The acceptance of traditional Chinese medicine among patients with Parkinson's disease:A hospital survey

Objective:The efficacy of medications for Parkinson’s disease(PD)tend to decline over time,which has a serious impact on patients’health and quality of life.To some extent,traditional Chinese medicine(TCM)can resolve the distressing problem of ineffective dopaminergic medication in PD patients.The purpose of this study was to investigate the attitude,acceptance,and independent predictors of TCM in PD patients admitted to the outpatient department of a tertiary hospital.Methods:A cross-sectional study of PD patients was conducted in the outpatient department of a large tertiary hospital in Beijing from March 2022 to June 2023.A self-report questionnaire was developed to investigate PD patients’attitudes and acceptance of TCM based on the questionnaire.Multivariate logistic regression analyses were also performed to further clarify the independent predictors influencing patients’adoption of TCM therapy.Results:A total of 397 patients completed the questionnaire,of which 78.09%were willing to be treated with TCM and 21.91%indicated that they were not willing to use TCM.Multifactorial logistic regression analysis showed that several parameters were correlated with a patient’s willingness to include TCM in their therapeutic regime.These included education level of a bachelor’s degree(odds ratio[OR)=8.554;95%confidence interval[CI]:4.112–17.794;P<0.001,vs junior high school education),living in an urban setting(OR=8.022;95%CI:4.577–14.060;P<0.001,vs rural),having other underlying diseases(OR=5.126;95%CI:3.078–8.537;P<0.001,vs none),having previously used TCM(OR=3.083;95%CI:1.852–5.134;P<0.001,vs not used),believing that TCM therapy is safe(OR=3.530;95%CI:1.446–8.616;P=0.006,vs not thought),believing that TCM therapy is effective(OR=3.859;95%CI:1.482–10.047;P=0.006,vs not understood),and being willing to discuss ongoing TCM therapy with an attending physician(OR=62.468;95%CI:30.350–128.574;P<0.001,vs not informed).Conclusion:This study initially investigated the acceptance,attitude,and independent predictors of TCM use among PD patients.To expand the prevalence of TCM use among patients with PD,we recommend to broadening the public outreach for TCM via contemporary means of Internet and broadcast communication,enhancing access to TCM services in rural communities,and strengthening the communication between doctors and patients.

Ameliorating effects of traditional Chinese medicine preparation, Chinese materia medica and active compounds on ischemia/reperfusion-induced cerebral microcirculatory disturbances and neuron damage

Ischemic stroke and ischemia/reperfusion(I/R) injury induced by thrombolytic therapy are conditions with high mortality and serious long-term physical and cognitive disabilities. They have a major impact on global public health. These disorders are associated with multiple insults to the cerebral microcirculation, including reactive oxygen species(ROS) overproduction, leukocyte adhesion and infiltration, brain blood barrier(BBB) disruption, and capillary hypoperfusion, ultimately resulting in tissue edema, hemorrhage, brain injury and delayed neuron damage. Traditional Chinese medicine(TCM)has been used in China, Korea, Japan and other Asian countries for treatment of a wide range of diseases.In China, the usage of compound TCM preparation to treat cerebrovascular diseases dates back to the Han Dynasty. Even thousands of years earlier, the medical formulary recorded many classical prescriptions for treating cerebral I/R-related diseases. This review summarizes current information and underlying mechanisms regarding the ameliorating effects of compound TCM preparation, Chinese materia medica,and active components on I/R-induced cerebral microcirculatory disturbances, brain injury and neuron damage.

Progression of the Wei-Qi-Ying-Xue Syndrome,Microcirculatory Disturbances,in Infectious Diseases and Treatment with Traditional Chinese Medicine

Lipopolysaccharide(LPS)-induced endotoxemia is a critical condition that initiates microcirculatory disturbance and may progress to multiple organ failure that threatens the lives of millions of people around the world each year.The pathology of endotoxemia involves multiple insults mediated by a range of signaling pathways.Multitarget management is required to relieve endotoxemia.Traditional Chinese medicine(TCM)is a type of therapeutic that commonly contains numerous components and,thus,exhibits multitarget potential.More importantly,some TCM formulas have been proposed and used for effective treatment of endotoxemia-like diseases.In the past 20 years,an increasing number of studies have explored the effects and mechanisms of these formulas and their major bioactive components on microcirculatory disturbance and organ injury caused by LPS.The results obtained thus far provide support for the clinical use of TCM and shed light on the underlying mechanisms.

