Traditional Patent Medicine Research Articles

Repurposing cyclovirobuxine D as a novel inhibitor of colorectal cancer progression via modulating the CCT3/YAP axis.

Colorectal cancer (CRC) ranks second in mortality worldwide and requires effective and affordable remedies. Cyclovirobuxine D (CVB-D) is the main effective component of Huangyangning tablet, an approved traditional patent medicine, which is mainly used for cardiovascular treatment. As a multibioactive natural compound, CVB-D possesses underlying anticancer activities. Cell viability and clone-forming ability were determined in human CRC lines. Western blot, immunofluorescence assay, transmission electron microscopy and senescence-associated β-galactosidase (SA-β-Gal) staining were utilized to investigate cell autophagy and senescence. The molecular mechanisms were explored by virtual prediction and experimental validation. Patient-derived xenograft (PDX), dextran sulfate sodium salt (DSS), and azomethane (AOM)/DSS mouse models were employed for in vivo studies. CVB-D inhibited the growth and development of advanced CRC cells / mice by inducing autophagic and senescent activities through the chaperonin containing TCP1 subunit 3 (CCT3)/yes-associated protein (YAP) axis. CVB-D acted as a promising inhibitor of CCT3 by interacting with its ATP site. In PDX tumours, CVB-D showed potential therapeutic effects by targeting CCT3. Treatment with CVB-D alleviated the mouse model of colitis induced by DSS and attenuated AOM/DSS-induced formation of adenomatous polyps by its action on CCT3. Our study has provided a scientific basis for the suggestion that CVB-D may be recognized as a prospective drug candidate for the therapy of CRC in patients.

Efficacy of Chinese traditional patent medicines for heart failure with preserved ejection fraction: a Bayesian network meta-analysis of 64 randomized controlled trials.

Heart failure with preserved ejection fraction (HFpEF) is associated with substantial morbidity and mortality, and modern medicine offers less effective treatment for HFpEF. Much evidence shows that Chinese traditional patent medicines (CTPMs) have good efficacy for HFpEF, but the advantages and disadvantages of different CTPMs for HFpEF are still unclear. This study used network meta-analysis (NMA) to compare clinical efficacies of different CTPMs for HFpEF. Randomized controlled trials (RCTs) of CTPMs for treating HFpEF were searched in seven Chinese and English databases from inception to September 2023: China National Knowledge Infrastructure (CNKI), Wanfang, VIP, China Biology Medicine, PubMed, Cochrane Library, and Embase. Two researchers independently screened the literature, extracted data, and evaluated the quality of the included studies. The GeMTC package in R (version 4.1.2) was used to perform Bayesian NMA. A total of 64 RCTs were included, involving six CTPMs and 6,238 patients. The six CTPMs were Qili Qiangxin capsule (QLQXC), Qishen Yiqi dropping pill (QSYQDP), Yixinshu capsule (YXSC), Yangxinshi tablet (YXST), Shexiang Baoxin Pill (SXBXP), and Tongxinluo capsule (TXLC). Conventional Western medicine (CWM) treatment was given to the control group, and CWM treatment combined with CTPM treatment was given to the experimental group. The results indicated that CPTMs + CWM were all superior to CWM alone; SXBXP + CWM had the best efficacies in improving the New York Heart Association cardiac functional classification efficiency; TXLC + CWM was best at improving the ratio of early diastolic mitral inflow velocity to late diastolic mitral inflow velocity (E/A); QSYQDP + CWM was best at reducing N-terminal pro-B type natriuretic peptide (NT-proBNP); and QSYQDP + CWM was best at improving the 6-min walking test. In terms of safety, there was no significant difference between CTPMs + CWM and CWM. Compared with CWM alone, CTPMs + CWM combinations have certain advantages and good safety in the treatment of HFpEF. QSYQDP + CWM and SXBXP + CWM may be the potential optimal integrative medicine-based treatments for HFpEF. Given the limitations of this study, further high-quality, multicenter, large sample, randomized, and double-blind studies are needed to confirm the current results. identifier, CRD42022303938.

LC-MS-based metabolomics reveals the mechanism of anti-gouty arthritis effect of Wuwei Shexiang pill.

