A pan-cancer analysis of the biological function and clinical value of BTLA in tumors

B and T-lymphocyte attenuator(BTLA)plays an immunosuppressive role by inhibiting T-and B-cell functions.BTLA is associated with a variety of diseases,especially cancer immunity.However,the function of BTLA in various cancers and its clinical prognostic value have still not been comprehensively analyzed.This study aimed to identify the relationship between BTLA and cancer from the perspectives of differences in BTLA expression,its clinical value,immune infiltration,and the correlation with immune-related genes in various cancers.Data regarding mRNA expression,miRNA expression,lncRNA expression,and clinical data of patients of 33 existing cancers were collected from the TCGA database.Target miRNA of BTLA and the lncRNA that interacts with the target miRNA were obtained from the StarBase database.Based on bioinformatics analysis methods,the relationship between various types of cancers and BTLA was thoroughly investigated,and a competing endogenous RNA network of BTLA,target miRNA,and interacting lncRNA was constructed.The Kaplan-Meier(KM)prognostic analysis of BTLA and target miRNA(has-miR-137)in various types of cancers was completed using the KM plotter.BTLA expression varied in different cancers,with statistical significance in nine cancer types.KM plotter to analyze the overall survival(OS)and regression-free survival prognosis of cancer patients revealed that the BTLA expression was statistically different in the OS of 11 types of cancers out of 21 types of cancers;the OS of 8 type of cancers was also statistically different.Correlation analysis of tumor immune genes revealed a positive correlation of BTLA expression with immunosuppressive gene(CTLA4 and PDCD1)expression.Gene Set Enrichment Analysis showed that BTLA and its co-expressed genes mainly act through biological processes and pathways,including immune response regulation,cell surface receptor signaling pathway,antigen binding,antigen receptor-mediated signaling pathway,and leukocyte migration.BTLA has the potential as a prognostic marker for CLL,COAD,NSCLC,and OV and a diagnostic marker for CLL,COAD,and KIRC.BTLA has a close and complex relationship with the occurrence and development of tumors,and cancer immunotherapy for BTLA is worthy of further analysis.

Interaction between systemic iron parameters and left ventricular structure and function in the preserved ejection fraction population:a two-sample bidirectional Mendelian randomization study

BACKGROUND Left ventricular(LV)remodeling and diastolic function in people with heart failure(HF)are correlated with iron status;however,the causality is uncertain.This Mendelian randomization(MR)study investigated the bidirectional causal relationship between systemic iron parameters and LV structure and function in a preserved ejection fraction population.METHODS Transferrin saturation(TSAT),total iron binding capacity(TIBC),and serum iron and ferritin levels were extracted as instrumental variables for iron parameters from meta-analyses of public genome-wide association studies.Individuals without myocardial infarction history,HF,or LV ejection fraction(LVEF)<50%(n=16,923)in the UK Biobank Cardiovascular Magnetic Resonance Imaging Study constituted the outcome dataset.The dataset included LV end-diastolic volume,LV endsystolic volume,LV mass(LVM),and LVM-to-end-diastolic volume ratio(LVMVR).We used a two-sample bidirectional MR study with inverse variance weighting(IVW)as the primary analysis method and estimation methods using different algorithms to improve the robustness of the results.RESULTS In the IVW analysis,one standard deviation(SD)increased in TSAT significantly correlated with decreased LVMVR(β=-0.1365;95%confidence interval[CI]:-0.2092 to-0.0638;P=0.0002)after Bonferroni adjustment.Conversely,no significant relationships were observed between other iron and LV parameters.After Bonferroni correction,reverse MR analysis showed that one SD increase in LVEF significantly correlated with decreased TSAT(β=-0.0699;95%CI:-0.1087 to-0.0311;P=0.0004).No heterogeneity or pleiotropic effects evidence was observed in the analysis.CONCLUSIONS We demonstrated a causal relationship between TSAT and LV remodeling and function in a preserved ejection fraction population.