AMELIORATING EFFECTS OF CARDIOTONIC PILLS,A COMPOUND CHINESE MEDICINE ON MYOCARDIAL MICROCIRCULATORY DISTURBANCE AND MYOCARDIAL INJURY AFTER ISCHEMIA-REPERFUSION

Cardiotonic Pills(CP)is a compound preparation of Chinese medicine consisting of Salvia miltiorrhiza,Panax notoginseng and Borneol,and it has been approved in 1994by the China State Food and Drug Administration for treating ischemic angina pectoris.It has passed the Phase II clinical trials by the US Food and Drug Administration in2009,December,demonstrating its potential to prolong

Integration of Traditional Chinese Medicine with Modern Science is the Way Forward

On behalf of the editorial team of World Journal of Traditional Chinese Medicine(WJTCM),we would like to convey our sincere gratitude to the great efforts of our editorial board members,referees,authors,readers and all the warmhearted supporters to contribute for the journal growth in the first year of its release in 2015.

Discovery of the mechanisms of acupuncture in the treatment of migraine based on functional magnetic resonance imaging and omics

Migraine is one of the most prevalent and disabling neurological disease,but the current pharmacotherapies show limited efficacy and often accompanied by adverse effects.Acupuncture is a promising complementary therapy,but further clinical evidence is needed.The influence of acupuncture on migraine is not an immediate effect,and its mechanism remains unclear.This study aims to provide further clinical evidence for the anti-migraine effects of acupuncture and explore the mechanism involved.A randomized controlled trial was performed among 10 normal controls and 38 migraineurs.The migraineurs were divided into blank control,sham acupuncture,and acupuncture groups.Patients were subjected to two courses of treatment,and each treatment lasted for 5 days,with an interval of 1 day between the two courses.The effectiveness of treatment was evaluated using pain questionnaire.The functional magnetic resonance imaging(fMRI)data were analyzed for investigating brain changes induced by treatments.Blood plasma was collected for metabolomics and proteomics studies.Correlation and mediation analyses were performed to investigate the interaction between clinical,fMRI and omics changes.Results showed that acupuncture effectively relieved migraine symptoms in a way different from sham acupuncture in terms of curative effect,affected brain regions,and signaling pathways.The anti-migraine mechanism involves a complex network related to the regulation of the response to hypoxic stress,reversal of brain energy imbalance,and regulation of inflammation.The brain regions of migraineurs affected by acupuncture include the lingual gyrus,default mode network,and cerebellum.The effect of acupuncture on patients’metabolites/proteins may precede that of the brain.

Effect of Electroacupuncture Stimulation on mRNA Expression of Angiotensinogen,Angiotensin Ⅱ Type 1 Receptor,Endothelin-1,and Endothelin A Receptor in Spontaneously Hypertensive Rat Aorta

Objective： To observe the effect of electroacupuncture （EA） stimulation on the expressions of angiotensinogen （AGT）, angJotensin Ⅱ type 1 receptor （ATIR）, endothelin-1 （ET1）, and endothelin A receptor （ETAR） mRNA in spontaneously hypertensive rat （SHR） aorta. Methods： Eighteen male SHRs were randomly divided into three groups, an SHR group, an SHR Baihui （DU 20） and Zusanli （ST 36） acupoint （SHR-AP） group, and an SHR non-acupoJnt （SHR-NAP） group, with 6 rats in each group. Six Wistar rats were used as a control. Rats in the SHR-AP group were stimulated by DU 20 and ST 36 acupoints, both of which were connected with EA. EA was handled one time every Monday, Wednesday and Friday, for total 24 times （8 weeks）. SHR- NAP rats were acupointed at a 15° angle flat into 0.5 cm to two points, which were 1 and 2 cm from rail tip separately. EA parameters were the same as the SHR-AP rats. SHR control rats and Wistar rats were fixed without EA. Real-time quantitative polymerase chain reaction （PCR） was used to measure AGT, AT1 R, ET1, and E-TAR mRNA expression in rat aorta. Results： EA stimulation significantly reduced rat aorta vascular AGT, ET1, ETAR and AT1R mRNA expressions in the SHR-AP and SHR-NAP groups （P〈0.01）. Among these four genes, ATIR mRNA expression was significantly lower in the SHR-AP than in the SHR-NAP group （P〈0.01）. Conclusion： EA could reduce the ATIR mRNA expression in SHR-AP rat aorta, indicating a potential mechanism for the hypotensive effects of EA.

