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Chinese medicine dispensing granules, the result of the efforts to transform Chinese medicinal decoction pieces in China, features portability and ease of storage. Thus, it is destined to be an indispensible dosage form in the modernization drive of Chinese medicine. The Announcement on Ending the Pilot Project of Chinese Medicine Dispensing Granules was released in February 2021 and relevant regulations went into force in November 2021, which marks the a new journey for the development of Chinese medicine dispensing granules and the beginning of the "post-pilot era". However, it faces the challenges in quality and standard. This study reviewed the history of Chinese medicine dispensing granules, analyzed the technical progress, market, and main problems in development, and proposed suggestions and prospects for its development in the "post-pilot era", which is expected to serve as a reference for its industry development and rational use.
Subject(s)
China , Drugs, Chinese Herbal/therapeutic use , Industrial Development , Medicine, Chinese Traditional , Pilot ProjectsABSTRACT
Objective: To investigate theaccuracy of artificial intelligence sleep staging model in patients with habitual snoring and obstructive sleep apnea hypopnea syndrome (OSAHS) based on single-channel EEG collected from different locations of the head. Methods: The clinical data of 114 adults with habitual snoring and OSAHS who visited to the Sleep Medicine Center of Beijing Tongren Hospital from September 2020 to March of 2021 were analyzed retrospectively, including 93 males and 21 females, aging from 20 to 64 years old. Eighty-five adults with OSAHS and 29 subjects with habitual snoring were included. Sleep staging analysis was performed on the single lead EEG signals of different locations (FP2-M1, C4-M1, F3-M2, ROG-M1, O1-M2) using the deep learning segmentation model trained by previous data. Manual scoring results were used as the gold standard to analyze the consistency rate of results and the influence of different categories of disease. Results: EEG data in 124 747 30-second epochs were taken as the testing dataset. The model accuracy of distinguishing wake/sleep was 92.3%,92.6%,93.5%,89.2% and 83.0% respectively,based on EEG channel Fp2-M1, C4-M1, F3-M2, REOG-M1 or O1-M2. The mode accuracy of distinguishing wake/REM/NREM and wake/REM/N1-2/SWS , was 84.7% and 80.1% respectively based on channel Fp2-M1, which located in forehead skin. The AHI calculated based on total sleep time derived from the model and gold standard were 13.6[4.30,42.5] and 14.2[4.8,42.7], respectively (Z=-2.477, P=0.013), and the kappa coefficient was 0.977. Conclusions: The autonomic sleep staging via a deep neural network model based on forehead single-channel EEG (Fp2-M1) has a good consistency in the identification sleep stage in a population with habitual snoring and OSAHS with different categories. The AHI calculated based on this model has high consistency with manual scoring.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Artificial Intelligence , Electroencephalography , Neural Networks, Computer , Retrospective Studies , Sleep , Sleep StagesABSTRACT
Objective:To explore the application and feasibility of PDCA cycle mode during the initial review of medical ethics committee in the hospital, to further promote the sustainable capacity building of ethics committee.Methods:To improve the quality of initial review management in the hospital ethics committee, PDCA method was used in this study from four aspects that including planning, implementation, inspection and action.Results:Measures adopted including clarifying the scope of ethical review, strengthening the practicability and operability of the review system, standardizing the ethical review procedures, strengthening the substantive review, reinforcing the cooperation among departments, and strengthening the training of medical ethics. Along with the implementation of these measures, ethics committee members were empowered their capacity of conducting initial review, at the same time, investigators also had better understandings and be more serious of the initial review. Furthermore, a PDCA improvement plan was proposed, which including the establishment of independent consultant expert database, the initiative of ethical review data management system, adopting clinical decision analysis methods in ethical review, as well as the improvement of post-approval management and operating procedures.Conclusions:The ethical review management work is continuingly improved under the guidance of PDCA cycle theory. The method of PDCA cycle theory is an ideal model for the long-term development of ethical management.
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Saussurea involucrata,a traditional Chinese medicinal material,is effective in the treatment of rheumatoid arthritis with cold-dampness blockage syndrome,cold pain in lower abdomen,and menstrual irregularities. However,due to the specific habitat,low natural reproduction rate,slow growth,and overexploitation,it is at the high risk of extinction. S. involucrata cells can be obtained through callus culture,suspension culture,and hairy root culture. This study highlighted the influences of reactor type,culture system,precursor,elicitor type, and light wavelength on the suspension culture of S. involucrate cells. The chemical components of S. involucrata cells mainly include phenylpropanoids,flavonoids,lignans,and steroids,among which phenylpropanoids are the most abundant. S. involucrata cells have multiple pharmacological activities of anti-inflammation,analgesia,activating blood and resolving stasis,immunoregulation,increasing bone density,lowering blood lipids,anti-hypoxia,anti-exercise fatigue,anti-radiation,anti-obesity,and anti-oxidation. Moreover,it has the potential of treating aplastic anemia. This study reviews the cell culture technologies,chemical components,and pharmacological activities of S. involucrata cells,laying a basis for the further research,development,and utilization.
