Study on the mechanism of Euphorbia fischeriana Steud.- Jujubae Fructus in the treatment of hepatocirrhosis based on network pharmacology

The active components,targets,and pathways of Euphorbia fischeriana Steud.-Jujubae Fructus in treating hepatocirrhosis and the mechanism of action were explored by means of network pharmacology.Firstly,the active components and related targets of Jujubae Fructus were screened by TCMSP database and standardized by Uniprot database.The compounds of Euphorbia fischeriana Steud.were obtained by searching the literature and finally screened by PubChem database,Swiss ADME,and SwissTargetPrediction.Hepatocirrhosis targets were obtained through Genecards database,PPI network analysis was conducted on common targets of Euphorbia fischeriana Steud.-Jujubae Fructus and hepatocirrhosis by using String database,GO enrichment analysis and KEGG pathway enrichment analysis was conducted through Metascape database by using intersection targets of Euphorbia fischeriana Steud.-Jujubae Fructus and hepatocirrhosis,and the results were drawn by using Weishengxin online drawing platform.Then,the network of drug-compound-target-pathway was constructed by the software of Cytoscape3.8.0.Finally,the above results were verified by molecular docking.47 active compounds from Euphorbia fischeriana Steud.-Jujubae Fructus were screened out,which had 38 common targets,162 intersection targets,and 340 signal pathways with hepatocirrhosis,mainly involving hepatitis C,JAK-STAT signal pathway and AGE-RAGE signal pathway.Targets,such as MAPK1,AKT1,TNF,JUN,IL6 and PTGS2,play important roles in the treatment.The findings suggested that the main active ingredients of Euphorbia fischeriana Steud.-Jujubae Fructus in treating hepatocirrhosis are quercetin,scopolamine,physcion,7-deoxyrangduin,17-Hydroxyjolkinolide A,etc.Molecular docking results showed that the main active components and core targets might have a good binding capacity.This study preliminarily explored the potential mechanism of Euphorbia fischeriana Steud.-Jujubae Fructus in treating hepatocirrhosis and provided a theoretical basis for the clinical application of Euphorbia fischeriana Steud.-Jujubae Fructus.

Influence of lactulose on interventional therapy for HCC patients with hepatocirrhosis and hypersplenism

Objective: To investigate the influence of lactulose on immunity of hepatocellular carcinoma(HCC) patients with hepatocirrhosis and hypersplenism after double-interventional therapies. Methods: A total of 40 HCC patients with hepatocirrhosis and hypersplenism, hospitalized during January 2013 to June 2014, were enrolled and randomized into control group and observation group. Both groups received partial splenic embolization combined with transcatheter arterial chemoembolization. Besides, observation group orally took lactulose 30 m L/d. Four days before interventional therapies and at day 1, 3, 7 and 14 after therapies, fasting venous blood was collected to detect white blood cell count, red blood cell count(RBC), and platelet count(PLT). Four days before therapies and at day 7 and 14 after therapies, the levels of alanine aminotransferase, aspartate transaminase, total bilirubin, malondialdehyde, super-oxide dismutase(SOD), IFN-α, and IL-4 as well as the distribution of T cell subsets in peripheral blood were tested. Complications were observed after interventional therapies. Results: Before interventional therapies the levels of white blood cell count, PLT and RBC in both groups showed no difference, while after interventional therapies the levels of PLT and RBC in both groups showed an increasing tendency(P<0.05). At day 14 after interventional therapies, the level of blood cell as well as that of SOD, IFN-α and IL-4 in serum were significantly higher than that before therapies; meanwhile, the levels of alanine aminotransferase and total bilirubin of observation group after therapies were significantly lower than before and control group(P<0.05), the levels of CD4+/CD8+, SOD and IFN-α were all higher than before and control group(P<0.05). Conclusions: Oral administration of lactulose could adjust the imbalance of oxidation system/antioxidant system in HCC patients with hepatocirrhosis and hypersplenism after interventional therapies, and improve the antitumor immunity and prognosis.

