Rethinking Yi’an(Medical Cases)as a Tool for Narrative Medicine in China

When narrative medicine(NM)was introduced into China,traditional Chinese medicine scholars found that the core concepts advocated by NM are manifested in Chinese yi’an.But why NM echoes with ancient Chinese yi’an?How can we better integrate NM into Chinese medical practices?To answer those questions,this article first investigates how NM establishes itself as a remedy to biomedicine by taking traditional healing models including TCM as its ideal Other.Then,the narrative traditions of both case histories and yi’an are examined respectively.This article argues that NM is searching for a lost tradition of narrative case histories,but yi’an functions as a living tradition of TCM.The Parallel Chart in NM,designed as a complement to the dehumanized hospital chart,is still based on a dichotomy of science and art and a conflictual doctor-patient model.But yi’an exemplifies the holistic and humane healthcare that NM hopes to achieve.A comparison of both genres also inspired us to rethink the genre of yi’an in NM.Thus,it is concluded that yi’an should be viewed as an epistemic genre integrating individualization and generalization,a bridge linking medicine and literature.And narrative yi’an can well serve as a tool for NM in China.It is also proposed that a thick description of yi’an be encouraged to further promote a pluralistic NM in China.

The Research of the Relationship Between Yangming’s Yixue and His Xinxue

Yangming’s Yixue had been developed several times in his life since originated in Longchang.Yangming’s Yixue and his Xinxue are both sides of the same corn.The Yangming’s Yixue can be roughly divided into two periods.There were the early and middle period of Yangming’s Yixue,which is intended to explain the principles of Yi Zhuan(《易传》)with the theory of Xinxue.The finish of Yangming’s Yixue was a second stage in Yangming’s later years.From the perspective of form and content,there are differences that cannot be ignored between Yangming’s early and middle period and his later years.In the first stage of Yangming’s study,the“Virtuousness”(贞)in Book of Changes is the principle and nature in university.In the later period,Yangming had not focused on interpreting the“Yi Zhuan”,but on the interpretation of ZhouYi’s(《周易》)principles to supplement the connotation of the propositions of Xinxue.This article intends to understand the relationship between Yangming’s Yixue and his Xinxue by dividing the different stages of Yangming’s Yixue firstly.Then by focusing on the influence of Yangming’s later years’Yixue on his Xinxue,we can observe the relation between his Yixue and Xinxue.

A Brief Introduction of Yi Xue Shi (《医学史》 History of Medicine)

The book Yi Xue Shi(《医学史》History of Medicine)was written and edited by Cecilia Mettler and Fred Mettler couple,published in 1947.The book is about the literature research of systematic introduction to the history of medical development worldwide.The book provides a detailed description of the development of various medical disciplines and subjects through various documents and the authors and publication dates.Especially,Prof.Mettler has introduced the Chinese Yin and Yang(阴阳)and the five element theory(五行学说)and Shen Nung’s Materia Medica(神农本草)in this book.

Textual research on Xu Chunfu's life

Xu Chunfu was a famous medical expert in the Ming Dynasty, who authored the Gu Jin Yi Tong Da Quan and the Yi Xue Zhi Nan Jie Jing Liu Shu. This paper uses the Xu family genealogy, literature catalog, historical records to study the Xu family’s life and deeds. Xu Chunfu was born in the second year of the Jiajing reign of the Ming Dynasty (1523) and passed away in the 24th year of the Wanli reign of the Ming Dynasty (1596). He served as an official in the Tai Hospital for about 20 years. His work Gu Jin Yi Tong Da Quan was written around the 43rd year of the Jiajing reign of the Ming Dynasty (1556), with a lower limit of the fifth year of the Longqing reign of the Ming Dynasty (1571), and the initial engraving time was not earlier than the eighth year of the Wanli reign of the Ming Dynasty (1580). This paper corrects the shortcomings and errors in previous research, and provides a comprehensive and systematic examination of Xu Chunfu’s life and works.

