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02 January 2020, Volume 5 Issue 1 Previous Issue    Next Issue
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Frequent attacks on health workers in China: social changes or historical origins?
Editor Group of Traditional Medicine Research
1Traditional Medicine Research. 2020, 5 (1): 1-3.   https://doi.org/10.12032/TMR20191030144
Abstract ( 169 )   HTML ( 6 )     PDF (265KB) ( 98 )  

According to a message posted by the official Weibo account of Chengguan Sub-bureau of the Lanzhou Public Security Bureau in Gansu Province of China, on the morning of October 22, 2019, a suspect named Yang (male, aged 54 years, a native of Lanzhou City of Gansu Province) attacked a doctor Feng (female, aged 42 years, a native of Lanzhou City) with a knife at Gansu Provincial Hospital. Unfortunately, despite all efforts to rescue her, Feng passed away. After the incident, Public Security Institutions immediately took control of suspect Yang. According to the preliminary investigation, Yang once underwent a surgery for rectal cancer at Gansu Provincial Hospital, in which Doctor Feng was his attending physician. The case is currently under further investigation [1].

History book entitled Shi Ji (the Grand Historian) combines the biographies of famous doctors Bian Que and Chunyu Yi into the Bian Que Cang Gong Lie Zhuan (Biography of Bian Que and Cang Gong) [2]. According to the record of Shi Ji, as early as in the Zhou Dynasty (1046-256 B.C.E.) of China, Bian Que (407-310 B.C.E.) died from murder. When the chief physician of Qin State Li Xi—learned that his medical skills were not as good as Bian Que’s, he sent an assassin to kill him.

