动脉粥样硬化(atherosclerosis,AS)是导致心脑血管疾病的主要病因.微小RNA(microRNA,miRNA)具有转录后调节基因表达的能力.大量研究显示,miRNA中的miR-33通过调节炎症反应、脂质代谢、自噬及线粒体功能参与调控AS发生发展的各个阶段.随着中医药研究的发展,部分中药已被证明可通过调节miR-33及其相关靶点发挥抗AS的作用.本文就miR-33调控AS的相关靶点及中药调控miR-33防治AS的相关研究进行述评.

胃癌发病率和病死率逐年上升,胃癌前病变(precancerous lesions of gastric cancer,PLGC)是正常胃黏膜转化成胃癌的重要过程.益胃抗癌汤为王新杰教授自拟方,通过多年临床运用发现其在改善胃黏膜功能,延缓胃癌进程方面疗效显著,文章基于网络药理学方法探讨益胃抗癌汤治疗胃癌前病变的分子机制,获得益胃抗癌汤1889个活性成分和499个潜在治疗靶点,通过GeneCards得到胃癌前病变1612个相关靶点,交集靶点168个,从PPI核心网络筛选出71个关键靶点,GO和KEGG分析相关靶基因,参与了 4870个生物学反应过程、447个细胞功能、329个细胞组分以及345个相关信号通路,通过分子对接,所有核心靶基因与核心成分均具有较好的结合活性,其中对接分数较高的是小檗碱、非洲防己碱和氢化小檗碱.为临床应用和进一步的实验验证提供参考.

目的:探讨平消胶囊联合替吉奥(S-1)加奥沙利铂方案治疗晚期胃癌的疗效分析.方法:收集2016年09月至2019年09月郑州大学第一附属医院患者67例,分为治疗组33例和对照组34例,分别给予平消胶囊联合S-1加奥沙利铂化疗和单纯替吉奥加奥沙利铂化疗,连用2个周期.结果:两组患者治疗前后的PFS比较,治疗组明显高于对照组,差异有统计学意义(P<0.05),而OS比较则无明显差异;KPS及QOL评分比较,治疗组明显高于对照组,差异有统计学意义(P<0.05);两组的临床疗效总有效率分别为治疗组84.8％、对照组61.8％,治疗组明显优于对照组(P<0.05),差异具有统计学意义.结论:平消胶囊联合S-1加奥沙利铂方案能显著缓解及减轻晚期胃癌患者的临床症状,改善患者的近期疗效.

Objective:To investigate the effects of directly laparoscopic separation in urological retroperitoneal laparoscopic surgery.Methods:Between June 2017 and June 2019, 60 patients who underwent retroperitoneal laparoscopic surgery in the department of Urology at Changge People′s Hospital were enrolled in this study, including 35 males and 25 females, aged(45.12±12.65)years old, ranging from 25 to 66 years old.The patients were randomly divided into the direct separation group and self-made balloon group, with 30 cases in each group.In the direct separation group, the retroperitoneum was established by directly laparoscopic separation for retroperitoneal laparoscopic surgery, while in the self-made balloon group, the retroperitoneum was established by self-made gasbag for retroperitoneal laparoscopic surgery.The success rate and duration of retroperitoneum establishment, bleeding volume during cavity construction, operation duration, and the occurrence of postoperative complications were compared between the two groups.Results:The success rate of retroperitoneum establishment in the direct separation group was [96.7%(29/30)], higher than [73.3%(22/30)] in the self-made balloon group, the duration of retroperitoneum establishment and operation duration were [(6.26±1.21) minutes] and [(103.84±13.77) minutes], shorter than [(10.89±2.03) minutes] and [(126.45±15.65) minutes] in the self-made balloon group, and the bleeding volume during cavity construction was [(4.22±1.65) ml], less than [(8.73±1.52) ml] of the self-made balloon group, the incidence of complications in the direct separation group was [6.6%(2/30)], lower than [26.7%(8/30)] in the self-made balloon group, and the differences were statistically significant( P<0.05). Conclusion:Directly laparoscopic separation has significant clinical effects in urological retroperitoneal laparoscopic surgery.It is high success rate, less time-consuming, less bleeding, safe and reliable, which is worthy of clinical application.

