Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Research progress of traditional Chinese medicine in the treatment of complications related to spinal cord injury

Spinal cord injury is one of the common neurological diseases in clinical practice.It has the characteristics of high incidence rate,high disability rate and high cost.It brings great pain and mental stress to patients.Spinal cord injury patients with neurological impairment,slow recovery,in the process of disease treatment is easy to produce a series of complications,such as respiratory complications,neurogenic bladder,spasm,deep vein thrombosis,pressure sores and so on.At present,western medicine and auxiliary equipment are mainly used in the treatment of related complications,but traditional Chinese medicine also plays a very important role.Traditional Chinese medicine is not only economical,cheap and has little side effects,but also can promote the functional rehabilitation of patients with spinal cord injury and reduce the incidence of complications.In this paper,through searching the literature reports on the treatment of spinal cord injury related complications with traditional Chinese medicine at home and abroad,we review the treatment of neurogenic bladder,spasm,venous embolism,neuropathic pain,neurogenic intestinal dysfunction,pressure sores,respiratory complications with traditional Chinese medicine,in order to provide reference for the clinical treatment of spinal cord injury related complications.

Mechanisms and status of research on the protective effects of traditional Chinese medicine against ischemic brain injury

Ischemic brain injury occurs when the metabolic needs of brain tissue cannot be met due to insufficient blood supply to the brain.It is one of the main causes of death and adult disability worldwide.The recurrence rate of ischemic brain injury is high.It places a heavy economic burden on families and society,and seriously affects human health and quality of life.In traditional Chinese medicine,ischemic stroke belongs to the category of“stroke”.The use of traditional Chinese medicine to treat stroke has a long history.After years of experimental research,a large amount of theoretical knowledge and practical experience have been accumulated.Promoting blood circulation and removing blood stasis is the basis of traditional Chinese medicine theory on the treatment of ischemic stroke.Commonly used single Chinese medicines include Chuangxiong(Ligusticum chuanxiong hort),Danggui(Angelica sinensis),Danshen(Salvia miltiorrhiza Bunge),Honghua(Carthamus tinctorius L.),Mudanpi(Moutan Cortex),and Huangqi(Astragali Radix).Buyang Huanwu decoction,Xinglou Chengqi decoction,Taohong Siwu decoction,and other traditional Chinese medicine prescriptions are believed to have a protective effect against brain damage caused by ischemic stroke.With the development of modern medical technology,the mechanism of traditional Chinese medicine treatments for ischemic brain injury has gradually been explored.This article reviews the mechanisms of traditional Chinese medicine’s protection against ischemic brain injury and its current clinical application.

Pharmacological Action and Research Progress of Traditional Chinese Medicine on Liver Injury

According to the different types of liver damage,there should also be different Chinese medicine and dose for different degrees of treatment and protection.This paper studies the Chinese medicine treatment of different types of liver injury,and is expected to provide a reference for the further application of Chinese medicine in liver injury.

Study on the relationship between knee injury recovery and traditional Chinese medicine constitution of young male amateur cyclist in Hainan island cycling league

Objective:To study the relationship between the recovery of knee joint injury and traditional Chinese medicine constitution of young male amateur cyclist in Hainan.Methods:720 young male amateur cyclists were selected from the tour nanli lake national wetland park cycling race and Hainan international tourism island cycling league(ding'an station)in 2019.According to the classification criteria of TCM constitutions in classification and determination of TCM constitutions revised by the Chinese association of traditional Chinese medicine in April 2009,the TCM constitutions were divided into mild constitution group and Yin deficiency constitution group.Standard Kujala knee pain questionnaire was used to evaluate knee joint function in pinyin and Yin deficiency groups.To observe the relationship between TCM constitution and functional injury and recovery degree of knee joint.Results:Body mass index(BMI)of Yin deficiency quality was lower than that of pinyin deficiency quality(P<0.01).Score of knee flexion and extension degree was higher in Yin deficiency quality 30 minutes before the race(P<0.05).The score of Yin deficiency quality was lower after 30 minutes of squatting(P<0.01)and jumping(P<0.05).The total score of knee joint was higher 5 days after the race(P<0.01).The knee flexion and extension(P<0.05)and jump(P<0.05)were higher in the pre-race and post-race scores.Conclusion:There is a high correlation between the constitution of traditional Chinese medicine and the degree of functional injury and recovery of knee joint.The degree of post-game sports injury is higher and the recovery of post-game sports injury is faster.Therefore,different sports protection schemes can be formulated for different constitutions in bicycle RACES to reduce the occurrence of sports injuries and accelerate the recovery time of sports injuries.

