Surface-enhanced Raman spectroscopy as a powerful method for the analysis of Chinese herbal medicines.

Chinese herbal medicines (CHMs) derived from nature have received increasing attention and become more popular. Due to their diverse production processes, complex ingredients, and different storage conditions, it is highly desirable to develop simple, rapid, efficient and trace detection methods to ensure the drug quality. Surface-enhanced Raman spectroscopy has the advantages of being time-saving, non-destructive, usable in aqueous environments, and highly compatible with various biomolecular samples, providing a promising analytical method for CHM. In this review, we outline the major advances in the application of SERS to the identification of raw materials, detection of bioactive constituents, characterization of adulterants, and detection of contaminants. This clearly shows that SERS has strong potential in the quality control of CHM, which greatly promotes the modernization of CHM.

Tailoring enzymatic loading capacity on CdS nanorods@ZnIn2S4 nanosheets 1D/2D heterojunctions: Toward ultrasensitive photoelectrochemical bioassay of tobramycin.

Despite advances in the development of photoelectrochemical (PEC) sensor, modulating the PEC response of assembled heterostructure interface is still a great challenge. Here, an ultrasensitive PEC aptasensor for tobramycin (TOB) assay was conducted based on one-dimensional/two-dimensional CdS nanorods@ZnIn2S4 nanosheets (1D/2D CdS NRs@ZnIn2S4 NSs) heterojunctions by tailoring enzymatic loading capacity. Firstly, alkaline phosphatase modified TOB aptamer (ALP-Apt) was linked via specific base complementary pairing, and insoluble precipitations were then produced through the ALP-triggered catalytic reaction with the aid of Ag+, which prevented the charge transfer and resulted in the decrement of photocurrent. In the presence of TOB, partial ALP-Apt detached from the electrode surface due to the strong affinity between TOB and its aptamer, leading to a reduction in the amount of ALP and insoluble precipitate, in turn the PEC response partially recovered. The photocurrents exhibited a wider linear range towards the TOB concentration of 1.0-5.0 × 104 pg mL-1, with a low detection limit of 0.96 pg mL-1. The constructed PEC aptasensor gained satisfactory results for TOB assay in milk samples as well, which also offered significant promise for other pollutants in environmental analysis.

Yun shou tai chi with visual feedback can improve the balance of stroke survivors / 中华物理医学与康复杂志

Objective:To observe any effect of Yun shou tai chi training with visual feedback on the balance of persons who have survived a stroke.Methods:Fifty-six stroke survivors were randomly divided into an observation group and a control group, each of 28. Both groups were given routine balance function training, while the observation group was additionally given Yun shou tai chi training with visual feedback. Before and after the four weeks of training, the subjects′ balance and posture were evaluated using a Nomex visual feedback balance system. Lower limb strength was evaluated with a microFET2 portable muscle strength tester. The Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), 10-metre walk times (10MWTs) and the modified Barthel Index (MBI) were also applied.Results:After the training the average BBS, TUGT, 10MWT and MBI results of the observation group had improved significantly. Among the control group only TUGT times and MBI scores had improved significantly, but even then the average MBI score of the observation group was significantly higher. The training improved the strength of the trainees′ quadriceps femoris (QUA), tibialis anterior (TA) and gastrocnemius (GAS) on the hemiplegic side. Their hamstrings and GAS on the non-hemiplegic side were also significantly stronger, on average. The improvement in the QUA of the hemiplegic side in the observation group was significantly better than the control group′s average improvement. The path length (PL) and the covered area (CA) in the observation group had decreased significantly after the training, while among the controls only the CA had decreased significantly. The average PL in the observation group was therefore significantly shorter than in the control group.Conclusion:Yun shou tai chi training with visual feedback can promote the recovery of balance function after a stroke. Such training is worthy of clinical promotion and application.

Effectiveness of Baduanjin Exercise on Quality of Life and Psychological Health in Postoperative Patients With Breast Cancer: A Systematic Review and Meta-analysis.

