Hepatocellular carcinoma （HCC）， an insidious malignant tumor with high incidence and lethality， poses a major threat to physical and mental health of human beings. The pathological mechanism needs to be further studied. Surgery， radiotherapy， chemotherapy， and targeted drugs are effective but induce many adverse reactions. Traditional Chinese medicine （TCM） has unique advantages and abundant clinical experience in the treatment of HCC. There has been an explosion of research on the pathways， targets， and mechanism of TCM against HCC from the perspective of molecular biology. According to previous research， Chinese medicinals or compound Chinese medicine prescriptions， directly or indirectly prevent the occurrence and progression of HCC through multiple pathways and targets， which is closely related to the pathophysiological processes such as cell proliferation， metastasis， apoptosis， autophagy， inflammatory response， and immune response. This paper summarizes and analyzes research on the action pathways and mechanisms of Chinese medicine against HCC. Specifically， isoliquiritigenin， dendrobium candidum and Yexiazhu compound Ⅱ regulate phosphatidylinositol 3-kinase/protein kinase B （PI3K/Akt） signaling pathway to inhibit the growth， proliferation and metastasis of tumor cells. Toad venom and dioscorea zingiberensis induce and enhance HCC autophagy by modulating mammalian target of rapamycin （mTOR） signaling pathway. Myricetin， asparagus， and Biejiajian Wan regulate mitogen-activated protein kinase （MAPK） signaling pathway to promote HCC cell cycle arrest， inhibit angiogenesis， and induce apoptosis. Polygonum odoratum， tetragonum， and plantainoside modulate nuclear factor-kappa B （NF-κB） to inhibit inflammatory response and HCC metastasis and reduce drug resistance. Quercetin and erigeron breviscapus control the Janus kinase 2/signal transducer and activator of transcription 3 （JAK2/STAT3） signaling pathway to suppress epithelial-mesenchymal transition （EMT） and remodel cytoskeleton. This paper is expected to lay a theoretical basis for the in-depth research on and clinical application of Chinese medicine in the treatment of HCC.

OBJECTIVETo evaluate the efficacy of sacral nerve stimulation (SNS) therapy for fecal incontinence.

METHODSClinical researches which evaluated the efficacy of SNS and were published between 1946 and 2016 were systematically searched from electronic databases, including PubMed, Ovid Medline, Web of Science, Wanfang database and Chinese Journal Full-text Database. Grey area literatures were also searched. Influence of SNS therapy on fecal incontinence episodes (FIE) or Wexner incontinence score (WIS) was systematically evaluated. The statistical analysis was performed by RevMan5.2.

RESULTSA total of 6 studies including 270 patients (147 patients in SNS group and 123 patients in control group) with fecal incontinence were enrolled in this systematic review. SNS therapy was associated with a significant reduction in FIE (SMD=-0.69, 95%CI: -0.97 to -0.41, P<0.001) and a significant reduction in WIS (SMD=-5.05, 95%CI: -8.73 to -1.36, P=0.007). Sensitivity analysis showed that the results of this study were stable and the direction and significance of results were not changed (P=0.000 for both). Publication bias was not found by funnel picture in this study.

CONCLUSIONSNS significantly improves the outcome of patients with fecal incontinence.

Previous studies have demonstrated that exocytotic release from large dense cored vesicle(LDV)at structurally non-specialized areas within axon terminal of the medullary dorsal horn and it has been speculated that non-synaptic exocytosis from LDV may be a probable mechanism for neuropeptide release. This study provides the evidence that SP containing LDV can release their contents by exocytosis at non-synaptic sites of axon terminal within superficial dorsal horn of medulla oblongata in the rat with ultrastructural immunohistochemistry staining by an unilateral deafferentation. The results of this study confirmed previous hypothesis that SP and perhaps other peptides containing LDV release their contents by exocytosis at non-specialized sites and the significance of such release is discussed.

AIM: To investigate the effects of antisense oligonucleotides (asODN) of PKC-? and PKA-Ⅰon growth and proliferation of the CNE-2Z cells. METHODS: The expression of PKC-? and PKA-Ⅰ was observed with immunohistochemistry method. The asODNs of (1)PKC-?, (2)PKA-Ⅰ, (3)PKC-? and PKA-Ⅰ, were transfected into CNE-2Z cells by lipofectin (LP), and a random sequence as a control was used. The cell growth index (GI) and the clone formation rate of CNE-2Z were detected by MTT colorimetric assay and soft agar assy, respectively. RESULTS: The expression of PKC-? or PKA-Ⅰin CNE-2Z in experimental group were both significantly lower than that of control group(P

