Hypoglycemia in diabetic patients can increase the risk of complications, such as heart disease and diabetic peripheral neuropathy. The clinical research finds that the use of traditional Chinese medicine (TCM) has a positive effect on the treatment of hypoglycemia. Here the authors reviewed the current understanding of sensing and counterregulatory responses to hypoglycemia, and discuss combining traditional Chinese and Western medicine and the theory of iatrogenic hypoglycemia in diabetes treatment. Furthermore, the authors clarify the feasibility of treating hypoglycemia on the basis of TCM theory and CNS and have an insight on its clinical practice.

The microorganism in human body is related to human health and disease,which plays a significant role in the exclusion of pathogen invading,participation of immune regulation and occurrence and development of the tumors.Studies have indicated that dysbacteriosis is often detected in cancer patients;especially,enteric dysbacteriosis can promote the occurrence and development of the tumors by influencing homeostatic balance of intestinal tract,gut metabolite and immunological function.Moreover,proportion detection of intestinal flora can be used as a non-invasive screening method and a diagnostic indicator for early detection of the malignant neoplasms.This review summarizes the recent studies on the associations of intestinal flora with human diseases and the possible mechanisms causing tumorigenesis,which may provide a novel research paradigm for cancer prevention and treatment.