The effect of Tai Chi lower extremity exercise on the balance control of older adults in assistant living communities.

BACKGROUND: Although Tai Chi (TC) is an evidence-based fall prevention training for older adults, its effective movements remain unclear, which may limit the practice of TC. The purpose of this study was to compare the effectiveness of TC lower extremity exercise (TC LEE), the 8-form Tai Chi (8-form TC), and a stretching control intervention for improving balance and functional mobility among older adults. METHODS: This was a randomized controlled trial. A total of 102 participants (79 ± 6 years old) were recruited from assisted living facilities. All participants were randomly assigned to the TC LEE (n = 40), 8-form TC (n = 31), and stretching (n = 31) groups in which they received the respective interventions for 16 weeks. The Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and center of pressure (COP) measurements during quiet stance were collected prior to and following the 16-week interventions. Comparisons on all measurements were conducted among all groups. RESULTS: Significant improvements were found in BBS (P = 0.002), TUG test (P = 0.001), root mean square amplitude of COP displacement in the anterior-posterior (P = 0.001) and medial-lateral (P = 0.001) directions, and average COP speed in the anterior-posterior (P = 0.001) and medial-lateral (P = 0.001) directions after training in the TC intervention groups compared with the stretching group. The upper limit of the 95% confidence interval (CI) of differences in change scores on the BBS (-0.8 - 1.3 points) between the TC LEE group and the 8-form TC group was within equivalence margins (1.8 points), while the upper limit of the 95% CI of differences in change scores on the TUG test (0.1 - 2.1 s) exceeded the equivalence margin (0.7 s) with the TC LEE group having the larger change scores. CONCLUSION: TC LEE can improve balance and functional mobility in older adults, and may have greater effect than the 8-form TC on improving functional mobility as measured by the TUG test. TRIAL REGISTRATION: ChiCTR2300070600 retrospectively registered.

Tai Chi counteracts age-related somatosensation and postural control declines among older adults.

Objective: To investigate the effect of a 16-week Tai Chi practice on strength, tactile sensation, kinesthesia, and static postural control among older adults of different age groups. Methods: This is a quasi-experimental study. Thirteen participants aged 60-69 years (60-69yr), 11 aged 70-79 years (70-79yr), and 13 aged 80-89 years (80-89yr) completed 16 weeks of 24-form Tai Chi practice. Their ankle and hip peak torque, tactile sensation, ankle and knee kinesthesia, and the root mean square of the center of pressure (Cop-RMS) were measured before (week 0) and after (week 17) practice. Results: 80-89yr showed less ankle plantar/dorsiflexion and hip abduction peak torques (p = 0.003, p < 0.001, p = 0.001), and a greater ankle plantar/dorsiflexion kinesthesia (p < 0.001, p = 0.002) than 60-69yr and 70-79yr. Greater ankle plantar/dorsiflexion and hip abduction torques (p = 0.011, p < 0.001, p = 0.045), improved arch and heel tactile sensation (p = 0.040, p = 0.009), and lower knee flexion/extension kinesthesia (p < 0.001, p = 0.044) were observed at week 17. The significant group*practice interaction for the fifth metatarsal head tactile sensation (p = 0.027), ankle plantar/dorsiflexion kinesthesia (p < 0.001, p = 0.004), and the CoP-RMS in the mediolateral direction (p = 0.047) only in 80-89yr revealed greater improvement at week 17. Conclusion: Tai Chi practice increased strength, tactile sensation, kinesthesia, and static postural control among older adults. Tai Chi practice improved tactile, kinesthesia sensations, and static postural control among older adults over 80, who presented with worse strength and kinesthesia than their younger counterparts. Tai Chi practice offers a safe exercise option for those aged over 80 to encourage improvements in sensorimotor control.

Confirmation of pain-related neuromodulation mechanism of Bushen Zhuangjin Decoction on knee osteoarthritis.

