[Association between hair trace element and all-cause death in elderly people in Hainan].

Objective: To explore the association between hair trace element and all-cause death in the elderly in Hainan Province. Methods: The subjects of the study were elderly people from China Hainan Centenarian Cohort Study, a total of 163 elderly were included. The association between hair trace element level and all-cause death was analyzed by using Cox proportional risk regression model. Results: After fully adjusting the covariates, the multiple Cox proportional hazards regression analyses showed that selenium (Se), manganese (Mn), strontium (Sr) concentrations in hair were significantly associated with all-cause mortality, the hazard ratio (HR) were 0.72 (95%CI: 0.54-0.98, P=0.035), 1.50 (95%CI: 1.07-2.11, P=0.020) and 0.54 (95%CI: 0.37-0.79, P=0.001), respectively. Subgroup and cross analysis showed that hair copper (Cu) were significant association with death in the people with anemia, the HR were 1.81 (95%CI: 1.13-2.88, P=0.013). And, hair Mn interacted with anemia, the HR was 0.46 (95%CI: 0.22-0.94, P=0.033). Conclusions: Se, Mn and Sr concentrations in hair were associated with the elevated risk for all-cause death in the elderly in Hainan. Se, Mn and Sr concentrations in hair can be used as a reference index for the prediction of the death risk of long-lived elderly in community, suggesting that the daily diet of elderly people are rich and diverse, in order to maintain normal and balanced trace element content in the body.

[HbA1c comparison and diagnostic efficacy analysis of multi center different glycosylated hemoglobin detection systems].

Objective: Compare and analyze the results of the domestic Lanyi AH600 glycated hemoglobin analyzer and other different detection systems to understand the comparability of the detection results of different detectors, and establish the best cut point of Lanyi AH600 determination of haemoglobin A1c (HbA1c) in the diagnosis of diabetes. Methods: Multi center cohort study was adopted. The clinical laboratory departments of 18 medical institutions independently collected test samples from their respective hospitals from March to April 2022, and independently completed comparative analysis of the evaluated instrument (Lanyi AH600) and the reference instrument HbA1c. The reference instruments include four different brands of glycosylated hemoglobin meters, including Arkray, Bio-Rad, DOSOH, and Huizhong. Scatter plot was used to calculate the correlation between the results of different detection systems, and the regression equation was calculated. The consistency analysis between the results of different detection systems was evaluated by Bland Altman method. Consistency judgment principles: (1) When the 95% limits of agreement (95% LoA) of the measurement difference was within 0.4% HbA1c and the measurement score was≥80 points, the comparison consistency was good; (2) When the measurement difference of 95% LoA exceeded 0.4% HbA1c, and the measurement score was≥80 points, the comparison consistency was relatively good; (3) The measurement score was less than 80 points, the comparison consistency was poor. The difference between the results of different detection systems was tested by paired sample T test or Wilcoxon paired sign rank sum test; The best cut-off point of diabetes was analyzed by receiver operating characteristic curve (ROC). Results: The correlation coefficient R2 of results between Lanyi AH600 and the reference instrument in 16 hospitals is≥0.99; The Bland Altman consistency analysis showed that the difference of 95% LoA in Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180) was -0.486%-0.325%, and the measurement score was 94.6 points (473/500); The difference of 95% LoA in the Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant II) was -0.727%-0.612%, and the measurement score was 89.8 points; The difference of 95% LoA in the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT) was -0.231%-0.461%, and the measurement score was 96.6 points; The difference of 95% LoA in the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT) was -0.469%-0.479%, and the measurement score was 91.9 points. The other 14 hospitals, Lanyi AH600, were compared with 4 reference instrument brands, the difference of 95% LoA was less than 0.4% HbA1c, and the scores were all greater than 95 points. The results of paired sample T test or Wilcoxon paired sign rank sum test showed that there was no statistically significant difference between Lanyi AH600 and the reference instrument Arkray HA8180 (Z=1.665,P=0.096), with no statistical difference. The mean difference between the measured values of the two instruments was 0.004%. The comparison data of Lanyi AH600 and the reference instrument of all other institutions had significant differences (all P<0.001), however, it was necessary to consider whether it was within the clinical acceptable range in combination with the results of the Bland-Altman consistency analysis. The ROC curve of HbA1c detected by Lanyi AH600 in 985 patients with diabetes and 3 423 patients with non-diabetes was analyzed, the area under curve (AUC) was 0.877, the standard error was 0.007, and the 95% confidence interval 95%CI was (0.864, 0.891), which was statistically significant (P<0.001). The maximum value of Youden index was 0.634, and the corresponding HbA1c cut point was 6.235%. The sensitivity and specificity of diabetes diagnosis were 76.2% and 87.2%, respectively. Conclusion: Among the hospitals and instruments currently included in this study, among these four hospitals included Nanjing Maternity and Child Health Care Hospital in Jiangsu Province (reference instrument: Arkray HA8180), Tibetan Traditional Medical Hospital of TAR (reference instrument: Bio-Rad Variant Ⅱ), the People's Hospital of Chongqing Liang Jiang New Area (reference instrument: Huizhong MQ-2000PT), and the Taihe Hospital of traditional Chinese Medicine in Anhui Province (reference instrument: Huizhong MQ-2000PT), the comparison between Lanyi AH600 and the reference instruments showed relatively good consistency, while the other 14 hospitals involved four different brands of reference instruments: Arkray, Bio-Rad, DOSOH, and Huizhong, Lanyi AH600 had good consistency with its comparison. The best cut point of the domestic Lanyi AH600 for detecting HbA1c in the diagnosis of diabetes is 6.235%.

