Medical Research Articles

Current Research Status of Traditional Chinese Medicine External Treatment for Diarrhea Type Irritable Bowel Syndrome

Irritable bowel syndrome (IBS-D) with diarrhea is a common gastrointestinal functional disease in clinical practice, which seriously affects the quality of life of patients. Currently, Western medicine has poor therapeutic effects, while traditional Chinese medicine has unique advantages in relieving IBS-D symptoms and preventing recurrence. In recent years, especially with external treatment of traditional Chinese medicine, it has become a new treatment direction in clinical practice and has achieved good therapeutic effects. This article will provide a review of recent research on the treatment of IBS-D using traditional Chinese medicine external treatment methods.

Analysis of the Clinical Effect of Chinese Medicine Combined with Acupuncture and Moxibustion on Insomnia

Objective: To explore and analyze the clinical efficacy of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia. Method: 80 patients with primary insomnia were selected as the study sample, with 20 cases randomly selected as the control group and the rest as the observation group. The control group was treated with ordinary western medicine, while the observation group patients were treated with traditional Chinese medicine combined with acupuncture and moxibustion based on this syndrome differentiation. The comparison items were treatment effect, sleep quality, mental health, quality of life, specific sleep indicators, cerebral blood flow and neurotransmitters. Result: The treatment effectiveness showed that the observation group had a higher treatment effectiveness rate than the control group (P<0.05); The results of sleep quality showed that after treatment, the scores of the observation group were lower than those of the control group in seven dimensions: sleep quality, sleep time, sleep onset time, sleep efficiency, sleep disorders, hypnotic drugs, and daytime dysfunction score (P<0.05); The quality of life results showed that after treatment, the observation group had higher scores than the control group in eight dimensions: physiological function, physiological function, physical pain, health status, energy, social function, emotional function, and mental health (P<0.05); The results of slow wave sleep time and fast eye movement sleep time showed that after treatment, the HAMA and HAMD scores of the physiological mechanism in the observation group were lower than those in the control group (P<0.05); The results of cerebral blood flow and neurotransmitter indicators show that after treatment, glutamate γ- the peak systolic blood flow velocity of aminobutyric acid, vertebral artery, and basilar artery in the observation group was higher than that in the control group (P<0.05). Conclusion: The clinical treatment of Chinese medicine combined with acupuncture and moxibustion in the treatment of insomnia patients can significantly improve the clinical treatment effect, and improve the cerebral hemorrhage and neurotransmitter status of patients, promote the improvement of their physical and mental status, can more significantly improve the quality of sleep, reduce sleep difficulties, reduce the dosage of sleeping pills, which has important clinical application value.

Clinical efficacy and gene chip expression analysis of Shenzhu Guanxin recipe granules in patients with intermediate coronary lesions.

To evaluate the clinical efficacy and safety of Shenzhu Guanxin recipe granules (, SGR) in treating patients with intermediate coronary lesions (ICL), and to investigate the potential mechanism though a transcriptome sequencing approach. ICL patients with Qi deficiency and phlegm stasis were adopted and randomly assigned to a case group or a control by random number generator in a 1:1 randomization ratio to evaluate the clinical efficacy. There was no significant difference between the two groups in coronary computed tomography angiography related indexes in the two groups before and after intervention. Through the gene chip expression analysis, it is finally concluded that there are 355 differential mRNAs (190 up-regulated genes and 165 down regulated genes) when compared the SGR group and placebo group. Through protein-protein interaction network analysis of differentially expressed genes, 10 hub genes were finally obtained: CACNA2D2, CACNA2D3, DNAJC6, FGF12, SGSM2, CACNA1G, LRP6, KIF25, OXTR, UPB1. SGR combined with Western Medicine can be safely used to treat ICL patients with Qi deficiency and phlegm stasis. The possible mechanism of action and relevant gene loci and pathway were proposed.

