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05 September 2019, Volume 4 Issue 5 Previous Issue    Next Issue
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Prescribing Chinese patent medicines without traditional Chinese medicine training is now banned in China
Editor Group of Traditional Medicine Research
1Traditional Medicine Research. 2019, 4 (5): 222-223.   https://doi.org/10.12032/TMR20190725126
Abstract ( 251 )   HTML ( 10 )     PDF (259KB) ( 108 )  
On July 1, 2019, the website of the National Health Commission of the People’s Republic of China issued the “Notice on printing and distributing the first batch of national key monitoring and rational drugs (chemicals and biological products)” (National Health Office Medical Letter [2019] No. 558) [1], where the third article stipulates: “Other types of physicians, after not less than one year of systematically studying Chinese medicine professional knowledge and passing the examination, in accordance with the basic principles of syndrome differentiation, can issue prescriptions for Chinese patent medicine”. This mandates that Western medicine doctors in China no longer prescribe Chinese patent medicines (CPM) without completing the required training. Before the implementation of this regulation, it was common for Western medicine doctors to prescribe CPM. The market for CPM is quite large [2]. Many traditional Chinese medicine (TCM) doctors believe that Western medicine doctors who have not received specific training in TCM run the risk of incorrectly prescribing CPM [3]. In fact, the vast majority of CPM are subject to the same evaluation criteria and assessment procedures as are chemical drugs. CPM are evaluated using modern medical evaluation systems, are evaluated after they are marketed, and are subjected to standardized clinical trials rather than to evaluation using the TCM theory. Patients experiencing toxic effects from the use of TCM are found to be genetically susceptible to the effects of certain herb ingredient. For example, a recent study found that the genetic basis for susceptibility to Heshouwu (Fallopia multiflora), resulting in liver damage, is the HLA-B*35:01 allele [4]. It is difficult for Western medicine doctors to identify which patients may be genetically susceptible to the toxic effects of Heshouwu (Fallopia multiflora). The method of syndrome differentiation based on TCM theory has also proven to be unsuccessful in identifying this susceptibility. In China, Chinese and Western medicine systems are equally important, and both are held in high regard [5]. As early as the 1950s, China organized various “Western Medicine Learning TCM” classes [6] and successfully trained a group of integrated medicine physicians. At the present time, 70% of CPM are prescribed by Western medicine doctors [7]. This above-mentioned regulation restricts Western medicine doctors from prescribing CPM that patients can purchase from pharmacies, and, furthermore, compels Western medicine doctors to gain knowledge in TCM. We question whether this will result in Western medicine doctors abandoning the use of CPM. Interestingly, the stock prices of CPM companies offered in the A-share market fell after these new regulations were announced.
Comment
Antitumor applications of nano-traditional Chinese medicine
Jing-Na Zhou, Guo-Wei Zhang
1Traditional Medicine Research. 2019, 4 (5): 224-226.   https://doi.org/10.12032/TMR20190813129
Abstract ( 300 )   HTML ( 17 )     PDF (240KB) ( 190 )  
An article by Deng et al. [1] that was first published in ACS Nano in 2019 revealed that nanoparticles extracted from cuttlefish ink (CINPs) could inhibit tumor growth by synergizing immunotherapy and photothermal therapy. The researchers found that these CINPs, which had significant antitumor efficacy, could effectively reprogram tumor-associated macrophages (TAMs) from the immune-suppressive M2-like phenotype to the antitumor M1-like phenotype. There were reportedly approximately 18.1 million new cancer cases and 9.6 million cancer-related deaths in 2018 worldwide [2]. As of 2015, the mortality rate from malignant tumors accounted for 23.91% of all causes of death in China, and this rate is still on the rise [3]. The pathogenesis of human tumors is the result of multiple factors jointly influencing gene expression, which implies that these tumors have low controllability. Hence, it is a topic of wide concern in clinical settings.
Special Issue on Inflammation and Immunity
Immunomodulatory effect of schisandrae oil in mouse model of autoimmune hepatitis induced by concanavalin A
Wen-Qian Dong, Peng Luo, Da-Peng Lu, Hao Wang, Bao-Long Wang
1Traditional Medicine Research. 2019, 4 (5): 227-236.   https://doi.org/10.12032/TMR20190717124
Abstract ( 661 )   HTML ( 11 )     PDF (1331KB) ( 244 )  

Highlights

Schisandra oil has a protective effect on liver injury in model of autoimmune hepatitis by inhibiting the activation of T cells and reducing the expression of proinflammatory cytokines.

