RESUMO
【Objective:】 To explore the practice experience of narrative medicine among postgraduates majoring in Traditional Chinese Medicine (TCM) and its impact on their professional identity. 【Methods:】 A total of 56 first-year master’s and doctoral degree students majoring in TCM at a university were selected through purposive sampling for a 16-hour narrative medicine course training and 4 weeks of clinical practice in narrative medicine. They were asked to complete an open-ended writing assignment on their practical experience after this clinical practice. Subsequently, the topic analysis method in qualitative research was used to analyze their writing contents. 【Results:】 After learning narrative medicine, the students’ practical experience in clinical practice included 3 major themes and 9 sub-themes: wide application range (all diagnosis and treatment stages, multiple departments, and disease types), integration of multiple communication skills and diagnosis and treatment methods (communication skills, psychological techniques, reflection, and TCM humanistic diagnosis and treatment methods), and increasing professional identity (achieving mutual healing, building the harmonious doctor-patient relationship, and enhancing confidence in TCM). The themes were further integrated to form the relationship between the narrative medical practice cycle and professional identity, and presented in the form of charts. 【Conclusion:】 By exploring the narrative medical practice experience among TCM postgraduates, it was found that through the use of multiple methods and techniques in the entire diagnosis and treatment stage and multi-disciplinary diseases, it is possible to harmonize the doctor-patient relationship, achieve mutual healing, and enhance confidence in TCM. These internalized recognition and sense of achievement contributes to improving professional identity, which may provide new ideas for the development of professional identity for medical students in China and the exploration of the localization of narrative medical practice.
RESUMO
In recent years， the incidence of colorectal cancer has been rising in China， and with the promotion of early screening and early diagnosis， most colorectal cancers are able to achieve long-term survival through timely diagnosis and treatment. Nevertheless， 30%-70% of patients with early to mid-stage colorectal cancer after radical surgery still have psychological problems such as anxiety， depression， and fear of recurrence and metastasis， and they hope to seek help from traditional Chinese medicine（TCM） treatment. In order to further standardize the integrated traditional Chinese and western medicine psychological rehabilitation interventions of stage Ⅰ-Ⅲ colorectal cancer after radical surgery， and to improve the diagnosis and treatment level， under the support of the pilot project of clinical collaboration between Chinese and western medicine for major and difficult diseases of National Administration of TCM， experts in oncology， integrated Chinese and western medicine， psychology， surgery， nursing， evidence-based medicine and other disciplines from 10 units nationwide participated in the work， led by Xiyuan Hospital，China Academy of Chinese Medical Sciences and Beijing Cancer Hospital. Based on the methodology and process of guideline development of the World Health Organization Handbook for Guideline Development and the Regulations for Group Standards of China Association of Chinese Medicine， the Guidelines for Psychological Rehabilitation Intervention Combined Integrated Traditional Chinese and Western Medicine After Radical Surgery for Early and Middle Stage Colorectal Cancer have been developed according to the current best evidence， extensive consultation with clinical experts and following the situation of current clinical practice. The guideline provides the psychological characteristics， the needs and willingness to accept psychological rehabilitation， the interventions for psychological rehabilitation， evaluation of efficacy， follow-up review， educational guidance and others of patients with stage Ⅰ-Ⅲ colorectal cancer after radical surgery. It can provide guidance for TCM（integrated Chinese and western medicine） clinicians and psychologists engaged in the psychological rehabilitation of integrated Chinese and western medicine oncology， especially for doctors in primary medical institutions.
RESUMO
Europe occupies an important position in the world herbal medicine market. The registration of Traditional Chinese Medicine (TCM) in EU is of great significance to the internationalization of TCM. The European Medicines Agency (EMA) has designed a relatively complete management system and regulatory guidelines for the registration and supervision of herbal medicinal products. The promulgation of the DIRECTIVE 2004/24/EC (2004 / 24 / EC) indicates that TCM could enter the EU market through simplified registration. Based on the registration conditions, registration authority and document guideines of Traditional Herbal Medicinal Products (THMPs) in EU, this paper analyzes the application requirements of simple registration of traditional herbal products in EU, and provides suggestions for the simplified registration of TCM in EU according to the registration requirements of medicinal history, quality requirements and application data format.
