Traditional Clinical Application Research Articles

Use of nano-enabled approaches to advance acupuncture therapy for disease management.

Acupuncture is an ancient form of therapy, which has long been part of traditional Chinese medicine (TCM); however, its use has spread globally, to the point where it is currently practiced worldwide. Although metal needles continue to be used most commonly, through multidisciplinary research, novel technologies, including nanotechnology, have allowed acupuncture to evolve to the point of achieving greater efficiency and more sophisticated functions in clinical practice. We summarized recent advancements in the literature using nano-enabled strategies to create novel needles that enhance and expand their therapeutic effects and found that nanotechnology may help provide new evidence to verify acupuncture theory, improve the features of acupuncture needles and their clinical effects by combining with drug delivery, and even enable new therapeutic methods when combined with acupuncture needles. The use of nano-technology with acupuncture delivery looks very promising for potential clinical applications. We also envisage that with nanotechnology, innovations in acupuncture needles could generate a multi-functional toolbox for use in both diagnostic and therapeutic medicine. Such new types of acupuncture needles could be used at acupoints and data collected to guide the planning of clinical trials may be more consistent with acupuncture theory and traditional clinical applications of this therapeutic modality.

Morphological, chemical and genetic analyses reveal high diversity and blurred genetic boundaries in Cornus officinalis Siebold & Zucc. in China

Cornus officinalis Siebold & Zucc. is an important Chinese herbal medicine with traditional clinical applications, a long history of cultivation and high economic value in China. C. officinalis is distributed mainly in the Shaanxi, Henan, and Zhejiang provinces of China, which are also historically the main production areas, and which still provide 90% of the medicinal material of this species for the contemporary market. In this study, we investigated the main germplasm resources of C. officinalis across its distribution, based on fruit morphology, the concentrations of selected medicinally active ingredients, and molecular population genetic analysis. The results indicated that the C. officinalis populations sampled had abundant variation in fruit morphology and chemical component content, and showed high genetic diversity, as revealed by microsatellite markers. Clustering results based on morphology, active ingredient concentration and microsatellite markers supported the idea that populations from Zhejiang province were distinct from those in Shaanxi and Henan. The fruit and molecular data suggested that the Shaanxi and Henan populations were mixed, which could be attributed to their close geographical distance and frequent germplasm exchange. Most of the C. officinalis populations had relatively weak genetic differentiation from others sampled, and most of the individuals sampled showed extensive admixture. We suggest that artificial gene flow caused by intensive cultivation and widespread trading is responsible for the observed admixture of genetic components and blurred genetic boundaries between C. officinalis populations, especially in the Shaanxi and Henan populations. We also propose some suggestions for the efficient utilization and conservation of C. officinalis germplasm. These findings provide valuable information on the genetic resources of C. officinalis and offer guidelines for breeding programs and scientific management of C. officinalis.

Recent Developments and Future Directions of Wearable Skin Biosignal Sensors

AbstractThis review article explores the transformative advancements in wearable biosignal sensors powered by machine learning, focusing on four notable biosignals: electrocardiogram (ECG), electromyogram (EMG), electroencephalogram (EEG), and photoplethysmogram (PPG). The integration of machine learning with these biosignals has led to remarkable breakthroughs in various medical monitoring and human–machine interface applications. For ECG, machine learning enables automated heartbeat classification and accurate disease detection, improving cardiac healthcare with early diagnosis and personalized interventions. EMG technology, combined with machine learning, facilitates real‐time prediction and classification of human motions, revolutionizing applications in sports medicine, rehabilitation, prosthetics, and virtual reality interfaces. EEG analysis powered by machine learning goes beyond traditional clinical applications, enabling brain activity understanding in psychology, neurology, and human–computer interaction, and holds promise in brain–computer interfaces. PPG, augmented with machine learning, has shown exceptional progress in diagnosing and monitoring cardiovascular and respiratory disorders, offering non‐invasive and accurate healthcare solutions. These integrated technologies, powered by machine learning, open new avenues for medical monitoring and human–machine interaction, shaping the future of healthcare.

