Cisplatin is a widely used chemotherapeutic agent, but its dose-limiting nephrotoxicity remains a major clinical challenge. 6-Shogaol, a bioactive compound with potent anti-inflammatory and antioxidant properties, exhibits strong binding affinity for STING-a key mediator in cisplatin-induced kidney injury. This study aims to investigate the renoprotective effects of 6-shogaol against cisplatin nephrotoxicity and elucidate its underlying mechanisms. Using a murine model of cisplatin-induced nephrotoxicity and in vitro experiments with HK-2 cells, we evaluated the cytoprotective effects of 6-shogaol. Molecular docking simulations confirmed its high binding affinity for STING. A comprehensive approach, including flow cytometry, RNA sequencing, ELISA, qPCR, histopathological staining (H&E staining), immunofluorescence, and Western blot analyses, was employed to assess renal function, tubular injury, inflammatory responses, and molecular mechanisms. CRISPR/Cas9-mediated STING knockout was performed to validate the mechanistic role of STING. 6-Shogaol significantly attenuated cisplatin-induced renal damage, as evidenced by reduced serum creatinine and blood urea nitrogen levels, diminished macrophage infiltration, and downregulated expression of CCL2 and CCL5 in renal tissues. Molecular docking revealed stable binding between 6-shogaol and STING. In vitro, 6-shogaol mitigated cisplatin-induced cellular injury, suppressed the cGAS-STING pathway, and reduced pro-inflammatory cytokine (IL-1β, IL-6, TNF-α) and chemokine (CCL2, CCL5) expression. STING knockout in HK-2 cells abolished cisplatin-induced cytotoxicity and attenuated the protective effects of 6-shogaol. These findings demonstrate that 6-shogaol alleviates cisplatin-induced kidney injury by targeting STING, thereby inhibiting CCL2/CCL5-mediated macrophage infiltration and subsequent inflammation.

BACKGROUND:Diffuse large B-cell lymphoma (DLBCL) is defined as a highly heterogeneous type of lymphoma which lacks specific biomarkers and drug targets. Past studies revealed changes in plasma metabolites, immune cells and inflammatory factors in the development of DLBCL, yet findings remain inconsistent. Our study aims to elucidate the mediating effects of peripheral cells and inflammatory factors on the relationship between metabolites and DLBCL, and offer therapeutic targets for DLBCL treatment. METHODS:We evaluated the association between plasma metabolites, peripheral cells, inflammatory factors and DLBCL risk using two-sample Mendelian randomization (MR) analysis. The proportion of peripheral cells and inflammatory factors in the metabolite-DLBCL axis was further calculated. Sensitivity analyses were conducted to validate the robustness of the results. Besides, summary data-based Mendelian randomization (SMR) analysis and heterogeneity in dependent instruments (HEIDI) test were performed to identify potential drug targets. Further more, in silico docking and molecular dynamic (MD) simulation studies were presented to elucidate the mode of interaction of the top predicted drugs. RESULTS:MR analysis identified a total of 52 plasma metabolites, 58 peripheral cells and 8 inflammatory factors that were genetically associated with DLBCL. We subsequently identified 6 mediated relationships, with 5 immune cells acting as potential mediators between 6 metabolites and DLBCL. Sensitivity analyses confirmed the robustness of these associations. Further SMR analysis and HEIDI test revealed 5 target genes existed correlation with DLBCL-related metabolites. Additionally, stable drug-target complexes were identified by utilizing molecular docking and dynamic simulation. CONCLUSION:This study revealed a significant causal link between plasma metabolites, peripheral cells, inflammatory factors and DLBCL. It remarkably enhances our understanding of the interplay between immune responses, metabolites and DLBCL risk, providing insights into the development of therapeutic strategies from the metabolite-immune axis alternation perspectives.

Background and objectivesPatients with corona virus disease 2019 (COVID-19) face not only physical strains but also significant psychological stress, highlighting the importance of addressing their mental health concerns. This study aimed to evaluate the impact of Lianhua Qingwen on the psychological well-being of asymptomatic and mildly symptomatic COVID-19 patients, providing empirical evidence to guide clinical practices.

