V. Significance Testing

V. Significance Testing

Based on the sample mean or rate, estimate the range of the population mean or rate. In medical practice, the 95% confidence interval is commonly used, indicating that there is a 95% probability that the population rate will fall within this range based on the sample mean or estimated value. If the lower limit of a treatment regimen is higher than the upper limit of another regimen (with a 95% probability), the difference is considered statistically significant (p < 0.05); if the probability is 99% (confidence interval), the difference is considered highly significant (p < 0.01).

The Chi-square test is the preferred method for comparing two sets of data: first calculate the T-value, then compute the Chi-square statistic, and finally refer to the Chi-square table to determine the p-value. A p-value less than 0.05 indicates a statistically significant difference, while a p-value less than 0.01 signifies a very highly significant difference.

Summary of Snake Seed Therapy, August 29, 2000

1. Snake seed treatment for cytomegalovirus infection: Commonly seen in pregnant women whose immune systems are weakened—while ordinary people may only experience herpes, pregnant women often face miscarriages, stillbirths, and even birth defects or intellectual disabilities due to CMV infection. Therefore, CMV infection in pregnant women has become a critical concern. For women experiencing miscarriage accompanied by cold symptoms during the second or third month of pregnancy, it is important to promptly test for CMV IgG and IgM antibodies. If both are positive, the diagnosis can be confirmed. A combination of Shou Tai Wan and Si Wu Tang, with 6g of snake seed added, has proven highly effective.

2. Snake seed can treat anovulatory menstrual cycles: For patients experiencing infertility after marriage due to anovulatory menstruation, snake seed can be incorporated into the Fufu Formula.

3. Treatment for sore throat and cough: For chronic pharyngitis, adding 10g of snake seed to the Yang Yin Qing Fei Decoction has proven effective.

4. External genital warts: 50g of snake seed, 30g of He Shou Wu, 30g of walnut kernels, 30g of white moss, and 30g of hawthorn. For kidney deficiency, add Deer's Tongue Grass; for blood deficiency, add Rehmannia Root, Dried Rehmannia Root, and Angelica Sinensis; for damp-heat, add Atractylodes Macrocephala and Phellodendron Amurense; for vaginal swelling, add White Flower Snake Tongue Herb. Brew the herbs in water, take one dose daily; the remaining herbal residue can be wrapped in gauze and applied as a warm compress, or used for sitz baths.

5. Snake seed can also treat asthma, vasculitis, arrhythmias, prostatitis, and rectal prolapse in children—indicating that these conditions are often related to autonomic nervous system dysfunction, which snake seed may help regulate.

In summary, snake seed can: ① inhibit viruses, treat CMV infections in pregnant women, and alleviate chronic pharyngitis; ② promote ovarian function and treat infertility caused by anovulatory menstruation; ③ regulate the function of the autonomic nervous system.

Bethlem's Disease – A Brief Overview, August 29, 2000

10g of Chai Hu, 10g of Huang Qin, 10g of Zhimu, 10g of Long Dan Cao, 10g of Chi Xiao Dou, 30g of Sheng Yi Ren, 10g of Shihu, 10g of Zhu Ling, 10g of Dang Gui, 6g of She Gan, 6g of Cang Zhu, 10g of Huang Bai, 3g of Huang Lian, 10g of Shan Zhi, 30g of Sheng Shi Gao, and 10g of Chuan Niu Xi. This formula contains Huang Lian for detoxification, Long Dan for clearing the liver, Si Miao, and Bai Hu. The mnemonic phrase is: “Huang Long Si Hu Jia Shi Zhu Niu Bai Se Shi.”

2. Xie Ning No. 2, September 14, 2000 Friend Huang Qingcheng came to visit, saying that Liu Guo’an’s formula for treating chronic colitis in “Practical Internal Medicine of Traditional Chinese and Western Medicine” was truly remarkable. Upon reviewing the formula, he found that it included Dang Shen, Bai Zhu, Fu Ling, Gan Cao, Chen Pi, Shan Yao, Gan Jiang, Fu Pi, Wu Mei, Huang Lian, Huang Qin, and Pomegranate Peel. This formula was derived from Wu Mei Wan, with the addition of Yi Gong San and Shan Yao.

Wu Mei Wan: 10 plums, 4g of Sichuan Pepper, 9g of Gan Jiang, 16g of Huang Lian, 6g of Huang Bai, 6g of Dang Shen, 4g of Dang Gui, 6g of Xixin, 6g of Fu Zi, 6g of Gui Zhi—this is the complete composition of Wu Mei Wan. The formula emphasizes Huang Lian and Wu Mei in large quantities, followed by Gan Jiang, while the remaining herbs are each administered in 6g doses.

Herbal Remedies for Flat Warts, September 5, 2000

10g of Da Qing Ye, 20g of Ban Lan Gen, 12g of Tu Fu Ling, 10g of Shan Ci Gu, 10g of Tao Ren, 6g of Hong Hua, 20g of Bai Qi Li, 30g of Cang Zhu, 6g of Huang Bai, 10g of San Ling, 10g of E Zhu, 6g of Dan Shen, 6g of Chang Pu, 10g of Xia Ke Cao—these herbs are decocted in water and taken orally. This formula became my specialized remedy for treating flat warts. According to Mr. Huang Qingcheng from Tian Shui, he had repeatedly tested and verified this formula in clinical practice.

The Essence of Zhang Xichun’s Canhe Zhenqi Decoction, September 25, 2000

10g of Dang Shen, 15g of Ochre Stone, 6g of Shan Yu, 10g of Shan Yao, 15g of Sheng Long Mu, 15g of Sheng Bai Shao, 10g of Su Zi, 20g of Qian Shi, 6g of Gan Cao—this formula was developed by Zhang for patients with qi deficiency and shortness of breath. The formula includes a number of astringent and qi-regulating herbs, and it has proven effective in treating shortness of breath caused by chronic anemia, emphysema, and hypotension.

A Case of Skin Cancer Recovery, October 11, 2000

In August of the Year of the Dragon, Mr. Xu, a farmer from Tong County, was diagnosed with skin cancer covering an area of 20cm × 80cm, extending to his lower limbs and the inner and outer sides of his thighs. The surface of the lesion resembled cauliflower, with ulcerated nodules and purulent discharge. A pathology biopsy conducted at Dingxi Hospital revealed skin squamous cell carcinoma. Based on the following formula: Da Qing Ye, Ban Lan Gen, Gong Ying, Baisiang, Tao Ren, Hong Hua, Sheng Yi Ren, Bai Qi Li, Cang Zhu, Huang Bai, Dang Gui, Bai Shao, Tu Fu Ling, Shan Ci Gu, San Ling, E Zhu, and Xia Ke Cao—this formula was used. After 20 doses, the nodules on the surface shrank by half, the ulcers healed and formed scabs, local pain disappeared, and the foul odor was eliminated.

Hematopoietic Stem Cell Transplantation (HSCT), October 13, 2000

High-dose radiation and chemotherapy were used to eliminate tumor cells in the body and block the underlying mechanisms of disease. Subsequently, the patient received autologous or allogeneic hematopoietic stem cell transplantation to rebuild blood cells or the immune system. The procedure for achieving this goal is known as Hematopoietic Stem Cell Transplantation. Initially, this method was primarily used for leukemia and malignant lymphoma. In recent years, it has made significant progress in the treatment of autoimmune diseases such as SLE (lupus erythematosus), RA (rheumatoid arthritis), and MS (multiple sclerosis). However, relapse of the disease after transplantation remains a major challenge; the treatment of relapse is extremely difficult. The primary reasons for relapse lie in the lack of sensitivity to chemotherapy and the development of drug resistance in tumor cells. The simultaneous use of immunomodulators like IL-2 and interferon, along with chemotherapy drugs, can enhance transplant success and reduce relapse rates. Post-transplant hormone therapy and chemotherapy can also help reduce relapse, but they may exacerbate immune dysregulation and increase the occurrence of complications.

Segmentation of Normal Lung Lobes, November 20, 2000

For clinical purposes, the localization of lung lobes on X-rays is quite important. The left lung consists of two lobes, while the right lung comprises three lobes. Typically, the left lung is 1–2 cm higher than the right lung. Each lung lobe is separated by interlobar fissures. The right lung has horizontal and oblique fissures, whereas the left lung only has oblique fissures.

The upper lobe of the right lung is composed of the apical, posterior, and anterior segments; the middle lobe is formed by the lateral and medial segments; the lower lobe consists of the basal segment, the lateral segment, the anterior segment, the posterior segment, and the dorsal segment.

