Lung cancer is one of the diseases with high morbidity and mortality,and non-small cell lung cancer accounts for a large proportion of it.Traditional Chinese medicine has a long history in treating tumors.More and mor...Lung cancer is one of the diseases with high morbidity and mortality,and non-small cell lung cancer accounts for a large proportion of it.Traditional Chinese medicine has a long history in treating tumors.More and more researchers have paid more attention to it.At present,many studies have proved that traditional Chinese medicine extracts such as astragalus,turmeric,ginseng,coix seed,and gallbladder can inhibit tumor cell proliferation,and have synergistic effects when used in combination with radiotherapy and chemotherapy Its mechanism of action is mostly related to regulating the cell cycle,inhibiting the expression of cancer-related genes,and inducing apoptosis.It is believed that with the development of purification technology,Chinese medicine extracts will play a greater role.展开更多
Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for ...Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.展开更多
Chemotherapy is the main treatment for non-small cell lung cancer(NSCLC),but it often leads to serious side effects.Modern studies indicated that medicinal diets can reduce the side effects of chemotherapy.However,bli...Chemotherapy is the main treatment for non-small cell lung cancer(NSCLC),but it often leads to serious side effects.Modern studies indicated that medicinal diets can reduce the side effects of chemotherapy.However,blindly taking medicinal diet always fails to achieve curative effect and even aggravates the patient's condition.In order to provide dietary guidance for NSCLC patients undergoing chemotherapy,based on the basic theory of traditional Chinese medicine,the article elaborates the application of medicinal diets in those NSCLC patients who have been treated by chemotherapy.展开更多
The most common subtype of lung cancer is non-small cell lung cancer(NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradu...The most common subtype of lung cancer is non-small cell lung cancer(NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradually become the mainstream of NSCLC treatment. Traditional Chinese medicine(TCM) can be used effectively either as an adjunctive therapy or alone throughout the NSCLC therapy,which has a significant impact on survival, quality of life, and reduction of toxicity. Therefore, this paper reviewed the theoretical basis, the latest clinical application, and combined treatment mechanisms in order to explore the advantage stage of TCM treatment and the synergistic therapeutic mechanisms.展开更多
Objective：Vitamin D and its receptor（VDR） involve in multiple cellular processes and play an important role in the initiation and progression of malignancy.Thus we hypothesized that plasma vitamin D levels and sing...Objective：Vitamin D and its receptor（VDR） involve in multiple cellular processes and play an important role in the initiation and progression of malignancy.Thus we hypothesized that plasma vitamin D levels and single nucleotide polymorphisms（SNPs） in VDR may be of prognostic significance in non-small cell lung cancer（NSCLC）.Methods：We examined plasma 25-hydroxyvitamin D [25（OH）D] levels in 87 patients diagnosed with NSCLC using enzyme-linked immunosorbent assay（ELISA） and genotyped seven potentially functional SNPs in VDR in 568 NSCLC patients on Illumina Golden Gate platform.Results：Patients with higher plasma 25（OH）D levels had worse survival than patients with lower ones（P for trend = 0.048）.The SNPs of rs1544410 and rs739837 were independently associated with NSCLC survival（adjusted HR = 1.61,95% CIs = 1.06-2.45 for rs739837 AA vs AC/CC and adjusted HR = 1.51,95% CIs = 1.06-2.16 for rs1544410 AG/AA vs GG）.A joint effect was observed between rs1544410 and rs739837 and the risk of death elevated as the number of unfavourable genotypes patients carried increased（P for trend = 0.003）.There were no significant associations between VDR polymorphisms and plasma 25（OH）D levels.Conclusion：Our findings indicate that plasma 25（OH）D levels and genetic variants of VDR may serve as prognostic markers for NSCLC in this Chinese population.展开更多
Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanaly...Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.展开更多
Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in sta...Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.展开更多
Objective： To observe the clinical effect of the combined therapy using argon-helium cryosurgery （Ar-He knife） and Chinese herbal medicine in treating non-small cell lung cancer （NSCLC）. Methods： Fifty-seven pat...Objective： To observe the clinical effect of the combined therapy using argon-helium cryosurgery （Ar-He knife） and Chinese herbal medicine in treating non-small cell lung cancer （NSCLC）. Methods： Fifty-seven patients of NSCLC were treated with the combined therapy and observed. Results： The treatment was successfully completed in all patients with mild adverse reactions. The effective rate was 83.8% 3 months after the operation, 79.6% 6 months after the operation, and 77.3% 12 months after the operation, with median survival of 9 months. The survival rate after 12 months was 46.67% （21/45）, 34.62% （9/26） after 18 months, and 36.36% （4/11） after 24 months. Conclusion： Argon-helium cryosurgery therapy is superior in its assured orientation, quick tumor load deprivation and less post- operational reaction. Combined with Chinese herbal medication, Argon-helium cryosurgery therapy can prolong survival time, relieve clinical symptoms, and elevate the quality of life in NSCLC patients, and is thus worthy of promotion.展开更多
Objective： To investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive 1-125 seeds interstitial implantation （ISI） synchronized chemotherapy and Chinese medicine （CM） for ...Objective： To investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive 1-125 seeds interstitial implantation （ISI） synchronized chemotherapy and Chinese medicine （CM） for the treatment of advanced stage of non-small cell lung cancer （NSCLC）. Methods： Ninety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups： the synchronized therapy group （A）, the chemotherapy plus CM-treated group （B）, and the chemotherapy-treated group （C）; a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers （carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment）, clinical symptoms, and quality of life （QOL） in patients. Results： The total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing significant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more significant in Group A than those in Group C （all P〈0.05）. Conclusion： The synchronized therapy of 1-125 implantation with chemotherapy and CM was a safe therapeutic method and can be regarded as a new mode for treatment of advanced-stage NSCLC.展开更多
Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung ca...Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung cancer(NSCLC)and identify factors that influence progression and prognosis.Methods Clinical data of 855 patients with advanced NSCLC who received multidisciplinary and comprehensive CM treatments at Longhua Hospital from January 2009 to December 2018 were retrospectively analyzed.Univariate analysis was performed by the Kaplan-Meier method and log-rank sequential inspection.Multivariate analysis of significant variables from the univariate analysis was performed with Cox regression modeling.Key factors correlated to progression and prognosis were screened out,and a Cox proportional hazard model was established to calculate the prognostic index.Results The PFS and MST of 855 advanced NSCLC patients were 9.0 and 26.0 months,respectively.The 1-,2-,3-,and 5-year survival rates were 79.2%,54%,36.2%,and 17.1%,respectively.Gender,pathologic type,and clinical stage were independent prognostic risk factors;surgical history,radiotherapy,treatment course of Chinese patent medicine,intravenous drip of Chinese herbal preparation,duration of oral administration of Chinese herbal decoction(CHD),and intervention measures were independent prognostic protective factors.Gender was an independent risk factor for progression,while operation history and oral CHD administration duration were independent protective factors(all P<0.05).Women with stage IIIb–IIIc lung adenocarcinoma had the best outcomes.Conclusions Female patients have lower progression risk and better prognoses than male patients,younger patients have higher progression risk but better long-term prognoses than the elderlys,and patients with lower performance status scores are at lower risk for progression and have better prognoses.Comprehensive CM treatments could significantly reduce progression risk,improve prognosis,and prolong survival time for patients with advanced NSCLC.This treatment mode offers additional advantages over supportive care alone.展开更多
Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medi...Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medicine（WM） alone. Methods： This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage Ⅲ–Ⅳ NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network（NCCN） guidelines. In the integrative medicine（IM） group, individualized CM（Chinese patent medicines and injections） and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months. Results： The median survival was 16.60 months in the IM group and 13.13 months in the WM group（P〈0.01）. The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group（P〈0.05）. The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course（P〈0.05）. Conclusions： Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio-and chemotherapy may be attenuated as CM is used in combination with conventional treatments.展开更多
Objective： To investigate the prognostic influence on long-term overall survival （OS） from treatment with Chinese medicine （CM） and chemotherapy or targeted therapy in advanced non-small-cell lung cancer （NSCLC...Objective： To investigate the prognostic influence on long-term overall survival （OS） from treatment with Chinese medicine （CM） and chemotherapy or targeted therapy in advanced non-small-cell lung cancer （NSCLC） patients. Methods： The clinical data of 206 advanced NSCLC patients who were treated with CM and Western medicine in Beijing Cancer Hospital from April 1999 to July 2013 were retrospectively analyzed. Long-term survivors were defined as OS ≥ 3 years after treatment with CM and chemotherapy. Twenty-eight patients had OS ≥ 3 years, 178 had OS 〈 3 years, and all clinical data were statistically analyzed with the Cox model. Variables were gender, age, smoking status, performance status （PS） score, pathological type, clinical stage, first-line chemotherapy, targeted therapy, and use of CM. Univariate survival analysis was performed using the Kaplan-Meier method and log-rank sequential inspection. Multivariate survival analysis was used to analyze the meaningful factors of univariate survival analysis with the Cox model. Results： The survival rate of patients with OS ≥ 3 years was 13.6% （28/206）. Cox multivariate regression analysis showed that PS score, clinical stage, disease control rate to first-line chemotherapy, and use of CM were independent factors of long- term OS （all P〈0.05）. However, gender, age, smoking, and use of epidermal growth factor receptor tyrosine- kinase inhibitor were not significant （P〉0.05）. Conclusion： PS score, clinical stage, disease control rate to first- line chemotherapy, and use of CM are probably independent prognostic factors for long-term OS in patients with advanced NSCLC.展开更多
Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell...Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.展开更多
Objective: To investigate the efficacy of integrated Chinese and Western medicine extending the progression-free survival(PFS) and overall survival(OS) of limited-stage small-cell lung cancer(LS-SCLC) patients after t...Objective: To investigate the efficacy of integrated Chinese and Western medicine extending the progression-free survival(PFS) and overall survival(OS) of limited-stage small-cell lung cancer(LS-SCLC) patients after the first-line chemoradiotherapy. Methods: The data of 67 LS-SCLC patients who received combined treatment of Chinese medicine(CM) and Western medicine(WM) between January 2013 and May 2020 at the outpatient clinic of Guang’anmen Hospital were retrospectively analyzed. Thirty-six LS-SCLC patients who received only WM treatment was used as the WM control group. The medical data of the two groups were statistically analyzed. Survival analysis was performed using the product-limit method(Kaplan–Meier analysis). The median OS and PFS were calculated, and survival curves were compared by the Log rank test. The cumulative survival rates at 1, 2, and 5 years were estimated by the life table analysis. Stratified survival analysis was performed between patients with different CM administration time. Results: The median PFS in the CM and WM combination treatment group and the WM group were 19 months(95% CI: 12.36–25.64) vs. 9 months(95% CI: 5.96–12.04), respectively, HR=0.43(95% CI: 0.27–0.69, P <0.001). The median OS in the CM and WM combination group and the WM group were 34.00 months(95% CI could not be calculated) vs. 18.63 months(95% CI: 16.43–20.84), respectively, HR=0.40(95% CI: 0.24–0.66, P<0.001). Similar results were obtained in the further stratified analysis of whether the duration of CM administration exceeded 18 and 24 months(P<0.001). Conclusion: The combination treatment of CM and WM with continuing oral administration of CM treatment after the first-line chemoradiotherapy for LS-SCLC patients produced better prognosis, lower risks of progression, and longer survival than the WM treatment alone.(Registration No. Chi CTR2200056616)展开更多
