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In this paper, the varieties and origin of Primulaceae plants that used in Tibetan medicine were analyzed. The results showed that there were 3 genera and 44 species (including the varieties) of Primulaceae plants were recorded in the relevant literatures. Among them, 17 varieties were recorded in Tibetan names, 24 varieties were recorded in Chinese names and 1 variety was used in both of them. In current quality criteria of standards at all levels in China country, 6 varieties were recorded in Tibetan names and 6 original plants were involved, which were 35% and 14% of them respectively. Seventeen varieties were recorded in Chinese name and 7 original plants were involved, which were 30% and 16% of them respectively. In Tibetan medicine standards and literatures, there were big differences between Tibetan names and Chinese names which were translated from Tibetan names and its original plants. There were only regulations of morphological identification and microscopic authentication, so the standards were very inadequate. Therefore, through literatures research, resources and current situation investigations, combining the research and specification of the name and original of Tibetan medicine, the level of normalization and standardization could be enhanced, the stable and controllable safety and utility in clinical medication could be ensured to promote advancement of industry technology Tibetan medicine.

This study aimed to investigate the role of different types and frequencies of physical exercise in biomarkers of oxidative stress among middle-aged and elderly community residents with essential hypertension in China. A community-based cross-sectional survey was undertaken in 7 subdistricts. Individuals, 45-79 years old, with essential hypertension (n = 402) and without cardiovascular disease (n = 1047) were included. Superoxide dismutase (SOD) activities and plasma levels of malondialdehyde (MDA) and 4-hydroxynonenal (4-HNE) were determined. Multilevel linear regression was used to estimate the associations between various types of physical exercise and oxidative stress biomarker levels. Participants engaged in high frequency walking/square dancing or taiji/yoga demonstrated decreased systolic blood pressure in both groups; however, diastolic blood pressure decreased only among individuals with hypertension participating in walking/square dancing. In individuals with hypertension, MDA levels decreased in those participating in walking/square dancing, SOD activity increased in those participating in walking/square dancing, and 4-HNE levels decreased in those involved in taiji/yoga. In individuals without cardiovascular disease, MDA levels decreased in those involved in walking/square dancing or taiji/yoga, SOD activity increased in those performing walking/square dancing, and 4-HNE levels decreased in those involved in taiji/yoga. Oxidative stress marker levels also improved in those involved in walking/square dancing or taiji/yoga groups as the exercise frequency increased. Thus, frequent participation in walking/square dancing or taiji/yoga effectively decreases hypertension-related oxidative stress biomarker levels.

Abstract Juniperus pingii var. wilsonii has been traditionally used in Tibetan medicine for the treatment of inflammatory diseases. In the present study, J. pingii var. wilsonii polysaccharides (JPWP), with high content of d ‑galacturonic acid, showed potent anti-complementary activity in vitro and significantly attenuated acute lung injury (ALI) induced by H1N1 influenza virus in vivo through reducing the inflammatory responses, alleviating oxidative stress and inhibiting the activation of complement. Thus, anti-complementary activity-guided fractionation of JPWP led to the isolation of an acidic homogeneous polysaccharide, JPWP-PS, whose structure was further elucidated by acid hydrolysis, PMP derivation, methylation and NMR analysis. JPWP-PS had potent anti-complementary activity with the CH 50 value of 0.073 ± 0.009 mg/mL, and was characterized by the residues of T-Ara f -(1→, →3)-Ara f -(1→, →3,5)-Ara f -(1→, →3)-Gal p -(1→ and →4)-Gal p A-(1→. Graphical abstract Unlabelled Image Highlights • Juniperus pingii var. wilsonii polysaccharides (JPWP) improved survival rate of H1N1 virus infected mice. • JPWP treated acute lung injury via inhibiting inflammatory responses, oxidative stress and activation of complement. • A homogeneous acidic polysaccharide with potent anti-complementary activity was isolated from JPWP. [ABSTRACT FROM AUTHOR]

