Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine

BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.

Application of multidisciplinary team-based integrated traditional Chinese medicine and Western medicine in rotator cuff injury patients undergoing arthroscopic surgery

BACKGROUND Arthroscopic rotator cuff repair is a common surgical treatment for rotator cuff injuries(RCIs).Although this procedure has certain clinical advantages,it requires rehabilitation management interventions to ensure therapeutic efficacy.AIM To investigate the effect of integrated traditional Chinese medicine and Western medicine(TCM-WM)under the multidisciplinary team(MDT)model on the postoperative recovery of patients undergoing arthroscopic surgery for RCIs.METHODS This study enrolled 100 patients who underwent arthroscopic rotator cuff repair for RCIs at the Seventh People’s Hospital of Shanghai University of Traditional Chinese Medicine between June 2021 and May 2024.They were divided into a control group(n=48)that received routine rehabilitation treatment and an experimental group(n=52)that received TCM-WM under the MDT model(e.g.,acupuncture,TCM traumatology and orthopedics,and rehabilitation).The results of the Constant–Murley Shoulder Score(CMS),Visual Analogue Scale(VAS),Shoulder Pain and Disability Index(SPADI),muscular strength evaluation,and shoulder range of motion(ROM)assessments were analyzed.RESULTS After treatment,the experimental group showed significantly higher CMS scores in terms of pain,functional activity,shoulder joint mobility,and muscular strength than the baseline and those of the control group.The experimental group also exhibited significantly lower VAS and SPADI scores than the baseline and those of the control group.In addition,the experimental group showed significantly enhanced muscular strength(forward flexor and external and internal rotator muscles)and shoulder ROM(forward flexion,abduction,and lateral abduction)after treatment compared with the control group.CONCLUSION TCM-WM under the MDT model improved shoulder joint function,relieved postoperative pain,promoted postoperative functional recovery,and facilitated the recovery of muscular strength and shoulder ROM in patients with RCIs who underwent arthroscopic rotator cuff repair.

Patient-reported Outcomes (PROs): An Approach to Evaluate Treatment Efficacy of Chinese Medicine or Integrative Medicine

Chinese medicine (CM) has been an experience based practice over the past three thousand years. The safety and efficacy of CM has been practised through experience, rather than nowadays’ modern scientific measurements. In this way, the development of CM has not been keeping pace with the advance in science and technology and the progress in orthodox medicine. In order to meet the requirements of modern science and technology, an evidence based approach must be adopted. Reassurance is needed to convince people for safety and efficacy of CM and give confidence to the evidence based demands ——“Tradition is confirmed by Modern Science” (1) .

Therapeutic Evaluation on Advanced Pancreatic Cancer Treated by Integrative Chinese and Western Medicine──Clinical Analysis of 56 Cases

Objective: In comparison with chemotherapy, to evaluate therapeutic effects on advanced pancreatic cancer treated by integrative Chinese and western medicine (ICWM) therapies. Methods: Based on the retrospective study of 56 patients with advanced pancreatic cancer, life table was applied to the analysis of patients' survival rate and Xz test to the comparison of therapeutic response between ICWM and chemotherapy groups. Results: The results showed that 1-year survival rate in the ICWM group was 55. 37%±3.24%; 2-year survival rate 34. 61%±16. 31%; 3-year survival rate 25. 96%±24. 64%; 5-year survival rate 25. 96%±24.64%; and median survival period 16. 3 months. However 1-year survival rate in the chemotherapy group was 21. 95%±27. 54% ; 2-year survival rate 7. 31%±27. 54% ; 3-year survival rate 0 % ; and median survival period 7. 5 months. The therapeutic effects between two groups were significantly different (P=0. 004). Further analysis suggested that the reduction of cancer mass in the ICWM group was more than that in chemotherapy group (P=0.049) and the improvement of advanced pancreatic cancer related-symptoms better than that of chemotherapy group (P = 0. 002). Conclusion: The ICWM comprehensive therapy is of important value in the treatment of advanced pancreatic cancer.

Effects of Integrative Chinese and Western Medicine on Arterial Oxygen Saturation in Patients with Severe Acute Respiratory Syndrome

Objective: To evaluate the effects of treatment of integrative Chinese and Western medicine (ICWM) on arterial oxygen saturation (SaO2) in patients with severe acute respiratory syndrome (SARS). Methods:The non-randomized, controlled trial was conducted on 447 SARS patients treated synchronously with western conventional treatment (WM group, n = 171) alone and ICWM (ICWM group, n = 276). The changes of the cases with normal level (≥95% ) or abnormal level (<95% ) SaO2 were observed dynamically. Results: In the 3rd-14th day of the therapeutic course, the percentage of patients with normal SaO2 in the ICWM group was higher than that in the WM group (OR = 0.5178, P = 0.0038), and this tendency was more evident in patients of the severe type (OR = 0. 18, P = 0. 0001). However, the statistical significance of difference was only shown in patients for whom the ICWM treatment started in the early period after the onset (≤7 days after it, OR = 0.3803, P = 0.006), but not shown in those who received ICWM treatment later in the mid-late period of SARS ( P>0. 05). Conclusion: ICWM treatment, particularly when it is used for intervention in the early stage, is beneficial for maintaining normal SaO2 in SARS patients.