Non-small cell lung cancer （NSCLC） is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage of the disease, the overall survival rates for advanced disease remain...Non-small cell lung cancer （NSCLC） is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage of the disease, the overall survival rates for advanced disease remain low. Herein we present a case of NSCLC who was treated with Chinese medicine and chemotherapy with a longer overall survival.展开更多
Objective:Based on data mining technology, we attempted to explore the medication rules of modern traditional Chinese medicine (TCM)compounds in non-small cell lung cancer (NSCLC) treatment, to provide a reference for...Objective:Based on data mining technology, we attempted to explore the medication rules of modern traditional Chinese medicine (TCM)compounds in non-small cell lung cancer (NSCLC) treatment, to provide a reference for clinical drug use. Methods:From 2010 to 2017, TCM compounds used for NSCLC treatment were collected from the Beijing 301 Hospital. The modern TCM compounds utilized in the treatment of NSCLC were established in the prescription database. Excel, SPSS 22, and SPSS Modeler14.2 software were utilized for the frequency analysis, factor analysis, cluster analysis, and association analysis. Then, the quantitative and qualitative analyses of the regularity of TCM compound medications were performed, and the possible mechanism was discussed. Results:The treatment of NSCLC using Chinese herbal compounds involved 231 prescriptions, 389 types of Chinese herbs, and 135 types of high-frequency Chinese herbs. Of these, Fritillaria cirrhosa, stir-baked fried Scutellariae, raw Os Draconis, Poria cocos (Schw.) Wolf, and Scutellaria barbata were the top five frequently prescribed Chinese herbs. Among the 39 types of drugs, heat-clearing and detoxifying drugs and qi-tonifying drugs were the leading. Cold,warm, flat, slightly cold, sweet, bitter, and pungent of four properties and five tastes and the meridians of lung, spleen, and stomach were most commonly selected. Factor analysis extracted 12 common factors, and the cumulative contribution rate was 65.595%, which mainly contained tonifying qi and blood;tonifying yin, clearing away heat, and eliminating stagnation;tonifying the spleen, regulating qi, and eliminating phlegm.Forty drug groups were obtained by cluster analysis;a total of 63 association rules were obtained by association analysis. The pairs of Poria cocos→dried tangerine peel and fried Atractylodes macrocephala→dried tangerine peel were commonly used in NSCLC, while the three most frequent herb groups were raw Astragalus→fried A. macrocephala and Poria cocos;raw-medicated leaven→fried A. macrocephala and Poria cocos;and dried tangerine peel→fried A. macrocephala and Poria cocos. Conclusion:Lung cancer is mainly caused by qi stagnation,phlegm obstruction, phlegm, and blood stasis. Based on the principle of strengthening the body and dispelling pathogens, clinical treatment of NSCLC involves clearing heat and detoxifying, tonifying the spleen, regulating qi, eliminating phlegm to dispel pathogens, and tonifying qi and blood to strengthen the body.展开更多
Objective：To evaluate the objectivity and comprehensiveness of Response Evaluation Criteria of Traditional Chinese Medicine for Solid Tumor（Draft,REC-TCM-ST） in application of Chinese medicine therapeutic effect in...Objective：To evaluate the objectivity and comprehensiveness of Response Evaluation Criteria of Traditional Chinese Medicine for Solid Tumor（Draft,REC-TCM-ST） in application of Chinese medicine therapeutic effect in patients with advanced non-small cell lung cancer（NSCLC）.Methods：A retrospective clinical research was used in 104 NSCLC patients in stages of Ⅲ-Ⅳ,53 cases were in Chinese medicine（CM） group and 51 cases were in Western medicine（WM） group.The therapeutic effect of the two groups was evaluated with both REC-TCM-ST and Response Evaluation Criteria in Solid Tumor（RECIST）.Kaplan-Meier method was used to analyze the survival time.Kappa test method was used to test the consistency of the two kinds of evaluation results.Results：According to REC-TCM-ST,the effective rate on relieving tumor mass in the CM group was significantly lower than that in the WM group（P〈0.05）,but there was no significant difference in tumor-mass stable rate（P〉0.05）;the symptom of weakness in the CM group was improved significantly,indicating better therapeutic effect than that in the WM group（P〈0.01）.Karnofsky score in the CM group was significantly better than that in the WM group（P〈0.01）.In terms of survival conditions,the median survival time and the survival rate of 6 months,1 year and 2 years of the CM group were higher than the WM group.The total effective rate was 9.62%,and the total stable rate was 72.12%for 104 cases according to RECIST;while the total effective rate was 34.62%,and the total stable rate was 84.62%according to REC-TCM-ST,thus there were significant differences between the results of the two criteria（P〈0.01）,and there was also some consistency between them,but not satisfactory.Conclusions：REC-TCM-ST was used to evaluate the therapeutic effect of CM in the treatment of advanced NSCLC,which shows that its evaluation results can better reflect the advantages and disadvantages of CM,and the effectiveness of CM is more objective and comprehensive than RECIST,so REC-TCM-ST is worthy of further improvement and clinical expansion.展开更多
BACKGROUND： Traditional Chinese medicine （TCM） is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer （NSCLC） are a complex ...BACKGROUND： Traditional Chinese medicine （TCM） is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer （NSCLC） are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC. METHODS AND DESIGN： This is a double-blind controlled, multi-center, and prospective study with randomly selected participants from elderly NSCLC patients in China. Seventy-six patients who meet the inclusion criteria will be allocated into two groups, which will receive treatments of 3-week single-agent chemotherapy with TCM or placebo for four cycles Progression-free survival （PFS） is the primary end point, and the secondary end points are overall survival, objective response rate, time-to-progression, and quality of life （EORTC QLQ-LC43, and TCM syndrome score） Meanwhile, other end points such as toxicity, side effects and safety of the treatments will be assessed. DISCUSSION： Results from this study may provide evidence on the effectiveness, and parameters for the usage of single-agent chemotherapy combined with or without TCM on PFS of elderly patients with NSCLC.展开更多
