Primary liver cancer (PLC) is one of the most common solid malignancies. However, PLC drug development has been slow, and first-line treatments are still needed; thus, studies exploring and developing alternative strategies for effective PLC treatment are urgently needed. Chinese herbal medicine (CHM) has long been applied in the clinic due to its advantages of low toxicity and targeting of multiple factors and pathways, and it has great potential for the development of novel natural drugs against PLC.Purpose: This review aims to provide an update on the pharmacological mechanisms of Chinese patent medicines (CPMs) and the latest CHM-derived compounds for the treatment of PLC and relevant clinical evaluations.Materials and Methods: A systematic search of English literature databases, Chinese literature, the Clinical Trials Registry Platform, and the Chinese Clinical Trial Registry for studies of CHMs for PLC treatment was performed.Results: In this review, we summarize the clinical trials and mechanisms of CPMs for PLC treatment that have entered the clinic with the approval of the Chinese medicine regulatory authority. These CPMs included Huaier granules, Ganfule granules, Fufang Banmao capsules, Jinlong capsules, Brucea javanica oil emulsions, and compound kushen injections. We also summarize the latest in vivo, in vitro, and clinical studies of CHM-derived compounds against PLC: icaritin and ginsenoside Rg3. Dilemmas facing the development of CHMs, such as drug toxicity and low oral availability, and future developments are also discussed.Conclusion: This review provides a deeper the understanding of CHMs as PLC treatments and provides ideas for the development of new natural drugs against PLC.

Background. Chinese herbal medicine (CHM) has been used in the treatment of chronic heart failure (CHF) for a long time. Treatment based on syndrome differentiation and the main characteristic of TCM is the fundamental principle of TCM practice. In this study protocol, we have designed a trial to assess the efficacy and safety of CHM on CHF based on syndrome differentiation.Methods/Design. This is a three-stage trial of CHM in the treatment of CHF. The first stage is a literature review aiming to explore the common syndromes of CHF. The second is a multicentral, randomized, placebo-controlled trial to evaluate the efficacy and safety of CHM for the treatment of CHF. The third is a multicentral, randomized controlled clinical trial aiming to make cost-effectiveness analysis and evaluate the feasibility, compliance, and universality of CHM on CHF.Discussion. This trial will evaluate the efficacy, safety, feasibility, compliance, and universality of CHM on CHF. The expected outcome is to provide evidence-based recommendations for CHM on CHF and develop a prescription of CHM in the treatment of CHF. This trial is registered withNCT01939236(Stage Two of the whole trial).

Coronary microvascular dysfunction(CMVD) refers to a clinical syndrome of myocardial ischemia caused by abnormal microvascular structure or function of coronary arteries with a diameter less than 500µm.It is closely related to adverse cardiovascular events,and its treatment remains a clinical challenge. Shexiang Tongxin Dropping Pill(SXDP) shows the effect of improving coronary microvascular perfusion, but the underlying mechanism remains largely unclear.In this study,we aims to observe the effects of SXDP on enhancing coronary blood flow in coronary artery disease(CAD) patients undergoing percutaneous coronary intervention (PCI) treatment and coronary microvascular embolism(CME) mice model while investigating potential mechanisms linked to oxidative stress and inflammatory responses.Firstly, we selected 62 patients with angina pectoris who were negative for cardiac troponin and randomly divided them into control group and SXDP group, with 31 cases in each group. The control group was given aspirin, statin, ACEI, and β-receptor blocker, the SXDP group added the SXDP on the basis of the above drugs. Both groups took the medicine for three consecutive days, coronary angiography(CAG) and(or) PCI were performed on the the fourth day,two hours before surgery, the control group received 300mg of aspirin and 300mg of clopidogrel, while the SXDP group received 10 pills of SXDP in addition to the aforementioned medication, Subsequently implemented CAG to observe the corrected TIMI frame count(CTFC) value of coronary blood flow, as well as the TC, LDL-C, Lp-PLA2,FIB and hs-CRP in serum. Secondly,we utilized electrocardiogram recordings, laser speckle imaging, and histological examination to assess the enhancement of coronary blood flow in CME mice model induced by autologous blood clot particles following SXDP treatment. Additionally, an in vitro model of oxygen-glucose deprivation (OGD) was established using human umbilical vein endothelial cells(HUVECs) to investigate the impact of SXDP on lncRNA H19 and P66^shc DNA methylation. In clinical trials, we observed that SXDP can increase coronary CTFC values and reduce the serum levels of TC, LDL-C, Lp-PLA2, FIB and hs- CRP to varying degrees.And in the CME mice model, SXDP was found to enhance myocardial blood supply, decrease thrombosis and myocardial micro- infarctions, and improve coronary microvascular endothelial function. In vitro experiments, we observed SXDP enhances p66^shc DNA methylation through the inhibition of lncRNAH19 expression, leading to a reduction in oxidative stress and inflammatory responses in coronary microvessels. Our findings suggested that SXDP can effectively improve coronary microvascular blood flow in patients with CAD and CME model mice,Simultaneously, lncRNAH19 is a key molecule in SXDP's regulation of P66^shc,we should focus on lncRNAH19 as potential values for evaluating CMVD.