Therapeutic effects of ginsenosides on osteoporosis for novel drug applications.

Osteoporosis (OP) is a metabolic bone disease with a high incidence rate worldwide. Its main features are decreased bone mass, increased bone fragility and deterioration of bone microstructure. It is caused by an imbalance between bone formation and bone resorption. Ginsenoside is a safe and effective traditional Chinese medicine (TCM) usually extracted from ginseng plants, having various therapeutic effects, of which the effect against osteoporosis has been extensively studied. We searched a total of 44 relevant articles with using keywords including osteoporosis, ginsenosides, bone mesenchymal cells, osteoblasts, osteoclasts and bone remodeling, all of which investigated the cellular mechanisms of different types of ginsenosides affecting the activity of bone remodeling by mesenchymal stem cells, osteoblasts and osteoclasts to counteract osteoporosis. This review describes the different types of ginsenosides used to treat osteoporosis from different perspectives, providing a solid theoretical basis for future clinical applications.

Comparison of the Effects of Ureteroscopy with Holmium Laser Lithotripsy and Extracorporeal Shock Wave Lithotripsy in the Treatment of Ureteral Calculi.

Objective: This study aims to compare the efficacy of ureteroscopy with holmium laser lithotripsy and extracorporeal shock wave lithotripsy (ESWL) in treating ureteral calculus (UC). Methods: We enrolled 86 patients with UC treated in our urology department from November 2020 to November 2022. Group A (n=43) underwent ureteroscopic holmium laser lithotripsy, while Group B (n=43) received ESWL. We recorded treatment duration, post-treatment hematuria duration, and post-treatment stone clearance rates. Renal function and stress response were assessed before and 3 days after treatment. Post-treatment complications were documented, and patient quality of life was evaluated using the SF-36 health questionnaire. Results: Group A exhibited significantly shorter treatment and post-treatment hematuria durations compared to Group B (P < .05). In stones >1 cm, group A demonstrated a higher clearance rate (P < .05). Post-treatment, Group A showed improved renal function and lower stress response (P < .05). The incidence of post-treatment complications did not differ significantly between groups (P > .05), but SF-36 scores were higher in Group A (P < .05). Conclusions: Ureteroscopy with holmium laser lithotripsy proves effective in UC treatment, contributing to a shortened recovery period and enhanced patient quality of life.

Corrigendum: The effects of Tai Chi on physical function and safety in patients with rheumatoid arthritis: a systematic review and meta-analysis.

[This corrects the article DOI: 10.3389/fphys.2023.1079841.].

[Professor HAN Wei's clinical experience of acupuncture and moxibustion with Tongyang Xingshen for adolescent depressive disorder].

Professor HAN Wei 's clinical experience of acupuncture and moxibustion with Tongyang Xingshen (promoting yang and regaining consciousness) for adolescent depressive disorder is introduced. It is believed that the internal causes of adolescent depressive disorder are mostly emotional and physical factors, while the external causes are mainly social factors, and yang-qi stagnation and emotional disorder are the key pathogenesis. The key of acupuncture and moxibustion with Tongyang Xingshen is warming and regulating the governor vessel. The governor vessel acupoints at head, neck and back are selected. At head, Baihui (GV 20) and Yintang (GV 24+) are selected; at neck, Fengfu (GV 16) and Dazhui (GV 14) are selected; at back, Taodao (GV 13), Shenzhu (GV 12), Shendao (GV 11), Zhiyang (GV 9) and Jinsuo (GV 8) are selected. The combination of disease differentiation and syndrome differentiation should be highly valued, and the moxibustion with Tongyang and acupuncture with Xingshen should be used simultaneously, and the strong stimulation is suggested.

The effects of Tai Chi on physical function and safety in patients with rheumatoid arthritis: A systematic review and meta-analysis.

Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory autoimmune disease that results in the destruction of joints, connective tissues, muscle, tendons and fibrous tissue. Until now, there are no cure therapies. Objective: We aimed to assess the effectiveness of Tai Chi (TC) on RA patients by meta-analysis. Methods: The PubMed, Cochrane Library, EMBASE, web of science, China National Knowledge Infrastructure and Google Scholar were searched up to January 2023. We included randomized controlled trials (RCTs) or controlled clinical trials (CCTs) comparing TC to control conditions for RA patients. Review Manager (Version 5.3) software was used to analyze outcomes of time to walk 50 feet, joint tenderness, number of swollen joints or tender joints, handgrip strength, pain, the Health Assessment Questionnaire (HAQ) and withdraws overall. Results: A total of 351 patients with RA from six RCTs and three CCTs were included for meta-analysis. TC could also significantly decrease withdrawals overall in studies (OR = 0.28, 95% CI 0.12 to 0.67, p = 0.002). No significant treatment effects of physical function were identified of the other outcomes. Conclusion: Our findings indicated that TC was safe to RA patients, but it cannot improve physical function and pain. However, there is still lack of more evidence. Systematic Review Registration: [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=367498], identifier [CRD42022367498].

