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TGF-β1-induced expression of Id-1 is associated with tumor progression in gastric cancer.

TGF-β1-induced expression of Id-1 is associated with tumor progression in gastric cancer.
TGF-β1-induced expression of Id-1 is associated with tumor progression in gastric cancer.

ORIGINAL PAPER

TGF-b 1-induced expression of Id-1is associated with tumor progression in gastric cancer

Huiying Ma ?Ye Wei ?Yongmei Leng ?Shichao Li ?Lingling Gao ?Heng Hu ?Long Chen ?Fei Wang ?Honglei Xiao ?Chouwen Zhu ?Chunmin Liang

Received:2April 2014/Accepted:30April 2014óSpringer Science+Business Media New York 2014

Abstract Transforming growth factor b 1(TGF-b 1)and inhibitor of differentiation/DNA-binding 1(Id-1)have been shown to be associated with aggressive metastatic behavior of cancer cells in many malignant tumors.How-ever,their role in gastric cancer (GC)has not been estab-lished.In this study,we investigated the relationship between expression of Id-1and TGF-b 1in GC as well as their association with GC progression.The immunohisto-chemical analysis of 71human GC samples indicated that both Id-1and TGF-b 1were markedly upregulated in tumor tissue compared with the adjacent tissue;in addition,a signi?cant positive correlation was found between the expression levels of Id-1and TGF-b 1by Pearson’s corre-lation analysis.Furthermore,the investigation of the association of Id-1and TGF-b 1with patient clinical characteristics revealed that Id-1expression was signi?-cantly correlated with tumor differentiation,while TGF-b 1was associated with lymph node metastasis.The results were validated in vitro by using a GC cell line,AGS.The expression of Id-1was upregulated at 24and 48h after the

treatment with TGF-b 1,whereas it did not affect the pro-liferation of cells.TGF-b 1also in?uenced the expression of N-cadherin and b -catenin.Our results suggested that Id-1and TGF-b 1played important roles in the progression of GC,in which Id-1might act as a downstream mediator of TGF-b 1signaling through a regulatory mechanism involving N-cadherin and b -catenin.The TGF-b 1/Id-1axis might serve as a future therapeutic target for GC.Keywords Inhibitor of differentiation 1áTransforming growth factor b 1áGastric cancer áClinical pathology áAGS

Introduction

Gastric cancer (GC)is one of the most common malig-nancies worldwide.Despite the declining incidence,GC remains the second leading cause of cancer-related deaths [1,2].The advances in diagnostic techniques and treatment strategies ensure an early detection and low mortality rate for early stages of GC [3,4];however,the candidate prognostic biomarkers for patients with advanced metas-tasized GC need to be further explored.

Inhibitor of cell differentiation/DNA-binding (Id)pro-teins is a family of helix–loop–helix (HLH)transcription factors (Id-1–Id-4).They regulate cell cycle and cell dif-ferentiation by antagonizing the DNA-binding activity of basic HLH transcription factors [5].Accumulated evidence suggests that Id-1plays multiple roles in the progression of various cancers via stimulation of angiogenesis [6,7],inhibition of differentiation [8,9],and induction of metastasis [10–13].Clinical studies involving GC patients have revealed a signi?cant association of Id-1overex-pression with cancer invasion and metastasis [14–16].

Huiying Ma,Ye Wei and Yongmei Leng have equally contributed to this article.

H.Ma áL.Gao áH.Hu áL.Chen áF.Wang áH.Xiao áC.Liang (&)

Laboratory of Tumor Immunology,Department of Anatomy and Histology &Embryology,Shanghai Medical College,Fudan University,138Yi Xue Yuan Road,Shanghai 200032,People’s Republic of China e-mail:cmliang@https://www.wendangku.net/doc/0e3409068.html,

Y.Wei áY.Leng áS.Li áC.Zhu (&)

General Surgery Department,Zhongshan Hospital,Shanghai Medical College,Fudan University,180Feng lin Road,Shanghai 200032,People’s Republic of China e-mail:cwzhu@https://www.wendangku.net/doc/0e3409068.html,

Med Oncol (2014)31:19

DOI 10.1007/s12032-014-0019-3

Further studies demonstrate that inhibition of GC cells differentiation by Id-1contributes to GC progression[17, 18].However,the molecular mechanism underlying Id-1 functions in GC progression is not fully elucidated.

Transforming growth factor b1(TGF-b1),polypeptide belonging to the TGF-b family of growth factors,is shown to be upregulated in the tumor microenvironment and contributes to tumor metastasis[19,20].Once TGF-b1 binds to its receptor,the receptor is phosphorylated and then activates the downstream signaling mediator SMAD2/ 3to exert its biological activities[21].It has been reported that overexpression of TGF-b1in head and neck epithelia causes severe in?ammation and angiogenesis,which may consequently contribute to the malignant phenotype med-iated by vascular endothelial growth factor(VEGF)and activin receptor-like kinase1(ALK1)[22–24].Previous ?ndings have also shown that TGF-b1induces migration and invasion of tumor cells and promotes metastasis by upregulating the protein level of matrix metalloproteinase-9[25,26].

Although both Id-1and TGF-b1are involved in tumor progression,their interrelationship in carcinogenesis requires further clari?cation.To date,several reports have suggested that Id-1expression may be involved in TGF-b-signaling pathway,but the data are controversial.Id-1 expression is downregulated by TGF-b1in prostate epi-thelial cell lines[27–29].On the contrary,Id-1proves to be signi?cantly upregulated by stimulating TGF-b3in endo-thelial cells[30],and TGF-b1in metastatic breast tumor cells[31]and in prostate cancer cells[32].However,to the best of our knowledge,there are no reports elucidating the relationship between TGF-b1and Id-1and their functions in GC progression.

In this study,we investigated the relationship between Id-1and TGF-b1in shaping the permissive GC microen-vironment.The results showed that the expression of Id-1 and TGF-b1was increased in GC tissue compared with that in the adjacent tissue and was positively associated with tumor differentiation and lymph node metastasis, respectively.Moreover,a signi?cant positive correlation between the expression of Id-1and TGF-b1was revealed in GC tissue.These results were further validated in GC AGS cells,which showed an increase of Id-1expression,as well as N-cadherin and b-catenin,after stimulation with TGF-b1.

