The reports of severe adverse effects and fatalities associated with herbal medicinal products adulterated with synthetic compounds have raised global concerns. The objective of this study is to analyze one commercial herbal medicinal product suspected to be adulterated with synthetic drugs in order to identify potential adulterants, to verify if the product contained the herbs listed as ingredients in label claim and to determine quality consistency among different batches of the product. Analyses of suspected product obtained from seven different batches were performed using ultra performance liquid chromatography coupled to quadrupole time-of-flight mass spectrometry (UPLC-Q-TOF-MS) with multiple data processing tools and multivariate analyses. In addition, 23 individual powdered herbs (12 as per label claim and 11 suspected herbs), 11 marker compounds of the labeled herbs and five suspected synthetic drugs as adulterants were also concurrently analyzed to have clear understanding of product composition. Based on our analysis, the major ingredients of studied product were found to be 5 synthetic compounds: caffeine, chlorphenamine, piroxicam, betamethasone and oxethazaine. Three of them have been found to exceed their recommended doses. From the herbal composition analysis, GanCao (Glycyrrhizae radix et rhizoma) was found to be the main ingredient, which is not among the claimed 12 herbs that were supposed to be in the product. Other herbs detected as minor ingredients were MuGua (Chaenomelis fructus), DangGui (Angelicae sinensis radix), and HuangQi (Astragali radix), which are among the 12 herbs that were supposed to be in the product. Based on our results we demonstrated that UPLC-QTOF MS is an effective and versatile tool for the analysis of herbal medicinal products. It is highly desirable to have a streamlined process with automatic workflow and fit-for-purpose database to increase efficiency and productivity of sample analysis. Results of this work also highlight the need for the better quality control and regulatory measures to protect consumers from the potentially harmful effects of such adulterated products.

Objective: To identify common edible and medicinal mushrooms using the internal transcribed spacer (ITS) region. Method: A total of eighty-five samples belonging to forty-three species were used in this study. ITS regions were amplified and sequenced. All ITS regions were analyzed using BLAST and MEGA 5.10 methods. Results: Forty species were identified correctly via BLAST method whereas forty-one species were distinguished via Neighbor joining (NJ) tree. All the species could be distinguished by BLAST combined with NJ tree and ITS sequence characteristics. Conclusion: Forty-three common species of edible and medicinal mushrooms were effectively identified using DNA barcoding technology based on ITS region.

Traditional Chinese medicine (TCM), an ancient medical system, has the advantages of multi-targeting and multi-ingredient preparations, and is different from modern pharmacology. However, because of the complexity of TCM and the limitation of present investigation method, the research for deciphering the scientific basis and systematic features of TCM is difficult to go further. Metabolomics has a significant increased study in recent years and enables mapping of early biochemical changes in disease and hence provides an opportunity to develop predictive biomarkers. Moreover, its method and design resemble those of traditional Chinese medicine. Therefore, it can provide useful tools for exploring essence of TCM, and will help to in-depth understand Chinese medicine syndromes. In this mini-paper, particular attention will be paid to the past successes in applications of robust metabolomics to contribute to small metabolites discovery in TCM development.

Background: There is a growing interest in the possible role of diet in the prevention of rheumatoid arthritis (RA). However, the evidence for diet having a role in the etiology of RA is inconsistent, sometimes conflicting. Objective: To critically appraise the literature to pool the results of studies to clarify the relation between diet risk and RA. Methods: We performed a systematic review using guideline-recommended methodology to evaluate the association between pre-illness diet or diet pattern and the risk of subsequent RA diagnosis. Results: A total of 25 studies met the inclusion criteria. They include 13 cohort studies, 10 case-control studies and 2 nested case-control studies, with a total of 1279810 participants. There were new evidences of a protective effect of long term consumption of alcohol. High sodium intake was associated with an increased risk of RA. Fish intake has consistently been shown to have no effect on the development of RA. Mediterranean diet pattern, Vitamin D intake, and the consumption of long-chain omega-3 acids were not associated with an increased/ decreased risk of RA in every two studies. There were non-statistically significant association between RA and sugar-sweetened soda, red meat, vegetable and fruits in each single study. The association between coffee, tea and RA was consistent, and here exists an inverse relationship between olive oil and RA. Due to the heterogeneity of study designs and analyses, the results could not be pooled. Conclusion: The results of this SR indicate that alcohol consumption and sodium intake may be associated with RA risk, especially evidence from recent studies. Because of some discordant results, the debate continues on whether some other dietary intakes increase or decrease RA risk.

