Research progress of Traditional Chinese Medicine in the treatment of tumor-related depression

Cancer related depression(CRD)refers to the significant and lasting depression of the patient due to tumor diagnosis,treatment and comorbidities.It can be attributed to the category of“stagnation syndrome”in traditional Chinese medicine(TCM).Clinically,cancer-related depression can be divided into three stages,namely primary,middle and final stages by analogy with depression syndrome.The location of the initial disease is in the liver.The main syndrome was excess,while the basic pathogenesis is mainly due to liver-qi stagnation syndrome and the principle of treatment is dispersing stagnated liver qi for relieving qi stagnation by using modified Xiaoyao Powder and Chaihu Shugan Powder.In the middle stage of the disease,the location is in the spleen and stomach.The main syndrome was intermingled deficiency and excess.The principle of treatment is relaxing bowels,dissipating phlegm and eliminating dampness,regulating qi-flowing and promoting blood,invigorating spleen and heart,nourishing qi and blood.Xuefuzhuyu tang,Guipi decotion,Bailongjieyu granules can be used as treatment for this period.At the final stage of the disease,the main syndrome was deficiency,the principle of treatment is replenishing lung and heart,benefiting qi and regulating spleen,nourishing lung and kidney.Baihe formulas,Kai-Xin-San are chosed at this stage.

Shenxian Shengmai Oral Liquid for treatment of slow arrhythmia： a randomized controlled trial

缓慢性心律失常是临床上比较常见的疾病,在中老年人群中有着较高的发病率.已经有多项临床研究表明,参仙升脉口服液可以缓解改善缓慢性心律失常患者的临床症状.本试验纳入60名缓慢性心律失常的受试者,按照2：1随机分配到试验组（参仙升脉口服液）和对照组（参仙升脉口服液模拟剂）中.该临床试验是一项先导性试验,比较参仙升脉口服液治疗慢性心律失常的疗效,初步明确参仙升脉口服液对缓慢性心律失常患者的安全性及有效性.

Systematic review and meta-analysis of Bupi Yichang pills for ulcerative colitis

Objective:To evaluate the clinical efficacy and safety of Chinese patent medicine Bupi Yichang Pill in the treatment of ulcerative colitis.Method:Use a computer to retrieve English and Chinese database(PubMed,EMBASE,CNKI,VIP,and Wanfang)from the establishment of the database to May 2020.The literature of clinical randomized controlled trials of Chinese patent medicine Bupi Yichang Pill for the treatment of ulcerative colitis were collected.Two researchers independently extracted the data and evaluated the quality of the included studies and meta-analysis was conducted by Using Stata 16.0 software,and the results were graded and evaluated by GRADE.Result:Eight studies with 835 patients were included.The overall analysis showed that Bupi Yichang Pill was more effective than mesalazine sustained-release granules both in mucosal score under colonoscopy(SMD=-0.93,95%CI[-1.20,-0.67])and total efficiency(RR=1.26,95%CI[1.11,1.43]).Compared with sulfasalazine,Bupi Yichang Pill produced a more significant effect in terms of total efficiency(RR=1.13,95%CI[1.05,1.21]).In the comparison of total symptom score,Bupi Yichang Pill group was lower than mesalazine sustained-release granules group(SMD=-0.94,95%CI[-1.16,-0.72]).The more adverse effect occurred in the mesalazine group when comparing with the Bupi Yichang Pill group(RR=0.46,95%CI[0.16,1.28]).Conclusion:Bupi Yichang Pill with great safety can effectively improve the clinical effectiveness of ulcerative colitis but the conclusions above are still needed a further study through the higher quality of evidence.

