Influencing factors of cancer-related fatigue in acute leukemia patients: A cross-sectional study.

Purpose: To investigate influencing factors of cancer-related fatigue (CRF) in adult patients with acute leukemia (AL). Methods: A total of 288 adult patients diagnosed with acute leukemia in West China Hospital were included in this study. A cross-sectional survey, including the Clinical Information Questionnaire, the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Pittsburgh Sleep Quality Index (PSQI), and Hospital Anxiety and Depression Scale (HAD), was provided to the patients. Hierarchical multiple linear regression analyses were conducted to evaluate the associations of the variable factors and the AL patients' CRF. Results: The CRF score of AL patients was 33.25 ± 10.35. Gender, age, albumin level, depression, anxiety status of the patients and treatment cycles were identified as influencing factors of CRF in AL patients (P < 0.05). The CRF level of acute leukemia patients in the complete remission group was lower than that of patients who were not achieving complete remission. Depression, anxiety, age, employment, albumin, and sleep disturbance were independent influencing factors for CRF in patients who were not achieving complete remission. Conclusions: Acute leukemia patients who are female, older, hypoalbuminemia，or in the induction therapy have a higher risk of developing a high degree of CRF. Clinical staff should pay more attention to the CRF of patients who were not achieving complete remission. Early screening and aggressive intervention could be adopted in caring for these patients.

Validation of the FACT-G7 in patients with hematologic malignancies.

Background: It is essential to evaluate the quality of life in patients with hematologic malignancies to reflect the therapeutic effect and prognosis, but lengthy assessments are often burdensome. The 7-Item Functional Assessment of Cancer Therapy-General (FACT-G7) is a brief, easy, and rapid index for evaluating quality of life. Nevertheless, there is no report about its application in Chinese patients with hematologic malignancies. Objective: The purpose of this study was to validate the Chinese version of the FACT-G7 for patients with hematologic malignancies. Methods: This study is a cross-sectional study. A total of 855 patients with hematologic malignancies completed the Functional Assessment of Cancer Therapy-General (FACT-G) and were scored the Eastern Cooperative Oncology Group Performance Status (ECOG-PS) by nurses. Cronbach's alpha, confirmatory factor analyses, Pearson's correlation, and one-way analysis of variance were conducted to evaluate internal consistent reliability, structural validity and concurrent validity. Results: The FACT-G7 showed acceptable internal consistency, as indicated by a Cronbach's alpha of 0.73. The confirmatory factor analyses test for single-factor model fit for the FACT-G7 scale was almost adequate. The satisfactory correlations between the FACT-G7 and the FACT-G and its subscales, and ECOG-PS groups differed in FACT-G7 scores demonstrating concurrent validity. Conclusion: This study suggested that the Chinese version of the FACT-G7 provides a useful and rapid measure for assessing quality of life in Chinese patients with hematologic malignancies, which providing a reference for further evaluation and care.

Data on the effects of The-Optimal-Lymph-Flow program on lymphedema symptoms in breast cancer survivors.

A substantial proportion of more than 50% of breast cancer survivors, who remain undiagnosed with lymphedema, encounter a daily struggle with the presence of multiple and concomitant lymphedema associated symptoms (i.e., lymphedema symptoms). The-Optimal-Lymph-Flow (TOLF) program was developed based on physiological-cognitive-behavioral principles to educate breast cancer survivors on effective self-care strategies. Physiologically, TOLF program was designed to stimulate lymphatic system to enhance lymph flow, thereby alleviating lymphedema symptoms and mitigating the risk and severity of lymphedema. The dataset presented in this article was obtained from a randomized clinical trial (RCT) that assessed the preventive effects of the TOLF program in improving lymphedema symptom experience and optimizing lymph fluid status among breast cancer survivors who were at higher risk for lymphedema. Between January 2019 and June 2020, a RCT was conducted to recruit 92 eligible participants who were assigned randomly to either the TOLF group (intervention) or the arm mobility group (control). Demographic and clinical data were collected at baseline and updated over the study period. Outcome data were collected at baseline and three months after intervention. Study outcomes included lymphedema symptom experience (i.e., number, severity, distress of lymphedema symptoms, and impact on daily activities) and lymph fluid status. The Breast Cancer and Lymphedema Symptom Experience Index (BCLE-SEI) was utilized to assess lymphedema symptoms and circumferential arm measurement was utilized to estimate limb volume differences (a surrogate for lymph fluid status). The dataset based on the RCT allowed confirmation of positive effects of the TOLF intervention during early postoperative period. The dataset can be further utilized as a benchmark reference in clinical settings or experimental research to determine the effects of optimal lymphatic exercise dosage on lymphedema risk reduction and symptom alleviation as well as provide a basis for future research related to this topic.

