Integration of traditional,complementary,and alternative medicine with modern biomedicine:the scientization,evidence,and challenges for integration of traditional Chinese medicine

Traditional medicine has garnered significant global recognition,with an estimated 80%of the global population using it.Therefore,it is essential to fully understand the integration of traditional medicines into current healthcare systems.This review aims to provide a comprehensive overview of the standard process to modernize traditional medicine scientifically in the context of modern biomedicine,further termed here as“scientization”.Specifically,we aim to summarize the advancements made in understanding the efficacy,effectiveness,and underlying mechanisms of herbal medicine.We also examined the transition from experience-to evidence-based medicine during acupuncture.Furthermore,we explore the development of universal safety and quality control standards.Finally,we discuss international trade and export markets for Chinese medical products.The development and integration of traditional medicine have allowed it to further improve human health,resulting in a more comprehensive health solution for the global population.

Chinese Medicine,Acupuncture and Science

Ever since the introduction of Western biomedicine into China, there has been friction between proponents of this new approach, and proponents of the traditional medical practices that had evolved over thousands of years in China. For the most part, this friction has been couched in the unexamined assumption that Western medicine is based on science, while Chinese medicine is not. This article will examine that assumption, which in this author’s opinion is unjustified and incorrect. Having practiced acupuncture for the past 50 years, after receiving my doctoral degrees in medicine and physiology, my thinking on this topic has also evolved over time. I will begin this article with some historical information that bears on the topic under discussion, followed by my personal ideas about how to resolve the confiicts that have arisen.

Introduction of Western Medicines into China and Improvement on Decoctions during Modern China

During the late Qing dynasty(1840 A.D.-1912 A.D.),a large quantity of Western medicines entered China,which continuously impacted the traditional Chinese medicine(TCM)market and revealed the shortcomings of Chinese medicines.Some personages in the TCM community followed the trend of learning from the West,and attempted to reform TCM,with the improvement on decoction becoming an important aspect of this effort.Through debates and trials,the improvement on decoction underwent three stages of conceptual evolution:“taking Chinese medicines as the foundation and referring to the dosage forms of Western medicines”,“introducing Western techniques to serve the preparation of decoctions”and“integrating the theories of TCM and Western medicine to improve decoctions”.The study highlights the effective complementarity between modern TCM and Western medicine in the field of pharmacy,and provides valuable experience and support for the reevaluation of the value of TCM in contemporary society.

Study of the Management and Disposal Practices of Unused or Out-of-Date Medicines by Households in the Municipality of Ouagadougou, Burkina Faso

Introduction: Not all medicines that pass-through consumers’ hands are used, and some often expire in households. These health products can be sources of accidental risks and pollution when they are not properly disposed of. In Burkina Faso, there are as yet no guidelines for the disposal of unused medicines in households. The aim of this study was to estimate the extent of household possession of unused or expired medicines, and to describe attitudes and disposal practices. Methods: This was a descriptive cross-sectional study covering households in the Ouagadougou commune conducted from June to August 2021. Two-stage stratified sampling was used: selection of Enumeration Zones (EZs) and selection of households, with each EZ comprising several households. Data collection was based on direct interviews using a structured questionnaire. Data were processed using Epi Info software version 7.2.4.0. Results: In total, 417 household residents were surveyed out of the planned 423 households, corresponding to a completion rate of 98.58% compared with the initial sample. Among the respondents, 79.62% had unused and/or expired medicines in their household. A total of 2562 drug packaging units were counted, for a total weight of 121.90 kg. Nearly 75% were aware that improper disposal was a danger to the environment. Some respondents kept their unused medicines at home until they expired (43.41%), and disposed of them mainly by throwing them in the household garbage (75.58%). The majority (79%) were in favor of the government setting up a take-back program for these medicines. Conclusion: The introduction of a take-back program for unused or out-of-date medicines will ensure safer disposal of medicines, and better protection for households and the environment.

Growth of Chinese Medicine in Iran: Past, Present, and Prospects

The international recognition of traditional Chinese medicine(TCM)has continuously increased,and that medical practice has gradually become incorporated into the medical systems of many nations.As an important country in the Belt and Road Initiative,Iran has enormous potential for cooperation with China in medical and health care.High-level officials of the two countries attach great importance to cooperation in both areas.Despite the recent rapid development of TCM in Iran,that medical practice still faces many problems;examples here are the lack of practitioners of TCM as well as the paucity of comprehensive cooperation among herbal medicine factories,publishing houses,traditional medicine colleges,and universities in the two countries.The present study collected and analyzed materials related to the practice of TCM in Iran;it made a deep examination of the current situation,problems,and development prospects regarding TCM in Iran with the aim of providing ideas and references to promote the international development of that form of medicine.Following an analysis of the development trends of TCM in Iran in recent years,it became evident that the prospects for TCM in that country are extensive,and the practice has excellent potential.