Research progresses of dual-layer spectral detector CT for preoperative evaluation on colorectal cancer

Dual-layer spectral detector CT is a new spectrum CT imaging technology based on detector being able to obtain both images similar to true plain and spectral images in one time scanning.The reconstructed multi-parameter spectral images can not only improve image quality,enhance tissue contrast,increase the visualization and detection ability of occult lesions,but also provide qualitative and quantitative analysis of the lesions,so as to provide more imaging information and multi-dimensional diagnostic basis.The research progresses of dual-layer spectral detector CT for preoperative evaluation on colorectal cancer were reviewed in this article.

Ferritinophagy: A new idea for liver diseases regulated by ferroptosis

Background:The discovery of regulatory cell death has led to a breakthrough in the therapeutic field.Various forms of cell death,such as necrosis,apoptosis,pyroptosis,autophagy,and ferroptosis,play an important role in the development of liver diseases.In general,more than one form of cell death pathways is responsible for the disease state.Therefore,it is particularly important to study the regulation and interaction of various cell death forms in liver diseases.Data sources:We performed a PubMed search up to November 2022 with the following keywords:ferritinophagy,ferroptosis,and liver disease.We also used terms such as signal path,inducer,and inhibitor to supplement the query results.Results:This review summarized the basic characteristics of ferritinophagy and ferroptosis and the regulation of ferroptosis by ferritinophagy and reviewed the key targets and treatment strategies of ferroptosis in different liver diseases.Conclusions:Ferritinophagy is a potential therapeutic target in ferroptosis-related liver diseases.

Relationship between serum neutrophil gelatinase-associated lipocalin levels and cognitive impairment, anxiety, and depressive symptoms in acute ischemic stroke

BACKGROUND Acute ischemic stroke(AIS)is a significant global health issue with increasing incidence owing to aging populations and rising cardiovascular risk factors.In addition to physical impairments,AIS frequently leads to neuropsychiatric co-mplications,such as cognitive impairment,anxiety,and depressive symptoms,which adversely affect patients’quality of life and rehabilitation.Neutrophil ge-latinase-associated lipocalin(NGAL)has emerged as a potential biomarker for various conditions,including AIS.This study investigated the association bet-ween serum NGAL levels at admission and neuropsychiatric complications in patients with AIS.neuropsychiatric complications in patients with AIS.METHODS Between January 2022 and December 2023,150 patients with AIS were enrolled.Serum NGAL levels were measured at admission using an enzyme-linked immu-nosorbent assay.Cognitive function was assessed using the Mini-Mental State Examination,while anxiety and depressive symptoms were evaluated using the Hospital Anxiety and Depression Scale at discharge.The relationship between serum NGAL levels and cognitive impairment,anxiety,and depressive symptoms was analyzed using multivariate logistic regression,adjusted for potential con-founders of age,sex,body mass index,smoking status,hypertension,diabetes mellitus,dyslipidemia,previous stroke,and stroke severity.RESULTS The mean age of the participants was 65.4±10.2 years,and 58%were males.Prevalence rates of cognitive impairment,anxiety,and depressive symptoms at discharge were 34.7%,28.0%,and 32.0%,respectively.Serum NGAL levels were significantly higher in patients with cognitive impairment(median:5.6 ng/mL vs 3.2 ng/mL,P<0.001),anxiety(median:5.1 ng/mL vs 3.5 ng/mL,P=0.002),and depressive symptoms(median:5.4 ng/mL vs 3.3 ng/mL,P<0.001),compared to those without these conditions.Multivariate logistic regression analysis showed that higher serum NGAL levels at admission were independently associated with cognitive impairment[odds ratio(OR)=1.42,95%confidence interval(CI):1.18-1.71,P<0.001],anxiety(OR=1.28,95%CI:1.09-1.51,P=0.003),and depressive symptoms(OR=1.39,95%CI:1.16-1.67,P<0.001)after adjusting for potential confounders.CONCLUSION Elevated serum NGAL levels were independently associated with cognitive impairment,anxiety,and depressive symptoms in patients with AIS;and may function as potential biomarkers for patients at risk.

