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Hawthorn (Crataegus) may play a role in the prevention and treatment of cardiovascular diseases such as hypertension, hyperlipidemia, and in particular, congestive heart failure. Evidence is accumulating that hawthorn may induce anti-ischemia/reperfusion-injury, anti-arrhythmic, hypolipidemic and hypotensive effects. These beneficial effects may in part be due to the presence of antioxidant flavonoid components. While a number of studies have been performed to evaluate the clinical efficacy of hawthorn, an international, multi-center, prospective clinical study including a large number of New York Heart Association (NYHA) class II/III heart failure patients is ongoing to test hawthorn's long-term therapeutic effects. Further clinical trials as well as pharmacokinetic and mechanistic studies are needed to explore and confirm its effectiveness, safety and pharmacological mechanism.

The bioactive elements in Chinese therapeutic foods and herbs that are frequently consumed by people in both the East and West are analyzed. These elements in their appropriate dosage range are considered to be beneficial to health. Inductively Coupled Plasma Mass Spectrometry (ICP-MS) and Atomic Absorption Spectrometry (AAS) were applied to determine the concentrations of various elements. Twenty-two Chinese therapeutic foods and herbs, resourced from the traditional high therapeutic quality areas or provinces were selected. Bioactive analysis focused on Lanthanum (La), Strontium (Sr), Zinc (Zn) and Selenium (Se), especially in the prevention and treatment of hyperlipidemia and its associate disorders. The higher elemental concentration herbs, La in: Rhizoma Gastrodiae Elatae, Fructus Crataegi and Herba Hedyotidis Diffusae. Sr in: Radix Puerariae and Folium Ginkgo Biloba. Zn in: Flos Carthami Tinctorii and Fructus Crataegi. Se in: Flos Lonicerae Japonicae and Portulaca Oleracea. The results mainly showed that Chinese herbs which are also therapeutic foods may be used as nutritional supplements for preventing and treating elemental deficiency, e.g., hyperlipidemia. More attention in this regard should be paid to herbs that contain La and are traditionally used for regulating cardiovascular disorders. The knowledge of the effects and concentrations of bioactive elements in foods and herbs could guide the selection of Chinese herbs in clinical practice in conjunction with traditional Chinese medicine theories. Further studies should also be considered in relation to Sr, Zn and blood regulating herbs, which could prove to be beneficial.

Morus alba L. has been used in traditional Chinese medicine and almost all parts of this plant are useful in cardiovascular, liver and spleen disorders. The present study was designed to investigate the inhibitory effect of a water extract from Morus alba L. (WMA) on vascular dysfunction in rat models fed a high fat and high cholesterol diet. Male rats were fed an atherogenic diet consisting of food with 7.5% cocoa butter and 1.25% cholesterol, with or without 100 or 200 mg/day/kg WMA, for 14 weeks. Chronic treatment with low (100 mg/kg/day) or high (200 mg/day/kg) doses of WMA markedly attenuated hypertension and the impairments of acetylcholine-induced relaxation of aortic rings in rats fed an atherogenic diet. WMA reduced intima/media thickness in rats fed an atherogenic diet. WMA improved plasma levels of triglyceride (TG) and augmented plasma levels of high-density lipoprotein (HDL) and plasma low-density lipoprotein (LDL), but did not affect blood glucose levels. Interestingly, WMA suppressed increased cell adhesion molecules such as E-selectin, vascular cell adhesion molecule-1 (VCAM-1), and intracellular adhesion molecule-1 (ICAM-1) expression in the aorta. Taken together, these results suggested that Morus alba L. could improve an atherogenic diet-induced hypertension, hyperlipidemia, and vascular dysfunction through inhibition of cell adhesion molecules expression and induction of vascular relaxation.

Diabetes mellitus is the leading cause of vascular complications such as atherosclerosis. This study was designed to investigate whether Prunella vulgaris (APV) would inhibit diabetic atherosclerosis in db/db mice with type 2 diabetes. The db/db mice were treated with high fat/high cholesterol (HFHC) diet and an aqueous extract of APV (100 and 200 mg/kg/day) for eight weeks to examine the long-term effect on metabolic abnormalities and diabetic atherosclerosis. APV treatment markedly lowered blood glucose and systolic blood pressure. The db/db mice experienced an increase in blood urea nitrogen as well as a decrease of creatinine clearance, the latter of which was restored by treatment with APV. Treatment with APV markedly decreased total plasma cholesterol, triglyceride, and LDL-cholesterol and also increased the HDL-cholesterol. In addition, malondialdehyde and TGF-β1 were decreased by treatment of APV. On the other hand, total NO level was decreased in db/db mice. However, the NO level was increased by treatment with APV, suggesting an association with vascular dysfunction. Vascular relaxation of aortic rings by acetylcholine or SNP-inducement was ameliorated by APV in a dose-dependent manner. Damage of vascular intima and hypertrophic of media were observed in db/db mice; however its dysfunction was improved by the treatment of APV. APV treatment significantly reduced the aortic expressions of ICAM-1, VCAM-1, ET-1, and nitrotyrosine. Furthermore, expression of eNOS in aortic was remarkably increased by APV treatment. Taken together, APV suppressed hyperglycemia and diabetic vascular dysfunction in HFHC diet-db/db mice. The present data suggest that Prunella vulgaris may prevent development of diabetic atherosclerosis.

