The theory of formulas corresponding to syndromes is one of the characteristics of Treatise on Cold Damage and Miscellaneous Diseases (Shanghan Zabing Lun) and one of the main principles in applying classic prescriptions. It is important to take effect by following the principle of formulas corresponding to syndromes. However, some medical practitioners always feel that the actual clinical effect is far less than expected. Six errors in the use of classic prescriptions as well as the theory of formulas corresponding to syndromes are the most important causes to be considered, i.e. paying attention only to the local syndromes while neglecting the whole, paying attention only to formulas corresponding to syndromes while neglecting the pathogenesis, paying attention only to syndromes while neglecting the pulse diagnosis, paying attention only to unilateral prescription but neglecting the combined prescriptions, paying attention only to classic prescriptions while neglecting the modern formulas, and paying attention only to the formulas but neglecting the drug dosage. Therefore, not only the patients’ clinical syndromes, but also the combination of main syndrome and pathogenesis simultaneously is necessary in the clinical applications of classic prescriptions and the theory of prescription corresponding to syndrome. In addition, comprehensive syndrome differentiation, modern formulas, current prescriptions, combined prescriptions, and drug dosage all contribute to avoid clinical errors and improve clinical effects.

On the basis of medical literature review and clinical research experience, the authors analyzed the reasons for low recognition rate of depression and poor progress of traditional Chinese medicine (TCM) differentiation of depression in this paper and put forward that depressive episode symptoms and the corresponding common terminology classification of Chinese and Western medicine should be the breakthrough points. Through symptom stratification and combination, as well as distinguishing between primary and secondary symptoms, the comprehensive integrative medicine clinical assessment of depression was explored so as to further obtain expert consensus and provide a methodology reference for the TCM differentiation of depression and the research of etiology and pathogenesis.

Fructus Xanthii is commonly used in rhinology, especially used in treatment of chronic rhinitis and sinusitis. But Fructus Xanthii is toxicant, and it maybe result in poisoning when used excessively, without preparation or in inappropriate preparation. This article reviewed all poisoning cases from 1960 to 2000, its toxicology and methods for detoxification.

World Health Organization aims to develop safe, effective and practical traditional medicine. Traditional Chinese medicine (TCM) and other complementary and alternative medicine are being recognized in the whole world nowadays. However, the definite effect of Chinese medicine is still in need of scientific research proof. Placebo control is of equal importance to active control and blank control in clinical trial of TCM. This article briefly reviewed the importance of placebo control and commented on its present situation in clinical trial of TCM. This article also brought up the preliminary proposals of placebo application in TCM clinical trial. We should emphasize scientific placebo preparation and good design of placebo-controlled trial, which are directed by International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use. A good clinical trial project will avoid unnecessary wastes and provide safe and effective treatment for people.

Pulmonary-fibrosis (PF) is the result of interstitial lung disease which has different causes and it is one of the most intractable diseases in respiratory system. The PF is characterized by progressive difficulty of breath and dying of respiratory failure, seriously threatening the health of people. Immunosuppressive drugs and glucocorticoids have been widely adopted as the main methods in treatment, but the results are not satisfactory and the side effects are obvious. Many specialists have tried traditional Chinese medicine in recent years with satisfactory effect, indicating that the prospect of using traditional Chinese medicine in the treatment of PF is optimistic. This article outlines the researches about using traditional Chinese medicine in the treatment of PF.

“Association of the kidney with the ears” is central to the traditional Chinese medical (TCM) theory of the viscera and their manifestations. Previous studies have shown that thyroxin, aldosterone, calcium and iron might be the material basis of the correlation between the kidney and the ears. Due to restriction in research techniques and methods, there has been no further progress in this research field, whose modern biological mechanisms and scientific connotations have not been explained clearly. In recent years, the progress of biological techniques and research on kidney essence provided promising opportunities for research of the association between the kidney and the ears. This article summarized the study progress of “association of the kidney with the ears” theory and posed some meaningful study thoughts. Presbycusis is a kind of degenerative disease caused by aging, which is one aspect of aging of the human body. Because aging is considered as physiological “kidney deficiency”, presbycusis can be regarded as a model of “kidney deficiency” deafness. In conclusion, investigating the correlation between “kidney deficiency” and presbycusis using biotechnology systems combined with “essence of kidney”, should provide a sound basis for study of the theory of the relationship between the kidney and the ears. This will provide new and valuable information for the modern biological research about the theory of visceral associations in TCM.