This study aimed to develop a PANoptosis-related gene prognostic index (PANGPI) to explore its potential value in predicting the prognosis and immunotherapy response of diffuse large B-cell lymphoma (DLBCL). Differentially expressed genes of DLBCL from GEO databases were analyzed and mapped to the PANoptosis gene set. The independent prognostic value of the PANGPI signature was evaluated using LASSO Cox regression and multivariate Cox regression. Additionally, the tumor infiltrating lymphocyte (TIL) characteristics and mutation landscape of both subgroups were evaluated, and drug sensitivity was predicted using the GDSC database. Furthermore, in silico docking and molecular dynamic simulation studies were presented to elucidate the mode of interaction of these predicted drugs. The PANGPI risk score was an independent risk factor for the prognosis of patients with DLBCL and exhibited good prognostic predictive performance. Furthermore, the cytolytic activity of the TILs was positively correlated with the PANGPI scores. Additionally, the PANGPI enabled the identification of 3 chemotherapeutic agents, including BMS-536924, Gefitinib, Navitoclax for DLBCL patients in the high-risk group. We established a novel PANoptosis-related gene subtyping system in DLBCL, which could shed a novel light on the development of new biomarkers for DLBCL.

目的 观察血府逐瘀汤对血瘀证的结直肠癌伴抑郁、焦虑患者的临床疗效及肠道代谢产物的影响.方法 将2019年1月～ 2022年1月上海交通大学医学院附属瑞金医院收治的120例血瘀证型Ⅲ期结直肠癌伴抑郁、焦虑患者,随机分为治疗组和对照组,每组60例.治疗组给予血府逐瘀汤口服,对照组给予安慰剂口服.3个月后比较分析两组心理量表(包括SDS、SAS、HAMD、HAMA)、中医症状评分、无疾病生存期(disease free survival,DFS)及代谢组学.结果 治疗后,组内比较,治疗组的乏力得分较前增加(P＜0.05),量表(SDS、SAS、HAMD、HAMA)、不寐、脘腹胀满、心烦易怒得分较前明显下降(P＜0.01);对照组HAMD、HAMA、不寐、乏力得分较前明显下降(P＜0.01).两组间比较,治疗组SDS、HAMD、不寐、心烦易怒得分均低于对照组(P＜0.05),HAMA、脘腹胀满得分明显低于对照组(P＜0.01).治疗组DFS为38.72±2.22个月,较对照组延长2个月(P＞0.05).两组肠道代谢产物差异分析主要为脯氨酸、6-羟基烟酸、丝氨酸、肌醇、丙二酸、阿魏酸、吲哚丁酸、丁酸等.结论 中药血府逐瘀汤可改善结直肠癌的抑郁、焦虑,调节肠道代谢,延长无疾病生存期.

BACKGROUND:Breast cancer is one of the most common cancers in women, affecting more than 2 million women worldwide annually. However, effective treatments for breast cancer are limited. Nobiletin is a flavonoid present in the dried mature pericarp of mandarin orange (Citrus reticulata Blanco), which is used to prepare Citri Renetulatae Pericarpium and can inhibit tumour growth and progression according to modern pharmacological studies. However, whether nobiletin exhibits an antimetastatic role in breast cancer and its potential mechanism need to be further investigated.PURPOSE:This study aims to evaluate the inhibitory effect of nobiletin on breast cancer and to elucidate potential mechanisms against invasion and migration.METHODS:Cell viability was determined by cell counting kit-8 and colony formation assays. Wound healing and Boyden chamber assays detected cancer cell migration and invasion capabilities. Immunoblotting and qPCR were applied to determine the protein and mRNA expression levels of extracellular signal-regulated kinases (ERK) and the c-Jun N-terminal kinase (JNK) signalling pathways. Molecular docking was used to assess the degree of nobiletin binding to phosphatidylinositol 3-kinase (PI3K). Xenografts and liver metastases were constructed in BALB/c nude mice to evaluate the anticancer effect of nobiletin in vivo. H&E staining and immunohistochemistry were used to detect proliferation and the expression of related proteins.RESULTS:Nobiletin induced cell death in a concentration- and time-dependent manner and possessed anti-invasion and anti-migration effects on MCF-7 and T47D cells by suppressing the interleukin-6-induced ERK and JNK signalling pathways. In addition, nobiletin docked with the binding site of PI3K, and the binding score was -8.0 kcal/mol. Furthermore, the inhibition of breast cancer growth and metastasis by nobiletin was demonstrated by constructing xenografts and liver metastases in vivo.CONCLUSION:Nobiletin inhibited liver metastasis of breast cancer by downregulating the ERK-STAT and JNK-c-JUN pathways, and its safety and efficacy were verified, indicating the potential of nobiletin as an anticancer agent.

