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Cheng YY, Huang YY, Yang TH, Chang YJ, Fu RH, Chen HY. Acupuncture and Acupoints for Managing Pediatric Cerebral Palsy: A Meta-Analysis of Randomized Controlled Trials. Healthcare (Basel) 2024; 12:1780. [PMID: 39273805 PMCID: PMC11395486 DOI: 10.3390/healthcare12171780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2024] [Revised: 08/24/2024] [Accepted: 08/28/2024] [Indexed: 09/15/2024] Open
Abstract
BACKGROUND Acupuncture is frequently used to manage pediatric cerebral palsy (CP), yet updated evidence is needed to guide future research and clinical practice. METHODS Seven databases were searched from 1994 to 26 June 2023. Randomized controlled trials (RCTs) involving body, scalp, or ear acupuncture for managing CP, excluding acupoint injection, catgut embedding, electro-acupuncture, or laser acupuncture, were included. RESULTS Twenty RCTs with 1797 participants were analyzed. Acupuncture groups had better improvements in gross motor function measure (GMFM) scores by 5% (mean difference: 5.93, 95% CI: 3.67-8.19, p < 0.001, I2 = 57%); a 16% higher probability to yield prominent improvement in effectiveness rate (ER) (risk ratio: 1.16, 95% CI: 1.08-1.25, p < 0.001, I2 = 0%); and better outcomes in the Modified Ashworth Scale (MAS) (standardized mean difference [SMD]: 0.3, 95%, CI: 0.11-0.49, p < 0.001, I2 = 0%), the Berg Balance Scale (BBS) (SMD: 2.48; 95% CI: 2.00-2.97, p < 0.001, I2 = 72%) and ADL (SMD: 1.66; 95% CI: 1.23-2.08, p < 0.001, I2 = 91%). Studies with eight core acupoints identified from all ninety-five acupoints had better ER. CONCLUSIONS Acupuncture, especially using core acupoints, may be effective for managing symptoms in children with CP.
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Affiliation(s)
- Ya-Yun Cheng
- Division of Chinese Acupuncture and Traumatology, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333008, Taiwan
| | - Ying-Yu Huang
- Division of Chinese Internal and Pediatric Medicine, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333008, Taiwan
| | - Tsung-Hsien Yang
- Division of Chinese Internal and Pediatric Medicine, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333008, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333008, Taiwan
| | - Yi-Jung Chang
- Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan 333008, Taiwan
| | - Ren-Huei Fu
- Department of Pediatrics and Neonatology, Chang Gung Memorial Hospital, Linkou 333423, Taiwan
| | - Hsing-Yu Chen
- Division of Chinese Internal and Pediatric Medicine, Center of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Taoyuan 333008, Taiwan
- School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan 333008, Taiwan
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Wu Z, Peng H, Shu Y, Zhang L, Zhang S, Zhang J, Li S, Fan Q, Wei Y, Ming L, Tong J, Zhang Y. Electroacupuncture activates the peroxisome proliferators-activated receptor pathway to improve the phenotype of cerebral palsy. CNS Neurosci Ther 2024; 30:e14876. [PMID: 39049731 PMCID: PMC11269887 DOI: 10.1111/cns.14876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/03/2024] [Accepted: 07/11/2024] [Indexed: 07/27/2024] Open
Abstract
AIM This study explores the efficacy of electroacupuncture (EA) in treating cerebral palsy (CP) in Sprague-Dawley (SD) pups, specifically CP animal models, and its molecular mechanisms. METHODS Gait analysis and Y-maze were used to detect the improvement of motor ability and cognitive function of CP rats after EA treatment. Transcription sequencing was used to determine the key pathway for EA to improve the symptoms of CP. PPAR agonists were used to verify the causal relationship between the pathway and the improvement of CP phenotype. RESULTS The motor ability and cognitive function of CP pups were improved after EA treatment. The results of transcriptome sequencing suggest that the improvement of CP phenotype may be caused by the activation of PPAR pathway. PPAR pathway is widely activated in the epithelium of CP pups treated with EA, which is verified by qPCR. Rosiglitazone (Ros), a PPAR agonist, can improve CP phenotype while activating PPAR pathway, which proves the causal relationship between PPAR pathway activation and CP phenotype improvement. CONCLUSION Our study demonstrated behavioral improvements and enhanced cognitive functions in CP models after EA treatment by activating PPAR pathway, suggesting new perspectives for CP rehabilitation, and providing theoretical support for acupuncture treatment of CP.
