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Wilson's disease （WD） is a copper metabolism disorder caused by mutations in the ATP7B gene， with diverse phenotypes and complex pathogenesis. It is one of the few rare diseases that can achieve good clinical efficacy through standardized treatment. Since there are few systematic reviews of this disease， we summarize the pathogenesis and treatment methods of WD from traditional Chinese and western medicine by reviewing the literature related to WD. In western medicine， ATP7B gene mutation is considered as the root cause of WD， which affects copper transport and causes copper metabolism disorders. The excessive copper deposited in the body will result in oxidative stress， defects in mitochondrial function， and cell death. Western medicine treatment of WD relies mainly on drugs， and copper antagonists are the first choice in clinical practice， which are often combined with hepatoprotective and antioxidant therapy. Surgery is a common therapy for the patients with end-stage WD， and gene therapy provides an option for WD patients. According to the traditional Chinese medicine （TCM） theory， WD is rooted in constitutional deficiency and copper accumulation and triggered by dampness-heat accumulation or phlegm combined with stasis. The patient syndrome varies in different stages of the disease， and thus the treatment should be based on syndrome differentiation. The TCM treatment method of nourishing the liver and kidneys and warming the spleen and kidneys can address the root cause. The methods of clearing heat and drying dampness， resolving phlegm and dispelling stasis， and soothing liver and regulating qi movement can be adopted to treat symptoms. On the basis of syndrome differentiation， special prescriptions for the treatment of WD have been formulated， such as Gandou decoction， Gandouling， and Gandou Fumu decoction， which have been widely used in clinical practice. TCM and western medicine have their own advantages and shortcomings. The integrated Chinese and western medicine complementing with each other demonstrates great therapeutic potential. This paper summarizes the pathogenesis and treatment of WD with integrated Chinese and western medicine， aiming to provide a reference for the clinical diagnosis and treatment of this disease.
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By combing the application and funding situation of general， young scholar and regional scholar programs from National Natural Science Foundation of China（NSFC） in field of integrated traditional Chinese and western medicine in 2023， this paper summarizes the distribution of supporting units， application and funding hotspots， and the problems of application and funding projects in this discipline， in order to provide a reference for applicants and supporting organizations to understand the hotspot dynamics and reporting requirements of the discipline. In 2023， the discipline of integrated traditional Chinese and western medicine received a total of 2 793 applications， and there were 1 254 applications for general programs， 1 278 applications for young scholar programs， and 261 applications for regional scholar programs. The amounts of project funding obtained by the three were 145， 164 and 35， respectively， and the funding rates were 11.56%， 12.83% and 13.41% in that order. From the situation of obtaining funding， the age distribution of the project leaders who obtained funding for the general， young scholar and regional scholar programs were mainly distributed in the age of 40-46， 30-34， 38-44 years， respectively. Within the supported programs， the Chinese medicine affiliations accounted for 55.52%. With respect to research subjects， the proportion of one single Chinese herbs， or monomers， or extracts accounted for 29.4%， but the proportion of Chinese herb pairs or prescriptions accounted for 47.1%. Research hotspots included ferroptosis， bile acid metabolism， macrophages， mitochondria， microglia， exosomes， intestinal flora， microecology and so on. The current research mainly focused on the common key problems of the advantageous diseases of Chinese and western integrative medicine， but still need to be improved in the basic theories of Chinese and western medicine and multidisciplinary cross-disciplinary research.
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At present， there is no consensus on the diagnosis， treatment， and management of pulmonary nodules with integrated traditional Chinese and Western Medicine in China. To establish the clinical management strategy of pulmonary nodules with integrated medicine， a consensus was formed after full discussion by the experts from the Cancer Committee of Chinese Association of Integrative Medicine and the Cancer Committee of Beijing Association of Chinese Medicine according to the guidelines for pulmonary nodules issued in recent years and the clinical practice of multiple hospitals in the treatment of cancers with integrated Chinese and Western medicine. This consensus involves the existing clinical management guidelines of pulmonary nodules and the intervention methods of traditional Chinese medicine （TCM）. Considering the therapeutic positioning and value of TCM， this consensus standardizes the whole-process management of pulmonary nodules with integrated traditional Chinese and Western medicine， which will help more patients.
