Latest Issue
      2021 Year 27 Vol. 6 Issue

        Feature Article

      • Di WANG,Miao QU
        2021, 27(6): 403-407. DOI: 10.1007/s11655-021-2861-4
        Abstract：In recent years, the ancient yin-yang theory has been gradually adopted by modern researchers, especially European and American scholars, and it has also been applied to modern scientific research on sleep, viruses, metabolism, cancer, genes, autoimmune diseases, and so on. It is very promising and fruitful results have been reported. However, the understanding of the connotations of yin-yang theory is not sufficient and thorough enough in these studies. If we understand and apply yin-yang theory more comprehensively, it may provide us with additional potential mechanisms and research directions worthy of study. On the basis of promoting a comprehensive understanding of all three connotations of yin-yang theory, this review attempts to illustrate this theory, summarize its applications in modern scientific research, and reveal the potential research direction of modern medicine.  
        Keywords：yin-yang theory;homeostasis research;sleep and cognitive;infection and latency;leptin and ghrelin;cancer and autoimmunity;gene expression and repression   
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        Published：2021-09-01

        Original Article

      • Xue-jun CUI,Yue-li SUN,Chang-qing ZHANG,Tao WU,Jun TAN,Zhen-an ZHU,Yong-qiang CHEN,Qiu-gen WANG,Ming LI,Yong-jun WANG
        2021, 27(6): 408-416. DOI: 10.1007/s11655-021-2868-x
        Abstract：Objective:To evaluate the safety and effectiveness of Qishe Pill (芪麝丸) on neck pain in realworld clinical practice.Methods:A multi-center, prospective, observational surveillance in 8 hospitals across Shanghai was conducted. During patients receiving 4-week Qishe Pill medication, Visual Analogue Scale (VAS) and Neck Disability Index (NDI) assessments have been used to assess their pain and function, while safety monitoring have been observed after 2 and 4 weeks.Results:Results from 2,023 patients (mean age 54.5 years) suggest that the drug exposure per unit of body mass was estimated at 3.41±0.62 g/kg. About 8.5% (172/2,023) of all participants experienced adverse events (AEs), while 3.8% (78/2,023) of all participants experienced adverse reaction. The most common AEs were gastrointestinal events and respiratory events. The VAS score (pain) and NDI score (function) significantly decreased after 4-week treatment. An effect-quantitative analysis was also conducted to show that the normal clinical dosage may be consider as 3–4 g/kg, at which dosage the satisfactory pain-relief effect may achieve by 40-mm reduction in VAS.Conclusion:These findings showed that patients with cervical radiculopathy who received Qishe Pill experienced significant improvement on pain and function. (Registration No. NCT01875562)  
        Keywords：neck pain;pain assessment;post-marketing surveillance;Qishe Pill;Chinese medicine;complementary and alternative medicine   
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        Published：2021-09-01
      • Wei GU,Xiao-min HOU,Chun-sheng LI
        2021, 27(6): 417-423. DOI: 10.1007/s11655-021-2855-2
        Abstract：Objective:To investigate whether Shenfu Injection (SFI, 参附注射液) can alleviate post-resuscitation myocardial dysfunction by inhibiting the inflammatory response.Methods:After 8 min of ventricular fibrillation and 2 min of basic life support, 24 pigs were randomly divided into 3 groups (n=8), which were given intravenous bolus injections of SFI (1.0 mL/kg), epinephrine (EP, 0.02 mg/kg) and normal saline (SA), respectively. The animals were sacrificed at 24 h after restoration of spontaneous circulation (ROSC), and serum interleuking-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were measured by enzyme-linked immunosorbent assay (ELISA); expressions of Toll-like receptor 4 (TLR4)/nuclear factor kappa B (NF-κB) mRNAs and proteins were determined by RT-PCR and Western blot, respectively.Results:Compared with the EP and the SA groups, the ultrastructure of myocardial cells were slightly damaged and the systolic function of the left ventricle was markedly improved in the SFI group at 24 h after ROSC (P<0.05). In addition, compared with the EP and SA groups, the SFI group also showed significantly reduced levels of serum IL-6 and TNF-α, protein and mRNA levels of myocardial NF-κB and TLR4 (P<0.05).Conclusions:Activation of TLR4/NF-κB signaling pathway may be involved in the pathological mechanisms of post-resuscitation myocardial dysfunction. SFI may block NF-κB-mediated inflammatory response by reducing the activity of NF-κB and the level of TNF-α, thus playing a protective role in post-resuscitation myocardial dysfunction.  
        Keywords：Shenfu Injection;Chinese medicine;cardiopulmonary resuscitation;post-resuscitation myocardial dysfunction;TLR4/NF-κB   
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        Published：2021-09-01
      • Mei-zhong PENG,Mei-ling YANG,A-ling SHEN,Xue-ling ZHOU,Yan LU,Qi LI,Zhi-qing SHEN,Bin HUANG,Jun PENG,Jian-feng CHU
        2021, 27(6): 424-431. DOI: 10.1007/s11655-020-2862-8
