1.Postoperative Stage-based Functional Protection Strategies for Lung Cancer Based on Theory of "Lungs Governing Qi"
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Wei HOU ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):86-93
Lung cancer (LC) is a significant global public health issue, with both its incidence and mortality rates ranking among the highest worldwide. The age-standardized incidence and mortality rates are increasing annually, posing a serious threat to the life and health of LC patients. Radical surgical resection is the primary treatment for malignant lung tumors. However, postoperative multidimensional functional impairments, including respiratory, mucosal, and psychological functions, are common. These impairments not only reduce patients' quality of life and affect their treatment tolerance and duration, but also negatively correlate with prognosis, facilitating disease recurrence and metastasis. At present, postoperative functional dysfunction after LC surgery remains a key clinical challenge that urgently needs to be addressed. There is a lack of standardized and regulated postoperative rehabilitation treatment management and traditional Chinese medicine (TCM) differentiation and treatment strategies for LC. Focusing on the core underlying pathogenesis of "Qi sinking" after LC surgery, and guided by the classical TCM theory of "lungs governing Qi", this study, based on the core concept of the "five perspectives on treatment" theory, innovatively proposes the respiratory dysfunction as the core pathogenesis of "Qi sinking in the chest" during the rapid rehabilitation phase, mucosal dysfunction as the core pathogenesis of "Yin deficiency and Qi sinking" during the postoperative adjuvant treatment phase, and the psychological dysfunction as the core pathogenesis of "Qi sinking with emotional constraint" during the consolidation phase. Accordingly, stage-specific dynamic functional protection strategies are constructed. In the rapid rehabilitation phase, the strategy emphasizes tonifying Qi and uplifting sinking Qi, with differentiation and treatment based on the principle of ''descending before ascending''. In the adjuvant treatment phase, the approach focuses on nourishing Yin and uplifting Qi, with prescription combinations that integrate unblocking and tonification. In the consolidation phase, the strategy aims to resolve constraint and uplift Qi, with clinical treatment emphasizing a combination of dynamic and static methods. At each stage of functional rehabilitation, clinical differentiation and treatment should support healthy Qi and eliminate pathogenic factors simultaneously. This study is the first to propose the concept of postoperative functional protection in TCM, offering a new approach for TCM differentiation and treatment in the full-cycle, stage-based, and dynamic protection of postoperative function in LC patients. It is expected to contribute to the construction and development of an integrated TCM-Western medicine comprehensive program for cancer prevention and treatment in China.
2.A Hierarchical Strategy for Differentiation and Treatment of Recurrent Aphthous Oral Ulcers Related to Targeted Therapy for Lung Cancer Based on Yin Deficiency and Qi Collapse
Luchang CAO ; Guanghui ZHU ; Ruike GAO ; Manman XU ; Xiaoyu ZHU ; Ming LIN ; Ying ZHANG ; Jie LI
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(18):116-125
Tumor treatment-related adverse reactions are a major focus of clinical concern, among which recurrent aphthous oral ulcers (RAU) associated with targeted therapy for lung cancer (LC) are among the most painful and distressing for patients. Currently, modern medical interventions show limited efficacy, and there is an urgent need for more effective treatment strategies. This study differentiates RAU associated with targeted therapy for LC from chemotherapy-related and ordinary oral ulcers, elucidates the pathophysiological basis of such ulcers, and traces the theoretical origin of "Yin deficiency and Qi collapse". Based on the new system of "five perspectives on diagnosis and treatment" for tumor prevention and treatment, with a focus on the core and symptom perspectives and rooted in the traditional concept of "lung dominating Qi", we innovatively propose the concept of "medicine-induced ulcer" and are the first to introduce the theory of "Yin deficiency and Qi collapse" into the syndrome differentiation and treatment of RAU associated with targeted therapy for LC (i.e., medicine-induced ulcer). We propose that "Yin deficiency and Qi collapse" is the core pathogenesis of medicine-induced ulcers, in which the collapse of formless Qi is the key to their onset, while the deficiency and stasis of tangible Yin and blood constitute the root of recurrence. A hierarchical strategy for syndrome differentiation and treatment is established: first treating the collapse of formless Qi, then replenishing tangible deficiencies, and concurrently preventing recurrence. We emphasize that treatment should address both root and manifestation, with appropriate prioritization. In the acute phase, while relieving symptoms and promoting ulcer healing by nourishing Qi, uplifting collapse, and generating body fluids, attention should also be paid to nourishing spleen Yin, facilitating the circulation of nutritive Qi, and alleviating stasis to target the root pathogenesis and reduce recurrence. A verified case is presented to support this approach. This study enriches the theoretical framework and clinical methods of traditional Chinese medicine (TCM) in the treatment of RAU associated with targeted therapy for LC, promotes symptom management of treatment-related adverse reactions through integrated TCM and Western medicine, and provides theoretical support for the construction and development of a comprehensive differentiation and treatment system for lung cancer prevention, treatment, and rehabilitation.
