The current work is supported by grants from the (1) National Nature Science Foundation (81973877 and 82174408), (2) National Key R&#38;D Program of China (2020YFE0201600), (3) Shanghai Top Priority Research Center construction project (2022ZZ01009), (4) Shanghai Collaborative Innovation Center of Industrial Transformation of Hospital TCM Preparation, and (5) Research Projects within Budget of Shanghai University of Traditional Chinese Medicine (2021LK047).

This protocol describes the detailed gavage technique in osteosarcoma model mice by using the Yiqi Jiedu decoction as a sample. Four-week-old, male athymic mice (BALB/c nude) were used in this experiment and kept in the SPF-grade breeding room of Laboratory Animal Center in Shanghai University of Traditional Chinese Medicine. All animal experiments were approved by the Animal Management and Committee of Shanghai University of Traditional Chinese Medicine, complied with the Code of Ethics for Laboratory Animals (Animal Ethics Approval Number: PZSHUTCM2304060007), and conducted in strict accordance with the international requirements related to laboratory animals.
1. Materials
<ol>
	<li>Obtain the following materials: Chinese herbs (Ginseng 42 g, Hedyotis diffusa 52.5 g, Barbed skullcap herb 31.5 g), 1 mL syringe, and 12G/55 mm elbow gavage needle (Figure 1).</li>
</ol>
2. Dosage determination
<ol>
	<li>Calculate the daily dosage as follows: the daily dosage for adults with a standard body weight of 60 kg is Ginseng 12 g, Hedyotis diffusa 15 g, and Barbed skullcap herb 9 g, with a total of 36 g decoction-ready medicine, that is, 0.6 g decoction-ready medicines/kg body weight. Referring to the 12 times for equivalent dose, 6 times for low dose, and 24 times for high dose between the adults with standard body weight of 60 kg and the mice with standard body weight of 25 g according to the body surface area11, as well as our preliminary data, use a 20 times dose ratio of Yiqi Jiedu decoction for the mice in the current study, therefore, the dosage for mice was 12 g decoction-ready medicines/kg body weight.</li>
	<li>Calculate the dosage for each mouse by using the equation: 
	dosage for mouse (stand body weight) = dosage for adult (stand body weight) x 20 (designated equivalent dose ratio). 
	The daily dosage of each mouse is 0.3 g [(12 g decoction-ready medicines/1000 g body weight) x 25 g body weight] in 200 &#181;L with a final concentration of 1.5 g/mL.</li>
	<li>Calculate the total decoction-ready medicines for mice (n=7) in the Yiqi Jiedu decoction group with gavage administration for 28 days to be 58.8 g. Concentrate this to 39.2 mL to reach a final concentration of 1.5 g/mL.</li>
	<li>Considering possible drug loss during the decoction and the gavage stages, and for the convenience of calculation, prepare a total of 126 g (Ginseng 42 g, Hedyotis diffusa 52.5 g, Barbed skullcap herb 31.5 g) decoction-ready medicine, concentrate into a final volume of 84 mL.</li>
</ol>
3. Cell source and culture
<ol>
	<li>Purchase human-derived 143B osteosarcoma cells from ATCC cell bank.</li>
	<li>Seed 1 x 106 143B cells in 10 mL of MEM medium containing 10% FBS, 100 U/mL penicillin, and 100 &#181;g/mL streptomycin in a 10 cm cell culture dish.</li>
	<li>Culture 143B cells at 37 &#176;C in a 5% CO2 incubator until the cells are 80%-90% confluent.</li>
</ol>
4. Modeling methods
<ol>
	<li>Collect the 80% confluent cultured 143B cells, resuspend into 6 mL of 10% serum-containing MEM medium and mix with basement membrane matrix gel at a volume ratio of 1:1 to make a cell suspension with a final concentration of 1 x 107 cells/mL.</li>
	<li>Inject 10 &#181;L of the cell suspension into the left tibia of each athymic mouse to establish an in situ xenograft osteosarcoma mouse model, as being described in our previous publication12. The steps in brief are as follows.
	<ol>
		<li>Wash the cells 2x with PBS. Trypsinize the cells with 1.5 mL of 0.25% trypsin for 3 min. Add 6 mL of 10% serum-containing MEM media. Collect the cells in a 15 mL centrifuge tube.</li>
		<li>Aspirate 20 &#181;L of cell suspension into the chamber of the cell counting plate and calculate cell concentration using an automatic cell counter. Centrifuge the cells at 800 x g for 5 min at room temperature.</li>
		<li>Discard the supernatant with a pipette, resuspend the cell pellet in 8.5 mg/mL basement membrane matrix, and place them on ice.</li>
		<li>Anesthetize the mice by exposing them to 2% isoflurane and 98% oxygen (oxygen flow rate, 2 L/min). Apply a small amount of vet ointment on the eyes to prevent dryness while under anesthesia.</li>
		<li>Perform the entire procedure in a well-ventilated area. Before osteosarcoma cell injection, ensure that each mouse is under deep anesthesia by gently touching the foot; if the mouse still has responses, such as twitch or jerk.&#160;Wait for a longer time if the mouse still has responses, such as twitch or jerk, until these responses disappear.</li>
		<li>Place the mouse in a supine position. Hold the ankle of the mouse using the thumb and index finger and disinfect the injection site of the tibia with three alternating rounds of betadine and 70% ethanol swab.</li>
		<li>Attach the needle to a 1 mL syringe and point the needle tip toward the injection site paralleling to the axis of the tibia. Percutaneously insert the needle to drill a hole through the tibia platform toward the distal end of the tibia.</li>
		<li>Load the osteosarcoma cell suspension previously being placed on ice into a microvolume syringe and replace the 1 mL syringe in the tibia with the osteosarcoma cell-loaded microvolume syringe. Slowly inject approximately 10 &#181;L of (1 x 107 cells/mL) osteosarcoma cell suspension into each athymic mouse&#39;s tibia.</li>
