The basic core traditional C hinese medicine for the prevention and treatment of COVID-19 and its active mechanisms

Background:COVID-19 has had a dramatic impact on human health,economies,societies,and livelihoods around the world.Traditional Chinese medicine(TCM)formulae have played an important role in the prevention and treatment of COVID-19.WHO evaluated the role of TCM in treating of COVID-19 and encouraged other countries to promote the use of TCM formulae.However,the key is to find the basic core traditional Chinese medicine(BC-TCM)among those formulae.Methods:For the first time,we mined the data of TCM formulae in CNIPA and analyzed herb characteristics and association rules.We then determined the BC-TCM and screened main compounds and therapeutic targets.Finally,the potential molecular mechanisms were explored by using enrichment analyses and molecular docking.Results:This study screened 123 patented TCM formulae,including 312 herbs.According to frequency statistics and association rules,nine herbs(Gan Cao,Jin Yinhua,Guang Huoxiang,Fu Ling,Huang Qi,Jie Geng,Lian Qiao,Cang Zhu,Ku Xingren)were selected as the BC-TCM.The BC-TCM involved 166 main compounds and 48 therapeutic targets.The active compounds Hederagenin,Spinasterol,Beta-sitosterol,and Liquiritin had high binding activity to the COVID-19 targets 3CL,ACE2,and core targets RELA,HSP90AA1,STAT3,MAPK3,and TP53 according to molecular docking results.Interestingly,Hederagenin might be a potential compound for the prevention and treatment of COVID-19.Conclusion:Our research predicted and confirmed the preventive therapeutic effect of BC-TCM on COVID-19.This has the potential to broaden the scope of TCM,guide people in using clinical formulae,and provide valuable insights for future TCM discovery research.

Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence--taking stroke as an example

Objective: To explore the methodology of the evidence-based expert consensus formulation process of traditional Chinese medicine(TCM) nursing taking stroke as an example.Methods: First, preliminary and comprehensive presentation of all stroke-related symptoms and corresponding TCM nursing techniques involved were revealed through bibliometric analysis. Then, selection of stroke symptoms and TCM nursing techniques for inclusion in the consensus was performed using an expert consultation method. Next, we determined the search strategy for a precise evidence search;conducted an evaluation of evidence quality and the grade of the evidence;and completed evidence extraction, evidence analysis, and evidence synthesis based on the included symptoms and TCM nursing techniques. The Delphi method was then applied to determine the strength of each recommendation and the choice of nursing care points by referring to the Grading of Recommendations, Assessment, Development, and Evaluations grid. Finally, we conducted an external expert validation of the Delphi results to form an expert consensus guideline.Results: Through the bibliometric analysis, 22 stroke symptoms and 18 TCM nursing techniques were identified in the literature. Then, after expert consultation, 22 symptoms and 111 pairs of symptoms combined with TCM nursing techniques were selected for the evidence search. Evidence integration yielded 10 stroke symptoms corresponding to 29 bodies of evidence;these 10 symptoms were retained through the Delphi consultation, and recommendation strength results for 26 recommendations were obtained. A total of 9 symptoms were further retained for expert external validation to form 24 recommendations, with a recommendation process score range of 7.64-9.99 points and a more scientific and standardized recommendation-formation process.Conclusion: Owing to the current limited conditions of evidence-based resources for TCM nursing, the present consensus-building process represents only a preliminary exploration of an evidence-based expert consensus for TCM nursing to provide a reference for a more scientific and standardized methodology.

Expert Survey on the Prevention and Treatment Situation of Traditional Chinese Medicine for Coronary Artery Disease

Objective: To grasp the current situation of Traditional Chinese Medicine (TCM) on prevention and treatment for coronary artery disease (CAD) and the possible advantages and disadvantages. Method: Using a survey in the form of questionnaire among 60 cardiovascular disease experts, to grasp current situation of TCM on prevention and treatment of CAD and the possible advantages and disadvantages. Results: In most areas of China, CAD is common, and angina is the most common clinical type. More than 91% experts choose to integrate traditional and western medicine for treatment and prevention of CAD. TCM proprietary medicine, traditional herbal decoction and intravenous TCM are widely used in the clinical work. Clinical advantages of TCM in the prevention of CAD that are listed in the questionnaire include improving symptoms, enhancing quality of life, increasing exercise tolerance, improving cardiac function, relieving angina, secondary prevention of myocardial infarction, etc. The shortcomings include troublesome brewing of herbal medicine, unpleasant taste of decoction, minimal clinical evidence, slow onset of effects and non-standardized prescription of medicine, etc. Conclusion: The survey reflects the present situation of clinical diagnosis and treatment of TCM on prevention and treatment of CAD to a certain extent;more accurate conclusions need the broader, deeper and large-scale clinical survey.

