Adulterants and counterfeits were found in some of the commercial traditional Chinese medicine (TCM) decoctions in Hongjin Xiaojie Jiaonang, Hongjin Xiaojie Pian, and Chaihuang Keli during the national drug sampling inspection. However, it was difficult to determine the species of the adulterants and counterfeits by conventional testing methods. Therefore, a total of 184 samples of the TCM decoctions and raw materials belong to the prescriptions of above mentioned traditional Chinese patent medicines, including Bupleuri Radix, Bajiaolian, Heimayi, and Shufuchong, were collected and authenticated by DNA barcoding technology. 111 ITS2 sequences were obtained from 115 commercial TCM decoctions and raw materials of Bupleuri Radix, among which 71 were Bupleurum chinense, three were B. scorzonerifolium, and 31 were closely related species in the same genus. In addition, counterfeits derived from different genera, such as Ailanthus altissima (one sample), Saposhnikovia divaricate (two samples), and Solidago decurrens (three samples), were also detected. 21 ITS2 sequences were obtained from 22 commercial TCM raw materials of Bajiaolian, among which 15 were Diphylleia sinensis and six were Dysosma versipellis and other species in genus Dysosma. For 22 Heimayi samples, PCR amplification of COI sequence was failed due to genomic DNA degradation. Among 38 Shufuchong samples, 24 COI sequences were obtained and only nine of them were the genuine species (Armadillidium vulgare) recorded in the Chinese Pharmacopoeia, 11 were Porcellio laevis, two were Mongoloniscus sinensis, and two samples could not be identified due to the limitation of database. This study demonstrates that DNA barcoding technology is suitable for the species authentication of the decoctions of traditional Chinese patent medicine prescription. It is a conductive way for the establishment of traceability system for the whole TCM industrial chain.

Objective To investigate the clinical efficacy of heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine in treating lumbar intervertebral disc herniation. Methods One hundred and twenty patients with lumbar intervertebral disc herniation were randomized to treatment and control groups, 60 cases each. The treatment group received heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine and the control group, heat-sensitive point medicinal moxibustion alone. The VAS score and the JOA Score for Back Pain score were recorded in the two groups before and after treatment. The clinical therapeutic effects were compared between the two groups. Results There were statistically significant pre-/post-treatment differences in the JOA Score for Back Pain score and the VAS score in the two groups (P<0.01). There were statistically significant post-treatment differences in the JOA Score for Back Pain score and the VAS score between the treatment and control groups (P<0.01). The excellent and good rate was 80.0％ in the treatment group and 55.0％ in the control group; there was a statistically significant difference between the two groups (P<0.01). Conclusion Heat-sensitive point medicinal moxibustion plus percutaneous administration of tetrandrine is an effective way to treat lumbar intervertebral disc herniation.

OBJECTIVETo establish questionnaire scaling and reliability and examine the clinical and psychometric validity of the quality of life assessment based on Traditional Chinese Medicine for advanced gastric cancer (QLASTCM-Ga).

METHODSThe QLASTCM-Ga was developed based on programmed decision procedures with multiple nominal and focus group discussions, in-depth interview, pretesting and quantitative statistical procedures. The questionnaire was administered to 240 patients diagnosed with advanced gastric cancer before and after treatment. Structured group methods were employed to establish a general and a specifific module respectively. The psychometric properties of the scale were evaluated with respect to validity, reliability and responsiveness.

RESULTSThe three identified scales of the QLASTCM-Ga and the total score demonstrated good psychometric properties. Test-retest reliability of the total scale and all domains ranged from 0.90 to 0.94, and internal consistency ranged from 0.86 to 0.93. Correlation and factor analysis demonstrated good construct validity. Signifificant difference in the subscales and the total score were found among groups differing in traditional Chinese medicine syndrome, supporting the clinical sensitivity of the QLASTCM-Ga. Statistically signifificant changes were found for each scale and the total score. Responsiveness was also good.

CONCLUSIONSThe QLASTCM-Ga demonstrates good psychometric and clinical validity to assess quality of life in patients with advanced gastric cancer undergoing traditional Chinese medicine therapy. This study is an important fifirst step for future research in this area.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Neoplasm Staging ; Psychometrics ; methods ; Quality of Life ; Reproducibility of Results ; Stomach Neoplasms ; pathology ; Syndrome

BACKGROUNDTraditional Chinese medicine (TCM) is considered an important complementary therapy with beneficial effects for cancer patients. Elderly patients with non-small-cell lung cancer (NSCLC) are a complex patient group with increasing co-morbidity and shrinking physiological reserve, and may derive substantial benefit from the supportive aspects of TCM. Researchers from Shanghai Longhua Hospital found that qi and yin deficiency is a common syndrome in patients with stage III or IV lung cancer. This project was designed to study the combination of single-agent chemotherapy with TCM methods of benefiting qi and yin in elderly patients with advanced NSCLC.

