Latest Issue
      2019 Year 25 Vol. 4 Issue

        Feature Article

      • Rui-hua ZHAO
        2019, 25(4): 243-245. DOI: 10.1007/s11655-018-2931-9
        Abstract：Endometriosis (EM) is a major cause of infertility and has a complex pathogenesis, which brings severe challenges in both clinical treatment and scientific research. Current clinical research focuses on the difficult problem of improving the pregnancy rate of EM patients. Our studies found that Chinese medicine has significant advantages in terms of improving the pregnancy rate of EM patients.  
        Keywords：endometriosis;infertility;promoting blood circulation-regulating Gan (Liver)-tonifying Shen (Kidney) sequential therapy   
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        Original Article

      • Yan DENG,Wei XUE,Yan-fang WANG,Xiao-hui LIU,Shi-yang ZHU,Xiao MA,Hong-ling ZUO,Jian-fa JIANG,Ting-ping ZHENG,Ai-jun SUN
        2019, 25(4): 246-251. DOI: 10.1007/s11655-018-2947-1
        Abstract：Objective:To assess the efficacy and safety of the Chinese medicine Dingkun Pill (定坤丹, DKP) on insulin resistance in women with polycystic ovary syndrome (PCOS).Methods:A total of 117 women with PCOS were randomly assigned to Group A (38 women), Group B (40 women), or Group C (39 women) in a randomization sequence with SAS software and a 1:1:1 allocation ratio using random block sizes of 6, and were given 7 g of oral DKP daily (Group A), 1 tablet of Diane-35 orally daily (Group B), or 7 g of oral DKP daily plus 1 tablet of Diane-35 orally daily (Group C). Patients took all drugs cyclically for 21 consecutive days, followed by 7 drug-free days. The treatment course for the 3 groups was continued for 3 consecutive months. Oral glucose tolerance tests (OGTT) were performed before treatment and again after 2 and 3 months of therapy, respectively, and homeostasis model assessment for insulin resistance (HOMA-IR) and quantitative insulin sensitivity check index (QUICKI) were calculated.Results:Of 117 women with PCOS, 110 completed the entire course of therapy: 35 in Group A, 36 in Group B, and 39 in Group C. After treatment, all three groups showed significant decreases in fasting glucose: at 1 h glucose decreased significantly in Group A (by 0.5±1.4 mmol/L, P=0.028) and Group C (by 0.5±1.2 mmol/L,P=0.045); while showing a tendency to increase in Group B (by 0.4±1.9 mmol/L, P=0.238). HOMA-IR decreased significantly in Group C [by 0.5 (–2.2 to 0.5) mIU mmol/L2, P=0.034]. QUICKI was significantly increased in Groups A and C (by 0.009±0.02, P=0.033 and by 0.009±0.027, P=0.049, respectively), while no change was observed in Group B. Repeated-measure ANOVA showed that the absolute changes in all parameters (except for glucose at 1 h), including glucose and insulin levels at all time-points during OGTT and in HbA1c, HOMA-IR, and QUICKI, were not significantly different among the 3 groups after treatment (P>0.05).Conclusion:DKP or DKP combined with Diane-35 produce a slight improvement in insulin sensitivity compared with Diane-35 alone in PCOS patients (Trial Registration: ClinicalTrials.gov, NCT03264638).  
