Chinese Herbal Medicine for Idiopathic Pulmonary Fibrosis: An Overview of Systematic Review.

Objective: To summarize the use of Chinese Herbal Medicines (CHMs) for Idiopathic Pulmonary Fibrosis (IPF) and provide high-level evidence for clinical decisions. Methods: We analyzed systematic reviews (SRs). Two English-language and three Chinese-language electronic databases were searched from inception to July 1, 2019. Published SRs and meta-analyses evaluating CHM use in IPF and reporting clinically-relevant outcomes such as lung function, PO2, and quality of life were eligible for inclusion in this overview. The methodological qualities of the included SRs were assessed by AMSTAR and ROBIS tools. Results: All reviews were published from 2008 to 2019. 15SRs were published in Chinese-language while 2 were in English. A total of 15550 participants were included. All intervention arms received CHM with or without conventional treatment and were compared with control arms with conventional treatment alone, or hormone therapy. Twelve SRs were assessed with low risk of bias while five were assessed high risk by ROBIS. The quality of evidence was assessed to be "moderate" or "low" or "very low" using GRADE. Conclusions: CHM has potential benefits for patients with IPF especially in improving lung function (forced vital capacity (FVC), total lung capacity (TLC), and diffusing capacity of the lungs for carbon monoxide (DLCO)), PO2 level, and the quality of life of patients. Due to the low methodological quality of reviews, our findings should be interpreted with caution.

Ginseng as a Key Immune Response Modulator in Chinese Medicine: From Antipandemic History to COVID-19 Management.

The cytokine storm plays an indispensable role in the severe and critical illness and death of the COVID-19 vulnerable population. Thus, suppressing the cytokine storm is of great significance. Ginseng is a traditional Chinese herb originally used for improving physiological conditions and ameliorating disease. Common throughout the history of ancient Chinese medicine is utilizing ginseng as a major ingredient to successfully fight various pandemics, and the most famous decoction is Renshen Baidu powder. In recent years, ginseng has been observed to provide preventive and therapeutic benefits in the treatment of various conditions by suppressing hyper-inflammation, inhibiting virus intrusion, and balancing the host's immunity. This paper summarizes the ancient Chinese medicine books' recordings of, the clinical practice of, and the laboratory exploration of ginseng for the treatment of pandemics and COVID-19. Ginseng and its active ingredients were found to downregulate inflammatory cytokines, upregulate anti-inflammatory cytokines, stimulate the secretion of the antiviral cytokine IFN-[Formula: see text], prevent viral entry and replication, and improve viral clearance. Furthermore, ginseng modulates both natural and acquired immunity during viral infection. Collectively, we propose that ginseng can act as a key immune response modulator against the cytokine storm of COVID-19. This paper may provide a new approach to discover specific medications using ginseng to combat COVID-19.

Danlou Tablet May Alleviate Vascular Injury Caused by Chronic Intermittent Hypoxia through Regulating FIH-1, HIF-1, and Angptl4.

Background: Danlou tablet (DLT), the traditional Chinese medicine has been commonly used for dyslipidemia, atherosclerosis, and coronary heart disease. Whether it was effective against vascular injury caused by CIH has remained unknown. The aim of the current study was to observe the effects of DLT on chronic intermittent hypoxia (CIH)-induced vascular injury via regulation of blood lipids and to explore potential mechanisms. Methods: Sixteen 12-week-old male ApoE-/- mice were randomly divided into four groups. The sham group was exposed to normal room air, whereas the other three groups were exposed to CIH. Mice in the CIH + normal saline (NS) group were gavaged with NS. Mice in the CIH + Angptl4-ab group were intraperitoneally injected with Angptl4-antibody. Mice in the CIH + DLT group were gavaged with DLT. After four weeks of intervention, serum lipid concentrations, and serum lipoprotein lipase (LPL) activity were detected. The changes in atherosclerosis in vascular tissue were detected by hematoxylin and eosin (H&E) staining. Quantitative real-time polymerase chain reaction (qRT-PCR) and Western blot analysis were applied to detect the expression levels of hypoxia-induciblefactor-1 (HIF-1), factor-inhibiting HIF-1 (FIH-1), angiopoietin-like 4 (Angptl4), and LPL in different tissues. Results: CIH exposure increases serum lipid levels, decreases serum LPL activity, and exacerbates atherosclerosis. Both Angptl4-ab and DLT treatment reversed the changes in lipid concentration, LPL activity, and atherosclerosis caused by CIH. In the epididymal fat pad, CIH exposure decreased the expression of FIH-1 and increased the expression of HIF-1, whereas DLT treatment increased the expression of FIH-1 and LPL and inhibited the expression of HIF-1 and Angptl4. In heart tissue, the expression levels of LPL and Angptl4 were not affected by modeling or treatment. Conclusions: DLT improved vascular damage by improving the increase in blood lipids induced by CIH, potentially by upregulating FIH-1 and downregulating HIF-1 and Angptl4 in adipose tissue. Therefore, DLT may be a promising agent for the prevention and treatment of CIH-induced vascular injury.

