Granular β-1,3-glucan extracted from the wall of Ganoderma lucidum spores, named GPG, is a bioregulator. In this study, we investigated the structural, thermal, and other physical properties of GPG. We determined whether GPG ameliorated immunosuppression caused by Gemcitabine (GEM) chemotherapy. Triple-negative breast cancer mice with GPG combined with GEM treatment had reduced tumor burdens. In addition, GEM treatment alone altered the tumor microenvironment(TME), including a reduction in antitumor T cells and a rise in myeloid-derived suppressor cells (MDSC) and regulatory T cells (Tregs). However, combined GPG treatment reversed the tumor immunosuppressive microenvironment induced by GEM. GPG inhibited bone marrow (BM)-derived MDSC differentiation and reversed MDSC expansion induced by conditioned medium (CM) in GEM-treated E0771 cells through a Dectin-1 pathway. In addition, GPG downgraded PD-L1 and IDO1 expression on MDSC while boosting MHC-II, CD86, TNF-α, and IL-6 expression. In conclusion, this study demonstrated that GPG could alleviate the adverse effects induced by GEM chemotherapy by regulating TME.

目的：观察参芪益肠汤对胃癌根治术后患者的癌因性疲劳、生活质量、胃肠功能及免疫功能的影响。方法：选取接受胃癌根治术的患者90例，采用回顾性研究，按照术后是否使用参芪益肠汤分为治疗组和对照组，每组各45例。对照组予以西医常规对症支持治疗，治疗组在对照组基础上加用参芪益肠汤治疗，疗程均为4周。比较2组治疗前后Piper疲乏量表评分、癌症患者生命质量测定量表（FACT-G）评分、淋巴细胞亚群指标[CD4 + 、CD8 + 、CD4 + /CD8 + 、自然杀伤细胞（NK）]水平及治疗后胃肠功能恢复情况。结果：2组治疗后Piper疲乏量表评分、FACT-G各项指标评分和淋巴细胞亚群指标水平均较治疗前改善，且治疗组优于对照组（P＜0.05或P＜0.01）。治疗组肠鸣音恢复时间、肛门排气时间、排便时间均短于对照组，胃管总引流量较对照组减少，差异均有统计学意义（P＜0.01）。结论：参芪益肠汤可明显改善胃癌根治术后患者癌因性疲劳症状，促进胃肠功能恢复，增强机体免疫功能，提高生活质量。

目的:探讨保守治疗对老年胆结石患者临床结局的影响.方法:2013年5月-2016年10月收治老年胆结石患者188例,所有患者出院后的平均随访时间为2年,分析随访期间患者出现的不适症状、接受的治疗方法等,通过Kaplan-Meier生存曲线分析复发情况以及可能的复发因素.结果:纳入患者平均年龄为(70.6±8.2)岁,其中男103例.住院的主要原因包括急性结石性胆囊炎114例、胆绞痛37例、胆管炎21例、胆总管结石16例.经保守治疗后,胆结石复发率为37.2％;平均复发时间为(249.8±55.6)d,其中72.9％的患者在出院后1年内复发.胆管疾病组患者复发率明显高于胆囊疾病组,差异有统计学意义(P<0.01).在入院期间出现两个或以上相关诊断的胆结石患者有更高的复发率,差异有统计学意义(P<0.01).结论:1/3以上的老年胆结石患者在接受保守治疗后2年内会出现复发,针对这些患者应在入院时尽早考虑接受胆囊切除术,以防止复发,提高生活质量.

目的:观察清胰方对高脂血症性胰腺炎(HLP)患者的临床疗效及免疫功能的影响.方法:将80例HLP患者随机分为治疗组和对照组,每组各40例.对照组予西医常规治疗,治疗组在对照组基础上加用清胰方治疗,疗程均为7d.比较2组治疗前后中医证候(腹胀腹痛、恶心呕吐、身热、大便不通、舌红、脉滑数)积分、急性生理与慢性健康(APACHEⅡ)评分及实验室指标[三酰甘油(TG)、白细胞(WBC)、C反应蛋白(CRP)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、免疫球蛋白A(IgA)]的变化.结果:2组治疗前后中医证候积分、APACHEⅡ评分及TG、WBC、CRP、IgG、IgM、IgA水平治疗前后组内比较及治疗后组间比较,差异均有统计学意义(P＜0.05).结论:清胰方可以有效改善HLP患者的中医证候积分和APACHEⅡ评分,降低炎症因子水平,调节机体免疫功能,提高临床疗效.

目的 回顾性比较两所不同等级医院对良、恶性甲状腺结节的诊疗方式.方法 收集南京中医药大学附属中西医结合医院(三甲医院,甲组,408例)和江苏省建湖县人民医院(三乙医院,乙组,155例)甲状腺结节患者术前诊断检查资料、手术方式及术后病理结果,采用美国放射学会甲状腺成像报告和数据系统(ACR-TIRADS)对所有结节进行分级,并计算总体ACR-TIRADS的诊断效能.结果 与甲组相比,乙组甲状腺癌患者年龄和结节直径较大(P＜0.01).甲组甲状腺癌患者的术前颈部CT检查和超声引导下细针穿刺细胞学检查实施率高于乙组(95.99％ vs.0和82.22％vs.5.56％) (P＜0.01).甲组对甲状腺良性结节处理和对甲状腺癌手术方式选择的合理率均高于乙组(88.51％ vs.41.71％和94.13％ vs.58.62％)(P＜0.01).ACR-TIRADS 4级诊断总体甲状腺癌的灵敏度、特异度、阳性预测值、阴性预测值和准确性分别为97.05％、68.78％、79.70％、94.86％和84.56％.结论 不同等级医院在甲状腺结节术前诊断和手术治疗方式上存在显著差异,应推动基层医院甲状腺结节规范化诊疗,提高甲状腺结节的管理水平.

