Latest Issue
      2020 Year 26 Vol. 4 Issue

        Hot Topic

      • Hui LUO,Qiao-ling TANG,Ya-xi SHANG,Shi-bing LIANG,Ming YANG,Nicola Robinson,Jian-ping LIU
        2020, 26(4): 243-250. DOI: 10.1007/s11655-020-3192-6
        Abstract：Objective:Since December 2019, an outbreak of corona virus disease 2019 (COVID-19) occurred in Wuhan, and rapidly spread to almost all parts of China. This was followed by prevention programs recommending Chinese medicine (CM) for the prevention. In order to provide evidence for CM recommendations, we reviewed ancient classics and human studies.Methods:Historical records on prevention and treatment of infections in CM classics, clinical evidence of CM on the prevention of severe acute respiratory syndrome (SARS) and H1N1 influenza, and CM prevention programs issued by health authorities in China since the COVID-19 outbreak were retrieved from different databases and websites till 12 February, 2020. Research evidence included data from clinical trials, cohort or other population studies using CM for preventing contagious respiratory virus diseases.Results:The use of CM to prevent epidemics of infectious diseases was traced back to ancient Chinese practice cited in Huangdi's Internal Classic (Huang Di Nei Jing) where preventive effects were recorded. There were 3 studies using CM for prevention of SARS and 4 studies for H1N1 influenza. None of the participants who took CM contracted SARS in the 3 studies. The infection rate of H1N1 influenza in the CM group was significantly lower than the non-CM group (relative risk 0.36, 95% confidence interval 0.24–0.52; n=4). For prevention of COVID-19, 23 provinces in China issued CM programs. The main principles of CM use were to tonify qi to protect from external pathogens, disperse wind and discharge heat, and resolve dampness. The most frequently used herbs included Radix astragali (Huangqi), Radix glycyrrhizae (Gancao), Radix saposhnikoviae (Fangfeng), Rhizoma Atractylodis Macrocephalae (Baizhu), Lonicerae Japonicae Flos (Jinyinhua), and Fructus forsythia (Lianqiao).Conclusions:Based on historical records and human evidence of SARS and H1N1 influenza prevention, Chinese herbal formula could be an alternative approach for prevention of COVID-19 in high-risk population. Prospective, rigorous population studies are warranted to confirm the potential preventive effect of CM.  
        Keywords：Chinese medicine;corona virus disease 2019 (COVID-19);prevention program;clinical evidence;review   
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        Published：2021-08-23

        Feature Article

      • Xin-bing SUI,Tian XIE
        2020, 26(4): 251-255. DOI: 10.1007/s11655-019-3180-x
        Abstract：Resistance to anticancer drugs is a major problem in oncology, which causes the failure of antitumor treatment. A variety of factors contribute to drug resistance, including drug efflux and metabolism, tumor cell heterogeneity, tumor microenvironment stress-induced genetic or epigenetic alterations in the cancer cells and so on. However, how to circumvent this resistance to improve anticancer efficacy remains to be determined. To circumvent chemotherapeutic resistance, many reversal agents have been developed, but most of them fail in clinical trials due to severe adverse effects. Recently, several natural products have been reported to augment sensitivity or overcome resistance of anticancer chemotherapeutic drugs, including elemene, curcumin, Shenqi Fuzheng Injection (参芪扶正注射液), PHY906, etc. Thus, understanding the novel function of Chinese medicine may allow us to develop a promising therapeutic approach to enhance the effects of anticancer strategies and prevent or overcome their resistance in the treatment of cancer patients.  
        Keywords：Chinese medicine;Western medicine;integrative Chinese and Western medicine;resistance;anticancer drugs   
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        Published：2021-08-23

