BACKGROUND Colorectal cancer is a leading malignancy worldwide, with the liver being the most common site of metastasis and the primary cause of death. While chemotherapy improves overall survival (OS) in colorectal cancer liver metastases (CRLM), conventional Western medicine has limited efficacy. In the previous cohort study on CRLM conducted by our team, it was observed that integrated Chinese and Western medicine (ICWM) may offer advantages in treating CRLM, but high-level evidence is still lacking. AIM To analyze the survival benefits of ICWM treatment in patients with CRLM. METHODS A retrospective cohort study was conducted, with "continuous traditional Chinese medicine (TCM) treatment for >= 3 months" as the exposure factor. A total of 499 patients from four tertiary grade A hospitals were divided into two cohorts: The ICWM treatment cohort (cohort A) with 185 patients and the Western medicine treatment cohort (cohort B) with 314 patients. OS, 3-year/5-year survival rates, and subgroup efficacy were compared. Multivariate Cox proportional hazards regression was employed to identify independent prognostic factors. RESULTS The study demonstrated a significant improvement in OS for patients receiving ICWM treatment (cohort A) compared to Western medicine alone (cohort B). The median OS was 36 months vs 28.37 months (hazard ratio = 0.65, P < 0.01), with higher 3-year and 5-year survival rates (47.03% vs 35.99%; 19.46% vs 10.51%). Subgroup analysis revealed statistically significant differences (P < 0.05) between two cohorts in subgroups such as age, sex, the primary tumor site, different genotypes, whether local treatment of liver metastases, treatment stage and whether there is concurrent extrahepatic metastasis were administered. Multivariate analysis identified right-sided colon location and rat sarcoma viral oncogene homolog/B-Raf proto-oncogene, serine/threonine kinase mutations as poor prognostic factors, while local treatment of liver metastases and integrated TCM therapy were protective, reducing mortality risk by 39% and 47%, respectively. CONCLUSION ICWM treatment is associated with longer overall survival in CRLM patients and improve their 3rd and 5th survival rates, with TCM integration serving as an independent protective factor.

INTRODUCTION:Pancreatic Cancer (PC) remains highly lethal with limited treatment options. The causal roles of DNA methylation and protein Quantitative Trait Loci (pQTL) in its development are not fully understood, warranting further investigation into potential mechanisms and therapeutic targets. METHODS:We integrated data from the IEU Open GWAS (n = 476,245), GoDMC (n = 27,750), and a large-scale pQTL study (n = 35,559) to perform Mendelian randomization (MR) analyses and identify potential causal genes and regulatory mechanisms for PC. The inverse variance weighted (IVW) method was used as the primary approach, with robustness assessed through a series of sensitivity analyses. Single-cell RNA sequencing data were used to validate gene expression patterns, and mediation analysis was applied to evaluate the role of gene expression in linking DNA methylation to PC risk. RESULTS:MR analysis identified a significant inverse association between the Platelet-Derived Growth Factor Receptor Beta (PDGFRB) expression and PC risk(OR=0.9179, 95% CI=0.8837- 0.9535, P=9.96×10-6). Sensitivity analyses confirmed the absence of heterogeneity and pleiotropy. Notably, PDGFRB expression was enriched in pancreatic islet-derived single-cell RNA sequencing datasets, suggesting a potential protective role in pancreatic microenvironment homeostasis. Mediation analysis revealed that DNA methylation at locus cg11042320 mediated 97.62% of the association between PDGFRB and PC, underscoring its regulatory importance. DISCUSSION:Using an integrative MR framework linking pQTLs, mQTLs, and single-cell data, we identify PDGFRB as a protective factor for pancreatic cancer, with cg11042320 methylation as a key upstream regulator. These results outline a causal path from methylation to expression to risk and suggest PDGFRB helps stabilize the tumor microenvironment. Clinically, PDGFRB expression and cg11042320 methylation may support risk stratification and selection of epigenetic or microenvironment-targeted therapies. CONCLUSION:Two-sample MR showsthat higher PDGFRB expression is associated with lower pancreatic cancer risk (IVW OR ≈0.92), primarily mediated by cg11042320 methylation (~98%), with findings robust to heterogeneity and pleiotropy tests. Together with single-cell evidence, these data prioritize PDGFRB and its epigenetic regulation as actionable targets and ensure functional and multi-ancestry validation.

