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Quality 4.0 technologies to enhance traditional Chinese medicine for overcoming healthcare challenges during COVID-19
Abid Haleem, Mohd Javaid, Ravi Pratap Singh, Rajiv Suman
2021, 4(2): 71-80. doi: 10.1016/j.dcmed.2021.06.001
[Abstract](21) [FullText HTML] (13) [PDF 15506KB](0)
The Quality 4.0 concept is derived from the industrial fourth revolution, i.e., Industry 4.0. Quality 4.0 is the future of quality, where new digital and disruptive technologies are used to maintain quality in organizations. It is also suitable for traditional Chinese medicine (TCM) to maintain quality. This quality revolution aims to improve industrial and service sectors’ quality by incorporating emerging technologies to connect physical systems with the natural world. The proposed digital philosophy can update and enhance the entire TCM treatment methodology to become more effective and attractive in the current competitive structure of the pharmaceutical and clinical industries. Thus, in healthcare, this revolution empowers quality treatment during the COVID-19 pandemic. There is a major requirement in healthcare to maintain the quality of medical tools, equipment, and treatment processes during a pandemic. Digital technologies can widely be used to provide innovative products and services with excellent quality for TCM. In this paper, we discuss the significant role of Quality 4.0 and how it can be used to maintain healthcare quality and fulfill challenges during the pandemic. Additionally, we discuss 10 significant applications of Quality 4.0 in healthcare during the COVID-19 pandemic. These technologies will provide unique benefits to maintain the quality of TCM throughout the treatment process. With Quality 4.0, quality can be maintained using innovative and advanced digital technologies.
Analysis of the hotspots and trends in traditional Chinese medicine immunomodulation research based on bibliometrics
XIAO Li, MA Ning, LAI Han, YAN Junfeng, PENG Qinghua
2021, 4(2): 81-91. doi: 10.1016/j.dcmed.2021.06.002
[Abstract](21) [FullText HTML] (11) [PDF 27218KB](0)
ObjectiveTo analyze the intellectual structure, hotspots and trends of traditional Chinese medicine (TCM) in immune regulation research.MethodsThe data were extracted from the Web of Science Core Collection (WoSCC) and the China National Knowledge Infrastructure (CNKI) and verified by two experienced TCM researchers. The time of literature retrieval is up to 2020. CiteSpace 5.7.R1 and Microsoft Excel 2016 were used for the statistical analysis and bibliometric diagrams, including the co-occurrence network of authors, institutions, countries, keywords, references, dual-map overlays of journals and citation bursts, etc.ResultsA total of 12 270 publications related to TCM in immune regulation were included. The annual number of publications has increased in this field. There was close cooperation of countries and institutions, while the distribution of scholars was scattered. China was the core of the cooperation network. The dual-map overlays analysis of journals showed that core and marginal fields had increased. The keywords and references analysis showed that network pharmacology, metabolism and cancer were the most high-frequency keywords with high-intensity bursts.ConclusionTCM in immune regulation has attracted wider attention, with multi-country, multi-field, multi-disciplinary and multi-level research developing toward informatization. Network pharmacology, metabolism and cancer may be the focus of future research in this field.
Research on classification diagnosis model of psoriasis based on deep residual
LI Peng, YI Na, DING Changsong, LI Sheng, MIN Hui
2021, 4(2): 92-101. doi: 10.1016/j.dcmed.2021.06.003
[Abstract](21) [FullText HTML] (11) [PDF 12552KB](0)
ObjectiveA classification and diagnosis model for psoriasis based on deep residual network is proposed in this paper. Which using deep learning technology to classify and diagnose psoriasis can help reduce the burden of doctors, simplify the diagnosis and treatment process, and improve the quality of diagnosis.MethodsFirstly, data enhancement, image resizings, and TFRecord coding are used to preprocess the input of the model, and then a 34-layer deep residual network (ResNet-34) is constructed to extract the characteristics of psoriasis. Finally, we used the Adam algorithm as the optimizer to train ResNet-34, used cross-entropy as the loss function of ResNet-34 in this study to measure the accuracy of the model, and obtained an optimized ResNet-34 model for psoriasis diagnosis.ResultsThe experimental results based on k-fold cross validation show that the proposed model is superior to other diagnostic methods in terms of recall rate, F1-score and ROC curve.ConclusionThe ResNet-34 model can achieve accurate diagnosis of psoriasis, and provide technical support for data analysis and intelligent diagnosis and treatment of psoriasis.
