Exploration of the Potential Mechanism of Yujin Powder treating Dampness-heat Diarrhea by Integrating UPLC-MS/MS and Network Pharmacology Prediction.

BACKGROUND: Yujin powder (YJP) is a classic prescription for treating dampness-heat diarrhea (DHD) in Traditional Chinese Medicine (TCM), but the main functional active ingredients and the exact mechanisms have not been systematically studied. OBJECTIVES: This study aimed to preliminarily explore the potential mechanisms of YJP for treating DHD by integrating UPLC-MS/MS and network pharmacology methods. METHODS: Ultra performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) technology was used to determine the ingredients of YJP. And then, the targets of these components were predicted and screened from TCMSP, SwissTargetPrediction databases. The disease targets related to DHD were obtained by using the databases of GeneCards, OMIM, DisGeNET, TTD, and DrugBank. The protein-protein interaction networks (PPI) of YJP-DHD were constructed using the STRING database and Origin 2022 software to identify the cross-targets by screening the core-acting targets and a network diagram by Cytoscape 3.8.2 software was also constructed. Metascape database was used for performing GO and KEGG enrichment anlysis on the core genes. Finally, molecular docking was used to verify the results with AutoDock 4.2.6, AutoDock Tools 1.5.6, PyMOL 2.4.0, and Open Babel 2.3.2 software. RESULTS: 597 components in YJP were detected, and 153 active components were obtained through database screening, among them the key active ingredients include coptisine, berberine, baicalein, etc. There were 362 targets treating DHD, among them the core targets included TNF, IL-6, ALB, etc. The enriched KEGG pathways mainly involve PI3K-Akt, TNF, MAPK, etc. Molecular docking results showed that coptisine, berberine, baicalein, etc., had a strong affinity with TNF, IL-6, and MAPK14. Therefore, TNF, IL-6, MAPK14, ALB, etc., are the key targets of the active ingredients of YJP coptisine, baicalein, and berberine, etc. They have the potential to regulate PI3K-Akt, MAPK, and TNF signalling pathways. The component-target-disease network diagram revealed that YJP treated DHD through the effects of anti-inflammation, anti-diarrhea, immunoregulation, and improving intestinal mucosal injury. CONCLUSION: It is demonstrated that YJP treats DHD mainly through the main active ingredients coptisine, berberine, baicalein, etc. comprehensively exerting the effects of anti-inflammation, anti-diarrhea, immunoregulation, and improving intestinal mucosal injury, which will provide evidence for further in-depth studying the mechanism of YJP treating DHD.

Network Pharmacology Was Used to Predict the Active Components and Prospective Targets of Paeoniae Radix Alba for Treatment in Endometriosis.

Endometriosis is one of the most common benign gynecologic diseases. Paeoniae Radix Alba (PRA) has been utilized to treat endometriosis. We wished to identify potential targets for PRA in the treatment of endometriosis, as well as to provide a groundwork for future studies into its pharmacological mechanism of action. Network pharmacology was employed to conduct investigations on PRA. Target proteins were chosen from the components of PRA for endometriosis treatment. A protein-protein interaction (PPI) was established using overlapping genes. Analyses of enrichment of function and signaling pathways were undertaken using the Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes databases to select "hub genes." Finally, the feasibility of analysis based on network pharmacology was determined using real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR) and western blotting. We demonstrated that PRA has 25 bioactive components and 167 putative targets that are therapeutically important. The anti-inflammatory and immune-boosting actions of tumor necrosis factor, albumin, signal transducer and activator of transcription (STAT)3, mitogen-activated protein kinase, Jun, interleukin (IL)-1B, prostaglandin-endoperoxide synthase 2, matrix metalloproteinase-9, vascular endothelial growth factor A, and IL-6 were identified as prospective targets. Seven major compounds in PRA and related to the STAT3 pathway could bind spontaneously to it. RT-qPCR and western blotting showed that expression of STAT3 and phospho-STAT3 was reduced significantly after PRA intervention. Hence, analyses of the active components of traditional Chinese medicine formulations through network pharmacology may open up new ideas for the treatment of diseases.

[Effect of Xijiao Dihuang Combined Prescription on Human Dendritic Cell Function Induced by Lipopolysaccharide].

