The mechanism of polyphyllin in the treatment of gastric cancer was verified based on network pharmacology and experimental validation.

Background: Polyphyllin is a class of saponins extracted from Paris polyphylla rhizomes and has been used in clinical application in China for more than 2000 years. However, the mechanism for treating gastric cancer (GC) is still unclear. This study was designed to predict the targets and mechanisms of total Polyphyllin from Paris polyphylla rhizomes for the treatment of GC. Method: Firstly, PubChem and Swiss Target Prediction databases were utilized to collect the 12 ingredients of total Polyphyllin from Paris polyphylla rhizomes and their targets. GC-related genes were obtained from the GEO database. Then the intersecting targets to all these molecules that identified using Venny. Secondly, the intersecting targets were imported into STRING platform for protein-protein interaction (PPI) network. Moreover, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses were conducted in DAVID website. In addition, the GEPIA was applied to perform the expression levels, transcript levels, staging, and overall survival of hub genes. In addition, we used AutoDock Vina to evaluate binding affinity of molecular docking between key ingredients and anti-GC targets. In vitro cell experiments, we detected the cell viability of gastric cancer cells at 24, 36, and 48 h using CCK-8 assay. The G0/G1 of cell cycle and apoptosis were detected by flow cytometry. Finally, quantitative real time polymerase chain reaction (qRT-PCR) was used to detect the level of hub genes, and Western blot was used to detect the changes of PI3K/Akt signal pathway. Results: Firstly, we identified 12 ingredients and 286 targets of total Polyphyllin. A total of 2653 GC-related differentially expressed genes (DEGs) were collected, including 1366 up-regulated genes and 1287 down-regulated genes. Moreover, 45 targets were obtained after intersection. Secondly, results of the GO enrichment suggested that these genes were closely related to cell proliferation, migration and aging. KEGG analysis suggested that Polyphyllin in GC therapy were mostly regulated by multiple pathways, including the pathways in cancer, calcium signaling pathway, Rap1 signaling pathway, phospholipase D signaling pathway, etc. In addition, GEPIA results exhibited that PDGFRB, KIT, FGF1, GLI1, F2R, and HIF1A were associated with GC progression, stage, and survival. Besides, the molecular docking results further confirmed that the binding energy of Polyphyllin Ⅲ with HIF1A was minimal. In vitro cell experiments, Polyphyllin Ⅲ inhibited the cell viability of gastric cancer cells, blocked the cell cycle G0/G1 phase, and induced cell apoptosis. In addition, Polyphyllin Ⅲ down-regulated the mRNA levels of PDGFRB, KIT, FGF1, GLI1, F2R, and HIF1A, and regulated the PI3K/Akt signal pathway. Conclusions: The results revealed that total Polyphyllin treated GC through multiple targets, multiple channels, and multiple pathways. In addition, Polyphyllin Ⅲ played an anti-gastric cancer role by inhibiting the proliferation of gastric cancer.

Financial hardship experience in middle- and older-aged patients with advanced lung cancer.

PURPOSE: Advancements in medical treatments have resulted in increased medical costs for cancer patients. More than half of the patients with advanced lung cancer reported unmet financial needs. The purpose of this study is to examine the differences in the prevalence and correlates of financial hardship between middle- and older-aged patients with advanced lung cancer, and its impact on multiple health-related outcomes. METHODS: This study presents a cross-sectional analysis involving 226 patients with advanced lung cancer, who were enrolled in a randomized controlled trial conducted between 2018 and 2020. Data collection was performed through self-reported questionnaires and electronic medical records. Multivariable logistic and linear regression models were adopted for analysis. RESULTS: 58.0% reported experiencing financial hardships. Middle-aged participants who were single and had a lower education level were more likely to experience financial difficulties. However, males and higher performance status were associated with a lower likelihood of experiencing financial difficulties among older-aged participants. Financial hardship was significantly associated with anxiety (p < 0.001), depression (p < 0.001), sleep disturbances (p < 0.001), quality of life, global health status (p = 0.002), functional scale score (p < 0.001), symptom scale score (p < 0.001), and lung cancer-specific scale score (p < 0.001). CONCLUSIONS: More than half of the patients with advanced lung cancer experienced financial hardships caused by cancer or its treatment, with a higher prevalence reported in middle-aged patients. Different sociodemographic and clinical variables correlated with financial hardship in middle- and older-aged participants, respectively. More attention should be paid to middle-aged patients with advanced lung cancer, particularly during routine assessments.

