对左明焕教授治疗肺癌的用药规律及经验进行归纳总结.左教授认为肺癌发病是以正虚为本,痰、瘀、湿、毒积聚为标,在临床中多以培补正气、化痰祛瘀、解毒散结、利水渗湿为法;并且注重脏腑之间五行生化联系,兼顾肺、脾、肾三脏,喜用培土生金法、肺肾同治法调治上下.附验案2则.

《理瀹骈文》是中国历史上第一部论述中医外治法的专著,该书以理、法、方、药俱全,治法简、便、效、廉等特点被人们称作"外治之宗".书中提出的"外治亦本于辨证""三焦分治""拔截相得""膏统百病""针药并用"等思想对胃肠恶性肿瘤的综合治疗亦有重要的指导意义,文章就以上外治思想在胃肠恶性肿瘤术后胃瘫、肠梗阻,化疗相关恶心呕吐、放射性肠炎及晚期患者腹水、癌痛控制等方面的应用进行详细阐述,以期为胃肠恶性肿瘤的综合治疗提供更多元化的治疗思路及方法.

目的 挖掘名老中医从瘀论治胃癌的组方规律,并基于网络药理学探讨核心药物的分子作用机制.方法 计算机检索中国知网、万方、维普数据库2000年1月1日—2019年10月1日名老中医治疗胃癌的相关文献,结合人工检索书籍的方式收集名老中医处方;采用古今医案云平台(V1.5.6)对纳入处方的常用药对、核心药物组合等进行分析;采用中药系统药理学数据库和分析平台(TCMSP)、GeneCards及在线人类孟德尔遗传数据库(OMIM)筛选药物靶点和疾病靶点相互作用的有效靶点,并将有效靶点导入String数据库得到蛋白-蛋白相互作用(PPI)网络,利用R软件对有效作用靶点进行基因本体(GO)分析及京都基因和基因组百科全书(KEGG)通路富集分析.结果 共纳入处方68首,得到8个核心药物,筛选出131个活性成分,获得62个核心药物有效作用靶点.GO功能分析集中在类固醇激素反应、对有毒物质的反应、细胞核受体活性等,KEGG分析可得主要作用通路为PI3K-Akt信号通路、细胞凋亡、MAPK信号通路、缺氧诱导因子-1(HIF-1)信号通路等.结论 本研究结果提示活血化瘀核心药物主要通过影响细胞周期、促进细胞凋亡、逆转化疗耐药性、影响血管生成对胃癌发挥作用,为后期实验研究提供了理论依据.

目的 使用网络药理学研究方法构建半枝莲-半边莲药对基于多成分、多靶点、多通路作用于胃癌的机制.方法 利用TCMSP、TCMID、PharmMapper数据库获取药物有效活性成分及药物对应潜在靶标,利用GeneCards、OMIM及DisGeNET数据库筛选胃癌相关靶点;利用String数据库及Cytoscape 3.7.2构建化合物-靶点网络、Venn图以及PPI网络图;利用ClueGO及CluePedia插件对筛选出的基因进行GO功能和KEGG通路富集分析.结果 共筛选出半枝莲-半边莲44种化学成分,对应301个靶点,得到作用于胃癌的交集靶点157个,GO功能分析集中在对细胞死亡、凋亡的调控,对多种蛋白激酶活性的调节等方面,KEGG分析得到PI3K-Akt信号通路和MAPK信号通路等重要通路.结论 该研究结果预测了半枝莲-半边莲药对治疗胃癌的可能作用靶点及通路,但尚有不足之处,需要后期实验研究验证.

