Apparent Diffusion Coefficient on Diffusion-Weighted Magnetic Resonance Imaging to Predict the Prognosis of Patients with Endometrial Cancer: A Meta-Analysis.

Apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (DWI) may help diagnose endometrial cancer (EC). However, the association between ADC and the recurrence and survival of EC remains unknown. We performed a systematic review and meta-analysis to investigate whether pretreatment ADC on DWI could predict the prognosis of women with EC. PubMed, Embase, and Cochrane's Library were searched for relevant cohort studies comparing the clinical outcomes between women with EC having low versus high ADC on pretreatment DWI. Two authors independently conducted data collection, literature searching, and statistical analysis. Using a heterogeneity-incorporating random-effects model, we analyzed the results. In the meta-analysis, 1358 women with EC were included from eight cohort studies and followed for a median duration of 40 months. Pooled results showed that a low pretreatment ADC on DWI was associated with poor disease-free survival (DFS, hazard ratio [HR]: 3.29, 95% CI: 2.04 to 5.31, p < 0.001; I2 = 41%). Subgroup analysis according to study design, tumor stage, MRI Tesla strength, ADC cutoff, follow-up duration, and study quality score showed consistent results (p for subgroup analysis all > 0.05). The predictive value of low ADC for poor DFS in women with EC decreased in multivariate studies compared to univariate studies (HR: 2.59 versus 32.57, p = 0.002). Further studies showed that a low ADC was also associated with poor overall survival (HR: 3.36, 95% CI: 1.33 to 8.50, p = 0.01, I2 = 0). In conclusion, a low ADC on pretreatment DWI examination may predict disease recurrence and survival in women with EC.

Effect of total flavones of Clematis filamentosa Dunn on the oxLDL-induced injury of vascular smooth muscle cells by regulating miR-455-5p.

This experiment was conducted to investigate whether total flavones of Clematis filamentosa Dunn affect the inflammatory response and apoptosis of vascular smooth muscle cells induced by oxidized low-density lipoprotein (oxLDL) by regulating microRNA-455-5p (miR-455-5p). 50 mg/mL oxLDL was performed to stimulate the injury of vascular smooth muscle cells, and the total flavones of Clematis filamentosa Dunn were added at concentrations of 75, 150, and 300 µg/mL. The expressions of inflammatory factors IL-1ß and TNF-α were analyzed by ELISA, the apoptosis was evaluated by flow cytometry, the expression of Bcl-2 and Bax was determined by western blot, and the real-time fluorescence quantitative PCR (qRT-PCR) was applied to detect miR-455-5p expression. MiR-455-5p mimic was transfected into vascular smooth muscle cells and then induced injury with oxLDL; miR-455-5p inhibitor was transfected into vascular smooth muscle cells and treated with oxLDL and 300 µg/mL total flavones of Clematis filamentosa Dunn. The above methods were employed to investigate the inflammatory response and apoptosis of cells. The total flavones of Clematis filamentosa Dunn significantly inhibited the expression of IL-1ß, TNF-α, apoptosis rate, Bax protein expression of oxLDL induced vascular smooth muscle cells, and remarkably promoted the expression of Bcl-2 protein and miR-455-5p, which all showed concentration dependence (p<0.05). Overexpression of miR-455-5p reduced IL-1ß, TNF-α expression, apoptosis rate, Bax protein expression, and greatly increased Bcl-2 protein expression in oxLDL injured vascular smooth muscle cells (p<0.05). After interfering with the expression of miR-455-5p, the inhibitory effect of total flavones of Clematis filamentosa Dunn on the expression of IL-1ß, TNF-α, apoptosis, Bax protein expression of oxLDL-induced vascular smooth muscle cells was reversed, and its promotion effect on Bcl-2 protein expression was also reversed. Total flavones of Clematis filamentosa Dunn can reduce oxLDL-induced vascular smooth muscle cell inflammation and inhibit its apoptosis. The mechanism of action is related to the up-regulation of miR-455-5p expression.

Modified Si-Miao-San inhibits inflammation and promotes glucose disposal in adipocytes through regulation of AMP-kinase.

Modified Si-Miao-San (mSMS) is composed of Rhizoma Coptidis, Cortex Phellodendri, Rhizoma Coptidis Semen Coicis and Atractylodes Rhizome. The prescription is used for the management of diabetes and insulin resistance in the clinic. This study aims to investigate its regulation of glucose disposal in adipocytes. Differentiated 3T3-L1 adipocytes were stimulated with conditioned medium derived from activated macrophages to induce insulin resistance and observed the effects of Mac-CM on insulin-mediated glucose uptake along the insulin receptor substrate-1/PI3K/Akt signaling pathway. Moreover, its regulation of AMPK phosphorylation was also investigated. mSMS enhanced AMPK phosphorylation and promoted basal glucose uptake in adipocytes; mSMS inhibited NF-κB activation by reducing P65 phosphorylation and improved insulin-stimulated IRS-1 tyrosine and Akt phosphorylation, leading to the restoration of insulin-mediated glucose uptake when cells were exposed to inflammatory stimulation. These beneficial effects were diminished in the presence of the AMPK inhibitor compound C. mSMS positively regulated AMPK activity, and this action contributed to improving insulin PI3K signaling by the beneficial regulation of IRS-1 function through inhibition of inflammation in adipocytes.