Guidelines for Traditional Chinese Medicine Diagnosis and Treatment of Metastatic Colorectal Cancer / 中国实验方剂学杂志

Colorectal cancer is one of the most common malignant tumors of digestive tract. In 2020， 1.93 million new cases of colorectal cancer were diagnosed globally， ranking third in the global incidence spectrum， and 930 000 new deaths were reported， ranking second in the global cause of death spectrum. Meanwhile， the medical cost of metastatic colorectal cancer is the highest among all stages. A large number of studies have demonstrated that traditional Chinese medicine（TCM） treatment can bring clinical benefits to patients with metastatic colorectal cancer with unique efficacy. In order to further standardize the TCM diagnosis and treatment for metastatic colorectal cancer and improve the level of TCM diagnosis and treatment， Xiyuan Hospital， China Academy of Chinese Medical Sciences， together with other relevant units in China， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the relevant requirements of the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， the Regulations for Group Standards of China Association of Chinese Medicine and others， combined with the characteristics of TCM diagnosis and treatment and the actual situation in China， the Guidelines for TCM Diagnosis and Treatment of Metastatic Colorectal Cancer was developed in accordance with the Catalogue of TCM Diagnosis and Treatment Plans for 105 Diseases in 24 Specialties issued by Department of Medical Administration of National Administration of TCM.

Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer / 中国实验方剂学杂志

In recent years， the incidence of colorectal cancer has been rising in China， and with the promotion of early screening and early diagnosis， most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless， 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety， depression， and fear of recurrence and metastasis， and they hope to seek help from traditional Chinese medicine（TCM） treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery， and to improve the diagnosis and treatment level， under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM， experts in oncology， integrated Chinese and western medicine， psychology， surgery， nursing， evidence-based medicine and other disciplines from 10 units nationwide participated in the work， led by Xiyuan Hospital，China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine， the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence， extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics， the needs and willingness to accept psychological rehabilitation， the interventions for psychological rehabilitation， evaluation of efficacy， follow-up review， educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM（integrated Chinese and western medicine） clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology， especially for doctors in primary medical institutions.

Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer / 中国实验方剂学杂志

Colorectal cancer is one of the common malignant tumors with high morbidity， and changes in lifestyle， dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine（TCM） can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer， and have proved that TCM has unique efficacy， but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， under the framework of relevant laws， regulations and technical guidance documents， combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation， and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology， pathogenesis， syndrome differentiation and treatment of TCM intervention for colorectal cancer， which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.

Discussion on Mechanism of Danggui Buxue Decoction in treatment of chemotherapy-induced myelosuppression based on network pharmaccology and molecular docking / 国际中医中药杂志

Objective:To screen the main active components of Danggui Buxue Decoction in improving chemotherapy-induced myelosuppression; To predict the key targets and signaling pathways; To establish a multi-level network structure and comprehensively reveal the synergistic mechanism of Danggui Buxue Decoction in improving chemotherapy-induced myelosuppression.Methods:Main components of Danggui Buxue Decoction were searched in TCMSP detabase, combined with literature reports to supplement and improve information. The protein targets of compounds were standardized in the UniProt protein database. Myelosuppression targets were obtained by querying TTD database, GeneCards database, DrugBank detabase and OMIM database. The effective components and common targets of Danggui Buxue Decoction were screened, and the protein-protein interaction (PPI) network of intersection targets was analyzed by String platform to construct the PPI network of effective components and disease targets. Gene ontology (GO) analysis and enrichment pathway analysis of Kyoto gene and genome encyclopedia (KEGG) of key target proteins were conducted through Metascape data platform. Both the results of GO and KEGG analysis were presented. AutoDock software was used for molecular docking to explore the interaction between core targets and active components, and the results were imported into PyMOL software for visual analysis.Results:Danggui Buxue Decoction has a total of 22 active components of Chinese materia medica for improving chemotherapy-induced myelosuppression, 294 potential targets, 3 301 disease targets, and 210 common targets of Chinese materia medica and diseases. Core targets were obtained through network topology analysis and molecular docking. The first five were ESR1, MAPK1, RELA, AKT1, PIK3R1; GO enrichment results obtained 2 430 biological processes, 125 cellular components and 217 molecular functions, including responses to inorganic substances, membrane rafts, micro-organisms membrane region, transcription factor binding, etc.; KEGG enriched 385 pathways, of which cancer pathway, PI3K-Akt signaling pathway, AGE-RAGE signaling pathway, etc. were the main signaling pathways; molecular docking results showed that β-sitosterol has the best binding performance with HSP90AA1, formononetin and RELA in astragalus when it was in Angelicae Sinensis Radix.Conclusion:Danggui Buxue Decoction regulates ESR1, MAPK1, RELA, AKT1 and other core targets through various active components such as quercetin, formononetin, and β-sitosterol. PI3K-AKT and other related signaling pathways can improve chemotherapy-induced myelosuppression and provide a basis for its clinical application.

