Efficacy and safety of S-1 maintenance therapy in advanced non-small-cell lung cancer patients

BACKGROUND

Previous reports have demonstrated that S-1 has remarkable effects in the maintenance treatment of advanced non-small-cell lung cancer (NSCLC), and has less toxic and side effects than conventional drugs.

AIM

To investigate the efficacy and safety of S-1 maintenance therapy in patients with advanced NSCLC.

METHODS

Ninety-four patients with NSCLC admitted to our hospital from September 2015 to April 2018 were included in the study and divided into the S-1 group (47 cases) and the gemcitabine group (47 cases) by random digital table method. The S-1 group was treated with S-1, while the gemcitabine group received gemcitabine treatment. The clinical efficacy and quality of life of the patients after treatment in the two groups were evaluated.

RESULTS

There was no significant difference in the total effectiveness rate between the two groups (P = 0.519). The quality-of-life scores indicated that there was no significant difference between the two groups in terms of four dimensions of the GQOLI-74 questionnaire (P = 0.518, 0.094, 0.338, 0.418). The incidence of nausea and vomiting, granulocytopenia and diarrhea in the S-1  group was significantly lower than that in the gemcitabine group (P = 0.001, 0.001 and 0.001, respectively). There was no significant difference in the incidence of thrombocytopenia (P = 0.366), the progression-free survival (P = 0.064), and the survival between the two groups (P = 0.050).

CONCLUSION

S-1 maintenance therapy shows a significant therapeutic effect in patients with advanced NSCLC. It has the same clinical efficacy as gemcitabine, but with less toxic and side effects than conventional drugs.

[Preoperative planning of constitutional varus alignment in patients with varus knees and coronal femoral lateral bowing]

Objective: To investigate the preoperative constitutional varus alignment (CA) inpatients withvarus osteoarthritic knees and coronal femoral lateral bowing (FLB) by comparing the femoral axis of the patients and volunteers' with straight femoral shaft (SFS) and healthy knees, which would be used to guide the selection of valgus correction angle(VCA) of distal femur in total knee anthroplasty (TKA). Methods: From January 2018 to December 2018, 45 nonconsecutive patients (90 knees) with varus osteoarthritic knees and obvious FLB (>5°) received primary TKA,and 50 limbs with healthy knees and SFS in 25 volunteers were studied at Xinqiao Hospital.The medial proximal femoral angle (MPFA) and anatomic lateral distal femoral angle (a-LDFA) were measured and compared between the two groups.The VCA formed by distal femoral mechanical axis (DMA) and distal femoral anatomic axis (DAA) in patients and the VCA based on neutral mechanical axis (NMA) in volunteers were also compared. The Pearson's correlation analysis was performed between the angle of bowing (α) and the VCA based on NMA in patients. The measurement data was compared with t test between the two groups. Results: The results showed that the MPFA and the a-LDFA were not significantly different between the volunteers with SFS and patients with FLB (MPFA:84.9°±3.7° vs 85.6°±1.8° and a-LDFA:81.7°±1.7° vs 81.2°±1.6°, t=1.26, 1.70, both P>0.05). The VCA based on NMA in volunteers with SFS was 5.5°±0.6°(4.5°-7.4°), the preoperative DAA-DMA angle was 5.3°±0.7°(4.3°-7.8°) in patients with FLB, there was no significant difference between the two groups (t=1.70, P=0.09). The angle of bowing (α) was 7.9°±2.9° (6°-16°), the VCA based on NMA was 8.4°±1.5°(5°-10°), there was a significantly positive correlation between VCA and α (R=0.607, P<0.01). Conclusion: There is no significantly proximal or distal femoral deformity in patients with varus osteoarthritic knee and FLB (>5°), the degree of the DMA-DAAangle based on the DMA doesn't change with the increasing angular deformity of the bowing, then the bowing would be reserved if the distal femur is cut based on DMA in TKA and the preoperative CA should be restored successfully.