Modulating the crosstalk between macrophage and Th17: potential mechanism of natural products on acute lung injury

Sepsis is a life-threatening multiple organ dysfunction syndrome caused by the imbalance of the immune response to infection,featuring complex and variable conditions,and is one of the leading causes of mortality in ICU patients.Lung injury is a common organ damage observed in sepsis patients.Macrophages and Th17 cells,as crucial components of innate and adaptive immunity,play pivotal roles in the development of sepsis-induced acute lung injury(ALI).This review summarizes the alterations and mechanisms of macrophages and Th17 cells in sepsis-induced ALI.By focusing on the“cross-talk”between macrophages and Th17 cells,this review aims to provide a solid theoretical foundation for further exploring the therapeutic targets of traditional Chinese medicine formulas in the treatment of sepsis complicated with ALI,thereby offering insights and guidance for the clinical application of traditional Chinese medicine in managing sepsis-associated ALI.

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.

Traditional Chinese medicine “Qing Yi Tang” alleviates oxygen free radical injury in acute necrotizing pancreatitis

AIM To observe the changes in oxygen free radical (OFR) and the curative effect of traditional Chinese medicine 'Qing Yi Tang' in acute necrotizing pancreatitis (ANP).METHODS After induction of ANP by injection of sodium taurocholate into pancreatic duct, 16 dogs were randomly divided into control group and Chinese medicine group. Serum amylase, SOD and MDA were determined on postoperative day 1, 2, 4 and 7. The animals were sacrificed on day 7. SOD and MDA in organs were determined, and pathological changes in pancreas were observed.RESULTS As compared with control group, the serum level of amylase (734U/L vs 2783U/L) and MDA (7.8nmol/ml vs 14.8nmol/ml) in Chinese medicine group were decreased on day 7 (P＜0.05), while SOD increased significantly (281nU/ml vs 55nU/ml, P＜0.01), and similar changes occurred in MDA and SOD in organs, especially in the pancreas; the pathological changes in the pancreas were alleviated as well.CONCLUSION 'Qing Yi Tang' is effective in clearing OFRs and alleviating pathological changes in ANP.

Research Progress of Traditional Chinese Medicine in the Treatment of Acute Respiratory Distress Syndrome

Based on the modern pathological research mechanism of ARDS,this paper summarizes the clinical therapeutic effect of traditional Chinese medicine on ARDS from the aspects of reducing inflammatory mediators,cells and factors,regulating signal pathway,regulating aquaporin,anticoagulation and so on.The purpose is to provide new theoretical basis and ideas for scholars in the future,and to improve the internationalization process of traditional Chinese medicine in the treatment of acute respiratory distress syndrome.

Mechanisms and Research Progress of Traditional Chinese Medicine Regulating NF-κB in the Treatment of Acute Lung Injury/Acute Respiratory Distress Syndrome

Acute lung injury(ALI)has multiple causes and can easily progress to acute respiratory distress syndrome(ARDS)if not properly treated.Nuclear factorκB(NF-κB)is a key pathway in the treatment of ALI/ARDS.By exploring the relevance of NF-κB and the pathogenesis of this disease,it was found that this disease was mainly associated with inflammation,dysfunction of the endothelial barrier,oxidative stress,impaired clearance of alveolar fluid,and coagulation disorders.Traditional Chinese medicine(TCM)has the characteristics of multitargeting,multipathway effects,and high safety,which can directly or indirectly affect the treatment of ALI/ARDS.This article summarizes the mechanism and treatment strategies of TCM in recent years through intervention in the NF-κB-related signaling pathways for treating ALI/ARDS.It provides an overview from the perspectives of Chinese herbal monomers,TCM couplet medicines,TCM injections,Chinese herbal compounds,and Chinese herbal preparations,offering insights into the prevention and treatment of ALI/ARDS with TCM.