Network pharmacology-based mechanism of Sijunzi Decoction in treatment of colorectal cancer / 国际中医中药杂志

Objective:To explore the potential target and signaling pathway of Sijunzi Decoction in treating Colorectal Cancer (CRC) with network pharmacology.Methods:The Traditional Chinese Medicine System Platform (TCMSP) and Swiss Target Prediction database were adopted to establish the database of Sijunzi Decoction effective ingredients and targets. Therapeutic Target Database (TTD), Online Mendelian Inheritance in Man, Drugbank and GeneCards were used to build the CRC target database. The common gene names of target proteins were checked in Uniprot database. The STRING database was applied to analyze the interactions between the targets and the DAVID was used for the enrichment analysis on gene ontology (GO) biological process and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway. The network topology results were analyzed by Cytoscape 3.7.1 software.Results:134 active compounds of Sijunzi Decoction were gained, and PPI includes 125 targets protein (TP53,AKT1,IL-6,et al.). The 516 cellular biological processes, 53 cellular component and 98 molecular function were obtained through GO biological process enrichment analysis. The result of KEGG pathway enrichment showed that PI3K-Akt signaling pathway, TNF signaling pathway and FoxO signaling pathway were the main pathways.Conclusion:Sijunzi Decoction is mainly used to treat CRC by regulating key proteins such as TP53,AKT1, IL-6 and interfering with signal pathways such as PI3K-Akt, TNF and FoxO, reflecting the characteristics of Sijunzi Decoction in the treatment of CRC with multi-component,multi-target and multi-pathway characters.

Discussion on Methods for Tied Survival Times in Cox Model / 世界科学技术-中医药现代化

Cox regression model is one of the most widely used methods in the survival analysis.One assumption of this model is that there is no tie in the failure times,that is,individual has different failure times.In practical applications,the existence of ties in time data is very common.In this paper,four common methods of dealing with ties in Cox model,including Exact method,discrete model method,Efron method and Breslow method,were compared with simulation.The results showed that Exact method and discrete model were the best,but they took the longest time.Efron method and Breslow method were faster but there was a greater deviation in parameter estimation.Moreover,the sample amount and ties degree also affect the results.In general,when there are a few ties,the difference between four methods was small;and in the case of large datasets or a large number of ties,the bias of three approximation methods increased except Exact method.However,there was no significant change on computational time.While the computational time of the Exact method increased rapidly.Therefore,if the estimation precision is not as important as the estimation time,Efron method and Breslow method will be good choices.Efron method is more preferably as it is more precise.And Breslow method tends to underestimate the true β.If there is no limit in time,Exact method and discrete model can be chosen to achieve more accurate results.

Clinical Observation on Traditional Chinese Medicine Dietary Therapy for Improving Symptoms of Cancer Patients with Chemotherapy / 世界科学技术-中医药现代化

This study was aimed to verify the effect of traditional Chinese medicine (TCM) dietary therapy in improving symptoms induced by chemotherapy.A total of 20 patients were included in the study according to the inclusion and exclusion criteria.The randomized autocontrol double-blind method was used in the trial.In group A,the dietary therapy was used in the first chemotherapy cycle,and the control therapy was used in the second chemotherapy cycle;and vice versa for group B.There were 3 cases fell out of the study.Finally,there were 8 cases in group A and 9 cases in group B.There were all together 17 patients.Observations were given on patients from both groups for 2 cycles.So the total observed case number was 34 person-time.Observations were given on differences of quality of life (QOL) and unpleasant symptoms (including fatigue,poor appetite,dry stool,loose stool,nausea and vomiting,night sweating,spontaneous sweating,dry mouth and throat,bitter taste in the mouth,pain,restlessness and irritable,insomnia and other symptoms) by TCM dietary therapy and control therapy on cancer patients during chemotherapy.The results showed that there was significant difference on the tenth day of chemotherapy from the QOL (P＜0.05).There was significant difference on the tenth day of chemotherapy from the total score of unpleasant symptoms (P＜0.05).Among them,there were significant differences on fatigue and poor appetite on the tenth day of chemotherapy (P＜0.05).It was concluded that TCM dietary therapy has certain effects in the improvement of patients' clinical symptoms during chemotherapy.On the tenth day of chemotherapy,the unpleasant symptoms of TCM dietary therapy group were lower than that of the control group (P＜0.05);the QOL score was higher in the treatment group than that of the control group (P＜0.05).After in-depth discussion,there was statistical significance on dietary therapy in improving fatigue and poor appetite in the dietary therapy group.It demonstrated that TCM dietary therapy help patients during chemotherapy.

