Does local vaginal estrogen after tension-free transobturator vaginal tape reduce overactive bladder symptoms in postmenopausal women? A prospective randomized, controlled study

Objective:We aimed to evaluate the efficacy of topical estrogen after transvaginal tension-free vaginal tape-obturator(TVT-O)in the treatment of de novo overactive bladder symptoms that appear after surgery.Methods:This is a prospective randomized controlled study performed in the Urology and Gynecology Departments,Kasr Al Ainy Hospital,Cairo University,Cairo,Egypt.Two hundred and ten postmenopausal females presenting during the period between January 2017 and November 2020 with stress urinary incontinence were included in the study.Patients were divided into two groups,105 patients in Group A(treatment group)and 105 patients in Group B(control group).Patients in Group A underwent transvaginal TVT-O followed by local vaginal estrogen treatment for 6 months,while patients in Group B underwent transvaginal TVT-O only.The study included any postmenopausal female with urodynamic stress urinary incontinence.All patients had to fulfill a 3-day bladder diary,overactive bladder symptoms score,urine analysis,urodynamic study,and post-voiding residual urine measurement by abdominal ultrasound preoperatively and at 3-month and 6-month follow-ups.Results:At 6-month follow-up,daytime frequency was reduced to 8%in Group A(increased to 21%in Group B)with a statistically significant difference between both groups(p=0.009).At 6-month follow-up,nocturia was 8%in Group A(11%in Group B)with no statistically significant difference between both groups(p=0.469).There was a statistically significant difference between both groups as regards to urinary urgency at 6-month follow-up(p=0.024).There was a statistically significant difference in postoperative wound healing events as regards to cure,hyperemia,gapping,and wound infection 1 week after intervention between both groups(p=0.008).No local or systemic side-effects were reported from local estrogen use.Conclusion:Local vaginal estrogen treatment given to postmenopausal patients after midurethral sling procedures can reduce the symptoms of daytime frequency and urinary urgency.Long-term follow-up is needed.

Clinicopathological Features and Long-Term Prognostic Role of Human Epidermal Growth Factor Receptor-2 Low Expression in Chinese Patients with Early Breast Cancer:A Single-Institution Study

Objective This study aimed to comprehensively analyze and compare the clinicopathological features and prognosis of Chinese patients with human epidermal growth factor receptor 2(HER2)-low early breast cancer(BC)and HER2-IHC0 BC.Methods Patients diagnosed with HER2-negative BC(N=999)at our institution between January2011 and December 2015 formed our study population.Clinicopathological characteristics,association between estrogen receptor(ER)expression and HER2-low,and evolution of HER2 immunohistochemical(IHC)score were assessed.Kaplan-Meier method and log-rank test were used to compare the long-term survival outcomes(5-year follow-up)between the HER2-IHC0 and HER2-low groups.Results HER2-low BC group tended to demonstrate high expression of ER and more progesterone receptor(PgR)positivity than HER2-IHC0 BC group(P<0.001).The rate of HER2-low status increased with increasing ER expression levels(Mantel-Haenszelχ^(2)test,P<0.001,Pearson’s R=0.159,P<0.001).Survival analysis revealed a significantly longer overall survival(OS)in HER2-low BC group than in HER2-IHC0 group(P=0.007)in the whole cohort and the hormone receptor(HR)-negative group.There were no significant differences between the two groups in terms of disease-free survival(DFS).The discordance rate of HER2 IHC scores between primary and metastatic sites was 36.84%.Conclusion HER2-low BC may not be regarded as a unique BC group in this population-based study due to similar clinicopathological features and prognostic roles.

