June 13, 2013: Surgical Treatment for Obesity and Type 2 Diabetes Mellitus

The main clinical manifestations of these endocrine tumors include: ① hypertension, sympathetic crisis, parasympathetic crisis. ② increased calcitonin, decreased blood calcium, decalcification. ③ refractory gastrointestinal ulcers, bleeding, perforation. ④ headache, dizziness, fatigue, profuse sweating, tremors, disorientation, confusion, epilepsy. ⑤ watery diarrhea, hypotension, abdominal pain. ⑥ glossitis, stomatitis. ⑦ weight loss, diarrhea, gallstones. ⑧ compression symptoms, jaundice, obstruction, pancreatitis.

June 13, 2013: Surgical Treatment for Obesity and Type 2 Diabetes Mellitus

At the recently held China Diabetes and Obesity Surgery Treatment Summit Forum, expert consensus on this surgical procedure was announced.

1. Indications Type 2 diabetes mellitus with a disease course of ≥15 years. ② Obesity index >27.5 kg/m². ③ Age between 18–45 years. ④ Pancreatic reserve function at least half of the normal lower limit. ⑤ C-peptide ≥ half of the normal lower limit.

2. Surgical method: Gastric anastomosis between the jejunum and the cardia, with free suturing from the duodenal stump.

June 13, 2013: Further Discussion on Osteoporosis

Osteoporosis and rheumatic diseases (rheumatoid arthritis, rheumatoid joint inflammation, ankylosing spondylitis) are closely related. Patients with rheumatic diseases often suffer from osteoporosis, which is closely linked to the activity level of the disease, the duration and dosage of glucocorticoid use, and whether or not vitamin D is deficient. Currently, the most commonly used anti-osteoporosis preparation in clinical practice is calcitriol. If calcium supplements are used in conjunction with this agent, the effect can be doubled.

June 18, 2013: Pangolin Paste for Treating Neck Masses

Pangolin 30g, Cicada slough 10g, Fish bladder 30g, Processed frankincense and processed myrrh each 20g, Wolf poison 5g, Earthworm 20g, Gallnuts 30g, Centipedes 10, Radix et Rhizoma rehmanniae 30g, Euphorbia pekinensis 20g, Dragon’s blood 15g, Thoroughly penetrating herb 30g, Prunella vulgaris 30g, Sappan wood 30g, Green wind vine 30g, Camphor 1g. All ingredients are ground into powder, sifted, then mixed with 500g of aged vinegar and boiled until it turns into a black paste, which is then applied externally. This formula is an external ointment specifically for treating cervical lymph node cysts, cervical lymph node tuberculosis, and thyroid masses.

June 19, 2013: Formula for Lowering Erythrocyte Sedimentation Rate

Ephedra sinica 10g, Apricot kernel 10g, Coix lacryma-jobi 30g, Gui Zhi 10g, Paeonia lactiflora 20g, Anemarrhena asphodeloides 20g, Glycyrrhiza 6g, Aconitum carmichaelii and Aconitum kusnezoffii each 15g (pre-decocted), Liaoning Asarum 10g (pre-decocted), Semen stramonii 1 piece (fried), Tripterygium wilfordii 20g (pre-decocted), Raw gypsum 60g, Japonica rice 30g, Coptis chinensis 4g, Scutellaria baicalensis 10g, Phellodendron amurense 4g, Gardenia jasminoides 10g, Ginseng 15g, Prince ginseng 15g, Codonopsis pilosula 15g, North sand ginseng 15g, Rehmannia glutinosa 12g, Cornus officinalis 30g, Ginger 6g, Four Dates 4 pieces.

This formula includes Gui Zhi-Paeonia-Anemarrhena-Tongzhi Soup, Ginseng White Tiger Soup, Coptis Detox Soup, Lan He, Ma-Xing-Yi-Gan Soup, integrating wind-dispelling, fire-purging, qi-tonifying, and yin-nourishing effects in one. Accelerated erythrocyte sedimentation is usually caused by excessive internal fire, wind-fire interaction, qi-yin deficiency, and qi-stagnation-blood-stasis. This formula addresses all four issues simultaneously, making it suitable for clinical trials.

June 20, 2013: A Reassessment of High Erythrocyte Sedimentation Rate

Erythrocyte sedimentation rate is an early-used laboratory indicator. When the buoyancy of blood cells in plasma decreases, the sedimentation rate accelerates. What causes the decrease in buoyancy? Increased globulin, fibrinogen, and blood viscosity, along with decreased albumin and increased aggregation of red blood cells—all are contributing factors. Autoimmune disease antigen-antibody complexes can increase globulin and decrease albumin, as well as increase red blood cell aggregation. Due to the heavier mass of aggregated red blood cells sinking, plasma buoyancy and blood viscosity increase, accelerating sedimentation. Infections, tuberculosis, and tumors all have certain immune responses, so sedimentation rates also increase somewhat, but not as markedly as in autoimmune diseases.

