Elemental diet preventative effects for adverse events during chemotherapy in patients with esophageal cancer - A systematic review and meta-analysis.

The effectiveness of an elemental diet (ED) for preventing adverse events (AEs) during chemotherapy for patients with esophageal cancer (EC) remains unclear. The aim of this meta-analysis was to comprehensively assess the efficacy of ED for preventing AE in EC patients during chemotherapy. Medline (via PubMed), Embase, the Cochrane Library, and Web of Science were searched to retrieve prospective and randomized studies published before April 12, 2023. The odds ratio (OR) of each AE was calculated using Review Manger 5.4.1. The risk of bias was assessed, and a random effect model-based meta-analysis was used to analyze the available data. Four prospective and randomized studies involving 237 patients were identified after a systematic search. Regarding gastrointestinal toxicities, the findings indicated a trend toward a decrease in the risk of mucositis (OM) (OR = 0.54, 95 % CI: 0.25-1.14), constipation (OR = 0.87, 95 % CI: 0.49-1.53), and anorexia (OR = 0.99, 95 % CI: 0.32-3.05), as well as an increasing trend in the risk of diarrhea (OR = 1.48, 95 % CI: 0.79-2.79), among patients treated with ED. However, none of these reached statistical significance. For hematological toxicities, the risk of all-grade neutropenia (OR = 0.28, 95 % CI: 0.14-0.57), grade ≥ 2 leucopenia (OR = 0.43, 95 % CI: 0.22-0.84), grade ≥ 2 neutropenia (OR = 0.34, 95 % CI: 0.17-0.67), and grade ≥ 3 neutropenia (OR = 0.28, 95 % CI: 0.12-0.63) was significantly decreased. There is no firm evidence confirming the preventive effect of an ED against OM or diarrhea. However, an ED may potentially be helpful in preventing neutropenia and leucopenia.

Efficacy and safety of cyclophosphamide in anthracycline- and taxane-based neoadjuvant chemotherapy in breast cancer: a meta-analysis.

BACKGROUND: Our study aimed to compare the efficacy and safety of anthracycline plus taxane (AT)-based neoadjuvant chemotherapy (NAC) with or without cyclophosphamide in the treatment of breast cancer. METHODS: We searched PubMed, Embase, Web of Science and the Cochrane Library for randomized controlled studies comparing the efficacy and safety of AT-based NAC with or without cyclophosphamide in breast cancer patients. RESULTS: Four eligible studies with 2,302 individuals were ultimately included in the quantitative analysis. After applying the AT-based NAC regimen, the overall rates of pathologic complete response (pCR) and breast conserving surgery in all included subjects were 26.5% and 70.6%, respectively. The rates of pCR [risk ratio (RR): 1.35; 95% CI: 0.75, 2.45; P=0.32], breast-conserving surgery (RR: 1.07; 95% CI: 0.97, 1.19; P=0.17) and clinical response (RR: 1.08; 95% CI: 0.97, 1.19; P=0.15) in patients in the cyclophosphamide group were similar to those in the control group. However, participants in the cyclophosphamide group had a lower no clinical response rate than those in the control group (RR: 0.72; 95% CI: 0.60, 0.87; P<0.001). Subjects in the cyclophosphamide group had significantly lower rates of infection (RR: 0.57; 95% CI: 0.41, 0.79; P<0.001) and diarrhea (RR: 0.46; 95% CI: 0.30, 0.68; P<0.001) and higher rates of thrombocytopenia (RR: 3.38; 95% CI: 1.96, 5.84; P<0.001), sensory/motor neuropathy (RR: 1.57; 95% CI: 1.03, 2.39; P=0.03) and nausea/vomiting (RR: 1.51; 95% CI: 1.11, 2.06; P=0.009) than those in the control group. CONCLUSIONS: The AT-based NAC regimen with or without cyclophosphamide had similar clinical outcomes in breast cancer patients. The addition of cyclophosphamide might increase the risks of thrombocytopenia, sensory/motor neuropathy and nausea/vomiting.