Integrating Chronic Obstructive Pulmonary Disease Treatment With 8-Week Tai Chi Chuan Practice: An Exploration of Mind-Body Intervention and Neural Mechanism.

Objective: This study aims to explore the effect of integrating routine treatment with Tai Chi Chuan (TCC) intervention on the clinical symptom of patients with Chronic Obstructive Pulmonary Disease (COPD) from clinical and neurological perspectives. Methods: Twenty patients with COPD were recruited for regular treatment combined with 8-week TCC rehabilitative practice. Clinical symptoms were evaluated by Chronic Obstructive Pulmonary Symptom Assessment Scale (CAT) and Modified Dyspnea Scale (mMRC) at baseline and after treatment. Resting-state MRI scan was also performed with multiline T2-weighted echo-planar imaging (EPI) to acquire their functional images before and after the treatment. TCC rehabilitation involved a total of 8 weeks of practice with 90 min per session, three times a week. Results: After an 8-week integration routine treatment with TCC practice, the patient's clinical symptoms improved significantly. Imaging analysis showed that COPD patients exhibited decreased Degree of Centrality (DC) in the right inferior frontal gyrus (IFG), right middle frontal gyrus, bilateral cingulate cortex, bilateral precuneus, and right precentral gyrus. Moreover, correlation analysis found that the decreased DC in the right IFG was positively correlated with the CAT improvements. Conclusion: The routine treatment involving TCC rehabilitation practice could improve the clinical symptoms of patients with COPD. The right IFG might be a key brain region to contribute to the neural mechanism underlying integrative intervention on the clinical symptoms in COPD. These findings provide neurological evidence for treating COPD rehabilitation practice with mind-body practice based on Chinese culture to some extent, which also advances the understanding of the efficacy of TCC as the adjuvant technology from a neuroscience perspective. Clinical Trial Registration: [http://www.chictr.org.cn/showproj.aspx?proj=45189], identifier [ChiCTR1900028335].

Danlou Tablet Improves Chronic Intermittent Hypoxia-Induced Dyslipidemia and Arteriosclerosis by HIF-1α-Angptl4 mRNA Signaling Pathway.

