A major hurdle that humbles the modernization of traditional Chinese herbal medicine (CHM) is the inconsistency of chemical composition, which is inevitable due to the natural origins of CHM. Here I propose a concept of a new category of drugs, named "post-absorption/metabolism multicompound drug (PAMD)" that will meet every standard of modern pharmaceuticals, yet maintain the fundamental principle of traditional Chinese medicine, which is an integrative therapeutic approach through multiple mechanisms by a cocktail of various herbs. The PAMD concept is based on the fact that the most of chemical ingredients in an orally taken CHM remedy may never enter the blood stream owing to the poor gastrointestinal absorption. Only a few original ingredients or, most likely, a few metabolites of those absorbed ingredients are found in the blood or target organs. The compounds after the absorption/metabolic process are the only ones responsible for pharmacological functions of the remedy. Given the limited number of species, those compounds, once isolated and tested for their pharmacological activity, can be formulated with designed ratios to form new drugs that should theoretically possess an equivalent or better therapeutic efficacy than the original CHM remedy. Strategies of developing PAMDs and possible difficulties are also discussed.

The incidence of breast cancer increased rapidly in recent years. Breast cancer has become the most frequent malignant tumor of female especially in the developed regions. Traditional Chinese medicine (TCM) is effective in treating breast cancer, but its theories appear hysteretic, restricting the progress in clinical practice, teaching and research of TCM in the treatment of breast cancer. This article described the significance and urgency to work out the standardization of syndrome differentiation based on stages for breast cancer and put it into practice. It also analyzed the foundations, ideas and approaches of the research of standardization of syndrome differentiation based on stages for breast cancer in light of the changes of spectrum of diseases, the weaknesses of modern medicine in treating breast cancer, and the existed problems in the update clinical practice.

National Natural Science Foundation of China (NSFC) is an important part of national system for innovation, which provides financial assistance mainly for the basic and applied researches of natural sciences, especially for the researchers who work in the learning institutions and the agencies of scientific research with advanced facilities. This paper summarized the applications and approved projects on traditional Chinese medicine in NFSC in 2005. We initially analyzed the growth, quality, characteristics, tendency and problems of these items.

The use of complementary and alternative medicine (CAM) is currently widespread and appears to be growing. As an increasing proportion of the population turns to CAM therapies, whether singly or in combination with allopathic medicine, the need for quality research in this area is reinforced. Much of this research consists of clinical studies aimed primarily at clinicians, yet challenges arising from poor methodological quality will occur when interpreting study findings and their implications. For clinicians to be effective consumers of the scientific literature, familiarization with the principles of evidence-based medicine (EBM) is essential. The goal of this review is to introduce clinicians to the concept of critical appraisal of clinical studies and foster critical thinking when reading research articles in order to best evaluate and incorporate study findings into their daily practice. Topics discussed in this article include: (1) fundamentals of EBM; (2) types of clinical studies; (3) hierarchy of evidence; (4) Consolidated Standard of Randomized Trials (CONSORT) statement to evaluate the quality of reporting in randomized controlled trials (RCTs); (5) methodologic quality rating scales for RCTs; and (6) issues specific to evaluating studies of Chinese herbal medicine.

Deficiency of Qi (healthy energy) and blood stasis are the basic pathological changes of hepatic fibrosis according to the theories of traditional Chinese medicine. Fuzheng Huayu Capsule, a compound Chinese herbal medicine for hepatic fibrosis, is produced in the light of this pathological mechanism. More than a decade of clinical studies and experimental researches show that this medicine has effects of protecting hepatic cells, relieving liver injury, and controlling the development of hepatic fibrosis. It has definite functional mechanisms on anti-hepatic fibrosis. It is a safe and effective medicine for hepatic fibrosis, and deserves to be well introduced to clinic.

The clinical evaluation system for therapeutic effects of tumor, which focuses on survival period and tumor response rate, has been proved not very proper for evaluating the therapeutic effects of traditional Chinese medicine (TCM). Quality of life (QOL) has been introduced into the effective evaluation system of TCM and integrative medicine because of its similarity in concept and extension with TCM at theory basis, syndrome differentiation-treatment, and evaluation of therapeutic effects. But there are no QOL questionnaires which can evaluate the therapeutic effects of TCM and integrative medicine precisely. This article discussed the necessity and significance of developing QOL questionnaire special for TCM.

Objective

To investigate the immunoregulation and short-term therapeutic effects of super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules, a compound Chinese herbal medicine, on patients with late gastric cancer.

Methods

Forty patients with late gastric antrum cancer were randomly divided into study group and control group. Patients in the study group were orally administered Fuzheng Kang'ai Granules 48 hours after the first super-selective left gastric artery chemotherapy with high-dose drugs (EAP regime: VP16 100 mg/m²+ epirubicin 60 mg/m²+ carboplatin 200 mg/m²), while patients in the control group were only administered the same local artery chemotherapy as in the study group.