OBJECTIVE: To observe the effects of drug-containing serum of Xijiao Dihuang combined prescription(XJDH) on the related functions of dendritic cells(DCs) induced in vitro, and to explore the mechanisms underlying the effectiveness of XJDH treatment on primary immune thrombocytopenia(ITP). METHODS: Peripheral blood samples were colle-ted from 6 healthy volunteers. Mononuclear cells were isolated by density gradient centrifugation, and CD14+ mononuclear cells were collected by the magnetic separation technique. CD14+ mononuclear cells were induced into immature DCs by recombinant human granulocyte-macrophage colony stimulating factor (GM-CSF) and recombinant human interleukin 4 (IL-4). Immature DCs were divided into three groups: control group, model group and XJDH group. CCK-8 assay was used to determine the intervention concentration and time of drug-containing serum. Lipopolysaccharide(LPS) with the final concentration of 1 µg/ml was added to model group and XJDH group respectively for 24 h to induce DCs maturation. Normal rat serum was added to control group and model group, and XJDH was added to XJDH group for 24 h. Flow cytometry was used to detect the levels of CD80, CD83 and HLA-DR on the surface of DCs. Western blot was used to detect the expression of TLR4 and NF-κB, and levels of IL-6, IL-12 and TNF-α in cell supernatant was detected by ELISA. RESULTS: Compared with the control group, LPS stimulation increased the expression of CD80, CD83 and HLA-DR, with subsequent increasing expression of TLR4 and NF-κB, as well as IL-6, IL-12 and TNF-α increased(P<0.05). In comparison with model group, the expression of DCs surface molecules CD80, CD83 and HLA-DR, DCs' expression of TLR4 and NF-κB protein, and the levels of IL-6, IL-12 and TNF-α in the cell supernatant of XJDH group decreased after the intervention of XJDH (P<0.05). CONCLUSION: Drug containing serum of Xijiao Dihuang combined prescription can down-regulate TLR4/NF-κB signaling pathway related protein expression, inhibit DCs maturation, and reduce proinflammatory factor secretion, which may be one of the mechanisms of drug-containing serum of Xijiao Dihuang combined prescription in the treatment of immune thrombocytopenia.

[Key Bacteria for the Microbial Degradation of Pollutants in Cellar Water].

The study aimed to identify the key bacteria and the potential interactions among these bacteria during the degradation of pollutants in cellar water, The main pollution characteristics were nitrogen, phosphorus and organic pollution. The structure and function of the bacterial community and its correlation with water quality variables were analyzed. A network of seven associations of microbial co-occurrence was set up, based on 16S rRNA and the model for inferring co-occurrence or interspecific interactions of microbial species. This showed that there were a large number of microorganisms with relatively specific ecological functions in the cellar water, and that many metabolic activities were involved. The ecological relationships of most bacteria in the association network were a form of mutualism. The most prominent genera included Lacibacter, Arthrobacter, Candidatus Protochlamydia, Methylocaldum, Sulfuritalea, Mycobacterium, Aquirestis, Rhodobacter, and, Methylotenera. The strong associations were observed between following bacteria:Sulfuritalea-Rhodobacter, Azospirillum-Rhodobacter, Methylocaldum-Rhodobacter, Arthrobacter-Rhodobacter, Rhodoplanes-Rhodobacter, Candidatus Protochlamydia-Rhodobacter, Methylotenera-Rhodobacter, Rhodobacter-Aquirestis, Mycobacterium-Rhodobacter, Planctomyces-Candidatus Solibacter, Planctomyces-Legionella, Hymenobacter-Adhaeribacter, and Luteolibacter-Crenothrix. It was considered that Rhodobacter, Methylocaldum, Methylotenera, Acinetobacter, Novosphingobium, Planctomyces, Hymenobacter, and Luteolibacter were the key bacteria involved in microbial degradation of cellar water pollutants, and Rhodobacter was the representative genus of the key bacteria. The authors concluded that the research results improved understanding of the microbial degradation mechanism of pollutants in cellar water.

Effectiveness and safety of traditional Chinese medical bath therapy combined with ultraviolet irradiation in the treatment of psoriasis: A systematic review and meta-analysis of randomized controlled trials.