Inetetamab combined with tegafur as second-line treatment for human epidermal growth factor receptor-2-positive gastric cancer: A case report

BACKGROUND Human epidermal growth factor receptor-2(HER-2)plays a vital role in tumor cell proliferation and metastasis.However,the prognosis of HER2-positive gastric cancer is poor.Inetetamab,a novel anti-HER2 targeting drug independently developed in China,exhibits more potent antibody-dependent cell-mediated cytotoxicity than trastuzumab,which is administered as the first-line treatment for HER2-positive gastric cancer in combination with chemotherapy.In this case,the efficacy and safety of inetetamab combined with tegafur was investigated as a second-line treatment for HER2-positive gastric cancer.CASE SUMMARY A 52-year-old male patient with HER2-positive gastric cancer presented with abdominal distension,poor appetite,and fatigue two years after receiving six cycles of oxaliplatin combined with tegafur as first-line treatment after surgery,followed by tegafur monotherapy for six months.The patient was diagnosed with postoperative recurrence of gastric adenocarcinoma.He received 17 cycles of a combination of inetetamab,an innovative domestically developed anti-HER2 monoclonal antibody,and tegafur chemotherapy as the second-line treatment(inetetamab 200 mg on day 1,every 3 wk combined with tegafur twice daily on days 1–14,every 3 wk).Evaluation of the efficacy of the second-line treatment revealed that the patient achieved a stable condition and progression-free survival of 17 months.He tolerated the treatment well without exhibiting any grade 3-4 adverse events.CONCLUSION Inetetamab combined with chemotherapy for the treatment of metastatic HER2-positive gastric cancer demonstrates significant survival benefits and acceptable safety.

Estrogen restores disordered lipid metabolism in visceral fat of prediabetic mice

BACKGROUND Visceral obesity is increasingly prevalent among adolescents and young adults and is commonly recognized as a risk factor for type 2 diabetes.Estrogen[17β-estradiol(E2)]is known to offer protection against obesity via diverse me-chanisms,while its specific effects on visceral adipose tissue(VAT)remain to be fully elucidated.AIM To investigate the impact of E2 on the gene expression profile within VAT of a mouse model of prediabetes.METHODS Metabolic parameters were collected,encompassing body weight,weights of visceral and subcutaneous adipose tissues(VAT and SAT),random blood glucose levels,glucose tolerance,insulin tolerance,and overall body composition.The gene expression profiles of VAT were quantified utilizing the Whole Mouse Genome Oligo Microarray and subsequently analyzed through Agilent Feature Extraction software.Functional and pathway analyses were conducted employing Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses,respectively.RESULTS Feeding a high-fat diet(HFD)moderately increased the weights of both VAT and SAT,but this increase was mitigated by the protective effect of endogenous E2.Conversely,ovariectomy(OVX)led to a significant increase in VAT weight and the VAT/SAT weight ratio,and this increase was also reversed with E2 treatment.Notably,OVX diminished the expression of genes involved in lipid metabolism compared to HFD feeding alone,signaling a widespread reduction in lipid metabolic activity,which was completely counteracted by E2 adminis-tration.This study provides a comprehensive insight into E2's local and direct protective effects against visceral adiposity in VAT at the gene level.CONCLUSION In conclusion,the present study demonstrated that the HFD-induced over-nutritional challenge disrupted the gene expression profile of visceral fat,leading to a universally decreased lipid metabolic status in E2 deficient mice.E2 treatment effectively reversed this condition,shedding light on the mechanistic role and therapeutic potential of E2 in combating visceral obesity.

Comprehensive Analysis of Estrogen Receptor 1 Dysregulation in Liver Hepatocellular Carcinoma: Implications for Prognosis and Therapeutic Targeting - A Secondary Publication

The study investigates the expression pattern and regulatory mechanisms of estrogen receptor 1 (ESR1) in liver hepatocellular carcinoma (LIHC) through comprehensive bioinformatics analysis. Utilizing UALCAN and GEPIA2 databases, significant down-regulation of ESR1 expression is observed in LIHC samples compared to normal controls, indicating its potential role in tumor progression. Further analysis reveals consistent down-regulation across different clinical variables including patient age, gender, race, and various stages of LIHC, affirming the regulatory role of ESR1 in tumor development and progression. Additionally, promoter methylation analysis demonstrates hypermethylation of ESR1 in LIHC samples, negatively correlating with its expression. This association persists across different clinical parameters, emphasizing the inverse relationship between ESR1 methylation and expression levels. Survival analysis indicates that up- regulation of ESR1 is associated with better overall survival, suggesting its potential as a prognostic biomarker in LIHC. Furthermore, genetic mutation analysis using cBioPortal reveals a spectrum of alterations in ESR1, including amplification, missense mutation, deep deletion, splice mutation, and truncating mutation, highlighting the genetic complexity of ESR1 in LIHC. These findings collectively contribute to a deeper understanding of ESR1 dysregulation in LIHC and its clinical implications as a potential therapeutic target and prognostic marker.