Rutin alleviates EndMT by restoring autophagy through inhibiting HDAC1 via PI3K/AKT/mTOR pathway in diabetic kidney disease.

BACKGROUND: Diabetic kidney disease (DKD) is a primary microvascular complication of diabetes. However, a complete cure for DKD has not yet been found. Although there is evidence that Rutin can delay the onset of DKD, the underlying mechanism remains unclear. PURPOSE: To investigate the renoprotective effect of Rutin in the process of DKD and to explore its potential molecular mechanisms. METHODS: Db/db mice and high glucose (HG)-induced human renal glomerular endothelial cells (GEnCs) were used as in vivo and in vitro models, respectively. Western blot (WB), Immunohistochemistry (IHC)and Immunofluorescence (IF) staining were used to identify the expression level of proteins associated with endothelial-to-mesenchymal transition (EndMT) and autophagy. Tandem Mass Tag (TMT)-based proteomics analysis was utilized to reveal the mechanism of Rutin in DKD. Transfection with small interfering RNA (siRNA) to reveal the role of histone deacetylase 1 (HDAC1) in HG-induced GEnCs. RESULTS: Following 8 weeks of Rutin administration, db/db mice's kidney function and structure significantly improved. In HG-induced GEnCs, activation of autophagy attenuates cellular EndMT. Rutin could alleviate EndMT and restore autophagy in vivo and in vitro models. Proteomics analysis results showed that HDAC1 significantly downregulated in the 200 mg/kg/d Rutin group compared with the db/db group. Transfection with si-HDAC1 in GEnCs partially blocked HG-induced EndMT and restored autophagy. Furthermore, Rutin inhibits the phosphorylation of the PI3K / AKT/ mTOR pathway. HDAC1 overexpression was suppressed in HG-induced GEnCs after using Rapamycin, a specific mTOR inhibitor, verifying the correlation between mTOR and HDAC1. CONCLUSION: Rutin alleviates EndMT by restoring autophagy through inhibiting HDAC1 via the PI3K/AKT/mTOR pathway in DKD.

Strategies in activating lymphatic system to promote lymph flow on lymphedema symptoms in breast cancer survivors: A randomized controlled trial.

Background: Many breast cancer survivors face long-term postoperative challenges as a result of developing lymphedema symptoms and chronic lymphedema. The-Optimal-Lymph-Flow (TOLF) program is an intervention based on physiological-cognitive-behavioral principles that teaches patients self-management strategies to activate lymphatic system and promote lymph flow to decrease lymphatic pain, reduce the risk and severity of lymphedema. Objective: The purpose of this pilot clinical trial was to evaluate the use of TOLF program as an early intervention on improving lymphedema symptom experience (i.e., symptom number, symptom severity, symptom distress, and the impact of symptoms on patients' activities of daily living) and optimizing lymph fluid levels (measured by the arm volume differences) among breast cancer survivors. Methods: This study is a parallel, randomized clinical trial. A total of 92 breast cancer patients were randomly assigned to either the TOLF intervention group or the control group focusing on promoting arm mobility. Data were collected at baseline and end of the trial at the 3-month post intervention. The Breast Cancer and Lymphedema Symptom Experience Index was used to measure lymphedema symptom experience. Anthropometric measurements were used for circumferential arm measurements. Generalized linear mixed-effects models were used to evaluate the trial outcomes. Results: Significant improvements of lymphedema symptom experience were found in patients in the TOLF intervention group in comparison with patients in control group: the number of lymphedema symptoms (P<0.001) and the severity of lymphedema symptoms (P<0.001) as well as the impact of symptoms on patients' daily living function (P<0.001). Patients in both groups showed improvements in all study outcomes over the 3 months, whereas those in the TOLF group gained greater benefits in reducing the number and severity of lymphedema symptoms. Moreover, the TOLF group had significantly fewer patients with ≥5% arm volume differences ([5/45] vs [13/43], P=0.035) at the study endpoint. Conclusions: Findings of the study demonstrated positive outcomes of relieving lymphedema symptom experience, optimizing arm circumference and halting the progression of lymphedema status in breast cancer survivors receiving TOLF intervention during early postoperative time. Given its feasibility, acceptability, and effectiveness, this program may be incorporated in routine breast cancer care. Clinical Trial Registration: http://www.chictr.org.cn/index.aspx, identifier ChiCTR1800016713.

