TCM Intervention in Progression of Esophageal Precancerous Lesions into Esophageal Cancer： A Review / 中国实验方剂学杂志

China has a high incidence of esophageal cancer，more than 90% of which are esophageal squamous cell carcinoma （ESCC）. Abnormal proliferation，migration and new microvessels of intraepithelial neoplasia cells are the important pathogenic links in the transformation from esophageal intraepithelial neoplasia （EIN） to ESCC. Studies on the progression of esophageal precancerous lesions into esophageal cancer mostly focus on environment and genetic susceptibility，such as inflammatory factors，abnormal vascular endothelial growth factor （VEGF） signaling pathway transduction，p53 gene mutation，and DNA methylation. Some pharmacology studies have confirmed that traditional Chinese medicine （TCM） can inhibit inflammatory factors，regulate abnormal signaling pathways and improve the microenvironment. A large number of patients with esophageal cancer have been found to be in advanced stage，and the 5-year survival rate is low even after active treatment. The quality of life of patients in advanced stage is worrying due to esophageal obstruction and lung infection，and therefore， early prevention is important. Early intervention in patients with esophageal precancerous lesions is in line with clinical needs and embodies the TCM theory of “treating disease before its onset.” The mechanism of action and clinical efficacy of TCM has been gradually confirmed and promoted， with certain clinical significance. To explore simple，economical and effective TCM intervention measures conforms to the clinical diagnosis and treatment standards and the modernization of TCM.

Research status on efficacy enhancement and toxicity reduction of Chinese medicine in treatment of malignant tumors: a review of projects supported by National Natural Science Foundation of China / 中国中药杂志

Through a retrospective analysis of the projects supported by the National Natural Science Foundation of China in the past ten years in the field of Chinese medicine for the treatment of malignant tumors, this article systematically summarized the main research contents and hotspots of Chinese medicine in efficacy enhancement and toxicity reduction. The efficacy enhancement of Chinese medicine mainly included the mitigation of molecule-targeted drug resistance, multidrug resistance, and chemotherapy resistance, synergistic efficacy enhancement, and radiotherapy sensitization. The toxicity reduction is mainly reflected in the alleviation of the side effects of radiotherapy and chemotherapy. In addition, Chinese medicine has advantages in reducing serious adverse reactions of malignant tumors, providing more options for the adjuvant treatment of tumors.

Clinical Observation of Effects of Modified Xiangsha Liujunzi Tang Application on Adverse Reaction of Moderately/Highly Emetogenic Chemotherapy for Gastrointestinal Tumors / 中国实验方剂学杂志

Objective:To investigate the effects of external application of modified Xiangsha Liujunzi Tang in improving gastrointestinal reaction，immune function， and quality of life in patients with gastrointestinal tumors after moderately/highly emetogenic chemotherapy. Method:A total of 140 inpatients （from January 2018 to May 2021） with gastrointestinal malignancies diagnosed by the Oncology Department of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital and treated with moderately/highly emetogenic chemotherapy were randomly divided into an experimental group （<italic>n</italic>=70） and a control group （<italic>n</italic>=70） according to the Good Clinical Practice （GCP）. Participants were given routine antiemetic treatment once 20 minutes before chemotherapy （tropisetron 5 mg + dexamethasone 5 mg or methylprednisolone 40 mg）. On this basis， the patients in the experimental group were treated with external application of modified Xiangsha Liujunzi Tang for 1 week on the second day after chemotherapy （the selected points were Zhongwan， Neiguan and Zusanli， 6 hours a day， and the application was changed every day）， and the patients in the control group were applied with comfort patch at the same time. The gastrointestinal reaction grade， subset concentration of lymphocytes， and Karnofsky score in two groups before and one week after chemotherapy were recorded， and all data were analyzed by SPSS 19.0 statistical software. Result:The grades of chemotherapy-related gastrointestinal reaction in two groups after treatment decreased as compared with that before treatment （<italic>P</italic><0.05）. The experimental group was superior to the control group after treatment in terms of grade decrease （<italic>P</italic><0.05）. The total response rate of the experimental group was 81.43% （57/70）， higher than 62.86% （44/70） in the control group （<italic>χ</italic>²=9.73， <italic>P</italic><0.05）. Stratified analysis was performed on the experimental group. Compared with the conditions before treatment， the grade of gastrointestinal reaction in patients with esophageal cancer and colorectal cancer of the experimental group decreased after treatment （<italic>P</italic><0.05）， and that in patients of different genders decreased after treatment （<italic>P</italic><0.05）. The results of immune function showed that there was no significant difference in the concentrations of CD3⁺， CD4⁺， CD8⁺， and NK cell subsets of the control group before and after treatment， while the concentrations of CD3⁺， CD4⁺， and NK cell subsets of the experimental group were higher than those before treatment and even superior to those in the control group （<italic>P</italic><0.05）. The Karnofsky score of quality of life in the experimental group was higher than that in the control group， with quality of life improved （<italic>P</italic><0.05）. Conclusion:External application of modified Xiangsha Liujunzi can improve the gastrointestinal reaction，immune function， and quality of life of patients with gastrointestinal tumors after moderately/highly emetogenic chemotherapy.

