Tumors of the pancreas,the ampulla of Vater,and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system.This obviates t...Tumors of the pancreas,the ampulla of Vater,and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system.This obviates the need for discovery of biomarkers with diagnostic and prognostic value for these tumors.Mucins,especially MUC-1,-2,-4 and-5AC,are important candidates for developing into such reliable biomarkers.Increased expression of MUC1 occurs in pancreatic ductal adenocarcinomas and is associated with increased degrees of dysplasia in pancreatic intraepithelial neoplasia(Pan IN).Positive expression of MUC2 in intraductal papillary mucinus neoplasms(IPMN) of the intestinal type indicates high potential progression to invasive carcinoma with de novo expression of MUC1,while absence of MUC2 expression in IPMNs of gastric type implies low potential to malignant evolution.De novo MUC4 expression correlates to the severity of dysplasia in Pan IN and is associated with a poor prognosis in patients with pancreatic ductal adenocarcinomas.In biliary intraepithelial neoplasia(Bil IN),increased expression of MUC1 is associated with higher degrees of dysplasia.Intrahepatic cholangiocarcinomas(ICC) are characterized by increased expression of all glycoforms of MUC1.Positive MUC2 expression in intraductal papillary neoplasm of the bile ducts(IPNB) of the intestinal type indicates high malignant potential with de novo expression of MUC1 in the invasive element.Absent MUC2 expression in any degree of Bil IN may prove useful in differentiating them from IPNB.De novo expression of MUC4 is associated with poor prognosis in patients with ICC or carcinoma of the extrahepatic bile ducts(EHBDC).High de novo expression of MUC5 AC is found in all degrees of Bil IN and all types of IPNB and ICC.The MUC5 AC is useful in the detection of neoplastic lesions of the bile duct at an early stage.Increased expression of mucin MUC1 in carcinoma of the ampulla of Vater associated with unfavorable behavior of the tumor,such as lymph node metastasis,infiltration of the pancreas and duodenum,advanced TNM classification and worse prognosis.Patients withintra-ampullary papillary-tubular neoplasm(IAPN) of the pancreatobiliary immunophenotype did not show MUC2,while those of the intestinal immunophenotype are MUC2 positive.The expression of MUC4 is associated with poor prognosis in patients with carcinoma of the ampulla of Vater favoring metastasis and making them resistant to apoptosis.Moreover,it appears that MUC4 positivity correlates with recurrence of the tumor.Expression of MUC5 AC is associated with the invasive potential of the tumor.展开更多
Fourty-three cases of globoid dysplasia and signet ring cell carcinoma were stained by mucin and CEA (ABC method). It was found that there were three kinds of mucins (neutral, sialo and sulphomucin in both globoid dys...Fourty-three cases of globoid dysplasia and signet ring cell carcinoma were stained by mucin and CEA (ABC method). It was found that there were three kinds of mucins (neutral, sialo and sulphomucin in both globoid dysplastic cells and signet ring cells. The percentages of the three kinds of mucins seen in the two kinds of cells were not much different. It was indicated that the altered mucins in the gastric epithelial cells must be a sign of dedifferentiation of the cells and the results of malfunction. The globoid dysplasia type I mainly contained neutral mucin, whereas type II, the acid mucin was predominant, especially the sulphomucin. The CEA positive reaction became stronger as the atypia being remarkable, and the characteristics of distribution of CEA positive particles were similar in the two kinds of cells namely, randomly or disorderly in the cells. Based on the analysis of the results, a conclusion can be made that the variety of mucins in globoid dysplastic cells can be used as a reference point in classification and is not much significant in grading, but the amount of CEA positive matter can be a reference point in grading. The globoid dysplasia is such a lesion with special features in morphology and function manifested in the process of de-differentiation towards signet ring cell carcinoma following the successive action of carcinogens upon the cells of gastric epithelium.展开更多
AIM: To determine the expression of membrane-bound mucins and glycan side chain sialic acids in Helicobacter pylori (H. pylori)-associated, non-steroidal inflammatory drug (NSAID)-associated and idiopathic-gastric ulc...AIM: To determine the expression of membrane-bound mucins and glycan side chain sialic acids in Helicobacter pylori (H. pylori)-associated, non-steroidal inflammatory drug (NSAID)-associated and idiopathic-gastric ulcers.展开更多
T cell immunoglobulin mucin (TIM) family plays a key role in regulating immune re-sponses.In this study,the interactions of human TIM family with apoptotic cells were evaluated in order to provide a foundation for fur...T cell immunoglobulin mucin (TIM) family plays a key role in regulating immune re-sponses.In this study,the interactions of human TIM family with apoptotic cells were evaluated in order to provide a foundation for further study on the roles of human TIM genes in apoptosis.Nine kinds of pEGFP-N1 eukaryotic expression vectors containing different lengths of the three members of human TIM genes for the expression of TIM-EGFP and the vectors for the expression of TIM-Fc fusion pro-teins were constructed.It was found that human TIM proteins could recognize and bind to apoptotic cells directly,but not to viable cells.The interactions of sTIM-1-EGFP,sTIM-3-EGFP and sTIM-4-EGFP with apoptotic cells were blocked by TIM-1-Ig,TIM-3-Ig and TIM-4-Ig fusion proteins respectively.In addition,human TIM proteins mediated the recognition of apoptotic cells and bound to apoptotic cells directly via the IgV domains.In conclusion,the TIM family may play a key role in the regulation of apoptosis.Our data also suggest that human TIM proteins probably serve as novel proteins for the detection of the early cellular apoptosis.展开更多
The sequential histological and sialomucins histochemical changes in colonic epithelium during the N-methyl-N-nitrosourea (MNU) induced colonic carcinogenesis were studied in female ICR mice. The sialomucin histochemi...The sequential histological and sialomucins histochemical changes in colonic epithelium during the N-methyl-N-nitrosourea (MNU) induced colonic carcinogenesis were studied in female ICR mice. The sialomucin histochemical changes were assessed by use of high iron diamine-alcian blue staining (HID-AB) at PH 2.5. In the untreated controls, the epithelial cells in the distal colon are characterized by a predominance of sulfomucins, and the cells in the proximal site stain for abundant sialomucins, with occasioual sulfomucins in the base of the crypt. The earlier changes detected at the 4th week are focal areas of hyperplasia in which sulfomucins still predominant as in controls. As the experimental progress, the number of lesions with severe dysplasia increase, with carcinoma in situ and invasive carcinoma appeariug from the 10th week. The areas of mild or moderate dysplasia show marked changes in the composition of mucin, characterized by the progressively increased of staining of sialomucins and accompanied in general by a decrease of sulfomucins, similar to those changes described in transitional mucosa (TM) adjacent to colorectal cancer in the human. It is suggested the morphological malignant transformation of colonic epithelium were paralleled qualitatively enhanced sialomucin staining in concert with reduced sulfomucin staining of epithelial cells, providing further evidence that the mucin changes in TM characterized by an increase in sialomucins might reflect early primary premalignant transformation.展开更多
