Latest Issue
      2021 Year 27 Vol. 1 Issue

        Feature Article

      • Jin-gen LI,Hao XU
        2021, 27(1): 3-6. DOI: 10.1007/s11655-020-2860-x
        Abstract：Covid-19 pandemic has caused hundreds of thousands deaths and millions of infections and continued spreading violently. Although researchers are racing to find or develop effective drugs or vaccines, no drugs from modern medical system have been proven effective and the high mutant rates of the virus may lead it resistant to whatever drugs or vaccines developed following modern drug development procedure. Current evidence has demonstrated impressive healing effects of several Chinese medicines (CMs) for Covid-19, which urges us to reflect on the role of CM in the era of modern medicine. Undoubtedly, CM could be promising resources for developing drug candidates for the treatment of Covid-19 in a way similar to the development of artemisinin. But the theory that builds CM, like the emphasis of driving away exogenous pathogen (virus, etc.) by restoring self-healing capacity rather than killing the pathogen directly from the inside and the 'black-box' mode of diagnosing and treating patients, is as important, yet often ignored, an treasure as CM herbs and should be incorporated into modern medicine for future advancement and innovation of medical science.  
        Keywords：Chinese medicine;Covid-19;SARS-CoV-2;coronavirus;herbal medicine   
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        Published：2021-08-16

