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TCM for flu receives FDA approval for clinical tests
(Xinhua) Updated: 2015-12-25 14:01

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This file photo taken on April 8, 2015 shows a box of Lianhuaqingwen capsule.[Photo/IC]

SHIJIAZHUANG - A listed Chinese herbal medicine maker on Thursday said its compound flu formula has received approval from the U.S. Food and Drug Administration (FDA) for clinical tests.

The decision has paved the way for Chinese herbal medicine to enter the U.S. market.

The Shenzhen-listed Yiling Pharmaceutical said that its wholly owned subsidiary in the U.S. received the approval for trials for its Lianhuaqingwen capsule, a compound herbal medicine for treating the common cold and influenza virus.

Chinese therapists have adopted prescriptions from ancient records on herbal medicine and used modern research on viruses and bacteria in developing the medicine.

The Western medical circle has long questioned the efficacy and safety of Chinese herbal medicine due to the complex herbal ingredients and pharmacology of traditional Chinese medicine.

When the influenza type A H1N1 virus broke out in 2009, nine Chinese hospitals that participated in international exchanges for treating the epidemic used the medicine in clinical treatment, which tested its efficacy and safety. The hospitals' records of using the drug during the epidemic have been recognized by the World Health Organization.

The Chinese medicine has shown effectiveness in treating flu symptoms including fever, nasal congestion, cough and muscle soreness in clinical tests.

As one of the top-selling anti-influenza drugs in China, the capsule is available in 120,00 pharmacies around China and is also available in Hungary, Canada and Indonesia.

The company based in Shijiazhuang, capital of north China's Hebei Province, said getting an FDA certificate would further enhance the herbal medicine's standing in the international market.



you aware the drug industry in North America is heavily regulated to keep new players out. the fact that many westerners and chinese are using TCM and wary on big pharma is a testament to the effectiveness of TCM. there's thousands of years historical relevance. if it did not work, TCM would have died out long before westerners came out of caves
 
China has 50,000 TCM medical institutions
2017-01-14 17:02 | Xinhua | Editor: Gu Liping

China has 50,000 medical and health institutions that offer Traditional Chinese Medicine (TCM) therapies, according to China's TCM authority.

The State Administration of Traditional Chinese Medicine revealed that 40 percent of the population have access to TCM programs at the local level.

Wang Guoqiang, director of the administration, said that in the first nine months of 2016, the average fee for TCM treatments and the per capita in-patient cost at public TCM hospitals were 10.82 percent and 23.54 percent lower than treatments offered by other public hospitals.

Wang said that the public have benefited from TCM treatment being included in the country's medical insurance system.

He also called for a bigger role for TCM in disease prevention and treatment, and rehabilitation.

China's top legislature last month adopted a law on TCM, giving it a bigger role in the country's medical system.


********

When it comes to China scale, the numbers are huge.
Nobody bats an eyelid when you say 50,000.
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you aware the drug industry in North America is heavily regulated to keep new players out. the fact that many westerners and chinese are using TCM and wary on big pharma is a testament to the effectiveness of TCM. there's thousands of years historical relevance. if it did not work, TCM would have died out long before westerners came out of caves

The cavemen give lecture about TCM.

***

Wikipedia called irresponsible on acupuncture

(China Daily) 08:27, January 20, 2017

A top practitioner of traditional Chinese medicine has called Wikipedia irresponsible over its entry on acupuncture, which calls the practice "pseudoscience".

Acupuncture is not based on widely accepted scientific knowledge, according to the English version of the free online encyclopedia, which also says that TCM in general is "fraught with pseudoscience".

But Li Zhenji, vice-chairman of the World Federation of Chinese Medicine Societies, countered that the "efficacy of acupuncture has been proved by history and is widely practiced in China and abroad".

"It's irresponsible to list the medical technique as pseudoscience," he added.

Statistics from the World Health Organization show acupuncture has been practiced in 103 countries besides China. In 18 of them, Li said, acupuncture treatments are covered by health insurance, which he said is a recognition of its efficacy.

Liu Baoyan, head of the World Federation of Acupuncture-Moxibustion Societies, said the Wikipedia entry "won't hurt people's confidence, with its efficacy proved already over time, but it could serve as a reminder for us to conduct more clinical studies on its therapeutic effects".

TCM is largely experience-based, he said, adding that its therapies, such as acupuncture, lack the lab-based evidence that is crucial in Western medicine.

"TCM should catch up in that sense, presenting itself with an approach more acceptable to the outside world," he said, urging the Chinese government to invest more in scientific research and studies of the ancient medical science.

The WHO said via an e-mail to China Daily that its objectives regarding TCM are to build the knowledge base, strengthen national regulatory systems and promote universal health coverage by integrating traditional and complementary medicines into healthcare services.

Li called on Wikipedia, based on user-edited content, to make immediate changes to its article on acupuncture.

Previously, TCM supporters from China and other regions petitioned the Wikimedia Foundation, which operates the website, but a spokeswoman told Legal Evening News last week that Wikipedia content is contributed and edited by users after certain procedures, including verification.

She said the foundation would follow the issue closely but couldn't make any changes itself.

On Wednesday, President Xi Jinping presented a bronze copy of an acupuncture statue to Margaret Chan, the WHO director-general, as a gift during a visit to the headquarters of the UN health agency in Geneva, Switzerland.

The copy features more than 600 acupuncture points.