Yishen Huashi Granules Ameliorated the Development of Diabetic Nephropathy by Reducing the Damage of Glomerular Filtration Barrier.

Background: Diabetic nephropathy (DN) is one of the most common complications of diabetes and the primary cause of end-stage renal disease. At present, renin-angiotensin-aldosterone system (RAAS) blockers have been applied as first-class drugs to restrain development of DN; however, its long-term effect is limited. Recent evidence has shown definite effects of Chinese medicine on DN. Yishen Huashi (YSHS) granule is a traditional Chinese Medicine prescription that has been used in the clinic to treat DN, but its mechanism is not understood. Methods: In the present study, both in vitro and in vivo studies were carried out. The DN model was induced by STZ in Wistar rats, and GEnC and HPC cell lines were applied in the in vitro study. Quality of YSHS was evaluated by LC-MS/MS. A metabolomic study of urine was carried out by LC-MS; influence of YSHS on composition of DN was analyzed by network pharmacology. Mechanism of the YSHS on DN was analyzed by Q-PCR, Western Blot, and multi-immunological methods. Results: We found YSHS administration significantly reduced levels of HbA1c and mALB. Histopathological analysis found that YSHS preserved integrity of glomerular filtration barrier by preserving viability of glomerular endothelial cells and podocytes, inhibiting glomerular fibrosis, reducing oxidative stress damage, and enhancing cross-talk among glomerular endothelial cells and podocytes. Network pharmacology, differential metabolite analysis, as well as intracellular pathway experimental study demonstrated that the PI3K/AKT/mTOR signaling pathway played a pivotal role in it. Conclusion: Our present findings supplied new understanding toward the mechanism of YSHS on inhibiting DN.

Study on the Salivary Microbial Alteration of Men With Head and Neck Cancer and Its Relationship With Symptoms in Southwest China.

This study explored the association between oral microbes and head and neck cancer (HNC) as well as symptoms related to patients with HNC before surgical treatment. Fifty-six patients with HNC and 64 matched healthy controls were recruited from West China hospital in Southwest China. The demographic, clinical, and symptom data were collected. Salivary samples were collected to determine the microbial characteristics using 16S rRNA gene sequencing. Patients with HNC presented increased Capnocytophaga abundances. The oral microbial markers as Capnocytophaga (area under the curve=0.81) achieved a high classification power between the HNC patients and healthy controls. Moreover, using Capnocytophaga in conjunction with symptom of voice/speech difficulty achieved an overall predicting accuracy of 92.5% comparing with using Capnocytophaga alone (79.2% accuracy) in distinguishing the HNC patients from healthy controls. Salivary microbial profiles and HNC symptoms may be potential biomarkers for HNC screening.

Exercise adherence in breast cancer patients: A cross-sectional questionnaire survey.

