标准心脏自主功能检测（SCFT :要求受检测者在试验前夜禁

二、心脏自主神经紊乱之检测方法

标准心脏自主功能检测（SCFT):要求受检测者在试验前夜禁

烟、茶、酒或咖啡，并认真配合。

1.VALSAVA试验：（患者向血压囊内吹气至40mmHg,保持15

秒，同步心电图计算最长R-R间期与最短R-R间期之间期比。正常

1.11～1.20为阳性。

2.深呼吸试验：每分钟6次深呼吸，同步心电图，最快与最慢心

率为11～14次之间，小于10次为阳性。

3.由卧位到立位心率变化，R-R间期小于1.00。

4.由卧位到立位，收缩压变化大于30mmHg为阳性。

上述实验说明心脏自主神经之调节功能已紊乱，不能随条件变

化而代偿。在吹气加压时，在深呼吸时，在体位变化时，心率之变化较正常时为小，说明心脏之代偿功能差；血压之变化大，说明心脏维

护正常血压之功能亦差。

消炎痛之新用途 2001.3.15

本品为非甾类止痛剂，近来有报道可治痛经、月经过多、精液过

少、神经性尿频、输尿管绞痛、盗汗、皮肤瘙痒症、体位性低血压、慢性肾炎、肾病综合征等多种疾患。余之观点：鉴于此药能引致胃肠反应，切不可服用，故对慢性肾炎、肾病综合征、月经过多、精液过少等

宜选择胃肠功能较好者，始可投之。

隐球菌性脑膜炎 2001.3.15

本病来势急，高烧、昏迷、颅内压迅速增高，脑脊液中细胞达

2000/mm³以上，颅内压达4000mmHg以上。患儿除高热、昏迷外，尚有

顽固性头痛、喷射性呕吐，一部分病人伴有偏瘫、耳聋、失明。上海长

征医院廖石清教授主张鞘内注射、血液静注、口服三者联合应用广

谱抗真菌药物，如斯皮仁诺、大扶康（氟康唑）。

前列腺小议 2001.3.15

前列腺位于膀胱之下，围尿道而居，形如小栗，重仅20g,靠睾丸

素之刺激而生长发育，可谓有睾则生，无睾则死。儿童期仅以皮肤皱

褶形式出现，少年时睾丸开始发育，则前列腺始增长矣，16～65岁时

前列腺异常繁忙，分泌前列腺液稀释精液，完成精液动态，以适于性

交之用。过分频繁之使用则可促成前列腺之肥大、感染。过分闭置则

成前列腺之萎缩。65岁以后前列腺因睾丸素之刺激逐年减少，因

而渐渐停止发育，代之而起者为结缔组织之增生，老年性前列腺肥

大则属此类。

戊型肝炎之再认识 2001.3.15

戊型肝炎由HEV引起，既往谓之非甲非乙型肝炎，一部分属于

此类。20世纪80年代以来，在亚洲、非洲，拉丁美洲约20多个国家有

此病流行。我国南疆地区1986年戊肝大流行，其临床症状与甲肝相

似，但本病之黄疸较为多见，重症亦多见，青少年、孕妇易感此病，病

情较重，死亡率较高。

1983年前苏联学者首先报告非甲非乙型肝炎病毒之存在，经美

国学者证实并命名为E型肝炎，本病之临床与甲肝表现相同，主要依

据流行病学资料和特异病毒培养。戊肝之发生肝性脑病者亦多于甲

肝，说明本病病情较甲肝重，病程较甲肝长，多为3～4个月，甚至超过

半年，同时伴白球比例失调，总蛋白减少，凝血酶之时间延长，给人

以慢性活动型肝炎之假象。戊肝之发病无季节性，不像其他之肝病

易发生于夏秋。其传播途径以消化道为主，血制品为副。

血小板减少性紫癜2例 2001.3.24

余治疗此病曾用党参、白术、黄芪、甘草、大黄、黄芩、黄连、制乳没、白蒺藜；亦用仙鹤草、土大黄、鸡血藤、赤小豆、黄柏、山栀、甘草、

生地、知母、丹皮、丹参、连翘；仙鹤草、茜草、益母草、灯心草、旱莲草、紫草；亦用玉竹、黄精、大黄、生地。近来治天水黄藏珍之孙，血小

气板3.6万，百药无效，余以金银花、连翘、公英、败酱草、地丁、山栀、丹皮、丹参、木通草、坤草、茜草、白芍、女贞子、生地、泽兰、香附（六虎

丹丹草，白女生兰香）。服药7剂后，血小板升至29.1万。

川畸病小记 2001.3.24

多见于小儿，症见高热，皮疹，淋巴结肿大，结膜、舌体、口腔黏膜红肿。由病理角度看乃淋巴、皮肤、黏膜综合征也。基本病变，血管

炎也，动脉、静脉毛细血管均可罹患，然以毛细血管发病为主。因其

炎症分布于皮肤黏膜淋巴，故该处肿、红、热、痛也。侵犯于大血管

者，因其压力过大，管壁张力弹性因炎症而减，故可膨胀、扩张，名曰

血管瘤。此病之治疗甚为棘手，但大多数病儿可以自己向愈。

全身瘙痒之治验 2001.3.26

苍术6g、公英10g、赤芍6g、银花10g、丹皮6g、生地12g、地肤子

10g、百部6g、桃仁10g、苦参10g、黄柏6g、川椒6g、甘草6g、生苡仁20g、

苦参20g、蝉衣10g,水煎服，每日1剂。上方治一妇人之全身瘙痒症获

大效，该方之组成：苍公方合黄花草地汤也。

干扰素再议 2001.3.26

干扰素以抗肿瘤、抗病毒为主要作用，天然α干扰素来源于人体

白细胞，经仙台病毒素诱导后产生，学名为α-nl干扰素。近年来，由人成纤维细胞产生之高活性天然干扰素称之为β干扰素。随着基因

工程之发达，人们采用生物高技术制备出γ干扰素，又有基因工程采

用DNA重组技术生产出α-1b干扰素。至此，干扰素α、β、γ全部制备

生产。干扰素是人体巨噬细胞的主要激活因子，具有增强单核细胞

循环，增加自然杀伤细胞（NK)之作用。干扰素具有致敏性（异体蛋

白），凡系过敏者，均亦行过敏试验，一部分患者有明显之副作用，如

头晕、恶心、心悸、虚烦等。目前因厂家不同，本品之名称亦较杂乱烦

多，如赛若金，即α-2b干扰素，上生雷素即γ干扰素。

鸭胆子浅说 2001.3.27

为苦木科半常绿灌木鸦胆子之成熟果实，苦寒入肝、大肠经，人

大肠经则治痢，人肝经则截疟，究其原乃杀虫也。痢者阿米巴痢也，

疟者疟原虫也，故此药传统中医主要用之于杀虫。通常以龙眼肉包

裹吞服，以防伤胃，成人每次10～30粒，儿童以每增1岁加1粒为宜，可

口服1～3次。自50年代以来，陆续报道用鸦胆子油治外耳及喉部乳头

状瘤及面部赘疣、寻常疣、青年尖锐湿疣等取得明显效果。最近有人

报道用鸦胆子油治疗乳腺癌、肛肠癌、食道癌取得了显著疗效。河北

石道县城关卫生所报道用本剂治疗食道癌曾引起人们的普遍关注。

20世纪末国外从鸦胆子油中提取了鸦胆子苦味素，并发现了该素之

显著抗癌活性，此后国内对鸦胆子油之抗癌作用进行了深入细致之

研究，并成功地制备了鸦胆子油乳液，可供静注、口服、腔灌。

鸦胆子口服液对食道癌、胃癌、结肠癌有一定疗效；对肺、肝癌

等亦有一定作用。每日2次，每次1支，1月为一疗程。

肾功能衰竭研究之进展 2001.4.3

有人称血肌酐浓度177µmol/L定为不可逆点。部分肾单位之破

坏，残存肾单位之代偿，肥大、增生之残存肾单位，终于达到不能代

偿，此即矫枉失衡说。该学说目前被多数学者所赞同，其实为健存肾

单位之高灌注、高压力、高过滤等三高状态，其结果引起下列病理改

变：①肾小球肥大，内皮细胞和基底细胞增生；②肾小球内血小板凝

聚，微血栓形成，致肥大之肾小球趋向硬化；③肾小球通透性增加、超限度增加可引致尿中蛋白丢失。上述三方面之改变促进肾小球功能进一步破坏。这种恶性循环是所有肾功能衰竭发展至尿毒症之共

同途径。

近年来发现血管紧张素Ⅱ(AngⅡ),在肾衰恶化进程中起着重要

作用，AngⅡ是有力的血管收缩剂，对肾血管之收缩作用强烈。近年来，除发现增加肾小球之血压外，还能促进肾小球基质之血管硬化。

肾衰之危险因素：高血压、感染、肾毒药物、糖尿病、高蛋白饮

食、激素的应用、高脂血症、尿蛋白上升。

治疗对策：①低蛋白饮食，研究表明，0.6g/(kg·d)蛋白可满足人

体蛋白质的基本需要，即50kg重的成人每日30g蛋白即可，一个鸡蛋

60g,半个鸡蛋即可。须知淀粉及蔬菜中尚含一定蛋白质，同时淀粉 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: In necessary cases, protein can also be converted into protein; therefore, the daily protein requirement for the human body is only 20g.

The normal value for GFP (glomerular filtration rate) is 10–20 ml/min; if GFP levels increase, protein intake should be increased accordingly.

If protein intake is too low, it can undoubtedly lead to a decrease in essential amino acids (EAA) in the blood. An ideal formulation is an EAA and ketone acid mixture, which can be used for patients with renal failure who are on long-term low-protein diets. The combination of ketone acids and ammonia can generate essential amino acids (EAA), while simultaneously reducing urea formation. However, ketone acids are expensive, and the typical dosage is 0.1–0.2 kg/day.

Additionally, the use of ACEIs is also important. Captopril, Enalapril, and Belindapril are commonly administered at a dose of 25 mg, taken 1–3 times daily.

Key Points in the Clinical Treatment of Acute Myocardial Infarction – April 5, 2001

According to a recent report in Health News, the treatment of acute myocardial infarction can be represented by the letters TH-ABC. “T” refers to thrombolysis, which can be performed using urokinase, streptokinase, and other agents. “H” stands for heparin, administered at a dose of 5,000 units. While administering these medications, it is essential to regularly monitor coagulation time and thrombin time. “A” represents post‑reperfusion therapy: A is aspirin, B is beta-blockers, and C is angiotensin‑converting enzyme inhibitors.

Traditional Chinese Medicine Treatment for Post-Poliomyelitis Sequelae – April 6, 2001

Three months ago, Mr. Wang, a 9-year-old boy from Wushan County, suffered from polio when he was 3 years old. He has had lower limb movement disorders ever since. As he grew older, his mobility became increasingly limited. Based on the “Jin Gui Yao Lü” formula—Feng Yin Tang combined with Tao Hong Si Wu San Chong Tang and Si Miao—after more than 20 doses of medication, his lower limb movements suddenly returned to normal! Here is the prescription: 30g of Han Shui Shi, 30g of Sheng Gao Shi, 15g of Chi Shi Zhi, 15g of Bai Shi Zhi, 15g of Sheng Jue Shi, 15g each of Sheng Long Mu and Guizhi, 15g of Hua Shi, 6g of Gan Jiang, 10g of Gui Zhi, 10g of Da Huang, 10g of Niu Xi, 30g of Mu Gua, 10g of Qin Tiao, 10g of Wei Ling Xian, 12g of Sheng Di, 10g of Dang Gui, 6g of Zhang Can, 6g of Quan Xie, 10g of Qiang Zhen, 10g of Tao Ren, 3g of Hong Hua, 6g of Huang Bo, 20g of Sheng Yi Ren, 15g each of Chuan Cao Wu (first decocted for 1 hour), and 1 piece of Ma Qian Zi (fried in oil). The herbs were decocted twice, yielding a total volume of 600ml, to be taken in 6 divided doses over 2 days.

Meniere’s Disease Caused by Arteriosclerosis of the Basilar Artery – April 7, 2001

Arteriosclerosis of the cerebral arteries, particularly those located in the internal capsule region, can lead to hemiplegia: right-sided lesions result in left-sided paralysis, while left-sided lesions may cause right-sided paralysis. In addition to hemiplegia, left-sided lesions can also lead to aphasia. When the disease affects the basilar artery, it can cause episodic dizziness. This type of dizziness is largely similar to what is commonly referred to as ear-related dizziness—both involve a feeling of heaviness in the head when moving the head, though the latter is less pronounced when closing the eyes. The basilar artery supplies blood to the inner ear, so head movements can affect blood flow, whereas closing the eyes does not impact blood supply. Fixing one’s sleep in a particular position, especially with the head positioned at a certain angle, often exacerbates or alleviates dizziness. This characteristic can aid in diagnosis. In spring of the year Xin Yi, I treated the sister-in-law of Director Xu Wei of the Gan Newspaper, who experienced such dizziness. She had visited both Hospital 301 and Jishuitan Hospital, where she received similar diagnoses. However, her treatment did not yield effective results, so she returned to me for further treatment. I prescribed the following formula: 10g of Chi Shui, 10g of Chuan Xiong, 3g of Hong Hua, 10g of Jiang Xiang, 20g of Dan Shen, 3g of Han San Qi (mixed and taken), 10g of Shui Zhi, 10g of Hou Pu, 20g of Gou Teng, 10g of Zhu Ling, 15g of Sheng Jue Shi, 10g of Xia Ku Cao, 6g of Ban Xia, 10g of Che Qian Zi, 10g of Wu Wei Zi, 10g of Dang Gui, 10g of Yuan Rou, 30g of Ze Xie, 10g of Bai Zhu, all decocted in water and taken orally. After 14 doses, she began to see improvement.

Experience in Treating Fatty Liver by Director Feng of the Provincial Academy of Agricultural Sciences – April 9, 2001

In spring of the year Xin Yi, Director Feng of the Provincial Academy of Agricultural Sciences suffered from chronic hepatitis B combined with fatty liver and hyperlipidemia, along with elevated transaminases. I used Xiao Chai Hu and Yin Shan He Ji, taking over 20 doses. Both lipid levels and transaminase levels returned to normal. Below is the prescription: 10g of Chai Hu, 10g of Huang Qin, 6g of Ban Xia, 10g of Dang Shen, 6g of Gan Cao, 6g of Sheng Jiang, 4 dates, 10g of Dan Shen, 10g of Mu Xiang, 10g of Cao Kou, 20g of Yin Chen, 10g of Shan Zha, 10g of Sang Ji Sheng, 10g of Gei Zi, 20g of Dan Shen, 16g of Bai Hua She Ti Cao, 16g of Ban Zhi Lian, 10g of Wu Wei Zi (mixed and taken).

Another Case of Chronic Pancreatitis – April 8, 2001

Director Li of the Provincial United Front Work Department had been suffering from stomach pain for three years, but various treatments had proven ineffective. He had previously sought treatment at Beijing’s 301 Hospital, but without significant improvement. The patient experienced fullness and pain in both flanks, as well as distension in the epigastric region, with pain radiating to the lower back. His tongue was red, coated with thick, yellowish, greasy coating, and he experienced constipation. Endoscopic examination confirmed atrophic gastritis, with positive Helicobacter pylori results. Considering this, after having tried various gastric medications over the past three years, and having visited multiple hospitals, including large ones, the patient was diagnosed with pancreatitis—a condition that existed alongside his gastric issues, though not as the primary concern. Therefore, he was prescribed a formula for combined gallbladder and pancreatic conditions. After more than 20 doses, the pain in both flanks and in the epigastric region improved significantly, though the back pain worsened. To address this, I administered 0.2g of Chen Long Luo Xin and 250ml of Metronidazole via intravenous infusion. Three days later, the back pain subsided, and the pain in both areas also decreased. However, the stomach bloating intensified, indicating that while the pancreatitis had eased, the three Western medications still irritated the stomach, leading to increased abdominal distension. I encouraged the patient to continue treatment; in this case, the gallbladder and pancreatic formula included Dragon's Herb, Aloe Vera, and Angelica Sinensis, inspired by the Angelica and Aloe Vera pills. These three herbs—Dragon and Aloe Vera—have traditionally been known to irritate the stomach. Yet, literature reports suggest they can alleviate pain in the left flank, which is precisely the area affected by pancreatitis. The CT scan for this case showed no signs of pancreatic pathology, indicating that even chronic pancreatic inflammation can remain undetected on CT imaging. In treating patients with chronic pancreatitis, dozens of CT scans have shown no pancreatic abnormalities.

The Latest Concept: Nanomedicine in the 21st Century – April 13, 2001

Nanometer is a unit of length, where 1 nm = 1/10^9 m, equivalent to the size of an atom. When matter is reduced to this scale, its optical, acoustic, thermal, electrical, and magnetic properties exhibit vastly different characteristics compared to their macroscopic counterparts. With this technology, people can achieve numerous practical applications. As early as the 1980s, researchers developed the Scanning Tunneling Microscope (STM), a remarkable instrument capable of capturing biological information at the nanoscale, allowing scientists to observe left-handed DNA, double helix DNA, and parallel double helix DNA through STM images. In recent years, Chinese scientists have successfully captured snapshots of the DNA synthesis process using STM. In summary, nanotechnology is an ultra-microscopic technology that has enhanced our ability to store and process information by hundreds of times under ultra-microscopic conditions. This allows us to create ultra‑microscopic machines and materials, enabling work to be carried out at ultra‑microscopic scales. For example, in the pharmaceutical industry, we can manufacture drug particles smaller than red blood cells, allowing them to freely travel through bodily fluids and exert unique effects. We can also create artificial kidneys, artificial joints, and artificial hearts—and even coat drug particles directly onto enzymes and biopeptides, thereby controlling their biological effects. Simple applications include the preparation of wound dressings and self-cleaning clothing, which can exhibit extraordinary performance.

The 131I Therapy for Hyperthyroidism – April 14, 2001

Hyperthyroidism occurs when thyroid hormone levels in the blood are excessively high, leading to accelerated metabolism, goiter, and in some cases, exophthalmos—a syndrome characterized by bulging eyes. In the past, treatment typically involved antithyroid drugs like methimazole and thiamazole, which inhibited thyroid hormone synthesis, allowing the immune response to resolve on its own. However, this approach had a long-term remission rate of only around 40%, with potential side effects such as liver and bone marrow toxicity. Recently, surgical and radioactive iodine therapies have gained popularity, as they help reduce thyroid hormone secretion. Radioactive iodine therapy offers high efficacy, safety, simplicity, affordability, and minimal side effects. It has become the preferred treatment for hyperthyroidism. The specific method involves oral administration of 131I—former U.S. President George H. W. Bush’s wife was cured of hyperthyroidism using 131I. The radioactive substance enters the thyroid tissue, destroying the tissue and causing the thyroid gland to shrink to 50% of its original weight, thereby significantly reducing thyroid hormone production. The dosage of 131I should be calculated based on the thyroid’s weight: thyroid weight = constant (K) × thyroid surface area × height. Of course, there are other calculation methods, which are common in the field of nuclear medicine.

Statistics on the Causes of Heart Failure – April 14, 2001

In 1980, heart failure was primarily caused by rheumatic heart disease, accounting for 47% of cases; by 1990, this figure had dropped to 24%, and by 2000, it had fallen to just 8.9%. In 1989, coronary heart disease accounted for 29.1% of cases, rising to 38.8% in 1990, and then increasing to 50% in 2000. The average age of onset for heart failure has been steadily increasing over the years: 51.1 years in 1980, 58.9 years in 1990, and 68.8 years in 2000. In conclusion, the causes of heart failure have shifted from rheumatic heart disease to coronary heart disease, reflecting the growing prevalence of coronary heart disease as living standards improve, while heart failure rates have declined due to better medical care.

Dizziness Caused by Arteriosclerosis of the Basilar Artery – April 18, 2001

Mr. Chen, a 56-year-old woman from Lanzhou University, suffered from persistent dizziness. She had been diagnosed with basilar artery sclerosis and infarction at major hospitals in Beijing and Shanghai. The patient experienced episodic dizziness, with mild discomfort when closing her eyes and severe discomfort when moving her head, accompanied by mild nausea and vomiting. I combined the Blood-Regulating Decoction with Guan Yi, Han San Qi, Shui Zhi, Hou Pu, Chuang He, Che Qian Zi, Wu Shan, and Gui Yuan, among others, adjusting the formulas as needed. After 7 doses, no significant improvement was observed; however, after more than 20 doses, her condition began to improve, demonstrating that the effectiveness of traditional Chinese medicine lies in gradual progress. Furthermore, the principle of promoting blood circulation and resolving stasis indeed helped improve blood circulation in the brain, while also effectively treating dizziness associated with cerebral infarction.

“Plasma Purification” Therapy for Hyperlipidemia (Blood Cleansing Therapy) – April 19, 2001

Hyperlipidemia refers to elevated total cholesterol and triglyceride levels, with increased low-density lipoprotein levels exceeding normal ranges, while high-density lipoprotein levels show a negative correlation. Hyperlipidemia is one of the most significant risk factors for coronary heart disease, angina pectoris, myocardial infarction, and cerebral infarction. It goes without saying that preventing and treating hyperlipidemia can significantly reduce the incidence of these diseases, thereby improving work capacity and extending lifespan. First, it’s important to maintain a light diet, limiting oily foods, and reducing consumption of fatty meats, animal organs, and egg yolks. Instead, eat more vegetables, beans, and fruits, quit smoking and drinking alcohol, and increase physical activity and exercise. Typically, when checking lipid levels, it’s also advisable to test SGPT, CK, BUN, and CR, as most lipid-lowering medications can cause damage to liver and kidney function. If these indicators rise, it’s best to reduce the dosage of lipid-lowering drugs or stop taking them altogether. Common lipid-lowering medications include vitamin P, vitamin PP, Pantoprazole, aspirin, Atorvastatin (combined with Prunus persicae for cardiovascular health), fish oil rich in omega-3 fatty acids, and linoleic acid (the Yishou Ning formulation was popular in China during the 1960s). In recent years, the emergence of statin drugs has brought good news to patients with hyperlipidemia—these medications are not only highly effective but also offer forward-looking preventive benefits. Numerous international studies have shown that statins can significantly reduce mortality from coronary heart disease and hypertension, by lowering TC and TG levels to their lowest possible values, restoring some arterial atherosclerosis to normal. Currently available statin medications in China include: ① Shujiang (Simvastatin); ② Lixi (Pravastatin), typically taken once daily before bedtime, at a dose of 20–40 mg.

Statin medications can potentially harm liver and kidney function, so individuals with elevated transaminases or elevated BUN levels should avoid taking these drugs. Additionally, these medications may cause muscle pain or tenderness, as well as increased creatine kinase (CK) levels.

Sodium Chlorpyrifosinate – April 20, 2001

This medication functions similarly to sodium pyrophosphate, another bisphosphonate-based bone metabolism drug. It has a strong affinity for calcium phosphate in bones, helping to improve bone tissue structure, reduce blood calcium levels, and minimize bone diseases. It is highly effective in treating hypercalcemia and bone pain caused by bone metastases from malignant tumors. Each capsule contains 200 mg of anhydrous sodium chlorpyrifosinate, or 0.2 g per capsule. For bone metastases from malignant tumors, take 4 capsules (0.8 g) once daily, tid, po; for osteoporosis, take 0.2 g once daily, tid, po.

Rational Use of Diuretics in Cardiovascular Diseases – April 23, 2001

The more severe the heart failure, the poorer the response to diuretics; increasing the dosage does not necessarily enhance therapeutic efficacy. Taking moderate doses multiple times may yield better results. When sodium and potassium levels are low, distal diuretics are less effective—distal diuretics act on the distal ureters (the distal collecting duct). These diuretics often have a potassium-sparing effect, such as hydrochlorothiazide and amiloride. Common diuretics like furosemide act on the ascending limb of the loop of Henle, while hydrochlorothiazide acts on the descending limb of the loop. The former is a potent diuretic, while the latter is a medium‑efficacy diuretic. Medications that act on the distal ureters include acetazolamide. All of these drugs inhibit sodium reabsorption.

For mild heart failure, loop diuretics are often chosen first; however, in severe heart failure, loop diuretics are absorbed more slowly, and the more severe the heart failure, the poorer the diuretic effect. Increasing the dose of diuretics may not yield additional benefits. A low-sodium diet over a long period can lead to low sodium and potassium levels in urine, making distal diuretics less effective; when urine contains low sodium and high potassium, distal diuretics may be more effective. For patients with refractory congestive heart failure who do not respond well to high‑dose loop diuretics, metabolic alkalosis may occur. In such cases, treatment with acetazolamide can still be beneficial.

Current Status of Primary Liver Cancer Treatment – May 6, 2001

China accounts for 42.5% of global liver cancer cases. Over the past two decades, the mortality and incidence rates of liver cancer in China have risen sharply. The use of alpha-fetoprotein in the 1970s, advancements in ultrasound technology in the 1980s, and further developments in biological diagnostic techniques in the 1990s created preconditions for surgical treatment of liver cancer. Domestic experiences in routine liver cancer resection, cold ablation surgery, bloodless liver resection, and local radical surgery have accumulated extensive knowledge. From a statistical perspective, these procedures have established the world’s largest database of liver cancer resection cases. According to statistics from the Eastern Hepatobiliary Surgery Hospital of Shanghai Second Military Medical University, from 1966 to 1996, a total of 3,932 liver cancer surgeries were performed, with a 5-year survival rate of 36.1%. Among 28,000 hospitalized liver cancer patients, fewer than 20% underwent surgery. Before 1977, the 5-year survival rate for surgical patients was 16.0%; between 1978 and 1988, the survival rate rose to 30.6%; after 1990, it reached 48.6%, demonstrating significant progress in liver cancer surgery in China. The treatment of liver cancer should focus on the following aspects:

1. Early resection: For non‑metastatic tumors, when the tumor diameter is less than 5 cm; if the tumor is multifocal, the total tumor diameter is less than 5 cm. The standard set by Chang Hai Hospital is 3 cm; for small liver cancers, the 5-year survival rate is 79.0%, with those less than 3 cm reaching 83.3%.

2. Transarterial chemoembolization (TACE): Preoperative TACE often helps shrink tumors and reduces surgical trauma. However, some scholars question whether this procedure can promote cancer cell adhesion and detachment, thereby increasing postoperative recurrence.

3. Intraoperative prevention: Minimize compression and traction on the liver, and treat the cut surfaces with substances like anhydrous alcohol or sponge implants containing chemotherapy drugs. Recent advances include microwave coagulation and cryotherapy. Visible intraluminal cancer thrombi should be removed in small amounts. Inserting infusion devices into the portal or hepatic arteries is also an option.

4. Postoperative comprehensive treatment: Postoperative chemotherapy, traditional Chinese medicine, immunotherapy, and drug delivery systems (DDS) can all enhance survival rates, reduce recurrence, and extend survival. In recent years, there have been many reports on postoperative interventional chemotherapy and embolization (TACE). Scholars generally agree that this method can prolong disease-free survival, especially for patients with good liver function. Additionally, oral 5-Fu, combined with protective medications like calcium tetrahydrofolate, has shown certain anti‑recurrence effects.

5. Prediction of liver cancer recurrence and metastasis: Factors that increase the likelihood of recurrence include multiple tumors, larger tumor margins, vascular branch cancer thrombi, and ascites.

In conclusion, surgical treatment of liver cancer has made significant strides over the past 20 years. For early-stage liver cancer, the 5-year survival rate can reach 79%, with 83.3% of tumors less than 3 cm.

Angiotensin-Converting Enzyme Inhibitors – May 10, 2001

Among angiotensin‑converting enzyme inhibitors, Captopril (captopril) is the most widely used clinically. Its primary mechanism of action involves the renin‑angiotensin‑aldosterone system. Captopril inhibits the conversion of angiotensin I to angiotensin II, thereby reducing vasoconstriction, decreasing aldosterone secretion, and alleviating sodium and water retention. In addition to Captopril, there are second-generation products like Ramipril, Enalapril, and Doenapril, all of which have lower dosages than Captopril—5–10 mg, taken once daily. The main function of these medications is to block the production of angiotensin. Angiotensin II is a potent vasoconstrictor and a growth stimulant for the cardiovascular system; it can reduce left ventricular ejection fraction, promote cardiac remodeling, and possesses receptors that allow it to exert these effects. Consequently, the development of angiotensin II receptor blockers (ARBs) emerged, with drugs like Losartan and Valsartan serving as representative examples. These medications not only share the characteristics of ACEIs but also demonstrate more prominent improvements in cardiac dynamics.

Cardiac Myxoma – May 12, 2001

Myxomas are benign tumors of the heart, relatively rare in occurrence. In recent years, with the advent of echocardiography and ECT, accurate diagnoses have become possible. According to a 20-year statistical analysis from 1955 to 1977 at Shanghai Chest Hospital, a total of 10 cases were treated, with only 4 cases being diagnosed preoperatively. The clinical symptoms of this disease depend on the location of the tumor within the heart; most tumors are found in the left ventricle, potentially causing mitral valve insufficiency and resulting in a blowing murmur during systole. Sometimes, tumors grow extremely rapidly, causing plaque rupture in a short period and triggering pulmonary embolism. Tumors occurring in other locations may remain asymptomatic for years, unnoticed by patients. When tumors grow rapidly, they release metabolites and toxins, which can cause fever, anemia, elevated erythrocyte sedimentation rate, protein alterations, joint pain, and other symptoms. Diagnosis of this disease primarily relies on echocardiography and ECT, as it is relatively rare and often misdiagnosed. In recent years, thanks to advancements in imaging technology and the widespread availability of medical facilities, the clinical detection rate of this disease has been increasing year by year. Once diagnosed, surgery is recommended.

