Latest Issue
      2021 Year 27 Vol. 10 Issue

        Perspective

      • S. Anjani D. Mattai,Ka-Kit P. Hui
        2021, 27(10): 723-728. DOI: 10.1007/s11655-021-3500-9
        Abstract：Convergence of principles of palliative care and integrative medicine has led to the introduction of the new practice of integrative palliative care in which integrative therapies (including mind-body modalities, traditional Chinese medicine, Ayurveda, and dietary supplements) are used to provide symptom management for patients who are dying or experiencing the sequelae of serious illness and its treatment. We propose an East-West Integrative palliative care model using non-drug therapies, such as acupuncture, diet, exercise, and stress management that shift the paradigm from suppressing the symptoms of illness to addressing both the root cause of the symptoms and the imbalance and declining homeostatic reserve that perpetuate these symptoms. This whole-person model expands the reach of palliative care, prolonging a better quality of life and allowing the patient to maintain as many activities as possible by preventing symptoms and improving function. Through this approach we reframe the dialogue such that patients are "living better" rather than "dying better" when faced with serious illness or death. In this article, we provide an overview of the principles of palliative care, integrative medicine, and the novel area of integrative palliative care, and propose an East-West integrative palliative care model that incorporates and broadens the scope of these existing approaches.  
        Keywords：person-centered model;palliative care;integrative medicine;traditional Chinese medicine;acupuncture;symptom management;cost-effectiveness;reframing healthcare   
        17
        |
        2
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203508 false
        Published：2021-10-18

