Chemotherapy-induced nausea and vomiting (CINV) is one of the common adverse reactions in cancer patients undergoing chemotherapy, with a relatively high incidence. This article reviews the research progress on risk prediction models for CINV, introduces the basic information of related risk prediction models, and compares differences in research methods and risk factors, aiming to provide reference for the establishment of a prevention and assessment system for CINV in cancer patients.

OBJECTIVE: To analyze the efficacy and safety of decitabine-based myeloablative preconditioning regimen for allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with acute myeloid leukemia (AML). METHODS: The clinical characteristics and efficacy of 115 AML patients who underwent allo-HSCT at the First Medical Center of Chinese PLA General Hospital from August 2018 to August 2022 were retrospectively analyzed, including 37 patients treated with decitabine conditioning regimen (decitabine group) and 78 patients without decitabine conditioning regimen (non-decitabine group). The cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), non-relapse mortality (NRM) and graft versus host disease (GVHD) were analyzed. RESULTS: For the patients in first complete remission (CR1) state before allo-HSCT, the 1-year relapse rates of decitabine group(22 cases) and non-decitabine group(69 cases) were 9.1% and 29.6%, respectively, the difference was statistically significant(P =0.042). The 1-year cumulative incidence of acute graft-versus-host disease (aGVHD) in decitabine group and non-decitabine group was 62.2% and 70.5%, respectively, and the 1-year cumulative incidence of chronic inhibitor-versus-host disease (cGVHD) was 18.9% and 14.1%, respectively, there were no significant differences in the incidence of aGVHD and cGVHD between the two groups (P >0.05). Of the 115 patients, there were no significantly differences in the 1-year CIR(21.7% vs 28.8%, P =0.866), NRM(10.9% vs 3.9%, P =0.203), OS(75.2% vs 83.8%, P =0.131) and LFS(74.6% vs 69.1%, P =0.912) between the decitabine group(37 cases) and the non-decitabine group(78 cases). CONCLUSION Decitabine-based conditioning regimen could reduce the relapse rate of AML CR1 patients with good safety.
Humans ; Leukemia, Myeloid, Acute/therapy* ; Hematopoietic Stem Cell Transplantation/methods* ; Decitabine/therapeutic use* ; Transplantation Conditioning/methods* ; Retrospective Studies ; Graft vs Host Disease ; Transplantation, Homologous ; Male ; Female ; Adult ; Middle Aged ; Adolescent ; Young Adult

OBJECTIVE: Microcirculatory disturbance is pathologically critical to acute pancreatitis (AP), which can be effectively alleviated by traditional Chinese medicine (TCM) formulas that activate blood flow. However, there has been no evidence-based research to date. Therefore, a well-designed systematic review and meta-analysis is necessary to elucidate the therapeutic transformative benefit of improving microcirculation during AP. This study aims to confirm the therapeutic efficacy of TCM formulas and explore the potential mechanisms underlying their effects on AP treatment. METHODS: Studies from eight databases including Pubmed, Embase, Web of Science, Cochrane Library, CNKI, CBM, Wanfang, and Chinese VIP, were screened for the eligible randomized controlled trials (RCTs). The APACHE II score and effectiveness rate were set as primary outcomes, while mortality rate, complications, total hospital stays, serum amylase recovery time, the time until the disappearance of abdominal pain, microcirculation indicators, and inflammation indicators were chosen as secondary outcomes. A systematic review and meta-analysis were subsequently conducted. Network pharmacology analysis was performed to analyze potential bioactive components with relevant targets of the core herbs included in the TCM formulas for activating blood flow. RESULTS: A total of 51 RCTs (n = 3 721) were included. Compared with conventional western medical treatments alone, TCM groups were associated with lower APACHE II score (SMD =  - 1.36, 95% CI: -2.01 to - 0.71, P = 0.000) and higher effectiveness rate (RR: 1.22, 95% CI: 1.18 to 1.26, P = 0.000). Furthermore, the formulas for activating blood flow demonstrated significant efficacy in improving both microcirculation and inflammation indicators. Additionally, six core Chinese herbal medicines including Rhei Radix et Rhizoma with the highest frequency, Aurantii Fructus Immaturus, Paeoniae Radix Rubra, Bupleuri Radix, Salviae Miltiorrhizae Radix et Rhizoma, and Corydalis Rhizoma were filtered out from the adopted TCM formulas. Finally, 166 shared targets between the six herbs and AP were identified. KEGG analysis indicated that lipid and atherosclerosis pathway is highly related to microcirculation. CONCLUSION TCM formulas for activating blood flow significantly improve microcirculation and alleviate AP. Further high-quality, well-designed RCTs and deep mechanism exploration are required.

