A highly selective C-rhamnosyltransferase from Viola tricolor and insights into its mechanisms

C-Glycosides are important natural products with various bioactivities. In plant biosynthetic pathways, the C-glycosylation step is usually catalyzed by C-glycosyltransferases (CGTs), and most of them prefer to accept uridine 5'-diphosphate glucose (UDP-Glc) as sugar donor. No CGTs favoring UDP-rhamnose (UDP-Rha) as sugar donor has been reported, thus far. Herein, we report the first selective C-rhamnosyltransferase VtCGTc from the medicinal plant Viola tricolor. VtCGTc could efficiently catalyze C-rhamnosylation of 2-hydroxynaringenin 3-C-glucoside, and exhibited high selectivity towards UDP-Rha. Mechanisms for the sugar donor selectivity of VtCGTc were investigated by molecular dynamics (MD) simulations and molecular mechanics with generalized Born and surface area solvation (MM/GBSA) binding free energy calculations. Val144 played a vital role in recognizing UDP-Rha, and the V144T mutant could efficiently utilize UDP-Glc. This work provides a new and efficient approach to prepare flavonoid C-rhamnosides such as violanthin and iso-violanthin.

Retropharyngeal lymph node dissection in head and neck cancers treated with transoral robotic surgery / 中华肿瘤杂志

Objective: To evaluate the indications, safety, feasibility, and surgical technique for patients with head and neck cancers undergoing transoral robotic retropharyngeal lymph node (RPLN) dissection. Methods: The current study enrolled 12 consecutive head and neck cancer patients (seven males and four females) who underwent transoral robotic RPLN dissection with the da Vinci surgical robotic system at the Sun Yat-sen University Cancer Center from May 2019 to July 2020. Seven patients were diagnosed as nasopharyngeal carcinoma with RPLN metastasis after initial treatments, 4 patients were diagnosed as thyroid carcinoma with RPLN metastasis after initial treatments, and one patient was diagnosed as oropharyngeal carcinoma with RPLN metastasis before initial treatments. The operation procedure and duration time, intraoperative blood loss volume and complications, nasogastric feeding tube dependence, tracheostomy dependence, postoperative complications, and hospitalization time were recorded and analyzed. Results: All patients were successfully treated by transoral robotic dissection of the metastatic RPLNs, none of which was converted to open surgery. RPLNs were completely resected in 10 patients, and partly resected in 2 patients (both were nasopharyngeal carcinoma patients). The mean number of RPLN dissected was 1.7. The operation duration time and intraoperative blood loss volume were (191.3±101.1) min and (150.0±86.6) ml, respectively. There was no severe intraoperative complication such as massive haemorrhage or adjacent organ injury during surgery. Nasogastric tube use was required in all patients with (17.1±10.6) days of dependence, while tracheotomy was performed in 8 patients with (11.6±10.7) days of dependence. The postoperative hospitalization stay was (8.5±5.7) days. Postoperative complications occurred in 4 patients, including 2 of retropharyngeal incision and 2 of dysphagia. During a follow-up of (6.5±5.1) months, disease-free progression was observed in all patients, 10 patients were disease-free survival and other 2 patients were survival with tumor burden. Conclusions: The transoral robotic RPLN dissection is safety and feasible. Compared with the traditional open surgical approach, it is less traumatic and safer, has fewer complications and good clinical application potentiality. The indications for transoral robotic RPLN dissection include thyroid carcinoma, oropharyngeal carcinoma, and some selected nasopharyngeal carcinoma and other head and neck cancers. Metastatic RPLNs from some nasopharyngeal carcinoma with incomplete capsule, unclear border and adhesion to the surrounding vessels are not suitable for transoral robotic RPLN dissection.