Novel pyrimidine-benzimidazole hybrids with antibacterial and antifungal properties and potential inhibition of SARS-CoV-2 main protease and spike glycoprotein
Sharuk Khan, Mayura Kale, Falak Siddiqui, Nitin Nema
2021, 4(2): 102-119. doi: 10.1016/j.dcmed.2021.06.004
[Abstract](28) [FullText HTML] (11) [PDF 40369KB](0)
ObjectiveThe study aimed to synthesize and characterize pyrimidine-linked benzimidazole hybrids, define their antimicrobial and antifungal activities in vitro, and determine their ability to inhibit the main protease and spike glycoprotein of SARS-CoV-2.MethodsThe ability of the synthesized compounds to inhibit the main protease and spike glycoprotein inhibitory of SARS-CoV-2 was investigated by assessing their mode of binding to the allosteric site of the enzyme using molecular docking. The structures of pyrimidine-linked benzimidazole derivatives synthesized with microwave assistance were confirmed by spectral analysis. Antibacterial and antifungal activities were determined by broth dilution.ResultsGram-negative bateria (Escherichia coli and Pseudomonas aeruginosa) were more sensitive than gram-positive bateria (Staphylococcus aureus and Streptococcus pyogenes) to the derivatives. Candida albicans was sensitive to the derivatives at a minimal inhibitory concentration (MIC) of 250 μg/mL. The novel derivatives had better binding affinity (kcal/mol) than nelfinavir, lopinavir, ivermectin, remdesivir, and favipiravir, which are under investigation as treatment for SARS-CoV-2 infection. Compounds 2c, 2e, and 2g formed four hydrogen bonds with the active cavity of the main protease. Many derivatives had good binding affinity for the RBD of the of SARS-CoV-2 spike glycoprotein with the formation of up to four hydrogen bonds.ConclusionWe synthesized novel pyrimidine-linked benzi-midazole derivatives that were potent antimicrobial agents with ability to inhibit the SARS-CoV-2 spike glycoprotein. Understanding the pharmacophore features of the main protease and spike glycoprotein offers much scope for the development of more potent agents. We plan to optimize the properties of the derivatives using models in vivo and in vitro so that they will serve as more effective therapeutic options against bacterial and SARS-CoV-2 infections.
Evaluation of Baishao (Radix Paeoniae Alba) and Chishao (Radix Paeoniae Rubra) from different origins based on characteristic spectra of amino acids
LI Shasha, ZHANG Yiping, DENG Yuanhui, WANG Qian, XIE Zhiru, Ibarra-Estrada Emmanuel, XIAO Xue
2021, 4(2): 120-129. doi: 10.1016/j.dcmed.2021.06.005
[Abstract](15) [FullText HTML] (8) [PDF 16829KB](0)
ObjectiveTo evaluate the difference between Baishao (Paeoniae Radix Alba, PRA) and Chishao (Paeoniae Radix Rubra, PRR) from different regions based on the characteristic spectra of amino acids (AAs).MethodsFingerprints of the 21 standard AAs were established using O-phthalaldehyde-9-fluorenylmethyl chloroformate (OPA-FMOC) pre-column derivation method. The AA components in PRA and PRR were characterized qualitatively and quantitatively, and different AAs were screened using pattern recognition technology.ResultsTwelve AAs were identified in both PRA and PRR. Meanwhile, aspartic acid, glutamic acid, arginine, alanine, and gamma-aminobutyric acid were screened as characteristic components, and their concentrations could effectively distinguish PRA from PRR.ConclusionThe established characterization method, which is based on the characteristic spectra of AAs, is accurate, efficient, and sensitive and can effectively distinguish between PRA and PRR from different producing areas, thus providing a reference for the overall characterization and evaluation of Chinese medicinal materials.
