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Chinese Medicine
Why Chinese medicine is heading for clinics around the world
TCM is based on theories about qi, a vital energy, which is said to flow along channels called meridians and help the body to maintain health. In acupuncture, needles puncture the skin to tap into any of the hundreds of points on the meridians where the flow of qi can be redirected to restore health. Treatments, whether acupuncture or herbal remedies, are also said to work by rebalancing forces known as yin and yang. Practitioners of TCM and Western-trained physicians have often eyed each other suspiciously. The Western convention is to seek well-defined, well-tested causes to explain a disease state. And it typically requires randomized, controlled clinical trials that provide statistical evidence that a drug works. From the TCM perspective, this is too simplistic. Factors that determine health are specific to individuals. Drawing conclusions from large groups is difficult, if not impossible. And the remedies are often a mix of a dozen or more ingredients with mechanisms that cannot, they say, be reduced to a single factor. There has, however, been something of a détente. Organizations steeped in the Western conventions, such as the US National Institutes of Health (NIH), have created units to research traditional medicines and practices. And TCM practitioners are increasingly looking for proof of efficacy in clinical trials. They often speak of the need to modernize and standardize TCM. Chapter 26 is meant to be a standard reference that all practitioners can use to help diagnose disease and assess possible causes. For example, ‘wasting thirst syndrome’ is characterized by excessive hunger and increased urination and explained by “factors which deplete yin fluids in the lung, spleen or kidney systems and generate fire and heat in the body”. On the basis of those observations, physicians can work out how to treat them. The patient, who would probably be diagnosed as diabetic by a Western doctor, would probably be prescribed acupuncture, various tonics and moxibustion — in which practitioners burn herbs near the skin of the patient. Spinach tea, celery, soya beans and other ‘cooling’ foods would also be recommended. TCM practitioners around the world are gearing up for Chapter 26, which is set to be implemented by WHO member states in 2022. “For the first time in history, ICD codes will include terminology such as Spleen Qi Deficiency or Liver Qi Stagnation,” reads a post on the website of Five Branches University, a TCM training and research institution based in San Jose, California, which worked with the WHO on a field trial of the diagnostic criteria in Chapter 26.   Source :
Chinese Medicine
Students and lecturers unite against illegal wildlife medicine
  On May 25, students, lecturers, and faculty staff from five of Vietnam’s traditional medicine (TM) universities developed communications strategies to combat the use of illegal wildlife products in traditional medicinal treatments as part of a two-day workshop that was concluded today in Cuc Phuong National Park. Thirty students and lecturers from Tue Tinh Medical College, Thanh Tay University, Pham Ngoc Thach Medical University, Hanoi Medical University, and Hanoi Medical College joined the workshop, which was funded by WWF Germany and organised by TRAFFIC, Vietnam Oriental Traditional Medicine Association (VOTMA), and behaviour change communication orginisation Intelligentmedia as part of their efforts to reduce demand for illegal wildlife products. “We are committed to ensuring that traditional medicine continues to be practiced in Vietnam in accordance with the law and sustainable principles. As the tide turns against the use of illegal flora and fauna as ingredients in traditional treatments, we are working to leave a positive legacy that will endure as part of our heritage,” said Tran Xuyen Nguyen, chairman of the Professionalism Department of the Vietnam Oriental Traditional Medicine Association. The workshop provided attendees with up-to-date information on the state of illicit wildlife trade in Vietnam in sessions held with representatives from TRAFFIC and CITES Management Authority. The event also included a session from VOTMA debunking unscientific beliefs surrounding the medicinal properties of illegal wildlife, particularly rhino horns, tiger bones, and pangolin scales. Discussions were held on alternatives that have proven benefits and can be legally sourced. The lecturers and students were given communications guidelines and suggestions of activities to help them form effective strategies to deter the use of illegal wildlife products in formal prescriptions by TM practitioners and dispensaries to customers. The students and lecturers worked together to develop action plans that could be implemented in their respective universities. TRAFFIC and VOTMA challenged each participant to pass on the message to more than 1,000 of their classmates and colleagues. Nguyen Van Thai, director from the Vietnamese NGO Save Vietnam’s Wildlife, led a session on how