目的 探讨血管生成拟态(VM)与结直肠癌患者不良预后的相关性.方法 计算机检索建库至2021年4月PubMed、Embase、Cochrane Library、Web of Science、CBM、CNKI、VIP 及万方数据库发表的关于 VM 与结直肠癌不良预后关系的队列研究,采用Stata 14.0软件进行meta分析,计算合并风险及95％CI以评估VM阳性对结直肠癌不良预后的价值,并进行亚组分析.结果 最终纳入5篇文献进行meta分析,共769例患者,VM阳性患者203例.meta分析结果显示,VM阳性与不良预后之间存在显著相关性(HR=2.433,95％CI:1.844～3.023,P＜0.001).亚组分析显示样本量、患者预后情况的提取方法、组间可比性校正对VM阳性与患者预后相关性无明显影响(I2＜50％,P＞0.1).结论 VM阳性与结直肠癌不良预后有显著相关性,VM可能为临床治疗结直肠癌提供了潜在方向.

大肠癌是常见的消化系统恶性肿瘤,中医治疗大肠癌有着独特的优势.引火归元作为从《黄帝内经》中延伸的一种治疗法则,为临床辨证论治、增强治疗效果提供了思路.大肠癌的发生发展过程与相火离位、脾肾亏虚、阳气不足有关.先天禀赋不足,加之外邪侵袭,相火易离其位,导致机体脾肾亏虚、阳气不足,病理产物堆积,易发展为大肠癌,癌毒损伤机体阳气,同时经过手术、化疗等治疗后,阳虚更甚,脾肾不足,致离位之相火不能归位,形成恶性循环,病情日渐加重.引火归元法作为扶阳法中重要的一部分,可引离位之相火下行、温补脾肾、扶助补益阳气.应用引火归元法治疗大肠癌的代表方有肾气丸、潜阳封髓丹及引火汤,根据症状灵活加减,可提高临床疗效.

目的 系统评价华蟾素注射液治疗恶性胸腹腔积液的有效性和安全性并进行meta分析.方法 计算机检索三大中文数据库(CNKI、WanFang、VIP)和三大英文数据库(PubMed、Cochrane Library、EMbase)自建库至2019年6月,按照预先制订的筛选标准筛选出华蟾素注射液治疗恶性胸腹腔积液的临床随机对照试验,采用RevMan 5.3软件进行meta分析.结果 共检索出145篇文献,最终纳入9项研究,总样本量为532例,试验组267例,对照组265例,所纳入研究总体质量普遍偏低、样本量偏少.meta分析结果显示:华蟾素+西药治疗组在减少恶性胸腹腔积液的总量(OR=4.78,95％ CI:3.12～7.32,P＜0.000 01)、提高生活质量(OR=3.56,95％ CI:2.06～6.18,P＜0.000 01)和骨髓抑制(OR=0.56,95％CI:0.33～0.94,P=0.03)等方面均优于西药治疗组.结论 华蟾素注射液联合西药治疗可有效减少恶性胸腹腔积液的总量,改善患者的生活质量,同时降低不良反应中骨髓抑制的发生率.

[Objective]Make the research about the anti-cancer effect and mechanism of GeXiaZhuYu Decoction combined cyclophosphamide affect EAC hepatumor cells in mice.[Methods]Forty KB mice were injected EAC hepatumor cells(2.0×106/mL,0.2 mL/single)by subcutaneous.Then we use GeXiaZhuYu decoction,cyclophosphamide,GeXiaZhuYu Decoction combined cyclophosphamide to deal with the mice respectively.After ten days,the mice were killed and calculate inhibitory percentage of tumor cell;the ultra structure of tumor were observed under transmission electron microscopy;tumor cell morphology change were observed by HE dyeing.[Results]GeXiaZhuYu decoction combined cyclophosphamide is the most obvious effects of tumor cell,and the inhibitory percentage of tumor is 38.65%.Tumor cell apoptosis can be effective induced by Traditional Chinese medicine combined with Western medicine.[Conclusions]GeXiaZhuYu Decoction combined cyclophosphamide has significant inhibitory effects of tumor on EAC hepatumor cells in mice,and may be the mechanism of tumor inhibition by inducing tumor cell apoptosis.

