Streptococcus salivarius pneumonia-associated pneumomediastinum: a case report and literature review.

BACKGROUND: Streptococcus salivarius is an opportunistic pathogen, and there have been no reported cases of Streptococcus salivarius pneumonia to date. Pneumomediastinum is usually secondary to tracheal or esophageal injury and is very rare as a complication of pneumonia. We report a case of Streptococcus salivarius pneumonia complicated by pneumomediastinum, aiming to enhance clinicians' awareness of rare pathogens and uncommon complications in pneumonia. CASE PRESENTATION: The patient, a 36-year-old male, presented with a persistent cough and sputum production for one week, accompanied by a sore throat that had developed just one day prior. Chest computed tomography (CT) disclosed pneumomediastinum alongside obstructive atelectasis in the left lower lobe. Streptococcus salivarius infection was conclusively identified through bronchoalveolar lavage metagenomic next-generation sequencing (mNGS), as well as smear and culture analyses. The patient was administered intravenous amoxicillin-clavulanate potassium for a duration of seven days as part of the anti-infection regimen. Given the stability of the patient's respiratory and circulatory systems, a tube drainage procedure was deemed unnecessary. Post-treatment, the patient's clinical symptoms notably improved. A subsequent chest CT scan revealed the re-expansion of the left lower lung and near-complete resolution of pneumomediastinum. CONCLUSION: There are numerous pathogens that can cause pneumonia. While focusing on common pathogens, it is important not to overlook rare ones. When considering infections from rare pathogens, it is recommended to promptly perform a bronchoscopy and submit bronchoalveolar lavage fluid for mNGS to improve pathogen detection rates. During the diagnosis and treatment of pneumonia, it is crucial to be vigilant for rare complications. When a patient presents with symptoms such as dyspnea or subcutaneous emphysema, it is advisable to immediately perform a chest CT scan to rule out pneumomediastinum.

Loading of Single Atoms of Iron, Cobalt, or Nickel to Enhance the Electrocatalytic Hydrogen Evolution Reaction of Two-Dimensional Titanium Carbide.

The rational design of advanced electrocatalysts at the molecular or atomic level is important for improving the performance of hydrogen evolution reactions (HERs) and replacing precious metal catalysts. In this study, we describe the fabrication of electrocatalysts based on Fe, Co, or Ni single atoms supported on titanium carbide (TiC) using the molten salt method, i.e., TiC-FeSA, TiC-CoSA, or TiC-NiSA, to enhance HER performance. The introduction of uniformly distributed transition-metal single atoms successfully reduces the overpotential of HERs. Overpotentials of TiC-FeSA at 10 mA cm-2 are 123.4 mV with 61.1 mV dec-1 Tafel slope under acidic conditions and 184.2 mV with 85.1 mV dec-1 Tafel slope under alkaline conditions, which are superior to TiC-NiSA and TiC-CoSA. TiC samples loaded with transition-metal single atoms exhibit high catalytic activity and long stability under acidic and basic conditions. Density functional theory calculations indicate that the introduction of transition-metal single atoms effectively reduces the HER barrier of TiC-based electrocatalysts.

Determination of Age- and Sex-Specific 99th Percentile Upper Reference Limits for High-Sensitivity Cardiac Troponin I in Healthy Chinese Adults.

INTRODUCTION: Age- and sex-specific reference intervals (RIs) for high-sensitivity cardiac troponin I (hs-cTnI) are not available in China. The objective of the present research was to determine the assay-specific 99th percentile upper reference limits (URLs) for hs-cTnI in healthy Chinese adults. METHODS: Apparently healthy individuals were first screened with a questionnaire. The reference population was selected according to the International Federation of Clinical Chemistry (IFCC) criteria using surrogate biomarker for diabetes, myocardial dysfunction, and renal dysfunction. The serum concentration of hs-cTnI was measured using the automatized VITROS 5600 Immunodiagnostic system (Ortho Clinical Diagnostics, Raritan, NJ, USA). RESULTS: A total of 2,183 healthy individuals (1,051 men and 1,132 women aged from 20 to 95 years) were enrolled in the study. The serum overall 99th percentile URLs of hs-cTnI were 11.1 ng/L (12.5 ng/L in men, 9.6 ng/L in women). In both men and women, the 99th percentile URLs were significantly higher in individuals ≥55 years old than those in the <55 years old, especially in women. Moreover, 78.8% of males and 70.1% of females presented with hs-cTnI concentrations above the limit of detection of 0.43 ng/L. CONCLUSION: The hs-cTnI-VITROS assay coincided with the performance standard of the IFCC for high-sensitivity cTnI assays. The 99th percentile URLs for hs-cTnI in healthy Chinese adults were different from the manufacturer declared and appeared heterogeneous, potentially susceptible to factors such as age and sex.