        Original Article

      • Jie-mei GUO,Yan XIAO,Tang-yan CAI,Jian-hui WANG,Bao-lin LI,Lu-lu HUANG,Xiao MAO,Xing-quan LAI,Ya-ju ZHU,Yi-qiang ZHANG,Shao-qing CHEN,You-xin SU
        2021, 27(10): 729-736. DOI: 10.1007/s11655-021-3488-6
        Abstract：Objective:To determine the effects of Chinese medicine (CM) involving triple rehabilitation therapy on the progression of knee osteoarthritis (KOA).Methods:A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally, using a cluster randomization design. Health education combined with CM involving triple rehabilitation therapy for KOA (electro-acupuncture, Chinese medicinal herb fumigating-washing, and traditional exercises) was administered in the treatment group while conventional rehabilitation therapy (physical factor therapy, joint movement training, and muscle strength training) was administered in the control group. Patients with a visual analog scale (VAS) scores ≥4 were treated with dispersible meloxicam tablets (7.5 mg, once daily). The Lequesne index scores, VAS scores, range of motion (ROM), lower limb muscle strength, knee joint circumference, quantitative scores of KOA symptoms, and the short-form 36 item health survey questionnaire (SF-36) scores were measured for each patient at 5 checkpoints (before treatment, at the 2nd week and the 4th week during the 4-week treatment period, at 1 month and 3 months after end of treatment), and adverse reactions were observed also.Results:A total of 696 patients completed the entire process, with 351 in the treatment group and 345 in the control group. At all treatment checkpoints, the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores, effective rate and improvement rate of the total Lequesne index scores, VAS scores, lower limb muscle strength, knee circumference, quantitative scores of KOA symptoms, and SF-36 scores as well (P<0.05 or P<0.01). No adverse reactions were encountered in this study.Conclusions:CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling, improve lower limb muscle strength, promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA. It is suitable for patients with early or mid-stage KOA. (Registration No. ChiCTR-TRC-12002538)  
        Keywords：knee osteoarthritis;Chinese medicine involving triple rehabilitation therapy;electro-acupuncture;Chinese medicinal herb fumigating-washing;traditional exercises;community rehabilitation   
        22
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203748 false
        Published：2021-10-18
      • Hao-xu DONG,Qing WANG,Zhi WANG,Xiao-ke WU,Ling CHENG,Zhong-ming ZHOU,Li YANG,Ping YI,Dong-mei HUANG
        2021, 27(10): 737-743. DOI: 10.1007/s11655-021-3482-z
        Abstract：Objective:To explore the effect of electro-acupuncture (EA) on glucose and lipid metabolism in unmarried patients with polycystic ovary syndrome (PCOS).Methods:Fifty-four PCOS patients were equally randomized into true acupuncture group and sham acupuncture group (control) for totally 16 weeks of treatment by random method with a computerized randomization program. Patients in true acupuncture group accepted traditional acupuncture methods with EA and two sets of acupoint groups were used alternatively. The first set consisted of Zhongji (CV 3), Qihai (CV 6), Guilai (ST 29), Sanyinjiao (SP 6), Yinlingquan (SP 9), Hegu (LI4) and Baihui (GV 20), and the second set consisted of Tianshu (ST 25), ST 29, CV 3, CV 6, SP 6, Taichong (LR 3), Neiguan (PC) 6 and GV 20. Patients in the sham acupuncture group accepted shallow acupuncture methods through EA without electricity at 4 non-meridian points in each shoulder and upper arm. Outcome measures included body mass index (BMI), waist-hip-ratio (WHR), oral glucose tolerance test (OGTT), insulin release test, glucose and lipid metabolism indicators such as total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, adiponectin, leptin, visfatin, resistin, and interleukin (IL-6).Results:Twenty-six subjects in the true acupuncture group and 20 subjects in the sham group completed the clinical trial. After 16 weeks of treatment, no significant difference in the outcome measures were observed between the two groups (P>0.05). However, as compared with baseline data, a reduction in weight, BMI, hipline, WHR, fasting glucose, homeostatic model assessment of insulin sensitivity, visfatin and HDL-C, and an increase in resistin and IL-6 were observed in the true acupuncture group (P<0.05). In addition, a reduction in visfatin and an increase in TC were also observed in the sham group (P<0.05).Conclusions:Acupuncture may have a beneficial effect in the treatment of PCOS by improving glucose and lipid metabolism. Moreover, the sham acupuncture may be not completely ineffective. Sham acupuncture may improve some of the aspects of the glucose and lipid metabolism of PCOS patients through a placebo effect. (Registration Nos. ChiCTR-TRC-12002529 and NCT01812161)  
        Keywords：electro-acupuncture;glucose and lipid metabolism;sham acupuncture;visfatin;polycystic ovary syndrome   
        15
        |
        0
        |
        2
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203618 false
        Published：2021-10-18
      • Hai-yan WANG,Hui-fen ZHOU,Yu HE,Li YU,Chang LI,Jie-hong YANG,Hai-tong WAN
        2021, 27(10): 744-751. DOI: 10.1007/s11655-020-3215-3
