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Evidence-Based Complementary and Alternative Medicine
Volume 2016 (2016), Article ID 4305074, 10 pages
http://dx.doi.org/10.1155/2016/4305074
Review Article

Substitutes for Bear Bile for the Treatment of Liver Diseases: Research Progress and Future Perspective

School of Chinese Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong

Received 20 January 2016; Accepted 3 March 2016

Academic Editor: Siyaram Pandey

Copyright © 2016 Sha Li et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. Y. J. Zhang, S. G. Yuan, S. B. Ruan, and Z. F. Hong, “Review on Chinese pharmacology and clinical application of bear bile,” Journal of Liaoning University of Traditional Chinese Medicine, vol. 12, no. 17, pp. 107–108, 2010. View at Google Scholar
  2. Y.-H. Chen, H.-W. Xue, and C.-F. Zhou, “Research of rare animal medicine bear gall,” Chinese Journal of New Drugs, vol. 21, no. 9, pp. 952–968, 2012. View at Google Scholar · View at Scopus
  3. J. Still, “Use of animal products in traditional Chinese medicine: environmental impact and health hazards,” Complementary Therapies in Medicine, vol. 11, no. 2, pp. 118–122, 2003. View at Publisher · View at Google Scholar · View at Scopus
  4. Y. Feng, K. Siu, N. Wang et al., “Bear bile: dilemma of traditional medicinal use and animal protection,” Journal of Ethnobiology and Ethnomedicine, vol. 5, no. 2, pp. 1–9, 2009. View at Publisher · View at Google Scholar · View at Scopus
  5. C.-F. Zhou, G.-J. Gao, and Y. Liu, “Advances in studies on bear bile powder,” China Journal of Chinese Materia Medica, vol. 40, no. 7, pp. 1252–1258, 2015. View at Google Scholar · View at Scopus
  6. Z. R. Feng and J. B. Jia, “Medicinal use and substitution of bear gallbladder,” Journal of Anhui Agricultural Science, vol. 43, no. 7, pp. 150–152, 2015. View at Google Scholar
  7. G. J. Kou, C. Zhang, Z. L. Wang, Q. Xu, and B. H. Wang, “Study progress on pharmacology of bear bile powder,” Chinese Journal of Drug Evaluation, vol. 31, no. 3, pp. 142–145, 2014. View at Google Scholar
  8. S. Fu and J. P. Fan, “Protective effects and mechanism of bear bile powder on H2O2-induced apoptosis in PC12 cells,” China Journal of Traditional Chinese Medicine and Pharmacy, vol. 29, no. 1, pp. 55–59, 2014. View at Google Scholar
  9. J. S. Park, D. H. Yoo, I. J. Lee, E. Roh, Y. Kim, and K. Han, “Therapeutic effect of whole bear bile and its components against croton oil-induced rectal inflammation in rats,” Biomolecules and Therapeutics, vol. 18, no. 1, pp. 83–91, 2010. View at Publisher · View at Google Scholar · View at Scopus
  10. J.-Y. Zhao, W. Lin, Q.-C. Zhuang, X.-Y. Zhong, J. Peng, and Z.-F. Hong, “Bear bile powder inhibits angiogenesis in vivo and in vitro,” Chinese Journal of Integrative Medicine, vol. 21, no. 5, pp. 369–375, 2015. View at Publisher · View at Google Scholar · View at Scopus
  11. M. Tao, W. J. Zhao, and J. W. Wang, “Research progress of pharmacology and clinical application of bear bile,” Information on Traditional Chinese Medicine, vol. 30, no. 3, pp. 153–155, 2013. View at Google Scholar
  12. Y. Shi, Q. W. Zou, F. Wei, S. C. Ma, and R. C. Lin, “The research progress on bear gall powder,” Chinese Pharmaceutical Affairs, vol. 28, no. 1, pp. 82–85, 2014. View at Google Scholar
  13. A. J. Dutton, C. Hepburn, and D. W. Macdonald, “A stated preference investigation into the Chinese demand for farmed vs. wild bear bile,” PLoS ONE, vol. 6, no. 7, Article ID e21243, 2011. View at Publisher · View at Google Scholar · View at Scopus
