Efficacy Of Medicine Research Articles

Comparative efficacy and safety of Chinese patent medicines as an adjunctive therapy for diabetic peripheral neuropathy: systematic review and network meta-analysis of randomized controlled trials

Context Diabetic peripheral neuropathy (DPN) is the most common complication of diabetes mellitus. Chinese patent medicines (CPMs) are widely used in clinical practice to treat DPN. Objective This study aims to summarize the latest evidence on the harms and benefits of CPMs as adjunctive therapy for DPN. Materials and methods We conducted searches for randomized controlled trials (RCTs) evaluating CPMs in conjunction with mecobalamin (Mec) or alpha-lipoic acid (αLA) across eight databases up to July 2024. The surface under the cumulative ranking area (SUCRA) was utilized to assess the clinical efficacy rate (CER), the peroneal motor nerve conduction velocity (pMNCV), the peroneal sensory nerve conduction velocity (pSNCV), the median motor nerve conduction velocity (mMNCV), and the median sensory nerve conduction velocity (mSNCV). Results The search yielded 128 eligible studies with 31 CPMs with Mec and 39 eligible studies with 17 CPMs with αLA. SUCRA rankings indicated that, when combined with Mec, Mailuoning liquid (lMLN) was the most effective regimen for CER, Honghua injection (iHH) for pMNCV, Maixuekang capsule (cMXK) for pSNCV, Dengzhanxixin injection (iDZXX) for mMNCV, and Tongxinluo capsule (cTXL) for mSNCV. Combined with αLA, Danhong injection (iDH) showed the highest efficacy for CER, pSNCV, and mSNCV, while Xueshuantong injection (iXShT) was the most effective for pMNCV and mMNCV. Conclusion This network meta-analysis confirms the efficacy and safety of 37 CPMs combined with Mec or αLA for treating DPN. However, given the potential risk of bias and the very low certainty of the evidence, these recommendations should be adopted with caution.

Efficacy and safety of Chinese herbal medicines combined with biomedicine in the treatment of idiopathic membranous nephropathy: a systematic review and network meta-analysis

BackgroundChinese herbal medicines have been extensively used to treat idiopathic membranous nephropathy (IMN). However, their efficacy and safety remain uncertain. Therefore, this study employed a network meta-analysis to evaluate the efficacy and safety of various Chinese herbal medicines in combination with biomedicines for treating IMN.MethodsA comprehensive literature search was performed across several databases, including PubMed, EMBASE, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), WanFang Data, VIP Database, and Chinese Biomedical Literature Database (CBM), to identify randomized controlled trials (RCTs) concerning the treatment of IMN using a combination of Chinese herbal medicines and biomedicine, up to 31 May 2024. Two researchers independently conducted the literature screening and data extraction. The quality of the included studies was assessed using the Cochrane quality review manual, and Stata 14.2 software was employed for network meta-analysis.ResultsA total of 31 RCTs involving 2195 IMN patients and 15 different Chinese herbal medicines were analyzed. The network meta-analysis revealed that QQC + BM (84.7%) was the most effective in reducing 24-hour urinary protein. For improving serum albumin, HZC + BM (86%) was the most effective. LGT + BM (77.2%) was the best for enhancing serum creatinine levels. MXC + BM demonstrated the highest effectiveness in lowering total cholesterol (89%) and triglycerides (97%). Lastly, WZC + BM (90.8%) was the most effective in reducing the incidence of adverse reactions. BM.ConclusionThe current evidence suggests that integrating Chinese herbal medicines with biomedicine may provide significant benefits in treating IMN. Specifically, QQC + BM appears to be the most effective in reducing 24-hour urinary protein, HZC + BM seems to excel in improving serum albumin levels, MXC + BM is noted for its effectiveness in lowering triglycerides and total cholesterol, LGT + BM is optimal for reducing serum creatinine, and WZC + BM shows the lowest rate of adverse reactions. Nevertheless, due to limitations in the quantity and quality of the included studies, further validation of these conclusions is necessary.Systematic Review Registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024561028], identifier [CRD42024561028].