Wuwei Shexiang Pill (WSP) is a Tibetan traditional medicine, which has been demonstrated to exhibit potent anti-inflammatory and anti-gout effects. However, the specific pharmacological mechanism is not elucidated clearly. In the present study, liquid chromatography-mass spectrometry (LC-MS)-based metabolomics was applied to investigate the alteration of serum metabolites induced by WSP treatment in MSU-induced gouty rats. Subsequently, bioinformatics was utilized to analyze the potential metabolic pathway of the anti-gout effect of WSP. The pharmacodynamic data discovered that WSP could ameliorate ankle swelling and inflammatory cell infiltration, as well as downregulate the protein expression of IL-1β, p-NF-κB p65, and NLRP3 in the synovial membrane and surrounding tissues of gouty ankles. LC-MS-based metabolomics revealed that there were 30 differential metabolites in the serum between sham-operated rats and gouty ones, which were mainly involved in the metabolism of fructose and mannose, primary bile acid biosynthesis, and cholesterol metabolism. However, compared to the model group, WSP treatment upregulated 11 metabolic biomarkers and downregulated 31 biomarkers in the serum. KEGG enrichment analysis found that 27 metabolic pathways contributed to the therapeutic action of WSP, including linoleic acid metabolism, phenylalanine metabolism, and pantothenate and CoA biosynthesis. The comprehensive analysis-combined network pharmacology and metabolomics further revealed that the regulatory network of WSP against gout might be attributed to 11 metabolites, 7 metabolic pathways, 39 targets, and 49 active ingredients of WSP. In conclusion, WSP could ameliorate the inflammation of the ankle in MSU-induced gouty rats, and its anti-gout mechanism might be relevant to the modulation of multiple metabolic pathways, such as linoleic acid metabolism, phenylalanine metabolism, and pantothenate and CoA biosynthesis. This study provided data support for the secondary development of Chinese traditional patent medicine.

Effect of Wuling capsule on patients with generalized anxiety disorder

Purpose: To investigate the effectiveness of Wuling capsule for the treatment of patients diagnosed with generalized anxiety disorder (GAD).
 Methods: Patients with generalized anxiety disorder (GAD) admitted in Affiliated Hospital of Huanghe Science and Technology College, Zhengzhou, China were treated with the Chinese traditional patent medicine, Wuling capsule. A self-control study was conducted before and after treatment. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Global Rating Scale (CGI-SI) were used to evaluate the symptoms of anxiety and depression suffered by GAD patients before and after treatment. Inflammatory factors (IL-6, IL-8, and IFN-γ), superoxide dismutase (SOD), γ-aminobutyric acid (GABA), and glutamic acid (Glu) levels were assessed in the peripheral blood of patients using ELISA before and after treatment.
 Results: A total of 58 patients with GAD completed 8 weeks of fixed-dose Wuling capsule treatment. After treatment, total scores on the HAMA scale, HAMD scale, and CGI scale significantly improved compared with baseline, and the differences before and after treatment were statistically significant (p < 0.01). The levels of inflammatory factors (IL-6, IL-8, and IFN-γ) in the peripheral blood of patients decreased significantly (p < 0.05). SOD and GABA/Glu increased after treatment (p < 0.05). Nine patients (15.5 %) had mild reactions, but no patients withdrew from the study as result of adverse reactions. 
 Conclusion: The Chinese traditional patent medicine, Wuling capsule, is effective in the treatment of GAD patients with high safety. Future studies will need to explore the specific biological pathways and physiological processes that are involved in the treatment of GAD using Wuling capsule.

Isolation of oleanolic acid from Clematis armandii for differentiation it from adulterants by HPTLC/HPLC

Clematis armandii has been used in many Chinese traditional patent medicines all over the world as a form of Caulis Clematidis Armandii. However, it has often been adulterated by Aristolochia manshuriensis, and Iodes vitiginea. A. manshuriensis must not be part of any herbal medicines because it contains aristolochic acid I, a nephrotoxin and potential carcinogen. The current pharmacopoeial methods have had limitation for differentiation of C. armandii from its adulterants. Thus, a specific, comprehensive, sensitive, and reproducible HPTLC/HPLC for quality control of C. armandii was proposed. Oleanolic acid from C. armandii has been isolated by vacuum liquid chromatography and column chromatography. The purified compound has been identified using Ultra Violet spectrophotometry (UV–Vis), Fourier Transform Infrared (FTIR), mass spectrometry (MS) and nuclear magnetic resonance (NMR) spectroscopy. Therefore, oleanolic acid should be detected for positive identification of Caulis Clematis Armandii. Minimum content of oleanolic acid can be evaluated by the validated HPTLC procedure proposed as well.