  14. B. Yuan, Y.-L. Ren, L. Ma, H. Gu, Y. Wang, and Y.-J. Qiao, “Analysis on replacement of traditional Chinese medicine bear bile with bile acids based on drug properties,” China Journal of Chinese Materia Medica, vol. 39, no. 4, pp. 738–743, 2014. View at Publisher · View at Google Scholar · View at Scopus
  15. N. Wang, Y. Feng, F. Cheung et al., “A comparative study on the hepatoprotective action of bear bile and coptidis rhizoma aqueous extract on experimental liver fibrosis in rats,” BMC Complementary and Alternative Medicine, vol. 12, article 239, 2012. View at Publisher · View at Google Scholar · View at Scopus
  16. C. M. Yang, H. Z. Wang, R. L. Hu, and Z. S. Feng, “Studies on the bile-acid compositions of several fowl and domestic animal bile,” Xinjiang Agricultural Sciences, vol. 43, no. 6, pp. 467–472, 2006. View at Google Scholar
  17. M. S. Miao and X. Y. Fang, “The experimental research progress of bear bile,” Journal of Medical Forum, vol. 24, no. 11, pp. 78–79, 2003. View at Google Scholar
  18. J. Gao, Y. W. Li, and X. M. Gao, “The rational application of bear bile,” Tianjin Journal of Traditional Chinese Medicine, vol. 29, no. 2, pp. 197–200, 2012. View at Google Scholar
  19. N. Wang, Y. Feng, T. N. Xie et al., “Chemical and biological analysis of active free and conjugated bile acids in animal bile using HPLC-ELSD and MTT methods,” Experimental and Therapeutic Medicine, vol. 2, no. 1, pp. 125–130, 2011. View at Publisher · View at Google Scholar · View at Scopus
  20. X. Qiao, W. Song, X.-H. Lin et al., “Rapid chemical analysis of bear bile: 5 minute separation and quantitation of bile acids using UHPLC-qTOF-MS,” Analytical Methods, vol. 6, no. 2, pp. 596–601, 2014. View at Publisher · View at Google Scholar · View at Scopus
  21. D.-L. Lin, H.-C. Chang, and C.-Y. Chen, “Identification and quantitation of bile acids in bear bile by HPLC,” Journal of Food and Drug Analysis, vol. 8, no. 4, pp. 283–288, 2000. View at Google Scholar · View at Scopus
  22. Q. Luo, Q. C. Chen, Y. Wu et al., “Chemical constituents of bear bile,” China Journal of Chinese Materia Medica, vol. 35, no. 18, pp. 2416–2419, 2010. View at Publisher · View at Google Scholar · View at Scopus
  23. D. Bi, X.-Y. Chai, Y.-L. Song, Y. Lei, and P.-F. Tu, “Novel bile acids from bear bile powder and bile of geese,” Chemical & Pharmaceutical Bulletin, vol. 57, no. 5, pp. 528–531, 2009. View at Publisher · View at Google Scholar · View at Scopus
  24. L.-H. Jian, X.-H. Mao, K. Wang, and S. Ji, “Structure determination of three novel bile acids from bear bile powder,” Acta Pharmaceutica Sinica, vol. 48, no. 8, pp. 1297–1300, 2013. View at Google Scholar · View at Scopus
  25. Y.-W. Li, X.-Y. Zhu, P. P.-H. But, and H.-W. Yeung, “Ethnopharmacology of bear gall bladder: I,” Journal of Ethnopharmacology, vol. 47, no. 1, pp. 27–31, 1995. View at Publisher · View at Google Scholar · View at Scopus
  26. J. H. Boatright, J. M. Nickerson, A. G. Moring, and M. T. Pardue, “Bile acids in treatment of ocular disease,” Journal of Ocular Biology, Diseases, and Informatics, vol. 2, no. 3, pp. 149–159, 2009. View at Publisher · View at Google Scholar · View at Scopus
  27. S. Z. Yu, “Pharmacological effects and clinical application of bear bile,” Lishizhen Medicine and Materia Medica Research, vol. 18, no. 5, pp. 707–708, 2007. View at Google Scholar
  28. Y. J. Lee, “The use of bear bile as medicine versus tonic,” in Proceedings of the Third International Symposium on the Trade in Bear Parts, D. F. Williamson and M. J. Phipps, Eds., pp. 122–126, Traffic East Asia, Seoul, Republic of Korea, October 1999.