Editor-in-Chief of Special Issue on Integrative Oncology
1Traditional Medicine Research. 2020, 5 (1)  
Abstract ( 53 )     PDF (196KB) ( 19 )  
Prof. Li had oncology research experience at Cornell University and University of South Florida in the United States. Now he is mainly engaged in researches on molecular mechanism of cancer metastasis and new targets for cancer prevention and treatment, as well as Traditional Chinese Medicine therapies for the clinical prevention and treatment. He received Special Government Allowances of the State Council and won honorary titles including Millions of Leading Engineering Talent, National Young and Middle-aged Expert with Outstanding Contributions, Shanghai Extraordinary Academic Leader, Shanghai Leading Talent, Shanghai Medical Leading Talent, and Shanghai Traditional Chinese Medicine Leading talents. He is the president of Specialty Committee of Precision oncology in WFCMS (World Federation of Chinese Medicine Societies) , the vice chairman of Integrated Traditional and Western Medicine Cancer Branch of China Anti-Cancer Association, the vice president of WFCMS Specialty Committee of Classical Traditional Chinese Medicine Formula for Cancer Treatment and Research, and the vice president of Immunology Branch of China Association for the promotion of traditional Chinese Medicine, Vice Chairman of Shanghai Anti-Cancer Association, Deputy Director of Tumor Branch of Shanghai Association of Chinese Integrative Medicine, and Standing Committee Member of Cancer Branch of China Association of Chinese Medicine. Prof. Li has undertaken 1 national key discipline of traditional Chinese medicine, and presided over 6 major research projects including international ones and others funded by National Natural Science Foundation of China, and 36 major projects at the provincial and ministerial level. The research achievements won 15 awards including Ministry of Education Science and Technology Progress Award, China Medical Science and Technology Award, China Traditional Chinese Medicine Science and Technology Progress Award, and Shanghai Science and Technology Progress Award. He has over 20 national patents and received awards including the first Contribution Awards for China Integrated Traditional Chinese and Western Medicine, Meiji Life Science Award, Shanghai Silver Snake Award, and Shanghai Science and Technology Innovation Model. He published 5 monographs as an editor-in-chief and more than 360 articles in domestic and foreign journals including Cell Metabolism, British Journal of Cancer, Nature Communications, PNAS, 95 of which were published by SCI journals. The total impact factor is over 300, with the highest of 22.415. Besides, he trained 52 students including masters, doctoral, and postdoctoral researchers. Main research direction: 1. To prevent and treat precancerous lesions, multi-drug resistance, angiogenesis and metastasis via Integrative Chinese Medicine and Western medicine; 2. Biological basis and mechanism of intestinal microbiota in colorectal cancer with damp-heat syndrome; 3. Establishment of the targeted drug delivery system of Traditional Chinese Medicine and its application in tumor treatment.
Comment·Special Issue on Integrative Oncology
The role of acidic microenvironment in the tumor aggressive phenotypes and the treatment
Jian Hao
1Traditional Medicine Research. 2020, 5 (1): 4-6.   https://doi.org/10.12032/TMR20191231153
Abstract ( 143 )   HTML ( 13 )     PDF (743KB) ( 120 )  
Recently, the scammer who advocated "acid constitution" as the source of all diseases was fined 105 million US dollars, and the "acid-base balance" theory he founded was also criticized. Although the "acid constitution" of the human body is full of pseudoscience, many tumors are indeed "acid constitution". Increased glycolysis, hypoxia, and insufficient tissue perfusion as well as a large amount of acid and metabolite metabolites that accumulated in the tumor microenvironment, making the tumor microenvironment acidic [1–3]. Microenvironment acidification plays an important role in tumor progression and can provide a favorable environment for tumor cell generation [4]. Acidosis is one of the basic characteristics of tumor microenvironment. Unlike normal cells, cancer cells can adapt to a low pH environment by increasing glycolysis, while activating the activity and expression of proton transporters that normalize the pH in the cell [1–4]. Acidosis-driven adaptation also triggers the emergence of aggressive tumor cells in subpopulations that exhibit increased invasion, proliferation, and resistance [5]. Acidosis can also promote immune escape and thus maintain tumor growth [6, 7]. Although there is an important relationship between too much lactic acid in tumor microenvironment and tumor cell invasion, few studies have explored which areas in the tumor are acidic and how too much lactate affects gene expression to promote tumor invasion. Researchers have conducted in-depth research on this issue and found that the slightly acidic environment in tumors can help cancer cells produce proteins that make them more malignant. Related research results have been published in Cancer Research [8]. Researchers determined the acidic sites in tumors by injecting a tumor-tagged mouse with a fluorescently labeled pH-responsive polypeptide. Unexpectedly, the researchers found that the acidic region not only overlapped with the hypoxic region, but also with the highly proliferative and highly invasive cell regions at the tumor matrix interface. These regions were characterized by increased expression of matrix metalloproteinase and degradation of the basement membrane degree. By performing RNA sequencing of cells in the low pH region, the researchers found that the reset of the transcriptome involved in RNA splicing increased the targets of RNA-binding proteins that specifically bind to AU-rich sequences. The low-pH signature indicated extensive changes in alternative splicing and was notably enriched for splicing of genes implicated in regulation of adhesion and cell migration. Surprisingly, this selective shear could be reversed by experiments that neutralize the acidic environment in vitro and in vivo. These findings reveal the impact of local acidity in tumor microenvironment on tumor invasion and metastasis.
Special Issue on Integrative Oncology
Complementary and alternative medicine applications in cancer medicine
Milena Jurisevic, Sergey Bolevich
1Traditional Medicine Research. 2020, 5 (1): 7-21.   https://doi.org/10.12032/TMR20190728127
Abstract ( 441 )   HTML ( 9 )     PDF (443KB) ( 404 )  

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.

Research hotspot and frontier progress of cancer under the background of precision medicine
Li-Hong Zhou, Yan Li, Qi Li
1Traditional Medicine Research. 2020, 5 (1): 22-33.   https://doi.org/10.12032/TMR20190225101
Abstract ( 132 )   HTML ( 5 )     PDF (471KB) ( 88 )  

Highlights

This paper takes stock from five aspects, namely, treatment methods, detection technology, new drug research and development, information data and traditional Chinese medicine, with a view to "from the point to the surface", "from the outside to the inside", and "the combination of Chinese and western", so as to explore the overall picture of cancer treatment and research.

Abstract

The timely introduction and rapid development of precision medicine have provided strong theoretical support and technical support for tumor research. The treatment methods have been developed from single to multiple; the research technology has been transformed from macro to micro; the treatment drugs have been updated from systemic chemotherapy to targeted therapy and immunotherapy, and cancer has changed from a highly lethal disease to a "chronic disease". Based on the current international cancer research hotspots and treatment frontiers, this paper takes stock from five aspects, namely, treatment methods, detection technology, new drug research and development, information data and traditional Chinese medicine, with a view to "from the point to the surface", "from the outside to the inside", and "the combination of Chinese and western", so as to explore the overall picture of cancer treatment and research.

