A new modality of colorectal cancer screening based on chronic disease management.

BACKGROUND: To develop a new modality of colorectal cancer screening based on chronic disease management (CDM) to improve the participation rate of screening, and maximize the benefits of limited resources. METHODS: Patients under CDM were assigned to screening intervention group (SI) and screening control group1 (SC1), residents from natural community were assigned to screening control group2 (SC2). A parallel controlled community intervention study was performed. Only SI would achieve "one-to-one" intervention services. Meanwhile, 200 subjects were selected from each of the three groups for the Knowledge-Attitude-Practice (KAP) questionnaire before and after intervention, named questionnaire intervention group(QI), questionnaire control group1(QC1) and questionnaire control group2(QC2). The outcome of the intervention was evaluated using the difference-in-differences method and multiple regression analysis. RESULTS: The preliminary screening participation rate was 43.63%(473/1084) in SI, 14.32%(132/922) in SCI, and 5.87%(105/1789) in SC2. The baseline questionnaire showed low knowledge scores in the three questionnaire groups with no statistically significant differences, while attitude scores in QI and QC1 were significantly higher than QC2. The differences between baseline and terminal showed QI increased larger in knowledge and attitude scores than QC1 and QC2, while no difference was detected between QC1 and QC2. CONCLUSION: The colorectal cancer screening model based on chronic disease management effectively improved the screening participation rate, and the "one-to-one" intervention and the inherent characteristics of the patient population under CDM were the core elements of the new modality.

Circ_0078607 increases platinum drug sensitivity via miR-196b-5p/GAS7 axis in ovarian cancer.

Platinum-based chemotherapy is one of the predominant strategies for treating ovarian cancer (OC), however, platinum resistance greatly influences the therapeutic effect. Circular RNAs (circRNAs) have been found to participate in the pathogenesis of platinum resistance. Our aim was to explore the involvement of circ_0078607 in OC cell cisplatin (DDP) resistance and its potential mechanisms. Circ_0078607, miR-196b-5p, and growth arrest-specific 7 (GAS7) levels were assessed by qPCR. Circ_0078607 stability was assessed by ribonuclease R digestion and actinomycin D treatment. Cell viability of various conic of DDP treatment was measured by CCK-8. The cell proliferation was determined by CCK-8 and colony formation assay. Western blotting was performed for determining GAS7, ABCB1, CyclinD1 and Bcl-2 protein levels. The direct binding between miR-196b-5p and circ_0078607 or GAS7 was validated by dual-luciferase reporter and RIP assay. DDP resistance in vivo was evaluated in nude mice. Immunohistochemistry staining for detecting Ki67 expression in xenograft tumours. Circ_0078607 and GAS7 was down-regulated, but miR-196b-5p was up-regulated in OC samples and DDP-resistant cells. Overexpression of circ_0078607 inhibited DDP resistance, cell growth and induced apoptosis in DDP-resistant OC cells. Mechanistically, circ_0078607 sequestered miR-196b-5p to up-regulate GAS7. MiR-196b-5p mimics reversed circ_0078607 or GAS7 overexpression-mediated enhanced sensitivity. Finally, circ_0078607 improved the sensitivity of DDP in vivo. Circ_0078607 attenuates DDP resistance via miR-196b-5p/GAS7 axis, which highlights the therapeutic potential of circ_0078607 to counter DDP resistance in OC.

[Advances in Pelvic Lymph Node Dissection for Bladder Cancer].

Bladder cancer has high morbidity and mortality rates worldwide. Its incidence is high in western countries and has shown an increasing trend in China. While radical cystectomy combined with pelvic lymph node dissection (PLND) is the standard treatment for bladder cancer,the optimal range of PLND remains controversial. In addition,the prognostic value of lymph node factors is also unclear. This article reviews research advances in PLND.

The chemistry and pharmacology of Ligularia przewalskii: A review.

