Effects of Oral Steroids Combined with Postauricular Steroid Injection on Patients with Sudden Sensorineural Hearing Loss with Delaying Intervention: A Retrospective Analysis.

Background: In the otology clinic, we often receive some sudden sensorineural hearing loss (SSNHL) patients accompanied by annoying tinnitus, who usually visited over three weeks after the onset. Nevertheless, due to the high treatment cost and relatively low cure rate, there are still great disputes about hospitalization or not for these patients. Aim: This study aimed to perform a retrospective analysis for analyzing the efficacy of treatment with oral steroids combined with postauricular steroid injection in patients with delaying effective treatment. Material/Methods: A total of 157 eligible SSNHL patients with delaying effective treatment over three weeks were enrolled in this study. According to different treatment methods of oral steroids with or without postauricular steroid injection, these patients were divided into three groups: PO (prednisone oral) group, PSI (prednisone oral and postauricular steroid injection) group, and PII (prednisone oral and postauricular lidocaine injection) group. The changes in level of hearing, mean subjective tinnitus loudness, and side effects were analyzed in the three groups. Results: Hearing improvement and tinnitus remission were all observed in three groups after treatment. Compared with PO and PII groups, those patients in PSI groups had more improvement in level of hearing and mean subjective tinnitus. The level of tinnitus loudness was statistically significantly correlated with the level of PTA both before treatment and after treatment. Conclusion: Oral steroids combined with postauricular steroid injection should be employed for treatment of SSNHL patients with delaying effective treatment over three weeks.

Effect of lncRNA MALAT1 expression on survival status of elderly patients with severe pneumonia.

OBJECTIVE: The aim of this study was to explore the relationship between serum MALAT1 level and clinical features of elderly patients with severe pneumonia and its impact on patients' survival. PATIENTS AND METHODS: A total of 150 elderly patients with severe pneumonia were enrolled in this study. According to patients' prognosis, enrolled subjects were divided into two groups, including death group (n=63) and survival group (n=87). The clinical data and indicators of subjects were collected, and χ2 and t-tests were used for statistical analysis. MALAT1 expression in the serum of all subjects was examined through the qPCR assay. Meanwhile, the predictive value of MALAT1 for patient death was assessed by the receiver operating characteristic curve (ROC). RESULTS: PT, APTT, DD, APACHE II scores, and MODS scores in death group were remarkably higher, while HB, HCT, TT, and PaO2/FiO2 were conversely lower than those in survival group (p<0.05). QRT-PCR results revealed significantly increased MALAT1 expression in death group when compared with survival group, especially in those patients with a history of smoking and COPD (p<0.05). In addition, ROC analysis confirmed the predictive value of MALAT1 for the prognosis of elderly patients with severe pneumonia. CONCLUSIONS: MALAT1 is highly expressed in the serum of elderly patients with severe pneumonia. Furthermore, it may serve as a marker for the prediction of survival of these patients.

Efficacy and safety of tranexamic acid in orthopaedic trauma surgery: a meta-analysis.

OBJECTIVE: To systematically review the efficacy and safety of tranexamic acid (TXA) in reducing blood transfusion and total blood loss in patients undergoing orthopaedic trauma surgery. MATERIALS AND METHODS: A systematic literature search was performed using PubMed, Embase and Cochrane Library databases. The search time was incepted to February 2019. Two reviewers independently screened literature, extracted data, and assessed risk of bias. Then, meta-analysis was performed using RevMan 5.3. RESULTS: A total of 10 studies were included, with 936 patients. The pooled results indicated that TXA group was superior to control group in the total blood loss [MD=-157.61, 95%CI (-250.09, -65.13), p=0.0008], blood transfusion [OR=0.59, 95%CI (0.43, 0.81), p=0.001], and the wound complications [OR=0.59, 95%CI (0.43, 0.81), p=0.001]. There was no significant difference in risk of thromboembolic events [OR=1.27, 95%CI (0.78, 2.12), p=0.35] and the mortality [OR=0.79, 95%CI (0.35, 1.78), p=0.57] between TXA and control group. CONCLUSIONS: TXA could effectively reduce blood transfusion, total blood loss, and wound complications in patients undergoing orthopedic trauma surgery. Furthermore, TXA does not significantly increase the incidence of thromboembolic events and mortality. Due to the limited quality of the included studies, more high-quality works are required to verify the above conclusions.