        Original Article

      • khaton Zare Elmi Halimeh,Gholami Mohammad,Saki Mandana,Ebrahimzadeh Farzad
        2021, 27(1): 7-15. DOI: 10.1007/s11655-020-2727-1
        Abstract：Objective:To assess the effect of valerian root extract on the sleep quality of patients after coronary artery bypass graft (CABG) surgery.Methods:The patients who participated in this triple-blind clinical trial were selected by permuted block randomization. The participants were assigned to the valerian (n=36) and placebo (n=36) groups. The valerian group received 530 mg of valerian capsules for 30 nights after CABG surgery, and the placebo group received 530 mg of the placebo capsules containing wheat flour. The Pittsburgh Sleep Quality Index (PSQI), the prothrombin time (PT) and partial thromboplastin time (PTT) were assessed on four occasions, including the baseline, the 3rd, 14th and 30th days following intervention.Results:The odds ratio of worsened sleep quality significantly varied over time (the interaction of time and group) in the valerian group compared to the placebo group in various dimensions including total sleep quality (P=0.001), sleep latency (P<0.01), sleep duration (P=0.020), sleep efficiency (P=0.001) and daytime dysfunction (P=0.025). No significant difference was observed in the alterations of the odds ratio of PT in the two groups over time. (P=0.371).Conclusion:The consumption of oral valerian root extract over 30 nights could significantly improve the patients' sleep quality safely after CABG surgery.  
        Keywords：coronary artery bypass graft;herbal medicine;randomized controlled trial;sleep quality;valerian   
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        Published：2021-08-16
      • Yuan-shen ZHOU,Shuai MAO,Li-heng GUO,Xiong-yi GAO,Xu ZOU,Min-zhou ZHANG
        2021, 27(1): 16-23. DOI: 10.1007/s11655-020-2722-6
        Abstract：Background:Although percutaneous coronary intervention (PCI) had become widely employed therapeutic procedure for coronary artery disease, stent restenosis limited the benefits of this revascularization and the question how to prevent such events remained unresolved. While numerous empirical observations suggested Tongguan Capsules (通冠胶囊), a patented Chinese Medicine, could decrease frequency and duration of angina pectoris attacks, evidence supporting its efficacy on restenosis remained inadequate.Objective:This trial was designed to determine whether Tongguan Capsules would reduce restenosis rate in patients after successful stent implantation.Methods:Approximately 400 patients undergoing percutaneous coronary stent deployment were enrolled and randomized to control group or Tongguan Capsules (4.5 g/d) for 3 months. All patients received standard anti-platelet, anti-coagulation and lipid-decreasing treatments, concurrently. The primary clinical endpoint was the 12-month incidence of the major adverse cardiovascular events (defined as cardiac death, myocardial infarction, and recurrence of symptoms requiring additional revascularization). The angiographic end point was restenosis rate at 6 months.Conclusion:This study would provide important evidence for the use of Tongguan Capsules in patients after stent implantation in combination with routine therapies, which may significantly reduce incidence of the restenosis so as to potentially improve the clinical outcomes. (registration number: ChiCTR-TRC- ChiCTR-IIR-17011407)  
        Keywords：Tongguan Capsules;stent restenosis;percutaneous coronary intervention   
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        Published：2021-08-16
      • Chan JIANG,Xi WANG,Song DANG,Xin WANG,Qing DENG,Juan HU,Cong-xin HUANG
        2021, 27(1): 24-30. DOI: 10.1007/s11655-018-2578-1
        Abstract：Objective:To investigate the effect of Chinese compound Shensong Yangxin Capsule (参松养心 胶囊, SSYX) on myocardial microcirculation in myocardial-infarcted rabbits.Methods:Myocardial infarction (MI) was established in rabbits by ligation of the left circumflex coronary. Thirty rabbits were randomly divided into the control group, the MI group (model), and the MI treated with SSYX group (MI+SSYX) by a random number table method. After 4 weeks of administration, low-energy real-time myocardial contrast echocardiography (RT-MCE) was conducted to assess the microcirculatory perfusion. Immunofluorescence double staining was used to detect the capillary density. The endothelial ultrastructure was observed with a transmission electron microscope. The mRNA expression levels of vascular endothelial growth factor (VEGF), endothelin 1 (ET-1), prostaglandin I2 (PGI2) and endothelial nitric oxide synthase (eNOS) were measured by real-time quantitative polymerase chain reaction (Real-time PCR). The plasmic levels of ET-1, thromboxane A2 (TXA2), nitric oxide (NO) and von willebrand factor (vWF) were examined with enzyme-linked immunosorbent assays (ELISA).Results:SSYX significantly improved the myocardial blood volume, myocardial micro bubble velocity, and myocardial inflow according to the examination of RT-MCE, and it visibly ameliorated the capillary endothelial structure. Furthermore, compared with the MI group, the plasma levels of TXA2, ET-1 and vWF contents significantly decreased in the MI+SSYX group, and the ET-1 mRNA expression levels of myocardium in the border zone significantly decreased, and the VEGF, PGI2 and eNOS mRNA expression levels significantly increased (all P<0.05).Conclusions:SSYX has favorable advantages in ameliorating the impaired myocardial microcirculation following MI. The mechanisms of the effect are related to the ability of SSYX in balancing the endothelial-derived vasodilators and vasoconstrictors, and up-regulating the expression of VEGF and eNOS.  
        Keywords：myocardial infarction;microcirculation;endothelium;angiogenesis;Shensong Yangxin Capsule   
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        Published：2021-08-16
      • Tian-shuang XIA,Liu-yue LIN,Qiao-yan ZHANG,Yi-ping JIANG,Chang-hui LI,Xiao-yan LIU,Lu-ping QIN,Hai-liang XIN
        2021, 27(1): 31-38. DOI: 10.1007/s11655-019-2700-z