ETHNOPHARMACOLOGICAL RELEVANCE: Bushen Zhuangjin Decoction (BZD) are an herbal compound commonly used to treat osteoarthritis (OA) in China. AIM OF THE STUDY: This study aimed to verify the mechanism of Bushen Zhuangjin Decoction in relieving the pain of knee osteoarthritis. MATERIALS AND METHODS: Network pharmacology evaluation was used to discover the potential targets of BZD to relieve pain in KOA. The therapeutic effects of BZD treatment on KOA pain using histomorphology, behavioral assessments, suspension chip analysis, and ultra-high performance liquid chromatography/tandem mass spectrometry (UHPLC-MS/MS) assays. The functional magnetic resonance imaging was used to explore the effects of BZD treatment on brain function associated to KOA. RESULTS: Network pharmacological analysis revealed the association between the analgesic effect of BZD on KOA and the pain signaling neurotransmitter 5-HT. Subsequently, we conducted experiments to verify the therapeutic effect of BZD on pain in KOA animal models. Behavioral tests demonstrated that the pain threshold of knee osteoarthritis rats decreased in PWT and PWL, but BZD was able to increase the pain threshold. Histopathological staining indicated thinning of the cartilage layer and sparse trabeculae in the subchondral bone. Suspension chip analysis revealed a significant increase in pro-inflammatory factors of IL-1α, IL-5, IL-12, IL-17A, RANTES, TNF-α and M-CSF in KOA, along with a significant decrease in anti-inflammatory factor of IL-13. However, BZD treatment decreased the expression of pro-inflammatory factors and increased the content of anti-inflammatory factor. UHPLC-MS/MS analysis showed a significant decrease in the serum levels of GABA, E, GSH, Kyn, Met, and VMA in KOA, which were significantly increased by BZD. Conversely, the serum levels of TrpA, TyrA, Spd, and BALa were significantly increased in KOA and significantly decreased by BZD. ELISA and Western blot analysis showed increased expression of subchondral bone pain-related neuropeptides SP, CGRP, TH, NPY, VEGFA, 5-HT3 in KOA, which were decreased in BZD. Functional magnetic resonance imaging demonstrated that BZD exerts its therapeutic effect on KOA by modulating the activity and functional connections of the cortex, hypothalamus, and hippocampus. CONCLUSIONS: This study confirmed the significant role of pain-related neuromodulation mechanisms in the analgesic therapy of BZD and provides a theoretical foundation for using BZD as a traditional Chinese medical treatment for KOA pain.

Muscle co-contraction and pre-activation in knee and ankle joint during a typical Tai Chi brush-knee twist-step.

This study aimed to investigate the co-contraction and pre-activation of agonistic and antagonistic muscles in experienced Tai Chi (TC) practitioners during normal walking (NW) and brush-knee twist-step (BKTS). The electromyographic activities of rectus femoris, biceps femoris, and tibialis anterior and lateral gastrocnemius muscles were collected during BKTS and NW in 28 TC practitioners. The pre-activation of knee and ankle joints before initial landing of left foot, and the co-contraction of knee and ankle joint in double-stance phase I (DSI), single-stance phase (SS), double-stance phase II (DSII), and swing phase (SW) were calculated during BKTS and NW. Ankle co-contraction significantly increased during DSI and SS in BKTS movements than compared with that in NW. For DSI and SW, SS and DSII, and DSII and SW, a significant difference was found in BKTS. The pre-activation of knee joint significantly decreased in BKTS and NW. This study indicated greater ankle joint muscle co-contraction in DSI and SS of stance phase and lower knee joint muscle co-contraction and pre-activation than in NW in BKTS movement. In addition, greater ankle joint muscle co-contraction was observed in the DSI, SS, and DSII of stance phase than those of swing phase in BKTS movement.

Tai Chi practice enables prefrontal cortex bilateral activation and gait performance prioritization during dual-task negotiating obstacle in older adults.

Background: With aging, the cognitive function of the prefrontal cortex (PFC) declined, postural control weakened, and fall risk increased. As a mind-body exercise, regular Tai Chi practice could improve postural control and effectively prevent falls; however, underlying brain mechanisms remained unclear, which were shed light on by analyzing the effect of Tai Chi on the PFC in older adults by means of functional near-infrared spectroscopy (fNIRS). Methods: 36 healthy older adults without Tai Chi experience were divided randomly into Tai Chi group and Control group. The experiment was conducted four times per week for 16 weeks; 27 participants remained and completed the experiment. Negotiating obstacle task (NOT) and negotiating obstacle with cognitive task (NOCT) were performed pre- and post-intervention, and Brodmann area 10 (BA10) was detected using fNIRS for hemodynamic response. A three-dimensional motion capture system measured walking speed. Results: After intervention in the Tai Chi group under NOCT, the HbO2 concentration change value (ΔHbO2) in BA10 was significantly greater (right BA10: p = 0.002, left BA10: p = 0.001), walking speed was significantly faster (p = 0.040), and dual-task cost was significantly lower than pre-intervention (p = 0.047). ΔHbO2 in BA10 under NOCT was negatively correlated with dual-task cost (right BA10: r = -0.443, p = 0.021, left BA10: r = -0.448, p = 0.019). There were strong negative correlations between ΔHbO2 and ΔHbR under NOCT either pre-intervention (left PFC r = -0.841, p < 0.001; right PFC r = -0.795, p < 0.001) or post-intervention (left PFC r = -0.842, p < 0.001; right PFC r = -0.744, p < 0.001). Conclusion: Tai Chi practice might increase the cognitive resources in older adults through the PFC bilateral activation to prioritize gait performance during negotiating obstacles under a dual-task condition.

