The Making of a Health Profession:How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.

The Application and Development of Music Therapy in Rehabilitation Medicine

Music therapy,as an ancient and continually evolving therapeutic approach,has demonstrated unique effects and extensive potential applications in the field of rehabilitation medicine.This paper first explores the physiological and psychological impacts of music and theoretical models of its therapeutic mechanisms.It further details the specific applications of music therapy in neurological rehabilitation,motor function recovery,psychological and emotional adjustment,and chronic disease and pain management.The article also investigates the prospects of integrating music therapy with modern technologies such as virtual reality and artificial intelligence and emphasizes the importance of interdisciplinary collaboration and policy support in advancing this field.Through comprehensive analysis,the paper identifies future development directions and research needs for music therapy in rehabilitation medicine.

Annual advances of traditional medicine on tumor immunity regulation in 2020

Tumor burden remains a global health problem that threatens human life worldwide.Over the past few years,the evolution of immune checkpoint inhibitors has represented one of the most successful approaches in the field of tumor therapy.Drugs regulating tumor immune microenvironment or enhancing body immunity have indicated a novel perspective to treat tumors.Therefore,an increased number of scientists have been shifting their research focus to explore the immunity regulation effects of anti-tumor traditional medicine or natural products.In this review,we summarize the research progress of traditional medicines on tumor immunity regulation in 2020.Our findings suggest that more herbal medicine-derived phytochemicals and formulas were derived from traditional Chinese medicine,and more papers were published in comprehensive journals.Traditional medicine can comprehensively regulate the tumor immune microenvironment,including natural killer cells,dendritic cells,CD4+/CD8+T lymphocytes,regulatory T cells,myeloid-derived suppressor cells,tumor-associated macrophages,immunosuppressive factors,and immune checkpoints.In 2020,a greater number of research papers focused on active ingredients and formulas that regulate tumor-associated macrophages and immune checkpoints.Active ingredients such as flavonoids became a global hotspot in 2020.Certain natural products were also found to exert synergistic anti-tumor activity with immune checkpoint inhibitors,such as curcumin.However,a distinct lack of high-quality experimental and clinical studies remains a prevalent and challenging issue that hinders the further development of traditional medicine.

Integrating traditional Chinese (herbal) medicines into risk based regulation-With focus on non-clinical requirements to demonstrate safety

Within the public health sector of Hong Kong(China),there is a consensus around the important role of traditional Chinese medicines.For Hong Kong(China)to play a bridging role to bring Chinese medicines to the global market requires a concerted effort from the government,academic institutes and industries.The release of the final version of the European Medicines Agencies guidance document,which details the acceptance of minimum requirements to nonclinical package in bibliographical applications,grants the opportunity for well-established and traditional herbal medicines to demonstrate an‘acceptable safe’status for registration in the European Union.It is anticipated that this minimum nonclinical package can be applied to demonstrate the safe use of many traditional Chinese medicines regardless of their eligibility to be registered under the simplified procedure within the European Union.This paper conceptualizes an integration of a simplified evaluation route for eligible proprietary Chinese medicines(pCm)with long history of use into the existing drug regulatory framework in Hong Kong(China).Such integration utilizing the minimum nonclinical package,based on bibliographical data or expert report,as proof of evidence to demonstrate safety for pCm with long history of use requires less demand in scientific resources.With Hong Kong(China)conducting‘first hand’review for eligible pCm,it provides an option for overseas and local pharmaceutical companies to register their products in Hong Kong(China)without the need to rely on issuance of Certificate of Pharmaceutical Product from other countries.This could bring eligible pCm with long history of use to reach international risk-based standard and to be marketed globally as‘medicines’to reach their full therapeutic potential.An important process to positioning Hong Kong(China)to compete with other countries in promoting importation and exportation of pCm to better serve the global health.

Traditional Chinese Medicine in Malaysia: A Brief Historical Overview of Laws and Regulations

Although traditional Chinese medicine(TCM)has been a part of the Malaya and the Malaysia people’s method of maintaining health and well-being for many centuries,it was never been enrolled in the public health-care system.However,the rising cost of Western drugs and the increasing number of people frequenting TCM has driven the government to search for cheaper options and to look into its safe practice.In 1992,the government mandated all TCM herbal products to be registered with the National Pharmaceutical Control Bureau.All TCM products sold in Malaysia are now Good Manufacturing Practice certified.The government has also established a Traditional and Complementary Medicine Division within the Ministry of Health.Between 2008 and 2014,a traditional and complementary medicine unit was set up in major hospitals in all states.TCM is one of the main services offered by the unit.In 2016,the government enacted the Traditional and Complementary Medicine Act to regulate the TCM practice.Subsequently,a 10-vear blueprint has been drawn to support the development of all traditional and complementary medicines in Malaysia.This article aims to provide a brief overview on the regulatory development of TCM in Malaysia.

