The Comparative Study on Two Models of Syndrome Differentiation of the Hand, Foot and Mouth Disease: An Investigation Analysis of the Signs and Symptoms on 2325 Cases

Objective To realize the characteristics of "zheng" differentiation-treatment for hand, foot and mouth disease(HFMD), a new methodology of syndrome differentiation for different stages of HFMD has been explored. Methods Total of 2 325 cases with HFMD were recorded by distributing them into exterior syndrome stage, interior syndrome stage, severe syndrome stage and recovered syndrome stage, respectively, and the main symptoms and subsidiary symptoms of different stages of HFMD have been observed. The major and minor pathogenesis of HFMD in different stages were obtained, and compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD". Results It was found that the major pathogenesis of exterior stage was defined as "the invation of the wenevil to the defender of the body with the collaterals got involved ", and the minor as "qi deficiency"; in interior stage, "the fury of Gan-Yang" was the main pathogenesis, and "qi in chaos and qi deficiency" was the minor; in severe syndrome stage, "the damage of heart, liver and lung" was the main pathogenesis, and "qi in chaos" was the minor; and the pathogenesis of recovered stage was "qi-yin deficiency". Compared with the "2010 Guideline for the Diagnosis and Treatment of HFMD", it showed that "the obstruction of the fei-pi qi by the mixture of shi-re evil" and "the mixture of shi-re" in vivo was quite difficult to be explained in completely different context in the general situation; in the severe stage, the TCM clinical characteristics of syndrome differentiation might lose; in the early acute severe cases, the phenomenon that xin-yang and fei-qi almost ran out was difficult to be observed, then, the line between the severe and the acute severe became vague.Conclusions The theory of syndrome differentiation by stages of HFMD was reasonable in the actual situation of clinical description on HFMD which was expected to be further tested and widely applied in the "zheng" differentiation-treatment of HFMD in the future.

Can TCM Treatment be Performed on the Basis of Differential Diagnosis of the Diseases Instead of the Syndromes?

Great advances have been achieved in the integration of western and traditional Chinese medicine (TCM).More and more TCM physicians in their practice accept the term 'differential diagnosis of the diseases' instead of the syndromes since western medicine has been introduced into the TCM circle.

Differentiating and Treating Gynecological Diseases based on the Theory of Collateral Diseases

The collateral disease theory is a unique component of the theoretical system of traditional Chinese medicine(TCM),which is currently applied to all kinds of diseases related to the collaterals.With the in-depth study of collaterals theory by many practitioners,its advantages in differentiating and treating gynecological diseases are gradually embodied.Based on the theory of collaterals disease,we discussed the pathogenesis,syndrome differentiation and treatment of gynecological diseases,concluded that the deficient collaterals under nourishment and the stagnant and blocked uterine collateral are the important pathogenesis of gynecological illness.Then we pointed out that invigorating the spleen and tonifying the kidney,and unblocking collateral and dissipating stasis are important treatment methods.We discussed the application of collateral disease theory in Tianjin HA's gynecology,and provided certain theoretical basis and clinical reference for the treatment of gynecologic diseases.

A Validated Model for the Imaging Diagnosis of Cystic Lung Disease

Rationale and Objectives: Cystic lung disease may be accurately diagnosed by imaging interpretation of specialist radiologists, without other information. We hypothesized that with minimal training non-specialists could perform similarly to specialist physicians in the diagnosis of cystic lung disease. Methods: 72 cystic lung disease cases and 25 cystic lung disease mimics were obtained from three sources: 1) a prospective acquired diffuse lung disease registry, 2) a retrospective search of medical records and 3) teaching files. Cases were anonymized, randomized and interpreted by 7 diffuse lung disease specialists and 15 non-specialist radiologists and pulmonologists. Clinical information other than age and sex was not provided. Prior to interpretation, non-specialists viewed a short PDF training document explaining cystic lung disease interpretation. Results: Correct first choice diagnosis of 85%-88% may be achieved by high-performing specialist readers and 71%-80% by non-specialists and lower-performing specialists, with mean accuracies in the diagnosis of LAM (91%, p Conclusion: With specific but limited training, non-specialist physicians can diagnose cystic lung diseases from CT appearance alone with similar accuracy to specialists, correctly identifying approximately 75% of cases.

Genetic factors associated with non-motor symptoms in Parkinson’s disease

Parkinson’s disease (PD) is the second most common neurodegenerative disorder after Alzheimer’s disease. It is a complex syndrome with heterogeneous aetiologies, pathogenesis and manifestations. Patients with PD may present with motor symptoms and various non-motor symptoms (NMSs). NMSs have been reported in almost every diagnosed case of PD and usually precede motor symptoms. Multiple factors have been proved to be associated with the occurrence of NMSs in PD, among which genetic differentiation is a featured one. With the development of sequencing techniques, an increasing number of NMS-related genetic factors have been identified. This article reviews some of the latest discoveries in this regard.