Patients’Knowledge, Attitude and Practices on Disposal Methods of Expired and Unused Medicines: Implication for Creation of Drug Take-Back Program

Background: Handling of medicines is a day-to-day activity by patients and many health care providers. However, multiple studies have brought to light inappropriate disposal methods for expired and unused medication (EUM). Improper disposal of expired and unused medicines is hazardous both to humans and the environment. Objective: This sought to measure patients’ knowledge, attitude, and practices on disposal methods of EUM. Methods: A cross-sectional study was carried out among 384 patients at three outpatient pharmacies at the University Teaching Hospitals (UTHs). The structured questionnaire was used to collect data and STAT version 15.1 was used to analyse the data. Results: 384 respondents participated in this study and, at some point, had EUM. In this study, 356 (92.7%) of the participants reported that they had never heard of a drug take-back system. Most of the participants 285 (74.2%) and 239 (62.2%) kept and donated their unused medicine, respectively. Additionally, 244 (63.5%), 212 (55.2%), and 176 (44.8%) of the participants disposed of expired medicines in the bin or garbage, flushed them in toilets or sinks, or burned them, respectively. Occupation was significantly associated with unsafe disposal of unused medicine [P-value = 0.019]. Conclusion and Relevance: Knowledge of safe disposal methods for EUM was good amongst most participants. However, used unsafe disposal methods. The majority of the participants exhibited positive attitude concerning safe disposal methods. This study highlights the need for drug-take-back program creation in Zambia.

The evolution and significance of medicine and food homology

Historical insights into medicine and food homology(MFH)Evolution of the MFH theory MFH,a basic concept in traditional Chinese medicine(TCM),suggests that many materials function as both food and medicine,providing nourishment and simultaneously treating ailments.This concept has evolved significantly throughout TCM history^([1]).Integral to this evolution was the discovery of certain materials with dual purposes during early searches for food.These materials not only offer sustenance and nutrition but are also capable of treating simple illnesses^([2]).

An Interview with Peter Deadman—Acupuncture Pioneer and Founder of The Journal of Chinese Medicine

This interview was conducted on August 21st, 2022 by Charles Buck and Ioannis Solos. Peter Deadman has worked in the field of health promotion for 50 years. He co-founded Infinity Foods(an organic and natural foods workers co-op) in 1971, followed by the Brighton Natural Health Centre-a charity dedicated to teaching ways to improve personal, community and planetary health and wellbeing. He qualified as an acupuncturist in 1978 and in Chinese herbal medicine in 1990. He founded The Journal of Chinese Medicine(UK) in 1979(Fig. 1), and co-authored A Manual of Acupuncture(published in 1998). He is the author of Live Well Live Long: Teachings from the Chinese Nourishment of Life Tradition. He has taught Chinese medicine and health promotion internationally for decades and is a dedicated practitioner and teacher of Qi Gong(气功).

Special Issue: The Global Cross-cultural Integration of TCM in the Mainstream Healthcare, Medical Education and the Practice of Medicine

Ioannis Solos Ph.D.,M.D.(China),L.Ac.currently serves as President and CEO at the Saint George Clinic and Research Institute,Scottsdale,AZ.,and Associate Editor for Chinese Medicine and Culture.Professor Solos has earned his Master of Medicine in Traditional Diagnosis at the Beijing University of Chinese Medicine,and his Medical Ph.D.in Chinese and Western Integrative Medicine at the Jinan University in Guangzhou.He practices and teaches integrative clinical medicine,Jing Fang(经方TCM formulas),martial lineage acupuncture,and his personalized style of“tendon and fascia reconditioning manipulations for bone and joint disease”.

Mechanism of traditional Chinese medicine in the treatment of psoriasis with depression:A review

Psoriasis is a kind of immune-mediated, chronic, inflammatory skin disease, which is often associated with different degrees of psychological disorders. Specifically, there is a significant correlation between psoriasis and depression, and they show the relationships of reciprocal causation and mutual promotion. Psoriasis with depression is more harmful than simple psoriasis, and its prognosis is worse, which brings a huge burden to the family and society and is worthy of clinical attention. Based on the pathogenic factors of western medicine and pathogenesis of traditional Chinese medicine in psoriasis with depression, the paper summarized and elaborated the research progress on the mechanism of traditional Chinese medicine in the treatment of psoriasis with depression, in order to provide new ideas for clinical treatment.