        Original Article

      • Ling-ling SUN,He-zheng LAI,Zhuang-zhong CHEN,Xiao-shu ZHU,Li-zhu LIN
        2020, 26(4): 256-262. DOI: 10.1007/s11655-020-3185-5
        Abstract：Objective:To evaluate the effect of Chinese herbal medicine formula, modified Liujunzi Decoction (六君子汤, MLJZT), for anorexia, utilized as adjunct therapy during chemotherapy treatment for patients with advanced non-small cell lung cancer (NSCLC).Methods:The study adopted a propensity score-matched design based on a prospective database. From February 2016 to September 2017, patients with advanced NSCLC that received both cisplatin-based chemotherapy and MLJZT (IM group) were 1:1 propensity score-matched to patients that received the cisplatin-based chemotherapy alone (control group). Changes in anorexia and weight, as well as side effects were evaluated per week within 4-cycle chemotherapy.Results:Overall, 156 patients with advanced NSCLC that had received chemotherapy from our database were identified and 53 pairs were matched successfully. In total, 48.6% (50/53) of patients in the IM group had anorexia-improvement compared to 28.3% (15/53) of patients in the control group, and a total of 39.6% (21/53) of patients in the control group had a worsening of anorexia compared to only 7.8% (8/53) of patients in the IM group (P<0.01). The weight reduced significantly over time in the control group (–2.36±2.53 kg) as compared to the IM group (–0.62±3.89 kg, P<0.01). CHM didn't reduce the efficacy of chemotherapy in shrinking tumor size, and didn't increase the incidence of side effects such as hematological and hepatorenal toxicity.Conclusion:MLJZT is effective and safe for alleviating anorexia in patients with NSCLC. These findings warrant the conduct of a randomized controlled trial.  
        Keywords：anorexia;food intake;Chinese medicine;chemotherapy;lung cancer   
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        Published：2021-08-23
      • Ai-ping TIAN,Yu-kun YIN,Lei YU,Bo-yan YANG,Ning LI,Jian-ying LI,Zhi-min BIAN,Shang-ying HU,Chun-xiao WENG,Li FENG
        2020, 26(4): 263-269. DOI: 10.1007/s11655-019-3167-7
        Abstract：Objective:To evaluate whether low-frequency ultrasound-facilitated transdermal delivery of a Chinese medicine (CM) formula could improve the efficacy of intrapleural administration of interleukin-2 (IL-2) in treatment of malignant pleural effusion (MPE).Methods:A total of 110 eligible participants were randomized into the low-frequency sonophoresis (LFS) of CM (LSF/CM) group (55 cases) and the control group (55 cases) by simple randomization using a random number table. The control group was treated with an intrapleural administration of IL-2; and the LFS/CM group was treated with LFS of a CM gel formulation, combined with the same IL-2 injection as in the control group. The CM formula consisted of Semen Lepidii, Semen Sinapis, Ramulus Cinnamomi , Poriacocos, Herba Lycopi, and Radix Paeoniae Rubra. After 2-week treatment, the therapeutic outcome was determined by the change of the amount of MPE, which was evaluated by B-scan ultrasound and/or chest X-ray, and the change of quality of life (QOL) scores, which were evaluated by the Eastern Cooperative Oncology Group (ECOG) performance status.Results:A significantly higher objective remission rate (ORR) was obtained with intrapleural IL-2 plus LFS/CM than IL-2 treatment alone (P=0.049). In addition, more patients in the LFS/CM group than in the control group had an improved QOL score (P=0.048), and no patients in the LFS/CM group had a reduced QOL.Conclusion:LFS of CM formulation could effectively alleviate MPE and improve the QOL of cancer patients.  
        Keywords：malignant pleural effusion;low-frequency ultrasonic penetration;Chinese medicine;randomized controlled trial   
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        Published：2021-08-23
      • Jian HAO,Xiu-li DING,Xue YANG,Xiong-zhi WU
        2020, 26(4): 270-276. DOI: 10.1007/s11655-016-2587-x