Objective To study the anti-cancer effects and mechanism of Gexia-Zhuyu decoction combined with cyclophosphamide on EAC liver cancer mice.Methods Choose EAC liver cancer mice cell lines and production of animal models of tumor.The mice were completely randomized into blank group,model group,the Chinese medicine group,CTX group,Chinese medicine and CTX group.The blank group and model group were given normal saline 0.4 ml/d; traditional Chinese medicine group was administrated with Gexia-Zhuyu decoction (11 g/kg body weight ) 0.4 ml/d gavage; CTX group was given intraperitoneal injection of 2 mg/ml of cyclophosphamide 0.4 ml/d; and traditional Chinese medicine and CTX group was given Gexia Zhuyu decoction 0.4 ml/d orally and CTX intraperitoneal injection of 0.4 ml/d.Ten days after the administration,the body weight of mice and the general condition were tested,and morphology was observed under the light microscope electron microscope mesenchymal tumor angiogenesis situation.Results Gexia-Zhuyu decoction combined with cyclophosphamide in mice could improve appetite,gain weight,and greatly reduce the tumor stroma in the number of capillaries under the electron microscope together with significant pathological morphological changes.Conclusion Gexia-Zhuyu decoction combined with cyclophosphamide had anti-cancer effects which can improve the quality of life and inhibit the growth of tumor in interstitial capillaries.

[Objective] Discuss the anti-cancer function and mechanism of small entrapement soup and western chemotherapeutics cyclophosphamide on EAC mice affected liver cancer.[Methods] 40 mice from Kuming,hypodermic injection of 2.0×106/mL EAC cancer liver mice cell line 0.2mL/,treat it with entrapement soup,cyclophosphamide,entrapement soup and cyclophosphamide separately,Immune group test the law endothelium growth factor express.The morphological changes were observed under the light microscope.Then find the situation of hepatumor cells with transmission electron microscope.[Results] Immunohistochemistry showed,XiaoChaiHu group,CTX group,XiaoChaiHu +CTX group VEGF po-sitive expression,XiaoChaiHu group,CTX group,XiaoChaiHu +CTX group VEGF po-sitive expression rate and average strength in dyeing were lower than the control group,XiaoChaiHu +CTX group to reduce the most obvious.Under light microscope,XiaoChaiHu group,CTX group,XiaoChaiHu +CTX group can reduce the quantity of tumor stromal capillaries in newborn,XiaoChaiHu +CTX group is the most obvious.XiaoChaiHu group is the second.Under electron microscope,XiaoChaiHu group,CTX group,XiaoChaiHu +CTX group can damage the structure of tumor stromal capillaries in newborn,xcht+CTX group to damage the most obvious.[Conclusions] XiaoChaiHu Decoction combined with Cyclophosphamide may reduce liver cancer in mice EAC tumor VEGF protein expression and restrain the grown of the Tumor interstitial vascularity.

[Objective]Make the research about the Anti-cancer effect and mechanism of small entrapement soup combined cyclophosphamide affect EAC hepatumor cells in mice.[Method]Forty KB mice were injected EAC hepatumor cells(2.0 106/mL,0.2 mL/single)by subcutaneous.Then we use small entrapement soup,cyclophosphamide,small entrapement soup combined cyclophosphamide to deal with the mice respectively.After ten days,the mice were killed and calculate inhibitory percentage of tumor cell;the ultrastructure of tumor were observed under transmission electron microscopy;tumor cell morphology change were observed by HE dyeing.[Result]Small entrapement soup combined cyclophosphamide is the most obvious effects of tumor cell,and the inhibitory percentage of tumor is 38.85%.Tumor cell apoptosis can be effective induced by Traditional Chinese medicine combined Western medicine.[Conclusion]Small entrapement soup combined cyclophosphamide has significant inhibitory effects of tumor on EAC hepatumor cells in mice,and may be the mechanism of tumor inhibition by inducing tumor cell apoptosis.