  29. C. Fimognari, M. Lenzi, G. Cantelli-Forti, and P. Hrelia, “Apoptosis and modulation of cell cycle control by bile acids in human leukemia T cells,” Annals of the New York Academy of Sciences, vol. 1171, pp. 264–269, 2009. View at Publisher · View at Google Scholar · View at Scopus
  30. X.-J. Wang, G.-L. Yan, A.-H. Zhang et al., “Metabolomics and proteomics approaches to characterize and assess proteins of bear bile powder for hepatitis C virus,” Chinese Journal of Natural Medicines, vol. 11, no. 6, pp. 653–665, 2013. View at Publisher · View at Google Scholar · View at Scopus
  31. J. J. Liu, X. H. Xiao, Y. Xue, and L. H. Chai, “Protective effect of bear bile powder on alcohol-induced oxidative damage in mouse primary cultured hepatocytes,” Chinese Journal of Wildlife, vol. 34, no. 4, pp. 223–225, 2013. View at Google Scholar
  32. C. S. Zhou, Z. Y. Yin, W. X. Zhao et al., “Study of bear bile on immunologic feature of hepatic stellate cells in vivo,” China Journal of Traditional Chinese Medicine and Pharmacy, vol. 26, no. 10, pp. 2251–2254, 2011. View at Google Scholar
  33. C. S. Zhou, Z. Y. Yin, W. X. Zhao et al., “Bear bile affects immunologic feature of hepatic stellate cells,” Journal of Hepatobiliary Surgery, vol. 20, no. 3, pp. 204–208, 2012. View at Google Scholar
  34. Y. Liu, Z. F. Hong, W. R. Shi et al., “Effects of compound Xiongdanyinchen granules on fat content and lipase activity in liver of hyperlipemia model rats,” Journal of Fujian University of Traditional Chinese Medicine, vol. 23, no. 3, pp. 21–22, 2013. View at Google Scholar
  35. M.-J. Quan, R.-S. Jin, L. Piao, and D.-M. Piao, “Inhibitory effects of bear bile powder on dimethylnitrosamine-induced liver fibrosis in rats,” World Chinese Journal of Digestology, vol. 13, no. 20, pp. 2487–2490, 2005. View at Google Scholar · View at Scopus
  36. C.-S. Zhou, Z.-Y. Yin, W.-X. Zhao et al., “Bear bile inhibits the immunosuppression activity of hepatic stellate cells in vivo,” Hepato-Gastroenterology, vol. 59, no. 117, pp. 1529–1536, 2012. View at Publisher · View at Google Scholar · View at Scopus
  37. J.-Y. Zhao, Z.-H. Chen, W. Lin et al., “Bear bile powder induces apoptosis of human hepatocellular carcinoma cells via mitochondrion-dependent pathway,” Chinese Journal of Integrative Medicine, vol. 20, no. 2, pp. 123–129, 2014. View at Publisher · View at Google Scholar · View at Scopus
  38. J.-Y. Zhao, L.-Y. Liu, A.-L. Shen et al., “Effect of bear bile powder on STAT3 pathway in hepatocellular carcinoma xenograft,” Chinese Journal of Integrated Traditional and Western Medicine, vol. 34, no. 8, pp. 976–981, 2014. View at Google Scholar · View at Scopus
  39. J.-Y. Zhou, Z.-Y. Yin, S.-Y. Wang et al., “Influence of bear bile on rat hepatocarcinoma induced by diethylnitrosamine,” Acta Pharmaceutica Sinica, vol. 47, no. 11, pp. 1483–1488, 2012. View at Google Scholar · View at Scopus
  40. W. Cui, S. Liu, M. Yang et al., “Study on inhibitory effect of combined administration of bear bile powder and cyclophosphamide on colorectal cancer liver metastasis by regulating tumor microenvironment,” China Journal of Chinese Materia Medica, vol. 38, no. 7, pp. 1036–1040, 2013. View at Publisher · View at Google Scholar · View at Scopus