BACKGROUND: Baduanjin exercise is a traditional Chinese Qigong exercise. This study aimed to investigate the effects of Baduanjin exercise on the quality of life and psychological status of postoperative patients with breast cancer. METHODS: A systematic review and meta-analysis were conducted. Eight databases were searched from inception to December 15, 2021, restricting the language to English and Chinese. RevMan5.3 software was employed for data analysis. This study was registered in PROSPERO, number CRD 42020222132. RESULTS: A total of 7 randomized controlled trials (RCTs) with 450 postoperative breast cancer patients with or without Baduanjin exercise were collected. Compared with the group without Baduanjin, those who practiced Baduanjin showed significant improvement in quality of life (WMD = 5.70, 95% CI 3.11-8.29, P < .0001). Subgroup analysis showed significant improvement in physical (WMD = 1.83, 95% CI 1.13-2.53, P < .00001) and functional well-being (WMD = 1.58, 95% CI 0.77-2.39, P = .0001), which were measured by the functional assessment of cancer therapy-breast (FACT-B). Subgroup analysis also showed that role-physical (WMD = 11.49, 95% CI 8.86-14.13, P < .00001) and vitality (WMD = 8.58, 95% CI 5.60-11.56, P < .00001) were significantly increased, as measured by a 36-item Short Form survey (SF-36). In terms of psychological health, Baduanjin exercise reduced patients' anxiety (WMD = -8.02, 95% CI -9.27 to -6.78, P < .00001) and depression (WMD = -4.45, 95% CI -5.62 to -3.28, P < .00001). CONCLUSIONS: Baduanjin is an effective exercise, which can significantly improve the quality of life and psychological health of breast cancer patients after operation.

Treatment of decentralized low-strength livestock wastewater using microcurrent-assisted multi-soil-layering systems: performance assessment and microbial analysis.

Discharge of decentralized livestock wastewater without effective treatment has become a common problem in rural areas, threatening the regional water environment. A new microcurrent-assisted multi-soil-layering (MSL) system was developed for treating rural decentralized livestock wastewater. The results showed the highest removal rates of chemical oxygen demand (COD) and total phosphorus (TP) in MSL systems reached 95.45% and 92.0%, respectively. The removal rate of total nitrogen (TN) in MSL systems ranged from 60 to 75%. The bacterial diversity changes among MSL systems showed that high-level height of bottom submergence had a positive effect on the abundance of denitrifying bacteria, while low-level height of bottom submergence had a positive impact on the abundance of nitrifying bacteria. The effect of low-level external voltage on bacterial abundance was better than that of high-level external voltage. Both high- and low-level influent C/N ratios had no significant effect on bacterial abundance. The metabolism and activity of microorganisms were promoted with microcurrent stimulation from the perspective of increased bacterial abundance in MSL systems with improved treatment performance.

Predictive Role of Executive Function in the Efficacy of Intermittent Theta Burst Transcranial Magnetic Stimulation Modalities for Treating Methamphetamine Use Disorder-A Randomized Clinical Trial.

Background: Repetitive transcranial magnetic stimulation (rTMS) has therapeutic effects on craving in methamphetamine (METH) use disorder (MUD). The chronic abuse of METH causes impairments in executive function, and improving executive function reduces relapse and improves treatment outcomes for drug use disorder. The purpose of this study was to determine whether executive function helped predict patients' responses to rTMS treatment. Methods: This study employed intermittent theta burst stimulation (iTBS) rTMS modalities and observed their therapeutic effects on executive function and craving in MUD patients. MUD patients from an isolated Drug Rehabilitation Institute in China were chosen and randomly allocated to the iTBS group and sham-stimulation group. All participants underwent the Behavior Rating Inventory of Executive Function - Adult Version Scale (BRIEF-A) and Visual Analog Scales (VAS) measurements. Sixty-five healthy adults matched to the general condition of MUD patients were also recruited as healthy controls. Findings: Patients with MUD had significantly worse executive function. iTBS groups had better treatment effects on the MUD group than the sham-stimulation group. Further Spearman rank correlation and stepwise multivariate regression analysis revealed that reduction rates of the total score of the BRIEF-A and subscale scores of the inhibition factor and working memory factor in the iTBS group positively correlated with improvements in craving. ROC curve analysis showed that working memory (AUC = 87.4%; 95% CI = 0.220, 0.631) and GEC (AUC = 0.761%; 95% CI = 0.209, 0.659) had predictive power to iTBS therapeutic efficacy. The cutoff values are 13.393 and 59.804, respectively. Conclusions: The iTBS rTMS had a better therapeutic effect on the executive function of patients with MUD, and the improved executive function had the potential to become a predictor for the efficacy of iTBS modality for MUD treatment. Clinical Trial Registration: ClinicalTrials.gov, identifier: ChiCTR2100046954.

