Dihydroartemisinin inhibits the migration of esophageal cancer cells by inducing autophagy.

Esophageal cancer (EC) is a complex gastrointestinal malignancy and its global incidence rate ranks 7th among all cancer types. Due to its aggressive nature and the potential for early metastasis, the survival rates of patients with EC are poor. Dihydroartemisinin (DHA) is the primary active derivative of artemisinin, and, as well as its use as an anti-malarial, DHA has also exhibited antitumor activity in various cancer models, such as cholangiocarcinoma, head and neck carcinoma, and hepatocellular carcinoma cells. However, the molecular mechanisms underlying the antitumor effect of DHA in the treatment of EC remains poorly understood. The results of the present study demonstrated that DHA significantly inhibited the migration of TE-1 and Eca-109 EC cells in a dose-dependent manner by activating autophagy. DHA treatment also significantly reversed epithelial-mesenchymal transition (EMT) by downregulating the EMT-associated markers, N-cadherin and vimentin, and upregulating the expression of E-cadherin. Mechanistically, DHA treatment decreased Akt phosphorylation and inhibited the Akt/mTOR signaling pathway, leading to the activation of autophagy. The levels of the autophagy-associated proteins were suppressed and DHA-mediated inhibition of migration in EC cells was reversed when an active form of Akt was overexpressed. In conclusion, the present study demonstrated the potential value of DHA in the treatment of EC, and revealed the underlying mechanism by which FDHA inhibits cellular migration.

The association of hepatitis B virus screening and antiviral prophylaxis with adverse liver outcomes in Chinese cancer patients undergoing chemotherapy: A retrospective study.

Currently, the association of the initiation time of hepatitis B virus (HBV) screening and antiviral prophylaxis with adverse liver outcomes in cancer patients undergoing chemotherapy remains conflicting.This retrospective study was designed to determine the association of HBV screening and antiviral prophylaxis with adverse liver outcomes, and then proposed optimal management strategies on HBV screening and antiviral prophylaxis.We analyzed the medical data of Chinese cancer patients undergoing chemotherapy between 2000 and 2015. Descriptive statistics and Chi square tests were performed to analyze the basic characteristics of patients. Time-to-event analysis was used to determine incidence, and competing risk analysis was used to determine the hazard ratios (HRs) for outcomes.A total of 12,158 patients (81.1% with solid tumors) were analyzed. Among solid tumors patients, late screening and late antiviral therapy of chronic HBV were associated with higher incidence of hepatitis flare (HR 3.29, 95% confidence interval [CI] 2.26-4.79; HR 6.79, 95% CI 4.42-10.41), hepatic impairment (HR 2.96, 95% CI 2.03-4.32; HR 8.03, 95% CI 4.78-13.48), liver failure (HR 2.19, 95% CI 1.41-3.40; HR 14.81, 95% CI 6.57-33.42), and HBV-related death (HR 3.29, 95% CI 2.26-4.79; HR 8.30, 95% CI 4.95-13.91) in comparison with early screening and early therapy.Early HBV screening and antiviral therapy could reduce the risk of adverse liver outcomes among chronic HBV patients receiving chemotherapy. Hepatitis B surface antibody-positivity was associated with a decreased risk of liver failure and chronic HBV, late screening or late antiviral therapy were predictors of liver failure for patients with anti-tumor therapy. However, it should be applied cautiously into each types of solid tumors and hematologic malignancies because subgroup analysis according to type of cancer was not designed.

The role of gene sculptor microRNAs in human precancerous lesions.

MicroRNAs (miRNAs) are small noncoding RNAs. These noncoding RNAs regulate the expression of target genes and inhibit the translation of target proteins at the post-transcriptional level. miRNAs also play an important role in human health, from the development and differentiation of cells to the occurrence and progression of disorders such as cancer, cardiovascular diseases, and neurodegenerative diseases. Precancerous lesions are lesions prior to invasive carcinomas, and carcinogenesis is a very complicated process, which is multistage and the result of multigene synergy. miRNAs exert effects as both oncogenes and tumor suppressor genes by regulating target genes involved in signaling pathways. Hence, precancerous lesions are accompanied by relevant miRNA changes. Based on the morphology of miRNAs in vivo and the specificity of miRNA, various novel miRNA analysis methods have been developed, including reverse transcription quantitative PCR, enzyme analysis, molecular beacons, and deep sequencing. For example, in the laryngeal epithelial precancerous lesions, the data demonstrate that the expression of miR-10a-5p is downregulated and miR-484 is the most abundant miRNA in hepatic precancerous lesions. In this review, we discuss the functional roles of miRNAs in human precancerous lesions.