Regulation Progress of Traditional Medicines in China

Let me introduce Chinese medicines. I will speak in Chinese, and I will express myself more clearly. Just now I listened carefully to Professor Werner Knoess, the doctor's report, giving me a deep feeling. As long as it is the medicine, modern or traditional, the general requirements to conform with, are the same, namely, safe, efficient and quality control. We cannot say that because these are traditional medicines.

Contribution Regulations for Asian Journal of Traditional Medicines

Editorial Policy Asian Journal of Traditional Medicines is an international journal devoted to the advancement of research on traditional medicines.The followed areas are covered.

The Globalization of Traditional Medicines: Perspectives Related to the European Union Regulatory Environment

In the Member States of the European Union (EU), a harmonized legislation on medicinal products has been enforced, which specifically defines herbal medicinal products and traditional herbal medicinal products. The scope was to create a regulatory environment that takes into account the particular characteristics of herbal medicinal products. The harmonization of standards is intended to harmonize assessment and facilitate access to the market in different Member States. The standards defined by the EU herbal monographs of the Committee on Herbal Medicinal Products (HMPC) and the quality requirements laid down in the European Pharmacopoeia represent an excellent model of multinational harmonization of the regulatory environment for herbal and traditional medicines. It has also been demonstrated that this framework is at least partially applicable for herbal and traditional medicines from traditional Chinese medicine (TCM) to gain access to the EU market. Moreover, the HMPC provides specific guidance documents and pilot projects on monographs on the safety and efficacy of Chinese herbal drugs. In the European Pharmacopoeia, the number of quality monographs of herbal drugs with an origin in TCM is continuously growing. These developments indicate that globalization of traditional medicines is an ongoing process. Communication and cooperation between regulators, the scientific community, and interested stakeholders will set the stage for the convergence of diverse regulatory environments. This will contribute to worldwide availability of traditional medicines based on appropriate standards.

Chinese medicine in the treatment of autoimmune hepatitis:Progress and future opportunities

Autoimmune hepatitis(AIH)is a chronic inflammatory liver disease occurring in indi-viduals of all ages with a higher incidence in females and characterized by hypergam-maglobulinemia,elevated serum autoantibodies and histological features of interface hepatitis.AIH pathogenesis remains obscure and still needs in-depth study,which is likely associated with genetic susceptibility and the loss of immune homeostasis.Steroids alone and in combination with other immunosuppressant agents are the pri-mary choices of AIH treatment in the clinic,whereas,in some cases,severe adverse effects and disease relapse may occur.Chinese medicine used for the treatment of AIH has proven its merits over many years and is well tolerated.To better under-stand the pathogenesis of AIH and to evaluate the efficacy of novel therapies,several animal models have been generated to recapitulate the immune microenvironment of patients with AIH.In the current review,we summarize recent advances in the study of animal models for AIH and their application in pharmacological research of Chinese medicine-based therapies and also discuss current limitations.This review aims to provide novel insights into the discovery of Chinese medicine-originated therapies for AIH using cutting-edge animal models.

Potential Treatment of COVID-19 with Traditional Chinese Medicine: What Herbs Can Help Win the Battle with SARS-CoV-2?

Traditional Chinese medicine(TCM)has been successfully applied worldwide in the treatment of coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).However,the pharmacological mechanisms underlying this success remain unclear.Hence,the aim of this review is to combine pharmacological assays based on the theory of TCM in order to elucidate the potential signaling pathways,targets,active compounds,and formulas of herbs that are involved in the TCM treatment of COVID-19,which exhibits combatting viral infections,immune regulation,and amelioration of lung injury and fibrosis.Extensive reports on target screening are elucidated using virtual prediction via docking analysis or network pharmacology based on existing data.The results of these reports indicate that an intricate regulatory mechanism is involved in the pathogenesis of COVID-19.Therefore,more pharmacological research on the natural herbs used in TCM should be conducted in order to determine the association between TCM and COVID-19 and account for the observed therapeutic effects of TCM against COVID-19.

