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This study aimed to investigate the clinical benefits of single-vessel transection Roux-en-Y (SR-Y) reconstruction after total gastrectomy.

To investigate whether genetic variants may provide additional prognostic value to improve the existing clinical staging system for gastric cancer (GC), we performed two genome-wide association studies (GWASs) of GC survival in the Jiangsu (N= 1049) and Shanghai (N= 1405) cohorts. By using a TCGA dataset, we validated genetic markers identified from a meta-analysis of these two Chinese cohorts to determine GC survival-associated loci. Then, we constructed a weighted polygenic hazard score (PHS) and developed a nomogram in combination with clinical variables. We also evaluated prognostic accuracy with the time-dependent receiver operating characteristic (ROC) curve, net reclassification improvement (NRI) and integrated discrimination improvement (IDI). We identified a single nucleotide polymorphism (SNP) of rs1618332 at 15q15.1 that was associated with the survival of GC patients with a Pvalue of 4.12 × 10−8, and we also found additional 25 SNPs having consistent associations among these two Chinese cohort and TCGA cohort. The PHS derived from these 26 SNPs (PHS-26) was an independent prognostic factor for GC survival (all P< 0.001). The 5-year AUC of PHS-26 was 0.68, 0.66 and 0.67 for Jiangsu, Shanghai and their pooled cohorts, respectively, which increased to 0.80, 0.82 and 0.81, correspondingly, after being integrated into a nomogram together with variables of the clinical model. The PHS-26 could improve the NRIs by 16.20%, 4.90% and 8.70%, respectively, and the IDIs by 11.90%, 8.00% and 9.70%, respectively. The 26-SNP based PHS could substantially improve the accuracy of prognostic assessment and might facilitate precision medicine for GC patients.

ObjectiveAlthough a subset of genetic loci have been associated with gastric cancer (GC) risk, the underlying mechanisms are largely unknown. We aimed to identify new susceptibility genes and elucidate their mechanisms in GC development.DesignWe conducted a meta-analysis of four genome-wide association studies (GWASs) encompassing 3771 cases and 5426 controls. After targeted sequencing and functional annotation, we performed in vitro and in vivo experiments to confirm the functions of genetic variants and candidate genes. Moreover, we selected 33 promising variants for two-stage replication in 7035 cases and 8323 controls from other five studies.ResultsThe meta-analysis of GWASs identified three loci at 1q22, 5p13.1 and 10q23.33 associated with GC risk at p<5×10−8 and replicated seven known loci at p<0.05. At 5p13.1, the risk rs59133000[C] allele enhanced the binding affinity of NF-κB1 (nuclear factor kappa B subunit 1) to the promoter of PRKAA1, resulting in a reduced promoter activity and lower expression. The knockout of PRKAA1promoted both GC cell proliferation and xenograft tumour growth in nude mice. At 10q23.33, the rs3781266[C] and rs3740365[T] risk alleles in complete linkage disequilibrium disrupted and created, respectively, the binding motifs of POU2F1 and PAX3, resulting in an increased enhancer activity and expression of NOC3L, while the NOC3Lknockdown suppressed GC cell growth. Moreover, two new loci at 3q11.2 (OR=1.21, p=4.56×10−9) and 4q28.1 (OR=1.14, p=3.33×10−11) were associated with GC risk.ConclusionWe identified 12 loci to be associated with GC risk in Chinese populations and deciphered the mechanisms of PRKAA1at 5p13.1 and NOC3Lat 10q23.33 in gastric tumourigenesis.

IMPORTANCE: Peritoneal metastasis is the most frequent pattern of postoperative recurrence in patients with gastric cancer. Extensive intraoperative peritoneal lavage (EIPL) is a new prophylactic strategy for treatment of peritoneal metastasis of locally advanced gastric cancer; however, the safety and efficacy of EIPL is currently unknown. OBJECTIVE: To evaluate short-term outcomes of patients with advanced gastric cancer who received combined surgery and EIPL or surgery alone. DESIGN, SETTING, AND PARTICIPANTS: From March 2016 to November 2017, 662 patients with advanced gastric cancer receiving D2 gastrectomy were enrolled in a large, multicenter, randomized clinical trial from 11 centers across China. In total, 329 patients were randomly assigned to receive surgery alone, and 333 patients were randomly assigned to receive surgery plus EIPL. Clinical characteristics, operative findings, and postoperative short-term outcomes were compared between the 2 groups in the intent-to-treat population. MAIN OUTCOMES AND MEASURES: Short-term postoperative complications and mortality. RESULTS: The present analysis included data from 550 patients, 390 men and 160 women, with a mean (SD) age of 60.8 (10.7) years in the surgery alone group and 60.6 (10.8) in the surgery plus EIPL group. Patients assigned to the surgery plus EIPL group exhibited reduced mortality (0 of 279 patients) compared with those assigned to surgery alone (5 of 271 patients [1.9%]) (difference, 1.9%; 95% CI, 0.3%-3.4%; P = .02). A significant difference in the overall postoperative complication rate was observed between patients receiving surgery alone (46 patients [17.0%]) and those receiving surgery plus EIPL (31 patients [11.1%]) (difference, 5.9%; 95% CI, 0.1%-11.6%; P = .04). Postoperative pain occurred more often following surgery alone (48 patients [17.7%]) than following surgery plus EIPL (30 patients [10.8%]) (difference, 7.0%; 95% CI, 0.8%-13.1%; P = .02). CONCLUSIONS AND RELEVANCE: Inclusion of EIPL can increase the safety of D2 gastrectomy and decrease postoperative short-term complications and wound pain. As a new, safe, and simple procedure, EIPL therapy is easily performed anywhere and does not require any special devices or techniques. Our study suggests that patients with advanced gastric cancer appear to be candidates for the EIPL approach. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02745509

