The Relationship between Traditional Chinese Medicine and Modern Medicine

Association between color value of tongue and T2DM based on dose-response analyses using restricted cubic splines in China: A cross-sectional study

This study aimed to explore the relationship between international commission on illumination (CIE) L*a*b* color value of tongue and type 2 diabetes mellitus (T2DM). We used restricted cubic spline method and logistic regression method to assess the relationship between CIE L*a*b* color value of tongue and T2DM. A total of 2439 participants (991 T2DM and 1448 healthy) were included. A questionnaire survey and tongue images obtained with tongue diagnosis analysis-1 were analyzed. As required, chi-square and t tests were applied to compare the T2DM and healthy categories. Our findings suggest the 95% confidence interval and odds ratio for body mass index, hypertension, and age were 0.670 (0.531-0.845), 13.461 (10.663-16.993), and 2.595 (2.324-2.897), respectively, when compared to the healthy group. A linear dose-response relationship with an inverse U-shape was determined between CIE L* and CIE a* values and T2DM (P < .001 for overall and P < .001 for nonlinear). Furthermore, U-shaped and linear dose-response associations were identified between T2DM and CIE b* values (P = .0160 for nonlinear). Additionally, in adults, the CIE L*a*b* color value had a correlation with T2DM. This novel perspective provides a multidimensional understanding of traditional Chinese medicine tongue color, elucidating the potential of CIE L*a*b* color values of tongue in the diagnosis of T2DM.

Heritage and hesitancy: how preference for traditional Chinese medicine influences vaccine attitudes

Introduction

Vaccine hesitancy, amplified by the COVID-19 pandemic, is a pressing public health challenge. This study investigates the association between Traditional Chinese Medicine (TCM) preference and COVID-19 vaccine hesitancy within China.

Methods

The study uses data from the 2021 Chinese General Social Survey (CGSS) (N = 2,690). Logistic regressions and Karlson-Holm-Breen (KHB) method are employed to analyzed the relationship between TCM preference and vaccine hesitancy.

Results

The study reaffirms prior findings by revealing a robust and stable association between TCM preference and vaccine hesitancy, which remains unaffected by socioeconomic and demographic confounders, as well as institutional trust dynamics of healthcare system. Contrary to expectations, TCM enthusiasts do not exhibit vaccine hesitancy based on divergent epistemological views concerning vaccine risks and immunity acquisition compared to biomedicine.

Discussion

This research enriches understandings of the intricate relations between healthcare paradigms and vaccine attitudes, inviting further inquiry into the role of CAM in shaping vaccination behaviors across different cultures and contexts. The insights bear significant public health implications for enhancing vaccine acceptance and coverage, particularly among populations where CAM practices wield substantial influence.

A review of traditional Chinese medicine diagnosis using machine learning: Inspection, auscultation-olfaction, inquiry, and palpation

Traditional Chinese medicine (TCM) is an essential part of the Chinese medical system and is recognized by the World Health Organization as an important alternative medicine. As an important part of TCM, TCM diagnosis is a method to understand a patient's illness, analyze its state, and identify syndromes. In the long-term clinical diagnosis practice of TCM, four fundamental and effective diagnostic methods of inspection, auscultation-olfaction, inquiry, and palpation (IAOIP) have been formed. However, the diagnostic information in TCM is diverse, and the diagnostic process depends on doctors' experience, which is subject to a high-level subjectivity. At present, the research on the automated diagnosis of TCM based on machine learning is booming. Machine learning, which includes deep learning, is an essential part of artificial intelligence (AI), which provides new ideas for the objective and AI-related research of TCM. This paper aims to review and summarize the current research status of machine learning in TCM diagnosis. First, we review some key factors for the application of machine learning in TCM diagnosis, including data, data preprocessing, machine learning models, and evaluation metrics. Second, we review and summarize the research and applications of machine learning methods in TCM IAOIP and the synthesis of the four diagnostic methods. Finally, we discuss the challenges and research directions of using machine learning methods for TCM diagnosis.

Juan Bi Tang, a traditional Chinese medicine, for alleviating pain related to arteriovenous fistula in maintenance hemodialysis patients: An interventional pilot study with brief review

Myofascial pain around an arteriovenous fistula (AVF) during hemodialysis (HD) can affect a patient compliance with HD and quality of life. Prolonged use of analgesics is often associated with increased adverse events. Juan Bi Tang (JBT) is an ancient decoction of Chinese traditional medicinal plants commonly used to treat spasms and pain in the shoulder and upper arm, and it is popularly believed to have favorable outcomes in Asian populations. This interventional prospective pilot study was worked to demonstrate the potential of JBT for fistula-associated myofascial pain in HD patients and to prepare for future randomized controlled trials. Eligible patients were enrolled in this study and took JBT to treat fistula-associated myofascial pain for 4 weeks. Pain scores on a visual analogue scale (VAS) were reported at baseline, after a 4-week intervention, and 2 weeks after completion of treatment. The Kidney Disease Quality of Life 36-Item Short Form and a safety laboratory monitor were statistically compared between different time points. A total of 20 patients were selected as eligible participants and completed the intervention and questionnaires. The mean VAS score was significantly reduced after JBT treatment (P < .01). Participants reported improved physical (P < .01) and mental health (P < .05) after treatment. However, only improvements in mental health were preserved 2 weeks after the end of treatment (P < .05). In this study, complementary JBT for HD patients with fistula-related myofascial pain was viable and well tolerated, and it demonstrated the expected effects on pain control.

Monitoring blood pressure and cardiac function without positioning via a deep learning-assisted strain sensor array

Continuous and reliable monitoring of blood pressure and cardiac function is of great importance for diagnosing and preventing cardiovascular diseases. However, existing cardiovascular monitoring approaches are bulky and costly, limiting their wide applications for early diagnosis. Here, we developed an intelligent blood pressure and cardiac function monitoring system based on a conformal and flexible strain sensor array and deep learning neural networks. The sensor has a variety of advantages, including high sensitivity, high linearity, fast response and recovery, and high isotropy. Experiments and simulation synergistically verified that the sensor array can acquire high-precise and feature-rich pulse waves from the wrist without precise positioning. By combining high-quality pulse waves with a well-trained deep learning model, we can monitor blood pressure and cardiac function parameters. As a proof of concept, we further constructed an intelligent wearable system for real-time and long-term monitoring of blood pressure and cardiac function, which may contribute to personalized health management, precise and early diagnosis, and remote treatment.

