Latest Issue

    2020 Year 26 Vol. 11 Issue

      Original Article

    • Wei-ping HU,Xiao-dan WU,Zhuo-zhe LI,Jing ZHANG
      2020, 26(11): 806-811. DOI: 10.1007/s11655-020-3321-2
      Abstract:Objective:To investigate the efficacy of Qingfei Yihuo Capsules (清肺抑火胶囊, QYCs) in preventing the air pollution associated exacerbation of chronic obstructive pulmonary disease (COPD).Methods:This was a prospective, parallel, single-blind, randomized, placebo-controlled trial. Sixty patients with stable Group D COPD were randomly allocated to receive either oral QYCs (intervention group) or placebos (control group, 30 cases per group) for 15 days in the presumed high-incidence air pollution season and followed-up for 1 year. Both groups were given individualized Western medicine therapy according to the Global Initiative for Chronic Obstructive Lung Disease criteria as usual. Total and separate numbers of acute exacerbation (AE) associated with striking air pollution was the primary outcomes. Secondary outcomes included total numbers of deteriorating respiratory symptoms and separate numbers associated with striking air pollution, as well as scores of COPD Assessment Test (CAT) and modified Medical Research Council Scale (mMRC).Results:All the 60 patients completed the study. There was no statistical significance in total numbers of AE between the two groups (P>0.05). Compared with the control group, a significant reduction in air-pollution associated numbers of deteriorated respiratory symptoms was observed in the intervention group (1.9±1.2 vs. 3.6±2.4, P<0.01). At the end of follow-up, there was no significant difference in CAT and mMRC scores between the two groups (P>0.05). Only 2 patients in the intervention group reported diarrhea and recovered after drug discontinuance.Conclusion:For patients with Group D COPD, oral QYCs in high-incidence season of air pollution can effectively mitigate respiratory symptoms associated with air pollution, although there was no evidence that it had a significant reductive effect on AEs. (Registered at Chinese Clinical Trial Registry, registration No. ChiCTR-IOR-17013827)  
      Keywords:chronic obstructive pulmonary disease;Qingfei Yihuo Capsules;air pollution;acute exacerbation;randomized controlled trial;Chinese medicine   
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      Published:2021-08-23
    • Juan Luis Santiago,Eva Maria Galan-Moya,Jose Ramon Muñoz-Rodriguez,Miguel Angel de la Cruz-Morcillo,Francisco Javier Redondo-Calvo,Ignacio Gracia-Fernandez,Peter M. Elias,Jose Manuel Perez-Ortiz,Mao-Qiang Man
      2020, 26(11): 812-818. DOI: 10.1007/s11655-020-3086-7
      Abstract:Objective:To determine whether topical applications of thiosulfinate-enriched Allium sativum extract (TASE) can accelerate acute cutaneous wound healing (WH) in a murine model.Methods:Keratinocyte viability and in vitro wound closure were assessed in keratinocyte cultures. Effects of topical TASE (0.5 μg/mL of allicin in 97% ethanol) on acute cutaneous WH were determined in a murine model of acute cutaneous wound. Twelve mice were alternately assigned to the vehicle- and TASE-treated groups (n=6 per group). Expression levels of mRNA for keratinocyte differentiation marker-related proteins (filaggrin, loricrin and involucrin) and lipid synthetic enzymes (elongation of very long chain fatty acids protein 4 (ELOVL4), fatty acid synthase (FA2H), 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase (HMGCoA), and serine palmitoyltransferase (SPT)) were assessed using real-time quantitative polymerase chain reaction on day 3 and 8 after wounding, while transepidermal water loss (TEWL) rates were measured in wounded areas.Results:TASE accelerated WH both in vivo (40% vs. 22% reduction in wound area, P<0.01) and in vitro (90% vs. 65% reduction in wound area, P<0.01). Moreover, topical applications of TASE upregulated the expression levels of epidermal mRNA for ELOVL4, HMGCoA, SPT, filaggrin, loricrin and involucrin (P<0.05 vs. vehicle-treated controls) on day 3 after wounding. Likewise, TASE significantly lowered TEWL rates in comparison with vehicle alone on day 8 (33.06±2.09 g/(m2•h) vs. 24.60±2.04 g/(m2•h), P<0.01).Conclusions:Topical applications of TASE stimulated keratinocyte proliferation and formation of epidermal permeability barrier function, leading to acceleration of acute cutaneous WH. Topical products containing TASE could be used to manage acute cutaneous WH.  
      Keywords:Allium sativum;thiosulfinate;wound healing;permeability barrier;keratinocytes;proliferation   
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      Published:2021-08-23
    • Jue WANG,Yin-yin YING,Zhao-hui CHEN,Ke-ding SHAO,Wei-ping ZHANG,Sheng-you LIN