BACKGROUND AND OBJECTIVE: To systematically evaluate the clinical effects and safety of traditional Chinese medical bath therapy (TCMBT) combined with ultraviolet irradiation in the treatment of psoriasis. METHODS: Electronic database retrieval was utilized. The foreign retrieval databases consulted included those of the Cochrane Library, PubMed and EMBASE; the domestic retrieval databases included the Chinese Biomedical Literature Database (Sino-Med), the China National Knowledge Infrastructure (CNKI), VIP and the WangFang Database. Clinical randomized controlled trials were conducted to evaluate the effects of TCMBT combined with ultraviolet irradiation in the treatment of psoriasis; the language of the retrieved articles was Chinese or English. Each database was searched from its inception to August 1, 2015. Two researchers independently collected the data and analyzed the methodology of the documented literature. The researchers conducted a meta-analysis with RevMan 5.2.3 software. RESULTS: According to the available literature, 25 RCTs (randomized controlled trials) of low research quality were conducted. According to the meta-analysis, the total effective rate of TCMBT combined with ultraviolet irradiation was relatively higher than that of ultraviolet irradiation alone. The recurrence rate, incidence of adverse reactions and Psoriasis Area and Severity Index (PASI) for the combined therapy was lower than that of ultraviolet irradiation (P<0.05). CONCLUSION: For the treatment of psoriasis, the clinical effects and safety of TCMBT combined with ultraviolet irradiation are generally better than those of ultraviolet irradiation alone. However, the original literature was written in Chinese, and the quality of the studies was not high. Thus, it is difficult to confirm the clinical effects and safety of TCMBT combined with ultraviolet irradiation. It is necessary to conduct a scientific, normalized and high-quality RCT with multiple large samples and centers.

[Reversion Mechanism Study of PESV to Multidrug Resistance at Leukemia Stem Cell Level].

OBJECTIVE: To explore the effect of peptide extract from scorpion venom (PESV) to multidrug resistance (MDR) of leukemic stem cell (LSC) in vivo. METHODS: K562/A02 cells were cultured and collected in the logarithmic phase. K562/A02 stem cells were screened using immunomagnetic beads for reserve. K562/A02 LSC was injected to 5 of 40 BABL/c nude mice for preparing subcutaneous tumor. The rest 35 nude mice were then randomly divided into 7 groups, i.e., the normal control group, the model group, the Adriamycin (ADM) group, the PESV group, the ADM +high dose PESV group, the ADM + middle dose PESV group, the ADM +low dose PESV group, 5 in each group. Tumor tissue was embedded in all groups except the normal control group. One milliliter normal saline was peritoneally injected to mice in the model group after modeling, once per day. ADM 0. 05 mg was peritoneally injected to mice in the ADM group, once per other day. PESV 2 µg was peritoneally injected to mice in the PESV group, once per day. Mice in 3 ADM + PESV groups were peritoneally injected with ADM 0. 05 mg (once per other day) plus PESV (5, 2, and 1 µg respectively, once per day). All medication lasted for 14 days. P-glycoprotein (P-gp) was detected using flow cytometry. Breast cancer resistance protein (BCRP) and mRNA expression of multidrug resistance 1 (MDR1) were measured using RT-PCR. Aldehyde dehydrogenase 1 (ALDH1) was detected using immunohistochemistry. Phosphoinositide 3-kinase (PI3K) was detected using Western blot. NF-κB content was detected using ELISA. RESULTS: CD34 + CD38-ratio was 31.5% and IC50 was (60.33 ± 10. 68) µg/mL before K562/A02 cells were screened with immunomagnetic beads, while they were 92. 8% and (58. 33 ±9. 72) µg/mL after screen. The tumor formation rate was 100% in modeling mice. Compared with the model group, no statistical difference of each index occurred in the ADM group (P <0. 05). There was statistical difference in BCRP, MDR1 mRNA, or NF-κB factor between the model group and the PESV group (P <0. 05). The expression level of P-gp obviously decreased and the protein expression of P13K was down-regulated in 3 ADM + PESV groups (P <0. 05); mRNA expression of BCRP decreased and mRNA ex- pression of MDR1 obviously increased in the ADM + high dose PESV group and the ADM + middle dose PESV group, with statistical difference (P <0. 05). Protein expression of P13K was down-regulated in the ADM+ high dose PESV group, with statistical difference (P <0. 05). P-gp value, BCRP mRNA expression, MDR1 mRNA expression, PI3K, and NF-κB factor were all obviously down-regulated in the ADM +high dose PESV group, as compared with the ADM group and the PESV group respectively (P <0. 05). There was no statistical difference in ALDH1 positive rate among all groups (P >0. 05). Conclusion PESV combined ADM could down-regulate expression levels of P-gp, BCRP, MDR1, P13K, and NF-κB, strengthen the sensitivity of K562/A02 LSC to ADM in vivo, and reverse MDR of LSC.