3.Ultrasonography assistance in reconstruction of soft tissue defect in ankle and foot with perforator pedicled propeller flap: a report of 26 cases
Junming LI ; Yanfang ZHUANG ; Guanghui MA ; Pengwei DAI ; Lei WAN ; Yanhua LI ; Daoxuan LI ; Hejun HUANG ; Shichuang YING ; Yi ZHANG
Chinese Journal of Microsurgery 2024;47(3):273-279
Objective:To explore the clinical effect of perforator pedicled propeller flap (PPPF) in reconstruction of soft tissue defect in ankle and foot, as well as the role of preoperative ultrasonography in assistance of the location of perforators in donor site.Methods:From January 2017 to June 2023, the Department of Microorthopedics of the Second Affiliated Hospital of Luohe Medical College of Higher Education applied PPPF to reconstruct small and medium-sized soft tissue defects in the ankle and foot for 26 patients. The patients were 17 males, 9 females, aged 18 to 68 years old with 46 years old in average. The defect sites were 3 in forefoot and 6 in midfoot and combined with different degrees of tendon and bone exposure, 17 in ankle and heel and combined with various degrees of bone exposure, 12 with ankle open injury and 5 with Achilles tendon exposure. The area of soft tissue defects ranged from 2.5 cm×1.5 cm to 16.0 cm × 6.5 cm. The width of injury was measured before surgery, and a HHD was used to detect the perforators proximal to the defect site, and then high-frequency CDU was used to locate and confirm the location of the perforator and its alignment, blood flow and diameter. The line drawn between the 2 perforators was set as the axis of flap. The donor site was assessed by a "pinching and lifting" method to determine a direct closure of donor site or to have it closed by a flap transfer. The sizes of flap were from 2.8 cm×1.5 cm to 24.0 cm×7.5 cm. Twenty-two donor sites were directly closed and 4 received flap transfers. Four flaps had sutures with the skin nerves in the recipient site. Masquelet technique was performed in 6 patients with bone defects in the surgery. Patients received outpatient reviews with 1-2 weeks of intervals in the first 2 months after surgery, and X-ray reviews per 1-2 months for those with bone implants until bone healing.Results:All flaps survived successfully without any special treatment after surgery, except 1 flap that had blood vessel congestion and showed swelling and poor blood supply to the distal flap at 24 hours after surgery. The blood vessel congestion was revised by removal of part of the suture at the tip of flap pedicle. One week later, the tip of the flap remained with a small area of necrosis, which was then healed after dressing changes. A total of 21 patients were included in postoperative follow-up with 4 months to 3 years. All of the flaps had satisfactory appearance, colour and texture, and without any ulceration. Three cases of nerve suture were also included in follow-up. According to the assessment criteria of British Medical Research Council (BMRC), the sensory recovery of the flaps was found of S 2 in 1 flap and S 3 in 2 flaps. According to the American Orthopaedic Foot and Ankle Society (AOFAS), the ankle-hindfoot function scores, there were excellent in 16 patient and good in 5 patients. Conclusion:With the assistance of ultrasound, the PPPF can be effectively used in reconstruction of soft tissue defects in ankle and foot.