ETHNOPHARMACOLOGICAL RELEVANCE: Ligularia przewalskii (Maxim.) Diels (LP) (called zhangyetuowu in Chinese), is generally found in moist forest areas in the western regions of China. The root, leaves and flower of LP are utilized as a common traditional medicine in China. It has been utilized conventionally in herbal remedies for the remedy of haemoptysis, asthma, pulmonary phthisis, jaundice hepatitis, food poisoning, bronchitis, cough, fever, wound healing, measles, carbuncle, swelling and phlegm diseases. AIM OF THE STUDY: The review aims to provide a systematic summary of LP and to reveal the correlation between the traditional uses and pharmacological activities in order to provide updated, comprehensive and categorized information and identify the therapeutic potential for its use as a new medicine. MATERIALS AND METHODS: The relevant data were searched by using the keywords "Ligularia przewalskii" "phytochemistry", "pharmacology", "Traditional uses", and "Toxicity" in "Scopus", "Scifinder", "Springer", "Pubmed", "Wiley", "Web of Science", "China Knowledge Resource Integrated databases (CNKI)", "Ph.D." and "M.Sc. dissertations", and a hand-search was done to acquire peer-reviewed articles and reports about LP. The plant taxonomy was validated by the databases "The Plant List", "Flora Reipublicae Popularis Sinicae", "A Collection of Qinghai Economic Plants", "Inner Mongolia plant medicine Chi", Zhonghua-bencao and the Standard of Chinese herbal medicine in Gansu. RESULTS: Based on the traditional uses, the chemical nature and biological effects of LP have been the focus of research. In modern research, approximately seventy-six secondary metabolites, including thirty-eight terpenoids, nine benzofuran derivatives, seven flavonoids, ten sterols and others, were isolated from this plant. They exhibit anti-inflammatory, antioxidative, anti-bacterial and anti-tumour effects, and so on. Currently, there is no report on the toxicity of LP, but hepatotoxic pyrrolizidine alkaloids (HPA) were first detected with LC/MSn in LP, and they have potential hepatotoxicity. CONCLUSIONS: The lung-moistening, cough-relieving and phlegm-resolving actions of the root of LP are attributed to the anti-inflammatory properties of flavonoids and terpenoids. The heat-clearing, dampness-removing and gallbladder-normalizing (to cure jaundice) actions of the flowers of LP are based on the anti-inflammatory, antioxidant and hepatoprotective activity properties of terpenoids, flavonoids and sterols. The Traditional Chinese Medicine (TCM) characteristics of LP (bitter flavour) corroborate its potent anti-inflammatory effects. In addition, the remarkable anti-inflammatory and antioxidant capacities of LP contribute to its anti-tumour and antitussive activities. Many conventional uses of LP have now been validated by modernized pharmacological research. For future research, further phytochemical and biological studies need to be conducted on LP, In particular, the safety, mechanism of action and efficacy of LP could be of future research interest before beginning clinical trials. More in vivo experiments and clinical studies are encouraged to further clarify the relation between traditional uses and modern applications. Regarding the roots, leaves and flowers of LP, their chemical compositions and clinical effects should be compared. The information on LP will be helpful in providing and identifying its therapeutic potential and economic value for its use as a new medicine in the future.

Isocoumarin derivatives and monoterpene glycoside from the seeds of Orychophragmus violaceus.

Five new compounds, including four new isocoumarin derivatives [orychophramarin A-D (1-4)] and a new monoterpene glycoside [orychovioside A (5)], together with fourteen known compounds were isolated from the seeds of Orychophragmus violaceus. Their structures were established on the basis of chemical evidence and spectroscopic analysis. Compound 1 showed significant cytotoxicity against HCT-116 and Hela cell lines compared with the positive control group (Cisplatin) with IC50 values of 5.10 and 8.91µM, respectively. Compound 1 exhibited evident cell cycle retardation that arrested HCT-116 cells at G2 phase and induced apoptosis in HCT-116 cells in the further mechanism study.

Orychophragines A-C, Three Biologically Active Alkaloids from Orychophragmus violaceus.

Orychophragines A-C (1-3), three new alkaloids with an novel 2-piperazinone-fused 2,4-dioxohexahydro-1,3,5-triazine skeleton, were isolated from the seeds of Orychophragmus violaceus. Their structures were established on the basis of spectroscopic analysis and X-ray crystallographic analysis. Orychophragines A (1) exhibited remarkable cytotoxicity against HepG2, A549, Hela, and HCT-116 cells with IC50 values of 7.73, 10.79, 11.91, and 9.93 µM, respectively. Orychophragines C (3) showed moderate 60Co γ radiation protection activity in HUVEC cells. A plausible biosynthetic pathway for 1-3 was proposed.

New Anti-HBV C-Boivinopyranosyl Flavones from Alternanthera philoxeroides.

C-boivinopyranosyl flavones have rarely been isolated from nature. In the search for anti-HBV (hepatitis b virus) constituents of Alternanthera philoxeroides, two new compounds, luteolin-6-C-ß-D-boivinopyranosyl-3'-O-ß-D-glucopyranoside (1) and chrysoeriol-6-C-ß-D-boivinopyranosyl-4'-O-ß-D-glucopyranoside (2), along with three known C-boivinopyranosyl flavones (compounds 3-5) were isolated. Their structures were determined by spectroscopic analyses including 1D and 2D NMR, HR-ESI-MS, IR spectra. Compounds 1, 2 and 3 showed significant anti-HBV activities through specifically inhibiting the secretion of HBsAg in HepG2.2.15.

