For cardiotonic actions, DF caused a transient increase in contractility and a transient decrease in contraction rate in an isolated rat heart perfusion system. The positive inotropic effect and the negative chronotropic effect were generated by the dose-dependent inhibitions of Na+/K +-ATPase and Ca2+-ATPase respectively in rat heart homogenate. In both assays, Danshen exhibited more potent inhibitions than DF, while Fenge showed negligible inhibitory actions. / In vivo study on Spontaneously Hypertensive Rats (SHR) showed that DF could not restore the established high blood pressure to the normal level. Earlier DF treatment attenuated, but could not prevent, hypertension development. In aorta, DF improved endothelium-dependent vasodilation by potentiating acetylcholine-induced relaxation and basal nitric oxide (NO) production, and inhibiting endothelial Ca2+ATPases. Relaxation of vascular smooth muscle cells (VSMC) towards NO donors was also enhanced. For anti-oxidation, upon DF treatment, mRNA levels of superoxide dismutase (SOD), extracellular superoxide dismutase (ecSOD), catalase and glutathione peroxidase (GPx) were elevated in heart and aorta. However, studies on SOD and catalase demonstrated insignificant changes in the protein expression levels in both organs. For vasodilation, mRNA level of endothelial nitric oxide synthase (eNOS) in the aorta was upregulated, but no change on eNOS and phosphorylated eNOS (peNOS) proteins were detected. A parallel study showed that DF did not cause hypotension or improve antioxidant defense in normotensive Wistar Kyoto rats (WKY). These findings suggest the use of the Danshen and Fenge 7:3 (w/w) formulation on the comprehensive cardiovascular protection. / Previously established Danshen and Fenge 7:3 (w/w) formulation (DF) was shown to exhibit antioxidative activity by preventing oxidant-induced red blood cell hemolysis and H9c2 rat myoblast cell death in a dose-dependent manner, in which Danshen was demonstrated to be a more potent antioxidant than DF. Fenge showed no antioxidative property. The effect of in vivo ischemia-reperfusion was mimicked by the hypoxia-reoxygenation model of primary culture of neonatal rat heart cardiomyocytes. Danshen could protect cardiomyocytes against hypoxiareoxygenation damage. / Reactive oxygen species attack on cardiovascular system can lead to atherosclerosis and finally cardiac ischemia. Reperfusion, allowing the restoration of blood flow in treating atherosclerosis, in turn generates free radicals which irreversibly damage cardiomyocytes and endothelial cells. Endothelial cell damage eventually leads to hypertension. Radix Salviae Miltiorrhizae (Danshen) and Radix Puerariae Thomsonii (Fenge) have long been used together to treat various heart diseases in China. This project was focused on the antioxidative, cardiotonic and vasodilative effects of the aqueous extracts of Danshen and Fenge. / Lam Hung Ming. / "September 2006." / Adviser: Miu Yee Mary Waye. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1381. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. 218-230). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Ma Shuang-Cheng. / "March 2002." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2002. / Includes bibliographical references (p. 289-324). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Deng Xue-Long. / "January 2003." / Thesis (Ph.D.)--Chinese University of Hong Kong, 2003. / Includes bibliographical references (p. 196-230). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Mode of access: World Wide Web. / Abstracts in English and Chinese.

Asthma has long been considered as one of the most common health problems in the world. In Hong Kong, the prevalence of childhood asthma has increased from 4.8% in 1989, to 10.2% in 2002. In spite of the popularity of using Chinese herbs to treat asthma in Hong Kong, evidence on the effectiveness of herbal treatments is lacking. The Chinese herbal formula CUF2 is an innovative formula developed in the Institute of Chinese Medicine, The Chinese University of Hong Kong and it is composed of 5 commonly used Chinese herbs: Radix astragali, Cordyceps sinesis, Radix Scutellaria, Bulbus fritillariae cirrhosae and Radix stemonae. These herbs are chosen because of their well-known effects on either reducing coughing and sputum production, or anti-inflammatory and immunomodulatory activities. Based on the theoretical benefits of CUF2, we conducted a series of animal, in vitro and clinical studies to explore the efficacy, safety and mechanism of action of CUF2. / Following the establishment of the animal model, we have investigated the effect of CUF2 using this model of asthma. We found that 28 days pretreatment with CUF2 could reduce total cell number and eosinophilia in bronchoalveolar lavage fluid (BALF), prevent the eosinophil infiltration of airways, decrease pulmonary inflammatory cells, and reduce mucus and goblet cell hyperplasia. Especially in the reduction of goblet cell hyperplasia, we demonstrated that there was no significant difference between the effects of high dose CUF2 and dexamethasone (DEX). The eosinophilic immune-inflammatory responses in the airways in OA-sensitized/challenged rats were completely blocked by DEX returning to almost the same as those in normal rats, but the loss of thymus index and body weight were also observed. In contrast to the overall immunosuppressive effects of DEX, decreased production of inflammatory cytokines and chemokines [interleukin (IL)-4, tumor necrosis factor (TNF)-alpha, macrophage inflammatory protein (MIP)-2 and monocyte chemotactic protein-1 (MCP-1)], increased production of IL-10 and interferon-gamma (IFN-gamma) in BALF and no suppression of body weight and thymus index were demonstrated in the CUF2-treated groups. There was a dose-response relationship with more prominent effects seen with higher doses of CUF2. These findings indicate that the CUF2 has anti-airway inflammatory activity and exhibits immunomodulatory effect on Th1/Th2 responses in ovalbumin sensitized rats after allergen challenge, and this may imply its potential application to patients with allergic