Increased Midkine and Estrogen Receptor-β Expression in Human Non-Small Cell Lung Cancer

Objective： Midkine （MK）, a new member of the heparin-binding growth factor family, has been found recently to have a high expression level in many tumor specimens including lung carcinoma. Estrogens may be involved in lung carcinogenesis, and estrogen receptors, mainly estrogen receptor-β （ER-β）, are present and functional in normal lung and tumor cell lines and tissues. In addition, estrogens and growth factors may promote the progression of human non-small cell lung cancer （NSCLC）. Previously, we have immunohistochemically demonstrated that MK and ER-β proteins were overexpressed in NSCLC and their expression levels were both significantly negatively correlated with the pathological classification. The purpose of this study was to further verify their expression and its correlation with NSCLC. Methods： Taking NSCLC tissues and their corresponding paraneoplastic and normal lung as research objects, we further examined the expression of MK and ER-β by meas of RT-PCR, in situ hybridization and Western blot analyses at the levels of messenger RNA （mRNA） and protein, respectively. Results： The increased MK and ER-β mRNA expression was found in NSCLC by RT-PCR and in situ hybridization analyses. Furthermore, Western blot analysis also displayed increased expression of MK and ER-β proteins in NSCLC. Finally, their correlation analysis at the levels of mRNA and protein expression in NSCLC demonstrated that MK protein level was significantly correlated to estrogen receptor-β （P〈0.01, rs=0.535）; in spite of their correlation at the mRNA level, there was no remarkable difference between MK and ER-β （P〉0.05, rs=0.178）. Conclusion： All these results in the present study confirmed that MK and ER-β were overexpressed in human NSCLC.

Current medical treatment of estrogen receptor-positive breast cancer

Approximately 80% of breast cancers(BC) are estrogen receptor(ER)-positive and thus endocrine therapy(ET) should be considered complementary to surgery in the majority of patients. The advantages of oophorectomy, adrenalectomy and hypophysectomy in women with advanced BC have been demonstrated many years ago, and currently ET consist of(1) ovarian function suppression(OFS), usually obtained using gonadotropinreleasing hormone agonists(Gn RHa);(2) selective estrogen receptor modulators or down-regulators(SERMs or SERDs); and(3) aromatase inhibitors(AIs), or a combination of two or more drugs. For patients aged less than 50 years and ER+ BC, there is no conclusive evidence that the combination of OFS and SERMs(i.e., tamoxifen) or chemotherapy is superior to OFS alone. Tamoxifen users exhibit a reduced risk of BC, both invasive and in situ, especially during the first 5 years of therapy, and extending the treatment to 10 years further reduced the risk of recurrences. SERDs(i.e., fulvestrant) are especially useful in the neoadjuvant treatment of advanced BC, alone or in combination with either cytotoxic agents or AIs. There are two types of AIs: type Ⅰ are permanent steroidal inhibitors of aromatase, while type Ⅱ are reversible nonsteroidal inhibitors. Several studies demonstrated the superiority of the third-generation AIs(i.e., anastrozole and letrozole) compared with tamoxifen, and adjuvant therapy with AIs reduces the recurrence risk especially in patients with advanced BC. Unfortunately, some cancers are or became ET-resistant, and thus other drugs have been suggested in combination with SERMs or AIs, including cyclin-dependent kinase 4/6 inhibitors(palbociclib) and mammalian target of rapamycin(m TOR) inhibitors, such as everolimus. Further studies are required to confirm their real usefulness.