		<li>Remove the microvolume syringe from the injection site, and press the injection site with the cotton swab for about 30 s. Place the mouse back into a clean cage and observe its recovery for 10 min.</li>
	</ol>
	</li>
</ol>
5. Preparation of traditional Chinese medicine decoction formula for gavage (&#160;Figure 2)
<ol>
	<li>Calculate the dosage as per step 2.</li>
	<li>Soak all the medicinal herbs for decoction, except for the expensive herb Ginseng, in drinking water with a level 3 cm higher than the medicine surface, for 30 min, and then perform the decoction 2x as described below.</li>
	<li>Perform the first decoction by heating to boiling over a strong fire, and then heating for 15-25 min over a mild fire. Mild fire refers to a low-power heat with temperatures typically ranging from 80 &#176;C to 100 &#176;C, while strong fire refers to a high-power heat typically ranging from 200 &#176;C to 300 &#176;C.</li>
	<li>Pour the decoction liquid into one container.</li>
	<li>Perform the second decoction by heating the medicinal herbs in drinking water, with a volume just enough to submerge the medicine surface, to boiling over a strong fire, and then heating for 15-25 min over a mild fire.</li>
	<li>Pour the decoction liquid into the same container as in step 5.4.</li>
	<li>Soak and decoct 42 g of Ginseng separately, with drinking water 3 cm higher than the medicine surface, since it is expensive.</li>
	<li>Perform the first decoction of soaked Ginseng by heating it over a strong fire for 60 min. 
	Pour the decoction liquid into the same container as in step 5.4.</li>
	<li>Perform the second decoction of Ginseng in drinking water with a volume just enough to submerge the medicine surface, by heating over a mild fire for 40 min. Pour the decoction liquid into the same container as in step 5.4. 
	NOTE: The containers used for decoction should be chemically stable, such as casseroles (the most commonly used in clinical practice), ceramics, glass, and stainless steel to avoid possible chemical reactions with the medicinal substances. All decoction liquid obtained from different steps must be put in the same container.</li>
	<li>Mix and filter the decoction liquid using three layers of gauze fixed at the mouth of a measuring cup with rubber bands.</li>
	<li>Boil the filtered decoction on a strong fire in a pot, then change to mild fire and keep the mild fire until reaching the target concentration (a final volume of 84 mL with a final concentration of 1.5 g/mL).</li>
	<li>Prepare 21 mL aliquots of the concentrated decoction according to the dose required for intragastric administration for 1 week, and store the aliquots in a refrigerator at -20 &#176;C.</li>
</ol>
6. Gavage administration in mice by using a gavage device
<ol>
	<li>Place the mouse on the surface of the mouse cage or other rougher surface.</li>
	<li>Grasp the mouse&#39;s tail with the thumb and index finger of the right hand. Then, grasp the mouse&#39;s neck with the thumb, index finger, and middle finger of the left hand.</li>
	<li>Hold the mouse tail with the other two fingers of the left hand to make the head, neck, and body of the mouse in a straight line. 
	NOTE: Make sure to keep the mouse relaxed during the entire grasping process. If the mouse keeps struggling to move, the grasping process should be performed until the mouse is relaxed.</li>
	<li>Hold the gavage device in the right hand and load 200 &#181;L of decoction formula for a mouse with 20 g body weight (100 &#181;L decoction formula/10 g body weight of mouse).</li>
	<li>Insert the gavage needle into the mouth from the corner and push the tongue against the upper jaw of mouse.</li>
	<li>Keep the mouse body in the same direction and gently push the gavage needle toward the stomach along the esophagus until about 10 mm of the gavage needle is left outside. 
	NOTE: There is a hollow feeling when the gavage needle enters into the esophagus.The length of the gavage needle inserted into the mouse should be measured to the top of the sternum. The total length of the gavage needle is 60 mm (Figure 3), therefore, about 50 mm of the gavage needle should be inserted into the body of mouse before the decoction formula is injected into the stomach of mouse.</li>
	<li>Inject the decoction formula into the stomach of mouse. Meeting resistance or liquid coming out of the mouth corner means misplacement of the gavage needle, which must be avoided. In addition, the injection speed must be slowed down if the decoction formula is thick.</li>
	<li>Release the mouse and observe them for 10 min. The gavage is successful if no breathing abnormality is observed and return the mouse into the cage (Figure 4).</li>
</ol>
7. Course of treatment
<ol>
	<li>To explore the therapeutic efficacy of Yiqi Jiedu decoction, set up a control group and a Yiqi Jiedu decoction group. For mice in the control group, administer physiological saline, once a day for 28 days. For mice in the Yiqi Jiedu decoction group, administer the Yiqi Jiedu decoction once a day for 28 days.</li>
</ol>
8. Adverse reactions
<ol>
	<li>Closely observe the status of the mice after being placed back into the cage, including weight loss and decreased mental status due to the inability of food to enter into the stomach.</li>
	<li>Mice will experience difficulty in breathing and shortness of breath due to food-caused tracheal obstruction and will cough in an attempt to clear the trachea. If any of these symptoms is observed during gavage, immediately stop the gavage and&#160;euthanize the mice.</li>
</ol>