Exploring the effects of peripheral sensibility on visuospatial and postural capacities during goal-directed movements in long-term Tai Chi practitioners.

Background: Falls are directly related to visuospatial ability and postural stability. Perturbations of upper body movements pose a challenge to older adults and may cause falls. This study investigated visuospatial ability and postural stability during goal-directed upper body movements between the Tai Chi and control groups and tried to connect them with their sensations. Materials and methods: Thirty-seven older adults were recruited to perform the touch (TT) and blind touch (BTT) tasks. The target positioning error (TPE), ankle proprioception, tactile sensation, time to stabilization (TTS), and maximum displacement (Dmax) of the center of pressure trajectory were compared between the groups during the tasks. The relationships of visuospatial ability and postural stability to proprioception and tactile sensation were investigated. Results: Dmax in the mediolateral (DmaxML) direction decreased during BTT compared to TT among the Tai Chi group but not the control group. Compared to the control group, less Dmax in the anterio-posterior (DmaxAP) direction, and shorter TTS in AP/ML (TTSAP/TTSML) directions were observed among the Tai Chi group. Compared to TT, DmaxAP decreased during the BTT. The Tai Chi group had less TPE in the vertical (TPEV) direction and in three-dimensional space. Among the Tai Chi group, TPEV, TTSML, and DmaxAP were correlated to their proprioception during plantarflexion; TTSAP was correlated to tactile sensation at the great toe during the TT and BTT; DmaxAP was correlated to tactile sensation at the great toe during the TT. Among the control group, TTSML was correlated to ankle proprioception during dorsiflexion and plantarflexion during the BTT. Conclusion: Long-term Tai Chi practitioners exhibited superior visuospatial ability and postural stability during goal-directed upper body movements, which was associated with sensitive proprioception and tactile sensation.

Effects of Tai Chi on the neuromuscular function of the patients with functional ankle instability: a study protocol for a randomized controlled trial.

BACKGROUND: Ankle instability limits physical activities and undermines a person's quality of life. Tai Chi's health benefits have been reported in different population groups. However, the effects of Tai Chi on neuromuscular function among young adults with functional ankle instability (FAI) remain unclear. Therefore, we aim to investigate the effect of Tai Chi on young adults with FAI. METHODS: This study will be conducted as a randomized controlled trial with blinded assessors. A total of 104 young adults with FAI will be recruited and randomly assigned to intervention and control groups. The participants in the simplified Tai Chi exercise program (STCEP) group will receive a 12-week Tai Chi training. The participants in the control group will receive a low-intensity exercise program and health education for 12 weeks. The primary and secondary outcomes will be assessed at baseline, 4th, 8th, and 12th weeks. Primary outcome measures will include the Cumberland Ankle Instability Tool (CAIT) score, kinematics/kinetics data, electromyography during single-leg landing tasks, and the modified Star Excursion Balance Test (mSEBT). Secondary outcome measures will include the total time of Dynamic Leap and Balance Test (DLBT), ankle muscle strength, and ankle proprioception. DISCUSSION: This study will investigate the effects of Tai Chi exercise on the neuromuscular function of patients with FAI, as indicated by ankle joint biomechanics, ankle proprioception, balance, ankle muscle strength, and ankle muscle activation. Results will demonstrate that Tai Chi can be an effective exercise for young adults with FAI. TRIAL REGISTRATION: Chinese Clinical Trial Registry ChiCTR2100044089 . Registered on 10 March 2021.

