Extramedullary plasmacytoma with the uvula as first affected site:A case report

BACKGROUND Extramedullary plasmacytoma(EMP)represents one of the rarer forms of plasma cell malignancies,capable of impacting a variety of tissues and organs throughout the body.The majority of EMP cases are predominantly found in the head and neck region,especially within the laryngopharynx,as well as in the gastrointestinal tract.While there have been documented instances of oropharyngeal involvement in EMP cases in the academic literature,it is important to note that EMP specifically affecting the uvula is exceedingly uncommon.Furthermore,it is noteworthy that over 60% of epithelial carcinomas in the upper respiratory tract and oropharynx tend to metastasize to the cervical lymph nodes,indicating a propensity for regional spread in these types of cancers.In this context,we present a rare case of extramedullary plasmacytoma where the uvula served as the initially affected site.This case emphasizes the need for heightened awareness among clinicians regarding such unusual comorbidities,as early recognition and diagnosis can significantly influence patient management and treatment outcomes.In addition,a review of the relevant literature is included to further educate and inform healthcare professionals about this rare presentation,ultimately aiming to enhance clinical understanding and improve patient care in similar situations.CASE SUMMARY A 51-year-old man was admitted to our hospital because of a slowly enlarging neck mass.A physical examination revealed a palpable left lymph node,and magnetic resonance imaging(MRI)of the oropharynx and the neck showed a soft tissue mass in the oropharynx and enlargement of multiple lymph nodes in the neck.The soft tissue mass was diagnosed as plasmacytoma by immunohistochemical analysis.Monoclonal immunoglobulins and bone marrow biopsy showed normal results.Therefore,we diagnosed that as EMP of the uvula.After four cycles of adjuvant chemotherapy dominated by bortezomib,MRI reexamination showed a significant reduction of the mass in the oropharynx and the cervical lymph nodes.Afterwards,the λ light chain returned to normal levels.There was no evidence of evolution to multiple myeloma.CONCLUSION We have reported a rare case of extramedullary plasmacytoma with the uvula as the first affected site and the relevant literature is reviewed to improve clinicians'awareness of such rare comorbidities.

Study of Quality Standards of Xiao’er Qingre Enema Preparation in Hospitals

Objective:To establish the quality standards for the preparation of Xiao’er Qingre enema in hospitals.Method:Thin-layer chromatography(TLC)was used to identify Radix Isatidis and Glycyrrhizae in the prescription.The content of(R,S)-Goitrin was determined by high-performance liquid chromatography(HPLC).Results:In TLC identification,there was no interference between the negative controls of Radix Isatidis and glycyrrhizae,and the spots were well-separated.The HPLC results of(R,S)-Goitrin showed a good linear relationship between the peak area and concentration within the range of 0.476-95.2μg·mL-1(r=0.9999).Conclusion:The TLC and HPLC methods established in this experiment are simple,reproducible,and specific,making them suitable for the quality control Xiao’er Qingre enema preparation in hospitals.

Comparison of different surrogate markers of muscle mass for the diagnosis of sarcopenia in patients with colorectal cancer