[Analysis of prognostic factors in patients with refractory sudden sensorineural hearing loss].

Objective:To explore the relationships between glucocorticoid (GC) sensitivity and the prognosis of refractory sudden sensorineural hearing loss (SSNHL), and to analyze the related factors being affected the prognosis of SSNHL. Method:Ninety-one refractory SSNHL patients were enrolled in the present investigation. Peripheral blood mononuclear cells (PBMCs) from the refractory SSNHL were extracted to conduct GC proliferation dexamethasone (DEX) inhibition experiments. All patients accepted comprehensive treatment with methylprednisolone. Result:Total effective rate was 40.66% in refractory SSNHL patients. Gender, number of affected ear, age, accompanying with vertigo, tinnitus or not and the procedure of methylprednisolone treatment were irrelevant to the efficacy. Only the inhibitory rate of DEX and the time from onset to visit were related to GC treatment effect, especially for inhibitory rate of DEX. The DEX inhibition rate of the effective group was higher than that of the ineffective group. Conclusion:DEX inhibition rate can predict GC sensitivity and prognosis of SSNHL. GC sensitivity and the time from onset to treatment are two important factors affecting the prognosis of refractory SSNHL patients..

Research on the correlation of changes in plasma lncRNA MEG3 with change in inflammatory factors and prognosis in patients with traumatic brain injury.

OBJECTIVE: To study the correlation between the plasma long non-coding RNA (lncRNA) maternally expressed gene 3 (MEG3) and the levels of inflammatory cytokines in patients with traumatic brain injury (TBI) and to evaluate its prognosis to screen new biological targets for the diagnosis and treatment of TBI. PATIENTS AND METHODS: 40 patients with TBI (TBI group) and 40 healthy people (control group) were collected and venous blood was drawn. The plasma MEG3 in subjects was quantitatively analyzed via quantitative Polymerase Chain Reaction (qPCR). Moreover, the levels of inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-1ß (IL-1ß), IL-6, and IL-8] in plasma in each group were detected via enzyme-linked immunosorbent assay (ELISA). Finally, the correlation analysis was performed for the MEG3 expression level and inflammatory cytokine levels in patients with TBI. Patients were divided into high-expression MEG3 group and low-expression MEG3 group, high-level inflammatory cytokine group and low-level inflammatory cytokine group according to the median, followed by prognosis evaluation. The MEG3 expression level in TBI group was significantly decreased compared to that in control group, and the levels of inflammatory cytokines in plasma, including TNF-α, IL-1ß, IL-6, and IL-8, were significantly higher than in control group. RESULTS: The results of the correlation analysis showed that the expression level of plasma MEG3 had a significantly negative correlation with the level of each inflammatory cytokine. The prognostic analysis revealed that the prognosis of patients with high MEG3 expression level and low inflammatory cytokine levels was good, while it was poor in patients with low MEG3 expression level and high inflammatory cytokine levels; the difference was significant. In patients with TBI, the expression level of plasma MEG3 is decreased, while the inflammatory cytokine levels are increased, and there is a significantly negative correlation between the two items. CONCLUSIONS: The prognosis of patients with high MEG3 expression level and low inflammatory cytokine levels is good so MEG3 and inflammatory cytokines can be used as biomarkers for diagnosis and treatment of TBI, improving the prognosis of patients.

Astragalosides modulates contractile function of toad gastrocnemius muscle.

Huangqi (Radix Astragali) is a well-known traditional Chinese herbal medicine, it is an effective treatment for consumptive disease, such as the common cold, diarrhea, fatigue and cardiac diseases. Astragalosides (AST) is the main component of Huangqi. The purpose of this study is to investigate the modulation effect of AST on the skeletal muscle contractile function. Our results showed that the toad gastrocnemius muscle contractile response was significantly increased after the use of AST (25 mg/L, bath for the isolated muscle), which produced a left-ward shift of the contractile force-stimulation intensity curve. Moreover, AST also prevented the repetitive stimulation-induced decrease in muscle contractile force and recovery amplitude of muscle contraction. These results demonstrate that AST can affect contractile performance of toad gastrocnemius muscle and contribute to skeletal muscle anti-fatigue.

Downregulation of long non-coding RNA DBH-AS1 inhibits osteosarcoma progression by PI3K-AKT signaling pathways and indicates good prognosis.