Three spirostanol saponins and a flavane-O-glucoside from the fresh rhizomes of Tupistra chinensis.

Four new compounds, including three new spirostanol saponins [tupistroside G-I (1-3)] and a new flavane-O-glucoside [tupichiside A (4)], together with ten known compounds, were isolated from the fresh rhizomes of Tupistra chinensis. The structures of the new compounds were elucidated by spectroscopic analysis and chemical evidence. All compounds were tested in vitro for their cytotoxic activities against the Human LoVo and BGC-823 cell lines, and six of them were found to possess potent cytotoxicity. Compounds 2, 8 and 9 showed significant cytotoxicity against the tested tumor cell lines with IC50 values ranging from 0.2 to 0.9µM.

Chemical constituents, anticancer, antimicrobial and antioxidant activities of essential oil from Anaphalis lacteal grown in Qinghai-Tibet Plateau.

The chemical constituent of the essential oil from Anaphalis lacteal was determined; 31 compounds, representing 93.91% of the total oil, were identified by gas chromatography-mass spectrometry analysis. Three Gram-positive bacteria species, three Gram-negative bacteria species and four fungi were used to determine antimicrobial activity; the results revealed that the essential oil had a remarkable antimicrobial effect against bacteria and a susceptive effect against fungus. The oil also possessed more efficient free-radical scavenging activities than butylated hydroxytoluene (BHT) with 50% inhibitory concentration (IC50) value 31 µg/mL (40 µg/mL for BHT). MTT assay illustrated that the oil expressed certain effect in inhibiting the growth of HeLa and Hep-6 cancer cells.

A new pregnane glycoside from Rubus phoenicolasius and its antiproliferative activity.

Chemical investigations of the whole plant ethanol extract of Rubus phoenicolasius led to the isolation and identification of a new pregnane glycoside, 3-O-ß-glucopyranosyl-3ß,15ß-dihydroxypregn-5-en-20-one (1), along with other nine known compounds (2-10). All the isolates were reported from this plant for the first time. The structure of compound 1 was determined by detailed analysis of its spectral data including 1D and 2D NMR. In vitro anti-proliferative activities of compounds 1-3 on MCF-7 and NCI-H460 tumour cell lines were evaluated, and compound 1 was active against the two cell lines with IC50 values of 15.6 and 13.5 µM, respectively.

[Effects of interval time between prostate biopsy and surgery on laparoscopic radical prostatectomy].

OBJECTIVE: To investigate the length of interval time between biopsy and laparascopic radical prostatectomy in difficulty and effects of surgery. METHODS: We retrospectively analyzed 89 cases of laparascopic radical prostatectomy from June 2011 to September 2013. The patients were divided into two groups according to the interval time of 6 weeks. The mean interval time was 3.1 weeks (ranging from 1.5 to 4.4 weeks) in group IT< 6 weeks and 4.4 weeks (ranging from 6.0 to 16.2 weeks) in group IT ≥ 6 weeks. The mean age was 67 years (ranging from 57 to 78 years). The PSA level was 15.4 µg/L (ranging from 5.2 to 72.0). The prostate volume was 55 mL (ranging from 42 to 89 mL). The parameters, such as operation duration, blood loss, positive surgical margin rate, incharge time postoperation, were evaluated. RESULTS: All the surgeries went successfully. The average operation duration was 150 min (ranging from 110 to 242 min), and the blood loss was 230 mL (ranging from 100 to 750 mL). The positive surgical margin rate was 18% and the urinary continence rate was 100% at 3 months after operation. The clinical recurrence was not found during the follow-up. No significant difference was found between the groups in the patients' age, preoperative PSA, Gleason score and prostate volume (P > 0.05). No statistical significance existed in the operation time, blood loss, positive margin rate, post-operative hospital stay, urinary continence rate at 3 months after operation, postoperative differences of clinical recurrence rates. CONCLUSION: The length of interval time between prostate biopsy and laparascopic radical prostatectomy does not influence the difficulty and effect in the early stage, and the long time survival and recurrent rate need further observation.

Two new 2,3-seco-hopane triterpene derivatives from Megacodon stylophorus and their antiproliferative and antimicrobial activities.

