Latest Issue

    2020 Year 26 Vol. 3 Issue

      Original Article

    • Xue-wei PAN,Xiao-guang ZHANG,Xia-chan CHEN,Qi LU,Ying-si HU,Li-ya HAN,Jian-le ZHENG,Jie JIN,Guo-qing ZHENG
      2020, 26(3): 168-173. DOI: 10.1007/s11655-018-2560-y
      Abstract:Objective:To investigate the prevalence and spectrum of complementary and alternative medicine (CAM) application and its related-factors in Parkinson's disease (PD) patients in China.Methods:A structured questionnaire regarding the use of CAMs was administered to PD patients by face-to-face interview. Demographic and social variables, clinical characteristics and treatments, and the related factors of PD were also surveyed.Results:Ninety out of 113 patients (79.6%) reported that they had received CAMs treatment, of which 48.6% (55/113) patients had received CAMs treatment for PD. The top 3 kinds of CAMs for PD were Chinese materia medica, rehabilitation exercise, and acupuncture ordinally. The source of information regarding CAMs treatment mainly came from relatives and friends (51.8%, 73 cases), followed by physicians (31.9%, 45 cases), and medias such as television, newspapers or the internet (16.3%, 28 cases). Fifty percent of CAM users reported a good therapeutic efficacy, whereas 39% patients reported that they felt neither better nor worse after the treatment, while 11% patients claimed worsening of symptoms. Multiple correspondence analyses survey found the main factors affecting the selectivity of CAMs ranked in the following order: income, education, occupation, habitation, age at onset, Hoehn and Yahr staging, PD duration, and gender.Conclusion:CAMs, especially Chinese materia medica, rehabilitation exercise, and acupuncture, are widely used for PD patients in China.  
      Keywords:Parkinson's disease;complementary and alternative medicine;Chinese medicine   
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      Published:2021-08-23
    • Seika Kanezawa,Yan-bo ZHU,Qi WANG
      2020, 26(3): 174-179. DOI: 10.1007/s11655-019-2709-3
      Abstract:Objective:Chinese medicine (CM) is widely applied in cosmetics and dermatology. The theory of CM believes that skin characterizations reflect the internal status of balance which can be represented by body constitution, but relevant studies are few. This study aims to analyze the relationship between body constitution of CM and skin condition.Methods:Participants were recruited from a private health and beauty clinic in Tokyo, Japan from June 2013 to January 2015. Each participant was assessed using Constitution in Chinese Medicine Questionnaire (CCMQ) for body constitution and the Baumann Skin Type Questionnaire for skin type. Spearman's rank correlation and stepwise multiple linear regression were used to investigate the effect of body constitutions on skin types.Results:A total of 187 Japanese females were recruited in this study. Higher dampness-heat and phlegm-dampness scores were associated with oilier skin while higher qi-depression and blood-stasis were associated with drier skin. Higher score in Inherited Special and yin-deficiency constitutions tended to have more sensitive skin, and higher score in blood-stasis was associated with more pigmented skin and wrinkles.Conclusions:Our findings supported the "Constitution-Skin Correlated theory" in CM. Understanding of the association between skin conditions and the body constitutions might be helpful to explore more individualized treatment options for skin care and dermatological diseases through modifications of the unique body constitutions using CM modalities.  
      Keywords:Chinese medicine;constitution in Chinese medicine;Baumann Skin Type;constitution-skin correlated theory   
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      Published:2021-08-23
    • Fei HE,Jian-feng CHU,Hong-wei CHEN,Wei LIN,Shan LIN,You-qin CHEN,Jun PENG,Ke-ji CHEN
      2020, 26(3): 180-187. DOI: 10.1007/s11655-019-2705-7
      Abstract:Objective:To elevate the effects of Qingxuan Jiangya Decoction (清眩降压汤, QXJYD) on hypertension and vascular structural remodeling (VSR) in spontaneously hypertensive rats (SHRs), and investigate the underlying mechanisms.Methods:SHRs (n=8) were given intra-gastric administration with 60 mg/kg of QXJYD or saline, daily for 8 weeks, while rats in SHR-control (n=8) and WKY (n=8) groups were received equal volumes of saline solution. Systolic blood pressures (SBP), diastolic blood pressures (DBP) and mean blood pressures (MBP) were measured once a week. The levels of angiotensin Ⅱ (Ang Ⅱ), endothelin 1 (ET-1) and plasma renin activity (PRA) were tested by enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay, respectively. The effect of QXJYD on VSR