Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current...Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.展开更多
Cell death is a crucial process required for development, tissue homeostasis, and pathological cell loss in multicellu- lar organisms. Cell death mainly occurs in two alternative modes： apoptosis or necrosis. Apoptos...Cell death is a crucial process required for development, tissue homeostasis, and pathological cell loss in multicellu- lar organisms. Cell death mainly occurs in two alternative modes： apoptosis or necrosis. Apoptosis is a form of pro- grammed cell death with typical morphological features, including cell shrinkage, chromatin condensation, and DNA fragmentation （Degterev and Yuan, 2008）. The dying cell is eventually fragmented into membrane-bound apoptotic bodies that are engulfed by surrounding phagocytes.展开更多
Objective：To investigate the potential efficacy of panaxadiol saponins component（PDS-C）,a biologically active fraction isolated from total ginsenosides,to reverse chemotherapy-induced myelosuppression and pancytope...Objective：To investigate the potential efficacy of panaxadiol saponins component（PDS-C）,a biologically active fraction isolated from total ginsenosides,to reverse chemotherapy-induced myelosuppression and pancytopenia caused by cyclophamide（CTX）.Methods：Mice with myelosuppression induced by CTX were treated with PDS-C at a low-（20 mg/kg）,moderate-（40 mg/kg）,or high-dose（80 mg/kg） for 7 consecutive days.The level of peripheral white blood cell（WBC）,neutrophil（NEU） and platelet（PLT） were measured,the histopathology and colony formation were observed,the protein kinase and transcription factors in hematopoietic cells were determined by immunohistochemical staining and Western blot.Results：In response to PDS-C therapy,the peripheral WBC,NEU and PLT counts of CTX-induced myelosuppressed mice were significantly increased in a dose-dependent manner.Similarly,bone marrow histopathology examination showed reversal of CTX-induced myelosuppression with increase in overall bone marrow cellularity and the number of hematopoietic cells（P〈0.01）.PDS-C also promoted proliferation of granulocytic and megakaryocyte progenitor cells in CTX-treated mice,as evidenced by significantly increase in colony formation units-granulocytes/monocytes and-megakaryocytes（P〈0.01）.The enhancement of hematopoiesis by PDS-C appears to be mediated by an intracellular signaling pathway,this was evidenced by the up-regulation of phosphorylated mitogen-activated protein kinase（p-MEK） and extracellular signal-regulated kinases（p-ERK）,and receptor tyrosine kinase（C-kit） and globin transcription factor 1（GATA-1） in hematopoietic cells of CTX-treated mice（P〈0.05）.Conclusions：PDS-C possesses hematopoietic growth factor-like activities that promote proliferation and also possibly differentiation of hematopoietic progenitor cells in myelosuppressed mice,probably mediated by a mechanism involving MEK and ERK protein kinases,and C-kit and GATA-1 transcription factors.PDS-C may potentially b展开更多
OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 p...OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 patients with malignant tumors were included in this prospective single-blinded study, and randomized to receive either electroacupuncture or acupuncture treatment on basis of chemotherapy.The chemotherapy was continued for 2 courses as previous before the treatments, with 21 days as a course of treatment.Patients received acupuncture and electroacupuncture once per day starting at the day before chemotherapy for consecutive 7 days followed by 14 days off, with 21 days as a course of treatment, and continued for two courses of treatment.Then CIPN, traditional Chinese clinical symptoms,quality of life and immune status were all evaluated for each patient prior treatment and after two courses of treatment.RESULTS:The gender, age, cancer species as well as incidence(83.3% vs 84.2%) and grades