        Abstract：Objective:To systematically evaluate the protective effects of Humulus lupulus L. extract (HLE) on osteoporosis mice.Methods:In vivo experiment, a total of 35 12-week-old female ICR mice were equally divided into 5 groups: the sham control group (sham); the ovariectomy with vehicle group (OVX); the OVX with estradiol valerate [EV, 0.2 mg/(kg•d)]; the OVX with low- or high-dose HLE groups [HLE, 1 g/(kg•d) and 3 g/(kg•d)], 7 in each group. Treatment began 1 week after the ovariectomized surgery and lasted for 12 weeks. Bone mass and trabecular bone mircoarchitecture were evaluated by micro computed tomography, and bone turnover markers in serum were evaluated using enzyme-linked immunosorbent assay (ELISA) kits. In vitro experiment, osteoblasts and osteoclasts were treated with HLE at doses of 0, 4, 20 and 100 μg/mL. Biomarkers for bone formation in osteoblasts and bone resorption in osteoclasts were analyzed.Results:Compared with the OVX group, HLE exerted bone protective effects by the increase of estradiol (P<0.05), the improvement of cancellous bone structure, bone mineral density (P<0.01) and the reduction of serum alkaline phosphatase (ALP), tartrate resistant acid phosphatase (TRAP), bone gla-protein, c-terminal telopeptides of type Ⅰ collagen (CTX-Ⅰ) and deoxypyridinoline levels (P<0.01 for all). In vitro experiment, compared with the control group, HLE at 20 μg/mL promoted the cell proliferation (P<0.01), and increased the expression of bone morphogenetic protein-2 and osteopontin levels in osteoblasts (both P<0.05). HLE at 100 μg/mL increased the osteoblastic ALP activities, and HLE at all dose enhanced the extracellular matrix mineralization (both P<0.01). Furthermore, compared with the control group, HLE at 20 μg/mL and 100 μg/mL inhibited osteoclastic TRAP activity (P<0.01), and reduced the expression of matrix metalloproteinase-9 and cathepsin K (both P<0.05).Conclusion:HLE may protect against bone loss, and have potentials in the treatment of osteoporosis.  
        Keywords：Humulus lupulus L.;osteoporosis;ovariectomy-induced mice;osteoblasts;osteoclasts   
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        Published：2021-08-16
      • Lee Bombi,Muk Choi Gwang,Sur Bongjun
        2021, 27(1): 39-46. DOI: 10.1007/s11655-020-2724-4
        Abstract：Objective:Post-traumatic stress disorder (PTSD) is a psychiatric disorder characterized by depression and anxiety, that arises due to an imbalance of neurotransmitters in response to excessive stress. Hesperidin (HSD) is a naturally occurring flavonoid shown to exert a variety of biological activities, including antioxidant, anti-inflammatory, and neuroprotective effects.Methods:This study was used the open field test (OFT) and forced swimming test (FST) to examine the effects of HSD on the depression-like response of rats after exposure to a single prolonged stress (SPS) leading to the dysregulation of the serotonergic activation system. Male rats were given HSD (20, 50, and 100 mg/kg, intraperitoneal injection, n=6–7 per group) once daily for 14 days after exposure to SPS. The influence of administration of HSD on SPS-induced behavioral responses and concentrations of serotonin (5-HT), 5-hydroxyindoleacetic acid (5-HIAA), and monoamine oxidase-A (MAO-A) in the rat brain were also investigated using enzyme-linked immunoassays (ELISAs).Results:Daily HSD administration significantly improved depression-like behaviors in the FST (P<0.05), increased the number of lines crossed in the central zone of the OFT (P<0.01), and reduced freezing behavior both in contextual and cued fear conditioning. HSD treatment also attenuated the reduction in SPS-induced 5-HT concentrations in the hippocampus and amygdala. This increase in 5-HT concentrations during HSD treatment was partially attributed to a decrease in the 5-HIAA/5-HT ratio in the hippocampus of rats with PTSD. Furthermore, HSD treatment inhibited activity of MAO-A and decreases of tryptophan hydroxylase-1 expression in the hippocampus.Conclusion:HSD was shown to exert antidepressant effects in rats exposed to SPS, suggesting that this natural flavonoid may be an effective medicine for PTSD.  
        Keywords：hesperidin;post-traumatic stress disorder;depression;serotonin   
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        Published：2021-08-16
      • Jia-hui ZHAO,Lei ZHANG,Yang LIU,Qing-li CHENG
        2021, 27(1): 47-53. DOI: 10.1007/s11655-019-3162-z
        Abstract：Objective:To investigate the effect of Shexiang Baoxin Pill (麝香保心丸, SBP) on early hypertensive renal injury in rats and to explore the possible mechanism.Methods:Twelve-week-old spontaneous hypertensive rats (SHRs) with high-salt diet (dietary containing 8% NaCl) were randomized into the SBP group [40 mg/(kg•d)], losartan potassium group [20 mg/(kg•d)] and saline group by stratified random sampling method, 12 in each group. Blood pressure and urea albumin creatinine ratio were measured. After 10 weeks, the expression levels of serum creatinine (Scr), hypersensitive C-reactive protein (hs-CRP), interleukin (IL)-1β, IL-6, tumor necrosis factor α (TNF-α), and transforming growth factor β (TGF-β) in serum were assessed. Kidney pathology periodate-schiff staining was performed. Semi-quantitative count of macrophage infiltration was determined by immunochemistry of CD68 staining. Real-time quantitative polymerase chain reaction and Western blot were performed to examine the mRNA and protein expressions of Toll-like receptor 4 (TLR4), nuclear factor κB (NF-κB), monocyte chemokine peptide (MCP-1), inducible nitric oxide synthase (iNOS), and arginase-1 (Arg-1).Results:SBP did not affect the mortality of SHR (P<0.05). SBP significantly reduced the level of elevated blood pressure of SHRs, but the effect was less significantly than that of losartan potassium. SBP decreased urine protein (P<0.01) and the expression levels of IL-1β, IL-6, TNF-α, and TGF-β in serum. The 22-week-old SHRs showed mild proliferation of glomerular endothelial cells, glomerular ischemic lesions, inflammatory cell infiltration in renal tubular interstitium and arteriosclerosis. Both SBP and losartan potassium had alleviated renal pathological change, and significantly reduced the infiltration of macrophage (P<0.05, P<0.01). SBP and losartan potassium decreased the expressions of TLR4, NF-κB, MCP-1, iNOS, and Arg-1.Conclusion:SBP significantly modified the early hypertensive renal injury by reducing inflammation, and the effect was similar to losartan potassium.  
        Keywords：hypertension;kidney injury;Shexiang Baoxin Pill;Chinese medicine;inflammation   
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        Published：2021-08-16

