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    2017 Year 23 Vol. 1 Issue

      OriginalPaper

    • Arthur Yin Fan,Jun Xu,Yong-ming Li
      2017, 23(1): 3-9. DOI: 10.1007/s11655-016-2630-y
      Abstract:In the last twenty years, in the United States and other Western countries, dry needling (DN) became a hot and debatable topic, not only in academic but also in legal fields. This White Paper is to provide the authoritative information of DN versus acupuncture to academic scholars, healthcare professional administrators, lawmakers, and the general public through providing the authoritative evidence and experts' opinions regarding critical issues of DN versus acupuncture, and then reach consensus. DN is the use of dry needles alone, either solid filiform acupuncture needles or hollow-core hypodermic needles, to insert into the body for the treatment of muscle pain and related myofascial pain syndrome. DN is sometimes also known as intramuscular stimulati on, trigger points (TrP) acupuncture, TrP DN, myofascial TrP DN, or biomedical acupuncture. In Western countries, DN is a form of simplified acupuncture using biomedical language in treating myofascial pain, a contemporary development of a portion of Ashi point acupuncture from Chinese acupuncture. It seeks to redefine acupuncture by reframing its theoretical principles in a Western manner. DN-like needling with filiform needles have been widely used in Chinese acupuncture practice over the past 2,000 years, and with hypodermic needles has been used in China in acupuncture practice for at least 72 years. In Eastern countries, such as China, since late of 1800s or earlier, DN is a common name of acupuncture among acupuncturists and the general public, which has a broader scope of indications, not limited to treating the myofascial pain.  
      Keywords:dry needling;acupuncture;biomedical acupuncture;authoritative evidence;experts’ opinions;consensus   
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      Published:2021-08-27
    • Li-ming Lu,Jun He,Jing-chun Zeng,Mu-xi Liao,Chao Jia,Hai-hua Pan
      2017, 23(1): 10-17. DOI: 10.1007/s11655-016-2451-z
      Abstract:To evaluate and compare the reports' qualities of acupuncture randomized controlled trials (RCTs) conducted in China before and after the implementation of two guidelines, i.e., the Consolidated Standards of Reporting Trials (CONSORT) statement and the Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA). Proportions of studies that reported CONSORT and STRICTA items were compared for the years before and after implementation of these two guidelines. In addition, the total score of each item's reporting were calculated and reported differences during different date ranges were compared. For CONSORT items (maximum score 8), there was evidence of a slight improvement in reporting between 1994–1995 and 1999–2000 combined (2.5±0.6) and 2004–2005 and 2009–2010 combined (3.0±0.9; difference 0.4, 95% confidence interval, 0.3 to 0.6, P<0.01). For STRICTA items (maximum score 17), there was evidence that a slight improvement in reporting between 1994–1995 and 1999–2000 combined (8.6±2.1) and 2004–2005 and 2009–2010 combined (10.1±1.8; difference 1.5, 95% confidence interval, 1.1 to 1.9, P<0.01). Quality of reporting for RCTs of acupuncture treatment conducted in China have generally improved since the introduction of the STRICTA and CONSORT guidelines.  