Chemical investigation of the ethanol extract of the whole plant of Megacodon stylophorus led to the isolation and identification of two new seco-hopane triterpenoids, 2,3-seco-22(29)-hopene-2-carboxyl-3-aldehyde (1) and 2,3-seco-4(23),22(29)-hopene-2-carboxyl-3-aldehyde (2), along with 10 known compounds, 3-12. All the isolates were reported from this plant for the first time. The structures of compounds 1 and 2 were determined by detailed analysis of their spectral data including 1D and 2D NMR. In addition, compound 1 was further analyzed by X-ray crystallography. Compounds 1-3 were evaluated for their in vitro anti-proliferative activities on HeLa, MCF-7, and Hep-G2 tumor cell lines. Compound 2 was active against the three cell lines with IC50 values of 3.6, 7.5, and 13.6 µM, respectively, while compound 1 exhibited cytotoxicity on MCF-7 (IC50 14.0 µM) and HeLa (IC50 18.2 µM) cell lines. Antimicrobial activities of compounds 1-2 (minimum inhibitory concentration values in the range of 3.12-12.50 mg/mL) were also observed.

A trehalose ester from Lancea tibetica.

A phytochemical study of the 95% ethanolic extract of the whole plant of Lancea tibetica Hook. f. et Thoms. led to the isolation of a new trehalose ester, 6-O-undecanoyl-α,ß-trehalose (1), along with 23 known compounds (2-24), of which compounds 2-17 were isolated from this plant for the first time. The structures of these compounds were established on the basis of spectroscopic methods. Compound 1 was evaluated for their in vitro anti-proliferative activities against MCF-7, NCI-H460 and Hep-G2 tumour cell lines. Compound 1 exhibited potent inhibitory activity against NCI-H460 cell growth, in contrast to moderate cytotoxic activity against MCF-7 and Hep-G2 cells.

Two new sesquiterpenes from Artemisia sieversiana.

Two new sesquiterpenes, together with 32 known compounds(3-34), were isolated from Artemisia sieversiana Ehrhart ex willd. and the compounds 3-21 were isolated from this plant for the first time. The new compounds were elucidated as 2α,9α-dihydroxymuurol-3(4)-en-12-oic acid (1) and 13α-methyl-(5αH,6αH,7αH,8αH)-austricin 8-O-ß-D-glucopyranoside (2), respectively. The structural identification of these compounds was mainly achieved by spectroscopic methods including 1D and 2D NMR techniques, and the structure of compound 1 was confirmed by a single crystal X-ray diffraction experiment. Compounds 1-2 were evaluated for cytotoxic activity in vitro against MCF-7, NCI-H460 and Hep-G2 cell lines, respectively.

Two new diterpene derivatives from Euphorbia lunulata Bge and their anti-proliferative activities.

A new ent-abietane-type diterpene lactone (1) and a new jatrophane-type diterpenoid (2), together with twelve known compounds including three diterpenes (3-5), five triterpenes (6-10) and four sterides (11-14) were isolated from the ethanol extract of the whole plant of Euphorbia lunulata Bge. The structure of compounds 1 and 2 was elucidated on the basis of 1D and 2D NMR spectra and the HR-ESI-MS data. The structure of compound 2 was further analyzed by an X-ray crystallographic study. The in vitro anti-proliferative activities against MCF-7 and NCI-H460 cell lines for compounds 1-5 (diterpene) were evaluated. The results showed marked activity for compound 1 against the two cell lines with the IC50 values 19.5 (NCI-H460) and 18.6 (MCF-7) µM, while for cis-platinum (a positive cytotoxic control agent) 29.7 (NCI-H460) and 27.7 (MCF-7) µM. Compounds 2-5 exhibited moderate cytotoxic activities for the two cell lines with the IC50 values ranging from 32.1 to 58.2 µM.

Cytotoxic activity of lignans from Justicia procumbens.

Three new lignans, Pronaphthalide A (1), Procumbiene (2), and Procumbenoside J (3), along with a novel natural product Juspurpudin (4), and twelve other known lignans were isolated from Justicia procumbens. The structures of the new compounds were elucidated by extensive spectroscopic analyses and the data of 3 provided insight into the conformational equilibria existing in it. All compounds were evaluated for their in vitro cytotoxic activity against Human LoVo and BGC-823 cell lines except for compound 2, and eight of them were found to possess potent cytotoxicity. The structure-activity relationship (SAR) analysis revealed that (i) the parent structure of 2-carbonyl arylnaphthalide lactone attached with 6 and 7-OMe was the essential element; (ii) the polarity of substituents on C-4 might significantly affect the activity; (iii) a proper cyclic lipophilic group at the C-3″ and C-5″ of apiofuranose on C-4 might enhance the activity, which could optimize the application of 3 similar to VP-16.