        Abstract：Objective:To study the effects of Prunella vulgaris polysaccharide (PVP) on human breast carcinoma-associated fibroblasts (CAFs).Method:Cell viability was detected by 3-[4,5-dimethylthiazol-2-yl]-2,5-(3-carboxymethoxyphenyl)-2-4-sulfophenyl)-2H-tetrazolium (MTS) assay. Wound healing experiment and transwell migration assay were used to investigate the anti-migration effects. Flow cytometry was applied to detect cell apoptosis and cell cycle distribution. Reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay were used to detect the expression of basic fibroblast growth factor (bFGF) in CAFs. Culture SKBr-3 with CAFs conditioned medium (CAFs-CM) to evaluate the indirect function on the proliferation of breast cancer SKBr-3 cells.Results:PVP inhibited the viability of CAFs by inducing apoptosis (P<0.01) and arresting cell cycle (P<0.01). It also inhibited the migration of CAFs (P<0.01). bFGF promoted CAFs proliferation (P<0.01) and migration (P<0.01), protected CAFs from apoptosis (P<0.05) and reduced G0 phase to 49.06% (P<0.01). However, these effects of bFGF on CAFs could be abrogated by PVP. Culturing SKBr-3 with CAFs-CM, PVP could inhibit the viability of breast cancer SKBr-3 cells indirectly. Moreover, PVP reduced the mRNA expression (P<0.01) and protein secretion of bFGF (P<0.01) in CAFs.Conclusion:PVP could exert an anti-cancer effect on breast CAFs by inhibiting bFGF expression, thus inhibiting the growth of breast cancer SKBr-3 cells indirectly.  
        Keywords：Prunella vulgaris polysaccharide;carcinoma-associated fibroblasts;basic fibroblast growth factor;SKBr-3;Chinese medicine   
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        Published：2021-08-23
      • Hong-ping HOU,Guang-ping ZHANG,Li-na MA,Ping SU,Zhong-xiu ZHANG,Bao-qiang DAI,Zu-guang YE
        2020, 26(4): 277-282. DOI: 10.1007/s11655-019-3164-x
        Abstract：Objective:To study the antimalarial effects and mechanisms of artemisinin (Qinghaosu in Chinese, QHS) on mitochondria in mice infected with Plasmodium berghei.Methods:A total of 108 C57 mice infected with Plasmodium berghei were randomly divided into 3 groups by weight: the control group, 200 and 400 mg/kg QHS groups. The two QHS treatment groups were further divided into 4 sub-groups with 12 animals each time according to the treatment time, 0.5, 1, 2, and 4 h. Normal saline was intragastrically (i.g.) administered to the control group. The other two groups received different doses of QHS by i.g. administration. Animals were treated once with QHS for different detection time as follows: 0.5, 1, 2, and 4 h. The mitochondrial energy metabolism, oxidative damage, membrane potential, and membrane permeability and other indexes were detected.Results:After administration of 200 and 400 mg/kg QHS, adenosine triphosphate (ATP) levels in Plasmodium and its mitochondria were reduced (P<0.05), the levels of reactive oxygen species (ROS) and malondialdehyde (MDA) were increased (P<0.05), and the activity of superoxide dismutase (SOD) was also increased (P<0.05). At the same time, the membrane potential of the mitochondria was reduced and the degree to which the membrane permeability transition pore was opened was irreversibly increased (P<0.05).Conclusions:Mitochondria in Plasmodium were the targets of QHS, which can adversely affect mitochondrial energy metabolism, oxidative damage, membrane potential, and membrane opening, and ultimately exert an antimalarial effect.  
        Keywords：Qinghaosu;Clinese medicine;Plasmodium;mitochondria;antimalarial effect   
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        Published：2021-08-23
      • Da-wei SUN,Qing GAO,Xin QI
        2020, 26(4): 283-291. DOI: 10.1007/s11655-019-3165-9
