The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,...The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.展开更多
Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems ...Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems remain that require solutions. In the prevention and treatment of CHD with traditional Chinese medicine(TCM), great therapeutic advantages have been demonstrated. However, the expression of its advantages relies on scientific evidence-based research and evaluation, which require further optimization and improvement. Therefore, this review aims to comprehensively emphasize our understanding of the current deficiencies in TCM evidence-based studies and the necessity of adopting scientific evidence-based optimization methods for use in research. In this process, evidence should be produced in a standard manner, and the advantages of TCM patterns should be accurately stated because these factors contribute to efficient transformation and proper verification of the obtained evidence.Additionally, focusing on patient-oriented medicine and doctor-patient relationships is also essential.These methods are of great significance to prove the clinical efficacy of TCM and promote its development.展开更多
Tongue diagnosis is an important process to non-invasively assess the condition of a patient’s internal organs in traditional Chinese medicine(TCM)and each part of the tongue is related to corresponding internal orga...Tongue diagnosis is an important process to non-invasively assess the condition of a patient’s internal organs in traditional Chinese medicine(TCM)and each part of the tongue is related to corresponding internal organs.Due to continuing computer technological advances,especially the artificial intelligence(AI)methods have achieved significant success in tackling tongue image acquisition,processing,and classification,novel AI methods are being introduced in traditional Chinese medicine tongue diagnosis medical practices.Traditional tongue diagnose depends on observations of tongue characteristics,such as color,shape,texture,moisture,etc.by traditional Chinese medicine physicians.The appearance of the tongue color,texture and coating reflects the improvement or deterioration of patient’s conditions.Moreover,AI can now distinguish patient’s condition through tongue images,texture or coating,which is all possible increasingly with help from traditional Chinese medicine physicians under the traditional Chinese medicine tongue theory.AI has enabled humans to do what was previously unimagined:traditional Chinese medicine tongue diagnosis with feeding a large amount of tongue image and tongue texture/coating data to train the AI modes.This review focuses on the research advances of AI in TCM tongue diagnosis thus far to identify the major scientific methods and prospects.In this article,we tried to review the AI application in resolving the tongue diagnosis of traditional Chinese medicine on color correction,tongue image extraction,tongue texture/coating segmentation.展开更多
As a major medical and scientific problem perplexing mankind,cardiovascular disease seriously endangers human health and life safety,which is still the primary cause of death.Traditional Chinese medicine(TCM)plays an ...As a major medical and scientific problem perplexing mankind,cardiovascular disease seriously endangers human health and life safety,which is still the primary cause of death.Traditional Chinese medicine(TCM)plays an irreplaceable role in the prevention and treatment of cardiovascular diseases and has its own characteristics and definite advantages.However,the unclear mechanism hinders its further promotion,which is not conducive to the prevention and treatment of cardiovascular diseases.Translational medicine advocates interdisciplinary integration and cooperation between academic groups,to establish effective interaction between basic research and clinical application,lead more medical research to focus on the prevention and treatment of clinical diseases,as well as to accelerate the transformation from“discovery”to“realization”,and finally to benefit patients,that is,“from clinic and serve clinic”.This provides a reference mode for the development and research direction of TCM,which comes from clinical practice originally.Based on this,considering the important role of angiogenesis in the occurrence and prognosis of cardiovascular diseases,under the guidance of the concept of translational medicine,this manuscript sorts out the overview of TCM treatment on angiogenesis related cardiovascular diseases from four aspects:theoretical basis,pathogenesis and pathology,applied prescriptions and material basis,in order to summarize the translational medicine experience of TCM prevention and treatment from clinical practice to modern research,to provide a basis for basic research and clinical diagnosis and treatment of related diseases.展开更多
