肿瘤发病机制的中医系统学诠释

在中医系统学框架内,机体有三大生理功能:气化、运化、疏泄。其中气化与运化是影响整体状态的两个序参量,疏泄则是调节两者间平衡的中介参量。气化受损可致虚,运化不及则为瘀,疏泄不力可生毒。从典型的肿瘤患者发病情况看,通常都有"累""乱""气"三种情况。累,伤及肺肾,导致气化功能降低,出现"虚";乱,损及心脾,以致运化功能障碍,出现"瘀";气,伤害心包与肝,造成疏泄功能失衡,出现"毒"。三者叠加,非线性相互作用,引起机体节奏紊乱,触及某个临界点时,肿瘤发生。肿瘤是最有代表性的慢病,发病过程、临床表现、治疗反应均个体化差异很大,临界点的不同是导致差异的关键要素。了解肿瘤发病机制,不仅可以强有力地推进肿瘤防治,也有助于全面深入认识慢病的一般规律。

The rationale behind the four major anti-COVID-19 principles of Chinese herbal medicine based on systems medicine

As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.

An analysis on present situation and development of Medical Delivery System in China

Objective:To explore the present situation and development of Medical Delivery System in China.Methods:The data in three Nation Health Service Investigations were compared and analyzed by applying literature meta-analysis,Delphi and cross-sectional investigation,etc.Results:The Medical Ser- vice resource develops fast,and public cost for medical treatment keeps increasing.Organization structure presents a vertical and flat trend.Inhabitant health level rises year by year,and it is hard to resolve the problem of potential medical demand transformed.Conclusion:Medical Delivery System in China has formed,but the development of Medical Service System still exists structural problems in the deeper lay- er.The development trend predicts that the supervision of the government is gradually reinforcing and community health service develops step by step.

Mechanism analysis of Traditional Chinese Medicine in treatment of Diabetic Nephropathy based on network pharmacology and Traditional Chinese Medicine inheritance support system

Diabetic nephropathy is one of the most serious complications of diabetes mellitus. In the early stage, edema and proteinuria are the main clinical manifestations. In the later stage, glomerulosclerosis and interstitial fibrosis will occur. And the prognosis is poor. Nowadays, traditional Chinese medicine has a remarkable curative effect in the treatment of diabetic nephropathy. There are more and more studies on the treatment of diabetic nephropathy with traditional Chinese medicine, but most of them focus on the syndromes of diabetic nephropathy, which are short of in-depth research and summary on the mechanism of Chinese herbal prescriptions. In this paper, the traditional Chinese medicine inheritance support system and network pharmacology BATMAN-TCM software were used to collect and analyze the relevant literature. It was found that the core compatibility of Shanzhuyu, Fuling and Shuyu in the treatment of diabetic nephropathy is closely related to the signal transduction pathway and target of diabetic nephropathy, and has a positive effect on the improvement of clinical symptoms such as proteinuria, glycometabolism disorder, edema, etc. This paper explores the core compatibility of Shanzhuyu, Fuling and Shuyu on diabetic nephropathy, in order to provide reference for clinical treatment.

Study on the difference of payment time of medical insurance in China

Since medical insurance of our country developed, it is continued to deepen reform and became the basic form of the pcrfcct medical insurance system. However, regional differences still exist. The current medical insurance system of China＇s urban and rural structure background of two structures of serious, city residents, workers and rural residents is significantly difference in the payment period ,for this question ,the difference between our country will solve the basic medical insurance payment period, the relative level of regulating wages and medical people in our country and develop the medical insurance level, narrow the regional differences, reduce cost problem caused by population flow management, the basic medical insurance system for suggestions to improve the unified and promoting the social and economic level, people＇s medical security level, perfect improvement of physical insurance system of medical insurance according to the long-term sustainable development has a far-reaching significance.

A systematic review of herbal medicines for the treatment of cancer cachexia in animal models

Objective: The aim of this study is to summarize preclinical studies on herbal medicines used to treat cancer cachexia and its underlying mechanisms. Methods: We searched four representing databases, including Pub Med, EMBASE, the Allied and Complementary Medicine Database, and the Web of Science up to December 2016. Randomized animal studies were included if the effects of any herbal medicine were tested on cancer cachexia. The methodological quality was evaluated by the Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies(CAMARADE) checklist. Results: A total of fourteen herbal medicines and their compounds were identified, including Coptidis Rhizoma, berberine, Bing De Ling, curcumin, Qing-Shu-Yi-Qi-Tang, Scutellaria baicalensis, Hochuekkito, Rikkunshito, hesperidin, atractylodin, Sipjeondaebo-tang, Sosiho-tang, Anemarrhena Rhizoma, and Phellodendri Cortex. All the herbal medicines, except curcumin, have been shown to ameliorate the symptoms of cancer cachexia through anti-inflammation, regulation of the neuroendocrine pathway, and modulation of the ubiquitin proteasome system or protein synthesis. Conclusions: This study showed that herbal medicines might be a useful approach for treating cancer cachexia. However, more detailed experimental studies on the molecular mechanisms and active compounds are needed.