Healing Arts

Healing Arts

Enhanced convolutional neural network enabled optimized diagnostic model for COVID-19 detection

Computed tomography (CT) films are used to construct cross-sectional pictures of a particular region of the body by using many x-ray readings that were obtained at various angles. There is a general agreement in the medical community at this time that chest CT is the most accurate approach for identifying COVID-19 disease. It was demonstrated that chest CT had a higher sensitivity than reverse transcription polymerase chain reaction (RT-PCR) for the detection of COVID-19 illness. This article presents gray-level co-occurrence matrix (GLCM) texture feature extraction and convolutional neural network (CNN)-enabled optimized diagnostic model for COVID-19 detection. In this diagnostic model, CT scan images of patients are given as input. Firstly, GLCM algorithm is used to extract texture features from the CT scan images. This feature extraction helps in achieving higher classification accuracy. Classification is performed using CNN. It achieves higher accuracy than the k-nearest neighbors (KNN) algorithm and multi-layer preceptor (MLP). The accuracy of GLCM based CNN is 99%, F1 score is 99% and the recall rate is also 98%. CNN has achieved better results than MLP and KNN algorithms for COVID-19 detection.

Association of Sex and Trends in Guideline-directed Medical Therapy Use Among Patients Undergoing Intervention for Infrainguinal Peripheral Artery Disease in the Vascular Quality Initiative, 2010-2023

Association of Sex and Trends in Guideline-directed Medical Therapy Use Among Patients Undergoing Intervention for Infrainguinal Peripheral Artery Disease in the Vascular Quality Initiative, 2010-2023

Towards a disease prediction system: BioBERT-based medical profile representation

<p>Healthcare professionals are increasingly interested in predicting diseases before they manifest, as this can prevent more serious health conditions and even save lives. Machine learning techniques are now playing an important role in healthcare, including in the early prediction of diseases based on prior medical knowledge. However, one of the biggest challenges is how to represent medical information in a way that can be processed by machine learning algorithms. Medical histories are often in a format that computers cannot read, so filtering and converting this information into numerical representations is a crucial step. This process has become easier with the advancement of natural language processing techniques. In this paper, we propose three representations of medical information, two of which are based on BioBERT, the latest text representation techniques for the biomedical sector. The efficiency of these representations is tested on the MIMIC-III database, which contains information on 46,520 patients. The focus of the study is on predicting Coronary Artery Disease, and the results demonstrate the effectiveness of the proposed approach. The study highlights the importance of medical history in disease prediction and demonstrates the potential of machine learning techniques to advance healthcare.</p>

GARLIC: Nature's potent antifungal and antibacterial ally - cream formulation and evaluation

In the pursuit of effective and safe treatments for infectious diseases, herbal remedies have garnered significant attention due to their diverse phytochemical composition and potential therapeutic properties. This study aimed to explore the phytochemical profile and evaluate the antibacterial and antifungal properties of herbal garlic extracts. Traditional natural products continue to be sought after for their bioactive compounds, which offer promising avenues for therapeutic intervention in both human and veterinary medicine. Our investigation not only sheds light on the regional variation of stomach disease occurrence, highlighting the role of dietary factors, but also underscores the importance of herbal preparations in medicinal practice. By combining various plant classes, herbal formulations can exert localized effects upon application, penetrating the skin or mucous membranes to target underlying conditions. The effectiveness of these combined medications may lie in their synergistic mechanisms, offering a comprehensive therapeutic approach. This research contributes valuable insights into the potential of herbal remedies as adjuncts or alternatives to conventional treatments, paving the way for further exploration in infectious disease management and prevention strategies.

Challenges in developing the Chinese traditional medical knowledge databases in China

This article discusses the development of a comprehensive database for traditional Chinese medical knowledge (TMK), addressing the dual goals of safeguarding this heritage and promoting its responsible utilization and dissemination, mindful of China’s cultural and historical nuances. It offers a critical analysis of the complex interplay between China’s unique historical and cultural fabric, global dynamics and the evolution of the TMK databases within the nation. The focus is on illuminating how these multifaceted elements converge to shape the way the TMK is managed and represented digitally, thereby offering insights for developing more responsive, culturally sensitive and effective TMK database systems.

