Sphingosine-1-phosphate transporter spinster homolog 2 is essential for iron-regulated metastasis of hepatocellular carcinoma.

Iron dyshomeostasis is associated with hepatocellular carcinoma (HCC) development. However, the role of iron in HCC metastasis is unknown. This study aimed to elucidate the underlying mechanisms of iron's enhancement activity on HCC metastasis. In addition to the HCC cell lines and clinical samples in vitro, iron-deficient (ID) mouse models were generated using iron-free diet and transferrin receptor protein knockout, followed by administration of HCC tumors through either orthotopic or ectopic route. Clinical metastatic HCC samples showed significant ID status, accompanied by overexpression of sphingosine-1-phosphate transporter spinster homolog 2 (SPNS2). Mechanistically, ID increased SPNS2 expression, leading to HCC metastasis in both cell cultures and mouse models. ID not only altered the anti-tumor immunity, which was indicated by phenotypes of lymphatic subsets in the liver and lung of tumor-bearing mice, but also promoted HCC metastasis in a cancer cell autonomous manner through the SPNS2. Since germline knockout of globe SPNS2 showed significantly reduced HCC metastasis, we further developed hepatic-targeting recombinant adeno-associated virus vectors to knockdown SPNS2 expression and to inhibit iron-regulated HCC metastasis. Our observation indicates the role of iron in HCC pulmonary metastasis and suggests SPNS2 as a potential therapeutic target for the prevention of HCC pulmonary metastasis.

Sleep quality and military training injury during basic combat training: a prospective cohort study of Chinese male recruits.

OBJECTIVE: To examine the association between sleep quality and military training injury (MTI) in recruits during basic combat training (BCT). METHODS: Participants were new recruits undergoing 12-week military BCT in China. Sleep quality was measured by the Pittsburgh Sleep Quality Index (PSQI) . Participants were classified into two groups based on their sleep quality (group 1, good sleep, PSQI score <7; group 2, poor sleep, PSQI score ≥7) at the start of BCT. Logistic regression analysis was conducted to test whether baseline PSQI score was associated with MTI incidence during BCT. RESULTS: A total of 563 participants were included. The incidence of MTI was significantly lower in group 1 (48/203, 23.6%) than in group 2 (150/360, 41.7%) (p<0.001). Logistic regression analysis showed that the odds of MTI were 2.307 times higher in group 2 than in group 1 without adjusting for confounders: OR=2.307, p<0.001. When the model was adjusted for age, ethnicity, educational level and family income (OR=2.285) or for the previous confounders plus body mass index (OR=2.377), the results were similar (both p<0.001). Analysis of the types of initial MTI showed that group 2 had about 2.1 times higher odds of soft tissue injury than group 1 (p<0.001 in all the three models). CONCLUSION: Sleep quality before BCT influences the incidence of MTI, especially of soft tissue injury.

Traditional herbal medicine prevents postoperative recurrence of small hepatocellular carcinoma: A randomized controlled study.

BACKGROUND: To explore the clinical efficacy of traditional herbal medicine (THM) in the prevention of disease recurrence of small hepatocellular carcinoma after surgery, a prospective randomized controlled study was conducted between October 2006 and May 2010. The results indicated that THM prevented the recurrence of SHCC with an efficacy that was superior to that of transarterial chemoembolization (TACE) during a median follow-up of 26.61 months. METHODS: The patients were followed up every 6 months, and the clinical data before October 20, 2015 were analyzed. The primary outcome measure was recurrence-free survival (RFS), and the secondary outcome measure was overall survival (OS). RESULTS: The 364 patients included 180 in the THM group and 184 in the TACE group. At the time of the data cutoff of October 20, 2015, a total of 205 patients demonstrated disease recurrence, including 85 patients in the THM group and 120 patients in the TACE group. The median RFS of the THM and TACE groups demonstrated a statistically significant difference (P<.001). Until October 20, 2105, there were 91 deaths, including 34 in the THM group and 57 in the TACE group. The median OS demonstrated a significant difference between the 2 groups (P = .008). Multivariate analysis indicated that THM was an independent factor influencing RFS and OS. CONCLUSIONS: The efficacy of THM was found to be superior to that of TACE in preventing disease recurrence in patients with small hepatocellular carcinoma and prolonging OS. Cancer 2018;124:2161-8. © 2018 American Cancer Society.

