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Effects of Tai Chi on gait kinematics, physical function, and pain in elderly with knee osteoarthritis--a pilot study.

Am J Chin Med. 2008;36(2):219-32

Authors: Shen CL, James CR, Chyu MC, Bixby WR, Brismée JM, Zumwalt MA, Poklikuha G

Our previous study has demonstrated that 6 weeks of Tai Chi exercise significantly improves knee pain and stiffness in elderly with knee osteoarthritis. This study also examine the effects of Tai Chi exercise on gait kinematics, physical function, pain, and pain self-efficacy in elderly with knee osteoarthritis. In this prospective, pretest-posttest clinical trial, 40 men and women (64.4+/-8.3 years) diagnosed with knee osteoarthritis participated in 6 weeks of instructed Tai Chi training, 1 hour/session, 2 sessions/week. The following measures were taken at baseline and the conclusion of the intervention: (a) gait kinematics including stride length, stride frequency, and gait speed quantified using video analysis, (b) physical function, (c) knee pain, and (d) pain self-efficacy. Data were analyzed using repeated MANCOVA, MANOVA, ANOVA and Wilcoxon tests. After 6 weeks of Tai Chi exercise, stride length (p=0.023; 1.17+/-0.17 vs. 1.20+/-0.14 m), stride frequency (p=0.014; 0.91+/-0.08 vs. 0.93+/-0.08 strides/s), and consequently gait speed (p<0.025; 1.06+/-0.19 vs. 1.12+/-0.15 m/s) increased in the participants. Physical function was significantly improved (p<0.001) and knee pain was significantly decreased (p=0.002), while no change was observed in pain self-efficacy. In conclusion, these findings support that Tai Chi is beneficial for gait kinematics in elderly with knee osteoarthritis, and a longer term application is needed to substantiate the effect of Tai Chi as an alternative exercise in management of knee osteoarthritis.

PMID: 18457357 [PubMed - indexed for MEDLINE]

(Source: The American Journal of Chinese Medicine)

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Acupuncture analgesia: a review of its mechanisms of actions.

Am J Chin Med. 2008;36(4):635-45

Authors: Lin JG, Chen WL

The mechanism of acupuncture analgesia (AA) has been widely explored since the 1970s. Early studies investigated the relationship between acupuncture and endogenous opiates (beta-endorphin, enkephalin, endomorphin and dynorphin). Before the 1990s, most experts agreed on the concept that in normal animal models, lower frequency electroacupuncture (EA) stimulates the release of beta-endorphin, enkephalin and endomorphin, which in turn activates the mu- and delta-opioid receptors, and that higher frequency EA stimulates dynorphin which activates the kappa-opioid receptor. Besides endogenous opiates, our studies have focused on serotonin. The serotoninergic descending inhibitory pathway is suggested to be an important mechanism of acupuncture analgesic, collaborating with endogenous opiates. Many efforts have been made to clarify these mechanisms, but to date no satisfactory consensus has been reached. In the late 1990s, researchers began to focus on the different analgesic effects of EA between normal and hyperalgesic animal models. Published data from these studies imply that normal and hyperalgesic animals respond differently to EA. Results from experiments on the anti-hyperalgesia effect of EA have raised a new issue about the influences of EA on receptors to excitatory amino acid in the spinal cord level. Results from various studies have shown that these receptors play a role in the mechanism of AA. Recently, research on the autonomic nervous system (ANS) seem to indicate its connection with acupuncture. The inflammatory reflex (via the ANS) might be a crucial part of anti-hyperalgesia elicited by acupuncture, and this reflex, which regulates the immune system in the organism, can elucidate not only the mechanism of AA but also the mechanism of acupuncture applied to other inflammatory conditions. Innovation of functional image study enables us to analyze the responses of cortex on living human body to acupuncture. However, results of these experiments are still controversial. After 30 years of acupuncture research, there are still many puzzles left to be solved regarding the mechanism of AA.

PMID: 18711761 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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Effects of 14-week tai ji quan exercise on metabolic control in women with type 2 diabetes.