asthma. / In order to evaluate the clinical efficacy and safety, we conducted a multicenter, randomized, double blind, parallel and placebo controlled clinical trial. The same Chinese herbal formula was used in this clinical trial in 85 children aged 7-15 years with mild to moderate perennial asthma as an adjuvant therapy for 6 months. The primary outcome measure was the steroid dosage reduction. Other outcome measures included changes in disease severity score (DSS), lung function, serum concentrations of total IgE and the levels of some key allergy and inflammatory markers in peripheral blood, fractional exhaled nitric oxide (FENO), frequency of asthma attacks and quality of life (QOL). To assess safety, we did urinalysis, complete blood count, liver function and renal function at baseline and the end of the study. Drug compliance and adverse effects were also checked at each monthly visit. All patients were maintained on inhaled corticosteroid at their usual dose and dosing interval, and continued to receive short-acting, inhaled beta2-agonists as needed. There were no serious adverse events reported in the 6-month study period by any of the subjects. Hematological (except eosinophils count) and biochemical profiles (including renal function and liver function) remained within normal limits in the CUF2 group and placebo group at the end of the study. CUF2 was well tolerated in asthmatic children. Both CUF2 group and placebo group showed an improvement in most of clinical parameters. The dosage of inhaled corticosteroid was successfully reduced in both groups. Both groups had similar decrease in DSS, improved QOL and improved lung function parameter PEFR (L/min). Although these parameters showed no statistically significant difference between two groups, the percentage of eosinophils and lymphocytes were significantly decreased in CUF2 group as compared with the placebo group. The CUF2 group also showed improved diary symptom score, reduced expression of TNF-alpha and slight increase in anti-inflammation cytokine IL-18 in the blood. A trend of greater improvement in frequency of upper respiratory infection (URI) in CUF2 group was noted, but no statistical significance was attained. The changes in lung function parameter FEV1%, FENO, frequency of asthma attacks and serum concentrations of total IgE, IgE HDM, IgE cat, cockroach, TARC, LTB4 and LTC4D4E4 showed no statistically significant difference CUF2 group and placebo group. Overall, our data demonstrated that CUF2 treatment had some immunomodulatory effect in childhood asthma. Our findings should support further investigations of Chinese herbal medicine in the area of asthma without steroid therapy. / In the animal study, firstly we attempted to establish a novel murine model of asthma. We adopted a modified sensitization procedure using 10-point subcutaneous and intraperitoneal injections of Ovalbumin (OA) with freshly prepared Al(OH)3 and successfully induced severe airway allergic reactions in young Sprague Dawley (SD) rats. In this SD rat model, allergen exposure triggered accumulation of inflammation cells and eosinophils in the airway submucosa and goblet cells hyperplasia in mucosa, lung function test revealed obstructive lung function changes that included increase of lung resistance (RL) and decrease of dynamic lung compliance (Cdyn). Cytokine and chemokine assays showed that there was a change of the TH1/Th2 balance as illustrated by the high Th2 (interleukin-4)/Th1 (interferon-gamma) ratio. These results demonstrated the feasibility and validity of the SD rat model for studying allergic asthma. This SD model is much cheaper and readily available than the Brown Norway rat model and may facilitate further drug trial in asthma. / In the in vitro study, we investigated the effect of CUF2 on the release of cytokines and/or gene expression using human mast cell line HMC-1, human bronchial epithelial cell line BEAS-2B, peripheral blood mononuclear cells (PBMCs) from healthy subjects and airway cells present in induced sputum from asthmatic patients. We have shown (1) the CUF2 had no cytotoxic effects in final working concentration; (2) CUF2 had inhibitory effects on IL-6, TNF-alpha and granulocyte-macrophage colony-stimulating factor (GM-CSF) secretion from HMC-1 in a dose-dependent manner. However, no reduction of IL-8 production in HMC-1 was demonstrated. (3) In addition, study of the effect of CUF2 on the expression of cytokine gene from HMC-1 showed that IL-4, IL-6 and GM-CSF mRNA expressions were down regulated at 24 hours, 24 hours, 16 hours and 24 hours of time points, respectively. No effects on IL-8 and TNF-alpha mRNA expression was observed. (4) Furthermore, CUF2 also significantly inhibited in vitro IL-6 and GM-CSF secretion in TNF-alpha stimulated BEAS-2B cell and reduced GM-CSF production in airway cells present in induced sputum from asthmatic children. (5) We observed that CUF2 enhanced TNF-alpha and IL-6 production but did not alter the levels of GM-CSF and IL-8 in mitogen-stimulated PBMCs from health subject. These findings suggest that pharmacological activities of the CUF2 may be mediated by regulating the production of cytokines in human mast cell, bronchial epithelial cell, airway cell and PBMCs. / In this study, a novel animal asthma model has been established. This model has extensively characterized and exhibited several inflammatory, immunological features that resemble those of human asthma and may facilitate further drug trial in asthma. CUF2 showed its efficacy treating the animal model of allergic asthma. In vitro study also provided evidence of its beneficial dichotomous effects on cytokine and chemokine production in HMC-1, PBMCs and airway cells. A multi-center, randomized, double blind, placebo controlled clinical trial showed that CUF2 had a certain degree of clinical efficacy. Furthermore, the use of CUF2, with the study dose and treatment period, was safe. The efficacy of individual ingredient and the mechanism of CUF2 have not been clarified and further investigations are warranted. In conclusion, our results provided evidence of the potential beneficial effect of CUF2 on immune system functions and supported the potential use of TCM as therapeutic drugs for allergic inflammatory diseases. / by Wong Yeuk Oi. / "September 2005." / Advisers: Yn Tz Sung; Kowk Pui Fung. / Source: Dissertation Abstracts International, Volume: 67-11, Section: B, page: 6296. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (p. 330-349). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

