The treatment principle for primary liver cancer referring as hepatocellular carcinoma (HCC) in this article is comprehensive treatment based on radical hepatectomy. Focusing on improving the resection rate and reducing the recurrence rate after operation, the conversion therapy, preoperative neoadjuvant therapy and postoperative adjuvant therapy have emerged to become potentially curative strategies and research hotspots. HCC is highly invasive and often complicated with cirrhosis, so comprehensive treatment is essential for better prognosis. However, due to the controversy of surgical indications and heterogeneity among individuals, the concepts and treatment methods of above three therapies, especially between the conversion therapy and the preoperative neoadjuvant therapy, remain overlap and puzzle sometimes. Moreover, because of the different therapy goals, the above three therapies are different in the selection of treatment methods, duration of therapy and evaluation criteria. Based on clinical practice, the authors investigate the progress and hot spots of the conversion therapy, preoperative neoadjuvant therapy and post-operative adjuvant therapy of HCC, expecting more clinical evidence-based medicine to standardize the development of comprehensive treatment, so as to become a breakthrough to improve the diagnosis and treatment of HCC.

Objective To prepare rabbit antibody against mouse AD-004 by AD-004 expressed in the prokaryotic expression system and to identify its distribution in the testis and adrenal. Methods The full-length cDNA of mouse AD-004 was cloned into PET28 plasmid, and the protein was induced in E. coli BL21 bacteria by adding IPTC and then purified by Ni2+ -NTA column. The purified protein was used as an immunogen to prepare polyclonal antibody ( pAb) of AD-004. The specificity of the antibody was detected by Western blotting. Immunohistochemical staining was performed in the mouse adrenal and testis via pAb of AD-004. Results Hisfused AD-004 was expressed efficiently in the prokaryotic system. Western blot analysis showed that the polyclonal antibody was duly bound to purified AD-004 with high specificity and sensitivity. AD-004 could be abundantly identified in the adrenal medulla and mainly expressed in the Leydig cells of testis. Conclusion The mouse protein of AD-004 is obtained from the prokaryotic expression system. The rabbit anti-AD-004 antibody has been prepared successfully. AD-004 protein is mainly localized in the interstitium of testis, suggesting that AD-004 may play a role in the synthesis of sex-steroid hormone.

Surgery is the most important radical treatment for hepatocellular carcinoma (HCC), but less than 30% of HCC patients have the chance for radical surgery at initial diagnosis. How to transform unresectable tumor into the candidate of radical resection becomes an important way to improve the survival rate of HCC and has been a research hotspot in recent years. At present, comprehensive application of the therapies including hepatic artery catheterization, radiotherapy, and targeted therapy can achieve the downstaging of HCC, or portal vein embolization, liver partition, and portal vein ligation can rapidly increase residual liver volume; all these methods can realize successful conversion and help patients obtain the opportunity for radical resection. However, further exploration and studies are needed to investigate how to optimize a variety of treatment modes, standardize the multidisciplinary diagnosis and treatment of complex liver cancer, and improve the efficiency and safety of surgical resection.

OBJECTIVEpopulation genetic study of Magnolia officinalis and M. officinalis var. biloba was performed in this paper. The objectives of this study are to provide baseline data of molecular pharmaceutics for quality control of Cortex Magnoliae Officinalis.

METHODA total of 15 populations of M. officinalis and M. officinalis var. biloba were collected. PCR amplification and sequencing were performed with two chloroplast intergenic spacers psbA-trnH and trnL-trnF. Chloroplast haplotype frequencies were calculated, genetic diversity and genetic structure were estimated by using the program HAPLONST, and a haplotype network depicting the mutational relationships among distinct haplotypes was drawn following the principle of parsimony by TCS version 1.13.

RESULTThe differentiation of haplotype frequencies between M. officinalis and M. officiunalis var. biloba was significant although there was no private haplotypes of themselves.

CONCLUSIONThere was certain genetic divergence between M. officinalis and M. offcinalis var. biloba although the monophyletic clade of themselves was not still formed.

