Randomized phase II adjuvant trial to compare two treatment durations of icotinib (2 years versus 1 year) for stage II-IIIA EGFR-positive lung adenocarcinoma patients (ICOMPARE study)

BACKGROUND

Despite the prolonged median disease-free survival (DFS) by adjuvant targeted therapy in non-small-cell lung cancer patients with epidermal growth factor receptor (EGFR) mutations, the relationship between the treatment duration and the survival benefits in patients remains unknown.

PATIENTS AND METHODS

In this multicenter, randomized, open-label, phase II trial, eligible patients aged 18-75 years with EGFR-mutant, stage II-IIIA lung adenocarcinoma and who had not received adjuvant chemotherapy after complete tumor resection were enrolled from eight centers in China. Patients were randomly assigned (1 : 1) to receive either 1-year or 2-year icotinib (125 mg thrice daily). The primary endpoint was DFS assessed by investigator. The secondary endpoints were overall survival (OS) and safety. This study was registered at ClinicalTrials.gov (NCT01929200).

RESULTS

Between September 2013 and October 2018, 109 patients were enrolled (1-year group, n = 55; 2-year group, n = 54). Median DFS was 48.9 months [95% confidence interval (CI) 33.1-70.1 months] in the 2-year group and 32.9 months (95% CI 26.6-44.8 months) in the 1-year group [hazard ratio (HR) 0.51; 95% CI 0.28-0.94; P = 0.0290]. Median OS for patients was 75.8 months [95% CI 64.4 months-not evaluable (NE)] in the 2-year group and NE (95% CI 66.3 months-NE) in the 1-year group (HR 0.34; 95% CI 0.13-0.95; P = 0.0317). Treatment-related adverse events (TRAEs) were observed in 41 of 55 (75%) patients in the 1-year group and in 36 of 54 (67%) patients in the 2-year group. Grade 3-4 TRAEs occurred in 4 of 55 (7%) patients in the 1-year group and in 3 of 54 (6%) patients in the 2-year group. No treatment-related deaths or interstitial lung disease was reported.

CONCLUSIONS

Two-year adjuvant icotinib was shown to significantly improve DFS and provide an OS benefit in EGFR-mutant, stage II-IIIA lung adenocarcinoma patients compared with 1-year treatment in this exploratory phase II study.

Role and mechanism of actin-related protein 2/3 complex signaling in cancer invasion and metastasis: A review

The actin 2/3 complex (Arp2/3) regulates actin polymerization and nucleation of actin filaments, is associated with cell motility, and has been shown to play a key role in the invasion and migration of cancer cells. nucleation-promoting factor (NPF) such as N-WASP (neural-WASP famly verprolin-homologous protein family), WAVE (WASP famly verprolin-homologous protein family), and WASH (WASP and Scar homologue) undergo conformational changes upon receipt of multiple upstream signals including Rho family GTPases, cdc42 (Cell division control protein 42 homolog), and phosphatidylinositol 4,5-bisphosphate (PtdIns 4,5 P2) to bind and activate the Arp2/3 complex. Once activated, the Arp2/3 complex forms actin-based membrane protrusions necessary for cancer cells to acquire an invasive phenotype. Therefore, how to influence the invasion and migration of cancer cells by regulating the activity of the Arp2/3 complex has attracted great research interest in recent years. Several studies have explored the effects of phosphorylation modifications of cortactin and several NPFs (Nucleation Promoting Factor) including N-WASP and WAVE on the activity of the Arp2/3 complex and ultimately on cancer cell invasiveness, and have attempted to suggest new strategies for antiinvasive therapy as a result. Other studies have highlighted the potential of targeting genes encoding partial or complete proteins of the Arp2/3 complex as a therapeutic strategy to prevent cancer cell invasion and metastasis. This article reviews the role of the Arp2/3 complex in the development, invasion, and metastasis of different types of cancer and the mechanisms regulating the activity of the Arp2/3 complex.

Hypoxia-mediated activation of hypoxia-inducible factor-1α in head and neck squamous cell carcinoma: A review

Since the 1950s, hypoxia has been recognized as a crucial characteristic of cancer cells and their microenvironment. Indeed, hypoxia promotes the growth, survival, and metastasis of cancer cells. In the early 1990s, we found that as many phenomena in hypoxia can occur through hypoxia-inducible factor-1α (HIF1α). HIF1α is known as an angiogenesis converter in hypoxia, which promotes tumorigenesis, development, immune escape, recurrence, etc; This page goes into great detail on how HIF1α is activated during hypoxia and how the 2 signaling channels interact. It specifically emphasizes the significance of reactive oxygen species, the function of the PI3K/the serine/threonine kinase Akt/mammalian target of rapamycin cascade, and outlines the similarities between the 2 important factors (reactive oxygen species and PI3K/the serine/threonine kinase Akt/mammalian target of rapamycin cascade), nuclear factor κB, for HIF1α Important implications, in an effort to offer fresh views for the treatment of head and neck squamous cell carcinoma and HIF1α research.

A Topical Emollient Mitigates the Progression of Cognitive Impairment in the Elderly: A Randomized, Open-Label Pilot Trial

BACKGROUND

Cognitive impairment is common in the elderly. Prior studies suggest a link between chronic inflammation and cognitive dysfunction, while aging-associated epidermal dysfunction has been connected to elevations in circulating cytokines.

OBJECTIVE

We assessed here whether improvements in epidermal function can mitigate the progression of cognitive impairment.