Gut Microbiota and Aging: Traditional Chinese Medicine and Modern Medicine

The changing composition of gut microbiota, much like aging, accompanies people throughout their lives, and the inextricable relationship between both has recently attracted extensive attention as well. Modern medical research has revealed that a series of changes in gut microbiota are involved in the aging process of organisms, which may be because gut microbiota modulates aging-related changes related to innate immunity and cognitive function. At present, there is no definite and effective method to delay aging. However, Nobel laureate Tu Youyou's research on artemisinin has inspired researchers to study the importance of Traditional Chinese Medicine (TCM). TCM, as an ancient alternative medicine, has unique advantages in preventive health care and in treating diseases as it already has formed an independent understanding of the aging system. TCM practitioners believe that the mechanism of aging is mainly deficiency, and pathological states such as blood stasis, qi stagnation and phlegm coagulation can exacerbate the process of aging, which involves a series of organs, including the brain, kidney, heart, liver and spleen. Our current understanding of aging has led us to realise that TCM can indeed make some beneficial changes, such as the improvement of cognitive impairment. However, due to the multi-component and multi-target nature of TCM, the exploration of its mechanism of action has become extremely complex. While analysing the relationship between gut microbiota and aging, this review explores the similarities and differences in treatment methods and mechanisms between TCM and Modern Medicine, in order to explore a new approach that combines TCM and Modern Medicine to regulate gut microbiota, improve immunity and delay aging.

Practices, Knowledge, and Attitudes of Chinese University Students Toward Traditional Chinese Herbal Medicine for the Control of COVID-19

BACKGROUND

The application of traditional Chinese herbal medicine has been officially recommended and strongly promoted in China as an important complement to conventional prevention and treatment for COVID-19. Capturing the practices, knowledge and attitudes of young adult population toward using Chinese herbs for COVID-19 is important for understanding the future of Chinese herbal medicine over the coming decades.

METHODS

This cross-sectional questionnaire-based study was conducted from May to June, 2022, among 313 student volunteers in Wuhan University of Science and Technology, a provincial comprehensive university in China.

RESULTS

Results showed that only 18% of students had used Chinese herbs to prevent COVID-19. The main information sources were social media, the students' family members, relatives, friends, etc. as well as the healthcare professionals. However, most students only sometimes paid close attention to related reports and news articles in social media. Clear pharmacological and toxicological properties of herbs were considered by 43% students as the most important factor to promote their own application of Chinese herbs to fight COVID-19. The mean knowledge score was 1.64 out of 5. Students' overall attitudes toward application of Chinese herbal medicine to fight COVID-19 were very positive.

CONCLUSION

These data suggests most university young adults had a positive attitude but lack of practices and knowledge towards traditional Chinese herbal medicine for COVID-19 control.

Trends in the disparities and equity of the distribution of traditional Chinese medicine health resources in China from 2010 to 2020

BACKGROUND

At present, improving the accessibility to traditional Chinese medicine (TCM) health resources is an important component of China's health policy. This study evaluated the trends in the disparities and equity of TCM health resource allocation from 2010 to 2020 to inform optimal future local health planning and policy.

METHOD

The data for this study were extracted from the China Health Statistical Yearbook (2011-2021) and China Urban Statistical Yearbook (2020). The equity and rationality of the allocation of TCM health resources at the national and provincial levels were evaluated using the Gini coefficient and the health resource aggregation degree, respectively.

RESULT

The number of TCM-related institutions, beds, health staff, outpatients and admissions increased by 1.97, 2.61, 2.35, 1.72 and 2.41 times, respectively, between 2010 and 2020. The population-based Gini coefficients for health staff, beds and institutions were 0.12, 0.23 and 0.13, respectively, indicating acceptable equity, while the geographical area-based Gini index for health staff, beds and institutions were 0.65, 0.62 and 0.62, respectively, indicating serious inequity. The agglomeration degree as a function of geographical area was as follows: eastern region > central region > western region. Moreover, the institutional and health staff gaps between the geographical areas increased from 2012 to 2020. In addition, there was a relatively balanced agglomeration degree based on the population in these three regions and an increasingly equitable allocation of institutions and health staff.

CONCLUSION

In recent years, China's TCM health resources and services have increased rapidly, but their proportions within the overall health system remain low. The equity and rationality of TCM health allocated by the population was better than that by the geographic area. Regional differences and inequalities, especially for institutions, still exist. A series of policies to promote the balanced development of TCM need to be implemented.

Paeoniflorigenone regulates apoptosis, autophagy, and necroptosis to induce anti-cancer bioactivities in human head and neck squamous cell carcinomas

ETHNOPHARMACOLOGICAL RELEVANCE

Paonia suffruticosa Andr. belonging to the family Paeoniaceae and has been used as a medicinal plant in Asian countries including China, Korea, and Japan. The roots of P. suffruticosa has been used in traditional medicine in various diseases including cancer and cardiovascular, female genital, and inflammatory diseases.

AIM OF THE STUDY

Head and neck squamous cell carcinomas (HNSCCs) pathologically account for 90% of all head and neck cancers. However, effective targeted therapies for HNSCCs are insufficient and the prognosis is very poor, especially in patients with metastatic HNSCCs. To overcome the current limitations of available therapies for HNSCCs, pathological approaches using natural compounds are attracting attention. Our study aimed to demonstrate the anti-cancer effects of paeoniflorigenone (Paeo, 98.9% purity) isolated from the root bark of P. suffruticosa.