Analysis on the medication rule of traditional Chinese medicine in the treatment of COVID-19 patients.

Objective:To describe patterns of utilization of traditional Chinese medicine (TCM) in the treatment of patients with coronavirus disease 2019 (COVID-19).Methods:Adult patients with COVID-19 who received TCM treatment were divided into a non-serious group (mild and moderate types) and a serious group (severe and critical types) according to their admission conditions. The medical records and prescriptions of these patients were investigated to determine their TCM utilization patterns.Results:In all, 3,872 COVID-19 patients were included. Oral Chinese traditional patent medicine (CPM) was the most commonly used type of TCM, followed by decoction. The proportion of multi-drug combinations was higher than single drug use (55.0% vs. 45.0%). Decoction combined with oral CPM was the most common combination (39.1%, 1,514/3,872). Orally administered, injected, and externally applied CPM were significantly more common in the serious group than in the non-serious, while decoction and non-drug TCM treatments were more common in the non-serious than in the serious group. Multi-drug combinations were used for the majority of patients in both groups, mainly in the form of decoctions combined with oral CPM. Among the serious patients, injected CPM was more often used in patients who died during treatment (35.0%, 36/103). The two most common medication patterns were decoction combined with oral CPM and oral CPM alone in the two finally discharged groups. Oral CPM alone or used in combination with injected CPM were seen most commonly in the death group. Significant differences were established in TCM utilization and medication patterns among patients in three groups who had different prognoses and outcomes.Conclusions:The treatment measures and medication patterns of TCM commonly used in COVID-19 patients with the range of conditions found in this study should be further explored in the future to provide a more complete reference for COVID-19 treatment.

An Integrated Approach Based on Network Analysis Combined With Experimental Verification Reveals PI3K/Akt/Nrf2 Signaling Is an Important Way for the Anti-Myocardial Ischemia Activity of Yi-Qi-Tong-Luo Capsule.

Background: Yiqi-Tongluo Capsule (YTC) is a Chinese traditional patent medicine that has been used in the treatment of myocardial ischemia (MI). However, its molecular mechanisms against MI have not been clear. Methods: Network analysis and experimental verification were used to explore the potential molecular mechanisms of YTC for MI treatment. Firstly, the main components in the capsules and the potential targets of these components were predicted by online databases. The MI related genes were collected from Genecards and Online Mendelian Inheritance in Man (OMIM) databases. The drug targets and disease targets were intersected, and then the protein-protein interaction (PPI) and Drug-Molecular-Target-Disease Network (DMTD) were constructed, and GO enrichment analysis and KEGG pathway enrichment analysis were performed. Based on the H2O2-stimulated H9c2 cells, flow cytometry, western blot (WB) and immunofluorescence experiments were performed to verify the network analysis prediction. Results: A total of 100 active components and 165 targets of YTC were predicted, in which there were 109 targets intersected with the targets of MI. GO and KEGG analysis showed that these potential targets were related to a variety of biological processes and molecular mechanisms, including oxidative stress and PI3K/AKT pathway. Astragaloside IV (AS IV) and paeoniflorin (PAE) might be the main active components in YTC. The results of cell counting kit-8 (CCK-8) showed that YTC alleviated the damage of H2O2 to H9c2 cells. The results of flow cytometry, DAPI staining and JC-1 probe showed that YTC alleviated H2O2 induced apoptosis in H9c2 cells. In addition, YTC reduced the level of intracellular superoxide anion, increased the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GSH-Px), and reduced the content of malondialdehyde (MDA) in H2O2-induced H9c2 cells. The results of immunofluorescence and WB showed that the phosphorylation of PI3K and Akt were increased, the expression of Bcl-2 was up-regulated and the expression of cleaved caspase-3 and Bax were down-regulated. Besides, the nuclear translocation of Nrf2 were increased. Conclusion: In conclusion, the results of this study showed that YTC might alleviate MI by suppressing apoptosis induced by oxidative stress via the PI3K/Akt/Nrf2 signal pathway.

Rapid detection of illegally added nifedipine in Chinese traditional patent medicine by surface-enhanced Raman spectroscopy.

