Latest Issue
      2021 Year 27 Vol. 4 Issue

        Original Article

      • Li LI,Chun-yan GOU,Xue-mei LI,Wen-yan SONG,Xiao-jun WANG,Hong-ying LI,Hong-yan LI,Xiu-hui LI
        2021, 27(4): 245-251. DOI: 10.1007/s11655-021-3328-3
        Abstract：Objective:To observe the changes of symptoms, Chinese medicine (CM) syndrome, and lung inflammation absorption during convalescence in patients with coronavirus disease 2019 (COVID-19) who had not totally recovered after hospital discharge and whether CM could promote the improvement process.Methods:This study was designed as a prospective cohort and nested case-control study. A total of 96 eligible patients with COVID-19 in convalescence were enrolled from Beijing Youan Hospital and Beijing Huimin Hospital and followed up from the hospital discharged day. Patients were divided into the CM (64 cases) and the control groups (32 cases) based on the treatment with or without CM and followed up at 14, 28, 56, and 84 days after discharge. In the CM group, patients received the 28-day CM treatment according to two types of CM syndrome. Improvements in clinical symptoms, CM syndrome, and absorption of lung inflammation were observed.Results:All the 96 patients completed the 84-day follow-up from January 21 to March 28, 2020. By the 84th day of follow-up, respiratory symptoms were less than 5%. There was no significant difference in the improvement rates of symptoms, including fatigue, sputum, cough, dry throat, thirst, and upset, between the two groups (P>0.05). Totally 82 patients (85.42%) showed complete lung inflammation absorption at the 84-day follow-up. On day 14, the CM group had a significantly higher absorption rate than the control group (P<0.05) and the relative risk of absorption for CM vs. control group was 3.029 (95% confidence interval: 1.026–8.940). The proportions of CM syndrome types changed with time prolonging: the proportion of the pathogen residue syndrome gradually decreased, and the proportion of both qi and yin deficiency syndrome gradually increased.Conclusions:Patients with COVID-19 in convalescence had symptoms and lung inflammation after hospital discharge and recovered with time prolonging. CM could improve lung inflammation for early recovery. The types of CM syndrome can be transformed with time prolonging. (Registration No. ChiCTR2000029430)  
        Keywords：Covid-19;convalescent patient;Chinese medicine;syndrome evolution;pneumonia absorption   
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        Published：2021-08-16
      • Qian-yu ZHAO,Rong-hua TANG,Guo-xiong LU,Xu-zheng CAO,Lu-ran LIU,Ji-hua ZHANG,Jin-tao ZHANG,Bin XU,Hong-tao WEI,Miao YANG,Ling WEI,Mei ZHANG,Wen-zong ZHU,Hong WANG,Hong-lin LI,Li-ping MA,Chi ZHONG,Yan-jie GAO,Na ZHANG,Shan REN,Lu CHEN,Yun-hai LIU,Zhi-gang CHEN
        2021, 27(4): 252-258. DOI: 10.1007/s11655-020-3320-3
        Abstract：Objective:To evaluate whether the efficacy of Getong Tongluo Capsule (葛酮通络胶囊, GTC, consisted of total flavone of Radix Puerariae) on improving patients' quality of life and lowering blood pressure are superior to the extract of Ginkgo biloba (EGB) for patients with convalescent-phase ischemic stroke and primary hypertension.Methods:This randomized, positive-drug- and placebo-controlled, double-blind trial was conducted from September 2015 to October 2017. Totally 477 eligible patients from 18 hospitals in China were randomly assigned in a 2:1:1 ratio to the following interventions, twice a day for 12 weeks: (1) GTC 250 mg plus EGB-matching placebo 40 mg (237 cases, GTC group), (2) EGB 40 mg plus GTC-matching placebo 250 mg (120 cases, EGB group) or (3) GTC-matching placebo 250 mg plus EGB-matching placebo 40 mg (120 cases, placebo group). Moreover, all patients were orally administered aspirin enteric-coated tablets 100 mg, once a day for 12 weeks. The primary outcome was the Barthel Index (BI). The secondary outcomes included the control rate of blood pressure and National Institutes of Health Stroke Scale (NIHSS) scores. The incidence and severity of adverse events (AEs) were calculated and assessed.Results:The BI relative independence rates, the clinical recovery rates of NIHSS, and the total effective rates of NIHSS in the GTC and EGB groups were significantly higher than the placebo group at 12 weeks after treatment (P<0.05), and no statistical significance was found between the GTC and EGB groups (P>0.05). The control rate of blood pressure in the GTC group was significantly higher than the EGB and placebo groups at 12, 18 and 24 weeks after treatment (P<0.01). There were no statistically significant differences in the incidences of AEs, adverse drug reactions, or serious AEs among the 3 groups (P>0.05).Conclusion:GTC exhibited significant efficacy in improving patients' quality of life as well as neurological function and controlling hypertension. (Registration No. ChiCTR1800016667)  
