Background:
Ovarian cancer (OvC) is a malignant tumor which invades ovarian epithelium and interstitium. Reduction surgery combined with adjuvant chemotherapy is standard treatment for OvC patients, but the adverse effects due to chemotherapy still remains a major problem. While Chinese herbal medicine (CHM) therapy has a unique therapeutic effect to reduce side effects of chemotherapy by boosting immune system, the evidence of CHM in the treatment of OvC patients are limited.
Objective:
We conducted a systematic review to evaluate the efficacy and safety of CHM in the treatment of OvC after reduction surgery and adjuvant chemotherapy.
Method:
Chinese National Knowledge Infrastructure (CNKI) and PubMed up to Dec 31st 2018 were searched to identify relevant studies. Only randomized controlled trials (RCTs) were included, and there was no limitation on language of the publication. Data were extracted from all included studies and meta-analysis was performed with Review Manager 5.3. Study quality was assessed and pooled risk ratios (RR) or mean difference (MD) with 95% CIs were used to evaluate the efficacy and safety of CHM.
Results:
A total of 18 RCTs involving 975 participants were included. There was no placebo, no treatment and CHM alone. Compared with Western Medicine (WM) alone, Chinese herbal Medicine combined with WM (CHM-WM) significantly improved TCM syndromes and symptoms, KPS scores, CD4 counts, CA125 levels, and 3-years survival rate (
P
< 0.05). Incidences of gastrointestinal reactions, marrow depression, urinary system symptoms were significantly lower in CHM-WM group than in WM group (
P
< 0.01). There was no significant difference in CD3 counts, CD8 counts, quality of life, liver function, and peripheral neuropathy between the two groups (
P
> 0.05).
Conclusion:
The systematic review indicated that CHM combined with WM is effective and safe as a treatment for OvC patients after reduction surgery and adjuvant chemotherapy. However, more high-quality and large-scale RCTs are needed to confirm the efficacy and safety of CHM intervention.
Reference evapotranspiration (ET0) in the hydrological cycle is one of the processes that is significantly affected by climate change. The Qinghai–Tibet Plateau (QTP) is universally recognized as a region that is sensitive to climate change. In this study, an area elevation curve is used to divide the study area into three elevation zones: low (below 2800 m), medium (2800–3800 m) and high (3800–5000 m). The cumulative anomaly curve, Mann–Kendall test, moving t-test and Yamamoto test results show that a descending mutation occurred in the 1980s, and an ascending mutation occurred in 2005. Moreover, a delay effect on the descending mutation in addition to an enhancement effect on the ascending mutation of the annual ET0 were coincident with the increasing altitude below 5000 m. The annual ET0 series for the QTP and different elevation zones showed an increasing trend from 1961 to 2017 and increased more significantly with the increase in elevation. Path analysis showed that the climate-driven patterns in different elevation zones are quite different. However, after the ascending mutations occurred in 2005, the maximum air temperature (Tmax) became the common dominant driving factor for the whole region and the three elevation zones.
In a Maxwell's demon experiment on a dilute granular gas made up of two species of particles placed in two closely connected containers, a cyclic oscillation similar to the chemical oscillations is recognized that the two species of particles cluster alternately in the two containers. Then the nonlinear behavior is qualitatively explained based on a flux model.
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