RESUMO
By searching for the Canadian Licensed Natural Health Products Database, (LNHPD), this paper analyzed the characteristics and current status of 92 Chinese patent medicines successfully registered and listed in Canada, and found that the enterprises of successfully registered enterprises are mainly located in areas with better development condition of Traditional Chinese Medicine (TCM) such as Beijing, Guangdong and Tianjin; The successfully registered Chinese patent medicines include 64 kinds of single medicine or medicine with single active ingredient (69.6%) and 28 kinds of compound medicine (30.4%), the forms of the dosage are mainly tablets and capsules, which have the characteristics of accuracy in dosage and stable physicochemical properties. There are also granules, solutions, powders and other dosage forms, which can be preserved for a long time and have low requirements on technic and environment. These Chinese patent medicines are mainly used to treat respiratory and circulatory system diseases, some are used to treat urogenital and digestive system diseases, and few are used to treat difficuilt diseases like tumors, diabetes. There are some other health care products. It is suggested to strengthen the connection between domestic standards of TCM registration and international standards, and promote the scientific and technological capacity of relevant enterprises, and encourage enterprises to strengthen international registration of advantageous products, so as to accelerate the speed of international development of TCM in China.
RESUMO
This paper analyzes the laws, regulations and concre measures of Traditional Chinese Medicine (TCM) in Canada, so as to provide reference for TCM products to enter Canada, and for the establishment of TCM regulation system and the improvement of its detailed rules in China. The regulation of TCM in Canadian, on the one hand, supervision is to provide guidance for the protection of consumers' rights and interests, including the guidance of rational drug use and rational purchase for consumers; on the other hand, it is to supervise enterprises, including the safety, effectiveness and quality certification of TCM products, labeling and packaging requirements, as well as the site certification of product manufacturing, packaging, labeling and import. The Ministry of health of Canada takes evidence as the core of evaluation, and ensures the safe and effective use of TCM products in Canada through product and site licensing evaluation. In the supervision of TCM, relevant departments in China should further strengthen the protection of consumers' drug rights and interests, strengthen the construction of TCM registration evidence system, and pay attention to the risk management of drug production quality.
RESUMO
At present, the registration process of Traditional Chinese Medicine (TCM) in Canada is refering to the requirements of Natural Health Products (NHPs). In terms of registration material, both NHPs and TCM include plants, animals and minerals with medicinal components, but the fundamental difference between them is that TCM is guided by the basic theory of TCM. As for the registration classification of TCM in Canada, first of all, judge whether the product to be applied for is NHPs; Secondly, we should clarify the types and ways of registration, mainly including simple application, traditional application and non-traditional application, and provide application forms, label texts, summary reports, evidence, animal tissue forms, finished product specifications and other materials according to different requirements. At present, the successful registration experience of TCM products in Canada mainly mainly includes applying for superior varieties, selecting appropriate application channels, communicating with local health management units and providing sufficient scientific evidence and good clinical application records. The regulations on the registration of NHPs in Canada have not fully considered the particularity of TCM and the registration of TCM products is still facing some difficulties. In the future, we can learn from the registration process and requirements of the Health Canada, promote the interconnection and mutual recognition of the Pharmacopoeia of the People's Republic of China and the NNHPD monographs in Canada, reduce the obstacles to the local application for registration of TCM, and promote the further improvement of the international standards of TCM.
RESUMO
Traditional Chinese Medicine (TCM) products could be registered as natural health products (NHPs) in Canada. Its registration process could be mainly divided into simple-application, traditional-application and non-traditional application. By analyzingi the TCM registration evidence system and its safety, effectiveness and quality required by different registration categories in Canada, we found that "simple-application" procesure needs to submit evidence based on the parameters of a component in the monograph. As for "traditional application", TCM products need to be used at least 50 years with, traditional material or Pharmacopoeia can be used as evidence; As for non-traditional application, TCM products need to provide evidence according to the disease risk level, and most of them need to provide scientific experiment evidence. Therefore, from the experience of TCM registration evidence system in Canada, the registration of TCM products should pay attention to improve the its classification method, refining its evidence requirements and data types, promoting the formulation of monograph of TCM, realizing the scientific evaluation and rapid review of classic famous prescriptions, and promoting the inheritance and innovative development of TCM in China.
