A multi-center retrospective study of perioperative chemotherapy for gastric cancer based on real-world data / 中华胃肠外科杂志

Objective: To explore the effect of perioperative chemotherapy on the prognosis of gastric cancer patients under real-world condition. Methods: A retrospective cohort study was carried out. Real world data of gastric cancer patients receiving perioperative chemotherapy and surgery + adjuvant chemotherapy in 33 domestic hospitals from January 1, 2014 to January 31, 2016 were collected. Inclusion criteria: (1) gastric adenocarcinoma was confirmed by histopathology, and clinical stage was cT2-4aN0-3M0 (AJCC 8th edition); (2) D2 radical gastric cancer surgery was performed; (3) at least one cycle of neoadjuvant chemotherapy (NAC) was completed; (4) at least 4 cycles of adjuvant chemotherapy (AC) [SOX (S-1+oxaliplatin) or CapeOX (capecitabine + oxaliplatin)] were completed. Exclusion criteria: (1) complicated with other malignant tumors; (2) radiotherapy received; (3) patients with incomplete data. The enrolled patients who received neoadjuvant chemotherapy and adjuvant chemotherapy were included in the perioperative chemotherapy group, and those who received only postoperative adjuvant chemotherapy were included in the surgery + adjuvant chemotherapy group. Propensity score matching (PSM) method was used to control selection bias. The primary outcome were overall survival (OS) and progression-free survival (PFS) after PSM. OS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the last effective follow-up or death. PFS was defined as the time from the first neoadjuvant chemotherapy (operation + adjuvant chemotherapy group: from the date of operation) to the first imaging diagnosis of tumor progression or death. The Kaplan-Meier method was used to estimate the survival rate, and the Cox proportional hazards model was used to evaluate the independent effect of perioperative chemo therapy on OS and PFS. Results: 2 045 cases were included, including 1 293 cases in the surgery+adjuvant chemotherapy group and 752 cases in the perioperative chemotherapy group. After PSM, 492 pairs were included in the analysis. There were no statistically significant differences in gender, age, body mass index, tumor stage before treatment, and tumor location between the two groups (all P>0.05). Compared with the surgery + adjuvant chemotherapy group, patients in the perioperative chemotherapy group had higher proportion of total gastrectomy (χ(2)=40.526, P<0.001), smaller maximum tumor diameter (t=3.969, P<0.001), less number of metastatic lymph nodes (t=1.343, P<0.001), lower ratio of vessel invasion (χ(2)=11.897, P=0.001) and nerve invasion (χ(2)=12.338, P<0.001). In the perioperative chemotherapy group and surgery + adjuvant chemotherapy group, 24 cases (4.9%) and 17 cases (3.4%) developed postoperative complications, respectively, and no significant difference was found between two groups (χ(2)=0.815, P=0.367). The median OS of the perioperative chemotherapy group was longer than that of the surgery + adjuvant chemotherapy group (65 months vs. 45 months, HR: 0.74, 95% CI: 0.62-0.89, P=0.001); the median PFS of the perioperative chemotherapy group was also longer than that of the surgery+adjuvant chemotherapy group (56 months vs. 36 months, HR=0.72, 95% CI:0.61-0.85, P<0.001). The forest plot results of subgroup analysis showed that both men and women could benefit from perioperative chemotherapy (all P<0.05); patients over 45 years of age (P<0.05) and with normal body mass (P<0.01) could benefit significantly; patients with cTNM stage II and III presented a trend of benefit or could benefit significantly (P<0.05); patients with signet ring cell carcinoma benefited little (P>0.05); tumors in the gastric body and gastric antrum benefited more significantly (P<0.05). Conclusion: Perioperative chemotherapy can improve the prognosis of gastric cancer patients.

Isolation and idetification of a new aglycone from acid hydrolysis products of saponin in Centella asiatica / 中草药

Objective: To study the chemical constituents of the acid hydrolysis products, in order to find some new aglycones from the hydrolysate of the saponin of Centella asiatica. Methods: The acid hydrolytic product was separated by repeated silica gel, Sephadex LH-20 chromatography. The cytotoxic activities in vitro of some compounds isolated were evaluated. Their structures isolated were identified by analysis of their spectral data of NMR, MS, IR, and UV. Results: Four aglycones, 2α,3β,23-trihydroxyurs-6,12-dien-28-oic acid (1), asiatic acid (2), 6β-hydroxy asiatic acid (3), terminolic acid (4), were isolated from the hydrolysis product. Conclusions: Compound 1, named centella-6-ene, was a new ursane-type aglycone and it showed no cytotoxic activities against the tested cancer cell lines.

A new cucurbitane triterpene in acid-treated ethanol extract from Momordica charantia / 中草药·英文版

Objective: To study the chemical constituents in the acid-hydrolyzed ethanol extract from Momordica charantia. Methods: The ethanol extract from M. charantia was hydrolyzed by 36% HCl and the hydrolysate was isolated by silica gel column chromatography and preparative HPLC. The structures of the isolated compounds were identified by spectral analyses, physical constants, and chemical evidences. Results: Two cucurbitane triterpenoids were isolated and identified as 5β,19-epoxy-cucurbita-6,22. E,24-trien-3β-ol (1) and cucurbita-6,22(E),24-trien-3β-ol-19,5β-olide (2). Conclusion: Compound 1 is a new compound. © 2013 Tianjin Press of Chinese Herbal Medicines.

Safety and feasibility of early oral feeding after gastrectomy: a meta-analysis / 中华胃肠外科杂志

<p><b>OBJECTIVE</b>To systematically evaluate the safety and feasibility of early oral feeding after gastric cancer surgery.</p><p><b>METHODS</b>Available literatures of Embase, PubMed, Journals@Ovid, Web of Science, Springerlink, Google Scholar, Wanfang, and CNKI published before October 2012 were searched. Inclusion criteria and quality assessment were performed.</p><p><b>RESULTS</b>Nine studies including 778 patients undergoing gastrectomy were enrolled. Among them, 381 started oral intake before the recovery of bowel function(early oral feeding group), and 397 received traditional feeding. Differences in overall complication(RR=0.88, 95%CI:0.68-1.16) and tolerance (RR=1.01, 95%CI:0.96-1.06) between the two groups were not statistically significant. Patients the in early oral feeding group had faster bowel function recovery (MD=-0.86, 95%CI:-1.20--0.51) and shorter hospital stay(MD=-2.40, 95%CI:-3.33--1.47).</p><p><b>CONCLUSION</b>Early oral feeding after gastrectomy is safe and feasible, and associated with faster recovery of bowel function and earlier discharge from hospital.</p>

Studies on flavonoids from Blumea riparia / 中国中药杂志

<p><b>OBJECTIVE</b>To separate and identify the chemical constituents of Blumea riparia.</p><p><b>METHOD</b>The compounds were separated and purified by repeated silica gel, Sephadex LH -20 column chromatographiy. The structures of these compounds isolated were identified by analysis of their spectral data, physical and chemical properties.</p><p><b>RESULT</b>Six flavonoids were isolated from B. riparia. and their structures were identified as eriodictyol-7, 4'-dimethyl ether (1), eriodictyol-7, 3'-dimethyl ether (2), eriodictyol-7-methyl ether (3), quercetin-7, 3', 4'-trimethyl ether (4), tamarixetin (5), rhamnocitrin (6).</p><p><b>CONCLUSION</b>Compound 1-6 were obtained from B. riparia for the first time.</p>