  41. S. X. Yu and Y. Gao, “The pharmacological study of natural and artificial bear bile,” Jilin Chinese Medicine, vol. 25, no. 3, pp. 55–56, 2005. View at Google Scholar
  42. R. Wimmer, S. Hohenester, T. Pusl, G. U. Denk, C. Rust, and U. Beuers, “Tauroursodeoxycholic acid exerts anticholestatic effects by a cooperative cPKCα-/PKA-dependent mechanism in rat liver,” Gut, vol. 57, no. 10, pp. 1448–1454, 2008. View at Publisher · View at Google Scholar · View at Scopus
  43. T. Pusl, T. Vennegeerts, R. Wimmer, G. U. Denk, U. Beuers, and C. Rust, “Tauroursodeoxycholic acid reduces bile acid-induced apoptosis by modulation of AP-1,” Biochemical and Biophysical Research Communications, vol. 367, no. 1, pp. 208–212, 2008. View at Publisher · View at Google Scholar · View at Scopus
  44. A. L. Rivard, C. J. Steer, B. T. Kren et al., “Administration of Tauroursodeoxycholic Acid (TUDCA) reduces apoptosis following myocardial infarction in rat,” American Journal of Chinese Medicine, vol. 35, no. 2, pp. 279–295, 2007. View at Publisher · View at Google Scholar · View at Scopus
  45. X. Qiao, M. Ye, D.-L. Pan et al., “Differentiation of various traditional Chinese medicines derived from animal bile and gallstone: Simultaneous determination of bile acids by liquid chromatography coupled with triple quadrupole mass spectrometry,” Journal of Chromatography A, vol. 1218, no. 1, pp. 107–117, 2011. View at Publisher · View at Google Scholar · View at Scopus
  46. C. Gluud and E. Christensen, “Ursodeoxycholic acid for primary biliary cirrhosis,” The Cochrane Database of Systematic Reviews, no. 1, Article ID CD000551, 2002. View at Google Scholar
  47. D. Festi, M. Montagnani, F. Azzaroli et al., “Clinical efficacy and effectiveness of ursodeoxycholic acid in cholestatic liver diseases,” Current Clinical Pharmacology, vol. 2, no. 2, pp. 155–177, 2007. View at Publisher · View at Google Scholar · View at Scopus
  48. R. Poupon, “Ursodeoxycholic acid and bile-acid mimetics as therapeutic agents for cholestatic liver diseases: an overview of their mechanisms of action,” Clinics and Research in Hepatology and Gastroenterology, vol. 36, no. 1, pp. S3–S12, 2012. View at Publisher · View at Google Scholar · View at Scopus
  49. O. F. W. James, “Ursodeoxycholic acid treatment for chronic cholestatic liver disease,” Journal of Hepatology, vol. 11, no. 1, pp. 5–8, 1990. View at Publisher · View at Google Scholar · View at Scopus
  50. D. M. Heuman, “Hepatoprotective properties of ursodeoxycholic acid,” Gastroenterology, vol. 104, no. 6, pp. 1865–1869, 1993. View at Google Scholar · View at Scopus
  51. C. Rust and U. Beuers, “Medical treatment of primary biliary cirrhosis and primary sclerosing cholangitis,” Clinical Reviews in Allergy and Immunology, vol. 28, no. 2, pp. 135–145, 2005. View at Publisher · View at Google Scholar · View at Scopus
  52. J. S. De Caestecker, R. P. Jazrawi, M. L. Petroni, and T. C. Northfield, “Ursodeoxycholic acid in chronic liver disease,” Gut, vol. 32, no. 9, pp. 1061–1065, 1991. View at Publisher · View at Google Scholar · View at Scopus