[Research progress in anti-tumor effect of emodin].

Emodin is one of the main active ingredient of Rheum palmatum, and has anti-inflammatory, anti-bacterial, anti-viral and other effects. In recent years, it arouse concern since it has a significant anti-tumor effect with low toxicity. In this paper we mainly report the anti-cancer effects of emodin according to the studies of the past five years, including four parts such as inhibit tumor growth, inhibit migration and invasion, enhance the efficacy of combination therapy, increase chemosensitivity and attenuated side effects. We hope that our work may provide a reference for further study.

Melittin analog p5RHH enhances recombinant adeno-associated virus transduction efficiency.

OBJECTIVE: Melittin and its derivative have been developed to support effective gene delivery systems. Their ability to facilitate endosomal release enhances the delivery of nanoparticle-based gene therapy. Nevertheless, its potential application in the context of viral vectors has not received much attention. Therefore, we would like to optimize the rAAV vector by Melittin analog to improve the transduction efficiency of rAAV in liver cancer cells and explore the mechanism of Melittin analog on rAAV. METHODS: Various melittin-derived peptides were inserted into loop VIII of the capsid protein in recombinant adeno-associated virus vectors. These vectors carrying either gfp or fluc genes were subjected to quantitative polymerase chain reaction assays and transduction assays in human embryonic kidney 293 (HEK293T) cells to investigate the efficiency of vector production and gene delivery. In addition, the ability of a specific p5RHH-rAAV vector to deliver genes was examined through in vitro transduction of different cultured cells and in vivo tail vein administration to C57BL/6 mice. Finally, the intricate details of the vector-mediated transduction mechanisms were explored by using pharmacological inhibitors of every stage of the rAAV2 intracellular life cycle. RESULTS: A total of 76 melittin-related peptides were identified from existing literature. Among them, CMA-3, p5RHH and aAR3 were found to significantly inhibit transduction of rAAV2 vector crude lysate. The p5RHH-rAAV2 vectors efficiently transduced not only rAAV-potent cell lines but also cell lines previously considered resistant to rAAV. Mechanistically, bafilomycin A1, a vacuolar endosome acidification inhibitor, completely inhibited the transgene expression mediated by the p5RHH-rAAV2 vectors. Most importantly, p5RHH-rAAV8 vectors also increased hepatic transduction in vivo in C57BL/6 mice. CONCLUSION: The incorporation of melittin analogs into the rAAV capsids results in a significant improvement in rAAV-mediated transgene expression. While further modifications remain an area of interest, our studies have substantially broadened the pharmacological prospects of melittin in the context of viral vector-mediated gene delivery. Please cite this article as: Meng J, He Y, Yang H, Zhou L, Wang S, Feng X, Al-shargi OY, Yu X, Zhu L, Ling, C. Melittin analog p5RHH enhances recombinant adeno-associated virus transduction efficiency. J Integr Med. 2024; 22(1): 72-82.

Comparison of registered and published primary outcomes in randomized controlled trials of gastroenterology and hepatology.

OBJECTIVES. The need for trial registration as well as the benefits it has brought for the transparency of medical research has been recognized for years. Trial registration has turned from an exception to a mandatory guideline in recent years. The present study aimed to examine the characteristics of registered randomized controlled trials (RCTs) in a sample of recently published gastroenterology RCTs, and to assess the consistency of registered and published primary outcome (PO) in RCTs. METHODS. Articles published in the top five "general and internal journals" and top five "gastroenterology and hepatology journals" categories between 2009 and 2012 were searched in PubMed. Basic characteristics and the registration information were identified and extracted from the included RCTs. PO consistency analysis was conducted to compare between the registered and published format. RESULTS. A total of 305 RCTs were included; among them 252 could be identified with a registration number. Nearly half of these RCTs were funded solely by industry (141/305, 46.3%). ClinicalTrials.gov was the most popular registry for these RCTs (214/252, 84.9%). A total of 155 RCTs were included in the PO consistency analysis. Among them, 22 (14.2%) RCTs had discrepancies between POs registered in the trial registry compared to the published article. CONCLUSIONS. Based on the results of the present study, selective outcome reporting of gastroenterology RCTs published in leading medical journals has been much improved over the past years. However, there might be a sampling bias to say that consistency of registered and published POs of gastroenterology RCTs has been better than before.