Salt and Health – May 12, 2001

Salt (sodium chloride) is an essential chemical compound for the human body. The body’s fluid contains 0.9% salt. 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: 化钠完全靠饮食摄入，一定数量之氯化钠是人体生理活动的基本保

证，缺乏、不足均可致病。但是过量摄入则可引起一系列不良反应。

健康人群通过生理调节机制，多余之氯化钠可排出体外，从而达到

平衡；对于一些有病机体，过剩之氯化钠可形成病情的进展。美国

Qchsner医院的Messcil医师检索了1996～2000年的医学文献资料，认

为过量摄入氯化钠增加血小板的反应性，从而促使凝聚，由此则钠

的摄入与高血压、脑卒中、猝死成正性相关。24小时尿钠中位排出量

与病死率、体质质数（P=0.009)、饮酒（P=0.008)均显著相关。钠的靶

器官有心、脑、肾、血管等，高盐饮食可加重心脏、脑、血管、肾等脏器

的负担，可使肾细胞肥大、肾组织纤维化增加，肾血流量减少。在临

床上高盐饮食能使血管紧张素转换酶抑制剂之抗尿蛋白作用抵

消。脑组织在高盐作用下可出现脑血管之负荷加重，易产生卒中、

猝死。

综上所述，高盐饮食之最主要靶器官血管乃周身血管也，心、

脑、肾之高盐影响均系通过血管而作用。

长期慢跑使人受益 2001.5.12

丹麦Schnqhr等研究，对96名慢跑男性死亡率与4562例未做慢

跑运动男性死亡率之间对比，跟踪访问20年，发现坚持长跑者之寿

命普遍高于未坚持长跑者，统计学处理有非常显著之意义。

系统性红斑狼疮性下肢血栓静脉炎 2001.5.19

辛已夏初，荟萃堂门诊来一铁路职工，女，患系统性红斑性狼

疮8年，曾用激素长期治疗，同时服用雷公藤、昆明山海棠、中药复合制

剂，病情时好时坏。近年来，双下肢持续肿胀、胀痛，愈来愈重，乃至

活动严重受限，求余诊治。余断为红斑性狼疮合并下肢静脉血栓，投

下方：当归、川芎、王不留行、威灵仙、穿山甲、丹参、郁金、赤芍、元

参、夏枯草、茯苓合桂枝芍药知母汤，川草乌15g(先煎1小时），泻火

冲剂，半包，每日2次，再用古圣1号、消风除湿胶囊，共14剂，腿肿全

消，患者之关节疼痛及全身乏力、红斑较前好转。

舌苔之研究 2001.5.20

通常望诊所指之舌苔由舌面丝状乳头之角化树及分布于其中

之脱落细胞组成，亦参合有少许食物残渣及细菌。丝状乳头及其角

化树是组成舌苔之基础结构。丝状乳头覆盖舌面之前三分之二，每

一个丝状乳头由初状乳头和次状乳头两部分组成。初状乳头形如一

顶王冠；次状乳头系由初状长出之数根毛状物。初状乳头上覆盖鳞

状上皮，次状乳头上有菌斑，向咽部方向倾斜。无论初、次状乳头均

有柱状轴心支撑，系结缔组织结构。舌面之不同部位丝状乳头大体

相同，唯不同者乃次状乳头之数量大不相同也。上述为上海复旦大

学刘耿教授报告，该教授未能就舌象之病理引申研究，乃缺陷也。余

据40年之临床经验提出如之论断，确否？待后人在临床实践中去评

说也。

1.舌质：代表正气之盛衰，肥大则淤血、水肿，前者紫红，后者白

淡；老瘦则脱水也，营养不良也；色淡则血虚、气虚；色红则阴虚、热

盛也。

2.舌苔：代表邪气之消长，黄为热，可代表现代医学之发炎、感

染，说明丝状乳头、次状乳头、毛状物之间充塞了大量多形核白细胞

和炎性脱落细胞；白代表寒，说明充塞细胞以上皮细胞为主，此胃肠

消化功能之紊乱；厚则病进，薄则病退，无苔则阴津亏耗，即脱水及

电解质紊乱也。

甘草汤治疗冠心病 2001.5.30

《伤寒论》182条云："脉结代，心动悸，炙甘草汤主之。"此方为通

阳复脉，滋阴补血之名剂。古人抓住了脉之特点，缓而中止曰结，止

有定数曰代，然具此脉者大多心前区闷胀疼痛。目前冠心病之发病

日趋增长，成人脉结代者，大多为冠心病。辛已春，余接诊二例病人：

①齐中砥，女，54岁，冠心病，胸闷痛，心悸，气短，心电图示完全性室内传导阻滞。余以下方：瓜蒌10g、薤白20g、半夏10g、赤芍10g、川芎10g、红花6g、降香10g、丹参30g、三七3g(分冲）、桂枝10g、党参10g、阿胶10g(烊化）、麦冬20g、生地20g、苦参30g、火麻仁10g、生姜6g、大枣4枚、炙甘草20g,服40剂，诸证平，心电图正常。②王某，女，54岁，冠心病，胸闷，心悸，气短，胸痛彻背，未见心律不齐。余仍予上方，仅3剂而见大效。炙甘草汤治冠心病有效，效在治心前区之疼，此余之

经验也。

另有一方，治疗冠心病有效，方之组成如下：山楂、生地、当归、

党参、川楝子、圆肉、生龙牡、菖蒲、远志、桂枝，此方中之生地、党参、桂枝与炙甘草汤同也；另有一方之组成如下：桂枝、川芎、葛根、丹参、生地、紫石英、炙甘草、党参、麦冬、五味子，方中之桂枝、生地、党参、炙甘草、麦冬与炙甘草汤亦同也；另有一方之组成如下：紫石英、生地、丹参、党参、麦冬、炙甘草、黄连、川芎、桂枝，方中之生地、麦冬、党参、炙甘草与炙甘草汤亦同也。综上所述，前述三方中之共同药味：生地20g、麦冬20g、炙甘草20g、党参10g、川芎20g、葛根20g、桂枝10g、丹参30g、苦参30g,组成治疗冠心病之专剂。口诀：桂枝川葛

参（生）石草。

细胞死亡之方式 2001.6.12

通常细胞死亡方式有：坏死和凋亡两种。坏死指细胞之意外死

亡，凋亡则是基因之异常表达，从而启动慢性死亡程序，先是内源性

核酸酶切断DNA链，出现染色体聚集靠边，核固缩，凋亡小体形成。

在细胞凋亡之全过程中，细胞始终完整，因此有人说细胞凋亡是细

胞内部向死亡之衍化，细胞死亡则是外界因素引起之细胞破坏、崩

解，成分浸润和渗出。

紫参片治疗癫痫 2001.6.20

山慈姑10g、五倍子10g、续随子5g、大戟6g、雄黄3g、朱砂3g、麝香

1g、苦参30g,共研为末，制成片剂，0.3g1片，日服3次，每次2片，治疗

癫痫其有效率达75%.上药为紫金锭加苦参而成。紫金锭方出《宁玉

心书》，为中医急症常用药，可内服亦可外用。主治疗疮疖肿，伴秽恶

痰浊，舌秽腻，脉滑数等症。亦可用于急性中毒、中毒性痢疾、急性胃

痉挛，总之化脓性疾患、脓毒败血症、疖、痈、蜂窝组织炎等属本剂之

适应证。方中之大戟、续随子性温有小毒，化淤消肿，攻下逐水，与五

倍子同用，以防峻下太过；雄黄、山慈姑、麝香均具消炎抗菌之作用；

朱砂安神镇静。上方治化脓性感染，经数百年经验证明有效，说明中

医之通腑疗法确有现实价值，雄、山、射三药除共具抗炎制毒作用

外，或软坚，或解毒，或开窍散利，均可大助于疖肿疮痈之消散耳。此

方加苦参，我谓其清热解毒之功急剧增加，对紫金锭原有之作用肯

定明显加强。然此方定名为紫参片，以治疗癫痫为最主要之功能，说

明紫金锭中之雄、射、慈、五尚有解除脑组织之兴奋、形成强大之镇

静效果。有歌曰：五山随大硫，紫朱苦亦香。

NF-KB与肾炎之关系 2001.6.27

NF-KB最初发现于B细胞核，属二聚体蛋白质，它对特定之细胞

因子和刺激敏感，所谓特定之细胞因子和刺激可致细胞受损及细胞

核生物生长停顿，在这种情况下NF-KB被激活。激活了的NF-KB可

调节与上述因素有关之基因。近年来研究证明NF-KB有明显之抗

炎、抗敏、抗凋亡作用，因此NF-KB之表达成为最重要炎症转录因子

之一。而许多药物也正是通过阻断或抑制NF-KB之活性来抑制炎症

反应，达到抗炎和免疫抑制作用。细胞凋亡时NF-KB同样呈激活状态，这两种作用是互相独立的。有人提出NF-KB间或有一定抗凋亡

作用，目前证据欠确，尚未定论。

甲状腺癌压迫上肢静脉治验 2001.7.18

辛巳夏，患者王某，确诊甲状腺癌，左上肢浮肿，服下方：浙贝母

10g、元参10g、牡蛎15g、三棱6g、莪术6g、三七3g、水蛭10g、白花舌

蛇草15g、半枝莲6g、黄连3g、黄芩10g、黄柏10g、山栀10g、姜黄6g、桂枝10g、海藻10g、昆布10g,水煎服，7剂后，上肢浮肿消失。

耳源性眩晕再说 2001.7.18

此病之治法余辄以半钩、厚钩、五山等方为主，若合并耳鸣

则加当白桂方，合并呕吐加旋覆代赭方，但合并高血压者则决不

能加当白桂也。考当白桂方乃麻黄、桂枝、细辛、白芷，辛温助阳，

用之于高血压则头痛益甚也。辛巳夏，余治疗天水市张津梁市长

之岳母，问之，曰：血压不高，但有头晕眩，伴耳鸣、恶心，余轻信

患者之言，以上方投之服6剂。余友黄庆成来电云：服药后头晕痛

加剧。余闻之乃顿悟该患者有高血压及动脉硬化之存在，问之果

真若此。凡有高血压兼眩晕者则宜变冠I合半钩、厚钩，汉三七3g

（分冲）、水蛭10g（分冲），此方专治脑椎底动脉硬化引致之美尼尔氏综

合征也。

再论急性心梗之TH+ABC 2001.8.30

急性心梗（AMI)之发病较多，死亡率极高，近年来采用PTCA(扩

冠术）和CAGT(搭桥术），可使部分病人缓解，但在急诊期乃必须进行

合理抢救，为手术创造条件。合理抢救之纲领是TH+ABC.T是

Thromholysis即溶栓疗法。我国当前常用之静脉溶栓药主要是链激

酶（SK)、尿激酶（UK)、基因重组组织型纤溶酶系激活酶（γt-PA)。

H是指Hepazin,即肝素或低分子肝素，该药对预防血栓再形成可起

到重要作用，通常以每kg体重100µ,即50kg常人用5000µ,维持量

为每kg体重10µ；低分子肝素每kg体重0.01ml,即50kg常人用0.5ml,

后者无须以凝酶之时间来监测。A是阿司匹林，目的是抑制环氧化

酶（COX),从而抑制血栓之形成，小剂量阿司匹林（40～80mg)需要

数日才能达到抗血小板凝聚之效应，因此在AMI时应嚼碎服药，利

用口腔黏膜吸收，这样可加快阿司匹林之吸收速度，使之迅速达到

效应，阿司匹林水溶液巴米尔似更易于吸收。心梗早期用阿司匹林

可显著降低心梗死亡率，降低幅度可达25%～50%.B是β受体阻制

剂，可限制梗死范围，降低心率和血压，降低心肌耗氧量，减少疼

痛，倍他乐克静推5mg,总量达15mg后给予口服，每日150mg,分3次

服。C是血管紧张素转化酶抑制剂（ACEI),此药之典型代表为卡托

普利，25mg,Tid,口服，纠正潜在性心衰，降低心梗死亡率。最后应

着重谈谈溶栓疗法之适应证及相关问题。适应证：ST段抬高，且用

硝酸甘油后未见恢复者；有持续性胸痛，V1-V3 ST段下降之后壁

Q波型心梗，应特别提醒不能认为一旦心电图出现Q波不宜做溶

栓治疗之观点，该观点是错误的。出现Q波意味着已为陈旧性心

梗，但若有ST段之下降或弓背向上，则说明血栓正在形成，故仍

宜溶栓治疗。尿激酶50 000µ(UK)加入葡萄糖内10分钟滴完，继

则每小时60 000µ,连续静脉12小时，链激酶（先做皮试）250

000µ加入5%葡萄糖100ml内，30～60分钟内滴完，继用100 000µ/1

小时，连续滴注12小时，为防止链激酶引起发烧，则可先用非那

根25mg肌肉注射。

肺栓塞再谈 2001.8.31

肺栓塞（PE)之发病较多，但大多数病例误诊。下肢静脉血栓是

引致本病最常见之原因，80%之肺栓塞与下肢静脉血栓同时存在。

过去诊断本病单纯依赖教科书上所讲之"尖端指向肺门之楔形阴

影"，事实上该表现之临床占有率尚不足50%,故而有50%之肺栓塞

通常被误诊。一旦死亡，则归咎于冠脉急性痉挛、闭塞等。深层下肢

静脉之血栓可源于风湿性心脏病瓣膜损害，也可源于动脉粥样硬化

斑块之脱落。肺组织有双重血液供应，具强大的代偿能力，肺血管之

50%受阻力方能引致症状，因此PE之轻者可无症状，重者则病情凶

险。通常呼吸困难占85%,胸痛占80%,咯血40%～50%,晕厥、休克20%,伴

休克者表示有大血管梗塞，危险性极大。

诊断：血气分析：氧分压下降，二氧化碳分压正常或下降，但此

条并非诊断绝对依据。心电图：肺性P波，右束支传导阻滞，ST段非

特异性变化，V4、V5T波倒置。X线：取决于栓塞部位和栓子大小，可

表现为支气管炎变化，栓塞部位肺纹理减少，透光度增加，两肺纹

理不对称，胸腔少量积液，所谓底部与胸腔粘连，尖端指向肺门之楔形阴影其实少见。也可见右心室扩大，肺动脉圆锥增大。CT增强

扫描是高度敏感的诊断方法，肺动脉造影是最准确可靠的诊断方

法。

治疗：根据具体情况用通常治疗方法之同时，抗凝和溶栓是PE

治疗之关键。抗凝用肝素5000～10000u静滴，首量后1000u每小时维

持。凝血酶原时间维持在正常值之2倍左右。溶栓治疗国内以尿激酶

每千克体重2万单位，成人以100万单位2小时内滴入最满意。

胃痛治疗经验 2001.9.11

胃胀胃痛之治法，余向有香砂、泻心、丹参、枳术、芍药甘草、叶

氏养胃、大小建中、慎公方、杨流仙胃药等，然对顽固性胃脘痛，时而

痛剧，又排除肝胆胰脾诸疾患者尚少效。辛已冬，余治省人才交流中

心李某，上腹胃脘部持续性疼痛，餐后加重，中西药用遍未效。余以

下方予之：当归、川芎、赤白芍、黄芪、良姜、制乳没、香附、半夏、枳实、砂仁、元胡、煅瓦楞、明矾、三棱、莪术、吴萸、乌药、蒲黄、党参、白术、茯苓、陈皮、檀香、生龙牡、乌贼骨。水煎服，每日1剂，6剂大效。

继服10剂，诸症解除，李某专程谢曰："先生乃神医也。"

食道癌治疗经验 2001.9.12

王吉英，男，57岁，张掖市小河乡东口二社，农民，1998年11月20

日胃镜检查食道中段癌，钡餐造影食道中段癌，病理活检：鳞癌。服

用中药100余剂，症状完全消失，胃镜、钡餐未见异常。方药主要如

下：生地、山萸肉、山药、牡丹皮、茯苓、泽泻、陈皮、远志、夏枯草、黄

芪、丹参、当归、白芍、制乳没、穿山甲、皂角刺、郁金、浙贝、砂仁、杵

头糠、荷叶蒂、鸡内金、生苡仁，水煎服，每日1剂。

此方有六味地黄汤、托里消毒丹、启膈散加鸡内金、苡仁、陈皮、

远志、夏枯草等。服药100剂，症状全消，胃镜检查肿瘤已不复存在。

此例之治愈，实属偶然，患者因经济困难，无法行手术、放、化疗，瞎

猫逮住死老鼠，接着吃下去，因有效，故能坚持自服百余剂。

慢性充血性心力衰竭之现代观点 2001.9.24

心衰为所有心血管疾病终末期症状。心血管疾病之共同机理均

可导致心排出量之不足。为代偿性提高心排出量，机体动用全身各

系统之代偿机制，包括植物神经系统和血管紧张素系统。长期增加

上述系统之工作，则其神经介质、内分泌系统之激活酶类均呈增生

状态，产生之自由基类可直接毒害心脏和血管内皮，使之心室肥大，

心肌肥厚，心功能进一步降低。随后之主要变化是慢性交感神经之

兴奋，儿茶酚胺之增加：①正肾素增加CAMP介调，使细胞Ca^2+^增加， 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: High-energy phosphates decline, mitochondrial function decreases, and myocardial function declines; ② Heart rate accelerates, myocardial contraction strengthens, oxygen consumption increases, leading to myocardial ischemia; ③ Changes in the systemic cytokine network regulation,

This cytokine network regulation achieves its regulatory objectives through the following factors: tumor necrosis factor (TNF-α), interleukin-6 (IL-6), soluble tumor necrosis factor receptor I (STNF-RI), and transforming growth factor β (TGF-β) concentrations.

Autoimmune Hepatitis, September 28, 2001

The disease was first officially named in recent years, with a relatively high incidence in Europe and America, accounting for 15% of chronic liver diseases. China is also a region with a high incidence rate. The clinical manifestations of this disease are similar to those of viral hepatitis, yet their treatments differ significantly.

As early as 1950, some scholars proposed the concept of "autoimmune liver disease," and recently, international conferences have officially designated it as "autoimmune hepatitis." This disease is associated with genetic factors and tends to occur in susceptible populations within families. Certain triggering factors—such as infections, medications, or environmental stimuli—can trigger an immune response, leading to the formation of antigen-antibody complexes. Diagnosis of this disease relies on exclusionary criteria: ① hypergammaglobulinemia; ② jaundice; ③ hepatosplenomegaly; ④ cirrhosis (which may be decompensated); ⑤ elevated erythrocyte sedimentation rate; ⑥ liver function impairment that is no different from other forms of hepatitis.

Treatment for this disease primarily involves corticosteroids, which can complement liver protection efforts. The course of the disease is long, with an average treatment duration of 18 months. The 5-year survival rate for patients is relatively low, and the prognosis is poor. Today, several antibody tests are still valuable for diagnosing this disease, including ANA (anti-nuclear antibodies), AMA (mitochondrial antibodies), SMA (smooth muscle antibodies), and LSP (liver cell-specific antibodies). A positive result for any of these three tests can aid in diagnosis.

Acute Exacerbation of Chronic Obstructive Pulmonary Emphysema and Cor Pulmonale, October 26, 2001

The clinical manifestations of acute exacerbation of chronic obstructive pulmonary disease (COPD) include increased cough, increased sputum production, and shortness of breath. In severe cases, patients may experience increased heart rate, heart failure, and respiratory failure.

Most experts agree that the primary cause of these exacerbations is upper respiratory tract infection. These infections are typically caused by viral or bacterial agents. According to foreign data, approximately 80% of COPD exacerbations are due to viral infections, mainly influenza bacteria (24%), syncytial virus (6.5%), rhinovirus (19%), coronavirus (14%), adenovirus (7%), and chlamydia (5–10%). While bacterial infections are less common as initial infections, secondary bacterial infections are the most significant cause of exacerbation. Therefore, when selecting antibiotic therapy, both viral initial infections and secondary bacterial infections should be considered.

The Weight-Loss Effects of Norepinephrine, October 29, 2001

This medication is also known as Western Curmin. In the 21st century, obesity has become a serious public health issue worldwide. The World Health Organization has designated obesity as a key area of prevention and control. Experts predict that within the next 10 years, the number of obese individuals in China could exceed 200 million. Norepinephrine is a new weight-loss drug developed by Abbott Pharmaceuticals in the United States, approved by the U.S. Food and Drug Administration as a dual-mechanism weight-loss medication. The dual mechanism refers to increasing feelings of fullness and reducing food intake, while also enhancing energy expenditure and correcting metabolic imbalances in the body. After one year of use in six major hospitals in China, it was confirmed that taking Norepinephrine once daily for 6 months led to significant reductions in body weight, waist circumference, and hip circumference. In addition, Norepinephrine also helped improve blood lipid and blood glucose levels.

Diagnostic Key Points for Tuberculosis, October 31, 2001

The three main diagnostic criteria for tuberculosis today are: ① chest X-ray; ② tuberculin test; ③ sputum smear and culture. Before these examinations, if you experience recurrent colds lasting more than two weeks, fatigue, cough, expectoration, fever, or blood in your sputum—and if you were previously classified as a highly sensitive individual for tuberculosis—such individuals often exhibit nodular erythema, herpetic conjunctivitis, or keratitis. Additionally, individuals with tuberculosis-related conditions such as diabetes, gastrectomy, pneumoconiosis, HIV-positive status, or those who have been using immunosuppressive drugs like corticosteroids for extended periods may also be at risk. Chest X-rays now classify tuberculosis into four types: ① primary pulmonary tuberculosis, which includes past primary syndromes and bronchogenic lymph node tuberculosis. This type is characterized by poorly defined cloud-like shadows or patchy shadows appearing along the margins of the lung fields near the pleura. Lymphangitis accompanied by enlarged lymph nodes often results in one or more groups of swollen lymph nodes, sometimes resembling dumbbells. ② hematogenous disseminated pulmonary tuberculosis: this type encompasses acute, subacute, and chronic presentations, with punctate or snowflake-like patterns appearing in the upper lung fields. ③ secondary pulmonary tuberculosis: this type encompasses infiltrative pulmonary tuberculosis, focal pulmonary tuberculosis, caseous pneumonia, and fibrotic cavitated pulmonary tuberculosis. ④ tuberculous pleurisy. Historically, tuberculosis was categorized into four stages based on infiltration progression, dissolution and dissemination, resolution, and hardening and calcification. Today, however, the classification is based on exudative, caseous, cavity-forming, and proliferative lesions, with calcification as a key feature. When examining sputum smears under acid-fast staining, if fewer than 10 "+" signs are observed in 100 fields, fewer than 10 "++" signs are seen in 10 fields, and fewer than 10 "+++ " signs are detected in a single field, then the presence of 10 or more "++++" signs in each field is considered significant.

Interpreting Sputum Culture Results, October 31, 2001

No colony growth (-), one-quarter of the slide (+), half of the slide (++), three-quarters of the slide (+++), or all of the slide (++++).

Evaluating the Tuberculin Test, October 31, 2001

A positive tuberculin test (OT, PPD) can confirm a diagnosis; weakly positive results may also be false positives, while negative results can rule out tuberculosis. However, in clinical practice, there are various scenarios: small cell lung cancer may show positive or strongly positive tuberculin test results. Malignant lymphoma often exhibits strong positive tuberculin test reactions. Additionally, in cases of tuberculous pleurisy or early-stage acute miliary pulmonary tuberculosis, tuberculin test reactions may be negative.

Treatment of Pulmonary Tuberculosis, November 1, 2001

Commonly used medications include isoniazid (INH), rifampicin (RFPR), pyrazinamide (PZAZ), and ethambutol (EMBE). The treatment course lasts for 6 months; if Z or R-containing medications are not used, the treatment period should extend to 9–12 months. Tuberculosis treatment is typically divided into an intensive phase and a consolidation phase: during the former, 3–4 medications are combined for 8 weeks to eliminate multiple bacterial strains; during the latter, 2–3 medications are used for 4 months to achieve complete recovery. The national tuberculosis conference recommends the following regimens: ① 2H3R3Z3/4H3R3; ② 2H3R3Z3E3/4H3R3.

The Century-Long Prospects of Calcium Channel Blockers, November 8, 2001

In the 1960s, Fleckenstein first discovered the anti-anginal effects of calcium channel blockers (CCBs), which work by blocking myocardial contractility. With the widespread clinical application of nifedipine, researchers found that its half-life was short and blood drug concentrations did not reach a stable level. As a result, efforts began to focus on sustained-release and controlled-release formulations. Five years ago, questions arose about whether CCBs could lead to serious complications—this concern had been sparked by erroneous conclusions drawn from a small number of cases, sparking a debate that lasted for half a year. Ultimately, after careful deliberation by the FDA and WHO, a positive conclusion was reached.

The pharmacological mechanisms of CCBs differ from those of digitalis-based medications in that they exert negative inotropic effects, which significantly reduce myocardial oxygen consumption and thereby protect the heart. Another important effect is their negative chronotropic action, which shares similarities with the mechanism of digitalis. Beyond these effects, CCBs are particularly notable for their ability to reverse myocardial hypertrophy. Left ventricular hypertrophy in patients with hypertension is a long-term adaptation to high blood pressure, where increased intracellular free calcium ions play a crucial role in promoting myocardial thickening. CCBs inhibit calcium ion influx, reducing the factors that drive myocardial hypertrophy, dilate blood vessels, counteract smooth muscle proliferation, and help prevent atherosclerosis. Five years ago, American researchers questioned whether CCBs could exacerbate coronary artery disease, tumors, or upper gastrointestinal bleeding, sparking a heated debate. To address these concerns, China organized a study involving 2,394 patients with hypertension, who were treated with nifedipine as a first-line therapy. Follow-up studies over four years demonstrated that nifedipine significantly reduced overall mortality, cardiovascular events, stroke, and coronary artery disease, proving that calcium channel blockers could indeed lower blood pressure, prevent coronary disease, and reduce the risk of stroke—while remaining safe and offering long-term benefits. The debate is now nearing its end, and CCBs are being widely used around the globe with unstoppable momentum.

Introduction to Common Lipid-Lowering Medications, November 15, 2001

Recent commonly prescribed statins include simvastatin (Zocor, Lovastatin) 20 mg, fluvastatin (Lescol) 20 mg, pravastatin (Pravachol) 20 mg, and lovastatin (Lipitor) 20 mg. These medications can lower total cholesterol while also reducing triglycerides. Their common side effects include elevated AST and ALT levels, as well as increased CK and PCK levels. More serious side effects include muscle pain, though rare cases of rhabdomyolysis have been reported. Dosage: 10–20 mg, Qd.

Renal Toxicity of Aristolochia Plants, November 16, 2001

In 1993, Belgian researchers first reported that traditional Chinese medicines containing aristolochic acid, such as Stephania tetrandra and Aristolochia fangchi, could cause interstitial nephritis, drawing global attention. Research in China also confirmed this effect. There are three main sources of Aristolochia used in traditional Chinese medicine: ① Stephania tetrandra, a plant of the Aristolochiaceae family; ② Aristolochia fangchi, a plant of the Aristolochiaceae family; and ③ Aristolochia debilis, a plant of the Ranunculaceae family.

There are two main sources of Aristolochia used in traditional Chinese medicine: ① Aristolochia fangchi, a plant of the Aristolochiaceae family; and ② Aristolochia fangchi, a plant of the Aristolochiaceae family, also known as Guangfangchi.

Aristolochia plants are perennial vines or creeping herbaceous plants belonging to the Aristolochiaceae family. This plant is bitter and cooling, aiding digestion, clearing the lungs, relieving cough, and dissolving phlegm. In Brussels, Belgium, researchers found that two young women developed interstitial kidney disease after taking weight-loss pills containing Aristolochia fangchi. Subsequent analysis confirmed that the aristolochic acid present in Aristolochia fangchi was the cause of interstitial nephritis. Japanese researcher Yuichi Tanaka also reported similar findings.

Bacterial Infections and Antibiotic Use: A Brief Discussion, December 14, 2001

Typically, only 20–30% of patients with fever are infected with bacteria, indicating that most fevers do not respond to antibiotics, and some cases may even experience increased adverse reactions. Over half of childhood diarrhea cases are caused by rotavirus, suggesting that antibiotics are ineffective in half of cases. A study conducted in Beijing, Shanghai, and Guangzhou between March and June 2000, focusing on antibiotic susceptibility testing in children’s respiratory infections, revealed that ampicillin was effective against influenza bacteria in over 84% of cases; pneumococci in Beijing were sensitive to penicillin, but not in Guangzhou—only 64% were sensitive—showing that antibiotic sensitivity varies across regions for the same bacterial strains. Additionally, it is essential to pay attention to the issue of combining antibiotics. While quinolone-based treatments are effective in over 90% of urinary tract infections, their efficacy is often reduced when used in combination with chloramphenicol or gentamicin. Doctors should stay updated with new knowledge about antibiotics, otherwise problems may arise in this area.

Wegener's Granulomatosis, December 5, 2001

Wegener's granulomatosis (WG) is characterized by the following features: ① onset in young adults; ② upper respiratory tract involvement precedes other areas—such as the middle ear, nasal turbinates, throat, and posterior nasal passages—followed by lung involvement in 95% of patients, kidney involvement in 85%, skin and muscle involvement in 85%, neurological involvement, cardiac involvement, enlargement of the liver, spleen, and lymph nodes, and even Raynaud’s phenomenon. Diagnostic criteria include: ① urinalysis: RBC (+–++++), though negative results can be confirmed with sediment tests; ② chest X-ray: nodules, cavities, and exudates; ③ oral, middle ear, and nasopharyngeal lesions; ④ biopsy of granulomas, where granulomas can be difficult to distinguish from cancer cells.

In 1982, researchers discovered that antineutrophil cytoplasmic antibodies (ANCA) were associated with WG, making ANCA positivity a useful reference point for diagnosing this disease. Treatment for WG focuses on immunosuppression, with hormones and CTX often providing temporary relief. Traditional Chinese medicine can also be effective in treating this condition.

Acute Coronary Syndrome (ACS), December 14, 2001

ACS typically consists of three components: ① unstable angina (VA); ② ST-segment elevation myocardial infarction; ③ ST-segment depression myocardial infarction. The probability of ST-segment elevation myocardial infarction combined with Q waves is 92–95%; the probability of ST-segment depression myocardial infarction combined with Q waves is lower, making it more challenging to differentiate between the two. Diagnosis is critical: cardiac enzyme profiles and C-reactive protein are highly significant. Cardiac enzymes include creatine kinase (CK), creatine kinase isoenzyme, phosphokinase (CK-MB), and cardiac troponin quantification are also diagnostic indicators. C-reactive protein (CRP) indicates the presence of inflammation, with rapid inflammatory progression being a hallmark of myocardial infarction—CRP is a highly sensitive, non-specific marker of inflammation. One of the major risk factors for ACS is the rapid expansion of reactive inflammation; early use of aspirin can help prevent this inflammatory response. Of course, the use of broad-spectrum antibiotics is absolutely essential, as reactive inflammation can quickly lead to bacterial infections.

Electrocardiographic Diagnosis of Acute Myocardial Infarction, December 22, 2001

ST-segment elevation, inverted T-waves, and Q-wave appearance are three key indicators for diagnosing myocardial infarction. If these three indicators appear in V1, it suggests an inferior wall infarction; in V2, it suggests an anterior wall infarction; in V5, it suggests a lateral wall infarction; in II and III, it suggests a lower wall infarction; in I, it suggests a high wall infarction—these indications can help guide further diagnosis.

Emergency Medications for Myocardial Infarction, December 22, 2001

1. Nitroglycerin: 5–10 µg/min, Xiangxintong: 40 µg/min. During the acute phase, continuous intravenous nitroglycerin infusion is recommended for 24 hours, at 1 mg every 24 hours, slowly infused over 250 ml of 5% glucose solution. If the infusion is completed within 2 hours, the dosage should generally meet the requirement of 5–10 µg/min.

2. Urokinase: 1.5 million units, administered once daily, 100 ml of 5% glucose solution via intravenous drip. Repeat administration can be done every 4–5 hours until coronary circulation is restored. During this time, perform coagulation tests every 2 hours to check prothrombin time and partial thromboplastin time.