目的 探讨中药芩黄方对弥漫大B细胞淋巴瘤(DLBCL)患者使用R-CHOP方案化疗后免疫功能的影响.方法 选取行R-CHOP方案化疗的DLBCL患者300例,根据化疗后是否接受芩黄方治疗分为中药治疗组(150例,至少接受过6个月的芩黄方治疗)和对照组(150例,未行中药治疗).分别检测所有患者在化疗前、化疗3个月、化疗结束时、化疗结束后3个月、化疗结束后6个月、化疗结束后1年、化疗结束后2年T细胞亚群(CD3+T细胞、CD4+T细胞、CD8+T细胞绝对值及CD4/CD8比值)和IgG、IgA、IgM水平.结果 DLBCL患者化疗后CD3+T细胞绝对值、CD4+T细胞绝对值、CD4/CD8比值及IgG、IgA、IgM水平均显著低于化疗前(P<0.05);与化疗3个月比较,化疗结束后6个月的CD4+T细胞绝对值显著升高(P<0.05),化疗结束后2年的IgG水平显著升高(P<0.05).中药治疗组CD3+T细胞及CD4/CD8比值在化疗结束后1～2年恢复至化疗前水平,而对照组在化疗结束后2年仍低于化疗前(P<0.05);中药治疗组化疗结束后2年较化疗3个月CD3+T细胞、CD4+T细胞绝对值及CD4/CD8比值的升高程度显著高于对照组(P<0.05).化疗结束后各时间点中药治疗组与对照组CD8+T细胞绝对值差异均无统计学意义(P>0.05).中药治疗组和对照组化疗结束后IgG、IgA、IgM水平均显著低于化疗前(P<0.05);IgA在化疗结束后1年、IgG在化疗结束后2年恢复至化疗前水平;化疗结束后2年IgM水平仍低于化疗前(P<0.05).中药治疗组化疗结束后2年较化疗3个月IgG、IgA、IgM水平的升高幅度与对照组比较,差异均无统计学意义(P>0.05).结论 DLBCL患者经R-CHOP方案化疗后会出现长期免疫抑制;芩黄方可促进DLBCL患者化疗后的免疫功能重建.

糖尿病是严重威胁人类健康的世界性公共卫生问题,其患病率在发达国家及发展中国家逐年迅速增长,糖尿病及其并发症严重威胁着人类健康,给社会和家庭带来沉重的经济负担.而糖尿病前期(prediabetes)是由血糖正常向2型糖尿病过渡的重要环节,是介于血糖正常和糖尿病之间的一种状态,包括空腹血糖受损(impaired fasting glucose,IFG)和糖耐量减低(impaired glucose tolerance,IGT).糖尿病前期的发生率呈迅速上升态势,预估全球糖尿病前期患病人数于2025年将达4亿7 200万.糖尿病前期还属于中医的"未病"状态,由于糖尿病前期的糖代谢异常状态是可逆转的过程,因此及时发现并积极干预糖尿病前期对于延缓或阻断糖尿病及其并发疾病的发生意义重大.

