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参桃软肝胶囊抗肝癌作用及其机理初探
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摘要
目的
     本试验目的在于从体内试验、体外实验实验入手,研究参桃软肝胶囊治疗肝癌的机理。
     方法
     1.体外实验:制备低、中、高剂量含药血清,取处于对数增长期的肿瘤细胞,实验分为6组,即正常对照组,正常血清组,低剂量含药血清组,中剂量含药血清组,高剂量含药血清组和阳性对照组。采用MTT法检测含药血清对于HepG2人肝癌细胞增殖情况的影响;采用流式细胞术检测含药血清对HepG2人肝癌细胞的早期凋亡情况的影响;采用RT-PCR检测含药血清对HepG2人肝癌细胞内bax和bcl-2mRNA水平的影响;采用wb检测含药血清对细胞内bax、bcl-2和活化的caspase-3蛋白水平的影响。
     2.体内试验:建立H22荷瘤小鼠模型,将荷瘤小鼠随机分为五组,分别为阴性对照组、低剂量组、中剂量组、高剂量组和阳性对照组,每组8只。阴性对照组(生理盐水),低剂量组(参桃软肝胶囊混悬液0.35g/kg),中剂量组(参桃软肝胶囊混悬液0.7g/kg),高剂量组(参桃软肝胶囊混悬液1.4g/kg),阳性对照组(顺铂注射液2.0mg/kg),每天2次,共3周,停药后24小时取材。观察药物对荷瘤小鼠的抑瘤作用以及促进肿瘤组织内肿瘤细胞凋亡作用;检测荷瘤小鼠血浆及肿瘤组织内TNF-α、IL-1β、IL-6的含量、检测荷瘤小鼠脾脏淋巴细胞对H22细胞的杀伤活性、检测荷瘤小鼠外周血及脾脏淋巴细胞CD4+和CD8+细胞比例,以药物对荷瘤小鼠的免疫功能影响;针对肿瘤组织,采用免疫组化法检测CD34和VEGF水平、采用RT-PCR法检测bcl-2和bax mRNA水平、采用免疫组化检测活化的caspase-3水平、采用western blot方法检测bcl-2,bax和活化的caspase-3的蛋白水平,以探讨参桃软肝胶囊的抗肝癌机制。
     结果
     1.体外实验
     1.1参桃软肝胶囊含药血清作用于HepG,人肝癌细胞后,与用药前相比,形态发生改变,细胞数量减少。
     1.2含药血清对HepG2人肝癌细胞增殖的影响,正常大鼠的血清对人肝癌细胞HepG2的增殖没有明显的影响(P>0.05),低、中和高剂量含药血清和顺铂都能够明显抑制肝癌细胞的增殖(P<0.05)。其中,低、中和高剂量含药血清处理组随着血清中中药有效成分浓度的增加,抑制细胞增殖的能力逐渐加强,呈现一定的剂量依赖关系。
     1.3流式细胞术结果显示,普通培养的人肝癌细胞HepG2自然凋亡率比较低,约为5%-10%左右,正常的大鼠血清对HepG2细胞的凋亡没有明显的影响,低、中和高剂量含药血清和顺铂都能够明显诱导HepG2细胞的凋亡。
     1.4RT-PCR结果显示,正常大鼠的血清对人肝癌细胞HepG2胞内Bax和Bcl-2mRNA水平没有明显的影响(P>0.05),低中高剂量的含药血清和阳性化疗药物都能够明显诱导Bax基因的转录(P<0.01),抑制Bcl-2基因的转录(P<0.01),明显上调Bax/Bcl-2基因的比值。其中低中高剂量含药血清组Bax mRNA水平的上调,Bcl-2mRNA水平的下调,同药物浓度呈现一定的剂量依赖关系。
     1.5western blot结果显示,正常大鼠的血清对人肝癌细胞HepG2胞内Bax、Bcl-2和活化的caspase-3蛋白水平没有明显的影响(P>0.05),低、中、高剂量的含药血清和阳性化疗药物都能够明显诱导Bax蛋白的表达,抑制Bcl-2蛋白的表达,明显上调Bax/Bcl-2蛋白的比值,活化caspase-3。其中,低、中、高剂量组中,随着药物浓度的增加,这种作用不断增强。
     2.体内实验
     2.1模型组肿瘤最大,重量最重;阳性对照组肿瘤最小,肿瘤最轻;低剂量给药组、中剂量给药组和高剂量给药组介于它们之间,随着药物浓度的增加,抑瘤效果不断增强,同模型组相比,各组瘤重明显的降低,具有显著差异(P<0.01)。
     2.2模型组小鼠肿瘤组织本身就存在一定的自然凋亡率,在2%-5%左右,低、中、高剂量给药处理和腹腔注射阳性化疗药物,都能够明显的在体内诱导肿瘤细胞的凋亡,细胞的凋亡率明显增加,其中以阳性对照组最为明显(50%-70%),其次为中药高剂量组(40%-60%),接着是中药中剂量组(30%-50%),最次是中药低剂量组(20%-30%)。
     2.3荷瘤小鼠血浆中细胞因子的含量明显的低于正常对照组(P<0.01),给予中药处理,随着药物浓度的增加,能够明显的增加血浆内细胞因子的含量,同模型组比,具有明显的差异(P<0.01);阳性化疗药物处理的小鼠,血浆内这些细胞因子的含量并没有得到改善(P>0.05)。小鼠肿瘤组织内这些细胞因子的含量也有类似于血浆的趋势,中药组均能明显提高局部肿瘤组织内细胞因子的含量,从而改善机体的免疫状态,而阳性化疗药物则没有此作用。
     2.4同正常小鼠比,荷瘤小鼠外周血和脾脏T淋巴细胞中CD4+细胞比例明显降低,CD8+细胞比例明显升高,CD4+/CD8+的比值明显降低。中药低、中、高剂量组均能明显改善小鼠的细胞免疫功能(P<0.01),而阳性化疗药物则没有改善作用(P>0.05)。
     2.5同正常小鼠相比,荷瘤小鼠脾脏淋巴细胞对H22细胞的杀伤活性明显减弱,中药低、中、高剂量组能够明显增强荷瘤小鼠脾脏淋巴细胞的杀伤活性(P<0.01),而且杀伤活性均高于正常非荷瘤小鼠。阳性化疗药物对荷瘤小鼠脾脏淋巴细胞的杀伤活性没有改善作用(P>0.05)。
     2.6同模型组,阳性对照组、中药低、中、高剂量组MVD计数明显减少,具有明显的统计学意义(P<0.01);各组之间VEGF表达水平无明显差异。
     2.7中药低、中、高剂量组的中药和阳性化疗药物都能够明显诱导Bax基因的转录(P<0.01),抑制Bcl-2基因的转录(P<0.01),明显上调Bax/Bcl-2基因的比值。其中低中高剂量组Bax mRNA水平的上调,Bcl-2mRNA水平的下调,同药物浓度呈现一定的剂量依赖关系。
     2.8模型组中,活化的caspase-3日性细胞比例最低,阳性对照组最高,低中高剂量中药处理组介于2者之间,呈现一定的剂量依赖关系。
     2.9低中高剂量的中药和阳性化疗药物都能够明显诱导Bax蛋白的表达,抑制Bcl-2蛋白的表达,明显上调Bax/Bcl-2蛋白的比值,其中低中高剂量组中,随着药物浓度的增加,这种作用不断增强。小鼠肿瘤组织内活化的caspase-3蛋白水平表达趋势也与上面免疫组化的结果类似,与模型组相比,低中高剂量组和阳性组小鼠肿瘤组织内活化的caspase-3蛋白水平明显增加,其中低中高剂量组中,活化的casapse-3蛋白水平的增加同剂量呈现一定的依赖关系。
     结论
     1.参桃软肝胶囊含药血清可能抑制HepG2人肝癌细胞生长,并诱导其凋亡。
     2.参桃软肝胶囊可能抑制H22肝癌小鼠肿瘤细胞生长,并诱导凋亡的作用。
     3.参桃软肝胶囊可能具有改善机体的免疫功能状态的作用。
     4.参桃软肝胶囊可能具有抑制肿瘤血管生成的作用。
     5.参桃软肝胶囊可能通过调节Bax/Bcl-2比值,活化casapse-3蛋白来实现抗肿瘤的作用。
Objective
     This trial aims to study the therapeutic mechanism of Sen Tao Ruan Gan Capsules (STRGC) for hepatoma from three perspectives, including in vivo, in vitro and Immunohistochemistry.