METHODS AND DESIGNThis is a double-blind controlled, multi-center, and prospective study with randomly selected participants from elderly NSCLC patients in China. Seventy-six patients who meet the inclusion criteria will be allocated into two groups, which will receive treatments of 3-week single-agent chemotherapy with TCM or placebo for four cycles. Progression-free survival (PFS) is the primary end point, and the secondary end points are overall survival, objective response rate, time-to-progression, and quality of life (EORTC QLQ-LC43, and TCM syndrome score). Meanwhile, other end points such as toxicity, side effects and safety of the treatments will be assessed.

DISCUSSIONResults from this study may provide evidence on the effectiveness, and parameters for the usage of single-agent chemotherapy combined with or without TCM on PFS of elderly patients with NSCLC.

TRIAL REGISTRATIONClinicalTrials.gov. (Identifier: NCT01780181).

Aged ; Carcinoma, Non-Small-Cell Lung ; drug therapy ; mortality ; Combined Modality Therapy ; Disease-Free Survival ; Double-Blind Method ; Humans ; Lung Neoplasms ; drug therapy ; mortality ; Medicine, Chinese Traditional ; Prospective Studies

OBJECTIVETo study the possible clonal origin of neuroendocrine cells in colorectal adenocarcinoma.

METHODSTwenty-six microsatellite loci were screened using laser capture microdissection, DNA extraction and whole genome amplification. Microsatellite instability (MSI) and loss of heterozygosity (LOH) in adenocarcinoma cells and neuroendocrine cells amongst 30 cases of colorectal carcinoma with neuroendocrine differentiation were detected using polymerase chain reaction-single strand conformation polymorphism (PCR-SSCP)-silver staining. The mutation status of p53 was evaluated by PCR-sequencing. The clonal origin of neuroendocrine cells in colorectal adenocarcinoma was determined.

RESULTSAmongst the 30 cases studied, the prevalence of MSI was 16.9% while that of LOH was 8.5%. The rate showed no statistically significant difference between adenocarcinoma cells and neuroendocrine cells. In 6 cases, the microsatellite alteration was entirely consistent. In 23 cases, the rate of microsatellite alteration consistency was greater than that of inconsistency. In 1 case, the consistency and inconsistency rates were identical. There was statistically significant difference between consistency and inconsistency of microsatellite alteration. The prevalence of p53 mutation was 16.7% which was the same for both adenocarcinoma cells and neuroendocrine cells.

CONCLUSIONSAdenocarcinoma cells and neuroendocrine cells in colorectal adenocarcinoma with neuroendocrine differentiation have similar biologic changes. It is likely that they are of identical origin.

Adenocarcinoma ; genetics ; pathology ; Colorectal Neoplasms ; genetics ; pathology ; DNA Mutational Analysis ; Humans ; Laser Capture Microdissection ; Loss of Heterozygosity ; Microsatellite Instability ; Neuroendocrine Cells ; pathology ; Tumor Suppressor Protein p53 ; genetics

OBJECTIVETo investigate the therapeutic efficacy and safety of aspartate-ornithine granules in patients with nonalcoholic steatohepatitis (NASH).

METHODSSeventy-two patients with NASH were included in this multiple-dose parallel controlled clinical trial and received a 12-week course of aspartate-ornithine granule treatment at either high-dose (6 g bid po; n = 38) or low-dose (3 g bid po; n = 34). Clinical efficacy was assessed by monitoring data from urinalysis, serologic tests (alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and triglyceride (TG)), and abdominal computed tomography (CT) scan. Safety was assessed by occurrence of adverse events (fatigue, anorexia, abdominal distension, nausea, and vomiting). Statistical analyses were conducted to determine the significance of differences between parameters before (baseline) and after treatment.