Effects of polyethylene glycol 2 L alone or with ascorbic acid compared with polyethylene glycol 4 L alone for bowel preparation before colonoscopy: protocol for a systematic review and network meta-analysis.

INTRODUCTION: Colonoscopy has been regarded as a standard method of detecting and removing gastrointestinal lesions early, while adequate bowel preparation is the prerequisite of determining the diagnostic accuracy and treatment safety of this process. Polyethylene glycol (PEG) based bowel preparation regimens remain the first recommendation, but the optimal option is still uncertain. The aim of this systematic review and network meta-analysis of randomised controlled trials (RCTs) is to determine the optimal PEG based bowel preparation regimen before colonoscopy. METHODS AND ANALYSIS: We will assign two investigators to independently search all potential citations, screen records, abstract essential information and appraise the risk of bias accordingly. Then, random effects pairwise and network meta-analyses of RCTs comparing PEG 2 L alone or with ascorbic acid with PEG 4 L alone will be performed using RevMan 5.3 (Copenhagen, Denmark: The Nordic Cochrane Centre, The Cochrane Collaboration, 2013), Stata 14 (StataCorp, Texas, USA) and WinBUGS 1.4 (Imperial College School of Medicine, St Mary's, London, UK) from January 2000 to April 2017. The surface under the cumulative ranking curve will also be calculated in order to rank the regimens. ETHICS AND DISSEMINATION: Ethics approval and patient written informed consent will not be required because all of the analyses in the present study will be performed based on data from published studies. We will submit our systematic review and network meta-analysis to a peer reviewed scientific journal for publication. SYSTEMATIC REVIEW REGISTRATION: PROSPERO: CRD42017068957.

Measurement of brain edema by noninvasive cerebral electrical impedance in patients with massive hemispheric cerebral infarction.

BACKGROUND: Malignant cerebral infarction often occurs in patients with massive cerebral infarction. Monitoring brain edema is therefore helpful to make correct clinical decisions. Our previous studies have confirmed that cerebral electrical impedance (CEI) can sensitively reflect the brain edema after stroke. METHODS: The CEI was measured consecutively by a noninvasive brain edema monitor in 69 patients with massive hemispheric cerebral infarction (MHCI). The results of the CEI were converted into the perturbation index (PI). The characteristics of dynamic changes of the CEI after MHCI were analyzed. Receiver-operating characteristics analysis was used to calculate predictive values for PI and other known parameters including NIHSS score and infarct volume. RESULTS: (1) The overall rate of positive CEI was 88.4% (61/69) in all patients with MHCI. (2) The PI on the infarct side increased significantly within 24 h after stroke onset and reached a peak level 3-5 days after stroke onset (p < 0.01). (3) Age, NIHSS score at admission, infarct volume, and the PI at 24 h after stroke onset were significantly different between the malignant and nonmalignant groups. The best predictor of a malignant MHCI was the PI at 24 h after stroke onset with a cut-off value of 10.02 (90.9% sensitivity, 87.2% specificity, 76.9% positive predictive value, 95.3% negative predictive value). CONCLUSIONS: The noninvasive CEI can sensitively reflect the brain edema in patients with MHCI. Monitoring the CEI may help to predict malignant MHCI and guide treatment decisions.

[Application of noninvasive cerebral electrical impedance measurement on brain edema in patient with cerebral infarction].

