A systematic review of qualitative research on the self-management experience of breast cancer patients.

OBJECTIVE: To integrate the qualitative research on the self-management experience of breast cancer patients and conduct a systematic review of their self-management experience. METHODS: Using a computer to search a series of databases such as CNKI, Wanfang, VIP, and China Biomedical Database, systematically collect and integrate qualitative research on the self-management experience of breast cancer patients, and the search time is limited to January 2010 to December 2022. The qualitative research quality evaluation standard of the Joanna Briggs Institute Centre for Evidence-Based Health Care in Australia was used as the evaluation standard of this project to complete the accurate evaluation of the literature; Meta-analysis was used to complete the effective integration of the results. RESULTS: 17 pieces of literature were included in this project, and 37 research results with strong integrity were extracted accordingly. On this basis, 7 different categories were summarised, and three integrated results were obtained: the experience of maintaining self-management, symptom recognition, and self-management. CONCLUSION: In the different stages of self-management of breast cancer patients, medical staff should give targeted guidance to help patients obtain a good prognosis.

Hemolysis attributed to high dose vitamin C: Two case reports.

BACKGROUND: High-dose vitamin C treatment (HVCT) can reduce the adverse effect of chemotherapy and enhance the effect of antitumor therapy, which has been considered one of the safest alternative treatments. However, the severity of its adverse effects may have been underestimated. The most serious adverse effect is hemolysis, which may result in acute kidney injury or death. Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is considered to be the main cause, the probability and pathological mechanism are not completely understood, leading to a lack of effective and standardized treatment methods. CASE SUMMARY: Two patients with colorectal cancer developed hemolytic anemia after using 1 g/kg HVCT. In contrast to previous cases, the lowest hemoglobin level in the two cases was < 50 g/L, which was lower than previously reported. This may be because Case 1 had chronic hepatitis B for many years, which caused abnormal liver reserve function, and Case 2 had grade II bone marrow suppression. Both patients improved and were discharged after blood replacement therapy. Our cases had the most severe degree of hemolysis but the best prognosis, suggesting that our treatment may be helpful for rescue of drug-induced hemolysis. This is the first review of the literature on hemolysis caused by HVCT, and we found that all patients with G6PD deficiency developed hemolysis after HVCT. CONCLUSION: G6PD deficiency should be considered as a contraindication to HVCT, and it is not recommended for patients with bone marrow suppression, moderate-to-severe anemia, hematopoietic abnormalities, or abnormal liver and kidney function. Early blood purification and steroid therapy may avoid acute kidney injury or death caused by HVCT-related hemolytic anemia.

Dietary therapy of the herbal porridge improves the symptoms of functional dyspepsia: A randomized, double-blind, placebo-controlled, clinical trial.

This study (ISRCTN17174559) aimed to explore the efficacy and safety of a kind of herbal porridge (Hou Gu Mi Xi) on the clinical symptoms of functional dyspepsia (FD). This was a single-center, single-dose, prospective, double-blind, randomized controlled trial involving 64 participants with FD (35 cases and 29 controls) for 2 months of intervention and 1 month of follow-up. The 7-point Global Overall Symptom Scale (GOSS), 36-Item Short Form Survey (SF-36), and other indicators were assessed at baseline (day 0), at days 15, 30, and 60 of treatment, and at follow-up 1 month after the end of the intervention. Many participants with FD achieved remission of their epigastric symptoms at follow-up on the 90th day after treatment with herbal porridge compared to the placebo group (45.71% vs. 20.69%, p = .036). Furthermore, herbal porridge appeared to be effective in improving the quality of life of participants with FD, which was reflected in the rising SF-36 scores for physical role, bodily pain, emotional role, and mental health. Although adverse events were reported, there was no overall difference in the number of adverse events between the two groups (p = .578). Herbal porridge is another effective and safe method for improving the symptoms and quality of life in patients with FD.

Network pharmacology-based analysis of heat clearing and detoxifying drug JC724 on the treatment of colorectal cancer.