        Abstract：Objective:To evaluate the effects of Huoxin Pill (活心丸, HXP) on cardiac fibrosis and heart failure (HF) in isoproterenol (ISO)-induced HF rats.Methods:Thirty Wistar rats were randomly divided into 5 groups including control, HF, isosorbide mononitrate (ISMN), HXP low (HXP-L), and HXP high (HXP-H) groups (n=6 for each group) according to the complete randomization method. Rats were pretreated with ISMN (5 mg/kg daily), low concentration of HXP (10 mg/kg daily) or high concentration of HXP (30 mg/kg daily) or equal volume of saline by intragastric administration for 1 week, followed by intraperitoneal injection of ISO (10 mg/kg, 14 days), and continually intragastric administrated with above medicines or saline for additional 6 weeks. The effects of HXP treatment on the cardiac function, heart weight index (HWI), pathological changes, and collagen content were further assessed. Moreover, the role of HXP on activation of transforming growth factor-β1 (TGF-β1)/Smads pathway was further explored using immunohistochemistry (IHC) and Westernblot assay.Results:HXP treatment significantly alleviated the decrease of ejection fraction (EF) and fractional shortening (FS), while decreased the elevation of left ventricular end-systolic volume (LVESV) in ISO-induced HF rats (P<0.05). Moreover, HXP treatment obviously attenuated the increase of HWI and serum level of creatine kinase MB (CK-MB, P<0.05), as well as pathological changes in ISO-induced HF rats. Further determination indicated that HXP treatment alleviated the elevation of collagen Ⅰ and collagen Ⅲ protein expression in cardiac tissues of ISO-induced HF rats. Furthermore, HXP treatment significantly down-regulated the increase of TGF-β1 and p-Smad2/3 protein expression in cardiac tissues of HF rats (P<0.05), while did not affect the expression of total Smad2/3.Conclusions:HXP attenuated heart failure and cardiac fibrosis in ISO-induced HF rats by suppression of TGF-β1/Smad2/3 pathway.  
        Keywords：Huoxin Pill;heart failure;cardiac fibrosis;isoproterenol;TGF-β1/Smad2/3 pathway   
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        Published：2021-09-01
      • Shu-jun JIANG,Hui DONG,Ke FANG,Guang CHEN,Jing-bin LI,Li-jun XU,Xin ZOU,Fu-er LU
        2021, 27(6): 432-439. DOI: 10.1007/s11655-021-2863-2
        Abstract：Objective:To explore the protective effect and the underlying mechanism of Hu-Lu-Ba-Wan (葫芦巴丸, HLBW) on the testis of diabetic rats.Methods:Twenty-four male Wistar rats (160–180 g) were randomly divided into 3 groups according to a random number table, including a control group (n=8), diabetic group (n=8), and HLBW group (n=8). Diabetic rat model was established by high-fat-diet administration and single intravenous injection of streptozotocin (26 mg/kg). Then HLBW granule was administrated for 12 weeks. Fasting blood glucose and insulin levels as well as serum total testosterone level and testicular testosterone content were examined. Oxidative stress markers in both serum and testis were tested. Meanwhile, testicular morphology was observed under hematoxylin and eosin (HE) and the ultrastructure of Leydig cell was observed by electron microscope. The superoxide anion level was detected by DHE, and TUNEL-positive cells of testis was evaluated by TUNEL assay. The gene and protein expression of protein kinase C (PKCα), phosphorylated PKCα (P-PKCα) and P47phox in testicular tissues were determined by quantitative RT-PCR analysis and Western bolt analysis.Results:Compared with the diabetic group, HLBW treatment significantly reduced the fasting glucose levels and increased the levels of fasting insulin and testosterone in serum (P<0.01). HLBW administration also reduced the levels of reactive oxygen species (ROS) in plasma and alleviated the damage of oxidative stress in the testis of diabetic rats. Additionally, HLBW down-regulated the protein and mRNA levels of PKCα, P-PKCα and P47phox in testicular tissues.Conclusion:HLBW may attenuate the oxidative stress in the testis of diabetic rats via PKCα /NAPDH oxidase signaling pathway.  
        Keywords：Hu-Lu-Ba-Wan;Chinese medicine;oxidative stress;testis;diabetes;nicotinamide-adenine dinucleotide phosphate (NADPH) oxidase   
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        Published：2021-09-01
      • Gao-jie XIN,Yu-wei ZHAO,Ling-mei LI,Fei-fan JIA,Xiao HAN,Lei LI,Hao GUO,Hong-xu MENG,Jian-hua FU,Jian-xun LIU
        2021, 27(6): 440-445. DOI: 10.1007/s11655-021-2859-y
        Abstract：Objective:Using network pharmacology to explore the mechanism of the 'invigorating qi and promoting blood circulation' drug pair Ginseng-Danshen (Salvia miltiorrhiza) on treatment of ischemic heart disease (IHD).Methods:The chemical constituents of ginseng and Danshen drug pair were identified by searching the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and the potential targets of the pair were identified. The pharmacodynamics of the pair was analyzed using network pharmacology. The targets of IHD were identified by database screening. Using protein-protein interaction network, the interaction targets of Ginseng-Danshen on IHD were constructed. A "constituent-target-disease" interaction network was constructed using Cytoscape software, Gene Ontology (GO) term enrichment analysis and biological pathway enrichment analysis were carried out, and the mechanism of improving myocardial ischemia by the Ginseng-Danshen drug pair was investigated.Results:Seventeen active constituents and 53 targets were identified from ginseng, 53 active constituents and 61 targets were identified from Danshen, and 32 protein targets were shared by ginseng and Danshen. Twenty GO terms were analyzed, including cytokine receptor binding, cytokine activity, heme binding, and antioxidant activity. Sixty Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathways were analyzed, including phosphatidylinositol 3-kinase-serine-threonine kinase (PI3K-AKT) signaling pathway, p53 signaling pathway, interleukin 17 signaling pathway, tumor necrosis factor signaling pathway, and the advanced glycation end product (AGE)-the receptor for AGE (RAGE) signaling pathway in diabetic complications.Conclusion:The specific mechanism of Ginseng-Danshen drug pair in treating IHD may be associated with improving the changes of metabolites inbody, inhibiting the production of peroxides, removing the endogenous oxygen free radicals, regulating the expression of inflammatory factors, reducing myocardial cell apoptosis and promoting vascular regeneration.  
        Keywords：network pharmacology;Ginseng-Danshen;Salvia miltiorrhiza;drug pair;ischemic heart disease;invigorating qi and promoting blood circulation   
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        Published：2021-09-01