Results

The short-term therapeutic efficacy in the study group and control group were 82.5% and 57.5% respectively (P＜0.01). The occurrence rates of side effects in the study group were significantly lower than those in the control group (P＜0.01). The Karnofsky score of life quality of the study group was obviously higher than that of the control group after treatment (P<0.05). The half survival time and one year survival rate in the study group and control group were (24.9±1.36) month, 70% (28/40) and (13.7±0.72) month, 35% (14/40) respectively. They were significantly improved in the study group compared with the control group (P＜0.01). The levels of cytokines interleukin 2 (IL-2), tumor necrosis factor-α (TNF-α), interferon-gamma (IFN-γ) after treatment in the study group were significantly higher than those before treatment (P<0.05 or P<0.01), as well as than those after treatment in the control group (P＜0.01). On the other hand, the level of immune inhibitory factor soluble interleukin-2 receptor (sIL-2R) after treatment in the study group was lower than that before treatment, as well as than that after treatment in the control group (P<0.01).

Conclusions

The super-selective intra-arterial chemotherapy combined with Fuzheng Kang'ai Granules has good short-term therapeutic efficiency and few side effects for patients with late gastric antrum cancer. It can significantly improve the life quality, extend the survival period, and improve the survival rate in patients with late gastric antrum cancer, which may be due to the up-regulation of the immune regulating factors such as IL-2, TNF-α, IFN-γ and down-regulation of the immune inhibitory factor sIL-2R.

Objective

To explore the correlation between the width of lingual varix and changes of hemodynamics of portal system in patients with primary liver cancer so as to supply the data for the forecast of portal hypertension by observing lingual varix.

Methods

The diameter of lingual vein (Dlv) was measured by vernier caliper as dependent variable, and the diameters and indexes of hemodynamics of portal vessels were measured by Doppler as independent variables, then a multipe stepwise analysis was performed.

Results

The diameters of portal vein (Dpv) and splenic vein (Dsv) entered the formula Dlv (mm)=0.185+0.311 Dsv (mm) +0.236 Dpv (mm) when the entry and removal values were α_in=0.10 and α_out=0.15, respectively.

Conclusion

The width of lingual vein is closely correlated with the diameters of portal vein and splenic vein in patients with primary liver cancer.

Background & Objective: Oldenlandia diffusa (Bai Hua She She Cao) is one of the herbs most commonly used in traditional Chinese medicine for treating cancer. Various studies using the herb alone or in combination with other therapy plans have evidenced the effectiveness of the herb in the management of cancers of different tissue origin. However, the mechanisms underlying its anti-cancer activity are unknown. In the present study, we attempted to investigate the apoptotic activity of crude extracts of the herb as well as the possible molecular pathways. Methods:We incubated human promyelocytic leukemia cell line HL60 cells with ethanol or aqueous extracts of the herb, and determined the levels of intracellular superoxide at 2 and 4 hours as well as caspase activity at 3, 6 and 8 hours using photospectrometry. Cancer cell survival and apoptosis were quantified at 24 hours by using MTT and flow cytometry analyses respectively.Results: We found that it dose-dependently inhibited the cancer cell growth in MTT assay. Flow cytometry analysis revealed that it elicited significant production of sub-G₁ population of the cells, indicating the extract-evoked cell apoptotic death. The LD₅₀ of the ethanol extract was estimated to be approximately 320 μg/ml. Moreover, treatment of the cancer cells with the ethanol component markedly increased the production of superoxide within few hours. Significant elevation in the protease activities of caspases-2 and -3 were detected at as early as 3 and 6 hours respectively. Conclusion: Our results show that the ethanol extract of the herb effectively evokes cancer cell apoptosis, possibly through burst-mediated caspase activation.

Objective

To explore the mechanisms of the effects of Runing Recipe in anti-invasion and anti-recurrence of breast cancer by experimental research in vitro.

Methods

SD female rats were randomly divided into Runing Recipe-treated group and its decomposed formulas Kidney-Warming Recipe and Liver-Soothing Recipe-treated groups, tamoxifen (TAM) -treated group, cyclophosphamide (CTX) -treated group, and normal control group to make medicated serums. Methods of matrigel basement membrane and real-time reverse transcription polymerase chain reaction were employed to investigate the gene expressions of vascular endothelial growth factor (VEGF), matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) after MDA-MB-435 cells were treated with the medicated serums.

Results

The gene expression of VEGF was dropped in CTX-treated, TAM-treated and Liver-Smoothing Recipe-treated groups. The gene expression of TIMP-1 was up-regulated in CTX-treated, Runing Recipe-treated and Kidney-Warming Recipe-treated groups; while MMP-9 was down-regulated in these groups.