Preoperative neutrophil-to-lymphocyte ratio predicts symptomatic anastomotic leakage in elderly colon cancer patients: Multicenter propensity score-matched analysis

BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomatic postoperative ana-stomotic leakage(AL)in elderly patients with colon cancer is unclear.AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed.Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR.Twenty-two covariates were matched using a 1:1 propensity score matching method,and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.RESULTS Of the 577 patients included,36(6.2%)had symptomatic AL.The optimal cutoff value of the NLR for predicting AL was 2.66.After propensity score matching,the incidence of AL was significantly greater in the≥2.66 NLR subgroup than in the<2.66 NLR subgroup(11.5%vs 2.5%;P=0.012).Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoper-atively,preoperative albumin concentration,preoperative prognostic nutritional index,and preoperative NLR and AL occurrence(P<0.05);multivariate logistic regression analysis revealed that an NLR≥2.66[odds ratio(OR)=5.51;95%confidence interval(CI):1.50-20.26;P=0.010]and blood transfusion intraoperatively and within 2 d postoperatively(OR=2.52;95%CI:0.88-7.25;P=0.049)were risk factors for the occurrence of symptomatic AL.CONCLUSION A preoperative NLR≥2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer.The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.

Intensity-modulated radiotherapy for breast cancer:a systematic review

Objective:The aim of this study was to assess the long-term effect of breast conservation with breast intensitymodulated radiotherapy (IMRT) for early-stage breast cancers.Methods:Pub Med,EMBASE,Cochrane Library,Chinese Biomedical Literature Database were searched to identify relevant original published trails,and the references of eligible studies were manually screened.Randomized controlled trails reported in any language,comparing breast IMRT with conventional radiotherapy (RT) in patients with early-stage breast cancer were eligible for inclusion.Two investigators independently assessed the quality of included trials and extracted data.The RevMan 5.0 software was used for statistical analysis.Results:Four trials involving 1440 patients were included.The results showed that in the IMRT group,the occurrence of acute moist dermatitis,the edema of the mammary gland and the occurrence of hyperpigmentation were lower than those of RT group,the pooled risk ratio value and 95% confidence interval were 0.28 (0.17-0.48),0.03 (0.00-0.21) and 0.06 (0.02-0.15) respectively.The use of IMRT did not correlate with pain and quality of life,but the presence of moist desquamation did significantly correlate with pain and reduced quality of life.Conclusion:The currently available evidence showed that IMRT significantly reduces the occurrence of moist acute dermatitis anywhere in the breast and alleviates the suffering of patients and improves the quality of life of patients.Future large-scale,high-quality,double-blind trials are needed.

