Concurrent chemoradiotherapy using gemcitabine and nedaplatin in recurrent or locally advanced head and neck squamous cell carcinoma.

BACKGROUND: Patients with recurrent or locally advanced head and neck squamous cell carcinoma (HNSCC) typically have limited treatment options and poor prognosis. AIM: To evaluate the efficacy and safety of two drugs with potent radio-sensitization properties including gemcitabine and nedaplatin as concurrent chemoradiotherapy regimens in treating HNSCC. METHODS: This single-arm prospective study enrolled patients with HNSCC to receive gemcitabine on days 1 and 8 and nedaplatin on days 1 to 3 for 21 days. Intensity-modulated radiation therapy with a conventional fraction was delivered 5 days per week. Objective response rate (ORR), disease control rate, and toxicity were observed as primary endpoints. Overall survival (OS) and progression free survival were recorded and analyzed as secondary endpoints. RESULTS: A total of 24 patients with HNSCC were enrolled. During the median 22.4-mo follow-up, both ORR and disease control rate were 100%. The one-year OS was 75%, and one-year progression-free survival (PFS) was 66.7% (median PFS was 15.1 mo). Recurrent HNSCC patients had a poorer prognosis than the treatment-naïve patients, and patients who achieved complete response had better survival than those in the PR group (all P < 0.05). The most common grade 1-4 (100%) or grade 3-4 toxicities (75%) were hematological, and the most common grade 3-4 non-hematological toxicity was mucositis in 17 (71%) patients. CONCLUSION: Gemcitabine plus nedaplatin with concurrent chemoradiotherapy is a therapeutic option for HNSCC with predictable tolerability. Considering the high adverse event rate, the optimized dose and schedule must be further explored.

[Clinical observation on wheat grain moxibustion for chronic superficial gastritis of spleen-stomach deficiency and cold].

OBJECTIVE: To compare the clinical effect of wheat grain moxibustion and warming acupuncture on chronic superficial gastritis of spleen-stomach deficiency and cold. METHODS: A total of 200 patients with chronic superficial gastritis of spleen-stomach deficiency and cold were randomly divided into a wheat grain moxibustion group (100 cases, 13 cases dropped off ) and a warming acupuncture group (100 cases, 16 cases dropped off ). The acupoints of Zhongwan (CV 12), Tianshu (ST 25), Qihai (CV 6), Liangqiu (ST 34) and Zusanli (ST 36) were selected in both groups. The patients in the wheat grain moxibustion group were treated with wheat grain moxibustion, and 5 cone were given on every acupoint each time. Moxibustion was performed after acupuncture in the warming acupuncture group, and 3 cone each acupoint. Both groups were treated every other day for 15 times. The scores of clinical symptoms and signs, scores of physical component summary (PCS) and mental component summary (MCS) of quality of life in the two groups were recorded before and after treatment and during follow-up 1 month after treatment, and the clinical effects of the two groups were evaluated after treatment and during follow-up. RESULTS: After treatment and during follow-up, the scores of clinical symptoms and signs of the two groups were lower than before treatment (P<0.05), and the scores of PCS and MCS of quality of life were higher than before treatment (P<0.05). At follow-up, the score of clinical symptoms and signs in the wheat grain moxibustion group was lower than that in the warming acupuncture group (P<0.01), and the scores of PCS and MCS of quality of life were higher than those in the warming acupuncture group (P<0.001). The total effective rate of the wheat grain moxibustion group was 93.1% (81/87), which was higher than 82.1% (69/84) of the warming acupuncture group at follow-up (P<0.001). CONCLUSION: The wheat grain moxibustion can effectively improve the clinical symptoms, signs and quality of life in patients with chronic superficial gastritis of spleen-stomach deficiency and cold, and its long-term effect is better than warming acupuncture.

A new indole-type alkaloid from the roots of Clematis florida var. plena.

One new indole-type alkaloid, α-L-rhamnopyranosyl-(1→6)-ß-D- glucopyranosyl 6-methoxy-3-indolecarbonate (1), together with three known alkaloids (2-4), one aromatic acid (5) and five known saponins (6-10), was isolated from the roots of Clematis florida var. plena. Their structures were established by NMR spectroscopic analysis and acid hydrolysis. In in vivo anti-inflammatory activity, n-butanol extract was found to be potent against ear edema in mice, with inhibition rate of 48.7% at a dose of 800 mg/kg. Furthermore, compounds 8 and 9 obtained from the n-butanol extract exhibited significant anti-inflammatory activities with inhibition rates of 50.9% and 54.7% at a dose of 200 mg/kg.

Identification of Herb Pairs in Esophageal Cancer.