目的:观察益胃抗癌汤治疗胃癌前病变的临床疗效.方法:选择郑州大学第一附属医院收治的胃癌前病变患者83例,分为两组.对照组40例口服荆花胃康胶囊,2丸/次,3次/d;治疗组43例给予益胃抗癌汤(党参、茯苓、白术、黄连、延胡索、丹参、法半夏、黄芩、木香、莪术、炒麦芽、山楂、神曲、甘草),1剂/d,水煎服.两组均于连续治疗3个月后判定疗效.结果:临床疗效方面,治疗组显效23例,有效13例,无效7例,有效率为83.72％;对照组显效13例,有效11例,无效16例,有效率为60.00％.两组对比,差异有统计学意义(P<0.05).病理疗效方面,治疗组显效24例,有效13例,无效6例,恶化0例,有效率86.05％;对照组显效11例,有效14例,无效15例,恶化0例,有效率62.50％.两组对比,差异有统计学意义(P<0.05).结论:益胃抗癌汤治疗胃癌前病变疗效确切.

目的 明确益气扶正法治疗食管癌气虚型癌因性疲乏的临床疗效.方法 选择郑州大学第一附属医院收治的中晚期食管癌患者101例,按治疗方法分为两组,对照组给予紫杉醇加顺铂方案化疗(紫杉醇150 mg/m2,d1,静滴;顺铂75 mg/m2,分1～3天,静滴,Q3W),治疗组在化疗的基础上,加服中药自拟芪归复元汤:炙黄芪30～50 g,当归20 g,鸡血藤30 g,炒薏苡仁30 g,党参15 g,生白术30 g,茯苓15 g,山药20 g,阿胶9 g(烊化),陈皮12 g,代赭石12 g,焦三仙各12 g,水煎服,每天1剂,两组均连续治疗2个疗程(6周)后判定疗效.结果 两组治疗后比较,在疲乏程度Piper评分、生活质量(quality of Life,QOL)评分、一般状况卡氏评分(karnofsky performance status,KPS)及临床疗效等方面对比,治疗组均明显优于对照组,差异均有统计学意义(P<0.05).结论 运用具有益气养血、扶正固本功效的芪归复元汤联合化疗治疗食管癌气虚型癌因性疲乏等症临床疗效确切.

目的 观察通噎消积方联合西药治疗中晚期食管癌患者的近期疗效.方法 将中晚期食管癌患者61例随机分为治疗组30例和对照组31例,治疗组给予通噎消积方加西医基础治疗;对照组只给予西医基础治疗,每4周为1个疗程,共治疗2个疗程.观察两组患者治疗前及治疗1、2个疗程后的功能状态(KPS)、生活质量(QOL)、肿瘤标志物[包括癌胚抗原(CEA)、糖类抗原(CA19-9)]及安全性指标,治疗后评价临床疗效. 结果 治疗组治疗1、2个疗程后KPS、QOL评分均较治疗前显著上升,CEA、CA19-9水平显著下降(P＜0.05或P＜0.01),且治疗2个疗程后QOL、CA19-9改善均较治疗1个疗程后更为显著(P＜0.05).治疗2个疗程后,治疗组与对照组总有效率分别为56.7％、30.0％,治疗组疗效显著高于对照组(P＜0.05).结论 通噎消积方联合西药能明显提高临床疗效,改善患者的功能状态与生活质量,优于单独应用西药.

目的：观察消癌平联合TP方案治疗晚期食管癌的临床疗效。方法将晚期食管癌患者62例随机均分为治疗组和对照组。治疗组给予静脉滴注消癌平注射液40 mL／d，21 d为1个疗程；同时给予TP方案化疗，即紫杉醇每平方米135 mg溶入0．9％氯化钠溶液500 mL中静脉滴注4 h第1天，顺铂25 mg／m2静脉滴注第1—4天，21 d为1个疗程，化疗2个疗程。对照组只给予TP方案化疗。观察对比治疗前及每周期后2组实验室检查、一般状况卡氏评分（ KPS）、生活质量评分（ QOL）及SCT的疗效评价等结果。结果治疗2个疗程后，治疗组WBC、RBC及Plt均无明显变化（P均＞0．05），而对照组各项均明显下降（P均＜0．05），且2组治疗后各项比较差异均有统计学意义（P均＜0．05）。治疗1个疗程及2个疗程后，2组肝肾功能各项指标与治疗前比较差异均无统计学意义（P均＞0．05），且组间比较差异无统计学意义（P均＞0．05）。治疗2个疗程后，治疗组KPS评分和QOL评分均明显上升（P均＜0．05），而对照组各项评分无明显改善（P均＞0．05）。治疗1个疗程和2个疗程后，治疗组总有效率均显著高于对照组（P均＜0.05）。2组不良反应发生率比较差异无统计学意义（P＞0．05）。结论消癌平联合TP方案治疗晚期食管癌疗效显著，可明显改善患者预后生活水平，提高患者生活质量，且不良反应少。

食管癌是常见的恶性肿瘤,目前治疗西医仍以手术、放化疗为主要手段,放化疗有一定的毒副反应且有一定的疗程时限,而复发、转移或毒副作用大是中晚期患者疗效差的主要原因.中西医结合在肿瘤的综合治疗中有优势.我们近年在临床上应用中药复方斑蝥胶囊联合TP方案治疗晚期食管癌,取得了较满意的疗效现总结报告如下.