Protective effects of lycopene on mitochondrial oxidative injury and dysfunction in the liver of aflatoxin B1-exposed broilers.

This study was conducted to investigate the effects of lycopene (LYC) on mitochondrial oxidative injury and dysfunction in the liver of aflatoxin B1 (AFB1)-exposed broilers. A total of 192 healthy 1-day-old male broilers were randomly divided into 3 groups with 8 replicates of 8 birds each. Birds in the 3 groups were fed basal diet (control), basal diet with 100 µg/kg AFB1, and basal diet with 100 µg/kg AFB1 and 200 mg/kg LYC, respectively. The experiment lasted 42 d. The results showed that AFB1 decreased average daily body weight gain (ADG), average daily feed intake, and gain to feed ratio (G :F) compared to the control group, the LYC supplementation increased ADG and G/F compared to AFB1 group (P < 0.05). Broilers in the AFB1 group had lower mitochondrial glutathione (mGSH) concentration and glutathione peroxidase (GSH-Px), manganese superoxide dismutase (MnSOD), and thioredoxin reductase activities, and higher hydrogen peroxide (H2O2) and reactive oxygen species (ROS) concentrations than the control group (P < 0.05). The LYC increased mGSH concentration and GSH-Px and MnSOD activities, and decreased H2O2 and ROS concentrations compared to AFB1 group (P < 0.05). Broilers fed the AFB1 diet showed increased mitochondrial swelling and decreased adenosine triphosphate concentration than the control group, and LYC had opposite effects (P < 0.05). The AFB1 decreased the activities of mitochondrial electron transfer chain (ETC) complexes I, II, III, and V, downregulated the mRNA expression levels of hepatic MnSOD, thioredoxin 2, thioredoxin reductase, peroxiredoxin-3, peroxisome proliferator-activated receptor γ coactivator 1α, nuclear respiratory factor 1, and mitochondrial transcription factor A compared with the control group (P < 0.05), and LYC increased activities of mitochondrial ETC complexes III and V, and upregulated mRNA expression levels of these genes in comparison to AFB1 group (P < 0.05). In conclusion, the LYC protected broilers from AFB1-induced liver mitochondrial oxidative injury and dysfunction by stimulating mitochondrial antioxidant capacity and maintaining mitochondrial biogenesis.

Inverse association between bone mineral density and fibrinogen in menopausal women.