For the development of a G6PD-deficient mouse model, we introduced the mutant Gpdxa-m1Neu allele (a severe ENU-induced mutation that results in 13-15% G6PD activities of wild type littermates) into the C57L/J background (a strain that constitutively exhibits low G6PD activity) through a breeding program. Of significance is that 78% of the F2 generation had G6PD activities <2 U/g Hb, levels similar to those of severe G6PD deficiency in human. The efficacy of this model was preliminary verified by the known haemolytic agent, naphthalene, as demonstrated by the decrease of GSH/GSSG ratio by 24.6% (P=0.032) and increase of methaemoglobin by 4.5 fold (P=0.8) when compared with the respective control without treatment. / Genetic analysis of 14 mutation hotpots was performed on 98 hemi-/homozygous and 17 heterozygous G6PD-deficient human subjects. We developed a novel Multiplex Primer Extension Reaction (MPER) assay and detected seven specific mutations in 97 subjects: c.1376G>T (33.7%), c.1388G>A (29.6%), c.871G>A + c.1311C>T (12.3%), c.95A>G (9.2%), c.392G>T (7.1%), c.1024C>T (6.2%) and c.1360C>T (1.0%). For the genotyping of 15 heterozygous female, all mutations were identified as follows: c.1376G>T/Normal (33.3%), c.1388G>A/Normal (26.7%), c.871G>A/Normal + c.1311C>T/Normal (20.0%), c.95A>G/Normal (13.3%) and c.392G>T./Normal (6.7%). The c.871G>A and 'silent' mutation c.1311 C>T was newly found to coexist in a high proportion of genotype in our population. / Glucose-6-phosphate dehydrogenase (G6PD)-deficient subjects are vulnerable to chemical-induced haemolysis if exposed to oxidative agents. Little is known, however, of the haemolytic effects of Chinese herbal medicine on G6PD-deficient subjects. Only one case study has reported that a G6PD-deficient newborn developed severe haemolysis after ingestion of Rhizoma Coptidis. Besides, recent studies reported that green tea and its constituents exerted pro-oxidative effects on cellular systems in culture. / Glucose-6-phosphate dehydrogenase deficiency is a genetic disorder inherited in the X-linked manner. The condition is prevalent in the Mediterranean region, Africa and Southeast Asia. In Hong Kong, the frequency of G6PD deficiency is around 4.5% in males and 0.3% in females. Over 140 specific mutations of the X-linked gene for G6PD have been characterized in various geographic regions. However, the local mutation pattern has not been clearly determined. / In conclusion, some Chinese herbal medicine, tea and tea polyphenols significantly altered the oxidative status of G6PD-deficient erythrocytes in vitro. Their in vivo effects on G6PD-deficient individuals would be further investigated by the novel G6PD-dificient mouse model. / In this study, we aim (1) to investigate effects of (a) a panel of Chinese Herbal Medicine (CHM), (b) tea and its constituents, on the oxidative status of human G6PD-deficient erythrocytes in vitro ; (2) to characterize the genotype of G6PD-deficiency in the Chinese population and their specific response to oxidative stress; (3) to develop a novel strain of mice as a model for study of chemicals agents on G6PD-deficient red cell in vivo. / Our results showed that six of eighteen CHM significantly reduced GSH levels in the G6PD-deficient erythrocytes (p<0.05, n=10). After exposure to 1 mg/mL of Rhizoma Coptidis, GSH levels in G6PD-deficient erythrocytes was decreased by 48.9 +/- 5.4% (P<0.001, n=10). At 5 mg/mL of Cortex Moutan, Radix Rehmanniae, Radix Bupleuri, Rhizoma Polygoni Cuspidati and Flos Chimonanthi, GSH levels were decreased significantly (P=0.001 to 0.004) by 51.8 +/- 7.6%, 25.9 +/- 6.7%, 21.0 +/- 6.9%, 17.5 $ 6.7% and 8.7 +/- 6.8% respectively. There were noticeable increases in levels of methaemoglobin by 2.8 fold (5 mg/mL, P=0.012) and 3.4 fold (10 mg/mL, P=0.016) in the presence of Rhizoma Coptidis and Cortex Moutan, respectively, in G6PD-deficient erythrocytes. / We also investigated the pro-oxidative effect of tea and its polyphenolic components on G6PD erythrocytes from G6PD-deficient (n=8) and normal adult (n=8) subjects. The tea extracts significantly reduced GSH and increased GSSG levels in G6PD-deficient erythrocytes in a dose-dependent manner (0.5-10 mg/mL), but not in normal erythrocytes. Similar dose-dependent responses to (-)-Epigallocatechin (EGC) and (-)-Epigallocatechin-3gallate (EGCG), but not to the other polyphenols, were observed. In G6PD-deficient cells, GSH was reduced by 43.3% (EGC at 0.05 mg/mL) and 33.3% (EGCG at 0.5 mg/mL), compared with pre-challenged levels. The concentration of methaemoglobin was increased significantly when these cells were challenged with tea extracts, and EGC. Plasma haemoglobin levels were higher in G6PD-deficient samples after exposure to tea extracts, EGCG, EGC and gallic acid, compared with those in normal blood. / Ko Chun Kay. / "August 2006." / Advisers: Tai Fai Fok; Kwai Har Karen Li. / Source: Dissertation Abstracts International, Volume: 68-03, Section: B, page: 1577. / Thesis (Ph.D.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (p. xxii-xliii). / Electronic reproduction. Hong Kong : Chinese University of Hong Kong, [2012] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Electronic reproduction. [Ann Arbor, MI] : ProQuest Information and Learning, [200-] System requirements: Adobe Acrobat Reader. Available via World Wide Web. / Abstracts in English and Chinese. / School code: 1307.

