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   Table of Contents - Current issue
October-December 2019
Volume 5 | Issue 4
Page Nos. 181-296

Online since Tuesday, December 3, 2019

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Treatment of visceral pain associated with irritable bowel syndrome using acupuncture: Mechanism of action Highly accessed article p. 181
Aleksandar Zivaljevic, Bin Shi, Elisa M S. Tam, Vahideh Toossi
Irritable bowel syndrome (IBS) is a relatively common condition characterized by abdominal pain, among other symptoms, that significantly impacts the quality of life of IBS patients. Therapeutic treatment of IBS results in limited success, and the focus is placed on relieving patients of some of the symptoms, visceral pain in particular. Acupuncture is commonly used as a treatment modality of choice. However, the debate on whether acupuncture can be effectively used for this purpose is ongoing. In this work, we critically review the available literature to establish a potential mechanism of action in treating visceral pain in IBS using acupuncture. The sources used are Google Scholar, EBSCO, Cochrane Library and PubMed as well as Chinese database sources. The keywords used in the literature search are “acupuncture,” “IBS,” “Irritable Bowel Syndrome,” and “visceral pain.” We find that the literature strongly indicates that acupuncture, by stimulating points located on the dermatomes proximal to the spinal level of the area where the sympathetic outflow of the particular gut area affected by the pain is, can interfere with the efferent signal that transports information about the noxious stimuli and interrupt the “connectivity” between the gut and brain, and as a final result, reduce or stop IBS pain. Our findings justify that clinical trials are conducted to test the utility of acupuncture in treating abdominal visceral pain in IBS.
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The present scenario, challenges, and future anticipation of traditional mongolian medicine in China p. 187
Hai-Ying Tong, Shao-Qian Zhang, Ghulam Murtaza, Hui-Hui Zhao, Xian-Ju Huang, Hu-Rilebagen , Wu-Lanqiqige , Wu-Ye Bao, Wu-Jisiguleng , Wu-Yunsiriguleng , Lu-Yao Chen
The objective was to study the present scenario, challenges, and future anticipation of traditional Mongolian medicine (TMM) in China. The literature was retrieved using various sources of information such as meetings with TMM experts, research and review articles, national health databases, and government websites and authoritative papers. Health care using TMM, TMM education and research, and the pharmaceutical industry of TMM has been improved by implementing TMM growth policies. TMM has been extensively used for health care in Mongolia and in various regions of China including Beijing. The national education system of China contains a stream of TMM education. There is a yearly increase in research productivity in the field of TMM due to extensive research funding by the government. The rapidly growing pharmaceutical industry of TMM has provided more availability of TMM to more patients. The literature search revealed good preservation and development of TMM in China, urging the need to take steps for the promotion of its spread and development in China and worldwide.
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Meta-analysis of niaoduqing granules combined with raas system blocker in the treatment of diabetic nephropathy p. 193
Jing Zhang, Jing Li, Hai-Li Zhang, Hai-Shun Qu, Xian-Zhi Zhang, Ya-Qing Cheng, Zheng-Mei Zhang, Jia-Qin Huang
To systematically evaluate the efficacy of urinary granules combined with RAAS system blockers in the treatment of diabetic nephropathy (DN). A meta-analysis of the data required in the literature in accordance with this study was performed using RevMan 5.3 software. Fifteen randomized controlled trials were analyzed in the present study to evaluate the clinical effect of Niaoduqing-angiotensin converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB) in DN patients. A total of 1063 patients were involved, including 538 patients receiving the combination treatment and 525 patients in the control group. The results showed that the clinical efficacy of Niaoduqing granule combined with ACEI/ARB was significantly better than of the control group (odds ratio = 2.92, 95% confidence interval [CI] 1.76–4.86). The treatment combined with Niaoduqing granule decreased the 24-h urinary protein quantitation (mean difference [MD] 0.71, 95% CI 0.28–1.14) and urine albumin excretion rate (UAER) (MD 41.13, 95% CI 26.66–55.59) levels. However, the combination group had no treatment advantage on reducing serumurea nitrogen (MD 0.86, 95% CI 0.05–1.68, P = 0.02) and fasting blood glucose (MD −0.03, 95% CI −0.15–0.09, P = 0.61). And there was no significance in adverse events between two groups (risk ratio = 2.34, 95% CI 0.69–7.95, P = 0.17). Niaoduqing granule-ACEI/ARB combination group maybe as safe as ACEI/ARB alone, and the combination played an advantage in improvement in total effective rate, reduction of 24-h urinary protein quantitation and UAER.