Relationship of weight loss to quality of life and symptom distress among postsurgical survivors of oesophageal cancer who received chemotherapy.

PURPOSE: Weight loss is highly prevalent in oesophageal cancer survivors, who often experience disease-related or treatment-related symptoms and quality of life (QoL) impairment. This study aimed to explore the relationships among weight loss, symptom distress, and QoL postoperatively in patients with oesophageal cancer undergoing chemotherapy and to identify the factors influencing the QoL. METHODS: We conducted a retrospective observational study with 101 patients and collected data on weight loss (percentage of total body mass loss), QoL (EORTC-QLQ-C30 and EORTC-QLQ-OES-18), and symptom distress (MDASI-GI-C). The associations among weight loss, QoL, and symptom distress were assessed using Pearson's correlation. Multiple linear regression analysis was used to identify independent factors influencing patients' QoL scores. RESULTS: The distribution of weight loss of each stage in survivors of oesophageal cancer was 1.00% (SD: 2.48%), 4.69% (SD: 4.73%), 1.66% (SD: 5.37%), 2.83% (SD: 4.89%) respectively. The mean QoL score was 66.24 (SD 18.65). The participants' mean symptom severity and symptom interference scores were 3.30 (SD 1.74) and 2.76 (SD 1.90), respectively. Weight loss and symptom distress were negatively related to patients' QoL (p < 0.05, p < 0.01, respectively). Weight loss between 6 months before diagnosis and the time of diagnosis (p < 0.05) and symptom interference (p < 0.01) were independent predictors for the QoL. CONCLUSIONS: This study suggests that oesophageal cancer survivors with larger weight reduction between 6 months before diagnosis and the time of diagnosis and more symptom distress have a worse QoL. Clinicians should focus more on patients' weight and symptom management to improve their QoL.

Predictive factors based on the health belief model on cancer screening behaviour in first degree relatives of patients with Lynch syndrome-associated colorectal cancer.

Objectives: This study aimed to investigate colorectal cancer-related knowledge, health beliefs, and screening behaviour in first-degree relatives (FDRs) of patients with Lynch syndrome-associated colorectal cancer (CRC) and explore the predictive factors of screening behaviour based on a health belief model. Methods: This cross-sectional study was conducted in the colorectal department of a Class A tertiary hospital in Guangzhou from December 2017 to December 2019. A total of 265 FDRs of 96 patients with Lynch syndrome-related CRC were selected. The study was conducted in the colorectal department of a tertiary cancer centre in Guangzhou. The demographic questionnaire, the simplified CRC knowledge questionnaire, and the Champion's Health Belief Model Scale were used for evaluation. Data were analyzed using statistical description, between-group comparisons, and binary logistic regression. Results: A total of 160 (60.4%), 61 (23.0%), and 44 (16.6%) of the participants had high, medium, and low levels of knowledge about CRC, respectively; the average overall score of health belief was 121.36 ± 13.02. Sixty-one participants (23.0%) underwent Lynch syndrome-associated cancer screening. The predictive factors of screening behaviour included sex (male), age (older), married status (married), multiple primary cancers of the index patients, and high levels of knowledge and health beliefs (P < 0.05). Conclusions: The knowledge and health beliefs of cancer and cancer screening in FDRs of patients with Lynch syndrome-associated CRC should be improved. Both knowledge and beliefs are critical in promoting their cancer screening behaviour. Interventions should focus on health education and enhance health beliefs of the FDRs for better screening behaviour.

Chinese Lynch syndrome-associated colorectal cancer patients' self-concept and adherence to surveillance.

