Purpose
Cyclophosphamide/methotrexate/fluorouracil (CMF) is a proven adjuvant option for patients with early-stage breast cancer. Randomized trials with other regimens demonstrate that dose-dense (DD) scheduling can offer greater efficacy. We investigated the feasibility of administering CMF using a DD schedule.
Patients and Methods
Thirty-eight patients with early-stage breast cancer were accrued from March 2008 through June 2008. They were treated every 14 days with C 600, M 40, F 600 (all mg/m2) with PEG-filgrastim (Neulasta®) support on day 2 of each cycle. The primary endpoint was tolerability using a Simon’s 2-stage optimal design. The design would effectively discriminate between true tolerability (as protocol-defined) rates of ≤ 60% and ≥ 80%.
Results
The median age was 52-years-old (range, 38–78 years of age). Twenty-nine of the 38 patients completed 8 cycles of CMF at 14-day intervals.
Conclusion
Dose-dense adjuvant CMF is tolerable and feasible at 14-day intervals with PEG-filgrastim support.
Endoplasmic reticulum (ER) stress plays important roles in oxidative stress (OS), contributing to liver injury. Lactiplantibacillus plantarum P8 (P8) was reported to regulate broiler OS and the gut microbiota in broilers, but its roles in hepatic ER stress remain unclear. In the present study, the role of P8 in liver OS and ER stress was evaluated, and proteomics was performed to determine the mechanism. Results revealed that P8 treatment decreased liver OS and ER stress in dexamethasone (DEX)-induced oxidatively stressed broilers. Proteomics showed that differentially expressed proteins (DEPs) induced by DEX cover the "cellular response to unfold protein" term. Moreover, the DEPs (GGT5, TXNDC12, and SRM) between DEX-and DEX + P8-treated broilers were related to OS and ER stress and enriched in the glutathione metabolism pathway. RT-qPCR further confirmed the results of proteomics. In conclusion, P8 attenuates hepatic OS and ER stress by regulating GGT5, TXNDC12, SRM, and glutathione metabolism in broilers.
Background: Hepatic encephalopathy is a severe neuropsychiatric complication of decompensated cirrhosis associated with high short-term mortality. Objectives: This study aimed to evaluate the predictive value of non-invasive scoring systems and develop a prognostic nomogram to identify the risk of 3-month mortality in patients with hepatic encephalopathy. Methods: Retrospective data from 251 patients with decompensated cirrhosis and hepatic encephalopathy were collected. Clinical data and non-invasive scoring systems were compared between survivors and non-survivors using univariate and multivariate logistic regression analyses. A prognostic model was developed and validated using bootstrap resampling procedures. Results: Among the 251 patients, 40 (15.9%) died within three months. The non-survivor group had a higher incidence of complications and higher non-invasive scores (all P < 0.01). Multivariate analysis revealed that hepatorenal syndrome, spontaneous bacterial peritonitis, upper gastrointestinal bleeding, and Fibrosis-4 index were independent risk factors. A new model incorporating the Fibrosis-4 index and complications was developed, and discrimination was assessed using a bootstrap-corrected C statistic of 0.831. The area under the receiver operating characteristic curve of the new model (0.840, 95% confidence interval: 0.789 - 0.883) was significantly higher than that of the non-invasive scoring systems (all P < 0.05). The calibration plot and Hosmer-Lemeshow test (P = 0.771) showed good calibration accuracy. Kaplan-Meier survival analysis showed that the cumulative survival rate in the high-risk group was significantly lower (P < 0.01). Conclusions: The prognostic nomogram consisting of the Fibrosis-4 index and complications can effectively predict the risk of 3-month mortality in patients with hepatic encephalopathy.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.