3. Heparin: 5,000 units added to 50–100 ml of normal saline, administered via intravenous drip or slow injection. Typically, after slow injection, maintain a dose of 1,000 units per hour. Recently, low molecular weight heparin (enoxaparin 20 mg, 0.2 ml, subcutaneous injection, once daily) has become increasingly popular.

4. For patients with severe hypertension, sodium nitroprusside can be used: 10–30 mg added to 250 ml of 5% glucose solution, administered via intravenous drip once daily.

5. Oral medications: aspirin, propranolol, captopril.

Diagnostic Tests Using Urokinase in Myocardial Infarction, December 23, 2001

PT (prothrombin time), TT (thrombin time), APTT (partial thromboplastin time), FIB (fibrinogen quantitative determination)

1. PT: 12–15 seconds; values exceeding or falling by more than 3 seconds are diagnostic. Prolongation may indicate liver disease, vitamin K deficiency, obstructive jaundice, DIC, or oral or anticoagulant medication use. Shortening may suggest hypercoagulability, acute myocardial infarction, cerebral embolism, thrombophlebitis, multiple myeloma, digitalis toxicity, or ether anesthesia.

2. TT: 12–15 seconds; values exceeding or shortening by more than 3 seconds are also diagnostic.

3. APTT (partial thromboplastin time): 30–50 seconds; prolonged by 10 seconds or shortened by 10 seconds is clinically significant.

4. FIB (fibrinogen quantitative determination): 2–4 g/L; elevated levels may indicate diabetes, acute myocardial infarction, cerebrovascular disease, atherosclerosis, hyperlipidemia, thrombophlebitis, acute infectious diseases, or liver disease. Decreased levels may occur in severe hepatitis.

5. 3P (plasma protamine sulfate parafactor assay): Normal individuals are negative; a positive result indicates the presence of thrombin in the blood, often seen during thrombolysis treatment.

6. Fibrin degradation products (FDP): A marker of fibrinolytic activity, which should be checked during thrombolysis. A positive result is normal.

Diabetic Ketoacidosis, December 26, 2001

Infections, poisonings, emotional stress, colds, fever, or excessive physical exertion can lead to elevated blood sugar levels and the development of ketoacidosis. Ketoacidosis occurs when ketone bodies increase in the blood; when blood sugar levels rise too high, the body’s metabolism becomes overwhelmed, resulting in the accumulation of incomplete metabolic products in the tricarboxylic acid cycle. The main byproducts of incomplete metabolism are ketone bodies. Ketone bodies typically include acetoacetic acid, α-ketoglutaric acid, β-hydroxybutyric acid, and acetylacetone; the latter two are strong acids, causing acidosis. Therefore, ketoacidosis is essentially a form of acidosis. Clinical manifestations of diabetic ketoacidosis include thirst, polyuria, increased urine volume, followed by drowsiness, loss of consciousness, fatigue, decreased skin elasticity, sunken eye sockets, and in severe cases, deep coma, hypotension, and a weak pulse.

The key points in treating this condition are threefold: ① insulin infusion; ② fluid and electrolyte replacement; ③ infection control.

Calcium Folinate and Coenzyme Q10, December 2, 2001

Full name: calcium folinate, also known as calcium methylfolate, abbreviated as CF. It is a chemotherapy drug used in cancer treatment; when MTX is administered in excess, its strong folate antagonistic effect can disrupt folate synthesis. Therefore, it is advisable to use CF 50 mg IV. Each vial contains 5 mg of this product.

Coenzyme Q10 has protective effects on the liver and also supports the heart and brain, making it beneficial for patients with heart, liver, or brain disorders.

Characteristics of Liver Blood Supply and Theoretical Basis of Hepatic Artery Embolization, December 29, 2001

The liver receives dual blood supply—through the hepatic artery and the portal vein. The former supplies 20% of blood flow, with 50% of oxygen delivery; the latter supplies 80% of blood flow, with 20% of oxygen delivery. Although oxygen supply is limited, the liver cells possess tremendous tolerance to hypoxia, allowing them to compensate for up to 95% of blood flow. Therefore, complete embolization of the hepatic artery does not pose significant physiological challenges.

The blood supply to malignant liver tumors is primarily through the portal vein in the early stages, while the hepatic artery plays a larger role in later stages. Early-stage pressure is low, but late-stage pressure is higher, with the portal vein serving as the outflow pathway.

Sweating and Restlessness Due to Cerebral Arteriosclerosis, January 1, 2002

Sweating and restlessness are common symptoms of cerebral arteriosclerosis or systemic arterial sclerosis. Treatment for these symptoms often yields noticeable results with the following formula: 6 g of Xianmao, 6 g of Yin Yanghuo, 10 g of Ba Ji Tian, 10 g of Zhimu, 10 g of Huang Bai, 10 g of Dang Gui, 6 g of Chuan Xiong, 10 g of Chi Shao, 3 g of Hong Hua, 10 g of Jiang Xiang, 20 g of Dan Shen, 12 g of Sheng Di, 10 g of Tao Ren, 10 g of Chai Hu, 10 g of Zhi Ke, 10 g of Jie Geng, 6 g of Gan Cao, 10 g of Niu Xi, 30 g of Huang Qi, 3 g of Huang Lian, 10 g of Huang Qin—boiled and taken as a decoction daily. This formula is also known as “Er Xian,” “Guan I,” and “Xue Fu Zhu Yu Tang.”

Further Considerations on Electrocardiography in Myocardial Infarction, January 2, 2002

① Significant ST-segment elevation, with upward arching, reflecting myocardial damage, typically appearing within a few hours after onset and recovering within 3–10 days. ② Q waves or QS waves, indicating myocardial necrosis, appearing within 12 days.

Conclusion: The Role of Calcium Channel Blockers in Cardiovascular Disease, January 2, 2002

Calcium channel blockers are effective in treating cardiovascular diseases, particularly in cases of myocardial infarction. They can help reduce the risk of complications and improve patient outcomes. However, it is important to note that these medications should be used under the guidance of a healthcare professional, as they may have side effects and interactions with other medications.

For more information on the use of calcium channel blockers in cardiovascular disease, please refer to the relevant medical literature or consult with a healthcare provider. 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: Within a few hours, once an abnormal Q wave appears, it often persists permanently; sometimes, in some patients, it may suddenly disappear after several years or even months.

Effective Formulas for Stomach Distension and Pain – January 11, 2002

6g of Xiangfu, 6g of Liangjiang, 6g of Banxia, 10g of Zhishi, 3g of Sharen, 6g of Muxiang, 10g of Danshen, 6g of Cao Kou, 3g of Huanglian, 10g of Huangqin, 6g of Ganjiang, 10g of Dangshen, 6g of Houpu, 3g of Dahuang, 15g of Baishao, 15g each of Longmu and Sheng, 15g of Wuchui, decocted in water and taken daily as one dose. This formula is effective for treating stomach distension and pain.

Traditional Chinese Medicine Treatment for Headaches – January 10, 2002

1. 10g of Mahuang, 10g of Guizhi, 10g of Xingren, 6g of Gancao, 6g of Chuanxiong, 6g of Baiyi, 3g of Xixin, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, 10g of Caiyuzi, 10g of Xinmi, 20g of Erhua, 20g of Lianqiao, 10g of Zhike, decocted in water and taken daily as one dose. (Headaches caused by external infections or sinusitis)

2. 10g of Dangshen, 10g of Baizhu, 20g of Huangqi, 10g of Danggui, 6g of Fushen, 10g of Yuanzhi, 12g of Zao Ren, 3g of Muxiang, 10g of Yuanrou, 10g of Shanyao, 6g of Chuanxiong, 3g of Baiyi, 3g of Xixin, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, decocted in water and taken daily as one dose. (Headaches caused by anemia or neurasthenia)

3. 6g of Huanglian, 10g of Huangqin, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, 6g of Chuanxiong, 10g of Huoxiang, 6g of Gancao, 6g of Baiyi, 3g of Xixin, decocted in water and taken daily as one dose. (Neural headaches)

4. 10g of Danggui, 10g of Huangqin, 10g of Manjingzi, 10g of Ju Hua, 10g of Mai Dong, 6g of Gancao, 6g of Chuanxiong, 6g of Baiyi, 3g of Xixin, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, decocted in water and taken daily as one dose. (Neural headaches)

5. 6g of Cangzhu, 10g of Bohe, 10g of Huangqin, 10g of Jingjie, 3g of Shengma, 20g of Fengegen, 10g each of ChiBai and Hongbai, 6g of Gancao, decocted in water and taken daily as one dose. (Thunderhead wind, allergic headaches)

6. 10g of Danggui, 6g of Chuanxiong, 10g of ChiBai, 12g of Shengdi, 10g of Taoren, 6g of Honghua, 10g of Chaihu, 10g of Zhike, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, decocted in water and taken daily as one dose. (Cerebral arterial sclerosis-related headaches)

7. 6g of Xianlingpi, 6g of Xianmao, 10g of Bajitian, 6g of Zhimu, 6g of Huangbo, 10g of Danggui, 10g of ChiBai, 6g of Chuanxiong, 3g of Honghua, 6g of Jiangxiang, 20g of Dangshen, 3g of Han Sanqi (mixed), 10g of He Teng (mixed), 6g of Banxia, 30g of Gou Teng, 10g of Che Qian Zi, 10g of Xia Ku Cao, 15g of Sheng Oushi, decocted in water and taken daily as one dose. (Spondylotic-basilar artery sclerosis, dizziness, Meniere’s disease)

8. 10g of Dangshen, 6g of Wu Yu, 6g of Shengjiang, 6g of Baiyi, 6g of Yin, 6g of Huang, 10g of Danggui, 10g of ChiBai, 6g of Xixin, 10g of Qiangguo, 12g of Fangfeng, decocted in water and taken daily as one dose. (Neural headaches combined with chronic colds)

9. 10g of Xia Ku Cao, 10g of Sang Ji Sheng, 10g of Huangqin, 30g of Gou Teng, 10g of Madou Ling, 6g of Chuanxiong, 6g of Baiyi, 3g of Xixin, 10g each of Qiangduo Huo and Qiangguo, 12g of Fangfeng, decocted in water and taken daily as one dose. (Headaches caused by high blood pressure)

10. 60g of Hua Niu Xi, 15g of Sheng Longmu, 15g of Sheng Oushi, 15g of Sheng Bai Shao, 15g of Sheng Gui Ban, 10g of Yuan Shen, 15g of Tian Dong, 20g of Chuan Lian Zi, 10g of Mai Dong, 20g of Yin Chen, 6g of Gancao, decocted in water and taken daily as one dose. (Headaches caused by hypertension, with systolic blood pressure around 180 mmHg and diastolic blood pressure around 120 mmHg)

Lean Meat Additive Poisoning – January 11, 2002

The main component of lean meat additives is Clenbuterol. On the Chinese market, lean meat additives include Asthma Sine, Ke Chuan Su, Amibit, Am Double Chloride, among others. This product belongs to the beta-adrenergic receptor agonist class. Compared to other beta-adrenergic agonists, Clenbuterol is eliminated more slowly from the body, with a half-life ranging from 25 to 39 hours. Because of this, it can both promote metabolism, eliminate fat, and increase lean muscle mass, but also carries the risk of accumulation and poisoning. Some people add Clenbuterol to animal feed to increase livestock weight and enhance lean meat production. However, this substance accumulates significantly in animal liver tissue, often reaching up to 4.5 mg/kg. If a person consumes 100 g of such liver tissue, they may experience poisoning. The primary symptoms of poisoning include palpitations, nervousness, tachycardia, tremors, dizziness, muscle pain, nausea, and abdominal distension.

If you encounter such patients, you can administer beta-blockers like Propranolol (Inderal) or Metoprolol (Tenormin) to alleviate their symptoms.

Two Coronary Vasodilators – January 11, 2002

1. Lunan Xinkang is a third-generation sorbitol-based product—namely, Sorbitol, Xiao Xin Tong, and Lunan Xinkang—taken at 20–40 mg orally three times a day. It has strong coronary vasodilation effects and lasts longer than nitroglycerin, making it a medium-efficiency vasodilator.

2. Nifudafa is a sustained-release formulation of Xintong, taken at 20 mg orally twice a day. Its duration of action is longer compared to Xintong, typically lasting for one dose per day.

Liver Transplantation – January 11, 2002

The first liver transplant surgery at the University of Pittsburgh in the United States was performed 37 years ago. According to recent statistics, the 1-year survival rate is 87%, the 3-year survival rate is 77%, and the 10-year survival rate is 60%. In recent years, the number of liver transplant patients in the United States has remained around 5,000 per year, but the supply of donor livers is significantly insufficient. New immunosuppressive agents, such as cyclosporine, have proven highly effective in overcoming rejection during liver transplant procedures.

Clinical Application of Qinggu San – January 13, 2002

10g of QinTiao, 15g of BiJia, 10g of Digeopi, 10g of YinChaiHu, 6g of HuHuangLian, 10g of QingHao, 10g of Zhimu, 6g of Gancao. The mnemonic: “QinTiao, BiJia, Digeopi, YinChaiHu, HuHuangLian, QingHao, Zhimu, ChuanXiong, HongHua, JiangXiang, DangShen, 20g of BaiYi, 10g of GuiZhi, 10g of BaiYu, 30g of ZeXie, 10g of MaHuang, 3g of Xixin, 6g of PuHuang, 3g of HanSanQi (mixed).”

Treatment of Supraorbital Moles – January 13, 2002

During the New Year of Renwu, I treated a woman who had been suffering from supraorbital moles for over 20 days, despite trying numerous medications without success. The man was 57 years old, with normal blood pressure, a hard and tense pulse, and early signs of arteriosclerosis. I prescribed the following formula, consisting of 10 doses, which completely alleviated her moles: 10g of XianMaо, 10g of YinYangGuo, 10g of Bajitian, 10g of Zhimu, 10g of HuangBo, 10g of ChiBai, 10g of ChuanXiong, 6g of HongHua, 10g of JiangXiang, 20g of DangShen, 6g of BaiYi, 10g of GuiZhi, 10g of BaiYu, 30g of ZeXie, 10g of GouTeng, 30g of BaiTiLi, 20g of ShiJueMing, decocted in water and taken as one dose. After completing the 10 doses, the moles completely disappeared. This formula was adapted from Wang Qingren’s XueFu Zhu Yu Tang.

Another Formula for Dizziness Caused by Spondylotic-Basilar Artery Sclerosis – March 12, 2003

At the beginning of the Renwu year, a woman suffered from dizziness due to arteriosclerosis, accompanied by frequent dizziness, tinnitus, and headache, with blood pressure at 140/90 mmHg. I prescribed the following formula: 10g of XianMaо, 10g of XianLingPi, 10g of Bajitian, 6g of Zhimu, 6g of HuangBo, 10g of DangGui, 10g of SangYe, 15g of Ju Hua, 10g of DanPi, 10g of ShanZhi, 10g of ShengDi, 10g of Qi Zi, 10g of BaiYu, 10g of ZeXie, 30g of TianMa, 30g of GouTeng, 30g of BaiTiLi, 20g of ShiJueMing, decocted in water and taken as 7 doses, with remarkable efficacy. I recall that six years ago, I treated Mr. Cai Zimin, General Manager of BaiYin Company, using this same formula, adding 10g of GuanXin No. 1, 10g of He Teng (mixed), and 3g of Han SanQi (mixed). You can also add ChuanXiong to adjust the formula.

Research Focus on Kidney Disease Today – March 13, 2003

There is no doubt that genetic research on kidney disease remains a current hotspot. The population is a polygenic group, and different groups and individuals exhibit distinct biological activities, showing significant differences in susceptibility and resistance to disease—differences rooted in different genetic factors. The essence of kidney disease genes lies in DNA sequence variations, among which single nucleotide polymorphisms (SNPs) are the most common. From this perspective, research on glomerular nephropathy is expected to make progress.

Non-Lipid-Lowering Effects of Statins – March 28, 2002

The formation and rupture of atherosclerotic plaques are key factors in the progression of coronary heart disease. However, smooth muscle cells in the vessel walls already possess the function of synthesizing the fibrous cap prior to this process, a function that reflects endothelial dysfunction. A study showed that statins exert direct effects on rabbit aortic strips and cultured endothelial cells, inducing potent vasodilatory responses while simultaneously exhibiting significant anti-inflammatory properties. These effects are achieved through regulation of smooth muscle cells (SMCs). Other studies have confirmed that statins can reduce the number of giant cells and SMCs within atherosclerotic plaques. Recent research found that 24 patients with cerebral ischemia caused by carotid artery atherosclerosis experienced significant symptom relief after 3 months of statin treatment; those who did not receive statin therapy, however, continued to experience worsening symptoms.

In summary, in addition to lipid-lowering effects, statins also exhibit notable anti-atherosclerotic properties, a mechanism closely related to their proactive actions on SMCs in the vascular wall.

Research Progress on Helicobacter pylori – March 29, 2002

1. Digestive System: Chronic atrophic gastritis, gastric and duodenal bulb ulcers, superficial gastritis, reflux esophagitis, gastric MALT lymphoma, salivary gland MALT lymphoma, hepatic encephalopathy—all of these conditions are positively correlated with Hp infection.

2. Chronic Bronchitis: In recent years, some interesting animal experiments have shown that inflammation associated with the upper digestive tract and Hp may trigger chronic bronchitis via a non-adrenergic, non-cholinergic sensory nerve pathway, rather than the previously believed direct infection.

3. Hematological System: Autoimmune thrombocytopenia (PATP), also known as primary thrombocytopenia, has been found to be clearly linked to Hp infection. Iron deficiency anemia also shows a strong correlation with Hp infection.

4. Cardiovascular System: Primary headaches, primary Raynaud’s phenomenon, and anemic heart disease are all associated with Hp infection.

5. Immune Disorders: Hashimoto’s thyroiditis, Johann’s disease, and other immune disorders are all linked to Hp infection.

6. Beyond these, chronic urticaria, alopecia areata, psoriasis, and other conditions also show clear associations with Hp infection. Diabetes and growth retardation in children are also strongly linked to Hp infection.

These diseases share a clear connection with Hp infection, thus reinforcing the ancient saying that the spleen is the source of qi and blood, the spleen is the root of postnatal life, illness enters through the mouth, and all six qi are transformed into fire.

In conclusion, the discovery of Hp in the latter half of the last century was groundbreaking, introducing entirely new concepts regarding the onset and pathogenesis of many diseases.

Current Status of Restenosis After PTCA and CAPG – April 8, 2002

Within one year after PTCA, restenosis rates reach 35%–50%; within one year after CAPG, restenosis rates are 10%, and within two years, the restenosis rate rises to 20%. For major arterial bypass surgery, the restenosis rate is 15% after five years. The mechanisms behind restenosis include: ① compensatory increases in smooth muscle cells; ② damage to the vascular endothelium during surgery leads to platelet aggregation, and the involvement of the coagulation system promotes thrombus formation; ③ vascular remodeling. Prevention and treatment strategies for restenosis include: ① minimizing vascular damage during surgery; ② conducting genetic research to prevent restenosis formation—essentially, introducing genes that inhibit vascular layer proliferation into the recipient; this falls under the category of genetic engineering; ③ intravascular irradiation: B-ray irradiation, which falls under the realm of nuclear medicine; ④ photodynamic therapy, utilizing lasers or ultraviolet light, which falls under the domain of physics; ⑤ preoperative drug coating of stents. In addition to these five methods, if restenosis occurs, further interventional procedures can be performed. Common surgical options include: ① thrombolysis and plaque removal surgery at the stenosis site; ② artificial vascular bypass surgery; ③ venous–arterialization: this involves connecting a healthy artery to the great saphenous vein; ④ genetically modified therapy—also known as autologous bypass surgery or vascular regeneration surgery, where genes are introduced into the proximal end of the blocked vessel to promote regeneration of the distal vessels; ⑤ thrombolysis.

Acute Renal Failure – April 10, 2002

Prerenal causes include trauma, infection, shock, massive blood loss, and poisoning; renal causes include renal tumors, nephritis, renal calculi, and renal tuberculosis; postrenal causes include prostate issues and tumors, among others, all of which can lead to acute renal failure.

Clinical manifestations typically include oliguria, polyuria, and recovery phases. Oliguria is characterized by urine output of less than 400 ml in 24 hours; polyuria is defined by urine output exceeding 1500 ml. Initial symptoms include nausea, vomiting, loss of appetite, abdominal distension, and loose stools, followed by headache, dizziness, irritability, and even coma. Anemia and decreased levels of red blood cells, white blood cells, and platelets are commonly observed; systemic infections may also occur. During oliguria, hyperkalemia, hypermagnesemia, hyperphosphatemia, hyponatremia, and hypocalcemia are prevalent; during polyuria, hypochlorhydria, hypophosphatemia, hypokalemia, and hyponatremia are observed. Regardless of whether it's oliguria or polyuria, urea nitrogen and creatinine levels tend to rise, while CO2-P levels decrease, indicating acidosis. Urine specific gravity is crucial for diagnosis—specific gravity below 0.012 can confirm the diagnosis, while urine sodium levels above 30 mmol/L indicate elevated sodium levels, while urea nitrogen and creatinine levels in urine are reduced.

[Urine Sodium mmol/L]{.underline}

Urine Creatinine / Blood Creatinine

Renal Failure Index: >2

Treatment of Hyperthyroidism – April 20, 2002

During the New Year of Renwu, a female patient had been suffering from hyperthyroidism for over two years, experiencing excessive sweating, palpitations, and poor sleep quality. I prescribed Tian Dong, Sheng Di, Yuan Shen, Huang Qi, Chai Hu, Nu Zhen Zi, Shi Jue Ming, and Xiang Fu, along with 6 doses, which proved highly effective. After taking another 10 doses, all symptoms were completely resolved. The formula’s mnemonic: “Hu Nu Zeng Ye Shi Huang Qi.”

Selection of Several Commonly Used New Medications – May 23, 2002

1. Cebirin (Cebirin) – Flunarizine capsules, a calcium channel blocker used specifically for migraine prevention, also effective for ear-related dizziness. Dosage: 5–10 mg, once nightly. Elderly patients may experience transient tremors, rigidity, agitation, or difficulty with jaw movements as side effects. Some patients may also experience transient drowsiness, increased appetite, and weight gain. Packaging: 5 mg × 10.

2. Naoshu Ting (Shu Xue Ning) – This product is a complex formulation of flavonoid glycosides or ginkgo lactones, suitable for hypertension, arteriosclerosis, and coronary heart disease. Its effects include reducing oxidative stress, increasing coronary blood flow, and alleviating myocardial ischemic injury and the extent of cerebral infarction. Take 2 tablets daily, 12 tablets x 2 per box.

3. Lotin Xin (Benazepril) – An angiotensin-converting enzyme inhibitor, similar in mechanism to Captopril. Suitable for hypertension at all stages and congestive heart failure. Due to the risk of a sharp drop in blood pressure after the first dose, it is generally recommended to start with 5–10 mg once daily, gradually increasing the dosage based on the patient’s condition. Patients with severe heart failure may begin with 2.5 mg. Side effects are mild: headache (10%), cough (5.4%), dizziness (4.2%), fatigue (3.6%), muscle pain (2.6%), nausea (2.5%), rhinitis (2.4%), diarrhea (2.0%), and sometimes sore throat, back pain, or abdominal pain.

Pyrazinamide Tablets – May 23, 2002

An anti-tuberculosis medication, alongside streptomycin, isoniazid, rifampicin, and ethambutol, forming the “five-drug combination” for tuberculosis treatment. Take 0.25–0.5 g orally, three times a day, PO. Side effects include diabetes, gout, and potential liver function impairment—use with caution in patients with diabetes or gout.

Children should avoid taking this medication.

Unstable Angina Pectoris (VAP) vs. Acute Myocardial Infarction (AMI) – May 23, 2002

VAP and AMI together are referred to as acute coronary syndrome. VAP tends to have a younger average age of onset than AMI, yet the coronary lesions are more severe in VAP cases. One possible reason for this is that VAP is often associated with significantly lower HDL-C levels and markedly elevated TG levels. As a result, the TC/HDL-C and TG/HDL-C ratios are notably higher in VAP compared to AMI.

The coronary lesions in VAP are relatively more severe, but acute myocardial infarction occurs less frequently—perhaps because long-term ischemia in these patients has already formed rich collateral circulation networks. Based on these findings, VAP is typically treated with coronary artery bypass grafting; AMI, on the other hand, is best treated with percutaneous coronary angioplasty.

Side Effects of Statins: Rhabdomyolysis – May 23, 2002

Simvastatin (Zocor), fluvastatin (Lescol), lovastatin (Levitra), pravastatin (Pravachol), cerivastatin (Bayer), and atorvastatin (Lipitor)—since the advent of these drugs, they have become widely popular for their remarkable lipid-lowering effects. However, the biggest drawback of these medications lies in their potential to cause myalgia, myositis, and rhabdomyolysis, which can often worsen to lead to renal dysfunction and failure, resulting in death. In the United States, there was a case involving the death of a patient due to Bayer’s Lipitor. The FDA announced that Bayer would compensate for the losses and ordered the suspension of cerivastatin, which was voluntarily withdrawn from the market in 2001. Additionally, when this medication was used in combination with gemfibrozil, the incidence of adverse events increased significantly compared to monotherapy. Therefore, pharmacopeias explicitly prohibit the use of these medications in combination with fibrates. Among fibrates, gemfibrozil is the most representative, a highly effective lipid-lowering agent.

Pineal Gland – June 5, 2002

The pineal gland is a newly discovered anatomical structure in the human body, measuring approximately 0.8 cm in diameter and weighing around 0.2 g. Located in the posterior midbrain between the two hemispheres of the brain, the pineal gland in lower vertebrates serves primarily as a sensory organ; in humans, however, the pineal gland does not possess this function. Recent research has confirmed that the pineal gland functions as an endocrine organ, secreting hormones primarily composed of acetylmethoxytyramine. Acetylmethoxytyramine exerts two primary effects: ① it reduces neurotransmitter levels in the brain—neurotransmitters refer to substances like serotonin and norepinephrine, whose decline can induce sedation and hypnotic effects; ② it inhibits the development of the pituitary gland, thyroid gland, adrenal glands, prostate gland, and seminal vesicle gland. Based on these functions, researchers have dubbed the acetylmethoxytyramine extract from the pineal gland “brain gold.” As we’ve seen, brain gold has a calming effect; moreover, it is also not recommended for minors. Brain gold contains melatonin, also known as “sleep-inducing melatonin.”

Malignant Hematopoietic Cell Neoplasm – July 8, 2002

This disease is commonly referred to as malignant hematopoietic cell neoplasm or MH. It is a malignant disorder characterized by the infiltration of malignant hematopoietic cells into the liver, spleen, kidneys, bone marrow, lymph nodes, and other organs such as the heart, pericardium, lungs, pleura, gastrointestinal tract, and pancreas. 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: Adenoids, gallbladder, and other organs can all be affected. Most cases occur in adolescents, with males more frequently than females. Common symptoms include: ①

Fever, liver and kidney damage, hepatomegaly, and jaundice; ② A decrease in the three-line cells, with a particularly noticeable reduction in white blood cells.

A large number of histiocytes can be observed in blood smears or bone marrow smears.

Treatment: Chemotherapy can be administered using either the COP or COPP regimens. The Nanchang City Leukemia Collaborative Group’s

No. 7 for Cancer Treatment: 30g of Coix Seed, 10g of Phyllanthus urinaria, 30g of Solanum nigrum, 3g of Panax notoginseng, 4 black plums, 5g of Herba Lysimachiae, decocted in water and taken as one dose daily. This formula achieved complete remission in seven patients with severe leukemia, leading to its widespread use across the country. Add Anemarrhena ashi, gypsum, and Echinoopsis (for persistent fever); add

Xue Jian Chou, Xianhe Cao, and Charcoal (for hemostasis).

Key Points for Reading Chest CT Scans – July 10, 2002

1. At the lung apex level (second thoracic vertebra): The trachea, blood vessels, and the common carotid artery on both sides of the vertebral bodies, along with the subclavian artery and subclavian vein, form a triangular shape.

2. At the arch level (third thoracic vertebra): The trachea, esophagus, and the right side of the vertebral body—specifically the head-arm venous plexus, the head-arm arteries, and the head veins—occupy a large area in the anterior right portion. On the left side, the common carotid artery and the left subclavian artery still dominate.

3. At the aortic arch level (fourth thoracic vertebra): The trachea, esophagus, vertebral bodies, and the retrosternal fat tissue are present. The right upper front is shaped like an arc, forming the aortic arch, while the left upper part is occupied by the superior vena cava. The small blood vessels on both sides of the vertebral bodies are the intercostal veins.

4. At the arch below (sixth thoracic vertebra): The trachea, esophagus, and vertebral bodies—on the front, there is the massive ascending aorta, and on the back, the larger descending aorta. The right front is the superior vena cava, while the intercostal veins run alongside the vertebral bodies.

5. At the tracheal branch level: The trachea divides into two segments (black holes), with the posterior esophagus and vertebral bodies. In addition to the aforementioned ascending and descending aortas, there are also prevertebral glands behind the sternum. One can even observe the left pulmonary artery in front of the trachea, the inferior vena cava behind the trachea, and the intercostal veins along the vertebral bodies.

6. At the pulmonary artery level (seventh thoracic vertebra): From the trachea, esophagus, and vertebral bodies, in addition to the previously mentioned ascending and descending aortas, one can see the left and right branches of the pulmonary artery between them. On the left side of the vertebral bodies, one can observe the intercostal veins.

7. At the cardiac level (eighth thoracic vertebra): This level is characterized by the aortic root serving as the central point in front of the vertebral bodies. Starting from the right atrium on the right side, the sequence proceeds clockwise: right atrium → right ventricle → left ventricle → left atrium, completing a full circle. In front of the right ventricle, the right coronary artery is located, while the left coronary artery runs in front of the left ventricle.

DNA Embedding Agents: A Revisit – August 1, 2002

DNA embedding agents work by inserting themselves into DNA, thereby disrupting the normal function of the DNA. The Latin letter at the end of these agents is “Bicin,” which is why they are referred to as “Bisheng” in Chinese. The most commonly used drugs in this category include doxorubicin (Adriamycin), epirubicin (Epirubicin), and doxorubicin (Doxorubicin). In recent years, Japanese scholar Professor Hamazaki Hamano has artificially synthesized a new generation of Bisheng agents—pyrarubicin—which exhibits broader therapeutic effects compared to previous generations, while having relatively fewer side effects.

The dosage of pyrarubicin is 40mg dissolved in 5% glucose, administered once every four weeks. Additionally, mitoxantrone also falls under this category; these drugs share a common characteristic: their color is red-purple. The primary side effect is cardiotoxicity.

