Chemotherapy effect on myocardial fibrosis markers in patients with gynecologic cancer and low cardiovascular risk.

Background: Patients with gynecologic cancers experience side effects of chemotherapy cardiotoxicity. We aimed to quantify cardiac magnetic resonance (CMR) markers of myocardial fibrosis in patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy. Methods: This study is part of a registered clinical research. CMR T1 mapping was performed in patients with gynecologic cancer and low cardiovascular risk undergoing chemotherapy. The results were compared with those of age-matched healthy control subjects. Results: 68 patients (median age = 50 years) and 30 control subjects were included. The median number of chemotherapy cycles of patients was 9.0 (interquartile range [IQR] 3.3-17.0). Extracellular volume fraction (ECV) (27.2% ± 2.7% vs. 24.5% ± 1.7%, P < 0.001) and global longitudinal strain (-16.2% ± 2.8% vs. -17.4% ± 2.0%, P = 0.040) were higher in patients compared with controls. Patients with higher chemotherapy cycles (>6 cycles) (n=41) had significantly lower intracellular mass indexed (ICMi) compared with both patients with lower chemotherapy cycles (≤6 cycles) (n=27) (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 34.30 g/m2 [IQR 29.93-39.79 g/m2]; P = 0.002) and the control group (median 27.44 g/m2 [IQR 24.03-31.15 g/m2] vs. median 32.79 g/m2 [IQR 27.74-35.76 g/m2]; P = 0.002). Patients with two or more chemotherapy regimens had significantly lower ICMi compared with both patients with one chemotherapy regimen (27.45 ± 5.16 g/m2 vs. 33.32 ± 6.42 g/m2; P < 0.001) and the control group (27.45 ± 5.16 g/m2 vs. 33.02 ± 5.52 g/m2; P < 0.001). The number of chemotherapy cycles was associated with an increase in the ECV (Standard regression coefficient [ß] = 0.383, P = 0.014) and a decrease in the ICMi (ß = -0.349, P = 0.009). Conclusion: Patients with gynecologic cancer and low cardiovascular risk who undergo chemotherapy have diffuse extracellular volume expansion, which is obvious with the increase of chemotherapy cycles. Myocyte loss may be part of the mechanism in patients with a higher chemotherapy load. Clinical trial registration: http://www.chictr.org.cn, identifier ChiCTR-DDD-17013450.

Cognition of the warning symptoms and risk factors for cancer among Chinese college students: a cross-sectional study based on a summer social practice activity.

BACKGROUND: To investigate the cognition of cancer warning symptoms and cancer risk factors among Chinese college students, analyze the influencing factors, and explain the correlations between cancer cognition and cancer symptom discrimination, cancer fear and psychological distress. METHODS: Chinese college students were recruited in this cross-sectional study funded by a summer social practice activity in Yunnan Province, China. Cognition rates of cancer warning symptoms and cancer risk factors were evaluated using Cancer Warning symptoms Cognition Questionnaire (CWSCQ) and Cancer Risk Factors Cognition Questionnaire (CRFCQ), respectively. Factors associated with cognition of cancer warning symptoms, and factors associated with cognition of cancer risk factors were evaluated using multiple linear regression analysis. Interactions between cancer cognition, cancer symptom discrimination, psychological distress, and cancer fear were evaluated by structural equation modeling. RESULTS: There were 846 effective samples, with an effective rate of 80.9%. The cognition rates of cancer warning symptoms were from 47.9% to 84.4%, which were affected by cancer symptom discrimination, education, attitudes towards cancer screening, living expenses, drinking history, and ways to obtain cancer knowledge (p < 0.05). The cognition rates of cancer risk factors were from 46.3% to 91.3% in participants, which were affected by education, cancer symptom discrimination, psychological distress, attitudes towards cancer screening, life satisfaction, cancer history in relatives and friends, ways to obtain cancer knowledge, smoking history, and nursing history for cancer patients (p < 0.05). Cancer cognition and cancer symptom discrimination showed intermediary effects on psychological distress and cancer fear (p < 0.001). CONCLUSIONS: The overall cancer cognition situation among Chinese college students is not optimistic, which highlights the necessity of improving the cancer health literacy among Chinese college students. With the increasing morbidity and mortality rates of cancer, it is necessary to raise awareness of early detection, and early treatment of cancer among the general public. Health education interventions are helpful to improve cancer health literacy.

