Asian Medicine Research Articles

Pattern Identification and Acupuncture Prescriptions Based on Real-World Data Using Artificial Intelligence

In traditional East Asian medicine, acupuncture practitioners gather clinical data, identify patterns, and choose appropriate acupoints. The pattern identification procedure is crucial for clinical diagnosis and acupuncture treatment. Understanding the pattern identification process, i.e. gathering and synthesizing clinical information from patient signs and symptoms, is crucial for characterizing the complicated relationships between symptoms and acupoints. Here, we briefly overview recent studies describing the use of a bodily sensation map to identify spatial patterns of “acupoint indications”, an artificial neural network model to characterize the rules connecting symptoms with acupoints, and medical data extrapolated from case reports to reveal associations between diagnoses and acupoint prescriptions. We also propose a method based on pattern identification to optimize acupoint selection for treatment. Artificial intelligence has substantially advanced traditional East Asian medicine by facilitating decision-making and aids understanding of clinical decision-making as it relates to acupuncture treatment.

Chemical composition and biological activity of wild <i>Linum</i> (Linaceae) Species

The review presents data from literature sources on the component composition and biological activity of aboveground and underground parts of wild species of the genus Linum L. (Linaceae DC. ex Perleb). In recent decades, studies have been carried out on the component composition of not only flaxseed oil, but also cell cultures in vitro. This information is especially relevant for starting herbal materials derived from wild Linum species with small habitats or insignificant thicket density. Currently, information on the component composition and biological activity of oils or extracts has been obtained for 54 wild Linum species, belonging to 8 sections of 2 subgenera. In the aboveground and underground parts of the studied wild species of the genus Linum, the following sunstances were found: mucilage (in leaves and seeds), proteins (in seeds), vitamins (in leaves, seeds), alkaloids, flavonoids, saponins, coumarins, tannins, pigments, cyanogenetic glucosides and lignans. Essential oil was isolated from the aboveground flowering parts of L. perenne L., L. ausrtiacum L., L. hirsutum L., L. pubescens Willd. ex Schult., L. tenuifolium L., and L. catharticum L. The chemosystematics does not contradict the system we previously compiled based on morphological, anatomical and molecular characteristics of Linum species. Asian and European herbal medicine traditionally uses aboveground parts of L. perenne, L. baicalense Juz., L. altaicum Ledeb. ex Juz., L. olgae Juz. and L. heterosepalum Regel. The seeds and fatty oil exhibit coating, wound-healing, mild laxative, and analgesic properties. Extracts of wild-growing Linum species, as well as their individual components, have varied bioactivity like antibacterial, antimicrobial, antifungal, yeast-static, antiviral, cytotoxic, inhibitory, antitumor, anti-inflammatory, wound healing, and antioxidant. Species characterized by a high content of aryldihydronaphthalene-type lignans (a typical representative is justicidin B) have an antiviral effect and are effective against SARS-Cov-2. The yellow-flowered Linum species in the section Syllinum, with predominant aryltetralin lignans (e.g. 6-methoxypodophyllotoxin and its derivatives), exhibit anticancer activity. In the section Linopsis, L. corymbulosum Reichenb., which contains (–)-hinokinin, may prove to be an object of comprehensive research as a promising source of domestic herbal substances that can be used as adjunctive treatments in the anti-hepatitis B therapy.

Fermented Codonopsis lanceolata root extract exhibits anti-viral effects against influenza A infection by inhibiting neuraminidase activity and inflammatory responses

Codonopsis lanceolata, traditionally used in Asian herbal medicine to treat respiratory inflammation, contains various bioactive compounds, including saponins. The influenza A virus (IAV) is notorious for causing pandemics due to its ability to undergo antigenic shifts and drifts, complicating vaccine effectiveness and treatment approaches. This study investigates the protective and therapeutic effects of fermented C. lanceolata root extracts (FCLE) against IAV, comparing its efficacy with that of the original C. lanceolata root extracts (CLE) in both in vitro and in vivo models. FCLE demonstrated significantly higher antioxidant activity and an increased content of total polyphenols, saponins, and reducing sugars compared to CLE, although the content of lancemaside A was decreased in FCLE. FCLE also showed superior efficacy in reducing IAV-induced cytopathic effects and nucleocapsid protein expression in A549 cells, and virus titer in MDCK cells, particularly in post-treatment mode. However, CLE did not exhibit any protective effects against IAV infection. FCLE effectively inhibited neuraminidase (NA) activity and also tended to inhibit hemagglutinin. Furthermore, oral administration of FCLE at 100 mg/kg dramatically protected against lethal IAV infection, achieving a 100% survival rate, reducing virus titer, and ameliorating lung histopathological changes, with specific reductions in KC and IL-1β levels in bronchoalveolar lavage fluid (BALF). These results suggest that FCLE has considerable antiviral efficacy against IAV by both directly inhibiting viral replication via NA activity and orchestrating an antiviral immune response. Collectively, our findings indicate that FCLE could be a promising nutraceutical ingredient for respiratory health.