OBJECTIVE: To describe Chinese Lynch syndrome-associated colorectal cancer patients' self-concept and adherence to surveillance and explore the factors influencing patients' adherence to surveillance. METHODS: This was a cross-sectional quantitative study of a group of 83 Lynch syndrome-associated colorectal cancer patients, using the Lynch syndrome self-concept scale and medical records. IBM SPSS 20.0 was used for statistical analysis. RESULTS: Patients' adherence to surveillance, for colorectal cancer, gastric cancer and small intestinal cancer, endometrial and ovarian cancer, they were 93.2%, 41.8% and 56.7% respectively. Older patients had lower surveillance adherence of colorectal cancer, gastric cancer and small intestinal cancer than younger patients (p < 0.05). Occupation was the major factor influencing their surveillance adherence of endometrial and ovarian cancer (p < 0.05). The score for Lynch syndrome self-concept was 72.23 ± 25.65. CONCLUSION: The surveillance adherence of patients is high for colorectal cancer but low for extracolorectal cancers. Low surveillance adherence is associated with old age, living with family members and less secure employment. Chinese patients' self-concept scores were slightly higher than foreign patients. Nurses should pay more attention to the surveillance adherence and self-concept of Lynch syndrome-associated colorectal cancer patients and develop effective interventions to improve their surveillance adherence.

Acute kidney injury in cancer patients and impedance cardiography-assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital.

Acute kidney injury (AKI) in cancer patients may disrupt anticarcinogenic treatment and greatly increase associated mortality rates. The present study reported on the management of cancer patients with AKI and, from the nephrologic viewpoint, on the significance of fine volume control during the continuous renal replacement therapy (CRRT). The records of 117 cancer patients with AKI treated over three years were reviewed and their data were compared with those of 120 healthy controls. AKI was defined according to the Kidney Disease: Improving Global Outcomes criteria with serum creatinine levels determined on initial admission and for the diagnosis of AKI. CRRT with concomitant impedance cardiography (ICG) monitoring was performed in 79 patients. On average, AKI manifested as a 1.68±0.38-fold increase in serum creatinine within 10.2±5.7 days. The causes of AKI were diverse, with the major ones being nephrotoxic agents, hypotension and obstructive nephropathy. Renal biopsy confirmed two cases of thrombotic microangiopathy, due to the use of interfon-α and sunitinib malate, respectively, and a third case of cast nephropathy caused by immunoglobulin D multiple myeloma. The patients were generally marantic and had compromised cardiac function compared with the healthy controls. The CRRT prescription was discriminatingly optimized by the ICG parameters effecting discreet fluid balance, as the thoracic fluid content was significantly correlated with the ultrafiltration rate. By considering the causative mechanisms and applying subtle ICG-assisted volume control, the present study may thus help to improve the safety and efficacy of CRRT in cancer patients with AKI. In addition, it provided information to bring advances in onconephrology, a novel nephrological subspecialty field.

A simple, post-additional antioxidant capacity assay using adenosine triphosphate-stabilized 2,2'-azinobis(3-ethylbenzothiazoline)-6-sulfonic acid (ABTS) radical cation in a G-quadruplex DNAzyme catalyzed ABTS-H2O2 system.

The scavenging of 2,2'-azinobis(3-ethylbenzothiazoline)-6-sulfonic acid (ABTS) radical cation (ABTS(+)) by antioxidants has been widely used in antioxidant capacity assay. Because of ABTS(+) disproportionation, however, this radical cannot be prepared on a large scale and stored long-term, making it unsuitable for high-throughput detection and screening of antioxidants. We developed a modified "post-additional" antioxidant capacity assay. This method possessed two remarkable features: First, instead of natural peroxidases, an artificial enzyme, G-quadruplex DNAzyme, was used for the preparation of ABTS(+), thus greatly reducing the cost of the assay, and eliminating the strict demand for the storage of enzymes. Second, an ABTS(+) stabilizer, adenosine triphosphate (ATP), was used. In the presence of ATP, the disproportionation of ABTS(+) was effectively inhibited, and the lifetime of this radical cation was prolonged about 6-fold (12 days versus 2 days), making the large-scale preparation of ABTS(+) possible. Utilizing this method, the antioxidant capacities of individual antioxidants and real samples can be quantified and compared easily. In addition, this method can be developed as a high-throughput screening method for antioxidants. The screening results could even be judged by the naked eye, eliminating the need for expensive instruments.

G-quadruplex DNAzyme-based Hg2+ and cysteine sensors utilizing Hg2+-mediated oligonucleotide switching.

