This paper explored the clinical thinking way in treating disease by integration of traditional Chinese and western medicine(ITCWM). In accordance with the challenge and problems the subject of ITCWM faced, the standard of diagnosis, treatment and evaluation of therapeutic response should be established. The combination of symptoms-differentiation with special prescription/drug for special disease to increase the accuracy of treatment is the developing direction for clinical medicine and ITCWM. Absorption and utilization of modern science and technique is the prerequisite for breaking through in ITCWM theory. The key of combining two different medical theories is to look for link joint.

The stem cell hypothesis for cancer suggests that only a specific subset of cancer cells within each tumor is responsible for tumor initiation and propagation,termed cancer stem cells(CSCs),which have a character of self-renewal and multilineage differentiation,and responsible for the recurrence,metastasis and resistance to therapy.The CSC of pancreatic cancer were isolated and identified in 2007,and recent data has been reported to confirm the change of the related signal pathway,the relationship with metastasis,therapy resistance and the puzzle.This review article summarizes the latest advances with regard to the pancreatic cancer stem cells.

Background and purpose:Advanced pancreatic cancer is characteristic of poor treatment eff icacy and short survival time. Gemcitabine is considered as front-line therapy for advanced pancreatic cancer. Gemcitabine combinations have shown a favorable impact on survival. We compared gemcitabine-based combination cheme therapy and gemcitabine(GEM) alone in patients with advanced pancreatic cancer through Meta analysis in phase Ⅲ clinical trials. Methods:MEDLINE and EMBASE searches were supplemented by information from trial registers of phase Ⅲ randomized controlled trials(RCTs) for GEM-based combination therapy and GEM alone for advanced pancreatic cancer. A quantitative meta-analysis was carried out by two reviewers based on the inclusion criteria from all available RCTs. The Meta-analysis involved 6-months and 1-year survival rate and objective remission rate(ORR) . Results:The Meta-analysis included 20 RCTs. The result of our Meta-analysis showed that there was signifi cant improvement in the GEM combination group with regard to the 1-year survival rate(RR:0.87,95%:(0.78,0.96) ,P=0.008) . The other result of our meta-analysis showed no signifi cant difference between two groups. Conclusion:GEM-based combination therapy may be effective with regard to the survival rate compared with GEM alone.

Purpose:To study the effect of the herbal decoction Qingyi Xiaoji Formula(QYXJ) on the proliferation of human pancreatic cancer cell line SW1990 in vivo and to explore the mechanism of its functions by means of cDNA microarray.Methods:Tumor-burdened nude mice were randomized into control group,5-FU group,and QYXJ groups at different dosages.After treatment,inhibiting rates of tumor growth were calculated.Tumor mRNA of the control group and the QYXJ group at moderate dose was extracted.The fluorescent cDNA probes were prepared,labeled with two different dyes Cy3 and Cy5,and then hybridized with cDNA microarray and scanned for fluorescent intensity.The genes with different expression were identified through the analysis of gene expression profile.Results:Inhibition rates of tumor growth in the QYXJ groups were 21.31%,38.16% and 29.09%,in the dose of 18 g/kg,36 g/kg,and 72 g/kg respectively.7 genes with reduced expression were identified,the functions of which were oncogene,protein translation and synthesis,DNA synthesis and repair,cell signal transduction,etc.Conclusions:QYXJ decoction may inhibit the proliferation of pancreatic cancer in vivo,possibly by blocking the action of an oncogene and its downstream signaling,or by regulation of protein synthesis in cancer cells.

OBJECTIVE: To observe the correlation between serum level of TXB2, 6-Keto-PGF1alpha and liver metastasis. METHODS: The metastatic model was made by injection of W256 carcinosarcoma. Rats were randomly divided into two groups: rats with blood stasis group and control group. Rats in control group were given normal saline via abdominal cavity once a day. Rats in blood stasis group were injected adrenalin in the fourteenth day. Tumor size and liver metastasis were observed. Serum TXB2 and 6-Keto-PGF1alpha were tested by radioimmunoassay. RESULTS: Tumor size in rats with blood stasis was significantly smaller than that of the control group (P<0.01). Occurrence of liver metastasis in rats with blood stasis was significantly lower than that of the control group (P<0.01). The values of 6-Keto-PGF1alpha, TXB2, and TXB2/6-Keto-PGF1alpha were higher in the group with blood stasis. CONCLUSION: In the status of blood stasis, W256 carcinosarcoma grows slowly, and liver metastasis increases insignificantly, with the elevations of 6-Keto-PGF1alpha, TXB2 and TXB2/6-Keto-PGF1alpha.

