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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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 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.

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.

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.

Background

Acute mastitis is an acute infectious disease of breast. Antibiotic treatment is often unable to obtain a good effect, and we should actively look for a safe and effective non-drug therapy.
Objective

To validate the clinical efficacy of kneading and dispersing manipulation in treatment of early-stage acute mastitis.Design, setting, participants and interventions: According to the multicenter randomized controlled trial design, 198 cases of acute mastitis from Yueyang Hospital of Integrated Traditional Chinese Medicine, Longhua Hospital, and Shanghai Yangpu Maternity and Child Health Hospital were randomly divided into treatment group and control group. There were 99 cases in each group. Patients in the treatment group were only treated with manipulation, and cefradine was orally administered to patients in the control group.Main outcome measures: The local breast lump size, clinical symptoms and the adverse reactions in the two groups were observed before and after the treatment.
Results

The total response rates in the treatment and control group were 95.92% (94/98) and 80% (76/95) respectively. There was a significant difference in the total response rate between the two groups (P<0.05). There were significant differences in the score of breast lump size, and the score of signs and symptoms between the two groups (P<0.05).
Conclusion

Kneading and dispersing manipulation has certain effects on early-stage acute mastitis, and the therapy is safe and repeatable.

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.

“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.

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 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.

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.

In July 2002, the Women's Heath Initiative (WHI) clinical trial, designed to clarify the risks and benefits of combination hormone replacement therapy (HRT) to the postmenopausal women declared that interim safety review after an average follow-up of 5.2 years found that a combination of estrogen and progestin frequently prescribed to postmenopausal women in USA increased the risk of invasive breast cancer, heart disease, stroke, and pulmonary embolism while reduced bone fractures and colorectal cancer. The overall risks of HRT outweigh the benefits, which provides an opportunity for traditional Chinese medicine (TCM) going abroad. A variety of clinical and experimental evidences have showed that TCM exerts quite satisfactory effect on relieving postmenopausal symptoms with little adverse effect, hence a potential role to replace or to improve HRT or to reduce the side effect induced by HRT.

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.