The upper lobe of the left lung is divided into two parts: the upper portion and the lingual portion. The upper portion comprises the apical and anterior segments; the lingual segment is composed of the upper lingual segment and the lower lingual segment. The lower lobe is further divided into the dorsal segment, the anterior segment, the posterior segment, the basal segment, and the lateral segment.

Another Effective Formula for Treating Coronary Heart Disease, November 20, 2000

The Yang Xin Tang, previously mentioned, had not shown significant efficacy in clinical practice. Recently, however, this formula has yielded remarkable results in treating coronary heart disease patients, so we would like to share it.

Patient Wang Mou experienced chest tightness, palpitations, shortness of breath, and occasional chest pain radiating to the back. Using Guo Lou Xie Bai Ban Xia and Guan I, the treatment did not yield significant results. We then prescribed the following formula: 20g of Jiao Shan Zha, 12g of Sheng Di, 10g of Dang Gui, 10g of Dang Shen, 20g of Chuan Lian Zi, 10g of Yuan Rou, 6g of Yuan Zhi, 10g of Chang Pu, 15g of Sheng Long Mu, 10g of Chao Shao, 6g of Huang Lian, 10g of Huang Qin, 10g of Chuan Lian Zi, 3g of Zhi Ru Mo, 6g of Ban Xia, 6g of Chen Pi, 6g of Gan Jiang, 15g of Sheng Long Mu, 15g of Wu Che Gu, and decocted in water. After 20 doses, the jaundice significantly improved; total bilirubin dropped from 48 to normal levels, and transaminases decreased from 75 to normal levels. The patient’s mental state improved, appetite increased, skin color gradually turned pink, and stomach discomfort eased compared to before. Upon reflection, this formula is a harmonious approach to soothing the liver and stomach—just as ancient practitioners used Xiaoyao San to treat liver-stomach disharmony, this formula is a true masterful approach to treating liver diseases. The formula uses Chai Hu to soothe the liver, Xiao Dan Shen to clear the heart, Xiang Sha Six Jun to harmonize the stomach, thereby enhancing the effects of soothing the liver and stomach. The addition of Sheng Long Mu and Wu Che Gu helps manage stress-induced gastric acid production. Yuan Zhi, Chuan Lian Zi, Zhi Ru Mo, Qing Pi, Turmeric, Cinnamon, San Ling, and E Zhu are all herbs that promote qi and blood circulation, perfectly aligning with the treatment of liver fibrosis. Adding Yin Chen and Zhizhi further enhances the effect of resolving jaundice. In conclusion, this formula is a highly effective treatment, and it can serve as a foundation for future research and development of liver cirrhosis formulations.

Internal Medicine Treatment for Lung Cancer, December 8, 2000

Bronchial lung cancer is categorized into two types: 1. Small Cell Lung Cancer (SCLC): oat cell, diamond cell, polygonal cell; ② Non-Small Cell Lung Cancer (NSCLC): squamous, adenocarcinoma, large cell. In urban areas, this disease ranks first among cancers in terms of incidence; in rural areas, it ranks fourth, following gastric cancer, esophageal cancer, and gynecological cancers, with a male-to-female ratio of 2:1.

Treatment principles: Whether it’s small cell or non-small cell cancer, the general principle is early detection and early treatment. For patients who are candidates for surgery, efforts should be made to surgically remove the primary tumor. Small cell cancer is often detected at an advanced stage, making surgery less suitable. Therefore, chemotherapy is recommended; if the cancer has metastasized to the brain, radiotherapy can be combined, as can spinal cord injections. For bone metastases, treatments such as strontium-89 and samarium-153 are effective. For non-small cell cancer, surgical resection is generally preferred; preoperative chemotherapy and postoperative chemotherapy are often recommended.

Combined chemotherapy regimens: SCLC—limited stage (no metastasis) can achieve a response rate of 80%–90%, with CR rates reaching 50%–60%, and a median survival period of 12–14 months. For extensive stage, the response rate can reach 70%–… 80%, CR reaches 15%–30%, with a median survival period of 7–10 months. Common chemotherapy regimens include: ① CE regimen: CPB 300 mg/m², administered intravenously on days 1–4, Vp-16 60–100 mg, on days 1–4; treatment lasts for 28 days per week.

② CAP regimen: CTX 500 mg, on day 1, Vp-16 60–100 mg, on day 1–4; DDP 30 mg, on day 2–4; treatment cycles are three weeks each, with three cycles constituting one course of therapy. ③ EAP regimen: ADM 30 mg, on day 1, Vp-16 100 mg, on days 2–5; DDP 30 mg, on days 5–7.

NSCLC chemotherapy: EPD regimen: ADM 30 mg, on day 1, Vp-16 100 mg, on days 1–4; DDP 20 mg, on days 2–4; NP regimen: NVB (Vincristine) 25 mg/m², on day 1, Vp-16 100 mg, on days 1–4; after adding NVB to 250 ml of NS solution, administer DXM 5–10 mg intravenously, followed by flushing the vein with normal saline to prevent phlebitis. DDP 30 mg, administered intravenously on days 2–4; this regimen is used every 3 weeks, with three cycles constituting one course of therapy. NIP regimen: NVB (Vincristine) 25 mg/m², on day 1, Vp-16 100 mg, on days 1–5; DDP 30 mg, administered intravenously on days 5–7. This regimen is used every 3 weeks, with three cycles constituting one course of therapy. GP regimen: GEM 1000 mg, on days 1, 8, and 15; DDP 20 mg, on days 2–4; NP regimen: NVB (Vincristine) 25 mg/m², on day 1, Vp-16 100 mg, on days 1–4; DDP 30 mg, administered intravenously on days 1–5; this regimen is used every 3 weeks, with three cycles constituting one course of therapy.

In summary, a treatment cycle lasts for 3 weeks, and three cycles constitute one course of therapy.

Another Advancement in Liver Cirrhosis Treatment – December 10, 2000

1. Treatment for Gastric Pain in Liver Disease: This is an important measure in advanced liver cirrhosis. Hyperemia of the gastric mucosa, stress ulcers, esophageal varices, and bile stasis are all common causes of gastric pain and vomiting. Although this principle has long been documented in traditional Chinese medicine theory as “Liver Wood overcoming Earth,” most doctors have not fully grasped its true therapeutic significance. In such cases, treatment should follow the principle of “treat the symptoms when they arise.” Specifically, for conditions involving liver treatment, it is advisable to focus on treating the spleen rather than the liver—using Xiangsha Liu Jun Shen Tang combined with Xuanfu Daihe Tang as the first choice. For patients with ulcers, Hanzheng Tang is recommended; for those experiencing diarrhea, Weiling Tang is suitable. I have seen significant efficacy using this approach, and I often say: “Treating the spleen is also treating the liver—when the condition is mild, treat the liver; when it’s severe, treat the stomach. This is the fundamental principle of liver treatment.”

2. Jaundice in Liver Disease Patients and Post-Jaundice Yellowing of the Conjunctiva: This is a difficult condition to treat in liver disease patients, indicating bile stasis. What causes bile stasis? It can result from compression of the small bile ducts, hepatocellular necrosis, or infections in the liver tissue and biliary system. The combined formula for gallbladder and pancreatic disorders has proven effective in treating liver disease and jaundice; adding Yin Chen and Zhizhi further enhances its therapeutic effects. This formula integrates bile regulation, bile promotion, anti-inflammatory action, and blood production into a single formulation, offering remarkable efficacy in rescuing critically ill patients with severe liver conditions and treating acute jaundice. However, since many people lack this experience, do not underestimate its importance. After the jaundice index declines, yellowing of the conjunctiva and darkening of the skin may persist for a considerable time. At this stage, employing methods that nourish the kidneys and promote blood circulation can be highly beneficial. I usually use Xuefu Zhuoyu Tang for this purpose, and Liwei Tang also proves effective. White Tribulus, Female Genitalia, Dry Lotus Seed, Dahuang, Herba Astragali, Tussilago, and Polygonum Cuspidatum are all suitable additions to this formula.

Treatment of Hepatic Hemangiomas – December 16, 2000

In the winter of Gengchen, Mr. Wu experienced pain in his liver region, which had not improved despite various treatments. He sought my care. Using Chaihu Shu Gan combined with Xiao Dan Shen, San Ling, E Jiu, Qing Pi, Turmeric, and Cinnamon, the treatment proved highly effective. Upon reflection, I realized that while Mr. Wu’s liver function was normal, the hemangioma was the primary lesion—different from the liver pain associated with liver cirrhosis. Therefore, I chose to use He Xia Zuo Yu Tang for this condition.

