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.

Chinese traditional surgery, an important branch of traditional Chinese medicine, has contributed greatly to the people’s health in the history. With the fast development of modern medicine, Chinese traditional surgery is faced with serious challenges and its shortcomings have appeared more and more evident. In this article, the authors analyzed some problems in the development of Chinese traditional surgery and the opportunities for its further development, and suggested that the superiorities of Chinese traditional surgery should be enhanced in its future development.

The study on use of traditional Chinese medicine in perioperative management of breast cancer is still in the beginning phase. With the emergence of new understanding about the biological characteristics of breast cancer, the concept of treatment has changed. For instance, the resection extent is tending to be narrower, large doses of radiotherapy may be adopted during the operation, and early use of adjuvant chemotherapy is advocated after the operation. These have bought about changes to the intervention factors in the perioperative period for breast cancer. Some related problems about the participation of traditional Chinese medicine in perioperative management of breast cancer are discussed in this article, so as to make the perioperative management perfect.

Clinical effect is of great importance to traditional Chinese medicine (TCM), and the rigorous and scientific methods for clinical effect assessment should be highly stressed in the clinical research of TCM. In this article, the authors analyzed the current status of the effect assessment of TCM and proposed some measures to improve the current effect assessment of TCM, in the hope of establishing an internationally accepted system of effect assessment reflecting the superiority and characteristics of TCM therapies.

Along with the changes of disease spectrum, medical models and health concept, people pay more and more attention to the diagnostic and therapeutic approaches of traditional Chinese medicine (TCM). With the effect assessment being changed from disease-based model to patient-based model, how to scientifically and objectively explain the validity of TCM has become the premise for further development of TCM and dissemination of it throughout the world. In this article, the authors analyzed the status quo and problems of the effect assessment of TCM, and proposed some general methods for clinical effect assessment of TCM, including formulating criteria for syndrome differentiation under the guidance of TCM theories, paying attention to quality of life, proper selection of indexes for outcome assessment, application of modern clinical study methods, such as the methods of evidence-based medicine and clinical epidemiology, designing randomized controlled trials, multi-subject co-operation, strict supervision of the quality of researches, and establishment of organizations for professional training.

Objectives

To assess the efficacy of Fuhuang Tablets in treating internal hemorrhoid hemorrhage and discussing the design and quality control of clinical trials of traditional Chinese medicine. 

Methods

According to two-center, randomized, blinded and controlled study, 144 patients with internal hemorrhoids were divided into 2 groups. Seventy-two patients were treated with Fuhuang Tablets (4 tablets t.i.d. per os) and the other 72 patients were treated with Zhining Tablets (4 tablets t.i.d. per os). Symptoms and signs of the patients were recorded and evaluated at the third and seventh day of treatment respectively.

Results

At the third day of treatment, the overall response rates of Fuhuang Tablets-treated group and Zhining Tablets-treated group were 58.57% and 27.78% respectively, with statistic difference between the two groups (P<0.05). At the seventh day of treatment, the overall response rates of Fuhuang Tablets-treated group and Zhining Tablets-treated group were 91.43% and 81.94% respectively, with no statistic difference between the two groups. The laboratory test results and life signs of the 144 patients were normal before and after the treatment.

Conclusion

Fuhuang Tablets are effective and safe in treating internal hemorrhoid hemorrhage.

Objective

To observe the effect of perioperative administration of rhubarb on the acute inflammatory response in patients with gastric cancer.

Methods

In this prospective, single-blinded, controlled clinical trial, thirty-one patients with gastric cancer operatively treated were randomly divided into two groups, with 14 patients in control group and 17 in study group. Patients in both groups were given an isocaloric and isonitrogenous enteral diet. The enteral diet was started 36 hours after operation, and continued for 6 days. Patients in the study group were fed with rhubarb before operation, and at 1 day and 2 days after operation. Indexes of acute inflammatory response such as serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α), and indexes of nutritional status such as serum albumin (ALB), prealbumin (PA) and transferrin (TRF) were measured before operation, and at 1 day, 3 and 7 days after operation.

Results

Patients in both groups had acute inflammatory response, and the indexes of nutritional status decreased after operation. IL-6, CRP and TNF-α tested at 3 and 7 days after operation were lower in the study group as compared with those in the control group, and the recovery time of gastrointestinal motility such as borborygmus, gas elimination and defecation was shorter in the study group as compared with that in the control group. The indexes of nutritional status showed no significant differences between two groups after operation.

