BACKGROUND Neoadjuvant chemotherapy improves the resection rate and reduces postoperative recurrence in gastric cancer(GC)but is often associated with significant toxicity.Traditional Chinese medicine has unique advan...BACKGROUND Neoadjuvant chemotherapy improves the resection rate and reduces postoperative recurrence in gastric cancer(GC)but is often associated with significant toxicity.Traditional Chinese medicine has unique advantages in the treatment of cancer,and Baohe Pingwei powder can help alleviate the side effects of chemotherapy and enhance the therapeutic effect.However,there is no clinical evidence supporting its use in patients who underwent surgery for GC treatment.AIM To evaluate the safety and efficacy of Baohe Pingwei powder combined with neoadjuvant chemotherapy in postoperative patients with GC and to provide evidence-based medical evidence for the treatment of postoperative patients with GC with integrated traditional Chinese and Western medicine.METHODS A retrospective analysis was conducted on 80 postoperative patients with GC admitted to the Department of Gastroenterology of our hospital and treated between May 2024 and November 2024.According to different treatment methods,they were divided into a control group(54 patients received S-1+oxaliplatin chemotherapy 4 weeks after surgery)and a study group(26 cases were combined with Baohe Pingwei powder combined with S-1+oxaliplatin).Clinical data were collected to compare the differences in objective response rate(ORR),disease control rate(DCR),progression-free survival,overall survival,and adverse reactions of patients with GC after surgery under different treatment methods.Further based on the control of GC,patients were divided into an effective group(62 cases)and an ineffective group(18 cases).The relationship between Baohe Pingwei powder and clinical efficacy was analyzed through univariate and multivariate logistic regression analysis as well as a multivariate Cox risk model.RESULTS The baseline characteristics including age,gender,and other demographic factors showed no significant differences between the control and observation groups(P>0.05).In the observation group,there were 24 cases of effective treatment and 2 cases of ineffective treatment,with an ORR of 84.62%and a DCR of 92.31%.In the control group,there were 38 cases of effective treatment and 16 cases of ineffective treatment,with an ORR of 46.30%and a DCR of 70.37%.The treatment effect of the observation group was significantly higher than that of the control group(P<0.05).The Kaplan Meier curve showed that the risk of tumor recurrence and death in the observation group was significantly reduced compared to the control group(log rank P=0.030 and P=0.035,respectively).Subsequent stratification based on treatment response identified 62 patients in the effective group and 18 in the ineffective group.Intergroup comparison showed that the effective group had a higher proportion of Baohe Pingwei powder(P=0.000),and there were statistically significant differences in tumor size,differentiation degree,and post-treatment levels of CD3+,CD4+,CA19-9,CA242,IL-6,IL-10,and TNF-αbetween the groups(P<0.05).Further univariate and multivariate logistic analysis revealed that CD3+and CD4+T cell levels were significantly associated with treatment efficacy.The use of Baohe Pingwei powder was a protective factor for effective treatment,while CA19-9 and IL-6 levels were independent risk factors for ineffective treatment(P<0.05).Multivariate Cox proportional hazards model analysis found that without adjusting the model,the risk of ineffective treatment in patients significantly decreased with the increase of CD3+and CD4+and the decrease of CA19-9 and IL-6(group 1 as a reference;group 2 hazard ratio:0.624,95%confidence interval:0.437-0.986,P=0.019).After adjusting for confounding factors such as Baohe Pingwei powder in Model 3,Cox regression results showed an increased risk of treatment failure.With the decrease of CD3+and CD4+and the increase of CA19-9 and IL-6,the risk of treatment failure in patients significantly increased(Group 1 as a reference;Group 2 hazard ratio:1.439,95%confidence interval:1.208-1.614,P=0.006).CONCLUSION The combination therapy of Baohe Pingwei powder with neoadjuvant chemotherapy demonstrated significant clinical benefits in postoperative patients with GC,including improved the ORR,DCR,extended progression-free survival,and overall survival as well as a reduced incidence of treatment-related adverse events.Furthermore,our finding indicated that decreased CD3+and CD4+levels along with evaluated CA199 and IL-6 levels served as important biomarkers predicting increased risk of treatment failure in this patient population.展开更多