Tumor biology in estrogen receptor-positive,human epidermal growth factor receptor type 2-negative breast cancer:Mind the menopausal status

Breast cancer is not one disease,but can be categorized into four major molecular subtypes according to hormone receptor [estrogen receptor(ER) and progesterone receptor(Pg R)] and human epidermal growth factor receptor type 2(HER2) expression status. Ki67 labeling index and/or multigene assays are used to classify ERpositive,HER2-negative breast cancer into luminal A and luminal B(HER2-negative) subtypes. To date,most studies analyzing predictive or prognostic factors in ER-positive breast cancer have been performed in postmenopausal women,mainly using patients and samples in adjuvant aromatase inhibitor trials. In contrast,even the clinical roles of Pg R and Ki67 have been little analyzed so far in premenopausal women. Pg R is one of the estrogen-responsive genes,and it has been reported that plasma estradiol levels are related to expression levels of estrogen-responsive genes including PGR in ER-positive breast cancer. In this article,biological differences,especially differences in expression of Pg R and Ki67 in ER-positive breast cancer between pre- and postmenopausal women are discussed. Clinical roles of Pg R and Ki67 in ER-positive breast cancer differ between pre- and postmenopausal women. We suggest that the mechanisms of development and estrogen-dependent growth of ER-positive breast cancer might differ according to menopausal status.

Liuwei Dihuang formula(六味地黄方)protect endothelial cells from apoptosis by up-regulating expression of estrogen receptor-α

OBJECTIVE:To evaluate the efficacy of Liuwei Dihuang formula(六味地黄方,LWDHF)on endothelial cells,and to study the mechanism behind the action of modulating expression of estrogen receptors.METHODS:Hydrogen peroxide(H_(2)O_(2))was applied to induce the apoptosis of human umbilical vein endothelial cells(HUVECs).The concentration of nitric oxide(NO),endothelial nitric oxide synthase(eNOS)and inducible NOS(iNOS)were measured by assay kits.Western blot and real-time polymerase chain reaction(RT-PCR)were used to detect the expression of iNOS,eNOS,b-cell lymphoma-2(Bcl-2),Bcl-2-associated X protein(Bax),estrogen receptor(ER)αand ERβ.Also,small interfering RNA(siRNA)was involved to confirm whether the protective effects of LWDHF was medicated by ERs.In vivo,the female rats were ovariectomized to establish postmenopausal vascular injury model.Then the model rats were divided into three groups and treated with saline,estradiol and LWDHF respectively.The concentration of NO and NOS in serum were measured by assay kits,and the expression of Bax,Bcl-2,ERαand ERβwere detected by western blot and immunohistochemistry.RESULTS:In vitro study,LWDHF significantly protected HUVECs from H_(2)O_(2)-induced apoptosis,with the increase of Bcl-2 and the decrease of Bax.The treatment with LWDHF inhibited concentration of NO and iNOS,and upregulated the expression of eNOS,ERαand ERβ.In addition,ERαsiRNA could block the protective effects of LWDHF,while ERβsiRNA showed little influence.In vivo,the treatment with LWDHF suppressed the vascular injury and reduced the level of NO and NOS.LWDHF increased the expression of Bcl-2,ERαand ERβ,as well as inhibiting the Bax expression.CONCLUSION:LWDHF could improve endothelial function and protect HUVECs from apoptosis via increasing the expression of ERα.

Adjuvant tamoxifen switched to exemestane treatment in postmenopausal women with estrogen receptor-positive early breast cancer:A pragmatic,multicenter,and prospective clinical trial in China

Objective:This post-approval safety study assessed the efficacy and safety of exemestane after 2-3 years of tamoxifen treatment among postmenopausal women with estrogen receptor-positive(ER+)early breast cancer in China.Methods:Enrolled patients had received 2-3 years of tamoxifen and were then switched to exemestane for completion of 5 consecutive years of adjuvant endocrine therapy.The primary endpoint was the time from enrollment to the first occurrence of locoregional/distant recurrence of the primary breast cancer,appearance of a second primary or contralateral breast cancer,or death due to any cause.Other endpoints included the proportion of patients experiencing each event,incidence rate per annum,relationships between human epidermal growth factor receptor 2 status and time to event,and relationship between disease history variables and time to event.Results:Overall,558 patients were included in the full analysis set:397(71.1%)completed the study,20experienced an event,and 141 discontinued[47 owing to an adverse event(AE);37 no longer willing to participate].Median duration of treatment was 29.5(range,0.1-57.7)months.Median time to event was not reached.Eventfree survival probability at 36 months was 91.4%(95%CI,87.7%-95.1%).The event incidence over the total exposure time of exemestane therapy was 3.5 events/100 person-years(20/565).Multivariate analysis showed an association between tumor,lymph node,and metastasis stage at initial diagnosis and time to event[hazard ratio:1.532(95%CI,1.129-2.080);P=0.006].Most AEs were grade 1 or 2 in severity,with arthralgia(7.7%)being the most common treatment-related AE.Conclusions:This study supports the efficacy and safety of exemestane in postmenopausal Chinese women with ER+breast cancer previously treated with adjuvant tamoxifen for 2-3 years.No new safety signals were identified in the Chinese population.