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Affiliation(s)
- Zhi‐Feng Wu
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Hong‐Hao Peng
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Yun Shu
- Medical College of Acu‐Moxi and RehabilitationGuangzhou University of Chinese MedicineGuangzhouChina
| | - Li Zhang
- Department of NeurosurgeryChildren's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of PediatricsChongqingChina
| | - Si Zhang
- Department of RadiologyArmy Medical University Xinqiao HospitalChongqingChina
| | - Jing‐Yang Zhang
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Si‐jie Li
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Qiong‐Li Fan
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Yun Wei
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Li Ming
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
| | - Jing‐Jing Tong
- Department of Traditional Chinese MedicineArmy Medical University Xinqiao HospitalChongqingChina
| | - Yu‐Ping Zhang
- Department of PediatricsArmy Medical University Xinqiao HospitalChongqingChina
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Sun Z, Li C, Sun L, Yang W, Qu X, Li Y, Duan X, Guo F, Sun X, Yang M, Qi T, Zhu L, Wang S, Xia Y, Du Y, Luo S, Li L, Gu Y, Wang Y, Yang L. Electroacupuncture stimulation modulates functional brain connectivity in the treatment of pediatric cerebral palsy: a case report. Front Psychiatry 2024; 15:1392958. [PMID: 38751414 PMCID: PMC11094465 DOI: 10.3389/fpsyt.2024.1392958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/03/2024] [Indexed: 05/18/2024] Open
Abstract
Background Pediatric cerebral palsy (CP) is a non-progressive brain injury syndrome characterized by central motor dysfunction and insufficient brain coordination ability. The etiology of CP is complex and often accompanied by diverse complications such as intellectual disability and language disorders, making clinical treatment difficult. Despite the availability of pharmacological interventions, rehabilitation programs, and spasticity relief surgery as treatment options for CP, their effectiveness is still constrained. Electroacupuncture (EA) stimulation has demonstrated great improvements in motor function, but its comprehensive, objective therapeutic effects on pediatric CP remain to be clarified. Methods We present a case of a 5-year-old Chinese female child who was diagnosed with CP at the age of 4. The patient exhibited severe impairments in motor, language, social, and cognitive functions. We performed a 3-month period of EA rehabilitation, obtaining resting state functional magnetic resonance imaging (rs-fMRI) of the patient at 0 month, 3 months and 5 months since treatment started, then characterized brain functional connectivity patterns in each phase for comparison. Results After a 12-month follow-up, notable advancements were observed in the patient's language and social symptoms. Changes of functional connectivity patterns confirmed this therapeutic effect and showed specific benefits for different recovery phase: starting from language functions then modulating social participation and other developmental behaviors. Conclusion This is a pioneering report demonstrating the longitudinal effect of EA stimulation on functional brain connectivity in CP patients, suggesting EA an effective intervention for developmental disabilities (especially language and social dysfunctions) associated with pediatric CP.
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Affiliation(s)
- Zongbo Sun
- School of Medicine, Liao Cheng University, Liaocheng, Shandong, China
| | - Chenglin Li
- Department of Rehabilitation, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Laixin Sun
- Department of Rehabilitation, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Wenwen Yang
- Department of Rehabilitation, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Xueli Qu
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Yuanyuan Li
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Xiao Duan
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Fengyu Guo
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Xuejing Sun
- Medical Genetics Laboratory, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Mingzhu Yang
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Tong Qi
- Department of Rehabilitation, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Longyun Zhu
- Department of Rehabilitation, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Shuai Wang
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Yu Xia
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Yanan Du
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Shuhui Luo
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Lingling Li
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Yu Gu
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Yaya Wang
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
| | - Li Yang
- Department of Radiology, Maternal and Child Health Hospital, Dongchangfu, Liaocheng, China
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Chu C, Huang S, Wang X, Zhao G, Hao W, Zhong Y, Ma Z, Huang C, Peng Y, Wei F. Randomized controlled trial comparing the impacts of Saccharomyces boulardii and Lactobacillus rhamnosus OF44 on intestinal flora in cerebral palsy rats: insights into inflammation biomarkers and depression-like behaviors. Transl Pediatr 2024; 13:72-90. [PMID: 38323178 PMCID: PMC10839280 DOI: 10.21037/tp-23-566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 01/16/2024] [Indexed: 02/08/2024] Open
Abstract
