The rising costs of cancer care and subsequent medical financial hardship for cancer survivors and families are well documented in the United States. Less attention has been paid to employment disruptions and loss of household income after a cancer diagnosis and during treatment, potentially resulting in lasting financial hardship, particularly for working-age adults not yet age-eligible for Medicare coverage and their families. In this article, the authors use a composite patient case to illustrate the adverse consequences of cancer diagnosis and treatment for employment, health insurance coverage, household income, and other aspects of financial hardship. They summarize existing research and provide nationally representative estimates of multiple aspects of financial hardship and health insurance coverage, benefit design, and employee benefits, such as paid sick leave, among working-age adults with a history of cancer and compare them with estimates among working-age adults without a history of cancer from the most recently available years of the National Health Interview Survey (2019–2021). Then, the authors identify opportunities for addressing employment and health insurance coverage challenges at multiple levels, including federal, state, and local policies; employers; cancer care delivery organizations; and nonprofit organizations. These efforts, when informed by research to identify best practices, can potentially help mitigate the financial hardship associated with cancer.
Treatment integrating traditional Chinese and Western medicine for primary Sjögren's syndrome (pSS) has yielded positive results and gained wide acceptance. However, the absence of standardized clinical management in certain regions has led to suboptimal outcomes in the diagnosis and treatment of pSS in China. In response, the Center for Traditional Chinese and Western Medicine at the China-Japan Friendship Hospital, in collaboration with the Beijing Association of Traditional Chinese and Western Medicine Rheumatology Professional Committee, initiated a project led by the Traditional Chinese Medicine Department of Rheumatism. The project (Beijing Association of the Integrating of Traditional and Western Medicine standardization expert consensus record number: 2021Z031A3) aims to develop a set of quality control indicators for the integrated treatment of pSS using traditional Chinese and Western medicine. Based on the 2021 version, the consensus revision incorporates seven new items, focusing on essential assessment areas for pSS patients, treatment response, and healthcare cost management. The 2023 expert consensus update seeks to enhance pSS diagnosis and treatment practices in China, offering a benchmark for medical quality control.
Coronary heart disease (CHD) poses a significant threat to human life and well-being. The presence of psycho-cardiology diseases not only exacerbates the progression of CHD but also imposes a substantial financial burden. Consequently, there is a pressing need to prioritize the prevention and management of psycho-cardiology conditions. Given the complex adverse effects associated with antidepressants, it is imperative to investigate alternative, safer, and more efficacious early interventions for psycho-cardiology diseases. The trial will randomly divide 99 patients who meet the inclusion criteria into two groups in a ratio of 1:2. Both groups will be administered standard western medicine treatment for CHD. The Qi-Shao-Tong-Mai-An-Shen (QSTMAS) group will be treated with an additional 30 mL QSTMAS herbal paste orally twice daily for up to 12 weeks. The primary endpoints are the changes of Generalized Anxiety Disorder-7 and Patient Health Questionnaire-9 scores after the intervention for 12 weeks. The secondary endpoints include the scores of Traditional Chinese medicine syndromes, 6-min walking test, Insomnia severity index sleep scale, laboratory tests, and other examinations of both groups after the intervention for 12 weeks. The QSTMAS herbal paste exhibits potential and promise as a treatment modality for mild-to-moderate psychological disorders within the department of cardiology. The implementation of a rigorous trial design will facilitate an objective and scientific assessment of the clinical effectiveness and safety of combining QSTMAS herbal paste with standard western medicine for CHD patients with depression and/or anxiety. Trial Registration: China Clinical Trial Registry, ChiCTR2200065179. Registered 31 October 2022.
Background: Diabetic kidney disease (DKD) is one of the most common microvascular complications of diabetes mellitus and has become the primary cause of end-stage renal disease in China. In patients with severe renal insufficiency, Western medical treatments often yield unsatisfactory results. Preliminary studies have indicated that the Chinese herbal formula Tangshen Fang improves estimated glomerular filtration rate (eGFR) in patients with DKD.