Reducing the consumption of personal protective equipment by setting up a multifunctional sampling station in the emergency department to screen for COVID-19 infection in Taiwan

In Taiwan, high-risk patients have been identified and tested for preventing community spread of COVID-19. Most sample collection was performed in emergency departments (EDs). Traditional sample collection requires substantial personal protective equipment (PPE), healthcare professionals, sanitation workers, and isolation space. To solve this problem, we established a multifunctional sample collection station (MSCS) for COVID-19 testing in front of our ED. The station is composed of a thick and clear acrylic board (2 cm), which completely separates the patient and medical personnel. Three pairs of gloves (length, 45 cm) are attached and fixed on the outside wall of the MSCS. The gloves are used to conduct sampling of throat/nasal swabs, sputum, and blood from patients. The gap between the board and the building is only 0.2 cm (sealed with silicone sealant). ED personnel communicate with patients using a small two-way broadcast system. Medical waste is put in specific trashcans installed in the table outside the MSCS. With full physical protection, the personnel conducting the sampling procedure need to wear only their N95 mask and gloves. After we activated the station, our PPE, sampling time, and sanitization resources were considerably conserved during the 4-week observation period. The MSCS obviously saved time and PPE. It elevated the efficiency and capacity of the ED for handling potential community infections of COVID-19.

Potential Mechanism of Jiaotaiwan for Diabetes Based on Integrative Pharmacology Method / 中国实验方剂学杂志

Objective: Jiaotaiwan is a classic prescription in traditional Chinese medicine for insomnia. Modern clinical research has proved its anti-diabetes effect by "the same treatment for different diseases" theory, so it is necessary to study its pharmacological mechanism for anti-diabetes effect. Method: In this study, the integrative pharmacology platform of traditional Chinese medicine (TCMIP) was used to explore the potential target and mechanism of Jiaotaiwan, and construct its core target network for diabetes. Then the enrich analysis of GO and KEGG on key targets was conducted to build the visual multilayer association network of "Jiaotaiwan-active composition-core target-key pathway". Result:28 active ingredients were obtained from Jiaotaiwan in this study. Its anti-diabetes effect was relevant to 187 core targets,including 15 known disease targets such as vasopressin V2 receptor (AVPR2), receptor activity-modifying protein 1 (RAMP1), receptor activity-modifying protein 3 (RAMP3), insulin receptor (INSR), and insulin-like growth factor 1 receptor (IGF1R); as well as 71 predictive drug targets such as cyclin-dependent kinase 9 (CDK9), glucokinase (GCK), NF-kappa-B inhibitor alpha (NFKBIA), NF-kappa-B p100 subunit (NFKB2), and hypoxia inducible factor-1 alpha (HIF1A). Conclusion:The anti-diabetes mechanism of Jiaotaiwan may be associated with activation of adenylate cyclase activity, cellular response to glucagon stimulus, activation of mitogen-activated protein kinase (MAPK) activity, endocrine system, gonadotropin-releasing hormone (GnRH) signaling pathway, Chemokine signaling pathway, phosphatidylinositol 3-kinase-serine/threonine kinases (PI3K-Akt) signaling pathway and other related biological processes and pathways. This study provides a scientific evidence for further study of the anti-diabetes mechanism of Jiaotaiwan.

Anti-Melanogenic Effect from Submerged Mycelial Cultures of Ganoderma weberianum

Compounds from Lingzhi has been demonstrated the ability for inhibiting tyrosinase (a key enzyme in melanogenesis) activity. In this study, we investigated the anti-melanogenic activity from the submerged mycelial culture of Ganoderma weberianum and elucidated the skin lightening mechanism by B16-F10 murine melanoma cells. From the cellular context, several fractionated mycelium samples exhibited anti-melanogenic activity by reducing more than 40% extracellular melanin content of B16-F10 melanoma cells. In particular, the fractionated chloroform extract (CF-F3) inhibited both secreted and intracellular melanin with the lowest dosage (25 ppm). Further analysis demonstrated that CF-F3 inhibited cellular tyrosinase activity without altering its protein expression. Taken together, our study has demonstrated that the chemical extracts from submerged mycelial culture of G. weberianum have the potential to serve as an alternative anti-melanogenic agent.