Sepsis is a life-threatening multiple organ dysfunction syndrome caused by the imbalance of the immune response to infection,featuring complex and variable conditions,and is one of the leading causes of mortality in I...Sepsis is a life-threatening multiple organ dysfunction syndrome caused by the imbalance of the immune response to infection,featuring complex and variable conditions,and is one of the leading causes of mortality in ICU patients.Lung injury is a common organ damage observed in sepsis patients.Macrophages and Th17 cells,as crucial components of innate and adaptive immunity,play pivotal roles in the development of sepsis-induced acute lung injury(ALI).This review summarizes the alterations and mechanisms of macrophages and Th17 cells in sepsis-induced ALI.By focusing on the“cross-talk”between macrophages and Th17 cells,this review aims to provide a solid theoretical foundation for further exploring the therapeutic targets of traditional Chinese medicine formulas in the treatment of sepsis complicated with ALI,thereby offering insights and guidance for the clinical application of traditional Chinese medicine in managing sepsis-associated ALI.展开更多
Objective: To explore the specific pharmacological molecular mechanisms of Laoke Formula(LK)on treating advanced non-small cell lung cancer(NSCLC) based on clinical application, network pharmacology and experimental v...Objective: To explore the specific pharmacological molecular mechanisms of Laoke Formula(LK)on treating advanced non-small cell lung cancer(NSCLC) based on clinical application, network pharmacology and experimental validation. Methods: Kaplan-Meier method and Cox regression analysis were used to evaluate the survival benefit of Chinese medicine(CM) treatment in 296 patients with NSCLC in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2015. The compounds of LK were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, and the corresponding targets were performed from Swiss Target Prediction. NSCLC-related targets were obtained from Therapeutic Target Database and Comparative Toxicogenomics Database. Key compounds and targets were identified from the compound-target-disease network and protein-protein interaction(PPI) network analysis, respectively. Kyoto Encyclopedia of Genes and Genomes(KEGG) and Gene Ontology(GO) enrichment analysis were used to predict the potential signaling pathways involved in the treatment of advanced NSCLC with LK. The binding affinities between key ingredients and targets were further verified using molecular docking. Finally, A549 cell proliferation and migration assay were used to evaluate the antitumor activity of LK. Western blot was used to further verify the expression of key target proteins related to the predicted pathways. Results: Kaplan-Meier survival analysis showed that the overall survival of the CM group was longer than that of the non-CM group(36 months vs.26 months), and COX regression analysis showed that LK treatment was an independent favorable prognostic factor(P=0.027). Next, 97 components and 86 potential targets were included in the network pharmacology, KEGG and GO analyses, and the results indicated that LK was associated with proliferation and apoptosis. Moreover,molecular docking revealed a good binding affinity between the key ingredients and targets. In vitro, A549 cell proliferation and migration assay showed that the biological inhibition effect was more obvious with the increase of LK concentration(P<0.05). And decreased expressions of nuclear factor κB1(NF-κB1), epidermal growth factor receptor(EGFR) and AKT serine/threonine kinase 1(AKT1) and increased expression of p53(P<0.05)indicated the inhibitory effect of LK on NSCLC by Western blot. Conclusion: LK inhibits NSCLC by inhibiting EGFR/phosphoinositide 3-kinase(PI3K)/AKT signaling pathway, NFκB signaling pathway and inducing apoptosis, which provides evidence for the therapeutic mechanism of LK to increase overall survival in NSCLC patients.展开更多
基金Shanghai municipal health and wellness commission excellent talent training program project(No.1705)。
文摘Lung cancer is one of the diseases with high morbidity and mortality,and non-small cell lung cancer accounts for a large proportion of it.Traditional Chinese medicine has a long history in treating tumors.More and more researchers have paid more attention to it.At present,many studies have proved that traditional Chinese medicine extracts such as astragalus,turmeric,ginseng,coix seed,and gallbladder can inhibit tumor cell proliferation,and have synergistic effects when used in combination with radiotherapy and chemotherapy Its mechanism of action is mostly related to regulating the cell cycle,inhibiting the expression of cancer-related genes,and inducing apoptosis.It is believed that with the development of purification technology,Chinese medicine extracts will play a greater role.
文摘Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.
文摘Chemotherapy is the main treatment for non-small cell lung cancer(NSCLC),but it often leads to serious side effects.Modern studies indicated that medicinal diets can reduce the side effects of chemotherapy.However,blindly taking medicinal diet always fails to achieve curative effect and even aggravates the patient's condition.In order to provide dietary guidance for NSCLC patients undergoing chemotherapy,based on the basic theory of traditional Chinese medicine,the article elaborates the application of medicinal diets in those NSCLC patients who have been treated by chemotherapy.
基金supported by National Administration of Traditional Chinese Medicine: The Seventh Batch of National Traditional Chinese Medicine Experts Academic Experience Inheritance ProjectTianjin Municipal Education Commission Scientific Research Plan Project (No. 2021KJ143)。
文摘The most common subtype of lung cancer is non-small cell lung cancer(NSCLC), which has a poor prognosis and seriously threatens the health of human beings. The multidisciplinary comprehensive treatment model has gradually become the mainstream of NSCLC treatment. Traditional Chinese medicine(TCM) can be used effectively either as an adjunctive therapy or alone throughout the NSCLC therapy,which has a significant impact on survival, quality of life, and reduction of toxicity. Therefore, this paper reviewed the theoretical basis, the latest clinical application, and combined treatment mechanisms in order to explore the advantage stage of TCM treatment and the synergistic therapeutic mechanisms.
