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Risk of Treatment-related Mortality with Sorafenib in Patients with Cancer

  • Zhang, Xin-Ji;Zhang, Tian-Yi;Yu, Fei-Fei;Wei, Xin;Li, Ye-Sheng;Xu, Feng;Wei, Li-Xin;He, Jia
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6681-6686
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    • 2013
  • Background: Fatal adverse events (FAEs) have been reported with sorafenib, a vascular endothelial growth factor receptor kinase inhibitor (VEGFR TKI). We here performed an up-to-date and detailed meta-analysis to determine the overall risk of FAEs associated with sorafenib. Methods: Databases, including PubMed, Embase and Web of Science, and abstracts presented at the American Society of Clinical Oncology annual meetings were searched to identify relevant studies. Eligible studies included randomized controlled trials evaluating sorafenib effects in patients with all malignancies. Summary incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated for FAEs. In addition, subgroup analyses were performed according to tumor type and therapy regimen. Results: 13 trials recruiting 5,546 patients were included in our analysis. The overall incidence of FAEs with sorafenib was 1.99% (95%CI, 0.98-4.02%). Patients treated with sorafenib had a significantly increased risk of FAEs compared with patients treated with control medication, with an RR of 1.77 (95%CI 1.25-2.52, P=0.001). Risk varied with tumour type, but appeared independent of therapy regimen. A significantly increased risk of FAEs was observed in patients with lung cancer (RR 2.26; 95% CI 1.03-4.99; P= 0.043) and renal cancer (RR 1.84; 95% CI 1.15-2.94; P= 0.011). The most common causes of FAEs were hemorrhage (8.6%) and thrombus or embolism (4.9%). Conclusions: It is important for health care practitioners to be aware of the risks of FAEs associated with sorafenib, especially in patients with renal and lung cancer.

A Comparative Study on Theories of Optical Disease Based on Si-sheng-xin-yuan and Eui-gam-jung-ma (<사성심원>과 <의감중마>의 안병이론에 관한 비교 고찰)

  • Lee Sang man;Eun Hyun Sup;Chi Gyoo Yong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.17 no.5
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    • pp.1141-1146
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    • 2003
  • In order to investigate different and original theories on pathology of eyes from the past main etiology of fire and heat, two texts of Si-sheng-xin-yuan written by Huang Yuan Yu and Eui-gam-jung-ma written by Lee Gyu Jun are selected and analysed in terms of pathology and prescription. Huang explained that diseases of the eyes are usually born of functional disorders of spleen and stomach(脾胃升降失調) accompanied with turbidity change of energy and blood(氣血淸濁變化). In the meantime, Lee described that the diseases are made from disorders of activities of essence, spirit, energy and blood stored in 5 viscera. So following them, the main point of treatment for the diseases of eyes is to restore and clarify the stagnated gastrointestinal(GI) function, or to supply the clear essence and blood to eyes respectively. Also they have same opinions that the fire and heat are the secondary symptoms of the optical diseases. Therefore Huang focused on cleaning the phlegm and leaking the moisture of GI tract to treat those symptoms, and Lee emphasized on nourishing essential energy of kidney and liver on the other hand. Although they preferred to use radical therapy than symptomatic one. But it can be deduced that Huang's theory is more positive and direct therapy and Lee's one is more basic but indirect treatment.

The View of Disease and the View of Body in Zubi Shiyi Mai Jiujing ($\ll$족비십일맥구경$\gg$의 질병관과 신체관)