Laparoscopic surgery for endometrial cancer in aged patients: Experience from a tertiary referral center in Eastern China

OBJECTIVE

The aim of the present study was to evaluate the feasibility and safety of laparoscopic surgery for endometrial cancer in aged patients and show the experiences of laparoscopic surgery for elderly endometrial cancer patients in Eastern China.

MATERIALS AND METHODS

A total of 211 patients (≥60 years) with endometrial carcinoma treated with surgery were retrospectively analyzed, including 104 patients who underwent laparoscopic surgery, and 107 who underwent laparotomy.

RESULTS

The operation time was similar in both groups (192.9 vs. 185.5 min, P = 0.722). For all cases, the estimated blood loss was less in the laparoscopic group relative to that of in the open group (227.5 vs. 382.6 ml, P = 0.000). There was no difference in the complication rate between the two groups (21.2% vs. 29.0%, P = 0.191). Overall, right pelvic and periaortic lymph node dissections were similar for the laparoscopic and laparotomy groups, but the former procedure dissected more left pelvic lymph nodes than that of in laparotomy (13.3 vs. 7.2 nodes, P = 0.038). The hospital stay was shorter after laparoscopic surgery than that of after laparotomy (7 vs. 10.5 days, P = 0.000). The recurrence rate was similar in the two groups (7.7% vs. 10.3%, P = 0.511).

CONCLUSIONS

Laparoscopy could be a safe alternative to laparotomy for endometrial cancer in aged patients.

Baicalin is an inhibitor of subgroup J avian leukosis virus infection

Avian leukosis virus subgroup J (ALV-J) can cause great economic losses to the poultry industry worldwide. Baicalin, one of the flavonoids present in S.baicalensis Georgi, has been shown to have antiviral activities. To investigate whether baicalin has antiviral effects on the infection of ALV-J in DF-1 cells, the cells were treated with baicalin at different time points. We found that baicalin could inhibit viral mRNA, protein levels and overall virus infection in a dose- and time-dependent manner using a variety of assays. Baicalin specifically targeted virus internalization and reduced the infectivity of ALV-J particles, but had no effect on the levels of major ALV-J receptor and virus binding to DF-1 cells. Collectively, these results suggest that baicalin might have potential to be developed as a novel antiviral agent for ALV-J infection.

Xpert MTB/RIF Assay for Pulmonary Tuberculosis and Rifampicin Resistance in Children: a Meta-Analysis

BACKGROUND

The Xpert MTB/RIF assay has been recommended by WHO to replace conventional microscopy, culture, and drug resistance tests. It simultaneously detects both Mycobacterium tuberculosis infection (TB) and resistance to rifampicin (RIF) within two hours. The objective was to review the available research studies on the accuracy of the Xpert MTB/RIF assay for diagnosing pulmonary TB and RIF-resistance in children.

METHODS

A comprehensive search of Pubmed and Embase was performed up to October 28, 2014. We identified published articles estimating the diagnostic accuracy of the Xpert MTB/RIF assay in children with or without HIV using culture or culture plus clinical TB as standard reference. QUADAS-2 tool was used to evaluate the quality of the studies. A summary estimation for sensitivity, specificity, diagnostic odds ratios (DOR), and the area under the summary ROC curve (AUC) was performed. Meta-analysis was used to establish the overall accuracy.

RESULTS

11 diagnostic studies with 3801 patients were included in the systematic review. The overall analysis revealed a moderate sensitivity and high specificity of 65% (95% CI: 61 - 69%) and 99% (95% CI: 98 - 99%), respectively, and a pooled diagnostic odds ratio of 164.09 (95% CI: 111.89 - 240.64). The AUC value was found to be 0.94. The pooled sensitivity and specificity for paediatric rifampicin resistance were 94.0% (95% CI: 80.0 - 93.0%) and 99.0% (95% CI: 95.0 - 98.0%), respectively. Hence, the Xpert MTB/RIF assay has good diagnostic and rifampicin performance for paediatric pulmonary tuberculosis.

