The meridian theory is an important component of traditional Chinese medicine, playing a crucial role in disease diagnosis, treatment, and health preservation. Serving as the media for the effects of acupuncture, moxibustion, herbal medicine, and acupressure massage, meridians exert undeniable impact on the human body. However, the essence of meridians remains a topic of debate. Recent research has primarily focused on their anatomical structures, leading to numerous hypotheses. Simultaneously, other researchers have approached this subject from an energetic perspective, discovering information interactions within the meridian system. These findings suggest that meridians possess both physical and information dimensions, indicating that a singular approach to their study is insufficient. To bridge this gap, a shift from purely structural research toward an exploration of the information aspects of meridians is necessary. By integrating this information approach with traditional meridian theory, it may be possible to develop a new, modernized meridian theory that is aligned with contemporary concepts, making it more accessible and applicable in clinical settings.
Co-inhibitory receptors serve as crucial regulators of T-cell function, playing a pivotal role in modulating the delicate balance between immune tolerance and autoimmunity. Initially identified in autoimmune disease models, co-inhibitory receptors, including CTLA-4, PD-1, TIM-3, and TIGIT, were found to be integral to immune regulation. Their blockade or absence in these models resulted in the induction or exacerbation of autoimmune diseases. Additionally, scholars have observed that co-inhibitory receptors on lymphocytes hold the potential to influence the prognosis in the context of chronic inflammation. Consequently, the blocking of co-suppressor receptors has emerged as a novel therapeutic approach for inhibiting refractory inflammatory diseases, particularly rheumatoid arthritis. From the standpoint of traditional Chinese medicine (TCM), the treatment of rheumatoid arthritis based on the “strengthening body resistance (Fú Zhèng)” theory can be construed as the regulation of co-suppressor receptors to modulate the body’s immune function in combating chronic inflammation. This article provides a succinct overview of the role of co-suppressor receptors in anti-inflammatory processes and explores the research prospects of co-suppressor receptor intervention in the treatment of rheumatoid arthritis. The exploration integrates the “strengthening body resistance (Fú Zhèng)” theory with relevant Chinese medicine formulations.
Acute myocardial infarction (MI) is associated with high morbidity and mortality and poses a significant challenge to human health. Despite advances in medicine, effective treatment options for MI are still associated with adverse outcomes, such as heart failure. Consequently, identifying the pathogenesis of MI is a promising avenue for developing practical treatments. The inflammatory response plays a critical role in the pathogenesis of MI. Gasdermin D (GSDMD)-mediated pyroptosis regulates the inflammatory response, which is a pathogenic and potential therapeutic target for MI. Therefore, anti-pyroptosis treatment is emerging as a promising therapeutic approach for MI. Overall, this article reviews the mechanism and treatment strategies for GSDMD-mediated pyroptosis in MI, with the hope of providing insights into pathogenic interventions.
Objective: The paper is to comprehensively summarize and analyze the basic situation and methodological quality of clinical randomized controlled trials (RCTs) of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions published in 2022, to provide evidence and reasonable suggestions for the advancement of clinical research and the formulation of policies and guidelines.
Methods: The Evidence Database System of clinical evidence-based evaluation of traditional Chinese medicine was searched, and data from China National Knowledge Infrastructure (CNKI), PubMed, and other databases were supplemented. The search duration was from January 1, 2022, to December 31, 2022. RCTs of traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were included as the source of clinical evidence, and published information, sample size, intervention, control measures, treatment course, methodological quality, and key link report were analyzed and evaluated.
Results: A total of 1,464 RCTs of traditional Chinese patent medicines were included, which comprised 667 types of traditional Chinese patent medicines; “traditional Chinese patent medicinesβ+βWestern medicine vs. Western medicine” was the most widely used intervention and control setting, involving 417 RCTs (28.48%). A total of 245 RCTs of traditional Chinese classic famous prescriptions were included, comprising 55 types of traditional Chinese classic famous prescriptions. “Decoctionβ+βconventional treatment vs. conventional treatment” was the most widely used intervention and control setting, with 87 RCTs (35.51%). Published RCTs on traditional Chinese patent medicines and traditional Chinese classic famous prescriptions were limited by the study design and implementation. Most “allocation concealment” and “blinding of patients and personnel” were rated as medium to high risk. There are insufficient reports on key research links such as experimental registration and ethical approval.
