AIM: To discover more active and water-soluble derivatives of tetracyclic diterpenoids containing an exo-methylene cyclopentanone or an α-methylenelactone moiety. METHODS: All of the key intermediates were synthesized from stevioside, and the target compounds were obtained through glycosylation of the 4-carboxyl group. The cytotoxicity of the target compounds against six human cancer cell lines, HepG2, Bel-7402, A549, U251, MCF-7 and MDA-MB-231, were evaluated by the MTT assay. RESULTS: Compound 1b was more effective than the positive control adriamycin against the HepG2, Bel-7402, A549, MCF-7, and MDA-MB-231 cell lines with IC50 values of 0.12, 0.91, 0.35, 0.08, and 0.07 μmol·L(-1), respectively. Moreover, compound 3c exhibited the most potent and selective cytotoxic activity against the HepG2 cell line (IC50, 0.01 μmol·L(-1)). CONCLUSION Compounds 1b and 3c could be considered as potential anticancer candidates for further study.
Antineoplastic Agents ; chemistry ; toxicity ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Diterpenes, Kaurane ; chemistry ; toxicity ; Drug Evaluation, Preclinical ; Glycosylation ; Humans ; Molecular Structure

Objective To explore the clinical effect of high intensity focused ultrasound(HIFU)combined with transcatheter arterial chemoembolization(TACE)in the treatment of primary liver cancer.Methods A total of 106 patients with primary liver cancer were divided into two groups:50 cases were treated with TACE,and the other 56 were treated with combination of HIFU and TACE.The changes of AFP levels and the size of tumors after three months treatment were analyzed and compared with each other.The survival rates for one,two and three years were calculated with Kaplan-Meier method and compared between the two groups.Results In the two groups,AFP decreased significantly after treatment,but the combined group was superior to the other in AFP decrease.In the combined group,the 1-,2-and 3-year survival rates were higher than those in the TACE group with 82.3%,60.8%and 39.2% vs 68.0%,42.6%and 21.0%respectively(P＜0.01).No serious complications were seen,such as burn of skin,bleeding,gastrointestinal perforation. Conclusion The use of HIFU combined with TACE in the treatment of patients with primary liver cancers is feasible and safe.The combined group is superior to simple TACE for the management of primary liver cancers,and the former is more effective in decreasing AFP level and improving survival rates.

Objective To compare the prophylactic efficacy of combination of ganciclovir and acy- clovir or acyclovir alone against cytomegalovirus pneumonia in renal transplant recipients.Methods A to- tal of 217 renal transplant recipient(124 men and 93 women;mean age,32 years;age range,16-72 years) were divided into 3 groups randomly.In 51 cases,acyclovir was taken orally at a dose of 400 mg,3/d,from the third d to 3 months after transplantation.In 74 cases,ganciclovir was administered at a dose of 250 mg/d intravenously from the 21st d to 27th d to replace Acyclovir.In 92 cases,no prophylaxis against eytomegalov- irus pneumonia was performed.All patients were followed 3 months after transplantation.Comparison of the incidence rates of cytomegalovirus pneumonia among the 3 groups was performed using Fisher's exact test. Results Cytomegalovirus pneumonia developed in 20 cases in the 3 groups,including 4 cases(5.4%) in combined use group,2 cases(3.9%)in acyclovir alone group,and 14 cases(15.2%)in control group. Significant difference existed between the 2 experimental and control groups(P＜0.05).However,no signifi- cant difference existed between the 2 experimental groups(P＞0.05).Of the 20 cases,17(85.0%)were cured,and 3 died of respiratory failure.Conclusions Ganciclovir and acyclovir have prophylactic effect a- gainst cytomegalovirus pneumonia in renal transplant recipients.These 2 medications are inexpensive,and the patients have good compliance.

