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Polyethylene,light,versatile synthetic resin made from the polymerization of ethylene.Polyethylene is a member of the important family of polyolefin resins.It is the most widely used plastic in the world,being made into products ranging from clear food wrap and shopping bags to detergent bottles and fuel tanks.What Are the Properties of the Alkaline Earth Metals?Sep 07,2019 Properties of Low#0183;Properties of the Alkaline Earth Metals .The alkaline earths possess many of the characteristic properties of metals.Alkaline earths have low electron affinities and low electronegativities.As with the alkali metals,the properties depend on the ease with which electrons are lost.The alkaline earths have two electrons in the outer shell.Thermal Properties of Plastic MaterialsThermal Properties of Plastic Materials Material Formula Coefficient of thermal expansion x10-6 K-1 Heat-deflection temperature - 0.45MPa C Heat-deflection temperature - 1.8MPa C Lower working temperature C Specific heat J K-1 kg-1 Thermal conductivity W m-1 K-1 Upper working temperature C
Engineering Thermal Properties of Metals,Conductivity,Thermal Expansion,Specific Heat Data - Metals in general have high electrical conductivity,high thermal conductivity,and high density.Typically they are malleable and ductile,deforming under stress without cleaving.Thermal Properties of Metals,Conductivity,Thermal 31 rows Properties of Low#0183;Engineering Thermal Properties of Metals,Conductivity,Thermal Expansion,Specific HeatStructure and Properties of Ceramics The American The ionic and covalent bonds of ceramics are responsible for many unique properties of these materials,such as high hardness,high melting points,low thermal expansion,and good chemical resistance,but also for some undesirable characteristics,foremost being brittleness,which leads to fractures unless the material is toughened by
In addition,elongation increases at low temperatures.Except for the sand cast nickel-aluminum-bronze alloy,all alloys had notched-to-unnotched tensile ratios above one,and good or very good impact properties.Only the sand cast alloy was brittle at low temperature.Semiconductor quantum dots and related systems Electronic Nov 08,2010 Properties of Low#0183;(2001).Semiconductor quantum dots and related systems Electronic,optical,luminescence and related properties of low dimensional systems.Advances in Physics Vol Related searches for Properties of Lowlow property tax in floridashow low property for salereal property improvements definitionhouse property for saleshow low propertylowe's real estate departmentmaryland homes and propertylowes realty jamaica vtPrevious123456Next
Properties of Saturated Steam - Pressure in Bar - Saturated Steam Table with properties like boiling point,specific volume,density,specific enthalpy,specific heat and latent heat of vaporization; Sizing Steam Pipes - Steam is a compressible gas where pipe lineProperties of Concrete - Workability,Setting,Bleeding Setting of Concrete.The hardening of concrete before its hydration is known as setting ofWorkability of Concrete.Workability is often referred to as the ease with which a concrete can be(a).Concrete Bleeding.Bleeding in concrete is sometimes referred as water gain.It is a particularHydration in concrete.Concrete derives its strength by the hydration of cement particles.TheAir Entrainment.Air entrainment reduces the density of concrete and consequently reduces theSynthesis,properties,and optical applications of low In particular,the optical properties of a metal-halide perovskite can be widely manipulated once its bulk structure has been reduced to a low-dimensional structure,allowing multiple functionalities of light generation,emission,transmission,andProperties of Cast Iron - Science StruckLow Tensile Strength Different varieties of cast iron are used in the construction of structures and machinery.Cast iron having a tensile strength of 5 tons per square inch or less,and is of no significant value for purposes where the alloy is required to possess strength.
hardness properties of low and high phosphorus deposits,as described later.The structure of electroless nickel is responsible for some of its unique properties.It differs greatly from the crystalline structure of electrodeposited nickel and it can normally beProperties and applications of LDPE or Low Density LDPE (Low Density Polyethylene) After its experimental preparation in the 1930s,the application in high frequency radar cables during World War II,gave impetus to its commercial production.This thermoplastic is available in a range of flexibilities depending on the production process.Physical And Mechanical Properties Of Intermetallic Nov 30,2011 Properties of Low#0183;The low toughness of the intermetallics combined with the tendency to concentrate stress at the interface layers must be viewed as undesirable.Some researchers have found that cracking either originates in the intermetallic layer or rapidly travels to it and then along it [1,6].
The molecular structure of silicone rubber results in a very flexiblebut weakchain.Silicones are very stable at low and high temperatures.Although fillers may improve properties somewhat,tear and tensile strengths remain relatively low.Peabody Properties,Inc.Why Choose Peabody Properties? We are a full-service real estate company with a tradition of success committed to maintaining communities and relationships for over four decades.Your trusted partner specializing in residential and condominium management,marketing and leasing,construction management,capital improvement,relocation PROPERTIES OF WOOD AND STRUCTURAL WOODsuch properties as moisture content,density,dimensional stability,thermal and pyrolytic (fire) properties,natural durability,and chemical resistance.Familiarity with physical properties is important because those properties can significantly influence the performance and strength of wood used in structural applications.3-5
Jan 14,2021 Properties of Low#0183;By combining large amounts of low-fidelity data with smaller quantities of high-fidelity data,nanoengineers have developed a new machine learning method to predict the propertiesMaterial Properties - Engineering ToolBoxThermal properties of air - density,viscosity,critical temperature and pressure,triple point,enthalpi and entropi,thermal conductivity and diffusicity,and more.Air Properties - Imperial Units .Thermodynamic properties of air at low pressures - imperial units.Air Properties - SI Units .Ideal gas properties of air at low pressures - in MATERIALTHERMAL CONDUCTIVITY BTU / (DENSITY (LBS/IN3)SPECIFIC HEAT (BTUAluminum1360.0980.24Brass (Yellow)69.330.3060.096Copper2310.3220.095Gold1830.6980.032 31 rows on engineersedgePermeability Properties of Plastics and Elastomers The molecular structure of silicone rubber results in a very flexiblebut weakchain.Silicones are very stable at low and high temperatures.Although fillers may improve properties somewhat,tear and tensile strengths remain relatively low.
The low-temperature properties of silver also make it an attrac-tive choice in applications that are not directly related to superconductivity.These properties are its high thermal and electrical conductivities,diamagnetism,high reflec-tance,and low emittance.Low Exothermic Epoxy Systems MasterBondOther Properties of Low Exotherm Epoxies Available in a range of viscosities,hardnesses and colors including transparency for light emission,these systems feature minimal shrinkage,dimensional stability,excellent physical strength properties.I LOW TEMPERATURE METALSinfluence the low-temperature toughness of alloys; for example,increasing amounts of nickel up to 13% significantly raise the notched-bar impact properties of low-c,arbon steels (Fig.3a).For this reason,low-carbon alloy constructional steels containing up to 9%.nickel are commercially employed for cryogenic-fluid storage tanks and trans-
influence the low-temperature toughness of alloys; for example,increasing amounts of nickel up to 13% significantly raise the notched-bar impact properties of low-c,arbon steels (Fig.3a).For this reason,low-carbon alloy constructional steels containing up to 9%.nickel are commercially employed for cryogenic-fluid storage tanks and trans-High and Low Temperature Properties of FT-Paraffin The rheological properties of modified bitumen at high and intermediate temperatures are measured by using Dynamic Shear Rheometer (DSR) (ASTM D7175),the creep stiffness of bitumen at low temperatures is measured by using Bending Beam Rheometer (BBR) (ASTM D6648) and the viscosity of the bitumen is evaluated by application of Brookfield Find Affordable Rental Housing USAGovFind Affordable Rental Housing.People with low income Low Income a total family income thats no more than the Section 8 low-income limit established by HUD.Individuals are considered one-person families.,seniors Senior for housing benefit eligibility purposes,a person who is 62 or older.,and people with disabilities Person with a Disability a person whose physical or mental
Pharmacokinetic properties of low-dose SoluMatrix meloxicam in healthy adults Clin Rheumatol.2016 Apr;35(4):1099-104.doi 10.1007/s10067-015-3121-9.Epub 2015 Dec 5.Authors Azra Hussaini 1 ,Daniel Solorio 2 ,Clarence Young 3 Affiliations 1 PAREXEL File Size 1MBPage Count 15TECHNICAL WHITEPAPER Low Temperature Properties ofLow Temperature Properties of Polymers Introduction Most plastics at room temperature show their familiar properties of flexibility (a low Youngs modulus) and high resistance to cracking but when the temperature decreases this can change rapidly and many common plastics become brittle with lowElastomer Properties DuPont Performance PolymersProperties highest-performing elastomer with excellent heat and chemical resistance.DuPont manufactures finished parts.Heat resistance up to 327 Properties of Low#176; C.Very low volume swell in aggressive chemicals and plasmas.Long seal life for low operating costs.
Jan 26,2017 Properties of Low#0183;In another study,focusing on low income housing tax credit developments,the authors noted significant spillover effects of LIHTC developments in Charlotte and Cleveland.In Charlotte,there was a high turnover rate in areas after the completion of a LIHTC development particularly in higher-income areas and a decrease in property values of Cryogenic Properties of CopperCryogenic Properties of Copper.Copper and copper alloys retain a high degree of ductility and toughness at subzero temperatures.In fact,copper alloys become stronger and more ductile as the temperature goes down,retaining excellent impact resistance to 20 K (-253 C or -424 F).Coronavirus Rental Assistance and Eviction MoratoriumIf you've experienced job loss because of the coronavirus pandemic,you may qualify for rental assistance through your state HUD program.And a Properties of Low#160;fedFind Affordable Rental HousingPeople with low income,seniors,and people with disabilities may qualify for help from the U.S.Department of Housing and Urban Development (HUD)How to Get Help Paying RentIf you need help paying your rent,contact your state housing finance agency or your local public housing agency office.You may qualify for governHousing Choice Voucher Program (Formerly Section 8)Find out how the Housing Choice Voucher Program can help you pay for rental housing.Get information about eligibility requirements,how you can apPublic HousingFind out about public housing,including what it is,whether you're eligible,how to apply,and who to contact if you have a complaint.What is publIdentify and Complain about Housing DiscriminationHousing discrimination happens when a housing provider acts in a way that blocks someone from renting or buying housing because of theirRace or colProperties of Plastic Materials Table Curbell PlasticsUse our interactive properties table below to explore by property group,sort,or compare two or more plastic materials.Also,you may want to use our Plastic Material Selection Guide or Interactive Thermoplastics Triangle to assist with the material selection process based on your application requirements.For chemically resistant plastic,view our Chemical Resistance of Plastics chart.
For many low-alloy steels,the primary function of the alloying elements is to increase hardenability in order to optimize mechanical properties and toughness after heat treatment.In some cases,however,alloy additions are used to reduce environmental degradation under certain specified service conditions.Cited by 73Publish Year 2015Author Roberta Di Caprio,Serena Lembo,Luisa Di Costanzo,Anna Balato,Giuseppe MonfrecolaAnti-Inflammatory Properties of Low and High Doxycycline AbstractIntroductionMaterials and MethodsResultsDiscussionConclusionDisclosureDoxycycline is used to treat infective diseases because of its broadspectrum efficacy.High dose administration (100 or 200mg/day) is often responsible for development of bacterial resistances and endogenous flora alterations,whereas low doses (2040mg/day) do not alter bacteria susceptibility to antibiotics and exert anti-inflammatory activities.In this study,we wanted to assess the efficacy of both low and high doxycycline doses in modulating IL-8,TNF-,and IL-6 gene expression in HaCaT cells stiSee more on hindawiCited by 73Publish Year 2015Author Roberta Di Caprio,Serena Lembo,Luisa Di Costanzo,Anna Balato,Giuseppe MonfrecolaPeople also askWhat are the properties of low temperature polymers?What are the properties of low temperature polymers?Low Temperature Properties of Polymers Introduction Most plastics at room temperature show their familiar properties of flexibility (a low Youngs modulus) and high resistance to cracking but when the temperature decreases this can change rapidly and many common plastics become brittle with low failure stresses.TECHNICAL WHITEPAPER Low Temperature Properties of PolymersCited by 3Publish Year 2016Author Azra Hussaini,Daniel Solorio,Clarence YoungClassification of Carbon and Low-Alloy SteelsCarbon SteelsHigh-Strength Low-Alloy SteelsLow-Alloy SteelsThe American Iron and Steel Institute (AISI) defines carbon steel as follows Steel is considered to be carbon steel when no minimum content is specified or required for chromium,cobalt,columbium [niobium],molybdenum,nickel,titanium,tungsten,vanadium or zirconium,or any other element to be added to obtain a desired alloying effect; when the specified minimum for copper does not exceed 0.40 per cent; or when tSee more on totalmateriaPolyethylene Chemical Composition and PropertiesA.K.A.PropertiesMiscellaneousPolyethene,Polythene,PE,LDPE,HDPE,MDPE,LLDPE 1.LDPE (Low Density Polyethylene) is defined by a density range of 0.910 - 0.940 g/cm3.It has a high degree of short and long chain branching,which means that the chains do not pack into the crystal structure as well.It has therefore less strong intermolecular forces as the instantaneous-dipole induced-dipole attraction is less.This results in a lower tensile strength and increased ductility.LDPE is created by free radical polymerization.The high degreSee more on plasticmoulding.caGlass Transition Temperature -125 oC (-193 oF)Notched Impact Strength no breakMelting Point 110 oC (230 oF)Tensile Strength 0.20 - 0.40 N/mm Properties of Low#178;Properties and applications of electroless nickelhardness properties of low and high phosphorus deposits,as described later.The structure of electroless nickel is responsible for some of its unique properties.It differs greatly from the crystalline structure of electrodeposited nickel and it can normally be
Aug 18,2018 Properties of Low#0183;Advantages of Low Heat Cement Assists in minimising the potential for thermal cracking in thick concrete sections.Improvised durability performance.Excellent performances such as high final strength,sulphate corrosion resistance,good lasting properties,good Increased workability and Carbon Fiber Properties Clearwater Composites,LLCThe fiber type,fiber amount,fiber orientation,etc can all be changed to achieve certain properties,whether for mechanical reasons (strength,stiffness) or for other reasons,such as low CTE (coefficient of thermal expansion).Metals and other materials do not have this tailor ability.Anti-inflammatory properties of low and high doxycycline High dose administration (100 or 200 mg/day) is often responsible for development of bacterial resistances and endogenous flora alterations,whereas low doses (20-40 mg/day) do not alter bacteria susceptibility to antibiotics and exert anti-inflammatory activities.
Alcohol - Alcohol - Physical properties of alcohols Most of the common alcohols are colourless liquids at room temperature.Methyl alcohol,ethyl alcohol,and isopropyl alcohol are free-flowing liquids with fruity odours.The higher alcoholsthose containing 4 to 10 carbon atomsare somewhat viscous,or oily,and they have heavier fruity odours.9 Impressive Health Benefits of BeetsMay 26,2017 Properties of Low#0183;Beets have a high water and low calorie content.Both of these properties are beneficial for weight loss.9.Delicious and Easy to Include in Your Diet.This last one is not a health benefit,yet 9 Evidence-Based Health Benefits of AlmondsSep 06,2018 Properties of Low#0183;Almonds are low in carbs and high in protein and fiber. Due to their satiating properties,nuts are a great addition to an effective weight
Aug 10,2016 Properties of Low#0183;The mechanical properties of polymers,particularly as a function of temperature and strain rate,are key for implementation of these materials in design.In this paper,the compressive response of low density polyethylene (LDPE) was investigated across a range of strain rates and temperatures.The mechanical response was found to be temperature and strain rate dependent,