Hawthorn Extract Alleviates Atherosclerosis through Regulating Inflammation and Apoptosis Related Factors: An Experimental Study

Objective: To determine the effects of hawthorn extract on serum lipid levels, pathological changes in aortic atherosclerosis plaque, inflammatory factors, and apoptosis-related protein and mRNA expression in apolipoprotein E gene knockout(ApoE^(-/-)) mice. Methods: Thirty-six ApoE^(-/-) mice were fed with a high-fat diet starting at the age of 8 weeks. Mice were randomly divided into 3 groups by a random number table including model group, hawthorn extract group, and simvastatin group, 12 mice in each group. Twelve 8-week-old C57BL/6 mice were fed a basic diet and served as control. The mice in the control and model groups were administered 0.2 mL saline daily, the mice in the hawthorn extract and simvastatin groups were administered with 50 mg/kg hawthorn extract or 5 mg/kg simvastatin daily for 16 weeks. After 16 weeks, plasma lipids including total cholesterol(TC), triglyceride(TG), low-density lipoprotein cholesterol(LDL-C) and high-density lipoprotein cholesterol(HDL-C) were determined by an enzymatic assay. Aortic atherosclerotic lesions were observed by light microscopy, scanning and transmission electron microscopy, respectively. Plasma levels of monocyte chemoattractant protein-1(MCP-1), interleukin-1β(IL-1β), adiponectin(APN), and hypersensitive C-reactive protein(hs-CRP) were measured by enzyme-linked immunosorbent assay(ELISA). Protein and mRNA expressions of Bax and Bcl-2 in the aorta were assessed by Western blotting and quantitative real-time polymerase chain reaction(qR T-PCR), respectively. Results: Compared to the control group, the plasma levels of TC, TG and LDL-C were significantly increased and HDL-C were significantly decreased in the model group(P<0.01). Compared to the model group, treatment with hawthorn extract significantly decreased the plasma levels of TC, TG, and LDL-C and increased the plasma level of HDL-C in ApoE^(-/-)mice(P<0.01). The levels of MCP-1, IL-1β, and hs-CRP in the model group were significantly increased and APN was significantly decreased compared with the control group(P<0.01). Compared to the model group, treatment with hawthorn extract decreased the levels of MCP-1, IL-1β, and hs-CRP and increased the APN level(P<0.01). Compared to the control group, the protein and mR NA expression of Bax in the model group were significantly increased and the expression of Bcl-2 was significantly decreased(P<0.01). Hawthorn extract also reduced the protein and mR NA expression of Bax and increased the Bcl-2 expression in the aorta(P<0.01). Conclusion: Hawthorn extract has anti-atherosclerosis and stabilizing unstable plaque effects. The mechanism may be related to the inflammation and apoptosis signaling pathways.

Systematic Review of β-Elemene Injection as Adjunctive Treatment for Lung Cancer

Objective： To evaluate the effectiveness and safety of βelemene Injection as an adjunctive treatment for lung cancer by systematic review. Methods： We retrieved randomized controlled clinical trials related to the use of β elemene Injection as an adjunctive treatment for lung cancer from Chinese Biomedical （CBMweb）, Chinese Medical Current Content （CMCC）, China National Knowledge Infrastructure （CNKI）, Chinalnfo, Cochrane Central Register of Controlled Trials; MEDLINE, EMBASE, OVID and TCMLARS. We also referred to an unpublished conference proceeding titled Clinical Use and Basic： Elemene Injection. We then divided the studies into nonsmall cell lung cancer （NSCLC） and small cell lung cancer （SCLC） subgroups by RevMan 5.1 software. Results： A total of 21 source documents （1,467 patients） matched prespecified criteria for determining the effectiveness and safety of β elemene Injection as an adjunctive treatment for lung cancer. Five studies involving 285 NSCLC patients reported a higher 24month survival rate （39.09%） with the adjunctive treatment than with chemotherapy alone （26.17%; RR, 1.51; 95% CI, 1.03 to 2.21）. Four studies involving 445 patients reported that the increased probability for improved performance status for patients treated with elemenebased combinations was higher than that of patients treated with chemotherapy alone （RR, 1.82; 95% CI, 1.45 to 2.29）. The results from a subgroup analysis on 12 studies involving 974 NSCLC patients and 9 studies involving 593 patients with both SCLC and NSCLC showed that the tumor control rate for NSCLC improved more in the elemenebased combinations treatment group （78.70%） than in the chemotherapy alone control group （71.31%; RR, 1.06; 95% CI, 1.00 to 1.12）. The tumor response rate for NSCLC also improved more among patients treated with elemene based combinations （50.71%） than among patients treated with chemotherapy alone （38.04%; RR, 1.34; 95%CI, 1.17 to 1.54）. In addition, the main adverse reaction to βelemene Injection was phlebitis, but usually only to a mild degree. An Egger＇s test showed no publication bias in our study （P=0.7030）. Conclusions： The effectiveness of chemotherapy for the treatment of lung cancer may improve when combined with β elemene injection as an adjunctive treatment. The combined treatment can result in an improved quality of life and prolonged survival. However, these results require confirmation by rigorously controlled trials.