Reference intervals for 26 common biochemical analytes in term neonates in Jilin Province, China.

BACKGROUND: Biochemical analytes provide information for neonatal disease management and therapy, and population-based reference intervals (RIs) are essential to accurately interpret laboratory test results. This study aimed to establish local RIs for biochemical assays in term neonates. METHODS: A total of 195 healthy term neonates from birth to 3rd day were recruited as reference individuals prospectively. Analytes of 26 common biochemistries were measured using the VITROS 5600 Integrated System. The 3-level nested ANOVA was performed to assess the need for partitioning RIs of each analyte, and RIs were derived by a nonparametric method or robust method. Multiple regression analysis was used to evaluate specific correlations between the analytes and individual characteristics including age, gender, gestational age, birthweight and delivery mode. RESULTS: There were no between-sex differences in all analytes, whereas there were significant between-day-age differences in 6 analytes. Small between-delivery-mode differences were observed in the results for potassium, phosphorus, and urea. The major related factor of most analytes was postnatal age. During the first 3 days, values of iron, lipids and lipoproteins increased; creatinine, urea, uric acid, creatine kinase and lactate dehydrogenase decreased; other analytes showed slight changes or relatively stable trends. Reference limits of some analytes, particularly lactate dehydrogenase and alkaline phosphatase, were significantly different from adult and pediatric groups. CONCLUSIONS: RIs of 26 common biochemical analytes are established for term neonates aged 0 to 3 days in northeast China. Additionally, it is suggested that age-related changes should be valued in the clinical decision-making process for newborns.

Establishment of age- and sex-specific reference intervals for serum liver function tests in pediatric population aged 1-<18 years: A prospective study.

BACKGROUND: The diagnosis, treatment, and prognosis of pediatric diseases rely on the accurate establishment of the reference interval (RI). This study aimed to establish pediatric RIs for liver function tests and evaluated the correlation of the analytes. METHODS: Pediatric population (aged 1-<18 years) was prospectively recruited in Jilin Province, China. Analytes detected by Ortho VITORS 5600 automatic biochemical analyzer. All strata were divided using the regression tree and Harris and Boyd's method. The dynamic changes of RI were evaluated by the lambda-mu-sigma method. RESULTS: Reference individuals were comprised of 6,322 children and adolescents. Age and sex differences were present in all analytes except serum total protein. The serum albumin, total protein, γ-glutamyl transferase, total bilirubin, and unconjugated bilirubin levels increased with age while serum aspartate aminotransferase was opposite. The serum alanine aminotransferase level reached a trough at the age of 5 and later steadily in males but slowly decreased in females. The serum alkaline phosphatase level dropped rapidly after reaching a peak at 9 years old in females and 12 years old in males. RIs were divided into 11 partitions at most and 5 partitions at least. The strongest correlation between analytes was total bilirubin and unconjugated bilirubin (r = 0.788), followed by total bilirubin and albumin (r = 0.511). CONCLUSIONS: Analytes show unique dynamic changes in pediatric population. The correlations among liver function tests can inform future studies of particular variables. Age- and sex-special pediatric RIs should be established to help an accurate diagnosis of disease.

Screening active components from Rubus amabilis for pancreatic ß-cells protection.

