Vitamin B3 inhibits apoptosis and promotes autophagy of isletβcells under high glucose stress

Background:Hyperglycemia is a typical symptom of diabetes.High glucose induces apoptosis of isletβcells.While autophagy functions in cytoprotection and autophagic cell death.The interaction between autophagy and apoptosis is important in the modulation of the function of isletβcells.Vitamin B3 can induce autophagy and inhibit isletβapoptosis.Method:The mechanism of vitamin B3-mediated protective effect on the function of isletβcells was explored by the method of western blot,immunofluorescence and flow cytometry.Results:In the present study,high glucose stress increased the apoptosis rate,while vitamin B3 reduced the apoptosis rate.The effect of vitamin B3 on autophagy flux under normal and high glucose stress was also investigated.Vitamin B3 increased the number of autophagosomes and increased the light chain(LC)3-II/LC3-I ratio.In contrast,vitamin B3 decreased sequestosome 1(SQSTM1)/p62 protein expression and inhibited the phosphorylation of mammalian ribosomal protein S6 kinaseβ-1(p70S6K/S6K1),which was a substrate of mammalian target of rapamycin(mTOR)under normal and high glucose stress.To further verify the protective effect of vitamin B3 on apoptosis,we treated isletβcell RIN-m5F with autophagy inhibitor 3-methyladenine(3-MA).Vitamin B3 decreased the apoptosis rate under high glucose stress,while the inhibition of apoptosis by vitamin B3 was blocked after adding 3-MA.Conclusion:Our data suggested that vitamin B3 reduced the apoptosis rate ofβcells,possibly through inducing autophagy under high glucose stress.

Recurrent ascites due to spontaneous intraperitoneal bladder rupture after pelvic radiation therapy for cervical cancer

Radiation cystitis is one of the major complications following radiotherapy for cervical cancer. However, spontaneous intraperitoneal bladder rupture as a result of radiation cystitis following radiotherapy for cervical cancer is extremely rare. Case presentation: We report a 52-year-old patient who received radiation therapy for cervical cancer 15 years prior to presentation. Eight years prior to presentation, she developed recurrent abdominal distension, oliguria, and ascites. Following ascites drainage and supportive treatment, all symptoms were relieved. However, all symptoms subsequently recurred every few months. The patient underwent exploratory laparotomy twice. The first exploratory laparotomy in July 2015 found no specific abnormalities. The second exploratory laparotomy in November 2016 found an intraperitoneal bladder rupture, and the patient underwent surgical repair. The ascites subsequently resolved. Conclusion: The occurrence of spontaneous intraperitoneal bladder rupture after radiation therapy for cervical cancer is rare. The prognosis is good when diagnosis and treatment are prompt.

Nutritional status changes in patients with advanced non-small cell lung cancer receiving first-line chemotherapy

Objective This study aimed to assess the real-life nutritional status changes and gastrointestinal symptoms in patients with advanced non-small cell lung cancer(NSCLC) receiving chemotherapy.Methods A total of 104 patients with metastatic NSCLC receiving first-line chemotherapy were included in this study. Unintentional weight loss, body mass index(BMI) changes, and gastrointestinal symptoms were recorded and evaluated. Biochemical parameters [hemoglobin(Hb) and albumin levels] were compared before and after two chemotherapy cycles using SPSS software.Results Of these patients, 65.38%(68/104) experienced unintentional weight loss, whereas 30.77% and 12.5% presented with ≥ 5% and ≥ 10% degrees of weight loss, respectively, within 6 months before first-line chemotherapy was administered. Then, 48.08%(50/104) of the patients experienced unintentional weight loss after two chemotherapy cycles. The mean body weight after chemotherapy was 61.47 ± 10.37 kg, which was significantly decreased relative to that before chemotherapy(P < 0.05). The mean BMI after chemotherapy was 22.66 ± 3.34 kg/m^2, which was also significantly diminished with respect to that during the previous chemotherapy cycle(P < 0.05). The most common gastrointestinal symptoms reported among all the study patients were anorexia(80/104, 76.92%), nausea(53/104, 50.96%), constipation(49/104, 47.12%), vomiting(48/104, 46.15%), taste disorders(40/104, 38.46%), and early satiety(32/104, 30.77%). The mean Hb levels after chemotherapy were 117.06 ± 16.67 g/L, which were significantly lower than those before chemotherapy(132.73 ± 16.42 g/L)(P < 0.05). No significant difference was noted between the mean albumin levels before and after chemotherapy(38.29 ± 4.22 g/L vs 38.17 ± 4.54 g/L; P = 0.798). Conclusion Weight loss history, gastrointestinal symptoms, and Hb level decreases are determinant factors of nutritional status in patients with advanced NSCLC and must be included in the screening, evaluation, and treatment of lung carcinoma.

Local definitive intensity-modulated radiation therapy recommended for patients initially diagnosed with nasopharyngeal carcinoma with distant metastasis after an effective systemic chemotherapy

Objective The aim of the study was to propose a hypothesis that local definitive intensity-modulated radiation therapy(IMRT) should be recommended for initially diagnosed metastatic nasopharyngeal carcinoma(NPC) and demonstrate its feasibility.Methods Recently published papers on local definitive radiotherapy for initially diagnosed metastatic NPC were reviewed to propose a hypothesis.Results Several studies revealed the survival benefits of adding local definitive radiotherapy to the systemic chemotherapy in patients initially diagnosed with metastatic NPC.Conclusion We suggested that local definitive IMRT should be recommended in patients initially diagnosed with NPC with distant metastasis after an effective systemic chemotherapy, which may possibly prolong their survival time and potentially treat the disease.