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Tonifying kidney, lung, and spleen combined with western medicine for stable chronic obstructive pulmonary disease: A systematic review p. 202
Ying-Ying Liu, Zhen Gao
Introduction: This study aimed to evaluate the clinical effectiveness and safety of tonifying kidney, lung, and spleen (TKLS) combined with Western medicine for stable chronic obstructive pulmonary disease (COPD). Materials and Methods: Randomized controlled trials (RCTs) of TKLS for stable COPD were searched from four databases including PubMed, the Cochrane Library, China Biology Medicine, and China National Knowledge Infrastructure from inception to December 2017. Two reviewers independently screened the literature, extracted the data, and assessed the risk of bias in the included studies. RevMan5.3 software was used for meta-analysis. Results: Fourteen RCTs involving 1339 patients with stable COPD were included. Five of the included articles described the specific method of randomization, 1 of them was double-blind method research, and 1 of them was single-blind method research. Compared with the conventional Western medicine (CWM) group, the use of TKLS, if combined with CWM demonstrated significantly improved effective rate (relative risk = 1.25, 95% confidence interval [CI]: 1.18–1.33, P < 0.00001), decreased traditional Chinese medicine syndrome score (mean difference [MD] −5.72, 95% CI: −8.31 to −3.14, P < 0.0001), Decreased St George's Respiratory Questionnaire total score (MD −7.39, 95% CI: −10.46 to −4.31, P < 0.00001), increased 6-min walk distance in meters (MD 78.46, 95% CI: 60.18–96.73, P < 0.00001), increased forced expiratory volume 1% (MD 6.49, 95% CI: 3.64–9.33, P < 0.00001), increased CD4 (MD 9.84, 95% CI: 6.73–12.94, P < 0.00001), CD8 (MD −1.84, 95% CI: −3.62 to −0.06, P = 0.04) and CD4/CD8 (MD 0.26, 95% CI: 0.20–0.32, P < 0.0001), and increased immunoglobulin M (MD 0.15, 95% CI: 0.10–0.20 P < 0.00001).. Conclusions: For stable COPD, TKLS combined with CWM is superior to CWM alone with regard to clinical effectiveness, symptoms, and quality of life. The above conclusion needs to be validated by further well-designed, multicentric, large-scale, double-blinded RCTs.
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Effects of sialic acid from edible bird nest on cell viability associated with brain cognitive performance in mice p. 214
Siti Khadijah Abdul Khalid, Aswir Abd Rashed, Saleha Abdul Aziz, Hafandi Ahmad
Background: Edible bird nest (EBN) is a natural food product rich in glycoprotein such as sialic acid, which has been reported to improve brain functions. The EBN is widely consumed due to its higher nutritional contents and antioxidant status; however, an interaction of EBN on brain cell metabolic activity and viability are still unclear. Objective: The objectives of this study were to identify the effect of sialic acid from EBN on the cell viability and to determine the appropriate concentration of sialic acid on cognitive performance in mice. Materials and Methods: The viability of pheochromocytoma and neuroblastoma cell lines were tested using the 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide assay. For in vivo study, 7-week-old female BALB/c mice were randomly assigned into four treatment groups and were treated with sialic acid for 21 days. At day 22, all mice were tested on cognitive performance by Y-maze test. Results: Treatment concentration of sialic acid extract and sialic acid standard at 60 μg/mL (0.6 ppm) increased cell viability and showed no cytotoxicity effects in pheochromocytoma and neuroblastoma cell lines. In addition, an administration of higher dose of sialic acid at 0.6 ppm in animals improved Y-maze test performance, which they showed significantly higher number of entries and time spent in the novel arm. Conclusion: Thus, the current study shows that the sialic acid extract at 0.6 ppm improved brain cognitive performance in mice associated with an increased viability of pheochromocytoma and neuroblastoma cell lines.
