2. Acute Non-Lymphoblastic Leukemia

2. Acute Non-Lymphoblastic Leukemia

1. COAP Protocol: Administer 100 mg of cytarabine intravenously once daily; 200 mg of cyclophosphamide intravenously twice weekly; 2 mg of vincristine intravenously once weekly; 20 mg of prednisone, taken orally three times daily.

2. HOAP Protocol: Replace cyclophosphamide in the COAP protocol with 2 mg of taxol, administered intravenously once daily.

3. HCOAP Protocol: Replace cytarabine with taxol.

Qingre Buxue Tang for Oral Inflammation – October 6, 1985

Angelica Sinensis 10 g, White Peony 15 g, Ligusticum Chuanxiong 6 g, Rehmannia Root 12 g, Anemarrhena Rhizome 6 g, Phellodendron Amurense 6 g, Ophiopogon 10 g, Schisandra 6 g, Bupleurum 10 g, Paeonia Lactiflora 6 g, Radix Rehmanniae 10 g—this formula is prepared by decocting these herbs together, one dose per day.

This formula is particularly effective for those with Yin deficiency and dry heat, oral inflammation, ulcerations, severe pain, and prolonged symptoms. I believe that the oral inflammation treated by this formula includes aphthous stomatitis and vitamin E deficiency.

Bianzhi Xinqi Yin Decoction – October 7, 1985

Zhi Shi 10 g, Ban Xia 6 g, Fuling 12 g, Gan Cao 6 g, Su Zi 10 g, Gui Zhi 10 g, Bin Lang 10 g, Die Jia 20 g, Wu Yu 6 g, Sang Bai Pi 10 g, Mu Tong 6 g—this formula is prepared by decocting these herbs together. The formula primarily nourishes the spleen through the use of medicinal ingredients like Ban Xia, which helps to replenish the spleen’s Yin; Fuling helps to eliminate excess dampness from the spleen; Ban Xia warms the spleen’s Yang; Chuanduan and Su Zi strengthen the kidneys and support dental health; Peach Kernel and Apricot Kernel promote blood circulation and open the lungs—since the lungs and kidneys share a common origin, and water and metal are mutually reinforcing. The formula’s mnemonic is: “Wu Jia Sang Tong Bin Su Gui, Zhi Shi Yi Chen Er Chen Rui.”

This formula can treat heart failure due to cardiac disease; the entire formula is based on the Er Chen Tang, with Zhi Shi replacing Chen Pi—this is because the liver is enlarged, with a hard mass resembling a plate in the lower abdomen. Asthma caused by left ventricular failure is due to pulmonary congestion; Die Jia is a nourishing and softening ingredient that helps to reduce blood viscosity and clear heat from the blood, providing some relief for pulmonary congestion; Gui Zhi promotes yang and disperses cold, while the two herbs complement each other perfectly. Bin Lang promotes qi flow and dispels cold, Wu Yu lowers qi and disperses cold—both aim to stimulate the sympathetic nervous system and reduce fluid secretion; Su Zi calms qi and relieves asthma, while Sang Bai Pi clears phlegm and promotes water metabolism; Mu Tong promotes water flow. In summary, this formula aims to eliminate phlegm, activate blood circulation, promote yang, aid water metabolism, and regulate qi—making it an effective remedy for heart-related asthma. (Japanese Experience)

A Formula for Periodontitis – December 24, 1985

I traditionally treated periodontitis using Lushan Tang. Its composition includes: Lushan Root 10 g, Chinese Yam 10 g, Fuling 12 g, Fennel Seeds 10 g, Curcuma Longa 6 g, Scolopendra Subterranea 6 g, Chuanduan 6 g, Peach Kernel 10 g, Apricot Kernel 10 g, Talc 12 g, Gan Cao 6 g—this formula primarily nourishes the lungs, spleen, and kidneys. The formula uses Chinese Yam to nourish the spleen’s Yin, Fuling to eliminate dampness from the spleen, Fennel Seeds to warm the spleen’s Yang, Chuanduan and Scolopendra to strengthen the kidneys and support dental health, Peach Kernel and Apricot Kernel to promote blood circulation and open the lungs—since the lungs and kidneys share a common origin, and water and metal are mutually reinforcing. The mnemonic is: “Lushan Fuling Xiao Jin Gu, Tao Xing Liu Xing.”

