OBJECTIVETo investigate the preventive effect of magnesium isoglycyrrhizinate against acute drug-induced liver damage from initial chemotherapy treatment in patients with gastrointestinal cancer.

METHODSA total of 216 cases with early stage gastric cancer and indications for systemic chemotherapy that had been diagnosed with gastrointestinal malignant tumors by pathology in our hospital were enrolled for study during the period of January 2011 to June 2013.Using a prospective randomized controlled study design,differences were assessed between groups treated with glycyrrhizic acid magnesium (experimental group; n=114) or glutathione (control group; n=102) and the FOLFOX regimen (n=104) or the XELOX regimen (n=112).Patients in the FOLFOX group received intravenous infusion of L-OHP (85 mg/m²) at day 1,followed by a bolus injection of 5-FU (400 mg/m²) at days 1-2 and continuous intravenous infusion of 5-FU (600 mg/m²) for 22 h at days 1-2,with one cycle comprising 2 weeks. Patients in the XELOX group received intravenous infusion of L-OHP (130 mg/m²) at day 1, followed by capecitabine (1 000 mg/m²) oral twice a day at days 1-14,with one cycle comprising 3 weeks.In the first cycle of chemotherapy,serum was extracted from the patients at 1 day before chemotherapy and 1 week after chemotherapy.An automated biochemistry analyzer was used to measure alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and alkaline phosphatase (ALP). Differences between groups were statistically analyzed by the t-test and x² test.

RESULTSAmong the total 216 cases treated with chemotherapy,40 showed hepatic biochemical abnormalities (12 cases in the experimental group, 28 cases in the control group), and the effect of prevention was significantly different between the two groups (10.53% vs. 27.25%; x² =10.219, P less than 0.005).The acute and subacute hepatic toxicity reaction degrees for the experimental and the control groups were: 0:94.78% vs. 88.2%; 1:5.3% vs. 11.8% (x² =6.99, P < 0.01). One week after chemotherapy, the liver biochemical indexes in the experimental group (ALT:35.93 ± 8.33 U/L; AST:24.84 ±2.91 U/L; TBil:13.29 ± 5.89 mumol/L; ALP:125.1 ± 53.61 U/L) were statically different from those in the control group (all P < 0.05). The liver biochemical indexes before and after chemotherapy were also significantly different between the experimental group (ALT:13.18t3.23 U/L; AST:5.39 ± 2.57 U/L; TBil:2.79 ± 0.23 mumol/L; ALP:52.08 ± 4.83 U/L) and the control group (all P < 0.05).One week after chemotherapy in the experimental group, the groups treated with the FOLFOX regimen or the XELOX regimen showed no statistical differences in the liver biochemical indexes.One week after chemotherapy in the control group, though, the groups treated with the FOLFOX regimen showed significantly lower AST (26.24 ± 3.50 U/L vs. 29.80 ± 6.57 U/L, t=-2.431, P < 0.05),but the residual liver biochemical indexes were not significantly different.In the experimental group, the FOLFOX group showed significantly lower ALP (53.44 ± 2.47 U/L vs. 56.58 ± 6.70 U/L, t =-2.201, P < 0.05), AST (6.48 ± 3.15U/L vs. 9.88 ± 4.57 U/L, t =-5.223, P < 0.05), but the residual liver biochemical index was not significantly different.

CONCLUSIONMagnesium isoglycyrrhizinate is an effective drug for the prevention of drug-induced liver damage after initial chemotherapy in patients with early stage gastrointestinal cancer.

Alanine Transaminase ; Alkaline Phosphatase ; Antineoplastic Combined Chemotherapy Protocols ; Aspartate Aminotransferases ; Bilirubin ; Chemical and Drug Induced Liver Injury ; Deoxycytidine ; analogs & derivatives ; Fluorouracil ; analogs & derivatives ; Gastrointestinal Neoplasms ; Glycyrrhizic Acid ; Humans ; Leucovorin ; Organoplatinum Compounds ; Prospective Studies ; Saponins ; Triterpenes

Objective To investigate the effect of serum of esophageal squamous cell carcinoma (ESCC) patients with blood stasis syndrome (BSS) on proliferation and cycle of EC9706 cells, and to explore the action of blood micro-environment of ESCC patient with BSS on EC9706 cells. Methods Human EC9706 cells were cultured in an incubator with RPMI-1640 medium containing fetal bovine serum ( FBS) , at 37℃ and under 5% saturated humidity for 24 h. After EC9706 cells were starved in serum-free medium for another 24h, the three experimental groups were treated with serum of ESCC patients with BSS, serum of ESCC patients with spleen-qi deficiency syndrome (SQDS), and serum from healthy volunteers, respectively. Cell proliferation was determined by methyl thiazolyl tetrazolium ( MTT) assay, EC9706 cell morphology was observed under light microscope, and cell cycle was measured by flow cytometer (FCM). Results The serum concentrations of ESCC patients with BSS and ESCC patients with SQDS for obtaining 50 percent cell proliferation rates ( PI50) were 71.1 μL/mL and 118 μL/mL, respectively. And the proliferation of EC9706 cells in the both groups all arrived to the peak values at culturing hour 48. The light microscopy results showed that the feature of EC9706 cells in both groups presented as spindle-like or polygon-like shape, and cell count in BSS group was larger than SQDS group. FCM assay results for EC9706 cell cycle showed that the percentage of G1-phase EC9706 was decreased and the percentage of S-phase EC9706 was increased in BSS group as compared with those in SQDS group ( P<0.05). Conclusion Serum micro -environment in ESCC patients with BSS is more beneficial to EC9706 cells proliferation than ESCC patients with SQDS, and the mechanism may be related to the regulation of cell cycle.

Skull defects in children can be caused by a variety of congenital and acquired factors.Cranioplasty is an important surgical method to reconstruct the cranial integrity, protect brain tissue and maintain the beautiful appearance of skull, which are very important to ensure the normal development of brain and psychology of children with skull defect.Due to the dynamic development of brain and skull in children, there are great controversies about the opportunity, method and material selection for repairing the skull defect.Now, the domestic and foreign research on the application of childhood cranioplasty was reviewed to provide references for further improving the treatment decisions of children with skull defects.