Lung cancer is the top cause of cancer deaths globally.Advances in immune checkpoint inhibitors(ICIs)have transformed cancer treatment,but their use in lung cancer has led to more side effects.This study examined if past pulmonary tuberculosis(TB)affects ICIs'effectiveness and safety in lung cancer treatment.We reviewed lung cancer patients treated with ICIs at Beijing Chest Hospital from January 2019 to August 2022.We compared outcomes and side effects between patients with and without prior TB.Of 116 patients(40 with TB history,76 without),prior TB didn't reduce treatment effectiveness but did increase severe side effects.Notably,older patients(≥65 years)faced a higher risk of severe side effects.Detailed cases of two patients with severe side effects underscored TB as a risk factor in lung cancer patients receiving ICIs,stressing the need for careful monitoring and personalized care.

Neurodegenerative diseases are a type of disease characterized by specific types of neuronal loss and progressive progression,mainly represented by Alzheimer's disease and Parkinson's disease.This type of disease,due to its intractable and irreversible symptoms,brings great physical and psychological burden to patients,which is seriously disturbing their normal life.In terms of treatment,there is currently no specific treatment for Alzheimer's disease in clinical practice,and first-line treatment drugs for Parkinson's disease also have great limitations.In traditional Chinese medicine,kidney governs bone,generates marrow,and connects to the brain.In clinical evidence typing,premature aging,fatigue and forgetfulness,and tremor of limbs caused by kidney deficiency and medullary reduction are considered to be the main pathologies of these diseases.Di-Huang-Yin-Zi decoction which is derived from the"General Records of Holy Universal Relief",is recorded as a good formula for nourishing kidney yin and filling kidney yang.Clinical data shows that this formula has significant therapeutic effects in treating neurodegenerative diseases caused by kidney essence deficiency.Modern research results indicate that its mechanism of action involves inhibiting inflammatory reactions,regulating mitochondrial autophagy,reversing The hypothalamic-pituitary-adrenal axis abnormalities,and neuroprotection.The main effective ingredients in this formula include loganin,echinarin,and schisandrin A.This article aims to summarize and analyze the clinical efficacy,mechanism of action,and active ingredients of Di-Huang-Yin-Zi decoction in the treatment of Alzheimer's and Parkinson's disease in recent years,in order to clarify the research status of Di-Huang-Yin-Zi decoction in the neurodegenerative disease and provide reference for further research.

Objective:To investigate the value of MRI in diagnosing the high expression of transcription factor E2F2 in breast cancer, in order to further evaluate the biological aggressiveness of breast cancer.Methods:The study was cross-sectional. The clinical and imaging data of 92 patients with breast cancer who were pathologically diagnosed in the Second Affiliated Hospital of Nantong University from October 2014 to December 2020 were retrospectively analyzed. All patients were female, aged 32 to 82 (56±11) years. All patients underwent MRI, including T 1WI, T 2WI, diffusion-weighted imaging (DWI), and dynamic enhanced MRI. According to the immunohistochemical results, the patients were divided into E2F2 high expression group and E2F2 low expression group. Independent sample t test, Mann-Whitney U test or χ2 test were used to compare the clinical data, MRI features and pathological features of the two groups. Characteristics with P≤0.1 from univariate analyses were included in multivariate logistic regression to screen for independent risk factors predicting high expression of the transcription factor E2F2 in breast cancer. Results:Among 92 patients, 68 were in the high E2F2 expression group and 24 were in the low E2F2 expression group. There were significant differences between the two groups in peritumoral edema, type composition ratio of time-signal intensity curve, estrogen receptor expression, human epidermal growth factor receptor 2 expression, endovascular cancer embolus and molecular type composition ratio (all P<0.05). Multivariate logistic regression analysis showed that peritumoral edema alone ( OR=7.061, 95% CI 1.837—27.144, P=0.004) was an independent risk factor for predicting the high expression of transcription factor E2F2 in breast cancer. Conclusion:MRI show that peritumoral edema is an independent risk factor for predicting high expression of the breast cancer transcription factor E2F2, which is associated with the aggressiveness of breast cancer.