This paper finds a north‐south contrast of subsurface salinity trend during 2002–2013 in the northwestern Pacific. Both Argo float data and long‐term repeat hydrographic measurements along the 137°E section show that salinity anomalies along the isopycnals of 24.5–25.4 kg/m3exhibit a pronounced decreasing trend north of 15°N and an increasing trend south of 15°N. We perform a quantitative analysis based on satellite‐derived data and a qualitative analysis that used a lower‐order isopyncal salinity model that represents key balance terms (i.e., evaporation E, precipitation P, and wind forcing advection). Both of the analyses consistently show that the subsurface salinity anomalies in the north and south of 15°N are induced by different physical processes. Fresher surface waters in the northwestern subtropical outcrop region due to an excess freshwater supply (E − P < 0) contribute to the freshening of subsurface waters north of 15°N. In contrast, saltier surface waters in the northeastern subtropical subduction region induced by a deficit of freshwater (E − P > 0) and anomalous ocean circulation associated with the recent accelerated trade winds of the tropical Pacific cause the saltiness of subsurface waters south of 15°N. The results imply that the salinity north‐south contrast may play an important role in changing ocean thermocline structure and upper ocean stratification in the northwestern Pacific. Salinity, along with temperature and density, is a fundamental variable for seawater and can be considered as a tracer of ocean circulation. Additionally, as an important indicator of freshwater flux, salinity change is an essential measure of the hydrological cycle. The observations show a north‐south contrast of salinity trends in the northwestern Pacific. This north‐south contrast features will change upper ocean structure such as mixed layer depth and oceanic barrier layers and ocean heat budget in the northwest Pacific, thus affecting the tropical cyclone and climate variability. The north‐south contrast feature was caused by different physical processesFresher surface waters in the northwestern subtropical outcrop region are subducted and advected by mean oceanic circulationSaltier surface waters in the northeastern subtropical subduction region and anomalous ocean circulation cause the saltiness south of 15°N

We study the spontaneous decoherence of coupled harmonic oscillators confined in a ring container, where the nearest-neighbor harmonic potentials are taken into consideration. Without any external symmetry-breaking field or surrounding environment, the quantum superposition state prepared in the relative degrees of freedom gradually loses its quantum coherence spontaneously. This spontaneous decoherence is interpreted by the gauge couplings between the center-of-mass and the relative degrees of freedoms, which actually originate from the symmetries of the ring geometry and the corresponding nontrivial boundary conditions. In particular, such spontaneous decoherence does not occur at all at the thermodynamic limit because the nontrivial boundary conditions become the trivial Born-von Karman boundary conditions when the perimeter of the ring container tends to infinity. Our investigation shows that a thermal macroscopic object with certain symmetries has a chance for its quantum properties to degrade even without applying an external symmetry-breaking field or surrounding environment.

Background: Considerable evidence has indicated that most noncoding RNA (ncRNA) transcripts act directly as functional RNAs rather than as encoded peptides. However, a recent study of ribosome occupancy reported that many large intergenic ncRNAs (lincRNAs) are bound by ribosomes, raising the possibility that they are translated into proteins. These lincRNAs contain either Internal Ribosomal Entry Sites (IRES) or short Open Reading Frames (sORFs), and other translation elements, which can be translated into peptides with physiological functions. Conclusion: This review discusses three major types of ncRNA-encoded peptides (ncPEPs). First, microRNA(miRNA)-encoded peptides (miPEPs) are translated from their primary transcripts of miRNA genes and can promote the development of plant roots. Second, a long ncRNA(lncRNA) containing sORF encodes a 90 residues long regulatory peptide. Upon the amino acid response, the lncRNA-encoded peptide reduces the activity of mammalian Target Rapamycin complex 1 (mTORC1) and promotes muscle regeneration. Third, a circular RNA (circRNA) of the Na+/Ca2+ exchanger gene 1 (NCX1) exon 2 transcript encodes a truncated NCX1 protein exhibiting the Na+/Ca2+ exchange activity. It is also of worth noting that the majority of ncRNAs is not translated. This review summarizes the current understanding of the translatability of ncRNAs and the functions of ncPEPs in cellular processes, which may provide novel insights into the roles of ncPEPs.