Nursing perspective of expert consensus on the diagnosis and treatment of cerebral infarction with integrated traditional Chinese and Western medicine

Cerebral infarction(CI)is also known as ischemic stroke.It is one of the most common cerebrovascular diseases,with high mortality and disability rate,which has seriously threatened human health.To better apply the diagnosis and treatment plan of integrated traditional Chinese and Western medicine to the treatment of patients with CI,the Chinese Association of Integrative Medicine issued the Expert Consensus on the Diagnosis and Treatment of Cerebral Infarction with the Integrated Traditional Chinese and Western Medicine in 2021.It involves etiology and pathogenesis of CI,diagnosis and treatment standards of Traditional Chinese Medicine(TCM)and Western Medicine,syndrome elements of TCM,as well as rehabilitation nursing of CI with integrated traditional Chinese and Western medicine during acute period and recovery period.This study interprets the consensus from routine nursing,dietary nursing,emotional nursing,complication nursing,rehabilitation nursing,and continuous nursing,aiming to provide evidence-based support for clinical TCM nursing practice.

Study on traditional Chinese medicine syndrome of esophageal cancer based on Delphi method

Esophageal cancer is one of the common malignant tumors in humans.Traditional Chinese medicine(TCM)has unique advantages in the treatment of esophageal cancer.However,the TCM syndrome classification of esophageal cancer is not standardized.This Delphi survey aimed to explore the TCM syndrome classification and symptom characteristics of esophageal cancer.Methods:Based on literature research,an expert consultation questionnaire was developed for the study of the TCM syndrome rules of esophageal cancer.Two rounds of questionnaire surveys were conducted among 62 experts across the country.Statistical description and statistical analysis of the mean,coefficient of variation,grade sum,and unimportant percentage of the retrieved data.TCM syndrome rules and diagnostic indicators for esophageal cancer after screening and sorting out the questionnaire items,convening experts to demonstrate.Results:62 valid questionnaires were collected,and the expert positive coefficient was 100%.The Kendall's coefficient of concordance W of the first and second rounds are 0.232 and 0.2334 respectively.In addition,the Kendall's coefficient of concordance W of the second round has been improved compared with the first round,suggesting that experts have a better degree of coordination on the importance of indicators.The common TCM syndromes of esophageal cancer are obtained:"liver-stomach disharmony,phlegm and qi obstruction syndrome","liver and spleen disorders,phlegm accumulating with stagnation syndrome","deficiency of liver and kidney yin,stubborn blood syndrome","deficiency of spleen and kidney yang,stubborn blood syndrome".Conclusion:The TCM syndrome indicators of esophageal cancer has been established.It provides a basis for the standardized research of TCM syndrome diagnosis of esophageal cancer,which is of positive significance for improving the level of clinical diagnosis and treatment.

Discussion on Ideological and Political Theories Teaching in Traditional Chinese Medicine Courses Based on National Standard for Teaching Quality

This paper analyzes the necessity and existing problems of ideological and political theories teaching in traditional Chinese medicine courses,and puts forward some suggestions,such as improving the ideological and political ability of professional teachers,perfecting the evaluation mechanism,and exploring ideological and political elements based on the characteristics of courses,so as to provide the basis for ideological and political theories teaching in traditional Chinese medicine courses under the National Standard for Teaching Quality.

An Expert Consensus of Integrated Chinese and Western Medicine Treatment on Lung Cancer

Lung cancer is a malignant tumor of the lung originating from the bronchial mucosa,glands or alveolar epithelium.With the population aging and environmental pollution getting increasingly severe,lung cancer has become the malignant tumor with the highest incidence and mortality rate in China,seriously endangering people’s life and health.However,there is no standardized guideline for the integrated Chinese and Western medicine treatment of lung cancer in China.In order to standardize and improve integrated Chinese and Western medicine diagnosis and treatment of lung cancer in China,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,together with oncologists from the Sun Yat-sen University Cancer Center,compiled this consensus under the coordination of the Medical Policy Department of the National Administration of Traditional Chinese Medicine,taking into account the main results of the pilot project of Chinese and Western Medicine Clinical Collaboration for Major Difficult Diseases(lung cancer).