MATERIALS AND METHODS

Our scientific methodology was performed as follows: cytotoxicity, morphological changes, and apototic DNA fragmentation were analyzed using MTT, light microscopy, and TUNEL assays. Protein expression, apoptosis, necroptosis, and autophagy were analyzed using Western blot and immunofluorescence assays. Cell migration and invasion were analyzed using wound healing and Boyden chamber assays.

RESULTS

We demonstrated that Paeo significantly reduced cell proliferation and cell division, leading to caspase-dependent apoptotic cell death in human YD-10B HNSCC cells. This result was associated with PI3K/AKT/mTOR/p70S6K signaling in these cells. In addition, we investigated other programmed cell death mechanisms associated with apoptosis and found that Paeo inhibited necroptosis via dephosphorylation of key necroptotic proteins (RIP and MLKL), whereas Paeo induced autophagy via increased LC3I/II expression and autophagosome formation in human YD-10B HNSCC cells. The anti-metastatic effects of Paeo significantly suppressed cell migration and invasion in human YD-10B HNSCC cells.

CONCLUSION

Overall, our results demonstrated that the bioactive compound, Paeo, exhibited anti-cancer bioactivities in human YD-10B HNSCC cells, suggesting that Paeo may be an attractive pathological approach for patients with human HNSCCs.

Effect of Traditional Chinese Medicine on the Cardiovascular Diseases

Background: Traditional Chinese medicine (TCM) is the health care system developed with the help of clinical trials that are based ideally on the scientific model of regulation. Objective: This systematic health care system relies on some specific unique theories and practical experiences to treat and cure diseases, thus enhancing the public's health. Review Methodology: The current review covers the available literature from 2000 to 2021. The data was collected from journals research articles, published books, thesis, and electronic databases, search engines such as Google Scholar, Elsevier, EBSCO, PMC, PubMed, ScienceDirect, Willey Online Library, Springer Link, and CNKI) searching key terms, cardiovascular disease, traditional Chinese medicines, natural products, and bioactive compounds. Full-length articles and abstracts were screened for the collection of information included in the paper. Results: Clinical trials on the TCM and basic research carried out on its mechanism and nature have led to the application and development of the perfect design of the research techniques, for example, twofold striking in acupuncture that aid in overcoming the limitations and resistances in integrating and applicability of these experiences and trials into the pre-existing biomedical models. Furthermore, TCM has also been utilized from ancient times to treat heart diseases in Asia, particularly in China, and is now used by people in many other areas. Cardiovascular disease (CVD) is mainly developed by oxidative stress. Hence antioxidants can be beneficial in treating this particular disease. TCM has a wide variety of antioxidant components. Conclusion: The current review article summarizes the underlying therapeutic property of TCM and its mechanism. It also overviews the evidence of the mechanism of TCM action in CVD prevention by controlling oxidative stress and its signaling pathway.

Panoramic tongue imaging and deep convolutional machine learning model for diabetes diagnosis in humans

Diabetes is a serious metabolic disorder with high rate of prevalence worldwide; the disease has the characteristics of improper secretion of insulin in pancreas that results in high glucose level in blood. The disease is also associated with other complications such as cardiovascular disease, retinopathy, neuropathy and nephropathy. The development of computer aided decision support system is inevitable field of research for disease diagnosis that will assist clinicians for the early prognosis of diabetes and to facilitate necessary treatment at the earliest. In this research study, a Traditional Chinese Medicine based diabetes diagnosis is presented based on analyzing the extracted features of panoramic tongue images such as color, texture, shape, tooth markings and fur. The feature extraction is done by Convolutional Neural Network (CNN)—ResNet 50 architecture, and the classification is performed by the proposed Deep Radial Basis Function Neural Network (RBFNN) algorithm based on auto encoder learning mechanism. The proposed model is simulated in MATLAB environment and evaluated with performance metrics—accuracy, precision, sensitivity, specificity, F1 score, error rate, and receiver operating characteristics (ROC). On comparing with existing models, the proposed CNN based Deep RBFNN machine learning classifier model outperformed with better classification performance and proving its effectiveness.

Anti-tumor effects of jaceosidin on apoptosis, autophagy, and necroptosis in human glioblastoma multiforme

Glioblastoma multiforme (GBM) is the most aggressive and common malignant neoplasm. Nevertheless, a 5-year survival rate of patients with GBM has remained below 5%. Artemisia princeps PAMPANINI, used as a food and traditional medicine, have shown beneficial properties including anti-inflammatory, anti-oxidative, and anti-cancer activities. Thus, this study aimed to investigate biological mechanism of a bioactive compound, jaceosidin (JAC), isolated from A. princeps in human GBM T98G cells. Herein, as a result of analysis in terms of cancer survival and death, we found that JAC significantly reduced cell survival against T98G cells. In addition, JAC increased apoptotic cell death via changes on morphological and molecular phenotypes in T98G cells as evidenced by cellular shapes and DNA fragmentation. The apoptotic cell death was confirmed by the cleavage of caspase-3 and PARP, the downregulation of survivin and Bcl-2. Moreover, JAC decreased the expression of cyclinD1 and Cdks and increased the phosphorylation of EKR, JNK, and p38 MAPKs. Specifically, JAC suppressed the PI3K/AKT signaling and its downstream molecules including p70S6, GSK3β, and β-catenin. In addition, as a result of analysis in terms of metastasis using wound healing and Boyden chamber assays, JAC showed anti-migrative and anti-invasive activities. Finally, we analyzed in terms of autophagy and necroptosis that are modes of programmed cell survival and death different from apoptosis in T98G cells. We found that JAC inhibited autophgic regulatory proteins including Beclin-1, Atgs, and LC3A/B, thereby reducing autophagic-mediated cell survival, whereas JAC did not affect phosphorylation of key proteins in necroptosis, especially MLKL. Given these findings, our results provided novel evidences on the biological mechanisms of JAC in T98G cells, suggesting that JAC may be a therapeutic agent for patients with GBM.