Shayanzi, Lotus Seed Heart, and Raspberry Fruit – August 6, 2002

All three herbs are primarily used to tonify the kidneys and tighten essence. Shayanzi is also known as Shayanzi Qi, and it is the mature fruit of a leguminous plant called Flat Stem Astragalus. It is non-toxic, with dosages ranging from 10 to 25 grams. Beyond its kidney-tonifying and essence-tightening properties, Shayanzi can also help consolidate the bladder and stop nocturnal emissions. Lotus Seed Heart, derived from the seeds of the lotus flower, is a plant belonging to the water lily family. Besides its kidney-tonifying and essence-tightening effects, it also helps clear the heart and calm the mind, with dosages ranging from 6 to 10 grams. Raspberry Fruit, from the rose family, is the fruit of the raspberry plant, colored red and tasting sweet and sour. Harvested in summer and autumn, it is delicious to eat—and beyond its kidney-tonifying and essence-tightening properties, it can also help consolidate the bladder and promote urination.

All three herbs are non-toxic. However, during the midsummer months of June and July, two patients who suffered from nocturnal emissions due to kidney deficiency took Shayanzi and other herbal remedies, experiencing vomiting, headache, and dizziness. One patient developed a severe reaction and had to be hospitalized for fluid infusion. Why? Fan Junling, manager of Hui Cui Tang, once instructed her staff to try the same treatment, and similar reactions did indeed occur. Could Shayanzi be a counterfeit drug? Given that Lotus Seed Heart and Raspberry Fruit are edible, could they have been infested with insects?

Traditional Chinese Medicine Treatment for Coronary Heart Disease – August 15, 2002

Today, there are many medications available for treating coronary heart disease, including calcium channel blockers, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, nitroglycerin preparations, digitalis preparations, diuretics, and others—all of which can play a role to some extent. Traditional Chinese Medicine has proven effective in treating this condition. The Guo Lou Xie Bai Ban Xia Tang, Guan Yi, Panax notoginseng, and Water Scooter are often used as foundational formulas for emergency treatment. Typically, additional ingredients such as 20g of fresh hawthorn, 12g of rehmannia, 10g of angelica, 10g of codonopsis, 15g each of raw shan zha and raw oyster shell, 6g of stone grass, 6g of far Eastern ginseng, 20g of chuan lian zi, and 10g of round flesh are added to these formulas. If arrhythmia occurs, a formula containing roasted licorice can be used; among the key ingredients, 30g of danshen, 30g of kudzu, 20g of rehmannia, and 20g of wheat germ should be added. For patients with weak stomachs and intestines, adding wood fragrance and cardamom can be beneficial; for patients experiencing shortness of breath, adding five-flavor berry can be helpful. Some patients experience lower limb edema, indicating varying degrees of heart failure. Western medicine may prescribe digoxin, while traditional Chinese medicine can utilize Gusheng No. 2.

For chronic pulmonary congestion, which often leads to infections, a certain amount of antibiotics can be prescribed. Sleep at night is especially important; if necessary, sedatives can be administered before bedtime.

Down Syndrome – August 28, 2002

In humans, chromosomes reside within the cell nucleus, consisting of 46 chromosomes in 23 pairs, with one pair being the sex chromosome. Chromosomes serve as the primary foundation of genetic information. Sperm contribute 23 chromosomes, and eggs also provide 23 chromosomes; the fertilized egg then receives both sets of chromosomes, bringing the total number of chromosomes up to 46, 23 pairs. Fertilized eggs formed through incestuous marriages, drug abuse, severe infectious diseases, or immunodeficiency may contain 47 chromosomes—whether sperm or eggs are overproduced can lead to such conditions. When this happens, infants may exhibit Down syndrome, characterized by unusual facial expressions, distinctive physical features, and intellectual disabilities.

Non-Steroidal Anti-Inflammatory Analgesics – August 28, 2002

The first generation included indomethacin, the second generation featured ibuprofen, while long-acting formulations like naproxen were available. The third generation included rilpivirine (nabumetone). The mechanism of action for nonsteroidal anti-inflammatory analgesics (NSAIDs) involves inhibiting cyclooxygenase (COX), arachidonic acid metabolism, and prostaglandins. COX can be divided into COX-1 and COX-2; COX-1 acts primarily on muscles and joints, while COX-2 affects the gastrointestinal tract. Both the first and second-generation NSAIDs significantly inhibit COX-1 and COX-2. As a result, the production of prostaglandins in muscles and joints is suppressed, inflammation subsides, and pain is alleviated. Simultaneously, prostaglandins in the gastrointestinal tract are also inhibited, potentially preventing gastrointestinal complications. The third-generation products primarily suppress COX-1 more effectively than COX-2, thus causing less irritation to the gastrointestinal tract.

Acute Lymphoblastic Leukemia – September 1, 2002

In midsummer of the Year of the Horse, Li, a resident of Jiangxi Province, came to Lanzhou specifically, carrying a prescription that stated he had taken over 400 doses of this formula, along with Qingkou capsules developed by him. He had previously been diagnosed with acute lymphoblastic leukemia (ALL) at the Hematology Department of Lanzhou First People's Hospital, but after several rounds of chemotherapy failed to yield significant results, he was introduced to our clinic. Following treatment with the herbal formula he had prescribed, his condition gradually improved, and he has now gone two years without undergoing chemotherapy. Recently, a bone marrow biopsy conducted by the Hematology Department of Jiangxi Medical College showed that his leukemia had completely resolved, though the original leukemia cells still remained at 1.5%. Upon examination, we found that the prescription he carried was actually our Lanzhou formula—its composition had already been described earlier—and he continued to take Qingkou capsules, composed of the following herbs: blue indigo, cardamom, belladonna, and toad venom. This formula had previously shown effectiveness in treating multiple cases of leukemia, but never before had it yielded such remarkable results. He said that last year, his original leukemia cells had risen to 3%, but after taking Qingkou capsules for a month, the test results showed a decline to 1.5%.

Pelvic Congestion Syndrome – September 5, 2002

This condition arises when women of childbearing age experience pelvic venous congestion, presenting with abdominal pain, dyspareunia, menstrual pain, increased vaginal discharge, and autonomic nervous system dysfunction as primary clinical manifestations. Although the female pelvis contains veins that run alongside arteries, they are interconnected by numerous anastomotic branches and collateral connections, forming a vast pelvic venous plexus. As blood flows from arteries into veins, the flow slows down, making congestion more likely. This condition itself often leads to varying degrees of congestion. Factors such as women’s working postures, uterine positioning, pregnancy-related factors, endocrine influences, and tubal ligation can all increase the degree of congestion. Diagnosis of this condition can be somewhat challenging, but ultrasound imaging reveals enlarged uterus and ovaries, as well as thickened endometrium. Color Doppler ultrasound can reveal varicosities in the veins; the most reliable diagnostic methods are pelvic venography and ovarian venography. Palpation during gynecological examinations is a key feature of this condition and serves as an objective indicator for diagnosing it.

Treatment: Currently, Western medicine lacks ideal treatment options. In severe cases, surgical intervention—such as ligating or suspending pelvic veins—is recommended. Traditional Chinese Medicine offers a wide range of treatments for this condition, including Gui Zhi Fu Ling Wan, Dang Gui Shao Yao San, Tao Hong Si Wu Tang, Shao Fu Zhu Yu Tang, Da Huang Zhe Chong Wan, and Xue Fu Zhu Yu Tang—all of which are effective formulas for this condition, though they can be adjusted based on individual circumstances.

Recently Used Antibiotics – September 8, 2002

1. Dian Sha (Pefloxacin) injection, 0.4g diluted in 5% glucose and administered via slow intravenous drip, Qd–Bid, protected from light. Side effects include gastrointestinal reactions, photosensitivity, rash, epilepsy, and psychiatric abnormalities.

2. Clindamycin, 2ml, 0.3g, administered via intramuscular injection or intravenous drip in 250ml of NS, twice daily. Side effects include gastrointestinal reactions, phlebitis, and hematologic reactions. Suitable for Gram-positive cocci and anaerobic bacteria.

3. Xian Qing (Clindamycin), 0.6g diluted in 100ml of NS, protected from light, 0.6–2.4g per day.

4. Ling Lan Xin (Cefoperazone plus Sulbactam), 2g, administered via intramuscular injection, intravenous injection, or intravenous drip. Twice daily. Most of the piperazine derivatives are excreted via bile; patients with liver or gallbladder disorders, especially those with obstructive jaundice, should adjust the dosage accordingly. Patients with impaired renal function should reduce the dosage to a low level.

5. Ceforal, 2g, administered twice daily via intramuscular injection, intravenous injection, or intravenous drip. It can be used in patients with renal impairment, but the dosage should be reduced. In severe cases, it may trigger seizures.

6. Xin Fur Xin (Cefuroxime), 0.25g, 0.75g, 1.5g. Beta-lactamase inhibitors, protected from light. Intramuscular injection: 0.25g, intravenous injection: 0.25–0.75g, intravenous drip: 1.5g diluted in 100ml of NS, 1–3 times daily.

7. Xin An Lin (Amoxicillin with Sulbactam), 0.75g, intramuscular injection, Bid–Tid, 1.5–3.0g.

8. Sige (Amoxicillin with Potassium Clavulanate), potassium clavulanate and sulbactam are both beta-lactamase inhibitors. 1.2–2.4g, Qd; 100ml, IV, Bid.

9. Ming Ke Xin (Cefuroxime), 0.75–1.5g, Qd, added to 100ml of NS, with a total dose reaching up to 6g. When combined with strong diuretics, caution is advised, as this combination may lead to renal failure, passing through the blood-brain barrier.

10. Lifu Xing (Levofloxacin), 0.2g, 100ml, 0.2–0.3g, IV, Bid, protected from light, slow infusion; avoid concurrent use with theophylline, nor with Ca²⁺-Mg.

11. Fluroshaxin Mannitol Injection, protected from light, slow drip, 0.2–0.4g, Qd–Bid, IV, 100ml.

12. Netilmicin (synthetic aminoglycoside): ① 1ml (5000u); ② 2ml (10000u), Bid, m/IV. Side effects include ototoxicity and nephrotoxicity.

13. Vancomycin (narrow-spectrum antibiotic), suitable for resistant Gram-positive bacteria and pseudomembranous colitis, 0.4–0.8g, 250ml, IV. Side effects include renal impairment.

These antibiotics can be broadly categorized as follows:

1. Penicillin-based drugs: Xin An Lin, Sige—both are combinations of amoxicillin with sulbactam, while Sige is a combination of penicillin with clavulanate; skin tests indicate no renal toxicity.

2. Quinolone-based drugs: Levofloxacin, Dian Sha, Lofloxacine. ① Protected from light; ② Slow drip; ③ Limited dosage; ④ Renal impairment; ⑤ 100ml; ⑥ Use with caution in patients under 18, pregnant women, or breastfeeding mothers; ⑦ Suitable for both Gram-positive and Gram-negative bacteria.

3. Cephalosporin-based drugs: Xin Fu Xin, Ming Ke Xin, Cefotaxime, 0.2g, IV, Bid, with mild renal impairment; these drugs can cross the blood-brain barrier, and penicillin can cause cross-allergy.

4. Lincosamide-based drugs: Clindamycin, Xian Qing, 0.3–0.6g, IV, Bid, with renal impairment.

5. Miscellaneous drugs: Vancomycin, Netilmicin.

High-Dose Cisplatin Combined with Sodium Thiosulfate for Pleural Effusion – September 18, 2002

Cisplatin (DDP) 100mg was infused into the affected pleural cavity via 40ml of NS, Qd, while simultaneously administering 12g of sodium thiosulfate (STS). STS was administered via intravenous drip in 5% glucose, once weekly, with 4 administrations constituting a course of treatment. According to reports, CR+PR = 88%, with CR reaching 68%.

Among the cases discussed above, 15 patients had lung cancer accompanied by pleural effusion, 4 patients underwent radical mastectomy for breast cancer with pleural effusion, 2 patients had mesothelioma with pleural effusion, 2 patients had osteosarcoma with pleural effusion, and 9 cases involved large amounts of pleural effusion.

HBV Mutations in Hepatitis B – September 24, 2002

During hepatitis B treatment, two unexpected scenarios often arise:

1. Pre-C region mutations: Three-system testing revealed “small three positives,” meaning HBeAg (-), yet HBV-DNA quantification indicated active replication, with levels exceeding 1×10^4 copies/ml. This suggests that the patient’s HBV strain carries a pre-C region mutation, and treatment should be extended accordingly.

2. YMDD variant strains: After more than six months of standard treatment, if ALT levels remain persistently elevated, various causes should be ruled out. In such cases, the presence of the YMDD variant strain can be considered.

Both of these scenarios carry poor prognoses; therefore, intensified treatment and prolonged therapy are recommended.

Treatment of Hidden Coronary Heart Disease – October 25, 2002

In early stages of coronary heart disease, many patients experience intermittent pain in the apical region. The following treatment regimen has shown notable efficacy.

Guo Lou 10g, Xie Bai 10g, Ban Xia 6g, Chi Shao 10g, Chuan Xiong 6g, Hong Hua 6g, Jiao Xiang 10g, Dan Shen 10g, Panax notoginseng 10g, Mu Xiang 10g, Cao Kou 10g, Xiang Fu 6g, Shan Zhi 10g, Cang Zhu 6g, Shen Qu 10g, Raw Long Ma 15g, Wu Che Gu 15g. This formula addresses both the heart and the stomach, as coronary heart disease often presents with difficulty distinguishing between the heart and the stomach in its early stages. Stomach discomfort can lead to heart issues, while heart discomfort can manifest as stomach problems.

Director Mou of the Central Ethnic Affairs Commission’s wife, Jiang Fengying, also suffers from stomach issues but does not have coronary heart disease. She visited Lanzhou for a family visit, staying at Ningwozhuang Hotel for over a week. Despite numerous social engagements and invitations, her stomach troubles flared up, and she suddenly experienced heart symptoms—chest tightness, shortness of breath, a heart rate of 160 beats per minute. A phone call rang in the middle of the night. Director Mou, a longtime friend, shared his concerns about her condition over the phone. I suggested that she first take 10mg of Madinil and 0.15g of Ranitidine, which helped alleviate her stomach pain and reduce her heart rate to 100 beats per minute. Chest tightness, chest pain, and shortness of breath all eased. The next day, I visited her, and all her symptoms had improved. Her pulse was regular, and although she reported poor sleep quality, I suggested that she continue with Guipi Tang to support her recovery.

Challenges Facing Antibiotics – November 10, 2002

In 1928, British scientist Fleming discovered penicillin—a groundbreaking contribution that gave humanity a powerful tool to combat bacterial infections. Yet, as time passed, pathogens quickly developed resistance. In the early 1950s, drug-resistant Staphylococcus aureus emerged, posing a significant challenge to antimicrobial treatment. Since the 1980s, a class of enzymes known as beta-lactamases began to emerge in pathogenic bacteria, capable of breaking down the active components of penicillin, cephalosporins, and other antibiotics, thereby reducing their antibacterial efficacy. Consequently, penicillin dosages increased year after year—from 20,000 units in the 1950s to 200,000–800,000–2,000,000–4,000,000 units. Meanwhile, the challenges posed by these pathogens grew ever greater. Medical researchers developed sulbactam preparations to neutralize beta-lactamases, creating beta-lactamase inhibitors—providing a partial solution to the problem of bacterial resistance. More recently, potassium clavulanate was discovered, sharing similar mechanisms of action to sulbactam.

Electrolyte Replacement – November 13, 2002

Using the equivalent of sodium ions as the standard, measured in millimoles per liter, electrolyte disturbances can be classified into three levels: 130–135 mmol/L represents mild disturbance, 120–130 mmol/L indicates moderate disturbance, and less than 120 mmol/L signifies severe disturbance.

135 – (actual measured value) × body weight (kg) × 0.6 = required millimoles of sodium ions (mmol)

Typically, 17 mmol = 1 g of NaCl. Based on this concept, an additional 10 mmol of sodium requires approximately 0.9% NaCl, 20,000 ml.

Overview of Sarcoidosis – November 13, 2002

Sarcoidosis is a systemic disease that can affect any organ in the body, with pulmonary involvement being the most common manifestation. After China first reported a case in 1958, numerous reports followed from various regions. In 1982, China established the Sarcoidosis Treatment Collaboration Group; by 2002, 20 years later, 198 hospitals had published 502 articles, reporting a total of 5,000 cases. The exact cause of sarcoidosis remains unclear; some believe it may be linked to tuberculosis or spirochetes. The organs affected include the lungs, liver, eyes, spleen, skin, and lymph nodes. Pulmonary involvement accounts for nearly 80% of cases, with common symptoms including high fever, rapid erythrocyte sedimentation rate, elevated gamma-globulin levels, nodular lesions in the lungs, positive antinuclear antibodies, though sometimes negative. Clinical treatment typically focuses on hormone therapy.

Triple Blocking for Pregnant Women with Hepatitis B – November 28, 2002

Women with “small three positives” generally pose little risk of infection to the fetus; 95% of their babies are healthy and typically do not require triple blocking. However, pregnant women with “large three positives” must undergo triple blocking, which can result in a 97%–99% chance of the baby developing HBsAb seropositivity. The triple blocking protocol is as follows: ① Pregnant women receive 200–400 units of high-titer hepatitis B immune globulin via intramuscular injection at 28 weeks, 32 weeks, and 36 weeks; ② After birth, the baby receives 200 units of high-titer hepatitis B immune globulin at 24 hours and again at 15 days; ③ One month, three months, and six months after birth, the baby receives one dose of inactivated hepatitis B vaccine. The first two blocks are passive immunity, while the third block is active immunity; together, these measures can achieve a surface antibody positivity rate of up to 99% for the baby.

Smoking Causes Colon Polyps – November 29, 2002

According to evidence from a study published in China Medical Forum (November 7, 2002) by Stony Brook University, the incidence of rectal polyps among smokers is nearly double that of non-smokers. 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: The traditional Chinese medical theory that the lungs and large intestine are in a relationship of mutual reflection is another strong piece of evidence. Previously: ①

Colon cancer with lung metastasis; ② Liangge San used to clear the large intestine and treat pulmonary hemoptysis; ③ Wang Jin Da’s experimental study on ligation of the mesenteric vessels, which resulted in lung tissue necrosis. In connection with this, we can draw parallels with the principle of “Liver Wood overcoming Earth”: ① Nausea and loss of appetite, along with abdominal distension, are common symptoms of hepatitis; ② Gastroesophageal reflux gastritis caused by bile reflux; ③ Relaxing the liver can help treat stomach issues. This illustrates that the traditional theories of Chinese medicine originate from scientific truths derived from practical experience.

Diabetes Patients with Gastroparesis – November 29, 2002

Due to prolonged stimulation from elevated blood glucose levels and ketone bodies, diabetic patients often experience dysfunction of the gastrointestinal autonomic nervous system, leading to significantly reduced gastrointestinal peristalsis and impaired gastric emptying. Clinically, this condition is known as gastroparesis. At this stage, diabetic patients may experience not only increased thirst, frequent eating, and excessive urination, but also nausea, vomiting, and fullness or discomfort in the upper abdomen. Recent studies have suggested that injecting botulinum toxin into the pylorus may be effective in treating this condition. The mechanism behind this approach may involve inhibiting the release of acetylcholine at the pyloric region, thereby relaxing the pylorus and promoting gastric emptying.

Several Experimental Studies on Drug Writing – December 21, 2002

SOD: Superoxide dismutase (clears free radicals). GSH-Px: Glutathione peroxidase (clears free radicals). MDA: Malondialdehyde (one of the free radicals).

Bile Reflux Gastritis – December 26, 2002

Bile reflux gastritis is quite common in clinical practice, often accompanied by nausea, fullness and distension in the chest and epigastrium, as well as sharp pain in the flank area. Conventional medications for the stomach often fail to provide significant relief. Recently, I have found great success in treating this condition using the following formula: Chai Hu 10g, Zhi Shi 10g, Bai Shao 10g, Gan Cao 6g, Chuan Xiong 6g, Xiang Fu 6g, Dan Shen 10g, Mu Xiang 10g, Cao Kou 10g, Da Huang 6g, Huang Lian 3g, Ban Xia 6g, Gua Lou 10g, Xuan Fu Hua 10g, Sheng He Shi 20g, Sheng Long Mu each 15g, Wu Che Gu 15g, Gan Jiang 6g. All ingredients are decocted in water and taken as one dose daily.

Naloxone Intravenous Injection – December 31, 2002

This medication is a recent emergency treatment option, with effects similar to those of Codeine, Lobeline, and Reserpine—stimulating both the respiratory and circulatory centers. Its mechanism involves blocking opioid receptors, allowing it to quickly cross the blood-brain barrier, with effects that are faster and more pronounced than those of previous emergency treatments. Dosage: 0.4–4 mg administered intravenously, repeated once every half hour; alternatively, 4 mg can be added to 500 ml of 5% glucose solution for intravenous infusion.

Re-evaluating Diabetes – January 10, 2003

Type 1 diabetes is characterized by insulin deficiency, while Type 2 diabetes is marked by insulin resistance. In Type 1 diabetes, the function of pancreatic beta cells declines; in Type 2 diabetes, the body’s sensitivity to insulin decreases, even though insulin levels in the bloodstream remain normal or even higher than normal. Diagnosis of diabetes is based on blood glucose levels—both fasting and postprandial—and urine glucose testing. Postprandial blood glucose tests are conducted at 0.5 hours, 1 hour, 2 hours, and 3 hours after a meal, and these measurements are referred to as glucose tolerance tests. Typically, after a meal, blood glucose returns to normal within 3 hours, with a normal fasting blood glucose level between 3.5 and 5.9 mmol/L; the peak postprandial blood glucose level should ideally stay below 9.1 mmol/L.

Quantitative measurement of insulin and C-peptide are key indicators for diagnosing Type 1 and Type 2 diabetes. A low quantitative value of insulin suggests Type 1 diabetes, while high or normal levels indicate Type 2 diabetes. Insulin levels vary depending on fasting and postprandial conditions, providing useful reference points. C-peptide is a precursor to insulin; when beta cells release insulin, they also release C-peptide, converting proinsulin into insulin. Since C-peptide remains in the bloodstream, its quantification can reflect changes in insulin levels in the blood. For diabetic patients undergoing insulin therapy, C-peptide levels tend to be more accurate than insulin levels.

Additionally, measuring glycated hemoglobin and fructosamine can provide insights into the dynamic management of blood glucose levels in diabetic patients. The normal range for glycated hemoglobin is below 7%; the normal range for fructosamine is below 3 mmol/L. Elevated levels of glycated hemoglobin indicate poor blood glucose control over the past day, while elevated levels of fructosamine suggest poor blood glucose control over the previous half-day.

Interferon – January 6, 2003

Also known as human interferon, alpha-interferon is derived from white blood cells, beta-interferon from fibroblasts, and gamma-interferon from lymphocytes. Both alpha- and beta-interferons exert similar effects, working through shared receptors to promote anti-cancer activity. This product has shown excellent therapeutic efficacy when combined with DTIC for acute and chronic leukemia, acute lymphoma, multiple myeloma, ovarian cancer, and pancreatic cancer, particularly in melanoma treatment. It can be administered via intrathecal injection or intra-thoracic and intra-abdominal injections.

Toxic side effects include fever; doses exceeding 44,000 units per kilogram per day may lead to high fever, bone marrow suppression, myocardial damage, severe hypertension, and cerebrovascular disease. Occasionally, transient liver damage, hair loss, skin rashes, and jaundice may occur.

Transfer Factor – January 18, 2003

Originally known as normal human leukocyte transfer factor, this product consists of small molecular peptides extracted from human white blood cells and is a type of T lymphocyte. It possesses powerful biological activity, enhancing immune function and boosting overall immunity. Because this product is composed solely of small molecular peptides, it does not exhibit antigenic activity. It is administered via intramuscular injection twice weekly, at 1 unit each time.

Sarcoidosis – January 27, 2003

Sarcoidosis is an autoimmune disorder affecting multiple organs, with 40–50% of cases initially impacting the hilar region. The primary symptoms include high fever, anemia (with a predominance of decreased white blood cells), elevated globulin levels, rapid erythrocyte sedimentation rate, splenomegaly, and elevated serum calcium levels. Specific diagnostic tests include: ① Angiotensin-converting enzyme activity testing (SACE), which is elevated in this condition; ② Broncho-pulmonary lavage fluid analysis (Bien), which reveals increased lymphocytes in this condition.

Hemolytic Anemia – January 27, 2003

Hemolytic anemia is typically classified as either intravascular or extravascular, with causes ranging from intracellular abnormalities to extracellular anomalies. ① Intracellular abnormalities include hereditary spherocytosis, paroxysmal nocturnal hemoglobinuria, and glucose-6-phosphate dehydrogenase deficiency. ② Extracellular abnormalities include β-lipoprotein deficiency (spiky cell syndrome), chemical substances, physical factors, and splenic hyperfunction leading to hemolysis.

Key characteristics of hemolytic anemia include: ① Increased free hemoglobin levels (>4%); ② Elevated serum iron levels >21 µmol/L; ③ Increased iron-containing reticulocytes in the bone marrow (+ to +++); ④ Positive occult hematuria; ⑤ Elevated bilirubin levels; ⑥ Increased urobilinogen and porphyrin levels; ⑦ Reticulocyte counts increase to 1–3%, with severe cases reaching up to 30%. Single-ingredient treatment for hemolytic anemia includes 15 g of fire nitrate, 30 g of black alum, 30 g of turmeric, and 30 g of salvia miltiorrhiza. All ingredients are ground into a powder, then made into pills weighing 9 g, taken three times daily with Yin Chen water.

Overview of Tumor Hyperthermia – March 1, 2003

As early as over 100 years ago, people unexpectedly discovered that high fever could be used to treat malignant tumors. Case studies showed that cancer patients suffering from cellulitis experienced high fever lasting for several days at 40°C—resulting in unexpected benefits, as their cancer was cured. In 1973, Palzer found that heating the body to 42°C for 60–120 minutes had the greatest impact on the S phase and G2 phase of cell division. In 1976, Dvery and others demonstrated that the fundamental principle behind heat-induced cancer killing lies in promoting changes in lysosomes. They also discovered that the blood flow within tumors is only 1–15% of that in adjacent tissues. Due to the low blood flow, the temperature during hyperthermia does not dissipate easily, resulting in temperatures 8–10°C higher than those in nearby normal tissues. This favorable environment helps to kill cancer cells. In 1984, combining radiation therapy, chemotherapy, and hyperthermia to treat cancer yielded better therapeutic outcomes than either radiation or chemotherapy alone. In 1985, Storm tested radiofrequency hyperthermia combined with chemotherapy on 3,790 cancer patients, achieving satisfactory results.

In recent years, advancements in electronic technology have opened up unprecedented possibilities for hyperthermia, encompassing areas such as thermobiology, cellular thermobiology, vascular thermobiology, and thermodynamic dosimetry.

1. Heating Techniques: ① Radiofrequency hyperthermia: a. Capacitive electrical methods (for surface and body cavities); b. Inductive methods: for superficial tumors on the body surface; c. Interstitial heating techniques. ② Microwave hyperthermia: a. Surface radiation; b. Intracavitary radiation; c. Insertion-based radiation (radiators inserted into the body). Combining these two approaches is known as high-frequency hyperthermia.

2. Commonly Used Hyperthermia Devices: radiofrequency hyperthermia machines, microwave hyperthermia machines, ultrasonic hyperthermia machines, extracorporeal circulation hyperthermia machines, and multi-head radiofrequency devices.

3. Classification of Hyperthermia: whole-body hyperthermia (WBH), regional hyperthermia (RHT), and local hyperthermia (LHT).

4. Key Terms: ① Radiofrequency (also known as high frequency): electromagnetic waves with frequencies ranging from 300 MHz to 100 kHz. Domestic SR-100 radiofrequency hyperthermia machines are equipped with a 40.68 MHz radiofrequency hyperthermia system. ② Heat Sensitizers: commonly used heat sensitizers include Tween 80. Theoretically, this agent can enhance the sensitivity of cancer cells to heat, thereby reducing the required heating temperature and protecting normal tissues. ③ Fat Barrier: as radiofrequency increases, temperature rises relatively, but when the frequency reaches 40 MHz, fat temperature no longer increases, nor does muscle temperature rise.

Kanglait Injection – April 14, 2003

The main ingredient of this formulation is raw lotus seed oil, refined into a golden, emulsified liquid. The dosage is 100 ml per vial, containing 10 g, stored in a sealed, dark place in a cool location. It can be dissolved in saline or 5% glucose solution.

This product is another example of traditional Chinese medicine used in cancer treatment, alongside Adi (beetles) and castor oil (castor seeds).

The most common side effects include fat allergy reactions, chills, fever, and localized phlebitis.

Yabo Injection – April 14, 2003

This formulation combines ornithine and aspartic acid, promoting liver cell repair and reducing blood ammonia levels. Ornithine, aspartic acid, and acetylglutamine combine with blood ammonia to form urea. As a third-generation ammonia-reducing drug following glutamate, arginine, and acetylglutamine, this product not only lowers ammonia levels but also supports enzyme activity and reduces jaundice, ultimately benefiting liver health. Each vial contains 10 ml, administered intravenously once daily, with 4–8 vials per day for hepatic encephalopathy; for patients without hepatic encephalopathy, 1–2 vials per day are sufficient, with a maximum daily dose not exceeding 20 vials.

Aixinli (Sodium Fructose Diphosphate) – April 24, 2003

This product acts as a tonifying agent for myocardial ischemia and systemic tissue ischemia, promoting cellular metabolism, accelerating tissue repair, restoring normal cardiac function, and increasing energy utilization. Its primary function is to enhance red blood cell adaptability and maintain cellular oxygen supply capacity. It is suitable for various heart diseases causing myocardial ischemia, as well as ischemia due to peripheral vascular occlusion and shock, especially in critically ill patients experiencing systemic cell ischemia. 50 ml per vial, 5 g per vial, administered intravenously once daily.

Facial Hotness in Women – April 25, 2003

Facial hotness in women is often caused by autonomic nervous system dysfunction. These patients frequently experience menstrual irregularities, including early menstruation and reduced menstrual flow; some patients may also experience amenorrhea or delayed menstruation. Treatment for this condition typically involves using coptis, scutellaria, phellodendron, rehmannia, gardenia, angelica sinensis, white peony, white atractylodes, poria, chai hu, peach kernel, safflower, citrus peel, platycodon root, licorice, and achillea millefolium. These formulas are often derived from the Coptis detoxification soup, the Dan Zhi Xiao Yang Decoction, and the Xue Fu Zhu Yu Decoction.