Role of β2-glycoprotein I in the pathogenesis of the antiphospholipid syndrome

Antiphospholipid syndrome(APS)is typically characterized by increased levels of three classes of antiphospholipid antibodies,namely lupus anticoagulant,anti-β2-glycoprotein I(anti-β2GPI),and anticardiolipin antibodies.β2-Glycoprotein(β2GPI)is a phospholipid-binding protein composed of five domains(DI-V)and a major antigen in APS.β2GPI is expressed on the surfaces of several cell types,including endothelial cells,monocytes,trophoblast cells,and platelets.Its binding to the anti-β2GPI antibody triggers downstream signaling events and ultimately exerts a variety of cellular effects.β2GPI modulates hemostasis and the complement system,as well as playing an important role in APS-associated vascular injury.Therefore,studying β2GPI will help elucidate the pathogenesis of APS and improve the treatment of patients with this condition.This review will mainly focus on the structure and function of β2GPI,as well as its implication in the pathogenesis of APS.

Effectiveness and safety of electroacupuncture for the treatment of pain after laparoscopic surgery: a systematic review

OBJECTIVE:To evaluate the clinical effectiveness and safety of electroacupuncture for treating pain after laparoscopic surgery.METHODS:The following databases were searched(since their establishment until November 16,2021)for randomized controlled trials(RCTs)on electroacupuncture for pain after laparoscopic surgery:Pub Med,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,and Chinese Biomedical Literature Database.Data were screened independently and extracted by two reviewers.Two researchers independently extracted and cross-checked data and applied the modified Jadad scale and the Cochrane-recommended assessment method to evaluate the bias risk.The Meta-analysis was conducted using Rev Man5.3 software.RESULTS:Twelve RCTs enrolling 788 patients were included.(a)For postoperative 24 h visual analogue scale,five trials were included on electroacupuncture+routine analgesia therapy vs routine analgesia therapy with significance in electroacupuncture conducted after surgery[mean difference(MD)=-0.63,95%confidence interval(CI)(-0.90,-0.37)],as well as in electroacupuncture conducted before and after surgery[MD=-1.01,95%CI(-1.62,-0.41)]and in surgery.However,two trials were included in electroacupuncture conducted 24 h before surgery with no significant difference[MD=-0.16,95%CI(-0.44,0.12)].(b)The anesthetics intake of electroacupuncture+routine analgesia therapy vs.routine analgesia therapy was significant[MD=-121.71,95%CI(-164.92,-78.49)].(c)The adverse effects of electroacupuncture+routine analgesia therapy vs.routine analgesia therapy were significant both in the incidence of postoperative nausea and vomiting[risk rate(RR)=0.49,95%CI(0.39,0.61)]and postoperative dizziness and headache[RR=0.14,95%CI(0.04,0.47)].CONCLUSION:The evidence showed that electroacupuncture combined with routine analgesia therapy effectively treated pain after laparoscopic surgery.However,more rigorously designed RCTs are required due to the low quality of the included studies and the incomplete outcome evaluation system.

Biomarkers of aging

Aging biomarkers are a combination of biological parameters to(i)assess age-related changes,(ii)track the physiological aging process,and(iii)predict the transition into a pathological status.Although a broad spectrum of aging biomarkers has been developed,their potential uses and limitations remain poorly characterized.An immediate goal of biomarkers is to help us answer the following three fundamental questions in aging research:How old are we?Why do we get old?And how can we age slower?This review aims to address this need.Here,we summarize our current knowledge of biomarkers developed for cellular,organ,and organismal levels of aging,comprising six pillars:physiological characteristics,medical imaging,histological features,cellular alterations,molecular changes,and secretory factors.To fulfill all these requisites,we propose that aging biomarkers should qualify for being specific,systemic,and clinically relevant.

Chemerin promotes proliferation and migration of ovarian cancer cells by upregulating expression of PD-L1

Ovarian cancer is the third-most-common malignant reproductive tumor in women.According to the American Cancer Society,it has the highest mortality rate of gynecological tumors.The five-year survival rate was only 29%during the period from 1975 to 2008(Reid et al.,2017).

Compound Danshen injection improves endotoxin-induced microcirculatory disturbance in rat mesentery