Objective:To evaluate intervention effects of cognitive behavioral therapy on reducing negative emotions in patients with intracranial tumors and improving their quality of life and sleep quality by using Meta-analysis.Methods:Cochrane Library, Web of Science, Embase, PubMed, CNKI, VIP Chinese Journal Database, China Biology Medicine disc and Wanfang Database were searched for randomized controlled studies on interventions of cognitive behavioral therapy in anxiety, depression, quality of life and sleep quality of patients with brain neoplasm. After screening, extracting and evaluating data, the two researchers performed a Meta-analysis using RevMan 5.3 statistical software.Results:A total of 22 literatures met the inclusion criteria, with a total sample size of 1 702 cases. The analysis of the results showed that cognitive behavioral therapy could help reduce the anxiety level of patients with brain neoplasm [ SMD=-1.13, 95% CI: (-1.31, -0.96) , P<0.01], depression level [ SMD=-1.09, 95% CI: (-1.27, -0.92) , P<0.01], which could improve quality of life [ SMD=0.29, 95% CI: (0.06, 0.51) , P=0.01] and sleep quality [ MD=-0.32, 95% CI: (-0.36, -0.28) , P<0.01] of patients and improve satisfaction of patients with nursing [ MD=-8.25, 95% CI: (3.54, 19.24) , P<0.01]. Conclusions:Existing evidence shows that the use of cognitive behavioral therapy can help improve the negative emotions of patients with brain neoplasm, improve their quality of life and sleep quality and improve their satisfaction with nursing.

Objective:To systematically integrate the experience and feelings of informal caregivers of patients with intracranial tumors.Methods:Qualitative researches on the real experience and inner needs of informal family caregivers of patients with intracranial tumors were retrieved in the PubMed, Web of Science, China National Knowledge Infrastructure (CNKI) , WanFang Data, China Biomedical Database and VIP Chinese Journal Database by computer. The search time was from the establishment of the database to May 31, 2021. After screening and analysis, the critical appraisal tool for qualitative research (2017) of the Joanna Briggs Institute (JBI) Evidence-based Health Center in Australia were used to evaluate the articles and the results were Meta-integrated.Results:A total of 14 articles meeting the criteria were included. A total of 48 complete research themes were refined, and they were summarized and combined to form 3 comprehensive Meta-integration results and 4 new categories. The 3 Meta-integration results were that the caregiver experienced the shock, sadness, disbelief and hope in the early stage of diagnosis, and began to assume responsibility and learn to become a caregiver's psychological and emotional changes; the caregiver's family role and living environment changed, affecting the quality of life of caregivers; caregivers lacked information, care experience and social support.Conclusions:The quality of life of informal caregivers of patients with intracranial tumors and the changes in family functions have attracted attention. Social and medical workers should combine our country's cultural background to formulate effective intervention strategies and related health policies for the difficulties and challenges faced by this special population.

Objective To evaluate the anesthetic effect of ultrasound guided thoracic paraverte-bral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy. Methods Eighty patients (38 male and 42 female ) undergoing selected thoracoscopic sympathectomy,aged from 16 to 28 years,in ASA physical status Ⅰ or Ⅱ,were equally divided into study group and control group,40 patients in each,according to random number table.Fifteen mi-nutes before paravertebral blockade,while study group received loading dose (0.5 μg/kg)of dexme-detomidine (4 μg/ml)intravenously within 10 min and received continuous intravenous pumping (0.3-0.5 μg·kg-1·h-1 )throughout the operation,control group received isovolumetric normal saline in the same pattern.Patients'heart rate (HR),respiratory rate (RR),mean arterial pressure (MAP),SpO 2 ,observer's assessment of alertness/sedation (OAA/S)scale and adverse reactions were recorded in several time points,namely timing of entrance (T0 ),timing of paravertebral block-ade (T1 ),timing of skin incision (T2 ),timing of sympathectomy (T3 )and the end (T4 ),respective-ly.Results Compared to the control group,while MAP and HR in the study group were obviously decreased through T1-T4 (P <0.05),RR was obvious increased in T2 and T3 (P <0.05)and OAA/S scale was obviously lowered in the study group (P <0.05 ).The study group and the control group had one case and two cases of adverse reaction,respectively,with no significant difference between the two groups.Conclusion The application of ultrasound guided thoracic paravertebral blockade combined with intravenous dexmedetomidine in thoracoscopic sympathectomy is safe and effective.

