ABSTRACT
ObjectiveTo investigate the clinical effect of Fuhe Beihua prescription combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer patients with liver depression and spleen deficiency and its effect on T lymphocyte subsets. MethodsA retrospective analysis was performed for the clinical data of stage Ⅲ primary liver cancer patients with liver depression and spleen deficiency who were treated in Department of Hepatology and Department of Oncology in The First Affiliated Hospital of Guangxi University of Chinese Medicine from January 2018 to January 2020. According to whether the traditional Chinese medicine Fuhe Beihua prescription was used, the patients were divided into treatment group (treated with routine TACE and oral administration of Fuhe Beihua prescription) and control group (treated with routine TACE alone), and the course of treatment was 16 weeks for both groups. The two groups were compared in terms of short-term response rate, quality-of-life score, serum alpha-fetoprotein (AFP) level, four indicators of liver fibrosis, coagulation function parameters, peripheral blood T lymphocyte subsets, and liver function parameters. The independent samples t-test was used for comparison of continuous data between two groups, and the chi-square test was used for comparison of categorical data between two groups. A repeated-measures analysis of variance was used for comparison of continuous data between different groups at different time points. ResultsA total of 218 patients were selected, with 118 in the control group and 100 in the treatment group. The treatment group had an objective response rate of 33% and a disease control rate of 66% at week 8 of treatment and an objective response rate of 34% and a disease control rate of 69% at week 16 of treatment, and the control group had an objective response rate of 26.27% and a disease control rate of 68.64% at week 8 of treatment and an objective response rate of 30.51% and a disease control rate of 68.64% at week 16 of treatment; there was a significant difference in objective response rate between the two groups at weeks 8 and 16 of treatment (P＜0.05). Both groups had significant increases in Karnofsky Performance Scale (KPS) score, fibrinogen, and albumin (Alb) from before treatment to weeks 8 and 16 of treatment (all P＜0.05), and there were significant differences in KPS score, fibrinogen, and Alb between the two groups at weeks 8 and 16 of treatment (all P＜0.05). Both groups had significant reductions in AFP, the four indicators of liver fibrosis, alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time (PT), and traditional Chinese medicine (TCM) syndrome score after treatment (all P＜0.05), and at weeks 8 and 16 of treatment, there were significant differences between the two groups in AFP, the four indicators of liver fibrosis, ALT, AST, PT, and TCM syndrome score (all P＜0.05). At weeks 8 and 16 of treatment, the treatment group had significant increases in the levels of CD3+, CD4+, and CD4+/CD8+ (all P＜0.05) and a significant reduction in the level of CD8+ (P＜0.05), and there were significant differences in the levels of T lymphocyte subsets between the two groups at weeks 8 and 16 of treatment (all P＜0.05). ConclusionFuhe Beihua prescription combined with routine TACE has a better clinical effect than TACE alone in the treatment of primary liver cancer patients with liver depression and spleen deficiency, possibly by regulating the levels of T lymphocyte subsets.
ABSTRACT
ObjectiveTo establish the reference value of inhibin-A in the serum of pregnant women with gestational age from 15 to 20+6 weeks in Guangdong province,and assess the efficiency of inhibin-A and quadruple test in Down syndrome screening.Methods A total of 2802 singleton pregnancies receiving triple test screening in Guangzhou Women and Children's Medical Center from March 2008 to December 2010 were included in this study.Inhibin-A was measured by automatic enzyme-linked immunosorbent chemiluminescence assay. The concentration of inhibin-A was expressed as multiples of the median (MoM),and adjusted with maternal weight and gestational age.Parameters of SURUSS were used to recalculate the risk of Down syndrome.The efficacy of single marker and combination were evaluated by receiver operating characteristic curve and the area under the curve. Results(1) In normal singleton pregnancies,the median concentration of inhibin-A was 286.60,267.10,249.10,243.40,242.30 and 256.60 pg/ml respectively for each week of gestational age from 15 to 20+6 weeks.The distribution of inhibin-A in each gestational week was relatively stable.The mean concentration [(852.83±370.04) pg/ml] and MoM (2.82) of inhibin-A in twelve pregnant mothers with Down syndrome fetuses were significantly higher than those without [(293.28±149.46) pg/ml (t=5.37,P＜0.05) and 1,respectively].(2) The detection rate was 83.3％ (10/12) by using the quadruple test including free human chorionic gonadotropin-β,alphafetoprotein,unconjugated estriol and inhibin-A at false positive rate of 5.8％; while when the detection rate of triple test including alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 83.3％,the false positive rate was 7.7％.When the false positive rate was set to 5.0％,the area under the curve of inhibin-A,alpha-fetoprotein,free human chorionic gonadotropin-β and unconjugated estriol was 63.7％,20.5％,46.1％ and 4.8％,respectively,and the relative area under the curve of routine triple test and quadruple test was 45.5％ and 63.1％,respectively.ConclusionsInhibin-A is suggested to be the most effective marker used for secondtrimester screening,which could be used for second trimester Down syndrome screening in Chinese population combined with existing three markers.