Developments in the study of Chinese herbal medicine's assessment index and action mechanism for diabetes mellitus

In traditional Chinese medicine(TCM),based on various pathogenic symptoms and the‘golden chamber’medical text,Huangdi Neijing,diabetes mellitus falls under the category‘collateral disease’.TCM,with its wealth of experience,has been treating diabetes for over two millennia.Different antidiabetic Chinese herbal medicines re-duce blood sugar,with their effective ingredients exerting unique advantages.As well as a glucose lowering effect,TCM also regulates bodily functions to prevent diabetes associated complications,with reduced side effects compared to western synthetic drugs.Chinese herbal medicine is usually composed of polysaccharides,saponins,al-kaloids,flavonoids,and terpenoids.These active ingredients reduce blood sugar via various mechanism of actions that include boosting endogenous insulin secretion,enhancing insulin sensitivity and adjusting key enzyme activity and scavenging free radicals.These actions regulate glycolipid metabolism in the body,eventually achiev-ing the goal of normalizing blood glucose.Using different animal models,a number of molecular markers are available for the detection of diabetes induction and the molecular pathology of the disease is becoming clearer.Nonetheless,there is a dearth of scientific data about the pharmacology,dose-effect relationship,and structure-activity relationship of TCM and its constituents.Further research into the efficacy,toxicity and mode of action of TCM,using different metabolic and molecular markers,is key to developing novel TCM antidiabetic formulations.

Model informed precision medicine of Chinese herbal medicines formulas-A multi-scale mechanistic intelligent model

Recent trends suggest that Chinese herbal medicine formulas(CHM formulas)are promising treatments for complex diseases.To characterize the precise syndromes,precise diseases and precise targets of the precise targets between complex diseases and CHM formulas,we developed an artificial intelligence-based quantitative predictive algorithm(DeepTCM).DeepTCM has gone through multilevel model calibration and validation against a comprehensive set of herb and disease data so that it accurately captures the complex cellular signaling,molecular and theoretical levels of traditional Chinese medicine(TCM).As an example,our model simulated the optimal CHM formulas for the treatment of coronary heart disease(CHD)with depression,and through model sensitivity analysis,we calculated the balanced scoring of the formulas.Furthermore,we constructed a biological knowledge graph representing interactions by associating herb-target and gene-disease interactions.Finally,we experimentally confirmed the therapeutic effect and pharmacological mechanism of a novel model-predicted intervention in humans and mice.This novel multiscale model opened up a new avenue to combine“disease syndrome”and“macro micro”system modeling to facilitate translational research in CHM formulas.

Unveiling the anticancer effect of traditional Chinese herbal medicine

In this issue of World Journal of Gastroenterology,Huang et al reported that Calculus bovis(CB),a traditional Chinese herbal medicine,impedes the growth of liver cancers in vivo.Through further in vitro studies,they showed that CB suppressed the M2 polarization of tumor-associated macrophages by suppressing the Wnt signaling pathway,which consequently inhibited the growth of liver cancer.Although the effects of traditional Chinese herbal medicine are often not scientifically proven,Huang et al successfully identified the molecular mechanism involved in the anticancer effect of CB,and it is anticipated that the molecular mechanisms involved in the effects of other traditional Chinese herbal medicines will be scientifically elucidated,as demonstrated in this article.

Chinese herbal medicine combined with Western medicine for Mycoplasma pneumoniae pneumonia in children:An overview of systematic reviews