        Keywords：convalescent-phase of ischemic stroke;primary hypertension;Getong Tongluo Capsule;total flavone of Radix Puerariae;randomized controlled trial;Chinese medicine   
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        Published：2021-08-16
      • Li-jun GUO,Ke-ji CHEN,Ming-qian SUN,An-zhu WANG,Feng GAO,Yuan ZHENG,Xiao-chang MA
        2021, 27(4): 259-264. DOI: 10.1007/s11655-020-3479-7
        Abstract：Objective:To reveal the underlying relationships between Chinese medicine (CM) syndromes and ultrafiltration (UF) in the treatment of heart failure based on a metabonomic approach.Methods:Seventeen acute decompensated heart failure (ADHF) patients were enrolled, and their CM syndromes before and after UF were collected. In addition, their venous plasma collected before and after UF was used for liquid chromatographmass spectrometer-based metabonomic analysis. Both reversed phase liquid chromatography and hydrophilic interaction liquid chromatography were used to analyze the plasma samples. Partial least-squares to latent structure-discriminant analyses were used for data analysis.Results:An obvious difference was observed preand post-treatment. A total of 17 potential biomarkers associating with alterd syndromes with UF including hypoxanthine, 1-methylhistidine, phytosphingosine, O-decanoyl-R-carnitine, etc. were screened out, showing a significant change after UF. The major adjusted metabolic pathways were purine metabolism, histidine metabolism, leucine and isoleucine metabolism, arginine and proline metabolism, carnitine shuttle, sphingolipid metabolism and phospholipid metabolism.Conclusions:Metabonomic approach is a useful tool to identify potential biomarkers of altered syndromes link to UF and could provide a theoretical basis for further research on the therapeutic mechanism of UF combined with CM.  
        Keywords：metabonomics;heart failure;ultrafiltration;Chinese medicine   
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        Published：2021-08-16
      • Duan CHENG,Xuan WANG,Jie HU,Ling-li DAI,Ying LV,Hui FENG,Yan ZHANG,Yan GUO,Lei WANG
        2021, 27(4): 265-272. DOI: 10.1007/s11655-021-3278-9
        Abstract：Objective:To study the effect of Tai Chi (TC) and resistance training (RT) with different intensity on the cancer-related fatigue (CRF) and quality of life (QoL) of middle-aged and elderly cancer patients.Methods:Totally 120 cancer patients were enrolled and randomly assigned to 4 groups by a random number table, including TC group, high-intensity 60% one repetition maximum (1-RM) RT group (HIRT), low-intensity (30% 1-RM) RT group (LIRT) and control group, 30 patients in each group. Participants in the TC group received 24-form simplified Yang-style TC training at a frequency of 40 min per day, 3 days per week for 12 weeks. Patients in the two RT groups received 10 sessions, 6 designated movements per day, 3 days per week for 12 weeks. The 1-RM of 6 muscle groups, fat mass (FM), lean body mass (LBM), along with the scores of Brief Fatigue Inventory (BFI), QoL questionnaire for Chinese cancer patients receiving chemobiotherapy (QLQ-CCC), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9) and Pittsburgh Sleep Quality Index (PSQI) were measured before and after training. The adverse effect was also observed.Results:After 12-week intervention, patients in both TC and RT groups showed significant improvements in CRF and QLQ-CCC compared to pre-treatment (P<0.05). Compared with the LIRT and TC groups, patients in the HIRT group improved more significantly in increasing muscle strength and LBM, and reducing in FM (P<0.05). Patients in the TC group significantly increased in lower limb muscle strength compared with the LIRT group (P<0.05). In addition, patients in the TC group showed more significant improvements in scores of GAD-7, PHQ-9 and PSQI than 2 RT groups (P<0.05).Conclusions:TC and RT, both low- and high-intensity training, can significantly increase muscle strength, reduce CRF and improve QoL in the middle-aged and elderly cancer patients. TC has a better effect than RT in terms of sleep quality and mental health. The long-term application is needed to substantiate the effect of TC as an alternative exercise in cancer patients.  