        Evidence-Based Integrative Medicine

      • Cheng-yu LI,Yao-long CHEN,Jia-yuan HU,Min LI,Xiao-yu ZHANG,Yang SUN,Rui ZHENG,Shi-qi CHEN,Song-jie HAN,Tian-mai HE,Hong-cai SHANG
        2021, 27(1): 54-61. DOI: 10.1007/s11655-020-2725-3
        Abstract：Objective:To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both Chinese medicine (CM) and integrative medicine, through systematic literatures searching and quality assessment.Methods:Data bases including Chinese Biomedical Literature Database, the China National Knowledge Infrastructure, Wanfang Data, China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses. The website www. medlive.cn was also retrieved as supplementary. The clinical practice evaluation tool AGREE Ⅱ was used to assess the quality of included guidelines or consensuses.Results:A total of 31 relevant clinical practice guidelines or expert consensuses were included, covering diagnosis, treatment, Chinese patent and patient fields. Common cardiovascular diseases like coronary heart diseases, heart failure and arrhythmia were also involved. Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year. A total of 4 evidence-based clinical practice guideline has been found, one of which was a guideline project plan. Except that, the remaining 27 reports were all consensusbased guidelines. The scores of each field, from highest to lowest, were clarity of presentation (58%), scope and purpose (54%), stakeholder involvement (28%), rigor of development (21%), applicability (13%) and editorial independence (8%).Conclusions:Although clinical practice guidelines in cardiovascular domain of Chinese have gained increasing concern, with both quantity and quality improved, there is still huge gap in methodology and reporting standards between CM guidelines and international ones. On the one hand, it is essential to improve and standardize the methodology of developing CM guidelines. On the other hands, the evaluation system of evidence and recommendation with CM characters should be developed urgently.  
        Keywords：integrated medicine;Chinese medicine;cardiovascular disease;clinical practice guideline;systematic review   
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        Published：2021-08-16