Objective:To summarize the characteristics and evaluate the quality of the methodology and evidence within systematic reviews(SRs)of Chinese herbal medicine(CHM)for Mycoplasma pneumoniae pneumonia(MPP)inchildren.Methods:SRs of randomized controlled trials were searched using PubMed,the Cochrane Library,Embase,the Chinese National Knowledge Infrastructure Databases(CNKI),the Chinese Scientific Journals Database(VIP),Wanfang,and the SinoMed Database.SRs on the use of CHM alone or in combination with Western medications for MPP in children were included.The study compared the effects of Western medicine alone with those of CHM.The evidence quality using the A Measurement Tool to Assess Systematic Reviews(AMSTAR)2,the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020,and the Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)criteria.The primary indicators were the total effective rate,fever subsidence time,and cough disappearance time.The secondary outcomes were pulmonary rale disappearance time,average hospitalization time,lung X-ray infiltrate disappearance time,immunological indices,and inflammatory cytokine levels.Results:Twelve relevant SRs were included;75%(9/12)were assessed as very low quality,and 25%(3/12)Were rated as low quality using the AMSTAR 2 criteria.According to the PRISMA 2020 checklist,the average SR score was 20.3 out of a 27 point maximum.In all SRs,CHM demonstrated improvement in symptoms and signs among children with MPP.The evidence quality using the GRADE criteria ranged from"very low"(>50%)to"moderate"(<5%).The most common downgrading factor was imprecision,followed by publication bias and inconsistency.Conclusion:This overview highlights the limited quality of the methodology and evidence of the included SRs.Although the included studies showed the beneficial effects of CHM on MPP in children,it was difficult to draw firm conclusions owing to methodological flaws.

Integration of 1H-NMR-Based Metabolomics Approach with Traditional Chinese Pulse Diagnosis to Evaluate the Qi-Enhancing Activity of Herbal Tea

Human metabolism is intricately linked to an individual’s health status. Regardless of living habits, it will be reflected in the metabolic characteristics of urine. The utilization of the 1H NMR-based metabolomics method has enabled examine the metabolomic changes in urine under various physiology conditions, providing valuable insights into metabolites. In this particular study, volunteers were divided into two groups based on the strength of their spleen pulses, using the pulse diagnosis method employed in traditional Chinese medicine. Subsequently, their urine samples were analyzed, revealing notable variances in urea, creatinine, citric acid, succinic acid, trimethylamine-N-oxide (TMAO), alanine, hippuric acid, and glycine between the two groups. Interestingly, individuals with weak spleen pulses showed significant improvements after consuming herbal tea. Furthermore, we conducted LC-MS analysis on herbal tea and performed adenosine triphosphate (ATP) activity tests on the C2C12 mouse skeletal muscle cell line. The results indicated that within a reasonable concentration range, exposure to herbal tea led to an increase in the mitochondrial ATP production capacity of C2C12 cells. These findings shed light on the relationship between traditional Chinese medicine pulse diagnosis and urine metabolites, highlighting their potential as non-invasive and straightforward health assessment indicators. They can aid in the preliminary determination of necessary dietary and lifestyle changes to enhance overall bodily health.

The potential of Chinese herbal medicines in treating anxiety disorders

In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.

The Chinese Herbal Formula Weichang’an Reduces the Proliferation of Human Gastric Cancer Cells via Mitochondrial Apoptosis