Conclusions: The number of RCTs on traditional Chinese patent medicines has decreased in 2022, but there has been a slight improvement in the research quality and impact. There are relatively few studies on traditional Chinese classic famous prescriptions. Measures must be taken to improve clinical trial design, implementation, and reporting. Methodological experts should be invited to provide professional technical guidance on the trial design. In the research implementation process, attention should be paid to quality control, particularly the standardization of the randomized execution.
Tai Chi, a traditional Chinese martial art and health exercise, has gained significant global attention and recognition. The clinical benefits of Tai Chi have been studied extensively in recent decades. We conducted a systematic search of PubMed, Web of Science, EMBASE databases, and the China National Knowledge Infrastructure, identifying and reviewing 241 clinical trials on the benefits of Tai Chi from their inception to June 1, 2023. Most of these studies have consistently demonstrated the positive impact of Tai Chi on balance, cognitive function, mood regulation, sleep quality, pain relief, cardiorespiratory function, and overall health. In the future, the key to fostering the ongoing development of this field lies in comprehensive research on standardized study designs and reporting, the scope of Tai Chi applications, and the core factors influencing its efficacy.
Objectives: Low back and pelvic girdle pain (LBPGP) is common during pregnancy. Acupuncture is an effective and safe therapy for pain relief. However, further evidence is required to confirm the efficacy and safety of acupuncture in treating LBPGP during pregnancy. This study aimed to systematically review and investigate the clinical efficacy and safety of acupuncture for the treatment of pregnancy-related LBPGP.
Methods: The PubMed, EMBASE, Cochrane Library, CNKI, VIP, and WanFang databases were searched from January 2000 to August 2023. Only the randomized controlled trials (RCTs) involving pregnant women between 16 and 34 weeks of gestation diagnosed with LBPGP were included in the study. A meta-analysis was conducted and pooled risk ratios (RRs) or mean differences (MDs) with 95% confidence intervals (CIs) were compared.
Results: Meta-analysis included 12 RCTs involving 1,641 participants. Eleven trials compared acupuncture alone or acupuncture combined with standard care (SC), of which three trials also used non-penetrating or placebo acupuncture as the control group. One trial compared acupuncture alone with non-penetrating acupuncture. Compared with SC, acupuncture combined with SC group significantly decreased visual analog scale score (mean difference (MD)β=β-2.83, 95% CIβ=β-3.41 to -2.26, P < 0.00001), cesarean section rate (RRβ=β0.69, 95% CIβ=β0.49-0.97, Pβ=β0.03), preterm birth rate (RRβ=β0.42, 95% CIβ=β0.27-0.65, Pβ<β0.0001), labor duration (MDβ=β-1.97, 95% CIβ=β-2.73 to -1.20, Pβ<β0.0001), and Oswestry disability index score (MDβ=β-9.14, 95% CIβ=β-15.68 to -2.42, Pβ=β0.008). In addition, acupuncture combined with SC significantly improved 12-Items Short Form Health Survey of physical component summaries (SF12-PCS). No significant differences were observed in the spontaneous delivery rate, newborn weight, drowsiness, and 12-Items Short Form Health Survey of mental component summaries (SF12-MCS) between the two groups. Adverse events such as needle pain and needle bleeding were aggravated in both the SC and acupuncture treatment groups but none were associated with acupuncture during or after the treatment period.
Conclusions: Meta-analysis showed that acupuncture combined with SC had better efficacy than SC alone and could be a potential therapy for LBPGP during pregnancy. The safety results imply that acupuncture caused few adverse reactions; however, more evidence is required for further confirmation.