of CIPN before treatments were all similar in patients receiving acupuncture or electroacupuncture(all P >0.05).After treatments, most patients with peripheral neuropathy were cured by two courses of electroacupuncture(84.2% vs 21.1%), whereas the other group of patients had similar incidences of peripheral neuropathy compared with prior-acupuncture(83.3% vs 72.2%).Besides, patients receiving electroacupuncture had lower incidence of peripheral neuropathy than those receiving acupuncture treatment(χ~2= 9.745, P = 0.002).The grades of peripheral neuropathy were significantly different in the two groups post-treatment(χ~2= 13.983, P =0.007).The total effective rates for traditional Chinese clinical symptoms were 16.7% and 84.2% in acupuncture and electroacupuncture groups, respectively(Z =-4.239, P < 0.001).The electroacupuncture treatment provided a more satisfactory life for patients compared with acupuncture(Z =-4.76, P < 0.001).Both electroacupuncture and acupuncture had no effects on immune function.CONCLUSION:展开更多
Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associ...Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.展开更多
质子泵抑制剂(proton pump inhibitors,PPIs)具有抑制胃酸分泌和保护胃黏膜作用,临床常用于治疗酸相关性疾病.肿瘤化疗引起的胃肠道黏膜损伤,一直受到肿瘤学界的重视,在美国国立癌症综合网络(National Comprehensive Cancer Network,NC...质子泵抑制剂(proton pump inhibitors,PPIs)具有抑制胃酸分泌和保护胃黏膜作用,临床常用于治疗酸相关性疾病.肿瘤化疗引起的胃肠道黏膜损伤,一直受到肿瘤学界的重视,在美国国立癌症综合网络(National Comprehensive Cancer Network,NCCN)与癌症辅助治疗多国协会(Multinational Association of Supportive Care in Cancer,MASCC)临床止吐指南中,PPIs之一的奥美拉唑被推荐用于治疗肿瘤化疗引起的上腹痛症状.目前PPIs的适应症有增加趋势,国内临床上广泛用于防治肿瘤化疗引起的胃肠道黏膜损伤.本文就化疗引起胃肠道黏膜损伤机制、PPIs保护胃肠道黏膜机制及其防治化疗引起胃黏膜损伤的临床应用作一综述.展开更多
Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 20...Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.展开更多
Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for color...Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for colorectal and other gastrointestinal cancers present with CID;moreover, about 5% of early deaths associated with combination anti-cancer chemotherapy are due to CID. Chronic post-treatment diarrhoea amongst cancer survivors can persist for more than 10 years greatly effecting long-term quality of life. Gastrointestinal toxicities such as diarrhoea and vomiting are amongst the primary contributors to dose reductions and delays throughout anti-cancer treatment, presenting a significant hurdle in clinical management of anti-cancer regimes and often result in sub-optimum treatment. However, little is known about pathophysiological mechanisms underlying CID. This work provides a review of chemotherapy-induced diarrhoea, current management guidelines, and shortcomings of current treatments as well as emerging and already existing anti-diarrhoeal treatments potentially suitable for CID.展开更多
Background:Highly emetogenic chemotherapy induces emesis in cancer patients without prophylaxis.The purpose of this study was to evaluate the efficacy and safety of a fosaprepitant-based triple antiemetic regimen for ...Background:Highly emetogenic chemotherapy induces emesis in cancer patients without prophylaxis.The purpose of this study was to evaluate the efficacy and safety of a fosaprepitant-based triple antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting(CINV)in patients with solid malignant tumors,determine risk factors and externally validate different personalized risk models for CINV.Methods:This phase III trial was designed to test the non-inferiority of fosaprepitant toward aprepitant in cancer patients who were to receive the first cycle of single-day cisplatin chemotherapy.The primary endpoint was complete response(CR)during the overall phase(OP)with a non-inferiority margin of 10.0%.Logistic regression modelswere used to assess the risk factors ofCRand no nausea.To validate the personalized risk models,the accuracy of the risk scoring systems was determined by measuring the specificity,sensitivity and area under the receiver