domain: chemistry


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Two New Hampshire men were charged after allegedly assaulting each other, one with a flashlight and the other with a construction tool.
An 85-year-old man was arrested Saturday after an alleged road rage incident led to an hours-long police standoff at his home.
The man’s attorney says the Bristol County Sheriff’s Department failed to prevent the suicide.
A Quincy man is accused of pulling a knife and a stun gun on a driver in a road rage incident.
Boston police have released video of an SUV they’re looking for in connection with a deadly road rage incident.
Police have identified the victim who was shot to death after an apparent road rage incident in Roxbury Saturday afternoon.
A man was shot to death after an apparent road rage incident in Roxbury Saturday afternoon, police say.
A road rage incident in Bourne led to a drug bust, police say.
Police say a driver hit a car carrying a mother and her two children on a highway, didn’t stop and brandished a knife at them when they followed.
The other winners were “Make yah Ma proud, wear yah seatbelt,” to encourage belt use and “Put down the phone! Your LOLs and OMGs can wait,” to fight distracted driving.

domain: law


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One of the people we support set up a fun day for everyone to attend at Century House. The fun day was in aid of The Cheshire East Hospice. Over £1000 was raised!! Thank you for everyone who came to support!
Happy 1st Birthday to FountainStreet We celebrated Fountain Street’s 1st Birthday, We had a fun filled day with lots of food and laughter. What a year it has been since the service has opened! And many more years to come!!

