A nomogram for predicting severe myelosuppression in small cell lung cancer patients following the first-line chemotherapy.

This study aimed at establishing and validating a nomogram to predict the probability of severe myelosuppression in small cell lung cancer (SCLC) patients following the first-line chemotherapy. A total of 179 SCLC cases were screened as the training group and another 124 patients were used for the validation group. Predictors were determined by the smallest Akaike's information criterion (AIC) in multivariate logistic regression analysis, leading to a new nomogram. The nomogram was validated in both training and validation groups and the predicting value was evaluated by area under the receiver operating characteristics (ROC) curve (AUC), calibration curve, and decision curve analysis (DCA). Age and tumor staging were extracted as predictors to establish a nomogram, which displayed the AUC values as 0.725 and 0.727 in the training and validation groups, respectively. This nomogram exhibited acceptable calibration curves in the two groups and its prediction added more net benefits than the treat-all scheme and treat-none scheme if the range of threshold probability in the DCA was between 15 and 60% in the training and validation groups. Therefore, the nomogram objectively and accurately predict the occurrence of severe myelosuppression in SCLC patients following the first-line chemotherapy.

Plasma etching effect on the molecular structure of chitosan-based hydrogels and its biological properties.

To reasonably use hydrogels in healthcare field, this study four kinds of chitosan (CTS)-based hydrogels with different molecular structures. With plasma etching, the morphology, chemical groups' proportion, and hydrophilicity of the hydrogel surface were changed. At 40 min of modification, the ratios of CO and NH2 on the CTS40-based hydrogel surface increased and reached their maximum values of 40.31 % and 89.17 %, respectively. Combined with the changes in hydrophilic chemical groups and the hydrogel's network structure, the hydrogel surface's wettability changed after plasma etching. From the results, CTS40-based hydrogel showed the lowest contact angle (77.40 ± 3.89°) with 80 min modification due to its dense network structure of CTS and appropriate ratio of hydrophilic groups on the surface. With these molecular structural changes, the antibacterial properties of CTS-based hydrogels against Staphylococcus aureus were improved. Moreover, the functional components delivery system coating with these CTS-based hydrogels showed colon-site controlled-release property. The hydrogels also facilitated the growth of Caco2 and Hic cells, which had 72.74 %-453.27 % cell viability of Caco2 cells on the surface. Therefore, the antibacterial property and biocompatibility of plasma modified CTS-based hydrogels have been demonstrated. The mechanism between molecular structure changes of CTS with plasma etching and its properties was discussed, which would provide a promising carrier material for utilizing healthcare field.

Knockdown of PAR2 alleviates cancer-induced bone pain by inhibiting the activation of astrocytes and the ERK pathway.

OBJECTIVE: Cancer-induced bone pain (CIBP) is a kind of pain with complex pathophysiology. Proteinase-activated receptor 2 (PAR-2) is involved in CIBP. This study explored the effects of PAR-2 on CIBP rats. METHODS: CIBP rat model was established by injecting Walker 256 rat breast cancer cells into the left tibia of female Sprague-Dawley rats and verified by tibial morphology observation, HE staining, and mechanical hyperalgesia assay. CIBP rats were injected with PAR-2 inhibitor, ERK activator, and CREB inhibitor through the spinal cord sheath on the 13th day after operation. CIBP behaviors were measured by mechanical hyperalgesia assay. On the 14th day after operation, L4-5 spinal cord tissues were obtained. PAR-2 expression, co-expression of PAR-2 and astrocyte marker GFAP, GFAP mRNA and protein levels and the ERK pathway-related protein levels were detected by Western blot, immunofluorescence double staining, RT-qPCR, and Western blot. RESULTS: CIBP rats had obvious mechanical hyperalgesia and thermal hyperalgesia from the 7th day after modeling; mechanical hyperalgesia threshold and thermal threshold were decreased; PAR-2 was increased in spinal cord tissues and was co-expressed with GFAP. PAR-2 silencing alleviated rat CIBP by inhibiting astrocyte activation. p-ERK/t-ERK and p-CREB/t-CREB levels in CIBP spinal cord were elevated, the ERK/CREB pathway was activated, while the ERK/CREB pathway was inhibited by PAR-2 silencing. The alleviating effect of PAR-2 inhibitor on hyperalgesia behaviors in CIBP rats were weakened by ERK activator, while were partially restored by CREB inhibitor. CONCLUSIONS: PAR-2 knockdown inhibited the ERK/CREB pathway activation and astrocyte activation, thus alleviating CIBP in rats.

UGT1A1 Allele Test Not Only Minimizes the Toxicity But Also Maximizes the Therapeutic Effect of Irinotecan in the Treatment of Colorectal Cancer: A Narrative Review.

