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05 November 2019, Volume 4 Issue 6 Previous Issue   
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Tu Youyou:A scientist moving forward in controversy
Editor Group of Traditional Medicine Research
1Traditional Medicine Research. 2019, 4 (6): 288-289.   https://doi.org/10.12032/TMR20190922136
Abstract ( 130 )   HTML ( 0 )     PDF (305KB) ( 31 )  

The 13th National People's Congress Standing Committee was held in Beijing on Sept. 17, 2019. President of China Xi Jinping signed a presidential decree to award individuals, national medals and honorary titles. Tu Youyou, the winner of the 2015 Nobel Prize in physiology or medicine, was awarded the Medal of the Republic [1].

As the winner of the 2015 Nobel Prize in physiology or medicine, Tu Youyou and her team, discovered that artemisinin and dihydroartemisinin could be used to treat malaria [2]. Although Tu Youyou won the Nobel Prize in 2015, she didn’t have a Ph.D. degree. In 2017, she did not been admitted to the Chinese Academy of Sciences again [3].

As early as Oct. 9, 2015, <em>The New York Times</em> reported, “Q. and A.: Tu Youyou on Being Awarded the Nobel Prize”: “Q: Are you disappointed not to have been admitted to the Chinese Academy of Sciences? A: I applied many times, because people told me I should. I did receive a few awards for the discovery. At the National Science Conference in 1978, my team was given an award. As the team leader, I accepted on behalf of the team. The Minister of Public Health personally recommended me for academy membership. However, many factors must come into play. It’s complicated [4].”

Usually, the Nobel Prize is awarded to individuals only [5]. Research of artemisinins has been carried out since the early 1970s, by hundreds of scientists all together under the “whole nation" system. For example, Xu Liu of Guilin Pharmaceutical Company designed and synthesized dihydroartemisinin C10-monoesters of diacids [6]. “Tu was the first to show that this component, later called Artemisinin, was highly effective against the malaria parasite, both in infected animals and humans.”the Nobel Committee said [7].

In 2011, Tu Youyou was awarded by the Lasker Foundation. The Lasker Award is often seen as a precursor to the Nobel Prize. This event reignited a controversy over whether one person should be recognized for developing the drug. Some Chinese scientists even co-authored letters to the Nobel Committee, stating that "We would rather no-one have this Nobel Prize, rather than Tu Youyou have it alone [8, 9]." 

It is noted that Tu Youyou turned to ancient texts of Chinese medicine named <em>Zhouhou Beiji Fang</em> and discovered clues to identify and extract the active component of the Chinese herbal medicine Qinghao (<em>Artemisia carvifolia</em>&nbsp;Buch.-Ham. ex Roxb. Hort. Beng.). She then delivered her Nobel Lecture titled “Discovery of Artemisinin - A Gift from Traditional Chinese Medicine to the World” on Dec. 17, 2015 at Aula Medica, Karolinska Institutet in Stockholm [10]. This made traditional medical practitioners, especially Chinese medicine practitioners very excited as they hoped it would bring some positive publicity to usefulness of traditional medicine. However, the Prize motivation on official website is still just "for her discoveries concerning a novel therapy against Malaria [2]."

On May 30, 2019, the latest research results of the Tu Youyou team were published on <em>The New England Journal of Medicine</em> titled A Temporizing Solution to “Artemisinin Resistance" [11]. In addition, the application for the "Clinical trial of dihydroartemisinin tablet in the treatment of systemic lupus erythematosus and discoid systemic lupus erythematosus" submitted by the Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, where the Tu Youyou team is located, has been approved. Kunming Pharmaceuticals, Inc. is the responsible party [12].