domain: sociology


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Acupuncture and Herbal Medicine for Cancer PatientsView this Special Issue
Review Article | Open Access
Zhan Zheng, William Chi-Shing Cho, Ling Xu, Juyong Wang, Daniel Man-Yuen Sze, "Lessons Learnt from Evidence-Based Approach of Using Chinese Herbal Medicines in Liver Cancer", Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 656351, 11 pages, 2013. https://doi.org/10.1155/2013/656351
Lessons Learnt from Evidence-Based Approach of Using Chinese Herbal Medicines in Liver Cancer
This paper is a systematic review of evidence-based studies of the effectiveness of Chinese herbal medicine (CHM) in the treatment of liver cancer. After a detailed analysis of the literature, five animal studies and four human clinical trials met the criteria for inclusion. Analysis revealed that results of the clinical trials, whilst encouraging, need to be interpreted with caution as problems with study designs may lead to apparent benefits being attributable to various forms of bias. However, as each of the CHM agents used in these studies appeared to be potentially beneficial, further well-designed and controlled randomized clinical trials are warranted. The second part of this review focused on the lessons learned from the relationships between Traditional Chinese Medicine (TCM) theory, TCM Syndrome Differentiation, and modern scientific understanding of mechanisms of action of CHM agents. The understanding of TCM Syndrome Differentiation may allow identification of different patterns of disharmony and may provide important guidance to the prescription of CHM. Furthermore, quality control using both biological and chemical fingerprinting of CHM is important to ensure batch-to-batch consistency to deliver sustained therapeutic benefit. Also, careful assessment of herb-drug interactions is paramount for safety and integrative use of western chemotherapeutic and CHM agents.
This review aimed to examine the evidence for using Chinese herbal medicine (CHM) in cancer treatment in terms of the benefits and potential mechanisms of action. As the same CHM formulae may be used for different cancer types with different effectiveness, in this review, liver cancer or hepatocellular carcinoma (HCC) has been used as the specific focus for discussion. Liver cancer is the second leading cause of cancer death in men and the sixth in women worldwide with an estimated 748,300 new liver cancer cases and 695,900 liver cancer deaths occurring in 2008 . The highest liver cancer rates are found in East and South-East Asia and in Middle and Western Africa. In the United States between 1990 and 2007, the increase in death rates for liver cancer accounted for nearly 70% of the total increase in the cancer death rates in men and for almost 23% of the increase in women .
Liver cancer has a poor prognosis, and the 5-year survival rate reported between 1973 and 2007 remained below 12% in the United States . Early stage liver cancer is currently difficult to diagnose due to the lack of a sensitive screening test. As a result, only 30% to 40% of patients with liver cancer are candidates for potentially curative treatments at the time of their diagnosis . Treatment modalities such as surgical resection, liver transplantation, and local ablation are only considered for patients with preserved liver function. However, most newly diagnosed liver cancer patients are already at an advanced stage. For these intermediate or late stage liver cancer patients, the therapeutic options are limited to palliative approaches using transcatheter arterial chemoembolization (TACE) or chemotherapeutic agents . However, many patients are either not suitable for TACE or suffer from poor outcomes with conventional systemic cytotoxic chemotherapy .
A meta-analysis summarized the results of 193 randomized controlled trials (RCTs) of a range of medical modalities for HCC treatment reported during 2005–2010 indexed by MEDLINE, CANCERLIT, Embase databases, and the Cochrane Library . From the 32 studies that met their inclusion criteria, only 17 studies were eventually selected based on the strength of the trials. Of these, one study used chemoembolization, three used tamoxifen hormonal treatment, and a further three employed systemic chemotherapy treatment modalities such as doxorubicin and PIAF—cisplatin/interferon alpha 2b/doxorubicin/fluorouracil. The researchers summarized the effects of all these treatment modalities for HCC in the category of “No survival benefit.”
New conventional medicine treatment approaches for HCC now rely on molecular targeted therapies such as the multikinase inhibitor Sorafenib. In a recent randomized multicenter placebo-controlled phase III trial, Sorafenib exhibited a benefit in advanced liver cancer patients by extending overall survival, but this was only by 2 to 3 months compared with the placebo . Therefore in view of the poor clinical effectiveness of a broad range of medical modalities including the molecular targeted approach, new therapeutic agents with low cost and high effectiveness, such as herbal medicines, are urgently needed.
Natural products represent a rich reservoir of potential bioactive compounds exhibiting anticancer properties . Several compounds have been found to have powerful antitumor effects, such as taxol, which was identified by screening approximately 114,000 plant extracts and obtained therapeutic approval from the Food and Drug Administration of the United States . Although herbal medicines have been used in clinical applications for centuries, their present use lacks stringent supporting scientific evidence in terms of double-blind placebo-controlled clinical trials. In addition, since there are usually multiple compounds in a single herb, the actual active compounds and their sites of action and mechanisms of action are generally unknown. The situation is further complicated by the use of herbal medicines as a formula with multiple components [10–12], which represents a “polychemical” approach in contrast to the “single-chemical” approach of classical chemotherapeutics.
CHM has been practiced for centuries by local physicians caring for a huge population in China and in East Asia including Korea and Japan and has developed a comprehensive set of well-documented medical theories. CHM usually requires the use of multiple herbs, minerals, or even compounds derived from animal parts. In light of CHM theory, management of health can be characterized as holistic with the emphasis on regulating the integrity of the human body functions and the interaction between various organs and the internal environment. Likewise, liver cancer is a systemic disease associated with a local tumor. Therefore, CHM therapies not only focus on eliminating the local malignancy, but also aim to restore the homeostasis of the whole body.
This review focuses on the current understanding of CHM as a therapy for liver cancer and explores approaches for its future development as an evidence-based complementary and alternative medicine (CAM) for liver cancer management. Based on the premise that a successful CHM cancer treatment would require the clinical efficacy substantiated by clinical trials in humans, this review aims to first present a critical analysis of the clinical studies and the related preclinical animal in vivo studies, followed by experimental in vitro results which can help to delineate the underlying mechanisms of action of CHM treatment. This review highlights some important lessons from critical analysis of the CHM anti-HCC research, including inadequacies in the reported clinical trials, possible CHM candidates for future clinical trials, and quality control of CHM to ensure batch-to-batch consistency. These considerations may contribute to enhancing the development of an evidence-based cancer research platform using CHM.
2. Preclinical and Clinical Studies of CHM in Liver Cancer
2.1. Study Selection
An extensive search was performed in four electronic databases (PubMed, EMBASE (Excerpta Medica Database), China Biological Medicine database, and CNKI (Chinese Journal Full-Text Database for clinical trials and animal studies of CHM-based therapy) targeting liver cancers. The database search period covered 1980 to February 2012. The search terms were comprised of the following combinations: “Chinese herbal medicine,” “Chinese herb,” “herbal medicine,” “CHM,” “traditional Chinese medicine,” “TCM,” “liver cancer,” “hepatocellular carcinoma,” “cholangiocarcinoma,” and “hepatic carcinoma.” No other restrictions were imposed. In addition, the reference lists of recent reviews related to this topic were examined.
The flow chart demonstrating the selection process of the systematic analysis is shown in Figure 1. An initial screen of identified abstracts or titles was performed followed by a thorough reading of selected full-text articles. Studies were considered eligible if they met the following criteria: (1) the study design was a clinical trial or animal study; (2) the language of publication was English; (3) the main exposure of interest was CHM; (4) the outcome of interest was treatment effects for liver cancer. Using the previous criteria, 30 clinical trials in the area of integrative CHM with western medicine for treating liver cancer reported in Chinese were excluded from this review . This review focused on the evaluation of four CHM formulas or extracts in human trials and five related preclinical animal experiments targeting liver cancer. We attempted to critically analyze the reports of use of these CHM extracts or formulas in clinical trials (216 liver cancer patients in total). A meta-analysis was not performed because of the small number of identified studies.
2.2. Preclinical Studies in Animal Models and Anticancer Mechanism of CHM
Effects of five CHM extracts of Bufalin, Scutellaria barbate D. Don, Kanglaite injection, PHY906, and Ganfujian or formulas on liver cancer have been reported in animal models (Table 1).
