A clinical study on insomnia in patients with cancer during chemotherapy containing high-dose glucocorticoids

In this prospective, open-labeled study, 240 cancer patients were assigned to either a high-dose glucocorticoids (HDG) group that received chemotherapy containing HDG, or a control group that received chemotherapy without glucocorticoids. The Pittsburgh Sleep Quality Index (PSQI) was chosen to assess insomnia. The results of the study showed that dimensions of sleep latency, sleep duration, and sleep efficiency had the three largest differences in values and numbers of patients, with a score increase in the HDG group compared to the control group (p < 0.001). After chemotherapy in the HDG group, the PSQI score significantly increased in patients with stage II cancer (both p < 0.05), and patients diagnosed with lymphoma (p < 0.01), whereas the complete response and partial response rates (p < 0.05) had the smallest elevations. The average score of each dimension did not significantly decrease after hypnotics (p > 0.05). Our study suggests that the major clinical manifestations of insomnia in cancer patients receiving chemotherapy containing HDG include difficulty falling asleep, short sleep duration, and low sleep efficiency. however, we cannot definitively state that hypnotics can improve poor sleep quality.

Overexpression of PLCE1 in Kazakh esophageal squamous cell carcinoma: implications in cancer metastasis and aggressiveness

Three recent large-scale genome-wide association studies (GWAS) in Chinese Han populations have identified an esophageal squamous cell carcinoma (ESCC) susceptibility locus within phospholipase C epsilon 1 (PLCE1) gene, which encodes a phospholipase involved in intracellular signaling. The expressed PLCE1 in ESCC, however, are inconsistent. This study examined PLCE1 expression by immunohistochemistry (IHC) from 110 ethnic Kazakh ESCC patients and 50 from adjacent normal esophageal tissues (NETs). The expressed PLCE1 was localized in cytoplasm, especially in the peripheral layers of cancer cell nests, which was significantly higher in tumors than in NETs (p < 0.001). Increased expression of PLCE1 was correlated with advanced tumor-node-metastasis (TNM) stages (p = 0.015) and lymph node metastasis (p = 0.003) in patients with ESCC. Of the 110 patients, we examined 50 paired ESCC tissues and corresponding NETs by quantitative RT-PCR (polymerase chain reaction) and the mean mRNA level of PLCE1 in ESCC was 1.85-fold higher compared with those in corresponding NETs (p = 0.0012). Meanwhile, 4 of 5 ESCC cell lines also showed elevated expression of PLCE1 mRNA. Furthermore, elevated expression of PLCE1 mRNA in Kazakh ESCC was associated with its immunoreactivity (ρ = 0.297, p = 0.040), lymph node metastasis (p < 0.001), and advanced TNM stages of ESCC (p = 0.013). To our knowledge, this study demonstrates for the first time that PLCE1 overexpression correlates with lymph node metastasis and advanced TNM stages of Kazakh ESCC, implicating a role of PLCE1 in cancer metastasis and aggressiveness in ethnic Kazakh patients with ESCC. Furthermore, the current findings may warrant investigations into whether inhibiting PLCE1 could be a strategy for targeted anticancer therapy particularly for Kazakh ESCC.

Emodin regulating excision repair cross-complementation group 1 through fibroblast growth factor receptor 2 signaling

AIM: To investigate the molecular mechanisms underlying the reversal effect of emodin on platinum resistance in hepatocellular carcinoma.

METHODS: After the addition of 10 μmol/L emodin to HepG2/oxaliplatin (OXA) cells, the inhibition rate (IR), 50% inhibitory concentration (IC₅₀) and reversal index (IC₅₀ in experimental group/IC₅₀ in control group) were calculated. For HepG2, HepG2/OXA, HepG2/OXA/T, each cell line was divided into a control group, OXA group, OXA + fibroblast growth factor 7 (FGF7) group and OXA + emodin group, and the final concentrations of FGF7, emodin and OXA in each group were 5 ng/mL, 10 μg/mL and 10 μmol/L, respectively. Single-cell gel electrophoresis was conducted to detect DNA damage, and the fibroblast growth factor receptor 2 (FGFR2), phosphorylated extracellular signal-regulated kinase 1/2 (p-ERK1/2) and excision repair cross-complementing gene 1 (ERCC1) protein expression levels in each group were examined by Western blotting.

RESULTS: Compared with the IC₅₀ of 120.78 μmol/L in HepG2/OXA cells, the IC₅₀ decreased to 39.65 μmol/L after treatment with 10 μmol/L emodin; thus, the reversal index was 3.05. Compared with the control group, the tail length and Olive tail length in the OXA group, OXA + FGF7 group and OXA + emodin group were significantly increased, and the differences were statistically significant (P < 0.01). The tail length and Olive tail length were lower in the OXA + FGF7 group than in the OXA group, and this difference was also statistically significant. Compared with the OXA + FGF7 group, the tail extent, the Olive tail moment and the percentage of tail DNA were significantly increased in the OXA + emodin group, and these differences were statistically significant (P < 0.01). In comparison with its parental cell line HepG2, the HepG2/OXA cells demonstrated significantly increased FGFR2, p-ERK1/2 and ERCC1 expression levels, whereas the expression of all three molecules was significantly inhibited in HepG2/OXA/T cells, in which FGFR2 was silenced by FGFR2 shRNA. In the examined HepG2 cells, the FGFR2, p-ERK1/2 and ERCC1 expression levels demonstrated increasing trends in the OXA group and OXA + FGF7 group. Compared with the OXA group and OXA + FGF7 group, the FGFR2, p-ERK1/2, and ERCC1 expression levels were significantly lower in the OXA + emodin group, and these differences were statistically significant. In the HepG2/OXA/T cell line that was transfected with FGFR2 shRNA, the FGFR2, p-ERK1/2 and ERCC1 expression levels were significantly inhibited, but there were no significant differences in these expression levels among the OXA, OXA + FGF7 and OXA + emodin groups.

