Predictive value of a nomogram for melanomas with brain metastases at initial diagnosis.

BACKGROUND: Estimation of incidence and prognosis of melanomas with brain metastases (MBM) at initial diagnosis based on a large cohort is lacking in current research. This study aims to construct an effective prognostic nomogram for newly diagnosed MBM. MATERIALS AND METHODS: Patients diagnosed with melanomas from Surveillance, Epidemiology, and End Results program between 2010 and 2014 were enrolled in our study. Risk factors predicting brain metastases (BM) were identified using logistic regression analysis. Cox regression analysis was performed to identify prognostic factors of overall survival (OS). Nomogram for estimating 6-, 9-, and 12-month OS was established based on Cox regression analysis. The discriminative ability and calibration of the nomogram were tested using C statistics, calibration plots, and Kaplan-Meier curves. RESULTS: Sixty-two thousand three hundred and sixty-nine melanoma patients were enrolled, including 928 with BM. Sex, marital status, insurance status, subsite, surgery of primary sites, radiation, chemotherapy, bone metastases, liver metastases, and lung metastases were associated with MBM at initial diagnosis. On multivariable Cox regression, the following eight variables were incorporated in the prediction of OS: age, unmarried status, absence of surgery to primary sites or unknown, absence of radiation or unknown, absence of chemotherapy or unknown, with bone metastases, with liver metastases, and with lung metastases. The nomogram showed good predictive ability as indicated by discriminative ability and calibration, with the C statistics of 0.716 (95% CI, 0.695-0.737). CONCLUSIONS: The incidence and prognosis of MBM patients were well estimated in this study based on a large cohort. The nomogram performed well and could be a useful tool to predict prognosis.

[Comparison of Therapeutic Effects Between Thermosensitive Moxibustion and Medication in the Treatment of Insomnia of Liver-Qi Stagnation Pattern].

OBJECTIVE: To compare the therapeutic effect of thermosensitive moxibustion (TSM) and medication in the treatment of insomnia patients with the syndrome of stagnation of liver-qi. METHODS: A total of 60 insomnia patients with the syndrome of liver-qi stagnation were randomly divided into TSM group and medication group (n ＝ 30 in each). Mild moxibustion was applied to bilateral Taichong (LR 3) and Qiuxu (GB 40) alternatively till the patient experienced an intense warmth (diathermic, heat transmission, etc.) feeling in the local region. The treatment was conducted once daily for 15 d. Patients of the medication group were ordered to take Estazolam tablets (1 mg/d) 1 h before sleeping, once daily for successive 15 days. The sleep quality (sleeping quality, falling asleep time, sleep duration, sleep efficiency, sleep disorders, hyponotic and day time dysfunction, 0－21 points) was evaluated by using Pittsburgh Sleep Quality Index (PSQI). The therapeutic effect was assessed in accordance with the "Guide Principles for Clinical Trials on New Drugs of Chinese Materia Medica (1993)" and international united sleep efficiency value. RESULTS: Following the treatment, the PSQI of both groups were significantly decreased relevant to their own pre-treatment (P<0.05), but without significant difference between the two groups (P>0.05). Of the two 30 cases in the medication and moxibustion groups, 12 (40.00%) and 20 (66.67%) had marked improvement, 7 (23.33%) and 6 (20.00%) were effective, and 11(36.67%) and 4 (13.33%) were invalid, with the effective rates being 63.33 % (19/30) and 86.67% (26/30), respectively. The effective rate of the TSM group was significantly higher than that of the medicine group (P <0.05). CONCLUSION: Thermosensitive moxibustion applied to the source points of the Liver and Gallbladder Meridians can improve the quality of sleep in insomnia patients with syndrome of liver-qi stagnation.

Astaxanthin rescues neuron loss and attenuates oxidative stress induced by amygdala kindling in adult rat hippocampus.

Oxidative stress plays an important role in the neuronal damage induced by epilepsy. The present study assessed the possible neuroprotective effects of astaxanthin (ATX) on neuronal damage, in hippocampal CA3 neurons following amygdala kindling. Male Sprague-Dawley rats were chronically kindled in the amygdala and ATX or equal volume of vehicle was given by intraperitoneally. Twenty-four hours after the last stimulation, the rats were sacrificed by decapitation. Histopathological changes and the levels of reactive oxygen species (ROS), malondialdehyde (MDA) and reduced glutathione (GSH) were measured, cytosolic cytochrome c (CytC) and caspase-3 activities in the hippocampus were also recorded. We found extensive neuronal damage in the CA3 region in the kindling group, which was preceded by increases of ROS level and MDA concentration and was followed by caspase-3 activation and an increase in cytosolic CytC. Treatment with ATX markedly attenuated the neuronal damage. In addition, ATX significantly decreased ROS and MDA concentrations and increased GSH levels. Moreover, ATX suppressed the translation of CytC release and caspase-3 activation in hippocampus. Together, these results suggest that ATX protects against neuronal loss due to epilepsy in the rat hippocampus by attenuating oxidative damage, lipid peroxidation and inhibiting the mitochondrion-related apoptotic pathway.