The relationship of plasma fibrinogen with clinicopathological stages and tumor markers in patients with non-small cell lung cancer.

Numerous studies have shown that the blood of cancer patients are generally in hypercoagulable statement. The aim of the present research is to study the relationships of plasma fibrinogen (Fbg) levels with clinicopathological stages (CS) and tumor markers of non-small cell lung cancer (NSCLC).Baseline information, plasma Fbg levels, CS, and expression level of tumor markers were collected from medical records retrospectively. Unitary linear regression was used to analyze the relationships between continuous variables and Fbg, and multiple linear regression was used to analyze the relationships between categorical variables and Fbg. National Comprehensive Cancer Network Clinical Practice Guidelines in Oncology (Version 4) for NSCLC were adopted to evaluate CS.A total of 652 NSCLC patients were included. Compared with the females, male patients had higher mean plasma Fbg levels (P < .001). The later the N stages (P = .002), M stages (P = .002), and CS (P = .001) were, the higher the average plasma Fbg levels were. The levels of squamous cell carcinoma antigen (P = .001), carbohydrate antigen 125 (P = .041), and neuron-specific enolase (P < .001) were positively correlated with plasma Fbg concentration. The plasma level of Fbg in lung adenocarcinoma patients (P < .001) was the lowest, while that of lung squamous cell carcinoma patients (P < .001) was the highest in NSCLC patients.The plasma Fbg concentration is related to gender, CS, and tumor markers in patients with NSCLC.

The efficacy of dietary Spirulina as an adjunct to chemotherapy to improve immune function and reduce myelosuppression in patients with malignant tumors.

BACKGROUND: Recent studies have demonstrated functional benefits of Spirulina (Arthrospira sp.) in the treatment and prevention of cancer. However, it is unclear if Spirulina can be used to limit the side effects of chemotherapy in patients with malignant tumors. METHODS: In this study, cancer patients receiving four cycles of chemotherapy were randomized into control or treatment groups. The treated group consumed Spirulina for the first two cycles while the control group did not. The extent of myelosuppression and immune function were assessed after each cycle of chemotherapy, and patients were monitored for myelosuppression-related adverse events throughout the study period. RESULTS: In total, 100 patients were recruited and randomized into control (n=40) or treatment (n=60) groups. The white blood cell (WBC) and neutrophil (NEU) levels were similar in both groups at baseline while they were higher in the treated group relative to controls after Cycle1 (P=0.028 for WBC; P=0.006 for NEU) and Cycle2 (P=0.023 for WBC; P=0.013 for NEU). Hemoglobin (HGB) and platelet counts (PLT) were not statistically different between the groups at baseline or after treatment. Patients in the treatment group had a significantly lower rate of severe myelosuppression (P=0.034) and less modification of the chemotherapy regimen was necessary (P=0.012). After four cycles of chemotherapy, the IgM level and number of CD8+ T cells increased in the treatment group, but decreased in the control group (P=0.004 for IgM; P=0.022 for CD8+ T cells). CONCLUSIONS: Spirulina reduces myelosuppression and improves immune function after chemotherapy in patients with malignant tumors.

Short-term clinical outcomes of enteral nutrition versus parenteral nutrition after surgery for pancreatic cancer: a meta-analysis.