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ObjectiveTo explore the predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating aplastic anemia （AA） in non-elderly adults， so as to provide a reference for predicting the prognosis of this therapy. MethodA retrospective study was conducted with the clinical data of non-elderly adult AA patients who visited 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 and were treated with Yiqi Yangxue Prescription combined with western medicine. According to the efficacy evaluation results at the 6th month of treatment， the patients were assigned into effective and ineffective groups. The two groups were compared in terms of the gender， age， disease classification ［non-severe aplastic anemia （NSAA）/severe aplastic anemia （SAA）］， course of disease， family history， complications， history of drug allergy， baseline blood routine examination ［hemoglobin （HGB）， white blood cell （WBC）， neutrophil （ANC）， platelet （PLT）， and reticulocyte （Ret）］， T lymphocyte subsets， degree of proliferation of nucleated cells in bone marrow， and expression of T-bet and GATA-3. ResultA total of 101 non-elderly adult AA patients were enrolled in this study， including 81 in the effective group and 20 in the ineffective group. The effective group had a higher proportion of the patients without a history of drug allergy than the ineffective group （P<0.05）. The body height， body weight， gender， age， disease classification， course of disease， family history， and complications showed no significant differences between two groups. The effective group had higher levels of ANC and PLT before treatment （P<0.05） and higher proportion of patients with ANC≥1.6×109/L and PLT≥25×109/L （P<0.05， P<0.01） than the ineffective group. The baseline levels of WBC， HGB， and Ret showed no significant statistical differences between two groups. The levels of CD3+HLA-DR+T cells in the effective group before treatment was higher than that in the ineffective group （P<0.05）. The levels of CD3+CD19-T cells， CD4+T cells， CD8+T cells， Th1 cells， Th2 cells， and CD3+CD25+T cells showed no significant statistical differences between two groups before treatment. The proportion of patients with active bone marrow nucleated cells proliferation in the effective group before treatment were significantly higher than that in the ineffective group, while the proportion of patients with reduced or extremely reduced proliferation were significantly lower than that in the ineffective group （P<0.05）. The expression levels of T-bet and GATA-3 genes had no significant differences between two groups before treatment. The multivariate binary logistic regression analysis showed that the ANC level before treatment and history of drug allergy were independent influencing factors for efficacy （P<0.05， P<0.01）， while other indicators were not influencing factors for efficacy. The receiver operating characteristic （ROC） curve was applied to analyze the predictive value of the ANC level before treatment in the treatment of AA in non-elderly adults with Yiqi Yangxue prescription combined with western medicine. The area under the curve was 0.679 （P<0.05）， with the critical value of 1.595×109/L， the sensitivity of 0.42， and the specificity of 0.95. ConclusionThe history of drug allergy， pre-treatment ANC， PLT， CD3+HLA-DR+ T cell levels， and proliferation of nucleated cells in bone marrow before treatment are predictive factors for the efficacy of Yiqi Yangxue prescription combined with western medicine in treating AA in non-elderly adults. This therapy tends to be more effective for the patients with no history of drug allergy， higher ANC and PLT levels before treatment， especially those with ANC≥1.6×109/L， PLT≥25×109/L， and higher CD3+ HLA-DR+T cell levels and the more active proliferation of nucleated cells in bone marrow before treatment.