Ethnopharmacological relevance: Fuzheng Xiaojijinzhan (FZXJJZF) decoction is an effective prescription for treating colorectal cancer liver metastasis (LMCRC). Aim of the study: To elucidate the pharmacological mechanism of the FZXJJZF decoction therapy on LMCRC. Materials and methods: Firstly, a network pharmacological approach was used to characterize the underlying targets of FZXJJZF on LMCRC. Secondly, LMCRC-related genes are obtained from the public database TCGA, and those genes are further screened and clustered through Mfuzz, an R package tool. Then, targets of FZXJJZF predicted by network pharmacology were overlapped with LMCRC related genes screened by Mfuzz. Meanwhile, FZJZXJF intervened in LMCRC model,epithelial-to-mesenchymal transition (EMT), and migration and invasion of HCT-116 cells. Thirdly, the transcriptomics data of FZJZXJF inhibited HCT-116 cells of EMT cells were overlapped with EMT database data to narrow the possible range of targets. Based on this, the potential targets and signal pathways of FZJZXJF were speculated by combining the transcriptomics data with the targets from network pharmacology-TCGA. Finally, the anti-cancer mechanism of FZXJJZF on LMCRC was verified in vitro by Real-Time PCR and Western Blot in vitro. Results: By network pharmacological analysis, 282 ingredients and 429 potential targets of FZXJJZF were predicted. The 9268 LMCRC-related genes in the TCGA database were classified into 10 clusters by the Mfuzz. The two clustering genes with the most similar clustering trends were overlapped with 429 potential targets, and 32 genes were found, such as CD34, TRPV3, PGR, VDR, etc. In vivo experiments, FZJZXJF inhibited the tumor size in LMCRC models, and the EMT, migration, and invasion of HCT-116 also be inhibited. Intersecting transcriptomics dates with 32 target genes, it is speculated that the VDR-TGF-beta signaling pathway may be an effective mechanism of FZXJJZF. Additionally, it is shown that FZXJJZF up-regulated the expression levels of VDR and E-cadherin and down-regulated the expression levels of TGF-beta and Snail1 in vitro. These results confirmed that FZXJJZF plays an effective role in LMCRC mainly by inhibiting EMT phenotype via the VDR-TGF-beta signaling pathway. Conclusions: Collectively, this study reveals the anti-LMCRC effect of FZXJJZF and its potential therapeutic mechanism from the perspective of potential targets and potential pathways.

As an original traditional Chinese medicinal formula, Qin Huang formula (QHF) is used as adjuvant therapy for treating lymphoma in our hospital and has proven efficacy when combined with chemotherapy. However, the underlying mechanisms of QHF have not been elucidated. A network pharmacological-based analysis method was used to screen the active components and predict the potential mechanisms of QHF in treating B cell lymphoma. Then, a murine model was built to verify the antitumor effect of QHF combined with Adriamycin (ADM) in vivo. Finally, IHC, ELISA, 18F-FDG PET-CT scan, and western blot were processed to reveal the intriguing mechanism of QHF in treating B cell lymphoma. The systemic pharmacological study revealed that QHF took effect following a multiple-target and multiple-pathway pattern in the human body. In vivo study showed that combination therapy with QHF and ADM potently inhibited the growth of B cell lymphoma in a syngeneic murine model, and significantly increased the proportion of tumor infiltrating CD4+ and CD8+ T cells in the tumor microenvironment (TME). Furthermore, the level of CXCL10 and IL-6 was significantly increased in the combination group. Finally, the western blot exhibited that the level of TLR2 and p38 MAPK increased in the combination therapy group. QHF in combination of ADM enhances the antitumor effect of ADM via modulating tumor immune microenvironment and can be a combination therapeutic strategy for B cell lymphoma patients.

This study aimed to explore the potential molecular mechanisms of FuZheng XiaoJi prescription (FZXJP) on Colorectal Cancer (CRC) cells. Transcriptome sequencing was performed on HT-29 cells treated with FZXJP and not followed by selecting differentially expressed genes (DEGs). Functional enrichment analysis and protein-protein interaction (PPI) analysis were performed for the DEGs. The transcription factors were predicted using TRRUST and miRWalk 3.0. Finally, Real-time PCR (qRT-PCR) was used to verify the results of transcriptome sequencing. HT-29 had a more sensitive response to FZXJP. Transcriptome sequencing revealed 1522 DEGs, and they were enriched in various biological processes and pathways, such as regulation of cellular biosynthetic process and MAPK signaling pathway. Totally 61 proteins in the PPI network with degree > 5 were screened as hub genes, including EGR1, KLHL11, UBA7, IRF1, HERC6, and IFI35. The qRT-PCR confirmed that the expression of those genes was consistent with that of transcriptome analysis. Three transcription factors and 15 miRNAs were predicted. All the three transcription factors were found to interact with EGR1. IRF1 was a target of miR-93-5p. This study provided a theoretical basis for the regulation of FZXJP in HT-29cells, which lays a foundation for the treatment of CRC.

