Efficacy and Safety of Chinese Medicine Resuscitation Pack for Enhanced Recovery after Bronchoscopy: A Randomized, Single-Blind, Placebo-Controlled Clinical Trial.

OBJECTIVE: To evaluate the efficacy and safety of a hospital-made resuscitation pack, a Chinese medicinal herbal compound formula designed to enhance recovery in post-bronchoscopy patients. METHODS: In this randomized, single-blind, placebo-controlled clinical trial, eligible patients were randomly assigned 1:1 to either the treatment or control groups. The patients in the treatment group applied the resuscitation pack, which contained aromatic compounded Chinese herbs. The patients in the control group applied a hospital-made, single herb placebo pack. Packs were placed on the Tiantu (CV 22) acupuncture point for 4 h as soon as the bronchoscopy finished. Efficacy indicators, such as recovery time, patients' symptoms including nausea and dizziness, and adverse events (AEs) were observed and compared. The outcome indices were evaluated at baseline, 1 and 24 h after the bronchoscopy. Subgroup analysis was further performed by patients' age and depth of sedation. RESULTS: When applying generalized estimating equations (GEE) to evaluate the intensity of post-bronchoscopy nausea and vomiting, the intensity was lower in the treatment group (163 cases) compared with the control group (162 cases; 95% CI: 0.004, 0.099, P=0.03]. Also, significantly lower intensity of nausea was observed in the 60-70 years of age subgroup (95% CI: 0.029, 0.169, P=0.006) and deep sedation subgroup (95% CI: 0.002, 0.124; P=0.04). There was no significant difference in dizziness between two groups by GEE (95% CI: -0.134, 0.297; P=0.459). In addition, no serious AEs were observed in either group. CONCLUSIONS: Our study found that the resuscitation pack markedly improved patients' symptoms by reducing nausea and vomiting after bronchoscopy without AEs, compared with placebo in the perioperative period. (Trial registration No. ChiCTR2000038299).

Down-regulation of theta amplitude through neurofeedback improves executive control network efficiency in healthy children.

Despite extensive clinical research on neurofeedback (NF) in attention-deficit/hyperactivity disorder (ADHD), few studies targeted the optimization of attention performance in healthy children. As a crucial component of attention networks, the executive control network, involved in resolving response conflicts and allocating cognitive resources, is closely linked to theta activity. Here, we aimed to answer whether theta down-regulating NF can enhance healthy children's attention performance, especially the executive control network. Sixty children aged 6-12 years were randomly assigned to the NF and waitlist control groups. The NF group received theta down-regulation NF training for five days (a total of 100 mins), and the attention performance of both groups was measured by the attention network test (ANT) in the pre, post-NF, and 7-day follow-up. The electroencephalographic (EEG) results demonstrated a significant decrease in resting-state theta amplitude within sessions. For the behavioral results, the NF group exhibited significant improvements in overall attention performance and the efficiency of the executive control network relative to the control group in the post-NF and follow-up assessment, whereas the alerting and orienting networks remained unchanged. These findings proved the feasibility of theta down-regulating NF and its positive effect on attention in the healthy children population. In particular, the facilitation of the efficiency of the executive control network and the unaltered performance of the other two attention networks in the NF group may support the causality between theta rhythm and the executive control network.

Chemical profiling and investigation of molecular mechanisms underlying anti-hepatocellular carcinoma activity of extracts from Polygonum perfoliatum L.

Polygonum perfoliatum L. is an herbal medicine that has been extensively used in traditional Chinese medicine to treat various health conditions ranging from ancient internal to surgical and gynecological diseases. Numerous studies suggest that P. perfoliatum extract elicits significant anti-tumor, anti-inflammatory, anti-bacterial, and anti-viral effects. Nevertheless, the underlying mechanisms of its anti-liver cancer effects remain poorly understood. Our study suggests that P. perfoliatum stem extract (PPLA) has a favorable safety profile and exhibits a significant anti-liver cancer effect both in vitro and in vivo. We identified that PPLA activates the cGMP-PKG signaling pathway, and key regulatory genes including ADRA1B, PLCB2, PRKG2, CALML4, and GLO1 involved in this activation. Moreover, PPLA modulates the expression of genes responsible for the cell cycle. Additionally, we identified four constituents of PPLA, namely taxifolin, myricetin, eriodictyol, and pinocembrin, that plausibly act via the cGMP-PKG signaling pathway. Both in vitro and in vivo experiments confirmed that PPLA, along with its constituting compounds taxifolin, myricetin, and eriodictyol, exhibit potent anti-cancer activities and hold the promise of being developed into therapeutic agents.