BACKGROUND: Heat-clearing and detoxifying drugs has protective effect on colorectal cancer (CRC). Given the complicated features of Traditional Chinese medicine formulas, network pharmacology is an effective approach for studying the multiple interactions between drugs and diseases. AIM: To systematically explore the anticancer mechanism of heat-clearing and detoxifying drug JC724. METHODS: This study obtained the active compounds and their targets in JC724 from Traditional Chinese Medicine System Pharmacology Database. In addition, the CRC targets were obtained from Drugbank, TTD, DisGeNET and GeneCards databases. We performed transcriptome analysis of differentially expressed genes in CRC treated with JC724. Venn diagram was used to screen the JC724-CRC intersection targets as candidate targets. Core targets were selected by protein-protein interaction network and herb ingredient-target-disease network analysis. The functional and pathway of core targets were analysed by enrichment analysis. RESULTS: We found 174 active ingredients and 283 compound targets from JC724. 940 CRC-related targets were reserved from the four databases and 304 CRC differentially expressed genes were obtained by transcriptome analysis. We constructed the network and found that the five core ingredients were quercetin, ß Beta sitosterol, wogonin, kaempferol and baicalein. The core JC724-CRC targets were CYP1A1, HMOX1, CXCL8, NQO1 and FOSL1. JC724 acts on multiple signaling pathways associated with CRC, including the Nrf2 signaling pathway, oxidative stress, and the IL-17 signaling pathway. CONCLUSION: In this study, we systematically analyzed the active ingredients, core targets and main mechanisms of JC724 in the treatment of CRC. This study could bring a new perspective to the heat-clearing and detoxifying therapy of CRC.

Correlations between serum lipid and Ki-67 levels in different breast cancer molecular subcategories.

Breast cancer has the highest incidence rate among all cancer types worldwide, seriously threatening women's health. The present retrospective study explored differences in serum lipid contents in different breast cancer (BC) subcategories and their correlation with Ki-67 expression levels in patients with invasive BC with the aim of identifying novel diagnostic and prognostic indicators for personalized BC treatment. The study included 170 patients diagnosed with BC who were diagnosed with invasive BC by postoperative pathological examination. Data on patient age, body mass index and menopausal status were collected, in addition to estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2 (HER2) and antigen Ki-67 expression levels and pathological tumor type. Preoperative circulating lipid levels, specifically the levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides (TG) and apolipoproteins A1 (ApoA1) and B (ApoB) were also obtained. Molecular subcategories of BC were grouped based on their immunohistochemistry. Differences in serum lipid levels between the groups were assessed, and correlations between serum lipid and Ki-67 expression levels were explored. While TC, LDL-C, HDL-C and ApoA1 levels differed significantly among molecular subcategories. TG and ApoB levels did not. Circulating TC and LDL-C levels were considerably higher in patients with triple-negative BC (TNBC) and HER2-positive [hormone receptor (HR)-negative] BC than in those with luminal A and B (HER2-negative) BC. Serum HDL-C levels were significantly diminished in the TNBC and HER2-positive (HR-negative) groups compared with the luminal A and B (HER2-negative) groups. ApoA1 levels were significantly reduced in cases of TNBC and HER2-positive (HR-negative) BC compared with luminal A and B BC. Ki-67 expression levels were positively correlated with circulating TC and LDL-C levels and inversely correlated with circulating HDL-C and ApoA1 levels but exhibited no correlation with serum ApoB and TG levels. The results indicate that elevated TC and LDL-C levels and diminished HDL-C and ApoA1 levels were high-risk factors in patients with TNBC and HER2-positive (HR-negative) BC, but not patients with luminal subcategories of BC. Abnormal serum lipid levels were correlated with Ki-67 expression levels, with elevated circulating TC and LDL-C levels and reduced circulating HDL-C and ApoA1 levels indicating a poor prognosis in patients with BC.

Machine learning predicts cancer-associated deep vein thrombosis using clinically available variables.