目的 观察中医经验方葛芪方辅助治疗2型糖尿病(T2DM)的临床疗效.方法 将80例T2DM患者随机分为治疗组和对照组,每组40例.两组患者均给予盐酸二甲双胍片治疗,治疗组加用中药葛芪方治疗,两组疗程均为3个月.比较两组患者治疗前后空腹血糖、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、体质指数、血脂、C反应蛋白(CRP)水平及稳态模型评价胰岛素抵抗(HOMA-IR)指数的变化.结果 治疗后,治疗组患者空腹血糖、2hPBG、HbA1c、HOMA-IR指数均低于对照组(均P＜0.05),两组血脂、体质指数、CRP水平均无统计学差异(均P＞0.05).结论 葛芪方辅助治疗T2DM能更有效地降低患者血糖,减轻胰岛素抵抗.

Background The toxicity and side effects caused by adjuvant chemotherapy (ACT) after radical surgery for lung adenocarcinoma (LAC) lead to early termination frequently. This study was conducted to provide an objective basis for the effect of Chinese herbal medicine formulas (CHMFs) combined with chemotherapy in reducing toxicity and enhancing efficacy of ACT. Method From February 17th, 2012 to March 20th, 2015, 233 patients from 7 hospitals diagnosed with LAC in IB~IIIA stage were randomly assigned into ACT + CHMF group (116 patients) and ACT + placebo group (117 patients). CHMF was taken orally until the end of chemotherapy. Chemotherapy-related toxic, side effects were investigated as the primary outcome. Disease-free survival (DFS) and overall survival (OS) were used as the secondary outcome. Results At one week following chemotherapy, the incidence of dry mouth, diarrhea and thrombocytopenia significantly decreased in CHMF group ( P = 0.017, P = 0.033, P = 0.019, respectively). At two weeks following chemotherapy, fatigue and diarrhea were more obvious in the placebo group ( P = 0.028, P = 0.025, respectively). In addition, patients in the CHMF group showed an increase in median DFS from 37.1 to 51.5 months compared with placebo group although there was no statistical significance ( P = 0.16). In the stage IB subgroup, the CHMF group had a significantly better DFS (HR (95% CI) = 0.53 (0.28–0.99), P = 0.046). There was no significant difference in OS between the groups ( P = 0.72). Conclusion For patients with LAC, ACT combined with CHMF after radical surgery can prolong the DFS time especially in the early stage, and reduces the chemotherapy-related toxic and side effects. Trial Registration NCT 01441752 . Registered 14 July, 2011.

目的:探讨336例随访期非霍奇金淋巴瘤(NHL)患者的中医证型分布、中医症状特点及证型与临床检验指标的相关性,初步推测各证型的预后.方法:选取2018年3月至2019年4月于瑞金医院中医科及血液科住院处于随访期的NHL患者,总结336例NHL患者的中医证型分布和中医症状特点;分析证型与临床检验指标的相关性,推测各中医证型的预后.结果:中医证型频次从高到低依次为:脾虚湿盛证、痰湿凝滞证、痰热内蕴证、痰瘀互结证、阴虚证、气血两虚证.中医症状频次较高的依次是倦怠乏力、腰膝酸软、口干口渴、夜寐不佳.在6个证型中,LDH、血β2-MG、sIL-2R水平存在显著差异(P＜0.05).在血β2-MG水平上,与脾虚湿盛证比较,痰瘀互结证、阴虚证水平较高(P＜0.01,P＜0.05);在sIL-2R水平上,与脾虚湿盛证比较,痰湿凝滞证、痰热内蕴证、痰瘀互结证的水平较高(P＜0.05,P＜0.01);与气血两虚证比较,痰瘀互结证的水平较高(P＜0.05).结论:随访期NHL患者中医证型与临床相关指标有一定的相关性,脾虚湿盛证预后可能较好,痰湿凝滞证、痰热内蕴证、痰瘀互结证、阴虚证可能预后较差.