CONTEXT: Rubus species (Rosaceae) have been used in folk medicine to treat diabetes due to their hypoglycaemic activity. OBJECTIVE: To screen the active components that act as hypoglycaemic agents in Rubus amabilis Focke and the underlying mechanisms. MATERIALS AND METHODS: Aqueous stem extract of R. amabilis was incubated with MIN6 ß-cells, PBS was used as the blank control. Then the cells were washed, cell membrane-bound components were dissociated and identified by UPLC/MS. Total procyanidins (PCs) in R. amabilis was enriched and the cytotoxicity and anti-proliferation on ß-cell were evaluated by MTT assay. PCs at 25, 50, and 75 µg/mL was applied for 24 h to determine its effects on palmitate (PA)-induced apoptosis and GSIS. Western blotting was employed to detect the protein expression of PI3K/Akt/FoxO1 signalling. The antioxidant indices were also measured. RESULTS: ß-Cell membrane-bound components were identified as three procyanidin B dimers and a C trimer. PCs showed no significant cytotoxicity up to a concentrations of 100 µg/mL. PCs treatment reversed the elevated apoptosis rate and impaired GSIS induced by PA. PCs markedly decreased the intracellular ROS and MDA production and increased the SOD activity. Moreover, PCs promoted the phosphorylation of Akt and FoxO1, and regulated Pdx-1 and Bax expression in MIN6 cells. Discussion and conclusion: The active components that act as hypoglycaemic agents in R. amabilis are procyanidins, which protected MIN6 cells against PA-induced apoptosis by activating PI3K/Akt/FoxO1 signalling. These results indicate that ß-cell extraction, combined with UPLC/MS, is a valid method for screening antidiabetic components from herbal medicines.

[Study on chemical constituents from seed of Oroxylum indicum].

Oroxylum indicum was a traditional Chinese medicine. In order to study the chemical constituents from the seed of O. indicum, the chemical constituents of 80% methanol extract of seeds of O. indicum were subjected to chromatography on silica gel, Sephadex LH-20, and preparative HPLC, leading to the isolation of eleven compounds. The structures were identified by various spectroscopic data including ESI-MS, 1H-NMR and 13C-NMR data as oroxin B (1), chrysin (2), baicalein (3), neglectein (4), quercetin-3-O-ß-D-galactopy ranoside (5), quercetin-7-O-ß-D-glucopyranoside (6), 2α,3ß-dihydroxylluPeol (7), lupeol (8), rengyol (9), ß-sitostero (10), and stigmasterol (11). Among them, compound 5 were firstly obtained from O. indicum.

Insect tea originated from ethnic minority regions in Southwest China: A review on the types, traditional uses, nutrients, chemistry and pharmacological activities.

ETHNOPHARMACOLOGICAL RELEVANCE: Insect tea is a special non-Camellia tea produced from the feces of insects in ethnic minority regions in Southwest China. Insect tea was recorded to have the traditional functions to treat summer heat, dampness, digestive disturbance, excessive phlegm, shortness of breath and otitis, etc. AIM OF THIS STUDY: This review provides an updated and comprehensive review of insect tea on the tea types, host plants, tea-producing insects, producing process, traditional uses, nutritional values, chemistry, pharmacological activities, biological safety and toxicity. Moreover, the general challenges and the possible suggestions on insect tea in future were also discussed. MATERIALS AND METHODS: The relevant literature on insect tea was obtained from scientific database, including Elsevier, PubMed, Springer, Wiley, Web of Science, Google Scholar, SciFinder, China National Knowledge Infrastructure (CNKI), Baidu Scholar, Wanfang Database, etc. In addition, pertinent information available in Ph.D theses, MSc. dissertations, books, records, and some classical Chinese herbal literature were also included. The references cited in this review were up to September 2022. RESULTS: Insect tea has been traditionally used as popular beverage with various medicinal functions in the ethnic minority regions in Southwest China for centuries. At present, ten types of insect teas are recorded in different regions. Ten species tea-producing insect and fifteen species host plants are used to in the production of the tea. Insect teas were rich in various nutrients including proteins, carbohydrates, fat, minerals, dietary fiber and Vitamins. A total of 71 compounds have been isolated from insect teas, mainly including flavonoids, ellagitannins, chlorogenic acids and other phenolic compounds as well as the alkaloids. Modern studies demonstrated that insect tea had a variety of pharmacological activities in vitro and in vivo, such as anti-diabetic, lipid-lowing and anti-hypertensive, hepato-protective, gastro-intestinal promoting, anti-cancer, anti-mutagenic, antioxidant, and anti-aging activity, etc. Moreover, existing experimental results showed that insect teas are non-toxicity and biological safety. CONCLUSION: Insect tea is a unique and niche product originated in the ethnic minority regions of Southwest China with various health-promoting benefits. Phenolics including flavonoids, ellagitannins, chlorogenic acids were reported as the main chemical constituents identified from insect tea. Multiple pharmacological activities of insect tea have been reported, which indicated that it had great potential for further development and application as drugs and health-promoting products. However, more studies on the tea-producing insects, host plants, chemistry and pharmacological activity of insect tea, as well as the toxicology should be further investigated.