Quality of life and survival analyses of breast cancer cases treated with integrated traditional Chinese and Western medicine

BACKGROUND Breast cancer(BC)is the second leading cause of tumor-related mortality after lung cancer.Chemotherapy resistance remains a major challenge to progress in BC treatment,warranting further exploration of feasible and effective alternative therapies.AIM To analyzed the quality of life(QoL)and survival of patients with BC treated with integrated traditional Chinese and Western medicine(TCM-WM).METHODS This study included 226 patients with BC admitted to the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine between February 2018 and February 2023,including 100 who received conventional Western medicine treatment(control group)and 126 who received TCM-WM treatment(research group).The total effective rate,side effects(alopecia,nausea and vomiting,hepatorenal toxicity,and myelosuppression),QoL assessed using the European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ-C30),1-year overall survival(OS),recurrence and metastasis rates,and serum inflammatory factors[interleukin(IL)-6,IL-10,and tumor necrosis factor alpha]were comparatively analyzed.RESULTS The research group showed statistically better overall efficacy,EORTC QoL-C30 scores,and 1-year OS than the control group,with markedly lower side effects and 1-year recurrence and metastasis rates.Moreover,the posttreatment levels of serum inflammatory in the research group were significantly lower than the baseline and those in the control group.CONCLUSION Overall,TCM-WM demonstrated significantly improved therapeutic efficacy while ensuring drug safety in BC,which not only improved patients’QoL and prolonged survival,but also significantly inhibited the inflammatory response.

Evidence-based Clinical Chinese Medicine:What Has Changed Over the Past 20 Years

Chinese medicine has been used for centuries to treat a range of health conditions.This history has produced a wealth of classical literature,case studies and clinical research data detailing its use and effectiveness.However,high-quality and conclusive evidence that meets modern requirements for clinical decision support is lacking.This evidence gap limits the integration of Chinese medicine with contemporary medicine,which in turn limits global access and acceptance of Chinese medicine as a form of safe and effective health care.Over the past 20 years,researchers and organisations around the world,including the World Health Organization(WHO)and United Nations,have worked to support the integration of traditional medicines,such as Chinese medicine,with conventional medicines to improve global health care.This paper provides an overview of Chinese medicine studies published in the top four general medical journals(BMJ,JAMA,Lancet and New England Journal of Medicine)from February 2005 to February 2024 in the past 20 years to highlight the progress in the development of this evidence base.It also highlights key actions taken to promote evidence-based clinical Chinese medicine,including product and practitioner regulation,formalising education standards,and international collaborations.Research conducted at the China-Australia International Research Centre for Chinese Medicine demonstrates the benefits of such a collaboration.Through development of its unique and inclusive‘whole-evidence’approach,plus clinical studies and systematic reviews,the Centre has significantly contributed to the evidence base for clinical Chinese medicine.In addition,its high-impact papers and groundbreaking monographs have been cited in international conventional medicine guidelines.While progress has certainly been made during the past 20 years to build a stronger evidence base for clinical Chinese medicine,there is still a considerable gap that limits its integration with conventional medicine.Future funding and research are needed to continue this work and achieve to safe,effective and accessible traditional medicine as part of the WHO’s Universal Health Coverage strategy.

A Survey on Treatment of Dry Eye by Traditional Chinese Medicine and Integrative Chinese and Western Medicine

Dry eye is now one of the most common superficial disorders in ophthalmology at home and abroad, and more and more people attach importance to the study. The ideal approach for treatment of dry eye is to normalize the condition by rebuilding the superficial circumstance of the eye, and to make tear film work as well as possible so as to relieve the irritating symptoms in the eye. The authors are making a comprehensive discussion on the methods and curative effects of treating dry eye by traditional Chinese medicine and by integrative Chinese and Western medicine in recent years, so as to introduce the distinctive features of the traditional Chinese medicine and integrative Chinese and Western medicine in this field.