Herb Decoction Formulation and Gavage Standardization in Osteosarcoma Mice

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	<li>Gao, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Discussion+on+advantages+and+improvement+of+traditional+Chinese+medicine+decoction.">Discussion on advantages and improvement of traditional Chinese medicine decoction.</a> Chinese Community Physicians (Comprehensive Edition). (21), 12 (2005).</li><li>Chinese Pharmacopoeia Commission. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Pharmacopoeia of the People's Republic of China. , (2015).</li><li>An, Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Interpretation+on+specification+of+traditional+Chinese+medicine+decoction.">Interpretation on specification of traditional Chinese medicine decoction.</a> Herald Med. 42 (11), 1648-1652 (2023).</li><li>Chen, S., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Research+strategies+in+standard+decoction+of+medicinal+slices.">Research strategies in standard decoction of medicinal slices.</a> China J Chinese Materia Medica. 41 (8), 1367-1375 (2016).</li><li>Luo, F. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effect+of+soaking+traditional+Chinese+medicine+before+decoction+on+active+components.">Effect of soaking traditional Chinese medicine before decoction on active components.</a> Shanghai Yiyao. 40 (9), 63-64 (2019).</li><li>Liu, F., Chen, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+the+standardization+of+decocting+methods+of+modern+decoction.">On the standardization of decocting methods of modern decoction.</a> Global Trad Chinese Med. 7 (5), 377-378 (2014).</li><li>Li, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+decocting+times+and+instrument+on+the+quality+of+decoction.">Influence of decocting times and instrument on the quality of decoction.</a> J Trad Chinese Med. 50 (6), 550-552 (2009).</li><li>Li, X., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Herbal+decoctosome+is+a+novel+form+of+medicine.">Herbal decoctosome is a novel form of medicine.</a> Sci China. Life Sci. 62 (3), 333-348 (2019).</li><li>Lan, Y., Hu, Y., Huang, W., Tang, S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Reflections+on+PK+-+PD+model+based+on+animal+experiments+for+study+of+Chinese+medicine.">Reflections on PK - PD model based on animal experiments for study of Chinese medicine.</a> Lishizen Med Materia Medica Res. 34 (2), 395-397 (2023).</li><li>Li, Y., Bai, M., Song, Y., Guo, H., Miao, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Research+and+reflection+on+standard+decoction+of+Chinese+materia+medica.">Research and reflection on standard decoction of Chinese materia medica.</a> Chinese Trad Herbal Drugs. 49 (17), 3977-3980 (2018).</li><li>. Estimating the maximum safe starting dose in initial clinical trials for therapeutics in adult healthy volunteers Available from: <a target="_blank" href="https://www.fda.gov/regulatory-information/search-fda-guidance-documents/estimating-maximum-safe-starting-dose-initial-clinical-trials-therapeutics-adult-healthy-volunteers">https://www.fda.gov/regulatory-information/search-fda-guidance-documents/estimating-maximum-safe-starting-dose-initial-clinical-trials-therapeutics-adult-healthy-volunteers</a> (2005)</li><li>Chang, J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Intratibial+osteosarcoma+cell+injection+to+generate+orthotopic+osteosarcoma+and+lung+metastasis+mouse+models.">Intratibial osteosarcoma cell injection to generate orthotopic osteosarcoma and lung metastasis mouse models.</a> J Vis Exp. (176), 63072 (2021).</li><li>He, C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+animal+science.">Laboratory animal science.</a> , (2006).</li><li>Patten, A. R., Fontaine, C. J., Christie, B. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+comparison+of+the+different+animal+models+of+fetal+alcohol+spectrum+disorders+and+their+use+in+studying+complex+behaviors.">A comparison of the different animal models of fetal alcohol spectrum disorders and their use in studying complex behaviors.</a> Fronti Pedia. 2, 93 (2014).</li><li>Jones, C. P., Boyd, K. L., Wallace, J. 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The authors declare that they have nothing to disclose.