      2020, 26(11): 819-824. DOI: 10.1007/s11655-020-3098-3
      Abstract:Objective:To evaluate the effect of Guilu Erxian Glue (龟鹿二仙胶, GEG) on cyclophosphamide (CTX)-induced bone marrow hematopoietic stem cells (HSCs) senescence in mice and explore the underlying mechanism.Methods:The H22 liver cancer ascites lump model was established in male Kunming mice by injecting intraperitoneally (i.p.) with 5×106/mL H22 cells per mouse. Fifty tumor-bearing mice were divided into the control, model, pifithrin-α, GEG, and GEG+pifithrin-α groups using a random number table, 10 mice in each group. CTX (100 mg/kg i.p.) was administrated to mice from day 1 to day 3 (d1–d3) continuously except for the control group. The mice in the pifithrin-α, GEG and GEG+pifithrin-α groups were treated with pifithrin-α (2.2 mg/(kg•d) i.p.) for 6 consecutive days (d4–d9), GEG (9.5 g/(kg•d) i.p.) for 9 consecutive days (d1–d9), and GEG plus pifithrin-α, respectively. HSCs were collected after 9-d drug treatment. The anti-aging effect of GEG was studied by cell viability, cell cycle, and β-galactosidase (β-gal) assays. The mRNA and protein expressions of cyclin-dependent kinase 2 (CDK2), CDK4, inhibitor of cyclin-dependent kinase 4a encoding the tumor suppressor protein p16 (p16INK4a), p21Cip1/Waf1, p53, and phosphorylated retinoblastoma (pRb) were evaluated by quantitative real-time reverse transcription-polymerase chain reaction and semi-quantitative Western blot, respectively.Results:Compared with the model group, GEG increased cell viability as well as proliferation (P<0.05 or P<0.01) and reduced β-gal expression. Furthermore, GEG significantly decreased the expressions of p16INK4a, p53 and p21Cip1/Waf1 proteins, and increased the expressions of CDK2, CDK4 and pRb proteins compared with the model group (P<0.05 or P<0.01).Conclusion:GEG can alleviate CTX-induced HSCs senescence in mice, and the p16INK4a-Rb signaling pathway might be the underlying mechanism.  
      Keywords:bone marrow suppression;hematopoietic stem cell senescence;p16INK4a;Guilu Erxian Glue;Chinese medicine   
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      Published:2021-08-23
    • Rui-lin LI,Jin-xin WANG,Li-juan CHAI,Hong GUO,Hong WANG,Lu CHEN,Li-min HU,Shao-xia WANG
      2020, 26(11): 825-832. DOI: 10.1007/s11655-020-3088-5
      Abstract:Objective:To investigate the ameliorate effect and underlying mechanism of Xueshuantong for Injection (Lyophilized, 注射用血栓通, XST) in streptozocin (STZ)-induced diabetic retinopathy (DR) rats.Methods:Diabetes mellitus (DM) model was induced by intraperitoneal (i.p.) injection of STZ (60 mg/kg) in Sprague-Dawley rats. Diabetic rats were randomized into 3 groups (n=10) according to a random number table, including DM, XST50 and XST100 groups. XST treatment groups were daily i.p. injected with 50 or 100 mg/kg XST for 60 days, respectively. The control and DM groups were given i.p. injection with saline. Blood glucose level and body weight were recorded every week. Histological changes in the retina tissues were observed with hematoxylin-eosin staining. Apoptosis and inflammation related factors, including cleaved caspase-3, glial fibrillary acidic protein (GFAP), tumor necrosis factor-α (TNF-α) and intercellular cell adhesion molecule-1 (ICAM-1) were detected by Western blot or real-time polymerase chain reaction. Then, the levels of advanced glycation end product (AGE) and its receptor (RAGE) were investigated. Tight junctions proteins (Zonula occludens-1 (ZO-1), Occludin and Claudin-5) of blood-retinal barrier were detected by Western blot. The levels of retinal fibrosis, transforming growth factor-β1 (TGF-β1)-Smad2/3 signaling pathway were evaluated at last.Results:There was no significant difference in the body weight and blood glucose level between XST and DM groups (P>0.05). Compared with the DM group, XST treatment significantly increased the retinal thickness of rats (P<0.05 or P<0.01), and suppressed cleaved caspase-3 expression (P<0.01). XST increased the protein expressions of ZO-1, Occludin and Claudin-5 and decreased the mRNA expressions of matrix metalloproteinase 2 (MMP-2) and MMP-9 (P<0.05 or P<0.01). Moreover, XST significantly reduced the productions of AGE and RAGE proteins in the retina of rats (P<0.05 or P<0.01), suppressed the over-expression of TNF-α, and decreased the elevated level of ICAM-1 in retina of rats (P<0.05 or P<0.01). XST significantly reduced the levels of α-smooth muscle actin (α-SMA), connective tissue growth factor (CTGF), TGF-β1 and phosphorylation of Smad2/3 protein in rats (P<0.05 or P<0.01).Conclusions:XST had protective effects on DR with possible mechanisms of inhibiting the inflammation and apoptosis, up-regulating the expression of tight junction proteins, suppressing the productions of AGE and RAGE proteins, and blocking the TGF-β/ Smad2/3 signaling pathway. XST treatment might play a role for the future therapeutic strategy against DR.  