Traditional Chinese medicine has accumlated rich experience in treating dysfunction of gastrointestinal peristalsis. In recent years, a large number of studies have been made on the mechanism and effects of traditional Chinese medicines on the gastrointestinal peristalsis, and the concept of "gastrointestinal promoting Chinese medicine" has been advocated. These traditional Chinese medicines can be divided into three types: promoting the gastrointestinal peristalsis, inhibiting the gastrointestinal peristalsis, and bi-directional modulating. The in vivo and/or in vitro experiments showed that some of the traditional Chinese medicines for activating blood or regulating qi could promote the stomach peristalsis, and the traditional Chinese medicines for moistening intestines to relieve constipation or invigorating spleen to promote digestion could accelerate the intestinal peristalsis. The mechanism lies in the neuroregulation and gut-peptide regulation. Further research on multi-regulation and of multi-target should be done, for the mechanism of the traditional Chinese medicines in regulating the gastrointestinal peristalsis is far more complicated.

Effect of clinical intervention on human body is multistage and multifaceted, involving physiology, psychology, social function and the surrounding resources, etc. Therefore, the range of clinical outcome assessment includes patient, his or her family and care giver. The evaluation of clinical intervention mainly focuses on its effectiveness, safety and health economics. Effects of clinical interventions are measured by comparisons of the outcome of intervention and control groups. Different effect measures come from different comparisons.

Our ancestor found that some of the Chinese herbal drugs were toxic during their clinical practice. They graded the toxicity of Chinese herbal drugs into three degrees and thought that the term "toxicity of the Chinese herbal drugs" could be used in a broad and a narrow sense. In modern times, toxic components of the Chinese herbal drugs and their toxic mechanisms, especially the toxicity on the kidney, were further revealed. The factors that affect the toxicity of the Chinese herbal drugs include the species, preparation, dose and environment. To prevent the toxicity of the Chinese herbal drugs, we must strengthen the management of the Chinese herbal drugs. On the other hand, doctors' recognition of the toxicity of Chinese herbal drugs should be enhanced. At the same time, patients should be told to decoct and take Chinese herbal drugs correctly.

Pathology and pathophysiology are sciences studying the laws and mechanisms of the occurrence and developmont of diseases,linking up the preclinical and clinical medicine.Owing to the different perspectives and ways of thinking,the western medicine and the traditional Chinese medicine developed respectively their independent theoretical,diagnostic and therapeutic systems.Integrative medicine,combining the theories and treatments of both western medicine and traditional Chinese medicine,has become the developing trend of medicine along with the social development.For this reason,pathological and pathophysiological research in integrated traditional Chinese and western medicine is highly significant for revealing the internal relations between the clinical manifestation and the pathological changes,for expounding the causes,conditions.mechanisms and laws of the occurrence and development of diseases.In doing related research,we should combine the disease and the syndrome,combine the macro-level and the micro-level,combine the part and the whole.We should manage to systematize the clinical research,to establish animal models of the syndromes,and to integrate the animal models of syndromes with the clinical characteristics of disesses.We should apply the theories of traditional Chinese medicine to the pathological and pathophysiological research of modern medicine.

Metabolic syndrome also can be named insulin resistance syndrome. The main clinical manifestations include metabolic disorders of glucose and lipid and some diseases caused by the metabolic disorder, such as impaired glucose tolerance or diabetes, obesity, hyperlipemia, fatty liver, hypertension, coronary heart disease, microalbuminuria, etc. According to the theory of zang-fu organs (viscera) in traditional Chinese medicine, these diseases all result from the deficiency of spleen-qi. They are characterized by deficiency in the Ben (root) and excess in the Biao (branch). The Ben (root) is the failure of the spleen in transportation, and the Biao (branch) is stagnation of qi, blood, phlegm, fire, dampness and food. In the prevention and treatment of metabolic syndrome, it is advocated that the intervention of medicine should be used as early as possible, so as to slow down the occurrence and development of insulin resistance, and that emphasis should be transferred from decreasing blood glucose alone to comprehensive prevention of risk factors, especially to the prevention of cardiovascular events. The effect of traditional Chinese herbs is not as good as the western drugs in decreasing the blood pressure and glucose. However, the traditional Chinese herbs have distinctive superiority in ameliorating the insulin resistance, protecting the injury of vascular endothelial cells, regulating the metabolism of lipid, inhibiting the hypercoagulability, and treating the inflammation. Moreover, they are relatively safe. Therefore, the integration of the traditional Chinese medicine and western medicine is worth further research.