目的通过研究癌基因RAS、MAPK及细胞周期素D1在正常组织、食管癌旁组织、食管癌组织中的表达,探讨癌基因RAS/MAPK通路及cyclinD1与食管癌发生的关系及意义。方法将临床收集的105例食管鳞癌组织石蜡切片,分为正常组,癌旁组,癌组织高、中、低分化组,转移和未转移组及浸润程度深和浅组。采用免疫组化方法,先检测各组组织中RAS、MAPK及cyclinD1的表达,再检测癌组织高、中、低分化组,转移和未转移组及浸润程度深和浅组各组中抗体RAS、MAPK、cyclinD1的表达。结果 RAS、MAPK、cyclinD1在正常组、癌旁组及癌组织中的表达中,正常组和癌组织比较均有统计学差异(P<0.05),在癌组织高、中、低分化组间比较无统计学差异(P>0.05),在癌组织转移和未转移组间有统计学差异(P<0.05),在癌组织浸润深和浅2组比较无统计学差异(P>0.05)。结论癌基因RAS、MAPK及其通路和cyclinD1的活化高表达与食管癌的发生与转移有关。

Objective :To study the Clinical efficacy of tongye oral liquid on the KPS and QOL of esophagea1carcinoma.Methods:A total of 60 cases ofesophageal carcinomawere randomly divided into 2 groups.Treat-ment groupwas given tongye oral liquid(one times perday) and TP chemical treatment;thecontrol groupwas given TP chemical treatment.The general condition,Karnofsky(KPS) and qualifyof life(QOL) of the 2 groupswere observed,before treatmen and the end of one course of treatmentand two course of treatment.Results:After treatment,the general condition,KPS,QOL in twogroups were both improved(P 0.05 or 0.01),and those of treatment group were better(P 0.01).The total effective rate in treatmentgroup was higher than that in control group after 2 months treatment(P 0.05).Conclusion:Tongye oral liquid can improve the general condition,the KPS and QOL of esophageal carcinoma.

原发性肝癌是我国常见的恶性肿瘤,其特点为病程进展快、恶性程度高,且大多伴有肝炎后肝硬化、癌性腹水、黄疸等症,发现时多为中晚期,失去手术机会,或者因体质差,不能耐受手术或放化疗,笔者近年来运用中西医结合的方法,即复方苦参注射液结合西药对症支持疗法,对30例中晚期原发性肝癌患者进行临床治疗观察,现报道如下.

目的:观察益气健脾冲剂对转移性肝癌的抑制作用,探讨其抗转移作用的机制。方法:将40只癌肉瘤造模大鼠随机分为中药组和对照组;中药组灌喂蒸馏水溶解的益气健脾冲剂0.3 mL(益气健脾冲剂浓度相当于生药剂量2 g/mL),对照组灌喂等量生理盐水,每日1次,连续给药21 d;处死动物,剥离脾脏瘤结节称重,计算抑瘤率;观察转移性肝癌结节数,分离瘤组织,以原位杂交法检测瘤组织中MMP-1 mRNA的表达。结果:益气健脾冲剂明显抑制转移性肝癌瘤灶生长,中药组平均瘤重(1.38±0.29)g,抑瘤率达41.25%(P<0.001);中药组转移性肝癌灶数平均(7.5±2.21)个,转移抑制率为40.6%;转移肝癌瘤组织原位杂交检测结果显示,中药组MMP-1阳性表达率30%,且无一样本呈强阳性,与对照组(70%)比较,差异显著(P<0.05)。结论:益气健脾冲剂能有效地抑制瘤细胞在肝脏的生长,防止转移性肝癌的形成,其抑制肝转移的作用与抑制瘤细胞MMP-1表达有关。

Aim: To study the effect of Dougenguanshitong oral liquid in treatment of esophageal carcinoma.Methods: A total of 60 cases of esophageal carcinoma were randomly divided into 2 groups. Treatment group was given Dougenguanshitong oral liquid, 3 times per day, the control group was given an anti-tumor drug, 3 times per day. The general condition, clinical symptoms and qualify of life of the 2 groups were observed, and the serum IL-6 and IL-10 were determined before treatment, at the end of 1 month and 2 months treatment.Results: After treatment, the general condition, clinical symptoms, and qulity of life in 2 groups were both improved (P0.05 or 0.01), and those of treatment group were better (P0.01). Compared with control group, the serum IL-6 increased and IL-10 decreased. The total effective rate in treatment group was higher than that in control group after 2 months treatment (46.7% vs 23.3%, P0.05).Conclusion: Dougenguanshitong oral liquid can improve the general condition, symptoms and quality of life, which may involve in its increasing serum IL-6 and decreasing IL-10.

