A Case Report on Treating Progressive Supranuclear Palsy with a Combination of Chinese and Western Medicine

A case of progressive supranuclear palsy in a 66-year-old woman is presented.The patient complained of“progressive stiffness of both lower limbs for five years,accompanied by choking and coughing for more than 1 year,”and was diagnosed with paralysis in traditional Chinese medicine(TCM),which was characterized by a deficiency of liver and kidney,and phlegm and blood stasis blocking the collaterals.Western medicine diagnosed it as progressive supranuclear palsy.The patient was diagnosed with“Parkinson’s disease”several times in the past and was given“polybasic hydrazide”and“amantadine hydrochloride tablets,”etc.The patient did not have significant symptomatic relief,so she sought further treatment with a combination of traditional Chinese and Western medicine.Based on the concept of deficiency and excess,this disease is categorized as a paralytic disease in Chinese medicine,and the onset of the disease is closely related to the deficiency of the body after a long period of illness,with wind,phlegm,blood stasis,and deficiency as the main pathogenetic mechanism.The treatment is based on the combination of disease and evidence,with traditional Chinese medicine and acupuncture as the main treatments,supplemented by intermediate-frequency pulsed electrical stimulation,transcranial repetitive magnetic stimulation,medicated canisters,wax therapy,traditional Chinese medicine guasha,and acupoint injections.Western medicine is based on symptomatic treatment,and the patient’s symptoms were relieved significantly after the combination of Chinese and Western medicine.

Irritable bowel syndrome: Pathogenesis, diagnosis, treatment, and evidence-based medicine

Irritable bowel syndrome (IBS) is a chronic and debilitating functional gastrointestinal disorder that affects 9%-23% of the population across the world. The percentage of patients seeking health care related to IBS approaches 12% in primary care practices and is by far the largest subgroup seen in gastroenterology clinics. It has been well documented that these patients exhibit a poorer quality of life and utilize the health care system to a greater degree than patients without this diagnosis. The pathophysiology of IBS is not clear. Many theories have been put forward, but the exact cause of IBS is still uncertain. According to the updated ROME III criteria, IBS is a clinical diagnosis and presents as one of the three predominant subtypes: (1) IBS with constipation (IBS-C); (2) IBS with diarrhea (IBS-D); and (3) mixed IBS (IBS-M); former ROME definitions refer to IBS-M as alternating IBS (IBS-A). Across the IBS subtypes, the presentation of symptoms may vary among patients and change over time. Patients report the most distressing symptoms to be abdominal pain, straining, myalgias, urgency, bloating and feelings of serious illness. The complexity and diversity of IBS presentation makes treatment difficult. Although there are reviews and guidelines for treating IBS, they focus on the efficacy of medications for IBS symptoms using high-priority endpoints, leaving those of lower priority largely unreported. Therefore, the aim of this review is to provide a comprehensive evidence-based review of the diagnosis, pathogenesis and treatment to guide clinicians diagnosing and treating their patients.

Progress in diagnosis and treatment of small cell lung cancer with integrated traditional Chinese and Western medicine

Lung cancer is one of the most common major diseases that seriously threaten human health,lung cancer includes small cell lung cancer(SCLC)and non-small cell lung cancer(NSCLC).Although patients with SCLC account for about 20%of the total number of patients with lung cancer,the mortality rate is much higher than that of patients with NSCLC.Integrated traditional Chinese and Western medicine has obvious advantages in the treatment of patients with SCLC.According to the relevant literature reports on the treatment of SCLC in recent years,this article will summarize the research progress of integrated traditional Chinese and western medicine in the treatmentof SCLC from the aspects of traditional Chinese medicine(TCM)combined with surgery,chemotherapy,radiotherapy,and molecular targeted therapy.

