A comprehensive update:gastrointestinal microflora,gastric cancer and gastric premalignant condition,and intervention by traditional Chinese medicine

With the recent upsurge of studies in the field of microbiology,we have learned more about the complexity of the gastrointestinal microecosystem.More than 30 genera and 1000 species of gastrointestinal microflora have been found.The structure of the normal microflora is relatively stable,and is in an interdependent and restricted dynamic equilibrium with the body.In recent years,studies have shown that there is a potential relationship between gastrointestinal microflora imbalance and gastric cancer(GC)and precancerous lesions.So,restoring the balance of gastrointestinal microflora is of great significance.Moreover,intervention in gastric premalignant condition(GPC),also known as precancerous lesion of gastric cancer(PLGC),has been the focus of current clinical studies.The holistic view of traditional Chinese medicine(TCM)is consistent with the microecology concept,and oral TCM can play a two-way regulatory role directly with the microflora in the digestive tract,restoring the homeostasis of gastrointestinal microflora to prevent canceration.However,large gaps in knowledge remain to be addressed.This review aims to provide new ideas and a reference for clinical practice.

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.