Chan Wai-Lung, William. / Thesis submitted in: December 2000. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 124-131). / Abstracts in English and Chinese. / Abstract --- p.i / Abstract (Chinese Version) --- p.iii / Acknowledgements --- p.v / Table of Contents --- p.vi / List of Tables --- p.ix / List of Figures --- p.xii / List of Abbreviations --- p.xvi / Chapter 1 --- Introduction --- p.1 / Literature Review --- p.4 / Chapter 1.1 --- A Brief Introduction of Cancer --- p.4 / Chapter 1.2 --- Natural Products as a Drug --- p.5 / Chapter 1.2.1 --- Development of terrestrial plants as a drug --- p.6 / Chapter 1.2.1.1 --- Anticancer drugs from terrestrial plants and Chinese medicinal herbs --- p.7 / Chapter 1.2.2 --- Development of marine organisms as a drug --- p.8 / Chapter 1.2.2.1 --- Anticancer drugs from marine organisms --- p.9 / Chapter 1.3 --- Anticlastogenic Study - an Anticancer Study --- p.10 / Chapter 1.3.1 --- Anticlastogenesis mechanisms study --- p.11 / Chapter 1.3.2 --- In vivo anticlastogenic study --- p.13 / Chapter 1.4 --- Anticlastogenic Study of Chinese Medicinal Herbs and Marine Algae --- p.17 / Chapter 1.4.1 --- Selection of nine Chinese medicinal herbs and three marine algae for anticlastogenic screening --- p.18 / Chapter 1.5 --- Methods of Investigation --- p.20 / Chapter 1.5.1 --- Extraction methods --- p.20 / Chapter 1.5.2 --- Single cell gel electrophoresis (Comet assay) --- p.21 / Chapter 2 --- Materials and Methods --- p.27 / Chapter 2.1 --- Materials --- p.27 / Chapter 2.1.1 --- Chinese medicinal herbs --- p.27 / Chapter 2.1.2 --- Marine algae --- p.27 / Chapter 2.1.3 --- Animals --- p.27 / Chapter 2.1.4 --- Chemicals and solutions --- p.28 / Chapter 2.2 --- Methods --- p.31 / Chapter 2.2.1 --- Crude extraction of natural products --- p.31 / Chapter 2.2.1.1 --- Water extraction of Chinese herbs --- p.31 / Chapter 2.2.1.2 --- Water extraction of marine algae --- p.31 / Chapter 2.2.2 --- Test for the effective dosage of clastogen ethyl methanesulfonate (EMS) to BALB/c mice --- p.31 / Chapter 2.2.2.1 --- In vitro test --- p.32 / Chapter 2.2.2.2 --- In vivo test --- p.32 / Chapter 2.2.3 --- Anticlastogenic bioassays --- p.33 / Chapter 2.2.3.1 --- In vitro anticlastogenic screening --- p.33 / Chapter 2.2.3.2 --- In vitro anticlastogenic mechanisms investigation --- p.33 / Chapter 2.2.3.3 --- In vivo anticlastogenic screening --- p.34 / Chapter 2.2.3.4 --- Different in vivo anticlastogenic treatment schedules --- p.35 / Chapter 2.2.4 --- Single cell gel electrophoresis assay (Comet assay) --- p.36 / Chapter 2.2.5 --- White blood cell viability determination --- p.37 / Chapter 2.2.6 --- Statistical analysis --- p.38 / Chapter 3 --- Results --- p.40 / Chapter 3.1 --- Extraction amount of different natural products and cell viability checking --- p.40 / Chapter 3.1.1 --- Chinese medicinal herbs --- p.40 / Chapter 3.1.2 --- Seaweeds --- p.40 / Chapter 3.1.3 --- Cell viability --- p.42 / Chapter 3.2 --- Effective dosage of clastogen EMS to BALB/c mice peripheral white blood cells --- p.42 / Chapter 3.2.1 --- In vitro --- p.42 / Chapter 3.2.2 --- In vivo --- p.42 / Chapter 3.3 --- In vitro anticlastogenic screen test and mechanisms investigation --- p.44 / Chapter 3.3.1 --- In vitro anticlastogenic screen test --- p.44 / Chapter 3.3.1.1 --- Chinese herbs --- p.44 / Chapter 3.3.1.2 --- Seaweeds --- p.53 / Chapter 3.3.2 --- In vitro anticlastogenic mechanisms investigation --- p.55 / Chapter 3.3.2.1 --- H. dilatata --- p.56 / Chapter 3.3.2.2 --- S. angustifolium --- p.56 / Chapter 3.3.2.3 --- S. siliquastrum --- p.63 / Chapter 3.4 --- In vivo anticlastogenic screen test and mechanisms investigation --- p.66 / Chapter 3.4.1 --- In vivo anticlastogenic screen test --- p.66 / Chapter 3.4.1.1 --- Chinese herbs --- p.66 / Chapter 3.4.1.2 --- Seaweeds --- p.73 / Chapter 3.4.2 --- Different treatment methods in in vivo anticlastogenic test --- p.86 / Chapter 3.4.2.1 --- Simultaneous application method --- p.86 / Chapter 3.4.2.2 --- Pre-drug treatment method --- p.91 / Chapter 3.4.2.3 --- Post drug treatment method --- p.91 / Chapter 4 --- Discussion --- p.94 / Chapter 4.1 --- Cell viability and water extracts in Chinese medicinal herbs and marine algae --- p.94 / Chapter 4.2 --- Clastogenic effect of EMS to pWBCs of BALB/c mice --- p.94 / Chapter 4.3 --- In vitro anticlastogenic screen test of nine water extracts of Chinese medicinal herbs and three water extracts of marine algae --- p.99 / Chapter 4.4 --- In vitro anticlastogenic mechanisms investigation of three \03 marine algae extracts --- p.103 / Chapter 4.5 --- In vivo anticlastogenic screen test of Chinese herbs extracts and seaweeds extracts --- p.108 / Chapter 4.6 --- Different administration methods in in vivo anticlastogenic test --- p.115 / Chapter 4.6.1 --- Intraperitoneal route of administration --- p.115 / Chapter 4.6.2 --- In vivo pre- and post-treatment methods --- p.116 / Chapter 5 --- Summary and Conclusion --- p.120 / References --- p.124

by Koo Po Lan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2001. / Includes bibliographical references (leaves 120-130). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.ii / Abstract (Chinese version) --- p.iv / Content --- p.vii / List of Abbreviations --- p.xi / List of Figures and Tables --- p.xiii / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Saponins --- p.1 / Chapter 1.2 --- Structure of Saponin --- p.2 / Chapter 1.2.1 --- Triterpene Class --- p.2 / Chapter 1.2.2 --- Steroid Class --- p.3 / Chapter 1.2.2.1 --- Spirostanol Glycoside --- p.4 / Chapter 1.2.2.2 --- Furostanol Glycoside --- p.4 / Chapter 1.2.3 --- Steroid Alkaloid Class --- p.5 / Chapter 1.3 --- Steroidal Saponin as Anti-Tumor Drug --- p.5 / Chapter 1.4 --- Possible Anti-Tumor Action Mechanisms of Steroid Saponin --- p.6 / Chapter 1.4.1 --- Direct Cytotoxic and Growth Inhibitory Effects --- p.7 / Chapter 1.4.2 --- Immune-Modulatory Effects --- p.8 / Chapter 1.5 --- Possible Anti-Carcinogenicity Action Mechanism of Saponin --- p.9 / Chapter 1.5.1 --- Saponin Binding to Bile Acids --- p.9 / Chapter 1.6 --- Saponin as Cardioactive Drug --- p.9 / Chapter 1.7 --- Liver Cancer --- p.10 / Chapter 1.7.1 --- Prevalence of Hepatocellular Carcinoma (HCC) --- p.11 / Chapter 1.8 --- Coronary Heart Disease (CHD) --- p.12 / Chapter 1.8.1 --- Prevalence and Risk Factors of CHD --- p.12 / Chapter 1.9 --- Diosgenin --- p.14 / Chapter 1.10 --- Hong Kong (HK) Products --- p.15 / Chapter 1.10.1 --- HK-18 (Polyphyllin