基金supported in part by Key Grant of the National Natural Science Foundation of China (No. 30730080)National Natural Science Foundation of China (No. 30972541, 30901233)+1 种基金National Outstanding Youth Science Foundation of China (No. 30425001)Key Laboratory of Laboratory Mecicine of Jiangsu Province (No. XK200731)
文摘Objective：Vitamin D and its receptor（VDR） involve in multiple cellular processes and play an important role in the initiation and progression of malignancy.Thus we hypothesized that plasma vitamin D levels and single nucleotide polymorphisms（SNPs） in VDR may be of prognostic significance in non-small cell lung cancer（NSCLC）.Methods：We examined plasma 25-hydroxyvitamin D [25（OH）D] levels in 87 patients diagnosed with NSCLC using enzyme-linked immunosorbent assay（ELISA） and genotyped seven potentially functional SNPs in VDR in 568 NSCLC patients on Illumina Golden Gate platform.Results：Patients with higher plasma 25（OH）D levels had worse survival than patients with lower ones（P for trend = 0.048）.The SNPs of rs1544410 and rs739837 were independently associated with NSCLC survival（adjusted HR = 1.61,95% CIs = 1.06-2.45 for rs739837 AA vs AC/CC and adjusted HR = 1.51,95% CIs = 1.06-2.16 for rs1544410 AG/AA vs GG）.A joint effect was observed between rs1544410 and rs739837 and the risk of death elevated as the number of unfavourable genotypes patients carried increased（P for trend = 0.003）.There were no significant associations between VDR polymorphisms and plasma 25（OH）D levels.Conclusion：Our findings indicate that plasma 25（OH）D levels and genetic variants of VDR may serve as prognostic markers for NSCLC in this Chinese population.
文摘Background:Combination therapy with traditional Chinese medicine and chemotherapy was proposed as a therapeutic strategy for non-small cell lung cancer patients.Therefore,we performed a systematic review and metaanalysis of randomized controlled trials to assess effects of this combination therapy on non-small cell lung cancer.To evaluate the efficacy and safety of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the treatment of non-small cell lung cancer.Methods:A randomized controlled study of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy in the databases of China National Knowledge Infrastructure Database,WanFang Database,VIP Database,Sino-Med Database,PUBMED,EMBASE and Cochrane library was searched by computer.The literatures published from the database establishment to July 1,2020 were included in the search scope.After 2 evaluators independently evaluated and cross checked the quality of the study,Revman 5.3 was used to meta analyze the clinical effect of the Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy on patients with non-small cell lung cancer.Results:A total of 1,370 lung cancer patients were included in 20 RCTs.The results of meta-analysis showed that there were significant differences between the 2 groups in clinical efficacy(RR=1.32,95%CI(1.20,1.44)),quality of life(RR=1.44,95%CI(1.32,1.57)),immune function(MD=0.53,95%CI(0.23–0.83)),adverse reactions(RR=0.49,95%CI(0.41,0.58)).Conclusion:The Chinese patent medicine Kang’ai injection adjunct with TP chemotherapy is effective and safe in the treatment of non-small cell lung cancer,and has great prospects for further development.However,the quality of evidence was very low-to-moderate.Considering the poor quality of evidence,we are not very confident in the results.We look forward to more research and update results in the future and improve the evidence quality.
文摘Objective: To observe and compare the effect of traditional Chinese medicine (TCM) combined with chemotherapy (CT) on immune function and quality of life (QOL)of patients with non-small cell lung cancer (NSCLC) in stage Ⅲ-Ⅳ. Methods: One hundred cases with stage Ⅲ-Ⅳ NSCLC were randomly divided into two groups. The treated group (n=50) received CT combined with TCM, and the control group received CT alone. The percentage of T lymphocyte subset in peripheral blood and the change of natural killer (NK) cell count were observed after treatment. The QOL and tolerance of CT were also compared between the two groups after treatment. Results: In the treated group, CD3 cell count, CD4 cell count, CD4/ CDg ratio and NK cell activity were higher than those in control group, while CD8 cell count in the treated group was lower than that in the control group (P<0.05), and QOL and tolerance of CT in the treated group were also better (P<0.05). Conclusion: TCM combined with CT could raise the patients' ability in tolerating CT in stage Ⅲ-ⅣNSCLC.
文摘Objective： To observe the clinical effect of the combined therapy using argon-helium cryosurgery （Ar-He knife） and Chinese herbal medicine in treating non-small cell lung cancer （NSCLC）. Methods： Fifty-seven patients of NSCLC were treated with the combined therapy and observed. Results： The treatment was successfully completed in all patients with mild adverse reactions. The effective rate was 83.8% 3 months after the operation, 79.6% 6 months after the operation, and 77.3% 12 months after the operation, with median survival of 9 months. The survival rate after 12 months was 46.67% （21/45）, 34.62% （9/26） after 18 months, and 36.36% （4/11） after 24 months. Conclusion： Argon-helium cryosurgery therapy is superior in its assured orientation, quick tumor load deprivation and less post- operational reaction. Combined with Chinese herbal medication, Argon-helium cryosurgery therapy can prolong survival time, relieve clinical symptoms, and elevate the quality of life in NSCLC patients, and is thus worthy of promotion.
文摘Objective： To investigate the effects of brachytherapy with computed tomography-guided percutaneous radioactive 1-125 seeds interstitial implantation （ISI） synchronized chemotherapy and Chinese medicine （CM） for the treatment of advanced stage of non-small cell lung cancer （NSCLC）. Methods： Ninety patients diagnosed with NSCLC by biopsy were randomly assigned to three groups： the synchronized therapy group （A）, the chemotherapy plus CM-treated group （B）, and the chemotherapy-treated group （C）; a 2-month course of treatment was administered to them all. The effectiveness of treatment was evaluated based on tumor size, tumor markers （carcinoembryonic, squamous cell carcinoma-associated antigen, and cytokeratin 19 fragment）, clinical symptoms, and quality of life （QOL） in patients. Results： The total effective rates of Groups A to C were 83.33%, 46.67%, and 43.33%, respectively. The tumor markers were reduced obviously in Group A, showing significant difference compared with those in the other two groups. Additionally, QOL was elevated and cancer-related symptoms were alleviated more significant in Group A than those in Group C （all P〈0.05）. Conclusion： The synchronized therapy of 1-125 implantation with chemotherapy and CM was a safe therapeutic method and can be regarded as a new mode for treatment of advanced-stage NSCLC.
