In the hundred years'change of Traditional Chinese medicine(TCM),the dispute between ancient and modern,west and east runs through the whole process,furthermore science and non-science's conflict is the core of the debate.Cultural celebrities,scientists,western medicine scholars,politicians appeared and launched a heated debate.In the debate,TCM adjust to deformation.Not only promotes scientific experiments,but put forward such propositions as convergence,reform,revolution and scientization.Science maintained the essential tension for TCM to seek a third route between science and non-science.It is owing to science,TCM had completed the transformation to modernity.

胰腺癌的治疗手段不断改进,但临床疗效仍然不尽人意.究竟难在哪呢? 五大难题让胰腺癌很凶险 ●本刊记者:"癌王",因何凶险? ○何裕民:因目前存在尚无制胜之法的"五大难题" :①一旦发现多属晚期,手术不行,化放疗弊大于利,且大都无效.②严重的腹部疼痛与腰部酸胀感.所有癌痛中,胰腺癌疼痛最为剧烈.③局部梗阻,甚至严重的阻塞性黄疸.④很容易周边转移、浸润,且周边均属重要脏器.⑤消化道障碍,运用止痛剂后会加重消化道障碍.

许多疑似癌症病人一听到"穿刺"这个词就异常抵触,抛开怕疼不说,很多人意识中就觉得,做穿刺容易让"病灶"扩散、转移或者引发一些并发症.穿刺真的会引起转移吗? 有时穿刺还是很必要的 ●本刊记者:做穿刺有必要吗?如果觉得大概率是恶性肿瘤,直接做手术不就行了?

一位记者在采访日本实业家稻盛和夫时问道,"一个人成功的关键是什么?"稻盛和夫回答说:"思维方式."斯言确矣.拥有生活智慧的人,会用超然的心态看待这个世界.接受世事的无常、事物的转变,从而超脱自我,进入人生的新境界.在我所接触的一些癌症患者中,也不乏这种心态超然的人.

疼痛,现实生活中很常见,几乎每个人都曾经历过,但不见得都能很好地应对. 疼痛是一种复杂的生理心理活动,既包括刺激作用于肌体引起的痛感,又涉及肌体对刺激的反应(躯体反应、内脏反应等),还与个体的感知能力及注意状态等有关,并常伴有强烈的情感色彩.因此,疼痛的机理复杂,需要有一些应对的心理小技巧.

结合现时代临床,提出医疗要回归"初心","初心"就是"人命贵",这是医学伦理起点,也是医学的最高宗旨;而要贯彻"初心",又应讲究医疗科技和医学人文及伦理之间形成合力.分析认为:现时代医学伦理可能以"生态伦理"更为合适;应区分重大疫情、急性抢救、慢性病纠治等不同情况,考虑"合力"所涉及的不同方面之轻重缓急;并针对生命伦理的有利原则,指出"有利"只是动机及出发点,还需深入思考,确立动机的基线和起点;就基线而言,要搞清楚是本然"有利",还是科学"有利",并做出一定区分;应在科学"有利"和本然"有利"之间保持适度的张力与平衡.

今天人类应对癌有很多方法,然效果不太佳.重要的不是高科技的缺失,而是智慧的离场.只是迷信科技,而令智慧虚化,以至于陷入癌症控制不佳的尴尬境地.从癌本身的特别之处、临床实际案例、正反经验教训等探讨了这一问题,指出既要认识癌的错综性,某些惰性癌无需大动干戈,又提出性质不明朗时的几种富含智慧之对策.并且,强调治癌既需向前探究高科技,也需不时向后寻求历史智慧照耀,包括可吸取《孙子兵法》中的很多真知卓见,诸如不战而胜、慎战等在防范癌症中都有意义.着重指出,需要时"观察,未尝不是积极的诊疗措施".

分析、论述了惰性病变(惰性癌)的客观及普遍存在,这在许多常见癌中比率不低.随着高敏诊断方法等的涌现,预估其趋势还会恶化,将加剧过度诊断及治疗,不仅引起恐惧心理,造成巨大心理压力,而且不当的积极检查及治疗,还将降低其后续的生存质量,防控癌的效果适得其反.为此,明确提出全社会需深化对癌的认识,不加选择地倡导"早发现、早治疗"并不合理,对惰性病变无须过度应对,倡导人人应把防癌及确保健康的主动权掌控在自己手中,并提出了一系列带有大健康意识的防范措施,且应从改变观念、普及相关知识做起.

患癌后,什么能吃,什么不能吃,是困扰很多患者及其家属的难题,生怕吃错导致病情进展.所以,最近我们收集了一批抗癌明星的康复期食谱,根据不同癌种分门别类,下面推荐几款易操作的家常菜.

