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Optimization of evidence-based research in the prevention and treatment of coronary heart disease with traditional chinese medicine:A comprehensive review

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Journal of Traditional chinese Medical Sciences 2022年第2期9卷 100-107页

作者： Hongcai Shang Kaige Zhang Zhiyue Guan Xiaoyu Zhang key laboratory of chinese internal medicine of ministry of education Dongzhimen HospitalBeijing University of Chinese MedicineBeijing100700China

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.

关键词： Coronary heart disease Traditional chinese medicine Evidence-based research Evidence-based medicine Patient-oriented medicine Doctorepatient relationships Optimization

Flavonoids from traditional chinese herbs for diabetes in rats:a network Meta-analysis

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Journal of Traditional chinese medicine 2022年第1期42卷 1-8页

作者： WU You HU Yuli LIU Wei SUN Boju ZHANG Chengfei WU Lili LIU Tonghua key laboratory of Health Cultivation of the ministry of education Beijing University of Chinese MedicineBeijing 100029China

OBJECTIVE:In this Meta-analysis,we evaluated the hypoglycemic effect of 5 flavonoids found in traditional chinese herbs(naringenin,kaempferol,puerarin,baicalein,and luteolin)on diabetic rats.METHODS:Four databases including Pub Med,Web of Science,Embase,and Cochrane Library,were searched from inception to May 2020.Only studies using diabetes model rats were included in the analysis.Blood glucose data from the last measurement were collected and analyzed.Pair-wise Meta-analyses were conducted using STATA v14.0 software and a Meta-analysis was conducted using STATA v14.0,ADDIS v1.16.6,and R v3.6.1.The quality of included studies was assessed with the SYRCLE risk of bias tool for animal studies,and publication bias was evaluated with a comparisonadjusted funnel plot.RESULTS:A total of 33 studies were included in the analysis,in which all 5 flavonoids showed a beneficial effect on blood glucose level of diabetic rats were included in the final analysis.The standardized mean differences(95%confidence intervals)were-4.92(-6.67,-3.17)for naringenin,-12(-18.74,-5.27)for kaempferol,-2.52(-3.77,-1.26)for puerarin,-3.04(-5.75,-0.34)for baicalein,and-1.94(-2.95,-0.92)for luteolin.The network Meta-analysis showed no statistically significant differences between the effect sizes of the flavonoids.CONCLUSION:The results of the Meta-analysis showed that naringenin,kaempferol,puerarin,baicalein,and luteolin all have clear hypoglycemic effects in rat diabetes models,highlighting their therapeutic potential for preventing and treating diabetes mellitus in clinical practice.

关键词： diabetes mellitus naringenin kaempferol puerarin baicalein luteolin Meta-analysis

Mechanism of Qili Qiangxin Capsule for Heart Failure Based on miR133a-Endoplasmic Reticulum Stress

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chinese Journal of Integrative medicine 2024年第5期30卷 398-407页

作者： JI Xiao-di YANG Ding CUI Xi-yuan LOU Li-xia NIE Bo ZHAO Jiu-li ZHAO Ming-jing WU Ai-ming Dongzhimen Hospital Affiliated to beijing University of chinese medicine Key Laboratory of Chinese Internal Medicine of Ministry of Education and BeijingBeijing 100700China Department of Traditional chinese medicine Fuwai HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100037China

Objective:To investigate the pharmacological mechanism of Qili Qiangxin Capsule(QLQX)improvement of heart failure(HF)based on miR133a-endoplasmic reticulum stress(ERS)pathway.Methods:A left coronary artery ligation-induced HF after myocardial infarction model was used in this study.Rats were randomly assigned to the sham group,the model group,the QLQX group[0.32 g/(kg·d)],and the captopril group[2.25 mg/(kg·d)],15 rats per group,followed by 4 weeks of medication.Cardiac function such as left ventricular ejection fraction(EF),fractional shortening(FS),left ventricular systolic pressure(LVSP),left ventricular end diastolic pressure(LVEDP),the maximal rate of increase of left ventricular pressure(+dp/dt max),and the maximal rate of decrease of left ventricular pressure(–dp/dt max)were monitored by echocardiography and hemodynamics.Hematoxylin and eosin(HE)and Masson stainings were used to visualize pathological changes in myocardial tissue.The m RNA expression of mi R133a,glucose-regulated protein78(GRP78),inositol-requiring enzyme 1(IRE1),activating transcription factor 6(ATF6),X-box binding protein1(XBP1),C/EBP homologous protein(CHOP)and Caspase 12 were detected by RT-PCR.The protein expression of GRP78,p-IRE1/IRE1ratio,cleaved-ATF6,XBP1-s(the spliced form of XBP1),CHOP and Caspase 12 were detected by Western blot.Td T-mediated d UTP nick-end labeling(TUNEL)staining was used to detect the rate of apoptosis.Results:QLQX significantly improved cardiac function as evidenced by increased EF,FS,LVSP,+dp/dt max,-dp/dt max,and decreased LVEDP(P<0.05,P<0.01).HE staining showed that QLQX ameliorated cardiac pathologic damage to some extent.Masson staining indicated that QLQX significantly reduced collagen volume fraction in myocardial tissue(P<0.01).Results from RT-PCR and Western blot showed that QLQX significantly increased the expression of mi R133a and inhibited the m RNA expressions of GRP78,IRE1,ATF6 and XBP1,as well as decreased the protein expressions of GRP78,cleaved-ATF6 and XBP1-s and decreased p-IRE1/IRE1 rati