Autoimmune diseases often present with persistent high fever, joint pain, skin ecchymosis, fluid accumulation, and liver damage—clinical manifestations that can be summarized as fire, wind, dampness, toxin, deficiency, and stasis. Based on fifty years of clinical experience, I formulated the “Sedimentation Reduction No. 2” formula to lower ESR. The formula includes Ma-Xing-Yi-Gan Soup and Gui Zhi-Paeonia-Anemarrhena-Tongzhi Soup to dispel wind and dampness; White Tiger Soup to clear heat and purge fire; Coptis Detox Soup to purge fire and detoxify; Tuoli Tou Nong San to search out and expel toxins; and Yanghe Tang to resolve exterior symptoms and drain pus.

Sedimentation Reduction No. 2: Gui Zhi 10g, Paeonia lactiflora 10g, Anemarrhena asphodeloides 20g, Glycyrrhiza 6g, Dry ginger 6g, Ledebouria socialis 12g, Ephedra sinica 10g, Atractylodes macrocephala 10g, Aconitum carmichaelii and Aconitum kusnezoffii each 15g (pre-decocted), Tripterygium wilfordii 15g (pre-decocted), Liaoning Asarum 15g (pre-decocted), Apricot kernel 10g, Coix lacryma-jobi 30g, Raw gypsum 60g, Coptis chinensis 6g, Scutellaria baicalensis 10g, Phellodendron amurense 10g, Astragalus membranaceus 30g, Angelica sinensis 10g, Turtle shell 15g, Soapberry thorn 15g, Processed frankincense 10g, Processed myrrh 10g, White mustard seed 10g, Deer antler glue 10g, Rehmannia glutinosa 12g, Cinnamon 3g, Ginger 6g, Four Dates 4 pieces. One dose daily, decocted in water and taken orally.

June 21, 2013: Alzheimer’s Disease (AD) and Vascular Dementia (VD)

Alzheimer’s Disease (AD) and Vascular Dementia (VD) are common diseases among the elderly. AD, also known as senile dementia, shares similar clinical manifestations with vascular dementia—impairment of memory, cognition, behavior, and language—but AD progresses more rapidly and prominently, whereas VD develops gradually and intermittently.

The exact cause of senile dementia remains unclear, and treatment outcomes are poor. At the recent Global Alzheimer’s Surgery Forum held in Beijing, experts recommended using memantine 20 mg once daily to treat this condition.

The cause of vascular dementia is cerebral arteriosclerosis, brain atrophy, and cerebral infarction, and treatment focuses on lowering blood pressure, lipids, sugar, and uric acid. Recently introduced cytidine diphosphate choline, nervonic acid, and melatonin can be used in conjunction with the above medications; deep-sea fish oil, panaxatriene, rutin, and olive oil can also be used as appropriate.

June 29, 2013: Tumor Suppressor Genes

BRCA1 and BRCA2 are two tumor suppressor genes. When these genes mutate, cancer develops. Current experimental research shows that when BRCA1 mutates, the incidence of breast cancer reaches 50%–80%, and all cases are triple-negative breast cancer; when BRCA2 mutates, the incidence of breast cancer can also reach 60%–80%.

Other known tumor suppressor genes include P56, P16, P19, Ki67, and S1. When these genes mutate, they lose their tumor-suppressive properties, leading to cancer development or providing a foundation for cancer occurrence. Additionally, studies show that breast cancer-related genes BRCA1 and BRCA2, as well as esophageal cancer-related gene c-myc, all provide a foundation for cancer development.

June 30, 2013: Characteristics of Leukorrhea in Gynecological Diseases

1. Trichomonas vaginalis infection: leukorrhea is foamy, white, yellow, or gray, accompanied by vulvar itching.

2. Candidiasis vaginalis infection: leukorrhea is curd-like, with unbearable vulvar and vaginal itching and pain.

3. Bacterial vaginosis: leukorrhea is grayish-white, uniform, thin, and low-viscosity.

July 2, 2013: Selected Extracts from “Shanghan Lun”

“The disease of Jueyin is characterized by thirst, rising qi hitting the heart, burning sensation in the heart, hunger but no desire to eat, vomiting worms after eating. Diarrhea persists even after purgation.”

“The disease of Taoyin is characterized by abdominal distension and vomiting, inability to eat, worsening diarrhea, and occasional abdominal pain. If purgation is performed, hard masses will definitely form under the chest.”

“The disease of Shaoyin is characterized by a weak and fine pulse, with a strong desire to sleep.”