CONCLUSIONS

The Xpert MTB/RIF is sensitive and specific for diagnosing paediatric pulmonary TB. It is also effective in detecting rifamnicin resistance. It can, therefore, be used as an initial diagnostic tool.

Deficiency of the cysteine protease cathepsin S impairs microvessel growth

During angiogenesis, microvascular endothelial cells (ECs) secrete proteinases that permit penetration of the vascular basement membrane as well as the interstitial extracellular matrix. This study tested the hypothesis that cathepsin S (Cat S) contributes to angiogenesis. Treatment of cultured ECs with inflammatory cytokines or angiogenic factors stimulated the expression of Cat S, whereas inhibition of Cat S activity reduced microtubule formation by impairing cell invasion. ECs from Cat S-deficient mice showed reduced collagenolytic activity and impaired invasion of collagens type I and IV. Cat S-deficient mice displayed defective microvessel development during wound repair. This abnormal angiogenesis occurred despite normal vascular endothelial growth factor and basic fibroblast growth factor levels, implying an essential role for extracellular matrix degradation by Cat S during microvessel formation. These results demonstrate a novel function of endothelium-derived Cat S in angiogenesis.

Glycation cross-links inhibit matrix metalloproteinase-2 activation in vascular smooth muscle cells cultured on collagen lattice

AIMS/HYPOTHESIS

Extracellular matrix glycation has been proposed to contribute to the arterial stiffness observed in aging and diabetes. We examined whether matrix protein glycation regulates the proleolytic process through the manipulation of matrix metalloproteinases (MMPs) activation, using collagen fibrils model.

METHODS

Vascular smooth muscle cells were cultured on control or glycated collagen fibrils. Matrix metalloproteinase-2 activation and the production of tissue inhibitors of metalloproteinase (TIMPs) were measured in the conditioned medium by using gelatin zymography and immunoblotting. Membrane type 1 matrix metalloproteinase (MT1-MMP) expression was also measured in cell lysates.

RESULTS

When smooth muscle cells were cultured on collagen fibrils, pro-MMP-2 processing to active form was observed in the conditioned medium in coincidence with the increased MT1-MMP expression and the suppressed TIMP-2 production. Culturing smooth muscle cells on glycated collagen fibrils inhibited MMP-2 activation and attenuated MT1-MMP expression without the alteration of TIMP-2 production compared with control fibrils, indicating the possible mechanism of the suppression of MT1-MMP expression for the inhibition of MMP-2 activation on glycated collagen fibrils. Inclusion of aminoguanidine, an inhibitor of cross-linking formation, during collagen glycation restored the MMP-2 activation, suggesting the role of cross-links on the inhibition of MMP-2 activation.

CONCLUSION/INTERPRETATION

These observations suggest that glycation-induced cross-linking formation in interstitial collagen contributes to arterial stiffness in aging and diabetes through the manipulation of matrix metalloproteinase activation along with the reduction of the susceptibility to proteolytic enzymes.

Activation of MMP-2 by Clostridium difficile toxin B in bovine smooth muscle cells

Matrix metalloproteinase-2 (MMP-2) plays critical roles in cell migration through the breakdown of the extracellular matrix. Cell movements require dynamic actin reorganization, which is controlled by Rho family GTPases. In order to examine the relation between MMP-2 regulation and actin reorganization, we used several inhibitors of Rho family GTPases. Treatment of smooth muscle cells with Clostridium difficile toxin B known to inactivate Rho family GTPases activated MMP-2. However, neither C3 transferase, a Rho inhibitor, nor Y-27632, a specific inhibitor of Rho-kinase, induced MMP-2 activation. Treatment with C3 transferase and Y-27632 caused morphological changes into the round and stellate shape, respectively, by inhibition of actin stress fiber formation. In addition, toxin B treatment induced expression and processing of MT1-MMP, a major activator of MMP-2. Taken together, we suggest the involvement of Rho family GTPases, although inhibition of neither Rho nor Rho-kinase is sufficient, in the activation of MMP-2 through expression and activation of MT1-MMP.

