Combined traditional Chinese medicine therapy for the treatment of infertility with polycystic ovary syndrome: A network meta-analysis of randomized controlled trials.

BACKGROUND: Polycystic ovary syndrome (PCOS) infertility has attracted great attention from researchers due to its high incidence. Numerous studies have shown that Chinese medicine is effective in treating this disease, but there is a wide variety of Chinese medicine therapies available, and there is a lack of comparative evaluation of the efficacy of various Chinese medicine combination therapies in the clinic, which requires further in-depth exploration. This study aims to evaluate the efficacy of a combined traditional Chinese medicine (TCM) therapy for the treatment of infertility with PCOS using network meta-analysis (NMA). METHODS: In PubMed, web of Science, Cochrane Library, Embase, China Knowledge Network, Wanfang Data, VIP Database, China Biomedical Literature Database (SinoMed) databases, searchs were conducted for information about the randomized controlled trials (RCTs) of combined TCM therapy for the treatment of infertility with PCOS. Quality evaluation was performed using the Cochrane 5.3 risk of bias assessment tool, and NMA using Stata 16.0. RESULTS: This study comprised 28 RCTs using 8 combined TCM therapies in total. The results of the NMA showed that moxibustion + herbal, fire acupuncture + herbal, acupuncture + herbal, electroacupuncture + herbal, and acupoint application + herbal improved the clinical pregnancy rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Additionally, ear point pressure + herbal enema + herbal, acupuncture and moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal improved the ovulation rate better than acupuncture, herbal, and western medicines monotherapy (P < .05). Moxibustion + herbal, fire acupuncture + herbal, and acupuncture + herbal are the 3 most effective therapies for improving the clinical pregnancy rate. Fire acupuncture + herbal, acupuncture + herbal, and ear point pressure + herbal enema + herbal are the 3 most effective therapies for improving the ovulation rate. CONCLUSION: The combined TCM therapy demonstrated better efficacy for the treatment of infertility with PCOS compared to acupuncture, herbal, and western medicines monotherapy. However, the optimal treatment therapy varied depending on the outcome indicators. Further large sample, high-quality, and standardized RCTs are needed to verify these findings.

Antiproliferative polycyclic polyprenylated acylphloroglucinols from Garcinia paucinervis.

Bioassay-guided isolation of the stems of Garcinia paucinervis led to one new adamantane-type polycyclic polyprenylated acylphloroglucinols (PPAPs), (-)-garpauvinin A (1), and four known analogues (2-5). The structure and absolute configuration of 1 was established via spectroscopic techniques and ECD method. All the isolates displayed moderate antiproliferative activity against HL-60, PC-3 and Caco-2 human cancer cell lines with IC50 values ranging from 0.81 to 19.92 µM, and exhibited low toxicity on WPMY-1 normal human cells, showing selectivity between normal and malignant prostate cells. The biosynthetic pathways of the isolated PPAPs were proposed.

[Isoquinoline alkaloids from two species of Thalictrum genus plants].

The chemical constituents from the roots of Thalictrum cultratum and T. baicalense were investigated. By various isolation methods, such as silica gel, aluminium oxide, ODS, and Sephadex LH-20 column chromatographies, and semi-preparative HPLC, 11 simple isoquinoline alkaloids were isolated from the ethanol extract of the roots of these two plants, including a new compound, named dehydrothalflavine(1), and ten known ones(2-11): N-methylcorydaline(2), N-methylthalidaldine(3), thaliflavine(4), oxyhydrastinine(5), noroxyhydrastinine(6), dimethoxyisoquinolone(7), thalactamine(8), dehydronoroxyhydrastinine(9), 6,7-dimethoxy-2-methyl-1,2,3,4-tetrahydroisoquinoline(10), and isopicnarrhine(11). Their structures were elucidated on the basis of HR-ESI-MS and 1 D and 2 D NMR techniques. Compound 1 was a new isoquinoline alkaloid. Compound 11 was obtained from Tha-lictrum plant for the first time. All compounds did not show cytotoxic activities against HL-60, U937, HCT116, Caco-2, and HepG2 cancer cell lines.

Pegaharmols A-B, Axially Chiral ß-Carboline-quinazoline Dimers from the Roots of Peganum harmala.

Two nonbiaryl axially chiral ß-carboline-quinazoline dimers, pegaharmols A (1) and B (2), were isolated from the roots of Peganum harmala. Their planar structures were elucidated by the spectroscopic methods of high-resolution mass spectrometry and 1D and 2D nuclear magnetic resonance (NMR). The stereochemistry was established by a comparison between the experimental data of NMR and electronic circular dichroism and the computed data by quantum mechanical calculations. It is discovered for the first time that the ß-carboline at the C-8 position is bonded to the vasicine at the C-9 position. 1 exhibited moderate cytotoxic activity against HL-60 and A549 cell lines.

Baicalensines A and B, Two Isoquinoline Alkaloids from the Roots of Thalictrum baicalense.