Efficacy of integrated traditional Chinese and western medicine in managing mild-moderate acute pancreatitis: a real-world clinical perspective analysis

BackgroundGiven the prevalent utilization of integrated traditional Chinese and western medicine (ITCWM) in the management of acute pancreatitis, the majority of studies have concentrated on severe cases, lacking robust evidence-based medical research. Real-world investigations can provide an objective assessment of the clinical effectiveness of combining traditional Chinese medicine with western medicine. Consequently, relying on real-world research, we intend to evaluate the clinical efficacy and safety of the combined approach in treating mild to moderate acute pancreatitis.MethodsA total of 563 AP patients from Henan Central Hospital were collected from January 2019 to October 2023. A propensity score matching (PSM) analysis was conducted to evaluate the clinical efficacy of traditional Chinese medicine (TCM) in treating mild to moderate acute pancreatitis. Patients were divided into a control group (61 cases) and an integrated traditional Chinese and Western medicine (ITCWM) group (120 cases). To further assess the clinical efficacy of TCM enema in the treatment of mild to moderate acute pancreatitis, PSM analysis was conducted across three groups. The patients were categorized into a control group (n = 49), an oral TCM treatment group (OCM group, n = 274), and an oral TCM plus enema treatment group (OCM+E group, n = 131). Logistic regression was used to analyze factors after treatment in each group, and the Kaplan-Meier method compared symptom duration in each group.ResultsCompared with the control group, the ITCWM group significantly decreased C-reactive protein (CRP, mg/L) (17.8 [1.2–59.5] vs. 8.0 [3.3–33.5], P = 0.022), shortened the duration of abdominal distension, abdominal pain, nausea and bitter taste symptoms (P < 0.05), and shortened the length of hospital stay (median 19.0 and 11.5 days, respectively, P = 0.001); Compared with the other two groups, the neutrophil percentage (NEUT%) was lower (74.1 vs. 61.9 vs. 59.5, P < 0.05) and serum prealbumin (PA, mg/L) was higher (116.0 vs. 184.4 vs. 220.0, P < 0.05), the length of hospitalization (days) was shortened (19.0 vs.12.0 vs.10.0, P < 0.05) in the OCM+E group.ConclusionThe combination of traditional Chinese medicine and modern medicine has been shown to effectively decrease inflammatory indicators in patients with mild to moderate acute pancreatitis, leading to a reduction in symptom duration and hospitalization period, as well as promoting disease recovery. Notably, the use of traditional Chinese medicine in conjunction with enema therapy yields more pronounced benefits.

Metabolic Characterization of Vamorolone in Human Liver Microsomes: Implications for Anti-Doping.

Vamorolone, a potential alternative to conventional glucocorticoids, shows significant promise in sports medicine due to its reduced side effects and superior pharmacodynamic properties. This study aims to investigate the metabolic characteristics of this novel synthetic cyclodextrin-steroid anti-inflammatory drug and elucidate the metabolic pathways in human liver microsomes (HLMs) invitro, thereby providing a scientific basis for assessing its potential risks for athletes. All compounds are detected by liquid chromatography-high resolution mass spectrometry (LC-HRMS) and metabolite identification was performed using Compound Discoverer 3.3 software. In the HLMs model, 12 metabolites of vamorolone are successfully identified, including 10 phase I metabolites and 2 phase II metabolites. Among these, the reduction metabolite M1 exhibited the highest peak area, indicating it as one of the primary metabolic pathways. The dehydrogenated compound M2 had the second highest peak area, further elucidating the metabolic characteristics of vamorolone. This study systematically identifies the metabolite structures of vamorolone in HLMs and provide crucial data for the pharmacokinetics and biomarker research of this drug. The findings not only enhance the understanding of its metabolic mechanisms but also offer a scientific basis for evaluating its safety and efficacy in sports medicine. Meanwhile, these discoveries can contribute to better regulation and control of Vamorolone's use in competitive sports, ensuring fairness in competitions.