     Methods
     1. In vitro study
     We prepared low, medium and high dosage of drug serums and tumor cells in increased logarithmic phase. Six groups were established in the trial, including normal control group, normal serum group, three drug serum groups (low, medium and high dosages) and positive control group. With MTT T assay, inhibition ratios of drug serums was determined in the cells of hepatoma HepG2, respectively;with Flow cytometry. effect of drug serum on early apoptosis in human hepatoma HepG2cells; with RT-PCR, effect of drug serum on levels of bax and bcl-2mRNA in human hepatoma HepG2cells; with wb, effect of drug serum on levels of bax, bcl-2and activated caspase-3proteins in cells.
     2. In vivo study
     The tumor-bearing mouse models were randomized into five groups,8in each, with the aim to explore anti-hepatoma mechanism of STRGC. The negative control group was assigned to saline; low, medium and high dosage groups to STRGC Suspension0.35g/kg,0.7g/kg and1.4g/kg, respectively; positive control group to Cisplatin Injection2.Omg/kg; twice daily, three weeks in total. The samples were harvested24hours after the withdrawal. We observed the drug effect on tumor inhibition and apoptosis in tumor cells in mice and determine the contents of TNF-a, IL-1β and IL-6in serums and tumor tissues of mice as well as the killing quality of splenic lymphocytes on H22cells, the proportion of CD4+and CD8+in peripheral blood and splenic lymphocytes and drug effect on mice's immunity. In tumor tissues, with immunohistochemistry, the levels of CD34and VEGF and activated caspase-3were determined; with RT-PCR, the levels of bcl-2and bax-RNA; wi th western blot, the levels of bcl-2, activated caspase-3proteins.
     Results
     1. In vitro study
     1.1After the administration of STRGC-containing serum, morphology change was noted in the human hepatoma HepG2cells as well as a decline in cell number.
     1.2The role of drug serum in hepatoma cell proliferation:the normal mouse serum plays'no role in the hepatoma cell proliferation (P>0.05). Low, medium and high dosage of drug serum and Cisplatin showed significant inhibitory action (P<0.05). The inhibitory action grew with the increased concentration of STRGC in serum in three drug serum groups (low, medium and high dosages) and had dose-dependent quality.
     1.3Flow cytometry revealed that:normally cultured human hepatcma hepG2cells have5%-10%natural apoptosis; normal mouse serum has no remarkable effect on apoptosis of hepG2cells; low, medium and high dosage of drug serum and Cisplatin had significant role in inducing apoptosis of hepG2cells.
     1.4RT-PCR showed that:normal mouse serum had no significant effect on the levels of Bax and Bcl-2mRNA in human hepatoma HepG2cells (P>0.05). Low, medium and high dosage drug serums and positive chemo drug played a significant role in inducing the transcription of Bax gene (P<0.01), inhibiting the transcription of Bcl-2gene (P<0.01) and elevating the value of Bax/Bcl-2. The increase in the Bax mRNA level and decrease in Bcl-2mRNA level in low, medium and high dosage drug serum groups were to some extent dependent upon the STRGC concentration.
     1.5western blot suggested that:normal mouse serum had no significant effect on the levels of Bax, Bcl-2and caspase-3proteins in human hepatoma HepG2cells (P>0.05). Low, medium and high dosage drug serums and positive chemo drug played a significant role in inducing the expression of Bax protein, inhibiting the expression of Bcl-2protein, elevating the ratio of Bax/Bcl-2and activating caspase-3. This action grew with the increased concentration of STRGC in low, medium and high dosage groups.
     2. In vivo study
     2.1The maximum tumor size and weight were noted in model group while the minimum in positive control group with the low, medium and high dosage group in between. The anti-tumor effect grew with the increased concentration of drug and compared to the model group, a significant reduction was noted in tumor weight in all other groups, which is significantly different (P<0.01).
     2.2The mouse tumor tissue in model group has2%-5%natural apoptosis. The low, medium and high dosage of STRGC and peritoneal injection of positive chemo drug played a significant role in inducing the apoptosis of tumor cells in vivo. The apoptosis ratio was significantly elevated and the highest of which was noted in positive control group (50%-70%), followed successively by high dosage group (40%-60%), medium dosage group (30%-50%), and the low dosage group (20%-30%).
     2.3The content of cytokine in serum of tumor-bearing mouse, which was obviously lower than that in the normal control group (P<0.01), was significantly elevated with the increased concentration of STRGC, which is significantly different (P<0.01), compared to the model group. No improvement was made in the cytokine content in serum of mouse managed with positive chemo drug (P>0.05). The cytokine content in the tumor tissue of mouse held the trend that was similar to blood serum. The STRGC was able to significantly elevate the content of cytokine in local tumor tissue, thus improving the immunity, but not the positive chemo drug.
     2.4Compared with the normal mouse, a reduction was noted in CD4+cells and an increase in CD8+cells in the peripheral blood and splenic T lymphocytes, resulting in a reduction in the value of CD4+/CD8+.The low, medium and high dosage of STRGC was capable of significantly improving the cellular immunity in mice (P<0.01), but not the positive chemo drug (P>0.05).
     2.5Compared with the normal mouse, the ability of splenic lymphocytes to kill the H22cells in tumor-bearing mouse is significantly weakened. The low, medium and high dosage of STRGC can significantly enhance the killing ability of splenic lymphocytes (P<0.01) which is stronger than that in normal mouse, but not the positive chemo drug (P>0.05).
     2.6Compared with the model group, a significant reduction in the MVD counts was noted in the positive control group, low, medium and high dosage group, which is statistically significant (P<0.01). There's no definite difference in VEGF expression level between groups.
     2.7STRGC in low, medium and high dosage groups and positive chemo drug played a significant role in inducing the transcription of Bax gene (P<0.01), inhibiting the transcription of Bcl-2gene (P<0.01) and elevating the value of Bax/Bcl-2. The increase in the Bax mRNA level and decrease in Bcl-2mRNA level in low, medium and high dosage drug serum groups were to some extent dependent upon the STRGC concentration.
     2.8The minimum proportion of activated caspase-3cell was noted in model group while the maximum in positive group, with low, medium and high dosage group in between, which was to some extent dependent upon the dosage.
     2.9Low, medium and high dosage of STRGC and positive chemo drug played a role in inducing the expression of Bax protein, inhibiting the expression of Bcl-2protein and elevating the value of Bax/Bcl-2. In low, medium and high dosage groups, these effects grew with the increased concentration of STRGC. The tread of expression of activated caspase-3protein in tumor tissues of mice was similar to that in the immunohistochemistry study and compared with the model group, a significant increase in the level of activated caspase-3protein was noted in the tumor tissues of mice in the low, medium and high dosage groups (depending on the dosage) and positive group.
     Conclusions
     1. STRGC-containing serum could play a role in inhibition and apoptosis of the human hepatoma HepG2cells.
     2. STRGC could play a role in tumor growth inhibition and apoptosis of tumor cells in H22hepatoma-bearing mouse.
     3. STRGC could contribute to improving the immunity.
     4. STRGC could play a role in inhibition of tumor angiogenesis.
     5. STRGC could play a role in activating caspase-3protein for suppress tumor by modulating the ratio of Bax/Bcl-2.
引文
[1]Jemal A., Bray F., Center M. M., et al. Global cancer statistics[J]. CA Cancer J Clin, 2011.61(2):69-90.
    [2]Jemal A., Murray T., Ward E., et al. Cancer statistics,2005[J].CA Cancer J Cl in, 2005.55(1):10-30.
    [3]El-Serag H. B., Rudolph K.L. Hepatocellular carcinoma:epidemiology and molecular carcinogenesis[J]. Gastroenterology,2007.132(7):2557-76.
    [4]李倩,杜佳,关鹏,等.中国2008年肝癌发病、死亡和患病情况的估计与预测[J].中华流行病学杂志,2012.33(6).
    [5]陈建国,朱健,张永辉,等.江苏省启东地区1973至2002年肝癌发病率长期趋势的评价[J].中华医学杂志,2005(43):34-38.
    [6]屈中玉.我院原发性肝癌流行病学病因分析[J].中国医药导报,2010(02):122-123.
    [7]涂燕云,陈枝俏,许剑.广西原发性肝癌流行和临床特点分析[J].广西中医学院学报,2006(03):20-21.
    [8]Sterling R. K., Jeffers L., Gordon F., et al. Clinical util ity of AFP-L3% measurement in North American patients with HCV-related cirrhosis[J]. Am J Gastroenterol,2007. 102(10):2196-205.
    [9]Leerapun A., Suravarapu S. V., Bida J.P., et al. The utility of Lens culinaris agglutinin-reactive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: evaluation in a United States referral population[J]. Clin Gastroenterol Hepatol,2007. 5(3):394-402; quiz 267.
    [10]孙桂珍,赵秀英,李俊红,等.凝集素微量离心柱法检测甲胎蛋白异质体用于肝癌的诊断及分析[J].中华医学杂志,2008.88(28):1986-1988.