[Anti-tumor effects of triptolide on osteosarcoma cells in vitro and in vivo: an experimental research].

OBJECTIVE: To observe in vitro and in vivo effects of triptolide on growth inhibition and apoptosis of osteosarcoma cells, and to further explore its correlated molecular mechanisms. METHODS: The growth inhibition effects of triptolide on osteosarcoma cells were detected using MTT assay. The apoptosis was detected using flow cytometry.The protein expressions of associated signals were detected using Western blot. The in vivo anti-osteosarcoma effects of triptolide were verified in osteosarcoma nude mice. The in vivo associated protein expressions were detected using immunohistochemistry (IHC). RESULTS: Triptolide could significantly inhibit the proliferation of various osteosarcoma cells. Besides, it could induce their apoptosis. Triptolide triggered the mitochondrial dependent apoptotic pathway, significantly inhibited the in vivo growth of osteosarcoma cells, and caused in vivo apoptosis. CONCLUSIONS: Triptolide induced apoptosis of osteosarcoma cells partially through activating mitochondria associated apoptosis signal pathway. Triptolide also induced apoptosis of osteosarcoma cells and inhibited their in vivo growth in nude mice.

Total Saponin from Root of Actinidia valvata Dunn Inhibits Hepatoma 22 Growth and Metastasis In Vivo by Suppression Angiogenesis.

The root of Actinidia valvata dunn has been widely used in the treatment of hepatocellular carcinoma (HCC), proved to be beneficial for a longer and better life in China. In present work, total saponin from root of Actinidia valvata Dunn (TSAVD) was extracted, and its effects on hepatoma H22-based mouse in vivo were observed. Primarily transplanted hypodermal hepatoma H22-based mice were used to observe TSAVD effect on tumor growth. The microvessel density (MVD), vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) are characterized factors of angiogenesis, which were compared between TSAVD-treated and control groups. Antimetastasis effect on experimental pulmonary metastasis hepatoma mice was also observed in the study. The results demonstrated that TSAVD can effectively inhibit HCC growth and metastasis in vivo, inhibit the formation of microvessel, downregulate expressions of VEGF and bFGF, and retrain angiogenesis of hepatoma 22 which could be one of the reasons.

New triterpenoids with cytotoxic activity from actinidia valvata.

Two new triterpenoids, 30-O-beta-D-glucopyranosyloxy-2alpha,3alpha,24-trihydroxyurs-12,18-diene-28-oic acid O-beta-D-glucopyranosyl ester (1) and 2alpha,3beta,3,30-tetrahydroxyurs-12,18-diene-28-oic acid O-beta-D-glucopyranosyl ester (2) were isolated from roots of Actinidia valvata Dunn. Their structures were elucidated by means of extensive spectroscopic studies. Both these two new compounds showed moderate cytotoxic activity in vitro against BEL-7402 and SMMC-7721 tumor cell line.

A traditional Chinese herbal medicine compound preparation versus interventional therapy after resection of small hepatocellular carcinoma: 22-year follow-up.

OBJECTIVE: To compare the long-term effectiveness of compound Ruanjianhugan(RJH)tablets and interventional therapy (IT) in patients after resection of small hepatocellular carcinoma (HCC). in 399 patients after resection of small HCC who were admitted between January 1987 and December 2008 in the Department of Hepatobiliary Surgery and Center of Minimally Invasive Surgery, First Affiliated Hospital of Guangxi Medical University. Four groups were based on different therapy modes: a TCM-only (TCMO) group, a TCM combined with interventional therapy (TCM-IT) group, an interventional therapy-only (ITO) group, and a simple operation (SO) group. Prognostic factors were correlated with overall survival (OS) and OS rates were calculated with the Kaplan-Meier method, and multivariate analyses for factors affecting survival were evaluated by the Cox proportional hazard model. RESULTS: The median OS was 151.20 months in the TCM-IT group, 43.87 months in the ITO group, and 20.77 months in the SO group. All survival rates of the TCMO group were higher than those of the other three groups (>50%). The 5-, 10-, and 15-year OS in the TCMO and ITO patients were 83.94%, 45.50%, and 71.22% and 33.34%, 55.58%, and 9.26%, respectively (risk ratio, 0.209; 95% confidence interval, 0.126-0.347; P = 0.000). Multivariate analysis revealed that the independent risk factors were therapy mode (P = 0.000), sex (P = 0.005), family history (P = 0.011), TNM classification of malignant tumor staging (P = 0.000), medical care-seeking behavior (P = 0.021), and maximum diameter (P = 0.030). CONCLUSION: Long-term oral use of compound RJH tablets may improve OS for small HCC after resection compared with IT.

