Melatonin overcomes gemcitabine resistance in pancreatic ductal adenocarcinoma by abrogating nuclear factor‐κB activation

Constitutive activation and gemcitabine induction of nuclear factor‐κB (NF‐κB) contribute to the aggressive behavior and chemotherapeutic resistance of pancreatic ductal adenocarcinoma (PDAC). Thus, targeting the NF‐κB pathway has proven an insurmountable challenge for PDAC therapy. In this study, we investigated whether the inhibition of NF‐κB signaling pathway by melatonin might lead to tumor suppression and overcome gemcitabine resistance in pancreatic tumors. Our results showed that melatonin inhibited activities of NF‐κB by suppressing IκBα phosphorylation and decreased the expression of NF‐κB response genes in MiaPaCa‐2, AsPc‐1, Panc‐28 cells and gemcitabine resistance MiaPaCa‐2/GR cells. Moreover, melatonin not only inhibited cell proliferation and invasion in a receptor‐independent manner, but also enhanced gemcitabine cytotoxicity at pharmacologic concentrations in these PDAC cells. In vivo, the mice treated with both agents experienced a larger reduction in tumor burden than the single drug‐treated groups in an orthotopic xenograft mouse model. Taken together, these results indicate that melatonin inhibits proliferation and invasion of PDAC cells and overcomes gemcitabine resistance of pancreatic tumors through NF‐κB inhibition. Our findings therefore provide novel preclinical knowledge about melatonin inhibition of NF‐κB in PDAC and suggest that melatonin should be investigated clinically, alone or in combination with gemcitabine for PDAC treatment.     

Comparison of the erectile function in male patients with rectal cancer treated by preoperative radiotherapy followed by surgery and surgery alone

Purpose  

This study evaluates the erectile function of male patients treated by preoperative radiotherapy followed by surgery and surgery alone for locally advanced rectal cancer.     

Prospective validation of the Chinese University Prognostic Index and comparison with other staging systems for hepatocellular carcinoma in an Asian population

Background and Aim: Hepatitis B viral (HBV) infection is the predominant etiology of hepatocellular carcinoma (HCC) in Asia. Our group previously reported a staging system known as the Chinese University Prognostic Index (CUPI) for HCC populations of which HBV infection is the predominant etiology. This study aims to validate CUPI and compare with other published staging systems. Methods: We analyzed a prospective cohort of patients with newly diagnosed HCC from 2003 to 2005. All patients were staged with CUPI, Barcelona Clinic Liver Cancer Classification (BCLC), Cancer of the Liver Italian Program score (CLIP), tumor‐node‐metastasis (TNM) and Okuda systems at diagnosis. They were followed with survival data and the performance of each staging system (in terms of homogeneity, discriminatory ability and monotonicity of gradient) were analyzed and compared. Results: A total of 595 patients (80.2% with chronic HBV infection) were analyzed. The median follow‐up was 41.4 months and the median survival was 6.6 months. Multivariate analyses identified symptomatic disease, ascites, vascular involvement, Child‐Pugh‐stage, alpha‐fetoprotein and treatment to be the independent prognostic factors. CUPI could identify three groups with statistically significant survival difference (P < 0.0001). Both CUPI and CLIP had the most favorable performance in terms of discriminatory ability, homogeneity and monotonicity. CUPI performed the best in predicting 3‐month survival while CLIP performed better in predicting the outcome of 6‐ and 12‐month survival rate. BCLC was inferior to CLIP and CUPI in the overall performance. Conclusion: We have validated CUPI in a population composed of predominant HBV‐related HCC. CUPI is an appropriate staging system for HBV‐related HCC. In patients with advanced HCC, both CUPI and CLIP offer good risk stratification.     