癌症病人在被确诊之后,生存时间大不相同.医生们在长期的临床观察中,根据晚期癌症患者经验得失,总结出决定着晚期患者生存期长短的十大因素. 1.癌细胞的类型 癌症诊断时,我们常笼统地说患了肝癌、胃癌……其实,这只是就癌症发生的部位而言的,同样是肝癌,恶性程度及其预后往往差异巨大!这种差异主要体现在癌细胞的类型上.

部分新冠肺炎患者死因,确与炎症风暴等有关,而炎症风暴的产生,在一定程度上与现代医学干涉主义的一味对抗性治疗思路有关.引进"疾病耐受性"概念,认为提升机体耐受性也是应对病态时常用且有效之机制;重视这类机制,或许能在对抗性措施外,寻找到新的防范及缓解疾病反应的途径.此外,借"疾病耐受性"概念来分析中医药应对新冠肺炎疗效之机制,提出中医药可能不一定直接抗衡病因,也可能包括调动机体耐受性,减轻不适,以使机体更好地适应病态;在不同病理阶段下,中医药常运用不同思路与原则应对.这些,值得高度重视.

Ganoderma lucidum has salutary effects on tumor treatment, including pancreatic cancer and hepatocellular carcinoma. However, the molecular mechanisms underlying Ganoderma lucidum therapy is obscure. In this study, the Hepa1-6-bearing C57 BL/6 mouse model was utilized to explore the therapeutic efficacy of Ganoderma lucidum extract (GLE), documenting that it could effectively inhibit tumor growth. The microRNA (miRNA) profiles of GLE-treated and untreated mice were detected, and 25 differentially expressed (DE) miRNAs were determined, including 24 up-expressed and one down-expressed miRNAs. Using the ClusterOne algorithm, 8 hub miRNAs were isolated from the established miRNA-target network. The qRT-PCR assay demonstrated that these 8 miRNAs were up-expressed in the GLE treated tumor mice. Furthermore, the mRNA profiles showed that there are 76 DE mRNAs between GLE treated and model groups. The protein-protein interaction (PPI) network shows that Cntn1, Irs1, Nfkbia, Rybp and Ywhaz playing important roles, and qRT-PCR further revealed they were down-expressed in GLE treated Hepa1-6-bearing C57 BL/6 mice. The rebuilt miRNA-target network was shown that these 5 mRNAs were regulated by mmu-mir-23a-5p, -3102-3p, -337-3p, and -467a-3p, respectively. This study suggested that these 4 interesting miRNAs were potential biomarkers for evaluation of GLE efficacy, which may down-regulate the expression of Cntn1, Irs1, Nfkbia, Rybp and Ywhaz, and mediate many signaling pathways occurring in tumor treatment.

目前,社会上关于癌症最大误区可能就是认为“癌症是免疫力低下之故”,提高免疫力就可防范癌症,故推销保健品、食品给癌症患者时,只要沾上“提高免疫力”的边,就大行其道.因为人们总觉得:免疫力不是越高越好吗?其实,免疫力不等于抗癌力,这根本就是两回事.

结合人文关爱,探讨了癌症生存者的长链全程管理新模式.认为人文关爱本身就是疗愈慢性病的主要手段之一,而在癌症生存者管理中,人文关爱更是疗康的不可或缺之良药.分别介绍了癌症生存者管理体系探索中所尝试的种种实践活动及其意义,突出强调这一过程中人文关爱是核心,人文关爱本身就有治疗作用;而这一过程中促使患者自我形成正确的认知是关键.正念、积极心理学及认知疗法等对此都具有积极意义.并就人文关爱的“疗愈”作用中患者的心理因素进行了剖析,强调需促使或帮助患者自我学会掌控愈病疗疾的主动权.

癌症应对中体现在创伤性医疗措施里的人为干预力与温和的适度调整所促进的自我修复力之间存在着辩证关系,并借三组可比照之案例分析,指出癌症康复与否,自有深层次因素需破解,绝非简单借用创伤性的征服措施所能解决;需借助循证及叙事医学等方法,参照自我/他人经验,结合对一系列特殊问题的考量,恰当地做出把控及平衡.同时提出,在把控及平衡这关系时可参照中医学的“急者治标,缓则治本”理论,通过对癌症类型分析,兼顾年龄、体质等因素,综合评估后方能合理处置;而非仅以指南为据,按图索骥所能实现.

