Feiji Recipe inhibits the growth of lung cancer by modulating T-cell immunity through indoleamine-2,3-dioxygenase pathway in an orthotopic implantation model / 中西医结合学报

<p><b>OBJECTIVE</b>Escape from the body's immune response is a basic characteristic of lung cancer, and indoleamine-2,3-dioxygenase (IDO) plays a key role in mediating immune escape of non-small-cell lung cancer, which leads to recurrence and metastasis. Feiji Recipe, a compound Chinese herbal medicine, has the effect of stabilizing lesions and prolonging survival in patients with lung cancer. The purpose of this study was to investigate the mechanisms underlying the anticancer properties of Feiji Recipe.</p><p><b>METHODS</b>An orthotopic transplant model of mouse Lewis lung cancer, with stable expression of IDO gene, was established in C57BL/6 mice. Optical imaging was used to observe the effects of Feiji Recipe in the treatment of lung cancer in vivo. The effects of Feiji Recipe on the proliferation of mouse Lewis lung cancer cell line 2LL, 2LL-enhanced green fluorescent protein (2LL-EGFP) and 2LL-EGFP-IDO were investigated, and the apoptosis of T-cells was examined by 3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2H-tetrazolium bromide using flow cytometry. Chemical composition of Feiji Recipe was validated by high-performance liquid chromatography.</p><p><b>RESULTS</b>Compared to the control group, the survival of animals treated with Feiji Recipe was significantly prolonged (P = 0.0074), and the IDO protein level decreased (P = 0.0072); moreover, the percentages of CD4CD25 T-cells and Foxp3 T-cells were significantly decreased (P < 0.05). The molecular mechanism of Feiji Recipe against lung cancer may relate to the regulation of immune cells, such as T-cells and regulatory T-cells.</p><p><b>CONCLUSION</b>The molecular mechanism of Feiji Recipe in treatment of lung cancer is to restore the function of T-cells in the cancer microenvironment through interfering with the IDO pathway.</p>

Inhibitory Effect of Feiji Recipe on IDO Induced Immune Escape on the Murine Model of Lewis Lung Carcinoma / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the effect of Feiji Recipe (FR) intervening indoleamine 2,3-dioxygenase (IDO) induced immune escape on the murine model of Lewis lung carcinoma. Methods Totally 48 C57BL/6 mice inoculated with Lewis lung cancer cells transfected with human (enhanced green fluorescent protein,EGFP)-IDO gene were divided into four groups according to radom digit table, i.e., the model group (administered with normal saline by gastrogavage) , the Chinese medicine group (treated with FR Decoction at the daily dose of 100 mg/g by gastrogavage), the 1-methyl-D-trytaphan (1-MT) group (administered with 1-MT mixed liquor at the daily dose of 100 mg/kg by gastrogavage), and the Paclitaxel group (treated with Paclitaxel at the daily dose of 15 mg/kg by peritoneal injection), 12 in each group. The intervention was started from the 2nd day of modeling. The survival time was observed in 24 of them. Ratios of CD4+ CD25+ FoxP3+ regulatory T cells (Treg) in the spleen were detected in the rest 24 mice by flow cytometry respectively.</p><p><b>RESULTS</b>Compared with the model group, the survival time was significantly prolonged in the Chinese medicine group and the 1-MT group (P < 0.01); ratios of Treg cells remarkably decreased in the Chinese medicine group, the 1-MT group, and the Paclitaxel group (P < 0. 01). Compared with the Paclitaxel group, the survival time was significantly prolonged in the Chinese medicine group and the 1-MT group (P < 0.01); ratios of Treg cells decreased significantly in the 1-MT group (P < 0.05).</p><p><b>CONCLUSION</b>FR could inhibit the proliferation of lung cancer cells and immune eseape, improve the immune function, and prolong the survival of tumor-bearing mice.</p>

