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Background: To summarize the clinical efficacy and safety of Chinese herbal medicine (CHM) in the treatment of dermatologic events resulting from epidermal growth factor receptor (EGFR) inhibitors according to our experience of ten patients.Methods: Four males and six females, 35-73 years old, mainly with acneiform rash associated with EGFR inhibitors on the face, scalp, perineum, four limbs, and upper trunk, were treated at our traditional Chinese medicine (TCM) clinic in 2016 and 2017. CHM was prescribed thrice daily for 3.4 weeks, with clinical evaluation and photographic documentation performed during treatment. Size, severity, and quality of life (QoL) were documented. Therapeutic response was evaluated using the Skindex-16 dermatologic questionnaire and body surface area (BSA).Results: Our retrospective case series demonstrated significant improvement in QoL in 10 subjects with EGFR inhibitor-related skin toxicity treated with CHM. Mean overall scores of the Skindex-16 survey fell from 74.5% at baseline to 19.3% after treatment (p < 0.001). Improvements in BSA were consistent with an 82% reduction in the distribution of skin lesions after treatment (p < 0.05).Conclusion: CHM is feasible, effective, and safe for the treatment of patients with mild to moderate dermatologic events caused by EGFR inhibitors, according to our preliminary clinical experience, and has distinct advantages, including a direct approach to the TCM syndrome, diverse compatibility, and reduced anaphylactic reaction to traditional acne treatment. However, future perspectives and the need for well-designed prospective studies on CHM and EGFR inhibitors are proposed. [ABSTRACT FROM AUTHOR]

Background: Stroke is a leading cause of death worldwide. In this retrospective study, we investigated the different effects of gender on medical behavior, medical service, medical cost, and death from stroke in Taiwan.Methods: We collected data on the stroke-associated mortality rate according to gender and age group for the period between 2009 and 2013 from the official registry of Ministry of Health and Welfare, Taiwan. We analyzed the data related to stroke-associated medical care and costs in 2013 from the National Health Insurance Research Database (NHIRD).Results: The mortality rate due to stroke was higher in men than in women, despite more inpatient or outpatient medical treatment and higher medical costs, especially in patients aged <50years. Married women showed a significantly lower stroke-associated mortality compared to married men. Women were significantly more likely to accept Western medicine combined with traditional Chinese medicine (TCM) treatment than men (81.51% of women and 74.27% of men). They had lower medical expenditure and lower mortality from stroke than men did. Combined use of integrative Chinese and Western medicine also was associated with lower mortality from stroke than use of conventional Western medicine alone.Conclusions: In Taiwan, stroke-associated mortality is higher in men. Marriage or female sex hormone may have protective effect against stroke in women. Women also more tended to seek TCM complementary therapies combined with Western medicine. Integrated Chinese and Western medicine could thus be a potential treatment for stroke. [ABSTRACT FROM AUTHOR]

Introduction Chinese herbal medicine (CHM) is often used to treat cirrhotic patients under conventional treatment in Taiwan, but the course, outcome, and safety of patients receiving CHM for cirrhosis have seldom been analyzed. The purpose of this retrospective study was to determine whether CHM interferes with conventional treatment of cirrhotic patients with respect to survival and to clinical and laboratory changes. Methods This study examined medical charts from cirrhotic patients who were hospitalized at Kaohsiung Chang Gung Memorial Hospital and consented to CHM therapy between 2010 and 2012. The four-week survival rate, clinical staging, and laboratory assessments before and during CHM intervention were evaluated. Results Thirty-three patients were enrolled in the study. After an observation period of 4 weeks, 17 patients survived and 16 patients had died. The biochemical features of the first, second, and fourth weeks during the CMH treatment all exhibited unremarkable variations relative to those at baseline. Additionally, comparisons between the survivor group and the group that had died revealed that the scores on Model for End-Stage Liver Disease (MELD), the clinical staging system of the Eastern Cooperative Oncology Group (ECOG), and the Barcelona Clinic Liver Cancer (BCLC) staging system were worse in the expired group before the CHM intervention. Total bilirubin was also higher in the expired group before and during the CHM intervention. Conclusions This retrospective analysis determined that a short-term complementary CHM intervention neither hastens the progress of the disease nor interferes with current practice or laboratory tests for cirrhotic patients. This study also found survival benefits in patients with relatively better MELD scores and favorable ECOG performance statues or BCLC stages. A large, randomized, prospective, placebo or controlled study is needed to clarify the safety and evidence of CHM for such patients in the future. [ABSTRACT FROM AUTHOR]