        Methodology Research

      • Zi-qi MENG,Jia-rui WU,Ying-li ZHU,Wei ZHOU,Chang-geng FU,Xin-kui LIU,Shu-yu LIU,Meng-wei NI,Si-yu GUO
        2021, 27(1): 62-69. DOI: 10.1007/s11655-020-2716-4
        Abstract：Objective:To investigate the shared mechanisms of scutellarin in angina pectoris (AP) and ischemic stroke (IS) treatment.Methods:A network pharmacology approach was used to detect the potential mechanisms of scutellarin in AP and IS treatment by target prediction, protein-protein interaction (PPI) data collection, network construction, network analysis, and enrichment analysis. Furthermore, molecular docking simulation was employed to analyze the interaction between scutellarin and core targets.Results:Two networks were established, including a disease-target network and a PPI network of scutellarin targets against AP and IS. Network analysis showed that 14 targets, namely, AKT1, VEGFA, JUN, ALB, MTOR, ESR1, MAPK8, HSP90AA1, NOS3, SERPINE1, FGA, F2, FOXO3, and STAT1, might be the therapeutic targets of scutellarin in AP and IS. Among them, NOS3 and F2 were recognized as the core targets. Additionally, molecular docking simulation confirmed that scutellarin exhibited a relatively high potential for binding to the active sites of NOS3 and F2. Furthermore, enrichment analysis indicated that scutellarin might exert a therapeutic role in both AP and IS by regulating several important pathways, such as coagulation cascades, mitogen-activated protein kinase (MAPK) signaling pathway, phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling pathway, Toll-like receptor signaling pathway, hypoxia inducible factor-1 (HIF-1) signaling pathway, forkhead box O (FoxO) signaling pathway, tumor necrosis factor (TNF) signaling pathway, adipocytokine signaling pathway, insulin signaling pathway, insulin resistance, and estrogen signaling pathway.Conclusions:The shared underlying mechanisms of scutellarin on AP and IS treatment might be strongly associated with its vasorelaxant, anticoagulant, anti-inflammatory, and antioxidative effects as well as its effect on improving lipid metabolism.  
        Keywords：scutellarin;angina pectoris;ischemic stroke;network pharmacology   
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        Published：2021-08-16

        Literature Research

      • Xin-hui LU,Jun LI
        2021, 27(1): 70-79. DOI: 10.1007/s11655-018-2574-5
        Abstract：Objective:To summarize the current evidence for 8 frequently prescribed Chinese herbal formulas (CHF) as treatments for angina pectoris in patients with coronary heart disease (CHD) and the associated adverse reactions.Methods:Seven electronic databases were screened from their inception through July 2018 for all evidence related to classical CHF for the treatment of patients with CHD.Results:CHF improves CHD outcomes in terms of angina pectoris, electrocardiogram results, Chinese medicine syndromes and biomarkers iomarkers. The combination of CHF and Western medicine (WM) is more effective on CHD than WM alone. The use of CHF to treat CHD shows the same or better clinical effects as the use of WM alone. The 8 investigated CHF do not induce hepatic and renal toxicity or other serious adverse effects.Conclusions:The safety and efficacy of 8 frequently prescribed herbal formulas for treating CHD have been confirmed in many studies. The findings of these studies are positive but should be interpreted cautiously due to the poor methodological quality of the randomized controlled trials (RCTs) and meta-analyses. Additional high-quality, multi-center, large-sample RCTs should be performed to confirm these results.  
        Keywords：Chinese herbal formulas;coronary heart disease;complementary and alternative medicine;review   
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