Medical cannabis use in Australia seven years after legalisation: findings from the online Cannabis as Medicine Survey 2022–2023 (CAMS-22)

BackgroundCannabis was legalised for medical purposes in 2016. Uptake was initially slow, but since 2019 there has been a large increase in the number of Australians who have been prescribed cannabis for medical reasons. Yet a significant number of consumers continue to treat their medical conditions via illicitly-sourced cannabis. Little is known about how these two groups of medical cannabis consumers differ.MethodsThe anonymous Cannabis-As-Medicine Survey 2022–2023 (CAMS-22) was available for completion online from December 2022 to April 2023 to adult Australians who had used cannabis to treat a medical condition in the previous year. Recruitment occurred through social media, consumer forums, and medical practices. Questions included demographic characteristics, patterns of cannabis use, conditions treated, and self-rated effectiveness.ResultsOf the 3323 respondents included in these analyses, 2352 (73%) mainly used prescribed medical cannabis, 871 (27%) mainly used illicit. Prescribed users were significantly more likely than illicit users to have had their health condition diagnosed (OR = 1.7, 95% CI 1.3, 2.2), to consume their cannabis via oral (OR = 1.9; CI 1.5, 2.4) or vaporised (OR = 5.2; CI 4.0, 6.8) routes, and to be sure of the composition of their medical cannabis (OR = 25.0; CI 16.7, 50.0). Prescribed users were significantly less likely to have used cannabis non-medically before medical use (OR = 0.6, CI 0.5, 0.7), consume cannabis via smoked routes (OR = 0.2, CI 0.1, 0.2), and to report any side effects (OR = 0.1; CI 0.1, 0.2). The most common conditions among both prescribed and illicit users were pain (37%), mental health (36%), and sleep (15%) conditions. Prescribed users were significantly more likely to use cannabis to mainly treat a pain (OR = 1.3; CI 1.1, 1.5) or sleep condition (OR = 1.4; CI 1.1, 1.7) and less likely to treat a mental health condition (OR = 0.8; CI 0.7, 0.9). There were no between-group differences in effectiveness with 97% saying medical cannabis had improved their symptoms.ConclusionsFrom a harm-reduction perspective there is much to recommend prescribed medical cannabis; it has fewer side-effects than illicit, is used more safely (oral or vaporised versus smoked routes), gives consumers greater certainty regarding the composition and quality of their medicine, and does not risk exposure to the criminal justice system. Of concern, however, is the apparent willingness of prescribers to prescribe for indications for which there is limited evidence of efficacy, such as mental health and sleep conditions.

What makes an article a must read in medical education?

BackgroundThe dissemination of published scholarship is intended to bring new evidence and ideas to a wide audience. However, the increasing number of articles makes it challenging to determine where to focus one’s attention. This study describes factors that may influence decisions to read and recommend a medical education article.MethodsAuthors analyzed data collected from March 2021 through September 2022 during a monthly process to identify “Must Read” articles in medical education. An international team of health sciences educators, learners, and researchers voted on titles and abstracts to advance articles to full text review. Full texts were rated using five criteria: relevance, methodology, readability, originality, and whether it addressed a critical issue in medical education. At an end-of-month meeting, 3–4 articles were chosen by consensus as “Must Read” articles. Analyses were used to explore the associations of article characteristics and ratings with Must Read selection.ResultsOver a period of 19 months, 7487 articles from 856 journals were screened, 207 (2.8%) full texts were evaluated, and 62 (0.8%) were chosen as Must Reads. During screening, 3976 articles (53.1%) received no votes. BMC Medical Education had the largest number of articles at screening (n = 1181, 15.8%). Academic Medicine had the largest number as Must Reads (n = 22, 35.5%). In logistic regressions adjusting for the effect of individual reviewers, all rating criteria were independently associated with selection as a Must Read (p < 0.05), with methodology (OR 1.44 (95%CI = 1.23–1.69) and relevance (OR 1.43 (95%CI = 1.20–1.70)) having the highest odds ratios.ConclusionsOver half of the published medical education articles did not appeal to a diverse group of potential readers; this represents a missed opportunity to make an impact and potentially wasted effort. Our findings suggest opportunities to enhance value in the production and dissemination of medical education scholarship.