Amygdalin epimers exert discrepant anti-pulmonary fibrosis activity via inhibiting TGF-β1/Smad2/3 pathway

Idiopathic pulmonary fibrosis (IPF) represents a chronic and progressive tissue repair response that leads to irreversible scarring and lung remodeling. The decoction of bitter almond usually contains amygdalin epimers in traditional clinical application for lung disease. To reveal the differences of cytotoxicity and antifibrotic effect between amygdalin epimers, and potential mechanism is also explored. The cytotoxicity of amygdalin epimers were evaluated with MRC-5 cells in vitro. Their antifibrotic activities were evaluated in bleomycin-induced C57BL/6 mice and TGF-β1-induced MRC-5 cells. Here we demonstrated that L-amygdalin is more toxic of the amygdalin epimers in MRC-5 cells, and D-amygdalin is more effective in anti-pulmonary fibrosis among the amygdalin epimers in bleomycin-induced C57BL/6 mice. Herein, it was observed that D-amygdalin had a stronger inhibitory effect on inflammation than L-amygdalin, and had similar results in inhibiting the mRNA and protein expression levels of fibrosis-related biomarkers. The mechanism of anti-pulmonary fibrosis showed that amygdalin epimers suppressing expression of phosphorylation of Smads2/3, which implying deactivation of the TGF-β1induced Smads2/3 signal pathway. This study evaluates the amygdalin epimers cytotoxicity and antifibrotic effect, and its mechanisms were related to the TGF-β1/Smads2/3 signal pathway. It provides a reference for clinical safety and effectiveness of amygdalin epimers.

The potential of Valeriana as a traditional Chinese medicine: traditional clinical applications, bioactivities, and phytochemistry.

Valeriana plants are members of the Caprifoliaceae family, which include more than 200 species worldwide. We summarized previous reports on traditional clinical applications, bioactivities, and phytochemistry of Valeriana by searching electronic databases of Science Direct, Web of Science, PubMed, and some books. Some Valeriana species have been used as traditional medicines, demonstrating calming fright and tranquilizing mind, promoting Qi and blood, activating blood circulation and regulating menstruation, dispelling wind and eliminating dampness, regulating Qi-flowing to relieve pain, and promoting digestion and checking diarrhea, and treating diseases of the nervous, cardiovascular, and digestive systems, inflammation, gynecology, and others. Pharmacology studies revealed the effects of Valeriana, including sedative, hypnotic, antispasmodic, analgesic, antidepressant, anxiolytic, anticonvulsant, antiepileptic, neuroprotective, antibacterial, antiviral, cytotoxic, and antitumor effects as well as cardiovascular and cerebrovascular system improvements. More than 800 compounds have been isolated or identified from Valeriana, including iridoids, lignans, flavonoids, sesquiterpenoids, alkaloids, and essential oils. Constituents with neuroprotective, anti-inflammatory, cytotoxic, and sedative activities were also identified. However, at present, the developed drugs from Valeriana are far from sufficient. We further discussed the pharmacological effects, effective constituents, and mechanisms directly related to the traditional clinical applications of Valeriana, revealing that only several species and their essential oils were well developed to treat insomnia. To effectively promote the utilization of resources, more Valeriana species as well as their different medicinal parts should be the focus of future related studies. Clinical studies should be performed based on the traditional efficacies of Valeriana to facilitate their use in treating diseases of nervous, cardiovascular, and digestive systems, inflammation, and gynecology. Future studies should also focus on developing effective fractions or active compounds of Valeriana into new drugs to treat diseases associated with neurodegeneration, cardiovascular, and cerebrovascular, inflammation and tumors. Our review will promote the development and utilization of potential drugs in Valeriana and avoid wasting their medicinal resources.