Cancer-related depression (CRD) is a common pathological depression in the diagnosis and treatment of malignant tumors and an important factor affecting the progression and treatment of tumor diseases. Abdominal vibration therapy was developed from Professor Zang's loose vibration method. It is a set of techniques that mainly operates by vibrating the Shenque point; dredging meridians; and rubbing, pushing, and holding the abdomen. This therapy has unique advantages in the treatment of emotional diseases likely because it can stimulate the abdomen; tonify the spleen and stomach; and regulate the gut organs, the qi mechanism, and vitality. On the basis of the structure of the brain-gut axis, it regulates the inflammatory response then realizes the purpose of intervening in CRD.

ETHNOPHARMACOLOGICAL RELEVANCE:Huachansu (HCS) is a traditional Chinese medicine obtained from the dried skin glands of Bufo gargarizans and clinical uses of HCS have been approved in China to treat malignant tumors. The traditional Chinese medicine theory states that HCS relieves patients with cancer by promoting blood circulation to remove blood stasis. Clinical observation found that local injection of HCS given to pancreatic cancer patients can significantly inhibit tumor progression and assist in enhancing the efficacy of chemotherapy. However, the material basis and underlying mechanism have not yet been elucidated.AIM OF THE STUDY:To investigate the therapeutic potential of HCS for the treatment of pancreatic cancer in in situ transplanted tumor nude mouse model. Furthermore, this study sought to elucidate the molecular mechanisms underlying its efficacy and assess the impact of HCS on the microenvironment of pancreatic cancer. To identify the antitumor effect of HCS in in situ transplanted tumor nude mouse model and determine the Chemopreventive mechanism of HCS on tumor microenvironment (TME).METHODS:Using the orthotopic transplantation nude mouse model with fluorescently labeled pancreatic cancer cell lines SW1990 and pancreatic stellate cells (PSCs), we examined the effect of HCS on the pancreatic ductal adenocarcinoma (PDAC) microenvironment based on the transforming growth factor β (TGF-β)/Smad pathway. The expression of TGF-β, smad2, smad3, smad4, collagen type-1 genes and proteins in nude mouse model were detected by qRT-PCR and Western blot.RESULTS:HCS significantly reduced tumor growth rate, increased the survival rate, and ameliorated the histopathological changes in the pancreas. It was found that HCS concentration-dependently reduced the expression of TGF-β1 and collagen type-1 genes and proteins, decreased the expression of Smad2 and Smad3 genes, and downregulated the phosphorylation level of Smad2/3. Additionally, the gene and protein expression of Smad4 were promoted by HCS. Further, the promoting effect gradually enhanced with the rise of HCS concentration.CONCLUSIONS:The results demonstrated HCS could regulate the activity of the TGF-β/Smad pathway in PDAC, improved the microenvironment of PDAC and delayed tumor progression. This study not only indicated that the protective mechanism of HCS on PDAC might be attributed partly to the inhibition of cytokine production and the TGF-β/Smad pathway, but also provided evidence for HCS as a potential medicine for PDAC treatment.

