Acute coronary syndrome, stroke and other ischemic events continue to be the most common causes of mortality and morbidity in the world, and their incidence is rapidly increasing in the developing nations. These cardiovascular disorders clinically manifest as acute atherothrombotic events. Application of oral antiplatelet drugs is a milestone in the therapy of cardiovascular diseases. However, the limited efficacy of these drugs in the setting of arterial thrombosis, their unfavorable side effects, cost-to-benefit issues and the drug resistance phenomenon substantiate the need for the development of new and more efficacious antithrombotic drugs. In recent years, with the progress in the study of the Chinese medicine pharmacology, many Chinese herbs and formulas, as well as active constituents have been reported to possess not only effects on platelet aggregation and activation but also beneficial roles in vascular functions. Compared with currently used antithrombotic agents, herb remedies exert antithrombotic effects in a multi-pathway and multi-target manner. This paper will cover the progress in research on the ameliorating effects of herbal remedies on thrombosis, with focusing on their protection of vascular endothelial cells and inhibition of platelet activation.

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Toad venom, called as ChanSu in China, is a widely used traditional Chinese medicine (TCM) whose active components are mainly bufadienolides. ChanSu could exhibit cardiotonic, anti-microbial, anti-inflammatory and, most importantly, anti-cancer effects. In the present review, reports about the in vitro, in vivo and clinical anti-cancer effects of ChanSu or its representative component, bufalin, were summarized. And, reported anti-cancer mechanisms of cardenolides, structure analogues of bufadienolides, were also introduced. Based on the results got from research of ChanSu/bufalin and the results from cardenolides, possible signal network related to the anti-cancer effects of ChanSu/bufalin was predicted. Furthermore, future potential use of ChanSu in anti-cancer therapy was discussed. Abbreviations: TCM, traditional Chinese medicine; MAPK, mitogen-activated protein kinase; AP-1, activator protein-1; JNK, c-Jun N-terminal protein kinase; PAK, p21-activated kinase; CK2, casein kinase 2; PARP, poly ADP-ribose polymerase; COX-2, cyclooxygenase-2; VEGFR, vascular endothelial growth factor receptor; EGFR, epidermal growth factor receptor; NF-KB, nuclear factor-KB; ERK, extracellular signal-regulated kinase; ROS, reactive oxygen species; Hsp27, heat shock protein 27; TNF, tumor necrosis factor; BECN, Beclin; ATG8, autophagy related 8; Bid, BH3 interacting domain death agonist; AMPK, adenosine monophosphate kinase; mTOR, mammalian target of rapamycin; 4EBP1, eukaryotic translation initiation factor 4E binding protein 1; p70S6K1, ribosomal protein S6 kinase, 70kDa, polypeptide 1; ER, endoplasmic reticulum; AKT, protein kinase B; MMP, matrix metalloproteinase; TIMP, tissue inhibitors of metalloproteinase; TJs, tight junctions; GSK3p, glycogen synthase kinase 3 beta; FAK, focal adhesion kinase; Rho A, ras homolog gene family, member A; MEKK3, MAPK/ ERK kinase 3; MKK7, mitogen-activated protein kinase kinase 7; uPA, urokinase plasminogen activator; ER-a, estrogen receptor-a; TRAIL, TNF-related apoptosis-inducing ligand; STAT3, signal transducer and activator of transcription 3; Mcl-1, myeloid cell leukemia sequence 1; BNPs, bufalin-loaded mPEG-PLGA-PLL-cRGD nanoparticles; Bax, B-cell lymphoma 2-associated X protein; TACE, transcatheter arterial chemoembolization; THM, traditional herbal medicine; ORR, objective response rate; PI3K, phosphoinositide-3-kinase; Bu-BCS-NPs, bufalin encapsulating nanoparticles.

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Yin-Yang theory plays critical role in traditional Chinese medicine (TCM) science. However, there are many competing interpretations of Yin- Yang theory in the context with the development in biology, and no consensus has been established. Here we first propose that osteoblast should be regarded as Yin, while osteoclast should be considered as Yang in bone remodeling compartment (BRC). Our conceptions are consistent with the following key findings: 1)osteoblast and osteoclast both derive from the embryonic ectoderm; 2)osteoblast and osteoclast work collaboratively in BRC to maintain bone homeostasis; 3)the activities of osteoblast and osteoclast are coupled to remain dynamic balance; 4)osteoblast and osteoclast exert their function in ceaseless successions. Moreover, we argue that Yin-Yang relationships exist between osteoblast and osteoclast: osteoblast secretes the receptor activator for nuclear factor-κB ligand (RANKL) and the monocyte/macrophage colony-stimulating factor (M-CSF) and osteoprotegerin (OPG) to positively or negatively regulate osteoclast differentiation and function. Meanwile, osteoclast and bone resorption in turn release cytokines, such as transforming growth factor-β (TGF-β), insulin-like growth factor-1 (IGF-1) from bone matrix, to regulate osteoblast differentiation and function. Next, the unlimited division of Yin-Yang can be applied to divide sublevel of Yin-Yang inside osteoblast or osteoclast. Finally, Yin-Yang relationship of osteoblast and osteoclast is relative. Therefore, we come into the conclusion that the relationships between osteoblast and osteoclast as established in contemporary biology reflect the classic Yin-Yang in bone remodeling. The new Yin-Yang concepts of osteoblast and osteoclast may strengthen basic theory and clinical practice in TCM.