Comparison of gefitinib plus chemotherapy versus gefitinib alone for advanced non­small­cell lung cancer: A meta analysis.

This study aimed to perform a meta­analysis comparing the efficacy and safety of gefitinib in combination with chemotherapy versus gefitinib alone in patients with advanced Non­Small Cell Lung Cancer (NSCLC). We searched databases for clinical studies that reported the efficacy or safety of gefitinib plus chemotherapy in comparison with gefitinib alone. Raw data from included studies were extracted and pooled to calculate the Odds Ratio (OR) for Objective Response Rate (ORR) and Disease Control Rate (DCR), the Hazard Ratio (HR) for Progression-Free Survival (PFS) and Overall Survival (OS), and OR for complication ≥ Grade 3. A total of 10 studies containing 1,528 patients with NSCLC were identified and included in the analysis. Gefitinib plus chemotherapy showed significantly better efficacy in improving ORR (OR = 1.54; 95% CI [Confidence Interval], 1.13‒2.1; p = 0.006), DCR (OR = 1.62; 95% CI 1.14‒2.29; p = 0.007), PFS (HR=1.67; 95% CI 1.45‒1.94; p < 0.001) and OS (HR = 1.49; 95% CI 1.2‒1.87; p < 0.001) as compared with gefitinib alone. Consistent results were observed in the sub-population with positive EGFR mutation. The combination of gefitinib with chemotherapy had a significantly higher risk of complication (≥ Grade 3) with an OR of 3.29 (95% CI 2.57‒4.21; p < 0.001). The findings in the present study suggest that the combination of gefitinib with chemotherapy can provide better disease response and survival outcomes for patients with advanced NSCLC.

Cytotoxic iridoids from the roots of Patrinia scabra.

Six new iridoid glucosides, patriridosides D-I (1-6), and one new iridoid, scabrol A (7), along with 12 known non-glycosidic and glycosidic iridoids (8-19), have been isolated from an ethanolic extract of the roots of Patrinia scabra. The cytotoxic activity of the isolated compounds against human cervical carcinoma HeLa cells and gastric carcinoma MNK-45 cells was evaluated using the MTT assay. Compounds 1, 4-6, 8, and 18 showed cytotoxic activities against the MNK-45 cell line with respective IC50 values of 15.6, 8.7, 9.4, 30.9, 23.8, and 11.2 µM, while only compound 10 showed cytotoxicity against the HeLa cell line, with an IC50 value of 24.5 µM.