Lung cancer has high metastasis and drug resistance. The prognosis of lung cancer patients is poor and the patients’ survival chances are easily neglected. Ferroptosis is a programmed cell death proposed in 2012, which differs from apoptosis, necrosis and autophagy. Ferroptosis is a novel type of regulated cell death which is driven by iron-dependent lipid peroxidation and subsequent plasma membrane ruptures. It has broad prospects in the field of tumor disease treatment. At present, multiple studies have shown that biological compounds can induce ferroptosis in lung cancer cells, which exhibits significant anti-cancer effects, and they have the advantages in high safety, minimal side effects, and less possibility to drug resistance. In this review, we summarize the biological compounds used for the treatment of lung cancer by focusing on ferroptosis and its mechanism. In addition, we systematically review the current research status of combining nanotechnology with biological compounds for tumor treatment, shed new light for targeting ferroptosis pathways and applying biological compounds-based therapies.

Postoperative delayed gastric emptying is a prevalent complication following surgical procedures, imposing heavy physical and financial burdens on patients. However, current treatment options remain suboptimal. In recent years, an increasing number of studies have highlighted that the gut microbiota and its metabolites are closely associated with postoperative complications. Various factors can disrupt the gut microbiome after surgery. This review discusses the potential mechanisms by which the gut microbiota and their metabolites may contribute to the pathogenesis of postoperative delayed gastric emptying. However, the current knowledge base is limited in terms of fully understanding the exact mechanisms involved. It is therefore evident that further research is required to fully elucidate the role of the gut microbiome in postoperative delayed gastric emptying, with the aim of uncovering new possibilities for preventive measures and therapeutic treatments.

Ethnopharmacological relevance: Huachansu (HCS) is a traditional Chinese medicine obtained from the dried skin glands of Bufo gargarizans and clinical uses of HCS have been approved in China to treat malignant tumors. The traditional Chinese medicine theory states that HCS relieves patients with cancer by promoting blood circulation to remove blood stasis. However, the material basis and underlying mechanism have not yet been elucidated.Aim of the study: To investigate the therapeutic potential of HCS for the treatment of pancreatic cancer in in situ transplanted tumor nude mouse model. Furthermore, this study sought to elucidate the molecular mechanisms underlying its efficacy and assess the impact of HCS on the microenvironment of pancreatic cancer. To identify the antitumor effect of HCS in in situ transplanted tumor nudemouse model and determine the Chemopreventive mechanism of HCS on tumor microenvironment (TME).Methods: Using the orthotopic transplantation nude mouse model with fluorescently labeled pancreatic cancer cell lines SW1990 and pancreatic stellate cells (PSCs), we examined the effect of HCS on the PDAC microenvironment based on the TGF-β/Smad pathway. The expression of TGF-β, smad2, smad3, smad4, collagen Ⅰ genes and proteins in nude mouse model were detected by qRT-PCR and Western blot.Results: HCS significantly reduced tumor growth rate, increased the survival rate, and ameliorated the histopathological changes in the pancreas. It was found that HCS concentration-dependently reduced the expression of TGF-β1 and collagen Ⅰ genes and proteins, decreased the expression of Smad2 and Smad3 genes, and downregulated the phosphorylation level of Smad2/3. Additionally, the gene and protein expression of Smad4 were promoted by HCS. Further, the promoting effect gradually enhanced with the rise of HCS concentration.Conclusions: The results demonstrated HCS could regulate the activity of the TGF-β/Smad pathway in PDAC, improved the microenvironment of PDAC and delayed tumor progression. This study not only indicated that the protective mechanism of HCS on PDAC might be attributed partly to the inhibition of cytokine production and the TGF-β/Smad pathway, but also provided evidence for HCS as a potential medicine for PDAC treatment.

术后胃瘫综合征(postsurgical gastroparesis syndrome,PGS)多见于腹部手术后,是一种病因不明的非机械性梗阻性胃排空障碍.一般认为PGS的病因与迷走神经损伤有关,但最近有研究发现,即使患者手术前后迷走神经功能异常也不一定出现胃瘫症状,PGS是否出现临床症状可能也与其他因素有关.多项研究发现胸部手术后也会出现PGS,肺癌是最常见的恶性肿瘤之一,早期手术切除是其唯一可能治愈方法.中医认为,肺癌术后肺脏受损,致气机升降失调是肺癌PGS重要的发病因素,肺胃同治理论是治疗肺癌PGS的关键.本文从经络、藏象、病机3方面论述肺胃同治的理论基础,总结肺胃同治理论可指导治疗肺癌PGS的遣药组方,并结合临床典型病案加以阐述,为肺癌PGS的临床治疗提供新的思路.

