Low geriatric nutritional risk index as a poor prognostic biomarker for immune checkpoint inhibitor treatment in solid cancer.

Objective: In this investigation, we focused on the geriatric nutritional risk index (GNRI), a comprehensive metric that takes into account the patient's ideal weight, actual weight, and serum albumin levels to measure malnutrition. Our primary objective was to examine the predictive value of GNRI-defined malnutrition in determining the response to immunotherapy among cancer patients. Methods: Relevant articles for this study were systematically searched in PubMed, the Cochrane Library, EMBASE, and Google Scholar up to July 2023. Our analysis evaluated overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR) as clinical outcomes. Results: This analysis comprised a total of eleven articles encompassing 1,417 patients. The pooled results revealed that cancer patients with low GNRI levels exhibited shorter OS (HR: 2.64, 95% CI: 2.08-3.36, p < 0.001) and PFS (HR: 1.87, 95% CI: 1.46-2.41, p < 0.001), and lower ORR (OR: 0.46, 95% CI: 0.33-0.65, p < 0.001) and DCR (OR: 0.42, 95% CI: 0.29-0.61, p < 0.001). Sensitivity analyses confirmed that the above results were stable. Egger's and Begg's tests revealed that there was no publication bias in the above results. Conclusion: Our results imply that the GNRI is a useful predictor of immunotherapy response in cancer patients.

The role of folate receptor-positive circulating tumor cell analysis in the diagnosis of colorectal cancer: a retrospective cohort study.

OBJECTIVE: To explore the application value of folate receptor-positive circulating tumor cell analysis (FR+-CTC analysis) in the diagnosis of colorectal cancer (CRC). METHODS: Clinical data of CRC patients and healthy subjects admitted to our hospital from January 2019 to October 2019 were retrospectively collected. CTC result and serological and pathological outcomes of the study patients were collected and analyzed. Receiver operating characteristic curve (ROC curve) was drawn. RESULTS: The CTC levels of cancer patients (9.34 ± 3.53 FU/3 ml) were significantly higher than those of healthy subjects (7.00 ± 2.33 FU/3 ml). CTC levels could be related to cancer stage and metastasis in patients. ROC curves were drawn and the area under the ROC curve (AUC) was 0.702. The cutoff value was determined to be 8.87 FU/3 ml. At this cutoff value, the sensitivity and specificity of FR+-CTC analysis in the diagnosis of colorectal cancer were 61.8% and 82.6%, respectively. The diagnostic efficiency of FR+-CTCs in advanced CRC was significantly higher than that in the early stage. And the cutoff value of early and advanced stage CRC was determined to be 9.66 FU/3 ml. CONCLUSION: FR+-CTC analysis has high potential in recurrence diagnosis and decision of adjuvant chemotherapy for CRC.

Vitamin D3 Supplement Attenuates Blood-Brain Barrier Disruption and Cognitive Impairments in a Rat Model of Traumatic Brain Injury.

This study was designed to study the effects of vitamin D3 supplementation on the cognitive dysfunction and neurological function of traumatic brain injury (TBI) and the possible underlying mechanisms. To this purpose, different doses of vitamin D3 were intraperitoneally injection to TBI rats for one week before TBI surgery and three consecutive weeks after TBI. Brain edema evaluation was conducted on the third day and Evans blue staining for blood-brain barrier (BBB) permeability on the seventh day after TBI. Rat behavior was assessed by evaluation of neurological scores and morris water maze. It was revealed that vitamin D levels increased in serum after the administration of vitamin D3 for one week. TBI led to neurological deficit, together with brain edema, BBB disruption and inflammation. Vitamin D3 supplement ameliorated neurological deficit and cognitive impairments induced by TBI. Vitamin D3 administration reduced brain edema and impairments of blood-brain barrier induced by TBI, as well as decreased inflammatory response in TBI rat brain. Our results showed that vitamin D3 administration alleviated neurobehavioral deficits and improved brain edema after TBI. Vitamin D3 inhibited inflammatory cytokines and decreased BBB disruption in TBI rats. Vitamin D3 may be used for the treatment of TBI as a protective intervention.

Improvements in blood transfusion management: cross-sectional data analysis from nine hospitals in Zhejiang, China.