D) --- p.15 / Chapter 1.11 --- DI AO XIN XUE KANG (DI AO) --- p.17 / Chapter 1.12 --- Aims of My Project --- p.20 / Chapter 1.12.1 --- In Vitro Study of the Effect of HK-18 on Human Hepatocellular Carcinoma Cell Line (HepG2) --- p.21 / Chapter 1.12.2 --- In Vivo Study of the Effect of HK-18 by Human Liver Tumor HepG2 Cells-Bearing Nude Mice Model --- p.21 / Chapter 1.12.3 --- In Vitro Study of the Effect of HK-18 on Multidrug- Resistant Human Hepatocellular Carcinoma Cell Line (R-HepG2) --- p.22 / Chapter 1.12.4 --- Myocardial Ischemia-Reperfusion (IR) Injury in Isolated- Perfused Rat Heart Model --- p.23 / Chapter 1.12.5 --- Effect of DI AO Pretreatment on Global IR Injury --- p.26 / Chapter 1.12.6 --- Effect of DI AO Pretreatment on Isoproterenol-Induced Myocardial Injury in Rats --- p.26 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Materials --- p.28 / Chapter 2.1.1 --- Cell Lines and Culture Medium / Chapter 2.1.1.1 --- Cell Lines --- p.28 / Chapter 2.1.1.2 --- Culture Medium --- p.29 / Chapter 2.1.2 --- Chemicals --- p.30 / Chapter 2.1.3 --- Buffers and Reagents --- p.31 / Chapter 2.2 --- Methods / Chapter 2.2.1 --- In Vitro Studies --- p.33 / Chapter 2.2.1.1 --- In Vitro Cytotoxicity --- p.33 / Chapter 2.2.1.2 --- Cell Cycle Analysis by Flow Cytometry --- p.34 / Chapter 2.2.1.3 --- Maintenance of P-glycoprotein in R-HepG2 cells by Doxorubicin and HK-18 --- p.35 / Chapter 2.2.1.4 --- Assessment of DNA Fragmentation --- p.36 / Chapter 2.2.2 --- In Vivo Assessment of the Anti-Tumor Activity of HK-18 --- p.37 / Chapter 2.2.2.1 --- Animals and Tumor Inoculation --- p.37 / Chapter 2.2.2.2 --- Drug Administration --- p.37 / Chapter 2.2.2.3 --- Assessment of the Tumor Size and Tumor Weight --- p.38 / Chapter 2.2.2.4 --- Plasma Preparation --- p.38 / Chapter 2.2.2.5 --- Measurement of the Plasma Enzyme Activity --- p.39 / Chapter 2.2.3 --- Isoproterenol (ISO)-Induced Myocardial Injury (Rat Model) --- p.40 / Chapter 2.2.3.1 --- Animals --- p.40 / Chapter 2.2.3.2 --- Drug Preparations --- p.40 / Chapter 2.2.3.3 --- Animal Treatment --- p.41 / Chapter 2.2.3.4 --- Preparation of Myocardial Tissue Homogenate --- p.41 / Chapter 2.2.3.5 --- Preparation of Cytosolic Fraction of Heart Homogenates --- p.42 / Chapter 2.2.3.6 --- Myocardial Antioxidant Enzyme Activity --- p.42 / Chapter 2.2.3.6.1 --- Glutathione Reductase (GRD) --- p.42 / Chapter 2.2.3.6.2 --- Glutathione S-Transferases (GST) --- p.43 / Chapter 2.2.3.7 --- Myocardial Antioxidant Capacity --- p.43 / Chapter 2.2.3.7.1 --- Myocardial Malondialdehyde (MDA) Content --- p.43 / Chapter 2.2.3.7.2 --- Myocardial Thiol Content --- p.44 / Chapter 2.2.3.7.3 --- Tert-Butylhydroperoxide (tBHP)-Induced Thiol Depletion --- p.45 / Chapter 2.2.3.7.4 --- TBHP-Induced Thiobarbituric Acid-Reactive Substances (TBARS) Formation --- p.45 / Chapter 2.2.4 --- Myocardial Ischemia-Reperfusion (IR) Injury --- p.46 / Chapter 2.2.4.1 --- Langendorff Isolated Perfused Rat Heart --- p.46 / Chapter 2.2.4.1.1 --- Preparation of Perfusion Buffer --- p.46 / Chapter 2.2.4.1.2 --- Preparation of Isolated Rat Heart --- p.47 / Chapter 2.2.4.1.3 --- Myocardial Global Ischemia-Reperfusion Injury --- p.49 / Chapter 2.2.4.1.4 --- Contractile Force Recovery --- p.49 / Chapter 2.2.5 --- Statistical Analysis --- p.50 / Chapter Chapter 3 --- Study of HK-18 on Anti-Tumor Effect / Chapter 3.1 --- In Vitro Study of HK-18 on Human Hepatoma Carcinoma Cell Line (HepG2) --- p.51 / Chapter 3.1.1 --- The Effect of HK-18 on Cell Proliferation of HepG2 Cells by MTT Assay --- p.52 / Chapter 3.1.2 --- DNA Fragmentation Assay --- p.54 / Chapter 3.1.3 --- The Effect of HK-18 on Cell Cycle Phase Distribution --- p.57 / Chapter 3.2 --- In Vivo Study of HK-18 on HepG2-Inoculated Nude Mice --- p.61 / Chapter 3.2.1 --- Assessment of the Anti-Tumor Activity of HK-18 --- p.61 / Chapter 3.2.2 --- The Effect of HK-18 Towards Heart Tissue --- p.65 / Chapter 3.2.3 --- In Vitro Study of HK-18 on Multidrug Resistant Cell Line (R-HepG2) --- p.68 / Chapter 3.2.4 --- The Comparison of the Cytotoxicity of DOX on the Parental Cells and Resistant Cells of HepG2 --- p.69 / Chapter 3.2.5 --- The Effect of HK-18 on Cell Proliferation of R-HepG2 Cells by MTT Assay --- p.72 / Chapter 3.2.6 --- DNA Fragmentation Assay --- p.74 / Chapter 3.2.7 --- The Effect of HK-18 on Cell Cycle Phase Distribution --- p.77 / Chapter 3.2.8 --- The Relationship Between HK-18 and P-glycoprotein --- p.80 / Chapter Chapter 4 --- Study of the Cardioprotective Effect of DI AO / Chapter 4.1 --- Myocardial Ischemia-Reperfusion (IR) Injury in Isolated- Perfused Rat Heart --- p.82 / Chapter 4.1.1 --- Time Course of Global Ischemia-Reperfusion-Induced LDH Leakage --- p.82 / Chapter 4.1.2 --- Effect of DI AO Pretreatment on Global IR Injury --- p.85 / Chapter 4.1.2.1 --- LDH Leakage --- p.85 / Chapter 4.1.2.2 --- Contractile Force --- p.87 / Chapter 4.2 --- Isoproterenol-Induced Myocardial Injury in Rats --- p.89 / Chapter 4.2.1 --- Effect of DI AO Pretreatment --- p.89 / Chapter 4.2.2 --- Alternations in the Activity of Myocardial Antioxidant Enzymes --- p.91 / Chapter 4.2.3 --- Alternations in Myocardial Antioxidant Capacity --- p.94 / Chapter Chapter 5 --- Discussion / Chapter 5.1 --- The Significance of the Study of Saponin in the Treatment of Liver Cancer and Heart Injury --- p.96 / Chapter 5.2 --- Effect of HK-18 on Human Hepatocellular Carcinoma Cell --- p.101 / Chapter 5.3 --- Mechanism Study of Anti-Tumor Effect of HK-18 --- p.102 / Chapter 5.4 --- Cytotoxicity of HK-18 Toward Normal Tissue --- p.105 / Chapter 5.5 --- Effect of HK-18 on Multidrug Resistant Human Hepatocellular Carcinoma / Chapter 5.6 --- Protective Effect of DI AO Against Isoproterenol (ISO)- Induced Myocardial Injury --- p.110 / Chapter 5.7 --- Cardioprotective Effect of DI AO Against Ischemia- Reperfusion (IR) Injury --- p.111 / Chapter 5.8 --- Effect of DI AO Pretreatment on Myocardial Antioxidant Enzymes Activities and Antioxidant Capacity --- p.113 / Chapter 5.9 --- Conclusion and Future Prospect --- p.117 / Chapter Chapter 6 --- References --- p.121

