1.Pathogenesis and Treatment Strategies of Tumor Angiogenesis Based on the Theory "Latent Wind in Collaterals"
Zhenqing PU ; Guibin WANG ; Chenyang ZHANG ; Yi LI ; Bo PANG ; Baojin HUA
Journal of Traditional Chinese Medicine 2025;66(2):139-144
This article combined the pathogenic characteristics of "latent wind" with the theory of collateral diseases to clarify the pathological features of tumor blood vessels, including their active proliferation, high permeabi-lity, and promotion of metastasis. The theory framework of "latent wind in collaterals" as the tumor mechanism was proposed, which suggests that at the site of tumor lesions, the collaterals inherit the nature of latent wind to grow excessively, adopt an open and discharge nature to leak essence, and tumor toxins, characterized by their rapid movement and frequent changes, spread and metastasize, driving the progression of malignant tumors. Focusing on the fundamental pathogenesis of "latent wind in collaterals", specific clinical treatment principles and methods centered on treating wind are proposed, including regulating qi and dispelling wind, clearing heat and extinguishing wind, unblocking collaterals and expelling wind, and reinforcing healthy qi to calm wind, so as to provide references for enhancing the precision of traditional Chinese medicine in treating malignant tumors.
2.Experience of LIN Yi in Disease-Syndrome-Syptom Differentiation and Treatment of Breast Cancer in Consolidation Phase
Xinyue ZHAO ; Guibin WANG ; HongLin SITU ;
Journal of Traditional Chinese Medicine 2024;65(1):26-30
This article summarized the clinical experience of Professor LIN Yi in applying the idea of disease-syndrome-syptom combination to the differentiation and treatment of breast cancer in consolidation phase. It is believed that the fundamental pathogenesis of breast cancer in consolidation phase is deficiency of healthy qi, so the treatment should emphasize on reinforcing healthy qi as the main and eliminating pathogen as the supplement. Commonly, Sijunzi Decoction (四君子汤), Shenling Baizhu Powder (参苓白术散), and Liuwei Dihuang Decoction (六味地黄汤) are used as the basic formula to strengthen the spleen and kidney to reinforce healthy qi, and Baihua Sheshe Cao (Scleromitrion diffusum [Willd.] R.J.Wang), Yiyiren (Coix lacryma-jobi L.), and ezhu (Curcuma aromatica Salisb.) are used to eliminate cancer toxin. It is also believed that the biological characteristics of different molecular subtypes of breast cancer are of great significance to the syndrome differentiation and treatment in traditional Chinese medicine, therefore, the formulas used in clinical practice are often selected taking into considerations of molecular subtypes of breast cancer. For those with positive sex hormone receptor, the most important thing is to replenish the congenital and benefit kidney essence, with modified Baihua Qiqi Decoction (白花芪杞汤); for those with negative sex hormone receptor, the first step is to strengthen spleen and replenish kidneys, and it is especially important to strengthen the spleen with Baihua Qiling Decoction (白花芪苓汤). At the same time, it is suggested that the primary and the secondary symptoms of patients should be differentiated, and the diseases and symptoms, as well as the modern medical laboratory indicators should be combined to give suitable medication.
