Clinicopathological patterns and survival outcomes of colorectal cancer among young adults in Malaysia: an institutional cohort study

INTRODUCTION@#This study aimed to investigate the clinicopathological patterns and survival outcomes of patients with young-onset colorectal cancer (CRC) in Malaysia.@*METHODS@#A total of 206 patients with young-onset CRC (age < 50 years at diagnosis) and 1,715 patients with late-onset CRC (age ≥ 50 years at diagnosis) diagnosed during 2002-2016 were included. The clinicopathological characteristics of patients with young-onset CRC were compared with those of patients with late-onset CRC during 2009-2013. Kaplan-Meier survival analysis was performed to determine the overall survival (OS) and disease-specific survival (DSS) in these patients.@*RESULTS@#The overall proportion of young-onset CRC was 10.7%. The mean age for young-onset CRC was 39.5 ± 7.4 years, with a male-to-female ratio of 1.2:1. There were more Malay patients with young-onset CRC than late-onset CRC (44.0% vs. 19.9%, p = 0.004). Most CRCs were diagnosed at an advanced stage in both groups. However, young-onset CRC showed more aggressive tumour characteristics, such as poorer differentiation and mucinous subtype. Despite such differences, the OS and DSS in both groups were similar (five-year OS for young-onset CRC vs. late-onset CRC: 44.2% vs. 49.0%, p = 0.40; five-year DSS for young-onset CRC vs. late-onset CRC: 48.8% vs. 57.6%, p = 0.53; mean survival of young-onset CRC vs. late-onset CRC: 4.9 years vs. 5.4 years, p = 0.15). Advanced stage at diagnosis and the treatment modality used were independent prognostic factors.@*CONCLUSION@#The unique ethnic and histological differences between patients with young- and late-onset CRC suggest that young-onset CRC may represent a distinct entity. However, despite such differences, both groups were equivalent.

A new bis-sesquiterpenoid from artemisia selengensis / 中草药

Objective To study the chemical constituents of Artemisia selengensis. Methods The compound was isolated by silica gel column chromatography and HPLC, and its structure was elucidated by spectral analyses. Results A new bis-sesquiterpenoid (1) was isolated and identified from A. selengensis. Conclusion Compound 1 is a new compound named selengsisnin A.

Effectiveness and Safety of PDE5 Inhibitors for Men with Erectile Dysfunction Caused by Spinal Cord Injury.

Aims: The objective of this review was to assess the effectiveness of phosphodiesterase type 5 (PDE5) inhibitors in men with erectile dysfunction (ED) and spinal cord injury (SCI). Methodology: The following databases were sought up to May 2015: PubMed, Google scholar, EMBASE and Cochrane Library. We performed a meta-analysis of all available randomised controlled trials. We used odds ratios (ORs) to assess the strength of the association, and 95% confidence intervals (CIs) gave a sense of the precision of the estimate. Statistical analyses were performed by Review Manager, version 5.0. Results: After searching and screening the relevant articles, ten studies were included and assessed the effectiveness of PDE5 inhibitors in men with erectile dysfunction and spinal cord injury. The pooled results showed that sildenafil significantly improved erection compared with placebo in ED patients with SCI (OR = 5.96, 95% CI [3.36–10.55], P ＜ 0.00001) and there was no statistical difference compared incomplete injury group with complete injury group (OR = 0.73, 95% CI [0.38–1.43], P=0.36). It is evident that compared upper motor neuron with lower motor neuron, there were better responsive rates in sildenafil(OR = 11.56, 95% CI [2.88–46.36], P=0.0006). Because of lacking studies and data, we could not perform meta-analysis for other PDE5 inhibitors. The commonly reported adverse effects (AEs) were headache, flushing, dizziness and urinary tract infection in these studies. No severe adverse events were found. Conclusion: Current evidence suggests that sildenafil is effective treatment for ED patients with SCI. In future, we need more high quality randomized controlled trials (RCTs) to confirm these findings and evaluate the effectiveness of other PDE5 inhibitors.

Cyclosporine, prednisone, and high-dose immunoglobulin treatment of angioimmunoblastic T-cell lymphoma refractory to prior CHOP or CHOP-like regimen / 癌症

Angioimmunoblastic T-cell lymphoma (AITL) is a rare, distinct subtype of peripheral T-cell lymphoma, possessing an aggressive course and poor prognosis with no standard therapy. Twelve patients who have failed at least two initial CHOP or CHOP-like regimens were enrolled in this study and treated with individualized cyclosporine (CsA), prednisone (PDN), and monthly, high-dose intravenous immunoglobulin (HDIVIG). The dose of CsA was adjusted individually based on the blood trough concentration of CsA and renal function. All patients were examined for response, toxicity and survival. The most significant toxicities (≥ grade 2) were infection (16.7%), renal insufficiency (8.3%), hypertension (8.3%), diabetes (8.3%) and insomnia (16.7%). Discontinuation of treatment occurred in one patient (8.3%) due to grade 3 renal toxicity and subsequent grade 4 pulmonary infection. Treatment-related death was not observed. The overall response rate was 75.0% (complete response, 33.3%; partial response, 41.7%). With a median follow-up of 25.5 months, the median duration of response was 20 months (range, 12 to 49 months) and the median progression-free survival (PFS) was 25.5 months (range, 10 to 56 months). The 2-year PFS rate was 81.5%. Our findings indicate the combination of CsA, PDN and HDIVIG is an effective salvage regimen for refractory or relapsed AITL with predictable and manageable toxicity.