In Silico Evaluation of Natural Compounds for an Acidic Extracellular Environment in Human Breast Cancer

The survival rates for breast cancer (BC) have improved in recent years, but resistance, metastasis, and recurrence still remain major therapeutic challenges for BC. The acidic tumor microenvironment (TME) has attracted attention because of its association with tumorigenesis, metastasis, drug resistance, and immune surveillance. In this study, we evaluated natural compounds from traditional herbal medicine used to treat cancer that selectively target genes regulated by extracellular acidosis. We integrated four transcriptomic data including BC prognostic data from The Cancer Genome Atlas database, gene expression profiles of MCF-7 cells treated with 102 natural compounds, patterns of gene profiles by acidic condition, and single-cell RNA-sequencing from BC patient samples. Bruceine D (BD) was predicted as having the highest therapeutic potential, having an information gain (IG) score of 0.24, to regulate reprogrammed genes driven by acidosis affecting the survival of BC patients. BD showed the highest IG on EMT (IG score: 0.11) and invasion (IG score: 0.1) compared to the other phenotypes with the CancerSEA database. BD also demonstrated therapeutic potential by interfering with the tumor cell-TME interactions by reducing the amyloid beta precursor protein and CD44 expression. Therefore, BD is a potential candidate to target the acidic TME induced metastatic process in BC.

Systems Pharmacology and In Silico Docking Analysis Uncover Association of CA2, PPARG, RXRA, and VDR with the Mechanisms Underlying the Shi Zhen Tea Formula Effect on Eczema

Eczema is a complex chronic inflammatory skin disease impacted by environmental factors, infections, immune disorders, and deficiencies in skin barrier function. Shi Zhen Tea (SZT), derived from traditional Chinese medicine Xiao-Feng-San, has shown to be an effective integrative therapy for treating skin lesions, itching, and sleeping loss, and it facilitates reduction of topical steroid and antihistamine use in pediatric and adult patients with severe eczema. Yet, its active compounds and therapeutic mechanisms have not been elucidated. In this study, we sought to investigate the active compounds and molecular mechanisms of SZT in treating eczema using systems pharmacology and in silico docking analysis. SZT is composed of 4 medicinal herbs, Baizhu (Atractylodis macrocephalae rhizome), Jingjie (Schizonepetae herba), Kushen (Sophorae flavescentis radix), and Niubangzi (Arctii fructus). We first identified 51 active compounds from SZT and their 81 potential molecular targets by high-throughput computational analysis, from which we identified 4 major pathways including Th17 cell differentiation, metabolic pathways, pathways in cancer, and the PI3K-Akt signaling pathway. Through network analysis of the compound-target pathway, we identified hub molecular targets within these pathways including carbonic anhydrase II (CA2), peroxisome proliferator activated receptor γ (PPAR γ), retinoid X receptor α (RXRA), and vitamin D receptor (VDR). We further identified top 5 compounds including cynarine, stigmasterin, kushenol, β-sitosterol, and (24S)-24-propylcholesta-5-ene-3β-ol as putative key active compounds on the basis of their molecular docking scores with identified hub target proteins. Our study provides an insight into the therapeutic mechanism underlying multiscale benefits of SZT for eczema and paves the way for developing new and potentially more effective eczema therapies.

Sjogren's syndrome in clinical trials of traditional Chinese medicine: protocol for the development of a core outcome set

Background

Sjogren’s syndrome (SS) is a chronic autoimmune rheumatic disease with an incidence of 0.03 to 0.3%. In recent years, there are an increasing number of randomized controlled trials of traditional Chinese medicine (TCM) for SS. However, there are generally some problems in these published clinical trials: lack of reporting primary or long-term outcomes and the heterogeneous in different clinical trials’ outcome. Our study aims to determine the priority outcomes and standard TCM syndromes for all stakeholders and reach agreement on the COS and syndromes to be measured and reported in all future TCM trials in patients with SS.

Methods and analysis

A phase-wise refinement approach will be used, consisting of three phases, yet complementary, sub-work phases, whereby each phase will inform the next coming phases. The following are the three phases: (I-a) identifying of a long initial list of outcomes through systematic literature review and semi-structured qualitative interviews and (I-b) identifying an initial list of TCM syndromes through (1) systematic literature review, (2) referencing ancient Chinese medical books, and (3) retrospective studies of medical records; (II) prioritization of outcomes using Delphi survey with different stakeholders, such as health professionals and patients; and (III) through consensus meetings with patients and professionals to agree on the final COS and TCM syndromes.

Discussion

We summarized the actions of COS into three points: direct action, indirect action, and final action. After the final COSs is completed, we will publish this research in a journal to promote communication.

Trial registration

Core Outcome Measures in Effectiveness Trials Initiative (COMET) number 1429. Registered on 01 December 2019.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-021-05187-8.

Understanding Traditional Chinese Medicine Therapeutics: An Overview of the Basics and Clinical Applications

Traditional Chinese medicine (TCM) is a systematic healthcare system developed from clinical experience based on a scientific model of regulation. TCM relies on unique theories and practices to treat diseases and enhance health. These practices include Chinese herbal medicine and dietetics, acupuncture and moxibustion, and other non-medication therapies such as Chinese bodywork or manual therapy, known as "Tuina", and traditional biofeedback exercises, known as "Qigong" and "Taijiquan". The integration of TCM in Western health systems and research requires a rational communicable theory, scientific proof of efficacy and safety, and quality control measures. Understanding the structural concepts of the TCM language makes possible the parallelism to Western physiology, and the inherent rational use of the reflex therapeutic systems, anti-inflammatory mechanisms and mental training involved, for example, in acupuncture and "Qigong". The results of TCM clinical trials and fundamental research on its nature and mechanisms have encouraged the development and application of well-designed research strategies such as double blinding in acupucture to overcome limitations and resistances in integrating these practices into the existing biomedical paradigms of the West. This review aims to overview some TCM theoretical concepts and the evidence-based clinical application of TCM's leading practices to create an easy-to-consult and condensed source of information, available for the healthcare community, facilitating the understanding and communication between conventional health professionals and TCM practitioners and acupuncturists.