Chronic fatigue syndrome (CFS) has been more than 30 years since its concept came into being, with nearly 70 years related research. Different countries have proposed different diagnostic criteria at different times. This is a research field overwhelmed with twists and controversy. At present day, there is no convincing conclusion to satisfy everyone, and the detrimental effect of this disease continuing to rise. "Fatigue" has always been the center of attention, as it is one of the keywords in traditional Chinese medicine. Traditional Chinese medicine believes that fatigue is a comorbidity of many different diseases, hence an important factor in the clinical diagnosis of traditional Chinese medicine. From a professional perspective, it is not difficult to see that the biggest obstacle to the development of ME/CFS research lies in its vague boundary/scope and unclear concept. Therefore, in 2015, the National Institute of Medical Sciences proposed to reinitiate the study, and suggested renaming it as Systemic Exertion Intolerance Disease (SEID) and putting forward new diagnostic criteria. The updated SEID concept focuses on "deep fatigue" and reduces interactions with other diseases. In 2018, Nature published a long featured report, "A reboot for chronic fatigue syndrome research". The report became the buzz topic of the year. These actions may prompt new in-depth studies for this research. This paper combs through the cognitive changing process of chronic fatigue syndrome, and provides a positive response from reviewing the different perspectives of traditional Chinese medicine and Western medicine, reanalyzing the previous research in this field, to assess the possibility of incorporation of traditional Chinese medicine, and utilization of traditional Chinese medicine knowledge-based reference, and to put forward new insights as well as potential obstacles in the "reboot" study. Based on the theoretical analysis and the conclusion of our previous research, we believe that: after the clear diagnosis of SEID (or CFS), the influence of psychosocial factors should be taken into account when conducting intervention or in-depth research. In scientific research, this may lead to the solution of some of the problems. Clinically, this may enhance the body's psycho- physical harmonization and will help improve patient condition and the curative effect. Previous practice has shown that, the deep involvement of traditional Chinese medicine the reboot of this grand international project will help SEID patients to improve their self-perception and symptoms, and its role in the scientific mechanism will be conducive to promoting the systematization and deepening of research.

对于不同的症状,建议癌症患者应有针对性地配合食疗,以增强疗效. 化放疗后严重贫血 经常听到癌症患者这样说:“何教授,我化疗后贫血厉害,白细胞也下降了,怎么办呀?”肿瘤患者出现贫血、血小板减少和白细胞下降现象的非常多,特别是化疗后,这些现象尤为常见.对此,辅以食疗意义重大.

Background: The study aimed to analyze major underlying factors of the subhealth condition evaluation and find the optimization model. Methods: Selected 524 cases of health state and 453 cases of subhealth state from the research objects. A genetic algorithm was applied to discover the optimization model. The decision tree algorithm was used to find the main performance in the areas of physical, psychological, and social adaptation in the two populations which were the health state and the subhealth state. Conclusions: To establish the optimization model, the author would set up a curve-fitting equation between reduction of health self-assessment score (S-G1) and white blood cell (WBC) value in routine blood, so as to establish the relationship between S-G1 and WBC and found the approximate minimum solution of each equation. Besides, the author would analyze the differences between two populations in WBC examination to seize the difference. Revealed the differences of two populations in the areas of physical, psychological, and social adaptation by data mining and got the result that WBC of “the health state population” was higher than that of “the sub-health state population” in the index changes of WBC. The problem in social adaptation area of the subhealth state population was more serious in degree than the health state population; the reason was complex. If WBC of the health state population was near or below 5.5079, the object may be in the state of subhealth. However, if WBC was near or below 4.35, it is possible to enter the “morbid state.”

研究显示:性格与个体的健康和疾病,包括癌症的发生,有着密切的关系,专家们先后区分出A、B、C、D四种性格类型,A型争强好胜;B型容易满足现状;C型总是压抑自己的情绪;D型看待问题比较悲观,容易焦虑和抑郁.研究表明:A型人群易患冠心病、高血压、糖尿病等;C、D型人群则被认为与一些恶性肿瘤的发生、发展有着密切关系.

在中医药的发展路径上,前人做过许多探索;复古守旧、中西汇通、全盘西化等通通失败.在中医药新的发展历史时期,需要在继承、扬弃与吸收之间寻找平衡,保持适度的张力.中医药不缺继承的基因,继承时应以精神文化为核心,防止复古倾向;扬弃时应以新旧范式转化为目标,但要摒弃革命性思维,扬弃过程涉及解构与分析,继承在先,扬弃在后,顺序不可颠倒;吸收时要保持主体性,摆脱路径依赖,构建中医学自主性知识体系;在继承、扬弃和吸收之外,还存在创新问题,之间的联动,一起构成中医学发展的内在动力.