BACKGROUND Gastric cancer is a major global health issue,especially in East Asia.Radical gastrectomy,the primary treatment,often leads to complications like malnutrition and infection,impairing recovery.Traditional Ch...BACKGROUND Gastric cancer is a major global health issue,especially in East Asia.Radical gastrectomy,the primary treatment,often leads to complications like malnutrition and infection,impairing recovery.Traditional Chinese medicine may offer benefits in regulating gastrointestinal function and immunity.This study investigated the effects of a modified Pingwei Baohe decoction(MPBD)on postoperative immune function and nutritional status in gastric cancer patients.AIM To explore the influence of MPBD on the postoperative immune function and nutritional status of patients with gastric cancer.METHODS A total of 55 gastric cancer patients who underwent radical proximal gastrectomy in Hebei Provincial People's Hospital and The Fourth Hospital of Hebei Medical University from June 2023 to June 2025 were selected as the research objects and divided into the observation group(28 cases,receiving chemotherapy plus MPBD)and the control group(27 cases,receiving chemotherapy alone)at a ratio of 1:1 according to the random number table method.Inflammatory indicators,immune function,nutritional status,and gastrointestinal function recovery time were compared before and 28 days after intervention.RESULTS After 28 days,the observation group showed significantly lower levels of inflammatory markers(IL-6,IL-4,IL-2,IL-17A,IFN-γ,TNF-α,IL-10),neutrophil-to-lymphocyte ratio(NLR),and proportion of CONUT score>2,alongside significantly higher levels of CD3+,CD4+,CD4+/CD8+ratio,absolute lymphocyte count(ALC),lymphocyte percentage(LYM%),and TNF-α/IL-4 ratio compared to the control group(P2 were significantly lower than baseline,while the immune parameters(CD3+,CD4+,CD4+/CD8+ratio,ALC,LYM%,TNF-α/IL-4 ratio)were significantly higher(P<0.05).Additionally,gastrointestinal function recovery times(first flatus,bowel sounds recovery,abdominal distension relief)in the observation group were significantly shorter than in the control group(P<0.05).CONCLUSION MPBD significantly enhances postoperative immune function,mitigates inflammatory responses,improves nutritional status,and accelerates gastrointestinal function recovery in gastric cancer patients.展开更多
OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-perf...OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.展开更多
OBJECTIVE: To investigate the mechanism of Ping-wei capsules(PWC) in improving gastrointestinal m otility in rats with functional dyspepsia(FD).METHODS: We established an FD model by stimu-lating semi-starvation rats ...OBJECTIVE: To investigate the mechanism of Ping-wei capsules(PWC) in improving gastrointestinal m otility in rats with functional dyspepsia(FD).METHODS: We established an FD model by stimu-lating semi-starvation rats via tail damping, provo-cation, and forced exercise fatigue. The FD model group was further divided into five groups accord-ing to the treatment received: normal saline, dom-peridone, low-dose PWC, mid-dose PWC, or highdose PWC. The effect of PWC on FD was evaluated by measuring gastrointestinal motility. Changes in leptin and cholecystokinin(CCK) were detected through enzyme-linked immunosorbent assay, re-verse transcription-polymerase chain reaction, and immunohistochemistry.RESULTS: PWC significantly increased gastrointesti-nal m otility in FD rats. Furthermore, PWC signifi-cantly increased CCK m RNA and protein concentra-tions in the duodenum and antrum, decreased leptin protein concentrations in the duodenum, an-trum, and hypothalamus, and decreased CCK pro-tein concentration in the hypothalamus.CONCLUSION: PWC improves gastrointestinal mo-tor function in FD rats by decreasing the leptin con-centration in serum and the brain-gut axis, and by increasing the CCK concentration in gastrointesti-nal tissue. Our findings help to elucidate the mech-anism of FD and provide further insight into the pharmacokinetics of PWC.展开更多
基金Supported by Scientific Research Project of Hebei Administration of Traditional Chinese Medicine,No.2025271the Construction Project of National Clinical Research Base of Traditional Chinese Medicine,Science Letter[2018],No.131+4 种基金Natural Science Foundation of Hebei Province,No.H2023423001Key Research Project of the Ministry of Science and Technology,No.2018YFC1704100 and No.2018YFC1704102Provincial Science and Technology Program of Hebei Province,No.21377724D and No.21377740DScientific Research Project of Hebei Administration of Traditional Chinese Medicine,No.2021034,No.2022026,No.2022032,and No.2023022Medical Science Research Project of Hebei Province,No.20190756.