Safflor yellow A protects vascular endothelial cells from ox-LDL-mediated damage

Atherosclerosis is a chronic disease of arteries, which constitutes the pathological basis of a series of cardiovascular diseases. The inflammatory response of vascular endothelial cells mediated by oxidized low density lipoprotein (ox-LDL) is the early behavior and main signal of atherosclerosis. In this study, the damage model of vascular endothelial cells treated with ox-LDL was used to reproduce the damage process of vascular endothelial cells in the process of atherosclerosis. Cell viability was detected by CCK-8. The release levels of reactive oxygen species, nitric oxide, and superoxide dismutase (SOD) were detected by commercial kits. EdU cell proliferation assay was used to detect cell proliferation, real-time fluorescent quantitative PCR and Western blot were used to detect the expression level of related genes. The results showed we successfully constructed a vascular endothelial injury model by incubating vascular endothelial cells with gradient concentrations of ox-LDL. The incubation of safflor yellow A (SYA) partially restored the loss of viability of vascular endothelial cells mediated by ox-LDL, and SYA could promote the proliferation of injured vascular endothelial cells. In addition, SYA may transmit related signals through the AMPK pathway to protect vascular endothelial cells from ox-LDL-mediated damage. All these results provide a further understanding of the occurrence and development of atherosclerosis, provide a theoretical basis for the use of SYA-related drugs in the treatment of cardiovascular diseases, and provide a reference paradigm for studying the pharmacology, toxicology, and mechanism of action of key active substances in TCM.

Real-world evidence study for distribution of traditional Chinese medicine syndrome and its elements on chronic bronchitis in China

Objective: To investigate the distribution and characteristics of traditional Chinese medicine (TCM) syndromes and its elements on chronic bronchitis (CB) based on real-world data (RWD) so as to optimize the treatment strategies.

Methods: A real-world study based on 2207 medical records collected from five hospitals in China, to explore the relationship between TCM syndrome and CB using the big data methods. Factor analyses were used to reduce the dimensions of TCM syndrome elements and found common factors. Additionally, cluster analyses were performed to value combinations of TCM syndrome element. Finally, association rule analyses were employed to assess the structures of TCM syndromes elements and estimate the patterns of TCM syndrome.

Results: A total of 21 TCM syndromes were extracted from RWD in this work. There were four TCM syndromes consisting of Tan_Zhuo_Zu_Fei, Tan_Re_Yong_Fei, Feng_Han_Xi_Fei, and Feng_Re_Fan_Fei with [Formula: see text]% frequency based on the distribution frequency. The two top Xu TCM syndromes of Fei_Yin_Xu and Fei_Shen_Qi_Xu were identified. The top six pathogenesis TCM syndrome elements were Tan, Huo, Feng, Han, Qi_Xu, and Yin_Xu. Factor analyses, cluster analyses, and association rule analyses demonstrated that Tan, Huo, Feng, Han, Qi-Xu, Yin-Xu, Fei, and Shen were the core TCM syndrome elements.

Conclusion: The four common Shi TCM syndromes of Tan_Zhuo_Zu_Fei, Tan_Re_Yong_Fei, Feng_Han_Xi_Fei, and Feng_Re_Fan_Fei for CB were detected in the real world study, and the two Xu TCM syndromes of Fei_Yin_Xu and Fei_Shen_Qi_Xu were identified. The Mix TCM syndrome of Fei_Pi_Qi_Xu_Tan_Shi_Yun_Fei was the main syndrome. The core TCM syndrome elements of Tan, Huo, Feng, Han, Qi_Xu, and Yin_Xu, Fei, and Shen were determined in the entire sample.

The Role of Periplaneta americana (Blattodea: Blattidae) in Modern Versus Traditional Chinese Medicine

The purpose of this review is to elaborate the role of Periplaneta (P.) americana L. in modern and traditional Chinese medicine (TCM) and compare the use of the species in these two forms of medical treatments. From searches on Google Scholar, PubMed, and Web of Science databases, studies were identified involving TCMs with P. americana, which have a history of use over several thousand years, and demonstrate how extracts from this insect play a role in the treatment of diseases through antibacterial, antiviral, antitumor activity, and enhancement of immune function. Extracts from P. americana have not been fully developed for clinical use because the active components have not been completely purified or their molecular mechanisms thoroughly understood. The development of extraction technology in modern Chinese medicine has revealed that many extracts from P. americana are able to play an important role in the control of diseases such as cancer. Drugs such as 'Kangfuxin Solution' and 'Xinmailong Injection' are now widely used for gastrointestinal ulcers and chronic heart failure, having achieved beneficial curative effects in clinical studies. Based on this, the information from studies of P. americana in TCM and modern medicine should be combined and their respective advantages applied. This review provides an overview of the role of P. americana in modern and TCM and thus contributes to identification of further applications and area requiring drug development.

Ethyl acetate extract of sappanwood alleviates experimental atherosclerosis in rats through changes in FGF21 and SREBP-2 expression

Sappanwood extract shows promising effects against atherosclerosis. The fibroblast growth factor 21 (FGF21) and sterol regulatory element-binding protein 2 (SREBP2) are involved in atherosclerosis development. This study aimed to examine whether sappanwood ethyl acetate extract (SEAE) alleviates experimental atherosclerosis in rats through FGF21/SREBP-2 signaling. Rats were randomized to six groups (n=10/group): blank control, model, simvastatin (positive control, 4.2 mg/kg/d), and SEAE high-, medium-, and low-dose (2.30, 1.15, and 0.575 g/kg/d, respectively). The high-fat- and vitamin D3-induced rodent model of atherosclerosis was created (except in the blank control group). Aorta and liver underwent histopathologic examination. SREPB-2 and FGF21 expression levels were examined by real-time RT-PCR and western blot. Compared with the blank control group, the model group showed aortic and hepatic histopathology compatible with the development of atherosclerosis due to a high-fat diet. In addition, total cholesterol, triglycerides, and low-density lipoprotein cholesterol (LDL-C) were elevated (all P<0.05). SREBP2 expression was high, and FGF21 expression was low (both P<0.05). Compared with the model group, SEAE alleviated the changes in liver and aorta by histopathology and decreased total cholesterol, triglycerides, and LDL-C (all P<0.05), especially in the medium-, and high-dose groups. In addition, medium-dose SEAE increased FGF21 levels (mRNA: +296%; protein: +69%; P<0.05) and decreased SREBP2 levels (mRNA: -44%; protein: -77%; P<0.05). Simvastatin, as the positive control, had similar effects to those of SEAE. In conclusion, SEAE improves lipid metabolism and alleviates atherosclerosis through changes in FGF21 and SREBP-2 expression levels.