[Chinese herbal medicine for side effects of transarterial chemoembolization in liver cancer patients: a systematic review and meta-analysis].

BACKGROUND: Primary liver cancer is one of the most commonly seen tumors in clinical practice. Due to the stealthiness and fast progress of liver cancer, only 20% of the patients may have chance to receive operation for radical therapy. Patients seldom get benefit from systematic chemotherapy and as a result, local chemotherapy methods such as transarterial chemoembolization (TACE) have become the mainstay in the treatment of liver cancer. Compared with systematic chemotherapy, TACE produces fewer side effects and most of such side effects are caused by postembolization syndrome manifested as nausea and vomiting, abdominal pain, fever, loss of appetite, etc. OBJECTIVE: In this systematic review, effects of Chinese herbal medicine (CHM) in relieving side effects caused by TACE in patients with liver cancer were evaluated and meta-analysis was conducted when possible. SEARCH STRATEGY: Literature search was conducted on August 23rd, 2011. The Cochrane Hepato-Biliary Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE (Ovid SP), EMBASE (Ovid SP), and Science Citation Index Expanded, China National Knowledge Infrastructure Database, Chongqing VIP Database and Wanfang Data were searched with no time limits. INCLUSION CRITERIA: Randomized clinical trials (RCTs) of CHM for TACE-induced side effects in patients with primary liver cancer were eligible for this review, regardless of blinding, language, or publication status. DATA EXTRACTION AND ANALYSIS: Search results were screened to select the trials included in this review according to the inclusion criteria, and data were extracted from all the included RCTs by using a self-developed data extraction form. Assessment of risk of bias in included studies was conducted according to the Cochrane Handbook for Systematic Reviews of Intervention (Version 5.0.2): Criteria for judging risk of bias in the "risk of bias" assessment tool. Dichotomous data were expressed as risk ratio with its 95% confidence interval (CI). Continuous outcomes were expressed as mean differences with 95% CI. If there was no significant heterogeneity, the results from the fixed-effect model were presented. If the heterogeneity was not substantial, the results from the random-effect model were presented. If the heterogeneity was substantial, a meta-analysis was not performed and a narrative, qualitative summary was performed instead. In the event of substantial clinical, methodological, or statistical heterogeneity, the trial components such as patients, diseases, interventions, comparisons, and outcomes in the included trials were reviewed to decide the reason for heterogeneity. RESULTS: A total of 47 RCTs were included in this review after screening the search results. Among them, 46 were in Chinese and 1 was in English; 43 were journal articles and 4 were academic dissertations; all the authors were from mainland China and all the trials were conducted in mainland China. The results of assessment of risk of bias showed that there was unclear or high risk of bias in most of the included RCTs and thus they were all with low quality. The results of systematic evaluation and meta-analysis showed that CHM was beneficial to patients with liver cancer in prolonging life expectancy, improving quality of life, reducing side effects of TACE such as nausea and vomiting, fever, liver pain, and bone marrow suppression, improving liver function indexes and immunological indexes, and enhancing objective curative effect on the tumor size. However, due to the substantial heterogeneity presented in most of the indexes, only descriptive analysis was conducted for these indexes. The results of the heterogeneity analysis showed that the causes of substantial heterogeneity may be due to the obvious difference in treatment protocol, components and dosage form of CHM, time for delivering drugs and course of treatment. CONCLUSION: CHM is effective in prolonging life expectancy, improving quality of life, and reducing side effects of TACE in the treatment of liver cancer. However, due to the undesirable quality of the included RCTs and the substantial heterogeneity, most of the outcome measure indexes were failed to be meta-analyzed, and thus the significance of this review for clinical practice was limited.