was determined by examining the media thickness and the ex vivo contractility of thoracic aortic. The proliferation and fibrosis of vascular smooth muscle cells (VSMCs) were examined via immunohistochemical (IHC) staining for proliferating cell nuclear antigen (PCNA), collagen Ⅰ and collagen Ⅲ, respectively. The mRNA and protein expressions of transforming growth factorβ1 (TGF-β1), Smad3 and phosphorylation of Smad3 in thoracic aorta tissues were determined by real-time polymerase chain reaction (PCR) and Western blot assay, respectively.Results:QXJYD treatment led to a significant decrease of the elevation of blood pressure in SHRs and reduced the levels of Ang Ⅱ, ET-1 and PRA in the serum (P<0.05). In addition, QXJYD treatment remarkably ameliorated VSR and vascular function in SHRs. Moreover, QXJYD inhibited VSMC proliferation and fibrosis by suppressing the expression of PCNA, collagen Ⅰ and collagen Ⅲ in thoracic aortic. Furthermore, QXJYD inhibited the expression of TGF-β1, Smad3 and the phosphorylation of Smad3, respectively (P<0.05).Conclusion:QXJYD reversed VSR by inhibiting VSMC proliferation and collagen deposition via regulation of TGF-β1/Smad signaling pathway, which may, in part, illuminate its anti-hypertensive activities.  
      Keywords:Qingxuan Jiangya Decoction;Chinese medicine;vascular structural remodeling;transforming growth factor-beta 1/Smad signaling pathway   
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      Published:2021-08-23
    • Yong-cheng WANG,Du-fang MA,Ping JIANG,Yi-mei ZHANG,Guo-feng ZHOU,Jin-long YANG,Zhao-yu LI,Xiao LI
      2020, 26(3): 188-196. DOI: 10.1007/s11655-019-2706-6
      Abstract:Objective:To observe the imbalance of anatomical and functional innervation factors of sympathetic nerves, nerve growth factor (NGF) and leukemia inhibitory factor (LIF), in salt-sensitive hypertensive heart failure rats and to explore the effects of treatment with Guizhi Decoction (桂枝汤) on sympathetic remodeling by inhibiting cholinergic transdifferentiation.Methods:SS-13BN and Dahl salt-sensitive (DS) rats were divided into 3 groups: SS-13BN group (control group, n=9), DS group (model group, n=9) and GS group (Guizhi Decoction, n=9). After 10 weeks of a high-salt diet, the GS group rats were given Guizhi Decoction and other two groups were given saline at an equal volume as a vehicle. After 4 weeks' intragastric administration, rats were executed to detect the relevant indicators. Echocardiography and plasma n-terminal pro-B type natriuretic peptide (NT-proBNP) levels were used to assess cardiac function. Noradrenaline (NA) levels in the plasma and myocardium were detected to evaluate the sympathetic function. NGF and LIF expression were detected in the myocardium by Western blot or quantitative real-time PCR. Double immunofluorescence or Western blot was used to detect tyrosine hydroxylase (TH), choline acetyltransferase (CHAT) and growth associated protein 43 (GAP43) in order to reflect anatomical and functional changes of sympathetic nerves.Results:DS group had anatomical and functional deterioration of sympathetic nerves in the decompensation period of heart failure compared with SS-13BN group. Compared with the DS group, Guizhi Decoction significantly decreased the expression of LIF mRNA/protein (P<0.01), increased the expression of NGF (P<0.05 or P<0.01), enhanced the levels of TH+/GAP43+ and TH+/CHAT+ positive nerve fibers (P<0.01), and improved the protein expression of TH and GAP43 in left ventricle, but had no effect on CHAT (P>0.05). Guizhi Decoction inhibited inflammatory infiltration and collagen deposition of myocardial injury, increased the content of myocardial NA (P<0.05), reduced the plasma NA level (P<0.01), improved cardiac function (P<0.01), and improved weight and blood pressure to some extent (P<0.05), compared with DS group.Conclusions:Guizhi Decoction could inhibit cholinergic transdifferentiation of sympathetic nerves, improve the anatomical and functional denervation of sympathetic nerves, and delay the progression of decompensated heart failure. The mechanism may be associated with the correction of the imbalance of NGF and LIF.  
      Keywords:sympathetic;cholinergic transdifferentiation;nerve growth factor;leukemia inhibitory factor;Guizhi Decoction   
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      Published:2021-08-23
    • Wei LIU,Xiao-chun LIANG,Yue SHI
      2020, 26(3): 197-204. DOI: 10.1007/s11655-019-2712-8