Routine diagnosis of intestinal tuberculosis and Crohn's disease in Southern India

AIM:To investigate whether routinely measured clinical variables could aid in differentiating intestinal tuberculosis(ITB)from Crohn’s disease(CD).METHODS:ITB and CD patients were prospectively included at four South Indian medical centres from October 2009 to July 2012.Routine investigations included case history,physical examination,blood biochemistry,ileocolonoscopy and histopathological examination of biopsies.Patients were followed-up after 2 and 6 mo of treatment.The diagnosis of ITB or CD was re-evaluated after 2 mo of antituberculous chemotherapy or immune suppressive therapy respectively,based on improvement in signs,symptoms and laboratory variables.This study was considered to be an exploratory analysis.Clinical,endoscopic and histopathological features recorded at the time of inclusion were subject to univariate analyses.Disease variables with sufficient number of recordings and P<0.05 were entered into logistic regression models,adjusted for known confounders.Finally,we calculated the odds ratios with respective confidence intervals for variables associated with either ITB or CD.RESULTS:This study included 38 ITB and 37 CD patients.Overall,ITB patients had the lowest body mass index(19.6 vs 22.7,P=0.01)and more commonly reported weight loss(73%vs 38%,P<0.01),watery diarrhoea(64%vs 33%,P=0.01)and rural domicile(58%vs 35%,P<0.05).Endoscopy typically showed mucosal nodularity(17/31 vs 2/37,P<0.01)and histopathology more frequently showed granulomas(10/30vs 2/35,P<0.01).The CD patients more frequently reported malaise(87%vs 64%,P=0.03),nausea(84%vs 56%,P=0.01),pain in the right lower abdominal quadrant on examination(90%vs 54%,P<0.01)and urban domicile(65%vs 42%,P<0.05).In CD,endoscopy typically showed involvement of multiple intestinal segments(27/37 vs 9/31,P<0.01).Using logistic regression analysis we found weight loss and nodularity of the mucosa were independently associated with ITB,with adjusted odds ratios of 8.6(95%CI:2.1-35.6)and 18.9(95%CI:3.5-102.8)respectively.Right lower abdominal quadrant pain on examination and involvement of≥3 intestinal segments were independently associated with CD with adjusted odds ratios of 10.1(95%CI:2.0-51.3)and 5.9(95%CI:1.7-20.6),respectively.CONCLUSION:Weight loss and mucosal nodularity were associated with ITB.Abdominal pain and excessive intestinal involvement were associated with CD.ITB and CD were equally common.

Traditional Chinese Medicine Nursing Protocols for Wheezing Disease(Bronchial Asthma)

Wheezing disease( bronchial asthma) is a common but refractory disease among pulmonary diseases. It tends to attack repeatedly,and is difficult to be cured. In recent years,some studies have shown that effective traditional Chinese medicine( TCM) nursing interventions on the wheezing disease can significantly ameliorate the treatment compliance of patients,reduce the attack and improve the quality of life. Therefore,it is important for patients with different patterns of syndrome to receive effective and reasonable TCMnursing intervention. This article mainly explored the key points of common syndromes,TCMnursing methods and health guidance of wheezing disease in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.

Traditional Chinese medicine nursing protocols for chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease(COPD)is a complex respiratory disorder,characterized by chronic airflow limitation and an elevated inflammatory response of the airways.The people with COPD are more likely to develop comorbidities,with significant impacts on patients'quality of life,exacerbation frequency,and survival.Traditional Chinese medicine(TCM)exhibits good therapeutic effects on improving the clinical symptoms,lung function and quality of life in patients with COPD.Herein,this article primarily summarized the key points of common syndromes,TCM nursing methods and healthy guidance of COPD,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior.