        Keywords：Tai Chi;resistance training;cancer-related fatigue;quality of life   
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        Published：2021-08-16
      • Cho Su-Hyeon,Rae Kim Song,Seon Jeong Myeong,Choi Miri,Park SeonJu,Kim Kil-Nam
        2021, 27(4): 273-279. DOI: 10.1007/s11655-021-3330-9
        Abstract：Objective:To demonstrate the anti-inflammatory activity of Brassica napus L. hydrosols (BNH) in lipopolysaccharide (LPS)-stimulated RAW 264.7 cells.Methods:Composition analysis of BNH was conducted via gas chromatography-mass spectrometry after BNH were extracted. The nitric oxide (NO) production was measured using the Griess assay. Prostaglandin E2 (PGE2) production was evaluated with enzyme-linked immunosorbent assay. The effects of BNH on LPS-induced pro-inflammatory enzymes including inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2) were evaluated using Western blot analysis. Furthermore, phosphorylation of nuclear factor-kappa B (NF-κB) and nuclear translocation of NF-κB p65 were evaluated with Western blot analysis and immunofluorescence staining, respectively.Results:Compared with LPS-stimulated cells, BNH markedly decreased the generation of NO and PGE2 in LPS-stimulated RAW 264.7 cells (P<0.01 or P<0.05). Moreover, BNH inhibited protein levels of iNOS and COX-2 (P<0.01). Phosphorylation of NF-κB and nuclear translocation of NF-κB p65 was significantly inhibited by BNH (P<0.01 or P<0.05).Conclusion:The anti-inflammatory activities of BNH were mediated via blockage of the NF-κB signaling pathways in LPS-stimulated RAW 264.7 cells.  
        Keywords：Brassica napus L.;inflammation;lipopolysaccharide;RAW 264.7 cells;hydrosols   
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        Published：2021-08-16
      • Zhi-ping HOU,Shi-ying TANG,Hai-ru JI,Pei-yuan HE,Yu-hong LI,Xian-ling DONG,Meng-nan DU,Maznah Ismail,Wen-jing HE
        2021, 27(4): 280-285. DOI: 10.1007/s11655-019-3209-1
        Abstract：Objective:To investigate the mechanistic basis for the attenuation of bone degeneration by edible bird's nest (EBN) in ovariectomized rats.Methods:Forty-two female Sprage-Dawley rats were randomized into 7 groups (6 in each group). The ovariectomized (OVX) and OVX + 6%, 3%, and 1.5% EBN and OVX +estrogen groups were given standard rat chow alone, standard rat chow +6%, 3%, and 1.5% EBN, or standard rat chow +estrogen therapy (0.2mg/kg per day), respectively. The sham-operation group was surgically opened without removing the ovaries. The control group did not have any surgical intervention. After 12 weeks of intervention, blood samples were taken for serum estrogen, osteocalcin, and osteoprotegerin, as well as the measurement of magnesium, calcium abd zinc concentrations. While femurs were removed from the surrounding muscles to measure bone mass density using the X-ray edge detection technique, then collected for histology and estrogen receptor (ER) immunohistochemistry.Results:Ovariectomy altered serum estrogen levels resulting in increased food intake and weight gain, while estrogen and EBN supplementation attenuated these changes. Ovariectomy also reduced bone ER expression and density, and the production of osteopcalcin and osteorotegerin, which are important pro-osteoplastic hormones that promote bone mineraliztion and density. Conversely, estrogen and EBN increased serum estrogen levels leading to increased bone ER expression, pro-osteoplastic hormone production and bone density (all P<0.05).Conclusion:EBN could be used as a safe alternative to hormone replacement therapys for managing menopausal complications like bone degeneration.  