      Keywords:acupuncture;quality of reporting;randomized controlled trials;Consolidated Standards of Reporting Trials (CONSORT) statement;Standards for Reporting Interventions in Controlled Trials of Acupuncture (STRICTA)   
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      Published:2021-08-27
    • Jian-guo Jin,Hai-jian Shen,Yuan-lu Shan,Lei Chen,Xi-yue Zhao,Liang-rong Wang,Li-na Lin
      2017, 23(1): 18-24. DOI: 10.1007/s11655-016-2475-4
      Abstract:To compare the effect between nebulized and intravenous administration of Shenmai Injection (参麦注射液) on pulmonary gas exchange function of patients following tourniquet-induced lower limb ischemia-reperfusion. Thirty-eight patients scheduled for lower extremity surgery were randomized into three groups using the closed envelop method: Shenmai Injection was administered 30 min before tourniquet inflflation by nebulization [0.6 mL/kg in 10 mL normal saline (NS)] in the nebulization group or by intravenous drip (0.6 mL/kg dissolved in 250 mL of 10% glucose) in the intravenous drip group, and equal volume of NS was given intravenously in the NS group; 15 in each group. Arterial blood gases were analyzed, serum levels of malonaldehyde (MDA) and interleukine-6 (IL-6) and interleukine-8 (IL-8) were determined using the method of thiobarbituric acid reaction and enzyme-linked immuno sorbent assay respectively just before tourniquet inflflation (T0), and at 0.5 h (T1), 2 h (T2), 6 h (T3) after tourniquet deflflation. Compared with baselines at T0, MDA levels signifificantly increased at T2, T3 in the NS group and at T3 in the nebulization group, and IL-6 and IL-8 levels were signifificantly increased at T2, T3 in NS, the intravenous drip and the nebulization groups (P <0.05). Arterial pressure of oxygen (PaO2) at T3 was decreased, while alveolararterial oxygen tension showed difference (PA-aDO2) at T3 in the NS group; RI at T3 in both intravenous drip and the nebulization groups were enhanced (P <0.05). Compared with the NS group, MDA and IL-8 levels at T2, T3, IL-6 at T3 in the intravenous drip group, and IL-8 at T3 in the nebulization group were all remarkably increased (P <0.05). Additionally, MDA level at T3 in the nebulization group was higher than that in the intravenous drip group (P <0.05). Intravenous administration of Shenmai Injection provided a better protective effect than nebulization in mitigating pulmonary gas exchange dysfunction in patients following tourniquet-induced limb ischemia-reperfusion.  
      Keywords:Shenmai injection;Chinese Medicine;pulmonary gas exchange;tourniquet;administration routes   
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      Published:2021-08-27
    • Wing-sum Siu,Chun-hay Ko,Hing-lok Wong,Si Gao,Wai-ting Shum,Clara Bik-san Lau,Lung-kim Hung,Ping-chung Leung
      2017, 23(1): 25-32. DOI: 10.1007/s11655-016-2474-5
      Abstract:To further investigate the {ptin vitro} effects of an osteoprotective herbal formula "ELP" (Herba Epimedii, Fructus Ligustri Lucidi and Fructus Psoraleae) using seropharmacological approach. Rats were fed with ELP or its individual component herbs for 2 days. The serum containing the postabsorbed ingredients of the herbal items were collected for cell culture using UMR106 cell, RAW264.7 cell and mesenchymal stem cell (MSC) isolated from the bone marrow of the rats. The effects of the herbal-containing serum on cell toxicity were detected by 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay; bromodeoxyuridine assay was conducted to measure the cell proliferation of UMR106 cell and MSC; cell activity was measured using colorimetric method, and mRNA expression of runt-related transcription factor 2 (Runx2), alkaline phosphatase (ALP) and osteopontin (OPN) of UMR106 and MSC as well as matrix metalloproteinase 9 (MMP-9), tartrate-resistant acid phosphatase (TRAP) and cathepsin K of RAW264.7 were analyzed using real-time reverse-transcription polymerase chain reaction. ELP and its component serum exhibited no cytotoxic effects on the cells. The ELP-containing serum increased the proliferation of UMR106 cell and MSC by 25.7% and 14.4 %, respectively and the alkaline phosphatase activity of MSC was increased by 42.6%. On the contrary, it inhibited the RAW264.7 cell differentiation by 29.2 %. ELP serum upregulated the Runx2 expression of UMR and MSC by 1.18 fold and 1.27 fold, respectively. It also upregulated ALP and OPN expression in MSC by 1.69- and 2.12-fold, respectively. On the other hand, ELP serum down-regulated MMP-9 and cathepsin K expression of RAW264.7 cell by 0.46- and 0.36-fold, respectively. The serum of the animals fed with ELP contains active ingredients which are effective in promoting osteogenesis and inhibiting osteoclastogenesis.  