To systematically evaluate the efficacy and safety of berberine for the treatment of hyperlipidemia, six electronic literature databases including SinoMed, CNKI, WanFang Data, PubMed, Embase and The Cochrane Library were searched to collect clinical randomized controlled trials (RCTs) of berberine alone or combined with statins for the treatment of hyperlipidemia from the inception to 8 March 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included RCTs. Then, meta-analysis was performed by using RevMan 5.3 software. A total of 11 RCTs involving 1386 patients were finally included. The results of meta-analysis showed that compared with the placebo group, berberine could significantly reduce the total cholesterol and low-density lipoprotein levels and elevate the high density lipoprotein level ($P<0.05$). Compared with the simvastatin group, berberine was effective only in reducing the level of triglyceride ($\mathrm{\text{MD}}=-0.37$, 95% CI: $-$0.66, $-$0.07, $P=0.02$). There, however, was no statistical significance between the BBR group and simvastatin group in the low density lipoprotein and high density lipoprotein levels. Compared with the simvastatin group, berberine plus simvastatin was more effective in reducing the level of triglyceride ($\mathrm{\text{MD}}=-0.33$, 95% CI: $-$0.46, $-$0.20, $P<0.00001$) and total cholesterol ($\mathrm{\text{MD}}=-0.36$, 95% CI: $-$0.60, $-$0.12, $P=0.003$). In terms of adverse reactions, the incidence of adverse reactions including transaminase elevation and muscle aches was lower in the berberine alone or combined with simvastatin group than that in the control group, while the instance of constipation was higher. This study suggests that berberine is effective for hyperlipidemia. The quality and quantity of included studies, however, were dissatisfactory, which might decrease the reliability of the results. Higher quality studies are needed to provide more high quality evidence.

Corosolic acid (CA) is the main active component of Lagetstroemia speciosa and has been known to serve as several different pharmacological effects, such as antidiabetic, anti-oxidant, and anticancer effects. In this study, effects of CA on the hepatic lipid accumulation were examined using HepG2 cells and tyloxapol (TY)-induced hyperlipidemia ICR mice. CA significantly inhibited hepatic lipid accumulation via inhibition of SREBPs, and its target genes FAS, SCD1, and HMGCR transcription in HepG2 cells. These effects were mediated through activation of AMPK, and these effects were all abolished in the presence of compound C (CC, an AMPK inhibitor). In addition, CA clearly alleviated serum ALT, AST, TG, TC, low-density lipoprotein cholesterol (LDL-C), and increased high-density lipoprotein cholesterol (HDL-C) levels, and obviously attenuated TY-induced liver steatosis and inflammation. Moreover, CA significantly upregulated AMPK, ACC, LKB1 phosphorylation, and significantly inhibited lipin1, SREBPs, TNF-$\alpha$, F4/80, caspase-1 expression, NF-$\kappa$B translocation, and MAPK activation in TY-induced hyperlipidemia mice. Our results suggest that CA is a potent antihyperlipidemia and antihepatic steatosis agent and the mechanism involved both lipogenesis and cholesterol synthesis and inflammation response inhibition via AMPK/SREBPs and NF-$\kappa$B/MAPK signaling pathways.

Developing effective and safe lipid-lowering drugs is highly urgent. This study aims to investigate the effectiveness and underlying mechanisms of Gynostemma pentaphyllum (GP) in the treatment of hyperlipidemia. First, a meta-analysis was performed to determine the lipid-lowering effects of GP. Thereafter, hyperlipidemia was induced in mice using a high-fat diet (HFD) and was subsequently treated with Gynostemma pentaphyllum extract (GPE) by daily gavage for 12 weeks. The body weight, tissue weight, blood lipid level, and liver lipid level were determined. Additionally, mouse serum samples were subjected to metabolomic profiling and feces were collected at different time points for metagenomic analysis via 16S rDNA sequencing. A total of 15 out of 1520 studies were retrieved from six databases. The pooled results of the meta-analysis showed that GP effectively reduced triglyceride levels and increased high-density lipoprotein cholesterol (both $p<0.05$). Animal experiments revealed that GPE administration significantly reduced body weight, ameliorated high blood lipid levels, limited lipid deposition, and improved insulin resistance. Furthermore, GPE treatment markedly changed the intestinal microbiota structure and constitution of tryptophan metabolites. In conclusion, our results confirm the lipid-lowering effect of GP, which may be partly attributable to regulation of the intestinal microbiota and tryptophan metabolism.

Hyperlipidemia (HL) and unstable angina (UA) are two sequential diseases that cause more and more morbidity and mortality world-wide. Biomarkers selection in the level of physical and chemical specifications (PCS) plays a key role in understanding the pathology of both diseases. Neuro-Endocrine-Immune (NEI) system is a preferable pathway to investigate the interaction network of related PCS in the context of HL and UA. Data mining approaches are a kind of advanced statistical methods to unravel the "secret" of interaction network of PCS in both diseases. Feature selection methods are a branch of data mining approaches to select informative subset of PCS as biomarkers to distinguish a disease from healthy control cohort with high classification accuracy. In this paper, we firstly use three feature selection methods combined with decision tree classification algorithm to select several biomarkers from NEI network. The results show that SVM based decision tree is best fit to select biomarkers for both diseases. Furthermore, we use the theory from Traditional Chinese Medicine (TCM) to divide HL and UA patients into two subgroups. Based on this, we propose a novel feature selection method to distinguish the two subgroups. We combine variance analysis with classification method to select three to four biomarkers for two subgroups in the context of HL and UA respectively, which means that NEI specifications behave differently between two subgroups. According to basic theory of TCM, variant subgroups defined by TCM need to be treated differently. It means that patients with the same disease may be treated in a personalized way. The research efforts in the paper not only to provide a better avenue to understand the nature of diseases, but also to pave a basis to treat two diseases in a personalized way.

Review of China's Biopharmaceautical Industries in Recent Years.