Garlic supplementation for the treatment of chronic liver disease: a meta-analysis of randomized controlled trials.

Introduction: The efficacy of garlic supplementation for chronic liver disease remains controversial. We conduct a meta-analysis to explore the influence of garlic supplementation versus placebo on the treatment of chronic liver disease. Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2021 for randomized controlled trials (RCTs) assessing the efficacy of garlic supplementation versus placebo for chronic liver disease. This meta-analysis is performed using the random-effect model. Results: Four RCTs and 212 patients are included in the meta-analysis. Overall, compared with control group for chronic liver disease, garlic supplementation is associated with significantly reduced alanine aminotransferase (ALT), aspartate-aminotransferase (AST), total cholesterol, low density lipoprotein (LDL) and weight, but demonstrates no substantial impact on the incidence of adverse events. Conclusions: Garlic supplementation is effective to treat chronic liver disease.

Discussion on the indications of internal mammary sentinel lymph node biopsy in breast cancer in the era of precision medicine / 中华肿瘤杂志

Objective@#To determine the clinical benefits of internal mammary sentinel lymph node biopsy (IM-SLNB) acquired by breast cancer patients with clinically positive axillary lymph node (ALN), and further optimize the IM-SLNB indications.@*Methods@#All primary breast cancer patients with clinically positive ALN from February 2014 to September 2017 were prospectively recruited in this study. IM-SLNB was performed under the guidance of the modified injection technique. The success rate and visualization rate of IM-SLNB, metastatic rate of internal mammary sentinel lymph node (IMSLN) and its related factors were analyzed, and the clinical benefits were accessed according to the current guidelines.@*Results@#Among 126 patients, all of 94 patients (74.6%) who showed internal mammary drainage successfully underwent IM-SLNB. The incidence of internal mammary artery bleeding and pleural lesion were 4.3%(4/94) and 9.6%(9/94), respectively. The metastatic rate of IMSLN was 38.3% (36/94), which was significantly associated with the number of positive ALN (P<0.001) and tumor size (P=0.024). The lymph node staging of 94 patients who underwent IM-SLNB was more accurate. Among them, 36 cases with positive IMSLN underwent internal mammary radiotherapy (IMRT), while the other 58 cases with negative IMSLN avoided radiotherapy.@*Conclusions@#IM-SLNB should be routinely performed in patients with positive ALN. IM-SLNB can provide more accurate staging and guide tailored IMRT to benefit more breast cancer patients.

Experimental Research Progress on Action Mechanism ofTuo-Fa in Traditional Chinese Medicine Surgery / 世界科学技术-中医药现代化

Tuo-Fawas one of three internal treatment rules in traditional Chinese medicine (TCM) surgery. It had been widely used in the treatment of superficial suppurative diseases, visceral suppurative diseases and other diseases. This article was aimed to clarify the action mechanism ofTuo-Fa for carrying forward better services in the clinic. This article reviewed and recapitulated related literatures on experimental researches ofTuo-Fa in recent years. It mainly showed the research status on anti-infection, anti-tumor and anti-gastric ulcer withTuo-Fa and its prescriptions. It summarized the existed shortcomings, which was that experimental researches on the action mechanism ofTuo-Fa was still on the initial stage with a few references and obviously lagged behind clinical applications. However, some achievements were also made. It had initially revealed the action mechanism ofTuo-Fa in treatment of pyogenic infection. It also had research on action mechanism of anti-tumor and anti-gastric ulcer treatment. It developed new field for the clinical practice. Finally, the research on action mechanism ofTuo-Fa and future prospects were expressed.