METHODS

This randomized, open-label pilot trial was carried out in two cities in northern China. A total of 200 participants aged ≥65 years were randomly assigned to the emollient-treated and untreated groups at 1:1 ratio. Participants in the treated group were treated topically with Atopalm cream® twice-daily from November to the following May each year for three consecutive years, while the untreated subjects served as controls. The Global Deterioration Scale (GDS) was used to assess the severity of cognitive impairment, while epidermal biophysical properties were measured on the forearms and the shins in parallel.

RESULTS

Over the three-year trial, GDS significantly increased from baseline (p<0.0001) in the controls, while in the treated group, GDS stabilized. While stratum corneum hydration on the forearms did not change significantly in the controls, transepidermal water loss rates (TEWL), significantly increased by the end of the trial compared to baselines in the controls (p<0.0001). On the forearms of the treated group, stratum corneum hydration increased (p<0.0001) while skin surface pH decreased from baseline (p<0.0001).

CONCLUSIONS

These results suggest that improvements in epidermal function with topical emollient can mitigate the progression of cognitive impairment. However, the sample size was relatively small, and trials in a larger cohort are needed to validate the present results.

The Status of Iodine Nutrition after Removing Iodized Salt in High Water Iodine Regions: a Cross-sectional Study in China

Currently, the removal of iodized salt is carried out in high water iodine regions. The present situation of iodine nutrition and the prevalence of thyroid diseases in such regions have not been clearly elucidated. This study aimed to figure out these problems to help render effective measures for cases of abnormal iodine nutrition status. A cross-sectional study was carried out in four areas of Jining and Heze, Shandong Province, China, with different water iodine concentrations (WIC). In total, 1344 adults were enrolled in this study, and data related to their iodine nutrition, thyroid function, and thyroid ultrasonography were collected. Subjects were grouped according to WIC, urine iodine concentration (UIC), serum iodine concentration (SIC), and combined UIC and SIC for analysis. Iodine levels were in excess in the 100 μg/L ≤ WIC < 300 μg/L and WIC ≥ 300 μg/L areas. Compared with the control WIC group (10-100 μg/L), the WIC ≥ 300 μg/L group had a higher prevalence of thyroid autoimmunity (TAI, 21.25% vs. 13.19%, P <0.05), subclinical hypothyroidism (SH, 20.20% vs. 11.96%, P < 0.05), thyroid nodules (TN, 31.75% vs. 18.71%, P < 0.05), and thyroid dysfunction (23.62% vs. 12.26%, P < 0.05). Compared with the UIC control group (100-300 μg/L), high UIC group (≥ 800 μg/L) had a higher prevalence of TN (33.75% vs. 21.14%, P < 0.05) and thyroid dysfunction (25% vs. 14.47%, P < 0.05). Next, compared with the control SIC group (50-110 μg/L), high SIC group (≥ 110 μg/L) had a higher prevalence of TAI (33.80% vs. 14.47%, P < 0.05), SH (23.94% vs. 14.30%, P < 0.05), and thyroid dysfunction (33.80% vs. 15.29%, P < 0.05). Finally, subjects with the highest UIC and the highest SIC also had a higher prevalence of TAI (25.92% vs. 10.97%, P < 0.05), SH (23.45% vs. 10.97%, P < 0.05), TN (34.56% vs. 15.85%, P < 0.05), and thyroid dysfunction (27.16% vs. 13.41%, P < 0.05) than subjects with middle iodine levels. The iodine nutrition of subjects in the WIC ≥ 300 μg/L areas was still in excess after removing iodized salt from their diets. High levels of iodine also increased the prevalence of TAI, SH, TN, and thyroid dysfunction in those areas. Simply removing iodized salt may not be sufficient for high water iodine regions.

Three Novel Structural Variations at MHC and IL12B Predisposing to Psoriasis

BACKGROUND

Structural variations (SVs, defined as DNA variants ≥50 bp) have been associated with various complex human diseases. However, research to screen the whole genome for SVs predisposing to psoriasis is still lacking.

OBJECTIVES

This study aimed to investigate the association of SVs and psoriasis.

METHODS

We performed a genome-wide screen on SVs using an imputation method on 5 independent cohorts with 45,386 subjects from the Chinese Han population. Fine mapping analysis, genetic interaction analysis and RNA expression analysis were conducted to explore the mechanism of SVs.

RESULTS

We obtained 4,535 SVs in total and identified 2 novel deletions (esv3608550, OR=2.73, P<2.00×10^-308 ; esv3608542, OR=0.47, P=7.40×10^-28 ) at 6q21.33 (MHC), 1 novel Alu element insertion (esv3607339, OR=1.22, P=1.18×10^-35 ) at 5q33.3 (IL12B), and confirmed 1 previously reported deletion (esv3587563, OR=1.30, P=9.52×10^-60 ) at 1q21.2 (LCE) for psoriasis. Fine mapping analysis including SNPs and small Insertions/Deletions (InDels) revealed that esv3608550 and esv3608542 were independently associated with psoriasis, and a novel independent SNP (rs9378188, OR=1.65, P=3.46×10^-38 ) was identified at 6q21.33. By genetic interaction analysis and RNA expression analysis, we speculate that the association of 2 deletions at 6q21.33 with psoriasis might relate to their influence on the expression of HLA-C.

CONCLUSIONS

Our study constructed the most comprehensive SV map for psoriasis thus far and enriched the genetic architecture and pathogenesis of psoriasis as well as highlighted the nonnegligible impact of SVs on complex diseases.

