Integrated traditional Chinese and Western medicine refers to a clinical diagnosis and treatment model that incorporates the essence of traditional Chinese medicine in regard to treatment decisions based on syndrome differentiation and a reliance on modern western medicine as the basis of diagnosis and treatment.It is an organic combination of the two,with each bringing its own strengths into full play and complementing those of the other.After the founding of the People's Republic of China,the development of the integrated traditional Chinese and Western medicine has been increasingly valued.The unique advantages of the integration of traditional Chinese and Western medicine have been continuously utilized,resulting in fruitful achievements in theoretical inheritance and innovation and in the prevention and treatment of major diseases.Furthermore,integrated traditional Chinese and Western medicine has become a unique system of medicine of China.This article provides a review and elaboration of the entire process of the integration of traditional Chinese and Western medicine,including its significance,status of development,and achievements.It is suggested that,in the field of integrated traditional Chinese and Western medicine,efforts should made to delve into classic theories,identify the right entry points for integration,reconstruct and improve the theoretical system of integrated traditional Chinese and Western medicine by combining the cutting-edge achievements of modern medicine,and focus on enhancing clinical efficacy.

On September 26,2024,the World Federation of Chinese Medicine Societies(WFCMS)officially released the International Guideline for Clinical Practice of Chinese Medicine:Allergic Rhinitis(Standard No.SCM 80-2024).This guideline establishes a standardized framework of integrated Chinese and western medicine for the diagnosis and treatment of allergic rhinitis(AR).The guideline covers Chinese and western medicine diagnosis criteria for allergic rhinitis,and Chinese medicine internal treatment(prescription medicine and proprietary Chinese medicine),external treatment(acupuncture,acupressure,etc.),constitution identification and management strategy,preventive care program,clinical efficacy evaluation system,and core outcome sets(COS).The article outlines the background of this guideline and to explain the development of this guideline.This article outlines the background and development process of this guideline,provides a systematic academic interpretation of the core recommendations,and critically examines the advantages and limitations of this guideline.The goal is to support the clinical application and promotion of standardized Chinese medicine protocols for the management of AR around the world.

Objective: To analyse the mental state of patients with allergic rhinitis (AR) in Chengdu. Methods: One thousand five hundred and thirty-six AR patients from Sichuan Provincial Integrated Traditional Chinese and Western Medicine Hospital, West China Hospital of Sichuan University, Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, Sichuan People′s Hospital, Sichuan Second Hospital of Traditional Chinese Medicine were selected from July 2013 to January 2018. Eight hundred and twenty-seven patients were screened into study group by inclusion and exclusion standards. The symptom check list 90 (SCL-90) was used to group and score the mental state of these patients according to nine classification criteria: gender, BMI, age, marital status, monthly salary, disease duration, living environment, education level and working environment. Then, the scores were compared within groups. Inter-group comparison was made between the study group and the Chinese norm, and the positive factors for psychological disorders were extracted. Four symptoms in the study group, i.e. nasal itching, sneezing, clear discharge and nasal congestion, were scored on the visual analogue scale (VAS). SPSS 19.0 software was used to carry out statistical analysis. Partial correlation analysis was performed between the positive factors and the symptom scores by multiple regression statistical method. Results: The total score of SCL-90 in the study group was 2.64±0.25, which was accorded with mild to moderate mental health impairment. There were 124 (15.0%) without mental health damage, 176 (21.3%) with mild damage, 474 (57.3%) with mild to moderate damage, 41 (5.0%) with moderate to severe damage and 12 (1.4%) with severe damage. The in-group comparison showed that the top three categories of different items were the living environment, gender and working environment. The scores of somatization, obsessive-compulsive symptoms, interpersonal sensitivity, depression, anxiety, psychosis, other (sleep, diet) and total average score of urban residents were higher than that of country residents (3.29±0.61 vs 2.65±0.50, 2.81±0.77 vs 2.05±0.38, 3.10±0.19 vs 2.49±0.67, 3.40±0.84 vs 2.49±0.70, 3.04±0.64 vs 2.33±0.51, 3.02±0.55 vs 2.40±0.77, 3.40±0.41 vs 2.52±0.77, 2.91±0.11 vs 2.29±0.40, Z value was 4.88, 5.25, 4.57, 5.91, 5.09, 4.63, 5.55, -4.55, respectively, all P<0.05). Women scored higher than man for somatization, interpersonal sensitivity, depression and others (2.66±0.51 vs 2.00±0.45, 3.37±0.47 vs 2.63±0.51, 3.44±0.57 vs 2.85±0.52, 3.47±0.36 vs 2.76±0.45, Z value was -5.10, -5.51, -4.86, -5.28, respectively, all P<0.05). The scores of somatization, interpersonal sensitivity, psychosis and other (sleep, diet) were higher in the indoor group than those in the outdoor group (3.49±0.64 vs 2.78±0.46, 3.33±0.30 vs 2.56±0.68, 3.28±0.60 vs 2.67±0.31, 3.50±0.85 vs 2.85±0.37, Z value was 5.31, 5.79, 4.89, 5.00, respectively, all P<0.05). The outdoor group scored higher on obsessive-compulsive symptoms, anxiety and hostility (3.44±0.40 vs 2.83±0.35, 3.40±0.50 vs 2.57±0.93, 3.34±0.88 vs 2.69±0.56, Z value was 4.96, 6.22, 5.08, respectively, all P<0.05). The inter-group comparison found that depression, anxiety, psychosis and other (sleep, diet) could be partially correlated with VAS scores as 4 positive factors. The results of partial correlation analysis showed that depression was positively correlated with sneezing and nasal runny discharge, anxiety was positively correlated with nasal itching and nasal obstruction, psychosis was positively correlated with nasal itching and sneezing, and other (sleep, diet) was positively correlated with nasal runny discharge and nasal obstruction. Conclusion AR patients have mild to moderate mental health impairments, which are correlated with AR symptoms.