Objective:To establish a detection method for fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.Methods:The detection of fatty acid composition involves pre-test of the sam-ple using the methanol sodium methylation method,followed by direct injection analysis using gas chromatography,and finally calculating the content of each fatty acid composition using the area normalization method with correction factors.The detection of methoxylaniline value is achieved by dissolving and diluting the sample with isooctane:isopropanol(8∶2,volume ratio),reacting with 4-methoxylaniline,measuring the absorbance at a wavelength of 350 nm,and calculating the methoxylaniline value.Results:Under the composition of fatty acids,the 8 kinds of fatty acids have good separation degree.The methyl ricinoleate and methyl stearate have good linear relationship in the range of 0.1-5.0 mg·mL-1.The repeatabilityand intermediate precision(RSD)ofthe determination results of each fatty acid in the sample are all less than 5%.It is also found that only α-type of linolenic acid is present in castor oil,without γ-type.In the determination of methoxyaniline value,the blank solvent does not interfere with the determination of the sample,and the repeatability RSD is 3.6%.Conclusion:The detection method for fatty acid composition and meth-oxylaniline value established in this article is accurate and reliable,and can be used for the detection of fatty acid composition and methoxylaniline value in pharmaceutical excipient castor oil.

Purpose To investigate interhemispheric homotopic functional connectivity in patients with neuropsychological systemic lupus erythematosus(NPSLE)during resting state and its relationship with clinical indicators and neuropsychological scales.Materials and Methods This prospective study enrolled 35 patients with NPSLE and 31 healthy controls(control group)from Taizhou People's Hospital Affiliated to Nanjing Medical University(June 2020 to March 2023).All participants underwent resting state functional MRI and completed neuropsychological assessments including mini-mental state examination,Montreal cognitive assessment,hospital anxiety and depression scale,fatigue scale for motor and cognitive functions,along with laboratory tests(C3,C4,IgA,IgM,IgG).Image preprocessing and voxel-mirrored homotopic connectivity(VMHC)calculations were performed using DPABI V7.0 on Matlab R2013b.Between-group differences in VMHC values were compared,and correlations between VMHC values in significant regions and neuropsychological/clinical data were analyzed.Results The NPSLE group demonstrated significantly lower mini-mental state examination and Montreal cognitive assessment scores compared with those in control group(t=-6.297,-7.001,both P=0.001).Patients with NPSLE exhibited significantly decreased VMHC values in bilateral parahippocampal gyri,precentral gyri,middle frontal gyri,and medial/paracingulate gyri compared with those in control group(family-wise error corrected,voxel-level P<0.001,cluster-level P<0.05).In the NPSLE group,VMHC values in precentral gyri showed positive correlation with IgA levels(r=0.351,P=0.039),while VMHC values in medial/paracingulate gyri positively correlated with IgA(r=0.345,P=0.043)and negatively with C4(r=-0.368,P=0.030).Conclusion Patients with NPSLE demonstrate abnormal interhemispheric homotopic functional connectivity,and the correlation between imaging metrics and clinical data in differential brain regions may facilitate early diagnosis of NPSLE while providing novel insights into the neuropathological mechanisms of cerebral injury.

Purpose In this study,tract-based spatial statistical analysis was used to analyze the diffusion tensor imaging(DTI)data of breast cancer patients after chemotherapy,to observe the changes of white matter microstructure after chemotherapy and their correlation with neuropsychological cognitive test results,and to provide imaging markers for the evaluation of brain injury after chemotherapy for breast cancer.Materials and Methods A total of 29 patients with breast cancer before chemotherapy treatment and 30 patients with breast cancer after chemotherapy treatment were enrolled in the study from November 2022 to June 2023 in the Affiliated Taizhou People's Hospital of Nanjing Medical University.Neuropsychological cognitive test[Montreal cognitive assessment(MoCA),mini-mental state examination(MMSE)]and whole brain DTI examination were respectively performed in the two groups.Fractional anisotropy(FA)and mean diffusivity(MD)were used to compare the differences between the two groups at the structural level.The correlation between the results of DTI and neuropsychological cognitive test was analyzed.Results Compared with the patients with breast cancer before chemotherapy treatment group,patients with breast cancer after chemotherapy treatment group had decreased FA values in bilateral anterior corona radiata,superior corona radiata,corpus callosum body and genu,left posterior thalamic radiation,left external capsule,bilateral superior longitudinal fasciculus,and increased MD values in bilateral anterior corona radiata,superior corona radiata,right posterior corona radiata,corpus callosum body and genu,right posterior thalamic radiation,bilateral superior longitudinal fasciculus.The FA values of left superior corona radiata(r=0.302)and left external capsule(r=0.370)were positively correlated with MMSE results,and the FA values of left outer capsule(r=0.328)were positively correlated with MoCA results(all P<0.05).The MD values of corpus callosum body(r=-0.343)and genu(r=-0.378),left superior corona radiata(r=-0.311),right posterior corona radiata(r=-0.376),right posterior thalamic radiation(r=-0.341)and right superior longitudinal fasciculus(r=-0.392)were negatively correlated with MMSE results(all P<0.05).Conclusion In the chemotherapy group,FA and MD values in multiple brain regions are abnormal,and there is a certain correlation between FA and MD values in some brain regions and neurocognitive test results.The changes of FA and MD values in different brain areas may be potential imaging markers of the abnormal white matter microstructure in breast cancer patients treated with chemotherapy.