For patients with heart failure due to lung disease, this formula is used as a base, with Party Shen, Ban Xia, and Big Berries replaced by Fennel Seeds and Ginger, and the Gui Zhi formula removing White Peony, while the牡蛎 softens and strengthens the kidneys, and the Tianhua Fen acts to clear phlegm and nourish Yin.

Insights into Pulmonary Heart Disease – December 28, 1985

Medical professionals are increasingly focusing on infection-related issues in this condition. Pulmonary heart disease and cerebrovascular disease were formerly known as respiratory acidosis, followed by metabolic acidosis; patients often fall into a deep sleep state, eventually reaching a coma. Given this, in the past, during the 1960s, intermittent oxygen therapy was commonly recommended, but more recently, low-flow continuous oxygen therapy has become more prevalent. Because pulmonary heart disease often presents with obvious hypoxia symptoms, coupled with severe pulmonary infections, it is easy to develop disseminated intravascular coagulation (DIC). Consequently, clinical cases frequently exhibit bleeding symptoms.

Another Ophthalmological Approach – December 29, 1985

Shi Shou Li, an ophthalmologist at the Hebei Provincial Hospital of Traditional Chinese Medicine, used a disinfectant decoction to treat herpetic keratitis—a truly remarkable result! The formula consists of: Bupleurum 10 g, Prunella Vulgaris 15 g, Polygonum Cuspidatum 30 g, Isatis Leaf 15 g, Indigo Woad Root 30 g, Phellodendron Amurense 6 g, Mint 6 g, Honeysuckle 15 g, Cicada Ear 10 g, Red Peony 10 g, Herba Lonicerae 15 g, Chrysanthemum Flowers 15 g, Licorice 6 g—this decoction is prepared by decocting these herbs together, one dose per day. The mnemonic is: “Indigo Woad, Prunella, Indigo, Chrysanthemum, Herba Lonicerae, Red Peony.”

For sore throat, add Tianhua Fen and Mai Dong; for new blood vessel growth in the cornea, add Dan Pi; for red and painful urination, add Mu Tong; for constipation or purulent discharge in the anterior chamber, add Hong Huang and Mang Xiao; after the congestion subsides, gradually increase nourishing Yin and clearing cloudiness medications, such as Si Wu, Yuan Shen, and Mai Dong. This formula proved highly effective in treating herpetic keratitis, employing a formula that clears excess fire from the Liver Meridian. The Liver governs the eyes; inflammation in the eyes is often attributed to Liver Fire. Why does Liver Fire rise? It stems from stagnation—stagnation leads to heat, which is the root cause of Liver Fire. The formula uses Bupleurum to soothe the Liver, Red Peony to activate and soften the Liver, addressing the root cause. Indigo Woad, Indigo, Phellodendron Amurense, Herba Lonicerae, and Mint are all herbs that clear heat from the Liver Meridian, addressing the symptoms. The Liver is the Wood organ; when fire rises, it becomes wind-like, and when wind and fire combine, the fire becomes even more pronounced. Thus, Cicada Ear, Chrysanthemum, and Polygonum Cuspidatum dispel wind and cool the fire, serving as complementary treatments.

For sore throat, the fire is strong; when Yin is severely damaged, add Tianhua Fen and Mai Dong; for conjunctival congestion, add Dan Pi to promote blood circulation and resolve blood stasis. For red and painful urination, add Mu Tong; for constipation or pus accumulation in the anterior chamber, add Hong Huang and Mang Xiao—this is like drawing the fire out from the bottom of the pot. When compared with the previously mentioned Wu Zhu Yu Tang, we can see that one is real and one is virtual: the real one is conjunctival congestion, while the virtual one is ciliary body congestion. The latter is often associated with intraocular diseases such as glaucoma and iritis, whereas the former is often related to conjunctivitis and keratitis. (Chinese Journal of Traditional Chinese Medicine, Issue 1, 1984)