Subject(s)
Humans , Anti-Inflammatory Agents , Flavonoids , Plant Extracts , SaussureaABSTRACT
The Philippines’ medical system is mainly based on the provincial responsibility system and the limited hierarchical. The Philippine government implement Philhealth program which can provide medical insurance for most people. The top 10 fatal diseases in this country includes ischemic heart disease, stroke, lower respiratory tract infection and so on. Of these diseases, the increasing rate of hypertensive heart disease, chronic kidney disease and diabetes are fast. Bone setting, massage and herbal medicine are the major form of traditional medicine in the Philippines. The acceptance of acupuncture and moxibustion by the government and local people is relatively high acupuncture and moxibustion therapy has been included in its medical insurance. There are many limitations on the development of Traditional Chinese Medicine (TCM) theory and Chinese herbal medicine in the Philippines, and the clinical application of acupuncture and Chinese herbal medicine is still limited. TCM education in the Philippines is still not systematic. Therefore, it is suggested to improve the education system of TCM, strengthen the promotion of acupuncture and moxibustion, give full play of the advantages of TCM for native high-risk diseases, and to make use of modern technologies such as telemedicine.
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Malaysia is a multi-ethnic and multi-cultural constitutional monarchy and federal system located in Southeast Asia. The top three diseases that cause deaths are ischemic heart disease, lower respiratory tract infections and stroke. Lower respiratory tract infections, colorectal cancer and Alzheimer’s disease have been the fastest growing diseases in recent years. The health insurance system complements public and private health care system. Traditional medicine in Malaysia includes Malaysian Medicine, Traditional Chinese Medicine (TCM), Indian Medicine, Islamic Medicine and homeopathy. Although TCM, such as acupuncture, has not been covered by health insurance, it is widely used under the impetus of the local Chinese people. At present, in Malaysia, the TCM public acceptance and education need promotion, and scientific researches need to be improved. It is hoped that in the future, the development of TCM in Malaysia will be better developed and disseminated by promoting TCM relevant legislation, increasing public awareness, focusing on education and training, and carrying out international scientific research cooperation.
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Thailand is a constitutional monarchy located in the central and southern part in Southeast Asia. It mainly implements the civil service insurance plan, the social insurance plan and the "Thai 30" plan, and the government bears the main health expenditures. The Thai traditional and alternative medicine system includes Thai traditional medicine, indigenous medicine and alternative medicine. Traditional Chinese Medicine (TCM) belongs to the category of alternative medicine. Currently, Thai traditional medicine and Chinese acupuncture have been included in medical insurance. With Thailand’s approval of doctors to use Chinese medicine to treat diseases published (Notification No.1 of BE 2543), a series of activities such as the establishment of national TCM center, the certification of TCM doctors, and the set of TCM courses and training have promoted TCM development in Thailand. However, the application of Chinese herbal medicine is restricted by Thai medicine laws; the practical skills of acupuncture and moxibustion is insufficient; and the TCM education is not systematic and complete. Therefore, it is recommended to carry out extensive and continuous publicity in the future to promote policy and legislative support; to strengthen research and development of Chinese patent medicine on popular diseases in Thailand and promote localization; to establish a special practice training center to improve acupuncture clinical operation capacity; to add and refine the content of TCM regarding university education system as well as short-term training; and to encourage cooperation between China and Thailand in talent exchanges and scientific researches, promoting the development of TCM in Thailand.
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The popularization of medical insurance in Panama has been basically completed. The coverage of health insurance is high, but with the problem of polarization. The major causes of death in Panama are is chemic heart disease, stroke, AD and diabetes. In recent years, the chronic kidney disease and COPD are increasing significantly. Panamanian native medicine, considered as complementary and alternative medicine, is recognized by local laws and usedby most of indigenous groups and rural people. Traditional Chinese Medicine (TCM) in Panama is at the starting stage, and there is no relevant legislation. However, this country attaches great importance to indigenous traditional medicine, and more and more people gradually accept it. TCM has great development potential in this country. It is suggested to promote the development of TCM in Panama. By culture as the pathway, exploring various forms of cooperation and exchange, taking the research and development of traditional herbal medicine as the breakthrough point, and increasing the spead of acupuncture usage, etc.