  53. G. Paumgartner and U. Beuers, “Ursodeoxycholic acid in cholestatic liver disease: mechanisms of action and therapeutic use revisited,” Hepatology, vol. 36, no. 3, pp. 525–531, 2002. View at Publisher · View at Google Scholar · View at Scopus
  54. T. Pusl and U. Beuers, “Ursodeoxycholic acid treatment of vanishing bile duct syndromes,” World Journal of Gastroenterology, vol. 12, no. 22, pp. 3487–3495, 2006. View at Google Scholar · View at Scopus
  55. S. N. Cullen, C. Rust, K. Fleming, C. Edwards, U. Beuers, and R. W. Chapman, “High dose ursodeoxycholic acid for the treatment of primary sclerosing cholangitis is safe and effective,” Journal of Hepatology, vol. 48, no. 5, pp. 792–800, 2008. View at Publisher · View at Google Scholar · View at Scopus
  56. T. Ikegami and Y. Matsuzaki, “Ursodeoxycholic acid: mechanism of action and novel clinical applications,” Hepatology Research, vol. 38, no. 2, pp. 123–131, 2008. View at Publisher · View at Google Scholar · View at Scopus
  57. S.-D. Wu, L. Li, and J.-Y. Wang, “Ursodeoxycholic acid for nonalcoholic steatohepatitis,” European Journal of Gastroenterology and Hepatology, vol. 24, no. 11, pp. 1247–1253, 2012. View at Publisher · View at Google Scholar · View at Scopus
  58. V. Ratziu, V. de Ledinghen, F. Oberti et al., “A randomized controlled trial of high-dose ursodesoxycholic acid for nonalcoholic steatohepatitis,” Journal of Hepatology, vol. 54, no. 5, pp. 1011–1019, 2011. View at Publisher · View at Google Scholar · View at Scopus
  59. A. Dechene, U. Treichel, G. Gerken, and P. Hilgard, “Effectiveness of a steroid- and ursodesoxycholic acid combination therapy with drug-induced subacute liver failure,” Hepatology, vol. 42, no. 4, supplement 1, p. 358A, 2005. View at Google Scholar
  60. A. Wree, A. Dechêne, K. Herzer et al., “Steroid and ursodesoxycholic acid combination therapy in severe drug-induced liver injury,” Digestion, vol. 84, no. 1, pp. 54–59, 2011. View at Publisher · View at Google Scholar · View at Scopus
  61. L. L. Liu, T. Sakaguchi, X. Cui, Y. Shirai, T. Nishimaki, and K. Hatakeyama, “Liver regeneration enhanced by orally administered ursodesoxycholic acid is mediated by immunosuppression in partially hepatectomized rats,” The American Journal of Chinese Medicine, vol. 30, no. 1, pp. 119–126, 2002. View at Publisher · View at Google Scholar · View at Scopus
  62. S. Y. Wang, H. M. Tang, and Z. H. Peng, “A prospective, randomized, controlled clinical trial of the effects of ursodeoxycholic acid alleviating ischemia/reperfusion injury in liver transplantation,” Chinese Journal of Organ Transplantation, vol. 29, no. 3, pp. 133–136, 2008. View at Google Scholar
  63. S.-C. Lim, J. E. Choi, H. S. Kang, and H. Si, “Ursodeoxycholic acid switches oxaliplatin-induced necrosis to apoptosis by inhibiting reactive oxygen species production and activating p53-caspase 8 pathway in HepG2 hepatocellular carcinoma,” International Journal of Cancer, vol. 126, no. 7, pp. 1582–1595, 2010. View at Publisher · View at Google Scholar · View at Scopus
  64. R. Cao, X. D. Hu, T. Bai et al., “Comparison of therapeutic efficacy of ursodesoxycholic acid or tauro-ursodesoxycholic acid combined with polyene phosphatidylcholine for non-alcohol fatty liver disease,” China Pharmacy, vol. 24, no. 4, pp. 365–367, 2013. View at Google Scholar