Effects of siRNA targeting ADAMTS2 gene on hepatic stellate cells / 中华肝胆外科杂志

Objective To explore the preventive and therapeutic role of silencing type Ⅰ rat platelet-binding protein motifs depolymerization protein-like metalloproteinase 2(ADAMTS2)by siRNA on experimental liver fibrosis in vitro.By studying the mechanism of siRNA silencing of ADAMTS2,we also aim to evaluate the feasibility of ADAMTS2 as a target for anti-liver fibrosis therapy.Methods Three pairs of siRNAs targeting ADAMTS2 mRNA 2237,2597 and 690 targets were designed and synthesized by utilizing RNA design software.The most effective siRNA was chosen to transfect HSC-T6 cell line to test the tendency of hepatic stellate cell(HSC)activation and ex pression of ADAMTS2,COL1α1,COL(I),α-SMA,TGF-β1,MMP-2 and TIMP-3.These were quantified using real time-PCR,Western blotting,and MTT assays.Results Of the same dosage and time of injection,siRNA 2237 inhibited ADAMTS2 gene expression significantly more than other siRNAs.siRNA-ADAMTS2 2237 markedly inhibited ADAMTS2 gene and protein expression of HSCT6 with more than 80％ efficiency.Conversely,siRNA-ADAMTS2 2237 markedly reduced the gene and protein expressions of COL(I),α-SMA and TGF-β1 on HSC-T6 and inhibited the proliferation of HSC.Conclusions siRNA-ADAMTS2 2237 could effectively knockdown the gene and protein expression of ADAMTS2 in HSC-T6 cell lines.Silencing ADAMTS2 by siRNA significantly inhibited the activation,proliferation of HSC and the gene and protein expressions of COL(I),α SMA,and TGF-β1,and it may have a potential anti-fibrotic effect.ADAMTS2 might be an efficient target for anti-fibrotic therapy.

Effects of DDR2 siRNA on carbon tetrachloride-induced liver fibrosis in rats / 中华肝胆外科杂志

Objective To explore the effects of silencing DDR2 expression by siRNA on CCl4-induced liver fibrosis and its mechanism in rats. Methods Liver fibrosis model was induced by intraperitoneal injection of CCl4 twice a week for 6 consecutive weeks. Some rats were administered siRNA targeting DDR2 (0. 3 mg/kg), saline or control siRNA every three days from the beginning of CCl4 injection via tail vein injection, while other rats were treated in the same pattern after 2-week CCl4 injection. Quantitative real-time polymerase chain reaction (QRT-PCR) and Western blot were used to detect the mRNA and protein expressions of DDR2, MMP-2 and COL Ⅰ . Meanwhile, the pathological changes of liver tissues and the levels of liver function were also observed. Results QRT-PCR showed that the DDR2, MMP-2 and COL Ⅰ mRNA in the chemically synthetic cholesterol-modified siRNADDR2 group were significantly decreased as compared with those in the control group (P＜0.01) ,and the protein expressions of DDR2, MMP-2 and COL Ⅰ were also significantly decreased (P＜0. 01,4 wand 6w). In addition, in comparison with those in the control group, the pathological changes of liver tissues in the siRNA-DDR2 treated group were markedly attenuated, and the levels of ALT(1356.17 ±83.80 nkat/L vs 2532. 70±145.11 nkat/L,4w,1367. 60±321.76 nkat/L vs 2604.37±255.02 nkat/L,6w,P＜0. 01 ) and AST (2460. 80 ± 207. 58 nkat/L vs 3983. 70 ± 253. 08 nkat/L, 4w, P＜ 0. 01,2383.27±290.16 nkat/L vs 3227.70±353. 34 nkat/L,6w,P＜0. 05)were also significantly lowered,while the level of TBIL (7. 97 ± 1.60 μmol/L vs 3.80± 0.60 μmol/L, 4w, 10.40±1.61 μmol/L vs 6.10±0.79 μmol/L,6w,P＜0. 01)was markedly increased. Conclusion Systemic administration of cholesterol-modified siRNA targeting DDR2 could significantly suppress the expression of DDR2, decrease the contents of the extracellular matrix,and thus has a potential antifibrotic effect.