Background:This study compared the validity of the creatinine-to-cystatin C ratio(CCR),sarcopenia index(SI),and relative skeletalmuscle index(RSMI)as predictors of sarcopenia in patients with colorectal cancer(CRC)and explored their impact on the patient prognosis.Methods:We retrospectively studied patients with CRC who underwent surgical intervention at the Department of Colorectal and Anal Surgery,situatedwithin the First Affiliated Hospital of GuangxiMedical University.The investigation spanned from January 2015 to December 2017,encompassing a cohort of patients subject to surgical management forCRC during this period.Pearson’s correlation analysis was employed to evaluate the relationships between the CCR,SI,RSMI,and skeletal muscle index(SMI)and the patient prognosis.Receiver operating characteristic(ROC)curves were generated to evaluate the predictive precision of these biomarkers and ascertain the optimal cutoff values.Multivariate logistic regression analysis was conducted to pinpoint the independent factors linked with sarcopenia.Survival analyses,contingent on different surrogate markers of muscle mass and sarcopenia,were performed utilizing the Kaplan-Meier method alongside the log-rank test.Results:Weenrolled 815 patientswithCRC(522 male and 293 female patients)whowere eligible for the analysis.In accordancewith the guidelines set forth by the International Consensus on Sarcopenia,sarcopenia was diagnosed in a collective total of 503 patients.A Pearson’s correlation coefficient(r)analysis demonstrated that the CCR,SI,and RSMI were positively correlated with the SMI.In both male and female patients,the RSMI(male:r=0.400,P<0.001;female:r=0.640,P<0.001)was more strongly correlated with the SMI than with the CCR(male:r=0.203,P<0.001;female:r=0.192,P<0.001)or SI(male:r=0.335,P<0.001;female:r=0.285,P<0.001).In male patients,the areas under the ROC curves(AUC)for the CCR,SI,and RSMI were 0.596[(95%confidence interval(CI)=0.545-0.647)],0.648(95%CI=0.599-0.698),and 0.681(95%CI=0.629-0.733),respectively.In female patients,the AUC for the CCR,SI,and RSMI were 0.615(95%CI=0.551-0.680),0.660(95%CI=0.598-0.722),and 0.772(95%CI=0.719-0.825),respectively.A multivariable logistic regression analysis demonstrated that the CCR remained an influential factor for sarcopenia after correcting for confounding[odds ratio(OR)=0.993,95%CI=0.986-1.000,P=0.038].The SI and RSMI also remained influential factors for sarcopenia after correcting for confounding factors(OR=0.983,95%CI=0.972-0.994,P=0.002;and OR=0.401,95%CI=0.320-0.502,P<0.001,respectively).The groups characterized by low CCR and SI demonstrated notably reduced overall survival compared with their counterparts with high CCR and SI(P=0.007 and P=0.001,respectively),whereas the RSMI and sarcopenia did not exhibit a significant correlation with survival(P=0.608 and P=0.062,respectively).Conclusions:The CCR,SI,and RSMI all have predictive value for sarcopenia in patients with CRC.TheRSMI was a better predictor of sarcopenia than either the CCR or SI in both male and female patientswith CRC.However,the RSMI did not have any significant value for predicting the prognosis of patients with CRC.Subsequent prospective investigations are warranted to elucidate a superiormarker or amalgamation thereof,capable of accurately prognosticating sarcopenia and the overall prognosis in individuals diagnosed with CRC.Such studies should aim to meticulously evaluate a comprehensive array of potential markers,considering their individual and collective predictive value in delineating the clinical trajectory of CRC patients.By conducting rigorous prospective analyses,researchers can strive to uncover novel insights into the complex interplay between sarcopenia and CRC outcomes,thereby facilitating the development of more precise prognostic models and tailored therapeutic approaches.

Analysis of the Incidence and Risk Factors of Postoperative Infection in Patients with Class I Incisions Based on Literature Research

Objective To investigate the risk factors and variations in postoperative infection rates among different Class I surgical incisions,and to identify potential evaluation indicators that can impact the preoperative use of antimicrobial prophylaxis in Class I incisions.Methods Literature review was employed to establish inclusion and exclusion criteria,resulting in the initial examination of 4098 articles.Then,3149 articles were screened out,and after thorough reading of full texts,55 articles were studied carefully.Results and Conclusion Findings revealed that the incidence rate of surgical site infection(SSI)in Class I incisions ranged from 0.52%to 2.34%,with main risk factors including operation duration,underlying diseases,preoperative infections,antibiotic usage,length of hospital stay,and intraoperative bleeding.Risks of SSI varied significantly across different types of Class I incision surgeries.The key influencing factors in neurosurgery included emergency procedures,(nationalnosocomial-infection-surveillance)NNIS score,age,and postoperative drainage tubes.In orthopedics,surgery type was closely associated with infection risk.In addition,emergency surgeries,special surgery types,and low serum albumin levels were considered as risk factors for the increase of postoperative infections,but age showed little correlation.Although prophylactic use of antibiotics in thyroid,breast,and inguinal hernia surgeries was not recommended,research suggested that they should be considered based on varying surgical levels.Patient’s preoperative condition had to be thoroughly assessed to prevent postoperative infections.In clinical practice,combining the high-risk factors of postoperative infection in different Class I incisions,we should consider the evaluation indicators of preventive use of antibiotics before different surgeries,and decide the rational use of antibacterial drugs for Class I incisions.

