Prospects for the future of clinical efficacy evaluation of traditional Chinese medicine——Emphasis on original theory and clinical practice

Traditional Chinese medicine(TCM)clinical efficacy evaluation runs through the development of TCM and has been progressing so far.With the introduction of evidence-based medicine(EBM)in recent 20 years,TCM clinical efficacy evaluation has developed rapidly,accumulated research and experience,improved the quality and standardization of research,but also gradually found deep-seated deficiencies.In 2019,the China Center for Evidence-based Traditional Chinese Medicine(CCEBTCM)was established,and TCM was included in the 11th revision of the International Statistical Classification of Diseases(ICD-11).In above opportunities for TCM clinical efficacy evaluation,it is necessary to face up to the previous deficiencies,so that the TCM clinical efficacy evaluation can truly reflect the actual clinical practice characteristics,including TCM clinical problems,TCM thinking and TCM diagnosis&treatment mode.Based on the summary and analysis of past research,development concepts are proposed in this article.On the one hand,original concepts of TCM should be confidently paid more attention to the design and implementation of TCM clinical efficacy evaluation to be close to TCM clinical practice.On the other hand,it is necessary to consolidate the foundation of TCM clinical practice before evaluating efficacy.Evaluated object built on TCM ontology knowledge should be demonstrated based on clinical practice,and unknown evaluated object combined with new methods,technologies and concepts should be maturely integrated in clinical practice firstly.

Possible Evolutionary Models in the Initially Hydride Earth Theory

A modern view of the properties of chemical elements has confirmed the theory of the hot origin of the Earth. The next step in developing this theory was the hypothesis of the initial hydride Earth. In this work, we attempted to find additional evidence for this hypothesis and show additional effects that flow from it. The effect of the physical properties of atoms and ions on their behavior during the formation of the Earth was studied. The maximum contribution to the distribution of elements was made by those elements whose content in the original protoplanets of the disk was the maximum. Correlation dependence is obtained, which allows one to calculate the distribution of elements in the protoplanetary disk. It was shown that hydrogen was the main element in the proto substance located in the zone of the Earth’s formation. In this case, various chemical compounds formed, most represented by hydrogen compounds—hydrides. Since the pressure inside the Earth is 375 GPa, this factor forces the chemical compounds to adopt stoichiometry and structure that would not be available in atmospheric conditions. It is shown that many chemical elements at high pressure in a hydrogen medium form simple hydrides and super hydrides—polyhydrides with high hydrogen content. Pressure leads to a higher density of matter inside the planet. Given the possibility of forming polyhydrides, there is the possibility of binding the initially available hydrogen in an amount that can reach 49.3 mole%. Young Earth could contain about 10.7 mass% of hydrogen in hydrides, polyhydrides, and adsorbed form is almost twice higher than previous estimates. This fact additionally confirms the theory of the original hydride Earth. In hydrides, the occurrence of the phenomenon of superconductivity was discovered. Polyhydrides were shown as potential superconductors with a high critical temperature above 200 K. We, based on these data, hypothesized the presence of superconducting properties in the Earth’s core, which explains the presence of a magnetic field in the Earth, as well as the unevenness and instability of this field and the possibility of migration of the Earth’s poles. The fact that the Earth has a hydroid core causes its change in time due to the instability of hydrides. Arranged several possible models of the destruction of the Earth’s core. The calculations showed that both models give close results. These results give predictions that can be measured. The proposed models also made it possible to estimate the initial size of the Earth. Possible ways of further testing the hypothesis of the initial hydride Earth is shown.

Foot use and hand preference during feeding in captive black-and-white snub-nosed monkeys(Rhinopithecus bieti)

Postural origin theory predicts that body postures are related to hand preference in nonhuman primates due to hemispheric specialization.Foot preference,especially in manipulating objects,is also a good predictor of hemispheric specialization in humans.We studied limb(hand and foot)preferences in 11 captive adult black-and-white snub-nosed monkeys(Rhinopithecus bieti)to see how limb preference is influenced by postures and foot manipulation.Hand preference was significantly different for this group between quadrupedal standing and clinging postures,and sitting and clinging postures,but not between bipedal standing and clinging postures.Individuals were significantly more likely to use the right hand in the clinging posture than in quadrupedal standing or sitting postures.In the sitting posture,individuals maintained their respective hand preference even when the food was on the other side of the body.There was a gender difference in the sitting posture,where females preferred their right hand but males preferred their left.Individuals who did not routinely use their feet to manipulate objects,compared to those who did,shifted to greater right hand use from the clinging posture to the bipedal posture.One male individual and his offspring were more likely to use their feet to manipulate objects than the rest of the monkeys.In the present study,we reveal the first evidence of a postural effect on hand preference in R.bieti as well as a foot preference in this species.Our results mostly agree with the postural origin theory and hemispheric specialization.