AIM: To investigate the effect of compound Danshen injection on lipopolysaccharide (LPS)-induced rat mesenteric microcirculatory dysfunctions and the underlying possible mechanism by an inverted intravital microscope and high-speed video camera system. METHODS: LPS was continuously infused through the jugular artery of male Wistar rats at the dose of 2 mg/kg per hour. Changes in mesenteric microcirculation,such as diameters of arterioles and venules,velocity of RBCs in venules,leukocyte rolling,adhesion and emigration,free radicals released from post-capillary venules,FITC- albumin leakage and mast cell degranulation,were observed through an inverted intravital microscope assisted with CCD camera and SIT camera. Meanwhile,the expression of adhesion molecules CD11b/CD18 and the production of free radical in neutrophils,and the expression of intercellular adhesion molecule 1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs) were quantified by flow cytometry (FACS) in vitro. RESULTS: The continuous infusion with LPS resulted in a number of responses in microcirculation,including a significant increase in the positive region of venulestained with Monastral blue B,rolling and adhesion of leukocytes,production of oxygen radical in venular wall,albumin efflux and enhanced mast cell degranulation in vivo,all of which,except for the leukocyte rolling,were attenuated by the treatment with compound Danshen injection. Experiments performed in vitro further revealed that the expression of CD11b/CD18 and the production of oxygen free radical in neutrophils,and the expression of ICAM-1 in HUVECs were increased by exposure to LPS,and they were attenuated by compound Danshen injection. CONCLUSION: These results suggest that compound Danshen injection is an efficient drug with multi-targeting potential for improving the microcirculatory disturbance.

Total salvianolic acid improves ischemia-reperfusion-induced microcirculatory disturbance in rat mesentery

AIM:To investigate the effect of total salvianolic acid(TSA) on ischemia-reperfusion(I/R)-induced rat mesenteric microcirculatory dysfunctions.METHODS:Male Wistar rats were randomly distributed into 5 groups(n = 6 each):Sham group and I/R group(infused with saline),TSA group,TSA + I/R group and I/R + TSA group(infused with TSA,5 mg/kg per hour).Mesenteric I/R were conducted by a ligation of the mesenteric artery and vein(10 min) and subsequent release of the occlusion.TSA was continuously infused either starting from 10 min before the ischemia or 10 min after reperfusion.Changes in mesenteric microcirculatory variables,including diameter of venule,velocity of red blood cells in venule,leukocyte adhesion,free radicals released from venule,albumin leakage and mast cell degranulation,were observed through an inverted intravital microscope.Meanwhile,the expression of adhesion molecules CD11b/CD18 on neutrophils was evaluated by flow cytometry.Ultrastructural evidence of mesenteric venules damage was assessed after microcirculation observation.RESULTS:I/R led to multiple responses in mesenteric post-capillary venules,including a significant increase in the adhesion of leukocytes,production of oxygen radicals in the venular wall,albumin efflux and enhanced mast cell degranulation in vivo.All the I/R-induced manifestations were significantly reduced by pre-or post-treatment with TSA,with the exception that the I/R-induced increase in mast cell degranulation was inhibited only by pre-treatment with TSA.Moreover,preor post-treatment with TSA significantly attenuated the expression of CD11b/CD18 on neutrophils,reducing the increase in the number of caveolae in the endothelial cells of mesentery post-capillary venules induced by I/R.CONCLUSION:The results demonstrated that TSA protects from and ameliorates the microcirculation disturbance induced by I/R,which was associated with TSA inhibiting the production of oxygen-free radicals in the venular wall and the expression of CD11b/CD18 on neutrophils.

Responses of Primary Afferent Fibers to Acupuncture-Like Peripheral Stimulation at Different Frequencies:Characterization by Single-Unit Recording in Rats

The pain-relieving effect of acupuncture is known to involve primary afferent nerves(PANs) via their roles in signal transmission to the CNS.Using single-unit recording in rats,we characterized the generation and transmission of electrical signals in Aβ and Aδ fibers induced by acupuncture-like stimuli.Acupuncture-like signals were elicited in PANs using three techniques:manual acupuncture(MAc),emulated acupuncture(EAc),and electro-acupuncture(EA)-like peripheral electrical stimulation(PES).The discharges evoked by MAc and EAc were mostly in a burst pattern with average intra-burst and inter-burst firing rates of 90 Hz and 2 Hz,respectively.The frequency of discharges in PANs was correlated with the frequency of PES.The highest discharge frequency was 246 Hz in Aβ fibers and 180 Hz in Aδ fibers.Therefore,EA in a dense-disperse mode(at alternating frequency between 2 Hz and 15 Hz or between 2 Hz and 100 Hz) best mimics MAc.Frequencies of EA output>250 Hz appear to be obsolete for pain relief.

