Discovery of oral chemotherapeutic reversal agents for treating multidrug resistance cancer.

The major limitation of cancer treatment is multidrug resistance (MDR), which leads to the inactivation of chemotherapeutic drugs and greater than 90% mortality. To solve this ordeal, we applied ligand-based drug design and bioiosteric replacement strategy from an indazole to a pyrazole ring to discover compounds 27 and 43 with good potential for reversing drug resistance in combination with paclitaxel, and their reversal fold values were 53.2 and 51.0 at 5 µM, respectively, against an MDR cancer cell line (KBvin). Based on the PK profile results, we selected compound 43 with a longer half-life for mechanistic and animal experiments. Combination treatment with compound 43 and paclitaxel-induced apoptosis and enhanced subG1 by decreasing mitochondrial membrane potential in KBvin cells. In addition, 43 also inhibited P-gp function by interfering with ATPase activity. Meanwhile, cotreatment with compound 43 and paclitaxel significantly suppressed tumor growth (TGI = 55.5%) at a dose of 200 mg/kg (PO) in a xenograft model and showed no obvious liver or kidney toxicity by H&E staining. Overall, compound 43 may serve as a safe and effective oral resistance reversal chemotherapeutic agent.

A Novel Computer-Aided Detection/Diagnosis System for Detection and Classification of Polyps in Colonoscopy.

Using a deep learning algorithm in the development of a computer-aided system for colon polyp detection is effective in reducing the miss rate. This study aimed to develop a system for colon polyp detection and classification. We used a data augmentation technique and conditional GAN to generate polyp images for YOLO training to improve the polyp detection ability. After testing the model five times, a model with 300 GANs (GAN 300) achieved the highest average precision (AP) of 54.60% for SSA and 75.41% for TA. These results were better than those of the data augmentation method, which showed AP of 53.56% for SSA and 72.55% for TA. The AP, mAP, and IoU for the 300 GAN model for the HP were 80.97%, 70.07%, and 57.24%, and the data increased in comparison with the data augmentation technique by 76.98%, 67.70%, and 55.26%, respectively. We also used Gaussian blurring to simulate the blurred images during colonoscopy and then applied DeblurGAN-v2 to deblur the images. Further, we trained the dataset using YOLO to classify polyps. After using DeblurGAN-v2, the mAP increased from 25.64% to 30.74%. This method effectively improved the accuracy of polyp detection and classification.

The effect of anti-spasmodic administration on the accuracy of magnetic resonance imaging staging of rectal cancer.

BACKGROUNDS: Magnetic resonance imaging is the primary method for local staging in rectal cancer patients. Administration of intravenous (IV) hyoscine butylbromide is thought to improve accuracy, but there are contraindications and potential adverse effects. The aim was to assess the efficacy of IV hyoscine butylbromide on the accuracy of MRI rectal cancer staging of T2 and T3 rectal cancers. METHODS: A retrospective cohort study was carried out on patients prospectively recorded on the Cabrini Monash colorectal neoplasia database. A total of 74 patients (53 males, 21 females) MRI pelvis and rectums with antispasmodics were performed at multiple centres in the pre-operative setting between 2010 and 2016. Each patient underwent total mesorectal excision of rectal cancer. The excision specimens were assessed and given a pathological TNM stage, which was considered the reference standard. RESULTS: There was no statistically significant impact on the overall accuracy of MRI rectal cancer staging between patient groups who received IV hyoscine butylbromide and groups who did not receive IV hyoscine butylbromide. The accuracy of T2 and T3 staged rectal cancers was more likely to be correct (compared with T1 cancers) with the administration of IV hyoscine butylbromide. Still, there was no improvement in the accuracy of N-staging. CONCLUSION: Given the potential side effects and adverse outcomes of IV anti-spasmodic agents, department protocols may need to be re-assessed regarding the prescription of these medications for MRI rectal cancer staging.

Factors affecting the post-operative outcomes in patients aged over 80 following colorectal cancer surgery.