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Study on the mechanism of qingre huoxue prescription in the intervention and treatment of acute myocardial infarction based on network pharmacology p. 220
Cai-Xia Jia, Jin-Ping Wang, Fei-Long Zhang, Xiao-Han Pang, Wei-Lu Wang, Paulin-Xue Xu, Kuo Gao, Jian-Xin Chen
Objective: The objective is to study the mechanism of Qingre Huoxue prescription in the intervention and treatment of acute myocardial infarction (AMI) based on the method of network pharmacology. Materials and Methods: Five databases were used to screen the chemical compounds and targets of Ligusticum wallichii (chuanxiong), Radix Paeoniae Rubra (chishao), Lignum acronychiae (jiangxiang), Safflower (honghua), Salvia miltiorrhiza (danshen), Scutellaria baicalensis (huangqin), and Ilex pubescens (mao dong qing) in Qingre Huoxue prescription. Furthermore, Cytoscape-V3.2.1 software was used to construct the drug-component-target network. Functional protein association networks' database and the Database for Annotation, Visualization, and Integrated Discovery (DAVID) were used to visualize the protein interaction, pathway enrichment, and analysis. Results: A total of 44 active ingredients were screened out in Qingre Huoxue prescription. Among them, 178 targets and 41 compounds related to Qingre Huoxue prescription's function in treating AMI were obtained. After the analysis of the drug-component-action target network on Qingre Huoxue prescription, 14 key compounds and nine key targets with three scores above average were obtained. In addition, pathway enrichment and biological processes were conducted with the aid of the DAVID; and 8 related pathways and 10 biological processes were associated with AMI and related diseases; the PI3K-AKT signaling pathway, MAPK signaling pathway, and HIF-1 signaling pathway are the main pathways of Qingre Huoxue prescription for the treatment of AMI and related diseases. Conclusion: Qingre Huoxue prescription could treat AMI by multiple components, targets, and pathways. This study provides ideas and theoretical basis for further clinical studies on Qingre Huoxue prescription in treating AMI.
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Therapeutic effect of jianpi decoction combined with chemotherapy on postoperative treatment of colorectal cancer: A systematic review and meta-analysis p. 228
Wen-Jun Zhou, Bin Wei, Fei-Fei Cai, Meng-Die Yang, Xiao-Le Chen, Qi-Long Chen, Ming Zhao, Shi-Bing Su
Objective: The purpose of this systematic review is to assess the therapeutic effect of Jianpi decoctions in Chinese herbal medicines (CHM) combined with chemotherapy on the postoperative treatment of colorectal cancer. Methods: Literatures were obtained from Wanfang database, CNKI, PubMed, Cqvip, MEDLINE, Cochrane, CBM, and Springer LINK as well as other conference papers and theses. The search included all documents in English or Chinese published before September 2018. We selected randomized controlled trials based on specific criteria and the most important criteria were that Jianpi decoction should be applied in combination with chemotherapy on the postoperative treatment of colorectal cancer. Results: Publications in eight electronic databases were extensively searched and 20 trials were included for analysis eventually. A total of 1652 patients in total were enrolled in these studies. Among them, 879 patients received CHM and Western medicine combination therapy and another 773 participants only got Western medicine therapy. Compared with those patients receiving Western medicine alone, the survival rate of 1-year (odds ratio [OR] = 2.35, 95% confidence limit [Cl] = 1.30–4.28,P < 0.05), 3-year (OR = 2.02, 95% Cl = 1.49–2.73,P < 0.001), and 5-year survival rate (OR = 2.32, 95% Cl = 1.56–3.45,P < 0.001) of patients in the group of Jianpi decoctions in CHM and chemotherapy combination has significantly increased. Moreover, results also showed positive effects on immunoregulation such as CD3+ (OR = 0.68, 95% confidence interval [CI] = 0.52–0.85,P < 0.0001), CD4+/CD8+ (OR = 0.77, 95% CI = 0.29–1.26,P < 0.05). Side effects caused by chemotherapy such as nausea (OR = 0.35, 95% CI = 0.25–0.50,P < 0.0001) and vomiting (OR = 0.32, 95% CI = 0.22–0.46,P < 0.0001), diarrhea (OR = 0.42, 95% CI = 0.30–0.60,P < 0.0001), as well as metastasis and recurrence (OR = 0.38, 95% CI = 0.24–0.61,P < 0.001) were remarkably reduced. The quality of life (OR = 4.40, 95% Cl = 2.86–6.77,P < 0.0001) has been improved. Moreover, there was no statistically significant bias in the overall studies. Conclusion: This systematic review suggests that Jianpi decoction in CHM can reduce the chemotherapy toxicity, enhance the patient's immunity, prolong their survival rate, improve their quality of life as well as prevent metastasis, and recurrence for patients in postoperative treatment of colorectal cancer.