Low Noise, High Input Impedance Digital-Analog Hybrid Offset Suppression Amplifier for Wearable Dry Electrode ECG Monitoring

The portable real-time electrocardiogram (ECG) is a convenient and promising electronic device for cardiovascular diseases patients. However, unlike wet gel electrodes in traditional clinical applications, dry electrodes are competent for comfortable long-time wearing and can prevent skin ulceration. Its ultra-high source impedance and electrode offset (EOS) make traditional chopper amplifiers with low input impedance and limited EOS range difficult to apply to this area. To overcome these challenges, this paper proposes a novel chopper amplifier topology. This architecture includes a gain control loop, a ripple reduction loop, and a DC-servo loop (DSL). The proposed sampling input stage and digital-analog hybrid DSL are employed to boost input impedance and extend the EOS handing range. Designed with a 0.18 µm 1P6M 1.8 V CMOS salicide process, the proposed chopper capacitively coupled instrumentation amplifier achieves an ultra-high input impedance of 120 GΩ (<0.05 Hz) or 2.1 GΩ (0.6~250 Hz), an EOS handing range of ±325 mV and a low noise of 1.9 μVrms at 0.6~250 Hz. It occupies an area of 0.36 mm2 and only consumes a quiescent current of 11 μA.

A network pharmacology-based approach to analyse potential targets of traditional herbal formulas: An example of Yu Ping Feng decoction

Herbal formulas from traditional Chinese medicines (TCMs) have been extensively used in clinics as effective therapies, but it is still a great challenge to demonstrate the scientific basis for their therapeutic effects at the level of molecular biology. By taking a classic herbal formula (Yu Ping Feng decoction, YPF) as an example, this study developed a novel network pharmacology based method to identify its potential therapeutic targets. First, this study constructed a “targets–(pathways)–targets” (TPT) network in which targets of YPF were connected by relevant pathways; then, this network was decomposed into separate modules with strong internal connections; lastly, the propensity of each module toward different diseases was assessed by a contribution score. On the basis of a significant association between network modules and therapeutic diseases validated by chi-square test (p-value < 0.001), this study identified the network module with the strongest propensity toward therapeutic diseases of YPF. Further, the targets with the highest centrality in this module are recommended as YPF’s potential therapeutic targets. By integrating the complicated “multi-targets–multi-pathways–multi-diseases” relationship of herbal formulas, the method shows promise for identifying its potential therapeutic targets, which could contribute to the modern scientific illustration of TCMs’ traditional clinical applications.

Effect of Hearing Aid Directionality and Remote Microphone on Speech Intelligibility in Complex Listening Situations.

Remote microphones (RMs) have been developed to support hearing aid (HA) users in understanding distant talkers. In traditional clinical applications, a drawback of these systems is the deteriorated speech intelligibility in the near field. This study investigates advantages and disadvantages of clinical RM usage and the effects of different directionality settings of the HAs in complex listening situations in the laboratory. Speech intelligibility was investigated in 15 experienced severely hearing impaired participants in a noisy environment using a dual-task test paradigm where the tasks were presented from either a near field or a far field loudspeaker. Primary and secondary tasks were presented simultaneously so attention had to be shared on both tasks. In a second experiment, two speech intelligibility tests were presented from either the near field or the far field loudspeaker. The tests were interleaved to simulate a complex listening situation with shifting attention. Directional HA microphones yielded better performance than omnidirectional microphones (both combined with a RM) in near field when analyzing both tasks of the dual-task experiment separately. Furthermore, the integrated dual-task test results showed better performance with directional HA microphones compared with the omnidirectional setting (both cases in combination with a RM). These findings were confirmed by the results of the interleaved speech intelligibility test.

Advanced Techniques and Applications in Magnetic Resonance Spectroscopy for Pediatric Patients

AbstractMagnetic resonance spectroscopy (MRS) is a noninvasive tool that is often used in conjunction with conventional MR imaging to acquire information regarding the biochemistry of tissue. In pediatric patients, the traditional clinical application of MRS was in the preoperative diagnostic workup of brain tumors. In recent years with the boom of molecular testing, MRS application for tumor evaluation is becoming more advanced, now potentially serving as a biomarker for molecular subgroup classification. This article will review MRS techniques as well as clinical applications, both conventional and more advanced applications in the pediatric population including tumor assessment, hypoxic-ischemic injury, abusive head injury, and autism.