Morphological and transcriptional responses of Lycopersicon esculentum to hexavalent chromium in agricultural soil.

The carcinogenic, teratogenic, and mutagenic effects of hexavalent chromium (Cr[VI]) on living organisms through the food chain raise the immediate need to assess the potential toxicological impacts of Cr(VI) on human health. Therefore, the concentration-dependent responses of 12 Cr(VI)-responsive genes selected from a high-throughput Lycopersicon esculentum complementary DNA microarray were examined at different Cr concentrations. The results indicated that most of the genes were differentially expressed from 0.1 mg Cr/kg soil, whereas the lowest-observable-adverse-effect concentrations of Cr(VI) were 1.6 mg Cr/kg soil, 6.4 mg Cr/kg soil, 3.2 mg Cr/kg soil, and 0.4 mg Cr/kg soil for seed germination, root elongation, root biomass, and root morphology, respectively, implying that the transcriptional method was more sensitive than the traditional method in detecting Cr(VI) toxicity. Dose-dependent responses were observed for the relative expression of expansin (p = 0.778), probable chalcone-flavonone isomerase 3 (p = -0.496), and 12S seed storage protein CRD (p = -0.614); therefore, the authors propose the 3 genes as putative biomarkers in Cr(VI)-contaminated soil. Environ Toxicol Chem 2016;35:1751-1758. © 2015 SETAC.

The relationship of kinase insert domain receptor gene polymorphisms and clinical outcome in advanced hepatocellular carcinoma patients treated with sorafenib.

Kinase insert domain receptor (KDR) is the principal receptor that promotes the pro-angiogenic action of vascular endothelial growth factor and has been the principal target of anti-angiogenic therapies. Our aim was to determine whether single-nucleotide polymorphisms (SNPs) in KDR gene are associated with clinical outcomes after first-line sorafenib therapy in advanced hepatocellular carcinoma (HCC). The SNPs in KDR were tested in 78 advanced HCC patients receiving first-line sorafenib. Correlations with clinicopathological features and survival were analyzed. Patients with AA genotype of rs1870377 and AA genotype of rs2305948 were significantly associated with a better response and longer time to progression (TTP) (5.8 vs 4.0 months, P=0.001; 5.8 vs 4.5 months, P=0.016, respectively). Patients harboring AA genotype in rs1870377 and TT/TC genotype in rs2071559 had a longer overall survival (OS) (15.0 vs 9.6 months, P=0.001; 13.0 vs 9.0 months, P=0.007, respectively). At multivariate analysis, major vascular invasion and rs1870377 were independent factors in TTP and performance status, rs1870377, and rs2071559 were independent factors in OS. Our results suggest that SNPs in KDR gene can predict clinical outcome in advanced HCC patients receiving first-line sorafenib.

[Observation of long-term efficacy and life quality in allergic rhinitis treated with acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy].