The clinical efficacy of the prescribed herbs in traditional Chinese medicine is largely associated with the administered dose and dosage form; therefore, the establishment of a standardized decoction strategy and a skilled administration process are necessary in clinical practice, as well as in improving the reliability of experimental results.
In this study, we first provided a detailed strategy for the standardized decoction of Chinese herbs used in clinical practice of traditional Chinese ...

Decoction formula is the most commonly used dosage form of the traditional Chinese medicine and the liquid medicinal drugs1,2. The decoction formula of traditional Chinese medicine is processed by decocting the herbs in water after being soaked, followed by filtering to discard the dregs.
Because the decoction formula can be individualized based on clinical necessities, especially in line with the characteristics of evidence-based treatment in traditional Chinese medicine, this dosage form via trans-oral administration has been applied in clinical practice for thousands of years with specific and irreplaceable advantages3,4. The quality of the decoction formula is directly related to the clinical efficacy.&#160;Therefore, the decoction formula must be prepared based on the principles for the standardized decoction methods to ensure the active ingredients are maximally extracted and protected3. Meanwhile, decoction-ready medicines are the main form of raw Chinese herbs used in clinical practice; the quality standards and production methods of prescribed decoction-ready medicines must comply with the provisions of the Chinese Pharmacopoeia2. Moreover, the prescribed decoction-ready medicines must be soaked in cold drinking water for at least 30 min before being decocted in a special pharmaceutical pot by heating5. Studies have shown that most of the active ingredients can be extracted by decocting for two times, and the&#160;Code of Practice for the Administration of Decoction Rooms of Traditional Chinese Medicines in Medical Institutions also prescribes decoction to be done twice4,6,7. If special Chinese herbs, such as one with hard texture or tonics, are prescribed, the decoction time is recommended to be extended. The decoction utensils and storage containers that directly come in contact with the decoction formula, starting from the container in which the prescribed decoction-ready medicines are soaked, should be chemically stable and have lids, such as casseroles, ceramics, glass and stainless steel. However, aluminum and ordinary plastic products should not be used, while iron and other corrosive utensils should be prohibited to avoid possible chemical reactions, which will reduce therapeutic efficacy and even produce harmful effects4,6,7.
Due to the limitations of performing clinical experiments, small animals bearing the human diseases, such as mice, are often used in medical research to explore the therapeutic efficacy and comprehensive mechanisms of different interventions including the decoction formula of traditional Chinese medicine8,9; however, unlike humans, the decoction formulas should be prepared every day, mixed together, and freshly administered 2x a day in clinical practice. Animals are unable to voluntarily take their medications on time with the required dosage, and most of the animal experiments related to traditional Chinese medicine are gavage-based oral administration of the decoction formulas at present. The decoction formulas used for in vivo animal experiments should be prepared in advance, aliquoted, stored at -20 &#176;C and thawed just before use3,4,10. Moreover, substandard animal immobilization and gavage needle manipulation increase the risk of unnecessary injuries and negative emotions. Therefore, as an important method of trans-oral drug delivery, the skilled gavage technique is particularly important to avoid possible esophageal injury and drug spillage, thus ensuring that each model animal receives an equal amount of prescribed herbal medicine to achieve accurate experimental results. Here, we provide a gavage protocol for the decoction formula of traditional Chinese medicine.

