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Objective:To clarify the effect of Fangfeng Tongshengtang on early-stage serum endotoxin (ET) and programmed death-1/programmed ligand-1(PD-1/PD-L1) in patients with hepatitis B virus-related acute-on-chronic liver failure（HBV-ACLF）(early-stage), and exploring the mechanism of Fangfeng Tongshengtang in the treatment of early stage HBV-ACLF. Method:The 69 patients with early stage HBV-ACLF were enrolled in the study and all of them received antiviral drugs, liver protection and jaundice relieving drugs as well as supporting therapy. According to the random number table, 35 patients were randomly assigned to observation group (to take Fangfeng Tongshengtang, and 34 patients were assigned to control group to take placebo. The observation period was 3 weeks in both groups. Before treatment and 1, 2, and 3 weeks after treatment, theserum ET, expression of PD-1/PD-L1 in serum CD4+ and CD8+ T cells, liver function [alanine aminotransferase (ALT), aspartate aminotransferase (AST), albumin (Alb), total bilirubin (TBIL), and direct bilirubin (DBIL)], coagulation function [prothrombin time (PT), and prothrombin activity (PTA)] were detected to verify the effect of Fangfeng Tongshengtang on HBV-ACLF (early-stage). Result:After 3 weeks of treatment, ET, expression of serum CD4+PD-1+, CD4+PD-L1+, CD8+PD-1+, CD8+PD-L1+, ALT, AST, TBIL, DBIL, and PT decreased significantly (P<0.01), while Alb and PTA increased significantly（P<0.01）in both groups. As compared with the control group, the ET in observation group was lower at 1st, 2nd and 3rd week after treatment (P<0.01), the CD4+PD-1+, CD4+PD-L1+, CD8+PD-1+ and CD8+PD-L1+ in observation group were lower at 2nd week and 3rd week（P<0.05, P<0.01）， the ALT, AST, TBIL and DBIL in observation group were lower at 1st, 2nd and 3rd week（P<0.05, P<0.01）， the PT in observation group was lower at 2nd and 3rd week（P<0.05）， and the PTA in observation group was higher at the 2nd and 3rd week（P<0.01）. Conclusion:Fangfeng Tongshengtang can achieve the therapeutic effect for HBV-ACLF (early-stage) probably by reducing the serum ET and the expression of PD-1 / PD-L1 in serum CD4 +, CD8 + T cells.
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<p><b>OBJECTIVE</b>To detect the expressions of cyclooxygenase-2 (COX-2) and basic fibroblast growth factor (bFGF) and evaluate their value in predicting the radiotherapy sensitivity in nasopharyngeal carcinoma (NPC).</p><p><b>METHODS</b>The expressions of COX-2 and bFGF were detected immunohistochemically in biopsy samples of NPC, and their relationship with the radiotherapy sensitivity of the tumors were analyzed.</p><p><b>RESULTS</b>In 97 NPC cases, the positivity rates of COX-2 and bFGF were 71.1% (69/97) and 64.9% (63/97), respectively. Correlation analysis demonstrated that a positive COX-2 expression was positively correlated with an advanced T status and N status, and bFGF expression was positively associated with an advanced N status in NPCs. In radiotherapy-sensitive and radiotherapy-insensitive cases, the positive rate of COX-2 was 62.8% and 92.6%, and that of bFGF was 57.1% and 85.2%, respectively. The expression of COX-2 was positively correlated with that of bFGF (r=0.486, P<0.05). The radiotherapy sensitivity differed significantly among patients with different statuses of COX-2 and bFGF positivity.</p><p><b>CONCLUSION</b>COX-2 and bFGF can be effective and sensitive biomarkers for predicting radiotherapy sensitivity in NPC.</p>
