Investigation of potential pharmacodynamic substances and mechanism of Qingxin-zishen prescription decoction in treatment of menopause syndrome based on HPLC-Q-TOF-MS/MS and network pharmacology / 中国临床药理学与治疗学

AIM: To analyze the chemical ingredients of Qingxin-zishen prescription decoction (QZPD) and predict its main pharmacodynamic substances and mechanism in the prevention and treatment of menopause syndrome (MPS) with the help of high performance liquid chromatography-quadrupole-time of flight mass spectrometry (HPLC-Q-TOF/MS) combined with network pharmacology. METHODS: The chemical ingredients of QZPD were identified after analyzing the retention time, exact mass, secondary mass spectrometry fragmentation and other information obtained from HPLC-Q-TOF/MS and comparing them with the established chemical ingredients database and the literatures. The targets of ingredients in QZPD were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) and SwissTargetPrediction database. The disease targets of MPS were obtained through Online Mendelian Inheritance in Man (OMIM) and GeneCards Database. Gene ontology (GO) function enrichment and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis of potential targets were analyzed with the Metascape database. Cytoscape 3.7.2 software was used to construct the network of active components-key targets-pathways. AutoDockTools 4.2.5 software was applied in the molecular docking verification between the key active components and key targets. RESULTS: A total of 83 components were identified in QZPD and 847 drug targets were predicted. After intersection them with 3 050 disease targets, 395 common targets were obtained. After network topology analysis, 74 key targets were obtained, involving mitogen-activated protein kinase (MAPK), phosphatidylinositol-3 kinase/protein kinase B (PI3K/Akt), transforming growth factor-β (TGF-β) and other signaling pathways. Molecular docking analysis results indicated that 23 key active components, such as berberine, epiberberine, coptisine, geissoschizine methyl ether, liensinine, norcoclaurine, palmatine, quercetin, and luteolin, had good binding activity with several of the key targets. CONCLUSION: This study preliminarily identifies the potential effective chemical ingredients of QZPD, predicts its targets in the prevention and treatment of MPS, which provides supporting information for the further study of the pharmacodynamic substances and mechanisms of QZPD.

Systematic Review and Meta-analysis of Effect of Traditional Chinese Medicine in Treating Late Onset Hyponatremia / 中国实验方剂学杂志

Objective:The Meta-analysis was used to systematically evaluate the clinical efficacy of traditional Chinese medicine in treating Late onset hyponatremia （late onset hyponatremia，LOH）. Method:Pubmed，Web of Science，China Knowledge Base Database （CNKI），Wanfang Database （WanFang），Weipu Full-text Periodical Database（VIP），Chinese Biomedical Literature Database （CBM）were retrieved to collect randomized controlled trials of traditional Chinese medicine（TCM） for treatment of LOH. Two researchers independently screened out the literatures， extracted the data， conducted quality assessment by Cochrance bias risk assessment tool，and made Meta-analysis by RevMan 5.3.5 software. Result:Nine eligible documents were finally included. Meta-analysis results showed that the test group was superior to the control group in improving patient's physical fitness/cardiovascular score ［mean deviation（MD）=-1.42，95% CI（-2.39，-0.45），<italic>P</italic>=0.004］ and psycho-psychological score［MD=-0.74，95% CI（-1.26，-0.22），<italic>P</italic>=0.005］，with no statistically significant difference between test group and control group in sexual function score ［MD=-0.68，95% CI（-1.38，-0.03），<italic>P</italic>=0.06］，serum testosterone （TT） concentration［MD=-0.68，95% CI（-1.38，-0.03），<italic>P</italic>=0.06］ and effective rate ［odds ratio（OR）=1.57，95% CI（0.64，3.88），<italic>P</italic>=0.33］. Conclusion:TCM is equivalent to western medicine（testosterone undecanoate）in the treatment of late onset hypogonadism， and better than western medicine in improving patients' physical fitness/cardiovascular score and mental and psychological score.

Protective Effect of Tiaogeng Decoction in Improving Apoptosis of Hypothalamic Neurons Based on JNK Pathway / 中国实验方剂学杂志

Objective:To study the mechanism of Tiaogeng decoction in improving apoptosis of hypothalamic neurons through c-Jun N-terminal kinase (JNK) pathway. Method:The GT1-7 cell line of hypothalamic neuron cells treated by tributyltin chloride (TBTC) was used to induce a model of neuronal apoptosis, with 17β-estradiol as a positive drug. They were divided into control group, model group (1 mg·L-1), 17β-E2 group(100 nmol·L-1) and low, middle and high-dose Tiaogeng decoction groups (31.25,62.5,125 mg·L-1). The cell morphology was observed under a fluorescent inverted microscope, and cell counting kit-8 (CCK-8) was used to detect the cell viability. The cell nuclear morphology and the apoptosis rate of hypothalamic neurons were detected by Hoechst 33258 and Annexin V-FITC/propidium iodide(PI) double staining. Western blot was used to detect the expression levels of apoptosis signal-regulating kinase 1(ASK1), JNK, p53 and cleaved Caspase-3 of JNK pathway in GT1-7 cell. Western blot was used to analyze apoptosis-associated protein apoptosis signal-regulated kinase 1 (ASK1), JNK, p53, cleaved Caspase-3 expressions in JNK pathway and phosphorylation of JNK after intervention with JNK inhibitor SP600125, protein expression level of cleaved Caspase-3. Result:Compared with normal control group, the cell viability of the model group was significantly decreased (PPPPP-1)treatment significantly inhibited the expressions of p-JNK and cleaved Caspase-3 in GT1-7 cells (PConclusion:Tiaogeng decoction can improve the apoptosis of hypothalamic neurons through JNK pathway, and provide a theoretical basis for the treatment of menopausal syndrome and central nervous system protection.