OBJECTIVE: To detect whether Danlou Tablet (DLT) regulates the hypoxia-induced factor (HIF)-1α-angiopoietin-like 4 (Angptl4) mRNA signaling pathway and explore the role of DLT in treating chronic intermittent hypoxia (CIH)-induced dyslipidemia and arteriosclerosis. METHODS: The mature adipocytes were obtained from 3T3-L1 cell culturation and allocated into 8 groups including control groups (Groups 1 and 5, 0.1 mL of cell culture grade water); DLT groups (Groups 2 and 6, 0.1 mL of 1,000 µg/mL DLT submicron powder solution); dimethyloxalylglycine (DMOG) groups (Groups 3 and 7, DMOG and 0.1 mL of cell culture grade water); DMOG plus DLT groups (Groups 4 and 8, DMOG and 0.1 mL of 1,000 µg/mL DLT submicron powder solution). Groups 1-4 used mature adipocytes and groups 5-8 used HIF-1 α-siRNA lentivirus-transfected mature adipocytes. After 24-h treatment, real-time polymerase chain reaction and Western blot were employed to determine the mRNA and protein expression levels of HIF-1 α and Angptl4. In animal experiments, the CIH model in ApoE-/- mice was established. Sixteen mice were complete randomly divided into 4 groups including sham group, CIH model group [intermittent hypoxia and normal saline (2 mL/time) gavage once a day]; Angptl4 Ab group [intermittent hypoxia and Angptl4 antibody (30 mg/kg) intraperitoneally injected every week]; DLT group [intermittent hypoxia and DLT (250 mg/kg) once a day], 4 mice in each group. After 4-week treatment, enzyme linked immunosorbent assay was used to detect the expression levels of serum total cholesterol (TC) and triglyceride (TG). Hematoxylin-eosin and CD68 staining were used to observe the morphological properties of arterial plaques. RESULTS: Angptl4 expression was dependent on HIF-1 α, with a reduction in mRNA expression and no response in protein level to DMOG or DLT treatment in relation to siHIF-1 α -transfected cells. DLT inhibited HIF-1 α and Angptl4 mRNA expression (P<0.05 or P<0.01) and reduced HIF-1 α and Angptl4 protein expressions with DMOG in mature adipocytes (all P<0.01), as the effect on HIF-1 α protein also existed in the presence of siHIF-1 α (P<0.01). ApoE-/- mice treated with CIH had increased TG and TC levels (all P<0.01) and atherosclerotic plaque. Angptl4 antibody and DLT both reduce TG and TC levels (all P<0.01), as well as reducing atherosclerotic plaque areas, narrowing arterial wall thickness and alleviating atherosclerotic lesion symptoms to some extent. CONCLUSION: DLT had positive effects in improving dyslipidemia and arteriosclerosis by inhibiting Angptl4 protein level through HIF-1 α-Angptl4 mRNA signaling pathway.

Traditional Chinese exercise for COVID-19: A protocol for systematic review and meta-analysis.

BACKGROUND: A new type of coronavirus (COVID-19), is spreading all over the world. Under the background of the comprehensive medical treatment and strict prevention and control in China, the number of discharged patients increased substantially. By the end of July, more than 80,000 patients had been cured and discharged from hospital in China. In order to effectively promote the full recovery of the patient's physical and mental functions and quality of life, gradually shift the emphasis of clinical work to convalescence therapy is very important, thus Chinese experts draw up Expert Consensus on Rehabilitation of Chinese Medicine for COVID-19. This systematic review and meta-analysis will assess studies of the effects of traditional Chinese exercise (TCE) for COVID-19 patients. METHODS AND ANALYSIS: We will search 6 English and 4 Chinese databases by 01, December 2020. After a series of screening, Randomized Clinic Trials (RCTs) will be included related to TCE for COVID-19. Two assessors will use the Cochrane bias risk assessment tool to assess the RCTs. Finally, the evidence grade of the results will be evaluated. RESULTS: This study will provide a reliable evidence for the selection of TCE therapies for COVID-19. CONCLUSION: The results of this study will provide references for the selection of TCE treatment for COVID-19, and provide decision making references for clinical research. PROSPERO REGISTRATION NUMBER: CRD42020179095.