Exploration of Syndrome Differentiation Patterns in Coronary Heart Disease Patients during Peri-Operative Stage of Coronary Artery Bypass Graft

Objective: To explore the patterns of Syndrome Differentiation (SD) of coronary heart disease (CHD) patients in peri-operative stage of coronary artery bypass graft (CABG).Methods: One week after operation, thirty-seven CHD patients, who received CABG of internal mammary artery or great saphena vein under conventional general anesthesia with low or middle temperature extracorporeal circulation were differentiated as various syndromes, with the pre- or post-operational EKG, color Doppler echocardiography were done during and after operation. The hemodynamic parameters were monitored.Results: In the CHD patients, 64.9% were differentiated as Qi-Yin deficiency, 67.6% were complicated with phlegm syndrome and 62.2% with blood stasis, suggesting that Qi-deficiency, phlegm and stasis are the basic pathogenetic factors in patients with CABG. Moreover, the peri-operative syndrome was correlated with the condition of coronary artery lesion, heart and lung functions before operation, and the extracorporeal circulation time during the operation.Conclusion: TCM SD conducting in peri-operative stage might be useful in exploring the patterns of syndrome alteration which provided a basis for preventing peri-operative complications and elevating success rate of operation.

Traditional Chinese medicine nursing protocols for leukorrheal disease( pelvic inflammatory disease)

Leukorrheal disease is an ascending infection of the female genital tract,with high morbidity among reproductive age women. Antibiotics are usually used to treat leukorrheal disease in clinic,but they can lead to a variety of side effects if improper use or long-time use. In recent years,traditional Chinese medicine( TCM) has shown its unique advantages in the treatment of leukorrheal disease. This article mainly explored the key points of common syndromes,TCM nursing methods and health guidance of leukorrheal disease in order to further develop the advantages of TCM,improve its efficacy and standardized its nursing behavior.

Traditional Chinese Medicine nursing protocols for Legg-Calvé-Perthes disease

Legg-Calvé-Perthes disease(LCPD),a historically-considered osteochondrosis,is now being diagnosed as an idiopathic avascularnecrosis of the femoral head in children.At present,the treatment for LCPD mainly focuses on the preservation orrecovery of the arthrogenic component of the femoral head.The currently-available surgical methods are various,most of which can obtain bettertherapeutic effects in LCPD.Nerveless,these surgeries are not universally acknowledged,and may have some limitations like increased articularand vascularinjury.In recent years,Traditional Chinese Medicine(TCM)has been shown a certain advantage in LCPD.This article primarily investigated the key points of common syndromes,TCM nursing methods and healthy guidance of LCPD,aiming at maintaining and developing the strengths of TCM,improving its efficacy and standardizing its behavior.

Professor Chen Xianhai's experience of herb pairs in the treatment of pulmonary diseases

According to the theory of traditional Chinese medicine,based on the four properties and five flavors of traditional Chinese medicines,the lifting and lowering theory and channel tropism,Professor Chen combined with the theory of traditional Chinese medicine and constitution identification to prescribe for patients and used herb pairs to treat many kinds of pulmonary diseases.And he has achieved good clinical effect by"treatment methods selection according to syndromes".His experience in medication and compatibility mechanism are worthy of further exploration and promotion by scholars.

Implementation status quo of traditional Chinese medicine nursing program for advantaged diseases

With the promulgation of the traditional Chinese medicine(TCM)nursing program for advantaged diseases,its application in the clinic has drawn wide attention.TCM nursing program can actively promote the clinical development of TCM syndrome differentiation and nursing.This article introduces the implementation status quo of the TCM nursing program for advantaged diseases in clinical practice,summarize the existing problems in the implementation and put forward measures to promote its perfection.Finally,the article discusses and looks forward to the TCM nursing program for advantaged diseases.Provide theoretical basis and reference for medical workers to effectively promote the application and implementation of TCM nursing programs for advantaged disease.

Effects of TCM Nursing Based on Syndrome Differentiation on Pulmonary Function and Quality of Life in Patients with Acute Exacerbation of COPD

[Objectives] To investigate the effects of TCM nursing based on syndrome differentiation on pulmonary function and quality of life in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). [Methods] A total of 92 patients with AECOPD who came to Nanchong Chinese Medicine Hospital from March 2022 to February 2023 were selected for the study, and the intervention group (TCM nursing based on syndrome differentiation, 46 cases) and the conventional group (basic nursing, 46 cases) were selected for the study, and the pulmonary function and quality of life of the two groups were compared. [Results] Before nursing, there was no significant difference in levels of forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) between the intervention group and conventional group ( P >0.05). After 3 months of nursing, the levels of FVC, FEV1 and FEV1/FVC in the intervention group were higher than those in the conventional group ( P <0.05). Before nursing, there was no significant difference in the scores of health, emotion and social functions between the two groups ( P >0.05). At three months of nursing, the scores of health, emotion, and social functions in the intervention group were higher than those in the conventional group ( P <0.05). [Conclusions] The implementation of TCM nursing based on syndrome differentiation in patients with AECOPD can effectively improve the pulmonary function and quality of life of patients, and has significant clinical implementation value.

