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.

Advances in research on the efcacy of traditional Chinese herbal medicine in combating African swine fever

African swine fever(ASF)is a highly contagious disease of domestic and wild pigs caused by African swine fever virus(ASFV).The mortality rate associated with ASF is remarkably high,almost approaching 100%.Since the introduction of ASF into China in 2018,its rapid spread has caused marked economic losses in the country’s swine industry.To date,there are no safe and efective commercial vaccines or antiviral drugs against ASF;thus,there is an urgent need to develop novel prevention and control strategies.Traditional Chinese medicine(TCM),which comprises various herbs that are abundant in various potential functional components,holds great promise for the prevention and control of ASF.Here,we provide a comprehensive review of the advancements in TCM and the efects of its compound formulas against ASF,including the antiviral abilities,immunoregulatory activities,and practical application of these formulas for the prevention and control of ASF.We specifcally examined the potential and constraints of natural product-derived extracts and TCM formulas in combating ASFV.This review aims to ofer insights and ideas for the holistic management and containment of ASF.

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.

Integrating traditional Chinese (herbal) medicines into risk based regulation-With focus on non-clinical requirements to demonstrate safety

Within the public health sector of Hong Kong(China),there is a consensus around the important role of traditional Chinese medicines.For Hong Kong(China)to play a bridging role to bring Chinese medicines to the global market requires a concerted effort from the government,academic institutes and industries.The release of the final version of the European Medicines Agencies guidance document,which details the acceptance of minimum requirements to nonclinical package in bibliographical applications,grants the opportunity for well-established and traditional herbal medicines to demonstrate an‘acceptable safe’status for registration in the European Union.It is anticipated that this minimum nonclinical package can be applied to demonstrate the safe use of many traditional Chinese medicines regardless of their eligibility to be registered under the simplified procedure within the European Union.This paper conceptualizes an integration of a simplified evaluation route for eligible proprietary Chinese medicines(pCm)with long history of use into the existing drug regulatory framework in Hong Kong(China).Such integration utilizing the minimum nonclinical package,based on bibliographical data or expert report,as proof of evidence to demonstrate safety for pCm with long history of use requires less demand in scientific resources.With Hong Kong(China)conducting‘first hand’review for eligible pCm,it provides an option for overseas and local pharmaceutical companies to register their products in Hong Kong(China)without the need to rely on issuance of Certificate of Pharmaceutical Product from other countries.This could bring eligible pCm with long history of use to reach international risk-based standard and to be marketed globally as‘medicines’to reach their full therapeutic potential.An important process to positioning Hong Kong(China)to compete with other countries in promoting importation and exportation of pCm to better serve the global health.

Investigation of Heavy Metal Contents in Traditional Chinese Herbal Medicine Peristrophe roxburghiana Collected from Northwest of Guangxi

Objective] This study was conducted to evaluate the product quality and safety of Peristrophe roxburghiana_ col ected from different places in Hechi City, northwest of Gunagxi, so as to provide basic data for further development and uti-lization of the characteristic plant resource P. roxburghiana. [Method] Contents of 9 kinds of heavy metals including Cd, Mn, Pb, Zn and Cu in the herb were deter-mined by the method of wet digestion-flame atomic absorption spectrophotometry and atomic fluorescence spectrometry, respectively. [Results] Heavy metal contents of Cd, Mn, Pb, Fe, Cu, Zn, As, Hg and Se were 1.62-17.25, 8.93-142.53, 4.37-18.43, 103.7-242.81, 2.55-5.35, 85.40-146.30, 0.07-0.54, 0.00-0.08 and 0.00-0.47 mg/kg, respectively. According to the national food safety standards and Green Trade Standards of lmporting ＆amp; Exporting Medicinal plants ＆amp; Preparations, the heavy metal contents of the P. roxburghiana_samples col ected from different coun-ties in Hechi City exceeded standards or at the critical values. Among which, Cd, Pb and Zn contents of the samples are seriously higher than the standards. [Con-clusion] Therefore, the impact of soil heavy metal pol ution on the safety of edible plants in the northwest of Guangxi should be highly concerned.

