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Colorectal cancer is one of the most prevalent noncommunicable diseases worldwide. 5-Fluorouracil is the mainstay of chemotherapy for colorectal cancer. Previously, we have demonstrated that high glucose diminishes the cytotoxicity of 5-fluorouracil by promoting cell cycle progression. The synergistic impact of rosiglitazone on 5-fluorouracil-induced apoptosis was further investigated in this study. Besides control cell lines (CCD-18Co), two human colonic carcinoma cell lines (HCT 116 and HT 29) were exposed to different treatments containing 5-fluorouracil, rosiglitazone or 5-fluorouracil/rosiglitazone combination under normal glucose (5.5 mM) and high-glucose (25 mM) conditions. The cellular oxidative stress level was evaluated with biomarkers of nitric oxide, advanced oxidation protein products, and reduced glutathione. The cell apoptosis was assessed using flow cytometry technique. High glucose caused the production of reduced glutathione in HCT 116 and HT 29 cells. Correspondingly, high glucose suppressed the apoptotic effect of 5-fluorouracil and rosiglitazone. As compared to 5-fluorouracil alone (2 μg/mL), addition of rosiglitazone significantly enhanced the apoptosis (increment rate of 5–20%) in a dose-dependent manner at normal glucose and high glucose levels. This study indicates that high-glucose-induced reduced glutathione confers resistance to apoptosis, but it can be overcome upon treatment of 5-fluorouracil and 5-fluorouracil/rosiglitazone combination. Rosiglitazone may be a promising antidiabetic drug to reduce the chemotherapeutic dose of 5-fluorouracil for colorectal cancer complicated with hyperglycemia.

Colorectal cancer (CRC) is the third most leading cause of morbidity and mortality throughout the world. 5-fluorouracil (5-FU), which is often administrated to disrupt carcinogenesis, was found to elevate blood glucose level among CRC patients. Thus, this study was conducted to evaluate the influence of rosiglitazone on antiproliferative effect of 5-FU using cellular model. Two human colonic carcinoma cell lines (HCT 116 and HT 29) were cultured in the presence of 5-FU, rosiglitazone or in combination under normal and high glucose concentration. The drug cytotoxicity was evaluated using the MTT assay whereas the assessment of cell cycle was carried out using the flow cytometry technique. Combination index (CI) method was used to determine the drug interaction between rosiglitazone and 5-FU. High glucose diminished the cytotoxic effect of 5-FU but at a high drug dosage, this effect could be overcome. Cell cycle analysis demonstrated that 5-FU and rosiglitazone caused G1-phase arrest and S-phase arrest, respectively. CI values indicated that rosiglitazone exerted synergistic effect on 5-FU regardless of glucose levels. This study is the first to demonstrate the influence of rosiglitazone on cytotoxicity of 5-FU under normal or high glucose level. Rosiglitazone may be a promising drug for enhancing the efficacy of 5-FU in the treatment of CRC associated with hyperglycemia.

Ganoderma, a traditional medicine in Asian countries, has been used to prevent and treat various ailments for centuries. Ganoderma neo-japonicum (synonym Ganoderma bambusicola), also known as purple Lingzhi, is a species that is currently underutilised when compared to Ganoderma lucidum (Lingzhi). However, in recent decades, this mushroom has garnered significant attention due to its ethnomedicinal uses, especially in Southeast Asia regions like Malaysia. The taxonomy and nomenclature of this mushroom have been extensively studied. Numerous publications have reported that G. neo-japonicum displays a variety of medicinal properties, including antioxidation, anticancer, anti-hyperglycaemic, genoprotective, hepatoprotective, neuritogenic, and antidiabetic effects, both in vitro and in vivo. With the surge of research findings on this mushroom, this review aims to provide a systematic bibliometric analysis of G. neo-japonicum, published between 1991 to 2021. Additionally, the taxonomic description of this mushroom is discussed in detail. Our review reveals that G. neo-japonicum contains polysaccharides (α/β-D-glucans), triterpenoids, and sterols/ergosterol. However, the existing literature suggests that these active compounds have not yet been explored to their full potential as drug candidates. Moreover, most of the studies are preclinical and have several drawbacks. In conclusion, G. neo-japonicum possesses valuable pharmacological activities that merit further exploration.

Aim： To determine the efficacy and toxicities of sorafenib in the treatment of patients with multiple recurrences of hepatocellular carcinoma （HCC） after liver transplantation in a Chinese population. Methods： Twenty patients with multiple recurrences of HCC after liver transplantation were retrospectively studied. They received either transarterial chemoembolization （TACE） or TACE combined with sorafenib. Results： The median survival times （MST） after multiple recurrences was 14 months （TACE＋sorafenib group） and 6 months （TACE only group）. The difference was significant in MST between the two groups （P=0.005）. The TACE ＋ sorafenib group had more stable disease （SD） patients than the TACE group. The most frequent adverse events of sorafenib were hand-foot skin reaction and diarrhea. In the univariate analysis, preoperative bilirubin and CHILD grade are found to be significantly associated with tumor-free survival time, the survival time after multiple recurrences and overall survival time. TACE＋sorafenib group showed a better outcome than single TACE treatment group. In the multivariate COX regression modeling, the preoperative high CHILD grade was found to be a risk factor of tumor-free survival time. In addition, the preoperative high bilirubin grade was also found to be a risk factor of survival time after recurrence and overall survival time. Furthermore, survival time after recurrence and overall survival time were also associated with therapeutic schedule, which was indicated by the GROUP. Conclusion： Treatment with TACE and sorafenib is worthy of further study and may have more extensive application prospects.