The Nitraria tangutorum Bobr. fruit is an indigenous berry of the shrub belonging to the Zygophyllaceae family which grows at an altitude of over 3000 m in the Tibetan Plateau, and has been used as a native medicinal food for treating weakness of the spleen, stomach syndrome, dyspepsia, neurasthenia, dizziness, etc. for thousands of years. Nowadays, N. tangutorum industrial juice by-products generated from health food production can be a potential low cost source of some unique bioactive ingredients. In a prior study, we established a simultaneous microwave/ultrasonic assisted enzymatic extraction method for extracting antioxidant ingredients from the industrial by-products of N. tangutorum juice. In this study, these ingredients were selectively fractionated by cation-exchange resin chromatography to obtain an anthocyanin fraction namely NJBAE. NJBAE was found to be composed of 16 anthocyanins derived from six anthocyanidins by HPLC-ESI-MS, and has an appreciable cardioprotective effect on doxorubicin-induced injured H9c2 cardiomyocytes. The cardioprotective mechanism research showed that NJBAE could directly scavenge ROS, restrict further generation of ROS, promote the activity of key antioxidase, enhance glutathione redox cycling, then affect the apoptotic signaling changes in a positive way, and finally mediate caspase-dependent cell death pathways. Therefore, NJBAE has great potential to be used for preventing and treating cardiovascular disease in the food, pharmaceutical and other emerging industries.

The Nitraria tangutorum Bobr. fruit is an indigenous berry of the shrub belonging to the Zygophyllaceae family which grows at an altitude of over 3000 m in the Tibetan Plateau, and has been used as a native medicinal food for treating weakness of the spleen, stomach syndrome, dyspepsia, neurasthenia, dizziness, etc. for thousands of years. Nowadays, N. tangutorum industrial juice by-products generated from health food production can be a potential low cost source of some unique bioactive ingredients. In a prior study, we established a simultaneous microwave/ultrasonic assisted enzymatic extraction method for extracting antioxidant ingredients from the industrial by-products of N. tangutorum juice. In this study, these ingredients were selectively fractionated by cation-exchange resin chromatography to obtain an anthocyanin fraction namely NJBAE. NJBAE was found to be composed of 16 anthocyanins derived from six anthocyanidins by HPLC-ESI-MS, and has an appreciable cardioprotective effect on doxorubicin-induced injured H9c2 cardiomyocytes. The cardioprotective mechanism research showed that NJBAE could directly scavenge ROS, restrict further generation of ROS, promote the activity of key antioxidase, enhance glutathione redox cycling, then affect the apoptotic signaling changes in a positive way, and finally mediate caspase-dependent cell death pathways. Therefore, NJBAE has great potential to be used for preventing and treating cardiovascular disease in the food, pharmaceutical and other emerging industries.

Zuota is regarded as the king of Tibetan medicine. However, due to the confidentiality of this precious medicine, the scientific characterization of Zuota is very scarce, which limits the pharmacology and biosafety studies of Zuota. Herein, we collected four different Zuota samples from Tibet, Qinghai, Gansu, and Sichuan and characterized them by multiple techniques. Our results showed that Zuota was mainly an inorganic mixture of HgS, sulfur, and graphite. Morphologically, Zuota samples were composed of nanoparticles, which further aggregated into microsized particles. Chemically, the majorities of Zuota were S and Hg (in the forms of HgS and pure sulfur). All samples contained pure sulfur with orthorhombic crystalline. Zuota from Qinghai province had different HgS crystalline, namely, hexagonal crystalline. The others were all face-centered cubic crystalline. Carbon in Zuota NPs was in the form of graphite. The implication to future studies of Zuota was discussed.

