Sex differences in the scored Patient-Generated Subjective Global Assessment in 19,528 cancer patients

Background:The scored Patient-Generated Subjective Global Assessment(PG-SGA)has been widely used to assess the nutritional status of cancer patients.The purpose of this study is to compare the differences in PG-SGA scores and the 7 domain scores of the PG-SGA in male and female cancer patients.Methods:This study was conducted at 72 hospitals from July 2013 to December 2018,a part of the Investigation on Nutritional Status and its Clinical Outcomes of Common Cancers.The PG-SGA was recorded to evaluate the nutritional status of patients.A total of 19,528 patients with 13 common malignancies were included in this study.Student t test and the χ^(2) test were applied to analyze the sex diferences in the 7 domain scores.The Cancer Genome Atlas(TCGA)database was used to analyze the expression levels of symptom-related genes.Results:There were significant sex dfferences in the PG-SGA(P=0.032),notably in patients with gastric cancer(male vs female:9.09±4.86 vs 9.58±5.07,P=0.005)and esophageal cancer(9.64±4.90 vs 10.46±4.96,P=0.011)and the average total PG-SGA of female patients was slightly higher than that of male patients(7.64±4.98 vs 7.77±5.14).The differences were mainly related to the weight,eating,symptom,as well as activity and physical function scores in the stratified analysis.Possible causes of the sex differences were the rates of nausea,vomiting,dry mouth,and other symptoms,in both gastric and esophageal cancer patients.Analysis of the TCGA database suggested that most of the related genes were sex neutral,except for genes related to dysphagia in gastric cancer(VEGFC was higher in female patients,VEGFA and VEGFB higher in male patients).Conclusions:There are sex differences in the PG-SGA scores in patients with various tumor types(female patients generally had higher scores than male patients),with differences mainly in the weight,eating,symptom,as well as activity and physical function scores.The sex differences in PG-SGA scores might be due to the differences in the clinical manifestations of the disease,and further studies should be carried out to investigate other factors influencing the PG-SGA scores in cancer patients.This study provides basic data supporting the individualized nutritional treatment of cancer patients in clinical practice.

Intraperitoneal perfusion of cytokine-induced killer cells with local hyperthermia for advanced hepatocellular carcinoma

AIM:To study the effect and tolerance of intraperitoneal perfusion of cytokine-induced killer(CIK) cells in combination with local radio frequency(RF) hyperthermia in patients with advanced primary hepatocellular carcinoma(HCC).METHODS:Patients with advanced primary HCC were included in this study.CIK cells were perfused intraperitoneal twice a week,using 3.2 × 10 9 to 3.6 × 10 9 cells each session.Local RF hyperthermia was performed 2 h after intraperitoneal perfusion.Following an interval of one month,the next course of treatment was administered.Patients received treatment until disease progression.Tumor size,immune indices(CD3 +,CD4 +,CD3 + CD8 +,CD3 + CD56 +),alpha-fetoprotein(AFP) level,abdominal circumference and adverse events were recorded.Time to progression and overall survival(OS) were calculated.RESULTS:From June 2010 to July 2011,31 patients diagnosed with advanced primary HCC received intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia in our study.Patients received an average of 4.2 ± 0.6 treatment courses(range,1-8 courses).Patients were followed up for 8.3 ± 0.7 mo(range,2-12 mo).Following combination treatment,CD4 +,CD3 + CD8 + and CD3 + CD56 + cells increased from 35.78% ± 3.51%,24.61% ± 4.19% and 5.94% ± 0.87% to 45.83% ± 2.48%(P = 0.016),39.67% ± 3.38%(P = 0.008) and 10.72% ± 0.67%(P = 0.001),respectively.AFP decreased from 167.67 ± 22.44 to 99.89 ± 22.05 ng/mL(P = 0.001) and abdominal circumference decreased from 97.50 ± 3.45 cm to 87.17 ± 4.40 cm(P = 0.002).The disease control rate was 67.7%.The most common adverse events were low fever and slight abdominal erubescence,which resolved without treatment.The median time to progression was 6.1 mo.The 3-,6-and 9-mo and 1-year survival rates were 93.5%,77.4%,41.9% and 17.4%,respectively.The median OS was 8.5 mo.CONCLUSION:Intraperitoneal perfusion of CIK cells in combination with local RF hyperthermia is safe,can efficiently improve immunological status,and may prolong survival in HCC patients.