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Hyperuricemic nephropathy （HN）， a secondary renal damage common in clinical practice， is characterized by early concealing and continuous progression. The understanding of HN in traditional Chinese medicine （TCM） is from a macroscopic perspective. According to the TCM theory， HN is caused by the combination of external pathogens and internal injuries， with the main pathogenesis being root deficiency combined with superficial excess and deficiency-excess in complexity. In western medicine， the understanding of HN is from the microscopic perspective， which holds that the occurrence of HN is the result of inflammation， oxidative stress， renin-angiotensin-aldosterone system （RAAS） activation， and metabolic abnormalities. The TCM syndromes of HN include internal dampness and heat， obstruction in dampness and turbidity， deficiency of spleen and kidney， and deficiency of kidney yin. Accordingly， the prescriptions should clear heat and dampness， remove dampness and turbidity， tonify spleen and kidney， and nourish kidney yin， respectively. In addition to TCM prescriptions， single herbal medicines and their extracts， Chinese patent medicines， and external applications of Chinese medicines have played a significant role in the treatment of HN， promoting the application of TCM in the treatment of HN. Moreover， the integrated traditional Chinese and western medicine has also played a role in the treatment of HN， enriching the treatment schemes of HN. Different from common kidney diseases such as acute and chronic glomerulonephritis and nephrotic syndrome， HN with particularity should be carefully differentiated in clinical practice. This article systematically summarizes the research progress in the treatment of traditional Chinese medicine and integrated traditional Chinese and western medicine on hyperuricemic nephropathy with TCM and integrated traditional Chinese and western medicine， aiming to enrich the system and theory of HN treatment and further guide the clinical practice.
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Postpartum lochia （PL） is an abnormal postpartum retrogression disease characterized by persistent bloody lochia lasting for more than 10 days. The pathogenesis of traditional Chinese and western medicine is complex，and the mechanism of drug action is not yet clear. The author summarized the pathogenesis and drug action mechanism of postpartum lochia from the perspectives of traditional Chinese and Western medicine by reviewing relevant domestic and foreign research in recent years. It was found that the basic pathogenesis of this disease is the imbalance of Chong Ren Qi and blood，multiple deficiency and multiple stasis. Commonly used drugs are divided into single traditional Chinese medicine and traditional Chinese medicine compound formulas and their preparations. By regulating the transcription and expression of related factors through multiple targets and pathways，it promotes uterine contraction，regulates collagen metabolism Regulating the expression of hormones and their receptors，promoting vascular regeneration，regulating cell apoptosis，proliferation and differentiation，downregulating inflammatory response，maintaining blood coagulation balance，and affecting energy metabolism in the body can promote postpartum recovery. Western medicine is often associated with mechanisms such as incomplete uterine involution，residual tissue，and intrauterine infections. The treatment mainly involves the combination of uterine contractions and antibiotics，with a single mode of action and mechanism. Therefore，traditional Chinese medicine has obvious and concrete advantages in treatment. This article aims to review the etiology and pathogenesis of postpartum lochia in traditional Chinese and western medicine，as well as drug treatment. It aims to construct the relationship between its pathogenesis and mechanism of action，providing reference for the clinical diagnosis and treatment of this disease and drug research and development.
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Cardiometabolic disease （CMD） is a clinical syndrome in which there is a causal relationship between metabolic abnormalities and cardiovascular damage. The incidence and mortality rates of CMD remain high despite the use of potent pharmacologic interventions and clinical therapeutic approaches. There is an urgent need for effective evidence-based comprehensive management measures to improve patients' lifespan and quality of life. From the concept of "nourishing through food" proposed in the Huangdi's Internal Classic （Huang Di Nei Jing） to the widespread application of modern dietary patterns such as dietary restriction， plant-based diets， and Jiangnan cuisine， dietary regulation plays a significant role in preventing diseases， early treatment of existing diseases， and recovery. This article systematically reviewed the traditional Chinese medicine （TCM） theory related to dietary patterns， elucidated the cutting-edge evidence and mechanisms of modern dietary patterns like dietary restriction in preventing and treating CMD， and explored the strategy of integrating TCM theory with dietary patterns， aiming to establish a new food-nutrition-medicine approach that combines traditional Chinese and western medicine and provide novel insights and directions for the clinical management of CMD.