Use of artificial intelligence in the field of pain medicine

In this editorial we comment on the article“Potential and limitations of ChatGPT and generative artificial intelligence in medial safety education”published in the recent issue of the World Journal of Clinical Cases.This article described the usefulness of artificial intelligence(AI)in medial safety education.Herein,we focus specifically on the use of AI in the field of pain medicine.AI technology has emerged as a powerful tool,and is expected to play an important role in the healthcare sector and significantly contribute to pain medicine as further developments are made.AI may have several applications in pain medicine.First,AI can assist in selecting testing methods to identify causes of pain and improve diagnostic accuracy.Entry of a patient’s symptoms into the algorithm can prompt it to suggest necessary tests and possible diagnoses.Based on the latest medical information and recent research results,AI can support doctors in making accurate diagnoses and setting up an effective treatment plan.Second,AI assists in interpreting medical images.For neural and musculoskeletal disorders,imaging tests are of vital importance.AI can analyze a variety of imaging data,including that from radiography,computed tomography,and magnetic resonance imaging,to identify specific patterns,allowing quick and accurate image interpretation.Third,AI can predict the outcomes of pain treatments,contributing to setting up the optimal treatment plan.By predicting individual patient responses to treatment,AI algorithms can assist doctors in establishing a treatment plan tailored to each patient,further enhancing treatment effectiveness.For efficient utilization of AI in the pain medicine field,it is crucial to enhance the accuracy of AI decision-making by using more medical data,while issues related to the protection of patient personal information and responsibility for AI decisions will have to be addressed.In the future,AI technology is expected to be innovatively applied in the field of pain medicine.The advancement of AI is anticipated to have a positive impact on the entire medical field by providing patients with accurate and effective medical services.

A Brief Overview of the Development and Significance of Modern Scientific Medicine in China:Take Chinese Academy of Medical Science and Peking Union Medical College as an Example

Since the early 20th century,China has gradually established a clinical,educational,and research system centered around modern scientific medicine,which has now become the dominant force in China's medical and health system and services,with the construction and development of the Chinese Academy of Medical Sciences and Peking Union Medical College as the most prominent symbol.The scientific medicine in the new era requires close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system.It also involves combining the excellent traditional Chinese culture with Western medicine to explore a unique path of modern scientific medicine with Chinese characteristics.

Knee osteoarthritis:A review of animal models and intervention of traditional Chinese medicine

Background:Knee osteoarthritis(KOA)characterized by degeneration of knee cartilage and subsequent bone hyperplasia is a prevalent joint condition primarily affecting aging adults.The pathophysiology of KOA remains poorly understood,as it involves complex mechanisms that result in the same outcome.Consequently,researchers are interested in studying KOA and require appropriate animal models for basic research.Chinese herbal compounds,which consist of multiple herbs with diverse pharmacological properties,possess characteristics such as multicomponent,multipathway,and multitarget effects.The potential benefits in the treatment of KOA continue to attract attention.Purpose:This study aims to provide a comprehensive overview of the advantages,limitations,and specific considerations in selecting different species and methods for KOA animal models.This will help researchers make informed decisions when choosing an animal model.Methods:Online academic databases(e.g.,PubMed,Google Scholar,Web of Science,and CNKI)were searched using the search terms“knee osteoarthritis,”“animal models,”“traditional Chinese medicine,”and their combinations,primarily including KOA studies published from 2010 to 2023.Results:Based on literature retrieval,this review provides a comprehensive overview of the methods of establishing KOA animal models;introduces the current status of advantages and disadvantages of various animal models,including mice,rats,rabbits,dogs,and sheep/goats;and presents the current status of methods used to establish KOA animal models.Conclusion:This study provides a review of the animal models used in recent KOA research,discusses the common modeling methods,and emphasizes the role of traditional Chinese medicine compounds in the treatment of KOA.

The potential of Chinese herbal medicines in treating anxiety disorders

In recent years,there has not been much progress in developing anxiolytic drugs.Amongst the barriers are the lack of clarity on the pathogenesis of anxiety disorders,low product conversion rates for developing drugs targeting the receptors,and species variability.Some scientists have focused on natural medicines,especially herbal medicines in traditional Chinese medicine.New drugs with excellent anxiolytic activity are hoped to be found in herbal medicines with anxiolytic effects.This mini-review summarised three Chinese herbal medicines with anxiolytic effects and anxiolytic herbal formulas used in the traditional Chinese medicine clinic.Several key issues that block the development of new anxiolytic drugs are also discussed.We hope to provide some ideas for researching and developing new anxiolytic drugs and studying anxiolytic components in traditional Chinese medicine.

