Acupuncture originated in China and is an important component of traditional Chinese medicine. The elucidation of its anesthetic mechanisms, the medical needs of Western societies, as well as the proven therapeutic effects of this technique have made it the most widely used medical practice in the world. The concept of evidence-based medicine has been introduced in acupuncture research for technical improvement and the production of high-quality clinical evidence. Upon reviewing the acupuncture clinical research over the past 10 years, we found the gradually increasing range of diseases that it benefits, from pain management to neoplasms and genitourinary, digestive, and mental disorders. Acupuncture is included in a number of international guidelines for clinical practice. However, high-quality clinical evidence to support the efficacy and effectiveness of acupuncture is lacking as a result of multiple exceptional clinical trials conducted by Western researchers that have yielded antagonistic results. Future clinical research should focus on exploring objective evaluation methods for studying the therapeutic effects of acupuncture.
Acupoints and trigger points in traditional Chinese medicine represent two different minimally invasive therapy systems-based, respectively, on traditional acupuncture and dry needles. Many studies argue that trigger points and traditional acupoints are conceptually similar because they generally have identical locations on the human body. However, whether trigger points contribute to the formation of the traditional acupuncture technique is controversial. Although many relevant studies have been conducted, this controversy continues to hinder the development of both disciplines. Recently, researchers of Chinese acupuncture have proposed the “acupoint sensitization” theory, which postulates that traditional acupoints may be sensitized by diseases, environments, and therapies. This turns them into a “sensitized state.” Recent studies suggest that trigger points and sensitized acupoints share similar biological properties. To clarify the above-mentioned confusion, we reviewed relevant studies on these two concepts and attempted to analyze their relationship. In this paper, we provide a general summary of acupoint sensitization theory and sensitized acupoints. We then compare trigger points with sensitized acupoints by categorizing their similarities and differences, including location and range, pathological morphology, pain perception, surface temperature effects, and bioelectrical properties. We believe that, because trigger points and sensitized acupoints have many shared properties, they might constitute “the same book with different covers.”
Carbon quantum dots (CQDs) are fluorescent carbon nanomaterials that have been applied to biology, medicine, and optoelectronics, owing to their significant advantages such as simple synthesis methods, low cost, and widely available sources of raw synthesis materials. This review summarizes CQD preparation methods, which include hydrothermal and microwave-assisted synthesis methods, as well as separation methods such as centrifugation, dialysis, and filtration. Additionally, we review the application of CQDs in the detection of active ingredients, primarily phenolic compounds, in traditional Chinese medicine. We also discuss the quenching mechanism of CQD fluorescence using the active ingredients of traditional Chinese medicine. Limitations such as insufficient test selectivity, weak fluorescence intensity, and an unclear quantitative relationship between preparation methods and properties should be resolved for the efficient use of CQDs to detect active ingredients in Chinese medicine.
As the novel coronavirus disease 2019 (COVID-19) and its variants continue to rage into the second year of a global pandemic, many success stories of applying Chinese herbal medicine (CHM) to treat COVID-19 patients continue to emerge from China and other part of the world. Herewith, from a systems medicine perspective, the authors analyze those experiences and categorize them into four major treatment principles: (1) focusing on eliminating toxins in the early stage of the disease, (2) tonifying deficiency of the body throughout the entire disease course, (3) treating the affected lung and intestine simultaneously based on visceral interactions, (4) cooling blood and removing blood stasis at the later stage, as well as interpret the rationale of these principles. This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy, but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.
Objective: This work aimed to present a descriptive analysis of the outcome measures used in clinical trials of traditional Chinese medicine (TCM) for patients with stable angina pectoris, and to provide baseline data for the development of core outcome sets (COSs) for relevant clinical trials. Methods: Medical databases were searched to identify randomized trials of the effects of TCM for the treatment of stable angina pectoris. Outcome measures of each trial were extracted. Descriptive statistics were used to analyze the baseline characteristics of outcomes in clinical trials of TCM. Results: 94 randomized trials (with 9,111 participants) involving 79 different outcomes were identified. The mean number of outcomes was 5 (1-21 per trial). The 5 most commonly reported outcomes were efficacy rate of electrocardiogram, efficacy rate of angina pectoris, efficacy rate of TCM syndrome, fasting lipid indices, and withdrawal rate of nitroglycerin. Several challenges were identified: (1) significant heterogeneity of outcomes and differences in the technique and timing of the measurement of the same outcome; (2) transformation of continuous data into categorical data and presented as such in >90% of trials; (3) few trials on the outcomes associated with the advantages and characteristics of TCM; and (4) selective reporting of outcomes. Conclusions: The outcomes used are excessively heterogenous, and the choice of some outcomes (timing and techniques) for measurement is confusing or inappropriate. Hence, developing and implementing a COS is necessary for greater consistency.
Objective: This study aimed to lay the foundation for the research on Panax notoginseng saponins (PNS) in pH-sensitive in situ gel and the development and improvement of related preparations.Methods: We used Carbopol®940, a commonly used pH-sensitive polymer, and the thickener hydroxypropyl methylcellulose (HPMC E4M) as an ophthalmic gel matrix to prepare an ophthalmic in situ gel of PNS. In addition, formula optimization was performed by assessing gelling capability with the results of in vitro release studies. In vitro (corneal permeation, rheological, and stability) and in vivo (ocular irritation and preliminary pharmacokinetics in the vitreous) studies were also performed. Results: The results demonstrated that the in situ gelling systems containing PNS showed a sustained release of the drug, making it an ideal ocular delivery system for improving posterior ocular bioavailability. Conclusions: This study lays the foundation for the research of PNS contained in an in situ pH-triggered gel as well as the development and improvement of related preparations. It concurrently traditional Chinese medicine with a contemporary in situ gelling approach to provide new directions for the treatment of posterior ocular diseases such as diabetic retinopathy.
Objective: Lotus leaf is a traditional Chinese herb that has been used successfully for centuries for relieving edema by inducing diuresis. Based on its good clinical evidence and anti-hypertensive effectiveness, this study aimed to investigate the potential mechanism of the hyperuricemic inhibitory effects of lotus leaf crude extract (LL) and lotus leaf total alkaloids fraction (LA). Methods: The xanthine oxidase (XOD) inhibitory effect of LL and LA was analyzed in vitro by determining mRNA expression and protein expression levels of hepatic XOD. The hyperuricemic inhibitory effect of the lotus leaf was analyzed in vivo in a potassium oxonate (PO)-induced rat model by determining mRNA expression for renal urate transporters. Results: At a concentration of 40 μg/mL, LL and LA suppressed XOD enzymatic activity by 37.35% ± 9.50% and 47.73% ± 8.32%, respectively. Both LL and LA administration significantly reduced the concentration of uric acid in the serum and liver of PO-induced hyperuricemic rats. Both LL and LA administration could inhibit XOD mRNA and protein expression, activate renal organic anion transporter 1/3 mRNA expression, and inhibit renal urate reabsorption by decreasing renal GLUT9 and renal urate transporter 1.Conclusions: Insight was gained into the mechanism behind the hyperuricemic inhibitory effects of LL and LA. Our results suggest that they act on two targets: decreasing the production of uric acid by inhibiting mRNA and protein expression of XOD in the liver, and regulating the mRNA expression of renal urate transporters in the kidneys.