Bufalin, a cardiotonic steroid isolated from the skin and parotid venom glands of Bufo toad (Bufo bufo gargarizans Cantor), is a major active component of Huachansu . The molecular formula of bufalin is C24H34O4 with a relative molecular weight of 386.5 g/mol. To investigate the antitumor activity and apoptosis-regulating mechanism of bufalin in an animal model, human BEL-7402 tumors were implanted into the liver of 75 nude mice to establish orthotopic transplantation tumor models . This simulation used a novel intrahepatic tunnel implantation to establish the in situ hepatoma. Compared to the murine tumor model, in which cancer cells are subcutaneously transplanted in immune-deficient animals, this in situ transplantation model is closer to the clinical situation of liver cancer. The results indicated that bufalin alone could inhibit growth, leading to tumors with a significantly smaller size ( cm3) compared with those in the normal saline (NS) ( cm3; ) and Adriamycin (ADM) groups ( cm3; ). Bufalin also prolonged survival times of hepatoma-bearing mice compared with those in the NS group and ADM groups ( d versus d, , and d versus d, , resp.).
In addition to these effects, apoptosis was induced by bufalin which regulated the expression of an apoptosis-related gene, Bax, and the ratio of Bcl-2/Bax. Apoptotic characteristics such as cell shrinkage, cytoplasm concentration, and apoptotic corpuscles were also determined by ultrastructure observation. These results suggested that bufalin treatment can alleviate the tumor burden and prolong survival in the mouse model. Clinical trials should be inaugurated to test the efficacy of bufalin in liver cancer patients.
Kanglaite is an acetone extract of Coix seed (Semen Coicis) that is widely used in clinical cancer therapy in China. CHM theory states that Semen Coicis increases the energy of the body and reduces or eliminates nodes, as well as benefiting digestive disorders .
Effects of Kanglaite injection were investigated using rat models of transplanted Walker-256 hepatoma . Forty hepatoma-bearing Wistar rats were treated with intratumor injections of Kanglaite and compared with a control group receiving saline treatment. The hepatoma volumes of rats in the Kanglaite group were significantly smaller than those in NS group (235.4 mm3 versus 464.6 mm3, ). The tumor inhibitory rate in the Kanglaite group was 49.4%, and the serum levels of alanine aminotransferase, related to hepatic function, were significantly lower. Inhibition of proliferating cell nuclear antigen (PCNA) expression indicated that one of the antitumor mechanisms of Kanglaite could be inhibition of karyokinesis and propagation of cancer cells. The results indicated that intratumor injection of Kanglaite could effectively inhibit hepatoma in rats. Kanglaite was also reported to induce in vitro apoptosis of HepG2 cells through the activation of the Fas/FasL pathway . Although further studies of the mechanisms are needed, these findings have contributed to the understanding of Kanglaite’s anticancer activity.
2.2.3. Scutellaria Barbate D. Don
Scutellaria barbate D. Don, a perennial herb growing throughout southern China, is known as Banzhilian in CHM. According to CHM theory, it can be used to eliminate toxicity, promote blood circulation, and reduce tumor nodes. It has been widely used as a therapy for cancers of the liver, lung, stomach, and breast, as well as colorectal cancer . In an in vivo study of hepatoma investigating the antitumor effect and the mechanisms of a crude extract of Scutellaria barbate (SB) , 60 ICR H22 hepatoma-bearing mice were treated with SB, fluorouracil (5-FU), and NS. SB significantly inhibited tumor growth compared to use of NS ( g, g, resp.; ). In addition, SB significantly improved the phagocytotic function of macrophages, which was analyzed by comparing the chicken-red cell phagocytic rate, with both 5-FU and NS groups (). The phagocytotic function of macrophages can reasonably reflect the antitumor immune function. The study demonstrated the antitumor activity of SB in H22-bearing mice and suggested that a potential mechanism was the improvement of immune function. This study also demonstrated that SB was able to inhibit the proliferation of H22 cells in vitro in a dose- and time-dependent manner by use of MTT assays. Observation of ultrastructure revealed apoptosis of H22 cells induced by SB. Further detailed investigation of the mechanisms involved in the observed antitumor effects of SB is warranted.
PHY906 is derived from the formulation known as Huang Qin Tang, which was first described in CHM documents dating approximately 1,800 years ago and is used for the treatment of various gastrointestinal symptoms, including diarrhea, nausea, and vomiting . PHY906 consists of four herbs: Scutellaria baicalensis Georgi, Glycyrrhiza uralensis Fisch, Paeonia lactiflora Pall, and Ziziphus jujube Mill in the ratio of 1.5 : 1.0 : 1.0 : 1.0.
Researchers from Yale investigated if use of PHY906 could reduce the nonhaematological side effects of chemotherapy in particular GI problems. Surprisingly, in the preclinical mouse cancer model, NCr-nude mice bearing human HepG2 tumor and treated with herb-drug combinations including PHY906/CPT-11, PHY906/Capecitabine, PHY906/Doxorubicin, and PHY906/Thalidomide showed that the integrated treatment not only greatly alleviated side effects of the chemotherapy, but that PHY906 could actually potentiate tumor inhibition in a significant way. However, the nude mice used in the model have limited host cellular immunity and reduced humoral immunity, and so the model does not completely reflect human cancer patients who have intact but progressively defective immunity .
Encouraged by the in vivo findings, attempts were made to determine if the mouse model findings could be replicated in human clinical trials. Four clinical trials using different combinations of PHY906 and chemotherapeutic agents have been reported  showing promising results and are described in Section 2.3 and Table 2.
| TACE: transcatheter arterial chemoembolization; OS: overall survival; TTP: time to disease progression; QoL: quality of life; SD: stable disease; CR: complete response; PR: partial response; RR = CR + PR: total response rate.|
Other preclinical animal studies have shown that the use of PHY906 is not restricted to targeting HCC but is also active in other tumor models such as colorectal cancer and pancreatic cancer [27, 30]. In summary, although PHY906 used alone had no significant effect on tumor weight loss, it can work as an effective broad-spectrum adjuvant to enhance the chemotherapeutic efficacy of a variety of anticancer agents. In addition, other animal experiments of colorectal cancer indicated that PHY906 could reduce chemotherapy-induced toxicities by exhibiting anti-inflammatory effects and promoting the regrowth of intestinal progenitor/stem cells [23, 30] while not affecting the metabolism and antitumor activity of commonly used chemotherapeutic drugs.
Ganfujian is another CHM formula commonly used as a therapy for liver diseases. The main components are three herbs Rhizoma Dioscoreae, Fructus Crataegi, and Fructus Ziziphi Jujubae. These herbs are not toxic and may be used as dietotherapy for prolonged periods . A preclinical study to investigate the inhibitory effect of Ganfujian granule on diethylnitrosamine- (DEN-) induced hepatoma in SD rats involved the use of 165 rats with free access to water containing 0.1 g/L DEN for 16 weeks, which were assigned into two groups to receive either normal diet or Ganfujian, respectively . Thirty rats from each group were sacrificed at week 20 to observe incidence rate of liver cancer. Observation of the remaining animals continued to determine survival until week 28. At week 20, all 30 rats in the normal diet group had developed liver cancer, in comparison with 24 of 30 rats in the Ganfujian group (). The longest survival time of rats was 28 weeks in the Ganfujian group and 20 weeks in the control group (). The results suggested that Ganfujian could reduce and delay the incidence of hepatoma in rats and prolong survival time of hepatoma-bearing rats. The researchers found that Ganfujian could affect the cancer cell cycle by suppressing overexpression of related modulators such as cyclin D1 and CDK4, which is a potential antitumor mechanism . Ganfujian granule is a promising liver cancer chemical preventive agent, with potential for clinical application.
2.3. Clinical Trials
The selected articles included clinical trials investigating 4 CHM extracts or formulas and involving a total of 216 liver cancer patients. The CHM medications tested were Huachansu injection, Kanglaite capsule, PHY906, and Jinlong capsule (Table 2).
Huachansu (Cinobufacini), which is a water extract of Bufo toad skin, is used in CHM to treat conditions including swelling, pain, and heart failure . Huachansu is commercially prepared for injection and is widely used at oncology clinics in China . It is reported to have good effects in eliminating toxicity, as well as relieving swelling and pain. An in vitro pharmaceutical study of Huachansu conducted in China identified bufalin as a major anticancer component of Huachansu .
In a clinical trial of 11 HCC patients with stage III or IV disease who received Huachansu as a single agent, 6 patients were found to have stable disease with a response duration of 5.5 months to 11.1 months . One patient whose response lasted for 11.1 months had a 20% reduction in tumor mass. Patients with stable disease had improved quality of life as assessed by using the M.D. Anderson Symptom Inventory (MDASI) scores. There were no drug-related toxicity greater than grade II and no dose-limiting toxicities reported. There was a dose-dependent increase in bufalin levels, with a maximum level of bufalin reached two hours after infusion. Further clinical studies of Huachansu with larger sample sizes and including appropriate control arms are needed. An NIH-funded project on pancreatic cancer using Huachansu has recently been completed and the report will soon be available . This may shed light on the mechanism of action of clinical efficacy of Huachansu on solid tumors.