    [11]Capurro M. I., Xiang Y. Y., Lobe C., et al. Glypican-3 promotes the growth of hepatocellular carcinoma by stimulating canonical Wnt signaling[J]. Cancer Res,2005. 65(14):6245-54.
    [12]Kandil D., Leiman G., Allegretta M., et al. Glypican-3 immunocytochemistry in liver fine-needle aspirates:a novel stain to assist in the differentiation of benign and malignant liver lesions[J]. Cancer,2007.111(5):316-22.
    [13]Liu H., Li P., Zhai Y., et al. Diagnostic value of glypican-3 in serum and liver for primary hepatocellular carcinoma[J]. World J Gastroenterol,2010.16(35):4410-5.
    [14]Kladney R. D., Bulla G. A., Guo L., et al. GP73, a novel Golgi-localized protein upregulated by viral infection[J]. Gene,2000.249(1-2):53-65.
    [15]费迎明,许文芳,周健康,等.高尔基体蛋白73(GP73)在原发性肝癌中的早期诊断价值研究[J].医学研究杂志,2011.40(12):57-60.
    [16]Poon R. T., Lau C., Pang R., et al. High serum vascular endothelial growth factor levels predict poor prognosis after radiofrequency ablation of hepatocellular carcinoma: importance of tumor biomarker in ablative therapies[J]. Ann Surg Oncol,2007.14(6): 1835-45.
    [17]Tian L., Wang Y., Xu D., et al. Serological AFP/Golgi protein 73 could be a new diagnostic parameter of hepatic diseases[J]. Int J Cancer,2011.129(8):1923-31.
    [18]Iftikhar R., Kladney R. D., Havlioglu N., et al. Disease-and cell-specific expression of GP73 in human liver disease[J]. Am J Gastroenterol,2004.99(6):1087-95.
    [19]Willyard C. Researchers look for'sweet'method to diagnose cancer [J]. Nat Med,2007. 13(11):1267.
    [20]董志珍,姚登福,邹黎,等.转化生长因子β1诊断肝癌和肝癌监测转移的临床价值[J].中华肝脏病杂志,2007.15(7):503-508.
    [21]Dong Z. Z., Yao D. F., Yao M., et al. Clinical impact of plasma TGF-betal and circulating TGF-betal mRNA in diagnosis of hepatocellular carcinoma[J]. Hepatobiliary Pancreat Dis Int,2008.7(3):288-95.
    [22]El-Bassiouny A. E., Zoheiry M. M., Nosseir M. M., et al. Expression of cyclooxygenase-2 and transforming growth factor-betal in HCV-induced chronic liver disease and hepatocellular carcinoma[J]. MedGenMed,2007.9(3):45.
    [23]Kishimoto T..Interleukin-6:discovery of a pleiotropic cytokine[J]. Arthritis Res Ther,2006.8 Suppl 2:S2.
    [24]Gao S. P., Mark K. G., Leslie K., et al. Mutations in the EGFR kinase domain mediate STAT3 activation via IL-6 production in human lung adenocarcinomas[J]. JClin Invest,2007. 117(12):3846-56.
    [25]Liu Y., Li P. K., Li C., et al. Inhibition of STAT3 signaling blocks the anti-apoptotic activity of IL-6 in human liver cancer cells[J].J Biol Chem,2010.285(35):27429-39.
    [26]Porta C., De Amici M., Quaglini S., et al. Circulating interleukin-6 as a tumor marker for hepatocellular carcinoma[J]. Ann Oncol,2008.19(2):353-8.
    [27]Hisa CY, Huo TI, Chiang SY, et al. Evaluation of interleukin-6, interleukin-10 and human hepatocyte growthfactor as tumor markers for hepatocellular carcinoma [J]. Euro J Surg Oncol,2007.32(2):208-212.
    [28]Yamamoto K., Imamura H., Matsuyama Y., et al. AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC[J].J Gastroenterol,2010.45(12):1272-82.
    [29]Suzuki M., Shiraha H., Fujikawa T., et al. Des-gamma-carboxy prothrombin is a potential autologous growth factor for hepatocellular carcinoma [J].J Biol Chem,2005. 280(8):6409-15.
    [30]Inagaki Y., Tang W., Makuuchi M., et al. Clinical and molecular insights into the hepatocellular carcinoma tumour marker des-gamma-carboxyprothrombin[J]. Liver Int,2011. 31(1):22-35.
    [31]Nakamura S., Nouso K., Sakaguchi K., et al. Sensitivity and specificity of des-gamma-carboxy prothrombin for diagnosis of patients with hepatocellular carcinomas varies according to tumor size[J]. Am J Gastroenterol,2006.101(9):2038-43.
    [32]Murakami N., Tamano M., Yoneda M., et al. Des-gamma-carboxy prothrombin (DCP) ratio is a useful prognostic tumor marker for single nodule hepatocellular carcinoma (HCC)[J].Hepatogastroenterology,2008.55(81):197-201.
    [33]Kim H. S., Park J. W., Jang J. S., et al. Prognostic values of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-Ⅱ in hepatitis B virus-related hepatocellular carcinoma:a prospective study[J].J Clin Gastroenterol,2009.43(5): 482-8.
    [34]Wei X., Wang S., Rui J. [The value of serum alpha-L-fucosidase activity in the diagnosis of primary liver cancer][J]. Zhonghua Zhong Liu Za Zhi,2000.22(2):148-50.
    [35]Bertino G., Ardiri A.M., Calvagno G. S., et al. Prognostic and diagnostic value of des-gamma-carboxy prothrombin in liver cancer[J]. Drug News Perspect,2010.23(8): 498-508.
    [36]段聪明.α-L-岩藻糖苷酶在原发性肝癌中的诊断价值[J].实用医技杂志,2006.13(24):4332-4334.
    [37]李春海.肿瘤标志学基础与临床[M].北京:军事医学科学出版社,2008.
    [38]el-Houseini M.E., Mohammed M.S., Elshemey W. M., et al. Enhanced detection of hepatocellular carcinoma[J]. Cancer Control,2005.12(4):248-53.
    [39]梁恒秋,余红平,谭盛葵.原发性肝癌危险因素病例对照的非条件Logistic回归分析[J].广西医科大学学报,2007(06):854-856.
    [40]陆再英,终南山.内科学[M].北京:人民卫生出版社.
    [41]陈建国,宋新明.中国肝癌发病水平的估算及分析[J].中国肿瘤,2005(01):29-32.
    [42]Pikarsky E., Porat R. M., Stein I., et al. NF-kappaB functions as a tumour promoter in inflammation-associated cancer[J]. Nature,2004.431(7007):461-6.
    [43]王鲁华,林琛,方琳丽,等.原发性肝癌患者乙肝病毒感染模式及其与甲胎蛋白和肝功能的关系[J].中国校医,2005(05):19-22.
    [44]张广业.中医药免疫调节治疗慢性乙型病毒性肝炎研究进展[J].安徽中医临床杂志,2002(06):518-521.
    [45]张志军,孙长宇.乙型肝炎病毒感染和原发性肝癌的关系探讨[J].肿瘤基础与临床,2006(05):424-425.
    [46]Raza S. A., Clifford G.M., Franceschi S. Worldwide variation in the relative importance of hepatitis B and hepatitis C viruses in hepatocellular carcinoma:a systematic review[J]. Br J Cancer,2007.96(7):1127-34.
    [47]罗瑞虹,赵志新,周旭毓,等.中国人群HBV感染与原发性肝癌关系病例对照研究的Meta分析[J].热带医学杂志,2005(04):13-17+43.
    [48]叶小华,郜艳晖,张敏,等.HBV感染与肝癌关系的Meta分析[J].数理医药学杂志,2007(06):810-813.
    [49]Qu L. S., Liu T. T., Jin F., et al. Combined pre-S deletion and core promoter mutations related to hepatocellular carcinoma:A nested case-control study in China [J]. Hepatol Res, 2011.41(1):54-63.
    [50]Liu S., Zhang H., Gu C., et al. Associations between hepatitis B virus mutations and the risk of hepatocellular carcinoma:a meta-analysis[J].J Natl Cancer Inst,2009. 101(15):1066-82.
    [51]Fang Z. L., Sabin C. A., Dong B. Q., et al.HBV A1762T, G1764A mutations are a valuable biomarker for identifying a subset of male HBsAg carriers at extremely high risk of hepatocellular carcinoma:a prospective study[J]. Am J Gastroenterol,2008.103(9): 2254-62.
    [52]Asim M., Malik A., Sarma M. P., et al. Hepatitis B virus BCP, Precore/core, X gene mutations/genotypes and the risk of hepatocellular carcinoma in India[J]. J Med Virol, 2010.82(7):1115-25.