CONCLUSION: Emodin markedly reversed OXA resistance by enhancing OXA DNA damage in HepG2/OXA cells, and the molecular mechanism was related to the inhibitory effect on ERCC1 expression being mediated by the FGFR2/ERK1/2 signaling pathway.

Efficacy and safety of bevacizumab plus chemotherapy in Chinese patients with metastatic colorectal cancer: a randomized phase III ARTIST trial

The efficacy and safety of bevacizumab with modified irinotecan, leucovorin bolus, and 5-fluorouracil intravenous infusion (mIFL) in the first-line treatment of metastatic colorectal cancer (mCRC) has not been well evaluated in randomized clinical trials in Chinese patients. We conducted a phrase III trial in which patients with previously untreated mCRC were randomized 2:1 to the mIFL [irinotecan (125 mg/m²), leucovorin (20 mg/m²) bolus, and 5-fluorouracil intravenous infusion (500 mg/m²) weekly for four weeks every six weeks] plus bevacizumab (5 mg/kg every two weeks) group and the mIFL group, respectively. Co-primary objectives were progression-free survival (PFS) and 6-month PFS rate. In total, 214 patients were enrolled. Our results showed that addition of bevacizumab to mIFL significantly improved median PFS (4.2 months in the mIFL group vs. 8.3 months in the bevacizumab plus mIFL group, P < 0.001), 6-month PFS rate (25.0% vs. 62.6%, P < 0.001), median overall survival (13.4 months vs. 18.7 months, P = 0.014), and response rate (17% vs. 35%, P = 0.013). Grades 3 and 4 adverse events included diarrhea (21% in the mIFL group and 26% in the bevacizumab plus mIFL group) and neutropenia (19% in the mIFL group and 33% in the bevacizumab plus mIFL group). No wound-healing complications or congestive heart failure occurred. Our results suggested that bevacizumab plus mIFL is effective and well tolerated as first-line treatment for Chinese patients with mCRC. Clinical benefit and safety profiles were consistent with those observed in pivotal phase III trials with mainly Caucasian patients.

Survival without common toxicity criteria grade 3/4 toxicity following second-line treatment with pemetrexed for nonsquamous non-small cell lung cancer in Chinese patients

BACKGROUND

The efficacy of pemetrexed in the second-line treatment of Chinese patients with advanced non-small cell lung cancer (NSCLC) has been shown to be similar to that of docetaxel in a recent study; additionally, pemetrexed was associated with much better safety and toxicity profiles. Here, the survival without common toxicity criteria grade 3/4 toxicity (SWT) data from a post hoc analysis of this recent prospective NSCLC study in Chinese patients is reported. This post hoc analysis differs from the main study; it focuses on the nonsquamous population to align with the current approval for pemetrexed in China.

METHODS

A total of 154 patients with nonsquamous NSCLC received either pemetrexed (500 mg/m(2) intravenously (IV)) or docetaxel (75 mg/m(2) IV) on day 1 of 21-day cycles. SWT was analyzed using Kaplan-Meier and univariate Cox methods.

RESULTS

Patients treated with pemetrexed had a longer median SWT than patients treated with docetaxel (7.4 months versus 1.2 months; unadjusted hazard ratio = 0.59, 95% confidence interval (CI): 0.41-0.84; P = 0.003). At 12 and 18 months, the SWT event-free probability for pemetrexed patients (18 months: 24.5%, 95%CI 13.9%-36.6%, vs. 12.3%, 95% CI 4.8%-23.6%) was greater than that for docexatel patients (12 months: 37.3%, 95% CI 26.5%-48.0%, vs. 23.3%, 95% CI 14.4-33.4). The progression-free survival without common toxicity criteria grade 3/4 toxicity (PFS-WT) was also statistically significantly longer for patients treated with pemetrexed than patients treated with docetaxel (1.9 months vs. 1.1 months, P = 0.002).

CONCLUSIONS

Chinese patients with nonsquamous NSCLC disease treated with pemetrexed had improved SWT beyond 6 months than those receiving docetaxel. This analysis supports a benefit-to-risk profile that favors pemetrexed over docetaxel in the second-line treatment of Chinese nonsquamous NSCLC patients.

Pituitary metastasis from a renal cell carcinoma progressed after sorafenib treatment

Pituitary metastasis from renal cell carcinoma is rare and has never been reported for renal cell carcinoma primarily treated with sorafenib. Herein, we present a case of an advanced clear-cell renal cell carcinoma in which pituitary metastasis progressed but extracerebral metastases showed partial response to sorafenib treatment.