Objective:To analyze the registration information of Corona Virus Disease 2019(COVID-19)related clinical trials from all the clinical trial registry accepted by the International Committee of Medical Journal Editors(I...Objective:To analyze the registration information of Corona Virus Disease 2019(COVID-19)related clinical trials from all the clinical trial registry accepted by the International Committee of Medical Journal Editors(ICMJE).Methods:All the database of ICMJE-accepted clinical trial registry platform were searched for COVID-19 related clinical trials that registered from December 8,2019 to February 19,2020.Results:All the database totally contained data of 209 COVID-19 related clinical trials,including 66(31.6%)traditional Chinese medicine(TCM)related studies and 143(68.4%)non-TCM related studies.176(84.2%)clinical trials were registered in ChiCTR,as 33(15.8%)were registered in ClinicalTrials.gov.There were 152(72.7%)intervention trials,including 9(4.3%in total)preventive trials,136(65.1%in total)therapeutic trials and 7(3.3%in total)convalescent trials.Conclusion:At the present stage,clinical studies are still aiming at exploring the effective treatment of COVID-19,and the existing treatments need more high-quality clinical evidence supporting.Traditional Chinese medicine may have played an important role in all stages of the epidemic preventing and control,and the enthusiasm of carrying out scientific research has also been greatly improved.The relevant policies of clinical trial registration should be popularized among researchers,including traditional Chinese medicine researchers.And the methodological quality of clinical trials’design urges improving.展开更多
Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases charact...Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases characterized by cardiac hypertrophy and myocardial remodeling,and the pathophysiological processes of which include oxidative stress,endoplasmic reticulum homeostasis,apoptosis,autophagy,energy metabolism disorder,etc.The regulation of protein homeostasis intrinsically interrelates the above pathophysiological processes.Therefore,it is imperative to elucidate the molecular mechanism from the perspective of protein homeostasis to find new therapeutic targets for HF treatment.The dynamic regulation and post-translational modification of protein synthesis and degradation play a vital role in response of living organisms to physiological changes.The ubiquitin-proteasome system(UPS),which degrades 70-90%of endogenous proteins,plays an integral part in the pathophysiological processes of HF.The UPS can regulate oxidative stress,endoplasmic reticulum homeostasis,apoptosis and autophagy of cardiomyocytes(CMs),energy metabolism,targeting degradation signals and structural proteins,thus modulating cardiac hypertrophy,fibrosis and remodeling,finally contributing to the occurrence and progression of HF.Thus,regulating UPS is a promising effective strategy to treat HF.Increasing evidence indicates that traditional Chinese medicine(TCM)targeting the UPS is potential to ameliorate HF.This review will summarize the current knowledge focusing on the underlying mechanism and the important research advances related to UPS in treating HF,and the traditional Chinese medicine targeting UPS.展开更多
China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the ap...China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the appearance of adverse reactions,and target is the internal mechanism.The establishment of feature and target correlation model will contribute to the development of this field.This paper introduces the four steps of feature-target correlation method that risk identification,feature extraction,sign target correlation and experimental research.Xiyanping-Ribavirin combination is as an example to illustrate this method.It is expected that the method will be popularized and applied to protect clinical safety.展开更多
Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical ef...Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical efficacy evaluation has developed rapidly,accumulated research and experience,improved the quality and standardization of research,but also gradually found deep-seated deficiencies.In 2019,the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM)was established,and TCM was included in the 11th revision of the International Statistical Classification of Diseases(ICD-11).In above opportunities for TCM clinical efficacy evaluation,it is necessary to face up to the previous deficiencies,so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics,including TCM clinical problems,TCM thinking and TCM diagnosis&treatment mode.Based on the summary and analysis of past research,development concepts are proposed in this article.On the one hand,original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice.On the other hand,it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy.Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice,and unknown evaluated object combined with new methods,technologies and concepts should be maturely integrated in clinical practice firstly.展开更多