    [53]Feitelson M.A. Hepatitis B x antigen and p53 in the development of hepatocellular carcinoma[J].J Hepatobiliary Pancreat Surg,1998.5(4):367-74.
    [54]Jia L., Wang X. W., Harris C. C. Hepatitis B virus X protein inhibits nucleotide excision repair[J]. Int J Cancer,1999.80(6):875-9.
    [55]Kang-Park S., Lee J. H., Shin J. H., et al. Activation of the IGF-II gene by HBV-X protein requires PKC and p44/p42 map kinase signal ings[J]. Biochem Biophys Res Commun, 2001.283(2):303-7.
    [56]Arbuthnot P., Kew M. Hepatitis B virus and hepatocellular carcinoma[J]. Int J Exp Pathol,2001.82(2):77-100.
    [57]Webber E. M., Wu J. C., Wang L., et al. Overexpression of transforming growth factor-alpha causes liver enlargement and increased hepatocyte proliferation in transgenic mice[J].Am J Pathol,1994.145(2):398-408.
    [58]丙型肝炎防治指南[J].中华肝脏病杂志,2004(04):7-11.
    [59]葛祖恂,黄介飞,陆守曾.国内丙型肝炎病毒感染与肝细胞癌关系的19个病例对照研究的Meta分析[J].中国卫生统计,1997(01):12-14.
    [60]Baek K. H., Park H. Y., Kang C.M., et al. Overexpression of hepatitis C virus NS5A protein induces chromosome instability viamitotic cell cycle dysregulation[J]. J Mol Biol, 2006.359(1):22-34.
    [61]张志培,程庆书,黄立军,等HCVC蛋白、p53、Mdm2、p14和p21在原发性肝癌中的表达及相关性[J].现代肿瘤医学,2006(10):1252-1255.
    [62]Munakata T., Nakamura M., Liang Y., et al. Down-regulation of the retinoblastoma tumor suppressor by the hepatitis C virus NS5B RNA-dependent RNA polymerase[J]. Proc Natl Acad Sci U S A,2005.102(50):18159-64.
    [63]彭仙娥,林建银,林万松,等.中国人群HBV和HCV双重感染与肝细胞癌关系的Meta分析[J].中华肿瘤防治杂志,2008(02):89-92+104.
    [64]裴广军,付莉,崔亚玲,等.中国人群饮酒与原发性肝癌关系的Meta分析[J].现代预防医学,2008(14):2626-2627.
    [65]Chuang S. C., La Vecchia C., Boffetta P. Liver cancer:descriptive epidemiology and risk factors other than HBV and HCV infection[J]. Cancer Lett,2009.286(1):9-14.
    [66]王敏,李少华,郝冰.疏肝健脾汤治疗原发性肝癌58例[J].中医研究,2012(01):39-40.
    [67]李岩,高歌,王江滨,等.饮酒与原发性肝癌关系的调查——附吉林省1057例原发性肝癌病因学分析[J].临床肝胆病杂志,2003(03):140-142.
    [68]Kuper H., Ye W., Broome U., et al. The risk of liver and bile duct cancer in patients with chronic viral hepatitis, alcoholism, or cirrhosis [J]. Hepatology,2001.34 (4 Pt 1): 714-8.
    [69]Lee S. H., Arora J.A., Oe T., et al.4-Hydroperoxy-2-nonenal-induced formation of 1,N2-etheno-2'-deoxyguanosine adducts[J]. Chem Res Toxicol,2005.18(4):780-6.
    [70]吴燕,陆培新,王金兵,等.AFM1暴露量与原发性肝癌关系研究[J].中国实用内科杂志,2010(S1):10-12.
    [71]Ming L., Thorgeirsson S.S., Gail M. H., et al. Dominant role of hepatitis B virus and cofactor role of aflatoxin in hepatocarcinogenesis in Qidong, China[J]. Hepatology, 2002.36(5):1214-20.
    [72]李瑗,苏建家,曹骥,等.用cDNA阵列技术研究黄曲霉毒素B1诱发树鼩肝癌形成过程中的基因变化[J].中华肝脏病杂志,2003(02):33-36.
    [73]俞顺章,穆丽娜,蔡琳,等.饮水等三大环境危险因素与肝癌——泰兴市肝癌病例对照研究[J].复旦学报(医学版),2008(01):31-38.
    [74]苏德隆.饮水中蓝绿藻毒素与肝癌研究[J].医学研究通讯,2001(06):19-20.
    [75]Park H., Namikoshi M., Brittain S. M., et al. [D-Leu(1)] microcystin-LR, a new microcystin isoplated from waterbloom in a Canadian prairie lake[J]. Toxicon,2001.39(6): 855-62.
    [76]胡志坚,陈华,庞春艳,等.微囊藻毒素对肝细胞凋亡相关基因表达的影响[J].中华预防医学杂志,2007(01):13-16.
    [77]周珏平,沈建国,童建.微囊藻毒素LR对小鼠肝脏和淋巴细胞的损伤效应[J].环境与职业医学,2003(01):41-42.
    [78]Zegura B., Sedmak B., Filipic M. Microcystin-LR induces oxidative DNA damage in human hepatoma cell line HepG2[J]. Toxicon,2003.41(1):41-8.
    [79]金福顺,藤菁.华支睾吸虫病致原发性肝癌1例[J].北华大学学报(自然科学版),2002(01):58.
    [80]Fox J. G., Dewhirst F. E., Tully J. G., et al. Helicobacter hepaticus sp. nov., a microaerophilic bacterium isolated from livers and intestinal mucosal scrapings from mrice[J].J Clin Microbiol,1994.32(5):1238-45.
    [81]宣世英,李宁,战淑慧,等.原发性肝癌组织中螺杆菌属16SrRNA基因的检测及意义[J].中华传染病杂志,2006(06):396-400.
    [82]孙强,陈国林.原发性肝癌组织中幽门螺旋杆菌感染的研究[J].北京师范大学学报(自然科学版),2008(03):319-322.
    [83]Nilsson H.0., Mulchandani R., Tranberg K. G., et al. Helicobacter species identified in liver from patients with cholangiocarcinoma and hepatocellular carcinoma[J]. Gastroenterology,2001.120(1):323-4.
    [84]李宁,战淑慧,宣世英,等.原发性肝癌组织中螺杆菌感染的研究[J].中华流行病学杂志,2006(10):894-896.
    [85]田雪飞,范学工,黄燕,等.感染幽门螺杆菌小鼠肝组织Cyclin D1和PCNA的表达[J].世界华人消化杂志,2006(14):1341-1345.
    [86]方驰华,杨继震,康惠广.胆囊结石胆汁、粘膜、结石幽门螺杆菌与结石核心形成的关系[J].世界华人消化杂志,1999(03):52-54.
    [87]陈仁,范学工,黄燕,等.幽门螺杆菌对肝癌细胞HepG2的体外细胞毒作用[J].癌症,2004(01):44-49.
    [88]Fujikawa A., Shirasaka D., Yamamoto S., et al. Mice deficient in protein tyrosine phosphatase receptor type Z are resistant to gastric ulcer induction by VacA of Helicobacter pylori [J].Nat Genet,2003.33(3):375-81.
    [89]张艳,范学工,田雪飞,等.幽门螺杆菌对肝细胞系HepG2 cyclinDl, PCNA mRNA表达的影响[J].世界华人消化杂志,2004(01):99-102.
    [90]汪永录,周汉高,顾公望.肝癌研究进展[M].上海:上海科技文献出版社,1999:7-44.
    [91]孟炜,陆鸿雁,蔡如琳,等.原发性肝癌的遗传流行病学研究[J].中华流行病学杂志,2002(06):29-31.
    [92]米登海,罗好曾,陈学鹏,等.肝癌遗传模式与危险因素病例-对照研究[J].中国公共卫生,2006(07):849-850.
    [93]丁建华,吴建中,高长明,等.乙醛脱氢酶2基因多态性和饮酒习惯与肝癌的易感性[J].肿瘤,2004(04):309-312.
    [94]朱文吕,陈清,罗晨玲,等.CYP1A1与GSTM1的多态性与原发性肝癌遗传易感性的关系研究[J].肿瘤防治杂志,2001(06):572-574.
    [95]蒋文,邵建国,陆建荣.细胞色素P450 2C19基因多态性与原发性肝细胞癌的相关性研究[J].胃肠病学,2008(01):39-41.
    [96]Long XD, Ma Y, Wei YP, et al. X-ray repair cross-complemen-ting group 1 (XRCC1) Arg 399 Gln polymorphism and aflatoxinBl (AFB1)-related hepatocellular carcinoma (HCC) in uang-xi populatin[J]. Chinese J Cancer Res,2005.17(1):17221.
    [97]张吴,郝冰涛,贺福初.DNA损伤修复基因hOGGl的遗传多态与乙肝相关性HCC的风险[J].世界华人消化杂志,2006(23):2311-2314.
