Acupuncture Therapy ; Database Management Systems ; Integrative Medicine ; Internationality ; Medicine, Chinese Traditional ; Research Design

The field of integrative medicine (IM) has grown tremendously in the United States over last two decades, in terms of clinical practice, research, and education. Its growing popularity among patients has led to increased need for physicians with appropriate counseling skills and a knowledge base of the efficacy and safety of complementary and alternative medicine (CAM) therapies. Family medicine is the first specialty as a whole to embrace IM, which encounters similar ailing conditions and emphasizes similar core values-person centered, evidence based, proactive, and continuous in nature. As integrative family medicine emerges, family medicine educators have developed suggested curriculum guidelines and approved measurable competencies to implement the best of evidence-based CAM and principles of IM. There are currently over 40 family medicine residencies that officially advertise CAM/IM in their programs. Meanwhile, IM centers have also been developing their own primary care programs based on their unique characteristics. This physician-led IM workforce is similar to that of China's IM in the early 1960s. As the Chinese government embarks on repeating its efforts to educate more Western medicine trained physicians in Chinese medicine in primary care training programs, the process and insights related to implementation of their practice in the United States would provide useful food for thought.
China ; Complementary Therapies ; Curriculum ; Education, Medical ; Humans ; Integrative Medicine ; education ; Internship and Residency ; Physicians ; Primary Health Care ; United States

Objective To explore the protective mechanism of tea polyphenols (TPs) ion oxidative stress damage of the rat articular cartilage tissue caused by brick-tea fluorosis. Methods One hundred and twenty wistar male rats were randomly divided into 6 groups according to body mass: fluoride group with drinking water containing 100.00 mg/L F-, fluoride plus TPs group treated with 100.00 mg/L F- and 10.0 g/L TPs, fluoride plus aluminum group fed with 100.00 mg/L F- and 200.00 mg/L Al3+, fluoride plus aluminium and TPs group treated with 100.00 mg/L F-,200.O0 mg/L Al3+ and 10.0 g/L TPs;brick-tea group treated with drinking water containing 100.00 mg/L F-,215.00 mg/L Al3+ and 9.2 g/L TPs, which was steeped by the brick-tea;control group treated with tap water. The animals were bred for three months and then sacrificed. The level of SOD,T-AOC and MDA in blood serum were detected,also the level of NO and cytokine IL-1β and IL-6, the expression of iNOS mRNA and protein in articular cartilage were respectively analyzed by RT-PCR and immunohistochemistry. Results Blood serum SOD level in the fluoride plus aluminum and TPs group[(664.009 ± 29.589)kU/L] was higher compared with that in the fluoride group[(625.328 ± 27.199)kU/L], fluoride plus aluminum group[(652.282±13.926)kU/L], although no statistically significant differences was found(P > 0.05) ;blood serum T-AOC level of the fluoride plus TPs, fluoride plus aluminum and TPs group, brick tea group[(10.874 ± 0.721), (11.871 ± 0.941), (10.380 ± 2.747)kU/L] was higher compared with fluoride group, fluoride plus aluminum group [(8.849 ± 1.887), (8.210 ± 1.740)kU/L], the differences all being statistically significant(P < 0.05) ;blood serum MDA level in the fluoride plus aluminum and TPs group[(3.235 ± 0.446)μmol/L] had significances compared with fluoride group, fluoride plus aluminum group [(3.889 ± 0.387), (4.580 ± 0.474)μmol/L, all P < 0.05)];blood serum NO level in fluoride plus Tps group, fluoride plus aluminum and TPs group, brick-tea group[(23.278 ± 2.386), (20.643 ± 2.623), (24.367 ± 6.072) μmol/L] had tatistical differences compared with fluoride group, fluoride plus aluminum group[(32.962 ± 8.268), (34.909 ± 6.288)μmol/L, all P < 0.05];blood serum IL-1β level of fluoride group, fluoride plus aluminum, fluoride plus Tps, fluoride plus aluminum and TPs group and brick-tea group [(4.728 ± 0.297), (4.412 ± 0.229), (4.432 ± 0.285), (4.516 ± 0.351), (4.614 ±0.2270)n/L] did not have inter-group differences (F = 2.314,P > 0.05);the blood serum IL-6 level of fluoride plus aluminum and TPs group, brick-tea group[(7.231 ± 0.596), (7.325 ± 0.290)ng/L] had statistical differences compared with fluoride plus aluminum[(8.256 ± 0.635)ng/L, P < 0.05]. The iNOS mRNA correspondent expression content of fluoride plus Tps group, fluoride plus aluminum and TPs group, brick-tea group(0.482 ± 0.021,0.447±0.021,0.491 ± 0.022) had statistical differences compared with fluoride group, fluoride plus aluminum group (0.562 ± 0.025,0.591 ± 0.020, all P < 0.05). Cells with positive iNOS protein expression of control group were mainly distributed at the surface layer of joint, while the cells of experiment groups were distributed both at the surface layer and the intermediate layer. Conclusions Tea polyphenols could alleviate oxidative stress damage on the articular cartilage, exerting protection against brick-tea fluorosis on rats through cleaning up free radicals, elevating total anti-oxidation capability, diminishing the generation of lipid peroxide.

