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.

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.

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 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.

Objective

To study the chemical constituents of Fructus Xanthii and to determine the contents of total phenolic acids (TPA) in fruits of Xanthium from different populations for evaluating the quality of them.

Methods

Components in Fructus Xanthii were isolated and purified by various column chromatographies and the contents of TPA were determined by ultraviolet spectrophotometry with chlorogenic acid (CHA) as reference substance.

Results

Six caffeoylquinic acids along with caffeic acid and ferulic acid were isolated from Fructus Xanthii. The contents of TPA of the samples collected from 29 populations in China varied from 0.31% to 1.44%. Among the samples originated from two species and 1 variety of Xanthium, the contents of TPA in X. sibiricum var. subinerme samples with an average of 0.36% were relatively lower than those in other 2 species. While the content of TPA in Sample 3 collected from Shanghai was 1.44% and the highest among all the samples, and that in Sample 12 from Xinjian of Jiangxi Province was 0.38% and the lowest among the X. sibiricum samples.

Conclusion

5-O-caffeoylquinic acid, 1,4-di-O-caffeoylquinic acid and 4,5-di-O-caffeoylquinic acid were isolated from Xanthium plant for the first time. The difference of contents of TPA in samples from different species and different populations in China was relatively significant. Fructus Xanthii in Shanghai and Sanming of Fujian Province were considered high quality if contents of TPA were used as reference for quality evaluating.

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.

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.

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.

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.

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.

Acupuncture is widely used as an alternative therapy with few side effects because of its simple manipulation and low cost. However, accidents may occur if the practitioner uses it improperly. Early in the Qin dynastuy, the Canon of Medicine mentioned that improper use of acupuncture could cause injury to the body and even death, and it systematically described the occurrence and prevention of acupuncture accidents. Physicians in the successive dynasties frequently reported it, and nealized that the manipulation skills were significantly important in preventing the occurrence of acupuncture accidents.Since the 1950s, acupuncture accidents had been effectively prevented because of the improving of acupuncture instruments, enhancing of the quality of the practitioners, popularizing of sterilization and disseminating of anatomic knowledge. Nevertherless, with the renovating of acupuncture techniques, new accidents may occur constantly. The prevention of acupuncture accidents still should be an arduors task for acupuncturists. Nowadays, acupuncture therapy is being used in more than 140 countries, and acupuncture accidents due to improper application are incrcasing. Prevention of acupuncture accidents has become a global issue deserving of great attention.

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.

Acupuncture therapy is one of the original innovations in traditional Chinese medicine. The study of acupuncture has gradually advanced towards the world since 1970s. In these years the most important events might be the influence of acupuncture anesthesia, the attention of the World Health Organization, the establishment and development of the World Federation of Acupuncture and Moxibustion Societies, and the consensus development conference on acupuncture held by the National Institutes of Health in America, and so on. The reasons why acupuncture is accepted by the world are both the convinced curative effects and the scientific foundations, due to the great efforts of medical stuff in China guided by the principle of integration of traditional Chinese and western medicine. This article poses several proposals about further extending the influence of acupuncture. In brief, acupuncture research is one of the few fields that authentically impact the western scientific technology. It is of very important responsibility in the new century to impulse the acupuncture study to further progress and expand the international influence of acupuncture.

Evidence of the pharmacological activity of traditional Chinese medicine (TCM) provides the basis for clinical prescription. Study of the classification of Chinese medicines according to these activities is key to understanding the general active tendencies of medicinal prescriptions, exploring their material basis, investigating their properties and searching for their alternatives. Taking the herbal classic Shennong's Materia Medica Classic (Shennong Bencao Jing) for the data source, this paper studied the classification of Chinese medicines based on semi-supervised incremental clustering algorithm using "micro-cluster" concept in order to investigate the complex similarity among Chinese medicines. The results showed that 253 Chinese medicines were reasonably classified into 14 types, such as invigoration, clearing heat, diuresis, dredging blockages in the channels, treating gynecological conditions and treating strange diseases caused by ghosts. The results also showed that the other 112 Chinese medicines were classified into 112 individual types and the same high similarity to different known types was the main reason for this. The semi-supervised incremental clustering algorithm employed in the study had a high quality and a good development for clustering which is suitable for classification of Chinese medicines. This study illustrated the diversity of Chinese medicines and their complex similarities, thus aiming to provide innovative ideas and methods for related research.

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.

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.

Objective

To discuss the definition of "traditional Chinese medicine and western medicine integration" and "integrated traditional Chinese and western medicine".

Methods

Logic methods.

Results

It was found that there were a lot of problems on the definition of "traditional Chinese medicine and western medicine integration" and "integrated traditional Chinese and western medicine".

