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.

The concept of “prevention before disease” in Buddhism and its application & dissemination status in modern medicine: a review

The concept of“prevention before disease”in Buddhism has deep roots in traditional Indian medicine and has been integrated into Buddhist philosophy.The Buddhist philosophy of“prevention before disease”is based on the cultivation of mindfulness through the practice of meditation.This philosophy has been integrated into modern medicine through the development of mindfulness-based interventions,which have been found to be effective in reducing symptoms of anxiety,depression,and chronic pain.The article also discusses the spread of Buddhist philosophy and its“prevention before disease”concept in different regions of the world and the potential benefits of integrating this philosophy into patient care.Here,we summarized the concept of“Prevention before Disease”in Buddhism and its specific content in Buddhist teachings and discussed its application&dissemination status in modern medicine.

Efficiency and safety of Tripterygium Wilfordii Hook F for IgA nephropathy: an update systematic review and meta-analysis

Background:Immunoglobulin A Nephropathy(IgAN)currently stands as the most prevalent primary chronic glomerular disease worldwide.The latest guidelines recommend the application of renin-angiotensin system inhibitors(RASi)in conjunction with corticosteroids for the treatment of IgAN patients exhibiting persistent proteinuria of≥1 g/d.However,numerous randomized controlled trials(RCTs)have revealed a heightened risk of adverse events associated with corticosteroid treatment.Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW),a traditional Chinese medicine(TCM),has been employed in the treatment of Chronic Kidney Disease(CKD)for an extensive period.Recent years have witnessed an increasing number of RCTs providing evidence supporting the effectiveness of GTW therapy in IgAN.Despite this,there remains a paucity of systematic reviews on the application of GTW therapy for IgAN.Consequently,this study undertakes a systematic review to assess the clinical efficacy and safety of GTW therapy,aiming to elucidate the role of GTW therapy in the treatment of IgAN.Methods:To collect relative information of randomized controlled trials(RCTs)of GTW in the treatment of IgAN,we searched for theses and dissertations publicized before April 10,2023,in PubMed,Embase,the Cochrane Library,China National Knowledge Infrastructure(CNKI),Wanfang Data knowledge service platform(Wanfang Data),Chinese Scientific Journal Database(VIP),and Clinical Trial.The language limitation is English and Chinese.Independently,two reviewers performed literature screening,data extraction,and quality evaluation,and the meta-analysis was carried out with RevMan 5.4 and StataSE 15.0 software.Results:21 RCTs involving 1,405 Chinese patients were included.Compared to ACEI/ARB alone or in combination,GTW with RASi or alone reduced 24 h-Upro,ALB,Scr,GFR,BUN,CD4+,VEGF,ET-1,and improved clinical efficacy.However,no associations were found for TC,Ccr,and adverse events due to limited literature.Conclusion:This study highlights that Multi-glycoside of Tripterygium wilfordii Hook.f.(GTW)exhibits potential in safeguarding renal function and preserving the integrity of the basement membrane in patients with Immunoglobulin A Nephropathy(IgAN).Consequently,GTW emerges as a promising therapeutic option for individuals with IgAN.Nevertheless,it is crucial to acknowledge the limitations stemming from insufficient methodology and a small sample size,which currently obscure the relationships between certain clinical variables,such as total cholesterol(TC)and creatinine clearance(Ccr).Therefore,the substantiation of our findings necessitates more rigorous and expansive trials to enhance the robustness and generalizability of the results.

The diagnosis and treatment of depression in cancer patients with Chinese medicine

抑郁症,失调和焦虑等心理疾病在癌症患者中发病率很高.在大多数情况下,未经治疗的抑郁症可能会发展成慢性疾病,变得难以治疗.治疗癌症中的潜在精神障碍疾病不仅可能改善生活质量,而且提高生存率.传统中医肿瘤学专家将传统中医与西医医学整合起来,形成更有效的治疗方法.中医的本体论假设己经得到了统计学验证,使研宄人员能够使用基于中医诊断的更严格的纳入标准,而不仅仅是西医诊断.但是,日常保健推荐策略仍缺乏具体的指导和实施.我们建议应根据系统的研宄证据制定指南以支持临床实践,这些指南应包括中医专家在内的多学科方法.制定成年癌症患者抑郁症的临床指南是指导和改善肿瘤医疗服务质量的最佳实践.