3.Concept and strategy of traditional Chinese medicine balanced treatment of breast cancer from the perspective of "pathogenesis and state identification"
Guibin WANG ; Honglin SITU ; Li GUO ; Zhuobin WEN ; Hanguang JING ; Yi LIN
Journal of Beijing University of Traditional Chinese Medicine 2024;47(3):440-444
In view of the difficulties and blind spots of western medicine, how to make scientific decisions to standardize the treatment of breast cancer in traditional Chinese medicine and improve the participation of traditional Chinese medicine in the treatment of breast cancer is an important focus of innovative breakthroughs in breast cancer treatment. Based on the clinical experience of Professor LIN Yi, a master of traditional Chinese medicine, and on the basis of "disease identification and syndrome differentiation", this paper summarizes and refines the status of qi and blood imbalance, accumulation of phlegm and blood stasis, viscera deficiency, and cold heat cementation in breast cancer, and further proposes the "six views" of breast cancer balanced treatment: the pathogenesis view focuses on "evil invasion due to vital qi deficiency, and the proliferation of tumors", and the pathogenesis view focuses on "cancer toxin and imbalance of yin and yang", the diagnostic view focuses on "examining the underlying factors and understanding the causes and effects", the differentiation view focuses on "balancing qi, blood, yin, and yang to achieve harmony", the therapeutic view focuses on "supporting vital qi and eliminating evil, and considering the root cause and syndromes", and the rehabilitation view focuses on "adjusting balance to maintain a stable state". We are committed to holistic syndrome differentiation and treatment, balancing yin, yang, qi, and blood, thereby harmonizing the internal environment of the human body, and mobilizing the immune and rehabilitation functions of the body.
4.Quality Control and Analysis of Treatment for Hospitalized Cancer Patients: Interview and Medical Records Study from Nine Hospitals in Beijing
Liting LU ; Yanping ZHOU ; Xiang WANG ; Xiaoyuan LI ; Xiaorong HOU ; Lidong ZHU ; Xiaohong XU ; Guibin SUN ; Ziyuan WANG ; Jieshi ZHANG ; Lin ZHAO ; Yi BA
Medical Journal of Peking Union Medical College Hospital 2024;16(2):399-405
To analyze the current quality of treatment for hospitalized cancer patients in Beijing, identify major issues in treatment practices, and propose improvements. Nine hospitals in Beijing were selected for examination. Expert on-site interviews and medical record sampling were conducted. The "Beijing Cancer Diagnosis and Treatment Quality Control Checklist" was used to assess the hardware, management, anti-cancer drug therapy, radiation therapy, and surgical treatment during cancer treatment at these hospitals from January to October 2023. The relevant problems were analyzed. Among the nine hospitals, two (22.2%) were equipped with laminar flow rooms, and three (33.3%) had intravenous drug preparation centers. In terms of institutional management, seven hospitals (77.8%) had standardized anti-cancer drug prescription authority management, eight (88.9%) had complete emergency plans, and five (55.6%) had oncology specialist pharmacists. Regarding anti-cancer drug therapy, the areas with higher completion rates included pathology diagnosis support (97.6%), routine pre-treatment examinations (96.3%), adverse reaction evaluation(92.7%), discharge summaries (95.1%), and admission records (91.5%). However, the accuracy of tumor staging before treatment (70.7%) and the evaluation of therapeutic efficacy after drug treatment (76.9%) needed improvement. The oncology specialty significantly outperformed the non-oncology specialty in terms of the accuracy rate of TNM staging (86.0% There remains significant room for improvement in the quality of cancer treatment in China. It is recommended to standardize tumor staging assessment processes, strengthen entry assessments for non-oncology departments, promote the implementation of multidisciplinary treatment models, and establish a multi-department collaborative management model.Continuous monitoring of cancer diagnosis and treatment quality indicators is essential to promote ongoing improvements in cancer treatment quality.
