Robotic total gastrectomy with <Emphasis Type="Italic">π</Emphasis>-shaped esophagojejunostomy using a linear stapler as a novel technique

Objective

To evaluate the intraoperative and short-term postoperative outcomes of a novel robotic intracorporeal π-shaped esophagojejunostomy (EJS) after D2 total gastrectomy (TG) using the Da Vinci robotic surgical system for intracorporeal anastomosis after TG.

Background

Intracorporeal π-shaped EJS, using a linear stapler, was recently reported for laparoscopic total gastrectomy in patients with gastric cancer. However, robotic intracorporeal π-shaped EJS using a linear stapler has not been reported. This report aimed to describe the use of a novel technique for π-shaped EJS using the Da Vinci robotic system.

Methods

Robotic intracorporeal π-shaped esophagojejunostomy after total gastrectomy was performed in 11 consecutive patients diagnosed with early gastric cancer, and their perioperative outcomes were analyzed.

Results

All the operations were successful without conversion to open or laparoscopic surgery and postoperative complications. The total number of patients was 11 (7 males and 4 females). The mean age of the patients was 63.36?±?10.56?years old. Seven patients were diagnosed with cardia cancer, 3 patients were diagnosed with gastric body cancer, and 1 patient was diagnosed with gastric antrum cancer. The patients’ mean proximal resection margin was 3.18?±?1.17?cm, the distal resection margin was 6.18?±?1.40?cm, the mean length of the incision was 4.55?±?0.69?cm, the mean operative time was 287.27?±?30.69?min, the mean day of first flatus was 3.27?±?0.79?days, the mean day of the start of diet was 2.91?±?0.94?days, the mean postoperative hospital stay was 11.45?±?5.13?days, and the mean operative blood loss was 47.27?±?31.33?ml. No complications were observed during anastomosis, and the median anastomosis time was 19.5?min. The mean number of lymph node dissections was 17.91?±?4.59, the mean number of positive lymph nodes was 0.45?±?0.69, all patients were diagnosed with stage I–II gastric cancer, and the mean maximum diameter of the tumor was 2.67?±?1.30?cm. All the patients had a smooth hospital discharge.

Conclusion

A novel robotic gastrectomy with intracorporeal π-shaped EJS for esophagojejunal anastomosis described and shows acceptable resulted. This technique has the potential to offer better short-term surgical outcomes and overcomes the drawbacks of laparoscopy with a decreased risk of complications during and after surgery.

     

The physiological state of suspension cultured cells affects the expression of the β-glucuronidase gene following transformation of tall fescue (Festuca arundinacea) protoplasts

Both the stage of the growth cycle and the age of the cell culture used to isolate protoplasts had a pronounced effect on both transient and stable expression of the GUS gene. A level of GUS gene transient expression of 9000 pmol 4MU/μg protein/h and a frequency of GUS gene stable expression of 5.72% were obtained with protoplasts isolated from suspension cultures 10–20 weeks after initiation and 3–4 days after subculturing when an optimized transformation protocol and a rice actin 1 promoter-uidA gene construct were used. The effect of the cell growth cycle on GUS gene transient expression was closely correlated with the growth rate and the rate of protein synthesis in cell cultures whereas prolonged subculturing of the cells resulted in a gradual decline in both transient and stable expression. The length of time cells were digested in cell wall digestion enzyme and the osmolarity of the transformation medium were found to critically affect both the level of transient and stable GUS gene expression. The composition and osmolarity of the protoplast culture medium was less critical for transient GUS gene expression although the osmolarity of the medium was shown to have a significant effect on stable expression of the GUS gene.     

Dual inhibitors of RAF-MEK-ERK and PI3K-PDK1-AKT pathways: Design,synthesis and preliminary anticancer activity studies of 3-substituted-5-(phenylamino) indolone derivatives