Aerospace Medicine and Human Performance更名前后对比分析及启示

目的研究Aerospace Medicine and Human Performance更名前后的主要报道方向、国别、发文机构的变化情况等,以期为国内同行提供参考。方法主要利用CiteSpace的共词网络功能来对期刊报道方向、发刊国别、发文机构等变化进行分析。数据来自Web of Science核心合集的SCI拓展版,以期刊名“Aviation Space and Environmental Medicine”检索,时间跨度为1991年1月1日至2014年12月31日,剔除征稿启事、会议通知等非学术文献。导入NoteExpress软件进行去重,共有4830篇文章。该刊于2015年更名为“Aerospace Medicine and Human Performance”,检索策略为:时间跨度为2015年1月1日至2023年6月13日,数据清洗方法同上,共检索到1076篇文章。结果(1)主要发文机构:更名前主要供稿机构为美国空军(160篇)、美国国防部(93篇)和美国宇航局(NASA,77篇);更名后主要供稿机构未发生变化,但发文数量均较更名前减少,美国空军47篇,美国国防部24篇,NASA 24篇。(2)主要关键词对比:更名后主要关键词与飞行、航天相关的连接强度显著增加,而对一般健康问题的关注相对减少,出现了spaceflight、air travel等直接与飞行行为相关的内容。(3)主要国别:更名前美国发文2411篇(49.91%)、加拿大发文314篇(6.50%)、英国发文279篇(5.77%)、法国发文167篇(3.45%)、德国发文160篇(3.31%);更名后美国发文501篇(46.56%)、英国发文98篇(9.10%)、中国发文54篇(5.01%)、加拿大发文53篇(4.92%)、法国发文42篇(3.90%)。(4)年均发文量:根据检索结果,更名前共24年,年均发文201篇;更名后从2015年至本文检索截止时间共8.5年,年均发文127篇,年均报道量下降较多。(5)影响因子:截止2014年更名前共发文164篇,影响因子1.0051(含自引);2016年是该刊更名有影响因子等统计数据的第一年,共发文132篇,影响因子0.8250;2022年发文109篇,影响因子1.0001(含自引)。综合考量发文量和影响因子,该刊的综合影响力更名后并无显著提升。结论该刊在更名后,对于飞行环境的影响报道有所减少,主要讨论范围从之前的所有飞行类型聚焦为以太空飞行为主,关于飞行行为对人体健康的影响和绩效表现的报道大幅增长,同时也增加了关于飞行装备对飞行安全影响的讨论。随着航空航天技术的进步和航空装备的发展,更深入地探讨航空活动中环境因素对人体长时间复合作用的影响是必然。在该刊更名后,我国的发文数量排名第三,也在一定程度上说明存在高质量原创性成果外流的情况。我国期刊在坚持刊物原有特色的前提下,根据领域研究的发展,与时俱进,探索可持续发展的办刊模式;要进一步明确期刊定位与服务对象,以国家重大需求为导向,聚焦航空航天领域前沿、热点,适时调整栏目设置,提升期刊的学术质量和学科影响力,打造高质量的学术交流平台。

The Essential Role of Zheng Qi in Promoting Health: From the Perspective of Chinese Medicine and Modern Medicine

The concept of Zheng Qi in traditional Chinese medicine (TCM) refers to the vital energy produced by the interaction of Yin and Yang forces in the body. Zheng Qi performs two main functions: Wei Qi (defensive Qi), which shields the body from external pathogens, and Ying Qi (nutritive Qi), which sustains the internal organs and enhances their functionality. In TCM, Chinese tonifying herbs can help restore the balance of Yin/Yang and Qi/Blood function in visceral organs (i.e., optimal physiological functions), thereby fostering the efficient production of Zheng Qi and enhancing health. To ensure the quality of Chinese herbal products, functional assays to measure Yin/Yang, Qi/Blood functions, and Zheng Qi production should be implemented. The efficacy of Yang and Qi herbs can be evaluated by their ability to increase mitochondrial ATP in cultured mouse cardiomyocytes, while Yin and Blood herbs are tested through their immunostimulatory effects on antigen-induced T/B cell proliferation in mouse splenocytes and the production of erythropoietin/nitric oxide in hepatocytes/vascular endothelial cells, respectively. Additionally, Zheng Qi’s effect can be gauged by examining natural killer cell activity and antigen-induced T/B cell proliferation in mice ex vivo. These assays act as biomarkers for assessing the quality and effectiveness of herbal health products within TCM theory.