The intestinal mucus barrier is a crucial component of the host's innate defense system,playing a vital role in regulating intestinal microecology and maintaining intestinal homeostasis.Glycosylated mucins,the cor...The intestinal mucus barrier is a crucial component of the host's innate defense system,playing a vital role in regulating intestinal microecology and maintaining intestinal homeostasis.Glycosylated mucins,the core components of this barrier,are essential for preserving its integrity by preventing bacterial degradation.Additionally,mucins significantly contribute to establishing a balanced symbiotic relationship between the host and microbes.These mucins have the potential to mitigate intestinal epithelial damage by capturing and transporting cell debris and pathogenic bacteria.Meanwhile,certain bacteria help maintain the equilibrium and stability of the gut microbiome by degrading glycosylated mucins to utilize the carbohydrate chains,thus affecting the cytokine expression to regulate the synthesis and secretion of specific glycans.Investigating the complex connections between the mucus barrier and mucin glycosylation holds great promise for advancing our understanding of gastrointestinal disease mechanisms,paving the way for innovative prevention and treatment strategies.展开更多
In Nilaparvata lugens,a serious and widespread rice pest,high fecundity is one of the important reasons for large populations and outbreaks.As embryogenesis is a critical process associated with insect fecundity,this ...In Nilaparvata lugens,a serious and widespread rice pest,high fecundity is one of the important reasons for large populations and outbreaks.As embryogenesis is a critical process associated with insect fecundity,this study investigated the function of the Mucin2-like gene(NlMuc2)in the embryogenesis of N.lugens.The results showed that NlMuc2 was highly expressed in female reproductive organs and in 1-day-old eggs.Knockdown of NlMuc2 via RNA interference(RNAi)in 3rd instar nymphs resulted in increased mortality.In 5th instar nymphs,NlMuc2 knockdown led to a dramatic reduction in egg hatchability from 86.0%to 24.0%,offspring numbers from 330.4 to 81.5,egg count from 382.4 to 217.0,and resulted in 86.0%of eggs exhibiting inverted embryos.In newly emerged females,NlMuc2 knockdown retarded ovarian development and decreased the number of mature eggs,with 51.0%of eggs containing inverted embryos.Transcriptome sequencing analysis of eggs revealed that numerous genes were downregulated after NlMuc2 knockdown,with 16 and 15 downregulated genes enriched in the Wnt and MAPK pathways,respectively.Temporal and spatial expression profiling of selected differentially expressed genes,including Axin,δ-Catenin,Glypican-4-like,and Ror-like in the Wnt pathway,and MKK4 in the MAPK pathway,showed expression patterns similar to NlMuc2.Knockdown of Ror-like,Glypican-4-like,or MKK4 reduced the total number of eggs.Knockdown of Axin or MKK4 reduced the egg hatchability.A similar phenotype of eggs with inverted embryos was also observed in eggs laid by dsMKK4-and dsAxin-treated females.Thus,NlMuc2 is involved in embryonic development mainly by regulating the Wnt and MAPK signaling pathways.These findings may provide new targets for pesticide design and RNAi-based control of N.lugens,and will also provide new insights into insect embryonic development and the function of insect mucins.展开更多
BACKGROUND A literature review revealed that intraductal papillary mucinous neoplasm of the biliary tract(IPMN-B)cases with characteristic clinical,imaging,endoscopic,and pathological features are exceedingly rare.Her...BACKGROUND A literature review revealed that intraductal papillary mucinous neoplasm of the biliary tract(IPMN-B)cases with characteristic clinical,imaging,endoscopic,and pathological features are exceedingly rare.Herein,we present a case of typical IPMN-B with malignant transformation that required 4 years for a definitive diagnosis,to enhance the understanding of this disease entity.CASE SUMMARY A 67-year-old male patient was referred to our hospital due to abdominal pain and jaundice.Four years before this admission,a cystic lesion and left hepatolithiasis were incidentally discovered.Laboratory tests revealed mild increases in serum white blood cell count,total bilirubin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,and gamma-glutamyl transferase.Tumour marker levels were within normal limits.Imaging findings demonstrated an enlargement of the cystic tumour from 41 mm to 63 mm,along with the development of numerous enhancing papillary nodules within it,which showed hyperenhancement during the arterial phase.Duodenoscopy revealed an enlarged major duodenal papilla with a fish-mouth appearance and dilated orifice,exuding translucent jelly-like mucus.Endoscopic retrograde cholangiography demonstrated multiple cloudy,irregular filling defects within the dilated extrahepatic bile duct.Following the diagnosis of IPMN-B,left hepatectomy was performed.Postoperative histopathological examination and immunohistochemistry confirmed IPMN-B with high-grade intraepithelial neoplasia and associated invasive carcinoma.CONCLUSION Heightened vigilance and recognition of IPMN-B are essential when“hepatic cysts”or“biliary stones”are incidentally detected.展开更多
Acellular mucin refers to pools of mucin without epithelial component,oftentimes harboring inflammatory cells.Acellular mucin can be observed in both neoplastic and non-neoplastic lower gastrointestinal(GI)conditions....Acellular mucin refers to pools of mucin without epithelial component,oftentimes harboring inflammatory cells.Acellular mucin can be observed in both neoplastic and non-neoplastic lower gastrointestinal(GI)conditions.While mucinous neoplasms are classified and staged using established guidelines,interobserver variability occurs when acellular mucin pools are encountered,leading to inconsistent interpretation and staging.In particular,acellular mucin found in regional lymph nodes of colorectal adenocarcinoma patients who have not received treatment presents a diagnostic challenge,as its prognostic implication is not clearly defined.Acellular mucin is also commonly seen in treated colorectal adenocarcinoma,post neoadjuvant therapy.Although acellular mucin is not counted toward T or N staging in this setting,variation in how pathologists report and stage these cases persists.Acellular mucin can also be seen in non-neoplastic specimens,such as those from interval appendectomies,appendiceal diverticula,colonic diverticulitis,volvulus,and Crohn’s disease where it may mimic a neoplastic lesion.Acellular mucin in this setting is often a byproduct of inflammation,increased luminal pressure,and mural defect.This review highlights the clinical relevance and diagnostic complexity of acellular mucin in pathologic conditions of the lower GI tract.Further studies are needed to clarify its prognostic value and develop standardized guidelines.展开更多
BACKGROUND Barrett esophagus(BE),a metaplastic adaptive process to gastrointestinal reflux,is associated with a higher risk of developing esophageal adenocarcinoma.However,the factors and mechanism that drive the mali...BACKGROUND Barrett esophagus(BE),a metaplastic adaptive process to gastrointestinal reflux,is associated with a higher risk of developing esophageal adenocarcinoma.However,the factors and mechanism that drive the malignant progression of BE is not well understood.AIM To investigate the role of bile acids,a component of the reflux fluid,in the malignant progression of BE.METHODS Using engineered green fluorescent protein-labeled adult tissue-resident stem cells isolated from BE clinical biopsies(BE-ASCs)as the target,we studied the effect of hydrophobic deoxycholic acid(DCA)and hydrophilic tetrahydroxylated bile acids(THBA)on cell viability by fluorescence intensity analysis,mucin production by dark density measurement,tissue structure by pathology analysis,expression of different pro-inflammatory factors gene by quantitative polymerase chain reaction and proteins by Western blot.RESULTS We found that hydrophobic DCA has cytotoxic and proinflammatory effects through activation of interleukin-1β(IL-1β)-nuclear factor kappa-B(NF-κB)inflammatory pathway on BE-ASCs.This action results in impaired cell viability,tissue intactness,reduced mucin production,and increased transition to disorganized atypical cells without intestinal features.In contrast,co-culture with hydrophilic THBA inhibited the IL-1β-NF-κB inflammatory pathway with maintenance of mature intestinal type cellular and histomorphology.CONCLUSION Our data indicates that the hydrophilic bile acid THBA can counteract the cytotoxic and proinflammatory effect of hydrophobic DCA and prevent the malignant progression of BE by inhibiting the IL-1β-NF-κB pathway.展开更多