OBJECTIVE: Long non-coding RNA DBH-AS1 (DBH-AS1) has emerged as a novel regulator in cancer initiation and progression of several tumors. However, the expression of DBH-AS1 in osteosarcoma and its effect on the tumorigenesis of osteosarcoma are unclear. The purpose of this study was to determine the role of DBH-AS1 in osteosarcoma progression. PATIENTS AND METHODS: The expression level of DBH-AS1 in 119 pairs of osteosarcoma tissues and five cell lines was detected by quantitative Real Time-Polymerase Chain Reaction (qRT-PCR). The association of DBH-AS1 expression with clinicopathological factors and prognosis was also analyzed. Cell proliferation was measured by Cell Counting Kit-8 (CCK-8), EdU and cell colony formation assays and apoptosis in MG63 and U2OS cells was examined by flow cytometry. Following that, transwell invasion and wound-healing assays were used to explore cell migration and invasion, respectively. The expression of the PI3K/Akt pathway-related proteins was examined by Western blot analysis. RESULTS: We observed that DBH-AS1 was distinctly overexpressed in osteosarcoma tissue and cells, and associated with lymph node status and metastasis status. Osteosarcoma patients with a higher DBH-AS1 expression showed significantly poorer overall survival than those with lower DBH-AS1 expression. Multivariate analysis demonstrated that high DBH-AS1 expression was an independent poor prognostic factor for osteosarcoma patients. Functional assays revealed that knockdown of DBH-AS1 inhibited cell proliferation, migration and invasion, while promoted apoptosis in osteosarcoma. Moreover, suppression of DBH-AS1 could inhibit the activation of the PI3K/Akt pathway, which was demonstrated by examining the expression levels of p-PI3K and p-Akt. CONCLUSIONS: Our data first reported that DBH-AS1 may act as an oncogenic lncRNA by modulating the PI3K/Akt pathway in osteosarcoma, which may serve as a candidate prognostic biomarker and target for new therapies in osteosarcoma.

[Preparation, quality control and thyroid molecule imaging of solid-target based radionuclide ioine-124].

OBJECTIVE: To provide useful information for the further production and application of this novel radio-nuclide for potential clinical application. METHODS: 124Te (p,n) 124I nuclide reaction was used for the 124I production. Firstly, the target material, 124TeO2 (200 mg) and Al2O3 (30 mg) mixture, were compressed into the round platinum based solid target by tablet device. HM-20 medical cyclotron was applied to irradiate the solid target slice for 6-10 h with helium and water cooling. Then, the radiated solid target was placed for 12 h (overnight) to decay the radioactive impurity; finally, 124I was be purified by dry distillation using 1 mL/min nitrogen for about 6 hours and radiochemical separation methods. Micro-PET imaging studies were performed to investigate the metabolism properties and thyroid imaging ability of 124I.After 740 kBq 124I was injected intravenously into the tail vein of the normal mice, the animals were imaged with micro-PET and infused with CT. The micro-PET/CT infusion imaging revealed actual state 124I's metabolism in the mice. RESULTS: It was been successfully applied for 200 mg 124TeO2 plating by the tablet device on the surface of platinum. It showed smooth, dense surface and without obviously pits and cracks. The enriched 124Te target was irradiated for 6 to 10 hours at about 12.0 MeV with 20 µA current on HM-20 cyclotron. Then 370-1 110 MBq 124I could be produced on the solid target after irradiation and 370-740 MBq high specific activity could be collected afterdry distillation separation and radio-chemical purification.124I product was finally dissolved in 0.01 mol/L NaOH for the future distribution. The gamma spectrum of the produced 124I-solution showed that radionuclide purity was over 80.0%. The micro-PET imaging of 124I in the normal mice exhibited the thyroid and stomach accumulations and kidney metabolism, the bladder could also be clearly visible, which was in accordance with what was previously reported. To the best of our knowledge, it was the first production of 124I report in China. CONCLUSION: In this study, the preparation of 124TeO2 solid target was successfully carried out by using the tablet device. After irradiation of the 124TeO2 solid target and radio-chemical purification, we successfully produced 370-740 MBq high specific activity 124I by a cyclotron for biomedical application, and micro-PET imaging of 124I in normal mice exhibited the thyroid accumulations. Also, slight uptake in stomach were also monitored with almost nonuptake in other organs in the micro-PET imaging. The production of 124I is expected to provide a new solid target radionuclide for the scientific research and potential clinical application of our country.