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>143B cell line</td>
			<td>ATCC</td>
			<td>CRL-8303</td>
			<td>osteosarcoma cell line</td>
		</tr>
		<tr>
			<td>Anesthesia machine</td>
			<td>Shenzhen RWD Life Technology Co.,Ltd</td>
			<td>R500IP</td>
			<td>The Equipment of Anesthesia mice</td>
		</tr>
		<tr>
			<td>Automatic cell counter</td>
			<td>Shanghai Simo Biological Technology Co., Ltd</td>
			<td>IC1000</td>
			<td>Counting cells</td>
		</tr>
		<tr>
			<td>BALB/c athymic mice</td>
			<td>Shanghai SLAC Laboratory Animal Co, Ltd.</td>
			<td>Male</td>
			<td>Animal</td>
		</tr>
		<tr>
			<td>Barbed skullcap herb</td>
			<td>Shanghai Yanghetang Traditional Chinese Medicine Tablet Co., Ltd.</td>
			<td>20230606</td>
			<td>Decoction-ready medicines&#160;</td>
		</tr>
		<tr>
			<td>Basement Membrane Matrix</td>
			<td>Shanghai Uning BioscienceTechnology Co., Ltd</td>
			<td>356234, BD, Matrigel</td>
			<td>re-suspende cells</td>
		</tr>
		<tr>
			<td>Centrifuge tube (15 mL)</td>
			<td>Shanghai YueNian Biotechnology Co., Ltd</td>
			<td>430790, Corning</td>
			<td>Centrifuge the cells</td>
		</tr>
		<tr>
			<td>Elbow gavage needle (12-gauge/ 55 mm)</td>
			<td>RWD Life Science Co., Ltd.</td>
			<td>C21014-12</td>
			<td>Component of gastric perfusion device</td>
		</tr>
		<tr>
			<td>Gauze</td>
			<td>Haishi Hainuo Group Co., Ltd.</td>
			<td>LC45</td>
			<td>Decoction filter</td>
		</tr>
		<tr>
			<td>Ginseng</td>
			<td>Shanghai Wanshicheng Pharmaceutical Co., Ltd.</td>
			<td>20220704-2</td>
			<td>Decoction-ready medicines&#160;</td>
		</tr>
		<tr>
			<td>Hedyotis diffusa</td>
			<td>Shanghai Yanghetang Traditional Chinese Medicine Tablet Co., Ltd.</td>
			<td>2023071107</td>
			<td>Decoction-ready medicines&#160;</td>
		</tr>
		<tr>
			<td>isoflurane</td>
			<td>Shenzhen RWD Life Technology Co., Ltd</td>
			<td>VETEASY</td>
			<td>Anesthesia mice</td>
		</tr>
		<tr>
			<td>Micro-volume syringe</td>
			<td>Shanghai high pigeon industry and trade Co., Ltd</td>
			<td>0-50 &#956;L</td>
			<td>Inject precise cells into the tibia</td>
		</tr>
		<tr>
			<td>Phosphate-buffered saline</td>
			<td>Beyotime Biotechnology</td>
			<td>ST447</td>
			<td>wash the human osteosarcoma cells</td>
		</tr>
		<tr>
			<td>Rubber bands</td>
			<td>Shanghai Hengfei Biotechnology Co., Ltd.</td>
			<td>XPJ</td>
			<td>Fixing gauze on the measuring cup</td>
		</tr>
		<tr>
			<td>Syringe (1 mL )</td>
			<td>Shanghai Mishawa Medical Industry Co., Ltd.</td>
			<td>SBM0040</td>
			<td>Component of gastric perfusion device</td>
		</tr>
		<tr>
			<td>Trypsin (0.25%)</td>
			<td>Shanghai YueNian Biotechnology Co., Ltd</td>
			<td>25200056, Gibco</td>
			<td>trypsin treatment of cells</td>
		</tr>
	</tbody>
</table>

gavage strategy for decoction formula of traditional chinese medicine in osteosarcoma model mice

Decoction formula is the most commonly used dosage form in traditional Chinese medicine and applied in clinical practice for thousands of years by trans-oral administration, which is characterized by quick effect, easy absorption, and individualized treatment based on the specific syndromes of patients. The quality of the decoction formula is directly responsible for the clinical efficacy of traditional Chinese medicine; therefore, the standardization process of the decoction formula is important to avoid differences in decoction quality caused by subjective factors. Meanwhile, due to the limitations of performing clinical experiments, small animals bearing human diseases, such as mice, are often used in medical research to explore the therapeutic efficacy and comprehensive mechanisms of different interventions, including the decoction formula for traditional Chinese medicine.&#160;Consequently, as an important trans-oral administration method, the skilled gavage technique is particularly important to avoid potential esophagus damage and drug spillage, which will ensure an equal amount of medicine being administered to each model animal, leading to accurate experimental results. Furthermore, the standardized method of decoction formula preparation and skilled gavage strategy are necessary to protect animal welfare and minimize the number of animals used. Here, we reported a detailed standardization process of the decoction formula and gavage technique with Yiqi Jiedu decoction in osteosarcoma mouse model as an example. The efficacy was evaluated by the tumor volume. This protocol will maximize animal protection and improve the reliability of research data, therefore providing effective strategies for future investigating therapeutic efficacy and molecular mechanisms of decoction formula for traditional Chinese medicine in vivo.

The inhibitory effect of Yiqi Jiedu decoction on the growth of osteosarcoma in vivo was determined in an intra-tibial xenograft osteosarcoma mouse model, which was prepared by injecting the 143B osteosarcoma cells into the tibia of athymic mice. The Yiqi Jiedu decoction was administered to the mice of the Yiqi Jiedu decoction group by gavage for 28 days starting from the second day of the 143B injection. Physiological saline was given to the mice in the control group. All mice were euthanized after 28 days. The ...

Author Spotlight: Standardized Herbal Decoction Protocol for Enhanced Animal Studies

The protocol provides a detailed standardization process of decoction formula and gavage technique with Yiqi Jiedu decoction in the osteosarcoma mouse model as an example. It describes animal protection and improves reliability of research data, providing effective strategies for investigating therapeutic efficacy and molecular mechanisms of decoction formulas in vivo.