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Turkey is a presidential republic country located in the Eurasian continent, which has a universal health coverage since the health reform in 2003. The leading causes of death in this country are ischemic heart disease, stroke, and lung cancer. Besides, lower respiratory infections, chronic kidney disease, and hypertensive heart disease are the diseases which have a fastest growing rate. Chinese acupuncture was officially recognized by Turkey in 1991 with the promulgation of Acupuncture Treatment Legislation. At present, only trained practitioners and dentist could conduct acupuncture treatment, which was stated in Regulation of Tradition and Complementary Medicine Practice. The application of Turkish acupuncture and moxibustion is still applied in a simplified way that lack of TCM theory. Moreover, Chinese herbal medicine is still not officially recognized and still under control of the Ministry of Agriculture. Therefore, it is suggested to introduce TCM theory in the spread of acupuncture, to promote acupuncture research and clinical practice, to clarify the different standards between the two countries, and to cooperate in Chinese medicine researches, especially those related to the local high incidence and refractory disease so as to promote the development of TCM in Turkey and provide medical services for local residents.
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Egypt’s medical insurance is mainly covered by government and commercial insurance. The low coverage of commercial insurance and the quality of medical services needs more improvement in Egypt. Recently, the incidence rate of diabetes, chronic kidney disease, hypertensive heart disease, COPD and liver cancer is rising. Traditional Egyptian medicine is similar to Traditional Chinese Medicine (TCM), and its modern traditional medicine is mainly Arabian medicine. Acupuncture, as the main form of TCM, was introduced into Egypt in the 1970s, but it has not been covered by the medical insurance system. The development of TCM in Egypt needs improvement. It is suggested that further explorated fields should be focused on the acupuncture therapy, TCM education and TCM treatment of keeping health in Egypt.
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South Africa is an ethnically and culturally diverse presidential republic country. The medical and health system consists of public and private medical care. AIDS, lower respiratory infections, neonatal diseases, and interpersonal violence and road injuries are the leading causes of adult death. South Africa has rich herbal resources, and a long history of traditional medicine, which is mainly black African traditional medicine. Until the establishment of diplomatic relations between China and South Africa in 1998, the development of TCM was significantly improved, and legislation of TCM was adopted by the government in 2000. Chinese herbal medicine has not yet formed industrial standardization, the TCM application and TCM education are insufficient. Therefore, it is suggested to accelerate the standardization of TCM, to strengthen the TCM education for professional TCM practitioners, and to form a large-scale, industrial and standardized development model. Only in these ways can TCM provide good medical services for residents in South African.
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Objective:To establish a new fast and accurate method for identifying the authenticity and specifications of Fritillariae Cirrhosae Bulbus based on electronic nose technology， and to discuss the feasibility of this technology in the identification of decoction pieces. Method:Fritillariae Cirrhosae Bulbus was used as the research object， 80 batches of samples to be tested were collected， and the olfactory sensory data of the electronic nose were taken as independent variables （<italic>X</italic>）， the results of the method contained in the 2020 edition of <italic>Chinese Pharmacopoeia</italic> were taken as the focus， and the traditional empirical identification results were used as benchmarking information （<italic>Y</italic>）. Four chemometric methods， including discriminant analysis （DA）， least square support vector machine （LS-SVM）， principal component analysis-DA （PCA-DA） and partial least squares-DA （PLS-DA）， were used to establish the identification model ［<italic>Y</italic>=<italic>F</italic>（<italic>X</italic>）］ of authenticity and commodity specifications of Fritillariae Cirrhosae Bulbus， respectively. Wherein， the identification accuracy and time-consuming was taken as indicators to discuss the results. Result:After cross-verification by leave-one-out method， the correct rates of the above four models were 93.75%， 91.25%， 95.00% and 95.00%， respectively， and the PCA-DA and PLS-DA identification models were the best in terms of authenticity identification. In specification identification， the correct rates of these four models were 86.67%， 88.00%， 89.33% and 68.00%， respectively， and the PCA-DA identification model was the best. The electronic nose had a high accuracy in the identification of authenticity and specification model， and the time consuming was relatively short. Conclusion:Electronic nose technology can identify Fritillariae Cirrhosae Bulbus accurately and quickly， and has significant advantages in terms of timeliness and correct judgment rate.