Mechanisms of resveratrol in the prevention and treatment of gastrointestinal cancer

Gastrointestinal(GI)cancer is one of the leading causes of cancer-related deaths worldwide.According to the Global Cancer Statistics,colorectal cancer is the second leading cause of cancer-related mortality,closely followed by gastric cancer(GC).Environmental,dietary,and lifestyle factors including cigarette smoking,alcohol intake,and genetics are the most important risk factors for GI cancer.Furthermore,infections caused by Helicobacter pylori are a major cause of GC initiation.Despite improvements in conventional therapies,including surgery,chemotherapy,and radiotherapy,the length or quality of life of patients with advanced GI cancer is still poor because of delayed diagnosis,recurrence and side effect.Resveratrol(3,4,5-trihydroxy-trans-stilbene;Res),a natural polyphenolic compound,reportedly has various pharmacologic functions including anti-oxidant,anti-inflammatory,anti-cancer,and cardioprotective functions.Many studies have demonstrated that Res also exerts a chemopreventive effect on GI cancer.Research investigating the anti-cancer mechanism of Res for the prevention and treatment of GI cancer has implicated multiple pathways including oxidative stress,cell proliferation,and apoptosis.Therefore,this paper provides a review of the function and molecular mechanisms of Res in the prevention and treatment of GI cancer.

Berberine inhibits the proliferation of pancreatic cancer cells by targeting pancreatic cancer stem cells through regulating EMT signaling pathway

Pancreatic ductal adenocarcinoma(PDAC)is universally acknowledged as the cancer with the highest mortality rate.Berberine has high medicinal value and has been used as an anti-cancer agent.Hence the purpose of this study was to investigate the anti-cancer effect of berberine in PDAC.Berberine was shown to have a selective anti-cancer effect on PDAC by MTT assay in vitro.Pancreatic cancer stem cells(PCSCs),regulated by epithelial-mesenchymal transition(EMT),could promote the proliferation of PDAC cells.However,berberine suppressed the proliferation and stemness of PCSCs through immunofluorescence staining,stem cell sphere assays and so forth in vitro.In vivo,berberine reduced tumor size and decreased the expression levels of Ki67,a marker of cellular proliferation,in orthotopic pancreatic tumors.In addition,berberine inhibited the EMT signaling pathway by RT-PCR and Western blotting methods both in vitro and in vivo.Our study indicates that berberine inhibits the proliferation of PDAC cells both in vivo and in vitro.The mechanism of the anti-cancer effect of berberine likely involves the inhibition of EMT.Therefore,berberine may be a novel antineoplastic drug with clinical efficacy in PDAC.

Improving the protective effects of a FGF for peripheral nerve injury repair using sulfated chitooligosaccharides

Injury to the peripheral nerves can result in temporary or life-long neuronal dysfunction and subsequent economic or social disability. Acidic fibroblast growth factor(a FGF) promotes the growth and survival of neurons and is a possible treatment for peripheral nerve injury. Yet,the actual therapeutic utility of a FGF is limited by its short half-life and instability in vivo. In the present study,we prepared sulfated chitooligosaccharides(SCOS),which have heparinlike properties,to improve the bioactivity of a FGF. We investigated the protective effects of SCOS with or without a FGF on RSC96 cells exposed to Na2 S2 O4 hypoxia/reoxygenation injury. Cell viability was measured by MTT assay and cytotoxicity induced by Na2 S2 O4 was assessed by lactate dehydrogenase(LDH) release into the culture medium. Pretreatment with a FGF and SCOS dramatically decreased LDH release after injury compared to pretreatment with a FGF or SCOS alone. We subsequently prepared an a FGF/SCOS thermo-sensitive hydrogel with poloxamer and examined its effects in vivo. Paw withdrawal thresholds and thermal withdrawal latencies were measured in rats with sciatic nerve injury. Local injection of the a FGF/SCOS hydrogels(a FGF: 40,80 μg/kg) increased the efficiency of sciatic nerve repair compared to a FGF(80 μg/kg) hydrogel alone. Especially a FGF/SCOS thermo-sensitive hydrogel decreased paw withdrawal thresholds from 117.75 ± 8.38(g,4 d) to 65.74 ± 3.39(g,10 d),but a FGF alone group were 140.58 ± 27.54(g,4 d) to 89.12 ± 5.60(g,10 d)(a FGF dose was 80 μg/kg,P < 0.05,n = 8). The thermal withdrawal latencies decreased from 11.61 ± 2.26(s,4 d) to 2.37 ±0.67(s,10 d). However,a FGF alone group were from 17.69 ± 1.47(s,4 d) to4.65 ± 1.73(s,10 d)(P < 0.05,n = 8). Furthermore,the a FGF/SCOS hydrogels also exhibited good biocompatibility in mice. In summary,SCOS improved the protective effects of a FGF in RSC96 cells injured with Na2S2O4 and increased the efficiency of nerve repair and recovery of function in rats with sciatic nerve injury. These findings pave an avenue for the development of novel prophylactic and therapeutic strategies for peripheral nerve injury.