The Impact of Natural Product Dietary Supplements on Patients with Gout: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Natural product dietary supplements (NPDS) are frequently used for the treatment of gout, but reliable efficacy and safety data are generally lacking or not well organized to guide clinical decision making. This review aims to explore the impacts of NPDS for patients with gout. An electronic literature search was conducted to retrieve data published in English language from databases from inception to August 14, 2019. Randomized controlled trials (RCTs) that compared NPDS with or without placebo, diet modification, conventional pharmaceutics, or the other Chinese medicine treatment for gout patients were included. Two authors screened the articles, extracted the data, and assessed the risk of bias of each included trial independently. Meta-analysis was performed using Review Manager version 5.3.5. Results. Nine RCTS were enrolled in this review. The methodological quality of the nine RCTs was poor. The study results showed that in the majority of trials, NPDS demonstrated some degree of therapeutic efficacy for joint swelling, pain, and activity limitation. In contradistinction, serum uric acid (SUA) level (SMD -1.80, 95% CI: -4.45 to 0.86) (p > 0.05) and CRP levels (N = 232; SMD, -0.26; 95% CI, -0.55 to 0.04) (p > 0.05) did not improve significantly. The incidence of adverse events (AEs) was not lower in the participants treated with NPDS (N = 750; RR, 0.47; 95% CI, 0.20-1.11) (p > 0.05). Conclusion. Current existing evidence is not sufficient to provide clinical guidance regarding the efficacy and safety of NPDS as a treatment for gout due to poor trial quality and lack of standardized evaluation criteria. Larger and more rigorously designed RCTs are needed in the future.

Linking endotypes to omics profiles in difficult-to-control asthma using the diagnostic Chinese medicine syndrome differentiation algorithm.

Objective: Patients with difficult-to-control asthma have difficulty breathing almost all of the time, even leading to life-threatening asthma attacks. However, only few diagnostic markers for this disease have been identified. We aimed to take advantage of unique Chinese medicine theories for phenotypic classification and to explore molecular signatures in difficult-to-control asthma. Methods: The Chinese medicine syndrome differentiation algorithm (CMSDA) is a syndrome-scoring classification method based on the Chinese medicine overall observation theory. Patients with difficult-to-control asthma were classified into Cold- and Hot-pattern groups according to the CMSDA. DNA methylation and metabolomic profiles were obtained using Infinium Human Methylation 450 BeadChip and gas chromatography-mass spectrometer. Subsequently, an integrated bioinformatics analysis was performed to compare those two patterns and identify Cold/Hot-associated candidates, followed by functional validation studies. Results: A total of 20 patients with difficult-to-control asthma were enrolled in the study. Ten were grouped as Cold and 10 as Hot according to the CMSDA. We identified distinct whole-genome DNA methylation and metabolomic profiles between Cold- and Hot-pattern groups. ALDH3A1 gene exhibited variations in the DNA methylation probe cg10791966, while two metabolic pathways were associated with those two patterns. Conclusions: Our study introduced a novel diagnostic classification approach, the CMSDA, for difficult-to-control asthma. This is an alternative way to categorize diverse syndromes and link endotypes with omics profiles of this disease. ALDH3A1 might be a potential biomarker for precision diagnosis of difficult-to-control asthma.

[Technical specification of expert consensus statement in developing clinical practice guidelines of traditional Chinese medicine].

The formation of expert consensus statement is an indispensable part in the process of developing clinical practice guidelines. The Guidelines International Network believes that experts make group decisions for different stages and issues,and the process of gathering expert opinions is the process of reaching the consensus. GRADE system also requires that recommendations should be formed based on expert consensus in consideration of the risk and bias,patients' preferences and values,resources and other factors. At present,the main method for reaching consensus is the formal consensus method. According to the published clinical guidelines,most of them failed to report the specific methods and process of reaching expert consensus. Therefore,it is impossible to obtain an objective evaluation. This phenomenon is more common in the field of clinical practice guidelines of traditional Chinese medicine( TCM). There are two main reasons for this phenomenon. For one thing,the developers of the guidelines neglect the importance of transparency and objectivity in the implementation of expert consensus. For another,they know little about the methods and technical specifications for the formation of expert consensus. To solve them,based on the internationally recognized consensus-building methods,as well as the specific stages in the process of developing clinical practice guidelines of traditional Chinese medicine,it is of great significance to put forward the technical norms for TCM researchers to develop the expert consensus. This guide will provide detailed guidance for forming the expert consensus for TCM clinical practice guideline. This guideline has been approved and published by the Chinese Association of Traditional Chinese Medicine( No. T/CACM 1049-2017).