Objective: A model of inflammatory damage was induced by radiation to investigate whether ferulic acid (FA) can reduce the inflammatory response through the Sirt1-NLRP3 inflammatory pathway. This will help discover radiation-protective drugs and elucidate the molecular mechanisms related to radiation-induced inflammatory damage.
Methods: A mouse model of radiation-induced immunoinflammatory injury was established to verify the anti-inflammatory effects of FA in vivo. C57BL/6J mice were randomly divided into six groups, and 5 Gy whole-body irradiation was used for modeling. Mice were administered a gastric solvent, amifostine, or 25, 50, or 100 mg/kg FA daily for 12 days, consecutively, before irradiation. The serum of mice was collected 24 hour after irradiation to observe the content of inflammatory factors interleukin (IL)-1β, IL-18, IL-6, and tumor necrosis factor (TNF)-α. The spleen and thymus tissues of mice were weighed and the organ index was calculated for pathological testing and immunofluorescence detection.
Results: FA reduced the radiation-induced decrease in the spleen and thymus indices. FA significantly reduced the secretion of inflammatory factors in the serum and reversed the radiation-induced reduction in lymphocytes in the spleen and thymus of mice. FA activated Sirt1 and inhibited the expression of the NLRP3 inflammasome to alleviate the inflammatory response.
Conclusions: FA reduced radiation-induced inflammation in animals, possibly by activating Sirt1 and reducing nucleotide oligomerization domain (NOD)-like receptor thermal protein domain associated protein 3 (NLRP3) inflammasome expression, thereby reducing the secretion of inflammatory factors.
Objective: This study aimed to evaluate the anti-inflammatory effects of petal and stamen extracts of saffron crocus (Crocus sativus) and explore the underlying mechanism.
Methods: Local and systemic inflammation models were used to investigate the anti-inflammatory effects of C. sativus. A xylene-induced inflammation model or lipopolysaccharide (LPS)-induced inflammation model was used in this study. C. sativus petal and stamen extracts were each administered to the mice in the xylene and LPS models by gavage for 14 d at 0.1 and 0.4 g/kg doses, respectively. Enzyme-linked immunosorbent assay (ELISA) was used to measure the concentrations of tumor necrosis factor (TNF)-α and interleukin (IL)-1β in mouse serum. Hematoxylin and eosin (H&E) staining was used to observe the pathological changes in the ear in the xylene-induced inflammation model and in the spleen in the LPS-induced inflammation model. NOD-like receptor thermal protein domain associated protein 3 (NLRP3) protein levels within the nuclear factor-kappa B (NF-κB) pathway were assessed using western blotting. RAW264.7 cells were treated with LPS (5 μg/mL) and LPSβ+βC. sativus (0.05, 0.1, and 0.2 mg/mL) for 24 h, and a Cell Counting Kit-8 was used to measure cell proliferation. Changes in NLRP3 and NF-κB levels were evaluated by western blotting.
Results: Petal and stamen extracts of C. sativus attenuated the anti-inflammatory effects in local or systemic inflammatory models and repaired pathological changes in the ear in the xylene-induced inflammation model and spleen in the LPS-induced inflammation model. These extracts also decreased the concentrations of TNF-α and IL-1β in the mouse serum in the LPS-induced inflammation model. C. sativus downregulated NLRP3 protein level through the NF-κB pathway and downregulated LC-3 and BECLIN1 in vivo and in vitro. Carbonyl Cyanide3-ChloroPhenylhydrazone (CCCP) weakened the effects of C. sativus on the NLRP3-NF-κB pathway.
Conclusion: C. sativus has anti-inflammatory effects and regulates the NLRP3-NF-κB pathway.
Objective: Electroacupuncture (EA) is an alternative treatment option for pain. Different frequencies of EA have different pain-relieving effects; however, the central mechanism is still not well understood.
Methods: The Fos2A-iCreER (TRAP):Ai9 mice were divided into three groups (sham, 2 Hz, and 100 Hz). The mice were intraperitoneally injected with 4-hydroxytamoxifen (4-OHT) immediately after EA at Zusanli (ST36) for 30 min to record the activated neurons. One week later, the mice were sacrificed, and the number of TRAP-treated neurons activated by EA in the thalamus, amygdala, cortex, and hypothalamus was determined.