  • Ryu, Ki Hyun;Shin, Min Kyu;Kim, Su Jung;Hong, Moo Chang
    • Journal of Acupuncture Research
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    • v.31 no.1
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    • pp.1-6
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    • 2014
  • Objectives : This study was aimed to investigate the view of disease and the view of body in Zubi Shiyi Mai Jiujing. Methods : With Zubi Shiyi Mai Juijing which was excavated from Mawangdui Han Dynasty tomb, we compared this document to other three documents excavated from Mawangdui. Results : 1. Zubi Shiyi Mai Jiujing is the oldest document about meridian pulse system excavated. 2. Zubi Shiyi Mai Jiujing sorted disease to Yang bing and san Yin bing. Yang bing is Zu san yang mai's disease and San yin bing is Zu san yin mai's disease. Zu san yang mai's diseases are mostly pain and swelling. 3. Zu san yin mai's diseases are zu shao yin mai which is realated to pulsation and respiration, Zu tai yin mai which is realated to stomach and digestion, Zu jue yin mai which is related to excretion. 4. The most important symptom in Zubi Shiyi Maizu san yin mai is Fan xin. It is realated to Zubi Shiyi Mai thinking Zu shao yin mai important about concept of body. Because in Zubi Shiyi MaiZu tai yin mai and Zu jue yin mai does'nt come up to abdominal cavity so Zu shao yin mai is the only meridian which comes into body cavity. Conclusions : Zu san yin mai is related to heart and fan xin by Zu shao yin mai. In this perspective Zu shao yin mai is important in view of body of Zubi Shiyi Mai Jiujing.

Studies on the method and the theory of moxibustion in "BianQueXinShu(扁鵲心書) (vol. I)" ("편작심서(扁鵲心書).권상(卷上)"에 나타난 뜸법에 대한 연구(硏究))

  • Kim, Hyun-Dong;Lee, Yong-Bum
    • Journal of Korean Medical classics
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    • v.20 no.2
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    • pp.175-193
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    • 2007
  • A theory of the school which attach great importance to moxibustion therapy was more developed from 'Ge Hong(葛洪)', 'Wang Tao(王燾)' up to "BianQueXinShu(扁鵲心書)" of 'Dou Cai(竇材)' in Song Dynasty. The first volume of "BianQueXinShu" was described about the principles of health preserving method, diagnosis, treatment related with meridian system, support Yang theory, moxibustion therapy over the 10 chapters and in the continued 3 chapters, explained the symptoms and related moxibustion therapies. The summary is as follows. The Yang energy is the essence of the human body and it is minutely explained in "Hwangdineijing(黃帝內經)". However, the younger scholars after 'Zhang Zhongjing(張仲景)' held different views with "Hwangdineijing" so they didn't control serious diseases. Supporting the Yang energy, it will be possible to human body in good health and long life and perennial youth and longevity. To do like this, the first important thing is a moxibustion, the second is a Taoist hermit medication(丹藥) and the third is well usage of Radix Aconiti Lateralis Preparata. According to the sequence of Yang energy deficiency, the stages of diseases are classified as Ordinary Gi(平氣), Latter deficient state(微虛), The more deficient state(甚虛), Exhausting state(將脫), Exhausted state(已脫) and in the consideration of each stage, it is used gradually with warm-natured berbs, warm-acrid herbs, warm-heated herbs and moxibustion therapy. If it comes to the stage of Exhausted state, the Yang energy is too weak to treat a disease. Therefore it is easy to harm human body with usage the treatment of the Purgationist school theory or the Cold and cool medical school theory, so it is needed a great attention to use these therapies. To summarized the keynote of 'Du Jae''s moxibustion therapy, the one is a minority of selection of points(1$^{\sim}$2 acupuncture points), the second is a majority of moxibustion units(50$^{\sim}$500 units), and the other is a focused selection of points on spleen and kidney(especially Gwanwon, CC4). And in this book, it was explained concretely about the size of moxibustion, according to the experiment with mentioned size, the burning time of moxibustion was almost 4 min 40 sec, so the big size moxibustion was one of the characteristic of moxibustion therapy revealed in this book. Also it was used 'Suseongsan(睡聖散)' - a kind of analgesic herb complexes - to reduce a pain during the usage of moxibustion therapy in this book. To develop the moxibustion theory, it is more investigated in the future that there wasn't significant relation between Gwanwon(CC4) and spleen and kidney meridian in theory, compared to many used Gwanwon(CC4) in the prescription, where as mentioned the importance of spleen and kidney in treatment, that considering the burning time(1 unit - 4 min 40 sec, 12 units an hour, maximum 288 units a day) there were no guidances about meals, sleeping, stool and urine, and that there was no concrete study about the toxicity of 'Suseongsan' as analgesic moxibustion therapy.