4.Health promotion measures for common allergic diseases
Shunan LIU ; Hongxiang CHEN ; Ying XIONG ; Guanghui LIU ; Weikang ZHOU
Chongqing Medicine 2024;53(1):149-154
Allergic diseases seriously affect people's health,throughout the whole life cycle,from chil-dren to adults and then to the elderly allergy,can be lifelong onset,and need comprehensive prevention and treatment of the whole life cycle.Its occurrence and development have certain rules,it is usually first manifes-ted as atopic dermatitis in infants and young children,and then gradually develops into food allergy,allergic rhinitis(AR),and allergic asthma.Intervention in atopic dermatitis and or reducing the sensitization of food allergens can inhibit the allergic process and reduce the occurrence of AR and allergic asthma.Therefore,inter-vening and blocking the allergic processes is the key to the prevention and treatment of allergic diseases.This article focuses on the comprehensive intervention measures of allergic diseases(including health education,al-lergen intervention,nutrition intervention,daily nursing,psychological intervention)and disease monitoring,in order to promote the development of the prevention and treatment of allergic diseases.
5.Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine
Qianhui SUN ; Guanghui ZHU ; Bowen XU ; Ying ZHANG ; Jie LI
Journal of Traditional Chinese Medicine 2024;65(11):1120-1125
As an important concept in Chinese medicine theory, "qi sinking" is the inheritance and extension of the thought core of sinking of qi in whole body. This article explored the concept of sinking of pectoral qi, center qi, and kidney qi in the theory of qi sinking, and believed that sinking of pectoral qi, stagnation and sinking of center qi, deficiency and sinking of kidney qi were the core pathogenesis of postoperative injury in malignant tumours. Anchored to the method of reinforcing healthy qi and lifting the sunken, this article recommended to identify pattern and treat by guiding supplement and lifting the sunken. For lung gold impairment, heart yang depletion, and pectoral qi sinking, the treatment is to warm and supplement heart and lung, lift pectoral qi, and restore the respiratory function by modified Shengxian Decoction (升陷汤) plus Guizhi Decoction (桂枝汤); for spleen depletion and pathways blockage, liver failing to act freely, and center qi stagnation and sinking, the treatment is to warm and supplement center qi, raise yang and lift the sunken, and restore the digestive function by modified Buzhong Yiqi Decoction (补中益气汤); for source exhausted and essence deficiency, liver qi hiding, and kidney qi deficiency to inward invasion, the treatment is to nourish the kidney and astringe the liver, consolidate the original qi and lift qi, improve the pelvic floor dysfunction, and protect the kidney function by modified Liuwei Dihuang Pill (六味地黄丸) plus Shengma Chaihu Decoction (升麻柴胡汤). Modification need base on different disease patterns and stages, and new ideas for postoperative traditional Chinese medicine treatment and rehabilitation of malignant tumours were provided.