These passages indicate that Shaoyin represents heart-kidney deficiency-cold syndrome, also known as systemic deficiency-cold syndrome; Taoyin represents spleen-stomach deficiency-cold syndrome; and Jueyin represents mixed cold-heat syndrome. Lu Yuanlei said: Since Taoyin is spleen-stomach deficiency-cold syndrome and Shaoyin is systemic deficiency-cold syndrome, there is no other type of deficiency-cold syndrome. Therefore, only Jueyin can truly be considered a mystery throughout history.

July 5, 2013: Biological Therapy

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Biological therapy, also known as immunotherapy, has garnered attention from scholars since the 21st century. The "Huangdi Neijing" records: "When righteous qi resides within, evil cannot invade," and "Where evil gathers, qi must be deficient." The "Yizong Baidu" states: "What accumulates is due to deficiency of righteous qi, allowing evil qi to take hold." These passages all indicate that there exists a kind of righteous qi in the human body that protects it. Therefore, Traditional Chinese Medicine employs methods of reinforcing righteous qi and consolidating the root to achieve remarkable therapeutic effects in treating tumors. Forty years ago, I cured a leukemia patient named Ma by using a method of greatly tonifying middle qi and nourishing kidney qi, which made me well-known in the medical community. Later generations named the principal formula for treating this case of leukemia the "Lanzhou Formula." I subsequently used this formula, with modifications, to treat esophageal cancer, gastric cancer, liver cancer, leukemia, myelodysplastic syndrome, and other conditions, all achieving good results. Biological therapy, inspired by the TCM approach of reinforcing righteous qi to cure cancer, involves culturing immune cells outside the body and then infusing them into tumor patients to treat the disease.

The cells commonly used in biological therapy include: ① DC cells (dendritic cells): initiate immune responses and induce immune memory. ② CIK cells: kill tumor cells. ③ NK cells (natural killer cells): widely recognized as the first line of natural defense against infection and tumors. ④ γδT cells: T cells in the human body are divided into αβT cells and γδT cells, both of which have immune effects. However, because γδT cells can mediate non-specific cytotoxicity against tumor cells, promote specific anti-tumor responses, directly kill tumor cells, exhibit keen antigen recognition, and are easily expanded in vitro, current scholars consider them the most promising biological therapeutic agents. ⑤ CD3AK cells: cytotoxic cells activated by CD3 monoclonal antibodies. CD4 are helper cells, CD8 are suppressor cells, and a CD4/CD8 ratio of 1.2/2.5 is considered normal.

July 7, 2013: Ovulatory bleeding

Ovulatory uterine bleeding in women is a clinical manifestation of menstrual irregularities, essentially caused by low estrogen levels. In Traditional Chinese Medicine, it is believed that qi deficiency cannot control blood, and the traditional main treatment formula is Guipi Tang. I treat it with the following prescription.

Dang Gui 10g, Shan Zha 10g, Mu Xiang 3g, Xiang Fu 6g, Hong Hua 3g, Ze Lan 10g, Qing Pi 6g, Wu Yao 10g, San Leng 10g, E Zhu 10g, Zhi Mu 20g, Ji Nei Jin 20g, Tian Hua Fen 10g, Chen Cui 20g (to be taken in divided doses), Dang Shen 10g, Bai Zhu 10g, Huang Qi 30g.

A patient with functional uterine bleeding during ovulation took this formula for 10 doses, and the bleeding stopped immediately. Follow-up observation showed no recurrence of bleeding.

July 7, 2013: Three prescriptions for liver disease

1. Dan II Core + Strong Core, suitable for liver diseases (hepatitis A, B, and C) combined with cholecystitis.

2. Yi Gui Tong Yuan + Strong Core, suitable for liver disease patients with yin deficiency symptoms.

3. Dan Zhi Xiao Yao Shen Golden, Zhi Ke Mu Xiang plus Yin Chen, with heat—three yellow herbs must be used; lipid-lowering compound is as precious as gold. Suitable for cholestatic hepatitis.

July 8, 2013: Liver-soothing and wind-calming medicines

Gastrodia elata is the chief agent for soothing the liver and calming wind; dizziness, numbness, and convulsions are the main symptoms of wind. Shijue Ming and Bai Zili follow closely behind, with effects similar to Gastrodia elata. Jiang Can, Quan Xie, and Wu Gong also belong to this category, but their efficacy in treating numbness and convulsions is greater than that for dizziness. Only wind-calming medicines can reach the top of the head. All of the above liver-soothing and wind-calming medicines have the effect of treating convulsions. For headaches and convulsions, I use Qing Shang Juan Tong Tang, Xue Fu Zhu Yu Tang, and Xiong Shi San Pian Tang, adding Gastrodia elata, Shijue Ming, Bai Zili, Jiang Can, Quan Xie, and Wu Gong to enhance the therapeutic effect.