Impact of main vessel calcification on procedural and clinical outcomes of bifurcation lesion undergoing provisional single-stenting intervention: a multicenter, prospective, observational study

Background Few data on the combined effects of bifurcation and calcification on coronary artery disease(CAD)patients undergoing percutaneous coronary intervention(PCI)are available.This study evaluated the impact of main vessel(MV)calcification on the procedural and long-term outcomes in patients with CAD who underwent provisional single stent PCI.Methods This is a multicenter,prospective,observational study.Patients with bifurcation lesions were enrolled at 10 PCI centers in China from January 2015 to December 2017.Intravascular ultrasound or optical coherence tomography was performed in all patients to evaluate the MV calcification.Patients were treated with provisional single stent strategy using drug eluting stents and followed-up at 1 month,6 months and 12 months after discharge by telephone contact or outpatient visit.Repeated coronary imaging was performed within one year.We compared the procedural success rates in MV and in side branch(SB),and target lesion failure(TLF),defined as a composite of cardiac death,non-fatal myocardial infarction,definite or possible stent thrombosis and target lesion revascularization between patients with and without MV calcification.Results A total of 185 subjects were enrolled according to the inclusion and exclusion criteria of this study.MV calcification was detected in 119(64.3%,calcification group)and not found in 66(35.7%,non-calcification group)patients.The angiographic success rate of MV was 95.8%in the calcification group and 97.0%in the non-calcification group(P=0.91);the angiographic success rate of SB was 32.8%in the calcification group and 53.0%in the non-calcification group(P<0.05).During the one-year follow-up period,TLF occurred in 14(11.8%)patients in the calcification group and in 13(19.7%)in the non-calcification group{P=0.31).Multivariate regression analysis showed the same result(HR=1.23,95%CI:0.76-1.52,P=0.47).Calcification on group had higher recurrent angina than non-calcification group(13.51%vs.17.65%,P<0.05).Conclusions In patients with coronary bifurcation lesion treated with provisional one stent approach,calcification of MV is associated with lower SB procedural success rate,it could increase recurrence of angina;however,it was not associated with an increased risk of TLF.

Computed tomography-guided radiofrequency ablation of the retained iodized oil after simultaneous combination with transarterial embolization in small recurrent or residual hepatocellular carcinoma

Objective:To assess the clinical efficacy and safety of transarterial embolization(TAE)in simultaneous combination with computed tomography(CT)-guided radiofrequency ablation(RFA)for recurrent or residual hepatocellular carcinoma(HCC),and to determine the risk factors influencing local tumor progression following this procedure.Methods:One hundred eighteen patients with recurrent or residual HCC(tumor size,10–30 mm)underwent RFA.During the 19-month follow-up,59 patients received RFA only(RFA group),and the remaining 59 received RFA immediately after TAE(TAE+RFA group).All patients were followed up to observe the short-term therapeutic effects and complications.The cumulative local tumor progression rates in both groups were calculated using unpaired Student’s t tests and the Kaplan-Meier method.Results:The rate of major complications was 5.08%in the TAE+RFA group and 3.39%in the RFA group.The overall response rate was 96.61%in the TAE+RFA group and 79.66%in the RFA group(P=0.008).The disease control rate was significantly higher in the TAE+RFA group than in the RFA group(94.92%vs.79.66%,P=0.024).The median time to local tumor progression was 4.8 months in the RFA group and 9.6 months in the TAE+RFA group.The cumulative local tumor progression rate at 1 year was 10.60%in the RFA group and 23.60%in the TAE+RFA group(P=0.016).Conclusion:TAE in simultaneous combination with CT-guided RFA was effective and safe against recurrent or residual HCC.Local tumor progression can be minimized by the complete ablation of targeted iodized oil deposits after simultaneous TAE.