According to Liu, the first such copy was reportedly made during the Song Dynasty (960-1279) as a testing tool for students. Acupuncture points were covered by wax in the test. If a student correctly inserted a needle into the points, mercury that was infused beforehand would spill out.

Chan has urged the Chinese government to promote acupuncture and TCM worldwide to benefit more people.
 
The cavemen give lecture about TCM.

***

Wikipedia called irresponsible on acupuncture

(China Daily) 08:27, January 20, 2017

A top practitioner of traditional Chinese medicine has called Wikipedia irresponsible over its entry on acupuncture, which calls the practice "pseudoscience".

Acupuncture is not based on widely accepted scientific knowledge, according to the English version of the free online encyclopedia, which also says that TCM in general is "fraught with pseudoscience".

But Li Zhenji, vice-chairman of the World Federation of Chinese Medicine Societies, countered that the "efficacy of acupuncture has been proved by history and is widely practiced in China and abroad".

"It's irresponsible to list the medical technique as pseudoscience," he added.

Statistics from the World Health Organization show acupuncture has been practiced in 103 countries besides China. In 18 of them, Li said, acupuncture treatments are covered by health insurance, which he said is a recognition of its efficacy.

Liu Baoyan, head of the World Federation of Acupuncture-Moxibustion Societies, said the Wikipedia entry "won't hurt people's confidence, with its efficacy proved already over time, but it could serve as a reminder for us to conduct more clinical studies on its therapeutic effects".

TCM is largely experience-based, he said, adding that its therapies, such as acupuncture, lack the lab-based evidence that is crucial in Western medicine.

"TCM should catch up in that sense, presenting itself with an approach more acceptable to the outside world," he said, urging the Chinese government to invest more in scientific research and studies of the ancient medical science.

The WHO said via an e-mail to China Daily that its objectives regarding TCM are to build the knowledge base, strengthen national regulatory systems and promote universal health coverage by integrating traditional and complementary medicines into healthcare services.

Li called on Wikipedia, based on user-edited content, to make immediate changes to its article on acupuncture.

Previously, TCM supporters from China and other regions petitioned the Wikimedia Foundation, which operates the website, but a spokeswoman told Legal Evening News last week that Wikipedia content is contributed and edited by users after certain procedures, including verification.

She said the foundation would follow the issue closely but couldn't make any changes itself.

On Wednesday, President Xi Jinping presented a bronze copy of an acupuncture statue to Margaret Chan, the WHO director-general, as a gift during a visit to the headquarters of the UN health agency in Geneva, Switzerland.

The copy features more than 600 acupuncture points.

According to Liu, the first such copy was reportedly made during the Song Dynasty (960-1279) as a testing tool for students. Acupuncture points were covered by wax in the test. If a student correctly inserted a needle into the points, mercury that was infused beforehand would spill out.

Chan has urged the Chinese government to promote acupuncture and TCM worldwide to benefit more people.
Wikipedia is fake encyclopedia. I'm surprised it still exist. They are losing money fast. People stop donating to this mouth piece. No pun intended . Let it bankrupt.
The fact that you cannot quote Wikipedia in school essay is a testament that Wikipedia is just full of bullshit.
 
Public Release: 14-Feb-2017
Traditional Chinese medicine in HIV cure issue of AIDS Research & Human Retroviruses
Mary Ann Liebert, Inc./Genetic Engineering News

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AIDS Research and Human Retroviruses, published monthly online with open access options and in print, presents papers, reviews, and case studies documenting the latest developments and research advances in the molecular biology of HIV and SIV and innovative approaches to HIV vaccine and therapeutic drug research, including the development of antiretroviral agents and immune-restorative therapies.
Credit: Mary Ann Liebert, Inc., publishers


New Rochelle, NY, February 14, 2017--A special issue on progress toward a cure for HIV includes a description of a previously unreported study started in the early 2000s that describes AIDS patients currently ages 51-67 in good health. These nine individuals were treated with a unique formula of traditional Chinese herbal medicine (TCM) from 2001-2006 or longer, with or without occasional antiviral therapy added later. The fact that the patients currently have low or undetectable HIV in their systems is unexpected and intriguing, and suggests a potential promise of TCM as a functional cure for HIV/AIDS, as discussed in a Letter to the Editor in the special issue of AIDS Research and Human Retroviruses, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. The Letter to the Editor is available open access on the AIDS Research and Human Retroviruses website.

In "Long-Term Survival of AIDS Patients Treated with Only Traditional Chinese Medicine," Yifei Wang, Fujun Jin, Qiaoli Wang, and Zucai Suo, Jinan University (Guangdong, China) and The Ohio State University (Columbus), report that most of the individuals in this small study have undetectable viral loads, with one patient having a low viral load. Their CD4+ counts and CD4+/CD8+ ratios are all excellent.

In an accompanying Editorial entitled "Can a Traditional Chinese Medicine Contribute to a Cure for HIV?" Thomas Hope, PhD, Editor-in-Chief of AIDS Research and Human Retroviruses and Professor of Cell and Molecular Biology at Northwestern University, Feinberg School of Medicine (Chicago, IL), while pointing out the limitations in interpreting the outcome of this small, non-placebo-controlled study, comments on the importance of putting "these observations into the hands of the HIV research community." He writes, "I believe there should be some effort to further explore this phenomenon."

Both the Letter to the Editor and Editorial are part of a new Special Issue on HIV Cure Research published in AIDS Research and Human Retroviruses.


