OBJECTIVETo explore the effect of arsenic trioxide combined with itraconazole on proliferation and apoptosis of KG1a cells and its potential mechanism.

METHODSThe cell morphology was observed with Wrighe-Giemsa staining; cell survival rate was examined by CCK-8; and colony formation capacity was measured by methylcellulose colony formation test; the flow cytometry was used to analyse the cell apoptosis rate and cell cycle; the protein expressions of BCL-2,caspase-3,BAX,SMO,Gli1 and Gli2 were detected by Western-blot.

RESULTSThe arsenic trioxide and itraconazole alone both could inhibit the KG1a cell proliferation in dose-and time-dependent manner. In comparison between single and combined drug-treatment group, both the cell survival rate and the colony number of the single drug-treatment group were significantly lower(P<0.05), and the apoptosis rate was higher in the combined drug-treatment group. In the combined-treatment group, the protein expression of Caspase-3 and BAX was upregulated, while the protein expression of BCL-2,SMO,Gli1 and Gli2 was downregulated.

CONCLUSIONArsenic trioxide combined with itraconazole can inhibit the KG1a cell proliferation and induce apoptosis, which may be related with the inhibition of Hh signaling pathway and upregulation of both Caspase-3 and BAX protein expression, and provided experimental data of arsenic trioxide combined with itraconazole for the treatment of refractory AML.

BACKGROUNDCurrent understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual.

METHODSWe reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses.

RESULTSThis study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I-III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant differences in either 5-year DFS (χ2 = 0.440, P= 0.507) or 5-year OS (χ2 = 1.530, P= 0.216).

CONCLUSIONSThe prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

BACKGROUNDThere is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures. In this article, we performed a systematic review and meta-analysis to compare the short- and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).

METHODSPubMed, Embase, and the Cochrane Library were searched systematically up to January 2016. All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.

RESULTSIn total, eight prospective randomized studies involving 2206 patients were included. The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio: 0.56, 95% confidence interval [CI] = 0.38-0.80), re-operation (risk ratio: 0.17, 95% CI = 0.13-0.22), revision rates (risk ratio: 0.11, 95% CI: 0.08-0.16), and better function compared with their IF counterparts, and they were less likely to suffer postoperative pain. No statistically significant differences for the rates of mortality, infection, and/or deep vein thrombosis between AR and IF were found.

CONCLUSIONSBased on our analysis, we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly. However, IF may be appropriate for those who are very frail.

Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; methods ; Femoral Neck Fractures ; surgery ; Fracture Fixation, Internal ; methods ; Humans ; Treatment Outcome

OBJECTIVETo investigate the correlation between a diverse of clinical factors and bone metastases of prostate cancer.

METHODSThe clinical data of 80 patients with prostate cancer were collected and analyzed. The correlations of age, alkaline phosphotase (ALP), prostate specific antigen (PSA), erythrocyte sedimentation rate (ESR), Gleason score, and expressions of androgen receptor (AR) and Ki-67 with bone metastases were analyzed by one-way ANOVA and Logistic regression analysis. The cutoff value, sensitivity and specificity of the independent correlation factors were calculated.

RESULTSForty-five of the 80 patients (56%) were found to have bone metastasis, who had significantly older age and higher levels of ALP, PSA, ESR, Gleason score, and expressions of AR and Ki-67 than those without bone metastasis (P<0.05). Logistic regression analysis identified PSA, Gleason score and AR expression as independent factors correlated with bone metastasis with OR (95% CI) of 1.005 (1.001, 1.009) (P=0.008), 5.356 (1.431, 20.039) (P=0.013), and 18.594 (2.460, 140.524) (P=0.005), respectively. The cutoff values of PSA, Gleason Score and AR were 67.1 ng/ml, 7.5, and 2.5, respectively; their sensitivities were 55.6%, 75.6%, and 84.0% for predicting bone metastasis with specificities of 97.1%, 82.9%, and 91.4%, respectively.

CONCLUSIONOf the factors analyzed, PSA, Gleason score and AR expression, but not age, ALP, PSA, ESR, or Ki-67 expression, are the predictive factors of bone metastasis of prostate cancer.