Preliminary Study on the Training Mode of Chinese Pharmacy Professionals Based on the National Standard of Teaching Quality

With the promulgation of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities, the state has made clear regulations on the standard for the cultivation of Chinese pharmacy talents. Based on their own actual conditions, major colleges and universities have implemented different talent training modes, including talent training modes of running talent classes, "2+1+1", "Chinese Medicine Research Practice Class", employment-oriented professional talent training mode, three-level three-type diversified talent training mode, and talent training mode oriented with adapting to the characteristics of ethnic regions. Various talent training modes have different training objectives, and corresponding training programs are formulated to meet the requirements of the National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities. In addition, according to the notice on Solidly Promoting Labor Education into the "National Standard for the Teaching Quality of Undergraduate Majors in Ordinary Colleges and Universities" issued by the Department of Higher Education of the Ministry of Education, the introduction of labor education to the teaching of Chinese pharmacy majors will be a trend, and Chinese pharmacy professionals are required to achieve comprehensive and coordinated development of morality, intelligence, physique, beauty, and labor. How to integrate labor education with high quality and high efficiency into the training of Chinese pharmacy professionals is a problem that major universities will think about.

朱永康治疗分化型甲状腺癌术后并发症的经验

介绍朱永康教授治疗分化型甲状腺癌(DTC)术后并发症的临床经验。认为DTC术后的中医治疗分为早期和远期两个阶段,早期重在治“虚”,远期治疗除缓解其他治疗带来的毒副作用外,将“伏邪”理论引入治疗中,同时注重既病防变、已病防传和病愈防复。并附验案1则。

2022年NSFC心血管领域中、西医申请资助情况分析

系统梳理分析2022年国家自然科学基金心血管领域中、西医学面上项目、青年科学基金项目和地区科学基金项目3类常规项目的申请和资助情况、所涉及主要病种、研究热点和研究思路。结果显示,两个领域研究的主要病种相似,研究热点也基本一致。均以动脉粥样硬化、冠心病、心力衰竭、高血压、继发性心肌损伤和心律失常为主,主要开展表观遗传学、外泌体、细胞焦亡或铁死亡、细胞自噬、肠道微生物群以及线粒体功能方面的研究,思路呈现多样化的特点。但西医心血管领域的病种更为广泛,还包括心脏移植等中医心血管领域不涉及的病种。在科学问题导向和研究内容方面,中医心血管领域要求在中医药理论的指导下,以解决中医学科的关键科学问题为导向,体现中医药的特色。此外,研究热点只是探索科学问题的技术手段,应深入凝练科学问题,避免盲目追求结合研究热点反而缺乏了创新性思想和科学依据,鼓励原创性基础研究。

我国基层中医药服务现状及发展路径探讨

背景我国对基层中医药卫生服务的关注度持续提升,但是目前基层中医药卫生服务体系仍存在问题,制约了我国中医药事业的发展。目的分析我国基层中医药卫生服务体系现状,探索持续提升基层中医药服务能力的策略。方法于2022年12月,检索《中国卫生健康统计年鉴》《全国中医药统计编摘》及国家疾病预防控制局和国家心血管病中心官方网站获取数据,从卫生投入、服务产出、健康需要3个层面构建指标体系,结合秩和比法和WHO卫生系统绩效模块框架对基层中医药服务现状进行综合评价。结果卫生投入方面:2017—2021年,除乡镇卫生院外,其他能够提供中医药服务的基层医疗卫生机构数量均有所增加;社区卫生服务中心(站)、乡镇卫生院、门诊部中医类临床科室床位数呈现上升趋势,但门诊部中医类临床科室床位数占门诊部总床位数的比例有所下降;社区卫生服务中心(站)、乡镇卫生院、诊所中医类执业(助理)医师占比明显上升,而村卫生室的中医类执业(助理)医师占比保持稳定,门诊部的中医类执业(助理)医师占比逐年递减;近5年,基层医疗卫生机构财政投入的绝对数值稳步提高,而中医机构财政拨款波动减少。服务产出方面:尽管各类机构中医诊疗人次占机构总诊疗人次的比例按照一定增幅稳步增长(除中医类门诊部外),但仅村卫生室的中医诊疗量占比始终保持在30.0%以上;除乡镇卫生院外,其他基层医疗卫生机构的中医类执业(助理)医师人均担负年诊疗人次总体上呈下降趋势。根据综合评价结果,2017、2018、2021年处于资源分配适宜状态,而2019、2020年处于资源分配不均衡状态。结论目前,我国基层中医药卫生服务体系建设得到有效落实,但在有序推进的过程中也存在一些不足。基层中医药资源不足、服务与利用不均衡、中医药优势未充分发挥、人才培养机制不健全、财政投入少等问题制约中医药事业的发展。为推动基层医疗卫生机构持续提高中医药卫生服务能力,需要夯实政府职能,进一步弘扬中医药文化,建立激励机制以优化人才培养模式,加强中医药服务与医保政策紧密结合,建设以“信息一体化”为支撑的中医医联体。