Daptomycin and linezolid for severe methicillin-resistant Staphylococcus aureus psoas abscess and bacteremia:A case report and review of the literature

BACKGROUND Vancomycin remains a first-line treatment drug as per the treatment guidelines for methicillin-resistant Staphylococcus aureus(MRSA)bacteremia.However,a number of gram-positive cocci have developed resistance to several drugs,including glycopeptides.Therefore,there is an urgent need for effective and innovative antibacterial drugs to treat patients with infections caused by drugresistant bacteria.CASE SUMMARY A 24-year-old male was admitted to hospital owing to lumbago,fever,and hematuria.Computed tomography(CT)results showed an abscess in the psoas major muscle of the patient.Repeated abscess drainage and blood culture suggested MRSA,and vancomycin was initiated.However,after day 10,CT scans showed abscesses in the lungs and legs of the patient.Therefore,treatment was switched to daptomycin.Linezolid was also added considering inflammation in the lungs.After 10 d of the dual-drug anti-MRSA treatment,culture of the abscess drainage turned negative for MRSA.On day 28,the patient was discharged without any complications.CONCLUSION This case indicates that daptomycin combined with linezolid is an effective remedy for bacteremia caused by MRSA with pulmonary complications.

Mechanisms and status of research on the protective effects of traditional Chinese medicine against ischemic brain injury

Ischemic brain injury occurs when the metabolic needs of brain tissue cannot be met due to insufficient blood supply to the brain.It is one of the main causes of death and adult disability worldwide.The recurrence rate of ischemic brain injury is high.It places a heavy economic burden on families and society,and seriously affects human health and quality of life.In traditional Chinese medicine,ischemic stroke belongs to the category of“stroke”.The use of traditional Chinese medicine to treat stroke has a long history.After years of experimental research,a large amount of theoretical knowledge and practical experience have been accumulated.Promoting blood circulation and removing blood stasis is the basis of traditional Chinese medicine theory on the treatment of ischemic stroke.Commonly used single Chinese medicines include Chuangxiong(Ligusticum chuanxiong hort),Danggui(Angelica sinensis),Danshen(Salvia miltiorrhiza Bunge),Honghua(Carthamus tinctorius L.),Mudanpi(Moutan Cortex),and Huangqi(Astragali Radix).Buyang Huanwu decoction,Xinglou Chengqi decoction,Taohong Siwu decoction,and other traditional Chinese medicine prescriptions are believed to have a protective effect against brain damage caused by ischemic stroke.With the development of modern medical technology,the mechanism of traditional Chinese medicine treatments for ischemic brain injury has gradually been explored.This article reviews the mechanisms of traditional Chinese medicine’s protection against ischemic brain injury and its current clinical application.

Determination of cefcapene acid by LC-MS and their application to a pharmacokinetic study in healthy Chinese volunteers

Simple,rapid and specific liquid chromatography-mass spectrometry（LC-MS） methods have been developed and validated for the quantification of cefcapene acid in human plasma and urine.Plasma samples were simply pretreated with methanol for deproteinization.Urine samples were briefly diluted with methanol-water（50：50,v/v）,and centrifuged to remove large particles.Chromatographic separation was performed on a Hedera ODS-2 column.For the plasma assay,the isocratic mobile phase consisted of 35% solvent A（Methanol） and 65% solvent B（10 mM ammonium acetate buffer solution containing 0.2% folic acid） with a flow rate of 0.3 mL/min.For the urine assay,the isocratic mobile phase consisted of 30% solvent A（Methanol） and 70% solvent B（10 mM ammonium acetate buffer solution containing 0.2% folic acid） with a flow rate of 0.3 mL/min.The assays were linear over the concentration ranges of 0.03-5 μg/mL in plasma and 0.1-400 μg/mL in urine,and were successfully applied to a pharmacokinetic study after single and multiple oral administrations of cefcapene pivoxil hydrochloride tablets in healthy Chinese volunteers.