Natural history and long-term clinical course of Crohn's disease

Crohn’s disease is a chronic inflammatory disease process involving different sites in the gastrointestinal tract. Occasionally, so-called metastatic disease occurs in extra-intestinal sites. Granulomatous inflammation may be detected in endoscopic biopsies or resected tissues. Genetic, epigenetic and environmental factors appear to play a role. Multiple susceptibility genes have been described in both familial and non-familial forms while the disease is phenotypically heterogeneous with a female predominance. The disorder occurs over a broad age spectrum, from early childhood to late adulthood. More than 80% are diagnosed before age 40 years usually with terminal ileal and colonic involvement. Pediatric-onset disease is more severe and more extensive, usually with a higher chance of upper gastrointestinal tract disease, compared to adult-onset disease. Long-term studies have shown that the disorder may evolve with time into more complex disease with stricture formation and penetrating disease complications (i.e., fistula, abscess). Although prolonged remission may occur, discrete periods of symptomatic disease may re-appear over many decades suggesting recurrence or re-activation of this inflammatory process. Eventual development of a cure will likely depend on identification of an etiologic cause and a fundamental understanding of its pathogenesis. Until now, treatment has focused on removing risk factors, particularly cigarette smoking, and improving symptoms. In clinical trials, clinical remission is largely defined as improved numerical and endoscopic indices for “mucosal healing”. “Deep remission” is a conceptual, more “extended” goal that may or may not alter the long-term natural history of the disease in selected patients, albeit at a significant risk for treatment complications, including serious and unusual opportunistic infections.

Family history and disease outcomes in patients with Crohn's disease:A comparison between China and the United States

AIM To investigate the differences in family history of inflammatory bowel disease(IBD) and clinical outcomes among individuals with Crohn's disease(CD) residing in China and the United States.METHODS We performed a survey-based cross-sectional study of participants with CD recruited from China and the United States.We compared the prevalence of IBD family history and history of ileal involvement,CD-related surgeries and IBD medications in China and the United States,adjusting for potential confounders.RESULTS We recruited 49 participants from China and 145 from the United States.The prevalence of family history of IBD was significantly lower in China compared with the United States(China:4.1%,United States:39.3%).The three most commonly affected types of relatives were cousin,sibling,and parent in the United States compared with child and sibling in China.Ileal involvement(China:63.3%,United States:63.5%) and surgery for CD(China:51.0%,United States:49.7%) were nearly equivalent in the two countries.CONCLUSION The lower prevalence of familial clustering of IBD in China may suggest that the etiology of CD is less attributed to genetic background or a family-shared environment compared with the United States.Despite the potential difference in etiology,surgery and ileal involvement were similar in the two countries.Examining the changes in family history during the continuing rise in IBD may provide further insight into the etiology of CD.

Long-term natural history of Crohn’s disease

Crohn’s disease is a chronic inflammatory granulomatous process that usually involves different sites in the intestinal tract. Genetic and environmental factors are thought to play a role in its etiology and pathogenesis. The disorder has a heterogeneous clinical expression and data from tertiary care settings have documented its female predominance, occasional familial nature, and high rate of stricture formation and penetrating disease. It may appear from early childhood to late adulthood, although over 80% are currently diagnosed before age 40 years, usually with terminal ileal and colonic involvement. Several studies have now shown differences in phenotypic clinical expression depending on the initial age at diagnosis, with pediatric-onset disease being more severe and more extensive with more involvement of the upper gastrointestinal tract compared to adult-onset disease. In addition, long- term studies from these tertiary care settings have documented that the disorder may evolve with time into a more complex disease with stricture formation and penetrating disease complications (i.e. fistula and abscess). Although prolonged remission with no evidence of inflammatory disease may occur, discrete periods of symptomatic and active granulomatous inflammatory disease may re-appear over many decades. Long-term studies on the natural history have also suggested that discrete events (or agents) may precipitate this granulomatous inflammatory process.