The prevalence of health literacy of Chinese residents for infectious disease between 2011 and 2015： findings from a meta-analysis

目的：运用系统评价和Meta分析方法探讨2011年至2015年我国居民传染病健康素养的具备情况。方法：检索中国学术文献总库（CNKI）、万方数据库、维普（VIP）期刊全文数据库的文章，收集2011年至2015年我国居民传染病健康素养的横断面研究文献；用Joanna Briggs标准评价文献质量，以传染病健康素养具备率为结局指标，应用Stata12．0软件进行单个样本率的Meta分析。．结果：共纳入横断面研究文献35篇，纳入总人数为94631例，文献质量评价的平均分大于14分。单组率Meta分析显示，我国居民传染病健康素养具备率为20．00％（95％CI：18％～23％）。结论：我国居民具备传染病健康素养的总体水平不高，针对不同的人群应采取不同的健康教育活动，提高曙民传染病健康素养水平，以期有效控制传染病的发生发展。

Chemotherapy combined with bevacizumab for small cell lung cancer with brain metastases:A case report

BACKGROUND Small cell lung cancer(SCLC)is a common and aggressive subtype of lung cancer.It is characterized by rapid growth and a high mortality rate.Approximately 10%of patients with SCLC present with brain metastases at the time of diagnosis,which is associated with a median survival of 5 mo.This study aimed to summarize the effect of bevacizumab on the progression-free survival(PFS)and overall survival of patients with brain metastasis of SCLC.CASE SUMMARY A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks.The patient was diagnosed with limited-stage SCLC.He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo.CONCLUSION The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.

The effect of Modified Wen-Dan decoction on hippocampal astrocytes in depression model rats

Background:This study aimed to observe the effect of Modified Wen-Dan decoction on hippocampal astrocytes in depression model rats.Methods:A total of 48 rats were randomly divided into a control group,a model group,a Modified Wen-Dan decoction group(referred toas the traditional Chinese medicine group),and a fluoxetine control group(referred to as the Western medicine group).The control group was provided with a free diet and without any stimulation,while the remaining three groups were solitarily housed incombination with chronic unpredictable mild stress stimuli to replicate the depression rat model.The rats were subjected to the open-field and sucrose preference experiments for behavioral observation,and q-PCR was used to detect the mRNA of specific markers of hippocampal astrocytes,glial fibrillary acidic protein,and S100 calcium-binding proteinβ(S100β)in each group.Immunohistochemistry was used to observe the protein expression of glial fibrillary acidic protein and S100βin thehippocampus of rats of each group.Results:The behavioral results showed that,compared with the control group,the rats in the model group showed a decrease in the score of the open-field experiment and in the rate of sucrose preference(P<0.05).The score of the open-field experiment and the rate of sucrose preference was increased in the Chinese and Western medicine groups(P<0.05),compared to that of the model group.No significant difference was found between the Chinese and Western medicine groups(P>0.05).The q-PCR results showed that the mRNA and protein expression levels of GFAP and S100βwere downregulated in the model group compared to that of the control group(P<0.05).Compared with the model group,the mRNA expression levels of glial fibrillary acidic proteinand S100βwere upregulated in the traditional Chinese medicine group as well as in the Western medicine group(P<0.05).No significant difference between the Chinese and Western medicine groups was found.Conclusion:The mechanism of the antidepressant effect of Modified Wen-Dan decoction may be related to the improvement of hippocampal astrocyte dysfunction in rats.

Expression of E-Cadherin in Oral Squamous Cell Carcinoma is Associated with Clinical Prognosis

OBJECTIVE To investigate the correlation of E-cadherin expression with clinicopathological parameters and prognosis of patients with oral squa- mous cell carcinoma. METHODS We examined the expression of the protein E-cadherin in 43 oral squamous cell carcinoma (SCC) surgical speciments by SABC im- munohistochemistry. RESULTS There was a significant correlation between the level of E- cadherin expression and tumor stage (P=0.024), invasive pattern (P= 0.009) and lymph node metastasis (P=0.023). No relation was found with age (P=0.084), sex (P= 1.356) and differentiation (P=0.877). Using the Kaplan-Meier method we demonstrated that those cases which showed E-cadherin expression (-) or (+) had a significantly poorer prognosis compared those cases which showed expression (++) or (+++) (P= 0.0146). CONCLUSION E -cadherin, is an important indicator of clinical diag- noses and prognositic marker for oral SCC patients.

Effectiveness of hepatoprotective medication during cancer chemotherapy

目的：化疗可能会引起药物性肝脏损害,因此有必要在临床中研宄保肝药物的有效性.我们评估了东亚地区三种常用的天然物质对肝脏的保护作用.方法：收集三年来在中国某中西医结合医院接受化疗治疗,同时接受谷胱甘肽,异甘草酸镁或多烯磷脂酰胆碱治疗的所有肿瘤患者信息.每个治疗周期前后分别检测各组肝酶水平.使用配对t检验,卡方检验,F分布和方差分析来分析数据.结果：98例患者被纳入研宄.治疗后,在谷胱甘肽组中,患者丙氨酸转氨酶（P〈0.05）和天冬氨酸转氨酶（P〈0.05）的水平降低;患者肝损伤相关指标水平也较低（P〈0.05）.在异甘草酸镁组中,患者总蛋白（P〈0.05）,碱性磷酸酶（P〈0.05）和谷氨酰转肽酶值（P〈0.05）的水平降低;治疗后患者的肝损伤水平也较低（P〈0.05）.在多烯磷脂酰胆碱组中,没有发现研宄指标的降低,患者的肝损伤也没有得到改善（P〉0.05）.结论：在接受化疗的肿瘤患者中,谷胱甘肽和异甘草酸镁对保护肝功能和预防药物引起的肝损伤同样有效.在肿瘤进展期接受化疗的患者中,磷脂酰胆碱在保护肝功能和预防药物引起的肝损伤方面可能没有显著效果.

