‍Liver cirrhosis （LC） is the terminal pathological stage of various chronic liver diseases and is characterized by chronic inflammation， diffuse fibrosis， pseudolobular formation， and portal-systemic collateral circulation， which belongs to the category of jaundice， hypochondriac pain， and abdominal distension in traditional Chinese medicine. At present， there is still a lack of specific clinical treatment methods， and integrated traditional Chinese and Western medicine therapy can effectively delay the progression of LC. Based on the principle of evidence-based medicine and with reference to the summary of recent clinical practice and the latest guidelines and expert consensus published in China and globally， the guidelines in this article are formed by objectively evaluating the evidence of integrated traditional Chinese and Western medicine diagnosis and treatment of LC and extensively soliciting the opinions of experts in the fields of traditional Chinese medicine， clinical medicine， and clinical epidemiology， so as to provide a reference for integrated traditional Chinese and Western medicine diagnosis and treatment of LC in clinical practice.

Integrative medicine (IM), usually called integrated traditional and Western medicine in China, which came into being in the 1950s as a new form of medicine, although is now developing quickly, little is known about its status and existing problems. So a national survey in China was conducted through questionnaire in 2004 by Chinese Association of Integrative Medicine with the support of State Administration of Traditional Chinese Medicine (SATCM). The results show that, of all the medical professionals investigated in this survey, 91.21% and 93.52% respondents respectively favored IM as the best diagnostic and therapeutic method. Of all the patients who once went through TCM, Western medicine (WM) and IM therapies, 68.85%, 65.45% and 71.2% respondents respectively most appreciated IM, IM hospitals and IM therapeutic treatments. Most of the 6 595 respondents held that the optimal scientific research strategy in TCM should be integrating modern medical research method (n = 2 380) or modern scientific method (n = 2 920). However, many hospitals exposed the problems in the aspects of governmental supports and funding supports, human resources, and domestic or international academic activities. These results indicated that IM is the patients' social needs and doctors' aspiration in China. For further development of IM, the enhancement of scientific research construction and assistance by policies and finance from the government and other institutions are urgently needed in China.
Attitude of Health Personnel ; China ; Delivery of Health Care, Integrated ; Health Care Surveys ; Humans ; Medicine, Chinese Traditional ; National Health Programs ; Patient Satisfaction ; Physicians ; psychology ; Surveys and Questionnaires

Arthritis, Rheumatoid ; diagnosis ; therapy ; Diagnosis, Differential ; Humans ; Integrative Medicine ; methods ; trends ; Medicine, Chinese Traditional ; methods ; trends ; Professional Practice ; trends ; Therapeutics ; methods ; trends ; Treatment Outcome

In the past 50 years, integration of traditional Chinese medicine and Western medicine, known as the Chinese version of integrative medicine (IM), has achieved significant developments. In this article, the present situation and progress in IM development in China are summarized from the aspects of IM application, policy making, scientific research, education, academic exchanges, and its future development. With continuous support from the Chinese government and successful scientific achievements in the past 50 years, the authors believe that IM will be moving forwards to a full globalization.
China ; Health Policy ; Humans ; Integrative Medicine ; education ; trends ; Professional Practice ; Research

Chronic low-back pain (CLBP) is one of the most common pain conditions. Current clinical guidelines for low-back pain recommend acupuncture for CLBP. However, there are very few high-quality acupuncture studies on CLBP in older adults. Clinical acupuncture experts in the American Traditional Chinese Medicine Association (ATCMA) were interested in the recent grant on CLBP research announced by the National Center for Complementary and Integrative Health. The ATCMA experts held an online discussion on the subject of real-world acupuncture treatments for CLBP in older adults. Seven participants, each with more than 20 years of acupuncture practice, discussed their own unique clinical experience while another participant talked about the potential mechanism of acupuncture in pain management. As a result of the discussion, a picture of a similar treatment strategy emerged across the participants for CLBP in older adults. This discussion shows that acupuncture may have complicated mechanisms in pain management, yet it is effective for the treatment of chronic pain involving maladaptive neuroplasticity; therefore, it should be effective for CLBP in older adults.