The effects of aerobic exercise on the intestinal tumors and flora of the ApcMin/+ mouse

INTRODUCTION

Intestinal tumor is one of the most common tumors that seriously threaten the health of residents all over the world. Studies suggest that the imbalance of intestinal flora is associated with tumorgenesis; meanwhile, long-term regular aerobic exercise can improve the occurrence and development of tumors. However, moderate aerobic exercise affecting the development of intestinal tumors and their related flora has not been explored. Thus, the purpose of our study is to explore the effects of aerobic exercise on intestinal tumor growth and flora changes in Apc^Min/+ mice, and try to answer whether there is a correlation between them after exercise intervention.

METHODS

In this study, 18 required Apc^Min/+ mice were randomly divided into Model group (n = 6), Exercise group (n = 6), and Aspirin group (positive control, n = 6), while C57BL/6 J wild-type mice were used as the blank control group. Each group is given corresponding intervention. Weight monitoring, tumor counts, hematoxylin-eosin staining, TdT-mediated dUTP nick-end labeling (TUNEL) fluorescence assay, immunohistochemistry (IHC), fecal sampling and grouping, and bacterial 16S rDNA gene analysis were completed after 12 weeks' intervention for each group of mice.

RESULTS

As a result, we were able to show significant improvements in mice' body weight changing rates (Exercise group 8.6% higher than Model control group), tumor numbers (Exercise group 4.33 ± 0.94 vs. Model control group 7.33 ± 2.49, Then put the slides into xylenewith tumor inhibition rate 40.93%), tumor pathological staging (Exercise group mainly low-grade tumorous adenomas vs. Model group mainly high-grade adenomas), and TUNEL staining (Exercise group 8.59% higher positive rate of apoptotic cells in tumors than Model group). The 16s rRNA sequencing analysis results showed that aerobic exercise could regulate the abundance of some genus (16/149, P < 0.01), and the number of intestinal tumors correlates with changes in the abundance of some bacteria in the intestinal flora (positive correlation with probiotics abundance and negative correlation with conditioned pathogens).

DISCUSSION

Changes in flora abundance may be one of the reasons for aerobic exercise to reduce the number of intestinal tumors, probably mediated by cell apoptosis. Future studies should focus on the potential mechanism of aerobic exercise in preventing intestinal tumorgenesis, especially the molecular mechanism through intestinal flora.

CONCLUSION

Aerobic exercise has a preventive effect on intestinal tumors in Apc^Min/+ mice, and can regulate the abundance of intestinal flora.

Immune-Related lncRNA Signature for Predicting the Immune Landscape of Head and Neck Squamous Cell Carcinoma

Background: Long non-coding RNA (lncRNA) plays a significant role in the development, establishment, and progression of head and neck squamous cell carcinoma (HNSCC). This article aims to develop an immune-related lncRNA (irlncRNA) model, regardless of expression levels, for risk assessment and prognosis prediction in HNSCC patients.

Methods: We obtained clinical data and corresponding full transcriptome expression of HNSCC patients from TCGA, downloaded GTF files to distinguish lncRNAs from Ensembl, discerned irlncRNAs based on co-expression analysis, distinguished differentially expressed irlncRNAs (DEirlncRNAs), and paired these DEirlncRNAs. Univariate Cox regression analysis, LASSO regression analysis, and stepwise multivariate Cox regression analysis were then performed to screen lncRNA pairs, calculate the risk coefficient, and establish a prognosis model. Finally, the predictive power of this model was validated through the AUC and the ROC curves, and the AIC values of each point on the five-year ROC curve were calculated to select the maximum inflection point, which was applied as a cut-off point to divide patients into low- or high-risk groups. Based on this methodology, we were able to more effectively differentiate between these groups in terms of survival, clinico-pathological characteristics, tumor immune infiltrating status, chemotherapeutics sensitivity, and immunosuppressive molecules.

Results: A 13-irlncRNA-pair signature was built, and the ROC analysis demonstrated high sensitivity and specificity of this signature for survival prediction. The Kaplan–Meier analysis indicated that the high-risk group had a significantly shorter survival rate than the low-risk group, and the chi-squared test certified that the signature was highly related to survival status, clinical stage, T stage, and N stage. Additionally, the signature was further proven to be an independent prognostic risk factor via the Cox regression analyses, and immune infiltrating analyses showed that the high-risk group had significant negative relationships with various immune infiltrations. Finally, the chemotherapeutics sensitivity and the expression level of molecular markers were also significantly different between high- and low-risk groups.

Conclusion: The signature established by paring irlncRNAs, with regard to specific expression levels, can be utilized for survival prediction and to guide clinical therapy in HNSCC.

POS0320 POOR PROGNOSIS PREDICTION IN ANTI-MDA5 POSITIVE DERMATOMYOSITIS ASSOCIATED WITH INTERSTITIAL LUNG DISEASE: THE CROSS-CAR DECISION TREE MODEL

Background:

The prognosis of anti-melanoma differentiation-associated gene 5 positive dermatomyositis (anti-MDA5+ DM) – associated interstitial lung disease (ILD) is poor and heterogeneity.

Objectives:

The aim of this study was to evaluate prognostic factors and to develop a simple and generally applicable bedside decision tree model for predicting outcomes in patients with anti-MDA5+ DM and to guide treatment.

Methods:

We analyzed data for 246 anti-MDA5+ DM patients from Myositis Study Group-Jiangsu, a multicenter cohort across eighteen tertiary hospitals in Jiangsu province, from March 2019 to October 2020. The primary end point was all-cause death, and the secondary end point was occurring of rapidly progressive-ILD (rp-ILD). We used a multivariable Cox proportional hazards model to identify the independent prognostic risk factors of death and rp-ILD respectively. A decision-tree prediction model was developed by using data from 10 hospital of southern region (n=163), with validation by using contemporaneous data from northern region (n=83).

