Heteroclitin D (H.D) was successfully isolated from Kadsurae Caulis by using flash chromatography and recrystallized by methanol, 10.2 mg of H.D was obtained from 4.86 g of crude extract, and the purity determined by HPLC was 99.4%. The structure was identified by UV, IR, MS, and NMR analysis. The fast, simple and efficient method can be applied to the preparation of reference substance of H. D.

BACKGROUND:Bismth-doped iron nanoparticles modified by hyaluronic acid (HA-BiIOPs) not only act as an effective MRI contrast agent, but also as a radiotherapy sensitizer.OBJECTIVE:To fabricate the HA-BiIOPs and to observe its effect to enhance the radiosensitivity of glioblastoma cells U87MG under X-ray radiation.METHODS:HA-BiIOPs were synthesized using hydrothermal polyol method. (1) Cytotoxicity: A cytotoxicity test was carried out on U87MG cells and rat vascular smooth muscle cells (VSMCs). Cell proliferation rate of two kinds of cells cultured with different concentrations of HA-BiIOPs (0, 12.5, 25, 50, 100, 200, 400 mg/L) at 24 hours after culture were determined by cell counting kit-8 assay. (2) Histological analysis: ICR mice were sacrificed after intravenous injection of HA-BiIOPs, and pathological changes of mouse visceral organs were observed under an optical microscope. (3) Cellular uptake: The HA-BiIOPs after entered into the cytoplasm were observed by Prussian blue staining. (4) Radiosensitization test: U87MG cells at Logarithmic growth stage were cultured in culture medium as control group, subjected to X-ray irradiation (0, 3, 6, 9 Gy) as radiotherapy group, cultured in HA-BiIOPs (0, 12.5, 25, 50, 100, 200 and 400 mg/L) as HA-BiIOPs group or subjected to HA-BiIOPs culture plus X-ray irradiation as combined therapy group. Then, the cell proliferation rate and cloning efficiency were measured at 24 hours after treatment.RESULTS AND CONCLUSION:(1) The HA-BiIOPs at different concentrations were non-cytotoxic for VSMC and U87MG cells. (2) After intravenous injection of HA-BiIOPs, there was no obvious toxicity to the mouse susceptible organs. (3) After 6 hours of culture, the HA-BiIOPs could be internalized by U87MG cells. (4) The proliferation rate of U87 cells was negatively correlated with the concentration of HA-BiIOPs (0-200 mg/L) and X-ray dose (0-9 Gy). Especialy, the combination of 6 Gy X-ray irradiation with 200 mg/L HA-BiIOPs dramatically decreased the cell viability that was decreased to (41±7)%. In the combined therapy group with 6 Gy X-ray and 100 mg/L HA-BiIOPs, the cells proliferation rate was significantly lower than that in the control and radiotherapy groups (P < 0.05). These results indicate that HA-BiIOPs have a radiosensitizative effect on glioblastoma cells U87MG.