[Acupuncture combined with Qingfei Qutan decoction for stroke-associated pneumonia with phlegm-heat obstructing lung and its effect on cellular immune function].

OBJECTIVE: To observe the clinical effect of acupuncture combined with Qingfei Qutan decoction for stroke-associated pneumonia (SAP) with phlegm-heat obstructing lung, and explore its possible mechanism. METHODS: Ninety-nine patients of SAP with phlegm-heat obstructing lung were randomly divided into a combination group (33 cases, 1 case dropped off), a Chinese medication group (33 cases, 1 case dropped off) and an acupuncture group (33 cases, 1 case dropped off). On the basis of routine basic treatment, the patients in the acupuncture group were treated with acupuncture at Tiantu (CV 22), Feishu (BL 13), Taiyuan (LU 9), Sanyinjiao (SP 6), etc., once a day, with an interval of 1 day after continuous 6-day treatment; the patients in the Chinese medication group were treated with Qingfei Qutan decoction, 1 dose per day; the patients in the combination group were treated with acupuncture combined with Qingfei Qutan decoction. Two weeks were taken as a course of treatment, and two courses of treatment were given. Before and after treatment, the clinical pulmonary infection score (CPIS), inflammatory indexes (neutrophil-to-lymphocyte ratio [NLR], procalcitonin [PCT], C-reactive protein [CRP]), cellular immune function (CD+3, CD+4, CD+8 and CD+4/CD+8) were compared in the 3 groups. The clearance of pathogenic bacteria after treatment was observed in the 3 groups. The clinical efficacy of each group was evaluated. RESULTS: After treatment, the CPIS scores, NLR, PCT, CRP and CD+8 in the each group were lower than those before treatment (P<0.05), while the levels of CD+3, CD+4, CD+4/CD+8 were higher than those before treatment (P<0.05). The above indexes in the combination group were better than those in the acupuncture group and the Chinese medication group (P<0.05), and the above indexes in the Chinese medication group were better than those in the acupuncture group (P<0.05). There was no significant difference in the clearance rate of pathogenic bacteria among three groups (P>0.05). The cured and markedly effective rate was 65.6% (21/32) in the combination group, which was higher than 43.8% (14/32) in the Chinese medication group and 18.8% (6/32) in the acupuncture group (P<0.05). The cured and markedly effective rate in the Chinese medication group was higher than that in the acupuncture group (P<0.05). CONCLUSION: Acupuncture combined with Qingfei Qutan decoction could effectively improve the clinical symptoms of SAP patients with phlegm-heat obstructing lung, and the mechanism may be related to enhancing the cellular immune function and reducing the level of inflammatory reaction.

Tai Chi on bone mineral density of postmenopausal osteoporosis: A protocol for systematic review and meta-analysis.

BACKGROUND: Osteoporosis is a clinically common metabolic disease, especially in postmenopausal women. Tai Chi might be beneficial in osteoporosis patients. This study will be performed to examine the effects of Tai Chi on bone mineral density of postmenopausal osteoporosis. METHODS: We will search the electronical databases and hand-searching journals or reference lists. The study screening and data extraction will be carried out by 2 investigators independently. The primary outcome is bone mineral density (lumbar spine, Ward's triangle, trochanter, proximal femur, femoral neck, or total hip). Secondary outcomes are pain score, alkaline phosphatase, osteocalcin, and adverse effects. Review Manager V.5.3 software will be used to compute the data. RESULTS: The results of the study will provide a reliable evidence to assess the effects of Tai Chi on bone mineral density of postmenopausal osteoporosis. CONCLUSION: The conclusion of our systematic review will answer whether Tai Chi is an effective intervention to improve bone mineral density of postmenopausal osteoporosis.

Shi's Yi-Qi Bu-Shen Tong-Luo decoction combined with manipulation in the management of wrist stiffness after distal radius fracture: Study protocol clinical trial (SPIRIT Compliant).