Background Cerebral palsy (CP) is a unique neurological disorder which adversely affects motion. Cytokines and gut microbial composition contribute to CP and other diseases, such as reproductive tract inflammation and bone loss. Importantly, Saccharomyces boulardii (S. boulardii) reduces the degree of inflammation and improves overall health status. As our previous study showed that Lactobacillus rhamnosus (L. rhamnosus) OF44, a selected strain of gut bacteria originally used to treat reproductive tract inflammation and bone loss, has effects similar to that of S. boulardii, we decided to use L. rhamnosus OF44 on CP rats. Validation of the effects of L. rhamnosus OF44 on CP adds to its confirmed effects in treating osteoporosis and reproductive tract microbiota disorders, increasing its potential as a probiotic. The purpose of this was to ascertain whether L. rhamnosus OF44 can alleviate the symptoms of CP. Methods CP rat models were created through left carotid artery ligation. Following this, 100-day old CP rats were exposed to L. rhamnosus OF44, S. boulardii, or normal saline gastric gavage daily for 28 days. Grouping of the rats is determined randomly. Before and after the gavage, behavioral experiments were conducted and the inflammation levels assessed via measurements of interleukin (IL)-1β, IL-6, IL-8, and tumor necrosis factor alpha (TNF-α) inflammatory markers. The efficacy of the outcome is measured by performing statistical analysis like the t-test on the data to see its significance. Additionally, variations inside gut microbiome were evaluated via 16S ribosomal RNA sequencing. Results Before intervention, CP rats failed to exhibit depression-like behavior (P=0.6). L. rhamnosus OF44 treatment significantly reduced the level of IL-6 (P=4.8e-05), S. boulardii treatment significantly reduced the level of TNF-α (P=0.04). In addition, both treatments altered the composition and complexity of the gut microbiome. Conclusions Our results indicated that L. rhamnosus OF44 has potential in alleviating inflammation and altering the gut microbial composition in CP, and that it has the potential to clinically treat CP. There are some limitations of this study. For example, dietary differences and their effects on gastrointestinal dysfunction are not considered in this study, and only two behavioral experiments were used.
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Affiliation(s)
- Chunuo Chu
- International Department, Shenzhen Middle School, Shenzhen, China
| | - Shang Huang
- Department of Centre Lab, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Shenzhen, China
- Shenzhen Children’s Hospital of China Medical University, Shenzhen, China
| | - Xin Wang
- Department of Centre Lab, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Shenzhen, China
- School of Clinical Medicine, Jiamusi University, Jiamusi, China
| | - Guoqiang Zhao
- Department of Clinical Laboratory, Binzhou People’s Hospital, Binzhou, China
| | - Wenqi Hao
- Department of ENT, The First Affiliated Hospital of Jiamusi University, Jiamusi, China
| | - Yiyi Zhong
- Department of Nutrition, BGI Nutrition Precision Co., Ltd., Shenzhen, China
| | - Zhihui Ma
- Department of Nutrition, BGI Nutrition Precision Co., Ltd., Shenzhen, China
| | - Congfu Huang
- Department of Pediatrics, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Shenzhen, China
| | - Yuanping Peng
- The Outpatient Department, Longgang District Social Welfare Center, Shenzhen, China
| | - Fengxiang Wei
- Department of Centre Lab, Longgang District Maternity & Child Healthcare Hospital of Shenzhen City, Shenzhen, China
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Jin GY, Jin LL, Jin BX, Zheng J, He BJ, Li SJ. Neural control of cerebral blood flow: scientific basis of scalp acupuncture in treating brain diseases. Front Neurosci 2023; 17:1210537. [PMID: 37650106 PMCID: PMC10464620 DOI: 10.3389/fnins.2023.1210537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/03/2023] [Indexed: 09/01/2023] Open
Abstract
Scalp acupuncture (SA), as a modern acupuncture therapy in the treatment of brain diseases, especially for acute ischemic strokes, has accumulated a wealth of experience and tons of success cases, but the current hypothesized mechanisms of SA therapy still seem to lack significant scientific validity, which may not be conducive to its ultimate integration into mainstream medicine. This review explores a novel perspective about the mechanisms of SA in treating brain diseases based on its effects on cerebral blood flow (CBF). To date, abundant evidence has shown that CBF is significantly increased by stimulating specific SA points, areas or nerves innervating the scalp, which parallels the instant or long-term improvement of symptoms of brain diseases. Over time, the neural pathways that improve CBF by stimulating the trigeminal, the facial, and the cervical nerves have also been gradually revealed. In addition, the presence of the core SA points or areas frequently used for brain diseases can be rationally explained by the characteristics of nerve distribution, including nerve overlap or convergence in certain parts of the scalp. But such characteristics also suggest that the role of these SA points or areas is relatively specific and not due to a direct correspondence between the current hypothesized SA points, areas and the functional zones of the cerebral cortex. The above evidence chain indicates that the efficacy of SA in treating brain diseases, especially ischemic strokes, is mostly achieved by stimulating the scalp nerves, especially the trigeminal nerve to improve CBF. Of course, the mechanisms of SA in treating various brain diseases might be multifaceted. However, the authors believe that understanding the neural regulation of SA on CBF not only captures the main aspects of the mechanisms of SA therapy, but also facilitates the elucidation of other mechanisms, which may be of greater significance to further its clinical applications.