Effect of the modified wendan decoction on hippocampal astrocyte neurotrophy by regulating the TRP-KYN metabolic pathway in depression-model rats

Objective:To observe the effect of the modified Wendan decoction on the neurotrophic function of hippocampal astrocytes by regulating the tryptophan-kynurenine(TRP-KYN)neuroprotective metabolic pathway in depression-model rats.Methods:A total of 96 Sprague Dawley(SD)rats were randomly divided into the blank group,model group,sham surgery group,neurotoxicity blocker group(blocker 1 for short)group,decoction group,fluoxetine group,blocker 1 plus decoction group,and blocker 1 plus fluoxetine group.Depression in rats of all groups,except for the blank group,was generated by isolation combined with chronic unpredictable mild stress.After corresponding treatments of the rats in each group,the sucrose preference test was performed to evaluate the depressive behaviors of the rats.Serum levels of tryptophan(TRP),kynurenine(KYN),and kynurenic acid(KYNA)were detected via enzyme-linked immunosorbent assay(ELISA);the mRNA/protein expression of hippocampal astrocyte markers,glial fibrillary acidic protein(GFAP)and S100β,was detected via reverse transcription-polymerase chain reaction(RT-PCR)and immunohistochemistry.ELISA and RT-PCR were carried out to detect the levels/mRNA expressions of brain-derived neurotrophic factor(BDNF)and glial-cell-line-derived neurotrophic factor(GDNF),the nutrient secretions of hippocampal astrocytes in rats.Results:Compared to the blank group,the number of activities of rats was significantly reduced,and the GFAP expression in the hippocampus was significantly increased while the BDNF and GDNF expressions were significantly decreased in the model group.With the intervention of the modified Wendan decoction,the depression of rats was significantly improved,and the BDNF and GDNF expressions in the hippocampus were increased while the GFAP expression was decreased significantly in the model group.Conclusion:The modified Wendan decoction may improve the neurotrophic function of rats’hippocampal astrocytes by enhancing the neuroprotective function of the TRP-KYN pathway,thereby exerting an antidepressant effect.

Bibliometric and visual analysis of limb spasm after stroke based on Citespace software

Background:To apply CiteSpace software to the hotspot,trend and cutting-edge dynamics of limb spasm after stroke in nearly 20 years.Methods:From 2000 to 2018,spasming literature in the Web of Science database were searched,and cooperative analysis of authors'national institutions was conducted by using CiteSpace software,keyword analysis and cluster analysis,citation analysis of authors'literature journals,and visual map.Results:2005 articles were retrieved,and the number of articles increased year by year,and the country with the most articles was the United States.Keyword analysis shows that mechanistic research and clinical treatment of spasticity are research hotspots in this field.The most posts are Northwestern Univ and Univ Verona.Conclusion:Through the CiteSpace software analysis of spasticity literature,it is found that the research focus is embodied in the nerve regeneration technology and the standardized clinical study of botulinum toxin type A application,which has certain reference significance for the future research direction of spasticity.

Hyperprogression after anti-programmed death-1 therapy in a patient with urothelial bladder carcinoma:A case report

BACKGROUND Immune checkpoint inhibitors,including programmed death-ligand 1(PD-L1)and programmed death-1(PD-1)have recently been approved to treat locally advanced and metastatic urothelial carcinoma(UC).However,some patients experience rapid tumor progression rather than any clinical benefit from anti-PDL1/PD-1 therapy.CASE SUMMARY A 73-year-old woman with bladder UC showed the progression of multiple metastases after surgery and chemotherapy for over 12 mo.The patient could not tolerate further chemotherapy.Next-generation sequencing was performed,and the results indicated that the tumor mutational burden was 6.4 mutations/Mb.The patient received the anti-PD-L1 agent toripalimab combined with albuminbound paclitaxel.Compared with the baseline staging before immunotherapy,the patient had a treatment failure time of<2 mo,an increase in tumor burden of>50%,and a>2-fold increase in progression,indicating hyperprogression.CONCLUSION Selecting patients most likely to respond to treatment with immunotherapeutic agents remains challenging.For older patients with advanced UC who have already exhausted multi-line chemotherapy options,immunotherapy should be used prudently if no effective biomarker is available.Further studies are required to clarify the causes and mechanisms of hyperprogression.