        Keywords：Diane-35;Dingkun Pill;Chinese medicine;polycystic ovary syndrome;oral glucose tolerance tests;insulin resistance   
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        Published：2021-08-27
      • Hai-cui WU,Jian-wei ZHANG,Zhen-gao SUN,Shan XIANG,Yan QIAO,Fang LIAN
        2019, 25(4): 252-258. DOI: 10.1007/s11655-019-2948-3
        Abstract：Objective:To observe the effects of electroacupuncture (EA) on reproductive outcomes in women with Shen (Kidndy) deficiency syndrome after in vitro fertilization-embryo transfer (IVF-ET), and explore the underlying molecular mechanism.Methods:Sixty-six infertile patients with Shen deficiency syndrome undergoing IVF-ET were divided into EA or control groups according to a random table, 33 cases in each group. Before undergoing IVF, patients in the EA and control groups received EA therapy and placebo needle puncture, respectively, for 3 menstrual cycles. Shen deficiency syndrome scores were assessed. Other outcome measures included the number of retrieved oocytes and fertilization, high-quality embryo and clinical pregnancy rates. Follicular fluid was collected on the day of oocyte retrieval, and granulosa cell expression of phosphatidylinositide 3-kinases (PI3K), serine-threonine kinase (Akt) and forkhead box O3 (Foxo3a) mRNA were measured by reverse transcribed and quantitative real-time polymerase chain reaction.Results:Syndrome scores for pre- versus post-treatments decreased significantly (16.53±1.75 to 8.67±1.61) in the EA group (P<0.05), but showed no significant change in the control group (17.18±1.58 to 14.74±1.58). A significant difference in score change was found between the EA and control groups (P<0.05). High-quality embryo and clinical pregnancy rates were both increased in the EA group compared with the control group [69.15% (195/282) vs. 60.27% (176/292) and 66.67% (22/33) vs. 42.42% (14/33), respectively, P<0.05]. The fertilization rate was equivalent in EA and control groups. No difference was found in the number of retrieved oocytes between the two groups. Granulosa cell expression levels of PI3K and Akt mRNA were significantly increased in the EA group compared with the control group, while the expression of Foxo3a was reduced (all P<0.05).Conclusions:For infertile patients with Shen deficiency syndrome undergoing IVF, EA for tonifying Shen as an adjunct treatment may alleviate clinical symptoms and improve the high-quality embryo rate. The EA-induced mechanism may involve regulation of PI3K/Akt/Foxo3a expression in granulosa cells to improve the developmental microenvironment of oocytes and inhibit granulosa cell apoptosis, possibly contributing to the improved clinical pregnancy rate (Registration No. ChiCTR 1800016217).  
        Keywords：in vitro fertilization-embryo transfer;Shen deficiency;electroacupuncture;granulosa cells;PI3K/Akt/Foxo3a   
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        Published：2021-08-27
      • Hu-dan PAN,Xiao-li QI,Lei WANG,Jing-yan HE,Jiu-li LIU,Yun-bi ZHANG,Ye TIAN,Xing-wu DUAN,Hao-yu YANG,Yan-ping BAI
        2019, 25(4): 259-263. DOI: 10.1007/s11655-018-2940-8
        Abstract：Objective:To observe the clinical effectiveness and safety of fire-needle therapy, an external approach of Chinese medicine in treating plaque psoriasis.Methods:This study was a two-parallel-arm randomized controlled trial. A total of 151 participants with plaque psoriasis were randomly assigned to the fire-needle therapy group (treatment group, 76 cases) or the control group (75 cases) at a 1:1 allocation ratio using SAS software. All participants received Oral Huoxue Jiedu Decoction (活血解毒汤, HXJDD) and applied externally vaseline cream twice a day. Participants in the treatment group received fire-needle therapy once weekly for 4 weeks plus HXJDD and vaseline cream applied the same as the control group. The primary outcome measure was Psoriasis Area and Severity Index (PASI) score, and the secondary outcomes were Dermatology Life Quality Index (DLQL), and Hamilton Anxiety Rating Scale (HAMA), as well as Chinese medicine (CM) syndrome score and photos of target lesions. The indices were evaluated before and after treatment.Results:Sixty-eight patients in each group completed the study. The treatment group has not yet achieved significant improvement in PASI score (P>0.05) compared to the control group. However, significant differences were found between the two groups in relieving CM syndrome (P<0.05) and improving quality of life (P<0.05).Conclusions:Fire-needle appears to be safe and may have benefit for psoriasis, the short-term treatment and small sample size limit the conclusions of this study. Further rigorous randomized controlled trials with longer treatment are recommended.  