Effects of Acupoint Massage Combined with Psychological Nursing on Depression and Hope Level and Coping Style in Hospitalized Patients with Hepatocirrhosis

OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis for clinical treatment. METHODS: A total of 86 patients with hepatocirrhosis hospitalized in The Sixth Hospital of Handan from June 2015 to June 2018 were selected and divided into 2 groups according to the nursing method. The control group, with a total of 42 patients, were given psychological nursing intervention. The observation group, with a total of 44 patients, were given acupoint massage and psychological nursing intervention. Changes in depression levels, hope levels, and coping style scores were compared between the 2 groups. RESULTS: There was no significant difference in depression, hope level and coping style before the intervention between the 2 groups(P > 0.05). In the observation group, the self-rating depression scale(SDS) score of depression before intervention was 55.16 ± 4.17; and the positive attitude score was 8.40 ± 2.02; the positive action score was 8.33 ± 3.05; and the intimate score was 8.13 ± 2.44. The negative response score was 30.14 ± 3.31, and the positive response score was 30.49 ± 3.26. Before the intervention, the SDS score in the control group was 56.81 ± 4.39, and the positive attitude score was 8.29 ± 1.98. The positive action score was 8.04 ± 2.57, and the intimate score was 8.06 ± 2.31. The total level of hope score was 24.07 ± 3.11. The negative coping score was 30.55 ± 3.06, and the positive coping score was 30.93 ± 3.17. After intervention the SDS scores of the observation group were lower than those of the control group(P < 0.05). The SDS score of the observation group was 36.19 ± 4.19, and the SDS score of the control group was 42.95 ± 3.71. The total level of hope in the observation group was higher than that in the control group after intervention(P < 0.05). The positive attitude score of the observation group was 16.10 ± 2.15, and the score of positive action was 14.74 ± 3.11; the score of intimate relationship was 15.08 ± 5.45; and the total score of hope was 45.71 ± 5.63. The positive attitude score of the control group was 10.92 ± 2.07; the score of positive action was 11.38 ± 3.14; the score of intimate relationship was 10.92 ± 2.33; and the total score of hope was 34.09 ± 5.77. The patients in the observation group had lower response scores after intervention than the control group, and the positive response scores were higher than those in the control group(P < 0.05). The negative response score of the observation group was 20.14 ± 2.19; the positive response score was 38.92 ± 4.33; the negative response score of the control group was 26.61 ± 2.34; and the positive response score was 34.08 ± 2.69. CONCLUSION: Acupoint massage combined with psychological nursing can effectively improve depression in hospitalized patients with hepatocirrhosis, improve the patient's hope level, help patients cope with lifestyle changes from negative to positive, which is worthy of clinical promotion.

Clinical significance of half-hepatic blood flow occlusion technology in patients with hepatocellular carcinoma with cirrhosis

BACKGROUND Most patients with primary hepatocellular carcinoma(HCC)have a history of chronic hepatitis B and usually present with varying degrees of cirrhosis.Owing to the special nature of liver anatomy,the blood vessel wall in the liver parenchyma is thin and prone to bleeding.Heavy bleeding and blood transfusion during hepatectomy are independent risk factors for liver cancer recurrence and death.Various clinical methods have been used to reduce intraoperative bleeding,and the Pringle method is most widely used to prevent blood flow to the liver.AIM To investigate the effect of half-hepatic blood flow occlusion after patients with HCC and cirrhosis undergo hepatectomy.METHODS This retrospective study included 88 patients with HCC and liver cirrhosis who underwent hepatectomy in our hospital from January 2017 to September 2020.Patients were divided into two groups based on the following treatment methods:the research group(n=44),treated with half-hepatic blood flow occlusion technology and the control group(n=44),treated with total hepatic occlusion.Differences in operation procedure,blood transfusion,liver function,tumor markers,serum inflammatory response,and incidence of surgical complications were compared between the groups.RESULTS The operation lasted longer in the research group than in the control group(273.0±24.8 min vs 256.3±28.5 min,P<0.05),and the postoperative anal exhaust time was shorter in the research group than in the control group(50.0±9.7 min vs 55.1±10.4 min,P<0.05).There was no statistically significant difference in incision length,surgical bleeding,portal block time,drainage tube indwelling time,and hospital stay between the research and control groups(P>0.05).Before surgery,there were no significant differences in serum alanine transaminase(ALT),aspartate aminotransferase(AST),total bilirubin,and prealbumin levels between the research and control groups(P>0.05).Conversely,24 and 72 h after the operation the respective serum ALT(378.61±77.49 U/L and 246.13±54.06 U/L)and AST(355.30±69.50 U/L and 223.47±48.64 U/L)levels in the research group were significantly lower(P<0.05)than those in the control group(ALT,430.58±83.67 U/L and 281.35±59.61 U/L;AST,416.49±73.03 U/L and 248.62±50.10 U/L).The operation complication rate did not significantly differ between the research group(15.91%)and the control group(22.73%;P>0.05).CONCLUSION Half-hepatic blood flow occlusion technology is more beneficial than total hepatic occlusion in reducing liver function injury in hepatectomy for patients with HCC and cirrhosis.