Nifedipine is an antihypertensive chemical. The illegal addition of this chemical into Chinese traditional patent medicine (CTPM) is unstandardized and lacks regulation. It could bring serious side effects to patients, causing various symptoms. Therefore, accurate detection of nifedipine is very important for human health and the prevention of illegal additives. Surface-enhanced Raman spectroscopy (SERS) is a fast and sensitive fingerprint spectroscopic technique, which has been shown to be promising in drug detection. In this study, nifedipine in CTPM was determined qualitatively and quantitatively with SERS. Linear relationships between the concentrations of nifedipine and the intensities of the characteristic peaks were established. The results showed a linear relationship within the concentration range of 0.5-10mg/L, and the lowest detectable concentration of nifedipine in CTPM was 0.1mg/L (equivalent to 0.03% doping of nifedipine in CTPM). This method has shown a great potential in the detection of drugs illegally added to CTPM.

Identifying barriers to care to inform Lassa Fever health policies in rural Nigeria

Abstract Lassa fever (LF) is an emerging viral haemorrhagic disease endemic to West Africa that can potentially cause a global pandemic. Nigeria has experienced yearly LF outbreaks since 2012 and the 2018 outbreak recorded an unprecedented number of cases and deaths. A critical gap in controlling neglected tropical diseases such as LF is our limited understanding of how people access care and how structural and cultural factors constitute barriers to care. This study examines concepts of illness and healthcare-seeking behaviours to investigate these barriers. From October to December 2019, we conducted a mixed-methods community-based study consisting of 51 interviews, 21 focus groups, and direct observations, in 5 villages of a 2018 LF hotspot in Ebonyi state, Nigeria. Participants' perceived severity and frequency of diseases aligned with the current biomedical understanding. In contrast, some diseases were associated with witchcraft or bad behaviours. Most participants knew LF disease but denied its yearly recurrence. In addition, LF victims and caregivers suffered from a strong stigmatisation. We identified a mismatch between preferred and actual healthcare-seeking behaviours. Most participants preferred hospital care but defaulted to traditional healers and patent medicine vendors (chemists). Reasons reported were high care fees, life-sustaining jobs conflicting with commuting time to hospitals, and a low English literacy. Age and education correlated with healthcare-seeking behaviours: elder and less formally educated people preferred traditional healers. LF-related stigma reportedly impacted timeliness and adequacy of care during the 2018 outbreak. Participants had a good knowledge of the diseases and true barriers to care came from structural factors and LF-related stigma. This led to mismatches between disease knowledge and healthcare-seeking behaviours. Awareness campaigns may have a limited impact if they focus on disease knowledge without addressing barriers to care. Key messages To enhance LF detection and control, LF policies in rural Nigeria should focus on barriers to care through public health messaging addressing stigma and through bringing care closer to remote areas. This community-based study illustrates the importance of understanding the socio-cultural ecology of the diseases to inform evidence-based and locally adapted strategies for disease control.

Clinical Progress on Management of Pneumonia Due to COVID-19 With Chinese Traditional Patent Medicines.

Background: The outbreak of new coronavirus has tremendously threatened the public health system worldwide, including China. Chinese patent medicines (CPMs) have greatly contributed to the prevention and treatment of this viral infection, as well as the recovery of patients with COVID-19 infection. Therefore, numerous experts and guidelines recommend to take CPMs to treat pneumonia due to COVID-19.Aim of the Study: The present study reviewed CPMs recommended by the < Guidelines for diagnosis and management of COVID-19 (8th edition)> regarding evidence of their efficacy from clinical studies and the underlying mechanisms, which will lay the foundation for clinical use of these CPMs for COVID-19.Methods: The composition, efficacy, indications, history of use, and relevant clinical research on 14 recommended CPMs, including Huoxiangzhengqi capsules (pills, liquid, oral solution), Jinhuaqinggan granules, Lianhuaqingwen capsules (granules), Shufengjiedu capsules, Xiyanping injections, Xuebijing injections, Reduning injections, Tanreqing injections, Xingnaojing injections, Shenfu injections, Shengmai injections, Angongniuhuang pills, Suhexiang pills, were searched in both Chinese and English databases based on differences in stages of the disease and manifestations of such patients. Advantages of these CPMs over conventional treatments and their underlying mechanisms were explored by analyzing results from published articles and undergoing clinical trials.Results: Findings from clinical studies and Chinese experience in using these CPMs showed that CPMs, when used in combination with conventional treatments, were effective in managing COVID-19 with few side effects.Conclusion: CPMs have excellent efficacy in managing COVID-19 with a great potential for clinical use.