OBJECTIVETo investigate the correlation between intrahepatic eovalently closed circular (ccc)DNA of hepatitis B virus (HBV) and pathogen-and patient-related parameters.

METHODSUltrasound-guided liver biopsies were obtained from 60 patients with chronic HBV infection. Levels of intrahepatic HBV cccDNA and serum HBV DNA were measured by quantitative fluorescence PCR. Level of serum hepatitis B surface antigen (HBsAg) was measured by chemiluminescence immunoassay. Clinical parameters, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (AKP), albumin, globulin (GLO), white blood cell, platelet, prothrombin-international normalized ratio, were measured by standard assay. Demographic information was recorded.The correlation between intrahepatic HBV cccDNA and pathogen-and patient-related parameters was assessed.

RESULTSIntrahepatic HBV cccDNA level was negatively correlated with age, GLO, ALT and grade of necroinflammation. Patients with age of 30 years or more showed significantly higher level of HBV cccDNA level than patients under 30 years-old (7.44±0.58 and 5.66±1.35; t=7.157, P less than 0.001). Intrahepatic HBV cccDNA level was positively correlated with serum HBV DNA level (r=0.916, P less than 0.001) and serum HBsAg level (r=0.727, P less than 0.001). The median ratio of HBV cccDNA to HBV DNA was 1.18, and of HBV cccDNA to HBsAg was 1.67.

CONCLUSIONIntrahepatic HBV cccDNA levels decrease with age, level of ALT, level of GLO and grade of liver necroinflammation, but increase with level of serum HBV DNA and level of serum HBsAg. To a certain extent, serum HBV DNA and serum HBsAg levels may be a sufficient marker of intrahepatic HBV cccDNA levels.

Age Distribution ; Alanine Transaminase ; Aspartate Aminotransferases ; Biomarkers ; DNA, Circular ; DNA, Viral ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic ; Humans ; Real-Time Polymerase Chain Reaction ; Serologic Tests

Through summarization on published literatures on allergic rat model in recent 20 years, domestic current research status and trend were analyzed. Some insights were provided on how to build a standard process for modeling and post-modeling evaluation. “Allergic rhinitis,” “rat model of allergic rhinitis”, or “animal experiment” was used as search terms. Related published articles were searched in the CNKI database from August, 1993 to October, 2013. Documents and data, including modeling method, drug dose, modeling cycle, model assessment described in the articles were extracted, summarized and quantitative analyzed. The results showed that 208 valid articles were included in this study. SD rat was used as animal model. Ovalbumin plus aluminum hydroxide were used as adjuvant sensitizing agents. Intraperitoneal injection plus nasal stimulation were the most commonly used modeling method. Behavioral evaluation scale score was used as the main evaluation index. It was concluded that currently there were many methods for allergic rhinitis animal modeling domestically. The post-modeling evaluation was relatively single. It was urgent and necessary to establish the standard process for modeling and post-modeling evaluation for allergic rhinitis animal model.

