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Objective To explore the therapeutic effect of traditional Chinese medicine (TCM) on subsolid nodule (SSN). Methods A practical randomized controlled study method, including 254 SSN patients was adopted. The patients were divided into the TCM (102 cases) and follow-up (152 cases) groups. The follow-up group received regular check-ups in accordance with the guidelines, and the TCM group received TCM syndrome differentiation treatment for 24 weeks. The two groups were compared in terms of the changes in their SSN diameter, SSN number, TCM symptom score, and overall therapeutic effect before and after treatment. Adverse reactions and safety indicators were also recorded. Results The TCM group showed a significantly higher effective rate of treatment (16.7%) than the follow-up group (2.6%) (P<0.01). Compared with their condition before treatment, the TCM group showed no significant changes in their SSN diameter and number but presented considerably reduced fatigue, yellow and red urine symptoms, and overall TCM symptom score (P<0.05). The follow-up group exhibited significantly increased diameter and number of SSN (P<0.01). The follow-up group showed the significantly higher increase in SSN diameter after treatment than the TCM group (P<0.05). Moreover, the follow-up group showed significantly higher fatigue, depression, yellow and red urine symptom scores, and overall TCM symptom score than the TCM group (P<0.05 or P<0.01). Conclusion TCM treatment for SSN has a distinct clinical efficacy, reduces the malignant risk of SSN and improves clinical symptoms of SSN patients, and is safe and feasible.
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The theory of "supplementation/drainage for bitter-desire of the five viscera" originated from Elementary Questions （《素问》）， which is an important origin of the theory of supplementation and drainage prescription. By exploring the connotation of the theory of "supplementation/drainage for bitter-desire of the five viscera"， and adopting the archaeological method of literature research， we collected the relevant writings on the theory of "supplementation/drainage for bitter-desire of the five viscera" by the representative physicians of Yishui school， such as ZHANG Yuansu， LI Gao， WANG Haogu， LUO Tianyi， LI Zhongzi， etc.， combed through the inheritance and development of this theory， and explored the contribution of Yishui school on this. It was found that all the physicians of Yishui school， on the basis of inheriting the theory of "supplementation/drainage for bitter-desire of the five viscera"， combined with their own clinical practice to develop this theory， and promoted the application and development of this theory in clinic， such as ZHANG Yuansu's theories of cold-heat deficiency-excess in viscera and bowels， and the theory of viscera and bowels prescription， and LI Gao's theory of ascending and descending， floating and sinking， supplementing and draining in visceral qi， and other academic thoughts rooted in the theory of "supplementation/drainage for bitter-desire of the five viscera" of Elementary Questions. By clarifying the inheritance and development of this theory by physicians of Yishui school， we can deeply understand the connotation and the embedded rules of prescription of this theory， which can not only guide the clinical medication in traditional Chinese medicine， but also provide reference value to the research on the academic thoughts of the Yishui school and the theory of fsupplementation/drainage for bitter-desire of the five viscera.
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Based on the method of regulating qi and resolving toxins， this paper discussed the core pathogenesis of “inflammation-cancer” transformation of ulcerative colitis. It is believed that the disorder of qi movement， endogenous pathogenic factors of “heat， stasis and dampness” are cemented in the large intestine， and the pathogenic factors are too excessive to be solved， which will become toxic after a long time and lead to cancerous changes. Clinical prevention and treatment applies the method of regulating qi and resolving toxins， and the method of regulating qi was proposed as clearing internal qi， regulating blood qi and strengthening spleen qi， so as to clear heat， dissipate blood stasis and dissolve dampness； different methods of regulating qi and resolving toxins were flexibly combined according to the pathogenic characteristics of different stages of toxicity， in order to interrupt the process of “inflammation-cancer” transformation of ulcerative colitis.