Traditional Chinese medicine in HIV cure issue of AIDS Research & Human Retroviruses | EurekAlert! Science News

Paper:
Wang Yifei, Jin Fujun, Wang Qiaoli, and Suo Zucai.
Long-Term Survival of AIDS Patients Treated with Only Traditional Chinese Medicine. AIDS Research and Human Retroviruses. February 2017, 33(2): 90-92. DOI:10.1089/aid.2016.0288
 
New research set to improve traditional Chinese cancer treatment
March 9, 2017
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Chan Su is a traditional Chinese medicine derived from toad by-products. Credit: University of Queensland

Dried skin secretions from toads could soon be used in a treatment for the benefit of cancer patients.

Researchers from The University of Queensland are collaborating with colleagues at The Hong Kong Polytechnic University (PolyU) in China to develop a cancer treatment originating from Chan Su, a traditional Chinese medicine derived from toad by-products.

Dr Harendra Parekh from the Pharmacy Australia Centre of Excellence (PACE) in UQ's School of Pharmacy said Chan Su was used in China to treat heart failure, sore throats, skin conditions and other ailments.

"It also contains molecules - some of which are toxins and steroids - that are used in Chinese clinics for the treatment of various cancers," Professor Parekh said.

"Our collaboration with PolyU researcher Dr Sibao Chen has focussed on developing a soluble formulation of purified bufalin steroid, a key component of Chan Su which doesn't dissolve easily, making it difficult to administer as a medicine.

"Working together, the two research teams hope to show bufalin's anti-cancer effect in cell-based laboratory tests.

"Given the market acceptance of Chan Su as a traditional medicine in China, the jointly-developed technology will be further advanced and taken to market there."

PolyU will lead the patent prosecution process in China and facilitate further development of the treatment, having collaborated with UniQuest, UQ's main commercialisation company.

UniQuest CEO Dr Dean Moss said the collaboration presented some exciting opportunities.

"This deal is a good example of a commercial outcome from UQ's China engagement strategy," Dr Moss said.

"Our partner will lead on the commercialisation of our joint technology in China and, at any time, we could look to commercialise into other parts of the world with the right partner."

Director of PolyU's Innovation and Technology Development Office Professor Terence Lok-ting Lau said he was delighted to see the project progress from humble beginnings.

"This Australia-China collaboration began with a seed grant from the Shenzhen Government of China, so we are delighted that it has progressed into a potential product which combines novel technologies with traditional Chinese medicine," Professor Lau said.


New research set to improve traditional Chinese cancer treatment |
Medical Xpress
 
Scientists unlock TCM drug's role in weight loss
By Zhang Zhihao (China Daily) 08:41, April 18, 2017

Chinese scientists have identified the chemical mechanism of celastrol, which they call one of the most potent natural weight-loss agents, marking another step toward its possible future development into a major weight-loss drug.

The compound is extracted from the roots of thunder god vine, a toxic herb used in traditional Chinese medicine for centuries to cure arthritis and autoimmune diseases. In TCM, however, it is used in tiny amounts, mainly to treat severe diseases, because of its potentially dangerous side effects.

A research team led by Zhang Xiaokun, president of Xiamen University's Institute for Biomedical Research, found celastrol can change a cell's metabolism by eliminating inflamed mitochondria, leading to weight loss. Mitochondria are the cell's "energy factory".

"This is a huge step in turning celastrol into a feasible and safe medicine for humans," he said. "Celastrol could be a powerful tool to treat patients suffering from obesity and associated complications, such as Type 2 diabetes, heart disease and fatty liver."

Celastrol has long been a hot subject in biomedicine. In 2007, Cell, a prestigious science journal, listed celastrol with the discovery of antimalarial drug artemisinin-which won chemist Tu Youyou the Nobel Prize in 2015-among five natural herbal compounds with the most potential for modern medicine.

In 2015, scientists at Boston Children's Hospital and Harvard Medical School discovered celastrol can help obese mice lose up to 45 percent of their body fat by enhancing a cell's reaction to an appetite-suppressing hormone called leptin.

However, scientists did not know exactly how celastrol affects a cell's bioactivities. Since celastrol and the plant it comes from are extremely toxic, "some people were very skeptical or even objected to the idea that people can eat such a thing", Zhang said. "After all, the vine has a scary, centuries-old nickname: gut-cutting grass."

Terrifying as it may sound, on a cellular level, "celastrol may be beneficial" because it acts on an orphan receptor called Nur77, which induces inflamed mitochondria to dissolve, effectively taking out the root cause of many chronic inflammation diseases such as obesity, tumors and metabolic diseases, he said.

Mitochondria play a key role in cellular death, immunity and inflammation. By killing the malfunctioning mitochondria, celastrol can help control cell metabolism and increase a cell's sensitivity to leptin, a hormone that inhibits hunger, thus leading to weight loss, Zhang added.

Zhang said his team, whose findings were published this month by Molecular Cell, an international science journal, will now focus on how celastrol regulates metabolism in greater detail and find ways to reduce the substance's toxicity while keeping its weight loss potency.

Also, scientists are looking for other receptors for celastrol that may affect cells differently and possibly offer new solutions to chronic metabolic or autoimmune diseases such as rheumatoid arthritis, tumors and AIDS, he added.
 
Acupuncture can effectively reduce period pain: study
Source: Xinhua| 2017-07-18 12:32:54|Editor: Yamei



SYDNEY, July 18 (Xinhua) -- Acupuncture, a traditional Chinese medical practice, can effectively reduce the severity and duration of period pain, a new study has found.