Matrine ameliorates experimental autoimmune encephalomyelitis by regulating the differentiation of encephalitogenic Th1/Th17 and Th2/regulatory T cells

OBJECTIVE Experimental autoimmune encephalomyelitis(EAE),the classical animal model for multiple sclerosis(MS)is triggered by an impaired balance of T helper(Th)cells and regulatory T(Tregs)cells.Matrine(MAT),a quinolizidine alkaloid derived from the herb Radix Sophorae Flave,has been shown to ameliorate the clinical signs,inflammatory infiltration,demyelination in acute EAE rats.However,whether MAT protect from EAE by adjusting Th and Treg cells response in specific-cellular and molecular level is unknown.METHODS Herein,MAT was tested for its effects on Th1,Th2,Th17 and Treg cells in the spinal cord of EAE mice and splenocyte-extracted from EAE mice with MOG35-55-restimulated,respectively.RESULTS Our findings revealed that MAT significantly inhibit the proliferation of splenocyte,and remarkably down-regulate the differentiation of Th1/Th17 cells with decreased expressions of CD4+IFN-γ+cells and CD4+IL-17+cells in vivo and IL-17,IFN-γ,ROR-γt,T-bet in vitro,meanwhile it dramatically up-regulate the Th2/Treg cells response associated with increased levels of CD4+TGF-β+1cells and CD4+IL-10+cells in vivo and IL-4,IL-10,TGF-β1,Foxp3 and GATA3in vitro.CONCLUSION Considering the effective therapeutic effects of MAT on EAE,it′s worth to find its new values on other autoimmune diseases.

How to do when PFO closure failed under routine guidance:the first clinical experience for PFO closure

Patent foramen ovale(PFO)is the most common abnormality of fetal origin and is affecting approximately 25%of the worldwide adult population.[1]During the past two decades,instead of surgical closure,catheter-based procedures to close the PFO have become widely used among patients.Periprocedural guidance with fluoroscopy,transesophageal echocardiography(TEE)or intracardiac echocardiography have been the mainstream technique to ensure a safe and successful procedure.

Exploring the attenuation mechanisms of Dalbergia odorifera leaves extract on cerebral ischemia-reperfusion based on weighted gene co-expression network analysis

The attenuation function of Dalbergia odorifera leaves on cerebral ischemia-reperfusion(I/R)is little known.The candidate targets for the Chinese herb were extracted from brain tissues through the high-affinity chromatography.The molecular mechanism of D.odorifera leaves on cerebral I/R was investigated.Methods:Serial affinity chromatography based on D.odorifera leaves extract(DLE)affinity matrices were applied to find specific binding proteins in the brain tissues implemented on C57BL/6 mice by intraluminal middle cerebral artery occlusion for 1 h and reperfusion for 24 h.Specific binding proteins were subjected to mass-spectrometry to search for the differentially expressed proteins between control and DLE-affinity matrices.The hub genes were screened based on weighted gene co-expression network analysis(WGCNA).Then,predictive biology and potential experimental verification were performed for the candidate genes.The protective role of DLE in blood-brain barrier damage in cerebral I/R mice was evaluated by the leakage of Evans blue,western blotting,immunohistochemistry,and immunofluorescent staining.Results:952 differentially expressed proteins were classified into seven modules based on WGCNA under soft threshold 6.Based on WGCNA,AKT1,PIK3CA,NOS3,SMAD3,SMAD1,IL6,MAPK1,TGFBR2,TGFBR1,MAPK3,IGF1R,LRG1,mTOR,ROCK1,TGFB1,IL1B,SMAD2,and SMAD518 candidate hub proteins were involved in turquoise module.TGF-β,MAPK,focal adhesion,and adherens junction signaling pathway were associated with candidate hub proteins.Gene ontology analysis demonstrated that candidate hub proteins were related to the TGF-βreceptor signaling pathway,common-partner SMAD protein phosphorylation,etc.DLE could significantly reduce the leakage of Evans blue in mice with cerebral I/R,while attenuating the expression of occludin,claudin-5,and zonula occludens-1.Western blotting demonstrated that regulation of TGF-β/SMAD signaling pathway played an essential role in the protective effect of DLE.Conclusion:Thus,a number of candidate hub proteins were identified based on DLE affinity chromatography through WGCNA.DLE could attenuate the dysfunction of bloodbrain barrier in the TGF-β/SMAD signaling pathway induced by cerebral I/R.