Effects of Salinity Fluctuation and Dietary Traditional Chinese Herbal Medicines on Survival,Growth and Immunity of Exopalaemon carinicauda

[Objective]The aim of this study was to provide a theoretical basis for the large-scale breeding of Exopalaemon carinicauda. [Method]Effects of salinity fluctuation （S0,S3,S6 and S9 represented salinity fluctuations of 0,3,6 and 9 respectivley） and dietary traditional Chinese herbal medicines （0,1%,2% and 4% respectively） on survival,growth and immunity of E.carinicauda were studied,and its experiment lasted for 60 d. [Result]The results showed that specific growth rate,feed conversion efficiency and superoxide dismutase activity of E.carinicauda in the treatment group with 1% dietary traditional Chinese herbal medicine and S6 salinity fluctuation were higher than those in other treatments,which was significantly higher than the treatment groups with S0,S3 and S9 salinity fluctuation at the same adding level of 1% dietary traditional Chinese herbal medicine. The regression analysis indicated that at S0,S3 and S6 salinity fluctuation,the optimal adding level of dietary traditional Chinese herbal medicines in feeds decreased with the increase of salinity fluctuation,accounting for 2.74%,1.77% and 0.51% respectively. At four adding levels of dietary traditional Chinese herbal medicines,the optimal salinity fluctuation of E.carinicauda also decreased with the increase of dietary traditional Chinese herbal medicines in feeds,accounting for 5.26,4.95,3.54 and 1.97 respectively. [Conclusion]Salinity,dietary traditional Chinese herbal medicines and their interactions have a significant effect on survival,growth and immunity of E.carinicauda,which calls for attentions in the breeding.

Effects of Traditional Chinese Herbal Medicine on the Structure of Duodenal Mucosa of Chickens under Heat Stress

[Objective] This study aimed to investigate the effects of traditional Chinese herbal medicine on the structure of duodenal mucosa of chickens under heat stress. [Method] One hundred and twenty 88-day-old Isa Brown chickens were randomly divided into six groups, including three control groups （normal temperature control group, high temperature control group, high temperature Vc control group） and three high-temperature administration groups （high-dose administration group, moderate-dose administration group, low-dose administration group）. Chickens in normal temperature control group were reared at 14-25 ℃, and those in other five groups were reared at 28-39 ℃. The experiment lasted 10 d. Five chickens in each group were euthanized at 1, 4, 8 and 10 d post-treatment, respectively. The duodenal mucosa was collected and prepared into tissue slices with the conventional method for hematoxylin-eosin （HE） staining. Mucosal thickness, villus length and crypt depth of duodenal mucosa were measured. [Result] Under heat stress, duodenal mucosal thickness and villus length were both significantly lower than those in normal temperature control group, and the duodenal villi were scarce and thin. However, under high temperature conditions, various indicators in high-dose and moderate-dose administration groups were higher than those in high temperature control group and high temperature Vc control group, which exhibited extremely significant differences at 8 and 10 d post-treatment, especially. Moreover, various indicators in high-dose administration group were significantly higher than those in moderate-dose and low-dose administration groups. The traditional Chinese herbal medicine prescription exhibited higher protective effects on duodenal mucosa of chickens under heat stress compared with high temperature Vc control group. [Conclusion] Under heat stress, traditional Chinese herbal medicine reduced effectively the duodenal mucosa damage in chickens.

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.

Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders

Herbal traditional Chinese medicine(TCM) is used to treat several ailments, but its efficiency is poorly documented and hence debated, as opposed to modern medicine commonly providinge ffective therapies. The aim of this review article is to present a practical reference guide on the role of herbal TCM in managing gastrointestinal disorders, supported by systematic reviews and evidence based trials. A literature search using herbal TCM combined with terms for gastrointestinal disorders in Pub Med and the Cochrane database identified publications of herbal TCM trials. Results were analyzed for study type, inclusion criteria, and outcome parameters. Quality of placebo controlled, randomized, double-blind clinical trials was poor, mostly neglecting stringent evidence based diagnostic and therapeutic criteria. Accordingly, appropriate Cochrane reviews and meta-analyses were limited and failed to support valid, clinically relevant evidence based efficiency of herbal TCM in gastrointestinal diseases, including gastroesophageal reflux disease, gastric or duodenal ulcer, dyspepsia, irritable bowel syndrome, ulcerative colitis, and Crohn's disease. In conclusion, the use of herbal TCM to treat various diseases has an interesting philosophical background with a long history, but it received increasing skepticism due to the lack of evidence based efficiency as shown by high quality trials; this has now been summarized for gastrointestinal disorders, with TCM not recommended for most gastrointestinal diseases. Future studies should focus on placebo controlled, randomized, double-blind clinical trials, herbal product quality and standard criteria for diagnosis, treatment, outcome, and assessment of adverse herb reactions. This approach will provide figures of risk/benefit profiles that hopefully are positive for at least some treatment modalities of herbal TCM. Proponents of modern herbal TCM best face these promising challenges of pragmaticmodern medicine by bridging the gap between the two medicinal cultures.