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Endothelial cells in the inner wall of blood vessels respond to physical and chemical signals of the body by regulating vascular homeostasis， vascular tension， cell adhesion， cell proliferation， coagulation resistance and inflammatory factors， to maintain the stability of blood vessels. Angiogenesis is the key condition for tumor evolution， and the pathological mode of tumor angiogenesis provides nutrients and oxygen for tumor growth and promotes its proliferation. In recent years， endothelial cells have participated in tumor vascular infiltration and driven angiogenesis， which is considered to be the point link in tumor metastasis. By regulating metabolic remodeling， vascular endothelial cells provide the materials and energy needed in the process of tumor angiogenesis， and their abnormal metabolic characteristics facilitate their adaption to the changes of tumor microenvironment， which is often regarded as an important basis for tumor angiogenesis. The ''Yin fire'' theory in traditional Chinese medicine， originating from Huangdi's Internal Classic （Huang Di Nei Jing）， originally meant Yin deficiency generates internal heat， and belonged to the category of fire of internal injury. After the deduction and changes by physicians over the ages， the pathogenesis of ''spleen and stomach Qi deficiency-Yin fire rising-Qi and fire disharmony'' was gradually formed. The pathogenesis of metabolic remodeling of endothelial cells manifests the pathological characterization of Yin fire in an objective way， which is consistent with the disease state of uncontrolled and hyperactive tumor neovascularization. Changes in spleen and stomach Qi deficiency as well as imbalance of Qi movement lead to the failure of water and food in distribution， and thus metabolic disorders occur. Long term retention turns in phlegm and blood stasis， which combat with blood vessels， and result in abnormal local environment （formation of tumor microenvironment）， adverse pulse channel （imbalance of endothelial cell metabolism）， and tumor neovascularization. Under the guidance of ''Yin fire'' syndrome elements and by focusing on the correlation between Qi and fire， prescriptions are made based on the treatment method of ''strengthening the body and regulating Qi'' to regulate the metabolic function of endothelial cells， thus achieving a relatively balanced state of the body and inhibiting tumor angiogenesis. As a result， this study， centering on the metabolic remodeling of endothelial cells and ''Yin fire'' theory， elucidated the academic ideas， with the purpose of providing some theoretical support for the intervention of tumor vascularization by Chinese medicine.
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Cervical cancer is a gynecological malignant tumor with a high incidence in the world. With the insidious onset and lack of obvious symptoms and signs in the early stage， 13% of cervical cancer patients are diagnosed in the advanced stage of the disease， and the 5-year survival rate of metastatic cervical cancer is only 16.5%. So far， surgery and radiotherapy/chemotherapy are still the basic means for the treatment of cervical cancer. However， with the emergence of toxicity， drug resistance， and other side effects， there are still some limitations in the clinical application of these therapies. In recent years， natural compounds represented by polysaccharides have been found to have a significant anti-cervical cancer effect， which has attracted extensive attention from researchers in China and abroad. Widely distributed in the roots， stems， leaves， flowers， and fruits of higher plants， plant-based polysaccharides are important components of natural polysaccharides， as well as multimers with a complex structure and biological response regulators， which have been widely studied in the fields of cancer， cardiovascular， endocrine， and other diseases. This study reviewed the research on the anti-cervical cancer effect and mechanism of natural plant-derived polysaccharides by consulting the literature in the past 20 years to bring breakthroughs in the research and development of anti-cervical cancer new drugs. Through the literature review， the results indicated that natural plant-derived polysaccharides could exert anti-tumor effects by inhibiting cell proliferation， promoting apoptosis， inhibiting invasion and migration， promoting autophagy， arresting cell cycle of cervical cancer cells， regulating epithelial-mesenchymal transition （EMT）， resisting oxidative stress， inhibiting tumor angiogenesis， improving immunomodulatory activity， and regulating signaling pathways. It should be noted that in the current research on natural plant-derived polysaccharides against cervical cancer， the bioavailability of some natural polysaccharides is low and a considerable proportion of the research is limited to the in vitro experiment. Therefore， it is urgent to carry out more clinical experimental studies on the anti-cervical cancer of natural plant-based polysaccharides to obtain a more reliable theoretical and practical basis.