In the small study carried out by researchers in Australia and New Zealand, more than half of 74 women aged between 18 and 45 reported at least 50 percent reduction in the severity of their period pain after receiving acupuncture therapy, the Daily Mail online reported on Monday.

During the study, the women underwent 12 acupuncture treatments, either manual or electro, in three months. In their diaries, many reported significant alleviation in "peak pain" during the first three days of their period and in average pain experienced over their entire period, with the need for pain-relieving medications reduced.

Such effects sustained for 12 month, the study showed.

Meanwhile, the acupuncture treatments have also helped relieve secondary symptoms such as headache, nausea and mood swing, according to the study published in the journal PLOS One.

This was "unexpected and will be explored further in future, large trials," said Mike Armour, a postdoctoral research fellow at Western Sydney University's National Institute of Complementary Medicine.

The researchers also found that manual acupuncture, during which needles are inserted into certain points of the body, resulted in more relief of period pain than electro-acupuncture.

Acupuncture has been around for thousands of years, and traditional Chinese theory suggests needle placement helps balance the body's energy flow, called "qi".
 
Combined treatment of TCM and modern medicine effective in treating liver cirrhosis

By CGTN's Luo Yu and Li Jian
2017-09-18 11:15 GMT+8

Traditional Chinese Medicine (TCM) has been advancing and evolving for thousands of years. Its practitioners are now working alongside modern medical scientists to prevent and treat diseases in China, including hard-to-cure liver cirrhosis.

According to the gastroenterology department of the First Affiliated Hospital of Henan University of TCM in central China’s Henan Province, the rate of treating liver cirrhosis effectively is around 70 percent without applying Chinese herbs and TCM therapies.

However, when TCM and modern medical science are combined, the success rate reaches nearly 90 percent.

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A nurse monitors the screen of a medical equipment. /CGTN Photo

"Generally speaking, after two or three years of treatment, the hard lump on the liver can be resolved. And patients previously diagnosed with liver cirrhosis will no longer be detected by ultrasonography," said Dr. Zhao Wenxia, chief physician of the gastroenterology department.

"If we only use western medicine without applying traditional Chinese herbs and other therapies, the infection can be controlled, but many other complications such as spleen enlargement and portal hypertension will continue to exist," Zhao added.

The hospital applies both modern medical science and TCM. For example, liver cirrhosis can be detected by a FibroScan device that evaluates the degree of stiffness of the organ.

Complications such as varicose veins caused by the disease can be treated with endoscopes, and antiviral drugs can help reverse liver fibrosis and even early cirrhosis.

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Liver cells are observed under the microscope. /CGTN Photo

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Varicose veins caused by the disease can be treated with endoscopes. /CGTN Photo

In the meantime, TCM plays a pivotal part in curing the disease as well. Acupuncture can relieve pain immediately, while ginger moxibustion (a form of heat therapy) can improve immunity and quality of life. Chinese herbal medicine can significantly decrease pressure in the portal vein and the splenic vein. Even late evening herbal diets have been proven to enhance nutrition in patients and elevate their quality of life.

"I got liver disease nearly three decades ago and it has just developed into liver cirrhosis. The development of the disease is low. Why? I think that's mainly because I use Chinese herbal medicine and other TCM therapies. Apart from antiviral drugs, 80 percent percent of my prescriptions are traditional Chinese medicine," one patient told CGTN.

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Ginger moxibustion can improve a patient's immunity and quality of life. /CGTN Photo

Many medical experts say that TCM and modern medicine have two different theoretical systems, but there are signs the two are converging.

"TCM is macro. It emphasizes treating the whole body. Western medicine is micro and it focuses on molecules, cells and tissues. For example, when a patient develops liver disease, western medicine tends to think of it as one type of disease but TCM treatment is holistic. But now modern medicine and TCM converge in looking at illness," Dr. Zhao added.

More and more scientific evidence shows that both TCM and modern medicine share commonalities at the molecular level and they work pretty well together in areas such as infertility and liver cirrhosis.

It remains to be seen if such a marriage is the future of medical science, but TCM is expected to go much further in its process of modernization as it advances and integrates with modern medical science.
 
200,000 foreigners visit China for traditional medicine treatment annually
Source: Xinhua| 2017-09-28 16:44:36|Editor: An



HOHHOT, Sept. 28 (Xinhua) -- About 200,000 foreign patients come to China every year seeking traditional Chinese medicine treatment, a senior health official said Thursday.

Ma Jianzhong, deputy head of State Administration of Traditional Chinese Medicine, told a medical exposition in Inner Mongolia Autonomous Region that traditional Chinese medicine had gained increased recognition around the world.

Ma said that other than treating hundreds of thousands of foreign patients, China trained about 13,000 foreign students in traditional Chinese medicine every year.

He said the country had also opened 16 overseas centers in countries participating in the Belt and Road Initiative.

Based on Chinese philosophy and traditions, traditional Chinese medicine is entirely different medical from Western medicine. It puts more emphasis on maintaining the balance and harmony of the human body's energy than treating specific ailments.

Some of the most widely known forms of traditional Chinese medicine include acupuncture, cupping, massage and herbal medicines.

Ma said traditional Chinese medicine is China's contribution to creating a peaceful and healthy world.
 
Researchers find fungus used in traditional medicine can fight cancer
2017-10-23 19:43 GMT+8

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‍Chinese scientists have found evidence that a fungus used in traditional Chinese medicine widely sought by the public for its healing powers, also carries anti-cancer benefits.