operating characteristic(ROC)curve(AUC),while the predictive accuracy of the nomogram was measured using concordance index(C-index).Results:A total of 720 patients were randomly assigned.CR during the OP in the fosaprepitant group was not inferior to that in the aprepitant group(78.1%vs.77.7%,P=0.765)with a between-group difference of 0.4%(95%CI,-5.7%to 6.6%).Female sex,higher cisplatin dose(≥70 mg/m2),no history of drinking and larger body surface area(BSA)were significantly associated with nausea.The AUC for the acute and delayed CINV risk indexes was 0.68(95%CI:0.66-0.71)and 0.66(95%CI:0.61-0.70),respectively,and the C-index for nomogram CINV prediction was 0.59(95%CI,0.54-0.64).Using appropriate cutoff points,the three models could stratify patients with high-or low-risk CINV.No nausea and CR rate were significantly higher in the low-risk group than in the high-risk group(P<0.001).Conclusions:Fosaprepitant-based triple prophylaxis demonstrated non-inferior control for preventing CINV in patients treated with cisplatin-base chemotherapy.Female cancer patient展开更多
Objective: To observe the clinical efficacy and differences of the Zhuyu Juanbi formula delivered through ultrasound at Zusanli on patients with chemotherapy-induced peripheral neuropathy (CIPN) due to paclitaxel inje...Objective: To observe the clinical efficacy and differences of the Zhuyu Juanbi formula delivered through ultrasound at Zusanli on patients with chemotherapy-induced peripheral neuropathy (CIPN) due to paclitaxel injection. Methods: A total of 72 breast cancer patients with CIPN were randomly divided into two groups. The treatment group (36 cases) was treated with oral methylcobalamin plus ultrasonic medicine permeating Zhuyu Juanbi formulae, while the control group (36 cases) was treated with oral methylcobalamin alone. Following two 2 cycles of continuous treatment, the efficacy of peripheral neurotoxicity, TCM syndrome score, FACT/GOG-Ntx score, total neuropathy score, and safety indicators of gynecological cancer patients were observed in the two groups. Result: In the treatment of CIPN, the addition of ultrasonic medicine permeating Zhuyu Juanbi formulae was more effective than oral methylcobalamin alone in reducing peripheral neurotoxicity and improving the quality of life of patients. The difference between the two groups was statistically significant (P < 0.05), and ultrasound drug penetration Zhuyu Juanbi formulae significantly reduced the FACT/ GOG-Ntx score and TNS score in the treatment group. In terms of drug safety, it rarely caused adverse reactions such as grade 3 and 4 leukopenia, and the safety profile was therefore good. Conclusion: The combination of ultrasonic medicine permeating Zhuyu Juanbi formulae and methylcobalamin has been demonstrated to be an effective treatment for peripheral neurotoxicity in patients with PIPN. It has been shown to significantly improve the clinical symptoms of PIPN patients, improve the quality of life of patients, and have a good safety profile.展开更多
OBJECTIVE: To assess the efficacy and safety of Neiguan(PC6) acupoint acustimulation in preventing chemotherapy-induced nausea and vomiting(CINV),especially for patients with guideline-inconsistent CINV prophylaxis(GI...OBJECTIVE: To assess the efficacy and safety of Neiguan(PC6) acupoint acustimulation in preventing chemotherapy-induced nausea and vomiting(CINV),especially for patients with guideline-inconsistent CINV prophylaxis(GICP) due to personal reasons METHODS: From January 2021 to December 2021, 373 patients suffered from solid malignancy were recruited according to the inclusion criteria. Complete response(no emesis and no rescue medication use) rate during the overall phase(0-120 h of each chemo-cycle) was the primary assessment of CINV control. The Functional Living Index-Emesis(FLIE) questionnaire was investigated among these patients as a secondary 'quality of life' objective to assess the impact of CINV on