A simple and sensitive colorimetric Hg(2+) detection method is reported, based on the Hg(2+)-mediated structural switch of an unlabeled oligonucleotide strand. In the absence of Hg(2+), the oligonucleotide strand forms a stem-loop. A G-rich sequence in the strand is partially caged in the stem-loop structure and cannot fold into a G-quadruplex. In the presence of Hg(2+), T-Hg(2+)-T coordination chemistry leads to the formation of another stem-loop structure and the release of the G-rich sequence. The released sequence folds into a G-quadruplex, which binds hemin to form catalytically active G-quadruplex DNAzymes. This is detected as an absorbance increase in a H(2)O(2)-2,2'-azinobis(3-ethylbenzothiozoline)-6-sulfonic acid (ABTS) reaction system using UV-vis absorption spectroscopy. This simple colorimetric sensor can detect aqueous Hg(2+) at concentrations as low as 9.2 nM with high selectivity. Based on the strong binding interaction between Hg(2+) and the sulfur-containing amino acid cysteine (Cys), and the competition between Cys and a oligonucleotide for Hg(2+), the proposed Hg(2+)-sensing system can be further exploited as a Cys-sensing method. The method has a detection limit for Cys of 19 nM.

[Determination of fosetyl-aluminium by ion-pair reversed phase-high performance liquid chromatography with evaporative light scattering detection].

Ion-pair reversed phase-high performance liquid chromatography (RP-HPLC) with evaporative light scattering detection (ELSD) has been established for the analysis of fosetyl-aluminium and relevant impurities in technical or formulated substance. The method was achieved on a Symmetry Shield RP18 column by using n-butylamine as ion-pairing agent. The mobile phase was methanol-redistilled water containing 0.5% n-butylamine which was adjusted pH 5.0 with acetic acid (8:92, v/v) and the flow rate was set at 0.8 mL/min. The active ingredient fosetyl-aluminium was successfully separated from relevant impurities under the conditions. The calibration curve was linear in the range of 100-1200 mg/L. The average recoveries of two fortification levels (100 mg/L and 1000 mg/L) were 100.58% and 99.53%, and the relative standard deviations (RSDs) were 0.62% and 0.49%, respectively. The method is rapid, simple and accurate which provides another new and reliable means for the analysis of fosetyl-aluminium in its technical or formulated substance.

[Preparation of high viscous chitosan/glycerol phosphate and preliminary studies on its properties].

OBJECTIVE: To increase the viscosity of chitosan/glycerol phosphate (C/GP) and to improve its preparation technique in order to develop the application range of C/GP. METHODS: Chitosan was treated by high-pressure vapor sterilization in order to prepare high viscous C/GP (HV-C/GP) and prepare C/GP by standard methods. The rheologic changes of HV-C/GP and C/GP were detected dynamically by the Gemini rheometer. The initial solution viscosity, gelation temperature and gelation time were evaluated after the viscosity of the materials were increased. Two gelation materials were placed into continuous flow thermostated cells under the same condition and harvest them at predetermined time intervals, 1st, 2nd, 5th, 10th and 25th days, then they were dried, weighed and the mass loss rate was calculated. Ultrastructure of the freeze-dried samples was visualized by the scanning electron microscope. RESULTS: The initial viscosity of C/GP was 1.81 Pas and that of HV-C/GP was 17.24 Pas. The latter one increased 10 times as well as the former one. The gelation temperature of C/GP was 37 degrees C and that of HV-C/GP was 34 degrees C. There was no remarkable difference in gelation time between them. The mass loss rate of HV-C/GP at first day was 72.5% and at 25th days was 90.8%, while that of C/GP was 55.4% and 78.2%. Porous network structure was observed by the scanning electron microscope in both of them. The pore diameter of C/GP was 50-100 microm and that of HV-C/GP was 30-50 microm, which was obviously smaller than the former. CONCLUSION: The viscosity of HV-C/GP prepared by improved technique obviously increases and the thermosensitivity has no significant changes. The degradation time of HV-C/GP in vitro lengthens. The micrographs show that the HV-C/GP gels are porous and the pore diameter are smaller than C/GP.