In this study, we have examined the molecular events induced by parthenolide, a sesquiterpene lactone, and explored possible mechanisms of resistance and sensitization of tumor cells to Taxol. We showed that parthenolide could antagonize Taxol-mediated nuclear factor-κB (NF-κB) nuclear translocation and activation and Bcl-xl up-regulation by selectively targeting I-κB kinase activity. In A549 cells, inhibition of nuclear factor-κB by parthenolide resulted in activation of the mitochondrial death pathway to promote cytochrome c release and caspase 3 and 9 activation. In contrast, Taxol alone induced apoptosis via a pathway independent of mitochondria cytochrome c cascade. In addition, depletion of Bcl-xl rescued the apoptotic response to Taxol. Moreover, treatment with parthenolide increased the efficacy of the Taxol-induced inhibition of A549 tumor xenografts in mice. This study elucidated the cellular responses induced by parthenolide that decrease the threshold of mitochodria-dependent apoptosis in the treatment of non–small cell lung cancer cells. (Mol Cancer Res 2009;7(7):1139–49)

Enhanced recovery after surgery (ERAS) is acknowledged to reduce perioperative stress in several surgical diseases. Here, we investigated whether modified ERAS is associated with beneficial effects in the setting of emergency colorectal surgery. We retrospectively evaluated the medical records of 839 consecutive patients with obstructive colorectal cancer undergoing surgical intervention at 4 institutes. Among them, 356 cases were managed with a multidisciplinary team approach to care (modified ERAS protocols), and the remaining 483 cases were treated based on traditional protocols. According to modified ERAS or traditional care, propensity score (PS) matching was performed to adjust biases in patient selection. The primary outcome was gastrointestinal function recovery. Secondary outcomes included postoperative complications and length of hospital stay. Modified ERAS was associated with postoperative gastrointestinal function recovery, including time to first flatus (P = .002), first defecation (P = .008), and prolonged ileus (P = .016). According to the Clavien–Dindo classification, fewer total episodes of grade II or higher postoperative complications were observed in patients cared for with modified ERAS than in patients with traditional care (P = .002). Median (interquartile range) postoperative hospital stay in the modified ERAS group was 6 (3–22) days versus 9 (7–27) days in the traditional care group (P < .001). Furthermore, the interval from operation to postoperative chemotherapy (d) was significantly shorter in the modified ERAS group (35.6 ± 11.5 vs 47.6 ± 23.8, P < .001). The modified ERAS was safe and associated with clinical benefits, including fast recovery of bowel function, reduced postoperative complications, and shorter hospital stay for patients with obstructive colorectal cancer.

Background: The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has necessitated reliable and authoritative information for public guidance. The World Health Organization (WHO) has been a primary source of such information, disseminating it through a question and answer format on its official website. Concurrently, ChatGPT 3.5 and 4.0, a deep learning-based natural language generation system, has shown potential in generating diverse text types based on user input. Objective: This study evaluates the accuracy of COVID-19 information generated by ChatGPT 3.5 and 4.0, assessing its potential as a supplementary public information source during the pandemic. Methods: We extracted 487 COVID-19–related questions from the WHO’s official website and used ChatGPT 3.5 and 4.0 to generate corresponding answers. These generated answers were then compared against the official WHO responses for evaluation. Two clinical experts scored the generated answers on a scale of 0-5 across 4 dimensions—accuracy, comprehensiveness, relevance, and clarity—with higher scores indicating better performance in each dimension. The WHO responses served as the reference for this assessment. Additionally, we used the BERT (Bidirectional Encoder Representations from Transformers) model to generate similarity scores (0-1) between the generated and official answers, providing a dual validation mechanism. Results: The mean (SD) scores for ChatGPT 3.5–generated answers were 3.47 (0.725) for accuracy, 3.89 (0.719) for comprehensiveness, 4.09 (0.787) for relevance, and 3.49 (0.809) for clarity. For ChatGPT 4.0, the mean (SD) scores were 4.15 (0.780), 4.47 (0.641), 4.56 (0.600), and 4.09 (0.698), respectively. All differences were statistically significant (P<.001), with ChatGPT 4.0 outperforming ChatGPT 3.5. The BERT model verification showed mean (SD) similarity scores of 0.83 (0.07) for ChatGPT 3.5 and 0.85 (0.07) for ChatGPT 4.0 compared with the official WHO answers. Conclusions: ChatGPT 3.5 and 4.0 can generate accurate and relevant COVID-19 information to a certain extent. However, compared with official WHO responses, gaps and deficiencies exist. Thus, users of ChatGPT 3.5 and 4.0 should also reference other reliable information sources to mitigate potential misinformation risks. Notably, ChatGPT 4.0 outperformed ChatGPT 3.5 across all evaluated dimensions, a finding corroborated by BERT model validation.