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ObjectiveTo investigate the predictive indicators of early efficacy of Bushen Shengxue prescription combined with western medicine in the treatment of aplastic anemia， and provide prognosis indicators for the treatment of aplastic anemia （AA） with kidney-tonifying therapy in traditional Chinese medicine （TCM） combined with western medicine. MethodA total of 126 patients treated by Bushen Shengxue prescription combined with western medicine in 19 hospitals including Xiyuan Hospital of the China Academy of Chinese Medical Sciences from September 2018 to March 2021 were selected for a retrospective study. The therapy was proven to be effective after six months of treatment. According to the efficacy after 4 months of treatment， the patients were assigned into a 4-month effective group and a 4-month ineffective group. The age， sex， disease severity （including severe aplastic anemia and non-severe aplastic anemia）， course of disease， degree of bone marrow nucleated cell proliferation， baseline hemogram levels ［including white blood cell count （WBC）， absolute neutrophil count （ANC）， hemoglobin （HGB）， platelets （PLT）， and reticulocytes （RET）］， T lymphocytes subsets， and the expression levels of T-box transcription factor （T-bet） and GATA-binding protein-3 （GATA-3） were compared between the two groups before treatment. ResultThe proportions of patients within the age ranges of ［20， 40） and ［60， 80） were higher in the 4-month effective group （P<0.05）. The sex， disease severity， course of disease， and comorbidities had no significant differences between the two groups. The 4-month effective group had higher baseline levels of HGB， WBC， ANC， and PLT than the 4-month ineffective group （P<0.05）， and there was no significant difference in the RET level between the two groups before treatment. Binary Logistic regression analysis showed that the PLT level before treatment was an independent factor affecting the onset time， while other indicators did not affect the onset time. The receiver operating characteristic （ROC） curve was established to analyze the value of PLT level before treatment for predicting the onset time， and the area under the curve was 0.691. With the critical value of 40.5×109/L， the sensitivity and specificity of the prediction that the therapy will take effect within 4 months were 0.569 and 0.893， respectively. The two groups of patients were graded according to age ｛（14， 20）， ［20， 40）， ［40， 60）， and ［60， 80）｝ and PLT level before treatment （PLT<40×109/L， PLT≥40×109/L）. The proportion of the patients with PLT≥40×109/L before treatment in the 4-month effective group was significantly higher than that in the 4-month ineffective group （P<0.05）. The degree of bone marrow nucleated cell proliferation before treatment had no significant difference between the two groups. The level of total T lymphocytes in the 4-month effective patients was lower than that in the 4-month ineffective patients before treatment （P<0.05）. The levels of Th1 cells， Th2 cells， CD4+ T cells， and CD8+ T cells showed no significant differences between the two groups before treatment. The T-bet expression level in the 4-month effective group was higher than that in the 4-month ineffective group before treatment （P<0.05）， while the expression level of GATA-3 showed no significant difference between the two groups before treatment. ConclusionBushen Shengxue prescription combined with western medicine will achieve faster effect for the patients within the age ranges of ［20， 40） or ［40， 60）， with higher levels of HGB， WBC， ANC， and PLT （especially those with PLT≥40×109/L）， lower level of total T lymphocytes， or higher T-bet expression level before treatment.
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Liver transplant patients require lifelong immunotherapy， and if they are infected by SARS-Cov-2， their immune function will face double whammy. This report described the integrated approach of traditional Chinese and western medicine in the treatment of a liver transplant patient with severe COVID-19. The treatment was involved with western medicine such as antiviral， immunosuppressive， focusing on maintaining immune balance. Traditional Chinese medicine was given based on the differentiation of syndromes， targeting at the core pathogenesis and using methods such as promoting qi circulation， clearing heat and resolving dampness， draining lung and relieving panting. Following the treatment， the patient exhibited notable improvement in clinical symptoms and liver function， leading to the effective cessation of disease progression and a shortened recovery period.