5.Risk analysis of no-reflow phenomenon in patients with ST-segment elevation myo-cardial infarction based on HALP dynamic nomogram
Xing WANG ; Yan ZHANG ; Minglei ZHANG ; Jianbu GAO ; Yongjie ZHANG ; Guibin QI
Chinese Journal of Arteriosclerosis 2024;32(11):972-978
Aim To develop and validate a dynamic nomogram to predict the risk of no-reflow phenomenon(NRP)after percutaneous coronary intervention(PCI)in patients with ST-segment elevation myocardial infarction(STE-MI)by constructing HALP based on haemoglobin(Hb),albumin(Alb),lymphocytes(LYM),and platelets(PLT).Methods A retrospective analysis of 449 STEMI patients admitted to Nanyang Central Hospital from January 2022 to Janu-ary 2024 was divided into 145 cases in the NRP group and 304 cases in the normal reflow group according to whether the patients developed NRP after surgery.HALP was calculated based on Hb,Alb,LYM and PLT observations.Independ-ent influences on NRP risk were determined by multivariate Logistic regression analysis.Dynamic nomogram of NRP risk after PCI in STEMI patients were developed using the R language correlation software package.Results The incidence of NRP was 32.3%(145/449)among 449 patients with NRP.The HALP of patients in the NRP group was lower than that of patients in the normal reflow group(P<0.05).The area under the curve(AUC)of HALP for diagno-sis of NRP was 0.880(0.847-0.909),and the Kappa coefficient of its optimal cutoff value ≤3.04 versus patients with accurate diagnosis of NRP was 0.612.The results of multivariate Logistic regression analysis showed that age,diabetes mellitus,and high sensitivity C-reactive protein(hs-CRP)were independent risk factors for NRP after PCI in STEMI pa-tients(P<0.05),and left ventricular ejection fraction(LVEF)and HALP were independent protective factors(P<0.05).A dynamic nomogram(https://xz0311.shinyapps.io/DynNamicNRP/)based on HALP combined with age,di-abetes,LVEF,and hs-CRP was effective in predicting the risk of post-PCI NRP in STEM1 patients.Conclusion HALP is more effective than traditional risk factors in predicting NRP risk in STEMI patients after PCI,and the dynamic nomogram developed based on HALP will help develop personalized treatment strategies for patients with high NRP risk.
6.Application of transitional care based on Siebens domain management model in patients with atrial fibrillation
Xinmin WANG ; Jinhong MIAO ; Jianbu GAO ; Guibin QI
Chinese Journal of Modern Nursing 2024;30(24):3305-3308
Objective:To explore the application effect of transitional care based on Siebens domain management model in patients with atrial fibrillation.Methods:Using the convenient sampling method, a total of 150 atrial fibrillation patients who were admitted to Nanyang Central Hospital from October 2021 to December 2022 were selected as the research objects. Patients were divided into the study group and the control group using the random number table method, with 75 cases in each group. The control group received routine transitional care, while the study group received transitional care based on the Siebens domain management model. The intervention effect was evaluated using Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale.Results:There was no statistically significant difference in scores of Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale of patients between the two groups before intervention ( P>0.05). After intervention, scores of Morisky Medication Adherence Scale and Atrial Fibrillation Self Care Ability Scale of patients in the study group were higher than those of the control group, and the differences were statistically significant ( P<0.05) . Conclusions:Transitional care based on Siebens domain management model can improve medication adherence and self-care ability of atrial fibrillation patients.
7.Distribution pattern of respiratory symptoms and the relevant risk factors in patients with pulmonary nodules: A cross-sectional study
Haijie XU ; Weitao ZHUANG ; Qi WANG ; Junhan WU ; Hansheng WU ; Yali CHEN ; Yong TANG ; Guibin QIAO
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2023;30(08):1175-1180
Objective To explore the distribution pattern of respiratory symptoms and relevant factors in patients with pulmonary nodules. Methods Demographic and clinical information were collected from patients who visited the Thoracic Surgery Outpatient Clinic of Guangdong Provincial People’s Hospital from January 2021 to January 2022. Hospital Anxiety and Depression Scale (HADS) was used to assess their anxiety and depression level. Results A total of 1 173 patients were enrolled, including 449 males and 724 females, with an average age of 46.94±11.43 years. Among the patients with pulmonary nodules, 37.7% of them had at least one respiratory symptom; 24.4% had cough, 14.0% had expectoration, 1.3% had hemoptysis and 14.9% had chest pain. Old age, male, exposure to second-hand smoking or environmental smoke, hair coloring and history of tuberculosis were major risk factors for respiratory symptoms (P<0.05). Middle age, old age, male, exposure to environmental smoke were major risk factors for cough (P<0.05); old age, smoking, larger maximum nodules diameters, exposure to environmental smoke and history of pneumonia were major risk factors for expectoration (P<0.05); male, multiple nodules, hair coloring, exposure to second-hand smoking and history of tuberculosis were major risk factors for chest pain (P<0.05). Symptomatic patients showed generally higher HADS scores than asymptomatic patients (P<0.001). Conclusion Cough, expectoration and chest pain are the predominant respiratory symptoms for patients with pulmonary nodules. The presentation of respiratory symptoms increases patients' anxiety and depression.
