OBJECTIVE: To compare the efficacy and safety of doxorubicin with epirubicin in patients with metastatic breast cancer (MBC) by systematic review and Meta-analysis to provide reference for clinicians. METHODS: Randomized controlled trials (RCTs) that compared the efficacy, safety, or both, of doxorubicin with epirubicin in treatment of metastatic breast cancer were collected from the Cochrane library, PubMed, Embase, CNKI, CBM and Wanfang database using the following terms: doxorubicin, epirubicin, breast cancer, randomized controlled trials. In addition, the reference lists of relevant trials or reviews were screened. Trials that provided sufficient data on objective response rate (ORR) and/or overall survival (OS) were considered eligible for inclusion. Studies were assessed for quality. A fixed-effect model was used for Meta-analysis unless there was significant between-study heterogeneity. Meta-analysis was performed by Revman 5.3 software, with results expressed as odds ratio (OR), 95% confidence interval (CI) and P value. The other parameters were summarized by descriptive analysis. RESULTS: A total of 1221 patients from six RCTs were included for final analysis, with 614 patients in the doxorubicin group and 607 patients in the epirubicin group. The median OS was 549 d for the doxorubicin group and 480 d for the epirubicin group. The pooled risk ratio (RR) suggested that there was not statistically significant difference in the ORRs between the doxorubicin (general type and liposomal type) group and the epirubicin group for the treatment of MBC [for doxorubicin vs epirubicin, RR=1.12, 95% CI (0.99, 1.26), P=0.07; for liposomal doxorubicin vs epirubicin, RR=1.24, 95% CI (0.94, 1.62), P=0.12]; and for general doxorubicin vs epirubicin RR=1.09, 95% CI (0.96, 1.24), P=0.12); Descriptive analysis of safety showed that doxorubicin had similar incidences of hematologic toxicity and alopecia to epirubicin but was superior to epirubicin in aspect of cardiac toxicity. There was no significant heterogeneity among the included studies in most of the Meta-analyses. CONCLUSION: Epirubicin and doxorubicin are equally effective and the safety profile of the former is at least not worse than the latter in the first-line treatment of patients with metastatic breast cancer. But compared to doxorubicin, epirubicin might be a better choice for MBC patients especially those with cardiac diseases.

OBJECTIVETo determine the effect of type I transmembrane protein (IRE1alpha) deletions on the cell cycle of human periodontal ligament fibroblasts (hPDLFs) cells.

METHODSBased on the IRE1alpha deletions, a full-length model was successfully constructed. Moreover, overlapping polymerase chain reaction mutagenesis facilitated the establishment of two deletion mutants of IREla (pD-Kinase, pD-Rnase). The full-length model and two mutant eukaryotic expression vectors were transfected into hPDLFs cells. Western blot analysis was performed to identify the expression in the cells. The changes in the cell cycle of hPDLFS cells were detected by flow cytometry (FCM).

RESULTSThe two deletion mutants of IRE1alpha with eukaryotic expression vectors were successfully constructed and correctly expressed in hPDLFs cells based on Western blot analysis. Under stress conditions, the FCM assay showed that cell percentage of S phases increased, whereas that of G1 phases decreased in the IRE1alpha group (P < 0.05) compared with the control group of tunicamycin (TM) treatment. Moreover, the cell percentage of the S phases decreased, whereas that of the G1 phases increased in the D-Rnase group (P < 0.05) compared with the control. The deletion mutant D-Kinase had no influence on hPDLFS cell proliferation and cycle (P>0.05).

CONCLUSIONUnder stress conditions, IRE1alpha can improve the cell cycle of hPDLFs cells from the G1 to the S phase. The deletion mutant D-Rnase cause hPDLFs cell growth arrest at the G1 phase, whereas deletion mutant D-Kinase has no significant effect.