Objective To investigate the anti carcinoma role of integrin targeted photodynamic therapy (PDT) on pancreatic carcinoma cells in vitro.Methods Pancreatic carcinoma cells SW1990 were divided into four groups:cells without quantum dots (QDs) and light-treated as blank control group,pure light-treated group,photosensitizer group and PDT group.The targeting of QDs-arginine,glycine,aspartic acid (RGD) and integrin probe was confirmed by laser confocal microscopy.And as a photosensitizer for photodynamic therapy,after treated for 48 hours the morphology changes of pancreatic carcinoma cells of each group were observed.After 48 hours,the cell proliferation,apoptosis and cell cycle changes were detected by methyl thiazolyl tetrazolium (MTT) assay and flow cytometry (FCM).The expressions of myeloid cell leukemia-1 (Mcl-1),protein kinase B(Akt) and tumor necrosis factor-related apoptosis inducing ligand (TRAIL) were detected by reverse transcriptase polymerase chain reaction(RT-PCR).The amount of reactive oxygen species (ROS) of each group were evaluated by fluorescence probe.One-way ANOVA was performed for comparison between groups to analyze the treatment effects of PDT group.Results The QDs RGD probe could effectively targeting pancreatic carcinoma cells.The MTT results indicated that the relative inhibition rate of pancreatic carcinoma cells proliferation of PDT group was statistically higher than that of the other groups at 24,48,72 h (F=73.00,85.10,126.58; all P＜0.01).The FCM results revealed that the cell apoptosis rate of PDT group (17.860％ ±1.230％) was higher than that of the other groups (F=130.617,P＜0.01) and cell cycle G0/G1 phase (69.14％±2.63％) and S phase (24.41％ ± 2.67 ％) retardance was also significant (all P＜0.05).The expression of proliferation and apoptosis related gene Mcl-1 and Akt at mRNA level was lower than that of the other groups however the expression of apoptosis-inducing ligand TRAIL at mRNA level was higher than that of the other groups (F=567.456,446.817,145.238; all P＜0.05).The ROS level of PDT group was higher than that of the other groups (F=3262.559,P＜0.01).Conclusion PDT with a QDs-RGD probe could significantly inhibit pancreatic carcinoma cell proliferation and promote cell apoptosis.

Objective:To investigate the clinical and pathogenic characteristics of community acquired pyogenic liver abscess (PLA).Methods:The clinical data of 172 patients in First Affiliated Hospital of Soochow University with community acquired PLA from March 2013 to September 2018 were retrospectively collected, including clinical characteristics, distribution of the causative pathogens, treatment regimens and outcomes. Chi-square test was used for statistical analysis.Results:There were 158(91.9%) cases with fever, 69(40.1%) cases with abdominal pain among 172 PLA cases. One hundred and forty-three (83.1%) were solitary, and 141(82.0%) cases localized in right hepatic lobe. One hundred and six (61.6%) cases were PLA of cryptogenic origin. There were 156 cases underwent etiology detection, with the positive etiology detection of 99(63.5%) cases. Ninety-two (92.9%) cases were infected with a single strain, and seven (7.1%) cases were infected with mixed strains. A total of 115 strains of bacteria were isolated. The main strains included 71 (61.7%) Klebsiella pneumoniae (KP), 21 (18.3%) Escherichia coli (EC), among which 17 were extended spectrum β lactamase, and two carbapenem-resistant Enterobacteriaceae. Among the 61 KP-PLA patients, 42(68.9%) cases were diagnosed with diabetes, 16(26.2%) cases with biliary diseases, and one (1.6%) case with malignant tumor. Among the 15 EC-PLA patients, six cases were diagnosed with diabetes, nine cases with biliary diseases, and four cases with malignant tumors. There were statistically significant differences ( χ2=4.307, 4.784 and 8.536, respectively, all P<0.05). After admission, the patients were treated with antibiotics alone or combined with drainage. One-hundred and sixty-seven (97.1%) cases got improved. Conclusions:The clinical manifestations of PLA are atypical, and the dominant pathogens are KP and EC. The risk factors of PLA are diabetes mellitus, biliary diseases and malignant tumors.

Objective To investigate the relationship between aggressive trait of patients,patient-physician trust and illness perception. Methods Totally 500 patients were recruited from different medical departments from eight hospitals in Guangdong and 384 samples' valid data were obtained. The aggressive trait of patients,patient-physician trust and illness perception were assessed with the Buss-Perry aggression questionnaire( BPAQ), the Wake Forest physician trust scale ( WFPTS), and the brief illness perception questionnaire(BIPQ) respectively. SPSS 23. 0 and AMOS 20. 0 were used for data analysis and structural e-quation model construction. Results Pearson correlation analysis showed that the BPAQ (53. 2±13. 9) and BIPQ(38. 6±9. 1) were negatively correlated respectively with WFPTS (35. 3±6. 1) and benevolence (17. 6 ±3. 2) and technical competence (17. 8±3. 3),(r=-0. 14~-0. 18,P<0. 01). And there was positive corre-lation between BPAQ scores and BIPQ score(r=0. 37,P<0. 01). Mediation effect test showed that patient-physician trust mediated the associations between patient aggression and illness perception (B=0. 039,95% CI= (0. 002,0. 120)). Conclusion Aggressive trait and patient-physician are significantly related with ill-ness perception. Patient-physician trust exerts mediating effect on the relationship between aggression of pa-tients and illness perception.