Background: Irinotecan is a first-line agent in the systematic treatment of colorectal cancer (CRC). Adjusting the dose of irinotecan according to the uridine diphosphate glucuronosyltransferase (UGT) 1A1 genotype reflects the principle of individualized and precision medicine, and may improve the chemotherapy response and survival of CRC. Methods: To summarize the feasibility, efficacy and safety of high dose irinotecan in CRC patients with UGT1A1 wild-type or heterozygous alleles, PubMed, EMBASE, MEDLINE and the Cochrane Central Register of Controlled Trials online databases were searched from the date of creation to October 22, 2021. Results: A total of 1,186 related literatures were searched, and 14 studies were included for review according to the inclusion criteria. The results indicated that the maximum tolerated dose of irinotecan in CRC patients with UGT1A1 wild-type or heterozygous variant was significantly higher than the conventional recommended dose. Chemotherapy based on high dose irinotecan improved the clinical efficacy in mCRC patients with UGT1A1*28 wild-type and heterozygous variant, and the toxicity was tolerated, as reflected in most studies. Conclusions: We are optimistic about the application of high dose irinotecan for mCRC patients with UGT1A1*28 wild-type or heterozygous variant, which will provide a relatively clear direction for future research and certain norms for clinical practice.

Efficacy and Safety of Astragalus-Containing Traditional Chinese Medicine Combined With Platinum-Based Chemotherapy in Advanced Gastric Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND: Astragalus-containing traditional Chinese medicine (TCM) is widely used as adjunctive treatment to platinum-based chemotherapy (PBC) in patients with advanced gastric cancer (AGC) in China. However, evidence regarding its efficacy remains limited. This study aimed to evaluate the efficacy and safety of Astragalus-containing TCM combined with PBC in AGC treatment. METHODS: We searched for literature (up to July 19, 2020) in eight electronic databases. The included studies were reviewed by two researchers. The main outcomes were the objective response rate (ORR), disease control rate (DCR), survival rate, quality of life (QOL), adverse drug reactions (ADRs), and peripheral blood lymphocyte levels. The effect estimate of interest was the risk ratio (RR) or mean difference (MD) with 95% confidence intervals (CIs). Trial sequential analysis (TSA) was used to detect the robustness of the primary outcome and to calculate the required information size (RIS). Certainty of the evidence was assessed using the GRADE profiler. RESULTS: Results based on available literature showed that, compared with patients treated with PBC alone, those treated with Astragalus-containing TCM had a better ORR (RR: 1.24, 95% CI: 1.15-1.34, P < 0.00001), DCR (RR: 1.10, 95% CI: 1.06-1.14, P < 0.00001), 1-year survival rate (RR: 1.41, 95% CI: 1.09-1.82, P = 0.009), 2-year survival rate (RR: 3.13, 95% CI: 1.80-5.46, P < 0.0001), and QOL (RR: 2.03, 95% CI: 1.70-2.43, P < 0.00001 and MD: 12.39, 95% CI: 5.48-19.30, P = 0.0004); higher proportions of CD3+ T cells and CD3+ CD4+ T cells; higher ratio of CD4+/CD8+ T cells; nature killer cells; and lower incidence of ADRs. Subgroup analysis showed that both oral and injection administration of Astragalus-containing TCM increased tumor response. Whether treatment duration was ≥8 weeks or <8 weeks, Astragalus-containing TCM could increase tumor response in AGC patients. Furthermore, Astragalus-containing TCM combined with oxaliplatin-based chemotherapy could increase the ORR and DCR; when with cisplatin, it could only increase the ORR. CONCLUSION: Current low to moderate evidence revealed that Astragalus-containing TCM combined with PBC had better efficacy and less side effects in the treatment of AGC; however, more high-quality randomized studies are warranted. SYSTEMATIC REVIEW REGISTRATION: PROSPERO, identifier CRD42020203486.

Can Src protein tyrosine kinase inhibitors be combined with opioid analgesics? Src and opioid-induced tolerance, hyperalgesia and addiction.

The clinical application of opioids may be accompanied by a series of adverse consequences, such as opioid tolerance, opioid-induced hyperalgesia, opioid dependence or addiction. In view of this issue, clinicians are faced with the dilemma of treating various types of pain with or without opioids. In this review, we discuss that Src protein tyrosine kinase plays an important role in these adverse consequences, and Src inhibitors can solve these problems well. Therefore, Src inhibitors have the potential to be used in combination with opioids to achieve synergy. How to combine them together to maximize the analgesic effect while avoiding unnecessary trouble provides a topic for follow-up research.

The nonreceptor protein tyrosine kinase Src participates in every step of cancer-induced bone pain.