Analysis of Benign Bile Duct Diseases – February 20, 1986

Benign bile duct diseases clinically include bile duct inflammation and gallstones; among them, acute bile duct disease accounts for 23.4%, chronic bile duct disease for 35.0%, bile duct inflammation combined with stones for 21.5%, bile and pancreatic inflammation for 12.6%, and post-bile duct surgery syndrome for 7.5%. Due to the reduced neurohumoral responsiveness in elderly patients, local pain may be less noticeable, leading to frequent misdiagnosis. Some patients are admitted with high fever, others with vomiting, and still others with fatigue and loss of appetite. For these patients, the preferred treatment approach is a combination of traditional Chinese and Western medicine. One winter, my father suddenly developed a high fever that did not respond to any conventional treatments; after undergoing Western medical examination, he was diagnosed with chronic cholecystitis. After taking traditional Chinese medicine and receiving intravenous ampicillin, he recovered completely.

The Theory of Rising, Falling, and Floating – February 22, 1986

According to the Su Wen “Great Discussion on the Balance of Yin and Yang,” “Clear Yang rises to the upper channels, while turbid Yin descends to the lower channels; clear Yang activates the skin and muscles, while turbid Yin travels to the five internal organs; clear Yang resides in the four limbs, while turbid Yin returns to the six external organs.” “When clear Qi resides below, it gives rise to diarrhea; when turbid Qi resides above, it causes bloating.” According to the Su Wen “Great Discussion on the Six Organs,” “When the entry and exit are disrupted, the divine mechanism is lost; when rising and falling cease, Qi becomes isolated and vulnerable. Therefore, without entry and exit, there is no growth, no strength, no aging; without rising and falling, there is no growth, no transformation, no storage.”

Ancient Chinese Medical Texts and Their 24-Hour Designations – February 24, 1986

2 o’clock: Chicken Crowing; 4 o’clock: Last Day; 6 o’clock: Dawn; 8 o’clock: Midday; 10 o’clock: Morning Meal; 12 o’clock: Noon; 14 o’clock: Sun’s Rise; 16 o’clock: Afternoon; 18 o’clock: Sunset; 20 o’clock: Dusk; 22 o’clock: Nightfall; 24 o’clock: Midnight.

Electrocardiogram Summary – February 25, 1986

1. Electrical Axis: Focus on standard leads for observation—lead I shows upward waves, while lead III shows downward waves, indicating a leftward electrical axis; conversely, a rightward electrical axis indicates a leftward electrical axis.

2. Heart Position: Focus on leads aVL and aVF—lead aVL shows upward waves, indicating a transverse heart position; lead aVF shows upward waves, indicating a vertical heart position; both indicate a horizontal heart position.

3. Direction: Focus on lead V3—lead V3 shows downward waves, indicating a clockwise direction; lead V3 shows upward waves, indicating a counterclockwise direction.

4. The upright and inverted forms of each wave pattern show regular variations: P, QRS, and T waves are all inverted in lead aVR, while all other leads show upright waves. The P wave is upright in all leads; if it appears inverted, it is an ectopic P wave, which may originate from atrioventricular node impulses or from atrial impulses. The direction of the QRS complex varies significantly depending on heart position, electrical axis, and direction on the electrocardiogram—but overall, qR and Rs represent the left ventricular membrane potential, while rS and QS represent the right ventricular membrane potential. All leads show similar patterns in their overall wave morphology. When analyzing an electrocardiogram, it is important to keep this in mind.

Clinical Progression of Chronic Pulmonary Heart Disease – May 19, 1986

In 1961, the International Conference on Pulmonary Heart Disease proposed that this condition resulted from right ventricular hypertrophy caused by chronic respiratory diseases; in 1975, the European Conference on Pulmonary Heart Disease suggested that pulmonary heart disease was caused by a reduction in the volume of the pulmonary vascular bed, leading to right ventricular hypertrophy. This condition has a high incidence rate and poor prognosis. Boudik followed up on 829 cases of pulmonary heart disease over two years, finding that one-third died; after four years of follow-up, two-thirds had passed away, with only two cases surviving for six years. This condition often affects elderly and middle-aged individuals; young people can also develop it, though rarely. Besides common respiratory symptoms, clinical manifestations should also emphasize edema and lethargy. In terms of physical signs, in addition to emphysema and pulmonary heart disease, rapid heart rate and hepatomegaly should be noted. Laboratory tests should focus on increased hemoglobin levels and elevated white blood cell counts, as well as neutrophil increases. 39.5% of patients showed elevated non-protein nitrogen levels, while 58.6% exhibited respiratory acidosis in blood gas analysis—and some patients also experienced metabolic acidosis and alkalosis. Electrocardiographic changes included clockwise rotation, rightward electrical axis, right ventricular hypertrophy, S-T segment changes, and arrhythmias—all of which decreased sequentially from 90% to 10%.