8.The application law of Moutan Cortex in Synopsis of the Golden Chamber
Chuanlong ZHANG ; Fudong LIU ; Guibin WANG ; Bo PANG ; Baojin HUA
International Journal of Traditional Chinese Medicine 2023;45(2):136-140
We aimed to study the articles and applied prescriptions of Moutan Cortex in Synopsis of theGolden Chamber, summarize and analyze its laws on the disease location and disease nature, and analyze its compatibility, dosage and processing laws. Based on the knowledge of Moutan Cortex by Zhongjing, we found that the kidney, bladder, uterus and intestine involved in Zhongjing's application of peony bark prescription, which belongs to the disease of "lower abdomen" in Huangdi Nei Jing. And the prescription of Moutan Cortex mainly focused on the syndromes of "depression" and "blood stasis", which are characterised by five kinds: water depression, dampness depression, stasis-heat, blood stasis and ecchymosis. and the compatibility rule of Zhongjing application of Moutan Cortex is analyzed accordingly. In addition, the study found that as the downward movement of the disease position, the amount of Moutan Cortex increased, and the processing of the problem followed the principle of "if disease is slow onset, the Moutan Cortex heart should be removed, but if disease is acute, Moutan Cortex heart should be kept". Finally, we combined modern clinical application of Moutan Cortex with modern pharmacological research, in order to expand the scope of clinical application of Moutan Cortex and "the same treatment of different diseases" to provide theoretical guidance.
9.Chinese expert consensus on diagnosis, treatment and prevention of venous thrombus embolism associated with chest trauma (2022 version)
Kaibin LIU ; Yi YANG ; Hui LI ; Yonten TSRING ; Zhiming CHEN ; Hao CHEN ; Xinglong FAN ; Congrong GAO ; Chundong GU ; Yutong GU ; Guangwei GUO ; Zhanlin GUO ; Jian HU ; Ping HU ; Hai HUANG ; Lijun HUANG ; Weiwei HE ; Longyu JIN ; Baoli JING ; Zhigang LIANG ; Feng LIN ; Wenpan LIU ; Danqing LI ; Xiaoliang LI ; Zhenyu LI ; Haitao MA ; Guibin QIAO ; Zheng RUAN ; Gang SUI ; Dongbin WANG ; Mingsong WANG ; Lei XUE ; Fei XIA ; Enwu XU ; Quan XU ; Jun YI ; Yunfeng YI ; Jianguo ZHANG ; Dongsheng ZHANG ; Qiang ZHANG ; Zhiming ZHOU ; Zhiqiang ZOU
Chinese Journal of Trauma 2022;38(7):581-591
Chest trauma is one of the most common injuries. Venous thromboembolism (VTE) as a common complication of chest trauma seriously affects the quality of patients′ life and even leads to death. Although there are some consensus and guidelines on the prevention and treatment of VTE at home and abroad, the current literatures lack specificity considering the diagnosis, treatment and prevention of VTE in patients with chest trauma have their own characteristics, especially for those with blunt trauma. Accordingly, China Chest Injury Research Society and editorial board of Chinese Journal of Traumatology organized relevant domestic experts to jointly formulate the Chinese expert consensus on the diagnosis, treatment and prevention of chest trauma venous thromboembolism associated with chest trauma (2022 version). This consensus provides expert recommendations of different levels as academic guidance in terms of the characteristics, clinical manifestations, risk assessment, diagnosis, treatment, and prevention of chest trauma-related VTE, so as to offer a reference for clinical application.