Clinical Evaluation of Integrative Chinese and Western Medicine in Treating SARS

Objective:To evaluate the effective treatment with integrative Chinese and western medicine (ICWM) of severe acute respiratory syndrome (SARS). Methods: The 65 cases of SARS patients were treated with ICWM and 37 cases with western medicine (WM) alone as the control in our hospital from March 11 to April 30, 2003. The results were analyzed, with T subset profile tested for all the 102 patients. Results: Sixty-five cases of SARS patients treated with ICWM included 52 mild cases of whom 51 cases were cured (98.1%) and no patient died. As to the 13 severe cases in this group, 9 were cured (69. 2%) and 2 died (15. 4%). Of the 37 cases treated with WM alone, 16 out of the 18 common cases were cured (88. 9%) and 10 out of the 19 severe cases were cured (52. 6%), with the other 9 died (47. 4%). Comparison between the two groups (P=0. 061) showed the difference was close to the value for statistical significance. But considering that the number of samples was small, more cases are needed for further study. The immune function examination: in cases of the common type, after ICWM treatment, CD4 + T lymphocytes were increased from 360±247 cell/mm3 to 563±479 cell/mm3 (P<0. 05). In the group treated with WM alone, CD4+ T lymphocytes were increased from 331 ±193 cell/mm3 to 772±354 cell/mm3 (P<0. 05). As to the severe cases after ICWM treatment, CD4+ T lymphocytes increased from 352±279 cell/mm3 to 525±490 cell/mm3 (P>0. 05). In the group of severe cases treated with WM alone, CD4+ T lymphocytes reduced from 229±69 cell/mm3 to 205±108 cell/mm3 (P>0. 05). While after ICWM treatment, CD4+ T lymphocytes were significantly higher than that of the group treated with WM alone (P< 0. 05). Conclusion: Compared with the group treated with WM alone, ICWM can significantly improve the prognosis, reduce the mortality as well as improve the immune function of SARS patients.

Clinical Controlled Study of Integrative Chinese and Western Medicine in Treating 49 Cases of SARS

Objective: To evaluate the efficacy of integrative Chinese and western medicine (ICWM) in treating severe acute respiratory syndrome (SARS) patients. Methods: Through parallel control design, 49 SARS patients were observed. Used as control, there were in the western medicine (WM) group 29 patients, who were treated with Ribavirin, Levofloxacin, Thymopentin, Azithromycin, methylprednisolone, etc. , on the basis of 'Recommended Protocol for Infectious Atypical Pneumonia' (abbreviated as 'Recommended Protocol') issueed by Ministry of Health. As the treated group, there were in the ICWM 20 cases. The protocol for treatment of SARS in 'Special Science and Technological Action to Prevent and Treat SARS' (abbreviated as 'Special S-T Action'), issued by Ministry of Science and Technology, together with the same WM as those for the control group. Results: (1) Time from the disease onset to the symptom improvement were 5.10±2. 83 days and 7. 62±2. 27 days in ICWM and WM group respectively, P<0.05; (2) As to corticosteroid (CS) amount and days before reducing dosage, 2 groups showed no significant difference, P>0. 05;(3) There was no significant difference in the time from disease onset to the body temperature normalization and the total amount of CS and the duration of using CS before reducing it to 80 mg between the ICWM group and the WM group; (4) The days and amounts for use CS after reducing between the ICWM group and the WM group were significantly different (P<0. 05). Conclusion: There were obvious advantages in ICWM to treat SARS, compared with that of WM alone, especially in improving the clinical symptoms, promoting the recovery of immune function, promoting the absorption of pulmonary inflammation and reducing the dosage and duration of CS treatment.

Therapeutic Effect of Integrative Traditional Chinese and Western Medicine on 51 SARS Patients and Its Influence on Their TLymphocyte Subsets

Objective: To observe the clinical effect of integrative Chinese a nd western medicine (ICWM) in treatment of patients with severe acute respirator y syndrome (SARS) and its influence on their T lymphocyte subsets.Methods: Fifty one patients with SARS of severe type were obser ved with synchronous non randomized controlled method. They were divided into the ICWM group (29 patients) and the western medicine (WM) group (22 patients). Western medical treatment was applied to both groups, but to the ICWM group, Ch inese medicine was given additionally. The therapeutic course was 2-3 weeks for both groups. Clinical effect and changes of T lymphocyte subsets (CD4 +) aft er treatment were observed.Results: In the ICWM group, 26 patients (89.66%) were cured and 3 (10.34%) died, while in the WM group, 12 (54.55%) cur ed and 10 (45.45%) died, thus comparison of the cure rate between the two groups showing significant difference ( P <0.01). The score of clinical symptoms in the ICWM group was decreased from 7.14±5.20 scores before treatment to 1.82±3. 75 scores after treatment, while in the WM group, it lowered from 7.36±3.84 sco res before treatment to 5.17±4.17 scores after treatment, significant diffe rence shown in the comparison of the values between the two groups after treatme nt (P<0.01). Immunological function test showed that CD4 + T lymphocyte in the ICWM group rose from 361±278 cells/mm 3 before treatment to 630±454 c ells/mm 3 after treatment, showing significant difference( P <0.01 );bu t in the WM group, it merely rose from 288±186 cells/mm 3 to 376±285 cells/mm 3 in the corresponding period (P>0.05). Conclusion: ICWM could improve the clinical symptoms of SARS pa tients markedly, enhance their T lymphocyte immune function, and reduce their mortality.