目的:分析恶性肿瘤伴抑郁焦虑患者的面色、舌象(舌色、苔色)特点,以指导临床辨证治疗.方法:应用四诊仪采集97例恶性肿瘤伴抑郁焦虑患者的中医面色、舌象(舌色、苔色)特征性参数进行分析.结果:①恶性肿瘤伴抑郁焦虑观察组面色图中眼眶、鼻子、额头、口唇和整体图的灰度低于对照组,差异有统计学意义(P＜0.01);同时各部位的HSV V值(明度)低于对照组,HSV_H(Hue)值在颜色空间上色度接近黄色,对照组更接近红色;各部位的Lab_L值(亮度)低于对照组,组间比较提示观察组比对照组面色黑、颜色深、暗淡,提示气血两虚兼血瘀.②观察组舌象图中舌色图的灰度低于对照组,差异有统计学意义(P＜0.01);同时HSV_V值(明度)低于对照组,Lab L值(亮度)低于对照组.苔色图的灰度低于对照组,差异有统计学意义(P＜0.01);同时HSV V值(明度)低于对照组,Lab_L值(亮度)低于对照组.组间比较提示观察组比对照组舌色黯,苔色黄.提示血瘀、湿热.结论:中医面色、舌象的客观化参数提示恶性肿瘤伴抑郁焦虑病机为本虚(气血虚损)、标实(湿热、血瘀).

Background: To determine the clinical activity and safety of Chinese herbal medicine (CHM) combined with epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) in patients with advanced pulmonary adenocarcinoma (ADC) and the ability of CHM combined with EGFR-TKI to activate EGFR mutations. Methods: Three hundred and fifty-four patients were randomly assigned to EGFR-TKI (erlotinib 150 mg/d, gefitinib 250 mg/d, or icotinib 125 mg tid/d) plus CHM (TKI+CHM, N = 185) or EGFR-TKI plus placebo (TKI+placebo, N = 169). Progression-free survival (PFS) was the primary end point; the secondary end points were overall survival (OS), objective response rate (ORR), disease control rate (DCR), quality of life [Functional Assessment of Cancer Therapy-Lung (FACT-L) and Lung Cancer Symptom Scale (LCSS)], and safety. Results: The median PFS was significantly longer for the TKI+CHM group (13.50 months; 95% CI, 11.20-16.46 months) than with the EGFR-TKI group (10.94 months; 95% CI, 8.97-12.45 months; hazard ratio, 0.68; 95% CI, 0.51-0.90; P = 0.0064). The subgroup analyses favored TKI+CHM as a first-line treatment (15.97 vs. 10.97 months, P = 0.0447) rather than as a second-line treatment (11.43 vs. 9.23 months, P = 0.0530). Patients with exon 19 deletion had a significantly longer PFS than with 21 L858R. The addition of CHM to TKI significantly improved the ORR (64.32% vs. 52.66%, P = 0.026) and QoL. Drug-related grade 1-2 adverse events were less common with TKI+CHM. Conclusions: TKI+CHM improved PFS when compared with TKI alone in patients with EGFR mutation-positive advanced non-small-cell lung cancer (NSCLC). Clinical Trial Registration: www.ClinicalTrials.gov, identifier NCT01745302.