    [98]许丽,吴一迁,金晏,等.DNA修复基因XPD多态性和肝细胞肝癌危险性的病例-对照研究[J].肿瘤,2004(6):526-529.
    [99]高姗,杨万水,高静,等.肥胖与原发性肝癌队列研究的Meta分析[J].中国肿瘤,2010(05):300-305.
    [100]Hill-Baskin A. E., Markiewski M. M., Buchner D. A., et al. Diet-induced hepatocellular carcinoma in genetically predisposed mice[J]. Hum Mol Genet,2009.18(16):2975-88.
    [101]高珊,杨万水,高静,等.糖尿病与原发性肝癌队列研究的Mata分析[J].中华预防医学杂志,2010.44(8):711-716.
    [102]Furstenberger G., Senn H. J. Insulin-like growth factors and cancer[J]. Lancet Oncol, 2002.3 (5):298-302.
    [103]Yamasaki K., Hayashi Y., Okamoto S., et al. Insulin-independent promotion of chemically induced hepatocellular tumor development in genetically diabetic mice[J]. Cancer Sci,2010.101(1):65-72.
    [104]Asano T., Watanabe K., Kubota N., et al. Adiponectin knockout mice on high fat diet develop fibrosing steatohepatitis[J].J Gastroenterol Hepatol,2009.24(10):1669-76.
    [105]Furukawa S., Fujita T., Shimabukuro M., et al. Increased oxidative stress in obesity and its impact on metabolic syndrome[J].J Clin Invest,2004.114(12):1752-61.
    [106]Caldwell S. H., Crespo D. M., Kang H.S., et al. Obesity and hepatocellular carcinoma[J]. Gastroenterology,2004.127(5 Suppl 1):S97-103.
    [107]Chang C. K., Ulrich C. M. Hyperinsulinaemia and hyperglycaemia:possible risk factors of colorectal cancer among diabetic patients[J]. Diabetologia,2003.46(5):595-607.
    [108]Singh G., Driever P. H., Sander J. W. Cancer risk in people with epilepsy:the role of antiepileptic drugs [J]. Brain,2005.128(Pt 1):7-17.
    [109]黄明文,王刚,王恺,等.65例原发性肝癌的外科治疗分析[J].实用临床医学,2006(09):76-78.
    [110]杨秉辉,夏景林.中国抗癌协会肝癌专业委员会关于修订“原发性肝癌的临床诊断与分期标准”的说明[J].实用癌症杂志,2001(6):672.
    [111]李克善.原发性肝癌的手术治疗[J].临床和实验医学杂志,2008(01):72-73.
    [112]汤钊猷.临床肝癌学[M].上海:科学教育出版社,2008:81.
    [113]樊嘉,黄成.肝癌外科治疗进展[J].四川医学,2005(03):273-275.
    [114]芮静安.肝癌肝外科的现状和展望[J].现代实用医学,2004(06):315-317.
    [115]Creutzberg E. C., Wouters E. F., Vanderhoven-Augustin I.M., et al. Disturbances in leptin metabolism are related to energy imbalance during acute exacerbations of chronic obstructive pulmonary disease[J]. Am J Respir Crit Care Med,2000.162(4 Pt 1):1239-45.
    [116]吴孟超,张智坚.肝切除手术的并发症及防治[J].中华外科杂志,2002(05):15-18.
    [117]樊嘉,周俭,徐泱,等.肝癌肝移植适应证的选择:上海复旦标准[J].中华医学杂志,2006.86:1227.
    [118]张坤,江艺,高朋芬,等.几种不同治疗手段对原发性肝癌的疗效比较研究[J].胃肠病学和肝病学杂志,2005(6):575-576.
    [119]Llovet J.M., Bruix J., Gores G. J. Surgical resection versus transplantation for early hepatocellular carcinoma:clues for the best strategy [J]. Hepatology,2000.31 (4): 1019-21.
    [120]Vogl T. J., Naguib N. N., Nour-Eldin N. E., et al. Review on transarterial chemoembolization in hepatocellular carcinoma:palliative, combined, neoadjuvant, bridging, and symptomatic indications[J]. Eur J Radiol,2009.72(3):505-16.
    [121]Takayasu K., Arii S., Ikai I., et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients[J]. Gastroenterology,2006.131(2):461-9.
    [122]Lu W., Li Y. H., Yu Z. J., et al. A comparative study of damage to liver function after TACE with use of low-dose versus conventional-dose of anticancer drugs in hepatocellular carcinoma[J]. Hepatogast-roenterology,2007.54(77):1499-502.
    [123]刘嵘,王建华,周康荣,等.肝动脉化疗栓塞治疗原发性肝癌中碘油沉积良好患者疗效观察[J].介入放射学杂志,2001(04):212-214.
    [124]Peng Z. W., Zhang Y. J., Chen M. S., et al. Risk factors of survival after percutaneous radiofrequency ablation of hepatocellular carcinoma[J]. Surg Oncol,2008.17(1):23-31.
    [125]Ebara M., Okabe S., Kita K., et al. Percutaneous ethanol injection for small hepatocellular carcinoma:therapeutic efficacy based on 20-year observation[J]. J Hepatol, 2005.43(3):458-64.
    [126]Daniele B., De Sio I.,Izzo F., et al. Hepatic resection and percutaneous ethanol injection as treatments of small hepatocellular carcinoma:a Cancer of the Liver Italian Program (CLIP 08) retrospective case-control study [J]. J Cl in Gastroenterol,2003.36(1): 63-7.
    [127]郭佳,张丽生.超声引导下经皮肝穿刺瘤内无水酒精注射治疗小肝癌[J].中国介入影像与治疗学,2009(3):254-256.
    [128]Lu D.S., Yu N. C., Raman S.S., et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma as a bridge to liver transplantation [J]. Hepatology,2005.41 (5): 1130-7.
    [129]董宝玮,梁萍,于晓玲,等.超声引导经皮微波治疗原发性肝癌远期疗效评价[J].中华肿瘤杂志,2002(3):78-80.
    [130]Kennedy J. E. High-intensity focused ultrasound in the treatment of solid tumours[J].Nat Rev Cancer,2005.5(4):321-7.
    [131]杨秉辉,丛文铭,周晓军,等.原发性肝癌规范化诊治专家共识[J].临床肿瘤学杂志,2009(3):259-269.
    [132]苏学峰,戴建平.肝动脉化疗栓塞加三维适形放疗治疗肝癌38例临床观察[J].中国药物与临床,2008(4).
    [133]Peng B.G., Liang L.J., He Q., et al. Tumor vaccine against recurrence of hepatocellular carcinoma[J]. World j Gastroenterol,2005.11(5):700-4.
    [134]Tungpradabkul S., Sandee D., Puthong S., et al. Construction of scFv derived from a tumor-associated monoclonal antibody having tumoricidal activity on human hepatocellular carcinoma[J].Mol Immunol,2005.42(6):713-9.
    [135]Bertelli R., Neri F., Tsivian M., et al. Endolymphatic immunotherapy in inoperable hepatocellular carcinoma[J]. Transplant Proc,2008.40(6):1913-5.
    [136]Nomoto S., Kanda M., Okamura Y., et al. Epidermal growth factor-containing fibulin-like extracellular matrix protein 1, EFEMP1, a novel tumor-suppressor gene detected in hepatocellular carcinoma using double combination array analysis[J]. Ann Surg Oncol,2010.17(3):923-32.
    [137]Mizuguchi T., Nagayama M., Meguro M., et al. Prognostic impact of surgical complications and preoperative serum hepatocyte growth factor in hepatocellular carcinoma patients after initial hepatectomy[J]. J Gastrointest Surg,2009.13(2): 325-33.
    [138]Chen J., Huang K., Wu J., et al. Survival after anatomic resection versus nonanatomic resection for hepatocellular carcinoma:a meta-analysis[J]. Dig Dis Sci,2011.56(6): 1626-33.
    [139]Abou-Alfa G. K., Schwartz L., Ricci S., et al. Phase Ⅱ study of sorafenib in patients with advanced hepatocellular carcinoma[J]. J Clin Oncol,2006.24(26):4293-300.
    [140]Zhu A. X., Blaszkowsky L. S., Ryan D. P., et al. Phase Ⅱ study of gemcitabine and oxaliplatin in combination with bevacizumab in patients with advanced hepatocellular carcinoma[J]. J Clin Oncol,2006.24(12):1898-903.
    [141]Breuhahn K., Longerich T., Schirmacher P. Dysregulation of growth factor signaling in human hepatocellular carcinoma[J]. Oncogene,2006.25(27):3787-800.