        Abstract：Objective:To explore the specific molecular mechanisms of Danshensu (DSS) in the treatment of ischemia reperfusion injury (IRI).Methods:IRI model was established with isolated rat hearts by performing global ischaemia for 30 min, and then followed by 60 min reperfusion. Also, H9C2 cells were subjected to 4-h hypoxia followed by 3-h reoxygenation. Then 10 μmol/L DSS were added in the reperfusion/reoxygenation step to intervene IRI. Cardiac function, structural change and apoptosis were respectively tested by Langendorff System, hematoxylin and eosin (HE) and terminal-deoxynucleotidyl transferase mediated nick endabeling (TUNEL) stainings. Then lactate dehydrogenase (LDH), cardiac troponin T (cTnT), reactive oxygen species (ROS), superoxide dismutase (SOD) and glutathione peroxidase (GSH-PX) were detected by enzyme-linked immunosorbent assay (ELISA). Sirt1/FoxO1/Rab7 Signal Pathway was monitored at both protein and mRNA levels.Results:The results showed that IRI not only greatly attenuated cardiac function (LVDP and ±dp/dtmax, P<0.01, P<0.05) and increased the level of the marker enzymes (cTnT, LDH, P<0.01) from the coronary effluents, but also markedly induced changes in the structure of cardiomyocytes and contributed to apoptosis, which were mediated by boosted endogenous ROS. However, after treatment with DSS all above indexes were improved, which was related to activating Sirt1/FoxO1/Rab7 signal pathway accompanied with the enhancement of antioxidant defense system, such as SOD and GSH-PX.Conclusion:DSS is able to protect hearts from IRI, which may be attributable to inhibiting excessive ROS through Sirt1/FoxO1/Rab7 signaling.  
        Keywords：Chinese medicine;Danshensu;ischemia reperfusion injury;Sirt1/FoxO1/Rab7 signal pathway;reactive oxygen species;apoptosis   
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      • Shuai HUANG,Feng XU,Yin-ye WANG,Ming-ying SHANG,Chao-qun WANG,Xuan WANG,Shao-qing CAI
        2020, 26(4): 292-298. DOI: 10.1007/s11655-014-2008-y
        Abstract：Objective:To establish a novel cardiocentesis method for withdrawing venous blood from the right atrium, and to improve an acute blood stasis rat model using an ice bath and epinephrine hydrochloride (Epi) while considering the 3Rs (reduction, refinement, and replacement) of humane animal experimentation.Methods:An acute blood stasis model was established in male Sprague-Dawley rats by subcutaneous injection (s.c.) Epi (1.2 mg/kg) administration at 0 h, followed by a 5-min exposure to an ice-bath at 2 h and s.c. Epi administration at 4 h. Control rats received physiological saline. Rats were fasted overnight and treated with Angelicae Sinensis Lateralis Radix (ASLR) and Pheretima the following day. Venous blood was collected using our novel cardiocentesis method and used to test whole blood viscosity (WBV), prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) content.Results:The rats survived the novel cardiocentesis technique; WBV value returned to normal while hematological parameters such as hemoglobin level and red blood cell count were restored to >94% of the corresponding values in normal rats following a 14-day recovery. Epi (1.2 mg/kg, s.c.) combined with a 5-min exposure to the ice bath replicated the acute blood stasis rat model and was associated with the highest WBV value. In rats showing acute blood stasis, ASLR treatment [4 g/(kg•d) for 8 days] decreased WBV by 9.98%, 11.09%, 9.34%, 9.00%, 7.66%, and 7.03% (P<0.05), while Pheretima treatment [2.6 g/(kg•d), for 8 days] decreased WBV by 25.49%, 25.94%, 16.28%, 17.76%, 11.07%, and 7.89% (P<0.01) at shear rates of 1, 3, 10, 30, 100, and 180 s-1, respectively. Furthermore, Pheretima treatment increased APTT significantly (P<0.01).Conclusions:We presented a stable, reproducible, and improved acute blood stasis rat model, which could be applied to screen drugs for promoting blood circulation and eliminating blood stasis.  
        Keywords：acute blood stasis;rat model;cardiocentesis;whole blood viscosity;coagulation parameters;Angelicae Sinensis Lateralis Radix;Pheretima;Chinese medicine syndrome   
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        Published：2021-08-23