Misconception about Misconception – May 4, 2003

In the spring of Guiwei, SARS emerged in China, first spreading in Guangdong, then Beijing, followed by Shanxi, Inner Mongolia, Hebei, and other regions. Hong Kong and Taiwan were also affected soon after. Initially, many Hong Kong residents traveled to Canada and Vietnam, and subsequently, the disease broke out rapidly in these locations. In Hanoi, Vietnam, dozens of people fell ill; UN experts were dispatched to investigate, and Italian physician Urbani became a leading international expert in pathogenic research. During his research in Hanoi, he discovered that the disease was caused by a variant strain of the coronavirus. After spending a month immersed in research, Urbani identified the pathogen, determined the virus’s genetic sequence, and named it SARS. On March 29, 2002, Urbani suddenly passed away in Hanoi while battling SARS. The WHO recommended renaming the coronavirus variant to Urbani virus. The disease spread extremely quickly and was highly contagious, primarily transmitted through droplets, with both respiratory and contact transmission capable of causing illness. Western medical treatment focused mainly on antibiotics, hormones, and biological agents, with intubation and artificial respiration performed when necessary. The primary symptoms included high fever, dry cough, general weakness, and pain, followed by difficulty breathing, chest tightness, damage to multiple organs throughout the body, organ failure, and ultimately death.

Traditional Chinese medicine practitioners in Guangzhou, including Deng Tie Tao, advocated for formulas like Hao Qin Qing Dan Tang, Gan Lu Du Xiao Wan, San Ren Tang, and Huo Pu Xia Ling Tang. However, my perspective is that in the early stages, formulas like Mahuang Tang, Ma Xing Shi Gan Tang, and Da Xiao Qing Long Tang are more appropriate; in the later stages, formulas like Liang Ge San and Tao Ren Cheng Qi Tang are better suited. The formulas proposed by Old Master Deng should be adjusted and modified during the middle stages of treatment.

Additionally, several folk remedies popularized in society for preventing SARS—such as honeysuckle, indigo woad, atractylodes, large green leaves, psoralia, astragalus, white atractylodes, and windproof herbs—have yet to be definitively proven effective. My view is that administering biological preparations certainly enhances immune function, but definitive therapeutic efficacy still requires long-term observation before conclusions can be drawn.

Bone Marrow Diagnosis for Leukemia – May 11, 2003

Leukemia is categorized into acute lymphoblastic leukemia (ALL) and acute non-lymphoblastic leukemia (ANLL).

1. ANLL: ① M1 (undifferentiated type): Granulocytes ≥90%, early granulocytes are rare, with no mid- or late-stage granulocytes present; red blood cells and macrophages are suppressed, and Auer bodies may be observed. ② M2 (partial differentiation): Granulocytes account for 30–90% in M2, with less than 10% showing early granulocytes, 20% monocytes, and Auer bodies visible; M2: Granulocytes and early granulocytes make up 30–90% of the total, with a predominance of early granulocytes, nuclear lobes present, and imbalanced nuclear-to-cytoplasmic differentiation, with Auer bodies visible. ③ M3 (early granulocytic): Abnormal early granulocytes with increased granules reach 30%, and Auer bodies may be observed. M3a: Granules are coarse (stained with aniline blue); M3b: Granules are fine. ④ M4 (granulocytic): Granulocytes and early granulocytes account for >20%, with monocytes and early monocytes accounting for >20%. M4a: Granulocytes dominate; M4b: Monocytes dominate; M4c: Cells exhibit characteristics of both granulocytic and monocytic lineages; M4d: Coarse eosinophilic granules and coarse basophilic granules. ⑤ M5 (acute multinucleated leukemia): Monocytes dominate, with Auer bodies visible, and all three lineages—red blood cells, granulocytes, and macrophages—are suppressed. M5a (undifferentiated): Monocytes account for ≥80%; M5b (partial differentiation): Monocytes and early monocytes account for 30–80%. ⑥ M6 (red and white leukemia): Red blood cells account for 50%, while granulocytes account for 30%. ⑦ M7 (acute megakaryocytic leukemia): Megakaryocytes account for 30%, while red and granulocyte lineages are relatively suppressed.

2. ALL: ① L1: Primary and immature lymphocytes show increased granules, predominantly small lymphocytes. ② L2: Lymphocytes vary in size. ③ L3: Large lymphocytes dominate.

While the identification of these cells can generally be done, if there is a lack of typical criteria, differential staining may be required.

A. Peroxidase and Sudan Black Staining: Acute granulocytic leukemia shows strong positivity, acute lymphoblastic leukemia shows negative results, while acute monocytes show positive or weakly positive results.

B. Glycogen Staining: Acute lymphoblastic leukemia shows strong positivity, while acute granulocytic and monocytes show weak positivity.

C. Non-specific Lipase Staining: Acute monocytes show strong positivity, while acute granulocytic leukemia shows weak positivity.

A Brief Overview of Rheumatoid Arthritis – May 6, 2003

This disease is common and frequently occurs; in addition to joint pain, swelling, and deformity, ESR, C-reactive protein, and rheumatoid factor serve as important diagnostic markers. The majority of cases develop in middle-aged adults, though elderly individuals and adolescents can also be affected. Middle-aged adults typically experience acute fever and joint swelling, with all three tests—ESR and others—showing positive results. Elderly patients often develop chronic forms of the disease, where joint swelling is minimal, and pain becomes chronic; test results may not always be positive, and this condition is often referred to as atypical rheumatoid arthritis. The following types of arthritis should be differentiated from this condition.

1. Osteoarthritis: A degenerative condition affecting joints in older adults, with negative objective tests, normal blood count (-), accompanied by osteoporosis and degenerative changes within the joints.

2. Ankylosing Spondylitis: Often affects the lumbar spine and sacroiliac joints, with positive test results in all three areas; 95% of patients are HLA-B27 positive, making diagnosis relatively straightforward.

3. Rheumatoid Arthritis: Common in adolescents, often presents with migratory symptoms, accompanied by upper respiratory tract infections and pharyngitis in the early stages, followed by rheumatic fever in the middle stages, and endocardial disease in the later stages.

4. Gouty Arthritis: Foot pain, high uric acid levels, and kidney damage.

5. Psoriatic Arthritis: Associated with psoriasis.

6. Reiter’s Disease: A triad of eye, genital, and joint involvement.

7. Lupus-related Arthritis: Systemic lupus erythematosus complications.

8. Hepatitis B-related Arthritis: Associated with hepatitis B.

Treatment options for rheumatoid arthritis include Western medicine: ① hormones; ② methotrexate; ③ tripterygium wilfordii alkaloids.

Traditional Chinese Medicine: Gui Zhi Shaoyao Zhi Mu Decoction, Shaoyao Gan Cao San Teng, Wu Mi Niu Gu, Jin Niu Bai Huo, Ji Ming San, Wu Ji San, Wu Ya Shun Qi San (Wu Ya Shun Qi Ma Chen Jiang, Jie Jing Gan Cao Jiang Zao Chang, Bai Zhi Chuan Xiong and Xi Xin, for headaches, joint pain, and gastrointestinal issues), Si Wu Tang (Si Wu, Wu Ya, Xiang Fu).

X-ray Characteristics of Joint Disorders – June 15, 2003

Both osteoarthritis and rheumatoid arthritis are characterized by: ① narrowing of the joint space; ② demineralization of bone ends; ③ enhanced calcification of cortical bone on joint surfaces; ④ bone spurs. In ankylosing spondylitis, ligament calcification of the spine leads to a square-shaped vertebral body. Calcification of the ligaments above the spinal processes results in the appearance of spinal process edges on plain films.

Another Insight into Chronic Nephritis – June 16, 2003

I treated patients with chronic nephritis, starting with Gui Fu Ba Wei, Gui Zhi Fu Ling, Yi Shen Tang, Pasha Huang Tu, Shi Ting Bai Ye Da Sao Jin, and other formulas. Recently, I have found great success in treating this condition using the following formula: Bai Mao Gen 30 g, Shi Wei 20 g, Sheng Di 12 g, Shan Yu 6 g, Shan Yao 10 g, Dan Pi 6 g, Fu Ling 10 g, Ze Xie 10 g, Che Qian Zi 10 g, Niu Xi 10 g, Gui Zhi 10 g (dissolved in water), Yin Yang Huo 10 g, Po Gu Zhi 10 g, Ba Ji Tian 10 g, Dang Shen 10 g, Huang Qi 20 g, Sheng Yi Ren 20 g, Ting Li Zi 10 g, Han Fang Ji 10 g, Han Lian Cao 20 g. All ingredients are decocted in water and taken as one dose daily. 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: Total treatment for spleen deficiency should use Ba Shan, for kidney deficiency use Gui Fu, and for both spleen and kidney deficiency use this formula. For chronic conditions, use Gui Zhi.

Fuling and Yishen; for severe heat symptoms, use Shi Ting Bai Ye.

Kaiyang Yi Wei Tang and Wuyao Shun Qi San 2003.7.7

Ascending Yang and Benefiting Stomach: Dangshen 10g, Baizhu 10g, Huangqi 20g, Huanglian 3g, Banxia 6g, Gancao 10g, Chenpi 6g, Fuling 12g, Ze Xie 10g, Fangfeng 12g, Qiangduo Huo 10g, Chaihu 10g, Baishao 10g, Shengjiang 6g, Da Zao several pieces.

Wuyao Shun Qi San: Wuyao 12g, Mahuang 12g, Chenpi 6g, Jiangchong 6g, Jiegeng 20g, Gancao 6g, Shengjiang 6g, Da Zao 4 pieces, Chuanxiong 6g, Bai Zhi 3g, Xiexin 3g, Qiangduo Huo each 10g, Fangfeng 12g.

Both formulas treat external pathogenic factors; in the former, the pathogen resides in the Shaoyang meridian, so Xiaochaihu is combined with Qiangduo Huo and Fangfeng.

In the latter, the pathogen resides in the Taiyang meridian, so Mahuang is combined with Qiangduo Huo and Fangfeng. The former indicates depletion of middle qi, while the latter shows excessive fire in the upper jiao, so the former is treated with Liu Jin Zi and Bao Yuan, while the latter is supplemented with Jiegeng, Gancao, Chuanxiong, Bai Zhi, Xiexin. In summary, the primary symptoms of the former include stomach distension, joint pain, and headache; the primary symptoms of the latter include headache, joint pain, and pharyngitis.

Rescue Treatment for Severe Hepatitis 2003.7.15

The characteristics of this disease are three highs, three lows, and two edemas. The three highs include elevated blood ammonia, elevated false neurotransmitter levels (hydroxyethanolamine), and elevated aromatic amino acids. The three lows include low serum potassium, low serum albumin, and low blood glucose. The two edemas refer to edema in the lungs and brain.

1. Elevated blood ammonia can lead to hepatic encephalopathy, commonly known as hepatic coma. The most commonly used medications include glutamate, arginine, acetylglutamylamide, yabo-si, and potassium magnesium aspartate.

2. Increased levels of false neurotransmitters also indicate elevated hydroxyethanolamine. This substance shares a similar structure with dopamine and can replace dopamine in brain tissue, leading to a deficiency of dopamine in brain tissue and thereby exacerbating the progression of hepatic encephalopathy. Treatment aims to replenish dopamine, but since dopamine alone cannot directly cross the blood-brain barrier, it must be administered in the form of levodopa. However, levodopa can easily damage the liver, so it’s necessary to administer carbidopa in conjunction to avoid liver damage. Typically, 100mg of levodopa and 20mg of carbidopa are mixed into 250ml of 10% glucose solution and administered intravenously.

3. Elevated aromatic amino acids can be treated by administering six amino acids via intravenous drip to increase the proportion of branched-chain amino acids.

For the three lows, potassium, sugar, and albumin can be supplemented as appropriate.

Additionally, it’s important to overcome infection and bleeding to slow the progression of hepatorenal syndrome.

Treatment of Chronic Renal Failure 2003.8.1

In treating chronic renal failure (CRF), I once used Gui Fu Ba Wei Wan combined with “Si Du Shan,” which includes mulberry and leeches—most reliably, namely rhubarb,附片, San Ling, Eupolyphora, processed milkweed, pangolin, soapnut, Salvia miltiorrhiza, Astragalus, Cornus officinalis, Goji berries, mulberry, leeches, and Yidan Chiguo (Motherwort, Salvia miltiorrhiza, Red Peony, Amomum villosum). Additionally, rhubarb,附片, and oyster powder were used for enemas. Recently, I reviewed “Experiences of Famous Modern Doctors” and found an experience-based formula from old Chinese medicine practitioner Wang Rong of Sichuan: 15g of Shi Wei, 15g of Pi Pa Ye, 15g of Guan Zhong, 10g of Mu Che, 10g of Mu Hua, 20g of Yu Xing Cao, 6g of Jiang Chong, 10g of Hulu Ba, 10g of Yin Yang Huo, 10g of Gui Zhi, 6g of Fu Pian, 10g of Da Yun, 10g of Ba Ji Tian, 6g of Cornus officinalis, 10g of He Shou Wu, 12g of Sheng Di, 10g of Dang Gui, 20g of Huang Qi, 3g of Lu Rong, 20g of Sang Shen, all decocted and taken orally.

The former focuses on activating blood circulation, while the latter emphasizes strengthening yang energy.

Clinical Applications of Deer Antler 2003.8.1

Deer antlers are young antlers that have not yet ossified. Every year between March and April, the flower disc at the base of the antler falls off, and the old antler is then shed, giving rise to a new, round antler that has not yet ossified, rich in blood inside and covered with fine hairs on the outside—this is deer antler. Typically, antlers are harvested by sawing them down, or by chopping off the head to obtain the antler. In short, this product is derived from the Du Meridian, where the yang energy of the human body converges.

1. Tonifies the kidneys and strengthens yang energy, treating erectile dysfunction, nocturnal emission, premature ejaculation, lower back pain, leg weakness, coldness, and spontaneous sweating—sexual function decline.

2. Tonifies blood and generates marrow, treating anemia, palpitations, forgetfulness, fatigue, and frequent dreams.

3. Strengthens the body and bones, treating cold and painful joints, bone damage after fractures, and limited mobility due to calcium deficiency.

4. Treating excessive vaginal bleeding, delayed menstruation, amenorrhea, and menorrhagia—menopausal bleeding, ovarian insufficiency.

Indications for this product include: ① sexual function decline in both men and women—men experiencing erectile dysfunction, nocturnal emission, premature ejaculation; women experiencing excessive vaginal bleeding, delayed menstruation, light menstrual flow, or amenorrhea. ② developmental delays in children, intellectual disabilities, underdeveloped bodies, difficulty walking, and poor tooth and hair growth. ③ Low blood cell production, aplastic anemia, anemia. ④ Calcium deficiency and degenerative changes in bones and joints. ⑤ Uterine malformations, infertility; reduced sperm count, infertility. ⑥ Coronary heart disease, bradycardia, hypertension, hypotension—all of these conditions can benefit from its use.

Dosage: 1–6g, preferably taken as a decoction, and do not exceed high temperatures. According to recent research, this product contains both male and female hormones, making it suitable for both men and women.

Several Effective Herbal Remedies 2003.8.10

1. Rubia cordifolia: Its main function is to promote blood circulation and resolve blood stasis, with a dosage of 10–30g. It promotes blood circulation without causing bleeding, stops bleeding without coagulation, and can be used for abdominal pain, amenorrhea, dysmenorrhea, and joint pain; it is often used for uterine fibroids, ovarian cysts, amenorrhea, arthritis, and other conditions.

2. Earthworm: This herb helps dispel wind and phlegm, relieve acute spasms, activate blood vessels, and treat stroke—also aiding in asthma relief, clearing heat, opening channels, and calming wind. It also has effects in treating joint pain and muscle soreness.

3. Chai Ping Tang: Chai Hu, Huang Qin, Banxia, Dangshen, Gancao, Shengjiang, Da Zao, Cang Zhu, Hou Pu, Chen Pi. Chai Ping Tang is essentially Xiaochaihu Tang combined with Ping Wei San. It treats chronic gastritis, peptic ulcers, and chronic hepatitis.

4. Hou Pu: This herb is often used for those with abdominal distension and inability to pass gas. It can be paired with Zhi Shi, Rhubarb, and Radix Fallopiae, or combined with Tao Ren Cheng Qi Tang, or even with Bai Zhu. Generally, when intestinal peristalsis slows down, this herb is indicated for use—similar to the Western medicine medication Motilium. For patients with abdominal distension and no gas pain caused by Parkinson’s syndrome, this herb is often used.

5. Shihu: For stubborn proteinuria, a dosage of 10–45g, combined with Fuling, Ze Xie, Plantago Seed, raw Astragalus, Pig Lichen, and others, is effective in treating proteinuria.

6. Shen Ling Bai Zhu San: Dangshen, Bai Zhu, Fuling, Gancao, Shan Yao, Bian Dou, Jiegeng, Chen Pi, Lotus Seed Meat, raw Coix Seed—this formula is specifically designed to treat fatigue, chills, diarrhea, and is particularly effective for Lotus Seed, Coix Seed, and Jiegeng.

7. Cinnamon: For dry throat and mouth, red face, and hot body, cinnamon is a suitable remedy, with a dosage of 3–6g.

8. Astragalus: It is the primary remedy for all conditions characterized by both deficiency and excess. Such as nephritis, diabetes, heart failure, chronic hepatitis, gastric and duodenal ulcers, leukopenia, lupus erythematosus, influenza in the elderly, and more.

9. Xiao Xian Xiong: Can treat coronary heart disease, pleurisy, and pericardial effusion.

10. Si Ni San: Can treat chronic gastritis, ulcers, cholecystitis, hepatitis, colitis.

11. Er Xian Tang: Can treat hypertension, hyperthyroidism, menopausal syndrome, and functional uterine bleeding.

12. Turtle Shell: Has two major effects—nourishing yin and softening hard masses. It can treat cirrhosis, ovarian cysts, and uterine fibroids.

13. Chuan Cao Wu: Can be used at dosages of 3–30g, with larger doses requiring 1–2 hours of decoction. Some people suggest using Chuan Cao Wu together with Cao Wu for even greater efficacy. It can alleviate joint pain, headaches, stomachaches, and menstrual pain.

14. Ge Qin Qing Dan Tang: Kudzu Root, Huang Qin, Zhi Shi, Zhu Ru, Banxia, Chen Pi, Fuling, Gancao—can treat headaches and dizziness associated with hypertension and arteriosclerosis.

15. Chan Yi: Can treat stubborn headaches, neuralgia, allergies, etc. When combined with 25g of Lily Bulb and 25g of Night Jasmine Vine, it can treat persistent insomnia.

16. Gan Dan Ning Tang: Dangshen 10g, Bai Zhu 10g, Huang Qi 30g, Shan Yao 10g, Yun Ling 12g, Chuan Xiong 6g, Dang Gui 10g, Mai Dong 15g, Wu Wei Zi 3g, Sheng Ma 3g, Chen Pi 6g, Gancao 6g—treats recovery periods after hepatitis and cholecystitis.

17. Xin Tong Tang: Bai Zhu 20g, Dangshen 10g, Huang Qi 30g, Shan Yao 10g, Yun Ling 12g, Chuan Xiong 6g, Dang Gui 10g, Mai Dong 15g, Wu Wei Zi 3g, Sheng Ma 3g, Chen Pi 6g, Gancao 6g—treats recovery periods after coronary heart disease.

Gan Dan Ning and Xin Tong Tang are formulas developed by Hong Zuoyuan, a renowned physician in Kai Rong City, Liaoning Province. Both formulas are variations of Bu Zhong Yi Qi Tang, with the former adding Zhike, Mu Xiang, Xiang Fu, Hou Pu, and other herbs to regulate the liver and qi, while the latter adds Sheng Mai and Shan Yao.

18. Bai Gu Ding Chong Tang: Bai Gu 10g, Mahuang 10g, Ku Shen 15g, Banxia 6g, Su Zi 15g, Sang Bai Pi 15g, Xing Ren 15g, Yuan Zhi 6g, Gancao 6g. The mnemonic: Maha Xing Bai Gan, Sang Su Ku Ban Yuan.

19. Banxia Bai Zhu Tian Ma Tang: Used for Meniere’s disease caused by insufficient blood supply to the vertebral artery, as well as sequelae after cerebral arterial sclerosis. Composed of Banxia, Tian Ma, Bai Zhu, Fuling, Ju Hong, and Gancao.

Another Discovery in Liver Disease Treatment 2003.10.6

According to the Golden Chamber Essentials, “when treating liver diseases, supplement with sour flavors.” Based on this principle, Old Physician Cen Heling of Guangdong Provincial Hospital of Traditional Chinese Medicine believed that the liver belongs to Wood, governing the ascending fire. Wood can generate Fire, but Fire easily harms Yin. Therefore, the fundamental approach to treating liver disorders is to nourish Yin. There are many Yin-nourishing remedies—so which formula should be used? Old Physician Cen suggested using Fructus Cortex Phellodendri as the primary ingredient, accompanied by Powder of Five Flavors, Ligustici Wallichii Fruit, Ziziphus Jujuba, White Peony, Polygonum cuspidatum, Goji Berries, Cornus Officinalis, Chai Hu, Herba Artemisiae, Dang Gui, Mai Dong, and Salvia Miltiorrhiza. Adding Huang Qi, Herba Lysimachiae, and Herba Althaea to this formula provides four substances (lacking Chuan Xiong), two types of “Two-Go,” six flavors, and wheat flavor—reminding us of the differences between formulas. The mnemonic is: “Five Women, Ziziphus, White Peony, Chai Hu, Mountain Herb, Dry Land.”

Recent Discussions on New Antibacterial Drugs 2003.11.28

1. Teimeng (Imipenem/Sulbactam Sodium Salt): A broad-spectrum antibiotic with powerful antibacterial activity against Gram-positive, Gram-negative, anaerobic, and aerobic bacteria. It is expensive; patients with renal impairment can use it, 1g, IV, Bid. Half-life is 8 hours.

2. Dafukang (Fluconazole): Suitable for systemic candidiasis, cryptococcal infections, and fungal infections in severe cases—200mg/100ml, IV, half-life is 20 hours. It can be taken orally, 0.1g, Tid is the usual dosage.

3. Vancomycin: Deoxymethylvancomycin hydrochloride (expensive), this drug is effective against Gram-positive Staphylococcus aureus infections. Half-life is 8 hours; adults receive 0.8–1.6g (800,000–1,600,000 units), each vial containing 0.4g (400,000 units), dissolved in 250ml NS for intravenous infusion.

4. Cefotaxime Sodium: A semi-synthetic cephalosporin derivative. Suitable for Gram-positive aerobes, Staphylococcus, Streptococcus, and pneumococcus—1g, intravenous infusion, 1–2 times daily, half-life is 8 hours.

5. Kedelin (Ampicillin/Sulbactam): Ampicillin 2g + Sulbactam 1g = 3g, 3g equals 1 vial, intramuscularly or intravenously. 3–4 times daily, half-life is 1.5 hours. This drug was originally named Siamulin.

6. Weiqida (Amoxicillin/Sulbactam): 2:1, 0.75g/vial or 1.5g/vial, half-life is 1.5 hours, once daily, dissolved in 250ml NS, intravenously infused 1–2 times daily.

7. Azithromycin (Azithromycin Lactate) (Made in Jiangsu Yangtze River): This antibiotic is a macrolide antibiotic, similar to Erythromycin, with an extremely broad antibacterial spectrum—Gram-positive, Gram-negative, anaerobes, fungi can all be treated, and it is also effective against Chlamydia and Mycoplasma infections. Azithromycin has a half-life of 12 hours; it can be used once daily, 0.5g intravenously, 0.1g per vial, completed within 3 hours, course duration: 5–7 days.

8. Shufu (Cephalosporin) (Made in Taiwan): Half-life is 8 hours, 1–2g daily, twice daily.

9. Le Ke (Levofloxacin): 0.2g, intravenously infused twice daily, 2ml (0.1) ampoule, injection time is 0.1/hour (speed), patients with renal impairment should reduce the dose or avoid use altogether—wrapped in black paper.

Recent Readings from China Medical Forum Newspaper – Several Articles 2003.11.29

1. Breast Hyperplasia and Breast Cancer: The onset of these conditions is closely related to increased estrogen levels. The age range is 13–50 years, and both early and late onset are common. Infertility and lack of breastfeeding also increase the risk. During pregnancy and lactation, estrogen levels are low, which helps prevent the onset of these diseases. In conclusion, long-term high estrogen levels are the sole factor driving these conditions. Estrogen refers to estradiol and luteinizing hormone, with the former playing a more significant role, as it acts as the initial trigger. The current use of TAM (Tamoxifen, also known as Fale Tong) in breast cancer treatment is based on this principle. I am planning to develop specialized drugs to prevent breast cancer using ingredients like Ligustrum lucidum and Polygonum cuspidatum—though we haven’t started work on this yet.

2. Chest Pain Requires Attention: The most common cause of chest pain is cardiac origin (coronary heart disease), followed by recurrent inflammation of the stomach and esophagus—research on this topic has been particularly extensive in recent years.

Thymoma 2004.11.25

Thymomas are common tumors located in the anterior superior mediastinum. Two-thirds are benign, one-third are malignant. There is no significant difference in incidence between males and females, with most occurring in middle-aged individuals aged 30–50. Diagnosis is primarily made through chest X-rays and CT scans; initially, many patients show no symptoms. Tumors can compress nearby organs and cause symptoms such as coughing when they press on the trachea; compression of the sympathetic nerves may result in Horner’s sign; compression of the recurrent laryngeal nerve can lead to hoarseness; compression of the superior vena cava may cause superior vena cava syndrome. Consequently, half of these cases often lead to myasthenia gravis, making treatment relatively challenging. Surgical treatment is usually the first choice, though radiation therapy and chemotherapy are also necessary for malignant patients. After surgery, patients often develop secondary myasthenia gravis—a condition that is an autoimmune disorder, caused by lesions in the receptor sites at the neuromuscular junctions. Hormone therapy is effective, but it can lead to dependence; traditional Chinese medicine and herbal remedies are often the best options for treating severe myasthenia gravis. A commonly used formula is Zhang Xichun’s Zhenwei Tang: 20g of Huangqi, 10g of Dang Gui, 6g each of Zhi Lu Mo, Yuan Rou, 6g of Shan Yu, 15g each of Sheng Long Mu and Lu Jia Gao, 10g of Die Jiao, decocted and taken orally, once daily. Alternatively, Zhang Xichun’s Jia Wei Sheng Xian Tang can be used: 30g of Huangqi, 3g of Sheng Ma, 10g of Chai Hu, 20g of Zhi Mu, 20g of Jiegeng, 6g of Gancao, 10g of Gua Lou, 6g of Niu Bang Zi, 10g of Lian Fang, 15g of Shi Da Gong Lao, decocted and taken orally, once daily. Among Western medications, the most commonly used chemotherapeutic agents include cyclophosphamide, 5-Fu, hydroxyurea, and hormones.

Ovarian Tumors 2004.11.26

Among benign ovarian tumors, ovarian cysts are the most common. These cysts are often classified as serous cystadenomas, mucinous cystadenomas, corpus luteum cysts, and others, accounting for approximately 90% of all benign ovarian tumors. Peritoneal mucinous tumors often arise from ruptures of ovarian cysts.

Ovarian cancer is the second most common gynecological malignancy after cervical cancer and uterine cancer. Approximately 35% of ovarian cancers originate from serous cystadenomas, while 5–10% originate from mucinous cystadenomas. Additionally, endometrial-like cancer accounts for 10% of ovarian cancers, and clear cell carcinoma makes up 10% of ovarian cancers.

There are also benign teratomas and sex cells tumors, both of which have a cancerization rate of less than 4%.

Secondary tumors originating in the ovaries can spread from the gastrointestinal tract, breast, uterus, fallopian tubes, and other locations.

Krukenberg tumors are a special type of metastatic tumor originating from the gastrointestinal tract.

Staging for ovarian cancer:

Stage I: The tumor is confined to the ovary.

Stage Ia: One side, with intact capsule, no ascites.

Ib: Both sides, with intact capsule, no ascites.

Ic: One side or both sides, with capsule destruction.

Stage II: With pelvic spread.

Stage IIa: The uterus and fallopian tubes are involved.

Stage IIb: Other pelvic tissues.

Stage IIc: Ascites appears, with malignant tumor cells present in the ascitic fluid.

Stage III: Metastasis to organs outside the pelvis.

Stage IIIa: Histologically confirmed metastasis on the peritoneal surface.

Stage IIIb: Histologically confirmed peritoneal lymph nodes ≤2cm.

Stage IIIc: Histologically confirmed peritoneal lymph nodes >2cm.

Stage IV: Groin lymphadenopathy.

Chemotherapy: CTX, TSPA, DDP, ADM, CBP.

CT regimen: CTX 800mg, 1/W, TSPA 20mg, intravenous drip, every other day, 8 doses per cycle, total dose not exceeding 300mg.

FAC regimen: 5-FU 15mg/kg, ACD 6ug/kg, both drugs are administered intravenously for 1–5 days, CTX 400mg, every other day, 4 weeks per cycle.

COA regimen: CTX 800mg, 1/W, VCR 2mg, 1/W, ACD 0.5mg, 1–3/W, 1 week per cycle.

Hematopoietic Regulation Mechanisms 2004.11.29

① Bone marrow hematopoietic microenvironment; ② Immune factors; ③ Neurotransmitters; ④ Body fluids.

Among these four factors, the hematopoietic microenvironment is the most important. The hematopoietic microenvironment is the decisive factor determining how hematopoietic cells differentiate, proliferate, and mature. Thus, the relationship between the hematopoietic microenvironment and hematopoietic cells is akin to that between soil and seeds. The hematopoietic microenvironment includes blood vessels, nerves, and stromal cells.

The stromal cells consist of mesenchymal stem cells, fibroblasts, and extracellular matrix cells, among which mesenchymal stem cells are the primary components of the hematopoietic microenvironment. In 1974, Dtxt and others first established an in vitro bone marrow culture system. They created an experimental model simulating the hematopoietic microenvironment in vitro, creating preconditions for further research into hematopoietic regulation mechanisms. An in vitro hematopoietic microenvironment requires a well-developed adherent cell layer, which possesses the ability to induce hematopoiesis—primarily supporting the proliferation and directional differentiation of hematopoietic stem cells in vitro. The hematopoietic microenvironment of bone marrow is highly similar to the in vitro bone marrow culture system. The primary components of the bone marrow hematopoietic microenvironment include four types of stromal cells: fibroblasts, macrophages, endothelial-like cells, and adipocytes. It is precisely these four cell types that support and maintain the hematopoietic functions of bone marrow. The proliferation and differentiation of pluripotent stem cells rely on the induction and regulation of the bone marrow hematopoietic microenvironment; the differentiation and directional development of pluripotent stem cells (CFU) are induced by one of the aforementioned four bone marrow stromal cell types.

In summary, when observing drug efficacy, in vitro bone marrow culture techniques are typically employed to study the effects of drugs on bone marrow stromal cells (CFU-F), granulocyte-monocyte progenitors (CFU-GM), and megakaryocyte colonies (CFU-S).