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ObjectiveTo systematically evaluate the efficacy and safety of integrated traditional Chinese and western medicine in the treatment of chronic liver failure（CLF）. MethodSeveral databases was searched from the establishment date of these databases to January， 2023， including China National Knowledge Infrastructure（CNKI）， WanFang Data Knowledge Service Platform（WanFang）， China Biomedical Literature Database（CBM）， VIP Chinese Science and Technology Journal Database（VIP）， Cochrane Library， Embase and PubMed. The randomized controlled trial（RCT） conforming to the treatment of CLF with integrated traditional Chinese and western medicine were screened and included， the control group was treated with basic western medicine， and the test group was treated with traditional Chinese medicine on the basis of western medicine. Then， the Cochrane risk bias assessment tool was used to evaluate the quality of the included literature， and Meta analysis was performed by RevMan 5.3 software. ResultEleven literatures with a total of 1 110 patients were included， and Meta analysis showed that the integrated traditional Chinese and western medicine was better than western medicine alone in the treatment of patients with CLF in improving the overall effective rate［relative risk（RR）=1.36， 95% confidence interval（CI） （1.27， 1.46）， P<0.000 01］， reducing the mortality［RR=0.35， 95% CI（0.23， 0.53）， P<0.000 01）］， reducing alanine aminotransferase（ALT） level［mean difference（MD）=-38.73， 95% CI（-54.59， -22.87）， P<0.000 01］， reducing the aspartate aminotransferase（AST） level［MD=-58.16， 95% CI（-83.45， -32.79）， P<0.000 01］ and reducing the total bilirubin（TBil） level［MD=-69.21， 95% CI（-94.15， -30.53）， P<0.000 01］， promoting serum albumin（ALB） level［MD=3.24， 95% CI（0.82， 5.66）， P=0.009］ and prothrombin activity（PTA） level［MD=5.44， 95% CI（3.38， 7.50）， P<0.000 01］， and improving the traditional Chinese medicine（TCM） symptom score［MD=-4.28， 95% CI（-8.39， -0.17）， P=0.04］. ConclusionThe treatment of CLF with integrated traditional Chinese and western medicine has good clinical efficacy and safety. However， due to the limitations of the quality and quantity of the included literature， the above conclusions still need to be verified by larger scale of high-quality RCT， which is worthy of further expansion of the study.
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ObjectiveTo systematically evaluate the efficacy and safety of Jiedu Tongluo therapy in the treatment of diabetic kidney disease （DKD）. MethodDatabases including CNKI， Wanfang Data， PubMed， and Web of Science were systematically searched from January 2003 to December 2022 for clinical randomized controlled trials （RCTs） on the application of Jiedu Tongluo therapy for DKD treatment over the past 20 years. In these trials， the control group received conventional treatment （including diabetes and kidney health education， glycemic and blood pressure control， and lifestyle interventions）， along with western medicine or Chinese patent medicine treatment. The experimental group received primarily Jiedu Tongluo therapy via oral administration of Chinese medicine or in combination with western medicine. The Cochrane risk of bias assessment tool was used for the quality evaluation of the trials， and R 4.1.0 statistical software was used for analysis. ResultForty-one RCTs with 3 478 participants were included. The Meta-analysis results demonstrated that the experimental group， compared with the control group， showed significant improvement in overall clinical efficacy ［odds ratio （OR）=2.46， 95% confidence interval （CI） （2.08， 2.92）， I2=0%］， effective reduction of serum creatinine （Scr） levels ［mean difference （MD）=-15.83， 95% CI （-21.5， -10.37）， P< 0.01］， 24-hour urinary protein excretion rate （24 h-Up） ［MD=-350.88， 95% CI （-419.49， -282.28）， P< 0.01］， TCM syndrome score ［MD=-6.08， 95% CI （-7.81， -4.36）， P<0.01］， and effective regulation of fasting blood glucose （FBG） ［MD=-0.57， 95% CI （-0.75， -0.38）， P<0.01］. The treatment also demonstrated certain safety ［OR=0.99， 95% CI （0.35， 2.76）］. ConclusionJiedu Tongluo therapy in DKD treatment exhibits favorable clinical efficacy and safety. However， due to limitations in the quality and quantity of the included literature， these conclusions should be further validated through larger-scale， high-quality RCTs.