Isoflavone genistein protects high glucose-induced human aortic endothelial cell apoptosis through estrogen receptor-mediated pathway

Objective The aim of this study was to determine if isoflavone genistien has protective effects against high glucose-induced cell apoptosis in human aortic endlthelial cells, and investigate the possible mechanism for this protection. Methods Human aortic endothelial cells subjected to normal (5mmol/L) or high glucose (25mmol/L) were treated with genistein at 0, 50, 100nmol/L. Parallel experiments were performed with 100nM 17b-estradiol, and also in the presence and absence of the pure anti-estrogen ICI-182,780 (100nmol/L). The effects on cell apoptotic DNA fragmentation were determined using cell death ELISA, and the effects on cellular proliferation were determined using tritiated thymidine incorporation assay. Estrogen receptor expression was detected by Taqman quantitative PCR. Results Genistein at 100nmol/L significantly reduced high glucose-induced DNA fragmentation, and reversed cell DNA synthesis inhibition (P <0.001) after 24 hours' incubation. The effect of genistein was completely blocked by ICI-182,780 administration. Estrogen receptor beta, but not alpha was found to be expressed in these cells. Conclusion Isoflavone genistein shows protection against high glucose-induced cell damage through estrogen receptor beta, reducing apoptotic DNA damage and protecting from the inhibition of cell proliferation.

Estrogen weakens muscle endurance via estrogen receptor-MAPK mediated orosomucoid suppression

Gender differences in fatigue,manifesting as female more prone to feel exhausted with lower muscle endurance,still remains unclear mechanism.Here,we investigated whether orosomucoid,an endogenous anti-fatigue protein which can enhance muscle endurance,is involved in this regulation.Female rats showed lower muscle endurance,and this gender difference was disappeared in orosomucoid 1-deficient mice.Female rats also displayed weaker orosomucoid induction in serum,liver and muscle in response to fatigue when compared to male ones.Ovariectomy in female rats results in elevated orosomucoid level and increased swimming time which was reversed by estrogen replenishment,while exogenous estrogen treatment both in male or female mice produced opposite effects.In vitro C2C12 muscle and Chang liver cells,estrogen decreased orosomucoid expression and its promoter activity,and this effect was abolished when estrogen receptor or MAPK was blocked.Thus,estrogen negatively regulates orosomucoid expression,which is responsible for the weaker muscle endurance in females.

Clinical outcomes of lenvatinib plus transarterial chemoembolization with or without programmed death receptor-1 inhibitors in unresectable hepatocellular carcinoma