Objective With the increasing publication of clinical practice guidelines(CPG)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western Medicine(IM),the standardization and scientifiction of ...Objective With the increasing publication of clinical practice guidelines(CPG)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western Medicine(IM),the standardization and scientifiction of its formulation have gradually attracted many people’s attention.To offer an overview of TCM and IM CPGs published over the past decade and analyze their general characteristics and methodological quality.Methods The China National Knowledge Infrastructure(CNKI)and WANFANG databases were searched for clinical practice guidelines and expert consensus papers from January 2010 to June 2021.Two researchers independently completed the literature screening and cross-checking according to the inclusion and exclusion criteria of CPGs and extracted information on general characteristics and methodological quality of CPGs.Results According to the selection criteria,231 CPGs(EB-CPGs=119,CBCPGs=112)were selected and the number of CPGs published in the 11 years showed an overall upward trend.The vast majority of CPGs used the Western naming system for the diseases,and only 11 CPGs were named of TCM diseases or symptoms.TCM treatments were recommended in 223 CPGs.There were 156 ancient Chinese Medicine literature sources cited in 231 CPGs and opinions and experiences of 62 TCM experts cited in 37 CPGs.The methodological quality of EB-CPGs for TCM and IM were significantly better than CB-CPGs in 11 items.Only 60 EB-CPGs and 7 CB-CPGs designated clear criteria for grading quality of evidence and strength of the recommendations and 74 CPGs presented both the level of evidence and the strength of recommendations.We classified all CPGs according to whether or not they used GRADE,and the results showed that the CPGs using GRADE had higher methodological quality and more standardized reports.Conclusion This research has shown that the quantity and quality of CPGs in both TCM and IM have improved over the time span,but the methodological quality,especially evidence citation,and the use of criteria for grading quality of evidence and strength of the recommendations,still needs to further improvement in the future.展开更多
Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively refl...Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively reflects the blood status of patients with acute ischemic stroke(AIS)and is important in the treatment and prognosis of AIS.To identify the relationship between TCM syndrome factors and TEG in AIS patients and standardize TCM syndrome differentiation and treatment objectives,we designed a prospective cohort study of 103 AIS patients.Methods:We used the diagnostic criteria for AIS in the Chinese Guideline for Diagnosis and Management of Acute Ischemic Stroke 2010.Diagnosis of phlegm-heat and fu-organ excess syndrome was based on the TCM Scale for the Syndrome of Phlegm-heat and fu-organ Excess.The ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to identify and diagnose syndrome factors.General information,scores of syndrome factors and values of TEG parameters of all enrolled patients were recorded.Results:There were significant differences in internal fire and phlegm-dampness scores between patients with and without phlegm-heat and fu-organ excess syndrome(P<.05).In patients with phlegm-heat and fu-organ excess syndrome,internal fire was negatively correlated with TEG parameters R and K(P<.05)and positively correlated with alpha Angle and coagulation index(P<.01).There were no significant correlations between the two syndrome factors and MA(P Z.058)and LY30(P>.05)or between both syndrome factors and TEG parameters in patients without phlegm-heat and fu-organ excess syndrome.Conclusion:The syndrome factor internal fire is a potential predictor of increased platelet function and fibrinogen activity in AIS patients with phlegm-heat and fu-organ excess,and a potentially important predictor of blood hypercoagulability in TCM.展开更多