Dose-effect analysis of treatment by modified Zhibaidihuang decoction on polycystic ovary syndrome hyperandrogenism

OBJECTIVE: To observe the efficacy and safety of different dosages of modified Zhibaidihuang decoction(MZBDD) on polycystic ovary syndrome(PCOS) hyperandrogenism(HA) patients.METHODS: Ninety PCOS HA patients and 30 infertile patients due to tubal factor were selected. Ninety PCOS HA patients were randomly divided into three groups: low dosage group(LDG), medium dosage group(MDG) and high dosage group(HDG) and infertile patients were selected as normal control group(NCG). PCOS HA patients were treated with different dosage of MZBDD for 4 weeks. For HA patients, serum total testosterone(T), estrodial(E2), follicle stimulating hormone(FSH), luteinizing hormone(LH), prolatin(PRL), alanine aminotransferase(AST), aspartate amino transferase(AST) were determined before and after treatment, while acne scores(Rosenfield) were signed. Basal body temperatures(BBT) were asked to be measured every day. And for the else, T, E2,FSH, LH, PRL, AST, and AST were determined before treatment.RESULTS: Totally 111 patients completed the clinical research. There were no differences among the four groups on serum T before treatment(P =0.221). Serum T concentration of both MDG and HDG after treatment significantly were lower than that of before treatment(P = 0.039, P = 0.000),while there was no obvious difference in LDG(P =0.829). Serum T concentration of both MDG and HDG were significantly lower than that of LDG after treatment(P = 0.048, P = 0.006). To compared with before treatment, there were no differences in Serum FSH, LH, E2, P and PRL among the three groups(LDG, MDG, HDG)(as for FSH, P = 0.136, P = 0.503,P = 0.062; as for LH, P = 0.473, P = 0.513, P = 0.096;as for E2, P = 0.206, P = 0.927, P = 0.076; as for PRL,P = 0.120, P = 0.903, P = 0.407, as for P, P = 0.308, P =0.866, P = 0480). Acne scores of all the three groups were obviously lower than that of before treatment(P = 0.031; P = 0.033; P = 0.002). 39.5% of the patients had biphasic BBT, but there were no differences among the three groups(P = 0.510). There were no differences with ALT and AST between after and before treatment among the three groups(LDG, MDG, HDG)(as for ALT, P = 0.742, P = 0.383,P = 0.053; as for AST, P = 0.732, P = 0.519, P = 0.120).CONCLUSION: Different dosage of MZBDD has dose-effect relationship in treating PCOS HA.

Inhibition of hypoxia and serum deprivation-induced apoptosis by salvianolic acid in rat mesenchymal stem cells

OBJECTIVE:To investigate the influence and mechanism of salvianolic acid B(SalB) on apoptosis inhibition in rat bone marrow-derived mesenchymal stem cells(BMSCs) induced by hypoxia and serum deprivation(hypoxia/SD).METHODS:SalB concentration of 0.1,1,10 or 100 mg/L(drug groups) were investigated for their ability to inhibit apoptosis in rat BMSCs.BMSCs in both the apoptosis model and drug groups were cultured under hypoxic conditions for 6 h,after which cell apoptosis and change in mitochondrial membrane potential(MMP) were detected using flow cytometry.Activation of caspase-3 was detected using western blot analysis.RESULTS:Hypoxia/SD induced apoptosis in rat BMSCs.The early apoptosis rate was lower in the drug groups compared to the apoptosis model group(P<0.05).SalB was found to inhibit the reduction in MMP and decrease the activation of caspase-3.CONCLUSION:0.1,1 and 10 mg/L of SalB inhibits activation of caspase-3 and early apoptosis of rat BMSCs induced by hypoxia/SD and could therefore enhance the survival rate of grafted stem cells.