Objective:To investigate the efficacy of alveolar lavage combined with montelukast in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and its effect on oxidative stress and inflammatory factors in patients.Methods:A prospective study was conducted involving 90 patients with AECOPD who were admitted to the Intensive Care Unit of Shan County Central Hospital from December 2021 to December 2022. The patients were randomly divided into a control group and an observation group, with 45 patients in each group, using the random number table method. The control group received conventional treatment, while the observation group was additionally treated with alveolar lavage combined with montelukast. Symptom score, Acute Physiology and Chronic Health Evaluation II score, overall response rate, serum levels of oxidative stress markers (malondialdehyde, 4-hydroxynonenal, and superoxide dismutase), and serum levels of inflammatory factors (C-reactive protein, tumor necrosis factor-α, interleukin-6, and procalcitonin) were compared between the two groups before and after treatment.Results:After treatment, the symptom scores for both groups decreased significantly compared with their respective scores before treatment ( t = 6.68, 11.32, both P < 0.05). After treatment, the symptom score in the observation group was significantly lower than that in the control group [(8.69 ± 0.84) points vs. (15.39 ± 1.18) points, t = 8.75, P < 0.05]. After treatment, the Acute Physiology and Chronic Health Evaluation II score in the observation group was significantly lower than that in the control group ( t = 9.19, P < 0.05). The overall response rate in the observation group was significantly higher than that in the control group [93.33% (42/45) vs. 75.56% (34/45), t = 4.56, P < 0.05]. After treatment, serum levels of 4-hydroxynonenal and malondialdehyde in the observation group were significantly lower than those in the control group ( t = 4.20, 5.15, both P < 0.05), while serum level of superoxide dismutase in the observation group was significantly higher than that in the control group ( t = 5.23, P < 0.05). After treatment, serum levels of C-reactive protein, tumor necrosis factor-α, interleukin-6, and procalcitonin in the observation group were significantly lower than those in the control group ( t = 6.86, 5.60, 8.75, 4.89, all P < 0.05). Conclusion:Alveolar lavage combined with montelukast can reduce clinical symptoms in patients with AECOPD, promote recovery, enhances clinical efficacy, decreases oxidative stress responses, increases the body's antioxidant capacity, lowers the expression of inflammatory factors, and reduces inflammatory responses.

OBJECTIVETo study the pathogen distribution and risk factors of nosocomial infection in very preterm infants, as well as the risk of adverse outcomes.

METHODSA retrospective analysis was performed for the clinical data of 111 very preterm infants who were born between January and December, 2016 and had a gestational age of <32 weeks and a birth weight of <1 500 g. According to the presence or absence of nosocomial infection after 72 hours of hospitalization, the infants were divided into infection group and non-infection group. The infection group was analyzed in terms of pathogenic bacteria which caused infection and their drug sensitivity. A multivariate logistic regression analysis was used to investigate the potential risk factors and risk of adverse outcomes of nosocomial infection in very preterm infants.

RESULTSGram-negative bacteria were the main pathogens for nosocomial infection in very preterm infants and accounted for 54%, among which Pseudomonas aeruginosa was the most common one; the following pathogens were fungi (41%), among which Candida albicans was the most common one. The drug sensitivity test showed that Gram-negative bacteria were highly resistant to β-lactam and carbapenems and highly sensitive to quinolones, while fungi had low sensitivity to itraconazole and high sensitivity to 5-fluorocytosine and amphotericin B. Early-onset sepsis, duration of peripherally inserted central catheter, steroid exposure, and duration of parenteral nutrition were risk factors for nosocomial infection in very preterm infants (P<0.05). Compared with the non-infection group, the infection group had significantly higher risks of pulmonary complications (P<0.05), as well as a significantly longer length of hospital stay and a significantly higher hospital cost (P<0.001).

CONCLUSIONSNosocomial infection in very preterm infants is affected by various factors and may increase the risk of adverse outcomes. In clinical practice, reasonable preventive and treatment measures should be taken with reference to drug sensitivity, in order to improve the prognosis of very premature infants.

Cross Infection ; epidemiology ; etiology ; microbiology ; Female ; Gram-Negative Bacteria ; drug effects ; isolation & purification ; Health Care Costs ; Humans ; Infant, Newborn ; Infant, Premature ; Length of Stay ; Logistic Models ; Male ; Microbial Sensitivity Tests ; Retrospective Studies ; Risk Factors

OBJECTIVETo investigate the changes of GABA-activated currents in isolated dorsal root ganglion neurons in rats with neuropathic pain.

METHODSThe neuropathic pain model was established by chronic constriction injury (CCI) 7 days before electrophysiological-recording. The rat DRG neurons were enzymatically dissociated. Whole-cell patch clamp technique was used to record GABA-activated currents. The changes of currents of injured side and opposite side were expected to compare with control group.

RESULTS(1) The currents of injured side of CCI group were notablely decreased compared with control group (GABA concentration, 0.1-1000 micromol/L). (2) By the contrast, opposite side currents of CCI group increased significantly compared with those in injured side and control group (GABA concentration, 0.01-1000 micromol/L).

CONCLUSIONThe data indicates that the chronic constriction injury change both the function of GABAA receptors of injury side and opposite side. The decrease of pre-synaptic inhibition of GABA may be the possible reason of neuropathic pain.