Effects of Eight Methods and Five Steps of Tai Chi Practice on Balance Control Among Older Adults.

The team developed the newly compiled eight methods and five steps of Tai Chi (EMFSTC), which includes introductory routines to Tai Chi characterized by simple structures. This study examined the effectiveness of EMFSTC practice on balance control. A total of 31 participants were randomly assigned to EMFSTC (n = 15, age = 66.4 ± 1.7 years, received 16-week EMFSTC practice) or control (n = 16, age = 66.7 ± 1.8 years, received no practice) groups. Significant group by training interactions were observed. After EMFSTC practice, balance control improved, as indicated by decreased root mean square and mean velocity of center of pressure, proprioception threshold during knee extension, and plantar tactile sensitivity threshold at the arch. EMFSCT can be an effective rehabilitation modality to improve balance control among older adults.

Effects of a 16-week Tai Chi intervention on cutaneous sensitivity and proprioception among older adults with and without sensory loss.

This study investigated the effects of a 16-week Tai Chi (TC) intervention on cutaneous sensitivity and proprioception among older adults with and without sensory loss. Thirty-six older adults were divided into sensory loss and control groups, and they underwent a 16-week TC intervention. Significant interactions were detected in heel cutaneous sensitivity (p = 0.046, F = 4.419) and knee flexion (p = 0.043, F = 4.580), extension (p = 0.027, F = 5.529) and ankle plantar-flexion proprioception (p = 0.037, F = 4.860). The post hoc test indicated that in the sensory loss group, heel cutaneous sensitivity threshold (p = 0.034) and knee flexion (p = 0.004), extension (p = 0.002) and ankle plantar-flexion (p = 0.023) proprioception threshold decreased at week 17, whereas in the control group, knee flexion (p = 0.029) proprioception threshold decreased at week 17. TC intervention improved cutaneous sensitivity at more sites and proprioception in more joints among the older adults with sensory loss. TC intervention is a good option for older adults to exercise, and it is more effective among older adults with sensory loss.

[Evaluation of taste changes of Scutellariae Radix before and after wine-frying based on electronic ongue technology and its application in identification of Scutellariae Radix pieces].

Scutellariae Radix(Huangqin) is a well-known traditional Chinese medicine(TCM) used for the treatment of clearing heat in clinical application. It is bitter-cold by using directly, but the bitter-cold property can be relieved after wine-frying. The study of taste changes before and after wine-frying of Scutellariae Radix is of great significance in identifying Scutellariae Radix and wine-processed Scutellariae Radix and clarifying the traditional theory of wine-processing. In this experiment, 10 batches of Scutellariae Radix and wine-processed Scutellariae Radix were prepared. The contents of 5 flavonoids were determined by high performance liquid chromatography(HPLC), and principal component analysis(PCA) was performed with 5 flavonoids as variables. As a result, the contents were different in different batches of Scutellariae Radix, but Scutellariae Radix and wine-processed Scutellariae Radix could not be distinguished. Five sensory attributes(sour, salty, fresh, sweet, and bitter) were evaluated by artificial tasting, and the response values of 7 sensors(AHS, AHS, PKS, CTS, NMS, CPS, ANS, SCS) representing the taste of pieces were detected by electronic tongue. The correlation between sensory evaluation and response values of the electronic tongue were analyzed, and the results showed that the sensory evaluation of sour, salty, fresh, sweet, bitter and AHS, CTS, NMS, ANS, SCS sensors had different degrees of correlation, indicating that the electronic tongue technology can be used as an alternative to artificial taste and can serve as a means for quantifying the taste, and it can be used to evaluate the taste of TCM pieces. The taste method was used to analyze the response values of the electronic tongue, and the results showed that the bitterness of wine-processed Scutellariae Radix decreased and the salty taste increased. PCA was used to analyze taste changes before and after wine-processed Scutellariae Radix, and the results showed that taste differences between 2 pieces were divided into 2 categories. PCA loading scattering plots showed that response of saltiness and bitterness were the major factors to affect overall taste in Scutellariae Radix and wine-processed Scutellariae Radix. Based on electronic tongue response values, the Fisher discriminant model for Scutellariae Radix and wine-processed Scutellariae Radix was established, which showed that it could effectively discriminate them with a recognition rate of 100%. The experimental results showed that the electronic tongue combined with multivariate statistical analysis can be used to evaluate taste of TCM, at the same time, it could provide a fast and simple method for identifying different processed products.

