Objectives: Myrrh have been used as a traditional remedy to treat infectious and inflammatory diseases. However, it is largely unknown whether myrrh ethanol extract could exhibit the inhibitory activities against particulate matter (PM)-induced skin injury on human keratinocytes, HaCaT cells. Therefore, this study was aimed to investigate the inhibitory activity of myrrh ethanol extract on PM-induced skin injury in HaCaT cells. Methods: To investigate the inhibitory effects of myrrh ethanol extract in HaCaT cells, the skin injury model of HaCaT cells was established under PM treatment. HaCaT keratinocyte cells were pre-treated with myrrh ethanol extract for 1 h, and then stimulated with PM. Then, the cells were harvested to measure the cell viability, reactive oxygen species (ROS), pro-inflammatory cytokines including interleukin (IL) 1-beta, IL-6, and tumor necrosis factor (TNF)-𝛼, hyaluronidase, collagen, MMPs. In addition, we examined the mitogen activated protein kinases (MAPKs) and inhibitory kappa B alpha (I𝜅-B𝛼) as inhibitory mechanisms of myrrh ethanol extract. Results: The treatment of myrrh ethanol extract inhibited the PM-induced cell death and ROS production in HaCaT cells. In addition, myrrh ethanol extract treatment inhibited the PM-induced elevation of IL-1beta, IL-6, and TNF-𝛼. Also, myrrh ethanol extract treatment inhibited the increase of hyaluronidase, MMP and decrease of collagen. Furthermore, myrrh ethanol extract treatment inhibited the activation of MAPKs and the degradation of I𝜅-B𝛼. Conclusions: Our result suggest that treatment of myrrh ethanol extract could inhibit the PM-induced skin injury via deactivation of MAPKs and nuclear factor (NF)-𝜅B in HaCaT cells. This study could suggest that myrrh ethanol extract could be a beneficial agent to prevent skin damage or inflammation.

Objectives: Traditional Korean medicine (TKM) has been supplied as part of a national health care system in South Korea under a dual medical system, however it has been difficult to mix western medicine and TKM medical practices in existing hospitals. For the objective of innovative integration between them, Comprehensive and Integrative Medicine Hospital were founded in Daegu, South Korea. Here, we discussed the clinical outcomes of cancer patients who received integrative cancer treatment (ICT). Methods: A total of 678 patients previously diagnosed with cancer were retrospectively checked in our institution for 2 years. After applying inclusion/exclusion criteria, 573 patients were eligible for the final analysis. The overall survival (OS) of these patients in the aftercare period were determined. We looked at how clinical factors and treatments including chemotherapy, complementary and alternative medicine (CAM), and TKM affected the OS. Results: At the first visit, 212 subjects had no evidence of disease after tumor resection and 355 ones with advanced cancer, who receiving ICT including chemotherapy, CAM, and TKM showed better OS compared to the CAM including TKM or the best supportive care (median OS = 216, 78, and 46 days, respectively). The median OS was not reached in TKM only, even though the sample size was small (N=12). Even after adjusting for clinical factors associated to liver, renal, and hematologic manifestation, ICT still remained significant. Conclusions: We demonstrated that ICT might be beneficial for advanced cancer regardless of the performance status, liver and renal function, since it positively affected the OS.

Objectives: The purpose of this study is to investigate and analyze Korean domestic patents on aconiti ciliare radix and to identify the trend of aconitum tuber technology. Methods: To analyze the patent, a combinations of words such as "aconitum" or "korean aconite root" were used in search engine Kipris(www.kirpis.or.kr). The patents of aconiti ciliare radix were analyzed in three ways: year trend analysis, internatonal patent classification (IPC) code analysis related to content classification, and patent registration status analysis. Results: Among the patents found in the search results, 17 patents with significant contents were analyzed. Results showed that, first, patents were steadily registered until 2018, but recently there has been no new patent registration. Second, there were many patents related to efficacy verification and decoction method, and the number of IPC codes related to them was also high. Third, there are five patents maintaining the registration status, and they are patents related to the aconiti ciliare radix extraction method, toxicity removal, and combination method. Conclusions: In this study, the domestic patents of aconiti ciliare radix were analyzed. The analysis results of this study are expected to be exploited as basic data for the development of Korean medicine analgesics with fewer side effects by suppressing tuber toxicity and the creation of new medical technologies.