Objective To evaluate the efficacy, safety and the prognosis of rituximab combined with CHOP (R-CHOP) or combined with EPOCH (R-EPOCH) regimen in treatment of newly diagnosed myc/bcl-2 double-expression diffuse large B-cell lymphoma (DLBCL). Methods The clinical efficacy, adverse reactions and survival of 16 DLBCL patients who received R-CHOP regimen with double-expression and 15 DLBCL patients who received R-EPOCH regimen with double-expression between August 2014 and December 2017 in the First Affiliated Hospital of Zhengzhou University were retrospectively analyzed, and all patients with double or triple-hit lymphoma were excluded. Results The ratio of the International Prognostic Index (IPI) score ≥3 in R-EPOCH group was higher than that in R-CHOP group [10 cases vs. 5 cases, χ2＝ 3.888, P＝0.049]. There were no statistical differences in other clinical data of both groups. Complete remission (CR) was achieved in 75% (12/16) of R-CHOP group and 67% (10/15) of R-EPOCH group, and there was no statistical difference between the two groups (χ2＝ 0.013, P＝ 0.908). The incidence of grade 3-4 leukopenia and grade 3-4 thrombocytopenia in R-EPOCH group was higher than that in R-CHOP group, and the difference was statistically significant [93% (14/15) vs. 38% (6/16), χ 2＝ 10.542, P＝ 0.01; 73% (11/15) vs. 6% (1/16), χ 2＝ 14.685, P< 0.01]. The 1-year overall survival (OS) rate and progression-free survival (PFS) rate was 86.5% and 81.3% in R-CHOP group, 76.0% and 51.4% in R-EPOCH group. There was no statistical difference in the 1-year OS rate between the two groups (P＞0.05), and the 1-year PFS rate in R-CHOP group was higher than that in R-EPOCH group (P<0.01). The 1-year OS rate and PFS rate was 100.0% and 93.8% in IPI<3 group, 65.5% and 45.0% in IPI≥3 group. The 1-year OS rate and PFS rate in IPI<3 group were superior to those in IPI≥3 group (all P ＞0.01). The 1-year OS rate and PFS rate of the female group were lower than those of the male group (59.6% vs. 100.0%, 44.2% vs. 86.3%), and there were statistical differences (all P<0.01). Cox regression analysis showed that high IPI score was an independent prognostic factor for all patients ( HR＝6.335, 95% CI 0.740-54.261, P＝0.092). Conclusions R-EPOCH and R-CHOP are the ideal treatment methods for the double-expression lymphoma. Both regimens have similarities in the treatment outcome of myc/bcl-2 double-expression DLBCL. The adverse reactions in R-EPOCH group are severer than those in R-CHOP group.