BACKGROUND Programmed death receptor-1(PD-1)inhibitors have been approved as secondline treatment regimen in hepatocellular carcinoma(HCC),but it is still worth studying whether patients can benefit from PD-1 inhibitors as first-line drugs combined with targeted drugs and locoregional therapy.AIM To estimate the clinical outcome of transarterial chemoembolization(TACE)and lenvatinib plus PD-1 inhibitors for patients with unresectable HCC(uHCC).METHODS We carried out retrospective research of 65 patients with uHCC who were treated at Peking Union Medical College Hospital from September 2017 to February 2022.45 patients received the PD-1 inhibitors,lenvatinib,TACE(PD-1-Lenv-T)therapy,and 20 received the lenvatinib,TACE(Lenv-T)therapy.In terms of the dose of lenvatinib,8 mg was given orally for patients weighing less than 60 kg and 12 mg for those weighing more than 60 kg.Of the patients in the PD-1 inhibitor combination group,15 received Toripalimab,14 received Toripalimab,14 received Camrelizumab,4 received Pembrolizumab,9 received Sintilimab,and 2 received Nivolumab,1 with Tislelizumab.According to the investigators’assessment,TACE was performed every 4-6 wk when the patient had good hepatic function(Child-Pugh class A or B)until disease progression occurred.We evaluated the efficacy by the modified Response Evaluation Criteria in Solid Tumors(mRECIST criteria).We accessd the safety by the National Cancer Institute Common Terminology Criteria for Adverse Events,v 5.0.The key adverse events(AEs)after the initiation of combination therapy were observed.RESULTS Patients with uHCC who received PD-1-Lenv-T therapy(n=45)had a clearly longer overall survival than those who underwent Lenv-T therapy(n=20,26.8 vs 14.0 mo;P=0.027).The median progression-free survival time between the two treatment regimens was also measured{11.7 mo[95%confidence interval(CI):7.7-15.7]in the PD-1-Lenv-T group vs 8.5 mo(95%CI:3.0-13.9)in the Lenv-T group(P=0.028)}.The objective response rates of the PD-1-Lenv-T group and Lenv-T group were 44.4%and 20%(P=0.059)according to the mRECIST criteria,meanwhile the disease control rates were 93.3%and 64.0%(P=0.003),respectively.The type and frequency of AEs showed little distinction between patients received the two treatment regimens.CONCLUSION Our results suggest that the early combination of PD-1 inhibitors has manageable toxicity and hopeful efficacy in patients with uHCC.

Estrogen and oxytocin involvement in social preference in male mice:a study using a novel long-term social preference paradigm with aromatase,estrogen receptor-αand estrogen receptor-β,oxytocin,and oxytocin receptor knockout male mice

Certain aspects of social behavior help animals make adaptive decisions during encounters with other animals.When mice choose to approach another conspecific,the motivation and preference behind the interaction is not well understood.Estrogen and oxytocin are known to influence a wide array of social behaviors,including social motivation and social preference.The present study investigated the effects of estrogen and oxytocin on social preference using aromatase(ArKO),estrogen receptor(ER)α(αERKO),ERβ(βERKO),oxytocin(OTKO),oxytocin receptor(OTRKO)knockout and their respective wild-type(WT)male mice.Mice were presented with gonadally-intact versus castrated male(IC),intact male versus ovariectomized female(IF),or intact male versus empty cage(IE)stimuli sets for 5 days.ArWT showed no preference for either stimuli in IC and IF and intact male preference in IE,but ArKO mice preferred a castrated male or an ovariectomized female,or had no preference for either stimulus in IC,IF and IE stimuli sets,respectively,suggesting reduced intact male preference.αandβWT mice preferred a castrated male,showed no preference,and preferred an intact male in IC,IF and IE,respectively.αERKO mice displayed similar modified social preference patterns as ArKO,whereas the social preference ofβERKO mice remained similar toβWT.OTWT preferred a castrated male whereas OTKO,OTRWT and OTRKO mice failed to show any preference in IC and none showed preference for either stimuli in IF.Collectively,these findings suggest that estrogen regulates social preference in male mice and that impaired social preference in oxytocin-deficient mice may be due to severe deficits in social recognition.

Anticancer efficacy of 3-(4-isopropyl)benzylidene-8-ethoxy,6-methyl,chroman-4-one(SBL-060),a novel,dual,estrogen receptor-Akt kinase inhibitor in acute myeloid leukemia cells