[Characteristic genomics of peripheral blood mononuclear cells of hepatocellular carcinoma patients with liver-kidney yin deficiency syndrome].

OBJECTIVE: To explore the characteristic genomics of syndrome of liver-kidney yin deficiency in peripheral blood mononuclear cells of hepatocellular carcinoma (HCC) patients. METHODS: HCC patients with or without syndrome of liver-kidney yin deficiency were enrolled into the experimental group and the control group, respectively; their gene expression profiles were evaluated by a whole-genome Affymetrix GeneChip Human Genome U133 Plus 2.0 Array. The differentially expressed mRNAs were then selected by Gene Ontology (GO) and pathway analyses, respectively. Based on the results of GO and pathway analyses, gene coexpression networks were built according to the normalized signal intensity of specifically expressed genes. Finally, the results from microarray were confirmed by real-time fluorescence quantitative polymerase chain reaction and Western blot methods. RESULTS: The results showed that a set of 615 mRNAs were differentially expressed in the HCC patients with syndrome of liver-kidney yin deficiency. By GO enrichment analysis, the genes for anti-apoptosis, regulation of cell cycle, transmembrane transport, etc. were up-regulated or down-regulated in the experimental group. Another functional analysis of mRNAs by KEGG revealed that 10 signal transduction pathways were up-regulated and 16 were down-regulated, such as antigen processing and presentation, cell cycle, and protein export. Based on the above results, we constructed coexpression networks to determine which genes may play pivotal role in HCC patients with syndrome of liver-kidney yin deficiency. Some critical genes, including SEC62 (SEC62 homolog (S. cerevisiae)), CCNB1 (cyclin B1) and BIRC3 (baculoviral IAP repeat-containing 3), which rank the top 3 in |δ normalized degree| were chosen. Of another 60 samples, we found that the mRNA expressions of SEC62, CCNB1 and BIRC3 were significantly lower in HCC patients with syndrome of liver-kidney yin deficiency than those without syndrome of liver-kidney yin deficiency (P<0.01). Also, the protein expressions of SEC62, CCNB1 and BIRC3 were significantly lower (P<0.01). CONCLUSION: Gene chip technique allows rapid and high-throughput screening for different gene expression in HCC patients with or without liver-kidney yin deficiency syndrome. The results of this study further confirm the hypothesis on the essence of syndrome, namely, a kind of deviation from the normal state in multigene style on the levels of both mRNA and protein.

Effects of Sisheng Decoction on the immunity and anti-stress function in mice with spleen deficiency syndrome.

OBJECTIVE: To study the possible mechanism of Sisheng Decoction on spleen deficiency syndrome via the observation of general conditions, immunity and anti-stress function in Dahuang (Radix et Rhizoma Rhei Palmati)-induced mice model. METHODS: Mice were randomized and grouped based on the body weight. The establishment of model and the treatment were done simultaneously. Except the mice in normal group, the decoction and the Dahuang powder were separately given in the morning and the afternoon for 14 d. The general condition of the mice, the rectal temperature, the time of burden swimming, the indexes of thymus and spleen and the interleukin-2 (IL-2) concentration in the serum were observed. RESULTS: The group treated with Sisheng Decoction showed better performance than that of the model group, including less stool, strong appetite and fast growth; the medium- and high-dose Sisheng Decoction increased the rectal temperature of mice. There was no statistical difference in the thymus and spleen indexes between the groups treated by Sisheng Decoction and the normal group (P>0.05). The thymus index in groups treated by sisheng Decoction was significantly elevated as compared with the model group (P<0.05). The medium- and high-dose Sisheng Decoction significantly improved the concentration of IL-2 and prolonged the time of burden swimming, as compared to the model group (P<0.05). CONCLUSION: The medium- and high-dose Sisheng Decoction is good at invigorating spleen and replenishing qi. One of the possible mechanisms may be related with the improvement of the immunity and anti-stress function of the body.