Results:

To assess the risk of rp-ILD, we developed a combined risk score, the CROSS score, that included the following values and scores: C-reactive protein (≤8mg/L, 0; >8mg/L, 3), anti-Ro52 antibody (negative, 0; positive, 4), Sex (Female, 0; Male, 2) and Short course of disease (More than 3 months, 0; Less than 3 months, 2). The mortality risk was identified by the CAR score, including C-reactive protein (≤8mg/L, 0; >8mg/L, 1), Alanine Transaminase (≤50units/L, 0; >50units/L, 1) and rp-ILD (non-rpILD, 0; rp-ILD, 3). We divided patients into three risk groups according to the CROSS score: low, 0 to 3; medium, 4 to 7; and high 8-11. And then Use of a simple decision tree prediction model permitted stratification into three different outcome prediction groups. High-risk patients had significantly higher mortality rates than low- and medium-risk patients in both discovery and validation cohorts (p < 0.0001).

Conclusion:

The CROSS-CAR decision tree model is easy to evaluate the poor prognostic risk in MDA5+ DM patients during any follow-up period. Unnecessary lung examination, such as chest CT scan and arterial blood gas analysis was avoided in low- and medium- rpILD risk patients. The special ambulance, with red cross sign tagged on car in China, may help to screen the high risk patients and to guide further treatment.

Disclosure of Interests:

None declared

Comparison of therapeutic efficacy and mechanism of paclitaxel alone or in combination with methotrexate in a collagen-induced arthritis rat model

OBJECTIVE

To compare the therapeutic efficacy of paclitaxel (PTX) alone to its combination with methotrexate (MTX) on rheumatoid arthritis.

METHODS

A collagen-induced arthritis (CIA) rat model was established by induction of type II collagen. Rats were divided into blank control group, CIA model group, MTX group 1 mg/kg, PTX 1.5 mg/kg, PTX 2.5 mg/kg, PTX 3.5 mg/kg, and MTX 1 mg/kg + PTX 3.5 mg/kg, with 10 rats per group. The inflammation of the ankle joint was analyzed by H&E staining and interleukin (IL)-1β and IL‑6 expression was detected by immunohistochemistry. TUNEL assay was performed to detect synovial tissue cell apoptosis after administration of PTX and MTX either alone or in combination. TLR4 and p‑NF-κBp65 protein expression in synovial tissue and the changes of serum IL‑1β, IL‑6, IL‑12, MMP‑3, and TNFα protein factors were detected by western blot and ELISA, respectively.

RESULTS

PTX and MTX improved histopathological changes in CIA rats. Besides, the apoptosis rate of synovial tissue cells in the PTX 3.5 mg/kg group was more than that of the PTX + MTX group. Immunohistochemistry and western blot results indicated that PTX and MTX reduce the expression rate of IL‑6 and IL‑1β and downregulate TLR4 and p‑NF-κBp65 protein expression. Furthermore, TLR4 and p‑NF-κBp65 reduced the concentration of MMP‑3, IL‑12, IL‑6, IL1‑β, and TNFα.

CONCLUSION

Both PTX and MTX exert significant suppression on rheumatoid arthritis, and the combined effect of the two drugs is weaker than that of PTX alone. Moreover, intraperitoneal injection of PTX 3.5 mg/kg every other day was the optimal dose observed in this study.

ROR1-AS1 promotes tumorigenesis of colorectal cancer via targeting Wnt/β-catenin

OBJECTIVE

Recent studies have discovered that long noncoding RNAs (lncRNAs) play an important role in malignant tumors. In this research, lncRNA ROR1-AS1 was selected to identify how it affected the development of colorectal cancer (CRC).

PATIENTS AND METHODS

ROR1-AS1 expression was detected by Real-time quantitative polymerase chain reaction (RT-qPCR) in CRC tissue samples. ROR1-AS1 expression level and patients' overall survival time were analyzed. Functional experiments were conducted to identify the changes of biological behaviors in CRC cells after knockdown of ROR1-AS1. Moreover, we also explored the underlying mechanism.

RESULTS

Detection of ROR1-AS1 expression level in patients' tissues showed that ROR1-AS1 was higher in CRC tissues than that in adjacent ones. ROR1-AS1 expression was negatively associated with patients' overall survival time. Cell growth ability was inhibited due to knockdown of ROR1-AS1 in vitro. Moreover, cell migration and invasion abilities were repressed after ROR1-AS1 was knockdown. Furthermore, due to the knockdown of ROR1-AS1, the targeted proteins in Wnt/β-catenin signaling pathway were suppressed.

CONCLUSIONS

These results suggested that ROR1-AS1 could enhance cell metastasis and proliferation via inducing Wnt/β-catenin signaling pathway, which might offer a potential therapeutic target in CRC.

ROR1-AS1 promotes tumorigenesis of colorectal cancer via targeting Wnt/β-catenin

Since this article has been suspected of research misconduct and the corresponding authors did not respond to our request to prove originality of data and figures, "ROR1-AS1 promotes tumorigenesis of colorectal cancer via targeting Wnt/β-catenin, by T. Liao, S.-L.-M. Maierdan, C. Lv, published in Eur Rev Med Pharmacol Sci 2019; 23 (3 Suppl): 217-223-DOI: 10.26355/eurrev_201908_18650-PMID: 31389604" has been withdrawn. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18650.