ITRAQ-based proteomic analysis reveals the effect of ribosomal proteins on essential-oil accumulation in Houttuynia cordata Thunb.

Houttuynia cordata Thunb., also known as Yuxingcao in Chinese, occupies a pivotal role in Asian traditional medicine and cuisine. The aerial parts and underground stems of H. cordata exhibit remarkable chemical diversity, particularly in essential oil. Nevertheless, the mechanisms regulating essential oil biosynthesis in H. cordata remain unclear. In this study, we present a quantitative overview of the proteomes across four tissues (flower, stem, leaf, and underground stem) of H. cordata, achieved through the application of the isobaric tag for relative and absolute quantitation (iTRAQ). Our research findings indicate that certain crucial ribosomal proteins and their interactions may significantly impact the production of essential oils in H. cordata. These results offer novel insights into the roles of ribosomal proteins and their associations in essential oil biosynthesis across various organisms of H. cordata.

Effectiveness of Herbal medicines on male reproductive system: Evidence from meta-analysis

BackgroundThe increasing prevalence of male infertility has become a global concern. Traditional Chinese and Asian medicines have long been using herbal remedies to promote spermatogenesis. This study aimed to systematically explore the potential of herbal medicines and formulations to enhance the male reproductive function in humans. MethodsTwo prominent databases, MEDLINE and EMBASE, as well as scientific journals indexed in the Web of Science, were used for the literature search until October 2023. The studies included in the analysis focused on the impact of herbal medicines (Mucuna pruriens, Withania somnifera, Eurycoma longifolia, Panax ginseng, Lycopersicon esculentum, Crocus sativus, Vitis vinifera, Nigella sativa, Sesamum indicum, Curcuma longa, Lepidium peruvianum) and Chinese and Korean Polyherbal formulations (Shao-Fu-Zhu-Yu-Tang; 少腹逐瘀汤) on human serum reproductive hormone levels, semen parameters, and antioxidant enzymes. ResultsA total of 23 articles were deemed eligible for the review and meta-analysis, which included 1,194 men from seven countries (China, Korea, Iran, Peru, Japan, Malaysia, and India). Of these, 19 articles were analyzed for semen parameters. The use of herbal medicine increased seminal parameters, including semen volume during each ejaculation (standardized mean difference (SMD) = 0.89; 95 % CI: 0.52, 1.26), sperm concentration (SMD = 1.97; 95 % CI: 1.30, 2.64), total sperm count (SMD = 2.28; 95 % CI: 1.44, 3.11), sperm motility (SMD = 1.07; 95 % CI: 0.68, 1.46), and normal morphology (SMD = 1.47; 95 % CI: 0.62, 2.32). Additionally, 18 articles that analyzed sex hormone levels showed that treatment with herbal medicines favorably reduced serum prolactin (SMD = -0.70; 95 % CI: -1.13, -0.28) and FSH levels (SMD = -1.07; 95 % CI: -1.56, -0.56). Meanwhile, herbal medicines did not affect testosterone levels (SMD = 0.41; 95 % CI: -0.24, 1.06) and LH levels (SMD = 0.45; 95 % CI: -0.33, 1.23). Finally, six articles were analyzed for seminal biochemical and antioxidant profiles, and the results showed that herbal medicine increased the levels of ascorbic acid (SMD = 1.19; 95 % CI: 0.51, 1.86), corrected seminal fructose (SMD = 1.32; 95 % CI: 0.89, 1.76), superoxide dismutase activity (SOD) (SMD = 1.06; 95 % CI: 0.45, 1.68), and catalase activity (SMD = 0.91; 95 % CI: 0.69, 1.44) in seminal plasma. ConclusionHerbal remedies have been found to promote spermatogenesis by optimizing semen parameters, sex hormone levels, and antioxidant profiles. As a result, these treatments should be regarded as complementary approaches to male infertility.