A systematic approach of efficacy and safety of herbal medicine in the treatment of Vitiligo

Vitiligo is a chronic dermatological disorder caused by the loss of melanin. Conventional therapies for vitiligo require prolonged treatments, have low efficacy, and are complicated by side effects. This study aimed to review the role of herbal medicine in the treatment of vitiligo. A comprehensive search was conducted in PubMed, Embase, and Google Scholar for studies conducted till December 2023 using related keywords linked with Boolean operators such as AND, OR, and NOT. Subsequently, a more comprehensive search was performed using the name of each specific herb. A variety of herbs were used to treat vitiligo. The most widely used herbal therapies among vitiligo populations were Khellin, Ginkgo biloba L., Picrorhiza kurroa, Polypodium leucotomos, Cucumis melo, Psoralea corylifolia L., Turmeric, Curcumin, and Nigella sativa L. were used either alone or in combination with other therapies. The majority of herbs were found to be efficacious with negligible side effects. No severe toxicities were reported. Most herbal medicines showed a positive impact on vitiligo. Therefore, healthcare providers may consider herbal medicine as an option for patient’s refractory to conventional therapies

Impact of metrological correlation on the total combined risk in pharmaceutical equivalence evaluations

Pharmaceutical equivalence evaluation requires a multiparametric conformity assessment for both generic and reference medicines. This paper investigates the impact of metrological correlations on the total combined risk in pharmaceutical equivalence evaluations. The study focused on the equivalence between ranitidine hydrochloride tablets, assessed by determining the average weight, the assay of the active pharmaceutical ingredient, and the uniformity of dosage units. The risks of false conformity decisions were evaluated using Monte Carlo method simulations across four scenarios, each reflecting different correlation conditions. The results of the study focus on evaluating pharmaceutical equivalence between ranitidine hydrochloride tablets from two manufacturers. The tablets were tested for three parameters: average weight, active pharmaceutical ingredient (API) assay, and uniformity of dosage units. The measured values were within the regulatory specifications for both medicines A and B. Four scenarios of metrological correlation were assessed: #1 – actual correlation from shared analytical steps, #2 – correlation between parameters within the same medicine, #3 – correlation between generic and reference medicines, and #4 – uncorrelated parameters. The study revealed that correlations significantly affect total and combined risk values. The correlations between different parameters of the same medicine affect the total risk values, while the correlations between generic and reference medicines for a given parameter influence the combined particular risk values. Correlations between parameters of the same medicine affect total risk values, while correlations between generic and reference medicines impact combined particular risk values. Both types of correlations significantly influence combined total risk values, making metrological correlations crucial in pharmaceutical equivalence evaluations. Proper consideration of these correlations ensures the quality, efficacy, and safety of generic and reference medicines.

Effect of traditional Chinese medicine therapy on labor pain in patients with natural childbirth: A network meta-analysis.

This systematic review compared the efficacy of traditional Chinese medicine (TCM) treatments for outcomes of different stages and labor pain among pregnant women. Eight databases were electronically searched for TCM on labor pain between January 2012 and January 2022. The studies were recorded and screened according to inclusion criteria and subsequently entered in Note Express. The quality of the included studies was evaluated using the Cochrane risk of bias tool, and network meta-analysis was conducted with Stata 16.0. Forest plots and league tables were used to compare different treatment modalities' effect sizes. Additionally, the probabilities of various treatment modalities for each outcome under the cumulative ranking curve were determined. The protocol was registered in PROSPERO (CRD42022336091). This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Thirty articles encompassing 3277 participants were included in the network meta-analysis with 9 different treatment modalities. In terms of pain of labor at 30 minutes, acupuncture + autonomic nerve block was the most effective treatment modality. With regard to the 60-minute pain and the first stage of labor, acupressure + acupuncture therapy was most effective. In general, a combined treatment with acupressure and acupuncture is the most effective approach for relieving labor pain and shortening the duration of labor. Based on these data, we intend to explore further clinical TCM therapy for relieving maternal pain.

Efficacy and safety of traditional Chinese medicine for the treatment of epilepsy by wind quenching and phlegm resolving: A systematic review and meta-analysis.

