Systematic review with network meta-analysis: adjuvant therapy for resected biliary tract cancer.

BACKGROUND: Major adjuvant therapies for biliary tract cancer (BTC) include fluorouracil, gemcitabine and chemoradiation (CRT), but the optimum regimen remains inconclusive. AIM: To compare these therapies in terms of patient survival rates after resection and toxic effects. METHODS: We searched PubMed for controlled trials comparing the above three therapies with each other or observation alone until 31 January 2014. We estimated the hazard ratios (HRs) for death and odds ratios (ORs) for toxic effects among different therapies. Subgroup analyses based on positive lymph node or resection margin were also performed. RESULTS: Twelve eligible articles were included. Gemcitabine improved 5-year survival (HR 2.12, 95% CI, confidence interval 1.23-4.02, P = 0.01), whereas fluorouracil (HR 1.61, 95% CI 0.74-3.67) and CRT (HR 1.55, 95% CI 0.82-3.32) provided a poorer survival outcome compared with gemcitabine after 1 year. Similarly, for 5-year survival rates, although differing, CRT did not provide a significant improvement in survival (HR 0.46, 95% CI 0.20-0.97) compared with gemcitabine. Fluorouracil did not appear to provide benefit over gemcitabine (HR 1.56, 95% CI 0.77-3.35). CRT was ranked highest for toxic effects including haematological (OR 5.45, 95% CI 0.01-483.85) and nonhaematological (OR 5.77, 95% CI 0.01-3807.40). CONCLUSIONS: Chemotherapy with gemcitabine is the optimum adjuvant treatment with a balanced benefit-toxicity ratio for resected biliary tract cancer. Chemoradiation was more likely to cause toxic effects.

The effect of da-fang-feng-tang on treatment of type II collagen-induced arthritis in DBA/1 mice.

Da-Fang-Feng-Tang (DFFT), which is believed to be effective for treating human rheumatoid arthritis (RA), was given to DBA/1 mice at the onset of type II collagen-induced arthritis (CIA) to examine its effect. Granules of the crude DFFT extract were administered by gastric gavage at a dose of 1.6 g/kg/day for 12 weeks, starting the day CIA began. The levels of anticollagen IgG antibody were significantly decreased in the sera of the DFFT-treated group compared with the control group from weeks 2 to 7 after the onset of CIA. The severity of arthritis in the DFFT-treated group was markedly alleviated when compared with the control group. In addition, histological examination of the DFFT-treated group showed less cartilage and bone erosion. These results suggest that administration of DFFT suppressed the development of CIA in mice and support the belief that DFFT is effective in treating human RA.

[Reverse-phase HPLC determination of coumarins in the traditional Chinese drug bai-zhi (Angelica dahurica forma bai-zhi)].

A reversed phase HPLC procedure has been developed for the separation and determination of oxypeucedanin (I), imperatorin (II) and isoimperatorin (III) in Bai-zhi simultaneously. I, II and III were extracted from Bai-zhi by using ether. The solution was evaporated to dryness and the residue was redissolved in 25 ml of ethyl acetate and 10 microliters of the solution were analysed on Waters mu Bondapak C13 column (300 x 3.9 mm ID) using methanol-water (70:30) as the mobile phase and detecting at 254 nm. The results were calculated by external standard method on the basis of peak area. The average recoveries of the standards added to the sample were 101.36, 100.54 and 97.91% for I, II and III respectively, and coefficients of variation were less than or equal to 3.33%. Analytical results by HPLC method are in agreement with those by TLC method. This method is rapid, reproducible and accurate and has been applied to analyse the contents of three components in 42 samples of angelica. The results of fourteen samples were given.