Objective The aim of the study was to investigate the effects of Chinese herbal formula Weichang’an(WCA)on the proliferation and mitochondria-mediated apoptosis of human gastric cancer cells.Methods Cell Counting Kit-8(CCK8)was used to evaluate the antiproliferative activity ofWCA on MKN45 cells;Giemsa staining was used to investigate cell colony formation;flow cytometry was used to analyze cell cycle,apoptosis rate,and caspases activation;and Hoechst staining was used to analyze the morphology of cell nuclei.The mitochondrial membrane potential was analyzed by both flow cytometric measurements and fluorescence microscopy.Western blot was used to analyze the protein levels of pro-caspase-3,Bcl-2,Bax,and Bcl-X.MKN45 cells were subcutaneously injected into the right forelimb of 16 nude mice to establish the tumor xenograft model,and a total of 12 nude mouse tumor xenograft models were successfully created.The nude mice were divided into the control group and the WCA-treated group.The two groups received normal saline and WCA treatment at 35.49 g/kg by a single daily oral gavage for 21 days.The body weight and tumor size of the nude mice were measured twice a week.The ultrastructural changes of subcutaneous tumors were observed by a transmission electron microscope.Results WCA can suppress cell proliferation and colony formation.It can also induce changes in the mitochondrial membrane potential and increase the activities of caspases-3,caspases-8,and caspases-9 in MKN45 cells.WCA induced S-phase arrest and apoptosis in MKN45 cells,and decreased the expression levels of antiapoptotic proteins Bcl-2 and Bcl-X in MKN45 cells,while increasing the expression levels of the proapoptotic proteins Bax and pro-caspase-3 compared with the control group.WCA inhibited the growth of a xenografted MKN45 tumor in nude mice,and the protein levels of Bax and pro-caspase-3 were significantly increased,while Bcl-X and Bcl-2 were reduced compared with the control group.The differences are statistically significant(p<0.05).Conclusion WCA could suppress the proliferation of gastric cancer cells via mitochondrial apoptosis.

Guideline for the diagnosis and treatment of rheumatoid arthritis with integrated traditional Chinese medicine and Western medicine to increase efficiency and reduce toxicity

Rheumatoid arthritis imposes a huge disease burden.Existing practice guidelines do not meet the needs of integrated traditional Chinese medicine and Western medicine in the treatment of rheumatoid arthritis.We established a guideline working group consists of a steering committee,a secretary group,an evidence evaluation group,a consensus group and a review group and developed a guideline following the guidance of the World Health Organization Handbook and the Chinese Medical Association.The guideline includes 35 recommendations which reached consensus by the two rounds Delphi surveys.These recommendations were formulated to address the following themes of most concern to clinician:diagnostic imaging,disease staging,traditional Chinese medicine syndromes,effectiveness and toxicity of integrated traditional Chinese medicine and Western medicine.

Reflections on the Toxicity and Safety of Traditional Chinese Medicine Combined with the Cases of Nephrotoxicity and Hepatotoxicity

This paper analyzes the relationship between toxicity and safety of traditional Chinese medicine(TCM)based on the cases of current nephrotoxicity and hepatotoxicity,and summarizes the literature on hepatotoxicity and nephrotoxicity.It is found that the main reasons for the toxic reaction of TCM are own factors of drugs,irregular administration of medicine and individual difference.However,as long as the"quality"and"quantity"of TCM are guaranteed,the toxicity of TCM can be controlled within the safety range.

Herbal hepatoxicity from Chinese skullcap: A case report

The use of herbal supplements has increased considerably over the last decade. We report a case of an elderly woman who began taking Move Free Advanced for arthritis, which in addition to glucosamine and chondroitin, contained two herbal ingredients, Chinese skullcap and Black Catechu. Our patient presented with significant cholestasis and hepatitis which significantly improved after discontinuation of the supplement. Since neither the patient nor the treating physician recognized this supplement as a potential hepatotoxin, she resumed taking the supplement and again suffered from considerable hepatotoxicity. Liver biopsy at that time was consistent with acute drug induced liver injury. She, once again, recovered after discontinuation of the supplement. Review of the literature confirms that Chinese skullcap has been implicated as a possible hepatotoxic agent which was demonstrated in this case.

The effects of Chinese herbal fumigation on the prevention of peripheral neurotoxicity caused by chemotherapy:a meta-analysis