      Keywords:Osteoporosis;seropharmacology;osteogenesis;Herbal Formula   
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      Published:2021-08-27
    • Qin Yin,Cai-jun Wu,Jun Yang,Chen-chen Hang,Chun-sheng Li
      2017, 23(1): 33-39. DOI: 10.1007/s11655-016-2616-9
      Abstract:To investigate the effects of Shenfu Injection (参附注射液, SFI) on cerebral metabolism in a porcine model of cardiac arrest (CA). Thirty Wuzhishan minipigs were randomly assigned to the control group (n=6), epinephrine group (EP group, n=12) and Sfigroup (n=12). After 8 min of untreated ventricular fifibrillation (VF), pigs in the EP group or Sfigroup were administered with either EP (0.02 mg/kg) or Sfi(1.0 mL/kg), respectively. After successful resuscitation, cerebrospinal fluid (CSF) levels of glucose, pyruvate, lactate, glutamate and glycerol were measured at 1, 6, 12 and 24 h after recover from spontaneous circulation (ROSC). In addition, neurologic defificit score (NDS) was calculated at 24 h after ROSC. Surviving pigs were killed at 24 h after ROSC, and the brain tissue was obtained for ultra-microstructure examination. Compared with the EP group, CSF glucose and pyruvate levels were higher (all P<0.01), and lactate levels were lower in the Sfigroup (P<0.01). Meanwhile, CSF glutamate and glycerol levels in the Sfigroup were lower in comparison to the EP group (all P<0.05). In addition, Sfidecreased NDS at 24 h after ROSC (P<0.01), and alleviated the histopathological damage of the brain. Sficould alleviate brain injury after CA, which may be associated with improving cerebral metabolism.  
      Keywords:Shenfu Injection;cerebral metabolism;cardiac arrest   
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      Published:2021-08-27
    • Jian-yong Qi,Juan Yu,Dong-hui Huang,Li-heng Guo,Lei Wang,Xin Huang,Hai-ding Huang,Miao Zhou,Min-zhou Zhang,Jiashin Wu
      2017, 23(1): 40-47. DOI: 10.1007/s11655-016-2621-z
      Abstract:To analyze the effects of salvianolate on myocardial infarction in a murine in vivo model of ischemia and reperfusion (I/R) injury. Myocardial I/R injury model was constructed in mice by 30 min of coronary occlusion followed by 24 h of reperfusion and pretreated with salvianolate 30 min before I/R (SAL group). The SAL group was compared with SHAM (no I/R and no salvianolate), I/R (no salvianolate), and ischemia preconditioning (IPC) groups. Furthermore, an ERK1/2 inhibitor PD98059 (1 mg/kg), and a phosphatidylinositol-3-kinase (PI3-K) inhibitor, LY294002 (7.5 mg/kg), were administered intraperitoneal injection (i.p) for 30 min prior to salvianolate, followed by I/R surgery in LY and PD groups. By using a double staining method, the ratio of the infarct size (IS) to left ventricle (LV) and of risk region (RR) to LV were compared among the groups. Correlations between IS and RR were analyzed. Western-blot was used to detect the extracellular signal-regulated kinase 1/2 (ERK1/2) and protein kinase B (AKT) phosphorylation changes. There were no significant differences between RR to LV ratio among the SHAM, I/R, IPC and SAL groups (P>0.05). The SAL and IPC groups had IS of 26.1%±1.4% and 22.3%±2.9% of RR, respectively, both of which were significantly smaller than the I/R group (38.5%±2.9% of RR, P<0.05, P<0.01, respectively). Moreover, the phosphorylation of ERK1/2 was increased in SAL group (P<0.05), while AKT had no significant change. LY294002 further reduced IS, whereas the protective role of salvianolate could be attenuated by PD98059, which increased the IS. Additionally, the IS was not linearly related to the RR (r=0.23, 0.45, 0.62, 0.17, and 0.52 in the SHAM, I/R, SAL, LY and PD groups, respectively). Salvianolate could reduce myocardial I/R injury in mice in vivo, which involves an ERK1/2 pathway, but not a PI3-K signaling pathway.  