patients' daily life by recording score of nausea and vomiting. RESULTS: With acustimulation of Neiguan(PC6) acupuncture point through a portable, noninvasive and user-friendly device, in terms of complete response rate and scores in nausea/vomiting by FLIE questionnaire, patients achieve a better outcome in highly emetogenic chemotherapy(HEC) induced CINV, especially GICP subgroup. Meanwhile, analysis also demonstrated this tendency existed in other patients with HEC/GCCP(guideline consistent CINV prophylaxis) and moderate emetogenic chemotherapy, although the difference was not significant. CONCLUSION: Considering advantages of Neiguan(PC6) acustimulation such as noninvasive, covered by medical insurance and few side effects, we believe it would be an ideal auxiliary tool in CINV control, especially in patients who receive highly emetogenic chemoprotocol and are reluctant to GCCP for economic reasons.展开更多
To observe the effects of GuiCaoBaiDu Decoction(GCBD)on chemotherapy especially doxorubicin(DOX)-induced myocardial cardiotoxicity(DIC)and explore the mechanisms.The present study presents a case demonstrating the pre...To observe the effects of GuiCaoBaiDu Decoction(GCBD)on chemotherapy especially doxorubicin(DOX)-induced myocardial cardiotoxicity(DIC)and explore the mechanisms.The present study presents a case demonstrating the preventive and therapeutic effects of GCBD on myocardial injury following chemotherapy.Then network pharmacology was employed to predict the targets of GCBD.Subsequently,a DOX-induced apoptosis model of H9C2 cardiomyocytes was established and co-cultured with serum containing GCBD serum.The viability and myocardial enzyme levels were evaluated using CCK8 assay and ELISA assay,TUNEL was using for apoptosis test.The GCBD effect was confirmed by tests of ROS andα-actinin levels,evaluation of mitochondrial morphology,and BAX co-localization with mitochondria.Furthermore,the expression levels of apoptosis-related molecules were determined via Western blotting.Additionally,a mouse model exhibiting DOX-induced cardiac functional impairment was generated and subsequently treated with GCBD.Myocardial enzyme level was tested at first,then echocardiography was tested,myocardial apoptosis in mice was observed through HE staining while related proteins were detected using IHC.Network pharmacological analyses revealed that GCBD exerts its effects on BAX,Caspase7,and other related molecules.Initially,we demonstrated the effective amelioration of DIC in cardiomyocyte viability,LDH/CK levels,α-actinin and ROS levels,and apoptosis by GCBD through improvements in TUNEL test,mitochondrial morphology and WB.The efficacy of GCBD in enhancing cardiac function in DIC mice has been validated through animal experiments.Taken together,our study showed that GCBD could significantly alleviate DOX induced myocardial injury by regulating mitochondrial apoptosis.The utilization of GCBD can effectively contribute to the prevention and treatment of chemotherapy-induced myocardial injury when anthracycline chemotherapy is employed in clinical practice.展开更多
基金supported by MSD Holding Co.,Ltd.The funding was only for the payment of using CHIRA database
文摘Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.
基金supported by the National Basic Research Program of China (2013CB910102)the National Natural Science Foundation of China (31471303)a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions
文摘Cell death is a crucial process required for development, tissue homeostasis, and pathological cell loss in multicellu- lar organisms. Cell death mainly occurs in two alternative modes： apoptosis or necrosis. Apoptosis is a form of pro- grammed cell death with typical morphological features, including cell shrinkage, chromatin condensation, and DNA fragmentation （Degterev and Yuan, 2008）. The dying cell is eventually fragmented into membrane-bound apoptotic bodies that are engulfed by surrounding phagocytes.