BACKGROUND Runchangningshen paste(RCNSP)is a paste made of four medicinal and edible homologous Chinese medicine mixed with honey.It is known for its ability to nourish yin and blood as well as to loosen the bowel to ...BACKGROUND Runchangningshen paste(RCNSP)is a paste made of four medicinal and edible homologous Chinese medicine mixed with honey.It is known for its ability to nourish yin and blood as well as to loosen the bowel to relieve constipation.The pathophysiology of functional constipation(FC)is associated with a reduction in mucin-2(MUC2)secretion and microbial dysbiosis.AIM To investigate the underlying mechanism of RCNSP against FC through MUC2 and the gut mucosal microbiota.METHODS Ultra-performance liquid chromatography tandem mass spectrometry characterized RCNSP composition to elucidate the material basis of action.FC model was induced via loperamide gavage(16 mg/kg)twice daily for 7 days.Applying defecation function and gastrointestinal motility to assess constipation severity.Hematoxylin and eosin and Alcian blue-periodic acid-schiff staining analyzed colonic mucosal morphology.Transmission electron microscope was used to observe the ultrastructure of goblet cells(GCs).Immunofluorescence colocalization,quantitative PCR,and western blot assessed the impact of RCNSP on gene and protein expression within the NLRP6/autophagy pathway.16S rDNA was employed to sequence the gut mucosal microbiota.RESULTS RCNSP contained 12 components with potential laxative effects.It enhanced defecation function,accelerated gastrointestinal motility,and maintained colonic mucosal integrity.RCNSP treatment significantly increased GC abundance and MUC2 production while preserving GC ultrastructure.At the molecular level,RCNSP enhanced the colocalized expression of key regulatory proteins and modulated mRNA and protein expressions in the NLRP6/autophagy pathway.Through 16S rDNA sequencing analysis,RCNSP significantly altered the mucosal microbiota composition.Specifically,it increased beneficial bacterial strains while reducing harmful ones.Simultaneously,RCNSP reduced butyrate-producing bacteria like Proteobacteria,Enterobacteriaceae,Blautia,and Eubacterium and decreased hydrogen sulfide-producing species,such as Prevotellaceae.It also reduced bile acidinhibiting species,such as g_Eubacter_coprostanoligenes_group and Erysipelotrichaceae while increasing bile acidproducing species,such as Colidextribacter.CONCLUSION Our findings suggested that RCNSP ameliorated constipation through a dual mechanism:It stimulated colonic MUC2 secretion by activating NLRP6 inflammasome-mediated autophagy and modulated the composition of the mucosal microbiota.展开更多
BACKGROUND Liposarcomas(LPSs)are malignant mesenchymal tumors originating from adipocytes.Myxoid LPS(MLPS),a common subtype,predominantly arises in the extremities,retroperitoneum,and deep soft tissues,with a rare occ...BACKGROUND Liposarcomas(LPSs)are malignant mesenchymal tumors originating from adipocytes.Myxoid LPS(MLPS),a common subtype,predominantly arises in the extremities,retroperitoneum,and deep soft tissues,with a rare occurrence in the gastrointestinal tract.Primary mesenteric LPS is particularly uncommon,especially in the transverse colonic mesentery.CASE SUMMARY This report describes the case of a 65-year-old female patient who presented with abdominal distension and was diagnosed with a giant mucinous LPS of the transverse colonic mesentery.Upon admission,the patient underwent a comprehensive evaluation.Contrast-enhanced computed tomography(CT)of the chest and abdomen revealed a large malignant tumor with aortic dissection,while colonoscopy identified rectal cancer.Given the patient's condition and surgical risk,an interventional procedure was first performed to manage the aortic coarctation,followed by tumor resection via laparotomy.Intraoperative and histopathological findings confirmed a giant mucinous LPS originating from the transverse colon mesentery.Postoperatively,the patient underwent chemotherapy and regular follow-up CT.Although the rectal tumor did not recur,the mesenteric tumor showed extensive recurrence,compressing the intestinal lumen and causing mechanical obstruction,which severely threatened the patient's life.A second operation temporarily relieved the obstructive symptoms;however,it had a limited effect on tumor progression.The patient died four months later due to disease progression.CONCLUSION While no standardized treatment exists for MLPS co-occurring with multiple diseases,operation remains the mainstay.However,recurrence,metastasis,and poor postoperative prognosis continue to pose serious threats to patient survival.展开更多
Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in th...Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in the mouse model with dry eye disease(DED).Methods:A DED mouse model was induced using benzalkonium chloride(BAK),followed by treatment with O.japonicus extract-containing eye drops at varying concentrations.Experimental groups included a normal control,a DED model control,a positive control,and an O.japonicus extract-treated group.Corneal fluorescein staining and tear break-up time(TBUT)were used to assess tear film stability and ocular surface integrity.Enzyme-linked immunosorbent assay(ELISA)measured inflammatory factor levels in corneal and conjunctival tissues,whereas Western blot(WB)analyzed key antioxidant and inflammatory markers,including nuclear factor erythroid 2-related factor(2Nrf2)and heme oxygenase 1(HO-1).Periodic acid-schiff(PAS)staining and immunofluorescence were used to evaluate goblet cell density and mucin secretion.Results:O.japonicus extract significantly improved corneal damage,reduced fluorescein staining scores,prolonged TBUT,and increased tear secretion.It downregulated inflammatory markers,including interleukin-8(IL-8),interleukin-1β(IL-1β),and interferon-g(IFN-γ)while upregulating Nrf2,HO-1,and the interleukin-13(IL-13)/IFN-γ ratio,alleviating oxidative stress and inflammation.PAS staining showed increased conjunctival goblet cell density and restored mucin secretion,enhancing tear film stability.Conclusion:O.japonicus extract demonstrated significant anti-inflammatory,antioxidant,and goblet cell-stimulating effects in a DED model,with good biocompatibility and promising therapeutic potential.Future research should optimize extraction processes and validate their efficacy and safety in clinical settings.展开更多
BACKGROUND Pancreatic cystic lesions are common in patients eligible for solid organ transplan-tation.It has been shown that the need for immunosuppression after organ transplantation increases the rate of malignancie...BACKGROUND Pancreatic cystic lesions are common in patients eligible for solid organ transplan-tation.It has been shown that the need for immunosuppression after organ transplantation increases the rate of malignancies in organ recipients.However,the impact of immunosuppression on pancreatic cystic lesions is yet unknown.AIM To evaluate the prevalence of pancreatic cystic lesions and the risk of cyst progression in immunosuppressed patients.METHODS A systematic literature search was performed in relevant databases.Studies reporting either on the prevalence and/or the incidence of pancreatic cyst progression compared to a control group were implemented in the first systematic review and meta-analysis on this topic.RESULTS The prevalence of pancreatic cystic lesions was comparable with 7%(95%CI:5%-11%)in the immunosuppressed cohort and 9%(95%CI:5%-16%)in the control cohort.The mean cyst size increase in the immunosuppression group was 3.2 mm(range 1.0-5.2mm)compared to 3.5 mm(1.0-6.9)in the control group(standar-dized mean difference 0.0 mm,95%CI:-0.3-0.2 mm,P=0.72).There was also no significant increase in the development of resection criteria or worrisome features under immunosuppression either[relative risk 1.1(fixed effect model),1.2(ran-dom effects model),P=0.61].CONCLUSION Immunosuppression does not increase the prevalence of pancreatic cystic lesions,nor does it increase the risk of cyst progression in terms of cyst size and development of resection criteria.Therefore,pancreatic cystic lesions in transplant candidates should not be a contraindication for solid organ transplantation.展开更多
BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due...BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due to unspecific symptoms,with acute appendicitis,retroperitoneal tumors or adnexal mass.Cases of huge appendiceal mucinous neoplasms are even more extremely rare.CASE SUMMARY We report a 54-year-old patient who presented with a 10-month history of constant dull distension accompanied by nausea.A surgical procedure of total hysterectomy,bilateral adnexectomy,appendectomy,greater omentectomy and right hemicolectomy was performed as a result of the findings on ultrasound,computed tomography scan and magnetic resonance imaging.Diagnosis was made after the pathological examination,which revealed low-grade appendiceal mucinous neoplasm.The patient received hyperthermic intraperitoneal chemotherapy with cisplatin and was discharged from the hospital.CONCLUSION Low-grade appendiceal mucinous adenomas are rare tumors that are easily misdiagnosed,and a more thorough clinical workup is required to make a defi-nitive diagnosis.展开更多
BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated b...BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.展开更多
Mucin 2(MUC2)is a critical component of the intestinal mucus barrier.Lactic acid bacteria(LAB)strains can improve mucosal homeostasis.In this study,we determined the expression of Muc2 induced by dead bacteria and cel...Mucin 2(MUC2)is a critical component of the intestinal mucus barrier.Lactic acid bacteria(LAB)strains can improve mucosal homeostasis.In this study,we determined the expression of Muc2 induced by dead bacteria and cell-free conditioned medium(CM)of 50 LAB strains in the human goblet cell line,LS174T.Dead bacteria or CM of LAB affected the Muc2 expression in a species-and strain-specific manner under homeostasis.Next,LAB strains with different regulatory abilities were selected,gavaged into mice,and exposed to dextran sodium sulfate(DSS)after 1 week.Different LAB strains inhibited intestinal injury to different degrees,with Lactobacillus acidophilus FCQHC4L1 exerting the most potent effect.FCQHC4L1 significantly decreased the secretion of pro-inflammatory factors,promoted the expression and secretion of mucin,and inhibited colitis development.This strain also regulated the gut microbiota and increased the secretion of butyric acid.Moreover,CM of FCQHC4L1 inhibited endoplasmic reticulum(ER)stress and ameliorated the abnormal expression of MUC2 by suppressing the activation of the GRP78/ATF6 and GRP78/IRE1/XBP1 signaling pathways.Our results highlight the potential of FCQHC4L1 as a therapeutic agent for strengthening the mucus barrier and improving the gut health.展开更多
BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric ...BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.展开更多
Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during a...Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.展开更多
BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumul...BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumulation of external appen-diceal mucus.They may present as an extra-appendiceal mass-like bulge,mucus or polypoid tissue at the appendiceal orifice,or even with abdominal dissem-ination.The surgical approach is usually appendectomy,ileocecal resection or right hemicolectomy.It is essential to raise awareness of LAMNs and choose an appropriate treatment.CASE SUMMARY A 68-year-old man underwent a routine physical examination at our hospital on May 17,2022.The patient had no symptoms of abdominal pain,bloating,or weight loss,and his tumour marker levels were normal.The faecal occult blood test was negative,and no abnormalities were identified on physical examination.Colonoscopy revealed a submucosal protrusion at the appendiceal orifice.During endoscopic ultrasound,uneven echoes were observed in the appendix cavity.A contrast-enhanced computed tomography scan of the abdomen revealed a nodular thickening at the base of the appendix,with a diameter of approximately 1 cm.When all the examination results were considered,we suspected the lesion to be an appendiceal mucinous tumour.Laparoscopic surgery was performed using the double purse-string suture method.Postoperative pathology suggested a low-grade mucinous cystadenoma of the appendix with no involvement of the margins.A repeat colonoscopy 18 months after surgery revealed no significant abnormality at the appendiceal orifice.A contrast-enhanced computed tomography scan of the abdomen suggested only postoperative changes.CONCLUSION This study describes a case of LAMN that was treated by resecting the mass at the appendiceal orifice via the double purse-string suture technique and provides new insights on the diagnosis and treatment of LAMNs.展开更多
文摘Tumors of the pancreas,the ampulla of Vater,and the extrahepatic and intrahepatic bile ducts have significant histological similarities due to the common embryonic origin of the pancreatobiliary system.This obviates the need for discovery of biomarkers with diagnostic and prognostic value for these tumors.Mucins,especially MUC-1,-2,-4 and-5AC,are important candidates for developing into such reliable biomarkers.Increased expression of MUC1 occurs in pancreatic ductal adenocarcinomas and is associated with increased degrees of dysplasia in pancreatic intraepithelial neoplasia(Pan IN).Positive expression of MUC2 in intraductal papillary mucinus neoplasms(IPMN) of the intestinal type indicates high potential progression to invasive carcinoma with de novo expression of MUC1,while absence of MUC2 expression in IPMNs of gastric type implies low potential to malignant evolution.De novo MUC4 expression correlates to the severity of dysplasia in Pan IN and is associated with a poor prognosis in patients with pancreatic ductal adenocarcinomas.In biliary intraepithelial neoplasia(Bil IN),increased expression of MUC1 is associated with higher degrees of dysplasia.Intrahepatic cholangiocarcinomas(ICC) are characterized by increased expression of all glycoforms of MUC1.Positive MUC2 expression in intraductal papillary neoplasm of the bile ducts(IPNB) of the intestinal type indicates high malignant potential with de novo expression of MUC1 in the invasive element.Absent MUC2 expression in any degree of Bil IN may prove useful in differentiating them from IPNB.De novo expression of MUC4 is associated with poor prognosis in patients with ICC or carcinoma of the extrahepatic bile ducts(EHBDC).High de novo expression of MUC5 AC is found in all degrees of Bil IN and all types of IPNB and ICC.The MUC5 AC is useful in the detection of neoplastic lesions of the bile duct at an early stage.Increased expression of mucin MUC1 in carcinoma of the ampulla of Vater associated with unfavorable behavior of the tumor,such as lymph node metastasis,infiltration of the pancreas and duodenum,advanced TNM classification and worse prognosis.Patients withintra-ampullary papillary-tubular neoplasm(IAPN) of the pancreatobiliary immunophenotype did not show MUC2,while those of the intestinal immunophenotype are MUC2 positive.The expression of MUC4 is associated with poor prognosis in patients with carcinoma of the ampulla of Vater favoring metastasis and making them resistant to apoptosis.Moreover,it appears that MUC4 positivity correlates with recurrence of the tumor.Expression of MUC5 AC is associated with the invasive potential of the tumor.