A case report of traditional Chinese medicine in the treatment of Huhuo disease

Objective: To cultivate the clinical thinking of traditional Chinese medicine(TCM).Methods: A 53-year-old male patient with fever, systemic rash accompanied by oral, perineal and perianal ulcers for 5 days was enrolled and managed utilizing traditional Chinese medicine principles.Results: By enhancing relevant auxiliary examinations to exclude hand-foot-and-mouth disease, combined with the four diagnostic methods of traditional Chinese medicine, the diagnosis was established as Huhuo disease, and the differentiation was dampness-heat encumbering inside. On the basis of modern medical fluid rehydration and nutritional support(glucocorticoids, immunosuppressants and other drugs were not used in the whole treatment).The patient was treated with Chinese medicine differentiation, and administered Gancao Xiexin decoction for 9 days and then was recovered and discharged.Conclusions: Based on the trinity of “theory-classic-clinical”, the cultivation of TCM thinking can be realized.

Herbal Traditional Chinese Medicine and suspected liver injury: A prospective study

AIM To analyze liver tests before and following treatment with herbal Traditional Chinese Medicine(TCM) in order to evaluate the frequency of newly detected liver injury.METHODS Patients with normal values of alanine aminotransferase(ALT) as a diagnostic marker for ruling out pre-existing liver disease were enrolled in a prospective study of a safety program carried out at the First German Hospital of TCM from 1994 to 2015. All patients received herbal products, and their ALT values were reassessed 1-3 d prior to discharge. To verify or exclude causality for suspected TCM herbs, the Roussel Uclaf Causality Assessment Method(RUCAM) was used.RESULTS This report presents for the first time liver injury data derived from a prospective, hospital-based and largescale study of 21470 patients who had no liver disease prior to treatment with herbal TCM. Among these, ALT ranged from 1 × to < 5 × upper limit normal(ULN) in 844 patients(3.93%) and suggested mild or moderate liver adaptive abnormalities. However, 26 patients(0.12%) experienced higher ALT values of ≥ 5 × ULN(300.0 ± 172.9 U/L, mean ± SD). Causality for TCM herbs was RUCAM-based probable in 8/26 patients, possible in 16/26, and excluded in 2/26 cases. Bupleuri radix and Scutellariae radix were the two TCM herbs most commonly implicated. CONCLUSION In 26(0.12%) of 21470 patients treated with herbal TCM, liver injury with ALT values of ≥ 5 × ULN was found, which normalized shortly following treatment cessation, also substantiating causality.

Quality Inspection and Preparation of Diarrhea Arresting and Dysentery Treating Dietary Traditional Chinese Herbal Medicine for Livestock

[Objective] This study was aimed to formulate the quality inspection of diarrhea arresting and dysentery treating dietary traditional Chinese herbal medicines for livestock.[Methods] Physiochemical identification and contrast test of UV spectrophotometer qualitative detection were adopted.[Results] The difference in the peak value of maximum adsorption peak detected by diluted water method was greater than 1 nm; the maximum adsorption peak values obtained by the 0.9％ hydrochloric acid and 60％ ethanol methods had a difference of less than 1 nm,and the secondary adsorption peak values also had a difference of less than 1 nm.[Conclusion] The 0.9％ hydrochloric acid and 60％ ethanol methods were selected as the quality inspection standards for the preparation of diarrhea arresting and dysentery treating dietary traditional Chinese herbal medicines for livestock.

Drug discovery from traditional Chinese herbal medicine using high content imaging technology

Traditional Chinese medicine(TCM) has been widely used in China and other Asia countries for thousands of years to treat or prevent human diseases. Chinese herbal medicine, one of the most important components of TCM, has unique diversities in chemical components, and thus results in a wide range of biological activities. However, pharmaceutical industry is facing a major challenge to develop a large population of novel natural products and drugs, and considerable efforts have not resulted in highvolume of novel drug discovery and productivity. At present, increasing attention has been paid to Chinese herb medicine modernization in combination with the cutting-age technologies of drug discovery, especially the high throughput selection. High content imaging is an image-based high throughput screening method by using automated microscopy and image analysis software to capture and analyze phenotypes at a large scale to investigate multiple biological features simultaneously in the biological complex. Here, we described the pipeline of the state-of-the-art high content imaging technology, summarized the applications of the high content imaging technology in drug discovery from traditional Chinese herbal medicine, and finally discussed the current challenges and future perspectives for development of high throughput image-based screening technology in novel drug research and discovery.

