The Construction of Sustained-Release Systems of Tanshinone IIA and Sodium Tanshinone IIA Sulfonate by SBA-15 Mesoporous Material.

The basic problems of the low dissolution rate of Tanshinone IIA (TSN) and the instability and precipitation of sodium tanshinone IIA sulfonate (STS) injection limit their usage in clinical. For these facts, the study aims to improve the dissolution rate of TSN and to enhance the sustained release effects of TSN and STS by using SBA-15 mesoporous molecular sieve as a drug carrier. Furthermore, controlling the pore size of SBA-15 and using different loaded methods to achieve expectations and provide a novel scheme for existing Danshen formulations. The effect of loading methods on drug loading efficiency (DL%), as well as the influence of the pore size of SBA-15s, the drug polarities and release mediums on drug loading and release behaviors were analyzed. It was found that the DL% was enhanced with the enlargement of the pore size, and was higher of TSN than STS. The in vitro tests of drug-loaded SBA-15s confirmed that the dissolution rate of TSN was improved obviously as compared with pure TSN. Moreover, SBA-15s prolonged the release times up to 12 h of TSN and 60 h of STS and promoted the sustained-release behaviors by decreasing the pore size. To ascertain the kinetic mechanisms of these samples, the Korsmeyer-Peppas release model was employed and the fitted results indicated that TSN/SBA-15s followed Fickian diffusion and non-Fickian transport was the predominant kinetic release mechanisms for STS/SBA-15s.

[Comparison of the clinicopathological characteristics of colorectal cancer between elderly and young patients].

OBJECTIVE: To compare the clinicopathological characteristics between elderly and young patients with colorectal cancer (CRC). METHODS: A total of 727 patients with CRC treated between Jan 2003 and Dec 2005 were divided into elderly group (≥ 60 years old), middle-aged group (36-59 years old), and young group (≤ 35 years old). The clinicopathological characteristics of the 3 groups were analyzed retrospectively. RESULTS: The tumor occurred mainly in the rectum, sigmoid colon and ascending colon of the patients. The major initial symptoms included hemafecia and changes in bowel habits in the elderly and middle-aged cases, as compared to abdominal pain and hemafecia in the young group. The elderly patients had greater ratio of well differentiated neoplasm than the middle-aged and young patients. The ratio of radical operation was markedly higher in the elderly and middle-aged group than in the young group. The elderly patients were more likely to have stage II and III tumors than the middle-aged and young patients, having also significantly higher incidences of such complications as heart and lung diseases upon diagnosis. CONCLUSIONS: Compared with the middle-aged and young patients, elderly patients with CRC are more likely to have well differentiated tumor, multiple complications upon diagnosis, and higher radical operation rate.

[Analysis of twelve cases of angiofollicular lymph node hyperplasia with literature review].

BACKGROUND & OBJECTIVE: Angiofollicular lymph node hyperplasia (AFH) is a rare lymphoproliferative disorder disease. This study was to investigate the clinical characteristics, treatment and prognosis of AFH. METHODS: Clinical data of 12 AFH patients, admitted in Guangdong Provincial People's Hospital from Oct. 1989 to Dec. 2006, were analyzed. All cases were diagnosed by lymph node biopsy. RESULTS: Of the 12 cases of AFH, 9 were unicentric disease characterized by localized lymph node enlargement, and 3 were multicentric disease characterized by multiple lymph node enlargement accompanied by systemic symptoms. The 9 patients with unicentric disease received tumor resection and were followed up for a median of 30 months; 8 responded well to surgical resection and 1 was lost. Of the 3 patients with multicentric disease, 2 were treated with chemotherapy and achieved partial remission, 1 received no antitumor therapy and died of multi-organ failure in 21 months. CONCLUSION: Unicentric AFH can be cured by surgery alone and have a good prognosis after operation; multicentric AFH needs aggressive and systemic chemotherapy.

[Correlative analysis between serum dihydropyrimidine dehydrogenase, activity, concentration of 5-fluorouracil and adverse events in the treatment of advanced gastric cancer patients].