Materials and methods

Tissue specimens

Seventy-one GC patients who received surgical treatment at Zhongshan Hospital(Shanghai,China)between June 2011and December2011were enrolled in our study.The evaluation of the resected tumor specimens was performed according to the guidelines of the Japanese Gastric Carci-noma Association.Stage grading was performed in accor-dance with the TNM classi?cation of gastric carcinoma (UICC).None of the patients received radiotherapy,che-motherapy,or other medical interventions before the sur-gery.Specimens were collected only from patients who underwent complete clinical and pathological evaluation. Informed consent was obtained from all individuals.The study was approved by the Research Ethics Committee of Zhongshan Hospital.

Immunohistochemistry

Tumors and adjacent non-cancerous tissue samples were harvested from the71GC patients,?xed in formalde-hyde and embedded in paraf?n.Immunohistochemistry of paraf?n sections(5l m)was carried out using a two-step protocol.Brie?y,sections were deparaf?nized with xylene and rehydrated with graded ethanol solutions. After blocking the endogenous peroxide activity by incubation in0.3%H2O2,antigen retrieval was per-formed by placing the sections in boiling citrate or ethylenediamine tetraacetic acid(EDTA)buffer for 10min,and non-speci?c binding sites were blocked with 5%goat serum in19phosphate buffered saline(19 PBS,pH7.4).The slides were incubated with primary antibodies against Id-1and TGF-b1(1:25and1:200, respectively;Abcam;MA,USA),horseradish peroxidase (HRP)-conjugated secondary antibodies(1:200;KPL; MD,USA),and3,30-diaminobenzidine(DAB)solution (Sigma-Aldrich;MO,USA).Negative control slides without the primary antibodies were included in all assays.All specimens were counterstained with hema-toxylin and examined under light microscopy. Evaluation of immunohistochemical staining

Each immunostained slide was observed at2009and 4009magni?cations.At least?ve4009magni?cation images were processed and analyzed using ImageJ soft-ware(National Institutes of Health;Bethesda,MD,USA). For each specimen,the percentages of positively stained areas relative to the total observed areas of tumor cell(% area)were determined.The average percentage was cal-culated to ensure the sample representativeness and homogeneity for accurate statistical analysis.

Cell line and culture conditions

The human gastric adenocarcinoma AGS cell line was maintained in a5%CO2-humidi?ed atmosphere at37°C

19Page2of10Med Oncol(2014)31:19

in RPMI-1640medium(Biowest;France)supplemented with10%fetal bovine serum(FBS;Biowest). Immunocytochemistry

AGS cells were seeded in24-well plates with cover slips in RPMI-1640supplemented with10%FBS.After cell attachment,the medium was changed to1%FBS with or without TGF-b1(10ng/mL;PeproTech;NJ,USA)and continuously cultured.The cells were collected at24and 48h,respectively,?xed with4%paraformaldehyde for 15min and permeabilized with0.3%Triton X-100for 10min.After blocking with5%goat serum in19PBS with0.3%Triton X-100,the cells were incubated with mouse anti-Id-1(1:25),rabbit anti-N-cadherin(1:200; Epitomics;USA),and rabbit anti-b-catenin(1:200;Ab-cam)overnight at4°C.Cell monolayers were then incu-bated with?uorescein isothiocyanate(FITC)-labeled secondary antibody(1:200;KPL)for2h at room temper-ature and stained with1l g/l L of40,6-diamidino-2-phe-nylindole(DAPI;Sigma-Aldrich;USA)in PBS with0.3% Triton X-100.After three washes with19PBS,the slides were mounted and analyzed using a?uorescence micro-scope(magni?cation9200;H55OS;Nikon;Japan)or a laser-scanning confocal microscope(magni?cation9400; TCS-SP5;Leica Camera AG;Germany).

Western blotting

Cells were treated as described above and harvested at the indicated time points.Whole-cell lysates were prepared by re-suspending cells in RIPA lysis buffer(Beyotime; China),and protein concentrations were measured using the BCA protein assay kit(Beyotime).Equal amounts of denatured proteins were resolved by polyacrylamide gel electrophoresis and analyzed by immunoblotting with pri-mary antibodies against Id-1(1:50),Snail(1:500),b-cate-nin(1:2,000),Twist(1:100)(all from Abcam),E-cadherin (1:2,000),N-cadherin(1:6,000),and Vimentin(1:3,000) (all from Epitomics);GAPDH(1:10,000;KangChen Bio-tech Inc.,China)was used as a loading control.After the incubation with HRP-conjugated secondary antibodies (1:4,000),the signals were visualized by the ECL system

(Thermo Fisher Scienti?c Inc.,MA,USA)and quanti?ed using a Gel-Pro analyzer(Media Cy-bernetics Inc.,Silver Spring,MD,USA).The experiments were performed in triplicate.

Cell proliferation assay

Cell proliferation was quantitatively evaluated using the Cell Count kit-8(CCK-8;Beyotime,China).Cells were plated in 96-well plates at a density of29104cells/mL.After12h of incubation,RPMI-1640with1%FBS and TGF-b1was added to the experimental group.The cells were incubated for the indicated https://www.wendangku.net/doc/0e3409068.html,K-8solution(10l L)was then added to each well,and cells were incubated for an additional 2h at37°C.The absorbance at450nm(OD450)was determined using a microplate reader(Model680;Bio-Rad, CA,USA);RPMI1640containing10l L CCK-8was used as blank.The proliferation index(PI)was calculated using the formula:PI=OD450of the experimental group/OD450 of the control group.