Objective To analyze the correlation between covalently closed circular DNA (cccDNA) in the peripheral blood mononuclear cells (PBMC) of hepatitis B virus (HBV)-infected patients and serum HBV DNA,hepatitis B surface antigen (HBsAg),hepatitis B e antigen (HBeAg) and liver histology of hepatitis B patients,and to explore the clinical significance of HBV cccDNA detection in PBMC.Methods One hundred and eight patients with chronic HBV infection were involved in this study.PBMC were extracted using density gradient centrifugation.HBV cccDNA in PBMC and serum HBV DNA were detected by real-time fluorescence quantitative polymerase chain reaction.HBsAg and HBeAg were detected by chemiluminescence immunoassay.Liver biopsy was conducted in 59 out of the 108 patients.Chi-square test was used to compare the categorical variables.Correlation analysis was used to compare quantitative variables.Nonparametric test was used to compare the non-normal distribution parameters.Results In the overall population,HBV cccDNA in PBMC was positive in 59 patients (54.6％).Eleven of the 15 patients with liver failure were found to be HBV cccDNA positive,which was significantly higher than that in the acute hepatitis B group (only 2 of the 8 patients were HBV cccDNA positive; x2 =4.960,P＜0.05).One hundred and eight patients were categorized into three groups according to their serum HBV DNA levels,with group A:＞5 lg copy/mL,group B:3-5 lg copy/mL and group C:＜3 lg copy/mL.The proportions of HBV cccDNA positivity in PBMC in three groups were 76.1％ (51/67),5/18 and 13.0％ (3/23),respectively.Comparing with patients with lower HBV DNA (group B and C),the proportion of HBV cccDNA positivity was higher in patients with higher HBV DNA (group A; x2=14.751,P＜0.05 and x2 =28.384,P＜0.05,resepectively).The HBV cccDNA quantitation in PBMC was positively correlated with the serum HBV DNA level and HBsAg quantification (r=0.554,P＜0.05 and r=0.497,P＜0.05,respectively).The proportion of HBV cccDNA positivity in PBMC of patients with liver histology ≥G2 and/or ≥S2 was significantly higher than that in patients with liver histology ＜ G2/S2 (x2 =9.159,P＜0.05).Conclusions HBV cccDNA exists in PBMC of hepatitis B patients.The HBV cccDNA quantitation in PBMC is positively correlated with the serum level of HBV DNA and HBsAg quantification,and is also associated with liver histology injury.

Objective To explore the clinical value of early diagnosis of atherosclerosis in patients with systemic lupus erythematosus (SLE) using vascular echo-tracking technique and to detect changes of elastieity of carotid artery quantitatively in SLE patients.Methods Fifry patients with SLE were divided into SLE1 group(duration≤1 year),and SLE2 group(duration>1 year)based on different course.An ultrasonic echo-tracking method was used to measure patients'pressure strain elastic modulus (Ep),the stiffness constant(β),arterial compliance(AC),augmentation index(AI),pulse wave velocity (PWVβ) and intimamedia thickness(IMT)of the common carotid arteries in 50 patients with SLE and in 25 healthy control subjects.Results Among carotid artery elasticity indicators of three groups,there was no significant difference in AI(P>0.05).Ep,β,PWVβ parameters of SLE1 group and SLE2 group were statistically higher than that of the control group[Ep of SLE1 group,SLE2 group,control group was (69±20),(103±40),(48±18)kPa respectively;β was 5.2±1.9,8.0±3.1,4.2±1.3 respectively;PWVβ was 5.2±0.7,6.3±1.1,4.5±0.7]respectively,but AC(AC of SLE1 group,SLE2 group,control group was(1.1±0.3),(0.8±0.3),(1.2±0.6)mm2/k respectively]lower than the controls(P<0.01).Ep,β,PWVβ in SLE2 group was significantly increased compared with SLE1 group,but AC was decreased (P<0.01).Conclusion The application of echo-tracking technology can be used to diagnose early atherosclerosis.Complications of cardiovascular disease in SLE have high clinical value.

