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.

Objective To evaluate the efficacy of bisphosphonate thera-pies regarding the treatment of vertebraland non vertebral-non hip frac-tures in postmenopausal women with osteoporosis.Methods We searched systematic reviews on the databases in Cochrane Library , PubMed, SCI, CNKI, VIP, CBM and Wangfang database, as well as hand searching.The reviews were identified with a systematic literature search.Then the data were extracted by standardized forms, and the methodological qualities of the reviews were assessed by the AMSTAR tool.The endpoints of interest were vertebral and non -vertebral frac-tures.The Meta-analysis was evaluated by RevMan 5.3 software.Re-sults of all reviews were analyzed byindirect comparison.Results A to-tal of 12 systematic reviews were included.There were six bisphopho-nates in these reviews ( including alendronate, ibandrinate, etidronate, risedronate, pamidronate, and zoledronic acid).All the reviews were in high quality.The results of Meta-analysis showed that there was statisti-cally significant by five bisphosphonates, expect for pamidronate.So there were five bisphosphonates ( alendronate, ibandrinate, etidronate, risedronate, and zoledronic acid ) analyzed with indirect comparion.In vertebral fractures of all bisphophonates compared, zoledronic acidshowed a relative risk ( RR ) of 0.49 relative to placebo, and RRs were 0.49, 0.53, 0.51, 0.74 relative to risedronate, ibandronate, alendronate, etidronate.Regarding non-vertebral fractures, RRs of zoledronic acid relative to placebo, risedronate, alendronate, ibandronate, etidronate were 0.72, 0.71, 0.87, 0.89, and 0.90, respectively.Risedronate showed the greatest reduction in any fractures, followed by zoledronic acid.Conclusion In summary, zoledronic acid has the best effectiveness on the treatment of osteoporosis among the five bisphosphonate.

AIM To investigate the protective effects of Didang Decoction-containing serum on rat glomerular endothelial cells(RGECs)following high glucose injury.METHODS Rats were given distilled water or Didang Decoction by gavage to prepare the blank serum or Didang Decoction-containing serum.CCK8 method was used to screen the glucose concentration for the modeling and serum concentration of the drug.The RGECs were divided into the blank group,the model group,Didang Decoction group(10%Didang Decoction medicated serum),Dapagliflozin group(normal serum+2 μmol/L Dapagliflozin)and Didang Decoction+Dapagliflozin group(10%Didang Decoction medicated serum+2 μmol/L Dapagliflozin).24 hrs after the drug treatment,the RGECs had their mRNA and protein expressions of Nrf2,HO-1 and NQO-1 detected by RT-qPCR method and Western blot method;their Nrf2 fluorescence expression detected by immunofluorescence method;and their SOD activity and MDA level detected by colorimetric method.RESULTS Compared with the blank group,the model group displayed decreased mRNA and protein expressions of Nrf2,HO-1 and NQO-1 as well as the activity of SOD(P＜0.01),and increased MDA level(P＜0.01).Compared with the model group,the groups intervened with the drugs showed increased mRNA and protein expressions of Nrf2,HO-1 and NQO-1 as well as the activity of SOD(P＜0.05,P＜0.01),and decreased MDA level(P＜0.01).CONCLUSION Didang Decoction-containing serum can protect RGECs from high glucose injury through activating the Nrf2 signaling pathway.

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

Objective To investigate the safety and feasibility of simultaneous laparoscopic resection of colorectal carcinoma and synchronous liver metastasis. Methods Clinical 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. Results Procedure 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. Conclusion Laparoscopic approach for colorectal carcinoma and synchronous liver metastasis is safe and feasible in selected patients.

Objective To determine the effect of type Ⅰ transmembrane protein (IRE1α) deletions on the cell cycle of human periodontal ligament fibroblasts (hPDLFs) cells. Methods Based on the IRE1α deletions, a full-length model was successfully constructed. Moreover, overlapping polymerase chain reaction mutagenesis facilitated the establishment of two deletion mutants of IRE1α (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). Results The two deletion mutants of IRE1α 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 IRE1α 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). Conclusion Under stress conditions, IRE1α 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.