The peripheral nerves supplying the acupuncture points of the facial regionwere sectioned from 63 rats and their central terminations were traced by the loss ofthe acid phosphatase(ACP)activity in the substantia gelatinosa(SG)with themodified Gomori's method.1)The supraorbital nerve was cut,the loss of the ACP was confined to thelateral aspect of the substantia gelatinosa in spinal segments C_1.2)The infraorbi-tal nerve was transected,the ACP activity was absent from the central and lateralsectors of the SG in the medulla oblongata.3)The mental nerve was divided,theACP activity was absent from the most medial sector of SG in the medulla oblon-gata and C_1.4)The auriculotemporal nerve was severed,the activity of the enzymewas absent mainly in the inner medial sector of SG in the C_1 and C_2.5)Thefacial nerve was divided,the area deprived of enzyme activity is mainly found inthe central medial sector of SG in C_2.6)The vagal nerve was divided,a medialsector or central sector of SG in the C_1 and C_2 segment is devoid of ACP.7)Thegreat auricular nerve and the cutaneous cervical nerve were severed,the ACP activitywas absent in SG of the upper four cervical cords.The above results show that the primary sensory nerve of the peripheral nerveswhich supply the facial acupuncture points terminate in the SG of the subnucleuscaudalis of the trigeminal nerves and the dorsal horn and the primary sensory nervefibre of these nerves mostly terminate in C_1 and C_2 segment.

Nonglomerular synapses in the neuropil of the substantia gelatinosa of adult ratspinal trigeminal nucleus were subjected to electron microscopic examination. Nonglomerular synapses in the substantia gelatinosa were associated with four main types of axonal terminals. On the basis of vesicle shapes, these were classified as round vesicle, elongate vesicle, pleomorphie vesicle, and dense cored vesicle terminals. The category of round vesicle terminals could be subdivided into large round vesicle terminals and small round vesicle terminals according to their different size of synaptic vesicles. Nonglomerular synapses included four types, i. e. axodendritic, axo-axonic, dendro-dendritic and dendro-axonic synapses. Of these, the majority of synapses were axodendritie. The functional significance of the classification of these synapses and their axonal terminals had been discussed.

The substantia gelatinosa of subnucleus caudalis of the trigeminal nerve of the rat shows an intense extralysosomal acid phosphatase activity which disappears after the removal of it's skin of the facial regions.Different regions of the facial skin of 69 rats were excised and the projections of the cutaneous nerves were traced by studying the extralysosomal acid phosphatase activity with the modified Gomori's methods.A somatotopical localization was found within the substantia gelationosa. It agreed with what has been found in earlier studies where other techniques have been used. The findings showed that the fibers of the cutaneous areas along the dorsoventral axis of the body were found in a reverse order in the receptive fields in the substantia gelatinosa. The vertex and fore-head lay in the ventral, while skin of the mandibular areas in the dorsal region, and the skin of the facial areas lay successively from ventral to dorsal in following order: vertex and forehead eye region, dorsal vibrissae, ventral vibrissae-upper lip and finally lower lip-mandibulare region, in the receptive fields of the substantia gelatinosa.The cutaneous facial regions were disproportionately represented in substantia gelatinosa, for example, the field receiving projections from the vibrissae areas or fields were as large as 4mm~2 in the most medial portion of the ventral vibrissae-upperlip which are disproportionately large while the fields receiving projections from the forehead and mandibular cutaneous regions were disproportionately small. The provides a possible explanation for the specific function of analgesia of the acupuncture point Renzhong.

The glomerular synapses of the substantia gelatinosa in the spinal trigeminal nucleus of the rat were examined by electron microscopy. The central axonal ending in the glomcruli forms asymmetrical axodendritic synapses on adjacent type 1 and type 2 dendrites. Type 2 dendritic spines or shafts (dendrites which contain synaptic vesicles) form dendrodendritic synapses on Type 1 dendritic spine or shafts (dendrites without synaptic vesicles) and also form dendroaxonic synapses on the central ending. The peripheral terminals (P) form symmetrical axoaxonic synapses on the central ending and form axodendritic synapses on the dendrites in the glomeruli.

The ultrastructural localization of substance P (SP) immunoreactivity, especially the morphology, number and distribution of positive large granular vesicles (LGV) in SP axon terminals of the trigeminal subnucleus caudalis of the rat were studied by electron microscopic immunocytochemistry. This study revealed that SP immunoreactivity was mostly located in axon terminals and unmyelinated fibers. SP axon terminals contained both clear round vesicles and LGV. SP immunoreactivity was found in LGV, and on the surface of clear round vesicles and outer membrane of mitochondria. Positive LGV were spherical or oval in shape (60～120nm in diameter). The number of LGv was mostly 2～3 in a SP axon terminal. LGV often apposed to the axolemma or scattered in the centre of terminal. LGV were far from the presynaptic sites of the SP terminals which formed synapses. The number of LGV closed to the terminal membrane was significantly (P

The normal structure of axonal terminals in lamina V of cervical spinal cordof the adult rat was examined with EM.Among 4039 various types of terminals inlamina V,the terminals with clear round synaptic vesicles(R)and the terminalswith clear flat synaptic vesicles(F)constitute about 40% each,the terminals withlarge granular vesicles(LG)about 16% and the central terminals of syntapticglomeruli about 3%.In addition,about 3.2% of the various types of terminalscontain neurofilaments,about 0.9% exhibit low electron dense axoplasm and thevesicles are partly lost or clumping.The synapses of the terminals in lamina V aremainly axodendritic,a small number of them are axoaxonal.There are more F,fewer R and LG in lamina V than those in lamina Ⅱ;thesynapses between the terminals and proximal dendrites,and axosomatic synapses aremore commonly seen in lamina V than in Ⅱ.