Optimization of Water Extraction Technology of Total Polysaccharide of Shuanghu Capsules by Orthogonal Design / 中国药房

OBJECTIVE： To optimize the water extraction technology of total polysaccharide of Shuanghu capsules. METHODS： The total alkaloid was firstly extracted from Dendrobium nobile and Dendrobium officinale mixture of Shuanghu capsules with ethanol， and then total polysaccharide was extracted with water. Using glucose as control， total polysaccharide was treated with phenol-sulfuric acid method and its content was determined at 488 nm. Using comprehensive score calculated with the yield of the extract and the content of total polysaccharide as index， the effects of material-liquid ratio， extraction temperature， extraction time and times on the extraction were investigated by single factor test. Then L9（34） orthogonal test was used to optimize solid-liquid ratio，extraction temperature，extraction time and extraction times according to the results of single factor test. The optimized technology was validated. RESULTS： The linear range of glucose were 0.041 4-0.207 0 mg/mL（r＝0.999 9）. RSDs of intra-day and inter-day ranged 3.61％-8.24％ （n＝3，n＝5）， and RSD of repeatability test was 1.49％ （n＝6）. Average recovery rate was 98.65％（RSD＝1.45％，n＝6）. The optimal water extraction technology included solid-liquid ratio of 1 ∶ 25（g/mL），extraction temperature of 100 ℃，extracting for 90 min， extracting once. Results of validation tests showed that average content of total polysaccharide was 379.292 8 mg/g （RSD＝1.93％，n＝3） and average yield of the extract was 22.75％（RSD＝2.41％，n＝3）. CONCLUSIONS： Established phenol-sulphuric acid method is simple， precise and accurate. The optimal water extraction technology is stable and feasible， which can be used for the extraction of total polysaccharides from Shuanghu capsules.

Optimization of the Ethanol Extraction Technology of Total Alkaloids from Shuanghu Capsules by Orthogonal Design / 中国药房

OBJECTIVE： To optimize the ethanol extraction technology of total alkaloids from Shuanghu capsules. METHODS： Using dendrobine as control， the contents of total alkaloids from Dendrobium nobile and Dendrobium officinale in Shuanghu capsules were determined by acidic dyes colorimetry. Using comprehensive scores calculated by the yield of the extract and the contents of total alkaloids as evaluation indexes， the effects of soaking time， ethanol volume fraction， extraction time， solid-liquid ratio and extraction times were investigated with single factor tests. L9（34） orthogonal test was used to optimize ethanol volume fraction， extraction time， solid-liquid ratio and extraction times according to the results of single factor test. The optimized technology was validated. RESULTS： The linear range of dendrobine were 4.16-14.56 μg/mL （r＝0.999 2）. RSDs of repeatability and precision tests were all lower than 5％. Average recovery tests were 93.01％ （RSD＝1.97％， n＝6）. The optimal ethanol extraction technology included soaking for 12 h， ethanol volume fraction of 70％， solid-liquid ratio of 1 ∶ 12 （g/mL）， extracting for 28 min， extracting 3 times. Results of validation test showed that the average yield of extract was 12.80％ （RSD＝4.39％， n＝3）， and the content of alkaloids was 0.359 0 mg/g（RSD＝0.66％， n＝3）. CONCLUSIONS： Established acidic dyes colorimetry is simple， precise and accurate， which can be used for the content determination of total alkaloids. The optimized ethanol extraction technology is stable and feasible， and can be used for the extraction of total alkaloids from Shuanghu capsules.

Exclusively Endoscopic Resection of Nasopharyngeal Adenocarcinoma

We reported two patients with nasopharyngeal adenocarcinoma resected by using the exclusively endoscopic approach. Case reports and a review of the world literature concerning nasopharyngeal adenocarcinoma. The tumors were resected successfully via the exclusively endoscopic approach and no conversions to the conventional approach were necessary. The two patients were followed up for 26 and 18 months respectively, and no recurrence was noted without postoperative chemotherapy or radiotherapy. To the best of our knowledge, this is the first report of endoscopic resection of nasopharyngeal adenocarcinoma. Our experience revealed that not only for the early recurrent nasopharyngeal carcinoma, the exclusively endoscopic nasopharyngectomy can be expanded for the resection of selected nasopharyngeal adenocarcinoma.