Cancer-induced bone pain (CIBP) is a refractory form of pain that has a high incidence in advanced tumors. Src protein tyrosine kinase is mainly composed of six domains, with two states of automatic inhibition and activation. The modular domain allows Src to conveniently regulate by and communicate with a variety of proteins, directly or indirectly participate in each step of the CIBP process. Src is beneficial to the growth and proliferation of tumor cells, and it can promote the metastases of primary tumors to bone. In the microenvironment of bone metastasis, it mainly mediates bone resorption, activates related peripheral receptors to participate in the formation of pain signals, and may promote the generation of pathological sensory nerve fibers. In the process of pain signal transmission, it mainly mediates NMDAR and central glial cells to regulate pain signal intensity and central sensitization, but it is not limited to these two aspects. Both basic experimentation and clinical research have shown encouraging potential, providing new ideas and inspiration for the prevention and treatment of CIBP.

Effect of Jinlong capsule on proliferation and apoptosis of human pancreatic cancer cells BxPC-3.

OBJECTIVE: To study the possible roles of Jinlong capsule (JLC) on the proliferation and apoptosis of human pancreatic cancer cells BxPC-3. METHODS: The human pancreatic cancer cells BxPC-3 were treated with JLC at the concentration of 0.05-1.00 mg/mL for 24-120 h. The inhibition rate of JLC on human pancreatic cancer cells BxPC-3 was detected by 3-(4,5-dimethiylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay. Flow cytometry was employed to measure cell apoptosis using Annexin V-FITC/Propidium iodide (AV-FITC/PI) method. Cell cycles were determined by PI staining. The expression of 5100 Calcium binding protein A4 (S100A4) in cell matrix was measured by enzyme-linked immunosorbent assay (ELISA). The expression levels of apoptosis-related protein such as BCL2/adenovirus E1B 19 kDa interacting protein 3 (BNIP3), B-cell lymphoma/leukemia-2 (Bcl-2) and Cys-teinylaspartate specific proteinase 3 (Caspase-3) were detected by Western blotting. RESULTS: JLC significantly inhibited the proliferation of human pancreatic cancer cells BxPC-3 in a dose-dependent and time-dependent manner. JLC promoted cell apoptosis and maintained cell cycle in S and G2/M phase rather than G1/G0 phase. The expression of 5100A4 in the cell matrix was reduced. The expression of cell apoptotic protein BNIP3 was increased while Bcl-2 was decreased. CONCLUSION: JLC can inhibit the proliferation of human pancreatic cancer cells BxPC-3 by stimulating cell apoptosis, arresting the cell cycle at S and G2/M phase which blocks the circulation of normal cell cycle and reducing the expression of S100A4 protein. Higher pro-apoptosis protein BNIP3 and lower anti-apoptosis protein Bcl-2 levels were found, which may be related to the apoptotic effects of JLC.

Design, synthesis and evaluation of novel metalloproteinase inhibitors based on L-tyrosine scaffold.

A series of novel L-tyrosine derivatives were designed, synthesized and assayed for their inhibitory activities on matrix metalloproteinase 2 (MMP-2) and histone deacetylase 8 (HDAC-8). The results showed that these L-tyrosine derivatives exhibited inhibitory profiles against MMP-2 and HDAC-8. The compounds 6h (IC(50)=0.013 ± 0.001 µM) and 6j (IC(50)=0.017 ± 0.001 µM) were equal potent MMP-2 inhibitors to the positive control NNGH (IC(50)=0.014 ± 0.001 µM). As for HDAC-8 inhibition, some of the hydroxamate compounds, such as 6d (IC(50)=3.6 ± 0.2 µM) and 6c (IC(50)=5.8 ± 0.5 µM), were equal potent to the positive control SAHA (IC(50)=1.6 ± 0.1 µM). Structure-activity relationships were also briefly discussed.

[Research progress on anti-tumor effect of wind medicine].

Cancer research of Chinese medicine has formed some major fields, such as supporting healthy qi, heat clearing-detoxification and eliminating stasis-activating blood, and has made certain achievements. The "theory of anti-tumor effect with wind medicine" described the anti-tumor effects of wind medicine from a new view. In this review, and the relevant research was analyzed comprehensively. The mechanism and superiority of the anti-tumor effect of wind medicine was summarized, and the research problems was also discussed.

[Design and application of a new type minor smoke warming moxibustion cup].

OBJECTIVE: To design a new type minor smoke warming moxibustion cup for convenient use of both the physicians and the patients. METHODS: The double-deck minor smoke warming moxibustion cup is fixed on the part receiving moxibustion by vacuum adsorption; the filtration device on the upper can filtrate and adsorb the harmful substance in the moxa-smoke, and the device with a double-temperature control on the lower can sensitively regulate the moxibustion temperature. RESULTS: This new type minor smoke warming moxibustion cup has the advantages of minor smoke discharge, convenient fixation, sensitive regulation of temperature, saving moxibustion material, lasting action, safety, besides the advantages of traditional moxibustion. CONCLUSION: The new type minor smoke warming moxibustion cup can use for treatment and prevention of diseases, suitable to clinical treatment and family health care.