The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and te...The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and technology,but the low operability and slow update of integrated traditional Chinese and Western Medicine guidelines,and the lack of integration between guidelines and clinical practice,result in the guidelines not having the desired clinical effects in practice.The application of Artificial Intelligence(AI)to the field of CPGs development aims to shorten the development time,optimize and accelerate the whole process of CPG’s development.This article summarized the current research and application status of AI in development and implementation CPGs for TCM and Integrated Traditional Chinese and Western medicine and proposed the method of Combining real world data and AI technology to enrich for TCM and Integrated Traditional Chinese and Western medicine.展开更多
Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of ...Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of PubMed,Embase,Web of Science,SinoMed,China Network Knowledge Infrastructure,Wanfang Data,and Chinese Scientific Journals Database was performed to identify GAPT mouse/rat studies published from inception to July 2019.The outcomes extracted were Morris water maze results and molecular biological quantifications.Results:A total of 19 studies were included in this analysis.The analysis indicated that GAPT was able to significantly improve learning and memory abilities compared with model mice/rats,as assessed by Morris water maze,and showed similar efficacy as donepezil.Subgroup analyses showed that low,medium,and high doses resulted in no obvious dose-dependent effects.Additionally,the GAPT group had significantly reduced expression levels of amyloid-beta peptide,presenilin 1,phosphorylated tau,acetylcholinesterase,and glycogen synthase kinase-3b,but increased expression levels of Shank1,and protein phosphatase-2A,and improved synapses structures compared with the model group,and subgroup analyses showed the medium dose of GAPT was superior to the low and high doses.Conclusions:Based on the pooled analysis,GAPT improved the learning and memory abilities and regulated the expression levels of related proteins during the progression of AD in mouse/rat studies.Notably,the medium dose of GAPT exhibited better performance than the other two doses,providing experimental evidence for further applications of GAPT during clinical practice.展开更多
Cancer was gradually regarded as a metabolic disease,which might be linked to impairment of mitochondrial function.There are really some essential differences between the mitochondria of normal and cancer cells,which ...Cancer was gradually regarded as a metabolic disease,which might be linked to impairment of mitochondrial function.There are really some essential differences between the mitochondria of normal and cancer cells,which might become promising target for cancer chemotherapy.According to western pharmacology,a known target was needed for drug development.Unfortunately,the number of therapeutic agents relating to the mitochondrion are severely limited because of lacking of knowledge about mitochondrial biology.Unlike the“Western Medicine”,some traditional Chinese herbal medicine(TCHM)might be prone to targeting mitochondria despite the lack of precise molecular mechanisms.If it is the case,we might be able to screen and identify active anti-cancer drugs from traditional Chinese therapeutics by using mitochondrial functional assay.In this review,we would give an overview of the effect of TCHM on the mitochondrion,and the challenges and breakthroughs remaining in cancer treatment.展开更多
基金supported by Ministry of Science and Technology of the People's Republic of China(Grant No.:2022YFC3502300)Beijing Natural Science Foundation(Grant No.:L222150)+2 种基金the National Natural Science Foundation of China(Grant No.:82072247)the second batch of“Ten thousand plan”National High Level Talents Special Support Plan(Grant No.:W02020052)Beijing University of Chinese Medicine(Grant Nos.:XJYS21005,JY21024,MSGZF-202001,2022-syjs-05,and 2022-syjs-10).
文摘The automation of traditional Chinese medicine(TCM)pharmaceuticals has driven the development of process analysis from offline to online.Most of common online process analytical technologies are based on spectroscopy,making the identification and quantification of specific ingredients still a challenge.Herein,we developed a quality control(QC)system for monitoring TCM pharmaceuticals based on paper spray ionization miniature mass spectrometry(mini-MS).It enabled real-time online qualitative and quantitative detection of target ingredients in herbal extracts using mini-MS without chromatographic separation for the first time.Dynamic changes of alkaloids in Aconiti Lateralis Radix Praeparata(Fuzi)during decoction were used as examples,and the scientific principle of Fuzi compatibility was also investigated.Finally,the system was verified to work stably at the hourly level for pilot-scale extraction.This mini-MS based online analytical system is expected to be further developed for QC applications in a wider range of pharmaceutical processes.
