Use of Chinese Herbal Medicine Therapies in Comprehensive Hospitals in Central China: A Parallel Survey in Cancer Patients and Clinicians

Summary： Chinese herbal medicine （CHM）, as the largest application category of traditional Chinese medicine （TCM）, is widely accepted among cancer patients in China. Herbal slice （HS） and Chinese patent drug （CPD） are commonly used CHM in China. This study aimed to investigate the utilization of CHM among clinicians and cancer patients in central China. Five hundred and twenty-five patients and 165 clinicians in 35 comprehensive hospitals in central China were asked to complete an anonymous questionnaire that was designed to evaluate the use of CHM. The results showed that 90.74% clinicians and 72.24% cancer patients used CHM during cancer treatment. The educational backgrounds of the clinicians and the age, education level, annual income, and cancer stage of the cancer patients were re- lated to use of CHM. More than 90% clinicians and cancer patients had used CPD. Comparatively, the percentage of HS use was 10% lower than that of CPD use among clinicians and cancer patients. More clinicians preferred to use CHM after surgery than cancer patients did （20.41% vs. 5.37%）. Enhancing physical fitness and improving performance status were regarded as the most potential effect of CHM on cancer treatment （85.71% among clinicians and 94.07% among cancer patients）, in comparison with directly killing tumor cells （24.49% among clinicians and 31.36% among patients）. As for refusal rea- sons, imprecise efficacy was the unanimous （100%） reason for clinicians＇ rejection of CHM, and 95.58% patients objected to using CHM also for this reason. Furthermore, the side effects of CHM were more concerned by clinicians than by patients （33.33% vs. 15.81%）. In conclusion, our survey revealed that CHM was popularly accepted by clinicians and cancer patients in central China. The reasons of use and rejection of CHM were different between clinicians and cancer patients.

A traditional Chinese herbal medicine compound preparation versus interventional therapy after resection of small hepatocellular carcinoma:22-year follow-up

OBJECTIVE:To compare the long-term effectiveness of compound Ruanjianhugan(RJH)tablets and interventional therapy(IT) in patients after resection of small hepatocellular carcinoma(HCC).METHODS:A retrospective study was conducted in 399 patients after resection of small HCC who were admitted between January 1987 and December 2008 in the Department of Hepatobiliary Surgery and Center of Minimlly Invasive Surgery,First Affiliated Hospital of Guangxi Medical University.Four groups were based on different therapy modes:a TCM-only(TCMO) group,a TCM combined with interventional therapy(TCM-IT) group,an interventional therapy-only(ITO) group,and a simple operation(SO) group.Prognostic factors were correlated with overall survival(OS) and OS rates were calculated with the Kaplan-Meier method,and multivariate analyses for factors affecting survival were evaluated by the Cox proportional hazard model.RESULTS:The median OS was 151.20 months in the TCM-IT group,43.87 months in the ITO group,and 20.77 months in the SO group.All survival rates of the TCMO group were higher than those of the other three groups(>50%).The 5-,10-,and 15-year OS in the TCMO and ITO patients were 83.94%,45.50%,and 71.22% and 33.34%,55.58%,and 9.26%,respectively(risk ratio,0.209;95% confidence interval,0.126-0.347;P=0.000).Multivariate analysis revealed that the independent risk factors were therapy mode(P=0.000),sex(P=0.005),family history(P=0.011),TNM Classification of Malignant Tumor staging(P=0.000),medical care-seeking behavior(P=0.021),and maximum diameter(P=0.030).CONCLUSION:Long-term oral use of compound RJH tablets may improve OS for small HCC after resection compared with IT.

Yu Gan Long Ameliorates Hepatic Fibrosis by Inhibiting PI3K/AKT,Ras/ERK and JAK1/STAT3 Signaling Pathways in CCl4-induced Liver Fibrosis Rats

Yu Gan Long(YGL)is a Chinese traditional herbal formula which has been reported to attenuate liver fibrosis for many years and we have explored its anti-fibrotic mechanism through blocking transforming growth factor(TGF-β)in the previous study.But the mechanisms associated with platelet-derived growth factor(PDGF)-BB remain obscure.In this study,we further investigated the mechanism of YGL reducing carbon tetrachloride(CCl4)-induced liver fibrosis in rats.Our results showed that YGL suppressed CCl4-induced upregulation of collagen IV(Col IV),type HI precollagen(PCHI),hyaluronuc acid(HA)and laminin(LN),which are implicated in liver fibrosis.Also,YGL reduced theα-smooth muscle actin(α-SMA)expression,which acts as the indicator of liver fibrosis.Furthermore,YGL decreased the serum levels of hepatic stellate cell(HSC)mitogen PDGF-BB and inflammation cytokines,including TNF-α,IL-1β,IL-6.Markers involved in liver fibrosis,such as Ras,p-Raf-1,p-ERK1/2,p-JNK,p-P38,p-PI3K,p-AKT,p-JAKl,p-STAT3 were downregulated significantly after treatment with YGL.Our results indicated that YGL ameliorated CCl4-induced liver fibrosis by reducing inflammation cytokines production,and suppressing Ras/ERK,PI3K/AKT,and JAK1/STAT3 signaling pathways,which provided further evidence towards elucidation of the anti-fibrotic mechanism of YGL.