Myocardial edema during chemotherapy for gynecologic malignancies: A cardiac magnetic resonance T2 mapping study.

Objective: Myocardial edema is an early manifestation of chemotherapy-related myocardial injury. In this study, we used cardiac magnetic resonance (CMR) T2 mapping to assess myocardial edema and its changes during chemotherapy for gynecologic malignancies. Methods: We enrolled 73 patients receiving chemotherapy for gynecologic malignancies, whose the latest cycle was within one month before the beginning of this study, and 41 healthy volunteers. All participants underwent CMR imaging. Of the 73 patients, 35 completed CMR follow-up after a median interval of 6 (3.3 to 9.6) months. The CMR sequences included cardiac cine, T2 mapping, and late gadolinium enhancement. Results: Myocardial T2 was elevated in patients who were treated with chemotherapy compared with healthy volunteers [41ms (40ms to 43ms) vs. 41ms (39ms to 41ms), P = 0.030]. During follow-up, myocardial T2 rose further [40ms (39ms to 42ms) vs. 42.70 ± 2.92ms, P < 0.001]. Multivariate analysis showed that the number of chemotherapy cycles was associated with myocardial T2 elevation (ß = 0.204, P = 0.029). After adjustment for other confounders, myocardial T2 elevation was independently associated with a decrease in left ventricular mass (ß = -0.186; P = 0.024). Conclusion: In patients with gynecologic malignancies, myocardial edema developed with chemotherapy cycles increase, and was associated with left ventricular mass decrease. T2 mapping allows the assessment of myocardial edema and monitoring of its change during chemotherapy.

Development and reliability and validity test of the Fear of Cancer Scale (FOCS).

OBJECTIVE: To develop a Fear of Cancer Scale (FOCS) for non-cancer populations. METHODS: FOCS was developed by classical measurement theory. A total of 15 college students were invited to conduct semi-structured interviews. Seven experts were invited for expert consultation. A total of 2012 Chinese college students who had completed the electronic questionnaire on WJX.cn platform was included. The reliability and validity of FOCS were verified. Multiple linear regression analysis was adopted to explore the influencing factors of cancer fear among college students and further verify the validity of FOCS. RESULTS: There were 17 items in the FOCS, including two subscales - direct fear (8 items), and indirect fear (9 items). FOCS had good validity and reliability. Multiple linear regression showed that GAD-7 score, CSDS score, negative coping score, positive coping score, guardian's highest education, gender, life satisfaction, nationality and major were the influencing factors of cancer fear (p < .05). CONCLUSIONS: The 17-item FOCS was a reliable and valid measure to examine the level of cancer fear in non-cancer populations.

Myocardial microvascular function assessed by CMR first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies.