Comment
The research of acupuncture on the treatment of alcohol dependence: hope and challenge
Xue Yang
1Traditional Medicine Research. 2019, 4 (6): 290-292.   https://doi.org/10.12032/TMR20191009138
Abstract ( 96 )   HTML ( 3 )     PDF (295KB) ( 76 )  
Acupuncture, a well-known form of alternative therapy, has been used for treating various disorders including pain, certain drug addiction, and withdrawal syndromes [1-5]. Although there is not any histological or physiological evidence of traditional Chinese medical concepts such as Qi, meridians and acupoints, there is clear scientific evidence that acupuncture relates to endogenous opioid peptides release, and acupuncture can increase the activity of dopaminergic neuron in mesolimbic brain region through the endogenous opioid peptides [6-8]. Till today, there is no convincing evidence to illustrate the nature of acupoints and also no clear mechanism explaining how the signals transport to the central nervous system from the special acupoints. However, recent research have found that the afferent impulses induced by acupuncture can be transmitted by Aβ and AΔ fibers [9, 10], which sent the itch and tactile sensation to the brain; then the signals activate spinal cord, midbrain and pituitary-hypothalamus, which lead to the release of three endorphins and other monoamines [11-13]. These results suggest that acupuncture can indeed activate neurons in the brain to perform physiological functions.
Special Issue on Endocrine and Metabolism
A systematical review of traditional Ayurvedic and morden medical perspectives on Ghrita (clarified butter): a boon or bane
Vd. Varnika Singh, Vd. Shalini Rai, Vd. Vijay Kumar Rai
1Traditional Medicine Research. 2019, 4 (6): 293-304.   https://doi.org/10.12032/TMR20190325111
Abstract ( 325 )   HTML ( 4 )     PDF (435KB) ( 101 )  

Highlights

Ghrita (clarified butter), treated as the culprit of a number of diseases, has been depicted incorrectly for a long time. This review presents the complete picture in view of Ayurvedic perspective and recent researches on Ghrita to let the readers contemplate again on Ghrita.

Traditionality

Ghrita, also called as clarified butter in Sanskrita, has been used for more than 5, 000 years throughout the Indian subcontinent and has been an inevitable part of diet in the Indian cuisine. It has also been traditionally associated with a number of health benefits recorded in Charaka (the most ancient written text of Ayurveda dating to second century B.C.), such as promoting strength and longevity, promoting appetite and digestion, increasing cognition, etc.

Abstract

Background: For long dietary guidelines, it is recommended to avoid foods rich in saturated fatlike Ghrita, also named clarified butter or ghee, which is considered as the culprit of cardiovascular diseases, diabetes, stroke, etc. Contradictory to the modern medical science, Ayurveda advocated for numerous benefits of the usage of Ghrita in the judicious manner. This paper systematically reviews and analyses the scientific researches that carried out on the benefits and harms associated with the usage of Ghrita. Methods and Findings: A search over the various search engines like Pubmed, Google was made. The relevant articles and chapters from books retrieved in English language were saved to a folder and analysed for their utility relevant to the topic and the matter was presented in a systematic manner. Results: Ghrita consisted various fats (saturated, monosaturated and polyunsaturated), fatty acids, minerals, vitamins etc. And the composition of Ghrita varies along with the method of preparation. Scientific researches carried out on Ghrita plain as well as medicated have reported about the depressant effects of medicated Ghrita in gross behavioural tests, potentiated phentobarbitone sleeping time, analgesic effect and stimulatory effect on cognition. Further, studies conducted to evaluate the effect of Ghrita on the serum lipid levels showed a dose dependant decrease in the total cholesterol, low density lipoproteins, and very low density lipoproteins. Ghrita was also reported to have wound healing activity. Conclusion: The results of the study suggest the beneficial effects of plain as well as medicated Ghrita on the various components of health and break the myth associated to the exclusion of Ghrita in diet. These researches also substantiate the claims made by the classical texts of Ayurveda.

Effects of Siwei Yuganzi decoction on LXRα and CYP7A1 in hyperlipidemic rats
Ru-Yi Yang, Hong-Bin Wang, Pan-Pan Zhou
1Traditional Medicine Research. 2019, 4 (6): 305-313.   https://doi.org/10.12032/TMR20191024142
Abstract ( 194 )   HTML ( 1 )     PDF (1045KB) ( 36 )  

Highlights

A Tibetan (one of the ethnic minorities in China) compound preparation, Siwei Yuganzi decoction, can improve the serum levels of TC, TG, and LDL-C in the hyperlipidemic animal model via increasing the expression of both LXRα and CYP7A1 mRNA and proteins in the liver tissue.