Cell Cycle ; Cell Proliferation ; Endoribonucleases ; Fibroblasts ; Humans ; Periodontal Ligament ; Protein-Serine-Threonine Kinases ; Transfection

Objective:To study the astragalus polysaccharides ( APS) effect on immune induced by influenza A virus HA2 eu-karyotic expression vector.Methods: The HA2 encoded by the DNA vaccine vector was efficiently expressed in CHO cells, as determined by reverse transcription polymerase chain reaction ( RT-PCR) and fluorescence analysis.60 rats were divided into six groups randomly,which were immunized with normal saline,pEGFP-N1,pHA2/EGFP+different dose of APS by intramuscular injection.The control sera were collected before injection.After injected the 36th day, sera were collected to analyzing IFN-γ, IL-4 and IgG level.Results:IFN-γ,IL-4 and IgG level of pHA2/EGFP+mAPS group was different from that of pEGFP-N1 group or pHA2/EGFP+lAPS group( P<0.05 ).Conclusion: Middle dose of APS could increase immune induced by influenza A virus HA2 eukaryotic expression vector.

Objective:To observe the intervention mechanism of phlegm-stasis co-treatment for the JNK signaling pathway in the myocardium of diabetes rats.Methods:Totally 50 male SD rats of SPF grade were selected. Diabetes model was established by single intraperitoneal injection of 55 mg/kg streptozotocin (STZ) solution. After continued feeding for 3 weeks, the rats were divided into normal group, model group, alachloramine group, blood stasis removing group, phlegm removing group and phlegm-blood stasis co-treatment group according to random number table method, with 6 rats in each group. Xiaoxianxiong Decoction (4.05 g/kg), Xuefu Zhuyu Decoction (7.02 g/kg), Didang Xianxiong Decoction (8.10 g/kg) were administered to the stomach respectively in the phlegm removing group, the blood stasis removing group and the phlegm-blood stasis co-treatment group. Alachloramine (3 mg/kg) was administered to the stomach by gavage in the alachloramine group. After 8 weeks, HE staining was used to observe the morphological changes of myocardial tissue in diabetic rats. Masson staining was used to observe the deposition of collagen fibers in the myocardial interstitium in rats. The expression of JNK1 protein was determined by immunohistochemistry. JNK1 mRNA, IRS1 mRNA and NLRP3 expression levels were detected by Real-time PCR. Western blot was used to detect the protein expressions of IRS-1, p-Akt and NLRP3.Results:The myocardial cells in the model group were disorganized, with hypertrophy, blurred texture, inflammatory infiltration of interstitium, increased collagen fibers, and focal necrosis. All treatment groups could improve fibrosis, inflammatory infiltration and reduce myocardial collagen deposition in different degrees. Compared with the model group, the mRNA and protein expressions of JNK1 and NLRP3 bodies decreased ( P<0.01), the IRS-1 mRNA and protein increased ( P<0.01), and p-Akt protein expression increased ( P<0.01). Conclusions:The phlegm and stasis co-treatment can effectively improve the cardiomyopathy of diabetes rats, and the effect is better than the phlegm-resolving method or the stasis resolving method alone. The mechanism may be related to the inhibition of JNK signaling pathway activation, reduce the expressions of JNK1 and NLRP3, and increase the IRS-1 and Akt.

OBJECTIVETo observe the influence of Xinmaitong capsule (XMT) on serum matrix metalloproteinases-9, high sensitive C-reactive protein levels in patients with acute coronary syndrome.

METHOD63 cases were divided by randomized, contrastive assigned to XMT group (n = 31) and control group (n = 32). The serum levels of MMP-9 and hs-CRP before and after treatment in 12 weeks were detected.

RESULTAfter treatment, the serum levels of MMP-9 in control group had no changed and the levels of hs-CRP reduced. The serum levels of MMP-9 and hs-CRP in XMT group had significantly decreased. The serum levels of MMP-9 and hs-CRP had positive correlation, but had no correlation to levels of serum lipids.

CONCLUSIONXMT decreased breakdown of matrix collagen, and inflammatory reaction in the patients of ACS, which may have effect on plaque stabilization.

Acute Coronary Syndrome ; blood ; drug therapy ; Aged ; C-Reactive Protein ; metabolism ; Capsules ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; Cholesterol, LDL ; blood ; Drug Combinations ; Drugs, Chinese Herbal ; isolation & purification ; therapeutic use ; Female ; Humans ; Male ; Matrix Metalloproteinase 9 ; blood ; Middle Aged ; Phytotherapy ; Plants, Medicinal ; chemistry ; Triglycerides ; blood

OBJECTIVETo analyze the embryo development potential after intracytoplasmic injection of sperm from azoospermia patients with different spermatogenic functions.