Kampo Therapies and the Use of Herbal Medicines in the Dentistry in Japan

Dental caries and periodontal disease are two major diseases in the dentistry. As the society is aging, their pathological meaning has been changing. An increasing number of patients are displaying symptoms of systemic disease and so we need to pay more attention to immunologic aggression in our medical treatment. For this reason, we focused on natural products. Kampo consists of natural herbs-roots and barks-and has more than 3000 years of history. It was originated in China as traditional medicine and introduced to Japan. Over the years, Kampo medicine in Japan has been formulated in a way to suit Japan's natural features and ethnic characteristics. Based on this traditional Japanese Kampo medicine, we have manufactured a Kampo gargle and Mastic Gel dentifrice. In order to practically utilize the effectiveness of mastic, we have developed a dentifrice (product name: IMPLA CARE) and treated implant periodontitis and severe periodontitis.

Long-term survival in a patient with pulmonary spindle cell carcinoma treated with traditional Chinese medicine

Spindle cell carcinoma (SCC) is a rare pulmonary malignancy, accounting for only 0.2%-0.3% of all lung cancers. Therefore, the prognosis and treatment of pulmonary SCC is unclear. There are only 13 reported cases in literature, only three of which had a survival of more than 11 months. Here we reported a long-term survival of a patient with pulmonary SCC who underwent treatment with traditional Chinese medicine. At the most recent follow-up in July 2018, her survival after diagnosis is 48 months and she continues to do well. To our knowledge, this is the longest survival of late stage SCC with the largest tumour burden.

Inhibitory effect of blue honeysuckle extract on high-fat-diet-induced fatty liver in mice

Blue honeysuckle is rich in polyphenols, and recently receiving attention because of its potential antioxidant and anti-inflammatory properties. Nonalcoholic fatty liver disease (NAFLD) is the leading cause of chronic liver disease that develops hepatic inflammation and metabolic syndrome. The present study aims to study the effect of blue honeysuckle extract (BHE) on fat deposition and hepatic lipid peroxidation in a high-fat-diet (HFD)-induced mouse model. Mice were fed a normal diet (ND) or a HFD containing 0.5% or 1% of BHE or not for 45 d. Liver sections were stained by hematoxylin-eosin staining. Serum lipids were measured by a clinical analyzer. Insulin was examined by ELISA, and hepatic proteins were detected by Western blotting. Dietary supplementation of BHE dose-dependently suppressed HFD-induced obesity and hepatic fat deposition. Moreover, BHE improved glucose metabolism by increasing insulin sensitivity and attenuated oxidative stress potentially by up-regulating nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-mediated pathway.

Investigating the Molecular Mechanism of Aqueous Extract of Cyclocarya paliurus on Ameliorating Diabetes by Transcriptome Profiling

Diabetes is generally regarded as a metabolic disorder disease caused by various reasons, including pancreas islet injury and lipid metabolism disorders. The aqueous extract of Cyclocarya paliurus leaves (CPAE) was reported to be anti-diabetic. However, the possible molecular mechanisms have not been investigated. To elucidate the anti-diabetic effects of CPAE and the underlying potential mechanisms, we performed transcriptome profiling (RNA-Seq and miRNA-Seq) on the pancreas and liver from non-diabetic, diabetic and diabetic-CPAE rats. Our results demonstrated the CPAE could reduce excessive oxidative stress and inflammation in the pancreas, and maintain the balance of glucose and lipid metabolism in the liver. Transcriptome profiling and regulatory network analysis indicated that CPAE may ameliorate diabetes through improving β-cell survival and strengthening insulin secretion in the pancreas. Meanwhile, CPAE could improve impaired lipid metabolism and reduce excessive oxidative damage in the liver probably through miR-200/375-Aldh1b1/Hps5-Hes1 co-regulatory network. Taken together, our biochemical experiments combined with transcriptome profiling showed that the effects of CPAE on anti-diabetes may work through protecting pancreatic β-cell, improving dyslipidaemia and lipid metabolism disorders.

Mechanism of Yanghe Pingchuan granules treatment for airway remodeling in asthma

Purpose

Yanghe Pingchuan granules (YPG), a hospital preparation developed by The First Affiliated Hospital, Anhui University of Chinese Medicine, has been used for the clinical treatment of bronchial asthma (BA) for several decades. This study aimed to explore the mechanism of action of YPG in the treatment of BA.

Materials and methods

Male Sprague Dawley rats (n=60) were randomly divided into six groups (n=10 per group): control, a BA model, positive drug control (Guilong Kechuanning capsules; a proven effective treatment for BA), and model rats treated with a high, medium, or low dose of YPG. H&E staining was used to detect pathological changes in the bronchial tubes. The mRNA expression levels of PI3K, PKB, PCNA, and AR were determined by real-time PCR, and the protein levels of phospho- (p-)PI3K, p-PKB, p-PCNA, and p-AR were detected by Western blotting. ELISAs were used to detect the expression of PIP2, PIP3 IL-6, IL-8, IL-1β, and epinephrine (EPI).

Results

H&E staining demonstrated that BA can be ameliorated using YPG. Real-time PCR, Western blotting, and ELISA indicated that use of YPG decreased expression of the phosphoinositide 3-kinase (PI3K) signaling pathway and PCNA, and can also ameliorate the condition kidney Yang deficiency, which is associated with BA in Chinese traditional medicine.

Conclusion

YPG can attenuate BA therapeutically in a dose-dependent manner. The mechanism underlying its therapeutic effect comprises influences on three features that contribute to BA: the PI3K signaling pathway, cell proliferation, and “kidney-Yang deficiency”.