community engagement can be used to raise awareness and promote social behavioural change, using its conservation efforts for the pangolin as an example. The workshop builds on recent research findings which have identified the TM sector as a priority sector in the fight against illegal wildlife trade. It is hoped that through sessions like this one, future TM practitioners can promote legal, sustainable, and socially responsible practices for sourcing and prescriptions. To aid them in this task, TRAFFIC designed a purpose-built toolkit that was disseminated at the workshop. The kit contains a guide focusing on eliminating the use of endangered species in TM by providing suggestions for sustainable alternatives. The toolkit also contains important updates on Vietnam’s penal code with regards to wildlife crime. On January 1, 2018, poaching, killing, captive breeding, transporting, trading, storing, and consuming illegal wildlife became punishable by 15 years of imprisonment or a fine of up to VND15 billion ($660,000). The toolkit also features a design for a banner to be used at events and a pledge that students and practitioners can sign publicly to declare that they will not prescribe medicine containing illegal wildlife. “Traditional medicine practitioners and students have an important role to play as champions of best practices with their peers and associates, and this toolkit helps frame a zero-tolerance approach to endangered wildlife use in traditional medicine,” said Sarah Ferguson, head of TRAFFIC’s Vietnam office. “With the new penal code and Vietnam’s increased law enforcement efforts, it is critical that the provision of healthcare through the sector is practiced in a legal, sustainable way to ensure the reputation of practitioners remains in high regard in Vietnam,” Sarah Ferguson added. TRAFFIC, the wildlife trade monitoring network, works to ensure that trade in wild plants and animals is not a threat to the conservation of nature. TRAFFIC works closely with its founding organisations, IUCN and WWF, making a critical contribution to the achievement of their conservation goals through a unique partnership that complements and engages the considerable strengths of each of these two major global conservation organisations   Source:
Chinese Medicine
Classification and Clinical Features of Headache Disorders
INTRODUCTION ‘Headache is one of the most common neurological disorders encountered by clinicians.1 According to the World Health Organization (WHO), headaches are among the five most common clinical disorders worldwide. Evidence suggests that active headaches affect more than 46% of the global population, and the lifetime prevalence of headache is more than 90%. Higher prevalence of headaches is reportedly associated with greater social, economic, and family burden. Traditional Chinese Medicine (TCM) has a long history in treating headache disorders. Many treatments, such as herbal TCM treatments and physical TCM therapy, are effective in treating headaches and have therefore been the focus of studies in modern medicine. Several clinical practice guidelines (CPGs) for treating headache with TCM have been developed. Many studies have suggested that CPGs can improve clinical practice and reduce healthcare costs, but several different CPGs may be published on the same topic. If these guidelines are conflicting, this may affect the confidence of clinicians. To our knowledge, no critical appraisal has been performed on the guidelines covering TCM treatment for headaches. There are various guideline assessment tools available, but the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument is the most appropriate for guideline appraisal.   This study aimed to appraise the methodological quality of guidelines for the treatment of headache produced over the last two decades, and covering interventions using TCM. We hoped to determine the acceptance level worldwide of the different interventions using TCM, and also obtain realistic efficacy data about TCM treatments. By appraising and summarizing the current CPGs for TCM headache treatment, we can determine whether a further guideline for the treatment of headache with TCM is needed. METHODS Information sources We searched for guidelines on headache disorders in PubMed, EMBASE, Web of Science, and four Chinese academic electronic databases, the Chinese Biomedical Literature Database (CBM), China National Knowledge Infrastructure Database (CNKI), China Science and Technology Journal Database (VIP), and Wanfang database. We also searched two international guideline databases, the Guideline International Network (GIN) and National Guideline Clearinghouse (NGC), as well as a Chinese guideline database (Medlive). We used “headache” as a search term on the websites of several well-known organizations concerned with guideline development: World Health Organization (WHO), American Academy of Neurology (AAN), National Institute for Health and Care Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), and European Academy of Neurology (EAN). We carried out a manual search for gray literature to supplement