基金Supported by the Science and Technology Program Project of Zhejiang Province(No.2015C33173)Chinese Medicine Foundation of Young Talents in Zhejiang Province(No.2014ZQ006)Australia-China Institutional Links Research Program sponsored by the International Development Program of Education Australia(No.IDP 2-8)
文摘Objective：To investigate the potential efficacy of panaxadiol saponins component（PDS-C）,a biologically active fraction isolated from total ginsenosides,to reverse chemotherapy-induced myelosuppression and pancytopenia caused by cyclophamide（CTX）.Methods：Mice with myelosuppression induced by CTX were treated with PDS-C at a low-（20 mg/kg）,moderate-（40 mg/kg）,or high-dose（80 mg/kg） for 7 consecutive days.The level of peripheral white blood cell（WBC）,neutrophil（NEU） and platelet（PLT） were measured,the histopathology and colony formation were observed,the protein kinase and transcription factors in hematopoietic cells were determined by immunohistochemical staining and Western blot.Results：In response to PDS-C therapy,the peripheral WBC,NEU and PLT counts of CTX-induced myelosuppressed mice were significantly increased in a dose-dependent manner.Similarly,bone marrow histopathology examination showed reversal of CTX-induced myelosuppression with increase in overall bone marrow cellularity and the number of hematopoietic cells（P〈0.01）.PDS-C also promoted proliferation of granulocytic and megakaryocyte progenitor cells in CTX-treated mice,as evidenced by significantly increase in colony formation units-granulocytes/monocytes and-megakaryocytes（P〈0.01）.The enhancement of hematopoiesis by PDS-C appears to be mediated by an intracellular signaling pathway,this was evidenced by the up-regulation of phosphorylated mitogen-activated protein kinase（p-MEK） and extracellular signal-regulated kinases（p-ERK）,and receptor tyrosine kinase（C-kit） and globin transcription factor 1（GATA-1） in hematopoietic cells of CTX-treated mice（P〈0.05）.Conclusions：PDS-C possesses hematopoietic growth factor-like activities that promote proliferation and also possibly differentiation of hematopoietic progenitor cells in myelosuppressed mice,probably mediated by a mechanism involving MEK and ERK protein kinases,and C-kit and GATA-1 transcription factors.PDS-C may potentially b
基金Supported by the Study of Electric Acupuncture in Preventing the Peripheral Neuritis Induced by Chemotherapy and Promoting the Immune Function in Cancer Patients from:Comprehensive and Integrative Medicine Institute,KoreaMechanism Study of Electric Acupuncture in Oxaliplatin-chemotherapy-induced Peripheral Neuropathy by SP-NMDAR Pathway from:Shanghai TCM-integrated Hospital+3 种基金Effect of Bushen-Jianpi Decoction on Postoperative Recurrence and Vasculogenic Mimicry Formation after Recurrence in Liver Cancer Tissues of Nude Mice with Transplanted Liver Cancer(No.2012J003A)Mechanism Study of Fuzheng Jianpi Decoction on Tumor Metastasis Inhibition by Protecting Intestinal Barrier and Regulating PI3K/AKT Signaling Pathway Expression in Colorectal Tumor Microenvironment(No.15ZR1438700)Effect of Jianpi-Guchang Decoction on the Gut Barrier Function and Immune Function in Lung or Colorectal Cancer Patients Treated by Chemotherapy Based on the Thought of "Same Treatment for Different Diseases"(No.15401930300)Effect of Jianpi-Guben Decoction on the Gut Barrier Function in Postoperative Colorectal Cancer Patients Treated by Chemotherapy to Balance the Gut Enviroment(No.Hongkou 1502-01)