Cough Caused by Chronic Pharyngitis – December 16, 2000

In the winter of Gengchen, a patient who had undergone tracheostomy due to throat cancer was recovering. Due to a cold, he experienced paroxysmal cough, excessive phlegm, discomfort in his throat, and occasional sounds resembling water dripping. I treated him with Yangyin Qingfei Tang combined with Ma Xing Shi Gan Tang and Su Xing San, and after just three doses, significant improvement was achieved. “Yangyin Qingfei Tang” is a well-known formula from “Chong Lou Yu Kai,” authored by Zheng Mei Jian during the Qing Dynasty. Originally, this formula was specifically designed for treating diphtheria. The term “diphtheria” does not refer to modern diphtheria; it is a general term for all inflammatory diseases of the throat. In my view, the primary indications for this formula include chronic inflammation of the throat, such as chronic pharyngitis, chronic tonsillitis, and chronic laryngitis. Unlike formulas that focus on clearing heat, detoxifying, or draining fire, this formula actually reduces inflammation! Its key ingredients—Sheng Di, Yuan Shen, Mai Dong—serve to replenish fluids; Zhe Bei softens hardness and clears phlegm, while Bai Shao nourishes yin. Although Peppermint and Platycodon have some cooling and detoxifying properties, they are not the primary agents for clearing heat and detoxifying in traditional Chinese medicine. From this perspective, chronic inflammation is often characterized by yin damage—fire easily harms yin, and over time, yin damage becomes evident! Inflammation in the throat is similar to inflammation in the stomach! Ye Tian Shi’s Yang Wei Tang uses Sha Shen, Mai Dong, Yu Zhu, and Shihu as its main ingredients; inflammation in the lungs is similarly treated with Yuehua Wan, Lily, Baibu, Bai Wei, Beisha Shen, Chicken Gizzard, Tian Dong, Mai Dong, A Jiao, Soap Nut, Deer Gelatin, Han San Qi, Sheng Di, Shu Di, Sang Bai Pi, Platycodon, Poria, and other herbs. For hepatitis, Yibei Tongyuan Yin is another formula that nourishes yin and generates fluids—both are worth considering!

Application of Tai Neng in Elderly Patients with Infections – December 16, 2000

Tai Neng is currently one of the antibiotics with relatively good clinical efficacy, following Cefoperazone and Ceftriaxone. Its main active ingredient, Imipenem, is a carbapenem antibiotic that is more stable against β-lactamases compared to penicillins and cephalosporins, enabling it to effectively combat β-lactamase enzymes. Another component of Tai Neng, Cilastatin, effectively blocks the metabolism of Imipenem in the kidneys, allowing it to be excreted in its original form. This makes Tai Neng particularly effective in treating urinary tract infections, though it does place some strain on the kidneys.

Tai Neng is suitable for infections of the respiratory tract, digestive tract, and urinary tract—but the dosage should be reduced for urinary tract infections. Typically, the dose is 1–4 g, taken once or twice daily via intravenous infusion at a slow rate of no less than 40 minutes per 1 g. Therefore, it is recommended to add Tai Neng to 300 ml or 250 ml of NS solution, at a rate of 30 drops per minute.

Application of Brain Activator – December 16, 2000

Also known as Saifou Jin, this peptide is extracted from brain tissue and possesses functions that activate brain metabolism. It quickly crosses the blood-brain barrier, activating neurotransmitters within the brain, thereby improving brain cell metabolism, addressing functional disorders, cerebral arteriosclerosis, and post-traumatic brain injuries. Dosage: 20 ml (4 vials), IVgtt, Qd; 5 ml (1 vial), IM, BID. A course of treatment lasts for 15 days.

Case Study of Shen Zuo Zhen Qi Tang – December 17, 2000

In the winter of Gengchen, I treated a patient with emphysema who experienced chest tightness, shortness of breath, dizziness, and headaches, which worsened with colds. Despite multiple medical treatments, the patient’s condition did not improve. I treated him with Maimi Dihuang Tang, along with Dangshen, Zhi Shi, Shan Yao, Shan Yu, Sheng Longmu, Sheng Bai Shao, Su Zi, Qian Shi, Gan Cao. After six doses, the patient’s shortness of breath significantly eased. When treating emphysema, I had previously used Du Qi, Maimi, and Sheng Mai, but the clinical results were minimal. This time, I boldly adopted Zhang Xichun’s Shen Zuo Zhen Qi Tang, which demonstrated that Zhang’s concept of “lowered qi” could also be applied to emphysema. Zhang proposed both “lowered qi” and “rising yang to lift qi” approaches. Zhang’s Rising Yang Lifting Qi Tang includes Sheng Ma, Huang Qi, Chai Hu, Zhi Mu, and Ji Ge. This formula uses Huang Qi to tonify qi, Sheng Ma to elevate qi, Chai Hu to move qi, Ji Ge to lift qi, and Zhi Mu to nourish yin. When combined with Shen Zuo, Du Qi, Maimi, Sheng Mai, this formula yields remarkable results.

Case Study of Jia Baozhong – December 27, 2000

Jia Baozhong, Director of the Provincial Agricultural Department, suffered from chronic bronchitis and emphysema, with persistent cough, shortness of breath, chest tightness, and throat itching accompanied by phlegm. I treated him with Su Ye, Xing Ren, Ban Xia, Chen Pi, Fu Ling, Zhi Shi, Ji Ge, Bai Qian, Qian Hu, Gong Ying, Baishang, Sheng Shi, Sang Bai Pi, Di Guo Pi, Ting Li Zi, Da Zao, Su Zi, Lai Fu Zi, Bai Jie Zi, Sheng Di, Dang Gui, Gui Zhi, Gan Jiang, Xi Xin, Wu Wei Zi. After decocting these herbs and administering them orally, his condition improved. This formula is a comprehensive treatment for asthma, incorporating Su Xing San, Ma Xing Shi Gan Tang, Ting Li Da Zao Xie Fei Tang, Xie Bai San, San Zi Yang Qin Tang, Jin Shui Liu Jun Tang, and Da Xiao Qing Long Tang. Though the formula is diverse, its components are clearly organized, making it a case study of “diverse yet orderly.”

Treatment of Esophageal Cancer – December 2, 2000

A man in Zhangye, in his 50s, was diagnosed with esophageal cancer through gastroscopy, CT scan, and barium meal. Biopsy results confirmed squamous cell carcinoma. Given the difficulty of surgical intervention for mid-esophageal cancer and the poor prognosis following surgery, coupled with the patient’s financial difficulties, he chose not to undergo surgery and instead sought treatment from me. I prescribed Sheng Di, Shan Yao, Shan Yu, Huang Qi, Dang Gui, Bai Shao, Zhi Lu Mo, Chuan Shan Jia, Chen Pi, Yuan Zhi, Zao Ren, Su Gang, and others, and after 20 doses, his symptoms began to improve. Subsequently, after undergoing barium swallow tests, no obstruction or filling defects were observed, and gastroscopy revealed no signs of cancerous tumors.

This case was treated using the traditional Six Flavor Rehmannia Decoction, supplemented by Professor Zeng Junshan’s specialized formula for esophageal cancer—Huang Qi, Danshen, Bai Shao, Zhi Lu Mo, Chuan Shan Jia, Zao Jiao, Chen Pi, Yuan Zhi, Zao Ren, plus a modified version of Ban Xia Hou Pu Tang.

New Advances in Diabetes Diagnosis and Treatment – December 27, 2000

In China, the prevalence of diabetes ranges from 2% to 3%; in Taiwan, it is 5%–7%; in Hong Kong, it is 7%–8%; and in Singapore, it is 8%–9%. As we can see, even among Chinese individuals, as living standards continue to rise, the incidence of diabetes is steadily increasing.

Fasting blood glucose levels and postprandial blood glucose levels are higher than normal, but still below the diagnostic threshold for diabetes—this is referred to as impaired glucose tolerance. According to statistics, approximately 3%–20% of people in China exhibit impaired glucose tolerance (IGI). Current research suggests that all type 1 diabetic patients go through an IGI phase before developing full-blown diabetes.