Acupuncture for patients with chronic functional constipation: A randomized controlled trial.

BACKGROUND: Acupuncture is used to treat chronic functional constipation (CFC) in China, despite limited evidence. We aim to assess the effectiveness and safety of acupuncture in managing CFC. METHODS: A multicenter randomized controlled trial was performed involving 684 patients with CFC; the patients were randomly allocated to receive He acupuncture (n = 172), Shu-mu acupuncture (n = 171), He-shu-mu acupuncture (n = 171), or oral administration of mosapride (n = 170). Sixteen sessions of acupuncture were given in the treatment duration of 4 weeks. The primary outcome was the change in spontaneous bowel movements (SBMs) at week 4 (at the end of treatment) compared to baseline. The secondary outcomes included stool consistency (Bristol scale), the degree of straining during defecation, and adverse events. KEY RESULTS: The SBMs increased in all the four groups at week 4, and the magnitude of increase was equivalent in the four groups (He acupuncture, 2.7 [95% CI, 2.3-3.1]; Shu-mu acupuncture, 2.7 [95% CI, 2.3-3.0]; He-shu-mu acupuncture, 2.2 [95% CI, 1.9-2.5]; and mosapride, 2.4 [95% CI, 2.0-2.9]; P = .226). However, the change in SBMs at week 8 was significantly smaller in mosapride group (1.4 [95% CI, 1.0-1.8]) than the three acupuncture groups (2.4 [95% CI, 2.1-2.7], 2.3 [95% CI, 1.9-2.7], 2.1 [95% CI, 1.7-2.5] in He, Shu-mu, and He-shu-mu group, respectively, P = .005). CONCLUSIONS & INTERFERENCES: The three acupuncture treatments were as effective as mosapride in improving stool frequency and stool consistency in CFC, but the magnitude of the treatment effect is unknown due to the lack of sham acupuncture control.

HDAC6 regulates microRNA-27b that suppresses proliferation, promotes apoptosis and target MET in diffuse large B-cell lymphoma.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. Histone deacetylase 6 (HDAC6) is frequently altered in DLBCL and inhibition of HDAC6 has potent anti-tumor effects in vitro and in vivo. We profiled miRNAs that altered in the HDAC6 knockdown DLBCL cells with NanoString nCounter assay and identified microRNA-27b (miR-27b) as the most significantly increased miRNA. We validated decreased expression of miR-27b in DLBCL tissues, and we found that low expression of miR-27b was associated with poor overall survival of patients with DLBCL. In addition, forced expression of miR-27b suppressed DLBCL cell viability and proliferation in vitro, and inhibited tumor growth in vivo. Mechanistically, Rel A/p65 is found to negatively regulate miR-27b expression, and its acetylation and block of nuclear translocalization caused by HDAC6 inhibition significantly elevates miR-27b expression. Furthermore, miR-27b targets MET and thus represses the MET/PI3K/AKT pathway. These findings highlight an important role of miR-27b in the development of DLBCL and uncover a HDAC6-Rel A/p65-miR-27b-MET signaling pathway. Elevating miR-27b through HDAC6 inhibition would be a promising strategy for DLBCL treatment.

[Effects of 13-cis-retinoic acid combined with interferon-α2b in mantle cell lymphoma cell lines (Jeko-1) in vitro].

Objectives: To explore the effects of 13-cis-retinoic acid (13cRA) alone or combined with interferonα-2b (IFNα-2b) for the inhibition of cell growth and apoptosis induction of mantle cell lymphoma cell lines Jeko-1 cells. Methods: Jeko-1 cells were treated by different concentrations of 13cRA alone or combined with IFN-α2b. CCK-8 was used to measure the inhibition effects by different treatments. Cell cycles were analyzed by flow cytometry. Effects on apoptosis were assessed by staining of Annexin Ⅴ/PI. And the levels of Cyclin D1, caspase-9 and Rb proteins were measured by Western blot method. Results: 13cRA alone at different doses and its combination with IFNα-2b inhibited Jeko-1 cells growth and induced apoptosis, but the combination had higher inhibition potential and significant apoptosis rate (P<0.05) . The growth inhibition and apoptosis induction in Jeko-1 cells increased significantly with the elevation of drugs concentration and treating duration (P<0.05) . As well as the percentage of Jeko-1 cells at G(1)/G(2) phases increased (P<0.05) and cells at S phase decreased (P<0.05) , the levels of Cyclin D1 and Rb decreased with elimination caspase-9. Conclusion: 13cRA, IFN-α2b and their combined administration inhibited cells growth and induced apoptosis, decreased the cell populations at S phase and blocked the cells at G(1)/G(2) phase. Combination of the drugs may have a cooperated action. The therapeutic synergistic effects of 13cRA and IFN-α2b were assumed to lower the expression of Cyclin D1 and Rb proteins, and induce apoptosis by activating caspase-9 pathway.