Table1Characteristics of71gastric cancer patients Characteristics No.of patients% Age(years)a

\623549.3 C623650.7 Gender

Male4766.2 Female2433.8 Tumor size(cm)a

\43447.9 C43752.1 Operation method

Radical distal subtotal gastrectomy4360.6 Radical total gastrectomy2231.0 Palliative distal subtotal gastrectomy4 5.6 Palliative total gastrectomy2 2.8 Differentiation

I00.0 II1521.1 III5678.9 Primary tumor

Tis,T13 4.2 T21216.9 T31216.9 T44462.0 Regional lymph nodes

N02332.4 N11318.3 N21115.5 N32433.8 Distant metastasis

M06490.1 M179.9 TNM stage grouping

IA,IB1115.5 IIA,IIB2028.2 IIIA,IIIB,IIIC3346.5 IV79.8 a Split at median

Med Oncol(2014)31:19Page3of1019

Statistical analysis

Experimental data were presented as the mean?SEM of at least three independent experiments performed in duplicate.Statistical analysis was performed using GraphPad Prism5(GraphPad Software;USA)and SPSS 20.0software(SPSS;Chicago,IL,USA).Differences between tumor and adjacent tissue were analyzed by the Wilcoxon test.To assess the relationship between variables and clinical pathology parameters,all cases were divided into high and low expression groups(classi?ed by the median value),and then a chi-squared test was performed. Pearson’s correlation analysis was used to explore the association between Id-1and TGF-b1.Two-tailed levels of signi?cance were used and P\0.05was considered sta-tistically signi?cant.

Results

Clinical and pathological characteristics of GC patients

The clinic-pathological characteristics of71gastric carci-noma patients were summarized in Table1.The specimens included47male(66.2%)and24female(33.8%).The cutoffs of age and tumor size were set at their median values,62and4cm,respectively.The patients underwent surgical resection including radical(65,91.6%)and pal-liative(6,8.4%)gastrectomy.Differentiated tumors were classi?ed as stage II(15patients,21.1%)and III(56, 78.9%).As de?ned by the location of primary tumor,T1 was diagnosed in3(4.2%)cases,whereas T2in12 (16.9%)cases,T3in12(16.9%)cases,and T4in44 (62.0%)cases.Regional lymph nodes metastasis and distant metastasis were diagnosed in48(67.6%)and7 (9.9%)cases,respectively.The TNM stage grouping was distributed as follows:I,11cases,15.5%;II,20cases, 28.2%;III,33cases,46.5%;and IV,7cases,9.8%.

Expression of Id-1and TGF-b1in GC tissue

Specimens collected from tumor and adjacent tissues of GC patients were analyzed for Id-1and TGF-b1expression by immunohistochemistry.Representative images of Id-1 and TGF-b1immunostaining were shown in Fig.1a–h.Id-1 expression was predominantly observed in the cytoplasm of GC cells.The expression of TGF-b1was identi?ed as positive in the cytoplasm of tumor cells.The expression of Id-1and TGF-b1was quantitatively evaluated as the per-centage of positively stained area relative to the total analyzed cell area(%area);the statistical results were shown in Table2and https://www.wendangku.net/doc/0e3409068.html,pared with the adjacent tissue,GC tissue showed signi?cantly higher levels of both Id-1(P\0.01)and TGF-b1(P\0.01).

Association between Id-1and TGF-b1expression

and clinical characteristics

Further analyses were undertaken to evaluate the associa-tion of the levels of Id-1and TGF-b1in tumors with the clinical parameters of71GC patients.Based on Id-1and TGF-b1expression levels determined as%area by immunohistochemistry(median expression values were 3.407and8.344,respectively),the patients were divided into high and low expression groups.As shown in Table3, the statistical analysis by chi-square test revealed no sig-ni?cant correlation of Id-1and TGF-b1expression with patients’age,gender,tumor size,primary tumor parame-ters(T stage),distant metastasis,and TNM stage grouping. However,Id-1showed a statistically signi?cant association with tumor differentiation(P=0.048),whereas TGF-b1 levels were positively correlated with regional lymph node metastasis(P=0.028).

Correlation between Id-1and TGF-b1expression

The association between Id-1and TGF-b1levels in tumor tissue was assessed by Pearson’s correlation ana-lysis.The results shown in Fig.2revealed a signi?cant positive correlation between Id-1and TGF-b1expression levels(r=0.503,P\0.01):in the scatter plot,the linear regression analysis was carried out to show the linear trend between the two variables,indicating an apparent association between Id-1and TGF-b1in GC.

Id-1expression stimulated by TGF-b1in AGS cells

Based on the veri?ed correlation between Id-1and TGF-b1in human specimens,we further investigated Id-1 expression following the treatment with TGF-b1in GC cell line AGS in vitro.Immunocytochemistry analysis revealed that Id-1was localized to the cell cytoplasm and nucleus(Fig.3a–c),while Western blotting results showed Id-1upregulation in TGF-b1-treated AGS cells compared with untreated cells(P\0.05,Fig.3d,e).The effect of TGF-b1on cellular proliferation was assessed by the treatment of cells with different concentrations of TGF-b1(0,2,5,10,20,and50ng/mL)by CCK-8 assay.The results showed that there was no signi?cant difference in the proliferation between TGF-b1-treated cells and control cells,irrespective of the incubation time (Fig.3f).Overall,these results showed that TGF-b1 upregulated Id-1expression in GC cells independent of cell proliferation.

19Page4of10Med Oncol(2014)31:19

Expression of epithelial-mesenchymal transition-related proteins

The epithelial-mesenchymal transition (EMT)occurs as a key process in tumor metastasis [33].To investigate whe-ther TGF-b 1affects EMT in GC,we assessed the expres-sion of EMT-related proteins in TGF-b 1-treated AGS cells.The levels of N-cadherin,Vimentin,b -catenin,Snail,and Twist were evaluated after stimulation by TGF-b 1.Western blotting results revealed that N-cadherin and b -catenin were signi?cantly upregulated by TGF-b 1(P \0.05and P \0.01,respectively),but there was no change in Vimentin,Snail,and Twist levels compared with control cells (Fig.4a,b).These results were corroborated by the cell immuno?uorescence staining (Fig.4c–f).Besides,the staining results further showed the distribu-tions of detected proteins in AGS cells.N-cadherin was localized to cell membrane,whereas b -catenin

was

Fig.1Id-1and TGF-b 1expression in 71human gastric carcinoma.a –h Representative Id-1and TGF-b 1immunohistochemistry images of adjacent tissue and tumor tissue.Magni?cation:a ,c ,e ,and g 9200;b ,d ,f ,and h 9400.i Statistical summary of Id-1and TGF-b 1staining intensity in adjacent tissue and tumor tissue (**P \0.01).Note that increased Id-1and TGF-b 1expression in tumor tissue was observed in adjacent tissue.Error bars represent the mean intensity ?SEM

Table 2Descriptive statistics of immunohistochemical variables

**Compared with the matched adjacent tissues;signi?cance is at 0.01level

Variables Minimum Maximum Mean SE Median P

Adjacent tissues Id-10.00025.739 1.6630.5250.457TGF-b 10.01534.583 3.3130.878 1.185Tumor tissues

Id-10.02720.591 4.4220.486 3.407\0.01**TGF-b 1

0.073

23.303

8.077

0.617

8.344

\0.01**

Med Oncol (2014)31:19Page 5of 1019

detected in cytoplasm (as shown in Fig.4c,d).Vimentin was found in cytoplasm,while Snail was expressed in nucleus (as shown in Fig.4e,f).

