A national survey on how to improve traditional Chinese medicine learning internationally: Perceptions from both teachers and students.

Background: With the increasing popularity of traditional Chinese medicine (TCM) by the global community, how to teach basic knowledge of TCM to international students and improve the teaching quality are important issues for teachers of TCM. The present study was to analyze the perceptions from both students and teachers on how to improve TCM learning internationally. Methods: A cross-sectional national survey was conducted at 23 universities/colleges across China. A structured, self-reported on-line questionnaire was administered to 34 Chinese teachers who taught TCM course in English and to 1016 international undergraduates who were enrolled in the TCM course in China between 2017 and 2021. Results: Thirty-three (97.1%) teachers and 900 (88.6%) undergraduates agreed Chinese culture should be fully integrated into TCM courses. All teachers and 944 (92.9%) undergraduates thought that TCM had important significance in the clinical practice. All teachers and 995 (97.9%) undergraduates agreed that modern research of TCM is valuable. Thirty-three (97.1%) teachers and 959 (94.4%) undergraduates thought comparing traditional medicine in different countries with TCM can help the students better understand TCM. Thirty-two (94.1%) teachers and 962 (94.7%) undergraduates agreed on the use of practical teaching method with case reports. From the perceptions of the undergraduates, the top three beneficial learning styles were practice (34.3%), teacher's lectures (32.5%), case studies (10.4%). The first choice of learning mode was attending to face-to-face teaching (82.3%). The top three interesting contents were acupuncture (75.5%), Chinese herbal medicine (63.8%), and massage (55.0%). Conclusion: To improve TCM learning among international undergraduates majoring in conventional medicine, integration of Chinese culture into TCM course, comparison of traditional medicine in different countries with TCM, application of the teaching method with case reports, and emphasization of clinical practice as well as modern research on TCM should be fully considered.

An evaluation survey of traditional Chinese medicine learning among international students majoring in conventional medicine: a study from a university in China.

BACKGROUND: Traditional Chinese medicine (TCM) has gained increasing acceptance and popularity by the global community. The current study aimed to investigate self-reported evaluations of learning TCM and opinions about TCM courses among undergraduate international students majoring in conventional medicine at a university in China. METHODS: A cross-sectional survey was conducted at the Zhejiang University School of Medicine. A self-reported questionnaire was administered to international undergraduates who were enrolled in the TCM course during the 2018 and 2019 academic years (n = 157). The course employed a student-centered, multiform learning model. Demographic data and self-reported evaluations of TCM learning background and TCM learning course were obtained to conduct the analysis. RESULTS: A total of 133 students responded to the questionnaire. Among the respondents, 21.0% had some TCM-related knowledge, and 51.1% were interested in learning TCM before the course. Ninety-six students (85.7%) were from Asia. Students from Thailand showed significantly more interest in learning TCM than did students from other Asian countries (p = 0.025). After the course, 77.2% of students agreed that the course had brought about many benefits, 86.4% were satisfied with the course content, and 77.3% were satisfied with the teaching method. Students expressed their willingness to further learn acupuncture and to obtain more skilled practice through more visualized learning methods. CONCLUSIONS: The majority of the international students we surveyed agreed that the TCM course improved their interest in and understanding of TCM. It is thus suggested that TCM education should be directed toward students' learning barriers and needs.

The evaluation of online course of Traditional Chinese Medicine for MBBS international students during the COVID-19 epidemic period.

BACKGROUND: During the COVID-19 epidemic period, Traditional Chinese Medicine (TCM) course for international students of Medical Bachelor, Bachelor of Surgery (MBBS) program in Zhejiang University has shifted from traditional classroom to online environment. This study aimed to investigate MBBS international students' perception on online TCM course, and to assess the online learning efficacy. METHODS: A total of 84 MBBS international students attending course of "Basic Traditional Chinese Medicine" during 2020 academic years at Zhejiang University were enrolled in this study. A quantitative questionnaire was respectively completed before and after the TCM course using a pretest-post-test design. By means of two online learning platforms, Learning in ZJU and DingTalk, TCM course was broadcast in both live and archived format to students. RESULTS: A total of 48 participants completed both baseline and follow-up questionnaires. The majority of participants preferred face-to-face classroom learning (26, 54.17% of total) when compared with online learning. Students felt that the course had brought in much benefits (mean 3.88, SD 0.87), and they were satisfied with the course content (mean 3.83, SD 0.95). Students' TCM related knowledge and their behaviors of discussion and consulting were significantly improved by online TCM course (all P < 0.001). Students' awareness of the necessity of TCM education and their feeling of difficulty in learning TCM were significantly strengthened (P = 0.042, 0.025, respectively). CONCLUSION: Online learning is a good alternative for TCM course of MBBS international students when classroom learning is suspended, whereas it cannot replace the need for onsite and face-to-face learning.