[Correlation between color of Scutellariae Radix pieces and content of five flavonoids after softening and cutting by different methods].

Scutellariae Radix is one of the commonly used heat-clearing and damp-drying drugs in clinical practice. Establishment of the quality evaluation system for Scutellariae Radix is of great significance to ensure safety and effectiveness of clinical drug use.Scutellariae Radix pieces were prepared under different processing conditions with 3 softening methods: boiling,atmospheric steaming and pressurized steaming. High performance liquid chromatography( HPLC) method was used to determine the content of five flavonoids in Scutellariae Radix,and L*,a*,b*values representing color chromaticity of Scutellariae Radix powder were measured by colorimeter,then total color value E*was calculated. Simple correlation and canonical correlation analysis was used to explore the correlation between color of Scutellariae Radix powder and content of five flavonoids. The results showed that the contents of baicalin and wogonoside were significantly positively correlated with L*,b*and E*values,but negatively correlated with a*value. The contents of wogonin,apigenin,and melaleuca A were positively correlated with a*value,but negatively correlated with L*,b*,and E*values( P<0. 01). There was a significant negative correlation between the content of flavonoid glycosides and flavonoid aglycones( P<0. 01).All of these indicated that the color of Scutellariae Radix powder was significantly correlated with content of five flavonoids. The experiment results proved that when color difference between Huangqin pieces and medicinal materials was kept at ΔL*<6,Δb*<3,ΔE*<6,the total amount of the two glycosides in the pieces was about ±1. 5% of the medicinal materials; in this case,the total amount of the two glycosides was relatively high and stable,indicating that the color of Huangqin decoction pieces is a concrete manifestation of its intrinsic quality,and the chromaticity value detected by colorimeter can be used as a means to quickly evaluate the quality of Scutellariae Radix pieces. The results provide a new detection index for the characteristic quality evaluation system of Scutellariae Radix pieces.

Anlotinib, a novel small molecular tyrosine kinase inhibitor, suppresses growth and metastasis via dual blockade of VEGFR2 and MET in osteosarcoma.

Osteosarcoma is the most common primary malignant bone tumor in children and adolescents, with highly aggressive behavior and early systemic metastasis. The survival rates for osteosarcoma remain unchanged over the past two decades. Studies aiming to find new or alternative therapies for patients with refractory osteosarcoma are urgently needed. Anlotinib, a novel multi-targeted tyrosine kinase inhibitor (TKI), has exhibited encouraging clinical activity in NSLCC and soft tissue sarcoma, whereas its effect on osteosarcoma has not been studied. In our study, we investigated the anti-tumor activity and underlying mechanism of anlotinib in osteosarcoma. Various in vitro and in vivo models of human osteosarcoma were used to determine the anti-proliferative, anti-angiogenesis and anti-metastasis efficacy of anlotinib. Our results showed that anlotinib suppressed tumor growth and increased the chemo-sensitivity of osteosarcoma. In addition, anlotinib inhibited migration and invasion in osteosarcoma cells. Furthermore, in order to explore the anti-tumor mechanism of anlotinib, phospho-RTK antibody arrays were performed. These analyses confirmed that anlotinib suppressed the phosphorylation of MET, VEGFR2 and the downstream signaling pathway activation. Moreover, we demonstrated that anlotinib blocked hepatocyte growth factor (HGF)-induced cell migration, invasion and VEGF-induced angiogenesis. Notably, a 143B-Luc orthotopic osteosarcoma model further showed that anlotinib significantly inhibited growth and lung metastasis of implanted tumor cells. Our preclinical work indicates that anlotinib acts as a novel inhibitor of VEGFR2 and MET that blocks tumorigenesis in osteosarcoma, which could be translated into future clinical trials.

Glaucocalyxin A-induced oxidative stress inhibits the activation of STAT3 signaling pathway and suppresses osteosarcoma progression in vitro and in vivo.