        Abstract：Objective:To investigate the synergistic effect of Naoxintong Capsule (NXTC, 脑心通胶囊) and Guhong Injection (GHI, 谷红注射液) on cerebral ischemia-reperfusion (I/R) injury.Methods:Forty-eight Sprague-Dawley rats were divided into 6 groups: control group, oxygen and glucose deprivation (OGD) group, nimodipine group (9.375 mg/kg), NXTC group (0.5 g/kg), GHI group (5 mL/kg) and NXTC+GHI group (0.5 g/kg NXTC+5 mL/kg GHI), after the onset of reperfusion and once per day for the following 7 days. Blood was collected 1 h after final administration, and the sera were collected. Cultured primary rat brain microvascular endothelial cells (rBMECs) were subjected to OGD to establish a cell injury model. Untreated rBMECs were used as blank control. The cell counting kit-8 assay was used to assess cell viability using the sera. Malondialdehyde (MDA) and superoxide dismutase (SOD) levels were assessed using an enzymelinked immunosorbent assay. Apoptosis was evaluated after Hoechst33342 staining using fluorescence microscopy and flow cytometry. JC-1 staining was performed to assess changes in mitochondrial membrane potential.Results:Statistical analysis indicated that more than 95% of the cells were rBMECs. Compared with the OGD group, the cellular morphology of the all drug delivery groups improved. In particular, the combined drug group had the most significant effect. Compared with the OGD group, all drug intervention groups induced a decrease in the apoptotic rate of rBMECs, increased the SOD levels, and decreased the MDA levels (all P<0.01). Compared with the mono-therapy groups, the NXTC+GHI group exhibited a significant improvement in the number of apoptotic rBMECs (P<0.01). All drug intervention groups showed different degrees of increase in membrane potential, and the NXTC+GHI group was higher than the NXTC or GHI group (P<0.01).Conclusion:The combinationa application of NXTC and GHI on cerebral I/R injury clearly resulted in protective benefits.  
        Keywords：cerebral ischemia/reperfusion injury;Naoxintong Capsule;Guhong Injection;brain microvascular endothelial cells;apoptosis;rat   
        14
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203651 false
        Published：2021-10-18
      • Ye Seul Park,Gun He Nam,Kyung Jo Jo,Hye Won Kawk,Sang Yung Kim,Young Min Kim
        2021, 27(10): 752-759. DOI: 10.1007/s11655-021-3486-8
        Abstract：Objective:To determine the effect of Zanthoxylum piperitum extracet (ZPE) on apoptosis and analyze anticancer substances in ZPE, changes in proteins related to apoptosis, and pathological changes in tumors in mouse.Methods:Fifteen 4-week-old female BALB/c nu/nu mice were divided into 3 groups depending on ZPE dose, with 5 in each group. AGS gastric carcinoma cells (1×106 cells/200 μL) were subcutaneously injected into the flank of each mouse. One week after the injection of AGS cells, ZPE was administered to the skin tissue [10 or 50 mg/(kg•d)] in the low- and high-dose groups, respectively for 20 days. Control animals were injected with vehicle only. After 3 weeks, the tumor was extracted and carried out for immunohistochemistry, the tendency of apoptosis and p53 in the body was checked using TdT-mediated dUTP nick-end labeling (TUNEL) assay. For 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, annexin V dead cell staining, cell cycle arrest and Western blotting, AGS gastric carcinoma cells were incubated with various concentrations of ZPE for 24 h. Cell survival rates were analyzed by MTT assays. Apoptosis was analyzed using annexin V dead cell staining and cell cycle arrest and measured using Muse cell analyzer.Results:High performance liquid chromatography (HPLC) analysis showed that ZPE contained organic sulfur compounds such as alliin and S-allylcysteine. MTT assay results revealed that ZPE (10–85 μg/mL) could effectively inhibit the growth of AGS gastric cancer cells at higher concentrations (P<0.05, P<0.01). The annexin V & dead cell staining assay and cell cycle arrest assay confirmed a dose-dependent increase in the apoptosis rate and G1 phase in ZPE (10–70 μg/mL) groups. ZPE decreased the expression of anti-apoptotic proteins (p-Akt, p-MDM2, Bcl-2), while increased pro-apoptotic proteins (cleaved PARP, p53, pro-Caspase 3, Bax). TUNEL assays revealed an increase in cell apoptosis. Immunohistochemistry staining confirmed the involvement of p53.Conclusion:ZPE decreases AGS cell proliferation and induces apoptosis by inhibiting Akt and MDM2 expression.  
        Keywords：AGS gastric cancer cells;Zanthoxylum piperitum;apoptosis;Akt/MDM2/p53 signaling pathway;active compounds   
        14
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203779 false
        Published：2021-10-18
      • Ji-hao MO,Han-kun XIE,Ye-mian ZHOU,Ng Sihan-benjamin,Shao-xia LI,Lei WANG
        2021, 27(10): 767-773. DOI: 10.1007/s11655-021-3492-5
        Abstract：Objective:To elucidate the active compounds and the molecular mechanism of Cyathula Officinalis as a drug treatment for rheumatoid arthritis (RA).Methods:The target genes of active ingredients from Cyathula Officinalis were obtained from bioinformatics analysis tool for the molecular mechanism of traditional Chinese medicine. The protein-protein interaction between the target genes were analyzed using STRING and Genemania. The transcriptome of RA patients compared to healthy people (GSE121894) were analyzed using R program package Limma. The relative expression of the target genes was obtained from the RNA-seq datasets. The molecular docking analyses were processed based on the molecular model of estrogen receptor 1 (ESR1) binding with estradiol (PDB ID:1A52). The binding details were analyzed by SYBYL.Results:Inokosterone, ecdysterone, and cyaterone were the 3 active ingredients from Cyathula Officinalis that bind to target genes. Of all the significantly changed genes from RA patients, ESR1, ADORA1, and ANXA1 were significantly increased in mRNA samples of RA patients.Conclusion:ESR1, the transcription factor that binds inokosterone in the molecular binding analysis, is the target protein of Cyathula Officinalis.  
        Keywords：rheumatoid arthritis;estrogen receptor 1;inokosterone;Cyathula Officinalis;Chinese medicine   
        11
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203837 false
        Published：2021-10-18