        Keywords：fire-needle therapy;Chinese medicine;Huoxue Jiedu Decoction;plaque psoriasis;randomized controlled trial   
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        Published：2021-08-27
      • Xiao KANG,Hua-jun ZHOU,Jian YANG,Jian-hua ZHONG,Tao TANG,Han-jin CUI,Jing-hua ZHOU,Zhi-gang MEI
        2019, 25(4): 264-269. DOI: 10.1007/s11655-018-2917-7
        Abstract：Objective:To evaluate the effect of Buyang Huanwu Decoction (补阳还五汤, BYHWD) on glial scar after intracerebral hemorrhage (ICH) and investigate the underlying mechanism.Methods:Collagenase type Ⅶ (0.5 U) was injected stereotaxically into right globus pallidus to induce ICH model. One hundred and twenty Sprague-Dawley rats were randomly divided into 3 groups according to a random number table, including normal group (n=40), ICH model group (n=40) and BYHWD group (n=40), respectively. After ICH, the rats in the BYHWD group were intragastrically administered with BYHWD (4.36 g/kg) once a day for 21 days, while the rats in ICH group were administered with equal volume of distilled water for 21 days, respectively. Double immunolabeling was performed for proliferating cell nuclear antigen (PCNA)+/glial fibrillary acidic protein (GFAP)+ nuclei. The expression of GFAP and leukemia inhibitory factor (LIF) was evaluated by immunohistochemistry and quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR).Results:The astrocytes with hypertrophied morphology around the hematoma was observed on day 3 after ICH. The number of GFAP positive cells and GFAP mRNA levels increased notably on day 3 and reached the peak on day 14 post-ICH (P<0.01). PCNA+/GFAP+ nuclei were observed around the hematoma and reached the peak on day 14 post-ICH (P<0.01). In addition, LIF-positive astrocytes and LIF mRNA level in the hemorrhagic region increased significantly till day 14 post-ICH (P<0.01). However, BYHWD not only reduced the number of PCNA+/GFAP+ nuclei, but also decreased GFAP and LIF levels (P<0.05).Conclusion:BYHWD could attenuate ICH-induced glial scar by downregulating the expression of LIF in the rats.  
        Keywords：Buyang Huanwu Decoction;intracerebral hemorrhage;glial scar;leukemia inhibitory factor;Chinese medicine   
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        Published：2021-08-27
      • Bo SHUAI,Rui ZHU,Yan-ping YANG,Lin SHEN,Xiao-juan XU,Chen MA,Lin LU
        2019, 25(4): 270-277. DOI: 10.1007/s11655-016-2604-0
        Abstract：Objective:To investigate the impact of Qing'e Pill (青娥丸, QEP) on the cancellous bone microstructure and its effect on the level of β-catenin in a mouse model of postmenopausal osteoporosis.Methods:Ninety-six 8-week-old specific pathogen free C57BL/6 mice were randomly divided into 4 groups (24/group): sham, ovariectomised osteoporosis model, oestradiol-treated, and QEP-treated groups. Three months after surgery, the third lumbar vertebra and left femur of the animals were dissected and scanned using micro-computed tomography (micro-CT) to acquire three-dimensional (3D) parameters of their cancellous bone microstructure. The impact of ovariectomy, the effect of oestradiol and QEP intervention on cancellous bone microstructure, and the expression of β-catenin were evaluated.Results:The oestradioland the QEP-treated groups exhibited a significant increase in the bone volume fraction, trabecular number, trabecular thickness, bone surface to bone volume ratio (BS/BV), and β-catenin expression compared with those of the model group (P<0.05). In contrast, the structure model index, trabecular separation, and BS/BV were significantly decreased compared with those of the ovariectomised osteoporosis model group (P<0.05). No differences were observed in the above parameters between animals of the QEP- and oestradiol-treated groups.Conclusions:The increased β-catenin expression may be the mechanism underlying QEP's improvement of the cancellous bone microstructure in ovariectomised mice. Our findings provide a scientific rationale for using QEP as a dietary supplement to prevent bone loss in postmenopausal women.  
        Keywords：ovariectimised;osteoporosis;micro-Computed tomography;oestradiol;Qing'e Pill;Chinese medicine;β-catenin   
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        Published：2021-08-27
      • Sharma Neha,Kar Anand,Panda Sunanda
        2019, 25(4): 278-284. DOI: 10.1007/s11655-015-1793-z
        Abstract：Objective:To evaluate the comparative effects of fenugreek (Trigonella foenum graecum) seed extract (FSE) alone and in combination with an antidiabetic conventional medicine, glibenclamide (GLB), on the inhibition of in vitro lipid peroxidation (LPO) in liver, the major target organ of a drug.Methods:LPO was induced by ferrous sulphate (FeSo4), hydrogen peroxide (H2O2) and carbon tetrachloride (CCl4) and the effects of test seed extract and/or GLB were evaluated.Results:While FeSo4, H2O2 and CCl4 markedly enhanced the hepatic LPO, simultaneous administration of FSE reduced it in a concentration dependent manner. However, when both FSE and GLB were added to the incubation mixture, chemically induced hepatic LPO was further inhibited. The test extract also exhibited high antioxidative activity in 1,1-diphenyl-2-picrylhydrazyl radical and in 2,2'-azino-bis,3-ethylbenzothiazoline-6-sulphonic acid radical scavenging assays.Conclusion:FSE therapy in moderate concentration along with a hypoglycemic drug may prove to be advantageous in ameliorating diabetes mellitus and other diseases that are LPO mediated.  