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Colorectal cancer is one of the most common malignant tumors of digestive tract. In 2020， 1.93 million new cases of colorectal cancer were diagnosed globally， ranking third in the global incidence spectrum， and 930 000 new deaths were reported， ranking second in the global cause of death spectrum. Meanwhile， the medical cost of metastatic colorectal cancer is the highest among all stages. A large number of studies have demonstrated that traditional Chinese medicine（TCM） treatment can bring clinical benefits to patients with metastatic colorectal cancer with unique efficacy. In order to further standardize the TCM diagnosis and treatment for metastatic colorectal cancer and improve the level of TCM diagnosis and treatment， Xiyuan Hospital， China Academy of Chinese Medical Sciences， together with other relevant units in China， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the relevant requirements of the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， the Regulations for Group Standards of China Association of Chinese Medicine and others， combined with the characteristics of TCM diagnosis and treatment and the actual situation in China， the Guidelines for TCM Diagnosis and Treatment of Metastatic Colorectal Cancer was developed in accordance with the Catalogue of TCM Diagnosis and Treatment Plans for 105 Diseases in 24 Specialties issued by Department of Medical Administration of National Administration of TCM.
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In recent years， the incidence of colorectal cancer has been rising in China， and with the promotion of early screening and early diagnosis， most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless， 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety， depression， and fear of recurrence and metastasis， and they hope to seek help from traditional Chinese medicine（TCM） treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery， and to improve the diagnosis and treatment level， under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM， experts in oncology， integrated Chinese and western medicine， psychology， surgery， nursing， evidence-based medicine and other disciplines from 10 units nationwide participated in the work， led by Xiyuan Hospital，China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine， the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence， extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics， the needs and willingness to accept psychological rehabilitation， the interventions for psychological rehabilitation， evaluation of efficacy， follow-up review， educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM（integrated Chinese and western medicine） clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology， especially for doctors in primary medical institutions.
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Colorectal cancer is one of the common malignant tumors with high morbidity， and changes in lifestyle， dietary structure and environment in China in recent decades have been associated with an increase in the incidence of colorectal cancer. A large number of studies have shown that traditional Chinese medicine（TCM） can be used as a complementary and alternative treatment for colorectal cancer after conventional western medicine treatment. TCM physicians have accumulated a lot of clinical experience in the treatment of patients with stage Ⅰ-Ⅲ colorectal cancer， and have proved that TCM has unique efficacy， but there is still a lack of relevant clinical practice guidelines to standardize and guide the diagnosis and treatment of TCM. Based on this， according to the guideline development process of the World Health Organization Handbook for Guideline Development and the Clinical Evidence Grading Criteria on TCM Based on Evidence Body， under the framework of relevant laws， regulations and technical guidance documents， combined with the evidence of relevant domestic and foreign clinical research in recent years for evidence grading and opinion recommendation， and then the Guidelines for TCM Intervention After Conventional Western Medicine Treatment for Stage Ⅰ-Ⅲ Colorectal Cancer were developed by expert consensus. This guideline introduces the etiology， pathogenesis， syndrome differentiation and treatment of TCM intervention for colorectal cancer， which can provide guiding opinions for TCM clinicians and clinicians of integrated traditional Chinese and western medicine engaged in the prevention and treatment of colorectal cancer.
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With the development of modern society, the incidence rate of cervicogenic headache (CEH) in the population is younger and increasing year by year. CEH is a common and unique form of headache, characterized by inflammation or physiological changes in cervical structures such as bones, intervertebral discs, or soft tissues, resulting in chronic, unilateral head pain as the main manifestation of the syndrome. The nature of pain often manifests as involving pain. The combination of traditional Chinese and western medicine in the treatment of CEH has gradually become a research hotspot in this field. This article reviews recent domestic and foreign literature on CEH and reviews the latest research progress of traditional Chinese and western medicine treatment in cervical headache.