1. Types of Diabetes: Type 1 involves destruction and loss of insulin-producing cells; Type 2 involves insulin resistance or insufficient insulin secretion. In addition, there is gestational diabetes, gestational IGI, and symptomatic diabetes.

2. Diabetes diagnosis is influenced by factors such as family history, obesity—especially central obesity, hypertension, older age, recurrent infections, habitual miscarriages, premature birth, and prolonged fatigue without apparent cause. If any of these factors apply, blood glucose and urine sugar levels should be tested to rule out diabetes. Fasting blood glucose below 5.6 mmol/L can be ruled out; if it exceeds 7.0 mmol/L, a diagnosis can be made. If fasting blood glucose falls between 5.6 mmol/L and 7.0 mmol/L, a glucose tolerance test can be performed: take 75g of glucose orally on an empty stomach, then measure blood glucose levels after 2 hours. If blood glucose levels fall between 8–11.0 mmol/L, a classic glucose tolerance test should be conducted. If blood glucose levels rise again after 4 hours following oral glucose intake, it is considered diabetes; if blood glucose rises after 2 hours, it is considered impaired glucose tolerance. Some elderly individuals have normal fasting blood glucose levels but show elevated blood glucose levels 2 hours after meals—these individuals should be monitored continuously.

Thoughts on Liver Disease Recovery Pill – December 31, 2000

Huang Lian, Huang Qin, Huang Bai, Shan Zhi, Dang Gui, Chuan Xiong, Bai Shao, Sheng Di, Tao Ren, Hong Hua, Nu Zhen Zi, Han Lian Cao, Da Huang, Gan Jiang, Ban Xia, Danshen, Mu Xiang, Cao Qi, Huang Qi, Qin Tiao, Ban Lan Gen, Chai Hu, Dang Shen, Zuo Rong, Fu Ling, Gan Cao—after mixing all ingredients together and sieving them through a sieve, combine them with honey to form pills weighing 7 g, taken twice daily, one pill each time.

Huang Lian’s detoxification formula helps reduce congestion in the gastrointestinal mucosa and conjunctival layers, while increasing congestion in the deeper layers, aiding in the resolution of residual jaundice and pigmentation. Tao Hong Si Wu Tang is a primary formula for regulating the liver, capable of balancing liver qi and blood, as well as regulating the liver’s “xiang huo”—the autonomic nervous system. Beyond this, the “xiang huo” also plays a role in regulating smooth muscle tension, as well as controlling blood vessel dilation and contraction, which can improve facial complexion. Chai Ling Tang is widely recognized as a precursor to adrenal cortical hormones, helping to replenish the body’s adrenal cortex system and prevent adrenalin-induced phenomena—adrenalin-induced pigmentation. Yin Chen, Yin Chen Wu Ling San, and Yin Chen Hao Tang are all excellent formulas for treating jaundice in the Golden Mirror Classic. Xiao Dan Shen protects the stomach, while Nu Zhen and Han Lian Cao are two essential formulas for “two-to-one” treatment, renowned for their ability to regulate qi and blood, and are also popular beauty remedies for treating orbital pigmentation.

Traditional Chinese Medicine Formulas for Hepatic Encephalopathy – January 3, 2001

In the winter of Gengchen, Su Bo from the Statistics Bureau of Gansu Province was suffering from ascites due to liver cirrhosis. After hospitalization and treatment, his condition improved and he was discharged. However, due to poor dietary habits, he subsequently experienced upper gastrointestinal bleeding, leading to hepatic encephalopathy. His kidney function soon deteriorated, with a BUN level reaching 23 mmol/L, decreased urine output, only 250 ml in 24 hours, and constipation lasting for 3 days. In addition to standard medications for liver cirrhosis and hepatic encephalopathy, I used the traditional Chinese medicine formula Tao Ren Cheng Qi Tang combined with Xiao Chai Hu Tang and San Huang Xie Xin Tang. The formula included 20 g of rhubarb, 20 g of magnesium sulfate, 10 g of citrus peel, 6 g of thick bark, 10 g of cinnamon twig, 10 g of peach kernel, 10 g of winter melon seeds, 10 g of peony root, decocted in 300 ml of water and divided into two doses. After taking this formula for 3 doses, the patient regained consciousness, showed slight appetite, increased urine output to 3000 ml per day, and by the fourth day, the patient was able to get out of bed and walk!

Note: This case study demonstrates that the principles of “Yangming disease—delirium, treated with Da Cheng Qi Tang” and “Sunlight disease—heat accumulation in the bladder, with symptoms like delirium, blood flowing downward, and those who recover will be cured. Those whose external symptoms remain unresolved should not be aggressively treated; once external symptoms have subsided, treatment can begin—Tao Ren Cheng Qi Tang is a suitable choice.” These principles were remarkably accurate.

Brief Notes on Esophageal Cancer – January 15, 2001

Esophageal cancer is the second most common cancer in Gansu Province, after gastric cancer. In the autumn of Gengchen, I treated a patient in Zhangye who had already reached an advanced stage of esophageal cancer. While radiation therapy and chemotherapy provided some relief, the remission did not last. When seeking treatment from me, the patient experienced difficulty swallowing and chest tightness. I treated him with Six Flavor Rehmannia Decoction combined with Tuoli Disinfection Pill, along with Yuan Zhi, Chen Pi, and Xia Ku Cao. After 40 doses, the patient’s swallowing difficulties were completely resolved, and X-ray barium meal showed no abnormalities. Gastroscopy revealed normal mucosa in both the esophagus and the lower part of the stomach.

Six Flavor Rehmannia Decoction has been scientifically proven to be effective against esophageal cancer. Tuoli Disinfection Pill, combined with Chen Pi, Yuan Zhi, and Xia Ku Cao, is a formula based on the experience of Professor Zeng Junshan of Lanzhou Medical University. In addition to the above, formulas like Jie Ge San, Si Qi Tang, Ban Xia Hou Pu Tang, Xuanfu Daihe Tang, and Shi Jin Gan Cao are also options for treating esophageal cancer.

Treatment of Single Limb Paralysis – January 17, 2001

In the autumn of Gengchen, a patient experienced intermittent numbness in one upper limb, with corresponding numbness in the lower limb on the same side, though not severe. His blood pressure was normal. I prescribed Sheng Di, Shan Yu, Shan Yao, Gui Zhi, Fu Zi, Mai Dong, Wu Wei Zi, Shi Hu, Da Yun, Shi Chang Pu, Yuan Zhi, Dang Gui, Chuan Xiong, Chi Shao, Tao Ren, Hong Hua, Jang Chan, Quan Xie, and Xi Xin. After more than 60 doses, all symptoms disappeared. The formula was based on Dihuang Yin Zi, a remedy used by Liu Hejian to treat stroke-related speech impairment and leg paralysis—known as Feng Wei. Tao Hong Si Wu Tang, combined with Jang Chan, Mai Dong, and Quan Xie, was a famous formula used by Zhao Xinbo to treat epilepsy. Together, these formulas proved effective in treating unilateral numbness.

Formulas for Gynecological and Andrological Inflammations – January 17, 2001

Sheng Di 12 g, Chuan Xiong 6 g, Chi Shao 10 g, Dang Gui 10 g, Wu Ya 10 g, Xiang Fu 6 g, Gan Cao 6 g—decocted and taken orally. This formula was specially formulated to treat acute lower abdominal pain, often associated with gynecological inflammation and accumulation. It can also be used in combination with Gui Zhi Fu Ling Wan to treat uterine fibroids, ovarian cysts, and pelvic inflammation; the key focus of this formula lies in gynecology. Men’s prostate, seminal vesicles, and vas deferens inflammation can also lead to groin pain. The formula consists of Jing Jie, Fang Feng, Qiang Huo, Du Huo, Cang Zhu, Quan Xie, Chuang Wu, Chuang Wu, Dang Gui, Bai Shao, Ma Huang, He Shou Wu, Shi Hu, Xi Xin, and Gan Cao. Why does this formula treat groin pain? It combines Jing Fang Baidu San with Ma Huang Fu Zi Xi Xin Tang—Jing Jie, Fang Feng, Qiang Huo, Xi Xin are all components of Jing Fang Baidu San. This formula demonstrates that Jing Fang Baidu San can treat external wind-cold attacks, and can also address deep-seated inflammation. Chuang and Cao can treat not only wind-cold-damp痹, but also inflammatory pain; it’s no surprise that high concentrations of Uva Ursi extract from Chuang and Cao possess broad analgesic properties.