Animal experiments with Kanglaite, an acetone extract of CHM Semen Coicis, were described in Section 2.2 and Table 1. In a randomized controlled trial in China, 65 unresectable stage II or III HCC patients were enrolled to receive either Kanglaite with TACE (30 patients) or TACE alone (32 patients) . The method of randomization was not disclosed, and it was unclear whether the trial had used a blinded method to assess the outcome. It was reported that three subjects withdrew because of financial problems. The response rates of tumors in the combination group and the TACE group were 40% and 25%, respectively (). Serum alpha fetoprotein (AFP) levels in the combination group and the TACE group were 73.1% and 60.7% lower following therapy (). Kanglaite combined with TACE had a higher median time to progression (TTP) (7.0 months) than TACE alone (5.5 months) (). Compared with TACE alone, Kanglaite plus TACE improved immune function significantly by increasing the indexes of CD3+, CD4+, and CD4+/CD8+ (). The TACE-induced adverse reaction of liver damage was less serious in the combination group than that in the TACE group. Further trials are needed with improved methodological quality so that definite conclusions on the clinical benefits of using Kanglaite in HCC can be assessed.
To ensure reproducible clinical efficacy, the researchers first attempted to determine the batch-to-batch consistency among different batches of PHY906 through strict quality control Good Manufacturing Practices (GMP) production measures . They introduced a comprehensive technology platform termed “PhytomicsQC,” which is a multifaceted approach integrating chemical and biological fingerprinting. Together with a novel statistical analysis, the researchers showed that PhytomicsQC was useful to evaluate different batches of PHY906 and provide a robust platform to determine the batch-to-batch consistency of the four-herb CHM formula PHY906 effectively . The researchers also suggested that in vivo animal testing can be viewed as the ultimate quality control platform, if there is a discrepancy in the chemical and biological fingerprinting results.
The clinical trials of PHY906 not only demonstrated reduced chemotherapy-induced gastrointestinal toxicity but also reported an overall stronger protective effect of global toxicity . Two open-labeled clinical studies of PHY906 with capecitabine were conducted in patients with unresectable HCC . The first study was a phase I/II study with 93% of patients being enrolled in the US, whereas the second study was a phase II study in Taiwan. The phase I/II trial was a multicenter, open-label, dose-escalation, safety and efficacy study of PHY906 plus capecitabine. Only 3 patients from the Taiwan site were enrolled in the phase II study, and these Taiwanese patients were excluded from the data analysis as the enrollment criteria were slightly different from those for US subjects. Of the 18 US patients enrolled in a phase I trial to determine a safe and tolerable dosing regimen, it was found that the combination of PHY906 800 mg bid and capecitabine 750 mg/m2 bid was well tolerated.
Subsequently, 39 patients using the recommended dose were enrolled in a phase II trial to determine whether PHY906 enhances the response rate of capecitabine, overall survival time (OS), time to disease progression (TTP), and quality of life (QoL) of patients. One of the major limitations of this trial is that there was no control arm for comparison. The disease control rate was 65.2% with 8.7% having a moderate response (MR) and 56.5% exhibiting stable disease (SD). The median TTP was 3.4 months and median OS was 9.2 months. The 12-month survival rate was 44.5%. No patients experienced drug-related grade 4 or 5 toxicities. Patients’ QoL evaluated by functional assessment of cancer therapy-hepatobiliary (FACT-Hep) did not deteriorate significantly and changes in score did not exceed 25%. In subgroup analysis, the median OS of patients with hepatitis B or C was 13.8 months and nonhepatitis patients exhibited a median OS of 7.6 months. Median OS values for Child-Pugh A and Child-Pugh B patients were 10.9 and 6.5 months, respectively. The researchers stated that no formal statistical analysis was performed in this study.
The same study reported that, surprisingly, Asian patients had a higher median OS (16.5 months) than non-Asian patients (6.2 months) (). This significant survival benefit in Asian patients may be associated with their genetic phenotype of PHY906-sensitive, but further investigation with a larger patient sample is needed. The previously mentioned PHY906 clinical trials had very good quality control with consistently prepared 4-herb products, but some lacked appropriate control arms and involved relatively small numbers of patients. Therefore, future phases II and III double blind, randomized, placebo-controlled studies with sufficient patient populations are required to determine the efficacy of PHY906 in liver cancer therapy.
Jinlong capsules have been commonly used as a CHM therapy for liver cancer. The major constituents are three CHM products Gekko japonicas Dumeril et Bibron, Bungarus Parvus, and Agkistrodon, which are all derived from reptiles. CHM theories maintain that some animal-derived medicines, especially from reptiles, can produce stronger and more deeply penetrating effects compared with those derived from plants . Such CHMs are used to reduce or eliminate toxicity, activate meridians, and reduce or eliminate tumor nodes.
A randomized controlled trial (RCT) conducted in China enrolled 98 patients with liver cancer , of whom 53 received TACE plus Jinlong capsules and the other 45 received TACE alone. Randomization was achieved by using a table. The total response rate including both complete responses and partial responses of Jinlong in combination with TACE was 60.38% and RR of TACE alone was 40.00% (). The QoL of all patients before and after treatment was evaluated using Karnofsky (KPS). The KPS score of the combination group was higher than the TACE group after treatment ( versus ; ). After treatment, the level of serum osteopontin (OPN) which relates with tumorigenesis, invasion, and metastasis was lower in the combination group than in the TACE group ( μg/L, μg/L, resp.; ). The researchers did not report any adverse reactions. So, this trial suggests that short-term clinical efficacy and QoL in liver cancer can be improved by Jinlong capsules combined with TACE. Primary long-term outcomes such as overall survival time should be observed to provide further evidence of including Jinlong for liver cancer therapy.
3. Lessons Learned
Evidence-based clinical efficacy is the most important key criterion to be evaluated to establish whether CHM can benefit liver cancer management. Ideally the Chinese herbs chosen should comply with Chinese medicine theory in a holistic way (Section 3.1). To ensure consistent desirable clinical effects as well as safety and batch-to-batch consistency, quality control of CHM preparations is crucial (Section 3.2). As most regimens require use of CHM together with other chemotherapeutic agents, herb-drug interaction is another key factor in evidence-based CHM cancer management (Section 3.3). This section also acknowledges the multitargeted, multidimensional features of CHM by highlighting the related mechanisms of action and some possible active ingredients (Section 3.4). Other factors such as the ethical and regulatory issues of CHM products and the safe usage of health products have been addressed by other reviews  and will not be further discussed here.
3.1. Nature of the Chosen CHM
Why did the researchers choose the herbs described earlier for preclinical and clinical studies? Generally, the reason for choice of herbs originates from CHM theory. The herbs can be classified into several groups in terms of CHM thinking. Semen Coicis, Rhizoma Dioscoreae, Glycyrrhiza uralensis Fisch, Paeonia lactiflora Pall, and Ziziphus jujube Mill belong to herbs thought to strengthen healthy Qi. In contrast, Scutellaria baicalensis Georgi, Bufo bufo gargarizans Cantor, and Scutellaria barbate D. Don are herbs able to clear heat and remove toxins, while Gekko japonicas Dumeril et Bibron, Bungarus Parvus, and Agkistrodon reduce phlegm and soften hard solid mass. In the studies reviewed, herbs for strengthening healthy Qi appear to modulate immunity or affect the process of cancer cell cycle, while the heat-reducing and detoxifying herbs modulated immunity or induced cancer cell apoptosis. The anticancer mechanisms of herbs of reducing phlegm and softening hard solid mass were not reported in the animal studies. Choice of herbs used should also be in accordance with TCM Syndrome Differentiation, a theory that involves the categorization of patients into different patterns of unbalanced homeostasis, which is a vital element of TCM practice .
3.2. Quality Control of CHM to Ensure Batch-to-Batch Consistency of Clinical Efficacy
Quality control is crucial for ensuring the safety and efficacy of CHM . Consistent CHM batch preparation is essential for the reliability of clinical and preclinical studies. However, many studies including some described in this review fail to mention the quality control aspects of the CHM herb of interest or the combined complex multiple-herb CHM formula. This is understandable as CHM formulas may contain hundreds of different components. In addition, the majority of active ingredients related to the effective use of CHM in disease treatment are currently unknown. Thus, to control the production of such complex matrices of diverse compounds in single herb or herbal formulae with predictable clinical efficacy is extremely difficult or even not possible.
At present, identification of the major components in the CHM preparations is by means of an array of fingerprint technologies accredited by the World Health Organization as evaluation tools . These fingerprinting techniques comprise high-performance liquid chromatography, capillary electrophoresis, gas chromatography, X-ray diffraction, and DNA fingerprinting . However, it should be noted that major “peaks” or “features” may not have any relationship with the bioactivities or the desirable clinical effects of that particular herb or formula.