PURPOSE: In 2019, in Australia, there were 500,000 people aged 85 and over. Traditionally, clinicians have adopted the view that surgery is not desirable in this cohort due to increasing perioperative risk, perceived minimal clinical benefit, and shortened life expectancy. This cohort study is aimed at investigating postoperative outcomes from elective and non-elective colorectal cancer surgery in patients aged 80 and over. METHODS: A retrospective analysis was conducted on patients from 2010 to 2020 on a prospectively maintained colorectal database. Patients aged over 80 who underwent surgical resection for colorectal cancer were reviewed. Oncological characteristics, short-term outcomes, overall survival, and relapse-free survival rates were analysed. RESULTS: A total of 832 patients were identified from the database. Females comprised 55% of patients aged 80 and above. The median age was 84 for octogenarians and 92 for nonagenarians. Most patients were ASA 2 (212) or ASA 3 (501). ASA 3 and 4 and stage III pathology were associated with higher postoperative complications. Fifty percent of over 80 s and 37% of over 90 s were surgically discharged to their own home. Overall survival at 30, 180, and 360 days and 5 years was 98.1%, 93.1%, 87.2%, and 57.2% for the over 80 s and 98.1%, 88.9%, 74.9%, and 24.4% for the over 90 s. CONCLUSION: Our results demonstrate that surgical treatment of older patients is safe with acceptable short-, medium-, and long-term survival. Nonetheless, efforts are needed to reduce the rates of complications in older patients, including utilisation of multi-disciplinary teams to assess the optimal treatment strategy and postoperative care.

Magnolol Suppresses ERK/NF-κB Signaling and Triggers Apoptosis Through Extrinsic/Intrinsic Pathways in Osteosarcoma.

BACKGROUND/AIM: Osteosarcoma is an aggressive primary malignant bone tumor that occurs in childhood. Although the diagnostic and treatment options have been improved, osteosarcoma confers poor prognosis. Magnolol, an active component of Magnoliae officinalis cortex, has been widely applied in herb medicine and has been shown to have multiple pharmacological activities. However, whether magnolol possesses anti-osteosarcoma capacity remains unknown. MATERIALS AND METHODS: We examined magnolol is cytotoxicity, and whether it regulates apoptosis and oncogene expression using MTT, flow cytometry and Western blotting assays in osteosarcoma cells. RESULTS: Magnolol exerted toxicity towards U-2 OS cells by inducing intrinsic/extrinsic apoptosis pathways. Additionally, treatment of U-2 OS cells with magnolol inhibited MAPK1 mitogen-activated protein kinase 1 (ERK)/Nuclear factor kappa B (NF-B) signaling involved in tumor progression and reduced the expression of anti-apoptotic and metastasis-associated genes. CONCLUSION: Magnolol may induce apoptosis and inactivate ERK/NF-B signal transduction in osteosarcoma cells.

A comparison of extracorporeal side to side or end to side anastomosis following a laparoscopic right hemicolectomy for colon cancer.

BACKGROUND: This study aimed to investigate whether an extracorporeal side-to-side (SS) or end-to-side (ES) stapled anastomosis impacts short-term and long-term outcomes after an oncological laparoscopic right hemicolectomy. METHODS: A retrospective cohort study of prospectively collected data from two Victorian tertiary referral hospitals was performed. Patients who underwent oncological resection for colorectal cancer between February 2010 and September 2020 were selected from the colorectal neoplasia database. Patients were divided into two groups depending on the type of stapled anastomosis: Group 1 (functional end-to-end/side-to-side (SS)); and Group 2 (end-to-side (ES)). Primary outcomes were anastomotic leak, postoperative ileus, mortality and morbidity, length of stay post-surgery, readmission to hospital, and 30-day mortality. RESULTS: This large case series of 1040 patients (SS = 625, ES = 415) demonstrated that the type of stapling technique impacted operative duration and postoperative ileus rates. Patients in the SS group had a faster operation of 108 min rather than 130 min in the ES group (p < 0.001). The SS group were more likely to experience a post-operative ileus (p < 0.001) with no impact on length of stay (SS, 7 days versus ES, 7 days; p = 0.14). There were no differences between the two groups with respect to lymph node yield, lymph node ratio, anastomotic leaks, return to theatre, 30-day mortality and 5-year overall survival. DISCUSSION: The type of extracorporeal stapled anastomosis following an oncological laparoscopic right hemicolectomy has minimal impact on morbidity and survival outcomes; however, a side-to-side stapled anastomosis is more likely to be a faster operation with a higher postoperative ileus rate.