Antiproliferative activities of tea and herbal infusions.

The consumption of tea and herbal infusions has increased rapidly in recent years. More and more people consume these infusions as daily beverages as well as for health purposes. The aim of this study was to supply new information on the antiproliferative function of these infusions for nutritionists and the general public. The in vitro antiproliferative activities of 60 different tea and herbal infusions on four cancer cell lines were evaluated by MTT assay. The results showed that some infusions strongly inhibited the proliferation of A549 (human lung cancer cells), MCF-7 (human breast cancer cells), HepG2 (human hepatoma cells) and HT-29 (human colon cancer cells), and decreased the viability of these cancer cell lines in a dose-dependent manner. In addition, some bioactive components in the infusions were also separated and determined by HPLC. The results suggested that some tea and herbal infusions may be potential dietary supplements for the prevention and treatment of cancer.

Phenolic compounds and bioactivities of pigmented rice.

The pigmented rice has been consumed in China, Japan, and Korea for a long time. It has been used for strengthening kidney function, treating anemia, promoting blood circulation, removing blood stasis, treating diabetes, and ameliorating sight in traditional Chinese medicine. The extracts from pigmented rice are used as natural food colorants in bread, ice cream, and liquor as well as functional food. The pigmented rice is mainly black, red, and dark purple rice, and contains a variety of flavones, tannin, phenolics, sterols, tocols, γ-oryzanols, amino acids, and essential oils. Anthocyanins are thought as major functional components of pigmented rice. Several anthocyanins have been isolated and identified from the pigmented rice, including cyanidin 3-glucoside, cyanidin 3-galactoside, cyanidin 3-rutinoside, cyanidin 3,5-diglucoside, malvidin 3-galactoside, peonidin 3-glucoside, and pelargonidin 3,5-diglucoside. This review provides up-to-date coverage of pigmented rice in regard to bioactive constituents, extraction and analytical methods, and bioactivities. Special attention is paid to the bioactivities including antioxidant and free radical scavenging, antitumor, antiatherosclerosis, hypoglycemic, and antiallergic activities.

Nitrate and nitrite content in bottled beverages by ion-pair high-performance liquid chromatography.

Nitrate and nitrite levels in six types of beverages--total of 292 individual samples from 73 brands (four bottles each)--from Guangzhou city in China were evaluated by ion-pair high-performance liquid chromatography. All samples contained nitrate. Nitrate and nitrite ranges were 0.43-46.08 and <0.005-0.501 mg/L, respectively. The highest nitrate levels were detected in tea drinks (46.08 mg/L). For nitrite, the highest levels were found in fruit juice drinks (0.501 mg/L). Three brands of fruit juice drinks exceeded the Joint FAO/WHO Expert Committee on Food Additives provisional guideline value of 0.2 mg/L for nitrite and were considered to be hazardous for public health. This study supplies useful information on safety of Chinese bottled beverages.

Potential of fruit wastes as natural resources of bioactive compounds.

Fruit wastes are one of the main sources of municipal waste. In order to explore the potential of fruit wastes as natural resources of bioactive compounds, the antioxidant potency and total phenolic contents (TPC) of lipophilic and hydrophilic components in wastes (peel and seed) of 50 fruits were systematically evaluated. The results showed that different fruit residues had diverse antioxidant potency and the variation was very large. Furthermore, the main bioactive compounds were identified and quantified, and catechin, cyanidin 3-glucoside, epicatechin, galangin, gallic acid, homogentisic acid, kaempferol, and chlorogenic acid were widely found in these residues. Especially, the values of ferric-reducing antioxidant power (FRAP), trolox equivalent antioxidant capacity (TEAC) and TPC in the residues were higher than in pulps. The results showed that fruit residues could be inexpensive and readily available resources of bioactive compounds for use in the food and pharmaceutical industries.