BACKGROUND & OBJECTIVE: Toxicities and their severities vary among advanced gastric cancer patients when they receive the same regimen containing continuous infusion of 5-fluorouracil (5-FU). Dihydropyrimidine dehydrogenase (DPD) is the key rate-limiting enzymes which is closely related to toxicities of 5-FU in chemotherapy. This study was to explore the relationship between activity of DPD and concentration of 5-FU, and their correlation to adverse events among advanced gastric cancer patients treated with the same regimen containing 5-FU continuous infusion. METHODS: Patients received the same regimen (intravenous injection of paclitaxel 75 mg/m(2), leucovorin 200 mg/m(2) and 5-FU 375 mg/m(2), continuous infusion of 5-FU 2.5 g/m2 for 46 hours every two weeks). The peripheral blood was collected from 36 patients with advanced gastric cancer before and after chemotherapy to detect the activity of DPD and concentration of 5-FU by high-performance liquid chromatography (HPLC). Adverse events were assessed every cycle. RESULTS: Serum activity of DPD revealed a unimodel distribution, which globally fits to a guassian distribution (range 1.56-6.01). Mean and median DPD activity values were 2.38 and 2.13, respectively. No total DPD deficiency was found in the patients. The concentration of 5-FU varied from 179.2 microg/L to 1 589.2 microg/L, which demonstrated normality distribution after a logarithmic transformation was applied. The DPD activity was inversely correlated with 5-FU concentration (r=-0.376, P=0.024). The patients with low activity of DPD were more frequently suffering from severe diarrhea, mucositis, and myelosuppression. And high level of 5-FU concentration led to the increase of adverse events. CONCLUSION: Pre-chemotherapy DPD activity and 5-FU concentration during chemotherapy vary among gastric cancer patients, which may help to prevent severe toxicities during the treatment.

[Progression of adjuvant chemotherapy for colon cancer].

Postoperative adjuvant chemotherapy is benefit to survival of stage III colon cancer patients. Regimens containing 5-fluorouracil (5-FU) are used as the main therapy, including 5-FU/Lev, Mayo (FU/LV), protracted venous infusion of 5-FU, orally administered fluorouracil (UFT, Xeloda), and so on. 5-FU combined with oxaliplatin may improve therapeutic efficacy; however, further study on therapeutic efficacy of 5-FU combined with irinotecan is needed. The survival benefit of postoperative adjuvant chemotherapy for stage II colon cancer is controversial now; while postoperative adjuvant chemotherapy for high-risk colon cancer patients should be considered. The progression of postoperative adjuvant chemotherapy for colon cancer patients was reviewed in the article.

[Relationship of serum level of dihydropyrimidine dehydrogenase and serum concentration of 5-fluorouracil to treatment response and adverse events in colorectal cancer patients].

BACKGROUND & OBJECTIVE: Toxicities and response are different when patients with advanced colorectal cancer were treated with standard FOLFOX6 regimen. Serum level of dihydropyrimidine dehydrogenase (DPD) relates to efficacy and toxicities of chemotherapy containing 5-fluorouracil (5-FU). This study was to explore relationship of DPD to serum concentration of 5-FU in colorectal cancer patients treated with FOLFOX6 regimen, and their correlation to treatment response and adverse events. METHODS: Serum level of DPD in 72 patients with colorectal cancer was detected by high-performance liquid chromatography (HPLC) before chemotherapy. Serum concentration of 5-FU at steady state was detected by HPLC after patients received FOLFOX6 regimen. Treatment response and adverse events in the patients were assessed. RESULTS: Serum levels of DPD were normally distributed in 72 patients (ranged 1.55-5.94), while serum concentrations of 5-FU at steady state were not (ranged 141.1-1 741.9 microg/L). Serum level of DPD was negatively correlated with serum concentration of 5-FU (r=-0.460, P < 0.01). Occurrence of adverse events was lower when 5-FU concentration was less than 600 microg/L than when 5-FU concentration was more than 600 microg/L (P < 0.05). The mean serum concentration of 5-FU was significantly higher in patients with complete response and partial response than in patients with steady disease, and progressive disease (513.9 microg/L vs. 409.8 microg/L, and 259.3 microg/L, P < 0.05). Serum level of DPD was lower in patients suffered oral mucositis and diarrhea of grade II-IV than in patients suffered oral mucositis and diarrhea of grade 0-I (P=0.016, P=0.047). Serum level of DPD had no relation with treatment response of the patients (r=0.312, P=0.078). CONCLUSIONS: DPD level and serum 5-FU concentration vary a lot among patients with colorectal cancer. DPD level negatively correlates with serum 5-FU concentration. Serum concentration of 5-FU correlates with treatment effect and toxicities.