The Western model of integrative oncology — the contribution of Chinese medicine

<正>Western integrative oncology(IO) combines conventional mainstream medicine with complementary and alternative medicine(CAM) for the care of cancer patients.Since it includes patient orientation and the holistic approach of many CAM options,IO offers not only preventive measures,but also a wide spectrum of treatment modalities for all stages of illness,from the acute phases through the rehabilitation period.Many therapeutic methods of IO are supported by scientific evidence,for example,dietary and nutritional counseling,exercise,and mind-body medicine,among others.IO also includes therapeutic interventions of traditional Chinese medicine(TCM).At present acupuncture,qigong,and foot massage play an important role in the Western care of cancer patients.However,unlike in China, in Western countries herbal remedies are usually only used during those periods in which chemotherapy is not applied in order to avoid herb-drug interactions.Instead, acupuncture is widely used to manage the side-effects that often accompany chemotherapy.This paper focuses on the role of Chinese medicine in Western IO and reviews the scope and limitations of IO in the care of cancer patients today.The future challenges of IO will also be discussed in this paper.     

A survey of complementary and alternative medicine in Iran

Objective:To survey the use,capability and satisfaction of complementary and alternative medicine(CAM)in comparison with conventional medicine in Iran.Methods:In this national survey,a cross-sectional study was designed,5,000 people were surveyed to identify predictors of Iranian traditional medicine(ITM)use compared with conventional medicine.Data were collected through a questionnaire that covered three different predictor categories: demographic information,patient’s viewpoint,and patients’ experiences.Results: Most of the participants preferred government owned hospitals rather than other places.Praying for one’s own health was the most frequent and favorable ITM domain(P=0.017)based on patients’ interests,both in low-(P=0.08)and highlevel (P=0.011)educated subjects.Among the participants,97.8%had previous conventional medicine history due to their chronic diseases Conclusions:Iranian patients resort to ITM as a choice at the late stage of the disease.Current deficiency in integration of CAM and conventional medicine is in contrast to the increasing demand on patients’ side.Health care organizers should be facilitating the CAM services by tuition of CAM practitioners and supporting eligible CAM centers for diagnosis and treatment of patients.     

Introduction of nano chinese medicine

Traditional Chinese medicine has been used for thousands of years, and has been contributing to human health. It is considered as a great treasure of mankind. However, nowadays, Traditional Chinese medicine falls behind of modem medicine. It has not been accepted extensively in the worldwide. How can we change this situation? Medemizing traditional Chinese medicine is an effective way. We must improve traditional Chinese medicine with modern science and technology.     

纳米中药制剂的研究介绍

Traditional Chinese medicine has been used for thousands of years, and has been contributing to human health. It is considered as a great treasure of mankind. However, nowadays, Traditional Chinese medicine falls behind of modern medicine. It has not been accepted extensively in the worldwide. How can we change this situation? Modernizing traditional Chinese medicine is an effective way. We must improve traditional Chinese medicine with modern science and technology.     

Complementary and Alternative Medicine Therapies for Chronic Pain

Pain afflicts over 50 million people in the US, with 30.7% US adults suffering with chronic pain. Despite advances in therapies, many patients will continue to deal with ongoing symptoms that are not fully addressed by the best conventional medicine has to offer them. The patients frequently turn to therapies outside the usual purview of conventional medicine(herbs, acupuncture, meditation, etc.) called complementary and alternative medicine(CAM). Academic and governmental groups are also starting to incorporate CAM recommendations into chronic pain management strategies. Thus, for any physician who care for patients with chronic pain, having some familiarity with these therapies—including risks and benefits—will be key to helping guide patients in making evidence-based, well informed decisions about whether or not to use such therapies. On the other hand, if a CAM therapy has evidence of both safety and efficacy then not making it available to a patientwho is suffering does not meet the need of the patient. We summarize the current evidence of a wide variety of CAM modalities that have potential for helping patients with chronic pain in this article. The triad of chronic pain symptoms, ready access to information on the internet, and growing patient empowerment suggest that CAM therapies will remain a consistent part of the healthcare of patients dealing with chronic pain.     