Precision medicine in Asia enhanced by next-generation sequencing: Implications for Thailand through a scoping review and interview study.

Next-generation sequencing (NGS) significantly enhances precision medicine (PM) by offering personalized approaches to diagnosis, treatment, and prevention of unmet medical needs. Little is known about the current situation of PM in Asia. Thus, we aimed to conduct an overview of the progress and gaps in PM in Asia and enrich it with in-depth insight into the possibilities of future PM in Thailand. This scoping review focused on Asian countries starting with non-cancer studies, including rare and undiagnosed diseases (RUDs), non-communicable diseases (NCDs), infectious diseases (IDs), and pharmacogenomics, with a focus on NGS. Subsequent in-depth interviews with experts in Thailand were performed, and a thematic analysis served as the main qualitative methodology. Out of 2898 searched articles, 387 studies were included after the review. Although most of the studies focused on cancer, 89 (23.0%) studies were related to RUDs (17.1%), NCDs (2.8%), IDs (1.8%), and pharmacogenomics (1.3%). Apart from medicine and related sciences, the studies were mostly composed of PM (61.8%), followed by genetics medicine and bioinformatics. Interestingly, 28% of articles were conducted exclusively within the fields of medicine and related sciences, emphasizing interdisciplinary integration. The experts emphasized the need for sustainability-driven political will, nurturing collaboration, reinforcing computational infrastructure, and expanding the bioinformatic workforce. In Asia, developments of NGS have made remarkable progress in PM. Thailand has extended PM beyond cancer and focused on clinical implementation. We summarized the PM challenges, including equity and efficiency targeting, guided research funding, sufficient sample size, integrated collaboration, computational infrastructure, and sufficient trained human resources.

CyPD Inhibition for Alzheimer's: In-Silico Screening of Phytochemicals from Asian Medicinal Plants

CyPD Inhibition for Alzheimer's: In-Silico Screening of Phytochemicals from Asian Medicinal Plants

Evaluation of the potential of Stichopus Herrmanni extract in inhibiting cervical cancer cell proliferation

BackgroundSea cucumbers, particularly Stichopus herrmanni, are known for their medicinal value in Asian traditional medicine owing to the abundant presence of saponins, terpenoids, and phenols. Investigations on these bioactive compounds have revealed their cytotoxic propensity against various cancer cell lines, indicating their therapeutic potential. However, limited research exists on the potential application of sea cucumber extracts specifically in cervical cancer. PurposeThis study aimed to identify the bioactive components of Stichopus herrmanni extract, determine their association with potential targets in cervical cancer, and evaluate their cytotoxic effects on cervical cancer cells. Study DesignThis experimental study employed both in vitro and in silico methods to evaluate the potential cytotoxic effects of Stichopus herrmanni extracts on cervical cancer cells. MethodsLiquid Chromatography-Mass Spectrometry (LC-MS) was used to identify and quantify the bioactive constituents of Stichopus herrmanni crude extract. An in silico approach was used to identify the active components, potential targets, and signaling pathways of the extract. Furthermore, the MTT assay was used to determine the cytotoxicity of the extract. ResultsLC-MS analysis identified the presence of rengyol, eucommiol, ganoderic acid, and 6-isoinosine in the extracts. An in silico study based on structural analysis identified ganoderic acid and isoinosine as crucial active components capable of regulating majority of the targets associated with cervical cancer. Overlapping targets, namely, CASP3, CAT, FASLG, IL24, TP53, TP53BP1, ALB, BDNF, and COX2 between cervical cancer and the extract highlighted new therapeutic prospects for cervical cancer following protein-protein interaction network screening. The in vitro cytotoxic effects of the extracts were established in HeLa cells. ConclusionResearch indicates that Stichopus herrmanni may be a valuable source of bioactive compounds with potential applications in the treatment of cancer and the induction of apoptosis

Cytotoxic effect of Eleutherococcus trifoliatus (L.) S.Y. Hu stem bark extracts on Gastric, Lung, and Hepatocellular cancer cells