OBJECTIVE: to investigate the change of brain edema in patients with cerebral infarction (CI) by the measurement of noninvasive cerebral electrical impedance (CEI). METHODS: an invariable secure current at a frequency 50 kHz and an intensity of 0.1 mA was applied into a person's brain. The CEI of values for both hemispheres of 200 healthy volunteers and 107 CI patients was measured. The results were compared with the volume of edema on CT. RESULTS: (1) in healthy volunteers, the CEI values in the left and right hemisphere were 8.0 ± 1.0 and 8.0 ± 0.7 respectively. And there was no significant difference between either side (P > 0.05). Age, sex and different measuring time points did not obviously affect the CEI values (P > 0.05). (2) In CI patients, the CEI was more sensitive in the volumes of lesion which was more than 20 ml (80.0%), the CEI was75.9% and 83.3% in the volumes of lesion which was 20 - 50 ml and more than 50 ml respectively. The CEI was low when the volume fell under 20 ml; (3) The CEI of the ipsilateral side was higher than contralateral side in the patients at Day 3 after onset. It increased obviously at Days 3 - 5 after onset. The difference of two sides was the most significant. CEI of two sides was 9.2 ± 2.1 and 8.8 ± 1.8 (n = 91, P < 0.01) respectively at Day 3 after onset. CEI of the infarction side increased continuously at Day 5 after onset (9.2 ± 2.3 vs. 8.6 ± 1.9) (n = 84, P < 0.01) respectively. It gradually decreased at Day 7 after onset, but remained higher than that of the contralateral side (8.9 ± 2.2 vs. 8.7 ± 2.3, n = 68, P > 0.05); (4) There was a positive correlation between the ispilateral CEI and the volume of infarction detected within 24 hours (n = 31, r = 0.682, P < 0.05) and at Day 3 (n = 56, r = 0.602, P < 0.05) after onset. CONCLUSION: CEI may be a sensitive parameter for noninvasive monitoring the change of brain edema in CI patients. The higher the CEI, the more severe edema resulted. The sensitivity of CEI is higher when the volume of infarction exceeds 20 ml. CEI is a new technique for judging the patient condition of brain edema noninvasively.

Application of non-invasive cerebral electrical impedance measurement on brain edema in patients with cerebral infarction.

OBJECTIVE: To investigate the change of brain edema in patients with cerebral infarction by non-invasive cerebral electrical impedance (CEI) measurements. METHODS: An invariable secure current at a frequency of 50 kHz and an intensity of 0.1 mA was given into a person's brain. CEI values of the bilateral hemisphere of 200 healthy volunteers and 107 patients with cerebral infarction were measured by non-invasive brain edema monitor. The results of perturbative index (PI) converted from CEI were compared with the volumes of brain edema, which were calculated by an image analysing system according to magnetic resonance imaging or computed tomography. RESULTS: (1) In the healthy volunteers, PI values in the left and right hemisphere were 7.98 +/- 0.95 and 8.02 +/- 0.71 respectively, and there was no significant difference between the two sides (p>0.05). Age, gender and different measuring times did not obviously affect PI values (p>0.05). (2) In the cerebral infarction group, CEI measurements were more sensitive to the volumes of lesion, which were more than 20 ml. The positive ratio of PI was higher when the volumes of infarction were >20 ml (80.0%): the ratio of PI was 75.9% when the volumes of infarction were 20-50 ml and it was 83.3% when the volumes of lesion were more than 50 ml. PI was lower when the volumes were less than 20 ml. (3) PI of the infarction side increased obviously 3-5 days after onset; the difference of two sides was the most significant. There was a positive correlation between PI of the infarction side and volume of infarction. CONCLUSIONS: PI may be a sensitive parameter for non-invasive monitoring of the change of brain edema in patients with cerebral infarction. CEI is a valuable method for the early detection of brain edema.

[Clinical manifestations and imaging features of peripheral vestibular paroxysmia: a report of 7 cases].

OBJECTIVE: To investigate the clinical manifestations and imaging features of peripheral vestibular paroxysmal (PVP). METHODS: The clinical data, including magnetic resonance tomographic angiography (MRTA), of 7 PVP patients, 1 male and 2 females, aged 40-72, were retrospectively analyzed. RESULTS: (1) All 7 patients had non-specific cochleovestibular symptoms, e.g., recurrent vertigo and continuous dizziness. (2) The predominant symptom was transient vertigo or dizziness with the sudden change of head position. (3) MRTA showed cross of the cochleovestibular nerve (CNV) and blood vessel in all patients. (4) Carbamazepine and sibelium succeeded to relieve the symptoms. CONCLUSION: Compression of the cranial nerve VIII by crossing vessel thereon may be the mechanism of PVP which can be identified and diagnosed clinically.