      Abstract:Objective:To investigate protective effects of hirudin on oxidative stress and apoptosis of spinal dorsal root ganglion cells in high-glucose rats at the cellular and molecular level.Methods:Dorsal root ganglion neurons (DRGn) were harvested from embryonic day in 15 SD rats, purified and identificated after primary culture. They were divided into the normal control group, high-glucose (HG) group, positive control (alpha-lipoic acid, ALA) group, low-dose hirudin group (H1), medium-dose hirudin group (H2) and high-dose hirudin group (H3). The control group was cultured by neuron specific culture medium, while the HG group was cultured by neuron specific culture medium and 20 mmol/L glucose (HG medium). The hirudin groups were cultured by HG medium+0.25 IU/mL hirudin (H1), HG medium+0.5 IU/mL hirudin (H2) and HG medium+1 IU/mL hirudin (H3). The ALA group was cultured by HG medium+100 μmol/L ALA. 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenylt etrazolium bromide (MTT) assay was used to explore the optimum concentration and intervention time. Flow cytometry assay was used to detect the level of reactive oxygen series (ROS). Western blot and quantificational realtime polymerase chain reaction (qRT-PCR) were used to detect the expression of protein and mRNA of nuclear factor erythroid 2-related factor 2 (Nrf-2), hemeoxygence-1 (HO-1), nuclear factor-κB (NF-κB) and Caspase-3. TUNEL assay was used to test the apoptosis rate of different groups.Results:After 24 h of culture, the cell activity of hirudin and ALA groups were higher than that of HG group, and there was a statistical difference between the H1 group and HG group (P<0.05). In hirudin groups, the apoptosis rate of cells, the expression of activated Caspase-3 protein and Caspase-3 mRNA were lower than those of HG group (P<0.01), higher than those of ALA group (P<0.01 or P<0.05). The ROS level of hirudin groups was higher than that of ALA group (P<0.01), lower than that of HG group (P<0.01 or P<0.05). The expression of NF-κB (P65) protein in H3 group were lower than those of HG group (P<0.05). The expression of Nrf-2 protein in hirudin groups was higher than that of HG group (P<0.01), lower than that of ALA group (P<0.01 or P<0.05). The expression of HO-1 protein in hirudin groups was lower than that of ALA group (P<0.01 or P<0.05), higher than that of HG group (P<0.01 or P<0.05).Conclusions:The activity of DRGn cells can be promoted by hirudin under HG conditions. The effects of hirudin on the inhibition of HG on DRGn cells damage mainly include scavenging ROS, up-regulating Nrf-2/ HO-1 pathway, inhibiting activation of NF-κB pathway, down-regulating the expression of and Caspase-3 and reducing DRGn cell apoptosis.  
      Keywords:hirudin;diabetic peripheral neuropathy;oxidative stress;apoptosis;dorsal root ganglion neuron   
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      Published:2021-08-23
    • Wen-xiu XIN,Qing-lin LI,Luo FANG,Li-ke ZHONG,Xiao-wei ZHENG,Ping HUANG
      2020, 26(3): 205-211. DOI: 10.1007/s11655-018-2573-6
      Abstract:Objective:To observe the effect and molecular mechanism of ethyl acetate extract of Sceptridium ternatum (STE) on the monocrotaline (MCT)-induced pulmonary arterial hypertension (PAH).Methods:The main chemical components of Sceptridium ternatum were determined, and the effects in PAH rats were observed. A total of 140 Sprague Dawley rats were randomly and equally divided into the normal group, the model group, the Bosentan group, and the STE groups (2.5, 5, 10 g/kg) by the random number table method. The characteristic indicators of PAH were measured, and immunohistochemistry was used to observe the lung tissue of rats. Morphological changes of the lung tissue were observed under the light microscope.Results:Compared with the normal group, rats in the model group showed a significant increase in right ventricular free wall thickness (RVFWT), mean pulmonary arterial pressure (mPAP), mean right ventricular pressure (mRVP), max right ventricular pressure (max RVP), weight of right ventricle (RV), and lung index (LI), while a significant decrease in pulmonary artery acceleration time (PAAT, P<0.01). Compared with the model group, rats treated with STE had a significant decrease of RVFWT, mPAP, mRVP, max RVP, and RV, while a significant increase of PAAT (P<0.01). After injection of MCT, nuclear factor-κB (NF-κB) p65 and α-smooth muscle actin (α-SMA) expression levels were up-regulated, and on the contrary, the treatment groups showed a significant downregulation without dose-dependent trend.Conclusions:STE can relieve the PAH in rats. STE may relieve pulmonary vascular disease and pulmonary injury by down-regulating the expression of NF-κB p65 and α-SMA.  
      Keywords:pulmonary arterial hypertension;ethyl acetate extract of Sceptridium ternatum;mechanism;Chinese medicine   
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      Published:2021-08-23