Advances in traditional Chinese medicine for cardiovascular disease therapy in 2020

Cardiovascular diseases are a major cause of morbidity and mortality worldwide and there is an urgent need to develop new pharmacotherapies for managing cardiovascular diseases.In China,traditional Chinese medicine has been used in clinical settings for thousands of years.Although traditional Chinese medicine is very popular,Western medicine experts have not yet accepted it because some ingredients and mechanisms of action for its therapeutic effect are not fully clear.Emerging evidence has established that traditional Chinese medicine inhibits oxidative stress and inflammatory response,suppresses apoptosis,promotes angiogenesis,regulates autophagy and gut microbiota,and modulates metabolomics,among others.Therefore,it has a beneficial role against cardiovascular disease occurrence and progression,such as atherosclerosis,hypertension,myocardial ischemia/reperfusion injury,myocardial infarction,cardiomyopathy,arrhythmia,cardiac remodeling,pulmonary arterial hypertension,and heart failure.In this review,we have summarized the research progress on the relevant mechanisms by which traditional Chinese medicine regulates cardiovascular diseases in 2020 to reveal its application to cardiovascular disease prevention and/or therapy.

Advances in traditional Chinese medicine for liver disease therapy in 2020

Liver diseases are gradually becoming a serious threat to human health worldwide.Although a number of medications have been introduced for the prophylaxis,diagnosis,and treatment of liver diseases,several limitations and challenges remain.Traditional Chinese medicine is frequently used to treat liver diseases and well known to protect hepatocytes and inhibit inflammation,oxidative stress,and fibrosis.However,given the complex composition of traditional Chinese medicine,clarifying the mechanisms behind its curative and protective effects is difficult.In this review,research progress on traditional Chinese medicine for the treatment of liver diseases in 2020 is summarized on the basis of the literature available in the PubMed database.Herbal extracts derived from traditional Chinese medicine,including flavonoids,polysaccharides,saponins,and alkaloids,and Chinese medicinal formulas,such as the classic decoctions Chaihu Shugan powder,Linggui Zhugan decoction,and Huanglian Jiedu decoction,have shown promising therapeutic efficacy in liver disease treatment.We summarized the findings of several studies on the active ingredients of traditional Chinese herbs used for liver disease treatment in 2020,focusing mainly on their ability to confer antiviral effects to treat hepatitis,regulate antioxidant levels and apoptosis to treat liver injury,inhibit inflammation and improve dysfunctions in amino acids and energy metabolism to treat alcoholic liver disease,reduce hepatic lipid deposition to treat nonalcoholic fatty liver disease,promote activated hepatic stellate cells to treat liver fibrosis,inhibit the proliferation or promote the apoptosis of liver cancer cells to treat hepatocellular carcinoma,and improve bile acid metabolism to treat cholestasis.

Traditional Chinese medicine nursing protocols for anal fistulae

Anal fistula is a common disease in anorectal department that typically describes a miscommunication between the anorectum and the perianal skin. At present, surgical treatment is effective for anal fistulae, but the formation of fistula is different due to individual difference, consequently leading to a limited efficacy of surgical treatment. TCM has recently shown its unique advantages in accelerating the wound healing after anal fistula surgery, but the standards for syndrome differentiation of anal fistulae are still in deficiency. Thereby, this article mainly explored the key points of common syndromes, TCM nursing methods and health guidance of anal fistulae, in order to further develop the advantages of TCM and standardize related nursing management .

Review on the research of Chinese medicine promoting tissue regeneration

In the long history of the Chinese nation,traditional Chinese medicine has made great contributions to the protection of the health of the Chinese people.Given that many pathological processes can cause tissue damage,does Chinese medicine also promote tissue regeneration in the process of disease recovery?It has been found from recent research articles that traditional Chinese medicine can promote tissue regeneration in the treatment of diseases.The following is an illustration of the role of Chinese medicine in selected parts of the study.

Effects of Jisuikang on hemorheology and inflammatory factors in rats following spinal cord injury