关键词： heart failure Qili Qiangxin Capsule miR133a endoplasmic reticulum stress apoptosis

chinese herbal compound Jinsiwei(金思维)improves synaptic plasticity in mice with sporadic Alzheimer’s disease induced by streptozotocin

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Journal of Traditional chinese medicine 2023年第1期43卷 78-86页

作者： TIAN Meijing HE Yannan ZHENG Mingcui QIN Gaofeng GONG Zhuoyan HUANG Shuaiyang WANG Pengwen Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China Department of Traditional chinese medicine Affiliated Hospital of Binzhou Medical CollegeShandong 256603China Department of Respiratory medicine the Third Affiliated Hospital of Beijing University of Chinese MedicineBeijing 100029China

OBJECTIVE:To investigate the efficacy of Jinsiwei(a patented chinese herbal compound)on learning and memory impairment,the number of synapses and synaptic plasticity-related structural and functional protein expression in mice with sporadic Alzheimer’s disease(SAD)induced by streptozotocin.METHODS:Seventy-five C57/BL6J male mice were intracerebroventricularly injected with streptozotocin to establish the animal model of SAD.Mice were randomly divided into the model group(MG),donepezil group(DG),and the Jinsiwei high,medium,and low-dose groups(JH,JM,JL).Another fifteen C57/BL6J male mice were injected with artificial cerebrospinal fluid as the control group(CG).The intervention groups were intragastrically administrated with corresponding medicine,while the CG and MG were given 0.5%carboxymethyl cellulose by gavage.After 3 months,the Morris Water Maze test and step-down passive avoidance test were used to assess the learning and memory ability of mice.Synapses in hippocampal CA1 were observed by transmission electron microscope.Immunohistochemistry and western blotting were used to assess the distribution and expression levels of synaptic plasticity-related structural and functional proteins involving drebrin,cofilin,synapsin(syn),and N-methyl D-aspartate receptor subtype 2B(NR2B).RESULTS:The Morris Water Maze results showed that the escape latency in the Jinsiwei intervention groups was significantly shorter than that of the MG.Results of the step-down passive-avoidance test showed that the error times in the Jinsiwei intervention groups were significantly reduced compared with the MG.Transmission electron microscope results showed that the number of synapses in hippocampal CA1 was obviously increased in the Jinsiwei intervention groups compared with the MG.Immunohistochemical and western blotting results revealed that the positive cells and expression levels of drebrin,syn,and NR2B were significantly decreased in the MG and meanwhile cofilin significantly increased,while these changes were reversed after the Jin

关键词： Alzheimer disease streptozotocin neuronal plasticity Jinsiwei

Online pharmaceutical process analysis of chinese medicine using a miniature mass spectrometer: Extraction of active ingredients as an example

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Journal of Pharmaceutical Analysis 2023年第5期13卷 535-543页

作者： Wangmin Hu Junling Hou Wenjing Liu Xuan Gu Yulei Yang Hongcai Shang Mei Zhang School of chinese Materia Medica Beijing University of Chinese MedicineBeijing102488China Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing100700China Huayi Pharmaceutical Co. Ltd.Beijing102600China

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.