Sisi Wan – January 17, 2001

Sheng Di 20 g, Bo He 20 g, Ai Ye 20 g, Ce Bai Ye 20 g—use fresh ingredients for all four herbs, crushed and consumed in one go. In cases of hemoptysis, where blood is excessively hot and uncontrolled, Sheng Di clears heat and cools the blood, Ce Bai Ye stops bleeding, Bo He elevates qi and descends blood, while Ai Ye constricts and stops bleeding.

Two Formulas for Headaches – January 18, 2001

1. Kong Qing Gao: Huang Lian 3 g, Huang Qin 10 g, Qiang Huo 10 g, Chuan Xiong 6 g, Fang Feng 12 g, Chai Hu 10 g, Gan Cao 6 g—specifically for headaches, this formula is the best choice for wind-heat attacking the head.

2. Qing Zhen Tang: Sheng Ma 6 g, Cang Zhu 10 g, He Ye 15 g—decocted and taken orally, this formula treats thunderhead wind, headaches, and neck swelling. This formula was the primary treatment for Liu Hejian’s treatment of epidemic headwind, brain noise, and neck/face nodules. Sheng Ma avoids evil and detoxifies, Cang Zhu dries dampness and strengthens the spleen—both are key forces in dispelling pathogenic factors and dispersing external evils; He Ye’s color is clear and its fragrance is refreshing, its shape resembles a thunderbolt, helping to assist the rising of clear yang in the stomach.

Formula for Multiple Lipomas – January 18, 2001

Pig Tooth Soap, Liu Shen Qu, Jilin Ginseng, Ju Hong, Yuan Zhi, Chang Pu, Fu Shi, Chai Hu, Zhi Shi, Chuan Yu, Wu She, Bai Zhu, Wa Leng, Hai Zao, Kun Bu, Dang Gui, Bai Shao, Dan Shen, Ban Xia, Bai Jie Zi, Xiang Sha, Qing Meng Shi, San Ling, E Jiu, Chen Xiong, Shen Xiang, Qing Meng Shi. All ingredients are decocted into pills, each pill weighing 6 g, taken once daily with warm boiled water.

Understanding Cerebellar Hemorrhage – January 28, 2001

The cerebellum is located on the lateral side of the pons and medulla oblongata, bordering the brainstem. It accounts for one-tenth of the brain’s total weight, and its blood supply is provided by branches of the vertebral-basilar artery. Given this, vertebral-basilar artery hardening is the primary cause of cerebellar hemorrhage. The cerebellum’s function is to oversee human coordination and balance; therefore, the primary symptoms of hemorrhage or blockage include dizziness, vertigo, and other forms of ataxia. Furthermore, the cerebellum is adjacent to the fourth ventricle, so hemorrhage can often enter the fourth ventricle and affect the brain’s drainage pathways. Consequently, high intracranial pressure and meningeal irritation symptoms such as headache, nausea, and vomiting are common. If accompanying symptoms include slurred speech, nystagmus, choking, decreased muscle tone, or dull sensation in one side of the body, this condition should be considered. Many patients present with similar symptoms to Meniere’s syndrome, but in reality, it may also be caused by cerebral arterial sclerosis. When treating this condition, I often use formulas like Xuefu Zhuoyu Tang combined with Chuan Xiong Cha Tiao San, Xuanfu Daihe Tang, Wuling San, Hou Gou Zhu Shi Cao, and Ban Gou Che Xia Shi, adjusting the formulas as needed for optimal results. Adding blood-activating herbs like leeches and Sanqi can enhance therapeutic efficacy.

Case Study of Secretary Zhao from Lanzhou Railway Bureau – February 5, 2001

The patient had low blood pressure, frequently caught colds, and recently experienced excessive sweating and physical heaviness with even minimal activity. There were no external symptoms such as headache or chills, but the patient felt hot in the palms and soles, with a red tongue and a thin yellow coating. I prescribed Dang Gui Liu Huang Tang combined with Chai Hu Gui Zhi Tang, Gui Zhi Fu Zi Tang, Gan Mai Da Zao Tang, and Ban Gou Tang for comprehensive treatment. Dang Gui Liu Huang Tang helped treat excessive sweating due to excess heat, Gan Mai Da Zao Tang stopped sweating, Gui Zhi Fu Zi Tang addressed “post-sweat treatment of colds, resulting in continued leakage,” Chai Hu Gui Zhi Tang treated “stiffness in the heart area, pain in the limbs,” and Gui Zhi Fu Zi Tang treated “rigid muscles in the limbs, making movement difficult.” 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: "Stretching," in half-Qiang soup, is a remedy for wind-dispelling and pain-relief, while also possessing sedative and sleep-inducing effects. This formula also incorporates

Yu's Fuzheng Chongji. After taking this formula for 3 doses, the patient called to say: "The effect is excellent—sweats have stopped, my body feels cool, and the feeling of heaviness and fatigue has disappeared."

All symptoms have completely resolved.

The Pathogenesis of Pulmonary Heart Disease, February 6, 2001

Hypoxia is the primary cause of pulmonary hypertension; hypoxia leads to pulmonary vascular spasm. In the mechanism by which pulmonary vascular tension increases, the role of the autonomic nervous system is quite evident.

For example, it affects smooth muscle, as well as mediators such as histamine, angiotensin, and prostaglandins. It is worth noting that leukotrienes (LT3) and prostaglandins (PG) are also produced by various cells within the lungs, serving as products of arachidonic acid metabolism via lipoxygenase. Among these, LTC4, LTD4, and LTE4 can all contract pulmonary vessels. When animals experience hypoxia, the levels of LT substances in alveolar lavage fluid significantly increase, leading to a corresponding rise in pulmonary arterial pressure. In addition, platelet-derived activators, endothelial-derived vasodilators and vasoconstrictors, reactive oxygen species, and natriuretic peptides all participate in certain reactions involved in this process. In short, hypoxia causes contraction of pulmonary vessels; moreover, pulmonary vascular responses are also factors contributing to pulmonary vascular constriction, and the intrinsic contractility of pulmonary vessels varies greatly among individuals—individual differences are significant, as some individuals develop the disease at lower oxygen partial pressures, while others do not. Some researchers believe that CO2 partial pressure is one of the factors influencing pulmonary vascular contraction, but recent experimental studies indicate that this pressure relationship is not substantial; rather, blood pH plays a more significant role, suggesting that metabolic acidosis has a slightly greater impact on vascular reactivity than respiratory acidosis.

Non-Invasive Diagnosis of Pulmonary Heart Disease, February 8, 2001

Characteristics of pulmonary circulation: low pressure, low resistance, high compliance.

The average pulmonary arterial pressure is typically above 20 mmHg; pulmonary arterial pressure between 20–30 mmHg is considered mild; between 30–50 mmHg is moderate; and above 50–70 mmHg is severe. Since these diagnoses were first made during cardiac catheterization procedures, they are referred to as “invasive” diagnoses. Non-invasive diagnoses include:

1. Chest X-ray: Chronic bronchitis, emphysema, bulging of the pulmonary artery segment, enlargement of the right ventricle, and a pear-shaped heart shape. The main branches of the pulmonary artery are markedly dilated, with the right lower lobe being particularly affected—sometimes their diameter exceeds 1.5 cm. At the same time, the peripheral pulmonary arteries suddenly become thinner, forming a striking contrast with the dilation of the main branches. This phenomenon is known as the “truncation phenomenon” or “mouse-tail phenomenon,” and on fluoroscopic imaging, prominent pulmonary hilar fluctuations can be observed.

2. Electrocardiogram: Clockwise rotation, with a rightward shift in the electrical axis. RV1+SV5>1.05 mV, aVR: R/S>1.0. These two characteristics indicate right ventricular hypertrophy; pulmonary P waves: P waves >0.22 mV, or P waves >0.2 mV, presenting as sharp peaks.

3. Electrocardiogram vector analysis: No obvious right ventricular hypertrophy.

4. Nuclear medicine imaging—pulmonary perfusion and ventilation scans, as well as nuclear ventriculography.

5. Echocardiography is a non-invasive diagnostic technique that has developed over the past 30 years, allowing clear visualization of the heart and surrounding major blood vessels from the chest wall.

6. Pulmonary resistance flow and microflow mapping—using bioelectrical impedance to measure pulmonary vessel volume.

These six aspects constitute non-invasive diagnostic methods for pulmonary heart disease. While X-rays and electrocardiograms are often sufficient for diagnosis, they serve as qualitative tests without quantitative accuracy.