基金supported by the National Key R&D Program of China (2017YFC1700400)
文摘Coronary heart disease(CHD) has severely impacted the lives and health of patients for ages. Although the modern methods used for the prevention and treatment of CHD have been increasingly perfected,clinical problems remain that require solutions. In the prevention and treatment of CHD with traditional Chinese medicine(TCM), great therapeutic advantages have been demonstrated. However, the expression of its advantages relies on scientific evidence-based research and evaluation, which require further optimization and improvement. Therefore, this review aims to comprehensively emphasize our understanding of the current deficiencies in TCM evidence-based studies and the necessity of adopting scientific evidence-based optimization methods for use in research. In this process, evidence should be produced in a standard manner, and the advantages of TCM patterns should be accurately stated because these factors contribute to efficient transformation and proper verification of the obtained evidence.Additionally, focusing on patient-oriented medicine and doctor-patient relationships is also essential.These methods are of great significance to prove the clinical efficacy of TCM and promote its development.
基金China National Funds for Distinguished Young Scientists(CN)(Grants No.81725024)China Postdoctoral Science Foundation(No.2020M670236).
文摘Tongue diagnosis is an important process to non-invasively assess the condition of a patient’s internal organs in traditional Chinese medicine(TCM)and each part of the tongue is related to corresponding internal organs.Due to continuing computer technological advances,especially the artificial intelligence(AI)methods have achieved significant success in tackling tongue image acquisition,processing,and classification,novel AI methods are being introduced in traditional Chinese medicine tongue diagnosis medical practices.Traditional tongue diagnose depends on observations of tongue characteristics,such as color,shape,texture,moisture,etc.by traditional Chinese medicine physicians.The appearance of the tongue color,texture and coating reflects the improvement or deterioration of patient’s conditions.Moreover,AI can now distinguish patient’s condition through tongue images,texture or coating,which is all possible increasingly with help from traditional Chinese medicine physicians under the traditional Chinese medicine tongue theory.AI has enabled humans to do what was previously unimagined:traditional Chinese medicine tongue diagnosis with feeding a large amount of tongue image and tongue texture/coating data to train the AI modes.This review focuses on the research advances of AI in TCM tongue diagnosis thus far to identify the major scientific methods and prospects.In this article,we tried to review the AI application in resolving the tongue diagnosis of traditional Chinese medicine on color correction,tongue image extraction,tongue texture/coating segmentation.
基金supported by the National Natural Science Foundation of China(Grant No.81725024).
文摘As a major medical and scientific problem perplexing mankind,cardiovascular disease seriously endangers human health and life safety,which is still the primary cause of death.Traditional Chinese medicine(TCM)plays an irreplaceable role in the prevention and treatment of cardiovascular diseases and has its own characteristics and definite advantages.However,the unclear mechanism hinders its further promotion,which is not conducive to the prevention and treatment of cardiovascular diseases.Translational medicine advocates interdisciplinary integration and cooperation between academic groups,to establish effective interaction between basic research and clinical application,lead more medical research to focus on the prevention and treatment of clinical diseases,as well as to accelerate the transformation from“discovery”to“realization”,and finally to benefit patients,that is,“from clinic and serve clinic”.This provides a reference mode for the development and research direction of TCM,which comes from clinical practice originally.Based on this,considering the important role of angiogenesis in the occurrence and prognosis of cardiovascular diseases,under the guidance of the concept of translational medicine,this manuscript sorts out the overview of TCM treatment on angiogenesis related cardiovascular diseases from four aspects:theoretical basis,pathogenesis and pathology,applied prescriptions and material basis,in order to summarize the translational medicine experience of TCM prevention and treatment from clinical practice to modern research,to provide a basis for basic research and clinical diagnosis and treatment of related diseases.
基金the The National Science Fund for Distinguished Young Scholars(No.81725024).