A two-step ultra-high-performance liquid chromatography-quadrupole/time of flight mass spectrometry with mass defect filtering method for rapid identification of analogues from known components of different chemical structure types in Fructus Gardeniae-Fructus Forsythiae herb pair extract and in rat's blood

Fructus Gardeniae-Fructus Forsythiae herb pair is an herbal formula used extensively to treat inflammation and fever, but few systematic identification studies of the bioactive components have been reported. Herein, the unknown analogues in the first-step screening were rapidly identified from representative compounds in different structure types (geniposide as iridoid type, crocetin as crocetin type, jasminoside B as monocyclic monoterpene type, oleanolic acid as saponin type, 3-caffeoylquinic acid as organic acid type, forsythoside A as phenylethanoid type, phillyrin as lignan type and quercetin 3-rutinoside as flavonoid type) by UPLC-Q-Tof/MS combined with mass defect filtering (MDF), and further confirmed with reference standards and published literatures. Similarly, in the second step, other unknown components were rapidly discovered from the compounds identified in the first step by MDF. Using the two-step screening method, a total of 58 components were characterized in Fructus Gardeniae-Fructus Forsythiae (FG-FF) decoction. In rat's blood, 36 compounds in extract and 16 metabolites were unambiguously or tentatively identified. Besides, we found the principal metabolites were glucuronide conjugates, with the glucuronide conjugates of caffeic acid, quercetin and kaempferol confirmed as caffeic acid 3-glucuronide, quercetin 3-glucuronide and kaempferol 3-glucuronide by reference standards, respectively. Additionally, most of them bound more strongly to human serum albumin than their respective prototypes, predicted by Molecular Docking and Simulation, indicating that they had lower blood clearance in vivo and possibly more contribution to pharmacological effects. This study developed a novel two-step screening method in addressing how to comprehensively screen components in herbal medicine by UPLC-Q-Tof/MS with MDF.

What has traditional Chinese medicine delivered for modern medicine?

The field of Traditional Chinese Medicine (TCM) represents a vast and largely untapped resource for modern medicine. Exemplified by the success of the antimalarial artemisinin, the recent years have seen a rapid increase in the understanding and application of TCM-derived herbs and formulations for evidence-based therapy. In this review, we summarise and discuss the developmental history, clinical background and molecular basis of an action for several representative TCM-derived medicines, including artemisinin, arsenic trioxide, berberine and Salvia miltiorrhiza or Danshen. Through this, we highlight important examples of how TCM-derived medicines have already contributed to modern medicine, and discuss potential avenues for further research.

Philosophical thinking of Chinese Traditional Medicine

Traditional medicine is often an integration of ancient philosophy, clinical experiences, primitive knowledge of medicine, regional cultures and religious beliefs. Chinese Traditional Medicine (CTM) is the general appellation of all the traditional medicines of different ethnicities in China, which share great similarities of basic concept and philosophical basis, and conform to the development of empirical medicine, among which the medicine of Han ethnicity (Han medicine) is the most mature. The development of CTM is totally different from that of modern medicine, always revolving around the center of disease diagnosis and treatment, establishing the core theoretical system of Yin and Yang, Five Elements, Zang and Fu and Humoralism with the theoretical foundation of ancient Chinese philosophy, which represents the highest achievement of worldwide empirical medicine and philosophy form at that time. In general, the basic structure of CTM mainly consists of three parts as follows: the part that has already reached consensus with modern medicine, the part that is unconsciously ahead of modern medicine, and the part that needs to be reconsidered or abandoned.

The Anti-Inflammatory Effects of Invigorating Kidney and Supplementing Qi Chinese Herbal Formulae in Asthma Patients

BACKGROUND

The theories of Shen-reinforcement and Qi-supplementation are important in asthma treatment based on traditional Chinese medicine theories. Early studies suggested that Invigorating Kidney and Supplementing Qi herbal formulae, Bu Shen Fang Chuan (BSFC) and Bu Shen Yi Qi (BSYQ), conveyed promising results in asthma treatment. However, the efficacy and safety of the formulae need to be further investigated by a randomized double-blind clinical trial.

METHODS

328 eligible patients were randomly sent to BSFC, BSYQ, and placebo group. The two formulae were received as add-on therapy. The primary endpoints were rate of asthma exacerbation and Hamilton Rating Scale for Depression (HAM-D) score. The secondary endpoints included HPA axis function and inflammatory cytokine production profile. All indexes were measured before and after treatment.

RESULTS

The primary endpoints were not improved in both groups; however, the depression levels of subgroup patients with HAM-D score > 5 were improved in BSFC group. HPA axis functions and inflammatory cytokines level were also improved by two formulae. The incidences of adverse events were similar among groups.

CONCLUSIONS

The two formulae had multiple advantage effects on neuroendocrine-immune system. They are worth used as a replacement therapy in asthma.

TRIAL REGISTRATION

This trial is registered with clinical trial number ChiCTR-PRC-09000529.

Flavonoids from Artemisia sacrorum Ledeb. and their cytotoxic activities against human cancer cell lines

Flavonoids have been demonstrated to have cytotoxic activities toward numerous human cancer cells, whereas they have little or no effect on normal cells. The numerous flavonoids in traditional Chinese herbs may be promising candidates for the development of novel anti-cancer drugs. Our previous study demonstrated that CH₂Cl₂ and 95% ethanol eluate (EE) fractions have the strongest cytotoxic activities against human cancer cell lines of the 9 fractions separated from Artemisia sacrorum Ledeb., which is widely used to prevent and treat diverse diseases in Northeast China. In the present study, 8 flavonoids were isolated from the 95% EE fraction of Artemisia sacrorum Ledeb. The chemical structures of the compounds were elucidated by extensive spectroscopic analyses. The following 5 flavonoids were isolated for the first time from this plant: Jaceosidin, kaempferol, quercetin, luteolin and quercitrin. A total of 2 flavonoids from the CH₂Cl₂ fraction and 8 flavonoids from the 95% EE fraction were examined to evaluate their cytotoxic activities against human SK-HEP-1 hepatoma cancer cells and human HeLa cervical cancer cells, respectively. The results revealed that 2 flavonoids had marked cytotoxic activities against HeLa cells.