Schedule-dependent inhibition of T-cell lymphoma cells by cotreatment with the mTOR inhibitor everolimus and anticancer drugs.

OBJECTIVE: Everolimus (RAD001) is a novel mammalian target of rapamycin (mTOR) inhibitor, and anti-proliferative activity in various malignancies has been reported. This study evaluated the anti-tumor effects and schedule-dependent synergism of everolimus in combination with other chemotherapeutic agents in T-cell lymphoma cell lines. MATERIALS AND METHODS: Human T-cell lymphoma cell lines Hut-78 and Jurkat were treated with increasing doses of everolimus, alone or in combination with doxorubicin, etoposide, vincristine, or bortezomib, using different dosing schedules. Anti-tumor effects were measured by assays for cell proliferation, apoptosis, and cell cycle distribution. Drug interactions were determined by median effect analysis. RESULTS: Exposure to everolimus alone induced G1 phase cell cycle arrest without significant apoptosis. With certain dosing schedules, everolimus showed synergism with doxorubicin, etoposide, and bortezomib, but antagonism with vincristine. Cytotoxic synergism was observed following cotreatment with doxorubicin and everolimus, bortezomib and everolimus, doxorubicin followed by everolimus, and bortezomib followed by everolimus. By contrast, cell exposure to everolimus followed by doxorubicin or followed by bortezomib resulted in antagonistic effects. Sequential exposure to doxorubicin or bortezomib followed by everolimus effectively prevented potential negative interactions, and resulted in drug synergism. Drug combination synergisms or antagonisms were associated with variable effects on the cell cycle distribution. CONCLUSIONS: Everolimus effectively inhibited the growth of T-cell lymphoma cells in vitro. Specific schedule-dependent combinations of everolimus with other anti-tumor agents which avoid potential drug antagonism and produce effective synergism may lead to clinically effective treatments for T-cell lymphoma.

[Changes of c-fos, c-jun mRNA expressions in cardiomyocyte hypertrophy induced by angiotensin II and effects of tanshinone II A].

OBJECTIVE: To investigate the changes of proto-oncogene c-fos, c-jun mRNA expression in angiotensin II (Ang II)-induced hypertrophy and effects of tanshinone II A (Tan) in the primary culture of neonatal rat cardiomyocytes. METHOD: Twelve neonatal Wistar rats aged one day old of clean grade and both sexes were selected to isolate and culture cardiomyocytes. The cardiomyocytes were divided into: normal control group, Ang II (10(-6) mol x L(-1)) group, Ang II (10(-6) mol x L(-1)) +Tan (10(-8) g x L(-1)) group, Ang II (10(-6) mol x L(-1)) + valsartan (10(-6) mol x L(-1)) group, Tan (10(-8) g x L(-1)) group, valsartan (10(-6) mol x L(-1)) group. The cardiomyocyte size was determined by phase contrast microscope, the rate of protein synthesis in cardiomyocytes was measured by 3H-leucine incorporation. The c-fos, c-jun mRNA expression of cardiomyocytes were assessed using reverse transcription polymerase chain reaction (RT-PCR). RESULT: Ang II was added to the culture medium and 30 min later, the c-fos, c-jun mRNA expression of cardiomyocytes increased significantly (P < 0. 01). After Ang II took effect for 24 h, the rate of protein synthesis in Ang II group increased more prominently than that in normal control group (P < 0.01). After Ang II took effect for 7 days, the size of cardiomyocyte in Ang II group increased obviously (P < 0. 05). If tanshinone II or valsartan was added to the culture medium before Ang II, both of them could inhibit the increase of c-fos, c-jun mRNA expression (P < 0.01), cardiomyocyte protein synthesis rate (P < 0.01), and cardiomyocyte size (P < 0.05) induced by Ang II. CONCLUSION: Tanshinone II could ameliorate Ang II-induced cardiomyocytes hypertrophy by inhabiting c-fos, c-jun mRNA expression.

[Effects of tetrandrine on Ang II-induced cardiomyocyte hypertrophy and p-ERK1/2 expression].

OBJECTIVE: To observe effects of tetrandrine (Tet) on angiotensin II (Ang II)-induced cardiomyocyte hypertrophy and the activity and expression of phosphorylated ERK1/2 (p-ERK1/2). METHOD: In the primary culture of neonatal rat cardiomyocytes, as indexes of cardiomyocyte hypertrophy, pulsation rate was measured under phase contrast microscope. Cell size was determined by cell morphology analytical system. The total protein was determined by coomassie brilliant blue and protein synthesis rate was measured by [3H]-Leucine incorporation. ERK activity was measured by immuno-precipitation. The expression of p-ERK1/2 was assessed using Western blot. RESULT: Tet can decrease Ang II-induced elevations of the pulsation rate, cell size, total protein and protein synthesis rate; inhibit the activity and expression of p-ERK1/2. CONCLUSION: The anti-hypertrophic effect of Tet on Ang II-induced cardiomyocyte hypertrophy was associated with inhibition of ERK1/2 signaling pathway.