10.Continuous prone position ventilation in patients with severe acute respiratory distress syndrome at high altitude
Jinhai HAN ; Siqing MA ; Bin SUN ; Hao WANG ; Xiaolin SUN ; Guibin JIA
Chinese Critical Care Medicine 2021;33(2):161-164
Objective:To investigate the therapeutic effect of different prone position ventilation (PPV) on patients with severe acute respiratory distress syndrome (ARDS) at high altitude.Methods:The severe ARDS patients who met the Berlin standard admitted to the department of intensive care unit (ICU) of Qinghai Provincial People's Hospital from January 2017 to January 2020 were enrolled. The patients with classic PPV treatment (i.e. alternate prone supine position, about 16 hours per day) were included in the discontinuous PPV group; the patients with modified PPV treatment (i.e. alternate left and right prone positions 20°-30°, every 4 hours and continuous treatment for 24 hours per day) were included in the continuous PPV group. The oxygenation index (PaO 2/FiO 2), mechanics of breathing, ventilator parameters before treatment and 72 hours after treatment, and mechanical ventilation time, the length of ICU stay, and related complications between the two groups were analyzed. Results:Eighteen cases were treated with continuous PPV and 20 cases were treated with discontinuous PPV. There were no significant differences in gender, age, acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), PaO 2/FiO 2, lung compliance, driving pressure (ΔP) and positive end expiratory pressure (PEEP) before treatment between the two groups. Compared with before treatment, PaO 2/FiO 2 in discontinuous PPV group and continuous PPV group was increased significantly after 72-hour treatment [mmHg (1 mmHg = 0.133 kPa): 99.7±15.4 vs. 55.5±6.3, 121.8±25.3 vs. 55.1±7.1, both P < 0.05], lung compliance was improved significantly (mL/cmH 2O: 36.8±2.4 vs. 28.0±2.0, 43.4±6.7 vs. 27.7±2.1, both P < 0.05), and ΔP was decreased significantly [cmH 2O (1 cmH 2O = 0.098 kPa): 10.5 (10.0, 12.0) vs. 13.0 (12.3, 14.0), 10.0 (8.0, 12.0) vs. 13.0 (12.0, 14.0), both P < 0.05], PEEP was also decreased [cmH 2O: 12 (12, 14) vs. 14 (13, 14), 10 (8, 10) vs. 14 (12, 15), both P < 0.05], and the indexes in continuous PPV group were improved more significantly than those in discontinuous PPV group [PaO 2/FiO 2 (mmHg): 121.8±25.3 vs. 99.7±15.4, lung compliance (mL/cmH 2O): 43.4±6.7 vs. 36.8±2.4, ΔP (cmH 2O): 10.0 (8.0, 12.0) vs. 10.5 (10.0, 12.0), PEEP (cmH 2O): 10 (8, 10) vs. 12 (12, 14), all P < 0.05]. The duration of mechanical ventilation and the length of ICU stay in the continuous PPV group were significantly shorter than those in the intermittent PPV group [days: 6.0 (5.0, 7.3) vs. 8.0 (7.0, 9.0), 9.7±1.5 vs. 12.1±2.2, both P < 0.01]. During the PPV treatment, there were 3 cases of cheek skin damage and 2 cases of ear skin damage in the continuous PPV group, and 3 cases of facial skin damage in the intermittent PPV group. There was no significant difference in the incidence of complications between the two groups ( χ2 = 0.321, P = 0.571). All patients were repaired normally after PPV, without adverse consequences. Conclusion:Continuous PPV is more effective than discontinuous PPV in the treatment of severe ARDS patients at high altitude, and the related complications are did not increased in prolonged time of PPV.

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