Lapatinib plus capecitabine in treating HER2-positive advanced breast cancer: efficacy, safety, and biomarker results from Chinese patients

Overexpression of human epidermal growth factor receptor-2 (HER2) in metastatic breast cancer (MBC) is associated with poor prognosis. This single-arm open-label trial (EGF109491; NCT00508274) was designed to confirm the efficacy and safety of lapatinib in combination with capecitabine in 52 heavily pretreated Chinese patients with HER2-positive MBC. The primary endpoint was clinical benefit rate (CBR). Secondary endpoints included progression-free survival (PFS), time to response (TTR), duration of response (DoR), central nervous system (CNS) as first site of relapse, and safety. The results showed that there were 23 patients with partial responses and 7 patients with stable disease, resulting in a CBR of 57.7%. The median PFS was 6.34 months (95% confidence interval, 4.93–9.82 months). The median TTR and DoR were 4.07 months (range, 0.03–14.78 months) and 6.93 months (range, 1.45–9.72 months), respectively. Thirteen (25.0%) patients had new lesions as disease progression. Among them, 2 (3.8%) patients had CNS disease reported as the first relapse. The most common toxicities were palmar-plantar erythrodysesthesia (59.6%), diarrhea (48.1%), rash (48.1%), hyperbilirubinemia (34.6%), and fatigue (30.8%). Exploratory analyses of oncogenic mutations of PIK3CA suggested that of 38 patients providing a tumor sample, baseline PIK3CA mutation status was not associated with CBR (P = 0.639) or PFS (P = 0.989). These data confirm that the lapatinib plus capecitabine combination is an effective and well-tolerated treatment option for Chinese women with heavily pretreated MBC, irrespective of PIK3CA status.

MicroRNA-10b targets E-cadherin and modulates breast cancer metastasis

BACKGROUND

Recent studies have suggested that microRNA-10b (miR-10b) acts as a promoter of metastasis in breast cancer, although the underlying mechanism remains largely unknown. In this study, we provide the first evidence that E-cadherin (E-cad) is a potential target of miR-10b.

MATERIAL/METHOD

By applying gain-of-function and loss-of-function approaches in the metastatic breast cancer cell line MDA-MB-231, we demonstrated that miR-10b is necessary and sufficient to regulate the cellular expression of E-cad and in vitro tumor cell invasion.

RESULTS

Comparative expression analysis of miR-10b in benign breast lesions (N=16), primary breast cancers (N=21), and metastatic breast carcinomas (N=23) revealed that miR-10b transcription was uniquely up-regulated in metastatic cancers. The expression level of miR-10b positively correlated with tumor size, pathological grading, clinical staging, lymph node metastasis, Her2-positivity and tumor proliferation, but was negatively associated with estrogen receptor-positivity, progesterone receptor-positivity and E-cad mRNA and protein levels.

CONCLUSIONS

These findings indicate the existence of a novel E-cadherin-related mechanism by which miR-10b modulates breast cancer metastasis. In addition, miR-10b may be a useful biomarker of advanced progression and metastasis of breast cancer.

Randomised clinical trial: an assessment of acupuncture on specific meridian or specific acupoint vs. sham acupuncture for treating functional dyspepsia

BACKGROUND

Functional dyspepsia (FD) is a common disease without an established optimal treatment.

AIM

To determine (i) the effect of acupuncture in relieving FD symptoms and improving life quality; (ii) the effect difference between acupoint and non-acupoint; and (iii) the effect difference among different acupoints.

METHODS

A total of 712 eligible patients were included and randomly assigned to six groups (Group A: specific acupoints of the stomach meridian; Group B: non-specific acupoints of the stomach meridian; Group C: specific acupoints of alarm and transport points; Group D: specific acupoints of the gallbladder meridian; Group E: sham acupuncture of non-acupoints; and Group F: itopride). A treatment period of 4 weeks (continuous five sessions per week), and a follow-up period of 12 weeks were arranged. The outcomes were the (i) patients' response, (ii) symptoms improvement measured using the Symptom Index of Dyspepsia and (iii) quality-of-life improvement based on Nepean Dyspepsia Index.

RESULTS

All groups had an improvement in dyspepsia symptoms and the QoL at the end of treatment, and the improvement was sustained for 4 weeks and 12 weeks. The overall response rate was significantly higher in acupuncture group A (70.69%), and lower in sham acupuncture group (34.75%), compared with itopride and other acupuncture groups. Similarly, the difference in symptoms and QoL improvement was significant between group A and the other acupuncture groups.

CONCLUSIONS

Acupuncture is effective in the treatment of functional dyspepsia, and is superior to non-acupoint puncture. The benefit of acupuncture relies on acupoint specificity.

FGFR2: a key molecule in the progression of gastric cancer

Fibroblast growth factor receptor 2 (FGFR2) is a tyrosine kinase receptor of the FGFR family and plays an important role in the progression of gastric cancer. FGFR2 expression is closely associated with pathological type, clinical stage, lymph node metastasis, and distant metastasis in advanced gastric cancer. Monoclonal antibodies directed against FGFR2 can inhibit the proliferation of gastric cancer cells and, when used in combination with chemotherapy, has a synergistic effect against gastric cancer, suggesting that FGFR2 is a potential therapeutic target for advanced gastric cancer.

A unit-coordinator system: an effective method of reducing inappropriate hospital stays

BACKGROUND

Many hospitals would benefit from a reduction in the length of inpatient hospital stays; in this regard, nursing approaches require complementation to ensure optimized nursing care. Such action is particularly important in general hospitals in Korea, where the ratio of patients to nurses is more than 10:1.

OBJECTIVES

This study aimed to determine the effectiveness of a unit-coordinator system in complementing primary nursing in general hospitals as a means of reducing inappropriate hospital stays.