Results: In the cortex, 2 Hz EA activated more TRAP-treated neurons than 100 Hz EA did in the cingulate cortex area 1 (Cg1) and primary somatosensory cortex (S1), and 2 and 100 Hz EAs did not differ from sham EA. TRAP-treated neurons activated by 2 Hz EA were upregulated in the insular cortex (IC) and secondary somatosensory cortex (S2) compared with those activated by 100 Hz and sham EA. In the thalamus, the number of TRAP-treated neurons activated by 2 Hz EA was elevated in the paraventricular thalamic nucleus (PV) compared with those activated by sham EA. In the ventrolateral thalamic nucleus (VL), the number of TRAP-treated neurons activated by 2 Hz EA was significantly upregulated compared with those activated by 100 Hz EA, and sham EA showed no difference compared with 2 or 100 Hz EA. TRAP-treated neurons were more frequently activated in the ventral posterolateral thalamic nucleus (VPL) by 2 Hz EA than by 100 Hz or sham EA.
Conclusions: Low-frequency EA ST36 effectively activates neurons in the Cg1, S1, S2, IC, VPL, PV, and VL. The enhanced excitability of the aforementioned nuclei induced by low-frequency EA may be related to its superior efficacy in the treatment of neuropathological pain.
Background: Prior studies have affirmed the safety and effectiveness of traditional Chinese medicine in treating colorectal cancer patients. However, definitive evidence regarding whether traditional Chinese medicine can significantly enhance the survival of colorectal cancer patients remains elusive. This study seeks to provide conclusive insights by examining the postoperative administration of Xihuang capsules, Pingxiao capsules, and Zilongjin tablets and its impact on the 5-year overall survival (OS) and disease-free survival (DFS) rates among colorectal cancer patients.
Methods: A retrospective study was conducted, involving 1,361 patients selected from the medical center. This retrospective study was carried out at a medical center in Tianjin, China. We assessed differences in postoperative OS and DFS between the control group and the medication group using Kaplan-Meier survival analysis and Cox proportional hazards modeling. Additionally, propensity score matching was used to mitigate imbalances in baseline characteristics among patients.
Results: Before propensity score matching, Xihuang capsules could prolong the 5-year OS (79.9% vs. 81.4%, Pβ=β0.0480) and 5-year DFS (74.9% vs. 79.5%, Pβ=β0.0046) of patients after surgery. Similar conclusions were obtained after propensity score matching: OS (74.8% vs. 78.3%, Pβ=β0.0084), DFS (72.7% vs. 78.9%, Pβ=β0.008). Patients taking Pingxiao capsules showed improved 5-year OS (77.2% vs. 84.0%, Pβ=β0.0383) and 5-year DFS (69.9% vs. 80.0%, Pβ=β0.0157) after propensity score matching. Patients taking Zilongjin tablets showed improvement in the 2-year OS (84.2% vs. 93.1%, Pβ=β0.0390) and 1-year DFS (88.2% vs. 92.0%, Pβ=β0.0320) after propensity score matching.
Conclusion: Xihuang capsules and Pingxiao capsules significantly improved the 5-year OS and DFS of patients with colorectal cancer after surgery. Zilongjin tablets showed improvement in the 2-year OS and 1-year DFS after surgery for patients.
Recent research has highlighted the potential of Codonopsis Radix to modulate the immune system, making it a promising candidate for treating chronic inflammatory and cardiovascular diseases, tumors, and aging. However, because of the complex immune activities of its various components, a comprehensive understanding of Codonopsis Radix immune-regulating properties is still lacking. This knowledge gap hinders its widespread utilization in clinical practice. Therefore, this review aimed to assess the impact of Codonopsis Radix on the immune system and elucidate its underlying mechanisms. Additionally, we compared the immunomodulatory effects of different active ingredients derived from Codonopsis Radix to provide a theoretical basis for future investigations on immunomodulation.