Conclusion

The mechanisms of Runing Recipe in inhibiting the cancer cell invasion may be related to down-regulating the gene expressions of VEGF and MMP-9, and up-regulating the gene expression of TIMP-1.

Objective

To observe the effects of Jianpi Yishen Recipe (JPYSR), a compound Chinese herbal medicine, on recurrence, metastasis and life span of mice transplanted with proventriculus squamous carcinoma cells after tumorectomy.

Methods

JPYSR was orally administered to 615 mice transplanted with proventriculus squamous carcinoma cells in the palma of left hind limb after tumorectomy. The local tumor recurrence, lung metastasis and life span of the mice were evaluated and compared with those of the 5-FU-treated mice and untreated mice.

Results

The pulmonary metastasis rate was 94.4 % and the recurrence rate was 94.44 % in untreated group. The pulmonary metastasis rate was 68.4%, the inhibition rate of pulmonary metastasis was 27.5%, the recurrence rate was 78.95%, and the inhibition rate of tumor recurrence was 65.35% in JPYSR-treated group. The average and median life spans were obviously prolonged in JPYSR-treated group, as compared with those in untreated group. The life-prolonging rate was 100%.

Conclusion

JPYSR can effectively inhibit the local recurrence and pulmonary metastasis of the transplanted proventriculus squamous carcinoma in mice after tumorectomy, and prolong the life span.

Objective

To investigate the effects of Qinggan Huoxue Recipe (QGHXR), a compound Chinese herbal medicine, and its decomposed formulas Qinggan Recipe (QGR) and Huoxue Recipe (HXR) on expressions of CD14, Toll like receptor 4 (TLR4) and nuclear factor-κB (NF-κB) in Kupffer cells.

Methods

The isolated primary rat Kupffer cells were treated with lipopolysaccharide (LPS) for a certain period of time, a series of concentrations of drug-containing serums of QGHXR and its decomposed formulas were added, the expressions of NF-κB, tumor necrosis factor-α (TNF-α), CD14, and TLR4 of the Kupffer cells were detected in different culture conditions by using Western blot, real-time reverse transcription polymerase chain reaction (RT-PCR) and ELISA methods respectively.

Results

QGR could down-regulate the expression of membrane receptor CD14, but the expression of NF-κB and TNF-α were not significantly decreased after QGR treatment. HXR could down-regulate the expression of membrane receptor TLR4 and inhibit the expressions of NF-κB and TNF-α. QGHXR could down regulate the expressions of membrane receptors CD14 and TLR4 and inhibit the expressions of NF-κB and TNF-α.

Conclusion

QGHXR can protect liver cells by down regulating the expressions of CD14, TLR4 and NF-κB and inhibiting TNF-α expression.

Objective

to study the effects of cordyceps sinensis on dimethylnitrosamine-induced liver fibrosis in rats.

Methods

SD rats were divided into normal control group, untreated group and cordyceps sinensis-treated group. the rats in each group were fed with corresponding drug for 4 weeks. the rat's liver collagen deposition was observed with collagen staining. hydroxyproline (hyp) contents in liver tissue of the rats in 3 groups were determined with HCI hydrolysis. the tissue inhibitor of metalloproteinase-2(timp-2) and type Ⅳ collagen contents were observed by envision, and matrix metalloproteinases-2 (mmp-2) activity was detected by the method of enzyme-picture. type Ⅰ collagen was detected by western blotting. 

Results

the contents of hyp, timp-2, type Ⅳ collagen, and the expression of type Ⅰ collagen in untreated group were significantly higher than those in the normal control group, while those in cordyceps sinensis-treated group were significantly lower than those in the untreated group. the content of mmp-2 in untreated group was significantly lower than that in the normal control group, while that in cordyceps sinensis-treated group was significantly higher than that in the untreated group.

Conclusion

cordyceps sinensis can considerably relieve the liver fibrosis, and the mechanism may be related to promoting the degradation of the collagens.

Objective

To study the mechanisms of Shengqing Capsules, a compound Chinese herbal medicine for dispersing stagnated liver qi and promoting bile flow, in prevention and treatment of pigment gallstone.

Methods

Liver cells from guinea pigs with pigment gallstone were primarily cultured in vitro. The serums containing different concentrations of Shengqing Capsules were prepared by serum pharmacological method. The primary cultured hepatocytes with excessive expression of nuclear factor-κB (NF-κB) were stimulated with lipopolysaccharides (LPS) and the effects of the drug-containing serums on the NF-κB expression were detected by Western-blotting.

Results

Shengqing Capsules down-regulated the NF-κB expression increased by LPS stimulation. The effect is dose-dependent.