METHODS

The unit-coordinator system was implemented in seven wards in a hospital in Seoul for 8 weeks. The existing primary nursing system was maintained, and newly placed unit-coordinators organized the activities within each ward. The numbers of early admissions and early discharges were determined by assessing the electronic administrative records of the hospital. Further, the number of patients who had undergone check-ups and chemotherapy on the day of admission was confirmed from the daily reports of each ward. The effect of the unit-coordinator system on nurse satisfaction was assessed through direct interviews.

FINDINGS

Early-discharge and early-admission numbers increased significantly after implementation of the unit-coordinator system. Early admission allowed check-ups and treatments to be performed on the day of admission. Thus, this system reduced the length of hospital stay by 1 day, and the total reduction of inappropriate hospital stays over the 8-week study period was 66 days. Further, the unit-coordinator system also increased nurse satisfaction.

CONCLUSION

The unit-coordinator system is an effective method of complementing primary nursing and reducing inappropriate hospital stays.

Growth of multiple metal/semiconductor nanoheterostructures through point and line contact reactions

Forming functional circuit components in future nanotechnology requires systematic studies of solid-state chemical reactions in the nanoscale. Here, we report efficient and unique methods, point and line contact reactions on Si nanowires, fabricating high quality and quantity of multiple nanoheterostructures of NiSi/Si and investigation of NiSi formation in nanoscale. By using the point contact reaction between several Ni nanodots and a Si nanowire carried out in situ in an ultrahigh vacuum transmission electron microscopy, multiple sections of single-crystal NiSi and Si with very sharp interfaces were produced in a Si nanowire. Owing to the supply limited point contact reaction, we propose that the nucleation and growth of the sugar cane-type NiSi grains start at the middle of the point contacts between two Ni nanodots and a Si nanowire. The reaction happens by the dissolution of Ni into the Si nanowire at the point contacts and by interstitial diffusion of Ni atoms within a Si nanowire. The growth of NiSi stops as the amount of Ni in the Ni nanodots is consumed. Additionally, without lithography, utilizing the line contact reaction between PS nanosphere-mediated Ni nanopatterns and a nanowire of Si, we have fabricated periodic multi-NiSi/Si/NiSi heterostructure nanonowires that may enhance the development of circuit elements in nanoscale electronic devices. Unlike the point contact reaction, silicide growth starts at the contact area in the line contact reaction; the different silicide formation modes resulting from point and line contact reactions are compared and analyzed. A mechanism on the basis of flux divergence is proposed for controlling the growth of the nano-multiheterostructures.

Responsiveness to aspirin in patients with unstable angina pectoris by whole blood aggregometry

AIMS

To evaluate aspirin responsiveness in patients with unstable angina pectoris (UAP) by whole blood aggregometry. Another goal was to differentiate aspirin-resistant patients into pharmacokinetic or pharmacodynamic type.

METHODS

We measured platelet aggregation by determining impedance values in 70 normal volunteers and 104 UAP patients on aspirin (100 mg/day > or = 7 days) in four inducing conditions [1 microg/ml collagen, 2 microg/ml collagen, 5 micromol/l adenosine diphosphate (ADP) and 10 micromol/l ADP]. We calculated a cut-off value based on data from normal volunteers to define aspirin responsiveness in cases. Then, the correlation and agreement between the results in the four conditions was analysed to choose a preferred inducing condition for identification of aspirin resistance. Aliquots from all samples were incubated with 0.1 mmol/l aspirin and measured again for aspirin-resistant classification.

RESULTS

Aspirin resistance was observed in 38 patients (36.5%), 51 patients (49.0%), 67 patients (64.4%) and 67 patients (64.4%), respectively, for 1 microg/ml collagen, 2 microg/ml collagen, 5 micromol/l ADP and 10 micromol/l ADP among 104 patients. Collagen at low concentration was suggested as a preferred agent for detecting aspirin inhibitory effect according to the coefficient of sensitivity. After incubation, only three among 38 aspirin-resistant patients showed normal platelet aggregation and were classified into pharmacodynamic type.

CONCLUSIONS

In the presence of collagen at low concentration (1 microg/ml), the prevalence of aspirin resistance is about 36.5% in UAP patients, and according to a classification specific for resistant patients, most of the aspirin 'resistance' is just because of pharmacokinetic issues.

[Interference of HIF-1alpha by RNA reduces the expression of matrix metalloproteinase-2 in human cervical carcinoma HeLa cells]

BACKGROUND & OBJECTIVE

Hypoxia inducible factor-1 alpha (HIF-1alpha) is a hypoxia-responsive factor, which commonly exists in the tissues of solid tumors. It plays crucial roles in maintaining cell energy metabolism, tumor angiogenesis and metastasis, cell proliferation and apoptosis. This study was to investigate the effect of silencing HIF-1alpha by RNA interference on the expression of matrix metalloproteinase-2 (MMP-2) in human cervical carcinoma HeLa cells, and to further explore the mechanism.

METHODS

Fifteen nude mice were divided into three groups randomly, and were inoculated with HeLa cells, pGenesil-1-HeLa cells and HIF-1alpha-HeLa cells, respectively. Expressions of HIF-1alpha, E-cadherin, beta-catenin, MMP-2 in the xenograft tumors of nude mice were detected by immunohistochemistry. pGenesil-1-HeLa or HIF-1alpha-HeLa cells were cultured under a hypoxic(1% O2) or normoxic environment for 48 h, while HeLa cells were cultured under the same condition as control. Expressions of HIF-1alpha, E-cadherin, beta-catenin and MMP-2 were measured by Western blot.