OBJECTIVE: Inflammatory diseases are risk factors for osteoporosis. We aimed to explore whether fibrinogen, which is linked to chronic inflammation, is associated with bone mineral density (BMD) in menopausal women. METHODS: In this cross-sectional study, we analyzed 339 menopausal women from Zhejiang Province between January 2016 and October 2019. Linear regression analysis was performed to assess the relationship between fibrinogen and BMD. RESULTS: Significant inverse association was observed between the serum fibrinogen level and BMD in menopausal women. The mean BMD in each quartile of fibrinogen level was 0.901, 0.897, 0.892, and 0.855 g/cm2, respectively (p = 0.027). After adjusting for age, body mass index, metabolic profiles, blood inflammatory factors, and serum levels of estradiol, calcium, phosphorus, and alkaline phosphatase, fibrinogen levels remained significantly associated with BMD (regression coefficients for quartiles 1-3 vs. quartile 4 were 0.046, 0.027, and 0.036, respectively; p for trend <0.05). CONCLUSIONS: Higher fibrinogen levels were associated with lower BMD in menopausal women, which was independent of age, body mass index, estradiol, and other factors. Therefore, serum fibrinogen can be used as a new predictor of reduced BMD in menopausal women.

Effects of cottonseed meal on slaughter performance, meat quality, and meat chemical composition in Jiangnan White goslings.

Cottonseed meal (CSM), which is an unconventional protein material with abundant sources, high protein content, and a relatively cheap price, can be used in poultry diets. The aim of this study was to investigate the effects of CSM on slaughter performance, meat quality and meat chemical composition in Jiangnan White goslings. A total of 300 healthy 28-day-old male goslings were randomly divided into 5 treatments, with 6 pens containing 10 geese each. Five isonitrogenous and isocaloric experimental diets were formulated such that 0% (a corn-soybean meal basal diet, control), 25% (CSM25), 50% (CSM50), 75% (CSM75), and 100% (CSM100) protein from soybean meal was replaced with CSM (corresponding to 0, 6.73, 13.46, 20.18, and 26.91% CSM in the feed, respectively). On day 70, 1 goose from each pen (6 geese per treatment) was randomly selected and killed to measure the slaughter performance, meat quality, and the meat amino acid (AA) and fatty acid (FA) compositions. The results showed that dietary CSM did not affect the slaughter performance or meat quality of geese (P > 0.05). The fat content of breast muscle in the CSM100 group was higher than that in the control group (P < 0.05). A concentration of 13.46% or more dietary CSM increased the threonine content but decreased the cysteine content, and 20.18% dietary CSM also decreased the valine content (P < 0.05). Dietary CSM concentration had no effect on the content of total saturated FAs (SFAs, P > 0.05), but 20.18 and 26.91% dietary CSM increased the content of total monounsaturated FAs and decreased the content of total polyunsaturated FAs (PUFAs) and PUFA/SFA in the breast muscle of geese (P < 0.05). In conclusion, dietary CSM did not affect the slaughter performance or meat quality of geese, but the replacement of soybean meal with CSM in whole or high proportion altered the composition of AAs and FAs in breast muscle.

Nutrition therapy in esophageal cancer-Consensus statement of the Gastroenterological Society of Taiwan.

A number of clinical guidelines on nutrition therapy in cancer patients have been published by national and international societies; however, most of the reviewed data focused on gastrointestinal cancer or non-cancerous abdominal surgery. To collate the corresponding data for esophageal cancer (EC), a consensus panel was convened to aid specialists from different disciplines, who are involved in the clinical nutrition care of EC patients. The literature was searched using MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the ISI Web of Knowledge. We searched for the best evidence pertaining to nutrition therapy in the case of EC. The panel summarized the findings in 3 sections of this consensus statement, based on which, after the diagnosis of EC, an initial distinction is made between the patients, as follows: (1) Assessment; (2) Therapy in patients with resectable disease; patients receiving chemotherapy or chemoradiotherapy prior to resection, and patients with unresectable disease, requiring chemoradiotherapy or palliative therapy; and (3) Formula. The resulting consensus statement reflects the opinions of a multidisciplinary group of experts, and a review of the current literature, and outlines the essential aspects of nutrition therapy in the case of EC. The statements are: Patients with EC are among one of the highest risk to have malnutrition. Patient generated suggestive global assessment is correlated with performance status and prognosis. Nutrition assessment for patients with EC at the diagnosis, prior to definitive therapy and change of treatment strategy are suggested and the timing interval can be two weeks during the treatment period, and one month while the patient is stable. Patients identified as high risk of malnutrition should be considered for preoperative nutritional support (tube feeding) for at least 7-10 days. Various routes for tube feedings are available after esophagectomy with similar nutrition support benefits. Limited intrathoracic anastomotic leakage postesophagectomy can be managed with intravenous antibiotics and self-expanding metal stent (SEMS) or jejunal tube. Enteral nutrition in patients receiving preoperative chemotherapy or chemoradiation provides benefits of maintaining weight, decreasing toxicity, and preventing treatment interruption. Tube feeding or SEMS can offer nutrition support in patients with unresectable esophageal cancer, but SEMS is not recommended for those with neoadjuvant chemoradiation before surgery. Enteral immunonutrition may preserve lean body mass and attenuates stress response after esophagectomy. Administration of glutamine may decrease the severity of chemotherapy induced mucositis. Enteral immunonutrition achieves greater nutrition status or maintains immune functions during concurrent chemoradiation.