The impacts of gene polymorphisms on methotrexate in Chinese psoriatic patients

BACKGROUND

Methotrexate (MTX) is the first-line treatment for psoriasis in China. The metabolic processes of MTX include various proteins and genes. Previous studies have shown that gene polymorphisms had significant impacts on the efficacy of MTX. However, the influence of gene polymorphisms has not been reported in the Chinese psoriatic patients.

OBJECTIVE

The aim of this study was to verify the impacts of candidate genes polymorphisms on the effectiveness of MTX in a Chinese psoriatic population.

METHODS

In this study, we enrolled 259 psoriasis patients from two clinical centres. Each of them received MTX treatment at 7.5-15 mg/week for at least 8 weeks. Patients were stratified as responders and non-responders according to whether the Psoriasis Area and Severity Index score declined more than 75% (PASI75). According to previous reports, 16 single nucleotide polymorphisms (SNPs) were selected and genotyped for each patient using the Sequenom platform. Fisher's exact test, the chi-square test, Mann-Whitney tests and ANOVA analyses were used for statistical analysis.

RESULTS

Among 259 patients, there were 182 males and 77 females, 63 patients with psoriatic arthritis and 196 patients without arthritis phenotype, and the age of all patients ranged from 19 to 70 years (49.7 ± 13.6). The baseline PASI value of patients was 13.8 ± 8.5, and 33.2% of patients achieved a PASI75 response after MTX treatment. Patients carrying the ATP-binding cassette subfamily B member 1 gene (ABCB1) rs1045642 TT genotype were associated with more severe psoriasis skin lesion (P = 0.032). Furthermore, the ABCB1 rs1045642 TT genotype was found to be more frequent in non-responders (P = 0.017), especially in moderate-to-severe patients (P = 0.002) and patients without psoriatic arthritis (P = 0.026) after MTX treatment.

CONCLUSION

We have demonstrated for the first time that polymorphism of the ABCB1 rs1045642 TT genotype is predictive of a worse clinical response of skin lesions to MTX therapy in a Chinese psoriatic population.

Effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors

To explore the effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors, a total of 50 chronic secretory otitis media patients in the control group were subjected to caefaclor capsule, while the total of 50 cases in the observation group were treated with Qing Qiao Capsule. The traditional Chinese medicine (TCM) syndrome scores, therapeutic effects, and the levels of inflammatory factors were evaluated. After treatment, the scores of deafness, hearing loss, dizziness, soreness and weakness of the waist and knees, and fever is hens in palms and soles were significantly decreased in both groups (all P value &lt;0.05). However, each score in the observation group was markedly less than that of the control group (all P value &lt;0.05). Moreover, the C-reactive protein (CRP), procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) levels measured after treatment were significantly lowered than those before treatment (all P value &lt;0.05). Also, the levels of CRP, PCT and TNF-α in the observation group were obviously less than that of the control group (all P value &lt;0.05). And the total therapeutic efficacy of the observation group was significantly higher than that of the control group (P&lt;0.05). But no significant difference was observed in the rates of adverse reactions between both groups (P&gt;0.05). Application of Qing Qiao Capsule in the treatment of chronic secretory otitis media yields better results, lowers TCM syndrome scores, and alleviates the body's inflammatory response, which is a safe drug in clinical use.

Effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors

To explore the effects of Qing Qiao Capsule in the treatment of chronic secretory otitis media and the levels of serum inflammatory factors, a total of 50 chronic secretory otitis media patients in the control group were subjected to caefaclor capsule, while the total of 50 cases in the observation group were treated with Qing Qiao Capsule. The traditional Chinese medicine (TCM) syndrome scores, therapeutic effects, and the levels of inflammatory factors were evaluated. After treatment, the scores of deafness, hearing loss, dizziness, soreness and weakness of the waist and knees, and fever is hens in palms and soles were significantly decreased in both groups (all P value <0.05). However, each score in the observation group was markedly less than that of the control group (all P value <0.05). Moreover, the C-reactive protein (CRP), procalcitonin (PCT) and tumor necrosis factor-α (TNF-α) levels measured after treatment were significantly lowered than those before treatment (all P value <0.05). Also, the levels of CRP, PCT and TNF-α in the observation group were obviously less than that of the control group (all P value <0.05). And the total therapeutic efficacy of the observation group was significantly higher than that of the control group (P<0.05). But no significant difference was observed in the rates of adverse reactions between both groups (P>0.05). Application of Qing Qiao Capsule in the treatment of chronic secretory otitis media yields better results, lowers TCM syndrome scores, and alleviates the body's inflammatory response, which is a safe drug in clinical use.

Improvements in epidermal function prevent relapse of psoriasis: a self-controlled study

While therapeutic approaches for psoriasis are widely available, preventive regimens are lacking. We aimed to determine whether improvements in epidermal function could prevent psoriasis relapse. Two self-controlled cohort studies were designed, enrolling two cohorts of patients with psoriasis (n = 30 and n = 60) to be treated topically with an in-house-prepared emollient or ATOPALM^® cream applied twice daily to one forearm for 20 and 30 days, respectively, while the same sites on the contralateral arm served as the untreated control. Epidermal function on both arms was assessed prior to and at the end of the trials. Delayed relapse on the treated arm was seen in 54.5% and 71% of patients in the first and second cohort, respectively. The time of psoriatic relapse correlated with the extent of abnormalities in baseline epidermal function. These results suggest that improvements in epidermal function with topical emollients can prevent/attenuate the development of psoriasis.