Amnold-Chiari Malformation Combined with Sphincter Defect, February 9, 2001

In school-aged children, there are no systemic symptoms; however, sudden weakness in the right lower limb, crossed-gait, right foot drop with dorsal flexion, normal sensation to pain and touch, without a history of fever, infection, vaccination, or trauma, but with a history of intense physical activity. This condition is caused by a cerebellar tonsillar herniation—a congenital malformation of the posterior brain. Since the advent of MRI in clinical practice, the diagnosis of this condition has been resolved.

Clinical Application of Fenbid, February 10, 2001

Fenbid is a sustained-release ibuprofen capsule, 30 mg per tablet, taken twice daily to maintain pain-free conditions for 24 hours. It also has anti-inflammatory properties and is a nonsteroidal anti-inflammatory drug. The only side effect of this medication is gastrointestinal discomfort; when used in combination with prostaglandin-based drugs, this side effect can be reduced.

Clinical Application of Lai Shi Ke, February 10, 2001

Lai Shi Ke is a fluvastatin capsule, 20 mg per tablet, indicated for hyperlipidemia and hyperglycemia, as well as for arteriosclerosis of the brain, heart, and kidneys. Typically, among the three major risk factors for arteriosclerosis in these target organs, hyperglycemia is the leading risk factor, followed by vascular spasm, and then elevated blood pressure. Lai Shi Ke targets the leading risk factor, making it particularly effective in addressing this issue.

Medical Treatment of Gastric Cancer, February 12, 2001

Gastric cancer ranks first among all cancers in China, with high incidence rates in Qinghai, Ningxia, and Gansu provinces. Jiangsu, Shanghai, Zhejiang, and Fujian provinces have relatively higher incidence rates, while southern provinces generally exhibit lower rates. Pathology includes raised tumors, ulcers, and flat lesions—these are early-stage findings; polypoid and ulcerative lesions represent mid- to late-stage conditions. Histological classification includes adenocarcinoma, mucinous adenocarcinoma, poorly differentiated adenocarcinoma, undifferentiated adenocarcinoma, adeno-squamous carcinoma, and squamous cell carcinoma.

Treatment principles include: stage I radical surgery; stages II and III involve radical surgery combined with chemotherapy (preoperative and postoperative chemotherapy); in stage IV, chemotherapy is the primary treatment, though palliative surgery—such as decompression or jaundice relief—may also be employed when necessary. Radiation therapy is not commonly recommended due to its sensitivity to the gastric mucosa, making it difficult to achieve therapeutic goals. The recurrence rate after surgery for early gastric cancer is 50%, so patients should undergo 3–4 rounds of chemotherapy within 1–2 years post-surgery. According to ASCO statistics, the 5-year survival rate for gastric cancer surgery is 63% in stage I, 22% in stage II, 5% in stage III, and 0% in stage IV.

Chemotherapy: Single-drug regimens include MMC, 5-FU, ADM, EPI, DDP, VP-16, BCNU, CCNU, MTX—single-agent responses range from 20% to 30%.

Combination chemotherapy: Overall response rates are around 30%–50%. The most commonly used chemotherapy regimens include MFA: MMC, 5-FU, ADM, with an efficacy rate of 33% and a median survival of 6–7 months; MFC: MMC, 5-FU, Ara-C, with a PR rate of 30% and a median survival of 6 months; FAB: 5-FU, ADM, BCNU (chlorambucil), with an efficacy rate of 38% and a median survival of 6–8 months.

Gastric cancer treatment typically involves chemotherapy cycles of 3 weeks, with each cycle consisting of 3 weeks of treatment followed by 1 week of rest. Patients should undergo 3–4 cycles of chemotherapy within 2 years post-surgery.

Endometrial Cancer and Vaginal Bleeding, February 14, 2001

Commonly known as uterine cancer, endometrial cancer is a major cause of vaginal bleeding in women of perimenopausal age, easily misdiagnosed as menopausal uterine bleeding and treated incorrectly. It poses a serious threat to the health of middle-aged and elderly women, accounting for approximately 7% of all female cancers and about 30% of reproductive tract cancers. Approximately 80% of cases occur in women around the age of 50. Statistics from developed countries and major cities in China show that endometrial cancer ranks first among gynecological malignancies. Diagnosis requires careful consideration for women who experience prolonged bleeding around the age of 50. Prolonged bleeding and uterine enlargement are fundamental clinical manifestations. Ultrasound can clearly assess uterine size and endometrial thickness; if the endometrial thickness exceeds 5 mm, further sampling and cytological examination are recommended. Cytological examination is a crucial diagnostic tool—traditional cervical smear and posterior fornix aspiration have positive rates of only around 50%. Recent advancements in sampling techniques include intrauterine aspiration, negative-pressure irrigation, and direct intrauterine brushing. Direct brushing and segmented biopsy are becoming increasingly ideal, achieving a diagnostic accuracy of up to 97%. CT scans and hysteroscopy are often more informative.

Surgical treatment, combined with radiation therapy and chemotherapy, is standard care for this condition. Common risk factors include obesity, hypertension, diabetes, menstrual irregularities, early menarche, late menopause, lifelong infertility, multiple pregnancies, endometrial hyperplasia, and polycystic ovaries.

Uterine Sarcoma and Vaginal Bleeding, February 14, 2001

Uterine sarcomas are relatively rare, categorized into leiomyosarcomas, endometrial stromal sarcomas, and mixed mesenchymal sarcomas. Vaginal bleeding accompanied by rapid uterine enlargement, occurring after menopause and accompanied by abdominal pain, is a common presentation. Diagnosis involves performing a curettage and endometrial biopsy; intraoperative frozen section analysis may be performed. Some uterine fibroids are often misdiagnosed as uterine sarcomas. Treatment for this condition primarily involves surgical intervention, with chemotherapy and radiation therapy also employed as adjuncts.

Uterine Fibroids and Vaginal Bleeding, February 14, 2001

Periodic bleeding is a hallmark of uterine fibroids, characterized by increased blood volume, abdominal pain, prolonged menstrual periods, and shortened cycles—sometimes accompanied by systemic symptoms. The typical age of onset for fibroids is between 35 and 45 years. Endometrial hyperplasia, endometrial polyps, and uterine fibroids are all products of repeated estrogen stimulation; several conditions can coexist and even occur concurrently. Surgical treatment is usually the preferred option, while traditional Chinese medicine often proves effective, especially when combined with Western medicine: ① 50 mg of testosterone propionate, administered intramuscularly once daily for 3 days; after bleeding stops, switch to methyltestosterone, with long-acting formulations like 20 mg of testosterone acetate, administered intramuscularly once weekly. ② Nandazol (synthetic androgen), 2.5 mg, taken orally twice weekly. ③ Goserelin and bicalutamide can help reduce estrogen levels. ④ Mifepristone: a steroid antipregnancy agent, taken at 10 mg daily, can shrink uterine fibroids. Current surgical options include laparoscopic hysterectomy, abdominal hysterectomy, and vaginal hysterectomy.

Professor Shi Ji Zhao’s Treatment of Liver Disease Combined with Tumor Hyperplasia, February 14, 2001

Professor Shi believes that many patients with chronic liver disease also suffer from thyroid nodules, breast tumors, mammary gland hyperplasia, uterine fibroids, ovarian cysts, various polyps, lipomas, fibromas, molluscum contagiosum, and other conditions. Additionally, skin allergies, eczema, urticaria, herpes zoster, and simple herpes are frequently observed—skin lesions associated with viral infections are also common.

1. Chaihu 10 g, Danggui 10 g, Baishao 10 g, Fuling 12 g, Chuanxiong 10 g, Jixue Teng 30 g, Xiakecao 30 g, Wangbuliu Xing 10 g, decocted in water and taken daily as one dose.

2. Danggui 10 g, Danshen 10 g, Zhizhi Luomu 6 g each, Taoren 10 g, Honghua 6 g, Sanling 10 g, Ezhú 10 g, Chuanxiong 10 g, Chishao 10 g, Biejia 15 g, Lingzhi 10 g, Chuanduan 6 g, decocted in water and taken daily as one dose.

The front represents the “Xiao Yao Si Wu Xia Wang Ji,” which treats tumors of the thyroid and breast; the back features Zhang Xichun’s “Huoluo Xiao Ling Dan” and the “Taohong Si Wu Tang” supplemented with Sanling, Ezhú, Chuanduan, Biejia, and Lingzhi—this formula is used to treat ovarian cysts.