  65. E.-J. Cho, J.-H. Yoon, M.-S. Kwak et al., “Tauroursodeoxycholic acid attenuates progression of steatohepatitis in mice fed a methionine-choline-deficient diet,” Digestive Diseases and Sciences, vol. 59, no. 7, pp. 1461–1474, 2014. View at Publisher · View at Google Scholar · View at Scopus
  66. D. Laukens, L. Devisscher, L. Van den Bossche et al., “Tauroursodeoxycholic acid inhibits experimental colitis by preventing early intestinal epithelial cell death,” Laboratory Investigation, vol. 94, no. 12, pp. 1419–1430, 2014. View at Publisher · View at Google Scholar · View at Scopus
  67. A. Colell, O. Coll, C. García-Ruiz et al., “Tauroursodeoxycholic acid protects hepatocytes from ethanol-fed rats against tumor necrosis factor-induced cell death by replenishing mitochondrial glutathione,” Hepatology, vol. 34, no. 5, pp. 964–971, 2001. View at Publisher · View at Google Scholar · View at Scopus
  68. L. Falasca, G. Tisone, G. Palmieri et al., “Protective role of tauroursodeoxycholate during harvesting and cold storage of human liver,” Transplantation, vol. 71, no. 9, pp. 1268–1276, 2001. View at Publisher · View at Google Scholar · View at Scopus
  69. Y.-P. Vandewyncke, D. Laukens, L. Devisscher et al., “Tauroursodeoxycholic acid dampens oncogenic apoptosis induced by endoplasmic reticulum stress during hepatocarcinogen exposure,” Oncotarget, vol. 6, no. 29, pp. 28011–28025, 2015. View at Publisher · View at Google Scholar · View at Scopus
  70. C. L. Zhang, C. S. Li, and X. L. Yu, “The progress of Chinese patent about ursodeoxycholic acid of bear bile active component,” China Journal of Chinese Materia Medica, vol. 37, no. 19, pp. 2851–2854, 2012. View at Google Scholar
  71. S.-B. Yee, W. J. Yeo, B. S. Park et al., “Synthetic chenodeoxycholic acid derivatives inhibit glioblastoma multiform tumor growth in vitro and in vivo,” International Journal of Oncology, vol. 27, no. 3, pp. 653–659, 2005. View at Google Scholar · View at Scopus
  72. X. C. Gu, M. D. Li, J. Q. Chang, and G. Z. Cui, “Comparison between pharmacologic actions of rabbit bile and bear bile,” China Journal of Chinese Materia Medica, vol. 19, no. 9, pp. 556–575, 1994. View at Google Scholar · View at Scopus
  73. D. Q.-H. Wang and M. C. Carey, “Therapeutic uses of animal biles in traditional Chinese medicine: an ethnopharmacological, biophysical chemical and medicinal review,” World Journal of Gastroenterology, vol. 20, no. 29, pp. 9952–9975, 2014. View at Publisher · View at Google Scholar · View at Scopus
  74. R. L. Chen, W. Xu, M. Sha, Z. F. Hong, and H. Li, “Advance in studies on chemical constituents of bear bile and their pharmacological effects,” Journal of Liaoning University of TCM, vol. 14, no. 7, pp. 61–64, 2012. View at Google Scholar
  75. H. Y. Yan and C. C. Zou, “Determination of total cholic acid in bear bile powder, porcine gall powder, ox bile powder and chicken bile powder and study on the bacteriostatic action of these bile powder,” Chinese Journal of Hospital Pharmacy, vol. 32, no. 3, pp. 175–179, 2012. View at Google Scholar
