• Ziziphus jujuba
• chemical composition
• ecology
• pharmacological application

• № BG-RRP-2.004-0009. European Union-NextGenerationEU, through the National Recovery and Resilience Plan of the Republic of Bulgaria

Perimenopausal syndrome (PMS) is a chronic disease associated with estrogen deficiency. Because of the unsatisfactory outcomes of current conventional treatments for this condition, its treatment must be continuously explored and optimized.

To assess the clinical effectiveness of γ-oryzanol in combination with Femoston for PMS.

A total of 119 patients with PMS were selected from June 2023 to December 2023, which included 59 and 60 patients in the control and observation group, respectively. The control and observation groups were treated with Femoston and γ-oryzanol + Femoston, respectively. Comparative analyses were performed in terms of clinical effectiveness, safety (dizziness and headache, nausea and vomiting, and breast tenderness), sex hormones [estradiol (E₂), luteinizing hormone (LH), and follicle-stimulating hormone (FSH)], lumbar spine (L1–4) and bilateral femoral bone mineral density (BMD), and sleep quality (sleeping time and frequency of awakenings from sleep).

Compared with the control group, the observation group had statistically higher total effective rates of treatment; lower overall incidence of adverse events; higher post-treatment E₂ levels and L1–4 and bilateral femoral BMD; and lower LH and FSH levels, sleeping time, and frequency of awakenings from sleep after treatment.

Therefore, for the treatment of PMS, γ-oryzanol combined with Femoston is significantly better than Femoston alone in terms of clinical effectiveness, exhibiting more pronounced clinical advantages in improving safety, sex hormone levels, BMD, and sleep quality.

• γ-oryzanol
• Femoston
• Perimenopausal syndrome
• Clinical effectiveness
• Adverse reactions

• Caenorhabditis elegans
• Daf-16
• Jujubae Fructus
• Lifespan
• Stress tolerance

• Animals
• Caenorhabditis elegans/drug effects
• Caenorhabditis elegans/physiology
• Caenorhabditis elegans Proteins/metabolism
• Caenorhabditis elegans Proteins/genetics
• Longevity/drug effects
• Forkhead Transcription Factors/metabolism
• Forkhead Transcription Factors/genetics
• Plant Extracts/pharmacology
• Superoxide Dismutase/metabolism
• Superoxide Dismutase/genetics
• Ziziphus/chemistry
• Oxidative Stress/drug effects
• Fruit/chemistry

• 222102110412 Henan Science and Technology Research Plan Project of China
• XYBSKYZZ202135 Starting Research Fund from the Xin Xiang Medical University
• 19HASTIT015 Science and technology innovation talent Program of Henan Province

Ethnopharmacological relevance: Two types of traditional Chinese formulas of botanical drugs are prescribed for treating perimenopausal syndrome (PMS), a disorder in middle-aged women during their transition to menopause. One is for treating PMS as kidney deficiency (KD) due to senescence and declining reproductive functions, and the other is for treating it as liver qi stagnation (LQS) in association with stress and anxiety. Despite the time-tested prescriptions, an objective attestation to the effectiveness of the traditional Chinese treatment of PMS is still to be established and the associated molecular mechanism is still to be investigated.

Materials and methods: A model for PMS was generated from perimenopausal rats with chronic restraint stress (CRS). The effectiveness of traditional Chinese formulas of botanical drugs and a combination of two of the formulas was evaluated based on ¹H NMR plasma metabolomic, as well as behavioral and physiological, indicators. To investigate whether the formulas contained ligands that could compensate for the declining level of estrogen, the primary cause of PMS, the ligand-based NMR technique of saturation transfer difference (STD) was employed to detect possible interacting molecules to estrogen receptors in the decoction.

Results: Each prescription of the classical Chinese formula moderately attenuated the metabolomic state of the disease model. The best treatment strategy however was to combine two traditional Chinese formulas, each for a different etiology, to adjust the metabolomic state of the disease model to that of rats at a much younger age. In addition, this attenuation of the metabolomics of the disease model was by neither upregulating the estrogen level nor supplementing an estrogenic compound.

