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The Official Journal of China Anti-Cancer Association
Editor-in-Chief: XZ Wu, PhD
ISSN 2413-3973
1Traditional Medicine Research is an international peer-reviewed, Open Access journal. It is dedicated to report the research progress in clinical efficacy, action mechanism and theoretical research on traditional medicine, including traditional Chinese medicine, traditional Indian medicine, Persian medicine, regional medicine, minority medicine and other traditional medicine research around the world. In addition to the editorial, review, basic research and clinical research, letters, news and comment, the following topics are also welcome: comparative research, academic hypothesis, methodological research, traditional literature research, annual advances, standard and guideline. Researches of traditional medicine which have definite historical records, ethnic feature, and regional distribution are welcome especially. In order to focus on breakthrough research in a field, TMR insist on publishing special issues around a topic related to traditional medicine. ... More

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Current Issue     05 September 2019, Volume 4 Issue 5 Previous Issue   
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News
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 ( 122 )   HTML ( 3 )     PDF (259KB) ( 36 )  
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 ( 121 )   HTML ( 5 )     PDF (240KB) ( 68 )  
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 ( 321 )   HTML ( 2 )     PDF (1331KB) ( 105 )  

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.

Traditionality

Wuweizi (Schisandra chinensis) is the fruit of Chinese magnolia vine, a well-known plant species in traditional Chinese medicine. The first description of Wuweizi (Schisandra chinensis) was found in Bencao Gangmu, a famous ancient book of Chinese book written by Li Shizhen in the Ming Dynasty (1552 C.E.-1578 C.E.). The main components of schisandra oil are lignans, which are shown to have hepatoprotective activities.

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
Abstract ( 102 )   HTML ( 3 )     PDF (413KB) ( 46 )  

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.

Traditionality

The genus fumaria (Fumariaceae or Papaveraceae) includes more than 40 species in the world. Seven species are found in Iran. Fumaria vaillantii L. is one of the species which grow in a wide variety of areas of Iran with the common name of fumitory or earth smoke. The aerial parts of the plant which harvested during flowering time are used for medicinal purposes.

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
Abstract ( 54 )   HTML ( 2 )     PDF (437KB) ( 46 )  

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.

Traditionality

E. persicus is well-known as Shakarook in local Persian botany and it has been known since the time of Avicenna and was prescribed for cough and respiratory system as an effective drug. In Persian folk medicine, this plant has been widely prescribed as a flavoring agent and an effective remedy to treat influenza, cough, fever, throat dryness, etc. E. echinatus is also extensively utilized in Indian traditional folklore and Pakistan ethno-veterinary medicine.

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
Abstract ( 349 )   HTML ( 3 )     PDF (758KB) ( 170 )  

Highlights

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

Traditionality

Compared with non-steroidal anti-inflammatory drugs and glucocorticoids, natural anti-inflammatory compounds from plants may have more advantages due to less side effects and toxic reactions.

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
Abstract ( 82 )   HTML ( 3 )     PDF (717KB) ( 46 )  

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.

Traditionality

Flavonoids are found in some traditional Chinese medicines that function to clear heat and dampness, some pathological products resulted from diseases. The most representative drugs among them are Huangqin (Scutellaria baicalensis), Chuanhuangbai (Phellodendri Chinensis Cortex), and Kushen (Sophora flavescens). As early as the Donghan dynasty of China, these three herbs were recorded in an ancient book of Chinese medicine called Shennong Bencao Jing.

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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  • The role of natural products in regulating pyroptosis 
    ...
    Highlights
    This manuscript categorizes and concludes research results on the correlation between different natural products and pyroptosis in recent years.

    Traditionality

    The present review summarizes many natural products coming from traditional Chinese medicine that play the role in regulating pyroptosis, such as Chuanxinlian [Andrographis paniculata (Burm. f.) Nees.], Gancao (Glycyrrhiza uralensis Fisch.), Huanglian (Coptis chinensis Franch.), Tusizi (Cuscuta chinensis Lam.), Heizhima (Sesamum indicum L.), etc. The first record about Gancao (Glycyrrhiza uralensis Fisch.) and Huanglian (Coptis chinensis Franch) is in the ancient book of Chinese medicine named Shennongbencaojing (Donghan dynasty of China).