Medical Uses and Adverse Effects of Psilocybin

Medical Uses and Adverse Effects of Psilocybin

Core Elements of Excellent Hospital Leadership: Lessons from the 5 Top-performing Hospitals in China.

Substantial evidence indicates that leadership plays a critical role in an organization's success. Our study aims to conduct case studies on leadership attributes among China's five top-performing hospitals, examining their common practices. A semi-structured interview was conducted with 8 leaders, 39 managers, 19 doctors, and 16 nurses from the five sample hospitals in China. We collected information from these hospitals on the role of senior leadership, organizational governance, and social responsibility, aligning with the leadership assessment guidelines in the Baldrige Excellence Framework. Qualitative data underwent interpretation through content analysis, thematic analysis, and comparative analysis. This study adhered to the COREQ guidelines for reporting qualitative research. Our study revealed that the leaders of the five top-performing hospitals in China consistently established "Patient Needs First" as the core element of the hospital culture. Striving to build world-renowned hospitals with Chinese characteristics, the interviewees all believed strongly in scientific vigor, professionalism, and cooperative culture. The leaders adhered to a staff-centered approach, placing special emphasis on talent recruitment and development; creating a compensation system; and fostering a supportive environment conducive to enhancing medical knowledge, skills, and professional ethics. In terms of organizational governance, they continuously enhanced the communication between various departments and levels of staff, improved the quality and safety of medical care, and focused on innovative medical and scientific research, thereby establishing evidence-based, standardized hospital management with a feedback loop. Meanwhile, regarding social responsibility, they prioritized improvements in the quality of healthcare by providing international and domestic medical assistance, community outreach, and other programs. To a large extent, the excellent leadership of China's top-performing hospitals can be attributed to their commitment to a "Two Pillared Hospital Culture", which prioritizes putting patient needs first and adopting a staff-centered approach. Furthermore, the leaders of these hospitals emphasize hospital performance, operations management, and social responsibility.

Complementary and alternative medicine use in migraine patients: results from a national patient e-survey

ObjectThis cross-sectional study aims to investigate migraineurs’ preferred complementary and alternative medicine (CAM) types and the factors influencing their usage.Materials and methodsAn anonymous e-survey was distributed to Lithuanian Migraine Association members, and social media migraine support communities. The collected data consisted of demographic, migraine-related questions, personal qualities, CAM habits.Results470 respondents were analyzed. 95.96% were women with a median age of 37 (IQR 31, 44). The median duration of migraine was 17.5 years (IQR 10, 25) and the median headache severity was rated 8 (IQR 7, 10) out of 10. 68.90% of participants had one or more headache days per week. 71.49% of respondents were triptan users, 27.66% used medical prophylaxis, and 17.87% used monoclonal antibodies. 52.55% of respondents used CAM in the past 12 months. Physical activity (36.17%), dietary changes/fasting (27.02%), relaxation/meditation (26.60%) were the most used CAM types. Reasons for CAM use included dissatisfaction with conventional treatment effectiveness (42.51%), concerns about safety (48.18%) and adverse effects (37.25%). Factors associated with the decision to explore CAM included longer headache duration (p = 0.017, Mann–Whitney U test), frequent sick leaves (p &amp;lt; 0.001, Mann–Whitney U test), current preventive medication use (p = 0.016, chi-square test), positive views on CAM safety/naturality (p = 0.001/ p &amp;lt; 0.001, Mann–Whitney U test), belief of having a healthy diet (p &amp;lt; 0.001, chi-square test), food-related worries (p = 0.011, Mann–Whitney U test) and Big-five personality trait of openness to experience (p = 0.049, chi-square test). After logistic regression, the frequent need to take sick leaves, having a healthy diet, food-associated fears maintained statistical significance. CAM use was not associated with non-adherence to conventional medicine. 48.99% of CAM consumers disclosed CAM use to their doctors.ConclusionCAM is explored by a significant proportion of migraineurs, less than half communicate this to their doctors. In our sample, physical activity, dietary changes, and relaxation techniques were the most common. Many patients opted for CAM due to previously experienced side effects/ineffectiveness of conventional migraine treatment or the fear of potential harm from standard medication. Individual factors, such as openness of personality can be an important contributing factor.