文摘OBJECTIVE:To evaluate the effect of electroacupuncture on chemotherapy-induced peripheral neuropathy(CIPN), quality of life and immune status of patients with malignant tumors.METHODS:From Jan, 2013 to May, 2014, 37 patients with malignant tumors were included in this prospective single-blinded study, and randomized to receive either electroacupuncture or acupuncture treatment on basis of chemotherapy.The chemotherapy was continued for 2 courses as previous before the treatments, with 21 days as a course of treatment.Patients received acupuncture and electroacupuncture once per day starting at the day before chemotherapy for consecutive 7 days followed by 14 days off, with 21 days as a course of treatment, and continued for two courses of treatment.Then CIPN, traditional Chinese clinical symptoms,quality of life and immune status were all evaluated for each patient prior treatment and after two courses of treatment.RESULTS:The gender, age, cancer species as well as incidence(83.3% vs 84.2%) and grades of CIPN before treatments were all similar in patients receiving acupuncture or electroacupuncture(all P >0.05).After treatments, most patients with peripheral neuropathy were cured by two courses of electroacupuncture(84.2% vs 21.1%), whereas the other group of patients had similar incidences of peripheral neuropathy compared with prior-acupuncture(83.3% vs 72.2%).Besides, patients receiving electroacupuncture had lower incidence of peripheral neuropathy than those receiving acupuncture treatment(χ~2= 9.745, P = 0.002).The grades of peripheral neuropathy were significantly different in the two groups post-treatment(χ~2= 13.983, P =0.007).The total effective rates for traditional Chinese clinical symptoms were 16.7% and 84.2% in acupuncture and electroacupuncture groups, respectively(Z =-4.239, P < 0.001).The electroacupuncture treatment provided a more satisfactory life for patients compared with acupuncture(Z =-4.76, P < 0.001).Both electroacupuncture and acupuncture had no effects on immune function.CONCLUSION:
基金supported by grants from the Demonstrative Research Platform of Clinical Evaluation Technology for New Anticancer Drugs(Grant Nos.18ZX09201-015 and 2017ZX09304015)the Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences(Grant No.CIFMS,2016-I2M-1-001)。
文摘Chemotherapy-induced neutropenia(CIN)is a potentially fatal and common complication in myelosuppressive chemotherapy.The timing and grade of CIN may play prognostic and predictive roles in cancer therapy.CIN is associated with older age,poor functional and nutritional status,the presence of significant comorbidities,the type of cancer,previous chemotherapy cycles,the stage of the disease,specific chemotherapy regimens,and combined therapies.There are many key points and new challenges in the management of CIN in adults including:(1)Genetic risk factors to evaluate the patient’s risk for CIN remain unclear.However,these risk factors urgently need to be identified.(2)Febrile neutropenia(FN)remains one of the most common reasons for oncological emergency.No consensus nomogram for FN risk assessment has been established.(3)Different assessment tools[e.g.,Multinational Association for Supportive Care in Cancer(MASCC),the Clinical Index of Stable Febrile Neutropenia(CISNE)score model,and other tools]have been suggested to help stratify the risk of complications in patients with FN.However,current tools have limitations.The CISNE score model is useful to support decision-making,especially for patients with stable FN.(4)There are still some challenges,including the benefits of granulocyte colony stimulating factor treatment and the optimal antibiotic regimen in emergency management of FN.In view of the current reports,our group discusses the key points,new challenges,and management of CIN.
文摘质子泵抑制剂(proton pump inhibitors,PPIs)具有抑制胃酸分泌和保护胃黏膜作用,临床常用于治疗酸相关性疾病.肿瘤化疗引起的胃肠道黏膜损伤,一直受到肿瘤学界的重视,在美国国立癌症综合网络(National Comprehensive Cancer Network,NCCN)与癌症辅助治疗多国协会(Multinational Association of Supportive Care in Cancer,MASCC)临床止吐指南中,PPIs之一的奥美拉唑被推荐用于治疗肿瘤化疗引起的上腹痛症状.目前PPIs的适应症有增加趋势,国内临床上广泛用于防治肿瘤化疗引起的胃肠道黏膜损伤.本文就化疗引起胃肠道黏膜损伤机制、PPIs保护胃肠道黏膜机制及其防治化疗引起胃黏膜损伤的临床应用作一综述.
基金Supported by the National Basic Research Program of China:2014 CB 543201
文摘Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.
