BACKGROUNDTo compare the therapeutic effect, adverse reaction and effect on immunity of chemotherapy combined Aidi injection (AI) with those of chemotherapy alone in the treatment of advanced non small cell lung cancer (NSCLC).

METHODSNinety eight cases of advanced NSCLC were randomly divided into two groups, trial group and control group. In the trial group, NP plus AI (60 80 ml) were given intravenously by dissolving in 400 ml of normal saline per day for 8-10 days, while in the control group, only NP chemotherapy was given. Navelbine (25 mg/m², d1, 8) and cisplastin (40 mg/m², d1-3) were chosen in the chemotherapy. Each patient received at least two cycles of treatment.

RESULTSThe effective rate in the trial group and the control group was 53.1% and 44.9% respectively, without significant difference between the two groups ( P > 0.05). But the rate of progression, adverse reactions in bone marrow and digestive tract, and change of immunity in the trial group were all lower than those in the control group ( P < 0.05), and the improvement in Karnofsky score in the trial group was higher than that in the control group ( P < 0.05).

CONCLUSIONSChemotherapy of NP combined with AI shows benefit in the treatment of advanced NSCLC. AI could decrease the influence on immunity and adverse reaction of chemotherapy, and improve the quality of life in patients with NSCLC.

AIM:To investigate the effect of protein kinase C(PKC)-mammalian target of rapamycin(mTOR)pathway on the apoptosis of gastric smooth muscle cells in diabetic rats,and to explore the related mechanism.METHODS:Male and female 4-week-old specific pathogen-free Sprague-Dawley rats were randomly allocated to control,diabetes,diabetes+0.1 μmol/L phorbol 12,13-myristate acetate(PMA),diabetes+0.2 μmol/L PMA,diabetes+0.5 μmol/L PMA,diabetes+2 μmol/L bisindolylmaleimide I(GF109203X),diabetes+5 μmol/L GF109203X,and diabetes+10 μmol/L GF109203X groups(n=9).Primary rat gastric smooth muscle cells cultured in a high-glucose environment in vitro were treated with 0.1 μmol/L PMA,0.2 μmol/L PMA,0.5 μmol/L PMA,2 μmol/L GF109203X,5 μmol/L GF109203X,10 μmol/L GF109203X,or vehicle.The isolated muscle technique was used to evaluate the spontaneous contraction of gastric antral smooth muscle.The pathologic changes and apoptosis of rat gastric smooth muscle were identi-fied using HE staining and flow cytometry,respectively.The expression levels of stem cell factor(SCF),c-Kit,mTOR,phosphorylated(p)-mTOR,p70 ribosomal protein S6 kinase(p70S6K),p-p70S6K,eIF4E-binding protein 1(4E-BP1),p-4E-BP1,caspase-3,B-cell lymphoma-2(Bcl-2)and Bcl-2-associated X protein(Bax)in gastric smooth muscle were measured by Western blot.RESULTS:The contractility of the gastric antral smooth muscle was lower(P<0.05),gastric smooth muscle atrophy and the apoptosis rate was higher(P<0.01),and the expression of SCF,c-Kit,and p-mTOR was lower(P<0.05 or P<0.01)in the diabetes group than in the control group.There was no significant difference in the spon-taneous contraction of the gastric antral smooth muscle between the diabetes and diabetes+0.1 μmol/L PMA groups,but it was significantly greater in the diabetes+0.2 μmol/L PMA and diabetes+0.5 μmol/L PMA groups(P<0.05 or P<0.01).The phosphorylation levels of mTOR,p70S6K(T421/S424),and p70S6K(T389)were also higher in the diabetes+0.2 μmol/L PMA and diabetes+0.5 μmol/L PMA groups than in diabetes group(P<0.01).Furthermore,the phosphorylation of 4E-BP1 was higher(P<0.05)in the diabetes+0.5 μmol/L PMA group than in the diabetes group(P<0.01).There was no significant difference in the spontaneous contraction of the gastric antral smooth muscle between the diabetes and diabe-tes+2 μmol/L GF109203X groups,but it was significantly lower in the diabetes+5 μmol/L GF109203X and diabetes+10 μmol/L GF109203X groups(P<0.05 or P<0.01).The phosphorylation levels of mTOR and p70S6K(T389)were lower in the diabetes+5 μmol/L GF109203X and diabetes+10 μmol/L GF109203X groups(P<0.05),the phosphorylation of p70S6K(T421/S424)was lower in the diabetes+10 μmol/L GF109203X group(P<0.05),and the phosphorylation of 4E-BP1 was lower in the diabetes+GF109203X(2,5 and 10 μmol/L)groups(P<0.05)than in the diabetes group.Com-pared with the CK group,the apoptosis rate was high in the GF109203X-treated(2,5 and 10 μmol/L)groups(P<0.01),the expression of Bax and caspase-3 was low(P<0.05),and the expression of Bcl-2 was high in the PMA-treated(0.1,0.2 and 0.5 μmol/L)groups(P<0.05).CONCLUSION:The downregulation of the PKC-mTOR pathway in the gastric smooth muscle of diabetic rats leads to apoptosis of gastric smooth muscle cells through Bax/Bcl-2 and caspase-3 and the downregulation of SCF and c-Kit,which may play an important role in the gastric dysmotility that characterizes diabetes.