目的 总结近20年来发表的淋巴瘤名家经验总结及病例报道的文献中出现各种中医证型和方剂的频次,根据结果分析近年来淋巴瘤的中医辨证论治规律,为淋巴瘤的中医药规范化治疗奠定基础.方法 中国知网(CNKI)检索“全文:淋巴瘤,并且全文:中医”,检索范畴为“中医、中西医结合”,检索出1998年1月1日至2018年9月30号的期刊文献共449篇,根据纳入和排除标准,共筛选出文献137篇.用Excel2010列出每篇符合纳入标准的文献所提及的淋巴瘤中医证型及方剂,记录频次.结果 中医证型占前16位的分别是气血两虚证(13.06％)、痰瘀互结证(9.62％)、气阴两虚证(7.90％)、肝肾阴虚证(7.90％)、寒痰凝滞证(7.56％)、脾肾两虚证(5.50％)、气滞痰凝证(5.15％)、痰热内蕴证(4.81％)、肝气郁滞证(4.12％)、阴虚火旺证(3.44％)、瘀毒互结证(3.09％)、脾虚夹湿证(3.09％)、正虚毒恋证(3.09％)、痰湿凝滞证(2.41％)、脾胃气虚证(2.06％)、血燥风热证(2.06％),实证中排在前3位的是痰瘀互结证、寒痰凝滞证、气滞痰凝证,虚证中排在前3位的是气血两虚证、气阴两虚证、肝肾阴虚证,虚实夹杂证中排在前两位的是脾虚夹湿证、正虚毒恋证.方剂运用频次占前9位的分别是消瘰丸(19.15％)、阳和汤(17.02％)、二陈汤(6.38％)、青蒿鳖甲汤(4.26％)、大补阴丸(4.26％)、鳖甲煎丸(4.26％)、六味地黄丸(4.26％)、逍遥散(4.26％)、八珍汤(4.26％).结论 淋巴瘤临床表现为本虚标实之证,“症”为其主要病理因素.该研究对淋巴瘤文献中出现的中医证型和方剂频次的总结,为日后中医药规范化治疗淋巴瘤奠定了基础.

OBJECTIVE:To observe clinical efficacy and safety of Compound xiongshao capsules in the treatment of diabetic peripheral neuropathy (DPN).METHODS:A total of 97 DPN patients selected from our hospital during Jun.2015-Apr.2016 were divided into group A (compound xiongshao treatment group,46 cases) and control group (51 cases) according to random number table.The latter was divided into group B (epalrestat+beraprost sodium group,12 cases),group C (fursultiamine+mecobalamin group,12 cases) and group D (epalrestat group,27 cases) according to clinical symptoms and economic situation of patients.Four groups were given antidiabetic drugs for blood glucose control.Based on it,group A was additionally given Compound xiongshao capsules 0.9 g,tid;group B was additionally given Epalrestat tablets 50 mg,tid+Beraprost sodium tablets 40 μg,tid;group C was additionally given Fursultiamine tablets 50 mg,tid+Mecobalamin tablets 0.5 mg,rid;group D was additionally given Epalrestat tablets 50 mg,tid.All groups were treated for 6 months.Clinical efficacies were observed.TCSS scores,motor nerve conduction velocity (MCV),sensory nerve conduction velocity (SCV),incubation period and amplitude of median nerve and common peroneal nerve,the levels of hemorheology indexes,blood glucose,glycosylated hemoglobin,blood lipid,serum creatinine were compared before and after treatment.The occurrence of ADR was recorded.RESULTS:Total response rates of group A and B (82.61％,83.33％)were significantly higher than those of group C and D (33.33％,66.67％),total response rate of group D was significantly higher than that of group C,with statistical significance (P＜0.05).Before treatment,there was no statistical significance in TCSS scores,MCV,SCV,incubation period and amplitude of median nerve,MCV and amplitude of common peroneal never,SCV,incubation period and amplitude of common peroneal never or whole blood high-shear viscosity among 4 groups (P＞0.05).After treatment,TCSS scores of group A,B and D were decreased significantly compared to before treatment,and those of group A and B were lower than those of group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of median nerve in group A and B,amplitude of median nerve in group C,MCV and amplitude of median nerve in group D were significantly better than before treatment;MCV,incubation period and amplitude of median nerve in group A and B were significantly better than group C and D,with statistical significance (P＜0.05).MCV,incubation period and amplitude of common peroneal never in group A,B,C were significantly better than before treatment,MCV and amplitude of common peroneal never in group A,B were significantly better than group C,D;the improvement of incubation period of common peroneal never in group A,B,D were significantly better than group C,with statistical significance (P＜0.05).SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,B and D were significantly better than before treatment;SCV,incubation period and amplitude of median nerve,SCV and amplitude of common peroneal nerve in group A,SCV,incubation period and amplitude of median nerve and amplitude of common peroneal nerve in group B were significantly better than group C and D;SCV of median nerve in group D was significantly better than group C,with statistical significance (P＜0.05).Whole blood high-shear viscosity of group A was decreased significantly compared to before treatment,and significantly lower than those of group B,C and D,with statistical significance (P＜0.05).There was no statistical significance in total response rate and TCSS score between group A and B,and in the levels of blood glucose,glycosylated hemoglobin,blood lipid or serum creatinine among 4 groups (P＞0.05).No obvious ADR was found in 4 groups.CONCLUSIONS:Compound xiongshao capsules shows significant therapeutic efficacy for DPN,and improves nerve conduction velocity,incubation period and amplitude of median nerve and common peroneal nerve,whole blood high-shear viscosity.Its effect is similar to that of epalrestat combined with beraprost sodium,and better than those of fursultiamine combined with mecobalamin,epalrestat alone.It does not affect the blood glucose,blood lipid and serum creatinine levels with good safety.