Effect of Xianling Gubao capsules on bone mineral density in osteoporosis patients.

This paper aimed to analyze the clinical effects of Xianling Gubao capsules on the bone mineral density (BMD) of 94 patients with osteoporosis. After reviewing and analyzing the clinical information in our hospital from January 2015 to January 2016, the patients were divided into a control group and a treatment group with 47 cases in each group. Patients in the control group were treated with routine Western medicine, while the treatment group received Xianling Gubao capsules. Both groups were treated continuously for 3 courses (30 days each course) and had their BMD analyzed and compared. The effective rates of the treatment group and control group were 91.48% and 70.21%, respectively, with statistical significance (P less than 0.05). Compared with the same group before the treatment, the bone metabolic indexes (blood calcium, phosphorus, and alkaline phosphate) and the BMD of the femoral neck and lumbar vertebrae (L1-2, L3-4, L2-4) of both groups were all improved with statistical significance (P less than 0.05) after the treatment. The above indexes of the treatment group were all significantly higher than those of the control group, with statistical significance (P less than 0.05). Compared with the same group before treatment (P less than 0.05), the osteocalcin (OC) levels of both groups were increased, and the Cross-linked N-telopeptide of type 1 collagen (CTX-1) levels were decreased after the treatment. The OC level in the treatment group was higher when compared with the control group, while the CTX-1 level was lower compared to the control group (P less than 0.05). Moreover, no significant side-effects or adverse events were observed during the treatment and observation period. The Xianling Gubao Capsule possesses a therapeutic effect for BMD in osteoporosis patients, which can effectively increase their BMD, improve their bone metabolism, and control the loss of bone mass, therefore, can be used in clinical promotion and application.

Effects of beverages with variable nutrients on rehydration and cognitive function.

The purpose of the present study was to investigate the effect of carbohydrate-electrolyte solution (CE), lemon tea (LT), and distilled water (DW) on rehydration and cognitive performance after 60 min of moderate exercise. 9 healthy males and 10 eumenorrheic females completed 3 runs in a randomized crossover study design. During the 4-h recovery (REC) period, they consumed either a volume of CE, LT or DW equal to 150% of their body mass (BM) loss during the previous run. The 3 beverages vary in carbohydrate and electrolyte content. A battery of cognitive tests was performed upon arrival, immediately after exercise, and at the end of REC. After the REC, the restoration of BM loss was lower in the DW and LT trials than that in the CE trial in the female participants (CE vs. LT vs. DW: 59.3±2.8 vs. 41.7±5.7 vs. 45.6±2.2%). When compared with the DW, the accuracy of performances during a working memory task in both males and females was higher in the CE and LT trials. The results suggested that during a short-term recovery, both LT and CE show certain beneficial effect in maintaining cognitive performance. However, CE appears to be more effective than LT and DW in rehydrating female participants.

Nigari (deep seawater concentrate) enhances the treadmill exercise performance of gerbils.