METHODSWe performed ICSI with sperm retrieved from azoospermia patients with different spermatogenic functions using percutaneous epididymal sperm aspiration (PESA) and testicular sperm aspiration (TESA). Then we recorded and analyzed the rates of normal fertilization, cleavages, excellent embryos and pregnancies.

RESULTSNo statistically significant differences were found between the PESA and TESA groups in the rates of normal fertilization ([74.9 +/- 19.6] vs [66.3 +/- 22.7]%, P > 0.05), cleavages ([96.7 +/- 8.6] vs [92.8 +/- 19.8]%, P > 0.05), excellent embryos ([43.5 +/- 26.2] vs [35.0 +/- 29.4]%, P > 0.05) and pregnancies (44.0 vs 52.0%, P > 0.05). The normal fertilization rates in the patients with normal spermatogenesis, mild spermatogenic dysfunction (SD), moderate SD and severe SD were (77.8 +/- 18.4), (68.4 +/- 18.5), (73.5 +/- 19.8) and (51.4 +/- 27.9)%, respectively, with significant difference between the normal spermatogenesis and mild SD groups (P < 0.05) as well as between the severe SD and the other groups (P < 0.05); the cleavage rates were (96.7 +/- 9.2), (96.5 +/- 15.0), (93.9 +/- 12.1) and (93.7 +/- 11.1)%, respectively, with no significant difference among the four groups; the excellent embryo rates were (47.1 +/- 25.8), (40.3 +/- 27.6), (36.2 +/- 23.1) and (15.0 +/- 24.6)%, respectively, with significant difference between the severe SD and the other groups; the pregnancy rates were 54.8, 50.0, 13.6 and 10.0%, respectively, with significant differences among the four groups (P < 0.001).

CONCLUSIONICSI by PESA or TESA is an effective approach to azoospermia. There are no significant differences between PESA and TESA in the rates of normal fertilization, cleavages, excellent embryos and pregnancies. The severity of spermatogenic dysfunction affects fertilization and initial development of embryos, which were shown in the rates of normal fertilization, excellent embryos and pregnancies but not that of cleavages.

Adult ; Azoospermia ; physiopathology ; therapy ; Embryonic Development ; Epididymis ; Female ; Humans ; Male ; Pregnancy ; Pregnancy Rate ; Sperm Injections, Intracytoplasmic ; Sperm Retrieval ; Spermatogenesis ; Young Adult

OBJECTIVETo investigate the safety and feasibility of simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis.

METHODSClinical data of 11 patients undergoing simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis in our hospital from January 2011 to October 2013 were reviewed retrospectively. Feasibility, safety and efficacy of this procedure were investigated.

RESULTSProcedure was completely successful in all the cases without conversion. The mean operation time was (284.6 ± 28.8) min and the mean blood loss was (322.7 ± 75.4) ml. The mean time to intestinal function recovery was (2.9 ± 0.7) d and the mean hospital stay was (12.3 ± 1.9) d. There were no anastomosis leakage, bile leakage, abdominal massive bleeding or infection, and liver failure after operation. During follow-up of 3-35 months, only one patient died of tumor progression.

CONCLUSIONLaparoscopic approach for colorectal carcinoma and synchronous liver metastasis is safe and feasible in selected patients.

Adult ; Aged ; Colectomy ; methods ; Colorectal Neoplasms ; pathology ; surgery ; Female ; Hepatectomy ; Humans ; Laparoscopy ; methods ; Liver Neoplasms ; secondary ; surgery ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

OBJECTIVETo prepare and identify monoclonal antibodies (mAbs) against Helicobacter pylori (Hp).

METHODSBALB/c mice were immunized with the supernatant and precipitation of cultured Hp after ultrasonication and mAbs were obtained by means of hybridoma technique. The resultant mAbs was evaluated for subtype, titer, affinity, and further identified with Lpp20, HspA, urease A, CagA, urease B, and catalase prepared by recombinant expression.

