Clinical Study of Jiawei Xiaochaihutang Combined with Microwave Ablation in Treatment of Primary Hepatocellular Carcinoma / 中国实验方剂学杂志

ObjectiveTo observe the clinical efficacy of Jiawei Xiaochaihutang combined with microwave ablation （MWA） in the treatment of primary hepatocellular carcinoma （HCC） and its influence on tumor microenvironment. MethodA total of 128 patients were randomly divided into control group （64 cases： 2 cases of dropout，2 cases of elimination，and 60 cases of completion） and observation group （64 cases： 3 cases of dropout，2 cases of elimination，and 59 cases of completion）. Both groups were given comprehensive treatment after MWA surgery. Patients in control group took Biejiajian Wan orally （3 g/time，3 times/d）， and those in observation group took Jiawei Xiaochaihutang （1 dose/d）. The treatment lasted for 3 consecutive months. The size of solid tumor before and after treatment was evaluated to record the progression-free survival （PFS）. The alpha-fetoprotein-L13 （AFP-L3），des-γ-carboxy prothrombin （DCP），Golgi protein 73 （GP73），tumor necrosis factor-α （TNF-α），transforming growth factor-β （TGF-β），vascular endothelial growth factor （VEGF） and matrix metalloproteinase-2 （MMP-2） levels，as well as performance status （PS），liver function and syndrome of liver depression and Qi stagnation scores were also detected before and after treatment. In addition， the incidence of side effects of grade Ⅲ and above was compared. ResultThe total effective rate of solid tumor in observation group was 91.53% （54/59），higher than that （76.67%， 46/60） in control group（χ2=4.895，P<0.05）. The PFS in observation group was （7.16±0.95） months， longer than that （6.24±0.89 months） in control group （P<0.01）. The effective rate of traditional Chinese medicine （TCM） syndrome in observation and control groups were 88.14% （52/59）and 70.00% （42/60）， respectively （χ2=5.897，P<0.05）. The observation group （57.63%，34/59） had higher marked effective rate of TCM syndrome than control group （31.67%，19/60） （χ2=8.116，P<0.01）. The AFP-13，DCP，GP73，TNF-α，TGF-β，VEGF and MMP-2 levels and the PS，liver function and syndrome of liver depression and Qi stagnation scores in observation group were lower than those in control group （both P<0.01）. The cumulative incidence of side effects of grade Ⅲ and above in observation and control groups was 16.95% and 33.33%， respectively（χ2=4.261，P<0.05）. ConclusionConsolidation treatment of HCC after MWA surgery with Jiawei Xiaochaihutang relieved symptoms and side effects，improved PS and liver function，regulated tumor microenvironment，inhibited tumor markers and prolonged survival time. The clinical effect was better than that of Biejia decoction pill， and thus it was worthy of clinical use.

Effect of Huangqintang on Oxidative Stress and Ferroptosis-related Indexes GSH-Px4，P53，SLC7A11 in Ulcerative Colitis Mice / 中国实验方剂学杂志

Objective:To explore the possible mechanism of Huangqintang in treating ulcerative colitis （UC）. Method:The animal model of UC was induced by dextran sodium sulfate （DSS）．The experimental animals were divided into control group， model group，Huangqintang low dose （4.55 g·kg^-1）， medium dose （9.1 g·kg^-1）， and high dose（18.2 g·kg^-1） groups. Intragastric administration was also given in the modeling process for 7 consecutive days. At the end of the 8th day， colon tissues were collected to measure colon length and mass， and calculate the colon mass index. Pathological changes were observed by hematoxylin-eosin （HE） staining. Serum iron content， superoxide dismutase （SOD）， glutathione （GSH）， catalase （CAT） and myeloperoxidase （MPO） were determined by biochemical assay. Western blot was used to detect the protein expression of glutathione peroxidase 4 （GSH-Px4）， long-chain acyl-CoA synthetase 4 （ACSL4） and ferritin heavy chain 1（FTH1）. The mRNA expression levels of tumor trotein 53 （P53） and solute carrier family 7 member 11 （SLC7A11） in colon tissues were detected by Real-time fluorescence quantitative polymerase chain reaction （Real-time PCR）. Result:The experimental studies showed that compared with normal group， serum MPO and iron content， ACSL4 protein level and relative P53 mRNA expression in the model group significantly increased （<italic>P</italic><0.05）， while serum SOD， CAT， GSH content， GSH-Px4， FTH1 relative protein expression level and relative SLC7A11 mRNA expression in the model group significantly decreased （<italic>P</italic><0.01）. Compared with model group， serum MPO and iron content， ACSL4 protein level and relative P53 mRNA expression significantly decreased （<italic>P</italic><0.05）， while serum SOD， CAT， GSH content， GSH-Px4， FTH1 relative protein expression level and relative SLC7A11 mRNA expression significantly increased （<italic>P</italic><0.05） after the intervention of Huangqintang， and the effect was most significant in the high-dose group （<italic>P</italic><0.05）. The results of general condition， colon length， colon mass index and HE staining showed that Huangqintang could relieve clinical symptoms and histopathological changes in UC mice. Conclusion:These results indicated that Huangqintang had therapeutic effect on ulcerative colitis mice， and its mechanism might be related to inhibiting the oxidative stress and ferroptosis.