Objectives: The aim of this study is to modernize Nutrient Qi(營氣) and Defense Qi(衛氣) from the point of view of Visceral Body and Somatic Body. Methods: Investigate the areas of body and function of Nutrient Qi(營氣) and Defense Qi(衛氣) recorded in the 『HuangdiNeijing(黃帝內經)』 and 『Dongeuibogam(東醫寶鑑)』. And investigate Visceral Body and Somatic Body that anatomical structure is divided according to function based on the book 『Life and Rhythm』. Results: Nutrient Qi(營氣) works to nourish the body such as viscera and bowels in the meridian. Defense Qi(衛氣) works to protect the body such as skin, limb joint, eye outside the meridian. The human body is divided into Visceral Body called a vegetable organ and Somatic Body called an animal organ. Visceral body is the organ that manages "nutrition-reproductive" and is divided into the intestine(腸管), blood vessels(血管), and the nephridium(腎管). Somatic Body is an organ that manages 'sensory-motion' and is divided into a three-layer structure: the outer layer covering the body surface, the nerve layer connecting the outer layer and the muscle layer, and the muscle layer controling contraction and movement. Conclusions: It is estimated that Nutrient Qi(營氣) is similar to Visceral Body, and Defense Qi(衛氣) is similar to Somatic Body.

Objectives: Peer role-play (PRP) has been used in health care training simulations because standardized patient training requires considerable time and expense. This study described the implementation of clinical simulation using PRP and examined the effect. Methods: Final year students from a single college of Korean medicine engaged in PRP as part of clinical skills practice. Education tools from clinical practice guidelines were used to structure the PRP. Communication competency was assessed with the Korean Version of the Self-Efficacy Questionnaire (KSE-12). Whether this training helped to achieve graduate outcomes was evaluated on a five-point scale. Results: Fifty-nine students (53.2%) participated in the survey. Among 12 items on the KSE-12, the score for "How certain are you that you are able to successfully listen attentively to the patient?" was the highest. Further, PRP was found to be helpful for self-directed learning, establishment of one's professional identity, and the ability to communicate and manage patients. Three themes ("Benefits of role-play", "The importance of positive feedback", "Limitations and problems of role-play"), 15 categories, and 16 central meanings were derived by categorizing learners' subjective opinions about PRP. Conclusions: Study findings indicate that PRP may contribute to improving communication skills and establishing a professional identity for future Korean medicine doctors. We suggest using PRP in clinical education in colleges of Korean Medicine.

Objectives: The purpose of this study is to analyze the weight loss and the adverse events of overweight and obese adults on weight loss program with face-to-face treatment (FTF) and non-face-to-face treatment (NFTF) in 6 Korean Medicine obesity clinics. Methods: From March 2nd to March 10th, 2021, we collected data with a retrospective way from overweight and obese adults (body mass index, BMI≥23 kg/m²) who registered for a 12-week Gamitaeeumjowi-tang prescription program. After matching initial information of the FTF group and the NFTF group using propensity matching score, weight loss and BMI change were analyzed, and adverse events were evaluated in terms of causality, severity and system-organ classes. Results: Weight and BMI change from baseline to 12 weeks was -7.98±3.09kg (10.41±3.57%), -3.03±1.14kg/m² and -7.30±3.11kg (9.59±3.45%), -2.76±1.15kg/m² for FTF group and NFTF group, respectively. Body weight and BMI significantly decreased before and after treatment in both groups, and there was no significant difference in weight loss and BMI change between the two groups. No serious adverse events were reported. Conclusions: This study showed the potential that NFTF weight management treatment could be a good alternative way to FTF weight management treatment without serious adverse events.