Zuota is regarded as the king of Tibetan medicine. However, due to the confidentiality of this precious medicine, the scientific characterization of Zuota is very scarce, which limits the pharmacology and biosafety studies of Zuota. Herein, we collected four different Zuota samples from Tibet, Qinghai, Gansu, and Sichuan and characterized them by multiple techniques. Our results showed that Zuota was mainly an inorganic mixture of HgS, sulfur, and graphite. Morphologically, Zuota samples were composed of nanoparticles, which further aggregated into microsized particles. Chemically, the majorities of Zuota were S and Hg (in the forms of HgS and pure sulfur). All samples contained pure sulfur with orthorhombic crystalline. Zuota from Qinghai province had different HgS crystalline, namely, hexagonal crystalline. The others were all face-centered cubic crystalline. Carbon in Zuota NPs was in the form of graphite. The implication to future studies of Zuota was discussed.

OBJECTIVE: To investigate the chemical components and microstructure of Nengchi Bajin ashes which are adjuvant material in the refining of Tibetan medicine gTSo thal, in order to explore the material basis of the refining of gTSo thal.METHOD: Scanning electron microscope-energy dispersive spectrometer (SEM-EDX) and X-ray diffraction (XRD) were used to measure the Nengchi Bajin ashes. RESULT: SEM-EDX analysis show that except of themselves elements of Nengchi Bajin ashes, Nengchi Bajin ashes contain the major elements, such as S, O, C and so on, also contain small amount other elements. XRD analysis show that the structures are AuPb2, PbO (tetragonal and orthorhombic) and Pb in gold ash, Ag2S and PbO in silver ash, Cu1.98 (Zn0.73 Fe0.29)Sn0.99 S4, CuS, SiO2, NaCu2S2 and Ca (Fe(+2), Mg) (CO3)2 in bronze ash, Cu7S4 (orthorhombic and monoclinic) and CuO in red copper ash, Cu7 S4, PbS, ZnS, CaCO3and NaCu2S2 in brass ash, FeS, Fe+2 Fe(2+3)O4 and SiO2 in iron ash, SnS and SiO2 tin ash, PbS, PbSO4 and SnS2 in lead ash. CONCLUSION: We have acquired the datum of elements and microstructure of Nengchi Bajin ashes by SEM-EDX and XRD techniques, and that is benefit to explore the material basis of refining gTSo thal.

Zhuxi is a mineral medicine widely used in traditional Tibetan medicine throughout history. However, the bioactive component in Zhuxi still remains unclear. In order to enunciate the material basis of its pharmacological activity, the present research has determined the chemical component and structure of Zhuxi. X-ray fluorescence spectroscopy (XRF), inductively coupled plasma optical emission spectrometer (ICP-OES) and X-ray diffraction (XRD) were utilized to assay two samples of Zhuxi. XRF and ICP-OES analysis indicated that the main elements in Zhuxi are Fe, S and O, also containing some minor elements, such as Si, Na, Mg, Al, K, Ni, Ca, Ti and so on. XRD analysis suggested that the main crystal compound in Zhuxi is FeS2 (Cubic, Pa-3), also existing a few of Fe(+3)O(OH) (orthorhombic, Pbnm) and other some unknown compounds. These studies has highlighted the potential the element components and compound structures of Zhuxi, so it may be a good starting point for exploring the material basis of its pharmacological activity.

In order to reveal the chemical substance basis of pharmacodynamic effects of Zuotai, energy dispersive spectrometry of X-ray (EDX), X-ray fluorescence spectroscopy (XRF), synchrotron radiation X-ray absorption fine structure (SR-XAFS), X-ray diffraction (XRD), scanning electron microscope (SEM) and atomic force microscope (AFM) were used to analyze the elements, the chemical valence and local structure of mercury, and the chemical phase composition and micro-morphology of Zuotai. EDX and XRF analysis shows that the main elements in Zuotai are Hg and S, with some other minor elements, such as 0, Fe, Al, Cu, K, Ag, Ca, Mg etc. SR-XAFS analysis shows that: the oxidation state of mercury in Zuotai is divalence, its neighbor atoms are S, and its coordination number is four. XRD assay found that β-HgS (cubic, F-43m 216) and S8 (orthorhombic, Fddd 70) are the main phase compositions in Zuotai. Besides, it also has a small amount of C (hexagonal, P63/mmc 194), Fel.05 S0.95 (hexagonal, P63/mmc 194), Cu6S6 (hexagonal, P63/mmc 194), Cu1.8 S (cubic, F-43m 216) and so on. And it was found that the crystallinity of Zuotai is about 59%, and the amorphous morphology substance in it is about 41%. SEM and AFM detection suggests that Zuotai is a kind of ancient micro-nano drug, and its particle size is mainly in the range of 100-600 nm, even less than 100 nm, which commonly further aggregate into several to 30 µm loose amorphous particles. In summary, the present study elucidated physicochemical characterization(elements composition, coordination information of mercury, phase composition and micro-morphology) of Zuotai, and it will play a positive role in promoting the interpretation of this mysterious drug.;

