Effect of abiraterone acetate on fatigue in patients with metastatic castration-resistant prostate cancer after docetaxel chemotherapy

BACKGROUND

Fatigue is a common, debilitating side-effect of prostate cancer and its treatment. Patient-reported fatigue was evaluated as part of COU-AA-301, a randomized, placebo-controlled, phase III trial of abiraterone acetate and prednisone versus placebo and prednisone in metastatic castration-resistant prostate cancer (mCRPC) patients after docetaxel chemotherapy. This is the first phase III study in advanced prostate cancer to evaluate fatigue outcomes using a validated fatigue-specific instrument.

PATIENTS AND METHODS

The Brief Fatigue Inventory (BFI) questionnaire was used to measure patient-reported fatigue intensity and fatigue interference with activities of daily life. All analyses were conducted using prespecified responder definitions of clinically meaningful changes.

RESULTS

A total of 797 patients were randomized to abiraterone acetate and prednisone, and 398 were randomized to placebo and prednisone. Compared with prednisone alone, in patients with clinically significant fatigue at baseline, abiraterone acetate and prednisone significantly increased the proportion of patients reporting improvement in fatigue intensity (58.1% versus 40.3%, P = 0.0001), improved fatigue interference (55.0% versus 38.0%, P = 0.0075), and accelerated improvement in fatigue intensity (median 59 days versus 194 days, P = 0.0155).

CONCLUSIONS

In patients with mCRPC progressing after docetaxel chemotherapy, abiraterone acetate and prednisone yielded clinically meaningful improvements in patient-reported fatigue compared with prednisone alone.

Overexpression of heat shock protein 70 and its relationship to intestine under acute heat stress in broilers: 1. Intestinal structure and digestive function

The objective of this study was to investigate the relationship between heat shock protein 70 (HSP70) overexpression and intestinal structure and digestive function in heat-stressed broilers. In total, 240 male broilers were injected intraperitoneally with l-(1)-glutamine (0.75 mg/kg of BW) or quercetin (5 mg/kg of BW). Twenty-four hours later, they were heat-stressed for 0, 2, 3, 5, and 10 h, respectively, under 36 ± 1°C. The HSP70 protein and mRNA expression were obviously elevated at 3 h of heat stress, and glutamine induced the overexpression of HSP70 in the jejunal mucosa at different heat-stress times (P < 0.01). No significant change of jejunal villus height, crypt, and villus height:crypt ratio were observed after heat stress, and there were no effects of HSP70 overexpression on intestinal morphology under heat stress. The overexpression of HSP70 significantly increased alkaline phosphatase activity at 3 h of heat stress (P < 0.01). There was a strong correlation between HSP70 expression and the digestive enzyme activity (P ≤ 0.001). The overexpression of HSP70 significantly increased the amylase, lipase, and trypsin activity under heat stress (P < 0.001). These results demonstrated that glutamine was a good HSP70 enhancer to establish an HSP70 overexpression model. Although the overexpression of HSP70 did not change intestinal morphology conditions, it significantly increased broiler digestive enzyme activity under heat stress.

The first multicenter and randomized clinical trial of herbal Fufang for treatment of postmenopausal osteoporosis

This multicenter and randomized clinical trial showed that daily oral herbal formula Xian Ling Gu Bao (XLGB) was safe in postmenopausal women over a 1-year treatment. Those patients (n ∼ 50) treated with XLGB at the conventional dose demonstrated a statistically significant increase in dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) at lumbar spine at 6 months and a numerically increased BMD at 12 months.

INTRODUCTION

The aim of this study was to examine the safety and efficacy of a herbal formula XLGB in postmenopausal women (ChiCTR-TRC-00000347).

METHODS

One hundred eighty healthy postmenopausal women (≥60 years old) with BMD T-score ≤ -2.0 (lumbar spine or femoral neck) were recruited from four clinical centers to receive low-dose (conventional dose) XLGB (L-XLGB group, 3 g/day, n = 61) or high-dose XLGB (H-XLGB group, 6 g/day, n = 58) or placebo (CON group, n = 61). Women received daily calcium (500 mg) and vitamin D (200 IU) supplementation. Primary endpoints were lumbar spine BMD and safety; secondary endpoints were femoral neck BMD and bone turnover markers measured at baseline and at 6 and 12 months.

RESULTS

Of 180 women recruited, 148 completed the study. The compliance in each group was comparable. Prominent adverse events were not observed in either group. In the L-XLGB group at 6 months, lumbar spine BMD by DXA increased significantly from baseline (+2.11% versus CON +0.58%, p < 0.05), but femoral neck BMD did not; at 12 months, BMD in the L-XLGB group decreased from 6-month levels yet remained higher than baseline, but without difference from the CON group. There was no dose-dependent response. Bone turnover marker levels declined during the first 6 months after XLGB treatment. There was no significant difference in the overall incidence of side effects among treatment and control groups.