The studies of PHY906 highlight the use of “PhytomicsQC” that integrates both chemical and biological fingerprinting to evaluate different batches of PHY906 in order to effectively provide a robust quality control platform of batch-to-batch consistency of the four-herb CHM formula . Another approach advocated by Chau and his team was the use of “Quantitative-Pattern-Activity-Relationship (QPAR) [42, 43]. Using whole herbal medicines chromatographic/fingerprint profiles and their corresponding total biological activities as input, by means of sophisticated chemometrics computation, the QPAR approach can be used to explore and exploit the relationship between the CHM whole fingerprint profiles and their biological activities. Firstly, QPAR can reveal the important multiple features in the chromatographic profiles responsible for the biological activities, secondly, build a model for activities prediction simply using the chemical fingerprinting profiles, and thirdly, discover the active ingredients of the HM by identifying the multiple genuine “active” regions on the chromatogram, which are not necessarily the major components. In summary, future clinical trials using CHM should consider use of either “QPAR” or “PhytomicsQC” or similar platforms for the quality control of the batch to batch consistency to ensure reproducible clinical efficacy.
Other than quality control issues mentioned earlier, a few other important areas also require stringent control and management in order to obtain excellent batch-to-batch consistency. These areas comprise good manufacturing process conditions for high standard production and good agricultural practice to safeguard standardized plant cultivation.
3.3. Herb-Chemotherapeutics Interactions
Since CHMs have commonly been used in an integrative way with standard chemotherapeutics in cancer management protocols, it is pertinent to investigate if any herb-drug interaction is occurring. From both the physicians’ and patients’ points of view, it is important to understand if the CHMs affect the pharmacokinetics of the chemotherapeutic agent by reducing the level of chemotherapeutics in the patients’ blood leading to failure to provide enough dosage inside the cancer cells. Conversely, herb-drug interaction may also potentially relate to the drug safety, if the herb unexpectedly enhances absorption of the chemotherapeutic agent. For instance, in a clinical trial of lung cancer, an astragalus-based herbal formula, Jinfukang, was shown to alter the pharmacokinetics of docetaxel, with most patients experiencing increase in docetaxel levels by at least 33%, although no clear trend was evident .
Currently, there are few reports describing this key aspect of herb-drug interaction. One study has addressed the effects of PHY906 on the pharmacokinetics of CTP-11, capecitabine, gemcitabine, and sorafenib in colorectal cancer, HCC, and pancreatic cancer, respectively, in animal models . Importantly, results indicated that PHY906 did not affect the metabolism of these chemotherapeutic agents or their corresponding metabolites. However, it has to be noted that these findings were based on animal studies only, and it is therefore important that a similar approach should be adopted for human clinical trials. There is a clear need for more systematic coordinated herb-chemotherapeutic interaction studies to provide an in-depth knowledge base about use of combination therapy.
3.4. Mechanistic Evaluation of CHMs Leading to Personalized Integrative Medicine
Traditional Chinese Medicine theory proposes CHM formulae may provide holistic, multitargeted, multidimensional pharmacological therapies leading to effective cancer management. Accordingly, the mechanisms of action of CHM for liver cancer are also likely to be multifactorial. As shown in Tables 1 and 2, the potential mechanisms of action include anti-inflammation, antiangiogenesis, antivirus, apoptosis-induction, cell cycle arrest, modification of tumor microenvironment, and immune-modulation.
To date, relatively few studies have examined the mechanistic effects of CHM on the immune response, and the specific target proteins or the underlying related signal transduction pathways affected by CHM have also not been addressed. This may be due to the current poor understanding of the actual targets of the multiple active compounds of the CHM responsible for the clinical effects. A coordinated network of laboratories collaborating to determine these effects is urgently needed.
Methodologies to approach these multitargeted, multidimensional pharmacological activities of CHM have been proposed by several research groups [45–47]. These platforms make use of recent advances in “Omics” bioinformatics, pharmacogenomics, and systems biology, which have all been found to be useful for the analysis of diverse complex data .
Furthermore, as CHM targets the underlying disturbed homeostasis, studies concerning the mechanisms related to the characteristics of TCM Syndrome Differentiation that reflect the inner health status of the body should be conducted . Recent reports discovering “phenotypes” based on the systems biology approach may be the beginning of a new frontier of scientific research into this important aspect of TCM Syndrome Differentiation [50, 51]. A sophisticated and fuller understanding of Syndrome Differentiation may lead to TCM-based personalized treatment strategies for HCC CHM or integrative treatment, or it may provide the rationale for patient stratification of groupings with similar homeostasis imbalances for interpretation of clinical trials.
This review focused on some CHM therapies reported to have significant effects for liver cancer. These therapies have not yet gained wide acceptance as part of integrative liver cancer management. The explanation for this is multifaceted.
First, many publications of the use of CHMs in liver cancer management are written in Chinese; of the 139 articles excluded from this review, 85 were rejected due to this language criterion. These papers could potentially include useful information; however, they may suffer from the severe inadequacy of lack of independent assessment for veracity and reproducibility by western scientists .
Second, this review highlights preclinical studies using various laboratory experimental platforms and animal cancer studies, which are important for providing evidence of the efficacy and mode of action of CHMs in liver cancer clinical trials. This approach illustrates the potential of reverse-translational research. Laboratory experimental platforms are used to study the mechanisms of action and the potential “active ingredients” in the CHMs in relation to the effective clinical trials results. Such knowledge can lead to modifications of treatment and assist in the quality control of the CHM using defined amounts of those “active ingredients.” This knowledge can then be applied to the patients, leading to improvement and consistency of both clinical efficacy and safety.
Third, although some of the clinical studies included in this review suffered from problems of study design or other quality issues, they nevertheless provide credible evidence suggesting effectiveness of some selected CHMs. Further trials ensuring high quality control of production of CHM agents to reduce the batch-to-batch variations and rigorously designed randomized, controlled, multicentre trials are required.
In this review, most clinical studies examined the effectiveness of CHM therapies for liver cancer. In TCM, the medicines are prescribed according to syndrome. Syndrome differentiation remains the essence of CHM treatment and is the key to evaluating a patient’s disease state and developing an efficient, individualized treatment strategy. Therefore, syndrome differentiation should be applied to the treatment of liver cancer by CHM, possibly using a personalized treatment plan or a set of plans for a few defined syndrome profiles. We believe that the application of TCM syndrome differentiation to disease diagnosis can yield improved therapeutic efficacy. We also envision that TCM syndrome will be able to be assessed by modern technologies in the future. The diagnosis and efficacy of CHM therapies for liver cancer can then be evaluated on a molecular and Systems biology basis.
In this study, we systematically reviewed some CHMs for the treatment of liver cancer. We first summarized the CHM extracts or formulas in preclinical studies and clinical trials and evaluated these studies with focus on the mechanisms of action and TCM theory. Analysis of these clinical trials revealed the need for cautious interpretation of results as apparent benefits may actually attributable to various forms of bias inherent in the study designs. Overall these CHM agents appeared to be potentially beneficial, and further well-designed and controlled randomized clinical trials should be performed to enhance the creditability of CHM treatment. This critical analysis of the CHM anti-HCC research covered methodology in clinical trials, TCM Syndrome Differentiation and prescription, quality control for therapeutic consistency, assessment of herb-drug interactions, and the outlined shortcomings. The learned lessons based on the suggested improvements may contribute to the enhancement of developing a comprehensive evidence-based liver cancer CHM research platform.
This work was supported by National Science Foundation of China (81102579) and Longhua Medical Project (no. LYTD-02). The authors are also very indebted to Dr. Maureen Boost of The Hong Kong Polytechnic University for editing and proofreading of the paper.
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- R. A. Collins, “A ten-year audit of traditional Chinese medicine and other natural product research published in the Chinese Medical Journal (2000–2009),” Chinese Medical Journal, vol. 124, no. 9, pp. 1401–1408, 2011.
Copyright © 2013 Zhan Zheng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