文摘Objective:To analyze the registration information of Corona Virus Disease 2019(COVID-19)related clinical trials from all the clinical trial registry accepted by the International Committee of Medical Journal Editors(ICMJE).Methods:All the database of ICMJE-accepted clinical trial registry platform were searched for COVID-19 related clinical trials that registered from December 8,2019 to February 19,2020.Results:All the database totally contained data of 209 COVID-19 related clinical trials,including 66(31.6%)traditional Chinese medicine(TCM)related studies and 143(68.4%)non-TCM related studies.176(84.2%)clinical trials were registered in ChiCTR,as 33(15.8%)were registered in ClinicalTrials.gov.There were 152(72.7%)intervention trials,including 9(4.3%in total)preventive trials,136(65.1%in total)therapeutic trials and 7(3.3%in total)convalescent trials.Conclusion:At the present stage,clinical studies are still aiming at exploring the effective treatment of COVID-19,and the existing treatments need more high-quality clinical evidence supporting.Traditional Chinese medicine may have played an important role in all stages of the epidemic preventing and control,and the enthusiasm of carrying out scientific research has also been greatly improved.The relevant policies of clinical trial registration should be popularized among researchers,including traditional Chinese medicine researchers.And the methodological quality of clinical trials’design urges improving.
基金This work was supported by Beijing Natural Science Foundation(Grant No.JQ18026)the National Natural Science Foundation of China(NNSFC+2 种基金Grant Nos.82073978,81773589)Fundamental Research Funds for the Central Universities(2021-JYB-XJSJJ-053)Guangdong Provincial Key Laboratory of Chinese Medicine for Prevention and Treatment of Refractory Chronic Diseases(No.2018B030322012,MB2020KF01).
文摘Heart failure(HF)represents one of the leading causes of morbidity and mortality in the modern world,which threatened approximately 1%~2%of adults’lives.HF is the end stage of multiple cardiovascular diseases characterized by cardiac hypertrophy and myocardial remodeling,and the pathophysiological processes of which include oxidative stress,endoplasmic reticulum homeostasis,apoptosis,autophagy,energy metabolism disorder,etc.The regulation of protein homeostasis intrinsically interrelates the above pathophysiological processes.Therefore,it is imperative to elucidate the molecular mechanism from the perspective of protein homeostasis to find new therapeutic targets for HF treatment.The dynamic regulation and post-translational modification of protein synthesis and degradation play a vital role in response of living organisms to physiological changes.The ubiquitin-proteasome system(UPS),which degrades 70-90%of endogenous proteins,plays an integral part in the pathophysiological processes of HF.The UPS can regulate oxidative stress,endoplasmic reticulum homeostasis,apoptosis and autophagy of cardiomyocytes(CMs),energy metabolism,targeting degradation signals and structural proteins,thus modulating cardiac hypertrophy,fibrosis and remodeling,finally contributing to the occurrence and progression of HF.Thus,regulating UPS is a promising effective strategy to treat HF.Increasing evidence indicates that traditional Chinese medicine(TCM)targeting the UPS is potential to ameliorate HF.This review will summarize the current knowledge focusing on the underlying mechanism and the important research advances related to UPS in treating HF,and the traditional Chinese medicine targeting UPS.
基金supported by the National Natural Science Foundation of China(No.82204937).
文摘China is gradually establishing a multidisciplinary diagnosis and treatment system of traditional Chinese medicine(TCM)and western medicine.TCM-drug combination is prone to adverse reactions.Clinical feature is the appearance of adverse reactions,and target is the internal mechanism.The establishment of feature and target correlation model will contribute to the development of this field.This paper introduces the four steps of feature-target correlation method that risk identification,feature extraction,sign target correlation and experimental research.Xiyanping-Ribavirin combination is as an example to illustrate this method.It is expected that the method will be popularized and applied to protect clinical safety.
基金the National Natural Science Foundation of China(No.81725024).
文摘Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical efficacy evaluation has developed rapidly,accumulated research and experience,improved the quality and standardization of research,but also gradually found deep-seated deficiencies.In 2019,the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM)was established,and TCM was included in the 11th revision of the International Statistical Classification of Diseases(ICD-11).In above opportunities for TCM clinical efficacy evaluation,it is necessary to face up to the previous deficiencies,so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics,including TCM clinical problems,TCM thinking and TCM diagnosis&treatment mode.Based on the summary and analysis of past research,development concepts are proposed in this article.On the one hand,original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice.On the other hand,it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy.Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice,and unknown evaluated object combined with new methods,technologies and concepts should be maturely integrated in clinical practice firstly.