    [142]Ramanathan R. K., Belani C. P., Singh D.A., et al. A phase Ⅱ study of lapatinib in patients with advanced biliary tree and hepatocellular cancer[J]. Cancer Chemother Pharmacol,2009.64 (4):777-83.
    [143]Jiang X., Li H., Qiao H., et al. Combining kallistatin gene therapy and meloxicam to treat hepatocellular carcinoma in mice[J]. Cancer Sci,2009.100(11):2226-33.
    [144]Cormier J. N., Thomas K. T., Chari R. S., et al. Management of hepatocellular carcinoma[J].J Gastrointest Surg,2006.10(5):761-80.
    [145]Kerkar S., Carlin A. M., Sohn R. L., et al. Long-term follow up and prognostic factors for cryotherapy of malignant liver tumors[J]. Surgery,2004.136(4):770-9.
    [146]Boix L., Bruix J., Castells A., et al. Sex hormone receptors in hepatocellular carcinoma. Is there a rationale for hormonal treatment?[J].J Hepatol,1993.17(2): 187-91.
    [147]孔怡琳,张海波,张玉佩,等.从痰瘀角度探析肝癌的发病与防治思路[J].中国药物经济学,2012(02):354-356.
    [148]张景洲.基于毒邪和络病理论治疗原发性肝癌[J].中国中医药咨询,2012.4(1):424-426.
    [149]周滢,周萍.邓中甲教授治疗肝癌经验分析[J].中国实验方剂学杂志,2012(2):260-261.
    [150]袁海英.陈培丰教授治疗肝癌经验[J].浙江中西医结合杂志,2009(12):744-745.
    [151]李永健,方肇勤,邸若虹,等.2492例肝癌辨证分型临床报道的统计分析[J].中国中医基础医学杂志,2001(06):69-71.
    [152]白广德.中医及中西医结合治疗原发性中晚期肝癌的研究进展[J].辽宁中医药大学学报,2008(03):148-151.
    [153]李有骏.中医药治疗肝癌相关文献的证治用药之规律研究[D].南京中医药大学,2010.
    [154]张峰.中药为主治疗80例肝癌临床分析[J].光明中医,2006(12):83-84.
    [155]姚翔,中医药治疗晚期原发性肝癌疗效的Meta分析及原发性肝癌伴门静脉癌栓的中医证候学分析[D].浙江中医药大学,2010.
    [156]文洁,朱德增.终末期肝病模型与原发性肝癌患者中医证候的相关性研究[J].中华中医药学刊,2011(04):873-877.
    [157]张中建.西黄丸治疗晚期原发性肝癌28例临床观察[J].河北中医,2012(04):581-582.
    [158]蒋梅,周岱翰.槐耳冲剂治疗中晚期原发性肝癌98例[J].上海中医药杂志,2004(06):21-22.
    [159]彭海燕,章永红,王瑞平,等.补肝软坚方治疗肝癌100例临床观察[J].北京中医,2004(01):30-31.
    [160]蒋建龙,沈十明,徐海东,等.理肝实脾汤对晚期原发性肝癌患者生活质量的影响[J].现代中西医结合杂志,2011(30):3796-3797+3800.
    [161]江伟,冯继锋,潘良熹,等.三氧化二砷注射液治疗晚期原发性肝癌的临床观察[J].肿瘤基础与临床,2006(01):21-23.
    [162]周际昌.实用肿瘤内科学[M].第2版.北京:人民卫生出版社,2003:406.
    [163]栾祖鹏,李晓东,马敏.去甲斑蟊素注射液联合氟脲嘧啶治疗晚期肝癌的临床研究[J].河北医药,2005(07):542-543.
    [164]吕德政,赵崇瑜.康莱特注射液佐治肝癌介入术后的疗效观察——附38例报告[J].新医学,2004(07):415-416.
    [165]李涛,崔建东,龙桂宁,等.鸦胆子油乳联合肝动脉插管治疗肝癌124例临床观察[J].中国现代医学杂志,2012(13):91-94.
    [166]韩鸿彬,陈嘉勇.华蟾素抗肿瘤作用及其机制的研究进展[J].中国肿瘤生物治疗杂志,2005(02):160-162.
    [167]刘云霍,匡唐洪,蒋沈君.华蟾素注射液改善晚期癌症患者生活质量的临床观察[J].中国中医药利技,2005.12(1):45-46.
    [168]李琦,孙保木,彭永海,等.华蟾素联合肝动脉介入化疗栓塞治疗肝癌的临床研究[J].上海中医药大学学报,2008(02):32-34.
    [169]祁波,王维云,陈十宗,等.肝癌白芨粉栓塞化疗与常规栓塞化疗的比较研究[J].肿瘤防治杂志,2004(04):405-406.
    [170]梁宇闯,高珩,林坚,等.经肝动脉插管灌注榄香烯乳治疗中晚期肝癌的观察[J].右江民族医学院学报,2004(02):200-201.
    [171]陈武进,廖斌,陈禹略,等.斑蝥酸钠联合介入治疗原发性肝癌临床观察[J].新疆中医药,2004(03):13-15.
    [172]卢秋红,邓力.消癌平肝动脉灌注配合肝动脉栓塞化疗治疗肝癌的临床观察[J].现代中西医结合杂志,2004(20):2690-2691.
    [173]易晓文.中药外敷对原发性肝癌患者止痛作用的临床研究[J].中医临床研究,2012(01):30-31.
    [174]朱应来,柳庆明.中药外用治疗晚期肝癌31例[J].实用中医药杂志,2001(02):36.
    [175]杜小艳.镇痛酊剂外搽治疗癌性疼痛41例[J].湖南中医杂志,2001(04):38-39.
    [176]胡侠,凌吕全,周庆辉.腕踝针治疗中晚期肝癌疼痛的临床观察[J].中国针灸,2004(03):3-5.
    [177]邵飞宇,李云芳,张爱琴.中医药治疗原发性肝癌的临床研究进展[J].中国肿瘤,2011(10):764-767.
    [178]张玉军,胡同春,王玉强,等.中药组方联合化疗治疗中晚期原发性肝癌的临床研究[J].中国药物与临床,2012(04):474-475.
    [179]黄景玉.慈丹胶囊联合介入疗法治疗晚期原发性肝癌的近期临床观察[J].世界中医药,2008(05):271.
    [180]李大鹏,陶岚,王书浩,等.六君子汤治疗原发性肝癌介入术后栓塞综合征59例[J].新中医,2004(10):61-62.
    [181]黎才海.疏肝健脾化瘀法治疗原发性肝癌的临床研究[J].实用中西医结合临床,2011(04):48-49.
    [182]马春曦,彭国林,邓兰,等.艾迪注射液联合高强度聚焦超声治疗原发性肝癌[J].现代中西医结合杂志,2012(3).
    [183]赵红佳,杜建,陈曦,等.扶正抑瘤方协同微波消融治疗肝癌的临床研究[J].中国中西医结合杂志,2012(1).
    [184]郑翔,陈好远.中医药治疗对肝癌患者生存质量影响的研究进展[J].湖北中医杂志,2011(06):76-79.
    [185]谢益,戴建国.原发性肝癌的中医药治疗机制研究[J].长春中医药大学学报,2011(05):738-740.
    [186]丰俊东,徐晓玉.川芎嗪含药血清对人肝癌细胞HepG_2增殖的抑制作用[J].中草药,2005(04):551-553.
    [187]杨先照,江锋,叶永安.中医药防治肝癌前病变机制的探讨[J].中国中医基础医学杂志,2011(08):884-885.
    [188]Deng X., Yin F., Lu X., et al. The apoptotic effect of brucine from the seed of Strychnos nux-vomica on human hepatoma cells is mediated via Bcl-2 and Ca2+involved mitochondrial pathway[J]. Toxicol Sci,2006.91(1):59-69.
    [189]黄应中,肖军军,孟书聪,等.脂蟾毒配基通过线粒体途径诱导人肝癌Bel-7402细胞凋亡的研究[J].中国肿瘤临床,2006(20):1141-1145.
    [190]王丽华,朱传武,陈明.端粒和端粒酶在乙型肝炎、肝硬化和肝癌中的研究现状[J].实用肝脏病杂志,2010(02):148-151.
    [191]宋健宁,汤利华,康楷,等.槲皮素下调hTERT表达对肝癌HepG2细胞生长影响研究[J].生物技术通报,2007.18(4):128-131.
    [192]何芳,曾文铤,朱科伦.人参皂甙Rg3抑制肝癌移植瘤新生血管形成的研究[J].河南科技大学学报(医学版),2005(04):245-247.
    [193]夏绍军.中医药与肿瘤的免疫调节概述[J].中医药临床杂志,2004(04):388-390.
    [194]郭昱,姚树坤.黄岑甙对人肝癌BEL-7402细胞系侵袭和转移的影响[J].第三军医大学学报,2006(06):594-597.