    Abstract

    In recent years, large numbers of novel cell death types have been reported such as autophagic death, paraptosis, mitosis, oncosis and pyroptosis. As a new type of proinflammatory programmed cell death, pyroptosis has attracted increasing attentions gradually, and its morphological characteristics and molecular mechanisms are significantly different from other cell death types such as necrosis and apoptosis. Many research groups have demonstrated the association between pyroptosis and various human diseases including immunological disease, cancer, atherosclerosis, infectious disease, and cardiovascular and cerebrovascular disease. Natural products are small molecules synthetized in organisms including primary and secondary metabolites. Natural products are important sources of modern innovative drugs discovery and can be used as key tools to explore the molecular mechanism of cell fate. The aim of this study is to review the molecular mechanisms and pathways of pyroptosis, and to categorize and conclude research results on the correlation between different natural products and pyroptosis in recent years. In this study, a total of 39 papers were enrolled in analyses. The molecular pathways and mechanisms of pyroptosis were clearly described. Fourteen types of natural products, their sources, effects, mechanisms and therapeutic potentials are categorized and illuminated. It is showed that a variety of natural products and pyroptosis have close correlations. They negatively or positively affect or act on different positions of pyroptosis inflammatory pathways, indicating that they may have certain potential therapeutic effects on pyroptosis-related diseases. Pyroptosis, a relatively new way of cell death, is closely associated with a variety of diseases. Natural products can have obvious effects on the process of pyroptosis as potential sources of new drugs. In-depth studies using natural products to investigate pyroptosis will help to enhance our understandings of human diseases and establish effective prevention and treatment strategies.

    ...
    Yi-Zhen Bai, Ke-Wu Zeng
  • Treatment of diabetic foot ulcer with medicinal leech therapy and honey curcumin dressing: a case report 
    ...
    Highlights
    Wound healing impairment and ulcers in the foot, with pain and disability, are common complications of diabetes. The present case report shows the effectiveness of leech therapy in combination with honey and curcumin dressing on disease progression in a patient with diabetic foot ulcer. 

    Traditionality
    In Iranian traditional medicine, leeches are used to treat many diseases. Natural honey and curcumin are available for dressing all types of ulcers. Hakim Aghili reported several operative properties that make them appropriate for wounds. Medicinal leech therapy was first documented in a painting of an Egyptian tomb in 1500 B.C.E. Subsequently, the use of leech therapy for medicinal purposes increased dramatically in the 17th and 18th centuries in Europe and Asia. In 1960s, leeches were used in reconstructive surgery to eliminate intravenous congestion. In 1970s, leech therapy was used only in microsurgeries. The Food and Drug Administration legalized medicinal leech therapy in 2004. 


    Abstract 

    Background: Diabetic foot ulcers (DFUs) are common in patients with diabetes. The mortality rate of DFUs is ranked the highest after cancer. With advancements in modern medicine, leech therapy, a traditional treatment method for chronic wounds in Iranian medicine, has proven effective in relieving venous congestion. Herein, we aimed to observe the curative effects of leech therapy in combination with honey and curcumin dressing in a 77-year-old patient with a diabetic foot ulcer (UFC). Methods: Two medium-sized medicinal leeches were placed surrounding a grade 2 wound, based on Wagner’s classification system, located on the right first toe. The patient reported a visual analogue scale (VAS) score of 8. After leech therapy, the wound was covered with honey and curcumin, followed by oral administration of ciprofloxacin for 10 days. Results: Pain increased immediately after leech therapy (VAS: 9-10) but decreased significantly (VAS: 6) 2 days after the therapy. At the end of the 2nd day, pain completely disappeared. After 3 weeks, there was no wound on the toe. After 12 weeks, there were no traces of the wound. Conclusion: Leech therapy in combination with honey and curcumin dressing is effective against disease progression in patients with DFUs. 