Conclusion

Shengqing Capsules can down-regulate the NF-κB expression increased by LPS stimulation. It may be one of the important mechanisms of this Chinese herbal medicine in prevention and treatment for pigment gallstone formation and the inflammatory reaction in biliary tract

Objective

To observe the effects of Guben Huatan Tongmai Recipe (GBHTTMR), a compound Chinese herbal recipe, on expressions of macrophages and cell adhesion molecules (CAMs) of aortic endothelia in rats with syndrome of phlegm blocking blood vessel, and to explore the pathogenesis of the phlegm-pathogen.

Methods

Fifty normal male Wistar rats, 7-week in age, were randomly divided into five groups: normal control group, untreated group, high-dose GBHTTMR-treated group, low-dose GBHTTMR-treated group and simvastatin-treated group, with 10 rats in each group. Syndrome of phlegm blocking blood vessel was induced in rats of the latter 4 groups by feeding the rats with high lipid diet. Levels of blood lipid were compared among the 5 groups. The expressions of macrophages and CAMs in aortic endothelia were tested by immunohistochemical staining method.

Results

The level of blood lipid, and the expressions of macrophages and CAMs showed statistical differences between the normal control group and the untreated group (P＜0.01), and between the untreated group and the low-, high-dose GBHTTMR-treated and simvastatin-treated groups as well (P＜0.05). 

Conclusions

GBHTTMR can decrease the level of serum cholesterol and triglycerides, and increase the level of high density lipoprotein. It also can inhibit the expressions of macrophages, intercellular adhesion molecule-1, vascular cell adhesion molecule-1, P-selectin, and E-selectin.

Objective

To investigate the protective effect of hyperin (Hyp) on focal cerebral ischemia reperfusion injury in rats.

Methods

Sixty Wistar male rats were randomly divided into sham-operated group, untreated group, and high-, medium- and low-dose Hyp-treated groups（50, 25 and 12.5 mg·kg^-1·d^-1） and ginkgo leaf-treated group. The animals were intragastrically administered with drugs for 5 days. Thirty minutes after the end administration, the operation was performed to induce the middle cerebral artery occlusion (MCAO) model in rats with the method of intraluminal thread. The middle cerebral artery blood flow was blocked for 2 hours, and then reperfused. Twenty-four hours later, the rats' neurology score was observed. Brain triphenyltetrazolium chloride (TTC) staining and dried wet method were carried out to measure the infarct size and the water content of rat brain tissue respectively.

Results

The above-mentioned indexes in the untreated group showed significant differences compared with those in the sham-operated group (P＜0.01).The infarct sizes of rat brain tissue in the high- and medium-dose Hyp-treated groups were obviously decreased compared with that in the untreated group (P＜0.01, P＜0.05). The water content of rat brain and the neurology score were also obviously reduced compared with those in the untreated group (P＜0.05 or P＜0.01). Conclusions

Hyp could obviously reduce the brain infarct size and cerebral edema degree in focal cerebral ischemia reperfusion injury rats. Hyp has significant protective effect on focal cerebral ischemia reperfusion injury.

Objective

To study the effects of Naomaitong Recipe, a compound Chinese herbal medicine, on the expressions of nuclear factor-κB (NF-κB) and nitric-oxide synthases (NOSs) in brain tissue after focal cerebral ischemia reperfusion in aged rats and the dosage-effect relationship.

Methods

We adopted the middle cerebral artery occlusion (MCAO) in aged rats as the focal cerebral ischemia model, with 3-hour ischemia and 12-day reperfusion, and observed the changes of the nerve dysfunction score, the water content of cerebral constitution and the expressions of NF-κB, heat-shock protein 70 (HSP70) and NOSs in cerebral cortex.

Results

The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-κB, HSP70, neuronal nitric-oxide synthase (nNOS), endothelial nitric-oxide synthase (eNOS) and inducible nitric-oxide synthase (iNOS) in the untreated group were higher than those of the sham-operated group. The nerve dysfunction score, the water content of cerebral constitution, the expressions of NF-κB, iNOS and nNOS were lower, while the expressions of HSP70 and eNOS were higher in the high-, medium- and low-dose Naomaitong-treated groups and nimodipine-treated group than those of the untreated-group. The nerve dysfunction score and the expression of nNOS were lower, while the expression of eNOS was higher in the medium-dose Naomaitong-treated group than those of the nimodipine-treated group. The expressions of HSP70 and eNOS were higher, while the other indices were lower in the medium-dose Naomaitong-treated group than those of the low-dose Naomaitong-treated group.

Conclusion

Naomaitong Recipe can protect the brain cells from damage after focal cerebral ischemia reperfusion injury by adjusting the expressions of NF-κB, HSP70 and NOSs, and the medium-dose Naomaitong Recipe is more effective.