Ethoxysanguinarine Induces Apoptosis, Inhibits Metastasis and Sensitizes cells to Docetaxel in Breast Cancer Cells through Inhibition of Hakai.

Ethoxysanguinarine (ESG) is a benzophenanthridine alkaloid extracted from plants of Papaveraceae family, such as Macleaya cordata (Willd) R. Br. The anti-cancer activity of ESG has been rarely reported. In this study, we investigated the anti-breast cancer effect of ESG and its underlying mechanism. MTT assay and flow cytometry analysis showed that ESG inhibited the viability and induced apoptosis in MCF7 and MDA-MB-231 human breast cancer cells. Western blot revealed that ESG triggered intrinsic and extrinsic apoptotic pathways, as evidenced by the activation of caspase-8, caspase-9 and caspase-3. ESG attenuated breast cancer cell migration and invasion through Hakai/E-cadherin/N-cadherin. Moreover, Hakai knockdown sensitized ESG-triggered viability and motility inhibition, suggesting that Hakai mediated the anti-breast cancer effect of ESG. In addition, ESG potentiated the anti-cancer activity of docetaxel (DTX) in breast cancer cells. Overall, our findings demonstrate that ESG exhibits outstanding pro-apoptosis and anti-metastasis effects on breast cancer via a mechanism related to Hakai-related signaling pathway.

Effect of transcutaneous electrical acupoint stimulation on bone metabolism in patients with immobilisation after foot and ankle fracture surgery: a randomised controlled trial study protocol.

INTRODUCTION: Fracture is a disease with a high incidence worldwide. Foot and ankle fractures are common among fractures of the lower extremities. Foot and ankle fractures usually require surgical fixation and a period of fixed treatment, which can lead to decreased bone density. Although transcutaneous electrical acupoint stimulation (TEAS) is widely used for movement system diseases, there is minimal evidence to show the effectiveness of TEAS on patients after surgical fixation of ankle and foot fractures. This trial aims to evaluate whether TEAS can reduce bone loss in patients with immobilisation after ankle and foot fractures. METHODS AND ANALYSIS: A randomised controlled trial will be conducted in which 60 patients will be randomly divided into two groups: (a) the control group will be treated according to the routine procedures of basic orthopaedics treatment; (b) in the treatment group, bilateral SP36, BL23 and ST36 will be performed on the basis of the control group, and the test will be performed for 30 min every other day for a total of 8 weeks. Bone turnover markers will be used as primary outcome. Secondary outcomes are composed of blood phosphorus, blood calcium and bone mineral density. Treatment safety will be monitored and recorded. ETHICS AND DISSEMINATION: This trial is approved by the Ethics Committee of Beijing University of Chinese Medicine (2020BZYLL0611) and the Ethics Committee of Beijing Luhe Hospital (2020-LHKY-055-02), and inpatients who meet the following diagnostic and inclusion criteria are eligible to participate in this study. TRIAL REGISTRATION NUMBER: ChiCTR 2000039944.

Hybrid surgery for a severe infectious innominate artery pseudoaneurysm compressing the main trachea.

Here, we report a case of an infectious pseudoaneurysm at the root of the innominate artery, compressing the trachea, that resulted in massive hemorrhage due to rupture of the innominate artery. The patient, a 31-year-old man, had complained of persistent fever for 40 days and severe dyspnea for 1 week. Contrast-enhanced computed tomography imaging of neck and thorax showed a pseudoaneurysm originating from the root of the innominate artery that was severely compressing the main trachea. A hybrid surgery strategy was applied. We first implanted a covered stent in the root of the innominate artery. Then, we performed a left-to-right carotid-carotid bypass with a great saphenous vein graft. Finally, we performed a median thoracotomy in which both the pseudoaneurysm and the previously implanted covered stent were successfully extracted. The patient lost strength in the right upper limb muscle on postoperative day 2 but recovered to baseline strength after 3 months. A hybrid surgical technique may represent a practical solution for such conditions.

Endovascular treatment of aortic saddle embolism through percutaneous mechanical Thrombectomy via Straub Rotarex catheter.