The scientists found there was an interaction between two anti-cancer compounds in the fungus Cordyceps militaris.

The first, cordycepin, was noted in Cordyceps militaris in 1950, but how it interacted remained unknown. The second, pentostatin, was first identified from a bacterium and was developed as a commercial drug to treat leukemia and other cancers in the 1990s.

"For the first time, we decoded the biosynthesis mechanism of cordycepin in the fungus, and during the research we unexpectedly discovered pentostatin," said Wang Chengshu, head of the research team at the Institute of Plant Physiology and Ecology, a branch of the Shanghai Institutes for Biological Sciences of the Chinese Academy of Sciences.

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Cordyceps militaris /Xinhua Photo

"These two compounds coexist in fungal cells in the form of a protector and protege – that is to say, cordycepin is synthesized with the coupled production of pentostatin to protect the stability of the former," he said.

Their research also showed that the fungus initiates a detoxification process when the cordycepin in the body reaches an excessively high level, which can be toxic.

"It reminds us that excessive intake of the fungus may not be healthful," Wang said.

A paper about the team's findings after nearly eight years of research was published on the website of the international journal Cell Chemical Biology on Thursday.

Cordyceps militaris, bright orange-yellow mushrooms sold as a fresh supplement for soups and stews, is a much more affordable alternative to caterpillar fungus.

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Cordyceps militaris is a much more affordable alternative to caterpillar fungus. /China Daily Photo

"However, in the research, we've proved that neither of the compounds is produced in caterpillar fungus," Wang said.

Cordyceps fungi are popular in China for their widely believed immunity-enhancing and energy-strengthening properties. Their uses in medical treatment date back to the Compendium of Materia Medica, a book widely deemed the encyclopedia of traditional Chinese medicine written during the Ming Dynasty (1368-1644).

"There have been long-running arguments as to whether such fungi are antibacterial or anti-cancer, and people use them based on experience in most cases. It's a major advance that our team scientifically proved that Cordyceps militaris really carries such properties," said Guo Jinhua, Party chief of the institute.
 
Chrysanthemum Genome Sequenced
Dec 8, 2017 by Enrico de Lazaro

A team of researchers from the Institute of Chinese Materia Medica, China Academy of Chinese Medical Sciences, and the Amway Botanical Research Center has sequenced the genome of Chrysanthemum indicum (Indian chrysanthemum).

The Indian chrysanthemum (Chrysanthemum indicum). Image credit: KENPEI / CC BY-SA 3.0.

Chrysanthemums are flowering plants of the genus Chrysanthemum (family Asteraceae) native to Asia and northeastern Europe.

They are widely cultivated for ornamental, culinary, and medicinal uses throughout the world. For example, in Italy, chrysanthemum production covers 1,180 hectares with 437 million plants and continues to grow.

“Chrysanthemum is a highly evolved flowering plant that includes many cultivar varieties of the species,” said team member Dr. Jia Chen, Vice President of the Amway Botanical Research Center.

“The genus Chrysanthemum is a colossal taxonomic unit with many cultivar varieties of each species. Put it this way, the thousands of ornamental chrysanthemums seen at flower shows and in Traditional Chinese Medicine (TCM) are classified to the same species.”

“We are very excited to learn more about what this means for our studies of Traditional Chinese Medicine plants and how to integrate these findings into future product development.”

Dr. Chen and colleagues determined that the Chrysanthemum indicum genome has about 3 billion DNA base pairs — nearly the size of the human genome.

They also successfully identified 101,745 putative genes in the plant’s genome.

“The genome sequencing of Chrysanthemum indicum was accomplished through one of the most advanced sequencing technologies available — nanopore sequencing,” the researchers noted.

In addition to the Chrysanthemum indicum genome, they sequenced and analyzed the transcriptome of another Chrysanthemum species, Chrysanthemum morifolim.

“The transcriptome information of an important commercial cultivar of Chrysanthemum morifolim will greatly benefit the further and in-depth study on Chrysanthemum by scientists around the world,” the scientists said.


Chrysanthemum Genome Sequenced | Genetics | Sci-News.com
 
News | 11 December 2017
Acupuncture in cancer study reignites debate about controversial technique
Large study suggests acupuncture could help women stick with unpleasant cancer treatments.


Jo Marchant


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Acupuncture may be effective in easing pain for people with breast cancer, according to results from a large, multi-site trial.Credit: UIG via Getty

One of the largest-ever clinical trials into whether acupuncture can relieve pain in cancer patients has reignited a debate over the role of this contested technique in cancer care.

Oncologists who conducted a trial of real and sham acupuncture in 226 women at 11 different cancer centres across the United States say their results — presented on 7 December at the San Antonio Breast Cancer Symposium in Texas — conclude that the treatment significantly reduces pain in women receiving hormone therapy for breast cancer. They suggest it could help patients stick to life-saving cancer treatments, potentially improving survival rates. But sceptics say it is almost impossible to conduct completely rigorous double-blinded trials of acupuncture.

Interest in acupuncture has grown because of concerns over the use of opioid-based pain-relief drugs, which can have nasty side effects and are extremely addictive. Many cancer centres in the United States therefore offer complementary therapies for pain relief. Almost 90% of US National Cancer Institute-designated cancer centres suggest that patients try acupuncture, and just over 70% offer it as a treatment for side effects1. That horrifies sceptics such as Steven Novella, a neurologist at Yale University School of Medicine and founder of the blog Science-Based Medicine. Acupuncture has no scientific basis, he says; recommending it is “telling patients that magic works”.