Osteosarcoma (OS) is ranked as the most common primary bone malignancy in children and adolescents worldwide, and the 5-year overall survival rate of OS is not optimistic. Constitutive activation of signal transducer and activator of transcription 3 (STAT3) has been implicated in tumor cell growth, proliferation, and anti-apoptosis in OS. Therefore, the discovery of novel molecular compounds that can effectively block STAT3 activation, is essential for the treatment of OS and improving prognosis. Here, we investigate whether Glaucocalyxin A (GLA), derived from Rabdosia japonica, exhibit the potential anticancer effects in OS. First of all, we identify that GLA potently suppressed cell proliferation, induced G2/M phase arrest and promoted substantial apoptosis in OS. Next, we conclude that GLA could induce Reactive oxygen species (ROS)-mediated oxidative stress via an imbalance of GSH and GSSG. Then, we elucidate for the first time that GLA could significantly inhibit both constitutive and IL-6-inducible activation of STAT3 (Tyr705) and JAK2, the upstream regulator of STAT3. Furthermore, we elucidate that the inhibition of STAT3 is mainly induced by ROS-mediated oxidative stress. Overall, our findings demonstrate that GLA could exhibit potent anticancer effects through effectively blocking the STAT3 signaling pathway, which was induced by ROS-mediated oxidative stress in OS in vitro and in vivo.

The Effect of Velvet Antler Proteins on Cardiac Microvascular Endothelial Cells Challenged with Ischemia-Hypoxia.

Velvet antler (VA) is a precious traditional Chinese medicine that is capable of repeated regeneration. Based on the Chinese medicine theory of coordination the heart and kidneys, VA has been employed to treat heart diseases, including ischemic heart disease, heart failure, and arrhythmia. We examined the effects of VA proteins on primary cardiac microvascular endothelial cells (CMECs) that were subjected to ischemia-hypoxia (IH) to investigate their effects on and mechanism of action in the treatment of ischemic heart disease. Velvet antler proteins (VA-pro) were extracted with water as the solvent, the ultrasonic wave method, and freeze-drying technology; then it was analyzed by Nano LC-MS/MS. In addition, the role of VA-pro in cell viability, proliferation, apoptosis, and mitochondrial membrane potential (MMP) were evaluated by the MTS assay, the EdU assay, the Annexin V-FITC/PI double-staining assay, and the JC-1 assay, respectively. Cell migration were evaluated by the scratch assay and the Transwell assay. The expression of apoptosis-associate proteins, Akt and p-Akt, and tube formation in Matrigel of CMECs were also detected. In total, 386 VA-pro were identified. Our results showed that IH significantly reduced the viability of the CMECs (P < 0.001) and suppressed copies of DNA to hold back CMEC proliferation (P < 0.001). The OD of control group was 1.81 ± 0.08 and IH group OD was 1.25 ± 0.03. After suffering with IH for 46 h, CMECs were 75% less likely to migrate (P < 0.001), and its tubule formation ability and MMP were also decreased (P < 0.001). VA-pro treatment resulted in an improvement in CMECs' viability and proliferation (P < 0.001). Such as, the OD of 0.5, 1, and 2 mg/ml rose to 1.56 ± 0.5, 1.74 ± 0.1 and 1.65 ± 0.1, respectively. Similarly, CMECs' migration (for the scratch assay P < 0.001, for the Transwell assay P < 0.05) and tubule formation (P < 0.05) ability were better after treated with VA-pro. At the same time, the stability of MMP was retained preferably (P < 0.001). 50% apoptosis was induced after CMECs were cultured in IH conditions (P < 0.001), while VA-pro decreased the number of apoptotic cells (P < 0.001). All above results showed that 1 mg/ml VA-pro produced maximum results. Furthermore, the expression of pro-apoptosis proteins was higher, but the expression of anti-apoptosis proteins was lower in the IH group (P < 0.05); VA-pro reversed these changes (P < 0.001). These findings suggest that VA-pro ameliorate CMEC injuries induced by IH via regulating the PI3K/Akt signaling pathway.

Evaluation of velvet antler total protein effect on bone marrow­derived endothelial progenitor cells.