RESULTS

In HeLa, pGenesil-1-HeLa and HIF-1alpha-HeLa cell xenograft groups, the positive rates of HIF-1alpha protein were (69.0+/-12.1)%, (62.8+/-12.3)% and (17.4+/-8.8)%, respectively; expressions of E-cadherin were 1.00+/-0.07, 1.00+/-0.10, 3.21+/-0.25; expressions of beta-catenin were 4.21+/-0.92, 4.31+/-0.87, 1.29+/-0.72; and expressions of MMP-2 were 4.84+/-0.67, 4.50+/-0.71 and 1.00+/-0.83. HIF-1alpha and MMP-2 were positively correlated (correlation coefficient=0.521). Expressions of HIF-1alpha, beta-catenin and MMP-2 protein were low and that of E-cadherin protein was high in HIF-1alpha-HeLa cells under hypoxia or normoxia for 48 h; while opposite results were obtained in HeLa and pGenesil-1-HeLa cells.

CONCLUSION

Inhibition of HIF-1alpha could effectively down-regulate the expression of MMP-2 in human cervical carcinoma Hela cells.

[Chemokine receptor CXCR4 gene silencing with shRNA inhibits breast cancer metastasis to the lung in nude mice]

OBJECTIVE

To construct a CXCR4 specific recombinant plasmid vector and study its inhibiting effect on invasion capacity in vitro of human breast cancer MDA-MB-231 cell line and its metastatic potential to the lung in nude mice.

METHODS

A CXCR4 specific recombinant plasmid vector was constructed and transfected into the cultured MDA-MB-231 cell line with lipofectamine 2000. RT-PCR and Western blot were used to detect the mRNA and protein expression of CXCR4, respectively. Invasion capability in vitro of the cells was evaluated by Boyden chamber. The cell proliferation capacity was detected by MTT method. The nude mouse model of lung metastasis was established by injection of MDA-MB-231 cells into the tail vein. The animals were sacrificed at 6 weeks after the tumor cells injection. Whole lung tissues were harvested, embedded in paraffin, sectioned serially, and the HE-stained paraffin sections were examined pathologically to evaluate the presence and number of metastatic tumors.

RESULTS

The CXCR4 mRNA expression rate was 29.5% +/- 3.8% in the CXCR4-shRNA group, significantly lower than that of the control group (69.7% +/- 2.6%, P < 0.01) and mock-control group (67.8% +/- 3.5%, P < 0.01). The CXCR4 protein expression rate was 15.4% +/- 1.1% in the CXCR4-shRNA group, significantly lower than that of the control group (39.0% +/- 2.4%, P < 0.01) and mock-control group (35.9% +/- 3.9%, P < 0.01). Silencing of CXCR4 by shRNA lead to a significant decrease in breast cancer cell invasion and proliferation capacity in vitro. Furthermore, tumor cells with CXCR4 shRNA permanent transfcetion had a much lower lung metastatic potential in nude mice than control cells and mock control cells in vivo.

CONCLUSION

CXCR4 shRNA can inhibit the expression of CXCR4 and decrease the invasion and lung metastatic potential of human breast cancer cells.

Effects of HDAC1 silence by RNA interference on the apoptosis and proliferation of colorectal cancer cells

AIM: To construct the HDAC1 specific recombinant plasmid vector and investigate its effects on the apoptosis, proliferation and cell cycle distribution of colorectal cancer cells.

METHODS: HDAC1 specific short hairpin RNA (shRNA) plasmid vector was constructed and then transfected into the cultured SW480 cell line with lipofectamine 2000. Reverse transcription-polymerase chain reaction (RT-PCR) and Western blot were used to detect the expression of HDAC1 mRNA and protein, respectively, and p21^/WAF-1/CIP-1, CdK2, and Cyclin E proteins were detected by Western blot, too. The growth inhibition of SW480 cells was evaluated by MTT assay. Cell apoptosis and cell cycle distribution were determined by flow cytometry.

RESULTS: The levels of HDAC1 mRNA and protein in HDAC1-shRNA group were significantly lower than those in negative control group (30.4% ± 4.5% vs 64.6% ± 4.4%, P < 0.01; 27.4% ± 4.5% vs 58.1% ± 3.3%; both P < 0.01). In comparison with negative control group, HDAC1 silence led to a significant increase of p21^/WAF-1/CIP-1 protein (97.4% ± 2.6% vs 62.6% ± 3.4%, P < 0.01) and decrease of CdK2 and Cyclin E protein (27.7% ± 6.0% vs 42.6% ± 4.1%, P < 0.01; 42.0% ± 8.5 % vs 82.8% ± 3.7%, P < 0.01). MTT assay revealed that transfection of HDAC1-shRNA inhibited the growth of SW480 cells, and the inhibitory rates were markedly higher at 24, 48, 72, and 96 h time points than those in negative control group (24 h: 35.9% ± 4.9% vs 1.2% ± 0.6%, P < 0.01; 48 h: 47.5% ± 7.0% vs 1.3% ± 0.6%, P < 0.01; 72 h: 45.7% ± 6.2% vs 1.0% ± 0.5%, P < 0.01; 96 h: 48.2% ± 4.7% vs 1.2% ± 0.7%, P < 0.01). The percentage of apoptosis cells in HDAC1-shRNA group was significantly higher than that in negative control group (31.3% ± 2.8% vs 3.9% ± 0.7%, P < 0.01) and the cells were increased at G₀/G₁ and G₂/M phase (G₀/G₁: 64.5% ± 0.9% vs 57.8% ± 1.8%, P < 0.01; G₂/M: 17.4% ± 1.3% vs 14.5% ± 0.6%, P < 0.05), but decreased at S phase (17.5% ± 1.0% vs 27.7% ± 1.5%, P < 0.01).