Chemoprophylaxis, diagnosis, treatments, and discharge management of COVID-19: An evidence-based clinical practice guideline(updated version)

The novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is the cause of a rapidly spreading illness,coronavirus disease 2019(COVID-19),affecting more than seventeen million people around the world.Diagnosis and treatment guidelines for clinicians caring for patients are needed.In the early stage,we have issued"A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infected pneumonia(standard version)";now there are many direct evidences emerged and may change some of previous recommendations and it is ripe for develop an evidence-based guideline.We formed a working group of clinical experts and methodologists.The steering group members proposed 29 questions that are relevant to the management of COVID-19 covering the following areas:chemoprophylaxis,diagnosis,treatments,and discharge management.We searched the literature for direct evidence on the management of COVID-19,and assessed its certainty generated recommendations using the Grading of Recommendations,Assessment,Development and Evaluation(GRADE)approach.Recommendations were either strong or weak,or in the form of ungraded consensus-based statement.Finally,we issued 34 statements.Among them,6 were strong recommendations for,14 were weak recommendations for,3 were weak recommendations against and 11 were ungraded consensus-based statement.They covered topics of chemoprophylaxis(including agents and Traditional Chinese Medicine(TCM)agents),diagnosis(including clinical manifestations,reverse transcription-polymerase chain reaction(RT-PCR),respiratory tract specimens,IgM and IgG antibody tests,chest computed tomography,chest X-ray,and CT features of asymptomatic infections),treatments(including lopinavirritonavir,umifenovir,favipiravir,interferon,remdesivir,combination of antiviral drugs,hydroxychloroquine/chloroquine,interleukin-6 inhibitors,interleukin-1 inhibitors,glucocorticoid,qingfei paidu decoction,lianhua qingwen granules/capsules,convalescent plasma,lung transplantation,invasive or noninvasive ventilation,and extracorporeal membrane oxygenation(ECMO)),and discharge management(including discharge criteria and management plan in patients whose RT-PCR retesting shows SARS-CoV-2 positive after discharge).We also created two figures of these recommendations for the implementation purpose.We hope these recommendations can help support healthcare workers caring for COVID-19 patients.

Application of nanoparticles in the early diagnosis and treatment of tumors:current status and progress

Objective:Malignant tumors pose a serious threat to human life and health.Despite recent developments in modern medical techniques,the early diagnosis and treatment of tumors remain difficult due to their asymptomatic nature in the early stages of disease and the limitations in current clinical diagnostic methods.Advancements in nanotechnology,particularly in the area of multi-functional diagnostic nanomaterials,can help effectively resolve present inadequacies via concurrently achieving early diagnosis,image-guided intervention,and real-time monitoring and treatment of tumors.The development of nanomaterials and nanotechnology may also aid in the area of anti-cancer drug development by improving the safety and side-effect profile,as well as by enhancing the targeted specificity of the drugs,which are two of the long-standing challenges in Western medicine.The progress in the field of nanomaterials has also uncovered novel approaches for the clinical application of traditional Chinese medicine because the combination of traditional Chinese medicine components with nanoparticles overcomes various drawbacks,including poor water solubility,low bioavailability,and short half-life,of the former.Moreover,nanoparticles also enhance the biological effectiveness and targeted specificity of these medicines.In this review,we discuss the application of nanoparticles in the early diagnosis and treatment of tumors,through modern and traditional medicine.

Interpretation of Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7)

On March 3,2020,the National Health Commission and the National Administration of Traditional Chinese Medicine of China jointly promulgated the Notice on Printing and Distributing the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7).The content has been revised and supplemented on the basis of the Version 6,including etiological characteristics and pathological changes in lung,heart,kidney,spleen,liver,gallbladder,esophagus,stomach and intestinal mucosal epithelium.In particular,the diagnosis and treatment methods of traditional Chinese medicine are supplemented.It provides an evidence-based diagnosis and treatment protocol for the treatment and recovery of suspected and confirmed cases of novel coronavirus pneumonia with traditional Chinese medicine and Western medicine.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

An expert consensus on the evaluation and treatment of acute thoracolumbar spine and spinal cord injury in China