To describe social support, self-efficacy, and exercise adherence and to measure the correlations among these factors in postoperative breast cancer patients in Southwest China.Social support, self-efficacy, and exercise adherence are interacting factors that contribute to physical and mental health and quality of life. Little is known about the status of these factors in Southwest China, and little research has explored the relationships among them.Using a stratified sampling method, we selected patients who underwent modified radical mastectomy in 20 secondary and tertiary comprehensive hospitals in Southwest China. A descriptive cross-sectional study was conducted. Questionnaires were given to 632 breast cancer patients who met the inclusion and exclusion criteria (from August 2018 to February 2019). The questionnaire included the following 4 sections: general information, perceived social support scale, strategies used by people to promote health, and postoperative functional exercise adherence scale. Structural equation modeling was used to evaluate the hypothesized relationships among social support, self-efficacy, and exercise adherence.The level of social support of postoperative patients with breast cancer in Southwest China was high (63.43 ±â€Š9.25); however, levels of self-efficacy (95.00 ±â€Š18.81) and exercise adherence (49.07 ±â€Š10.57) were moderate. Higher social support correlated with higher exercise adherence (r = 0.526, P < .01). Higher self-efficacy was also correlated with higher exercise adherence (r = 0.427, P < .01). In-home support, out-of-home support, and self-efficacy had direct positive effects on exercise adherence (ß = 0.37, P < .01; ß = 0.23, P < .01; and ß = 0.32, P < .01, respectively); in-home support indirectly affected exercise adherence through self-efficacy (ß = 0.58, P < .01).Social support and self-efficacy correlated highly with exercise adherence. It is recommended that attention be paid to the development of self-efficacy and social support during postoperative rehabilitation to improve the exercise adherence of postoperative breast cancer patients.

Transplantation of Cerebral Dopamine Neurotrophic Factor Transducted BMSCs in Contusion Spinal Cord Injury of Rats: Promotion of Nerve Regeneration by Alleviating Neuroinflammation.

Traumatic spinal cord injury (SCI) causes neuron death and axonal damage resulting in functional motor and sensory loss, showing limited regeneration because of adverse microenvironment such as neuroinflammation and glial scarring. Currently, there is no effective therapy to treat SCI in clinical practice. Bone marrow-derived mesenchymal stem cells (BMSCs) are candidates for cell therapies but its effect is limited by neuroinflammation and adverse microenvironment in the injured spinal cord. In this study, we developed transgenic BMSCs overexpressing cerebral dopamine neurotrophic factor (CDNF), a secretory neurotrophic factor that showed potent effects on neuron protection, anti-inflammation, and sciatic nerve regeneration in previous studies. Our results showed that the transplantation of CDNF-BMSCs suppressed neuroinflammation and decreased the production of proinflammatory cytokines after SCI, resulting in the promotion of locomotor function and nerve regeneration of the injured spinal cord. This study presents a novel promising strategy for the treatment of spinal cord injury.

Glioma cells escaped from cytotoxicity of temozolomide and vincristine by communicating with human astrocytes.

Resistance to chemotherapeutic drugs remains a great obstacle to successful treatment of gliomas. Understanding the mechanism of glioma chemoresistance is conducive to develop effective strategies to overcome resistance. Astrocytes are the major stromal cells in the brain and have been demonstrated to play a key role in the malignant phenotype of gliomas. However, little is known regarding its role in glioma chemoresistance. In our study, we established a co-culture system of human astrocytes and glioma in vitro to simulate tumor microenvironment. Our results showed that astrocytes significantly reduced glioma cell apoptosis induced by the chemotherapeutic drugs temozolomide and vincristine. This protective effect was dependent on direct contact between astrocytes and glioma cells through Cx43-GJC. Moreover, in human glioma specimens, we found astrocytes infiltrating around the tumor, with a reactive appearance, suggesting that these astrocytes would play the same chemoprotective effect on gliomas in vivo. Our results expand the understanding of the interaction between astrocytes and glioma cells and provide a possible explanation for unsatisfactory clinical outcomes of chemotherapeutic drugs. Cx43-GJC between astrocytes and glioma cells may be a potential target for overcoming chemoresistance in gliomas clinically.