        Keywords：edible bird's nest;menopause;ovariectomy;rats;bone;osteoporosis   
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        Published：2021-08-16
      • Jie-hua DENG,Ji-hong LI,Yi-le ZHAO,Gang-sheng WANG
        2021, 27(4): 286-290. DOI: 10.1007/s11655-020-3075-x
        Abstract：Objective:To evaluate the effect and safety of cinnamaldehyde on immunosuppressed mice with invasive pulmonary candidiasis.Methods:An immunosuppressed BALB/c mouse model was established by intraperitoneal administration of cyclophosphamide (200 mg/kg) once daily for 2 days. The immunosuppressed mouse with invasive pulmonary candidiasis model was further established by nasal perfusion of Candida albicans suspension. In the cinnamaldehyde treatment group, immunosuppressed mice with invasive pulmonary candidiasis were orally given cinnamaldehyde 240 mg/(kg•d) for 14 consecutive days. Fluconazole and 0.9% saline were used as the positive and negative controls, respectively. The mice in the cinnamaldehyde safety evaluation group were orally administered cinnamaldehyde 480 mg/(kg•d) for 42 days to observe the safety of the drug. Microscopic identification, fungal culture, histopathological examination, and (1, 3)-beta-D-glucans detection were conducted to analyze the effect of cinnamaldehyde on C. albicans.Results:The fungal clearance rate in the cinnamaldehyde treatment group was higher than that in the fluconazole control group (80.00% vs. 56.67%, P<0.05). The level of (1, 3)-β-D-glucan in the cinnamaldehyde treatment group was lower than that in the fluconazole positive control group (1160.62±89.65 pg/mL vs. 4285.87±215.62 pg/mL, P<0.05). The survival rate of mice in the cinnamaldehyde safety evaluation group was 100%, and no significant pathological changes of kidney, lung and liver were observed.Conclusions:Cinnamaldehyde was effective and safe in treating immunosuppressed BALB/c mice with invasive pulmonary candidiasis. It would be a potentially novel drug for anti-candidiasis infection.  