Methods/design: This is a multicenter, randomized, open-label, controlled clinical trial. DKD patients with eGFR levels between 25 and 75 mL/min (1.73 m2) and urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g, or eGFR level between 25 and 60 mL/min (1.73 m2) and UACR <30 mg will be included. A total of 144 participants will be randomly allocated to the treatment group (Tangshen Fang plus standard Western medicine with or without other traditional Chinese medicine [TCM]) and the control group (standard Western medicine with or without other TCM) at a 1:1 ration. The study duration will be 24 weeks and the follow-up period will be extended to 96 weeks. The primary endpoint will be the change in eGFR from baseline to week 24. Secondary endpoints will include changes in UACR, body weight, waist circumference, blood pressure, lipid levels, fasting plasma glucose, glycosylated hemoglobin A1c (HbA1c), and improvement in TCM symptoms and quality of life. Adverse events will also be evaluated.
Discussion: This study will provide evidence of the effectiveness and safety of Tangshen Fang in treating patients with DKD. It will also form the clinical pathway and expert consensus on integrating traditional Chinese and Western medicine for DKD and provide clinical evidence for the rational use of hospital preparations of Tangshen Fang.
Trial registration: Chinese Clinical Trials Registry, ChiCTR2300069269. Registered March 10, 2023.
Objective: This study intends to investigate the medication patterns of traditional Chinese medicine (TCM) for the treatment of acute cardiorenal syndrome (ACRS) through clinical data mining.
Methods: A retrospective study was conducted at China-Japan Friendship Hospital, encompassing hospitalized patients with ACSR admitted from June 1, 2013, to June 30, 2022. Patient treatment records, including TCM prescriptions, were gathered to establish a comprehensive prescription database. The prescriptions underwent analysis using the ancient and modern medical case cloud platform, incorporating the frequency, properties and flavors and channel tropism of each herbs, and clustering patterns, combination relationships, and complex network analysis of the whole.
Results: A total of 330 prescriptions from eligible hospitalized patients were included, which totally involves 324 kinds of different herbs. The therapeutic effects primarily emphasized descending qi and eliminating turbidity, promoting diuresis and reducing swelling, drying dampness and dispelling phlegm, and promoting the ascension of Yang Qi. The properties were largely warm, netural, slightly cool and cold, with warm being predominant. The flavors were chiefly sweet, spicy, and bitter, with sweetness being the most common. The major channel tropism were the lung and spleen meridians, followed by the stomach, liver, heart, and kidney meridians. Combination analysis identified 30 pairs of combinations, with higher associations found in combinations such as Jiegeng, Huangqi, Chaihu, Baizhu, Zhimu, and Dangshen. Cluster analysis categorized high-frequency herbs into 4 groups: Gualou–Fabanxia–Chuanxiong–Chishao, Fuling–Baizhu–Zhigancao–Chenpi, Maidong–Guizhi–Huangqi–Chaihu–Shengma–Zhimu–Shanzhuyu, and Huangqi–Dangshen–Jiegeng–Chaihu–Shengma–Zhimu–Shanzhuyu. Complex network analysis revealed core prescriptions for treating ACRS, including 17 herbs.
Conclusions: In the treatment of ACRS, TCM herbs with the properties of warm and neturality, and the flavors of sweet and spicy are commonly utilized. The prescribed herbal formulas have the effect of descending qi and eliminating turbidity, tonifying qi, activating blood and resolving stasis, resolving phlegm and promoting water.
The patient was diagnosed with primary liver cancer featuring intrahepatic metastasis (Barcelona stage B; Stage IIB), hepatitis B infection, and post-hepatitis B cirrhosis during the period of compensated liver function. Following a 7-month regimen combining traditional Chinese herbal medicine (TCHM) with Renvatinib and Carrelizumab, the patient exhibited favorable tolerability, no bleeding risks, and stable tumor progression. The effectiveness of TCHM in this case was marked by significant symptom alleviation, reduced serum molecular markers, minimized adverse reactions, and obviated surgical intervention. Blood tests displayed alpha-fetoprotein levels ranging from 8.85 to 20.65 IU/mL, with no increase in bleeding risks.