Submitted by Fabíola Silva (fabiola.silva@famerp.br) on 2017-05-19T19:37:17Z No. of bitstreams: 1 sandrasegarra_dissert.pdf: 1704764 bytes, checksum: 485f845ed69e0d77fde1f179e0994867 (MD5) / Made available in DSpace on 2017-05-19T19:37:17Z (GMT). No. of bitstreams: 1 sandrasegarra_dissert.pdf: 1704764 bytes, checksum: 485f845ed69e0d77fde1f179e0994867 (MD5) Previous issue date: 2016-12-20 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Introduction: World Health Organization recognition of Integrative and Complementary Practices (PICs) and the high costs of biomedicine have encouraged countries to implement PICs in their Public Health Systems, since PICs require simplified technological resources and work in the promotion, prevention, treatment, and rehabilitation of most common illnesses, leading to the humanization of treatment. In Brazil, the insertion of these practices in the Unified Health System (SUS) was made possible in 2006, when the National Policy for PICs (Política Nacional de Práticas Integrativas e Complementares or PNPIC in Portuguese) was approved, aiming at broadening treatment at all levels while focusing on primary care. Among the PICs, acupuncture is highlighted due to its popularity and progressive acceptance in western society. Objective: To investigate the profile of acupuncture users and the financing of acupuncture sessions in a teaching hospital in the countryside of Sao Paulo state. Methods: This quantitative, descriptive and traversal study used, as a data source, all records computerized between 2010 and 2016 regarding 2,564 patients who received 19,034 acupuncture sessions as prescribed therapeutic interventions. The data were analyzed using descriptive statistics, the Mann-Whitney U test, the ANOVA test, the Games-Howell Multiple Comparison procedure, Pearson's correlation test, and Multiple Correspondence Analysis (multivariate approach) in order to investigate the relationship between the collected variables, the total number of sessions, and the total financial cost of acupuncture. Results: Most patients were female- 1952 (76.13%), were housekeepers-739 (28.82%), had elementary school education-1077 (42.00%), and were Catholics-1651 (64.39%). The mean number of acupuncture sessions was 7.42 with a standard deviation of 8.99 sessions and a median of 5.0 sessions. The mean financing round for the performance of acupuncture sessions was 91.99 Brazilian Reais/patient with a standard deviation of 120.10 Brazilian Reais and a median of 56.52 Brazilian Reais, reaching a maximum of 1429.06 Brazilian Reais. The mean financing round per session was 12.15 Brazilian Reais, with a standard deviation of 3.74 Brazilian Reais and a median of 14.13 Brazilian Reais, reaching a maximum of 21.47 Brazilian Reais per session. Conclusion: There is a need to offer other healthcare practices provided for in the PNPIC, and show that these practices, their benefits, and the government financing of PICs should be better publicized to users of the UHS and primary care providers, especially physicians. / Introdução: A Organização Mundial de Saúde tem reconhecido a importância das Práticas Integrativas e Complementares (PIC) e os altos custos da biomedicina tem estimulado os países a inserir seu uso no Sistema Público de Saúde, considerando que exigem recursos tecnológicos simplificados, que atuam na promoção, prevenção, tratamento e reabilitação dos principais agravos, com humanização do atendimento. Objetivo: analisar o perfil de usuários e o financiamento da acupuntura em um hospital de ensino no interior paulista. Método: pesquisa com abordagem quantitativa, transversal, com fonte de dados nos registros computadorizados entre os anos de 2010 a 2016, referente a 2564 pacientes que fizeram 19.034 atendimentos de acupuntura como prática terapêutica prescrita. Na análise dos dados foram realizadas técnicas de estatística descritiva e os teste de Mann-Whitney, de Análise de Variância (ANOVA), de comparação múltipla de Games-Howell, teste de correlação de Pearson e análise de Correspondência Múltipla (abordagem multivariada), para observar a relação entre todas as variáveis coletadas, o número total de atendimentos e o recurso financeiro total da prática de acupuntura. Resultados: a maioria dos pacientes era do sexo feminino- 1952 (76,13%); com ocupação do lar- 739 (28,82%); escolaridade em nível do ensino fundamental-1077 (42,00%); religião católica-1651 (64,39%). O número médio de atendimentos foi de 7,42 com desvio padrão de 8,99 atendimentos e mediana de 5,00 atendimentos. O financiamento médio com a realização da prática de acupuntura, por paciente, foi de 91,99 reais com desvio padrão de 120,10 reais e mediana de 56,52 reais, atingindo um máximo de 1429,06 reais. O financiamento médio, por atendimento, foi de 12,15 reais com desvio padrão de 3,74 reais e mediana de 14,13 reais, atingindo um máximo de 21,47 reais por atendimento. Conclusão: Há necessidade de ofertar outras práticas de atenção em saúde previstas na Política Nacional de Práticas Integrativas e Complementares e que deve ser mais divulgado entre usuários do SUS e aos profissionais de saúde no âmbito da Atenção Básica, principalmente aos médicos, os benefícios e o financiamento governamental das práticas integrativas e complementares.

Tong, Yan. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2011. / Includes bibliographical references (leaves 66-78). / Abstracts in English and Chinese; includes Chinese. / Acknowledgements --- p.i / Conferences & Academic Awards --- p.ii / Table of contents --- p.iii / List of figures --- p.vii / List of tables --- p.viii / List of abbreviations --- p.ix / Abstract --- p.x / Abstract (Chinese) / Chapter Chapter I --- Background of diabetes mellitus and DM complicating pregnancy …… --- p.1 / Chapter 1.1 --- Definitions and clinical manifestations of Diabetes Mellitus --- p.1 / Chapter 1.2 --- Diagnostic criteria of DM --- p.1 / Chapter 1.3 --- Classification of DM --- p.1 / Chapter 1.4 --- Prevalence of DM --- p.2 / Chapter 1.5 --- Aetiology and Pathogenesis of DM --- p.3 / Chapter 1.6 --- Treatment of DM --- p.3 / Chapter 1.7 --- Complications of DM --- p.4 / Chapter 1.8 --- DM complicating pregnancy --- p.4 / Chapter 1.8.1 --- Implications of DM complicating pregnancy --- p.4 / Chapter 1.8.2 --- Diabetic Embryopathy --- p.5 / Chapter 1.8.3 --- Incidences of the major congenital anomalies --- p.5 / Chapter 1.8.4 --- Possible pathogenesis of congenital anomalies in DM complicating pregnancy --- p.6 / Chapter 1.8.4.1 --- Apoptosis --- p.6 / Chapter 1.8.4.2 --- Oxidative stress --- p.7 / Chapter 1.8.4.3 --- Arachidonic acid and PGE2 --- p.7 / Chapter 1.8.5 --- Clinical management of DM complicating pregnancy --- p.8 / Chapter 1.8.5.1 --- Pre-pregnancy care --- p.8 / Chapter 1.8.5.2 --- Antenatal management of DM complicating pregnancy --- p.9 / Chapter Chapter II --- Background of Traditional Chinese Medicine in treatment of DM --- p.10 / Chapter 2.1 --- Definition and manifestations of DM in TCM theory --- p.10 / Chapter 2.2 --- Historical context of DM in TCM --- p.10 / Chapter 2.2.1 --- "Spring and Autumn Period and Warring States Period (770 B.C.