Pharmacokinetics of a fusion protein for human acidic fibroblast growth factor and transcriptional activator protein in rat and its penetration across blood-brain barrier / 药学学报

This paper is to report the study of the pharmacokinetics of a fusion protein TAT-haFGF(14-154) for human acidic fibroblast growth factor and transcriptional activator protein in rat plasma, and the investigation of their penetration across blood-brain barrier in mice and rats, in order to provide a basis for clinical development and treatment of Alzheimer's disease. Enzyme-linked immunosorbent assay (ELISA) was used to determine concentration of TAT-haFGF(14-154) in rat plasma and in mouse brain homogenate; and immunohistochemistry was used to analyze the distribution in brain. The concentration-time curve fitted two-compartment open model which was linear kinetics elimination after a single intravenous injection of TAT-haFGF(14-154) in rat at the dose of 300 microg x kg(-1). The half life time was 0.049 +/- 0.03 h for distribution phase and 0.55 +/- 0.05 h for elimination phase, and the weight was 1/C2. The result showed that TAT-haFGF(14-154) could be detected in the brain by ELISA and immunohistochemistry, the elimination of TAT-haFGF(14-154) in rat was swift, and TAT-haFGF(14-154) could penetrate across the blood-brain barrier, distribute in pallium and hippocampus and locate in the nucleus.

Impact of fluorine poisoning on sperm motility of male rats / 中国地方病学杂志

Objective To probe into the impact on sperm motility in male rat induced by fluorine poisoning, and provide experimental basis to further research for reproductive toxicity of fluoride. Methods According to bodyweight, 32 male Wistar rats were randomly divided into control group, the low-dose, medium-dose and high-dose group( 100,200,300 mg·kg~(-1)·d~(-1) NaF), and were treated by intragastric administration for 90 days, and the weight of the rats was observed each day. After the last intragastric administration, all rats were killed. The relative weight of liver, kidney and testis was calculated. Rat epididymides were plucked off and spermatozoa released from it. Sperm motility parameters were measured by WLJY-9000 color-detection system of sperm quality. Results Compared with high-dose group[(206.00 ± 18.16)g], the weight of low-dose and medium-dose group [ (235.00 ± 14.56), (235.44 ± 24.99)g] in 30 days were statistically significant increased(all P < 0.05) ; there were no significant differences between the groups in 60 days and in 90 days(F = 0.578,1.893, all P > 0.05). Comparison of organ coefficient of liver, kidney and testis among three groups showed no significant difference(F = 2.148,0.907, 1.801, all P > 0.05). The average path velocity(VAP) of the high-dose group[ (25.04 ± 4.59)μm/s] showed significant increase compared with control group[ (20.22 ± 3.29)μm/s] ; the straight line velocity(VSL) of the low- dose, medium-dose and high-dose group[ (18.82± 3.19), (17.84 ± 4.54), (16.46 ± 2.63)μm/s] showed significant increase compared with control group[ ( 12.48 ± 1.73 ) μm/s ] ; linearity (LIN) of the low-dese, medium-dose and high.dose group[(23.84±1.58)%,(24.99±3.37)%,(26.75±5.07)%]showed significant decrease compared with control group[(33.29±4.00)%];wobble(WOB)of the medium-dose and high-dose group[(47.03±3.98)%,(4921±723)%]showed significant increase compared with control group[(38.09±0.48)%];mean angular deviation (MAD)of the low-dose group[(68.29±5.71)radian/s]showed significant decrease compared with control group [(81.57±8.44)radian/s];beat cross frequency(BCF)ofthe high-dose group[(117±0.61)/s]showed significant increase compared with control group[(9.49±0.34)/s];sperm density(p)of the low-dose and medium-dose group [(1.26±0.24)×10~9/L,(1.84±0.50)×10~9/L]showed significant decrease compared with control group [(3.94±1.10)×10~9/L,all P<0.05].Comparison of the eurvilinearvelocity(VCL),straightness(STR),amplitude of lateral head displacement(ALH)among three groups showed no significant difference(F=0.264,2.209,1.667, all P>0.05).Conclusion Fluorine poisoning could change sperm motility parameters of the rat,reduce the sperm density and cau8e damage to the reproductive system.