OBJECTIVES: Cancer chemotherapy potentially increases the risk of myocardial ischemia. This study assessed myocardial microvascular function by cardiac magnetic resonance (CMR) first-pass perfusion in patients treated with chemotherapy for gynecologic malignancies. METHODS: A total of 81 patients treated with chemotherapy for gynecologic malignancies and 39 healthy volunteers were prospectively enrolled and underwent CMR imaging. Among the patients, 32 completed CMR follow-up, with a median interval of 6 months. The CMR sequences comprised cardiac cine, rest first-pass perfusion, and late gadolinium enhancement. RESULTS: There were no significant differences in the baseline characteristics between the patients and normal controls (all p > 0.05). Compared with the normal controls, the patients had a lower myocardial perfusion index (PI) (13.62 ± 2.01% vs. 12% (11 to 14%), p = 0.001) but demonstrated no significant variation with an increase in the number of chemotherapy cycles at follow-up (11.79 ± 2.36% vs. 11.19 ± 2.19%, p = 0.234). In multivariate analysis with adjustments for clinical confounders, a decrease in the PI was independently associated with chemotherapy treatment (ß = - 0.362, p = 0.002) but had no correlation with the number of chemotherapy cycles (r = - 0.177, p = 0.053). CONCLUSION: Myocardial microvascular dysfunction was associated with chemotherapy treatment in patients with gynecologic malignancies, and can be assessed and monitored by rest CMR first-pass perfusion. KEY POINTS: • Chemotherapy was associated with but did not aggravate myocardial microvascular dysfunction in patients with gynecologic malignancies. • Rest CMR first-pass perfusion is an ideal modality for assessing and monitoring alterations in myocardial microcirculation during chemotherapy treatment.

Advances on experimental models of rheumatoid arthritis / 中国药理学通报

Rheumatoid arthritis (RA) is a chronic immune-me- diated synovial disease with unknown aetiology, therefore, it is considered a chronic disease that cannot be cured. RA is caused by a complex interaction between genetic and environmental factors. As such long-standing efforts have been made for better understanding of disease pathogenesis and the development of new classes of therapeutics, the continuing elucidation of pathogenic events underlying RA mostly relies on animal model studies. Individually animal models allow molecular and spatiotemporal dissection of various pathological processes of RA development. We have herein comprehensively discussed different animal models in induction methods, pathogenesis, pathological events and disease characteristics, hoping to provide the basis and reference for the rational selection of experimental animal models for the basic research and drug screening of RA.

Improved synaptic and cognitive function in aged 3 × Tg-AD mice with reduced amyloid-ß after immunotherapy with a novel recombinant 6Aß15-TF chimeric vaccine.

Alzheimer's disease (AD) is the most common progressive neurodegenerative disorder impairing memory and cognition. In this study, we describe the immunogenicity and protective efficacy of the novel recombinant 6Aß15-TF chimeric antigen as a subunit protein vaccine for AD. Recombinant 6Aß15-TF chimeric vaccine induced strong Aß-specific humoral immune responses without Aß-specific T cell immunity in C57/BL6 and 3 × Tg-AD mice at different ages. As an early immunotherapy model for AD, this vaccine induced high titers of long-lasting anti-Aß42 antibodies in aged 3 × Tg-AD mice, which led to improve behavioral performance and markedly reduced the levels of insoluble and soluble Aß and Aß oligomers. In agreement with these findings, immunotherapy with 6Aß15-TF prevented the Aß-induced decrease of presynaptic and postsynaptic proteins in aged 3 × Tg-AD mice. Our results suggest that this novel and highly immunogenic recombinant 6Aß15-TF chimeric vaccine provides neuroprotection in AD mice and can be considered an effective AD candidate vaccine.

Enhanced effects of DNA vaccine against botulinum neurotoxin serotype A by targeting antigen to dendritic cells.

As dendritic cells (DCs) play a critical role in priming antigen-specific immune responses, the efficacy of DNA vaccines may be enhanced by targeting the encoded antigen proteins to DCs. In this study, we constructed a DC-targeted DNA vaccine encoding the Hc domain of botulinum neurotoxin serotype A (AHc) fused with scDEC, a single-chain Fv antibody (scFv) specific for the DC-restricted antigen-uptake receptor DEC205. Intramuscular injections of mice with the DC-targeted DNA vaccine (pVAX1-scDEC-AHc) stimulated more DCs to mature than the non-targeted DNA vaccine (pVAX1-SAHc) in the splenocytes. The DC-targeted DNA vaccine could induce more DCs maturation at the site of inoculation. The DC-targeted DNA vaccine induced stronger AHc-specific humoral immune responses, lymphocyte proliferative responses and protective potency against BoNT/A in mice than did pVAX1-SAHc. Moreover, the DC-targeting DNA vaccine provided effective protection after only two inoculations. In summary, these results showed that the DC-targeted fusion DNA vaccine could generate strong immunity, indicating that maturation of DCs induced by pVAX1-scDEC-AHc may be helpful for priming and boosting immune responses. Thus, we propose that the strategy of targeting antigen to DCs in vivo via DEC205 can enhance effectively the potency of DNA vaccines against BoNTs or other pathogens in an animal model.