Differential Gene Expression Profiles in Coronary Heart Disease Patients of Blood Stasis Syndrome in Traditional Chinese Medicine and Clinical Role of Target Gene

Objective:To investigate the differential gene expression profiles in coronary heart disease(CHD) patients of blood-stasis syndrome(BSS) by oligonucleotide microarray technique,and the clinical significance of target gene.Methods:Subjects were assigned to CHD patients with BSS(n=8),CHD patients without BSS (n=8),and BSS patients without CHD(n=8) based on coronary angiography and the diagnostic criteria of BSS. The sex- and age-matched healthy volunteers(n=8) were enrolled as the control group.Venous blood s...

ACUPUNCTURE TREATMENT ON 40 CASES OF IRRITABLE COLON SYNDROME ACCORDING TO DIFFERENTIATION OF SYMPTOMS AND SIGNS

Irritable intestinal tract syndrome was classified and treated with acupuncture according to differentiation of symptoms and signs.Of the 40 cases treated,28 were cured,11 improved,and 6 ineffective.The total effective rate was 85％.The syndrome was classified into fourtypes:weakness of the spleen and stomach,disharmony of the liver spleen,Yang deficiency ofthe spleen and kidney,and retention of dampness and heat.There was no statistically significant difference in therapeutic effects among the four types of syndromes.However,the curative effect in theacupuncture group was better than that in the medication group,and the difference was of statisticalsignificance.

Symptoms of spinal dysfunction mimicking systemic diseases(Ogundana Syndrome):a review of 35 cases treated with manual therapy over 30 years

Objective and Method:Symptoms manifesting in other parts of the body signaling the existence of spinal dysfunction(Ogundana Syndrome)in patients(N=35,age range 20-56yrs;mean age 36yrs)diagnosed to have systemic diseases but treated with manual therapy were identified after a 30 year case note review.Results:Incipient parkinsonism(general edema and expressionless mask face),stroke(weakness of one side of the body),tinnitus(headache with noise in one or both ears),breast cancer(breast pain)and dyspnea(difficulty in breathing)were some physician diagnoses and clinical symptoms presented.One percent rate occurrence was noted affecting significantly more females(74%)than males(26%,P<0.001).This involved people with family history of back pain(66%)engaged in low income occupations(farming 40%,trading 25%,artisans 15% and civil servants 20%).Symptoms got better after vertical oscillatory pressure therapy to appropriate spinal regions.Duration of treatment was influenced by duration of spinal dysfunction prior to therapy and age of younger patients.Conclusion:One percent of patients with spinal dysfunction misdiagnosed to have systemic diseases due to misleading symptoms are finally referred for physiotherapy of manifesting symptoms.Manual therapy to the appropriate vertebro-geographic region(s)relieves the symptom(s)without prejudice to existing diagnosis.

The conflict on posttreatment Lyme disease syndrome: a clinical mini review

Is Borrelia burgdorferi responsible for the persistence of symptoms after the standard successful course of antibiotics in Lyme disease patients?This highly controversial issue,concerning the underlying mechanism of posttreatment Lyme disease syndrome(PTLDS),still seems to be a matter of intense conflict of opinion.PTLDS is the manifestation of nonspecific symptoms including fatigue,musculoskeletal pain,dysesthesias,and neurocognitive deterioration after the standard antimicrobial therapy administered to patients suffering from Lyme disease.In this article,we review the conflicting views and published highlights of recent human studies regarding PTLDS.

Diagnostic Accuracy of Chinese Medicine Diagnosis Scale of Phlegm and Blood Stasis Syndrome in Coronary Heart Disease: A Study Protocol

Background Phlegm and blood stasis syndrome(PBSS) is one of the main syndromes in coronary heart disease(CHD). Syndromes of Chinese medicine(CM) are lack of quantitative and easyimplementation diagnosis standards. To quantify and standardize the diagnosis of PBSS, scales are usually applied. Objective: To evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. Methods: Six hundred patients with stable angina pectoris of CHD, 300 in case group and 300 in control group, will be recruited from 5 hospitals across China. Diagnosis from 2 experts will be considered as the "gold standard". The study design consists of 2 phases: pilot test is used to evaluate the reliability and validity, and diagnostic test is used to assess the diagnostic accuracy of the scale, including sensitivity, specificity, likelihood ratio and area under the receiver operator characteristic(ROC) curve. Discussion: This study will evaluate the diagnostic accuracy of CM diagnosis scale of PBSS in CHD. The consensus of 2 experts may not be ideal as a "gold standard", and itself still requires further study.(No. ChiCTR-OOC-15006599).