        Erratum

      • 2021, 27(10): 751.
          
        8
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203502 false
        Published：2021-10-18

        Original Articles

      • Teng-da WANG,Song-lin XU,Zheng-yi YU,Shao-bin NI,Cheng ZHANG,Zhi-xing JIAO
        2021, 27(10): 760-766. DOI: 10.1007/s11655-021-3495-2
        Abstract：Objective:To investigate the molecular mechanisms underlying the effects of arsenic trioxide (As2O3) in combination with leflunomide on the hamster-to-rat heart xenotransplant.Methods:Transplantation of LVG hamster hearts to Lewis rats was performed by anastomosis of vessels in the neck using end-to-end anastomosis with a non-suture cuff technique. Four groups of recipient rats (n=6 in each) were treated with normal saline (control), As2O3 [5 mg/(kg•day) intraperitoneally], leflunomide [5 mg/(kg•d) orally], or leflunomide [5 mg/(kg•d)+As2O3 [5 mg/(kg•d)] in combination. Donor hearts and/or rat spleens were harvested and analyzed 4 days after transplantation. Quantitative reverse-transcription polymerase chain reaction and Western blot analysis were performed to detect the expression of the nuclear factor erythroid-derived factor 2-related factor (Nrf2) and its target gene heme oxygenase-1 (HO-1), Treg cell marker fork-head Box P3 (FOXP3), apoptosis-associated proteins Bcl-2, Bax, and cleaved caspase-3. Immunohistochemical staining was used to detect the levels of inflammatory natural killer cell and macrophage infiltration, intercellular cell adhesion molecule-1 (ICAM-1) and complement C3.Results:Expression of Nrf2-ARE-HO-1 signaling pathway was upregulated in heart xenografts in rats treated with As2O3 plus leflunomide compared with control rats or rats treated with either drug alone (P<0.01), and this was accompanied by an increased Treg cells in the recipient rat spleen (P<0.01). In contrast, the expressions of Bax, cleaved caspase-3, ICAM-1, and complement C3, and infiltration of inflammatory cells in the xenografts were inhibited by As2O3 plus leflunomide treatment (P<0.01).Conclusion:Combination treatment with As2O3 and leflunomide protected hamster heart-xenografts in recipient rats.  
        Keywords：arsenic trioxide;leflunomide;Nrf2-ARE-HO-1 signaling pathway;inflammation;infiltration;xenotransplantation   
        14
        |
        1
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203761 false
        Published：2021-10-18