Cetyltrimethylammonium bromide inhibits the metastasis of breastcancer to the lungs by inhibiting epithelial-mesenchymal transition

Breast cancer is a highly aggressive cancer in females. Metastasis is a major obstacle to the efficient andsuccessful treatment of breast cancer. Cetyltrimethylammonium bromide (CTAB) has anti-tumor effects on a varietyof tumors. We showed that CTAB inhibits the metastasis of breast cancer to the lungs both in vitro and in vivo.Epithelial-mesenchymal transition (EMT) is thought to be one of the major processes mediating breast cancermetastasis. We found that CTAB suppressed EMT and regulated the levels of the classical EMT markers E-cadherin,N-cadherin, vimentin, Snail and Twist1. Moreover, as a candidate anti-tumor agent, CTAB showed primary safety invivo. Taken together, our results suggest that CTAB inhibits the migration of primary breast cancer to the lungs. Ourfindings confirm the clinical potential of CTAB for the treatment of breast cancer by targeting EMT. CTAB may thusbe a promising novel anti-tumor drug for the treatment of breast cancer metastasis.

Effects of Different Material Ratios on the Dissolution of Tongmai Pills

[Objectives]To study the effects of different material ratios on the dissolution of Tongmai pills.[Methods]Based on mixture uniform experiment design,the fiber,starch and grease-resin materials in Tongmai pills were proportioned.The contents of strychnine,brucine,paeoniflorin,calycosin,ferulic acid,hesperidin and salvianolic acid B in the solution were determined by HPLC,and the content of total flavonoids was determined by ultraviolet spectrophotometry.The weight coefficient of index components was determined by analytic hierarchy process,and the SAS software was used to optimize the dissolution model and calculate the dissolution parameter T40.MATLAB was used to establish a mathematical model and realize the data visualization between material ratio and dissolution parameter T40.[Results]The mathematical model between material ratio and dissolution parameter was T40=8.93-5.31X1-5.83X2+17.67X1X3(X1,X2,X3 are fiber,starch and grease-resin materials respectively,r2=0.9706,P=0.01,RMSE=0.5696).[Conclusions]Fiber can effectively promote the dissolution(P<0.05).Starch can promote the dissolution,but the effect is not obvious(P=0.05).The interaction between fiber and grease-resin can inhibit the dissolution,but was not significant(P=0.07).

Exploring the Mechanism of Blumea balsamifera(L.)DC in Preventing and Treating Alzheimer's Disease Based on HPLC-ESI-HRMS and Network Pharmacology

[Objectives]To expose the plausible mechanism of Blumea balsamifera(L.)DC.against Alzheimer s disease via network pharmacology and HPLC-ESI-HRMS technology.[Methods]To begin with,HPLC-ESI-HRMS was employed to identify the components of B.balsamifera.Secondly,the potential targets of the components were identified and predicted based on chemical similarity and online databases.Thirdly,by way of topological analysis of a component-disease target interaction network,the primary candidate targets and potential active components were identified.Lastly,molecular docking analysis was used to confirm the interaction between active components and therapeutic targets.[Results]According to the final results,HPLC-ESI-HRMS identified 70 components.Out of these,20 components were potentially biologically active,and most of them were sesquiterpenoids.According to the molecular docking results,the primary active components were appropriately coordinated with the core targets,indicating a high level of pharmacodynamic activity.Thus,the sesquiterpenes present in B.balsamifera are considered potential active ingredients having multi-target and multi-pathway effects for treating Alzheimer s disease.[Conclusions]This research will provide a scientific reference for the future pharmacological activity and clinical application of B.balsamifera.

Research Progress of Paederia scandens(Lour.)Merr in Modern Pharmacy

Paederia scandens(Lour.)Merr.is a traditional Chinese medicine,which mainly has the functions of analgesia,detoxification,anti-inflammatory and anticonvulsant.Modern studies show that the main chemical constituents of this plant are iridoids and volatile oil,which have biological activities such as analgesia,anti-inflammatory,hepatoprotection,renoprotection and antibacterial.This review highlights the chemical constituents and biological activities of P.scandens based on studies published in last decades and provides the references for the further development and utilization of this medicinal plant.