Conclusion

Rhubarb can positively modulate the acute inflammatory response, promote the recovery of postoperative gastrointestinal motility, and benefit enteral nutrition support in patients who have undergone major operations for gastric cancer.

Objective

To evaluate the diagnostic value of multi-slice spiral CT (MSCT) for plasma cell mastitis.

Methods

Radiographs of MSCT for forty-six patients with plasma cell mastitis diagnosed by pathological examination were reviewed.

Results

The findings of MSCT of plasma cell mastitis could be divided into four types, including the inflammation type, the abscess type, the sinus and fistula type, and the mixed type, and each type had its radiographic characteristics.

Conclusion

MSCT is helpful for diagnosing plasma cell mastitis and should be used as an examination of first choice for the patients.

Objective

To explore the pathological changes of lower extremity arteries of patients with metabolic syndrome.

Methods

Fifty patients with metabolic syndrome (MS) and 30 normal volunteers were included in this study. The inner diameters, peak systolic velocities and intima-media thicknesses of the lower extremity arteries, and the sizes and numbers of the plaques in the lower extremity arteries were obtained with color Doppler ultrasound (CDU). 

Results

In the fifty MS patients, the intima-media thicknesses of forty-one were thicker than 1.1 mm and thirty-three had plaques which had brought stenosis in different degrees. The intima-media thicknesses of the common femoral, popliteal and posterior tibial arteries in the MS patients were significantly thicker than those in the normal volunteers (P<0.01 or P<0.05), and a greater number of plaques in the lower extremity arteries were observed in the patients, as compared with the normal volunteers (P<0.01).

Conclusion

Various pathological changes had taken place in the lower extremity arteries of the MS patients. The sites and degrees of the lower extremity arterial diseases in MS patients can be definitely detected with CDU.

Objective

To explore the molecular mechanisms of Shengqing Capsules in treating cholelithiasis.

Methods

Sixty female guinea pigs were randomized into 3 groups: group Ⅰ (fed with normal diet), group Ⅱ (fed with low-protein diet) and group Ⅲ (fed with low-protein diet and Shengqing Capsules). After six-week feeding, the gallstone formation and the expressions of bilirubin UDP-glucuronosyltransferase (B-UGT) mRNA and cholesterol 7α-hydroxylase (CYP7A1) mRNA were observed.

Results

The proportions of stone-formed in groups Ⅰ, Ⅱ and Ⅲ were 2/14, 9/12 and 4/14, respectively. There were significant differences among the three groups (P<0.05). The expressions of B-UGT and CYP7A1 mRNAs were higher in both group Ⅰ and group Ⅲ as compared with those in the group Ⅱ (P<0.05).

Conclusion

Shengqing Capsules can reduce the rate of stone-formation, which may be due to its interference of metabolism of bilirubin and cholesterol and up-regulation of the expressions of B-UGT and CYP7A1 mRNAs.

Objective

To investigate the effects of antipyretic and purgative herbs on intestinal mucosal barrier and inflammatory response in the treatment of acute cholangitis.

Methods

Sixty SD rats were randomly divided into group A (untreated group, acute cholangitis was induced, n=20), group B (treatment group, acute cholangitis was induced and treated with antipyretic and purgative herbs, n=20) and group C (sham operation group, n=20). At the third or fifth day after operation, the rats were sacrificed and sampled. The serum endotoxin, cytokines and inflammatory mediators were tested and the numbers of labeled bacteria in the liver, spleen and mesenteric lymph nodes translocated from the gut were assayed.

Results

As compared with group A, the serum content of endotoxin, IL-6, IL-8, TNF-α, CRP and NO was significantly lower and that of IL-2 was significantly higher, and the translocated numbers of labeled bacteria from gut were reduced in both group B and group C（P<0.01).

Conclusion

Antipyretic and purgative herbs can play therapeutic roles in the treatment of acute biliary tract infections, including the protection of intestinal mucosal barrier from bacterial translocation, reduction of serum endotoxin content and regulation of inflammatory response.

Objective

To study the effects of Shengji Huayu Recipe (a traditional Chinese medicine compound recipe for resolving stagnation and promoting granulation) and its decomposed formulas (Huayu Recipe for resolving stagnation and Shengji Recipe for promoting granulation) on the synthesis of collagen types Ⅰ and Ⅲ in granulation tissue of rats in early wound healing.

Methods

Twenty-four male Sprague-Dawley (SD) rats with full-thickness skin lesion were randomized into 4 groups: Shengji Huayu Recipe-treated group, Shengji Recipe-treated group, Huayu Recipe-treated group and untreated group. Collagen types Ⅰ and Ⅲ in granulation tissue of the rats were tested with immunohistochemical methods and image analysis.