Microwave-assisted extraction of oxymatrine from Sophora flavescens.

In this paper, microwave-assisted extraction (MAE) of oxymatrine from Sophora flavescens were studied by HPLC-photodiode array detection. Effects of several experimental parameters, such as concentration of extraction solvent, ratio of liquid to material, microwave power, extraction temperature, and extraction time on the extraction efficiencies of oxymatrine were evaluated. The optimal extraction conditions were 60% ethanol, a 20:1 (v/v) ratio of liquid to material and extraction for 10 min at 50 °C under 500 W microwave irradiation. Under the optimum conditions, the yield of oxymatrine was 14.37 mg/g. The crude extract obtained could be used as either a component of some complex traditional medicines or for further isolation and purification of bioactive compounds. The results, which indicated that MAE is a very useful tool for the extraction of important phytochemicals from plant materials, should prove helpful for the full utilization of Sophora flavescens.

Microwave-assisted extraction of oleanolic acid and ursolic acid from Ligustrum lucidum Ait.

Oleanolic acid and ursolic acid are the main active components in fruit of Ligustrum lucidum Ait, and possess anticancer, antimutagenic, anti-inflammatory, antioxidative and antiprotozoal activities. In this study, microwave-assisted extraction of oleanolic acid and ursolic acid from Ligustrum lucidum was investigated with HPLC-photodiode array detection. Effects of several experimental parameters, such as type and concentration of extraction solvent, ratio of liquid to material, microwave power, extraction temperature and microwave time, on the extraction efficiencies of oleanolic acid and ursolic acid from Ligustrum lucidum were evaluated. The influence of experimental parameters on the extraction efficiency of ursolic acid was more significant than that of oleanolic acid (p < 0.05). The optimal extraction conditions were 80% ethanol aqueous solution, the ratio of material to liquid was 1:15, and extraction for 30 min at 70 °C under microwave irradiation of 500 W. Under optimal conditions, the yields of oleanolic acid and ursolic acid were 4.4 ± 0.20 mg/g and 5.8 ± 0.15 mg/g, respectively. The results obtained are helpful for the full utilization of Ligustrum lucidum, which also indicated that microwave-assisted extraction is a very useful method for extraction of oleanolic acid and ursolic acid from plant materials.

Total phenolic contents and antioxidant capacities of herbal and tea infusions.

In order to supply new information on the antioxidant function of selected beverages for nutritionists and the general public, total phenolic contents of 51 kinds of herbal and tea infusions made in China were measured by the Folin-Ciocalteu method, and their antioxidant capacities were evaluated using ferric reducing antioxidant power (FRAP) and Trolox equivalent antioxidant capacity (TEAC) assays. A significant correlation between FRAP and TEAC values suggested that antioxidant components in these beverages were capable of reducing oxidants and scavenging free radicals. The high correlation between antioxidant capacities and total phenolic contents indicated that phenolic compounds could be one of the main components responsible for antioxidant activities of these beverages. Generally, these beverages had high antioxidant capacities and total phenolic contents, and could be important dietary sources of antioxidant phenolics for prevention of diseases caused by oxidative stress.

Ultrasound-assisted extraction of phillyrin from Forsythia suspensa.

Forsythia suspensa (Thunb.) Vahl is one of the most widely used traditional Chinese medicines, and possesses important biological activities, such as antibacterial, antiviral, anti-inflammatory and antioxidant activities. Phillyrin is the main bioactive component of Forsythia suspensa. In this paper, ultrasound-assisted extraction of phillyrin from Forsythia suspensa was studied with HPLC-photodiode array detection. Effects of several experimental parameters, such as type and concentration of extracting solvent, ratio of liquid to material, extraction temperature, and time of sonication on extraction efficiencies of phillyrin from Forsythia suspensa were evaluated. The optimal extraction conditions were 1g plant sample with 10 ml of 20% methanol and the extraction for 60 min at 60°C under ultrasonic irradiation. Under the optimum conditions, the yield of phillyrin was 0.713±0.009 mg/g. The results indicated that the ultrasound-assisted extraction is a very useful method for the extraction of important phytochemicals from plant materials.