摘要BACKGROUND Neoadjuvant chemotherapy improves the resection rate and reduces postoperative recurrence in gastric cancer(GC)but is often associated with significant toxicity.Traditional Chinese medicine has unique advantages in the treatment of cancer,and Baohe Pingwei powder can help alleviate the side effects of chemotherapy and enhance the therapeutic effect.However,there is no clinical evidence supporting its use in patients who underwent surgery for GC treatment.AIM To evaluate the safety and efficacy of Baohe Pingwei powder combined with neoadjuvant chemotherapy in postoperative patients with GC and to provide evidence-based medical evidence for the treatment of postoperative patients with GC with integrated traditional Chinese and Western medicine.METHODS A retrospective analysis was conducted on 80 postoperative patients with GC admitted to the Department of Gastroenterology of our hospital and treated between May 2024 and November 2024.According to different treatment methods,they were divided into a control group(54 patients received S-1+oxaliplatin chemotherapy 4 weeks after surgery)and a study group(26 cases were combined with Baohe Pingwei powder combined with S-1+oxaliplatin).Clinical data were collected to compare the differences in objective response rate(ORR),disease control rate(DCR),progression-free survival,overall survival,and adverse reactions of patients with GC after surgery under different treatment methods.Further based on the control of GC,patients were divided into an effective group(62 cases)and an ineffective group(18 cases).The relationship between Baohe Pingwei powder and clinical efficacy was analyzed through univariate and multivariate logistic regression analysis as well as a multivariate Cox risk model.RESULTS The baseline characteristics including age,gender,and other demographic factors showed no significant differences between the control and observation groups(P>0.05).In the observation group,there were 24 cases of effective treatment and 2 cases of ineffective treatment,with an ORR of 84.62%and a DCR of 92.31%.In the control group,there were 38 cases of effective treatment and 16 cases of ineffective treatment,with an ORR of 46.30%and a DCR of 70.37%.The treatment effect of the observation group was significantly higher than that of the control group(P<0.05).The Kaplan Meier curve showed that the risk of tumor recurrence and death in the observation group was significantly reduced compared to the control group(log rank P=0.030 and P=0.035,respectively).Subsequent stratification based on treatment response identified 62 patients in the effective group and 18 in the ineffective group.Intergroup comparison showed that the effective group had a higher proportion of Baohe Pingwei powder(P=0.000),and there were statistically significant differences in tumor size,differentiation degree,and post-treatment levels of CD3+,CD4+,CA19-9,CA242,IL-6,IL-10,and TNF-αbetween the groups(P<0.05).Further univariate and multivariate logistic analysis revealed that CD3+and CD4+T cell levels were significantly associated with treatment efficacy.The use of Baohe Pingwei powder was a protective factor for effective treatment,while CA19-9 and IL-6 levels were independent risk factors for ineffective treatment(P<0.05).Multivariate Cox proportional hazards model analysis found that without adjusting the model,the risk of ineffective treatment in patients significantly decreased with the increase of CD3+and CD4+and the decrease of CA19-9 and IL-6(group 1 as a reference;group 2 hazard ratio:0.624,95%confidence interval:0.437-0.986,P=0.019).After adjusting for confounding factors such as Baohe Pingwei powder in Model 3,Cox regression results showed an increased risk of treatment failure.With the decrease of CD3+and CD4+and the increase of CA19-9 and IL-6,the risk of treatment failure in patients significantly increased(Group 1 as a reference;Group 2 hazard ratio:1.439,95%confidence interval:1.208-1.614,P=0.006).CONCLUSION The combination therapy of Baohe Pingwei powder with neoadjuvant chemotherapy demonstrated significant clinical benefits in postoperative patients with GC,including improved the ORR,DCR,extended progression-free survival,and overall survival as well as a reduced incidence of treatment-related adverse events.Furthermore,our finding indicated that decreased CD3+and CD4+levels along with evaluated CA199 and IL-6 levels served as important biomarkers predicting increased risk of treatment failure in this patient population.