    [195]孔连宝,杜竞辉,王学浩,等.人原发性肝癌病人多药耐药基因表达及意义[J].中华肝胆外科杂志,2001(01):22-23.
    [196]邢益阳.中药逆转肿瘤多药耐药的研究进展[J].中医药临床杂志,2007(01):91-93.
    [197]刘展华,黄海福.参桃软肝丸对术后复发性肝癌的治疗作用[J].广州中医药大学学报,2006.23(6):467-471.
    [198]林丽珠,周岱翰,王一凡,等.参桃软肝丸合并喜树碱对大肝癌的保肝抑瘤作用[J].广州中医药大学学报,2005.22(2):101-105.
    [199]林丽珠,周岱翰,刘琨,等.参桃软肝丸方合羟基喜树碱介入治疗大肝癌的预后因素分析[J].中国中西医结合杂志,2005.25(1):8-11.
    [200]石世德,杨太成,李任先,等.参桃软肝丸抑制人肝癌细胞增殖及增强LAK抑瘤活性的实验研究[J].中西医结合肝病杂志,2001.11(1):30-32.
    [201]石世德,李任先,周岱翰,等.参桃软肝丸对荷肝癌小鼠的抑瘤作用及提高IL-1,NK活性的实验研究[J].中药新药与临床药理,2001.12(3):216-218.
    [202]陈林香,戴馨仪,周岱翰,等.参桃软肝丸对肿瘤生长及T淋巴细胞亚群的影响[J].肿瘤防治杂志,2002.9(3):241-242.
    [203]陈林香,戴馨仪,周岱翰,等.参桃软肝丸抗大鼠肝纤维化的实验研究[J].中医药学刊,2003.21(4):519-520.
    [204]陈林香,戴馨仪,周岱翰,等.参桃软肝丸抗肿瘤实验及其诱导肿瘤细胞凋亡的研究[J].肿瘤防治研究,2002.29(6):473-474.
    [205]金岩,曲婷婷,柳越冬,等.人参皂苷Rbl Rgl与5-氟脲嘧啶对地塞米松诱导S-(180)荷瘤小鼠脾淋巴细胞凋亡影响的实验研究[J].中医药学刊,2006(07):1272-1273.
    [206]简捷,刘利珍,李小燕,等.人参皂营Rg3对人肝癌细胞Pim-3及Bad凋亡蛋白表达的影响[J].世界华人消化杂志,2008(20):2229-2233.
    [207]刘基巍,赵翌,富力,等.人参皂甙Rg3在小鼠肝癌淋巴结转移模型中诱导细胞凋亡的作用[J].中国肿瘤临床,2004(19):47-49.
    [208]王华,周滨,郭星,等.人参皂营Rh_2对肝癌SMMC-7721细胞增殖和细胞骨架的影响[J].中国病理生理杂志,2011(06):1226-1229.
    [209]Kim M. H., Byon Y.Y., Ko E.J., et al. Immunomodulatory activity of ginsan, a polysaccharide of panax ginseng, on dendritic cells[J]. Korean J Physiol Pharmacol,2009. 13(3):169-73.
    [210]Ahn J. Y., Choi I. S., Shim J. Y., et al. The immunomodulator ginsan induces resistance to experimental sepsis by inhibiting Toll-like receptor-mediated inflammatory signals[J]. Eur J Immunol,2006.36(1):37-45.
    [211]刘英,张伟刚,王雅贤,等.炒桃仁总蛋白对小鼠B细胞功能影响的实验研究[J].中医药学报,2001(02):55-56+0.
    [212]吕跃山,王雅贤,运晨霞,等.桃仁总蛋白对荷瘤鼠IL-2、IL-4水平的影响[J].中医药信息,2004(04):60-61.
    [213]刘英,张伟兵,张鹏宇,等.炒桃仁总蛋白对TNF-a、IL-2产生水平的影响[J].中医药学报,2001(04):50-51.
    [214]张晓平,陈建明,强世平,等.山桃仁水煎提取物对肝纤维化小鼠血清Ⅰ、Ⅱ型前胶原的降解作用[J].福建中医药,2002(04):36-37.
    [215]刘平.肝硬化及肝纤维化的中医药治疗[J].肝脏,2002(S1):33-35.
    [216]中华人民共和国国家药典委员会.中华人民共和国药典2010年版(一部)[S].北京:化学工业出版社,2010:42.
    [217]周荣耀,吴丽英,束家和.百令胶囊在胃肠道恶性肿瘤手术和化疗后的应用[J].浙江中西医结合杂志,2002(07):14-15.
    [218]刘丽娟,马世尧,袁宝荣.百令胶囊的药理作用及临床应用[J].中成药,2004(06):65-68.
    [219]郭炜,赵泽贞,单保恩,等.六种中草药抗突变及抗肿瘤活性的实验报告[J].癌变.畸变.突变,2002(02):94-98.
    [220]李红枝,黄清松,陈伟强,等.仙鹤草抗突变和抑制肿瘤作用实验研究[J].数理医药学杂志,2005(05):471-473.
    [221]马丽萍,赵培荣,王留兴,等.仙鹤草水提液对食管癌Eca109细胞生长的抑制作用[J].郑州大学学报(医学版),2007(01):149-151.
    [222]骆传环,崔玉芳,黄荣清,等.当归多糖的制备及抑瘤作用[J].科学技术与工程,2003(06):551-552.
    [223]Cao W., Li X. Q., Wang X., et al. Characterizations and anti-tumor activities of three acidic polysaccharides from Angelica sinensis (Oliv.) Diels[J]. Int J Biol Macromol, 2010.46(1):115-22.
    [224]洪艳,刘煜敏,王红玲,等.当归多糖对辐射损伤小鼠红细胞免疫粘附功能和IL-2的影响[J].中华放射医学与防护杂志,2001(04):77-78.
    [225]Yuan S.L., Wang X.J., Wei Y. Q. [Anticancer effect of tanshinone and its mechanisms] [J]. Ai Zheng,2003.22(12):1363-6.
    [226]符寒,和水祥,徐俊丽,等.丹参酮ⅡA对肝癌细胞血管内皮生长因子表达的影响[J].西安交通大学学报(医学版),2009(01):115-118.
    [227]唐忠志,付立波,唐瑛.丹参酮ⅡA抑制人肝癌细胞的生长及诱导其凋亡的实验研究[J].第三军医大学学报,2003(09):774-777.
    [228]Qing H G, Shen H M, H S. G. Emodin inhibits tumor cell adhesion through disruption of the membrane lipid raft-associated integrin signaling pathway[J]. Cancer Res,2006. 66(11):5807-5815.
    [229]Su Y. T., Chang H. L., Shyue S. K., et al. Emodin induces apoptosis in human lung adenocarcinoma cells through a reactive oxygen species-dependent mitochondrial signaling pathway[J]. Biochem Pharmacol,2005.70(2):229-41.
    [230]Kwak H. J., Park M.J., Park C. M., et al. Emodin inhibits vascular endothelial growth factor-A-induced angiogenesis by blocking receptor-2 (KDR/Flk-1) phosphorylation[J]. Int J Cancer,2006.118(11):2711-20.
    [231]司维柯,张广运,马立强,等.苦参碱对HepG_2细胞系增殖能力的影响[J].第三军医大学学报,2000(05):451-458.
    [232]王振宇,刘秀林,孙秀明.牛黄为主的中药组方加减防治恶性肿瘤化疗毒副作用的临床观察[J].北京中医药大学学报(中医临床版),2008(05):4-7.
    [233]王芬.培植牛黄抗氧化作用的研究[J].辽宁中医杂志,2005(01):73.
    [234]高洁,白茹,李长志,等.丹参酮Ⅱ_A对阿霉素抑制肿瘤细胞生长作用的影响[J].药物评价研究,2010(02):91-94.
    [235]Wang B. J., Won S. J., Yu Z. R., et al. Free radical scavenging and apoptotic effects of Cordyceps sinensis fractionated by supercritical carbon dioxide[J]. Food Chem Toxicol, 2005.43(4):543-52.
    [236]李航宇,鞠培新,钟鑫平,等.三氧化二砷诱导人肝癌细胞株HepG_2凋亡的机制研究[J].中国肿瘤临床,2008(04):210-213.
    [237]谭君,祝连彩,王伯初.Survivin在槲皮素诱导肝癌细胞SMMC7721凋亡中的调节作用研究[J].时珍国医国药,2008(10):2358-2360.
    [238]张明智,郑晓珂,刘宏民,等.夏枯草提取物体外诱导EL-4细胞凋亡的实验研究[J].江苏中医药,2008(04):80-83.
