In contemporary clinical practice of traditional Chinese medicine （TCM）， there is a strong emphasis on treating chronic difficult diseases and preventing diseases before they occur （"pre-disease" treatment）. However， the treatment of critical care medicine has not received as much attention and is even facing a trend of diminishing influence in the field of emergency medicine and critical care. Critical care medicine refers to a class of diseases that are characterized by rapid onset， severity， quick progression， and high mortality rates in clinical practice. The growth and development of renowned TCM experts throughout history have invariably been honed through practical experiences in managing critical care medicine. Treatise on Cold Damage （《伤寒论》） is a dedicated work for treating critical care medicine， and the classic prescriptions in Treatise on Cold Damage are particularly central to the treatment of these diseases. In the current clinical context， it is important to break through the prevailing mindset that the strengths of TCM lie solely in treating chronic diseases and maintenance-type illnesses， identify the entry point of TCM in the clinical advantages in the field of critical care medicine， explore the interdisciplinary relationship between Treatise on Cold Damage and critical care medicine， enhance the ability to treat critical care medicine using classic prescriptions， establish a disciplinary system for prescription-based treatment of critical care medicine， reveal clinical evidence for prescription-based treatment of these diseases， and elevate the contribution of TCM in the domain of critical care medicine. These have become a strong call and demand in contemporary TCM clinical practice. Regarding key scientific issues， the system of using classic prescriptions to treat critical care medicine encompasses traditional core theories such as the nature of cold damage， the essence of the six meridians， the implications of specific clauses， and the dosages of classic prescriptions. In the context of future academic inheritance and system construction， it is recommended to focus on clinical challenges， break away from the current limitations of traditional classical disciplinary systems， such as their singular patterns and weak innovative and translational capabilities， suggest defining diseases in critical care medicine responding specifically to TCM， advocate a research model based on combining disease mechanisms with pathology and combining medicinal properties with pharmacology， establish a comprehensive multidisciplinary thinking mode， and encourage collaborative innovative research among medical， educational， research， and manufacturing institutions. This will help chart the path and address key aspects of constructing a comprehensive system for prescription-based treatment of critical care medicine.

OBJECTIVETo observe the efficacy of chemotherapy consisted of bortezomib as main druy in maintenance therapy for recurrence of newly diagnosed MM patients.

METHODSThe clinical data and outcome of 37 MM patients during 2008-2013 were analyzed retrospectively, the 37 MM patients were divided into 2 group: 19 cases including 13 cases of newly diagnosed MM with symptoms and 6 cases of relapsed refractory MM were enrolled in group A; 17 cases of newly diagnosed MM with symptoms were enrolled in group B. The patients of group A received maintenance therapy consisted of bortezomib plus dexamethasone (VD group), while the patient group B received maintenance therapy consisted of melphalan plus prednisone(MP group), then the therapeutic efficacy of 2 group was compared.

RESULTSThe overall response rate(ORR) in VD groupe was 84.2%(16/19), out of which CR rate reached 42%(8/19), PR rate reached 31.6%(6/19), MR rate reached 10.5%(3/19). During median follow-up for 21.8(5-51) months, death occurred, while the ORR in MP group was 52(9/17), out of which CR rate was 23.5%(4/17), PR rate reached 23.5%(4/17), MR rate reached 5.9%(1/17). Druing median follow-up for 16.4(4-39) months, the worteity reaced 64.7%(11/17). The differencr between 2 groups was significant(P<0.05). The median OS time of patients in VD group was 21.6 months, that in MP group was 17.9 months(P<0.05). The median PFS in VD group and MP group were 13.4 and 9.4 months respectively(P<0.001).

CONCLUSIONThe ORR and CR rates of bortezomib maintenance therapy for newly diagnosed and relapsed / refractory MM patients are very high, and its toxicity can be controlled, therefore, the patients need maintenance therapy after remission.

The traditional conotation of combination of disease and syndrome means the combination of disease differentiation in traditional Chinese medicine (TCM) diseases and TCM syndrome differentiation,which was derived from the Yellow Emperor's Inner Classic.And the Treatise on Cold Damage and Miscellaneous Diseases describes the clinical application of this theory.Under the background of integrative medicine,the modern conotation of combination of disease and syndrome means TCM syndrome differentiation and treatment based on modern medicine disease differentiation,which is commonly used in the current clinical practice.The disease and syndrome combination diagnosis mode based on syndrome,etiology,pathology and pharmacology can understand the disease from a multiple and comprehensive level,in order to realize the combination and complementation of advantages from both medicines.In addition,formula-syndrome relation means the relationship between the formula and its relevant indications.In general,indications often involve syndromes,symptoms,diseases and body constitutions.And the application of formula in the Treatise on Cold Damage and Miscellaneous Diseases is the representative of this theory.Hence,the application of associated classical formula gives example to the clinical formula-syndrome relation application in modem times.

OBJECTIVETo investigate the correlation of patients with thrombosis or prothrombotic status with hyperhomocysteinemia (HHcy), activated protein C-resistance(APCR) and gene polymorphism of coagulation factor V.