摘要BACKGROUND Gastric cancer is a major global health issue,especially in East Asia.Radical gastrectomy,the primary treatment,often leads to complications like malnutrition and infection,impairing recovery.Traditional Chinese medicine may offer benefits in regulating gastrointestinal function and immunity.This study investigated the effects of a modified Pingwei Baohe decoction(MPBD)on postoperative immune function and nutritional status in gastric cancer patients.AIM To explore the influence of MPBD on the postoperative immune function and nutritional status of patients with gastric cancer.METHODS A total of 55 gastric cancer patients who underwent radical proximal gastrectomy in Hebei Provincial People's Hospital and The Fourth Hospital of Hebei Medical University from June 2023 to June 2025 were selected as the research objects and divided into the observation group(28 cases,receiving chemotherapy plus MPBD)and the control group(27 cases,receiving chemotherapy alone)at a ratio of 1:1 according to the random number table method.Inflammatory indicators,immune function,nutritional status,and gastrointestinal function recovery time were compared before and 28 days after intervention.RESULTS After 28 days,the observation group showed significantly lower levels of inflammatory markers(IL-6,IL-4,IL-2,IL-17A,IFN-γ,TNF-α,IL-10),neutrophil-to-lymphocyte ratio(NLR),and proportion of CONUT score>2,alongside significantly higher levels of CD3+,CD4+,CD4+/CD8+ratio,absolute lymphocyte count(ALC),lymphocyte percentage(LYM%),and TNF-α/IL-4 ratio compared to the control group(P2 were significantly lower than baseline,while the immune parameters(CD3+,CD4+,CD4+/CD8+ratio,ALC,LYM%,TNF-α/IL-4 ratio)were significantly higher(P<0.05).Additionally,gastrointestinal function recovery times(first flatus,bowel sounds recovery,abdominal distension relief)in the observation group were significantly shorter than in the control group(P<0.05).CONCLUSION MPBD significantly enhances postoperative immune function,mitigates inflammatory responses,improves nutritional status,and accelerates gastrointestinal function recovery in gastric cancer patients.