Objective: To evaluate the effectiveness and safety of Chinese herbal medicine (CHM) in the treatment of subacute thyroiditis.<br>Methods: Randomized controlled trials found in PubMed, Cochrane Library, and three Chinese databases were selected. RevMan 5.2 software was used to analyze the data with relative risk or mean difference, expressed with 95% of confidence interval. The quality of trials was assessed and graded the quality of evidence with GRADE profiler software.<br>Results: Twenty one studies were included. CHM was superior to Western Medicine (include prednisone and NSAIDs) in abating fever, relieving thyroid pain, recovering blood sedimentation, improving thyroid function, and preventing hypothyroidism (<b>P</b><0.05), while no statistical differences were found in eliminating goiter and reducing relapse rate. CHM plus Western Medicine were superior to Western Medicine in abating fever, relieving thyroid pain, eliminating goiter, and reducing relapse rate, while no statistical differences (<b>P</b>>0.05) were found in recovering blood sedimentation and improving thyroid function. The incidence of adverse reactions in treatment group was lower than that in control group (relative risk was 0.12 and 95% confidence interval was 0.03-0.51). The methodological quality of trials is generally poor with a high risk of bias.<br>Conclusion: CHM (particularly CHM combined with Western Medicine) used to treat subacute thyroiditis may improve clinical symptoms and signs, reduce relapse rate, and alleviate the side effects of hormones. Due to poor methodological quality of included trials, further more high-quality studies are warranted to confirm the effectiveness and safety of CHM.

Cirsilineol (4′,5-dihydroxy-3′,6,7-trimethoxyflavone) is a compound isolated from the herb of <i>Artemisia vestita</i> Wall (Compositae). In this study, we aimed at examining the anti-proliferative activity of cirsilineol against multiple types of cancer cells and the underlying mechanisms. Cirsilineol significantly inhibited proliferation of Caov-3, Skov-3, PC3 and Hela cells in a concentration-dependent manner. The compound also dose-dependently induced apoptosis in Caov-3 cells, as determined by annexin V/propidium iodide staining. Besides, cirsilineol induced a remarkable change in mitochondrial membrane potential and caused release of cytochrome <i>c</i> to cytosol. Furthermore, the compound caused a marked activation of capase-3, caspase-9 and poly (ADP-ribose) polymerase (PARP). These results suggested that the induction of apoptosis via the mitochondrial pathway was involved in the anti-proliferative activity of cirsilineol against cancer cells.

The comparative study of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in view of history development, theoretic basis, bloodletting location, bloodletting tool, operation method, bloodletting amount, indications, contraindications and the others are conducted in this paper. It is pointed out that the bloodletting therapy could be better carried forward and developed through the interaction and integration of bloodletting therapy between traditional Chinese medicine and Tibetan medicine in term of the theoretic, practical and development patterns under the guidance of these two different medical theoretical systems.