OBJECTIVE: To observe the impacts of acupoint catgut embedding therapy and acupuncture-moxibustion therapy on the long-term efficacy and patient's life quality in the treatment of allergic rhinitis. METHODS: Sixty-nine patients were randomized into the combined acupuncture-moxibustion and acupoint catgut embedding therapy group (combined therapy group, 36 cases) and an acupuncture-moxibustion group (33 cases). In the acupuncture-moxibustion group, acupuncture was applied at Yingxiang (LI 20), Shangyingxiang (EX-HN 8), Yintang (GV 29), Shangxing (GV 23), Tongtian (BL 7) and Zusanli (ST 36). Moxibustion was applied at Zusanli (ST 36), Feishu (BL 13), Dazhui (GV 14) and Fengmen (BL 12). In the combined therapy group, on the basis of the treatment as acupuncture-moxibustion group, the catgut embedding therapy was applied at Feishu (BL 13), Fengmen (BL 12), Pishu (BL 20), Shenshu (BL 23), Zhongwan (CV 12) and Qihai (CV 6). The treatment duration was 4 weeks in the two groups. The clinical efficacy of allergic rhinitis and rhinoconjunctivitis quality of life questionnaire (RQLQ) score were observed before and after treatment as well as in the 4-weeks follow-up after the end of treatment respectively. RESULTS: The markedly effective rate was 72.7% (24/33) in the combined therapy group and 48.4% (15/31) in the acupuncture-moxibustion group after treatment. The efficacy was similar between the two groups (P > 0.05). It was 57.6% (19/33) in the combined therapy group and was 22. 6% (7/31) in the 4-week follow-up after treatment, indicating the long-term efficacy in the combined therapy group was superior to that in the acupuncture-moxibustion group (P<0. 05). Scores of RQLO after treatment and in 4-week follow-up after treatment in both groups were improved as compared with those before treatment (all P < 0.05). In 4-week follow-up, the improvements in sleep and affection in the combined therapy group were superior to the acupuncture-moxibustion group (3.27 +/- 3.23 vs 4.61 +/- 3.56, 3.48 +/- 3.67 vs 5.81 +/- 4.15, both P < 0.05). CONCLUSION: The acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy are safe and effective in the treatment of allergic rhinitis and display the more roles in the long-term efficacy.

Sorafenib continuation after first disease progression could reduce disease flares and provide survival benefits in patients with hepatocellular carcinoma: a pilot retrospective study.

BACKGROUND: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. MATERIALS AND METHODS: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. RESULTS: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. CONCLUSIONS: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.

Observation of long-term efficacy and life quality in allergic rhinitis treated with acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy / 中国针灸

<p><b>OBJECTIVE</b>To observe the impacts of acupoint catgut embedding therapy and acupuncture-moxibustion therapy on the long-term efficacy and patient's life quality in the treatment of allergic rhinitis.</p><p><b>METHODS</b>Sixty-nine patients were randomized into the combined acupuncture-moxibustion and acupoint catgut embedding therapy group (combined therapy group, 36 cases) and an acupuncture-moxibustion group (33 cases). In the acupuncture-moxibustion group, acupuncture was applied at Yingxiang (LI 20), Shangyingxiang (EX-HN 8), Yintang (GV 29), Shangxing (GV 23), Tongtian (BL 7) and Zusanli (ST 36). Moxibustion was applied at Zusanli (ST 36), Feishu (BL 13), Dazhui (GV 14) and Fengmen (BL 12). In the combined therapy group, on the basis of the treatment as acupuncture-moxibustion group, the catgut embedding therapy was applied at Feishu (BL 13), Fengmen (BL 12), Pishu (BL 20), Shenshu (BL 23), Zhongwan (CV 12) and Qihai (CV 6). The treatment duration was 4 weeks in the two groups. The clinical efficacy of allergic rhinitis and rhinoconjunctivitis quality of life questionnaire (RQLQ) score were observed before and after treatment as well as in the 4-weeks follow-up after the end of treatment respectively.</p><p><b>RESULTS</b>The markedly effective rate was 72.7% (24/33) in the combined therapy group and 48.4% (15/31) in the acupuncture-moxibustion group after treatment. The efficacy was similar between the two groups (P > 0.05). It was 57.6% (19/33) in the combined therapy group and was 22. 6% (7/31) in the 4-week follow-up after treatment, indicating the long-term efficacy in the combined therapy group was superior to that in the acupuncture-moxibustion group (P<0. 05). Scores of RQLO after treatment and in 4-week follow-up after treatment in both groups were improved as compared with those before treatment (all P < 0.05). In 4-week follow-up, the improvements in sleep and affection in the combined therapy group were superior to the acupuncture-moxibustion group (3.27 +/- 3.23 vs 4.61 +/- 3.56, 3.48 +/- 3.67 vs 5.81 +/- 4.15, both P < 0.05).</p><p><b>CONCLUSION</b>The acupoint catgut embedding therapy combined with acupuncture-moxibustion therapy are safe and effective in the treatment of allergic rhinitis and display the more roles in the long-term efficacy.</p>

The blood neutrophil-to-lymphocyte ratio predicts survival in patients with advanced hepatocellular carcinoma receiving sorafenib.