  76. S. Watanabe, T. Kamei, K. Tanaka, K. Kawasuji, T. Yoshioka, and M. Ohno, “Roles of bile acid conjugates and phospholipids in in vitro activation of pancreatic lipase by bear bile and cattle bile,” Journal of Ethnopharmacology, vol. 125, no. 2, pp. 203–206, 2009. View at Publisher · View at Google Scholar · View at Scopus
  77. S. Watanabe and K. Tsuneyama, “Cattle bile but not bear bile or pig bile induces lipid profile changes and fatty liver injury in mice: mediation by cholic acid,” Journal of Toxicological Sciences, vol. 37, no. 1, pp. 105–121, 2012. View at Publisher · View at Google Scholar · View at Scopus
  78. S. Pong, Y. W. Lo, and K. C. Ho, “Herbal alternatives to bear bile,” in Proceedings of the Third International Symposium on the Trade in Bear Parts: 26–28 October, 1999, Seoul, Republic of Korea, D. F. Williamson and M. J. Phipps, Eds., pp. 154–157, Traffic East Asia, 1999. View at Google Scholar
  79. S. Appiah, P. Bremner, M. Heinrich, T. Kokubun, M. Simmonds, and C. Bell, “Herbal alternatives to bear bile: effects of Scutellaria baicalensis Georgi on IL-6 promoter and CYP3A4 activities,” Focus on Alternative and Complementary Therapies, vol. 11, supplement 1, p. 3, 2006. View at Publisher · View at Google Scholar
  80. F. Cheung, Y. Feng, N. Wang, M.-F. Yuen, Y. Tong, and V. T. Wong, “Effectiveness of Chinese herbal medicine in treating liver fibrosis: a systematic review and meta-analysis of randomized controlled trials,” Chinese Medicine, vol. 7, no. 1, 2012. View at Publisher · View at Google Scholar · View at Scopus
  81. Y. Feng, N. Wang, Y. Tong, and S. W. Tsao, “Berberine: an old drug but new use for liver diseases,” Planta Medica, vol. 78, no. 11, p. 1091, 2012. View at Publisher · View at Google Scholar
  82. H. Y. Tan, N. Wang, S.-W. Tsao, Z. J. Zhang, and Y. Feng, “Suppression of vascular endothelial growth factor via inactivation of eukaryotic elongation factor 2 by alkaloids in coptidis rhizome in hepatocellular carcinoma,” Integrative Cancer Therapies, vol. 13, no. 5, pp. 425–434, 2014. View at Publisher · View at Google Scholar · View at Scopus
  83. N. Wang, Y. Feng, M. F. Zhu et al., “Berberine induces autophagic cell death and mitochondrial apoptosis in liver cancer cells: the cellular mechanism,” Journal of Cellular Biochemistry, vol. 111, no. 6, pp. 1426–1436, 2010. View at Publisher · View at Google Scholar · View at Scopus
  84. N. Wang, M. Zhu, X. Wang, H.-Y. Tan, S.-W. Tsao, and Y. Feng, “Berberine-induced tumor suppressor p53 up-regulation gets involved in the regulatory network of MIR-23a in hepatocellular carcinoma,” Biochimica et Biophysica Acta—Gene Regulatory Mechanisms, vol. 1839, no. 9, pp. 849–857, 2014. View at Publisher · View at Google Scholar · View at Scopus
  85. Y. Feng, N. Wang, M. F. Zhu, Z. J. Zhang, Y. Tong, and S. W. Tsao, “Interdisciplinary approaches in study of chinese medicines: case of coptis,” International Journal of Molecular Medicine, vol. 26, supplement 1, p. S21, 2010. View at Google Scholar
  86. Y. Feng, N. Wang, X. Ye et al., “Hepatoprotective effect and its possible mechanism of Coptidis rhizoma aqueous extract on carbon tetrachloride-induced chronic liver hepatotoxicity in rats,” Journal of Ethnopharmacology, vol. 138, no. 3, pp. 683–690, 2011. View at Publisher · View at Google Scholar · View at Scopus