肺癌发病率和死亡率在我国及全球范围内均居前列,且发病率仍在逐年升高,发病年龄亦呈持续升高趋势.老年肺癌患者多久病体虚,较难承受杀伐有力的现代治疗方案,故多寻求较为和缓的中医治疗."命门学说"是张景岳的重要学术思想,命门、水火阴阳和五脏六腑相互协调,共同维持人体各项生理功能.我们认为,老年肺癌多因命门火衰、阳虚寒凝所致,临床治疗应从温阳散寒、补肾固本出发,多采用阳和汤加减温阳散寒,收效甚佳.

肿瘤转移影响预后,与生存期密切相关,故了解肿瘤转移的规律,以便更有效地预防转移.肿瘤传变与各脏腑的自身属性和五行特性相关,即肿瘤转移具有特发性和趋向性,如阴阳合体的肺、肝易发肿瘤,且恶性肿瘤容易转移至肺、肝;阳中之阳脏的心和阴中之至阴的脾不容易长肿瘤,即使脾脏虚弱,脾脏恶性肿瘤发病或癌症转移至脾的几率也比较小.此外,癌症的不同中医证型转移也具有特发性和趋向性,如肺癌痰热证型与脑转移相关,血瘀证型与肝转移相关.根据中医阴阳五行生克乘侮关系预判恶性肿瘤转移,对中晚期癌症患者,特别是局部晚期未发生转移患者,顾护未病之脏对延缓或防止转移很有必要."先安未受邪之地",使恶性肿瘤患者无疾病进展期.

This study aimed to test cinobufacini therapeutic potential for pancreatic cancer, verify its potential molecular mechanism, and evaluate the cinobufacini impact on pancreatic cancer microenvironment. First, the effect of cinobufacini-treated pancreatic stellate cells (PSCs) supernatant on the value-added ability of pancreatic cancer (PCCs) was tested. The results show that cinobufacini can effectively reduce the ability of PSCs supernatant to promote the value-added PCCs. Further results show that cinobufacini can effectively reduce the concentration of TGFβ in the supernatant of PSCs. Subsequently, the impact of cinobufacini on the transcription and translation levels of key genes in the TGFβ/Smads pathway was examined. The results showed that the impact of cinobufacini on the transcription levels of Smad2, Smad3, and Smad7 was in a concentration-dependent manner, while the transcriptional activity of collagen I mRNA was decreased with the increase of cinobufacini concentration. The results of protein expression showed that cinobufacini could upregulate the expression of inhibitory protein Smad7, inhibit the phosphorylation level of p-Smad2/3, and then suppress the expression of type I collagen (collagen I). On the one hand, this study shows that cinobufacini can inhibit the promotion of PSCs on the proliferation of PCCs. On the other hand, cinobufacini can upregulate the expression of the inhibitory molecule, Smad7, through the TGFβ/Smads pathway and reduce the phosphorylation level of p-Smad2/3, thereby inhibiting the expression of collagen I and pancreatic fibrosis. cinobufacin can inhibit the proliferation of SW1900 cells by blocking the TGFβ/Smads pathway of pancreatic stellate cells. These results provide a clinical basis for the treatment of pancreatic cancer.

癌痛严重影响患者的生活质量.中医认为疼痛源于"不通则痛"和"不荣则痛".不同研究者对癌痛患者进行辨证论治,或温阳祛寒,或活血化瘀,或祛痰化浊,或理气行气,或温阳益气,或滋阴养血,均获良效.著名肿瘤专家王沛教授提出了癌性疼痛的外用治疗三大法则,即温通、行气、活血化瘀,在选药上注重以温通为主.胡凯文教授在其"温通"指导原则下总结出丁香止痛膏,全方共奏温通解毒通络、行气活血止痛之功,临床运用多年,对于癌痛,尤其是肿瘤中晚期阳虚患者,疗效颇佳.