Oncothermia in Combination with Vitamin C Infusion for Non-small Cell Lung Cancer: a Case Report

We herein report an advanced case(T3N3M0,Stage ⅢB)of squamous cell lung cancer.The patient survived beyond 5 years only receiving intravenous vitamin C(VitC)infusion combined with modulated electrohyperthermia(mEHT,trade name:oncothermia).

Validity of the Chinese Version of the Patient-Generated Subjective Global Assessment (PG-SGA) in Gastric Cancer Patients

Purpose Malnutrition is severe among gastric cancer patients in China. While the Patient-Generated Subjective Global Assessment (PG-SGA) is a widely used nutritional assessment tool, the validation for Chinese patients with gastric cancer has not been performed yet. The aim of this research is to validate the Chinese version of the PGSGA in Chinese gastric cancer patients by conducting analyses of nutrition screening and assessment data. Methods Two thousand consecutive adult patients with gastric cancer were included in this observational, cross-sectional study in several tertiary hospitals in China. A survey was made among those patients, which included several questionnaires and some anthropometric parameters. We calculated the parameters to validate the use of PG-SGA categorizing the nutritional status of gastric cancer patients. Then we performed statistical analysis to evaluate the internal consistency, external consistency, and construct validity. Results This study verified the ability of the PG-SGA to differentiate gastric cancer patients into different nutritional groups. The confirmatory factor analysis verified the original four-factor structure of the PG-SGA. The internal and external consistency was measured by a concordance analysis which showed an intraclass correlation coefficients (ICC) of 0.987. The correlations of the Box 4 score with the Karnofsky performance status score demonstrated alternative form validity with good external consistency (Pearson, r = 0.643, P < 0.001). All three anthropometric dimensions of the PG-SGA were supported by principal component analysis. Spearman correlations (P < 0.001) were significant in the majority of tests. Conclusion The Chinese version of the PG-SGA is a valid tool to access the patients’ nutritional status for Chinese gastric patients.

Validity of the Chinese Version of the Patient-Generated Subjective Global Assessment (PG-SGA) in Lung Cancer Patients

The prevalence of malnutrition is high among oncology patients in China. Although the Patient- Generated Subjective Global Assessment (PG-SGA) is widely recognized as an important nutritional assessment tool, it has not been validated for Chinese cancer patients. The purpose of this study was to conduct an analysis of nutrition screening and assessment data to validate the Chinese version of the PG-SGA in Chinese patients with lung cancer. This was an observational, cross-sectional study of 2,000 consecutive adult patients with lung cancer treated at several tertiary hospitals in China. Anthropometric and patient descriptive data were collected. The PG-SGA generated a score for the nutritional risk and a global rating for the nutritional status. The internal consistency, external consistency, and construct validity were evaluated, and a known-groups comparison and principal component analyses were conducted to evaluate the reliability and validity of the PG-SGA. The known-groups comparison demonstrated the ability of the PG-SGA to differentiate lung cancer patients of different nutritional and body mass index (BMI) groups. A confirmatory factor analysis supported the original four-factor structure of the PG-SGA. In terms of the internal and external consistency, the PG-SGA demonstrated intra-class correlation coefficients (ICC) up to 0.987. Alternative form validity was also demonstrated between Box 4 of the PG-SGA and the Karnofsky Performance Status score, with excellent external consistency (r = 0.972, P < 0.001). The construct validity was supported, and selected questionnaire dimensions were evident in the principal component analysis. Significant Spearman correlations (P < 0.001) were demonstrated. The Chinese version of the PG-SGA demonstrated significant reliability and sufficient exploratory properties to support its validity. It seems to be a valid tool that can be used to access the nutritional status of Chinese lung cancer patients. The validity of the PG-SGA in Chinese cancer patients warrants further investigation in other cancer types.