This study investigated the effect of Wuling San on transforming growth factor-β1(TGF-β1)-induced fibrosis, inflammation, and oxidative stress in human renal tubular epithelial cells(HK-2) and its mechanism of antioxidant stress injury. HK-2 cells were cultured in vitro and divided into a control group, a TGF-β1 model group, and three treatment groups receiving Wuling San-containing serum at low(2.5%), medium(5.0%), and high(10.0%) doses. TGF-β1 was used to establish the model in all groups except the control group. CCK-8 was used to analyze the effect of different concentrations of Wuling San on the activity of HK-2 cells with or without TGF-β1 stimulation. The expression of key fibrosis molecules, including actin alpha 2(Acta2), collagen type Ⅰ alpha 1 chain(Col1α1), collagen type Ⅲ alpha 1 chain(Col3α1), TIMP metallopeptidase inhibitor 1(Timp1), and fibronectin 1(Fn1), was detected using qPCR. The expression levels of inflammatory cytokines, including tumor necrosis factor-α(TNF-α), interleukin-1β(IL-1β), interleukin-6(IL-6), interleukin-8(IL-8), and interleukin-4(IL-4), were measured using ELISA kits. Glutathione peroxidase(GSH-Px), malondialdehyde(MDA), catalase(CAT), and superoxide dismutase(SOD) biochemical kits were used to analyze the effect of Wuling San on TGF-β1-induced oxidative stress injury in HK-2 cells, and the expression of nuclear factor E2-related factor 2(Nrf2), heme oxygenase 1(HO-1), and NAD(P)H quinone oxidoreductase 1(NQO1) was analyzed by qPCR and immunofluorescence. The CCK-8 results indicated that the optimal administration concentrations of Wuling San were 2.5%, 5.0%, and 10.0%. Compared with the control group, the TGF-β1 model group showed significantly increased levels of key fibrosis molecules(Acta2, Col1α1, Col3α1, Timp1, and Fn1) and inflammatory cytokines(TNF-α, IL-1β, IL-6, IL-8, and IL-4). In contrast, the Wuling San administration groups were able to dose-dependently inhibit the expression levels of key fibrosis molecules and inflammatory cytokines compared with the TGF-β1 model group. Wuling San significantly increased the activities of GSH-Px, CAT, and SOD enzymes in TGF-β1-stimulated HK-2 cells and significantly inhibited the level of MDA. Furthermore, compared with the control group, the TGF-β1 model group exhibited a significant reduction in the expression of Nrf2, HO-1, and NQO1 genes and proteins. After Wuling San intervention, the expression of Nrf2, HO-1, and NQO1 genes and proteins was significantly increased. Correlation analysis showed that antioxidant stress enzymes(GSH-Px, CAT, and SOD) and Nrf2 signaling were significantly negatively correlated with key fibrosis molecules and inflammatory cytokines in the TGF-β1-stimulated HK-2 cell model. In conclusion, Wuling San can inhibit TGF-β1-induced fibrosis in HK-2 cells by activating the Nrf2 signaling pathway, improving oxidative stress injury, and reducing inflammation.
Humans ; Oxidative Stress/drug effects* ; Transforming Growth Factor beta1/metabolism* ; Fibrosis/genetics* ; Cell Line ; Drugs, Chinese Herbal/pharmacology* ; Epithelial Cells/immunology* ; Inflammation/metabolism*