Estrogen receptor(ER)αis expressed in a subset of patient-derived acute myeloid leukemia(AML)cells,whereas Akt is predominantly expressed in most types of AML.Targeting AML with dual inhibitors is a novel approach to combat the disease.Herein,we examined a novel small molecule,3-(4-isopropyl)benzylidene-8-ethoxy,6-methyl,chroman-4-one(SBL-060),capable of targeting AML cells by inhibiting ERαand Akt kinase.The chemical properties of SBL-060 were identified by proton nuclear magnetic resonance(^(1)H-NMR),^(13)C-NMR,and mass spectroscopy.In silico docking was performed using an automated protocol with AutoDock-VINA.THP-1 and HL-60 cell lines were differentiated using phorbol 12-myristate 13-acetate.ERαinhibition was assessed using ELISA.The MTT assay assessed cell viability.Flow cytometry was performed for cell cycle,apoptosis,and p-Akt analyses.Chemical analysis identified the compound as 3-(4-isopropyl)benzylidene-8-ethoxy,6-methyl,chroman-4-one,which showed high binding efficacy toward ER,with aΔG_(binding) score of−7.4 kcal/mol.SBL-060 inhibited ERα,exhibiting IC50 values of 448 and 374.3 nM in THP-1 and HL-60 cells,respectively.Regarding inhibited cell proliferation,GI50 values of SBL-060 were 244.1 and 189.9 nM for THP-1 and HL-60 cells,respectively.In addition,a dose-dependent increase in sub G_(0)/G_(1) phase cell cycle arrest and total apoptosis was observed after treatment with SBL-060 in both cell types.SBL-060 also dose-dependently increased the p-Akt-positive populations in both THP-1 and HL-60 cells.Our results indicate that SBL-060 has excellent efficacy against differentiated AML cell types by inhibiting ER and Akt kinase,warranting further preclinical evaluations.

Effect of estrogen pretreatment in GnRH antagonist protocol-Meta-analysis

Objective:To evaluate the effect of estrogen pre-treatment in patients with different ovarian response in antagonist protocol.Methods:Randomized controlled trials(RCTs)and retrospective studies about the effect of estrogen pre-treatment in antagonist prorocol were searched in PubMed,Web of Science,China National Knowledge Infrastructure,Wanfang Database.R software was used for meta-analysis.Results:Seven RCTs and two retrospective studies were included.In order to explore the source of heterogeneity,subgroup analysis was used,which was mainly conducted according to the ovarian response of the included population,which were divided into low responders,non-low responders and mixed responders.In the study about gonadotropin hormone(Gn)days,patients were divided into wash-out subgroup and non-wash-out subgroup according to drug use-pattern.Meta-results showed that the number of Gn days increased significantly in the non-wash-out subgroup(WMD=1.07,95%CI[0.83;1.31],I2=66%).The number of Gn days in the wash-out subgroup were not affected(WMD=-0.12,95%CI[-0.45;0.21],I2=0%).In the low-response subgroup,the number of oocytes retrieved(WMD=0.46,95%CI[-0.23;1.16],I2=81%),the fresh cycle clinical pregnancy rate(RR=0.77,95%CI[0.55;1.06],I2=73%)and the cycle cancellation rate(RR=0.80,95%CI[0.40;1.61],I2=83%)were not significantly changed with estrogen pre-treatment.In the non-low-response subgroup,the number of oocytes obtained(WMD=0.21,95%CI[-0.69;1.11],I2=2%),fresh cycle clinical pregnancy rate(RR=0.94,95%CI[0.77;1.14],I2=41%),live birth rate(RR=0.82,95%CI[0.62;1.08],I2=0%)and cycle cancellation rate(RR=0.89,95%CI[0.54;1.47],I2=2%)were not significantly changed with estrogen pre-treatment.Conclusions:Estrogen pre-treatment(with non-wash-out period)in antagonist protocol increases Gn days,dose not improve IVF outcomes in non-low responders and low responders.

Tyrosine kinase inhibitors and human epidermal growth factor receptor-2 positive breast cancer

The body of evidence investigating human epidermal growth factor receptor-2(HER2)directed therapy in patients with breast cancer(BC)has been growing within the last decade.Recently,the use of tyrosine kinase inhibitors(TKIs)has been of particular interest in the treatment of human malignancies.This literature commentary is intended to highlight the most recent findings associated with the widely-studied TKI agents and their clinical significance in improving the outcomes of HER2 positive BC.

ESTROGEN RECEPTOR-NEGATIVE BREAST CANCER CELLS TRANSFECTED WITH ESTROGEN RECEPTOR EXHIBIT DECREASED TUMOUR PROGRESSION AND SENSITIVITY TO GROWTH INHIBITION BY ESTROGEN

Breast cancer containing estrogen receptors (ER ) are responslve to antiestrogen treatment and have a better prognosis compared with ER-negative tumors. The loss of estrogen receptors appears to be associated with a progression to less clifferentiated cells. We transfected the human ER into the ER-negative breast cancer cell line MDA MD 231 cells. We found that expresslon of adequate ER is strong associated with the ability of human breast cancer cell growth inhibition and progression. Compared with nontransfected or mock-trans fected cells, ER-transfected cells exhibited growth slower, forming smaller colonles in soft agar and growth inhibited by estrogen and tamoxifen. Therefore reactivation or transfection of the estrogen receptor gene can be considered as therapeutic approaches to hormone-independent breast cancer.