Previous studies of the exchanges of the subtropical‐tropical salinity in the North Pacific are still not conclusive. Some studies suggest that surface salinity anomalies formed in the northeastern subtropics can subduct and penetrate to the subsurface of the northwestern Pacific, whereas others demonstrate that subsurface salinity anomalies in the northwestern Pacific cannot be traced back to those of the eastern subtropics. This study examined the variability of subsurface salinity in the northwestern Pacific, with focus on its propagation characteristic and forcing mechanism in its outcrop region. It is found that salinity anomalies on 24.5–25.4 kg m−3isopycnals exhibited a pronounced freshening trend in the northwestern Pacific during 2003–2012. This freshening can be traced back to the surface salinity anomalies in the outcrop zone of the northwestern subtropical gyre, rather than that of northeastern subtropics. The representative transit time from its outcrop region to the eastern Luzon Strait is about 1–3 years. The surface salinity anomalies in the outcrop zone are mainly controlled by air‐sea freshwater flux change, although the contribution of horizontal advection is also important, in particular for year‐to‐year variation. Compared to the air‐sea freshwater flux and horizontal advection, the contribution of mixed‐layer depth to the surface salinity anomalies is smaller and can be neglected in the outcrop zone of the northwestern Pacific. A freshening of subsurface water was found in the northwestern PacificThis subsurface freshening water can be traced back to the surface salinity anomalies in the northwestern subtropical PacificThe surface salinity anomalies in the northwestern subtropical Pacific are mainly dominated by the air‐sea freshwater flux, but the contribution of the advection cannot be neglected, in particular for annual variation

Human serum microRNAs (miRNAs) have been shown to serve as disease fingerprints for predicting survival of cancer patients. However, the roles of specific miRNAs involved in gastric cancer (GC) are largely unknown. In this study, miRNA profiling was performed on sera obtained from six patients in good- and poor-survival groups. Expression of miR-423-3p was validated by quantitative RT-PCR in another 67 GC serum samples and paired normal and cancerous gastric tissues. Luciferase reporter assays were used to identify the target gene Bcl-2-interacting mediator of cell death (Bim). As a result, between the good-survival and poor-survival groups, the expression of nine serum miRNAs was altered more than two-fold. Among these, miR-423-3p was significantly increased in the poor-survival group, and its overexpression in GC tissues predicted poor survival in 119 patients with GC. miR-423-3p was found to promote cell proliferation, migration, and invasion in cell lines and animal models. Mechanistically, knockdown of the autophagy-related gene (Atg) 7 rescued the GC-promoting effect of miR-423-3p. In conclusion, miR-423-3p activates oncogenic and Beclin-1-dependent autophagy and promotes GC progression by reducing the expression of Bim. The newly identified miR-423-3p-Bim axis might be a potential therapeutic target in GC.

BACKGROUND:Preoperative nutritional deficiency (ND) has been shown to be a valuable prognostic factor in urologic malignancies. We aimed to investigate the prognostic value of ND in patients with gastric cancer (GC). METHODS:A single-center cohort of 1026 GC patients undergoing curative resection between 2003 and 2012 was categorized to ND and nutritionally replete (NR) groups. Patients with body mass index <18.5 kg/m2, preoperative albumin <35 g/l, or preoperative weight loss ≥5% of body weight were defined as ND. RESULTS:Of the 1026 patients included in the study, 585 (57.0%) were categorized as ND. Overall survival (OS) at 5 years was 68.5% for ND patients and 44.0% for NR patients (P<.001). Multivariate analysis revealed that ND was a significant predictor of OS (hazard ratio: 1.954; 95% confidence interval: 1.552-2.460; P<.001). In stage-stratified analysis, it was still independently associated with OS in tumor-nodes-metastasis stage II and III (P=.004 and P<.001, respectively). Of note, the prognostic significance of ND was still maintained when stratified by age, sex, anemia, and adjuvant chemotherapy (all Ps<.05). CONCLUSION:Preoperative ND is a novel predictor of outcome in GC, especially in stage II to III GC, and may help clinicians identify high-risk patients for proactive nutritional interventions.