基金Supported by National Thirteenth Five-Year Science and Technology Major Special Project for New Drug Innovation and Development(No.2017ZX09304001)Shanghai Three-Year Action Plan for Further Accelerating the Development of TCM[No.ZY(2018-2020)-CCCX-1016]+3 种基金Shanghai Emerging Interdisciplinary Funding Program of TCMConstruction of the most Important Clinical Medical Center and Key Disciplines in Shanghai(No.2017ZZ01010)Pudong New Area Health Select Committee Health and Family Planning Scientific Research Project Plan(No.PW2019E-1)Shanghai Key Clinical Specialty Project(No.shslczdzk03701)。
文摘Objective To investigate the effects of multidisciplinary and comprehensive Chinese medicine(CM)treatments on progression-free survival(PFS)and median survival time(MST)in patients with advanced non-small cell lung cancer(NSCLC)and identify factors that influence progression and prognosis.Methods Clinical data of 855 patients with advanced NSCLC who received multidisciplinary and comprehensive CM treatments at Longhua Hospital from January 2009 to December 2018 were retrospectively analyzed.Univariate analysis was performed by the Kaplan-Meier method and log-rank sequential inspection.Multivariate analysis of significant variables from the univariate analysis was performed with Cox regression modeling.Key factors correlated to progression and prognosis were screened out,and a Cox proportional hazard model was established to calculate the prognostic index.Results The PFS and MST of 855 advanced NSCLC patients were 9.0 and 26.0 months,respectively.The 1-,2-,3-,and 5-year survival rates were 79.2%,54%,36.2%,and 17.1%,respectively.Gender,pathologic type,and clinical stage were independent prognostic risk factors;surgical history,radiotherapy,treatment course of Chinese patent medicine,intravenous drip of Chinese herbal preparation,duration of oral administration of Chinese herbal decoction(CHD),and intervention measures were independent prognostic protective factors.Gender was an independent risk factor for progression,while operation history and oral CHD administration duration were independent protective factors(all P<0.05).Women with stage IIIb–IIIc lung adenocarcinoma had the best outcomes.Conclusions Female patients have lower progression risk and better prognoses than male patients,younger patients have higher progression risk but better long-term prognoses than the elderlys,and patients with lower performance status scores are at lower risk for progression and have better prognoses.Comprehensive CM treatments could significantly reduce progression risk,improve prognosis,and prolong survival time for patients with advanced NSCLC.This treatment mode offers additional advantages over supportive care alone.
基金Supported by National Key Technologies Research and Development Program for the 11th Five-Year Plan(No.2006BAI04A05)
文摘Objective： To determine whether additional Chinese medicine（CM） could prolong survival and improve the quality of life（QOL） in patients with advanced non-small cell lung cancer（NSCLC） compared with Western medicine（WM） alone. Methods： This was a multicenter, prospective cohort study. A total of 474 hospitalized patients with stage Ⅲ–Ⅳ NSCLC were recruited and divided into 2 groups. Patients in the WM group received radiotherapy, chemotherapy, and optimal supportive therapy according to the National Comprehensive Cancer Network（NCCN） guidelines. In the integrative medicine（IM） group, individualized CM（Chinese patent medicines and injections） and WM were administered. The primary end point was overall survival, and the secondary end points were time to disease progression, adverse events, and QOL. Follow-up clinical examinations and chest radiography were performed every 2 months. Results： The median survival was 16.60 months in the IM group and 13.13 months in the WM group（P〈0.01）. The incidences of loss of appetite, nausea, and vomiting in the IM group were significantly lower than those in the WM group（P〈0.05）. The QOL based on Functional Assessment of Cancer Therapy-Lung in the IM group was markedly higher than that in the WM group at the fourth course（P〈0.05）. Conclusions： Additional CM may prolong survival and improve the QOL patients with NSCLC. The adverse effects of radio-and chemotherapy may be attenuated as CM is used in combination with conventional treatments.
基金Supported by the Fund for Scientific and Technologic Projects from Beijing Administration of Traditional Chinese Medicine(No.2004 Jing Zhong Zhong Ⅳ 15)
文摘Objective： To investigate the prognostic influence on long-term overall survival （OS） from treatment with Chinese medicine （CM） and chemotherapy or targeted therapy in advanced non-small-cell lung cancer （NSCLC） patients. Methods： The clinical data of 206 advanced NSCLC patients who were treated with CM and Western medicine in Beijing Cancer Hospital from April 1999 to July 2013 were retrospectively analyzed. Long-term survivors were defined as OS ≥ 3 years after treatment with CM and chemotherapy. Twenty-eight patients had OS ≥ 3 years, 178 had OS 〈 3 years, and all clinical data were statistically analyzed with the Cox model. Variables were gender, age, smoking status, performance status （PS） score, pathological type, clinical stage, first-line chemotherapy, targeted therapy, and use of CM. Univariate survival analysis was performed using the Kaplan-Meier method and log-rank sequential inspection. Multivariate survival analysis was used to analyze the meaningful factors of univariate survival analysis with the Cox model. Results： The survival rate of patients with OS ≥ 3 years was 13.6% （28/206）. Cox multivariate regression analysis showed that PS score, clinical stage, disease control rate to first-line chemotherapy, and use of CM were independent factors of long- term OS （all P〈0.05）. However, gender, age, smoking, and use of epidermal growth factor receptor tyrosine- kinase inhibitor were not significant （P〉0.05）. Conclusion： PS score, clinical stage, disease control rate to first- line chemotherapy, and use of CM are probably independent prognostic factors for long-term OS in patients with advanced NSCLC.