But Dawn Hershman, an oncologist at Columbia University Medical Centre in New York City, decided to investigate whether acupuncture could help to reduce the pain caused by aromatase inhibitors, one of the most commonly used treatments for breast cancer. These drugs lower oestrogen levels and, when taken over five to ten years, they reduce the risk that the cancer will recur. But they cause side effects, especially arthritis-like pain, which can cause up to half of women to take the medication irregularly, or to stop taking it altogether.

Meaningful relief

After a small trial at Columbia showed positive results2, Hershman and her colleagues conducted a larger one. The 226 women were placed into one of three groups: one that received acupuncture; another that got a sham treatment in which needles were inserted at non-acupuncture points, less deeply into the skin; and a third that received no treatment. The researchers trained the acupuncturists to deliver consistent treatments3. The women were asked to record their pain levels.

After a six-week course of treatment, ‘worst pain’ in the true-acupuncture group was about one point lower on a scale from zero to ten than in either the sham or no-treatment groups. This is a statistically significant effect, and larger than is seen with alternatives such as duloxetine, an antidepressant used to help reduce pain in people with cancer4. Meanwhile, the percentage of participants whose pain improved by at least two points (which Hershman describes as a “clinically meaningful” change) almost doubled, from around 30% in both control groups to 58% in the true-acupuncture group. Unlike with duloxetine, the benefits persisted after the acupuncture course had finished. Hershman concludes that acupuncture is a “reasonable alternative” to prescription medications such as duloxetine or opiates, neither of which were part of this study.

Rollin Gallagher, director of pain-policy research at the University of Pennsylvania in Philadelphia, and editor-in-chief of the journal Pain Medicine, welcomes the trial. “These are careful methodologists,” he says. “There is moderate to good evidence in clinical trials for acupuncture now, and this is another contribution.”

Placebo effect?

But sceptics have criticized the research. Regardless of how rigorous the trial was in other respects, the acupuncturists knew whether they were delivering real or sham treatment, says Edzard Ernst, emeritus professor of complementary medicine at the University of Exeter, UK. This could have influenced how the recipients responded, he says. “I fear that this is yet another trial suggesting that acupuncture is a ‘theatrical placebo’.”

But Jun Mao, chief of integrative medicine at the Memorial Sloan Kettering Cancer Centre in New York City, says that acupuncture trials such as Hershman’s are better blinded than studies of approaches such as palliative care, cognitive behavioural therapy or exercise, in which participants inevitably know what treatment they are receiving. Sceptics “accept trial results from those fields readily, but they make a special case against acupuncture”, he says. “It’s not fair to use that single argument to shut down the whole field.”

Gallagher says that many studies suggest that acupuncture triggers neurophysiological changes that are relevant to pain, in conditions from carpal tunnel syndrome to fibromyalgia5. Integrating acupuncture into mainstream medical care, rather than outsourcing it to independent, and perhaps unregulated, acupuncturists, minimizes the risk of lending authority to unscientific practitioners, he says. “That’s why we need to bring it in.”

For Hershman, the sceptics’ concerns risk losing sight of what’s best for patients. “To say that something that is pharmacologic is better, when it causes horrible toxicities, is also problematic,” she says. With acupuncture, “we tried to do the most rigorous study we could. At the end of the day, if it keeps somebody on their medication or improves the quality of their life, then it’s worth it.”


Acupuncture in cancer study reignites debate about controversial technique | Nature
 
NEWS FEATURE | 26 SEPTEMBER 2018
Why Chinese medicine is heading for clinics around the world
For the first time, the World Health Organization will recognize traditional medicine in its influential global medical compendium.

David Cyranoski

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A practitioner of traditional Chinese medicine treats a patient in Zhejiang province in China.Credit: China Daily/Reuters

Choi Seung-hoon thought he had an impossible assignment. On a grey autumn day in Beijing in 2004, he embarked on a marathon effort to get a couple of dozen representatives from Asian nations to boil down thousands of years of knowledge about traditional Chinese medicine into one tidy classification system.

Because practices vary greatly by region, the doctors spent endless hours in meetings that dragged over years, debating the correct location of acupuncture points and less commonly known concepts such as ‘triple energizer meridian’ syndrome. There were numerous skirmishes between China, Japan, South Korea and other countries as they vied to get their favoured version of traditional Chinese medicine (TCM) included in the catalogue. “Each country was concerned how many terms or contents of its own would be selected,” says Choi, then the adviser on traditional medicine for the Manila-based western Pacific office of the World Health Organization (WHO).

But over the next few years, they came to agree on a list of 3,106 terms and then adopted English translations — a key tool for expanding the reach of the practices.

And next year sees the crowning moment for Choi’s committee, when the WHO’s governing body, the World Health Assembly, adopts the 11th version of the organization’s global compendium — known as the International Statistical Classification of Diseases and Related Health Problems (ICD). For the first time, the ICD will include details about traditional medicines.

The global reach of the reference source is unparalleled. The document categorizes thousands of diseases and diagnoses and sets the medical agenda in more than 100 countries. It influences how physicians make diagnoses, how insurance companies determine coverage, how epidemiologists ground their research and how health officials interpret mortality statistics.

The work of Choi’s committee will be enshrined in Chapter 26, which will feature a classification system on traditional medicine. The impact is likely to be profound. Choi and others expect that the inclusion of TCM will speed up the already accelerating proliferation of the practices and eventually help them to become an integral part of global health care. “It will definitely change medicine around the world,” says Choi, now the board chair of the National Development Institute of Korean Medicine in Gyeongsan.