      Keywords:ischemia and reperfusion injury;salvianolate;extracellular signal-regulated kinase 1/2;protein kinase B;Chinese Medicine   
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      Published:2021-08-27
    • Yang Cheng,Jing-yin Mai,Mei-feng Wang,Gao-feng Chen,Jian Ping
      2017, 23(1): 48-54. DOI: 10.1007/s11655-016-2627-6
      Abstract:To study the effect of total flavonoids of Astmgali Radix (TFA) on liver cirrhosis induced with dimethylnitrosamine (DMN) in rats, and the effect on peroxisome proliferator-activated receptor γ (PPARγ), uncoupling protein 2 (UCP2) and farnesoid X receptor (FXR). Fifty-three Sprague-Dawley rats were randomly divided into a control group (10 rats) and a DMN group (43 rats). Rats in the DMN group were given DMN for 4 weeks and divided randomly into a model group (14 rats), a low-dosage TFA group (14 rats) and a high-dosage TFA group (15 rats) in the 3rd week. Rats were given TFA for 4 weeks at the dosage of 15 and 30 mg/kg in the low- and high-TFA groups, respectively. At the end of the experiment blood and liver samples were collected. Serum liver function and liver tissue hydroxyproline content were determined. hematoxylin-eosin (HE), Sirus red and immunohistochemical stainings of collagen I, smooth muscle actin (α-SMA) was conducted in paraffinembedded liver tissue slices. Real time polymerase chain reaction (PCR) was adopted to determine PPARγ, UCP2 and FXR mRNA levels. Western blot was adopted to determine protein levels of collagen I, α-SMA, PPARγ, UCP2 and FXR. Compared with the model group, TFA increased the ratio of liver/body weight (low-TFA group P<0.05, high-TFA group P<0.01), improved liver biochemical indices (P<0.01 for ALT, AST, GGT in both groups, P<0.05 for albumin and TBil in the high-TFA group) and reduced liver tissue hydroxproline content (P<0.01 in both groups) in treatment groups significantly. HE staining showed that TFA alleviated liver pathological changes markedly and Sirus red staining showed that TFA reduced collagen deposition, alleviated formation and extent of liver pseudolobule. Collagen I and α-SMA immunohistochemical staining showed that staining area and extent markedly decreased in TFA groups compared with the model group. TFA could increase PPARγ, it regulated target UCP2, and FXR levels significantly compared with the model group (in the low-TFA group all P<0.05, in the high group all P<0.01). TFA could improve liver function, alleviate liver pathological changes, and reduce collagen deposition and formation of liver pseudolobule in rats with liver cirrhosis. The antifibrotic effect of TFA was through regulating PPARγ signal pathway and the interaction with FXR.  
      Keywords:total flavonoids of Astmgali Radix;dimethylnitrosamine;liver cirrhosis;peroxisome proliferatoractivated receptor γ;uncoupling protein 2;farnesoid X receptor;rat   
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      Published:2021-08-27
    • Wei Wei,Hai-yong Chen,Wen Fan,Shui-fen Ye,Yi-hui Xu,Jing Cai
      2017, 23(1): 55-61. DOI: 10.1007/s11655-016-2618-7
      Abstract:To evaluate the efficacy of Chinese medicine (CM) adjunct to conventional medications for idiopathic Parkinson’s disease (PD). Electronic English and Chinese databases including PubMed, Cochrane Library, Web of Science, Chinese Medical Current Contents, China National Knowledge Infrastructure, China Science and Technology Journal Database, Wanfang Med Database, and Traditional Chinese Medical Database System were used for key words searching in a highly sensitive search strategy. The extracted data was analyzed by the Review Manager 5.0. Twelve trials involving 869 participants were included in the meta-analysis. Unified PD Rating Scale (UPDRS) I, II, III, IV scores and UPDRS V–IV total scores were used to be the primary outcomes, Parkinson Disease Question-39 (PDQ-39) and Scores of Chinese Medical Symptoms were the secondary outcomes. CM adjunct therapy had greater improvement in UPDRS I [2 trials; standardized mean difference (SMD)–0.40, 95% confidence interval (CI)–0.71 to–0.09; Z=2.49 (P=0.01)], II [5 trials; SMD–0.47, 95% CI–0.69 to–0.25; Z=4.20 (P<0.01)], III [5 trials; SMD-0.35, 95% CI–0.57 to–0.13; Z=3.16 (P=0.002)], IV scores [3 trials; SMD-0.32, 95% CI–0.60 to–0.03; Z=2.17 (P=0.03)], UPDRS I–IV total scores [7 trials; SMD-0.36, 95%CI–0.53 to–0.20; Z=4.24 (P<0.05)]. PDQ-39 and Chinese medical symptoms compared to the conventional medication only. CM adjunct therapy has potential therapeutic benefits by decreasing UPDRS scores and reducing adverse effect.  