Tai Chi for patients with mild cognitive impairment: A protocol for a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Mild cognitive impairment (MCI) is an intermediate stage between the cognitive changes of normal aging and early dementia. Tai Chi (TC) may be particularly beneficial to patients with MCI due to its whole-body coordination characteristics. This systematic review protocol aims to outline the methods that will be used to assess the comparative effectiveness and safety of TC for MCI through a systematic review and meta-analysis. METHODS: A systematic review will identify and evaluate randomized controlled trials (RCTs) that examined the effects and safety of TC compared to a placebo, conventional treatment, and no treatment on cognitive function in individuals with MCI. Studies from databases of MEDLINE, PubMed, Embase, Global Health, Cochrane Library, and Scopus from January 1990 to March 2019 reported in English will be searched. Two independent reviewers will screen the studies for inclusion with the eligibility criteria and extract data. Risk of bias of individual studies will be assessed in line with Cochrane risk of bias tool. The overall quality of cumulative evidence will be assessed using selected Grading of Recommendations, Assessment, Development, and Evaluations criteria. Statistics will be used for heterogeneity assessment, sensitivity analysis, data synthesis, generating funnel plots, and subgroup analysis. Meta-analysis will be performed, if sufficiently homogeneous studies are found. A narrative synthesis will be conducted, grouping studies by exposure and outcome definitions, and describing any differences by subgroups. RESULTS: This study will provide practical and targeted evidence in investigating the impact of TC exercise for individuals with MCI. CONCLUSION: The findings of our study will provide updated evidence to determine whether TC is an effective intervention to patients with MCI. TRIAL REGISTRATION NUMBER: International Prospective Register for Systematic Reviews (PROSPERO) number CRD42019125104.

[Clinical application evaluation and revision suggestions of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for acute pharyngitis].

The purpose of this study is to analyze the obstructive factors of clinical practice guideline on traditional Chinese medicine therapy alone or combined with antibiotics for acute pharyngitis, and summarize the revision suggestions for follow-up revision and promotion. Clinical physicians from 181 hospitals in 27 regions of China were selected to complete the online questionnaire survey for statistical analysis of obstructive factors. We collected 501 copies of the applicability evaluation questionnaire and 503 copies of the application evaluation questionnaire. The obstructive factors mainly focused on limitation of the Guideline, inconvenience of access, particularity of primary medical structure and uneven distribution of surveyed subjects. As for amendments, it was suggested to improve the syndrome differentiation, indications, prescriptions, and add characteristic TCM therapies in Chinese medicine; it was suggested to clarify the time to use antibiotics in Western medicine. According to the results of this study, the relevant contents of the Guideline should be further improved so as to be better applied in clinical practice.

[Advantages and problems of traditional Chinese medicine in treatment of acute pharyngitis].

This paper systematically studies relevant literatures at home and abroad in recent years. China National Knowledge Internet (CNKI) was used to collect the literatures for acute pharyngitis treated with traditional Chinese medicine from January 1, 2006, to December 31, 2016, and the bibliometric method was employed for statistical analysis. A total of 493 papers were preliminarily selected. According to the inclusion criteria and exclusion criteria, 182 eligible articles were selected. According to the evaluation and analysis of the literatures, the Guidelines for Clinical Research of New Drugs is currently used as the common standards for the diagnosis and treatment of acute pharyngitis; Chinese patent medicines are the main traditional Chinese medicine for treating this disease; Decoctions for treatment of this disease include Lonicerae Japonicae Flos, Scutellariae Radix, Platycodonis Radix, Forsythiae Fructus, Glycyrrhizae Radix et Rhizoma, Scrophdlariae Radix, Isatidis Radix, and Ophiopogonis Radix; The bloodletting puncture is the common external therapy. Traditional Chinese medicine and Western medicine have their own characteristics in the treatment of this disease. Western medicine for the treatment of acute pharyngitis are mainly antiviral, antibiotic and glucocorticoid drugs, whose disadvantages are toxicity, side effects, drug resistance and double infections. Traditional Chinese medicine doctors have rich experiences in the treatment of the disease, which is characterized by treatment determination based on syndrome differentiation, safe and reliable medication, significant curative effect, low drug resistance, and wide varieties of traditional Chinese medicine forms, convenient portability and taking, low price, and low toxic and side effects. It is an arduous and significant task to explore traditional Chinese medicine, and study and develop new-type effective drugs.