Animals ; Cell Separation ; Constriction ; Ganglia, Spinal ; pathology ; physiopathology ; Male ; Neuralgia ; etiology ; physiopathology ; Neurons ; metabolism ; physiology ; Patch-Clamp Techniques ; Rats ; Rats, Sprague-Dawley ; Receptors, GABA-A ; metabolism ; physiology ; Sciatic Nerve ; injuries

In view of gemcitabine resistance has limited clinical activity of gemcitabine as a cellulotoxic drug in pancreatic cancer patients, this study is designed to investigate the effect of emodin on the sensitivity of pancreatic cancer to gemcitabine as well as its mechanism. After gemcitabine-resistant pancreatic cancer cell line (SW1990/GZ) was established by escalating doses of gemcitabine serially in pancreatic cancer cell line (SW1990). The cellular proliferation was detected by cell counting kit-8 (CCK-8) assay. Flow cytometry (FCM) was used to determine apoptosis of pancreatic cancer cells. The activity of NF-kappaB in pancreatic cancer cells was measured by electrophoretic mobility shift assay (EMSA). Western blotting was used to detect the protein expression of Bcl-2 and Survivin in SW1990/GZ cells. Metastatic model simulating human pancreatic cancer was established by orthotopic implantation of histologically intact human tumor tissue into pancreatic wall of nude mice. Also, immunohistochemistry was used to detect the positive expression of Ki-67, NF-kappaB, Bcl-2 and Survivin in the tumors. The results show that pretreatment of cells with emodin followed by gemcitabine induced a higher percentage of growth inhibition and apoptosis of pancreatic cancer cells than that of gemcitabine alone. In addition to in vitro results, emodin in combination with gemcitabine is much more effective as an antitumor agent compared to either agent alone in the orthotopic tumor model. Further study showed that the emodin with or without gemcitabine significantly down-regulates NF-kappaB and its regulated molecules such as Bcl-2 and Survivin proteins both in vitro and in vivo. It is concluded that inactivation of NF-kappaB signaling pathway by emodin resulting in the chemosensitization of pancreatic cancer to gemcitabine, which is likely to be an important and novel strategy for the treatment of pancreatic cancer.
Animals ; Antimetabolites, Antineoplastic ; pharmacology ; Apoptosis ; drug effects ; Cell Line, Tumor ; Cell Proliferation ; drug effects ; Deoxycytidine ; analogs & derivatives ; pharmacology ; Drug Resistance, Neoplasm ; Emodin ; pharmacology ; Female ; Humans ; Inhibitor of Apoptosis Proteins ; metabolism ; Ki-67 Antigen ; metabolism ; Mice ; Mice, Inbred BALB C ; Mice, Nude ; NF-kappa B ; metabolism ; Neoplasm Transplantation ; Pancreatic Neoplasms ; metabolism ; pathology ; Proto-Oncogene Proteins ; metabolism ; Proto-Oncogene Proteins c-bcl-2 ; Repressor Proteins ; metabolism ; Tumor Burden ; drug effects

The aim of the present study was to investigate the effect of 18β-glycyrrhetinic acid (18βGA) on the membrane current of vascular smooth muscle cells (VSMCs) in arteriole. Guinea pig anterior inferior cerebellar artery (AICA) and mesenteric artery (MA) were isolated, and single VSMCs were harvested using digestion with papain and collagenase IA. Outward currents of the VSMCs were recorded by whole-cell patch clamp technique. Results were shown as below: (1) 1 mmol/L 4-AP and 1 mmol/L TEA both could partially inhibit the whole-cell current of VSMCs in arterioles. (2) 18βGA inhibited the outward current of VSMCs in a concentration-dependent manner. The inhibitory rates of 10, 30 and 100 μmol/L 18βGA on the membrane current of VSMCs (+40 mV) were (25.3 ± 7.1)%, (43.1 ± 10.4)% and (68.4 ± 3.9)% respectively in AICA, and (13.2 ± 5.6)%, (34.2 ± 4.0)% and (59.3 ± 7.3)% respectively in MA. There was no significant difference between the inhibitory effects of 18βGA on AICA and MA. 18βGA also inhibited the outward current of VSMCs in a voltage-dependent manner. 18βGA induced a more pronounced inhibition of the outward current from 0 to +40 mV, especially at +40 mV. (3) With the pretreatment of 10 mmol/L TEA, the inhibitory effect of 18βGA on the membrane current of VSMCs was significantly abolished. These results suggest that the outward current of VSMCs in arterioles is mediated by voltage-dependent K(+) channels (K(v)) and big conductance calcium-activated K(+) channels (BK(Ca)), which can be inhibited by 18βGA in concentration- and voltage-dependent way.
Animals ; Arterioles ; physiology ; Cerebellum ; blood supply ; Female ; Gap Junctions ; physiology ; Glycyrrhetinic Acid ; analogs & derivatives ; pharmacology ; Guinea Pigs ; In Vitro Techniques ; Male ; Membrane Potentials ; drug effects ; Mesenteric Arteries ; cytology ; physiology ; Muscle, Smooth, Vascular ; cytology ; physiology ; Myocytes, Smooth Muscle ; physiology ; Patch-Clamp Techniques ; Potassium Channels, Calcium-Activated ; physiology ; Potassium Channels, Voltage-Gated ; physiology