BACKGROUND: Chinese herbal medicine (CHM) is used widely to treat various diseases, including cancer. However, effective herb pairs for treating specific cancer types have so far not been identified. Here, we aimed to calculate the survival benefits of herb pairs by cluster analysis, association rules, and survival evaluation in patients with esophageal cancer (EC) treated with CHM. PATIENTS AND METHODS: 59 patients with EC who received 176 prescriptions including 178 types of herbs were enrolled into the study. The herb pairs were identified by both cluster analysis and association rules. Overall survival (OS) was estimated by the Kaplan-Meier method. RESULTS: Eight groups of herb pairs were identified by cluster analysis, and 4 groups of herb pairs were identified by association rules. Of these, 3 groups of herb pairs were identified by both methods. OS estimation showed that the pair of chicken gizzard-membrane/Astragalus was associated with improved survival in patients with EC treated with CHM. CONCLUSION: Patients who received prescriptions containing the pair of chicken gizzard-membrane and Astragalus had improved OS compared with patients who received prescriptions lacking this pair.

[Expression and significance of P57(kip2) and Maspin in pathological scar].

OBJECTIVE: To study the expression of P57(kip2) and Maspin in the pathological scar and their possible role in the pathogenesis of abnormal scars. METHODS: Immunohistochemistry integrated image analysis and reverse transcription polymerase chain reaction (RT-RCR) were performed to detect the expression of P57(kip2) and Maspin in hypertrophic scar, keloid, mature scar and normal skin. Statistics was used to analyze the datas. RESULTS: The expression of P57(kip2) protein was fixed to fibroblast intranuclear in abnormal scar, and the expression of P57(kip2) protein and P57(kip2) mRNA decreased (P < 0.05). The expression of Maspin protein was fixed to fibroblast cytoplasm and intranuclear in abnormal scar, and the expression of Maspin protein and Maspin mRNA decrease, compared with that in normal group (P < 0.05). There was positive correlation between P57(kip2) protein and Maspin protein expression (P < 0.01). CONCLUSIONS: The decreased expression of P57(kip2) and Maspin in abnormal scar shows that they are cicatrix-related genes. There is a positive relationship between the two genes. It may be one of the mechanisms of pathogenesis of abnormal scar. It makes effect through fibroblasts.

[Mechanism of Wnt signaling pathway regulation by a truncated mutant of Axin2 in colorectal cancer].

BACKGROUND & OBJECTIVE: Axin2 gene which negatively regulates the Wnt signaling pathway was cloned recently. A truncated mutation of Axin2 (mtAxin2) is the most common mutation pattern in colorectal cancer (CRC) and could enhance the luciferase activity of T-cell factor (TCF). This study was to explore the mechanism of Wnt signaling pathway regulation by mtAxin2 in CRC. METHODS: The expression of beta-catenin in a mtAxin2-positive and a mtAxin2-negative CRC specimens was detected by immunohistochemistry. Plasmids containing wild-type or mutated Axin2 (pCMV-Flag-wtAxin2 and pCMV-Flag-mtAxin2) were constructed and co-transfected into 293 cells. The interactions of wtAxin2 and mtAxin2 with core components in Wnt signaling pathway was tested by co-immunoprecipitation (IP) and Western blot. TNT T3/T7 in vitro transcription and translation system were used to produce mtAxin2 and wtAxin2 proteins to verify the homodimerization of mtAxin2. Firefly and Renilla activities of mtAxin2 were detected with dual-luciferase report assay. Retinoid X receptor (RXR) and ecodysone receptor (ECR) plasmids were prepared for the experiment of restoration of TCF activity of mtAxin2. RESULTS: Immunohistochemistry showed that beta-catenin accumulated in the nuclei of mtAxin2-positive CRC cells and in cytoplasm of mtAxin2-negative CRC cells. Western blot showed that mtAxin2 bound to GSK-3beta, APC, beta-catenin, DVL-1 and PP2A as wtAxin2 did. After co-transfection of wtAxin2 and mtAxin2 in 293 cells, mtAxin2 competitively bound to beta-catenin. TNT T3/T7 experiment showed that wtAxin2 formed oligomers or dimers with Flag-wtAxin2, but not with Flag-mtAxin2. TCF activity in 293 cells was increased after transfection of pCMV-mtAxin2-RXR, but reduced after transfection of pCMV-mtAxin2-ECR or co-transfection of pCMV-mtAxin2-RXR and pCMV-mtAxin2-ECR, indicating the fusion of mtAxin2 and RXR formed dimers and restored its inhibitory effect on TCF activity. CONCLUSION: Because of loss of DIX domain, mtAxin2 can not form dimmers, disturbs the degradation of beta-catenin, and leads to the nuclear accumulation of beta-catenin and activation of Wnt signaling pathway.