AIM: To observe the changes in tumor-weight-inhibiting rates,immunological function,liver and renal function and the blood cell in the peripheral blood after administration of Shengmai Injection combined with chemotherapeutic agent,Oxaliplatin. METHODS: Hepatoma 22 tumor bearing mice models were established and then divided randomly into five groups,including control group,Oxaliplatin group,Shengmai Injection(high,middle and low dose) combined with Oxaliplatin groups.Each group had 10 mice.The five groups were injected introperitoneally with same amount of 5% glucose injection,Oxaliplatin 6 mg/kg and Shengmai Injection(14 mL/kg,7 mL/kg and 3.5 mL/kg) plus Oxaliplatin 6 mg/kg respectively,once a day for 14 days. After that,mice in the five groups were all killed after being anesthetized and the tumor-weight-inhibiting rates and the index of immunological function,liver and renal function and the blood cell in the peripheral blood were observed. RESULTS: (1) The tumor-weight-inhibiting rates were higher in each Shengmai Injection plus Oxaliplatin group than that in the Oxaliplatin group (P

Aim To investigate the effects of triptolide on the proliferation and apoptosis of cell line A549 in human Lung Adenocarcinoma. Methods MTT, DNA fragmentation assay, fluorescence stain and flow cytometric analysis were carried out.Results Triptolide notably reduced the survival rate of A549 cells, and inhibited the proliferation of A549 cells. The 50 % inhibitory concentration (IC50) for 72 h was 75 nmol?L-1 and it arrested the cell cycle at S phase at the concentration of 14 nmol?L-1 (P

Objective To observe the efficacy of inhaled tiotropium bromide combined with budesonide/formoterol on reducing the frequency of acute episodes of symptom exacerbation and improving lung function,health status in chronic obstructive pulmonary disease (COPD). Methods Eighty-six patients with COPD were divided into 3 groups, combination group[29 cases, inhaled budesonide/formoterol (160 μg/4.5 μg, twice one day ) and tiotropium bromide ( 18 μg, once one day)], budesonide/formoterol group( 29 cases, 160 μg/4.5 μg, twice one day) and tiotropium bromide group(28 cases, 18 μg, once one day). The treatment continued for 3 months. Results Lung function, symptoms and health status improved obviously in three groups. The forced expiratory volume in one second (FEV1) of combination group after treatment was (1.24±0.18) L , which was improved by 11.7% compared with before treatment. It was significantly higher than that in budesenide/formoterol group and fiotropium bromide group (P < 0.01 ). The rescue medication consumptions and the times of acute episode of combination group were significantly decreased compared with those in the other groups,and there was significant difference (P <0.01). The SGRQ score of combination group was (35.6±13.9) points which was significantly lower than that of budesonide/formoterol group and tiotropium bromide group,and there was significant difference (P < 0.01 ).There was no statistical difference in the adverse events occurred in three groups (P > 0.05 ). Conclusions Combination treatment produces better control of symptoms and lung function and has no greater risk of sideeffects, compared with the treatment of budesonide/formoterol alone and tiotropium bromide alone. The combination treatment should be considered for patients with COPD.

OBJECTIVE: To evaluate the treatment effect, quality of life and side-effect of transcatheter arterial chemoembolization (TACE) and traditional Chinese medicine (TCM) in treating metastatic liver cancer. METHODS: Thirty-nine cases of colon metastatic liver cancer were randomly divided into two groups. Both TACE and TCM were used in the treatment group, while only TACE was used in the control group. The drug used in TACE included floxuridine, pirarubicin, cisplatin, and the herbs for strengthening the spleen and regulating Qi were used in TCM. RESULTS: The response rate in the treatment group was 30% (45% including minor remission patients), and the median survival time was 18.6 months. While in the control group the response rate was 15.8% (36.8% including minor remission patients), and the median survival time was 14.3 months. The 1-, 2-, 3- year survival rates of treatment group and the control group were 70.2%, 40.3%, 13.0% and 68.7%, 29.5%, 10.3% respectively. There were fewer other organ metastases in the treatment group. The score from the EORTC quality of life questionnaire QLQ-C30 in treatment group was higher than that in the control group. CONCLUSION: Integration of TACE and TCM in treating colon metastatic liver cancer has better results.