Eleutherococcus trifoliatus is a popular medicinal species used in Asian folk medicine with many uses in treating human diseases. Scientific research on this plant has been limited, but some scientific publications have described this herb's anti-inflammatory, antibacterial, antioxidant, and anti-cancer activities. Although it is a frequently used part of traditional medicine, current scientific evidence on the biological activities of E. trifoliatus stem bark is still lacking. By performing chemical reactions, free radical scavenging experiments, toxicity experiments on brine shrimp, and cytotoxicity tests using MTT dye, the study has shown the diversity in the metabolic composition of E. trifoliatus stem bark as well as the antioxidant capacity and safety of the total extract. The anticancer effect of the total extract was investigated and indicated the dramatical ability to inhibit the cell growth of liver cancer HCC-J5 cells (IC50 = 19.35 ± 4.89 µg/mL), lung cancer cells A549 (IC50 = 5.34 ± 1.62 µg/mL) and gastric cancer cells AGS (IC50 = 0.22 ± 0.20 µg/mL); the selectivity in effects was also observed. The chloroform fraction had the most potential to be further exploited in the direction of inhibiting cancer cells.

Microbiome-Metabolome Analysis Insight into the Effects of the Extract of Phyllanthus emblica L. on High-Fat Diet-Induced Hyperlipidemia.

The fruit of Phyllanthus emblica L. (FEPE) has a long history of use in Asian folk medicine. The main bioactive compounds in FEPE are polyphenols, known for their potent antioxidant, anti-inflammatory, and hypolipidemic activities. The present study aimed to investigate the intervention effect of FEPE (100 and 200 mg/kg) on hyperlipidemia for 8 weeks and preliminarily explored the potential mechanism by microbiome-metabolome analysis. The results showed that a high-dose FEPE (200 mg/kg) effectively alleviated dyslipidaemic symptoms and body weight gain in hyperlipidemic mice induced by a high-fat diet (HFD). Microbiome analysis showed that FEPE altered the structure of the intestinal microbiota, which included an increase in specific probiotics (such as Akkermansia, Anaerovorax, and Bacteroides) and a decrease in harmful bacteria (including A2, Acetitomaculum, Candidatus_Arthromitus, Lachnospiraceae_NK4A136_group, Lachnospiraceae_NK4B4_group, Rikenella, and Streptococcus), as well as a reduction in the level of short-chain fatty acids (SCFAs). In addition, significant changes in the hepatic metabolome were observed, and eight key metabolites associated with betaine metabolism, lysine degradation, methionine metabolism, and fatty acid metabolism pathways were primarily filtered. The correlated analysis identified several key "microbiota-metabolite" axes in the treatment of hyperlipidemia by FEPE extract. In conclusion, the present study is expected to provide a basis for treating hyperlipidemia with FEPE from the perspective of the microbiome-liver metabolome axis.

Deciphering the Systemic Impact of Herbal Medicines on Allergic Rhinitis: A Network Pharmacological Approach.

Allergic rhinitis (AR) is a systemic allergic disease that has a considerable impact on patients' quality of life. Current treatments include antihistamines and nasal steroids; however, their long-term use often causes undesirable side effects. In this context, traditional Asian medicine (TAM), with its multi-compound, multi-target herbal medicines (medicinal plants), offers a promising alternative. However, the complexity of these multi-compound traits poses challenges in understanding the overall mechanisms and efficacy of herbal medicines. Here, we demonstrate the efficacy and underlying mechanisms of these multi-compound herbal medicines specifically used for AR at a systemic level. We utilized a modified term frequency-inverse document frequency method to select AR-specific herbs and constructed an herb-compound-target network using reliable databases and computational methods, such as the Quantitative Estimate of Drug-likeness for compound filtering, STITCH database for compound-target interaction prediction (with a high confidence score threshold of 0.7), and DisGeNET and CTD databases for disease-gene association analysis. Through this network, we conducted AR-related targets and pathway analyses, as well as clustering analysis based on target-level information of the herbs. Gene ontology enrichment analysis was conducted using a protein-protein interaction network. Our research identified 14 AR-specific herbs and analyzed whether AR-specific herbs are highly related to previously known AR-related genes and pathways. AR-specific herbs were found to target several genes related to inflammation and AR pathogenesis, such as PTGS2, HRH1, and TBXA2R. Pathway analysis revealed that AR-specific herbs were associated with multiple AR-related pathways, including cytokine signaling, immune response, and allergic inflammation. Additionally, clustering analysis based on target similarity identified three distinct subgroups of AR-specific herbs, corroborated by a protein-protein interaction network. Group 1 herbs were associated with the regulation of inflammatory responses to antigenic stimuli, while Group 2 herbs were related to the detection of chemical stimuli involved in the sensory perception of bitter taste. Group 3 herbs were distinctly associated with antigen processing and presentation and NIK/NF-kappa B signaling. This study decodes the principles of TAM herbal configurations for AR using a network pharmacological approach, providing a holistic understanding of drug effects beyond specific pathways.