关键词： Process analytical technology TCM Pharmaceuticals Miniature mass spectrometry Online analysis

Effectiveness and safety of electroacupuncture for the treatment of pain after laparoscopic surgery: a systematic review

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Journal of Traditional chinese medicine 2022年第4期42卷 505-512页

作者： HUANG Yusi YANG Jiju LI Xinyi HAO Huifeng LI Chong ZHANG Fan LIN Haiming XIE Xianfei HE Ke TIAN Guihua beijing Dongzhimen Hospital Beijing University of Chinese MedicineBeijing 100700China Department of Integration of chinese and Western medicine Key Laboratory of Carcinogen esis and Translational Research(Ministry of Education/Beijing)Peking University Cancer Hospital&InstituteBeijing 100142China key laboratory of chinese internal medicine of MOE Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China Department of Manipulation Pain Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China

OBJECTIVE:To evaluate the clinical effectiveness and safety of electroacupuncture for treating pain after laparoscopic surgery.METHODS:The following databases were searched(since their establishment until November 16,2021)for randomized controlled trials(RCTs)on electroacupuncture for pain after laparoscopic surgery:Pub Med,Embase,the Cochrane Library,Web of Science,China National Knowledge Infrastructure Database,Wanfang Database,China Science and Technology Journal Database,and chinese Biomedical Literature Database.Data were screened independently and extracted by two reviewers.Two researchers independently extracted and cross-checked data and applied the modified Jadad scale and the Cochrane-recommended assessment method to evaluate the bias risk.The Meta-analysis was conducted using Rev Man5.3 software.RESULTS:Twelve RCTs enrolling 788 patients were included.(a)For postoperative 24 h visual analogue scale,five trials were included on electroacupuncture+routine analgesia therapy vs routine analgesia therapy with significance in electroacupuncture conducted after surgery[mean difference(MD)=-0.63,95%confidence interval(CI)(-0.90,-0.37)],as well as in electroacupuncture conducted before and after surgery[MD=-1.01,95%CI(-1.62,-0.41)]and in surgery.However,two trials were included in electroacupuncture conducted 24 h before surgery with no significant difference[MD=-0.16,95%CI(-0.44,0.12)].(b)The anesthetics intake of electroacupuncture+routine analgesia therapy vs.routine analgesia therapy was significant[MD=-121.71,95%CI(-164.92,-78.49)].(c)The adverse effects of electroacupuncture+routine analgesia therapy vs.routine analgesia therapy were significant both in the incidence of postoperative nausea and vomiting[risk rate(RR)=0.49,95%CI(0.39,0.61)]and postoperative dizziness and headache[RR=0.14,95%CI(0.04,0.47)].CONCLUSION:The evidence showed that electroacupuncture combined with routine analgesia therapy effectively treated pain after laparoscopic surgery.However,more rigorously designed RCTs are required due t

关键词： electroacupuncture laparoscopy pain treatment outcome safety systematic review

Comparative study of the effects of Danhong injection with different doses on ischemic stroke: A substudy of hospital-based Danhong injection registry

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Journal of Traditional chinese medicine 2018年第6期38卷 917-925页

作者： Du Yawei Wang Xiaoxia Zhong Liqun Wu Shengxian Department of Neurology Dongzhimen Hospital Beijing University of Chinese Medicine key laboratory of chinese internal medicine of ministry of education Dongzhimen Hospital Beijing University of Chinese Medicine

OBJECTIVE: To compare the effects of Danhong injection(DHI) with different doses on ischemic stroke.METHODS: chinese hospital registered DHI study is a perspective observational study, in which a total of 1292 patients with ischemic stroke were treated with DHI. Two different doses of DHI were used in the present study. The patients were matched by acute phase of ischemic stroke(within 2 weeks after onset), partial anterior circulation infraction, sex, age, and National Institute of Health Stroke Scale(NIHSS) score. Finally 148 patients were grouped into the 20 or 40 mL DHI group with 74 in each. The primary endpoint was the improvement of NIHSS score at 14-day after treatment.RESULTS: Of the 148 patients with ischemic stroke,the 74 in the 40 mL DHI group had clinically important improvements in the NIHSS score. The baseline and 14-day NIHSS score for the 40 mL DHI group were 6.6 ± 4.3 and 2.4 ± 2.5 respectively, versus 6.3± 5.7 and 3.6 ± 4.2, for the 20 mL DHI group(change from baseline in the 40 mL DHI group vs change from baseline in the 20 mL DHI group,-1.49points; P = 0.029). Improvements were maintained after the baseline characteristics and other drugs were controlled(P = 0.012). No adverse events were observed.CONCLUSION: Effects of DHI on partial anterior circulation infarction in patients with acute phase of ischemic stroke is dose-dependent; however, further studies with larger sample sizes are needed to validate our findings(chinese Clinical Trial Register,Number: ChiCTR-ONC-13003230).