Am J Chin Med. 2008;36(4):647-54

Authors: Zhang Y, Fu FH

The present study investigated the effects of 14 weeks of practicing Tai Ji Quan (TJQ) on metabolic control and lipid metabolism in women with type 2 diabetes. Twenty Beijing female residents (57.4 +/- 6.2 years) were recruited and were randomly assigned to either the TJQ training or the control group. In the TJQ group, the exercise duration was 1 hour per day and 5 days a week for 14 weeks. FPG, GSP, FPI, TC, HDL-C, LDL-C, TG, resting blood pressures and heart rate were measured before and after the 14 weeks in the 2 groups. It was found that after 14 weeks, the TJQ group had significantly lower FPG, GSP, TG and higher FPI concentration, whereas there were no significant differences in TC, HDL-C and LDL-C. It was concluded that TJQ exercise could be used as an intervention tool to improve glycaemic control and serum TG level in the elderly people. Future research with TJQ of different styles and exercise of different intensities were recommended.

PMID: 18711762 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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The distribution of yin-deficient symptoms and their relationship on survival rate in cancer patients with yin-deficiency.

Am J Chin Med. 2008;36(4):655-63

Authors: Lin SC, Chen MF, Li TC, Hsieh YH, Liu SJ

Yin-Deficiency (YD), representing a status of the human body under lack of nutrition and fluid in traditional Chinese medicine, is commonly seen in late stage of cancer patients. It is not known whether the severity of YD related symptoms/signs can predict the survival rate of cancer patients. This study evaluated the distribution of Yin-deficiency symptoms/signs (YDS) in cancer patients with YD, and investigated whether the severity of YDS can predict the survival rate of cancer patients with YD. From 5 January 2007 to 5 May 2007, we selected 43 cancer patients with diagnosis of YD from hospitalized patients and outpatients. The severity of YD was evaluated by a questionnaire. We further estimated the cumulative probabilities of the survival rates over 4 months since the start of study by the Kaplan-Meier product-limit method, and compared the differences among groups with various severities in each symptom/sign with the use of the log-rank test. The results revealed that, the 3 most common YDS were sleeplessness with annoyance, less or non-coated tongue with or without redness and dry mouth. In the survival rate analysis, only 2 parameters, rapidly small pulse (p = 0.002) and less-or non-coated tongue with paleness (p = 0.017), were found to be related to the decrease of cancer patients with YD. This suggests that, both rapidly small pulse and less-or non-coated tongue without redness may be used as predictors for the estimation of survival rate in cancer patients with YD.

PMID: 18711763 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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Randomized Phase II Trial on Mitomycin-C/Cisplatin +/- KLT in Heavily Pretreated Advanced Breast Cancer.

Am J Chin Med. 2008;36(4):665-74

Authors: Guo HY, Cai Y, Yang XM, Wang ZH, Wang JL, Zhao XM, Li J, Hu XC

A randomized phase II study using mitomycin (MMC)/cisplatin (DDP) regimen with or without Kanglaite (KLT, a traditional Chinese medicine) as salvage treatment was conducted to exploit KLT's potential effects on patients with advanced breast cancer (ABC). Triweekly regimen consisted of mitomycin (8 mg/m(2)) administered intravenously on day 1, and cisplatin (25 mg/m(2)) intravenously on days 1 to 3. KLT (100 ml) was given intravenously per day on days 1 to 14 every 3 weeks. Between April 2006 and July 2007, 60 patients with a median age of 48 years were randomized into MMC/DDP with or without KLT treatment. In all, the objective response rate (ORR) was 17.5%. There were no significant differences between experimental and control treatments in terms of ORR (14.3% vs. 20.7%, p = 0.730), clinical benefit rates (24.1% vs. 28.6%, p = 0.468), median time to progression (TTP; 3.63 vs. 4.0, p = 0.872), and overall survival (OS; 7.17 vs. not reached, p = 0.120). The median TTP for patients with complete or partial responses was 6.0 months, but only 2.1 months for patients with stable or progressive disease (SD or PD; p = 0.028). While the median OS for patients who obtained clinical benefit from chemotherapy was not reached, that of patients with SD of no more than 6 months or PD was only 7.17 months (p = 0.004). There is no additional benefit when KLT is added to the MMC/DDP doublet in the management of ABC. Patients who obtained clinical benefit from chemotherapy had a longer TTP and OS.