Collaborative design of a Chinese herbal medicine case report guideline (CHM-CARE)

IntroductionCase reports have a long history in Chinese herbal medicine (CHM), and even into the modern day, case reports are still a preferred format for traditional East Asian medicine (TEAM) practitioners. However, the tradition of case reports in teaching and research is not nearly as common in the English-speaking world as in China, possibly due to the lack of a specific case report guideline. This study aimed to co-design a CHM guideline (CHM-CARE) to assist practitioners in compiling structured and comprehensive case reports. MethodsA two-phased mixed approach was used to develop the case report guideline. In phase one, focus groups of TEAM practitioners were used to determine what components of existing guidelines (e.g., Case Report (CARE) and Case Report in Chinese Medicine (CARC)) were relevant to include, along with any additions or changes. Content analysis of phase 1 provided the checklist items for a two-round Delphi process (Phase 2). All checklist items from the first Delphi round with a median of three or higher were included in the second round, with consensus set at >70 % for inclusion in the final guideline. ResultsA total of 18 CHM practitioners from four countries joined five separate focus group discussions. Focus group discussions led to 98 checklist items being used in the first round of the Delphi process. Fifteen international experts on case reports participated in two rounds of Delphi. A total of 69 checklist items moved forward into the second round where 61 items (88 %) reached consensus and formed the final CHM-CARE guideline. ConclusionKey elements of a herbal medicine case report checklist were identified, and a 61-item case report guideline (CHM-CARE) was produced, providing clear guidelines for case reports to TEAM practitioners operating in private practice.

Neuroprotective effects of methanolic extract from Chuanxiong Rhizoma in mice with middle cerebral artery occlusion-induced ischemic stroke: suppression of astrocyte- and microglia-related inflammatory response

BackgroundIn traditional Asian medicine, dried rhizomes of Ligusticum chuanxiong Hort. (Chuanxiong Rhizoma [CR]) have long been used to treat pain disorders that affect the head and face such as headaches. Furthermore, they have been used primarily for blood circulation improvement or as an analgesic and anti-inflammatory medicine. This study aimed to investigate the neuroprotective effects of a methanol extract of CR (CRex) on ischemic stroke in mice caused by middle cerebral artery occlusion (MCAO).MethodsC57BL/6 mice were given a 1.5-h transient MCAO (MCAO control and CRex groups); CRex was administered in the mice of the CRex group at 1,000–3,000 mg/kg either once (single dose) or twice (twice dose) before MCAO. The mechanism behind the neuroprotective effects of CRex was examined using the following techniques: brain infarction volume, edema, neurological deficit, novel object recognition test (NORT), forepaw grip strength, and immuno-fluorescence staining.ResultsPretreating the mice with CRex once at 1,000 or 3,000 mg/kg and twice at 1,000 mg/kg 1 h before MCAO, brought about a significantly decrease in the infarction volumes. Furthermore, pretreating mice with CRex once at 3,000 mg/kg 1 h before MCAO significantly suppressed the reduction of forepaw grip strength of MCAO-induced mice. In the MCAO-induced group, preadministration of CRex inhibited the reduction in the discrimination ratio brought on by MCAO in a similar manner. CRex exhibited these effects by suppressing the activation of astrocytes and microglia, which regulated the inflammatory response.ConclusionsThis study proposes a novel development for the treatment of ischemic stroke and provides evidence favoring the use of L. chuanxiong rhizomes against ischemic stroke.