Study of kidney deficiency syndrome may utilize the modern molecular biology technique, such as gene chip, representational difference analysis (RDA) and genes sequence analysis, to clone the different genes of kidney deficiency syndrome from single TCM syndrome type of the disease, to investigate the inner connection between the various phenotypes of kidney deficiency syndrome and their genes expression pattern and their function products, then to definite the related genes of kidney deficiency syndrome. The research method may also be used for the study of other TCM syndrome types.

Objective: To study the possible pathway of the effect of musk on brain disorder,distributing into the brain through blood brain barrier.Methods: We used the musk ketone (muscone), a main composition of musk,to inject through the tail vein of the rats into the blood and took the brain and other organs at different times to make samples. Then gas chromatography was used to measure the distribution of muscone in the brain and other organs.Results: Muscone could pass through the normal rat's blood brain barrier into the brain and soon reached the highest peak and remained in higher concentration, and more slowly metabolized as compared with other organs.Conclusion: Musk distributing into the brain through blood brain barrier provides the basis for its effect in treating brain disorders. Chromatography is an effective method to study the active composition of Chinese herbal medicine distributing through the blood brain barrier into the brain.

International League Against Epilepsy announced the new International Classification of Epilepsy in 2001. One of the main objectives of the project is to adopt standard terms to describe seizure phenomena according to the terminological database. The project may profit academic communication and resource integration, and provide evidence for the individual treatment for epilepsy. Treatment based on syndrome differentiation is one of the characteristics of the treatment for epilepsy in traditional Chinese medicine (TCM). As far as the individuation on diagnosis and treatment is concerned, TCM and Western medicine present to reach the same goal by different routes gradually for the treatment of epilepsy. But for TCM, the diagnosis and treatment criteria for epilepsy are imperfect and the experts, opinions are not unified, so that the treatment based on syndrome differentiation becomes confused, hence the credit of treatment based on TCM is restricted accordingly. It is necessary to formulate advanced diagnosis and treatment criteria for syndromes of epilepsy in TCM.

Spinal disease is the injury caused by congenital malformation, degeneration, inflammation and trauma. These injuries lead to structural lesion of spinal itself, intervertebral discs, spinal cord, nerve root and the attachment, and can cause spinal and associated diseases. Spinal diseases include some frequently encountered diseases, as well as some stubborn and serious diseases. These diseases may cause pain of head and neck, shoulder and arm, waist and leg when they are mild, and partial or thorough paralysis when they are serious. In this article, the history, development, foundations and research progress of non-surgical operation of spinal diseases and the developing tendency of modern spinology are introduced.

Objective: To explore the effect of treating periarthritis of shoulder with manipulation through evaluating clinical reports with the theory of evidence-based medicine (EMB). Methods: By retrieval of some main medical literature databases in the past 5 years, 242 articles on treating periarthritis of shoulder with manipulation were available. Selected by admission standard, 10 of them were evaluated with EBM theory. Results: Both single-application and union-application of manipulation were effective to periarthritis of shoulder, but the evaluated articles were all low-quality articles. Conclusion: Because of low-quality clinic test and larvaceous publication bias, the extant evidence is not enough to recommend replacing other therapeutic methods by manipulation. The low quality of evaluated articles suggests that there exist some methodology problems in the clinic test on treating periarthritis of shoulder with manipulation.