Bronchoalveolar lavage fluid assessment facilitates precision medicine for lung cancer

Lung cancer is the most common and fatal malignant disease worldwide and has the highest mortality rate among tumor-related causes of death.Early diagnosis and precision medicine can significantly improve the survival rate and prognosis of lung cancer patients.At present,the clinical diagnosis of lung cancer is challenging due to a lack of effective non-invasive detection methods and biomarkers,and treatment is primarily hindered by drug resistance and high tumor heterogeneity.Liquid biopsy is a method for detecting circulating biomarkers in the blood and other body fluids containing genetic information from primary tumor tissues.Bronchoalveolar lavage fluid(BALF)is a potential liquid biopsy medium that is rich in a variety of bioactive substances and cell components.BALF contains information on the key characteristics of tumors,including the tumor subtype,gene mutation type,and tumor environment,thus BALF may be used as a diagnostic supplement to lung biopsy.In this review,the current research on BALF in the diagnosis,treatment,and prognosis of lung cancer is summarized.The advantages and disadvantages of different components of BALF,including cells,cell-free DNA,extracellular vesicles,and micro RNA are introduced.In particular,the great potential of extracellular vesicles in precision diagnosis and detection of drug-resistant for lung cancer is highlighted.In addition,the performance of liquid biopsies with different body fluid sources in lung cancer detection are compared to facilitate more selective studies involving BALF,thereby promoting the application of BALF for precision medicine in lung cancer patients in the future.

Regenerative medicine strategies for chronic complete spinal cord injury

Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.

Feasibility and Challenges of Interactive AI for Traditional Chinese Medicine: An Example of ChatGPT

As a complementary and alternative medicine(CAM),traditional Chinese medicine(TCM)represents an established medical system with a rich history and abundant clinical experience.TCM is an empirical medicine,the process of which is analogous to ChatGPT’s learning and development model.In TCM,inquiry is a relatively objective way of traditional syndrome differentiation.Although various artificial intelligence systems related to TCM consultation exist,their interactive abilities remain limited.The study standardized the primary complaint and instructed ChatGPT to simulate a TCM practitioner,conducting three comprehensive inquiry tests.The results yielded unexpected conclusions,revealing that ChatGPT could simulate a TCM practitioner’s inquiry with patients,confirming its potential in the field of TCM inquiry.However,current applications still pose certain limitations and risks.Hence,to integrate ChatGPT-like language models with traditional TCM AI to establish an associative mode that can facilitate TCM diagnosis and treatment with more convenience and standardization is crucial,yet at the same time,it should be treated very carefully.

The Making of a Health Profession:How Chinese Medicine Became a Nationally Registered Allied Health Profession in Australia

In 2012, traditional Chinese medicine(TCM) practitioners in Australia became nationally-registered allied health professionals in three categories: acupuncturist, Chinese herbal medicine practitioner, and Chinese herbal medicine dispenser. Australia was the first Western country to introduce national registration for Chinese medicine, followed by Portugal and, recently, New Zealand. The practice of TCM in Australia can be traced back to the beginning of Chinese immigration to Australia during the Victorian Gold Rush which began in the 1850s. The process which led to national registration commenced in the early 1970s with the establishment of the first acupuncture courses. Decades of gradual development of courses from unaccredited part-time diplomas to accredited bachelor degrees, and the development, by the profession, of national consensus on educational standards were essential elements in the process which led to registration. Professional associations, such as the Australian Acupuncture and Chinese Medicine Association Ltd.(AACMA), also developed a framework of professional selfregulation, including Codes of Ethics, Codes of Conduct, ongoing professional development requirements and Infection Control Guidelines, and provided leadership in the development of the profession. After decades of tribalism and division within the TCM profession, the National Academic Standards Committee brought almost all stakeholders together to reach a consensus on the Australian Guidelines for Traditional Chinese Medicine Education which were published by AACMA in 2001. Professional associations also collaborated on joint submissions to the government in support of registration, which was introduced first in the state of Victoria in 2000, and subsequently became national in 2012. Despite national registration, some barriers still remain, and professional associations continue to lobby the federal government for inclusion in Medicare, chronic disease management scheme, and Veterans Affairs.