BACKGROUND: To summarize our experience of endovascular treatment for abdominal aorta saddle embolism (ASE) through percutaneous mechanical thrombectomy (PMT). METHODS: Clinical data of three ASE patients treated with an endovascular approach using percutaneous mechanical thrombectomy (PMT) were reviewed and analyzed. RESULTS: After PMT, blood flow of limbs was restored in all of the three patients. However, two patients died from sudden cardiac arrest caused by hyperkalemia several hours after the procedure. The other one patient survived through continuous renal replacement therapy, which was initialized shortly after the surgical procedure. CONCLUSION: Endovascular treatment through PMT can quickly restore blood flow in the ASE patients. Blood purification through renal replacement therapy is crucial to reduce mortality after restoring blood flow of the limbs.

PACAP ameliorates hepatic metabolism and inflammation through up-regulating FAIM in obesity.

Obesity is considered a chronic inflammatory disease, the inflammatory factors, such as interleukin 6 (IL-6), monocyte chemoattractant protein 1 (MCP-1) and small inducible cytokine A5 (RANTES), are elevated in obese individuals. Pituitary adenylate cyclase-activating polypeptide (PACAP) suppresses anti-inflammatory cytokines and ameliorates glucose and lipid metabolism. Our previous study showed that Fas apoptosis inhibitory molecule (FAIM) is a new mediator of Akt2 signalling, increases the insulin signalling pathway and lipid metabolism. In this study, we found that PACAP promoted the expression of FAIM protein in a human hepatocyte cell line (L02). Overexpression of FAIM with lentivirus suppressed the expression of the inflammatory factor interleukin 6 (IL-6), monocyte chemoattractant protein 1 (MCP-1) and tumour necrosis factor alpha (TNF-α). Following treatment of obese mice with FAIM or PACAP for 2 weeks, inflammation was alleviated and the bodyweight and blood glucose levels were decreased. Overexpression of FAIM down-regulated the expression of adipogenesis proteins, including SREBP1, SCD1, FAS, SREBP2 and HMGCR, and up-regulated glycogen synthesis proteins, including Akt2 (Ser474) phosphorylation, GLUT2 and GSK-3ß, in the liver of obese mice. However, down-regulation of FAIM with shRNA promotes obesity. Altogether, our data identified that FAIM mediates the function of PACAP in anti-inflammation, glucose regulation and lipid metabolism in obese liver.

[Effect of Zhenwu Tang on regulating of "AVP-V2R-AQP2" pathway in NRK-52E cells].

This study was aimed to investigate the effect and mechanism of Zhenwu Tang on AVP-V2R-AQP2 pathway in NRK-52E cells in vitro. Forty eight male SD rats were randomly divided into eight groups with 6 animals in each group. Distilled water or 22.68 g·kg⁻¹·d⁻¹ Zhenwu Tang(calculated by raw drug dosage meter) was given by gavage. Blood samples were collected by cardiac puncture， and the medicated serum was centrifuged from the blood by 3 000 r·min⁻¹. NRK-52E cells were treated with different medicated serum or dDAVP. The condition of cell proliferation was detected by RTCA. The distribution of V2R and AQP2 in cells were detected by immunofluorescence. The expression of V2R， PKA and AQP2 were detected by Western blot and AQP2 mRNA level was detected by real-time PCR. Results showed that the level of AQP2 mRNA(P<0.01) and protein expression of V2R， PKA and AQP2(P<0.05， P<0.01， P<0.05) of Z7d group which was treated with Zhenwu Tang medicated serum for 24 h were significantly higher than that of normal rat serum group. And the expression level of V2R， p-AQP2 and AQP2(P<0.01， P<0.05， P<0.01) of Z7d+dDAVP group were significantly increased comparing to normal rat serum group. The results indicate that the applying of Zhenwu Tang medicated serum could increase the expression level of V2R， PKA and AQP2 which exist in AVP-V2R-AQP2 pathway in NRK-52E， and there is synergistic effect between Zhenwu Tang medicated serum and dDAVP. So the pathway of AVP-V2R-AQP2 may be one of the mechanism for which Zhenwu Tang regulate balance of water transportation.

Combined common femoral artery endarterectomy with superficial femoral artery stenting plus Shuxuening Injection infusion for chronic lower extremity ischemia: 3-year results.