文摘Chemotherapy-induced diarrhoea (CID) is a common side-effect experienced by patients being treated with a variety of antineoplastic agents. Approximately 80% of patients undergoing chemotherapeutic treatment for colorectal and other gastrointestinal cancers present with CID;moreover, about 5% of early deaths associated with combination anti-cancer chemotherapy are due to CID. Chronic post-treatment diarrhoea amongst cancer survivors can persist for more than 10 years greatly effecting long-term quality of life. Gastrointestinal toxicities such as diarrhoea and vomiting are amongst the primary contributors to dose reductions and delays throughout anti-cancer treatment, presenting a significant hurdle in clinical management of anti-cancer regimes and often result in sub-optimum treatment. However, little is known about pathophysiological mechanisms underlying CID. This work provides a review of chemotherapy-induced diarrhoea, current management guidelines, and shortcomings of current treatments as well as emerging and already existing anti-diarrhoeal treatments potentially suitable for CID.
文摘Background:Highly emetogenic chemotherapy induces emesis in cancer patients without prophylaxis.The purpose of this study was to evaluate the efficacy and safety of a fosaprepitant-based triple antiemetic regimen for the prevention of chemotherapy-induced nausea and vomiting(CINV)in patients with solid malignant tumors,determine risk factors and externally validate different personalized risk models for CINV.Methods:This phase III trial was designed to test the non-inferiority of fosaprepitant toward aprepitant in cancer patients who were to receive the first cycle of single-day cisplatin chemotherapy.The primary endpoint was complete response(CR)during the overall phase(OP)with a non-inferiority margin of 10.0%.Logistic regression modelswere used to assess the risk factors ofCRand no nausea.To validate the personalized risk models,the accuracy of the risk scoring systems was determined by measuring the specificity,sensitivity and area under the receiver operating characteristic(ROC)curve(AUC),while the predictive accuracy of the nomogram was measured using concordance index(C-index).Results:A total of 720 patients were randomly assigned.CR during the OP in the fosaprepitant group was not inferior to that in the aprepitant group(78.1%vs.77.7%,P=0.765)with a between-group difference of 0.4%(95%CI,-5.7%to 6.6%).Female sex,higher cisplatin dose(≥70 mg/m2),no history of drinking and larger body surface area(BSA)were significantly associated with nausea.The AUC for the acute and delayed CINV risk indexes was 0.68(95%CI:0.66-0.71)and 0.66(95%CI:0.61-0.70),respectively,and the C-index for nomogram CINV prediction was 0.59(95%CI,0.54-0.64).Using appropriate cutoff points,the three models could stratify patients with high-or low-risk CINV.No nausea and CR rate were significantly higher in the low-risk group than in the high-risk group(P<0.001).Conclusions:Fosaprepitant-based triple prophylaxis demonstrated non-inferior control for preventing CINV in patients treated with cisplatin-base chemotherapy.Female cancer patient
文摘Objective: To observe the clinical efficacy and differences of the Zhuyu Juanbi formula delivered through ultrasound at Zusanli on patients with chemotherapy-induced peripheral neuropathy (CIPN) due to paclitaxel injection. Methods: A total of 72 breast cancer patients with CIPN were randomly divided into two groups. The treatment group (36 cases) was treated with oral methylcobalamin plus ultrasonic medicine permeating Zhuyu Juanbi formulae, while the control group (36 cases) was treated with oral methylcobalamin alone. Following two 2 cycles of continuous treatment, the efficacy of peripheral neurotoxicity, TCM syndrome score, FACT/GOG-Ntx score, total neuropathy score, and safety indicators of gynecological cancer patients were observed in the two groups. Result: In the treatment of CIPN, the addition of ultrasonic medicine permeating Zhuyu Juanbi formulae was more effective than oral methylcobalamin alone in reducing peripheral neurotoxicity and improving the quality of life of patients. The difference between the two groups was statistically significant (P < 0.05), and ultrasound drug penetration Zhuyu Juanbi formulae significantly reduced the FACT/ GOG-Ntx score and TNS score in the treatment group. In terms of drug safety, it rarely caused adverse reactions such as grade 3 and 4 leukopenia, and the safety profile was therefore good. Conclusion: The combination of ultrasonic medicine permeating Zhuyu Juanbi formulae and methylcobalamin has been demonstrated to be an effective treatment for peripheral neurotoxicity in patients with PIPN. It has been shown to significantly improve the clinical symptoms of PIPN patients, improve the quality of life of patients, and have a good safety profile.