Characterization of a single-nucleocapsid nucleopolyhedrovirus of Thysanoplusia orichalcea L. (Lepidoptera: Noctuidae) from Indonesia

A single-nucleocapsid nucleopolyhedrovirus (NPV) isolated from Thysanoplusia orichalcea L. (Lepidoptera:Noctuidae) (ThorNPV) in Indonesia has tetrahedral occlusion bodies (OBs) with a width of 1. 22 microm (range = 0.803-1.931 microm). The length of the virion with an envelope averaged 0.29 and 0.23 microm without an envelope. ThorNPV was propagated in Pseudoplusia includens (Walker) and its authenticity was confirmed by sequence analysis of the polyhedrin gene of the ThorNPV produced in T. orichalcea and P. includens. Polyhedrin amino acid sequence analysis revealed that ThorNPV belongs to Group II of baculoviruses and is closely related to Trichoplusia ni single nucleocapsid NPV, sharing 97.6% sequence identity. Infectivity of ThorNPV against third instar P. includens was low, with a LD(50) value of 65,636 OBs/larva. Electron microscopy of infected tissues showed many polyhedra without virions embedded, which might explain the low virulence against P. includens. Differences in virion occlusion rates between individual cells in the same tissue suggested that the inoculum consisted of at least two variants that differed in the gene(s) controlling virion occlusion. In a host range test using the LD(50) value to P. includens against Spodoptera exigua, S. frugiperda, S. eridania, Anticarsia gemmatalis, Helicoverpa zea, Trichoplusia ni, and P. includens, P. includens was the only species infected. The virus infected primarily the fat body, tracheal epithelium, and hypodermis. The genomic size of the ThorNPV is 135 kb.

Circular configuration of the genome of ascoviruses

A circular configuration of genomic DNA was observed in ascoviruses isolated from two species of insects of the family Noctuidae [fall armyworm (Spodoptera frugiperda) and cotton bollworm (Helicoverpa zea)] using restriction endonuclease (REN) digestion, conventional gel electrophoresis, pulsed-field gel electrophoresis and Southern hybridization analysis. This circular configuration of ascovirus genomic DNA was established based on the difference between linear and circular DNA in the numbers of fragments resolved on agarose gel electrophoresis after single and double REN digestion. Genomic DNA of ascoviruses was found to be sheared after purification.

Polyhedrin sequence determines the tetrahedral shape of occlusion bodies in Thysanoplusia orichalcea single-nucleocapsid nucleopolyhedrovirus

A nucleopolyhedrovirus (NPV) isolated from the looper Thysanoplusia orichalcea L. (Lepidoptera: Noctuidae) (ThorNPV) is occluded in a tetrahedral protein matrix. The ORF of the ThorNPV polyhedrin gene contains 738 nt which code for 246 amino acids of the putative polyhedrin protein with an estimated molecular mass of 28,778 Da. The promoter of this gene is similar in length to the promoter of Spodoptera frugiperda NPV (SfMNPV), with a 5 nt deletion before the start codon compared to those of other NPVs. When the polyhedrin gene of Autographa californica NPV (AcMNPV), whose occlusion bodies (OBs) are polyhedral, was replaced by the polyhedrin gene of ThorNPV, which produces tetrahedral OBs, tetrahedral polyhedra with properly occluded virions were produced. This work establishes the importance of the polyhedrin protein sequence in determining OB shape. Leucine at position 43 of ThorNPV polyhedrin was identified as responsible for the tetrahedral shape of ThorNPV OBs by PCR-based site-directed mutagenesis. Susceptibility to alkaline buffer of OBs formed by recombinant AcMNPV (RECAcV) carrying the polyhedrin gene of ThorNPV was slightly greater than that of native ThorNPV OBs. The LD50 of RECAcV for third-instar beet armyworm (Spodoptera exigua) was significantly lower than that of AcMNPV (253 and 31 OBs per larva, respectively).