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Objective:To explore the effects of reducing myeloid-derived suppressor cells (MDSC) of Lewis lung cancer mice by anti-Gr-1 antibody on tumor growth and CD8 + T cell number in peripheral blood, spleen and tumor tissues. Methods:A mouse Lewis lung cancer cells tumor-bearing mouse model was constructed. MDSC were reduced by intraperitoneal injection of anti-Gr-1 antibody every 48 h (observation group), and model mice injected with equal amount of 0.7% NaCl solution were used as control group, and the injections lasted for 3 weeks. Three mice were killed on days 7, 14 and 21 after tumor inoculation. Flow cytometry was applied to dynamically monitor the proportions of MDSC and CD8 + T cells in the peripheral blood, spleen and tumor tissues of mice at different time points. Seven days after tumor inoculation, the longest and shortes diameters of subcutaneous tumors in mice were measured at regular intervals to monitor the tumor size of both groups. Results:The tumor volume in both groups increased with the extension of time, and the increase trend in the observation group was relatively slow. On day 20, the tumor volume in the observation group was smaller than that in the model group [(1 978±315) mm 3 vs. (1 356±432) mm 3, P = 0.001]. On days 7, 14 and 21 after tumor inoculation, the proportions of MDSC and CD8 + T cells in the peripheral blood, spleen and tumor tissues of mice of the observation group were lower than those of the control group. The proportion of MDSC in the peripheral blood of mice of both groups showed an upward trend over time, with the observation group showing a slower upward trend than the control group. The proportion of CD8 + T cells in the peripheral blood of both groups showed an upward trend from day 7 to day 14, and the observation group showed a more significant upward trend. The proportion of CD8 + T cells in both groups showed a downward trend from day 14 to day 21. The changes in the proportions of MDSC and CD8 + T cells in the spleen of mice of both groups were similar to those in the peripheral blood, but the proportion of CD8 + T cells in the control group showed a more significant upward trend than the observation group from day 7 to day 14. The proportion of MDSC cells in the tumor tissues of the control group showed a significant upward trend from day 7 to day 14, and stabilized from day 14 to day 21. The proportion of MDSC cells in the observation group slowly increased from day 7 to day 14, and decreased from day 14 to day 21. The proportion of CD8 + T cells in both groups showed an upward trend from day 7 to day 14, and decreased from day 14 to day 21. Conclusions:Anti-Gr-1 antibody can effectively reduce MDSC in the peripheral blood, spleen and tumor tissues of Lewis lung cancer tumor-bearing mice, and inhibit tumor growth, but also reduce the level of CD8 + T cells in the peripheral blood, spleen and tumor tissues.
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We aimed to study the articles and applied prescriptions of Moutan Cortex in Synopsis of theGolden Chamber, summarize and analyze its laws on the disease location and disease nature, and analyze its compatibility, dosage and processing laws. Based on the knowledge of Moutan Cortex by Zhongjing, we found that the kidney, bladder, uterus and intestine involved in Zhongjing's application of peony bark prescription, which belongs to the disease of "lower abdomen" in Huangdi Nei Jing. And the prescription of Moutan Cortex mainly focused on the syndromes of "depression" and "blood stasis", which are characterised by five kinds: water depression, dampness depression, stasis-heat, blood stasis and ecchymosis. and the compatibility rule of Zhongjing application of Moutan Cortex is analyzed accordingly. In addition, the study found that as the downward movement of the disease position, the amount of Moutan Cortex increased, and the processing of the problem followed the principle of "if disease is slow onset, the Moutan Cortex heart should be removed, but if disease is acute, Moutan Cortex heart should be kept". Finally, we combined modern clinical application of Moutan Cortex with modern pharmacological research, in order to expand the scope of clinical application of Moutan Cortex and "the same treatment of different diseases" to provide theoretical guidance.
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Based on the concept of “imbalance of qi movement with the latent cancer toxin”， it is believed that the development process of tumor pre-metastatic niche （PMN） could be summarized as tumor derived secretory factors， exosomes and other “cancer toxin”， which latent in the body， were diffusion-prone by means of meridians and membrane-sources. Besides， the latent toxin induced the imbalance of qi movement， especially the distant weakest qi， and the local sweat pore and collateral vessels were blocked， which resulted in phlegm and blood stasis， and the cross-aggregation of poison. We also proposed therapeutic principles of PMN as first regulating qi and then clearing and expelling toxin， and tried to discuss the theoretical model of traditional Chinese medicine for PMN based on the theory of qi regulation and detoxification， aimed at providing ideas for the future theory construction of traditional Chinese medicine prevention and treatment for malignant tumor metastasis.