Whether this is a good thing depends on whom you talk to. For Chinese leaders, the timing could not be better. Over the past few years, the country has been aggressively promoting TCM on the international stage both for expanding its global influence and for a share of the estimated US$50-billion global market.

Medical-tourism hotspots in China are drawing tens of thousands of foreigners for TCM. Overseas, China has opened TCM centres in more than two dozen cities, including Barcelona, Budapest and Dubai in the past three years, and pumped up sales of traditional remedies. And the WHO has been avidly supporting traditional medicines, above all TCM, as a step towards its long-term goal of universal health care. According to the agency, traditional treatments are less costly and more accessible than Western medicine in some countries.

Many Western-trained physicians and biomedical scientists are deeply concerned, however. Critics view TCM practices as unscientific, unsupported by clinical trials, and sometimes dangerous: China’s drug regulator gets more than 230,000 reports of adverse effects from TCM each year.

With so many questions about TCM’s effectiveness and safety, some experts wonder why the WHO is increasing support for such practices. One of them is Donald Marcus, an immunologist and professor emeritus at Baylor College of Medicine in Houston, Texas, and a prominent TCM critic. In his opinion, “at some point, everyone will ask: why is the WHO letting people get sick?”

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A pharmacy in a traditional-medicine hospital in Beijing dispenses medications.Credit: David Gray/Reuters

Different approach

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.

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A patient is treated with heated cups at a traditional-medicine clinic in south China’s Hainan Province.Credit: Xinhua/Avalon.red

Critics argue that there is no physiological evidence that qi or meridians exist, and scant evidence that TCM works. There have been just a handful of cases in which Chinese herbal treatments have proved effective in randomized controlled clinical trials. One notable product that has emerged from TCM is artemisinin. First isolated by Youyou Tu at the China Academy of Traditional Chinese Medicine in Beijing, the molecule is now a powerful treatment for malaria and won Tu the Nobel Prize in Physiology or Medicine in 2015.

But scientists have spent millions of dollars on randomized trials of other TCM medicines and therapies with little success. In one of the most comprehensive assessments, researchers at the University of Maryland school of medicine in Baltimore surveyed 70 systematic reviews measuring the effectiveness of traditional medicines, including acupuncture. None of those studies could reach a solid conclusion because the evidence was either too sparse or of poor quality1. The NIH’s National Center for Complementary and Integrative Health in Bethesda, Maryland, concludes that “for most conditions, there is not enough rigorous scientific evidence to know whether TCM methods work for the conditions for which they are used”.

In response to queries by Nature, the WHO said that its Traditional Medicine Strategy “provides guidance to Member States and other stakeholders for regulation and integration, of safe and quality assured traditional and complementary medicine products, practices, and practitioners”. It emphasized that the goal of the strategy “is to promote the safe and effective use of traditional medicine by regulating, researching and integrating traditional medicine products, practitioners and practice into health systems, where appropriate”.

China’s support of TCM started with former leader Mao Zedong, who reportedly didn’t believe in it but thought it a could reach under-served populations. Current Chinese President Xi Jinping has strongly supported TCM and, in 2016, the powerful state council developed a national strategy that promised universal access to the practices by 2020 and a booming industry by 2030. That strategy includes supporting TCM tourism, which steers large numbers of people to clinics in China. Every year, tens of thousands of mostly Russian tourists flock to Hainan off the southern coast seeking relief through TCM. The government has plans to build 15 TCM ‘model zones’ similar to the one in Hainan by 2020.

The country also has global ambitions. China’s Belt and Road trade initiative calls for creating 30 centres by 2020 to provide TCM medical services and education, and to spread its influence. By the end of 2017, 17 centres had sprung up in countries such as the United Arab Emirates, Hungary, Kazakhstan and Malaysia.

The ties are paying off. Sales of TCM herbal medicines and other related products exported to Belt and Road countries surged by 54% between 2016 and 2017, to a total of US$295 million.

Tight ties
The WHO’s support applies to all traditional medicines, but its relationship with Chinese medicine, and with China, has grown especially close, in particular during the tenure of Margaret Chan, who ran the organization from 2006 to 2017. In Beijing in November 2016, Chan gave an address full of praise for China’s advances in public health and its plans to spread traditional medicine. “What the country does well at home carries a distinctive prestige when exported elsewhere,” she said.

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During a meeting in Beijing in 2016, China’s president Xi Jinping talks with Margaret Chan, then director-general of the World Health Organization.Credit: Xinhua/Photoshot

Chan has supported traditional medicines, and specifically TCM, and has worked closely with China to promote this vision. In 2014, the WHO released a ten-year strategy that aims to integrate traditional medicines into modern medical care to achieve universal health coverage. The document calls on member states to develop health-care facilities for traditional medicine, to ensure that insurance companies and reimbursement systems consider supporting traditional medicines and to promote education in the practices.

In the same year, Chan wrote an introduction to a supplement that ran in Science and was sponsored by the Beijing University of Chinese Medicine and Hong Kong Baptist University2. (Nature ran a similar paid-for supplement in 2011.) Chan wrote that traditional medicines are “often seen as more accessible, more affordable, and more acceptable to people and can therefore also represent a tool to help achieve universal health coverage”. In a 2016 speech in Singapore, Chan said that TCM has excelled at preventing or delaying heart disease because it “pioneered interventions like healthy and balanced diets, exercise, herbal remedies and ways to reduce everyday stress”.