Backgroud:To evaluate the clinical efficacy of Chinese herbal fumigation to prevent peripheral neurotoxicity caused by chemotherapy.Methods:CNKI,VIP Database,Wanfang Database,PubMed and Cochrane Databases were searched from January 2014 to July 2019 for randomized controlled trials(RCTs)of herbal fumigation to prevent peripheral neurotoxicity caused by chemotherapy.The RCTs were selected according to the inclusion and exclusion criteria,and the data extraction and bias risk assessment were performed.RevMan 5.3 software was used for statistical analysis.Results:Five Chinese RCTs were eventually included,with a total of 331 patients.Meta-analysis showed that compared with the control group,herbal fumigation could significantly reduce the incidence of peripheral neurotoxicity induced by chemotherapy(OR=0.34,95%CI(0.21,0.55),P<0.01).Moreover,herbal fumigation could also reduce the incidence of peripheral neurotoxicity above grade 2(OR=0.17,95%CI(0.04,0.77)P=0.02).Conclusion:Herbal fumigation can effectively prevent the occurrence of peripheral neurotoxicity caused by chemotherapy without obvious adverse reactions.

Predicting the nephrotoxicity of Chinese herbal medicines based on a Bayesian network model

Objective:Based on a Bayesian network model(BNM),we constructed and evaluated a predictive model of Chinese herbal medicines(CHMs)nephrotoxicity,explored its influencing factors,and provided a reference for the prevention and control of nephrotoxicity.Methods:We searched for CHMs with nephrotoxicity through academic journals and academic works,screened non-nephrotoxic CHMs,and then tested the correlation between nephrotoxic and non-nephrotoxic CHMs and their four properties,five flavours,and channel tropism.The screened variables were used to construct the Bayesian network model(BNM),predict important factors affecting the nephrotoxicity of Chinese herbal medicines(CHMs),draw the receiver operating characteristic(ROC)curve of the model,and calculate the area under the curve(AUC)to evaluate the forecasting effect of the model.Results:Medicinal property theory(four properties and five flavours)are important factors affecting the nephrotoxicity of CHMs.Nephrotoxic and non-nephrotoxic CHMs are related to their four propertiesand five flavours(P<0.05).BNM showed that sweetness and flatness wereimportant protective factors for nephrotoxicity of CHMs;the prediction accuracy was 77.92%,the AUC result of the model ROC curve was 0.661(95%CI:0.620-0.701),and the best sensitivity(0.736)and specificity(0.571)were obtained at 0.65.Discussion:Modern mathematical statistics and modeling methods have certain reference significance and application value for the prediction of CHMs nephrotoxicity and toxicology research.

To set up a logistic regression prediction model for hepatotoxicity of Chinese herbal medicines based on the efficacy of Chinese herbal medicines

In our previous research,a logistic regression prediction model for hepatotoxicity of Chinese herbal medicines based on the four properties,five flavors and channel tropism has been successfully established.However,could Chinese herbal medicines efficacy also be applied to predict the hepatotoxicity of Chinese herbal medicines?Therefore,a logistic regression prediction model for hepatotoxicity of Chinese herbal medicines based on Chinese herbal medicines efficacy has been tentatively set up to study the correlations of hepatotoxic and nonhepatotoxic Chinese herbal medicines with efficacy by using a chi-square test for two-way unordered categorical data.Logistic regression prediction model was established and the accuracy of the prediction by this model was evaluated.It has been found that the hepatotoxicity and nonhepatotoxicity of Chinese herbal medicines were weakly related to the efficacy,and the coefficient was 0.295.There were 20 variables from Chinese herbal medicines efficacy analyzed with unconditional logistic regression,and 6 variables,rectifying Qi and relieving pain,clearing heat and disinhibiting dampness,invigorating blood and stopping pain,invigorating blood and relieving swelling,killing worms and relieving fright were chosen to establish the logistic regression prediction model,with the optimal cutoff value being 0.250.Dissipating cold and relieving pain(DCRP),clearing heat and disinhibiting dampness,invigorating blood and relieving pain(IBRP),invigorating blood and relieving swelling,killing worms,and relieving fright were the variables to affect the hepatotoxicity and the established logistic regression prediction model had predictive power for hepatotoxicity of Chinese herbal medicines to a certain degree.