Objectives To evaluate the effect of control measures and provide the basis for development of preventive measures though dynamical monitoring of the operation of water improvement projects and know The prevalent trends of endemic fluorosis.Methods In accordance with the provisions and requirements of the Surveillance Scheme of Drinking-Water-Borne Endemic Fluorosis(Trial),136 monitoring counties were selected in national 27 provinces(autonomous regions,municipalities) and Xin Jiang Production and Construction Corps,and 10 water improvement projects were selected in each county.The operation of water improvement projects was investigated,and water fluoride content was tested.Three epidemic villages were selected as fixed monitoring villages in each county.In the villages,the fluoride content in drinking water was detected by Standard Testing Method of Drinking Water.Dental fluorosis was diagnosed by Dean's method of all 8 to 12-year-old students in the villages.Stratified random sampling by age was used to select 50 adults over 25-year-old in each monitoring village,and skeletal fluorosis was examined by X-ray according to the Diagnosis Standard of Endemic Skeletal Fluorosis.Results ①A total of 1398 water improvement projects were monitored.Normal and intermittent operation and discarded projects accounted for 93.35％(1305/1398),5.29％(74/1398) and 1.36％(19/1398),respectively.The qualification rate of water fluoride content was 69.96％ (978/1398).② In the 327 surveyed villages with water improvement projects,the qualification rate of water fluoride content of the projects accounted for 76.15％(249/327).In the 84 surveyed villages without water improvement projects,villages of water fluoride ＞ 1.2 mg/L and ≤2.0 mg/L,＞ 2.0 mg/L,and ≤4.0 mg/L,and ＞ 4.0 mg/L,accounted for 57.14％ (48/84),32.14％(27/84) and 10.71％(9/84),respectively.③ In the 195 villages with water improvement projects and the projects were in normal operation with qualified water,the detection rate of dental fluorosis and the defect type of dental fluorosis in children were 25.03％ (3851/15 387) and 1.88％ (289/15 387),respectively,and for the 82 villages with fluoride content exceeded the national standard,the two rates were 56.27％ (3384/6014) and 10.92％(657/6014),respectively.④ In the 195 villages with water improvement projects and the projects were in normal operation with qualified water,the detection rate of X-ray skeletal fluorosis was 19.11％ (1465/7667).In the 79 villages with fluoride content exceeded the national standard,the detection rate of X-ray skeletal fluorosis was 17.47％ (634/3630).Conclusions The operation of water improvement projects and water quality need to be further improved,and the measure of changing water plays a certain role in control of drinking-water-borne endemic fluorosis,which needs a long-term consolidation.