Few studies have focused on the cost of acupuncture treatments although acupuncture has become popular in the United States (U.S.). The purpose of the current study was to examine the out-of-pocket costs incurred from acupuncture services based on an online website, OkCopay.com. We examined descriptive statistics (range, median and 20% intervals) for the cost of acupuncture "first-time visits" and "follow-up visits" in 41 metropolitan regions in the U.S. The acupuncture prices of 723 clinics throughout 39 metropolitan regions were included, except for Birmingham, Alabama and Detroit, Michigan as there was no online data available at the time of the study for these two regions. The cost range for a first-time acupuncture visit was $15-400; the highest median was $150 in Charleston, South Carolina, while the lowest was $45 in St. Louis, Missouri. The top 10 cities for the highest median were: Baltimore, Washington, D.C., New York, San Francisco, San Jose, Boston, Atlanta, Seattle, Portland and Indianapolis, with the median $120, while the median for all 723 clinics was $112. For the follow-up visits, the cost range was $15-300; the highest median was $108 in Charleston, South Carolina, and the lowest $40 in Miami, Florida. The 10 cities with highest median follow-up acupuncture visit costs were: New York, Baltimore, New Orleans, Washington, D.C., Philadelphia, San Francisco, San Jose, Seattle, Boston and Atlanta, with the median $85, while for all 723 clinics the median price was $80. The estimation of the average gross annual income of each acupuncturist from the regions studied was $95,760, while the total annual cost of patients seeking acupuncture services in the U.S. was about $3.5 billion in 2018.

OBJECTIVETo investigate the regulatory effect of Yijing Fang (YJF) on adenine-induced infertility in rats with kidney deficiency.

METHODSSixty healthy Wistar male rats, aged 1.5 mo and weighing (180 +/- 10) g, were normally fed for a week, and then divided into five groups of equal number (blank control, infertile model, high-dose YJF, mid-dose YJF, and low-dose YJF) according to the body weight of the rats. The models were made by intragastric administration of 500 mg/ml adenine in gum arabic solution in the ratio of 1:10 at the dose of 1 ml per 100 g body weight per day for 10 days. YJF was given at 3.38 g, 1.69 g and 0.85 g per 100 g body weight per day to the rats in the high-, mid- and low-dose groups, respectively. After 48 days of treatment, we observed kidney deficiency-related changes in sperm concentration and motility, the levels of testosterone (T) and other hormones and the volumes of the testis, epididymis, seminal vesicle and prostate, and compared the indexes among different groups.

RESULTSYJF exhibited a significant regulatory effect on sperm concentration and motility, the T level and the indexes of the gonad and other accessory glands in the model rats (P < 0.05). After 48 days of treatment, sperm concentrations were (87.85 +/- 28.44), (7.11 +/- 2.15), (35.98 +/- 14.04), (32.65 +/- 11.80) and (33.51 +/- 13.26) x 10(6)/ml in the blank control, infertile model, high-dose YJF, mid-dose YJF, and low-dose YJF groups, respectively; sperm motilities were (52.79 +/- 16.43), (31.14 +/- 3.07), (45.88 +/- 16.97), (51.56 +/- 13.35) and (49.53 +/- 10.16)%; the T levels were (194.07 +/- 40.29), (61.27 +/- 13.70), (121.87 +/- 24.35), (127.44 +/- 19.38) and (127.81 +/- 20.28) nmol/L; the luteinizing hormone (LH) levels were (7.017 +/- 0.269), (6.117 +/- 0.894), (7.060 +/- 0.871), (7.156 +/- 0.937) and (6.967 +/- 0.778) IU/L; the testis volumes were (3.775 +/- 0.183), (2.865 +/- 0.258), (3.236 +/- 0.058), (3.457 +/- 0.066) and (3.398 +/- 0.091) g; the epididymis volumes were (1.119 +/- 0.116), (0.833 +/- 0.226), (1.124 +/- 0.104), (1.132 +/- 0.107) and (1.114 +/- 0.106) g; the prostate volumes were (176.75 +/- 427.09), (131.67 +/- 39.45), (178.70 +/- 37.97), (180.11 +/- 37.39) and (179.00 +/- 35.42) mg; and the body weights were (188.50 +/- 7.12), (189.92 +/- 6.67), (187.42 +/- 5.47), (189.17 +/- 6.19) and (188.75 +/- 6.12) g. Testis histopathology showed obvious injuries in the infertile models and different degrees of improvement in the three YJF groups, most evidently in the mid-dose group.

CONCLUSIONYifing Fang had an evident therapeutic effect on kidney deficiency-related infertility in adenine-induced rat models.

Adenine ; adverse effects ; Animals ; Disease Models, Animal ; Drugs, Chinese Herbal ; therapeutic use ; Infertility, Male ; chemically induced ; drug therapy ; Male ; Phytotherapy ; Rats ; Rats, Wistar