      Keywords:Xueshuantong for Injection (Lyophilized);diabetic retinopathy;Panax notoginseng saponin;transforming growth factor-β/Smad2/3 signaling pathway;Chinese medicine   
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      Published:2021-08-23
    • Bin WANG,Ke-wu ZENG,Zi-fu HONG,Gui-xiang TI,Li-yun WANG,Pin LU,Zhen LIU
      2020, 26(11): 833-838. DOI: 10.1007/s11655-020-3077-8
      Abstract:Objective:To test the effect of Banxia Xiexin Decoction (半夏泻心汤, BXD) on the contraction and relaxation of gastric smooth muscle (SM) in diabetic gastroparesis (DGP) model rats, and to explore the mechanism of BXD in the prevention and treatment of DGP through experiments of signal pathway both in vivo and in vitro.Methods:Sixty Sprague-Dawley rats were divided into 6 groups according to a random number table: control group, model group, high-, medium- and low-dose BXD groups (9.2, 4.6 and 1.8 g/(kg•d), respectively), and domperidone group (10 mg/(kg•d)), 10 rats per group. DGP model was established initially by a single intraperitoneal injection of streptozotocin (STZ), and was confirmed by recording gastric emptying, intestinal transport velocity and gastric myoelectric activity of rats after 2 months. Each group was treated with a corresponding drug for 4 weeks. The mRNA and protein expressions of phospholipase C (PLC), inositol triphosphate (IP3), neuronal nitric oxide synthase (nNOS), and cyclic guanosine monophosphate (cGMP) dependent protein kinase G (PKG) were detected by reverse transcription-polymerase chain reaction and Western blot, respectively, while nitric oxide (NO) and cGMP expressions were detected by enzyme-linked immunosorbent assay. Gastric tissues were obtained from rats for primary cell culture preparation. Gastric SM cells were treated with 0.8 μmol/L of STZ or STZ plus 1,000, 500 and 200 μg/mL of BXD or STZ plus 2.5 μmol/mL of domperidone for 24, 48, 72 or 96 h, respectively. The length of gastric SM cells and intracellular Ca2+ concentration ([Ca2+]i) before and after BXD treatment was measured.Results:Compared with the model group, high- and medium-dose BXD and domperidone significantly increased the expressions of PLC, IP3, NO, nNOS, cGMP and PKG in rat's gastric tissue (P<0.01). Gastric SM cells treated with BXD showed a time- and dosedependent increase in cell viability (P<0.01). The treatment with high- and medium-dose BXD and domperidone inhibited the increase in gastric SM cells length and increased [Ca2+]i compared with the model cells (P<0.01).Conclusions:Treatment with high- and medium-dose BXD significantly attenuated STZ-induced experimental DGP in rats. The therapeutic effect of BXD on DGP rats might be associated with the PLC-IP3-Ca2+/NO-cGMP-PKG signal pathway.  
      Keywords:Banxia Xiexin Decoction;diabetic gastroparesis;phospholipase C-inositol triphosphate-calcium/ nitric oxide-cyclic guanosine monophosphate-cyclic guanosine monophosphate dependent protein kinase G;Chinese medicine   
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      Published:2021-08-23
    • Ji-Ye Kee,Seung-Heon Hong,Jin-Han Park
      2020, 26(11): 839-844. DOI: 10.1007/s11655-019-3157-9
      Abstract:Objective:To study the effect of Liuwei Dihuang Decoction (六味地黄汤) or Yukmijihwangtang (YJT) on endurance exercise by in vivo experiment.Methods:ICR mice were randomly divided into the control group (distilled water) and the YJT groups (1, 10, 100 mg/kg), 5 animals per group. YJT and distilled water were orally administered. The anti-fatigue effect of YJT was evaluated by open filed test (OFT), forced swimming test (FST), and tail suspension test (TST).Results:In the OFT, YJT significantly increased the total movement distance in a dose-dependent manner. Additionally, treatment with YJT significantly decreased immobility time in the FST and the TST. Various neurotransmitters such as norepinephrine (NE), serotonin (5-HT), dopamine (DA) levels were increased by FST. Administration of YJT down-regulated the expression levels of NE, 5-HT, 5-hydroxyindole-acetic acid (5-HIAA), and DA in the brain stem and hypothalamus of mice. Moreover, protein expression of HSP70 in mice liver and heart muscles was significantly increased in the YJT groups.Conclusion:YJT could ameliorate fatigue and enhance exercise tolerance through suppressing of brain monoamines including NE, 5-HT, 5-HIAA, and DA in FST mice model.  
      Keywords:Yukmijihwang-tang;Liuwei Dihuang Decoction;fatigue;forced swimming test;HSP70;neurotransmitter;Chinese medicine   
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      Published:2021-08-23