Traditional Chinese herbal medicine for vascular dementia

OBJECTIVE To systematically review the clinical efficacy and safety on TCHMs that are used for vascular dementia(VaD).METHODS To identify studies for systematical review,electronic searches were performed through several databases-ALOIS,CNKI,CBM,Weipu,Wanfang,etc.Only randomized control trials(RCTs)or controlled clinical trials(CCTs)were included.Patients were diagnosed with VaD by diagnostic criteria(DSM,NINDS-AIREN,ICD or HIS)as well as imaging technique(CT,MRI or functional imaging,etc).Eligible TCHMs must be recognized in the Chinese Pharmacopeia or the National Essential Drug List of the People′s Republic of China.Included studies were appraised using the Cochrane Collaboration risk-of-bias criteria.Efficacy and safety outcomes were evaluated by meta-analysis.Efficacy outcomes include cognition,daily function,global performance and behaviour;safety was assessed by the number of adverse events and number of subjects experiencing adverse events.Assessment of heterogeneity,subgroup analysis and sensitivity analysis were also performed.RESULTS A total of 46 trials on 29TCHMs(3522patients)were included.45 studies were RCTs and 1was CCT.In these 45 RCTs,only 2were appraised as adequately randomised.5of 46 trials were appraised as having low risk of bias in blinding.Sample sizes were generally small ranging from 26 to 216with a median of 68.All trials were conducted in China from 1997 to 2013.All 46 studies assessed cognition using one or a combination of the following scales:MMSE(n=40 studies;3096 patients),HDS(n=22;1664 patients),ADAS-Cog(n=4;241 patients),CDT(n=1;60patients)and CCSE(n=1;26patients).Half of the studies assessed daily function using either the ADL(n=22;1743 patients)or IADL(n=2;203patients).Only 6studies measured behaviour using the FAQ(n=3;226 subjects),BBS(n=1;48patients),NPI(n=1;100subjects)or Neurological Deficits Function Scale(n=1;91patients).30 studies measured global performance.31 of 46 studies made conclusions regarding the safety of the TCHMs.Despite the problems of methodology and reporting,we can identify three TCHMs-NaoXinTong,Shenfu and Tongxinluo as having relatively stronger evidence of efficacy.There is weak evidence for the safety of TCHMs for VaD.CONCLUSION There is weak evidence for the efficacy and safety of TCHMs for VaD because of the poor methodology,short duration of follow-up and inadequate reporting.However the agents appear to be relatively free of severe short-term AEs,hence we encourage further better designed and reported trials.

Traditional Chinese Herbal Medicine for Epilepsy Treatment Should Be Administered According to the Seizure Type and Epileptic Syndrome

Traditional Chinese herbal medicine (TCHM) has long been used to treat epilepsy. Although many clinical trials and animal studies have seemingly demonstrated its effect, the question of whether TCHM is efficacious in epileptic patients has not been certified because of insufficient supportive evidence. This insufficient supportive evidence stems from the fact that most of the current studies regarding TCHM for epilepsy treatment are not designed according to the different seizure types and epileptic syndromes (STESs). Here, we explore the reasons why many studies have not considered the various STESs and explain how to treat epilepsy according to the pharmacological mechanism for different STESs and exploit the advantage of TCHM for epilepsy treatment. Then, we explain how we treat epilepsy using TCHM according to the different STESs and Bian Zheng Lun Zi.

Traditional Chinese medicine for foot pain in a patient with complex regional pain syndrome: A case report

BACKGROUND Complex regional pain syndrome(CRPS)is characterized by pain as well as sensory,motor,and sudomotor disorders.Generally,it is classified into two types CRPS-I and CRPS-II.There is no single diagnostic test or treatment approach for CRPS,and a multidisciplinary approach is gaining attention to improve patients’symptoms and their quality of life.CASE SUMMARY A 35-year-old woman with an unremarkable medical history sought treatment for CRPS at a hospital of Korean medicine.During her first visit,she was wheelchairbound due to severe pain in her left lower extremity.She had edema and discoloration of the left foot.She was treated with a combination of traditional Chinese medicine(TCM)approaches,including acupuncture,moxibustion,pharmacopuncture,and herbal decoction,for approximately 20 sessions.The foot and ankle outcome score(FAOS)and visual analog scale(VAS)score for pain were evaluated,along with general signs and functions.Her symptoms,signs,FAOS,and VAS scores improved after treatment,with a significant 7-degree decrease in the VAS score and a 62-point increase in the FAOS score.Additionally,the foot swelling and discoloration gradually resolved.During the phone follow-up,5 mo after the last visit,additional improvements in outcomes were observed.CONCLUSION Combined TCM treatment may be a reasonable and safe option for alleviating symptoms and improving function in patients with CRPS.