Bioinformatics analysis and systematic review of key genes and therapeutic traditional Chinese medicine of ulcerative colitis active stage / 中国中药杂志

Data GSE75214 and GSE48959 that contained ulcerative colitis(UC) in the active stage was download from GEO database. Differential genes of UC in the active phase were obtained by using adjusted P<0.05 and |log_2 FC|≥1.5, which was the screening criteria. PPI analysis was performed in the STRING database, and GO and KEGG pathway analysis was performed in DAVID database. Cytoscape was used to visualize differential genes, and calculate key genes in the active phase. Coremine Medical was used to analyze and systematically evaluate traditional Chinese medicines for treating key genes. Finally, 139 differentially expressed genes in the active phase were screened out, which included the 109 up-regulated genes and 30 down-regulated genes. DAVID analyzed that the biology and pathways of these differential genes were mainly concentrated in inflammatory response, immune response, chemokine activity, TNF pathway, NF-κB pathway, and Toll-like receptor pathway. Cytoscape software calculated that IL-6, CXCL8, IL-1β, MMP9, CXCL1, ICAM1, CXCL10, TIMP1, PTGS2 and CXCL9 were the key genes of UC in the active phase. According to Coremine Medical analysis, traditional Chinese medicines for UC in the active stage included Curcumae Longae Rhizoma, Scutellariae Radix, Curcumae Radix had clearing heat clearing damp, reducing fire and detoxifying effects, which was in line with the pathogenesis of UC active stage, and was often used in clinical treatment of dampness-heat diarrhea. Therefore, Huangqin Decoction, which Scutellariae Radix was the principal drug, was selected for systematic evaluation. The evaluation showed that Scutellariae Radix was superior to Western medicine in terms of improving clinical efficiency, reducing inflammatory factors and immunoglobulin levels, with statistically significant differences and fewer adverse reactions. This study provided a new idea for further research on the pathogenesis of UC in the active phase by analyzing the genes and their mechanism of action, and the systematic evaluation of Chinese medicine for the treatment of UC active stage provided a basis for the clinical prevention and treatment of UC by Chinese medicine.

Adjunctive treatment of GnRHa combined wenshen xiaozheng decoction in treating endometriosis after laparoscopy: a clinical observation / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the therapeutic efficacy and safety of gonadotropin-releasing hormone agonist (GnRHa) combined Wenshen Xiaozheng Decoction (WXD) in auxiliary treating endometriosis after laparoscopy.</p><p><b>METHODS</b>One hundred and thirty-four endometriosis patients with confirmative pathological diagnosis were assigned to three groups depending on whether they would receive adjuvant therapy or Chinese medicine treatment, i.e., the control group, the observation 1 group, and the observation 2 group. The 22 patients in the control group received no adjuvant therapy after laparoscopy. The 42 patients in the observation 1 group were treated with GnRHa 3.6 mg by subcutaneous injection starting from the 1st day to the 5th day of menstruation, once per 28 days. The 70 patients in the observation 2 group were treated with GnRHa 3.6 mg by subcutaneous injection in combination with WXD starting from the 1st day to the 5th day of menstruation, once per 28 days. They also took WXD for 7 doses, one cycle per every 28 days. The treatment lasted for three to six months. Serum levels of estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), and cancer antigen 125 (CA125), as well as clinical efficacy, and adverse drug reactions were observed before and after treatment.</p><p><b>RESULTS</b>There was statistical difference in serum levels of E2, FSH, or LH between the control group and the observation 1 and 2 groups (P < 0.05). There was no statistical difference in serum levels of E2, FSH, or LH between the observation 1 group and the observation 2 group (P > 0.05). There was statistical difference in the clinical efficiency among the 3 groups (P < 0.05). There was statistical difference in the pre-post difference of CA125 levels among the three groups (P < 0.01). Compared with the control group, there was no statistical difference in the pre-post difference of CA125 levels between the observation 1 group and the observation 2 group (P > 0.05). No obvious adverse reaction occurred during the treatment.</p><p><b>CONCLUSIONS</b>GnRHa combined WXD showed confirmative clinical efficacy in treating endometriosis after laparoscopy. It also could lower serum levels of E2, FSH, and LH levels. So it was an ideal solution for treatment of endometriosis.</p>