Traditionality

Siwei Yuganzi decoction is an adaptation of a classical prescription of the Tibetan medicine called Sanguo decoction, which is recorded in the classic ancient book of Tibetan medicine entitled Sibu Jingdian, written by the famous Tibetan medical scientist named G.yuthog Rnyingma·Yontan Mgonpo in 800 C.E..

Abstract

Background: Hyperlipidemia (HLP) is a disorder in which lipids in the blood are disturbed due to abnormal lipid metabolism. Statins and fibrates lipid-regulating drugs prevent the generation of lipids and improves HLP, thereby reducing the likelihood of developing cardiovascular and cerebrovascular diseases. However, their adverse reactions and side effects limit a wide range of clinical applications. Tibetan medicine compound preparation Siwei Yuganzi decoction (SYD) is an adaptation of a classical prescription of the Tibetan medicine Sanguo decoction, that has been proved to have the effect of improving lipid metabolism; however, its possible mechanism remains unknown. Methods: Sixty specific-pathogen free grade Sprague Dawley rats were randomly divided into the blank control group, the HLP group, the Chinese patent medicine Xuezhikang positive control group, and the treatment groups with Tibetan SYD high-, middle-, and low-dosages respectively. Ten rats were assigned to each group. Every rat in these groups was fed with a high-fat emulsion to establish the hyperlipidemic animal model, except for those in the blank control group. Then the rats in the blank control and HLP groups were fed with 0.9% normal saline, those in Xuezhikang group were fed with Xuezhikang suspension at the dose of 0.11 g/kg/d, and those in SYD groups were fed with the SYD suspension at the dosage of 16.2 g/kg/d (high dosage), 10.8 g/kg/d (middle dosage), and 5.4 g/kg/d (low dosage), respectively. After 8 weeks, the levels of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were detected by the ELISA. The mRNA and protein expression levels of liver X receptor α (LXRα) and cholesterol 7α-hydroxylase 1 (CYP7A1) were detected using RT-PCR, western blotting, and immunohistochemistry. Results: The serum levels of TC, TG, and LDL-C in the HLP group were higher than those in the blank control group (P < 0.05), whereas the serum levels of HDL-C and the expression levels of both LXRα and CYP7A1 mRNA and proteins in the liver in the HLP group were lower than those in the control group (P < 0.05). After the treatment of the Xuezhikang and SYD, the serum levels of TG, TC, and LDL-C significantly decreased (P < 0.05), whereas the serum levels of HDL-C and the expression levels of both LXRα and CYP7A1 mRNA and proteins in the liver significantly increased compared with those in the HLP group (P < 0.05). Furthermore, The serum levels of TC, TG, and LDL-C in the SYD group at high dosage were lower (P < 0.05), the serum level of HDL-C was higher, and the expression levels of both LXRα and CYP7A1 mRNA and proteins in the liver tissue were higher than those in the Xuezhikang group (P < 0.05). Conclusion: SYD can improve the serum levels of TC, TG, and LDL-C in the hyperlipidemic animal model via increasing the expression of both LXRα and CYP7A1 mRNA and proteins in the liver tissue.

Effectiveness of health coaching on diabetic patients: A systematic review and meta-analysis
Nashwa Mohamed Radwan, Hisham Al Khashan, Fahad Alamri, Ahmed Tofek El Olemy
1Traditional Medicine Research. 2019, 4 (6): 314-325.   https://doi.org/10.12032/TMR20191024143
Abstract ( 78 )   HTML ( 2 )     PDF (802KB) ( 45 )  

Highlights

Health coaching intervention has a significant effect on hemoglobin A1c and high-density lipoprotein cholesterol of patients with diabetes mellitus.