RESUMO
Objective Few reports are seen on the methods of establishing the rabbit model of pancreatic cancer .This study was to compare the effect of Panc-1 cell suspension orthotopic implantation with that of VX-2 tissue orthotopic implantation in construc-ting the rabbit model of pancreatic cancer . Methods Using the random number table method , we divided 30 healthy rabbits into a tissue suspension group ( n=15) and a cell suspension group ( n=15) , VX-2 tissue suspension employed for in-situ implanting in the former group and panc-1 cell suspension utilized in the latter .Then we evaluated the two modeling methods by B-ultrasonography , 3.0T MRI, and CT. Results In the third week after modeling , transpla-ntive metastasis of lots of tumor tissues was observed in the duode-num, colon, appendix, and peritoneal wall in 5 rabbits of the tissue suspension group , but only in the greater omentum of 3 rabbits in the cell suspension group , with high signals of MR T 2 in the posterior gastric body .One case of duodenal metastasis was seen in the cell suspension group , with slightly high signals of MR LAVA in the posterior gastric body .The model of pancreatic cancer was successfully established in all the 15 rabbits of the tissue suspension group , but only in 3 of the cell suspension group .The success rate of tumor im-planting at 3 and 4 weeks was significantly higher in the former ( 46.66%and 100%) than in the latter group ( 6.67%and 20.00%) (P<0.05). Conclusion VX-2 tissue orthotopic implantation is a more feasible and convenient method than Panc -1 cell suspension orthotopic implantation for establishing the rabbit model of pancreatic cancer .
RESUMO
Objective To explore the application value of magnetic resonance molecular functional imaging diffusion weighted imaging(DWI) in the identification of pancreatic carcinoma and mass-type pancreatitis of animal model.Methods Each 8 cases of laboratory pancreatic head transplantation tumor model,chronic mass-type pancreatitis model and normal rabbits were selected and performed the MR DWI molecular functional imaging,the b values were 333,667,1 000 s/mm2 respectively.The apparent diffusion coefficients(ADC) of pancreatic carcinoma model,mass-type pancreatitis model and normal pancreas under different b values were observed.Then the change situation of ADC values of pancreatic carcinoma model,mass-type pancreatitis model and normal pancreas under different b values and difference of ADC(DADC) was analyzed.Moreover the differences in molecular diffusion,tissue perfusion among various groups were observed.Results Throughout the study period,the mortality rate of pancreatic head transplantation tumor model was 50%;the mass-type pancreatitis model and 8 normal rabbits were normally survival.The ADC value of pancreatic carcinoma under the same b value was significantly lower than that of chronic inflammation and normal pancreas area.The ADC value in each group was decreased with the increase of b value,and there was significant difference in ADC value when the b value was 333 s/mm2(F=6.662,P=0.014),in the pairwise comparison among groups,the difference between pancreatic cancer and pancreatitis (t=6.773,P=0.003) and between pancreatic cancer and normal pancreas(t=5.883,P=0.016) had statistical significance (P<0.05).The b value was increased,DADC was smaller,the difference change of DADC between pancreatic cancer area and chronic pancreatitis mass area,between pancreatic cancer area and normal pancreatic head area had statistical significance (P<0.05).Conclusion Rationally selecting the molecular functional imaging DWI technology of b value can better distinguish pancreatic cancer from mass-type pancreatitis,which may be promoted and applied in the evaluation of animal pancreatic head cancer model.
RESUMO
According to the project of WFCMS about carrying out the comparative study on different English versions of textbooks in TCM core courses, this study has done the research for one year. The selected English versions of HUANG DI NEI JING have been compared with the Chinese version sentences by sentences, paragraphs by paragraphs. It is found that the characteristics and diversities of the English versions home and abroad with the common problems of translation have been summarized. Thus, the solution of improvement has been provided and such results could be cited as the references for the translation and external-oriented teaching of HUANG DI NEI JING.