INTRODUCTION: Wrist stiffness is a common sequela of distal radial fractures. Manipulation is generally used and effective, but problems exist, such as intense pain, swelling during the process of manipulation and long treatment period. Therefore, a combinative therapeutic strategy is necessary to benefit rehabilitation after distal radius fracture. Shi's Yi-Qi Bu-Shen Tong-Luo decoction (BTD) combined with wrist manipulation has been used in the Shanghai Ninth People's Hospital Huangpu Branch in last few decades. BTD has potential therapeutic effects on rehabilitation after distal radius fracture, which should be evaluated by rigorous clinical trial. METHODS/DESIGN: A randomized, double-blind, placebo-controlled clinical trial will be conducted to determine the efficiency of BTD in relief of wrist stiffness and pain and function rehabilitation. A total of 80 wrist stiffness patients with or without pain and edema will be enrolled, and treated with wrist manipulation plus BTD or placebo for 4 weeks. The primary outcome measure is the Cooney wrist score. The second outcome measures include pain numerical rating scale, patient rated wrist evaluation, 36-item short form health survey questionnaire, and side effects. DISCUSSION: Although BTD has shown effects on rehabilitation after distal radius fracture in the Shanghai Ninth People's Hospital Huangpu Branch for decades, the universality of this efficacy needs evaluated. The results of this trial will provide a convincing evidence. TRIAL REGISTRATION: ChiCTR2000029260, January 19, 2020.

Enhanced liver-targeting via coadministration of 10-Hydroxycamptothecin polymeric micelles with vinegar baked Radix Bupleuri.

BACKGROUND: Vinegar baked Radix Bupleuri (VBRB) is a wildly used traditional Chinese medicine, it could be used as a meridian guided drug to enhance liver targeting efficiency of the delivered drug in addition to its therapeutic effect. PURPOSE: To investigate the liver targeting effect induced by VBRB via coadministration with 10-Hydroxycamptothecin loaded polymeric micelles. METHODS: First of all, the inhibitory effect of VBRB on the activity of glutathione S-transferase (GST) was investigated in vitro to select the most effective extract. After oral administration of 10-Hydroxycamptothecin (HCPT) polymeric micelles with low, medium and high doses of VBRB, pharmacokinetic parameters, including the ratio of Cmax in the liver (Ce) and the relative uptake efficiency (RUE), were employed to assess the liver targeting efficiency. RESULTS: It was found that VBRB extract BC1 has the strongest inhibition effect on GST activity in the five extracts. By coadministration of HCPT loaded micelles with three doses of BC1, the AUC0-t of HCPT in the liver raised by 42.5%, 23.0%, -0.2%, with RUE 1.45, 1.23, 1.02 for low, medium and high dose groups, respectively, indicating that low and medium dose of BC1 presented better liver-targeting enhancing effect than that of the high dose, which corresponded to the commonly used dose of VBRB in traditional Chinese medicine formulae. CONCLUSIONS: VBRB could effectively enhance the liver-targeting efficiency of HCPT loaded polymeric micelles after oral coadministration. Such a simple but effective strategy may enlighten on the potential use of meridian guided drug together with modern drug delivery system to achieve better active drug targeting.

Synthesis, characterization and liver targeting evaluation of self-assembled hyaluronic acid nanoparticles functionalized with glycyrrhetinic acid.

Recently, polymeric materials with multiple functions have drawn great attention as the carrier for drug delivery system design. In this study, a series of multifunctional drug delivery carriers, hyaluronic acid (HA)-glycyrrhetinic acid (GA) succinate (HSG) copolymers were synthesized via hydroxyl group modification of hyaluronic acid. It was shown that the HSG nanoparticles had sub-spherical shape, and the particle size was in the range of 152.6-260.7nm depending on GA graft ratio. HSG nanoparticles presented good short term and dilution stability. MTT assay demonstrated all the copolymers presented no significant cytotoxicity. In vivo imaging analysis suggested HSG nanoparticles had superior liver targeting efficiency and the liver targeting capacity was GA graft ratio dependent. The accumulation of DiR (a lipophilic, NIR fluorescent cyanine dye)-loaded HSG-6, HSG-12, and HSG-20 nanoparticles in liver was 1.8-, 2.1-, and 2.9-fold higher than that of free DiR. The binding site of GA on HA may influence liver targeting efficiency. These results indicated that HSG copolymers based nanoparticles are potential drug carrier for improved liver targeting.

Exploring the effect of hydrophilic and hydrophobic structure of grafted polymeric micelles on drug loading.