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Objective:To comparatively observe the effects of 20(R)-ginsenoside Rg3 and PEG-PLGA-Rg3 nanoparticles on the Lewis lung cancer mice and to explore the mechanisms of Rg3 and PEG-PLGA-Rg3 nanoparticle anti-cancer in vivo.Methods:Lewis lung cancer mouse model was established and 60 mice were randomly divided into 5 groups with twelve in each group:PEG-PLGA-Rg3 nanoparticles group (Rg3-N),PEG-PLGA group (PEG),Rg3 group (Rg3 ),normal control group (C),saline control group(NS),and received intragastric administration for 1 4 days.The weights of the mice were measured every 2 days and the weight curves were obtained.At the same time,the color pattern,activity and men-tal status were observed.The mice were sacrificed when the administration was over,and the effects of 20 (R)-ginsenoside Rg3 and PEG-PLGA-Rg3 nanoparticles on tumor weight,and the tumor:weight ratios were analysed.In addition,the tumor microvessel density (MVD)was measured by immunohistochemi-cal staining with anti-CD31 antibody to compare the effects of Rg3 and PEG-PLGA-Rg3 nanoparticles on the tumor angiogenesis in vivo.Furthermore,the levels of such angiogenesis and proliferation factors as MMP-9,HIF-1 α,VEGF,Ki-67 were examined by RT-PCR,Western blot and immunohistochemistry to explore the internal molecular mechanisms of anti-tumor effects in vivo.Results:The trends of variation of the mice weights in NS group and PEG group were rising early but declining later.In contrast,the trends of the other three groups were rising early and became stable later.In comparison with NS group, the mice of Rg3 group and Rg3-N group had better general status:brighter color,more active and better spirit.Compared with NS group,the tumor weight in PEG group,Rg3 group and Rg3-N group showed no significant difference but the tumor:weight ratio and MVD in Rg3 group and Rg3-N group declined signi-ficantly (P <0.01 ).Besides,there was no significant difference between Rg3 group and Rg3-N group. At the same time,the level of VEGF mRNA,the protein expression of MMP-9,HIF-1 α,VEGF in Rg3 group and Rg3-N group decreased compared with NS group.Furthermore,the level of each index above-mentioned in Rg3-N group was lower than that in Rg3 group.The expression of Ki-67 in PEG group,Rg3 group and Rg3-N group showed no significant difference compared with NS group.Conclusion:Rg3 and PEG-PLGA-Rg3 nanoparticle may suppress the expression of VEGF,MMP-9 and HIF-1 αin Lewis lung cancer mice,thereby indirectly contributing to their antitumor effects and alleviating the mice’s general status.In addition,PEG-PLGA nanoparticles embedding can promote Rg3 antitumor effect in vivo.
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Recurrence and metastasis are main causes ofsurgical treatment failure of non-small cell lung cancer.In prevention of non-small cell lung cancer recurrence and metastasis,Chinese medicine has achieved a certain effect. It has been proved by clinical use of Chinese patent drugs, compound modification based on syndrome differentiation, integrated traditional Chinese and western medicine treatment, and molecular mechanism of anti-recurrence and metastasis, though there are still some problems. This article reviews the recent clinical and experimental research status.
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Type 17 T helper cells (Th17) are novel subsets of CD4+ effector T cells discovered recently which are different from the traditional type 1 and type 2.They are mainly differentiated from initial T cell precursor.Tumor microenvironmental cytokines can recruit CD4 + Th17 cells from the peripheral blood into tumor sites.And the differentiation of Th17 cells is also affected by tumor microenvironmental factors.Tumorinfiltrating Th17 cells play a dual role for tumor growth in both pro- and anti-tumourigenic processes.A further understanding of the activities of Th17 cells will provide a new breakthrough point for the researches of cancer immunotherapy.
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Based on the theory of tumor angiogenesis,the vascular system is necessary for the advance and metastasis of the tumor.To inhibit or even cure the tumor,the researchers all over the world have made a great many of studies on the mechanism of tumor angiogenesis and have acquired some achievements.Based on the findings,a lot of factors are involved in tumor angiogenesis,and they constitute the complex regulating network through interaction at the molecular and cellular level.
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The theory of formulas corresponding to syndromes is one of the characteristics of Treatise on Cold Damage and Miscellaneous Diseases (Shanghan Zabing Lun) and one of the main principles in applying classic prescriptions. It is important to take effect by following the principle of formulas corresponding to syndromes. However, some medical practitioners always feel that the actual clinical effect is far less than expected. Six errors in the use of classic prescriptions as well as the theory of formulas corresponding to syndromes are the most important causes to be considered, i.e. paying attention only to the local syndromes while neglecting the whole, paying attention only to formulas corresponding to syndromes while neglecting the pathogenesis, paying attention only to syndromes while neglecting the pulse diagnosis, paying attention only to unilateral prescription but neglecting the combined prescriptions, paying attention only to classic prescriptions while neglecting the modern formulas, and paying attention only to the formulas but neglecting the drug dosage. Therefore, not only the patients' clinical syndromes, but also the combination of main syndrome and pathogenesis simultaneously is necessary in the clinical applications of classic prescriptions and the theory of prescription corresponding to syndrome. In addition, comprehensive syndrome differentiation, modern formulas, current prescriptions, combined prescriptions, and drug dosage all contribute to avoid clinical errors and improve clinical effects.