With diversification of treatment methods and standardization of multidisciplinary diagnosis and treatment, several strategies including down-staging of advanced hepatocellular carcinoma(HCC) by hepatic artery catheterization, radiotherapy, targeted therapy and other comprehensive treatments, rapid increasement of the future liver remnant through portal vein embolization or combined with hepatic septation and portal vein ligation, routine anti-viral therapy and liver protecting treatment have led to success conversion from advanced HCC or HCC with insufficiency of liver remnant function to resectable cancer, which has become an important way to improve the prognosis of HCC and attracted a lot of attention in clinical research. In this article, the author has further elaborated on the connotation, strategy and progression of the conversion therapy for HCC.

Objective To evaluate the clinical value of Fluorine-18-fluorodeoxyglucose (18F-FDG) positron-emission temography-computed tomography (PET-CT) examination in intrahepatic cholangiocarcinoma (ICC) staging.Methods The retrospective cross-sectional study was conducted.The clinicopathological data of 190 patients with ICC who were admitted to the Eastern Hepatobiliary Surgery Hospital Affiliated to Naval Military Medical University from September 2013 to June 2016 were collected.There were 107 males and 83 females,aged from 37 to 79 years,with an average age of 57 years.There were 90 cases without distant metastasis undergoing surgery treatment and 100 with distant metastasis undergoing non-surgical treatment.Patients underwent preoperative CT,magnetic resonance imaging (MRI),and PET-CT examination,and then received surgery or non-surgery according to preference of patients and their family members.Observation indicators:(1) imaging features on preoperative CT,MRI,PET-CT examination;(2) treatment;(3) evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation;(4) evaluation of regional lymph node metastasis by three tests in ICC staging of patients undergoing operation;(5) evaluation of distant metastasis in ICC staging by three tests.Measurement data with normal distribution were represented as Mean±SD,and comparison between groups was analyzed by single factor ANOVA and paired comparison was analyzed by SNK method.Measurement data with skewed distribution were described as M (range).Count data were described as absolute number or percentage,and comparison between groups was analyzed using the chi square test.Results (1) Imaging features on preoperative CT,MRI,PET-CT examination:all the 190 patients received routine upper abdominal CT,MRI,and systemic PET-CT examination before treatment.CT imaging of ICC showed inhomogeneous low density on plain scan,peripheral enhancement in arterial phase,persistent enhancement of tumor margin in portal phase,and sometimes mild to moderate centripetal enhancement.MRI imaging showed heterogeneous low signal on T1-weighted imaging,uneven high,and slightly high signal on T2-weighted imaging.Reinforcement on MRI is the same as CT.Transverse images,fusion transverse images and maximum intensity projection images of PET-CT imaging showed abnormal high FDG uptake around the tumor.(2) Treatment:81 out of the 90 ICC patients with surgery treatment underwent hepatectomy and lymphadenectomy,and 9 underwent only tumor tissue biopsy and lymph node biopsy due to intraoperative finding of abdominal metastasis.Of the 100 non-operated patients,30 received systemic chemotherapy,23 received local radiotherapy,and 47 gave up treatment.(3) Evaluation of tumor diameter,multiple tumors,macrovascular invasion,and bile duct invasion by three examinations in ICC staging of patients undergoing operation:the tumor diameters of ICC on CT,MRI and PET-CT were (6.8±2.8)cm,(6.9±2.9)cm,(7.2±2.8)cm,respectively.There was no significant difference among the three methods (F=0.085,P＞0.05).CT,MRI,PET-CT had similar accuracy of 80.0％ (72/90),78.9％ (71/90),72.2％ (65/90) on diagnosing multiple tumors,87.8％(79/90),92.2％ (83/90),94.4％ (85/90) for macrovascular invasion,and 93.3％ (84/90),95.6％ (86/90),96.7％ (87/90) for vascular and bile duct invasion,respectively,there was no significant difference in the above indicators between the three groups (x2 =1.801,2.662,1.131,P＞0.05).(4) Evaluation of regional lymph node metastasis by three examinations in ICC staging of patients undergoing operation:the accuracy of CT,MRI and PET-CT examination for lymph node metastasis was 62.2％ (56/90),68.9％(62/90),86.7％ (78/90) and sensitivity was 40.0％ (16/40),47.5％ (19/40),80.0％ (32/40),respectively,showing significant differences between the three groups (x2 =14.446,14.666,P＜0.05),showing a significant difference between CT and PET-CT examination (x2=14.134,13.333,P＜0.05),showing a significant difference between MRI and PET-CT examination (x2=8.229,9.141,P＜0.05).The sensitivity of CT,MRI and PET-CT examination for lymph node metastasis was 80.0％ (40/50),86.0％ (43/50),92.0％ (46/50),showing no significant difference between the three groups (x2=2.990,P＞0.05).(5) Evaluation of distant metastasis in ICC staging by three tests:there were 27,34 and 100 cases with distant metastasis evaluated by CT,MRI and PET-CT examination,including 40 with supraclavicular lymph node metastasis,32 with bone metastasis,30 with mediastinal lymph node metastasis,20 with hilar lymph node metastasis,17 with pulmonary metastasis;77 patients had more than 2 sites of metastasis.The accuracy of CT,MRI and PET-CT examination for distal metastasis in 190 ICC patients was 61.58％ (117/190),65.26％ (124/190),98.42％ (187/190),respectively,with a significant difference between the three groups (x2=83.639,P＜0.05),with a significant difference between CT and PET-CT examination (x2=80.592,P＜0.05),between MRI and PET-CT examination (x2=70.284,P＜ 0.05).Conclusion PET-CT examination makes up for the deficiency of CT and MRI in judging regional lymph node metastasis and distant metastasis,and contributes to the clinical staging of ICC.