Identification of potential DPP-4 inhibitors from Bryophyllum pinnatum by in-silico analysis

Background: An estimated 463 million people already live with diabetes and that figure is set to rise to over 700 million by 2045, as per the International Diabetes Federation (IDF). The current form of treatment for Type-2 DM can be done with sulfonylureas, meglitinides, metformin, thiazolidinediones, incretin mimetics: Glucagon-like peptide 1 (GLP-1), Glucose-dependent insulinotropic polypeptide (GIP), and amylin analogues (Pramlintide). Bryophyllum pinnatum (Lam.) Oken (B. pinnatum) belongs to the plant family crassulaceae used in traditional medicine in Asia. GLP-1 and Glucose-dependant Insulinotropic Polypeptide (GIP), both play a similar role in stimulating insulin secretion and are inactivated by dipeptidyl peptidase-4 (serine protease dipeptidyl peptidase-4) enzymes. Aims: To identify the potential anti-diabetic active compounds of Bryophyllum pinnatum against DPP-4 enzyme using in-silico methods. Methods and Material: The phytochemicals associated with Bryophyllum pinnatum were retrieved from ChEBI and canonical SMILES retrieved, followed by searching for its molecular properties and druglikeness using MolSoft LLC, toxicity test using ADVERPred, Swiss Target Prediction for predicting the DPP-4 inhibitors, molecular docking using Schrodinger software suite. Results: The in-silico study identified two phytochemicals from fourteen that have been predicted for DPP-4 inhibition potential against Type-2 DM. In CH2CL2 and CH3OH solvent compounds 3,5-dihydroxybenzoic acid (-5.623 kcal/mol) and 3,4-didehydro-N4-deethylbrinzolamide (-4.91 kcal/mol) displayed the highest docking scores against human DPP-4 (5Y7K). Conclusions: The above-mentioned compounds revealed no side effects. The in-silico results strongly favour the beneficial use of phytochemicals from Bryophyllum pinnatum as a probable herb that can be used for adjuvant therapy. Further in-vitro and in-vivo tests are needed for confirmation.

Modified Gwakjeongtang for Diarrhea-Predominant Irritable Bowel Syndrome: Study Protocol for a Randomized, Double-Blind, Placebo-Controlled, Pilot Clinical Trial.

Irritable bowel syndrome (IBS) is a chronic condition characterized by recurrent abdominal pain associated with bowel movements. Modified Gwakjeongtang (MGT), an herbal prescription rooted in traditional East Asian medicine, consists of thirteen botanical drugs known for their potential to enhance intestinal barrier function, regulate gastrointestinal motility, and exhibit anti-inflammatory and antioxidant properties. Despite a few previous clinical trials highlighting MGT's potential for IBS symptom management, limited evidence exists with placebo control. In this pilot randomized clinical trial protocol, we aim to exploratively evaluate the efficacy and safety of MGT in patients with diarrhea-predominant IBS (IBS-D) by comparing it with a placebo. A total of 60 IBS-D patients will be enrolled, and eligible participants will be randomly allocated to either the MGT or placebo groups. Over a 4-week period, they will receive MGT or placebo granules three times a day. The primary endpoint will be the overall response rate post-treatment, determined through daily assessments of abdominal pain intensity and stool consistency. This clinical trial protocol has received approval from the Korean Ministry of Food and Drug Safety for an investigational new drug application and Institutional Review Board of the Kyung Hee University Korean Medicine Hospital. The research findings will be submitted and published in international peer-reviewed journal. Clinical research information service (registration number: KCT0008523).

Visualizing a Cold Stress-Specific Pulse Wave in Traditional Pulse Diagnosis ('Tight Pulse') Correlated with Vascular Changes in the Radial Artery Induced by a Cold Pressor Trial.

Radial pulse diagnosis is the most common method to examine the human health state in Traditional East Asian Medicine (TEAM). A cold stress-related suboptimal health state (subhealth) is often undetectable during routine medical examinations, however, it can be detected through the palpation of specific pulse waves, particularly a 'tight pulse', in TEAM. Therefore, this study examined a correlation between 'tight pulse' and vascular changes in the radial artery (RA) induced by a cold pressor trial (CPT). Twenty healthy subjects underwent sequentially control trial and CPT with room-temperature and ice-cold water, respectively, on the right forearm. The radial pulse and vascular changes were then examined on the left arm. The radial pulse scores for frequencies of 'tight pulse' with strong arterial tension increased after the CPT compared with the control trial. The pulse scores were reversely correlated with the RA thickness and volumes in ultrasonography, but not with changes in the systolic/diastolic blood pressure. The RA thickness-based vascular surface and three-dimensional images visualized a 'tight pulse' showing the vasoconstriction and bumpy-/rope-shaped vascular changes in the radial pulse diagnostic region after the CPT. These findings provide valuable insights into the potential integration of clinical radial pulse diagnosis with ultrasonography for cold-related subhealth.