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Objective Observing the effect of Shuganyishen formula on hormone-dependant metastatic breast cancer and the mechanisms of anti-resistance and endocrine therapy. Methods 226 ITT cases were divided into two cohorts by treatment. 126 cases were treated with the combination of Shuganyishen formula and standard western medicine including endocrine therapy, and 100 cases were treated with western medicine alone. The end points were time to progress (TTP) and overall survival and quality of life (QOF). The effect of Shuganyishen formula on growth of TAM-resistance cell line in vitro was observed. Results There were statistical significances of median TTP between combination and western medicine in Luminal A (ER+ /PR+, HER2-) as well as Luminal B (ER+/PR+, HER2+), but no significances of OS; The extent and incidence of hot flush, sweat and syndromes related to bone were decreased significantly in combination treated group. Shuganyishen formula could reverse resistance to TAM. Conclusion Patients with LuminalA and LuminalB metastatic breast cancer benefit from Shuganyishen formula, which maybe related with its reverse resistance to endocrine therapy.
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Inflammatory microenvironment plays a key role in the tumor recurrence and metastasis.The inflammation of tumor microenvironment can start the tumor metastasis by regulating epithelial-mesenchymal transition ;can improve the tumor invasion by degradation the extracellular matrix;in addition to,inflammation can supply appropriate microenvironment for tumor vascular angiogenesis.
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<p><b>BACKGROUND</b>It has been known that there are declines of dendritic cell (DC) count and its function in the peripheral blood of patients with non-small cell lung cancer (NSCLC), which are remarkably related to the proceeding and prognosis of NSCIC. The aim of this study is to investigate the relationship and clinical significance between the DC subsets (CD11c+DC and CD123+DC) and immunology state of patients with advanced NSCLC.</p><p><b>METHODS</b>Flow cytometry was used to detect DC subsets, T cell subsets, NK cell percentage in the peripheral blood of 40 patients with advanced NSCLC and 10 healthy controls.</p><p><b>RESULTS</b>The expression of CD11c+DC (0.38%±0.18%) in the peripheral blood of advanced NSCLC patients, was decreased significantly compared with that of normal controls (0.66%±0.24%) (P < 0.01). The expression of CD123+DC in the peripheral blood of advanced NSCLC patients was (0.28±0.17)%, with no significant difference compared with that of normal controls (0.27%±0.11%) (P > 0.05). The percentage of CD3+ T cell and CD4+/CD8+ of patients with advanced NSCLC were significantly lower than those of normal controls (P < 0.01 and P < 0.05), and the percentage of CD8+ and NK cell of patients were higher than those of normal controls (P < 0.05). The correlation analysis showed that CD123+DC percentage was positively correlated to CD3+T cell percentage (P < 0.05) and negatively correlated to NK cell percentage (P < 0.01). The expression of DC subsets correlated with KPS and chemotherapy history of patients (P < 0.01).</p><p><b>CONCLUSIONS</b>The advanced NSCLC may induce significant decreasing expression of CD11c+DC and may induce significant decrease of immunology state. There are close relationship among the expression of DC subsets and the immunology state of patients as well as the clinical biological behaviors of patients with advanced NSCLC.</p>
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Objective To study the clinical effect and influence of Feiliuping Ⅱ on the quality of life quality of lung cancer patients. Methods 60 patients of later stage of lung cancer with definite diagnosis and stages in pathology were chosen, who had approximate condition. Among them, 30 cases were in Chemotherapy-only group, and 30 cases were in Feiliuping Ⅱ +Chemotherapy group. Chemotherapy was the treatment in Chemotherapy-only group. Besides chemotherapy, Feiliuping Ⅱ was taken orally, 20 g tid poin Feiliuping Ⅱ +Chemotherapy group. Three months were a period of treatment. To evaluating effect of two groups from clinical curative effect, symptoms changes, and quality of life. Results After treatment, stable rate of focus were notably higher in Feiliuping Ⅱ +Chemotherapy group than that in Chemotherapy-only group (P