Network pharmacology research and experimental verification of Huangqi (Astragalus Radix) and Jinyingzi (Rosae Laevigatae Fructus) in treating benign prostatic hyperplasia
ZHOU Huan, YANG Meng, YU Yipin, LIU Hui, QING Zhixing, CHEN Qihua
2021, 4(2): 130-143. doi: 10.1016/j.dcmed.2021.06.006
[Abstract](14) [FullText HTML] (8) [PDF 83493KB](2)
ObjectiveThis study aimed to analyze the mechanism of action of Huangqi (Astragalus Radix, HQ) - Jinyingzi (Rosae Laevigatae Fructus, JYZ) in the treatment of benign prostatic hyperplasia (BPH) based on network pharmacology and to verify the prediction through animal experimentation.MethodsBased on the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), Bioinformatics Analysis Tool for Molecular mechANism of Traditional Chinese Medicine (BATMAN-TCM) databases, and literature, the active components and related target genes of HQ and JYZ were screened. The BPH target genes were screened based on the DisGeNET and GeneGards databases, and Excel was used to merge and remove duplicates. The Perl language was used to obtain drug-BPH target genes by intersecting shared target genes. A drug-component-target gene network diagram was constructed using Cytoscape software. The drug-BPH intersection target genes were inputted into the STRING database, and the key target genes were selected according to the degree algorithm. The output formed the basis for Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses to determine the potential mechanism of HQ and JYZ in BPH treatment. High, medium, and low doses of HQ and JYZ extract were used to intervene in BPH rats, and then the prostate volume, wet weight, and prostate index of the BPH rats were determined. Changes in prostate histopathology and microvessel density (MVD) were evaluated using immunohistochemistry, and the optimal HQ and JYZ extract dose was confirmed. Finally, the optimal dose was used to intervene in a BPH rat model, and AKT1 and VEGF expressions were examined by immunohistochemistry. ResultsBased on network pharmacology, 33 active components and 772 target genes were identified from HQ and JYZ, along with 817 BPH target genes and 112 drug-BPH common target genes. Among them were 10 key target genes, including AKT1, JUN, MAPK1, IL-6, TNF, ESR1, and VEGFA. KEGG enrichment analysis revealed 135 signaling pathways, including PI3K/AKT, IL-17, TNF, p53, MAPK, VEGF, JAK-STAT, and NF-κB pathways. The animal experiment showed that HQ and JYZ significantly improved prostate volume, wet weight, prostate index, and prostate histopathology of BPH rats, reducing MVD. In addition, HQ and JYZ inhibited the expression of AKT1 and VEGF in the prostate tissue of rats, promoted epithelial cell apoptosis, and inhibited angiogenesis, consistent with the prediction. ConclusionThe combination of HQ and JYZ is effective for BPH therapy through multi-compound and multi-target collaboration. Its possible mechanism in treating BPH includes regulation of AKT1, VEGF protein, PI3K/Akt, and VEGF signaling pathways related to apoptosis, angiogenesis, and inflammation, with potential for clinical use and research.