        Acupuncture Research

      • Jang-Han Bae,Boncho Ku,Young Ju Jeon,Hyunho Kim,Jihye Kim,Haebeom Lee,Jong Yeol Kim,Jaeuk U. Kim
        2020, 26(4): 299-306. DOI: 10.1007/s11655-017-2972-0
        Abstract：Objective:To investigate the changes in radial pulse induced by thermal stresses (TSs).Methods:Sixty subjects were enrolled. Using an open-label, 2×2 crossover randomization design, both feet of each subject were immersed in 15 ℃ water for cold stress (CS) and in 40 ℃ water for heat stress (HS) for 5 min each. Radial pulse, respiration and electrocardiogram (ECG) signals were recorded before, during and immediately after the TSs.Results:The analysis of heart rate variability revealed that CS increased the low-frequency (LF) and high-frequency (HF) components (P<0.05) and that HS reduced the LF and HF components (P<0.01). Both TSs reduced the normalized LF, increased the normalized HF, and reduced the LF/HF ratio. The differences in the ECG signals were more dominant during the TS sessions, but those in the radial pulse signals became more dominant immediately after the TS sessions. CS decreased the pulse depth (P<0.01) and increased the radial augmentation index (P<0.1), and HS increased the pulse pressure (P<0.1) and subendocardial viability ratio (P<0.01). There were no significant differences in pulse rate during the three time sequences of each TS. The respiration rate was increased (P<0.1), and the pulse rate per respiration (P/R ratio) was significantly decreased (P<0.05) with CS. The HF region (10–30 Hz) of the pulse spectral density was suppressed during both TSs.Conclusions:CS induced vasoconstriction and sympathetic reactions, and HS induced vasodilation and parasympathetic reactions. Based on definitions used in pulse diagnosis, we made the novel discoveries that the pulse became slower (decreased P/R ratio), more floating and tenser under CS and that the HF region of the spectral power decreased significantly under both TSs.  
        Keywords：radial pulse;pulse diagnosis;thermal stress;electrocardiography;heart rate variability   
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        Published：2021-08-23

        Review

      • Fu-ming YANG,Lin YAO,Shen-jun WANG,Yi GUO,Zhi-fang XU,Chien-Hung ZHANG,Kuo ZHANG,Yu-xin FANG,Yang-yang LIU
        2020, 26(4): 310-320. DOI: 10.1007/s11655-019-3150-3
        Abstract：The scientific evidence of acupuncture studies has been improved in recent years, and one of the important manifestations is that more and more acupuncture clinical trials and mechanism researches have been published in the source periodicals of Science Citation Index (SCI). This study summarized the dominant diseases of acupuncture focusing on of acupuncture efficacy and mechanisms, and discussed the existing problems, highlighting the direction of future developments. Most clinical studies were published in journals with journal impact factor (JIF) score of 10 or above, and majority of the basic researches had JIF scores of 5 to 10. The above literature were further divided according to the International Classification of Diseases (ICD). The most concerned diseases in these articles were neurological diseases, musculoskeletal system and connective tissue diseases, tumor and digestive system diseases. The therapeutic effect and mechanism of acupuncture on each kind of disease were summarized. The results showed that the therapeutic effect of acupuncture on nerve injury focused on the anti-oxidation pathway, neuroprotective and anti-inflammatory processes. The antiinflammatory effect also played an important role in the treatment of musculoskeletal diseases. The analgesic effect was underlined in most of these studies. Clinical trials were well carried out on acupuncture curative effect of tumor complications and side effects of chemo-radiotherapy, but the potential mechanisms have not been clarified. Somato-visceral reflex was suggested to be strongly associated with the effects of acupuncture changing the motor activity of the gastrointestinal tract. Functional magnetic resonance imaging studies indicated that non-specific effects play important roles in acupuncture analgesia. Lines of evidence have pointed out that the regulation of neuro-endocrine-immune networks may be a common switch of acupuncture on different nerve system diseases.  
        Keywords：acupuncture;clinical trials;mechanism;anti-inflammation;neuro-endocrine-immune network   
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