        Evidence-Based Integrative Medicine

      • Ying WANG,Mei HAN,Christopher E. Pedigo,Zhi-min XIE,Wei-jie WANG,Jian-ping LIU
        2021, 27(10): 778-787. DOI: 10.1007/s11655-021-3497-0
        Abstract：Objective:To provide evidence on the efficacy and safety of Chinese herbal medicine (CHM) as interventions for systemic lupus erythematosus (SLE).Methods:Seven electronic databases, including the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), Chinese Biomedical Literature Service System (SinoMed), Wanfang, Embase, and PubMed, were comprehensively searched, from their inception to August 16, 2020, for all randomized controlled trials (RCTs) that focused on CHM used alone or in combination with conventional medicine for SLE. Outcomes were SLE activity index (SLEDAI), traditional Chinese medicine symptom/syndrome score (TCMSS), dosage of glucocorticoids, main serological testing, and incidence of adverse events. Data were extracted and pooled using Review Manager 5.3 software.Results:A total of 13 RCTs enrolling 856 participants met our inclusion criteria. Meta-analyses showed that, compared to placebo, CHM had statistically significant effect on reducing SLEDAI score (MD=–1.74, 95% CI: –2.29 to –1.18), diminishing TCMSS (SMD=–0.89, 95% CI: –1.16 to –0.62), decreasing dosage of glucocorticoids (MD=–2.41 mg/d, 95% CI: –3.34 to –1.48), lowering erythrocyte sedimentation rate (MD=–4.78 mm/h, 95% CI: –8.86 to –0.71), and increasing serum complement C4 level (MD=0.03 mg/dL, 95% CI: 0.00 to 0.06). No significant difference was found between CHM and placebo on adverse events.Conclusions:CHM provided significant beneficial effect on controlling disease activity and reducing dose of glucocorticoids used among SLE patients. Future advanced designed RCTs for CHM treating moderate to severe SLE with multicenter and longer follow-up are urgently needed.  
        Keywords：Chinese herbal medicine;systemic lupus erythematous;systematic review and meta-analysis;randomized controlled trials   
        12
        |
        1
        |
        1
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203877 false
        Published：2021-10-18

        Academic Exploration

      • Loh Cheng Toa Steven,Goh Xin Yi
        2021, 27(10): 788-793. DOI: 10.1007/s11655-020-3217-1
        Abstract：With Chinese medicine (CM) gaining popularity in recent years, researchers and clinicians have put in much interest and effort into the makings and effects of it, especially after the recent announcement of World Health Orgnitation's incorporation of CM into mainstream medical compendium. Individual herb has complex properties, coming from its pharmacological properties and the Chinese medical principles of organ-directed, taste and dynamic orientational behaviours. The use of individual herb in CM is rare, where various herbs/ingredients are mostly found in a prescribed formula. To fully reveal the effects of CM is a great challenge. The complexity of various herbs in combined effect, the absorption and utility rate by the body, uniqueness of individual physique, sub-types of pathological behaviors and time-line progression of the healing process add on to the complication of understanding the full effect of CM. Various theories such as pathophysiology guidance, pharmacokineticpharmacodynamic compatibility method, and Global Systems Biology for Integrative Genomics, Proteomics and Metabolomics, which interactively provide a wider scope, more details, with the consideration of development timeline, may shed more light to revealing the full picture of the effects of compatibility prescription.  
        Keywords：Chinese medicine;integrative effects;methodologies;prescription compatibility   
        7
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203872 false
        Published：2021-10-18

        Review

      • Purumea Jun,Endang Rahmat,Chang-Hyun Han,Changsop Yang,Youngmin Kang
        2021, 27(10): 794-800. DOI: 10.1007/s11655-021-3487-7
        Abstract：The decline in birth rates has become a very serious problem in various parts of the world. Many countries have implemented national programs for increasing birth rates, one of which involves the use of traditional medicine as an alternative solution. Among the fast-growing traditional medicines, traditional Chinese medicine (TCM) and traditional Indonesian medicine (TIM) have attracted a lot of demand globally. Here, we analyzed and compared the herbal medicines from TCM and TIM that must be avoided by pregnant women for preventing miscarriage and maintaining safety during pregnancy and the postpartum period. This review uses data from official reports from the respective government and national and international electronic databases for analysis. Although TCM and TIM have their own characteristics of treatment, they also have some similarities in concept and treatment, especially those related to herbal medicines. This review can be used as a reference base to help pregnant women consume herbal medicines at appropriate conditions and doses.  
        Keywords：traditional Chinese medicine;Chinese herbal medicine;traditional indonesian medicine;jamu;restricted herbal medicines;herbal contraindications for pregnancy   
        8
        |
        0
        |
        0
        <HTML>
        <Meta-XML>
        <CITATION> <Bulk Citation> 19203884 false
        Published：2021-10-18
      0