文摘Fourty-three cases of globoid dysplasia and signet ring cell carcinoma were stained by mucin and CEA (ABC method). It was found that there were three kinds of mucins (neutral, sialo and sulphomucin in both globoid dysplastic cells and signet ring cells. The percentages of the three kinds of mucins seen in the two kinds of cells were not much different. It was indicated that the altered mucins in the gastric epithelial cells must be a sign of dedifferentiation of the cells and the results of malfunction. The globoid dysplasia type I mainly contained neutral mucin, whereas type II, the acid mucin was predominant, especially the sulphomucin. The CEA positive reaction became stronger as the atypia being remarkable, and the characteristics of distribution of CEA positive particles were similar in the two kinds of cells namely, randomly or disorderly in the cells. Based on the analysis of the results, a conclusion can be made that the variety of mucins in globoid dysplastic cells can be used as a reference point in classification and is not much significant in grading, but the amount of CEA positive matter can be a reference point in grading. The globoid dysplasia is such a lesion with special features in morphology and function manifested in the process of de-differentiation towards signet ring cell carcinoma following the successive action of carcinogens upon the cells of gastric epithelium.
基金Supported by National Institute of Neurological Disorders and Stroke No.P30 NS047101Neurosciences Microscopy Shared Facility,UCSD from the G Harold and Leila Y Mathers Charitable Foundation No.CSD018NIH center grant No.DK080506
文摘AIM: To determine the expression of membrane-bound mucins and glycan side chain sialic acids in Helicobacter pylori (H. pylori)-associated, non-steroidal inflammatory drug (NSAID)-associated and idiopathic-gastric ulcers.
基金supported by a grant from the National Natural Science Foundation of China (No. 30672008)
文摘T cell immunoglobulin mucin (TIM) family plays a key role in regulating immune re-sponses.In this study,the interactions of human TIM family with apoptotic cells were evaluated in order to provide a foundation for further study on the roles of human TIM genes in apoptosis.Nine kinds of pEGFP-N1 eukaryotic expression vectors containing different lengths of the three members of human TIM genes for the expression of TIM-EGFP and the vectors for the expression of TIM-Fc fusion pro-teins were constructed.It was found that human TIM proteins could recognize and bind to apoptotic cells directly,but not to viable cells.The interactions of sTIM-1-EGFP,sTIM-3-EGFP and sTIM-4-EGFP with apoptotic cells were blocked by TIM-1-Ig,TIM-3-Ig and TIM-4-Ig fusion proteins respectively.In addition,human TIM proteins mediated the recognition of apoptotic cells and bound to apoptotic cells directly via the IgV domains.In conclusion,the TIM family may play a key role in the regulation of apoptosis.Our data also suggest that human TIM proteins probably serve as novel proteins for the detection of the early cellular apoptosis.
文摘The sequential histological and sialomucins histochemical changes in colonic epithelium during the N-methyl-N-nitrosourea (MNU) induced colonic carcinogenesis were studied in female ICR mice. The sialomucin histochemical changes were assessed by use of high iron diamine-alcian blue staining (HID-AB) at PH 2.5. In the untreated controls, the epithelial cells in the distal colon are characterized by a predominance of sulfomucins, and the cells in the proximal site stain for abundant sialomucins, with occasioual sulfomucins in the base of the crypt. The earlier changes detected at the 4th week are focal areas of hyperplasia in which sulfomucins still predominant as in controls. As the experimental progress, the number of lesions with severe dysplasia increase, with carcinoma in situ and invasive carcinoma appeariug from the 10th week. The areas of mild or moderate dysplasia show marked changes in the composition of mucin, characterized by the progressively increased of staining of sialomucins and accompanied in general by a decrease of sulfomucins, similar to those changes described in transitional mucosa (TM) adjacent to colorectal cancer in the human. It is suggested the morphological malignant transformation of colonic epithelium were paralleled qualitatively enhanced sialomucin staining in concert with reduced sulfomucin staining of epithelial cells, providing further evidence that the mucin changes in TM characterized by an increase in sialomucins might reflect early primary premalignant transformation.
基金supported by the National Natural Science Foundation of China(32202692)the Hunan Provincial Natural Science Foundation of China(2022JJ40176)National Key R&D Program of China(2021YFD1300403).
文摘The intestinal mucus barrier is a crucial component of the host's innate defense system,playing a vital role in regulating intestinal microecology and maintaining intestinal homeostasis.Glycosylated mucins,the core components of this barrier,are essential for preserving its integrity by preventing bacterial degradation.Additionally,mucins significantly contribute to establishing a balanced symbiotic relationship between the host and microbes.These mucins have the potential to mitigate intestinal epithelial damage by capturing and transporting cell debris and pathogenic bacteria.Meanwhile,certain bacteria help maintain the equilibrium and stability of the gut microbiome by degrading glycosylated mucins to utilize the carbohydrate chains,thus affecting the cytokine expression to regulate the synthesis and secretion of specific glycans.Investigating the complex connections between the mucus barrier and mucin glycosylation holds great promise for advancing our understanding of gastrointestinal disease mechanisms,paving the way for innovative prevention and treatment strategies.
基金supported by the National Natural Science Foundation of China(Grant No.32272538)China Agriculture Research System(Grant No.CARS-01)the Fundamental Research Funds for Central Public Welfare Research Institute,China(Grant No.CPSIBRF-CNRRI-202406).
文摘In Nilaparvata lugens,a serious and widespread rice pest,high fecundity is one of the important reasons for large populations and outbreaks.As embryogenesis is a critical process associated with insect fecundity,this study investigated the function of the Mucin2-like gene(NlMuc2)in the embryogenesis of N.lugens.The results showed that NlMuc2 was highly expressed in female reproductive organs and in 1-day-old eggs.Knockdown of NlMuc2 via RNA interference(RNAi)in 3rd instar nymphs resulted in increased mortality.In 5th instar nymphs,NlMuc2 knockdown led to a dramatic reduction in egg hatchability from 86.0%to 24.0%,offspring numbers from 330.4 to 81.5,egg count from 382.4 to 217.0,and resulted in 86.0%of eggs exhibiting inverted embryos.In newly emerged females,NlMuc2 knockdown retarded ovarian development and decreased the number of mature eggs,with 51.0%of eggs containing inverted embryos.Transcriptome sequencing analysis of eggs revealed that numerous genes were downregulated after NlMuc2 knockdown,with 16 and 15 downregulated genes enriched in the Wnt and MAPK pathways,respectively.Temporal and spatial expression profiling of selected differentially expressed genes,including Axin,δ-Catenin,Glypican-4-like,and Ror-like in the Wnt pathway,and MKK4 in the MAPK pathway,showed expression patterns similar to NlMuc2.Knockdown of Ror-like,Glypican-4-like,or MKK4 reduced the total number of eggs.Knockdown of Axin or MKK4 reduced the egg hatchability.A similar phenotype of eggs with inverted embryos was also observed in eggs laid by dsMKK4-and dsAxin-treated females.Thus,NlMuc2 is involved in embryonic development mainly by regulating the Wnt and MAPK signaling pathways.These findings may provide new targets for pesticide design and RNAi-based control of N.lugens,and will also provide new insights into insect embryonic development and the function of insect mucins.