Objective:To observe the effect of epalrestat on the heart rate variability in diabetes patients with silent myocardial is-chemia. Methods:Totally 60 patients were randomly divided into the control group and the treatment group with 30 cases in each. The two groups were given insulin or other routine drugs to keep blood sugar under control, ARB or ACEI and CCB to bring high blood pres-sure down, and statins to regulate lipid and anti-platelet aggregation, and both groups were without the use of beta blockers. The treat-ment group was given epalrestat 50mg three times a day for 4 weeks additionally. The indices of FPG, 2hPG, HbA1c, SBP, DBP, T-CHOL, TG, HDL-C, LDL-C and heart rate variability were observed after the treatment. Results: Compared with those before the treatment, the values of FPG, 2HPG, HbA1C, SBP, DBP, T-CHOL and LDL-c were decreased after the treatment in the two groups, and the differences were statistically significant (P <0.05), while the differences between the two groups were not obvious(P >0. 05). After the treatment, SDNN, SDANN, SDNNI, RMSSD, PNN50 and Mean HR in the treatment group were obviously im-proved, which were better than those in the control group (P<0.05). The adverse reactions in the two groups were similar (P<0. 05). Conclusion:Epalrestat can significantly improve HRV-related indicators in the diabetes patients with silent myocardial ischemi-a, which can reduce the risk of sudden death without significant adverse reactions in the combination with other drugs.

Objective To investigate the antagonistic effect of different doses of astragaloside Ⅳ (AST Ⅳ) on immune function of regulatory T (Treg) cells mediated by high mobility group box-1 protein (HMGB1) in rats and the mechanism by which AST Ⅳ exerts its influence.Methods CD4 + CD25 +Treg cells isolated from the spleens of clean-grade BALB/c mice were seeded on 72-well culture plate.Cells were divided into four groups (18 wells per group) according to the random number table,i.e.normal control group (cells were cultured merely),HMGB1 (1 μg/ml) group,HMGB1 (1 μg/ml) + AST Ⅳ (50 μg/ml) group,and HMGB1 (1 μg/ml)+AST Ⅳ (100 μg/ml) group.Each group consisted of three subgroups (6 wells per group),from which the Treg cells were collected at post-stimulation hours 24,48 and 72 respectively.Foxp3 intracellular protein and mRAN expressions were detected by flow cytometry and quantitative fluorescent PCR.Contents of IL-10 and TGF-β released into the supernatants were determined by ELISA method.Results As compared with the control group,Foxp3 intracellular protein and mRAN expressions in the Treg cells were decreased at 24 hours to 72 hours after HMGB1 stimulation (P ＜ 0.01),with particular reduction at 72 hours.Additionally,changes of IL-10 and TGF-βin the supernatants presented the same trends with Foxp3.Foxp3 protein and mRAN expressions in AST Ⅳ group were markedly higher than that in HMGB1 group at 24-72 hours (P ＜ 0.05) and the expressions in AST Ⅳ(100 μg/ml) group were much more significant than that in AST Ⅳ (50 μg/ml) group (P ＜ 0.05).While contents of IL-10 and TGF-β in supernatants revealed the same trend with Fox3 as well.Conclusions AST Ⅳ antagonizes the impact of HMGB1 on the activity of the Treg cells in a dose-dependent manner in vitro.It is suggested that AST Ⅳ has a strong inhibitory effect on HMGB1-mediated inflammatory response.

OBJECTIVETo study the chemical constituents of Iodes cirrhosa and evaluate their bioactivity.

METHODThe compounds were isolated and purified by various kinds of column chromatography methods and their structures were determined by spectroscopic data analysis. Neuroprotective assay against serum deprivation induced SH-SYSY-JNK3 cell apoptosis was evaluated by MTr method while potassium channel-blocking activity was assayed in both non-specific and specific K+ channel-regulator screening models.

RESULTTwenty-one compounds were obtained from an EtOAc portion of an ethanolic extract of the root of I. cirrhosa. Their structures were elucidated as 1beta, 3beta-dihydroxyurs-9(11),12-diene(1), bauerenyl acetate(2),3beta-hydroxy-11-oxo-olean-12-enyl palmitate(3), 3beta-acetoxy-urs-12-ene-11-one(4), betulinic acid(5), stigmasta-5, 22-diene-3beta-ol(6), 7beta-hydroxystigmasterol(7), stigmasta-5, 22diene-3beta-ol3-O-beta-D-glucopyranoside(8),scopoletin(9),scopolin(10),clovamide(11),methyl 3,5-di-O-caffeoylquinate(12),3,5-dicaffeoylquinic acid(13),2,6-dimethoxy-1,4-benzoquinone(14), protocatechualdehyde(15), vanillin(16), protocatechuic acid(17), vanillic acid(18),caffeic acid(19),azelaic acid(20),and succinic acid(21). Compound 3,4,6,9,10,14,15,18 and 20 showed neuroprotective activities against serum deprivation induced SH-SYSY-JNK3 cell apoptosis at a concentration of 1.0 x 10(6) mol x L(1) with relative protection rates of 177%, 144%, 137%, 137%, 143%, 145%, 137%, 189%, 130%, respectivley. Compound 16 could increase DiBAC4(3) fluorescence response in both non-specific and specific K+ channel-regulator screening models at the concentration of 1.0 x 10(-5) mol x L(-1).