Protective effects of Longhu Rendan on chronic liver injury and fibrosis in mice

Background and aimLiver fibrosis resulting from persistent liver injury represents a major healthcare problem globally. Traditional Chinese medicine has played an essential role in the treatment of liver fibrosis in recent years. Thus, this study aims to assess the effect of Longhu Rendan (LHRD), a Chinese traditional patent medicine, on liver fibrosis and its potential mechanism. MethodsThe liver fibrosis in mice was induced via the intraperitoneal injection of carbon tetrachloride (CCl4) for 6 weeks or bile duct ligation for 15 days. Various methods were used to judge the therapeutic effect of LHRD. ResultsLHRD significantly suppressed the activity of serum index of abnormal liver function, liver cell apoptosis, and necrosis, attenuating liver injury. Moreover, LHRD treatment alleviated liver fibrotic features, such as the reduction of collagen deposition and hepatic stellate cell activation as well as profibrotic gene expression. Mechanistically, LHRD treatment inhibited nuclear transcription factor-kappa B signaling and inflammatory gene expression and diminished the production of reactive oxygen species and 4-hydroxynonenal, along with the downregulation of NADPH oxidase 4. ConclusionsOverall, the present study demonstrates that LHRD ameliorates liver injury and fibrosis via the inhibition of inflammation and oxidative stress in mice, indicating that LHRD is a potential medicine for the treatment of liver fibrosis.

Systemic pharmacological investigation of the Feng Shi Gu Tong capsule in the treatment of rheumatoid arthritis.

Feng Shi Gu Tong (FSGT) capsule is a commonly used Chinese Traditional Patent Medicine in clinical practice, which has been proven to be effective for the treatment of active rheumatoid arthritis (RA). However, due to its complex composition, the precise molecular mechanism of the FSGT capsule in the treatment of RA is still indistinct. Therefore, the method of systemic pharmacology was used to obtain candidate compounds through absorption, distribution, metabolism, elimination (ADME) parameters, and supplementation of references. Network construction and analysis were also included to reveal the potential mechanism of FSGT capsule in treating RA. A total of 119 compounds were obtained in FSGT capsule, and a total of 107 compounds with targets were included in the study. These compounds acted on 267 targets in total. In addition, there were 317 targets related to RA disease. All constructed networks included four major networks and four minor networks. In addition, the clusters of RA disease protein-protein interaction (PPI) network and FSGT capsule-RA disease targets network revealed that the biological process involved in these clusters including immune response and apoptosis, etc. The pathways enriched by the direct targets of FSGT capsule acted on RA also highly overlapped with the pathways enriched by the RA PPI network, such as the TNF signaling pathway. Our research has managed to predict and explain the pharmacological effects and the molecular mechanisms of the FSGT capsule in RA, and provided a realistic exploration method for studying the potentially active ingredients of traditional Chinese medicines simultaneously.

Characteristics of prescriptions and costs for acute upper respiratory tract infections in Chinese outpatient pediatric patients: a nationwide cross-sectional study

BackgroundTo understand the characteristics of prescriptions and costs in pediatric patients with acute upper respiratory infections (AURI) is important for the regulation of outpatient care and reimbursement policy. This study aims to provide evidence on these issues that was in short supply.MethodsWe conducted a retrospective cross-sectional study based on data from National Engineering Laboratory of Application Technology in Medical Big Data. All outpatient pediatric patients aged 0–14 years with an uncomplicated AURI from 1 January 2015 to 31 December 2017 in 138 hospitals across the country were included. We reported characteristics of patients, the average number of medications prescribed per encounter, the categories of medication used and their percentages, the cost per visit and prescription costs of drugs. For these measurements, discrepancies among diverse groups of age, regions, insurance types, and AURI categories were compared. Kruskal-Wallis nonparametric test and Student-Newman-Keuls test were performed to identify differences among subgroups. A multinomial logistic regression was conducted to examine the independent effects of those factors on the prescribing behavior.ResultsA total of 1,002,687 clinical records with 2,682,118 prescriptions were collected and analyzed. The average number of drugs prescribed per encounter was 2.8. The most frequently prescribed medication was Chinese traditional patent medicines (CTPM) (36.5% of overall prescriptions) followed by antibiotics (18.1%). It showed a preference of CPTM over conventional medicines. The median cost per visit was 17.91 USD. The median drug cost per visit was 13.84 USD. The expenditures of antibiotics and CTPM per visit (6.05 USD and 5.87 USD) were among the three highest categories of drugs. The percentage of out-of-pocket patients reached 65.9%. Disparities were showed among subgroups of different ages, regions, and insurance types.ConclusionsThe high volume of CPTM usage is the typical feature in outpatient care of AURI pediatric patients in China. The rational and cost-effective use of CPTM and antibiotics still faces challenges. The reimbursement for child AURI cases needs to be enhanced.