Pain is one of the common symptoms of cancer which seriously affects the quality of life of the patients. Cancer pain is mainly treated with the three-step method, biological therapy or nerve block therapy based on antitumor therapy. However, up to 50 percent of patients with cancer-related pain do not receive adequate pain relief, affecting their physical and psychological well-being, and leading to a lower quality of life for the patient after conventional treatment. Clinical observation suggests that traditional Chinese medicine may alleviate cancer-related pain either by oral administration, topical administration, acupuncture or other means with continuing non-addictive and non-drug-resistant qualities. However, scientific evaluation of the efficacy of herbs in the treatment of pain is insufficient; the underlying mechanisms are unclear and, safety and toxicity remain a concern.

Objective

To study the efficacy and safety of Fuzheng Huayu Capsule (FZHY Capsule) against liver fibrosis with chronic hepatitis B.

Methods

Multicentric, randomized, double blinded and paralleled control led trial was conducted on patients (aged between 18 and 65) with liver fibrosis in chronic hepatitis B．Indexes observed: (1) hepatic histological changes and HBV markers were observed at 0 and 24th week during the treatment; serological indexes (HA, LN, P-Ⅲ-P, Ⅳ-C) were determined and B ultrasound examination of spleen and liver was taken at 0, 12th, 24th week; liver function (during the period of follow-up, liver function and serological indexes for liver fibrosis were evaluated) were observed at 0, 6th, 12th, 18th, 24th week; (2) indexes for safety: blood and urine routine tests, renal function and ECG were examined.

Results

(1) Enrollment and demographic data: There was no significant difference between the trial (110 cases) and control group (106 cases) in demographic feature, vital signs, course of illness,history for drug anaphylaxis, history of previous therapy, liver function, serological indexes for liver fibrosis, liver histological examination (99 cases for test group, 96 cases for control group), HBV markers, and renal function, etc. (2) Histological pathological examination: 93 cases of liver histological examination were taken, of these 50 cases for the trial group and 43 cases for control group which turned out to be at S mean value of 2.33 and 2.11 respectively pretreatment according to criteria for liver fibrosis staging. Post-treatment, the trial showed a significant decrease with S value of 1.80 compared to that of pretreatment; however, there was no significant improvement in control group before and after the treatment with S mean value of 2.14. There was significant difference in reversing rate (decrease at least 1 stage according to criteria for liver fibrosis staging) between the trial (52%) and control (23.3%) after liver biopsy. The trial had a rather good effect on improving inflammatory activity and was superior to control group with a marked decrease of mean value of inflammatory activity and score of inflammation (P<0.05). (3) Serological indexes for liver fibrosis: There was a significant decrease in HA, LN, P-Ⅲ-P, Ⅳ-C content in test group after 12 and 24 weeks' treatment compared to that of pretreatment; the differences of HA, LN, P-Ⅲ-P, Ⅳ-C between 12 , 24 weeks' treatment and pretreatment were significantly greater than control group (P<0.01 or 0.05); the effectual was defined as 2 of 4 indexes lowered more than 30% of the baseline, according to this criteria, the trial was 72.7%, while control group 27.4% (P<0.01). (4) Liver function: Obvious improvement of serum Alb, ALT, AST, GGT was seen in 2 groups; compared with control group, marked improvement of GGT and Alb in the trial (P<0.05); the effective rate of serum ALT in the trial group was 72.7%, while control 59.4%. (5) No changes of significant difference between pre- and post-treatment in routine tests for blood and urine, renal function and ECG, etc. There was also no difference in the stable rate of ALT and serological indexes for liver fibrosis between the trial and control group 12 weeks after withdrawal (P<0.05).

Conclusion

Fuzheng Huayu Capsule has good effect on alleviating liver fibrosis in chronic hepatitis B without any adverse effect and is superior to Heluo Shugan Capsule. Fuzheng Huayu Capsule is a safe and effective medicine for the treatment of liver fibrosis in chronic hepatitis B.