Recent Key Points in the Treatment of Acute Myocardial Infarction by ACC/AHN in the United States, February 14, 2001

The guidelines for AMI (acute myocardial infarction) were published in August 1999 and are summarized below:

1. Administer oxygen and continuously monitor ECG.
2. Take oral or sublingual nitroglycerin.
3. Administer low-dose aspirin.
4. In cases of cardiac arrest: If nausea and vomiting occur after morphine administration, or if there is atrioventricular block (AVB) or bradycardia, atropine can be used.
5. For patients experiencing severe pain, morphine or morphine-based medications can be administered.
6. Thrombolysis: For patients with ST-segment elevation, except those with a tendency to bleed, advanced age, or those whose ischemic pain has already subsided, heparin 2,000–4,000 units can be administered intravenously for thrombolytic therapy.
7. PTCA (percutaneous transluminal coronary angioplasty) and CABG (coronary artery bypass grafting) are both interventional procedures; the former is less invasive, while the latter is more invasive. From a traditional Chinese medicine perspective, these treatments focus on alleviating symptoms rather than curing the underlying disease.

If the disease has already progressed, then we treat the symptoms; if the disease has not yet reached a critical stage, we address the root cause.

Acute Coronary Syndrome, February 15, 2001

Acute coronary syndrome includes unstable angina, non-Q-wave myocardial infarction, and Q-wave myocardial infarction.

Some patients with Q-wave myocardial infarction had ST-segment elevation, while non-Q-wave myocardial infarction showed varying degrees of ST-segment elevation—typically, the elevation should form an upward arch.

1. Acute coronary syndrome with ST-segment elevation: Ischemic chest pain lasting longer than 30 seconds, with at least two limb leads showing ST-segment elevation or ≥0.1 mV of ST-segment elevation in adjacent precordial leads. Treatment options include direct PTCA or PTCA with stent placement; if a large thrombus blocks the vessel and PTCA cannot be performed smoothly, platelet glycoprotein IIb/IIIa receptor antagonists should be administered first—currently, no such drugs are available in China. If PTCA is not feasible, thrombolytic therapy is recommended.
2. Acute coronary syndrome without ST-segment elevation: Chest pain accompanied by ST-segment depression ≥0.05 mV, or T-wave inversion; patients who have previously undergone PTCA for myocardial infarction and now present with obvious Q-waves.
3. Unstable angina.

Major Milestones in Gene Research and Genetic Inheritance, February 16, 2001

From 1860 to 1870, Austrian scholar Gregor Mendel proposed the concept of genetic factors based on pea hybridization experiments and formulated Mendel’s laws of inheritance.

In 1909, Danish botanist Johnsson expanded on Mendel’s theories, introducing the term “gene.”

In 1944, three American scientists isolated bacterial DNA and concluded that DNA was the fundamental material responsible for carrying genetic information.

In 1953, Watson and Crick of the United States proposed a double-helix model for DNA structure through experimentation.

In 1969, scientists successfully isolated the first gene.

In 1990, the International Human Genome Project was launched, regarded as the “Apollo Moon Mission” of life sciences.

In 1998, the world-renowned genetic scientist James Watson and Francis Crick competed with the Apollo International Human Genome Project at the Roswell Foundation.

In December 1998, the complete sequence of a small nematode genome was determined.

In September 1999, China was approved to participate in the Human Genome Project, tasked with determining 1% of the human genome sequence. China became the sixth country to join the project, following the United States, the United Kingdom, France, Germany, and Japan—ahead of Russia.

In December 1999, the International Human Genome Project Joint Research Group announced that the genetic code of the 22nd human chromosome had been deciphered.

On April 6, 2000, Sequenom announced that the sequencing work for the 21st human chromosome had been completed.

In May 2000, Germany, Japan, and other countries announced the completion of sequencing efforts for the 21st human chromosome.

In June 2000, scientists released the human genome map.

In December 2000, the United States, the United Kingdom, and other countries announced the completion of the full sequence of the Arabidopsis genome.

On February 12, 2001, the United States, the United Kingdom, France, Germany, Japan, China, and other countries jointly announced the completion of the entire human genome map.

Traditional Chinese Medicine Induces Apoptosis in Tumor Cells, February 16, 2001

1. Heat-clearing and detoxifying herbs: ① Aconite: a plant of the Aconitaceae family, its alkaloids include aconitine, with pure aconitine being known as VP-16. ② Brechtia: a tuber extract from the Brechtia plant, containing brechtin. ③ Garlic: volatile oil extracted from the Allium genus of plants. ④ Trichosanthes: the root tubers of the Cucurbitaceae family, rich in trichosanthes saponins and trichosanthes proteins. ⑤ Scutellaria: a plant of the Lamiaceae family, containing various flavonoid compounds.

2. Blood circulation-promoting and blood-stasis resolving herbs: ① Salvia miltiorrhiza: a plant of the Lamiaceae family, containing crystalline furan-type pigments, including tanshinone. ② Turmeric: a plant of the Zingiberaceae family, containing curcumin. ③ Curcuma: the rhizome of the Zingiberaceae family contains the active ingredient curcumene. ④ Panax notoginseng: a plant of the Araliaceae family, containing quercetin, a flavonoid compound.

3. Tonifying and reinforcing herbs: ① Ganoderma lucidum: a fruiting body of the Polyporaceae family. ② Paclitaxel: the stem bark of the Taxus brevifolia tree of the Leguminosae family. ③ Epimedium: a plant of the Berberidaceae family, containing epigallocatechin gallate.

4. Other herbs: ① Stephania: a plant of the Stephaniaceae family, containing stephania alkaloids. ② Camel thistle: the seeds of the Asteraceae family, containing total camel thistle alkaloids.

Current Status of Herbal Medicine in Kidney Damage, February 21, 2001

In 1993, a report by Lgmmotane indicated that Hanchangfai could lead to renal failure. Since then, numerous similar reports have emerged worldwide. Today, herbal medicines that can cause kidney damage include Hanchangfai and Mufangfai from the Polygonaceae family, as well as Muding from the Aristolochiaceae family. In addition, plants like Xixin, Weilingxian, and Zhui Feng are also used. Compound preparations include Longdan Xiegan Wan, Daochi Wan, Ba Zheng San, and Fuke Fenqing Wan.

Correctly Approaching High-Dose Chemotherapy, February 21, 2001

For tumors such as malignant lymphoma, testicular tumors, breast cancer, and small cell lung cancer—tumors that are relatively sensitive to drugs—higher dosages often yield better therapeutic outcomes. However, once a certain dosage is reached, the body’s tolerance reaches its maximum limit; at this point, increasing the dosage does not necessarily lead to proportional improvements in efficacy. For some chemotherapy drugs that are not highly sensitive to tumor cells, there is no direct correlation between drug dosage and cancer treatment effectiveness.

Total Biliary Stricture in Chronic Pancreatitis, February 22, 2001

Chronic pancreatitis patients experience recurrent inflammatory episodes, leading to impaired pancreatic duct drainage and ultimately resulting in total biliary stricture. Retrograde infection can spread to the liver. Moreover, metabolic disorders in chronic pancreatitis contribute to fat accumulation in the liver, leading to fatty liver. On this basis, the liver begins to undergo fibrosis; if the common bile duct remains open, the progression of liver fibrosis slows down, and in some cases, the condition can even resolve retrogradely. The primary function of our developed Bile-Pancreas Granules is to soothe the liver and promote bile flow—essentially, they expand the common bile duct and clear the entire bile system. Previously, we used this approach to treat patients with cirrhosis; after the first use of Bile-Pancreas Granules, jaundice quickly subsided, liver function recovered, fully demonstrating this principle. However, during the New Year holiday, when family members gathered and the room became overly crowded, emotional stress and other factors triggered a relapse—initially, jaundice worsened, along with fatigue and weakness, and liver function was severely compromised. Although the relapse occurred, ultrasound examinations revealed that the spleen had shrunk by 3 cm compared to before, and the portal vein diameter had decreased by 2 mm, indicating that the initial liver-soothing treatment had achieved significant results. This relapse was merely a chance occurrence; we treated the patient with Strong Liver Decoction combined with Yin Chen Hao Decoction and Xiao Chai Huo Decoction, and the patient’s condition improved day by day. Even after improvement, it was still advisable to continue treatment with Bile-Pancreas Granules.