目的:探讨研究中西医结合治疗晚期胃癌的方法;方法:选60例晚期胃癌患者,随机分成两组,中西医治疗组30例用中药加化疗药物治疗,西药对照组30例单纯用西药化疗,两组化疗方案相同;结果:治疗组和对照组有效率分别为43.33%和36.67%,治疗组半年生存率和1年生存率分别为76.62%和43.33%,对照组半年生存率和1年生存率分别为36.67%和10%。结论:中西医结合治疗晚期胃癌虽未能明显改善肿瘤局部近期疗效,但能明显改善患者症状,明显延长患者生存期。

随着人类寿命的不断延长,老年妇女的比例不断升高,目前我国妇女己有五分之一步入老年期。而老年妇女的消化功能衰退与其性腺-生殖轴的紊乱有密切相关性,具有其自身的特殊性。根据《内经.上古天真论》“女子……五七,阳明脉衰;六七,三阳脉衰于上”的理论,认为“阳明经气不足”是此期特殊生理病理内环境改变的结果。研究二者的联系将会对其治疗带来一个新的启迪。本文探讨了“阳明脉衰”与天癸衰竭的病机相关性,认为滋阴填精改善老年妇女特殊的病理生理内环境是延缓“阳明经气不足”,防治消化功能衰退的治本措施。本文主要从足阳明胃经与老年女性天癸衰竭的关系,对其消化功能衰退的病因学提出管窥之见。

从实验研究和临床应用两个方面综述近年来中医药防治原发性肝癌的研究进展,认为活血化瘀、清热解毒、健脾理气、滋阴养血等治法治疗原发性肝癌有明显优势,预测中药介入将成为临床研究热点,同时指出目前研究中存在的主要问题和解决办法.

Objective:To study the effect of Dougenguanshitong for the immunology function of body and the effect of clinic,and explore the pathogenesis.Method:According to the radom method of comparing,It is key to have observed KPS.symptom body solicit and QOL.the cell of immunity globulin and Cytokin.Result:Before and After therapy KPS and QOL of two groups were improved obviously(P0.01),result of rerum cytokines of two groups:was improved obviously(P0.05,P0.01).Conclusion:The Dougenguanshitong Oral Liquid recipe can improve the general condition KPS.symptom body solicit and live quality QOL.and improve the cell of immunity globulinand Cytokin and the immunity function of body.

Objective To observe the effect of Dougenguanshitong (DGGST) oral liquids on the cell cycle regulation factor of modeled esophageal carcinoma rats, explore the function mechanism of the medicine at molecular level. Methods Healthy Wistar rats were treated with MANA 5 mg/kg (s.c. once/week) and randomly divided into the following groups: esophageal carcinoma group (the model), DGGST high dose group, DGGST middle dose group, DGGST low dose group, the Tegafur tablets group (the chemotherapy). Fedthem N·S or test drug, then the rats were sacrificed to examine the following index: ①The weight and survival rate of the rats. ②Esophageal carcinoma histopathology change by sight and under microscope. ③Immunohistochemical staining of p16, Rb, cyclin D1, CDK4, PCNA were performed using a streptavidin-biotin staining technique. Results ①Compared with chemotherapy group (P 0.01), DGGST oral liquids can decrease the death rate of the modeled rats, and regain the weight of the modeled rats, obviously in the DGGST high dose group (P 0.05). ②After treatment, the expression of p16 and Rb increased, evidently in the DGGST high dose group, compared with the model group, the results were significant (P 0.05). ③After treatment, the expression of cyclin D1 and CDK4 increased especially in the DGGST high dose group and the chemotherapy group, compared with the model group (P 0.05). Conclusion DGGST has good prevention and treatment effect on esophageal carcinoma. The molecular mechanism of DGGST resisting esophageal carcinima may be like that: By increasing the expression of the tumor suppressor genes (p16, Rb), decreasing the expression of the oncogenes (cyclin D1, CDK4), and stopping the process of cell cycle from G1 to S phase, the growth of esophageal carcinoma cells can be suppressed.