        Acupuncture Research

      • Xiao-qing HUANG,Jin-sen XU,Xiao-ran YE,Xuan CHEN
        2021, 27(6): 446-454. DOI: 10.1007/s11655-021-2865-0
        Abstract：Objective:To evaluate the effect of the pulse width of electroacupuncture (EA) in the treatment of denervation-induced skeletal muscle atrophy in rats and examine the role of insulin-like growth factor 1 (IGF-1)/phosphatidylinositol 3-kinase (PI3K)/Akt signaling pathway during EA.Methods:Sciatic nerve functional index (SFI), muscle wet weight and the cross-sectional area (CSA) of the gastrocnemius muscle were analyzed after treatment in model rats with EA of various pulse widths (0.5, 50, 100 and 200 ms). The apoptosis index (AI) and paired box (PAX) 3 and PAX7 protein expression were also determined. Further, the mRNA and protein expressions of components of IGF-1/PI3K/Akt pathway and their downstream targets were determined, along with the inhibiting effect of the pathway with a PI3-specific inhibitor.Results:EA with a pulse width of 200 ms was found to have the best effect with regard to increasing SFI, CSA and muscle weight, decreasing AI, and increasing the expression of PAX3 and PAX7. The IGF-1/PI3K/Akt pathway was found to be activated by denervation, although the downstream forkhead box O (FoxO) pathway was not suppressed by its activation. The PI3K/Akt pathway and its downstream molecule mammalian target of rapamycin (mTOR) were up-regulated further by EA to promote muscle protein synthesis. Meanwhile, the expressions of downstream FoxO and F-box protein 32 (ATROGIN-1) were down-regulated to reduce protein degradation.Conclusions:EA with 200-ms pulse width was found to have a more significant effect than 0.5-ms EA. The positive effects of EA disappeared after inhibition of the PI3K/Akt pathway.  
        Keywords：denervation;muscle;atrophy;electroacupuncture;pulse width;IGF-1/PI3K/Akt pathway   
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        Published：2021-09-01