BACKGROUND AND AIM: Increasing evidence correlates the presence of systemic inflammation with poor survival in patients with hepatocellular carcinoma (HCC). The aim of this study was to investigate the prognostic significance of the blood neutrophil-to-lymphocyte ratio (NLR) in patients with advanced HCC who received sorafenib monotherapy. METHODS: A total of sixty-five patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib were enrolled. Potential prognostic factors such as age, gender, tumoral characteristics, performance status and NLR were analyzed. RESULTS: Median OS and TTP for the entire cohort were 10.0 months (95%CI, 7.6-12.3 months) and 4.5 months (95% CI, 4.0-4.9 months). The mean NLR at baseline was 2.89. The median OS of patients with a high NLR (>4) was 6.5 months (95%CI, 5.2-7.7 months) compared with 12.5 months (95%CI, 9.9-15.0) for patients with a normal NLR (≤ 4) (P = 0.01). Age ≤ 65, NLR >4, extrahepatic metastases and vascular invasion were all predictors of poorer overall survival. Multivariate analysis showed that NLR > 4, vascular invasion and extrahepatic metastases were independent predictors of poorer overall survival. The median TTP of patients with a high NLR was 2.5 months (95%CI, 1.4-3.6 months) compared with 4.5 months (95%CI, 3.9-5.1 months) for patients with a normal NLR (P=0.012). CONCLUSIONS: High baseline NLR was associated with worse OS and TTP for patients with advanced HCC treated with sorafenib.

Effects of sorafenib combined with chemoembolization and radiofrequency ablation for large, unresectable hepatocellular carcinomas.

BACKGROUND: The prognosis of unresectable large hepatocellular carcinomas is poor. This study evaluated the efficacy and safety of sorafenib combined with transcatheter arterial chemoembolization and radiofrequency ablation in the treatment of hepatocellular carcinomas larger than 5 cm. METHODS: The treatment of 22 patients with large, unresectable hepatocellular carcinomas (5.0-16.5 cm) treated with sorafenib after transcatheter arterial chemoembolization combined with radiofrequency ablation between 2007 and 2011 was reviewed. The local effects, survival rates, toxicity, and prognostic factors were analyzed. RESULTS: During a follow-up of 9-49 months, 19 patients died and three survived. The median overall survival was 32 months. The overall cumulative 12, 24, and 36-month survival rates were 85.9%, 66.8%, and 23.5% respectively. Technical effectiveness was achieved in 12 out of 28 lesions (42.85%) at the first CT check. The median time to tumor progression was 21 months. The progression-free survival rates at 6, 12, and 24 months were 90.9%, 72.0%, and 38.4%, respectively. Combined therapy was generally well tolerated. There was only one major procedure-related complication, biloma (4.5%). Sorafenib-related adverse events exceeding grade 3 were hand-foot skin reaction (2/22, 9.1%), gastrointestinal hemorrhage (1/22, 4.5%), and diarrhea (2/22, 9.1%). The absence of vascular invasion before treatment was found to be the best prognostic factor in the univariate analysis. CONCLUSIONS: Sorafenib combined with transcatheter arterial chemoembolization and radiofrequency ablation is a promising approach to the treatment of large, unresectable hepatocellular carcinomas. However, large-scale randomized clinical trials are needed to determine the future role of this treatment.

Sorafenib in combination with transarterial chemoembolization and radiofrequency ablation in the treatment for unresectable hepatocellular carcinoma.

The purpose of this study is to assess clinical efficacy and safety of sorafenib combined with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) on patients with unresectable hepatocellular carcinoma (HCC). Efficacy and safety profiles of sorafenib in combination with TACE and RFA were evaluated based on retrospective data for thirty patients with unresectable HCC. Patients were treated with TACE initially when admitted to hospital, followed by RFA 3 days after TACE. All TACE and RFA were performed by the same team of doctors. Seven days after the first TACE, patients started taking continuous sorafenib 400 mg bid without breaks until unacceptable toxicities or disease progression. The response to treatment, overall survival (OS), time to progression (TTP), and adverse effects were evaluated. The disease control rate was 33.3% by RECIST criteria. The median TTP was 15.3 months (95% CI 4.8-23.5). The median OS was 28.8 months (95% CI 12.8-39.6). At the time of data record, 13 patients (43.3%) were dead. Median OS in patients with or without portal vein thrombosis was 12.3 months (95% CI 7.6-14.5) and 30.2 months (95% CI 24.2-34.5), respectively, P = 0.018. The most common adverse events related to sorafenib were hand-foot skin reaction (53.3%) and diarrhea (33.3%). The combination of sorafenib, TACE, and RFA proved both safe and effective in the treatment for unresectable hepatocellular carcinoma patients.

