Hello, everyone. We have discussed adequately the controversial aspects of the traditional Chinese medicine (TCM). Now, except the absolute pros and the strong cons that propose to get rid of TCM, are there any other approaches to the understanding of TCM? Today we are going to discuss the last topic of the controversial TCM, namely, looking at TCM in a different way. I hope all of you can just think outside the box, and look at TCM from a different perspective. I would like to guide you through this topic from three aspects. The first aspect outlines that Chinese medicine and western medicine are not incompatible with other. The second aspect covers the development and innovation of TCM. The third and last aspect is devoted to the education and inheritance of TCM. Well, let's start with the first aspect, i.e., Chinese medicine and western medicine are not incompatible with other. We have discuss the case of cerebral trauma in Britain, a typical case of joint efforts of Chinese medicine and western medicine. But for the British doctors' fine operations, the therapeutic effect would be significantly weakened. However, if we only relied on the British doctors, we could not manage to bring the patient to life, let alone make him stand, wall and live as a normal person. Accordingly, it was the collaboration of Chinese medicine and western medicine in the medical team that created the medical miracle. Frankly, Chinese medicine and western medicine share a common goal, which is to heal the wounded and rescue the dying". Of course, another important fact of TCM is life cultivation and health preservation, which is the intervention of the sub health state. Surely, modern medicine also puts emphasis on the preventive medicine, but it cares more about the epidemiological investigation, the improvement of sanitary condition, vaccination, and other preventive methods. Compared with TCM, western medicine has evolved with the development of natural science like biology, chemistry, physics and math, and witnessed rapid growth. It has even reached the genetic level, which makes it possible to transplant organs such as heart. Also, the discovery of penicillin and sulfonamide has started a new era of antibiotics and chemicals, making the treatment of infectious diseases even more efficiently. In addition, various new types of drugs and quality control methods provide guarantee for the stability and security of efficacy. In a word, western medicine has achieved tremendous accomplishment in the past 100 years. Then, let's take a look at Chinese medicine. In the past 100 years, we have witnessed the appearance of many great medical scientists and the discoveries of valuable medical findings like ”longdanxiegan pill“ (bolus of gentian for purging liver-fire) use for chronic myelogenous leukemia. From the classic “suhexiang pill”, we have developed quick-acting "subingdi pill" and hexiang baoxin wan (heart pill of musk) for the treatment of heart disease. The most renowned invention would be credited to artemisinin. During the Vietnam War starting from 1964, as the troops had to march trough the woods and bushes, malaria was a wide epidemic disease. The Vietnam government then turned to China for antimalarial drugs. China set up the 5·23 antimalarial research project office. After repeated sifting, researchers finally found in the artemisia annua, the later well-known antimalarial artemisinin. Atemisia annua was recorded in the journals as early as in the 168 BC, and the relevant records were found from Tomb 3 at Mawangdui, Changsha city. The excavated silk manuscripts recored that atemisia annua had the antimalarial efficacy. The outcomes of this project, has benefited a large part of human beings. since 2006, in order to overcome drug resistance, 世界卫生组织宣布用青蒿素的联合疗法 the WHO announced that the combined therapy of artemisinin has saved more than one million people in over 80 countries. Due to her key role in the discovery of artemisinin, Tu Youyou won the 2011 Lasker-DeBakey Clinical Medical Research Award. I thought she really gave a brilliant speech. She said that the discovery of artemisinin was a gift to the whole human beings from TCM. She called for global cooperation of TCM and other traditional medicine for the better health of human being. There are also many other renowned discoveries coming from TCM, say, tetrahydropalmatine, berberine and so on. Well then, besides the splendid outcomes of Chinese medicine researches, the research on the mechanism of acupuncture anesthesia has also achieved great success. We should not think that western medicine, having few development problems will have brighter prospects while Chinese medicine does not have a prosperous future. This leads to our second aspect, the development and innovation of TCM. In terms of drugs, radix isatidis are greatly popular among Chinese people. In case of influenza, many people would prepare radix isatidis in advance. Why is that? It is because it has good efficacy of treating headache and fever and other cold symptoms. Nevertheless, if we look from the perspective of modern medicine, neither its extractive nor its chemical components, provide good antisepsis and antiviral effect. So its efficacy could be proved at all. But when we apply radix isatidis in clinical use, it indeed could help ease the cold symptoms of fever and headache. What is the reason? Of course, now we have some primary research findings, indicating that radix isatidis may activate immune system by the metabolite produced after it is taken orally. From this case, it can be clearly seen that TCM is clinically based. The researches conducted in the laboratories should also take into consideration the clinical habits. Nonetheless, the modern medicine experiments and researches, may deviate from these basic rule. Innovation must be carried out reasonably on an integrated basis, otherwise the findings can not be regarded as scientific. We will next throw a look at the Medical School of Shanghai Jiao Tong University. Specifically, we'll examine a case in which Chinese medicine is used for leukemia。 