Objective To examine the localization of neuronal specific transcription factor DAT1 mRNA in the central nervous system of the rat. Methods In situ hybridization histochemistry staining method with digoxigen-labeled cRNA probe was used. Results The Transcripts of DAT1 mRNA were localized in somatic and dendritic profiles at most regions of adult rat central nervous system. It can be observed in cerebrum, cerebellum, thalamus, brain stem and spine. The intense hybridization signal can be seen in olfactory bulb, entorhinal cortex, prepirform cortex, striate cortex, hippocampus CA1 and dentate gyrus, lateral dorsal nucleus of thalamus, red nucleus, dorsal tegmental nucleus, central reticular nucleus of medulla oblongata,motor nucleus of trigemina, nucleus of hypoglossal, vagus nerve nucleus, external cuneate nucleus and ambiguous nucleus. The moderate staining was detected in Ⅱ-Ⅵ layer of cerebrum, hippocampus CA2 and CA3, amygdala nucleus, globus pallidus, medial geniculate body, lateral geniculate body, zona incerta, supraoptic nucleus,paraventricular nucleus, arcuate nucleus, substantia nigra, mesencephalon reticular nucleus, reticular nuclei of pons, gigantocellular reticular nucleus, lateral reticular nucleus, medial nucleus of the trapezoid body, vestibular nucleus, dorsal cochlear nucleus, locus ceruleus, cuneate nucleus, nucleus raphes dorsalis. The faint signal showed in septal nuclei, ventral lateral nucleus of thalamus, ventral posterior nucleus of thalamus, posterolateral nucleus of thalamus, dorsomedial nucleus of thalamus, anterodorsal nucleus of thalamus, premammillary nucleus, central gray, superficial gray layer of the superior colliculeus, central nucleus of the inferior colliculeus, lateral nucleus of the inferior colliculeus, trigeminal mesencephalic nucleus, spinal nucleus of trigeminal, nucleus of solitary tract, inferior olivary nucleus, superior central nucleus, cerebellar fastigial nucleus, interposed cerebellared nucleus, lateral cerebellellar nucleus and spinal cord gray matter. Conclusion The results demonstrated the widely presence of DAT1 mRNA in adult rat central nervous system ,close related to the dopaminergic nervous system, suggesting a role of regulation for this gene in various functions of rat central nervous system, especially in dopamine neurotransmitter regulation.

OBJECTIVETo observe the clinical effect of Chinese medical (CM) syndrome differentiation based Chinese herbs and recombinant human tumor necrosis factor receptor II-antibody fusion protein (etanercept) for treating ankylosing spondylitis (AS) patients.

METHODSTotally 35 AS patients were treated with syndrome differentiation based Chinese herbs and etanercept. Reinforcing Shen and strengthening Du channel, activating meridians to stop pain was principle used in syndrome differentiation based treatment. Etanercept was subcutaneously injected, 25 mg each time; twice per week for the first three months and once a week for the latter three months. The clinical efficacy was evaluated after 3 and 6 months of treatment. Meanwhile, ASAS20 and ASAS50 standards arriving rates were also observed. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), visual analog score (VAS) for spine pain, VAS for night pain, patient global assessment (PGA), VAS for physician global assessment, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, cervical rotation, Schober improved test, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were observed before treatment, 3 and 6 months after treatment.

RESULTSCompared with before treatment, BASDAI, BASFI, VAS for spine pain, night pain, physician global assessment, PGA, CM syndrome score, finger-ground distance, thoracic activity, tragus-wall distance, lumbar scoliosis, Schober improved test, ESR, and CRP all decreased after 3 and 6 months of treatment, with statistical difference (P < 0.05). Cervical rotation also decreased after 6 months of treatment, with statistical difference (P < 0.05). Compared with 3 months of treatment, total effective rate of CM syndrome, ASAS20 and ASAS50 standards arriving rates increased after 6 months of treatment, with statistical difference (P < 0.05). There were statistical differences in all indices mentioned above between after 3 months of treatment and after 6 months of treatment (P < 0.05).

CONCLUSIONSyndrome differentiation based Chinese herbs combined etanercept could alleviate inflammatory reaction favorably, control the progression of active AS, and improve joint functions.