Lu Rong, velvet antler (VA), is a traditional Chinese medicine, which is used as a food supplement and therapeutic drug in China, Japan, Russia, New Zealand and Southeast Asia. The regenerative characteristics of VA have resulted in great research interest, particularly regarding the fields of organ grafting and stem cell differentiation. Various VA proteomic studies verified that proteins act as the primary bioactive components of VA. The present study aimed to investigate if VA proteins (VA­pro) influence endothelial progenitor cell (EPC) viability. Various methods have previously been used to investigate VA­pro, including freeze­drying technology, ultrasonic wave methods, high performance liquid chromatography­mass spectrometry, EPCs extraction and culture. Results demonstrated that VA­pro promoted EPCs proliferation and migration, particularly at a concentration of 1 mg/ml. Furthermore, VA­pro increased the activation level of Notch1 intracellular domain and Hes1, and the level of phosphorylated­Akt and phosphorylated­mechanistic target of rapamycin. VA­pro may therefore affect EPC viability via regulation of the Notch and Akt signaling pathways. The present study revealed the effects and potential molecular mechanism of VA­pro on EPCs, and suggested an association between VA regeneration characteristics and the optimization of EPC viability. These findings may contribute to EPC transplantation research and aid in providing a novel treatment method for vascular diseases in the future.

[Clinical observation on delayed encephalopathy after carbon monoxide poisoning treated with acupuncture to restore consciousness combined with hyperbaric oxygen treatment].

OBJECTIVE: To compare the efficacy differences on delayed encephalopathy after carbon monoxide poisoning (DEACMP) between acupuncture to restore consciousness combined with hyperbaric oxygen treatment and simple hyperbaric oxygen treatment. METHODS: Forty-one patients with DEACMP were randomly divided into an observation group (21 cases) and a control group (20 cases). In the observation group, acupuncture was applied at Neiguan (PC 6), Shuigou (GV 26), Baihui (GV 20), Sishencong (EX-HN 1), Fengchi (GB 20), Hegu (LI 4), Sanyinjiao (SP 6) and Taichong (LR 3), and hyperbaric oxygen treatment was given as well. In the control group, simple hyperbaric oxygen treatment was used. The treatment was adopted once every day, and continuous 5 days' treatment made one session in the two groups. There were two days at the interval between two sessions and 6 sessions in the two groups. The changes of scores of mini mental state examination (MMSE) and Barthel index (BI) for activity of daily life and routine electroencephalogram (EEG) before and after treatment were compared. RESULTS: After treatment, the scores of MMSE and BI and EEG were all improved compared with those before treatment (all P<0.01). The raise of the scores of MMSE and BI in the observation group was more obvious than that in the control group (both P<0.05) and the improvement of EEG abnormal condition in the observation group was also superior to that in the control group after treatment (P<0.05). CONCLUSION: Acupuncture to restore consciousness combined with hyperbaric oxygen could obviously improve the cognitive function, activity of daily life and changes of EEG, and it is better than simple hyperbaric oxygen treatment.

[Adverse reaction induced by licorice preparations: clinical analysis of 93 cases].

Licorice is a traditional Chinese medicine commonly used in clinic. The products,what contain licorice or licorice extract, has early been involved in the field of cosmetics except for the field of pharmaceuticals and food. Consequently, the reporting on adverse reactions induced by licorice preparations are more frequent. Based on the clinical data of licorice preparations adverse reactions, we described the characteristics of the licorice-related adverse reactions, and proposed specific measures to reduce the incidence of adverse reactions, provided a reference for the rational use of licorice preparations.

Effects of Chinese medicine for tonifying the kidney and resolving phlegm and blood stasis in treating patients with amnestic mild cognitive impairment: a randomized, double-blind and parallel-controlled trial.

