Topiramate inhibits the proliferation of bladder cancer cells via PI3K/AKTR signaling pathway

Purpose: To explore new treatment options for bladder cancer (BC) based on topiramate (TPM).Methods: The MTT assay and flow cytometry were used to determine the effect of topiramate on partial growth-related malignant phenotype of BC cells. Expression levels of apoptosis-related biomarkers and signaling pathway-related factors were analyzed using quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting. In vivo experiments were conducted to investigate the role of TPM on tumor growth in mice with bladder cancer.Results: The MTT results showed that topiramate blocked the growth of BC cells (p < 0.05). Growth inhibition was positively correlated with TPM concentration. Flow cytometry results revealed that bladder cancer cell apoptosis rose with increase in TPM concentration, while the mRNAs of apoptosisassociated factors Bcl-2 and Mcl-1 were down-regulated in a concentration-based manner by TPM (p < 0.05). Western blot assay indicated that Bax and Caspase-3 proteins were up-regulated, and the higher the concentration of TPM, the more significant the protein expression levels (p < 0.05).Conclusion: Topiramate (TPM) slows down the rate of growth of BC cells and accelerates their rate of apoptosis through the regulation of P13K/AKT/mTOR signaling pathway. Thus, the compound has potentials for development as an anti-bladder cancer agent

Relationship Between Early Oral Intake Post Pancreaticoduodenectomy and Chyle Leakage: A Retrospective Cohort Study

Background Early oral intake is strongly recommended according to the enhanced recovery after surgery (ERAS) guidelines because it can reduce complications and improve recovery. However, early oral intake has been indicated to be associated with chyle leakage (CL) after pancreatic surgery, which may lead to worsening of existing malnutrition and impeded recovery. This study investigated the relationship between early oral intake and CL and identified risk factors for CL to reduce its occurrence and promote recovery after pancreaticoduodenectomy. Materials and Methods All patients who underwent pancreaticoduodenectomy between June 2014 and June 2018 were identified retrospectively. Patients were divided into the early-oral-intake and control groups according to whether they had early oral intake according to ERAS protocols. CL and other clinicopathological characteristics were recorded. Univariable and multivariable analyses assessed CL risk factors. Results Early oral intake improved recovery, leading to a shorter postoperative hospital stay for the early-oral-intake group in comparison to that of the control group [13.6 (range, 12–68) vs. 17.8 (range, 14–83) days; p = 0.047] without increasing the incidence of CL and other complications. CL was diagnosed significantly earlier in the early-oral-intake group than in the control group [4.6 (range 3–5) vs. 6.7 (range 3–9) days; p = 0.001]. Early oral intake did not increase the grade severity (p = 0.845) or the costs (p = 0.241) or prolong postoperative hospital stays (p = 0.611). A primary diagnosis of malignancy, para-aortic lymph node dissection, lymphatic invasion, lymph node metastases, the number of harvested nodes, and the number of positive nodes were significantly associated with CL (p < 0.05), whereas early oral intake was not (p = 0.525). Multivariate analyses demonstrated that para-aortic lymph node dissection (p = 0.039) and the number of harvested nodes (p = 0.001) were independent risk variables. Conclusion This study provides significant evidence that early oral intake after pancreaticoduodenectomy is not associated with CL. The identification of the independent risk factors for CL can help prevent it