PURPOSE: To develop and validate machine learning (ML) models for cancer-associated deep vein thrombosis (DVT) and to compare the performance of these models with the Khorana score (KS). METHODS: We randomly extracted data of 2100 patients with cancer between Jan. 1, 2017, and Oct. 31, 2019, and 1035 patients who underwent Doppler ultrasonography were enrolled. Univariate analysis and Lasso regression were applied to select important predictors. Model training and hyperparameter tuning were implemented on 70% of the data using a ten-fold cross-validation method. The remaining 30% of the data were used to compare the performance with seven indicators (area under the receiver operating characteristic curve [AUC], sensitivity, specificity, accuracy, balanced accuracy, Brier score, and calibration curve), among all five ML models (linear discriminant analysis [LDA], logistic regression [LR], classification tree [CT], random forest [RF], and support vector machine [SVM]), and the KS. RESULTS: The incidence of cancer-associated DVT was 22.3%. The top five predictors were D-dimer level, age, Charlson Comorbidity Index (CCI), length of stay (LOS), and previous VTE (venous thromboembolism) history according to RF. Only LDA (AUC = 0.773) and LR (AUC = 0.772) outperformed KS (AUC = 0.642), and combination with D-dimer showed improved performance in all models. A nomogram and web calculator https://webcalculatorofcancerassociateddvt.shinyapps.io/dynnomapp/ were used to visualize the best recommended LR model. CONCLUSION: This study developed and validated cancer-associated DVT predictive models using five ML algorithms and visualized the best recommended model using a nomogram and web calculator. The nomogram and web calculator developed in this study may assist doctors and nurses in evaluating individualized cancer-associated DVT risk and making decisions. However, other prospective cohort studies should be conducted to externally validate the recommended model.

[Effects of Microplastics on Embryo Hatching and Intestinal Accumulation in Larval Zebrafish Danio rerio].

Microplastics have been frequently detected in aquatic environments, and there are increasing concerns about the potential effects on aquatic organisms. In this study, the effects on hatching and the intestinal accumulation in embryos and larvae exposed to two sizes of polystyrene (PS) microplastics were evaluated. The two PS were green fluorescent polyethylene microplastics with 10 µm size (10GF-PM) and red fluorescent polystyrene microplastics with 0.5 µm size (0.5RF-PM). The results showed no significant difference between hatching rates compared with that of the control group of Danio rerio embryos after exposure for three days at 10-500 mg·L-1 10GF-PM, while the incubation rate was 37% at 500 mg·L-1 0.5RF-PM. The average survival rates of five day post fertilization larvae exposed to 10, 100, 200, and 500 mg·L-1 10GF-PM solutions were 80%, 54%, 44%, and 41%, and were 62%, 37%, 25%, and 12% in corresponding concentration of 0.5RF-PM solutions. A quantitative fluorescence analysis showed that the accumulation of 10GF-PM and 0.5RF-PM in larval intestines increased with the increase in the microplastic concentration, and the fluorescence values were 0.06, 0.53, and 1.84 and 0.63, 2.32, and 3.45 after exposure to 10, 100, and 500 mg·L-1 10GF-PM and 0.5RF-PM solutions for 0.5 h, and were 0.03, 0.08, and 0.56 and 0.06, 0.41, and 1.56 after transferred larval to clear water for 24 h, respectively. The negative effect of microplastics on zebrafish was related to the concentration and particle size:the higher the concentration, the lower the embryo hatching rates; the smaller the particle size, the easier it was to accumulate in the intestines.

Protection of tight junction between RPE cells with tissue factor targeting peptide.

AIM: To investigate the effect of tissue factor targeting peptide (TF-TP) on retinal pigment epithelium (RPE) cells tight junctions. METHODS: Cell counting kit-8 (CCK-8) was used to measure the proliferation of ARPE-19 cells. Expression of tight junction, ZO-1 in ARPE-19 cells was measured by Western blot and immunofluorescent staining. Western blot was also used to detect the expression of tissue factor (TF). CEC Transmigration Assay was used to measure the migration of ARPE-19 cells. The transport of fluorescent markers [fluorescein isothiocyanate dextrans of 4, 10, 20 (FD4, FD10, FD20)] and the transepithelial electrical resistance (TEER) were used to measure in ARPE-19 cell. RESULTS: CCK-8 assay showed that 5 µmol/L TF-TP can inhibit ARPE-19 cells abnormally proliferation stimulated by lipopolysaccharide (LPS; P<0.05). LPS increased the transport of fluorescent markers (FD4, FD10, FD20) and decreased TEER levels in ARPE-19 cells, respectively, which were prevented by 5 µmol/L TF-TP pretreatment (P<0.05). Furthermore, LPS significantly up-regulated the expression of TF and downregulated the expression of ZO-1 (P<0.05) in ARPE-19 cell which was inhibited by the TF-TP (P<0.05). In addition, TF-TP inhibited the abnormal migration induced by LPS in ARPE-19 cell (P<0.05). CONCLUSION: Our findings suggest that TF-TP suppressed proliferation and migration of ARPE-19 cells induced by LPS, and maintained the RPE tight junctions through inhibition of TF expression and increased expression of ZO-1.