Involvement of Opioid Peptides in the Analgesic Effect of Spinal Cord Stimulation in a Rat Model of Neuropathic Pain

Spinal cord stimulation(SCS)-induced analgesia was characterized,and its underlying mechanisms were examined in a spared nerve injury model of neuropathic pain in rats.The analgesic effect of SCS with moderate mechanical hypersensitivity was increased with increasing stimulation intensity between the 20%and 80%motor thresholds.Various frequencies(2,15,50,100,10000 Hz,and 2/100 Hz dense-dispersed)of SCS were similarly effective.SCS-induced analgesia was maintained without tolerance within 24 h of continuous stimulation.SCS at 2 Hz significantly increased methionine enkephalin content in the cerebrospinal fluid.The analgesic effect of 2 Hz was abolished byμorκopioid receptor antagonist.The effect of 100 Hz was prevented by aκantagonist,and that of 10 kHz was blocked by any of theμ,δ,orκreceptor antagonists,suggesting that the analgesic effect of SCS at different frequencies is mediated by different endorphins and opioid receptors.

A wave of Foxp3^(+) regulatory T cell accumulation in the neonatal liver plays unique roles in maintaining self-tolerance

Newborn animals require tightly regulated local and systemic immune environments to govern the development and maturation of multiple organs/tissues even though the immune system itself is far from mature during the neonatal period.Regulatory T cells(Tregs)are essential for maintaining immune tolerance/homeostasis and modulating inflammatory responses.The features of Tregs in the neonatal liver under steady-state conditions are not well understood.The present study aimed to investigate the phenotype,functions,and significance of neonatal Tregs in the liver.We found a wave of thymus-derived Treg influx into the liver during 1–2 weeks of age.Depletion of these Tregs between days 7 and 11 after birth rapidly resulted in Th1-type liver inflammation and metabolic disorder.More Tregs in the neonatal liver than in the spleen underwent MHC II-dependent activation and proliferation,and the liver Tregs acquired stronger suppressive functions.The transcriptomic profile of these neonatal liver Tregs showed elevated expression of PPARγand T-bet and features of Tregs that utilize lipid metabolic machinery and are capable of regulating Th1 responses.The accumulation of Tregs with unique features in the neonatal liver is critical to ensure self-tolerance and liver maturation.

Chinese herbal remedies affecting thrombosis and hemostasis: A review

Acute coronary syndrome, stroke and other ischemic events continue to be the most common causes of mortality and morbidity in the world, and their incidence is rapidly increasing in the developing nations. These cardiovascular disorders clinically manifest as acute atherothrombotic events. Application of oral antiplatelet drugs is a milestone in the therapy of cardiovascular diseases. However, the limited efficacy of these drugs in the setting of arterial thrombosis, their unfavorable side effects, cost-to-benefit issues and the drug resistance phenomenon substantiate the need for the development of new and more efficacious antithrombotic drugs. In recent years, with the progress in the study of the Chinese medicine pharmacology, many Chinese herbs and formulas, as well as active constituents have been reported to possess not only effects on platelet aggregation and activation but also beneficial roles in vascular functions. Compared with currently used antithrombotic agents, herb remedies exert antithrombotic effects in a multi-pathway and multi-target manner. This paper will cover the progress in research on the ameliorating effects of herbal remedies on thrombosis, with focusing on their protection of vascular endothelial cells and inhibition of platelet activation.

The existence of a nonclassical TCA cycle in the nucleus that wires the metabolic-epigenetic circuitry

The scope and variety of the metabolic intermediates from the mitochondrial tricarboxylic acid(TCA)cycle that are engaged in epigenetic regulation of the chromatin function in the nucleus raise an outstanding question about how timely and precise supply/consumption of these metabolites is achieved in the nucleus.We report here the identification of a nonclassical TCA cycle in the nucleus(nTCA cycle).We found that all the TCA cycle-associated enzymes including citrate synthase(CS),aconitase 2(ACO2),isocitrate dehydrogenase 3(IDH3),oxoglutarate dehydrogenase(OGDH),succinyl-CoA synthetase(SCS),fumarate hydratase(FH),and malate dehydrogenase 2(MDH2),except for succinate dehydrogenase(SDH),a component of electron transport chain for generating ATP,exist in the nucleus.We showed that these nuclear enzymes catalyze an incomplete TCA cycle similar to that found in cyanobacteria.We propose that the nTCA cycle is implemented mainly to generate/consume metabolic intermediates,not for energy production.We demonstrated that the nTCA cycle is intrinsically linked to chromatin dynamics and transcription regulation.Together,our study uncovers the existence of a nonclassical TCA cycle in the nucleus that links the metabolic pathway to epigenetic regulation.

Oxytocin and arginine vasopressin: a bridge between acupuncture and autism spectrum disorder

The status of autism spectrum disorder In the Sui Dynasty(581–618)of China,Chao’s“On the Etiology of Diseases”described the“hun se”(muddleheaded)and“yu chi”(language delay)phenotypes,which are clinically manifested as a lack of speech and neurodevelopmental retardation in children(Figure 1).