Patient feedback for acupuncture practice improvement: A survey from Mayo Clinic.

OBJECTIVE: To understand patient satisfaction with acupuncture appointment duration for the first and subsequent appointments in the plan of care, time spent with the acupuncture provider, willingness to pay for longer duration appointments, and lack of insurance coverage. METHODS: Patients who were referred for an acupuncture consult to the Center for Integrative Medicine at Mayo Clinic were asked to participate in the survey in August 2014. Patients were given paper survey at time of appointment check-in and entered into Research Electronic Data Capture Survey database tool to reveal patient-reported outcomes. RESULTS: In total, 104 of 329 patients receiving acupuncture treatment responded to the survey with a 32% response rate. Insight and recommended changes to the duration of the initial and subsequent appointments were obtained. Most patients reported that time spent with the provider (76 cases, 74%) and appointment length (74 cases, 68%) were "just right". Seventy cases (70%) of respondents indicated that they wanted longer treatment. Patients reported return appointments with duration of 30 min was not enough. Fifty-three patients (62%) were willing to pay for additional costs not covered by insurance. CONCLUSIONS: We used patient feedback to assess the acupuncture practice in a complementary and integrative medicine program. Most patients referred for the acupuncture consult appeared to be satisfied with the current level of practice. These findings were used to establish a quality improvement plan that may be implemented to improve patient satisfaction with the acupuncture practice.

Complementary and alternative medicine therapies for chronic pain.

Pain afflflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine (herbs, acupuncture, meditation, etc.) called complementary and alternative medicine (CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies-including risks and benefits-will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patient who is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.

Complementary and Integrative Medicine at Mayo Clinic.

Complementary and alternative medicine (CAM) has gained acceptance throughout the industrialized world. The present study was performed to provide information about the use of CAM at Mayo Clinic, an academic medical center in Northern Midwest of the US. We retrospectively reviewed the electronic medical records of 2680 patients visiting the CAM program at Mayo Clinic, Rochester, between 1 July 2006 and 31 March 2011. Services provided included acupuncture, massage, integrative medical consultations and executive stress management training. Data including age, gender, race, diagnosis and the number of treatment/consultation sessions were collected to describe the use of CAM in our institute over the last several years. It was found that the mean (standard deviation) age of patient was 52.6 (15.5) years. Of those, 73.1% were female and 26.9% were male. Most patients were white. The number of patients referred to CAM increased significantly from 2007 to 2010. The three most common diagnostic categories were back pain (12.9%), psychological disorders (11.8%), and joint pain (9.6%). Back pain was the most common diagnosis for patients receiving acupuncture, and fibromyalgia was the most common for patients receiving massage therapy. Psychological disorders (i.e., stress) were the major diagnosis referred to both integrative medical consults and executive stress management training. These results suggest that the diseases related to pain and psychological disorders are the main fields of CAM use. It also shows the increasing trend of the use of CAM at an academic medical center in the US.

Promoting health wellness-The essentials of Chinese medicine.

Chinese medicine is a healing medicine which respect the power of human body itself. The essentials of Chinese medicine is promoting health wellness instead of disease management. Modern medicine just realized the limits of its theory. P4 medicine (personalized, predictive, preventive, and participatory/precision) similar to Chinese medicine theory is beginning to representing the pioneer in the Western world. In this review, we summarized different domains of Chinese medicine. Based on the basic of promoting health wellness, we compared the fundamental theory of Chinese medicine to the new merging P4 medicine idea of Western medicine. We also discussed the potential for using modern computational medicine technique to integrate Chinese medicine theory and Western medicine theory.

The Comparative Study on Expression of SIRT1 Signal Transduction by Xuefuzhuyu Capsule.