Reaching the unreached: effectiveness and satisfaction with community-directed distribution of sulfadoxine-pyrimethamine for preventing malaria in pregnancy in rural South-East, Nigeria

BackgroundInnovative community strategies to increase intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) coverage is advocated particularly in rural areas, where health infrastructure is weakest and malaria transmission highest. This study involved proof-of-concept implementation research to determine satisfaction with and effectiveness of community-directed distribution of IPTp-SP on uptake among pregnant women in Ebonyi State, Nigeria.MethodsThis before-and-after study was carried out in 2019 in a rural community in Ebonyi State Nigeria. The intervention involved advocacy visits, community-wide sensitizations on malaria prevention, house-to-house directly observed IPTp-SP administration, and follow-up visits by trained community-selected community-directed distributors (CDDs). Monthly IPTp-SP coverage was assessed over 5 months and data analysed using SPSS version 20.ResultsDuring the study, 229 women received the first dose of IPTp while 60 pregnant women received 5 or more doses of IPTp. The uptake of ≥ 3 IPTp doses increased from 31.4% before the community-directed distribution of IPTp to 71.6% (P < 0.001) by the fourth month post-initiation of the community-directed distribution of IPTp. Sleeping under insecticide-treated net (ITN) the night before the survey increased from 62.4 to 84.3% (P < 0.001) while reporting of fever during pregnancy decreased from 64.9 to 17.0% (P < 0.001). Although antenatal clinic utilization increased in the primary health centre serving the community, traditional birth attendants and patent medicine vendors in the community remained more patronized. Post-intervention, most mothers rated CDD services well (93.6%), were satisfied (97.6%), and preferred community IPTp administration to facility administration (92.3%).ConclusionCommunity-directed distribution of IPTp-SP improved uptake of IPTp-SP and ITN use. Mothers were satisfied with the services. The authors recommend sustained large-scale implementation of community-directed distribution of IPTp with active community engagement.

Use of Chinese medicine in the prevention and treatment of COVID-19 in China and Asia

PurposeThe purpose of this paper is to describe and discuss the use of Chinese medicine in the prevention and treatment of coronavirus disease 2019 (COVID-19) in China and Asia.Design/methodology/approachThis paper provides a brief overview of the COVID-19. Based on the syndrome differentiation (辨證論治), the concept of clearing heat and detoxifying lung in traditional Chinese medicine is used to prevent and treat COVID-19 through restoring the vital qi (正氣) in human body and regulating the lung as well as spleen to strengthen the immune system. Traditional Chinese medicine has been used as a complementary therapy for the possible intervention of COVID-19 including traditional Chinese herbal decoctions, Chinese traditional patent medicines, acupuncture and moxibustion as well as the traditional health exercises in China and parts of Asia.FindingsTraditional Chinese medicine plays a significant role in the prevention and treatment of COVID-19 pandemic. The infection cases of China are around 80,000 and a steady decline compared with the USA which has 5,000,000 infection cases and continuous increases. It is shown that more than 90% of patients recovered after the treatment of traditional Chinese herbal decoctions and Chinese traditional patent medicines without any side-effect compared to the use of Remdesivir (GS-5734). Acupuncture (針灸) and moxibustion (艾灸) stimulate the immune and nervous systems for preventing infectious diseases. Taichi (太極) and Baduanjin (八段錦) as the auxiliary aerobic exercise under the theory of Chinese medicine can enhance the immune system and improve the lung function. Thus, an integration of traditional Chinese Medicine and Western medicine is the best strategy for the prevention, treatment and control of COVID-19 pandemic in the future.Originality/valueThis paper describes traditional Chinese medicine as an effective way for the prevention and treatment of COVID-19.

Anti-SARS-CoV-2 activities in vitro of Shuanghuanglian preparations and bioactive ingredients.