Discussion

In recent years,the relationship between Id-1and TGF-b 1has become a promising direction in cancer research.In metastatic breast tumor cells,Id-1levels increase almost twofold in response to TGF-b 1stimulation,suggesting that Id-1may be a mediator of TGF-b -induced responses to facilitate tumor reinitiation [31].In addition,it has been demonstrated that SMAD,the classical downstream mediator of TGF-b 1signaling,can directly interact with Id-1in promoting breast tumors for lung metastasis [34,35].A recent study of prostate cancer cells also demon-strates that TGF-b 1increases the proliferation and migra-tion of cancer cells by upregulating the expression of Id-1[32].Taken together,these ?ndings imply that Id-1is a TGF-b 1target gene and their vital roles in affecting the metastasizing potential of cancer cells.

In this study,we found that the expression levels of Id-1and TGF-b 1in 71human GC samples were higher than those in the adjacent tissue,which was consistent with previous ?ndings.Higher Id-1expression has been also detected in human ovarian tumors compared with border-line tumors [8];similar results have been obtained in prostate cancer biopsy samples [36]and esophageal squa-mous cell carcinoma specimens [11].The aberrant expression of TGF-b 1has been linked to pathological conditions in urinary tract [37],plasma [38],and tumor specimens [39–41].The results of our study showed that the expression of Id-1was related to tumor differentiation,while TGF-b 1expression was associated with regional lymph node metastasis,suggesting that Id-1and TGF-b 1levels could be signi?cant predictors of gastric carcinoma progression.

Another novel ?nding of this study was the positive correlation between the expression of Id-1and TGF-b 1in GC.Id-1has been identi?ed as a regulator of VEGF,and the combination of these two proteins has been proposed as a potential target for cancer therapy [42,43].It has been established that Id-1is co-expressed with a number of

Table 3Association between the expression levels of Id-1and TGF-b 1and clinical characteristics Characteristics

Id-1expression a TGF-b 1expression a Low

High P

Low High P

All patients 3635

36

35

Age (years)a

0.723

0.552

\6217181916C 621917

17

19

Gender 0.358

0.055

Male 22252027Female 1410

16

8

Tumor size (cm)a

0.403

0.718

\419151816C 4

1720

18

19

Differentiation 0.048*0.819

I,II 11487III

2531

28

28

Primary tumor 0.1640.164

Tis,T1,T2105105T3,T426

30

26

30

Regional lymph nodes 0.737

0.028*

N01112167N1,N2,N32523

20

28

Distant metastasis 0.662

0.662

M0

33313331M1

34

3

4

TNM stage grouping 0.2230.069

I 7492II 7131010III,IV

22

18

17

23

*Signi?cance is at 0.05level a

Split at

median

Fig.2Correlation between Id-1and TGF-b 1expression.There was a signi?cantly positive correlation between Id-1and TGF-b 1expression (r =0.503,**P \0.01)in 71human gastric carcinoma specimen

19Page 6of 10Med Oncol (2014)31:19

factors implicated in cancer cell invasiveness,including CD44[44],epidermal growth factor receptor (EGFR)[45],and thrombospondin 1(TSP-1)[46];however,the rela-tionship between Id-1and TGF-b 1remains unclear.Here,we found that the expression of Id-1showed a statistically signi?cant positive correlation with that of TGF-b 1.To the best of our knowledge,this is the ?rst demonstration of a direct association between Id-1and TGF-b 1in GC,which suggests that the combination of Id-1and TGF-b 1might promote the invasion and progression of GC.

In order to validate the clinical ?ndings and further explore the possible mechanism,in vitro experiments on AGS cell line were performed.After the treatment of TGF-b 1,the expression of Id-1increased and this elevation might relate to time.This demonstrated that Id-1might mediate the downstream effects of the TGF-b pathway.These results are in agreement with the ?ndings in breast and prostate cancers [31,32],but incompatible with those in breast epithelial cells,where TGF-b inhibited Id-1expression [47].This switched expression of Id-1in response to TGF-b 1may be caused by the loss of TGF-b growth-inhibitory responses [35].At the same time,we examined the effect of TGF-b 1on the proliferation of AGS at different concentrations.The results showed that Id-1expression induced by TGF-b 1was independent of cell number.

Given the well-established relationship between EMT,tumor metastasis,and TGF-b 1,we also examined the expression of EMT-related proteins [48,49].We found that N-cadherin and b -catenin expression was signi?cantly upregulated by TGF-b 1treatment,which was consistent with previous results showing the association between EMT proteins and TGF-b 1.We proposed that N-cadherin and b -catenin are upregulated by TGF-b 1via Id-1,because earlier data have indicated that the expression of Id-1has a positive correlation with that of N-cadherin and b -catenin,probably via the PI3K/Akt signaling pathway [50,51].Besides,one recent research in breast cancer has

revealed

Fig.3Effect of TGF-b 1on Id-1expression and proliferation in AGS cells.a and b Expression of Id-1protein was detected by immuno-?uorescence at 24h (a )and 48h (b )in the absence or presence of 10ng/mL TGF-b 1.The representative images were acquired with a magni?cation of 9200.c Statistical data were represented as the average gray value ?SEM of three independent experiments (*P \0.05).d and e Western blotting analysis of Id-1protein expression.GAPDH was used as an internal control.Each bar represents the mean ?SEM (*P \0.05).The results were consistent with data of immuno?uorescence.f Effect of different concentrations of TGF-b 1on AGS cells was determined by CCK-8at 24and 48h.No difference was found among the six groups

Med Oncol (2014)31:19Page 7of 1019

that TGF-b 1can induce Id-1expression,while Snail or Twist overexpresses [52].Therefore,based on our data and previous ?ndings,we propose a hypothesis that TGF-b 1stimulates the expression of Id-1,which in turn upregulates the levels of N-cadherin and b -catenin through activation of the PI3K/Akt signaling pathway.This hypothesis needs further experimental support.