Using wind-quenching and phlegm-resolving (WQPR) therapy for epilepsy has yielded beneficial results in various clinical studies. However, a comprehensive analysis of the WQPR approach to epilepsy has not yet conducted to date. This study aimed to evaluate the effectiveness and safety of the WQPR method in traditional Chinese medicine (TCM) for epilepsy. Eight databases, including The Cochrane Library, Web of Science, PubMed, Embase, Chinese Biomedical Database, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database (VIP), and WanFang Database, were comprehensively searched to include randomized controlled trials (RCTs) investigating the WQPR approach in epilepsy. Quality was evaluated by the Cochrane Handbook for Systematic Reviews of Interventions, and meta-analysis was conducted using the RevMan 5.4 and Stata 14.0 software. For the outcome indicators with the number of studies ≥ 10, funnel chart and Egger test were used to evaluate the bias, and the evidence quality was evaluated according to GRADEpro system. We included 19 randomized controlled trials with 1475 participants. Compared to the control group, the WQPR approach showed clinical efficacy for epilepsy (odds ratio = 3.23, 95% confidence interval [CI] [2.19, 4.77], Z = 5.90, P < .00001), reduced seizure frequency (standardized mean differences = -1.24, 95% CI [-1.62, -0.85], Z = 6.26, P < .00001), shortened seizure duration (standardized mean differences = -2.07, 95% CI [-2.99, -1.14], Z = 4.39, P < .0001), improved patient's quality of life (mean difference = 2.60, 95% CI [2.16, 3.03], Z = 11.62, P < .00001), and ameliorated TCM syndromes (mean difference = -4.37, 95% CI [-6.19, -2.56], Z = 4.72, P < .00001). The reduced rate of adverse reactions (odds ratio = 0.56, 95% CI [0.37, 0.85], Z = 2.71, P = .007). WQPR therapy appears to be an effective and safe approach for treating epilepsy, increasing clinical efficacy, reducing seizures' frequency and duration, improving patients' quality of life, ameliorating TCM syndromes, and reducing adverse reaction rates.

Efficacy and pharmacodynamics of herbal medicine in patients with metabolic phenotype of osteoarthritis

High prevalence of the metabolic phenotype of osteoarthritis (MPOA) and unsatisfactory methods of its treatment necessitate the development of novel therapeutic approaches for this phenotype of OA. Turmeric preparations have a wide range of biological activity; their use in patients with MPOA can be effective and reduce the drug burden. In the present paper, we review our own published research findings on the effectiveness and pharmacodynamics of turmeric preparations in patients with MPOA. In the two studies, we evaluated the effects of two curcumin-containing parapharmaceuticals: Epigenorm Antivir (EA) and Curcumin. Forty-one women with MFOA were included in both studies. Twenty-three patients received EA at a daily dose of 1000 mg for 12 weeks, and 18 patients received curcumin from Evalar at a dose of 1000 mg for 8 weeks. The endpoints for both studies were VAS pain, dysfunction and other symptoms of OA measured using the KOOS scale. After 12 weeks of EA treatment, there was a 2.5-fold decrease pain levels. The decrease in pain was associated with an improvement in the patient’s daily and sports activities and quality of life. These effect sizes were classified as moderate to large according to Cohen. No adverse events were observed during the period of taking EA. Clinical improvement was associated with a decrease in the content of MS individual components: low-density lipoprotein cholesterol and triglycerides. The treatment caused a decrease in the level of systemic inflammation, as evidenced by a decrease in the concentration of TNFα, histamine, IL-18, C-reactive protein, and neopterin. The concentrations of IL-10 and adiponectin increased after treatment. In another study, treatment with curcumin for 4 weeks had an analgesic effect, improved measures of function and quality of life. Clinical improvement was associated with the reductions in serum levels of a number of proinflammatory cytokines, C-reactive protein, and lipids. Thus, the results of the pilot studies evaluating efficacy, safety, and pharmacodynamics of parapharmaceuticals EA and Curcumin in patients with MFOA indicate pleiotropic effects of the interventions. The findings provide a rationale for conducting larger, controlled, blind, randomized clinical trials.