Mass spectrometry-based proteomic approaches to study pathogenic bacteria-host interactions

Elucidation of molecular mechanisms underlying host-pathogen interactions is important for control and treatment of infectious diseases worldwide. Within the last decade, mass spectrometry (MS)-based proteomics has become a powerful and effective approach to better understand complex and dynamic host-pathogen interactions at the protein level. Herein we will review the recent progress in proteomic analyses towards bacterial infection of their mammalian host with a particular focus on enteric pathogens. Large-scale studies of dynamic proteomic alterations during infection will be discussed from the perspective of both pathogenic bacteria and host cells.

"Experience of Professor Yang Yufei Using ""Tri-Traffic Dredging Liver And Nourishing Kidney Formula""in the Treatment of Breast Cancer with Traditional Chinese Medicine Combined with Western Medicine" / 世界科学技术-中医药现代化

Professor Y ang Y ufe i is the director and founder of the Oncology Department of X iyuan Hospital of China Academy of Chinese Medical Sciences. Professor Y ang Y ufei thinks highly of the treatment of breast cancer with harmonizing and dredging principle combining traditional Chinese medicine (TCM) and western medicine. She regards the basic pathogenesis of breast cancer is not only on traditional liver-kidney yin deficiency and liver-qi stagnation with spleen deficiency, but also three mechanisms which are breakdown of the normal physiological coordination be-tween the liver and kidney, heart and the kidney and Shaoyang. Professor Y ang gradually formed Tri-Traffic Dredg-ing Liver And Nourishing Kidney Formula base on tonification and purgation in combination. Y ang Y ufei thinks highly of combining treatment of TCM and western medicine, especially combined with endocrine therapy. Professor Y ang also pays much attention on immune function of patients and health education.

Analysis on Medication Rules of Using Chinese Medicine in Reducing Recurrence and Metastasis of Stage II and III Colorectal Cancer among Postoperative Patients / 世界科学技术-中医药现代化

This study was aimed to analyze the living status and medication rules of traditional Chinese medicine (TCM) treatment of postoperative patients with stage II and III colorectal cancer by Prof. Y ang Y ufei. A total of 70 postoperative patients with stage II and III colorectal cancer were enrolled in the cohort study at the Xiyuan Hospital from September 2007 to August 2009. The out-patient records were reviewed and follow-ups were given for the analysis. The results showed that until July 2013, the loss to follow-up rate was 8.6%, which was less than 15%. The four-year postoperative recurrence and metastasis rates of the high and low exposure group were 7.1% and 25.0%, respectively. The Fisher exact probability test showed that the high exposure and long period therapy of TCM treatment can significantly reduce the recurrence and metastasis rate of patients (P < 0.05). The analysis of Prof. Y ang Y ufei's medication rules in TCM treatment of postoperative colorectal cancer showed that the syndrome differ-entiation pattern with the highest frequency was spleen-stomach deficiency pattern; and the liver-kidney yin defi-ciency pattern was in the second place. The prescriptions used with the highest frequency were Si-Jun-Zi Decoction and Liu-Wei-Di-Huang Decoction. It was concluded that the comprehensive TCM treatment can improve the prog-nosis of stage II and III colorectal cancer. The treatment also has certain meaning in the reducing of the recurrence and metastasis rate of patients, and prolonging the time of the recurrence and metastasis.

Randomized Controlled Trial on Effectiveness of Traditional Chinese Medicine Five Elements Music Therapy in Improving Quality of Life for Senior and Non-senior Advanced Cancer Patients / 世界科学技术-中医药现代化