Abstract: Aim of the study: Still little is known about the cellular mechanisms that contribute to the attenuated proliferation of aortic smooth muscle cells under the influence of the oxidative stress factors such as homocysteine (Hcy). Thus, we aimed to evaluate whether Salvia miltiorrhiza Bunge (Labiatae), a Chinese medicinal herb widely used in folk medicine for therapy of variety of human cardiovascular disorders would modulate this Hcy promoted growth effect in model animal aortic cells system. Materials and methods: The Salvia miltiorrhiza roots aqueous extract (SMAE) containing 3,4-dihydroxybenzoic acid, 3,4-dihydroxyphenyl lactic acid and salvianolic acid B, as confirmed by narrow-bore HPLC analyses with binary gradient elution was used in variable concentrations for the treatment of the rat aortic smooth muscle A10 cells under Hcy stimulation. Two-dimensional electrophoresis (2-DE) coupled with MALDI-TOF mass spectrometry was applied for the elucidation of protein changes characterizing the response of the rat A10 cells into the Hcy-induced oxidative stress. Results: This study showed that a low dose (0.015mg/mL) of the SMAE significantly inhibited growth (>60%, p <0.05) of the Hcy stimulated rat A10 cells. In addition, concentration of intracellular reactive oxygen species (ROS) obviously decreased in the rat A10 cells after its incubation with SMAE in terms of catalase increasing activity. Next, marked down-regulation of protein kinase C beta-1 (PKC beta-1) and phosphorylated mitogen-activated protein kinase (p-MAPK) expression suggest that observed inhibitory effect of the polyphenol-rich SMAE on the Hcy-induced growth of rat A10 cells was realized via the PKC/p44/42 MAPK-dependent pathway. The intensity changes of 10 protein spots in response of the rat A10 cells to the Hcy-induced oxidative damage as alpha-4-tropomyosin, vimentin, F1F0-ATP synthase (beta subunit), glucose regulated protein 75 (GRP75), actin (fragment), prohibitin, capping protein, plakoglobin, endoplasmic reticulum protein (ERp29), and peptidylprolyl isomerase A (PPIase A), were detected with statistical significance (p <0.05). Meanwhile, it was showed that used here SMAE resist carbonylation of specific cytoskeleton and chaperone proteins as vimentin, alpha-4-tropomyosin and GRP75, respectively, leading to phenotype transformations in the rat A10 cells. Conclusion: These data suggest that applied here SMAE exerts its protective effect through circulating ROS suppression and subsequent modulation of protein carbonylation in rat aortic smooth muscle A10 cells. Redox-proteomics protocol highlighted in this study may be applicable in facilitating the assessing potential novel molecular therapeutic targets to reduce cardiovascular risk related with elevated Hcy levels in various human populations and elucidating new mechanisms through which protein functions can be regulated by the redox status with the use of naturally occurring antioxidants. [Copyright &y& Elsevier]

The use of traditional Chinese medicine (TCM) as a complementary and alternative medicine for the treatment of nasopharyngeal carcinoma (NPC) and its treatment-related side effects has been increasing. We investigated the utilization of Chinese herbal products (CHPs) for NPC in Taiwan. This retrospective, nationwide, population-based study was conducted and obtained data from the Registry for Catastrophic Illnesses Patient Database from 2001 through 2011 in Taiwan. The top ten most frequently prescribed formulae and single CHPs for treating NPC were assessed. Demographic characteristics, including sex and age at diagnosis of NPC, were examined, together with existing comorbidities. Descriptive statistics and multiple logistic regression analysis were employed to estimate the adjusted odds ratios (aORs) for CHP utilization. In total, 17,816 patients aged ≥20 years were newly diagnosed with NPC. Of these, 4749 patients used TCM outpatient services for NPC treatment. NPC patients using TCM were more likely to be women (aOR, 1.47; 95% CI, 1.37–1.58), young, and residents of central Taiwan (aOR, 1.49; 95% CI, 1.37–1.62) and southern Taiwan (aOR, 1.12; 95% CI, 1.05–1.21). The most commonly prescribed formula CHP was Gan-Lu-Yin (2.99%), followed by Xin-Yi-Qing Fei-Tang (1.52%) and Shan-Shen-Mai-Men-Dong-Tang (0.92%). The most commonly prescribed single CHP was Bai Hua She She Cao (Hedyotis diffusa) (3.23%), followed by Xuan Shen (Scrophularia ningpoensis) (2.24%) and Mai Men Dong (Radix Ophiopogonis) (1.84%). These findings provide information regarding personalized therapies for NPC and can promote further clinical experiments and pharmacological research on CHPs for NPC treatment in Taiwan. [ABSTRACT FROM AUTHOR]