The exploration of molecular mechanisms involved in the effect of Traditional Chinese Medicine in the treatment of intracerebral hemorrhage

Background: This study aimed to explore the underlying mechanism of the efficacy of Traditional Chinese Medicine (TCM) in alleviating intracerebral hemorrhage (ICH). Methods: Keywords for TCM treatment in ICH were searched in PubMed and CNKI, and relevant literature has been integrated to extract and collect related gene targets. These selected genes were further analyzed by Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). Protein-protein interaction (PPI) analysis was performed on the target genes in the String database. Results: A total of 491 key genes were identified from 555 references. GO and KEGG analysis of these genes revealed that anti-apoptotic, anti-inflammatory, and anti-oxidative stress-related processes and pathways were significantly enriched. PPI network uncovered the crucial genes involved in these biological functions were phosphatase and tensin homolog (PTEN), signal transducer and activator of transcription 3 (STAT3), the rearranged during transfection (RET) gene, signal transducer and activator of transcription 1 (STAT1), apolipoprotein E (APOE), 5-bisphosphate 3-kinase catalytic subunit alpha (PIK3CA), CXC chemokine receptor type 4 (CXCR4), Jun proto-oncogene (JUN), c-fos protein (FOS), and tumor necrosis factor (TNF). Conclusions: This study unveiled that TCM treatment plays an important role in the treatment of ICH via anti-inflammatory, anti-apoptotic, and anti-oxidative stress signaling.

Mind-Body Medicine in the Treatment of Depression: A Narrative Review of Efficacy, Safety and Mechanisms.

This narrative review examines the efficacy, mechanisms and safety of mind-body medicine (MBM) in the treatment of depression. We reviewed the potential effects of various MBM interventions such as yoga, tai chi, qigong, mindfulness-based interventions and nutrition on clinical and subthreshold depressive symptoms. Current studies indicate a growing interest in the use of MBM for psychiatric disorders, including depression. MBM interventions demonstrate efficacy in reducing depressive symptoms with fewer adverse effects and costs compared to pharmacological treatments. MBM has significant potential to improve mental health outcomes for depression. These interventions encourage self-care and stress management through behavioural, exercise, relaxation and nutritional approaches. While existing data are promising, further, more rigorous studies are required to confirm long-term effectiveness and to determine the role of MBM in comprehensive depression treatment strategies.

Homoeopathic Management of Chronic Urinary Tract Infection (UTI) in Males—Two Evidence-Based Case Reports

AbstractUrinary tract infections (UTI) are uncommon in men, with an incidence of 5 to 8 per 10,000 per year among those aged between 21 and 50 years, in contrast to women, where the incidence is 30 times higher. UTI in men can lead to severe and painful symptoms, often requiring surgical interventions. Considering the limitations and complications of conventional medical or surgical procedures, homeopathy may offer a viable solution for such conditions. Two cases of chronic UTIs in men are presented here, in which constitutional homeopathic medicines were prescribed with positive results. In the first case, the patient experienced frequent urination, urgency, straining before urination, and a drop-wise urine flow. A retrograde urethrogram X-ray diagnosed the condition as a stricture urethra. In the second case, the patient had been suffering from repeated UTIs with painful urination for two years and was diagnosed with cystitis and epididymo-orchitis. After detailed case assessments, both patients were prescribed constitutional homeopathic remedies. Sulphur was prescribed in the first case, and Arsenic in the second case, both in 50 millesimal potencies, providing relief within a short period. However, in both cases, Thuja was prescribed as complementary medicine, which cleared all UTI symptoms, leading to a negative urine culture result. Homeopathy proved effective in providing relief in two cases of chronic UTI. It's important to note that the conclusions drawn from these two cases may not be sufficient to reach a definitive conclusion. Therefore, clinical trials are suggested to establish the efficacy of constitutional medicine in the treatment of chronic UTIs in men.

Efficacy and safety of Atractylodes macrocephala-containing traditional Chinese medicine combined with neoadjuvant chemotherapy in the treatment of advanced gastric cancer: a systematic evaluation and meta-analysis.