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Objective: Qianliguang (Senecio scandens) is a common Chinese medicinal herb. Qianliguang-containing herbal proprietary products are registered as over-the-counter remedies in China and exported to Western countries. The presence of hepatotoxic pyrrolizidine alkaloids (PAs) has raised concerns about the safety of using Qianliguang and its products. The present study aims at investigation of different types of PAs present in Qianliguang collected from representative locations in China. Methods: In this study, a simple but specific UHPLC-QTOF-MS method for the determination of toxic PAs was developed, based on the characteristic fragment ions specific to different types of PAs. It was successfully applied for the identification and distinguishing of PAs present in Qianliguang and related Senecio species growing in different locations of China. Results: Significant diversity of the PA types and quantities were revealed among the samples tested. The estimated total amounts of toxic PAs in three of the samples exceed the toxic limits of PA intake restricted by WHO, demonstrating the timely and highly demand for regulating both types and quantities of PAs present in Qianliguang. Conclusions: This study provides the methodology for simultaneous identification and quantification of PAs present in herbs without requiring corresponding standards, which could be further used for more systematic investigations of the PA distribution in Qianliguang and other PA-containing herbs.

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Background: Moxibustion is a traditional Chinese medicine (TCM) therapy in which mugwort (Artemisia vulgaris) floss is burned to warm and stimulate acupoints. The modality has been used traditionally for thousands of years. However, smoke-related safety issues have recently been of concern, and little is known about moxa smoke and air quality in the clinical moxibustion environment. Objective: To assess the air quality in a typical moxibustion treatment room using particulate matter (PM) concentration and DNA oxidative damage at PM10. Methods: The study was conducted in August and November to December, 2011, at a TCM clinic in Beijing, China, in a moxibustion treatment room. A moxa-free treatment room and the outdoor area adjacent to the clinic were used as controls. PM10 concentrations were monitored with a portable digital dust indicator. The oxidative capacity of whole and water-soluble fractions of PM10 were detected using plasmid DNA assay. The results were shown as TD40 values; that is, the amount of PM10 that causes plasmid DNA damage of 40%. Results: Average PM10 concentrations in the moxibustion room were 2.56 mg m^-3 in summer and 2.78 mg m^-3 in winter, much higher than at control sites. For whole and water-soluble fractional PM10, the average summer TD40 values collected in the moxibustion room were 791.67 μg ml^-1 and 876.33 μg ml^-1 respectively, and the winter values were 779.86 μg ml^-1 and 879.57 μg ml^-1. These results of winter samples were significantly higher (p < 0.001) than the corresponding results from control sites. However, there was no statistical difference (p = 0.06) between the TD40 values of both the whole and water-soluble fractional PM10 from the moxibustion treatment room, while differences were significant in the general treatment room (p = 0.025) and at the outdoor site (P < 0.001). Conclusion: Our study shows that moxa smoke increases PM10 concentration. However, the oxidative capacity of PM10 in the moxibustion room was much lower than that at control sites with the same particulate burden, and the bioactivity at that site was mainly from the water-soluble fraction, another difference from the controls. This unexpected bioactivity is assumed to relate to the low toxicity of moxa smoke or to its proven antioxidant activity. Overall, further research is needed.

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Traditional Chinese Medicine (TCM) has been popular for thousand years in prevention and treatment of chronic diseases synergistically with Western medicine while producing mild healing effects and lower side effects. Although many TCMs have been proven effective by modern pharmacological studies and clinical trials, their bioactive constituents and the remedial mechanisms are still not well understood. Researchers have made great efforts to explore the real theory of TCM for many years with different strategies. Development of high performance liquid chromatography (HPLC) and mass spectrometry within recent decade can provide scientists with robust technologies for disclosing the mysterious mask of TCM. In this paper, important innovations of HPLC and mass spectrometry are reviewed in the application of TCM analysis from single compound identification to metabolomic strategy. Abbreviations: TCM, Traditional Chinese Medicine; Q-TOF, Quadrupole time-of-flight mass spectrometry; LC, Liquid chromatography; CE, Capillary electrophoresis; SFC, supercritical-fluid chromatography; QQQ, triple quadrapole

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The pathogenesis of cardiac diseases is very complex and involved in many gene transcription and protein expression. How to effectively treat the diseases has become the hotspot of modern medicine. Accumulating evidences over the past decades on integrative medicine have shown us hopeful future prospects. With the development of modern biomedicine, such as sketch mapping genomic sequence, functional genomics, proteomics and pharmacogenetics, more advanced techniques could be applied in elucidating the possibly complicated biological networks, or complex pathological and physiological mechanisms underlying cardiac diseases, by which integrative medicine will also bring out some new and more effective strategies in the treatment of cardiac diseases. Abbreviations: WM, Western Medicine; CDs, cardiac diseases; BP, blood pressure; TCM, Traditional Chinese medicine; CHM, Chinese herbal medicine; CHF, cardiac heart failure; PCI, post-percutaneous coronary intervention; CHD, coronary heart disease; ACS, acute coronary syndrome.

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