Radiotherapy combined with surgical treatment for gastric cancer:a meta-analysis

Objective:We carried out a meta-analysis to assess the effectiveness and safety of radiotherapy combined with surgery for gastric cancer.Methods:Randomized Clinical Trials (RCTs) in which radiotherapy (preoperative,intraoperative and postoperative),was compared with surgery alone in resectable gastric cancer were identified by searching Cochrane Library (Issue 2,2009),PubMed (Jan 1966-Jun 2009),EMBASE (Jan 1974-Jun 2009),Chinese Biomedical Literature Database (Jan 1978-Jun 2009),Chinese Science and Technology Periodicals Database (Jan 1989-Jun 2009),China National Knowledge Infrastructure (Jan 1994-Jun 2009) and Wanfang database (Jan 1997-Jun 2009) in English and Chinese languang.Two researchers assessed the quality of included randomized controlled trials (RCT) extracted data independently.The RevMan 5.0 software was used for meta-analysis.Our researchers assessed the quality of included randomized controlled trials (RCT) extracted data independently.The RevMan 5.0 software was used for meta-analysis.Results:Nine randomized controlled trials of 1 548 patients were selected for meta-analysis.Five randomized controlled trials were related with comparison of preoperative radiotherapy plus surgery with single surgery.Two randomized controlled trials were the comparative studies between surgery plus postoperative and single surgery.The meta-analysis results showed that:(1) compared with surgery alone,preoperative radiotherapy combined with surgery can increase 3 years (OR=1.78;95% CI 1.14-2.78,P=0.01),5 years (OR=1.67;95% CI 1.22-2.29,P=0.001),10 years (OR=1.64;95% CI 1.03-2.60,P=0.04) survival rate and resection rate (OR=2.15;95% CI 1.31-3.54,P=0.003);reduce the of tumor recurrence rate (OR=0.59;95% CI 0.37-0.92,P=0.02) and metastasis rate (OR=0.44;95% CI 0.27-0.73,P=0.001);(2) The tumor recurrent rates (OR=0.19,95% CI 0.03-1.14,P=0.07) and tumor metastasis rate (OR=0.09;95% CI 0.00-1.77,P=0.11) had no difference between single surgery group and peri-operative radiotherapy plus surgery group;(3) Postoperative radiotherapy compared with surgery alone had no significant effects on 1 year (OR=0.83;95% CI 0.60-1.15,P=0.26) and 3 years (OR=0.75;95% CI 0.51-1.11,P=0.15) survival rate compared with single surgery,but the 5-year survival rates (OR=0.57;95% CI 0.34-0.95,P=0.03) of the patients who received surgery alone was higher than those who received combined therapy.No difference of the tumor recurrence rate (OR=0.59;95% CI 0.33-1.05,P=0.07),tumor metestasis rate (OR=0.90;95% CI 0.51-1.59,P=0.71) and anastomotic leak (OR=0.98;95% CI 0.25-3.65,P=0.98) were observed between the two groups.Conclusion:Preoperative radiotherapy combined surgery is more rational and effective than surgery alone of gastric cancer.However,in terms of the clinical effects of perioperarive or postoperative radoiotherapy combined with surgery,much multicenter,largescale,high-quality,double-blind and rigorously designed studies would be needed than currently available in the future.

Hepatic venous pressure gradient measurement guiding nonselective beta-blocker therapy in a patient with clinically significant portal hypertension

Clinically significant portal hypertension(CSPH),defined as a hepatic venous pressure gradient(HVPG)≥10 mmHg,is an independent risk factor for decompensated events in patients with compensated cirrhosis.Currently,the Baveno VII consensus recommends using nonselective beta-blockers to treat compensated cirrhosis in patients with CSPH.Here,we report a unusual case of compensated cirrhosis with CSPH caused by hepatitis B,and we successfully adjust NSBBs drug treatment strategies monitoring by HVPG results and achieve response standards.Timely adjustment of NSBBs drug treatment strategies based on HVPG test results for patients with CSPH can improve the final response rate.

Drug repurposing for cancer therapy

Cancer,a complex and multifactorial disease,presents a significant challenge to global health.Despite significant advances in surgical,radiotherapeutic and immunological approaches,which have improved cancer treatment outcomes,drug therapy continues to serve as a key therapeutic strategy.However,the clinical efficacy of drug therapy is often constrained by drug resistance and severe toxic side effects,and thus there remains a critical need to develop novel cancer therapeutics.One promising strategy that has received widespread attention in recent years is drug repurposing:the identification of new applications for existing,clinically approved drugs.Drug repurposing possesses several inherent advantages in the context of cancer treatment since repurposed drugs are typically cost-effective,proven to be safe,and can significantly expedite the drug development process due to their already established safety profiles.In light of this,the present review offers a comprehensive overview of the various methods employed in drug repurposing,specifically focusing on the repurposing of drugs to treat cancer.We describe the antitumor properties of candidate drugs,and discuss in detail how they target both the hallmarks of cancer in tumor cells and the surrounding tumor microenvironment.In addition,we examine the innovative strategy of integrating drug repurposing with nanotechnology to enhance topical drug delivery.We also emphasize the critical role that repurposed drugs can play when used as part of a combination therapy regimen.To conclude,we outline the challenges associated with repurposing drugs and consider the future prospects of these repurposed drugs transitioning into clinical application.