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Objective:To investigate the application effect of the blended teaching model of "intelligent teaching" and "wisdom learning" in the practice teaching of integrated traditional Chinese and Western medicine in internal medicine.Methods:According to the principle of randomization, 54 interns in Class 1 of integrated traditional Chinese and Western medicine in the grade of 2019 were selected as control group and received traditional teaching, and 56 interns in Class 2 were selected as observation group and received blended teaching with "intelligent teaching" and "wisdom learning". After 6 months of internship, the two groups were compared in terms of the scores of theoretical assessment (basic theoretical knowledge and professional theoretical knowledge), clinical practice ability [Leicester Assessment Package (LAP)], and degree of satisfaction with teaching. SPSS 17.0 was used to perform the t-test and the chi-square test. Results:At the end of internship, compared with the control group, the observation group had significantly higher score of basic theoretical knowledge (41.53±3.42 vs. 38.71±3.38, P<0.05), score of professional theoretical knowledge (39.49±3.14 vs. 37.85±3.07, P<0.05), LAP score (84.32±6.65 vs. 78.46±6.17, P<0.05), and degree of satisfaction with teaching ( P<0.05). Conclusion:For interns majoring in integrated traditional Chinese and Western medicine, the blended teaching model of "intelligent teaching" and "wisdom learning" can strengthen their mastery of theoretical knowledge, enhance their clinical practice ability, and improve their degree of satisfaction with teaching.
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ObjectiveIn view of the standardization of clinical diagnosis and treatment of the acute abdomen and the inheritance of diagnosis and treatment experience of prestigious veteran traditional Chinese medicine（TCM） doctors， a diagnosis and treatment reasoning algorithm based on association rule mining under incomplete evidence（AMIE）+ random walk was proposed to provide information services and technical support for primary doctors by recommending personalized diagnosis and treatment plans based on medical records. MethodThe experience of diagnosis and treatment of acute abdomen of prestigious veteran TCM doctors and the text data of clinical diagnosis and treatment guidelines of integrated TCM and western medicine were collected to complete the task of knowledge extraction and construct acute abdomen knowledge graph based on Neo4j. On the basis of ontology-supported rule-based reasoning， the rule reasoning based on similar syndromes was used to expand the syndrome combinations whose Jaccard similarity was greater than the threshold in the syndrome recommendation results. The semantic path coverage algorithm was used to calculate the semantic similarity between the symptom nodes. The symptom nodes were divided into 10 categories， and the symptom nodes in the same category were extended. The random walk algorithm was used to search the symptom nodes connected with the syndrome， and the connection rules between the syndrome and symptom nodes were extended to realize the knowledge reasoning of AMIE+ random walk. ResultThe acute abdomen knowledge graph included 1 320 nodes and 2 464 relationships. According to the link prediction evaluation index of knowledge reasoning， the reasoning results of the three algorithms in the auxiliary diagnosis and treatment of acute abdomen were compared. The AMIE+ random walk algorithm complemented the knowledge graph by extending the similar syndrome connection rules and the syndrome-symptom connection rules. Compared with the knowledge reasoning algorithm based on ontology rules， the area under the curve （AUC） was 15.18% higher and the accuracy was 30.36% higher， which achieved more accurate and effective knowledge inference. ConclusionThis study used knowledge graph technology to visualize the diagnosis and treatment of acute abdomen with TCM and western medicine， assisting primary clinicians in intuitively viewing the diagnosis and treatment process and data relationship. The proposed diagnosis and treatment reasoning algorithm can realize the personalized diagnosis and treatment plan recommendation at the level of "disease-syndrome-diagnosis-treatment-prescription"， which can assist primary doctors in disease diagnosis and treatment and clinical decision-making， contribute to the knowledge sharing and application of diagnosis and treatment experience and clinical guidelines of prestigious veteran TCM doctors， improve the level of primary clinical diagnosis and treatment， and promote the normalization and standardization of the diagnosis and treatment process of acute abdomen with integrated TCM and western medicine.
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SUMMARY OBJECTIVE: This study aimed at the oral health problems of elderly patients with diabetes. A training course of integrated traditional Chinese and Western medicine was constructed, helping patients improve their oral health quality of life. METHODS: A randomized controlled prospective experimental study was conducted. A total of 190 elderly patients were divided randomly into an observation group and a control group with 95 cases in each. The control group received regular health education, while the observation group was based on the control group to implement the integrated experiential learning of traditional Chinese and Western medicine in small groups. The oral health knowledge, attitude, behavior, and blood glucose control status along with the oral health quality of life of the two groups were compared before the intervention and at 3-month postintervention. RESULTS: Three months after the intervention, the fasting blood glucose control and the 2-h postprandial blood glucose/glycosylated hemoglobin levels in the observation group were significantly better than in the control group, and the difference was statistically significant (p<0.05). The oral health quality of life in the observation group was significantly better than in the control group, and the difference was statistically significant (p<0.05). CONCLUSION: The small-group experiential learning model of integrated Chinese and Western medicine can promote the transformation of knowledge-beliefs-behaviors in elderly patients with diabetes, which is conducive to controlling blood sugar levels and improving the quality of oral health.