        Keywords：fenugreek;glibenclamide;antioxidant activity;lipid peroxidation   
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        Published：2021-08-27

        Acupuncture Research

      • Yu-mei ZHOU,Yi ZHUANG,Ding-jun CAI,Pei-ran LV,Jie ZHOU,Min WAN,Yu-lan REN,Fan-rong LIANG
        2019, 25(4): 285-291. DOI: 10.1007/s11655-018-2932-8
        Abstract：Objective:To quantify the purine concentrations of the acupoints along the pericardium and nonpericardium meridians under healthy and myocardial ischemia conditions to investigate the relationship between acupoint purine change and body functional status in rats.Methods:A total of 70 rats underwent an operation for myocardial ischemia, while 40 of them survived. They were randomly assigned to the following 5 subgroups: Neiguan (PC 6), Quze (PC 3), Tianquan (PC 2), Quchi (LI 11), and Jianyu (LI 15). Simultaneously, another 40 healthy rats were also randomized into the same 5 subgroups as the control group. The tissue fluids at the acupoints were collected by microdialysis for 30 min. Subsequently, the concentration of adenosine triphosphate (ATP), adenosine diphosphate (ADP), adenosine monophosphate (AMP), and adenosine (ADO) were quantified using the high-performance liquid chromatography method.Results:Compared with the healthy group, the ADO at PC 6 (P=0.012), PC 3 (P=0.038), PC 2 (P=0.024), and LI 15 (P=0.042) obviously increased in the model group, while no significant difference was observed at LI 11 (P=0.201). However, ATP, ADP, and AMP manifested no significant changes in these areas, except for ATP at LI 15 (P=0.036).Conclusions:Myocardial ischemia could induce an increase in ADO at acupoints of the upper arm and shoulder area, suggesting that the body functional status could affect the responsiveness of acupoints. The status of these acupoints could be pathogenically activated by disease, and distribution following some specific courses.  
        Keywords：acupoint;myocardial ischemia;pericardium meridian;purine;adenosine;microdialysis;highperformance liquid chromatography   
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      • Tian-wei CUI,Mao QIN,Bao-xing LIU,Yun-xiao GAO,Wen-jing MA,Xiu-ping ZHANG
        2019, 25(4): 292-297. DOI: 10.1007/s11655-018-2915-9
        Abstract：Objective:To assess the effect of electroacupuncture (EA) on expression of cytoskeletal proteins from Sertoli cells (SCs) and spermatogenesis in rats with oligozoospermia of insufficiency of Shen (Kidney) essence syndrome (OIKES).Methods:Twenty healthy male Sprague-Dawley rats were randomly assigned to four groups using a random number table: control, tripterygium glycosides (TG) treatment, sham and EA groups (n=5 in each group). A rat model of OIKES was established by oral gavage with TG. The EA group was treated with TG and received EA at Shenshu (BL 23) and Zusanli (ST 36) acupoints for 20 min, once daily for 30 days, while the sham group received EA at identical acupoints with skin penetration without stimulation. After 30 days, the final body weight and coefficients for the testis and epididymis were calculated and sperm parameters were measured. Immunohistochemical analyses were performed to detect expression of vimentin and α-tubulin in SCs and proliferating cell nuclear antigen (PCNA) immunoreactivity in germ cells. Apoptosis in germ cells was quantified by the transferase biotin-dUTP nick end labeling assay.Results:Compared with the control group, the final body weight and testis/epididymis coefficients of rats in the TG-treated group were not significantly different, but the sperm count and motility were lower (P<0.05). Expressions of vimentin and α-tubulin were also significantly weaker (P<0.01). The PCNA immunoreactivity of germ cells was decreased (P=0.059), whereas the apoptotic index of germ cells was increased significantly (P<0.01). In contrast, EA at BL 23 and ST 36 acupoints significantly improved the final body weight as well as the sperm count, concentration and motility (P<0.01 or P<0.05). EA increased expression of vimentin and α-tubulin in SCs markedly, and significantly enhanced PCNA immunoreactivity with decreased apoptosis in germ cells (P<0.01 or P<0.05).Conclusions:EA at BL 23 and ST 36 acupoints has protective effects on spermatogenesis in rats with OIKES. This effect seems to be achieved by attenuating TG-induced disruption of cytoskeletal protein in SCs.  