Malnutrition and Quality of Life in Chinese Cancer Patients: a Clinical Study of 23,994 Subjects

Background Malnutrition is common in patients with cancer,and can negatively impact their quality of life(QoL)and even survival.However,there is currently no large data available on the prevalence of malnutrition in Chinese cancer patients.This study evaluated the prevalence of malnutrition and the QoL of Chinese patients with locoregional,recurrent or metastatic cancer.Methods We conducted a nationwide observational,multi-center,hospital-based cross-sectional study within the Chinese Society of Nutritional Oncology(CSNO)Network.All of the patients were diagnosed with one of the following 18 different types of malignant tumors:lung cancer,gastric cancer,liver cancer,colorectal cancer,breast cancer,esophageal cancer,cervical cancer,endometrial cancer,nasopharyngeal carcinoma,malignant lymphoma,leukemia,pancreatic cancer,ovarian cancer,prostate cancer,bladder cancer,brain cancer,biliary tract malignant tumors or gastrointestinal stromal tumors.These patients were enrolled from 72 hospitals located in different regions of China.The patients’nutritional status was evaluated based on the body mass index(BMI),loss of bodyweight,laboratory measurements and patient generated-subjective global assessment(PG-SGA)scores.The cancer patients’physical status and QoL were assessed by the Karnofsky Performance Status(KPS)questionnaire and the European Organization for Research and Treatment of Cancer(EORTC)QLQ-C30 questionnaire,respectively.Results From December 2013 to April 2016,23,994 patients hospitalized for cancer treatment(such as surgery,chemotherapy or radiotherapy)were enrolled in the study.The patients included 12,494(52.9%)males and 11,124(47.1%)females.The mean age was 55.8±13.7 years.The proportions of patients in cancer stagesⅠ,Ⅱ,Ⅲ,Ⅳand uncertain were 11.5%,20.3%,27.5%,30.2%and 10.5%,respectively.Among the 23,994 inpatients,the proportions of patients who were underweight(BMI<18.5 kg/m2),normal(18.5 kg/m2<BMI<24 kg/m2),overweight(24 kg/m2≤BMI<28 kg/m2)and obese(BMI≥28 kg/m2)were 9.3%,59.9%,26.1%and 4.7%,respectively.A total of 18.3%(4,101/22,424)of patients had lost 5%or more of their bodyweight within the past month and 19.6%(2,463/12,538)of patients had lost 10%or more of their bodyweight within the past 6 months.According to the PG-SGA scores,26.6%of the patients were severely malnourished(score≥9),31.3%were moderately malnourished(scores 4~8).A total of 22.2%of patients had a serum albumin level lower than 35g/L.Only 8.6%(2056/23,991)of the patients had severe KPS scores(≤60).The patients with these severe KPS scores were most frequently among those with cancers of the brain(19.7%),prostate(18.0%),pancreas(15.5%)and bladder(15.0%).Based on the QLQ-C30 score,11.6%of patients had a poor QoL.The PG-SGA score and global QoL were correlated(r=-0.593,P<0.001).Conclusion The prevalence of malnutrition in patients with cancer is relatively high,and is related to a poorer QoL.The present findings should be kept in mind when assessing cancer patients,because addressing the patient’s problems in nutritional status would be expected to improve both the clinical outcomes and QoL in cancer patients with malnutrition.

Extension Protocol for the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China(INSCOC)Study:2021 update

Background Malnutrition is common in patients with cancer,and this adversely affects the survival and quality of life of patients.Chinese Society for Nutritional Oncology issued a multi-center,large-scale,long-term follow-up prospective study,the Investigation on Nutrition Status and Clinical Outcome of Patients with Common Cancers in China(INSCOC study)since 2013.This is an extension to the previous 2013-2020 study protocol.This study still sought to:①address the prognostic impact of nutritional factors and quality of life on cancer patient survival;②describe the overall and cancer-specific incidence and/or distribution of malnutrition and different measurements of patient quality of life.Methods and study design This is an observational,multi-centered,hospital-based prospective cohort study.Data collection will be performed at baseline(within 48 hours after patient admission),during the hospital stay and 30 days after hospital admission.Follow-up will be conducted for 1-20 years after enrollment.The primary outcome will be the all-cause mortality/overall survival,and secondary outcomes will be the length of hospital stay and costs of hospitalization.Study factors will include demographic characteristics,tumor characteristics,information about chronic diseases,hematological measurements(e.g.,red blood cell count,total lymphocyte counts,hemoglobin,albumin,prealbumin,creatinine,C-reactive protein,IL-6),anthropometric measurements(e.g.,height,weight,arm circumference,arm muscle circumference,triceps skinfold thickness,and waist circumference),body composition parameters,PG-SGA scores,quality of life(as indicated by the QLQ-C30 questionnaire),muscle mass(as indicated by the calf circumference),muscle strength(as indicated by the handgrip strength),muscle function(as indicated by the six-meter walking speed test)and physical status assessments(as indicated by the Karnofsky Performance Status scores).This clinical study protocol was approved by local Ethics Committees of all the participating hospitals.Written informed consent is required for each subject included.Discussion This multi-center,large-scale,long-term follow up prospective study will help improve the diagnosis of malnutrition in cancer patients and identify the risk factors associated with adverse clinical outcomes.The anticipated results of this study will highlight the need for a truly scientific appraisal of nutrition therapy in Chinese oncology populations,and finally help treat the potentially reversible elements of malnutrition in cancer patients to improve their clinical outcomes in the future.