The antidepressant effect of secoisolariciresinol, a lignan-type phytoestrogen constituent of flaxseed, on ovariectomized mice.

Secoisolariciresinol (SECO) is a natural lignan-type phytoestrogen constituent mainly found in flaxseed. It can be metabolized in vivo to mammalian lignans of enterodiol and enterolactone, which have been proven to be effective in relieving menopausal syndrome. Depression is one of the most common symptoms of menopausal syndrome, and is currently treated with estrogen replacement and antidepressant therapy. However, due to the serious side-effects of such agents, there are urgent needs for safer and more tolerable treatments. In this paper, using two classical depression models, the forced swimming test and the tail suspension test, we report the antidepressant effect of SECO on ovariectomized (OVX) mice by intragastric administration for 14 consecutive days at doses of 5, 10 and 20 mg/kg. The results showed that SECO (10 mg/kg) treatment could significantly reduce the duration of immobility of OVX mice in these two models compared with the control group (OVX mice + vehicle), which was similar to the positive control imipramine. In addition, SECO treatment could substantially increase brain monoamine (norepinephrine and dopamine) levels in OVX mice. The present studies showed that SECO can reverse depressive-like behavior and exhibit monoamine-enhancing effects.

[Relationship between sorafenib-associated hand-food skin reaction and efficacy in treatment of advanced hepatocellular carcinoma].

OBJECTIVE: To investigate the link between the antitumor efficacy of sorafenib and its cutaneous side effects in advanced hepatocellular carcinoma (HCC). METHODS: We retrospectively analyzed the incidence of hand-foot skin reactions (HFRS) of 51 patients with advanced HCC who treated by sorafenib combined with transcatheter arterial chemoembolization (TACE), comparing tumor disease control rate (DCR), median progression free survival (mPFS) and median overall survival (mOS) in the different severity HFRS groups. The Cox proportional hazard model was applied to the multivariate survival analysis for the PFS. RESULTS: Fifty-one HCC patients treated with sorafenib combined with TACE were included in this study. 13/51 without HFRS (grade 0), 38/51 developed at all grade 1-3, 27 developed at grade 1-2, 11 developed at grade 3. The DCR were 38.5%, 70.4% and 90.9% in the three groups (P < 0.05). Group grade 0 vs grade 1-3, P = 0.031, the difference had statistical significance. Group grade 1-2 vs grade 3, P = 0.352, the difference had no statistical significance. The mPFS were 2.8 months (95%CI 1.6 - 4.0), 4.5 (95%CI 1.3 - 7.7) months and 12.8 (95%CI 3.7 - 21.9) months (P < 0.05), group grade 0 vs grade 1-2, P = 0.019, HR (hazard ratio): 2.8 (95%CI 1.3 - 6.3), P = 0.010, group grade 0 vs grade 3, P < 0.01, HR 6.6 (95%CI 2.3 - 19.0), P < 0.01, group grade 1-2 vs grade 3, P = 0.054; the three groups' mOS were 8.5 months (95%CI 5.9 - 11.1), 13.0 (95%CI 10.1 - 15.9) months and 25.4 months, P < 0.05, there were statistically significant differences between the any two groups. CONCLUSIONS: HFRS should be closely monitored in HCC patients treated with sorafenib in relation to its potential role as a surrogate marker of efficacy, but it has yet to be demonstrated whether the efficacy increasing with the severity of HFRS or not.

[Clinical analysis of the treatment:transcatheter arterial chemoembolization combined with sorafenib in advanced hepatocellular carcinoma].