        Clinical Experience

      • Qing-rong LIU,Hong-xu LIU,Wen-long XING,Qi ZHOU,Hong-liang ZHANG,Hai-tong ZHANG,Guang-yuan SONG,Yong-jian WU
        2021, 27(6): 455-460. DOI: 10.1007/s11655-021-2853-4
        Abstract：Objective:To explore the effectiveness of Danhong Injection (丹红注射液) on improving microcirculatory injury after percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD).Methods:A randomized controlled trial was conducted and 90 patients were enrolled. A random sequence was generated using statistical analysis software. Patients with microcirculatory injuries after PCI were randomly divided into 3 groups for treatment (30 subjects in each group): Danhong Injection group: after PCI, Danghong Injections were given with intravenous administration with 40 mL twice a day for a week; statins intensive group: after PCI, atorvastatin calcium tablets were given oral medication with 80 mg once, and then atorvastatin 40 mg daily for 1 week; the control group: after PCI, atorvastatin calcium tablets were given oral medication with 10–20 mg daily for 1 week. The index of microcirculation resistance (IMR) was used to assess microcirculatory injury during PCI. The IMR of the target vessel was reexamined after 1 week of drug treatment.Results:After one week's drug treatment, IMR was significantly decreased in both statins intensive group and Danhong Injection group compared with the control group (P<0.01), but no difference was found between statins intensive group and Danhong injection group (14.03±2.54 vs. 16.03±5.72 U, P=0.080).Conclusions:The efficacy of Danhong Injection is non-inferior to statin. Early use of Danhong Injection after PCI can effectively improve coronary microcirculation injury after PCI.  
        Keywords：Danhong Injection;coronary artery;interventional therapy;coronary microcirculation injury;Chinese medicine   
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        Published：2021-09-01

        Academic Exploration

      • Chi ZHANG,Li LI,Ge ZHANG,Ke-ji CHEN,Ai-ping LU
        2021, 27(6): 465-469. DOI: 10.1007/s11655-018-2571-8
        Abstract：Biological complexity and the need for personalized medicine means that biomarker development has become increasingly challenging. Thus, new paradigms for research need to be created that bring together a different classifier of individuals. One potential solution is collaboration between biomarker development and Chinese medicine pattern classification. In this article, two examples of rheumatoid arthritis are discussed, including a new biomarker candidate casein kinase 2 interacting protein 1 (CKIP-1) and a micro RNA 214. The authors obtained a "snapshot" of pattern classification with disease in biomarker identification. Bioinformatics analyses revealed underlying biological functions of two biomarker candidates, in varying degrees, are correlated with Chinese medicine pattern of rheumatoid arthritis. The authors' initial attempt can provide a new window for studying the win-win potential correlation between the biomarkers and pattern classification in Chinese medicine.  
        Keywords：Chinese medicine pattern classification;biomarker;rheumatoid arthritis   
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        Published：2021-09-01

        Review

      • Yu-zhuo ZHANG,Rui-xiang ZENG,Yuan-shen ZHOU,Min-zhou ZHANG
        2021, 27(6): 470-480. DOI: 10.1007/s11655-021-2867-y
        Abstract：Angina pectoris (AP) is the most common symptom of cardiovascular diseases, which seriously affects the quality of life in cardiovascular patients. Kuanxiong (KX) Aerosol (宽胸气雾剂), a compound preparation that consists of 5 traditional Chinese medicines: Herba Asari, Rhizoma Alpiniae Officinarum, Lignum Santali Albi, Fructus Piperis Longi , and Borneolum, has been used in the treatment of AP for many years, exhibiting a significant curative effect and less side-effect. For the convenience and comprehensive understanding of KX Aerosol, this review systematically summarizes evidence on KX Aerosol in the treatment of AP including the pharmacological effects of its composition, clinical research, animal experiments, and network pharmacology prediction. Meanwhile, we highlight the research limitation of KX Aerosol at present. This review may guide the clinical application of KX Aerosol and further provide a reference for the research of AP.  
        Keywords：Kuanxiong Aerosol;angina pectoris;pharmacology;clinical application;network pharmacology   
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        Published：2021-09-01
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