Analysis on medication rule of traditional Chinese medicine treating chemotherapy-induced diarrhea based on traditional Chinese medicine(TCM) inheritance computing platform system

Objective:To dig deeper into the traditional Chinese medicine treatment rules of chemotherapy-induced diarrhea with traditional Chinese medicine(TCM)inheritance computing platform system.Methods:Taking“traditional Chinese medicine”,“chemotherapy”and“diarrhea”as the theme words,comprehensive search of the database of CNKI,Wanfang and VIP from its inception to November 2020 was conduct-ed.The formulas of external treatment of traditional Chinese medicine for chemotherapy-induced diarrhea were included and the association rule,clustering and factor analysis were carried out.Results:A total of 145 papers,57 prescriptions meeting the inclusion criteria were collected,among which high-frequency drugs including Baizhu(Atractylodis macrocephalae rhizoma),Fuling(Poria),Dangshen(Codonopsisradix),Huanglian(Coptidis rhizoma),Zhigancao(Glycyrrhizae radix et rhizoma praeparata cum melle)were the most commonly used.The confidence level was set as 0.7 and the support level was set as 10,12 core compatibility groups were obtained,and 6 categories were cluster analyzed.Conclusion:The principle of external treatment of chemotherapy-induced diarrhea is mainly“restore deficiency and benefiting qi”,“benefiting water infiltration and dampness”,“clearing heat”and“inducing astringency”.Prescription combination and new prescription combination based on traditional Chinese medicine(TCM)inheritance computing platform system can be used as reference for clinicians and applied in primary hospitals.

Traditional Chinese Medicine:How Is It An Invaluable Intangible Cultural Heritage

This article deals with the concept of intangible culture heritage and the reasons why traditional Chinese medicine(TCM)should be specially preserved.The potential value of TCM and the existing measures for carrying on the cultural heritage adopted by China are also explored in the article.

‘Food and medicine continuum’ in the East and West: Old tradition and current regulation

Food-medicine products are important materials for daily health management and are increasingly popular in the global healthy food market.However,because of the biocultural difference,food-medicine knowledge may differ among regions,which hinders the global sharing of such health strategies.Aim at bridging the food-medicine knowledge in the East and West,this study traced the historical roots of food and medicine continuum of the East and West,which was followed by a cross-cultural assessment on the importance of food-medicine products of China,thereafter,the current legislative terms for foodmedicine products were studied using an international survey.The results show that the food and medicine continuum in the East and West have their historical roots in the traditional medicines since antiquity,and the food-medicine knowledge in the East and West differs substantially;although the foodmedicine products have common properties,their legislative terms are diverse globally;with proofs of traditional uses and scientific evidence,food-medicine products are possible for cross-cultural communication.Finally,we recommend facilitating the cross-cultural communication of the food-medicine knowledge in the East and West,thus to make the best use of the traditional health wisdom in the globe.

Complementary and alternative medicine in European countries legislative framework

Complementary and alternative medicine(CAM)is a set of different diagnostic and therapeutic procedures,as well as the use of natural products for the treatment of patients,derived from previously known traditional methods and enriched with modern scientific knowledge.The present article reviews the available data regarding the use of CAM and the legislation behind it in European countries.The use of CAM is recorded in Europe as a whole and varies between 1070%of the population of individual European countries.At least 300,000 registered CAM providers have been identified in the European Union(EU),of which slightly more than half includes non-medical practitioners.The most practiced discipline is acupuncture,followed by homeopathy.CAM regulation and legislation in Europe is not precisely defined and is constantly striving to find a common approach.Since legal frameworks for CAM are not defined,each European country has its own regulations and legislation.In order to define universal legislation for CAM,the EU created the CAMbrella project,a project of the EU designed to find a unique system that would include the treatment of CAM in Europe.According to the data from CAMbrella,from 39 countries in the EU,17 have general CAM legislations.The status of CAM in Europe is characterized by enormous heterogeneity in all aspects,including terminology,methods,prevalence and ultimately,legal status,regulations and legislation.