domain: medical


text:
It was the Washington Capitals' turn to trash a birthday party last night. Toronto Coach Mike Nykoluk turned 47 -- and purple -- as the Capitals rolled up the highest score in their history in defeating the Maple Leafs, 11-2.
In a coincidence worthy of Ripley, just six nights ago Toronto had defeated the Capitals, 9-4, as Washington Coach Bryan Murray marked his 39th birthday.
Besides setting a club record for goals, the Capitals added marks with 53 shots on goal, nine unanswered goals, 30 scoring points and 19 assists. They tied team standards with 22 shots in one period, six goals in a period, six straight home triumphs and seven games without a loss at home.
Bobby Carpenter, Ryan Walter and Dennis Maruk each scored two goals for Washington. Carpenter, who lifted the Capitals into double figures for the first time in that 10-4 rout of Philadelphia Nov. 21, produced No. 11 this time. Incredibly, it came with almost 23 minutes left to play, but a combination of a natural letdown and some fine stops by Toronto goalie Bunny Larocque kept the score from mounting.
The triumph lifted Washington within three points of the fourth-place New York Rangers in the Patrick Division. The Capitals have a chance to creep closer tonight when they visit third-place Pittsburgh (WTOP-1500 at 8).
While Nykoluk lectured his players for the embarrassing performance, Murray was not 100 percent pleased, either. He kept recalling that 9-4 loss and wondering how it got away against the NHL's only sixth-place team.
"It's frustrating to think back to that game, playing against the same guys, and know we were so bad," Murray said. "We're playing consistently at home, but we want it to carry over on the road. That's a big game in Pittsburgh. I hope we can keep this going."
Carpenter opened the scoring at 5:21, on a setup by Tim Tookey, and at that point the shots were 7-0. Tookey then hit a power-play goal at 9:02 to make it 2-0. Darryl Sittler pulled the Leafs within a goal 15 seconds later, but Washington scored the next nine, in the space of 26 minutes 10 seconds.
"The only stage we were in the game was when it was 2-1," Nykoluk said. "We were never in it after that. To me only about five guys really tried, and two of them were goaltenders. That doesn't leave much to choose from. No one wanted to do anything to get involved."
While the Leafs joined the crowd of 13,172 in watching the Capitals perform, Gaetan Duchesne, Bengt Gustafsson and Walter boosted Washington's margin to 5-1. The shots were 22-6 at period's end and Maruk made it 6-1 on Washington's first shot of the second period. When Rick Green turned quickly at the left-wing boards and sent a long shot past starting goalie Vince Tremblay, Nykoluk summoned Larocque to the rescue.
At that point the shot clock read 27-9 and Nykoluk said, "There was no point making Tremblay suffer any longer, just because the rest of the guys weren't playing."
Maruk's waist-high deflection of a pass by Chris Valentine less than two minutes later raised the rout to 8-1 and Valentine, Walter and Carpenter had it up to 11 by 17:08 of the period. Some folks were wondering if Montreal's 61-year-old record of 16 goals in a game would fall, but the Capitals could not maintain the pace.
The first whistle of the third period came 7 1/2 minutes after the opening faceoff, as neither team did much to delay the inevitable.
"We didn't want to play poorly in the third period, because we wanted to carry this play over to tomorrow," Murray said. "I think we skated pretty well, but Larocque made some good saves. We didn't need any more goals anyway."
Washington scored four extra-man goals in nine attempts, as the Leafs repeatedly took foolish penalties. The power-play record under Murray is 25 for 92, after a 10-for-60 mark before he arrived.
"We wanted to be organized on the power play and we wanted to be aggressive forechecking," Murray said. "We thought the weakness of their hockey team was their blueline corps and we worked on it."
"Most of the penalties we took were stupidity," Nykoluk said. "You can't check from behind."
Walter now has scored goals in five straight games and points in eight. Valentine, with a goal and three assists, has 17 points in nine NHL games. He repeatedly set up Maruk and Walter for hat-trick attempts in the third period, without receiving further statistical recognition.
"I looked up there in the second period and we had 40 shots," Valentine said. "Not many goaltenders won't get worn out from that. We had so much momentum going. We'd just go down and score, go down and score. It just keeps building up."
Most of the Capitals have friends and relatives in Ontario and Murray felt the debacle last week was attributable, at least in part, to a tendency by everyone to try to do too much to impress them.
"Maybe we did try to work extra hard up there and when you do that, you get out of Bryan's system," Wes Jarvis said. "We worked up there, but nothing happened. After the last two losses, we had to have a win tonight. It shook us up and we had our noses to the grindstone."
Al Jensen played a superb game in goal for Washington, with 29 saves . . . Mike Palmateer skated in the morning workout, but had difficulty moving with his sore right knee . . . Jensen will play until Dave Parro feels his shoulder is fit, then Parro will become the No. 1 man. . . Paul MacKinnon was back on defense, after a month in Hershey. Timo Blomqvist was sent to the farm team . . . The club also announced it was sending forward Harvie Pocza to Hershey and calling up defenseman Howard Walker.