关键词： Stroke Endothelin-1 Danhong injection Clinical trial

Status Quo and Analysis of the Cardiovascular Clinical Practice Guidelines/Expert Consensuses of chinese and Integrative medicine:A Systematic

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chinese Journal of Integrative medicine 2021年第1期27卷 54-61页

作者： LI Cheng-yu CHEN Yao-long HU Jia-yuan LI Min ZHANG Xiao-yu SUN Yang ZHENG Rui CHEN Shi-qi HAN Song-jie HE Tian-mai SHANG Hong-cai Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing Universityof Chinese MedicineBeijing(100700)China Evidence-Based medicine center Lanznou UniversItyLanznou(73UUUU)China

Objective:To describe and analyze the status quo of cardiovascular clinical practice guidelines or expert consensuses including both chinese medicine(CM)and integrative medicine,through systematic literatures searching and quality assessment.Methods:Data bases including chinese Biomedical Literature Database,the China National Knowledge Infrastructure,Wanfang Data,China Science and Technology Journal Database were searched for published CM or integrative cardiovascular clinical practice guidelines or expert consensuses.The website *** was also retrieved as supplementary.The clinical practice evaluation tool AGREEⅡwas used to assess the quality of included guidelines or consensuses.Results:A total of 31 relevant clinical practice guidelines or expert consensuses were included,covering diagnosis,treatment,chinese patent and patient fields.Common cardiovascular diseases like coronary heart diseases,heart failure and arrhythmia were also involved.Through analysis it was found that both the quantity and quality of included guidelines have been improved year by year.A total of 4 evidence-based clinical practice guideline has been found,one of which was a guideline project plan.Except that,the remaining 27 reports were all consensusbased guidelines.The scores of each field,from highest to lowest,were clarity of presentation(58%),scope and purpose(54%),stakeholder involvement(28%),rigor of development(21%),applicability(13%)and editorial independence(8%).Conclusions:Although clinical practice guidelines in cardiovascular domain of chinese have gained increasing concern,with both quantity and quality improved,there is still huge gap in methodology and reporting standards between CM guidelines and international ones.On the one hand,it is essential to improve and standardize the methodology of developing CM guidelines.On the other hands,the evaluation system of evidence and recommendation with CM characters should be developed urgently.

关键词： integrated medicine chinese medicine cardiovascular disease clinical practice guideline systematic review

(+)/(-)-Yanhusuosines A and B, two dimeric benzylisoquinoline-protoberberine alkaloid atropo-enantiomers featuring polycyclic skeletons from Corydalis yanhusuo

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chinese Chemical Letters 2023年第7期34卷 151-154页

作者： Guiyang Xia Biaobing Xiao Lingyan Wang Huan Xia Yuzhuo Wu Yanan Wang Hongcai Shang Sheng Lin Key Laboratory of Chinese Internal Medicine of Ministry of Education and Beijing Dongzhimen HospitalBeijing University of Chinese MedicineBeijing 100700China State key laboratory of Bioactive Substance and Function of Natural medicines Institute of Materia MedicaChinese Academy of Medical Sciences and PekingUnionMedical CollegeBejing100050China

(+)/(-)-Yanhusuosines A(1) and B(2), two pairs of trace benzylisoquinoline-protoberberine atropoenantiomeric homodimers featuring an unprecedented 6/7/6/6/6/6 hexacyclic skeleton, were isolated from the tubers of Corydalis yanhusuo. The structures of(+)/(-)-1 and(+)/(-)-2 were elucidated using spectroscopic and quantum-chemical calculation approaches.(+)/(-)-Yanhusuosines A(1) and B(2)represent a new class of alkaloid dimers biogenetically constructed by a molecule of benzylisoquinoline with a unit of protoberberine via an intermolecular [4 + 3] cycloaddition. Their plausible biosynthetic pathways are discussed, and compound 2 exerted moderate inhibitory activity of NO formation in LPS induced RAW264.7 macrophages.

关键词： (+)/(-)-Yanhusuosine A (+)/(-)-Yanhusuosine B Bisbenzylisoquinoline alkaloids Atropo-enantiomeric homodimers Anti-inflammatory Corydalis yanhusuo