Screening of natural antioxidants from traditional Chinese medicinal plants associated with treatment of rheumatic disease.

In order to find new sources of natural antioxidants, the antioxidant capacities of 50 medicinal plants associated with treatment of rheumatic diseases were systemically evaluated using the ferric-reducing antioxidant power (FRAP) and Trolox equivalent antioxidant capacity (TEAC) assays, and their total phenolic contents were measured by the Folin-Ciocalteu method. Their antioxidant activities of some of these plants were analyzed for the first time. The FRAP and TEAC assay results suggested that the antioxidant compounds in these plants possessed free radicals scavenging activity and oxidant reducing power. A positive linear correlation between antioxidant capacities and total phenolic contents implied that phenolic compounds in these plants could be the main components contributing to the observed activities. The results showed that Geranium wilfordii, Loranthus parasiticus, Polygonum aviculare, Pyrrosia sheaeri, Sinomenium acutum and Tripterygium wilfordii possessed the highest antioxidant capacities and total phenolic content among 50 plants tested, and could be rich potential sources of natural antioxidants.

[Clinical observation of bushen er'xian decoction in treating premature ovarian failure].

OBJECTIVE: To observe the therapeutic effect and immune regulatory mechanism of Bushen Er'xian Decoction (BED) on patients with premature ovarian failure (POF). METHODS: Sixty patients with POF were randomly assigned to two groups in the ratio of 2:1, the 40 in the treatment group were treated with BED and the 20 in the control group were treated with artificial menstrual cycle therapy. The clinical efficacy was observed and the changes of serum reproductive hormone and T lymphocytes before and after treatment were observed. RESULTS: The total effective rate in the treatment group was 72.5% (29/40 cases), which was higher than that in the control group, 45.0% (9/20 cases, P < 0.05). Serum follicle-stimulating hormone (FSH) and luteinizing hormone (LH) decreased and estradiol (E2) increased in both groups after treatment (P <0.05), but the level of FSH was lower in the treatment group than in the control group (22.57 +/- 12.49 IU/L vs 31.10 +/- 14.50 IU/L, P <0.05). CD4 and CD4/CD8 increased, CD8 decreased in the treatment group after treatment, showing significant difference as compared with those before treatment and with those in the control group after treatment (P <0.01). CONCLUSION: BED is favourable for improving POF, being a good remedy with better clinical efficacy.

[Clinical observation on treatment of infertile patients with severe endometriosis by Kangyi Zhongyu Decoction combined with gonadotropin releasing hormone-a].

OBJECTIVE: To observe the therapeutic effect of Kangyi Zhongyu Decoction (KZD) combined with gonadotropin releasing hormone-a (GnRH-a) on infertile patients with severe endometriosis. METHODS: Seventy-five infertile patients with the diagnosis of endometriosis confirmed by laparoscope who were scheduled to receive in vitro fertilization and embryo transfer (IVF-ET) were randomly assigned to three groups, they were treated respectively with KZD (A), GnRH-a (B) alone and combined of both (C), and IVF-ET were applied in the patients after 3 months of treatment. The clinical efficacy and adverse reactions in the three groups were observed and the changes of serum cancer antigen 125 (CA125) and endometrial antibody (EMAb) levels before and after treatment were tested. RESULTS: Score of dyspareunia in Group A and C was obvioushy lower than that in Group B after treatment (P <0.01). Pregnancy rate in Group C was higher than that in Group A and B (P <0.05), with the adverse reactions less than in Group B (P <0.01). The positive rate of plasma EMAb was reduced obviously after treatment in Group C with the level lower than that in the other two groups (P<0.05). CONCLUSION: The combined use of KZD and GnRH-a is a new method in treating infertile patients with severe endometriosis with ideal effectiveness and fewer adverse reactions, and it could advance the successful rate of reproductive assistant technique.