In conclusion,our study demonstrated that both Id-1and TGF-b 1were upregulated in GC compared with the adjacent tissue and that this effect was related to GC progression.Moreover,the expression of Id-1was positively correlated with that of TGF-b 1in GC samples.The experiments in vitro showed that Id-1levels were upregulated by TGF-b 1,further con?rming the association between Id-1and TGF-b 1in GC.These results indicate that in gastric tumor cells,Id-1may be a speci?c downstream target of TGF-b 1,suggesting impor-tant roles of Id-1and TGF-b 1in GC development.Thus,this study provides new insights into the mechanism by which TGF-b 1/Id-1axis control tumor progression and may lead to new treatment strategies in

GC.

Fig.4Expression changes of EMT-related proteins.a Expression levels of N-cadherin,vimentin,b -catenin,Snail,Twist,and GAPDH were detected by Western blotting at 24h in the absence or presence of 10ng/mL TGF-b 1.GAPDH was used as an internal control.b Statistical data of Western blotting were represented as the average gray value ?SEM of three independent experiments (*P \0.05;

**P \0.01).All the data were normalized by the expression of GAPDH.c –f Cellular immuno?uorescence staining of N-cadherin,b -catenin,vimentin,and snail.The representative images were acquired with a magni?cation of 9400under laser-scanning confocal microscope

19Page 8of 10Med Oncol (2014)31:19

Acknowledgments This work was supported by grants from the National Science Foundation of China(No.30871312)and the National Basic Research Program of China(973program,No. 2011CB910700).

Con?ict of interest The authors have no con?ict of interest to declare.

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脑白质病变的特点及影像特征

脑白质病变的特点及影像特征 全网发布:2011-06-23 19:48 一、概论 有多种疾病累及中枢神经系统的脑白质,而脑白质病灶又分为原发和继发性两类?继发于中枢神经系统感染、中毒、变性和外伤等疾病的白质病灶,属继发性脑白质病;原发于脑白质的疾病称原发性脑白质病,简称脑白质病( Leukoencephalopathy ).脑白质病按发病时髓 鞘是否发育成熟再进一步分为2类: 1?先天性和遗传性脑白质病 此类脑白质病通常又称之为脑白质营养不良( Leukodystrophy )或遗传性脑白质营养不良(Heredity Leukodystrophy ),髓磷脂的产生、维持和分解异常是脑白质髓鞘形成障碍的病因?这类疾病通常包括:肾上腺脑白质营养不良、异染性脑白质营养不良、类球状细胞型脑白质营养不良、海绵状脑病、亚历山大病、皮质外轴突发育不良等 2. 获得性脑白质病 获得性脑白质病主要指已经发育成熟的正常髓磷脂被破坏,即:脑白质脱髓鞘 (demyelination )疾病?它主要包括:多发硬化、进行性多灶性脑白质病、急性散发性脑脊髓 炎、亚急性硬化性全脑炎、桥脑中央髓鞘溶解症、胼胝体变性、皮层下动脉硬化性脑病和同 心圆硬化等? 2、正常脑白质的结构、发育及影像诊断 (一)脑白质的结构 脑白质主要由神经纤维构成,而神经纤维分有髓和无髓两种?有髓神经纤维的外周有髓样结 构包裹,称之为髓鞘?在电子显微镜下,髓鞘由少突胶质细胞突起末端的扁薄膜包卷轴突而形成?一个

板层”样结构,其主要 少突胶质细胞有多个突起,分别包卷多个轴突,其胞体位于神经纤维之间 ?一个轴 突可被邻近几个少突胶质细胞的突起包绕, 这些突起相互融合,形成轴突外层 绝缘”的髓鞘. 髓鞘伴轴突一起生长,并反复包卷轴突多次,形成多层同心圆的螺旋 化学成份是类脂质和蛋白质, 习惯上称之为髓磷脂?由于类脂质约占髓鞘的 80%, 呈嫌水性, 带离子的水不容易通过, 而起绝缘”作用.当其受损时,较多水进入髓磷脂内, 引起脑白质的 水含量增加. (2) 脑白质的发育 髓鞘形成是脑白质发育的最后阶段 ?胎儿在宫内第3个月~6个月期间,自脊神经根和脊索、 从尾侧向头侧发展开始形成髓鞘 ?出生时,已经有相当数量的髓磷脂位于脑干、桥脑臂、内 囊后肢和半卵圆中心的放射冠等部位 ?其成熟过程主要发生于出生后,并持续到 20岁以前, 脑白质的髓鞘终生都在改建 ?后天性脑白质疾病的病灶在脑内呈弥散分布,通常病灶较小, 不引起脑形态结构的显著改变,但是各种脑白质病的晚期均导致脑萎缩 ?少数先天性脑白质 疾病可引起脑体积增大,多数亦不引起脑的形态改变 (3) 影像学表现 1 . MRI 表现 MRI 是显示脑发育过程中脑内各种解剖结构形态变化的最佳影像学手段,显示脑白质髓鞘 发育成熟过程也以 MRI 为首选?在T1加权像上,无髓鞘的脑白质呈低信号,随 髓磷脂出现 并成熟,脑白质逐渐变为 高信号?相反,在T2力口权像上,无髓鞘脑白质呈高信号,随髓磷 脂成熟,脑白质信号强度 逐渐下降?通常,在出生后头6个月~8个月,监测髓磷脂发育,以 T1加权像为佳;而出生6个月后,则以T2加权像更为敏感?(髓鞘越多、T1信号越高、T2 信号越低) 脑白质各部位髓鞘形成和成熟并非同步进行,而有先后顺序 ?足月健康新生儿,在丘脑、小 脑臂有髓磷脂沉积;1个月后,内囊后肢也可见到髓磷脂沉积 ;6个月时,在视放射区、内囊 前肢、放射冠及中央前回均显示有髓磷脂沉积 ;8个月时,额顶叶脑白质出现髓磷脂沉积 ;1

