Efficacy and safety of stereotactic body radiotherapy combined with karelizumab and apatinib in treatment of advanced hepatocellular carcinoma / 解放军医学杂志

Objective To investigate the efficacy and safety of stereotactic body radiotherapy(SBRT)combined with camrelizumab and apatinib in treatment of advanced hepatocellular carcinoma(HCC).Methods The clinical data were retrospectively analyzed of 85 patients with advanced HCC treated in the Fifth Affiliated Hospital of Zhengzhou University and People's Hospital of Zhengzhou from January 2019 to September 2021.They were divided into observation group(n=31,SBRT combined with camrelizumab and apatinib)and control group(n=54,treated with camrelizumab and apatinib)according to whether they received SBRT.The propensity score matching(PSM)was used to balance the influence of confounding factors.The objective remission rate(ORR)and disease control rate(DCR)were compared between the two groups.The 6-month overall survival rate,1-year overall survival rate and progression-free survival(PFS)were compared between the two groups by Kaplan-Meier method.The safety of the two groups was evaluated by Common Terminology Criteria for Adverse Events(CTCAE)version 5.0.Results Before PSM,there were significant differences in age(P=0.043),number of extrahepatic metastasis(P=0.028),and previous surgical treatment(P=0.038)between the two groups.After PSM,there was no significant difference in baseline characteristics between the two groups(P>0.05).After PSM,27 cases were included in each groups,and three months after treatment,the ORR in observation group and control group were 66.7%and 29.6%,respectively,showed difference with statistically significant(P=0.006);and the DCR in the both groups were 96.3%and 85.2%respectively,showed no statistically significant difference(P=0.175).There were statistical differences in 6-month overall survival rate(96.3%vs.80.9%,P=0.001),1-year overall survival rate(75.0%vs.61.4%,P=0.034)and median PFS(8 months vs.5 months,P=0.003)between the observation group and control group.Multi-factor Cox regression analysis showed that baseline alpha-fetoprotein(AFP)≥400 ng/ml was an independent risk factor for affecting the survival of patients with advanced HCC(HR>1,P<0.05),while the triple therapy and previous targeted drugs therapy were the protective factors for the survival of patients with advanced HCC(HR<1,P<0.05).In the observation group,4 patients had grade 3 adverse reactions,and the common adverse reactions were dyspepsia(14.8%).One case of grade 3 adverse reactions occurred in control group,and there was no statistically significant difference in the incidence of adverse reactions between the two groups(P=0.639).Conclusion SBRT combined with camrelizumab and apatinib is a safe and effective treatment for advanced HCC with significant clinical effect and controllable adverse reactions.

Protective Effect of Cordycepin on Impairment of Endothelial Function in Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases. The reduction of mitochondrial protein sirtuin protein 3 (SIRT3) has been reported to contribute to the development of T2DM by impacting mitochondrial respiration. Cordycepin is an adenosine derivative and is isolated from the culture filtrate of Cordyceps militaris. This study explored the protective effect of cordycepin on vascular impairment induced by T2DM and its properties and protective mechanism. In this study, a T2DM rat model was established. The endothelium-dependent relaxation of the thoracic aorta ring decreased in T2DM rats could be reversed by cordycepin. Next, mitochondrial impairment in human umbilical vein endothelial cells was detected by JC-1 staining. In vitro studies revealed that cordycepin plays a beneficial role in advanced glycation end product-induced endothelial mitochondrial impairment. Moreover, according to the cordycepin molecular docking analysis, cordycepin can bind to SIRT3. Cordycepin increased the expression and activation of SIRT3 in a dose-dependent manner. SIRT3 interruption blocked the protective effect of cordycepin on mitochondria in human umbilical vein endothelial cells. Cordycepin can conclusively protect vascular function impaired by T2DM, and the mechanism may potentially be involved in SIRT3 signaling pathways.

Recovery and Utilization of Alkaloids in Processing Wastewater of Aconiti Radix / 中国实验方剂学杂志

Objective: To optimize the recovery technology for 6 kinds of toxic alkaloids in the toxic wastewater from processing of Aconiti Radix with macroporous resin. Method:With the rates of adsorption and elution of benzoylmesaconine,benzoylaconine,benzoylhypaconine,mesaconitine,hypaconitine and aconitine as indexes,static and dynamic adsorption-elution tests were used to select the best one from 15 kinds of macroporous resin,and the recovery technology parameters of six toxic alkaloids in the wastewater from processing of Aconiti Radix were optimized. Result:D101 macroporous resin had a good adsorption and elution effect on 6 kinds of toxic alkaloids in the wastewater from processing of Aconiti Radix,its optimum technology conditions were as follows:each gram of macroporous resin could be used to treat processing wastewater from 4.3 g of Aconiti Radix,the sample loading speed was not higher than 3.0 mL·min-1,the resin column was eluted with 6 BV of 70% ethanol after removing impurities with 2 BV of water.The recoveries of benzoylmesaconine,benzoylaconine,benzoylhypaconine,mesaconitine, hypaconitine and aconitine were 98.03%,94.09%,96.53%,78.15%,85.40% and 70.57%,respectively. Conclusion:D101 macroporous resin can be used for detoxification treatment of processing wastewater of Aconiti Radix,at the same time,6 kinds of alkaloids are effectively recovered,which can solve the environmental problems and create certain economic benefits,and the optimized process conditions are stable and feasible.