BladderScan Feedback Method in Predicting Bladder Filling for Prostate Radiotherapy: A Prospective Study.

PURPOSE: Approximately 5%-10% of men who receive prostate cancer radiotherapy will suffer from radiation cystitis. Bladder filling before the administration of radiotherapy results in lower radiation exposure to the bladder. BladderScan, an ultrasound-based bladder volume scanner, has the potential to evaluate bladder volume during radiotherapy; thus, a prospective pilot study was initiated. METHODS: Eleven men receiving tomotherapy for localized prostate cancer were enrolled. The validity of BladderScan was evaluated by comparing the measurements from BladderScan with the calculated volume from megavoltage computed tomography (MVCT). With a crossover design to compare different methods in bladder filling, the radiotherapy was divided into 2 sequences. Conventional method: the patient was asked to drink water after voiding urine. The amount of water and the duration of waiting were the same as in the setting of the simulation. BladderScan feedback method: the bladder filling procedure depended on the BladderScan measurements. RESULTS: There were 314 sets of data from 11 patients. The correlation coefficient between VBS and VCT was 0.87, where VBS is the mean volume of 3 measurements by BladderScan and VCT is the bladder volume derived from MVCT. The BladderScan feedback method resulted in a significant larger bladder volume than the conventional method, with a mean difference of 36.9 mL. When the failure was defined as VCT <80% of planned volume, the BladderScan feedback method brought about a relative reduction in the failure rate with an odds ratio of 0.44 and an absolute reduction of 9.1%. CONCLUSION: The accuracy of BladderScan was validated by MVCT in our study. The BladderScan feedback method can help patients fill the bladder adequately, with a larger bladder volume and a lower failure rate.

Der p 2 promotes motility of airway epithelial cell attributing to AKT/GSK3ß-associated epithelial-to-mesenchymal transition.

Enhanced motility of epithelial cell plays a critical role in airway repair and remodeling involved in respiratory disorders such as asthma. Der p 2 (DP2) is a major allergen derived from Dermatophagoides pteronyssinus, the major source of indoor allergens causing airway hypersensitiveness. Herein, we hypothesized that DP2 may promote airway epithelial cell motility involved in airway remodeling. Using human bronchial cell BEAS-2B as cell model incorporating with immunoblotting and real-time quantitative PCR, our results revealed that DP2 significantly diminished epithelial marker E-cadherin and elevated mesenchymal marker vimentin and alpha-smooth muscle actin (α-SMA) in both protein and mRNA levels. Additionally, DP2 altered BEAS-2B cell morphology from cobblestone-like to fibroblast-like shape with reduced cell-cell contact. In parallel, nuclear translocation of Snail and Slug, the transcriptional repressors of E-cadherin, was increased in response to DP2. Further investigation showed that activation of AKT and extracellular response-regulated kinase 1/2 and inhibition of glycogen synthase kinase-3ß (GSK3ß) was involved in translocation of Snail/Slug triggered by DP2. In addition to regulation of epithelial and mesenchymal markers, DP2 enhanced cell motility of the airway epithelial cell associating with AKT/GSK3ß signaling using wound healing assay and invasion assay. In conclusion, DP2 not only altered expression of E-cadherin, vimentin, and α-SMA, but also enhanced migration and invasiveness of epithelial cell, attributing to modulation of AKT/GSK3ß signaling and Snail/Slug translocation. These findings also suggested that DP2 may initiate epithelial-mesenchymal transition involved in airway remodeling.

Predicting healthy lifestyle patterns among retirement age older adults in the WELL study: a latent class analysis of sex differences.

OBJECTIVES: The aim of this study was to identify subgroups of retirement age older adults with respect to their lifestyle patterns of eating, drinking, smoking, physical activity and TV viewing behaviors, and to examine the association between these patterns and socio-demographic covariates. METHODS: The sample consisted of 3133 older adults aged 55-65 years from the Wellbeing, Eating and Exercise for a Long Life (WELL) study, 2010. This study used latent class analysis (stratified by sex), with a set of lifestyle indicators and including socio-demographic covariates. Statistical analyses were performed by generalized linear latent and mixed models in Stata. RESULTS: Two classes of lifestyle patterns were identified: Healthy (53% men and 72% women) and less healthy lifestyles. Physical activity, TV-viewing time, and fruit intake were good indicators distinguishing the "Healthier" class, whereas consumption of vegetables, alcohol (men) and fast food (women) could not clearly discriminate older adults in the two classes. Class membership was associated with education, body mass index, and self-rated health. CONCLUSIONS: This study contributes to the literature on lifestyle behaviors among older adults, and provides evidence that there are meaningful sex differences in lifestyle behaviors between subgroups of older adults. From a policy perspective, understanding indicators or "markers" of healthy and less healthy lifestyle patterns is important for identifying target groups for interventions.