Treatment of adenomyosis patients by bushen huoxue sanyu decoction: a clinical study / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To observe the clinical efficacy of Bushen Huoxue Sanyu Decoction (BHSD) in treatment of adenomyosis (AM) patients.</p><p><b>METHODS</b>Seventy AM patients of Shen deficiency blood stasis syndrome (SDBSS) were randomly assigned to two groups, the CM treatment group (50 cases) and the Mirena group (20 cases). Patients in the CM treatment group were treated with BHSD, one dose per day. Levonorgestrel intrauterine system (Mirena) was placed in the uterine cavity of those in the Mirena group. The therapeutic course for all was 3 months. Changes of dysmenorrhea, menstrual quantity, SDBSS, CM syndrome, uterine volume, and serum CA125 levels were observed before and after treatment.</p><p><b>RESULTS</b>Compared with before treatment in the same group, scores for dysmenorrhea integral, scores for menstrual quantity, scores for SDBSS, and scores for CM syndrome all decreased in the two groups after treatment (P < 0.01). Compared with before treatment in the same group, the uterine volume was reduced after treatment in the two groups (P < 0.05) and serum carbohydrate antigen CA125 levels decreased between the two groups (P < 0.05, P < 0.01). Compared with the Mirena group, scores for dysmenorrhea integral increased and scores for SDBSS decreased in the CM treatment group (P < 0.01, P < 0.05). There was no statistical difference in the uterine volume or serum carbohydrate antigen CA125 levels (P > 0.05).</p><p><b>CONCLUSIONS</b>BHSD could effectively alleviate main symptoms of AM patients of QSBSS such as dysmenorrhea, profuse menstrual blood volume, and increased uterine volume, and lower scores for QSBSS and the total score for CM syndrome.</p>

Glutamine-Supplemented Parenteral Nutrition and Probiotics in Four Adult Autoimmune Enteropathy Patients

To evaluate the effects of glutamine-supplemented parenteral nutrition (PN) and probiotics in adult autoimmune enteropathy (AIE) patients. Four adult AIE patients were identified from April 2006 to January 2012. Clinical and nutritional data were obtained from the patients' medical records. Glutamine-supplemented PN started immediately when the AIE diagnosis was confirmed. The total PN duration was 351 days. According to the PN prescription, the average caloric intake ranged from 20 to 25 kcal/kg/day, and the protein intake ranged from 1.2 to 1.5 g/kg/day. Alanyl-glutamine (20 g/day) was administered to AIE patients for 4 weeks followed by a 2-week break, and this treatment schedule was repeated when PN lasted for more than 6 weeks. Body weight gain and an increased serum albumin level were achieved after PN, and defecation frequency and quality also improved. Each patient received oral supplements, 250 mL of Ensure and two probiotics capsules (each capsule containing 0.5x10(8) colonies) three times a day when enteral nutrition started. Three AIE patients were successfully weaned off PN, and one patient died of pneumonia. Glutamine-supplemented PN and probiotics show promise in managing patients with AIE and related malnutrition.

Experimental study on topical treatment of diabetic skin ulcers with yi medicine "yi bu a jie" extract / 中国结合医学杂志

<p><b>OBJECTIVE</b>To study the role and mechanism of the Yi medicine, Yi Bu A Jie () extract, in topical treatment of diabetic skin ulcers, with a view to finding a breakthrough natural drug for the prevention and treatment of diabetic skin ulcers.</p><p><b>METHODS</b>A model of diabetic skin ulcers in Kunming mice was developed. Yi Bu A Jie was extracted in a Soxhlet extractor. Two different concentrations of the extract (0.005 mg/mL and 0.01 mg/mL) were applied to the wound of diabetic skin ulcers once every 3 days, and local skin appearance and histopathological changes were observed.</p><p><b>RESULTS</b>The shortest healing time was 25.25±2.06 day with a low concentration (P=0.0037 compared with the high concentration group, 33.14±2.21 day; P=0.0082 compared with control group, 28.21±2.14 days). The longest healing time was in the high concentration group (P=0.0025 compared with the control group). In both groups, a large number of inflammatory neutrophil cells were exuded during the experimental period. In the low concentration group, capillary-rich granulation tissue and actively growing fibroblasts appeared in the wound, while there was much necrotic tissue in the high concentration group.</p><p><b>CONCLUSION</b>Yi Bu A Jie extract has an inhibitory effect on diabetic skin ulcers in mice, and the low concentration is more suitable.</p>

TCM differentiation and treatment of fibromyalgia syndromes based on meridian science / 中国针灸

Fibromyalgia syndrome (FS) is a rheumatic and immunologic disease and the disease incidence is ranked at the third in the rheumatic diseases, characterized by whole-body myalgia, and with mental and nervous symptoms and signs. At present, there is no ideal therapy for it. Based on TCM theories, this article tries to analyze the pathogenesis of FS from the angle of meridian and collateral science, and according to location of pain of the patient, TCM syndrome differentiation for corresponding channels and collaterals is made and FS possible relation with dysfunction of qi is raised, which is used to guide the treatment, so as to provide a better physical treatment way.