Aims: Traditional Chinese medicine (TCM) has been used for relief and treatment of ailments dating back thousands of years and continues to the present day, with rapidly increasing interest in evidence-based evaluation of its efficacy. Studies of TCM plants have demonstrated that several have antimicrobial properties but few have explored their anti-quorum sensing potential. Quorum sensing (QS), also known as bacterial cell-to-cell communication, is used by a number of opportunistic pathogenic bacteria in the regulation of virulence expression. Compounds that interfere with QS signals and attenuate bacterial virulence without killing them may offer an alternative therapeutic solution with less pressure of antibiotic resistance developing. This study screened TCM plants for anti-quorum sensing properties and antimicrobial activities. Methodology and Results: Twenty TCM plants commonly used in South-East Asia were screened for QS inhibitors using two biomonitor strains, Chromobacterium violaceum CV026 and Pseudomonas aeruginosa PAO1. Ten of these selected TCM plant (50%) were found to have QS inhibitory properties: Angelica sinensis (Umbelliferae), Cnidium monnieri (Umbelliferae), Astragalus membranaceus (Leguminosae), Crataegus cuneata (Rosaceae), Dioscorea nipponica (Dioscoreaceae), Lilium brownii (Liliaceae), Aloe barbadensis (Liliaceae), Magnolia officinalis (Magnoliaceae), Ephedra sinica (Ephedraceae) and Panax pseudoginseng (Araliaceae). Of these, six (30%) also showed varying antimicrobial activity against C. violaceum and P. aeruginosa. Conclusion, significance and impact of study: The results suggest that traditional Chinese medicinal plants could be a prospective source to explore for useful compounds in the fight against bacterial infections.

Lung cancer is the leading cause of cancer-related death around the world, being the top cause of cancer-related deaths among men and the second most common cause of cancer-related deaths among women in Singapore. Currently, no screening programme for lung cancer exists in Singapore. Since there is mounting evidence indicating a different epidemiology of lung cancer in Asian countries, including Singapore, compared to the rest of the world, a unique and adaptive approach must be taken for a screening programme to be successful at reducing mortality while maintaining cost-effectiveness and a favourable risk-benefit ratio. This review article promotes the use of low-dose computed tomography of the chest and explores the radiological challenges and future directions.