Clinical Observation on Curative Effect of Dissolving Phlegm-Stasis on 50 Cases of Knee Osteoarthritis

Objective： To observe the curative effect of dissolving phlegm-stasis on knee osteoarthritis. Methods： The 100 patients with knee osteoarthritis were randomly divided into two groups. The 50 patients in the treatment group orally took Chinese medicine while the other 50 patients in the control groups orally took Votalin and Vitamin C for one week as a course of treatment. At the end of 2-week treatment, analytic comparison was carried in evaluate the curative effect and the changes in total score of symptoms before and after treatment between the two groups. Results： The total score of symptoms after treatment was significantly lower than that before treatment in both groups （P〈0.01, P〈0.05）. The total score after treatment of patients with X-ray grade I and II in the treatment group was more obviously reduced as compared to the control group （P〈0.05）. The remarkably effective rate after treatment of patients with X-ray grade I and It in the treatment group was also higher than that in the control group （P〈0.05）. Conclusion： The treatment of knee osteoarthritis with dissolving phlegm-stasis can effectively improve the clinical symptoms.

Effects of Modified Sanhuang Decoction (加味三黄汤) Enemaon Serum Tumor Necrosis Factor-α and Colonic Mucosa Interleukin-1β,Interleukin-6 Levels in Ulcerative Colitis Rats

Objective：To investigate the effects of Modified Sanhuang Decoction（加味三黄汤,MSD）enema on the serum tumor necrosis factor alpha（TNF-α）and colonic mucosa interleukin-1β（IL-1β）,interleukin-6（IL-6）levels in experimental ulcerative colitis（UC）rats.Methods：Forty-five male Wistar rats were randomly divided into 4 groups：normal group（n=12）,model group（n=11）,salazosulfapyridine（SASP）group（n=11）and MSD group（n=11）.The UC model was induced by 2,4,6-trinitrobenzene sulfonic acid（TNBS）/ethanol solution.Rats in the normal group and model group were clystered with 0.9%normal saline,while in the SASP group and MSD group were clystered with SASP and MSD enema,respectively.After drug administration（10 mL/kg body weight,for 7 days）,colonic gross changes and colonic mucosa histology were observed,serum TNF-αand colonic mucosa IL-1β,IL-6 levels were tested by enzyme linked immunosorbent assay and radioimmunoassay,respectively.Results：As compared with the normal group,the experimental UC rats,the colonic mucosal damage index scores（CMDIs）,histopathological scores（HS）and the serum TNF-a and colonic mucosa IL-1β,IL-6 levels significantly increased（P〈0.05 or P〈0.01）.In the MSD and SASP groups,the ulcer area significantly reduced,and edema disappeared.The CMDIs,HS,the serum TNF-a and colonic mucosa IL-1β,IL-6 levels in the MSD and SASP groups significantly decreased（P〈0.05 or P〈0.01）compared with the model group.The CMDIs in the MSD group were lower than that in the SASP group（P〈0.05）,but there were no significant differences in HS,serum TNF-αor colonic mucosa IL-1β,IL-6 levels between the MSD and SASP groups.Conclusion：MSD enema can improve colonic mucosa impairment and decrease serum TNF-αand colonic mucosa IL-1β,IL-6 levels in experimental UC.