      Acupuncture Research

    • You-jin LI,Ming ZONG,Li-feng DING,Xiao-qing RUI,Bei-yin MA,Li-ping QIN
      2020, 26(11): 845-852. DOI: 10.1007/s11655-020-3099-2
      Abstract:Objective:To evaluate the efficacy of Chinese medicine acupoint application (CMAA) combined with Western medicine for perennial allergic rhinitis (PAR) in children.Methods:In this prospective, parallel, randomized, placebo-controlled and single-blind trial from August to September, 2017, 180 children with PAR were randomly assigned to an integrative group (CMAA and Montelukast), CMAA group (CMAA and placebo tablet), or Montelukast group (placebo CMAA and Montelukast). Participants were applied with CMAA for 6 sessions over 2 weeks, and/or Montelukast Chewable Tablet orally once daily for 12 weeks. The changes in severity of symptoms were measured by Visual Analog Scale (VAS) and rhinitis control assessment test (RCAT) at 0, 2, 4 and 12 weeks of treatment. Blood samples were collected for serum interleukin-4, interferon gamma γ and T helper type 1 (Th1)/Th2 flow cytometric analysis at the time points of 0, 4 and 12 weeks.Results:Eight cases dropped out from the trial, 3 in the integrative group, 2 in the CMAA group and 3 in the Montelukast group. The VAS scores decreased significantly while the RCAT scores increased significantly in all three groups at 4 and 12 weeks compared with baseline (P<0.01 or P<0.05). The VAS scores were significantly lower while the RCAT scores were significantly higher in the integrative and CMAA groups than the Montelukast group at 2 and 4 weeks (P<0.01 or P<0.05). At 2, 4 and 12 weeks, the scores of nasal congestion, sneezing, sleep problem, and rhinitis symptom control in the integrative and CMAA groups increased significantly compared with baseline (P<0.01 or P<0.05). The least percentages of Th2 and the most alleviated Th2 shift (highest Th1/Th2) were observed in the integrative group at 12 weeks compared with the other two groups (P<0.05).Conclusion:The combination of CMAA with Montelukast might be more effective and appropriate than either option alone for children with PAR. (Registered at Chinese Clinical Trial Register, registration No. ChiCTR-IOR-17012434)  
      Keywords:allergic rhinitis;Chinese medicine;acupoint application;Montelukast;interferon gamma/ interleukin-4;T helper type 1/T helper type 2   
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      Published:2021-08-23

