Pharmacological efficacy of the traditional Chinese medicinal formula Kun-Tai-1A in the treatment of letrozole-induced polycystic ovary syndrome

Background:Polycystic ovary syndrome(PCOS)is an endocrine disorder that occurs in women of child-bearing age.Moreover,PCOS patients have decreased pregnancy rates and clomiphene citrate resistance.The traditional Chinese medicine formula Kun-Tai-1S(KT1S),consisting of the seahorse species hippocampus,has been reported to elicit therapeutic effects in patients with PCOS.However,given the limited resources and global demand for wild hippocampus,whether KT1S with or without hippocampus can elicit similar therapeutic effects has not been confirmed.Methods:KT1S and Kun-Tai-1A(KT1A,KT1S without dry hippocampus)were used to treat a letrozole-induced rat model of PCOS with an established disease.The serum levels of testosterone,luteinizing hormone,anti-Müllerian hormone,and estradiol were determined,the luteinizing hormone/follicle-stimulating hormone ratio was determined,and the ovarian pathology was evaluated.Results:Similar to the therapeutic effects of cyproterone acetate,both the KT1S and KT1A treatments reduced the body weight and ovarian and uterine indices in the rats with PCOS.The serum levels of testosterone,anti-Müllerian hormone,and luteinizing hormone and the luteinizing hormone/follicle-stimulating hormone ratio were significantly lower in the KT1S and KT1A treatment groups compared to the model group(P<0.01 and P<0.05,respectively).Moreover,the histopathological assessment results suggested that both the KT1S and KT1A treatments significantly ameliorated the PCOS pathology in the rats with an established disease,with a reduced number of cystic and atretic follicles and an increased number of corpora lutea being observed in the ovaries.Notably,there was no obvious difference in the disease outcomes between the KT1S and KT1A-treated groups.Network pharmacology analysis revealed that 4’,7-dihydroxyflavanone,sinpemine A,quercetin,8-isopentenyl-kaempferol,and luteolin in KT1A may promote estrogen signaling;furthermore,the nitric oxide regulation pathway is also closely involved.Conclusion:KT1A and KT1S treatments both significantly ameliorated the PCOS-related pathology in rats,suggesting that the hippocampus component is dispensable for KT1S-mediated amelioration.Given the limited resources and global demand for wild hippocampus for use in complementary medicines,our findings may help conserve this species.Together,our results suggest that KT1A is a promising approach for treating PCOS.

针刺对围绝经期潮热的影响:一项随机对照临床试验研究方案

Background:Hot flashes are one of the most common symptoms in menopause and significantly affect the quality of life of 67% of menopausal women.Acupuncture is found to be a low risk treatment in treating hot flashes but the evidence for its effectiveness is inconclusive.We developed an optimized acupuncture treatment protocol and designed a randomized controlled trial(RCT) to assess the efficacy of acupuncture for reducing hot flashes in menopausal women.Methods:This is a single-site,single-blind,randomized sham-controlled trial with two parallel arms.A total of 60 eligible patients will be recruited and randomly assigned to either the acupuncture group(n=30) or the sham acupuncture group(n=30).Treatment will be given twice a week,for 30 min,for six consecutive weeks.The primary outcome is the hot flashes scores,assessed using the validated hot flashes diary at baseline,week 3,week 6 and week 10.The secondary outcome will be measured by menopause-specific quality of life(MENQOL) at baseline,week 6,and week 10.Meanwhile,any adverse events will be recorded.Discussion:If the outcome of this study confirms acupuncture to be an effective therapy to reduce hot flashes in menopausal women,we expect this study to inspire further investigations and provide useful information in forming an optimal acupuncture treatment protocol for clinic.Trial registration:Chinese Clinical Trial Registry identifier:ChiCTR1800018638,Date of registration:30 th September 2018.URL:http://www.chictr.org.cn/showproj.aspx?proj=31462.

A toxicological investigation of the air quality in a moxibustion treatment room as measured through particulate concentration and oxidative capacity

Background: Moxibustion is a traditional Chinese medicine(TCM) therapy in which mugwort(Artemisia vulgaris) floss is burned to warm and stimulate acupoints. The modality has been used traditionally for thousands of years. However, smoke-related safety issues have recently been of concern, and little is known about moxa smoke and air quality in the clinical moxibustion environment.Objective: To assess the air quality in a typical moxibustion treatment room using particulate matter(PM) concentration and DNA oxidative damage at PM10.Methods: The study was conducted in August and November to December, 2011, at a TCM clinic in Beijing, China, in a moxibustion treatment room. A moxa-free treatment room and the outdoor area adjacent to the clinic were used as controls. PM10 concentrations were monitored with a portable digital dust indicator. The oxidative capacity of whole and water-soluble fractions of PM10 were detected using plasmid DNA assay. The results were shown as TD40 values; that is, the amount of PM10 that causes plasmid DNA damage of 40%.Results: Average PM10 concentrations in the moxibustion room were 2.56 mg m^(-3) in summer and 2.78 mg m^(-3) in winter, much higher than at control sites. For whole and water-soluble fractional PM10, the average summer TD40 values collected in the moxibustion room were 791.67 μg ml^(-1) and 876.33 μg ml^(-1) respectively, and the winter values were 779.86 μg ml^(-1) and 879.57 μg ml^(-1). These results of winter samples were significantly higher(p < 0.001) than the corresponding results from control sites. However, there was no statistical difference(p = 0.06)between the TD40 values of both the whole and water-soluble fractional PM10 from the moxibustion treatment room, while differences were significant in the general treatment room(p = 0.025) and at the outdoor site(P < 0.001).Conclusion: Our study shows that moxa smoke increases PM10 concentration. However, the oxidative capacity of PM10 in the moxibustion room was much lower than that at control sites with the same particulate burden, and the bioactivity at that site was mainly from the watersoluble fraction, another difference from the controls. This unexpected bioactivity is assumed to relate to the low toxicity of moxa smoke or to its proven antioxidant activity. Overall, further research is needed.