Traditionality

The first use of the term "coach" arose around 1830 in Oxford University as a slang in relation with an instructor or trainer or tutor who "carried" a student through an exam. The term “coaching” thus refers to the process of transporting people from where they are to where they want to be. In 1915, the National Board of Medical Examiners was founded. In 2002, Wellcoaches partnered with the American College of Sports Medicine. In 2010, the National Consortium for Credentialing Health and Wellness Coaches was founded. In 2017, the International Consortium for Health and Wellness Coaching was established. Coaching as a method to improve healthy lifestyle behaviors has received special attention in recent years.

Abstract

Background: Using health coaching to improve the quality of life and health outcomes of the patients with diabetes mellitus, has emerged as a possible intervention. However, the few published randomized controlled trials using health coaching for patients with diabetes mellitus have reported mixed results. The present meta-analysis aimed to determine the effectiveness of health coaching on modifying health status and quality of life among diabetic patients and to clarify the characteristics of coaching delivery that make it most effective. Methods: This study searched for articles on randomized controlled trials of health coaching interventions targeting type 2 diabetic patients that were published in the English language from January 2005 through December 2018 in the Cochrane, Medline, PubMed, Trip, and Embase databases. Patients in the control group received usual diabetes mellitus care, and those in the experimental group received health coaching based on usual diabetes mellitus care. The primary outcomes included Hemoglobin A1c (HbA1c) and cardiovascular disease risk factors, including systolic blood pressure, diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol, total cholesterol, and body weight. The secondary outcomes included quality of life, self-efficacy, self-care skills, and psychological outcomes. Results: Health coaching intervention has a significant effect on HbA1c [mean difference (MD) = -0.35, confidence interval (CI) = -0.47, -0.22, I2 = 83%, P < 0.001] and HDL-C (MD = -0.50, CI = -0.93, -0.07, I2 = 10%, P = 0.02). The most effective strategy for health coaching delivery associated with improvement of HbA1c was decreasing the number of sessions and increasing the duration of each session. However, no significant difference was found for weight, SBP, diastolic blood pressure, triglyceride, low-density lipoprotein cholesterol, or total cholesterol. Mixed results were reported for the effect of health coaching on quality of life, self-efficacy, self-care skills, and depressive symptoms outcome. Conclusion: Health coaching intervention has a significant effect on HbA1c and HDL-C, and the most effective strategy is decreasing the number of sessions while increasing session duration. However, these results should be interpreted with caution as the evidence comes from studies at some risk of bias with considerable heterogeneity and imprecision.

Study on the relationship between the structure of bacterial flora on the tongue and types of tongue coating in patients with type 2 diabetes mellitus
Yu-Hong Ding, Xing-Yu Zheng, Wei-Wei Chen, Xin-Fu Lin, Xiao Yang, Jie-Wei Luo, Fang-Meng Huang, Yong-Xi Wu, Shi-Chao Wei
1Traditional Medicine Research. 2019, 4 (6): 326-337.   https://doi.org/10.12032/TMR20190530122
Abstract ( 241 )   HTML ( 3 )     PDF (1423KB) ( 100 )  

Highlights

The incidence of type 2 diabetes mellitus (T2DM) is related to the imbalance of oral microflora in the human body. The characteristic tongue coating flora structure, containing Prevotella, Fusobacterium, Streptococcus, Neisseria, etc., can influence the formation of yellow thick coating. However, the role of yellow thick coating in the incidence of T2DM needs further investigation.

Traditionality

Diabetes is called “Xiaoke” in traditional Chinese medicine. According to the record of Jin Kui Yao Lue (an ancient book of Chinese medicine published in the Han dynasty of China), the typical clinical symptoms of “Xiaoke” is thirsty for drinking water and dry mouth, suggesting that as early as Han dynasty, Chinese medicine associated the onset of diabetes with the mouth and tongue symptoms. Currently, it is believed that a two-way interaction exists between diabetes and periodontitis, a disease resulted from the imbalance oral microbial community. In 2015, “National Individual Microbiome Detection Project” was launched with the aim of finding biomarkers or risk factors for diseases in oral, skin, and intestinal microbial communities.