Syndromes constitute a core aspect in the study of Chinese medicine, and research on the concept of syndromes is important to the study of the process of modernization of traditional Chinese medicine. However, it is somewhat challenging to define a syndrome due to the complexity inherent in the subject, even with the assistance of the reductionism approach of modern medicine. Holistic and dynamic in nature and attaching much importance to functional changes, the newly emerging metabonomics is in many ways inline with the concepts of syndrome differentiation of pathological states in traditional Chinese medicine. Therefore, metabonomics has comparatively strong advantages in the very respect of revealing the natural laws of syndrome differentiation. By reviewing and analyzing the current research on the concept of syndromes and the application of metabonomic technology to exploring the essential core of syndrome differentiation, the authors illustrated the potential commonalities. This would also show the issues requiring attention between the study of syndromes and the metabonomic technology. In the meantime this study reflectd the core problems in detail and put forward suggestions with regard to reaching solutions.

According to TCM theory of the wholistic concept and the principles of sydrome differentiation and treatment, the characteristics of the pathogenesis of aplastic anemia (AA) were summarized and corresponding treatment was put forward on the basis of clinical observation and the study of literature. In the pathogenesis of AA, the deficiency of spleen and kidney is the primary aspect, fire attacking blood vessels is the secondary aspect and there is change because of blood stasis. In treatment,the method of invigorating spleen and tonifying kidney is adopted in order to get at the root, and releasing fire to stop bleeding is adopted in order to bring about a temporary solution, and activating blood circulation to dissipate blood stasis is adopted in order to produce blood. The outline should be caught hold of that consumption is primary aspect and fire is secondary aspect and there is change because of blood stasis in order to obtain satisfactory curative effect.

The concept of "three-yin and three-yang" in Shanghan Lun (Treatise on Cold Pathogenic Diseases), a classic written by Zhang Zhongjing in Han Dynasty, has been always the focus of dispute in successive dynasties. The essence of "three-yin and three-yang" has not been fully revealed up till now. Through studying the six divisions of day and night, the six diseases, the combination of syndromes, the complicated diseases, the complete recovery time and the space division of "three-yin and three-yang", the authors draw a conclusion that the "three-yin and three-yang" in Shanghan Lun is a concept of time-sequence, which is associated with the location of disease in space. So it is suggested that the "six diseases" in Shanghan Lun is a categorization for exogenous febrile diseases, and this categorization reveals a sort of inner relationship between the emergence, development, transformation of the febrile diseases and the time.

Objective: To study the feasibility of the establishment of the orthotopic transplantation tumor model of hepatocellular carcinoma in mice and its tumor biological characteristics.Methods: H₂₂ cells of hepatocellular carcinoma were inoculated to form ectopic transplanted model in mice by subcutaneous injection. Then the subcutaneous tumors were implanted into the liver of mice, and the orthotopic transplantation tumor model of hepatocellular carcinoma was established.Results: The successful rate of the orthotopic transplantation tumor model was 95.6% and the spontaneous metastatic rate was 81.8%, the rate of mass ascites was 40.9% and the natural extinctive rate was 0%. The natural survival time in the orthotopic transplantation tumor model was 28 days and the proliferation of tumor in transplanted model was accelerated after 2 weeks or so.Conclusion: The orthotopic transplantation tumor model in mice is an ideal model for studying the metastatic mechanism and screening anti-tumor drugs for liver cancer, just because of its high successful rate and high spontaneous metastatic rate with no natural extinction.

Objective: There exists a close relationship between drying of a fresh herb and its preservation and extraction of efficient components. In order to investigate the influences of different drying methods on extraction and separation of ginsenosides, three drying processes, such as drying in the sun, drying in oven and microwave drying, were used to dry fresh ginsengs .Methods: The ginsenosides of the dry ginsengs were extracted by poaching and microwave heating, and were separated by foam separation.The concentrations of ginsenosides were measured.Results: Microwave drying saved both time and labour, and was favorable for release of ginsenosides. The ginsenosides could be extracted from the dry ginsengs in a shorter time by microwave heating than poaching. The ginsenosides Rb₁, Rb₂, Rd could be observably concentrated by foam separation.Conclusion: Microwave drying and microwave assisted extraction are efficient and economic methods with a high recovery yield of ginsenosides.