In China, Atractylodes-containing Chinese medicines are widely used as adjuvant therapy to neoadjuvant chemotherapy (NAC) in individuals diagnosed with advanced gastric cancer (AGC). Nevertheless, the findings concerning its effectiveness are still restricted. The aim from this research was to examine the efficiency and security Atractylodes macrocephala-containing traditional Chinese medicine together with NAC in the management of AGC. Literature was systematically searched across 8 electronic databases until September 20, 2023. Two researchers conducted a thorough review of the selected studies. The primary outcome measures included the objective response rate (ORR), disease control rate (DCR), quality of life (QOL), adverse drug reactions (ADRs), and levels of peripheral blood lymphocytes. The relevant effect estimates are as follows as risk ratios (RR) or mean differences (MD) with corresponding 95% confidence intervals (CI). Credibility of information was evaluated using the GRADE analyzer. The results showed that solely on the basis of the accessible literature examined in NAC patients, individuals who received the therapeutic regimen containing Atractylodis Macrocephalae Chinese herbal preparations demonstrated a superior overall response rate (Relative Risk: 1.41, 95% confidence interval: 1.27-1.57, P < 0.001); DCR (RR: 1.20, 95% confidence interval: 1.13-1.27, P < 0.001), as compared to QOL (RR: 1.43, 95% confidence interval: 1.30-1.57, P < 0.001, MD: 8.47, 95% confidence interval: 7.16 - 9.77, P < 0.001); the proportions of CD3+ T-cells, CD4+ T-cells, CD8+ T-cells, CD4+CD8+ T-cells were increased; and the incidence of adverse reactions was decreased. Subgroup analyses showed that oral administration of all the traditional Chinese medicines containing Atractylodes macrocephala could improve tumor efficacy. Regardless of the duration of therapy of ≥8 weeks or <8 weeks, Atractylodes macrocephala-containing traditional Chinese medicine increased the tumor response in AGC patients. Combination of Atractylodes macrocephala-containing TCM with neoadjuvant chemotherapy increased ORR and DCR; when used in conjunction with cisplatin, only ORR was increased. The combination of Atractylodes macrocephala-containing herbs with NAC in the treatment of AGC improves efficacy, improves prognosis, and reduces adverse effects. Nevertheless, additional high-quality randomized trials are required. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42023461079.

The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study

Objective: To explore the efficacy of Traditional Chinese Medicine (TCM) acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke. Methods: This is a retrospective study using clinical records of 180 patients with ischemic stroke, hospitalized in the Department of Neurology of the Zhejiang Province Tertiary Class A Hospital, Huzhou, China from July 2022 to June 2023. The patients were divided into two groups on the basis of the nasogastric tube insertion method. We selected 90 patients for each group from the database of records by using a random list method. Patients in the observation group underwent TCM acupuncture-assisted blind insertion of nasointestinal tube and those in the control group underwent the traditional bedside blind insertion of bullet nasointestinal tube. Success rate of tube insertion, average tube insertion time, intragastric insertion time, stomach time to jejunal insertion, patient comfort, and patient satisfaction in both groups were compared. Results: The success rate of nasointestinal tube insertion was significantly higher in the observation group compared to the control group (96.6% and 88.9%, p&lt;0.05). There was no statistically significant difference in the time of nasoenteral tube insertion into the stomach (p&gt;0.05). The insertion time from stomach to jejunum in the observation group was significantly shorter than in the control group (p&lt;0.05). The patient comfort and satisfaction levels were significantly higher in the observation group compared to the control group (p&lt;0.05). Conclusion: TCM acupuncture-assisted blind insertion of bullet nasointestinal tube method improves the success rate of tube insertion, shortens the average catheterization time from the stomach to the jejunum and improves patient’s comfort and satisfaction. doi: https://doi.org/10.12669/pjms.40.10.9936 How to cite this: Zhao H, Chen J, Chen H, Lv X, Lu Z, Sun Y. The efficacy of acupuncture-assisted blind insertion of bullet nasointestinal tube method in patients with ischemic stroke: A retrospective study. Pak J Med Sci. 2024;40(10):2208-2212. doi: https://doi.org/10.12669/pjms.40.10.9936 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Potentiation of Tumor Hallmarks by the Loss of GULO, a Vitamin C Biosynthesis Gene in Humans.