      Clinical Experience

    • Hui-chan WANG,Nan-yang LIU,Shuai ZHANG,Yang YANG,Zhi-Yong WANG,Yun WEI,Jian-Gang LIU,Hui PEI,Hao LI
      2020, 26(3): 212-218. DOI: 10.1007/s11655-019-2717-3
      Abstract:Objective:To investigate the long-term therapeutic effects of the Chinese medicine Jiannao Yizhi Formula (健脑益智方, JYF) in the treatment of Alzheimer's disease (AD).Methods:Sixty mild-to-moderate AD participants were recruited and randomly allocated to the treatment (30 with JYF) and the control groups (30 with donepezil) for 6 months with the random numbers. The primary outcomes were scores of Alzheimer's Disease Rating Scale-Cognitive (ADAS-Cog) and Chinese Medicine Symptom Scale (CM-SS). The secondary outcomes were scores of Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Activities of Daily Living (ADL). Safety assessments were conducted at baseline and the 6th month of treatment. Serum levels of acetylcholine (Ach), amyloid-β protein 42 (Aβ42), and the microtubule-associated protein tau (Tau) were also determined by enzyme-liked immunosorbent assay.Results:Fifty-one participants were included in the final analyses (JYF n=27; donepezil n=24). Compared with baseline, both JYF and donepezil increased the MoCA and MMSE scores and decreased the ADAS-Cog and CM-SS scores (P<0.05 or P<0.01). Both drugs increased the serum levels of Ach and decreased the serum levels of Aβ42 and Tau (all P<0.05). There was no significant difference in these variables between the two groups, which showed that JYF was not inferior to donepezil. No obviously significant changes were observed in the ADL. No severe adverse events were observed in both groups.Conclusion:The effect and safety of JYF for the treatment of AD were not inferior to those of donepezil.  
      Keywords:Alzheimer's disease;Jiannao Yizhi Formula;Chinese medicine;clinical observasion   
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      Published:2021-08-23