The beneficial effect of magnesium supplementation on exercise performance has been reported by many researchers. In the present study, the effect of nigari, a concentrate of deep seawater containing high magnesium levels, on exercise performance, was examined. Gerbils were given double-distilled water or nigari (18 mg · kg(-1), po) orally 30 min before exercise. All animals were subjected to forced exercise on a treadmill for 90 min at three successive speeds of 10, 15, and 20 m · min(-1). The retention numbers were recorded. The retention numbers were 85.0 ± 21.0, 46.0 ± 9.7, and 48.0 ± 14.2 in the control group, and 44.0 ± 10.9, 23.0 ± 8.4, and 13.0 ± 4.8 in the nigari-treated group at the three speeds, respectively. The retention numbers were significantly reduced at higher speeds (by 50% at 15 and 73% at 20 m · min(-1), respectively) in the nigari-treated group when compared to those of the control group, respectively. Thus, nigari administration appeared to reduce retention numbers and enhance exercise performance in gerbils.

Effects of delta-aminolevulinic acid and vitamin C supplementation on feed intake, backfat, and iron status in sows.

This study was conducted to evaluate the effect of dietary administered delta-aminolevulinic acid (ALA) and vitamin C on the hematological profiles and performance of sows and sucking pigs and to determine if iron status could be improved by dietary administration of ALA. Seven days before parturition, 120 sows (Landrace x Yorkshire) were randomly assigned within parities to 1 of 4 dietary treatments. The lactation treatments were arranged as a 2 x 2 factorial with 2 ALA concentrations (0 or 10 mg/kg of feed, as fed) and 2 vitamin C concentrations (0 or 500 mg/kg of feed, as fed). After farrowing, daily feed allowance increased gradually, and sows had ad libitum access to feed by wk 2. Sows provided diets with ALA tended to consume more feed (P < 0.10) than sows fed diets that did not contain ALA. Conversely, backfat losses were less in sows that received the diets with ALA compared with those received the nonsupplemented diets (P < 0.05). Supplementation with ALA and vitamin C resulted in improved hematological profiles (total protein, albumin, and IgG) in sows (P < 0.05). The iron status in the blood and milk were also improved by ALA supplementation (P < 0.05). Moreover, the BW at weaning and the ADG during the sucking period increased in response to supplementation of ALA and vitamin C (P < 0.05). The blood iron status of piglets was also improved by ALA supplementation (P < 0.05). In conclusion, dietary supplementation of ALA can increase the blood iron status of sows and sucking pigs, as well as the iron transfer efficiency from sows to piglets through elevated milk iron concentrations.

Effects of chitooligosaccharide supplementation on performance, blood characteristics, relative organ weight, and meat quality in broiler chickens.

This study was conducted to evaluate the effects of dietary supplementation with chitooligosaccharide (COS) on growth performance, blood characteristics, relative organ weight, and meat quality in broilers. A total of 480 broilers with an average initial BW of 45.04 g per chick were randomly allocated into 1 of the following 4 dietary treatments (20 broilers per pen with 6 pens per treatment): 1) CON (basal diet), 2) ANT (basal diet + 44 mg/kg of avilamycin), 3) COS0.2 (basal diet + 14 g/kg of COS), 4) COS0.4 (basal diet + 28 g/kg of COS). The experiment lasted for 5 wk and avilamycin was administered from d 0 to 21. Growth performance was measured on d 0, 21, and 35, and all other response criteria were measured on d 35. No change in feed conversion (G:F) was observed in response to any of the treatments throughout the experimental period (P > 0.05). However, BW gain and feed intake were greater (P < 0.05) in broilers provided with feed supplemented with COS than in those in the control group. In addition, broilers had significantly greater (P < 0.05) red blood cell and high-density lipoprotein cholesterol concentrations when they were provided with the COS0.4 diet, whereas the triglyceride concentration was lower (P < 0.05) in broilers in the COS0.2 treatment group. No other blood characteristics were affected by the treatments. Additionally, as the dietary COS concentration increased, the liver weight increased (P < 0.05). Conversely, as the concentrations of dietary COS increased, abdominal fat decreased (P < 0.05). Furthermore, meat yellowness decreased (P < 0.05) as the concentration of COS increased. Finally, the breast meat and abdominal fat of birds provided with feed supplemented with COS had a lower (P < 0.05) saturated fatty acid concentration but a greater concentration of total monounsaturated fatty acids (P < 0.05) than that of birds in the control. In conclusion, COS can improve the performance and breast meat quality of broilers while increasing the red blood cell and high-density lipoprotein cholesterol concentrations in blood. In addition, COS can induce a decrease in abdominal fat and improve meat quality.

hTERT phosphorylation by PKC is essential for telomerase holoprotein integrity and enzyme activity in head neck cancer cells.