Direct evidence of VEGF-mediated neuroregulation and afferent explanation of blood pressure dysregulation during angiogenic therapy

Objective:Oncocardiology is increasingly hot research field/topic in the clinical management of cancer with anti-angiogenic therapy of vascular endothelial growth factor(VEGF)that may cause cardiovascular toxicity,such as hypertension via vascular dysfunction and attenuation of eNOS/NO signaling in the baroreflex afferent pathway.The aim of the current study was to evaluate the potential roles of VEGF/VEGF receptors(VEGFRs)expressed in the baroreflex afferent pathway in autonomic control of blood pressure(BP)regulation.Methods:The distribution and expression of VEGF/VEGFRs were detected in the nodose ganglia(NG)and nucleus of tractus solitary(NTS)using immunostaining and molecular approaches.The direct role of VEGF was tested by NG microinjection under physiological and hypertensive conditions.Results:Immunostaining data showed that either VEGF or VEGFR2/VEGFR3 was clearly detected in the NG and NTS of adult male rats.Microinjection of VEGF directly into the NG reduced the mean blood pressure(MBP)dose-dependently,which was less dramatic in renovascular hypertension(RVH)rats,suggesting the VEGF-mediated depressor response by direct activation of the 1st-order baroreceptor neurons in the NG under both normal and disease conditions.Notably,this reduced depressor response in RVH rats was directly caused by the downregulation of VEGFR2,which compensated the up regulation of VEGF/VEGFR3 in the NG during the development of hypertension.Conclusion:It demonstrated for the first time that the BP-lowering property of VEGF/VEGFRs signaling via the activation of baroreflex afferent function may be a common target/pathway leading to BP dysregulation in anti-angiogenic therapy.

Reanalysis of Lymph node metastasis as predictor of the survival of patients with follicular variant papillary thyroid carcinoma: From SEER database 2004-2014

Background: Follicular variant papillary thyroid carcinoma (FVPTC) is the most common subset of papillary carcinoma. Lymph-node metastasis (LNM) is one of the main predictors of survival in PTC patients, but we found few data related to the correlation between LNM and FVPTC. We therefore aimed to elucidate the relationship between LNM and survival in patients with FVPTC. Methods: Logistic regression models were used to determine the factors associated with LNM. The Cox proportional-hazards model was applied to assess the association between LNM and disease-specific mortality. Kaplan-Meier survival analysis and the log-rank test were used to estimate the disease-specific survival rates in patients with and without LNM. Results: In total, 1418 FVPTC patients were identified. The multivariate logistic regression model showed that age, female sex, being married, tumor size > 4cm and extrathyroidal extension and radiation were predictors of LNM. The multivariate Cox regression model showed that age, multifocality and radiation were risk factors of diseasespecific mortality. Especially, LNM (p=0.271) did not independently predict disease-specific mortality. Kaplan-Meier survival analysis and the log-rank method also showed that LNM did not impact survival in FVPTC (p=0.235). Conclusion: Using data in the SEER database from 2004 to 2014, and after multivariate model correction, we found that age, multifocality and radiation were strongly related to disease-specific mortality. It is worth noting that LNM does not impact the survival of FVPTC patients.

Effects of the ABCB1 genetic polymorphism on vancomycin blood concentration in critically ill patients of Chinese

To investigate the clinical application of vancomycin blood concentration monitoring in critically ill patients and the influence of the ABCB1 gene polymorphism on vancomycin dnug concentrations to guide clinically rational usage of vancomycin.The vancomycin blood concentration monitoring data on 141 critically ill patients in our hospital from November 2016 to March 2017 were analyzed and 68 patients who received the same dosages of vancomycin were subjected to ABCB1 genotyping.The results showed that among the 141 critically ill patients,68(48.22%)showed sub-target concentrations of vancomycin,averaging 5.58±2.54μg/mL;29 patients(20.56%)had higher than target concentrations,with an average value of 33.01±9.38μg/mL;and 44 cases(31.21%)were in the normal concentration range,with an average of 14.72±2.75μg/mL.The vancomycin concentrations in 1236TT-genotype patients were significantly higher than those of the 1236CC and 1236CT-genotype patients.The concentrations in the 2677AA-genotype patients were significantly higher than those in the 2677AT,2677GA,2677GG and 2677GT patients.Vancomycin concentrations in 3435CT patients were significantly higher than those in 3435CC,but slightly lower than those in 3435TT patients.The ABCB11236C>T,2677G>T/A and 3435C>T gene mutations may affect vancomycin blood concentrations.At the same time,other factors such as gender,age,co-morbidities and other transporters possiblely play the roles in influencing the concentration of vancomycin in patients.All these factors finally cause individual differences.