This is an expert consensus on the evaluation and treatment of thoracolumbar spinal injury, estab- lished from February 2009 to July 2010. The expert consensus consists mainly of six parts with a total of 54 recommendations including the overview （one item）; pre-hospital care （one item）; evaluation and diagnosis （13 items）; treatment （23 items）; prevention and treatment of major com- plications （12 items）; and rehabilitation （four items）. This is the first time that Chinese experts have published a consensus on spine and spinal cord injury. The expert consensus was established based on Delphi methods, literature analysis, and clinical experiences. Each recommendation is supported by and was interpreted using multi-level evidences. The level of agreement with the rec- ommendation among the panel members was assessed as either low, moderate, or strong. Each panel member was asked to indicate his or her level of agreement on a 5-point scale, with ＂1＂ cor- respondJng to neutrality and ＂5＂ representJng maxJmum agreement. Scores were aggregated across the panel members and an arithmetic mean was calculated. This mean score was then translated into low, moderate, or strong. After all of the votes were collected and calculated, the results showed no low-level recommendations, 10 moderate-level recommendations, and 44 strong-level recom- mendations. An expert consensus was reached and was recognized by Chinese spine surgeons. Wide-scale adoption of these recommendations is urgent in the management of acute thora- columbar spine and spinal cord injury in a broader attempt to create a standard evaluation and treatment strategy for acute thoracolumbar spine and spinal cord injury in China.

Understanding of Traditional Chinese Medicine and Western Medicine on Swimming Shoulder

Swimming shoulder refers to shoulder pain syndrome which is caused by repeated impinges on shoulder joints among swimmers.It is one of the most common causes of shoulder pain among swimmers with high incidence.Swimming shoulder can affect the systematization of swimmers’training and the improvement of their training level and performance,which is a difficult problem for many swimmers,coaches,medical staff and sports medical doctors.Therefore,attention should be paid to the treatment of swimming shoulder in daily diagnosis and treatment.

Clinical research progress of ischemic heart failure and prospect of traditional Chinese medicine

As one of the most common types of heart failure, the diagnosis and treatment of Ischemic heart failure are the main focus of clinic. In recent years, the studies on biomarkers have provided supports for clinical diagnosis, prognosis evaluation and stratification. The clinical application of new drugs and the development of non-drug treatment methods have brought more choices conventional treatment. At the same time, under the guidance of Traditional Chinese Medicine syndrome differentiation theory, Traditional Chinese Medicine therapy also plays an increasingly important role and shows its broad prospects .

The Usage Evolution of Syndrome and the Production of the Term Differentiation of Syndromes in the Ancient Literature

Syndrome stood for disease name and symptom in the ancient medical literature prior to the Tang Dynasty.With the development of pathogenesis theory,the meaning pathogenesis of syndrome came into being and the term differentiation of syndromes came into existence in the Song,Jin and Yuan Dynasties,hence differentiation of syndromes gradually became a diagnostics term of differentiating pathogenesis.

Novel tools for early diagnosis and precision treatment based on artificial intelligence

Lung cancer has the highest mortality rate among all cancers in the world.Hence,early diagnosis and personal-ized treatment plans are crucial to improving its 5-year survival rate.Chest computed tomography(CT)serves as an essential tool for lung cancer screening,and pathology images are the gold standard for lung cancer diagnosis.However,medical image evaluation relies on manual labor and suffers from missed diagnosis or misdiagnosis,and physician heterogeneity.The rapid development of artificial intelligence(AI)has brought a whole novel op-portunity for medical task processing,demonstrating the potential for clinical application in lung cancer diagnosis and treatment.AI technologies,including machine learning and deep learning,have been deployed extensively for lung nodule detection,benign and malignant classification,and subtype identification based on CT images.Furthermore,AI plays a role in the non-invasive prediction of genetic mutations and molecular status to provide the optimal treatment regimen,and applies to the assessment of therapeutic efficacy and prognosis of lung cancer patients,enabling precision medicine to become a reality.Meanwhile,histology-based AI models assist patholo-gists in typing,molecular characterization,and prognosis prediction to enhance the efficiency of diagnosis and treatment.However,the leap to extensive clinical application still faces various challenges,such as data sharing,standardized label acquisition,clinical application regulation,and multimodal integration.Nevertheless,AI holds promising potential in the field of lung cancer to improve cancer care.