基金the Guangdong Provincial Basic and Applied Basic Research Project:Mechanistic Study on the Regulation of Inflammatory Microenvironment and Improvement of Ulcerative Colitis by Lingnan Traditional Medicine Ficus Pandurata Hance through Wilms'Tumor 1-associating Protein-Mediated RNA Methyltransferase Promoting Toll Like Receptor 4 m6A Modification(2023A1515011699)the Zhongshan Medical Research Project:Mechanistic Study on the Action of Xiahuo Pingwei San in the Treatment of Ulcerative Colitis(2022A020446)。
摘要OBJECTIVE:To evaluate the therapeutic effects of Xiahuo Pingwei San(夏藿平胃散,XHPWS)on ulcerative colitis(UC)in mice and to explore the underlying mechanisms through a network pharmacology approach.METHODS:Ultra-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometry(UPLC-Q-TOF/MS)was utilized to identify the chemical composition and authenticate the active constituents of XHPWS,ensuring rigorous quality control across batches.A dextran sulfate sodium(DSS)-induced UC model was established in C57BL/6 mice,which were treated with XHPWS in vivo.The efficacy against UC was assessed by measuring parameters such as body weight,disease activity index(DAI)scores,and colon length.Levels of inflammatory cytokines,including interleukin-6(IL-6),interleukin-1β(IL-1β),and tumor necrosis factor-alpha(TNF-α),in colonic tissue were evaluated using enzymelinked immunosorbent assay(ELISA).Histological analysis of colon sections was conducted using hematoxylin and eosin staining.A network pharmacology approach was employed to explore the mechanisms of XHPWS and to predict its potential targets in UC treatment.Predicted protein expressions in colonic tissue were validated using immune-ohistochemistry(IHC)and Western blotting techniques.RESULTS:XHPWS effectively alle via ted DSS-induced UC symptoms in mice,as evidenced by restored body weight,reduced colon shortening,and decreased DAI scores.Histopathological examination revealed that XHPWS significantly reduced intestinal inflammatory infiltration,restored intestinal epithelial permeability,and increased goblet cell count.Network pharmacology analysis identified 63 active compounds in XHPWS and suggested that it might target 35 potential proteins associated with UC treatment.Functional enrichment analysis indicated that the protective mechanism of XHPWS could be related to the advanced glycation end products-receptor for advanced glycation end products(AGE-RAGE)signaling pathway.Notably,quercetin,kaempferol,wogonin,and nobiletin,the main components of XHPWS,showed strong correlations with the core targets.Additionally,experimental validation demonstrated that XHPWS significantly decreased levels of inflammatory cytokines interleukin 6(IL-6),interleukin 1 beta(IL-1β),and tumor necrosis factor alpha(TNF-α)in UC mice,while downregulating the expression of proteins related to the AGE-RAGE pathway.CONCLUSION:Our study demonstrated that XHPWS effectively alle via tes colitis symptoms and inflammation in UC mice,potentially through the regulation of the AGE-RAGE pathway.These findings provide strong evidence for the therapeutic potential of XHPWS in UC treatment,thereby broadening its clinical applications.
基金Supported by the Natural Science Foundation of China(Based on Brain-Gut Axis to Study Peptidomics of Liver Stag-nation and Spleen Deficiency with Functional Dyspepsia and Its Intervention of Shugan Jianpi Method,No.8136-0540)the Administration of Gansu Traditional Chinese Medicine and Chinese Herbs(A Study about Intervening Ef-fects of a Chinese Herbal Preparation w ith Resveratrol on In-sulin Resistance of Type 2 Diabetes Mellitus,No.GZK-2015-23)
摘要OBJECTIVE: To investigate the mechanism of Ping-wei capsules(PWC) in improving gastrointestinal m otility in rats with functional dyspepsia(FD).METHODS: We established an FD model by stimu-lating semi-starvation rats via tail damping, provo-cation, and forced exercise fatigue. The FD model group was further divided into five groups accord-ing to the treatment received: normal saline, dom-peridone, low-dose PWC, mid-dose PWC, or highdose PWC. The effect of PWC on FD was evaluated by measuring gastrointestinal motility. Changes in leptin and cholecystokinin(CCK) were detected through enzyme-linked immunosorbent assay, re-verse transcription-polymerase chain reaction, and immunohistochemistry.RESULTS: PWC significantly increased gastrointesti-nal m otility in FD rats. Furthermore, PWC signifi-cantly increased CCK m RNA and protein concentra-tions in the duodenum and antrum, decreased leptin protein concentrations in the duodenum, an-trum, and hypothalamus, and decreased CCK pro-tein concentration in the hypothalamus.CONCLUSION: PWC improves gastrointestinal mo-tor function in FD rats by decreasing the leptin con-centration in serum and the brain-gut axis, and by increasing the CCK concentration in gastrointesti-nal tissue. Our findings help to elucidate the mech-anism of FD and provide further insight into the pharmacokinetics of PWC.