目的:分析肺黏液表皮样癌患者的临床表现、影像学表现、病理学特征、治疗手段和预后,为该病的治疗和诊断提供依据.方法:收集1例肺黏液表皮样癌患者的临床资料,并结合相关文献复习,探讨肺黏液表皮样癌的临床特点、诊断和治疗方法.结果:患者,男性,59岁,因"诊断肺癌1年余,乏力1周"入院.查体,双胸廓对称,双肺语音震颤无增强,双肺叩诊呈清音,听诊双肺呼吸音清,未闻及干湿啰音.根据既往史明确诊断为肺黏液表皮样癌.入院时胸部CT片提示右上肺纵隔旁见团块影,密度减低,CT值为29～43 Hu,胸膜边缘模糊,大小为68 mm×40 mm,增强后动脉期CT值为73 Hu,静脉期CT值为83 Hu.右肺门及纵隔可见淋巴结影.既往右肺肿物根治性切除术后,化疗后复发,且不能耐受继续化疗和靶向治疗,遂行CT引导下右肺肿物氩氦刀冷冻消融术,术后1个月复查胸部CT检查结果显示病灶明显缩小,密度减低,CT值为34 Hu,大小为23 mm×26 mm,增强后未见明显强化,右肺门及纵隔淋巴结较前缩小.结论:肺黏液表皮样癌是一种特殊类型的肺癌,可无明显阳性体征,高级别肺黏液表皮样癌患者术后易复发,化疗效果差,缺乏疗效确切的靶向药物.氩氦刀冷冻治疗可局部消融病灶,延长患者生存期并提高生活质量.

癌性溃疡是晚期肿瘤患者常见的严重皮肤表现,因溃疡表面有肿瘤细胞浸润,合并感染,常伴有溃烂、渗液、渗血、恶臭等症状.王沛教授认为癌性溃疡由肿瘤所特有的癌毒所引起,外部治疗应着力于消除体表的癌毒,在癌毒消除后,给予生肌敛疮药,以促进创面恢复.治疗上,以拔毒去腐、清除疮疡为先,组方上多加用具有抗癌作用的生药、小毒药.癌性溃疡表面的溃烂腐肉清除之后,治疗上应着力于补气生血、生肌收口,常用补益脾肾、补益气血药.结合临床医案对王教授治疗癌性溃疡的经验进行介绍.

人类胃肠道系统内的肠道菌群在正常情况下保持动态平衡,具有促进代谢、增强免疫等功能.多项研究证明,肠道菌群失衡与肺癌的发生发展密切相关,肺癌患者肠道菌群的多样性及相对丰度明显不同于对照组.本文总结肠道菌群可能的关联途径,如调节代谢、炎症及免疫等促进肿瘤的发展、转移,也根据中医脏腑及五行相生理论,通过养护脾胃之气和调节肠道菌群平衡等方式抑制肿瘤的中药和方剂,旨在探讨调节肠道菌群联合靶向治疗和化疗成为未来治疗肺癌的常规疗法的可能性.

肿瘤患者食欲减退,病变脏腑主要在脾胃,与肝肾有关,受情志影响.基于李时珍在《本草纲目》中关于"土爱暖而喜芳香"这一论述,治疗上应以健脾运脾为基础,佐以醒脾补脾、疏肝补肾等,芳香中药贯穿治疗全程.以期为临床治疗提供思路.