BACKGROUND: Since 2008, updated perioperative blood management (PoBM) guidelines have been implemented in Zhejiang, China. These guidelines ensure that the limited blood resources meet increasing clinical needs and patient safety requirements. We assessed the effects of implementing updated PoBM guidelines in hospitals in Zhejiang, China. METHODS: We performed a retrospective multicenter study that included adult patients who received blood transfusions during surgical care in the years 2007 and 2011. The volume of allogeneic red blood cells or autologous blood transfusions (cell salvage and acute normovolemic hemodilution [ANH]) for each case was recorded. The rates of performing appropriate pre-transfusion assessments during and after surgery were calculated and compared between the 2 years. RESULTS: We reviewed 270,421 cases from nine hospitals. A total of 15,739 patients received blood transfusions during the perioperative period. The rates of intraoperative allogeneic transfusion (74.8% vs. 49.9%, p <  0.001) and postoperative transfusion (51.9% vs. 44.2%, p <  0.001) both decreased from 2007 to 2011; the rates of appropriate assessment increased significantly during (63.0% vs. 78.0%, p <  0.001) and after surgery (70.6% vs. 78.4%, p <  0.001). The number of patients who received cell salvage or ANH was higher in 2011 (27.6% cell salvage; 9.3% ANH) than in 2007 (6.3% cell salvage; 0.1% ANH). CONCLUSION: Continuing education and implementation of updated PoBM guidelines resulted in significant improvements in the quality of blood transfusion management in hospitals in Zhejiang, China.

ANTICANCER ACTIVITY OF 5, 7-DIMETHOXYFLAVONE AGAINST LIVER CANCER CELL LINE HEPG2 INVOLVES APOPTOSIS, ROS GENERATION AND CELL CYCLE ARREST.

BACKGROUND: Flavonoids are considered potential anticancer agents owing to their properties to interact with a diversity of cellular entities. Among flavonoids, methylated flavones are more efficient anticancer agents due to their higher stability in vivo. The purpose of the present study was, therefore, to evaluate the anticancer effect of methylated natural flavonoid 5, 7-dimethoxyflavone (5, 7-DMF). MATERIALS AND METHODS: MTT assay was used to determine the anticancer activity and IC50 of 5, -DMF). Cell viability, cell cycle distribution, reactive oxygen species (ROS) and mitochondrial membrane potential (ΔΨm) were carried out by flow cytometry. Apoptosis was studied by DAPI staining. RESULTS: MTT assay revealed that the molecule reduced the cell viability of HepG2 cancer cells. The IC50 of 5, 7-DMF was found to be 25 µM. Our result indicated that 5, 7-DMF triggered production of ROS and significantly reduced ΔΨm . It also leads to arrest of HepG2 cells in Sub-G1 stage of cell cycle, and ultimately induced apoptosis in a concentration-dependent manner, as indicated by DAPI staging. Additionally, 5, 7-DMF also reduced the colony forming potential of the HepG2 cells concentration dependently. CONCLUSION: Taken together, we conclude that 5, 7-DMF induces cell death via ROS generation, cell cycle arrest and apoptosis, and, therefore, may prove beneficial in the treatment of liver cancer.

Role of Daphnetin in Rat Severe Acute Pancreatitis Through the Regulation of TLR4/NF-[Formula: see text]B Signaling Pathway Activation.

Severe acute pancreatitis (SAP) often results in multiple-organ dysfunction syndrome with high mortality. There is no effective clinical therapy for SAP, yet daphnetin, a coumarin extracted from Dracaena marginata, has analgesic and anti-inflammatory effects, and has been used clinically in several diseases. The objective of this study was to investigate the role and underlying mechanisms of daphnetin in a rat SAP model. Male Wistar rats were pretreated with daphnetin via intraperitoneal injection, 30[Formula: see text]min before retrograde infusion of 5% sodium taurocholate into the biliopancreatic duct. Twelve hours after sodium taurocholate administration, rats were sacrificed and tissues and blood were harvested. Then, histological, chemical, and molecular analyses were performed. Daphnetin treatment reduced the levels of serum alanine transaminase and creatinine (CR), increased superoxide dismutase(SOD) activity, and decreased neutrophil infiltration and cell apoptosis of the pancreatic tissues in rat SAP. Daphnetin treatment significantly decreased expression of pro-inflammatory cytokines and increased expression of anti-inflammatory cytokines in rat SAP. Molecular analyses revealed that daphnetin reduced TLR4 expression and inhibited NF-[Formula: see text]B signaling pathway activation. These findings demonstrate that daphnetin attenuates acute pancreatic injury by regulating the TLR4/NF-[Formula: see text]B signaling pathway and inflammation in rat SAP model. Daphnetin may be a potential therapeutic agent for SAP.

Effect of local mild hypothermia on regional cerebral blood flow in patients with acute intracerebral hemorrhage assessed by 99mTc-ECD SPECT imaging.