BACKGROUND: The short-term clinical outcomes between early enteral nutrition (EEN) and total parenteral nutrition (TPN) after pancreaticoduodenectomy (PD) for pancreatic cancer were not clear. METHODS: We searched the PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI) and Wanfang databases to identify randomized controlled studies comparing EEN and TPN after PD for pancreatic cancer. Then a meta-analysis was conducted. RESULTS: Seven studies with 486 patients were included in the analysis. After surgery, patients in EEN group had higher level of plasma total protein (TP) [weighted mean difference (WMD): 1.83, 95% confidence interval (CI): 0.33-3.32, P=0.02], while the albumin (ALB) level was similar between the two groups (WMD: 0.25, 95% CI: -4.07-4.56, P=0.91). As for the bowel function, EEN group had shorter exhaust time (WMD: -0.66, 95% CI: -0.81 to -0.51, P<0.001) and bowel movement time (WMD: -2.27, 95% CI: -2.61 to -1.94, P<0.001) than TPN group. EEN group also had lower short-term total complication rate [relative risk (RR): 0.68, 95% CI: 0.51-0.92, P=0.01] and postoperative hemorrhage rate (RR: 0.22, 95% CI: 0.06-0.75, P=0.02), while there was no significant difference in infection rate (RR: 0.68, 95% CI: 0.38-1.22, P=0.20), pancreatic fistula rate (RR: 0.63, 95% CI: 0.35-1.16, P=0.14) and delayed gastric emptying (DGE) rate (RR: 0.72, 95% CI: 0.39-1.33, P=0.29) between the groups. In addition, EEN group had shorter hospital stay (WMD: -1.53, 95% CI: -2.12 to -0.94, P<0.001). CONCLUSIONS: Compared to TPN, EEN showed better outcomes in improving the nutritional status and bowel function as well as decreasing complication rate and hospital stay after PD in patients with pancreatic cancer.

Clinical Effects of Xihuang Pill Combined with Chemotherapy in Patients with Advanced Colorectal Cancer.

Objective. To investigate the therapeutic effects of Xihuang pill combined with chemotherapy on advanced colorectal cancer. Methods. Sixty-three patients with advanced colorectal cancer were divided into an experimental group (n = 32) and control group (n = 31). Patients in the experimental group were treated with traditional Chinese medicine combined with Western medicine (i.e., Xihuang pill with FOLFOX or FOLFIRI chemotherapy), and those in the control group were treated with FOLFOX or FOLFIRI chemotherapy alone. Changes in therapeutic efficacy, side effects, blood coagulation function, and quality of life (QOL) were compared between the two groups. Results. The response rate was higher in the experimental than control group (P = 0.011). The QOL score in the experimental group was significantly lower after treatment than before treatment (P = 0.003), while no significant change was found in the control group. In the experimental group, the posttreatment activated partial thromboplastin time and prothrombin time after treatment were 30.05 ± 3.85 and 10.40 ± 1.25 s, respectively, which were prolonged compared with those before treatment (29.12 ± 4.03 and 9.85 ± 1.00 s; P = 0.010 and 0.021, respectively). Conclusion. In patients with advanced colorectal cancer, Xihuang pill combined with chemotherapy can significantly enhance the therapeutic effects compared with chemotherapy alone and improve patients' QOL and hypercoagulability.

Associations between UGT1A1*6 or UGT1A1*6/*28 polymorphisms and irinotecan-induced neutropenia in Asian cancer patients.

PURPOSE: Neutropenia is a life-threatening side effect of irinotecan, and uridine diphosphate glucuronosyltransferases (UGTs) gene polymorphisms are considered to be one of the predictive markers of irinotecan-related toxicities. Many studies have demonstrated that patients bearing UGT1A1*28 have a higher risk of severe neutropenia on toxicity of irinotecan. However, UGT1A1 (TA7/TA7) was very rare in Asian populations. Some researches reported that UGT1A1*28 and/or UGT1A1*6 could predict irinotecan-induced toxicities in Asian populations, but controversial conclusions still remained. This study aims to investigate the association between UGT1A1 gene polymorphisms *6, *6/*28 and irinotecan-related neutropenia in Asian cancer patients receiving irinotecan regimen chemotherapy. EXPERIMENTAL DESIGN: Meta-analyses were done to assess the relationship between UGT1A1*6 or UGT1A1*6/*28 and irinotecan-induced neutropenia. RESULTS: The risk of neutropenia was significantly higher among patients with a UGT1A1*6 genotype than among those carrying the UGT1A1*1 allele(s) [odds ratio (OR) 3.276; 95 % confidence interval (CI) 1.887-5.688; P = 0.000 (*6/*6 vs. *1/*6 or *1/*1)], [OR 1.542; 95 % CI 1.180-2.041; P = 0.001 (*6/*6 or *1/*6 vs. *1/*1)]. Also, the risk was significantly higher among patients with a UGT1A1*6/*28 than among those carrying the UGT1A1*1 allele(s) [OR 3.275; 95 % CI 2.152-4.983; P = 0.000 (*6/*6 or *28/*28 or *6/*28 vs. *1/*6 or *1/*28 or *1/*1)]. CONCLUSIONS: In conclusion, the UGT1A1*6 and UGT1A1*6/*28 genotypes were associated with an increased risk of irinotecan-induced neutropenia in Asian cancer patients.