Treatment of Radical Resected NSCLC by Chinese Medicine Combined with Adjuvant Chemother- apy: a Clinical Study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of Chinese medicine (CM) combined adjuvant chemotherapy in postponing relapse and metastasis of radical resected Ib-IIIa stage non-small cell lung cancer (NSCLC) patients, and to explore its effect in improving their quality of life (QOL) and clinical symptoms.</p><p><b>METHODS</b>We designed a cohort study of 336 radical resected Ib-IIIa NSCLC patients by analyzing disease free survival (DFS) using Log-rank test. They were randomly assigned to the control group (155 cases, treated by adjuvant chemotherapy group) and the test group (181 cases, treated by adjuvant chemotherapy combined CM). By using controlled method, 60 radical resected NSCLC patients undergoing NP/NC program in 2012 (vinorelbine 25 mg/m2, combined with cisplatin 75 mg/m2 on day 1 and day 8/on day 1 or on day 1, 2, and 3; or carboplatin AUC = 5 on day 1) were assigned to the control group (29 cases) and the test group (31 cases). QOL scores (using EORTC QLQ-LC43 questionnaire) and TCM symptoms scores were compared between the two groups before chemotherapy, peri-chemotherapy (one day before the 2nd course of chemotherapy) , and after chemotherapy (20 days after ending the 4th course of chemotherapy).</p><p><b>RESULTS</b>(1) The median DFS was longer in the test group than in the control group, but with no statistical difference between the two groups (42.73 months vs 35.57 months , P = 0.179). In the subgroup analysis, there was statistical difference in IIIa stage DFS. The median IIIa stage DFS of was longer in the test group than in the control group with statistical difference (27.87 months vs 19. 93 months, P = 0.047). (2) In the control study, repeated measured data indicated there was significant difference in physical functions between the two groups (P < 0.05). Total scores for health states decreased more in the test group than in the control group, but with no statistical difference (P > 0.05). Scores for constipation and CM syndrome scores were higher in the test group than in the control group (P < 0.05).</p><p><b>CONCLUSIONS</b>CM had advantages in postponing DFS of radical resected NSCLC patients, especially in IIIa stage. CM could improve their QOL and clinical symptoms during adjuvant chemotherapy.</p>

Establishment of an orthotopic transplant tumor model of murine lung cancer with stable expression of human IDO gene in mice / 肿瘤

Objective: To establish an orthotopic transplant tumor model of murine lung cancer with stable expression of human indoleamine-2, 3-dioxygenase (IDO) gene in mice. Methods: The murine lung cancer 2LL-EGFP-IDO cells with stable expression of IDO gene were transplanted into the lung or subcutaneous tissue of mice. The survival time of mice was observed. The tumorigenesis of murine lung cancer cells in lung was detected by pathological examination. The orthotopic transplant tumor model of lung cancer in mice was treated with 0.9% NaCI (as a model group), Chinese medicinal formula Feiji Recipe, IDO inhibitor l-methyl tryptophan (l-MT) or paclitaxel, respectively. The dynamic change of growth of lung cancer was observed by in vivo optical imaging. The expression level of IDO protein in the orthotopic transplant tumor of murine lung cancer was detected by Western blotting. Results: The survival time of mice-bearing orthotopic transplant tumor of murine lung cancer was shorterned as compared with that of the mice-bearing subcutaneous transplant tumor (P = 0.002). The pathologic result showed that tumorigenesis could be observed in the lung in mice. As compared with the model group, the growth of orthotopic transplant tumor of lung cancer was inhibited by Feiji Recipe, l-MT and paclitaxel (all P < 0.05). The expression level of IDO protein in the model group was higher than those in high-dose (100 mg·g-1d-1) Feiji Recipe, low-dose (50 mg·g-1d-1) Feiji Recipe and 1-MT groups (all P < 0.05). Conclusion: The orthotopic transplant tumor model of murine lung cancer 2LL-EGFP-IDO cells in mice can be successfully established, and the growth of transplant tumor and the IDO expression level can be inhibited by Feiji Recipe and l-MT.

Chemotherapy in conjunction with traditional Chinese medicine for survival of elderly patients with advanced non-small-cell lung cancer: protocol for a randomized double-blind controlled trial / 中西医结合学报

<p><b>BACKGROUND</b>Traditional Chinese medicine (TCM) is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer (NSCLC) are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM. Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC.</p><p><b>METHODS AND DESIGN</b>This is a double-blind controlled, multi-center, and prospective study with randomly selected participants from elderly NSCLC patients in China. Seventy-six patients who meet the inclusion criteria will be allocated into two groups, which will receive treatments of 3-week single-agent chemotherapy with TCM or placebo for four cycles. Progression-free survival (PFS) is the primary end point, and the secondary end points are overall survival, objective response rate, time-to-progression, and quality of life (EORTC QLQ-LC43, and TCM syndrome score). Meanwhile, other end points such as toxicity, side effects and safety of the treatments will be assessed.</p><p><b>DISCUSSION</b>Results from this study may provide evidence on the effectiveness, and parameters for the usage of single-agent chemotherapy combined with or without TCM on PFS of elderly patients with NSCLC.</p><p><b>TRIAL REGISTRATION</b>ClinicalTrials.gov. (Identifier: NCT01780181).</p>