Effect of Jinlong capsule on proliferation and apoptosis of human pancreatic cancer cells BxPC-3

OBJECTIVE:To study the possible roles of Jinlong capsule(JLC) on the proliferation and apoptosis of human pancreatic cancer cells BxPC-3.METHODS:The human pancreatic cancer cells BxPC-3 were treated with JLC at the concentration of 0.05-1.00 mg/mL for 24-120 h.The inhibition rate of JLC on human pancreatic cancer cells BxPC-3 was detected by 3-(4,5-dimethiylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT) assay.Flow cytometry was employed to measure cell apoptosis using Annexin V-FITC/Propidium iodide(AV-FITC/PI) method.Cell cycles were determined by PI staining.The expression of S100 Calcium binding protein A4(S100A4) in cell matrix was measured by enzyme-linked immunosorbent assay(ELISA).The expression levels of apoptosis-related protein such as BCL2/adenovirus E1B 19 kDa interacting protein 3(BNIP3),B-cell lymphoma/leukemia-2(Bcl-2) and Cys-teinylaspartate specific proteinase 3(Caspase-3) were detected byWestern blotting.RESULTS:JLC significantly inhibited the proliferation of human pancreatic cancer cells BxPC-3 in a dose-dependent and time-dependent manner.JLC promoted cell apoptosis and maintained cell cycle in S and G 2 /M phase rather than G 1 /G 0 phase.The expression of S100A4 in the cell matrix was reduced.The expression of cell apoptotic protein BNIP3 was increased while Bcl-2 was decreased.CONCLUSION:JLC can inhibit the proliferation of human pancreatic cancer cells BxPC-3 by stimulating cell apoptosis,arresting the cell cycle at S and G 2 /M phase which blocks the circulation of normal cell cycle and reducing the expression of S100A4 protein.Higher pro-apoptosis protein BNIP3 and lower anti-apoptosis protein Bcl-2 levels were found,which may be related to the apoptotic effects of JLC.

Review of the powder and decoction formulae in Traditional Chinese Medicine based on pharmacologically active substances and clinical evidence

Powder formulae are an indispensable part of prescription in Traditional Chinese Medicine.Powder formulae are characterized by good therapeutic efficacy and low dose used for their preparation.Analysis of the therapeutic application and material basis of pharmacological active substance in power formulae can enable the development of new powder formulae.This in turn can contribute to reduction of wastage of drug material,relief of shortage of herbal medicinal resources and sustainable development of Traditional Chinese Medicine.

Chinese Medicine Sequential Therapy Improves Pregnancy Outcomes after Surgery for Endometriosis-Associated Infertility: A Multicenter Randomized Double-blind Placebo Parallel Controlled Clinical Trial

Objective:To evaluate the efficacy and safety of Chinese medicine(CM)improving pregnancy outcomes after surgery for endometriosis-associated infertility.Methods:A multicenter,randomized,doubleblind placebo parallel controlled clinical trial was designed.A total of 202 patients who had laparoscopy for endometriosis-associated infertility with qi stagnation and blood stasis syndrome were included and randomly divided into the CM treatment group and placebo control group at a ratio of 1:1 using a central block randomization from May 2014 to September 2017,101 patients in each group.The two groups received continuous intervention at 1–5 days after surgery,for 6 menstrual cycles.Before ovulation,the CM group was treated Huoxue Xiaoyi Granule(活血消异颗粒);after ovulation,Bushen Zhuyun Granule(补肾助孕颗粒)was involved.The control group was treated with placebo.Transvaginal ultrasonography was performed every menstrual cycle during the treatment,and female hormone levels in the follicular and luteal phases were measured during the 1 st,3 rd and 6 th menstrual cycles.The analysis was continued until pregnancy.The primary outcomes were clinical pregnancy rate and pregnancy outcome,and the secondary outcomes were follicular development and endometrial receptivity.Safety evaluations were performed before and after treatment.Results:(1)Clinical pregnancy and live birth rates:the clinical pregnancy and live birth rates of the CM group were significantly higher than those of the placebo group[44.6%(45/101)vs.29.7%(30/101),34.7%(35/101)vs.20.8%(21/101),both P<0.05].(2)Follicle development:the incidence of dominant follicles,rate of cumulative cycle ovulation,and rate of cumulative cycle mature follicle ovulation were significantly higher in the CM group than those in the placebo group[93.8%(350/373)vs.89.5%(341/381),80.4%(275/342)vs.69.1%(253/366),65.8%(181/275)vs 56.1%(142/253),P<0.05 or P<0.01]).The incidence of cumulative cycle luteinized unruptured follicle syndrome was significantly lower in the CM group than in the placebo group[11.7%(40/342)vs.17.8%(65/366),P<0.05).(3)Endometrial receptivity:after treatment,both endometrial types and endometrial blood flow types in the CM group were mainly types A and B,while those in the placebo group were mainly types B and C,with a significant difference between the two groups(both P<0.05).(4)Adverse events:the incidence of adverse events between the two groups was not significantly different(P>0.05).Conclusion:Strategies for activating blood circulation-regulating Gan(Liver)-tonifying Shen(Kidney)sequential therapy can effectively improve the clinical pregnancy rate and live birth rate of endometriosis-associated infertility with qi stagnation and blood stasis after laparoscopy,improve follicular development,promote ovulation,improve endometrial receptivity,while being a safe treatment option.(Trial registration No.NCT02676713).