Abstract

Objective: To analyze the characteristics of bacterial flora on the tongue and types of tongue coating between healthy individuals and patients with type 2 diabetes mellitus (T2DM) via detecting 16S rDNA of oral tongue coating microbial group. Methods: A total of 42 patients with T2DM were recruited, including 6 with thin white coating, 9 with mirror-like coating, 27 with yellow thick coating (YTC), and 28 healthy individuals. The V4 region of 16S rDNA from the tongue coating microbiota was sequenced using the Linux ubuntu sequencing platform, and the structure of bacterial flora in the tongue was analyzed. Treeplot construction, principal coordinates analysis, redundancy analysis, and linear discriminant analysis were conducted using R software to analyze the differences of bacterial flora in the tongue coating in each group. Results: A total of 8131 different operational taxonomic units (OTUs) were obtained via sequencing, of which 719 OTU samples showed significant differences (P < 0.05). Comparing OTUs with the 16S rDNA database of known species and annotation of parallel species revealed 16 species with differences at the phylum level, 31 at the class level, 54 at the order level, 88 at the family level, and 161 at the genus level. The dominant bacteria found in patients with T2DM included Lactobacillus, Streptophyta, Chloroplast, Cyanobacteria-Chloroplast, and Bifidobacteriaceae, etc. Dominant bacteria in the control group belonged to Pasteurellales, Pasteurellaceae, Leptotrichiaceae, Lachnoanaerobaculum, and Ignavibacteria among other bacterial families. All samples were clustered into three groups, each group characterized by dominant bacteria. The order of dominant bacteria in group 1 were Prevotella > Neisseria > Veillonella > Streptococcus > Fusobacterium > Leptotrichia and so on. The order of dominant bacteria of group 2 were Neisseria > Prevotella > Fusobacterium > Streptococcus > porphyromonas and so on. The dominant bacteria of group 3 were Prevotella > Fusobacterium > Streptococcus > Neisseria > Leptotrichia > Rothia > Veillonella > porphyromonas > f_Pasteurellaceae > Capnocytophaga > Actinomyces > Alloprevotella and so on. Single factor risk estimation: with group 1 used as the reference (OR = 1), the risk of carrying group 2 and group 3 microflora with T2DM increased (OR values were 4.77 and 7.78, respectively). The proportion of group 1 microflora in the control group (25.9%) was higher than that in the T2DM group (5.4%) (χ2 = 3.873, P = 0.049). Compared with group 1 and group 2, group 3 had a significantly dominant microflora structure in YTC group (χ2 = 7.120, P = 0.008). RDA analysis indicated that Neisseria, Fusobacterium, and Prevotella were associated with HbA1c values > 10 mmol/L, whereas Rothia, Streptococcus, and Veillonella were more correlated with HbA1c ≤ 10 mmol/L. Conclusion: The incidence of T2DM is related to the imbalance of oral microflora in the human body. The tongue coating flora structure may influence the formation of different tongue coating types in this metabolic condition. Additionally, flora structures of Prevotella, Neisseria, and Fusobacterium were associated with elevated HbA1c.

Treatment of diabetic foot ulcer with medicinal leech therapy and honey curcumin dressing: a case report
Shirbeigi Laila, Eghbalian Fatemeh, Bakhtyari Lida
1Traditional Medicine Research. 2019, 4 (6): 338-344.   https://doi.org/10.12032/TMR20190728128
Abstract ( 423 )   HTML ( 7 )     PDF (393KB) ( 183 )  

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.

Errata Notice
Errata Notice
Editor Group of Traditional Medicine Research
1Traditional Medicine Research. 2019, 4 (6): 345-345.   https://doi.org/10.12032/TMR20191022140
Abstract ( 63 )     PDF (316KB) ( 24 )  

On page 177, “确认是和 DNM 还是 DN 比较?” was a text comment written by an editor for fact checking purposes. It should have been removed before publishing. 

We deeply apologize to the readers and the authors of this article for this publishing mistake.

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