[Investigation on traditional Chinese medicine syndrome distribution of 4 618 hepatitis B virus infection subjects in Qidong of Jiangsu Province, China].

OBJECTIVE: To study the traditional Chinese medicine (TCM) syndrome distribution in patients with hepatitis B virus (HBV) infection in Qidong region of Jiangsu Province, China. METHODS: A cross-sectional survey was performed. Subjects from Qidong of Jiangsu Province of China were screened among the locally enrolled residents by detecting hepatitis B surface antigen (HBsAg) from May 2007 to May 2011 and were assigned to HBsAg-negative cohort or HBsAg-positive cohort. Then, the subjects were diagnosed according to alanine aminotransferase, alpha-fetoprotein and B ultrasound. The syndrome of the subjects was determined using a TCM questionnaire consisting of signs and symptoms. RESULTS: A total of 5 908 subjects were enrolled in this survey, among whom, 4 718 were diagnosed with HbsAg infection (positive result of HbsAg detection) and 1 147 were negative. 143 subjects were excluded for not receiving the blood examination. The final diagnoses of the subjects were non-HBV infection (n=1128), HBV carrier (n=4019), chronic hepatitis B (n=225), posthepatitic cirrhosis (n=263) or liver cancer (n=111). The TCM syndrome differentiation results showed that there were differences in syndrome distribution between HBV-infected and non-HBV-infected patients. The main syndromes of the HBV-infected patients were qi deficiency, qi stagnation, blood stasis and dampness heat, related to the Zang of liver and spleen. The distribution principles of TCM syndrome among patients of HBV carrier, chronic hepatitis B and cirrhosis were similar. Moreover, with the progression of the patients' condition, the scores of syndromes increased, and the number of accompanying syndromes increased as well. The main syndromes of patients with liver cancer were blood stasis and excess heat, which was slightly different from that of the other HBV-infected patients. CONCLUSION: The TCM syndrome distribution in patients of HBV infection in Qidong region of Jiangsu Province shows regularity. The disorder is mainly due to qi stagnation and blood stasis and is also related to deficiency of healthy qi, especially deficiency of spleen qi.

Opposite effect of basic combat training on mood state of recruits with different physical fitness: A study from perspective of fatigue.

Objective: Basic combat training (BCT) is a kind of necessary high-intensity training to help each military recruit convert into a qualified soldier. In China, both the physical fatigue and passive psychological state have been observed in new recruits during BCT. However, after same-intensity training, the degree of fatigue and passive mood vary among recruits. Therefore, this study aimed to explore the effect of BCT on mood state of recruits with different physical fitness levels from a perspective of fatigue. Materials and methods: Before and after BCT, the degree of fatigue and mood state of participants were evaluated via the Borg Rating of Perceived Exertion Scale and Profile of Mood States Questionnaire immediately after 20 push-ups as RPE and POMS scores [total mood disturbance (TMD), passive mood (Ttension, Tanger, Tfatigue, Tdepression, and Tconfusion) and positive mood (Tvigour and Testeem)]. The participants were divided into two groups according to the RPE score measured after BCT: (1) group 1: RPE score after BCT < 13 and (2) group 2: RPE score after BCT ≥ 13. Result: A total of 564 recruits were included (group 1: 456/564, 80.85%; group 2: 108/564, 19.15%). After BCT, in group 1, TMD (from 95.65 ± 17.89 to 87.52 ± 17.63) and passive mood Ttension (from 4.46 ± 3.18 to 3.79 ± 3.14), Tfatigue (from 4.94 ± 3.58 to 3.12 ± 3.04), Tdepression (from 2.86 ± 3.41 to 2.01 ± 2.75), Tconfusion (3.12 ± 2.72 to 2.42 ± 2.57) declined significantly (all within-group p < 0.001), but positive mood both increased significantly (Tvigour: from 13.21 ± 4.59 to 15.44 ± 5.42, Testeem: from 9.18 ± 3.36 to 11.04 ± 3.67; both within-group p < 0.001); while in group 2, only Tanger (from 4.27 ± 4.16 to 6.22 ± 5.94, within-group p = 0.001) and Testeem (from 8.36 ± 3.15 to 9.07 ± 3.67, within-group p = 0.031) increased significantly. Conclusion: BCT could alleviate passive mood and add to positive mood for recruits with better physical fitness, while had no ameliorative effects on or even deteriorate most of the passive mood for recruits with worse physical fitness.