BACKGROUND： Trauma can damage the spinal cord or cauda equina to different degrees. Previous studies have verified that traditional Chinese medicine has effects on spinal cord injury via a variety of pathways. OBJECTIVE： To observe changes in hemorheology and inflammatory factors in spinal cord injury rats following treatment with the Chinese medicine Jisuikang, to verify the dose-dependent effect of Jisuikang, and to compare its effects with the effects of prednisone. DESIGN, TIME AND SETTING： A randomized study was performed at the Research Institute of Orthopedics, and Experimental Center of First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, China from September 2007 to March 2008. MATERIALS： Jisuikang powdered extract, composed of milkvetch root （30 g）, Chinese angelica （12 g）, red peony root （12 g）, earthworm （10 g）, szechwan lovage rhizome （10 g）, peach seed （10 g） and safflower （10 g） was provided by the Experimental Center, First Clinical Medical College, Nanjing University of Traditional Chinese medicine. Each gram of powdered extract was equivalent to 6.47 g crude drug. METHODS： A total of 72 Sprague Dawley rats were randomly assigned into 6 groups （n = 12）. Rat models of spinal cord injury were established using the occlusion method. Rats in the model group were treated with distilled water. Rats in the 25 g/kg, 12.5 g/kg, and 6.25 g/kg Jisuikang groups were given 25 g＆g, 12.5 g/kg, or 6.25 g/kg Jisuikang by gavage, for 14 days. Rats in the prednisone group received 0.06 g/kg prednisone by gavage, for 7 days. Rats in the normal group were given the same volume of distilled water. The volume of administration was 15 mL/kg. MAIN OUTCOME MEASURES： Rat serum interleukin-10, tumor necrosis factor- α （TNF-α ）, nitric oxide, nitric oxide synthase levels, malondialdehyde content, superoxide dismutase activity and whole blood viscosity were measured in each group. Spinal cord around the site of the model was collected. Half the spinal cord was used for histopathologic examination. The other half was used for measurement of nitric oxide and NOS levels, malondialdehyde contents, and superoxide dismutase activity. RESULTS： Superoxide dismutase activity was higher in the 25 g/kg Jisuikang group than in the model group Malondialdehyde contents, nitric oxide and NOS levels were lower in the 25 g/kg and 12.5 g/kg Jisuikang groups compared with the model group. Whole blood viscosity was lower in the 25 g/kg and 12.5 g/kg Jisuikang groups compared with the model group （P 〈 0.05-0.01）. Serum TNF- α content was lower in each Jisuikang group compared with the model group （P 〈 0.05-0.01）. Serum interleukin-10 levels were greater in the prednisone group and each Jisuikang group compared with the model group （P 〈 0.01）. Mild hemorrhage and necrosis in the rat spinal cord, and unclear neural cell swelling were seen in the 25 g/kg Jisuikang group： Severe hemorrhage and necrosis in the rat spinal cord, and distinct neural cell swelling were seen in the 12.5 g/kg Jisuikang group. Edema in the white matter was found in the 6.25 g/kg Jisuikang group. Pathological changes in the prednisone group were identical to the 25 g/kg and 12.5 g/kg Jisuikang groups. CONCLUSION： Jisuikang inhibits nitric oxide synthase expression, reduces nitric oxide and TNF-α levels decreases malondialdehyde content, increases interleukin-10 levels and superoxide dismutase activity, improves indices of hemorheology, and prevents secondary changes in spinal cord injury, resulting in relieving pathological changes in spinal cord tissue. The outcome was significant in the 25 g/kg Jisuikang group compared with the 12.5 g/kg Jisuikang group.

Protective effect of oxysophoridine on cerebral ischemia/reperfusion injury in mice

Oxysophoridine, a new alkaloid extracted from Sophora alopecuroides L., has been shown to have a protective effect against ischemic brain damage. In this study, a focal cerebral ischemia/reperfusion injury model was established using middle cerebral artery occlusion in mice. Both 62.5, 125, and 250 mg/kg oxysophoridine, via intraperitoneal injection, and 6 mg/kg nimodipine, via intragastric administration, were administered daily for 7 days before modeling. After 24 hours of reperfusion, mice were tested for neurological deficit, cerebral infarct size was assessed and brain tissue was collected. Results showed that oxysophoridine at 125, 250 mg/kg and 6 mg/kg nimodipine could reduce neurological deficit scores, cerebral infarct size and brain water content in mice. These results provided evidence that oxysophoridine plays a protective role in cerebral ischemia/reperfusion injury. In addition, oxysophoridine at 62.5, 125, and 250 mg/kg and 6 mg/kg nimodipine increased adenosine-triphosphate content, and decreased malondialdehyde and nitric oxide content. These compounds enhanced the activities of glutathione-peroxidase, superoxide dismutase, catalase, and lactate dehydrogenase, and decreased the activity of nitric oxide synthase Protein and mRNA expression levels of N-methyI-D-aspartate receptor subunit NR1 were markedly inhibited in the presence of 250 mg/kg oxysophoridine and 6 mg/kg nimodipine. Our experimental findings indicated that oxysophoridine has a neuroprotective effect against cerebral ischemia/reperfusion injury in mice, and that the effect may be due to its ability to inhibit oxidative stress and expression of the N-methyI-D-aspartate receptor subunit NR1.