Gavage Strategy for Decoction Formula of Traditional Chinese Medicine in Osteosarcoma Model Mice

Decoction formula is the most commonly used dosage form in traditional Chinese medicine and applied in clinical practice for thousands of years by ...

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498 Views.  Shanghai University of Traditional Chinese Medicine. The protocol provides a detailed standardization process of decoction formula and gavage technique with Yiqi Jiedu decoction in the osteosarcoma mouse model as an example. It describes animal protection and improves reliability of research data, providing effective strategies for investigating therapeutic efficacy and molecular mechanisms of decoction formulas in vivo.

Video: Author Spotlight: Standardized Herbal Decoction Protocol for Enhanced Animal Studies

Preparation of Herbal Medicine: Er-Xian Decoction and Er-Xian-containing Serum for In Vivo and In Vitro Experiments

Traditional herbal medicine, an alternative medicine in the clinical setting, has received increased attention in recent years. Before delivery to the body, an additional extraction procedure is commonly required to release the active constituents from raw herbs. Water decoction is a classical extraction procedure that is still broadly used in the clinical settings. Here, we propose a detailed protocol for er-xian decoction (EXD) in order to apply herbal decoctions to experimental studies. The calculation of an animal-appropriate dose is described, as well as the four main steps of EXD: soaking, water decoction, filtration, and concentration. In addition, serum-containing EXD is introduced to rats as a means of in vitro validation. Here, rats were orally administered EXD for three days. Blood samples were then collected, inactivated, centrifuged, and filtered. The serum, diluted with the culture medium, can be utilized to treat cells or tissues in vitro. For example, EXD was applied to both in vivo and in vitro studies and demonstrated that EXD enhances osteogenesis. This protocol can be used as a reference for the preparation and application of herbal medicines.

Preparation of Herbal Medicine: Er-Xian Decoction and Er-Xian-containing Serum for In Vivo and In Vitro Experiments

Here, we present the preparation of an er-xian decoction (EXD) in four steps&#8212;soaking, decoction, filtration, and concentration&#8212;and demonstrate the administration of a prepared EXD-containing serum to rats. These methods are applicable to the in vivo and in vitro study of herbal decoctions such as traditional Chinese medicines.

Traditional herbal medicine, an alternative medicine in the clinical setting, has received increased attention in recent years. Before delivery to the ...

Preparation Of Gushukang (GSK) Granules for In Vivo and In Vitro Experiments

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang (GSK) granules, a marketed prescription in China, have bone-protective effects in treating POP. Before administration to the body, one standard preparation procedure is commonly required, which aims to promote the release of active constituents from raw herbs and enhance the pharmacological effects as well as therapeutic outcomes. This study proposes a detailed protocol for using GSK granules in in vivo and in vitro experimental assays. The authors first provide a detailed protocol to calculate the animal-appropriate dosages of granules for in vivo investigation: weighing, dissolving, storage, and administration. Second, this article describes protocols for micro-CT scanning and the measurement of bone parameters. Sample preparation, protocols for running the micro-CT machine and quantification of bone parameters were evaluated. Third, serum-containing GSK granules are prepared, and drug-containing serum is extracted for in vitro osteoclastogenesis and osteoblastogenesis. GSK granules were intragastrically administered twice per day to rats for three consecutive days. Blood was then collected, centrifuged, inactivated, and filtered. Finally, serum was diluted and used for performing osteoclastogenesis and osteoblastogenesis. The protocol described here can be considered a reference for pharmacological investigations of herbal prescription medicines, such as granules.

Preparation Of Gushukang GSK Granules for In Vivo and In Vitro Experiments

This article provides a detailed protocol for preparing a working solution of Gushukang granules for animal studies and GSK granule containing serum for in vitro experiments. This protocol can be applied to pharmacological investigations of herbal medicines as well as prescriptions for both in vivo and in vitro experiments.

Traditional Chinese herbal medicine plays a role as an alternative method in treating many diseases, such as postmenopausal osteoporosis (POP). Gushukang ...

Acupuncture in a Rat Model of Asthma

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes methods for the fabrication of the high platform, establishes a rat model of asthma and measures changes in respiratory function using a noninvasive and real-time whole-body plethysmography (WBP) system.

A high platform can fix rats without restriction and completely expose the acupoints on the back during acupuncture manipulation. This article describes ...