Norlathyrane diterpenes from the root of Euphorbia kansuensis.

Phytochemical investigation of the EtOH extract obtained from the root of the Euphorbia kansuensis Proch. grown in China resulted in the isolation of two novel norlathyrane diterpenes, named ekanpenoids A and B (1 and 2, resp.). Their structures were established by extensive 1D- and 2D-NMR spectroscopy, as well as other spectra. The isolated diterpenes exhibited potent cytotoxic activities against the HeLa and Hep-G2 cell lines with the IC50 values ranging from 3.6 to 9.7 µg/ml.

Metabolic syndrome and androgen deprivation therapy in metabolic complications of prostate cancer patients.

BACKGROUND: Incidence of prostate cancer in Chinese males grows significantly in the past decades. Androgen deprivation therapy has been generally employed in the treatment of locally advanced and metastatic prostate cancer for many years, yet only little data was known about the metabolic syndrome in patients receiving hormonal therapy. This study described the prevalence and the changing trends of hormone-related metabolic complications, and analyzed their correlation with different therapies. METHODS: In 125 patients treated with castration or maximal androgen blockage for at least 12 months, metabolic indicators were analyzed. RESULTS: Totally, 13.5% patients in castration group and 30.1% patients in maximal androgen blockage group were diagnosed metabolic syndrome 12 months after the beginning of treatments (χ(2) = 4.739, P = 0.029). In castration group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 12, increased fasting plasma glucose and blood pressure were significant at the month 4. In maximal androgen blockage group, increased triglyceride and decreased high-density lipoprotein-cholesterol were significant at the month 4, increased fasting plasma glucose and blood pressure were significant at the month 8. Total testosterone and free testosterone in maximal androgen blockage group were significantly lower than castration group at all visits, which were proved to show positive or negative correlations with metabolic indications. Severity of metabolic complications in maximal androgen blockage group was generally more serious than people received castration, with significantly statistical difference or not. Trends of high-density lipoprotein-cholesterol and fasting plasma glucose were significant different between two kinds of therapy (P = 0.005, P = 0.019, respectively). CONCLUSIONS: Prostate cancer patients receiving androgen deprivation therapy were at high risk of suffering metabolic syndrome. Severity of metabolic complications under different hormonal therapies were not completely consistent, suggested that androgen deprivation therapy may be individualized.

[Intravesical laparoscopic repair of vesicovaginal fistula].

OBJECTIVE: To introduce a new technique to treat vesicovaginal fistula (VVF) with intravesical laparoscopic repair, and assess its safety and efficacy. METHODS: Four female patients with iatronic VVF were treated with intravesical laparoscopic method between October 2008 and March 2010. The second case underwent open surgery repair four months ago. All the fistulae were in posterior wall of bladder,with 0.8 cm, 1.0 cm, 1.2 cm and 0.5 cm in size respectively. One 10 mm superpubic trocar and 2.5 mm lateral trocars were placed in surgery. Carbon dioxide gas was used to distend the bladder. RESULTS: Four operations were completed successfully. The operative time was 80-140 min, and the blood loss was 50-100 mL. The indwelling catheter was removed after 4 weeks. All the patients were followed up for 1-8 months. Three patients showed no recurrence of fistula and had normal urination. One patient developed urinary leakage through the vagina again after 1 month. CONCLUSION: Intravesical laparoscopic technique is a safe and effective treatment with micro-trauma for iatrogenic VVF, but more clinical files are needed for further evaluation.

[Diagnosis and treatment of bilateral testicular intratubular seminoma: a case report and review of literature].

OBJECTIVE: To explore the diagnosis and treatment of testicular intratubular seminoma. METHODS: One case of testicular intratubular seminoma was diagnosed with testicular biopsy. Epididymal sperm was aspirated and intracytoplasmic sperm injection ( ICSI) was performed. And local radiotherapy was conducted on the bilateral testes after fertilization. RESULTS: The result of testicular biopsy revealed bilateral testicular intratubular seminoma. Large numbers of sperms were found in the epididymal aspirate. ICSI did not succeed for the first time. The second ICSI succeeded. The local radiotherapy by 60Co had been conducted on the bilateral testes, and testicular tumor didn't develop further. CONCLUSION: Testicular intratubular seminoma is a type of intratubular germ cell neoplasia, with no clinical manifestations, and usually found in testicular biopsy. Earlier management promises better prognosis.