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Purification and identification of a novel protein isolated from Panax quinquefolium and evaluation of its In vitro antioxidant properties p. 236
Xue-Hui Li, Yang Yang, Zhao Yu, Ning Xu, Xiao-Lei Tang, Xue-Yuan Bai, Si-Ming Wang, Hao-Yuan Chen, Da-Qing Zhao, Li Liu, Bin Qi
Objective: A novel protein was first purified from Panax quinquefolius L. (AGNP), and in vitro antioxidant activities of AGNP were first studied in this work. Methods: AGNP was purified by Ion-exchange chromatography and Gel-filtration chromatography. The chemical characterizations of AGNP were tested by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE), high-pressure gel-filtration chromatography, MALDI-TOF-MS and HPLC. In vitro antioxidant effects were tested in simple antioxidant assay including 2,2-diphenylpicrylhydrazyl radical scavenging, superoxide radical (O2) scavenging, hydroxyl radical (OH) scavenging, and ferric-reducing ability. Results: The results showed which the content of AGNP measured by Bradford method was 2.42 mg/mL and the subunit molecular weight of AGNP measured by sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE) was 15 kD. The AGNP molecular weight was15, 114 Da both of SDS-PAGE and mass spectrum purity. The result of high-pressure gel-filtration chromatography demonstrated that the molecular weight of AGNP was 31,086 Da, which implied that AGNP was a homodimer. The in vitro Antioxidant results indicated that AGNP had obvious effects to remove the free radicals in vitro. Conclusion: In conclusion, AGNP had more powerful antioxidant capacity and it can be used as an effective natural antioxidant to alleviate oxidative stress.
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Effect of total flavonoids of Herba Taxilli on osteoporotic rats induced by retinoic acid p. 243
Yuan-Yuan Li, Ying Cui, Hong-Li Wang, Jing Feng, Ling-Ling Li
Objective: The objective was to study the effect of total flavonoids of Herba Taxilli (TFHT) on osteoporotic (OP) rats induced by retinoic acid (RA) and explore its mechanism. Methods: Three-month-old female Sprague Dawley rats were randomly divided into six groups, each with ten rats, i.e. normal control group, model group, and positive control group and three TFHT groups (at high-, middle-, and low-doses). Except the normal control group, rats of all the other groups were administered RA by gavage (70 mg/kg/day) every morning for 14 days to establish an OP model; at the same time, all the rats were given Corresponding therapeutic drug by gavage for 28 days: rats in the three TFHT groups were given TFHT (400, 200, and 100 mg/kg/day, respectively) and rats in the positive control group were given Long mu Zhuang gu Granule 300 mg/kg/day. Rats in the model group and normal group were given an equal volume of 1% sodium carboxymethyl cellulose sodium suspension. After the experiment, blood was taken to measure the levels of serum calcium (Ca2+), alkaline phosphatase (ALP), and tartrate-resistant acid phosphatase (TRAP); the spleen, uterus, and ovary were dissected to determine the organ coefficient; the left hind limb femur was dissected to determine bone mineral density (BMD), bone dry weight (BDW), bone wet weight (BWW), bone diameter (BD), bone length (BL), bone dry weight/rat weight (BDW/W), bone wet weight/rat weight (BWW/W), bone dry weight/bone wet weight (BDW/BWW), bone dry weight/bone length (BDW/L), and bone wet weight/bone diameter (BWW/D); and the right hind limb femur was dissected to observe the bone path morphological changes. Results: Compared with the model group, the serum Ca2+ content, uterus plus ovary coefficient, BMD, BDW, BDW/W, BWW/W, BDW/BWW, BDW/L, and BWW/D in the TFHT groups increased, whereas the spleen coefficient, ALP, and TRAP decreased in the TFHT groups, and the differences were statistically significant (P < 0.05 orP < 0.01). Conclusion: TFHT was found effective in treating OP in rats induced by RA; the main mechanisms were increasing the serum Ca2+ content and reducing the level of ALP and TRAP.
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Simultaneous determination of six compounds in rat plasma by ultra-performance liquid chromatography with tandem mass spectrometry: Application in the pharmacokinetic study of Qing Gan-Shu Yu-Fang p. 250
Hai Jiang, A-Jiao Hou, Yan-Yan Zhang, Wen-Jing Man, Liu Yang, Yong-Hai Meng, Xin-Yue Guo, Song Wang, Jia-Xu Zhang, Bing-You Yang, Qiu-Hong Wang, Kelvin Chan, Hai-Xue Kuang
A rapid and high selective ultra-performance liquid chromatography (UPLC) with tandem mass spectrometry method for simultaneous determination of six compounds including albiflorin, paeoniflorin, picroside I, picroside II, saikosaponin A, and saikosaponin D in rat plasma was developed and validated using butyl p-hydroxybenzoate as an internal standard. One-step direct protein precipitation with acetonitrile was used to extract the compounds from the rat plasma samples. Chromatographic separation was achieved using an ACQUITY UPLC BEH C18column (100 mm × 2.1 mm, 1.7 μm) at a flow rate of 0.4 mL/min, using gradient mode containing 0.1% formic acid in water and acetonitrile were used as the Mobile phase A and B. Electrospray ionization in negative ion mode and multiple reaction monitoring were used to identify and quantify active components. Calibration curves showed good linearity (R2 > 0.9908) over a wide concentration range for all compounds. The intra- and interday precision (relative standard deviation) ranged 2.4%–7.0% and 2.6%–8.0%, respectively. The accuracy (relative error) was from −13.0% to 13.2% at all quality control levels. The recovery ranged from 81.1% to 92.5%. The validated method was successfully applied to pharmacokinetic study in rats after oral administration of Qing Gan-Shu Yu-Fang. The results show that one can draw a conclusion that these six active ingredients can be quickly absorbed and play a pharmacodynamic role rapidly in vivo.