Conclusion

The understanding of the concepts of "traditional Chinese medicine and western medicine integration" and "integrated traditional Chinese and western medicine" was improved after the extensive discussion.

The scientificalness of traditional Chinese medicine (TCM) is often doubted and criticized for the record in Huangdi Neijing that the liver is located in the left of the human body. The most popular explanation of this criticism is that the conception of zang-fu viscera in TCM is quite different from which defined in Western medicine. It means that the zang-fu viscera in TCM are not exactly the corresponding anatomical organs in modern human anatomy but reflect the functions of some systems in human body. According to the classical theories of TCM in Huangdi Neijing, we consider that the record of liver located in the left of the human body is based on the Ba Gua (Eight Diagrams) of traditional Chinese philosophy, not the human anatomy. In brief, the conception of zang-fu viscera is initially a gross anatomical conception, and in a sense the anatomic sites and functions of which are mostly similar to those described in Western medicine.

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.

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.

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.

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.

Objective

To explore the way of quantified diagnosis of blood stasis syndrome (BSS) and the essence of BSS.

Methods

Using t-test and logistic regression to analyze the symptoms, signs, and objective indexes of BSS in clinical test.

Results

(1) The levels of endothelin, nitric oxide, and t-PA between 182 patients with BSS and non-BSS had notable difference. (2) The stepwise regression analysis about hemoglobin, triglyceride, total cholesterol, endothelin, nitric oxide, and t-PA in 170 patients with BSS or non-BSS revealed that the order of these indexes considering their importance was: endothelin, hemoglobin, t-PA, nitric oxide. However, the triglyceride and total cholesterol could not enter the regression equations. (3) The stepwise regression analysis about 40 symptoms and signs in 601 patients with BSS or non-BSS revealed that the 18 items had the very contribution to diagnose the BSS when the F value was 6, and so a regression equation was available. The total coincidence ratio was 94.24% when the other quantified data about BSS were tested in the equation.

Conclusion

The standardized TCM syndrome, which accorded with the criteria of combining diseases with syndrome,was made up of symptoms, signs, and objective indexes.The standard could be obtained by multi-center, prospective, random and controlled clinical epidemiological survey and clinical test.

Facing the challenge of modern medicine, how to develop Chinese traditional surgery is a question. The tremendous heritage of traditional Chinese medicine (TCM) is the springhead of the development and innovation of TCM. Succession and innovation is an eternal subject for the development of Chinese traditional surgery. In order to improve Chinese traditional surgery, we should explore traditional medical literature, and carry forward the theories of Chinese traditional surgery.

Radix Glycyrrhizae is a commonly used herbal drug for traditional Chinese medicine in China, and it is also an important material for drug, food, chemical industry, and dye industry. Furthermore, in Northwest China, Radix Glycyrrhizae acts as a key plant for preventing desertification, which currently is the most serious environmental problem in China. This report concentrated on discussing the great potential value of Glycyrrhiza on ecosystem, introducing the principles of protection and sustainable utilization of Glycyrrhiza resource, offering the suitable methods of utilization, and suggesting how to carry out the research on the substitute drugs. To protect the ecosystem and herbal resource of Radix Glycyrrhizae, we should use this herb in a more reasonable way.

Objective: To establish Caco-2 (a human colon adenocarcinoma cell line) cell monolayer model and the standard operation procedure for studying and assessing intestinal absorption of chemical components of traditional Chinese medicine.Methods: Caco-2 cell monolayer model was established and evaluated by morphology feature using scanning electron microscope, inverted microscope and transepithelial electrical resistance (TEER) assay. Additionally, the model was further tested for the activity of alkaline phosphatase and the apparent permeability (P_app) of standard compounds, i.e. propranolol and atenolol, which were the control substances for high and poor transcellular transport marker, respectively.Results: The integrality of cell monolayer, cell differentiation (reflected by expression of alkaline phosphatase and cell monolayer morphology), and the P_app value of standard compounds in the established Caco-2 cell model were satisfactory. All parameters tested were in good agreement with those reported in the literature.Conclusion: The established Caco-2 cell model can be used to study the intestinal absorption of orally administrated chemical components of traditional Chinese medicine and their absorption mechanism.

Index Medicus / MEDLINE / PubMed published by U.S. National Library of Medicine (NLM) is the most important and commonly used biomedical literature retrieval system in the world. According to the "List of Journals Indexed in Index Medicus (2004)", 4 098 journals are indexed for Index Medicus, including 70 journals from mainland China and Hong Kong and 9 journals from Taiwan. Journal of Chinese Integrative Medicine established in May, 2003 is indexed in Index Medicus in 2004. This article outlines the critical elements of journal selection for Index Medicus/MEDLINE and the journal selection process for indexing at NLM, and introduces some measures for the Journal of Chinese Integrative Medicine being indexed in Index Medicus / MEDLINE.