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To summarize Professor LIU Feng-bin's clinical experience and theoretical thoughts on chronic atrophic gastritis (CAG), the study group designed a retrospective study on his case series and expert interview. First of all, the data of CAG patients treated in the First Affiliated Hospital of Guangzhou University of Chinese Medicine between 2009 and 2013, e. g. herbs, diseases, syndrome type, prescription amount and number of herbs, was collected and processed. The statistical description and binary logistic regression were used to determined the syndrome type, initial basic remedy and modification. During the statistics, a complete and sub-group analysis was performed simultaneously. After the expert interview, the syndrome type and medication were finalized. As a result, a total of 228 CAG patients aged at (50.30 ± 10.18) were collected, including 151 males (66.23%). Of them, the TCM diagnosis and syndrome type were extracted from the information of 157 patients, including 115 cases with gastric stuffiness, 23 cases with gastric pain, 19 missing cases, 2 cases with spleen-stomach weakness syndrome, 57 cases with spleen deficiency and dampness-heat syndrome, 18 cases with spleen-stomach disharmony syndrome, 23 cases with syndrome of liver depression syndrome, 21 cases with liver qi invading stomach syndrome and 26 qi and yin deficiency syndrome, respectively. All of the 228 patients used totally 104 herbs, while the subgroups with 157 patients used 94 herbs. The most frequently used 15 herbs used in each groups were analyzed to determine the initial basic remedy and modification. Subsequently, based on the information of the sub-groups with 157 patients, with the syndrome type as the dependent variable, the logistic regression analysis was made on the most frequently used 32 herbs, in order to determined the modification in herbs for different syndrome types. After experts reviewed and modified, they believed the main causes of CAG were dietary irregularities, moodiness and weak constitution; the pathogenesis of CAG was spleen deficiency with qi stagnation, heat depression and blood stasis in the stomach meridian. The above six syndrome types and 12 herbs were determined, including Pseudostellariae Radix, Poria, Atractylodismacrocephalae Rhizoma, Glycyrrhizae Radix et Rhizoma, Fritillariae Thunbergii Bulbus, Sepiae Endoconcha, Arecae Pericarpium, Aurantii Fructus, Perillae Caulis, Herba Hedyotis Diffusae, Scutellariae Barbatae Herba, Curcumae Rhizoma. This study summarized Professor LIU Feng-bin's clinical experience and theoretical thoughts of chronic atrophic gastritis based on clinical practice data and expert interview, with a rigorous design and good scientificity and practicability.
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Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Chronic Disease , Gastritis, Atrophic , Drug Therapy , Logistic Models , Medicine, Chinese Traditional , Retrospective StudiesABSTRACT
Objective To explore the combination of lamivudine and adefovir dipivoxiltreatment in HBeAg positive patients with inappropriate timing of decompensated hepatitis B cirrhosis.Methods Make a retrospective analysis of HBeAg positive patients with decompensated hepatitis B cirrhosis of the liver our hospital in 2014 January ~2015 January were,100 cases of initial treatment, 50 patients given lamivudine plus adefovir dipivoxil resistance as control group,50 cases patients given lamivudine plus adefovir dipivoxil combined as the observation group, compared two groups of clinical curative effect of treatment.Results Observation group after treatment in patients with HBeAgseroconversion rate of 26.00% was significantly higher than that in control group 4.00% (P<0.05);after 12 weeks of treatment in the observation group (9.63 ±1.42), 24 weeks(8.57 ±1.45), 48 weeks(7.43 ±1.57) Child-Pugh grading score was significantly lower than the control group(9.74 ±1.21),(9.45 ±1.33)(8.57 ±1.04)(P <0.05); level of HBV-DNA after treatment in the observation group (2.23 ±1.25) was significantly lower than that of the control group(5.18 ± 1.63), and the Patients in the observation group (2.23 ±1.25)HBV-DNA load in serum was significantly lower than that before treatment(6.47 ± 1.55)(P<0.05).Conclusion patients with decompensated hepatitis B cirrhosis with combination of lamivudine and adefovir dipivoxil treatment, the clinical efficacy is more significant, HBeAg seroconversion rate is increased , the score of Child-Pugh become low and improve liver reserve function, reduce HBV-DNA load in serum.