presentations [7,8]. There was no heterogeneity between the studies. There was no difference in the technical success between the two approach (254/256 vs. 260/260) relative risk: 0.99 (0.97–1.01), P = 0.4. Accidental mucosotomy were more common in the anterior myotomy (54/256 vs. 20/260) relative risk: 2.7 (1.7–4.3), P < 0.0001 ((Fig. 1). Anterior and posterior myotomy at POEM is equally highly effective and safe for the treatment of achalasia. Anterior myotomy has a higher incidence of adverse events and accidental mucosotomy compared to the posterior approach.

目的:探讨三种超声征象及其联合应用对甲状腺乳头状癌(Papillary thyroid carcinoma,PTC)的诊断意义.方法:回顾性分析经手术病理证实的55例72枚PTC及18例28枚甲状腺良性结节(Benign thyroid nodules,BTN)的超声征象,包括纵横比≥1、边缘不规则和微钙化,计算三种超声征象及其联合应用诊断PTC的灵敏度、特异度、准确度.结果:纵横比≥1、边缘不规则和微钙化在PTC与BTN之间均具有统计学差异(P<O.05).单项超声征象中,边缘不规则的灵敏度和准确度最高,均为93%;纵横比≥1的特异度最高,为100%.三种超声征象联合诊断的灵敏度和准确度最高,分别为97%和96%,高于任一单项和任意两种征象联合的灵敏度和准确度.结论:纵横比≥1、边缘不规则和微钙化这三种超声征象单独应用在PTC的诊断中具有较高的特异度,联合应用可提高灵敏度及准确度,提示这三种超声征象及其联合应用对PTC的术前诊断具有重要价值.

目的:探讨理气散结方对甲状腺乳头状癌(PTC)术后免疫功能及生活质量的影响.方法:将60例PTC患者随机分为观察组30例和对照组30例.对照组单纯服用优甲乐治疗,观察组在优甲乐的基础上给予理气散结方治疗,两组疗程均为3个月.分别比较两组临床疗效;治疗前后免疫功能(CD3+、CD4+、CD8+)及日常生活质量评分;记录两组在治疗过程中出现的不良反应.结果:与对照组相比,观察组临床症状改善率明显提高,差异具有统计学意义(P＜0.05).两组治疗前各项指标比较差异无统计学意义(P＞0).05).疗程结束后,观察组CD8+水平下降程度较对照组更明显,CD3+、D4+水平及日常生活质量评分较治疗前明显好转,差异有统计学意义(P＜0.05);治疗过程中两组不适症状发生率差异无统计学意义(P＞0.05).结论:理气散结方不仅可以有效缓解PTC患者的临床症状,还可以提高机体免疫功能及术后生活质量,有较高的推广价值.

当归补血汤由黄芪、当归按5∶1组成。通过现代技术,从化学和药理指标方面研究发现,当归补血汤不管从配伍比例还是有效组分的溶出度、生物活性等方面均体现出组方之严谨,配伍之精当。从立方配伍,体内、外实验研究方面均证实了当归补血汤促血管新生的作用,但其作用机制仍不明确。当归补血汤中没有某一部分、部位或单体能代表全方功效及其物质基础,其促进血管新生的作用应归结于汤剂整体,这与中医的整体观及现代复杂性系统理论不谋而合。

目的:观察麦门冬汤加减治疗食管癌术后反流性咳嗽的临床疗效。方法:将56例患者随机分为治疗组和对照组各28例。治疗组予麦门冬汤加减治疗,对照组予奥美拉唑加多潘立酮治疗。结果:总有效率治疗组为92.8%,对照组为71.4%,两组比较,差异有统计学意义(P<0.05)。复发率治疗组为7.7%,对照组为30.0%,两组比较,差异有统计学意义(P<0.05)。结论:麦门冬加减治疗食管癌术后反流性咳嗽有较好的疗效。

Objective To observe the curative effect and safety of Sanhan Zhitong Plaster in the treatment of cold-dampness obstruction syndrome of knee osteoarthritis (KOA). Methods KOA patients (n=578) from 4 research centers were divided, accordind to a proportion of 2:2:1, into group A (n=233, treated with Fufang Nanxing Zhitong Plaster), group B (n=230, treated with Shangshi Jietong Plaster) and group C (n=115, treated with acrylics pressure-sensitive adhesive plaster), once a day for 6 days. The cure rate, effective rate, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), integrals of TCM syndromes and adverse effects after medication were compared among three groups before and after treatment. Results All data were analyzed by using Full Analysis Set (FAS) and Per-Protocol population (PP). The curative effect was the best in group A after knee pain scoring with Visual Analogue Scale (VAS). The change tendency of WOMAC had statistical significance in three groups before and after treatment. The curative effect on TCM syndromes was the best in group A after data analysis with FAS. There were no serious adverse reactions observed related to experimental medicinal. Conclusion Sanhan Zhitong Plaster is safe and effective in the treatment of cold-dampness obstruction syndrome of KOA

The aim of this study was to summarize the recent advances of wound repair pertaining to the pathogenesis and treatments by Chinese medicine and Western medicine.