Vitamin C plays a significant role in various physiological functions. Humans depend on external sources of vitamin C due to the loss of the L-gulono-γ-lactone oxidase (GULO) gene that contributes to the synthesis of vitamin C. During the evolutionary loss of the GULO gene, physical, chemical, and biological factors were different from the present environmental settings. Besides the evolutionary genetic loss of the GULO gene, there is a gap in the insightful discussion on the potential implications of the non-functional GULO gene towards the predisposition of humans to cancer that faces hostile and carcinogenic environments. Various methods by which vitamin C modulates cellular processes related to cancer, including DNA repair, epigenetic changes, and redox balance, are discussed. Furthermore, we present experimental and clinical evidence indicating that vitamin C deficiency promotes tumor growth, metastasis, and therapy resistance, emphasizing its potential as a cancer phenotypic modulator. Therapeutic implications of restoring vitamin C levels in cancer treatment range from improving the efficacy of conventional medicines to exploiting metabolic vulnerabilities in tumors. The relevance of assessing vitamin C status in cancer patients and the basis for additional research into vitamin C supplementation as an adjuvant therapy is emphasized. This paper presents a comprehensive overview of the implications associated with the functional deficiency of the GULO gene in human subjects exhibiting diverse tumor hallmarks, encompassing ECM remodeling, hypoxia, epigenetic reprogramming, oxidative stress, and drug responsiveness.

Efficacy and safety of traditional Chinese medicine in managing bone loss post-endocrine therapy in hormone receptor-positive breast cancer patients.

This study aims to evaluate the efficacy and safety of traditional Chinese medicine (TCM) kidney-tonifying methods in treating bone loss and osteoporosis following endocrine therapy in patients with hormone receptor-positive breast cancer. This research systematically searched 6 major medical electronic databases, initially identifying 986 articles, ultimately including 22 randomized controlled trials. These studies encompassed a total of 1579 patients and investigated the impact of TCM kidney-tonifying methods on lumbar spine bone density, lumbar spine bone density T-values, femoral neck bone density, clinical efficacy, and drug safety. The Cochrane quality scoring system was utilized to assess the quality of the literature, and data were synthesized using meta-analysis techniques. TCM kidney-tonifying methods significantly improved lumbar spine bone density (standardized mean difference [SMD] = 0.70, 95% confidence interval [CI]: 0.43-0.97) and lumbar spine bone density T-values (SMD = 1.012, 95% CI: 0.506-1.517). There was also a positive trend in enhancing femoral neck bone density (SMD = 0.645, 95% CI: 0.321-0.970). Although improvements in clinical efficacy did not reach statistical significance (relative risk [RR] = 1.122, 95% CI: 0.933-1.348), the studies indicated good safety of the treatment, with most studies reporting no significant adverse reactions. TCM kidney-tonifying methods may have a positive therapeutic effect on bone loss and osteoporosis following endocrine therapy in patients with hormone receptor-positive breast cancer, demonstrating good tolerability and safety. Given the current evidence, it is recommended to include TCM kidney-tonifying methods as a complementary therapeutic approach in treatment protocols. Future research should further validate these findings and explore their application in different patient subgroups.

Utilization of traditional Chinese medicine in the management of cutaneous ulceration induced by cervical lymph node metastasis in tonsillar carcinoma: A case report

ObjectiveCutaneous ulcers induced by metastasis present a challenging clinical issue, often resistant to conventional dressing change interventions. In this case, we demonstrates the efficacy of Traditional Chinese Medicine in managing ruptured tumors. Case presentationWe present a case study of a 40-year-old Chinese male patient diagnosed with advanced tonsillar squamous cell carcinoma with cervical lymph node metastasis and cutaneous ulceration. Despite nearly six months of conventional dressing treatment yielding minimal improvement, significant healing of the ulcerated surface of the neck metastasis was observed after approximately two months of decoction therapy. The cancerous lesion exhibited a reduction of nearly 90 %, with concomitant alleviation of secondly symptoms such as cold intolerance, excessive sweating, anxiety and depression. ConclusionsIn this case, we introduces Traditional Chinese Medicine may be an effective alternative therapy for the treatment of cancer-related disease. And it may also be an optional therapeutic approach for healthcare practitioners with cutaneous carcinoma ulceration.