The effect of corticosteroid injection in the treatment of greater trochanter pain syndrome: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: corticosteroid injection (CSI) has been used to treat greater trochanter pain syndrome (GTPS) for many years. However, so far, the efficacy of CSI in the treatment of GTPS is still controversial. Therefore, the aim of this review is to evaluate the effectiveness of CSI in comparison with sham intervention, nature history, usual care, platelet-rich plasma (PRP), physiotherapy/exercise therapy, dry needling, or other nonsurgical treatment for improvements in pain and function in GTPS. METHODS: PubMed (Medline), Embase, Cochrane Library were searched from their inception until April 2021. Randomized controlled trails (RCTs) comparing CSI to nonsurgical treatment were included. Data on the effect of CSI on pain and function were extracted and checked by two review authors independently. The treatment effect was analyzed in the short term, medium term, and long term. RESULTS: Eight RCTs (764 patients) were included. This review suggests CSI may be superior to usual care and 'wait and see,' ESWT, but may not be superior to exercise, PRP, dry needling, and sham intervention in short-term pain or function improvement. In terms of medium-term pain or function improvement, CSI may be superior to usual care and 'wait and see,' but may not be superior to PRP. In terms of long-term pain or function improvement, CSI may be inferior to PRP and ESWT, but it may be superior to usual care and 'wait and see' at 12 months. CONCLUSIONS: Due to the small sample size and lack of sufficient clinical studies, current evidence is equivocal regarding the efficacy of CSI in the treatment of GTPS. Considering the limitations, more large-sample and high-quality RCTs are needed to prove the therapeutic effect of CSI on GTPS. TRIAL REGISTRATION: PROSPERO registration number: CRD42021247991. Registered 09 May 2021.

[Chemical constituents from seeds of Alpinia katsumadai, inhibition on NF-kappaB activation and anti-tumor effect].

OBJECTIVE: To study the chemical constituents from the seeds of A. katsumadai, and their inhibition on NF-kappaB activation and antitumor effect. METHOD: Tweleve compounds were isolated from the seeds of Aplinia katsumadai on repeated column chromatography on silica gel, and Sephadex LH-20, and their structures were determined mainly by means of MS and NMR techniques; and their inhibition on NF-kappaB activation and antitumor effect were also tested by High-Content Screening (image-based) with immunofluorescent probe and MTT method, respectively. RESULT: From the EtOAC fraction of the seeds of A. katsumadai 12 compounds were isolated and identified as follows: (3S,5S)-trans-3,5-dihydroxy-1 ,7-diphenyl-hept-1-ene (1), (3R,5S)-trans-3,5-dihydroxy-1,7-diphenyl-hept-1-ene (2), 5-hydroxy-1,7-diphenyl-hepta-6-en-3-one (3), cardamonin (4), alpinetin(5), pinocembrin(6), pinostrobin(7), naringenin (8), (+)-catechin(9), chrysin(10), rutin(11) and 2,4- dihydroxy-6-phenethl-benzinic acid methyl ester (12). Compound 14 showed inhibitory effect on NF-kappaB activation with the IC50 values as 14.8, 16.5, 23.2 and 7. 5 micromol x L(-1), respectively. Compound 4 displayed cytotoxicity against leukemia K562 cells and human hepatoma cell line SMMC-7721 with IC50 values as 3.2 and 3.5 mg x L(-1), and compound 6 showed moderate cytotoxicity against SMMC-7721 with the IC50 value as 18.3 mg x L(-1). CONCLUSION: Compounds 7-12 were isolated from A. katsumadai for the first time and Compound 12 were isolated from the genus Aplinia for the first time; compound 4 has the activity of anti-tumor and NF-kappaB activation inhibition, compounds 1-3 have the activity NF-KB activation inhibition.

Laboratory Biosafety Considerations of SARS-CoV-2 at Biosafety Level 2.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen that causes coronavirus disease 2019 (COVID-19), which was first detected in Wuhan, China. Recent studies have updated the epidemiologic and clinical characteristics of COVID-19 continuously. In China, diagnostic tests and laboratory tests of specimens from persons under investigation are usually performed in a biosafety level 2 environment. Laboratory staff may be at greater risk of exposure due to a higher concentration and invasiveness of emerging pathogens. Current infection prevention strategies are based on lessons learned from severe acute respiratory syndrome, expert judgments, and related regulations. This article summarizes biosafety prevention and control measures performed in severe acute respiratory syndrome coronavirus 2 testing activities and provides practical suggestions for laboratory staff to avoid laboratory-acquired infections in dealing with public health emergencies.

Age- and Sex-Specific Pediatric Reference Intervals of Serum Electrolytes in Jilin Province of China Using the A Priori Approach.