Supramolecular lanthanide metallogrids exhibiting field-induced single-ion magnetic behavior.

A supramolecular strategy has been applied to construct two tetranuclear lanthanide complexes for investigating the magnetic properties of individual lanthanide ions. The Ln(III) complexes (Ln = Dy, Tb) display field-induced slow magnetization relaxation, typical of single-molecule magnet behavior. The four lanthanide ions in the molecules are well separated by distances of ca. 9 Å, and thus the slow magnetization relaxation should be assigned to single-ion magnet (SIM) behavior. Therefore, the present complexes are novel supramolecular aggregates of four isolated SIMs.

Syntheses, structure, and magnetic properties of heteronuclear Cu(II)4Fe(III)4 cluster and Cu(II)8 bimetallacycles.

The compartmental Schiff base ligands N,N'-ethylenebis(3-hydroxysalicylidene) (H(4)L) and N,N'-propylenebis(3-hydroxysalicylidene) (H(4)L') have been employed in the synthesis of a cyclic tetranuclear Cu(II) complex [Cu(4)(L')(2)(MeOH)(3)(H(2)O)]·[Cu(4)(L')(2)(MeOH)(3)] (1), a novel octanuclear Cu(II) complex [Cu(8)(L-L)(2)(H(2)O)(4)(µ(2)-H(2)O)]·3DMF·3H(2)O (2) and a hetero-octanuclear Cu(II)-Fe(III) complex [Cu(4)Fe(4)(L)(4)(H(2)O)(3)(µ(3)-O)(2)]·3DMF·3H(2)O (3). During the formation of the Cu(8) complex (2), a new bis-Schiff base ligand (L-L)(8-) forms via the ortho-para C-C coupling of two H(4)L ligands. The bicyclic complex (2) is comprised of two cyclic Cu(4) units that are similar to that of complex 1. In the Cu(4) unit, the alternate Cu(II) ions are singly bridged by phenoxo groups. The three complexes display overall antiferromagnetic coupling, and the Cu(II)-Cu(II) magnetic coupling constant falls in the range -117.2 to -473.6 cm(-1) for complexes 1 and 2 corresponding to the bridging Cu-O(phenoxide)-Cu bond angles of 124.3-131.0°.

Matrix metalloproteinase-9 was involved in the immuno-modulatory defect of mesenchymal stem cell from chronic myeloid leukemia patients.