Telomerase activity is suppressed in normal somatic tissues but is activated in most cancer cells. We have previously found that all six telomerase subunit proteins, including hTERT and hsp90 are needed for full enzyme activity. Telomerase activity has been reported to be upregulated by protein kinase C (PKC), but the mechanism is not clear. In this study, we examined how PKC regulates telomerase activity in head and neck cancer cells. PKC inhibitor, bisindolylmaleimide I (BIS), inhibited telomerase activity but had no effect on the expressions of telomerase core subunits. RNA interference (RNAi) and in vitro phosphorylation studies revealed that PKC isoforms alpha, beta, delta, epsilon, zeta specifically involved in telomerase regulation, and the phosphorylation target was on hTERT. Treatment with the hsp-90 inhibitor novobiocin dissociated hsp90 and hTERT as revealed by immunoprecipitation and immunoblot analysis and reduced telomerase activity. Treatment with the PKC activator SC-10 restored the association of hsp90 and hTERT and reactivate telomerase, suggesting that hTERT phosphorylation by PKC is essential for telomerase holoenzyme integrity and function. Analysis on clinical normal and tumour tissues reveal that the expressions of PKC alpha, beta, delta, epsilon, zeta were higher in the tumour tissues, correlated with telomerase activity. Disruption of PKC phosphorylation by BIS significantly increased chemosensitivity to cisplatin. In conclusion, PKC isoenzymes alpha, beta, delta, epsilon, zeta regulate telomerase activity in head and neck cancer cells by phosphorylating hTERT. This phosphorylation is essential for telomerase holoenzyme assembly, leading to telomerase activation and oncogenesis. Manipulation of telomerase activity by PKC inhibitors is worth exploring as an adjuvant therapeutic approach.

Effects of sediment phosphorus release associated with the density current on water quality of a subtropical and deep reservoir in Taiwan.

It was found that the increase of sediment P release in the anoxic state associated with the density current initiated by the cold front in the winter was the cause of the deterioration of the water quality of the subtropical, noncalcareous and deep reservoir, Feitsui Reservoir, in recent years. A mathematical model including the analytical solutions of the transport of the density current combined with a simple 2-layered water quality model has been established, describing the hydrodynamics and the water quality variation of the reservoir well. The continued sediment release of P in the anoxic state (from October to March) is an important P source and should be carefully assessed and controlled to reduce the impact of the internal loading of P incorporated with the density current on the water quality in future years.

Inhibitory effect of stevioside on calcium influx to produce antihypertension.

Stevioside is a sweet-tasting glycoside occurring abundantly in the leaves of Stevia rebaudiana (Compositae). It has been used popularly in Japan and Brazil as a sugar substitute for decades. Previous study has shown that it lowered blood pressure in spontaneously hypertensive rats (SHRs) when administered intravenously. This study shows that intraperitoneal injection of stevioside 25 mg/kg also has antihypertensive effect in SHRs. In isolated aortic rings from normal rats, stevioside could dose-dependently relax the vasopressin-induced vasoconstriction in both the presence and absence of endothelium. However, stevioside had no effect on phenylephrine- and KCl-induced phasic vasoconstriction. In addition, stevioside lost its influence on vasopressin-induced vasoconstriction in Ca(2+)-free medium. The results indicate that stevioside caused vasorelaxation via an inhibition of Ca(2+) influx into the blood vessel. This phenomenon was further confirmed in cultured aortic smooth muscle cells (A7r5). Using 10(-5) M methylene blue for 15 min, stevioside could still relax 10(-8) M vasopressin-induced vasoconstriction in isolated rat aortic rings, showing that this vasorelaxation effect was not related to nitric oxide. The present data show that the vasorelexation effect of stevioside was mediated mainly through Ca(2+) influx inhibition.

Interstitial low-dose-rate brachytherapy as a salvage treatment for recurrent head-and-neck cancers: long-term results.