But many Western physicians and scientists doubt that the herbal remedies and various other components of TCM or other traditional medicines have much to offer in their current use. They grant that TCM herbs might turn up useful molecules (many Western drugs are derived from plants, after all), but worry that TCM could replace proven drugs or be potentially dangerous.

Arthur Grollman, a cancer researcher at Stony Brook University in New York, has published work showing how aristolochic acid, an ingredient in many TCM remedies, can cause kidney failure and cancer3. He thinks that WHO documents should pay more attention to the risks of remedies that contain the chemical, which are still widely used.

For some scientists, the WHO’s embrace of TCM is perplexing. “I thought the WHO was committed to evidence-based medicine,” says Richard Peto, a statistician and epidemiologist at the University of Oxford, UK.

Many physicians and researchers also find the WHO’s declarations about traditional medicine hard to parse. Various WHO documents call for the integration of “traditional medicine, of proven quality, safety and efficacy”. But the agency does not say which traditional medicines and diagnostics are proven. Wu Linlin, a WHO representative in the Beijing office, told Nature that the “WHO does not endorse particular traditional and complementary medicine procedures or remedies”.

But that stands in sharp contrast to the WHO’s actions in other areas. The agency gives member countries specific advice on what vaccines and drugs to use and what foods to avoid. With traditional medicines, however, the specifics are mostly omitted. The WHO website carries some warnings and states that aristolochic acid is a carcinogen. But with the repeated emphasis on integrating traditional medicine, the message is clear, says Marcus. In his view, “the WHO is clearly saying these are safe and effective medicines”.

Nature tried to contact Chan multiple times through the WHO, but the agency says that she is not answering questions on matters related to the WHO.

Money matters
Despite the concern over the WHO’s decision to include TCM, even critics of the practices say that Chapter 26 could serve a constructive purpose. Peto says that Chapter 26 could help researchers to gather data on adverse reactions and what kinds of traditional treatments people are getting. “But if the aim is to endorse these things, it is inappropriate,” he says.

For those steeped in Western medicine, the continued spread of traditional treatments is worrisome. TCM practitioners increasingly talk of replacing proven Western medicines with traditional substitutes, where there is a cost advantage. Grollman thinks that ICD-11 is heading in that direction. Seventy per cent of money spent on health care globally is reimbursed or allocated on the basis of ICD information. Now TCM will be part of that system.

“The thing they want is to make it sound official and be recognized by the insurance companies. Because it’s relatively low cost, insurance companies will accept it,” says Grollman.

Many others agree that the WHO’s decision will help the spread of TCM. Inclusion in ICD-11 is “a powerful tool for [health-care] providers to say this is legitimate medicine” to insurers, says Ryan Abbott, a medical doctor who has also trained in TCM and is a faculty member at the University of California, Los Angeles, Center for East–West Medicine. The WHO’s action regarding TCM, he says, “is a mainstream acceptance that will have significant impact around the world”.

Nature 561, 448-450 (2018)

doi: 10.1038/d41586-018-06782-7



Why Chinese medicine is heading for clinics around the world | Nature.com
 
Precious legacy of traditional Chinese medicine: acupuncture and moxibustion
By Yang Meng
2018-09-27 15:16 GMT+8
Updated 2018-09-27 16:58 GMT+8
Inserting needles through the skin may sound scary, but acupuncture and moxibustion, two key components of traditional Chinese medicine (TCM), are said to boost the recipient's health and well-being.

Added to UNESCO's representative list of Intangible Cultural Heritage of Humanity in 2010, acupuncture and moxibustion are widely practiced in China. Their format and practice have distinctive regional characteristics and they have a precious heritage based on Chinese culture and science.

Theory of acupuncture and moxibustion

6f771f6c33334e38b90c9c6471f61c6b.jpg
An acupuncturist inserts a needle through a patient's skin. /VCG Photo

The theory of Chinese medicine believes the human body is a small universe with its own circulatory system, and in this system, there are acupoints connecting the channels. By stimulating these acupoints, the self-regulating functions of the human body can be promoted.

Acupuncture refers to the practice of inserting needles (usually filiform needles) into the body of a patient at a certain angle and using techniques such as twirling and lifting the needles to stimulate acupoints to treat diseases.

Moxibustion normally refers to placing moxa cones directly on acupoints or holding moxa sticks at a distance to warm the body.

Application of acupuncture and moxibustion

ce28438926bc4fa1af2c6faf1bccf1f6.jpg
Moxa cones burn on needles in a patient's back. ./VCG Photo

Acupuncture and moxibustion have a wide range of applications.

In 1995, the World Health Organization published 43 conditions that can be treated by acupuncture and moxibustion, including diseases of the respiratory system, ophthalmic, oral, gastrointestinal system and neurological, muscular and skeletal diseases.

Many people also use acupuncture to treat acne or lose weight.

International expansion

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A doctor explains acupoints to a patient. /VCG Photo

TCM has become more and more accepted by other countries in the world. According to China's white paper on TCM, the practice has spread to 183 countries and regions worldwide.

Data released by the World Health Organization shows 103 member states approved the practice of acupuncture and moxibustion, 29 member states enacted special statutes on traditional medicine and 18 have included acupuncture and moxibustion treatment in their medical insurance provisions.

(Video edited by Huang Chenchen, top image designed by Qu Bo.)
 

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