The concept of syndrome in traditional Chinese medicine (TCM) is a nonlinear, open and complicated huge system. Syndrome differentiation in TCM belongs to cognitive and noetic science. To establish a new syndrome differentiation system based on the key elements of the syndrome is necessary for TCM practitioners to promote differentiation ability and reach consensus on differentiation method. With combination of experience and computation models, the Bayesian network was used in the study of the relationship between the key elements of syndrome and the symptoms, and the relationship among different key elements, in which the computing diagnosis result was identical to the result from an experienced TCM doctor. The study showed that Bayesian network is a good method to deal with the information of symptoms and signs for syndrome differentiation, but it is also not to reflect comprehensively the thinking ability of TCM doctors in doing syndrome differentiation.

The suggestion of microcosmic syndrome differentiation is to meet the needs of clinical diagnosis and treatment of traditional Chinese medicine (TCM), the needs of evidence based medicine and the needs of the development of syndrome differentiation in TCM. The possibility of microcosmic syndrome differentiation might be the development of integration of traditional Chinese and Western medicine as well as modern science and technology. Microcosmic syndrome differentiation has its superiority and limitation. There are some problems in developing microcosmic syndrome differentiation, such as lack of standard for syndrome differentiation, contradiction between single microcosmic index and the entirety, non-specificity of the relationship between microcosmic indexes and syndromes, and the influence of disease on microcosmic syndrome differentiation, discrepancy between the essence study of TCM syndromes and the clinical practice. It is suggested that the concept of TCM syndrome is a certain pathological process during the onset and development of disease, composed of some subjective and objective indexes. The objective indexes include the macrocosmic and the microcosmic indexes, the entirety and the part.

Clinical practice guidelines play an important role in practitioner and patient decisions regarding appropriate clinical health care and in health policy formation. In the guideline development process, inappropriate methodologies and development strategies significantly influence the quality of guidelines; therefore, research and evaluation of guidelines have great significance. The original Appraisal of Guidelines for Research and Evaluation (AGREE) instrument was published in 2003 by a group of international guideline developers and researchers. AGREE has important significance for the quality guarantee and successful implementation of guidelines, and has extensively achieved endorsement since 2003. In 2009, The AGREE Collaboration has developed the AGREE Ⅱ by refining the original AGREE instrument. At present, the AGREE Ⅱ has already replaced the original AGREE instrument; however, related introduction regarding AGREE Ⅱ has not been found in China. The authors of this article briefly introduce the AGREE Ⅱ, and believe that it will add value to research and evaluation of the guidelines.

There exists close relationship between the damp-heat and the occurrence, development, treatment and prognosis of kidney diseases. The occurrence of damp-heat is based on water and wetness, which may come from outside or may be caused by internal damage. The water and wetness can change into heat if they are stored in the body for a long period, and the combination of water and wetness and heat may cause damp-heat syndrome. The function of spleen and stomach plays the most important role in the water metabolism of sanjiao. Kidney diseases are mainly caused by damp-heat of spleen and stomach resulted from internal damage of spleen and stomach, and symptoms of damp-heat of middle-jiao are commonly seen in most patients of chronic kidney diseases. During the development from renal function damage to renal failure, the remaining of damp-heat in san-jiao can affect the function of spleen and stomach for transportation, transformation and digestion, resulting in the symptoms of dysfunction of spleen and stomach. Regulating the function of spleen and stomach is one of the most important therapeutic methods for kidney diseases.

Severe acute respiratory syndrome is an infectious disease caused by a new type of coronavirus. It belongs to the seasonal febrile diseases in traditional Chinese medicine. The prevention and treatment of severe acute respiratory syndrome (SARS) can be under the guidance of the doctrines for treating febrile diseases of traditional Chinese medicine, treatment based on syndrome differentiation, such as syndrome differentiation of triple energizer, syndrome differentiation according to defensive phase, qi phase, nutrient phase and blood phase. During April and May of 2003, 8 cases of SARS were diagnosed in Shanghai, and 6 patients accepted complementary therapy of traditional Chinese medicine, without death case. The only one patient who didn't take glucocorticoid therapy was complementarily treated with traditional Chinese herbs through the whole treating procedure. Upon the successful treatment of the eight cases of SARS in Shanghai, it is demonstrated that the triple-energizer syndrome differentiation and defensive-qi-nutrient-blood syndrome differentiation in traditional Chinese medicine are of high value in treating SARS patients.