PURPOSE: Recurrent cancers of the head and neck within previously irradiated volume pose a serious therapeutic challenge. This study evaluates the response and long-term tumor control of recurrent head-and-neck cancers treated with interstitial low-dose-rate brachytherapy. METHODS AND MATERIALS: Between 1979 and 1997, 220 patients with prior radiation therapy with or without surgery for primary tumors of the head and neck were treated for recurrent disease or new primary tumors located within previously irradiated volumes. A majority of these patients had inoperable diseases with no distant metastasis. There were 136 male and 84 female patients, and median age was 56 years. All patients had previously received radiation therapy as the primary treatment or adjuvant treatment following surgery, with a median dose of 57.17 cGy (range, 39-74 cGy). The salvage brachytherapy consisted of a low-dose-rate, afterloading Iridium(192) implant, which delivered a median minimum tumor dose of 53 Gy to a mean tumor volume of 68.75 cm(2). Sixty percent of the patients also received interstitial hyperthermia, and 40% received concurrent chemotherapy as a radiosensitizing and potentiating agent. RESULTS: At a minimum 6-month follow-up, local tumor control was achieved in 77% (217/282) of the implanted tumor sites. The 2, 5, and 10-year disease-free actuarial survival rates for the entire group were 60%, 33%, and 22%, respectively. The overall survival rate for the entire group at 5 years was 21.7%. Moderate to severe late complications occurred in 27% of the patients. CONCLUSION: It has been estimated that approximately 20-30% of head-and-neck cancer patients undergoing definitive radiation therapy have recurrence within the initial treatment volume. Furthermore, similar percentages of patients who survive after successful irradiation develop new primary tumors of the head and neck or experience metastatic neck disease. A majority of such patients cannot be treated with a repeat course of external beam irradiation because of limited normal tissue tolerance, leading to unacceptable morbidity. However, in a select group of these patients, salvage interstitial brachytherapy may play an important role in providing patients with durable palliation and tumor control, as well as a chance for cure.

A pair of 24-hydroperoxyl epimeric dammarane saponins from flower-buds of Panax ginseng.

Further investigation on the saponins of the flower-buds of Panax ginseng C. A. Meyer has resulted in the isolation and structural elucidation of a pair of new 24-epimers of dammarane type saponins named ginsenoside I and II. The structures of the epimers were characterized on the basis of chemical and spectral evidence as 3-O-[beta-D-glucopyranosyl-(1-->2)-beta-D-glucopyranosyl]-20-S-O-beta-D-glucopyranosyl-3beta, 12beta,20(S)-trihydroxy-24xi-hydroperoxydammar-25-ene, except for their C-24 configurations. Ginsenoside I is a new triterpene glycoside, and ginsenoside II is a known compound first isolated from a natural plant.

Effects of ginsenosides from Panax ginseng on cell-to-cell communication function mediated by gap junctions.

Gap junctions have been shown or are believed to be involved in the pathogenesis of many inherited and acquired human diseases. Agents that regulate the gap junction-mediated intercellular communication (GJIC) function may facilitate prevention and treatment of GJIC-involved diseases. In the present study we examined the effects of 27 ginsenosides isolated from Panax ginseng on GJIC. The results show that compounds 1 (oleanolic acid), 2 (ginsenoside-R0), 3 (ginsenoside-Rb1), 5 (ginsenoside-Rb2), 7 (ginsenoside-Rd), 8 (ginsenoside-Rg3), 12 (panaxadial), 13 (notoginsenoside-R4), 17 [ginsenoside-Rg2 (20S)], 18 (ginsenoside-Rf), and 26 (ginsenoside-F3) did not obviously affect GJIC, whereas compounds 4 (ginsenoside-Rc), 6 (ginsenoside-Rb3), 9 (ginsenoside-Rd2), 10 (notoginsenoside-Fe), 11 (ginsenoside-Rh2),14 (ginsenoside-Ra1), 15 (ginsenoside-Re), 16 [ginsenoside-Rg2 (20R)], 19 (ginsenoside-Ia), 20 [ginsenoside-Rh1 (20S)], 21 [ginsenoside-Rh1 (20R)], 22 (ginsenoside-F1), 23 (protopanaxatriol), 24 (panaxatriol), 25 (ginsenoside-Rg1), and 27 (chikusetsaponin-L8) induced GJIC reductions at various degrees. Compounds 2, 7, and 8 protected against the tyrosine phosphatase inhibitor vanadate-induced GJIC reduction, while compounds 1, 5, 7, and 17 inhibited the cytokine interleukin 1 alpha (IL-1alpha)-induced reduction in GJIC. Nevertheless, no compounds protected against the protein kinase C (PKC) activator 12-O-tetradecanoylphorbol-13-acetate (TPA)-induced GJIC inhibition. On the other hand, GJIC reductions induced by compounds 6, 9,10, 20, 21, 22, 24, and 25 were inhibited by the tyrosine kinase (TK) inhibitor genistein, while GJIC reductions induced by compounds 6, 9, 14, 16, 19, 21, and 24 were attenuated in the presence of the PKC inhibitor calphostin C. However, GJIC reductions induced by compounds 4, 23, and 27 were not inhibited either by genistein or by calphostin C. These data indicate that various mechanisms are responsible for effects of ginsenosides on GJIC.