An In Vitro Dissolution Determination of Multi-Index Components in Tibetan Medicine Rhodiola Granules

The composition of the Tibetan medicine Rhodiola granules (RG) is complex, and the overall quality of RG is difficult to determine. Therefore, establishing a method to determine the multi-component in vitro dissolution of RG is of great significance for quality control. This study uses the second paddle method of the fourth general rule 0931 from the Chinese Pharmacopoeia (2020 edition), compliant with apparatus 2 of the United States Pharmacopeia (USP). The dissolution apparatus was set to a rotation speed of 100 rpm with ultrapure water as the dissolution medium. A sample volume of 1 mL was collected at each timepoint. Furthermore, the cumulative dissolution of gallic acid, salidroside, and ethyl gallic acid in RG at different time points was determined by high-performance liquid chromatography (HPLC). Finally, the dissolution curves were drawn, and the curves were fitted to the GompertzMod, the Gompertz, the Logistic, and the Weibull equations. The results showed that the cumulative dissolution of gallic acid in RG was over 80% at 1 min, the cumulative dissolution of salidroside and ethyl gallic acid was over 65% at 5 min, and the cumulative dissolution of each index component decreased after 30 min. The curve fitting demonstrated that the GompertzMod equation was the best-fitting model for each index component of RG. In conclusion, the dissolution test method described in this protocol is simple, accurate, and reliable. It can characterize the dissolution behavior of the index components in RG in vitro, which provides a methodological reference for quality control of RG and quality evaluation of other ethnic compounds.

An In Vitro Dissolution Determination of Multi-Index Components in Tibetan Medicine Rhodiola Granules

Here, we test the dissolution of Rhodiola granules (RG) in vitro, draw dissolution curves of salidroside, gallic acid, and ethyl gallate in ultrapure water, and fit the curves to different mathematical models. This protocol provides information and guidance for in vivo bioequivalence and in vivo-in vitro correlation studies of RG.

The composition of the Tibetan medicine Rhodiola granules (RG) is complex, and the overall quality of RG is difficult to determine. Therefore, ...

Visualization of Metabolites Identified in the Spatial Metabolome of Traditional Chinese Medicine Using DESI-MSI

The medicinal use of traditional Chinese medicine is mainly due to its secondary metabolites. Visualization of the distribution of these metabolites has become a crucial topic in plant science. Mass spectrometry imaging can extract huge volumes of data and provide spatial distribution information about these by analyzing tissue slices. With the advantage of high throughput and higher accuracy, desorption electrospray ionization mass spectrometry imaging (DESI-MSI) is often used in biological research and in the study of traditional Chinese medicine. However, the procedures used in this research are complicated and not affordable. In this study, we optimized sectioning and DESI imaging procedures and developed a more cost-effective method to identify the distribution of metabolites and categorize these compounds in plant tissues, with a special focus on traditional Chinese medicines. The study will promote the utilization of DESI in metabolite analysis and standardization of traditional Chinese medicine/ethnic medicine for research-related technologies.

In this study, a series of methods are presented to prepare DESI-MSI samples from plants, and a procedure of DESI assembly installation, MSI data acquisition, and processing is described in detail. This protocol can be applied in several conditions for acquiring spatial metabolome information in plants.

The medicinal use of traditional Chinese medicine is mainly due to its secondary metabolites. Visualization of the distribution of these metabolites has ...

Enema of Traditional Chinese Medicine for Patients with Severe Acute Pancreatitis

Severe acute pancreatitis (SAP) is characterized by high mortality rates, numerous complications, and extreme difficulties in treatment. A traditional Chinese medicine (TCM) enema has been widely utilized in clinical and experimental studies of SAP. It has been demonstrated to have beneficial effects in protecting pancreatic function and delaying disease progression. The procedure of TCM enema is to perfuse the Chinese medicinal liquid of raw rhubarb (Rheum officinale Baill. DaHuang) from the anus into the rectum and colon. Basic steps of the procedure include boiling the herbal solution in advance, using a disposable enema kit to assist patients in taking a left lying position, raising the patient's hip 10 cm, and carefully inserting the enema 30-35 cm into the anus, with a drip speed of 60-80 drops/min. The medicine liquid temperature should be equivalent to the patient's body temperature, typically between 37-39 &#176;C. The end of the enema operation should be slow, and Tui na (massage therapy) should be administered before extubation. The medication liquid should be kept in the rectum for more than 1 h. After issuing an enema, it is essential to observe the patient's feces and abdomen, and to evaluate the remission of abdominal signs and symptoms.

An enema is a type of traditional Chinese medicine (TCM) therapy used to treat severe acute pancreatitis (SAP). The therapy involves instilling a TCM liquid into the rectum and colon through the anus to keep the liquid in the intestine, absorbing through the intestinal mucosa. This study aims to standardize the enema procedure for SAP patients.

Severe acute pancreatitis (SAP) is characterized by high mortality rates, numerous complications, and extreme difficulties in treatment. A traditional ...

Objectification of Tongue Diagnosis in Traditional Medicine, Data Analysis, and Study Application

Tongue diagnosis is an essential technique of traditional Chinese medicine (TCM) diagnosis, and the need for objectifying tongue images through image processing technology is growing. The present study provides an overview of the progress made in tongue objectification over the past decade and compares segmentation models. Various deep learning models are constructed to verify and compare algorithms using real tongue image sets. The strengths and weaknesses of each model are analyzed. The findings indicate that the U-Net algorithm outperforms other models regarding precision accuracy (PA), recall, and mean intersection over union (MIoU) metrics. However, despite the significant progress in tongue image acquisition and processing, a uniform standard for objectifying tongue diagnosis has yet to be established. To facilitate the widespread application of tongue images captured using mobile devices in tongue diagnosis objectification, further research could address the challenges posed by tongue images captured in complex environments.