Adaptation in the Dorsal Belt and Core Regions of the Auditory Cortex in the Awake Rat.

The rat auditory cortex is divided anatomically into several areas, but little is known about the functional differences in information processing among these areas. Three tonotopically organized core fields, namely, the primary (A1), anterior (AAF), and ventral (VAF) auditory fields, as well as one non-tonotopically organized belt field, the dorsal belt (DB), were identified based on their response properties. Compared to neurons in A1, AAF and VAF, units in the DB exhibited little or no response to pure tones but strong responses to white noise. The few DB neurons responded to pure tones with thresholds greater than 60 dB SPL, which was significantly higher than the thresholds of neurons in the core regions. In response to white noise, units in DB showed significantly longer latency and lower peak response, as well as longer response duration, than those in the core regions. Responses to repeated white noise were also examined. In contrast to neurons in A1, AAF and VAF, DB neurons could not follow repeated stimulation at a 300 ms inter-stimulus interval (ISI) and showed a significant steeper ISI tuning curve slope when the ISI was increased from 300 ms to 4.8 s. These results indicate that the DB processes auditory information on broader spectral and longer temporal scales than the core regions, reflecting a distinct role in the hierarchical cortical pathway.

Exploring the decentralized treatment of sulfamethoxazole-contained poultry wastewater through vertical-flow multi-soil-layering systems in rural communities.

Sulfamethoxazole (SMX) is the most widely distributed sulfonamide antibiotics detected in decentralized poultry wastewater in rural communities. As an economically-feasible and eco-friendly technology for decentralized wastewater treatment in rural areas, vertical-flow multi-soil-layering (MSL) system was promising to mitigate the ecological and human health risks from SMX in such areas. The treatment of SMX-contained poultry wastewater by using MSL systems was investigated for the first time, and the main and interactive effects of related multiple variables on system performance were explored through factorial analysis, including material of permeable layer, concentration of SMX, and pH of influent. Results indicated that SMX concentration and pH of influent showed significantly negative effects on SMX removal. Medical stone used in MSL systems with larger surface area could intensify the SMX removal compared to anthracite. MSL systems showed stable performances on SMX removal with the best SMX removal efficiency more than 91%. A novel stepwise-cluster inference (SCI) model was developed for the first time to map the multivariate numeric relationships between state variables and SMX removal under discrete and nonlinear complexities. It was demonstrated that the effect of SMX in wastewater with high concentration was significant on the differentiation of soil bacteria composition in MSL systems based on microbial diversity analysis. These results can help better understand the mechanism of SMX removal in MSL systems from perspectives of factorial analysis, numeric modeling, and microbiological change.

Pentacyclic triterpenoid acids in Styrax as potent and highly specific inhibitors against human carboxylesterase 1A.