Xiao Chai Hu Tang and Chai Hu Saponins’ Hepatitis-Inhibiting Effects – May 20, 1986

This formula serves as a primary treatment for hepatitis. From a pathological perspective, treating hepatitis should consider the following two effects: first, inhibiting and eliminating hepatitis virus replication; second, suppressing and preventing liver cell damage from progressing to chronic stages. To achieve this, it is necessary to prevent cell membrane damage caused by immunological mechanisms, followed by further liver cell damage—both effects are similar to the actions of Xiao Chai Hu Tang and Chai Hu Saponins. Currently, it is believed that the body’s immune response against liver-specific antigens on liver cells is a key factor in the onset and progression of chronic hepatitis. In vitro studies have shown that Xiao Chai Hu can inhibit liver cell damage caused by ADCC (antibody-dependent cell-mediated cytotoxicity) and strongly counteract antibody production. Compared to corticosteroids and levamisole, the regulatory effects of Xiao Chai Hu on the body’s immune system are not only more effective but also have fewer side effects.

Discussion on Spleen Yin Deficiency – May 25, 1986

Li Dongheng’s discussion on the spleen and stomach only mentioned spleen-yin deficiency and spleen-yang deficiency, without mentioning spleen-yin deficiency. Many people tend to attribute spleen-yin deficiency to the stomach, but in clinical practice, there are three conditions that indeed reflect spleen-yin deficiency—these conditions should be clearly remembered. ① Xiao Jianzhong Tang: dry mouth and tongue accompanied by abdominal pain; ② Shen Ling Bai Zhu San: dry mouth and tongue accompanied by diarrhea; ③ Pi Yue Wan: dry mouth and tongue accompanied by constipation. The abdominal pain, diarrhea, and constipation associated with these three formulas are all common symptoms—but the underlying cause of these symptoms is spleen-yin deficiency. (Han Luan Shouyan, Modern Oriental Medicine, June 1985)

Fangji Huangqi Tang with Ephedra for Treatment of Deformative Knee Arthritis – June 1, 1986

Yasumori Michi, a 58-year-old woman who was overweight, lost weight to 66 kg after reducing her food intake. Six months ago, she developed deformities and swelling in her left knee joint, along with pain and lower back pain. Conventional Western medicine failed to alleviate her symptoms. Yasumori had previously treated patients with excess fat and fatigue using Fangji and Huangqi, and found success in many cases. He added Ephedra to this formula, and since she was experiencing constipation, he increased the dosage of Huangqi by 10 g. After one month of treatment, her knee and lower back pain improved. (Yasumori Michi, Clinical Practice of Hanfang, February 1985)

Hai Gou Bujin Wan for Menopause-Related Lower Back Pain – June 2, 1986

This medicine is often used to enhance male vitality, but in women during menopause, low estrogen levels can lead to excessive gonadotropin secretion, causing a series of autonomic nervous system disorders. Therefore, Hai Gou Bujin Wan not only relieves lower back pain but also alleviates systemic symptoms. (Kanai Masaki, Oriental Medicine, April 1985)

High Fever and Hanfang – June 3, 1986

In Hanfang, several formulas are used to treat high fever:

1. Mahuang Tang: Headache, fever with chills, floating pulse.
2. Ge Gen Qin Lian Tang: Fever with thirst, body heat, and loose stools.
3. Bai Hu Tang: High fever, intense thirst, rapid pulse, profuse sweating.
4. Cheng Qi Tang: Fever, yellow tongue, constipation.
5. Zhen Wu Tang: Fever, dry mouth, large pulse, loss of appetite, self-diuresis, constipation, slight sweating. (Osamu Mori, Japanese Journal of Oriental Medicine, October 9, 1984)

Among the five major fever formulas mentioned above, the remaining fever formulas are common knowledge; only the fifth formula represents an important discovery in treatment. The diuretic effect of Zhen Wu Tang is well-known, but its antipyretic effect is less recognized—Osamu Mori’s insights on this matter are quite insightful.