凉山州疾病预防控制系统艾滋病防治人员能力提高需求调查

目的了解凉山州疾病预防控制(疾控)系统及基层,从事艾滋病防治人员的人力资源现状及能力提高需求。方法采用定性和定量调查相结合的方式。采用函信调查的方式,由凉山州各县级艾滋病科负责人填写;采用面对面访谈的方式抽样访谈,数据处理采用描述性统计方法。结果共发放自填式调查表18份,回收有效调查表18份。访谈艾滋病科负责人12人,普通艾滋病工作人员8人。凉山州现有疾控系统及基层(乡镇卫生院、妇幼保健院/站)从事艾滋病防治人员241人,平均每个县13人,人员缺口为150人,能够满足现有人员防治工作需要的人员数量和资质严重不足,人员普遍感到工作负荷重,待遇偏低,工作热情一般,专职从事艾滋病防治工作的专业队伍尚未建立,一人多岗现象普遍。近一年内接受培训率较高,培训周期为1周一次为主,培训需求排在前3位的依次是:健康教育与行为干预、流行病学监测、实验室检测;最希望采取的培训方式是:到上级或科研机构进修学习。结论在对凉山州增加防治经费投入的同时,给予人力资源队伍建设和相关领域的培训支持,建立一支高素质的艾滋病防治队伍,满足凉山州艾滋病防治工作的需要。     

妊娠合并心脏病患者的妊娠风险度评估研究

目的 研究分析量化心脏相关高危风险指标在判断妊娠合并心脏病患者妊娠结局的独立或综合价值.方法 选择1999年1月至2008年12月广东省人民医院收治的416名孕妇共535次妊娠,这些孕妇包括先天性心脏病和获得性心脏病患者.将孕妇分为预测发生心脏事件组和实际发生心脏病事件组,就影响发生心脏事件各种相关因素进行综合分析.结...     

胰高血糖素样肽-1受体激动剂对初发2型糖尿病患者血脂代谢影响的研究

目的：本课题观察胰高血糖素样肽-1（ GLP-1）受体激动剂对2型糖尿病患者的治疗,通过对转氨酶、糖化血红蛋白、血脂及脂质运载蛋白-2的检测,探讨胰高血糖素样肽-1受体激动剂与血脂代谢间的关系,从而更有利于对2型糖尿病患者慢性并发症的控制。方法给药方法：两组初发2型糖尿病患者均口服二甲双胍1500 mg,根据治疗方式不同随机分成两组：二甲双胍联合GLP-1组（GL）24例,二甲双胍联合生理盐水组（ NS）24例,共给药16周。试验中随访体重指数、转氨酶、糖化血红蛋白、血脂及载脂蛋白-2。试验前3周为导入期,均注射生理盐水1 ml,皮下注射;第4～7周GL组给予GLP-1受体激动剂5μg,每日2次;第8～16周给予GLP-1受体激动剂10μg,每日2次。结果（1）两组体重、体重指数、糖化血红均降低（ P＜0.05）。（2）GL组甘油三酯、总胆固醇、低密度脂蛋白、载脂蛋白-2明显降低（P＜0.05）,NS组无明显降低（P＞0.05）。（3）GL组转氨酶明显降低（P＜0.05）。结论二甲双胍或二甲双胍联合应用GLP-1受体激动剂均可降低初发2型糖尿病患者的体重及糖化血红蛋白。 GLP-1可更加显著地降低糖尿病患者甘油三酯、总胆固醇、低密度脂蛋白、脂质运载蛋白-2的水平。     

药膳疗法联合中医经络推按对冠心病心绞痛病人生活质量的影响

[目的]探讨药膳疗法联合中医经络推按对冠心病心绞痛病人生活质量的影响.[方法]将400例冠心病心绞痛病人按照随机数字分组法分为对照组、经络推按组、药膳组、经络推按＋药膳组,每组100例.对照组予常规护理,其他三组在对照组的基础上分别给予经络推按、药膳、经络推按＋药膳治疗.采用健康状况调查问卷（SF-36）及西雅图心绞痛量表（ASQ）评价病人的生活质量.[结果]治疗后4组SF-36和SAQ各维度得分显著高于治疗前,差异有统计学意义（P〈0.05）.经络推按＋药膳组治疗后SF-36和SAQ各维度得分显著高于其他3组,组间比较差异有统计学意义（P〈0.05）.[结论]中医经络推按联合药膳治疗可以显著提高冠心病心绞痛病人的生活质量.