This study was aimed to evaluate effects of traditional Chinese medicine ( TCM ) five elements music therapy on the quality of life for both senior and non-senior advanced cancer patients , and improve TCM com-prehensive treatment mode . A total of 170 patients were stratified according to 70-year-old in a randomized controlled trial ( RCT ) with a parallel single-blind design . The ratio of patients among three groups was 2:2:1 . In the experimental group , TCM five elements music was given in the treatment . In the positive control group , western music was used in the treatment . And in the negative control group , no music was given in the treat-ment . The treatment was given for 30 min , 5 times per week . And the observation duration was 3 weeks . The Hospice Quality of Life Index-Revised ( HQOLI-R ) , Karnofsky Performance Scale ( KPS ) and Symptom Diary Score recorded by patients were used in the evaluation . The results showed that when comparing HQOLI-R , KPS and Symptom Diary Score before and after treatment among all advanced cancer patients in each group , there was a significant difference before and after treatment in the TCM five elements music therapy group ( P 0 . 05 ) . It was concluded that TCM five elements music therapy is effective in improving quality of life and subjective symptoms for both senior and non-senior advanced cancer patients . However , the sensitivity of using the Symptom Diary Score as an evaluation index among senior patients still needs to be further proved .

Preventive effect of Chinese traditional medicine-Qing-Xue granula on radiation induced lung injury in mice / 中华放射肿瘤学杂志

ObjectiveTo evaluate whether oral administration of Chinese tradiational medicine,Qing-Xue granula,can prevent mouse lung injury caused by thoracic radiation.Methods128 BalB/C mice were divided into 4 groups:control (C) group; radiation (R) group; radiation plus high dose Qing-Xue granula (H) group and radiation plus median dose Qing-Xue granula ( M ) group.The H and M groups were fed 0.64 g and 0.32 g of Qing-Xue granula dissolved in 0.5 nl anline once daily for two months,which were 4 and 2 times of human dosage,respectively.Whole thorax radiation of 12 Gy was delivered with a single ventral-dorsal field with 6 MV X-ray.Group C and group R received 21 days of 0.5 ml saline feeding.Mice were sacrificed at 1,2,4 or 6 months after radiation. Macrophage cell count of lung lavage fluid and hydroxyproline content of left lung were assayed,and the lung fibrosis was scorred according to the Ashcroft's criteria.The plasma interleukin-6 (IL-6) and vascular endothelial growth factor (VEGF) concentration were assayed with ELISA method.The One-way ANOVA was used to test the significance of any differences between groups at each time point. Results The macrophage cell number of lung lavage fluid was significantly lower in the 1st month in group M than in group R (2∶4,q =3.92,P ＜ 0.05 ),but had no significant difference between group M and C ( 1 ∶ 4,q =2.13,P＞0.05 ).The hydroxyproline content of group H was significantly lower than group R in the 1st and 6th months (q =3.62,3.54,all P ＜ 0.05 ),but still higher than group C ( q =4.09,3.72,all P ＜ 0.05 ).The fibrosis score of group H was significantly lower than group R in the 2nd,4th and 6th months (q=3.38 -4.16,all P＜0.05).The IL-6 concentration of group H was significantly lower than group R in the 1st month ( q=3.53,P＜0.05 ),but not significantly higher than group C (q =1.41,P＞0.05).The VEGF concentration was significantly higher in group R than group C since the 2nd month ( q =3.12 - 3.78,P ＜ 0.05 ).The VEGF concentration was significantly higher in group H and M than group R in the 2nd and 6th months ( q =3.08 - 3.92,all P ＜ 0.0 5 ).Conclusions Oral Chinese traditional medicine,Qing-Xue granula,could prevent radiation induced lung fibrosis in mice,especially at high dosage.The degree of elevation of VEGF in plasma was not parallel with that of lung fibrosis.

Theoretic Exploration to Tongyang Method Preventing and Treating Colon and Rectal Cancer / 浙江中医药大学学报

Combining with ancient people's experience and modern prevention and treatment on colon and rectal cancer,it views that the basic causa morbi is blocked collaterals,and the local is not reached by Yang Qi,which is also the basic mechanism of recurrence and diversion of the disease.Thereby it puts forwards "Tong(smooth) Yang" is the main discipline of the cancer;the pathogen-removing capsule made under "Tong Yang " theory displays the advantage of TCM therapy in preventing and treating colon and rectal cancer.