    [239]汪永锋,刘喜平,徐晓艳.半夏泻心方配伍药组含药血清对人胃癌细胞凋亡及凋亡相关基因的影响[J].中国中医药信息杂志,2006(05):27-29.
    [240]李明琦,王琪,王亚贤.桂枝茯苓丸诱导肿瘤细胞凋亡的实验研究[J].中医药学报,2008(01):51-54.
    [241]杨桂芹,王长泉.马齿苋甜菜红素抗肿瘤实验研究[J].时珍国医国药,2010(02):388-390.
    [242]刘艳红,章秀丽,陈少文,等.人参皂苷Rh2诱导人肝癌HepG2细胞凋亡的研究[J].中国实验诊断学,2011.15(12):2011-2012.
    [243]丁向萍,马力,魏书堂,等.虫草素诱导人肝癌HepG2细胞凋亡及对端粒酶活性影响的研究[J].中华肿瘤防治杂志,2008.15(2):109-113.
    [244]Liu J. J., Lin D. J., Liu P. Q., et al. Induction of apoptosis and inhibition of cell adhesive and invasive effects by tanshinone IIA in acute promyelocytic leukemia cells in vitro[J].J Biomed Sci,2006.13(6):813-23.
    [245]Efferth T., Kahl S., Paulus K., et al. Phytochemistry and pharmacogenomics of natural products derived from traditional Chinese medicine and Chinese materia medica with activity against tumor cells[J]. Mol Cancer Ther,2008.7(1):152-61.
    [246]许惠玉,运晨霞,王雅贤.桃仁总蛋白对荷瘤鼠T淋巴细胞亚群及细胞凋亡的影响[J].齐齐哈尔医学院学报,2004(05):485-487.
    [247]林子超,刘韬,黄伟强.109例肿瘤患者中药注射剂不良反应调研分析[J].中药材,2010.33(10):1671-1674.
    [248]邹夏慧.仙鹤草抗肝癌SMMC-7721细胞作用的实验研究[D].江西医学院,2005.
    [249]李羚青,赵映前.牛黄在肝癌治疗中的作用机理及临床研究进展[J].湖北中医杂志,2009(11):77-78.
    [250]Youle R. J., Strasser A. The BCL-2 protein family:opposing activities that mediate cell death [J]. Nat Rev Mol Cell Biol,2008.9(1):47-59.
    [251]Shimizu S., Eguchi Y., Kamiike W., et al. Bel-2 expression prevents activation of the ICE protease cascade[J]. Oncogene,1996.12(11):2251-7.
    [252]王卫东,陈正堂.Bcl-2/Bax比率与细胞“命运”[J].中国肿瘤生物治疗杂志,2007(04):393-396.
    [253]刘晓翌,刘建军Caspase与细胞凋亡[J].武汉大学学报,2004.25(6):742-745.
    [254]茅敏,付虹,黄秀深,等.小柴胡汤诱导荷瘤小鼠S-(180)细胞凋亡及对细胞周期的影响[J].现代中西医结合杂志,2005(20):2646-2648.
    [255]赵爱光,杨金坤,赵海磊,等.四君子汤诱导裸小鼠移植性人胃癌细胞凋亡的初步研究[J].癌症,2001(02):164-167.
    [256]冯泳,孟庆华,何前松,等.小半夏加茯苓颗粒含药血清体外对肝癌细胞SMMC-7721生长增殖的影响[J].中国实验方剂学杂志,2010(05):168-170.
    [257]郝群.免疫系统衰老的研究进展[J].上海免疫学杂志,2003(01):60-62.
    [258]Gao Q., Qiu S. J., Fan J., et al. Intratumoral balance of regulatory and cytotoxic T cells is associated with prognosis of hepatocellular carcinoma after resection[J].J Clin Oncol,2007.25(18):2586-93.
    [259]王秀霞.中药抗肿瘤免疫增效的研究进展[J].中国中医急症,2005.14(1):73.
    [260]周锋,秦健,朱建中,等.莲必治注射液(穿心莲内酯)对免疫功能的调节作用(英文)[J].Journal of Nanjing Medical University,2004 (01):40-43.
    [261]解庆东,赵慧男.黄芪抗肿瘤机制研究与临床应用[J].医药导报,2003(02):109.
    [262]何彦丽,应逸,许艳丽,等.枸杞多糖对荷瘤小鼠肿瘤微环境T淋巴细胞亚群及树突状细胞的影响[J].中西医结合学报,2005(05):44-47.
    [263]朱彩平,张声华.枸杞多糖对肝癌H-(22)荷瘤鼠的抑瘤和免疫增强作用[J].营养学报,2006(02):182-183.
    [264]陈鹊汀,刘智勤,朱惠学,等.当归补血汤联合环磷酰胺抗肿瘤实验研究[J].第三军医大学学报,2008(16):1568-1571.
    [265]张静,单保恩.中药抗肿瘤的免疫学调节作用和作用机制研究进展[J].中国免疫学杂志,2006(04):385-388.
    [266]Rousalova I., Krepela E. Granzyme B-induced apoptosis in cancer cells and its regulation (review) [J]. Int J Oncol,2010.37(6):1361-78.
    [267]宋怀宇,孙传岐.黄芪对原发性肝癌病人免疫功能的影响[J].山东中医药大学学报,2000(06):459-460.
    [268]郭凤丽,邱世翠,王志强,等.白术对小鼠淋巴细胞增殖、IL-2和抗体产生的影响[J].中国中医药科技,2003(02):85.
    [269]倪红梅.理气药治疗肝癌作用与机制实验研究[J].山西中医,20022(1):47.
    [270]包素珍,郑小伟,孙在典,等.十全大补汤对H-(22)肝癌小鼠免疫功能的影响[J].中国中医药信息杂志,2006(06):33-34.
    [271]田维毅,马春玲,白惠卿.天花粉及其组份对小鼠NK细胞杀伤活性的影响[J].贵州医药,2001(11):982-984.
    [272]王琪,程德春,王磊.川芎嗪对荷瘤鼠化疗后免疫功能的影响[J].齐齐哈尔医学院学报,2003(03):243-244.
    [273]周德丽,欧阳寿,黄敏,等.海参猴桃液辅以少量rIL一2对免疫杀伤细胞活性的正向调节研究[J].广西中医药,2000.23(2):46.
    [274]仇微红,郭世宁,李志华,等.中药免疫调节作用的研究进展[J].广东畜牧兽医科技,2008(02):9-13.
    [275]朱曙东,严茂祥,陈芝芸,等.金针菇多糖免疫活性的研究[J].浙江中医学院学报,2001(04):43-44.
    [276]曾慧,何广胜,吴德沛.树突状细胞与移植免疫耐受[J].中国实验血液学杂志,2006(04):849-852.
    [277]童向民,陆国华,马成坚,等.虫草多糖对慢性粒细胞白血病来源的树突细胞发育的影响[J].中华血液学杂志,2007.28(3):20.
    [278]郑红刚,朴炳奎,林洪生,等.肺瘤平膏对非小细胞肺癌患者树突状细胞亚型及免疫功能的影响[J].北京中医,2007(04):214-217.
    [279]王润田,单保恩,李巧霞,等.黄芪提取物免疫调节活性的体外实验研究[J].中国中西医结合杂志,2002(06):453-456.
    [280]吴清和.中药药理学[M].北京:高等教育出版社,2007:219-221.
    [281]丁松云.参附注射液对晚期肺癌化疗患者免疫功能影响的临床研究[J].实用中医内科杂志2001(04):3-4.
    [282]袁国荣,叶再元.人参皂苷Rg3联合紫杉醇抗胃癌转移的作用及机制研究[J].中华中医药学刊,2011.29(3):625-628.
    [283]Zhang Q. H., Wu C. F., Duan L., et al. Protective effects of ginsenoside Rg(3) against cyclophosphamide-induced DNA damage and cell apoptosis in mice[J]. Arch Toxicol,2008. 82(2):117-23.
    [284]涂雪松.丹参酮在免疫调节和抗肿瘤及性激素作用方面研究进展[J].中华临床医学杂志2006.7(12):46-47.
    [285]杨铁虹,贾敏,梅其炳.当归多糖对小鼠免疫功能的调节作用[J].中成药,2002.27(5):563-565.
    [286]杨铁虹,贾敏,梅其炳.当归多糖组分AP-3诱生小鼠脾细胞IL-2和IFN-γ的作用[J].药学学报,2006.41(1):54-57.
    [287]沈新娥,龚珊,蒋星红,等.复方虫草精华对小鼠免疫功能的影响[J].中国血液流变学杂志,2003.13(4):327-330.
    [288]Gerwins P., Skoldenberg E., Claesson-Welsh L. Function of f ibroblast growth factors and vascular endothelial growth factors and their receptors in angiogenesis[J]. Crit Rev Oncol Hematol,2000.34(3):185-94.

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