Traditional Chinese Medicine syndrome patterns and Qi-regulating,chest-relaxing and blood-activating therapy on cardiac syndrome X

OBJECTIVE:To master the syndrome patterns characteristics and explore the effective therapy methods ofTraditional Chinese Medicine(TCM) for cardiac syndrome X(CSX).METHODS:The TCM syndrome characteristics were mastered and the TCM intervention programs were determined by clinical investigations for TCM syndrome patterns characteristics of CSX patients.Then,the clinical efficacy studies on TCM intervention for CSX were carried out through randomized controlled trials.RESULTS:CSX is a clinical syndrome with the main manifestations of chest pain and chest stuffiness,and Qi stagnation,phlegm retention and blood stasis are the basic symptoms of CSX.As a result,the Qi-regulating,chest-relaxing and blood-activating therapy integrated with some Western Medicines was adopted for treatment.The effect of Qi-regulating,chest-relaxing and blood-activating therapy can reduce the frequency and degree of angina,improve the symptoms and exercise the tolerance of patients,inhibit the inflammatory response of vascular walls and protect the function of vascular endothelial cells,which is better than that of the simple and conventionalWestern Medicine alone.CONCLUSION:A good effect was achieved in the integration of Chinese and Western Medicines for CSX.The therapy is worthy to be applied further in clinical practice.On the other hand,more long-term and randomised controlled studies with large samples are still required to further determine the clinical efficacy and safety of the therapy.

Do our brains really belong to us?

As the most important and mysterious organ in our body,the brain has been explored by numerous scientists.In this context,this paper mainly aims at Hilary Putnam's hypothesis of"brain in a tank"in his book"Reason,Truth and History",and considers the possibility of the realization of this hypothesis in combination with practical experiments such as brain machine connection and brain wave transmission from regenerated brain cells,hoping to play a certain guiding role.

Efficacy and Safety of Mulberry Twig Alkaloids Tablet for Treatment of Type 2 Diabetes:A Randomized,Double-Blind,Placebo-Controlled Multicenter Clinical Study

Objective:To assess the efficacy and safety of mulberry twig alkaloids(Sangzhi alkaloids,SZ-A)for treatment of type 2 diabetes in a randomized,double-blind,placebo-controlled multicenter clinical trial.Methods:A total of 200 patients were randomized to receive SZ-A(n=100)or placebo(n=100)for 16 weeks.The data analysis system for electronic data capture clinical trial central randomization system was used for randomization and dispensing of drugs.The primary outcome was the change in glycosylated hemoglobin(Hb A1c)level.The secondary outcome included the proportions of cases with Hb A1c<7.0%and Hb A1c<6.5%,fasting blood glucose(FBG),postprandial blood glucose(PBG),area under curve for the PBG(AUC_(0-2h)),body weight,and body mass index(BMI).Adverse events(AEs),severe adverse events(SAEs),treatment-related adverse events(TAEs),gastrointestinal disorders(GDs),blood pressure,routine blood tests,and liver and kidney function were monitored.Results:Compared with baseline,the change of Hb A1c at week 16 was-0.80%(95%CI:-0.98%to-0.62%)and-0.09%(95%CI:-0.27%to 0.09%)in SZ-A group and placebo group,respectively.The proportion of patients with Hb A1c<7%and<6.5%was higher in the SZ-A group than in the placebo group(46.8%vs.21.6%and 29.9%vs.10.8%).The observed values and changes in FBG,1 h-PBG,2 h-PBG,and AUC_(0-2h) differed significantly between groups(P<0.001),but differences were not significant in body weight and BMI(P>0.05).The incidence rates of AEs,TAEs,and GDs differed significantly between groups(P=0.010,P=0.005,and P=0.006,respectively),whereas the incidence rates of SAEs showed no significant differences between groups(P=1.000).Conclusion:SZ-A are effective and safe for treatment of type 2 diabetes.

美国耳鼻喉学会推荐用针灸治疗过敏性鼻炎（英文）

In 2015,application of acupuncture is recommended by American Academy of Otolaryngology in the latest Clinical practice guideline:Allergic Rhinities.It is written in the Clinical practice guideline for Allergic Rhinities:Clinicians may offer acupuncture,or refer to a clinician who can offer acupuncture,for patients with AR who are interested in non pharmacologic therapy.

美国《术后痛临床指南》推荐使用针灸疗法（英文）

In February 2016,application of acupuncture is recommended by Guidelines on the Management of Postoperative Pain in America.This clinical practice guideline is from the American Pain Society,the American Society of Regional Anesthesia and Pain Medicine,and the American Society of Anesthesiologists’Committee on Regional Anesthesia,Executive Committee,and Administrative Council.