    ...
    Shirbeigi Laila, Eghbalian Fatemeh, Bakhtyari Lida
  • Complementary and alternative medicine applications in cancer medicine 
    ...
    Highlights
    (1) The use of complementary and alternative medicine (CAM) is growing rapidly especially among
    younger female patients with cancer with higher education.
    (2) Most patients with cancer consider CAM as a harmless option in their healing process, which is not
    always the case.
    (3) Clinical-based evidence for mind-body therapies has been established, and this type of CAM can be

    recommended for patients with cancer during chemotherapy.


    Traditionality

    The use of complementary and alternative medicine (CAM) plays an important role in the prevention and treatment of diseases since the ancient times. In the 16th-11th century B.C.E., there were earliest notes of tumors and their treatment methods were described by traditional Chinese practitioners. It has been known that herbal medicine are used in Egypt and in traditional Chinese medicine since 4500 B.C.E. Since the early 1970s, the use of CAM in cancer treatment has expanded worldwide. Numerous studies point to the benefits of Ayurveda yoga in patients with cancer, improving quality of life. China acupuncture has been shown beneficial in controlling vomiting and pain in patients with cancer. Reflexology, which was practiced for years by followers of Chinese, Egyptian, and Indian medicine, has been successfully used to relieve pain in patients with cancer. Mushroom Agaricus blazei has been mostly used in Japan but is currently in the first phase of the clinical trial in patients with cancer. 



    Abstract

    Besides conventional medicine, many patients with cancer seek complementary and alternative medicine (CAM) as an additional treatment option. Since the early 1970s, the use of CAM in cancer treatment has expanded worldwide. CAM, as a tempting option, was used by patients with cancer mainly due to easy accessibility. Patients with cancer used CAM to achieve better quality of life or to find a cure. As physicians are mainly unaware of CAM use by patients, doctor-patient communication about CAM use should be brought to a higher level. To identify circumstances in which CAM are preferred, further investigations are needed especially in biologically based therapies. Clinical-based evidence for mind-body therapies have been established, so this type of CAM can be recommended for patients with cancer during chemotherapy. Future studies are necessary to fill the gaps so that CAM users, as well as medical experts, are in position to clearly determine all the benefits and disadvantages of the mentioned therapy.



    ...
    Milena Jurisevic, Sergey Bolevich
  • Complementary and alternative medicine in European countries - legislative framework 
    ...

    Highlights
    The present article reviews the available data regarding the use of the complementary and alternative medicine and the legislation behind it in European countries. 

    Traditionality
    Complementary and alternative medicine has been used for centuries. Since ancient times to date, these methods have been improved in line with the progress of Western medicine. Today, these methods have been applied in many countries around the world. 

    Abstract 

    Complementary and alternative medicine (CAM) is a set of different diagnostic and therapeutic procedures, as well as the use of natural products for the treatment of patients, derived from previously known traditional methods and enriched with modern scientific knowledge. The present article reviews the available data regarding the use of CAM and the legislation behind it in European countries. The use of CAM is recorded in Europe as a whole and varies between 10-70% of the population of individual European countries. At least 300,000 registered CAM providers have been identified in the European Union (EU), of which slightly more than half includes non-medical practitioners. The most practiced discipline is acupuncture, followed by homeopathy. CAM regulation and legislation in Europe is not precisely defined and is constantly striving to find a common approach. Since legal frameworks for CAM are not defined, each European country has its own regulations and legislation. In order to define universal legislation for CAM, the EU created the CAMbrella project, a project of the EU designed to find a unique system that would include the treatment of CAM in Europe. According to the data from CAMbrella, from 39 countries in the EU, 17 have general CAM legislations. The status of CAM in Europe is characterized by enormous heterogeneity in all aspects, including terminology, methods, prevalence and ultimately, legal status, regulations and legislation.

    ...
    Jovana Milenkovic, Sergey Bolevich, Gvozden Rosic

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