Laryngeal reconstruction by complex hyoid bone flap after frontal partial laryngectomy / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>The aim of this study was to describe a new technique of combined hyoid bone and thyrohyoid membrane flap in laryngeal reconstruction after tumor resection, and to evaluate outcome.</p><p><b>METHODS</b>Six patients requiring an frontal partial laryngectomy for cancer were enrolled between September 2008 and August 2012.</p><p><b>RESULTS</b>Nasogastric feeding was initiated within 24 hours. The mean times to swallow batter, ability to drink water and removal of the nasogastric tube were 2.6, 5.5 and 6.3 days. All patients had good respiratory function. There were no deaths, and no reports of postoperative dyspnea or dysphagia. The vocal quality was satisfactory, slightly deeper and raspy, and the volume was weak when calling. The final follow-up assessment was in August 2012, and the overall mean follow-up period was 29.5months, range 14 to 47 months. Case two subsequently underwent total laryngectomy for recurrence in the paraglottic space, but there was no evidence of further tumor recurrence at the final assessment.</p><p><b>CONCLUSIONS</b>The combined muscle-pedicle hyoid bone and thyrohyoid membrane flap is a reliable graft for one-stage repair of laryngotracheal defects, providing effective repair of the mucosa and cartilage support. Vocal quality, swallowing function and ventilation after the procedure were favorable.</p>

Treatment results and prognostic factors of patients undergoing postoperative radiotherapy for laryngeal squamous cell carcinoma / 癌症

Postoperative radiotherapy (PRT) is widely advocated for patients with squamous cell carcinomas of the head and neck that are considered to be at high risk of recurrence after surgical resection. The aims of this study were to evaluate the treatment outcomes of PRT for patients with laryngeal carcinoma and to identify the value of several prognostic factors. We reviewed the records of 256 patients treated for laryngeal squamous cell carcinoma between January 1993 and December 2005. Disease-free survival (DFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Log-rank test was employed to identify significant prognostic factors for DFS and OS. The Cox proportional hazards model was applied to identify covariates significantly associated with the aforementioned endpoints. Our results showed the 3-, 5-, and 10-year DFS for all patients were 69.9%, 59.5%, and 34.9%, respectively. The 3-, 5-, and 10-year OS rates were 80.8%, 68.6%, and 38.8%, respectively. Significant prognostic factors for both DFS and OS on univariate analysis were grade, primary site, T stage, N stage, overall stage, lymph node metastasis, overall treatment times of radiation, the interval between surgery and radiotherapy, and radiotherapy equipment. Favorable prognostic factors for both DFS and OS on multivariate analysis were lower overall stage, no cervical lymph node metastasis, and using 60Co as radiotherapy equipment. In conclusion, our data suggest that lower overall stage, no cervical lymph node metastasis, and using 60Co as radiotherapy equipment are favorable prognostic factors for DFS and OS and that reducing the overall treatment times of radiation to 6 weeks or less and the interval between surgery and radiotherapy to less than 3 weeks are simple measures to remarkably improve treatment outcome.

Relationship between high-sensitive c-reactive and blood pressure / 中华心血管病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between c-reactive protein (CRP) and blood pressure in a general population.</p><p><b>METHODS</b>We randomly selected 3889 subjects aged 18 - 74 years stratified by gender and age in Baqiao, a rural area of Jiangsu Province. A standardized questionnaire was used to collect information on medical history, smoking, alcohol intake and use of medications. Blood pressure was measured by mercury sphygmomanometer. Serum CRP (hCRP) concentration was measured using a high sensitivity BNprosec immunonephelometric assay. Subjects were divided into 4 groups according to their interquartile range of CRP levers: group Q1 (men hCRP < 2.04 mg/L; women hCRP < 1.80 mg/L); group Q2 (men 2.04 mg/L ≤ hCRP < 3.01 mg/L; women 1.80 mg/L ≤ hCRP < 2.76 mg/L); group Q3 (men 3.01 mg/L ≤ hCRP < 4.14 mg/L; women 2.76 mg/L ≤ hCRP < 3.84 mg/L); and group Q4 (men 4.14 mg/L ≤ hCRP; women 3.84 mg/L ≤ hCRP).</p><p><b>RESULTS</b>Systolic blood pressure (SBP, adjusted P = 0.016) and pulse pressure (PP, adjusted P = 0.003) of men and PP (adjusted P = 0.002) of women were increased in proportion to increased CRP levels. Diastolic blood pressure was not associated with CRP levels. Multiple stepwise regression analysis showed that logCRP was independently associated with SBP and PP in men and PP in women. hCRP was independently associated with hypertension in men. Compared with group Q1, male people in group Q4 faced a 40.4% (95% confidence interval: 4.9% - 87.9%) higher risk of hypertension.</p><p><b>CONCLUSIONS</b>hCRP was independently associated with PP in men and women, and SBP in men. hCRP was independently associated with hypertension in men but not in women in this study population.</p>