RESUMO
Objective This study aims to explore antihypertension and heart protective effect of acupuncture on SHR rats through the observation of blood pressure, cardiac ultrasound and pathology examination of SHR rats after needling the Zusanli (ST 36) and Taichong (LR 3). Methods A total of 14 SHR rats (10 weeks) were randomly divided into two groups:6 for model group and 8 for acupuncture group, another 6 SD rats (10 weeks) were used as the control group. SHR rats in the acupuncture group were fixed in the holder, and then they exposed both lower limbs for needling both sides Zusanli (ST 36) and Taichong (LR 3), and then they retained needles for 20 minutes per time with four weeks. The other two groups were fixed in the holder without needling. Blood pressure was examined each week. LVSs, LVDd, LVPWs, LVPWd were measured and recorded by cardiac ultrasound in the day after the whole course of acupuncture. LVM, LVMI, RWT were calculated. The hearts of rats were dissected and fixed in formalin for heart pathology detection after doing the cardiac ultrasound. Results After acupuncture treatment, compared with model group, the systolic blood pressure (SBP) of the third week (178.38 ± 9.47 mmHg vs. 190.00 ± 13.90 mmHg) and the fourth week (167.96 ± 23.47 mmHg vs. 195.47 ± 11.36 mmHg) of acupuncture group significantly decreased (P<0.01). The diastolic pressure (DBP) of the third week (139.33 ± 13.20 mmHg vs. 159.56 ± 12.89 mmHg) and the fourth week (132.92 ± 18.02 mmHg vs. 165.61 ± 13.36 mmHg) of acupuncture group significantly decreased (P<0.01). The LVSs (0.96 ± 0.07 vs. 1.28 ± 0.24), LVPWs (1.15 ± 0.08 vs. 1.68 ± 0.19) of the acupuncture group were significantly lower than those of the model group (P<0.01). The LVM (0.51 ± 0.12 vs. 0.84 ± 0.17) and LVMI (14.96 ± 1.53 vs. 23.65 ± 5.04) of acupuncture group were significantly lower than those of the model group (P<0.01). Histopathologic examination of the heart of the model group showed chronic inflammatory granulation tissue hyperplasia and fibrosis in myocardial outer membrane, but the acupuncture group showed no obvious changes in the heart tissue. Conclusions Acupuncture treatment on Zusanli (ST 36) and Taichong (LR 3) could effectively control the left ventricular hypertrophy by decreasing the SBP and DBP , prevent cardiac remodeling, and protect myocardial cells.
RESUMO
The standardization of acupuncture and moxibustion in Canada is increasingly flouring nowadays:on one hand,acupuncture industry in legislated provinces is in the charge of direct administrative departments and associations of acu-moxi; on the other hand,according to the local situations,relevant regulations have been made,which are concentrated on two aspects-technical and administrative standards.Undoubtedly,Canadian Alliance of Regulatory Bodies for TCM Practitioners and Acupuncturist (CARB),united by each provincial TCM/Acupuncture Administration,is the first step to issue federal standards and establish federal level management institution.However,now the releasing of a fundamental regulatory file is in need of active corporation and publicity from each province and association.Therefore,it shows that the body of standardization in Canada is still not relatively perfect.Through introducing and analyzing the relevant information,the author expects that the readers can know the current development of acupuncture and moxibustion standardization in Canada.
RESUMO
The development of acupuncture in Australia has been booming.Under this circumstance,a series of acupuncture standards,codes and guidelines were established by different associations of TCM in Australia.Moreover,Australia has set the front pace in the field of acupuncture standards among the countries outside China.This paper is to introduce the acupuncture standards of Australia in three aspects respectively:national standards,industry standards and regional standards and to generalize the content of the main standards as well as analyze the current condition of Australian acupuncture standardization in order to generally give an all-around view of Australian acupuncture standards to the researchers in the field of international acupuncture standards.
RESUMO
@#ObjectiveTo observe effects of the nonunion of stale humeral shaft fracture treated by using the interlocking medullary nail.Methods21cases with the stale fracture of humeral shaft were treated with the interlocking medullary nail. The effect over post operation 1 year was evaluated.ResultsAll cases were recovery after treated by the interlocking medullary nail. Conclusions It shows that the effect of treating the fracture of humeral shaft with the interlocking medullary nail is very satisfactory.
RESUMO
@#Only by dressing the prosthesis can they play their compensatory functions for the amputees.The effectiveness of the compensatory is closely related to the condition of the stumps.Because of the complications,it is impossible to dress prosthesis to some stumps.This paper is a studying discussion on the rehabilitation of the non ideal stumps impairing prosthesis dressing,which of the 81 cases among the 164 amputees hospitalized in China Rehabilitation Research Center during the last 8 years.The paper advances the conception of the non ideal stumps impairing prosthesis dressing;the categories of non ideal stumps and their impairment to the prosthesis dressing and the principle and methods of the rehabilitation and the improvement of the making of the prosthesis and the method of the operations. To improve the conditions of the non ideal stumps,a good and comfortable prosthesis will be dressed.The compensatory functions will be satisfactorily played.
RESUMO
@#The prosthesis fitting were discussed in this paper for 48 un-reoperation of 91 cases the non-ideal stump of the lower limb amputees hospitalized in the past six years. The author suggests that silicon socks,the supplementary hang band,a combinative use of the prosthesis and orthosis,adjustment aligment of the prosthesis provide a good method for prosthesis fitting of the non-ideal stump of the lower limbamputees. It was able to wearing a good prosthesis and bring the compensatory functions into full play.