目的:采用网络药理学和分子对接的方法探究西黄丸防治非小细胞肺癌(NSCLC)潜在分子机制.方法:在中药系统药理学数据库与分析平台(TCMSP)及BATMAN-TCM数据库中筛选分析西黄丸的有效活性成分及作用靶点.在Gene-Cards数据库与人类孟德尔遗传数据库(OMIM)中检索获取NSCLC的相关靶点,选取与西黄丸的交集靶点作为研究靶点.利用STRING数据库构建蛋白质-蛋白质相互作用(PPI)网络图.采用Cytoscape 3.7.0软件构建药物-靶点-疾病可视化互作网络图.使用DAVID数据对筛选分析出的关键靶点,进行基因本体(GO)功能富集分析和京都基因和基因组百科全书(KEGG)通路富集分析,最后运用AutoDock Vina软件和Pymol软件对药物有效活性成分和关键靶点进行分子对接验证.结果:通过筛选得到西黄丸51个主要活性成分,包括槲皮素、β-谷甾醇等,其中作用于NSCLC的靶点有178个,关键靶点有MAPK1、JUN、AKT1、TP53、RELA等.GO和KEGG分析结果显示,西黄丸治疗NSCLC的机制涉及多个生物学过程及PI3K-AKT信号通路、MAPK信号通路、TNF信号通路等多种信号通路.药物有效活性成分与关键靶点对接活性良好.结论:网络药理学分析显示西黄丸治疗NSCLC是多成分、多靶点、多通路协同起效,为后续相关实验提供了充分的理论依据.

Abstract Background This study compared a co‐ablation (CA) system, which is a novel ablation device, with an argon‐helium cryoablation (AHC) system. We aimed to compare the efficacy and safety of CA and AHC for the treatment of stage III–IV non‐small cell lung cancer (NSCLC). Methods We conducted a multicenter randomized controlled trial (RCT) to determine whether CA was noninferior to AHC. The primary efficacy endpoints were the iceball coverage rate (ICR) and the disease control rate (DCR) one month after treatment. Noninferiority was declared if the lower limit of two‐sided 95% confidence interval (CI) was less than 10%. The ICR and DCR were identified by logistic regression. Treatment safety was assessed. Results A total of 81 patients underwent randomization (41 assigned to the CA and 40 assigned to the AHC groups)and transthoracic ablation. The ICRs in the CA and AHC groups were 99.24% ± 2.18% and 98.66% ± 3.79%, respectively. Central lesions were associated with an increased risk of an incomplete ICR. The DCRs in the CA and AHC groups were 97.6% and 95%, respectively. A smaller lesion area in the CA group was significantly correlated with a better DCR. The rate of complications was 29.26% in the CA group and 30% in the AHC group. (P = 0.943). There was less probe usage per patient in the CA group. Conclusions We determined that CA is noninferior to AHC in terms of efficacy and safety for the treatment of stage III–IV NSCLC. A smaller lesion area in the CA group was significantly correlated with a better DCR. Key points CA was noninferior to AHC for stage III–IV NSCLC.

"围城必阙"出自《孙子兵法·军争篇》,意为:围城之战,需要留出一门,这样守方以为留有一线生机,作战便不会以全力相对,故而便于攻方破城.肿瘤绿色治疗特别重视中医外治疗法的应用,讲求内外同治.箍围疗法作为中医外治疗法的重要组成部分,以箍围药布局在恶性肿瘤周围,对其进行围困,进而缩小肿瘤范围,并且在肿瘤周围人为的营造出一个"护场",进一步抑制肿瘤生长,在肿瘤的治疗上具有相当的优势,与"围城必阙"有异曲同工之妙.

乳腺癌是女性最常见的恶性肿瘤,2020年全球新发210万例,其发病率和死亡率均列在女性癌症首位.近年来,我国乳腺癌的发病率呈快速增长的趋势,尤以城市地区人群更为显著. 一项对北京地区1210人的调查结果显示,饮食习惯在女性乳腺癌的发展中起着重要作用,建立均衡的饮食习惯,是预防乳腺癌的良好开端.那么,日常生活中哪些食物可以预防乳腺癌呢?