Human infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and there is no cure currently. The 3CL protease (3CLpro) is a highly conserved protease which is indispensable for CoVs replication, and is a promising target for development of broad-spectrum antiviral drugs. In this study we investigated the anti-SARS-CoV-2 potential of Shuanghuanglian preparation, a Chinese traditional patent medicine with a long history for treating respiratory tract infection in China. We showed that either the oral liquid of Shuanghuanglian, the lyophilized powder of Shuanghuanglian for injection or their bioactive components dose-dependently inhibited SARS-CoV-2 3CLpro as well as the replication of SARS-CoV-2 in Vero E6 cells. Baicalin and baicalein, two ingredients of Shuanghuanglian, were characterized as the first noncovalent, nonpeptidomimetic inhibitors of SARS-CoV-2 3CLpro and exhibited potent antiviral activities in a cell-based system. Remarkably, the binding mode of baicalein with SARS-CoV-2 3CLpro determined by X-ray protein crystallography was distinctly different from those of known 3CLpro inhibitors. Baicalein was productively ensconced in the core of the substrate-binding pocket by interacting with two catalytic residues, the crucial S1/S2 subsites and the oxyanion loop, acting as a “shield” in front of the catalytic dyad to effectively prevent substrate access to the catalytic dyad within the active site. Overall, this study provides an example for exploring the in vitro potency of Chinese traditional patent medicines and effectively identifying bioactive ingredients toward a specific target, and gains evidence supporting the in vivo studies of Shuanghuanglian oral liquid as well as two natural products for COVID-19 treatment.

The Potential Mechanism of Wuwei Qingzhuo San against Hyperlipidemia Based on TCM Network Pharmacology and Validation Experiments in Hyperlipidemia Hamster.

Wuwei Qingzuo San (WWQZS), as a renowned traditional Mongolian patent medicine approved by Chinese State Food and Drug Administration, is used to treat hyperlipidemia, indigestion, and other ailments related to disorder of production of essence and phlegm, a typical abnormal metabolism of blood in traditional Mongolian medicine. A combination of network pharmacology and validation experiments in hyperlipidemia hamster is used to understand the potential mechanism of WWQZS for hypolipidemic effects, further for an integrated concept of traditional theory, bioactive constituents, and molecular mechanism for TMM. Through network pharmacology, we obtained 212 components, 219 predicted targets, and 349 known hyperlipidemia-related targets form public database and used Metascape to carry out enrichment analysis of 43 potential and 45 candidate targets to imply numerous BP concerned with metabolism of lipid, regulation of kinases and MF related to lipid binding, phosphatase binding, and receptor ligand activity that are involved in anti-hyperlipidemia. In addition, KEGG pathways that explicated hypolipidemic effect were involved in pathways including metabolism associated with kinase function according to MAPK signaling pathway, AMPK signaling pathway, and PI3K-Akt signaling pathway. Meanwhile, in HFD-induced hamster model, WWQZS could significantly reduce TC and ALT and help decrease TG, LDL-C as well; liver pathological section implied that WWQZS could relieve liver damage and lipid accumulation. Western blot indicated that WWQZS may upregulate CYP7A1 and activate AMPK to suppress the expression of HMGCR in livers. In conclusion, our results suggest that WWQSZS plays important dual hypolipidemic and liver-protective role in livers in HFD-induced hamster model. Through this research, a new reference is also provided to other researches in the study of ethnopharmacology.

Data mining on varieties, therapeutic uses and medicinal characteristics of Traditional Chinese Medicine preparations for treating hair loss

Purpose: To review the varieties, therapeutic uses, and medicinal characteristics of traditional Chinese medicine (TCM) preparations for treating hair loss, and to provide a reference for research and development of new drugs.Methods: For this review, literature from the last 50 years pertaining to the treatment of hair loss via TCM were collected mainly from China National Knowledge Infrastructure database and Wanfang Data Resource System database. Information on Chinese traditional patent medicines and ethnomedicines for treating hair loss was drawn from books.Results: A total of 322 preparations were identified, including 135 preparations made by medical institutions, 108 Chinese traditional patent medicines, 60 preparations produced by doctors themselves, and 19 ethnomedicines. The forms of dosage included decoctions, pills, capsules, tablets, granules, tinctures, liniments, and powders. These preparations are traditionally used in the treatment of skin and subcutaneous tissue diseases. A total of 400 medicinal materials were used in preparations, including 339 from plants, 40 from animals, 14 from minerals. The most commonly used Chinese medicinal materials in order of frequency were Rehmannia glutinosa (Gaertn.) DC., Fallopia multiflora (Thunb.) Haraldson, Angelica sinensis (Oliv.) Diels, Ligustrum lucidum W.T. Aiton and Ligusticum chuanxiong Hort.Conclusion: TCM preparations for treating hair loss are abundant in variety. They are mainly decoctions, and primarily botanical medicinal materials. Most of the preparations are composed of Chinese medicinal materials for ‘toning the kidneys’ and ‘nourishing the liver’. They are used mainly in the treatment of seborrheic alopecia and alopecia areata