基金Supported by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2022KY1246Science and Technology Bureau of Jiaxing City,No.2023AZ31002.
文摘BACKGROUND A literature review revealed that intraductal papillary mucinous neoplasm of the biliary tract(IPMN-B)cases with characteristic clinical,imaging,endoscopic,and pathological features are exceedingly rare.Herein,we present a case of typical IPMN-B with malignant transformation that required 4 years for a definitive diagnosis,to enhance the understanding of this disease entity.CASE SUMMARY A 67-year-old male patient was referred to our hospital due to abdominal pain and jaundice.Four years before this admission,a cystic lesion and left hepatolithiasis were incidentally discovered.Laboratory tests revealed mild increases in serum white blood cell count,total bilirubin,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,and gamma-glutamyl transferase.Tumour marker levels were within normal limits.Imaging findings demonstrated an enlargement of the cystic tumour from 41 mm to 63 mm,along with the development of numerous enhancing papillary nodules within it,which showed hyperenhancement during the arterial phase.Duodenoscopy revealed an enlarged major duodenal papilla with a fish-mouth appearance and dilated orifice,exuding translucent jelly-like mucus.Endoscopic retrograde cholangiography demonstrated multiple cloudy,irregular filling defects within the dilated extrahepatic bile duct.Following the diagnosis of IPMN-B,left hepatectomy was performed.Postoperative histopathological examination and immunohistochemistry confirmed IPMN-B with high-grade intraepithelial neoplasia and associated invasive carcinoma.CONCLUSION Heightened vigilance and recognition of IPMN-B are essential when“hepatic cysts”or“biliary stones”are incidentally detected.
文摘Acellular mucin refers to pools of mucin without epithelial component,oftentimes harboring inflammatory cells.Acellular mucin can be observed in both neoplastic and non-neoplastic lower gastrointestinal(GI)conditions.While mucinous neoplasms are classified and staged using established guidelines,interobserver variability occurs when acellular mucin pools are encountered,leading to inconsistent interpretation and staging.In particular,acellular mucin found in regional lymph nodes of colorectal adenocarcinoma patients who have not received treatment presents a diagnostic challenge,as its prognostic implication is not clearly defined.Acellular mucin is also commonly seen in treated colorectal adenocarcinoma,post neoadjuvant therapy.Although acellular mucin is not counted toward T or N staging in this setting,variation in how pathologists report and stage these cases persists.Acellular mucin can also be seen in non-neoplastic specimens,such as those from interval appendectomies,appendiceal diverticula,colonic diverticulitis,volvulus,and Crohn’s disease where it may mimic a neoplastic lesion.Acellular mucin in this setting is often a byproduct of inflammation,increased luminal pressure,and mural defect.This review highlights the clinical relevance and diagnostic complexity of acellular mucin in pathologic conditions of the lower GI tract.Further studies are needed to clarify its prognostic value and develop standardized guidelines.
文摘BACKGROUND Barrett esophagus(BE),a metaplastic adaptive process to gastrointestinal reflux,is associated with a higher risk of developing esophageal adenocarcinoma.However,the factors and mechanism that drive the malignant progression of BE is not well understood.AIM To investigate the role of bile acids,a component of the reflux fluid,in the malignant progression of BE.METHODS Using engineered green fluorescent protein-labeled adult tissue-resident stem cells isolated from BE clinical biopsies(BE-ASCs)as the target,we studied the effect of hydrophobic deoxycholic acid(DCA)and hydrophilic tetrahydroxylated bile acids(THBA)on cell viability by fluorescence intensity analysis,mucin production by dark density measurement,tissue structure by pathology analysis,expression of different pro-inflammatory factors gene by quantitative polymerase chain reaction and proteins by Western blot.RESULTS We found that hydrophobic DCA has cytotoxic and proinflammatory effects through activation of interleukin-1β(IL-1β)-nuclear factor kappa-B(NF-κB)inflammatory pathway on BE-ASCs.This action results in impaired cell viability,tissue intactness,reduced mucin production,and increased transition to disorganized atypical cells without intestinal features.In contrast,co-culture with hydrophilic THBA inhibited the IL-1β-NF-κB inflammatory pathway with maintenance of mature intestinal type cellular and histomorphology.CONCLUSION Our data indicates that the hydrophilic bile acid THBA can counteract the cytotoxic and proinflammatory effect of hydrophobic DCA and prevent the malignant progression of BE by inhibiting the IL-1β-NF-κB pathway.
基金Supported by National Natural Science Foundation of China,No.82174309and Shanghai Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine Siming Fund Special Project for Scientific Research,No.SGKJ-202304.
文摘BACKGROUND Runchangningshen paste(RCNSP)is a paste made of four medicinal and edible homologous Chinese medicine mixed with honey.It is known for its ability to nourish yin and blood as well as to loosen the bowel to relieve constipation.The pathophysiology of functional constipation(FC)is associated with a reduction in mucin-2(MUC2)secretion and microbial dysbiosis.AIM To investigate the underlying mechanism of RCNSP against FC through MUC2 and the gut mucosal microbiota.METHODS Ultra-performance liquid chromatography tandem mass spectrometry characterized RCNSP composition to elucidate the material basis of action.FC model was induced via loperamide gavage(16 mg/kg)twice daily for 7 days.Applying defecation function and gastrointestinal motility to assess constipation severity.Hematoxylin and eosin and Alcian blue-periodic acid-schiff staining analyzed colonic mucosal morphology.Transmission electron microscope was used to observe the ultrastructure of goblet cells(GCs).Immunofluorescence colocalization,quantitative PCR,and western blot assessed the impact of RCNSP on gene and protein expression within the NLRP6/autophagy pathway.16S rDNA was employed to sequence the gut mucosal microbiota.RESULTS RCNSP contained 12 components with potential laxative effects.It enhanced defecation function,accelerated gastrointestinal motility,and maintained colonic mucosal integrity.RCNSP treatment significantly increased GC abundance and MUC2 production while preserving GC ultrastructure.At the molecular level,RCNSP enhanced the colocalized expression of key regulatory proteins and modulated mRNA and protein expressions in the NLRP6/autophagy pathway.Through 16S rDNA sequencing analysis,RCNSP significantly altered the mucosal microbiota composition.Specifically,it increased beneficial bacterial strains while reducing harmful ones.Simultaneously,RCNSP reduced butyrate-producing bacteria like Proteobacteria,Enterobacteriaceae,Blautia,and Eubacterium and decreased hydrogen sulfide-producing species,such as Prevotellaceae.It also reduced bile acidinhibiting species,such as g_Eubacter_coprostanoligenes_group and Erysipelotrichaceae while increasing bile acidproducing species,such as Colidextribacter.CONCLUSION Our findings suggested that RCNSP ameliorated constipation through a dual mechanism:It stimulated colonic MUC2 secretion by activating NLRP6 inflammasome-mediated autophagy and modulated the composition of the mucosal microbiota.