Roles of single photo emission computed tomography-CT in detecting residual tumor from patients with thyroid carcinoma / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>As newly, functional, diagnostic measure-18F-deoxyglucose single photo emission computed tomography (18F-FDG SPECT-CT) has well sensitivity and specialty , it was proved availability in differentiating benign and malignant tumor. In this study, it was compared the efficiency of detecting residual tumor of thyroid cancer between 18F-FDG SPECT-CT and CT-TWIN.</p><p><b>METHODS</b>During May 2004 to August 2004, 56 patients with thyroid disease were divided into two groups, one group was 32 cases suffered thyroid tumor, another was 24 cases suffered improper operation. All cases must take 18F-FDG SPECT-CT and CT-TWIN.</p><p><b>RESULTS</b>Forty eight cases had been performed operation, and 8 cases waited and watched because they didn't be found residual tumor by 18F-FDG SPECT-CT and CT-TWIN. The results in detecting thyroid tumor showed that the same rate of diagnostic correction of SPECT-CT was 87.5% (28/32), and the Youden index of SPECT-CT was 0.667, higher than that of CT which was 87.5% (28/32) and 0.633 respectively. When the results two methods were accordant, the rate of diagnostic correction was 100% (24/24), and Youden index was 1, and the result had statistic signification. The rate of diagnostic correction of SPECT-CT in detecting residual tumor was 84.6%, and its Youden index was 0.675. The rate of diagnostic correction of CT in detecting residual tumor was 75.0%, and its Youden index was 0.492; and the result had statistics signification by being compared two different measures.</p><p><b>CONCLUSIONS</b>SPECT-CT and CT all had higher diagnostic efficacy, and they could promote the diagnostic efficacy when they have the same diagnosis in detecting thyroid tumor. The rate of detecting residual tumor of SPECT-CT was 81.3%, compared with that of CT the diagnostic efficacy has greater raise.</p>

Pathological character and treatment of epithelial-myoepithelial carcinoma of salivary gland / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>To review and evaluate pathologic features and treatment of epithelial-myoepithelial.</p><p><b>METHODS</b>Retrospectively reviewed 14 cases' pathological and clinical materials of epithelial-myoepithelial carcinoma of salivary gland. Eight cases origine from parotid gland, 2 cases from hard palate, 3 cases from submandibular gland and 1 case from nasal cavity. Three cases were performed induction chemotherapy preoperation. One case had palliative radiotherapy. Thirteen cases were performed radical surgery and 6 cases had radiotherapy postoperation.</p><p><b>RESULTS</b>Tumor arisen mostly from parotid gland and neck lymph node metastasis rate was 14.28% (2/14). The survival rate was calculated with Kaplan-Meier method. The overall 3-, 5- and 10-year survival rate were 67.20%, 45.49% and 17.06%. Its histological characteristics were inner layer composed by adenoid cells and outer layer composed by myoepithelial cells. Immunohistochemical exam show cytokeratin, S-100 and actin reaction positive.</p><p><b>CONCLUSIONS</b>Epithelial-myoepithelial carcinoma easily develops recurrence. It is sensitivity to radiotherapy and chemotherapy to some extent. It is suitable to adopt surgical treatment as primary modality combined with other therapies.</p>

Management option for cervical metastases in tongue squamous cell carcinoma with clinically N0 neck / 中华耳鼻咽喉头颈外科杂志