        Keywords：cinnamaldehyde;Candida albicans;invasive pulmonary infection;Chinese medicine;safety   
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        Published：2021-08-16

        Acupuncture Research

      • Bao-hu LIU,Dan ZHOU,Yi GUO,Sai ZHANG,Yong-ming GUO,Tong-tong GUO,Xu-yi CHEN,Yi-nan GONG,Hui-ling TANG,Zhi-fang XU
        2021, 27(4): 291-299. DOI: 10.1007/s11655-021-3326-5
        Abstract：Objective:To investigate whether blood-brain barrier (BBB) served a key role in the edema-relief effect of bloodletting puncture at hand twelve Jing-well points (HTWP) in traumatic brain injury (TBI) and the potential molecular signaling pathways.Methods:Adult male Sprague-Dawley rats were assigned to the shamoperated (sham), TBI, and bloodletting puncture (bloodletting) groups (n=24 per group) using a randomized number table. The TBI model rats were induced by cortical contusion and then bloodletting puncture were performed at HTWP twice a day for 2 days. The neurological function and cerebral edema were evaluated by modified neurological severity score (mNSS), cerebral water content, magnetic resonance imaging and hematoxylin and eosin staining. Cerebral blood flow was measured by laser speckles. The protein levels of aquaporin 4 (AQP4), matrix metalloproteinases 9 (MMP9) and mitogen-activated protein kinase pathway (MAPK) signaling were detected by immunofluorescence staining and Western blot.Results:Compared with TBI group, bloodletting puncture improved neurological function at 24 and 48 h, alleviated cerebral edema at 48 h, and reduced the permeability of BBB induced by TBI (all P<0.05). The AQP4 and MMP9 which would disrupt the integrity of BBB were downregulated by bloodletting puncture (P<0.05 or P<0.01). In addition, the extracellular signal-regulated kinase (ERK) and p38 signaling pathways were inhibited by bloodletting puncture (P<0.05).Conclusions:Bloodletting puncture at HTWP might play a significant role in protecting BBB through regulating the expressions of MMP9 and AQP4 as well as corresponding regulatory upstream ERK and p38 signaling pathways. Therefore, bloodletting puncture at HTWP may be a promising therapeutic strategy for TBI-induced cerebral edema.  
        Keywords：traumatic brain injury;cerebral edema;blood brain barrier;bloodletting puncture at hand twelve Jing-well points;mitogen-activated protein kinase pathway;Chinese medicine   
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        Literature Research

      • Hui SHEN,Wei-kai ZHU,Zhi LU,Hai-cheng ZHOU
        2021, 27(4): 304-312. DOI: 10.1007/s11655-020-3322-1
        Abstract：Objective:To summarize current hotspots and predict the potential trends in traditional drugs of diabetes treatment for further research.Methods:Publications on the application of traditional drugs in diabetes treatment were searched from PubMed without language limits. Highly frequent MeSH terms were identified through Bibliographic Item Co-Occurrence Matrix Builder (BICOMB). Biclustering analysis results were visualized utilizing the gCLUTO software. Finally, a strategic diagram was generated.Results:Totally 2, 386 relevant publications were obtained from PubMed on November 9th, 2018, and 69 highly frequent MeSH terms were identified. Biclustering analysis revealed that these highly frequent MeSH terms were classified into 7 clusters. After calculating the density and centrality of each cluster, strategy diagram was presented. Cluster 0 "Chinese medicine monomers such as antioxidant and hypoglycemic effects" was considered as the most potential research hotspot.Conclusions:In this study, we found 7 topics related to the application of traditional drugs in diabetes treatment. The molecular mechanisms of Chinese medicine monomers in diabetes could become a potential hotspot with high centricity and low density.  
        Keywords：hotspot;traditional drug;diabetes;bibliometrics;MeSH term;Chinese medicine   
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        Review

      • Nejatbakhsh Fatemeh,Ali Zareian Mohammad,Yaseliani Mahdi,Abolhassani Hassan
        2021, 27(4): 313-320. DOI: 10.1007/s11655-021-3332-7
        Abstract：The human immune system represents a dynamic multiscale system with high complexity in biology. Humoral immunity, as the main branch of adaptive immunity, is characterized by differentiated stages of the B lymphocytes, producing the final product of antibodies that has a diversity of the tuning mechanisms within genetic and epigenetic levels in confrontation with environmental exposures. Disorders because of disturbed humoral immunity are linked with dysregulation of feedback-regulated signaling and the dynamic of immune components that determine the overall response. Food products, mainly herbal components have a significant role in tailoring the immune system micro-ecosystem which can diversify the adaptive nature of humoral immunity. Herein, we review the current evidence-based approaches for the impact of medicinal herbs on humoral immunity signaling and antibody production with a focus on immunotherapeutic applications.  
        Keywords：B cells;adaptive immunity;antibody;immunotherapy;medicinal herb   
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