Telomerase 2004.11.29

Telomerase is a cap-like structure at the ends of chromatin, typically regulating cell division and proliferation. Telomerase activity is not high in peripheral blood, but it significantly increases in cancer patients. Therefore, researchers often use telomerase activity assays to determine certain cancers or precancerous lesions.

Mitochondria and Mitochondrial Diseases 2004.12.4

Mitochondria are located in the cytoplasm, and all eukaryotic cells contain mitochondria. Each Cell mitochondria number ranges from approximately 1 to 2,000, and their primary function is to participate in oxidation and acidification processes, thereby providing cells with ATP and storing energy. Another crucial role is to work together with chromatin present within the cell nucleus to regulate gene expression. The genes found in mitochondria are classified as mtDNA, while those in chromatin are classified as NDNA; the former is also known as Mendelian genes, and the latter as nuclear genes. The former are referred to as paternal genes, whereas the latter are called maternal genes. In addition to these two types of genes, there are also several wild-type genes and mutant genes. Although gene mutations are often associated with wild-type or mutant genes, their small number generally does not lead to organ or tissue abnormalities or functional disorders. However, when the number of wild-type genes and mutant genes reaches (or exceeds) a certain threshold, pathological changes or functional disturbances may occur in specific organs and tissues. The tissues most prone to such disorders include the heart, brain, and muscles, with common symptoms including ptosis of the eyelids, cardiomyopathy, proximal muscle disease, neurosensory hearing loss, diabetes, dementia, and migraine—most frequently observed in children, though maternal inheritance is also quite common. Lactic acid concentration and phosphatase kinase are the most important diagnostic tools.

New Insights into the Classification and Treatment of Lung Cancer – December 8, 2004

Currently, lung cancer is categorized into squamous cell carcinoma, adenocarcinoma, small cell carcinoma, large cell carcinoma, and others. Small cell lung cancer develops rapidly and has a high mortality rate; treatment strategies often include COPP, COMP, HOPP, and other approaches that have proven most effective. Typically, lung cancer outside of the small cell category is referred to as non-small cell lung cancer. Non-small cell lung cancer refers specifically to adenocarcinoma and squamous cell carcinoma. Chemotherapy drugs for this type of lung cancer usually include doxorubicin, carboplatin, and cyclophosphamide; MMC, 5-FU, and MTX can also be used, but their efficacy in treating advanced non-small cell lung cancer remains unsatisfactory. Recent studies have suggested combining targeted drug gefitinib with chemotherapy, which has shown significant therapeutic benefits for advanced non-small cell lung cancer. However, recent small-sample evidence-based medical observations indicate that the combination of gefitinib and chemotherapy is not superior to chemotherapy alone. Gefitinib is an epidermal growth factor receptor tyrosine kinase inhibitor. By inhibiting the epidermal growth factor receptor, this drug aims to suppress both squamous cell carcinoma and adenocarcinoma—both of which are targets activated by epidermal growth factor activity.

New Therapeutic Approaches Discovered Recently – December 10, 2004

1. For patients with myocardial infarction, treatments include thrombolysis, anticoagulation, vasodilation, bypass surgery, and stent placement, which have successfully addressed acute high-risk symptoms. However, even after these therapies, patients often experience recurrent episodes or develop heart failure, ultimately failing to achieve a healthy state. In light of this, some patients with severe conditions have turned to heart transplantation. Recently, researchers have developed methods using pluripotent stem cells to cultivate and repair cardiac muscle cells, achieving remarkable results in the treatment of heart failure.

2. Emphysema, cor pulmonale, and heart failure represent another formidable challenge for humanity, and like myocardial infarction mentioned earlier, they remain key research topics in global medical science today. Historically, treatment efforts focused on antibiotics and diuretics to reduce right ventricular load, emphasizing the critical importance of pulmonary arterial hypertension in these conditions. Why does pulmonary arterial pressure rise? Emphysema causes the lungs to expand, putting pressure on the pleura. Some researchers now advocate for thoracic cavity reduction surgery, where unnecessary lung tissue and diseased lung tissue are removed, reducing the volume of the chest cavity so that normal lung tissue can fully function—this is known as thoracic cavity reduction surgery.

New Approaches to the Treatment of Ischemic Heart Disease – December 1, 2004

Ischemic heart disease is a condition characterized by myocardial damage caused by coronary artery ischemia. This term encompasses not only common coronary artery disease but also heart diseases arising from hypotension, aortic atresia, anemia, and other conditions. Treatment options for ischemic heart disease include three main approaches: traditional pharmacological therapy, interventional therapy, and metabolic therapy. Metabolic therapy represents a novel approach to treating ischemic heart disease. While traditional medications for ischemic heart disease—regardless of their type—work by: ① reducing oxygen consumption in the myocardium; ② increasing oxygen supply to the myocardium, a strategy that combines both opening and closing the blood vessels. Metabolic therapy focuses on regulating myocardial metabolism, with Wanshuangli serving as a representative medication. When myocardial blood flow is reduced, the oxidation of free fatty acids increases, while glucose oxidation and phosphorylation decrease. Excessive glucose accumulates in the early stages of oxygen metabolism, preventing the release of ATP and instead leading to lactic acid buildup, resulting in acidosis in cardiac muscle cells. On the other hand, the oxidation of free fatty acids consumes more oxygen than glucose oxidation, thereby increasing oxygen demand in the myocardium and accelerating disease progression. Wanshuangli enhances glucose oxidation in ischemic heart disease, reducing oxygen consumption in the myocardium and minimizing lactic acid buildup, thus alleviating acidosis.

For these reasons, traditional medications cannot correct the imbalances in free fatty acid and glucose oxidation metabolism in the myocardium; although they may offer some relief, they ultimately fail to address difficult-to-treat cases. Interventions carry a relatively high recurrence rate—about one-quarter in the first year, with the rate increasing each subsequent year. Although recent advancements such as drug-eluting stents and anticoagulant therapies have improved outcomes, recurrence remains a persistent challenge. Heart transplantation is not easy to perform; it requires substantial costs, a shortage of donors, and the need to overcome rejection reactions. Given these challenges, metabolic therapy for ischemic heart disease—and the emergence of Wanshuangli—has become a beacon of hope in what was once a long night.

Introduction to Wanshuangli – December 13, 2004

Wanshuangli, also known as trimetazidine, is available in 20mg doses, taken once daily, and has been shown to significantly improve heart failure symptoms, making it the optimal choice for current anti-heart failure treatments. It is particularly suitable for patients with left ventricular function below 40%, who suffer from typical coronary artery disease. Additionally, this medication can treat angina pectoris and myocardial infarction, and even prevent their onset.

Randomized, Double-Blind, Controlled, Multi-Center, Large-Sample Studies – December 27, 2004

Randomized, double-blind, controlled, multi-center, large-sample studies represent modern evidence-based medicine methodologies. Prior to these studies, gathering “evidence” was essential—after all, the core of evidence-based medicine lies in evidence itself, and the accuracy of evidence is the key to evidence-based practice. Evidence is classified into five levels based on its degree of certainty, with varying origins, different levels of precision, and distinct analytical and comprehensive methods. Ultimately, evidence-based medicine can only be conducted in the modern era, when computers are networked.

Cholestatic Jaundice in Infants Aged 2–8 Weeks – December 27, 2004

This type of jaundice is characterized by elevated conjugated bilirubin levels, occurring between 2 and 8 weeks of life, indicating functional impairment in the liver and bile ducts. Jaundice occurring within the first week is considered neonatal jaundice, which is typically characterized by non-conjugated bilirubin levels. Neonatal jaundice can be physiological or lactational jaundice.

The incidence of cholestatic jaundice is commonly around 1 in 2,500, with the most common causes being biliary atresia and neonatal hepatitis. Neonatal hepatitis refers to a diffuse, cytotoxic histological change—a non-specific alteration unrelated to HV, but rather linked to infection and metabolism.

Irbesartan Reduces Type 2 Diabetes-Related Hypertension and Microalbuminuria – December 27, 2004

Diabetes is a leading cause of death, with arteriosclerosis (affecting the heart, kidneys, and brain) being the absolute cause of death. Recent data indicate that the incidence among men is 18%, and among women, 14%. Among the various markers of arteriosclerosis, urine microalbumin testing is the most sensitive indicator, with positive results accounting for 42% of Type 2 diabetes cases. In a typical person, the amount of microalbumin in 24-hour urine should not exceed 300 mg/day; the level of microglobulin should be 150 mg/day—roughly twice the amount, reflecting the ratio between albumin and globulin in the blood. Changes in microalbumin levels are among the most sensitive indicators of whether or not arteriosclerosis is progressing in the body. Irbesartan not only reduces blood pressure in diabetic patients but also significantly lowers microalbumin levels in 24-hour urine, demonstrating that irbesartan can help reduce the severity of arteriosclerosis in Type 2 diabetes patients.

Chronic Stable Angina Pectoris – December 27, 2004

This type of angina is also known as asymptomatic angina. It accounts for two-thirds of all angina cases, and treatment of this type of angina is of great significance in controlling acute attacks and the onset of acute unstable angina, thereby helping to reduce overall mortality rates from coronary artery disease. The goal of treating stable angina is to prevent acute myocardial infarction (AMI), reduce mortality, and extend lifespan; it also aims to reduce the frequency of angina attacks, improving quality of life.

Standardized treatment regimens include: ① aspirin 100–300 mg to inhibit platelet aggregation; ② beta-blockers such as propranolol; ③ lipid-lowering medications; ④ angiotensin-converting enzyme inhibitors, including angiotensin I converting enzyme inhibitors like captopril, and angiotensin II receptor blockers like losartan and candesartan.

Diagnosis of Infectious Diseases in Newborns and Children – December 27, 2004

Calcitonin is a polypeptide composed of 116 amino acids. When bacterial infections occur, calcitonin levels rise significantly—often earlier than CRP levels. Therefore, calcitonin is currently the best indicator for diagnosing inflammatory bacterial infections.

Recent Drug Updates – December 31, 2004

Antibiotics: Cephalosporins—first generation (1970s); First Generation Cephalosporin No. 1 (ceftriaxone sodium); Second Generation Cephalosporins No. 4, 5, and 6 (cefaclor, cefazolin sodium, cefradine); Third Generation Cefoperazone, ceftriaxone, cefradine, and cefixime sodium; Fourth Generation: Masispin.

Cardiovascular medications: ① Diuretics: hydrochlorothiazide and furosemide; ② Calcium channel blockers: nifedipine, nitrendipine, and isosorbide; ③ Beta-blockers: bisoprolol, metoprolol, and carvedilol; ④ Angiotensin-converting enzyme inhibitors (ACEI): captopril, benazepril, enalapril; ⑤ Angiotensin II receptor blockers (ARB): edarbi, cozaar, and hydralazine.

Diabetes medications: ① Biguanides: Glucophage and metformin; ② Sulfonylureas: D860, Dicarb, Glucobay, Diabeta, and Metformin; ③ O-glycosidase inhibitors: Byetta; ④ Logran (NovoLog); ⑤ Insulin sensitizers: rosiglitazone and rosiglitazone maleate (Vandi 4 mg); ⑥ Insulin: regular insulin, Lantus, and NovoRapid.

Latest Reports from Harvard University – January 29, 2005

Angiotensin I converting enzyme inhibitors (ACEI) have proven to be highly effective for patients with coronary artery disease. However, recent research conducted by Harvard Medical School, New York Institute of Technology, and Washington University School of Medicine, involving large-scale, multi-center randomized, double-blind, controlled trials, revealed that adding ACEI to existing coronary artery disease treatments did not improve mortality rates. This finding challenged conventional wisdom and has had a profound impact worldwide. Nevertheless, the fact that these medications can indeed improve quality of life remains undeniable.

New Insights into Thrombosis in Arteriosclerosis – January 31, 2005

Thrombosis in arteries is the most fundamental cause of patient death in cases of arteriosclerosis. Whether it’s unstable coronary artery disease or myocardial infarction, the root cause of death is thrombus formation—thrombi are often plaque deposits in atherosclerotic lesions. These plaques can rupture or detach, leading to blockages in the coronary arteries and ultimately causing myocardial infarction. It has been discovered that atherosclerotic plaques are rich in fibrin and fibrin peptides, with extensive capillary networks connecting them. Given these characteristics of thrombi, thrombi themselves can cause intravascular hemorrhage; combined with the aforementioned ruptures and detachments, this further increases the risk factors and mortality rates associated with coronary artery disease. The causes of thrombosis include: ① lipid deposition; ② platelet aggregation; ③ endothelial adhesion.

Based on these findings, it is believed that the primary cause of CAD (coronary artery disease) evolving into ACS (acute coronary syndrome), TIA (transient ischemic attack), and PAD (peripheral arterial disease) is thrombosis.

Formation of Thrombi in Arteriosclerosis – January 31, 2005

① C-reactive protein; ② fibrinogen; ③ fibrin peptide A; ④ CD40 ligand; ⑤ amyloid-beta in blood vessels; ⑥ vascular and cellular adhesion factors; ⑦ prothrombin fragments. Among these factors, the detection of C-reactive protein, prothrombin, fibrinogen, and fibrin peptide A is the most important measure—especially C-reactive protein. If high levels are detected, it indicates a higher likelihood of thrombus formation.

Advances in Hepatitis B Treatment – January 31, 2005

1. Pegylated interferon: Currently, pegylated interferons come in two forms—pegylated interferon α-2a and pegylated interferon α-2b, with the former marketed as Pegasys and the latter as Pegasys. Administered once weekly via intramuscular injection for 48 weeks, this treatment has shown efficacy higher than lamivudine.

2. Nucleoside analogs: Lamivudine and adefovir are commonly used nucleoside analogs, with lamivudine showing efficacy rates of 12–20%, while adefovir's efficacy is slightly higher. Other drugs include entecavir, tenofovir, and cleavilvire, all with efficacy rates ranging from 30–40%.

3. Current immunosuppressants used to prevent hepatitis B include passive hepatitis B vaccines and active hepatitis B immune globulins. Both formulations aim to prevent hepatitis B, but they can also be used for treatment.

Chemotherapeutic agents have been used to treat tumors for half a century, and while progress has been made in tumor treatment, breakthroughs have yet to emerge. Although numerous new-generation chemotherapeutic drugs such as Taxol, Doxorubicin, Vincristine, Gemcitabine, Irinotecan, and Oxaliplatin have been developed, these drugs often harm a large number of healthy cells while killing cancer cells, leading to toxic side effects. Recently, researchers have discovered that tumor growth and development are closely linked to multiple molecular biological factors: ① cellular epithelial growth factors; ② vascular endothelial growth factors; ③ genetic mutations. Given the close relationship between these three factors and tumor growth, highly targeted cellular drugs have emerged—such as gefitinib (ZD1839) targeting cellular epithelial growth factors, available in oral form at 50 mg, 100 mg, 200 mg, or 375 mg, once daily. Targeted drugs for vascular endothelial proliferation and for genetic mutations are also under active development.

Breast Anti-androgen Therapy – March 15, 2005

Randomized, double-blind, controlled, multi-center, large-sample studies have demonstrated that anti-androgen therapy following breast cancer surgery holds significant clinical value. Anti-androgen medications include: ① tamoxifen; ② anastrozole (aromatase inhibitors); ③ Faelode (Faslodex).

New Platinum-Based Anti-Cancer Drugs – March 15, 2005

Cisplatin (first generation), carboplatin (second generation), oxaliplatin (third generation), and ZD0473 (fourth generation).

Molecular Targeted Therapeutics – March 20, 2005

Rituximab—non-Hodgkin lymphoma; Gleevec—leukemia (chronic myeloid leukemia); Herceptin—breast cancer; Erbitux—lung cancer (non-small cell). Rituximab, also known as rituximab (RTX), along with MTX (methotrexate) and CTX (cyclophosphamide), are collectively referred to as the “three TXs.”

Salivary Gland Cancer – March 25, 2005

This type of cancer is relatively rare, often occurring in children and young adults. Histological classification shows it as a combination of neuroblastoma and rhabdomyosarcoma, making it a hybrid of neuro-myo-sarcoma in pathology. The tumor typically invades both sides of the spinal cord near nerve roots, such as in the retroperitoneum or nasopharynx. The malignancy of this disease varies depending on the degree of cellular differentiation; some patients exhibit extremely high malignancy, while most patients show well-differentiated tumors. Chemotherapy primarily uses CTX, VCR, and ADM.

Oxycodone Extended-Release Tablets (Oxycodone) – March 28, 2005

This medication is a second-generation version of Methadone. According to the WHO, the third-level pain relievers include nonsteroidal anti-inflammatory drugs like Indomethacin, Ibuprofen, Naproxen, Fenbid, Rofecoxib, and Celecoxib. The second-level opioids include weak opioids like Amphetamine, Codeine, and Strong Pain Relief. The third-level strong opioids include Tramadol, Methadone, and Oxycodone. Tramadol has a ceiling effect, while Oxycodone does not; typically, taking the medication once every 24 hours is sufficient to achieve satisfactory therapeutic effects.

Acute Upper Respiratory Infection (CAP) – March 28, 2005

This is one of the most common clinical conditions, with a higher mortality rate among elderly patients. Antibiotics are often administered within 4 hours, breaking away from traditional practices and shifting the focus toward antibiotic selection based on susceptibility testing. The most common CAP is caused by Streptococcus pneumoniae, and penicillin allergies are becoming increasingly prevalent. Those allergic to penicillin often experience some degree of allergy to cephalosporins and macrolides as well. Recently, the world has begun advocating for quinolones like levofloxacin, which offer clear advantages over respiratory tract infections.

Mycoplasma Infection – April 29, 2005

Among mycoplasma infections, Ureaplasma urealyticum is the primary pathogen; human mycoplasmas are secondary pathogens. In 9.15% of cases, the infection is a mixed infection of both. This type of infection is highly resistant, with a drug resistance rate of 87.03%, and is mostly sensitive to tetracyclines.

Brief Overview of Ovarian Tumors – April 29, 2005

Most ovarian tumors are benign, with malignant tumors accounting for only 10%—these are referred to as ovarian cancer. In gynecological cancers, ovarian cancer ranks third after cervical cancer and uterine cancer. However, its mortality rate surpasses that of cervical cancer and uterine cancer, ranking first. This disease predominantly affects women between the ages of 20 and 50; recent literature reports that women aged 50–60 are also at high risk.

Pathological classifications include: ① epithelial tumors; ② germ cell tumors; ③ stromal tumors; ④ metastatic tumors.

1. Epithelial tumors: ① serous cystadenoma, formerly known as serous ovarian cysts, with up to 35% of cases becoming malignant; among these, papillary cystadenomas have a malignant rate as high as 50%. Serous cystadenomas are the most common ovarian tumors, accounting for half of all ovarian tumors. ② mucinous cystadenomas have a malignant rate of 10%, representing 10% of malignant ovarian tumors. Other tumors include endometrioid carcinomas and clear cell carcinomas, which account for smaller proportions.

2. Germ cell tumors: These account for only 20% of ovarian tumors, with teratomas being the most common type.

3. Stromal tumors: Granular cell tumors, which tend to occur around age 50, have lower malignancy and better prognoses.

4. Metastatic tumors often originate from the gastrointestinal tract, with Krukenberg tumors being a prominent example.

Treatment options include surgery as the first-line approach. For malignant tumors, surgery, radiation therapy, and chemotherapy can all be considered depending on the case. Chemotherapeutic drugs include: CTX 800 mg, TSPA 20–40 mg, MMC 4–8 mg, 5-FU 750–1000 mg, DDP 40–100 mg, and ADM 10–50 mg.

Mycoplasma Infection – May 9, 2005

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: 支原体在过去仅引起呼吸道感染，称之非典型性肺炎。近年来

引起泌尿系感染者渐多，与昔日之淋病无异，为了区分，将此型泌尿

系感染称之曰非淋性尿道炎。非淋性尿道之病原除支原体外，尚有

衣原体。衣原体原系沙眼病原，引致沙眼，近年来发现此病原虽然可

致尿道炎，但为数较支原体引起者少。引致非淋之支原体主要是解

脲支原体，其次是人体支原体，约10%是混合感染。解脲支原体（u-

u),人体支原体（MH),前者占非淋之80%,后者占非淋之10%,二者

混合感染者占10%。

此病之最大特点为抗药，通常叫做多重耐药发生率，非淋之多

重耐药发生率为87.03%.此系清华大学第一附院王昕、李锋教授对

142例支原体感染者耐药性进行之研究，男88例，女54例，以标准法

收集标本，送实验室后当即接种。采用10种抗生素，耐药性由低到

高：米诺霉素9.1%,强力霉素10.5%,交沙霉素19.0%,阿奇霉素

42.3%,司帕沙星45.8%,罗红霉素47.1%,氧氟沙星64.0%,螺旋霉素

72.6%,环丙沙星77.4%,大观霉素90.1%.上述10种抗生素中前四种

为四环素族，后者依次为大环内酯、喹诺酮类、氨基糖甙。说明四环

素族对支原体感染最有效。

诊断梅毒之现代方法 2005.5.9

既往梅毒之确诊依靠康氏反应或华氏反应。自从血清学检测方

法酶标法、反向血凝法、放免法、克隆法开展以来，梅毒血清学之检

测常用RPR和TPPA两项，后来人们辄用梅毒血清螺旋体（TP)IgM抗

体之检测。

乳腺癌发病之近况 2005.5.11

西方国家乳腺癌发病居癌症之首位，我国之乳腺癌发病通常认

为较西方为少，然而近年来之事实证明此病在我国目前正以3%的

年增长率上升。上世纪末的10年间，我国城市妇女之乳腺癌增长率

较前增长了38%.我国乳腺癌之发病特点为发病年龄低，以40～49岁

为最多，较西方低10～15岁左右。美国之乳腺癌虽然发病率居高不下，但是因为普查、防治之及时，其死亡率明显低于其他国家水平。我国政府重视此病之防治及普查，最近我国卫生部疾病控制司与中国抗癌协会共同开展"中国百万妇女乳腺普查工程"，意义在于控制

此病之进一步发展。

乳腺癌中之HER-2单克隆抗体阳性表达说明其转移性强，预后

差，当前对此型乳腺癌采取赫塞汀（单克隆抗体）靶向细胞之治疗产

生了决定性效果。总之乳腺癌之治疗目前通过手术、放疗、化疗、内

分泌（三苯氧胺、来曲唑）、靶向细胞（赫赛汀）等综合措施治疗，则可

减少病死率。

意想不到之PEACE研究结果 2005.5.11

近年来ACEI之问世给冠状血管病者带来之益处是众所周知

的。然而美国哈佛大学、华盛顿大学、美国心病研究所等多家权威科

研机构采用多中心、大样本、随机、双盲、对照之循证研究结果表明，

ACEI(群多普利）对冠心病低危患者并非能带来更多益处。对这－

结果，专家们均表示惊讶！对其结果解释为：①受试者普遍曾接受他

汀类药物治疗，因此LDL胆固醇相对较低，对此类受试者群多普利

再无继续实质之功效，因为普利类与他汀类有大体相同之作用机

制。②并非所有的ACEI均具相同或相等之作用。例如最新一项研究

表明在降低c-反应蛋白方面喹那普利之作用远远高于依那普利。美

国密歇根大学之研究报告认为：许多未出现心肌重塑之冠心病患者

在接受介人或降脂治疗后，未能从ACEI之治疗中获得额外之心血

管保护。这就可以给患者减少不必要之药物负担和经济损失。

乳腺癌之病理分类 2005.5.12

通常之乳腺癌多属导管癌和小叶癌，特殊之乳腺癌有乳头状

癌、髓样癌、高分化腺癌、黏液腺癌、腺样囊性癌。乳腺癌之发病原因

有三：①晚婚晚育、未婚未育；②高蛋白饮食；③遗传。

虫类药物在类风湿治疗中之应用 2005.5.16

《全国中医名方大全》载方七首，方方不离虫药。蜈蚣1条，全蝎6

克，乌梢蛇10g,穿山甲10g,土鳖虫6g,地龙15g,蜂房10g,此为依常

用率次序排之。

治疗类风湿性关节炎向有：①桂枝芍药知母汤加味；②桑枝汤

加味；③五米牛骨汤加味；④白芍甘草三藤瓜加味；⑤金牛白活苡

枝鸡加味；⑥鸡鸣散加味；⑦五积散加味；⑧阳和汤加味；⑨独活寄

生汤加味；⑩九味羌活汤加味；①大秦艽汤加味；⑫黄芪桂枝五物

汤加味；⑬麻杏苡甘汤加味；④黄芪防己汤加味；⑮活络效灵丹加

味。用药则以川、草乌各15g,先煎1小时；细辛20g先煎1小时，马钱

子1个（油炸）为特点，体虚者酌加黄芪20g、当归10g、制乳没各6g为

宜。

前述之虫类药，余未曾常用也，此乃余之缺陷也，无怪余治类风

湿之患者多见常服药而不愈者，今后宜在常服草药中加用虫类药

物。

四逆散与黄芪建中汤 2005.5.16

四逆散（柴胡、枳实、白芍、甘草）为伤寒方，《伤寒论·少阴病脉

证篇》："少阴病四逆，其人或咳，或悸，或小便不利，或腹中痛，或泄

利下重者，四逆散主之。"说明四逆散之主证为四肢厥逆，然而厥逆

可由下列原因引起，或咳、或悸、或小便不利、或腹中痛、或下利后

重。呼吸、循环、泌尿、消化均可引起四肢之厥逆。笔者临床辄用斯方

治疗肝胆病及胃肠病。江苏省南通市中医院之吴震主任医师总结了

此方临床之七个方面，余谓乃真知灼见也。

1.肝胆系：急慢性肝炎、胆道疾患、胰腺炎、肋间神经病。

2.胃肠系：慢性胃炎、消化性溃疡、胃肠神经官能症。

3.神经官能症：癔病、神经衰弱。

4.冠心病、胸膜炎。

5.甲状腺肿、甲状腺瘤。

6.乳腺小叶增生、痛经、闭经、月经不调。

黄芪建中汤见于《金匮》，《金匮·血痹虚劳》："虚劳里急诸不足，

黄芪建中汤主之。""血痹，阴阳俱微，寸口关上微，尺中小紧，外证身体不仁，如风痹状，黄芪桂枝五物汤主之。"二方仅甘草一味之差（黄

芪桂枝五物汤中无甘草），充分说明了桂枝汤之外和营卫、内安脏腑

之作用。此二方余辄用之于胃脘疼痛，通常加煅瓦楞、香附、明矾取

效。

失眠之治疗 2005.5.17

余治疗失眠证，曾用归脾汤、天王补心汤、定心汤、安魂汤、酸枣

仁汤、半羌香米汤，有见效者亦有不见效者，后用生铁落饮曾使1例

顽固性失眠患者治愈。近见《中药新用》一书用何首乌、当归、半夏、

苦参为治疗失眠之大剂，今后当在临床观察之。健康报（2005.5.2号

刊）登出1例顽固性失眠患者之治愈，其主方：黄连6g、黄芩10克、阿

胶10g(烊化）、鸡子黄1个（温入煎药中）、白芍20g、甘草6g、女贞子

10g、旱莲草10g、龟板15g、生龙骨15g、菖蒲6g、远志6g,水煎服，谓疗

效如神，当在临床验证之。其中之黄连阿胶汤为《伤寒论》治疗心肾

不交之专方。《伤寒论》303条："少阴病，得之二三日上，心中烦，不得

卧，黄连阿胶汤主之。"