METHODSThree hundred healthy voluteers were selected as controls, 223 cases of thrombosis (80 cases of cerebral infarction of CT, the MI of 82 cases of myocardial infarction, venous thrombosis of VTE 61 cases), 270 cases of patients with prothrombotic state (76 cases of pregnancy disease of PIH, 62 cases of chronic obstructive pulmonary disease (COPD), 60 cases of diabetes(DM) and 72 cases of cancer) were enrolled in this study. The plasma APCR and hyperhomocysteinemia were detected by APTT coagulation method and cycling enzyme method respectively, and restriction fragment length polymorphism(RFLP) were was used to detect the gene polymorphism of FV G1691-A, G1091-C and A1090-G in the patient and control groups.

RESULTSAPCR positive rate was 62.29% and 7.33%, and the positive hyperhomocysteinemia accounted for 68.42% and 10.00% respectively in the group of the patients with venous thrombosis and the normal control group. 3 cases of heterozygous FV gene mutations were found in the APCR-positive patients with venous thrombosis.

CONCLUSIONHHcy possitive rate of patients with venous thrombosis is signiticantly higher than that in control, the HHcy is one of the important causes resulting in thrombosis, the patients with venous thrombosis have proved to be with APCR, and the possitive APCR may be related with the coagulation factor V gene polymorphism.

There is a regular pattern in the diagnosis and treatment of exogenous high-grade fever, of which the key point is formula syndrome identification. Syndrome differentiation of the six channels is appropriate for not only exogenous cold but also various other conditions. The diagnosis and treatment of high-grade fever can also follow the law of syndrome differentiation of the six channels. The theory of epidemic febrile diseases stems from and elaborates on an understanding of exogenous febrile conditions, so many effective formulas used to treat epidemic febrile diseases also have great value in the treatment of high-grade fever. Deteriorated syndrome, which is central to this condition, is very commonly seen in cases of high-grade fever, the key therapeutic principle of which is established according to syndromes. Allowing analysis that does not rigidly adhere to either established modern diagnosis or traditional Chinese syndromes, prominent achievements could be made in treating high-grade fever by summarizing the regular presenting patterns in terms of the constitution and symptoms.

Decoction for removing blood stasis in the chest is Wang Qingren's famous formula for promoting blood circulation, the syndromes of which is composed of Sini powder syndrome, Taohong Siwu decoction syndrome, balloonflower syndrome and achyranthes root syndrome. According to many years' research on formula-syndrome and clinical practice of decoction for removing blood stasis in the chest, the syndromes of decoction for removing blood stasis in the chest is analysised from founder decoction, herb-syndrome, original record and constitutional characteristics in order to provide reference for further study.
Adult ; Blood Circulation ; drug effects ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Thorax ; blood supply ; drug effects ; Vascular Diseases ; drug therapy ; physiopathology

Yi Guan Jian decoction is a traditional Chinese medicine formula noted in Wei Yu-huang's Xu Ming Yi Lei An (Supplement to the Classified Medical Records of Famous Physicians). Acne vulgaris and chronic pelvic inflammation could be successfully treated by the decoction following the principle of formula corresponding to syndromes. The identical characteristics of constitution are found among the patients treated by the decoction, known as the "Yi Guan Jian constitution". It indicates that patients can be treated according to the constitutional characteristics.

The research and development of traditional Chinese medicine (TCM) injections is an important innovation of modernization of TCM, which has great clinical value and irreplaceability in medical enterprise of China. But reports of adverse events of TCM injections gradually increased in recent years and the security problems received much concern with the enlargement of its application range. The reasons include unreliable herb sources and unreasonable utilization, in which the former includes historical reasons and non-unified standard and the latter includes combined use of Chinese and Western medicine, misused dosage and formula not corresponding to syndromes. We should face the problems, and preventive measures should be worked out by pharmaceutical factory, doctors and government. The first one is strictly guarding the pharmaceutical preparation procedures with advanced pharmaceutical technology; the second one is advocating the idea of formula corresponding to syndromes to minimize the occurrence of adverse effects; and the last one is strengthening the postmarketing reevaluation and market supervising management.

Abstract: The theory of formulas corresponding to syndromes is a relatively mature and integrated method contained in the classics of traditional Chinese medicine (TCM) for diagnosing and treatment of diseases. The development of the theory mainly includes three stages, i.e. prototype stage before Han Dynasty, sublimation stage of late Eastern Han Dynasty and the following improving stage. People recorded what they saw and heard of during their medical activities in prototype stage. In sublimation stage, Treatise on Febrile Diseases written by Zhang Zhong-jing found out the relationship of structure-fixed prescriptions used more often with symptoms and signs. Doctors after Han Dynasty repeated and verified the truth of classical prescriptions and the theory of formulas corresponding to syndromes. They also developed and improved the theory. Based on clinical experience, and classics, it was enriched, advanced and improved by doctors after then. It could provide reference for clinical treatment through systematically hackling the theories.

The formation of dyslipidemia is related to phlegm-blood stasis and Spleen-Kidney Deficiency in traditional Chinese medicine, the former of which is Biao and the latter is Ben of the disease. The therapeutic method is utilizing syndrome differentiation, specially get sick the special medicine and replenishing kidney. Long-term usage of lipid-regulating western medicine may cause Kidney Deficiency and Qi Deficiency, the phenomenon of which we should pay great attention to.
Drugs, Chinese Herbal ; therapeutic use ; Dyslipidemias ; drug therapy ; physiopathology ; Humans ; Kidney ; physiopathology ; Medicine, Chinese Traditional ; Qi