OBJECTIVE: This study aimed to observe the effect of local mild hypothermia on regional cerebral blood flow (rCBF) after acute intracerebral hemorrhage (ICH) and to evaluate its relation to clinical outcome in patients with ICH. METHODS: 36 CT proven ICH patients with Glasgow coma scale (GCS) score of 5 or more were randomly assigned to 2 group: local mild hypothermia with conventional mannitol (Group A) or conventional mannitol (Group B). SPECT study was performed at day 7 after therapy. The SPECT images were semi-quantitatively analyzed, and the radioactivity ratios of lesion to normal tissue (L/NT) were calculated. National Institutes of Health Stroke Scale (NIHSS) were used in evaluation at days 14 and 21 after therapy. RESULTS: There were significant differences in NIHSS score at days 14 and 21, and the L/NT ratios between the groups A and B (P < 0.05). Based on GCS, more patients in the group A showed favorable outcomes than patients in the group B (P < 0.05). Furthermore, the L/NT ratios significantly increased in patients with favorable outcomes compared to poor outcomes. Changes in NIHSS score at days 14 and 21 were closely negatively correlated with the L/NT ratios in the groups A and B (r= -0.58, -0.61, and -0.52, -0.75, respectively, P < 0.05). CONCLUSION: Local mild hypothermia could significantly increase rCBF and improve clinical outcome in ICH patients as evaluated by ^{99m}Tc-ECD SPECT study.

Methane storage in tea clathrates.

Methane can be stored in tea clathrates, that is kinetics of methane clathrate formation can be significantly accelerated (90% saturation uptake in 20 min) by ingredients (polyphenols and saponins) in tea infusions with a volumetric capacity of up to 172 v/v.

[Effects of Jinlong Capsule on expressions of interleukin-2 and soluble interleukin-2 receptor in patients with primary liver cancer after transarterial chemoembolization therapy].

OBJECTIVE: To observe and discuss the dynamic changes of interleukin-2 (IL-2) and soluble interleukin-2 receptor (sIL-2R) and their significance in the patients with primary liver cancer after transarterial chemoembolization (TACE) therapy combined with Jinglong Capsule. METHODS: A total of 48 patients with primary liver cancer, who failed to be treated by major surgery, were randomly divided into two groups: Jinlong Capsule group (TACE therapy plus Jinlong Capsule) and control group (TACE therapy alone). There were 24 cases in each group. The levels of peripheral blood IL-2 and slL-2R were measured before the first TACE and 1, 7 and 15 days after the second TACE respectively by using double-antibody sandwich enzyme-linked immunosorbent assay. The data from Jinlong Capsule group were compared with those from the control group. RESULTS: The level of sIL-2R in Jinlong Capsule group was significantly lower than that in the control group (P<0.05), while the level of IL-2 was significantly higher than that in the control group (P<0.05). CONCLUSION: Jinlong Capsule can significantly improve the lymphocyte function of the patients with primary liver cancer after TACE. The levels of IL-2 and sIL-2R can be considered as the valuable parameters for evaluating the effects on primary liver cancer, and Jinlong Capsule is helpful for the patients with primary liver cancer.

Antidepressant-like effect of liquiritin from Glycyrrhiza uralensis in chronic variable stress induced depression model rats.

Many flavonoids extracted from nature plants have been reported to exert antidepressant-like effect in animal studies. The present study was designed to observe the effects of liquiritin, a flavone compound derived from Glycyrrhiza uralensis, on the behaviors of chronic variable stress induced depression model rats and to explore the possible association between its antidepressant-like effect and antioxidative activity by measuring erythrocyte superoxide dismutase (SOD) activity and plasma malondialdehyde (MDA) level of the experimental animals. With the exposure to stressor once daily for consecutive 5 weeks, liquiritin and a positive control drug fluoxetine were administered via gastric intubation to rats once daily for consecutive 3 weeks from the 3rd week. The results showed that CVS reduced open-field activity and sucrose consumption significantly, but increased immobility time in forced swimming test. Treatment of liquiritin could effectively reverse alteration in immobility time and sucrose consumption but did not show significant effect on open-field activity. Moreover, liquiritin could increase SOD activity, inhibit lipid peroxidation, and lessen production of MDA, while fluoxetine did not. In conclusion, the present study demonstrated a potential antidepressant-like effect of liquiritin treatment on chronic variable stress induced depression model rats, which might be related to defense of liquiritin against oxidative stress.

[Fingerprint analysis of Radix Glycyrrhizae by fast HPLC].