Sociotechnical imaginaries in academic medicine strategic planning: a document analysis.

Purpose Along with other industries, healthcare is becoming increasingly digitized. Our study explores how the field of academic medicine is preparing for this digital future. Method Active strategic plans available in English were collected from faculties of medicine in Canada (n = 14), departments in medical schools (n = 17), academic health science centres (n = 23) and associated research institutes (n = 5). In total, 59 strategic plans were subjected to a practice-oriented form of document analysis, informed by the concept of sociotechnical imaginaries. Results On the one hand, digital health is discursively treated as a continuation of the academic medicine vision, with expansions of physician competencies and of research institutes contributions. These imaginaries do not necessarily disrupt the field of academic medicine as currently configured. On the other hand, there is a vision of digital health pursuing a robust sociotechnical future with transformative implications for how care is conducted, what forms of knowledge are prioritized, how patients and patienthood will be understood, and how data work will be distributed. This imaginary may destabilize existing distributions of knowledge and power. Conclusions Looking through the lens of sociotechnical imaginaries, this study illuminates strategic plans as framing desirable futures, directing attention towards specific ways of understanding problems of healthcare, and mobilizing the resources to knit together social and technical systems in ways that bring these visions to fruition. There are bound to be tensions as these sociotechnical imaginaries are translated into material realities. Many of those tensions and their attempted resolutions will have direct implications for the expectations of health professional graduates, the nature of clinical learning environments, and future relationships with patients. Sociology of digital health and science and technology studies can provide useful insights to guide leaders in academic medicine shaping these digital futures.

Establishing new medical schools in diverse contexts: A novel conceptual framework for success.

Establishing a new medical school is a significant venture involving many complex political, social, economic, educational, and organisational considerations. The published literature on the process of establishing a new medical school is, however, under-developed with minimal empirical research and no explicit reference to theory. This research sought to address these gaps and establish an empirical and theoretical evidence-base for the process of new medical school establishment in diverse contexts, particularly medically under-served areas. A Critical Realist Multiple Case Study was undertaken to examine the establishment of new medical schools across three continents. Data were collected between 2016 and 2018 through observational data gathered on site visits to three medical schools in medically under-served areas, relevant documents/audio-visual materials, and semi-structured interviews with key founding personnel. Data were analysed using the Critical Realist approach. Institutional Entrepreneurship theory was applied, adapted, and extended to explore and explain the phenomenon of new medical school establishment in diverse contexts. This study identifies eight critical success factors underpinning new medical school establishment. Framed as the Eight C's Framework (8CF), these factors include Context (field conditions), Catalysts (institutional entrepreneurs), Conducing (helping to bring about a particular situation or outcome), Collecting (resources), Connecting (relationships), Convincing (rationales), Challenges, and Consequences (outcomes). 8CF highlights that new medical schools are successfully established when Catalysts act within their Contexts to undertake the tasks of Conducing, Convincing, Collecting, and Connecting in order to produce desired Consequences and overcome Challenges. The Eight C's Framework is a theory-based, empirically supported framework that can be applied across different contexts to strategically guide the successful establishment of new medical schools. Founding leaders and stakeholders could use 8CF to ensure their establishment efforts are underpinned by theory and scholarship.

‘What’s a D and C between friends?’ Space, intimacy and the medicalisation of unmotherhood in modernist literature

This essay theorises what ‘unmotherhood’—or, living outside of motherhood—means within the specific context of ‘the modern’. Unmotherhood is an actively constructed state; it is explored through the parameters of agentive...