Subject(s)
Humans , Aged , Oral Health , Diabetes Mellitus/therapy , Quality of Life , China , Prospective Studies , Problem-Based Learning , Medicine, Chinese TraditionalABSTRACT
Hyperthyroidism is a systemic disease characterized by clinical signs and symptoms of hypermetabolism and sympathetic nervous excitement. Based on the clinical diagnostic criteria of traditional Chinese and western medicine for hyperthyroidism，the present study summarized and evaluated animal models of hyperthyroidism. In model evaluation，the models with high coincidence degree in western medicine included the exogenous drug delivery model， the model immune to adenovirus expressing thyrotropin receptor （TSHR），the model immune to nucleic acid， and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. The models with high coincidence degrees in traditional Chinese medicine included the exogenous drug delivery model， the model immune to adenovirus expressing TSHR，and the model of liver-yang ascendant hyperactivity syndrome and the model of yin deficiency and effulgent fire syndrome in the disease-syndrome combination. In light of the coincidence degree， and advantages and disadvantages of traditional Chinese and western medicine，the ideal hyperthyroidism animal models are the exogenous drug delivery model， and the model immune to adenovirus expressing TSHR. In addition to the evaluation of the coincidence degree of animal models of hyperthyroidism in traditional Chinese and western medicine，this study also analyzed the advantages，disadvantages， and problems of the animal models of hyperthyroidism. Most of the animal models of hyperthyroidism were not consistent with the complexity of hyperthyroidism in clinical practice， and standardized and unified syndrome differentiation standards and four-examination information collection standards have not yet been formed. Besides， there have been few studies on the hyperthyroidism model in disease-syndrome combination in traditional Chinese medicine. To make the animal models of hyperthyroidism suitable for clinical practice，the present study proposed the improvement directions of animal models of hyperthyroidism and the necessity of promoting the evaluation system to provide a theoretical basis for the evaluation of the curative effect of Chinese medicine on hyperthyroidism， and exploration of its pharmacological action， as well as the follow-up research on the pathogenesis，prevention， and treatment of hyperthyroidism，which is expected to establish a perfect disease-syndrome model of hyperthyroidism in line with clinical characteristics of traditional Chinese and western medicine.
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In the clinical practice of rheumatic immune diseases in traditional Chinese medicine （TCM），it`s still unclear about the dominant diseases and breakthrough points. It`s urgent missions to formulate TCM diagnosis and treatment guidelines widely recognized and integrated by traditional Chinese medicine and Western medicine. In order to clarify the dominant diseases and breakthrough points in rheumatism，China association of Chinese medicine initiated a research group covering experts in the field of rheumatism of traditional Chinese medicine and Western medicine. Based on questionnaire survey and on-site discussion，experts had reached the following consensus. Evidence-based medicine research using modern medical methods and scientific methods should be carried out to provide objective clinical evidences. "Four mutuality" were put forward as the basis for the work of integrated traditional Chinese and Western medicine，that is the mutual communication using the exchangeable context，the mutual explanation using common theories，the mutual certification using common standards，and the mutual integration using common means. Key works should focus on solving refractory rheumatism in the future. In terms of dominant diseases and breakthrough points，this paper introduces 21 breakthrough points in 6 dominant diseases，including rheumatoid arthritis，ankylosing spondylitis，Sjogren's syndrome，hyperuricemia and gout，systemic lupus erythematosus and fibromyalgia syndrome. Advice on this discussion can provide valuable references for developing the treatment scheme of rheumatism with TCM and integrated Chinese and Western medicine and clinical practice and scientific research.