First evidence of Mycoplasma haemocanis in China.

Previous studies show heamotropic Mycoplasma infection frequently occurs among splenectomized, immuno-suppressive or co-infected dog populations. However, in our study, the detection of 162 blood samples from dogs found 3 healthy, female dogs infected with Mycoplasma haemocanis in southeastern China. These infected dogs were grown in dog breeding center and had a history of tick infestation. This is the first molecular report of M. haemocanis in dogs from China. The 16S rRNA gene was partially sequenced and a phylogenetic tree constructed. Mycoplasma spp. was 99.9%-100% identical to the corresponding gene sequences of M. haemocanis and M. haemofelis available in GenBank. In this study, Mycoplasma spp. was identified as M. haemocanis because the bacterium was obtained from dogs.

[Anti-tumor effects of 13-cis-retinoic acid combined with interferon α-2b in animal model of mantle cell lymphoma].

Objective: To determine the anti-tumor effects of 13-cis-retinoic acid (13cRA) combined with interferonα-2b (IFNα-2b) in mantle cell lymphoma (MCL) animal model. Methods: The animal model of MCL was established by introducing Jeko-1 cell line into severe combined immunodeficiency disease mice. The successfully tumor-developed mice were assigned to different groups treated with negative control group (solvents), 13cRA (high dose: 200mg/kg; middle dose: 100mg/kg; low dose: 50 mg/kg) alone, IFNα-2b alone or combination of different dose of 13cRA with IFNα-2b, and positive control group (bortezomib, rituximab, cyclophosphamide), respectively. Variations of tumor volume were observed regularly. The relative tumor proliferation rate and tumor inhibition rate were calculated. Immunohistochemistry stain was used to detect the Ki-67 expression and TUNEL was applied to measure the apoptosis of tumor cells. Furthermore, the levels of Cyclin D1, caspase 9 and Rb protein were measured by Western-blot method. Results: ① The relative tumor proliferation rates (T/C%)were 30%, 37%, 32% and 33% in middle dose, high dose groups of 13cRA as well as their combination with IFN α-2b, respectively. ② Comparing with the negative control, both 13cRA at different doses and its combination with IFNα-2b remarkably inhibited the tumor growth (P<0.05), while no statistic significance existed in different dose group of 13cRA. IFN-α 2b alone didn't demonstrate the tumor-inhibition effects (P>0.05). Middle dose of 13cRA and its combination with IFN-α-2b demonstrated relatively high tumor-inhibition effects (59.2% and 62.6% respectively), which were similar to the effects in positive control (69.4%). ③ There was no statistic difference of Ki-67 in each experimental group. ④ Comparing with negative control group, all doses of 13cRA and their combinations with IFNα-2b remarkably increased the apoptosis (P<0.05), similar to the positive control group (P>0.05). However, IFNα-2b alone didn' t promote the apoptosis of tumor tissue (P=0.098). ⑤ Comparing with negative control group, IFNα-2b combined with each dose of 13cRA significantly decreased the levels of cycling D1 and procaspase-9, while increased the level of cleaved caspase-9 (P<0.05), which were similar to the positive control group (P>0.05). Nevertheless, 13cRA alone didn't demonstrate such effects. Conclusion: In the MCL animal model, IFNα-2b alone showed no effects, but combined with IFNα-2b, 13cRA displayed anti-tumor effects at different doses. The anti-tumor mechanism of 13cRA combined with IFNα-2b was probably down-regulation of the cyclin D1 expression, inhibition of cell proliferation and induction of apoptosis by activating caspase-9.