OBJECTIVES: The purpose of this study was to establish age- and sex-specific pediatric reference intervals of serum potassium (K), sodium (Na), chlorine (Cl), calcium (Ca), magnesium (Mg), and phosphorus (P) using a direct sampling technique. METHODS: In accordance with the a priori approach, healthy individuals (n = 6,466, aged 1 month to <18 years) were enrolled from five regions in Jilin Province, China, and all analytes were performed in the center laboratory. Reference intervals were divided according to the regression tree and Harris and Boyd's method, and then they were calculated by the nonparametric rank method. The dynamic changes of reference intervals were evaluated by the lambda-mu-sigma (LMS) method. RESULTS: Reference intervals of serum Na and Ca were divided into three age-specific partitions. The concentrations of K, Cl, and Mg remained stable with age. However, only dramatic sex-specific changes of P were shown in those 11 to less than 13 years old and 13 to less than 15 years old, with an earlier peak time in females than in males. The correlation between Na and Cl was the strongest among all serum electrolytes (r = 0.31). CONCLUSIONS: Serum electrolyte reference intervals for children and adolescents were established by regression tree, z test, and the LMS method, which provide a more accurate interpretation for diagnosis and prognosis evaluation of clinical pediatric diseases.

Corn silk (Zea mays L.), a source of natural antioxidants with α-amylase, α-glucosidase, advanced glycation and diabetic nephropathy inhibitory activities.

The oxidative stress plays a critical role in the progression of diabetes mellitus (DM) and its complications. Corn silk is a traditional medicine used to treat DM. The aim of this study is to investigate the antioxidant capacity of corn silk, as well as its inhibitory potential on DM and diabetic nephropathy (DN). The ethanol extract of corn silk (CS) was liquid-liquid fractionated to get petroleum ether fraction (PCS), ethyl acetate fraction (ECS), n-butanol fraction (BCS) and water fraction (WCS). The Folin-Ciocalteu and AlCl3 assay showed that silk corn contained considerable amount of phenolics and flavonoids, ECS and BCS were the two phenolic-enriched fractions with highest TPC and TFC values. The ECS and BCS showed the highest total antioxidant activity and reducing power, as well as the strongest scavenging activity against DPPH and hydroxyl radicals, compared to CS and other fractions. The ECS and BCS displayed appreciable anti-hyperglycaemic effect indicated by the significant inhibition on α-amylase and α-glucosidase in enzymatic assays. In BSA-glucose model, ECS and BCS effectively inhibited the formation of advanced glycation end products (AGEs). In addition, the anti-diabetic nephropathy activity assay displayed that CS, ECS and BCS significantly inhibited the production of Col IV, FN and IL-6 in high-glucose stimulated mesangial cells at 200 µg/mL. These findings suggested the antioxidant activities of corn silk could contribute, at least in part, to its traditionally claimed therapeutic benefits on DM and DN. The phenolic-enriched CS fractions could be considered as a source of natural antioxidants and further developed for the prevention and treatment of DM and its complications including DN.

Norlignan derivatives from Curculigo crassifolia and their DPPH radical scavenging activity.

A novel norlignan derivative, crassifogenin C (1), and a known compound, curcapital (2), were isolated from the ethanolic extract of the rhizomes of Curculigo crassifolia. Their structures were elucidated on the basis of spectroscopic evidence and comparisons with literature data. Curcapital (2) was isolated from this plant for the first time. The free radical scavenging activity of the isolated compounds along with crassifoside E (3) and crassifoside F (4), which were reported previously, was evaluated by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay. All compounds showed strong radical scavenging activity. The primary structure-activity relationship is also discussed.

New acetylenic norlignan compounds from rhizomes of Curculigo crassifolia.

Two pairs of diastereoisomeric acetylenic norlignan compounds with PhCH(OR(1))CH(OR(2))CH(2)C triple bond CPh skeleta: (1R, 2R)-1-O-methylnyasicoside (1) and (1S, 2R)-1-O-methylnyasicoside (2), and (1R, 2R)-crassifogenin D (3) and (1S, 2R)- crassifogenin D (4), were isolated from the ethanolic extract of rhizomes of Curculigo crassifolia. Compounds 3 and 4 are new and their structures were elucidated on the basis of spectroscopic evidence and comparisons with literature data.