OBJECTIVE: To investigate the efficacy and safety of combined common femoral artery (CFA) endarterectomy with superficial femoral artery (SFA) stenting plus Shuxuening Injection infusion in patients with complex multifocal arterial steno-obstructive lesions of the lower extremities. METHODS: From March 2006 to March 2011, 104 lower limbs in 96 patients with multilevel peripheral arterial steno-occlusive disease, involving SFA as well as CFA and deep femoral artery (DFA) orifice, were treated by combined surgical with endovascular therapy, such as SFA stenting as an adjunct to CFA endarterectomy and patch angioplasty with the great saphenous vein. Before the end of the operation, 20 mL of Shuxuening Injection was infused through the catheter located in the treated artery. Technical and hemodynamic success, as well as primary and primary-assisted patency, was determined according to the Society for Vascular Surgery Guidelines. During follow-up, clinical status assessment, ankle-brachial index (ABI) test, and duplex Doppler ultrasound were administered every 6 months, and computed tomography angiography or magnetic resonance angiography was performed at 12, 24, and 36 months after discharge. RESULTS: All patients underwent successful combined CFA endarterectomy with SFA stenting treatment. The average ABI after the combination treatment increased from pretreatment of 0.32±0.21 to 0.82±0.24 (P<0.01). No perioperative death and major limb amputations occurred. The mean duration of follow-up for 104 limbs from 96 patients was 1,180 days (range, 196-2,064 days). During follow-up, 5 patients died due to myocardial infarction, cerebral infarction, or pneumonia, and 5 patients were lost to follow-up. There were 21 cases (21.4%) of restenosis, with 15 that occurred in-stent and 6 near the distal end of the stent. A total of 18 (18.3%) reinterventions were performed, including 6 balloon angioplasty, 8 restenting procedures, 2 bypass surgeries, and 2 major limb amputations. The primary patency rates were 92.2%, 76.8%, and 61.3% at 12, 24, and 36 months, respectively, while the primary-assisted patency rates were 94.4%, 83.2%, and 75.6% at 12, 24, and 36 months, respectively. CONCLUSION: The combined CFA endarterectomy with SFA stenting plus Shuxuening Injection infusion appears to offer a safe, less invasive, and effective treatment option to patients with chronic lower extremity ischemia due to complex multifocal peripheral artery disease.

[Efficacy of double-door laminoplasty combined with hydroxyapatite artificial bone grafting for cervical spinal stenotic myelopathy].

OBJECTIVE: To evaluate the effects of double-door laminoplasty and hydroxyapatite artificial bone grafting in the treatment of cervical spinal stenotic myelopathy. METHODS: Twelve cases of cervical spinal stenotic myelopathy underwent expansive double-door laminoplasty of the cervical spine and hydroxyapatite artificial bone grafting. The clinical outcome of the patients and the operative procedures were assessed. RESULTS: The 5-year follow-up showed significantly alleviated clinical symptoms and improved physical signs in all the patients except for 1 patient who responded poorly to the surgery. CONCLUSIONS: Expansive double-door laminoplasty of the cervical spine in combination with hydroxyapatite artificial bone grafting is safe and effective for treating cervical spinal stenotic myelopathy. Hydroxyapatite artificial bone possesses good biological compatibility and osteoconduction, and is applicable in the laminoplasty procedures as an ideal bone graft material.

[Clinical analysis of endarterectomy to the stenosis and occlusion of carotid artery].

OBJECTIVE: To sum up the experience of carotid endarterectomy (CEA). METHODS: From January 1999 to July 2003, 59 patients were treated by CEA. There were 40 males and 19 females, and their age ranged from 56 to 79 years with an average of 71.8 years. The stenotic degree of internal carotid artery were over 80% in all cases. The left lesions were in 35 cases, and the right in 19, and the bilateral in 5. Patching were in 5, bypass with a great saphenous vein in 2. RESULTS: Fifty-five cases were excellent. Two patient died, one was caused by hyperperfusion syndrome, the another was due to the acute cardiac infarction at 31 days after operation. The complications included 5 hematosis and 1 hoarseness. CONCLUSION: CEA is still the best method in treating the stenosis and occlusion of carotid artery.