Abstract

Objective: To study the immunomodulatory effect of schisandra oil (SCO) in mouse model of autoimmune hepatitis induced by concanavalin A (ConA). Methods: C57BL/6 mice were divided into control group, model group and SCO group. Mice in SCO group were given SCO at 5 mg/kg by intragastric administration every day for 7 days, followed by intravenous injection of ConA at 10 mg/kg. 10 hours after ConA injection, the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) were measured by the kits, the expression of inflammatory cytokines like interferon-γ (IFN-γ), interleukin-4 (IL-4), interleukin-17 (IL-17), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β) and interleukin-6 (IL-6) in liver was detected by real-time quantitative PCR, and the T cell activation and IFN-γ expression in spleen and MLN were examined by flow cytometry. Results: Compared with control group, each indicator in model group were significantly higher. In SCO preventive treatment group, the levels of serum ALT, AST and LDH were significantly reduced (all P < 0.001), the expression levels of inflammatory cytokines in liver were downregulated, the T cell activation in spleen and MLN was inhibited (P = 0.006 and P = 0.008), the percentages of IFN-γ+ CD8+ and IFN-γ+ CD4+ T cells were decreased, and the frequencies of Th2 and Th17 cells in spleen and MLN were also decreased at the same time. Conclusion: SCO has a protective effect on immune liver injury by inhibiting the activation of T cells and reducing the expression of inflammatory cytokines, which reflects that SCO plays a role in the immunomodulation of autoimmune hepatitis, indicating that SCO is of great significance for the maintenance of autoimmune homeostasis.

Quantitation of phytochemical constituents of Fumaria vaillantii L. with different extract methods
Fahimeh Mohajerani, Zeinab Pourjabbar, Fatemeh Zamani Mazdeh, Roja Rahimi, Gholam-Reza Amin, Tayebeh Toliyat, Sareh Kargar, Mannan Hajimahmoodi
1Traditional Medicine Research. 2019, 4 (5): 237-245.   https://doi.org/10.12032/TMR20190905134
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Highlights

Total phenolic, total flavonoid, total alkaloid, ascorbic and organic acids yields in Fumaria vaillantii L. aerial parts with different extract methods are evaluated and compared by spectrophotometric and HPLC methods.

Abstract

Objective: The genus fumaria includes more than 40 species in the world. The aim of this study was to quantify the phytochemical constituents of Fumaria vaillantii L. aerial parts and compare the different methods of extraction. Total phenol, total flavonoid, total alkaloid, ascorbic and organic acids (oxalic, maleic, citric, succinic and fumaric acids) yields were evaluated in terms of the temperature effect, type of solvent and maceration time. Methods: Dried plant samples were extracted by different procedures. Total phenolic, total flavonoid, total alkaloid and ascorbic acid yields were determined by spectrophotometric methods. Also, the organic acid yields were analyzed using high performance liquid chromatography method. Results: With the same extraction method, the natural flora extract was showed more yields of oxalic, maleic and citric acids than the commercial one, while the commercial extract was showed more yields of total phenol, ascorbic, succinic and fumaric acids than the natural flora one. The water-boiled extract was showed more yields of total phenol and total flavonoid. The macerated in ethanol 80% extract was also demonstrated more amounts of total alkaloid and ascorbic acid. Among different aqueous macerated extracts of the commercial sample, as the maceration time increased, total phenol, total flavonoid, oxalic, maleic, succinic, fumaric and ascorbic acids yields decreased. Macerated commercial dried fumitory in double-distilled water for 24 hrs resulted in an extract with the highest possible fumaric acid yield. Conclusion: It can be concluded that both water-boiled and macerated in ethanol 80% extracts can be used as rich sources of total phenolic and total flavonoid, which are considered as the important antioxidants.

Assessment of microwave assisted and hydrodistllation extraction on Echinops persicus essential oils chemical composition and evaluation of its biological activity
Maryam Soori, Hossein Abbaspour, Hamid Hashemi-Moghaddam
1Traditional Medicine Research. 2019, 4 (5): 246-256.   https://doi.org/10.12032/TMR20190826132
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Highlights

Microwave assisted hydrodistillation method can extract more compounds and yield of essential oils from Echinops persicus than conventional hydrothermal method as well as further confirms that the methanol extract of E. persicus plant exhibits considerable antioxidant and antimicrobial properties.