Objectives: We investigated the isoflavone contained in SH003 and its fractions, and the effect of these components on the inhibition of breast cancer. Methods: The isoflavones in solvent fractions of SH003 extract were identified by UPLC-MS and its contents were quantified using HPLC analysis. The estrogenic activity of SH003 or fractions was assessed by ERE luciferase assay in estrogen receptor (ER)-positive MCF-7 cells. To test the breast cancer inhibitory effect, the cell viability was measured using an MTT assay. Results: In this study, we demonstrated that SH003 and fractions contain 4 isoflavones which are calycosin-7-β-D-glucoside, formononetin-7-β-D-glucoside, calycosin, and formononetin. Despite containing isoflavones, estrogen-dependent transcription activity was not altered by both SH003 and fractions. On the other hand, SH003 and fractions inhibited the cell viability of breast cancer. In addition, its isoflavone components also showed reduced cell viability in various breast cancer cells. Conclusions: Overall, the phytoestrogen included in SH003 and fractions did not influence the estrogenic activity, emphasizing the safety of SH003 and fractions in breast cancer treatment.

Objectives: This study investigated public opinion on the use of modern diagnostic medical devices by Korean Medicine doctors. Methods: A questionnaire looking into perceptions on the use of modern medical devices was developed. It was distributed by a third party and data was collected. Results were analyzed through frequency analysis, chi-square analysis (χ²-test), frequency and cross analysis using R program. The measurement variable in the study was the respondent's perspectives and expectations on the use of modern diagnostic medical devices by Korean Medicine doctors. The maximum significance level was 0.05. Results: There were a total of 3,000 responses and 80.8% of the respondents replied that there is a need for government-level discussion on endowing rights to Korean Medicine doctors as supervisors for safety management of radiation generating devices. Also, 83.3% of the respondents agreed the use of ultrasound imaging equipment in Korean Medicine clinics should be legalized. Conclusions: According to this study, respondents strongly support the use of modern diagnostic medical devices by Korean Medicine doctors. This is the first study to investigate public opinion in this area and it provides a significant insight into the public needs and desires for a wider scope of practice for Korean Medicine in the healthcare system.

Objectives: The purpose of this study was to investigate the anti-inflammatory effect of Cornus Officinalis fruit extract(CE) and Cornus Officinalis Fruit Cheonghyeol Plus(CCP) in Human Umbilical Vein Endothelial Cell. Methods: We measured cell viability of CE, CCP and treated HUVEC with TNF-α. We measured the mRNA expression levels of KLF2, eNOS, MCP-1, ICAM-1, VCAM-1, the protein expression levels of KLF2, eNOS, MCP-1, ICAM-1, VCAM-1, and the protein phosphorylation level of ERK, JNK, p38 and the biomarker expression levels of MCP-1, ICAM-1, VCAM-1. Results: 1.CE incresed the mRNA, protein expression levels of KLF2, eNOS at concentrations of 100㎍/㎖ compared to the control group. CE decresed the mRNA, protein and biomarker expression levels of MCP-1,ICAM-1,VCAM-1 at concentrations of 100㎍/㎖ compared to the control group. CE decresed the protein phosphorylation level of p38 at concentrations of 100㎍/㎖ compared to the control group. 2. CCP incresed the mRNA, protein expression levels of KLF2, eNOS at concentrations of 100㎍/㎖ or more compared to the control group. CCP decresed the mRNA, protein and biomarker expression levels of MCP-1, ICAM-1, VCAM-1 at concentrations of 100㎍/㎖ or more compared to the control group. CCP decresed the protein phosphorylation level of ERK at concentrations of 100㎍/㎖ or more, p38 at concentrations of 200㎍/㎖ or more, and JNK at concentrations of 400㎍/㎖ compared to the control group. Conclusions: These results present that CE and CCP has anti-inflammatory effect in HUVEC. So, it could help treat or prevent inflammation in vein caused by dyslipidemia and contribute prevention of cardiovascular and cerebrovascular cerebrovascular diseases.