[High mobility group box 1 promotes apoptosis of astrocytes after oxygen glucose deprivation/reoxygenation by regulating the expression of Bcl-2 and Bax]

OBJECTIVE

To investigate the effect of high mobility group protein box 1 (HMGB1) on apoptosis of astrocytes after oxygen glucose deprivation/reoxygenation (OGD/R), and to investigate the possible mechanism by evaluating the expression of apoptosis related protein Bcl-2 and Bax.

METHODS

The cerebral cortex astrocytes of neonatal rats were divided into normal group, model group, interference group and control group. Lentivirus vector of rat HMGB1 short hairpin RNA (shRNA) was used to suppress the HMGB1 protein expression in the astrocytes. Then the detection was made after astrocytes were deprived of oxygen and glucose 6 h, reoxygenation for 24 h. The effect of RNA interference was evaluated by Western blotting. The cell survival rate was measured by MTT assay. The apoptosis of astrocytes was determined by TUNEL assay. The expressions of Bcl-2 and Bax were detected by Western blotting.

RESULTS

Compared with the normal group, the protein expression of HMGB1 was significantly increased in model group after OGD/R (P<0.001), the astrocytes survival rate was decreased (P<0.001), the number of apoptotic cells labeled with TUNEL was increased (P<0.001), and the ratio of Bcl-2/Bax was decreased (P<0.001). Compared with the model group, RNA interference effectively inhibited the expression of HMGB1 in interference group (P<0.001), the astrocytes survival rate was increased (P<0.001), the number of apoptotic cells labeled with TUNEL was reduced (P<0.01), and the ratio of Bcl-2/Bax was increased (P<0.001).

CONCLUSION

The apoptosis of astrocytes can be induced by HMGB1 after OGD/R, and the mechanism may be related to regulating the expression of apoptosis related proteins Bcl-2 and Bax.

Overexpressed Sirt1 in MSCs Promotes Dentin Formation in Bmi1-Deficient Mice

Sirt1 promotes odontoblastic gene expression in human dental pulp cells, whereas the inhibition of Sirt1 downregulates the expression of those genes. To investigate whether the overexpression of Sirt1 in mesenchymal stem cells (MSCs) driven by Prx1 promoter could rescue the dentin formation defects in Bmi1-deficient (Bmi1^-/-) mice, we established the MSCs overexpressing Sirt1 in Bmi1 knockout mice (Sirt1^TGBmi1^-/-). First, we used Prx1-Cre/ROSA^nTnG mice to demonstrate that Prx1 linage cells exist mainly in the pulp horns at 4 wk of age. Second, we found that 4-wk-old Sirt1^TG mice had increased tooth volume as compared with wild-type (WT) littermates. The expression level of Sirt1 was significantly higher in dental papilla mesenchymal cells of Sirt1^TG mice than WT mice. Furthermore, we demonstrated that the tooth mineralization, dental volume, dentin sialoprotein-immunopositive areas, odontoblastic gene expression, and percentage of proliferating BrdU-positive cells were significantly elevated in the Sirt1^TG mice and dramatically reduced in the Bmi1^-/- mice versus the WT littermates at 4 wk of age. However, the areas of predentin and the percentage of TUNEL-positive apoptotic cells were significantly reduced in the Sirt1^TG mice but dramatically increased in the Bmi1^-/- mice as compared with the WT littermates. All these parameters were rescued in the Sirt1^TGBmi1^-/- mice versus the Bmi1^-/- mice. Finally, by using dental papilla mesenchymal cells, we found that the overexpression of Sirt1 rescued the reduced cell proliferation and differentiation and increased the cell apoptosis caused by Bmi1 deficiency, which was associated with increased p53 deacetylation. Therefore, this study indicates that Sirt1 is a potential therapeutic target for promoting dentin formation in an anabolic approach to the treatment of dental developmental defects.

Validation of GPSkin Barrier® for assessing epidermal permeability barrier function and stratum corneum hydration in humans

BACKGROUND

Measurements of transepidermal water loss (TEWL) and stratum corneum (SC) hydration are important for assessing epidermal functions. However, the availability of reliable and user-friendly devices, which can simultaneously measure both TEWL and SC hydration and can allow health providers to remotely access data in time, is limited.

MATERIALS AND METHODS

GPSkin Barrier^® was compared with MPA5 system in the measurements of TEWL and SC hydration on the cheek, the dorsal hand, and the forearm in 200 normal volunteers, including 126 females and 74 males, aged 1-78 years with an average age of 45.24 ± 1.04 years. Correlation of data measured with MPA5 system and GPSkin Barrier^® was determined.

RESULTS

Levels of both TEWL and SC hydration measured with the Barrie GPSkin Barrier^® were lower than that with MPA5 system on all 3 body sites except for hydration on the cheek. The levels of both TEWL and SC hydration measured with GpSkin Barrier^® were correlated well with that measured with MPA5 system on all 3 body sites CONCLUSIONS: GPSkin Barrier^® is a reliable, affordable, and versatile device for assessing epidermal permeability barrier function and SC hydration.

Etoposide and cisplatin versus paclitaxel and carboplatin with concurrent thoracic radiotherapy in unresectable stage III non-small cell lung cancer: a multicenter randomized phase III trial

Background

The optimal chemotherapy regimen administered currently with radiation in patients with stage III non-small cell lung cancer (NSCLC) remains unclear. A multicenter phase III trial was conducted to compare the efficacy of concurrent thoracic radiation therapy with either etoposide/cisplatin (EP) or carboplatin/paclitaxel (PC) in patients with stage III NSCLC.

