Changes in prostate cancer incidence, mortality and survival in relation to prostate specific antigen testing in New South Wales, Australia.

BACKGROUND: To examine changes in prostate cancer incidence and mortality rates, and 5-year relative survival, in relation to changes in the rate of prostate specific antigen (PSA) screening tests and the use of radical prostatectomy (RP) in the Australian population. METHODS: Prostate cancer stage-specific incidence rates, 5-year relative survival and mortality rates were estimated using New South Wales Cancer Registry data. PSA screening test rates and RP/Incidence ratios were estimated from Medicare Benefits Schedule claims data. We used multiple imputation to impute stage for cases with "unknown" stage at diagnosis. Annual percentage changes (APC) in rates were estimated using Joinpoint regression. RESULTS: Trends in the age-standardized incidence rates for localized disease largely mirrored the trends in PSA screening test rates, with a substantial 'spike' in the rates occurring in 1994, followed by a second 'spike' in 2008, and then a significant decrease from 2008 to 2015 (APC -6.7, 95% CI -8.2, -5.1). Increasing trends in incidence rates were observed for regional stage from the early 2000s, while decreasing or stable trends were observed for distant stage since 1993. The overall RP/Incidence ratio increased from 1998 to 2003 (APC 9.6, 95% CI 3.8, 15.6), then remained relatively stable to 2015. The overall 5-year relative survival for prostate cancer increased from 58.4% (95% CI: 55.0-61.7%) in 1981-1985 to 91.3% (95% CI: 90.5-92.1%) in 2011-2015. Prostate cancer mortality rates decreased from 1990 onwards (1990-2006: APC -1.7, 95% CI -2.1, -1.2; 2006-2017: APC -3.8, 95% CI -4.4, -3.1). CONCLUSIONS: Overall, there was a decrease in the incidence rate of localized prostate cancer after 2008, an increase in survival over time and a decrease in the mortality rate since the 1990s. This seems to indicate that the more conservative use of PSA screening tests in clinical practice since 2008 has not had a negative impact on population-wide prostate cancer outcomes.

Chinese herb cinobufagin-reduced cancer pain is associated with increased peripheral opioids by invaded CD3/4/8 lymphocytes.

OBJECTIVES: To investigate the mechanism of cinobufagin-reduced cancer pain in mouse cancer pain model and in vitro cell co-culture system. METHODS: Female Kunming mice were randomly divided into 4 groups. One group of animals was set as normal control without any treatment. Other three groups of animals received H22 hepatoma cell inoculation in right hind paw. At day 9 after inoculation, mice in other three groups were injected intraperitoneally once a day for 8 days with the solvent, morphine or cinobufagin, respectively. The pain behavior was recorded daily. On the last day, all mice were sacrificed and xenograft tissues homogenate and plasma levels of ß-endorphin (ß-END), corticotropin-releasing factor (CRF) and interleukin-1ß (IL-1ß) were assessed by ELISA assay. Immunohistochemistry was performed to determine the expression of ß-END, pro-opiomelanocortin (POMC) and the µ-opioid receptor (µ-OR) in the xenograft tissues. Immunofluorescence was used to localize lymphocytes with expression of CD3+, CD4+ and CD8+ in xenograft tumors and adjacent tissues. Mice splenic lymphocytes and H22 hepatoma carcinoma ascites cells were prepared for co-culture. ß-END and CRF were detected in co-culture supernatants. The MTT assay and cytometry were used to assess cell proliferation. RT-PCR was conducted to determine the gene expression of POMC and Cathepsin L (CTSL). Chemotaxis was examined using a transwell-based migration assay. RESULTS: Compared to the model group, the thermal and mechanical pain thresholds were increased in mice after cinobufagin treatment. The expression of ß-END and CRF in the plasma and tumor tissues of cinobufagin group were much higher than that of the model group mice, but the expression of IL-1ß in the plasma and tumor tissues was much lower than that in the model group mice. Meanwhile, the expression of ß-END, POMC and µ-OR proteins was significantly increased in the xenograft tissues from cinobufagin group. Lymphocyte population of CD3+, CD4+, CD8+ were also elevated in xenograft tumors and adjacent tissues. In the cell co-culture assays, the content of ß-END in the supernatant was significantly increased by cinobufagin in a dose-dependent manner. Cinobufagin also largely increased the proliferation of immune cells and inhibited H22 hepatoma carcinoma cell proliferation in single or co-culture cell assays. Gene expression of POMC and CTSL in cinobufagin group was significantly up-regulated comparing to the control group. Finally, cinobufagin addition enhanced the migration of immune cells in transwell assay. CONCLUSIONS: Cinobufagin-induced local analgesic effect might be associated with increased activity of POMC/ß-END/µ-OR pathway released from invaded CD3/4/8 lymphocytes in cancer tissues.

Effects of polysaccharides extracted from zhu zi shen (rhizoma panacis majoris) on oxidative stress and hemodynamics in rats with adriamycin-induced chronic heart failure.

OBJECTIVE: To probe into the intervening action of polysaccharides of Zhu Zi Shen (Rhizoma Panacis Majoris) (PZZS) on oxidative stress and hemodynamics in rats with adriamycin-induced chronic congestive heart failure (CHF). METHODS: After SD rats were successfully modeled with adriamycin, they were randomly divided into a normal control group, a model group, a PZZS group, and a captopril group, and were administrated respectively. At the end of experiment, the hemodynamic function, whole heart weight index, and the blood CK, SOD, MDA, NO, NOS were detected; and the myocardial morphological examinations were carried out. RESULTS: Compared with the normal control group, the arterial systolic pressure (SBP), diastolic pressure (DBP), mean arterial pressure (MAP), heart rate (HR), left ventricular systolic peak (LVSP), and left ventricular pressure change rate (dp/dt(max)) significantly decreased, and left ventricular end diastolic pressure (LVEDP), whole heart weight index, the blood CK, MDA, NO, NOS significantly increased in the model group. PZZS significantly improved the hemodynamic function, lowered the MDA and NO levels, and decreased the CK and NOS activities in the CHF rats. CONCLUSION: PZZS can improve the hemodynamic function, and alleviate the oxidative stress reaction in the CHF rat.