CONCLUSION: HDAC1 silence by shRNA can inhibit the growth of colorectal cancer cells through inducing apoptosis and cell cycle arrest.

[Correlation of aquaporin 1 with hypoxia-inducible factor 1 in breast cancer]

OBJECTIVE

To determinate the correlation of aquaporin 1 (AQP1) and hypoxia-inducible 1 (HIF-1).

METHODS

155 samples of breast cancer obtained during radical mastectomy underwent immunohistochemistry to detect the expression of AQP1 and HIF-1.

RESULTS

The positive rates of AQP1 in the HIF1 positive group was 297 +/- 25, significantly higher than that of HIF1 negative group (168 +/- 38, P < 0.001).

CONCLUSION

AQP1 is positively correlated with HIF1. The interaction of AQP1 and HIF1 may co-regulate the progress of breast cancer.

Postoperative sequence chemoradiotherapy for advanced gastric cancer: an analysis of 36 cases

AIM: To investigate the effect of postoperative sequence chemoradiotherapy compared with postoperative chemotherapy alone on survival of patients with advanced gastric cancer, and to evaluate the toxic effect.

METHODS: A total of 68 patients were collected from our hospital from January 2003 to December 2005. Thirty-six patients received sequence chemoradiotherapy following radical resection, and 32 patients received chemotherapy alone following radical resection. The 1- and 3-yr survival rate were evaluated, as well as the hematologic and gastrointestinal toxic effects, and liver and kidney function.

RESULTS: The 1- and 3-yr survival rate of the sequence chemoradiotherapy group was 77% and 47%, respectively, as compared with 61% and 25% in the chemotherapy only group (P = 0.041).The median survival time was 40 mo compared with 24.5 mo in the control group (P = 0.038). Grade Ⅲ-Ⅳ leukopenia occurred in 11.1% of the sequence chemoradiotherapy group compared with 6.3% in the control group. Grade Ⅲ-Ⅳ nausea and vomiting occurred in 8.3% compared with 3.1% in the control group. No statistic significant correlation was found in toxic effect.

CONCLUSION: Postoperative sequence chemoradiotherapy of gastric cancer improves the 1- and 3-yr survival rate significantly, and prolongs the median survival time compared with postoperative chemotherapy alone. The toxic effects are tolerable.

[Potentials of DNA-PKcs, Ku80, and ATM in enhancing radiosensitivity of cervical carcinoma cells]

BACKGROUND & OBJECTIVE

DNA double strand break (DSB) is the lethal damage of cells after irradiation. DNA-dependent protein kinase catalytic subunit (DNA-PKcs), Ku80, and ataxia-telangiectasia mutated (ATM) are the most important repair proteins of DSB. Cervical carcinoma is mainly treated by radiotherapy; however, the tumor cells display different radiosensitivity. This study tried to explore the correlations of DNA-PKcs, Ku80, and ATM expression to radiosensitivity of cervical cancer cells, and to probe their potentials in enhancing the radiosensitivity of cervical carcinoma.

METHODS

The expression of DNA-PKcs, Ku80, and ATM in 41 specimens of cervical carcinoma was detected by immunohistochemistry. Their expression in 8 tumor cell lines (including 4 cervical carcinoma cell lines) was measured by Western blot; the survival fraction at 2 Gy (SF2) and alpha value were measured by colony formation test; the correlations of protein expression to SF2 and alpha values were analyzed by Pearson linear correlation analysis. The small hairpin RNA (shRNA) targeting DNA-PKcs and a competitive DNA-PKcs inhibitor LY294002 were used to inhibit DNA-PKcs expression and activity in cervical carcinoma cell line HeLa. The SF2 and alpha values of HeLa cells after X-ray irradiation were measured by colony formation test; cell apoptosis was analyzed by flow cytometry.

RESULTS

The positive rates of Ku80, DNA-PKcs, and ATM in the 41 specimens of cervical carcinoma were 70.73%, 68.29%, and 19.51%, respectively. The expression of DNA-PKcs was positively related to the SF2 values of the 8 tumor cell lines (r = 0.72, P = 0.04); the expression of Ku80 and ATM had no correlation to SF2 and alpha values. The SF2 value was lower in DNA-PKcs shRNA-transfected HeLa cells than in control HeLa cells (0.37 vs. 0.53, P < 0.05). When treated with 50 mumol/L LY294002 for 1 h, the apoptosis rate of HeLa cells had no significant change ( P > 0.05); when irradiated by 6 Gy X-ray for 48 h and 72 h, the apoptosis rate was significantly higher in LY294002-pretreated HeLa cells than in control HeLa cells (t = 3.25, P = 0.03; t = 3.01, P = 0.04).

CONCLUSIONS

DNA-PKcs protein is highly expressed in cervical carcinoma, and its expression level could prognosticate the radiosensitivity of tumor cells. Inhibiting DNA-PKcs expression or activity may sensitize HeLa cells to X-ray.