Influence of various quantitative trait loci (QTL) mapping methods on the mapping accuracy under varying heritability levels.

The study of quantitative trait effects is of great significance for molecular marker-assisted breeding. The accuracy of quantitative trait loci (QTL) mapping is the key factor affecting marker-assisted breeding, and is extremely significant. The effect of different heritability rates (10, 30, 50, 70, and 90%) on the accuracy of QTL mapping of five recombinant inbred lines (RILs) were analyzed via computer simulation. RILs display additive and epistatic genetic effects. The QTLs were analyzed using four different mapping procedures: multiple QTL model (MQM), composite interval mapping (CIM), multiple interval mapping (MIMR), and inclusive composite interval mapping (ICIM). The results revealed an increase in the QTL mapping accuracy and QTL detection power, and a decrease in the QTL interval range with the increase in heritability; conversely, an irregular number of false positive QTLs were generated. CIM and MQM only screen the additive and dominant effects; MIMR and ICIM screen the additive, dominant, and epistatic effects. The highest QTL detection power obtained using MQM and CIM was only 75%, while MIMR and ICIM showed a detection power of 100%. At heritability rates of more than 50 and less than 10%, the detection powers of the MIMR and ICIM procedures were >95 and <35%, respectively. QTL mapping has no significance at heritability rates <10%. The results of this study suggest that QTL mapping has significance at a heritability rate >30% (at least >10%) for practical marker-assisted breeding.

A Cu/Zn superoxide dismutase from Jatropha curcas enhances salt tolerance of Arabidopsis thaliana.

Superoxide dismutases (SODs) are involved in protecting plants against diverse biotic and abiotic stresses. In the present study, a novel Cu/Zn-SOD gene (JcCu/Zn-SOD) was cloned from Jatropha curcas L. Quantitative reverse transcription-polymerase chain reaction analysis revealed that JcCu/Zn-SOD is constitutively expressed in different tissues of J. curcas and induced under NaCl treatment. To characterize the function of this gene with respect to salt tolerance, the construct p35S:JcCu/Zn-SOD was developed and transformed into Arabidopsis using Agrobacterium-mediated transformation. Compared with wild-type, transgenic plants over-expressing JcCu/Zn-SOD showed enhanced tolerance to salt stress during germination, seedling establishment, and growth in terms of longer root, larger rosette area, and a larger number of leaves in addition to higher SOD activity levels under NaCl stress. In addition, over-expression of JcCu/Zn-SOD resulted in lower monodialdehyde content in transgenic Arabidopsis compared to wild-type plants under the same NaCl stress. Therefore, JcCu/Zn-SOD can increase a plant salt stress tolerance potentially by reducing oxidant injury.

Inhibition of EGFR pathway signaling and the metastatic potential of breast cancer cells by PA-MSHA mediated by type 1 fimbriae via a mannose-dependent manner.

To identify more therapeutic targets and clarify the detailed mechanisms of Pseudomonas aeruginosa-mannose-sensitive hemagglutinin (PA-MSHA) on breast cancer cells both in vitro and in vivo. PA-MSHA was administered to epidermal growth factor receptor (EGFR)-positive human breast cancer cell lines MDA-MB-231HM and MDA-MB-468 in vitro and to mice bearing tumor xenografts. The mannose cocultured test was used to detect the effect of mannose on PA-MSHA-induced cell proliferation, cell cycle arrest, apoptosis, and EGFR pathway signaling. We found that cells stimulated with PA-MSHA exhibited a downregulation of EGFR signaling. The addition of mannose partially inhibited the PA-MSHA-stimulated cell anti-proliferative effect, cell apoptosis, cell cycle arrest, activation of apoptosis-associated caspases, and even downregulation of the EGFR signaling pathway. In vivo, PA-MSHA treatment significantly suppressed mammary tumorigenesis in xenografts in mice and decreased lung metastasis in MDA-MB-231HM cell-transplanted mice. Tumor sample analyses confirmed inhibition of the EGFR pathway in the PA-MSHA-treated mice. In conclusion, this study showed that the involvement of the mannose-mediated EGFR pathway has a critical function in the preclinical rationale for the development of PA-MSHA for the treatment of human breast cancer. It also suggests the potentially beneficial use of PA-MSHA in adjuvant therapy for breast tumors with EGFR overexpression.