Conclusion: Treatment of PMS with a traditional Chinese formula of botanical drugs targeting one of the two causes separately could ameliorate the disorder moderately. However, the best outcome was to treat the two causes simultaneously with a decoction that combined ingredients from two traditional prescriptions. The data also implicated a new paradigm for phytotherapy of PMS as the prescribed decoctions contained no interacting compound to modulate the activity of estrogen receptors, in contrast to the treatment strategy of hormone replacement therapy.

• Chinese traditional medicine
• ethnopharmacology
• metabolomics
• perimenopausal syndrome
• phytotherapy
• saturation transfer difference

The fruits of Ziziphus jujuba, commonly known as jujube, red date or Chinese date, are taken as fresh or dried food, and as traditional medicine worldwide due to high nutritional and health values. Traditionally in China, jujube is considered as a medicinal fruit that is being used in treating blood deficiency. In this review, the beneficial effects of jujubes on the hematopoietic functions are summarized and discussed. As illustrated in cell and animal models, the application of jujube extract possessed beneficial effects, including regulation of erythropoiesis via activation of hypoxia inducible factor-induced erythropoietin, potential capacity in recycling heme iron during erythrophagocytosis and bi-directional regulation of immune response. Thus, the blood-nourishing function of jujube is being proposed here. Flavonoid, polysaccharide and triterpenoid within jujube could serve as the potential active ingredients accounting for the aforementioned health benefits. Taken together, these findings provide several lines of evidence for further development of jujube as supplementary products for prevention and/or treatment of anemia.

• Rhamnaceae
• Ziziphus jujuba
• bio-active ingredient
• blood deficiency
• food supplement

• Adenosine
• Adenosine A1 receptor
• Adenosine A2A receptor
• Cordycepin
• Hippocampus
• Spontaneous alternation behavior

The fruits of Ziziphus jujuba, known as jujube or Chinese date, are being consumed all around the world because of their health benefits, as both food and herbal medicine. Traditionally, one of the main functions of jujube, as described in herbal medicine, is to benefit our brain by calming down the mind and improving quality of sleep. Here, the activities of jujubes on nervous system are summarized and discussed. Jujube possesses neuroprotective activities, including protecting neuronal cells against neurotoxin stress, stimulating neuronal differentiation, increasing expression of neurotrophic factors, and promoting memory and learning. Flavonoid, cAMP, and jujuboside could be the potential bioactive ingredients to account for the aforesaid biological activities. These findings imply that jujube is a potential candidate for development of health supplements for prevention and/or treatment of neurological diseases.

• Leptin
• spatial memory
• streptozotocin

• Rhamnaceae
• Ziziphus jujuba
• anti-oxidant enzyme
• neurotrophic factor

Estradiol changes associated with the menstrual cycle have a great impact on brain activation. δ frequency mainly appears during normal sleep status or brain injury diseases, including encephalitis and mental confusion. The current case report presents a 51-year-old female with prolonged menstruation and increased menstrual blood volume whose electroencephalogram (EEG) recording demonstrated a rare generalized 3 Hz δ frequency band in the waking status. The patient had been suffering from heart palpitations and dizziness for 6 months and was receiving treatment in the Department of Neurology (Second Xiangya Hospital). The individual had been experiencing prolonged menstruation and increased menstrual blood volume for 6 years. Gynecologial examination revealed secondary anemia and hysteromyoma. Hemoglobin levels were decreased to 69 g/l. Physical and neurological examinations, and computed tomography results appeared normal. The EEG recording indicated a generalized 3 Hz δ frequency band with 30–80 μV power and a long-range δ frequency band when the patient was hyperventilating. The prolonged menstruation and increased menstrual blood volume may have induced the generalized δ frequency without brain injury. To the best of our knowledge, this is the first formal case report of prolonged menstruation and increased menstrual blood volume with the abnormality of δ EEG power.