the electronic searches. The date of publication was restricted to between January 1996 and June 5, 2015. The terms “headache”, “headache disorders”, “cephalalgia”, “migraine”, “tension-type headache”, “practice guideline”, “consensus”, “statement”, “regulation”, and “recommendation” were used in both the “MeSH” and “Free-text” fields. We searched Chinese guidelines for headache disorders manually, as these were published in books and government documents. Inclusion and exclusion criteria We included all Chinese and English language CPGs that provided recommendations on the diagnosis, treatment, and management of headache disorders, and met the definition of guidelines, as described by the Institute of Medicine. Guidelines were excluded if they met any of the following criteria: (a) did not include TCM therapies for headaches, including both herbal (Chinese herbal formulas, Chinese patent medicine, and herbal extracts) and physical TCM therapies (acupuncture, moxibustion, massage, manipulation, and osteopathy); (b) translations of international guidelines into Chinese, adaptations of international guidelines for China, abstracts or summary reports of international guidelines, and other explanatory or evaluation reports of guidelines; and (c) beta versions or older versions of guidelines from the same source. Literature screening and review data extraction Using the inclusion and exclusion criteria, all records were classified using Endnote (Version X7, Thomson Reuters, USA), and duplicate studies were discarded. Next, two of the authors (Luo Hao and Yao Sha) independently screened all the search records by browsing the title and abstract using the predefined inclusion and exclusion criteria. We then obtained the full text of possible guidelines to determine whether they were eligible, and extracted the general characteristics of each CPG included. Disagreements were resolved by consensus between the two authors or by a third expert (Li Hui).’     Source and URL, Science Direct
Chinese Medicine
Cancer in China
INTRODUCTION ‘Lung cancer has the highest death rate among all types of cancers. In 2017 the most common cause of cancer death was still lung cancer in the United States, which contributes to more than a quarter of cancer mortality among all tumor types. In China, lung cancer is also the leading cause of cancer death for both males and females. Non-small cell lung cancer (NSCLC) accounts for 80%-85% of all lung cancers. Cisplatin-based chemotherapy has been widely used for patients with NSCLC in recent years. Although chemotherapy and targeted therapy have been improved in recent decades, the efficacy of chemotherapy for NSCLC is modest at present, and the 5-year survival rate of NSCLC is still unsatisfactory. Traditional Chinese Medicine (TCM) has been used in treatment of lung cancer for many years in China. The method of promoting Qi and activating blood is commonly used in the treatment. The combination of Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis) is one of the most common combinations in the method. The effective active ingredients of Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis), such as Astragalus saponins, Astragalus polysaccharide, β-elemene and Curcumin, have been reported to have anti-cancer effects. The research into the compatibility of Chinese herbs has risen from the herbal pieces level to the component formula level and the uniform experimental design has become a new valuable method in the compatibility research of Chinese medicine drugs. In this study, we used the uniform design method with a 4-factor and 8-level table to determine the optimal combination (E) of four components in Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis), namely Astragalus polysaccharide, Astragalus saponins, Curcumin and β-Elemene. Changes in the inhibition of A549 cell proliferation were observed as screening indices, and regression analysis was used to determine E. Using the chemical approach (CoCl2) to simulate hypoxia, we analyzed the expression of Bcl-2, Bax and caspase-3 in A549 lung cancer cells treated with various doses of E. MATERIALS AND METHODS Drugs and reagents Astragalus saponins and polysaccharide were purchased from Efebio Co., Ltd., (Shanghai, China). β-Elemene and Curcumin were purchased from the National Institutes for Food and Drug Control (Beijing, China). Antibody against Bax and antibody against β-actin were obtained from Abcam (Cambridge, UK). Antibody against caspase-3 was obtained from Cell Signaling Technology Inc. (Danvers, MA, USA). Antibody against Bcl-2, goat anti-rabbit IgG-horseradish peroxidase (HRP) and goat anti-mouse IgG-HRP were obtained from Santa Cruz Biotechnology Inc. (Santa Cruz, CA, USA). Trizol reagent was obtained from Invitrogen (Carlsbad, CA, USA). Other reagents included a HiFiMMLVcDNA First Strand Synthesis kit, Ultra-pure RNA extraction kit. An Annexin V-FITC/PI Apoptosis Detection kit and UltraSYBR mixture were obtained from CWbio Co., Ltd., (Beijing, China). A Cell Titer 96® AQueous One Solution Cell Proliferation Assay (MTS) was purchased from Promega (Madison, WI, USA). Cisplatin injection was obtained from Hospira (Mulgrave, Australia). CoCl2 was obtained from Sigma-Aldrich (St Louis, MO, USA). Cell culture and treatments The A549 human lung adenocarcinoma cell line was purchased from the Cell Center of the Chinese Academy of Medical Sciences (Beijing, China). The cells were cultured in Roswell Park Memorial Institute 1640 medium (RPMI-1640) (Gibco, NY, USA) containing 10% fetal bovine serum (Sijiqing, Hangzhou, China) and an antibioticmixture of Penicillin-Streptomycin Solution (Pasching, Austria). The cells were seeded on culture plates for each experiment and grown at 37 °C with 5% CO2. Astragalus saponins, Astragalus polysaccharide, Curcumin and β-Elemene were dissolved in dimethyl sulfoxide (DMSO) and diluted with RPMI-1640. The final concentration of DMSO never exceeded 5‰ (v/v). CoCl2 was dissolved in sterile water for injection and diluted with RPMI-1640. Cisplatin was diluted with RPMI-1640. In this study, the uniform design method was used to optimize the most effective component formula of Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis) in on effect of the proliferation of A549 lung cancer cells. A uniform design method with a 4-factor and 8-level table U8 (84) was used to optimize the proportions of four component in Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis), namely, Astragalus polysaccharide (X1), Astragalus saponins (X2), Curcumin (X3), and β-elemene (X4).Moreover, changes in the cellular proliferation inhibition rate (CPIR) were observed as evaluation indicator, and regression analysis was used to determine E.   RESULTS Proliferation inhibition of A549 cells A uniform design method with a 4-factor and 8-level table was used to optimize the proportions of four components in Huangqi (Radix Astragali Mongolici) and Ezhu (Rhizoma Curcumae Phaeocaulis) (Table 1). All CPIR observations of the eight uniform design groups were analyzed by stepwise regression analysis using SPSS 17.0 statistical software. Screening α into = α out = 0.15, two factors entered the model (X1 and X3), R2 = 0.805, it indicated that two influencing factors resulted in 80.5% CPIR variation and the model was relatively satisfactory. The optimal regression equation is = 0.003X1 + 0.26X3-0.503. Based on the partial regression coefficient, higher levels of X1 and X3 led to a higher CPIR. X2 and X4 were removed during the regression process, it indicated that changes of X2 and X4 did not affect the changes of CPIR. Therefore, the optimal test scheme obtained by the uniform design (E) was 200 mg/L Astragalus polysaccharide (X1) and 32 mg/L curcumin (X3). Apoptotic induction of A549 cells under chemical-induced hypoxia Apoptosis was analyses by flow cytometry in A549 cells. Results showed no significant difference between group 0 and group CoCl2 (P > 0.05). Compared with group 0, group DDP + CoCl2, 1E + CoCl2 and 2E + CoCl2 promoted the apoptosis rates of A549 cells (P < 0.05), and the apoptosis rates of group 0.5E + CoCl2, 1E + CoCl2 and 2E + CoCl2 were dose dependent. The apoptosis rates of the group 1E + CoCl2 and the group 2E + CoCl2 had no statistically significant difference compared with the group DDP + CoCl2 (P > 0.05).’   Source and URL : Science Direct 。
Chinese Medicine
Americans distrusting Big Pharma seek traditional Chinese cures
For the average American, there is little “accurate” knowledge as to what exactly is traditional Chinese medicine, with the majority of people thinking it only pertains to using specific herbs and natural remedies to cure health conditions. In all actuality however, Traditional Chinese Medicine is making its way into the Western World and is more and more being used by practitioners as a substitute for many medications. Chinese Medicine is becoming vastly popularized as to the point where there is no need to make a journey to Asia to get these sorts of treatments, as they are now accessible on the online market. Currently, the United States is facing, what some call, an opioid epidemic where millions of people are affected. This is a result from the combination of a heavy demand for highly-addictive painkillers, and the continued push by doctors from pharmaceutical companies to pitch certain drugs to their patients. Thus, there has been a significant increase in the number of people turning towards alternative methods of medicine such as acupuncture. Recently, a number of groups such as the Joint Commission on the Accreditation of Healthcare Organization, have publically come out in support for more natural remedies to counter act the high use of opioids in the medical market. Previously only a small select group of insurances companies covered treatments such as these, but with demand and popularity, groups such as Blue Shield and Aetna are now offering this kind of coverage. In addition, there is also the growing trend that now gives students and practitioners the opportunity to study Eastern Medicine with the funding and provision of select licenses. Herbal Therapy however still remains dormant, but is expected to rise as Eastern Medicine continues to grow in popularity.