BACKGROUND: Overwhelming evidences on chronic myeloid leukemia (CML) indicate that patients harbor quiescent CML stem cells that are responsible for blast crisis. While the hematopoietic stem cell (HSC) origin of CML was first suggested over 30 years ago, recently CML-initiating cells beyond HSCs are also being investigated. METHODS: We have previously isolated fetal liver kinase-1-positive (Flk1(+)) cells carrying the BCR/ABL fusion gene from the bone marrow of Ph(+) patients with hemangioblast property. In this study, we isolated CML patient-derived Flk1(+)CD31(-)CD34(-) mesenchymal stem cells (MSCs) and detected their biological characteristics and immunological regulation using fluorescence in situ hybridization (FISH) analysis, fluorescence activated cell sorting (FACS), enzyme-linked immunoadsorbent assay, mixed lymphocyte reaction assays; then we compared these characters with those of the healthy donors. RESULTS: CML patient-derived Flk1(+)CD31(-)CD34(-) MSCs had normal morphology, phenotype and karyotype while appeared impaired in immuno-modulatory function. The capacity of patient Flk1(+)CD31(-)CD34(-) MSCs to inhibit T lymphocyte activation and proliferation was impaired in vitro. CONCLUSIONS: CML patient-derived MSCs have impaired immuno-modulatory functions, suggesting that the dysregulation of hematopoiesis and immune response may originate from MSCs rather than hematopoietic stem cells (HSCs). MSCs might be a potential target for developing efficacious treatment for CML.

Pyrazine-2-amidoxime Ni(II) complexes: from ferromagnetic cluster to antiferromagnetic layer.

Tetranuclear [Ni(4)(Hpzaox)(2)(pzaox)(2)(py)(4)](ClO(4))(2)·2py (1), [Ni(4)(Hpzaox)(2)(pzaox)(2)(py)(4)](NO(3))(2)·4py (2), and two-dimensional (2D) [Ni(4)(Hpzaox)(2)(pzaox)(2)(H(2)O)(2)](NO(3))(2)·2H(2)O (3) are prepared via the reaction of NiX(2)·6H(2)O and pyrazine-2-amidoxime (H(2)pzaox). All compounds contain [Ni(4)(Hpzaox)(2)(pzaox)(2)](2+) fragments, which assemble to form a tetranuclear or polymeric network. Magnetic studies show that the tetranuclear compounds display usual ferromagnetic coupling via the oxime N-O bridges, and the 2D compound displays unusual antiferromagnetic behavior.

Ferromagnetic coupling in oximato-bridged multi-decker Ni(II) clusters.

Single-, double- and triple-decker oximato-bridged Ni(ii) clusters based on pyridine-2-amidoxime (H(2)pyaox) have been synthesized and characterized. The decks have the same tetranuclear cationic units [Ni(4)(Hpyaox)(2)(pyaox)(2)](2+) that are stably present in the reaction solution. Magnetic studies show that uncommon ferromagnetic exchange between the adjacent Ni(ii) ions through the oxime bridges is operative in the compounds with the magnetic coupling constant (J) in the range 0.6-6.3 cm(-1) (H = -2JS(Ni1)S(Ni2)). Density function theoretical (DFT) calculations and the experimental data confirm that the N-O bond distances of the bridging oxime group have a decisive effect in magnetic coupling. For the present Ni(ii) species, the elongation of N-O bond distances are responsible for the switching from antiferromagnetic to ferromagnetic exchange with the critical bond distance of 1.394 Å.

[The prevalence and risk factors for coronary stenosis in patients with cerebral infarction].

OBJECTIVE: To study the morbidity rate of and relevance to coronary stenosis in cerebral infarction patients. METHODS: CT coronary angiography was performed in 112 cases of cerebral infarction after CT cerebral angiography. Multivariate logistic regression analysis was carried out between the clinical data and coronary stenosis. RESULTS: In 112 cases receiving CT cerebral angiography, the morbidity rate of coronary stenosis was 46.4%. In 95 cerebral infarction patients, the morbidity rate of coronary stenosis was 51.6%. Multivariate logistic analysis showed that age, hypertension, hyperlipidemia, significant narrowing of cerebral artery were identified as independent predictors for coronary stenosis. CONCLUSIONS: Heart examination with 64 row CT should be routinely performed after cerebral angiography in cerebral infarction patients, especially in those with age greater than 65 years, hypertension, hyperlipidemia and significant narrowing of cerebral artery so as to detect coronary stenosis early.