As we all know, arsenic is highly toxic, and arsenic trioxide is its main toxic component. A dose of 0.005 to 0.05g would cause toxic. It has been assumed in "Slowly Poisoned to Death Like This", that arsenic was the possible cause of Napoleon's death. It is also said that in ancient China, arsenic is also a means of killing people. Therefore, people generally have a fear for arsenic. However, a SJTU research team led by Prof. Wang Zhenyi, started from arsenic's efficacy of leukemia, and conducted further research into the treatment of leukemia by combing arsenic trioxide and all-transretinoic acid. The research has increased the "five year survival rate" of the acute promyelocytic leukemia patients from 25% to 95%, which established the current worldwide standard therapy for the acute promyelocytic leukemia. American National Foundation for Cancer Research thus awarded the team "The 7th Szent-Györgyi Prize for Progress in Cancer Research." Compound traditional Chinese medicine is still remained a not fully cultivated virgin land. Though Compound TCM is mostly applied in the clinical cases, because of TCM's complicated composition, it is rather hard to get a clear understanding of compound medicine's effective constituent and mechanism. This explains why western medicine often holds suspect towards Chinese medicine. However, the TCM community adheres firmly to the traditional Chinese description and explanation of the compound mechanism. In a more accurate perspective of modern language, compound TCM is named after its features of multicomponent and multiple target points, wherein different medicine play rather distinctive roles. At the time when some scholars, for the sake of safeguarding the scientific spirit, continuously attacked TCM for its obscure scientific foundations, it was still the research team lad by Chen Zhu and Chen Saijuan that has discovered, via modern S&R measures and from the perspective of chemical compositions and pharmacological mechanism, an effective compound TCM for the treatment of leukemia. This compound medicine was made up of realgar, indigo naturalis and salviae miltiorrhizae. And a kind of chemical compound found in the realgar was the key element of this compound medicine, which directly attacked the oncoprotein in the leukemia cell. Likewise, the constituent of "Dianyuehong" in the indigo naturalis was the assisting element, which served to reduce the toxicity of realgar, and slow down the growing of cancer cell. Lastly, tanshinone in the salviae miltiorrhizae was another assisting element, which could help recover to a certain extent the metabolic pathways preventing cancer cell spreading. Dianyuehong and tanshinone worked together as conductant drug. They enhanced the expression level of channel protein gene in the cytomembrane, and increased channel protein to force cancer cell to absorb more chemical compounds. This paper was published in the journal Proceedings of the National Academy of Sciences on March 25, 2008. And in the Nature magazine issued on March 26, 2008, a review was published under the title of "The Modern Interpretation of An Ancient Prescription", and commented on the research findings. It wrote like this. This research well explained the molecular function and synergy mechanism of the major components of clinical compound TCM, which would be of great importance to the communication between TCM and modern medicine. This is the scientific way in which TCM is developed on a integrated basis. This provides not only outcomes but also a style of scientific thinking for future researches. It is worth noting that such research findings are based on the sufficient understanding of the regular laws of TCM, and scientific and reasonable experiments designing. A problem that exists in most current researches lies in their using western medicine thinking style to study TCM, regardless of TCM's distinctive features, which would often result in inappropriate and even fruitless results. Therefore, I would like to talk about the third aspect, that is the education and inheritance of TCM. TCM was rejected twice in the period of Beiyang Government and Government of the Republic China. In the early years of P.R.C, though there were still some people attempting to disturb TCM, under the help and guidance of old generations like Mao Zedong, TCM was successfully inherited and regained opportunities. However, because of some problems concerning the education system, TCM are now facing difficulty in education and inheritance. Unified modern educational mode is in conflict with TCM education to some extent. Traditional education mode of TCM is apprentice, i.e., studying under a teacher's step-by-step directions. Now even though it might take 5-10 years or even longer time for a medical student to study in medicine, the studying focuses mostly on clinical fundamental experience. TCM is not as standardized and visualized as modern medicine, therefore the current educational mode of western medicine could not cultivate real talents of TCM. What is the worse, education system is inappropriate. For example, we can see from a 2004 version of the five-year undergraduate education program in a university of TCM, that TCM courses account for only 33.8% while western medicine courses 39.4%. No wonder there are comments that criticize the higher education of TCM for its blind pursuit of combining TCM and western medicine, which results in non-proficiency of either one. When these students enter the society, they may even cause people's distrust in TCM because of their non-proficiency. This is what the old doctors of TCM called the "gravediggers-oriented higher education of TCM". Luckily, administrative agencies have been aware of such phenomenon by relaunching education mode of apprentice, and consciously preserving the experience and techniques of the old doctors of TCM. Of course it has not yet touched the comprehensive reform of the education system. I would like to emphasize the well inheritance of the TCM. Only based on that can we concentrate on the innovation and further development of TCM. If we do not stick to the distinct features and unique treatment means of TCM, or reform TCM in a western medicine way, we would achieve the opposite effect and harm TCM eventually. Therefore, it is only a waste of time to merely argue whether TCM is scientific or not. Rather, we should divert our attention and spend more time on understanding, researching and developing TCM. That is what a real scientist is supposed to do. OK, That's all for this class. Let's call it a day.