      Evidence-Based Integrative Medicine

    • Yuan-bin CHEN,Qiao LIU,Han XIE,Shuo-miao YIN,Lei WU,Xu-hua YU,Long FAN,Lin LIN
      2020, 26(11): 857-866. DOI: 10.1007/s11655-019-3078-7
      Abstract:Objective:To assess the efficacy and safety of Chinese medicine injection (CMI) for treating acute lung injury/acute respiratory distress syndrome (ALI/ARDS).Methods:Randomized controlled trials (RCTs) were identified by searching 3 English databases and 4 Chinese databases from their inceptions until February 2019. The Cochrane Handbook was used to evaluate risk of bias in the included studies. Data analysis was conducted using RevMan 5.3.3 software.Results:A total of 19 eligible RCTs involving 1,334 participants was included in this systematic review and meta-analysis. The main meta-analysis showed that CMI combined with conventional therapy (CT) was more effective than CT alone in reducing the acute physiology and chronic health evaluation (APACHE) Ⅱ score [mean difference (MD): –1.74 points, 95% confidence interval (CI): –2.77 to –0.71, I2=0] and increasing the total effective rate [relative risk (RR): 1.35, 95% CI: 1.17 to 1.56, I2=37%]. Compared with CT, CMI combined with CT showed improvements in the arterial partial pressure of oxygen (PaO2, MD: 9.25 mm Hg, 95% CI: 0.87 to 17.63, I2=98%) and oxygenation index [arterial partial pressure of oxygen (PaO2)/fraction of inspired oxygen (FiO2), MD: 50.75 mm Hg, 95% CI: 35.18 to 66.31, I2=94%]. CMI plus CT was superior to CT in reducing the systemic inflammatory response syndrome (SIRS) score (MD: –0.84 points, 95% CI: –1.26 to –0.42, I2=65%), length of hospital stay (MD: –4.22 days, 95% CI: –6.49 to –1.95, I2=92%), and duration of mechanical ventilation (MD: –2.94 days, 95% CI: –4.68 to –1.21, I2=89%). Only 1 study reported adverse events.Conclusions:CMI as an adjuvant therapy showed great potential benefits for the treatment of ALI/ARDS. However, we could not make a definite conclusion due to low quality of included studies and uncertain security. Future studies should focus on improving research design, especially in blindness and placebo. The reporting of adverse events was also needed.  
      Keywords:Chinese medicine injection;acute lung injury;acute respiratory distress syndrome;systematic review   
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      Academic Exploration

    • Meng XING,Ke-shen QU,Yu HUANG,Yu-rui XING
      2020, 26(11): 867-872. DOI: 10.1007/s11655-018-2945-3
      Abstract:Research on the molecular mechanisms controlling circadian rhythm in Western medicine is comparable to the study of a day-night rhythm in Chinese medicine (CM), as also focus on the same life phenomenon. By comparing the two, this paper elaborates on the differences between them in their respective issues of consciousness, ways of thinking, research methods and research results. Relatively speaking, Nobel Prize research has a stronger sense of the problems and concerns about the essence of "what", while CM focuses on "how a thing functions". The former mainly adopts experimental and mathematical methods, while the latter primarily depends on observation and understanding. The natural philosophy and natural science eventually lead to the results and the inevitable, quantitative and qualitative differences. Research on the life rhythm in CM should be proposed, scientific problems should be fully grasped, and research should be carried out with the aid of multidisciplinary new knowledge and new achievements through cross-disciplinary studies. On the basis of clinical epidemiological research and experimental research, a systematic review should be made of the human physiology of CM and the pathological rhythm model to explore the regulatory mechanism of time rhythm and create a new theory of time medicine.  
      Keywords:Nobel Prize;Chinese medicine;contrast between Chinese medicine and Western medicine   
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      Published:2021-08-23

      Review

    • Min YANG,Cong-cong WANG,Wen-le WANG,Jian-ping XU,Jie WANG,Chun-hong ZHANG,Min-hui LI
      2020, 26(11): 873-880. DOI: 10.1007/s11655-020-3091-x
      Abstract:Saposhnikovia divaricata (Turcz.) Schischk., a perennial herb belonging to the family Umbelliferae, is widely distributed in Northeast Asia. Its dried root (Radix Saposhnikoviae) is used as a Chinese herbal medicine for the treatment of immune system, nervous system, and respiratory diseases. Phytochemical and pharmacological studies have shown that the main constituents of S. divaricata are chromones, coumarins, acid esters, and polyacetylenes, and these compounds exhibited significant anti-inflammatory, analgesic, antioxidant, antiproliferative, antitumor, and immunoregulatory activities. The purpose of this review is to provide comprehensive information on the botanical characterization and distribution, traditional use and ethnopharmacology, phytochemistry, and pharmacology of S. divaricata for further study concerning its mechanism of action and development of better therapeutic agents and health products from S. divaricata.  
      Keywords:Saposhnikovia divaricata;Chinese medicine;ethnopharmacology;phytochemistry;pharmacology   
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