良法善规和美德合力护卫医学初心

救死扶伤、防病治病、护卫民众的生命和健康、坚持医学人道主义是医学的初心,但当今社会,资本、技术、权力在特定条件下正在一步一步地扭曲医学的初心,资本在医学中逐步主体化,这正是医学初心面临挑战的根本所在,守卫医学初心必须从良法善规着手,从制度上保障医学初心,同时,良法善规必须以美德为辅佐,美德是良法善规的基础,也是良法善规的核心,正确使用权力是护卫医学初心的重要条件,美德伦理与规范伦理必须相互结合,相互补充,才能确保医学初心的落实。

从“风火”论治变态反应性疾病思路

变态反应性疾病临床常见,其病位虽不同,但病机却有一定共性。总体而言,人体阴阳协调,则一气周流,如“春风”生养万物。一旦各种原因导致阳气郁而不升或逆而不降,疏布失常的“阳气”在人体内过度聚集,愈郁则愈欲疏泄,久积必终向外透解,如“风火”之邪侵及人体各处皮肤孔窍,则会出现相关部位的过敏症状。临床诊治中,根据变态反应性疾病发作的病机,常用熄风火以缓症状、透余热以防复发、养脉络以促复原、调五脏以兼标本等治法,并坚持以辨证为先、因势利导、急缓有异、清透兼施、整体局部辨证结合等为治疗原则,取得了良好疗效。文末列举一则验案加以说明,希望帮助读者更好理解和应用。

中医药通过自噬防治糖尿病周围神经病变作用机制研究进展

糖尿病周围神经病变(diabetic peripheral neuropathy,DPN)病程长且预后差,以轴突变性坏死、神经纤维节段性脱髓鞘、雪旺细胞凋亡等神经细胞损伤为主要病理特点。自噬是神经细胞的清洁机制,通过清除多余的代谢物来消除细胞压力源造成的伤害,从而维持细胞内稳态平衡。持续的高糖环境改变了机体自噬水平,自噬被抑制或过度激活均会造成神经细胞不可逆损伤,加速DPN进展,恢复自噬平衡,从而减轻神经损伤对于DPN的治疗尤为关键。DPN的治疗目前尚无满意方案,中医药在防治DPN的进程中以多靶点、多效应、多成分等独特优势取得了较好的临床效果,大量中医药治疗DPN的动物及临床研究均显示自噬是中医药治疗DPN的重要靶点,恢复自噬平衡可以减轻神经损伤、延缓神经细胞死亡进程,起到防治DPN的作用。但其具体机制不明,基于此,对自噬的调控及其在DPN发病过程中的作用机制,以及单味中药或复方有效成分对自噬干预作用进行总结,进一步探讨DPN发病机制及中医药干预自噬的潜在治疗靶点,为进一步提升中医治疗DPN的疗效提供参考。

中药监管科学:发展中的新兴融合科学

中药监管科学(Traditional Chinese Medicine Rugulatory Science)作为我国新兴的、亟待发展的中西医交叉融合科学,不仅是监管科学(Rugulatory Science)作为国际前沿科学在中药监管领域的全新应用场景,更是一种根植于传统中医药学土壤的中西医融合研究新模式和原创性科学思维方式。中药监管科学具有融合科学(Convergence Science)的问题导向性、多学科交叉、覆盖创新价值链、多元主体协同参与等特点。发展中药监管科学意味着中药监管科技创新朝向融合科学发生根本性变革,将有助于探索建立既符合中医药特点,又体现中西医融通的中药审评审批体系,以期获得中国式现代化中药监管领域的重大科技突破。

中医药对血管性认知障碍中调节性细胞死亡的调控作用研究进展

血管性认知障碍(VCI)是由脑血管病危险因素、明显或不明显脑血管病引起的,涵盖从轻度认知障碍到痴呆的一大类综合征,其发病率呈逐年上升的趋势,严重威胁老年人生活质量。调节性细胞死亡(RCD)是可调控的细胞死亡方式,包括细胞程序性坏死、自噬、细胞焦亡等多种形式,拥有独特的生化、形态特征。研究表明,缺血条件下调控RCD可促进细胞生存、减少神经细胞死亡,在延缓VCI的发生发展中具有较大的作用。化学药治疗VCI主要对改善血管风险因素及对发展到痴呆阶段后的认知能力进行干预,使用临床已成熟的药物较多,用药安全,但药效一般,对神经细胞的RCD调控较少。临床上也广泛使用中医药治疗VCI,疗效较好,但尚未明确其具体机制,其与RCD的关系也缺少相关总结。综述VCI中铁死亡、细胞焦亡、线粒体自噬及依赖性细胞死亡等不同形式RCD的研究进展,中医药对RCD的调控、对VCI的治疗作用,以期为探索临床VCI治疗的潜在靶点提供新的视角。