Clinical Analysis of Comprehensive Therapy with Database in Advanced Non-small Cell Lung Cancer / 医学研究杂志

Objective To analyze the effect of on comprehensive therapy advanced non-small cell lung cancer,and summarize the clinical experience.Methods Based on the comprehensive therapy characteristic,we designed a clinic cases analysis database using the SQL sever database technique.Results In the 102 patients with advanced non-small cell lung cancer in the Xiyuan Hospital,the mean survival period was 11.5 months and the 1 year survival rate was 37.5%.The weight was stable and KPS was increased.There was significant difference in the improvement of mental weariness and hypodynamia,deficient breath and indolence,cough,abundant sputum,pain,anorexia,sputum mixed with blood,constipation,abdominal diarrhea and distention(P

Microarray gene chip analysis and action of yiyiren oil on anti-tumor metastasis reactive gene / 中国组织工程研究

BACKGROUND: From yiyiren oil is extracted kanglaite injection that has been extensively used against lung cancer for its function against cancer. It is revealed that kanglaite injection inhibits many strains of cancer cells including LA795 metastatic lung cancer. Genechip is used here for detection of metastasis reactive differentially expressed genes in mice that carry LA795 metastatic lung cancer.OBJECTIVE: To detect the metastasis reactive diferentially expressed genes with genechip technology in metastatic cancer carrying mice that treated with y iyiren oil injection(kanglaite injection).DESIGN: It was a controlled trial with mice as subjects.SETTING: Oncology Department of Xiyuan Hospital Affiliated to China Academy of Traditional Chinese Medicine.MATERIALS: The trial was conducted from February through August 2003. Forty mice were implanted with T739 strain lung adenocarcinoma cells and were randomly and averagely assigned into 2 groups.METHODS: mRNA probe was made from cancer sample of the mice. ScanArray 3000 scanner was used to scan the fluorescence signal in cDNA expression genechip that contained 4096 mouse genes in order to detect the differentially expressed genes.MAIN OUTCOME MEASURES: The differentially expressed genes in the two groups of mice.RESULTS: The mice genes expressed differentially between the kanglaite injection group and control group. After examination being repeated for 3 times, 27 genes presented different expression; 25 genes expression increased in both groups and 2 genes decreased. Among these differentially expressed genes, 12 genes were of the mouse muscle cDNA. It was also observed that 6 genes might be associated with the occurrence and development of tumor.CONCLUSION: Gene expression spectrum genechip is useful in effectively detect the relevent differentially expressed gene induced by kanglaite injection.

Study on the gene expression patterns of KANGLAITE in anti-lung metastasis of LA795 mouse / 中国肺癌杂志

<p><b>BACKGROUND</b>To screen the differential expression genes of KANLAITE in anti-tumor metastasis.</p><p><b>METHODS</b>mRNA was extracted and purified from the lung of the mouse with LA795 lung metastasis, hybridized respectively on 4 096-gene chip. cDNA microarray was scanned for the fluorescent signals and analyzing difference expression.</p><p><b>RESULTS</b>Twenty-seven differential expressed genes were obtained. Among these genes, 25 were up-regulated and 2 were down-regulated. Twelve of them were Mus musculus cDNA clone. Six genes related with genesis, development and metastasis of tumor.</p><p><b>CONCLUSIONS</b>cDNA microarray for analysis of gene expression patterns is a powerful method to identify differential expressed genes. In this study, 6 genes are thought to be associated genes of KANGLAITE in anti-tumor metastasis.</p>

The application of traditional Chinese medicine synthetic effect criteria in the late stage lung cancer / 中国组织工程研究

Objective To inspect the correlation of synthetic effect criteria to sensitivity,reliability of late stage lung cancer curative effect verdict and median survival time. Method Using size change of tumor,symptom change related to tumor,Karnofsky score,body weight etc.as synthetic effect criteria and nstituting clinical synthetic effect criteria,to assess the curative effect of late stage lung cancer patients who received different treatment in department of tumor of Xiyuan Hospital between March 1997 and March 2000, to analysis medium survival time, and being compared with RR of tumor.Result 52 patients entered this experiment, in which 42 patients were assessable (follow up), 13 patients were effective(30.95％ ),17 were patients stable(40.48％ ),12 patients deteriorated (28.57％ ).The result of tumor objective remission rate: CR is 0,PR is 16.67％ (7 patients),NC is 64.29％ (27 patients) and PD is 19.05％ (8 patients).There was apparent difference between two effect criteria(P< 0.05).The mean survival time of this group is (9.3± 1.6)months,median survival time is 10.5 months(2～ 8months),survival rate of one year is 33.33％ (14 patients).In the patients who live longer than median survival time, most of them survive associated with tumor existence who are in NC of tumor objective remission rate, but also in the effective column of synthetic effect criteria. Compared with tumor objective remission rate,the synthetic effect criteria have more apparent correlation to survival time. Conclusion In the assessment of late stage lung cancer,synthetic effect criteria has better sensitivity and reliability,and emphasize survival quality,at same time it reflect the reaction of tumor and host to treatment,it reflect prognosis of tumor preferably and have better correlation to the survival time. It can be used as clinical effect criteria of late stage lung cancer after further consummation.