Sublingual Nodules: Diagnostic Markers of Metastatic Breast Cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To evaluate the diagnostic significance of sublingual nodules for metastasis of patients with breast cancer and further to explore the mechanisms of sublingual nodules.</p><p><b>METHODS</b>The image data of 117 in-patients with breast cancer in stage I-IV in Tianjin Medical University Cancer Institute and Hospital from December 2009 to September 2011 were assessed retrospectively. All photos of patients' tongue were recorded by the digital camera of uniform type within 1 month after serological examination and regular re-examined by computed tomography (CT), magnetic resonance imaging and positron emission tomography CT. The presence of sublingual nodules was the positive standard. Chi square test and two-independent-sample test were used to determine the diagnostic value between the status of sublingual nodules and Clinico-pathological characteristics. The optimal cut-off of uric acid (UA) level to diagnose sublingual nodules was determined by receiver operating curve (ROC) analysis.</p><p><b>RESULTS</b>Breast cancer patients with sublingual nodules had a higher risk of recurrence and/or metastasis than patients without it (P<0.001). Sublingual nodules was significantly correlated with increased serum UA level (P=0.001). The optimal cut-off value of UA level to diagnose sublingual nodules was 290 μmol/L. Furthermore, the elevated serum UA level (≥290 μmol/L) was significantly related to breast cancer recurrence and/or metastasis (P<0.001).</p><p><b>CONCLUSIONS</b>Sublingual nodules were potential diagnostic markers for metastatic breast cancer. The formation of sublingual nodules was associated with elevated level of serum UA.</p>

Chinese medicine herbal treatment based on syndrome differentiation improves the overall survival of patients with unresectable hepatocellular carcinoma / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the effects of Chinese medicine (CM) herbal treatment based on syndrome differentiation on patients with unresectable hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>A total of 94 patients with unresectable HCC were reviewed between June 2008 and June 2011. Survival analysis was performed between patients who received CM with/without non-curative antitumor treatments of Western medicine (WM) (CM group, 30 cases) and patients who were not treated with CM but with non-curative antitumor treatments of WM or supportive treatment alone (non-CM group, 64 cases). Then, survival analysis was performed between patients treated with CM combined with non-curative antitumor treatments of WM (combination therapy group, 25 cases) and patients with non-curative antitumor treatments of WM alone (non-curative antitumor treatments group of WM, 52 cases). The survival analysis was performed by Kaplan-Meier method and prognostic factors for overall survival (OS) were assessed by the Cox proportional hazards regression model.</p><p><b>RESULTS</b>The median survival time (MST), 1- and 2-year survival rates of the CM group and the non-CM group were 36 months, 76.7%, 56.1% and 12 months, 48.4%, 26.6%, respectively. The Log-rank test revealed significant difference between the two groups in OS (P<0.01). Cox proportional multivariate analysis revealed that CM was an independent favorable prognostic factor for OS. The MST, 1- and 2-year survival rates of combination therapy group and non-curative antitumor treatments group of WM were 36 months, 76.0%, 55.5% and 13 months, 55.8%, 30.8%, respectively. There was significant difference in OS between the two groups (P=0.004).</p><p><b>CONCLUSIONS</b>CM herbs based on syndrome differentiation have positive effects on survival of patients with unresectable HCC. Furthermore, combination therapy of CM and WM are recommended in HCC treatment.</p>

Nodule and eminence on frenulum labii superioris: diagnostic markers for metastatic colorectal cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To determine whether the nodule and eminence on the frenulum labii superioris, location of Yinjiao (DU28) according to the meridian theory, could be used to prognosticate the recurrence of patients with colorectal cancer.</p><p><b>METHODS</b>The data of 101 patients with colorectal cancer in Tianjin Medical University Cancer Institute and Hospital from May 2011 to November 2011 was analyzed. The photos of all patients' frenulum labii superioris were taken. Nodule and eminence on frenulum labii superioris were the positive standard. Biopsy and pathological testing for the nodule were carried out on one patient with large nodule on frenulum labii superioris.</p><p><b>RESULTS</b>Patients with positive frenulum labii superioris had a higher risk of recurrence and/or metastasis than patients with negative frenulum labii superioris. There were no significant differences in diagnosis of recurrence and/or metastasis between the status of frenulum labii superioris and the traditional diagnostic criteria (P =0.238). The Kappa was 0.606 (P <0.001). The sensitivity was 76.0% and the specificity was 85.4%. The pathological report demonstrated that the nodule on frenulum labii superioris was mucosal excrescence with normal structure.</p><p><b>CONCLUSION</b>Nodule and eminence on frenulum labii superioris are potential diagnostic markers for metastatic colorectal cancer.</p>