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Affiliation(s)
- Guan-Yuan Jin
- International Institute of Systems Medicine, Inc., Milwaukee, WI, United States
- Ace Acupuncture Clinic of Milwaukee, LLC, Milwaukee, WI, United States
| | - Louis Lei Jin
- The Woodlands Acupuncture and Herbal Clinic, The Woodlands, TX, United States
| | - Bonnie Xia Jin
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Jin Zheng
- HCA Houston Healthcare Conroe, Conroe, TX, United States
| | - Belinda Jie He
- The Woodlands Acupuncture and Herbal Clinic, The Woodlands, TX, United States
| | - Shi-Jiang Li
- Medical College of Wisconsin, Milwaukee, WI, United States
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Zhang CY, Yan BF, Mutalifu N, Fu YW, Shao J, Wu JJ, Guan Q, Biedelehan SH, Tong LX, Luan XP. Predicting the brain age of children with cerebral palsy using a two-dimensional convolutional neural networks prediction model without gray and white matter segmentation. Front Neurol 2022; 13:1040087. [PMID: 36504669 PMCID: PMC9730825 DOI: 10.3389/fneur.2022.1040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/02/2022] [Indexed: 11/27/2022] Open
Abstract
Background Abnormal brain development is common in children with cerebral palsy (CP), but there are no recent reports on the actual brain age of children with CP. Objective Our objective is to use the brain age prediction model to explore the law of brain development in children with CP. Methods A two-dimensional convolutional neural networks brain age prediction model was designed without segmenting the white and gray matter. Training and testing brain age prediction model using magnetic resonance images of healthy people in a public database. The brain age of children with CP aged 5-27 years old was predicted. Results The training dataset mean absolute error (MAE) = 1.85, r = 0.99; test dataset MAE = 3.98, r = 0.95. The brain age gap estimation (BrainAGE) of the 5- to 27-year-old patients with CP was generally higher than that of healthy peers (p < 0.0001). The BrainAGE of male patients with CP was higher than that of female patients (p < 0.05). The BrainAGE of patients with bilateral spastic CP was higher than those with unilateral spastic CP (p < 0.05). Conclusion A two-dimensional convolutional neural networks brain age prediction model allows for brain age prediction using routine hospital T1-weighted head MRI without segmenting the white and gray matter of the brain. At the same time, these findings suggest that brain aging occurs in patients with CP after brain damage. Female patients with CP are more likely to return to their original brain development trajectory than male patients after brain injury. In patients with spastic CP, brain aging is more serious in those with bilateral cerebral hemisphere injury than in those with unilateral cerebral hemisphere injury.
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Feng Q, Liu X, Ren Q, Liao W, Li J. Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy? Transl Pediatr 2022; 11:1735-1736. [PMID: 36345440 PMCID: PMC9636454 DOI: 10.21037/tp-22-249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Qingbo Feng
- Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Xiaoyin Liu
- Department of Neurosurgery, West China Medical School, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuping Ren
- Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Wenwei Liao
- Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
| | - Jiaxin Li
- Department of Liver Surgery & Liver Transplantation, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, China
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Xue Y, Shi S, Zheng S, Yang Z, Xu J, Gong F. Explanation of issues in " Is scalp-based acupuncture and moxibustion better than conventional rehabilitation therapy for children with cerebral palsy' from the readers?". Transl Pediatr 2022; 11:1737-1738. [PMID: 36345455 PMCID: PMC9636451 DOI: 10.21037/tp-2022-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/06/2022] [Indexed: 11/22/2022] Open
Affiliation(s)
- Yuman Xue
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Department of Rehabilitation II, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
| | - Shuai Shi
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Department of Rehabilitation III, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
| | - Shuang Zheng
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Key Disciplines Office, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
| | - Zhongfeng Yang
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Department of Rehabilitation Center, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
| | - Jiaben Xu
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Department of Massage II, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
| | - Feifei Gong
- Heilongjiang University of Traditional Chinese Medicine, Harbin, China
- Department of Rehabilitation II, Second Affiliated Hospital of Traditional Chinese Medicine of Heilongjiang University, Harbin, China
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