Human carboxylesterase 1A1 (hCES1A) is a promising target for the treatment of hyperlipidemia and obesity-associated metabolic diseases. To date, the highly specific and efficacious hCES1A inhibitors are rarely reported. This study aims to find potent and highly specific hCES1A inhibitors from herbs, and to investigate their inhibitory mechanisms. Following large-scale screening of herbal products, Styrax was found to have the most potent hCES1A inhibition activity. After that, a practical bioactivity-guided fractionation coupling with a chemical profiling strategy was used to identify the fractions from Styrax with strong hCES1A inhibition activity and the major constituents in these bioactive fractions were characterized by LC-TOF-MS/MS. The results demonstrated that seven pentacyclic triterpenoid acids (PTAs) in two bioactive fractions from Styrax potently inhibit hCES1A, with IC50 values ranging from 41 nM to 478 nM. Among all the identified PTAs, epibetulinic acid showed the most potent inhibition activity and excellent specificity towards hCES1A. Both inhibition kinetic analyses and in silico analysis suggested that epibetulinic acid potently inhibited hCES1A in a mixed inhibition manner. Collectively, our findings demonstrate that some PTAs in Styrax are potent and highly specific inhibitors of hCES1A and these constituents can be used as promising lead compounds for the development of more efficacious hCES1A inhibitors.

Bismuth chelate as a contrast agent for X-ray computed tomography.

BACKGROUNDS: Due to the unexpected side effects of the iodinated contrast agents, novel contrast agents for X-ray computed tomography (CT) imaging are urgently needed. Nanoparticles made by heavy metal elements are often employed, such as gold and bismuth. These nanoparticles have the advantages of long in vivo circulation time and tumor targeted ability. However, due to the long residence time in vivo, these nanoparticles may bring unexpected toxicity and, the preparation methods of these nanoparticles are complicated and time-consuming. METHODS: In this investigation, a small molecular bismuth chelate using diethylenetriaminepentaacetic acid (DPTA) as the chelating agent was proposed to be an ideal CT contrast agent. RESULTS: The preparation method is easy and cost-effective. Moreover, the bismuth agent show better CT imaging for kidney than iohexol in the aspect of improved CT values. Up to 500 µM, the bismuth agent show negligible toxicity to L02 cells and negligible hemolysis. And, the bismuth agent did not induce detectable morphology changes to the main organs of the mice after intravenously repeated administration at a high dose of 250 mg/kg. The pharmacokinetics of the bismuth agent follows the first-order elimination kinetics and, it has a short half-life time of 0.602 h. The rapid clearance from the body promised its excellent biocompatibility. CONCLUSIONS: This bismuth agent may serve as a potential candidate for developing novel contrast agent for CT imaging in clinical applications.

Recombinant Lactococcus lactis Expressing Ling Zhi 8 Protein Ameliorates Nonalcoholic Fatty Liver and Early Atherogenesis in Cholesterol-Fed Rabbits.

Atherosclerosis is an inflammatory disease characterized by lipid deposits in the subendothelial space leading to severe inflammation. Nonalcoholic fatty liver disease (NAFLD) shares several risk factors with atherosclerosis, including dyslipidemia, type 2 diabetes mellitus, and metabolic syndrome, all of which lead to lipid deposition in the liver causing inflammation and fibrosis. Several clinical trials have shown that certain Chinese herbal medicines with anti-inflammatory effects can be used as adjuvant therapy to prevent the development of cardiovascular events and liver disease. Ling Zhi 8 (LZ8) is an immunomodulatory protein isolated from a medicinal mushroom and has been well documented to possess a broad range of pharmacological properties. This study aimed to evaluate the protective effects of recombinant Lactococcus lactis expressing LZ8 protein on NAFLD and atherogenesis in a cholesterol-fed rabbit model. Twelve rabbits were divided into three groups and fed with syrup only, L. lactis vehicle, or recombinant L. lactis-LZ8 once a day on weekdays for five weeks, respectively. The gene expression of IL-1ß in the aorta was significantly suppressed after oral administration of L. lactis-LZ8. Moreover, in hematoxylin and eosin staining of the aorta, the intima-medial thickness was decreased, and foam cells were significantly reduced in the subendothelial space. LZ8 also inhibited the expression of IL-1ß in the liver, decreased fat droplet deposits and infiltration of inflammatory cells, and improved liver function by decreasing liver enzymes in an animal model. Our results suggest that the Lactococcus-expressing LZ8 appears to be a promising medicine for improving both NAFLD and early atherogenesis owing to its anti-inflammatory effect. Furthermore, it is available as a low-cost food-grade product.