Crucial steps in the natural history of inflammatory bowel disease

Inflammatory bowel diseases(IBD),including ulcerative colitis(UC) and Crohn's disease(CD),are chronic,progressive and disabling disorders.Over the last few decades,new therapeutic approaches have been introduced which have led not only to a reduction in the mortality rate but also offered the possibility of a favorable modification in the natural history of IBD.The identification of clinical,genetic and serological prognostic factors has permitted a better stratification of the disease,thus allowing the opportunity to indicate the most appropriate therapy.Early treatment with immunosuppressive drugs and biologics has offered the opportunity to change,at least in the short term,the course of the disease by reducing,in a subset of patients with IBD,hospitalization and the need for surgery.In this review,the crucial steps in the natural history of both UC and CD will be discussed,as well as the factors that may change their clinical course.The methodological requirements for high quality studies on the course and prognosis of IBD,the true impact of environmental and dietary factors on the clinical course of IBD,the clinical,serological and genetic predictors of the IBD course(in particular,which of these are rel-evant and appropriate for use in clinical practice),the impact of the various forms of medical treatment on the IBD complication rate,the role of surgery for IBD in the biologic era,the true magnitude of risk of colorectal cancer associated with IBD,as well as the mortality rate related to IBD will be stressed;all topics that are extensively discussed in separate reviews included in this issue of World Journal of Gastroenterology.

Inflammatory bowel disease course in Crohn's disease:Is the natural history changing?

Crohn’s disease (CD) is a multifactorial potentially debilitating disease. It has a variable disease course, but the majority of patients eventually develop penetrating or stricturing complications leading to repeated surgeries and disability. Studies on the natural history of CD provide invaluable data on its course and clinical predictors, and may help to identify patient subsets based on clinical phenotype. Most data are available from referral centers, however these outcomes may be different from those in population-based cohorts. New data suggest the possibility of a change in the natural history in Crohn’s disease, with an increasing percentage of patients diagnosed with inflammatory disease behavior. Hospitalization rates remain high, while surgery rates seem to have decreased in the last decade. In addition, mortality rates still exceed that of the general population. The impact of changes in treatment strategy, including increased, earlier use of immunosuppressives, biological therapy, and patient monitoring on the natural history of the disease are still conflictive. In this review article, the authors summarize the available evidence on the natural history, current trends, and predictive factors for evaluating the disease course of CD.

Wang Jimin(王吉民)and History of Chinese Medicine(《中国医史》)

Wang Jimin was not only a distinguished medical historian in modem China and an academician of the International Academy of the History of Science but also an originator of the first Museum of Chinese Medical[History and of the Chinese Medical History Society.This study briefly introduces Wang’s family academic history,his groundbreaking achievements in studies on medical history and the first monograph of History of Chinese Medicine(English edition)in China.It also reviews the foundation of the first Museum of Chinese Medical History.