Knowledge about, attitude and acceptance towards, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China: A cross-sectional survey.

OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has had a serious impact on health all over the world. Cancer patient, whose immunity is often compromised, faces a huge challenge. Currently, some COVID-19 vaccines are being developed and applied on general population; however, whether cancer patients should take COVID-19 vaccine remains unknown. Our study aimed to explore the knowledge, attitude, acceptance, and predictors of intention to receive the COVID-19 vaccine among cancer patients in Eastern China. METHODS: A cross-sectional study was conducted in Eastern China from June 17th to September 3rd, 2021. Patients were selected using a convenience sampling method. A self-report questionnaire was developed to assess knowledge about the COVID-19 vaccine, attitude towards the vaccine and acceptance of the vaccine; following a review of similar studies previously published in the scientific literature, multivariate logistic regression analysis was used to determine the predictors associated with COVID-19 vaccine acceptance. RESULTS: A total of 2158 cancer patients were enrolled in this study. The rate of vaccine hesitancy was 24.05% (519/2158); further, among the participants of vaccine acceptance, 767 had taken COVID-19 vaccine (35.54%), and 872 were willing to get vaccinated (40.01%). A total of 24 variables including demographic characteristics, clinical status of cancer, impact of COVID-19 pandemic on study participants, patients' knowledge about the COVID-19 vaccine, and attitude towards the vaccine, had significant differences between the "vaccine hesitancy" population and "vaccine acceptance" population. Multivariate logistic regression analysis indicated that parameters including alcohol consumption (odds ratio [OR] = 1.849; 95% confidence interval [CI]: 1.375-2.488; P-reference [P-Ref] < 0.001 vs non-drinkers), income impacted by COVID-19 pandemic (OR = 1.930, 2.037 and 2.688 for mild, moderate, and severe impact, respectively; all P-Ref < 0.01 vs no impact), knowledge of how the vaccine was developed (OR = 1.616; 95% CI: 1.126-2.318; P-Ref = 0.009 vs unknown), believing in the safety of the vaccine (OR = 1.502; 95% CI: 1.024-2.203; P-Ref = 0.038 vs denying the safety of vaccine), willingness to pay for the vaccine (OR = 3.042; 95% CI: 2.376-3.894; P-Ref < 0.001 vs unwilling), and willingness to recommend families and friends to get vaccinated (OR = 2.744; 95% CI: 1.759-4.280; P-Ref < 0.001 vs do not recommend) were contributors to vaccine acceptance. While such as being retired (OR = 0.586; 95% CI: 0.438-0.784; P-Ref < 0.001 vs unemployed), undergoing multiple therapies of cancer (OR = 0.408; 95% CI: 0.221-0.753; P-Ref = 0.004 vs no ongoing treatment), and worrying that the vaccine might deteriorate the prognosis of cancer (OR = 0.393; 95% CI: 0.307-0.504; P-Ref < 0.001 vs might not) were contributors to vaccine hesitancy. CONCLUSION: This study provided preliminary estimates of the rates of vaccine acceptance and vaccine hesitancy among cancer patients in Eastern China. The intention to receive the COVID-19 vaccine was impacted by factors such as patient occupation, alcohol consumption, and some parts of knowledge about and attitude towards COVID-19 vaccine. It is recommended to develop individualized vaccination plans that meet the healthcare needs of cancer patients.

Comprehensive evaluation of military training-induced fatigue among soldiers in China: A Delphi consensus study.