In order to find new anticancer drugs, a series of novel furoxan-based coumarin derivatives (<i>10a</i>-<i>k</i>) were synthesized and evaluated for their antiproliferative activities in vitro. All compounds displayed more potent inhibition on human cervical cancer HeLa cell proliferation than coumarin-3-carboxylic acid, and compounds <i>10b</i>,<i> 10c</i>,<i> 10f</i>,<i> 10h</i>, and <i>10i</i> with IC<sub>50</sub> values ranging from 0.88 to 5.95 μM were even stronger than doxorubicin (IC<sub>50</sub> = 10.21 μM). The further study showed that compound <i>10i</i> exerted the highest antiproliferative activity (IC<sub>50</sub> = 0.60 μM) against human breast cancer MCF-7 cells, and compound <i>10f</i> had broader spectrum antiproliferative activity against five cancer cells with IC<sub>50</sub> values in the low micromolar range of 1.86-9.85 μM. More interestingly, compound <i>10f</i> had little effect on normal intestinal epithelial CCD841 cells. Our findings suggest that these novel furoxan-based coumarin derivatives may provide a new framework for the discovery of novel antitumor agents for the intervention of human carcinoma cells.

In this study, we developed a method of liquid chromatography with fluoresce detector (LC-FLD) and on-line mass spectrometry identification (MSI) using 2-[2-(7H-dibenzo [a, g] carbazol-7-yl)-ethoxy] ethyl chloroformate (DBCEC-Cl) as pre-column derivatisation reagent for determination of the amino acids (AAs) in <i>Potentilla anserina</i> L<i>.</i> Separation of the derivatised AA exhibited a good baseline resolution in combination with a gradient elution. All AA derivatives give excellent linear responses with correlation coefficients of >0.9992. The detection limits of each AA were 2.60-24.3 fmol. Eighteen AAs, involving seven essential AAs, were detected in <i>Potentilla anserina</i> L<i>.</i> Quantitative recoveries of the AAs from the <i>Potentilla anserina</i> L<i>.</i> were 84-107%, and the relative standard deviation values were <1.45%. The established method in this study was sensitive and precision enough to separate and quantify AA composition of <i>Potentilla anserina</i> L. Good compositional data were obtained from the analysis of the AAs obtained from <i>Potentilla anserina</i> L<i>.</i> root.

A new fluorescent labeling reagent, benzimidazo[2,1-<i>b</i>]quinazolin-12(6<i>H</i>)-one-5-ethyl-<i>p</i>-toluenesulfonate (BQETS) was designed and synthesized, and it was successfully applied to the determination of fatty acids with liquid chromatography. BQETS can easily and quickly label fatty acids within 20 min at 90 °C in dimethylformamide with K<sub>2</sub>CO<sub>3</sub> as catalyst. The derivatives exhibit high stability and strong fluorescence with excitation and emission wavelengths of 247 and 401 nm, respectively. The 24 derivatives of fatty acids were completely separated by gradient elution on a Hypersil GOLD C18 column. Excellent linear responses for all fatty acids were observed with correlation coefficients of >0.9991. The method also showed good sensitivity and precision, with limits of detection in the 0.0024-0.0206 μg g<sup>−1</sup> range and relative standard deviations ≤9.6 %. This is the first time that BQETS fluorescent probe and its applications for the determination of fatty acids have been reported. Moreover, this is the first report on the comparison of free fatty acids composition in the above-ground part of <i>Coriandrum sativum</i> L. from different habitats in China.

OBJECTIVE: To develop an HPLC method for the determination of a Tibetan medicine Meconopsis quintuplinervia.METHOD: A Hypersil-Keystone-C18 column (4.6 mm x 250 mm, 5 microm) was used with the isocratic elution of acetonitrile and 0.012% glacial acetic acid. The flow rate was 1.0 mL x min(-1), and the detection wavelength was set at 237 nm. RESULT: The linear range of 0-methylflavinantine was 0.2-2.4 microg (r = 0.999 7). The average recovery was 96.26%. CONCLUSION: The developed method was reliable, and can be used for the quality control of M. quintuplinervia Regel.