Emerging Nanoparticle-Based Herbal Drug Delivery Systems for Colon Targeting Therapy

Abstract: Herbal medications hold a dominant position in the pharmaceutical sector due to their well-established therapeutic effects and extremely low negative effects. Besides, herbal remedies are easily available and highly economical. However, to circumvent the issue of poor bioavailability, the combinatorial strategy of incorporating herbal medicines and nano-technology is useful. The phytoconstituents molded in novel nanocarriers such as polymeric nanoparticles, polymeric micelles, liposomes, solid lipid nanoparticles, nanostructured lipid carriers, nanoemulsions, gold nanoparticles, etc., have been extensively investigated as they are the most promising approach for colon-targeting drug delivery systems. Although plant-based medicines have been developed for decades, there is enormous research interest in the development of an effective plant-derived delivery system for the incorporation of phytocon-stituents into various nanomaterials to overcome potential challenges related to solubility, bioavailability, and stability issues. The encapsulation of phytoconstituents in a novel nanocarrier is a promising approach to improving the bioavailability, stability, and therapeutic efficacy of herbal medicines. The herbal nanomedicines are used as a promising tool for tar-geted delivery to the colon, with potentially effective outcomes for the treatment of colonic diseases, viz., ulcerative colitis, diverticulitis, Crohn's disease, shigellosis, constipation, co-lonic polyps, colon cancer, etc. This article presents a comprehensive survey of recent find-ings and patents by innovators working exclusively on nanoparticles for the delivery of phy-tomedicines for colon targeting.

Ursolic Acid Restores Redox Homeostasis and Pro-inflammatory Cytokine Production in Denervation-Induced Skeletal Muscle Atrophy.

Skeletal muscle (SkM) atrophy results from metabolic disorders causing body and muscle mass loss, affecting morbidity and mortality. Increased oxidative stress, inflammation, and poor prognosis are the leading causes of involuntary weight loss. Ursolic acid (UA), known for its antioxidant and anti-inflammatory properties, can potentially reduce oxidative stress and inflammation in muscles, but its effects on muscle mass regulation are still unknown. Therefore, the present study investigated the medicinal efficacy of UA and its mode of action against the murine model of SkM atrophy over 7days of UA supplementation. Denervation-induced SkM atrophy significantly impacts overall body weight and the weight of individual muscles (p < 0.05). However, supplementation with UA can effectively counteract these effects by promoting the synthesis of the slow-myosin heavy chain, thereby restoring body weight and myotube diameter. Moreover, UA also plays a crucial role in reducing the production levels of reactive oxygen species (ROS), lipid peroxidation (LPO), and caspase-3-like activity in atrophied muscles. UA also prevents the leakage of creatine kinase (CK) through the upregulation of superoxide dismutase (SOD) and glutathione peroxidase (GPx) expression. Furthermore, the results obtained from qRT-PCR demonstrated a significant decrease in the levels of pro-inflammatory markers, namely IL-1β, IL-6, TNF-α, and TWEAK, up to four-fold after the third day of the UA intervention. UA also upregulated PGC-1α, Bcl2, and p-Aktser473 expression towards the regulation of redox homeostasis.

Long-Term Outcomes of Traditional Chinese Medicine in the Treatment of Granulomatous Lobular Mastitis: A Two-Year Follow-Up Study on Recurrence and New Occurrence Rates with Analysis of Risk Factors.

Patients with clinically cured granulomatous lobular mastitis (GLM) still face a high probability of recurrence and new occurrence. To evaluate the long-term efficacy of traditional Chinese medicine (TCM) in treating GLM and to hypothesize potential risk factors for recurrence or new occurrence. A retrospective analysis was conducted on GLM patients treated with TCM at Longhua Hospital affiliated with Shanghai University of Traditional Chinese Medicine from January 2016 to July 2021. We analyzed general data, two-year recurrence and new occurrence rates, and 12 risk factors associated with recurrence or new occurrence. This cross-sectional study included 261 GLM patients with an average age at onset of 31.95 years (primarily aged 31-40). The two-year recurrence rate for GLM was 1.53%, and the new occurrence rate was 4.21%. Univariate and multivariate conditional logistic regression analyses revealed that a history of inverted nipples was associated with the risk of both recurrence and new occurrence of GLM (HR = 8.672, 5.375, P < 0.05), and menstrual irregularity was related to a higher risk of recurrence (HR = 13.172, P < 0.001). A history of inverted nipples is identified as a potential risk factor associated with the long-term recurrence and new occurrence of GLM, while menstrual irregularity is associated with recurrence. Despite this, patients with GLM undergoing TCM demonstrate low rates of long-term recurrence and new occurrence after achieving clinical cure, underscoring the effectiveness of TCM. This study lays the groundwork for a long-term effectiveness strategy to guide future GLM treatments.