基金National and Natural Science Foundation of China:DGKZ Acts as a Potential Oncogene in Osteosarcoma Proliferation through Interaction with ERK1/2 and MYC Pathway (Grant Number 81972521)。
文摘OBJECTIVE: To assess the efficacy and safety of Neiguan(PC6) acupoint acustimulation in preventing chemotherapy-induced nausea and vomiting(CINV),especially for patients with guideline-inconsistent CINV prophylaxis(GICP) due to personal reasons METHODS: From January 2021 to December 2021, 373 patients suffered from solid malignancy were recruited according to the inclusion criteria. Complete response(no emesis and no rescue medication use) rate during the overall phase(0-120 h of each chemo-cycle) was the primary assessment of CINV control. The Functional Living Index-Emesis(FLIE) questionnaire was investigated among these patients as a secondary 'quality of life' objective to assess the impact of CINV on patients' daily life by recording score of nausea and vomiting. RESULTS: With acustimulation of Neiguan(PC6) acupuncture point through a portable, noninvasive and user-friendly device, in terms of complete response rate and scores in nausea/vomiting by FLIE questionnaire, patients achieve a better outcome in highly emetogenic chemotherapy(HEC) induced CINV, especially GICP subgroup. Meanwhile, analysis also demonstrated this tendency existed in other patients with HEC/GCCP(guideline consistent CINV prophylaxis) and moderate emetogenic chemotherapy, although the difference was not significant. CONCLUSION: Considering advantages of Neiguan(PC6) acustimulation such as noninvasive, covered by medical insurance and few side effects, we believe it would be an ideal auxiliary tool in CINV control, especially in patients who receive highly emetogenic chemoprotocol and are reluctant to GCCP for economic reasons.
基金supported by the National Natural Science Foundation of China(No.82074348,No.82274491)the innovation and development joint project of Shandong Province Natural Science Foundation(ZR2023LZL009)the Jinan clinical medical science and technology innovation plan(No.202225014,202328072).
文摘To observe the effects of GuiCaoBaiDu Decoction(GCBD)on chemotherapy especially doxorubicin(DOX)-induced myocardial cardiotoxicity(DIC)and explore the mechanisms.The present study presents a case demonstrating the preventive and therapeutic effects of GCBD on myocardial injury following chemotherapy.Then network pharmacology was employed to predict the targets of GCBD.Subsequently,a DOX-induced apoptosis model of H9C2 cardiomyocytes was established and co-cultured with serum containing GCBD serum.The viability and myocardial enzyme levels were evaluated using CCK8 assay and ELISA assay,TUNEL was using for apoptosis test.The GCBD effect was confirmed by tests of ROS andα-actinin levels,evaluation of mitochondrial morphology,and BAX co-localization with mitochondria.Furthermore,the expression levels of apoptosis-related molecules were determined via Western blotting.Additionally,a mouse model exhibiting DOX-induced cardiac functional impairment was generated and subsequently treated with GCBD.Myocardial enzyme level was tested at first,then echocardiography was tested,myocardial apoptosis in mice was observed through HE staining while related proteins were detected using IHC.Network pharmacological analyses revealed that GCBD exerts its effects on BAX,Caspase7,and other related molecules.Initially,we demonstrated the effective amelioration of DIC in cardiomyocyte viability,LDH/CK levels,α-actinin and ROS levels,and apoptosis by GCBD through improvements in TUNEL test,mitochondrial morphology and WB.The efficacy of GCBD in enhancing cardiac function in DIC mice has been validated through animal experiments.Taken together,our study showed that GCBD could significantly alleviate DOX induced myocardial injury by regulating mitochondrial apoptosis.The utilization of GCBD can effectively contribute to the prevention and treatment of chemotherapy-induced myocardial injury when anthracycline chemotherapy is employed in clinical practice.