Treatment of Severe Post-kidney-transplant Lung Infection by Integrative Chinese and Western Medicine

Objective： To explore treatments of severe post-kidney-transplant lung infection by integrative Chinese and Western medicine （ICWM）, in order to elevate the curing rate as well as to lower the death rate. Methods： Based on conventional ways of Western medical treatments of 18 cases of severe post-kidney-transplant lung infection, such as putting the patients in single individual ward, antibiotics to prevent infection, respiratory machines, blood filtration, nutritional support, steroids, and maintaining electrolytes balance, we applied integrated Chinese medicinal treatments, like altering conventional prescription ＂pneumonia Ⅲ ＂, and conducted clinical observation of effectiveness, and indexes including white blood cell （WBC）, neutrophilic granulocyte, blood urea nitrogen （BUN）, blood creatinine （Or）, etc. Results： Of the 18 cases studied, 7 were already cured, 8 proved the treatment effective, 3 died. All clinical indexes had statistically significant changes compared with those of before treatment （P〈0. 01 ）. Cenclusien. ICWM can increase curing rate and lower death rate.

Role of Traditional Chinese Medicine in Integrative Medicine

Complementary & alternative medicine (CAM) is getting more and more important in improving human health. Traditional Chinese medicine (TCM), with her thousands of years history and contributions to the health of Chinese people, definitely is vital in CAM in China. Medical sciences including CAM and mainstream medicine, with unified specific aim, could be integrated and become integrative medicine. During the integration, TCM would contribute much more in the progress with her cultural background and clinical efficacy. This paper will discuss how TCM takes part in the integration via her function in clinical practice.

THE NEW YEAR MESSAGE FROM CHINESE JOURNAL OF INTEGRATIVE MEDICINE

Two months into the year 2003 and one month into the Chinese lunar NewYear of goat,on behalf of the editorial board of the Chinese Journal of Integra-tive Medicine,I wish our readers,contributors and board members around theworld a prosperous and successful new year.

Chinese Journal of Integrative Medicine被列为SCI-E来源期刊

Chinese Journal of Integrative Medicine(中国结合医学杂志)于2008年起被列为美国《科学引文索引(扩展库)》(SCI-E)来源期刊。

Exploration on Integrative Traditional Chinese and Western Medicine Strategy for Treating Patients of Lung Cancer over 80 Years Old

Lung cancer incidence and mortality are much higher among elderly patients over 80 years'old.However,surgery,chemo and radiotherapy,target therapy all are refined in treating this population.This article summarized 3 types of over 80 years'old elderly cancer patient in real world,which include:1.advanced non-small cell lung cancer that cannot be tolerated by targeted therapy;2.Suspected lung malignancies for which a clear pathological diagnosis cannot be obtained;3.Advanced lung cancer with distance metastasis at first diagnosis.The current paper summarized real cases from YANG Yu-fei at Xiyuan Hospital and her traditional Chinese medicine treatment methods and experiences to guide further clinical practice were discussed and shared.

欢迎订阅《中国中西医结合杂志》及《CHINESE JOURNAL OF INTEGRATIVE MEDICINE》

《中国中西医结合杂志》是由中国科协主管,中国中西医结合学会和中国中医科学院主办的全国性中西医结合综合性学术期刊。

欢迎订阅《中国中西医结合杂志》及《CHINESE JOURNAL OF INTEGRATIVE MEDICINE》

《中国中西医结合杂志》是由中国科协主管,中国中西医结合学会和中国中医科学院主办的全国性中西医结合综合性学术期刊。自1981年创刊以来,积极宣传党的中医政策和中西医结合方针,报道我国中西医结合在临床、科研、预防、教学等方面的经验和成果,探讨中西医结合思路和方法,介绍国内外有关本专业的进展。本刊设有:述评、专题笔谈、临床论著、实验研究、博士之窗、临床经验、学术探讨、思路与方法学、临床报道、综述、会议纪要等栏目。本刊为大16开本,96页,月刊,国内外公开发行;铜版纸印刷,国内定价:10.00元/期,全年定价:120.00元,全国各地邮局均可订阅,国内邮发代号:2—52;