Objective:To analyze the global incidence and mortality of cancer from 1990 to 2019.Methods:The Global Burden of Disease Study 2019 (GBD2019) database was utilized to analyze the global incidence and mortality of cancer, the order of incidence and mortality of cancer, the incidence and mortality of different age groups, and the trend of incidence and mortality from 1990 to 2019. Standardized incidence and mortality rates were derived by utilizing the world standard population age structure.Results:In 1990, global cancer cases numbered 10.295 9 million with an incidence rate of 192.45/100 000, leading to 5.732 6 million deaths and a mortality rate of 107.16/100 000. While in 2019, global cancer cases escalated to 23.568 5 million with an incidence rate of 304.60/100 000, resulting in 10.022 8 million deaths and a mortality rate of 129.54/100 000, all higher than those in 1990. In 2019, lung cancer showed the highest incidence rate of both sexes combined in the world (29.21/100 000), followed by colorectal cancer, breast cancer, prostate cancer and gastric cancer. The incidence of lung cancer was highest among males (39.24/100 000), while the incidence of breast cancer was highest among females (51.27/100 000). Lung cancer also had the highest mortality rate worldwide in both sexes combined (26.40/100 000), followed by colorectal cancer, gastric cancer, breast cancer and pancreatic cancer. Lung cancer had the highest mortality among males (35.72/100 000), while breast cancer had the highest mortality among females (17.85/100 000). In 2019, the global cancer incidence rate showed an upward trend with age. The incidence rate was low before the age of 25, and increased rapidly after the age of 25. The incidence rates of both sexes combined, males and females all reached the peak in the age group of over 85 years old, which were 3 084.18/100 000, 4 434.81/100 000 and 2 353.07/100 000 respectively; The incidence rate of females in the age group of 20-50 years old was higher than that of males, but the incidence rate of males in the age group of over 55 years old was higher than that of females. Compared with 1990, the incidence rates of both sexes combined in the age group of over 20, of males over 55 years old, as well as of females over 15 years old, were all higher than those in 2019. In 2019, the global tumor mortality rate showed an upward trend with age. The mortality rate was relatively low before the age of 35, and increased rapidly after the age of 35. The mortality rates for both sexes combined, as well as for males and females, reached the peak in the age group of over 85 years old, which were 1 787.84/100 000, 2 509.87/100 000, and 1 369.99/100 000 respectively; The mortality rate of females in the age group of 20-40 years old was higher than that of males, and the mortality rate of males in the age group of over 45 years old was higher than that of females; For the age of 0-80 years old, the mortality rates for both sexes combined, males, and females were lower in 2019 than 1990, but higher in the age of 85 years old and above. The global standardized incidence rate of cancer showed an overall upward trend, with an average annual increase of 0.30% from 1990 to 2019. The global standardized mortality rate of cancer showed an overall downward trend, with an average annual decrease of 0.60% from 1990 to 2019.Conclusion:From 1990 to 2019, the global standardized incidence rate of cancers shows an overall upward trend, while the global standardized mortality rate of cancers has an overall downward trend, and the global incidence and mortality rate of cancers increases with age. The global burden of cancer disease is still heavy. Lung cancer is the cancer with the highest incidence and mortality rate in the world. The highest incidence rate is lung cancer among males, and breast cancer among females. Different countries or regions need to take corresponding cancer prevention and treatment strategies according to their actual conditions.

OBJECTIVETo investigate the antineoplastic effects of 2-Deoxy-D-glucose (2-DG) combined with Taxol on orthotopically transplanted breast cancer in C3H mice and explore the mechanism.

METHODSC3H mice bearing orthotopically transplanted breast cancer xenograft were randomly divided into 4 groups, namely the control group, 2-DG group, Taxol group, and 2-DG+Taxol group. The corresponding drugs were administered intraperitoneally every 3 days for 18 consecutive days, and the tumor volume was measured every 3 days to draw the tumor growth curve. The mice were then sacrificed to measure the tumor weight on day 19 and examine tumor cell apoptosis with TUNEL assay and VEGF expression using immunohistochemistry.

RESULTS2-DG combined with Taxol obviously suppressed the tumor growth with a tumor inhibition rate of 66.06% as compared to the rate of 36.97% in Taxol group. The combined treatment also caused more obvious cell apoptosis and significantly reduced VEGF expression in the tumor cells as compared with the other groups.

CONCLUSION2-DG can enhance the inhibitory effect of Taxol on orthotopically transplanted breast cancer xenograft in C3H mice probably by inducing tumor cell apoptosis and lowering VEGF expressions.