[Nerve classification with hyperspectral imaging technology].

In surgical nerve repair surgery, the identification of nerve fascicles is a key to a good repair of their broken end. Some of the existing nerve fascicles identification method are not ideal. Hyperspectral imaging (HSI) technology provides information of images and spectra of biological tissue at the same time. It can supply a qualitative, quantitative and positioning description of the test objectives, and identify different biological tissues by biochemical characteristic difference, and classify and position these tissues in the image. Compared to other medical imaging technology, this techriology has unique advantages. In this study, the hyperspectral imaging technology is used in the identification and classification of the nerve fascicles by the spectral characteristics of different nerve fascicles, and in determining the orientation of the nerve fascicles in the image by the image spectral information in order to better help surgical personnel to carry out the nerve repair surgery. The significance of this paper is: the first to propose a new method of identification and location of the nerve fascicles and assist surgical staff to improve the efficacy of nerve repair; the second to reserve hyperspectral imaging techniques used in qualitative and quantitative and orientation research combined with biological organization, and speed up the molecular hyperspectral imaging technology to the practical stage.

[Performance analysis and radiometric correction of novel molecular hyperspectral imaging system].

Integrating molecular imaging technology and hyperspectral technology, a novel molecular hyperspectral imaging (MHSI) system based on AOTF was presented. The system consists of microscope, spectrometer, matrix CCD, image collection card and computer. The system's performance was synthetically evaluated referring every part's performance. The spectral range of the MHSI system is from 550 to 1 000 nm. Two hundred twenty five bands can be continuously captured at a time. The spectral resolution is less than 2 nm. The spatial resolution is about 0.061 5 microm. CCD acquisition speed achieved 2.612 5 s x B(-1) in the integration mode and about 0.11 micros x B(-1) in the non-integration mode. Due to the infection of lamp, a spectral curve extracted directly from the original hyperspectral data can not truly present biochemical character and needs to be corrected. The paper proposes the gray correction coefficient algorithm with spatial dimension and spectral dimension, and gives concrete realization of the algorithm. Taking the sample of leukemia blood, by comparing the single-band images, pseudo-color images and spectra before and after correction, the results indicate the effectiveness of correction algorithm. The corrected data is effective for subsequent analysis.

[Molecular hyperspectral imaging (MHSI) system and application in biochemical medicine].

A novel molecular hyperspectral imaging (MHSI) system based on AOTF (acousto-optic tunable filters) was presented. The system consists of microscope, AOTF-based spectrometer, matrix CCD, image collection card and computer. The spectral range of the MHSI is from 550 to 1 000 nm. The spectral resolution is less than 2 nm, and the spatial resolution is about 0.3 microm. This paper has also presented that spectral curves extracted from the corrected hyperspectral data of the sample, which have been preprocessed by the gray correction coefficient, can more truly represent biochemical characteristic of the sample. The system can supply not only single band images in the visible range, but also spectrum curve of random pixel of sample image. This system can be widely used in various fields of biomedicine, clinical medicine, material science and microelectronics.