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Objective:To explore the effects of respiratory training on pulmonary and motor function for patients with Parkinson's disease. Methods:From January, 2018 to November, 2019, 60 inpatients with idiopathic Parkinson's disease from the Second Rehabilitation Hospital of Shanghai were randomly divided into control group (n = 30) and experimental group (n = 30). All the patients accepted routine rehabilitation, while the experimental group accepted respiratory training with Power Breathe in addition. They were measured the pulmonary function, and assessed with Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and modified Barthel Index (MBI) before and four weeks after treatment. Results:The scores of UPDRS II and III, and MBI improved in both groups after treatment (|t| > 2.550, P < 0.05), while the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and maximum expiratory flow rate at 50% vital capacity (MEF50) increased in the experimental group (|t| > 2.838, P < 0.01), but did not in the control group (|t| < 1.058, P > 0.05). FVC, FEV1, MEF50, MBI score and UPDRS II score improved more in the experimental group than in the control group (|t| > 2.191, P < 0.05). Conclusion:Respiratory training can improve pulmonary function for patients with Parkinson's disease, to further improve their activities of daily living. No synergistic effect is found on motor function.
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India is a parliamentary republic country located in South Asian. Its medical and healthcare insurance is paid by the state government and it has the world’s largest "free medical" service system. India has a long history of traditional medicine (TM) represented mainly by Ayurveda, Naturopathy, Yoga etc. As early as the 2nd century BC, Traditional Chinese Medicine (TCM) was introduced to India along with religious exchanges and trade activities. At present, acupuncture has achieved independent legal status in India and there are many acupuncture clinics and associations. However, non-acupuncture TCM treatments lack development in India, but the application of acupuncture lacks of systematic standards.
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Long non-coding RNA (lncRNA) plays a contributory role in rheumatoid arthritis (RA). In this review, we summarized the current findings of lncRNAs in RA, including cellular function and the potential mechanisms. Serum lncRNA levels are associated with serum proinflammatory cytokines and disease activity. LncRNAs regulate proliferation, migration, invasion and apoptosis of RA fibroblast-like synoviocytes (FLSs), modulate the differentiation of T lymphocytes and macrophages, and affect bone formation-destruction balance of chondrocytes. Besides, lncRNAs are involved in inflammation and cell motivation signaling pathways. In-depth research on lncRNAs may help elucidate the pathogenesis of RA and provides clues for novel treatment targets.
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@#【Objective】To explore the clinical manifestation of COVID- 19 severe cases.【Methods】Clinical data of one severe case with COVID-19 including the clinical characteristic ，laboratory testing results，radiography，treatment，complication and outcome of the patient were retrospectively collected and analyzed.【Results】 The patient with COVID-19 was a 61-year old male，He suffered with underlying disease. His symptoms included fever，cough，myalgia， fatigue，and dyspnea. Laboratory testing results included normal WBC count，decreased lymphocyte cells，elevated LDH and hypoxemia. Radiography findings showed bilateral lung infiltration. His condition deteriorated after intensive treatment for one week. He was intubated and treated with mechanical ventilation because of complicating with severe acute respiratory distress syndrome（ARDS）.【Conclusion】COVID-19 is an emerging acute communicable disease，which lack specific and effective treatment. Most patients have a good prognosis but mortality in severe cases is high. More attention should be paid on the high risk of progression in COVID-19 cases.
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Objective: To observe the orthodontic tooth movement after regeneration of Beagl dog' s periodontal tissue defect with biphasic calcium phosphate (BCP), and to elucidate the mechanism of BCP as a scaffold material for periodontal regeneration. Methods: Six adult male Beagle dogs were selected; the right upper quardrant (B) and the left lower quardrant (D) regions of each dog were used as blank control group, and the left upper quardrant (A) and the right lower quardrant (D) regions were used to establish the dog models of periodontal tissue defect of bilateral incisors. BCP was implanted into the defect to regenerate the defect. After 12 weeks of BCP implantation into the defect for defect tissue regeneration, the orthodontic tooth movement models were established (experimental group). Stress stimulation was applied in experimental group and control group, respectively. Two Beagle dogs were randomly executed at 1, 2 and 4 weeks after loading. The specimens were stained, the histological changes of regenerated periodontal tissue and the expression of core binding factor al (Cbfal) regulating osteogenesis under stress were observed; the changes in normal periodontal tissue under the same stress were observed. Results: The Masson staining results showed that the periodontal ligament of the dogs in experimental group and control group became narrower and denser at 1 week after stress stimulation; the alveolar bone of the dogs in dogs in experimental group was mainly blue; the alveolar bone of the dogs in control group was generally red except for the compression area of the periodontal ligament. At 4 weeks after stress stimulation, the alveolar bone of the dogs in experimental group was red-blue, while the alveolar bone of the dogs in control group was red; the blood vessels in periodontal ligament of the dogs in two groups were rounded. One week after stress stimulation, the alveolar bone surface of the dogs in experimental group and control group was covered with bone resorption lacunae containing the multinucleated osteoclasts, the cytoplasmic Cbfal staining was positive, and the compressed and deformed periodontal ligament cells were arranged disorderly. Four weeks after stress stimulation, the osteoclasts disappeared in experimental group, and the bone resorption lacunae was filled by osteoblasts, and the osteoblasts on the other side of the trabecula were also active; the expression of Cbfal was still found in the bone marrow mesenchymal cells and the marginal osteoblasts of alveolar bone. The expression of Cbfal was weak in control group. Conclusion: The periodontal tissue regenerated by BCP has reached the normal periodontal tissue. Under the action of orthodontic force, it has normal osteogenesis function and can complete the bone remodeling process of orthodontic tooth movement.