Rheum for Chronic Renal Failure – June 4, 1986

Terazawa Tetsuya and colleagues achieved significant therapeutic effects when treating chronic renal failure with pure rheum and rheum preparations. After treatment, BUN, serum creatinine, and free amino acid levels all dropped significantly and tended toward normal. The authors speculated that rheum may accelerate urea cycle and reduce urea nitrogen levels. (Terazawa Tetsuya et al., Abstracts of Papers from the Oriental Medical Society, 1985)

Hanfang for Bronchial Asthma – June 10, 1986

84 cases of bronchial asthma were classified into three types: ① Atopic type: triggered by bronchial spasms; ② Infection type: accompanied by infection; ③ Mixed type. All patients with the atopic type received medication for more than four months and all experienced improvement; this type had the highest remission rate, reaching 44%; the infection type saw a remission rate of 23%; the mixed type had a remission rate of 10%.

Among patients who had been treated for more than one year, 32.5% experienced remission, while 67.5% showed improvement, with an overall effectiveness rate of 100%. Among the formulas used, the Da Qing Long Tang and Ma Xing Shi Gan Tang—both containing ephedra—were found to be most effective for the atopic type, with a remission rate of up to 80%. Meanwhile, the Gan Cao Fu Ling formulas tended to be more effective for the infection type. (Abstracts of Papers from the Oriental Medical Society, 1985)

The Role of Momordica Cochinchinensis in Ophthalmology – June 11, 1986

This herb is often used in Indian folk medicine primarily to treat eye inflammation. The author found that a 5% Momordica cochinchinensis alcohol extract was effective in treating experimental uveitis; the extract did not cause significant irritation to the eyes. Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Use, safe for use in ophthalmic inflammation. (Abstracts of Papers from the Oriental Medical Society)

The Effect of Gui Zhi Fu Ling Wan on Experimental DIC Caused by Endotoxin – June 12, 1986

The preventive effect of Gui Zhi Fu Ling Wan on hemolytic syndrome was observed in experimental DIC, and it was found that the preventive effect on DIC is produced by the combination of five medicinal herbs, rather than by any single herb alone. (Ko Minaichi, Abstracts of Papers from the Oriental Medical Society)

Wei Bai Du Tang for Treatment of Unknown Fever – June 12, 1986

Ten-herb Disinfectant Decoction: Jing Jie, Fang Feng, Fu Ling, Chuan Xiong, Chai Hu, Gui Zhi, Ying Pi, Gan Jiang, Gan Cao, Du Huo. This formula is derived from a modified version of the Jing Fang Bai Du San; previously, Hu, Qiang Huo, and Zhi Ke were removed from the formula and replaced with Ying Pi, Gan Jiang, and Gan Cao. This formula was developed by Hua Gang Zou Chuan in Japan. Michiaki Yosano pointed out in “Commentary on Herbal Prescriptions” that this formula is used for purulent diseases and early stages of skin conditions; therefore, in addition to clearing heat and detoxifying, this formula can also help desensitize the body. (Shu Fang Li Fang, Clinical Practice of Traditional Chinese Medicine)

Qing Shang Fang Feng Tang for Treatment of Acne Vulgaris – June 13, 1986

Jing Jie, Fang Feng, Lian Qiao, Shan Zhi, Huang Lian, Huang Qin, Bo He, Chuan Xiong, Bai Zhi, Jue Qi, Zhi Shi, Gan Cao. In principle, this formula does not use antibiotics or vitamins for treating acne; taking this medicine alone achieves an effective rate of 75%. (Ko Takaaki, Clinical Practice of Traditional Chinese Medicine, February 1984)

Pharmacological Effects of Wu Zhu Yu – June 14, 1986

This medicine is the fruit of Evodia rulaecarpa, a plant belonging to the Rutaceae family. It is a warm-natured herb used to treat various chronic conditions characterized by decreased function, slowed metabolism, coldness, and nausea and vomiting caused by smooth muscle spasms in the stomach. Professor Yamada of Japan conducted research on the pharmacology of this medicine, and his findings were as follows:

1. Analgesic Effect: Intravenous injection of a 10% ethanol extract of Wu Zhu Yu had analgesic effects in rabbits, which were more pronounced under cold conditions.