The objective of this paper is to develop a fast analysis method to determine fingerprints of Radix Glycyrrhizae from different areas of China for identification and quality control. The experiments were carried out under following conditions: Agilent Eclipse Plus C18 (4.6 mm x 50 mm, 1.8 microm) column, acetonitrile and 0. 05% phosphoric acid solution as the mobile phases with gradient elution, flow rate 1.0 mL x min(-1), analysis time 11 min. The run time of the method was obviously decreased from 36 minutes to 11 minutes compared with routine HPLC method. The cluster analyses of the fingerprints of the 70 samples were performed by SPSS. The results showed that all samples were classified into 2 groups, 59 Glycyrrhiza uralensis as well as 11 G. inflata. Three compounds, liquiritin apioside, liquiritin and glycyrrhiza acid should be considered as effective references for quality control of Radix Glycyrrhizae. This method can be used widely for identification and quality control of Radix Glycyrrhizae.

Structural determination of seven new triterpenoids from Kadsura heteroclita by NMR techniques.

Seven new triterpenoids, namely heteroclitalactones G-M (1-7), were isolated from the ethanol extract of the stems of Kadsura heteroclita. Structures of these compounds were characterized by extensive 1D and 2D NMR spectroscopic analyses.

Simultaneous determination of seven major diterpenoids in Pseudolarix kaempferi by high-performance liquid chromatography DAD method.

A reversed phase high-performance liquid chromatography method was established for the first time to simultaneously qualify the seven major diterpenoids in Pseudolarix kaempferi, namely pseudolaric acid B O-beta-D-glucopyranoside (1), pseudolaric acid C2 (2), pseudolaric acid C1 (3), deacetylpseudolaric acid A (4), pseudolaric acid A O-beta-D-glucopyranoside (5), pseudolaric acid B (6) and pseudolaric acid A (7). The optimal conditions of separation and detection were achieved on an Inertsil ODS-3 column with gradient elution of methanol and 0.5% aqueous acetic acid (v/v) at the flow rate of 0.6 ml min(-1) within 40 min and detection wavelength set at 262 nm. All calibration curves showed good linear regression (r2>0.9999) within test ranges. This method provided good accuracy with recoveries in the range of 94.3-106.1% and good precision with R.S.D.s of repeatability and intermediate precision less than 0.57% and 4.67%, respectively. The method was successfully applied to qualitative and quantitative determination of 20 P. kaempferi among the 54 samples collected from different areas. The results revealed that the commercial crude drugs were seriously confused and the developed HPLC assay could be used as a suitable qualitative and quantitative determination method for P. kaempferi.

Cytotoxic diterpenoids from the bark of Pseudolarix kaempferi and their structure-activity relationships.

Four new diterpenoids, 11S-deacetylpseudolaric acid A (2), deacetylpseudolaric acid A O-beta-d-glucopyranoside (3), deacetylpseudolaric acid A 2,3-dihydroxypropyl ester (4), and deacetylpseudolaric acid B 2,3-dihydroxypropyl ester (5), and nine known diterpenoids were isolated from the bark of Pseudolarix kaempferi. Their structures were determined on the basis of chemical and spectroscopic analyses. In addition, their in vitro cytotoxic activities against three human cancer cell lines and their structure-activity relationships were evaluated.

New triterpenoids from Kadsura heteroclita and their cytotoxic activity.

Phytochemical investigations of the stem of Kadsura heteroclita (Roxb) Craib (Schizandraceae) resulted in the isolation and structure elucidation of six new triterpenoidal compounds named heteroclitalactones A-E (1-5) as well as heteroclic acid (6) and heteroclitalactone F (7), which was isolated for the first time from a natural source, and the six known compounds schisanlactone E (8), cycloartenone (9), schisandronic acid (10), nigranoic acid (11), changnanic acid (12) and schisanlactone B (13), respectively. The structures of these compounds were characterized by extensive 1D and 2D NMR spectral analyses. The majority of these triterpenoids showed moderate cytotoxic activity against the human tumor cell lines Bel-7402, BGC-823, MCF-7 and HL-60. Among the compounds tested, heteroclitalactone D (4) showed the strongest cytotoxic activity against the HL-60 cells with an IC50 of 6.76 microM.

Four new lignans from the stems of Kadsura heteroclita.

Two new C(18) dibenzocyclooctadiene lignans named heteroclitalignans A and B (1 and 3), one new C(19) homolignan named heteroclitalignan C(4) and one new natural product named heteroclitalignan D(2), together with the four known lignans kadsurarin (5), kadsulignan E (6), d-epigalbacin, and meso-dihydroguaiaretic acid were isolated from the stems of Kadsura heteroclita. The structures of these compounds were characterized by extensive 1D and 2D NMR spectral data analysis.