Advance in modern studies on compatibility of Coptidis Rhizoma and Evodiae Fructus

In traditional clinical application, Coptidis Rhizome and Evodiae Fructus have been combined to treat various stomach heat and cold syndromes, gastritis, gastric ulcer and the like. With the application of modem instruments and the development of molecular pharmacologic theory, their chemical constituents and pharmacological effects have been sufficiently studied. In this paper, literatures from Pubmed were adopted, with particular emphasis on findings of international counterparts and studies on compatibility of main chemical components in Coptidis Rhizoma and Evodiae Fructus, in order to elaborate on the scientific comparability of Coptidis Rhizoma and Evodiae Fructus through chemical analysis, and pharmacological and biopharmaceutics studies and introduce the future development trend of the studies.

Eastern medicine: from nutritional supplements to cancer research.

Eastern medicine: from nutritional supplements to cancer research.

Developing a Stone Database for Clinical Practice

Our objective was to design an intranet-based database to streamline stone patient management and data collection. The system developers used a rapid development approach that removed the need for laborious and unnecessary documentation, instead focusing on producing a rapid prototype that could then be altered iteratively. By using open source development software and website best practice, the development cost was kept very low in comparison with traditional clinical applications. Information about each patient episode can be entered via a user-friendly interface. The bespoke electronic stone database removes the need for handwritten notes, dictation, and typing. From the database, files may be automatically generated for clinic letters, operation notes. and letters to family doctors. These may be printed or e-mailed from the database. Data may be easily exported for audits, coding, and research. Data collection remains central to medical practice, to improve patient safety, to analyze medical and surgical outcomes, and to evaluate emerging treatments. Establishing prospective data collection is crucial to this process. In the current era, we have the opportunity to embrace available technology to facilitate this process. The database template could be modified for use in other clinics. The database that we have designed helps to provide a modern and efficient clinical stone service.

Angiogenic Pathway Inhibition of Corydalis yanhusuo and Berberine in Human Umbilical Vein Endothelial Cells

Corydalis yanhusuo, a well-known traditional Chinese medicine, is widely used in China as an analgesic for patients with terminal cancer. In this study, we want to expose the antiangiogenic effects and the underlying mechanisms of C. yanhusuo and the alkaloids obtained from this plant. The constituents of C. yanhusuo were first investigated for their inhibitory effects on angiogenesis, using several bioassays, including vascular endothelial growth factor (VEGF)-induced human umbilical vein endothelial cell (HUVEC) proliferation, migration, invasion, and tube formation. To determine the active antiangiogenic compounds in C. yanhusuo, we studied the antiproliferative activities of several main constituents of C. yanhusuo, which belong to a group of protoberberine alkaloids, on HUVECs and identified berberine as a powerful angiogenesis inhibitor in C. yanhusuo. Both C. yanhusuo extract and its active compound berberine significantly suppressed the VEGF-induced upregulation of matrix metalloproteinase 2 (MMP2) at both mRNA and protein levels. Their functional effects, including the inhibition of MMP2, were shown to be involved VEGF-triggered ERK1/2 pathways. Our findings provide novel insights into the antiangiogenic effects of C. yanhusuo and berberine, and offer scientific evidence for their traditional clinical application as a cancer treatment.