社区医学新课程体系的构建与实施

目的 初步构建临床医学专业适用的社区医学新课程体系,促进临床医学专业学生树立预防保健的整体观念,提高其社区卫生服务能力.方法 结合我国实际情况,通过借鉴国内外院校社区医学教学经验,对武汉市相关社区卫生服务中心进行实地考察和调研,收集资料,形成社区医学新课程教学大纲、教学计划及评估方法并付诸实施.结果 通过实施初步构建的社区医学新课程体系,学生初步树立了预防保健整体观念,社区卫生服务的能力得到了提高.结论 初步构建的社区医学新课程体系符合当前我国深化医药卫生体制改革的方向,有利于临床医学专业学生树立社区预防保健整体观和提高社区卫生服务能力.

Abstract：

Objective To construct a new curriculum system of community medicine that could promote clinical medical students to form a concept of preventive health care as a whole and improve their abilities to serve for community health. Methods On the basis of the interrelated data that collected after the inspection and investigation in some community health service centers in Wuhan City, the syllabus, teaching programs and assessment methods of the new curriculum of community medicine were constructed and put into effect according to the actual situation in China as well as some teaching experiences of community medicine from domestic and overseas colleges. Results The concept of preventive health care as a whole was constructed among clinical medical students and their abilities of community health service was improved after the implementation of new curriculum system. Conclusions The new curriculum system fits with the current reformation of medical and health system in China and benefit a lot for clinical medical students to built a concept of preventive health care as a whole and improve their abilities to serve for community health.     

Use of complementary and alternative medicine among Thai patients with type 2 diabetes mellitus

OBJECTIVE: Patients with diabetes commonly use complementary and alternative medicine(CAM). Little is known about types and factors related to CAM use in patients with diabetes in Thailand. This study aimed to examine types and factors that were associated with CAM use in Thai diabetic patients.METHODS: A cross-sectional study of diabetic patients being treated in four primary healthcare units and two secondary hospitals in the north of Thailand was conducted. A questionnaire was used to collect data. Frequency, percentage, and Chi-square test were used to describe or analyze data.RESULTS: The three most common types of CAM used by samples were Daode Xinxi(a modified version of Taichi), prayer and meditation. Women were more likely to use CAM than men(x~2=5.038, P=0.018). Patients aged between 40 and 69 years were more likely to use CAM than those aged younger than 40 or older than 69 years(x~2=11.041, P=0.026). Farmers were more likely to use CAM than those with other careers(x~2=19.248, P=0.007). Diabetes patients whose time since diagnosis was between 1 and 10 years were more likely to use CAM than those with a longer elapsed time since diagnosis(x~2 = 8.407, P = 0.038). Marital status, religion, education, health insurance type and conventional treatment approaches were not associated with CAM use in diabetic patients.CONCLUSION: The most common type of CAM used by Thai patients with diabetes was mind and body practice. CAM use was signifi cantly associated with gender, age, career and duration of diabetes. However, marital status, religion, education, health insurance types and conventional regimen for diabetics were not associated with CAM use.     

Development of general practice education and training in China

General practice as a discipline has largely evolved over the past 30 years in the field of primary health care. It originated in the 18th century m Europe. It was established in the United States in the 1960s and introduced to China in the late 1980s. In earlier times, medicine was not specialized, and general physicians dominated the medical field. At the end of the 19th century, with the development of basic medical disciplines, such as biology and anatomy, the development of more specialized medical practices began.     

Critical care medicine in China: history and perspective

Critical care medicine began in 1982 in China and is still in a phase of rapid development.Despite the inadequate resources compared with those of developed countries,critical care medicine has been recognized as a specialty by the government and by other specialties.National critical care societies are dedicated to promoting professional education and the academic improvement of critical care medicine in China.Although critical care services and clinical research are still underdeveloped due to scarce resources,great improvement is expected in the near future.     

Integrative oncology meets immunotherapy: New prospects for combination therapy grounded in Eastern medical knowledge

<正>As cancer rates rise globally,standard care is being questioned; new approaches involving immune therapies are emerging.With this shift comes a corresponding shift in the use and potential of herbal medicines and extracts.The focus of this article,which has evolved from a presentation at the Second Beijing International Symposium on Integrative Medicine(BISIM May 19-20,2012),is particularly on Chinese medicine,but is generalizable to Eastern medicine more broadly and to other herbal traditions.Until recently,herbal and related treatments have been used as adjuvants to conventional care - for reducing side-effects, enhancing cytotoxicity,and sometimes,undesirably counteracting the efficacy of chemotherapy and radiation.Now,in the context of a new class of immune-based cancer therapies,herbal and other complementary modalities are looked at as enhancers of the body's immunity.     