[Response of the artificial cyanobacterial crusts to low temperature and light stress and the micro-structure changes under laboratory conditions].

Low temperature and light are noticeable environmental conditions commonly experienced by cyanobacterial crusts growing in desert areas. Here we reported the effects of low temperature and light on the morphology, physiological characteristics and ultrastructural changes of artificial cyanobacterial crust. Firstly artificial cyanobacterial crusts were formed by inoculating Microcoleus vaginatus Gom. and Scytonema javanicum (Kütz.) Born et Flah onto shifting sand in Petri dishes. Then, the artificial cyanobacterial crusts were selected as the experimental materials and subjected to the following treatments: 28 degrees C + 60 microE x (m2 x s)(-1) (control), 10 degrees C + 60 microE x (m2 x s)(-1), 2 degrees C +60 microE x (m2 x s)(-1) and 2 degrees C + dark. On the 0th, 5th and 12th days during the experimental period, biomass (expressed as Chl-a), photosynthetic activities (optimal quantum yield, Fv/Fm), exopolysaccharide (EPS), scytonemin, carotenoid and C-phycocyanin contents of the crusts in different treatments were determined. We also observed the ultrastructural changes of the cyanobacterial crusts in the control and 2 degrees C treatments by means of scan electron microscope (SEM). Moreover, the morphological properties such as crust color, crust thickness and crust dry weight etc. were also examined. The results indicated that the morphology of the treated crusts suffered unfavorable effect under light and low temperature stress, and Chl-a, Fv/Fm, EPS, scytonemin and carotenoid contents as well as C-phycocyanin content of the treated crusts were all significantly lower than those of the crusts under control conditions (P < 0.05). When the cyanobacterial crusts were treated for 12 days under 2 degrees C + 60 microE (m2 x s)(-1), Chl-a, Fv/Fm, EPS, scytonemin and carotenoid contents as well as C-phycocyanin content within the crusts decreased by 61.48%, 94.89%, 66.37%, 31.01%, 59.38%, and 65.91%, respectively. Obvious destruction in ultrastructure was observed in the cyanobacterial crust under cold stress, such as the presence of numerous honeycombs within the crusts and the sparse and loose appearance of the algal filaments, etc. The research verified that the acquired treatments had negative effects on the morphology, growth and microstructures of the cyanobacterial crusts, and the cooperation of low temperature and dark could provide effective protection for the morphological, physiological and microstructural features of the crust subjected to cold and light stress. The aim of this study was to primarily discuss the responses of cyanobacterial crusts to low temperature and light stress, and to offer a basic understanding of cyanobacterial crusts against extreme environments in fields, which may have certain academic significance for researches interested in cyanobactrial crusts.

[Meta-analysis of randomized controlled trials comparing laparoscopic with open surgery for rectal cancer on oncologic clearance and long-term oncologic outcomes].

OBJECTIVE: To compare oncologic adequacy of resection and long-term oncologic outcomes between laparoscopic-assisted surgery (LS) and open surgery (OS) in the treatment of rectal cancer. METHODS: Literature searches of electronic databases (PubMed, Embase, Web of Science,and Cochrane Library) and manual searches up to June 30, 2010 were performed to identify RCTs comparing values of oncologic adequacy of resection, recurrence and survival following LS and OS. Fixed and random effects models were used. RESULTS: Six RCTs enrolling 1033 participants (LS group:577 cases, OS group:456 cases)were included in the meta-analysis. Number of lymph node harvested was similar(WMD=-0.38, 95%CI:-1.35-0.58, P=0.43). LS had a slightly higher circumference resection margin(CRM) positive rate with no statistical significance[7.94% vs. 5.37%; risk ratio(RR)=1.13; 95%CI:0.69-1.85, P=0.63]. There was no significant difference between the two groups in local recurrence (RR=0.55; 95%CI:0.22-1.40, P=0.21). The 3-year overall survival [Hazard ratio(HR)=0.76; 95%CI:0.54-1.07, P=0.11] and 3-year disease-free survival(HR=1.16; 95%CI:0.61-2.20, P=0.64) were not significantly different between the two groups. CONCLUSION: Compared with open surgery, laparoscopic surgery of rectal carcinoma offers similar oncological clearance and long-term oncological outcomes.