Clinical Equivalence of Two Cytokeratin Markers in Non-small Cell Lung Cancer : A Study of Tissue Polypeptide Antigen and Cytokeratin 19 Fragments

We have longstanding experience with tissue polypeptide antigen (TPA), a tumor marker of the cytokeratin (CK) family. In the mid-1990s, a new CK marker, CK 19 fragments (CYFRA 21-1), became popular and widely accepted. This is the first study specifically designed to compare the two markers. Analysis of a single institution database over a 3-year period (ie, 1998 to 2000). Community-based hospital and second referral level institution for a province of 500,000 people. The study included 180 new consecutive patients (143 men) with pathologically documented non-small cell lung cancer (NSCLC), who were observed during and after treatment, and eventually were assessed for status. Anthropometric, clinical, and laboratory data, including TPA and CYFRA 21-1 serum levels, were recorded prospectively. Standard nonparametric tests, Kaplan-Meyer survival analyses, Cox proportional hazards models, receiver-operating characteristic (ROC) curves, and estimates were used for statistical analysis. A total of 1,299 twin TPA and CYFRA 21-1 serum assays (180 performed at diagnosis and 1,119 performed during or after treatment) were obtained. Intermarker correlation tests revealed incredibly high Spearman rho indexes, ranging from 0.935 at diagnosis to 0.813 to 0.921 at the different follow-up times. The substantial equivalence of the two tests explained all the other results, as follows: their similar profile of correlation with the other variables (objective treatment response: TPA rho, 0.456; CYFRA 21-1 rho, 0.463; follow-up performance status: rho range, 0.424 to 0.435); their superimposable capability to predict important clinical situations (eg, recognizing a metastatic disease at diagnosis with areas under the ROC curve of 0.742 and 0.706, respectively); their nearly identical prognostic significance (the D statistic of the goodness-of-fit of a multivariate survival model: TPA, 851.0; CYFRA 21-1, 851.6). In most of their traditional clinical applications the two serum tests are equivalent because of their virtual identity. We strongly recommend using a CK test in the evaluation of each NSCLC patient. The choice between TPA and CYFRA 21-1 can be based on nonclinical factors, such as the laboratory experience or preference, and the cost of the two kits.

P-5-534 - Surgical management of glioblastoma multiforme

We have longstanding experience with tissue polypeptide antigen (TPA), a tumor marker of the cytokeratin (CK) family. In the mid-1990s, a new CK marker, CK 19 fragments (CYFRA 21–1), became popular and widely accepted. This is the first study specifically designed to compare the two markers.Analysis of a single institution database over a 3-year period (ie, 1998 to 2000).Community-based hospital and second referral level institution for a province of 500,000 people.The study included 180 new consecutive patients (143 men) with pathologically documented non-small cell lung cancer (NSCLC), who were observed during and after treatment, and eventually were assessed for status.Anthropometric, clinical, and laboratory data, including TPA and CYFRA 21–1 serum levels, were recorded prospectively. Standard nonparametric tests, Kaplan-Meyer survival analyses, Cox proportional hazards models, receiver-operating characteristic (ROC) curves, and estimates were used for statistical analysis.A total of 1,299 twin TPA and CYFRA 21–1 serum assays (180 performed at diagnosis and 1,119 performed during or after treatment) were obtained. Intermarker correlation tests revealed incredibly high Spearman ρ indexes, ranging from 0.935 at diagnosis to 0.813 to 0.921 at the different follow-up times. The substantial equivalence of the two tests explained all the other results, as follows: their similar profile of correlation with the other variables (objective treatment response: TPA ρ, 0.456; CYFRA 21–1 ρ, 0.463; follow-up performance status: ρ range, 0.424 to 0.435); their superimposable capability to predict important clinical situations (eg, recognizing a metastatic disease at diagnosis with areas under the ROC curve of 0.742 and 0.706, respectively); their nearly identical prognostic significance (the D statistic of the goodness-of-fit of a multivariate survival model: TPA, 851.0; CYFRA 21–1, 851.6).In most of their traditional clinical applications the two serum tests are equivalent because of their virtual identity. We strongly recommend using a CK test in the evaluation of each NSCLC patient. The choice between TPA and CYFRA 21–1 can be based on nonclinical factors, such as the laboratory experience or preference, and the cost of the two kits.