Patients and methods

Patients were randomly received 60-66 Gy of thoracic radiation therapy concurrent with either etoposide 50 mg/m2 on days 1-5 and cisplatin 50 mg/m2 on days 1 and 8 every 4 weeks for two cycles (EP arm), or paclitaxel 45 mg/m2 and carboplatin (AUC 2) on day 1 weekly (PC arm). The primary end point was overall survival (OS). The study was designed with 80% power to detect a 17% superiority in 3-year OS with a type I error rate of 0.05.

Results

A total of 200 patients were randomized and 191 patients were treated (95 in the EP arm and 96 in the PC arm). With a median follow-up time of 73 months, the 3-year OS was significantly higher in the EP arm than that of the PC arm. The estimated difference was 15.0% (95% CI 2.0%-28.0%) and P value of 0.024. Median survival times were 23.3 months in the EP arm and 20.7 months in the PC arm (log-rank test P = 0.095, HR 0.76, 95%CI 0.55-1.05). The incidence of Grade ≥2 radiation pneumonitis was higher in the PC arm (33.3% versus 18.9%, P = 0.036), while the incidence of Grade ≥3 esophagitis was higher in the EP arm (20.0% versus 6.3%, P = 0.009).

Conclusion

EP might be superior to weekly PC in terms of OS in the setting of concurrent chemoradiation for unresectable stage III NSCLC.

Trial registration ID

NCT01494558.

Effect of estrogen on chick primordial follicle development and activation

Steroid hormones and their receptors play pivotal roles in avian reproduction and development. 17β-estradiol (E₂ ) is an essential mediator in ovarian development. In this study, Day 3 (D3) chicks were injected with E₂ (0.025, 0.25 or 2.5 mg/kg body weight) for 4 days to assess the effects of estrogen on avian follicle development. Morphological analysis showed that treatment of E₂ at 2.5 mg/kg increased the number of growing follicles by 28. 5% and activated follicles by 8.9%, compared with the group. Treatment of E₂ also led to increased diameter and area of three kinds of follicles and oocytes, respectively. However, this stimulating effect of E₂ was inhibited by combined treatment of the estrogen receptor antagonist tamoxifen, resulting in decreased number of the growing follicles by 14.3% and the activated follicles by 5.8%, respectively. Immunohistochemical staining of the proliferating cell nuclear antigen (PCNA) revealed that the ratios of the PCNA-positive granulosa and interstitial cells were increased by 14.0% and 21.5%, respectively. Western blot analysis of PCNA confirmed this stimulating effect of E₂ . Expression of ERα mRNAs was elevated by administration of E₂ in vivo and in vitro. Furthermore, E- and N-cadherin displayed increased expression after E₂ treatment in vivo and in vitro. In conclusion, E₂ can promote chicken primordial follicle development and activation involving its increased receptor and cadherin production at the early stage of ovarian development.

Cytotoxic Edema in Posterior Reversible Encephalopathy Syndrome: Correlation of MRI Features with Serum Albumin Levels

BACKGROUND AND PURPOSE

Posterior reversible encephalopathy syndrome is a clinicoradiologic entity with typical MR imaging showing predominant vasogenic and occasional cytotoxic edema. It is unclear whether MR imaging correlates with levels of serum albumin. We determined potential risk factors for development of cytotoxic edema in posterior reversible encephalopathy syndrome.

MATERIALS AND METHODS

Seventy-nine cases with typical clinical symptoms and characteristic neuroradiologic findings conformed to posterior reversible encephalopathy syndrome diagnostic criteria and were included in this study. FLAIR, DWI, and ADC maps were interpreted to evaluate the severity and type of edema. MR imaging was correlated with the levels of serum albumin, and cytotoxic edema was compared with the location and severity of brain edema.

RESULTS

Pure vasogenic edema was found in 53 cases (67.09%), and vasogenic edema complicated with cytotoxic components, in 26 patients (32.91%). There was no difference in serum albumin levels between patients with cytotoxic components and those with vasogenic edema (P = .983). There was a significant difference in the edema scale scores between patients with cytotoxic edema and those with vasogenic edema (P = .006). The percentage of cytotoxic edema located in the area with higher scale scores of edema was significantly larger than that in areas with lower scale scores of edema (P = .002).

CONCLUSIONS

Serum albumin may contribute to the development of edema in PRES but is not a decisive factor for edema type. Cytotoxic edema in posterior reversible encephalopathy syndrome is probably related to regional decreased perfusion and arteriolopathy. Further work should be undertaken to discover the pathophysiologic mechanisms involved.

Investigation on formaldehyde release from preservatives in cosmetics

OBJECTIVE

To understand formaldehyde residue in cosmetics, an investigation on formaldehyde release from eight preservatives (methenamine - MA, paraformaldehyde - PF, poly(p-toluenesulfonamide-co-formaldehyde) -PTSAF, quaternium-15 - QU, imidazolidinyl urea - IU, diazolidinyl urea - DU, dimethyloldimethyl hydantoin - DMDM and bronopol - BP) under various conditions was performed.

METHODS

The concentration of released formaldehyde was determined by high-performance liquid chromatography with photodiode array detection after derivatization with 2,4-dinitrophenylhydrazine.