2. Promotion of Blood Circulation: A transient increase in blood pressure and respiratory rate was observed, along with an increase in carotid arterial blood flow.

3. Body Temperature Rise: Wu Zhu Yu alkaloid and Wu Zhu Yu secondary alkaloid were isolated from this medicine; both alkaloids exhibited a certain warming effect.

Fever Induced by Small-Molecule Dextran – June 15, 1986

This medicine is commonly known as Mai Tong Injection. It can cause periodic fever, characterized by the following features: ① Incubation period: 6–60 days; fever period: 2–20 days; intermission period: 5–50 days; ② Most cases present with remittent fever, with body temperature fluctuating between 37.5°C and 41°C, often peaking in the late afternoon, intensifying at night, and dropping in the early morning; ③ Hormone therapy can yield good results.

Gastric Lavage for Acute Organophosphorus Poisoning – June 20, 1986

Organophosphorus compounds are effective ingredients in many pesticides. As pesticide use becomes increasingly common, the clinical manifestations of organophosphorus poisoning include not only general symptoms such as abdominal pain, nausea, vomiting, shock, and coma, but also severe cases featuring constricted pupils, muscle tremors, excessive sweating, and a distinctive garlic-like odor. Additionally, a decrease in serum cholinesterase activity is an important diagnostic indicator of organophosphorus pesticide poisoning; however, this indicator often decreases in patients with liver disease, myocardial infarction, hypertension, or gastrointestinal tumors. Therefore, a decline in serum cholinesterase levels is not always specific. The key measures for emergency treatment of this condition include gastric lavage, induced vomiting, and emesis. Some experts suggest that induced vomiting may be better than gastric lavage, but most scholars believe that gastric lavage is still more thorough. After accidental ingestion of organophosphorus pesticides, regardless of the duration of exposure, gastric lavage should be performed. Even after gastric lavage, if there is suspicion that the lavage was not thorough, another round of gastric lavage may be necessary. There are two methods of gastric lavage: using a gastric tube or performing open gastric lavage. The lavage solution typically includes 2% NaHCO₃ solution (for parathion, use a 1:5000 ppm solution), saline, or plain water. Generally, when pesticide types are unknown, it is recommended to use plain water for gastric lavage, as the absorption of 2% NaHCO₃ can easily lead to alkalosis. Open gastric lavage is used when poisoning is severe and gastric tube lavage has failed within 4 hours. Although open gastric lavage causes additional trauma to the patient, it is only considered when other options are unavailable. Severe organophosphorus pesticide poisoning can often lead to acute pulmonary edema, cerebral edema, and respiratory failure; therefore, treatment should include: ① Oxygen therapy; ② Respiratory stimulants; ③ Scopolamine, which has been shown to be effective in rescuing respiratory failure; ④ Use of cardiac glycosides to improve cardiopulmonary function; ⑤ Correction of electrolyte imbalances.

Sick Sinus Syndrome – June 21, 1986

Approximately 50% of cases are caused by coronary heart disease or myocardial infarction, while the remaining half are due to idiopathic sick sinus syndrome—no obvious cause identified. However, pathological anatomy reveals fibrotic changes around the sinoatrial node. The clinical manifestations of this condition include chest tightness, palpitations, dizziness, episodic syncope, slow heart rate, and occasional episodes of rapid heartbeat, clinically referred to as tachycardia–bradycardia syndrome. Patients may even experience sudden death. The main diagnostic criteria for this condition include: ① Sinoatrial bradycardia; ② Sinoatrial block; ③ Sinoatrial pauses; ④ Atrial and atrioventricular escape rhythms; ⑤ Atrial fibrillation; ⑥ Paroxysmal supraventricular tachycardia. Among these ECG characteristics, ①, ②, and ③ represent the primary lesions, while ④ reflects compensatory changes, and ⑤ and ⑥ indicate insufficient compensation. Diagnosis involves: ① Exercise testing; ② Atropine test; ③ Isoproterenol test.

Treatment of Cardiac Preload and Postload in Heart Failure – June 23, 1986