The present study employed U-Net and other deep learning algorithms to segment a tongue image and compared the segmentation results to investigate the objectification of tongue diagnosis.

Tongue diagnosis is an essential technique of traditional Chinese medicine (TCM) diagnosis, and the need for objectifying tongue images through image ...

A Traditional Chinese Medicine Characteristic Therapy for Bronchial Asthma: Moxibustion

Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest tightness, or cough, as a result of increased airway reactivity. With high diurnal variation, these symptoms often occur or worsen at night or in the morning. By burning and roasting the Chinese medica above human acupoints, moxibustion is a type of treatment that stimulates the activity of the human meridians through drugs and heat stimulation to prevent and treat diseases. According to the principle of syndrome differentiation and treatment of traditional Chinese medicine, acupoints are selected on the corresponding parts, which has a definite effect. It is regarded as a characteristic traditional Chinese medicine therapy for bronchial asthma. This protocol elaborates the methods and steps of patient management, material preparation, selection of acupoints, operation, and postoperative nursing to ensure safe and effective moxibustion treatment to significantly improve the clinical symptoms and quality of life of patients with bronchial asthma.

This protocol presents a curative procedure of moxibustion in treating patients with bronchial asthma.

Bronchial asthma is a chronic inflammatory disease of the airway which can lead to symptoms such as recurrent wheezing, shortness of breath, chest ...

Treating Knee Osteoarthritis with Tuina in a Rabbit Model

Tuina Intervention in Rabbit Model of Knee Osteoarthritis

Knee osteoarthritis (KOA) is mainly characterized by degenerative changes in the knee joint's cartilage and surrounding soft tissues. The efficacy of Tuina in treating KOA has been confirmed, but the underlying mechanism needs to be investigated. This study aims to establish a scientifically feasible KOA rabbit model treated with Tuina to reveal the underlying mechanisms. For this, 18, 6-month-old normal-grade male New Zealand rabbits were randomly divided into sham, model, and Tuina groups, with 6 rabbits in each group. The KOA model was established by injecting 4% papain solution into the knee joint cavity. The Tuina group was intervened with Tuina combined with the knee joint rotary correction method for 4 weeks. Only the standard grasping and fixation were performed in sham and model groups. At the end of the 1-week intervention, the knee joint range of motion (ROM) was observed, and cartilage hematoxylin-eosin (HE) staining was done. The study shows that Tuina could inhibit chondrocyte apoptosis, repair cartilage tissue, and restore knee joint ROM. In conclusion, this study demonstrates the scientific feasibility of Tuina treatment for KOA model rabbits, highlighting its potential application in the study of KOA and similar knee joint-related conditions.

Author Spotlight: Using a Rabbit Model to Explore the Efficacy of Tuina in Treating Knee Osteoarthritis 

The protocol describes a method for Tuina intervention in a rabbit model of knee osteoarthritis.

Knee osteoarthritis (KOA) is mainly characterized by degenerative changes in the knee joint's cartilage and surrounding soft tissues. The efficacy of ...

HE Staining and Micro-CT to Evaluate Murine Trabecular Bone Microarchitecture

Trabecular Bone Microarchitecture Evaluation in an Osteoporosis Mouse Model

Bone microstructure refers to the arrangement and quality of bone tissue at the microscopic level. Understanding the bone microstructure of the skeleton is crucial for gaining insight into the pathophysiology of osteoporosis and improving its treatment. However, handling bone samples can be complex due to their hard and dense properties. Secondly, specialized software makes image processing and analysis difficult. In this protocol, we present a cost-effective and easy-to-use solution for trabecular bone microstructure analysis. Detailed steps and precautions are provided. Micro-CT is a non-destructive three-dimensional (3D) imaging technique that provides high-resolution images of trabecular bone structure. It allows for the objective and quantitative evaluation of bone quality, which is why it is widely regarded as the gold standard method for bone quality assessment. However, histomorphometry remains indispensable as it offers crucial cellular-level parameters, bridging the gap between two-dimensional (2D) and 3D assessments of bone specimens. As for the histologic techniques, we chose to decalcify the bone tissue and then perform traditional paraffin embedding. In summary, combining these two methods can provide more comprehensive and accurate information on bone microstructure.

Author Spotlight: An Economic and Efficient Method for Quantitative Evaluation of Bone Microarchitecture in a Murine Osteoporosis Model 

This protocol presents an economical and efficient method for quantitative evaluation of bone microarchitecture in a mouse model of osteoporosis by combining Hematoxylin-Eosin (HE) staining and micro-computed tomography (Micro-CT) techniques.

Bone microstructure refers to the arrangement and quality of bone tissue at the microscopic level. Understanding the bone microstructure of the skeleton ...