中医药在康复医学中的循证实践

Chinese medicine is among other traditional medical systems practiced either as a coadjutant intervention to Greek medicine or as the unique therapeutic intervention for illness prevention,treatment or rehabilitation.The complete spectrum from that traditional system includes acupuncture and moxibustion,herbal and food therapy,massage therapy(tuina),physical exercises(taijiquan),and breathing exercises(qigong).In this article,it is presented several randomized controlled trials and systematic reviews on the application of all therapeutic modalities from Chinese medicine in the physical rehabilitation scenario.The discussed studies encompasses both "positive" and "negative" results of Chinese medicine intervention for disabilities due to illnesses of the nervous,musculoskeletal or cardiovascular systems.Additionally,the importance of the personalized approach for Chinese medicineand rehabilitation is emphasized together with the need for reproducible methods for pattern differentiation and intervention selection.Chinese medicine resources are recognized as promising methods for therapeutic rehabilitation and can be incorporated into the rehabilitation science.The wide variety of therapeutic resources explains why Chinese medicine is currently a multidisciplinary practice for health protection and promotion,early diagnosis and treatment as well as rehabilitation with roles in the public health care system.     

Review on efficacy and health services research studies of complementary and alternative medicine in inflammatory bowel disease

Objective:To assess the evidence of the use and efficacy for complementary and alternative medicine(CAM) in inflammatory bowel disease(IBD). Methods:A systematic literature search in MEDLINE was performed for randomized controlled trials(RCTs) in Crohn’s disease and ulcerative colitis.Moreover,a selective literature search for health services research studies on the use of CAM in patients with IBD was performed.Results:Health services research studies showed a high use of CAM in adult and pediatric patients with IBD worldwide.In contrast to the high use among IBD patients,there was a lack of high-quality data for many of the used CAM methods.Although most of the studies showed positive results,the methodological quality of most studies was rather low;therefore,the results had to be interpreted with caution.While there were many studies for probiotics and fish oil,RCTs for the highly used method homeopathy, for most herbal products,and for traditional Chinese medicine methods apart from acupuncture RCTs were completely lacking.Conclusions:The lack of high-quality studies might be the consequence of the problems associated with the funding of clinical trials involving CAM.However,having the high user rates in mind,high-quality studies assessing efficacy and safety of those methods are urgently needed.Furthermore,there is a need for better representation of CAM in undergraduate and postgraduate medical education.     

Functional constipation in children:non-pharmacological approach

Teb(medicine)as described by Avicenna on the opening pages of the al-Qānūn fīal-Tibb(The Cannon of Medicine)was"a science by which one learns the conditions of the human body in health and in the nonexistence of health to keep health or to bring it back".According to Avicenna’s Canon of Medicine and other traditional Persian medicine(TPM)resources,the observance of the six essential qualities provides guidance to any medical intervention.     

Improving Clinical Practice Guideline Development in Integration of Traditional Chinese Medicine and Western Medicine

<正>Integration of traditional Chinese medicine(TCM)and Western medicine(WM),or called as integrative medicine(IM)in China,came into being in 1950s as a new form of medicine.IM emphasizes the combination of both conventional WM and TCM alternative approaches to address all aspects of health and illness.~((1))The major practice in IM includes the integration of disease diagnosis in WM and pattern classification(or syndrome differentiation)in TCM,and the integration of WM interventions     

Association between change of health care providers and pregnancy exposure to FDA category C, D and X drugs

Background Changing health care providers frequently breaks the continuity of care,which is associated with many health care problems.The purpose of this study was to examine the association between a change of health care providers and pregnancy exposure to FDA category C,D and X drugs.Methods A 50% random sample of women who gave a birth in Saskatchewan between January 1,1997 and December 31,2000 were chosen for this study.The association between the number of changes in health care providers and with pregnancy exposure to category C,D,and X drugs for those women with and without chronic diseases were evaluated using multiple logistical regression,with adjusted odds ratios （ORs） and its 95% confidence intervals （C/s） as the association measures.Results A total of 18 568 women were included in this study.Rates of FDA C,D,and X drug uses were 14.35%,17.07%,21.72%,and 31.14%,in women with no change of provider,1-2 changes,3-5 changes,and more than 5 changes of health care providers.An association between the number of changes of health care providers and pregnancy exposure to FDA C,D,and X drugs existed in women without chronic diseases but not in women with chronic disease.Conclusion Change of health care providers is associated with pregnancy exposure to FDA category C,D and X drugs in women without chronic diseases.     