Results

On the third day of wound healing, collagen Ⅰ of the rats in both Shengji Huayu Recipe-treated group and Shengji Recipe-treated group was higher than that in the untreated group, and collagen Ⅰ of the rats in Huayu Recipe-treated group was lower than that in the untreated group (P<0.05). Collagen Ⅲ of the rats in the three treated groups were lower than that in the untreated group (P<0.05). On the seventh day of wound healing, Collagen Ⅰ of the rats in both Shengji Huayu Recipe-treated group and Shengji Recipe-treated group was higher than that in the untreated group (P<0.05), and collagen Ⅲ of the rats in both Shengji Recipe-treated group and Huayu Recipe-treated group was higher than that in the untreated group (P<0.05).

Conclusion

Resolving stagnation and promoting granulation therapy can promote the wound healing in rats.

Objective

To study the effects of Wenshen Jianpi Recipe (WSJPR, a traditional Chinese medicine for warming kidney and invigorating spleen) on chronic wound healing and the mechanism.

Methods

Ninety-six SD rats were randomly divided into 4 groups, with 24 rats in each group, and back wound was made in the rats. For rats in 3 of the 4 groups, hydrocortisone injection was administered to induce chronic wound. Rats in 2 of the 3 groups were treated with WSJPR and Xinpukang Granules (XPKG) respectively, and the rats in the other group were untreated. The rats in the fourth group were taken as control. The wound healing time and the width of new epidermis were observed, and the histomorphological changes and cell cycle of the granulation tissue, and the protein expressions of epidermal growth factor (EGF), transforming growth factor-β₁ (TGF-β₁) and fibronectin (FN) in the granulation tissue were tested with immunohistochemical technique and flow cytometry.

Results

The wound healing time of the WSJPR-treated and XPKG-treated groups was (17.0±1.9) and (18.8±1.9) d respectively, much shorter than that of the untreated and control groups (P<0.05). On the 14th experiment day, the width of new epidermis of the WSJPR-treated and XPKG-treated groups was (3.73±0.19) and (3.21±0.15) mm respectively, much wider than that of the untreated and control groups (P<0.05). The numbers of angiogenesis, fibroblasts and cells in the S phase in WSJPR-treated and XPKG-treated groups were much higher than those in the untreated and control groups (P<0.05). Compared with the untreated and control groups, the protein expressions of EGF, TGF-β₁ and FN in WSJPR-treated and XPKG-treated groups were higher (P<0.05).

Conclusion

WSJPR can enhance the wound healing. It was likely through accelerating the cell proliferation and up-regulating the expressions of EGF, TGF-β₁ and FN.

Objective

To explore the mechanisms of Runing RecipeⅡ (a recipe composed of traditional Chinese herbs) in inhibiting the growth of breast cancer by observing its effects on the expressions of p53 and ras oncogene proteins and cell cycle of the transplanted Ca761 breast cancer in mice.

Methods

We established the breast cancer model by transplanting Ca761 cells in mice. The mice were randomly divided into 4 groups: normal saline control group, CTX-treated group, Runing RecipeⅡ-treated group, and Runing RecipeⅡand CTX-treated group, with 12 mice in each group. We detected the cell cycle of the cancer cells in the mice’s transplanted tumor with flow cytometry and measured the expressions of p53 and ras oncogene proteins in the transplanted tumor with immunohistochemical methods.

Results

The percentages of tumor cells in S-phase of the Runing RecipeⅡ-treated group, CTX-treated group and Runing RecipeⅡand CTX-treated group were significantly lower than that of the normal saline control group respectively (P<0.05). The percentage of tumor cells in G₀-G₁ phase of the Runing RecipeⅡ-treated group was lower than that of the CTX-treated group (P<0.05), while the percentage of tumor cells in G₂-M phase was higher than that of the CTX-treated group. The immunoreactive scores (IRSs) of p53 in the Runing RecipeⅡ-treated group and Runing RecipeⅡand CTX-treated group were significantly lower than that in the normal saline control group respectively (P<0.05). The effect of CTX on the expression of p53 was not significant. The IRSs of ras oncogene protein in the RecipeⅡ-treated group, CTX-treated group and Runing RecipeⅡand CTX-treated group were lower than that in the normal saline control group respectively (P<0.05).

Conclusion

Runing RecipeⅡ can inhibit the growth of Ca761 breast cancer in mice by controlling the cell cycle of the transplanted tumor. This may be related to its effect on the gene expressions of p53 and ras in the tumor tissue.