Objectives: This study was conducted to develop a Korean Medicine(KM) Clinical Practice Guidelines(CPG) of female infertility. We conducted this questionnaire survey to reflect the experiences of Korean Medicine doctors(KMD) and clinical field in Korea. Method: We sent a questionnaire survey to KMD belonging to the Association of Korean Medicine by e-mail. We received 665 responds, and analyzed the answers. Results: 51.2% of respondents knew the previously developed CPG of female infertility, and 18.3% actually used. 83.3% agreed about the necessity of CPG of female infertility, and 80.3% had practical use plan. 90.2% of respondents treated less than 5 infertility woman for a month. 22.7% of respondents treated 50% of patients with collaborative treatment of KM and Western medical treatments. The main age group of patients was '35~40 years'(54.7%), and the most common cause was unexplained infertility(61.7%). The most common pattern identification of female infertility patients was Kidney deficiency(55.4%). KMD used 'a combination of decoction of herbal medicine, acupuncture and moxibustion treatment' the most(43%), and 'a decoction of herbal medicine treatment alone' was next(35%). 84.2% conducted lifestyle modification education about diet, stress, exercise etc. Conclusion: We figured out Korean Medicine doctors' recognition about CPG of female infertility, preference of treatments, and also characteristics of patients visiting Korean Medical clinics to make a practical CPG reflecting clinical situation.

Objectives: This study was designed to investigate the clinical effectiveness of Ikgibohyeol-tang(Yìqìbǔxuè-tāng) granules and Deer antler granules on fatigue symptoms. Methods: This is a 39-patient case series from a retrospective chart review of outpatients who were treated with Ikgibohyeol-tang granules and Deer antler granules at a Kyung Hee University Korean Medicine Hospital (Seoul) between 1st, January 2015 to 1st, August 2021. We reviewed the patients who complained of fatigue and analyzed changes in the degree of discomfort with fatigue and accompanying symptoms and HRV (Heart Rate Variability) score before and after treatment. Results: After taking Ikgibohyeol-tang granules and Deer antler granules, the degree of discomfort with fatigue and accompanying symptoms decreased significantly compared to before taking them. After treatment, Autonomic nervous system activity, Stress resistance, Heart Stability increased, and Stress index, Degree of fatigue decreased significantly. Conclusions: This study showed subjective symptoms and objective indicator (HRV score) were improved by taking Ikgibohyeol-tang granules and Deer antler granules.

Objectives: This research aimed to develop a guideline for evaluating safety and performance of electronic warm-acupuncture apparatus. With the development of medical devices like electronic warm-acupuncture apparatus with improved performance, convenience and safety measures compared to traditional warm-acupuncture needling, safety and performance guideline is a necessity. Methods: By referring to existing standards and guidelines of other electronic devices for Korean medicine with heating function, guideline for safety and performance assessment of electronic warm-acupuncture apparatus was drafted Results: The guideline, presents explanation for adequate temperature and settings of the apparatus, and safety measurements providing against thermal runaway situations along with guidelines for the manual. Guideline for detailed test method for the performance of the apparatus such as accuracy of temperature increase and the timer, and safety unit was also provided. The test items and suggested test methods for the requirements of biological, electrical and electromagnetic safety were referred to Korean approval documents of ministry of Food and Drug Safety. Conclusion: We proposed the relevant items to verify performance and safety of warm-acupuncture apparatus to assure patient safety and improve the quality of currently developing devices for application in clinical field.