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Objective: To evaluate the effect of Chuankezhi injection on mouse model of pneumonia induced by influenza A (H1N1) FM1 strain. Method: ICR mice were randomly divided into normal group, model group, tamiflu control group (27.5 mg·kg-1·d-1) and Chuankezhi injection group (1.5 mL·kg-1·d-1). In the death protection experiment, mice were infected with 2×half lethal dose (LD50) of influenza virus FM1.The Chuankezhi injection was given once a day for 4 days. The number of death animal within 14 days was counted. The mortality and the death protection rate were calculated. In the treatment experiment, mice were infected with 0.8×LD50 of influenza virus, and the Chuankezhi injection was given once a day for 4 days. On the 5th day after the infection, the levels of interleukin-8 (IL-8) in lung, prostaglandin E2 (PGE2) and vasopressin (AVP) in brain were tested by enzyme-linked immunosorbent assay (ELISA). The viral load of influenza virus in lung was tested by Real-time PCR. In the pre-treatment experiment, mice were given Chuankezhi injection once a day for 5 days. 1 hour after the last treatment, mice were infected with 0.8×LD50 influenza virus. 4 days after the infection, the lung index, spleen index, thymus index, and viral load in lung tissue were calculated. Result: Compared with normal group, the IL-8, PGE2 content, lung index and viral load in the lung tissue of model group were significantly increased (P2, and the viral load of influenza(PPPPConclusion: Chuankezhi injection could effectively prevent the mouse model of pneumonia induced by influenza A (H1N1) virus. The mechanism might be related to the reduction of inflammation and inhibiting viral replication.
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@#【Objective】To investigate the differences of lung involvement between dengue and severe dengue.【Methods】227 dengue patients admitted in The Third Affiliated Hospital of Sun Yat-sen University from July 2014 to October 2018 were enrolled. The clinical characteristics，treatment and outcome of the patients were analyzed to explore the differences of lung involvement between dengue and severe dengue （SD）. 【Results】 The rate of old age ，smoking ，hypertension，diabetes and cerebrovascular disease was higher in dengue with lung involvement group（DWLI）than dengue without lung involvement group（DWOLI）（χ2 were 25.146，3.847，10.326，7.177，and 5.355，P was 0.050 for smoking，the others were < 0.05）. The rate of cough and breathlessness was higher in DWLI（χ2 were 11.465 and 6.068，P were 0.001 and 0.014），as well as in SD subgroup（χ2 were 4.585 and 6.717，P were 0.032 and 0.010）. C-reactive protein and procalcitonin were increased in DWLI（Z were - 2.591 and - 3.033，P were 0.010 and 0.002）. The rate of pleural effusion was higher in SD subgroup（χ2 = 4.987，P = 0.026）. Bilateral lung infiltration was correlated with SD（χ2 = 5.910，P =0.015）. The rate of acute liver injury，acute kidney injury and multi-organ dysfunction syndrome（MODS）was higher in DWLI（χ2 were 7.044，7.059，and 11.315，P were 0.008，0.008 and 0.001）. The rate of anti-virus，anti-bacteria and combined therapy was higher in DWLI（χ2 were 13.156，32.845，and 12.684，P all were < 0.001）.【Conclusion】Dengue patients who were with old age，smoking，or suffered from underlying disease of hypertension，diabetes and cerebrovascular disease were vulnerable to lung involvement. Cough，breathlessness，pleural effusion and bilateral lung infiltration were signs of severe dengue. Attention should be paid to dengue with lung involvement.