概念结构设计和逻辑结构设计

概念结构设计和逻辑结构设计 一.系统概述 本系统通过调查从事医药产品的零售,批发等工作的企业,根据其具体情况设计医药销售管理系统。医药管理系统的设计和制作需要建立在调查的数据基础上,系统完成后预期希望实现药品基本信息的处理,辅助个部门工作人员工作并记录一些信息,一便于药品的销售和管理。通过此系统的功能,从事药品零售和批发等部门可以实现一些功能,如:基础信息管理,进货管理,库房管理,销售管理,财务统计,系统维护等。 二.概念结构设计 1.员工属性 2.药品属性 3.客户属性 4.供应商属性 5.医药销售管理系统E--R 图 三.逻辑结构设计 该设计概念以概念结构设计中的E--R 图为主要依据,设计出相关的整体逻辑结构,具体关系模型如下:(加下划线的表示为主码) 药品信息(药品编号,药品名称,药品类别,规格,售价,进价,有效期,生产日期,产地,备注) 供应商信息(供应商编号,供应商名称,负责人,) 员工 姓名 家庭地址 E-maill 电话 员工 编号 年龄 帐号

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关于语文知识结构的构建 (王文君) 前几年,读魏书生老师的书,了解了“知识树”这个名词,也在自己的教学中有意无意的借鉴魏老师的做法,给学生介绍知识树。但从初一教到初四,总有相当一部分学生对“表达方式”、“修辞手法”、“写作方法”、“记叙六要素”、“小说三要素”、“铺垫”、“烘托”等一些列语文知识术语一塌糊涂。面对试卷上的相关阅读理解题,学生总是一头雾水,答非所问。每次阅卷,总是感慨:怎么就教不会学生学语文呢?当然,语文教育的终极目标不是应对考试,但语文素养高的人是不怕考试的。 反思自己多年来的语文教学,学生学不好语文,原因是多方面的,但至少有一点是十分重要的原因,那就是:没有教会学生用必要的语文知识学语文,以至于学生对纷繁复杂的语文万象的认识总是零散的、模糊的、杂乱的。一句话,没有教会学生构建起属于他自己的合理的语文学科知识结构。 上学期,我们大力倡导师生共同构建学科知识结构,培养学生的自主学习能力。学期初,要求每位任课教师通读教材,研读课标,根据课标要求和教材编写意图梳理每单元的知识点,确立单元教学目标和重点、难点,进而整理出本册教材的知识结构图,张贴在办公室和教室,以便师生在教学中适时运用、及时巩固。在这方面,我们只是刚刚起步,边学习边摸索,没什么经验可谈,只是有了一点点行动而已。相信很多老师在自己的教学实践中,一直都在默默坚持这样做着,

而且做得比我们好。 下面,从三方面和大家进行交流:一是构建学科知识结构的必要性,二是构建语文学科知识结构应注意的问题,三是介绍我们上学期整理的知识结构图。抛砖引玉,不当之处,请大家批评指正。 一、为什么要构建学科知识结构 下面与大家交流一下我读到的有关学科知识结构的论述文章和 我的一些粗浅认识,但愿这些交流能使我们对构建语文学科知识结构这一问题有更全面更理性的认识,使学科知识的构建更具科学性、实效性。 (一)、关于“语文知识树”的争鸣 “语文知识树”产生于20世纪70年代末,是魏书生老师有感于当时语文教育考题泛滥、教学缺乏序列的现状,引导学生画出来的。从大的方面基本确定为4部分22项131个知识点:4部分依次为“文言文知识”、“基础知识”、“阅读与写作”和“文学常识”。“文言文知识”具体包括“实词”、“虚词”、“字”和“句式”4项;“基础知识”包括“文字”、“句子”、“修辞”、“标点”、“语音”、“词汇”、“语法”和“逻辑”8项;“阅读与写作”包括“中心”、“结构”、“语言”、“材料”、“表达”和“体裁”6项;“文学常识”包括“古代”、“现代”、“当代”和“外国”4项。每一项下面又包括众多知识点共131个。 “语文知识树”自其产生以来的十多年中,在我国的语文教育界引起了较大的反响。综观各种评论,认为画知识树的作用主要有以下几点:

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计划维度的举例说明: (2)推广单元设置思路 建立好推广计划以后,我们要仔细地考虑合理划分推广单元。一个计划下一般会有多个推广单元,首先,需要参照计划的思路,细分单元,以便逻辑清晰,减少重复,而且更便于后期管理和评估。其次,需要“词义相近,结构相同”的关键词归到同一单元中,保持思路清晰,主题唯一,词性句式统一,这样做的好处同样可以便于商户撰写更相关的创意,有利于创意中嵌入关键词,在搜索结果页吸引更注意,提高点击率。 具体方法可以参考以下两种:为每一个推广单元设置单独的“主题” ,如:可以将“成人英语单元”和“少儿英语单元”分别设置为两个推广单元。因为“成人”和“少儿”分别是不同意义的词,而且推广商户为这两类业务撰写创意的角度也会不同,因此需要分为两个不同的单元。 按照网民的搜索意图建立推广单元,比如可以按照“兴趣、对比、购买”三个消费的阶段来划分。按照潜在受众搜索意图建立推广单元的办法,易于我们了解该品牌或该业务在市场中处于何种位置,便于推广商户及时跟进线下营销活动,提高公司整体效益。对于不同的产品或服务这几个阶段会有所不同,我们只是从这几个角度去考虑,不一定必须遵循这三个阶段,最终还是要根据建立的计划去进一步的细分单元。 单元设置的举例说明:

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成人脑白质病的CT及MRI诊断 【摘要】目的:探讨成人脑白质病的影像学特征,为临床诊断和治疗提供可靠依据。方法:对经临床证实的63例脑白质病影像学表现进行总结分析。结果:血管性脱髓鞘42例,硬化性脱髓鞘7例,感染性脱髓鞘6例,中毒性脱髓鞘4例,脑白质营养不良性脱髓鞘4例。CT表现为脑白质内多发斑片状低密度区,MRI表现为脑白质内多发T2信号。结论:MRI较CT能更清晰地显示脑白质异常,准确地反映病理改变的特点,有助于进一步提高对脑白质病变的诊断水平。 【关键词】脑白质病;成人;体层摄影术;X线计算机;磁共振成像;诊断 成人脑白质病不是一种独立的疾病,而是各种脑白质病变的总称。本病的正确诊断,可直接影响临床治疗方案,也直接决定患者的预后。笔者收集63例经临床证实的成人脑白质病资料,对其影像学表现进行回顾性分析,旨在进一步认识成人脑白质病变的影像学表现,以期为临床诊断和治疗提供可靠依据。 1 资料和方法 收集近年来经临床证实的成人脑白质病患者63例,男36例,女27例,年龄16~75岁,平均57岁。血管性脱髓鞘病例均有高血压病史5年以上伴反复心肌梗死史,硬化性脱髓鞘病例均有发作性加重和自发缓解史,经治疗随访确诊,中毒性脱髓鞘临床均有明确的中毒病史,感染性脱髓鞘和白质不良性脱髓鞘均经治疗和随访确诊。 使用西门子6排螺旋机和鑫高益OPEN-035磁共振仪。CT检查一般性常规轴位扫描,MRI检查应用FSE和SE以及FLAIR序列行常规横、矢、冠状扫描,层厚6~10 mm,视野256×192,采集次数2~4次。 2 结果 CT及MRI表现:血管性脱髓鞘42例多伴有多发性脑梗死及脑萎缩改变(见图1A、1B、1C);硬化性脱髓鞘7例,MRI表现为脑室周围、胼胝体、脑桥、延髓和小脑白质多灶性长T1长T2信号,CT上为低密度改变,伴有脑萎缩(见图2A、2B)。感染性脱髓鞘6例,好发于顶枕叶皮质下,远离脑室系统,可多

机械压紧手动拉板结构及原理

机械压紧手动拉板型结构及工作原理 1、机架部分 机架是由固定压板、活动压板、横梁、支架、大小脚组成。 (1)固定压板:它与小脚连接,除起到支承横梁的重要作用外,中间有进料孔,也可作为进气、进洗涤水的通道,暗流还具有出液通道。 (2)活动压板:是用来压紧滤板的。活动压板两侧装有滚轮,供其前后运动时支撑、定位,在压紧或拉开时,滚轮应处于滚动状态。 (3)横梁:它是滤板的运动导轨及支承件。 2、压紧机构 本压滤机采用机械压紧方式 机械传动压紧是采用电力机械驱动来压紧滤板的。在电力机械驱动下,丝杠带动活动压 板向前压紧全部滤板,向后则带动活动压板复位。 压紧机构是电动机、针轮减速机、主从动齿轮、平面轴承、丝杠螺母、丝杠、卡板等组成,它们固定在电机支架上,丝杠前端通过六角端盖固定在活动压板中心。当电机正转时,通过针轮减速机及齿轮的减速,带动丝杠螺母转动,从而带动丝杠向前推动活动压板向固定压板方向前进,使各滤板逐步形成压紧状态,随着丝杠不断的向前,压紧力越来越大,同时电机驱动电流相应增大,当压紧力达到一定程度时,电机驱动电流也将上升到过流继电器预先调定值,使过流继电器动作,电机停转。由于丝杠及丝杠螺母螺旋升角λ<4.5°小于摩擦角将产生自锁,保证滤板在工作中始终处于压紧状态。松开时,只需电机反转,当活动压板后退到检测感应区时,活动压板停止后退。 3、过滤机构 厢式压滤机的过滤机构由滤板、滤布所组成; 当滤板压紧后,物料进入滤板的滤室内,固体颗粒被滤布截留在滤室内,液体则穿过滤布顺着滤板沟槽进入出液通道,排出机外。

操作程序及使用方法 本系列压滤机运行前必须对泵站加足液压油,并确认各部位正常后按以下程序进行操作: 下 一 次 工 作 循 环 1.压紧滤板 (1)机械压紧:接通总电源,按下“滤板压紧”按钮,活动压板将在丝杠的推动作用下,把全部滤板压向固定压板一端,并施以预定的压紧力。 (2)液压压紧:接通总电源,按下“压板压紧”按钮,启动油泵。活动压板将在活塞杆的推动作用下,把全部滤板压向固定压板一侧,达到预定的压紧力。 2.进料过滤 滤板压紧后,检查各管路阀门开闭状况,确认无误后,启动进料泵。用储槽进料时,开启进料阀时,应缓慢调节到位。浆液即通过固定压板上的进料孔进入各滤室,在规定的压力范围

衣柜内部结构图以及内部功能细分 超详细

衣柜内部结构图以及内部功能细分超详细 卧室很漂亮也很温馨,可是总觉得缺少点什么?人离不开朋友,就像鱼儿离不开水一样,衣服也需要伴,它也怕孤单寂寞,我们就给它找个衣柜作伴,可卧室衣柜该怎么装修呢?内部结构如何?下面就随小编一起看看衣柜装修内部效果图以及功能部件。 常用衣物收纳配件介绍 带盖储物盒 存放使用率低的大件衣服,或者是过季衣物。可将几条被子或是衣物放在一起,看起来比较整洁。在风沙大、有尘土的北京,这种带盖储物盒很实用,可以有效防尘防土,部分产品还带有透明小视窗,方便日常查找,也可以在上面贴上标签,注明衣物种类。 拉篮

有抽屉式、网格式两种。网状拉篮,适合叠放比较薄的衣物,如毛衣、针织衣等。拉篮抽取方便,适合放置拿取频率比较高的衣物。 裤架 用于收纳需要挂起来的正装裤,一个裤架可以收纳20—25条正装裤。 储物箱 存放不常穿的衣服、小杂物,透明设计,方便寻找衣物。