Clinical study on microscopic syndrome differentiation and traditional Chinese medicine treatment for liver stomach disharmony in chronic gastritis

BACKGROUND Chronic gastritis (CG) is a common gastrointestinal disorder characterized by inflammation of the stomach lining. Liver-stomach disharmony (LSD) syndrome is believed to contribute to CG symptoms. AIM To evaluate the efficacy and safety of microcosmic syndrome differentiation and Chinese herbal medicine (CHM) treatment in patients with CG and LSD syndrome. METHODS Sixty-four patients with CG and LSD syndrome were randomly divided into two groups: The treatment group received CHM based on microcosmic syndrome differentiation and the control group received conventional Western medicine. The treatment course lasted 12 wk. The primary outcome was improvement in dyspeptic symptoms, measured using the Nepean Dyspepsia Index. The secondary outcomes included the improvement rate of endoscopic findings, histopathological findings, and microcosmic syndrome scores and the incidence of adverse events. RESULTS After 12 wk of treatment, the treatment group showed significantly greater improvement in dyspeptic symptoms than the control group (93.75% vs 65.63%, P &lt; 0.01). The treatment group also showed a significantly higher improvement rate in endoscopic findings than the control group (81.25% vs 53.13%, P &lt; 0.05). The improvement rates of histopathological findings and microcosmic syndrome scores were not significantly different between the two groups (P &gt; 0.05). No serious adverse events were observed in either group. CONCLUSION Microcosmic syndrome differentiation and CHM treatment can effectively improve dyspeptic symptoms and endoscopic findings in patients with CG and LSD syndrome and have a good safety profile. Further studies with larger sample sizes and longer follow-up periods are required to confirm the long-term efficacy and mechanism of action of this treatment.

Pistacia lentiscus: Phytochemistry and Antidiabetic Properties

Pistacia lentiscus L. (P. lentiscus) is an evergreen shrub (Anacardiaceae family) primarily found in the Mediterranean region. The plant has been thoroughly characterized, resulting in a high concentration of bioactive compounds as flavonoids and phenolics. Moreover, P. lentiscus was revealed to possess a great nutritional and industrial importance because of its variety of biological activities, including antibacterial, anti-inflammatory, anti-atherogenic and antioxidant properties. Many of its beneficial health properties and applications date back to antiquity, and the European Medicines Agency officially acknowledged it as an herbal medicinal product. Indeed, it is widely employed in conventional medicine to treat several diseases, including type 2 diabetes (T2D). On this basis, this review aims to summarize and describe the chemical composition of different parts of the plant and highlight the potential of P. lentiscus, focusing on its antidiabetic activities. The plant kingdom is drawing increasing attention because of its complexity of natural molecules in the research of novel bioactive compounds for drug development. In this context, P. lentiscus demonstrated several in vitro and in vivo antidiabetic effects, acting upon many therapeutic T2D targets. Therefore, the information available in this review highlighted the multitarget effects of P. lentiscus and its great potential in T2D treatment.

Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Treatment of ulcerative colitis (UC) and Crohn’s disease (CD) represents, in the majority of cases, a real challenge to the gastroenterologist’s abilities and skills as well as a clinical test concerning his/her levels of medical knowledge and experience. During the last two decades, our pharmaceutical arsenal was significantly strengthened, especially after the introduction of the so-called biological agents, drugs which to a large extent not only improved the results of conservative treatment but also changed the natural history of the disease. However, colectomy is still necessary for some patients with severe UC although smaller compared to the past, precisely because of the improvements achieved in the available conservative treatment. Nevertheless, surgeries to treat colon dysplasia and cancer are increasing to some extent. At the same time, satisfactory improvements in surgical techniques, the pre-and post-operative care of patients, as well as the selection of the appropriate time for performing the surgery have been noticed. Regarding patients with CD, the improvement of conservative treatment did not significantly change the need for surgical treatment since two-thirds of patients need to undergo surgery at some point in the course of their disease. On the other hand, the outcome of the operation has improved through good preoperative care as well as the wide application of more conservative surgical techniques aimed at keeping as much of the bowel in situ as possible. This article discusses the indications for surgical management of UC patients from the gastroenterologist’s point of view, the results of the emerging new techniques such as transanal surgery and robotics, as well as alternative operations to the classic ileo-anal-pouch anastomosis. The author also discusses the basic principles of surgical management of patients with CD based on the results of the relevant literature. The self-evident is emphasized, that is, to achieve an excellent therapeutic result in patients with severe inflammatory bowel disease in today’s era; the close cooperation of gastroenterologists with surgeons, pathologists, imaging, and nutritionists is of paramount importance.