CONCLUSION

XLGB over 1-year treatment at the conventional dose demonstrated safe and only a statistically significant increase in BMD at lumbar spine at 6 months in postmenopausal women.

Comparative evaluation of the microcolumn gel card test and the conventional tube test for measurement of titres of immunoglobulin G antibodies to blood group A and blood group B

The conventional tube test (CTT) and microcolumn gel card test (MG) were used to measure immunoglobulin G (IgG) antibody titres to blood group A (anti-A) and blood group B (anti-B) in 288 serum samples. Diagnostic concordance and correlations between the two methods were analysed. MG was more sensitive than CTT in the detection of both anti-A and anti-B IgG. Correlation coefficients for the two methods for the titration of anti-A and anti-B were 0.8470 and 0.8336, respectively. The regression equation representing the relationship between the two methods was calculated and used to convert critical values for anti-A and anti-B IgG antibodies determined by CTT to critical values for MG titration. Analyses showed 86.8% and 89.9% diagnostic concordant rates for the detection of anti-A and anti-B IgG, respectively. It was concluded that titration results obtained by MG correlate well with those obtained by CTT, but critical values determined by CTT need to be converted into corresponding MG values.

Contribution of visceral fat accumulation to carotid intima-media thickness in a Chinese population

Objective:

Recent observational studies have reported that body fat distribution might be differentially associated with subclinical atherosclerosis. We previously reported that visceral fat area (VFA) ⩾80 cm² is the optimal cutoff for identifying abdominal obesity in Chinese subjects. We examined whether VFA ⩾80 cm² reflects the association between abdominal obesity and subclinical atherosclerosis, and if determination of the visceral fat quantity is useful for assessing subclinical atherosclerosis in asymptomatic individuals.

Methods and results:

Participants (N=1005, men 515, women 490, 34–66 years) free of cardiovascular disease underwent magnetic resonance imaging and carotid ultrasound assessment to quantify VFA and carotid intima–media thickness (C-IMT). Overweight/obese subjects (body mass index (BMI) ⩾25.0 kg m⁻²) had a higher C-IMT than lean subjects (BMI <25.0 kg m⁻²) (P<0.01). Subjects with VFA ⩾80 cm² had significantly higher C-IMT than those without abdominal obesity regardless of BMI (P<0.01). By multivariate regression analysis adjusted for anthropometric measurements and cardiovascular risk factors, waist circumference but not BMI was independently correlated with C-IMT in men (P<0.001). Similar findings were observed with an accurate obesity indices adjusted model, which showed that VFA was an independent risk factor for increased C-IMT in men but not in women.

Conclusions:

VFA ⩾80 cm² effectively identified carotid atherosclerosis for both lean and obese individuals in middle-aged Chinese men.

Apoptotic gene expression by human periodontal ligament cells following cyclic stretch

BACKGROUND AND OBJECTIVE

Periodontal ligament cells play an important role in maintaining homeostasis of periodontal tissue upon mechanical force loading caused by mastication or orthodontic force. Previous studies revealed force-driven periodontal ligament cell death via apoptosis, but the force-sensing genes assigned to the apoptotic pathway have not been fully characterized. The present study aimed to identify force-sensing genes implicated in the apoptotic pathway in periodontal ligament cells.

MATERIAL AND METHODS

Human periodontal ligament cells were exposed to 20% stretch strain for 6 or 24 h, and the differential expression of 84 genes implicated in the apoptotic pathway were quantified by real-time PCR array technology.

RESULTS

Ten and 11 genes showed upregulated expression after 6 and 24 h stretches, respectively, and there were two downregulated genes in response to both 6 and 24 h stretches. These genes included those encoding the tumor necrosis factor ligand family (TNFSF8), tumor necrosis factor receptor family (FAS, TNFRSF10B, TNFRSF11B, TNFRSF25 and CD27), the Bcl-2 family (BAG3, BAK1, BCL2L11 and BCLAF1), the caspase family (CASP5 and CASP7), the inhibitor of apoptosis proteins family (BIRC3, BIRC6 and NAIP), the caspase recruitment domain family (RIPK2 and PYCARD) and the death domain family (DAPK1), as well as an oncogene (BRAF).

CONCLUSION

This study identified several force-sensing genes implicated in the apoptotic pathway in periodontal ligament cells and should facilitate future studies on force-driven apoptosis by providing putative target genes.

Introducing traditional Chinese nursing: a review of concepts, theories and practices

AIM

This paper discussed the basic concepts, theories and practices of traditional Chinese nursing (TCN) to enrich our understanding of relevant concepts and ways to contribute to human health.

BACKGROUND

Advantages of TCN include health education based on theories and techniques of traditional Chinese medicine. It focuses mainly on mobilizing humans' capacity for self-adjustment and self-rehabilitation to make a dynamic balance between yin and yang, qi and blood and zang and fu. It has played a significant role in the fields of primary nursing, geriatric nursing, hospice, family nursing, etc., in China.