      Keywords:Parkinson’s disease;Chinese Medicine;meta analysis;randomized controlled trials   
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    • Seong Eun Jin,Hyekyung Ha,Hyeun-Kyoo Shin
      2017, 23(1): 62-69. DOI: 10.1007/s11655-016-2476-3
      Abstract:To assess the effects of traditional herbal formulae Sijunzi Decoction (四君子汤, Sagunja-tang, SJZD), Siwu Decoction (四物汤, Samul-tang, SWD), Bawu Decoction (八物汤, Palmul-tang, BWD) and Shiquan Dabu Decoction (十全大补汤, Sipjeondaebo-tang, SDD) on the activities of human cytochrome P450 (CYP450), a drug-metabolizing enzyme. Herbal formula water extracts were filtered and lyophilized after the powder extracts were dissolved in distilled water. The activities of major human CYP450 isozymes (CYP3A4, CYP2C19, CYP2D6 and CYP2E1) were measured using in vitro fluorescence-based enzyme assays. The inhibitory effects of the herbal formulas on the activities of CYP450 were characterized as half maximal inhibition concentration (IC50) values. All the tested herbal formulae inhibited CYP2C19 activity (IC50: SJZD, 83.28 μg/mL; SWD, 235.54 μg/mL; BWD, 166.82 μg/mL; SDD, 178.19 μg/mL); SJZD (IC50 = 196.46 μg/mL), SWD (IC50 = 333.42 μg/mL) and SDD (IC50 = 163.42 μg/mL) inhibited CYP2E1-mediated metabolism; whereas BWD exhibited comparatively weak inhibition of CYP2E1 (IC50 = 501.78 μg/mL). None of the four herbal formulas significantly affected CYP3A4 or CYP2D6. These results suggest that SJZD, SWD, BWD and SDD could potentially inhibit the metabolism of co-administered synthetic drugs whose primary route of elimination is via CYP2C19. In addition, clinically relevant pharmacokinetic interactions could occur when SJZD, SWD or SDD is co-administered with drugs metabolized by CYP2E1. Our findings provide information for the safety and effective clinical use of these four classic herbal formulas.  
      Keywords:cytochrome P450;Sijunzi Decoction;Siwu decoction;Bawu Decoction;Shiquan Dabu Decoction;herb-drug interactions   
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      Published:2021-08-27
    • Yang Wang,Xi Huang,Mei-zuo Zhong,Ruo-huang Lu,Zi-an Xia,Rong Fan,Bo Liu,Wei Huang,Ping-ping Gan
      2017, 23(1): 70-75. DOI: 10.1007/s11655-016-2619-6
      Abstract:To investigate the effect of Shaoyao Gancao Decoction (芍药甘草汤, SGD) on the pharmacokinetics of intravenously administered paclitaxel in rats. Paclitaxel was intravenously administered to rats (3 mg/kg) with or without the concomitant administration of SGD (752 mg/kg, a single day or 14 consecutive days pretreatment). The paclitaxel in the serum was quantified using a simple and rapid ultra performance liquid chromatography (UPLC) method for the pharmacokinetic study. The pharmacokinetic parameters were calculated via a non-compartment model using the computer program DAS 2.0. The pharmacokinetic parameters of paclitaxel were significantly altered in response to 14 consecutive days of pretreatment with SGD. The area under the curve (AUC0-t, from 4 820±197 to 4 205±186 ng·mL-1·-1) and AUC0-∞ (from 5 237±280 to 4 514±210 ng·mL-1·-1) significantly decreased in response to the 14-day pretreatment with SGD. The values of Vdss (L/kg) were 10.74±1.08 and 9.35±0.49, those of CL (L/kg) were 0.67±0.03 and 0.57±0.03 and the t1/2 (h) values were 11.17±0.84 and 11.32±0.93, respectively, for the 14-day SGD pretreatment and intravenous paclitaxel alone. The AUC0-t and AUC0-∞ values decreased by 13% and 14% (P<0.01), respectively. The area under the curve decreased signifificantly (P<0.01), and the total clearance increased by 1.2-fold (P<0.01), after 14 consecutive days of pretreatment with SGD. A single-day pretreatment with SGD did not signifificantly affect the pharmacokinetic parameters of paclitaxel. SGD administration for 14 consecutive days increased the metabolism of paclitaxel, while a 1-day pretreatment had little effect. The results would contribute important information to the study on interaction between Chinese medicines and chemotherapy and also help to utilize SGD better in the adjunctive therapy of cancer patients.  
      Keywords:paclitaxel;Shaoyao Gancao Decoction;pharmacokinetic;drug interactions   
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      Published:2021-08-27
    • Tun-Pin Hsueh,Yu-Chiang Hung,Wen-Long Hu
      2017, 23(1): 76-79. DOI: 10.1007/s11655-016-2625-8
        
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