The effects of tree ages and geographic area on quality of bark of Magnolia officinalis (MO) and M. officinalis var. biloba (MOB) were studied. The volatile oils of samples extracted by a water stream distillation method were analyzed using a GC/MS method. The non-volatile ingredients of samples were determined by an HPLC method. Seven and twenty characteristic peaks were detected in the HPLC and GC fingerprint of MO, respectively, and the similar HPLC and GC fingerprint were showed in MOB. For samples collected in the same geographic area with different ages, the concentrations of active ingredients varied barely, whereas for those samples collected from different geographic area, differences on the concentrations of active ingredients were observed, for example, the concentrations of the amount of magnolol and honokiol in samples collected in Hubei province were higher than those collected in other areas. Big differences on the concentrations of active ingredients were found between MO and MOB, for MO, the ratio of honokiol/ magnolol was more than 0.7, whereas the ratio-was less than 0.7 in the case of MOB, and the concentrations of honokiol in MO were higher than those in MOB.
China ; Magnolia ; chemistry ; physiology ; Plant Bark ; chemistry ; physiology ; Plant Extracts ; analysis

The mild-natured and bitter-flavored traditional Chinese medicines (MB-TCMs) are an important class of TCMs that have been widely used in clinical practice and recognized as safe long-term treatments for chronic diseases. However, as an important class of TCMs, the panorama of pharmacological effects and the mechanisms of MB-TCMs have not been systemically reviewed. Compelling studies have shown that gut microbiota can mediate the therapeutic activity of TCMs and help to elucidate the core principles of TCM medicinal theory. In this systematic review, we found that MB-TCMs commonly participated in the modulation of metabolic syndrome, intestinal inflammation, nervous system disease and cardiovascular system disease in association with promoting the growth of beneficial bacteria Bacteroides, Akkermansia, Lactobacillus, Bifidobacterium, Roseburia as well as inhibiting the proliferation of harmful bacteria Helicobacter, Enterococcus, Desulfovibrio and Escherichia-Shigella. These alterations, correspondingly, enhance the generation of protective metabolites, mainly including short-chain fatty acids (SCFAs), bile acid (BAs), 5-hydroxytryptamine (5-HT), indole and gamma-aminobutyric acid (GABA), and inhibit the generation of harmful metabolites, such as proinflammatory factors trimethylamine oxide (TAMO) and lipopolysaccharide (LPS), to further exert multiplicative effects for the maintenance of human health through several different signaling pathways. Altogether, this present review has attempted to comprehensively summarize the relationship between MB-TCMs and gut microbiota by establishing the TCMs-gut microbiota-metabolite-signaling pathway-diseases axis, which may provide new insight into the study of TCM medicinal theories and their clinical applications.