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Effects of water-soluble tomato concentrate on platelet aggregation p. 260
Qian Zhang, Xu-Guang Zhang, Lei Liu, Qiong-Ling Zhang, Shi-Lan Ding, Ying Chen, Jin-Yu Wang, Lan Wang, Ri-Xin Liang, Fu-Long Liao, Ya-Hong Wang, Yun You
Objective: To investigate the antiplatelet aggregation effect of water-soluble tomato concentrate (WSTC) and explore the underlying molecular mechanisms. Materials and Methods: Platelet aggregometry was used to quantify rat platelet aggregation with the maximum aggregation rate in vitro and ex vivo. Then, the fibrinogen (FIB) binding assay was employed to detect the effect of WSTC on the activation of platelet integrin αIIβ3 (GP IIb/IIIa). Furthermore, Western blot was performed to assess the platelet protein levels of phosphoinositide 3-kinase 110 β (PI3K110 β), protein disulfide isomerase (PDI), platelet endothelial cell adhesion molecule 1 (PECAM-1), and β1-Tubulin. Results: WSTC inhibited adenosine diphosphate (ADP) and collagen-induced platelet aggregation in a concentration-dependent manner in vitro, at IC50values of 3.05 g/L and 8.03 g/L, respectively. Significantly reduced ex vivo ADP induced platelet aggregation was observed after oral consumption of WSTC for 4 weeks in rats; average inhibition rates were 24.42%, 21.48%, and 20.87% for 25 mg/Kg, 75 mg/Kg, and 150 mg/Kg WSTC, respectively. It appeared that WSTC had no influence on coagulation function in rats. Incubation with WSTC decreased FIB binding to GP IIb/IIIa by 17.47% and 32.29% at the concentrations of 0.6 and 6 g/L, respectively. WSTC at 0.6 and 6 g/L markedly downregulated PI3K110 β, PDI, and PECAM-1 in platelets, and upregulated β1-Tubulin, in a concentration-dependent manner. Conclusion: WSTC inhibits platelet activation through modulation of platelet skeletal stability and suppresses GP IIb/IIIa receptor-mediated platelet aggregation, likely via the PI3K signaling pathway and PDI inhibition.
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Efficacy of traditional chinese medicine in the treatment of rash caused by epidermal growth factor receptor inhibitors: A frequency statistics and meta-analysis p. 269
Shu-Yue Zheng, Hui-Juan Cui, Yan-Mei Peng, Qiang Li, Wen Shen, Jing-Yi Zhang, Chen-Yao Sun, Xu Zhang, Ke-Xin Tan, Xue-Jiao Jiang
Objective: The aim of this study is to evaluate the efficacy of Traditional Chinese Medicine (TCM) in the treatment of rash caused by epidermal growth factor receptor inhibitors (EGFRIs). Materials and Methods: Foreign language database (such as PubMed, Web of Science, Cochrane Library, EMBASE) and Chinese language database (such as China National Knowledge Infrastructure, VIP Database for Chinese Technical Periodicals [VIP], Wangfang, CBM disc) were searched for all trials of TCM in the treatment of rash caused by EGFRIs until January of 2019. We also looked through the references of relevant studies to supplement additional trials. The SPSS 25.0 was used for statistics of TCM with high frequency, and Review Manager 5.3 was used for meta-analysis. Results: A total of 22 studies were included in the study. We selected TCM whose frequency were >3.0%. They were Lonicera japonica(金银花), Licorice Roots Northwest Origin(生甘草), Cortex Dictamni(白鲜皮), Radix Sophorae Flavescentis(苦参), Schizonepeta(荆芥), Saposhnikovia Divaricate(防风). The meta-analysis revealed that the efficacy of TCM in treating EGFRIs-related rash was better than that of Western medicine or none. Conclusions: TCM could significantly relieve rash caused by EGFRIs, which is worth popularizing. Moreover, the mechanism deserves to be further explored.
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7th Annual meeting of the good practice in traditional chinese medicine research association p. 277

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