Update on the diagnosis and treatment of menopause syndrome / 中国基层医药

With the advance of medicine and the extension of life expectancy,the proportion of elderly people is increasing around the world,so is the postmenopausal women in the world~ population.More and more women will be bothered by various perimenopausal problems.Vasomotor symptoms(VMS) and the genitourinary syndrome of menopause(GSM) are recognized as the most frequent symptoms associated with menopause.Menopausal hormone therapy (MHT) is the most effective intervention for management of these symptoms.However,the role of MHT in the prevention of cardiovascular disease,skeleton,urogenital systems remains controversial.New drugs such as selective estrogen receptor modulators are equivalent to MHT on the relief of VMS.In addition,it can also prevent bone loss,becoming a new research highlights.Nonhormonal management is an important consideration when hormone therapy is not an option because of medical contraindications or a woman's personal choice,like lifestyle changes,selective serotonin reuptake inhibitors,serotonin-norepinephrine reuptake inhibitors,vaginal laser and etc.

Effect of Xiaoyao pill combined with low-dose corticosteroid on serum estrogens in menopause syndrome and its clinical efficacy / 中国生化药物杂志

Objective To explore the effect of Xiaoyao pill combined with low-dose corticosteroid on serum estrogens levels in the treatment of patients with menopause syndrome and its clinical efficacy.Methods 96 patients with menopause syndrome from April 2013 to February 2015 in department of obstetrics and gynecology of Lishui second people’s hospital were selected and divided into 2 groups according to a random number table, the control group (48 cases) were treated with small dose of hormone therapy, the treatment group (48 cases) were treated with Xiaoyao pill combined with small dose of hormone therapy.The serum estrogens levels, Kupperman score, endometrial thickness and clinical efficacy were compared. Results The total effective rate of control group(79.17%) was lower than that of treatment group(93.75%)(P<0.05).Compared with control group post-treatment, the serum follicle stimulating hormone (FSH) and luteinizing hormone (LH) levels were lower, estradiol (E2) level was higher, the Kupperman score was lower, the endometrial thickness was higher than those of control group, there were significant differences ( P <0.05 ) . Conclusion Xiaoyao pill combined with small dose of hormone could improve serum E2, FSH and LH levels in the treatment of patients with menopause syndrome with high security.

Study on the reliability and validity of the Chinese Menopause Rating Scale (CMRS) / 中华流行病学杂志

Objective To evaluate the feasibility,reliability,validity and responsiveness of a Chinese Menopause Rating Scale (CMRS).Methods Cross-sectional survey and convenience sampling were adopted. Participants:women with menopause syndrome and those in menopause but without menopause syndrome were recruited.All participants were asked to complete the CMRS,Kupperman Index,WHOQOL-BREF and MENQOL.The Self-control observation design was adopted when the responsiveness was evaluated.Patients were treated with TCM for weeks.MRSTCM was evaluated before and after the treatment.Results (1) Feasibility:3343 participants including 2320 patients and 1023 menopause women,were surveyed in 8 different settings.The recovery rate of CMRS was 100%,with a response rate as 99.7%.The completion of the CMRS took 10.30 minutes on average.(2)Reliability:Cronbach's alpha of CMRS,soma dimension,psychology dimension and community dimension of CMRS were 0.93,0.87,0.89 and 0.73 respectively,with the correlation coefficient of split half of the CMRS.Soma dimension,psychology dimension and community dimension were 0.92,0.89,0.86 and 0.73 respectively and the test-retest correlation coefficient of MRSTCM,the soma dimension,psychology dimension and community dimension were as 0.88,0.91,0.85 and 0.77 respectively.(3) Validity:CMRS was established on the basis of connotation of menopause syndrome,and a series of steps were adopted to modify the scale.CMRS was applicable for patients with menopause syndrome.CMRS seemed to have had good content-related validity.The result of exploratory factor analysis was accorded with the theory frame of CMRS by and large.The correlations between CMRS and KI,CMRS and WHOQOLBREF,CMRS and MENQOL seemed good.The CMRS was able to discriminate between groups of people with or without menopausal syndrome and bad good discriminative validity.(4) Responsibility:The CMRS was measured based on 174 patients with menopausal syndrome before and after the TCM therapy.Our result showed that the CMRS having the ability to measure the clinically important differences.Conclusion CMRS was suitable for outcome assessment of menopausal syndrome.This primary research proved that the CMRS had good feasibility,reliability,validity as well as responsiveness.

Male Menopause Syndrome and Its Acupuncture Treatment / 浙江中医药大学学报

Some men over 50 may show the clinical symptoms similar to female menopause,so called male menopause syndrome.It discusses its concept,mechanism and appearance,TCM recognition and acupuncture to it as well.

Comparative Observation on Therapeutic Effects of Treating Menopausal Syndrome with Auricular Points Sticking-pressure and Acupuncture / 针灸推拿医学（英文版）

Objective: To make a comparative observation on treating menopausal syndrome with auricular points sticking-pressure and acupuncture. Methods:The 86 cases were randomized into the group of auricular points sticking-pressure and acupuncture group, and then the comparative observation was made according to the modified Kupperman index. Results: The statistical analysis on the comparative observation showed there is no significant difference between the therapeutic effects of the two groups. Conclusion: Auricular points sticking-pressure and acupuncture are both effective for menopausal syndrome, and the auricular points sticking-pressure is worthy to spread with its easy operation.