METHOD

PubMed, CINAHL, Ovid Medline (English) and the Wang Fang (Chinese) databases were searched for literature on a range of keywords relating to traditional Chinese medicine and nursing. Forty references (13 English and 27 Chinese) were finally selected for review.

CONCLUSION

Practices of nursing care in traditional Chinese medicine are based mainly on the theories of yin-yang and the five elements. There are two prime characteristics in the theoretical system of TCN: holism and nursing determination based on syndrome differentiation. The distinctive content include prevention, daily care of patients, dietary nursing, etc. TCN, with its characteristics of little damage, little pain, ease of operation and low cost, is appropriately used in primary health care in China. By combining Western and Eastern philosophies and approaches to nursing, life phenomena can be better understood, and more ways to promote health can be exploited. Scientists are beginning to use Western research methods to establish effectiveness. Many common interventions would not, however, be considered safe in Western nursing practice without more evidence and consideration of health and safety issues.

The response scale for the intellectual disability module of the WHOQOL: 5-point or 3-point?

OBJECTIVE

To deal with the question of whether a 5-point response Likert scale should be changed to a 3-point scale when used in the field testing of people with intellectual disabilities (IDs), which was raised after the pilot study of World Health Organization Quality of Life (WHOQOL)-DIS, a module being developed with the World Health Organization measure of quality of life for disabilities.

METHODS

Three possible ways were used to generate hypothetical data by merging a 5-point scale into a 3-point scale. The analyses were based on both item response theory and classical measurement theory. The partial credit model for polytomous response was performed for item evaluation; the confirmatory factor analysis was used to check construct validity, the Cronbach's alpha for domain reliability, and correlation analyses for the relationship between the 5-point scale and the generated 3-point scale.

RESULTS

Most items with a 5-point response scale had disordered response options and/or unequal-length intervals between successive response options; these deficiencies were removed or improved without decline of validity and reliability in the hypothetical data of 3-point scales.

CONCLUSION

Instead of the 5-point scale, a 3-point scale could be used for IDs in the field test of developing the module WHOQOL-DIS.

Soybean-derived beta-conglycinin affects proteome expression in pig intestinal cells in vivo and in vitro

It is well known that β-conglycinin, a soybean allergen, induces allergies and causes intestinal damage in fetuses and neonates. However, the underlying mechanisms responsible for the adverse effects of β-conglycinin remain elusive. In particular, it is unknown whether or not this dietary substance causes direct damage affecting the proliferation and integrity of intestinal cells. This study evaluated the effect of different concentrations of β-conglycinin (0 to 1,500 µg/mL) and the duration of culture (48 or 72 h) on the proliferation and proteome of porcine intestinal epithelial cells. Eight individually housed piglets (10 d old; initial BW, 3.79 ± 0.07 kg) were randomly divided into 2 groups (n = 4) and challenged with or without β-conglycinin via oral administration d 10 through 28. After the last administration of β-conglycinin or PBS, piglets were killed and jejuna mucosal samples were collected for proteomic analysis. Supplementing β-conglycinin to either culture medium or weanling pigs increased (P < 0.05) the expression of proteins related to apoptosis, stress, and inflammation, but decreased (P < 0.05) the expression of proteins related to cytoskeleton and nucleus replication in intestinal cells. Further analysis confirmed an increase in caspase-3 expression in the cells exposed to β-conglycinin in vivo and in vitro. Collectively, these novel results indicate that β-conglycinin directly induces intestinal damage by depressing intestinal-cell growth, damaging the cytoskeleton, and causing apoptosis in the piglet intestine.

p85α mediates p53 K370 acetylation by p300 and regulates its promoter-specific transactivity in the cellular UVB response

Inducible acetylation of p53 at lysine residues has a great impact on regulating the transactivation of this protein, which is associated with cell growth arrest and/or apoptosis under various stress conditions. However, the factor(s) for regulating p53 acetylation remains largely unknown. In the current study, we have shown that p85α, the regulatory subunit of phosphatidylinositol-3-kinase, has a critical role in mediating p53 acetylation and promoter-specific transactivation in the ultraviolet B (UVB) response. Depletion of p85α in mouse embryonic fibroblasts significantly impairs UVB-induced apoptosis, as well as p53 transactivation and acetylation at Lys370 (Lys373 of human p53); however, the accumulation, nuclear translocation and phosphorylation of p53 are not affected. Interestingly, p85α binds to p300, promotes the p300-p53 interaction and the subsequent recruitment of the p53/p300 complex to the promoter region of the specific p53 target gene in response to UVB irradiation. Moreover, ablation of p53 acetylation at Lys370 by site-directed mutagenesis dramatically suppresses UVB-induced expression of the specific p53-responsive gene as well as cell apoptosis. Therefore, we conclude that p85α is a novel regulator of p53-mediated response under certain stress conditions, and targeting the p85α-dependent p53 pathway may be promising for cancer therapy.