Construction Regulation Of Patterns Of Syndrome In Primary Hepatic Carcinoma And The Effects Of SSD On Inducing Differentiation

Objective:To explore the regulation of the syndrome differentiation of Chinese medicine in primary hepatic carcinoma.To observe if Saikosapollin-d could induce differentiation, and discuss the mechanism of action initially.Methods:To explore the regulation of the syndrome differentiation of Chinese medicine in primary hepatic carcinoma by cross-sectional study and case control study. And to study the incidence of emotional disorder in patients with PHC by the method of SDS. In the part of experiment, To study the effects of SSD on inducing differentiation and mechanisms by observing SMMC-7721 cell morphous,, detecting biochemistry function,cell cycle and expression of signal transduction molecule such as P38MAPK,P21^WAF1) and NF-KB.Results:1. PHC happened in 40-80 years(P<0.005) and male mainly(P<0.05). And the cases of III stage were dominantposition; To compare with B and C hospitals, the rate of II stage in A hospital was remarkable improve,x²=8.458, P=0.004(<0.05).2. As to construction of patterns of syndrome in PHC, the patterns of QI ZHI XUE YU and SHI RE YUN JIE were dominant totally; But the difference of region was found in construction of patterns of syndrome; To compare with B and C hospitals,the rate of QI ZHI XUE YU syndrome was higher remarkably in C hospital(the region of north);But the rates of SHI RE YUN JIE syndrome and SHI YU BO JIE syndrome were dominant,P=0.000(<0.017).3.The construction of type syndrome of Chinese medicine were not different obviously betweenâ…¡andâ…¢stage of PHC (p<0.05). The PI XU GAN YU syndrome and QI ZHI XUE YU syndrome were dominant inâ…¡stage of PHC, and the SHI RE YUN JIE syndrome and SHI YU BO JIE syndrome were dominant inâ…¢stage of PHC.4. The results of logistic regression:ALT,ascitic fluid and stained yellow were dominant factors in the patterns of QI ZHI XUE YU (p<0.05); Stained yellow was dominant factors in the patterns of SHI RE YUN JIE (p<0.05); Ascitic fluid and stained yellow were dominant factors in the patterns of SHI YU BO JIE (p<0.05). 5.The rate of depressions were not different(p>0.05) between control and PHC groups,but the score of PHC group was higher than control group (p<0.05).6. Experimental result of MTT and Wright-Giemsa:SSD showed a dose-effect relationship on the inhibitory action.And the inhibition ratio was 84%in 20mg/L. The average area of cell nucleus diminished at the SSD concentration of 2.5 mg/L and 5 mg/L as well as the ATRA (p<0.05,vs control).7.SSD could improve the secretion of ALB,up-regulate the activity of ALP and down regulate the activity of LDH in HCC significantly (p<0.05). SSD had no remarkable effect on ALT (p>0.05), but could improve the activity of AST(p<0.05). SSD could obviously down regulate the secretion of AFP (p<0.05), but had no significant effect at 10mg/L (p>0.05).8.Effects of SSD on the cell cycle:The results showed significant difference in each group (p<0.005).The main difference was in G0/G1 (p<0.005).But it didn't show obvious difference..9.Effects of SSD on the P38MAP kinase,NF-kB and P21^WAF1:The effects had remarkable difference in every test groups compared with the control(P<0.05). The effects reached the peak in SSD at 5mg/L and 10 mg/L,but there was no significant difference between them.Conclusions:In the clinicalâ…¡stage of HCC,the syndromes of PI XU GAN YU and QI ZHI XUE YU were dominant; In the clinicalâ…¢stage of HCC,the syndromes of SHI RE YUN JIE and GAN SHEN YIN XU were dominant. And the incidence rate of depression is remarkable improve in HCC. SSD had notable induce differentiation on SMMC-7721 cell, could obviously down regulate the secretion of AFP and the activity of LDH,as well as up-regulate the activity of ALP and improve the secretion of ALB. SSD could obviously hold-up the cell cycle in G₀/G₁ and depress the cell multiplication activity.So the cells had the tendency of differentiation and apoptosis.The possible mechanisms may be up-regulating P38MAPK and P21^WAF1 and down regulating NF-kB.