Type 2 Diabetes: A Brief Overview, February 22, 2001

Most cases of type 2 diabetes are associated with central obesity; these patients often experience lipid metabolism disorders, hypertension, increased urinary microalbumin, and fibrinolytic abnormalities. Epidemiological studies show that approximately 70% of type 2 diabetes patients die from large vessel complications. Therefore, treatment for type 2 diabetes should not solely focus on lowering blood sugar; instead, it should aim to improve the pathological changes that lead to multiple metabolic disorders—insulin resistance. Metformin possesses these functions: it can control blood sugar levels while also improving large vessel complications. Metformin reduces hepatic gluconeogenesis and inhibits glycogen breakdown in muscles, thereby helping to lower blood sugar; additionally, metformin can also improve large vessel complications. Metformin… 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: 之所以可以改善大血管之并发症，主要是该药能降低甘油三脂

（TG)、降低LDL-C、降低游离脂肪酸（FFA)；与此同时尚能减轻体

重、升高HDL-C水平。①美国VKPDS研究显示：一组超重的Ⅱ型糖尿

病患者，在经过二甲双胍系统治疗10.7年后，心肌梗塞减少了40%,

中风亦减少了40%,而其他如胰岛素和磺脲类与普通组比较心梗和

中风均无减少。②二甲双胍对胰岛B细胞的保护作用：增加组织对胰

岛素的敏感性，从而减少β细胞的负担。

糖尿病之药物治疗 2001.2.23

常用药物可分为三类：①磺脲类；②双胍类；③胰岛素类。磺脲

类：D860、优降糖（格列苯脲）、迪沙（格列吡嗪）、达美康（格列奇

特）、糖适平（格列喹酮）。双胍类：降糖灵、二甲双胍，前者25mg,Tid,后者250mg,Tid,po.胰岛素类：普通胰岛素、中效胰岛素、长效

胰岛素。磺脲类适合Ⅱ型糖尿病之消瘦者、无动脉硬化、高血脂者；

双胍类则适合Ⅱ型糖尿病之肥胖者、合并动脉硬化、高血压、高血

脂者。胰岛素则适合于I型糖尿病。近来之观点：胰岛素适合于一

切糖尿病之患者，而且为预防糖尿病合并症之首选药，宜早用，愈

早愈好。

格林巴利综合征 2001.2.26

此病又称急性感染性多发性神经病（GBS).临床表现：①四肢

运动障碍；②四肢感觉障碍，手套样、袜套样；③神经核病变；④膈

肌、腰肌麻痹；⑤植物神经紊乱。脑脊液中细胞蛋白分离，蛋白多、细胞少。IgA、IgM、IgG增加，其中以IgM增加最为明显。本病之治疗以激

素、环磷酰胺等为最常用，用中药也可治疗。

变应性亚败血症（WFC) 2001.2.26

发热、皮疹、关节痛为主要特征。通常有儿童和成人两型，男女

发病率约为2:1.实验检查以血沉快为主要特征，伴贫血，但白细胞

数高，骨髓增生活跃，早幼粒、中幼粒增高。黏蛋白及γ球蛋白增加亦

为其特点。

抗核抗体（多肽抗体）阴性，类风湿因子阴性。皮疹之形态不

一，大小不等，可呈点状、丘疹状、猩红热状、麻疹状、荨麻疹状等。

以胸背腹最为多见，其次为四肢颜面。本病男多女少，中青年为好

发年龄，皮疹呈一过性，且在高烧时最为明显。有人以咽痛为本病

之第四大症状。另有患者出现肌痛及全身淋巴结肿大，本病之治疗

以激素、环磷酰胺为主要治法，中药桂枝芍药知母汤、竹叶石膏汤

为高烧时首选方。鸡血藤10g、淫羊藿10g、菟丝子10g、川牛膝10g、生地12g、元参10g、麦冬10g、旱莲草10g、萆薢10g(三蓄增液断肠

草）、紫草20g、乌蛇9g、蜈蚣1条，另外桂枝芍药知母汤也是治疗此

病之重要方剂。

黏液性水肿与心脏病 2001.2.28

黏液性水肿可出现心动过缓、心音低、低电压、ST-T改变，同时可合并心包积液，患者自觉心悸、气短、周身乏力、水肿、甲状腺吸碘

率24小时仅在20%以下。因病例较少，通常容易误诊。此病宜以甲状腺制剂治疗则效。综合上述，甲状腺机能亢进可引致心脏病，不足亦

可引致心脏病。

紫癜肾治验 2001.3.9

患者王鹏，紫癜肾多年，尿蛋白+～+++，尿潜血++～+++。余治疗此患者先给济生肾气汤加味，后予石葶白银汤加味，均出现一定疗

效，最后以杷山合剂：枇杷叶10g、山药10g、黄精20g、菟丝子20g、芡

实20g、金樱子20g、女贞子10g、旱莲草10g、党参10g、白术10g、茯苓

10g、阿胶10g、血余炭10g、当归10g、山栀10g、丹皮10g、丹参20g、生地

12g,水煎服，每日1剂，服药20剂，蛋白由++降至0,潜血由++降至0,

镜检（－）。此例之治愈说明紫癜肾之治疗宜健脾与补肾结合，杷山方

宜首选也；阿发方可亦辙用也。

几个新药之应用 2001.3.9

1.整肠生：此药为调节肠道菌群紊乱之专药，通常在肝硬化、胆

胰疾患时或其他重症疾患时使用。长期使用抗菌素时，肠道细菌敏

感者杀灭，非敏感者增生，此时则菌群失调，消化功能严重紊乱或霉

菌丛生。每粒2.5mg,每服5mg,Tid,PO。

2.吲达帕胺：此为最近临床开始应用之降压药物，原名寿比山，

为吲达类降压药，具有明显之利尿作用。本品副作用为少数患者出

现低钾综合征。特点为长效，口服，每日一次，2.5mg,服药3周后将剂

量增加1倍，分2次服用。

3.硝普钠：此药成分亚硝基铁氰化钠，本品为速效、强效静脉注

射用降压剂，对动静脉均有强大之扩张作用，可迅速减少心脏回血，

缓解心脏负担，心衰得以改善。但此品之作用急、消失快，用药1～2分钟即有明显作用，停1～2分钟作用即消失，药物很快自尿中排泄。此品为亚氰化钠类，长期应用可引起氰酸中毒，故硝普钠仅用于高血压危象者。本品遇光线则解体，故应用时须以黑纸包裹瓶装。本品之

剂量50mg/支，另附5ml葡萄糖溶液1支。通常应用时应注意：①勿长期应用，48小时不能连续采用；②黑物包裹；③血压下降后，改用其

他药物维持。

亚甲炎并多发性全身淋巴结炎 2001.3.12

辛已春，病房住院患者张某，女，36岁，3年前曾患亚甲炎，1年来

全身淋巴结肿大（黄豆大小），疼痛，门诊以全身淋巴结炎收住，抗菌

素治疗后，全身淋巴结肿大及疼痛均有不同程度的缓解，但患者颜

面潮红，五心烦热，心悸失眠，西药心得安、安定均无效。余予以下方

治疗：黄芪、当归、生地、熟地、黄芩、黄连、黄柏、桂枝、白芍、知母、干

姜、甘草、防风、麻黄、白术、川草乌各15g(先煎1小时），3剂大效，诸

症全消，患者谓此方真神，可继续服之。

阿波莫斯的临床应用 2001.3.14

此为新型血氨对抗剂，为L-鸟氨酸、L一门冬氨酸之复合剂，对

肝脏解毒功能大有裨益，作为支链氨基酸，参与肝脏氧化代谢，抑制

血氨之产生和重吸收。此剂之原产厂家为法国Skabe公司，我国与之

合资投产。每支50～200mg,由小到大，逐步增加剂量。

乳果糖的临床应用 2001.3.14

人工合成之含酮双糖，降低血氨，治疗便秘是其最基本之功用。

血氨向酸性环境中渗透，乳果糖在肠腔中分解为乳酸和醋酸，使肠

腔之pH值下降，血氨由血入肠，氨通常以NH；和NH4*两种形式存在

于肠腔中，前者易吸收，后者易排泄，酸性与NH3结合，使之变为

NH才+，故减少氨之重吸收。通常之食醋灌肠亦包含此种意义。本品之

副作用：腹胀、腹痛、恶心、呕吐、腹泻。应予以注意，通常服20～

40mg,Tid,po。

心脏自主神经紊乱对心脏疾患诊断之意义 2001.3.14