Meroterpenoids from Ganoderma petchii inhibiting migration of triple negative breast cancer cells.

Ganoderpetchoids A-E and (-)-dayaolingzhiol H, six undescribed meroterpenoids, were isolated from Ganoderma petchii. Their structures including the relative configurations were identified by means of spectroscopic methods and 13C NMR calculations. Chiral separation of the new racemics was performed to afford their respective enantiomers. The absolute configurations of the new isolates were clarified by computational approaches, CD comparisons and X-ray diffraction analysis. Biological studies toward triple negative breast cancer indicated that (+)-6 and (-)-6 significantly inhibit the migration of MDA-MB-231 cell line.

COX-2 and iNOS inhibitory epimeric meroterpenoids from Ganoderma cochlear and structure revision of cochlearol Q.

Four novel epimeric meroterpenoids, ganadone A (1), 3',10'-di-epi-ganadone A (2), 10'-epi-ganadone A (3), and 3'-epi-ganadone A (4) as well as another pairs of epimers, ganadone B (5) and 10'-epi-ganadone B (6), with a same basic skeleton compound ganadone C (7), together with two lactonized meroterpenoids, ganadones D and E (8 and 9) were isolated from the fruiting bodies of Ganoderma cochlear. Compounds 1-7 were constructed with fascinating adjacent 6',7'-bifuran ring system. Fortunately, we have revised our previously reported structure cochlearol Q, which was proposed pyrano[6',7'-b]pyran ring system into 6',7'-bifuran motif. All the isolates were characterized by analysis of HRESIMS, NMR spectroscopy and 1 was supported by X-ray crystallography analysis. The absolute stereochemistry of 1-9 were assigned by quantum chemical calculations. Biological evaluation of 1-9 showed that 5, 6, and 9 have significant anti-inflammatory potentials.

Spiroganodermaines A-G from Ganoderma species and their activities against insulin resistance and renal fibrosis.

Ganoderma mushrooms are a renowned Chinese medicine and functional food used worldwide. Seven undescribed spiro Ganoderma meroterpenoids spiroganodermaines A-G were isolated from Ganoderma species. Their structures were characterized by using spectroscopic, computational and X-ray diffraction methods. Biological studies showed that (+)-spiroganodermaine G significantly activates glucose uptake and IRS1 phosphorylation in insulin resistance C2C12 cells. Furthermore, (-)-spiroganodermaine G inhibits the expressions of fibronectin and α-SMA in TGF-ß1 induced NRK-52E cells. These findings demonstrate the potential of Ganoderma meroterpenoids as medicines and dietary supplements.

Alpha/Theta Ratio Neurofeedback Training for Attention Enhancement in Normal Developing Children: A Brief Report.

Attention plays an important role in children's development and learning, and neurofeedback training (NFT) has been proposed as a promising method to improve attention, mainly in population with attention problems such as attention deficit hyperactivity disorder. However, whether this approach has a positive effect on attention in normal developing children has been rarely investigated. This pilot study conducted ten sessions of alpha/theta ratio (ATR) NFT on eight primary students in school environment, with two to three sessions per week. The results showed inter-individual difference in NFT learning efficacy that was assessed by the slope of ATR over training sessions. In addition, the attention performance was significantly improved after NFT. Importantly, the improvement of attention performance was positively correlated with the NFT learning efficacy. It thus highlighted the need for optimizing ATR NFT protocol for the benefits on attention at the individual level. Future work can employ a double-blind placebo-controlled design with larger sample size to validate the benefits of ATR NFT for attention in normal developing children.

Zeaxanthin ameliorates obesity by activating the ß3-adrenergic receptor to stimulate inguinal fat thermogenesis and modulating the gut microbiota.