Abstract

Background: E. persicus which is well-known as Shakarook in local Persian botany and is extensively utilized in different parts of in Iran. Materials and methods: Essential oils from the aerial parts of Echinops persicus were isolated using hydrodistillation (HD) and microwave assisted hydrodistillation (MAHD) methods and the respective chemical profiles were analyzed by means of GC-MS technique. The in vitro antioxidant and antimicrobial activities of methanol extracts of E. persicus were investigated via using 2,2'-diphenyl-1-picrylhydrazyl (DPPH) assay as well as agar well-diffusion methods. The minimun inhibitory concentrations (MICs) of the methanol extracts of E. persicus against the test microorganisms were determined by the broth microdilution method. Results: GC-MS essential oils analysis shows 29 and 36 compounds constituting 91.9% and 98.2% of the total oils using HD and MAHD methods, respectively. Furthermore, the methanol extracts of E. persicus exhibited higher DPPH radical scavenging activity than vitamin C with an IC50 value of 0.42 ± 0.16 μg/mL. Moreover, the prepared methanol extracts preliminarily showed promising antimicrobial activities against S. aureus with the MIC value of 6.2 mg/mL. Conclusion: This study confirms that the methanol extract of E. persicus plant exhibits considerable antioxidant and antimicrobial properties in vitro.

Natural products as a crucial source of anti-inflammatory drugs: recent trends and advancements
Yan-Hang Wang, Ke-Wu Zeng
1Traditional Medicine Research. 2019, 4 (5): 257-268.   https://doi.org/10.12032/TMR20190831133
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Highlights

This review introduced the current major anti-inflammatory natural active molecules based on their chemical structures, and discussed their pharmacological mechanisms.

Abstract

Natural active molecules are key sources of modern innovative drugs. Particularly, a great amount of natural active molecules have been reported to possess promising therapeutic effects on inflammatory diseases, including asthma, rheumatoid arthritis, hepatitis, enteritis, metabolic disorders and neurodegenerative diseases. However, these natural active molecules with various molecular structures usually exert anti-inflammatory effects through diversiform pharmacological mechanisms, which is necessary to be summarized systematically. In this review, we introduced the current major anti-inflammatory natural active molecules based on their chemical structures, and discussed their pharmacological mechanisms including anti-inflammatory molecular signaling pathways and potential target proteins, which providing a referential significance on the development of novel anti-inflammatory drugs, and also revealing new therapeutic strategies for inflammatory diseases.

Plant distribution and pharmacological activity of flavonoids
Shao-Hui Wang, Yan-Lan Hu, Tong-Xiang Liu
1Traditional Medicine Research. 2019, 4 (5): 269-287.   https://doi.org/10.12032/TMR20190824131
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Highlights 

This review covers the plant distribution and pharmacological activities of flavonoids, stressing the importance of identifying such valuable flavonoids in another genus or family while providing a basis for fully exploiting the therapeutic potential of flavonoids.

Abstract

Flavonoids are natural organic compounds that are widely found in nature, their structural types are complex, and they mainly include flavonoids, flavonols, dihydroflavonols, isoflavones, dihydroisoflavones, chalcones, orange ketones, flavanoids, anthocyanidins, and biflavonoids. This review covers the plant distribution and pharmacological activities of flavonoids. Flavonoids are mainly distributed in angiosperms and gymnosperms, and they are abundant in plants such as Rutaceae, Labiatae, Zingiberaceae, Scrophulariaceae, and Leguminosae. Because of their wide distribution and variety, researchers have found that flavonoids have diverse biological activities, mainly focusing on anti-inflammatory, antibacterial and antitumor activities. Mechanistically, the anti-inflammatory effects are mainly related to the NF-κB and MAPK (mitogen-activated protein kinase) signaling pathway and then the inhibition of the production of inflammatory cytokines and mediators. The antibacterial activity is mainly manifested as inhibitory effects on many strains, including Escherichia coli, Cryptococcus neoformans, and Pseudomonas aeruginosa, via destroying the stability of the microbial membrane, inhibiting the invasion of virulent bacteria into host cells, promoting the apoptosis of bacteria, inhibiting bacterial fatty acid synthesis, etc. The antitumor activity of flavonoids is related to their inhibition of cell proliferation and induction of apoptosis via the mitochondria-mediated, endoplasmic reticulum-mediated, and death factor and its receptor-mediated signal transduction pathways. Understanding the plant distribution and pharmacological activity of flavonoids not only reveals the importance of identifying such valuable flavonoids in another genus or family but also provides a basis for fully exploiting the therapeutic potential of flavonoids.

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