Expression of CXC chemokine receptor CXCR4 in colorectal carcinoma and its correlation with prognosis Meng-Xian Zhang, Iqbal Kashif, Shi-Ying Yu

AIM: To investigate the expression of chemokine receptor CXCR4 in colorectal carcinoma and its correlation with the clinicopathologic characteristics and prognosis.

METHODS: Immunohistochemistry was used to detect the expression of CXCR4 and tumor microvessel density (MVD) in 67 tissue specimens of colorectal carcinoma, and the correlation between the CXCR4 expression and clinicopathologic factors was evaluated.

RESULTS: The positive rate of CXCR4 expression was 56.7% in colorectal carcinoma, which was correlated with lymph node metastasis, clinical staging and MVD as well as the survival of patients, but not with the sex and age of patients, tumor location, T staging, and pathological types. The expression of CXCR4 was 40.6%, 68.2% and 76.9% in cases of N0, N1 and N2 stage, 39.4% and 73.5% in cases of Ⅰ+Ⅱ and Ⅲ stage, respectively. The positive rate of CXCR4 expression was significantly lower in the case with low MVD than that with high MVD (36.4% vs 74.3%, P < 0.01), and the CXCR4-positive case had a higher recurrent or metastatic rate (47.4% vs 24.1%, P < 0.05) and a lower 3-year survival rate (32.6% vs 71.3%, P < 0.05) than the CXCR4-negative one.

CONCLUSION: Positive CXCR4 expression and high tumor MVD are associated with the poor prognosis of patients, and they can be used as potential predictive factors for the recurrence or metastasis of colorectal cancer.

[Effect of Ku80 expression inhibition by RNA interference on proliferation of cervical carcinoma cell line HeLa]

BACKGROUND & OBJECTIVE

Ku80 is a key protein plays a role in repairing DNA double strand break (DSB) after irradiation. There are a few studies about other roles of Ku80 except DSB repair. This study was to inhibit Ku80 expression in cervical carcinoma cell line HeLa with small interfering RNA (siRNA), and explore its effect on cell proliferation.

METHODS

Plasmids pKu80-siRNA and pNeg-siRNA (negative control) were constructed and transfected into HeLa cells. The expression of Ku80 in HeLa cells was detected by Western blot. The proliferation of HeLa cells in vitro and in vivo was determined by clone formation assay, MTT assay, and subcutaneous tumor formation in nude mice.

RESULTS

Two cell clones were screened from pKu80-siRNA-and pNeg-siRNA-transfected HeLa cells. Ku80 expression in HeLa cells was suppressed markedly after transfection of pKu80-siRNA; this clone was named Hela/Ku80-siRNA. The clone formation efficiency was significantly lower in HeLa/Ku80-siRNA cells than in control cells (0.46+/-0.05 vs. 0.62+/-0.02, t=5.11, P<0.01). The proliferation rate was significantly lower in HeLa/Ku80-siRNA cells than in control cells at 48 h and 72 h after transfection (P<0.05). At the 25th day after subcutaneous transplantation in nude mice, the tumor volume was significantly smaller in HeLa/Ku80-siRNA group than in control group [(18.92+/-3.60) mm(3) vs. (194.88+/-30.61) mm(3), t=12.69, P<0.01].

CONCLUSIONS

We successfully established a cell model that Ku80 expression is suppressed almost completely by siRNA. Ku80 inhibition inhibits the proliferation of HeLa cells in vivo and in vitro.

[Gefitinib in the treatment of advanced non-small-cell lung cancer]

OBJECTIVE

To study the anti-tumor effect and toxicity of Gefitinib in the treatment of patients with advanced non-small-cell lung cancer (NSCLC).

METHODS

From August 2003 to February 2005, 50 advanced NSCLC patients were treated with Gefitinib orally 250 mg once per day. All patients were stratified by gender, histology, smoking history and chemotherapy cycles. The response was evaluated as the time to tumor progression (TTP) and the median survival time (MST). Quality of life (QoL) was assessed using the Chinese version of European Organization for Research and Treatment of Cancer (EORTC) core questionnaire QLQ-30 and the brief fatigue inventory (BFI).

RESULTS

Even though none of these patients achieved complete response, 16.0% of them still gave partial response. Clinical benefit rate was 60.0% in this series. Objective tumor response was correlated with gender, pathological type and smoking history. Multivariate analysis suggested that gender, chemotherapy cycles and QoL obviously correlated with the tumor response. Twenty of these 50 patients (40.0%, 20/50) were still alive when the follow-up ended in February 2005. The 1-year survival rate was 14.0%. TTP and MST was 5 and 6 months, respectively, in patients who had been dead. The median survival time of patients who are still alive was 13 months. The mean survival time of PR patients was more than 9 months. The rate of QoL improvement was 58.0% and the rate of fatigue remission was 52.6%. The mean time to symptom improvement was 15 days. The main toxicities were reversible grade I or grade II skin rash and diarrhea. Two patients who developed radiation pneumonitis during previous radiotherapy became more deteriorated after Gefitinib treatment.

CONCLUSION

Gefitinib is effective and tolerated by the patients with advanced non-small cell lung cancer. It may remarkablely improve their symptoms and quality of life.