Performance analysis and life cycle greenhouse gas emission assessment of an integrated gravitational-flow wastewater treatment system for rural areas.

Due to the lack of appropriate wastewater treatment facility in rural areas, the discharging of wastewater without sufficient treatment results in many environmental issues and negative impact on the local economy. In this study, a novel integrated gravitational-flow wastewater treatment system (IGWTS) for treating domestic wastewater in rural areas was developed and evaluated. As the core module of IGWTS, the multi-soil-layering (MSL) system showed good performances for removing organic matters and nutrients in lab-scale experiments. Aeration was found to be the dominant positive factor for contaminant removal in factorial analysis, while bottom submersion had the most negative effect. Based on the critical operational factors obtained from lab-scale tests, the full-scale IGWTS consisting of multifunctional anaerobic tank (MFAT), MSL, and subsurface flow constructed wetland (SFCW) was designed, constructed, and operated successfully in the field application. The final effluent concentrations of COD, BOD5, TP, NH3-N, and TN reached 22.0, 8.0, 0.3, 4.0, and 11.0 mg/L, with removal rates of 92, 93, 92, 86, and 76%, respectively. The feasibility of IGWTS was also quantitatively evaluated from the perspectives of resource consumption, economic costs, water environment impact, and life cycle greenhouse gas (GHG) emissions. IGWTS has been proved to be a sound approach to mitigate GHG emissions compared with centralized wastewater treatment plant. It can also be featured as an eco-friendly technology to improve rural water environment, and an economic scenario with low construction and operation costs. Graphical abstract.

Discovery of natural pentacyclic triterpenoids as potent and selective inhibitors against human carboxylesterase 1.

Human carboxylesterase 1 (CES1), primarily expressed in the liver and adipocytes, is responsible for the hydrolysis of endogenous esters (such as cholesteryl esters and triacylglycerols) and the metabolism of xenobiotic esters (such as clopidogrel and oseltamivir), thus participates in physiological and pathological processes. In this study, a series of natural pentacyclic triterpenoids were collected and their inhibitory effects against CES1 and CES2 were assayed using D-luciferin methyl ester (DME) and N-(2-butyl-1,3-dioxo-2,3-dihydro-1H-benzo[de] isoquinolin- 6-yl)- 2-chloroacetamide (NCEN) as specific optical substrate for CES1, and CES2, respectively. To this end, betulinic acid (BA) was found with strong inhibitory effect on CES1 (IC50, 15 nM) and relative high selectivity over CES2 (>2400-fold). Primary structure-activity relationships (SAR) analysis and docking simulations revealed that the carboxyl group at the C-28 site of BA is very essential for CES1 inhibition. The inhibition kinetic analyses demonstrated that BA was a potent competitive inhibitor against CES1-mediated DME hydrolysis. Further investigation on the inhibitory effect of BA in living cells (HepG2) based assays demonstrated that BA displayed potent inhibitory effects on intracellular CES1 activities, with the low IC50 value of 1.30 µM. These results demonstrated that BA is potent and highly selective CES1 inhibitor, which might be used as the promising tool for exploring the biological functions of CES1 in complex biological systems.

Enhanced nitrogen removal in the treatment of rural domestic sewage using vertical-flow multi-soil-layering systems: Experimental and modeling insights.

Domestic sewage in rural areas is often poorly treated and discharged into waters, resulting in negative impacts on regional environment, natural resources and human health. A cost-efficient decentralized sewage treatment technology is sustainably necessary for rural areas. In this study, a modified multi-soil-layering (MSL) system was developed to specifically treat low C/N ratio domestic sewage in rural areas. The results proved the good performance of MSLs in sewage treatment under complex conditions. The highest degradation rates of COD, TP, NH4+-N, NO3--N, TN among all the devices could reach 98.29%, 100%, 76.60%, 96.15% and 69.86%, respectively. During the operation, MSL5 and MSL6 showed the best overall performance of contaminant removal. The effects of single factors and their interactions on the performance of MSL systems were further revealed through factorial analyses. In order to simulate and predict nitrogen removal of MSL system, a statistical relationship between TN removal rate and operation parameters was also successfully developed based on stepwise cluster analysis. Such modeling of nitrogen removal model can help develop an optimal strategy for the operation of MSL in treating low C/N ratio sewage from rural areas.