Analysis on regularity of traditional Chinese patent medicine in treating hyperlipidemia

To explore the regularity of traditional Chinese patent medicines for the treatment of hyperlipidemia recorded in Newly Edited National Chinese Traditional Patent Medicines,the Composition Principles of Chinese Patent Drugs,New Drug Conversion Standard,the Compilation of National Standard for Traditional Chinese Medicines and Chinese Pharmacopoeia. Researchers extracted the information of prescriptions from these cases according to the inclusion and exclusion criteria. Then microsoft excel 2010 was used to conduct frequency statistics and count the frequency of traditional Chinese medicine. SPSS Clementine( ver.12. 0) and SPSS( ver. 18. 0)were adopted respectively for frequency analysis,association rules analysis,cluster analysis and factor analysis. Besides,KMO test and Bartlett spherical test were performed for factor adaptation test. Finally,a total of 173 traditional Chinese medicines were included,involving 94 Chinese patent medicine prescriptions. The frequency results of traditional Chinese medicine showed that there were 33 kinds of high-frequency traditional Chinese medicine,mainly including those for tonifying medicine,activating blood and resolving stasis and blood-stasis,and clearing damp. The association rules analysis found out 12 association rules of drug pairs,3-herb pairs of 25 and4-herb pairs of 6. Totally 11 medicine groups with relevance were respectively extracted by cluster analysis. KMO test and Bartlett spherical test indicated that the method was suitable for factor analysis and 11 common factors were respectively extracted by factor analysis. The association rules reflected the therapeutic method for tonify the liver and kidney,activating blood and resolving stasis. Cluster analysis and factor analysis showed the therapeutic method of Qi-enriching and Yin-nourishing,and the factor analysis focused more on removing blood stasis and dampness. The decision tree with hawthorn as the dependent variable reflects the importance of alisma orientalis and fructus schisandrae in the drug matching. In conclusion,data mining technique can comprehensively analyze the regularity of prescriptions of traditional Chinese patent medicine for hyperlipidemia,and is helpful for guiding the development of Chinese patent medicines and the clinical practice of traditional Chinese medicine.

A Chinese Traditional Therapy for Bleomycin-Induced Pulmonary Fibrosis in Mice.

Pulmonary fibrosis is a chronic and fatal disease of lung tissue with high incidence and mortality in the world. The exploration of effective treatment for pulmonary fibrosis remains an urgent challenge. In our study, Qingfei Xieding was investigated as a novel Chinese traditional patent medicine against pulmonary fibrosis. A pulmonary fibrosis mouse model was constructed by injecting with bleomycin sulfate. Following Qingfei Xieding administration, lung samples were collected to assess pulmonary phenotype changes by analyzing lung coefficient, wet/dry, and histopathologic section. Levels of nitric oxide (NO), hydroxyproline (HYP), malondialdehyde (MDA), and total antioxidant capacity were measured to evaluate the degree of oxidation. A single-cell gel electrophoresis (SCGE) assay was used to evaluate bleomycin-induced DNA damage. Western blotting and real-time quantitative PCR were performed to determine the abundance of inducible nitric oxide synthase (iNOS), connective tissue growth factor (CTGF), alpha smooth muscle actin (α-SMA), and fibronectin (FN). In the present study, Qingfei Xieding administration significantly attenuated bleomycin-induced pulmonary fibrosis in mice by reducing lung coefficient, wet/dry, NO, HYP, and MDA as well as the expression of iNOS, CTGF, α-SMA, FN, and DNA damage. The results indicated that Qingfei Xieding is effective to resist oxidative damage and histopathologic lesion, serving a protection role on bleomycin-induced pulmonary fibrosis.