The dysfunction and mutual compensatory activation of RAF-MEK-ERK and PI3K-PDK1-AKT pathways have been demonstrated as the hallmarks in several primary and recurrent cancers. The strategy of concurrent blocking of these two pathways shows clinical merits on effective cancer therapy, such as combinatory treatments and dual-pathway inhibitors. Herein, we report a novel prototype of dual-pathway inhibitors by means of merging the core structural scaffolds of a MEK1 inhibitor and a PDK1 inhibitor. A library of 43 compounds that categorized into three series (Series I–III) was synthesized and tested for antitumor activity in lung cancer cells. The results from structure-activity relationship (SAR) analysis showed the following order of antitumor activity that 3-hydroxy-5-(phenylamino) indolone (Series III)?>?3-alkenyl-5-(phenylamino) indolone (Series I)?>?3-alkyl-5-(phenylamino) indolone (Series II). A lead compound 9za in Series III showed most potent antitumor activity with IC₅₀ value of 1.8?±?0.8?µM in A549 cells. Moreover, antitumor mechanism study demonstrated that 9za exerted significant apoptotic effect, and cellular signal pathway analysis revealed the potent blockage of phosphorylation levels of ERK and AKT in RAF-MEK-ERK and PI3K-PDK1-AKT pathways, respectively. The results reported here provide robust experimental basis for the discovery and optimization of dual pathway agents for anti-lung cancer therapy.     

RP-HPLC法测定青海产四种秦艽中獐牙菜苦苷的含量

建立了秦艽中獐牙菜苦苷含量测定的RP-HPLC方法。色谱条件：采用ZorbaxEclipseXDB-C18柱（150mm×4.6mm,5μm）,流动相：甲醇-0.03%磷酸水溶液梯度洗脱（0～25min：15%～23%;25～30min：23%～30%）,流速：1mL/min,柱温：25℃,检测波长240nm,獐牙菜苦苷在0.20～1.8μg范围内成良好的线性关系,r=0.9999,回收率RSD=1.32%。对青海产4种秦艽中獐牙菜苦苷的含量进行了定量分析,测定结果：小秦艽中獐牙菜苦苷的含量最高为：0.62%,麻花秦艽与管花秦艽的含量没有显著差异,分别为：0.43%,0.45%,簧管秦艽的含量最低为：0.32%。     

Molecular characterization,expression pattern,and functional analysis of the <Emphasis Type="Italic">OsIRL</Emphasis> gene family encoding intracellular Ras-group-related LRR proteins in rice

Leucine-rich repeat proteins constitute a large gene family and play important roles in plant growth and development. Among them, Arabidopsis PIRL is a plant-specific class of intracellular Ras-group-related leucine-rich repeat proteins. In this study, we identified eight homologues of PIRLs in rice and designated them as OsIRL proteins. We described the gene structures, chromosome localizations, protein motifs, and phylogenetic relationships of the OsIRL gene family. The expression profiles of OsIRL genes were analyzed throughout the entire rice life cycle, along with light and three hormone stress conditions, using quantitative RT-PCR and microarray data. All OsIRL genes were expressed in at least one experimental stage and exhibited divergent expression patterns, with several genes showing preferential expression at specific stages. OsIRL4 and OsIRL5 showed higher expression levels under light compared to dark. OsIRL4 and OsIRL7 exhibited significant differential expression in response to hormone treatments. Six T-DNA or Tos17 insertion lines for five individual OsIRL genes were identified and examined morphologically. The comprehensive expression profile elucidated in this investigation together with the characterized insertion lines will provide a solid foundation for in-depth dissection of OsIRL functions.     

PKS5, a SNF1-related kinase, interacts with and phosphorylates NPR1,and modulates expression of WRKY38 and WRKY62

NPR1 (Nonexpressor of Pathogenesis-Related gene 1) is a major co-activator of plant defense. Phosphorylations of NPR 1 play important roles in fine-tuning its activity, however a kinase corresponding to such modification remains uncharacterized. Here, we report that NPR1 interacts with PKS5 (SOS2-like Protein Kinase 5). The AKR (AnK yrin Repeats) motif of NPR1 is required for this interaction.PKS5 phosphorylates NPR1 at the C-temminal region. Expression of PKS5 is induced quickly by Pseudomonas syringae pv. tomato DC3000. Expression level of two NPR1 target genes, WRKY38 and WRKY62, is reduced and/or delayed in pks5 mutants. Moreover, the expression of WRKY38 and WRKY62 displays a similar pattern in npr1-1pks5-1 double mutant comparing to that in npr1-1. Our results suggest that PKS5 functions at the upstream of NPR1 and might mediate expression of WRKY38 and WRKY62 possibly by interacting with and phosphorylating NPR1.