Hemolysis attributed to high dose vitamin C: Two case reports.

BACKGROUND: High-dose vitamin C treatment (HVCT) can reduce the adverse effect of chemotherapy and enhance the effect of antitumor therapy, which has been considered one of the safest alternative treatments. However, the severity of its adverse effects may have been underestimated. The most serious adverse effect is hemolysis, which may result in acute kidney injury or death. Although glucose-6-phosphate dehydrogenase (G6PD) deficiency is considered to be the main cause, the probability and pathological mechanism are not completely understood, leading to a lack of effective and standardized treatment methods. CASE SUMMARY: Two patients with colorectal cancer developed hemolytic anemia after using 1 g/kg HVCT. In contrast to previous cases, the lowest hemoglobin level in the two cases was < 50 g/L, which was lower than previously reported. This may be because Case 1 had chronic hepatitis B for many years, which caused abnormal liver reserve function, and Case 2 had grade II bone marrow suppression. Both patients improved and were discharged after blood replacement therapy. Our cases had the most severe degree of hemolysis but the best prognosis, suggesting that our treatment may be helpful for rescue of drug-induced hemolysis. This is the first review of the literature on hemolysis caused by HVCT, and we found that all patients with G6PD deficiency developed hemolysis after HVCT. CONCLUSION: G6PD deficiency should be considered as a contraindication to HVCT, and it is not recommended for patients with bone marrow suppression, moderate-to-severe anemia, hematopoietic abnormalities, or abnormal liver and kidney function. Early blood purification and steroid therapy may avoid acute kidney injury or death caused by HVCT-related hemolytic anemia.

Network pharmacology and molecular docking technology for exploring the effect and mechanism of high-dose vitamin c on ferroptosis of tumor cells: A review.

To investigate the mechanism by which high-dose vitamin C (HVC) promotes ferroptosis in tumor cells via network pharmacology, vitamin C-related and ferroptosis-related targets were obtained from the PharmMapper and GeneCards databases, respectively, and their common targets were compared using the Venn diagram. Common targets were imported into the STRING database for protein-protein interaction analysis, and core targets were defined. Core targets were enriched for Gene Ontology terms and Kyoto Encyclopedia of Genes and Genomes pathways using the R language packages. A map of the core target-based interaction network and a map of the mechanism by which HVC regulates ferroptosis were constructed. A total of 238 vitamin C-related and 721 ferroptosis-related targets were identified, of which 21 targets were common to both. Furthermore, ALDOA, AHCY, LDHB, HSPA8, LGALS3, and GSTP1 were identified as core targets. GO enrichment analysis suggested that the main biological processes included the extrinsic apoptotic signaling pathway and pyruvate metabolic process. KEGG enrichment analysis suggested that HVC regulates ferroptosis mainly through the amino acid and carbohydrate metabolic pathways. The targets were validated by molecular docking. In conclusion, HVC may promote ferroptosis in tumor cells by regulating metabolic pathways, and there is a synergistic effect between HVC and type I ferroptosis inducers. Glycolysis-dependent tumors may be beneficial for HVC therapy. Our study provides a reference for further clinical studies on HVC antitumor therapy.

Study on the Cooling Effect of Asphalt Pavement Blended with Composite Phase Change Materials.

To explore the cooling effect of phase change materials (PCM) on asphalt pavement, a numerical model of the coupled heat transfer process of a typical monolithic subgrade of the G7 Expressway in the eastern Tianshan mountain area was developed. Three types of paraffin materials (OP55E, OP52E, OP47E) were mixed in a 4:3:3 volume ratio and blended into the asphalt upper layer and overall asphalt layer at volume ratios of 5%, 10%, 15% and 20%. The cooling effect of different PCM addition schemes was simulated and analyzed, and the frequency and duration of asphalt pavement high temperature operation status were also measured. The results showed that: (1) Th addition of PCM in the asphalt layer can effectively reduce the frequency of pavement high temperature rutting damage. The number of days and average daily duration of high temperature on the road surface were both reduced. (2) The cooling effect was positively correlated with the PCM volume mixing ratio, and the temperature drop of the pavement also increased with the increase of the PCM blending ratio. As the PCM mixing ratio increased from 5% to 20%, the initial 75 °C pavement cooled by 1.49 °C and 4.66 °C, respectively, and the number of days and hours of pavement temperature over 70 °C decreased to 4 days and 3.3 h, respectively. (3) The cooling effect of the asphalt upper layer PCM scheme was greater at a small mixing ratio (5%), whereas the performance of the overall asphalt layer PCM blended scheme was effectively promoted by increasing the equivalent heat capacity of system under the large mixing ratio (20%).

The relationship between birthing related factors and maternal breastfeeding confidence in China.

PROBLEM: The relationship between birthing related factors and breastfeeding confidence remain unknown among Chinese mothers. BACKGROUND: Breastfeeding confidence in the early postpartum period is an important predictor of breastfeeding duration. There are many postpartum and socio-demographic factors that have been linked to breastfeeding confidence. However, the relationship between birthing related factors and this confidence remain unknown. AIM: To explore the relationship between birthing related factors and breastfeeding confidence among Chinese mothers. METHODS: This is a cross-sectional study of 450 mothers who were recruited after birth and before discharge from hospital. From November 2018 to March 2019, we collected data related to socio-demographics and obstetric characteristics, as well as the Chinese version of Breastfeeding Self-Efficacy Scale and the Chinese version of Labor Agentry Scale. Associations of birthing related factors with breastfeeding self-efficacy were investigated. RESULTS: There was a significant correlation between perception of control during labor and breastfeeding confidence. Multiple linear regression showed that higher perception of control in labor scores were significantly associated with higher breastfeeding self-efficacy scores (B=0.282, P=<0.001), and lower breastfeeding self-efficacy scores were associated with women living in an extended family (B=-12.622, P=<0.001), perceived of insufficient milk supply (B=-5.514, P=0.038), mild fatigue (B=-8.021, P=0.03), moderate fatigue (B=-12.955, P=0.004). CONCLUSION: There is a significant relationship between perception of control during labor and maternal breastfeeding confidence in the early postpartum period. Strengthening perception of control during labor can improve breastfeeding self-efficacy. Providing professional and emotional support for women during the intrapartum period should be strengthened.