Background: Chinese Herb Medicine Formulas (CHMF) was reported to improve the quality of life (QoL) in advanced NSCLC patients. The present study was designed to investigate whether maintenance chemotherapy plus CHMF in patients would improve QoL and progression-free survival (PFS). Methods: Seventy-one patients were enrolled from 8 medical centers in China, and were randomly assigned to a maintenance chemotherapy plus CHMF group (n = 35) or a maintenance chemotherapy plus placebo group (n = 36). The outcome measures included PFS, Karnofsky performance status (KPS) scores, QoL (assessed with the lung cancer symptom scale (LCSS) questionnaire), and adverse events (AEs). Results: Patients in the CHMF group showed significant improvements in median PFS (HR = 0.55, 95% CI 0.28-0.88, P = 0.019), KPS scores (P = 0.047), fatigue (cycle [C] 3: P = 0.03), interference with daily activities (C3: P = 0.04) and dyspnea (C2: P = 0.03) compared with patients in the placebo group. Compared with the placebo group, the incidence of AEs decreased in the CHMF group, including loss of appetite (C2: P = 0.011, C4: P = 0.004) and dry mouth (C4: P = 0.011). Conclusion: The essential finding of our study is that maintenance chemotherapy combined with CHMF may prolong PFS, relieve symptoms, improve QoL and alleviate the side effects.

目的:观察扶正治癌中药组方联合表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)靶向药物治疗晚期非小细胞肺癌的疗效及安全性.方法:采用双盲、随机、安慰剂对照的前瞻性临床研究方法,将60例伴有EGFR基因突变的晚期非小细胞肺腺癌一线或二线治疗患者按照1:1比例随机分为2组:试验组(扶正治癌组方辨证中药+靶向治疗组)和对照组(安慰剂+靶向治疗组).研究主要疗效指标为:无进展生存时间(PFS);次要疗效指标:总生存时间(0S);客观缓解率(0RR);肺癌症状量表(LSCC量表);中医症候评分;不良反应和安全性评估;组织或血液标本的EGRF基因外显子(E19～21)、Kras、Braf、PI3KCA、ALK基因突变和ROS1基因重排检测.结果:实际50例患者进入意向性分析(试验组28例,对照组22例).试验组辨证分型气虚型患者中医临床证候改善显著优于对照组(P=0.001).LSCC量表分析试验组症状改善显著优于对照组(P=0.001).13例疾病进展患者进行基因突变动态监测,试验组未发现p.T790M耐药突变,对照组发现3例p.T790M突变率为42.86％.两组总体治疗相关药物不良反应发生率无显著差异.试验组严重药物不良反应发生率为6.67％,对照组为16.67％.结论:扶正治癌中药组方有延长TKI靶向治疗的晚期非小细胞肺腺癌患者PFS和OS的趋势,能够显著改善肺癌症状,提高生活质量,同时能够改善气虚型患者临床症候,以及减少严重不良反应事件发生.