IL-6 augmented motility of airway epithelial cell BEAS-2B via Akt/GSK-3ß signaling pathway.

Cell migration plays a pivotal role in airway repair and remodeling involved in respiratory diseases such as asthma. Interleukin-6 (IL-6) and fascin-1 are involved in cell migration upon stimulation; however, the roles of IL-6 and fascin-1 in migration of airway epithelial cell remain sketchy. The present study was aimed to investigate influence of IL-6 on cell motility with emphasis on the association with fascin-1. Wound healing assay and transmigration assay were performed to examine effect of IL-6 on migration and invasiveness of human bronchial epithelial cell BEAS-2B. Level of mRNA expression was determined by RT-PCR and quantitative real-time RT-PCR (Q-PCR). Involvement of kinase and transcription factor signaling in IL-6-induced cell migration was investigated using immunoblot and specific inhibitors. IL-6 significantly augmented cell migration and invasiveness in parallel with elevated fascin-1 expression. Further investigation showed that IL-6 dose-dependently upregulated fascin-1 expression in both mRNA and protein levels. We showed that IL-6 activated Akt and inhibited glycogen synthase kinase-3ß (GSK-3ß), highly associating with fascin-1 mRNA expression. Additionally, IL-6-induced migration was significantly diminished by phosphatidyl inositol 3-phosphate kinase (PI3K) inhibitor (wortamannin) and ß-catenin inhibitor FH535. Moreover, LiCl and SB216763, inhibitors of GSK-3ß augmented cell migration as well as fascin-1 mRNA expression. Conclusively, these findings reveal that IL-6-induced migration of BEAS-2B cell may be attributed to activation of Akt, inhibition of GSK-3ß, and the associated increase of ß-catenin and fascin-1 expression, indicating an important role of Akt/GSK-3ß signaling and ß-catenin/fascin-1 in IL-6 associated airway remodeling.

Non-proteolytic house dust mite allergen, Der p 2, upregulated expression of tight junction molecule claudin-2 associated with Akt/GSK-3ß/ß-catenin signaling pathway.

Non-proteolytic group 2 allergen, Der p 2 (DP2) is known as a major allergen derived from house dust mite Dermatophagoides pteronyssinus.Paracellular epithelial barrier, being composed of a number of tight junction (TJ) molecules, plays pivotal roles in resistance of pathogen invading. However, whether DP2 affects epithelial TJ molecules is unclear. Therefore, we aimed to investigate the effects of DP2 on epithelial TJ molecules, and the mechanism by which expression of junction molecules is regulated by DP2. Cell cycle and mRNA expression of TJ proteins of lung alveolar cell A549 were analyzed by RT-PCR and flow cytometry. Level of claudin-2, subcellular distribution of b-catenin and kinase activation was determined using immunoblot. Our findings revealed that DP2 had no significant influence on cell cycle distribution but affected mRNA expression of TJ molecules including claudin-2, occludin, and ZO-1 in A549 cells. Our results showed that DP2 significantly elevated level of claudin-2 and increased expression and nuclear translocation of b-catenin. Moreover, DP2 enhanced the phosphorylation of glycogen synthase kinase-3b (GSK-3b) and its potential upstream regulator Akt. The DP2-induced claudin-2 expression was also suppressed by GSK-3b inhibitor (lithium chloride) and phosphatidyl inositol 3-phosphate kinase (PI3K) inhibitor (wortamannin). Taken together, these findings showed that DP2 increased claudin-2 expression and its cell surface distribution in A549 cells, which may attribute to phosphorylation of GSK-3b and Akt and the consequent increase and nuclear translocation of b-catenin. It is suggested that presence of DP2 may alter epithelial junction by regulating expression of TJ molecules.