一8 A.D.): The first nomenclature of ""Wasting Thirst""" --- p.10 / Chapter 2.2.2 --- "Han Dynasty (9 A.D.-280 A.D.)： monograph on ""Wasting Thirst""" --- p.11 / Chapter 2.2.3 --- "Sui and Tang Dynasty (581 A.D.-960 A.D.)： the diagnosing marker of ""Wasting Thirst""" --- p.11 / Chapter 2.2.4 --- Song Dynasty (960 A.D.-1270 A.D.): the Golden Time of developing the treatment on DM --- p.12 / Chapter 2.2.5 --- Ming and Qing Dynasty (1270 A.D. - 1911 A.D.): the integration period of TCM theory on DM --- p.15 / Chapter 2.3 --- Aetiology of DM in TCM theory --- p.15 / Chapter 2.3.1 --- Congenital weakness --- p.16 / Chapter 2.3.2 --- Improper diet --- p.16 / Chapter 2.3.3 --- Emotional disorders and overstrain --- p.17 / Chapter 2.3.4 --- Excessive sexual activities --- p.17 / Chapter 2.4 --- Pathogenesis of DM in TCM theory --- p.17 / Chapter 2.5 --- Prognosis of DM in TCM theory --- p.19 / Chapter 2.5.1 --- """Dual Qi-Yin Deficiency"" and ""Dual Yin-Yang Deficiency""" --- p.19 / Chapter 2.5.2 --- "Multi-systemic malfunction of ""Zang Fu""" --- p.19 / Chapter 2.6 --- Principle of treatment --- p.20 / Chapter 2.7 --- Commonly used herbal remedies and recent experimental studies --- p.20 / Chapter 2.8 --- TCM on relieving DM complications --- p.21 / Chapter 2.9 --- "Dwarf Lilyturf Tuber (Ophiopogonis Radix, Mai Dong,麥冬）" --- p.21 / Chapter 2.10 --- Objectives and hypothesis --- p.22 / Chapter 2.10.1 --- Objectives --- p.22 / Chapter 2.10.2 --- Hypotheses --- p.23 / Chapter Chapter III --- Methodology and Results --- p.24 / Chapter 3.1 --- Set up of mouse embryos --- p.24 / Chapter 3.1.1 --- Mouse strain --- p.24 / Chapter 3.1.2 --- Research animal ethnics and care guidelines --- p.24 / Chapter 3.1.3 --- Mouse sacrifice and embryo dissection --- p.24 / Chapter 3.1.4 --- Grouping of embryos --- p.25 / Chapter 3.2 --- Preparations of D-glucose --- p.25 / Chapter 3.3 --- Chinese medicine quality controls and preparations --- p.25 / Chapter 3.4 --- Whole mouse embryo culture --- p.26 / Chapter 3.5 --- Morphological scoring on mouse embryos and statistical analysis --- p.27 / Chapter 3.6 --- Establishment of cranial NTD by D-glucose --- p.28 / Chapter 3.6.1 --- Dosage of D-glucose to induce cranial NTD --- p.29 / Chapter 3.6.2 --- Result --- p.30 / Chapter 3.7 --- Experimental designs --- p.31 / Chapter 3.8 --- Part I: Efficacy and dose-response effects of Maidong extract --- p.32 / Chapter 3.8.1 --- Safety dose of Maidong extract on non-diabetic mouse embryos --- p.32 / Chapter 3.8.1.1 --- Dosage --- p.32 / Chapter 3.8.1.2 --- Result --- p.35 / Chapter 3.8.2 --- Efficacy and dose-effect response of Maidong extract on non-diabetic mouse embryos --- p.36 / Chapter 3.8.2.1 --- Dosage and grouping --- p.37 / Chapter 3.8.2.2 --- Result --- p.38 / Chapter 3.9 --- Part II: Efficacy and dose-response effects of serum from Maidong extract-treated rat serum --- p.40 / Chapter 3.9.1 --- Preparation of Maidong treated non-diabetic full rat serum --- p.41 / Chapter 3.9.1.1 --- Rats --- p.41 / Chapter 3.9.1.2 --- Dosage for feeding --- p.41 / Chapter 3.9.1.3 --- Administration --- p.42 / Chapter 3.9.1.4 --- Termination of rats and preparation of rat serum --- p.42 / Chapter 3.9.2 --- Safety dose of Maidong treated non-diabetic full rat serum non-diabetic mouse embryos --- p.43 / Chapter 3.9.2.1 --- Dosage --- p.43 / Chapter 3.9.2.2 --- Result --- p.44 / Chapter 3.9.3 --- Protective Effect of Maidong extract-treated full rat serum --- p.46 / Chapter 3.9.3.1 --- Dosage and grouping --- p.46 / Chapter 3.9.3.2 --- Result --- p.47 / Chapter 3.10 --- "Part III: Efficacy and dose-response effects of Ophiopogonin D, a major chemical component of Maidong in preventing hyperglycemia-induced cranial neural tube defect" --- p.49 / Chapter 3.10.1 --- Safety dose of Ophiopogonin D --- p.50 / Chapter 3.10.1.1 --- Preparation of Ophiopogonin D --- p.50 / Chapter 3.10.1.2 --- Dosage --- p.50 / Chapter 3.10.1.3 --- Results --- p.52 / Chapter 3.10.2 --- Efficacy and dose-response effects of Ophiopogonin D --- p.53 / Chapter 3.10.2.1 --- Dosage and grouping --- p.53 / Chapter 3.10.2.2 --- Results --- p.55 / Chapter Chapter IV --- Discussion --- p.58 / Chapter 4.1 --- Whole embryo culture system --- p.58 / Chapter 4.2 --- Quality control of Maidong extract --- p.58 / Chapter 4.3 --- "Therapeutic effect of single herb, formula and chemical components" --- p.59 / Chapter 4.4 --- Dosage of D-glucose to induce cranial NTD --- p.60 / Chapter 4.5 --- Dosage and efficacy of Maidong extract and Ophiopogonin D --- p.60 / Chapter 4.6 --- Administration of Maidong extract to non-diabetic female rats --- p.61 / Chapter Chapter V --- Conclusions --- p.63 / Chapter Chapter VI --- Future Study --- p.64 / References --- p.66