6.Construction and Consideration of Comprehensive Evaluation System for Clinical Effectiveness of Traditional Chinese Medicine in Treating Malignant Tumors
Jingyuan WU ; Bowen XU ; Guanghui ZHU ; Yuansha GE ; Ying ZHANG ; Jie LI
Journal of Traditional Chinese Medicine 2023;64(19):1954-1960
With reference to the comprehensive evaluation system for the clinical effectiveness of Chinese patent medicine, this paper summarized the current status and problems of the comprehensive evaluation of the clinical effectiveness of traditional Chinese medicine (TCM) in the treatment of malignant tumors from seven aspects, including safety, effectiveness, cost-effectiveness, innovation, suitability, accessibility, and TCM features. On this basis, the characteristics of TCM and the disciplinary characteristics of oncology are considered, and multiple sources of evidence, focus on dominant groups of people, consideration of economic toxicity, paying attention to post-marketing research, targeting at patients' willingness of medication, anchoring the supply of TCM services, and introducing symptoms threshold events are further emphasized. Moreover, methods such as nested case-control studies, enrichment designs, real-world research, and intelligent TCM diagnosis and treatment platforms are used to obtain high-level clinical evidence, ultimately building a scientific, homogeneous, and standardized comprehensive evaluation system for the clinical effectiveness of TCM in the treatment of malignant tumors.
7.Design and Implementation of a Diagnosis and Treatment Resource Fusion and Discovery Platform Based on Knowledge Organization
Panpan DENG ; Junlian LI ; Ying CHEN ; Guanghui XIA
Journal of Medical Informatics 2023;44(11):71-77
Purpose/Significance To solve the problems of limited types,insufficient depth of disclosure and low fusion correlation of diagnosis and treatment resources,so as to lay the foundation for semantic fusion and discovery of multi-source heterogeneous diagnosis and treatment resources.Method/Process The paper proposes some fusion methods,such as resource aggregation based on knowledge system,data association based on enhanced knowledge representation,content integration based on entity alignment,etc.,which a-chieves deep standardized description,semantic integration and correlation of thematic resources,literature resources and public health education resources.Result/Conclusion A diagnosis and treatment resource fusion and discovery platform has been developed to support the multi-dimensional fusion and discovery of diagnosis and treatment resources through services such as intelligent retrieval and recom-mendation,result clustering and faceted classification,semantic association,etc.
8.Guidelines for diagnosis and nutritional intervention of mild to moderate non-IgE mediated cow′s milk protein allergy in Chinese infants
Tongxin CHEN ; Li HONG ; Hua WANG ; Jie SHAO ; Fan YANG ; Ying WANG ; Guanghui LIU ; Xiwei XU ; Xiao-Yang SHENG ; Chundi XU
Chinese Journal of Applied Clinical Pediatrics 2022;37(4):241-250
Cow′s milk protein allergy (CMPA) is one of the most common presentations of food allergy seen in early childhood.It is an abnormal immune response caused by cow′s milk protein.CMPA can be clinically subdivided into either immediate-onset IgE mediated or delayed onset non-IgE mediated, or both.At present, concerns regarding the early and timely diagnosis of CMPA have been high-lighted over the years and there are many expert consensus on CMPA in China, but these consensus did not distinguish IgE mediated or non-IgE mediated CMPA.In view of the obvious clinical differences between the two type of CMPA and non-IgE mediated CMPA is more common in infancy, experts focus on pediatric gastroenterology, allergy/immunology, dermatology, nutrition and child healthcare convened by the Allergy Prevention and Control Professional Committee of Chinese Preventive Medicine Association present this guideline to help practitioners in primary care settings to early recognize and make suitable management of non-IgE mediated CMPA in China.The guideline incorporates the cutting-edge international guidance and the actual situation of Chinese children describing in detail the types, clinical features, diagnosis and nutritional intervention of non-IgE mediated CMPA.There are 42 recommendations in 7 categories in total referring to the common questions related to non-IgE mediated CMPA.
