Efficacy of Daikenchuto in the prevention of bowel obstruction in patients with colorectal cancer undergoing laparoscopic surgery: An observational study using a Japanese administrative claims database.

PURPOSE: Daikenchuto is an herbal medicine widely used in Japan without clear evidence to prevent bowel obstruction after abdominal surgery. We evaluated the efficacy of Daikenchuto in laparoscopic surgery for colorectal cancer (CRC). METHODS: We included patients from the medical claims databases diagnosed with CRC between January 2012 and December 2019 and treated with laparoscopic surgery. We compared the Daikenchuto and control groups to evaluate early bowel obstruction (EBO) events for 1 year. The Daikenchuto group included patients prescribed Daikenchuto on postoperative day (POD) 0 or 1. An EBO event was defined as the use of a nasogastric tube, transnasal ileus tube, endoscopic balloon dilatation, or the requirement of reoperation for bowel obstruction from PODs 1 to 364. RESULTS: In total, 46,458 patients met the eligibility criteria; 2407 and 44,051 patients were included in the Daikenchuto and control groups, respectively. Some of the patient's characteristics were significantly different between the groups. The frequencies of EBO events in the Daikenchuto and control groups were 5.7% (95% confidence interval: 4.8-6.7) and 4.6% (4.4-4.8), respectively. The most frequent events were nasogastric tube (3.1%, 2.9%) and transnasal ileus tube insertions (1.4%, 0.8%) in the Daikenchuto and control groups, respectively. The hospital stay was significantly shorter in the Daikenchuto group than in the control; this trend was confirmed in the sensitivity analysis. CONCLUSIONS: Daikenchuto did not demonstrate efficacy for EBO. It might be adequate for shortening patient's hospital stay. Further studies are warranted.

Intergenerational comparison of 5-HT3RA in the prevention of chemotherapy-induced nausea and vomiting in gastric cancer patients receiving cisplatin-based chemotherapy: an observational study using a Japanese administrative claims database.

PURPOSE: In chemotherapy-induced nausea and vomiting (CINV), the superiority of the second-generation 5-hydroxytryptamine-3 receptor antagonist (5-HT3RA) over the first-generation 5-HT3RA is shown in the delayed emesis in cycle 1. We evaluate the antiemetic efficacy in real-world clinical practice that has not been sufficiently investigated in clinical trials. METHODS: We included patients who were diagnosed with gastric cancer between April 2012 and June 2017 from the medical claims databases and were treated with cisplatin (≥ 50 mg/m2) and standard antiemetic therapy (5-HT3RA + neurokinin-1 receptor antagonist [NK1RA] + dexamethasone). We compared the second-generation 5-HT3RA (2nd group) and the first-generation 5-HT3RA (1st group) groups to evaluate the additional antiemetic drug as the CINV event. RESULTS: In total, 3798 patients were extracted; 1440 and 2358 patients were included in the 1st and 2nd groups, respectively. The clinical and demographic characteristics did not differ between the groups. In the overall (days 1-6) in cycle 1, 51.7% and 44.3% of patients in the 1st and 2nd groups, respectively, had a CINV event. In the acute phase (days 1-2), 38.7% and 30.2% and in the delayed phase (days 3-6), 35.8% and 32.1% of patients in the 1st and 2nd groups, respectively, had a CINV event. Furthermore, the CINV event trend was the same as in cycles 1 to 5. CONCLUSION: The proportion of CINV events in the 2nd group was smaller than that in the 1st group at any cycle. These findings may suggest consistent antiemetic efficacy of second-generation 5-HT3RA throughout the cycle.

mRNA detection of individual cells with the single cell nanoprobe method compared with in situ hybridization.

BACKGROUND: The localization of specific mRNA generates cell polarity by controlling the translation sites of specific proteins. Although most of these events depend on differences in gene expression, no method is available to examine time dependent gene expression of individual living cells. In situ hybridization (ISH) is a powerful and useful method for detecting the localization of mRNAs, but it does not allow a time dependent analysis of mRNA expression in single living cells because the cells have to be fixed for mRNA detection. To overcome these issues, the extraction of biomolecules such as mRNAs, proteins, and lipids from living cells should be performed without severe damage to the cells. In previous studies, we have reported a single cell nanoprobe (SCN) method to examine gene expression of individual living cells using atomic force microscopy (AFM) without killing the cells. RESULTS: In order to evaluate the SCN method, we compared the SCN method with in situ hybridization (ISH). First, we examined spatial beta-actin mRNA expression in single living cells with the SCN method, and then the same cells were subjected to ISH for beta-actin mRNA. In the SCN method, quantity of beta-actin mRNA were analysed by quantitative PCR, and in ISH we used intensity of ISH as a parameter of concentration of beta-actin mRNA. We showed that intensity of ISH is higher; quantity of beta-actin mRNA detected by the SCN method increased more. CONCLUSION: In this study, we compare the SCN method with the ISH. We examined beta-actin mRNA expression in single cells using both methods. We picked up beta-actin mRNA from several loci of a single living cell using an AFM nanoprobe, and identical cells were subjected to ISH. The results showed a good correlation between the SCN method and ISH. The SCN method is suitable and reliable to examine mRNAs at medium or higher expression level.