One Yin-Yang Wu-Xing Model of TCM

Although Yin-Yang Wu-Xing （Yin-Yang and Five-Elements, subsystems of human body） has been the theoretical basis of traditional Chinese medicine （TCM） for more than 5 000 years, it has been primarily analytical or empirical in nature without a formal scientific foundation. Based on bipolar set theory, an equilibrium/non-equilibrium computational model of Yin-Yang Wu-Xing is proposed. The Yin-Yang Wu-Xing dynamical systems are formulated so that equilibrium and non-equilibrium conditions can be established and proved. Computer simulations of equilibrium and non-equilibrium processes show that this new approach can provide diagnostic decision support in TCM. Thus, this equilibrium-based approach provides a unique scientific basis for future research in TCM, Qi （vital energy）, QiGong, Meridians and Collaterals （acupuncture channels） and herbal treatment. On the other hand, it provides a basic Yin-Yang cellular network architecture for modem scientific research in genomics such that regulation mechanisms of the ubiquitous YY1 protein for cell processes can be explained.

Understanding association of spleen system with earth on Traditional Chinese Medicine theory

OBJECTIVE: The association of spleen system including both spleen and stomach with earth, one of the five elements, is a part of the theory of five elements. Practitioners of Traditional Chinese Medicine (TCM) used the theory as a reasoning tool to illustrate the Zang-Fu organs' physiological functions and the interaction among them.The exploration of how the theory of that spleen system is associated with earth was created may provide insights into how five-element theory is applied to TCM practice. METHODS: Using analogism as a method to explore the relationship between earth and spleen system inTCM. RESULTS: Chinese ancestors experienced and observed the features of earth from agricultural practice and used the knowledge for the explanation ofspleen system functions including physiological functions, pathological characteristics and for the treatment of related illnesses. CONCLUSION: The theory of the five elements in TCM is a kind of metaphor, which depends on observation and exploration of the natural world and experience of human beings.

Content analysis of systematic reviews on effectiveness ofTraditional Chinese Medicine

OBJECTIVE:To evaluate evidence for the efficacy of Traditional Chinese Medicine(TCM) in systematic reviews.METHODS:Chinese(TCM Periodical Literature Database,Chinese Biological Medicine database,Chinese Medical Current Contents,China Hospital Knowledge Database journal fulltext database,Virtual Machining and Inspection System,and Wanfang) and English(Cochrane Database of Systematic Reviews,PubMed and Embase) databases were searched.RESULTS:Three thousand,nine hundred and fifty-five articles were initially identified,606 of which met the inclusion criteria,including 251 in English(83 from the Cochrane Database) and 355 in Chinese.The number of articles published each year increased between 1989 and 2009.Cardiocerebrovascular disease was the most studied target disease.Intervention measures included TCM preparations(177 articles),acupuncture(133 articles) and combinations of TCM and Western Medicine(38 articles).Control measures included positive medical(177 articles),basic treatment(100 articles),placebo(219 articles),and blank and mutual(107 articles).All articles included at least one reference;the greatest number was 268.Six of 10 articles with high quality references demonstrated curative effectsagainst target diseases including upper respiratory tract infection,dementia and depression.Interventions that were not recommended were tripterygium for rheumatoid arthritis and TCM syndrome differentiation for pediatric nocturia.In 10.4% of the studies,the authors concluded that the intervention had a curative effect.The assessors agreed with the authors' conclusions in 88.32% of cases,but rejected 8.94%(54 articles).CONCLUSION:1) Training in systematic review methods,including topic selection,study design,methods and technology,should be improved.2) Upper respiratory tract infection,dementia and depression may become the predominant diseases treated by TCM,and the corresponding interventions could be developed into practical applications.3) Use of non-recommended interventions should be controlled,and there should be more research on side effects.

Characteristics of blood glucose excursions in type 2 diabetes mellitus patients with three different Traditional Chinese Medicine syndromes

OBJECTIVE:To explore the characteristics of blood glucose excursions of type 2 diabetes mellitus patients with three different Traditional Chinese Medicine(TCM) syndromes.METHODS:One hundred and nine patients with type 2 diabetes mellitus were recruited from the Department of Endocrinology and the Department of TCM of the Sixth People's Hospital affiliated to Shanghai Jiao Tong University.Subjects were divided into three groups according to TCM syndrome:intrinsic Damp(n- 42),Yin deficiency and internal Heat(n = 25),and Qi and Yin deficiency(n- 42).Subcutaneous interstitial glucose was monitored with a continuous glucose monitoring system for 3consecutive days to investigate the glycemic profile in each group.Plasma C-peptide levels were measured,and an arginine test was taken in 10 patients randomly selected from each group.Glucose data and glycemic variability were analyzed to investigate the differences among the groups.The change in C-peptide levels and the results from arginine trial were used to evaluate β cell function.RESULTS:Indicators reflecting blood glucose level were the highest in subjects with Yin deficiency and internal Heat syndrome,and parameters reflecting glycemic variability were the lowest in those with Qi and Yin deficiency syndrome.The change in C-peptide levels showed that subjects with Qi and Yin deficiency syndrome had the best βcell function among the three groups;this was confirmed by the arginine trial.CONCLUSION:Patients with Qi and Yin deficiency syndrome had a more stable blood glucose profile,as glycemic variability was higher in those with intrinsic Damp syndrome and those with Yin deficiency and internal Heat syndrome.