A preliminary analysis on using traditional Chinese medicine differentiation thinking for treatment of pancreatic pseudocyst induced by severe acute pancreatitis / 中国中西医结合急救杂志

Pancreatic pseudocyst (PPC) is one of the common peri-pancreatic complications of severe acute pancreatitis (SAP), and it belongs to the category of Zhengjiajiju in traditional Chinese medicine (TCM). Clinically, skilled use of surgical minimally invasive means combined with TCM treatment has remarkable advantages in promoting the rate of cystic absorption, reducing the surgical intervention rate, lowering the incidence of complications, etc. TCM syndrome differentiation treatment for SAP complicated with PPC can start from Shaoyang meridian lesions, and the treatment of Shaoyang liver and gallbladder visceral disease can be taken as an example. The clinical therapeutic result is significant by using soothing liver and normalizing gallbladder function, removing stagnancy and obstruction of the fu-organs and invigorating blood circulation and softening hard mass as the basic TCM rules to dialectically use the PPC basic prescription, locally accompanying with external therapy. The discussion of this article focuses on the experience of using TCM syndrome differentiation for treatment of patients with PPC induced by SAP.

Effect of bile duct ligation and recanalization on rat hepatocyte epithelial-mesenchymal phenotype and NOX4 protein expression / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe epithelial-mesenchymal phenotypes and oxidative stress related protein expressions of the liver cells in a rat model of liver fibrosis induced by bile duct ligation and recanalization.</p><p><b>METHODS</b>Twenty-four male Wistar rats were randomized into 4 groups, including a sham-operated group, two bile duct ligation groups with ligation for 2 and 4 weeks, and a bile duct ligation group with a 2-week ligation followed by a 2-week recanalization. HE staining and Masson staining were used to assess liver fibrosis in the rats, and immunohistochemistry and Western blotting were employed to detect expressions of the epithelial and mesenchymal marker proteins and oxidative stress-related proteins.</p><p><b>RESULTS</b>Compared with the sham-operated group, the rats with bile duct ligation showed obvious liver fibrosis, which worsened as the ligation time extended, accompanied by significantly increased expression of α-SMA, collagen I, NOX(4) and vimetin and reduced E-cadherin expression. Compared with the rats with bile duct ligation for 4 weeks, the rats in bile duct ligation-recanalization group showed obviously lessened liver fibrosis, significantly lowered expressions of NOX(4) and mesenchymal cell maker proteins, and enhanced expressions of epithelial cell marker proteins.</p><p><b>CONCLUSION</b>Bile duct ligation up-regulates mesenchymal phenotype-related proteins and NOX(4) protein expression and down-regulates the expression of epithelial phenotype-related proteins, and these changes can be reversed by subsequent bile duct recanalization.</p>