RESULTSAfter 12 weeks of treatment, the liver and spleen CT ratios in both the high-dose group (0.89 +/- 0.19) and the low-dose group (0.80 +/- 0.15) were significantly higher than at baseline (S = 329, P less than 0.0001 and S = 246, P less than 0.0001); the overall improvement was more robust in the high-dose group (52.63%) than in the low-dose group (38.23%) (Z = -2.1042, P less than 0.05). After 6 and 12 weeks of treatment, the serum ALT levels in both the high-dose group and the low-dose group were significantly lower than at baseline (6 weeks: S = 324.5, P less than 0.0001 and S = 223, P less than 0.0001; 12 weeks: S = 370.5, P less than 0.0001 and S = 297.5, P less than 0.0001); the overall improvement was more robust in the high-dose group (79.0%) than in the low-dose group (53.0%) (Z = -2.0533, P less than 0.05). Similar trends were seen for the serum levels of AST and GGT after 6 and 12 weeks of treatment (all P less than 0.01) and serum levels of TG after 12 weeks of treatment. The rate of adverse reactions was low and similar between the two groups (high-dose: 4.8% and low-dose: 4.4%; all gastrointestinal).

CONCLUSIONAspartate-ornithine granule therapy was an effective and safe treatment of nonalcoholic steatohepatitis, with the higher dose of 6 g bid po providing more robust clinical benefit without affecting the safety profile.

Adult ; Alanine Transaminase ; blood ; Aspartate Aminotransferases ; blood ; Dipeptides ; administration & dosage ; therapeutic use ; Dose-Response Relationship, Drug ; Female ; Humans ; Male ; Middle Aged ; Non-alcoholic Fatty Liver Disease ; drug therapy ; Treatment Outcome ; Triglycerides ; blood ; gamma-Glutamyltransferase ; blood

Adenocarcinoma ; pathology ; Adult ; Aged ; Female ; Humans ; Lasers ; Male ; Middle Aged ; Neuroendocrine Cells ; pathology ; Polymerase Chain Reaction ; methods ; Stomach Neoplasms ; pathology

Review the research and development status that Chinese medicine are compatible with Tripterygium wilfordii for attenuation and synergy for recent year. From modern medicine view and Chinese medicine dialectical perspective explain the mechanisms and methods of compatibility applied to attenuation and synergy of T. wilfordii. Provide a reference for reasonable application of other toxic Chinese medicine. Prefer the suggestion that Chinese medicinal formulae can be developed into Chinese medicine compound preparation.
Animals ; Drug Combinations ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; methods ; Tripterygium ; chemistry

OBJECTIVETo determine and evaluate the residuals of organochlorine pesticides and heavy metals in soil and in Pogostemon cablin in order to provide for GAP planting.

METHODGC method was applied to determine residuals of organochlorine pesticides, the contents of Pb, Cd, Cu, Cr, Hg and As were determined by IPC.

RESULTThe contents of residuals of organochlorine pesticides and heavy metals were different among three cultivars and planting bases clearly, but all of the residuals in soil from three planting bases were below the second standard of Environmental quality standard for soils (GB15618), and the residuals in P. cablin also meet the "Green standards of medicinal plants and preparations for foreign trade and economy".

CONCLUSIONResiduals of organochlorine pesticides and heavy metals in soil and P. cablin from three planting bases in Hainan province were conformed to GAP.

Hydrocarbons, Chlorinated ; analysis ; Lamiaceae ; growth & development ; Metals, Heavy ; analysis ; Pesticide Residues ; analysis ; Soil ; analysis ; Soil Pollutants ; analysis

OBJECTIVETo study the history of introduction and herbal medicine of Pogostemon cablin by textual researches and clarify the confusion in literatures.

METHODTextual research on historical literatures, practical applications and field investigation were adopted.

RESULTThe varieties of P. cablin for therapeutic uses were not chaotic, however there has existed confusion between P. cablin and Agastache rugosus in descriptions of appellation, habitat and characteristic of the original plants.

CONCLUSIONIt was proved that the term "Huoxiang" in Chinese medicinal works before Ming Dynasty was pointed to P. cablin. The cultivation history of P. cablin in China was traced to Liang Dynasty or before.

Agastache ; anatomy & histology ; chemistry ; growth & development ; China ; Ecosystem ; History, 15th Century ; History, 16th Century ; History, 19th Century ; History, 20th Century ; History, 21st Century ; History, Ancient ; History, Medieval ; Lamiaceae ; anatomy & histology ; chemistry ; growth & development ; Oils, Volatile ; analysis ; Pharmacognosy ; history ; Plant Leaves ; anatomy & histology ; chemistry ; Plants, Medicinal ; anatomy & histology ; chemistry ; growth & development