Safety of high-carbohydrate fluid diet 2 h versus overnight fasting before non-emergency endoscopic retrograde cholangiopancreatography:A single-blind,multicenter,randomized controlled trial

Background:Although overnight fasting is recommended prior to endoscopic retrograde cholangiopancreatography(ERCP),the benefits and safety of high-carbohydrate fluid diet(CFD)intake 2 h before ERCP remain unclear.This study aimed to analyze whether high-CFD intake 2 h before ERCP can be safe and accelerate patients’recovery.Methods:This prospective,multicenter,randomized controlled trial involved 15 tertiary ERCP centers.A total of 1330 patients were randomized into CFD group(n=665)and fasting group(n=665).The CFD group received 400 mL of maltodextrin orally 2 h before ERCP,while the control group abstained from food/water overnight(>6 h)before ERCP.All ERCP procedures were performed using deep sedation with intravenous propofol.The investigators were blinded but not the patients.The primary outcomes included postoperative fatigue and abdominal pain score,and the secondary outcomes included complications and changes in metabolic indicators.The outcomes were analyzed according to a modified intention-to-treat principle.Results:The post-ERCP fatigue scores were significantly lower at 4 h(4.1±2.6 vs.4.8±2.8,t=4.23,P<0.001)and 20 h(2.4±2.1 vs.3.4±2.4,t=7.94,P<0.001)in the CFD group,with least-squares mean differences of 0.48(95%confidence interval[CI]:0.26-0.71,P<0.001)and 0.76(95%CI:0.57-0.95,P<0.001),respectively.The 4-h pain scores(2.1±1.7 vs.2.2±1.7,t=2.60,P=0.009,with a least-squares mean difference of 0.21[95%CI:0.05-0.37])and positive urine ketone levels(7.7%[39/509]vs.15.4%[82/533],χ^(2)=15.13,P<0.001)were lower in the CFD group.The CFD group had significantly less cholangitis(2.1%[13/634]vs.4.0%[26/658],χ^(2)=3.99,P=0.046)but not pancreatitis(5.5%[35/634]vs.6.5%[43/658],χ^(2)=0.59,P=0.444).Subgroup analysis revealed that CFD reduced the incidence of complications in patients with native papilla(odds ratio[OR]:0.61,95%CI:0.39-0.95,P=0.028)in the multivariable models.Conclusion:Ingesting 400 mL of CFD 2 h before ERCP is safe,with a reduction in post-ERCP fatigue,abdominal pain,and cholangitis during recovery.Trail Registration:ClinicalTrials.gov,No.NCT03075280.

Critical involvement of lysyl oxidase in seizure-induced neuronal damage through ERK-Alox5-dependent ferroptosis and its therapeutic implications

Recent insights collectively suggest the important roles of lysyl oxidase(LysOX)in the pathological processes of several acute and chronic neurological diseases,but the molecular regulatory mechanisms remain elusive.Herein,we explore the regulatory role of LysOX in the seizure-induced ferroptotic cell death of neurons.Mechanistically,LysOX promotes ferroptosis-associated lipid peroxidation in neurons via activating extracellular regulated protein kinase(ERK)-dependent 5-lipoxygenase(Alox5)signaling.In addition,overexpression of LysOX via adeno-associated viral vector(AAV)-based gene transfer enhances ferroptosis sensitivity and aggravates seizure-induced hippocampal damage.Our studies show that pharmacological inhibition of LysOX withβ-aminopropionitrile(BAPN)significantly blocks seizure-induced ferroptosis and thereby alleviates neuronal damage,while the BAPN-associated cardiotoxicity and neurotoxicity could further be reduced through encapsulation with bioresponsive amorphous calcium carbonate-based nanocarriers.These findings unveil a previously unrecognized LysOX-ERK-Alox5 pathway for ferroptosis regulation during seizure-induced neuronal damage.Suppressing this pathway may yield therapeutic implications for restoring seizure-induced neuronal injury.