Comparison of gefitinib plus chemotherapy versus gefitinib alone for advanced non-small-cell lung cancer: A meta analysis

Abstract This study aimed to perform a meta-analysis comparing the efficacy and safety of gefitinib in combination with chemotherapy versus gefitinib alone in patients with advanced Non-Small Cell Lung Cancer (NSCLC). We searched databases for clinical studies that reported the efficacy or safety of gefitinib plus chemotherapy in comparison with gefitinib alone. Raw data from included studies were extracted and pooled to calculate the Odds Ratio (OR) for Objective Response Rate (ORR) and Disease Control Rate (DCR), the Hazard Ratio (HR) for Progression-Free Survival (PFS) and Overall Survival (OS), and OR for complication ≥ Grade 3. A total of 10 studies containing 1,528 patients with NSCLC were identified and included in the analysis. Gefitinib plus chemotherapy showed significantly better efficacy in improving ORR (OR = 1.54; 95% CI [Confidence Interval], 1.13‒2.1; p = 0.006), DCR (OR = 1.62; 95% CI 1.14‒2.29; p = 0.007), PFS (HR=1.67; 95% CI 1.45‒1.94; p < 0.001) and OS (HR = 1.49; 95% CI 1.2‒1.87; p < 0.001) as compared with gefitinib alone. Consistent results were observed in the sub-population with positive EGFR mutation. The combination of gefitinib with chemotherapy had a significantly higher risk of complication (≥ Grade 3) with an OR of 3.29 (95% CI 2.57‒4.21; p < 0.001). The findings in the present study suggest that the combination of gefitinib with chemotherapy can provide better disease response and survival outcomes for patients with advanced NSCLC.

Antioxidant phenolic compounds from rhizomes of Curculigo crassifolia.

A pair of new phenolic glycosides, crassifoside G (5) and isocrassifoside G (6), along with five known phenolic compounds (1-4 and 7), were isolated from the ethanolic extract of the rhizomes of Curculigo crassifolia. Their structures were established by spectroscopic techniques and chemical methods. Most of the isolated compounds exhibited strong antioxidant activity in the 1, 1-diphenyl-2-picryldydrazyl (DPPH) radical scavenging assay.

Cytotoxic Activities of Fractions of the Willow Bracket Medicinal Mushroom, Phellinus igniarius (Agaricomycetes), and the Induction of Cell Cycle Arrest and Apoptosis in MGC-803 Cells.

Phellinus igniarius, a perennial medicinal mushroom, has been used in China and other countries of East Asia for the treatment of various diseases, including cancer. The purpose of this study is to evaluate the cytotoxic activities of different fractions of an ethanol extract from Ph. igniarius and to elucidate a possible antitumor mechanism. An ethanol extract of Ph. igniarius was partitioned into a petroleum ether fraction, an ethyl acetate fraction (EAF), an n-butanol fraction, and a water-soluble fraction. The cytotoxic activity of all the fractions was initially screened in a brine shrimp lethality test, then evaluated by the Cell Counting Kit-8 assay against 5 human tumor cell lines: MGC-803, BEL-7402, HeLa, MCF-7, and HCT-116. The cell cycle distribution induced by EAF on MGC-803 cells was analyzed by flow cytometry with propidium iodide staining, and apoptosis was determined using flow cytometry with Annexin V/propidium iodide staining. The results of the brine shrimp lethality test and the Cell Counting Kit-8 assay showed that EAF was the most active fraction, displaying strong inhibitory activity against the MGC-803, BEL-7402, and MCF-7 cancer cell lines. Flow cytometry analysis indicated that EAF could induce S-phase cell cycle arrest in MGC-803 cells and cause apoptosis in a concentration-dependent manner. This study demonstrated that EAF, as the most active fraction of Ph. igniarius, exerted antitumor activity by inducing MGC-803 cell apoptosis via S-phase cell cycle arrest.