Objectives: The purpose of this study was to evaluate the effects of shenfu injection on myocardial protective effects after mitral valve replacement surgery. Methods: We searched four international databases (PUBMED, Embase, Web of Science and CNKI) and three domestic electronic databases (OASIS, RISS and NDSL) for relevant studies. We used following keywords 'shenfu', 'valve replacement', 'mitral valve' at PUBMED, Embase and Web of Science; '二尖瓣', '参附注射液', '瓣膜' at CNKI and '이첨판', '판막', '삼부' at domestic databases. The search range included randomized controlled trials. When appropriate, meta-analyses were performed. Results: Seven randomized controlled trials were selected. All studies used Shenfu injection after mitral valve replacement surgery. We analyzed myocardial damage, cardiac function, patients' recovery rate, with various evaluation indicators. We also used meta-analysis for CK-MB, cTnI, MDA and voluntary recovery of heartbeat. CK-MB was analyzed in two subgroups: 8 hours and 24 hours after surgery. Std was -2.34(95% CI -4.10, -0.58) for 8 hours and -1.95(95% CI -4.79 to 0.88) for 24 hours. 8 hours showed statistically significant difference. cTnI appeared significant decrease with Std of -2.13(95% CI -2.60, -1.66). MDA showed significant decrease with Std of -0.95(95% CI -1.43 to -0.47). Voluntary recovery of heartbeat significantly increased with the odd ratio of 4.34(95% CI 1.76, 10.70). Conclusions: We suggest that Shenfu injection after Mitral valve replacement surgery may have significant myocardial protective effects in terms of reducing myocardial damages, reactive oxygen species, increasing cardiac function and patients' recovery after surgery. However, the evidence is limited, further research is required.

Objectives: The purpose of this study is to investigate the effect of music therapy combined with hand manipulation on depression and cognition in elderly women with mild depression. Methods: In order to investigate the effects of a music therapy program through hand, 20 elderly women with a GDS-K score of 14-18 were selected among women aged 65 to 84 living in Busan. The 10 subjects in the experimental group were given the music therapy program 3 times a week for 4 weeks, 12 sessions, and the 10 subjects in the control group were not given it. GDS-K and K-MoCA were performed before and after the experiment, and data analysis was performed through Wilcoxon's test using the SPSS 24.0 statistical package program. Results: The music therapy program through hand manipulation is effective in reducing depression in elderly women with mild depression, and there was a significant decrease. The sub-domains of depression, such as tension and depressive emotions, life dissatisfaction, lethargy, cognitive difficulties, low energy, and loss of motivation, were significantly reduced. In addition, it has an effect on cognition, and it significantly increased in attention, delayed recall ability, which are sub-domains of cognition. There is a significant difference in depression between the experimental group and the control group, and there is a significant difference in cognition between the two groups. Conclusions: The music therapy program with hand manipulation has a positive effect on depression and cognition in elderly women with mild depression.

Objectives: This study aimed to emphasize the importance of accurate and timely diagnosis of acute abdominal pain with simple radiography by reporting a case of gastrointestinal perforation. Methods: We closely observed the diagnosis and progress of acute abdominal pain after biliary stent and reviewed the outline of gastrointestinal perforation. Results: Patient diagnosed with urethral cancer metastasis to lung and peritoneum was treated with complex Korean medicinal treatments to deal with anorexia, abdominal pain, jaundice and oliguria. During hospitalization, the patient's acute abdominal pain after biliary stent was diagnosed with gastrointestinal perforation by using plain chest and abdominal radiography. Conclusion: Using simple radiography to find out the emergency diseases such as perforation in acute abdominal pain is important clinically.

Objectives: The purpose of this case study was to report the clinical improvement of Long COVID(cough, sore throat) treated with Korean herbal medicine(Hyunggaeyungyo-tang and Saengmaek-san). Methods: To assess the treatment outcomes, I used the Visual analogue scale(VAS) to evaluate sore throat degree, and Leicester Cough Questionnaire Korean version(LCQ-K). Results: After treatments, cough and sore throat were significantly improved with VAS and LCQ-K. Conclusion: The Korean herbal medicine was effective in the treatment of patient who suffers Long COVID. This study suggested the possibility of Korean herbal medicine treatment for Long COVID.