The aim of the present study was to investigate the effects of acute hypoxia on the electrophysiological properties of vascular smooth muscle cells (VSMCs) in arteriole. Guinea-pig anterior inferior cerebellar artery (AICA) segments were isolated, and outer layer connective tissue was removed by collagenase A digestion and microforceps. By perfusion with physical saline solution containing no glucose and low oxygen, VSMC model of acute hypoxia was established. The model was studied by whole-cell patch clamp recording technique. Results were shown as below: (1) Acute hypoxia induced an outward current with amplitude of (36.4 ± 9.2) pA at holding potential of -40 mV, and the rest potential (RP) of the VSMCs was hyperpolarized from (-33.2 ± 1.9) mV to (-38.4 ± 1.5) mV. Acute hypoxia increased the outward current of VSMCs in a voltage-dependent manner, this enhancing effect being more pronounced at potentials ranging from 0 to +40 mV. The whole-cell membrane current of VSMCs induced by step command (+40 mV) increased from (650 ± 113) pA to (1 900 ± 197) pA. In the presence of 1 mmol/L tetraethylammonium (TEA), the enhancement of the VSMC membrane current by acute hypoxia was significantly reduced. (2) Acute hypoxia increased the membrane resistance (R(input)) of the VSMCs in AICA from (234 ± 63) MΩ to (1 211 ± 201) MΩ, and decreased the membrane capacitance (C(input)) from (279.3 ± 83.2) pF to (25.4 ± 1.9) pF. In the presence of 30 μmol/L 18β-glycyrrhetinic acid (18βGA) and 10 mmol/L TEA, the effects of acute hypoxia on the membrane current of VSMCs were nearly abolished. These results suggest that acute hypoxia causes vascular hyperpolarization and vasodilation, possibly by activating big conductance Ca(2+)-activated K(+) channels (BK(Ca)) of the VSMCs, and inhibits gap junctions between VSMCs, thus improving microcirculation and localizing the hypoxia-induced damage.
Animals ; Arteries ; physiopathology ; Cerebellum ; blood supply ; Female ; Gap Junctions ; metabolism ; physiology ; Guinea Pigs ; Hypoxia ; physiopathology ; In Vitro Techniques ; Male ; Muscle, Smooth, Vascular ; cytology ; metabolism ; physiology ; Myocytes, Smooth Muscle ; metabolism ; physiology ; Patch-Clamp Techniques ; Potassium Channels ; physiology

Objective To investigate the possible mechanism of lycopene on protecting against hypoxia/reoxygenation (H/R)-injury.Methods Primary cultured cardiomyocytes,isolated from neonatal mouse,were divided into three groups randomly:control group(C) ; H/R group(4 h H followed by 8 h R) ;lycopene + H/R group(L + H/R),in which the cardiomyocytes were pretreated with lycopene for 4 h before H/R.The survival of cardiomyocytes was counted.Apoptotic cells were detected by TUNEL assays.The release of cytochrome c from mitochondrial matrix into the cytosol,the activity of caspase-3,intracellular ROS levels and the activity of calpain were also determined in these groups respectively at the same time.Results The pretreatment of cardiomyocytes with lycopene significantly improved the survival of cardiomyocytes [C:(89.84 ± 5.15) ％,H/R:(63.59 ± 5.11) ％,L + H/R:(79.25 ± 1.48) ％,P ＜0.05] and reduced the extent of apoptosis [C:(10.37 ± 1.25) ％,H/R:(32.03 ± 4.79) ％,L + H/R:(22.57 ± 3.22) ％,P ＜ 0.05],significantly reduced caspase-3 activation [C:(2.61 ± 0.19),H/R:(5.82±0.92),L + H/R:(3.74 ±0.64) pNA pmol/μg protein,P ＜0.05].To further study the mechanism underlying the benefits of lycopene,interactions between lycopene and calpain activation were examined.Lycopene pretreatment of cardiomyocytes suppressed the activation of calpain (C:272.33 ±300.46,H/R:1156.00 ± 212.02,L + H/R:607.33 ± 166.23,P ＜ 0.05) by reducing the H/R induced increased intracellular ROS levels [C:100％,H/R:(239.79 ± 27.27)％,L + H/R:(188.19 ±17.63) ％,P ＜ 0.05].Conclusion Lycopene may protect against hypoxia/reoxygenation-induced injury by preventing calpain activation.