Effect of Aidi injection plus chemotherapy on gastric carcinoma:a Meta-analysis of randomized controlled trials

OBJECTIVE: To conduct a Meta-analysis of studies on the effect of Aidi injectioncombined with chemotherapy versus chemotherapy alone in the treatment of gastric cancer(GC).METHODS: Nine electronic databases and six gray literature databases were comprehensively searcheduntil April 20,2013. Two reviewers independently selected and assessed included trialsaccording to the inclusion and exclusion criteria. The risk of bias tool from the Cochrane Handbook version 5.1.0was used to assess trial quality. All calculations were performed using Review Manager 5.0.RESULTS: Thirty-two studies including 1927 participants met the inclusion criteria,most of which were low quality. Compared with chemotherapy alone,Aidi injection plusthe same chemotherapy significantly improved the effective rate [OR = 1.52,95% CI(1.24,1.86),P < 0.0001],clinical beneficial rate [OR = 1.77,95% CI(1.33,2.36),P < 0.0001],and quality of life [OR = 3.02,95% CI(2.39,3.82),P <0.000 01]. There was a significant improvement in nausea and vomiting incidence [OR = 0.34,95%CI(0.24,0.47),P < 0.000 01],diarrhea [OR = 0.47,95%CI(0.33,0.69),P < 0.000 01],leukopenia( 3,0.51),P = 0.05],hemⅢ-ogⅣ)[OR = 0.34,95%CI(0.2lobin decrease(thromⅢ-boⅣ) [OR = 0.42,95%CI(0.18-1.00),P = 0.05],cytopenia(4],and Ⅲ-damⅣ) [OR = 0.46,95%CI(0.22,0.96),P = 0.0age to liver function [OR = 0.36,95%CI(0.24,0.54),P < 0.000 01].CONCLUSION: Aidi injection combined with chemotherapy significantly improved the clinical effect of chemotherapy,reducing the incidence of adverse events. Use of the CONSORT statement for randomized controlled trials is recommended for stricter reporting.

Comment on“Diagnostic approach to faecal incontinence:What test and when to perform?”

We recently read with interest the article"Diagnostic approach to faecal incontinence:What test and when to perform?".This is a comprehensive and practical review,which has particular significance for guiding clinicians to improve the examination strategy.Although we appreciate their work very much,based on the in-depth analysis of this research,we found some detailed problems in the article and will give our comments in this letter.If the author can further improve the relevant research,it will be valuable.

The arsenal of TP53 mutants therapies:neoantigens and bispecific antibodies

A recent research published in Science by Hsiue et al.1 introduced a CD3-targeting bispecific antibody that can bind to tumor cells by recognizing mutation-associated neoantigens and activate T cell-mediated tumor killing by binding to CD3.The tumor suppressor gene TP53 is the most commonly mutated gene in various cancers.

Cancer cachexia:Focus on cachexia factors and inter-organ communication

Cancer cachexia is a multi-organ syndrome and closely related to changes in signal communication between organs,which is mediated by cancer cachexia factors.Cancer cachexia factors,being the general name of inflammatory factors,circulating proteins,metabolites,and microRNA secreted by tumor or host cells,play a role in secretory or other organs and mediate complex signal communication between organs during cancer cachexia.Cancer cachexia factors are also a potential target for the diagnosis and treatment.The pathogenesis of cachexia is unclear and no clear effective treatment is available.Thus,the treatment of cancer cachexia from the perspective of the tumor ecosystem rather than from the perspective of a single molecule and a single organ is urgently needed.From the point of signal communication between organs mediated by cancer cachexia factors,finding a deeper understanding of the pathogenesis,diagnosis,and treatment of cancer cachexia is of great significance to improve the level of diagnosis and treatment.This review begins with cancer cachexia factors released during the interaction between tumor and host cells,and provides a comprehensive summary of the pathogenesis,diagnosis,and treatment for cancer cachexia,along with a particular sight on multi-organ signal communication mediated by cancer cachexia factors.This summary aims to deepen medical community’s understanding of cancer cachexia and may conduce to the discovery of new diagnostic and therapeutic targets for cancer cachexia.