Application of nanoparticles in the early diagnosis and treatment of tumors: current status and progress
Chaoliang Tang, Heng Li, Junmou Hong, Xiaoqing Chai
1Traditional Medicine Research. 2020, 5 (1): 34-43.   https://doi.org/10.12032/TMR20191228152
Abstract ( 302 )   HTML ( 7 )     PDF (494KB) ( 154 )  

Highlights

The present review discusses the application of nanoparticles in the early diagnosis and treatment of tumors, through Western and traditional Chinese medicine, indicating the potential enhancement of biological effectiveness and target-specificity of the combination of nanoparticles and Western or Chinese medicine.

Traditionality

In the classical ancient Chinese medicine book of Huang Di Nei Jing (Yellow Emperor's Classic of Medicine) (221 B.C.E.-220 C.E.), the earliest known documents on traditional Chinese medicine (TCM), a set of theories has already been established on the diagnosis and treatment of tumors. However, the traditional formulations of TCM, including decoctions, pills, and powders are associated with various shortcomings, including poor water solubility, low bioavailability, and short half-life, which limit their effectiveness in the treatment of tumors. Early research efforts in this area were dedicated to improving the targeted delivery of the active components of TCM monomers. By combining the active TCM monomers with nanomaterials, the bioavailability and targeted specificity of TCMs can be effectively increased.

Abstract

Objective: Malignant tumors pose a serious threat to human life and health. Despite recent developments in modern medical techniques, the early diagnosis and treatment of tumors remain difficult due to their asymptomatic nature in the early stages of disease and the limitations in current clinical diagnostic methods. Advancements in nanotechnology, particularly in the area of multi-functional diagnostic nanomaterials, can help effectively resolve present inadequacies via concurrently achieving early diagnosis, image-guided intervention, and real-time monitoring and treatment of tumors. The development of nanomaterials and nanotechnology may also aid in the area of anti-cancer drug development by improving the safety and side-effect profile, as well as by enhancing the targeted specificity of the drugs, which are two of the long-standing challenges in Western medicine. The progress in the field of nanomaterials has also uncovered novel approaches for the clinical application of traditional Chinese medicine because the combination of traditional Chinese medicine components with nanoparticles overcomes various drawbacks, including poor water solubility, low bioavailability, and short half-life, of the former. Moreover, nanoparticles also enhance the biological effectiveness and targeted specificity of these medicines. In this review, we discuss the application of nanoparticles in the early diagnosis and treatment of tumors, through modern and traditional medicine.

Clinical distribution and molecular profiling on postoperative colorectal cancer patients with different traditional Chinese medicine syndromes
Li-Jun Jin, Ying Liu, Ming-Ming Zhang, Xue-Meng Han, Qiu-Jie Li, Yu Xiang, Bing-Tao Zhai, Peng Chen, Xia-Ying Chen, Wen-Gang Wang, Shui-Ping Liu, Duan Ting, Jiao Feng, Tian Xie, Xin-Bing Sui
1Traditional Medicine Research. 2020, 5 (1): 44-52.   https://doi.org/10.12032/TMR20190914135
Abstract ( 320 )   HTML ( 3 )     PDF (761KB) ( 165 )  

Highlights

The identification of syndrome conditions had different impacts on CRC prognosis, and which may be related with different mRNA expression levels. Our results prelimitarily uncovered that some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types and CRC patients with Dampness Heat syndrome might have a poor prognosis.

Traditionality

TCM syndrome is a kind of pathological profiles that reflect signs and symptoms at a certain stage of a disease, which is the most essential guidelines for the prescription of Chinese herbal formulae and also an important classification for CRC TCM therapy. A clear understanding biological basis of TCM syndrome will help the clinical diagnosis and the treatment for CRC patients hopefully.