OBJECTIVE: To provide more evidence sources to the standard treatment for patients with advanced hepatocellular carcinoma, the writer analyze patients' time to progression (TTP) and overall survival (OS) after patients receiving transcatheter arterial chemoembolization (TACE) combined with sorafenib as a treatment of advanced hepatocellular carcinoma (HCC); observe the healing effect embolization combined with anti-angiogenic treatment for advanced hepatocellular carcinoma; and also analyze treatment of security. METHODS: There are 36 patients, 33 male and 3 female had been Pathologically or clinical diagnosis. After receiving Transcatheter Arterial Chemoembolization (TACE) therapy, in the following 3 to 7 days, this group of patients continuously take sorafenib (brand name: Nexavar) (per tablet 200 mg), 2 tablets each time, 2 times a day. Every 4 to 8 weeks is called as one period of treatment. Referring to RECIST Evaluation, the writers mainly observe patients' tumor progression (TTP) and overall survival (OS), record adverse events. Using life table method to analyze survival rate, using Kaplan-Meier method to analyze all the survival curves. RESULTS: Till March, 2010, 14 of 36 evaluable patients died and 22 survive; the median time to tumor progression (mTTP) to 8.62 months (95%CI: 6.51-10.24 months); the median survival time (mOS) of 12.41 months (95%CI: 9.57-14.80 months). The overall survival rate to observation period is 61.1%; 36 patients had been studied, 22 survive. Among the survivals, there is no CR cases, and 1 case PR, 15 patients SD, 6 patients PD; disease control rate (DCR) (CR + PR + SD) is 44.4%. The side effects of taking Sorafenib mainly are hand-foot skin reaction, diarrhea, fatigue and loss of appetite. These side effects can be markedly eased after symptomatic treatment. CONCLUSION: Combined with sorafenib treatment may give patients with advanced hepatocellular carcinoma a longer longevity and keep the disease in a steady state. This therapy can be added into the treatments to patients with advanced hepatocellular carcinoma. The side effects of taking Sorafenib (Nexavar) could be stand.

Oligomer procyanidins from grape seeds induce a paraptosis-like programmed cell death in human glioblastoma U-87 cells.

CONTEXT: We recently reported that F2, an oligomer procyanidin fraction isolated from grape seeds, triggered an original form of cell death in U-87 human glioblastoma cells with a phenotype resembling morphological characteristics of paraptosis. However, the specific death mode induced by F2 and the mechanism of its action have not been assessed so far. OBJECTIVE: In the present work, we therefore further investigated the death mode of human glioblastoma cells induced by F2 and gained insight into the nature of the signaling pathways activated by F2 in glioblastoma cells. MATERIALS AND METHODS: Cell viability assay using MTT, (AO/EB) double staining, Western blot analysis, and Ca2+ assay using fura-2. RESULTS: Morphology studies revealed extensive cytoplasmic vacuolization in dying cells and no apoptotic body formation, membrane bleb formation, or nuclear fragmentation, though some was accompanied by MAPK activation and new protein synthesis, and was independent of caspase activation. Moreover, we demonstrated the involvement of calcium mobilization in F2-induced U-87 cell signaling. DISCUSSION AND CONCLUSION: Altogether we showed that F2 induced a kind of cell death resembling paraptosis in U-87 cells. The current report complements previous studies on the characterization of F2-induced U-87 cell death, enhances our understanding of the action mechanism of F2 on glioma, and helps in the development of novel antitumor therapeutics.

Preparative enrichment and separation of astragalosides from Radix Astragali extracts using macroporous resins.

The enrichment and separation of astragalosides I-IV (AGs I-IV) were studied on eight macroporous resins in the present study. SA-3 resin offered the best adsorption and desorption capacities for AGs I-IV than other resins. The models of adsorption kinetics were investigated in order to elucidate the mechanism of adsorption. The pseudo-second-order model was the better choice than the pseudo-first-order model to describe the adsorption behavior of AGs I-IV onto SA-3 resin. The equilibrium experimental data were well fitted to Langmuir and Freundlich isotherms. SA-3 resin adsorption chromatography tests were carried out to optimize the separation process of AGs I-IV from Radix Astragali extracts. With the optimum parameters for adsorption and desorption, the contents of AGs I-IV were 8.78-, 11.60-, 10.52- and 11.28-fold increased with the recovery yields being 65.88, 90.92, 84.25 and 94.17%, respectively. The preparative enrichment and separation of AGs I-IV from Radix Astragali extracts can be easily and effectively achieved by SA-3 resin adsorption chromatography. The developed methodology can also be referenced for the separation of other active constituents from herbal materials and manufacture of Radix Astragali products.