BACKGROUND:An elevated preoperative C-reactive protein/albumin (CRP/Alb) ratio has been reported to be associated with a poor prognosis for hepatocellular carcinoma. The aim of the present study was to investigate the prognostic value of the preoperative CRP/Alb ratio and compare it with other systemic inflammatory response markers in patients with gastric cancer (GC). METHODS:A retrospective study was performed in 455 patients with GC undergoing curative resection. We investigated the correlations between the preoperative CRP/Alb ratio and overall survival (OS). Kaplan-Meier and Cox regression models were used to assess independent prognostic factors. The area under the curve was used to compare the prognostic value of different markers. RESULTS:On multivariate analysis, the CRP/Alb ratio were independently associated with OS in patients with GC (hazard ratio: 1.626; 95% confidence interval: 1.191-2.219; P= .002), along with age (P= .003), preoperative body weight loss (P= .001), tumor location (P= .008), metastatic lymph node ratio (P< .001), and seventh tumor-nodes-metastasis stage (American Joint Committee on Cancer) (P= .007). However, several other systemic inflammation–based prognostic scores (neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index, Glasgow Prognostic Score, modified Glasgow prognostic score, and high-sensitivity modified Glasgow prognostic score) were not. In addition, the CRP/Alb ratio had a higher area under the curve value (0.625) compared with several other systemic inflammation–based prognostic scores (P< .001). CONCLUSION:The preoperative CRP/Alb ratio, a system inflammation-based prognostic score, is a superior predictor of OS in patients undergoing curative resection for GC and may help to identify the high-risk patients for treatment decisions.

We provide a general dynamical approach for the quantum Zeno and anti-Zeno effects in an open quantum system under repeated non-demolition measurements. In our approach the repeated measurements are described by a general dynamical model without the wave function collapse postulation. Based on that model, we further study both the short-time and long-time evolutions of the open quantum system under repeated non-demolition measurements, and derive the measurement-modified decay rates of the excited state. In the cases with frequent ideal measurements at zero-temperature, we re-obtain the same decay rate as that from the wave function collapse postulation (Nature, 2000, 405: 546). The correction to the ideal decay rate is also obtained under the non-ideal measurements. Especially, we find that the quantum Zeno and anti-Zeno effects are possibly enhanced by the non-ideal natures of measurements. For the open system under measurements with arbitrary period, we generally derive the rate equation for the long-time evolution for the cases with arbitrary temperature and noise spectrum, and show that in the long-time evolution the noise spectrum is effectively tuned by the repeated measurements. Our approach is also able to describe the quantum Zeno and anti-Zeno effects given by the phase modulation pulses, as well as the relevant quantum control schemes.

Abstract: Feshbach resonance is a resonance for two-atom scattering with two or more channels, in which a bound state is achieved in one channel. We show that this resonance phenomenon not only exists during the collisions of massive particles, but also emerges during the coherent transport of massless particles, that is, photons confined in the coupled resonator arrays linked by a separated cavity or a tunable two level system (TLS). When the TLS is coupled to one array to form a bound state in this setup, the vanishing transmission appears to display the photonic Feshbach resonance. This process can be realized through various experimentally feasible solid state systems, such as the couple defected cavities in photonic crystals and the superconducting qubit coupled to the transmission line. The numerical simulation based on the finite-different time-domain (FDTD) method confirms our assumption about the physical implementation.

Abstract: The diffuse attenuation coefficient for downwelling irradiance (K d(λ)) is an important parameter for ocean studies. Based on the optical profile data measured during three cruises in the northern South China Sea in autumn from 2003 to 2005, variations in the K d(λ) spectra were analyzed. The variability of K d(λ) shows much distinct features in both magnitude and spectra pattern, it is much higher in coastal waters than that of open oceanic waters; and the blue-to-green (443/555) ratio of K d(λ) tends to increase with chlorophyll a concentration ([Chl-a]) from open ocean to coastal waters. These characteristics can be explained most by the increase of a w+p(443)/a w+p(555) with [Chl-a]. In short waveband, the relation between K d(λ)-K w(λ) and [Chl-a] can be well described by a power law function, indicating the large contribution of phytoplankton to the variations in K d(λ). As for the spectral model of the diffuse attenuation coefficient, there are good linear relationships between K d(490) and K d(λ) in other wavelengths with own slope and intercept of a linear functions in the spectral range 412–555 nm. K d(490) is well correlated with the spectral ratio of remote sensing reflectance; and should enough measurement data are given, this empirical algorithm would be used in the K d(λ) retrieval from ocean color satellite data. The variation in K d(λ) provides much useful information for us to study the bio-optical property in the northern South China Sea.

The deubiquitinase CYLD suppresses activation of the tumor growth–promoting kinase Akt.