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An Oriental Medical Study on the Anorexia An Emphasis on the Etiology and Pathology of the Anorexia (식욕부진(食慾不振)에 대(對)한 한의학적(韓醫學的) 고찰(考察) - 병인병리(病因病理)를 중심(中心)으로 -)

  • Choi, Su-Deock;Won, Jin-Hee
    • The Journal of Korean Medicine
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    • v.19 no.2
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    • pp.194-210
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    • 1998
  • The main purpose of this work is the study on the etiology and pathology of the anorexia in oriental and western medicine. An appetite is stimulated by the need of supply of nutrition for life and the physical desire of hunger which appeared as the alternative of taste. In this paper, I investigated the anatomical and the physiological function system, the Piwei functional system and meridian distribution, and the differentiation of the disease according to the Zangfu(internal organs) in association with the anorexia. And conclusion could be summarized as follows : 1. The tongue, one of the Piwei functional system(脾胃機能系), is connected with Pi(脾), Xin(心), Gan(肝) and Shen(腎) meridian. Especially Pi and Xin meridian have the close relations with taste. 2. The appetite has the close relations with Piwei. The appetite and digestion is influenced by the function of smoothing and regulating and bloodflow of Ki(肝主疏泄), warming the Shen to activate the function of Pi(腎主溫養), cleansing the inspired air and keeping the Ki flowing downward(肺主肅降). 3. The cause of anorexia is the insufficiency of Ki of Piwei(脾胃氣虛), the attack of Wei by hyperactive Gan Ki(脾氣犯胃), the insufficiency of Wei Yin(胃陰不足), the declination of the fire from the vital gate(命門火衰) and the retention or stagnancy of undigested food (飮食停滯). Especially, the main cause of anorexia is the insufficiency of Ki of the Piwei(脾胃氣虛). 4. Recently the attack of Wei by hyperactive Gan Ki(脾氣犯胃) is raised by the main cause of anorexia. 5. The mental function of anorexia, which is induced by the unbalance of Pi, is directly associated with Xin(心) and Xin meridia(心經). 6. The goal of the treatment of the anorexia is dependent on the recovery of the weakness of the Pi. And for this goal, the disorders of the other organs is also treated. 7. In the point of the anatomy and physiology, the main cause of anorexia is the loss of function of the autonomic nerve system and the vagus nerve.

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Hanju Yi Jinsang(寒洲 李震相)'s concept of Li(理) through his viewpoint on the Ido-seol(理到說) (이도설(理到說)에 대한 견해를 통해 본 한주 이진상(寒洲 李震相)의 '리(理)' 개념)

  • Lee, Won-Jun
    • The Journal of Korean Philosophical History
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    • no.52
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    • pp.107-130
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    • 2017
  • The purpose of this study is to catch the characteristics of the Hanju Yi Jinsang (寒洲 李震相, 1818~1886)'s thought of the 'Li(理)' through Hanju's view on the Ido-seol(理到說), the Toegye Yi Hwang(退溪 李滉, 1501~1570)'s latter Mulgyuk(物格) theory, and to establish the foundation for identifying the aspects of development about Toegye School's concept of Li from Toegye's Ido-seol. The Ido-seol was criticized for regarding Li - the immovable principle - as 'living thing'. Toegye School's scholars tried to solve this problem by translating the 'word' correctly. Hanju also translated the word 'Do(到)', the verb of 'Ido', as meaning of 'perfectly understood' based on his translation of the word 'Gyuk(格)' as 'Ku(究)'. On the other hand, he also regarded the principle-application structure of Li and the its characteristic the 'Li as Hwalmul(活物)' as the main point of Toegye's Neo-confucianism thought his methodology 'Three viewpoints[三看法]'. Before Hanju, scholars dose not have more opinion from the translation of the word, and it is too difficult to identifying their scholarly identity through their viewpoints on Ido-seol. On the other hand, Hanju thought that the lack of the idea for comprehensive approach between Xin(心) and Li(理) will cause the misunderstanding the relationship between Xin and Li. In this reason, he evaluated Toegye's Ido-seol based on the concept of 'One principle and its manifoldness[理一分殊]'. Consequently, he concatenated the characteristic of Xin which includes all things with concept of Mulgyuk, and emphasized that Xin which penetrates the principle of all things has the characteristic of 'One principle(理一)'.