基于“三焦气化”理论探讨谢春光教授治疗痛风经验

痛风是由单钠尿酸盐沉积所致的晶体相关性关节病,现代医学药物治疗主要以碱化尿液、降尿酸和促尿酸排泄等为主,不良反应较多;而中医药治疗痛风颇具特色,谢春光教授总结30余年临床相关经验,注重三焦气化理论,立足于肺、脾、肾,提出通利三焦以促机体脏腑经络功能恢复,用药灵活,为中医药治疗痛风提供了新的思路。

国家重点研发计划中医药现代化研究文献计量分析

目的:分析国家重点研发计划中医药现代化研究重点专项(以下简称专项)的研究进展。方法:基于中国知网(CNKI)、中国学术期刊数据库(万方数据)、中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)和Web of Science核心合集数据库(WoSCC),检索2017—2023年专项资助发表的论文,利用文献计量学和CiteSpace软件对论文作者、机构、研究热点等进行分析。结果:共检索到中文文献2701篇,涉及核心作者108位、形成2个较大的研究团队,中国中医科学院发文量最多,研究热点包括用药规律、中医证候等中医药临床评价和机制研究,主要研究疾病包括心血管病、恶性肿瘤等。英文文献732篇,其中中国科学院发文量最多,药物效用机制、药物代谢动力学等药理学研究是研究热点。结论:在专项支持下,中医药基础研究和基于循证医学评价的临床研究不断深入,在中医药防治重大疾病研究方面取得了重要进展。未来应加强科技成果转化,深化人工智能技术在中医药现代化研究中的应用。

浅谈名老中医药专家学术传承工作中的融入式教学——以天津市名中医曹式丽教授学术传承教学为例

名老中医特色学术传承是当前推动相关领域中医药学术体系发展的重要途径。传承过程中的“融入式教学”对提升中医专业学生综合能力具有重要意义。文章以天津市名中医曹式丽教授学术传承过程中的融入式教学为例,分别从价值塑造、知识传授和能力培养等多层次予以初步探讨,以期为名老中医药专家学术传承过程中的教学创新贡献力量。

中国“互联网+中医医疗”现状评估与发展专家建议

中医药是我国医药卫生事业的重要组成部分,随着互联网的发展,“互联网+中医医疗”成为近年来兴起的一种中医诊疗模式。本研究通过问卷调查、访谈与专家会议调查总结了我国“互联网+中医医疗”的特征、发展现状、发展制约因素与发展前景,并提出专家建议,以期为我国“互联网+中医医疗”行业的发展提供参考。

Shanghai expert consensus on clinical protocol for traditional Chinese medicine treatment of COVID-19 among the elderly population(second edition)

This document is the revised edition of the previously issued Shanghai Expert Consensus on Clinical Protocol for Traditional Chinese Medicine Treatment of COVID-19 among the Elderly Population.Based on the clinical experience and the Protocol for Diagnosis and Treatment of COVID-19(Trial 9th Edition),this revised edition provides treatment approaches and recommendations to proactively cope with Omicron variant and increase the therapeutic efficacy for coronavirus disease 2019 among the elderly population in Shanghai,China.

中医医院医务人员绩效考核中的应用分析以资源为基础的相对价值比率在公立

样本医院在公立中医医院医务人员绩效考核改革中引入了RBRVS,以对中医医院医务人员的工作量进行绩效考核,实现了回归公益、医护分开、“双切断、一转变”的目标。多年来,医院绩效方案持续改进并始终充分体现办院宗旨,以医院战略目标、三级公立医院绩效考核及医保支付方式改革为导向,打破定价约束,以医务人员技术劳动价值为核心,建立了一整套符合中医医院特点的绩效考核与分配体系。