July 8, 2013: More on sore throat

I usually treat chronic pharyngitis combined with tonsillitis with Yang Yin Qing Fei Tang plus oyster shell instead of gold, increasing fluid to regulate three worms; if accompanied by cough, add Zhi Sou San. Jiang Can, Quan Xie, and Wu Gong, besides calming wind and stopping spasms, also have the effect of clearing heat and detoxifying, so they still treat pharyngitis. My father often used Ma Bo and She Pi, which also aligns with this principle. Ma Bo clears heat and detoxifies, while She Pi calms wind and relieves spasms. Ancient people said, "The throat is three parts sensitive," because sore throat is a combination of wind and heat. Heat also damages yin, so we use Sheng Di Huang, Xuan Shen, and Mai Dong to nourish yin and increase fluids. Jie Geng clears the throat, while Bai Shao nourishes yin.

July 15, 2013: A discussion on epigastric pain

Traditional Chinese Medicine has accumulated a large number of effective formulas and medicines for treating the stomach, so its efficacy is slightly better than Western medicine. Western medicine treats the stomach with four methods: acid suppression, spasmolysis, promoting gastric emptying, and aiding digestion. ① Acid-suppressing drugs: soda was used early on, and now there are cimetidine, ranitidine, and omeprazole. ② Spasmolytics: belladonna was used early on, and recently atropine and scopolamine are also used. ③ Prokinetic drugs: metoclopramide and domperidone. ④ Digestive aids: yeast tablets and multi-enzyme tablets.

Traditional Chinese Medicine offers diverse treatment methods with varied efficacies. When experiencing discomfort in the epigastric region, I often use Xiang Sha Liu Jun Zi Tang, Ye Shi Yang Wei Tang, and Ping Wei San; if the tongue is red with little coating, use Ye Shi Yang Wei Tang; if appetite is poor and the coating is thick, use Ban Xia Xie Xin; for abdominal distension, add "Xiang Fu Liang Jiang Ban Zhi Sha"; for pain, add "Wu Wu Pu Huang Rou"; for pain in both ribs, add "Dan He"; for shortness of breath and weakness, add "Lan He". Pain located on the left side is related to the liver, on the right side to the gallbladder, not to the heart; if it's two or three fingers above the navel, it's the stomach—this should be known.

July 22, 2013: Huang Lian A Jiao Tang and Ku Jiu Tang

1. Huang Lian A Jiao Tang Huang Lian 6g, Huang Qin 10g, Bai Shao 10g, A Jiao 10g (melted), one egg yolk (remove the white). Boil the first three herbs twice, extract 500mL of juice, add A Jiao and egg yolk while hot, take in two doses after breakfast and dinner. For fever and restlessness due to cold damage, unable to lie down, this formula is the main treatment.

2. Ku Jiu Tang Ban Xia 20g, Ku Jiu 50mL, one egg white. First boil Ban Xia twice, extract 500mL of juice, add Ku Jiu and egg white while hot, take in two doses after breakfast and dinner. For cold damage with sore throat and inability to speak, this formula is the main treatment.

Appendix: ① "For Shaoyin disease lasting more than two or three days, with restlessness and inability to lie down, Huang Lian A Jiao Tang is the main treatment." ("Shang Han Lun · Bian Shaoyin Bing Mai Zheng Bing Zhi")

② "For Shaoyin disease with sores in the throat, unable to speak, voiceless, Ku Jiu Tang is the main treatment." ("Shang Han Lun · Bian Shaoyin Bing Mai Zheng Bing Zhi")

July 26, 2013: Common passages from "Shang Han Lun · Bian Shaoyin Bing Mai Zheng Bing Zhi"

"For Shaoyin disease, the pulse is weak and fine, but the person wants to sleep." "For Shaoyin disease, with four extremities cold, the person may cough, palpitate, have difficulty urinating, abdominal pain, or severe diarrhea—Si Ni San is the main treatment." "For Shaoyin disease with vomiting and diarrhea, cold hands and feet, restlessness and near-death, Wu Zhu Yu Tang is the main treatment." "For dry heaving, salivation, and headache, Wu Zhu Yu Tang is the main treatment." "For Shaoyin disease lasting two or three days, with sore throat, you can use Gan Cao Tang; if it doesn't improve, use Jie Geng Tang." "For Shaoyin disease with sores in the throat, unable to speak, voiceless, Ku Jiu Tang is the main treatment." "For Shaoyin disease lasting more than two or three days, with restlessness and inability to lie down, Huang Lian A Jiao Tang is the main treatment."