Cardiac enzymes related to high-altitude hypoxic adaptation in Tibetan chicken / 中国应用生理学杂志

<p><b>AIM</b>The purpose of this experiment was to investigate the cardiac physiological characteristics for adaptation to high-altitude hypoxia in chickens.</p><p><b>METHODS</b>Tibetan, Dwarf Recessive White and Shouguang chickens were fed at low-and high-altitude, and measurements were made in heart weights, lactic acid (LA), lactate dehydrogenase (LDH), and succinate dehydrogenase (SDH) at the age of 10 weeks.</p><p><b>RESULTS</b>The results showed that Tibetan chickens at high-altitude had lower heart weight and LA content, and similar LDH activity, and higher SDH activity when compared to Dwarf Recessive White and Shouguang chickens.</p><p><b>CONCLUSION</b>It was concluded that the cardiac mechanisms of high-altitude hypoxic adaptation in Tibetan chickens were increasing neither heart weight, nor level of anaerobic metabolism, but the higher SDH activity was significant to the adaptation. The SDH was a symbol enzyme for hypoxic adaptation in Tibetan chicken.</p>

Predictive value of umbilical cord blood bilirubin level for subsequent neonatal jaundice / 中华儿科杂志

<p><b>OBJECTIVE</b>To investigate the predictive value of umbilical cord serum (UCS) bilirubin for subsequent jaundice in healthy term newborns.</p><p><b>METHODS</b>Five hundred and twenty-three healthy term newborns (275 boys, 248 girls) were selected. The cord blood total serum bilirubin concentration and the serum albumin concentration were determined. All the infants were assessed for jaundice daily by measurement of transcutaneous bilirubin (TCB). When the infant's TCB was >or= 18 within the first 24 h after birth, >or= 21 at 48 h, >or= 25 at or after 72 h, the venous total serum bilirubin (TSB) was determined and treatment against jaundice was applied as needed. The infants were aligned into four groups according to their UCS bilirubin levels, starting from < 30 micromol/L(group 1); >or= 30 micromol/L(group 2); >or= 36 micromol/L(group 3); >or= 42 micromol/L(group 4). The frequency of hyperbilirubinemia and phototherapy (PT) were compared among the four groups. An analysis of UCS bilirubin as a predictor of later development of jaundice was performed. The characteristics of the infants who became jaundiced (jaundiced group) were compared with the normal infants (non-jaundiced group).</p><p><b>RESULTS</b>A clear correlation between UCS bilirubin level and the development of hyperbilirubinemia was found in all populations of the four groups. Only eight of the 194 infants in group 1 showed a TCB index >or= 25. TSB values > 205 micromol/L but < 257 micromol/L were observed in 2 newborns. None of the infants in this group showed TSB > 257 micromol/L or needed PT. Thirty-two infants in group 2 showed TCB >or= 25, 12 infants had TSB > 205 micromol/L but < 257 micromol/L, 2 infants had TSB > 205 micromol/L and received PT. In group 3, one infant developed hyperbilirubinemia at 48 h after birth and received PT. Thirty-nine infants showed TCB >or= 25, 16 infants TSB > 205 micromol/L but < 257 micromol/L, 2 infants had TSB > 205 micromol/L and also received PT. In group 4, 4 infants showed a range of TSB from 200 to 215 micromol/L at 48 h and received PT. Twenty-two infants showed TCB >or= 25, 17 of them showed TSB > 205 micromol/L but < 257 micromol/L, and 5 of them had TSB > 205 micromol/L and received PT. The frequency of TSB > 205 micromol/L increased from 1.03% in group 1, 5.77% in group 2, 19.75% in group 3 and to 42.5% in group 4. None of the 194 newborns in group 1 needed phototherapy, whereas 0.96%, 3.70% and 22.5% of the newborns in groups 2 - 4, needed PT. The frequency of patients with hyperbilirubinemia or phototherapy increased with increasing UCS bilirubin levels. For the prediction of TCB >or= 25 using a UCS bilirubin cut-off level, such as >or= 35 micromol/L, we found a positive predictive value of 45.68% and sensitivity of 68.27%. It is significant to predict neonatal jaundice by UCS bilirubin levels (P < 0.001). In the jaundiced group (TCB >or= 25) UCS bilirubin levels were significantly higher than those in the non-jaundiced group (t = 10.96, P < 0.001). No significant differences were found in the cord blood serum albumin concentration (t = 2.38, P > 0.05), the gestational age (t = -0.90, P > 0.05), and birthweight (t = 0.10, P > 0.05) between the jaundiced and non-jaundiced groups.</p><p><b>CONCLUSIONS</b>UCS bilirubin level is useful in predicting the subsequent jaundice in healthy term infants. The use of UCS bilirubin values may help detect infants at low or high risk for hyperbilirubinemia and minimize an unnecessary prolongation of hospitalization.</p>