Biomechanical analysis of optic nerve injury treated by compound light granules and ciliary neurotrophic factor

In this study, rabbit models of optic nerve injury were reproduced by the clamp method. After modeling, rabbit models were given one injection of 50 ng recombinant human ciliary neurotrophic factor into the vitreous body and/or intragastric injection of 4 g/kg compound light granules containing Radix Angelicae Sinensis and Raidix Paeoniae Alba at 4 days after modeling, once per day for 30 consecutive days. After administration, the animals were sacrificed and the intraorbital optic nerve was harvested. Hematoxylin-eosin staining revealed that the injured optic nerve was thinner and optic nerve fibers were irregular. After treatment with recombinant human ciliary neurotrophic factor, the arrangement of optic nerve fibers was disordered but they were not markedly thinner. After treatment with compound light granules, the arrangement of optic nerve fibers was slightly disordered and their structure was intact. After combined treatment with recombinant human ciliary neurotrophic factor and compound light granules, the arrangement of optic nerve fibers was slightly disordered and the degree of injury was less than after either treatment alone. Results of tensile mechanical testing of the optic nerve showed that the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly lower than the normal optic nerve. After treatment with recombinant human ciliary neurotrophic factor and/or compound light granules, the tensile elastic limit strain, elastic limit stress, maximum stress and maximum strain of the injured optic nerve were significantly increased, especially after the combined treatment. These experimental findings indicate that compound light granules and ciliary neurotrophic factor can alleviate optic nerve injury at the histological and biochemical levels, and the combined treatment is more effective than either treatment alone.

An optimal dose of tea polyphenols protects against global cerebral ischemia/reperfusion injury

Previous studies addressing the protection of tea polyphenols against cerebral ischemia/ reperfusion injury often use focal cerebral ischemia models, and the optimal dose is not unified. In this experiment, a cerebral ischemia/reperfusion injury rat model was established using a modified four-vessel occlusion method. Rats were treated with different doses of tea polyphenols （25, 50, 100, 150, 200 mg/kg） via intraperitoneal injection. Results showed that after 2, 6, 12, 24, 48 and 72 hours of reperfusion, peroxide dismutase activity and total antioxidant capacity in brain tissue gradually increased, while malondialdehyde content gradually decreased after tea polyphenol intervention. Tea polyphenols at 200 mg/kg resulted in the most apparent changes. Terminal deoxynucleotidyl transferase-mediated nick end labeling and flow cytometry showed that 200 mg/kg tea polyphenols significantly reduced the number and percentage of apoptotJc cells in the hippocampal CA1 region of rats after cerebral ischemia/reperfusion injury. The open field test and elevated plus maze experiments showed that tea polyphenols at 200 mg/kg strengthened exploratory behavior and reduced anxiety of cerebral ischemia/reperfusion injured rats. Experimental findings indicate that tea polyphenols protected rats against cerebral ischemia/ reperfusion injury and 200 mg/kg is regarded as the optimal dose.

Chunggan extract, a traditional herbal formula, ameliorated alcohol-induced hepatic injury in rat model

AIM: To evaluate protective effects of Chunggan extract (CGX), a traditional herbal formula, under 4 wk of alcohol consumption-induced liver injury.

Extract of ginkgo biloba EGb761 inhibits cell apoptosis following spinal cord injury

The neuroprotective effects of ginkgo biloba extract have been shown in rats following spinal cord injury （SCI）. However, the precise protective mechanisms remain unclear. In the present study, low-acid water-soluble extract of ginkgo biloba EGb761 was used to treat rats with SCI. Xanthin oxidase, thiobarbituric acid, terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling assay, and immunohistochemistry were utilized to detect lipid peroxidation, neural cell apoptosis, and inducible nitric oxide synthase activity in rats with SCI. Results revealed significantly increased superoxide dismutase activity, decreased malondialdehyde content, apoptotic index, and inducible nitric oxide synthase expression in SCI rats following EGb761 treatment. Therefore, EGb761 suppressed lipid peroxidation following SCI, relieved neural cell apoptosis, inhibited inducible nitric oxide synthase expression, and ultimately exerted protective effects on SCI.