The mercury in Tibetan medicine has become important focus in the research on medicine safety evaluation. The total mercury and the ionic mercury in artificial gastric juice of Tibetan medicine Dangzuo were detected by Gold Amalgam Enrichment-Atomic Fluorescence Spectrometry (GAE-AFS). In the present study, Tibetan medicine Dangzuo was prepared by H2SO4-KNO3 digestion system and artificial gastric juice. The established method and condition of instrument were investigated. Under the optimum experimental conditions and instrumental operation parameters, the recovery (n=6) of HgS is 99.56$ (RSD = 1.94%), the limit of detection for mercury is 0.2 ng x L(-1), the linear range is 0-500 ng x L(-1), and r = 0.9999. Then, the total mercury and the ionic mercury in artificial gastric juice in Dangzuo samples from different Tibetan regions were assayed. The result showed that the ranges of total mercury and ionic mercury in artificial gastric juice were 3.9980-16.7358 x mg x g(-1) and 45.5377-1033.9850 ng x g(-1), respectively. The analytical method mentioned above is rapid and accurate for determining the amount of mercury in Tibetan medicine Dangzuo.

• A new low toxic dual-UADLLME coupled with microwave-assisted derivatization was proposed. • 4′-Carboxy-substituted rosamine was firstly used as derivatization reagent. • Simultaneous determination of PPD and PPT in rat plasma was achieved by UHPLC-MS/MS. • This method was successfully applied to pharmacokinetics study.<br>This paper, for the first time, reported a speedy hyphenated technique of low toxic dual ultrasonic-assisted dispersive liquid-liquid microextraction (dual-UADLLME) coupled with microwave-assisted derivatization (MAD) for the simultaneous determination of 20(<b>S</b>)-protopanaxadiol (PPD) and 20(<b>S</b>)-protopanaxatriol (PPT). The developed method was based on ultra high performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) detection using multiple-reaction monitoring (MRM) mode. A mass spectrometry sensitizing reagent, 4′-carboxy-substituted rosamine (CSR) with high reaction activity and ionization efficiency was synthesized and firstly used as derivatization reagent. Parameters of dual-UADLLME, MAD and UHPLC-MS/MS conditions were all optimized in detail. Low toxic brominated solvents were used as extractant instead of traditional chlorinated solvents. Satisfactory linearity, recovery, repeatability, accuracy and precision, absence of matrix effect and extremely low limits of detection (LODs, 0.010 and 0.015 ng/mL for PPD and PPT, respectively) were achieved. The main advantages were rapid, sensitive and environmentally friendly, and exhibited high selectivity, accuracy and good matrix effect results. The proposed method was successfully applied to pharmacokinetics of PPD and PPT in rat plasma.

This study aimed to find a simple and effective mindfulness training method for intervening depression. 95 university students with moderate or severe depression participated in the study and they were divided into three mindfulness training groups: 8-week complete group, 8-week informal group, and 4-week group. All subjects completed Beck Depression Inventory (BDI-Ⅱ) and Five Fact Mindfulness Questionnaire (FFMQ) before the intervention, after which, 55 subjects completed the assessments once more. Results showed the scores of specific dimensions representing mindfulness levels were different. For the 4-week group, scores of description, action aware and nonjudge significantly were improved, while the other two groups were improved significantly on all the five dimensions, especially the informal training group. In the discussion, it focused more on the effects of training time and training contents, and briefly discussed the relation of subjects dropout, subjects attendance, homework completion status and intervention effects. In conclusion, all the three intervention modes have magnificent intervention effects. Integrated many sided, 8-week informal training is of the best effects, which may be considered as a better mindfulness training mode henceforth, however, the comparison between the formal training and informal training still needs further study.

Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind-body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge's g = -0.39, 95% CI -0.39 to -0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge's g = 0.37, 95% CI 0.22 to -0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge's g = -0.58, 95% CI -0.81 to -0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge's g = -0.80, 95% CI -1.17 to -0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind-body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.