The stimulation of fat thermogenesis and modulation of the gut microbiota are promising therapeutic strategies against obesity. Zeaxanthin (ZEA), a carotenoid plant pigment, has been shown to prevent various diseases; however, the therapeutic mechanism for obesity remains unclear. Herein, whether ZEA improves obesity by activating the ß3-adrenergic receptor (ß3-AR) to stimulate white adipose tissue (WAT) thermogenesis and modulating the gut microbiota was investigated. C57BL6/N mice were fed a high-fat diet (HFD) supplemented with ZEA for 22 weeks. ZEA treatment reduced body weight, fat weight, adipocyte hypertrophy, liver weight, and lipid deposition, and improved dyslipidaemia, serum GPT, GOT, leptin, and irisin levels, glucose intolerance, and insulin resistance in HFD-fed mice. Mechanistically, ZEA treatment induced the expression of ß3-AR and thermogenic factors, such as PRDM16, PGC-1α, and UCP1, in inguinal WAT (iWAT) and brown adipose tissue. ZEA treatment stimulated iWAT thermogenesis through the synergistic cooperation of key organelles, which manifested as an increased expression of lipid droplet degradation factors (ATGL, CGI-58 and pHSL), mitochondrial biogenesis factors (Sirt1, Nrf2, Tfam, Nampt and Cyt-C), peroxisomal biogenesis factors (Pex16, Pex19 and Pmp70), and ß-oxidation factors (Cpt1, Cpt2, Acadm and Acox1). The thermogenic effect of ZEA was abolished by ß3-AR antagonist (SR59230A) treatment. Additionally, dietary supplementation with ZEA reversed gut microbiota dysbiosis by regulating the abundance of Firmicutes, Clostridia, Proteobacteria, and Desulfovibrio, which were associated with the thermogenesis- and obesity-associated indices by Spearman's correlation analysis. Functional analysis of the gut microbiota indicated that ZEA treatment significantly enriched the lipid metabolism pathways. These results demonstrate that ZEA is a promising multi-target functional food for the treatment of obesity by activating ß3-AR to stimulate iWAT thermogenesis, and modulating the gut microbiota.

The relationship of resting-state EEG oscillations to executive functions in middle childhood.

Executive functions (EFs) play important roles in children's development, but their neural mechanisms are rarely investigated, especially for the different components of EFs in middle childhood. Therefore, this study aimed to explore the links between resting-state EEG in the frontal scalp region and EFs in children aged 7-9 years. Fifty-nine typically developing children from the second and third grades performed two core EF tasks, i.e., inhibition and working memory, and a high-level EF task, i.e., planning, followed by the recording of EEG signals during eyes-open and eyes-closed resting states. The results showed that distinct EEG activities in the frontal scalp region predicted different EF components. More specifically, after controlling for age and verbal ability, alpha to theta power ratio (ATR) and beta to theta power ratio (BTR) during the eyes-open resting state positively predicted inhibition, and beta to theta power ratio (BTR) during the eyes-open resting state positively predicted planning. However, we did not find any EEG features related to working memory. Our results contributed to the understanding of inter-individual differences in EFs and provided insights into the regulation of corresponding EEG activities through EEG neurofeedback for enhancing children's EFs.

Generic Association Analysis on "Prescription-Formula-Dosage-Property" of Tibetan Medicine Based on Partial Order Structure and Property Theory / 中国实验方剂学杂志

Objective:In view of the complexity of the "Prescription-Formula-Dosage-Property" relationship of Tibetan medicine and the outstanding common relationship，it is difficult to reveal the hidden and specific rules of clinical medication of Tibetan medicine. Method:Based on the attribute partial order structure and the vector structure model of "Ro-Nus-Zhu-Rjes"（Taste，Post-Digestive Tastes and Potency），clustering analysis and other methods and software，this study analyzed the "Prescription-Formula-Dosage-Property" relationship of 184 commonly used prescriptions in the 1995 edition of the standards issued by the Ministry of Tibetan medicine（SIMTM）. Result:Among them，the analysis of the relationship between prescription and formula found that 11 prescriptions with the largest common attribute，such as Chebulae Fructus and Carthami Flos，were the key components of classification and compatibility，which could effectively classify the 8 kinds of prescriptions for the treatment of lung disease，tripa disease and blood fever. Among them，the san Yin and auxiliary viscera function prescriptions，such as Sanguotang powder and Liuwei Liangyao powder，had the strongest commonality. According to the analysis of relationship between formula and dosage ，the dosage of Chebulae Fructus，Carthami Flos，pomegranate seed，Phyllanthi Fructus was the highest，which suggested that these drugs were often used as primary drugs，while the Liuwei Liangyao powder，such as Amomi Fructus Rotundus and Tsaoko Fructus，had a higher frequency but a lower dose，which mainly played a role in regulating the overall drug property of the prescription and protecting the viscera. The Tibetan medicine-specific drugs including Moschus，Bovis Calculus，and Zhaxun，which were used in a high frequency but very low dose，had the effect of enhancing the drug property and guiding the affected part. According to the analysis of the relationship between dosage and property，there were many prescriptions belonging to cool nature，accounting for 75.6%. It was found that 67 prescriptions did not conform to the efficacy due to their different dosage. Conclusion:There are many common components and common usages in Tibetan medicine prescriptions. If these common associations are not treated，it will lead to the result that all diseases take these common associations as the core，but the hidden key factors cannot be solved. Therefore，it is necessary to pay attention to sensitivity and specificity at the multi-dimensional level of "prescription-formula-dosage-property"，so as to reveal the clinical medication thought of Tibetan medicine more effectively.