Introduction: Letrozole showed higher ovulation and live birth rates than clomiphene in infertile women with polycystic ovary syndrome (PCOS). Berberine, a major active component of Chinese herbal medicine rhizomacoptidis, has been used to improve insulin resistance to facilitate ovulation induction in women with PCOS, but there is no study reporting the live birth or its potential as a complementary treatment to letrozole. We aim to determine the efficacy of letrozole with or without berberine in achieving live births among 644 infertile women with PCOS in Mainland China. Methods and analysis: This is a prospective, randomized, multicentre, double-blinded, controlled design. Infertile women with PCOS were randomized into three-arm, letrozole and berberine, letrozole and berberine placebo, letrozole placebo and berberine. Data and blood were collected at baseline, the third month and sixth month after treatment, or immediately were collected if subject was pregnant. Statisticians and clinical investigators were blinded to treatment allocation and treatment related study results until the central database was locked for final data extraction and analysis determined. The statistical analysis plan described basic analysis principles, methods commonly encountered in data analysis issues, and the specific statistical procedures for analyzing the primary, secondary, and safety outcomes. Ethics and dissemination: The study was approved by the ethics committee of the First Affiliated Hospital, Heilongjiang University of Chinese Medicine. The study findings will be disseminated through peer-reviewed publications and conference presentations. Trial registration: Chinese Clinical Trial Registry: ChiCTR-TRC-09000376. ClinicalTrials.gov identifier: NCT01116167.

Multiple studies have investigated the associations between fluvatatin and the risk of breast cancer (BC), but their results were conflicting. A meta-analysis of observational studies published regarding this subject was conducted in the present study. It aims to estimate the associations between fluvastatin use and the risk of BC. Pubmed and chinese national knowledge infrastructure (CNKI) database was searched up to January, 2015 to identify eligible observational studies, and the Newcastle-Ottawa Scale (NOS) was used to assess quality of the studies. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated (fixed effect model: Mantel-Haenszel). Heterogeneities were evaluated before the calculation. A sensitivity analysis was also conducted. In total, four studies contributed to the analysis. Overall, fluvastatin use negatively correlated with BC risk (RR = 0.74, 95 % CI = 0.58, 0.95). In conclusion, fluvastatin use may reduce the risk of BC, but more research is needed to confirm this finding.

Objective: The present study aims to investigate whether the anticonvulsant effect of transcutaneous auricular vagus nerve stimulation is associated with balancing the autonomic dysfunction in rats. Methods: Healthy adult male Sprague-Dawley rats were anesthetized with an intraperitoneal injection of 10% urethane. Seizures were evoked by intraperitoneal injection of pentylenetetrazol (PTZ, 60 mg/kg). Femoral vein catheterization was performed for injection of sympathetic agonist and antagonists. Bipolar globe silver electrodes were utilized for epidural EEG recording. Three needles were inserted separately in subcutaneous muscles of left anterior limb, right anterior limb, and left hind limb to record ECG signals. ta-VNS was performed at auricular concha. Results: In comparison with preictal state, the mean heart rate (HR) increased slightly during epileptic seizures (P<0.05). In comparison with ictal state, the mean HR decreased a little at postictal state (P<0.05). When continuous epileptic seizures in EEG traces occurred (in ictal state), vein injection of propranolol hydrochloride (sympathetic antagonist) suppressed the epileptic seizures. When epileptic seizures occurred rarely (in postictal state), vein injection of adrenaline hydrochloride (sympathetic agonist) exacerbated the epileptic seizures. In comparison with pre-stimulation, the integral of EEG traces after ta-VNS decreased (P<0.05), the mean HR decreased (P<0.05), and the high power (HF) of HRV increased (P<0.05) after ta-VNS. Conclusion: The results showed that autonomic dysfunction occurred in epileptic rats characterized by enhanced sympathetic nerve activity. Epileptic seizures in EEG traces decreased, HR decreased and HF increased after ta-VNS, which indicated that ta-VNS may suppress epileptic seizures via balancing the autonomic dysfunction. Abbreviations: SUDEP: sudden unexpected death; HRV: Heart rate variability; HR: heart rate; EEG: electroencephalograph; ECG: electrocardiograph; LF: low-frequency; HF: high-frequency; VNS: vagus nerve stimulation; ta-VNS: transcutaneous auricular vagus nerve stimulation; NTS: nucleus tractus solitaries; UCMS: unpredictable chronic mild stress. Received 7 July 2016; Accept 8 October 2016