[Analysis of medicinal resources diversity of 33 pilots (districts) in Guizhou province].

This study is based on the data analysis of medicinal plant resources and diversity collected from the fourth Chinese traditional medicine resource survey( pilot). Through the analysis of relevant data from 33 census pioneer plots in Guizhou province( area),a total of 265 families,1 432 genera and 5 296 species of medicinal resources were reported,including algae,fungi,lichens,mosses,a total of 43 genera and 35 families,57,48 families,120 genera and 453 species of ferns,gymnosperms 11 families,22 genera and 61 species,167 families,1 243 genera and 4 721 species of angiosperms,4 genera and 4 families four medicinal animals.Compared with the data related to the third survey of traditional Chinese medicine resources,the number of ferns,gymnosperms and angiosperms in the fourth survey has increased far more than that of the third survey. From the regional distribution of medicinal resources,the composition of the genus,the type of life,and the location of the medicine,the richness of the medicinal plant resources in Guizhou province is not only reflected in many types,but also in the variety of medicinal resources. These studies provide a scientific basis for vigorously developing the Chinese herbal medicine industry and the sustainably using medicinal plant resources in Guizhou province.

CuS Nanodot-Loaded Thermosensitive Hydrogel for Anticancer Photothermal Therapy.

The purpose of this research is to establish an injectable hydrogel encapsulating copper sulfide (CuS) nanodots for photothermal therapy against cancer. The CuS nanodots were prepared by one-pot synthesis, and the thermosensitive Pluronic F127 was used as the hydrogel matrix. The CuS nanodots and the hydrogel were characterized by morphous, particle size, serum stability, photothermal performance upon repeated 808 nm laser irradiation, and rheology features. The effects of the CuS nanodots and the hydrogel were evaluated qualitatively and quantitatively in 4T1 mouse breast cancer cells. The retention, photothermal efficacy, therapeutic effects, and systemic toxicity of the hydrogel were assessed in tumor bearing mouse model. The CuS nanodots with a diameter of about 8 nm exhibited satisfying serum stability, photoheat conversion ability, and repeated laser exposure stability. The hydrogel encapsulation did not negatively influence the above features of the photothermal agent. The nanodot-loaded hydrogel shows a phase transition at body temperature and, as a result, a long retention in vivo. The photothermal-agent-embedded hydrogel played a promising photothermal therapeutic effect in the tumor bearing mouse model with low systemic toxicity after peritumoral administration.

Biophysiological and factorial analyses in the treatment of rural domestic wastewater using multi-soil-layering systems.

Multi-soil-layering (MSL) system was developed as an attractive alternative to traditional land-based treatment techniques. Within MSL system, the environmental cleanup capability of soil is maximized, while the soil microbial communities may also change during operation. This study aimed to reveal the nature of biophysiological changes in MSL systems during operation. The species diversity in soil mixture blocks was analyzed using Illumina HiSeq sequencing of the 16S rRNA gene. The interactive effects of operating factors on species richness, community diversity and bacteria abundance correlated with COD, N and P removal were revealed through factorial analysis. The results indicated the main factors, aeration, bottom submersion and microbial amendment, had different significant effects on microbial responses. The surface area and porosity of zeolites in permeable layers decreased due to the absorption of extracellular polymeric substances. The findings were applied for the design and building of a full-size MSL system in field and satisfied removal efficiency was achieved. The results of this study can help better understand the mechanisms of pollutant reduction within MSL systems from microbial insights. It will have important implications for developing appropriate strategies for operating MSL systems with high efficiency and less risks.

Chinese medicine as complementary therapy for female infertility.