Baicalensines A (1) and B (2) were isolated from the roots of Thalictrum baicalense and structurally characterized using spectroscopic data, 13C NMR calculations, and the CASE algorithm. Compound 1, representing a new class of alkaloid dimers, contains berberine conjugated to a ring-opened isoquinoline. Compound 2 is the first reported natural benzylisoquinoline bearing a formyl group at C-3. Plausible biosynthetic pathways are proposed. Compound 1 exerted moderate cytotoxicity against the Caco-2 and HL-60 cell lines.

Chiral resolution and anticancer effect of xanthones from Garcinia paucinervis.

Bioassay-guided fractionation of the dichloromethane-soluble portion of the stems of Garcinia paucinervis led to the isolation of eight new xanthones, including three pairs of enantiomers, (+) and (-) paucinervins L-N (1a-3a, and 1b-3b), one optically pure compound, (-) paucinervin O (4), and one new analogue, paucinervin P (5), as well as thirteen known xanthones (6-18). Their structures were established by detailed analysis of extensive spectroscopic data. The absolute configurations of 1-4 were confirmed by ECD calculations. All the isolates 1-18 displayed antiproliferative effect against HL-60 with IC50 values ranging from 0.87 to 29.14 µM, of which compound 5 was the most active. Compounds 6, and 14 exhibited potential inhibitory activity against PC-3 cells, while compounds 5-7, 14, and 16-17 displayed cytotoxic potency against Caco-2 cells. A preliminary structure-activity relationship was also discussed.

New Cytotoxic Alkylated Chalcones from Fatoua villosa.

Three new alkylated chalcones, villosins A - C (1 - 3), five known analogues, together with ten known coumarins, were isolated from Fatoua villosa. The structures of the new compounds were elucidated by extensive spectroscopic analysis, including 1D-, 2D-NMR, and MS data. Compounds 1 - 3 showed cytotoxicity against five kinds of human tumor cell lines (NB4, A549, SHSY5Y, PC3, and MCF7) with IC50 values ranging from 1.4 ± 0.1 to 5.7 ± 0.3 µm.

[Effect of electroacupuncture on expression of myocardial PI 3 K, HIF-1alpha and VEGF in rats with cerebral-cardiac syndrome].

OBJECTIVE: To observe the effect of electroacupuncture (EA) on the expression of myocardial 1-phosphatidylinositol 3-kinase (PI 3 K), hypoxia-inducible factor-1alpha (HIF-1alpha) and vascular endothelial growth factor (VEGF) in rats with cerebral-cardiac syndrome (CCS), so as to reveal its mechanism underlying reducing ischemic myocardial injury. METHODS: Forty SD rats were randomly and equally divided into sham-operation, model, EA and non-acupoint (the lateral-superior side of the hip) groups (10 rats/group). CCS model was established by injection of collagenase (1 U/microL) and heparin (7 U/microL) into the right caudate nucleus. Following modeling, EA (1.5 mA, 2 Hz, 20 min) was applied to "Shuigou" (GV 26), "Fengfu" (GV 16), "Neiguan" (PC 6) and "Xinshu" (BL 15) acupoints, once daily for three consecutive days. The expression levels of PI 3 K,HIF-1alpha and VEGF in the myocardium were detected by immunohistochemistry. RESULTS: Compared with the sham-operation group, the expression levels of myocardial PI 3 K, HIF-1a and VEGF proteins were significantly increased in the model group (P<0.01). While in comparison with the model group, there were little increase in the non-acupoint group (P>0.05) and considerable increase in the expression levels of the 3 myocardial proteins in the EA group (P<0.05). CONCLUSION: EA intervention has a function in upregulating the expression of myocardial VEGF, HIF-1alpha and PI 3 K proteins in CCS rats, which maybe contribute to its protective effect on ischaemic myocardial injury.

Speciation of inorganic- and methyl-mercury in biological matrixes by electrochemical vapor generation from an L-cysteine modified graphite electrode with atomic fluorescence spectrometry detection.

A novel nonchromatographic speciation technique for ultratrace inorganic mercury (Hg(2+)) and methylmercury (CH(3)Hg(+)) in biological materials is developed and validated by electrolytic vapor generation (EVG) coupled with atomic fluorescence spectrometry (AFS). The studies show that CH(3)Hg(+) and Hg(2+) can be converted to Hg vapor efficiently on an l-cysteine modified graphite cathode, which has never been reported before. We observe that only Hg(2+) can be converted efficiently to Hg vapor at low current mode (0.2 A). While at high current mode (2.2 A), both CH(3)Hg(+) and Hg(2+) can be reduced efficiently. As a result, we successfully establish an exact and sensitive method based on the current control to detect mercury speciation for the first time. The factors of electrolytic conditions have been optimized, and the potential mechanism is discussed. Under the optimal conditions, the detection limits (3s) of Hg(2+) and CH(3)Hg(+) in aqueous solutions are 0.098 and 0.073 µg L(-1), respectively. The relative standard deviations for 6 replicate determinations of 2 µg L(-1) Hg are determined as 3.2% and 4.7% for Hg(2+) and CH(3)Hg(+). The accuracy of the method is verified through the analysis of certified reference materials (CRM, NRC-DORM-2), and the proposed method has been applied satisfactorily to the determination of mercury speciation in several seafood samples by calibration curve mode.