Comparison of mechanisms and efficacies of five formulas for improving blood circulation and removing blood stasis
LI Jinxia, ZHOU Xiaoqing, ZHENG Caixing, LAI Lina, LI Ling
2001, 4(2): 144-158. doi: 10.1016/j.dcmed.2021.06.007
[Abstract](13) [FullText HTML] (8) [PDF 0KB](0)
ObjectiveThis study aimed to compare the mechanisms and efficacies of five formulas that improve blood circulation and remove blood stasis. Methods(1) A network pharmacology method was used to determine the targets of five formulas that promote circulation and remove blood stasis. Compounds of the five formulas, namely Danshen Yin (丹参饮, DSY), Huoluo Xiaoling Dan (活络效灵丹, HLXLD), Shixiao San (失笑散, SXS), Taohong Siwu Tang (桃红四物汤, THSWT), and Xuefu Zhuyu Tang (血府逐瘀汤, XFZYT), were retrieved from the Traditonal Chinese Medicine System Pharmacology Database (TCMSP), the Shanghai Institute of Organic Chemistry of CAS, and the TCM Integrated Database. Drug target network was constructed by searching the Swiss Target Prediction database and the STITCH database. The target network of stasis was extracted from the PharmGKB database, the Online Mendelian Inheritance in Man (OMIM) database, the Genetic Association Database (GAD), and the Therapeutic Target Database (TTD). Candidate targets were determined using protein–protein interaction (PPI) network extension and topology selection. Thereafter, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was used to determine the differentiation of the mechanism of the five formulas. (2) Animal experiments were conducted to explore the efficacies of the five formulas in treating blood stasis. Seventy New Zealand rabbits were exposed to high-fat feeding + epinephrine injection to construct a blood stasis syndrome model. The rabbits were evenly divided into control, model, DSY, HLXLD, SXS, THSWT, and XFZYT groups. The latter five groups were orally administered the corresponding formulas [DSY: 3.92 g/(kg·d), XFZYT: 7.10 g/(kg·d), SXS: 1.12 g/(kg·d), HLXLD: 5.60 g/(kg·d), THSWT: 4.48 g/(kg·d)]. Serum lipid and blood rheology were analyzed, and pathology slices were observed.Results(1) A total of 269, 358, 288, 370, and 376 candidate targets of DSY, HLXLD, SXS, THSWT, and XFZYT were obtained among which were 232 shared candidate targets. Fluid shear stress and atherosclerosis were the biological processes common to the five formulas. HLXLD, SXS, DSY, and THSWT regulated lipolysis in adipocytes, and XFZYT, HLXLD, SXS, and THSWT regulated the AGE-RAGE signaling pathway and complement and coagulation cascades. HLXLD, SXS, and XFZYT regulated the HIF-1 signaling pathway, DSY regulated the cGMP-PKG signaling pathway, HLXLD reduced platelet activation, SXS regulated the calcium signaling pathway, and XFZYT regulated the PPAR signaling pathway. (2) In the animal experiments, the values of total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDL), high density lipoprotein cholesterol (HDL), TC/HDL, and TG/HDL in each group decreased, among which the ones seen in XFZYT, HLXLD, and SXS groups were statistically significant (P < 0.05). XFZYT presented the best effect, followed by HLXLD and SXS. XFZYT and HLXLD decreased apolipoprotein B100 (apoB100) and increased apolipoprotein A1/apoB100 (P < 0.05). XFZYT decreased all the values of hematocrit (HCT), plasma viscosity, whole blood viscosity (WBV); HLXLD and SXS affected HCT; and DSY and THSWT regulated WBV (P < 0.05). All the five formulas decreased the values of optical density and area of plaque, among which XFZYT and HLXLD showed statistical significance (P < 0.05). ConclusionAdjusting fluid shear stress and alleviating the injury of endothelial cells might be the common mechanisms by which the five formulas promote blood circulation and remove blood stasis. Different formulas also have unique targets, which may provide guidance for clinical drug selection. By regulating different indices, the five formulas can regulate blood lipid and hemorheology, improve the state of blood stasis, and decrease the degree of aortic plaque in the blood stasis model rabbits. XFZYT and HLXLD had higher efficacies than DSY, THSWT, and SXS.