A traditional Chinese herbal medicine compound preparation versus interventional therapy after resection of small hepatocellular carcinoma:22-year follow-up

OBJECTIVE:To compare the long-term effectiveness of compound Ruanjianhugan(RJH)tablets and interventional therapy(IT) in patients after resection of small hepatocellular carcinoma(HCC).METHODS:A retrospective study was conducted in 399 patients after resection of small HCC who were admitted between January 1987 and December 2008 in the Department of Hepatobiliary Surgery and Center of Minimlly Invasive Surgery,First Affiliated Hospital of Guangxi Medical University.Four groups were based on different therapy modes:a TCM-only(TCMO) group,a TCM combined with interventional therapy(TCM-IT) group,an interventional therapy-only(ITO) group,and a simple operation(SO) group.Prognostic factors were correlated with overall survival(OS) and OS rates were calculated with the Kaplan-Meier method,and multivariate analyses for factors affecting survival were evaluated by the Cox proportional hazard model.RESULTS:The median OS was 151.20 months in the TCM-IT group,43.87 months in the ITO group,and 20.77 months in the SO group.All survival rates of the TCMO group were higher than those of the other three groups(>50%).The 5-,10-,and 15-year OS in the TCMO and ITO patients were 83.94%,45.50%,and 71.22% and 33.34%,55.58%,and 9.26%,respectively(risk ratio,0.209;95% confidence interval,0.126-0.347;P=0.000).Multivariate analysis revealed that the independent risk factors were therapy mode(P=0.000),sex(P=0.005),family history(P=0.011),TNM Classification of Malignant Tumor staging(P=0.000),medical care-seeking behavior(P=0.021),and maximum diameter(P=0.030).CONCLUSION:Long-term oral use of compound RJH tablets may improve OS for small HCC after resection compared with IT.

Yu Gan Long Ameliorates Hepatic Fibrosis by Inhibiting PI3K/AKT,Ras/ERK and JAK1/STAT3 Signaling Pathways in CCl4-induced Liver Fibrosis Rats

Yu Gan Long(YGL)is a Chinese traditional herbal formula which has been reported to attenuate liver fibrosis for many years and we have explored its anti-fibrotic mechanism through blocking transforming growth factor(TGF-β)in the previous study.But the mechanisms associated with platelet-derived growth factor(PDGF)-BB remain obscure.In this study,we further investigated the mechanism of YGL reducing carbon tetrachloride(CCl4)-induced liver fibrosis in rats.Our results showed that YGL suppressed CCl4-induced upregulation of collagen IV(Col IV),type HI precollagen(PCHI),hyaluronuc acid(HA)and laminin(LN),which are implicated in liver fibrosis.Also,YGL reduced theα-smooth muscle actin(α-SMA)expression,which acts as the indicator of liver fibrosis.Furthermore,YGL decreased the serum levels of hepatic stellate cell(HSC)mitogen PDGF-BB and inflammation cytokines,including TNF-α,IL-1β,IL-6.Markers involved in liver fibrosis,such as Ras,p-Raf-1,p-ERK1/2,p-JNK,p-P38,p-PI3K,p-AKT,p-JAKl,p-STAT3 were downregulated significantly after treatment with YGL.Our results indicated that YGL ameliorated CCl4-induced liver fibrosis by reducing inflammation cytokines production,and suppressing Ras/ERK,PI3K/AKT,and JAK1/STAT3 signaling pathways,which provided further evidence towards elucidation of the anti-fibrotic mechanism of YGL.