International study of physicians' opinion on physician-patient sex concordance when treating athletes.

The effect of physician-patient sex concordance in medicine has been reported in many studies. Whether physicians believe that the sex concordance between physician and athlete influences treatment has not been investigated. To determine whether physicians believe that the sex concordance between physician and athlete influences treatment. Cross-sectional study. Online survey. One thousand one hundred ninety-three sports medicine physicians in 51 countries. Participants were sports medicine physicians trained in orthopedics (n = 443 [37.1%]) and nonorthopedics (n = 750 [62.9%]). Not applicable. Participants were asked to decide whether sex of the physician made them better suited to care for athletes of concordant or different sexes along with their personal background. Orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians regarding the statement "MALE sports medicine physicians are better suited than their female counterparts to care for MALE athletes" (odds ratio [OR] 0.56, 95% confidence interval [CI] 0.35-0.91, p = .02), and compared to sports medicine physicians based in Europe, those based in Asia agreed more to this statement (OR 7.91, 95% CI 4.60-13.60, p < .01). In addition, regarding the statement "FEMALE sports medicine physicians are better suited than their male counterparts to care for FEMALE athletes," compared to sports medicine physicians based in Europe, those based in Asia (OR 9.12, 95% CI 5.63-14.79, p < .01) and North America (OR 2.18, 95% CI 1.46-3.25, p < .01) agreed more and orthopedic sports medicine physicians agreed less than nonorthopedic sports medicine physicians (OR 0.61, 95% CI 0.39-0.93, p = .02) to this statement. Sports medicine physicians trained in orthopedics felt sex concordance was less important than physicians trained in other specialties. Asian sports medicine physicians believed sex concordance was more important compared to physicians in other regions.

Abstract 975: Genomic landscape of circulating tumor DNA in cervical cancer in Asia: NCCH1905/A-TRAIN trial

Abstract Background: Cervical cancer is the second most common cancer among women worldwide, with over 500,000 new cases diagnosed annually and a 50% mortality rate in Asia. The incidence and prevalence of cervical cancer is high in Asia due to limited screening, awareness of HPV infection, and access to vaccines. The purpose of this study is to evaluate the comprehensive genomic profiles of circulating tumor DNA (ctDNA) in Asian cervical cancer patients with different histological subtypes and their association with clinicopathological features. Methods: This is an Asian multicenter prospective observational study conducted by nine institutions in Japan, Singapore, Malaysia, Thailand, and Vietnam (NCT05099978, ClinicalTrials.gov). Eligible patients had histological diagnosis of cervical cancer with metastatic or recurrent disease. Patients on chemotherapy or radiotherapy were excluded. ctDNA was analyzed in blood samples collected at newly initial diagnosis of metastatic disease and/or at disease progression. Genomic profiling was conducted by Guardant360 (Guardant Health). Results: Ninety-nine samples from 101 cervical cancer patients were analyzed. ctDNA was detected in 70 (70.7%) samples; median time to test results was 11 days. The median number of genomic abnormalities was 1 (range, 0-22). The most frequently altered genes were PIK3CA (n=28. 28.3%), TP53 (n=18, 18.2%), KRAS (n=12, 12.1%) and STK11 (n=6, 6.1%). Clinical trial-related genomic abnormalities were detected in 59 patients (59.6%) with 40 associated with approved drugs in other indication, including those targeting PIK3CA mutation (n=28), homologous recombination deficiency (BRCA1/2, ATM and CDK12 mutation) (n=5), ERBB2 amplification (n=4) and FGFR3alterations (n=3). In squamous cell carcinoma (n=59), commonly altered genes were PIK3CA (n=21, 35.6%), TP53(n=12, 20.3%), ERBB2 (n=5, 8.5%), NOTCH1 (n=5, 8.5%) and ARID1A (n=5, 8.5%). In adenocarcinoma (n=36), commonly altered genes were KRAS (n=7, 19.4%), PIK3CA (n=6, 16.7%) and TP53 (n=5, 13.9%). The number of patients with genomic alterations relevant for clinical trials was 39 (66.1%) and 19 (52.8%) for squamous cell carcinoma and adenocarcinoma, respectively. There were no differences in the number of genomic alterations according to prior chemotherapy or radiation therapy. Conclusion: Comprehensive genomic profiling using liquid biopsy can rapidly identify potential candidates for targeted therapy in cervical cancer patients, regardless of histopathology. Clinical studies of precision medicines in Asia are encouraged for such patients. Citation Format: Prathepamalar Yehgambaram, Yuki Kojima, Kazuki Sudo, Shu Yazaki, Momoko Tokura, Munehiro Ito, Mai Hoshino, Wong Yoke Fui, Pei Jye Voon, David SP Tan, Arb-aroon Lertkhachonsuk, Anh Tuan Pham, Thinh Dang Huy Quoc, Wan Zamaniah Wan Ishak, Hiroshi Yoshida, Shinji Kohsaka, Yukari Nagasaka, Ryunosuke Machida, Tomomi Hata, Kenichi Nakamura, Kan Yonemori. Genomic landscape of circulating tumor DNA in cervical cancer in Asia: NCCH1905/A-TRAIN trial [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 975.