Effects of ginger moxibustion combined with Chinese medicine iontophoresis on patients with primary dysmenorrhea

Objective:To observe the effects of Ginger moxibustion combined with iontophoresis with traditional Chinese medicine on the improvement of symptoms, serum platelet activating factor (PAF) level and uterine artery pulsation index in patients with primary dysmenorrhea.Methods 114 patients with primary dysmenorrhea who were treated in our hospital from August 2017 to February 2019 were divided into two groups according to the different treatment schemes. 57 patients in the control group were treated with ibuprofen capsules, and 57 patients in the study group were treated with Ginger moxibustion combined with iontophoresis with traditional Chinese medicine. After three menstrual cycles of treatment, the curative effect was evaluated and the improvement of symptoms was counted. PAF, PAF-AH and platelet adhesion rate were compared, uterine artery hemodynamics was measured, and levels of serum hs-CRP and IL-6 were measured.Results The overall response rate of the study group was significantly higher than that of the control group (P < 0.05). After treatment, the scores of different symptoms in the two groups were significantly lower than those before treatment (P < 0.05), and the scores of different symptoms in the study group were significantly lower than those in the control group (P < 0.05). After treatment, PAF and platelet adhesion rate in the two groups were significantly lower than those before treatment (P < 0.05), PAF-AH was significantly higher than that before treatment (P < 0.05), and PAF and platelet adhesion rate in the study group were significantly lower than those in the control group (P < 0.05), PAF-AH was significantly higher than that in the control group (P < 0.05). After treatment, the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those before treatment (P < 0.05), and the pulsation index, resistance index and peak systolic-diastolic ratio in the study group were significantly lower than those in the control group (P < 0.05). After treatment, the levels of serum hs-CRP and IL-6 in the two groups were significantly lower than those before treatment (P < 0.05), and the levels of serum hs-CRP and IL-6 in the study group were significantly lower than those in the control group (P < 0.05).Conclusions Ginger moxibustion combined with iontophoresis with traditional Chinese medicine is helpful to improve the overall response rate of primary dysmenorrhea treatment, reduce the score levels of different symptoms, rationally improve PAF, PAF-AH, platelet adhesion rate, and the pulse index, resistance index, peak systolic-diastolic ratio are decreased significantly, and serum hs-CRP and IL-6 levels tend to be normal.

Treatment Principles of Obesity with Chinese Herbal Medicine: Literature Analysis by Text Mining

Obesity represents a social health problem worldwide, associated with serious health risks and increased mortality. The prevalence of obesity is reported to be increasing in both developed and developing countries. Obesity is associated with a significant range of comorbidities and is linked with increases in mortality, thus the treatment of obesity is very important. Chinese herbal medicine (CHM) has been used for weight management both in China and in western countries for many years, the effectiveness and safety of CHMs in obesity have been proved. Yet the principles of treating obesity with CHMs are hard to manage due to the complexity of TCM theory. In this study, a novel text mining method was developed based on a comprehensive collection of literatures in order to explore the treatment principles more intuitively. Networks of TCM patterns and CHMs which are most frequently used in obesity treatment are built-up and analyzed, two major principles are explored in treating obesity: one is resolving phlegm and dampness, the other is clearing heat and reinforcing deficiency. These findings might guide the clinicians in treatment of obesity.

Sino-Europe Symposium on Traditional Chinese Medicine & Herbal Medicine

The symposium held from 25^th to 26^th,March 2019 in Yale Center Beijing provided an open dialogue between representatives of the national competent authorities and industries with respect to regulatory requirements for the authorization of traditional Chinese medicine (TCM) and traditional herbal medicinal products in China as well as in Europe,aiming at optimizing mutual understanding of the different herbal systems and ideally harmonizing views on similar quality control,clinical research and safety,herbal marketing and regulatory policies.

Sino-Europe Symposium on Traditional Chinese Medicine & Herbal Medicine

The symposium held from 25th to 26th , March in Yale Center Beijing provided an open dialogue between representatives of the national competent authorities and industries with respect to regulatory requirements for the authorization of traditional Chinese medicine (TCM) and traditional herbal medicinal products in China as well as in Europe, aiming at optimizing mutual understanding of the different herbal systems and ideally harmonizing views on similar quality control, clinical research and safety, herbal marketing and regulatory policies.