The Xuefuzhuyu capsule (XFZY) is widely used for the treatment of ischemic heart disease (IHD) in China. We previously demonstrated that XFZY could reduce apoptosis in Sprague-Dawley rat cardiomyocytes with the similar effect of resveratrol (Res) Hori et al. (2013), although its molecular mechanism underlying this protective effect is still unclear. Silent information regulator of transcription 1 (SIRT1) had been demonstrated to be responsible for cardioprotection against ischemia-reperfusion injury via long-term transcriptionally regulatory mechanism Braunersreuther and Jaquet (2012). Therefore, in the present study, we aimed to test if XFZY might contribute to the protection of ischemic myocardial cells induced by ischemia through SIRT1-mediated signal transduction pathway by using electron micrograph, RT-PCR assay, and western-blot test. All the result showed that the target genes of SIRT1 pathway including P53, NF-kB, FOXO1, FOXO3, and FOXO4 were significantly downregulated to SIRT1, suggesting that apoptosis pathway might transcriptionally be regulated to SIRT1. In addition, the expression level of SIRT1 was significantly increased by XFZ, it might prove that SIRT1 is the target of XFZY working on ischemia heart disease. Our findings supported that XFZY might function to protect myocardial cells and reduce myocardial injury though SIRT1 signaling pathway and has the same pharmacological effect with Res.

Efficacy of acupuncture for chronic constipation: a systematic review.

This study was to evaluate the efficacy and safety of acupuncture for chronic functional constipation. Randomized controlled trials were searched in several databases. The primary outcome was a change in the number of weekly spontaneous bowel movements. The secondary outcomes included colonic transit activity, effective rate, Cleveland Clinic Score, and health-related quality of life score. Meta-analysis was done by using RevMan 5.1. After strict screening, 15 RCTs were included, containing 1256 participants. All of them were conducted in China and published in Chinese journals. Meta-analysis indicated that acupuncture for chronic functional constipation was probably as effective as conventional medical therapy in the change of bowel movements. For the colonic transit activity, acupuncture might be the same as conventional medical therapy and could be better than sham acupuncture. For the Cleveland Clinic Score, acupuncture was unlikely inferior to conventional medical therapy and the deep acupuncture was better than normal depth acupuncture in abdominal region. No obvious adverse event was associated with acupuncture for constipation. In conclusion, acupuncture for chronic functional constipation is safe and may improve weekly spontaneous bowel movements, quality of life, and relevant symptoms. However, the evidence was limited by the small sample size and the methodological quality.

[Study on relationship between quantitative data of tongue picture and state of illness in 224 patients with severe acute respiratory syndrome].

OBJECTIVE: To observe the characteristics of tongue proper and tongue coating in patients with severe acute respiratory syndrome (SARS) and to explore the relationship between tongue picture and state of illness. METHODS: Tongue picture was taken by digital camera and colors (red, green and blue) of tongue proper and coating were analyzed quantitatively with image processing software. RESULTS: In the 69 patients of acute stage, the color of tongue proper was mostly light red (51 patients, 73.9%), with significant difference in comparing with other colors (P < 0.01). The color of tongue coating was mostly thin yellow (32 patients, 46.4%), and thin white was the second (29 patients, 42.0%). There was swollen tongue body in 5 patients (7.2%), teeth print on tongue margin in 12 cases (17.4%). In the 155 patients of recovery stage, the color of tongue proper was mostly dark pale (72 patients, 46.5%), the second light red (68 patients, 43.9%), color of tongue coating was mostly thin white (80 patients, 51.6%), which was significantly higher than other colors (P < 0.01), the second was yellow in tongue root region (31 patients, 20.0%). Swollen tongue body was found in 23 patients (14.8%) and teeth print on margin was found in 19 patients (12.3%). Most patients of ordinary state had light red tongue proper and thin white coating, patients of severe state mostly had dark pale tongue proper and yellow coating in root region, and the critical patients were mostly with dark pale proper and thick yellow coating. Patients with affected lung > or = 3 lobules mostly had pale dark proper and yellow coating on root, but those with involved lung < 3 lobules mostly had light red proper and thin white coating. CONCLUSION: The colors detected quantitatively by the method described above could comparatively reflect the difference of tongue proper and coating sensitively. Tongue picture is one of the objective evidence for judging state of illness and Syndrome Differentiation based on treatment in SARS patients.