Systematic review for geo-authentic Lonicerae Japonicae Flos

In traditional Chinese medicine, Lonicerae Japonicae Flos is commonly used as anti-inflammatory, antiviral, and antipyretic herbal medicine, and geo-authentic herbs are believed to present the highest quality among all samples from different regions. To discuss the current situation and trend of geo-authentic Lonicerae Japonicae Flos, we searched Chinese Biomedicine Literature Database, Chinese Journal Full-text Database, Chinese Scientific Journal Full-text Database, Cochrane Central Register of Controlled Trials, Wanfang, and PubMed. We investigated all studies up to November 2015 pertaining to quality assessment, discrimination, pharmacological effects, planting or processing, or ecological system of geo-authentic Lonicerae Japonicae Flos. Sixty-five studies mainly discussing about chemical fingerprint, component analysis, planting and processing, discrimination between varieties, ecological system, pharmacological effects, and safety were systematically reviewed. By analyzing these studies, we found that the key points of geo-authentic Lonicerae Japonicae Flos research were quality and application. Further studies should focus on improving the quality by selecting the more superior of all varieties and evaluating clinical effectiveness.

Value of multimodality imaging in diagnosing primary small cell carcinoma of breast

To the Editor: A 51-year-old woman presented with a palpable mass in the lower outer region of the left breast. There was no history of skin redness or nipple discharge. Craniocaudal mammography [Figure 1A] showed a circular homogenous mass with well-defined margins and without calcification located in the posterior region of the left breast. Ultrasonography (US)[Figure IB] of the left breast demonstrated a heterogeneous, hypoechoic lesion with an accompanying peripheral blood flow signal.

Meta Analysis of Lentinan Injection plus Cisplatin in Treatment of Malignant Pleural Effusion

Objective To evaluate the efficacy and safety of lentinan injection plus cisplatin(LIC)in the treatment of malignant pleural effusion(MPE).Methods We searched the database of Cochrane Library,PubMed,EMBASE, ISI Web of Knowledge,Chinese Biomedical Literature Database,Chinese Scientific Journals Full-text Database, Chinese Journal Full-text,and Google Scholar,etc.,up to February 28th,2011 to identify randomized controlled trials(RCTs)about lentinan injection(LI)for MPE,evaluate the quality of the included studies,and analyze the data by Cochrane Collaboration’s RevMan5.0 software.Results Twenty-nine RCTs involving 1831 patients were included.Meta analysis results suggested that there were some differences when comparing LIC with control groups suffering from MPE,for LIC could improve the near-term curative effect and the quality of life to some extent. Besides,compared with chemotherapy alone,LI plus chemotherapy had an advantage in relieving adverse reactions, such as gastrointestinal reactions,myelosuppression,chest pain,and general malaise.Conclusion The current evidence indicates that LI may have adjuvant therapeutic effects for MPE.

NAT 10 promotes gastric cancer metastasis via N4-acetylated COL5A1

Dear Editor,Gastric cancer(GC)is among the most prevalent gastrointestinal malignancies.The occurrence of local deep infiltration or distant metastasis in GC is commonly associated with weak treatment and poor prognosis.1 Although,N4-Acetylcytidine(ac4C)represents one of the extensive chemical modifications in mRNAs that plays a pivotal role in modulating mRNA stability and the mRNA translation process(Fig.1b).