OBJECTIVE: To observe the clinical efficacy of 3D printing spinal external fixator combined with McKenzie therapy for patients with lumbar dics herniation (LDH). METHODS: Sixty patients with LDH between January 2022 and January 2023 were enrolled. Among them, 30 patients were given McKinsey training. According to different treatment methods, all patients were divided into McKenzie group and McKenzie + 3D printing group, 30 patients in each group. The McKenzie group provided McKenzie therapy. The McKenzie + 3D printing group were treated with 3D printing spinal external fixation brace on the basis of McKenzie therapy. Patients in both groups were between 25 and 60 years of age and had their first illness. In the McKenzie group, there were 19 males and 11 females, with an average age of (48.57±5.86) years old, and the disease duration was (7.03 ±2.39) months. The McKenzie + 3D printing group, there were 21 males and 9 females, with an average age of (48.80±5.92) years old, and the disease duration was(7.30±2.56) months. Pain was evaluated using the visual analogue scale (VAS), and lumbar spine function was assessed using the Oswestry disability index (ODI) and the Japanese Orthopaedic Association (JOA) score. VAS, ODI and JOA scores were compared between two groups before treatment and at 1, 3, 6, 9 and 12 months after treatment. RESULTS: All patients were followed up for 12 months. The VAS for the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(6.533±0.860), (5.133±1.008), (3.933±0.868), (2.900±0.759), (2.067±0.640), (1.433±0.504), respectively. In the McKenzie group, the corresponding scores were (6.467±0.860), (5.067±1.048), (4.600±0.968), (3.533±1.008), (2.567±0.728), (1.967±0.809), respectively. The ODI of the McKenzie group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were (41.033±6.810)%, (37.933±6.209)%, (35.467±6.962)%, (27.567±10.081)%, (20.800±7.531)%, (13.533±5.158)%, respectively. For the McKenzie combined with 3D printing group, the corresponding ODI were(38.033±5.605)%, (33.000±6.192)%, (28.767±7.045)%, (22.200±5.517)%, (17.700±4.836)%, (11.900±2.771)%, respectively. The JOA scores of the McKenzie combined with 3D printing group before treatment and at 1, 3, 6, 9, and 12 months post-treatment were(8.900±2.074), (13.133±2.330), (15.700±3.583), (20.400±3.480), (22.267±3.084), (24.833±2.640), respectively. In the McKenzie group, the corresponding scores were(9.200±2.091), (12.267±2.406), (15.333±3.198), (18.467±2.240), (20.133±2.751), (22.467±2.849), respectively. Before the initiation of treatment, no statistically significant differences were observed in the VAS, ODI, and JOA scores between two groups (P>0.05). At 3, 6, 9, and 12 months post-treatment, the VAS in the McKenzie combined with 3D printing group was significantly lower than that in the McKenzie group, and the difference was statistically significant (P<0.05). The comparison of ODI between two groups at 1, 3, 6, 9, and 12 months post-treatment revealed statistically significant differences (P<0.05). At 6, 9, and 12 months post-treatment, the JOA score in the McKenzie combined with 3D printing group was significantly higher than that in the McKenzie-only group, and the difference was statistically significant (P<0.05). CONCLUSION The combination of 3D printed functional spinal external fixation brace with McKenzie therapy can significantly improve and maintain lumbar function in patients with LDH.
Humans ; Male ; Female ; Middle Aged ; Printing, Three-Dimensional ; Intervertebral Disc Displacement/surgery* ; External Fixators ; Lumbar Vertebrae/surgery* ; Adult ; Braces ; Treatment Outcome

There was a close relationship between microvascular invasion(MVI)and the therapeutic efficacy and prognosis of hepatocellular carcinoma.With the continuous development of imaging examination methods,multimodal magnetic resonance imaging(MRI)was a non-invasive and quantitative examination method that com bines multiple imaging modes,including magnetic resonance T1/T2 weighted imaging(T1/T2WI),functional MRI[diffusion-weighted imaging(DWI),intravoxel incoherent motion(IVIM)and diffusion-kurtosis imaging(DKI)],dynamic contrast-enhanced MRI(DCE-MRI),hepatobiliary phase imaging(HBP),etc,it can obtain various imaging parameters and provide more comprehensive and accurate diagnostic information for clinicians,it has been widely used in the diagnosis and grading,efficacy evaluation,prognosis,and MVI prediction of hepatocellular carcinoma.Based on this,this article reviews the relevant literature on the application of multimodal MRI in MVI of hepatocellular carci noma in recent years,and summarizes the research status and progress of multimodal MRI in predicting hepatocellular carcinoma MVI,the aim was to further analyze the challenges of multimodal MRI in the application of hepatocellular carcinoma MVI,promote the clinical application of predicting hepatocellular carcinoma MVI,and improve the accuracy of predicting of hepatocellular carcinoma MVI.