Background: Heart rate variability (HRV) as an accurate, noninvasive measure of the Autonomous Nervous System (ANS) can reflect mental health (e.g., stress, depression, or anxiety). Tai Chi and Yoga (Tai Chi/Yoga), as the most widely practiced mind-body exercises, have shown positive outcomes of mental health. To date, no systematic review regarding the long-lasting effects of Tai Chi/Yoga on HRV parameters and perceived stress has been conducted. Objective: To critically evaluate the existing literature on this topic. Methods: Five electronic databases (Web of Science, PubMed, Scopus, SportDiscus and Cochrane Library) were searched from the start of the research project to July 2018. Study selection, data extraction, and study quality assessment were independently carried out by two reviewers. The potentially identified randomized controlled trials (RCT) reported the useful quantitative data that were included only for meta-analysis. Results: meta-analysis of 17 medium-to-high quality RCTs showed significantly beneficial effects on HRV parameters (normalized low-frequency, Hedge's g = -0.39, 95% CI -0.39 to -0.56, p < 0.001, I2 = 11.62%; normalized high-frequency, Hedge's g = 0.37, 95% CI 0.22 to -0.52, p < 0.001, I2 = 0%; low-frequency to high-frequency ratio, Hedge's g = -0.58, 95% CI -0.81 to -0.35, p < 0.001, I2 = 53.78%) and stress level (Hedge's g = -0.80, 95% CI -1.17 to -0.44, p < 0.001, I2 = 68.54%). Conclusions: Stress reduction may be attributed to sympathetic-vagal balance modulated by mind-body exercises. Tai Chi/Yoga could be an alternative method for stress reduction for people who live under high stress or negative emotions.

Low well-being is common among Chinese pregnant women but few effective interventions currently exist to improve prenatal stress and negative emotions. Mindfulness-based stress reduction (MBSR) has been proved to be effective in reducing stress and rarely studies were focused on Chinese pregnant women. The aim of the current paper is to investigate the effects of 8-week MBSR on prenatal stress, anxiety and depression among Chinese pregnant women. A sample of 66 pregnant women randomly allocated into either the MBSR group (n=34) or the control group (n=32). Participants in the MBSR group received a group 8-week, 90-min each time intervention. The results found a significant interaction between time and condition for prenatal stress (F=45.51, p<0.001, η 2=0.427), anxiety (F=19.30, p<0.001, η 2=0.240), while depression showed no time-by-group interaction (F=0.29, p=0.589, η 2=0.005). As for the sub-scale of state anxiety, while there was only no time effect (F=3.68, p=0.060, η 2=0.057). The findings of this study preliminary indicated effects of the MBSR intervention on self-reported prenatal stress and anxiety in comparison to a treatment-as-usual control. Effect on depression was not observed may due to the low level of depression of participants. This study provides preliminary evidence that MBSR is suitable for Chinese pregnant women and be effective in decreasing prenatal stress, anxiety.

Low well-being is common among Chinese pregnant women but few effective interventions currently exist to improve prenatal stress and negative emotions. Mindfulness-based stress reduction (MBSR) has been proved to be effective in reducing stress and rarely studies were focused on Chinese pregnant women. The aim of the current paper is to investigate the effects of 8-week MBSR on prenatal stress, anxiety and depression among Chinese pregnant women. A sample of 66 pregnant women randomly allocated into either the MBSR group (n=34) or the control group (n=32). Participants in the MBSR group received a group 8-week, 90-min each time intervention. The results found a significant interaction between time and condition for prenatal stress (F=45.51, p<0.001, η 2=0.427), anxiety (F=19.30, p<0.001, η 2=0.240), while depression showed no time-by-group interaction (F=0.29, p=0.589, η 2=0.005). As for the sub-scale of state anxiety, while there was only no time effect (F=3.68, p=0.060, η 2=0.057). The findings of this study preliminary indicated effects of the MBSR intervention on self-reported prenatal stress and anxiety in comparison to a treatment-as-usual control. Effect on depression was not observed may due to the low level of depression of participants. This study provides preliminary evidence that MBSR is suitable for Chinese pregnant women and be effective in decreasing prenatal stress, anxiety.

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