Chemotherapy-induced nausea and vomiting (CINV) is one of the most common and distressing side effects in patients with cancer. The introduction and development of antiemetic drugs have significantly improved the ability of clinicians to control CINV, but it is not easy to translate to practical application, owing to financial issues, provider-related barriers, and patient factors. Nondrug therapies are needed to alleviate the symptoms of CINV. Acupuncture is an appropriate adjunctive treatment for CINV, but additional evidence is needed. This study is a multicenter, randomized, sham-controlled prospective clinical trial. A total of 136 participants will be randomly allocated into the intervention group (verum acupuncture) or the control group (sham acupuncture) in a 1:1 ratio. All treatment will be given for 5 days. Participants in both groups will receive acupuncture sessions twice on the first day of chemotherapy and once consecutively on the following 4 days. Each session takes approximately 30 minutes. The primary outcome measure will be the Common Terminology Criteria for Adverse Events to assess CINV. The secondary outcome measures will be the Eastern Cooperative Oncology Group score, Simplified Nutritional Appetite Questionnaire, and Hospital Anxiety and Depression scale. Safety will be assessed at each visit. The results of this trial will provide clinical evidence for the effect and safety of acupuncture for CINV. ISRCTN Registry identifier: ISRCTN13287728 ). Registered on 28 February 2015. ClinicalTrials.gov identifier: NCT02369107 . Registered on 17 February 2015.

Background: Obesity has become a critical public health challenge worldwide. Prioritizing prevention and tackling root causes—rather than merely managing symptoms—is critical to curbing this pandemic. Strategies that activate and expand brown adipose tissue and beige adipose tissue increase energy expenditure in animal models and offer therapeutic promise to treat obesity. Sanhuang Xiexin Decoction (SHX) is a well-known traditional Chinese medicine that possesses several beneficial effects, including anti-inflammatory and anti-atherosclerotic properties. This study aims to investigate whether SHX can alleviate obesity by promoting the browning process in adipose tissue. Methods: UPLC MS/MS was used to detect the constituents of SHX extraction, as well as the absorbed components of SHX in rat plasma. In vivo, C57BL/6 J mice were fed with 60% calorie high-fat diet for 8 weeks to induce obesity. 3T3-L1 white adipocyte and HIB-1B brown adipocyte were cultured. Parameters of body weight, food intake, Lee’s index, skin temperature, adipose tissue mass, and blood glucose and lipids of mice were detected. The histological features of BAT and iWAT were observed by H&E staining, and the protein expression of UCP1 in adipose tissue was detected by immunohistochemistry method, and the UCP1 protein expression of 3T3-L1 and HIB-1B cells was tested using immunofluorescence staining. Gene expression of browning markers (e.g. Ucp1, Pgc1α, Prdm16, Cidea, Cd137, Tbx1, and Tmem26), fatty acid oxidation factors (e.g. Cpt-1β, Cyto-c, and Fatp1) and mitochondrial biogenic transcription factors (e.g. Nrf1, Nrf2, and Tfam) of adipose tissue, 3T3-L1 and HIB-1B cells was detected using qRT-PCR method. Results: A total of 58 chemical components of Sanhuang Xiexin Decoction were identified by UPLC-LTQ-Orbitrap-MSⁿ method, which provided the basis for the basic research of SHX pharmacodynamic substances. In vivo, SHX extraction could reduce body weight gain, improve glucose and lipid metabolism, enhance the activity of brown adipose tissue and induce the development of brown-like adipocytes of iWAT in obese mice. Furthermore, SHX extraction improved the gene expression of brown markers including Ucp1, Pgc1α and Prdm16, and mitochondrial biogenic transcription factors including Nrf1 and Tfam, as well as the UCP1 protein levels in white and brown adipocytes. Conclusions: Our study suggested that Sanhuang Xiexin Decoction could be used as a potential therapeutic candidate for the treatment of obesity and its complications by inducing browning of white adipose tissue and activating brown adipose tissue.