Animals ; Antineoplastic Agents ; pharmacology ; therapeutic use ; Apoptosis ; Breast Neoplasms ; drug therapy ; pathology ; Cell Line, Tumor ; Deoxyglucose ; pharmacology ; therapeutic use ; Drug Synergism ; Female ; Mice ; Mice, Inbred C3H ; Paclitaxel ; pharmacology ; therapeutic use ; Vascular Endothelial Growth Factor A ; metabolism ; Xenograft Model Antitumor Assays

Objective:To evaluate the diagnostic value of the von Willebrand factor (vWF) GPIb activity to antigen ratio for thrombotic thrombocytopenic purpura (TTP) at acute phase.Methods:A cohort of 93 patients with suspected TTP and admited to our hospitalfrom January 2018 to December 2019 were prospectively enrolled, we analyzed the levels of vWF: GPIb activity and vWF antigen at acute phase, the diagnosis of acquired TTP was defined as ADAMTS13 activity<10%.The PLASMIC score and final diagnosis of included patients were recorded.Results:Twenty-twopatients were diagnosed as TTP, the median (interquartile range) of ADAMTS13 activity were 1.0% (0-7.4%), other diagnoses included hemolytic uremic syndrome (HUS, n=8), severe infection ( n=21), malignancy( n=3), connective tissue disease( n=8), et al. The vWF: GPIb activity, vWF antigen, and ratio of vWF: GPIb activity to antigen were all significantly lower in patients with TTP than in those without ( P<0.05). The ratio of vWF: GPIb activity to vWF antigen <0.75 could yield a sensitivityof 81.8% and a specificity of 95.2% respectively for TTP. In patients with PLASMIC score≥6, 88.9% patients with the ratio of vWF: GPIb activity to vWF antigen <0.75 were confirmed as TTP, and 15.4% patients with the ratio≥0.75 were confirmed as TTP. Conclusions:The ratio of vWF: GPIb activity to vWF antigen based on automaticassays might be useful for differential diagnosis and stratification of TTP at acute phase, especially when the ADAMTS13 assay is not available in time.

Objective:In order to investigate the genetic diversity of mitochondrial cytochrome b (Cytb) gene of Taenia asiatica ( T. asiatica) in Dali Bai Autonomous Prefecture (Dali Prefecture), Yunnan Province. Methods:From May 2019 to August 2021, a total of 131 samples of Taenia were collected from patients admitted to the Dali Prefecture Institute of Schistosomiasis Control, involving five locations (i.e., five groups), including Dali City (58 samples), Weishan Yi and Hui Autonomous County (Weishan County, 14 samples), Midu County (18 samples), Yangbi Yi Autonomous County (Yangbi County, 24 samples) and Eryuan County (17 samples). Primers were designed based on mitochondrial Cytb gene sequence, and part of the Cytb gene sequence was amplified by PCR, then sequenced and homology comparisons were performed. MEGA 7.0 and DNASP 5.10.01 were used to analyze the measured sequence, and data such as base composition, genetic distance, genetic diversity parameters, genetic differentiation index and gene flow were obtained. Results:The amplified fragments of Cytb gene in 131 samples of Taenia were 235 bp. After homology comparisons, they were all T. asiatica. The average contents of A, T, G and C bases were 23.8%, 42.3%, 24.0% and 9.9%, respectively. Of the 131 samples of T. asiatica, 12 haplotypes were defined. The haplotype diversity and nucleic acid diversity were 0.295 9 and 0.006 0, respectively. The ranges of genetic differentiation index and gene flow among the five groups were-0.053 00 to 0.050 40 and 4.710 31 to 162.087 66, respectively. The genetic distance between the five groups ranged from 0.003 5 to 0.009 0, of which the genetic distance between Midu County and Weishan County was the largest, and the genetic distance between Dali City and Yangbi County was the smallest. Conclusions:The mitochondrial Cytb gene of T. asiatica in Dali Prefecture has rich genetic diversity. There is frequent gene exchange among the five groups, and no significant genetic differentiation has been formed.