雷永仲治胃癌方 2005.5.23

焦三仙各10g、鸡内金10g、丹参10g、木香10g、草蔻10g、元胡15g、

川楝子15g、夏枯草15g、海藻15g、昆布15g。此方之组成可谓：金小三

夏海（金铃子散、鸡内金、小丹参、焦三仙、夏枯草、海藻、海带。气滞

加香附、青皮；痛著加郁金、乳没；大便隐血加白芨、生蒲黄、仙鹤草；

虚者加参芪、熟地、何首乌。此方为上海医大雷永仲方，曾治疗胃癌

293人，疗效显著。方之特点：木香、郁金、元胡、乳没之量偏大，均至

15g左右；白芨、生蒲黄止胃出血，余尚少用，当后验之临床；仙鹤草

之用量达30g,可供借鉴耳。

过敏性紫癜之用药 2005.5.23

1.金银花、连翘、公英、败酱、板蓝根。

2.生地、赤白芍、丹皮、制乳没。

3.甘草、紫草、仙鹤草、白茅根、槐花、地榆。

前述三类：①清热解毒；②活血化淤；③止血凉血。此证之病机

当为血淤妄行于脉外，淤久化热，热结为毒，风火相煽之证也。查余

治疗过敏性紫癜之最常用方：金银花、连翘、公英、败酱、土茯苓、白

茅根、白藓皮、生地、防风、萆薢、赤芍、丹皮、甘草、蝉衣，水煎服。方

歌为：三味消毒（土）白地风，萆薢赤丹草蝉鸣。此方中有：生地、赤

芍、丹皮三味；更有金银花、连翘、公英、败酱等味，所谓"草"者则系

加仙鹤草、紫草。

自身免疫性胰腺炎 2005.5.25

此病近年来才有命名，日本信州大学川茂信教授首先介绍了

此病。男性中老年占83%,平均年龄62.2岁。黄疸占68%,胰区不适

占78%,严重疼痛比较少见。血清酶学异常、免疫球蛋白异常、自身

抗体阳性者占80%.66%患者BT-BAPA试验阳性，51%糖化血红蛋

白》5.8；B超显示：胰腺肿胀，低回声改变；CT显示：胰腺肿胀，边缘

呈直线，包膜样改变；ERCP显示：胰管不规则狭窄伴胆管下段狭

窄，其中胰管弥漫性狭窄者占50%左右；组织学检查示：纤维化伴

淋巴和浆细胞浸润，阻塞性静脉炎。HLA抗系DR4、DQ4亚型与本病

关系密切，尚在探讨中。IgG4显著升高为其特点。球蛋白之升高为

另一特点。

拜糖平（阿卡波糖） 2005.5.25

此为Ⅱ型糖尿病治疗之专药，属α葡萄糖苷酶抑制剂，此药可降

低血糖，也可有效降低心血管病之发生，此药之作用是抑制碳水化

合物之吸收，从而降低心血管疾病（CVD)之危险，血管病之产生乃

持续高血糖之使然也。本品之常用量100mg、Tid,鉴于此品抑制碳水

化合物之吸收，因而最常见之副作用为腹胀或兼腹痛。

蜂制品之严重不良反应 2005.5.25

蜂采花粉可能来自多种植物，包括对人类异常过敏之单花粉。

蜂王浆是工蜂下颌腺之分泌物；蜂胶是杨树脂和针叶树芽收集物与

蜂蜡之混合物。上述蜂类制品以各种商品名称出现。1998年1月1日

加拿大卫生部收到蜂制品引起各种不良反应之报告共4起；分别为：

急咽、喉、气管水肿，呼吸窘迫，皮肤水肿，皮疹，自身免疫性肝炎，癫痫等。鉴于此，加拿大卫生部特别发表了公报，当心蜂制品之严重不

良反应。

类风湿性关节炎之再讨论 2005.6.2

《全国名中医专家验方选》中共举类风湿方药20首，用药之规律

总结如下：

1.祛风胜湿：桑枝、桂枝、羌独活、防风、威灵仙、海桐皮、仙鹤

草、伸筋草、钻地风、寻骨风、透骨草、五加皮、汉防己、萆薢、木瓜、狗

脊、穿山甲、徐长青、白芷。

2.活血化淤：汉三七、土鳖虫、血竭、桃仁、红花、乳没、苏木、姜

黄、穿山甲、元胡。

3.祛风虫类：露蜂房、蜈蚣、全蝎、乌蛇、白花蛇、蕲蛇。

4.燥湿类：苍术、胆星、白附子、川草乌、细辛、白芥子、附片。

5.清热泻火：黄柏、龙胆草、红藤。

6.扶正：黄芪、当归、白芍。

以上六类药物之用量：细辛20g、川草乌各15g、附片20g,均为先

煎1小时；乳没、桃仁、红花均可用至10g；元胡、穿山甲、汉三七均可

用至10g。

几种常见消化道中药之药理作用 2005.6.6

1.厚朴：①对消化道黏膜之保护作用。②对横纹肌之松弛作用，

小剂量促进平滑肌之蠕动，大剂量松弛作用。③对革兰氏阳性菌及

酵母菌之抑制作用。厚朴生服有毒，煎服无毒。

2.木香：①抑制肠管蠕动，扩张胆管，松弛平滑肌。②气管平滑

肌之痉挛也可对抗之。③对真菌具有明显之抑制作用，对其他细菌

之作用不大。

3.乌药：①乌药之作用与木香相反，促进平滑肌之紧张，增加收

缩、通畅排气，尚可增加消化液之分泌。②有广泛之抑菌作用。

4.松香、沉香之作用与木香大同，亦可对胃肠平滑肌产生松弛

作用，对革兰氏阴性菌及肠道杆菌有一定抑制作用。

5.佛手、青皮之作用为抑制平滑肌之痉挛、对气管、肠管均有一

定作用，此作用与木香、松香、沉香之作用大体相同。

6.枳实增加副交感神经之紧张性，加强肠蠕动，促进胃肠分泌。

枳实对全身血管及心、脑、肾血管之收缩使血浓度增加、灌注增加。

7.草蔻、砂仁、白蔻增加胃肠分泌，促进消化功能。小剂量增加

胃肠蠕动，大剂量抑制蠕动。

8.肉桂、良姜、丁香之作用与前述之草蔻、砂仁、白蔻大同，均能

促进胃肠分泌功能，小剂量促进蠕动，大剂量抑制蠕动。

9.吴萸、小茴香之作用抑制胃肠分泌之同时能抑制蠕动，同时

尚具有镇痛之作用。

综上所述，木香、松香、沉香、青皮、佛手、陈皮减少胃肠蠕动，扩

张胆管。枳实、厚朴、乌药增加胃肠蠕动，促进排泄。吴萸、小茴香兴

奋大于抑制，止痛效果最佳。草蔻、砂仁、白蔻帮助消化，增加胃肠分

泌。肉桂、良姜、丁香之作用只是增加分泌。

乙型肝炎之抗病毒 2005.6.8

乙型肝炎之抗病毒研究始于80年代，苦参素、甘草甜素、辅酶

Q10、聚肌胞、蚂蚁制剂等先后上市，因其疗效不大，均未形成较大

影响，直到Q干扰素上市对乙肝病毒之抑制率始达15%～20%,但因

其价格昂贵长期使用当属困难，加之为注射剂，不宜长期应用。拉米

夫定（贺普丁）100mg,Qd,有一定疗效，HBsAg转阴率达10%～20%,

HBeAg转阴36%～38%,算是登上一定层次。相继上市之核苷类似物

阿德福韦、恩替卡韦则较拉米夫定又有一定提高。2005年3月29日，

美国FDA批准恩替卡韦上市，该药正式用于治疗慢性乙型肝炎。其

适应证：HBV活动、复制，ALT、AST升高或组织学检查示活动性肝病

之患者。

克罗恩病和溃疡性结肠炎 2005.4.10

二者同属自身免疫性疾病，克罗恩病即克隆氏病，与溃疡性结

肠炎同属慢性肠道疾患（IBD),西医用激素或免疫抑制剂疗效较好，

中医治疗此病则以乌梅丸、香连丸为基础，恢复期可用升阳益胃汤。

浅谈胰岛素 2005.6.10

胰岛素之使用历来久矣！治疗糖尿病为众所周知之功用，然而

尚有下列功用被人们忽略：①抗炎作用；②扩血管作用；③抑制血小

板凝聚；④保护心脏。

我国著名糖尿病专家李伟光教授说："胰岛素之作用不仅是降

低血糖，其强大之抗炎作用，具有非常重要之意义。糖尿病患者之

炎症反应增强，是动脉粥样硬化、急性心血管事件突发之主要原

因。胰岛素可产生更多之NO,扩张血管，保持血液流通，更重要的是

减小细胞因子之生成，阻止单核细胞和氧化性LDL进入血管内皮细

胞，同时胰岛素还有抑制VF-KB的作用，多方面抑制炎症。来自动物

脏器之胰岛素当前有完全被基因重组之胰岛素类似物代替之可

能。"

国际著名之诺和诺德公司是专营人工重组胰岛素之国际领头

羊，20世纪80年代基因重组胰岛素开始取代胰岛素，今后之趋势是

胰岛素类似物必然完全取代胰岛素市场。目前有长效、短效、予混等

三型胰岛素类似物，其中短效胰岛素类似物－诺和锐、中效胰岛

素－诺和灵2002年在我国上市。预计长效胰岛素类似物将于明年

在我国上市。今年该公司在我国又推出了予混胰岛素类似物诺和锐 30.

Atopic Dermatitis, June 8, 2005

Previously known as allergic dermatitis or atopic eczema, 70% of cases of atopic dermatitis occur in children under the age of 10; adults are also not uncommon. The primary symptoms include pruritus, edema, erythema, vesicles, exudation, skin thickening, and lichenification. One-third of patients also develop asthma, while one-third experience allergic dermatitis, which can be classified as mild, moderate, or severe.

Hepatic Tuberculosis, June 13, 2005

Hepatic tuberculosis is a rare but not uncommon condition. According to statistics, 75%–100% of cases of hematogenous pulmonary tuberculosis are accompanied by hepatic tuberculosis; among infiltrative pulmonary tuberculosis cases (active), 2.7% also exhibit hepatic tuberculosis. Clinically, any patient presenting with persistent high fever that does not subside, hepatomegaly, or liver function impairment should be considered for this disease.

Epidemiological Characteristics of Hepatitis B, June 13, 2005

1. Changes in Transmission Routes: With the introduction of vaccines and maternal-infant transmission prevention measures, vertical transmission has significantly decreased recently; meanwhile, sexual transmission and injection-related transmission have seen a notable increase. According to WHO statistics, injection-related transmission and sexual transmission account for 32% of newly diagnosed hepatitis B cases worldwide.

2. Increased Rates of “Small Three-Yang” Cases: Recent studies indicate that 89% in Japan, 79% in mainland China, 80% in Taiwan, 89% in Hong Kong, and 84% in India represent the proportion of “Small Three-Yang” patients among all hepatitis B cases globally. It’s important to note that “Small Three-Yang” patients may undergo C-terminus mutations.

HBV DNA Detection via PCR, June 13, 2005

Covalently closed circular DNA (CCDNA) serves as the original template for HBV pre-genomic DNA replication. Its quantity is extremely low—only 5–50 copies per hepatocyte—and it is more representative than the DNA typically detected. If the original DNA were present in peripheral blood, CCDDNA would serve as the original template for DNA release, akin to an aircraft carrier launching its fighter jets.

Entecavir and Adefovir, June 13, 2005

The latest nucleoside analogs approved for clinical use recently received FDA approval in the United States. Both drugs have completed Phase III clinical trials. Their clinical efficacy is superior to lamivudine, though the HBeAg seroconversion rates between the two drugs and lamivudine show no significant difference; their effectiveness is primarily observed in reducing viral DNA levels and lowering ALT levels.

Three Major Nutritional Issues Affecting Children’s Growth in China, July 1, 2005

Nutritional deficiencies remain prevalent among rural children, mainly due to protein and vitamin deficiencies. Additionally, some children’s absorption of trace elements is affected by differences in their local soil and water conditions, as well as variations in their own digestive systems. The final issue is nutritional excess among urban children, leading to obesity. These three problems constitute the three major nutritional challenges currently impacting children’s development.

Discussion on Gestational Trophoblastic Cancer, July 11, 2005

Gestational trophoblastic cancer is a type of germ cell tumor. In the past, it had a mortality rate exceeding 90% (and even higher in recent years), with rapid onset and swift progression to death, earning it the nickname “the king of cancers.” In the 1960s, renowned Japanese obstetrician-gynecologist Academician Song Hongzhao developed a radical treatment for gestational trophoblastic cancer, achieving a cure rate of 90%. As a result, countries around the world began adopting this effective approach.

Gestational trophoblastic cancer typically develops after molar pregnancies or malignant molar pregnancies. After evacuation of the uterus and continued vaginal bleeding, the serum human chorionic gonadotropin (HCG) levels drop and then rise again, often remaining persistently elevated. In such cases, the presence of the disease should be considered. Half of gestational trophoblastic cancers occur after normal pregnancies, with most cases occurring within one year. Occasionally, elderly women in menopause or young girls who are unmarried and childless may also develop the disease.

In summary, the ratio of benign molar pregnancies, malignant molar pregnancies, and gestational trophoblastic cancer is approximately 2:1:1. The clinical manifestations of these diseases are similar to those of benign and malignant molar pregnancies: first comes amenorrhea, followed by vaginal bleeding accompanied by abdominal pain. Severe cases may present with shock, anemia, and cachexia. Treatment typically involves evacuation of the uterus and total hysterectomy, with postoperative chemotherapy and radiation therapy being the mainstay of treatment, with regular monitoring of HCG levels.

Irritable Bowel Syndrome (IBS), August 10, 2005

The most common symptom experienced by IBS patients is urgent bowel movements. Recent research indicates that this symptom is associated with accelerated colonic transit, though it is not directly related to the rectum; instead, the stool becomes loose and soft. Among individuals with chronic constipation, the likelihood of developing IBS is 3.16 times higher than that of the general population. The onset of IBS is linked to heightened central sensitization or visceral hypersensitivity in certain populations—those with economic hardship are more likely to develop IBS, while others may experience increased mast cells in the intestinal mucosa due to environmental factors. Economic hardship is often associated with unemployment, low self-esteem, and a lack of stability in life. This condition is most commonly observed in middle-aged women. Alosetron is a 5-HT3 receptor antagonist, while tegaserod is a 5-HT4 receptor agonist, both of which can treat IBS.

Evidence-Based Treatments for Chronic Hepatitis B, August 12, 2005

Among the global population of 6 billion, 350 million people live with chronic hepatitis B, and 25%–40% ultimately succumb to cirrhosis or liver cancer. Each year, over 1 million people worldwide die from hepatitis B-related diseases.

1. “Large Three-Yang” Patients: After 48 weeks of lamivudine treatment, 16%–18% transitioned to “Small Three-Yang,” while another study showed a conversion rate of 20%–30%. Following 48 weeks of treatment, the overall success rate reached 41%. Drug resistance mutations frequently occur during treatment; the mutation rate can reach as high as 67% after a 4-year course, and 90% after 5 years. The IFN-a treatment regimen achieved an HBsAg seroconversion rate of 8%–12%, while the HBeAb seroconversion rate was 33%–37%.

2. “Small Three-Yang” Patients: IFN-α treatment was administered three times weekly for 24 weeks, resulting in only a 2.5% HBsAg seroconversion rate and a 28% reduction in HBV-DNA levels. Today, it is widely believed that interferon therapy is effective in reducing HBV-DNA levels by 15%–37%, while lamivudine’s effectiveness is around 16%. However, the biggest challenge with lamivudine lies in drug resistance mutations. Small sample studies have shown that lamivudine combined with IFN-α yielded a 36% HBeAg seroconversion rate; however, detailed statistical reports from large-scale studies are still lacking.

3. New Antiviral Medications: Adefovir dipivoxil is a precursor to oral adefovir, a nucleoside analog. This medication, when taken at 10 mg daily for 48 weeks, resulted in histological changes in 50%–60% of cases, with DNA levels reduced to 1/5–1/3 log10 copies. Entecavir, administered at 0.5 mg daily for 48 weeks, saw HBV-DNA levels decrease to less than 400 copies; therefore, entecavir is a more effective treatment option compared to lamivudine.

Clavudine is a nucleoside analog originating from South Korea, and its antiviral activity is significantly higher than lamivudine, particularly beneficial for patients with elevated ALT levels. Other medications in this category include tenofovir, whose efficacy is currently being evaluated through practical observations.

Nuclear Markers for Tumor Screening, August 14, 2005

Carbohydrate antigens: CA-50 – liver cancer; CA-125 – ovarian cancer; CA-153 – breast cancer; CA-199 – pancreatic cancer; CA-724 – gastric cancer and colorectal cancer.

Neurofilament antigen NSE – small cell lung cancer.

Cytokeratin CYFRA211 – non-small cell lung cancer.

Ferritin SF – liver cancer and blood disorders.

Saliva SA – non-specific marker.

Folic acid FA – non-specific marker.

Carcinoembryonic antigen CEA – non-specific marker.

Alpha-fetoprotein AFP – liver cancer.

Rheumatoid Arthritis, August 21, 2005

Rheumatoid arthritis (RA), osteoarthritis (OA), Sjögren’s syndrome (SS), multiple sclerosis (SSC), lupus erythematosus (SLE), and lupus nephritis (CN). All of these conditions are autoimmune disorders. Historically, hormone therapy has been the preferred treatment for these conditions, but it often leads to resistance, rebound effects, and a cycle of failure—often resulting in treatment failure. Nowadays, immunosuppressants have introduced three new agents: TX, RTX (rituximab), CTX (cyclophosphamide), and MTX (methotrexate). These three TX agents can be used in combination with hormones, or they can be used alone, or in combination with other agents. RTX is administered at 500 mg once weekly, CTX at 800 mg once weekly, and MTX at 10 mg once weekly.

Guillain-Barré Syndrome (GBS), August 25, 2005

GBS is an acute infectious demyelinating polyneuropathy. ① Acute infections of the upper respiratory tract and gastrointestinal tract (before onset). ② Lower limb paralysis. ③ Sensory deficits in the limbs, often manifesting as glove-like or sock-like distribution of weakness or loss of sensation. ④ Twelve pairs of cranial nerves may be affected, or they may remain unaffected; if affected, the damage may be limited to just one or two pairs. ⑤ Cerebrospinal fluid may show protein and cell separation—proteins increase while cells do not—allowing differentiation from bacterial intracranial infections. ⑥ Some patients may develop ascending respiratory muscle paralysis and circulatory paralysis, leading to death within a short period. ⑦ Autonomic dysfunction, with weakened deep and superficial reflexes. ⑧ Treatment for this condition involves using hormones as the primary therapeutic approach in Western medicine.

Pharmacological Treatments for Chronic Insomnia, August 31, 2005

Western pharmaceutical treatments fall into three categories: benzodiazepines (also known as benzodiazepine derivatives), benzodiazepine receptor agonists, and antidepressants. Among these three groups, benzodiazepines are commonly referred to as “benzos,” with Valium being a representative example. Other drugs include clonazepam, nitrazepam, flurazepam, estazolam, and triazolam. Benzodiazepine receptor agonists exert stronger effects than benzodiazepine derivatives; currently, FDA-approved products include zolpidem, which has a short half-life of 3 hours, offering comparable efficacy to triazolam. Zaleplon is an ultra-short-acting agent with a half-life of just 1 hour, administered at 5–20 mg per dose. Antidepressants primarily include tricyclic and tetracyclic antidepressants, such as norepinephrine reuptake inhibitors, amitriptyline, and norepinephrine desipramine. The primary clinical manifestations of depression include feelings of sadness, negativity, suicidal thoughts, fatigue, and apathy. The underlying causes of depression are related to decreased levels of norepinephrine, serotonin, and dopamine in brain tissue; tricyclic and tetracyclic antidepressants help enhance the action of these neurotransmitters, increasing their concentrations in brain tissue.

Precautions in Diabetes Treatment, September 2, 2005

Type 1 diabetes is characterized by a deficiency in insulin production, or a disruption in insulin secretion, stemming from impaired function of pancreatic beta cells. Type 2 diabetes, on the other hand, involves normal insulin secretion, but the body’s own insulin counteracts insulin production. Previously, it was thought that treating Type 2 diabetes with insulin was not always the first choice; however, practice has shown that the body’s own insulin counteracts insulin, yet external insulin remains effective. Therefore, insulin therapy is now considered the preferred treatment for all types of diabetes—it not only helps lower blood sugar levels but also reduces inflammation, lowers lipids, and decreases enzyme levels, making it a truly miraculous remedy for metabolic syndrome, where elevated blood sugar is the initial trigger.

Clinical methods for insulin administration: International guidelines specify that all insulin formulations come in 1 ml doses of 40 units. Human insulin is divided into two categories: regular insulin and long-acting insulin. Long-acting insulin refers to zinc-containing insulin. Artificially recombinant insulin has been used clinically since the 1980s, with brands like NovoLog and Lantus available today.

The starting dose of insulin for diabetes treatment can be determined based on two factors: ① Body weight in kilograms × 0.4 = the initial insulin dosage in units; ② Fasting blood glucose level in mmol × 1.8 = the initial insulin dosage in units. After administering insulin according to these methods, (fasting blood glucose level – 7) × 1.4 = the adjusted insulin dosage.

These methods are merely guidelines; however, individual responses vary greatly, so adjustments should be made based on specific patient conditions.

GH Replacement Therapy Beneficial for Cardiovascular Health in Individuals with GH Deficiency, September 5, 2005

A research report from Norway’s Oslo National Hospital indicated that physiological GH (growth hormone) deficiency is a key factor contributing to cardiovascular events. This hormone originates from the pituitary-adrenal axis. Typically, the anterior pituitary gland contains three types of cells, each with distinct functions: ① basophils—stimulating thyroid, adrenal, and gonadal functions; ② eosinophils—promoting growth and lactation; ③ chromophiles—non-secretory cells. The posterior pituitary secretes antidiuretic hormone and vasopressin.

As humans age beyond 65, the hypothalamus, pituitary gland, and adrenal axis begin to produce insufficient amounts of GH, leading to immune and metabolic dysregulation—or even decline—in the body. First and foremost, GH secretion decreases, and this hormonal deficiency is a major contributor to cardiovascular events.

Some argue that as humans age, eosinophils stop functioning, causing growth and lactation to naturally cease. Meanwhile, as gonadal cells gradually decline, gonadotropin—follicle-stimulating hormone and luteinizing hormone—increases to a certain extent. Simultaneously, the function of basophils begins to activate to varying degrees, leading middle-aged individuals to experience central obesity, hyperlipidemia, high blood viscosity, hypertension, hyperglycemia, and hyperuricemia—these are all components of metabolic syndrome.

Treatment of Psoriasis, September 8, 2005

This condition is also known as “psoriasis” in traditional Chinese medicine. While various theories exist regarding its causes—such as infection, allergic reactions, autoimmune mechanisms, genetic predisposition, and more—no definitive conclusion has been reached yet, and further research is needed. Clinical manifestations of psoriasis include pinpoint lesions, patches, and scaly areas covered with white scales; when the white scales are removed, the base of the lesion appears bright red, with visible pinpoint hemorrhages underneath. Beneath the white scales, there are plate-like lesions, which are the three main characteristics of psoriasis. The primary subjective symptom is intense itching, which often persists for a long time. Traditional Chinese medicine currently lacks effective treatments for this condition.

Historically, treatment options for psoriasis have included: Shanci Bai Tu Dong Sheng Lan, Ke Yin No. 1 Weilingxian; Shanci Yin Yuan Da Qiao Qing, Ke Yin No. 2 Huomai Ren; Ma Huang Gui Zhi Dong Mi Tang. Recently, reviewing “Fang Yao Chuan Jing” and “Contemporary Famous Doctors’ Complete Works,” we found the following formulas:

1. Mercury 10 g, large maple seeds 50 g, green walnut shells 15 g, sesame oil 15 g—first decoct the large and green seeds, concentrate into a paste, then add the mercury.
2. Poria 15 g, Kieria 15 g, Hedysarum 30 g, Herba Lysimachiae 10 g, Sophora 20 g, Cortex Phellodendri 6 g, Licorice 6 g, White Moss Skin 15 g, Rehmannia Root 50 g, Tribulus terrestris 30 g, Ledebouriella 12 g, Weilingxian 10 g—decoct in water, one dose per day. Use Shanci Bai Tu, Kieria San Feng Weilong.
3. Poria 15 g, Herba Lysimachiae 20 g, White Moss Skin 20 g, Sophora 10 g, Forsythia 10 g, Curcumae Rhizoma 10 g, Angelicae Sinensis 10 g, Peony Root 10 g, Rehmannia Root 12 g, Salvia Miltiorrhiza 20 g—decoct in water, one dose per day. Use White Moss Skin, Angelicae Sinensis, and other herbs together.

Traditional Chinese Medicine Treatment for Hair Loss, October 21, 2005

Hair is a product of blood; blood is the mother of qi, and qi governs blood. When treating hair loss, the principle of treating both qi and blood simultaneously is essential. The lungs govern qi, while the heart governs blood; thus, regulating the heart and lungs is a necessary step in balancing qi and blood. Initially, Yigong He Erti Wan, supplemented with Platycladi Seed, White Trichosanthes, Fritillaria Cirrhosa, Polygonum Cuspidatum, Goji Berry, Dried Perilla Seeds, Earthworm Skin, and Clematis Armandii Vine; later, the formula was expanded with Boshou Si Wu Er Ti Wan and added White Mulberry Fruit and Licorice. The former focuses on qi, while the latter emphasizes blood, encompassing both qi and blood.

Reading Notes, October 24, 2005

1. Clopidogrel, also known as Plavix, is a substitute for aspirin, possessing all the effects of aspirin while avoiding its side effects—especially without harming the gastrointestinal tract. Current research suggests that this medication’s benefits extend beyond inhibiting platelet aggregation; it also significantly suppresses the entire process of atherosclerosis, including lipid deposition, endothelial adhesion, and prostaglandin antagonism.

2. The three major symptoms of depression are low mood, loss of interest, and low confidence. In Western countries, 40%–50% of the population experiences these symptoms at least once in their lifetime; in China, the rate is 20%–30%.

3. The 1-year, 5-year, 10-year, and 15-year survival rates for cardiac interventions are 95%, 88%, 76%, and 66%, respectively, highlighting the superiority of this surgical procedure. Percutaneous intervention is advancing, offering a more advanced alternative compared to traditional arterial catheterization.

4. For primary liver cancer, the overall efficacy of chemotherapy is relatively poor. Platinum-based drugs, fluorouracil-based drugs, camptothecin-based drugs (such as irinotecan), and anthracycline-based drugs (such as doxorubicin and mitoxantrone) generally achieve only 12%–17% efficacy.

5. The Spanish flu virus first spread across the globe during World War I in 1919–1920, claiming 500 million lives. In India alone, the death toll ranged from 30 million to 50 million. Subsequently, outbreaks occurred in 1957 and 1968, each claiming over a million lives.

6. Several indicators for chronic kidney disease (CKD) include: ① Glomerular filtration rate: urine volume per minute—normal ranges from 80 to 90 ml/min, representing the amount of urine filtered through the glomeruli each minute. The calculated glomerular filtration rate is based on creatinine clearance, which measures the ability of the body to eliminate creatinine per minute. Since the average urinary output per kg contains 1 mole of creatinine, the absolute value of creatinine clearance is equivalent to the glomerular filtration rate mentioned earlier.

② Urinary protein excretion should be below 120 mg per 24 hours. ③ B2 microglobulin levels should be below 0.2 mg/L.

Asmee’s Anti-inflammatory Effects in a COPD Rat Model, October 28, 2005

Asmee, also known as Compound Meclizine Capsules, contains a small amount of aminophylline. The COPD rat model is established using either smoke inhalation or lipopolysaccharide injection. Monitoring indicators include TNF-α (tumor necrosis factor), IL-1β (interleukin-1β), IL-6β (interleukin-6β), and TGF-β (transforming growth factor-β)—all four biological markers can be considered inflammatory factors.

When Asmee was administered orally at 3 mg, 9 mg, and 27 mg daily, the results showed that all four inflammatory factors were reduced in the Asmee-treated group, with a significantly greater reduction compared to the control group. There were statistically significant differences between the two groups (p < 0.05), indicating that the three different dosages demonstrated clear differences, suggesting that low doses may not provide optimal therapeutic effects.

Current Medications for Osteoarthritis Treatment, October 31, 2005

Salicylate-based drugs (aspirin), phenylamine-based drugs (amitriptyline), pyrazolone-based drugs (anaprilin), opioid-based drugs (including synthetic opioids like tramadol, methadone, oxymorphone, fentanyl, morphine, etorphine), corticosteroid-based drugs (prednisone), nonsteroidal anti-inflammatory drugs (ibuprofen, indomethacin, naproxen, fenbid, rofecoxib, celecoxib, naproxen), and acid-suppressing drugs (flucloxacillin, chloramphenicol)—all belong to the nonsteroidal class. Diclofenac is also a nonsteroidal drug.

Among the five categories of pain relievers mentioned above, each has distinct side effects: opioid addiction, steroid-induced weight gain, increased blood pressure, and immune suppression; nonsteroidal drugs can cause stomach irritation. In recent years, following the development of COX-2 inhibitors—based on nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and indomethacin—novel drugs such as rofecoxib, celecoxib, naproxen, and riluzole were developed to minimize gastrointestinal side effects. Riluzole is the most prominent among them.

A Brief Discussion on Smoking, November 2, 2005

Currently, there are 1.1 billion smokers worldwide, with 350 million in China, accounting for 35% of the global population. Chinese smokers make up 36% of the national population; male smokers account for 63% of the male population, while female smokers represent only 3% of the female population—but because of passive smoking, their health risks are comparable to those of men. China spends 6.5 billion USD annually on tobacco consumption. 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: 25%之肺癌与吸烟有直接相关。吸烟与心血管疾患之关系也异常相

关，其量化资料正在研发中。

HPV感染 2005.11.4

宫颈癌是我国发病率最高之恶性肿瘤，其发生过程是一个由癌

前病变逐渐演变为宫颈癌之过程。所谓癌前病变，主要是指宫颈之

非典型增生（CIN),其发生主要与人乳头状瘤病毒（HPV)之感染相

关。据统计，HPV感染率在宫颈糜烂增生（CIN)患者中占70%～78%；

在宫颈癌患者中占95%.人群HPV感染之高峰率为17%～34%,新感

染病例占20%～24%.HPV主要通过性交感染，感染情况直接与女性

之性伴侣数以及其性伙伴之性伴侣数有关。HPV也可以发生于无性

活动之患者，和免疫力之下降有关。HPV无法在体外培养，在体内也

无法诱导出用于检测之免疫试验，因此无法采用血清学方法对其诊

断和分型。HPV之诊断通过典型之临床症状和肉眼可见之尖锐湿疣

确定，当然脱落细胞之观察也是重要参数（如发现凹空细胞、癌变细

胞），分子生物学基因检测是诊断HPV广泛应用之技术。HPV的感染

可自行消退，只是感染了所谓之高危亚型时才可能发展为宫颈癌。

目前尚未开发出抑制HPV之专药。局部处理：激光、冷冻、电切、锥

切。干扰素在理论上有效，实际疗效尚待观察。HPV自然消退过程8～

14月。

妇科临床之几个问题 2005.11.5

1.巴氏腺和纳氏腺：前者位于大阴唇下端内侧，腺管口在处女

膜近旁；后者位于宫颈口内侧黏膜下，腺管口在宫颈管内。两种腺体

之分泌物随性高潮之来临而增加，润滑阴道，其作用与男性前列腺

相类似。因其所处特殊位置，故易感染、化脓，慢性者易形成囊肿，小

者无症状，大者可行手术切除，感染则以抗感染治疗为首选。

2.宫颈炎症可见糜烂、肥大、息肉。刮片有时可见非典型增生，

此检查分巴氏一、二、三级，如为三级则有宫颈癌之虞，宜做宫颈活

检。活检应采用上（12)、下（6)、右（9)、左（3)四个点。

3.宫颈糜烂之外用药：黄柏60g、蜈蚣7g、冰片3g、雄黄16g、轻粉

1.6g,共研细外用。

胸椎黄韧带骨化 2005.11.7

胸椎黄韧带骨化系引起椎管狭窄之根本原因。黄韧带骨化分成

熟型和未成熟型两种，前者压迫脊髓，椎管仅轻度狭窄，后者则在进

行性发展，椎管大多狭窄，脊髓不同程度受压。胸椎黄韧带骨化之诊

断主要有下列依据：①下肢力弱，感觉障碍，80%～90%；②排便、排尿困难，括约肌功能障碍70%；③胸部及下肢束带样感觉40%,其次

为腰腿疼痛或肋间神经痛。CT、MRI是诊断黄韧带骨化之最重要指

标。一、二、三度均可采用中药治疗，四度则宜手术治疗。

本病始见中老年人，原因尚未完全明确，但与老年激素水平之

减少、内分泌之紊乱有关。黄韧带之改变、钙化女多于男，后纵韧带

之改变男多于女。

泰能之临床应用 2005.11.16

Tienam(亚胺培南／西拉司丁钠盐）系广谱β-内酰胺霉抗菌素，

此药之抗菌谱较当前应用于临床之任何一种抗菌素之抗菌谱广，作

用之强大堪与目下之三代头孢相媲美。中国泰能以静脉滴注为主要

形式，1g,Bid,速度宜慢，40gtt/min,肾功能不全之成人可用，但剂量

宜减少。

支气管哮喘之相关资料 2005.11.16

1.发作与家庭装修、地板平整有关。

2.治疗肺动脉高压之新药塞塔生坦。该药之疗效与波生坦相

似，波生坦是目前唯一用于PAN(肺动脉高压）之药物，塞塔生坦之

开发则拓宽了PAN之药物选择，此类药物属内皮素受体拮抗剂。选

择性内皮素受体是研究一切过敏因子致喘之切入点。

3.肾上腺皮质激素是内皮素受体抑制剂，布地奈德（内皮激素

之专门制剂）经瑞典学者研究对COPD有明显之心脏保护作用。

4.最新统计，全球3亿人患哮喘，6亿人患COPD,且发病率逐年

上升。哮喘是炎症导致之气道反应病，治疗哮喘之关键是消炎和吸

入性糖皮质激素气雾剂、B2受体激动剂。

绝经后激素治疗（HT) 2005.11.18

前用雌激素、孕激素显示弊端，近来推出替波隆（利维爱）既可

代替激素治疗，又无激素治疗之副作用。

1.减少雌二醇生成，抑制乳腺增生并促进其凋亡。

2.减轻乳腺疼痛，并不增加纤维密度。

3.对阴道上皮及宫颈黏膜有雌激素作用，可缓解阴道干燥和性

交疼痛，提高女性反应能力。

4.增加性欲，唤起勃起，提高满意度。

还原型谷胱甘肽 2005.11.22

是含有巯基（SH)之三肽类化合物：①活化氧化还原系统；②解

毒。上述作用是在参与三羧循环之基础上产生的，因而其作用与辅

酶相同。基于上述作用，此药对放化疗之副作用有较好之疗效，同时

对肝病也有疗效。市售之还原型谷胱甘肽有阿拓莫兰、双益健等，分

别为0.3g,0.6g,肌注，静滴以生理盐水或5%葡萄糖为溶剂均可。

水解肝肽 2005.11.22

促进蛋白合成、防止白蛋白分解，因而具明显之保肝作用，因而

适合于肝病之治疗。肌注20mg,Qd,静滴100mg,Qd,以5%或10%葡

萄糖为溶剂。

PSA与前列腺病 2005.11.25

常人之PSA主要存在于前列腺分泌之黏液中，精液中之浓度为

0.5～5g/L,是血液中浓度之10万倍。当前列腺发生肿瘤或炎症时，前

列腺中之内容物进入血液，血中PSA上升。PSA之半衰期为2～3天，其

血清浓度在24小时内波动较少，正常血清浓度0.4mg/L以下。

乳腺癌患者之激素受体 2005.11.25

雌二醇和孕酮之水平虽在乳腺癌患者无变化，但二者之受体却

与癌之进退紧密相关。ER(雌二醇受体），PR(孕酮受体），此二者均

为阳性则内分泌治疗之有效率在75%以上；一者阳性则有效率仅

25%～40%；二者均为阴性则有效率为0%,则不需进行内分泌治疗。

所谓内分泌治疗：三苯氧胺、来曲唑之治疗。

儿茶酚胺物质 2005.11.25

CA(儿茶酚胺物质）含一切植物神经之介质，即交感神经介质

肾上腺、去甲肾上腺、多巴胺；副交感神经介质乙酰胆碱、五羟色胺。此类物质在恶性肿瘤时均可见增加，但因其增加属非特异性，故不

可以作为肿瘤标志物。

Rh因子 2005.11.28

汉族人中99%的人Rh因子阳性，1%阴性，因此Rh因子阴性之人

与阳性者之婚配，则可产生Rh阳性之胎儿，胎儿则可产生新生儿黄疸，母体则在头胎后体内形成抗体，下次再孕之胎儿则胎死腹中，一部分母体则可产生溶血性黄疸。Rh因子系附着于血球表面之特殊