Three xanthones and a benzophenone from Garcinia mangostana.

Investigation of the constituents of Garcinia mangostana has led to the isolation of four new compounds: three minor xanthones, garcimangosone A (1), garcimangosone B (2), and garcimangosone C (3), and a benzophenone glucoside, garcimangosone D (4). The structures of these four compounds were established by spectral (NMR and MS) and chemical methods.

Taxane diterpenoids from the stem bark of Taxus mairei.

Three new 11(15-->1)-abeo-taxanes, taxumairols U-W (1-3), have been isolated from extracts of the stem bark of Formosan Taxus mairei. The structures of 1-3 were identified as 5alpha,7beta,9alpha,13alpha,20-pentaacetoxy-2alpha,10beta,15-trihydroxy-11(15-->1)-abeo-taxene, 5alpha,7beta,9alpha,20-tetraacetoxy-2alpha,10beta,13alpha,15-tetrahydroxy-11(15-->1)-abeo-taxene, and 2alpha,4alpha,7beta,10beta-tetraacetoxy-5beta,20-epoxy-9alpha,13alpha,15-trihydroxy-11(15-->1)-abeo-taxene, respectively, on the basis of 2D NMR techniques including COSY, HSQC, HMBC, and NOESY experiments as well as chemical reactions of compounds 1-3 to give 4 (5alpha,7beta,9alpha,10beta,13alpha,20-hexaacetoxy-2alpha,15-dihydroxy-11(15-->1)-abeo-taxene) and 5 (4alpha,7beta,10beta-triacetoxy-9alpha,13alpha-dibenzoxy-5beta,20-epoxy-2alpha,15-dihydroxy-11(15-->1)-abeo-taxene), which are also novel taxane derivatives. Taxumairols U (1) and V (2) exhibited significant cytotoxicities against human hepatoma tumor cells, while taxumairol W (3) was inactive.

Six new dammarane-type triterpene saponins from the leaves of Panax ginseng.

Six new minor saponins, together with known ginsenosides, were isolated from the leaves of Panax ginseng. The new saponins were named as ginsenoside-Rh5, -Rh6, -Rh7 -Rh8, -Rh9 and -Rg7, and their structures were elucidated on the basis of chemical and physicochemical evidence to be as follows: ginsenoside-Rh5: 3beta,6alpha,12beta,24zeta-tetrahydroxy-dammar-20(22),25-diene 6-O-beta-D-glucopyranoside (1), -Rh6: 3beta,6alpha12beta,20(S)-tetrahydroxy-25-hydroperoxy-dammar-23-ene 20-O-beta-D-glucopyranoside (2), -Rh7: 3beta,7beta,12beta,20(S)-tetrahydroxy-dammar-5,24-diene 20-O-beta-D-glucopyranoside (3), -Rh8: 3beta,6alpha,20(S)-trihydroxy-dammar-24-ene-12-one 20-O-beta-D-glucopyranoside (4), -Rh9: 3beta,6alpha,20(S)-trihydroxy-12beta,23-epoxy-dammar-24-ene 20-O-beta-D-glucopyranoside (5) and -Rg7: 3-O-beta-D-glucopyranosyl 3beta,12beta,20(S),24(R)-tetrahydroxy-dammar-25-ene 20-O-beta-D-glucopyranoside (6).