基金Supported by Canadian Terry Fox Run Foundation for Cancer Research
文摘Objective： To observe the clinical efficacy and benefit response of extracorporeal high frequency thermotherapy （EHFT） combined with Chinese medicine （CM） in the treatment of patients with advanced non-small cell lung cancer. Methods： The study adopted a prospective, small sample and randomized controlled method, and the advanced non-small cell lung cancer patients were assigned to two groups according to the table of random digits, one having the treatment of EHFT combined with CM （the treatment group）, the other only with CM （the control group）. The patients in the treatment group were treated with EHFT one hour once per day, together with CM differentiation decoction, 250 mL orally taken, twice daily for 14 days as one cycle, and 3-4 cycles was performed. The patients in the control group were treated only with CM differentiation decoction using the same dose as the treatment group. The efficacies were evaluated after three to four cycles of treatment. Primary endpoints were disease control rate （DCR） and time to progression （TTP）. Secondary endpoints were overall survival time and 1-year survival rate. Results： Sixty-six patients accomplished the study. After the patients underwent different treatments, none of the patients got a complete response or partial response in both groups. In the treatment group, DCR was 72.2%, and 10 had progression of disease （28.8%）, while the DCR of the control group was 63.3%, and 11 had progression of disease （36.7%）; there was a significant statistical difference （P0.05）, suggesting that the combined regimen had superiority on the DCR. As for long-term efficacy, the median survival time （MST） of the treatment group was 7.5 months, TTP was 5.5 months, and 1-year survival rate was 21.4 %; in the control group, the results were 6.8 months, 4.5 months and 16.6% respectively. There was significant statistical difference on TTP （P0.05）, but no difference on MST or 1-year survival rate. Conclusion： EHFT combined with CM differentiation has better tolerance and short-term efficacy in the treatment of patients with advanced NSCLC.
基金the Science and Technology Innovation Project of the China Academy of Chinese Medical Sciences(No.CI2021A01808)the Natural Science Foundation of Beijing(No.7212189)the Outstanding Young Scientific and Technological Talents(Innovation)Training Program of China Academy of Chinese Medical Sciences(No.ZZ15-YQ-026)。
文摘Objective: To investigate the efficacy of integrated Chinese and Western medicine extending the progression-free survival(PFS) and overall survival(OS) of limited-stage small-cell lung cancer(LS-SCLC) patients after the first-line chemoradiotherapy. Methods: The data of 67 LS-SCLC patients who received combined treatment of Chinese medicine(CM) and Western medicine(WM) between January 2013 and May 2020 at the outpatient clinic of Guang’anmen Hospital were retrospectively analyzed. Thirty-six LS-SCLC patients who received only WM treatment was used as the WM control group. The medical data of the two groups were statistically analyzed. Survival analysis was performed using the product-limit method(Kaplan–Meier analysis). The median OS and PFS were calculated, and survival curves were compared by the Log rank test. The cumulative survival rates at 1, 2, and 5 years were estimated by the life table analysis. Stratified survival analysis was performed between patients with different CM administration time. Results: The median PFS in the CM and WM combination treatment group and the WM group were 19 months(95% CI: 12.36–25.64) vs. 9 months(95% CI: 5.96–12.04), respectively, HR=0.43(95% CI: 0.27–0.69, P <0.001). The median OS in the CM and WM combination group and the WM group were 34.00 months(95% CI could not be calculated) vs. 18.63 months(95% CI: 16.43–20.84), respectively, HR=0.40(95% CI: 0.24–0.66, P<0.001). Similar results were obtained in the further stratified analysis of whether the duration of CM administration exceeded 18 and 24 months(P<0.001). Conclusion: The combination treatment of CM and WM with continuing oral administration of CM treatment after the first-line chemoradiotherapy for LS-SCLC patients produced better prognosis, lower risks of progression, and longer survival than the WM treatment alone.(Registration No. Chi CTR2200056616)
文摘Non-small cell lung cancer （NSCLC） is the leading cause of cancer death in the industrialized world. Despite significant progress in early stage of the disease, the overall survival rates for advanced disease remain low. Herein we present a case of NSCLC who was treated with Chinese medicine and chemotherapy with a longer overall survival.
文摘Objective:Based on data mining technology, we attempted to explore the medication rules of modern traditional Chinese medicine (TCM)compounds in non-small cell lung cancer (NSCLC) treatment, to provide a reference for clinical drug use. Methods:From 2010 to 2017, TCM compounds used for NSCLC treatment were collected from the Beijing 301 Hospital. The modern TCM compounds utilized in the treatment of NSCLC were established in the prescription database. Excel, SPSS 22, and SPSS Modeler14.2 software were utilized for the frequency analysis, factor analysis, cluster analysis, and association analysis. Then, the quantitative and qualitative analyses of the regularity of TCM compound medications were performed, and the possible mechanism was discussed. Results:The treatment of NSCLC using Chinese herbal compounds involved 231 prescriptions, 389 types of Chinese herbs, and 135 types of high-frequency Chinese herbs. Of these, Fritillaria cirrhosa, stir-baked fried Scutellariae, raw Os Draconis, Poria cocos (Schw.) Wolf, and Scutellaria barbata were the top five frequently prescribed Chinese herbs. Among the 39 types of drugs, heat-clearing and detoxifying drugs and qi-tonifying drugs were the leading. Cold,warm, flat, slightly cold, sweet, bitter, and pungent of four properties and five tastes and the meridians of lung, spleen, and stomach were most commonly selected. Factor analysis extracted 12 common factors, and the cumulative contribution rate was 65.595%, which mainly contained tonifying qi and blood;tonifying yin, clearing away heat, and eliminating stagnation;tonifying the spleen, regulating qi, and eliminating phlegm.Forty drug groups were obtained by cluster analysis;a total of 63 association rules were obtained by association analysis. The pairs of Poria cocos→dried tangerine peel and fried Atractylodes macrocephala→dried tangerine peel were commonly used in NSCLC, while the three most frequent herb groups were raw Astragalus→fried A. macrocephala and Poria cocos;raw-medicated leaven→fried A. macrocephala and Poria cocos;and dried tangerine peel→fried A. macrocephala and Poria cocos. Conclusion:Lung cancer is mainly caused by qi stagnation,phlegm obstruction, phlegm, and blood stasis. Based on the principle of strengthening the body and dispelling pathogens, clinical treatment of NSCLC involves clearing heat and detoxifying, tonifying the spleen, regulating qi, eliminating phlegm to dispel pathogens, and tonifying qi and blood to strengthen the body.