CONCLUSIONCompound 1 was a new compound and all compounds were isolated from this genus for the first time. Compounds 3,4,6,9,10,14,15,18 and 20 showed neuroprotective activities while 16 exhibited K+ channel-blocking activity.

Apoptosis ; drug effects ; Cell Line, Tumor ; Humans ; Magnoliopsida ; chemistry ; Neuroprotective Agents ; chemistry ; pharmacology ; Plant Extracts ; chemistry ; pharmacology ; Potassium Channels ; drug effects

OBJECTIVETo investigate the chemical constituents of Heteroplexis micocephal and their bioactivities.

METHODThe constituents were isolated by using a combination of various chromatographic techniques including column chromatography over macroporous adsorbent resin, silica gel, Pharmadex LH-20, and C-18, as well as reversed-phase HPLC. Structures of the isolates were identified by spectroscopic data analysis. In vitro cytotoxic, HIV-1 replication, neuroprotective, and anti-inflammatory activities were screened by using cell-based models.

RESULTThirty-one compounds were obtained. Twelve of them are phenylpropanols, and the structures were elucidated as (+)-(7S,8R)-guaiacylglycerol (1), ferulic acid (2), cinnamate methyl ester (3), 1-eicosanyl 3,4-dihydroxycinnamate (4), morinin B (5), sinapyl diangelate (6), chlorogenic acid (7), 4-O-caffeoylquinic acid (8), 5-O-caffeoylquinic acid (9), 5-O-caffeoylquinic acid methyl ester (10), 1,5-di-O-caffeoylquinic acid (11) and 4,5-di-O-caffeoylquinic acid methyl ester (12). Three lignans, (+)-pinoresinol (13), prinsepiol (14) and (+)-pinoresinol-O-beta-D-glucopyranoside (15). Four acetophenones, 2,4-diacetylanisole (16), espeleton (17), viscidone (18) and 12-hydroxytremetone-12-O-beta-D-glucopyranoside (19). Nine flavones, isosakuranetin (20), hesperetin (21), 3-methoxy-5,7,3',4'-tetrahydroxyflavone (22), acacetin (23), 5-hydroxy-7,4'- dimethoxyflavone (24), 7-methoxy-4',5, 6-trihydroxyflavone (25), 3,3'-dimethylquercetin (26), kaempferol 3-O-rutinoside (27), rutin (28). And three coumarins scopoletin (29), umbelliferone (30) and ayapin (31). Compound 6 and 22 showed selective cytotoxicities against a human stomach cancer cell line(BGC-823) and a human lung cancer cell line (A549) with IC50 values of 3.74 x 10(-5) and 7.17 x 10(-5) mol L(-1), respectively. In addition, Compound 6 showed a potent activity inhibiting HIV-1 replication with an IC50 value of 4.04 x 10(-6) mol L(-1), while 22 showed neuroprotective activity Against the MPP+ induced PC12-syn cell damage, with a relative protection ratio of 105.2% (P < 0.01) at a concentration of 10(-5) mol L(-1). Compound 26 and 31 showed inhibitory activities against the release of beta-glucuronidase of the polymorphous nuclear leukocytes induced by platelet activating factor (PAF), with inhibitory rates of 75.6% (P < 0.001) and 53. 9% (P < 0.01), respectively.

CONCLUSIONCompounds 1-31 were obtained from the genus Heteroplexis for the first time. Compound 6 and 22 possessed selective cytotoxicities against human cancer cell lines BGC-823 and A549, respectively. In addition, Compound 6 showed a potent activity inhibiting HIV-1 replication while 22 showed neuroprotective activity against the MPP+ induced PC12-syn cell damage. Compound 26 and 31 were potent anti-inflammatory agents.

Animals ; Antiviral Agents ; analysis ; pharmacology ; Cell Line, Tumor ; HIV-1 ; drug effects ; physiology ; Humans ; Myrtaceae ; chemistry ; Neurons ; cytology ; drug effects ; Neuroprotective Agents ; analysis ; pharmacology ; Plant Extracts ; analysis ; pharmacology ; Rats ; Virus Replication ; drug effects