西秦岭八卦庙金矿床原位S-Pb同位素组成对成矿物质来源和成矿过程的指示意义

八卦庙金矿床位于西秦岭造山带凤太多金属矿田北部,已探明金储量约106 t(平均金品位1.56 g/t),属于特大型金矿。金矿体受脆韧性剪切带控制,总体走向NWW,倾向北,赋矿地层为上泥盆统星红铺组下段。文章在成矿期次研究基础上,采用硫化物原位S-Pb同位素分析方法,对八卦庙金矿成矿过程和成矿物质来源进行了约束。基于详细的野外观察和矿相学研究,矿区识别出了2个金成矿期:顺层磁黄铁矿-石英成矿期和NE向黄铁矿-石英成矿期。顺层磁黄铁矿-石英成矿期可划分为自形黄铁矿-石英(Ⅰ)、磁黄铁矿-自然金-铁白云石(Ⅱ)、白云母-绿泥石-绿帘石-石英(Ⅲ)3个阶段;NE向黄铁矿-石英成矿期由自形磁黄铁矿-黄铁矿-粗粒石英(Ⅳ)、他形黄铁矿-细粒石英(Ⅴ)、他形磁黄铁矿-自然金-铁白云石(Ⅵ)和石英-黑云母(Ⅶ)4个阶段构成。顺层磁黄铁矿-石英成矿期硫化物的δ34S值集中在1.60‰~5.89‰和14.07‰~16.87‰两个区间;NE向黄铁矿-石英成矿期硫化物的δ34S值也集中在2.77‰~5.52‰和9.11‰~15.9‰两个区间,通过与围岩和区内岩浆岩对比,笔者认为2个成矿期成矿热液中硫的来源和演化具有相似之处,初始流体中的硫既有围岩硫的贡献,也有岩浆硫的加入,随着成矿作用和水-岩相互作用的进行,成矿流体中围岩硫的比例逐渐升高。顺层成矿期硫化物具有混合铅的铅同位素特征(206Pb/^(204)Pb=18.041~18.436,^(207)Pb/^(204)Pb=15.364~15.724,^(208)Pb/^(204)Pb=38.138~38.754),指示区内中酸性岩浆和赋矿地层来源铅的混合。NE向成矿期硫化物的铅同位素(206Pb/^(204)Pb=18.393~18.400,^(207)Pb/^(204)Pb=15.639~15.687,^(208)Pb/^(204)Pb=38.648~38.917)略低于围岩硫化物,指示成矿流体中的铅主要来源于地层,但有少量岩浆铅的混入。

Barrett’s esophagus:Review of natural history and comparative efficacy of endoscopic and surgical therapies

Barrett's esophagus(BE)is the precursor to esophageal adenocarcinoma(EAC).Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately,invasive neoplasia.Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates.This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier,and potentially curative stage.The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy(EET)for management of dysplastic and early neoplastic BE,and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence.This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage,and the effectiveness of interventions in attenuating the risk posed by its natural history.Key findings were as follows.Non-dysplastic Barrett’s is associated with extremely low risk of progression,and interventions cannot be justified.The annual risk of cancer progression in low grade dysplasia is between 1%-3%;EET can be offered though evidence for its benefit remains confined to highly select settings.High-grade dysplasia progresses to cancer in 5%-10%per year;EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication.Risk of nodal metastases in intramucosal cancer is 2%-4%,which is comparable to operative mortality rate,so EET is usually preferred.Submucosal cancer is associated with nodal metastases in 14%-41%hence surgery remains standard of care,except for select situations.

MOFTEC Minister Wu Yi on China's Foreign Trade and Economic Cooperation

The structure of China’s foreign trade now conforms basically to international trade norms China will set up a legal system for foreign trade and economic cooperation in three years Foreign investment enterprises will enjoy national treatment China shall become the member of the World Trade Organization at the earliest possible

Xi Jinping's Discussion of Civilization History and the Discourse Construction of China's Road

The significance of discourse construction in the civilization discussion of Xi Jinping is explored in this paper: The 500-year history of world socialism and the 5000-year history of Chinese civilization, Xi Jinping' s studies of Socialism with Chinese characteristics in the long history of civilization development, highlighting Socialism with Chinese characteristics as a product in the development of human civilization, the great contribution to world civilization progress and the creative development of Marxism which has been the most distinctive feature in Chinese discourse structure since the 18 th National Congress of the CPC. As the conscious construction of epistemology, it has given unprecedented historical and cultural implications to China' s road and opened the new theory space for the discourse construction of Socialism with Chinese characteristics or the academic expression of China' s road.

Organized Fan Groups and Sports Journalism in Brazil： A Social History of Soccer Fans in the City of Rio de Janeiro