[Comparison between R-CHOP regimen and CHOP regimen in treating naive diffuse large B-cell lymphoma in China--a multi-center randomized trail]

BACKGROUND & OBJECTIVE

CHOP regimen is a standard treatment for patients with diffuse large B-cell non-Hodgkin's lymphoma (NHL), and its 5-year overall survival (OS) rate is 30%-40%. Rituximab is a chimeric monoclonal antibody (MoAb) directly against CD20-positive B cells, and has good effect on diffuse large B-cell NHL. Rituximab combined with standard chemotherapy has been approved for treating aggressive B-cell NHL in Europe and the US. This study was to determine efficacy and safety of the combination of Rituximab and CHOP regimen in treating Chinese patients with CD20-positive diffuse large B-cell NHL.

METHODS

From Sep. 2003 to Nov. 2004, a total of 63 patients in 9 centers were enrolled. All the patients were randomized into 2 groups: 32 received CHOP regimen alone (CHOP group), and 31 received Rituximab and CHOP regimen (R-CHOP group). All patients signed informed consent. The complete response rates, overall response rates, and side events of the 2 groups were compared.

RESULTS

The complete response rates were similar in R-CHOP and CHOP groups (41.9% vs. 37.5%, P=0.719); the overall response rates were slightly higher in R-CHOP group than in CHOP group (83.8% vs. 65.6%, P=0.096). Disease progression during treatment was reported for 7 (21.9%) patients in CHOP group and 1 (3.2%) patient in R-CHOP group (P=0.026). The occurrence rates of adverse events were similar in R-CHOP and CHOP groups (65.6% vs. 67.7%, P=0.859). The most common adverse event was leukopenia; fever and chills were rather common in R-CHOP group. Clinically relevant toxicity was similar in both groups.

CONCLUSION

When compared with standard CHOP alone, the addition of Rituximab to standard CHOP regimen reduces the risk of treatment failure in patients with diffuse large B-cell NHL, and doesn't increase the occurrence of chemotherapy-related adverse events.

[Effects of hypoxia on expression of HIF-1alpha,P53, and cyclin D1 in human lung adenocarcinoma cell line A549]

BACKGROUND & OBJECTIVE

Many studies showed that hypoxia inducible factor-1 alpha (HIF-1alpha)was an essential component for hypoxia- induced cell cycle arrest, but the definite mechanism and the degree of HIF-1alpha affecting cell cycle arrest were unknown yet. This study was to explore the probable mechanism of hypoxia-induced tumor cell cycle arrest.

METHODS

Human lung adenocarcinoma cell line A549 were divided into 3 groups: 12-h hypoxia group, 24-h hypoxia group, and control group. The hypoxia groups were exposed to hypoxic conditions (37degrees C, 5% CO2, and 2.0% O2) for 12 h, and 24 h, respectively, while control group was exposed to normal oxygen conditions (37 degrees C, 5% CO2, and 21% O2) for 24 h. Flow cytometry was used to measure the distribution of cell cycles and the expression of cyclin D1. The expression of HIF-1alpha, and p53 was detected using immunohistochemistry.

RESULTS

(1) The ratio of G(0)/G(1) in 12-h hypoxia group was (70.20+/-3.33)%, and in 24-h hypoxia group was (82.85+/-1.75)%, significantly higher than that in control group [(50.36+/-4.09) %] (F=202.34, P< 0.01).(2) There was significant difference in cyclin D1 expression among 12-h hypoxia group [(80.22+/-1.55)%], 24-h hypoxia group [(73.65+/-2.10)%], and control group [(90.35+/-2.68)%] (F=100.45, P< 0.01). (3) HIF-1alpha expression in 12-hypoxia group, 24-hypoxia group, and control group was 0.16 +/- 0.02, 0.26 +/- 0.05, and 0.01 +/- 0.00, respectively, with significant difference among the 3 groups (F=105.28, P< 0.01). (4) In hypoxia groups, cyclin D1 expression was negatively correlated with G(0)/G(1) arrest (r=-0.91, P< 0.01), HIF-1alpha expression was positively correlated with p53 expression (r=0.84, P< 0.01), and negatively correlated with cyclin D1 expression (r=-0.90, P< 0.01), and p53 expression was negatively correlated with cyclin D1 expression (r=-0.78,P< 0.01).

CONCLUSIONS

Hypoxia can cause G(0)/G(1) cell cycle arrest in human lung adenocarcinoma cell line A549. HIF-1alpha-p53-cyclin D1 pathway might play an important role in the hypoxia-induced G(0)/G(1) cell cycle arrest of human lung adenocarcinoma cell line A549.

In vitro skin permeation of estradiol from various proniosome formulations

The skin permeation of estradiol from various proniosome gel formulations across excised rat skin was investigated in vitro. The encapsulation efficiency and size of niosomal vesicles formed from proniosomes upon hydration were also characterized. The encapsulation (%) of proniosomes with Span surfactants showed a very high value of about 100%. Proniosomes with Span 40 and Span 60 increased the permeation of estradiol across skin. Both penetration enhancer effect of non-ionic surfactant and vesicle-skin interaction may contribute to the mechanisms for proniosomes to enhance estradiol permeation. Niosome suspension (diluted proniosomal formulations) and proniosome gel showed different behavior in modulating transdermal delivery of estradiol across skin. Presence or absence of cholesterol in the lipid bilayers of vesicles did not reveal difference in encapsulation and permeation of the associated estradiol. The types and contents of non-ionic surfactant in proniosomes are important factors affecting the efficiency of transdermal estradiol delivery.