Exercise-induced changes of T lymphocytes subgroups and immune factors / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the changes in white blood cell populations, lymphocyte subsets and stress-related cytokines after long-term exercise training and address the association between blood cell changes and stress-related cytokines in relation to exercise.</p><p><b>METHODS</b>A total of 1038 professional athletes were examined for CBC with Sysmex XE2100, and the T, B, and NK lymphocyte subsets were analyzed with flow cytometry. The testees' RNA were extracted from 1 ml whole blood, and the stress-related cytokines such as CRP, SELL,TNF-α, IL8, IL4, ICAM1, PECAM1, IL6, and NOS were tested by multi-RT-PCR and fragments separated by capillary electrophoresis using Beckman Coulter GeXP system.</p><p><b>RESULTS</b>No obvious difference was found in WBC count between the athletes, all within normal range. The proportion of lymphocytes was increased in the athletes by 20%-40% in comparison with the normal level, and the CD3+, CD3+CD4+, and CD3+CD8+ T, B, and NK lymphocyte subsets were all lower in the athletes than the normal range. The cytokine expressions exhibited no significant gender-related difference. IL-8, TNF-α and SELL expressions increased while IL-4 decreased in the athletes. Correlations were noted between the changes of the cells and the cytokine expressions.</p><p><b>CONCLUSION</b>Long-term exercise training affects the immune system and cause stress, which may potentially increase the risks of some chronic diseases.</p>

Automated tongue segmentation in hyperspectral images for medicine.

Automatic tongue area segmentation is crucial for computer aided tongue diagnosis, but traditional intensity-based segmentation methods that make use of monochromatic images cannot provide accurate and robust results. We propose a novel tongue segmentation method that uses hyperspectral images and the support vector machine. This method combines spatial and spectral information to analyze the medical tongue image and can provide much better tongue segmentation results. The promising experimental results and quantitative evaluations demonstrate that our method can provide much better performance than the traditional method.

Classification of hyperspectral medical tongue images for tongue diagnosis.

Human tongue is one of the important organs of the body, which carries abound of information of the health status. The images of the human tongue that are used in computerized tongue diagnosis of traditional Chinese medicine (TCM) are all RGB color images captured with color CCD cameras currently. However, this conversional method impedes the accurate analysis on the subjects of tongue surface because of the influence of illumination and tongue pose. To address this problem, this paper presents a novel approach to analyze the tongue surface information based on hyperspectral medical tongue images with support vector machines. The experimental results based on chronic Cholecystitis patients and healthy volunteers illustrate its effectiveness.

[Anticancer efficacy of combining cytosine deaminase/5-fluorocytosine gene therapy and radiotherapy on cervical carcinoma].

OBJECTIVE: To observe the effect of combining cytosine deaminase (CD)/5-fluorocytosine (5-FC) gene therapy with radiotherapy on cervical carcinoma in nude mice, and to explore if there is a synergistic effect between the two therapies. METHODS: HeLa cells were injected into the 24 female nude mice who were 6-8 weeks old. When the tumors grew to 4.0-7.0 mm in diameter, the mice were divided into 4 groups randomly: control group, CD/5-FC gene therapy group, CD/5-FC gene therapy plus radiotherapy group, radiotherapy group. The volumes and inhibiting rates of the tumors were calculated. RESULTS: (1) The tumor volumes in CD/5-FC gene therapy group (728 +/- 201) mm(3), CD/5-FC gene therapy plus radiotherapy group (357 +/- 113) mm(3), radiotherapy group (739 +/- 419) mm(3), were smaller compared with that in the control group (1168 +/- 380) mm(3), the difference was significant (P < 0.05); tumor volumes in CD/5-FC gene therapy plus radiotherapy group was significantly smaller compared with that in the CD/5-FC gene therapy group and radiotherapy group (P < 0.05). (2) The tumor-inhibiting rate of the radiotherapy group was 36.74%, of the CD/5-FC gene therapy group was 37.66%, and of the CD/5-FC gene therapy plus radiotherapy group was 69.45%, the latter being significantly higher than that of the former two groups (P < 0.05). (3) There was a synergistic effect between CD/5-FC gene therapy and radiotherapy. CONCLUSIONS: There is a synergistic effect between CD/5-FC gene therapy and radiotherapy. CD/5-FC gene therapy combined with radiotherapy may be a good supplementary method for cancer synthetic treatment.

[An intelligent optometry system based on Client/Server Mode].