The article focuses on sources of Brazilian sports journalism and demonstrates the role of organized soccer fan groups in Rio de Janeiro between the 1940s and 1980s, this is achieved through reports provided by the Brazilian newspaper Jornal dos Sports. From the beginning, there are biographical notes made about the most well-known fan leaders in Rio, such as Jaime de Carvalho, who founded the Charanga （1942）. The emergence of dissent among the fans, in the late 1960s, is then covered, which establishes itself within the organized fans in Rio with these individuals beginning to question the authority of the old fan group leaders. This is against the principle of giving unconditional support to the club and it is postulated that the fans have the right to criticize and protest against the club＇s management, even if this means using forceful tactics. Along with the journalistic narrative, there is a break-off by the ＂Young Fans＂ and a process of emancipation begins which occurs over the 1970s, this happens by means of the use of fan coaches and the invention of a lifestyle that is associated with soccer. Finally, the 1980s is marked by the constructive and destructive potential that is linked to fan groups. On the one hand, creating an Association of fans--Astorj--is pointed to in order to reach a mutual understanding, but it should be noted, on the other, that there are feuds, in a scenario of spiraling violence, in which fights, beatings, and even murders begin to be commonplace.

First Forum on China Casting Quality Standards & Overview of Revision History of China's National/Industrial Standards for Foundry Operations

Both national and local governments have been paying great attention to the work of industrial standardization with the enormous increase in international trade after China joined WTO. According to the standards revising plan of Standardization Administration Committee of China (SAC),TC54 has already revised a series of national standards and industrial standards for foundry operations,and proposed some new ones. As a result,some old fashioned standards containing low-level techniques have been gradually discontinued or replaced with new versions.……

Effect of fertility history and parity on Alzheimer’s disease:a mini review from animal to human studies

More women than men have Alzheimer's disease(AD)or other dementias.There are a number of potential biological and social reasons for the sex difference in the risk of AD,such as women live longer than men on average,and estrogen depletion after menopause in women,biological or genetic variations,and education,occupation or rates of heart disease.Recent studies showed a link between reproductive history and dementia risk in women.Women with fertility history showed lower risk of dementia compared to women with no child.Other studies also suggested that women's pregnancy history may influence AD's risk.In this review,we will focus on the relationship between women fertility and cognition and discuss the potential role of sex hormones in the brain and cognition,especially on AD pathogenesis.

Historical Reconstruction - Reread Kenzaburo Oe＇ s Banengannen＇ s Soccer Team

The novel Banengannen’s Soccer Team published in 1967has been classified as historical"meta narration"of Kenzaburo Oe.In the novel,there are two main characters—Mitsusaburo and Takashi,both of whom represent two ways of exploring the historical truth.In the process of exploration of the two characters,Kenzaburo Oe symbolically analyzed the value presetting of the Japanese people—getting one’s own value through projecting the"Emperor",recreating a new chapter of history from personal experience.

Minister Wu Yi On the Development of China's Foreign Trade and Economic Cooperation in the 1990s

Minister of Foreign Trade and Economic Cooperation Wu Yi made a report entitled Opportunity and Prospects: Basic Thoughts on the Development of China’s Foreign Trade and Economic Relations in the 1990s to Chinese and foreign participants working in this fields at an international seminar on China’s Foreign Trade and Economic Cooperation held in Beijing in mid-May.

Continuities of Historical Crises and Discourses of Europe From the “Neo-Latin Past” to the 21st Century

Europe and the EU have been facing many crises and challenges in recent years.From Brexit and rising nationalism to economic problems and unanimous refugee policies,most of them remain unsolved.Instead of moving forward with the European integration project,Europe seems to regress in many instances.Considering this turmoil,it seems all the more important to historicize the affirmative discourse of Europe and to expand the knowledge of the European unification process with novel insights into its history.Only if a broad understanding of its roots and developments prevails,the conflicts of the present can be better evaluated and addressed.Particularly one set of so far neglected sources from Europe’s past serves as guiding light in that respect:the early modern Europe literature written in the Latin language.Between 1400 and 1800,Latin enjoyed a similar status in promoting scientific discoveries,negotiating political affairs and generally communicating on an international level as modern-day English.By offering a brief glance at some historically influential Latin texts from the early modern discourse of Europe,this article will show that the early modern European crises strikingly resemble Europe’s current crises despite the difference in political,social,and economic circumstances.The discourse of Europe has from the beginning been a stable discourse,characterized by the same recurring questions for centuries.When used as reference point for the crises of the 21st century,the prospects for the European integration look better than presumed.