A survey on knowledge of recommended heart failure guidelines among Chinese physicians / 中华心血管病杂志

<p><b>OBJECTIVE</b>To obtain the knowledge status on recommended heart failure (HF) guidelines among Chinese physicians.</p><p><b>METHODS</b>Questionnaire on heart failure including 20 multiple choice questions and 10 fill in the blank questions was designed based on the Chinese guidelines for the diagnosis and treatment of chronic heart failure in 2007 and the Chinese guidelines for the diagnosis and treatment of acute heart failure in 2010. The rate of correct answer for each item was calculated and compared among physicians specialized for cardiovascular diseases and not.</p><p><b>RESULTS</b>The Questionnaire was completed in 400 physicians, including 208 physician specialized for cardiovascular disease and 192 physicians not specialized in cardiovascular disease. The rate of correct answer for 20 multiple choice questions was lower than 60% in 8 questions, 60%-80% in 8 questions, higher than 80% in 4 questions. The rate of correct answers for 10 fill in the blank questions focusing on the aimed dosage of 10 ACEI/ARB/β-blockers was 49%. The 8 multiple choice questions with correct answer rate <60% are detailed items of myocardial remodeling, symptoms suggestive of HF, diagnosis tools for patients with suspected HF, the AHA stages of heart failure, the Forrester's hemodynamic classes of acute heart failure, the goals of ACEI/ARBs treatment in patients with HF, names of heart diseases which might benefit from ACEI/ARBs treatment defined by evidenced based medicine, and detailed application methods of ACEI/ARBs and β-blockers for HF patients. In general, the rate of correct answer was significantly higher in physicians specialized for cardiovascular disease compared physicians not specialized for cardiovascular disease.</p><p><b>CONCLUSION</b>There is a considerable knowledge gap on the Chinese guidelines for the diagnosis and treatment of chronic heart failure and the Chinese guidelines for the diagnosis and treatment of acute heart failure among Chinese physicians. Efforts must be made to educate physicians to improve their knowledge and improve HF patient care.</p>

Predictive value of combined ABCD2 scores and tracheal constriction resulted from internal carotid atherosclerosis in cerebral infarction after a transient ischemic attack / 中华神经医学杂志

Objective To explore the predictive value of combined ABCD2 scores and tracheal constriction resulted from internal carotid atherosclerosis (ICAS) in cerebral infarction within 7 d of onset of a transient ischemic attack (TIA). Methods The clinical data of 171 patients with TIA,admitted to our hospital from September 2008 to March 2011, were retrospectively analyzed. All patients were evaluated with ABCD2 scale and degrees of tracheal constriction resulted from ICAS were examined by Color Doppler ultrasound.And 7-d follow-up of patients was performed to select those patients appearing cerebral infarction; and then, the relationships between risk of post-TIA cerebral infarction and both ABCD2 scores and degrees of tracheal constriction were analyzed using chi-square test. Results Among 171 TIA patients,39 (22.8％) suffered cerebral infarction within 7 d of onset of TIA.Significant difference of risk of post-TIA cerebral infarction was noted in patients with different ABCD2 scores and degree of tracheal constriction (P＜0.05): the higher the ABCD2 scores/ the degrees of tracheal constriction, the higher incidence of cerebral infarction in TIA patients. Conclusion A rather high accuracy may be achieved with ABCD2 scale in the prediction of short-term risk of cerebral infarction after onset of TIA,and a higher accuracy may be expected by combination of ABCD2 scale with carotid atherosclerosis findings.

Transgenic animals bioreactors / 生物工程学报

The production of human recombinant proteins in milk of transgenic farm animals offers a safe, very cost-effective source of commercially important proteins that cannot be produced as efficiently in adequate quantities by other methods. This review has summarized the current status of gene selection, vector construct, transgenic methods, economics, and obvious potential in transgenic animals bioreactors. Recently, a more powerful approach was adopted in the transgenic animals founded on the application of nuclear transfer. As we will illustrate, this strategy presents a breakthrough in the overall efficiency of generating transgenic farm animals, product consistency, and time of product development. The successful adaptation of Cre-/lox P-mediated site-specific DNA recombination systems in farm animals will offer unprecedented possibilities for generating transgenic animals.