Alkaline Phosphatase ; metabolism ; Bone Neoplasms ; diagnosis ; secondary ; Humans ; Male ; Neoplasm Grading ; Predictive Value of Tests ; Prostate-Specific Antigen ; blood ; Prostatic Neoplasms ; pathology ; Receptors, Androgen ; metabolism ; Sensitivity and Specificity

OBJECTIVETo understand the epidemiological characteristics of head injuries in children.

METHODSData was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age.

RESULTSA total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%).

CONCLUSIONSIn 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Asian Continental Ancestry Group ; statistics & numerical data ; Automobile Driving ; Child ; China ; epidemiology ; Craniocerebral Trauma ; epidemiology ; Environment ; Female ; Humans ; Male ; Population Surveillance ; Recreation ; Sports ; Transportation ; Wounds and Injuries ; epidemiology

OBJECTIVETo understand the epidemiologic characteristics of fall in people aged ≥60 years in China and provide evidence for the development of prevention and control measures of fall in old population.

METHODSData of fall in people aged ≥60 years in China in 2014 were collected from National Injury Surveillance System (NISS) for the descriptive epidemiologic analysis.

RESULTSA total of 41,073 fall cases were reported in people aged ≥60 years in 2014, accounting for 52.81% of total unintentional injuries in this population. The fall to unintentional injury ratio was higher in older age group. The gender ratio of fall cases was 0.77 and the proportion of females increased with age. Fall mainly occurred during 8:00-11:59 in the morning (33.31%). The top three places where fall might occur were home (55.66%), public residential places (20.52%) and roads (11.64%). Recreational activity (68.94%) and housework/study (16.14%) were the major causes for fall. The common injury sites were low limbs (29.28%), head (24.40%) and body (20.04%), while the common injuries caused by fall were bruise (45.76%) and fractures (29.52%), spain/strain (13.28%). The fall injuries were mainly mild (64.20%), while more moderate and serious fall injuries occurred in older age group.

CONCLUSIONFall is the major cause of injury in old population in China, and the proportion of fall in unintentional injury in this population increased with age, indicating that the prevention of fall in old population should be strengthened.

Accidental Falls ; statistics & numerical data ; Aged ; Aged, 80 and over ; China ; Environment ; Female ; Humans ; Male ; Middle Aged ; Recreation ; Residence Characteristics

OBJECTIVETo understand the incidence of violence injury and its prevention in China, and provide reference for the prevention and control of violence injury.

METHODSThe violence injury data in China were collected from national death surveillance data set (2006-2013) and national injury surveillance system (2013) for the descriptive epidemiological analysis on the incidence of violence injury and related death. The laws and policies about violence injury prevention, related data collection capacity and violence injury prevention programs in China were described.

RESULTSThe violence injury mortality declined by 46.3% during 2006-2013 from 1.21/100000 to 0.65/100000. The incidence of violence injury death in males peaked in age group 30-34 years (1.42/100000), and it was low in age group<15 years. Three peaks of violence injury death were found in females, i.e. 0.84/100000 in infants, 0.72/100000 in age group 30-34 years and 1.18/100000 in age group≥85 years. The laws and policies about violence injury prevention were imperfect, and the data about violence injury were limited. Most prevention programs were limited in scale and duration.

CONCLUSIONSThe crude and standardized violence injury mortality declined in China during 2006-2013. It is necessary to conduct gender specific prevention strategies and improve the related law and policy development, data collection and prevention service.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China ; Data Collection ; Female ; Humans ; Incidence ; Infant ; Male ; Middle Aged ; Violence ; prevention & control ; Wounds and Injuries ; epidemiology ; prevention & control ; Young Adult

OBJECTIVETo analyze early hematopoietic response and long-term survival of very severe aplastic anemia (VSAA) patients with different absolute neutrophil counts (ANC) after frontline immnunosuppressive therapy (IST).

METHODSClinical data and outcome of 145 VSAA patients treated with rabbit antithymocyte globulin combined with cyclosporine were retrospectively analyzed. Hematopoietic responses to IST and long-term survival were statistically analyzed for VSAA patients in different ANC subgroups.