9.Control rate of ambulatory blood pressure and influencing factors among hypertensive patients in Shanghai Fengpu community
Haiying CHEN ; Ying YU ; Xiaoxiao CAO ; Guanghui WANG
Chinese Journal of General Practitioners 2022;21(8):731-736
Objective:To analyze the control status of ambulatory blood (BP) pressure and influencing factors among hypertensive patients in Shanghai Fengpu community.Methods:From April 2020 to February 2022, 318 hypertensive patients in Shanghai Fengpu community were enrolled in the study. The basic information and thropometric indicators of patients, course of hypertension, the medication, complications, life habits, and biochemical indicators as well as the ambulatory BP monitoring (ABPM) data were collected. Multivariate analysis was used to evaluate the risk factors for lack of 24-hour BP control.Results:Among 318 patients, 63 cases (19.8%) had an average 24-hour BP controlled; the control rate of daytime BP and nighttime BP was 23.3% (74 cases) and 15.7% (50 cases), respectively. The proportion of combined medication in the control group and non-control group was 46.0% (29/63) and 51.8% (132/255), respectively (χ 2=0.66, P=0.415). There were significant differences in gender, proportion of patients with hypertension>10 years, the office blood pressure control rate, the abnormal diastolic circadian rhythm, abdominal obesity, the level of fasting blood glucose, diabetes, physical activity levels, and smoking and drinking (all P<0.05) between the control group and non-control group. Multivariate analyses showed that male gender ( OR=2.00, 95 %CI:1.07-3.76) and abdominal obesity ( OR=2.04, 95 %CI:1.10-3.76) were risk factors for uncontrolled ambulatory BP. Conclusions:The control rate of ambulatory BP in patients with hypertension is relatively low in Shanghai Fengpu community. The ABPM should be enhanced and the management for hypertensive patients with abdominal obesity and lack of physical activity should be strengthened in the community.
10.Dosimetric contribution of ovoid in the cervical cancer brachy radiotherapy through the intracavity combined with interstitial technique
Zhipeng ZHAO ; Ying LIU ; Zhuang MAO ; Guanghui CHENG
Chinese Journal of Radiological Medicine and Protection 2021;41(3):188-193
Objective:To discuss the dosimetric contribution of the ovoid in the cervical cancer brachytherapy through the intracavity combined with interstitial(IC/IS)technique.Methods:The data on 20 patients with FIGO(2009)stageⅡ A, Ⅱ B or Ⅲ Bcervical cancer treated with radical radiotherapy in China-Japan Union Hospital of Jilin University during 2015-2017 was collected. External irradiation treatment was 45 Gy/1.8 Gy× 25 fractions. Brachytherapy was MRI-guided IC/IS brachytherapy with a prescription of 28 Gy/7 Gy× 4 fractions. All of 20 patients developed two kinds of plans, the ovoid group and the non-ovoid group. The original MRI-guided brachytherapy treatment plan was set(80 fractions)to the ovoid group. As contrast model that removed the ovoid and consisted of tandem combined with needles set to the non-ovoid group was built, and the same physicist designed the plan to make the dose of D90% for high-risk clinical target volume(HR-CTV)similar to the ovoid group. The dosimetric differences of the D90% and D98% for HR-CTV, D90% and D98% for intermediate-risk clinical target volume(IR-CTV)and D2 cm 3 for the bladder, rectum, sigmoid colon and small intestines between two groups of plans were analyze by paired t-test. Results:Compared with the ovoid group, the non-ovoid group showed no significant difference on HR-CTV D90%( P>0.05), but the HR-CTV D98%(6.99±0.60 vs. 6.78±0.76), IR-CTV D90%(4.71±0.58 vs. 4.26±0.57) and D98%(3.77±0.58 vs. 3.26±0.59) of the non-ovoid group decreased significantly( t=3.906, 9.860, 8.636, P<0.05). The sigmoid colon showed no significant difference( P>0.05), while the bladder (5.29±0.67 vs. 4.92±0.74), rectum (3.72±0.69 vs. 3.35±0.92) and small intestines (3.05±1.37 vs. 2.98±1.34) D2 cm 3of the non-ovoid group decreased significantly( t=8.758, 7.543, 8.059, P<0.05). Conclusions:Ovoid is very important for IC/IS technique in cervical cancer brachytherapy. Reasonable optimization of the dose weight ratio of the ovoid and the needle can bring better clinical benefits.

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