Anticancer effects of 5-fluorouracil combined with warming and relieving cold phlegm formula on human breast cancer / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate the anticancer effects of warming and relieving cold phlegm formula (, WRCP), a Chinese medical mixture composed of the aqueous extracts of Aconitum carmichaeli, Rhizoma bolbostemmatis, Phytolacca acinosa, Panax notoginseng, and Gekko swinhonis Gūenther, combined with 5-fluorouracil (5-FU) on human breast cancer in vivo.</p><p><b>METHODS</b>Seventy-two Nu/Nu mice inoculated with MDA-MB-231 breast cancer cells were randomized into the control group, 5-FU group, high-dose WRCP (hWRCP) group, medium-dose WRCP (mWRCP) group, low-dose WRCP (lWRCP) group, or combination of mWRCP and 5-FU group in a 1:1:1:1:1:1 ratio. Drug administration was commenced on the day following tumor implantation. The control group was injected daily with normal saline (N.S.) intraperitoneally; the 5-FU group was injected with 5-FU at 30 mg/kg intraperitoneally every third day for a total of 7 treatments; the hWRCP group, mWRCP group and lWRCP group received daily doses of 5, 1, and 0.2 g/kg of WRCP, respectively, by gastric perfusion; and the combination group was treated with 5-FU plus mWRCP on the same schedules as above. All treatments lasted for 22 days. Tumor volume, tumor weight, inhibition rate of tumor weight, necrosis rate of tumor, organ index, and change in body weight of nude mice were measured.</p><p><b>RESULTS</b>The combination group and the hWRCP group had significantly smaller tumor volumes (580±339 mm(3) and 587±249 mm(3) versus 1055±234 mm(3), respectively), lower tumor weights (0.42±0.29 g and 0.52±0.29 g versus 0.80±0.15 g, respectively), and higher tumor necrosis rates (22.7% and 25.6% versus 9.4%, respectively) as compared with the control group (all <0.05). Similar changes were found in the 5-FU, mWRCP, and lWRCP groups when compared with the control group but were not statistically significant, except for the tumor weight for the 5-FU group. The combination group and the hWRCP group had significantly smaller tumor volumes compared with the 5-FU group (778±202 mm(3), both <0.05). The combination group had the highest tumor inhibition rate (47.7%), followed by the hWRCP group (35.2%) and 5-FU group (28.3%). The 5-FU group had a lower body weight increase (1.37±2.06 g versus 5.60±0.72 g, <0.05) and a lower spleen index (4.064±1.774 mg/10 g versus 5.294±1.796 mg/10 g) as compared with the control group, whereas the combination group reversed the changes in the 5-FU group with the body weight increase of 3.52±1.80 g (P <0.05) and spleen index of 7.036±1.599 mg/10 g (P <0.05). The spleen indices in the hWRCP, mWRCP, and IWRCP group were all significantly higher than that in the 5-FU group (P <0.01 or P<0.05). No significant differences in body weight change were observed in WRCP groups compared with the control group P>0.05).</p><p><b>CONCLUSION</b>The treatment combination of WRCP and 5-FU was more effective in the inhibition of tumor growth than either agent alone and may have potentially additional benefit in improving the general condition and immunity of the mice with human breast cancer cell implants.</p>

Using a new generation of classification system of antineoplastic drugs to guide Chinese medicine research / 中国中西医结合杂志

A new generation of classification system of antineoplastic drugs was put forward based on comparing the first with the second generation classification system of antineoplastic drugs. Antineoplastic drugs are divided into cytotoxic drug, cells biological behavior regulator, biological response modifier and biochemical modulator. The using of biological response modifier (immune modulator for instance) and biochemical modulator are supplementary methods for Western medicine treatment in tumor, because the cytotoxic effects of Chinese herbs are lower than those of chemotherapeutic drugs. For the new breakthrough of Chinese medicine oncology research, new idea, new technology and new target should be used, the Chinese medicine mechanism should be studied from a new view. Reversing abnormal biological behavior of tumor cells by Chinese medicine could be an important breakthrough of Chinese medicine oncology research.

Study on objectivation of syndrome typing of jaundice / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To investigate the essence of dampness and heat, the two main etiological factors of jaundice, to seek the objectified indices for syndrome typing of jaundice.</p><p><b>METHODS</b>Ninety-five adult in-patients with icteric viral hepatitis B were eligible, 61 of them were free from bacterial or fungal infection, while 34 with secondary bacterial or fungal infection. The serum biochemical indexes, and clinical features such as the color of jaundice, tongue picture and pulse frequency were observed.</p><p><b>RESULTS</b>Dark-yellow colored skin, red or normal tongue proper with white tongue fur appeared in most patients with dominant elevation of direct bilirubin, in whom the ratio of direct bilirubin to indirect bilirubin (DBIL/IBIL > or =1). The color of tongue proper often turned pale in patients with cirrhosis due to the complicated anemia caused by hyperactivity of spleen, while the quick pulse and yellow tongue fur always presented in patients accompanied with infection. On the contrary, bright-yellow colored skin, red tongue with yellow fur appeared in patients with dominant elevation of indirect bilirubin, in whom DBIL/IBIL <1.</p><p><b>CONCLUSION</b>DBIL/IBIL ratio can exactly reflect the syndrome types of jaundice, when it is equal to or above 1, the type is mostly of dampness dominant, whereas it is less than 1, heat dominant. If quick pulse and yellow tongue fur appeared in patients with DBIL/IBIL > or =1, it indicates that the presence of heat conversion of the dampness stagnancy.</p>