文摘Objective：To evaluate the objectivity and comprehensiveness of Response Evaluation Criteria of Traditional Chinese Medicine for Solid Tumor（Draft,REC-TCM-ST） in application of Chinese medicine therapeutic effect in patients with advanced non-small cell lung cancer（NSCLC）.Methods：A retrospective clinical research was used in 104 NSCLC patients in stages of Ⅲ-Ⅳ,53 cases were in Chinese medicine（CM） group and 51 cases were in Western medicine（WM） group.The therapeutic effect of the two groups was evaluated with both REC-TCM-ST and Response Evaluation Criteria in Solid Tumor（RECIST）.Kaplan-Meier method was used to analyze the survival time.Kappa test method was used to test the consistency of the two kinds of evaluation results.Results：According to REC-TCM-ST,the effective rate on relieving tumor mass in the CM group was significantly lower than that in the WM group（P〈0.05）,but there was no significant difference in tumor-mass stable rate（P〉0.05）;the symptom of weakness in the CM group was improved significantly,indicating better therapeutic effect than that in the WM group（P〈0.01）.Karnofsky score in the CM group was significantly better than that in the WM group（P〈0.01）.In terms of survival conditions,the median survival time and the survival rate of 6 months,1 year and 2 years of the CM group were higher than the WM group.The total effective rate was 9.62%,and the total stable rate was 72.12%for 104 cases according to RECIST;while the total effective rate was 34.62%,and the total stable rate was 84.62%according to REC-TCM-ST,thus there were significant differences between the results of the two criteria（P〈0.01）,and there was also some consistency between them,but not satisfactory.Conclusions：REC-TCM-ST was used to evaluate the therapeutic effect of CM in the treatment of advanced NSCLC,which shows that its evaluation results can better reflect the advantages and disadvantages of CM,and the effectiveness of CM is more objective and comprehensive than RECIST,so REC-TCM-ST is worthy of further improvement and clinical expansion.
基金supported by the Longhua Medicial Project (D-11)The Science and Technology Commission of Shanghai Municipality (No.12401905700)
文摘BACKGROUND： Traditional Chinese medicine （TCM） is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer （NSCLC） are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC. METHODS AND DESIGN： This is a double-blind controlled, multi-center, and prospective study with randomly selected participants from elderly NSCLC patients in China. Seventy-six patients who meet the inclusion criteria will be allocated into two groups, which will receive treatments of 3-week single-agent chemotherapy with TCM or placebo for four cycles Progression-free survival （PFS） is the primary end point, and the secondary end points are overall survival, objective response rate, time-to-progression, and quality of life （EORTC QLQ-LC43, and TCM syndrome score） Meanwhile, other end points such as toxicity, side effects and safety of the treatments will be assessed. DISCUSSION： Results from this study may provide evidence on the effectiveness, and parameters for the usage of single-agent chemotherapy combined with or without TCM on PFS of elderly patients with NSCLC.
基金supported by the National Natural Science Foundation of China(No.82104581,No.82060864).
文摘Sepsis is a life-threatening multiple organ dysfunction syndrome caused by the imbalance of the immune response to infection,featuring complex and variable conditions,and is one of the leading causes of mortality in ICU patients.Lung injury is a common organ damage observed in sepsis patients.Macrophages and Th17 cells,as crucial components of innate and adaptive immunity,play pivotal roles in the development of sepsis-induced acute lung injury(ALI).This review summarizes the alterations and mechanisms of macrophages and Th17 cells in sepsis-induced ALI.By focusing on the“cross-talk”between macrophages and Th17 cells,this review aims to provide a solid theoretical foundation for further exploring the therapeutic targets of traditional Chinese medicine formulas in the treatment of sepsis complicated with ALI,thereby offering insights and guidance for the clinical application of traditional Chinese medicine in managing sepsis-associated ALI.
基金Supported by National Natural Science Foundation of China(Nos.82174103 and 81473441)。
文摘Objective: To explore the specific pharmacological molecular mechanisms of Laoke Formula(LK)on treating advanced non-small cell lung cancer(NSCLC) based on clinical application, network pharmacology and experimental validation. Methods: Kaplan-Meier method and Cox regression analysis were used to evaluate the survival benefit of Chinese medicine(CM) treatment in 296 patients with NSCLC in Tianjin Medical University Cancer Institute and Hospital from January 2011 to December 2015. The compounds of LK were screened using the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform, and the corresponding targets were performed from Swiss Target Prediction. NSCLC-related targets were obtained from Therapeutic Target Database and Comparative Toxicogenomics Database. Key compounds and targets were identified from the compound-target-disease network and protein-protein interaction(PPI) network analysis, respectively. Kyoto Encyclopedia of Genes and Genomes(KEGG) and Gene Ontology(GO) enrichment analysis were used to predict the potential signaling pathways involved in the treatment of advanced NSCLC with LK. The binding affinities between key ingredients and targets were further verified using molecular docking. Finally, A549 cell proliferation and migration assay were used to evaluate the antitumor activity of LK. Western blot was used to further verify the expression of key target proteins related to the predicted pathways. Results: Kaplan-Meier survival analysis showed that the overall survival of the CM group was longer than that of the non-CM group(36 months vs.26 months), and COX regression analysis showed that LK treatment was an independent favorable prognostic factor(P=0.027). Next, 97 components and 86 potential targets were included in the network pharmacology, KEGG and GO analyses, and the results indicated that LK was associated with proliferation and apoptosis. Moreover,molecular docking revealed a good binding affinity between the key ingredients and targets. In vitro, A549 cell proliferation and migration assay showed that the biological inhibition effect was more obvious with the increase of LK concentration(P<0.05). And decreased expressions of nuclear factor κB1(NF-κB1), epidermal growth factor receptor(EGFR) and AKT serine/threonine kinase 1(AKT1) and increased expression of p53(P<0.05)indicated the inhibitory effect of LK on NSCLC by Western blot. Conclusion: LK inhibits NSCLC by inhibiting EGFR/phosphoinositide 3-kinase(PI3K)/AKT signaling pathway, NFκB signaling pathway and inducing apoptosis, which provides evidence for the therapeutic mechanism of LK to increase overall survival in NSCLC patients.