Wong, Ka Yee. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2010. / Includes bibliographical references (leaves 177-189). / Abstracts in English and Chinese; includes Chinese. / Abstract --- p.i / 摘要 --- p.iii / Acknowledgements --- p.v / Table of Contents --- p.vii / List of Appendices --- p.xi / List of Tables --- p.xii / List of Figures --- p.xiv / Abbreviations --- p.xvi / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- General Introduction --- p.1 / Chapter 1.2 --- Background to the study --- p.2 / Chapter 1.2.1 --- Epidemiology of cancer --- p.2 / Chapter 1.2.1.1 --- Incidence and mortality in the World --- p.2 / Chapter 1.2.1.2 --- Incidence and mortality in Hong Kong --- p.4 / Chapter 1.2.2 --- Prevalence of Traditional Chinese Medicine (TCM) --- p.5 / Chapter 1.2.3 --- Prevalence of Traditional Chinese Medicine (TCM) in cancer --- p.6 / Chapter 1.2.4 --- Development of TCM in Hong Kong --- p.7 / Chapter 1.3 --- Theoretical rationale of the study --- p.8 / Chapter 1.4 --- Significance of the study --- p.11 / Chapter Chapter 2 --- Literature Review --- p.13 / Chapter 2.1 --- Introduction --- p.13 / Chapter 2.2 --- The concept of Advanced Cancer --- p.13 / Chapter 2.2.1 --- Pathology of Advanced Cancer --- p.14 / Chapter 2.2.1.1 --- Metastatic Cancer --- p.14 / Chapter 2.2.2 --- Sign and Symptoms of Advanced Cancer --- p.19 / Chapter 2.2.3 --- Diagnosis of Advanced Cancer --- p.19 / Chapter 2.2.4 --- Current Treatment for Advanced Cancer --- p.21 / Chapter 2.2.5 --- Limitation of Current Treatments --- p.24 / Chapter 2.3 --- Diagnosis and Treatment by TCM of Advanced Cancer --- p.26 / Chapter 2.3.1 --- (Advanced) Cancer from the TCM perspectives --- p.26 / Chapter 2.3.2 --- Diagnosis by TCM of Advanced Cancer --- p.27 / Chapter 2.3.3 --- Treatment by TCM of Advanced Cancer --- p.28 / Chapter 2.4 --- Current Evidences about the Clinical Effectiveness of TCM on Cancer Patients --- p.29 / Chapter 2.5 --- The concept of Health-related Quality of Life (HRQOL) --- p.35 / Chapter 2.5.1 --- The importance of HRQOL to cancer patients --- p.35 / Chapter 2.5.2 --- HRQOL instruments --- p.37 / Chapter 2.5.2.1 --- EORTC QLQ-C30 --- p.38 / Chapter 2.5.2.2 --- SF-36 --- p.39 / Chapter 2.6 --- Summary of Literature Review --- p.40 / Chapter 2.7 --- The research questions --- p.41 / Chapter 2.8 --- Research Hypotheses --- p.42 / Chapter 2.9 --- The design of TCM protocol --- p.42 / Chapter Chapter 3 --- Methodology --- p.45 / Chapter 3.1 --- Introduction --- p.45 / Chapter 3.2 --- Protocol --- p.45 / Chapter 3.2.1 --- Study Design --- p.46 / Chapter 3.2.2 --- Selection of Participants --- p.46 / Chapter 3.2.2.1 --- Inclusion criteria --- p.48 / Chapter 3.2.2.2 --- Exclusion criteria --- p.49 / Chapter 3.2.3 --- Sample size calculation --- p.50 / Chapter 3.2.4 --- Setting --- p.51 / Chapter 3.2.5 --- Interventions --- p.51 / Chapter 3.2.5.1 --- Treatment --- p.51 / Chapter 3.2.5.2 --- Medication and dose/dosage --- p.52 / Chapter 3.2.5.3 --- Treatment Assignment --- p.55 / Chapter 3.2.5.4 --- Concurrent Medications --- p.56 / Chapter 3.2.6 --- Procedure and Methods --- p.56 / Chapter 3.2.6.1 --- Informed Consent --- p.56 / Chapter 3.2.6.2 --- Documentation --- p.57 / Chapter 3.2.6.3 --- Assessment Procedure --- p.57 / Chapter 3.2.7 --- Outcome Measurements --- p.62 / Chapter 3.2.7.1 --- Survey Questionnaire --- p.62 / Chapter 3.2.7.2 --- Quality of life (QOL) instruments --- p.62 / Chapter 3.2.7.3 --- Global Ratings --- p.64 / Chapter 3.2.7.4 --- Physical Examination and Laboratory tests --- p.65 / Chapter 3.2.8 --- Safety Considerations --- p.66 / Chapter 3.2.8.1 --- Adverse Events (AE) --- p.66 / Chapter 3.2.8.2 --- Serious Adverse Event (SAE) --- p.66 / Chapter 3.2.8.3 --- Causality Assessment --- p.67 / Chapter 3.2.9 --- Ethical consideration --- p.68 / Chapter 3.2.10 --- Data Collection --- p.69 / Chapter 3.3 --- Data analysis --- p.69 / Chapter 3.4 --- Expected Outcomes of Study --- p.71 / Chapter Chapter 4 --- Results --- p.72 / Chapter 4.1 --- Study Progress --- p.72 / Chapter 4.2 --- The Participants --- p.72 / Chapter 4.3 --- Clinical characteristics and Socio-demographics of Participants --- p.75 / Chapter 4.4 --- Main Outcome - Quality of Life --- p.78 / Chapter 4.4.1 --- QLQ-C30 --- p.79 / Chapter 4.4.1.1 --- Scoring and Transforming of items into scales --- p.79 / Chapter 4.4.1.2 --- Changes of Individual Scale at Different Visits --- p.80 / Chapter 4.4.1.3 --- Clinical significance of Scales --- p.98 / Chapter 4.4.2 --- SF-36 --- p.104 / Chapter 4.4.2.1 --- Scoring and Transforming of items into scales --- p.104 / Chapter 4.4.2.2 --- Changes of Individual Scale at Different Visits --- p.104 / Chapter 4.4.2.3 --- SF-36 Summary Scales --- p.113 / Chapter 4.4.3 --- Correlation of QLQ-C30 and SF-36 --- p.115 / Chapter 4.5 --- Measurement of Physical examination --- p.117 / Chapter 4.5.1 --- Body Weight --- p.117 / Chapter 4.6 --- Measurement of Laboratory Blood tests --- p.118 / Chapter 4.6.1 --- "Comparison of CBC, RFT, LFT and LD" --- p.118 / Chapter 4.6.2 --- Tumor Markers --- p.120 / Chapter 4.7 --- Adverse Events and Serious Adverse Events --- p.121 / Chapter 4.8 --- Global Ratings --- p.123 / Chapter 4.8.1 --- Global Rating 1 - Severity of Disease --- p.123 / Chapter 4.8.2 --- Global Rating 2 - Global Disease Status --- p.124 / Chapter 4.8.2.1 --- Change in Global Disease Status --- p.125 / Chapter 4.8.2.2 --- Agreement between RCMP and clinician --- p.125 / Chapter 4.8.2.3 --- Patients' perception after treatment --- p.126 / Chapter 4.9 --- Distribution of TCM patterns and Chinese herbal medicines --- p.127 / Chapter 4.10 --- Survival Rate --- p.132 / Chapter 4.11 --- Conclusion --- p.133 / Chapter Chapter 5 --- Discussion --- p.135 / Chapter 5.1 --- Conclusion on findings --- p.135 / Chapter 5.2 --- Baseline profile of participants --- p.137 / Chapter 5.3 --- Feasibility of TCM on advanced cancer patients --- p.139 / Chapter 5.3.1 --- Recruitment of Participants --- p.139 / Chapter 5.3.2 --- Compliance of participants to the study schedule --- p.140 / Chapter 5.4 --- Health-related Quality of Life --- p.142 / Chapter 5.5 --- Safety of TCM --- p.149 / Chapter 5.6 --- Chinese medicine practitioner vs Western medicine doctor --- p.150 / Chapter 5.7 --- TCM pattern differentiation and treatment --- p.151 / Chapter 5.8 --- Implication of study --- p.154 / Chapter 5.8.1 --- Clinical implication --- p.154 / Chapter 5.8.2 --- Policy implication --- p.154 / Chapter 5.9 --- Limitations of the study --- p.155 / Chapter 5.10 --- Recommendations for further studies --- p.157 / Chapter 5.11 --- Overall Conclusion --- p.158 / Appendices --- p.160 / References --- p.177