RESULTSPre-IST ANC=0.05×10(9)/L acted as the best cutoff level to predict IST response at 3, 6 months. For 145 VSAA patients, early death rate was 13.4% (11/82) vs 1.6% (1/63), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group (P<0.05). Hematopoietic response rates to IST was 22.0% vs 54.0% (P=0.000) at 3 months, 34.1% vs 63.5% (P=0.000) at 6 months; the overall five-year survival rate was only (62.5±5.4) % vs (91.4±3.7) % (P=0.000) and five-year event-free survival rate was (42.3±5.5) % vs (63.1±6.5) % (P=0.003), respectively, in the ANC≤0.05×10(9)/L group and ANC>0.05×10(9)/L group.

CONCLUSIONVSAA patients with extremely low ANC (≤0.05×10(9)/L) had high early death rate and with very low response rate to frontline IST and poor survival, so it is urgent to seek for the alternative frontline therapy that will bring faster and better outcome for these patients.

Anemia, Aplastic ; blood ; drug therapy ; Animals ; Antilymphocyte Serum ; therapeutic use ; Cyclosporine ; therapeutic use ; Disease-Free Survival ; Humans ; Immunosuppressive Agents ; therapeutic use ; Leukocyte Count ; Neutrophils ; cytology ; Rabbits ; Retrospective Studies ; Survival Rate ; Treatment Outcome

The aim of this study was to investigate the relationship between the acetylcholine concentration in the blood and gelsenicine-induced death in mice. Kunming mice were given intraperitoneal injections of normal saline, gelsenicine or different doses of acetylcholine chloride. Atropine was given to the mice which received gelsenicine or medium dose acetylcholine chloride injection. The blood was sampled immediately when the mice died or survived for 20 min after injection. The acetylcholine concentration and acetylcholinesterase activity in the blood were measured by the testing kits, and the mortality was calculated and analyzed. The results showed that half lethal dose of gelsenicine (0.15 mg/kg) reduced the acetylcholinesterase activity and increased the blood acetylcholine concentration. The blood acetylcholine concentration of the dead mice in the gelsenicine group was increased to 43.0 μg/mL (from 31.1 μg/mL in the control), which was lower than that (53.9 μg/mL) of the dead mice in the medium dose acetylcholine chloride group, but almost equal to that (42.7 μg/mL) of the survival mice in the medium dose acetylcholine chloride group. Atropine could successfully rescue the mice from acetylcholine poisoning, but its efficiency of rescuing the mice from gelsenicine intoxication was weak. These results suggest that gelsenicine can inhibit acetylcholinesterase activity and increase blood acetylcholine concentration, but the accumulation of acetylcholine may not be the only or main cause of the death induced by gelsenicine in mice.
Acetylcholine ; Animals ; Death ; Indole Alkaloids ; Mice

BACKGROUNDDNA hypomethylation of long interspersed nuclear elements-1 (LINEs-1) occurs during carcinogenesis, whereas information addressing LINE-1 methylation in Wilms tumor (WT) is limited. The main purpose of our study was to quantify LINE-1 methylation levels and evaluate their relationship with relative telomere length (TL) in WT.

METHODSWe investigated LINE-1 methylation and relative TL using bisulfite-polymerase chain reaction (PCR) pyrosequencing and quantitative PCR, respectively, in 20 WT tissues, 10 normal kidney tissues and a WT cell line. Significant changes were analyzed by t-tests.

RESULTSLINE-1 methylation levels were significantly lower (P < 0.05) and relative TLs were significantly shorter (P < 0.05) in WT compared with normal kidney. There was a significant positive relationship between LINE-1 methylation and relative TL in WT (r = 0.671, P = 0.001). LINE-1 Methylation levels were significantly associated with global DNA methylation (r = 0.332, P < 0.01). In addition, relative TL was shortened and LINE-1 methylation was decreased in a WT cell line treated with the hypomethylating agent 5-aza-2'-deoxycytidine compared with untreated WT cell line.

CONCLUSIONThese results suggest that LINE-1 hypomethylation is common and may be linked to telomere shortening in WT.

Cell Line, Tumor ; Child ; Child, Preschool ; DNA Methylation ; genetics ; Female ; Humans ; Long Interspersed Nucleotide Elements ; genetics ; Male ; Polymerase Chain Reaction ; Telomere ; genetics ; Wilms Tumor ; genetics