Construction of Tibetan Medicine Prescription Database for Treating "Gnyan-rims" and Analysis of Their Medication Law Based on Python Language / 中国实验方剂学杂志

Objective:To construct the database of Tibetan medicine prescriptions for "Gnyan-rims" disease， and to explore the invisible medication law of Tibetan medicine in the treatment of "Gnyan-rims" disease， such as prescription compatibility and combination of drug properties. Method:The prescriptions for treating "Gnyan-rims" were retrieved from four Tibetan medical literatures such as <italic>The Four Medical Tantras</italic>，<italic> Kong-sprul-zin-tig，</italic> <italic>Phyag-rdor-gso-rig-phyogs-bsgrigs</italic> and <italic>Sman-sbyor-lag-len-phyogs-bsgrigs</italic>， and the database was constructed under Python code， and the Apriori algorithm and the vector structure model of taste property flavor transformation were used for analysis. Result:According to the characteristics of Tibetan medicine prescription data， with six fields of prescription name， formula， dosage， efficacy， source and original text as the core， a Tibetan medicine treatment "Gnyan-rims" prescription database with functions of cleaning， searching and exporting was established. A total of 7 602 prescriptions were included in the database， among which 598 prescriptions had therapeutic effects of "Gnyan" and "Rims". The results of compatibility analysis showed that Shexiang， Hezi， Honghua， Mukuer Moyao， Tiebangchui， Tianzhuhuang and Bangga were the most frequently used drugs， while the correlation degrees of Shexiang-Mukuer Moyao， Honghua-Tianzhuhuang， Shexiang-Hezi and Shexiang-Tiebangchui were the strongest， and all the drug composition of Wuwei Shexiang pills appeared in the top ten correlations. According to the property analysis of 40 prescriptions containing high-frequency drugs， 19 prescriptions were found to have excessive bitter taste， followed by 9 prescriptions such as Sanchen powders with excessive sweetish taste， and the ratios of sweetish and bitter tastes in six tastes were >35%. The total of sweetish and bitter prescriptions accounted for 70% of the total prescriptions. Among the three flavors， the bitter flavor was the most abundant. The cool effect， dull effect and heavy effect were prominent among the seventeen effects. Conclusion:The prescription database of Tibetan medicine for "Gnyan-rims" can promote the high-quality development of research on prevention and treatment of plague with ethnic medicine. Tibetan medicine treatment of "Gnyan-rims" focuses on the composition of Wuwei Shexiang pills， with the property combination of "cool-bitter and sweet-bitter flavor-cool， dull and heavy"， which mainly treats diseases such as "heat sharp light-mkhris pa-heat". These studies can provide data basis and theoretical reference for the selection of Tibetan medicine prescription and its composition for treating plague.

Advances in Research on Different Compatibility Ratios of Coptidis Rhizoma-Evodia Fructus / 中国实验方剂学杂志

Coptidis Rhizoma-Evodia Fructus is a classic herb pair in traditional Chinese medicine prescriptions, the famous prescription is called Zuojinwan, which comes from Danxi Xinfa, is composed of Coptidis Rhizoma-Evodia Fructus (6∶1). In this formula, Coptidis Rhizoma has the effect of clearing heat and drying diuresis, purging fire to remove toxin and clearing heart. Evodia Fructus has the effects of expelling cold and alleviating pain, checking upward adverse flow of Qi tostop vomiting, and assisting yang to stop diarrhea. Coptidis Rhizoma has the properties of bitter and cold, and Evodia Fructus has the properties of pungent and calidus. Pungent drugs have divergent effects, and bitter drugs have sedimentation effect, when used in combination, they can clear the liver and purge fire, calm the adverse-rising energy and stop vomiting. On the basis of Zuojinwan, Coptidis Rhizoma-Evodia Fructus medicine has derived different compatibility ratios. Different ratios are different in terms of efficacy, usage, clinical application. Although with the application of modern analytical instruments and the development of molecular pharmacology theory, the chemical constituents and Pharmacological effects of Coptidis Rhizoma and Evodia Fructus have been fully studied, as to the principle of compatibility, and the study of pharmacological effects and chemical constituents after the compatibility of the two drugs in different proportions, there is still no comprehensive system summary. This article makes a systematic and comprehensive explanation of Coptidis Rhizoma-Evodia Fructus from the aspects of famous literature, chemical composition, pharmacological effects and clinical applicationthrough querying literature and ancient books. In order to make this herb pair more standardized, and provide reference materials for further research and development for this herb pair.