Objective To detect the integration of hepatitis B virus (HBV) DNA in HBVrelated human hepatocellular carcinomas (HCC). Methods Extracted DNA from the liver tissue samples and amplified by nested polymerase chain reaction (PCR) with specially designed U-base primers. According to the known genes and human Alu repeat sequences (Alu repeat) , primers were designed respectively. Integrated clones combined target HBV DNA and the adjacent cell gene sequences were established by PCR and products were sequenced by biotechnology companies.Accurate locations of HBV genes integrated in the human genomes were analyzed by national center for biotechnology information (NCBI) basic local alignment search tool (BLAST) and Map Viewer search. Results In 24 HBsAg positive HCC samples, 15 cases showed the integrations of HBV fragment. And the other 8 samples didn't show any evidence of integration. Among 14 samples with integration, forward insertions of HBV DNA into the host chromosomal DNA were found in 10 samples and reverse insertions were found in 8 samples while both forward and reverse insertions were found in 5 samples. Analysis from viral-cellular junctions suggested that the integrations were all happened with truncated viral DNA and could be in any locus of X gene. Conclusion HBV DNA integration is not distributed evenly throughout the host genome.

OBJECTIVE: To provide anatomic data of pterygopalatine fossa(PPF) for endoscopic PPF surgery. METHOD: Fifteen wet adult skull specimen fixed in 10% formaldehyde were studies. From center the skulls were sawed, the middle and inferior turbinate were resected, the anterior and posterior ethmoid sinuses were resected. Then after punch out perpendicular part of palatine bone and posterior wall of maxillary,the pterygopalatine fossa were showed and some related measurements were made. RESULT: This pathway can lead to a good view of pterygopalatine fossa. The main soft structures in PPF were maxillary artery and nerve with their branches. The diameter of artery branches was smaller than 3 mm. CONCLUSION The endoscopic PPF surgery is safe and practical from the anatomic data.
Adult ; Endoscopy ; Ethmoid Sinus ; anatomy & histology ; Humans ; Maxilla ; anatomy & histology ; Maxillary Artery ; anatomy & histology ; Maxillary Sinus ; anatomy & histology ; surgery ; Nasal Cavity ; surgery ; Palate, Hard ; anatomy & histology ; Pterygopalatine Fossa ; anatomy & histology ; surgery

OBJECTIVE: To provide transsphenoidal endoscopic surgery with the anatomic reference through anatomic study on the lateral wall of sphenoid sinus under transnasal endoscope. METHOD: The dissection of the lateral wall of sphenoid sinus were performed on 10(20 sides) damp cadaveric heads of Chinese adults via transsphenoidal approach. The anatomic relationship of the lateral wall of sphenoid sinus and its adjacent structures were observed. The distance and angle from the bony prominence of optic canal and internal carotid artery to the columella nasi and midline of sellar floor were measured by ruler and protractor respectively. RESULT: From the study of endoscopic anatomy, the specific structure of optic canal and internal carotid artery were found, and the lateral wall of the cavernous sinus could be exposed by tracing the internal carotid artery. The mean distance from the midpoint of the medial wall of optic canal orbital aperture and the anterior bony prominence of internal carotid artery to the columella nasi were (75. 33 +/- 5. 59)mm and (81. 02 +/- 5. 29) mm respectively, to the midline of sellar floor were (5. 81+/- 1. 52)mm and (5. 53 +/- l. 47)mm respectively. The angle from the midpoint of the medial wall of optic canal orbital aperture to columella nasi was (53.4 +/- 4. 1) degrees. CONCLUSION Taken the columella nasi and midline of sellar floor as the reference points, the anatomic observation and measurement under endoscope via transsphenoidal approach can provide a guide for surgeons.
Adult ; Anatomy, Regional ; Endoscopy ; Humans ; Sphenoid Sinus ; anatomy & histology ; surgery