Nutritional Assessment of Gynecological Cancer Patients in China

Background Malnutrition is common among cancer patients,but few studies have evaluated the nutritional status among gynecological cancer patients in China.This study aimed to assess the nutritional status of women with gynecological cancer using the patient-generated subjective global assessment(PG-SGA).Methods Data for gynecological cancer patients treated at 44 tertiary hospitals were retrieved from a multicenter study on tumor nutrition.The R Software was used for statistical analyses.Univariate analyses of PG-SGA scores were performed using the Chi-squared test for categorical variables and the Wilcoxon-rank sum test or Kruskal-Wallis test for continuous variables,as appropriate.The significance level was 0.05.Results Data for 1962 women with three types of gynecological cancer(cervical,uterine and ovarian cancer)were used for the data analysis.The median PG-SGA score was 4(interquartile range,IQR:1,8),the median participants’age was 51(IQR:46,59)years old,and the patients had a median BMI of 22.9(IQR:20.7,25.4).The percentages of women who had a medical co-morbidity,or had undergone any radical resection,chemotherapy,or radiotherapy were approximately 27.7%,55.4%,52.5%,and 30.2%,respectively.The levels of serum albumin and high density lipoprotein cholesterol(HDL-C)were 40.1g/L(IQR:36.8,43.1)and 1.2mmol/L(IQR:1.0,1.5),respectively.The identified risk factors for malnutrition based on the PG-SGA score were age(0.05±0.01,p=0.002),BMI(-0.34±0.04,p<0.001),having a medical co-morbidity(0.95±0.33,p=0.004),receiving radiotherapy(1.52±0.31,p<0.001),the serum albumin level(-0.18±0.03,p<0.001),and the HDL-C(-1.12±0.35,p=0.001)as indicated by a linear regression analysis.Conclusions A higher PG-SGA score is positively associated with the age of the patient,having a medical co-morbidity,and receiving radiotherapy,and is negatively related to the patients’BMI and serum albumin and HDL-C levels.

Effect of modified Taohongsiwu decoction on patients with chemotherapy-induced hand-foot syndrome

OBJECTIVE:To observe the effect of the Traditional Chinese Medicine,modified Taohongsiwu decoction,versus pyridoxine on patients with hand-foot syndrome(HFS)from capecitabine,sorafenib,and gefitinib chemotherapy for gastric,lung,breast,colon,or rectal cancer.Also,to compare quality of life of patients in each group.METHODS:Patients were assigned randomly to group A or B.Group A was given modifiedTaohongsiwu decoction to soak hands and feet for 30 min,once daily.Group B was given 100 mg pyridoxine orally,twice daily.After a 2-week treatment,thetherapeutic effect was assessed by observing three major symptoms,including pain,ulceration,and muscular atrophy.This was assessed with the HFS-14 questionnaire.RESULTS:Significant differences were observed between the two groups in pain relief,and improvement of daily life,walking,and interpersonal communication(P<0.01).No significant differences in driving ability or interpersonal relationships were found.After 2 weeks,the effective rate was 88.3%in group A,which was significantly higher than the50%in group B(P=0.00).CONCLUSION:Modified Taohongsiwu decoction is effective in the treatment of patients with HFS.It improves patients'quality of life according to the HFS-14.