Abstract

Background: Traditional Chinese medicine (TCM) syndrome, also named syndrome, are comprehensive and integral analyses of clinical information which helps to guide different individualized treatment prescriptions. Methods: Thirty healthy controls and 80 colorectal cancer (CRC) patients (including 33 Spleen Qi Deficiency syndrome, 23 Dampness Heat syndrome, 17 Blood Stasis syndrome and 7 other syndrome) were enrolled into this study. Human mRNAs were extracted from peripheral blood mononuclear cells. The gene expression for CRC patients with different TCM syndrome was determined by microarray and qRT-PCR. Results: Spleen Qi Deficiency, Dampness Heat and Blood Stasis were the most common syndromes in CRC patients. There is a significant difference was found in mRNA expression levels (especially for PIK3CA, STAT3, SOX9 and KDM5C) among Spleen Qi Deficiency, Dampness Heat and Blood Stasis syndrome groups. The higher mRNA levels of JNK1, TP53, MLH1, MSH6, PMS2, SOCS3, TCF7L2, FAM123B, PSAP, FBXW7, SALL4 and the lower expression of inflammatory cytokine IL-6 were found in Spleen Qi Deficiency group but not other syndrome types. The higher mRNA levels of KRAS, MUC16, EGFR, GRASP65, PIK3CA, MAPK7, CD24, STAT3, SLC11A1, Bcl-2, TXNDC17 and some inflammatory cytokines (IL-6, IL-23, TNF-a, CXCR4) were found in Dampness Heat group but not other syndrome types. Blood Stasis syndrome showed higher expression of SOX9, MLH1, MSH6, KDM5C, PCDH11X, PSAP and SALL4, and lower mRNA levels of PIK3CA, CD24, STAT3, CXCR4, TXNDC17 and TP53. The CRC patients with Dampness Heat syndrome might have a poor prognosis than other syndrome types. Conclusion: The identification of syndrome conditions had different impacts on CRC prognosis, and which might be related with different mRNA expression levels. Some oncogenes and pro-inflammatory cytokines were highly expressed in Dampness Heat group but not other syndrome types, suggesting that the CRC patients with Dampness Heat syndrome might have a poor prognosis. Our results prelimitarily uncovered the molecular basis of syndrome differences in CRC prognosis, a better understanding for TCM treatment of CRC.

Astragalus injection as an adjuvant treatment for colorectal cancer: a meta-analysis
Jia Wang, Zhu Yang, Fengxi Long, Li Luo, Jinlin Wu, Ting Yu, Dongxin Tang
1Traditional Medicine Research. 2020, 5 (1): 53-61.   https://doi.org/10.12032/TMR20191228151
Abstract ( 94 )   HTML ( 2 )     PDF (635KB) ( 70 )  

Highlights

As an adjuvant treatment of colorectal cancer, a Chinese patent medicine Astragalus injection can reduce the toxicity and improve the efficiency of the conventional Western medicine.

Traditionality

The herb Huang Qi (Astragalus membranaceus (Fisch.) Bge.) was first recorded in the the classical ancient Chinese medicine book entitled Shen Nong Ben Cao Jing (Shennong’s Classic of Materia Medica) (Three Kingdoms period of China, 25 C.E.-220 C.E.). Huang Qi (Astragalus membranaceus (Fisch.) Bge.) was considered as one of the representative herb with the function of tonifying the Qi (one of the vital energies in the traditional Chinese medicine theory that circulates around the body at all times). Pharmarcology studies have found that Huang Qi (Astragalus membranaceus (Fisch.) Bge.) plays an anti-cancer role by regulating immunity, inducing apoptosis of tumor cells, and inhibiting the growth and metastasis of tumor cells. Astragalus injection, a Chinese patent medicine approved by the State Food and Drug Administration of China with the serial number of 2001ZFB0171, contains Huang Qi (Astragalus membranaceus (Fisch.) Bge.) and other ingredients that are widely used in clinical practice of cancer treatment.

Abstract

Background: The combination of Chinese patent medicine Astragalus injection and Western medicine has achieved a certain clinical effect in colorectal cancer patients. However, due to the uneven basic conditions and research indicators of these clinical trials, it is difficult to comprehensively evaluate the effect of Astragalus injection in the adjuvant treatment of colorectal cancer. This study aimed to systematically evaluate the efficacy and safety of Astragalus injection as an adjuvant treatment for colorectal cancer. Methods: The Cochrane Library, VIP database, Wanfang database, and Chinese Academic Journal Full Text database were searched for potentially eligible articles from inception to December 15, 2018. Randomized controlled trials in which patients were diagnosed with colorectal cancer were included. Patients in the control group received chemotherapy alone or combined with other drugs, or chemotherapy combined with radiotherapy. Patients in the experimental group were treated with Astragalus injection combined with interventions in the control group. Results: A total of 8 articles were included. Compared with Western medicine alone, the Astragalus injection could improve the therapeutic effect (RR = 1.18, 95% CI (1.01, 1.38), P = 0.03), improved the quality of life of colorectal cancer patients (SMD = 1.18, 95% CI (0.86, 1.50), P <0.001), inhibited leukopenia (RR = 0.55, 95% CI (0.42, 0.71), P < 0.001), reduced neurotoxicity (RR = 0.43, 95% CI (0.34, 0.56), P < 0.001), and reduced the incidence of nausea and vomiting (RR = 0.67, 95% CI (0.55, 0.80), P < 0.001). Conclusion: Astragalus injection can reduce the toxicity and improve the efficiency of the conventional Western medicine in the treatment of colorectal cancer.

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