基金Supported by The Shandong Natural Science Foundation of China,No.ZR2021QH046.
文摘BACKGROUND Liposarcomas(LPSs)are malignant mesenchymal tumors originating from adipocytes.Myxoid LPS(MLPS),a common subtype,predominantly arises in the extremities,retroperitoneum,and deep soft tissues,with a rare occurrence in the gastrointestinal tract.Primary mesenteric LPS is particularly uncommon,especially in the transverse colonic mesentery.CASE SUMMARY This report describes the case of a 65-year-old female patient who presented with abdominal distension and was diagnosed with a giant mucinous LPS of the transverse colonic mesentery.Upon admission,the patient underwent a comprehensive evaluation.Contrast-enhanced computed tomography(CT)of the chest and abdomen revealed a large malignant tumor with aortic dissection,while colonoscopy identified rectal cancer.Given the patient's condition and surgical risk,an interventional procedure was first performed to manage the aortic coarctation,followed by tumor resection via laparotomy.Intraoperative and histopathological findings confirmed a giant mucinous LPS originating from the transverse colon mesentery.Postoperatively,the patient underwent chemotherapy and regular follow-up CT.Although the rectal tumor did not recur,the mesenteric tumor showed extensive recurrence,compressing the intestinal lumen and causing mechanical obstruction,which severely threatened the patient's life.A second operation temporarily relieved the obstructive symptoms;however,it had a limited effect on tumor progression.The patient died four months later due to disease progression.CONCLUSION While no standardized treatment exists for MLPS co-occurring with multiple diseases,operation remains the mainstay.However,recurrence,metastasis,and poor postoperative prognosis continue to pose serious threats to patient survival.
基金the National Natural Science Foundation of China(82070928 and 82171026).
文摘Objective:To investigate the anti-inflammatory,antioxidant,and goblet cell-stimulating effects of a suspension of Ophiopogon japonicus(L.f.)Ker Gawl.(O.japonicus,Mai Dong)extract combined with hyaluronic acid(HA)in the mouse model with dry eye disease(DED).Methods:A DED mouse model was induced using benzalkonium chloride(BAK),followed by treatment with O.japonicus extract-containing eye drops at varying concentrations.Experimental groups included a normal control,a DED model control,a positive control,and an O.japonicus extract-treated group.Corneal fluorescein staining and tear break-up time(TBUT)were used to assess tear film stability and ocular surface integrity.Enzyme-linked immunosorbent assay(ELISA)measured inflammatory factor levels in corneal and conjunctival tissues,whereas Western blot(WB)analyzed key antioxidant and inflammatory markers,including nuclear factor erythroid 2-related factor(2Nrf2)and heme oxygenase 1(HO-1).Periodic acid-schiff(PAS)staining and immunofluorescence were used to evaluate goblet cell density and mucin secretion.Results:O.japonicus extract significantly improved corneal damage,reduced fluorescein staining scores,prolonged TBUT,and increased tear secretion.It downregulated inflammatory markers,including interleukin-8(IL-8),interleukin-1β(IL-1β),and interferon-g(IFN-γ)while upregulating Nrf2,HO-1,and the interleukin-13(IL-13)/IFN-γ ratio,alleviating oxidative stress and inflammation.PAS staining showed increased conjunctival goblet cell density and restored mucin secretion,enhancing tear film stability.Conclusion:O.japonicus extract demonstrated significant anti-inflammatory,antioxidant,and goblet cell-stimulating effects in a DED model,with good biocompatibility and promising therapeutic potential.Future research should optimize extraction processes and validate their efficacy and safety in clinical settings.
文摘BACKGROUND Pancreatic cystic lesions are common in patients eligible for solid organ transplan-tation.It has been shown that the need for immunosuppression after organ transplantation increases the rate of malignancies in organ recipients.However,the impact of immunosuppression on pancreatic cystic lesions is yet unknown.AIM To evaluate the prevalence of pancreatic cystic lesions and the risk of cyst progression in immunosuppressed patients.METHODS A systematic literature search was performed in relevant databases.Studies reporting either on the prevalence and/or the incidence of pancreatic cyst progression compared to a control group were implemented in the first systematic review and meta-analysis on this topic.RESULTS The prevalence of pancreatic cystic lesions was comparable with 7%(95%CI:5%-11%)in the immunosuppressed cohort and 9%(95%CI:5%-16%)in the control cohort.The mean cyst size increase in the immunosuppression group was 3.2 mm(range 1.0-5.2mm)compared to 3.5 mm(1.0-6.9)in the control group(standar-dized mean difference 0.0 mm,95%CI:-0.3-0.2 mm,P=0.72).There was also no significant increase in the development of resection criteria or worrisome features under immunosuppression either[relative risk 1.1(fixed effect model),1.2(ran-dom effects model),P=0.61].CONCLUSION Immunosuppression does not increase the prevalence of pancreatic cystic lesions,nor does it increase the risk of cyst progression in terms of cyst size and development of resection criteria.Therefore,pancreatic cystic lesions in transplant candidates should not be a contraindication for solid organ transplantation.
基金Supported by the National Natural Science Foundation of China,No.82204123.
文摘BACKGROUND Low-grade appendiceal mucinous neoplasms are papillary or flat mucinous tumors with low-grade cytologic atypia.They are the most frequent source of pseudomyxoma peritonei.They can be easily misdiagnosed,due to unspecific symptoms,with acute appendicitis,retroperitoneal tumors or adnexal mass.Cases of huge appendiceal mucinous neoplasms are even more extremely rare.CASE SUMMARY We report a 54-year-old patient who presented with a 10-month history of constant dull distension accompanied by nausea.A surgical procedure of total hysterectomy,bilateral adnexectomy,appendectomy,greater omentectomy and right hemicolectomy was performed as a result of the findings on ultrasound,computed tomography scan and magnetic resonance imaging.Diagnosis was made after the pathological examination,which revealed low-grade appendiceal mucinous neoplasm.The patient received hyperthermic intraperitoneal chemotherapy with cisplatin and was discharged from the hospital.CONCLUSION Low-grade appendiceal mucinous adenomas are rare tumors that are easily misdiagnosed,and a more thorough clinical workup is required to make a defi-nitive diagnosis.