基金This work was supported by the National Natural Science Foundation of China(No.82174230 and No.81904055).
文摘Objective With the increasing publication of clinical practice guidelines(CPG)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western Medicine(IM),the standardization and scientifiction of its formulation have gradually attracted many people’s attention.To offer an overview of TCM and IM CPGs published over the past decade and analyze their general characteristics and methodological quality.Methods The China National Knowledge Infrastructure(CNKI)and WANFANG databases were searched for clinical practice guidelines and expert consensus papers from January 2010 to June 2021.Two researchers independently completed the literature screening and cross-checking according to the inclusion and exclusion criteria of CPGs and extracted information on general characteristics and methodological quality of CPGs.Results According to the selection criteria,231 CPGs(EB-CPGs=119,CBCPGs=112)were selected and the number of CPGs published in the 11 years showed an overall upward trend.The vast majority of CPGs used the Western naming system for the diseases,and only 11 CPGs were named of TCM diseases or symptoms.TCM treatments were recommended in 223 CPGs.There were 156 ancient Chinese Medicine literature sources cited in 231 CPGs and opinions and experiences of 62 TCM experts cited in 37 CPGs.The methodological quality of EB-CPGs for TCM and IM were significantly better than CB-CPGs in 11 items.Only 60 EB-CPGs and 7 CB-CPGs designated clear criteria for grading quality of evidence and strength of the recommendations and 74 CPGs presented both the level of evidence and the strength of recommendations.We classified all CPGs according to whether or not they used GRADE,and the results showed that the CPGs using GRADE had higher methodological quality and more standardized reports.Conclusion This research has shown that the quantity and quality of CPGs in both TCM and IM have improved over the time span,but the methodological quality,especially evidence citation,and the use of criteria for grading quality of evidence and strength of the recommendations,still needs to further improvement in the future.
基金This work was supported by the National Science and Technology Pillar Program during the 12th Five-year Plan Period of the People’s Republic of China:Heritage Study on the Special Therapeutic Principles and Methods of Famous Experts in Traditional Chinese Medicine(No.2013BAI13B02).
文摘Objective:Syndrome differentiation is a unique part of traditional Chinese medicine(TCM).Syndrome factors play an important role in the diagnosis and treatment of TCM syndromes.Thromboelastography(TEG)intuitively reflects the blood status of patients with acute ischemic stroke(AIS)and is important in the treatment and prognosis of AIS.To identify the relationship between TCM syndrome factors and TEG in AIS patients and standardize TCM syndrome differentiation and treatment objectives,we designed a prospective cohort study of 103 AIS patients.Methods:We used the diagnostic criteria for AIS in the Chinese Guideline for Diagnosis and Management of Acute Ischemic Stroke 2010.Diagnosis of phlegm-heat and fu-organ excess syndrome was based on the TCM Scale for the Syndrome of Phlegm-heat and fu-organ Excess.The ischemic Stroke TCM Syndrome Factor Diagnostic Scale was used to identify and diagnose syndrome factors.General information,scores of syndrome factors and values of TEG parameters of all enrolled patients were recorded.Results:There were significant differences in internal fire and phlegm-dampness scores between patients with and without phlegm-heat and fu-organ excess syndrome(P<.05).In patients with phlegm-heat and fu-organ excess syndrome,internal fire was negatively correlated with TEG parameters R and K(P<.05)and positively correlated with alpha Angle and coagulation index(P<.01).There were no significant correlations between the two syndrome factors and MA(P Z.058)and LY30(P>.05)or between both syndrome factors and TEG parameters in patients without phlegm-heat and fu-organ excess syndrome.Conclusion:The syndrome factor internal fire is a potential predictor of increased platelet function and fibrinogen activity in AIS patients with phlegm-heat and fu-organ excess,and a potentially important predictor of blood hypercoagulability in TCM.