Simultaneously ‘national medicine’ and ‘East Asian medicine’: A cross-boundary network of medical exchange in wartime East Asia

Abstract This article examines a transnational network of advocates for Kampō (traditional) medicine in Japan, occupied China, and Manchukuo during the Sino-Japanese War (1931–1945), shedding new light on collaborationism, Asianism, and the modernization of traditional medicine in East Asia. In the 1930s, despite deteriorating Sino-Japanese relations, the Kampō revival movement in Japan joined forces with the struggle to preserve traditional medicine in China. In 1938, the Association of East Asian Medicine was founded in Japan, gathering together Chinese, Korean, and Japanese advocates under the banner of ‘East Asian medicine’. This article delineates the evolution of what I call ‘medical Asianism’ and how it was institutionalized in different parts of the Japanese empire. Participants in this network differed in their priorities and ideological commitments, yet they tactfully utilized the Japanese imperial infrastructure and wartime circumstances to promote traditional medicine. Their work laid important intellectual and institutional foundations for the postwar development of traditional medicine across East Asia. This study also contributes to a more nuanced understandings of collaborationism. The type of collaboration examined in this article was preceded by a long history of intellectual exchange, based on a shared body of knowledge and morals, motivated by mutual empathy, and for a cause that was much valued in postwar Asia. As a result, unlike most Chinese collaborators who were prosecuted as ‘traitors’, protagonists in this study continued to prosper professionally and became valuable assets in the postwar rebuilding of Sino-Japanese relations.

Methanol extract of Ligusticum chuanxiong Hort. Rhizome ameliorates bilateral common carotid artery stenosis-induced cognitive deficit in mice by altering microglia and astrocyte activation.

In traditional Asian medicine, Ligusticum chuanxiong Hort also known as Conioselinum anthriscoides "Chuanxiong", is mainly used for improving blood circulation or for analgesic and anti-inflammatory purposes, but they also have a long history of use for pain disorders in the head and face, such as headache. Despite the possibility that the plant is effective for diseases such as cerebral infarction and vascular dementia (VaD), the mechanism of action is not well understood. To determine if the dried rhizomes of L. chuanxiong (Chuanxiong Rhizoma, CR) methanol extract (CRex) has activity in a VaD mice model. Through network analysis, we confirm that CR is effective in cerebrovascular diseases. In mice, we induce cognitive impairment, similar to VaD in humans, by chronically reducing the cerebral blood flow by performing bilateral common carotid artery stenosis (BCAS) and administering CRex for 6weeks. We measure behavioral changes due to cognitive function impairment and use immunofluorescence staining to confirm if CRex can inhibit the activation of astrocytes and microglia involved in the inflammatory response in the brain. We quantify proteins involved in the mechanism, such as mitogen-activated protein kinases (MAPK), in the hippocampus and surrounding white matter, and analyze gene expression and protein interaction networks through RNA sequencing to interpret the results of the study. CRex administration rescued cognitive impairment relating to a novel object and inhibited the activation of astrocytes and microglia. Western blotting analysis revealed that CRex regulated the changes in protein expression involved in MAPK signaling such as extracellular signal-regulated kinase (ERK) and p38 mitogen-activated protein kinase (p38). The administration of CRex suppressed approximately 44% of the pathological changes in gene expression caused by BCAS. CRex extract effectively inhibited cognitive impairment caused by BCAS, and the mechanism through which this occurred is inhibited activation of astrocytes and microglia.