Analysis of novel coronavirus pneumonia treatment with Chinese herbal compound

Objective: To analyze the prescription law of TCM compound in the treatment of new coronavirus pneumonia, and provides reference for the clinical treatment of new coronavirus pneumonia. Methods: Collected Collected 24 novel coronavirus pneumonia related diagnostic and therapeutic plans issued by the National Health Council and the Chinese medicine authority from January 26, 2020 to March 8th ,the filtered solution involved in the formula, establishing database of traditional Chinese medicine compound prescription for the treatment of new crown pneumonia, the frequency of using frequency analysis methods of analysis and clustering analysis and association rules analysis to sort out data mining analysis of traditional Chinese medicine compound. Results: In this study, a total of 159 TCM compounds were included in the treatment of new crown pneumonia from the country and 23 provinces, municipalities and autonomous regions, involving 189 TCM compounds. A total of 62 high-frequency traditional Chinese medicines (frequency ≥ 11) were obtained, mainly including licorice, almond, ephedra, gypsum, Poria cocos, Huoxiang, etc The drug types are mainly heat-clearing drugs, vacuous drugs, moisture-curing drugs, and surfactant drugs. The main effect of the medicine was warm, cold, lukewarm and flat, the main effect of the medicine was bitter and bitter, and the main effect of the medicine was the lung, stomach and spleen. Cluster analysis results according to the performance of traditional Chinese medicine treatment of new crown pneumonia high frequency drugs into 7 classes;Association rule analysis results in 29 common drug pairs. Conclusion: In the treatment of pneumonia caused by new coronavirus infection with traditional Chinese medicine, the following characteristics are presented: the number of times of supplementing qi and Yin is more than that of attacking evil and maintaining health;The method of dispersing and solving the attack of wet, beneficial, wet, permeable and wet medicine fully embodies a variety of ways to drive away evil;In terms of drugs, heat-clearing drugs, deficiency drugs, dampness drugs and surface drugs are the main ones, highlighting that the basic treatment method is to dissolve dampness and detoxify, and replenish qi and Yin. In summary, this study can provide reference for guiding clinical drug use and developing new drugs.

Medications and medical care of the Buyi ethnicity in Buyimojingbooks:an investigation on its philosophical origin

Studies on various Buyimojingbooks of the minority group“Buyi”in China,combined with information collected through visits to Buyi doctors,revealed that six ideas mainly comprised Buyi treatment and therapeutic principles,i.e.,inviting,expelling,liberating,supplementing,transporting,and recovering.Based on these ideas,the medical philosophy and laws of medication use were investigated to reveal and sort out Buyi therapeutic and pharmaceutical systems to achieve the goal of inheriting and further developing Buyi culture of medicine.

China Anti‑Cancer Association(CACA)guidelines for holistic integrative management of lymphoma(version 2022)Lymphoma,Guideline,Diagnosis,Treatment,Holistic integrative medicine

Purpose Lymphoma has become a major threat to human health.Fortunately,the diagnosis and treatment of lymphoma have developed rapidly,and research progress has emerged in an endless stream,with new drugs emerging one after another.These results are constantly rewriting guidelines changing clinical practice,need to be popularized and applied more widely.Methods This guideline has integrated consensuses reached by the Lymphoma Committee of China Anti-Cancer Association(CACA),based on China’s practice,tracking previous results of the most advanced clinical researches,absorbing the latest clinical evidence,and referring to domestic and international lymphoma guidelines.Results This holistic integrative guideline of lymphoma introduces the latest progress in the diagnosis and treatment of different subtypes of lymphoma,guide the clinical application of new drugs,standardized and precise management for lymphoma patients.Conclusions CACA guidelines for holistic integrative management of lymphoma(version 2022)enhance standardization and precision of the management for lymphoma patients in China.