Molecular mechanism and research progress of traditional Chinese medicine in the treatment of prostate cancer

Prostate cancer(PCa)is one of the most common malignant tumors in the male genitourinary system,ranking second in incidence worldwide.Traditional Chinese medicine(TCM),as an important component of complementary and alternative medicine,shows unique advantages in cancer treatment.Chinese herbal medicine is usually composed of multiple ingredients and involves multiple signaling pathways,which showed function of inducing apoptosis of cancer cells,arresting the cell cycle,inhibiting invasion and metastasis,reducing drug resistance,and regulating immune function.Physical therapy is also an important treatment of TCM.Currently,Physical therapy such as acupuncture or Tai Chi and Qigong are gaining increased recognition in the management of PCa,particularly in addressing issues like urinary incontinence and bone metastasis-related pain.This article reviews the TCM treatment and therapy of PCa,in order to provide new research avenues and treatment options for the treatment of PCa with TCM and improve the quality of life of patients.

In Silico Screening of Potential Inhibitors against dPLA2 from Named Chinese Herbs for Identification of Compounds with Antivenom Effects Due to Deinagkistrodon acutus Snake Bites

Phospholipase A2 (PLA2) is the key enzyme to the venom from Deinagkistrodon acutus which is one of the highly venomous snakes in China. In addition to being a catalyst for the hydrolysis of phospholipases A2 from snake venom, its well known that it possesses a broad spectrum of pharmacological activities, such as myotoxicity, neurotoxicity, cardiotoxicity, and hemolytic, anticoagulant and antiplatelet activities. However, snakebites are not efficiently treated by conventional serum therapy. Acute wounds can still cause poisoning and death. In order to find effective inhibitors of Deinagkistrodon venom acid phospholipase A2 (dPLA2), we obtained 385 compounds in 9 Chinese herbs from the TCMSP. These compounds were further performed to virtual screen using in silico tools like ADMET analysis, molecular docking and molecular dynamics (MD) simulation. After Pharmacokinetics analysis, we found 7 candidate compounds. Besides, analysis of small molecule interactions with dPLA2 confirmed that the amino acid residues HIS47 and GLY29 are key targets. Because they bind not only to the natural substrate phosphatidylcholine and compounds known for having inhibitory functions, but also for combining with potential antidote molecules in Chinese herbal medicine. This study is the first to report experience with virtual screening for possible inhibitor of dPLA2, such as the interaction spatial structure, binding energy and binding interaction analysis, these experiences not only provide reference for further experimental research, but also have a guideline for the study of drug molecular mechanism of action.

Integration of traditional,complementary,and alternative medicine with modern biomedicine:the scientization,evidence,and challenges for integration of traditional Chinese medicine

Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into current healthcare systems.This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine,further termed here as“scientization”.Specifically,we aim to summarize the advancements made in understanding the efficacy,effectiveness,and underlying mechanisms of herbal medicine.We also examined the transition from experience-to evidence-based medicine during acupuncture.Furthermore,we explore the development of universal safety and quality control standards.Finally,we discuss international trade and export markets for Chinese medical products.The development and integration of traditional medicine have allowed it to further improve human health,resulting in a more comprehensive health solution for the global population.

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis(CG)is a common gastrointestinal disorder characterized by inflammation of the stomach lining.Liver-stomach disharmony(LSD)syndrome is believed to contribute to CG symptoms.AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine(CHM)treatment in patients with CG and LSD syndrome.METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups:The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine.The treatment course lasted 12 wk.The primary outcome was improvement in dyspeptic symptoms,measured using the Nepean Dyspepsia Index.The secondary outcomes included the improvement rate of endoscopic findings,histopathological findings,and microcosmic syndrome scores and the incidence of adverse events.RESULTS After 12 wk of treatment,the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group(93.75%vs 65.63%,P<0.01).The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group(81.25%vs 53.13%,P<0.05).The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups(P>0.05).No serious adverse events were observed in either group.CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile.Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