文摘BACKGROUND Complete appendiceal intussusception(CAI)coexisting with appendiceal tumor represents an exceptionally rare clinical tumor.This study presented a retrospective analysis of a case involving CAI complicated by appendiceal mucinous tumor,supplemented by a review of 10 previously reported cases to distill diagnostic and therapeutic insights.CASE SUMMARY A 74-year-old male patient presented with abdominal pain.Abdominal contrastenhanced computed tomography(CECT)initially suggested a colonic tumor with intussusception.Colonoscopy identified a mass in the colon 60 cm from the anus.Intraoperative exploration confirmed CAI secondary to an appendiceal neoplasm.The patient underwent laparoscopic right hemicolectomy with regional lymphadenectomy under general anesthesia.Postoperative recovery was uneventful,and the patient was discharged 9 days post-surgery.Twelve-month follow-up revealed no evidence of recurrence or metastasis.CONCLUSION Plain abdominal computed tomography may underestimate the presence of CAI and appendiceal mucinous tumor,whereas CECT significantly improves diagnostic accuracy.Preoperative suspicion of appendiceal malignancy should be entertained in cases of CAI.In the absence of definitive biopsy results,intraoperative frozen section analysis is recommended to guide radical resection.
基金funded by the Guangdong Province Key Research and Development Project(2022B111107006)the National Natural Science Foundation of China(32021005 and 31820103010)the Fundamental Research Funds for the Central Universities(JUSRP622013)。
文摘Mucin 2(MUC2)is a critical component of the intestinal mucus barrier.Lactic acid bacteria(LAB)strains can improve mucosal homeostasis.In this study,we determined the expression of Muc2 induced by dead bacteria and cell-free conditioned medium(CM)of 50 LAB strains in the human goblet cell line,LS174T.Dead bacteria or CM of LAB affected the Muc2 expression in a species-and strain-specific manner under homeostasis.Next,LAB strains with different regulatory abilities were selected,gavaged into mice,and exposed to dextran sodium sulfate(DSS)after 1 week.Different LAB strains inhibited intestinal injury to different degrees,with Lactobacillus acidophilus FCQHC4L1 exerting the most potent effect.FCQHC4L1 significantly decreased the secretion of pro-inflammatory factors,promoted the expression and secretion of mucin,and inhibited colitis development.This strain also regulated the gut microbiota and increased the secretion of butyric acid.Moreover,CM of FCQHC4L1 inhibited endoplasmic reticulum(ER)stress and ameliorated the abnormal expression of MUC2 by suppressing the activation of the GRP78/ATF6 and GRP78/IRE1/XBP1 signaling pathways.Our results highlight the potential of FCQHC4L1 as a therapeutic agent for strengthening the mucus barrier and improving the gut health.
文摘BACKGROUND The pathogenesis of non-ampullary duodenal epithelial tumors(NADETs)is not fully understood.NADETs that express gastric-type mucin phenotypes(GNADETs)are noteworthy because of their high malignancy.Gastric foveolar metaplasia,from which G-NADETs originate,protects the duodenal mucosa from gastric acidity.As gastric acid secretion is affected by endoscopic gastric mucosal atrophy(EGMA),we hypothesized that EGMA would be associated with GNADETs.AIM To evaluate the association between EGMA and the occurrence of G-NADETs.METHODS This cross-sectional retrospective study investigated the relationship between EGMA and NADETs in 134 patients.The duodenum was divided into parts 1(bulb),2(superior duodenal angle to the papilla),and 3(anal side of the papilla to the horizontal part).The effects of gastric acidity and presence of Brunner’s glands were considered.EGMA was divided into types C(no or mild atrophy)and O(severe atrophy).Mucin phenotype expressions in NADETs were divided into gastric,intestinal,gastrointestinal,and unclassifiable.RESULTS When NADETs were classified according to EGMA,105 were classified as type C and 29 as type O.G-NADETs were present in 11.9%(16 cases)of all cases,and all 16 cases were of type C.Among G-NADETs,93.8%(15 cases)were present in part 1 or 2.There was an association between G-NADETs and type C in part 1,and 50.0%(eight of 16 cases)of G-NADETs were associated with a current or previous Helicobacter pylori infection status.Additionally,all eight cases occurred in part 1.CONCLUSION G-NADETs were significantly associated with type C.Gastric acidity and Brunner's gland growth may be associated with G-NADETs.
文摘Appendiceal mucinous neoplasms(AMNs)are rare tumors originating from mucin-producing epithelial cells of the appendix.They can exhibit both benign and malignant behavior.They are often incidentally discovered during appendectomy.Clinical presentation ranges from asymptomatic to mimicking acute appendicitis.Histologically,noninvasive AMNs are classified as low-grade AMNs(LAMNs)or high-grade AMNs(HAMNs),whereas invasive tumors are categorized as mucinous adenocarcinomas.Although LAMNs and HAMNs are generally nonmalignant,rupture can lead to pseudomyxoma peritonei(PMP).Surgical resection is the primary diagnostic and therapeutic approach,with intraoperative assessment to prevent rupture.Treatment strategies vary based on findings and include appendectomy,right hemicolectomy,and cytoreductive surgery with hyperthermic intraperitoneal chemotherapy.Histological diagnosis relies on mucin detection,and immunohistochemical markers such as cytokeratin 20(diffusely positive),cytokeratin 7(often negative),mucin 5AC,and special ATrich sequence-binding protein 2 assist in characterization.Molecular profiling frequently identifies KRAS,GNAS,and TP53 mutations.KRAS mutations are generally associated with a favorable prognosis,whereas GNAS and TP53 mutations correlate with poorer survival outcomes.These findings highlight the potential role of molecular profiling in guiding treatment strategies for AMN and PMP.
基金Supported by Jinhua City Science and Technology Plan Projects“Improve the Polarization of Cancer-related Fatigue:Clinical Efficacy Study”,No.2018-4-049.
文摘BACKGROUND Low-grade appendiceal mucinous neoplasms(LAMNs)are a class of histolo-gically well-differentiated adenomas that can proliferate outside the appendix in the form of malignant tumours,resulting in the accumulation of external appen-diceal mucus.They may present as an extra-appendiceal mass-like bulge,mucus or polypoid tissue at the appendiceal orifice,or even with abdominal dissem-ination.The surgical approach is usually appendectomy,ileocecal resection or right hemicolectomy.It is essential to raise awareness of LAMNs and choose an appropriate treatment.CASE SUMMARY A 68-year-old man underwent a routine physical examination at our hospital on May 17,2022.The patient had no symptoms of abdominal pain,bloating,or weight loss,and his tumour marker levels were normal.The faecal occult blood test was negative,and no abnormalities were identified on physical examination.Colonoscopy revealed a submucosal protrusion at the appendiceal orifice.During endoscopic ultrasound,uneven echoes were observed in the appendix cavity.A contrast-enhanced computed tomography scan of the abdomen revealed a nodular thickening at the base of the appendix,with a diameter of approximately 1 cm.When all the examination results were considered,we suspected the lesion to be an appendiceal mucinous tumour.Laparoscopic surgery was performed using the double purse-string suture method.Postoperative pathology suggested a low-grade mucinous cystadenoma of the appendix with no involvement of the margins.A repeat colonoscopy 18 months after surgery revealed no significant abnormality at the appendiceal orifice.A contrast-enhanced computed tomography scan of the abdomen suggested only postoperative changes.CONCLUSION This study describes a case of LAMN that was treated by resecting the mass at the appendiceal orifice via the double purse-string suture technique and provides new insights on the diagnosis and treatment of LAMNs.