Effects of Senegenin against Hypoxia/Reoxygenation-Induced Injury in PC12 Cells

Objective： To investigate the effect and the potential mechanism of Senegenin （Sen） against injury induced by hypoxia/reoxygenation （H/R） in highly differentiated PC12 cells. Methods： The cultured PC12 cells were treated with H/R in the presence or absence of Sen （60 μmol/L）. Four groups were included in the experiment： control group, H/R group, H/R＋Sen group and Sen group. Cell viability of each group and the level of lactate dehydrogenase （LDH） in culture medium were detected for the pharmacological effect of Sen. Hoechst 33258 staining and annexin V/propidium iodide double staining were used to analyze the apoptosis rate. Moreover, mitochondrial membrane potential （△ψm）, reactive oxygen species （ROS） and intracellular free calcium （[Ca2＋]i） were measured by fluorescent staining and flow cytometry. Cleaved caspase-3 and activity of NADPH oxidase （NOX） were determined by colorimetric protease assay and enzyme linked immunosorbent assay, respectively. Results： Sen significantly elevated cell viability （P〈0.05）, decreased the leakage of LDH （P〈0.05） and apoptosis rate （P〈0.05） in H/R-injured PC12 cells. Sen maintained the value of △ψm （P〈0.05） and suppressed the activity of caspase-3 （P〈0.05）. Moreover, Sen reduced ROS accumulation （P〈0.05） and [Ca2＋]i increment （P〈0.05） by inhibiting the activity of NOX （P〈0.05）. Conclusion： Sen may exert cytoprotection against H/R injury by decreasing the levels of intracellular ROS and [Ca2＊]~, thereby suppressing the mitochondrial pathway of cellular apoptosis.

Mechanism and effect of Shijueming (Concha Haliotidis) on serum calcium in spontaneously hypertensive rats

OBJECTIVE: To observe the impact of Shijueming (Concha Haliotidis) on spontaneously hypertensive rats via blood pressure, serum calcium, vascular smooth muscle membrane L-type calcium channel α1 C subunit (CaL-α1C), plasma membrane calcium-ATPase (PMCA) mRNA expression, and the L-type calcium channel in vascular smooth muscle cells. METHODS:Twelve-week-old male rats with spontaneous hypertension were divided into three groups: a Shijueming (Concha Haliotidis) group (group 1), a nifedipine group (group 2), and a distilled water group (group 3). All were given a four-week treatment. Blood pressure and dissociative serum calcium were examined before treatment. Blood pressure was taken every week during treatment. Atomic absorption spectrometry was used to examine dissociative serum calcium. Re-verse transcription-polymerase chain reaction was used to examine the expression of CaL-α1C and PM-CA1 mRNA. The patch clamp technique was used to examine the electrophysiological characteristics of the vascular smooth muscle cell calcium channels. RESULTS: After treatment, blood pressure of the Shijueming (Concha Haliotidis) group lowered but not significantly (P>0.05). Blood pressure of the nifedipine group lowered significantly (P<0.05). Blood pressure of the distilled water group remained high. The concentration of serum calcium in the Shijueming (Concha Haliotidis) and the distilled water groups lowered (P<0.05). Expression of CaL-α1C mRNA in the nifedipine group decreased compared with the distilled water group (P<0.01). There was the decreasing trend in the Shijueming (Concha Haliotidis) group, but it was not statistically significant. Shijueming (Concha Haliotidis) also had effects on the expression of PMCA1 mRNA but with- out statistical significance. However, there was a significant decreasing effect on vascular smooth muscle cell I Ca-L flow. CONCLUSION: This study indicated that Shijueming (Concha Haliotidis) could increase serum calcium and decrease blood pressure. It may work by influencing calcium channels, expression of PMCA1 mRNA, and regulating ion calcium channels and calcium-ATPase.