抗原因子。

癌前病变与分子生物学 2005.12.7

1.北京肿瘤医院发现胃癌之H-ras突变率为30%～40%,肠化兼

有异型增生之萎缩性胃炎，其H-ras突变率为16%～25%,故而确定萎缩性胃炎合并肠化、异型增生者为癌前病变。H-ras突变是H-ras基因之过量表达，此种过量表达提示细胞之增殖活跃。肿瘤之抗癌基因之缺乏是又一引发癌症之重要原因之一，如p53基因之缺乏和突变则可引起细胞增殖和癌瘤之产生。另外p16也为新发现的一种抑

癌基因，其作用与p53相似。

2.Barretts食管，系指食管正常之复层鳞状上皮被异常之柱状上

皮代替，此时PCNC、p53、p16等出现突变，另外还有Ki67、SI等均与

p53、p16有同样之抑瘤作用。

3.溃疡性结肠炎与克隆氏病，具有很高之癌变风险，此风险与

病变之大小和病变之时间明显相关。上述二病可统称为炎症肠病（IBD).最近实验研究发现IBD患者之肠上皮细胞与常人相比较，有

较高之增殖指数，其抑癌基因p53之突变率较高。

几个小通讯 2005.12.12

1.低睾酮老年易患精神抑郁症。

2.精神分裂症患者易于骨质疏松。

3.o干扰素长期应用，可致精神抑郁。

4.碳酸钙可治疗双向情感障碍之患者。

肝移植免疫抑制金标准 2005.12.12

骁悉（吗替麦考酚酯）+他克莫司+激素（肾上腺皮质酮）是2005

年11月5日成都"肝移植研讨会"确定之金标准。

胃食管反流病（GerD)之药物治疗 2005.12.12

此病西方较多，然而近年亚洲（包括我国在内）发病明显增加。

我国发现病例大多数症状较轻，即非糜烂型食管反流病（NERD),早

期治疗即可预防胃非典型增生和Barretts食管。治疗主要在抗酸、护

膜、促动三方面。

1.抗酸是治疗此病之主要手段，GERD之主要病理产物是胃酸，

抗酸可明显改善症状，前用H受体阻断剂（西咪替丁、雷米替丁），近

来质子泵抑制剂（PPI)上市，因其较H2受体阻断剂制酸作用强，且对

餐后胃酸、夜间胃酸有强大之抑制作用，因而在临床上取得非常显

著之疗效。目前上市之PPI共有五个：奥美拉唑、兰索拉唑、雷贝拉

唑、泮托拉唑、埃索拉唑，奥美拉唑即洛赛克。

2.护膜：硫糖铝、铝碳钙、铝碳镁、螺旋藻，除中和胃酸外，尚可

在胃及食管黏膜上形成一种保护膜。

3.促动：食管及胃动力障碍是本病发生原因之一，因而促动药

物可产生较好之疗效。常用药物多属多巴胺受体抑制剂或五羟色胺

受体激动剂，前者有多潘立酮，后者有莫沙必利。过去常用之甲氧氯

普胺（胃复安）虽然也是多巴胺受体抑制剂，但因其能进入血脑屏

障，引起椎体外系反应，临床已较少用。多潘立酮又名吗叮啉，莫沙

必利又名西沙必利，前者止吐较胃复安强23倍，后者则强100倍。鉴于上述三个方面应用，中医中药在治疗反流性食管、胃病方面应加

强和胃、降逆、止酸三方面。

1.和胃：香砂六君、平胃、叶氏、良附、小丹参。

2.降逆：生赭石、旋覆花、半夏、赤石脂、四逆散、柴胡舒肝散。

3.止酸：生龙牡、乌贼骨、煅瓦楞、明矾、元胡、香附。

肥胖小资料 2005.12.19

标准体重＝（身高－100)×0.9。

体重指数＝体重（kg)/身高（cm）。

美国临床肿瘤学会（ASCO)评出2005年肿瘤临床研究十一大进展 2006.2.9

1.曲妥珠单抗可大大降低HER-2(表皮细胞生长因子受体－2)

阳性之乳腺癌之发病率。此种乳腺癌约占全部乳腺癌之25%～30%,

预后较差，因为HER-2受体表达阳性之患者对放疗、化疗不敏感。

2.术后化疗可提高早期肺癌患者之生存率。术后化疗通常用长

春瑞滨、顺铂，经大样本统计总的生存率为94个月。未进行术后化疗

者总生存率为73个月。

3.术后化疗可降低结肠癌之复发率，奥沙利铂（L-OHP)、5-氟

尿嘧啶（5-FU)、亚叶酸（LV)之联合化疗最好。提出奥沙利铂可能是

结肠癌术后之最佳选药，可使结肠癌之复发减少24%。

4.贝伐单抗可延长晚期肺癌患者之生存期。贝伐单抗是血管内

皮生长因子抑制剂，可通过抑制血管内皮生长抑制肿瘤之生长。

研究证明紫杉醇和卡铂加贝伐单抗可延长NSCLC之生存期，单给

紫杉醇+卡铂之平均生存期为10.2个月，贝伐单抗组则为12.5个

月。

5.贝伐单抗可使结肠癌患者之总生存率提高17%左右。

6.疫苗可有效预防HPV之感染，HPV为宫颈乳头状病毒，引发

宫颈癌之重要因素，其中HPV16、HPV18是与宫颈癌关系最为密切

之两种病毒，另外HPV6、HPV11为此种病毒中之致宫颈癌明显者。

最近研究出之疫苗（HPV)对上述四种病毒均有明显之抑制作用。

7.Lenalidomide可减少骨髓异常增生综合征遗传异常和增生次

数。

8.化疗可改善胃癌患者之生存率，胃癌治疗中，经常对放疗和

化疗产生抵抗力。最近美国有一实验研究表明术前胃癌之化疗可缩小瘤体、增加手术生存率12%,术前化疗之方案：表柔比星、顺铂、5-氟尿嘧啶。

9.替莫唑胺治疗恶性胶质瘤有效。替莫唑胺加放疗可延长恶性

胶质瘤患者之生命。鉴于恶性胶质瘤具高度耐药，因此，此药之出现

具重大意义。

10. 40岁以下人群之皮肤癌发病率增高。

11.很多肿瘤患儿成年后存在明显健康问题。由于肿瘤治疗学

之进展，带瘤生存之患儿成年后存在健康问题多于非肿瘤患儿之5

倍。

2005年国际国内十大医学新闻 2006.2.12

1.人禽流感取得新进展。

2.药物临床实验结果公开化。2006年1月6日全球制药公司签署

自愿协议，同意将其全部药物，包括已上市药物和未上市药物之临

床实验结果在互联网上公开发表，如有论文发表，则需公开其论文。

3.非甾体止痛药（NSAID)心血管安全性受到置疑。环氧合酶

（COX-2)抑制剂：消炎痛、炎痛喜康、布洛芬、芬必得、塞来昔布、洛

非昔布等对心血管系统之危害性曾长期受到置疑，后来美国FDA曾

同意此说，但认为该类药物尚可在市场上应用。

4.病毒被首次列入致癌物质。2006年1月31日，美国卫生与人类

服务部公布致癌物质报告，第一次列病毒于其中。

5.抗生素不能预防冠脉事件。由于肺炎衣原体参与了动脉粥样

硬化，美国两项大型循证医学报告研究了可根除肺炎衣原体之抗菌

素能否预防冠脉事件，结果"否"。

6.首例活体胰岛移植在日本京都大学医学院获得成功。

7.低剂量电离辐射有致癌危险。

8.幽门螺杆菌发现者获本年度诺贝尔医学奖。

9.人类基因"差异图"公布。

10.韩国科学家黄禹锡论文造假事件。他宣布用11个皮肤细胞

之核植人供体卵子细胞内，通过体外干细胞培养，培育出人类干细

胞11个。

肝硬化之国际分级 2006.2.17

肝病评分模型（MELD)和CTP分级，是肝移植前对肝硬化患者

预后评估之国际方法。尤其是CTP分级被广泛应用于肝硬化患者之

术前评估。

淤胆型肝硬化 2006.2.17

淤胆型肝硬化（DSC)是一种自身免疫性肝病，目前尚无理想疗

法。曾建议用鹅去氧胆酸治疗，挪威学者发表实验报告认为无效。

派罗欣治疗乙型肝炎之结论 2006.2.20

治疗6个月时，对派罗欣产生应答之患者，可继续观察6～12月以

产生最终疗效。此种应答之具体指标是ALT低水平和DNA无复制。

另外HBeAg定量检测可预测派罗欣治疗能否产生持续性应答。

派罗欣治疗丙肝之临床研究 2006.2.20

首先应确知派罗欣是聚乙二醇化干扰素a-2a(40KD),而非聚

乙二醇化干扰素o-2b(12KD)(佩乐能）。由于后者联合利巴韦林治

疗丙肝约有50%不产生应答，因此人们把这部分丙肝称之为难治性

丙肝。对难治性丙肝，最近用派罗欣（聚乙二醇化干扰素a-2a)

（40KD)治疗产生了较好之疗效，其方案仍然是派罗欣与利巴韦林相

结合之联合治疗方案。这一方案中随着患者之体重增加，加大利巴

韦林之剂量能提高丙肝患者之病毒学应答率（SVR),特别对难治性 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: Gene 1 type patients; the efficacy of treatment for Gene 2 or 3 type patients over 24 weeks versus 48 weeks is similar.

Similarly, ribavirin at 1400 mg is safe for patients weighing 105 kg. From this, it can be inferred that

for adults weighing around 65 kg, a daily dose of ribavirin of 900 mg is appropriate, i.e., 300 mg, three times a day, by mouth.

Previously, Virazole was administered in 50 mg tablets; now, Virazole is available in 100 mg tablets.

Benazepril can effectively treat chronic renal insufficiency – February 27, 2006

The renoprotective effects of angiotensin-converting enzyme inhibitors are particularly evident in mild cases of renal insufficiency.

Diagnosis and Treatment of Chronic Cough – March 3, 2006

Clinical cough lasting more than 8 weeks, without obvious lung lesions on examination, is generally referred to as chronic cough. Because there are no significant lung lesions, such coughs are often misdiagnosed as chronic bronchitis. Due to unclear diagnoses, doctors frequently prescribe antibiotics repeatedly, which not only wastes substantial medical resources but also delays treatment and leads to adverse outcomes. Japan and Western Europe have conducted systematic research on chronic cough and developed diagnostic and treatment guidelines for this condition. The Respiratory Society of the Chinese Medical Association has also formulated diagnostic and treatment guidelines for chronic cough, drawing inspiration from international guidelines and the latest advances in the field. Generally speaking, the common causes of chronic cough include postnasal drip syndrome, variant asthma, and gastroesophageal reflux. These three types of causes (or conditions) are designated as PNDS, CVA, and GER.EB is the code for eosinophilic bronchitis. Postnasal drip syndrome refers to chronic cough caused by chronic pharyngitis, chronic rhinitis, and chronic laryngitis; variant asthma is triggered by an increase in eosinophils, leading to EB. These three types of cough account for 70%–95% of all chronic cough cases seen in outpatient clinics.

Fengyin Tang for Peripheral Nerve Disorders – March 1, 2006

According to the Jin Gui: “In cases of stroke with intermittent episodes, use Fengyin Tang to clear heat and treat boils.” Ingredients include 20 g of Han Shui Shi, 20 g of Sheng Gou Shi, 20 g of Zi Shi Ying, 10 g of Hua Shi, 20 g of Sheng Long Mu, 6 g of Da Huang, 6 g of Gan Jiang, 10 g of Gui Zhi, 10 g of Niu Xi, 20 g of Mu Gua, 10 g of Qin Tiao, 10 g of Wei Ling Xian, 12 g of Sheng Di, and 12 g of Dang Gui. Mr. Lan Yi Qing of Liaoning used modifications to the Jin Gui formula and pioneered its application in treating polyneuritis, achieving remarkable therapeutic results. Lan’s approach included using Bai Zhi, Chuan Xiong, Xi Xin, San Chong, Ji Xue Teng, and Guo Sui Bu, which were all found to be effective in treating this condition.

Functional Dyspepsia (FD) – March 8, 2006

Gastrointestinal disorders can generally be categorized into two groups: organic lesions and functional dyspepsia. Organic disorders are characterized by specific lesions, such as gastric ulcers or duodenal bulb ulcers, whereas functional dyspepsia involves disruptions in the autonomic nervous system and endocrine functions of the gastrointestinal tract. This type of disorder accounts for a large proportion of outpatient visits and has a high incidence rate. In the United States, the diagnosis of functional dyspepsia typically relies on exclusionary tests such as gastroscopy, imaging studies, ultrasound, and Helicobacter pylori testing. Clinical manifestations of functional dyspepsia include heartburn and acid reflux, which are the primary symptoms; abdominal distension, constipation, and loss of appetite are secondary symptoms.

Warning signs include: ① patients who develop the condition before the age of 55; ② a family history of upper gastrointestinal tumors; ③ unexplained weight loss; ④ gastrointestinal bleeding; ⑤ progressive difficulty swallowing; ⑥ pain during swallowing; ⑦ iron-deficiency anemia of unknown cause; ⑧ vomiting; ⑨ palpable abdominal masses; ⑩ jaundice and superficial lymph node enlargement. Warning signs indicate that, in addition to functional dyspepsia, organic or space-occupying lesions may arise.

New Guidelines for the Diagnosis and Treatment of Helicobacter pylori – March 12, 2006

Previous guidelines focused on chronic gastrointestinal inflammation, such as chronic atrophic gastritis, peptic ulcers, early-stage gastric cancer, and malignant lymphoma; additionally, they addressed coronary heart disease, rheumatoid arthritis, and other conditions. The new guidelines emphasize primary thrombocytopenic purpura and iron-deficiency anemia, highlighting their importance in the treatment of these diseases. Currently, the standard treatments for eradication of Helicobacter pylori include lansoprazole, amoxicillin, clarithromycin, and metronidazole.

Acute Coronary Syndrome – March 15, 2006

1. Objectives: ① Reduce myocardial infarction volume, maintain left ventricular function, and prevent and treat heart failure; ② Promote myocardial blood circulation and stabilize myocardial regeneration; ③ Reduce the occurrence of complications.

2. Methods: ① Thrombolysis; ② Anticoagulation; ③ Anti-inflammatory therapy; ④ ABC regimen: aspirin, beta-blockers, bisoprolol, carvedilol, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers.

Helicobacter pylori – March 18, 2006

In 1983, Australians Marshall and Warren officially published their experimental report on Helicobacter pylori, ushering in a new era in microbiology. In 1665, British scientist Robert Hooke observed the structure of cork chips through a homemade 100x magnifying glass, discovering cells and introducing the new concept of “cell”; around the same time, Dutch scientist Antonie van Leeuwenhoek used a homemade 270x magnifying glass to observe human bones and skeletal muscle cells, making detailed records of their morphology. In the early 19th century, German pathologist Rudolf Virchow predicted that cells are the fundamental units of the human body. In the 1930s, two German pathologists, Schleiden and Schwann, conducted detailed observations of cell structure, discovering cell membranes, cell nuclei, mitochondria, and other components—laying the groundwork for the groundbreaking work of German pathologist Albert von Karcher in the late 19th century. Von Karcher’s cell pathology became a milestone in the development of Western medicine, as he believed that the body is composed of cells, and all diseases originate from pathological processes within cells. He established the world’s most advanced pathological diagnostic methods at the time, inventing the original pathological slide-making machine and pioneering pathological reports. In the late 19th century, American physician Charles Lister, French scientist Louis Pasteur, and German scientist Friedrich Hoffmann, along with his students, made tremendous contributions to microbiology, forming microbiology as a complete discipline. In the early 20th century, in 1929, British scientist Alexander Fleming first invented penicillin, opening a new era in Western medicine where pathogens could be effectively eliminated. Since then, antibiotic research flourished like mushrooms after a spring rain—from the introduction of sulfonamides to the emergence of macrolides, aminoglycosides, quinolones, and cephalosporins. In the 1970s, following the launch of cephalosporins, the first generation of cephalosporins—such as cefotaxime sodium (Cepin 1) and second-generation cephalosporins like cefalexin sodium (Cepin 4) and cefazolin sodium (Cepin 5)—were introduced. Shortly thereafter, in the 1980s, four cephalosporin classes—ceftriaxone, cefoperazone, cefixime, and cefotaxime sodium—were launched, marking the third generation of cephalosporins. In the early 21st century, the fourth generation of cephalosporins arrived, with Moxifloxacin being the first to be released. However, due to its high cost, this drug has yet to become widely adopted domestically. In summary, cephalosporin generations have continuously evolved, with increasing efficacy, broader antibacterial spectra, and some drugs capable of crossing the blood-brain barrier while causing minimal damage to kidney function. The advancement of these antibacterial drugs has been driven by the ongoing evolution of bacterial resistance. In 1983, Australians Marshall and Warren discovered Helicobacter pylori on human gastric mucosa, initially naming it “Helicobacter pylori,” but later realized that this bacterium was the root cause of all gastrointestinal diseases, closely associated with gastric ulcers, duodenal bulb ulcers, chronic gastritis, and ulcerative colitis. Recently, the World Health Organization convened multiple meetings to discuss the pathogenic mechanisms and prevention strategies for Helicobacter pylori, and formulated guidelines for its control and treatment. Additional guidelines have been proposed recently. In conclusion, the discovery of Helicobacter pylori represents a major breakthrough in modern medicine, comparable in significance to Alexander Fleming’s invention of penicillin in 1929 and to Louis Pasteur’s discovery of the hepatitis B virus in 1963. As such, in 2005, the Nobel Prize was awarded to Marshall and Warren for their discovery of Helicobacter pylori.

A Good Formula for Treating Hypertension-Related Retinal Disease – April 7, 2006

In the second month of the Year of Bing Xu, an elderly woman came to my clinic carrying a prescription she had received from me. She said this formula was miraculously effective for eye ailments, having cured her eye problems with over 20 doses of the formula 22 years ago. I examined the prescription and realized it was the same formula I had prescribed for her back in 1982: 15 g of Sheng Di, 15 g of Sheng Jue Shi, 15 g of Huai Niuxi, 12 g of Ju Hua, 6 g of Huang Lian, 12 g of Qing Xiang Zi, 15 g of Cao Jue Ming, 12 g of Bai Shao, 15 g of Dan Shen, 15 g of Gua Lou, 9 g of Xiang Fu, and 6 g of Mu Xiang.

The composition of this formula can be considered a combination of Zhen Gan Xi Feng Tang and Qing Cao Huang Hua Tang: Sheng Di, Sheng Jue Shi, Huai Niuxi, and Sheng Bai Shao are ingredients of Zhen Gan Xi Feng Tang; Qing Xiang Zi, Cao Jue Ming, Huang Lian, and Ju Hua are ingredients of Qing Cao Huang Hua Tang. The former helps lower blood pressure, while the latter improves eyesight. Dan Shen and Gua Lou help protect the heart, while Xiang Fu and Mu Xiang support the stomach. This formula is particularly effective for treating age-related arterial sclerosis-induced eye diseases, which can often be cured. The formula’s mnemonic is: “Qing Cao Huang Hua, Zhen Gan Xi Feng, Xiang Fu, Mu Xiang.”

Chemotherapy for Non-Small Cell Lung Cancer – April 7, 2006

Recently, the U.S. government released data showing that cancer incidence and mortality rates have declined significantly compared to previous years—due to two key factors: early detection and widespread screening efforts, as well as timely chemotherapy. Beyond the traditional AP and NP regimens, non-small cell lung cancer (NSCLC) treatment has seen the emergence of the GP regimen, namely the gemcitabine/platinum-based regimen. Gemcitabine: 200 mg of gemcitabine (GH) is administered once weekly, with a total dose of 1000 mg added to normal saline, repeating every week for a 3-week cycle. Non-small cell lung cancer is classified into squamous cell carcinoma and non-squamous cell carcinoma; non-squamous cell carcinoma is treated with paclitaxel/cisplatin combined with monoclonal antibodies, offering superior outcomes compared to other options.

Currently, another promising drug, Ribotex, has emerged—similar to docetaxel, though it carries a higher toxicity profile than docetaxel. For small cell lung cancer, chemotherapy options include COAP, COMP, and VP-16, administered at 100 mg per square meter via intravenous infusion, starting on day 1–3, with methotrexate at 10 mg via intravenous injection twice weekly.

Heart Failure Revisited – February 10, 2006

Heart failure can be divided into two categories: ischemic heart failure and non-ischemic heart failure. Ischemic heart failure refers to coronary artery disease, while non-ischemic heart failure encompasses all heart failures occurring outside of coronary artery disease. CRT (Cardiac Resynchronization Therapy) is a form of cardiac resynchronization therapy that not only significantly improves heart failure symptoms but also reverses left ventricular remodeling in patients with heart failure—particularly in non-ischemic heart failure, where the degree of reversal is better than in iron-deficiency heart failure. What exactly is cardiac resynchronization therapy? This therapy is a non-pharmacological treatment for heart failure, involving interventional procedures—often performed via open-heart surgery or percutaneous intervention, aiming to reconstruct coronary bypass grafts. Recent evidence-based studies have shown that this treatment is indicated for approximately 30% of heart failure patients.

A Few Key Facts – April 10, 2006

1. Statins are beneficial for patients with chronic kidney disease.
2. Methotrexate is beneficial for chronic heart failure.
3. Diuretics can reduce mortality in patients with chronic heart failure.

Review of Chemotherapy – April 12, 2006

Since the birth of the first chemotherapeutic drug, nitrogen mustard (HN2), in the 1920s, chemotherapy has evolved into a distinct system for treating tumors, thanks to the advent of cyclophosphamide (CTX) in the 1940s. To understand the mechanisms of chemotherapy, we must first examine the properties of drugs and their relationship to the cell cycle. The cell cycle consists of M phase and S phase: M phase lasts 1–2 hours, while S phase lasts 1–2 days (2–30 hours). Before S phase, there is G1 phase, and after S phase, there is G2 phase—both phases are extremely short, often lasting only a few minutes or seconds. After M phase comes G phase, which is the longest phase, sometimes lasting several days or even years, though it can also be as brief as a few minutes or seconds. Common chemotherapy drugs fall into three broad categories: non-specific cytotoxic agents, antimicrobials, and platinum-based drugs. These drugs act at any stage of the cell cycle, even during G0 phase. Alkaloids—such as vincristine, vinblastine, VP-16, and colchicine—act during M phase; cytarabine, 5-FU, MTX, and GMP act during S phase. Given the short duration of M phase, when developing chemotherapy regimens, single M phase drugs alone cannot handle the task alone; they must be used in combination with non-specific drugs, while S phase drugs can be used individually when appropriate.

Targeted therapies, beginning in the 21st century, opened up new frontiers in cancer treatment. Unlike previous cytotoxic drugs, these therapies aim to disrupt the growth, development, and division of tumor cells.

Clinical Significance of ALT and AST – April 24, 2006

ALT stands for alanine aminotransferase, while AST stands for aspartate aminotransferase (or aspartate transaminase). When liver function is impaired, both enzymes can rise. Because ALT granules are larger and AST granules are smaller, AST is released more easily from the serum, while ALT is released more slowly from the serum. Therefore, the typical ratio of AST to ALT in human serum is around 1.15, meaning that ALT levels are slightly lower than AST levels. During acute liver injury, late-stage liver cancer, or hepatic necrosis, AST levels increase, resulting in a higher ratio; in chronic liver disease, ALT levels rise, but the ratio decreases.

mAST, the aspartate transaminase, shares the same significance as AST, but because this enzyme is tightly bound to the mitochondria, it is less likely to be released. Only when extensive cellular necrosis occurs and the condition worsens does this enzyme begin to be released, at which point the disease tends to progress to a more advanced stage.

Bristol-Myers Squibb Oncology Forum – April 24, 2006

The forum was held in March 2006 at the Hong Kong & Macao Center in Beijing, focusing on non-small cell lung cancer and breast cancer. Professors Rubert and Calson from Stanford University in the United States delivered presentations titled “First-Line Treatment for Advanced Non-Small Cell Lung Cancer” and “Systemic Treatment for Early Breast Cancer,” respectively.

1. Breast Cancer: CTX 500 mg, days 1, 8; MTX 20 mg, days 1, 8; 5-FU 500 mg, days 1, 8. Since the 1990s, paclitaxel has emerged, leading to sequential therapies combining paclitaxel (Taxol) with EC therapy (doxorubicin and cyclophosphamide), which reduced the risk of complications by 17% compared to AC monotherapy. Some patients used EFC (doxorubicin + 5-FU + cyclophosphamide) in combination with Taxol; compared to pure EFC, the risk of complications decreased by 57%.

2. Non-Small Cell Lung Cancer: APC (adriamycin) 30 mg, once every 3 weeks; cisplatin 20 mg, days 1–3; cyclophosphamide 800 mg, days 1–3. NP regimens (vincristine and carboplatin), GP regimens (gemcitabine and oxaliplatin); gemcitabine was also used in the case of gemcitabine.

Chemotherapy Regimens for Rectal Cancer – April 25, 2006

The most commonly used regimen currently is OFC (oxaliplatin 100 mg, once every 3 weeks; 5-FU 500 mg, days 1–5; calcium folinate 100 mg, days 1–5).

Latest Advances in Liver Disease Treatment – April 28, 2006

1. Hepatitis B: The introduction of pegylated interferon alpha-2a, lamivudine, adefovir, and entecavir has opened up new prospects. ① PEG-IFN-alpha-2a, 180 µg, for 48 weeks, resulted in an HBeAg seroconversion rate of 32%. ② Adefovir, 10 mg, for 96 weeks, showed an HBeAg seroconversion rate of 71%, and by 144 weeks, 79% of patients had achieved HBeAg seroconversion. However, after 144 weeks, 5.9% of patients were found to have developed drug-resistant mutations. ③ Entecavir, 5 mg, showed a DNA seroconversion rate of 69% by 48 weeks, with histological seroconversion rates reaching 30% among HBeAg-negative patients. In 2005, the Asia-Pacific Association for the Study of the Liver issued a consensus statement emphasizing the importance of antiviral therapy for hepatitis B, and the Chinese Medical Association’s Liver Disease Society also published guidelines for the diagnosis and treatment of hepatitis B in 2005, highlighting the critical role of antiviral therapy.

2. Hepatitis C: Pegylated interferon combined with ribavirin remains the standard treatment option currently recognized by many experts. Some reports suggest that oral protease inhibitors like Scn503034 have shown good efficacy, though they have not yet been approved for market release.

3. Liver Fibrosis and Cirrhosis: French scholars have proposed using transient elastography—a non-invasive ultrasound technique—to detect liver fibrosis and cirrhosis. In terms of treatment, some researchers have suggested performing intrahepatic portal vein shunt surgery via arteries and veins. These two treatment techniques are currently still in the trial phase.

4. Acute Liver Failure: There is now a general consensus that patients with pre-existing liver cirrhosis may experience worsening liver function within 26 weeks, leading to bleeding or altered mental status—these patients can be diagnosed with “acute liver failure.” It is worth noting that patients with hepatolenticular degeneration or autoimmune hepatitis who exhibit the aforementioned symptoms within 26 weeks can also be diagnosed with “acute liver failure.” This differs somewhat from the diagnostic criteria set forth by China’s Liver Disease Society in 2000.

5. Primary Liver Cancer (HCC): nodules smaller than 1 cm should be given particular attention; nodules between 1–2 cm in diameter, especially those affecting patients with hepatitis B or C, require close monitoring; nodules larger than 2 cm in diameter, particularly those with positive AFP levels, should be treated as liver cancer. For nodules smaller than 2 cm, alternative treatments such as water-based alcohol injections or radiofrequency ablation may be recommended, while microwave cryotherapy is also an option. Surgical treatment remains one of the most impactful treatment approaches available today.

6. Liver transplantation is the ultimate treatment for end-stage liver disease, and China has seen rapid advancements in this field over recent years.

Ten Years of Experience Summary – May 8, 2006