<p><b>OBJECTIVE</b>This study was designed to explore the optimal management option for cervical metastases in tongue squamous cell carcinoma (SCC) with clinically N0 neck in order to avoid excessive or inadequate treatment in clinical practice.</p><p><b>METHODS</b>Clinical data of 327 cases of tongue SCC with cN0 neck were retrospectively analyzed. Neck control rates affected by different pathoclinical parameters were compared. Prognosis analysis and death analysis were also performed.</p><p><b>RESULTS</b>Overall 3-year survival was 69.7% (228/327), 3-year survival of neck recurrent group and non-recurrent group was 39.1% (25/64) and 77.2% (203/263), and 51.5% (51/99) of the death related to neck failure. Overall neck control rate was 80.4% (263/327); neck control rate of wait and watch group, level I neck dissection, level I + II neck dissection, supraomohyoid neck dissection, radical neck dissection, functional neck dissection, was 67.5% (27/40), 72.7% (24/33), 60.0% (15/25), 84.9% (45/55), 86.8% (131/151), 84.0% (21/25), respectively. Treatment modality and cervical lymph node involvement were independent factors for neck control.</p><p><b>CONCLUSIONS</b>Neck control is a key for prognosis of tongue SCC with cN0 neck. Supraomohyoid neck dissection is the first choice in management of cervical metastases in tongue SCC with cN0 neck, during which the suspected involved lymph nodes should be sent for frozen section to determine whether comprehensive neck dissection required. Multimodal metastasis and/or capsular spread are the indications for postoperative irradiation.</p>

Study on the seropositive prevalence of human immunodeficiency virus in a village residents living in rural region of central China / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the human immunodeficiency virus (HIV) prevalence of residents living in a village located in rural region of central China where the paid blood donors used to be popular.</p><p><b>METHODS</b>All residents of one village "ZY" were asked to participate in HIV serologic screening test. Those over the age of 16 and participated in HIV serologic test was followed to undergo an indoor interview a week later, to finish a questionnaire, which including information on demography, marital status, smoking and drinking habits, history of blood donation, sexual behavior and history of drug use. Names on those either died from AIDS or having HIV serologic testing before were collected from local hospitals and the Center of Disease Control and Prevention.</p><p><b>RESULTS</b>There were in total 2364 residents in 527 households in "ZY" village including 1551 residents participated in the HIV serologic screening test, and 926 completed questionnaires. A total of 115 HIV seropositive residents were found in the HIV screening. 5 had been undergone HIV screening tests before, and 24 died of AIDS. The HIV prevalence of the whole population was 9.1% (CI: 7.7% - 10.6%). There were 19.6% households had at least one member living with HIV, out of which 25% had over two HIV seropositive members. No significant difference was found between genders with respect to HIV prevalence. 40 - 50 years old group had the highest HIV prevalence, significantly differed from other age groups. The HIV prevalence among former paid blood donors was 22.4%. The proportions of getting HIV infection through routes of blood transfusion, sex and mother-to-child, were 0.9%, 9.6% and 5.2% respectively among 115 HIV seropositive residents.</p><p><b>CONCLUSION</b>Some villages in the rural regions of central China showed high HIV prevalence. Former paid blood donation was responsible for the main transmission route in these villages. However, sexual transmission and mother-to-child transmission were becoming dominant routes in general population which called for effective action be taken to contain the spread of HIV.</p>

Treatment of second primary malignant tumor induced by radiotherapy / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study the diagnosis and treatment of a second primary malignant tumor induced by previous radiotherapy.</p><p><b>METHODS</b>From March 1970 to March 1997, 108 nasopharyngeal cancer (NPC) patients who developed a second primary malignant tumor induced by radiotherapy were treated. There were squamous carcinoma 43 (39.8%), sarcoma 26 (24.1%), malignant fibrous histiocytoma 14 (13.0%), adenoid cystic carcinoma 12 (11.1%), thyroid papillary adenocarcinoma 8 (7.4%) and malignant melanoma 5 (4.6%). Fifty patients underwent operation, 32 received radiotherapy, 18 received chemotherapy and 8 received operation combined with chemotherapy.</p><p><b>RESULTS</b>The 3- and 5-year tumor-free survival rates were 64.0% and 36.0% in the operation group. They were 34.4% and 18.8% in the radiotherapy group.</p><p><b>CONCLUSION</b>Surgery, if not contra-indicated, is the first choice for the second primary malignant tumor induced by radiotherapy. Aggressive treatment for these patients is, hence, indicated clinically.</p>