The objective of this paper is to explore the effect of hydrophilic and hydrophobic structure of grafted polymeric micelles on drug loading, and elucidate whether drug-polymer compatibility, as predicted by Hansen solubility parameters (HSPs), can be used as a tool for drug-polymer pairs screening and guide the design of grafted polymeric micelles. HSPs of 27 drugs and three grafted copolymers were calculated according to group contribution method. The drug-polymer compatibilities were evaluated using the approaches of Flory-Huggins interaction parameters (χFH) and polarity difference (△Xp). Two models, model A and B, were put forward for drug-polymer compatibility prediction. In model A, hydrophilic/hydrophobic part as a whole was regarded as one segment. And, in model B, hydrophilic and hydrophobic segments were evaluated individually. First of all, using chitosan (CS)-grafted-glyceryl monooeate (GMO) based micelle as an example, the suitability of model A and model B for predicating drug-polymer compatibility was evaluated theoretically. Thereafter, corresponding experiments were carried out to check the validity of the theoretical prediction. It was demonstrated that Model B, which evaluates drug compatibility with both hydrophilic and hydrophobic segments of the copolymer, is more reliable for drug-polymer compatibility prediction. Moreover, the approach of model B allows for the selection of a defined grafted polymer with for a specific drug and vice versa. Thus, drug compatibility evaluation via HSPs with both hydrophilic and hydrophobic segments is a suitable tool for the rational design of grafted polymeric micelles. The molecular dynamics (MD) simulation study provided further support to the established model and experimental results.

[Effects of Acupuncture Stimulation on Dynamic Changes of Cerebral TNF-α and C-reaction Protein Levels in Cerebral Ischemia-reperfusion Rats].

OBJECTIVE: To observe the influence of "Tong Du Tiao Shen" (Governor-Vessel-Dredging and Mental Activity Regulating) acupuncture method on dynamic changes of cerebral TNF-α and C-reaction protein (CRP) levels in focal cerebral ischemia-reperfusion (CI/R) rats, so as to master the optimal time point of acupuncture therapy for cerebral infarction. Methods A total of 72 adult male Wistar rats were randomly divided into blank control, sham-operation, model and acupuncture groups which were further divided into 6 h, 24 h and 48 h subgroups (n 6 in each subgroup) . The CI/R model was established by occlusion of the middle cerebral artery. Acupuncture stimulation of "Baihui" (GV 20), "Fengfu" (GV 16) and "Dazhui" (GV 14) was conducted for 30 min. Neurological deficit symptoms were assessed with the Zea-Longa neurological deficit score and TNF-α and CRP contents in the brain tissue were detected using double sandwich ABC-ELISA method. RESULTS: In comparison with the model group, the Zea-Longa neurological deficit score was significantly decreased in the acupuncture group (P<0. 01). Cerebral TNF-α and CRP levels at time-points of 6 h, 24 h and 48 h after CI/R were significantly increased in the model group than in both control and sham groups (P<0. 01). In the acupuncture group, cerebral TNF-α and CRP levels were obviously lower than those of the model group (P<0. 01). CONCLUSION: Manual acupuncture stimulation of GV 20, GV 16 and GV 14 can relieve neurological deficit function in CI/R rats, which may be related to its function in suppressing TNF-α and CRP levels.

[Effect of electrovaporization on the prostate and its surrounding tissues].

OBJECTIVE: Transurethral electrovaporization of the prostate (TVP) for benign prostatic hyperplasia (BPH) has proven to be efficacious with lower morbidity than transurethral resection of the prostate (TURP) on clinical studies. However, no histopathologic data are available to support the clinical findings in human studies. The following study was done using a canine model in an effort to evaluate these histopathologic changes. METHODS: Nine canines received antegrade electrovaporization or resection of the prostate, via an open cystoma, using Storz series resectoscope and video equipment. The dogs were sacrificed and their prostates harvested at 0 week (immediately after operation), 1 week or 5 weeks after electrovaporization or resection. The prostates were evaluated grossly as well as histologically for cavitary defects and depth of necrosis. RESULTS: Prostate examination revealed superficial necrosis (less than 1.8 mm deep) at 0 week following the 270 watts operation, and less than 3 mm deep necrosis with acute inflammation and focal hemorrhage at 1 week. The depths of necrosis were less than 1.3 mm and 2.2 mm at 0 week and 1 week after the 180 W electrovaporizion. And the 120 W resection resulted in necrosis 1.1 mm and 1.6 mm deep at most, which was localized in the vaporized prostate only, with no histopathologic change in the surrounding tissues. Epithelial stratification was underway by the fifth week, but with inflammation. CONCLUSION: TVP in the canine model showed only shallow necrosis at the site of the vaporization. These data provide a histopathologic rationale for the minimal morbidity and efficacious nature of this technique demonstrated in clinical studies.