      Evidence-Based Integrative Medicine

    • Mei-li YU,Si-ming LI,Xiang GAO,Jin-gen LI,Hao XU,Ke-ji CHEN
      2020, 26(3): 219-226. DOI: 10.1007/s11655-018-2556-7
      Abstract:Objective:To assess whether an adjunctive therapy of Sodium Tanshinone ⅡA Sulfonate Injection (STS) is effective and safe in improving clinical outcomes in patients with coronary heart disease (CHD).Methods:A literature search was conducted through PubMed, the Cochrane Library, Knowledge Infrastructure Databases (CNKI), Chinese Biomedical Literature Database (SinoMed), Chinese Science and Technology Periodical Database (VIP) and Wanfang Database up to August 2017. Randomized controlled trials (RCTs) comparing STS with placebo or no additional treatments on the basis of standard conventional medicine therapies were included. The outcomes were all-cause mortality, major acute cardiovascular events (MACEs), cardiac function and inflammatory factors. The risk of bias assessment according to the Cochrane Handbook was used to evaluate the methodological quality of the included trials. Revman 5.3 software was used for data analyses.Results:A total of 22 RCTs involving 1,873 participants were included. All of the trials used STS as adjunctive treatment to standard conventional medicine therapy. Due to the poor quality of methodologies of most trials, only limited evidence showed that a combination of STS with percutaneous coronary intervention (PCI) or thrombolytic therapy (TT) might be more effective on reduction of all cause death rate than TT alone [risk ratio (RR) 0.25, 95% confidence interval (CI) 0.07 to 0.87] or PCI alone (RR 0.42, 95% CI 0.04 to 4.36). The results of 6 trials comparing STS plus TT with TT alone showed that the addition of STS significantly reduced the incidence of cardiac shock (RR 0.35, 95% CI 0.14 to 0.86), heart failure (RR 0.41, 95% CI 0.20 to 0.83) and arrhythmia (RR 0.21, 95% CI 0.12 to 0.46). STS combined with TT also showed a superior effect on cardiac function and inflammatory factor. No severe adverse event was reported related to STS.Conclusions:As an adjunctive therapy, STS combined with standard conventional medicine seems to be more effective on all-cause mortality or MACEs than conventional medicine treatment alone with less side effects. However, we cannot make a firm conclusion due to low quality of inclusion trials. Well-designed trials with high methodological quality are needed to validate the effect of STS for CHD patients.  
      Keywords:Tanshinone ⅡA;coronary heart disease;meta-analysis;systematic review   
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      Published:2021-08-23
    • Xiao-yu ZHANG,Yang SUN,Xin-yu YANG,Jia-yuan HU,Rui ZHENG,Shi-qi CHEN,Min LI,Cheng-yu LI,Yin JIANG,Shuo LIU,Chen ZHAO,Yan-wei XING,Hong-cai SHANG
      2020, 26(3): 227-234. DOI: 10.1007/s11655-019-2703-9
      Abstract:Objective:To systematic review the effect of Chinese medicine (CM) on no or slow reflow after percutaneous coronary intervention (PCI) in myocardial infarction (MI) patients.Methods:The PubMed, EMBASE databases, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), Chinese BioMedical Literature Database (CBM), Wanfang Knowledge Service Platform (Wanfang Database) and Chinese Scientific Journal Database (VIP) were searched up to December 2017. Randomized controlled trials (RCTs) which evaluated the effect of CM therapies on no or slow reflow after PCI in MI patients were included. The primary outcome was the effect of reperfusion. Secondary outcomes were left ventricular ejection fraction, incidence of major adverse cardiovascular events and adverse effect.Results:Ten RCTs covering 814 patients were included. Two studies revealed that the incidence of no or slow reflow was less in Shenmai Injection (参麦注射液) group than in the control group measured by thrombolysis in myocardial infarction (TIMI)≤ 2 (risk ratio=0.55, 95% confidence interval 0.38 to 0.81, P=0.003, I2=37%). Two studies indicated that Salvianolate Injection showed no additional benefit on no or slow reflow measured by corrected TIMI frame count compared with the conventional treatment (mean difference –4.24, 95% confidence interval –13.03 to 4.54, P=0.34, I2=86%). In addition, Tongxinluo Capsules (通心络胶囊), Danhong Injection (丹红注射液) and Xuesaitong Injection (血塞通注射液) may have the potential to reduce no or slow reflow measured during or after PCI in individual studies.Conclusions:Current evidence from RCTs are not sufficient to evaluate the effect of CM adjuvant therapies on no or slow reflow after PCI for MI patients. The included studies are limited by small sample size and unclear baseline conditions. Further rigorously designed researches and verification studies with sufficient number of patients are warranted.  
      Keywords:Chinese medicine;no reflow phenomenon;percutaneous coronary intervention;myocardial infarction;myocardial reperfusion   
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      Published:2021-08-23

      Review

    • Lai-lai LI,Xiao-wei MENG,Ke-tao FAN,Yan-yan WANG,Yang XIAO,Yi WANG
      2020, 26(3): 235-240. DOI: 10.1007/s11655-016-2263-1
      Abstract:Rhizoma Dioscoreae Collettii, is known as Huang Dioscorea collettii, Rhizoma Coptidis Brevisepalae or yellow ginger. It is neutral in nature and bitter in taste which is described to Gan (Liver) meridian, Wei (Stomach) meridian and Pangguang (Bladder) meridian. It was often used in the treatment of chyloid stranguria, gonorrhea, leucorrhagia, rheumatism arthralgia pain, joints disable, and lumbar knee pain syndrome in clinical.  
      Keywords:Rhizoma Dioscoreae Collettii;identification;chemical constituents;pharmacology;clinical application   
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      Published:2021-08-23
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