Andrographolide as An Anti-H1N1 Drug and the Mechanism Related to Retinoic Acid-Inducible Gene-I-Like Receptors Signaling Pathway

Objective： To observe the anti-virus effects of andrographolide （AD） on the retinoic acid-inducible gene-I （RIG-I）-Iike receptors （RLRs） signaling pathway when immunological cells were infected with HIN1. Methods： Leukomonocyte was obtained from umbilical cord blood by Ficoll density gradient centrifugation, and immunological cells were harvested after cytokines stimulation. Virus infected cell model was established by H1N1 co-cultured with normal human bronchial epithelial cell line （16HBE）. The optimal concentration of AD was defined by methyl-thiazolyl-tetrazolium （MTT） assay. After the virus infected cell model was established, AD was added into the medium as a treatment intervention. After 24-h co-culture, cell supernatant was collected for interferon gamma （IFN- ~, ） and interleukin-4 （IL-4） enzyme-linked immunosorbent assay （ELISA） detection while immunological cells for real-time polymerase chain reaction （RT-PCR）. Results： The optimal concentration of AD for anti-virus effect was 250 μg/mL. IL-4 and IFN-γ in the supernatant and mRNA levels in RLRs pathway increased when cells was infected by virus, RIG-I, IFN-13 promoter stimulator-1 （IPS-1）, interferon regulatory factor （IRF）-7, IRF-3 and nuclear transcription factor K B （NF- K B） mRNA levels increased significantly （P〈0.05）. When AD was added into co-culture medium, the levels of IL-4 and IFN-γ were lower than those in the non-interference groups and the mRNA expression levels decreased, RIG-I, IPS-1, IRF-7, IRF-3 and NF- K B decreased significantly in each group with significant statistic differences （P〈0.05）. Conclusions： The RLRs mediated viral recognition provided a potential molecular target for acute viral infections and andrographolide could ameliorate H1N1 virus-induced cell mortality. And the antiviral effects might be related to its inhibition of viral-induced activation of the RLRs signaling pathway.

Effects of moxibustion on Treg cells in sarcoma microenvironment

Objective:To investigate the therapeutic effect of moxibustion on sarcomas from mesenchymal tissues,which have a low response rate to chemotherapy and radiotherapy.Methods:S180 sarcoma cell line was inoculated in C57 BL/6 mice to form transplanted tumor.Moxibustion therapy was directly applied at the transplanted tumor sites,at a distance of 3.0 cm,10 min per session,till skin temperature reached 45°C,once a day,for 14 consecutive days of intervention.After the mice were killed,serum was collected and used to detect concentrations of interleukin-10(IL-10),transforming growth factor-b1(TGF-b1),IL-4 and interferon-c(IFN-c)by Luminex liquid suspension chip.The numbers of Treg^(^(+) )T cells and CD4^(+) CD25^(+) Forkhead Box P3(Foxp3)^(+) T cells were detected by flow cytometry.Fluorescence in situ hybridization was used to analyze the changes of CD4,CD8,Foxp3 and TGF-b1 in the tumor microenvironment(TME).Results:Weight of S180 transplanted tumor in the control group was(2.03±0.54)g,and that in the moxibustion group was(1.27±0.29)g,which was statistically different(P=0.023).The mean value of Foxp3^(+) T cells in the normal group was 2.01%,which increased to 3.63%after the formation of transplanted tumor,and decreased to 1.48%after moxibustion treatment.The moxibustion group also had reduced numbers of CD4^(+) CD25^(+) Foxp3^(+) T cells in the spleen of mice with transplanted tumor.The concentrations of IL-10,TGF-b1 and IL-4 decreased in the serum of mice with transplanted tumor,while the concentration of IFN-c increased.Moxibustion was associated with downregulation in expression of Foxp3,IL-10 and TGF-b1 genes in the transplanted tumor,and increases in the gene expression of CD4^(+) T cells and CD8^(+) T cells in the TME.Conclusion:Moxibustion may have therapeutic effects on sarcomas by reducing the number of Treg cells in the blood and controlling the infiltration of Treg cells in the TME.

Homo-harringtonine,highly effective against coronaviruses,is safe in treating COVID-19 by nebulization

Dear Editor,Coronaviruses have increasingly become the causal agent of epidemics in humans as well as in domesticated animals(Perlman and Mc Intosh,2020;Wu et al.,2021).Since the beginning of this century,there have been 3 such epidemics.