原发性干燥综合征合并血细胞减少中医诊治研究进展

原发性干燥综合征(pSS)是一种慢性炎症性自身免疫病,除累及外分泌腺之外,还可累及多器官、系统,其中以血液系统受累最为常见,多表现为一系或多系血细胞减少。目前对于pSS合并血细胞减少缺乏统一公认的治疗方案,西医治疗多以糖皮质激素、免疫抑制剂为主,而中医药治疗本病具有较好疗效。通过总结pSS合并血细胞减少的中医诊治经验,并对相关研究进行综述后发现,现代医家认为pSS核心病机为气阴亏虚,久之则产生热、毒、瘀等多种病理产物,相互影响,导致全身气血津液失常,引起血细胞减少。本病病位多责之于肝、脾、肾,治以滋阴、益气、养血之法,辅以清热解毒、化瘀通络之法,并根据其合并血细胞减少类型的不同以及是否使用糖皮质激素用药各有侧重。中医药治疗本病较西药治疗能够更好地改善血细胞水平且不良事件发生率更低,具有一定优势。

考试焦虑障碍临床诊疗中国专家共识

考试焦虑障碍是一组与考试等评价性刺激相关的综合征,是考试带来的较为严重的心理问题之一。长期的考试焦虑容易引起紧张、恐惧、烦躁、抑郁等负性情绪,损害个体的工作记忆、注意等认知能力,严重的甚至会导致个体出现自杀意念。为进一步规范考试焦虑障碍的临床诊疗,在中华医学会心身医学分会考试焦虑协作组的组织下,由13名专家组成专家组,包括精神科医师和心理学专家,基于国内外文献和临床诊疗经验等制定本专家共识,以期从流行病学、病因、临床表现、评估、治疗等方面为临床医生提供科学、全面的指导。

2型糖尿病中西医结合诊疗指南

2型糖尿病(T2DM)是全球性的公共卫生问题,目前我国患病总人数已超过1亿。为指导2型糖尿病规范化中西医诊疗,中国中西医结合学会联合中华中医药学会、中华医学会共同开展中西医结合诊疗方案制订工作,本指南组织国内22位内分泌及相关领域中西医专家,通过前期调研、专家访谈、共识会议,结合循证医学证据,最终形成了2型糖尿病中西医结合诊疗指南。主要内容包括2型糖尿病的诊断标准、高危人群筛查、中医证候分型、治疗原则和方法。治疗方案涵盖健康教育与管理、营养与药膳、运动与功法、心理调节与情志疗法,以及中药辨证论治、中成药、中医外治法等中医疗法与西药的联合干预。强调以患者为中心,注重个体化治疗,旨在改善血糖控制,减少并发症,提高生活质量。本指南适用于中医、中西医结合医疗机构的临床医师及相关护理人员,也可供西医临床医师和健康管理相关专业人员参考。

上海市胃食管反流病中医分级诊疗指南

胃食管反流病是临床常见病,在我国的患病率逐年上升,中医药诊治本病有一定的特色和优势,近年来也取得不少进展,但在基层医院中的应用推广仍不足.因此有必要制定市级中医分级诊疗方案以更好地指导临床实践.本指南由上海市中西医结合学会消化内镜专业委员会、上海市胃食管反流病中医专病联盟、上海市级医院消化内科临床能力促进与提升专科联盟组织我市本领域的有关专家组成专家委员会进行多轮讨论并投票,最终达成共识.

高血压患者规范管理与家医签约一体化的现况调查

目的了解北京市月坛地区高血压患者进行家医签约的一般现状,探索高血压管理与家医签约的整合现况,为提高高血压管理效率、促进家医签约服务的可持续发展探索切合社区实际工作的方法。方法采用现况调查的方法,对2022年6—8月在月坛社区卫生服务中心进行电子签约家医服务的高血压患者进行问卷调查。问卷包括基本情况、高血压诊疗服务及需求、高血压知识知晓情况及家医签约服务满意度。结果在签约家医服务的高血压患者中,失眠和使用降压药物种类对血压的控制差异有统计学意义(P<0.05)。高血压患者对高血压相关用药知识的知晓率为20.45%,对其危险因素的知晓率为43.18%,对其并发症的知晓率为33.64%。高血压患者且对诊疗预约服务和微信服务有较大需求。高血压患者对原有家医签约服务满意度得分的中位数为93分。结论应积极控制高血压患者的失眠情况及使用降压药物的种类,充分利用家医签约服务微信群及时增强诊疗预约和健康教育能力,促进高血压管理与家医签约的充分融合。