PMID: 18711764 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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Symptom Combinations Assessed in Traditional Chinese Medicine and Its Predictive Role in ACR20 Efficacy Response in Rheumatoid Arthritis.

Am J Chin Med. 2008;36(4):675-83

Authors: He Y, Lu A, Lu C, Zha Y, Yan X, Song Y, Zeng S, Liu W, Zhu W, Su L, Feng X, Qian X, Tsang I

The predictive roles of symptom combination traditionally evaluated in traditional Chinese medicine (TCM) in the treatment of rheumatoid arthritis (RA) were explored. Three hundred and ninety six patients were randomly divided into 197 subjects receiving Western medicine therapy (WM) and 199 subjects receiving TCM therapy (TCM). A complete physical examination and 18 clinical manifestations typically assessed in TCM were recorded before the randomization. The ACR responses were used for efficacy evaluation. ACR20 and 50 responses with WM treatment were higher than in the TCM group. The 18 symptoms in RA could be clustered into 4 symptom combinations with factor analysis, which represent joint symptoms, cold pattern, deficiency pattern and hot pattern in TCM respectively. TCM would be more effective in patients with weak-symptom combination 3 (deficiency pattern in TCM), and WM would be more effective in patients with symptom combination 2 (cold pattern in TCM). Symptom combinations judged with TCM may have influence on the efficacy of therapy in the treatment of RA.

PMID: 18711765 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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Panax Notoginseng Burk Attenuates Impairment of Learning and Memory Functions and Increases ED1, BDNF and beta-Secretase Immunoreactive Cells in Chronic Stage Ischemia-Reperfusion Injured Rats.

Am J Chin Med. 2008;36(4):685-93

Authors: Chuang CM, Hsieh CL, Lin HY, Lin JG

Panax Notoginseng Burk (PN) has been reported to improve blood circulation, as well as learning and memory functions. The purpose of the present study was to investigate the effect of PN on learning and memory functions in chronic cerebral infarct rats. A cerebral infarct animal model was established by blocking the blood flow of both common carotid arteries and right middle cerebral artery for 90 min followed by reperfusion for 4 weeks. PN (0.5 g/kg) was administered orally 3 days per week for 4 weeks, whereas the control group provided bait and water only. The learning and memory functions were estimated by measuring how successful rats were able to negotiate an 8-arm radial maze test; the test was performed after operation once a week for 4 weeks. Finally, the rats were sacrificed and their brains were removed. The brains were sectioned and analyzed for ED1, glial fibrillary acid protein (GFAP), nuclear factor-kappaB, and brain derivative neurotrophin factor (BDNF) and beta-secretase by immunostaining. Cerebral infarct rats given PN were able to successfully navigate the 8-arm radial maze test four weeks after cerebral infarction. PN also increased ED1, BDNF and beta-secretase immunoreactive cells, but did not increase GFAP and NF-kappaB immunoreactive cells. PN attenuated the reduction in learning and memory functions induced by cerebral infarction in cerebral ischemia-reperfusion injured rats; it also increased the amount of activated microglia and BDNF. These data suggest that the effect of PN, at least in part, is closely related to the increase in BDNF that was generated by activated microglia. The effect that PN has on astrocytes, NF-kappaB and beta-secreatase immunoreactive cells requires further study.

PMID: 18711766 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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Effect of Total Flavonoids of Chrysanthemum indicum on the Apoptosis of Synoviocytes in Joint of Adjuvant Arthritis Rats.