Ebola outbreak in West Africa: a neglected tropical disease

Neglected tropical diseases(NTDs) are remediable injustices of our times. Poverty is the starting point, and the ultimate outcome, of NTD. Ebola is just one of many NTDs that badly need attention. Ebola exacerbates West Africa's poverty crisis. The virus spreading in Guinea,Liberia and Sierra Leone has led to food shortages and neglect of other devastating tropical illnesses. A health crisis that was ignored for months until it was out of control is now beginning to get the attention required, if not the resources. So far, the world′s nations have contributed far less than the $ 1 billion. The U.N. estimates would need to control the epidemic before it becomes endemic. Past outbreaks of Ebola have flared up in remote, forested communities, disconnected from much of the outside world. But the outbreak in West Africa has not slowed yet, and it worsens there the chances of it spreading to other countries. Ebola draws attention to NTD. Ebola is not only a health emergency, but also it′s a poverty crisis.The current Global Ebola crisis presents a multitude of challenges in terms of our capacity to respond; the future is even less predictable. Ebola outbreak represents inequity in health as the occurrence of health differences considered unnecessary, avoidable, unfair, and unjust, thus adding a moral and ethical dimension to health inequalities. Health equity does not refer only to the fairness in the distribution of health or the provision of health care; rather, it is linked with the larger issues of fairness and justice in social arrangements.     

Integrative network analysis: bridging the gap between Western medicine and traditional Chinese medicine

There is a global movement calling for the integration of Western medicine (WM) and traditional Chinese medicine (TCM)[1].The World Health Organization suggests that health care would be improved by integrating traditional and complementary medicines into the practices of health care service delivery and self-health care[1].The WM and TCM are commonly integrated in the contemporary practice of medicine in China.About 90％ of the general hospitals and 75％ of health centers have TCM departments[2].Even in WM hospitals,around 40％ of the medicines prescribed are TCM.Similarly,in the TCM hospitals 40％ of all prescribed drugs are WM[3].Meanwhile,over 80％ of Chinese patients have received TCM treatment at some point in their lives[2].However,differences exist in typical use of prescribed medications between WM and TCM and can result in the incorrect use,thus leading to concerns about the efficacy and safety of integrative treatment[4].     

New understanding of the basic theory of traditional Chinese medicine

Traditional Chinese medicine(TCM) plays an important role in the medical system used in health care and treatment of diseases.This article reviews the basic theory of TCM based on its formation and contributions.Two new personal points are proposed as follows:Six Zang(六脏) theory and deemphasization of the five-element theory.The basic theory of Chinese herbs is also discussed.     

探索结合医学的全新模式

This article provides global and Indian scenario with strengths and limitations of present health care system. Affordability, accessibility and availability of health care coupled with disproportionate growth and double burden of diseases have become major concerns in India. This article emphasizes need for mindset change from illness-disease-drug centric curative to person-health-wellness centric preventive and promotive approaches. It highlights innovation deficit faced pharmaceutical industry and drugs being withdrawn from market for safety reasons. Medical pluralism is a growing trend and people are exploring various options including modern, traditional, complementary and alternative medicine. In such a situation, knowledge from Ayurveda, yoga, Chinese medicine and acupuncture may play an important role. We can evolve a suitable model by integrating modern and traditional systems of medicine for affordable health care. In the larger interest of global community, Indianand Chinese systems should share knowledge and experiences for mutual intellectual enrichments and work together to evolve a novel model of integrative medicine.     

中医药教育在美国发展现状及挑战

Over the past 4 decades Chinese medicine （CM） has comeincreasingly into the spotlight in the United States as the clinical effectiveness ofCM has been not only empirically well-tested over a long period of time but alsoproven by recent scientific research. It has proven cost effectiveness, safety, andis authorized for natural and holistic approaches. In consideration, CM is one of theunderutilized health care professions in the United States with a promising future.However, CM faces many challenges in its education and system, its niche in thehealth care system as an independent profession, legal and ethical issues. This paperdiscusses the confronting issues in the United States： present education, standardsof CM education with shifting first professional degree level, new delivery systemsof CM education. Development of new research models, training of evidence-basedpractice, and implementation of integrative medicine into CM education also are the key issues in the currentCM profession. This paper also discusses opportunities for the CM profession going beyond the current status,especially with a focus on fusion medicine.