Transplanted: Chinese Herbal Medicine in the United States, 1800-1911

Chinese medicine has a long history in the United States, dating back to its colonial period and extending up to the present. This essay focuses on the earliest generation of practitioners of traditional Chinese medicine in the United States. Although acupuncture is the modality most commonly associated with Chinese medicine in today's medical marketplace, up until the 1970s, Chinese healers in the United States typically specialized in herbalism. Well before mass emigration from China to the United States began, Chinese material medica crossed the oceans, in both directions: Chinese medicinal teas and herbs came west while Appalachian ginseng went east. Beginning in the 1850s, Chinese immigrants came to the United States and transplanted their health practices, sometimes quite literally by propagating medicinal plants in their adopted home. Over time, Chinese doctors learned how to sell their services to non-Chinese patients by presenting herbalism as “nature's remedies.”

Comparative efficacy of traditional Chinese herbal injection for chronic renal failure:A systematic review and network meta-analysis of randomized controlled trials

Objective: To conduct a systematic review and network meta-analysis(NMA) for the comparison of the efficacy and safety of Chinese herbal injection(CHI) combined with Western medicine(WM) and WM monotherapy for chronic renal failure(CRF).Methods: Eight databases were searched from inception to August 30, 2022. Randomized controlled trials(RCTs) regarding the comparison of CHI-WM combination therapy and WM monotherapy were included. Literature search, risk-of-bias assessment, and data extraction were conducted by 2 reviewers independently. NMA was performed by Stata 14.0, R 4.0.4 software, and the latest risk of bias assessment tool 2(RoB 2).Results: A total of 53 RCTs were finally included, involving 4445 participants and 16 CHIs. RoB 2 showed that 2 of these studies had a high risk of bias. Tianqi injection(TQ) + WM was the most effective in reducing serum creatinine(Scr) level. Xingding injection(XD) + WM was the most effective in reducing blood urea nitrogen(BUN) and cystatin C(Cys C) levels. Guhong injection(GH) + WM had the highest endogenous creatinine clearance rate(Ccr). Shuxuetong injection(SXT) + WM was the most effective in improving the clinical effective rate. Danhong injection(DH) + WM resulted in the lowest 24-h urinary protein quantity(24 h-UPQ), while Danshen injection(DS) + WM led to the lowest blood uric acid(UA)level. Shenfu injection(SF) + WM was the most effective in increasing hemoglobin(Hb) level.Conclusion: CHIs-WM combination therapy is more effective than WM monotherapy in treating CRF.Considering all of the indicators, SK + WM may be the optimal treatment option for improving renal function in patients with CRF.

Clinical Observation of Chinese Medicinal Prescriptions for Swelling and Pain in The Postoperative Treatment of Mixed Hemorrhoids

Objective:To observe the clinical effect of traditional Chinese medicine(TCM)on reducing swelling and pain in patients with mixed hemorrhoids.Methods:Sixty patients with mixed hemorrhoids who were admitted to the Hospital of Traditional Chinese Medicine of Qiqihar from January 2023 to January 2024 were selected and divided into two groups.The treatment group(n=30)was treated with mixed hemorrhoid ligation combined with traditional Chinese swelling and pain medicine,and the control group(n=30)was only treated with mixed hemorrhoid ligation.The pain level,edema score,and prognosis of the two groups after the intervention were analyzed.The clinical efficacy was used as the evaluation criterion to compare the clinical effects of different treatment options.Results:After the treatment,the pain score,edema score,and prognostic wound score of the treatment group were all lower than those of the control group(P 0.05).The total clinical effectiveness of the treatment group(100%)was higher than that of the control group(76.67%),(χ^(2)=4.2857,P<0.05).Conclusion:The application of traditional Chinese swelling and pain medicine in treating patients with mixed hemorrhoids effectively reduced the patient’s pain,reduced the degree of wound edema,promoted wound healing,and improved the patient’s prognosis.The curative effect was significant and had a positive impact.