碎物储藏件可将各种领带、袖口以及皮带分类盛放,整洁清晰,也可存放于抽屉中,在出席各种正式场合前能够更方便找到最合适搭配的配饰。 多功能衣架 可以将围巾和挂饰分开挂放,两者不会再因为藏在抽屉里而相互缠绕,方便取用。 挂衣杆 用于挂放熨烫后的衣服。 挂式储物格 可以挂在衣橱中,将内衣内裤、围巾、薄毛衣、针织衣卷放在中间,每个格子都可以放置多件衣物,既便于分类和查找,也可充分利用衣柜的立体空间。 收纳观念十分重要 “生活中之所以会出现装不下、找不到的情况,并不是衣柜本身不够大,而是许多消费者存在不合理的收纳概念仅仅是储存而已,不能进行有效利用衣柜空间。”宜家北京商场室内设计师曹永隽表示,要做好衣柜收纳,第一步就是建立正确的收纳理念做好衣被的具体分

业务结构

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1、公司占地面积 2、土地权属、是否租赁 3、办公楼面积权证 4、研发设备 I I 1、外地办事部, 门市部情 I I 况 > 2、销售网点分 布 | I 工厂(200人 产品B 品及一系 列产品,原 材料外购, 委托外厂 加工,最后 封装和销 售由该公 司负责。 问题2 : 研发制造销售营销 1、车间包括几个?分 别是什么? 2、车间建筑面积,什 * 么结构,权证,是否租 赁 3、车间内 主要生产设备简要说明,特点,优势 4、仓库建筑面积,什么结构,权证,是否租赁 I I 图二、三企业基础设施情况分析图管理部门(25人) 第二、宏观环境和市场分析 问题1 : (6人) 目前重点 开发A产产品A 销售 部 (40 人) 国际贸易部 (10 人)

脑白质

脑白质 大脑是由上百亿个神经元组成的,而神经元又是由细胞体和神经纤维组成的,细胞体中有细胞核(颜色深),神经纤维中有细胞质(颜色浅)。 在大脑中细胞体聚集在大脑表层,看起来颜色深,叫做脑灰质;而神经纤维聚集在大脑内部,看起来颜色浅,叫做脑白质。 脑白质病是一种大脑的结构性改变,以中枢神经细胞的髓鞘损害为主要特征,病变累及专门发挥高级大脑功能的白质束。其临床表现从注意力不集中、健忘和个性改变,到痴呆、昏迷,甚至死亡。 而中毒性脑白质病是由多种毒性因素引起脑白质病:颅脑照射;药物治疗,如某些抗肿瘤药、抗生素及免疫制剂;滥用药物,如甲苯、乙醇、海洛因等;还有环境毒素等。在这些因素中,颅脑照射和抗肿瘤化疗是中毒性脑白质病非常确定的病因。随着肿瘤患者放、化疗的广泛应用,出现医源性脑白质损害的肿瘤患者越来越多。为了更好地认识这一病症,笔者就肿瘤放、化疗引起中毒性脑白质病的临床及其研究进行综述。 脑白质病最显著的临床表现是精神状态的改变,即在没有失语的情况下有注意力、记忆力、视觉空间技能、执行功能和情感状态等其中至少一项缺陷。轻度病例表现为慢性意识模糊状态,伴注意力不集中、记忆力丧失和情感功能障碍;更为严重的病例则产生痴呆、意识缺失、木僵和昏迷等严重后遗症。而灰质的疾病则相反,是以累及语言、行为或感觉功能为主。如果脑白质发生了局灶性坏死,

则精神状态改变比一般体征如偏瘫、感觉障碍和视力丧失突出。中毒性脑白质病的病变分布通常是弥漫性的,其临床分度总体上与白质损害的严重程度相平行。 初步精神状态检查,包括评价注意力不集中的试验、鉴定记忆力障碍的三词延迟回忆试验、评价视觉功能障碍的时钟绘画和评价脑功能的交替运动序列。如果精神状态检查结果可疑,可进一步进行神经精神学测试。如果初步精神状态检查的前两类试验未发现任何缺陷,则可确定无可察觉的大脑损害;如果前两类试验发现异常,可进行大脑神经影像学检查。加权磁共振成像是首选检查手段,是鉴别早期或轻微脑白质病与精神疾病的重要手段,而CT仅能显示重度脑白质损害。 确实有脑白质毒素接触史,如放、化疗和免疫治疗等,并排除其他脑白质损害原因,如遗传性脱髓鞘病等;接触毒源后发生精神状态改变,以及可能的剂量症状反应关系;有确凿的神经放射学证据,或典型神经病理结果。 要重视肿瘤放化疗性脑白质病的研究 .为什么说颅脑照射和抗肿瘤化疗是中毒性脑白质病的非常确定病因?因为,随着肿瘤发病率的上升,以及肿瘤放、 化疗和免疫治疗等广泛的应用,抗肿瘤治疗所致的脑白质病越来越多,所以,我们进一步认识肿瘤放化疗引起的脑白质病有着重要的临床意义。

循环结构1

第一节for 循环 for循环是一种自动计数型循环。 [例3.1] 试打印出1~20的自然数。 解:①用a代表1~20各数,同时也用a兼作计数,以控制循环次数; ②让a从1开始; ③输出a; ④a自动计数(加1),如果未超越所规定的循环范围则重复步骤③,否则结束循环。 Pascal程序: Program Exam12; Var a: byte; Begin for a:=1 to 20 do Writeln (a); Readln End. 程序中for a:=1 to 20 do Writeln (a);是for循环语句。 for 循环语句有两种格式: (1) for循环变量:=初值To 终值do 语句; (2) for循环变量:=初值downto 终值do 语句; 第(1)种格式的初值小于等于终值,循环变量值按自动加1递增变化; 第(2)种格式的初值大于或等于终值,循环变量值按自动减1递减变化。for 循环是(以递增1或以递减1) 计数型循环。 比如: 若将[例3.1]程序改为倒计数(递减)循环,则输出20~1的自然数数: Program Exam31; Var a: byte; Begin for a:=20 downto 1 do Writeln(a) ; Readln End. [例3.2]打印出30至60的偶数。] 解: 方法一: = 1 \* GB3 ①设a表示30至60的所有的数,可用for循环列出; = 2 \* GB3 ②用式子 a mod 2=0筛选出其中的偶数并输出。 Pascal程序: Program ex32; Var a : integer; Begin For a := 30 to 60 do If (a mod 2=0) then writeln(a);

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