The effect of estrogen-mediated ubiquitin on cardiovascular diseases:a bioinformatics analysis

Objective:Using data mining tools,study the potential pathways of estrogen’s cardiovascular effects.Methods:The GeneExpression Omnibus database was used to download the relevant high-throughput microarray dataset GSE72180,which was then analyzed for differential genes using the GEO2R online analysis tool,gene function and pathway enrichment analysis using DAVID 6.8,protein interaction network analysis using the STRING database,and core network extraction using the MCODE algorithm.Results:A total of 131 differential genes were identified and enriched for gene function and signaling pathway analysis,which indicated that these genes were related with focal adhesion and the HIF-1 signaling pathway.MCODE algorithm analysis extracted 1 core sub-network of these genes to be related to ubiquitin protein transferase activity,protein polyubiquitination,protein ubiquitination involved in ubiquitin-dependent proteolytic metabolic processes,ligase activity,and clustering on ubiquitin-mediated protein hydrolysis signaling pathway.Conclusion:By using data mining tools,it is possible to identify how estrogen may influence the cardiovascular system by controlling the ubiquitination process.This information may be used as a reference for etiology and preventive studies of cardiovascular illnesses.

养阴宁神方对去势小鼠海马神经元突触的可塑性调节

目的观察养阴宁神方对雌性小鼠去势后认知功能的影响。方法将60只C57BL/6J雌性小鼠随机分为假手术组,模型组,雌激素组,低、中、高剂量组,每组10只。假手术组仅切开皮肤和腹膜,不摘除小鼠的卵巢;其余各组均进行双侧卵巢切除术。假手术组、模型组均给予等容量的生理盐水(0.1 mL/10 g),雌激素[雌二醇(estradiol,E2),0.09 mg/kg]组及低剂量组(9.459 g/kg)、中剂量组(18.459 g/kg)、高剂量组(36.99 g/kg)灌胃药液,均灌胃3周。记录小鼠术后伤口愈合时间,去势前、去势1周、去势4周进行水迷宫潜伏实验和穿梭实验测试小鼠的学习记忆功能。采用ELISA法测定血清E2含量;HE染色观察小鼠海马神经元的形态;尼氏染色观察海马神经尼氏染色阳性细胞的数量;共聚焦显微镜下观察小鼠海马神经元细胞超微结构情况。结果与假手术组相比,模型组伤口愈合时间延长(P<0.05);与模型组、雌激素组及低、高剂量组比较,中剂量组伤口愈合时间缩短(P<0.05)。去势1周,与假手术组比较,模型组、雌激素组及低、中、高剂量组逃避潜伏期延长、穿梭次数减少(P<0.05)。去势4周,与假手术组比较,模型组逃避潜伏期延长、穿梭次数减少(P<0.05);与模型组相比,雌激素组及低、中、高剂量组逃避潜伏期缩短、穿梭次数增加(P<0.05)。去势4周,与假手术组比较,模型组E2浓度明显降低(P<0.01);与模型组比较,雌激素组及低、中、高剂量组E2浓度明显增高(P<0.01)。尼氏染色显示,与假手术组比较,模型组尼氏阳性细胞数减少(P<0.01);与模型组比较,雌激素组及低、中、高剂量组尼氏阳性细胞数增加(P<0.01)。HE染色显示,假手术组,雌激素组,低、中、高剂量组锥体神经元增多,且突起明显;模型组锥体神经元较少、颗粒细胞较多。共聚焦显微镜下见,假手术组,雌激素组,低、中、高剂量组海马神经元囊泡和突触粗面内质网结构增多;模型组海马神经元囊泡和突触减少。结论养阴宁神方可能通过提高血浆E2水平、改善海马神经元突触形态和功能可塑性、增加去势小鼠的认知功能,从而发挥脑保护作用。