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.

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.

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.

To observe the effects of Shengmai Injection on enhancing efficacy and reducing toxicity of 5-fluorouracil (5-FU).

Smoothened (SMO) is a member of sonic hedgehog homology (SHH) signaling pathway. It plays a key role as a bridge between patched-1 (PTCH-1) and Gli. Aberrant SHH expression can be detected in various malignant tissues, and the expression in pancreatic cancer stem cells is higher apparently. SHH signals are closely associated with self-duplication of cancer stem cells, formation of tumor vessels as well as matrixes. SMO antagonists such as cyclopamine, GDC-0449 and so on show potential to inhibit activity of SHH signaling, and arrest the growth as well as metastases of tumors. Recently, a few of SMO antagonists have been studied in phase I clinical trials and some are in phase II, meanwhile, phase I or II trials of SMO antagonists to treat pancreatic cancer are performed currently. As the classical SMO antagonist, cyclopamine is extracted from a medicinal plant. Perhaps researchers may be able to determine more effective SMO-targeting drugs from herbal medicines in the future.

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