Chinese medicine (CM) has been used in clinical treatment for thousands of years in China, Japan, Korea, and other countries. CM is at present attracting many attentions around the world for reproductive health care and disease prevention, including treatment of female infertility. This review focuses on the CM treatment for female infertility patients, and supplies a summary on the efficacy, safety, and mechanism of some Chinese herbal medicines, herbal medicine-derived active compounds, and acupuncture. A large number of researches have reported that CM could alleviate or even cure female infertility by regulating hormone, improving reproductive outcome of in vivo fertilization, affecting embryonic implantation, curing polycystic ovarian syndrome, endometriosis, pelvic inflammatory disease, relieving mental stress, and regulating immune system. Meanwhile, a few studies claimed that there was little adverse reaction of CM in randomized controlled trials. However, up to present there is a lack of adequate evidences with molecular mechanistic researches and randomized controlled trials to prove the CM as an effective and safe treatment for infertility. Thus, utility of CM as a complementary medicine will be a feasible method to improve the outcome of female infertility treatment.

Controversies regarding and perspectives on clinical utility of biomarkers in hepatocellular carcinoma.

The prevalence of hepatocellular carcinoma (HCC) worldwide parallels that of persistent infection with the hepatitis B virus (HBV) and/or hepatitis C virus (HCV). According to recommendations by the World Health Organization guidelines for HBV/HCV, alpha-fetoprotein (AFP) testing and abdominal ultrasound should be performed in routine surveillance of HCC every 6 mo for high-risk patients. These examinations have also been recommended worldwide by many other HCC guidelines over the past few decades. In recent years, however, the role of AFP in HCC surveillance and diagnosis has diminished due to advances in imaging modalities. AFP was excluded from the surveillance and/or diagnostic criteria in the HCC guidelines published by the American Association for the Study of Liver Diseases in 2010, the European Association for the Study of the Liver in 2012, and the National Comprehensive Cancer Network in 2014. Other biomarkers, including the Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ-carboxyprothrombin, Dickkopf-1, midkine, and microRNA, are being studied in this regard. Furthermore, increasing attention has focused on the clinical utility of biomarkers as pre-treatment predictors for tumor recurrence and as post-treatment monitors. Serum and tissue-based biomarkers and genomics may aid in the diagnosis of HCC, determination of patient prognosis, and selection of appropriate treatment. However, further studies are needed to better characterize the accuracy and potential role of these approaches in clinical practice.

A randomized controlled trial comparing total glucosides of paeony capsule and compound glycyrrhizin tablet for alopecia areata.

OBJECTIVE: To observe the efficacy and safety of total glucosides of paeony capsule (TGPC) in patients with mild and moderate alopecia areata. METHODS: A total of 86 outpatients were randomly allocated into two groups of TGPC (treatment, 44 cases) and compound glycyrrhizin tablet (control, 42 cases). The treatment group was given oral TGPC, three times daily and 600 mg per time; the control group was given oral compound glycyrrhizin tablets, three times daily and 50 mg per time. In addition, both groups were given 10 mg of vitamin B(2) and tapped the bold patches with massage. The treatment course was three months for both groups. Peripheral blood T-cell subsets (CD3(+)CD4(+), CD3(+)CD8(+), Th, Ts, Th/Ts) of 10 patients randomly selected from each group respectively were tested before and after three months of treatment. The effectiveness and adverse reaction of all cases were observed each month. The safety was evaluated according to the incidence rate of adverse reaction. RESULTS: In the treatment group, the cured and markedly effective rate was 36.36% (16/44), 50.00% (22/44) and 68.18% (30/44) at the end of first, second and third month of treatment, respectively, and the incidence rate of adverse reaction was 13.64% (6/44). In the control group, the cured and markedly effective rate was 38.10% (16/42), 57.14% (24/42) and 71.43% (30/42), respectively, and the incidence rate of adverse reaction was 16.67% (7/42). The cured and markedly effective rate and the incidence rate of adverse reaction were similar in both groups (P>0.05). TGPC and compound glycyrrhizin tablet can inhibit CD3(+)CD4(+) and CD3(+)CD8(+), and decrease the ratio of Th/Ts (P<0.05). CONCLUSION: TGPC is effective and safe in the treatment of alopecia areata.