[Effect of Acupuncture on Reproductive Endocrine and p-Akt Protein Expression in Polycystic Ovary Syndrome Rats with Insulin Resistance].

OBJECTIVE: To observe the effect of manual acupuncture intervention on the reproductive endocrine and p-Akt protein expression in polycystic ovary syndrome with insulin resistance (PCOS-IR) rats, so as to reveal its mechanism in relieving PCOS-IR. METHODS: Female Wistar rats were randomly divided into control, model, medication (Metformin) and acupuncture groups (n＝8 in each). The PCOS-IR model was established by subcutaneous injection of Dehydroepiandrosterone (DHEA, 6 mg/100 g), once daily for 20 days. Rats of the medication group were treated by gavage of Metformin solution (100 mg/kg), once daily for 28 days. For rats of the acupuncture group, manual acupuncture stimulation (lifting-thrusting and rotating of needles) was applied to the bilateral "Shenshu"(BL 23), "Yishu"(EX-B 3), "Zigong" (EX-CA 1), "Sanyinjiao"(SP 6), "Fenglong"(ST 40) and "Guanyuan"(CV 4) for 5 min, once a day for 28 days. H．E. staining was used to observe the histopathologic changes of the ovary tissue. Serum levels of follicle-stimulating hormone (FSH), estradiol (E2), luteinizing hormone (LH), testosterone (T) and fasting insulin (FINS) were measured by ELISA. Fasting plasma glucose (FPG) was measured by blood glucose meter, and homeostasis model assessment-insulin resistance index (HOMA-IR) was calculated. Western blot was used to detect the expression of Akt and p-Akt proteins in ovarian tissues. RESULTS: Following modeling, the ovaries showed polycystic changes and an increase of atresia follicles with a larger diameter and no corpus luteum in the model group. After the intervention, there were various types of follicles and a small amount of corpus luteum at different stages of development in both acupuncture and medication groups. In comparison with the control group, serum FSH and E2 levels as well as ovarian Akt and p-Akt protein expression were considerably decreased (P<0.05, P<0.01), and serum LH, T and FINS contents and HOMA-IR were significantly increased in the model group (P<0.01). Following the intervention, the decreased serum FSH and E2 levels as well as ovarian Akt and p-Akt protein expression, and the increased serum LH, T and FINS contents and HOMA-IR were remarkably reversed in both acupuncture and medication groups (P<0.05，P<0.01), without significant differences between the two groups in the levels of those serum and ovary indexes (P>0.05)．. CONCLUSION: Acupuncture intervention can regulate the levels of reproductive endocrine hormones and reduce insulin resistance in PCOS-IR rats, which may be related to its effect in up- regulating the expression of p-Akt protein in the ovaries.

Biofeedback therapy for chronic pelvic pain syndrome.

AIM: To evaluate the efficacy of biofeedback therapy in patients with chronic pelvic pain syndrome (CPPS). METHODS: From November 2001 to April 2002, patients visiting the Urological Outpatient Clinic of this Hospital were evaluated by means of the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) and classified by the NIH classification standard. Sixty-two patients of CPPS category III were involved in this study. All patients had been treated by conventional approaches such as antibiotics and alpha-blockers for more than half a year without any improvement. The expressed prostatic secretion results were as follows: WBC 5 to 9/high power field, lipid + approximately +++ and bacterial culture negative. Their NIH-CPSI were 12 approximately 40. All the 62 cases complained of micturitional irritation (frequency, urgency, splitted stream and sense of residual urine), 32 cases, of pain or discomfort at the testicular, penile, scrotal, pelvic or rectal region and 13 cases, of white secretion-dripping. The patients were treated by the Urostym Biofeedback equipment (Laborie Co., Canada) 5 times a week for 2 weeks with a stimulus intensity of 15 mA approximatley 23 mA and duration of 20 minutes. RESULTS: Sixty patients were significantly improved or cured, while no significant improvement in the remaining 2. No apparent side effect was observed. The NIH-CPSI dropped to 6 to 14 with an average reduction of 21 (P<0.01). In the 60 improved cases, pain was relieved after 2 approximately 3 treatment courses and other symptoms disappeared after 4 approximately 5 courses. CONCLUSION: Biofeedback therapy is a safe and effective treatment for CPPS. Large randomized clinical trials are needed to confirm its efficacy and to explore the mechanism of action.