        Keywords：electroacupuncture;Sertoli cells;cytoskeletal proteins;oligozoospermia;insufficiency of Shen (Kidney) essence syndrome   
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        Published：2021-08-27

        Clinical Experience

      • Hakan Çoksüer,Mert Ulaș Barut,Murat BozkurT,Elif Agacayak,Sibel Sak,Mustafa Demir,Eray Calıskan
        2019, 25(4): 298-302. DOI: 10.1007/s11655-018-2918-6
        Abstract：Objective:To analyze the effects of acupuncture on in vitro fertilization patients with unexplained infertility.Methods:We retrospectively analyzed the charts of a total of 302 cycles performed in 273 patients attending Assisted Reproductive Technology (ART) Centre from August 2013 to August 2016. During the study period, embryo transfer with acupuncture (Acupuncture group, 46 cases) and without acupuncture (Control group, 42 cases) were applied. Prior to embryo transfer, the following points were used in the acupuncture group: Neiguan (CX 6), Diji (SP 8), Taichong (Liv 3), Baihui (Gv 20), and Guilai (S 29). These sessions were carried out two times before and after embryo transfer in a single day. In addition, auricular acupuncture was also performed at ear points, including ear point 55 (Shenmen), ear point 58 (Zhigong), ear point 22 (Neifenmi) and ear point 34 (Naodian). The biochemical pregnancy rate and clinical pregnancy rate after transplantation were compared between two groups.Results:The clinical pregnancy rate in the acupuncture group was higher than that in the control group [60.9% (28/46) vs. 33.3% (14/42), respectively, P<0.05]. Likewise, the live birth rate in the acupuncture group was also higher than that in the control group [71.7% (33/46) vs. 31.0% (12/42), P<0.01).Conclusion:Administration of acupuncture on the day of embryo transfer dramatically improved fertility results in women who underwent in vitro fertilization/intra-cytoplasm sperm injection for reproduction.  
        Keywords：acupuncture;assisted reproduction;embryo transfer;pregnancy rate   
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        Review

      • Jie LI,Xuan-ke GUAN,Ru-xiu LIU
        2019, 25(4): 307-315. DOI: 10.1007/s11655-018-2943-5
        Abstract：Recently, studying myocardial energy metabolism pathways or improving myocardial metabolism through drugs is another effective strategy for treating ischemic heart disease. Many active components of Chinese herbal medicines (CHMs) have been found to modulate energy metabolism in myocardial cells, cerebral vascular cells, endothelial cells and tumour cells. This paper reviews the advances in studies on the active components of CHMs that modulating energy metabolism in treating cardiovascular diseases over the past five years.  
        Keywords：biologically active ingredient;Chinese herbal medicine;cardiovascular disease;ischemic heart disease;heart failure   
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        Published：2021-08-27
      • Wei SONG,Yong-wei ZHU
        2019, 25(4): 316-320. DOI: 10.1007/s11655-017-2911-0
        Abstract：Diabetic retinopathy (DR), a chronic microvascular retinal disorder leading to retinal nonperfusion and ischemia, is one of the leading causes of blindness among individuals of working age. Inflammation and neovascularization play important roles in the development of DR, especially proliferative DR (PDR). Therapies with Chinese medicines (CMs) that improve microcirculation complementary to conventional treatments increase the chances of delaying PDR development and improving visual acuity in diabetes patients. This review aimed to introduce promising CMs targeting DR patients in clinical practice, together with their underlying molecular mechanisms.  
        Keywords：diabetic retinopathy;Chinese medicine;inflammation;neovascularization   
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