Immunomodulatory and anticancer potential of Gan cao (Glycyrrhiza uralensis Fisch.) polysaccharides by CT-26 colon carcinoma cell growth inhibition and cytokine IL-7 upregulation in vitro

BACKGROUND

Chinese licorice, (Glycyrrhiza uralensis Fisch.) is one of the commonly prescribed herbs in Traditional Chinese Medicine (TCM). Gancao, as commonly known in China, is associated with immune-modulating and anti-tumor potential though the mechanism of action is not well known. In this study, we investigated the in vitro immunomodulatory and antitumor potential of Glycyrrhiza uralensis polysaccharides fractions of high molecular weight (fraction A), low molecular weight (fraction B) and crude extract (fraction C).

METHODS

Cell proliferation and cytotoxicity was investigated using Cell Counting kit 8 (CCK-8) on Intestinal epithelial cell line (IEC-6) and Colon carcinoma cell line (CT-26). IL-7 gene expression relative to GAPDH was analysed using Real time PCR. The stimulation and viability of T lymphocytes was determined by Trypan blue exclusion assay.

RESULTS

G.uralensis polysaccharides did not inhibit proliferation of IEC-6 cells even at high concentration. The ED50 was found to be 100 μg/ml. On the other hand, the polysaccharides inhibited the proliferation of cancer cells (CT-26) at a concentration of ≤50 μg/ml. Within 72 h of treatment with the polysaccharides, expression of IL-7 gene was up-regulated over 2 times. It was also noted that, IEC-6 cells secrete IL-7 cytokine into media when treated with G.uralensis polysaccharides. The secreted IL-7 stimulated proliferation of freshly isolated T lymphocytes within 6 h. The effect of the polysaccharides were found to be molecular weight depended, with low molecular weight having a profound effect compared to high molecular weight and total crude extract.

CONCLUSION

Our findings indicate that G.uralensis polysaccharides especially those of low molecular weight have a potential as anticancer agents. Of great importance, is the ability of the polysaccharides to up-regulate anticancer cytokine IL-7, which is important in proliferation and maturation of immune cells and it is associated with better prognosis in cancer. Therefore, immunomodulation is a possible mode of action of the polysaccharides in cancer therapy.

The Traditional Medicine and Modern Medicine from Natural Products

Natural products and traditional medicines are of great importance. Such forms of medicine as traditional Chinese medicine, Ayurveda, Kampo, traditional Korean medicine, and Unani have been practiced in some areas of the world and have blossomed into orderly-regulated systems of medicine. This study aims to review the literature on the relationship among natural products, traditional medicines, and modern medicine, and to explore the possible concepts and methodologies from natural products and traditional medicines to further develop drug discovery. The unique characteristics of theory, application, current role or status, and modern research of eight kinds of traditional medicine systems are summarized in this study. Although only a tiny fraction of the existing plant species have been scientifically researched for bioactivities since 1805, when the first pharmacologically-active compound morphine was isolated from opium, natural products and traditional medicines have already made fruitful contributions for modern medicine. When used to develop new drugs, natural products and traditional medicines have their incomparable advantages, such as abundant clinical experiences, and their unique diversity of chemical structures and biological activities.

A Quantitative Investigation of Pulse and Tongue Features in Post-Stroke Depressive Patients and Healthy Volunteers: An Observational Pilot Study

BACKGROUND

Depression is among the most common neuropsychiatric complications after stroke, having a negative impact on one's quality of life. A number of therapeutic modalities have been used for post-stroke depression (PSD) including traditional Chinese medicine (TCM). However, a lack of objectivity in TCM hampers further improvement in diagnosis and research, since TCM diagnosis is mainly based on subjective judgment of clinicians. In this study, a modern TCM diagnostic device was used to conduct an objective study of pulse and tongue features in PSD patients and healthy individuals.

METHODS

A total of 67 volunteers participated. Pulse and tongue information of each participant was acquired and analyzed by the TCM Four Diagnosis Auxiliary Apparatus. Quantitative data were gathered and compared between the PSD group and the healthy group.

RESULTS

Higher rates of weak, slow, slippery, and string pulse were observed in the PSD group (p < 0.01), whereas normal pulse (p < 0.01) was detected in the healthy group. In the tongue analysis, higher rates of purple tongue (p < 0.01) with yellow fur (p < 0.01) and pale-pink tongue (p = 0.023) with white fur (p < 0.01) were observed in the PSD and the healthy groups, respectively. Abnormal tongue features (old, soft, thin, enlarged, thorny, and cracked) were detected (p < 0.05) in the PSD group.

CONCLUSIONS

Objective and quantitative data of PSD patients and healthy individuals may help providing valuable clinical information for PSD research and establish quantitative TCM diagnostic standards for pulse and tongue diagnosis in clinical practice and research.

Designing clinical studies that take into account traditional East Asian medicine's systems and methods - with focus on pattern identification

This article is based on two presentations held at Chinese medicine conference in Rothenburg (2013), Germany and at the 19th Anniversary of Korean Institute of Oriental Medicine (KIOM) International Symposium of Current Research Trends in Traditional Medicine - Pattern of Identification (2013). In designing clinical studies, it is a research question that leads to appropriate study design. However, they are mostly diagnostic procedures and techniques that are the key points to reflect the application of systems and methods in all forms of medicine - traditional East Asian medicine (TEAM) is no exception. The challenges within TEAM based on research reflect in different systems of medicine/theories such as traditional Japanese acupuncture, traditional Korean acupuncture and traditional Chinese acupuncture. This diversity of medical systems and methods applied in East Asia seems to have been fruitful within the different countries and traditional medicines have found their places within the respective countries health systems. The existing diversity, from a clinician's point of view, may be viewed as a treasure when dealing with patients in the 'real world'. On the other hand, this diversity seems to challenge the scientific mind worldwide, especially when it comes to research. Hence, there is a gap between clinical practice and research.