Am J Chin Med. 2008;36(4):695-704

Authors: Chen XY, Li J, Cheng WM, Jiang H, Xie XF, Hu R

Chrysanthemum is a traditional Chinese medicine used in China to treat inflammatory diseases. The total flavonoids Chrysanthemum indicum (TFC) were extracted from the dried bud of Chrysanthemum indicum. Our previous study had demonstrated that TFC was a new class of effective anti-inflammation, analgesia and immunoloregulation agents. In this study, we established an adjuvant arthritis (AA) model by injection of Freund's Complete Adjuvant (FCA) to investigate the effect of TFC on the apoptosis of synoviocytes in AA Rats. Synoviocytes isolated from knee joint of rats were treated with different doses of TFC in vitro. Synoviocytes proliferation was measured by MTT assay, and DNA fragmentations were evaluated on agarose gel electrophoresis. The levels of caspase-3 cleaved fragments were analyzed by Western blot. The annexin V stain assay was used to explore the inhibition of caspase-3 on the amelioration of synoviocytes apoptosis. The results showed that TFC inhibited the proliferation of synoviocytes. Electrophoresis showed higher ladders of DNA bands in the TFC group. Cleaved fragments of caspase-3 were increased significantly. Furthermore, the apoptotic synoviocytes were markedly decreased by the caspase-3 specific inhibitor. These results suggest that TFC could induce synoviocytes apoptosis and suppress proliferation of synoviocytes in adjuvant-induced arthritis rats.

PMID: 18711767 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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The protective effect of yi-qi-yang-yin-ye, a compound of traditional chinese herbal medicine in diet-induced obese rats.

Am J Chin Med. 2008;36(4):705-17

Authors: He GW, Qu WJ, Fan B, Jing R, He R

The present study was undertaken to determine the effect of Yi-Qi-Yang-Yin-Ye (Y-Q-Y-Y-Y), a compound of Traditional Chinese Herbal Medicine, on insulin resistance (IR) in the diet-induced obese rat model induced by intravenous injection with a low dose of streptozotocin and fed a high fat and high caloric diet. Y-Q-Y-Y-Y (2, 4, 8 g/kg) was administered via gavage daily for 4 weeks. The results showed that Y-Q-Y-Y-Y treatment decreased the levels of body weight, total cholesterol (TC), triglycerides (TG), low density lipoprotein-cholesterol (LDL-C), free fatty acid (FFA), insulin (INS) and fast blood glucose (FBG) and increased the level of high density lipoprotein-cholesterol (HDL-C) in the diet-induced obese rats. Glucose tolerance was improved in the diet-induced obese rats treated with Y-Q-Y-Y-Y as well as GIR (glucose infusion rate) in the hyperinsulinemic euglycemic clamp experiment compared to the model control rats (p < 0.01). Moreover, treatment with Y-Q-Y-Y-Y up-regulated glycogen contents in both liver and skeletal muscle and increased insulin receptor amounts on the erythrocytes surface as assessed by using (125)I-labeled auto-antibodies against insulin receptors. Taken together, our data suggested that Yi-Qi-Yang-Yin-Ye ameliorates insulin resistance in the diet-induced obese rats.

PMID: 18711768 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)

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The antithrombotic effect of borneol related to its anticoagulant property.

Am J Chin Med. 2008;36(4):719-27

Authors: Li YH, Sun XP, Zhang YQ, Wang NS

Borneol is consumed excessively in China and Southeast Asian countries particularly in combined formula for preventing cardiovascular disease, but few studies were conducted on its effects on thrombosis. In this study, the antithrombotic and antiplatelet activities of borneol were investigated on thrombosis in vivo and on platelet aggregation ex-vivo. In addition, the coagulation parameters and influence on fibrinolytic activity were also assessed. The results showed that borneol had concentration dependent inhibitory effects on arterio-venous shunt and venous thrombosis but no effect on ADP and AA-induced platelet aggregation. Meanwhile, borneol prolonged the coagulation parameters for prothrombin time (PT) and thrombin time (TT), but did not show any fibrinolytic activity. It suggested that the antithrombotic activity of borneol and its action in combined formula for preventing cardiovascular diseases might be due to anticoagulant activity rather than antiplatelet activity.

PMID: 18711769 [PubMed - in process]

(Source: The American Journal of Chinese Medicine)