基金the National Key Research and Development Program of China(No.2016YFC0106300)Health and Family Planning Commission of Hubei province joint funding project(No.WJ2018H0009).
文摘The translation and implementation of clinical practice guidelines(CPGs)for Traditional Chinese Medicine(TCM)and Integrated Traditional Chinese and Western medicine is crucial to the adoption of medical science and technology,but the low operability and slow update of integrated traditional Chinese and Western Medicine guidelines,and the lack of integration between guidelines and clinical practice,result in the guidelines not having the desired clinical effects in practice.The application of Artificial Intelligence(AI)to the field of CPGs development aims to shorten the development time,optimize and accelerate the whole process of CPG’s development.This article summarized the current research and application status of AI in development and implementation CPGs for TCM and Integrated Traditional Chinese and Western medicine and proposed the method of Combining real world data and AI technology to enrich for TCM and Integrated Traditional Chinese and Western medicine.
基金Institutions of Higher Education for Academic Disciplinary Innovations(the“111 Project”)(B08006)Program for Changjiang Scholars and Innovative Research Team in University(IRT0810)+1 种基金Research Project for Practice Development of National TCM Clinical Research Bases(JDZX2015297)the National Natural Science Foundation of China(81573824,81503625,and 81473518).
文摘Objective:To evaluate the efficacy of the Chinese herbal compound GAPT for the treatment of Alzheimer’s disease(AD)and to provide current evidence for potential treatment mechanisms.Methods:A comprehensive search of PubMed,Embase,Web of Science,SinoMed,China Network Knowledge Infrastructure,Wanfang Data,and Chinese Scientific Journals Database was performed to identify GAPT mouse/rat studies published from inception to July 2019.The outcomes extracted were Morris water maze results and molecular biological quantifications.Results:A total of 19 studies were included in this analysis.The analysis indicated that GAPT was able to significantly improve learning and memory abilities compared with model mice/rats,as assessed by Morris water maze,and showed similar efficacy as donepezil.Subgroup analyses showed that low,medium,and high doses resulted in no obvious dose-dependent effects.Additionally,the GAPT group had significantly reduced expression levels of amyloid-beta peptide,presenilin 1,phosphorylated tau,acetylcholinesterase,and glycogen synthase kinase-3b,but increased expression levels of Shank1,and protein phosphatase-2A,and improved synapses structures compared with the model group,and subgroup analyses showed the medium dose of GAPT was superior to the low and high doses.Conclusions:Based on the pooled analysis,GAPT improved the learning and memory abilities and regulated the expression levels of related proteins during the progression of AD in mouse/rat studies.Notably,the medium dose of GAPT exhibited better performance than the other two doses,providing experimental evidence for further applications of GAPT during clinical practice.
基金the National Natural Science Foundation of China(No.81773170)BeijingNovaProgram(No.Z1511000003150121)Beijing Talents Fund(No.2015000021223ZK23).
文摘Cancer was gradually regarded as a metabolic disease,which might be linked to impairment of mitochondrial function.There are really some essential differences between the mitochondria of normal and cancer cells,which might become promising target for cancer chemotherapy.According to western pharmacology,a known target was needed for drug development.Unfortunately,the number of therapeutic agents relating to the mitochondrion are severely limited because of lacking of knowledge about mitochondrial biology.Unlike the“Western Medicine”,some traditional Chinese herbal medicine(TCHM)might be prone to targeting mitochondria despite the lack of precise molecular mechanisms.If it is the case,we might be able to screen and identify active anti-cancer drugs from traditional Chinese therapeutics by using mitochondrial functional assay.In this review,we would give an overview of the effect of TCHM on the mitochondrion,and the challenges and breakthroughs remaining in cancer treatment.