Objective: Military training-induced fatigue (MIF) often results into non-combat attrition. However, standard evaluation of MIF is unavailable. This study aimed to provide credible suggestions about MIF-evaluation. Methods: A 3-round Delphi study was performed. The authority of the experts was assessed by the authority coefficient (Aa). In round 1, categories of indicators were collected via anonymous survey of experts, then potential indicators were selected via literature search. In round 2, experts should evaluate the clinical implication, practical value, and importance of each potential indicators, or recommend new indicators based on feedback of round 1. Indicators with recommendation proportions ≥ 70% and new recommended indicators would be included in round 3 to be rated on a 5-point Likert scale. "Consensus in" was achieved when coefficient of concordance (Kendall's W) of a round was between 0.2 and 0.5 and the coefficient of variation (CV) of each aspect for an indicator was < 0.5. If round 3 could not achieve "consensus in," more rounds would be conducted iteratively based on round 3. Indicators included in the recommendation set were ultimately classified into grade I (highly recommended) or grade II (recommended) according to the mean score and CV of the aspects. Results: Twenty-three experts participated with credible authority coefficient (mean Aa = 0.733). "Consensus in" was achieved in round 3 (Kendall's W = 0.435, p < 0.001; all CV < 0.5). Round 1 recommended 10 categories with 73 indicators identified from 2,971 articles. After 3-round consultation, consensus was reached on 28 indicators focusing on the cardiovascular system (n = 4), oxygen transport system (n = 5), energy metabolism/metabolite level (n = 6), muscle/tissue damage level (n = 3), neurological function (n = 2), neuropsychological/psychological function (n = 3), endocrine function (n = 3), and exercise capacity (n = 2). Among these, 11 indicators were recommended as grade I: basic heart rate, heart-rate recovery time, heart rate variability, hemoglobin, blood lactic acid, urine protein, creatine kinase, reaction time, Borg Rating of Perceived Exertion Scale, testosterone/cortisol, and vertical jump height. Conclusion: This study developed a reliable foundation for the comprehensive evaluation of MIF among soldiers.

Novel flavonoids from the leaves of Actinidia valvata Dunn: structural elucidation and antioxidant activity.

Two novel flavonoids, kaempferol 3- O- α-L-rhamnopyranosyl (1-3) (2,4-di- O-acetyl-α-L-rhamnopyranosyl) (1-6) ß-D-galactopyranoside (1) and kaempferol 3- O-α-L-rhamnopyranosyl (1-3) (4-O-acetyl-α-L-rhamnopyranosyl) (1-6) ß-D-galactopyranoside (2), along with three known ones, kaempferol-3- O-ß-D-galactopyranoside (3), kaempferol (4), and 7-hydroxychromone (5), have been isolated from the leaves of Actinidia valvata Dunn, and their structures were elucidated based on spectroscopic methods. Compounds 1-3 exhibited dose-dependent activity in scavenging 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radicals, superoxide anion radicals, and hydroxyl radicals, and inhibited lipid peroxidation of mouse liver homogenate IN VITRO.

[Relationships between constitutional types of traditional Chinese medicine and motion sickness in 145 ocean sailors].

OBJECTIVE: To investigate the relationships between constitutional types of traditional Chinese medicine (TCM) and motion sickness. METHODS: A survey of TCM constitutions in ocean sailors participating in a voyage was performed by using the TCM Constitution Questionnaire developed by Beijing University of Traditional Chinese Medicine, while the survey of motion sickness was operated by Graybiel's diagnostic criteria. The incidences of motion sickness among sailors with different types of constitutions were compared. RESULTS: Prior to the voyage, 50.3% of sailors exhibited a gentleness constitution, 14.5% were of dampness-heat constitution, 10.3% were of qi-stagnation constitution, whereas the percentages of qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis and special diathesis constitutions were 6.2%, 7.6%, 6.2%, 4.1% and 0.7%, respectively. None exhibited a phlegm-dampness constitution. By the end of the 176-day voyage, the percentages of gentleness, dampness-heat, qi-depression, qi-deficiency, yang-deficiency, yin-deficiency, blood-stasis, special diathesis and phlegm-dampness constitutions were 33.8%, 13.8%, 13.1%, 11.0%, 6.9%, 9.7%, 4.1%, 0.7% and 6.9%, respectively. The incidence of motion sickness was 69.7% (101 sailors) during this voyage. The incidences of motion sickness among sailors with different types of constitutions before the voyage showed significant difference (P<0.001). The incidence of motion sickness was higher in the sailors with dampness-heat constitution than in those with gentleness constitution. CONCLUSION: Types of Chinese medical constitution can be related to susceptibility to motion sickness. Furthermore, ocean voyage may have an effect or influence on the type of Chinese medical constitution of sailors involved.