domain: news


text: Global and International Funds Investors seeking world investments can choose between global and international funds. What's the difference? Related Content A Brief Guide To Condo Insurance Important items to consider when purchasing condo insurance. Four Great, Unexpected Places to Raise a Family Here are 4 great, and sometimes unexpected, places to raise a family. New Retirement Contribution Limits for 2023 A look at the new, record-high retirement contribution limits from the IRS.

domain: finance


SHENZHEN BERGEK TECHNOLOGY CO., LTD. has been strengthening the development of new products and has gained promising results. Compared with other similar Guangdong, China products in the market, Sheet metal fabrication, CNC machining, CNC milling, CNC turning, Sheet metal bending, stamping, welding, and Custom metal parts can be very stable and long-lasting when applied in the field(s) of Machining Services. SHENZHEN BERGEK TECHNOLOGY CO., LTD. adheres to the corporate spirit of 'pragmatism & innovation' and aims to create benefits for our stakeholders. Driven by the fierce competition in the market, SHENZHEN BERGEK TECHNOLOGY CO., LTD. hold a firm belief that we must focus on R&D and develop new technologies to adapt to the market trends.
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German-born soprano, Crystal Marie is a thriving young performer in the New England musical community. During her reign last year as Ms. Maine 2018, she was named a top 10 finalist in Boston’s American Idol auditions.
Crystal is currently competing in songwriting competitions around the US. This fall, she will record an album in Nashville and can be seen performing in Masterstroke Experience, a Queen tribute band, around New England. She coaches private vocal lessons and acting for students of all ages.
Interesting facts: She threw up on Elvis’ pool table as a kid (not on purpose)She is a certified Life Coach. She sang and also spoke about eating disorder recovery to 20,000 people last year at WEBelieve summit in Saint John, New Brunswick.


text:
Sleep medications like Ambien (zolpidem) are designed to assist people for a short period of time. The sleep these drugs can deliver can allow people to catch up on their rest and feel a little more refreshed, and when they do, they might be more likely to sleep soundly without the assistance of any medications at all. In general, people who take these drugs properly for a few nights don’t experience problems experts would classify as addictions. However, if the abuse continues, an addiction could very well take place within a remarkably short period of time.
Measuring the Dangers
It’s difficult to determine exactly how long it might take for a person to develop an addiction to Ambien, simply because the drug works so very differently in different people. For example, someone who is petite and dainty might develop an addiction much quicker than a person who is large and bulky, simply because the smaller person is obtaining a bigger hit with each pill taken.
Similarly, it can be difficult to measure onset of Ambien addiction because many people who develop these problems already have an addiction in play. For example, in an article in the journal Addiction, researchers suggest that zolpidem abuse was typically associated with the use of opiates, and those who used zolpidem only did so in order to augment the use of their drug of choice. Measuring an addiction in a person like this might be hard, simply because there are too many drugs in the person’s body at any given time.
In general, however, experts suggest that people who take these sorts of drugs for weeks at a time, with no sobriety break in the middle, can develop a physical dependence on the drug. At the same time, they might develop a psychological need to take the drug, and they might be willing to do anything to ensure that they have access to the drug they want. This is typically considered an addiction.
It can be tempting to ignore an Ambien addiction, as some families might hope that turning a blind eye could allow the person to heal without suffering any embarrassment. However, zolpidem is much too dangerous to ignore. For example, in a study conducted at China Medical University in Taiwan, researchers found that Ambien use was associated with cardiovascular disease. Other studies have linked the drug with impulsive eating and even sleep driving. Leaving the addiction in place could mean exposing people to all sorts of dangers.
- Individual therapy
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This is the kind of help we can offer at Black Bear Lodge. Our counselors have years of experience in helping people to understand their zopidem addictions, along with the steps they’ll need to take control of those problems. Whether the addiction is old or new, we can help. Please call us, and we’ll tell you more about our zolpidem (Ambien) program and what it can do for your family.

domain: psychology


text:
Hong kong and chinese officials have actually struck right back at us sanctions and one of this citys economic regulators cautioned organizations as to how they react to the actions, on a daily basis after donald trump significantly ratcheted up their fight with beijing within the area.
The us president on friday imposed limitations on 11 hong-kong and chinese officials, including carrie lam, hong kongs chief executive, and luo huining, mainland chinas top authoritative in town. the actions will freeze possessions the individuals hold in america and prevent them from doing business in the united kingdom.
The sanctions will be the newest step in an escalating struggle between asia in addition to united states after beijing relocated to enforce a controversial nationwide safety legislation regarding the town following months of anti-government protests just last year.
Mr trump has already revoked hong kongs unique trade condition, a designation that exempted the city from restrictions the united states relates to mainland china, in an indicator that washington no more views the area as independent from beijing.
Independently, mr trump on friday banned us businesses from using two leading chinese technology teams: wechat, the texting system possessed by tencent; and bytedance, the master of tiktok, a video clip app that microsoft is within foretells buy. he also recommended that chinese businesses be delisted from us stock areas unless beijing allowed united states regulators appropriate usage of the firms accounts.
Edward yau, hong kongs business assistant, called the sanctions unreasonable and barbarous, and said they would fundamentally backfire against united states investment in the asian financial hub.
Mr luo, director of beijings representative company in the city, stated his addition in the listing revealed he had done what he needs to have done for china and hong kong. he included he did not have one penny of possessions international but could send $100 towards the united states for mr trump to freeze.
Hong kongs securities and futures commission, the securities regulator, stated it absolutely was keeping track of closely what impact the sanctions could have on city. it included it would anticipate any reaction from economic organizations becoming essential, reasonable, and also have regard to the most effective passions of the clients and integrity for the marketplace.
The sfc included it was uninformed of any facet of the new sanctions which would affect the way firms carry on their regular functions in hong-kong.
The hong kong financial expert, the citys de facto central lender, said in a letter to financial institutions and ms lam that unilateral sanctions enforced by international governing bodies had no appropriate status within the area. it included that panels and senior management of [authorised organizations] needs to have specific regard to the treat customers relatively maxims.
Financial institutions in hong-kong have-been grappling to understand the ramifications regarding the barrage folks constraints. a senior town official told the financial circumstances final thirty days that members of the federal government had been finding it more and more tough to bank with foreign loan providers because of growing tensions between your us and china over the area.