RESULTSTotally 34 hybridoma cell lines were established which secreted specific mAbs, including 31 against the supernatant and 3 against the precipitation of Hp, and the prepared mAbs showed specific reaction against Lpp20 (3 strains), HspA (2 strains), urease A (4 strains), CagA (1 strain), urease B (5 strains), and catalase (2 strains) antigens, respectively. The mAbs was all identified as immunoglobulin G1 (IgG1) and theirs titer in the culture supernatant and ascites was 1:16 to 1:32 and 1:32000 to 1:64000 respectively with affinity constants (K(aff)) ranging from 1 x 10(-10) to 5.2 x 10(-12) mol/L.

CONCLUSIONThe mAbs specially against Hp have been obtained, which may facilitate further study of detection and vaccine development of Hp.

Animals ; Antibodies, Bacterial ; biosynthesis ; immunology ; Antibodies, Monoclonal ; biosynthesis ; immunology ; Antibody Specificity ; Female ; Helicobacter pylori ; immunology ; Humans ; Hybridomas ; immunology ; Mice ; Mice, Inbred BALB C

BACKGROUNDFunctional neuroimaging has been used in neurolinguistic research on normal subjects and on patients with brain damage. This study was designed to investigate the differences of the neural basis underlying language processing between normal subjects and aphasics.

METHODSFunctional magnetic resonance imaging (fMRI) was used to map the language network in 6 normal subjects and 3 patients with aphasia who were in the stage of recovery from acute stroke. The participants performed a word generation task during multi-slice functional scanning for the measurement of signal change associated with regional neural activity induced by the task.

RESULTSIn normal subjects, a distributed language network was activated. Activations were present in the frontal, temporal, parietal and occipital regions. In the patient group, however, no activation was detected in the left inferior frontal gyrus whether the patient had a lesion in the left frontal lobe or not. Two patients showed activations in some right hemisphere regions where no activation appeared in normal subjects.

CONCLUSIONSfMRI with word generation task is feasible for evaluating language function in aphasic patients. Remote effect of focal lesion and functional redistribution or reorganisation can be found in aphasic patients.

Adult ; Aged ; Aphasia ; physiopathology ; Brain Mapping ; Cerebral Cortex ; physiology ; Humans ; Language ; Magnetic Resonance Imaging ; Male ; Middle Aged

OBJECTIVETo observe the effect of fluid shear stress on the eNOS gene expression and NO production in endothelial progenitor cells (EPCs).

METHODSThe peripheral blood mononuclear cells from healthy volunteers were inducted into EPCs and divided into stationary group (0 dyn/cm(2), 1 dyn/cm(2) = 0.1 Pa), low-flow shear stress group (5 dyn/cm(2)), medium-flow shear stress group (15 dyn/cm(2)) and high-flow shear stress group (25 dyn/cm(2)). The effects of shear stress on the endothelial nitric oxide synthase (eNOS) gene expression and nitric oxide (NO) production in human EPCs were measured.

RESULTSTypical "spindle-shaped" appearance was shown in EPCs derived from peripheral blood mononuclear cells and were positively labeled by acetylated-LDL, lectin, FLK-1 and vWF. After 4 hours treatment with various shear stresses, the ratio of eNOS/beta-actin mRNA expression by human EPCs in low, medium and high-flow shear stress group was 0.364, 0.505 and 0.548 respectively, which was significantly higher than that in stationary group (0.183, all P < 0.05) and the NO secretion in human EPCs in low, medium and high-flow shear stress group was also significantly higher than that in stationary group (all P < 0.05).

CONCLUSIONFluid shear stress enhances the eNOS mRNA expression and NO secretion in human EPCs, therefore, shear stress could potentiate the repair efficacy of EPCs for endothelial injury.

Cell Differentiation ; Cells, Cultured ; Endothelial Cells ; cytology ; metabolism ; secretion ; Humans ; Nitric Oxide ; metabolism ; Nitric Oxide Synthase Type III ; genetics ; metabolism ; Stem Cells ; cytology ; metabolism ; secretion ; Stress, Mechanical