RESULTS

The amounts of formaldehyde release were in the order of PF > DU > DMDM ≈ QU ≈ IU > MA > BP > PTSAF. The releasing amounts of formaldehyde were the highest in the presence of aqueous matrices for the releasers except QU and IU, and the releasing effect was also relative to pH. More formaldehyde was released with longer storage time and higher temperature. Furthermore, all preservatives in cosmetic matrices released fewer amounts of formaldehyde than in pure aqueous or organic matrices, and the formaldehyde-releasing amounts were also cosmetic specific.

CONCLUSION

Formaldehyde release was dependent on the matrix, pH, time and mainly temperature, and the releasing effect was also cosmetic specific.

2D square arrays of protein nanocages through channel-directed electrostatic interactions with poly(α, l-lysine)

Reconstructed ferritin nanocages with expanded 4-fold channels can self-assemble into 2D square arrays through channel-directed electrostatic interactions with poly(α, l-lysine) at pH 7.0. Structurally, protein cages are aligned along their common 4-fold symmetry axis, imposing a fixed disposition of neighboring ferritins.

The influence of food on the pharmacokinetics of amlodipine and losartan after single-dose of its compound tablets in healthy chinese subjects

We aim to identify the effects of food on the pharmacokinetics (PK) of amlodipine, losartan and losartan's active metabolite (EXP3174) after oral administration of the Compound Amlodipine Tablets with single dose in healthy Chinese subjects. 12 subjects took the compounds (10 mg/100 mg, amlodipine/losartan) at the conditions of a high-fat breakfast and an overnight fast with a washout period of 14 days. Plasma samples were obtained at scheduled time, and determined by HPLC-MS/MS for the concentrations of amlodipine and HPLC-MS for the concentrations of losartan and EXP3174, respectively. PK parameters were calculated using Software Drug and Statistics (Version 2.0). When tablets were co-administered with food, there was no significant difference of AUC for amlodipine and losartan, but the AUC of EXP3174 was reduced by 19.1%. Meanwhile, the Cmax of amlodipine, losartan and EXP3174 were reduced by 11.4%, 20.0% and 41.4%, and the Tmax of losartan and EXP3174 were 1.3 and 1.8 h longer, respectively. No significant difference was found at t1/2 following food intake. In conclusion, the Compound Amlodipine Tablets, are affected by food administration by reducing the AUC of EXP3174. It is thus suggested that the Compound Amlodipine Tablets should be administered 1 h before or 2 h after meal.

A more rapid, sensitive, and specific HPLC-MS/MS method for nifedipine analysis in human plasma and application to a pharmacokinetic study

A more rapid, sensitive and specific high-performance liquid chromatography coupled to -tandem mass spectrometry (HPLC-MS/MS) was developed and validated for the quantification of nifedipine in human plasma, and applied to the pharmacokinetic study of nifedipine in Chinese healthy volunteers. Nifedipine and internal standard (IS) acetaminophen in plasma were extracted with ethyl acetate, separated on a C18 (150 mm×4.6 mm, 5 µm) reversed-phase column, eluted with acetonitrile mixed with 5 mM ammonium acetate solution (pH=6.62) (60:40, v/v), ionized by negative ion pneumatically assisted electrospray and detected in the multi-reaction monitoring mode using precursor→product ions of m/z 354.1→222.2 for nifedipine and 150.1→107.1 for the IS. A single oral dose of 20 mg nifedipine sustained release tablets and blood samples (4 mL) was collected before and 1, 2, 2.5, 3, 3.5, 4, 4.5, 5, 6, 8, 12, 24, and 36 h after administration. The main pharmacokinetic parameters of nifedipine, as Tmax, t1/2α, t1/2β, t1/2z, Cmax, AUC0~36, AUC0~∞ were 2.80±0.50 h, 6.78±2.52 h, 6.82±2.53 h, 6.69±2.22 h, 76.69±19.51 (ng/mL), 546.49±162.28 (ng · h/mL) and 564.05±176.74 (ng · h/mL), respectively. The calibration curve was linear over the concentration range of 0.17-102 ng/mL (r2>0.99, n=5) with a lower limit of quantification (LLOQ) of 0.17 ng/mL. The intra- and inter-day precision was less than 15% for all quality control samples at concentrations of 0.42, 6.53 and 81.60 ng/mL and the accuracy (relative error, RE) was - 3.92% to 7.31% at 3 quality control levels. The specificity, matrix effect, recovery, sensitivity, linearity, accuracy, precision and stabilities were validated, and can fulfill the requirement of pharmacokinetic study of nifedipine sustained release tablets in Chinese volunteers.

Antiviral activity and mode of action of extracts from neem seed kernel against duck plague virus in vitro1

Four fractions obtained from alcohol extracts of neem (Azadirachta indica) seed kernel by column chromatography were investigated for antivirus activity against the duck plague virus (DPV) in vitro. Duck embryo fibroblasts (DEF) infected with DPV were treated with the neem seed kernel extracts, and the effect of antivirus was judged by 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di-phenytetrazoliumromide colorimetric method assay and direct immunofluorescence assay. The mode of action was tested by the plaque reduction assay. The results showed that fractions 1 to 3 were inactive. The median inhibitory concentration (IC(50)) of fraction 4 was 10.9 μg/mL and inhibited the virus protein expression in the direct immunofluorescence assay. In the plaque reduction assay, fraction 4 could significantly reduce the number of plaques compared with the negative control (P < 0.01) in all modes of action. This study indicated that the fourth fraction obtained from neem seed kernel could improve the viability of infected cells, and reduce the cytopathic effects caused by DPV and the amount of the virus protein expressed in virus-infected cells. The antiviral activity works in the whole process of virus infecting the normal cells.