Banxia Xiexin Decoction(半夏泻心汤)Treats Diabetic Gastroparesis through PLC-IP3-Ca^2+/NO-cGMP-PKG Signal Pathway

Objective To test the effect of Banxia Xiexin Decoction(半夏泻心汤,BXD)on the contraction and relaxation of gastric smooth muscle(SM)in diabetic gastroparesis(DGP)model rats,and to explore the mechanism of BXD in the prevention and treatment of DGP through experiments of signal pathway both in vivo and in vitro.Methods Sixty Sprague-Dawley rats were divided into 6 groups according to a random number table:control group,model group,high-,medium-and low-dose BXD groups(9.2,4.6 and 1.8 g/(kg·d),respectively),and domperidone group(10 mg/(kg·d)),10 rats per group.DGP model was established initially by a single intraperitoneal injection of streptozotocin(STZ),and was confirmed by recording gastric emptying,intestinal transport velocity and gastric myoelectric activity of rats after 2 months.Each group was treated with a corresponding drug for 4 weeks.The mRNA and protein expressions of phospholipase C(PLC),inositol triphosphate(IP3),neuronal nitric oxide synthase(nNOS),and cyclic guanosine monophosphate(cGMP)dependent protein kinase G(PKG)were detected by reverse transcription-polymerase chain reaction and Western blot,respectively,while nitric oxide(NO)and cGMP expressions were detected by enzyme-linked immunosorbent assay.Gastric tissues were obtained from rats for primary cell culture preparation.Gastric SM cells were treated with 0.8µmol/L of STZ or STZ plus 1,000,500 and 200µg/mL of BXD or STZ plus 2.5µmol/mL of domperidone for 24,48,72 or 96 h,respectively.The length of gastric SM cells and intracellular Ca^2+concentration([Ca^2+]i)before and after BXD treatment was measured.Results Compared with the model group,high-and medium-dose BXD and domperidone significantly increased the expressions of PLC,IP3,NO,nNOS,cGMP and PKG in rat’s gastric tissue(P<0.01).Gastric SM cells treated with BXD showed a time-and dose-dependent increase in cell viability(P<0.01).The treatment with high-and medium-dose BXD and domperidone inhibited the increase in gastric SM cells length and increased[Ca^2+]i compared with the model cells(P<0.01).Conclusions Treatment with high-and medium-dose BXD significantly attenuated STZ-induced experimental DGP in rats.The therapeutic effect of BXD on DGP rats might be associated with the PLC-IP3-Ca^2+/NO-cGMP-PKG signal pathway.

Thoughts on Intervention in HIV/AIDS with Traditional Chinese Medicine

HIV/AIDS has become a worldwide pandemic and highly active antiretroviral therapy (HAART) is the only generally recognized effective therapy at present. However, various unresolvable problems appear with the widespread use of HAART. Traditional Chinese Medicine shows good efficacy for intervention in HIV/AIDS and could become an effective treatment option.