Disease Progression ; Drugs, Chinese Herbal ; therapeutic use ; Etanercept ; therapeutic use ; Humans ; Pain ; prevention & control ; Pain Management ; Spondylitis, Ankylosing ; drug therapy ; Treatment Outcome

Air Pollutants, Occupational ; analysis ; Ammonium Sulfate ; analysis ; Chromatography, Ion Exchange ; methods ; Workplace

0.05)respectively.Histological changes of donor biopsy before implantation and 30 min after reperfusion were similar in two groups.Conclusion Within the cold ischemic time considered,Celsior and UW solution are equal in effectiveness for clinical use in liver transplantation.

Objective To investigate the effect of safflower yellow pigment on plasma D-dimer (D-D) and β-human chorionic gonadotropin (β-HCG) in ectopic pregnancy patients.Methods 96 patients with conservative treatment of ectopic pregnancy from April 2014 to April 2016 in our hospital were divided into control group and experimental group according to the method of drawing lots.The control group was treated with routine therapy, the experimental group was treated with safflower yellow pigment based on the control group.Pelvic mass disappearance time, D-D, β-HCG, vascular endothelial growth factor, carbohydrate antigen 125 and safety of the two groups were compared.Results The total effective rate of the experimental group(97.91%) was higher than that of the control group(83.33%),the difference was statistically significant (P<0.05) .The time of disappearance of pelvic mass in the experimental group was shorter than that in the control group (P<0.05); the levels of VEGF and CA125 in the experimental group were lower than those in the control group ( P<0.05 ) .There was no difference in safety between the two groups. Conclusion Conventional therapy plus safflower yellow pigment can promote the absorption of pelvic mass and reduce the levels of plasma D-D and β-HCG in the conservative treatment of ectopic pregnancy.

ObjectiveTo investigate the protective effect of all-trans retinoic acid (ATRA) on injury of human immortalized hepatocytes (HHL-5 cells ) induced by sodium arsenite and possible mechanisms.Methods After cultured for 48 h,HHL-5 cells were divided into four groups:normal group,ATRA group,sodium arsenite group and ATRA + sodium arsenite group.HHL-5 cell viability was tested by using cell proliferation experiment (WST).Superoxide dismutase(SOD),glutathione peroxidase(GSH-Px) activity,malondialdehyde(MDA) content,and aspartate aminottransferase (AST) activity in each group were determined by biochemical method.The microstructure of HHL-5 cells in each group was observed under transmission electron microscopy.ResultsHHL-5 cell viability(0.57 ± 0.02) of sodium arsenite group was compared with that of normal group(0.70 ± 0.01 ),the difference was statistically significant(P ＜ 0.05).Levels of SOD,GSH-Px,MDA and AST[ (153.84 ± 2.35),(0.08 ±0.02)U/mg Prot,(4.15 ± 0.50)nmol/mg Prot,(265.43 ± 4.62) × 103 U/L] of sodium arsenite group were compared with that of normal group[(237.41 ± 18.30),(0.93 ± 0.02)U/mg Prot,(2.26 ± 0.40)nmol/mg Prot,(177 ± 9.85) ×103 U/L],and the difference was statistically significant (all P ＜ 0.05).HHL-5 cell viability (0.65 ± 0.04) of ATRA + sodium arsenite group was compared with that of sodium arsenite group, and the difference was statistically significant (P ＜ 0.05).Levels of SOD,GSH-Px,MDA and AST[ (286.85 ± 3.39),(0.56 ± 0.09)U/mg Prot,(3.36 ± 0.37)nmol/mg Prot, (220.02 ± 1.07) × 103 U/L] of ATRA+ sodium arsenite group were compared with that of sodium arsenite group,the difference was statistically significant(all P ＜ 0.05).Compared with normal group and ATRA group,the surface microvilli of HHL-5 cells of sodium arsenite group decreased,double-membrane structure was unclear,vacuolar degeneration was seen in the cytoplasm,and glycogen was aggregated.The damage level of ATRA + sodium arsenite group was decreased.ConclusionsATRA plays a protective role through increasing intracellular antioxidant enzyme activity of HHL-5 cells,removal or reduction of oxygen free radicals produced by sodium arsenite.