BACKGROUND: It is important to detect and prevent Alzheimer disease (AD) at its early stage. Constituting the early stage sign of AD, amnestic mild cognitive impairment (aMCI) has drawn much attention. Studies have shown that donepezil could reduce the AD assessment scale-cognitive subscale (ADAS-Cog) score in MCI patients and improve the patient's attention and speed of response; however, it also has many side effects. Therefore, the authors aim to explore the effects of Chinese herbal medicine for treating aMCI. OBJECTIVE: To explore the clinical efficacy and safety of Chinese medicine for tonifying the kidney, and resolving phlegm and blood stasis in the treatment of aMCI. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This clinical trial used randomized, double-blind, double-dummy and parallel-controlled design. According to the randomized, double-blind principle, some aMCI patients were randomly divided into Chinese medicine group and donepezil group. Other patients who did not receive any treatment were enrolled as the control. Patients in the Chinese medicine group received oral administration of Chinese medicine, 1 bag/dose, two doses per day, while patients in the donepezil group received donepezil hydrochloride, 5mg/day. Twelve weeks were allocated as the trial period. MAIN OUTCOME MEASURES: After 12 weeks, the Chinese medicine group patients, the donepezil group patients and those patients who did not receive any treatment were accessed using the scores of ADAS-Cog and mini-mental status examination (MMSE). RESULTS: The ADAS-Cog and MMSE scores of the Chinese medicine group and the donepezil group were both improved from baseline (P=0.001, P=0.000), but the non-treatment group showed no change from baseline (P=0.151, P=0.125); furthermore, there was no significant difference between the Chinese medicine group and the donepezil group. The attention function of the Chinese medicine group was better than baseline (P=0.015), but no change was seen in the donepezil group (P=0.085) at the 12th week. Safety data showed that the occurrence of insomnia, nausea and diarrhea was greater in the donepezil group than in the Chinese medicine group (P=0.002, P=0.005, P=0.000), and both treatments had no influence in participants' vital signs and laboratory examination results. CONCLUSION: Both Chinese medicine and donepezil can improve global cognition in patients with aMCI after 12 weeks of treatment. Chinese medicine can also improve attention function and some clinical symptoms in patients with aMCI. Furthermore, Chinese medicine is safe for aMCI patients. Further study is necessary to explore the long-term effect of Chinese medicine for aMCI.

Correlation between cognitive functions and syndromes of traditional Chinese medicine in amnestic mild cognitive impairment.

OBJECTIVE: To explore the correlation between the cognitive functions and syndromes of traditional Chinese medicine (TCM) in amnestic mild cognitive impairment (aMCI), and to provide evidence for clinical syndrome differentiation treatment. METHODS: Six hundred subjects from Dongzhimen Hospital and seven communities in Beijing, aged between 40 and 85 years, accepted neuropsychological assessments, imaging and biochemical examinations, and syndrome differentiation, from whom 159 aMCI patients, 213 normal control (NC) subjects and 171 Alzheimer's dementia (AD) patients were screened out. Correlation between the cognitive functions and TCM syndromes in aMCI patients was analyzed. RESULTS: Mini-Mental State Examination (MMSE) score in aMCI patients was closely correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.11, r = -0.11; P = 0.003, P = 0.015). Delayed Word Recall (DWR) score was correlated with kidney essence vacuity (r = -0.20, P = 0.020). Instant Story Recall (ISR) and Delayed Story Recall (DSR) scores were respectively correlated with turbid phlegm blocking upper orifices (r = -0.11, r = -0.27; P = 0.021, P = 0.000). Language function was correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.11, r = -0.13; P = 0.042, P = 0.007). Attention/calculation was also closely correlated with kidney essence vacuity and deficiency of blood and qi (r = -0.10, r = -0.21; P = 0.039, P = 0.010). Attention score of aMCI patients was correlated with excess of heat toxin syndrome (r = -0.29, P = 0.026). CONCLUSION: The memory decline of aMCI is correlated with kidney essence vacuity and turbid phlegm blocking upper orifices. Furthermore, turbid phlegm blocking upper orifices is correlated with episodic memory decline, which is closely related to AD. The aMCI patients with phlegm have the risk to progress into AD. Although other cognitive functions of aMCI remain relatively intact, the patients' language function, attention/calculation and the whole cognitive function may be worsen as the aggravation of kidney essence vacuity, deficiency of blood and qi, phlegm and heat toxin, and may eventually lead to multiple cognitive domains impairment, even dementia.

Stage-oriented comprehensive acupuncture treatment plus rehabilitation training for apoplectic hemiplegia.

OBJECTIVE: To study the effect of stage-oriented comprehensive acupuncture treatment plus rehabilitation training for the recovery of apoplectic hemiplegia. METHODS: The 60 cases of acute apoplectic hemiplegia were divided randomly into the treatment and control groups with 30 in each. Based on the routine medication, acupuncture combined with modern rehabilitation techniques was applied for the treatment group, while only rehabilitation treatment for the control group. Before and three months after treatment, the evaluation was done on the motor function and daily life ability for both groups respectively with simplified Fugl-Meyer Evaluation and modified Barthel index. RESULTS: The therapeutic effect of treatment group was significantly superior to that of the control group (P < 0.05). CONCLUSIONS: Based on Brunnstrom's theory of six-stage in the recovery of hemiplegia, the effect of stage-oriented comprehensive acupuncture therapy combined with rehabilitation training is very good, helpful in raising the daily life ability of patients.