The optometry in physical examinations is conducted manually at present and this method is neither precise nor efficient. After studying the standard logarithmic visual acuity charts which is popular in our country, we have designed an optometry system based on Client/Server Computing Mode. The system's architecture and its working principle are also presented in the article.

Clinical trial on ibandronate in patients with tumor-associated hypercalcemia / 中华肿瘤杂志

<p><b>OBJECTIVE</b>Ibandronate, a third generation bisphosphonate, inhibits bone resorption in human and animal studies. This study is to evaluate the efficacy and safety of ibandronate as a single agent in patients with tumor-associated hypercalcemia.</p><p><b>METHODS</b>An open, multicenter, non-controlled clinical trial was conducted in 22 patients. The patients received 2 mg ibandronate intravenously if the corrected calcium was less than 3.0 mmol/L but more than 2.7 mmol/L; they received 4 mg ibandronate iv if corrected calcium was more than 3.0 mmol/L.</p><p><b>RESULTS</b>There was 100% efficacy in these two dose groups but the calcium correcting effect was more pronounced in the 4-mg dose group than the 2-mg dose group. The most common adverse reactions were fever and skin itching with an incidence of 4.5%.</p><p><b>CONCLUSION</b>Ibandronate is active in patients with tumor-associated hypercalcemia and the adverse effects are well tolerated.</p>

Multi-center prospective randomized trial on paclitaxel liposome and traditional taxol in the treatment of breast cancer and non-small-cell lung cancer / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To analyze the effects and side effects of paclitaxel liposome formula on breast cancer and non-small cell lung cancer, compared with traditional taxol.</p><p><b>METHODS</b>129 patients from multicenters were prospectively randomized into a test group, given paclitaxel liposome at 135 mg/m(2) each session, and a control group, given traditional taxol at 135 mg/m(2) each session. Both groups received these regimens combined with ADM or DDP for two cycles (3 weeks per cycle).</p><p><b>RESULTS</b>Of 129 cases, 128 were eligible for the analysis of side effects and 126 for the overall response rate. The complete remission rate, partial remission rate and overall response rate were 1.6%, 33.3%, 34.9% in the test group and 6.3%, 22.2%, 28.6% in the control group. There was no significant difference between the two groups. Though there was no significant difference in hematological toxicity between the two groups, the toxicity from the mixed solvent of polyethoxylated castor oil and ethanol was significantly lower in the test group than that in the control group.</p><p><b>CONCLUSION</b>Paclitaxel liposome combined with ADM or DDP in the treatment of advanced breast cancer and non-small-cell lung cancer, being similarly effective as taxol, can significantly lower the incidence of serious hypersensitive reactions.</p>

Result of phase II clinical trial of herceptin in advanced Chinese breast cancer patients / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy and adverse effects of herceptin for advanced Chinese breast cancer patients.</p><p><b>METHODS</b>Thirty-one pathologically proved advanced breast cancer women were treated by herceptin. In the first week, a loading dose 4 mg/kg was administered by intravenous infusion and from the second week, a routine dose of 2 mg/kg was given every week for at least 3 months.</p><p><b>RESULTS</b>There were 2 CR, 6 PR, 7 SD, and 16 PD among 31 patients after treatment by herceptin, the response rate being 25.8%. In factors influencing the prognosis, age and general condition were factors favoring the results, and pathological type, site of metastasis, grade of her-2 over expression and prior treatment were irrelevant to the results. The adverse effects were mild but different from those of the common anticancer drugs.</p><p><b>CONCLUSION</b>Herceptin is effective and well tolerated by the Chinese breast cancer patients.</p>

[Development of research for combined gene therapy and radiotherapy for cancer patients].

Cancer treatment is one of the most important fields in medical research. All strategies such as radiotherapy, chemotherapy, surgery, and gene-based therapy have their own advantage and disadvantages. Nowadays, a novel method which combined traditional therapy with gene therapy plays an important role in the field of cancer research. This review described the current state of combined therapies of gene-based and radiate radiotherapy. Meanwhile, we evaluated the prospect of this combined treatment.