Protein kinase A-mediated cardioprotection of Tongxinluo relates to the inhibition of myocardial inflammation, apoptosis, and edema in reperfused swine hearts

Background Our previous studies have demonstrated that Tongxinluo （TXL）, a traditional Chinese medicine, can protect hearts against no-reflow and reperfusion injury in a protein kinase A （PKA）-dependent manner. The present study was to investigate whether the PKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis. Methods In a 90-minute ischemia and 3-hour reperfusion model, minipigs were randomly assigned to sham, control, TXL （0.05 g/kg, gavaged one hour prior to ischemia）, and TXL ＋ H-89 （a PKA inhibitor, intravenously and continuously infused at 1.0 μg/kg per minute） groups. Myocardial no-reflow, necrosis, edema, and apoptosis were determined by pathological and histological studies. Myocardial activity of PKA and myeloperoxidase was measured by colorimetric method. The expression of PKA, phosphorylated cAMP response element-binding protein （p-CREB） （Ser133）, tumor necrosis factor a （TNF-a）, P-selectin, apoptotic proteins, and aquaporins was detected by Western blotting analysis. Results TXL decreased the no-reflow area by 37.4% and reduced the infarct size by 27.0% （P〈0.05）. TXL pretreatment increased the PKA activity and the expression of Ser133 p-CREB in the reflow and no-reflow myocardium （P 〈0.05）. TXL inhibited the ischemia-reperfusion-induced elevation of myeloperoxidase activities and the expression of TNF-a and P-selectin, reduced myocardial edema in the left ventricle and the reflow and no-reflow areas and the expression of aquaporin-4, -8, and -9, and decreased myocytes apoptosis by regulation of apoptotic protein expression in the reflow and no-reflow myocardium. However, addition of the PKA inhibitor H-89 counteracted these beneficial effects of TXL. Conclusion PKA-mediated cardioprotection of TXL against no-reflow and reperfusion injury relates to the inhibition of myocardial inflammation, edema, and apoptosis in the reflow and no-reflow myocardium.

Clinical and Experimental Studies on Composite Divitriol Infusion in Treating Tinea Manum

Objective: To investigate the effect of Composite Divitriol Infusion (CDI) in treating tinea manum and study its antimycotic action.Methods: CDI was used to treat 139 patients with tinea manum and compared with Tinea Unguium Infusion in treating 77 cases as control. The experimental study in vivo was done, and electron microscopy (EM) was used to observe the therapeutical effect of CDI.Results: Among the 139 patients of the CDI group, 104 were cured, 21 markedly effective, 10 improved and 4 ineffective, the cure and markedly effective rate being 89.9%. The difference of effect between the CDI group and the control group was significant statistically (X 2>12.84,P < 0.005). The antimycotic action of CDI was studied in vitro. The minimum inhibitory concentration (MIC) of CDI were about 0.25% for Trichophyton rubrum and 0.5% for Trichophyton gypseum and Microsporum gypseum. Trichophyton rubrum immersed with CDI showed that the mycelia became roughened, deformed, and macroconidium became smaller under EM.Conclusion: CDI is valuable in treating tinea manum.

The clinical efficacy of Lou’s Wentong method in the treatment of lactational mastitis: A retrospective self-control study with 158 cases

Background:As a common breast disease in lactating women,lactational mastitis is clinically manifested as painful breast lumps and systemic symptoms.To a certain extent,this disease may affect the physical and mental health of lactating women and even the breastfeeding of infants.Objective:This study was conducted to evaluate the clinical efficacy of Lou’s Wentong Method in the comprehensive treatment of lactational mastitis and its effects on relevant symptoms.Methods:A total of 158 patients who were diagnosed with lactational mastitis in The First Affiliated Hospital of Zhejiang Chinese Medical University from January 2022 to January 2024 were included in this study to conduct a retrospective analysis.The treatment method comprised oral administration of traditional Chinese medicine prescriptions guided by the concept of“Wentong zhi yong”(warming and dispersing therapy for treating abscesses),puncture and pus extraction for patients with abscess formation,and milk drainage for patients with milk stagnation.The clinical symptoms of these patients were collected according to the seven indexes in Lou’s quantitative scorecard for evaluating the condition of canker sores before and after treatment.Additionally,the improvement of each symptom after treatment,the total effective rate of the clinical treatment,and the total symptom evaluation score before and after treatment were also analyzed.Results:It was demonstrated that there were significant differences in the overall distribution of different severity symptoms(skin erythema,breast pain,number of lumps,size of lumps,breast abscesses,and body temperature)at three time points(P<0.01).The evaluation of these symptoms at different time points revealed that all symptoms were effectively mitigated over time.Meanwhile,the efficacy was assessed according to the efficacy index to evaluate the efficacy of Lou’s Wentong Method in the comprehensive treatment of lactational mastitis.The results corroborated the pronounced efficacy of Lou’s Wentong Method in treating lactational mastitis,exhibiting statistical significance(P<0.01).Conclusion:Lou’s Wentong Method has significant therapeutic effects in the comprehensive treatment of lactational mastitis.Furthermore,this method is conducive to alleviating the clinical symptoms of these patients as soon as possible and can reduce the pain of patients,thus promoting their recovery.